Deprecated: preg_replace(): The /e modifier is deprecated, use preg_replace_callback instead in /home/public/Sources/Load.php(225) : runtime-created function on line 3
Healthcare Squabbles
I Read This
July 17, 2018, 07:35:43 EDT *
Welcome, Guest. Please login or register.

Login with username, password and session length
News: If you have any issues at all, visit our support site.
 
   Home   Help Search Calendar Login Register  
Pages: [1] 2
  Print  
Author Topic: Healthcare Squabbles  (Read 5123 times)
wodan46
Pundit
****
Offline Offline

Posts: 1469


« on: July 21, 2009, 22:53:05 EDT »

Is it just me, or is the primary force behind Republican opposition to the various pieces of healthcare legislation not whether it would work or not, but that if they shoot down the plan, they will make Obama look bad by killing one of his policy centerpieces, allowing them to do in 2010 what they did previously in 1994?  They seem to have no real concern over trying to fix or overhaul the plan, their sole concern seems to be to shoot it down to earn political points, even if doing so results in nothing happening and problems remaining unsolved.  Typical.  The Republicans don't have the slightest interest in bipartisanship, its either their way or the highway, and if they can't have it their way, then no one else will either.

That said, healthcare specifics are incomprehensible to me as a whole.  All I know is that currently the government spends 0.7 trillion on healthcare and the public 1.0 trillion more, while if you go by the cost per person for France, we would be paying a flat 1.0 trillion or so, and get better care.  Their waiting lists aren't particularly bad and aren't a concern at all for their most immediate care, and that chronic diseases would not be covered by the public systems but only by private groups is unsurprising.  As for us, its pretty obvious that Health Insurance Companies desire to make a profit drains money that should be spent on healthcare, that people getting sicker and unproductive when they are denied the insurance would drain money, and that people being more costly to treat, and with tax-payer dollars no less, because they got sicker and ended up in the emergency room would also drain money.  3 drains, and all of them a product of for-profit healthcare.

The specific quote that provoked this is a Republican Senator stating "If we're able to stop Obama on this, it will be his Waterloo. It will break him."
« Last Edit: July 22, 2009, 15:02:33 EDT by wodan46 » Logged

The plural of "anecdote" is "anecdotes". Not "data".
Medivh
Pundit
****
Offline Offline

Posts: 3466


Power-mad elf


« Reply #1 on: July 23, 2009, 00:43:03 EDT »

See, that's the kind of thing you can use to gut the Republican support base if you know what you're doing. A lot of people have been convinced that the Republican platform is in their self-interest, or will be in the near future.

A series of commercials, outside of election times, pointing out what a crock the Republican party is, using their own words, might shift opinions in a significant way. Unfortunately, if this works, you have a one party system for a while. At this point, it would be fairly easy to convince pretty much everyone that the voting system needs an overhaul. Especially the remaining Republican voters.

And if that happens, the political backing behind the religious right collapses. Which would be awesome.
Logged

And if i catch you comin' back my way
I'm gonna serve it to you
And that ain't what you want to hear
But that's what I'll do
-- "Seven Nation Army", The White Stripes

So what you're telling me is that LTV's fudge factor means more than it's independent variable?
Yes...
Current
Pundit
****
Offline Offline

Posts: 3141


« Reply #2 on: July 24, 2009, 12:57:11 EDT »

How is it though that the US is going to copy France's healthcare industry?  This is what I would like to know.
Logged
wodan46
Pundit
****
Offline Offline

Posts: 1469


« Reply #3 on: July 24, 2009, 19:55:38 EDT »

How is it though that the US is going to copy France's healthcare industry?  This is what I would like to know.
By taking steps.  Sitting on our asses will solve nothing, as will trying to shift the whole system overnight.  You have to start somewhere.
Logged

The plural of "anecdote" is "anecdotes". Not "data".
Current
Pundit
****
Offline Offline

Posts: 3141


« Reply #4 on: July 25, 2009, 08:15:12 EDT »

What though makes you think that this is a step in the right direction?
Logged
Medivh
Pundit
****
Offline Offline

Posts: 3466


Power-mad elf


« Reply #5 on: July 25, 2009, 09:21:29 EDT »

1) France pays roughly half of what the US does for health care per capita. Less government spending is a good thing.
2) France's health care system is rated higher in all areas than the US's, from life expectancy to infant mortality to customer happiness. Better outcomes from a system are a good thing.

