This is the Government that You Want to Run Health-care? [Archive] - Page 4

Ohmer

20th March 2008, 12:20 PM

There was a radio programme item this morning about the inadvisability of omitting travel insurance when going on holiday (apparently people are now going snowboarding and bungee jumping on Saga holidays, and need the appropriate cover).

The biggest scare story was about a woman who went to the USA on a short break, and didn't take out insurance (very very silly move). She had a heart attack. The bill was £250,000, and she had to sell her house to pay it. Presumably she ended up having to be housed and supported by the state, as she was left with no assets after paying the medical bill.

This tells us nothing but that it is very very silly to go to the USA without insurance in place. Oh, and that treating a myocardial infarction is likely to cost £250,000.

Rolfe.

See, the problem is, she was thinking like Brit. The American way is to simply ignore the bill and get a decent lawyer to handle a "medical bankruptcy". She would have gotten to keep most of her assets just taken a hit to her credit rating.

My father worked as a handy man in a trailer park in Nevada. He was paying about $250 per month for medical insurance. He was the only employee of the company so they couldn't get a cheap plan like large employers. In January 2007 he had a hemorrhagic stroke that required 2 weeks in the ICU and 2 months in the Hospital. The bill? $400,000. His insurance maxed out at $50,000.

His is doing pretty well now and may be able to work soon. The medical bills simply will not get paid. The hospital will eat the cost and pass it on to the next patients. He doesn't own anything that the bankruptcy courts can take so it won't have that much effect on him. They can't touch his family.

This is how it works in America. Socialized medicine implemented in an absurdly stupid way. Oh, and Medicaid, the government insurance that he has been paying for all of his life decided he wasn't qualified to receive their benefit.

Architect

20th March 2008, 12:29 PM

SO bankrupcy and fraud are the solution? Fantastic. Remind me again how this proves your system is better than ours, especially given that it costs you more?

balrog666

20th March 2008, 12:37 PM

You're being sarcastic, right?

The UK, Candada, and others have state-run universal healthcare which, it has been shown, provides superior healthcare to the US system for a much lower cost to the individual.

In what bizarre, topsy-turvy world would this not be a "good thing"? I would have thought that anybody with two brain cells to rub together might have wanted to imporve the US system based upon the successes of other comparable countries? Are you really saying, as your US citizens drop dead earlier and more kids die, that there's nothing to be learnt from us?

But we are not proposing that the UK or Canada or anyone else take over health care in the USA.

The government currently runs Medicare, Medicaid, the VA, the NAHCS, the military health care system, etc. Why would any sane person want that demonstrably lousy coverage expanded?

balrog666

20th March 2008, 12:39 PM

Note what I actually said in the post Jerome hailed with "BINGO!".

Emphasis added.

The main conclusion from all this seems to be that the almighty US of A is incapable of running the proverbial whelk stall.

Rolfe.

Yes, exactly, the only whelks in the stall would be 10-days-dead and would cost 10 times more.

Matthew Best

20th March 2008, 01:58 PM

But we are not proposing that the UK or Canada or anyone else take over health care in the USA.

Maybe you should?

Blue Mountain

20th March 2008, 01:58 PM

But we are not proposing that the UK or Canada or anyone else take over health care in the USA.

The government currently runs Medicare, Medicaid, the VA, the NAHCS, the military health care system, etc. Why would any sane person want that demonstrably lousy coverage expanded?
Balrog, what in your opinion is demonstratively lousy about the programs you mentioned? (I ask partly because VA seems to be doing pretty good overall, after an overhaul in the past decade.)

balrog666

20th March 2008, 02:16 PM

Maybe you should?

Can you staff 60,000 hospitals on 30 days notice? Please? :rolleyes: ;)

Balrog, what in your opinion is demonstratively lousy about the programs you mentioned? (I ask partly because VA seems to be doing pretty good overall, after an overhaul in the past decade.)

You've forgotten the Walter Reed mess and "medical holds" already? Although, yes, improvements have been made in the last ten years in the military and VA systems with the push for modernizing both facilities and support infrastructure. Similar improvements were made in the private systems a decade earlier and continue to be improved upon.

Medicare and Medicaid suffer from heavily bureaucratized and incredibly inefficient administration (or are those the same thing?) and a refusal to allow either state competition or effective improvements in the process.

Nationalizing all that, even if it were possible, would just put more pork power in the hands of the Parliament of Whores.

Ohmer

20th March 2008, 02:35 PM

SO bankrupcy and fraud are the solution? Fantastic. Remind me again how this proves your system is better than ours, especially given that it costs you more?

No fraud, just bankruptcy. It's not the solution, its reality. It's also part of the reason medical bills are so absurd. When someone like my dad who does not and never will have the money to pay his hospital bill, it's gets passed along to the next patient and the spiral continues. Insurance goes up, more people can't afford sufficient insurance, more bills go unpaid, prices go up. It's an absurd death spiral.

Dad lives near one of the practice bomb sites at Nellis Air Force base. Last time I was there I got to see some awesome low level bombing runs. The jet dove, dropped it's payload at shot straight up like a rocket, releasing flares as it went. It was moving so fast it didn't look real. It is absolutely amazing what the US government can accomplish when it makes it a priority.

Fiona

20th March 2008, 02:38 PM

One thing I can agree with is that means tested benefits of any sort tend to use up a lot of resource in administration. That is why it is better to have universal provision

Rolfe

20th March 2008, 03:59 PM

No fraud, just bankruptcy.

I think Architect was also referring to an earlier post, where a situation was described of a young woman, apparently healthy, and with no medical insurance, who suddently needed expensive eye medication. In order to get this, someone else with good insurance cover induced his own doctor to write a prescription for the medication, as if it were for himself, the insured party.

This is definitely fraud.

I also dread to think what it's doing to the integrity of people's medical records.

Of course, you might describe taking goods and services which you cannot pay for and have no intention of paying for as fraud too, I'm not sure of the legal definition.

Oh, but the USA must do things this way because it is too honourable to freeload on the back of all the people who were conquered and enslaved to make the country as prosperous as it is. Britain has no right to spend less money to provide its entire population with good-quality care, because it also did some stuff in the past that wasn't too ethical.

And if you understand that, good luck to you.

Rolfe.

Rolfe

20th March 2008, 04:04 PM

It is absolutely amazing what the US government can accomplish when it makes it a priority.

And this is in fact true. I have no idea, really, why G'Kar is so pessimistic about the capabilities of his own country.

Um, it's this way because everybody realises they have no right to cheap and effective universal coverage because of slavery, and the treatment of the Native Americans. These past sins mean that morally the country is obliged to spend a ton of money more than it has to, to provide patchy, inconsistent and poor-quality coverage to less than half its population.

You know, thinking like Jerome is giving me a headache.

Rolfe.

balrog666

20th March 2008, 05:29 PM

And this is in fact true. I have no idea, really, why G'Kar is so pessimistic about the capabilities of his own country.

[snip]

Rolfe.

Because I've seen it up close and personal - bureaucratic inertia is truly the scourge of our society.

And it's the same reason, no one is out rioting for universal health care - aside from a few anecdotal stories, 1) no one lacks health care, crappy as it might be, and 2) why would they expect better care afterwards when they would get their care from the same people and facilities they get it from now?

Blue Mountain

20th March 2008, 08:44 PM

And it's the same reason, no one is out rioting for universal health care - aside from a few anecdotal stories, 1) no one lacks health care, crappy as it might be, and 2) why would they expect better care afterwards when they would get their care from the same people and facilities they get it from now?
At the risk of being accused of splitting hairs, I'll take exception to your point #1 by saying no one lacks emergency care. Real healthcare--the kind where you have access to the medical system outside of the emergency room--is unobtainable for the uninsured and poorly insured. By most counts that's about 20 million people in the US. (That number is recalled from memory; I'm open to correction if someone provides a more accurate number.)

As for point #2, I think the bureaucratic nightmares are there because of a lack of universality: a lot of effort goes into determining if you are eligible for this program or that program based on your needs, and insurance companies and HMOs actively trying not to pay for your procedures. Replace that with a system where citizenship and residency are about the only two eligibility requirements and that part of the bureaucracy almost disappears, since there are already government departments taking care of that.

And for the most part we're advocating placing the insurance into the public sector. Canada likes to have the hospitals and clinics in the public sector, too, but in my opinion that's not the best way. The USA could have a broad-coverage publicly funded health insurance system and have the actual provision of those services covered by the private sector. And the cost for that, as we've consistently shown here, is only slightly higher than what you're paying in taxes right now.

JEROME DA GNOME

20th March 2008, 09:23 PM

JEROME DA GNOME

20th March 2008, 09:27 PM

So you admit that your point about USA having a better health care system due to Canadians crossing the border for our product is invalid? Thanks.

Please at least attempt thought. If America had price controls on drugs there would be no incentive to create new drugs and as such neither Canadian nor Americans, nor anyone else would have new life saving drugs.

If America had price controls on drugs, what would the world be like?

Do yourself a favor and think on this question.

JEROME DA GNOME

20th March 2008, 09:31 PM

Of course, you might describe taking goods and services which you cannot pay for and have no intention of paying for as fraud too, I'm not sure of the legal definition.

Is that not the definition of the NHS?

Architect

21st March 2008, 01:39 AM

Why did not the NHS cover her?

My insurance pays no matter where I receive care.

European citizens are entitled to free treatment in other European countries and, in addition, a significant number of third part states including (for example) Australia and the like on much the same terms.

America, however, is not part of the programme. The odd man out, as it were.

In all cases, UK citizens normally take out travel insurance which for a small sum (typically £20 per person per year) will cover anything likely to happen to you whilst abroad including baggage loss, theft, cancellation, missed connections, and - of course - medical cover over and above the local "free" level.

That the woman was daft enough not to do so in no way means that we should not feel sypathetic about such a bankrupcy-inducing bill. And btw, bankrupcy doesn't go the same way in the UK. House, assets, etc. all go generally.

Now back on point, Jerome, when are you going to "prove" (don't make me laugh) that your expensive, less effective healthcare system is somehow preferrable to our cheaper, result-producing NHS?

Architect

21st March 2008, 01:40 AM

Is that not the definition of the NHS?

If you're tryingto make a case, then you'd better produce some reasoning and analysis. Mind you, based upon your performance on "defence" and "colonial wealth" I'm not holding my breath.

Architect

21st March 2008, 02:04 AM

Please at least attempt thought. If America had price controls on drugs there would be no incentive to create new drugs and as such neither Canadian nor Americans, nor anyone else would have new life saving drugs.

If America had price controls on drugs, what would the world be like?

Do yourself a favor and think on this question.

Tch tch tch. Time for you to try the research thing, Jerome.

What countries to these leading pharma companies, who have developed many of our medical drugs, come from:

GlaxoSmithKline
Sanofi-Aventis
AstraZeneca
Roche
Novartis

The pharmaceutical industry has always been one of Europe’s flagship industries for innovation and competitiveness. Some of the biggest names in the sector, as well as a multitude of smaller players, are based and undertake research and development in the EU.

Now, you are going to argue that these European companies have an unfair advantage or somesuch because there are no price controls in the US, hence there is a degree of cross-Atlantic subsidy.

Well that might be true - you'd have to do some work and actually produce a cogent argument, which would be a first - but importantly, there are vast differences between Europe and the US in overall R&D investment in the pharmaceutical field given that the levels of public spending differ greatly across the Atlantic.

The American National Institutes of Health (NIH) invests over $27 billion annually in medical research, an impressive figure for which there is no equivalent in the EU. The funding is awarded through almost 50,000 competitive grants to more than 212,000 researchers at over 2,800 universities, medical schools, and other research institutions.

That's right. Your government subsidises it's medical R&D sector to the tune of $27b per annum. European companies don't see a penny of that, do they? Yet still, amazingly, we manage to produce a whole range of new medicinal drugs.

At the end of the day, it comes back to the same thing. The US system pays far, far more and gets less.

Architect

21st March 2008, 02:13 AM

Because I've seen it up close and personal - bureaucratic inertia is truly the scourge of our society.

And it's the same reason, no one is out rioting for universal health care - aside from a few anecdotal stories, 1) no one lacks health care, crappy as it might be, and 2) why would they expect better care afterwards when they would get their care from the same people and facilities they get it from now?

By "our", can we take it to mean that you are referring to your own country? And have you considered that the lack of demand for better health care might be because so few of you know that you pay more, and get less, than comparable developed countries with unversal healthcare?

At the end of the day, however, I suspect your objection to this is philosophical/political. So let me ask you a few questions:

1. Do you believe that a mature society has a duty of care to look after those who are least able to look after themselves, for whatever reason?

2. Do you believe that all people should have access to healthcare for all life-threatening and serious illnesses/conditions, at an adequate level (i.e. full treatment through to good health) level, regardless of ability to pay?

3. Do you believe that the current US system does this, regardless of the apparent disparrity in benchmark indicators with comparable developed nations?

4. Assuming that you do not, how do you think this issue is best addressed?

Corsair 115

21st March 2008, 02:50 AM

If America had price controls on drugs, what would the world be like?Price controls are not the only reason why many drugs are cheaper in Canada. Another contributing factor is that when the health plan makes a purchase from a supplier in the U.S., it is making an absolutely huge buy, and as a result the money involved allows for some very good per-unit pricing. In other words, volume discount.

JEROME DA GNOME

21st March 2008, 06:26 AM

Now back on point, Jerome, when are you going to "prove" (don't make me laugh) that your expensive, less effective healthcare system is somehow preferrable to our cheaper, result-producing NHS?

Why do you choose to compare government run systems?

I agree that government run health-care in America is poorly run and expensive.

JEROME DA GNOME

21st March 2008, 06:30 AM

Price controls are not the only reason why many drugs are cheaper in Canada. Another contributing factor is that when the health plan makes a purchase from a supplier in the U.S., it is making an absolutely huge buy, and as a result the money involved allows for some very good per-unit pricing. In other words, volume discount.

They are price-controlled in Canada and Americans are paying over market value, thus Americans are subsidizing Canada's drug costs.

Thanks would be in order.

JEROME DA GNOME

21st March 2008, 06:32 AM

Tch tch tch. Time for you to try the research thing, Jerome.

What countries to these leading pharma companies, who have developed many of our medical drugs, come from:

GlaxoSmithKline
Sanofi-Aventis
AstraZeneca
Roche
Novartis

Do these companies sell in the American market sans price controls?

You must start thinking beyond step one.

Architect

21st March 2008, 06:34 AM

I agree that government run health-care in America is poorly run and expensive.

You're weaseling again. Be specific:

Do you agree that government run universal health care systems operated in (for example) the UK, France, Germany, Canada, and the Antipodes provide at least comparable standards of healthcare and that, on the basis of the figures posted here, do so at significantly lower cost per head than the US?

JEROME DA GNOME

21st March 2008, 06:36 AM

At the end of the day, it comes back to the same thing. The US system pays far, far more and gets less.

