Health Care Reform - A Modest Proposal
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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.
Rob Graham wrote:
Even so, 3.8% of the medicare population using 30% of the program funds is a rather disproportionate share that is difficult to justify.
Also difficult to criticise without more detail. Sick people do consume a hugely disproportionate share of medical expenses. That is to be expected.
John Carson
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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
Stan Shannon wrote:
It still refutes your central point that there is or was anything inherently uncivil in American society.
My central point is that your system is uncivil, and relies on a civility that exists, but easy excludes people. And, that the cost of health care, especially in the US, is also exclusionary by definition.
Stan Shannon wrote:
Only becuase it has been intentionally attacked and made dysfunctional for the express purpose of making people more dependent upon government.
Bollocks. It's because people have retreated into their own worlds, or online worlds, and generally been cut off from their communities.
Stan Shannon wrote:
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?
This is a dumb question. Everybody dies.
Stan Shannon wrote:
You seem to believe that there is some completely incomprehensible reason why medical care would out pace every other sector of the economy.
No, the answer is that the way that it's paid for in your system, and the way your government works, allows for this sort of abuse. Just like the endless stream of advertising allowed on TV, whose sole aim is to get people addicted to pills they don't need.
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.
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The problem is that this is how you end up spending 80% of your medical dollars on the last 6 months of life. A better plan would be to stop burning all the cannabis seized at our borders, and instead divert it as ree palliative treatment for those with a life expectancy of less than one year. And maybe we could solve a lot of problems in Afghanistan by outbidding the Taliban for the annual poppy crop. Decent medical care doesn't mean the taxpayers should fund every possible symptomatic treatment. Reasonable pain management is one thing, expensive treatments with marginal benefits are another.
I think it's a little ignorant to essentially reduce palliative care to not only just analgesics but crappy analgesics at that. Palliation is more than pain management. It's (for example) surgery to remove a bowel obstruction so that someone can eat during the last month of their life instead of being on TPN while constantly vomiting/shitting blood. It's active management of symptoms and keeping someone as active and engaged as possible until their ultimate end, and hey, sometimes we're even surprised by how long and how well someone can live if you just control the worst of it. Frankly, it's all well and good for you to complain about the expense of palliative management, but the fact is unless you're one of the lucky lucky few who go out like a candle, you would greatly regret having limited access to palliative care at the end of your life, having someone with no medical knowledge claim, say, that the knee arthroscopy you're getting so that you can keep walking and not be bedridden until the tumor finally blows out your brainstem in six months is only of "marginal benefit." Not only that, but you're essentially creating barriers to research - if we're not allowed to treat a certain patient group, how are we going to test treatments that could improve on that estimated life expectancy that's causing them to be refused care in the first place?
- F
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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
I'm a proud denizen of the Real Soapbox[^]
ACCEPT NO SUBSTITUTES!!! -
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
John Carson wrote:
I am guessing
In other words, you are pulling an explanation out of your ass. I at least had the honesty to publish figures that didn't agree with mine. You on the other hand don't seem to be able to conceive of the idea that you are wrong - and would rather scream and shout and hope no-one notices that the emperor has not clothes. I'm done, John - you've reverted to your nasty mode and I really don't have time for unintelligent conversations. Talk to me when and if you have something worth saying and the facts to back you up.
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
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John Carson wrote:
I am guessing
In other words, you are pulling an explanation out of your ass. I at least had the honesty to publish figures that didn't agree with mine. You on the other hand don't seem to be able to conceive of the idea that you are wrong - and would rather scream and shout and hope no-one notices that the emperor has not clothes. I'm done, John - you've reverted to your nasty mode and I really don't have time for unintelligent conversations. Talk to me when and if you have something worth saying and the facts to back you up.
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 wrote:
In other words, you are pulling an explanation out of your ass. I at least had the honesty to publish figures that didn't agree with mine. You on the other hand don't seem to be able to conceive of the idea that you are wrong - and would rather scream and shout and hope no-one notices that the emperor has not clothes.
I did significant Googling before linking to the article that I did and everything I found was consistent with that article. You then posted some figures that seemed anomalous. Since the link was to a brief part-article without much explanation, I made a guess as to how the conflicting figures might be reconciled and identified it as a guess. I see nothing wrong with that. It looks like my guess was incorrect. The more likely explanation for the anomalous data is that the comments in the part-article you linked to are BS: the Canadian Institute of Actuaries never made the claim about 30-50% of costs being incurred in the last 6 months of life. Here is a media release by the organization from the same year:
Various sources have stated that between 30% and 50% of total lifetime health care expenditures occur in the last six months of life. While research in support of such specific statements is sparse–and this is a systemic problem with the Canadian health care system–there is no question that we incur significant health care costs as we near the end of our lives.
http://www.actuaries.ca/publications/2002/202062e.pdf[^] Plainly, the Canadian Institute of Actuaries did not endorse the 30-50% estimate.
Oakman wrote:
Talk to me when and if you have something worth saying and the facts to back you up.
Talk to me when you have some actual figures from a reputable source that contradict the figures in the article I linked to. So far all you have done is blow smoke.
John Carson
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Stan Shannon wrote:
It still refutes your central point that there is or was anything inherently uncivil in American society.
My central point is that your system is uncivil, and relies on a civility that exists, but easy excludes people. And, that the cost of health care, especially in the US, is also exclusionary by definition.
Stan Shannon wrote:
Only becuase it has been intentionally attacked and made dysfunctional for the express purpose of making people more dependent upon government.
Bollocks. It's because people have retreated into their own worlds, or online worlds, and generally been cut off from their communities.
Stan Shannon wrote:
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?
This is a dumb question. Everybody dies.
Stan Shannon wrote:
You seem to believe that there is some completely incomprehensible reason why medical care would out pace every other sector of the economy.
No, the answer is that the way that it's paid for in your system, and the way your government works, allows for this sort of abuse. Just like the endless stream of advertising allowed on TV, whose sole aim is to get people addicted to pills they don't need.
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.
Christian Graus wrote:
My central point is that your system is uncivil, and relies on a civility that exists, but easy excludes people.
And I have demonstrated that isn't true. All systems exclude people. Historically, ours has excluded fewer that have any other, precisely because our society was structured around christianity and capitalism.
Christian Graus wrote:
It's because people have retreated into their own worlds, or online worlds, and generally been cut off from their communities.
You simply cannot discount the overt political assault that has been leveled against traditional American society by powerful media, educational and political forces. American society was purposefully designed to depend upon the good will of people towards one another. Our society was perfectly functional until modern government began assuming more of the respnsibilities that were once the province of neighbors.
Christian Graus wrote:
This is a dumb question. Everybody dies.
Of course its a dumb question, but unless you can show tht they are dieing in substantially less numbers under your system than under ours, yet alos claim that some subtantial numbers of ours are dieing due to neglect, the question has to be asked: What are yours dieing from? If not neglect it can only be on purpose.
Christian Graus wrote:
No, the answer is that the way that it's paid for in your system, and the way your government works, allows for this sort of abuse. Just like the endless stream of advertising allowed on TV, whose sole aim is to get people addicted to pills they don't need.
Than why is our educational system following precisly the same trend? The two sectors of our society that are most influenced by government control, health care and education, are both becoming ever more expsensive as they become ever less effective. Government is the only common variable.
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.