Downsides seem to be that there are fewer people employed in the insurance industry. I can't think of another realistic downside, but feel free to jump in.

EDIT: Forgot "per capita".
« Last Edit: July 25, 2009, 11:01:04 EDT by Medivh » Logged

And if i catch you comin' back my way
I'm gonna serve it to you
And that ain't what you want to hear
But that's what I'll do
-- "Seven Nation Army", The White Stripes

So what you're telling me is that LTV's fudge factor means more than it's independent variable?
Yes...
Current
Pundit
****
Offline Offline

Posts: 3141


« Reply #6 on: July 26, 2009, 14:28:19 EDT »

But how will this healthcare legislation bring things closer to the French state of affairs?
Logged
Medivh
Pundit
****
Offline Offline

Posts: 3466


Power-mad elf


« Reply #7 on: July 26, 2009, 23:10:05 EDT »

That is a different question entirely. Not having looked at the legislation in question, I have no idea. But, I'd estimate that there's only one way to make a health care system worse than the US has done, and that's to provide no safety net. Thus, any move that doesn't abolish medicare is a good one.
Logged

And if i catch you comin' back my way
I'm gonna serve it to you
And that ain't what you want to hear
But that's what I'll do
-- "Seven Nation Army", The White Stripes

So what you're telling me is that LTV's fudge factor means more than it's independent variable?
Yes...
Current
Pundit
****
Offline Offline

Posts: 3141


« Reply #8 on: July 27, 2009, 12:53:07 EDT »

That is a different question entirely. Not having looked at the legislation in question, I have no idea. But, I'd estimate that there's only one way to make a health care system worse than the US has done, and that's to provide no safety net. Thus, any move that doesn't abolish medicare is a good one.
Although the results of comparisons vary in some Britain and Ireland healthcare performs worse than the US.

Besides, it is by no means certain that *any* change to the US healthcare industry will improve it's performance.  I think it's far to simplistic to say that "any change that doesn't abolish medicare is a good one".  What about screwing up the rest of the industry?
Logged
Medivh
Pundit
****
Offline Offline

Posts: 3466


Power-mad elf


« Reply #9 on: July 27, 2009, 23:29:11 EDT »

That is a different question entirely. Not having looked at the legislation in question, I have no idea. But, I'd estimate that there's only one way to make a health care system worse than the US has done, and that's to provide no safety net. Thus, any move that doesn't abolish medicare is a good one.
Although the results of comparisons vary in some Britain and Ireland healthcare performs worse than the US.

From the point of view of customer satisfaction, this is pure misinformation.

Two indicators of healthcare outcomes, infant mortality rate and life expectancy are much better in the UK than in the US. This puts your statement squarely in the "pure misinformation" column from the point of view of the actual work of the system too.

Besides, it is by no means certain that *any* change to the US healthcare industry will improve it's performance.  I think it's far to simplistic to say that "any change that doesn't abolish medicare is a good one".  What about screwing up the rest of the industry?

Who cares about the industry? Healthcare is not something you want to be measuring in dollars. And there aren't many things that the legislative branch of the US can do about healthcare right now. Expanding medicare is one. Destroying it is another. Setting up a new medicare-type organisation is pretty much the last thing that they can do.