Where you trying to make my point? It is apparent that the socialists are feeding at the trough of America. What are the socialists going to do when America's economy falls? When are the socialists going to give thanks to America?

Architect

21st March 2008, 06:48 AM

You're weaseling again. Be specific:

Do you agree that government run universal health care systems operated in (for example) the UK, France, Germany, Canada, and the Antipodes provide at least comparable standards of healthcare and that, on the basis of the figures posted here, do so at significantly lower cost per head than the US?

Answer the question, Jerome.

Architect

21st March 2008, 06:51 AM

Do these companies sell in the American market sans price controls?

You must start thinking beyond step one.

When you can be bothered doing some research and posting evidence that alleged EU controls on drugs prices lead to a substantive penalty against the US then I might give this some weight.

So, for example, dig out some information on the drugs that are subject to such restrictions, the final implications in view of overall volume, and the returns required by the manufacturers.

I suspect you'll not be willing to put in the work, as usual.

JEROME DA GNOME

21st March 2008, 07:11 AM

Answer the question, Jerome.

The answer to the question is no.

JEROME DA GNOME

21st March 2008, 07:15 AM

When you can be bothered doing some research and posting evidence that alleged EU controls on drugs prices lead to a substantive penalty against the US then I might give this some weight.

You need evidence that price controls lower the price were there are price controls, and increase the cost where there are not price controls.

Would you also like evidence that the Earth rotates?

Architect

21st March 2008, 08:08 AM

The answer to the question is no.

That is wholly illogical.

It has been shown to you that the UK and Canada, amonst others, pay less for healthcare than the US. It has also been shown that, by the commonly accepted indicators such as infant mortality and life expectancy, citizens of these countries enjoy better health.

So why do you believe the slower, less effective US system is superior?

Architect

21st March 2008, 08:12 AM

You need evidence that price controls lower the price were there are price controls, and increase the cost where there are not price controls.

Would you also like evidence that the Earth rotates?

With respect, reading comprehension is clearly not your strong point. Perhaps you should have finished high school. Let's look at the question again:

When you can be bothered doing some research and posting evidence that alleged EU controls on drugs prices lead to a substantive penalty against the US then I might give this some weight.

So, to make life easy for you:

1. Post links proving that the EU states exercise significant cost control on pharmaceutical drugs.

2. Show that the prices so imposed lead to a substantive penalty against the US manufacturers.

Come on, it can't be any harder than supporting your colonial wealth argument, can it......oh, just a minute, you got your arse kicked over there too......

JEROME DA GNOME

21st March 2008, 05:41 PM

That is wholly illogical.

It has been shown to you that the UK and Canada, amonst others, pay less for healthcare than the US. It has also been shown that, by the commonly accepted indicators such as infant mortality and life expectancy, citizens of these countries enjoy better health.

So why do you believe the slower, less effective US system is superior?

You don't pay much attention, do you?

I would explain it to you, but alas, you will ignore what I write and then write a facsimile of your above post.

JEROME DA GNOME

21st March 2008, 05:45 PM

With respect, reading comprehension is clearly not your strong point. Perhaps you should have finished high school. Let's look at the question again:

So, to make life easy for you:

1. Post links proving that the EU states exercise significant cost control on pharmaceutical drugs.

2. Show that the prices so imposed lead to a substantive penalty against the US manufacturers.

Come on, it can't be any harder than supporting your colonial wealth argument, can it......oh, just a minute, you got your arse kicked over there too......

Would you also like evidence that the Earth rotates on an axis?

Your requests are ridiculous. Even if they were not than you would continue to repeat the same demand for evidence despite receiving such.

Corsair 115

21st March 2008, 09:09 PM

Your requests are ridiculous. Even if they were not than you would continue to repeat the same demand for evidence despite receiving such.So, when challenged to support your claim, you choose not to cite evidence? That doesn't seem to me much of a way of getting others to accept your position.

JEROME DA GNOME

21st March 2008, 09:39 PM

So, when challenged to support your claim, you choose not to cite evidence? That doesn't seem to me much of a way of getting others to accept your position.

No, that quote was directed specifically at Architect and his requests for evidence.

Blue Mountain

21st March 2008, 10:04 PM

No, that quote was directed specifically at Architect and his requests for evidence.

Ditto Corsair's remarks. You were asked for evidence to back up your claims and refused to supply it. So far all you've done is simply assume it's self-evident, to the extent you asked us if we also wanted evidence that the Earth rotates n its axis.

I have news for you: it's not self-evident that the Earth rotates on its axis. If it was, Galileo would not have had his famous run-in with the Inquisition in 1633. In the same vein, your assertions about European drug pricing policies are not self-evident either. That's why we're asking you to post your evidence.

Jerome, you can be a frustrating person to "debate" with. When you make an outlandish statement and we ask you to back it up with some evidence, you get all huffy about it. When we show you our evidence for our assertions, you simply ignore it. And when we show you evidence that your assertions are incorrect, you change the topic.

We have another class of poster on this forum who live in a similar fantasy world and act the same way. You can find them in the conspiracy theories section.

JEROME DA GNOME

21st March 2008, 10:24 PM

Ditto Corsair's remarks. You were asked for evidence to back up your claims and refused to supply it. So far all you've done is simply assume it's self-evident, to the extent you asked us if we also wanted evidence that the Earth rotates n its axis.

I have news for you: it's not self-evident that the Earth rotates on its axis. If it was, Galileo would not have had his famous run-in with the Inquisition in 1633. In the same vein, your assertions about European drug pricing policies are not self-evident either. That's why we're asking you to post your evidence.

Jerome, you can be a frustrating person to "debate" with. When you make an outlandish statement and we ask you to back it up with some evidence, you get all huffy about it. When we show you our evidence for our assertions, you simply ignore it. And when we show you evidence that your assertions are incorrect, you change the topic.

We have another class of poster on this forum who live in a similar fantasy world and act the same way. You can find them in the conspiracy theories section.

You are arguing that it is not self evident that price controls lower cost for the areas in which price controls are instituted and raise cost in the areas in which there are no price controls.

If this is not apparent to someone than there is no evidence to show such to someone.

Fiona

22nd March 2008, 12:54 AM

Well you are not really saying that though. are you? You appear to be saying that drugs companies need a certain level of return to make them viable; that the prices paid in europe are below that rate of return (thus they sell at a loss there); and that they do this altruistic thing because they get a bigger rate of return than necessary in the us, thus subsidising the price in europe. None of that is obvious to me and I do think it needs evidence: in particular, I see no reason to suppose that most companies will base price on cost recovery alone, rather than on what the market will bear: nor any reason to suppose that most companies will bother to sell at a loss - thus I still do not see why they would sell in europe at all, if this were the case. I saw earlier that those same companies sell at different prices in different countries and that this has led to some countries threatening to breach patent if the price is not lowered. If the price sought was below profitability I do not see why the comanies would comply, given that drugs are controlled and that generics produced under special licence could not be legally exported. Are you arguing that the price in America is based on some notion of "true cost" ? If you are can you provide some evidence as to how this is arrived at? Or do you say that the price in America is too high? If that is the case then why is it not sensible to introduce price controls there too?

Architect

22nd March 2008, 03:17 AM

Jerome

You deliberately obfusicate and misdirect.

Fiona and Blue Mountain have summed it up more than adequately but at the end of the day it comes to this. YOU, and you alone, have claimed (amongst other things) that the US subsidises drug sales in the EU because of price control mechanisms. However you have failed - once again - to provide any evidence for this startling hypothesis. This would necessarily include details of the controls which you allege exist and a review of the impact upon overall product profitability.

This is a sceptics' site. If you produce a claim then you are expected to back it up. If you cannot do so, then do not whine when we point it out to you. Instead pick up your baggage and make your way over to the Loose Change forums. They don't demand pesky things like evidence over there.

JEROME DA GNOME

22nd March 2008, 06:37 AM

Well you are not really saying that though. are you?

In fact I am saying that. You just read it and then you proceed to create a straw-man to blow below.

You appear to be saying that drugs companies need a certain level of return to make them viable; that the prices paid in europe are below that rate of return (thus they sell at a loss there); and that they do this altruistic thing because they get a bigger rate of return than necessary in the us, thus subsidising the price in europe. None of that is obvious to me and I do think it needs evidence: in particular, I see no reason to suppose that most companies will base price on cost recovery alone, rather than on what the market will bear: nor any reason to suppose that most companies will bother to sell at a loss - thus I still do not see why they would sell in europe at all, if this were the case. I saw earlier that those same companies sell at different prices in different countries and that this has led to some countries threatening to breach patent if the price is not lowered. If the price sought was below profitability I do not see why the comanies would comply, given that drugs are controlled and that generics produced under special licence could not be legally exported. Are you arguing that the price in America is based on some notion of "true cost" ? If you are can you provide some evidence as to how this is arrived at? Or do you say that the price in America is too high? If that is the case then why is it not sensible to introduce price controls there too?

:mgduh

jimbob

22nd March 2008, 06:46 AM

Thank you for your kind offer, zooterkin. ;-)

Jerome, are you going to explain how people on $6/hr are going to afford medical care in an entirely free-market situation.

I would like some breakdown of where I have overestimated the costs, because I can't see how they could.

First question: What is the maximum that someone on $6/hr could afford? Will this change if they have $4k of assets?

Second Question: How much will a 5-hour coronary bypass cost in a complete free market? - Explain how you arrived at a breakdown of the figures.

Third Question: For most people, is it going to be cheaper to be insured or uninsured?

Fourth Question: You pay more for a service which, measured on life expectancy and infant mortality, produces tangibly less benefits that the unversal healthcare systems in the UK and Canada (amongst others). These systems provide, as a minimum, comparable standards of healthcare to everyone regardless of insurers. How can paying less but getting more be a bad thing?

You are arguing that it is not self evident that price controls lower cost for the areas in which price controls are instituted and raise cost in the areas in which there are no price controls.

If this is not apparent to someone than there is no evidence to show such to someone.

I didn't mantion the cost of drugs at all in my post.

I simply asked about the cost of labor, capital, and loss of income.

Can you answer these questions convincingly?

JEROME DA GNOME

22nd March 2008, 06:57 AM

I didn't mantion the cost of drugs at all in my post.

I simply asked about the cost of labor, capital, and loss of income.

Can you answer these questions convincingly?

I am sorry, but your questions are inane.

volatile

22nd March 2008, 06:59 AM

Why are all your posts evasive one-liners? Would it hurt you to put a coherent argument together now and again? Please?

JEROME DA GNOME

22nd March 2008, 07:06 AM

Why are all your posts evasive one-liners? Would it hurt you to put a coherent argument together now and again? Please?

I have found that if I put together much more than two sentences than the post is either ignored or a single line is taken out of context and off-point then debated ad nauseam.

I like to keep it simple and succinct. They say one should always remember one's audience.;)

Blue Mountain

22nd March 2008, 07:25 AM

I have found that if I put together much more than two sentences than the post is either ignored or a single line is taken out of context and off-point then debated ad nauseam.
Sometimes. Other times people will pick apart entire posts line by line.

I like to keep it simple and succinct. They say one should always remember one's audience.;)

But lately you've taken to just saying "It's obvious; it's obvious" without even trying to address the points we're discussing. About the only thing different between that and the 9/11 truthers is you're not adding "!!11!eleventyone!" to your statements.

It's now obvious that Jerome is here to preach and not debate. At least Balrog666 (G'Kar) backs up his assertions with some evidence when he's asked to do so--witness him asking me about the Walter Reed mess when I mentioned the VA.

JEROME DA GNOME

22nd March 2008, 07:30 AM

Sometimes. Other times people will pick apart entire posts line by line.

Yes, I had forgotten that technique used to obscure the salient points of a post.

But lately you've taken to just saying "It's obvious; it's obvious" without even trying to address the points we're discussing. About the only thing different between that and the 9/11 truthers is you're not adding "!!11!eleventyone!" to your statements.

It's now obvious that Jerome is here to preach and not debate. At least Balrog666 (G'Kar) backs up his assertions with some evidence when he's asked to do so--witness him asking me about the Walter Reed mess when I mentioned the VA.

Basically I decided to respond in kind to Architect. I wanted to see how many posts he would make following me around the forum stating that I do not provide evidence. His efforts are herculean.

zooterkin

22nd March 2008, 08:03 AM

I have found that if I put together much more than two sentences than the post is either ignored or a single line is taken out of context and off-point then debated ad nauseam.

Or perhaps your evidence gets pulled apart because it isn't very good in the first place, and it's safer not to expose it to public scrutiny?
They say one should always remember one's audience.;)

You have an audience of sceptics and critical thinkers; perhaps you should remember that.

JEROME DA GNOME

22nd March 2008, 08:07 AM

Or perhaps your evidence gets pulled apart because it isn't very good in the first place, and it's safer not to expose it to public scrutiny?

Not at all.

You have an audience of sceptics and critical thinkers; perhaps you should remember that.

There are some here, yes. Many are only pretending. ;)

jimbob

22nd March 2008, 08:42 AM

Blue Mountain

22nd March 2008, 09:25 AM

Yes, I had forgotten that technique used to obscure the salient points of a post.
So when we respond to only one part of a post it's because we're being pedantic and jumping on one little inconsequential point, but when we take the time to dissect all the silliness in a post it's because we're trying to obscure stuff. Great way for you to win all time. :eye-poppi

Basically I decided to respond in kind to Architect. I wanted to see how many posts he would make following me around the forum stating that I do not provide evidence. His efforts are herculean.
As opposed to your efforts where you just spout off some right-wing free-market one-liners, then scamper away when you're called on it.

Architect

22nd March 2008, 10:40 AM

As opposed to your efforts where you just spout off some right-wing free-market one-liners, then scamper away when you're called on it.

Alas and alack, JDG employs no more than glib soundbites in a manner which suggests they are of far greater depth and import than is ever likely to be the case. Time and time again over the last few weeks he has spouted forth with some right-wing counterpoint which has evaporated under the spotlight of analysis like morning mist. And now, clearly upset at being shown to have opinions of no substance, he seeks to whine and claim it's all a cunning piece of bluff.

Sorry, Jerome, not convincing. You've lost the arguments; be a man, and admit it.

Architect

22nd March 2008, 10:41 AM

There are some here, yes. Many are only pretending.

I am surprised....this shows a level of self analysis that your posts had hitherto not hinted at. Keep working at it.

JEROME DA GNOME

22nd March 2008, 10:42 AM

Alas and alack, JDG employs no more than glib soundbites in a manner which suggests they are of far greater depth and import than is ever likely to be the case. Time and time again over the last few weeks he has spouted forth with some right-wing counterpoint which has evaporated under the spotlight of analysis like morning mist. And now, clearly upset at being shown to have opinions of no substance, he seeks to whine and claim it's all a cunning piece of bluff.

