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Old 07-22-2009, 07:56 PM   #41
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sorry, this is OT, but I have the window open...

I can't believe he is talking about the Gates thing when he does not have all the facts (unless he got briefed on every detail by the local police and all witnesses, which I doubt).

Some of the reports I've read say that it was Gates that started with the racial accusations towards the officer, who was responding to a 911 call regarding a break in.

I don't know how it will turn out, but I think he should have done a "no comment" w/o the facts. That just does not sound smart to me.

-ERD50
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Old 07-22-2009, 08:29 PM   #42
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Originally Posted by samclem View Post
Can we assume that people in these countries really know about our system?
According to the Gallup World Poll

Quote:
The US ranks 81st out of 115 countries in the fraction of people who have confidence in their healthcare system, and has a lower score than countries such as India, Iran, Malawi, or Sierra Leone.
So they may not know our system, they just like theirs better than we like ours.
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Old 07-22-2009, 08:46 PM   #43
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Or, as I suspect, Americans tend to grouse about things no matter how good they are because they could always be better. This despite the fact that we are pretty high up there compared with other countries. Looks a lot better than 81st.

From Wikipedia:

"On comprehensive measures such as the UN Human Development Index the United States is always in the top twenty, currently ranking 15th. On the Human Poverty Index the United States ranked 16th, one rank below the United Kingdom and one rank above Ireland.On the Economist's quality-of-life index the United States ranked 13th, in between Finland and Canada, scoring 7.6 out of a possible 10. The highest given score of 8.3 was applied to Ireland. This particular index takes into account a variety of socio-economic variables including GDP per capita, life expectancy, political stability, family life, community life, gender equality, and job security."
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Old 07-22-2009, 08:58 PM   #44
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At 47 minutes after the hour, he said (in more words) NO.

He did say that the public plans are "more like the Federal Employees plan", but he did not say they would use the same plan.

I hope to find a transcript later...

-ERD50
I'm so skeptical of this administration. In order to keep from having the federal employees give up their health care plan, he tells us that he is trying to make our new plan like theirs. That is just so much BS! No matter how it works out, OUR plan will never be as good as THEIRS, He'll try to convince you that it is but I just know better. It's a politician talking.
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Old 07-22-2009, 10:24 PM   #45
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I'm so skeptical of this administration. In order to keep from having the federal employees give up their health care plan, he tells us that he is trying to make our new plan like theirs. That is just so much BS! No matter how it works out, OUR plan will never be as good as THEIRS, He'll try to convince you that it is but I just know better. It's a politician talking.
Here's the transcript:
Quote:
.... can you, as a symbolic gesture, say that you and the Congress will abide by the same benefits in that public option?

OBAMA: Well, number one, not only in the public option, but the insurance regulation that we want to put in place will largely match up with what members of Congress are getting through the federal employee plan.
"largely match up" leaves a lot of wiggle room.

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Old 07-22-2009, 11:02 PM   #46
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Details on the plan
Fred Thompson: Interviews
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Old 07-23-2009, 12:44 AM   #47
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Originally Posted by ERD50 View Post
Here's the transcript:


"largely match up" leaves a lot of wiggle room.

-ERD50
I was listening carefully for his answer to that question too......

The "largely match up" statement made me hopeful. But then he went on, at some length, to say that they would NOT be the same plan. That's very disappointing and a signal that there will be haves and have-nots in the possible new system.

It makes no sense that fed employees would not have the same plan we'll wind up with, especially if we're being given the truth about what is being proposed.

Is that how it works in Canada? Non-govt workers get plan B. Govt workers get superior plan A?

As someone who has always had good health insurance coverage, this is starting to be of concern.........
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Old 07-23-2009, 08:26 AM   #48
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Before you jump to conclusions on how great the FEHB is, please read the following:


Health Care Heartburn
By Alyssa Rosenberg
President Obama's prime-time news
conference on Wednesday night was designed, in part, to make the case for immediate health care reform, which is facing some obstacles in Congress. Most of the debate is focused on how much a reform plan would control spiraling health care costs and how many uninsured people it would cover. But lawmakers and advocacy groups continue to discuss health care reform's effect on the Federal Employees Health Benefits Program and its role in finding a solution.