Oh, I'm sure that they could nationalise the industry. If they didn't want to get re-elected for 20 years...
Logged

And if i catch you comin' back my way
I'm gonna serve it to you
And that ain't what you want to hear
But that's what I'll do
-- "Seven Nation Army", The White Stripes

So what you're telling me is that LTV's fudge factor means more than it's independent variable?
Yes...
Current
Pundit
****
Offline Offline

Posts: 3141


« Reply #10 on: July 29, 2009, 10:22:27 EDT »

That is a different question entirely. Not having looked at the legislation in question, I have no idea. But, I'd estimate that there's only one way to make a health care system worse than the US has done, and that's to provide no safety net. Thus, any move that doesn't abolish medicare is a good one.
Although the results of comparisons vary in some Britain and Ireland healthcare performs worse than the US.

From the point of view of customer satisfaction, this is pure misinformation.
I agree that customer satisfaction may be greater.  I'm not convinced though that customers are well informed.

Two indicators of healthcare outcomes, infant mortality rate and life expectancy are much better in the UK than in the US. This puts your statement squarely in the "pure misinformation" column from the point of view of the actual work of the system too.
Infant mortality in the US is heavily influenced by immigration, it is a poor measure.

Life expectancy is also a poor measure.  There are many other influences apart from healthcare on length of life.  As a recent study said
Quote from: Preston and Hu
But measures of population health such as life expectancy do not depend only on what transpires within the health care system-- the array of hospitals, doctors and other health care professionals, the technologies they employ, and the institutions that govern access to and utilization of them. Such measures also depend upon a variety of personal features that affect an individual’s health such as diet, exercise, cigarette smoking, and compliance with medical protocols. The health care system could be performing exceptionally well in identifying and administering treatment for various diseases, but a country could still have poor measured health if personal health care practices were unusually deleterious. This is not a remote possibility in the United States, which had the highest level of cigarette consumption per capita in the developed world over a 50-year period ending in 1985 (Forey et al. 2002). Smoking in early life has left an imprint on mortality patterns that remains visible as cohorts age (Preston and Wang 2006). Recent trends in obesity are also more adverse in the United States than in most other developed countries (OECD, 2008; Cutler, Glaeser, and Shapiro 2003).

What would be a better comparison is to take some diseases that occur fairly evenly across the developed world and to compare how healthcare systems respond to them.  This is what Preston & Ho do in their paper.  On this sort of measure the US performs very well, better than european systems.

Besides, it is by no means certain that *any* change to the US healthcare industry will improve it's performance.  I think it's far to simplistic to say that "any change that doesn't abolish medicare is a good one".  What about screwing up the rest of the industry?

Who cares about the industry? Healthcare is not something you want to be measuring in dollars. And there aren't many things that the legislative branch of the US can do about healthcare right now. Expanding medicare is one. Destroying it is another. Setting up a new medicare-type organisation is pretty much the last thing that they can do.
Would expanding Medicare improve things in the long term though?  Medicare's structure is not similar to the more successful of the nationalised health systems in other countries.

Insuring the uninsured is good for votes and of course it is beneficial to the uninsured.  However, I don't see any evidence that what is being proposed will help in the long term.
Logged
Medivh
Pundit
****
Offline Offline

Posts: 3466


Power-mad elf


« Reply #11 on: July 30, 2009, 00:34:39 EDT »

That is a different question entirely. Not having looked at the legislation in question, I have no idea. But, I'd estimate that there's only one way to make a health care system worse than the US has done, and that's to provide no safety net. Thus, any move that doesn't abolish medicare is a good one.
Although the results of comparisons vary in some Britain and Ireland healthcare performs worse than the US.

From the point of view of customer satisfaction, this is pure misinformation.
I agree that customer satisfaction may be greater.  I'm not convinced though that customers are well informed.

Well informed or not is largely irrelevant. As much as the brits complain about the NHS, most people who go from NHS to the US "system" want the NHS back quick-smart.

Unfortunately, healthcare is one of those things that gets bad press or none. The best that anyone doing PR for a healthcare system can hope for is for everyone to forget that healthcare exists. Except the politicians funding it. Even then...