Sorry, Jerome, not convincing. You've lost the arguments; be a man, and admit it.

Which right-wing?

JEROME DA GNOME

22nd March 2008, 10:45 AM

Sorry, Jerome, not convincing. You've lost the arguments; be a man, and admit it.

I would not attempt to win an argument against those that hold fast to their faith. This is an impossible task. Some worship the Gods and others worship the State.

As Joe Friday would say: "Just the facts".

Architect

22nd March 2008, 10:46 AM

If that's your idea of a witty retort, son, you'd better start reading a lot more books.

JEROME DA GNOME

22nd March 2008, 10:49 AM

If that's your idea of a witty retort, son, you'd better start reading a lot more books.

Was I attempting wit?

jimbob

22nd March 2008, 10:51 AM

But they wouldn't make any money in selling inherently expensive treatment at below cost.

According to this (http://www.federalreserve.gov/pubs/bulletin/2006/financesurvey.pdf) the median net worth of a renting household was $4k in 2004 (if I am reading the data correctly)

How could a household with a net worth of that actually pay any more than $4k for anything? Especially as they are likely to be poor credit risks, so borrowiong the money would be difficult.

Can we get the coronary healthcare cost below $4k?

5-hour bypass surgery: General surgeon with less than 1-year experience, $170k, Anaesthetist , less than 1-year experience, median salary $145k.

Both work 60 hour weeks for 50 weeks a year. This means that their combined equivalent hourly rate is $105/hour.

Now they are not performing surgery all of that time, so the actual money that the they are paid as an hourly rate whilst in theatre has to be higher.

As well as the two highly-skilled doctors, you need support staff, (in one photo, the team seemed to be four people), so that makes two other wages that need paying directly during the surgery.

You also need to pay for the use of the theatre, and expensive equipment, say $3million, depreciated over 5-years, when the equipment is in yse 52 weeks per year, gives a theatre cost of $11.5k/week. Now the theatre can't be in use all this time, there has to be preparation, so (generously) we could also assume a 60-hour week for the theatre, which gives $190/hour just for the theatre. Actually it will cost a lot more than this, but I am making a conservative point.

So far just taking the cost of the theatre depreciation and the salaries of the surgeon and anaesthetist, both at the bottom of their respective pay scales, and both working 60-hr weeks in theatre, we get to $295/hour, or $14745 for the five-hour surgery.

You could probably double this for more realistic utilisation rates.

You now need to add in the cost of the other two team members, and of the provision of facilities, and of the proportion of the hospital capital cost that is being depreciated (say over 30 years), and the cost of the bed and accomodation over (three days) stay inhospital.

It soon costs more than the $4k that these people have.

Rolfe works in a free-market system providing medical care to animals, so I will ask him this next question:

If someone's pet needs treatment that costs more than they can afford, do you (as the representative of the free market pixie) reduce the price of the treatment, or does the animal not get any treatment?

All those numbers are ridiculously high because of governmental interference with the market.

These questions are not inane, the answer is.

jimbob

22nd March 2008, 10:52 AM

Further, this is in response to Jerome's assertion that if there was an unfettered free market everyone in the US would be able to afford healthcare.

JEROME DA GNOME

22nd March 2008, 10:52 AM

If that's your idea of a witty retort, son, you'd better start reading a lot more books.

I can understand that with a mighty history such as the United Kingdom's that citizens would feel envy, embarrassment, and resentment for the support America gives freely that allows for the socialist life-style currently enjoyed.

:gnome:

JEROME DA GNOME

22nd March 2008, 10:54 AM

Well, can you explain why you consider them to be inane?

You are asking for an explanation for the reworking of the global economy. That is inane.

jimbob

22nd March 2008, 10:58 AM

Architect

22nd March 2008, 11:01 AM

the support America gives freely that allows for the socialist life-style currently enjoyed.

Prove that the US in some way subsidised the economies of comparable western nations such as to allow them to provide citizens with a socialist welfare state.

I'll not hold my breath, as it's clear that this is just another oot-yer-erse soundbite that you'll be wholly unable to substantiate.........although whining will doubtless ensue.

Architect

22nd March 2008, 11:02 AM

I would not attempt to win an argument against those that hold fast to their faith. This is an impossible task. Some worship the Gods and others worship the State.

As Joe Friday would say: "Just the facts".

Yes, and the moment you start posting facts will be quite a day. In the meantime we'll expect more unsubstantiated waffle, eh?

JEROME DA GNOME

22nd March 2008, 11:02 AM

No I am not, I am asking how someone on $7/hr with less than $4K savings could afford a week in hiospital including paying the wages of the nurses, the anaesthetist, the general surgeon, and the amortised capital costs, involved in a 5-hour surgary,, couple of days in intensive care, and three days in a general ward.

Nothing to do with reworking the global economy.

Do you accept that taxes are taken from this America worker and the American health-care industry for the result of subsidizing the economies in socialist nations around the world?

Architect

22nd March 2008, 11:05 AM

Do you accept that taxes are taken from this America worker and the American health-care industry for the result of subsidizing the economies in socialist nations around the world?

Nope. Prove it.

JEROME DA GNOME

22nd March 2008, 11:08 AM

Prove that the US in some way subsidised the economies of comparable western nations such as to allow them to provide citizens with a socialist welfare state.

Are you unaware of the American armies in Europe?

Are you unaware of the American contributions to the United Nations?

volatile

22nd March 2008, 11:13 AM

Do you accept that taxes are taken from this America worker and the American health-care industry for the result of subsidizing the economies in socialist nations around the world?

So you're saying that the reason the US pays more and gets less is because nations with nationalised healthcare systems are somehow not paying the full price for them?

How? Where? What is subsidised? By how much? Which parts are we in the UK not paying the full amount for? How does the US taxpayer ensure our surgeons work for less than they deserve, or that our operating costs are lower than they really should be?

Spell it out...

JEROME DA GNOME

22nd March 2008, 11:13 AM

Prove that the US in some way subsidised the economies of comparable western nations such as to allow them to provide citizens with a socialist welfare state.

It is hard to believe that you don't know any of this.

Here is a bone.

Marshall Plan (http://usinfo.state.gov/products/pubs/marshallplan/)

The U.S. Congress approved Marshall's long-sighted proposal in 1948, and by 1952 the United States had channeled some $13 billion in economic aid and technical assistance to 16 European countries. During the program's four years, participating countries saw their aggregate gross national product rise more than 30 percent and industrial production increase by 40 percent over prewar levels.

Notice that this is ABOVE prewar levels.

JEROME DA GNOME

22nd March 2008, 11:15 AM

So you're saying that the reason the US pays more and gets less is because nations with nationalised healthcare systems are somehow not paying the full price for them?

If the socialist nations demand that the care is sold below market prices than someone without price controls will have to make up that difference.

I am honestly dumbfounded that this is not understood.

volatile

22nd March 2008, 11:19 AM

Are you unaware of the American armies in Europe?

Are you unaware of the American contributions to the United Nations?

It seems from this line of thinking, that you are of the opinion that as America subsidises our defence, we are able to afford healthcare.

This is a nonsense argument, as it has been pointed out to you that we spend LESS and get MORE. It's not as if we have a spare chunk of change lying around that we would otherwise have to spend on defence that is now suddenly freed up for medicine.

If your argument was correct, our spending would be HIGHER than yours.

volatile

22nd March 2008, 11:22 AM

If the socialist nations demand that the care is sold below market prices than someone without price controls will have to make up that difference.

Market prices are paid; they are just paid for out of taxation rather than individual pockets.

Please: in what way is the American taxpayer pushing down wages for our poor, impoverished GPs on $150,000 per annum?

Spell it out. Make an argument. State your case. Stop with the aphorisms and produce something coherent.

JEROME DA GNOME

22nd March 2008, 11:29 AM

It seems from this line of thinking, that you are of the opinion that as America subsidises our defence, we are able to afford healthcare.

Yep.

This is a nonsense argument, as it has been pointed out to you that we spend LESS and get MORE. It's not as if we have a spare chunk of change lying around that we would otherwise have to spend on defence that is now suddenly freed up for medicine.

The Marshall plan is nonsense?

Let me know when the American people will be payed back with interest.

Gratitude would be the proper response. Socialist seem to think that the world owes them for something. I wonder why that is.

If your argument was correct, our spending would be HIGHER than yours.

Your spending is subsidized. Your logic here makes no sense. Of course you spend less, it is subsidized.

KoihimeNakamura

22nd March 2008, 11:39 AM

The Marshall Plan has already been payed back, Jerome. Mind actually providing proof?

volatile

22nd March 2008, 11:41 AM

Yep.

Righty-ho.

Let's just make this clear - you assert that because we are able to spend less on defence, we can spend more on healthcare.

Why, then, do we SPEND LESS than America on healthcare but get MUCH BETTER breadth and depth of service?

Follow your logic, Jerome! If it were true that our healthcare is better simply because we have more money to spend on health, our spending would be GREATER than yours. See?

Your spending is subsidized. Your logic here makes no sense. Of course you spend less, it is subsidized.You're making two confused arguments, both of which are nonsense, and both of which are contradictory. Please pick one.

The first is, as outlined above, we are able to spend more on health because America "subsidises" our defence, giving us more disposable income to spend elsewhere. This is obviously nonsense, because, as above, we spend LESS than you do on health but get more.

The second is that American directly subsidises European healthcare. This seems to be your claim in the second part of this post, and it's as nonsense as the first. WHAT is subsidised (Our staff wages? Building costs? What?)? HOW does this subsidisation occur? In what way does the American taxpayer contribute directly towards the British NHS?

Which argument do you want to make - that there is direct subsidy (as implied when you state "[o]f course you spend less, it is subsidized."), or that there is indirect subsidy (as implied when you answered my question "you are of the opinion that as America subsidises our defence, we are able to afford healthcare" in the affirmative).

Both are absurd, of course, it would just be nice to have you clarify your position and stop the weaselling.

jimbob

22nd March 2008, 11:44 AM

If the socialist nations demand that the care is sold below market prices than someone without price controls will have to make up that difference.

I am honestly dumbfounded that this is not understood.

Aren't you arguing with me that "socialised healthcare pushes the costs up?

This would lower the costs, because the market price would be lower.

JEROME DA GNOME

22nd March 2008, 11:51 AM

Righty-ho.

Let's just make this clear - you assert that because we are able to spend less on defence, we can spend more on healthcare.

Why, then, do we SPEND LESS than America on healthcare but get MUCH BETTER breadth and depth of service?

Follow your logic, Jerome! If it were true that our healthcare is better simply because we have more money to spend on health, our spending would be GREATER than yours. See?

You are incorporating the inefficiency of American government provided health-care and ignoring the cost payed by Americans to subsidize European health-care.

JEROME DA GNOME

22nd March 2008, 11:52 AM

Aren't you arguing with me that "socialised healthcare pushes the costs up?

This would lower the costs, because the market price would be lower.

Price controls are not market prices.

JEROME DA GNOME

22nd March 2008, 11:54 AM

The first is, as outlined above, we are able to spend more on health because America "subsidises" our defence, giving us more disposable income to spend elsewhere. This is obviously nonsense, because, as above, we spend LESS than you do on health but get more.

Find what you are attempting to say, logically. :confused:

You do know that America has a bigger pot.

volatile

22nd March 2008, 11:55 AM

You are incorporating the inefficiency of American government provided health-care and ignoring the cost payed by Americans to subsidize European health-care.

What?

That's not an argument, Gnome, and nor does it answer the questions posed. I've been reasonable, and posted what are clear and obvious objections to your 'argument' such that it is. If you have a case to make at all, damn well make it.

I asked two very simple, very concise questions. For your convenience, I shall post them again:

1) Are you claiming direct or indirect subsidy?

2) If the former: What is subsidised (and by how much), and how does this subsidisation occur?

volatile

22nd March 2008, 12:00 PM

Find what you are attempting to say, logically. :confused:

You do know that America has a bigger pot.

If it were the case that our healthcare was better because we had more money to spend due to "subsidy" elsewhere, our healthcare spending would, relatively, be greater than that in the US, would it not? If it were simply a case that the US cannot afford to provide good healthcare, you would expect per capita spending on public healthcare provision there to be lower, correct?

I'll repeat the salient point from my earlier post: If it were true that our healthcare is better simply because we have more money to spend on health, our spending would be GREATER than yours. It isn't, and you have the numbers sprinkled throughout this thread that demonstrate that to be the case.

In other words, if it were simply the size of available capital that dictated healthcare provision, British healthcare spending would be relatively higher than in the US. It isn't, this indirect subsidy cannot be the reason for the disparity in US and European healthcare...

JEROME DA GNOME

22nd March 2008, 12:00 PM

What?

That's not an argument, Gnome, and nor does it answer the questions posed. I've been reasonable, and posted what are clear and obvious objections to your 'argument' such that it is. If you have a case to make at all, damn well make it.

I asked two very simple, very concise questions. For your convenience, I shall post them again:

1) Are you claiming direct or indirect subsidy?

2) If the former: What is subsidised (and by how much), and how does this subsidisation occur?

That is three questions numbered as two. I now understand your misunderstandings.

jimbob

22nd March 2008, 12:01 PM

Price controls are not market prices.

So Canadian prices for prescription drugs don't (ETA: effectively) set an upper limit on the prices just across the border?

JEROME DA GNOME

22nd March 2008, 12:06 PM

In other words, if it were simply the size of available capital that dictated healthcare provision, British healthcare spending would be relatively higher than in the US. It isn't, this indirect subsidy cannot be the reason for the disparity in US and European healthcare...

Your argument hinges on British capital being equal to American capital.

Please don't ask my to prove this one. ;)

volatile

22nd March 2008, 12:07 PM

That is three questions numbered as two. I now understand your misunderstandings.

You're the most irritating person I've (n)ever had the misfortune to encounter.

I take it you can't answer them, then? You won't even commit to a position on exactly what you're arguing?

Maybe we should take this slowly, for your benefit. I see you can't handle more than one sentence of thinking at a time. Let's start here:

Does the US subsidise the British healthcare system directly or indirectly?

This is a simple question, and has four possible answers:

1) Directly.
2) Indirectly.
3) Both.
4) Neither.

Pick one. I dare you.

jimbob

22nd March 2008, 12:08 PM

Once more:

If a true free market would allow everyone to afford healthcare now (in a way completely unlike the situation when that was last tried).

How would this work?

How can someone on $7/hr with less than $4K savings could afford a week in hospital including paying the wages of the nurses, the anaesthetist, the surgeon, and the amortised capital costs, involved in a 5-hour surgary, couple of days in intensive care, and three days in a general ward.

Would they need insurance to cover that?

What weekly cost of that could they afford.

I suppose I should ask what this would be without anyu form of social security, becuase that must distort the lower end of the market.

India doean't have effective social security, so I suppose that everyone should be able to afford healthcare there, especially as the Indian economy is growing so rapidly. (If my reasoning is wrong for India, please tell me where the error is).