FEHBP long has been part of the health care debate because it preserves enrollees' choice among competing plans and levels of coverage, and its costs are relatively low compared with the costs of operating and participating in private sector plans. During the 2008 presidential election, Democratic candidate Hillary Clinton proposed a version of health care reform that would allow the general public to participate in FEHBP, but would create a separate risk pool to protect federal employees from cost increases that could result if sicker or older participants enrolled in the program's plans. In March, representatives from the Obama administration said they were looking to FEHBP as a model, though they were unlikely to use it as a public option in a reform bill to force competition with the private sector.

On Wednesday, the American Cancer Society Cancer Action Network and the Georgetown University Health Policy Institute issued a report that examined FEHBP from another angle -- as a potential model for the minimum level of coverage insurers would have to provide to participants. The report analyzed how much coverage FEHBP's Blue Cross Blue Shield Standard Option Plan, the program's most popular offering, provides to patients with breast or colon cancer, heart disease or diabetes, and how clearly the plan explains coverage to participants.
The researchers found that Stage II breast cancer patients covered under Blue Cross could pay between $10,000 and $13,000 over two years for treatment, while Stage II colon cancer patients could pay between $15,000 to $17,000 during the same length of time.

They also found that some confusing elements of the plan could lead participants to pay more than they expected for medical care. For example, Blue Cross pays for different amounts of coverage, depending on whether a health care provider participates in their network. The insurer also has preferred providers within the subset of in-network providers, but its Web site does not identify them outright, making it difficult to find the physicians who will receive the highest rate of reimbursement from Blue Cross when they treat plan members, according to the report. In addition, researchers said it might not be clear to participants that enrolling as a family might allow them to pay less out-of-pocket annually than signing up as individuals if both adults are eligible to enroll in the program as federal employees.
"The study shows that the Blue Cross Blue Shield Standard Option plan is 'adequate,' " wrote the reports' authors, Karen Pollitz, Eliza Bangit, Jennifer Libster from the American Cancer Society, and Nicole Johnston from Georgetown. "It offers good protection by covering the most important benefits without caps and with an overall limit on cost-sharing liability. However, it is certainly not 'Cadillac' coverage."
But even if some of the FEHBP options do not provide the best health care money can buy, lawmakers are still protective of the program overall. Rep. Darrell Issa, R-Calif., ranking member of the House Oversight and Government Reform Committee, asked Chairman Edolphus Towns, D-N.Y., to hold hearings on the House Democrats' health care reform bill, H.R. 3200, on the grounds that FEHBP might not meet the standards in the bill for a "qualified health benefits plan." To meet that standard, providers would have to satisfy a number of conditions, including agreeing to cover pre-existing medical conditions, guaranteeing that individuals can re-enroll in their insurance plan unless they have failed to pay premiums, covering mental and physical health treatment the same way, and ensuring that adequate provider networks are available to participants.

"This legislation should not move forward until we know its effect on our federal employees," Issa wrote to Towns in a letter.

On Monday, Towns denied Issa's request to hold hearings, saying the legislation includes a five-year grace period for plans to make changes to meet the criteria for qualified plans, so FEHBP would have until 2018 to make what Towns described as the minor administrative and coverage changes necessary to meet those standards.
Even if Oversight and Government Reform doesn't hold hearings on health care reform, other committees will. And as lawmakers struggle to determine how to cover as many people as possible for the least amount of money, the programs available to federal employees will be in the spotlight.
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Old 07-23-2009, 10:03 AM   #49
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Before you jump to conclusions on how great the FEHB is, please read the following:
Regardless how good the FEHB is or isn't, it just comes across as a bit patronizing to say that this new plan is great for American's, but no, we are not going to have our Federal Employees in that plan.

The reporter even said it could be a symbolic act. I thought it was a very good point. Though I agree that the President and VP should have way above-and-beyond the "normal" plan, the stability that comes from knowing their health status and heading any problems off is important to the country.

-ERD50
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Old 07-23-2009, 11:36 AM   #50
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Originally Posted by . . . Yrs to Go View Post

Quote:
Originally Posted by samclem View Post
Can we assume that people in these countries really know about our system?
Quote:
According to the Gallup World Poll

The US ranks 81st out of 115 countries in the fraction of people who have confidence in their healthcare system, and has a lower score than countries such as India, Iran, Malawi, or Sierra Leone.
So they may not know our system, they just like theirs better than we like ours.
Sierra Leone You might want to check the methodology of that study. I suspect that the residents of Sierra Leone would LOVE our system if they knew about it.

In Life expectancy, SL ranks 215 out of 221 countries in this list.