Two indicators of healthcare outcomes, infant mortality rate and life expectancy are much better in the UK than in the US. This puts your statement squarely in the "pure misinformation" column from the point of view of the actual work of the system too.
Infant mortality in the US is heavily influenced by immigration, it is a poor measure.

If infant mortality in the US is heavily influenced by immigration, then the UK is more affected, being in that the main statistic driving UK population growth right now is immigration. Thus the US having the worse statistic for infant mortality means the US is doing a worse job. Much worse, if your statement is correct.

Life expectancy is also a poor measure.  There are many other influences apart from healthcare on length of life.  As a recent study said
Quote from: Preston and Hu
But measures of population health such as life expectancy do not depend only on what transpires within the health care system-- the array of hospitals, doctors and other health care professionals, the technologies they employ, and the institutions that govern access to and utilization of them. Such measures also depend upon a variety of personal features that affect an individual’s health such as diet, exercise, cigarette smoking, and compliance with medical protocols. The health care system could be performing exceptionally well in identifying and administering treatment for various diseases, but a country could still have poor measured health if personal health care practices were unusually deleterious. This is not a remote possibility in the United States, which had the highest level of cigarette consumption per capita in the developed world over a 50-year period ending in 1985 (Forey et al. 2002). Smoking in early life has left an imprint on mortality patterns that remains visible as cohorts age (Preston and Wang 2006). Recent trends in obesity are also more adverse in the United States than in most other developed countries (OECD, 2008; Cutler, Glaeser, and Shapiro 2003).

One of the main drivers of life expectancy (above a certain level), though, is the availability of primary care providers (PCPs). You may know them as general practitioners (GPs), as I do.

PCP availability in the US is limited by 1) cash and 2) PCP time. There aren't enough PCPs in the US, and getting an appointment can involve waiting several days. Looking back in the customer satisfaction survey we see that few UK residents have trouble getting to see a PCP on the same day that they figure out that they might need to.


What would be a better comparison is to take some diseases that occur fairly evenly across the developed world and to compare how healthcare systems respond to them.  This is what Preston & Ho do in their paper.  On this sort of measure the US performs very well, better than european systems.

That study doesn't even begin to do what you say it does. It doesn't take "some diseases". It takes prostate cancer. It briefly looks at breast cancer. It says that it looks at these two diseases because they're less influenced by behaviour when behaviour affected by poor healthcare systems is part of the problem.

Not to mention the fact that because prostate cancer has such a low incidence, the people who can't get to a PCP, can't afford the treatment fall into the error bars. It's really a study that says "now that you're one of the people who the system actually cares for, the level of care is sufficient! Isn't that great!"

It even hints at the fact that it's not a good study for your purposes by stating that blacks have an 80-in-100,000 higher rate of death from prostate cancer than whites. And that's just the ones who didn't die mysteriously and were never checked.

Besides, it is by no means certain that *any* change to the US healthcare industry will improve it's performance.  I think it's far to simplistic to say that "any change that doesn't abolish medicare is a good one".  What about screwing up the rest of the industry?

Who cares about the industry? Healthcare is not something you want to be measuring in dollars. And there aren't many things that the legislative branch of the US can do about healthcare right now. Expanding medicare is one. Destroying it is another. Setting up a new medicare-type organisation is pretty much the last thing that they can do.
Would expanding Medicare improve things in the long term though?  Medicare's structure is not similar to the more successful of the nationalised health systems in other countries.

Insuring the uninsured is good for votes and of course it is beneficial to the uninsured.  However, I don't see any evidence that what is being proposed will help in the long term.