JEROME DA GNOME

22nd March 2008, 12:08 PM

So Canadian prices for prescription drugs don't (ETA: effectively) set an upper limit on the prices just across the border?

If price controls in one market set the price lower than market value than in another market without price controls the cost will increase to make-up for the loss.

Architect

22nd March 2008, 12:12 PM

Are you unaware of the American armies in Europe?

There is a separate thread for you to substantiate your unfounded assertions regarding US defence of Western Europe. You have thus far declined to post there. I assume that, as with healthcare, you are unable to substantiate your bluster.

Are you unaware of the American contributions to the United Nations?

Are you aware of European contributions to the UN?

JEROME DA GNOME

22nd March 2008, 12:12 PM

volatile

22nd March 2008, 12:12 PM

Your argument hinges on British capital being equal to American capital.

Please don't ask my to prove this one. ;)

Go on. Explain it. Please.

Explain how we actually need more money per capita to provide our vastly superior healthcare system but somehow spend less on actually supplying it.

It'll be fun and educational for all the family, I'm sure.

Architect

22nd March 2008, 12:14 PM

Yep.

The Marshall plan is nonsense?

Let me know when the American people will be payed back with interest.

Let me know how much aid the UK received from the Marshall Plan.

Let me know how much cash the UK paid to the US under lend lease.

Really, you're not very good at this Jerome, are you?

Architect

22nd March 2008, 12:15 PM

Are we talking about India or America? The UK should answer for India.

And yet, interestingly, you have been unable to substantiate your claim that the UK illicitly purloined colonial wealth in order to help create it's welfare state.

Try again, son, and stick in at school.

Please keep in mind the Membership Agreement and do not use personal attacks to argue your point.

JEROME DA GNOME

22nd March 2008, 12:16 PM

There is a separate thread for you to substantiate your unfounded assertions regarding US defence of Western Europe. You have thus far declined to post there. I assume that, as with healthcare, you are unable to substantiate your bluster.

I was playing a game with you by not evidencing anything you asked for. Now the above is a blatant lie because I just presented evidence and you are; per my prediction, ignoring it and repeating the same claims.

Thanks for evidencing that you are not interested in evidence and are a liar.

LukeB

22nd March 2008, 12:16 PM

Jerome is living proof that an internet troll never need fear going hungry.

JEROME DA GNOME

22nd March 2008, 12:17 PM

Let me know how much aid the UK received from the Marshall Plan.

Let me know how much cash the UK paid to the US under lend lease.

Really, you're not very good at this Jerome, are you?

You are a lying liar that lies.

Architect

22nd March 2008, 12:18 PM

If the socialist nations demand that the care is sold below market prices than someone without price controls will have to make up that difference.

I am honestly dumbfounded that this is not understood.

I am honestly dumfounded that you have stated that drugs in Europe are so subsidised without posting a shred of evidence in support of your claim.

Are we just to accept your word for it, despite all the other times you've been proven to be full of what might be politely termed "hot air"?

jimbob

22nd March 2008, 12:18 PM

2004: New Zealand 8.5% of GDP on healthcare, 77.2% of this was public spending.

This makes about 6.5% percent of GDP spent on healthcare. But with the GDP only 58% of the US.

It seems a far more effective use of every dollar than the US system.

New Zealand more than paid its way in the Twentieth Century as far as contributing to global stability, and when there was no immediate threat to it.

New Zealand:
Quote:
Infant mortality rate: total: 5.67 deaths/1,000 live births
male: 6.48 deaths/1,000 live births
female: 4.82 deaths/1,000 live births (2007 est.)
Quote:
Life expectancy at birth: total population: 78.96 years
male: 75.97 years
female: 82.08 years (2007 est.)
Quote:
GDP - per capita (PPP): $27,300 (2007 est.)

The US
Quote:
Infant mortality rate:
total: 6.37 deaths/1,000 live births
male: 7.02 deaths/1,000 live births
female: 5.68 deaths/1,000 live births (2007 est.)
Quote:
Life expectancy at birth:
total population: 78 years
male: 75.15 years
female: 80.97 years (2007 est.)
Quote:
GDP - per capita (PPP): $46,000 (2007 est.)

JEROME DA GNOME

22nd March 2008, 12:19 PM

Jerome is living proof that an internet troll never need fear going hungry.

You should read your membership agreement about staying on topic. See, when you make a single post in a thread that does nothing more than name-call you are presenting yourself as...

Architect

22nd March 2008, 12:19 PM

I was playing a game with you by not evidencing anything you asked for. Now the above is a blatant lie because I just presented evidence and you are; per my prediction, ignoring it and repeating the same claims.

I see. Which post was that, chum? Give us the number/link.

JEROME DA GNOME

22nd March 2008, 12:20 PM

I am honestly dumfounded that you have stated that drugs in Europe are so subsidised without posting a shred of evidence in support of your claim.

Are we just to accept your word for it, despite all the other times you've been proven to be full of what might be politely termed "hot air"?

Are there price controls, liar?

JEROME DA GNOME

22nd March 2008, 12:22 PM

I see. Which post was that, chum? Give us the number/link.

It is in this thread today. Try some research. You have exampled that you ignore other's research and continue to make the same liar claims.

Architect

22nd March 2008, 12:22 PM

Jerome is living proof that an internet troll never need fear going hungry.

He's certainly proof that they don't know when they're beaten. Talk about a kicking.......

:boggled:

jimbob

22nd March 2008, 12:23 PM

UK settles WWII debts to allies (http://news.bbc.co.uk/1/hi/uk/6215847.stm)

Britain needed money for reconstruction and importing food

Britain will settle its World War II debts to the US and Canada when it pays two final instalments before the close of 2006, the Treasury has said.

The payments of $83.25m (£42.5m) to the US and US$22.7m (£11.6m) to Canada are the last of 50 instalments since 1950.

The amount paid back is nearly double that loaned in 1945 and 1946. "This week we finally honour in full our commitments to the US and Canada for the support they gave us 60 years ago," said Treasury Minister Ed Balls.

I think that counts as paying for the lend-lease

Architect

22nd March 2008, 12:24 PM

Are there price controls, liar?

You're the one that claimed there were but failed to follow it through with evidence or analysis, just a single quote IIRC. Now come on, do you have any evidence or do we have to wade through yet more spurious bluster?

jimbob

22nd March 2008, 12:24 PM

Remind me how much money New Zealand, Canada and Australia received from the Mashall Plan?

JEROME DA GNOME

22nd March 2008, 12:26 PM

You're the one that claimed there were but failed to follow it through with evidence or analysis, just a single quote IIRC. Now come on, do you have any evidence or do we have to wade through yet more spurious bluster?

You don't even know the working of your own nation? I am to evidence what you should know?

By the way, why do you lie?

Architect

22nd March 2008, 12:26 PM

It is in this thread today. Try some research. You have exampled that you ignore other's research and continue to make the same liar claims.

I'm asking because you patently did not produce any research today. I just wondered which of your posts you considered to include such fantasy.

I'll just assume you can't (again) as it's clearly your MO. All talk, no show. And an amazing inability to tell when you've had a kicking.

JEROME DA GNOME

22nd March 2008, 12:27 PM

Remind me how much money New Zealand, Canada and Australia received from the Mashall Plan?

I said that that was but just one bone thrown.

Architect

22nd March 2008, 12:28 PM

You don't even know the working of your own nation? I am to evidence what you should know?

Because, Jerome, you're the one who claimed that the EU countries operate price caps on pharma drugs. It's your job to prove it, not ours.

By the way, why do you lie?

Proof?

JEROME DA GNOME

22nd March 2008, 12:28 PM

I'm asking because you patently did not produce any research today. I just wondered which of your posts you considered to include such fantasy.

I'll just assume you can't (again) as it's clearly your MO. All talk, no show. And an amazing inability to tell when you've had a kicking.

Here you are admitting that you will not do any research or you are lying again.

Which is it?

ETA: I quoted you, the research should be easy.

Architect

22nd March 2008, 12:29 PM

UK settles WWII debts to allies (http://news.bbc.co.uk/1/hi/uk/6215847.stm)

I think that counts as paying for the lend-lease

I note with considerable amusement that JDG has ignored this again!

balrog666

22nd March 2008, 12:29 PM

By "our", can we take it to mean that you are referring to your own country? And have you considered that the lack of demand for better health care might be because so few of you know that you pay more, and get less, than comparable developed countries with unversal healthcare?

At the end of the day, however, I suspect your objection to this is philosophical/political. So let me ask you a few questions:

Yes, political, philosophical, and economic.

1. Do you believe that a mature society has a duty of care to look after those who are least able to look after themselves, for whatever reason?

A broad question - too broad. Are you interested in discussing a general principle or some absolute imperative, because there will always be exceptions to any rule and limits to any coverage.

And a "mature society" means what exactly? One that provides free food to the poor (like ours does), free heat in the winter to the poor (like ours does), rent subsidies to the poor (like ours does), and free medical care to the poor (like ours does)?

But aside from that, no. People do that themselves, families do that, charities do that - at what point is it the government's responsibility and why? At what point do quality of life issues and direct costs enter the question?

2. Do you believe that all people should have access to healthcare for all life-threatening and serious illnesses/conditions, at an adequate level (i.e. full treatment through to good health) level, regardless of ability to pay?

Again, even ignoring cost and quality of life issues, no - and I note that "adequate", "full treatment", "good health" are all subjective terms (even "life-threatening" can be) and nowhere do I see (lack of) personal responsibility or aberrant behavior enter your consideration. [And I say that because those are the current hot-button initiatives to expand current medical care coverage mandates here.]

3. Do you believe that the current US system does this, regardless of the apparent disparrity in benchmark indicators with comparable developed nations?

No. With respect to government provided services, the system acts as a medical care provider of last resort and does it poorly.

Perhaps this where I'm supposed to say "But even lousy doctors have to work somewhere" or do I point out again that no is less interested in reform or improvements than the government bureaucracy and the regulatory machine in Congress?

4. Assuming that you do not, how do you think this issue is best addressed?

Which issue? That some people don't get all the free health care they want? Or that it's currently too expensive for many? Or that healthy young people often make different choices than old unhealthy ones? Or that some people are left out in the cold entirely? Or that cost and/or quality of life are sometimes a consideration in people's decision making? Or something else entirely?

And I want to point out again that it's government policy that has severely limited reform efforts and squashed competition and experimental options already. Not doctors, not hospitals, not insurance companies, and not people rioting in the street.

jimbob

22nd March 2008, 12:32 PM

Originally Posted by jimbob
Once more:

If a true free market would allow everyone to afford healthcare now (in a way completely unlike the situation when that was last tried).

How would this work?

How can someone on $7/hr with less than $4K savings could afford a week in hospital including paying the wages of the nurses, the anaesthetist, the surgeon, and the amortised capital costs, involved in a 5-hour surgary, couple of days in intensive care, and three days in a general ward.

Would they need insurance to cover that?

What weekly cost of that could they afford.

I suppose I should ask what this would be without anyu form of social security, becuase that must distort the lower end of the market.

India doean't have effective social security, so I suppose that everyone should be able to afford healthcare there, especially as the Indian economy is growing so rapidly. (If my reasoning is wrong for India, please tell me where the error is).

Are we talking about India or America? The UK should answer for India.

Why don't you answer for how someone in the US on $7/hr could afford that treatment?

jimbob

22nd March 2008, 12:39 PM

If price controls in one market set the price lower than market value than in another market without price controls the cost will increase to make-up for the loss.

Not if the customers can choose to pay the lower prices, which they do and can, according to evidence poeted earlier...

Architect

22nd March 2008, 01:53 PM

Yes, political, philosophical, and economic.

I suspect that what we're seeing, although it's impossible to draw conclusions from such a teeny sample group (i.e. us!), is the difference in general societal views each side of the Atlantic.

A broad question - too broad. Are you interested in discussing a general principle or some absolute imperative, because there will always be exceptions to any rule and limits to any coverage.

An interesting point. Do we agree the general principle and that the issue therefore becomes the limit to same?

And a "mature society" means what exactly?

By "mature" I meant stable, relatively free of major civil strife, and sytematic government capable of implementing such policies.

One that provides free food to the poor (like ours does), free heat in the winter to the poor (like ours does), rent subsidies to the poor (like ours does), and free medical care to the poor (like ours does)?

The question would be the level at which these are provided. Is each the bear minimum necessary for survival? Are they benchmarked to a standard and how is that standard arrived at. No-one would argue that the willful malingerer should be encouraged back to work, but what of the long-term ill (for example)? Do we benchmark their standards seperately?

But aside from that, no. People do that themselves, families do that, charities do that - at what point is it the government's responsibility and why? At what point do quality of life issues and direct costs enter the question?

This is probably where we disagree. I do not, personally, believe that the families should be left to stump up. That's why my government, for example, pays for care homes for the elderly (albeit implemented largely through the private sector). I hasten to add that there's an asset ceiling.

Again, even ignoring cost and quality of life issues, no - and I note that "adequate", "full treatment", "good health" are all subjective terms (even "life-threatening" can be) and nowhere do I see (lack of) personal responsibility or aberrant behavior enter your consideration. [And I say that because those are the current hot-button initiatives to expand current medical care coverage mandates here.]

I can see no scope for agreement on this point. It is a cornerstone of political thinking in most of Western Europe that healthcare be provided to all, at the same standard, regardless of ability to pay or personal circumstances.

No. With respect to government provided services, the system acts as a medical care provider of last resort and does it poorly.

Noted. The statistics would certainly seem to be a damning indictment of the system.

Which issue? That some people don't get all the free health care they want? Or that it's currently too expensive for many? Or that healthy young people often make different choices than old unhealthy ones? Or that some people are left out in the cold entirely? Or that cost and/or quality of life are sometimes a consideration in people's decision making? Or something else entirely?

I think you miss the point. You accept that your current national medical safety net system is poorly run. Presumably you do not believe it should just be disbanded completely. Ergo how do you think it might be most productively immproved?

And I want to point out again that it's government policy that has severely limited reform efforts and squashed competition and experimental options already. Not doctors, not hospitals, not insurance companies, and not people rioting in the street.

Having crap politicians isn't much of an excuse though.....look at ours, and we've got halfway decent healthcare and educashun and everyfin'.

balrog666

22nd March 2008, 05:28 PM

I suspect that what we're seeing, although it's impossible to draw conclusions from such a teeny sample group (i.e. us!), is the difference in general societal views each side of the Atlantic.

I would not suspect that my views are widely held even here except among fringe groups of educated and interested parties.

For the sheep, it’s still “Party on, dude!”

Oooh, he said “sheep!” Dead giveaway! [Commentary provided at no charge! - ;)]

An interesting point. Do we agree the general principle and that the issue therefore becomes the limit to same?

Yes, we agree on the general principle. The question then becomes when does a safety net become a hammock.