List of countries by life expectancy - Wikipedia, the free encyclopedia

rank/overall/M/F

215 Sierra Leone 40.58 38.36 42.87

Sierra Leone - Wikipedia, the free encyclopedia
Quote:
Print media is not widely read in Sierra Leone, especially outside Freetown, partially due to the low levels of literacy in the country.[69]

GDP (PPP) 2008 estimate
- Total $4.266 billion[2]
- Per capita $724[2]

Sierra Leone is the lowest ranked country on the Human Development Index and seventh lowest on the Human Poverty Index,[14] suffering from endemic corruption[15] and suppression of the press.[16]

Sierra Leone Literacy - Demographics
Quote:
Literacy: definition: age 15 and over can read and write English, Mende, Temne, or Arabic
total population: 35.1%
male: 46.9%
female: 24.4% (2004 est.)
Healthcare in Sierra Leone - Wikipedia, the free encyclopedia

Quote:
Public health in Sierra Leone is generally poor and in 2007 the country had the highest level of child mortality in the world.

The country suffers from epidemic outbreaks of diseases including yellow fever, cholera, lassa fever and meningitis. [2]
But they are happy with their health care! I suspect that would also like a hunk of half-rotted meat and some sanitary drinking water more than we would like our medium-rare steak that we ordered rare that got served with a Cabernet instead of the Zinfandel we ordered (oh the horror - we should sue!)...

Let's get some of them on the Congressional committee, I'm sure we could learn a thing or two from the ones who can read and write! Geez, talk about cherry-picking some data...

A little balance - the US is much farther down that list than we should be, we do need reform.

-ERD50
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Old 07-23-2009, 11:55 AM   #51
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We are where we are on this list in part because of huge variability in quality in the US depending on where you are and who your are. McAllen Texas versus Rochester Minnesota. Insured versus uninsured.

Interestingly, I recently read that there is evidence that our elderly in the US have as good of outcomes on the average as elderly in other countries with national health care. Our elderly have national health care through medicare and the elderly poor are supplemented by medicaid.

I'm sorry, for the life of me I can't find the source of the statistic above.
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Old 07-23-2009, 12:02 PM   #52
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One that gets me is the stat on cancer deaths in Canada. With all our air pollution and higher smoking rates, the Canadian Cancer death rate is 16% higher due to health care delay times and treatment limitations. Also think about Great Britain who denies breast cancer treatment for the women over age 60 I think it is.
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Old 07-23-2009, 12:25 PM   #53
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"Also think about Great Britain who denies breast cancer treatment for the women over age 60 I think it is."

Like I said, see the movie "Logan's Run." In England they also will not provide dialysis or other necessary life sustaining treatment once you reach a certain age (in some cases by putting you on a waiting list where you are expected to die before you will get treatment) . The tradeoff of health care for all, at least in that country, comes at the expense of the elderly ill. I'm not a fan of prolonging life at all costs, but I don't want the government making the decision for me. I had to pull the plug (literally by telling the Dr to turn off the respirator) on my mother after she had a major stroke at 89, but I knew she would not want to live that way - with no quality of life whatsoever.
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Old 07-23-2009, 03:23 PM   #54
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One that gets me is the stat on cancer deaths in Canada. With all our air pollution and higher smoking rates, the Canadian Cancer death rate is 16% higher due to health care delay times and treatment limitations. Also think about Great Britain who denies breast cancer treatment for the women over age 60 I think it is.
I think your Canada number is misleading and likely incorrect.

Some research, now a few years old, indicates that Americans have the best chance of survival of five years for two of the five cancers that the researchers considered: breast cancer in women and prostate cancer. Cuba actually claims number 1 in breast cancer survival (but this is questioned by many), US number 2 and Canada number 3. Canada is not far behind the US. For prostate cancer, the US was number 1, Australia number 2 and Canada number 3.

The big problem is that US has huge variability which Canada does not have, for example white middle and upper class women do very well if they have breast cancer but poor black women do substantially worse. This is a big problem. It doesn't do much good to say to an uninsured person in the US that the US has the best breast cancer care in the US when it is not true for them. But yes, we do not want to slip either and given how much more money we spend on health care and the fact that leading edge drugs are often available here first, we do not need to slip in the treatment of these diseases. It isn't like we do everything bad.

