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Old 02-11-2009, 05:47 PM   #41
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I hope you editors had the sense to understand that I was not dissing the "crazy xxx" category I referenced since everyone here knows I am one of them. The word you are looking for is sarcasm. Lets try a politically correct version:

"The only thing [the people who support what is being derided as "socialized medicine"] want out of this is a system...
Don, I like to think I'm a pretty funny gal and enjoy a good bout of sarcasm whenever possible but when I read your original post I didn't realize you were being sarcastic. And I really don't know most people's political leanings, including yours. And the other mods have a lot of sense and understanding.

I think this is a really good thread with a good discussion going. I don't think it's soapbox-ish in the least.
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Old 02-11-2009, 05:56 PM   #42
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Originally Posted by Rich_in_Tampa View Post
I'm OK with basic coverage for all, with add-ons if you are willing to pay more, but the definitions of what is basic coverage can get tricky.
That is what concerns me, too.


From the Bloomberg article:

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.


Bolded type is my emphasis.
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Old 02-11-2009, 05:57 PM   #43
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Food, lodging, water--for almost every human need we allow people to go to the free market and make decisions about what they want...
For whatever reason, many people want to turn their back on this model when it comes to health care. They either want the government (e.g. other taxpayers) to give it to them for "free," or they want their employer to provide it for "free." For health care, many people want to turn to the model that has historically done the very poorest job of providing needed goods and services.
Substitute defense, police service, fire service, schools, roads, electricity and, yes, social security, and it is clear that as a people we choose to support many essentials collectively. Just read the worries expressed on this forum about the precarious state of access to health insurance in ER and it is easy to understand why many of us believe universal access is an imperative. It does not automatically lead to substandard care delivered by faceless bureaucrats.
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Old 02-11-2009, 06:07 PM   #44
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Just read the worries expressed on this forum about the precarious state of access to health insurance in ER and it is easy to understand why many of us believe universal access is an imperative. It does not automatically lead to substandard care delivered by faceless bureaucrats.
Universal access is kind of like the right to pursuit of happiness. Results are highly variable.
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Old 02-11-2009, 06:40 PM   #45
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By and large most people are selfish. And this is a good thing.... it is a HUMAN thing. It is about preserving yourself, your life, and perhaps the well being of your family. By the previous definition, most people that I know would say it is a fairly positive thing.

People become doctors because they truly want to help people, but doctors are people too, and as such want to be highly compensated for their rare skills. After all not EVERYONE is metally skilled enought to achieve that. Are any of us here in the forum any different? If there was suddenly some urgent govt need for engineers and they were not willing to pay something agreeable to most engineers, should they be "forced" to perform their services?

If you remove the profit motive from heathcare it will inevitably reduce the quality of healthcare. Why is that? Well... when doctors can charge what they wish... it then becomes a choice if people want to use their services or not. Doctors that are truly "a cut above the rest" may actually get that higher rate. Lesser doctors may not, and will have to lower their rates to survive. If the govt via nationalized healthcare declares that all doctors doing heart surgury for example will make the same, then why would those truly exceptional doctors wish to stay in a profession that does not reward their greater skill? The only doctors that will stay, will be the average and the mediocre caliber.

That is unless you really belive that most doctors are 100% altruistic and only think of others and never themselves. You might find a very few like that..... but I personally have never met anyone like that.... ever.
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Old 02-11-2009, 07:17 PM   #46
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If you remove the profit motive from heathcare it will inevitably reduce the quality of healthcare. Why is that? Well... when doctors can charge what they wish... it then becomes a choice if people want to use their services or not. Doctors that are truly "a cut above the rest" may actually get that higher rate. Lesser doctors may not, and will have to lower their rates to survive. If the govt via nationalized healthcare declares that all doctors doing heart surgury for example will make the same, then why would those truly exceptional doctors wish to stay in a profession that does not reward their greater skill? The only doctors that will stay, will be the average and the mediocre caliber.
There isn't much call here for a totally nationalized health care system - the profit motive isn't going away. The types of systems people are looking at work well elsewhere. Are French, Dutch, Canadian, British doctors a different species than ours?

And riddle me this, why do we have the best military system in the world with no multi-million dollar CEO style bonuses for the Generals?
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Old 02-11-2009, 07:32 PM   #47
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There isn't much call here for a totally nationalized health care system - the profit motive isn't going away. The types of systems people are looking at work well elsewhere. Are French, Dutch, Canadian, British doctors a different species than ours?
I do think that some of the claims that universal health care is "socialized medicine" are overblown. It's not really "socialized" unless insurance companies are gone and health care workers are employees of the government.

I do think opponents of universal health insurance/care should be a little more careful about their misuse of terms.
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Old 02-11-2009, 07:32 PM   #48
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Donheff
Let me know if you think we can get by with the same number of generals as doctors. That last statement is just about the most absurd thing I have seen someone post. Maybe it is just your sarcasm showing through again.