By "mature" I meant stable, relatively free of major civil strife, and sytematic government capable of implementing such policies.

Okay. No argument there.

The question would be the level at which these are provided. Is each the bear minimum necessary for survival? Are they benchmarked to a standard and how is that standard arrived at. No-one would argue that the willful malingerer should be encouraged back to work, but what of the long-term ill (for example)? Do we benchmark their standards seperately?

No, we allow a minimum (even ******) standard and you pay for anything else you want. But part of the problem here is that medical care insurance is tied to employment. Big problem with an easy solution, but I suspect it won't be fixed any time soon.

This is probably where we disagree. I do not, personally, believe that the families should be left to stump up. That's why my government, for example, pays for care homes for the elderly (albeit implemented largely through the private sector). I hasten to add that there's an asset ceiling.

Ditto here. Medicare and Medicaid will pay for such care. After the patient is essentially bankrupt.

I can see no scope for agreement on this point. It is a cornerstone of political thinking in most of Western Europe that healthcare be provided to all, at the same standard, regardless of ability to pay or personal circumstances.

Having watched certain members of the Dew Generation (of idiots) do their thing and break bone after bone after brain cell after brain cell, as well as the Christian fools who want vegetative people [expensively] cared for long after they are brain-dead, and those who want to allow alcoholics, addicts, and the irreparably diseased onto transplant lists, et al, there must be a cut-off for both self-inflicted damage and quality-of-life purposes.

And then there are the idiots who want addiction recovery, weight loss, and [essentially unlimited] mental health treatments paid for by society in general (including not just your standard variety of recreational drugs, but tobacco usage, weight control and even teenage angst).

And, beyond that, we have the idiots [for lack of a better word] who want their homeopathic, reike-healing, and/or woo-woo treatments paid for.

Where do you stop with the ignorant and bamboozled who can't be educated and think they are being denied something they don't even understand?

Noted. The statistics would certainly seem to be a damning indictment of the system.

Yes, quite probably, although our statistics gathering is more comprehensive than elsewhere. Live births counted here include any babe that draws breath once including those that will inexorably die within minutes or hours Deaths include gang-bangers, illegal aliens, and the AIDS-demographic hump, among other causes. If you want to see how long an un-ill, non-smoking, non-obese, adult Caucasian will live you must look elsewhere for that info [and it is out there].

I think you miss the point. You accept that your current national medical safety net system is poorly run. Presumably you do not believe it should just be disbanded completely. Ergo how do you think it might be most productively immproved?

As I posted previously, I was greatly in favor of the Oregon Plan that the Feds killed. In brief, it included cost, efficacy, and quality of life issues as weighed and balanced by both doctors and patients. One interesting side point of the plan was that, if you wanted to add more money to the Oregon Plan, you could see, in advance, [i]exactly what it would pay for. Illuminating to say the least.

Having crap politicians isn't much of an excuse though.....look at ours, and we've got halfway decent healthcare and educashun and everyfin'.

Aside from general cultural issues, things work a little differently [and much faster] with a Parliamentary Executive like you have. Our system is much slower to act and tends to solve problems that don’t exist anymore or that lobbyists bribe for. And you can't shoot them all - mores the pity.

aries

23rd March 2008, 02:44 PM

I also come from a country, Denmark, in which the state (or the government) regulates the health care system. And last time i checked, the Danish Healt Care cost about 6-7 percent of our BNP whereas the US Healt Care costs about 12-14 percent of the US BNP.

The state also give old people their folk pension (same as pensioner's check or retirement money). The big difference is, as I understand it, that in the US, you would have to had a job to get this pension whereas in Denmark all people can get this.

Another thing is this: I once read an article about how some big companies like GM were short of oging under because they couldn't afford the pension for all their workers anymore. I think the figure was about 6 million US Dollars - pr. year (or was that in the future??) Anywho, the point is that even the corporations in the US are calling for a chance to this system.

In the UK, in the 1950's they made the NHS system and in Denmark in that time we had a system called 'the sickness system'. It basicallly were a system in which you paid a small amount of money to your union each month (I think) and then you got some stamps (I think) to put in a book.And if you got sick, you could get help...

I know that many people from the US mistrusts the government. However, maybe some sort of middle ground between the US based indvididual insurance model and the more Danish etc. collective insurance group model could be found.

Let me just say this:

In Denmark we don't pay anything to go to the doctor, but they do in Sweden and Norway. Nor do we pay for being admitted to a hospital but they do so in Sweden - and possibly Norway? And for some reason, we pay a lot (too much some say) to go to the dentist, and can only get minimum help paying for glasses, even for children. Hearing aids seem to be subsidized, though.

Personally, I wouldn't mind paying like 10$ or 20$ to see a doctor, if I knew these money went back into the health care system, lowering the prices to go see the dentist, for example.

Matthew Best

31st March 2008, 01:18 PM

According to this BBC News story (http://news.bbc.co.uk/1/hi/health/7321500.stm), Oregon is having a lottery for places in its health care scheme.

In her comfortable home in Portland, Oregon, Louanne Moldovan sifts through a pile of papers.

They are unpaid medical bills, stretching back a year, arising from treatment for Crohn's Disease, the chronic intestinal condition she suffers from. She thinks she owes nearly $15,000 (£7,500) in all.

"It's a symbol of how degraded our system is in this country that we are resorting to a lottery," she tells me.

More than 90,000 in Oregon are vying for a maximum of 10,000 places in the state's healthcare plan. Yet it is a drop in the ocean. There are some 600,000 uninsured in Oregon.

More at link (http://news.bbc.co.uk/1/hi/health/7321500.stm).

volatile

31st March 2008, 01:57 PM

That's horrific.

balrog666

31st March 2008, 02:31 PM

That's horrific.

True. But it's only because the Feds already squashed the original Oregon Plan that would have covered them all.

And the Feds may squash this idea too - who knows what an bureaucrat scorned can or will do?

volatile

31st March 2008, 02:42 PM

Explain to me why this mystical "Oregon Plan" is better than the universal healthcare you seem so opposed to?

Also: do you now distance yourself from the earlier claim that "no one lacks health care, crappy as it might be".

jimbob

31st March 2008, 03:15 PM

Volitile, I think that was JdG and not Balrog.

balrog666

31st March 2008, 05:19 PM

Explain to me why this mystical "Oregon Plan" is better than the universal healthcare you seem so opposed to?

Do you really need a link?

Also: do you now distance yourself from the earlier claim that "no one lacks health care, crappy as it might be".

Read the article again. Does she lack for health care or just the means to pay for it from her own resourses?

SezMe

31st March 2008, 07:21 PM

Do I lack a 200 foot yacht or just the means to pay for it?

There is no practical distinction.

volatile

31st March 2008, 10:16 PM

Volitile, I think that was JdG and not Balrog.

Nope. That was him.

Because I've seen it up close and personal - bureaucratic inertia is truly the scourge of our society.

And it's the same reason, no one is out rioting for universal health care - aside from a few anecdotal stories, 1) no one lacks health care, crappy as it might be, and 2) why would they expect better care afterwards when they would get their care from the same people and facilities they get it from now?

volatile

31st March 2008, 10:18 PM

Do you really need a link?

No. I asked a simple question. What I really need is for you to spell out why the Oregon Plan is better than nationalised universal healthcare, morally, economically or practically.

Please. Go ahead. You seem to think you have an argument; it'd be more fun, and more interesting, if you'd actually say what it was. Maybe I'll learn something. Maybe you will. We won't know unless we try, will we?

Read the article again. Does she lack for health care or just the means to pay for it from her own resourses?What SezMe said. You're smarter than this, Balrog.

jimbob

1st April 2008, 10:12 AM

Sorry volatile,

JdG said that if there was a total free market, with no government subsidies, then magically everyone would be able to afford healthcare.

jimbob

1st April 2008, 10:24 AM

Looking back on this thread, I am struck by the asumption of bureaucratic incompetence in the US.

The NHS functions, yet over the last 60-years, the UK's governments haven't exactly been exemplars of organisational brilliance.

balrog666

1st April 2008, 11:34 AM

Do I lack a 200 foot yacht or just the means to pay for it?

There is no practical distinction.

You are being silly. She got medical treatment, did she not? Somehow, I don't thank that means you have a 200-foot yacht in your bathtub ...

No. I asked a simple question. What I really need is for you to spell out why the Oregon Plan is better than nationalised universal healthcare, morally, economically or practically.

Please. Go ahead. You seem to think you have an argument; it'd be more fun, and more interesting, if you'd actually say what it was. Maybe I'll learn something. Maybe you will. We won't know unless we try, will we?

What SezMe said. You're smarter than this, Balrog.

What I said previously was that the Oregon Plan of 1989 was a very interesting attempt to reform (and significantly improve) Medicaid. I still think so.

Looking back on this thread, I am struck by the asumption of bureaucratic incompetence in the US.

The NHS functions, yet over the last 60-years, the UK's governments haven't exactly been exemplars of organisational brilliance.

The assumption? Our DMV's and public agencies are legendary for bureaucratic indifference, incompetence, blatant stupidity, and outright hostility to their "customers". And our public employee unions are utterly corrupt. Not a good combination if your life is hanging in the balance.

volatile

1st April 2008, 11:39 AM

What I said previously was that the Oregon Plan of 1989 was a very interesting attempt to reform (and significantly improve) Medicaid. I still think so.

That's not an answer to my question.

I asked you why you thought "the Oregon Plan is better than nationalised universal healthcare, morally, economically or practically".

So, why?

balrog666

1st April 2008, 01:40 PM

That's not an answer to my question.

I asked you why you thought "the Oregon Plan is better than nationalised universal healthcare, morally, economically or practically".

So, why?

I have no idea why you think expanding Medicaid to cover more people will result in an improvement in it ...

volatile

1st April 2008, 01:56 PM

I have no idea why you think expanding Medicaid to cover more people will result in an improvement in it ...

Am I asking you to compare extended Medicaid with this Oregon plan? No.

I am asking you, quite plainly (and for the fourth time now!), to explain why you think the Oregon plan is better financially, morally or practically than nationalised healthcare as rolled out successfully in dozens of countries. It's not a hard question, though I understand your reticence to answer it.

Please. If you're interested in moving this discussion forward, you need to make your case more coherently than you're currently doing. Why is this Oregon plan better than a nationalised system? It might well be, but I'll never know unless you actually explain your reasoning.

Pick a metric, make a case.

Architect

1st April 2008, 02:04 PM

volatile

1st April 2008, 02:09 PM

I find it ironic that this is raising it's head again on the day that the Scottish Government announced that it was dropping means-tested prescription charges as part of its committment to improving NHS coverage in Scotland.

[/smug]

So what is this Oregon Plan, then?

I have no idea. I wish Balrog would actually explain what it is, why it's so good, and why it's better than a nationalised system, though.

jimbob

1st April 2008, 02:14 PM

I have no idea about this site's (http://virtualmentor.ama-assn.org/2005/02/pfor2-0502.html) accuracy

The Oregon Plan
In 1989, the state of Oregon began work on a controversial plan for the allocation of health care resources. The goal, noble enough, was to provide Medicaid benefits for more people than had previously been covered. But how? One option would obviously be to raise more money for health services, though the corresponding tax increases would have been unpopular. Oregon chose another approach: to make fewer services available to an enlarged pool of Medicaid recipients. So, by restricting services, they could afford to grant access to more people.

What Is Covered?
Once Oregon came up with its plan, it had to determine which treatments to cover and which to exclude. The mission of the plan, to provide fewer treatments to more people, now needed teeth. How were they to decide what to cover and what not to cover? In 1991, Oregon developed a list of more than 700 diagnoses and treatments and ranked these in order of merits. For example, “Diagnosis: severe or moderate head injury, hematoma or edema with loss of consciousness; Treatment: medical and surgical treatment” was ranked at the top of the list and “Diagnosis: mental disorders with no effective treatment; Treatment: evaluation” was ranked near the bottom (#741) [2]. The state then decided it would extend Medicaid coverage for treatment of the top 587 items, though this list and the cutoff point has shifted slightly over the years. If the diagnosis/treatment for a particular patient was above the cutoff line, which is currently at about 578, the treatment would be covered and, if not, coverage would be denied.

OKaaaay...

That seems like a bureaucratic nightmare.

balrog666

1st April 2008, 07:10 PM

Am I asking you to compare extended Medicaid with this Oregon plan? No.

I am asking you, quite plainly (and for the fourth time now!), to explain why you think the Oregon plan is better financially, morally or practically than nationalised healthcare as rolled out successfully in dozens of countries. It's not a hard question, though I understand your reticence to answer it.

Please. If you're interested in moving this discussion forward, you need to make your case more coherently than you're currently doing. Why is this Oregon plan better than a nationalised system? It might well be, but I'll never know unless you actually explain your reasoning.

Pick a metric, make a case.

I am against nationalized medical treatment just as I am against nationalized rent control, nationalized grocery distribution, nationalized fishing trips, nationalized plumbing repair, and nationalized babysitting.

For the umpteenth time, Medicaid, Medicare, the VA system, the AINHS (among others) are all government run/controlled/paid medical treatment systems. I would cut off my left nut rather than accept treatment from any of them and you arguing that they should be expanded to cover everyone.

Frankly, the only word to describe that is crazy. :rolleyes::rolleyes::rolleyes:

balrog666

1st April 2008, 07:15 PM

I have no idea about this site's (http://virtualmentor.ama-assn.org/2005/02/pfor2-0502.html) accuracy

OKaaaay...

That seems like a bureaucratic nightmare.

Actually it wasn't.

And all parties had a voice.

And the legislature was limited in it's spendthrift ways.

But the Feds killed it.

And, in my NHO, that was because it might have worked just a little too well and provided a blueprint for both further improvements and as a rational basis for discussion of medical treatments.

SezMe

1st April 2008, 08:32 PM

I am against nationalized medical treatment just as I am against nationalized ...
I am left to conclude that you're ideologically blind to federal government involvement in just about anything (except, I would guess, the military) no matter that other countries may have demonstrated that such involvement improves the lives and satisfaction of the citizenry.

Sad, no?

SezMe

1st April 2008, 08:35 PM

But the Feds killed it.

And, in my NHO, that was because it might have worked just a little too well and provided a blueprint for both further improvements and as a rational basis for discussion of medical treatments.
In this I think you are correct. I think the same is true of the reasoning behind Bush's veto of the SCHIP program. It worked, and, well, we just can't have the feds involved in something that actually works.

volatile

2nd April 2008, 02:34 AM

I am against nationalized medical treatment just as I am against nationalized rent control, nationalized grocery distribution, nationalized fishing trips, nationalized plumbing repair, and nationalized babysitting.

That doesn't sound very sceptical to me. You sound like an evangelical Christian. "It's bad because the bible said so the government sucks."

Let's hear the case. Please. You can't just say "Because" and expect it to be a convincing argument.You still haven't answered the question. For the sixth time, why is the Oregon plan better than a nationalised system in real terms?