My data is from an article in Lancet. I have also linked to an article that talks about survival rates and gives good grades to the US, as compared to Europe and Canada. Here I can link to more info: U.S. Cancer Care Is Number One - Brief Analysis #596

Some points from that article:

  • For women, the average survival rate for all cancers is 61 percent in the United States, compared to 58 percent in Canada.
  • For men, the average survival rate for all cancers is 57 percent in the United States, compared to 53 percent in Canada.
I do not look at the UK as a good model for health care delivery.

However, this stuff is really very muddy. Sometimes differences are due to how deaths are reported, is it postrate cancer or the heart attack that immediately caused the death? This wiki comparing Canada and the US gives a taste of how difficult it is to compare the outcomes on cancer: http://en.wikipedia.org/wiki/Canadia...stems_compared Note that some research shows better or as good outcomes for Canadians.

It is easier when countries have more dramatic differences.
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Old 07-23-2009, 03:27 PM   #55
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Hey, I posted when I wasn't done and am forced to Galt once again.

More comparative information can be found on the Commonwealth Fund site:

Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care - The Commonwealth Fund

"Compared with five other nations—Australia, Canada, Germany, New Zealand, the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives."

We need to see what we do right and well as what we do wrong and not lose what we do right in the process. Again, the data can be muddy but we nevertheless can learn from what others do right and wrong.
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Old 07-23-2009, 04:40 PM   #56
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Looking at the chart of life expectancies in all the countries got me to thinking (I know, that's dangerous). Everything has to be considered in life expectancies and I"ll bet that we have the highest death rate due to automobile accidents, murder and possibly suicide. That will skew the numbers Anyone out there willing to weigh in on stats? However, I also heard that we don't have a very good track record on infant mortality. Maybe I'm all wet.
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Old 07-23-2009, 04:47 PM   #57
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Some research, now a few years old, indicates that Americans have the best chance of survival of five years for two of the five cancers that the researchers considered: breast cancer in women and prostate cancer.
These 5 year survival rates can be misleading. Breast and prostate cancers are usually slow growing. The biggest influence on 5 year survival may have nothing to do with the ultimate survival rate, and much more with how young the tumor is when it is discovered. Imagine that something is going to kill you in 10 years. Your five year survival rate depends al ot of when that clock starts ticking. In America where we have vigorous screening for these two cancers especially, our 5 year survial rates might appear better than some country with less screening, while in actuality there is no difference as to length of life which is really what counts.
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Old 07-23-2009, 05:05 PM   #58
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Right Ha, it is very hard to do an accurate comparison on cancer survival rates. When was it diagnosed? Was it diagnosed so early that odds of survival were high anyway? You have to compare all those things. I think that is the reason for the wide variability in statistics comparing the countries.
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Old 07-23-2009, 05:10 PM   #59
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Looking at the chart of life expectancies in all the countries got me to thinking (I know, that's dangerous). Everything has to be considered in life expectancies and I"ll bet that we have the highest death rate due to automobile accidents, murder and possibly suicide. That will skew the numbers Anyone out there willing to weigh in on stats? However, I also heard that we don't have a very good track record on infant mortality. Maybe I'm all wet.
Johnnie,

On the infant mortality rate AFAIK other countries do not interceed near as much as we do with Mother Natures spontaneous abortions. We do our utmost with technology and medications to help mom's to deliver a live birth. That gives us the ultra-preemies which may or may not be a great thing. Here we put mom's to be on total bedrest and sometimes hospital care for weeks to deliver an ultra preemie weighing ounces that may spend months in a neo-natal unit costing several thousand dollars per day.

We are high on murder, but per mile driven our road deaths were in line when I saw a study a few years back. The suicide rate is higher in other places as well AFAIK.
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Old 07-23-2009, 05:18 PM   #60
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Johnnie,

On the infant mortality rate AFAIK other countries do not interceed near as much as we do with Mother Natures spontaneous abortions. We do our utmost with technology and medications to help mom's to deliver a live birth. That gives us the ultra-preemies which may or may not be a great thing. Here we put mom's to be on total bedrest and sometimes hospital care for weeks to deliver an ultra preemie weighing ounces that may spend months in a neo-natal unit costing several thousand dollars per day.

We are high on murder, but per mile driven our road deaths were in line when I saw a study a few years back. The suicide rate is higher in other places as well AFAIK.
One thing that drives our infant mortality down is groups of people who are not getting proper care. But yes, it is another statistic that has to be looked at closely to make sure people are measuring the same thing. Your info on murder, highway accidents and suicide jibe with what I recall.
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