Medicare, AFAIK, is structured in a very similar way to Australia's own system (incidentally called Medicare too). And, to be brutally honest, Australia's healthcare system is in need of patching but it still kicks fifteen different kinds of arse over the US system by most metrics.
Logged

And if i catch you comin' back my way
I'm gonna serve it to you
And that ain't what you want to hear
But that's what I'll do
-- "Seven Nation Army", The White Stripes

So what you're telling me is that LTV's fudge factor means more than it's independent variable?
Yes...
Blue Boy from Red Country
Political Analyst
***
Offline Offline

Posts: 125


« Reply #12 on: August 09, 2009, 19:50:14 EDT »

Is it just me, or is the primary force behind Republican opposition to the various pieces of healthcare legislation not whether it would work or not, but that if they shoot down the plan, they will make Obama look bad by killing one of his policy centerpieces, allowing them to do in 2010 what they did previously in 1994?  They seem to have no real concern over trying to fix or overhaul the plan, their sole concern seems to be to shoot it down to earn political points, even if doing so results in nothing happening and problems remaining unsolved.  Typical.  The Republicans don't have the slightest interest in bipartisanship, its either their way or the highway, and if they can't have it their way, then no one else will either.

That said, healthcare specifics are incomprehensible to me as a whole.  All I know is that currently the government spends 0.7 trillion on healthcare and the public 1.0 trillion more, while if you go by the cost per person for France, we would be paying a flat 1.0 trillion or so, and get better care.  Their waiting lists aren't particularly bad and aren't a concern at all for their most immediate care, and that chronic diseases would not be covered by the public systems but only by private groups is unsurprising.  As for us, its pretty obvious that Health Insurance Companies desire to make a profit drains money that should be spent on healthcare, that people getting sicker and unproductive when they are denied the insurance would drain money, and that people being more costly to treat, and with tax-payer dollars no less, because they got sicker and ended up in the emergency room would also drain money.  3 drains, and all of them a product of for-profit healthcare.

The specific quote that provoked this is a Republican Senator stating "If we're able to stop Obama on this, it will be his Waterloo. It will break him."

Sadly, the majority of Republicans still seem to hold onto the classic ideal that private industries are always more efficient and preferable to government agencies. They don't see those costs to society that aren't  as easily stated in business terms - the "3 drains" you mention among them.

I'm particularly annoyed with the insinuations that the current efforts are an attempt to socialize and ration health care. Its largely intended to expand coverage so everyone has access to affordable care. It's been my experience, though, that conservatives believe that "all good Americans" are gainfully employed by businesses that can afford to provide coverage. The part I find ironic is that those most likely to not have coverage in the current US system include entrepreneurs and workers at family businesses.
Logged
wodan46
Pundit
****
Offline Offline

Posts: 1469


« Reply #13 on: August 15, 2009, 13:17:39 EDT »

I also find it funny how people honestly believe that they are more likely to receive better health insurance from a private company whose profits are directly tied to how frequently they deny you service, than from a government whose very jobs are dependent on you voting for them.

I also find it funny how no one seems to recognize how socialized things like Transportation, Education, and Law Enforcement already are, and how the concept of de-socializing such things would be horrendously and obviously bad.  Unless you live in a delusion that all communities are benevolent utopias with the strong willing and able to help the weak.
Logged

The plural of "anecdote" is "anecdotes". Not "data".
Ihlosi
Political Analyst
***
Offline Offline

Posts: 232


« Reply #14 on: September 11, 2009, 18:02:32 EDT »

Having spent the last couple of days in the US, I found it interesting how the whole healthcare "debate" (or lack thereof, I don't consider hysterical yelling and screaming part of a debate) is playing out, especially compared to what happened while the last president was in office. Sometimes, I wish the Democrats would have raised as much hell against the policies back then as they're facing now, but then again, they're usually too civil for that.

Also, it seems that you don't need the internet for a decent flamewar, letters to the editor of the local newspaper will do just fine. Wink
Logged
Pages: [1] 2
  Print  
 
Jump to:  

Powered by MySQL Powered by PHP Powered by SMF 1.1.11 | SMF © 2006-2009, Simple Machines LLC Valid XHTML 1.0! Valid CSS!