Financially, practically or morally, why is your way better than ours? Beyond blind ideology, why is your way the better way?

Stop with the blunt assertion and start making an argument.

Rolfe

2nd April 2008, 06:10 AM

Police, schools, rubbish collection, fire service, road building and repairs....

Oh noes! Must be bad! I insist on my right to buy a piece of road or a fireman or a policeman as and when I need it!

Rolfe.

Architect

2nd April 2008, 07:17 AM

I am against nationalized medical treatment just as I am against nationalized rent control, nationalized grocery distribution, nationalized fishing trips, nationalized plumbing repair, and nationalized babysitting.

But you accept that our nationlised public healthcare system provides population-wide medical cover to standards comparable to the US private system and Medicare/Aid, and at less cost?

Really, if you like being parted from your cash for no benefit then I'll send you my address.

balrog666

2nd April 2008, 11:40 AM

That doesn't sound very sceptical to me. You sound like an evangelical Christian. "It's bad because the bible said so the government sucks."

Let's hear the case. Please. You can't just say "Because" and expect it to be a convincing argument.You still haven't answered the question. For the sixth time, why is the Oregon plan better than a nationalised system in real terms?

Financially, practically or morally, why is your way better than ours? Beyond blind ideology, why is your way the better way?

Stop with the blunt assertion and start making an argument.

You need to learn to read for content. I have not claimed that the Oregon Plan is an alternative to nationalized medical care. I have claimed that the Oregon Plan was an improvement of government provided medical care. Can you tell the difference?

I see no reason to expand lousy coverage (government provided Medicaid, Medicare, et al) to cover people who currently have a better health plan. But at the same time I have no objection to improving that level of care in a rational way; in fact, I insist upon it.

Simply put, fix it before you force everyone into it.

Police, schools, rubbish collection, fire service, road building and repairs....

Oh noes! Must be bad! I insist on my right to buy a piece of road or a fireman or a policeman as and when I need it!

Rolfe.

;)

Private security and investigative services are common here, private garbage collect is extremely common, private and volunteer fire departments are also common, etc. And they are almost always significantly cheaper than similar government provided services (government overhead rates, unions, corruption, politics, bribes, etc. eat up a lot).

But you accept that our nationlised public healthcare system provides population-wide medical cover to standards comparable to the US private system and Medicare/Aid, and at less cost?

Really, if you like being parted from your cash for no benefit then I'll send you my address.

Certainly. I agreed with that previously. I also pointed out that we have 60,000 hospitals here spread out over 10 billion square kilometers. If you recall, my question (paraphrased) was, "What parts of our system are you going to close to bring down our collective cost?" ...

But the facts that your system works for you and that you are happy with it don't mean we can overhaul our entire system similarly without massive costs and significant disruption. And all so that everyone can "enjoy" the Medicaid experience! Git-r-done! :rolleyes:

Rolfe

2nd April 2008, 04:09 PM

I just don't know why you're so convinced that your own country is so incompetently governed. Or if it is, you assume this is irreparable.

Rolfe.

MarkCorrigan

2nd April 2008, 05:11 PM

Hey Jerome, I'd like to put my point in.

The UK healthcare system saved my life. I would not be alive today if I was born in the US, and that is, without shadow of a doubt, absolutely true.

The UK healthcare system you hate so much has given me almost 21 years of life I would not have had if I had been born in the US, because the operation that saved my life was pretty much brand new. My parents, who weren't particularly poor (can you say Middle class managers?) would not have been able to afford any insurance plan that would have covered the op, and it's certain that even if it had paid a small amount, they simply would not have had the cash to pay for the rest of the procedure. Oh, and I'm pretty damn sure the procedure would also have needed transport to the UK, since the op was exclusive to the UK at the time, or so I am led to believe.

The system which sucks so badly moniters me every 2 years (it was every 6 months before my last op) to ensure I'm not is serious danger. So you know what? Screw you, jackass.

volatile

2nd April 2008, 05:21 PM

You need to learn to read for content. I have not claimed that the Oregon Plan is an alternative to nationalized medical care. I have claimed that the Oregon Plan was an improvement of government provided medical care. Can you tell the difference?

Mine is still a valid question. You support the Oregon Plan but find nationalised systems problematic; ergo, you think the Oregon Plan is better than a nationalised system.

So, make the case. For the seventh time, why is the Oregon Plan better than a fully nationalised system?

JEROME DA GNOME

2nd April 2008, 05:44 PM

JEROME DA GNOME

2nd April 2008, 05:51 PM

Hey Jerome, I'd like to put my point in.

So you know what? Screw you, jackass.

http://www.crazycritterlady.com/pictures/donkey.jpg

MarkCorrigan

2nd April 2008, 06:03 PM

Your system is disregarding the principal of survival of the fittest. This is adversely effecting human evolution.

What now?

Are you saying I should have died or something?

(Of course, not only is this a weird (or extremely angry AND weird) statement, it also gets the concept of survival of the fittest wrong. What a shocker.)

balrog666

2nd April 2008, 06:08 PM

I just don't know why you're so convinced that your own country is so incompetently governed. Or if it is, you assume this is irreparable.

Rolfe.

Because I've lived it. And I live it every day.

It is not irreparable. Everything breaks.

But it is not currently fixable under the bureaucratic rules the government has imposed. A couple of years of $100 oil and who knows ...

Mine is still a valid question. You support the Oregon Plan but find nationalised systems problematic; ergo, you think the Oregon Plan is better than a nationalised system.

So, make the case. For the seventh time, why is the Oregon Plan better than a fully nationalised system?

No, your question is not valid. That you refuse to understand why is your problem. Perhaps you should ask your friends for help or, at the very least, make plans to read this entire thread some day. :rolleyes:

Rolfe

2nd April 2008, 06:28 PM

Because I've lived it. And I live it every day.

It is not irreparable. Everything breaks.

But it is not currently fixable under the bureaucratic rules the government has imposed.

You know what? I'd emigrate.

Rolfe.

Rolfe

2nd April 2008, 06:36 PM

What now?

Are you saying I should have died or something?

(Of course, not only is this a weird (or extremely angry AND weird) statement, it also gets the concept of survival of the fittest wrong. What a shocker.)

Jerome has so totally run out of arguments that he has now resorted to posting pure provocation, explicitly designed to "yank chains". I recommend ignoring him.

I earlier posted a link to this similar story about a young life saved by NHS surgery (http://www.theherald.co.uk/news/news/display.var.1982567.0.0.php). I asked Jerome two things. Specifically, what could the allegedly superior US system have done for Abigail that the NHS ("the system that sucks") did not do? And if Abigail had been born in the USA, would she have been guaranteed to get the treatment she actually got (free) from the NHS?

His only response was to criticise the picture of Abigail's mother for showing that she had not bothered to have Hollywood-style cosmetic dentistry performed.

Rolfe.

Rolfe

2nd April 2008, 06:39 PM

jimbob

2nd April 2008, 10:09 PM

As JdG has joined the thread again:

If price controls in one market set the price lower than market value than in another market without price controls the cost will increase to make-up for the loss.

Not if the customers can choose to pay the lower prices, which they do and can, according to evidence poeted earlier...

Jerome, are you going to explain how the price in the northern US is going to rise becase there is a low price in Canada? Given that US citizens are free to travel to Canada and pay their prices.

And back to my other question about the free market pixies:

Why don't you answer for how someone in the US on $7/hr could afford that treatment?

I would like to know

What amount you consider to be affordable for someone on $7/hr?
What the wages of the medics would be, and their connsequent costs?
What the cost of any drugs would be?
What the amortised cost of the capital equipment would be?
What the cost of intensive care would be?
What the cost of food, accomodation and normal care?
What the cost of amortised capital for the hoptial building?
Any proposed profit margin?
Whether this is covered by insurance or not?

Indeed a proper breakdown of the figures that I have given in many places before e.g. here (http://forums.randi.org/showthread.php?postid=3531258#post3531258):

volatile

3rd April 2008, 01:15 AM

No, your question is not valid. That you refuse to understand why is your problem. Perhaps you should ask your friends for help or, at the very least, make plans to read this entire thread some day. :rolleyes:

Of course its valid. It's the only question conducive to further discussion. You said the Oregon Plan was good, I just want you to explain why, and why it's better than the alternative of fully nationalised healthcare.

Please, spell out your case. Why is the Oregon plan so good, and why is it practically, financially and morally better than full healthcare?

Architect

3rd April 2008, 01:22 AM

Survival of the fittest?

I wonder if Jerome had his smallpox and other vaccinations when he was wee?

It's a sure sign that he's lost the argument and, as Rolfe says, just trying to wind us up.

:rolleyes:

Architect

3rd April 2008, 01:24 AM

Of course its valid. It's the only question conducive to further discussion. You said the Oregon Plan was good, I just want you to explain why, and why it's better than the alternative of fully nationalised healthcare.

Please, spell out your case. Why is the Oregon plan so good, and why is it practically, financially and morally better than full healthcare?

As far as I can tell, Balrog's objection is based exclusively on his opinion that the USG couldn't organise the proverbial in a brewery, hence their only option is to go to the other proverbial in a teacup.

I'll say this for him, he's making me feel a lot better about the clowns we have in charge at Westminster (*)

(*) You'll note I didn't say Holyrood. Away the lads!

volatile

3rd April 2008, 01:31 AM

As far as I can tell, Balrog's objection is based exclusively on his opinion that the USG couldn't organise the proverbial in a brewery, hence their only option is to go to the other proverbial in a teacup.

Hmmm... I think it's more complex than that, though of course we won't know unless he stops being coy and actually states his opinions clearly. See his recent "I hate everything nationalised" post - this goes deeper, and I'd like a decent discussion on why he holds the beliefs he does, and how they can be justified in the face of overwhelming evidence that they're not the best way of doing things.

He seems to like this absurdly bureaucratic Oregon plan. I'd like to know why he thinks this is better than full healthcare, and I'd like him to discuss the financial, practical and moral implications of his position. Is that too much to ask?

volatile

3rd April 2008, 01:33 AM

Because I've lived it. And I live it every day.

It is not irreparable. Everything breaks.

But it is not currently fixable under the bureaucratic rules the government has imposed. A couple of years of $100 oil and who knows ...

So you'd like full healthcare but don't think it's feasible to make the change? That's a whole 'nother argument...

Rolfe

3rd April 2008, 01:57 AM

Yes, it's obvious that it would be both politically and logistically difficult for the US to introduce universal healthcare starting from where they are now. I think we could all agree on that. I did start a thread some weeks ago asking how such a move might practically be approached, but although there were some insightful posts, as usual the thread degenerated into assertions that such a move was not only impossible, it was undesirable.

Why is it undesirable? Well, apparently because it's impossible.

You figure. I can't.

Rolfe.

SezMe

3rd April 2008, 02:39 AM

Is that too much to ask?
Yes....and I'm not being facetious. There is a segment of the American populace that simply does not accept that good government has a role to play in the betterment of its citizens lives. I presume the same segment exists elsewhere (in greater or lesser proportions) but correct me if I am wrong. This sentiment was famously expressed by a powerful neocon who said he wanted to shrink the (federal) government down to a size where he could drown it in the bathtub.

To these people, goverment programs, especially on the social side are anathma. It is axiomatic, not something to be explained.

Interestly enough, most of this same segment is patriotic (nationalistic is probably a better word) to excess. Thus, they staunchly defend military spending, which is the most wasteful of all USA goverment spending.

Several pages back, Rolfe asked this same question another way which I've been meaning to respond to so now while I'm jabbering away I'll take a crack at it. Rolfe's question focused on "the commons" and did not Americans recognize its importance. JdG and others of his mindset who think private health care provided by the "free market" is the answer to USA's health care quagmire prompted the question.

I'd say recognition of the value of The Commons and how to maintain it is the defining difference between the left and right in America.

The right values what they might call rugged individualism. "I got a job, why can't those lazy wellfare queens get one" is an extreme expression of this position. It holds that the free marketplace will produce the best solution and that government regulation is in the most part counterproductive. JdG holds this position for health care as you have seen in this thread. Balrog does too but he won't give his position full voice. Other ways this mindset manifests is advocacy for school vouchers (education is not on the commons), rejection of pinko environmentalists (clean air and water aren't on the commons), etc.

The left tends to make the commons explicit and sees government involvement in protecting it as a vital role that it can successfully fulfill if done properly. Early childhood education, universal health care, etc. are seen by this segment as defining elements of the commons and proper areas for the federal government to play a substantial, although not exclusive role.

Anyway, that is my Cliff Notes version of politics in America. Buyer beware.

Architect

3rd April 2008, 03:44 AM

You know, one thing to bear in mind is that the private sector does play a role in state provision of areas such as healthcare.

The Thatcher government market tested a wide range of areas, as a result of which some aspects were outsourced. Many of these have now been brought back in-house because of quality control issues, most notably the railway infrastructure.

Likewise much schools infrastructure is funded by way of PFI/PPP, where the private sector provides the facilities and then recoups its money through lease agreements.

One of the principal problems with these, however, has been the fact that the additional cost to cover private sector profit margins seems to exceed the savings arising from public sector inneficiencies, where they exist. It's just not been as successful. For that reason further private sector involvement is likely to remain limited.

But of course you'd be better asking an economist about this, rather than an architect.

volatile

3rd April 2008, 04:14 AM

An excellent post, SezMe. Really, excellent.

The right values what they might call rugged individualism. "I got a job, why can't those lazy wellfare queens get one" is an extreme expression of this position. It holds that the free marketplace will produce the best solution and that government regulation is in the most part counterproductive.

...which is why I'd like Balrog to explain why the opposite seems to be the case in places with nationalised healthcare systems. As far as I can tell, universal healthcare is a serious challenge to this way of thinking, and I cannot understand why someone on a sceptic's board would not take the time to enunciate the consequences of their viewpoint.

At the moment, all we've got is "The Oregon Plan is better because there's minimal government involvement", which seems like a hugely weak argument in the face of the moral, financial and practical benefits a fully nationalised system seems to have, and because he has yet to fully explain even why government intervention is bad in the first place.

If Balrog thinks government intervention is axiomatically counter-productive, let's hear him explain the anomaly that healthcare provision is cheaper and more successful in countries with nationalised systems. I mean, really, what does "counter-productive" even mean if this really is the case?

SezMe

3rd April 2008, 12:47 PM

You know, one thing to bear in mind is that the private sector does play a role in state provision of areas such as healthcare.
Following on from my briefest description of the left in America I suspect most (but not all) would recognize the important role that the private sector can play in protecting the commons. When both sides (government and industry) are at their best, they would be addressing the question, "How can we best work together to ensure the long-term viability of the commons". Below optimum in the real world, of course, relations are a bit more contentious.

balrog666

3rd April 2008, 12:49 PM

Wow, are you people really so clueless about this? Do you not read my replies at all?

Just for y'all, here it is again.

I supported the Oregon Plan as a reform of Medicaid. That has little to do with nationalizing medical services.

I oppose nationalizing medical service here because we already have government-supplied medical care services (Medicare, Medicaid, INHS, VA, etc) and they stink. In fact, one of you even posted a news story of someone dying from the incompetence and staff indifference in a government-run ER!?

Yes, many of you have a functioning national health care system that is cheaper, in the aggregate, than our current public and private systems combined. So, again, which of our 60,000 hospitals are you going to shut down to reduce costs?

jimbob

3rd April 2008, 12:51 PM

Further to the comments about th ecompetence of British governments compared to the US...

Our governments have been so well organised that they first nationalised the railways, then privatised them (and paid these private railway companise more in subsidies than they paid for British Rail), and then they renationalised the track, in a complete fiasco.

Terminal5? (Labour)

The Milennium Dome (started under Tories, continued under Labour)

Suez (Tories)

DEFRA (Labour)

This contains some really stonking examples, for example the single farm payment, which the Welsh and Scots got OK... In England there was such a delay that some farmers were due to pay tax on money that they hadn't received. Whatever you think about farm subsidies, that has to be a contender for mass cock-up of the decade.

The treatment of the 2001 foot and mouth crisis (no lessons learnt from the 1967 outbreak, which my father was involved with, and his predictions* for the 2001 outbreak were pretty accurate). Also the delay in getting the army involved, when the job (and sorry to Rolfe here) involved a lot of digging trenches and killing things.

There have also been many cockl-ups in NHS IT systems, and despite all this evidence of cockups, the healthcare system is still superior to the US system.

Do the above examples give evidence that we have clowns in power too?

ETA:

*concerning for example the effect of not imposing movement restricytions immediately.

jimbob

3rd April 2008, 12:55 PM

Balrog,

As someone who isn't intimately familiar with the Oregon plan, what were the advantages, and why was it chopped?

Rolfe

3rd April 2008, 02:51 PM

The treatment of the 2001 foot and mouth crisis (no lessons learnt from the 1967 outbreak, which my father was involved with, and his predictions* for the 2001 outbreak were pretty accurate). Also the delay in getting the army involved, when the job (and sorry to Rolfe here) involved a lot of digging trenches and killing things.

Couldn't agree more. If you have a few hours to spare, I could elaborate on that one.

So, our politicians are idiots too. Nothing new there. But even our idiots manage to deliver a healthcare system that actually, well, delivers.

I don't think the US posters really understand what we've got here. This week I happen to be sharing my office with a student, on extra-mural study. He's at the local uni, but he's from Texas. He's been in the country nearly two years.

We got talking about healthcare. He said his father had been asking him how it was going with the "socialised medicine". How were the wait times and so on? Brendan said no problem. He's on medication, and he just registered with a local GP, got an appointment, and got a prescription. No wait. £6.70 or so to pay for the prescription fee. Brendan is pleased that this is now cut to £5 and is to be abolished. He was also able to tell his father about the good general level of service, as opposed to the atypical horror stories that make the papers and get peddled in the States.

Having heard about the healthcare from the inside, Brendan's dad is now well advanced in his plans to move to Scotland. (No, not because of that - he was considering it, for family reasons, but healthcare was one of his worry points. Having had that amply removed, he's going to go for it.)

There seem to be quite a few areas where US people are badly misinformed as regards life outwith their borders. (See that bloody "gun controll" thread for a start.) I think some of them need to get out more.

And realise that even idiot politicians can, if properly kicked where it hurts, get some things right some of the time.

Rolfe.

Architect

3rd April 2008, 03:06 PM

Of course technically, not having paid National Insurance, he's not going to be eligible. But as long as he lives here, he'll get the same treatment as the rest of us.

Rolfe

3rd April 2008, 04:13 PM

Of course technically, not having paid National Insurance, he's not going to be eligible. But as long as he lives here, he'll get the same treatment as the rest of us.

Are you sure? Enlighten me.

I thought that technically National Insurance was what was earmarked for pensions. And that the NHS was paid for out of ordinary taxes. I know this is mere semantics as tax-and-national-insurance are in reality all the same thing. But I did think, technically, National Insurance was my entitlement to my OAP, not my NHS.

I don't really know how NHS entitlement works, but it does seem to be, live here, get treated. My cat-show friend Eleanor has lived in England for a long time, and is now retired in England. But she's Merikan, and while she was working she paid US taxes because her job was with the US embassy in London.

Didn't stop her getting NHS treatment including a knee replacement. I think I know at least one reason she isn't going back to the old country now she's retired.

Rolfe.

MarkCorrigan

3rd April 2008, 05:07 PM

Are you sure? Enlighten me.

I thought that technically National Insurance was what was earmarked for pensions. And that the NHS was paid for out of ordinary taxes. I know this is mere semantics as tax-and-national-insurance are in reality all the same thing. But I did think, technically, National Insurance was my entitlement to my OAP, not my NHS.

I don't really know how NHS entitlement works, but it does seem to be, live here, get treated. My cat-show friend Eleanor has lived in England for a long time, and is now retired in England. But she's Merikan, and while she was working she paid US taxes because her job was with the US embassy in London.

Didn't stop her getting NHS treatment including a knee replacement. I think I know at least one reason she isn't going back to the old country now she's retired.

Rolfe.

You aren't allowed free treatment if you spent a certain period of time (a few months, I believe) out of the country, as this is seen (pretty fairly if you ask me) that you no longer desire to be a British citizen.

balrog666

3rd April 2008, 06:08 PM

Balrog,

As someone who isn't intimately familiar with the Oregon plan, what were the advantages, and why was it chopped?

The Oregon Plan was an attempt to expand the number of people served by the Medicaid health plan in Oregon, improve the medical services provided, and streamline the bureaucratic controls imposed in authorizing services. The Plan used input from doctors, patients, and insurance companies, including the cost of specific services, their immediate efficacy and long-term quality-of-life outcomes, to prioritize services for which the state would pay.

The planners reasoned that instead of rationing medical care by excluding certain members of the population from having any access, they could provide better care to more people by rationing care according to a priority list of services, an arguably better use of the dollars spent.

At the time, the plan was controversial, confrontational, and quite revolutionary. It was a radical stab at the one-size-fits-all-healthcare-model currently mandated by directing the dollars to be spent where they were most efficacious as determined by all parties involved. I discussed some other benefits of the Oregon Plan previously but they are mostly by-products allowing greater transparency in the legislative process.

Anyway, the Feds sued in court to require their own standards be used at all times by all parties at all times. And the Feds won in court. They haven't changed any minds but experimentation, or reform, is essentially dead in all states.

The Oregon Plan is still debated today as the most obvious method of mini-max optimization of fixed resources for application to health care.

___________________________________________

Oh, and among other things I am reminded of this post Post #676 (http://forums.randi.org/showpost.php?p=3512405&postcount=676)

I would hope it clear to everyone that when you say "nationalized heath care", while you may think "NHS", we think "Medicaid". ;)

SezMe

3rd April 2008, 08:20 PM

I would hope it clear to everyone that when you say "nationalized heath care", while you may think "NHS", we think "Medicaid". ;)
Speak for yourself. I do not. Would you care to defne the group that thinks this way?

jimbob

3rd April 2008, 09:55 PM

I just want to add that Idon't just of the NHS; the French, Canadian, German, Kiwi, and Australian systems are also better than the US systems, and some of them might be more appropriate for the US.

The main advantage of the NHS is that it is cheap.

If you are talking about whether a system can cover large, sparsely-populated areas, then Canada shows that it can be done.

Architect

4th April 2008, 03:28 AM

In all fairness, the French system is better than ours.

Darat

4th April 2008, 03:44 AM

I'll just add another voice to the "We know the NHS is not perfect!" brigade. There are lots of things it doesn't do as well as it could and should, however in overall terms it provides an excellent level of treatment and care at a cost that is below systems that provide comparable levels of treatment and coverage.

Rolfe

4th April 2008, 08:07 AM

Could I reopen the National Insurance question?

I understood that these contributions were (theoretically) to fund the Old Age Pension, and the the NHS is funded from general taxation. Am I correct, or is Architect?

Rolfe.

Architect

4th April 2008, 09:23 AM

That's a question I never thought of, rather having just assumed.

Certainly the Direvt Gov web site notes:

You pay National Insurance contributions (NICs) to build up your entitlement to certain social security benefits, including the State Pension. The type and level of NIC you pay depends on how much you earn and whether you're employed or self employed. You stop paying NICs when you reach State Pension age.

CAB note:

National insurance is a kind of government insurance system which helps to pay for benefits which you get when, for example, you're sick. It also helps to pay for your State Retirement Pension.

NHS England note:

Are you visiting the United Kingdom? Have you been living outside the UK for more than 3 months? Did you know that you may have to pay for hospital treatment whilst here? Hospital treatment is free to people who ordinarily live in the United Kingdom (UK). If you do not normally live here then you may be required to pay for any treatment you might need. This is regardless of whether you are a British citizen or have lived or worked here in the past.

jimbob

4th April 2008, 09:27 AM

Architect, is that incapacity benefit, as opposed to healthcare?

balrog666

4th April 2008, 09:31 AM

Speak for yourself. I do not. Would you care to defne the group that thinks this way?

Gee, I would think that that would be practically anyone who has ever depended on Medicaid. Or the VA. Or the INHS. Or ...

Architect

4th April 2008, 09:35 AM

Architect, isn't that incapacity benefit, as opposed to healthcare?

I think I'm now agreeing with Rolfe. You merely have to live here for a period of at least 3 months in order to become eligible for free NHS treatment.

So you don't even need to be a taxpayer! Even better!!

Rolfe

4th April 2008, 10:26 AM

I think the NHS used just to treat anyone who walked in the door because it was cheaper than checking everyone's entitlement. However there has been a bit of health tourism going on, with people coming here expressly to access free healthcare, and they have been clamping down a bit. I think it's a residency thing, not tax-paying, because how otherwise would children and other dependents by treated? That would get very messy very quickly.

However, if I want to claim any subsistence benefits such as my OAP or invalidity benefit or whatever, I'm pretty sure my NI contribution record will be scrutinised closely.

Rolfe.

volatile

5th April 2008, 03:30 AM

I supported the Oregon Plan as a reform of Medicaid. That has little to do with nationalizing medical services.

But - you think the Oregon plan is good and you think nationalised systems are bad. Ergo, the Oregon Plan is, in your opinion, better than nationalised systems.

You still haven't said why that is the case with reference to any useful metric - financially, practically and morally. That's why we keep asking you the question. So please, do a comparison. Why is the Oregon Plan better than the British NHS?

Yes, many of you have a functioning national health care system that is cheaper, in the aggregate, than our current public and private systems combined. So, again, which of our 60,000 hospitals are you going to shut down to reduce costs?That's a question of the transition, not the benefits of actually having a nationalised systems in the first place. The experience of other countries shows cheap and effective nationalised systems can be developed, and yet you seem to be against one for the US in principle and not just because it would be practically difficult to implement.

And you still haven't explained honestly why you're against these systems in principle. You've been shown they are not more expensive than the US-type modes, you've been shown they produce broad and deep cover relatively effectively and you've been shown they produce qualitative better healthcare outcomes. So we'd all really like to hear what your problem with them is.

If it is, as SezMe surmised, an axiomatic distaste of government, perhaps you'd like to justify why an ideological commitment to individualism trumps cheaper, more effective healthcare for everyone. As Architects pointed out, you seem to be willing to pay more taxes just to avoid getting a government-run healthcare system. This is really odd, and needs some cogent and coherent arguments from you to defend it.

I know you think you're making an argument, but you're not. You're vague, imprecise and non-committal. You've doggedly avoided putting the weight of an argument behind your positions. Please do so now.

volatile

5th April 2008, 03:33 AM

Gee, I would think that that would be practically anyone who has ever depended on Medicaid. Or the VA. Or the INHS. Or ...

But those aren't nationalised healthcare.

jimbob

5th April 2008, 04:18 AM

Fourther to the people who say that the US geography works against some form of universal healthcareprovision.

Canada shows it can be done for large, sparsely-populated areas; the EU as a whole shows that it can be done for large populations, with varying population density and with a myriad of different systems.

Architect

5th April 2008, 08:13 AM

Presumably the Scandahooligans manage.

balrog666

5th April 2008, 10:04 AM

But - you think the Oregon plan is good and you think nationalised systems are bad. Ergo, the Oregon Plan is, in your opinion, better than nationalised systems.

You still haven't said why that is the case with reference to any useful metric - financially, practically and morally. That's why we keep asking you the question. So please, do a comparison. Why is the Oregon Plan better than the British NHS?

Well, gosh, thanks for putting your words in my mouth yet again.

FYI, I think the Oregon Plan provides an improvement of Medicaid. For the hard-of-thinking, that doesn't mean it is good per se or that there are no other alternatives but nationalization and central control of medical services.

That's a question of the transition, not the benefits of actually having a nationalised systems in the first place.

Benefits? Restricting medical services to achieve lower costs is a benefit? Having more government bureaucrats instead of doctors and patients making medical decisions is a benefit? Who knew?

[SNIP, SNIP, SNIPPITY-SNIP]

I know you think you're making an argument, but you're not. You're vague, imprecise and non-committal. You've doggedly avoided putting the weight of an argument behind your positions. Please do so now.

Well, gee, buddy, want to answer my questions before I choose to disrupt 15% of our economy and potentially throw a million people out of work to achieve some vague, nebulous goal (of yours)?

Which of our 60,000 hospitals will you close down to bring down costs?
Which of our 800,000 doctors and 2.5 million nurses will have to take a huge pay cut to reduce costs?
For the that matter, do you really want to deal with nurses, lab workers, and technicians as public employee unions?
Oh, and will you require that acupuncture be covered?
How about chiropractic manipulation?
Reiki healing?
Homeopathic remedies?
Mental health treatment for teenage angst?
And where do you draw the line on treatment for illegal aliens?

I can come up with a few hundred more if you like.

volatile

5th April 2008, 10:19 AM

Well, gosh, thanks for putting your words in my mouth yet again.

Words in your mouth?

You are advocating the Oregon Plan. Thus you think it is good. You are denigrating nationalised systems, thus you think they are bad. Given that both the Oregon Plan and nationalised healthcare are solutions to the same problem, it necessarily follows that you can provide a cost/benefit analysis of the two showing why the Oregon Plan is better.

You still haven't done so.

FYI, I think the Oregon Plan provides an improvement of Medicaid. For the hard-of-thinking, that doesn't mean it is good per se or that there are no other alternatives but nationalization and central control of medical services.That's all well and good, but peripheral to the issue. As above, you obviously think the Oregon Plan is better than a nationalised system, even if it isn't perfect.

If you now want to make the claim that there are better alternatives, you still need to show your working as to why they are practically, financially or morally superior to nationalised healthcare. You're still not making an argument, you're simply hand-waving.

What is your solution to the problem of healthcare provision, and why is it better than a nationalised system. I'm getting tired of repeatedly asking you this.

Benefits? Restricting medical services to achieve lower costs is a benefit? Having more government bureaucrats instead of doctors and patients making medical decisions is a benefit? Who knew?Do you think medical decisions in nationalised systems are made by "government bureaucrats"? They certainly aren't. Indeed, if your characterisation of the Oregon Plan is correct, it seems that there is bureaucratic override to medical practice made in advance - this whole idea of listing illnesses and treatments by some bureaucratically arbitrary order of merit in advance is actually more unwieldy and features more intervention than the alternative fully nationalised system where all patients are treated according to need. I'm willing to be convinced otherwise, but just trying to pretend this is self-evident when it clearly isn't does not a powerful argument make.

In terms of costs, it has been demonstrated that nationalised systems actually cost less than private ones do, so why you think this will lower costs below the levels demonstrably achievable by nationalised systems is beyond me. The evidence is in. The tests are done. We pay less and get more.

[SNIP, SNIP, SNIPPITY-SNIP]

Disappointing, because you've actually snipped out the questions you need to answer if anyone is ever going to be convinced you're right.

I'll post them again. Why are answers to straightforward questions so hard for you to provide?

"And you still haven't explained honestly why you're against these systems in principle. You've been shown they are not more expensive than the US-type modes, you've been shown they produce broad and deep cover relatively effectively and you've been shown they produce qualitative better healthcare outcomes. So we'd all really like to hear what your problem with them is.

If it is, as SezMe surmised, an axiomatic distaste of government, perhaps you'd like to justify why an ideological commitment to individualism trumps cheaper, more effective healthcare for everyone. As Architects pointed out, you seem to be willing to pay more taxes just to avoid getting a government-run healthcare system. This is really odd, and needs some cogent and coherent arguments from you to defend it."

Well, gee, buddy, want to answer my questions before I choose to disrupt 15% of our economy and potentially throw a million people out of work to achieve some vague, nebulous goal (of yours)?Your questions seem to imply that this experiment hasn't been done. It has. Canada and the UK both have nationalised systems and cost less to administer and run than the current, shoddy US system. So it is manifestly and demonstrably true that nationalised systems do not cost more than private or quasi-private ones do.

Why is that so hard to understand? You seem to be beholden to the idea that nationalised systems cost more than private ones do, when the experience of other countries proves your weird free-market axiom to be untenable.

balrog666

5th April 2008, 10:19 AM

But those aren't nationalised healthcare.

They are government owned, controlled, and/or paid for.

I don't know how your health care systems worked before nationalization but here most (medical service) doctors are not just employees. They, individually and in groups, tend to own their own medical corporations, clinics, surgery centers, labs, MRI facilities, etc.

Outright nationalization here will mean seizing both the private property and livelihoods of hundreds of thousands of individuals, corporations, and investors. That's not going to make any of them very happy (except the ones who are already failures).

If you look at what the current crop of idiots, ah, I mean presidential candidates, are proposing, even in their political double-speak, it isn't anything close to nationalization. Nor are they even proposing to eliminate business-supplied health insurance as a middleman (gee, I guess you can't exclude the cash cow from your plan, huh?).

volatile

5th April 2008, 10:27 AM

They are government owned, controlled, and/or paid for.

So? You said when people hear "nationalised", they think "Medicaid". That's not true, because Medicaid is not nationalised healthcare.

I don't know how your health care systems worked before nationalization but here most (medical service) doctors are not just employees. They, individually and in groups, tend to own their own medical corporations, clinics, surgery centers, labs, MRI facilities, etc.

Outright nationalization here will mean seizing both the private property and livelihoods of hundreds of thousands of individuals, corporations, and investors. That's not going to make any of them very happy (except the ones who are already failures).

If you look at what the current crop of idiots, ah, I mean presidential candidates, are proposing, even in their political double-speak, it isn't anything close to nationalization. Nor are they even proposing to eliminate business-supplied health insurance as a middleman (gee, I guess you can't exclude the cash cow from your plan, huh?).OK, so we're back to the problems of implementation. I agree, it'll be problematic. No-one has ever disputed that. But I'm sure it is possible - Rolfe said she's posted some ideas in another thread, for example. But the "How" of the transition is, for the time being, peripheral to the "Why" of cost/benefit analysis. If you simply refuse to enact change because change is complicated, then you'll never progress as a nation ever again.

Yes. Implementing a national health system in the US will be complicated, politically fraught and probably quite expensive in the first instance. It won't involve "seizing" so much as "buying", like any other nationalisation programme. It won't involve the total expurgation of private companies from healthcare provision. It won't remove medical autonomy or divert control from individual doctors, hospitals or healthcare trusts. Nationalised healthcare systems are not run or administered by central government, contrary to your rabid libertarian paranoia. Nevertheless, yes, implementation will be difficult.

Your argument is deeper, though. You're against nationalised systems in principle. Why?

balrog666

5th April 2008, 10:34 AM

Words in your mouth?

You are advocating the Oregon Plan. Thus you think it is good. You are denigrating nationalised systems, thus you think they are bad. Given that both the Oregon Plan and nationalised healthcare are solutions to the same problem, it necessarily follows that you can provide a cost/benefit analysis of the two.

Not at all. The Oregon Plan was introduced as attempt to force the scientific method, statistical analysis, and simple economics into publicly financed health care. I am all for that. Whether that would have produced other improvements is unknown, but I certainly considered it likely. Too bad it's a dead issue.

National health care systems are not a solution to the same problem in any sense of the word nor do I necessarily consider them bad. Perhaps this is where you keep getting confused.

volatile

5th April 2008, 10:41 AM

Not at all. The Oregon Plan was introduced as attempt to force the scientific method, statistical analysis, and simple economics into publicly financed health care. I am all for that. Whether that would have produced other improvements is unknown, but I certainly considered it likely. Too bad it's a dead issue.

It looked like a bureaucratic nightmare in which medical opinion on individual cases was overridden by an arbitrarily drawn-up, economically motivated and bureaucratically overseen list of conditions and their appropriate treatments.

Why is that better than the UK system, where the patient is (virtually) always and automatically treated according to their physician's estimation of the patient's requirements?

National health care systems are not a solution to the same problem in any sense of the wordErrrm. Yes they are (and I noticed you skipped the principal and practical question again!!!!!).

Problem: Sick people.
Solution A: Nationalised Healthcare
Solution B: The Oregon Plan.

Now, this is not a dichotomy and I'm all for seeing what you think the best solution is but you're not saying. That's the whole problem with this "discussion", such that it is. You're stubbornly refusing to put your cards on the table and actually make a case. What is your solution to the generic problem of public health, and why is it better than the nationalised systems you denigrate so much?

Please, for the love of Ed, make a damn argument. It wouldn't hurt you, would it?

I've been asking the same questions of your for pages now. Just answer them!

Architect

5th April 2008, 12:51 PM

They are government owned, controlled, and/or paid for.

I don't know how your health care systems worked before nationalization but here most (medical service) doctors are not just employees. They, individually and in groups, tend to own their own medical corporations, clinics, surgery centers, labs, MRI facilities, etc.

Outright nationalization here will mean seizing both the private property and livelihoods of hundreds of thousands of individuals, corporations, and investors. That's not going to make any of them very happy (except the ones who are already failures).

Well, surely the answer to that is - for example - that one might retain the private infrastructure but create a publicly funded national insurance system which went to the market for the services, but on the basis (say) of competitive tender under a framework agreement. That would ensure value for money as well as a private sector profit margin.

Of course that's a gross simplification, and no more than floating an idea, but I do it to show that there's a risk of creating a false dichotemy (sp?) here.

Fiona

5th April 2008, 01:04 PM

The medical establishment in the UK opposed the NHS concept. This objection was met by"stuffing their mouths with gold". It worked

jimbob

5th April 2008, 01:06 PM

Indeed Fiona, I imagine that there would have been similar problems anywhere where such a system was set up.

Architect

5th April 2008, 01:11 PM

In all fairness I suspect that the intervening 60-odd years have seen a major scaling of the problem, however that is not to say that there isn't a medium term strategy which would tackle the problem.

Incidentally have you seen how much it apparently costs to study medicine in the States? Daylight bloody robbery, no wonder they have to earn a wad afterwards.....

Rolfe

5th April 2008, 03:43 PM

So, again, which of our 60,000 hospitals are you going to shut down to reduce costs?

Which of our 60,000 hospitals will you close down to bring down costs?
Which of our 800,000 doctors and 2.5 million nurses will have to take a huge pay cut to reduce costs?
For the that matter, do you really want to deal with nurses, lab workers, and technicians as public employee unions?
Oh, and will you require that acupuncture be covered?
How about chiropractic manipulation?
Reiki healing?
Homeopathic remedies?
Mental health treatment for teenage angst?
And where do you draw the line on treatment for illegal aliens?

I had a reply to this all written and lost it. Moral of the story, stop keying control-R when you mean to key shift-R at the end of a post. In the mean time, Volatile seems to have said much of what I was going to.

To address the question. "When did you stop beating your wife?"

Why would you assume "I" would close any of your 60,000 hospitals? Yes, you may seem to have excess capacity at the moment, but that appears to be mainly because many people who need treatment aren't getting it. If these people were to receive the treatment they need, I'm betting all 60,000 hospitals would be entirely necessary.

Why assume that any savings necessary would be made by cutting front-line services? I'll tell you what I'd cut. I'd cut the departments that decide who is and who isn't eligible to be treated by this or that system. I'd cut the insurance companies. I'd cut the invoicing departments, that bill every patient for every last cotton-wool swab or hypodermic needle. Quite a saving to be made there I reckon.

Oh, I'm conflating public and private healthcare here. Yes, and that's legitimate. If you had universal healthcare, then nobody would have to pay insurance premiums or medical bills. That money becomes free and may be routed back into the system if that is determined as the way to go.

Why do you assume anyone involved in front-line healthcare would have a pay cut? As Fiona pointed out, the way it was made to work in Britain was by ensuring that doctors were paid well, and that they were also free to run private practices alongside their NHS work. As a result, these guys tend to have more money than God. I know a few of them. Had a lovely weekend sailing on the Clyde in a private yacht belonging to an old school friend (a GP) and her husband (an NHS consultant). G'Kar, I think you speak of things you do not understand.

Why do you assume medical services would be restricted? On the contrary, many many more people would have access. But even as regards people with good cover now, why do you assume that these people would be less well served? The more I hear about the US system, the less I believe this myth that is is "the best in the world" for those with money. I've yet to hear of anything anyone has got in the US system that they would have been denied on the NHS, apart from a private room. And the NHS is probably the cheapest of the universal systems. Remember Abigail? (http://www.theherald.co.uk/news/news/display.var.1982567.0.0.php) In what way was her care "restricted"?

Why do you continually rail against government deciding on what care an individual gets, but we hear nothing of the problem of insurance companies deciding what care an individual gets? And that one's another straw man anyway. In the NHS, your doctor decides what treatment you need.

Why do you assume there would be more administration? For sure, healthcare administrators need regular culling and kicking in any society, but they do not blossom disproportionately in universal systems. On the contrary, the absence of any need to prove entitlement, the absence of any need to calculate and administer bills, and the absence of any need for individuals to make prior provision for healthcare costs reduces the amount of unproductive bureaucracy markedly.

Indeed, it is likely that many of the people involved in insurance sales and administration, in hospital invoicing and almoning departments and so on, might have to find other gainful employment. So what? The world moves on. Not much call for cart-wheel repairmen either these days. Should we have refused to move on from horsedrawn carts in order to save their jobs? I thought the USA was one of the most ruthless countries in the world when it came to getting rid of obsolete freeloaders!

And as for coverage of looney-tunes treatments. I'd advise against it. But hey, it's usually a democratic decision. Which is why we're lumbered with some of that nonsense.

And do you really think no other country has yet had to figure out what to do about illegal aliens?

But you're simply back to logistics. You sound like some unionists I've met, who, faced with absolutely no rational argument against Scottish independence, start reeling off a list of practical difficulties. Nobody said it would be straightforward. Nobody is dictating how it would have to be done either. We merely point out that there are a variety of systems up and running in various countries, and we would have thought it wasn't beyond the wit of the country that likes to think of itself as the greatest in the world to work something out.

This argument is getting awfully circular.

The rest of the world: USA, wouldn't you be better off with a system of universal healthcare?

G'Kar: Medicaid is a shambles, why would I want more of that?

The rest of the world: But that's not what we were suggesting. Everybody else of your level of technological development and civilisation seems to manage it, so it's not impossible.

G'Kar: It's impossible here. Our politicians are so uniquely incompetent that it could never work.

The rest of the world: We think you're being a bit over-pessimistic here. But tell us, don't you think that, in principle, a well-run universal healthcare system which costs no more than you currently spend but delivers good-quality care to all your citizens would be a good thing?

G'Kar: No. Medicaid is a shambles so why would I want more of it?

Quite a short repeat loop, it seems.

G'Kar, could you answer Volatile's questions? When Jerome is around you may seem like a model of sense by comparison, but when he's not here you do just revert to his methods - dogmatic statements, apparently ill-thought-through, which you then refuse to explain.

And here's my single question, for now. Imagine a system of universal healthcare, which covered everyone living in your country, which was delivered efficiently, was of high quality, and which cost no more than the country spends on healthcare at the moment.

Do you think that would be a good thing, or not?

Rolfe.

jimbob

5th April 2008, 04:09 PM

Why do you assume medical services would be restricted? On the contrary, many many more people would have access. But even as regards people with good cover now, why do you assume that these people would be less well served? The more I hear about the US system, the less I believe this myth that is is "the best in the world" for those with money. I've yet to hear of anything anyone has got in the US system that they would have been denied on the NHS, apart from a private room. And the NHS is probably the cheapest of the universal systems. Remember Abigail? (http://www.theherald.co.uk/news/news/display.var.1982567.0.0.php) In what way was her care "restricted"?

Or another poster on this thread:

Hey Jerome, I'd like to put my point in.

The UK healthcare system saved my life. I would not be alive today if I was born in the US, and that is, without shadow of a doubt, absolutely true.

The UK healthcare system you hate so much has given me almost 21 years of life I would not have had if I had been born in the US, because the operation that saved my life was pretty much brand new. My parents, who weren't particularly poor (can you say Middle class managers?) would not have been able to afford any insurance plan that would have covered the op, and it's certain that even if it had paid a small amount, they simply would not have had the cash to pay for the rest of the procedure. Oh, and I'm pretty damn sure the procedure would also have needed transport to the UK, since the op was exclusive to the UK at the time, or so I am led to believe.

The system which sucks so badly moniters me every 2 years (it was every 6 months before my last op) to ensure I'm not is serious danger. So you know what? Screw you, jackass.