By the way there are 30 in all the services. So it is like comparing doctors to cabinet members or Senators or say the president.
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Old 02-11-2009, 07:52 PM   #49
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Donheff
Let me know if you think we can get by with the same number of generals as doctors. That last statement is just about the most absurd thing I have seen someone post. Maybe it is just your sarcasm showing through again.
Sorry, I didn't learn my lesson. I was being sarcastic. I will try not to pop off with those bon mots anymore My point was that we have an excellent military and we are not paying them big, market driven salaries. We leave that to Blackwater. Oh, darn, there I go again.

As an aside, I think you must have meant 300 something for the number of generals, not 30. Unless my CEO reference made you think 4 stars or something. Once again, sorry for the sarcasm, I am beginning to see that it can lead the conversation astray.
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Old 02-11-2009, 07:58 PM   #50
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There are 306 Army generals according to Google. However there are only 30 4 stars in the services. By the way, while all are called General, only the 4 stars are Generals. Accept for the Navy and they are Admirals. All others or Major, Lt, Comodore or some other qualifier. Just to pick nits.
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Old 02-11-2009, 08:11 PM   #51
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Just read the worries expressed on this forum about the precarious state of access to health insurance in ER and it is easy to understand why many of us believe universal access is an imperative.
I think the discussion is more valuable if we avoid imprecise or misleading terms. As an example: "universal access" is precisely what we have today. Anybody can have access to any medical care. Sometimes people use the term to mean "everybody gets medical care that they don't have to pay for as an individual service."

Some proponents of nationalized/socialized/single-payer systems are actually against universal access, as they would prohibit universal ability to buy the health care an individual might desire.
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Old 02-11-2009, 08:16 PM   #52
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If you remove the profit motive from heathcare it will inevitably reduce the quality of healthcare. Why is that? Well... when doctors can charge what they wish... it then becomes a choice if people want to use their services or not. Doctors that are truly "a cut above the rest" may actually get that higher rate. Lesser doctors may not, and will have to lower their rates to survive. If the govt via nationalized healthcare declares that all doctors doing heart surgury for example will make the same, then why would those truly exceptional doctors wish to stay in a profession that does not reward their greater skill? The only doctors that will stay, will be the average and the mediocre caliber.
Even in countries with socialized medicine, doctors are highly compensated professionals. They still earn much more than other highly qualified professionals, like engineers. Also, even if the "good" and "bad" doctors charge the same per patient, the "good" ones have more patients and make a better living. Specialists still make more than generalists. And, the very best doctors sometimes command a premium (not reimbursed by the state). Overall, there is still a pretty wide distribution of incomes among doctors, enough to reward the best of them and motivate the others to do better.
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Old 02-11-2009, 08:19 PM   #53
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It is very common for the term "socialized medicine" to be used by its opponents to appy to virtually any type of health care reimbursement other than fee for service. But that is a gross distortion, often feeling much like a scare tactic. That really bogs down rational debate. Here is my unsophisticated understanding:

Socialized medicine - where heatlh care resources are owned and managed by the federal government. Relevant issues of eligibility, medical necessity, etc. are all part of national policy.

Universal coverage: everyone has health insurance, though not necessarily the same level. The basic lowest level covers all necessary nonelective medical and surgical care including preventive measures. Higher cost coverage might include cosmetics, unproven (though not necessarily ineffective) modalities such as chiropractic (a whole other matter of debate), private rooms, etc.. A national debate would have to address things such as whether aggressive measures such as dialysis are covered for people over age XX, etc. It would get ugly at that level. It would look a lot like what we have now, but everyone would have some source of premium payments, so that we insured folks would not have to pay exorbitant amounts for Emergency Room care for colds, etc.
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Old 02-11-2009, 08:20 PM   #54
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My brother gets his health care at the Portland Or VA facility and it has been excellent. They are focusing on preventing illness and have gotten a couple issues managed (weight, blood pressure). He had surgery there with good outcome.
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Old 02-11-2009, 09:00 PM   #55
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I think the discussion is more valuable if we avoid imprecise or misleading terms. As an example: "universal access" is precisely what we have today. Anybody can have access to any medical care. Sometimes people use the term to mean "everybody gets medical care that they don't have to pay for as an individual service."

Some proponents of nationalized/socialized/single-payer systems are actually against universal access, as they would prohibit universal ability to buy the health care an individual might desire.
To say we have universal access is like saying all men are created equal. Neither are true. You might not have access to health care because you do not have the ability to pay and you are not covered by any government program.
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Old 02-11-2009, 09:32 PM   #56
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Accept for the Navy and they are Admirals. All others or Major, Lt, Comodore or some other qualifier. Just to pick nits.
Navy keeps changing the ranks when the other services seem to be about to figure things out. The latest version is:
Admiral
Vice admiral
Rear admiral (upper half)
Rear admiral (lower half)

O-6s in charge of a squadron (more than one ship) are referred to as commodores even though they're wearing the rank of captain. They revert to captain when they leave the billet.

Luckily we never had to live with Congress' bright idea of "commodore admiral"...
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Old 02-11-2009, 09:39 PM   #57
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To say we have universal access is like saying all men are created equal. Neither are true. You might not have access to health care because you do not have the ability to pay and you are not covered by any government program.
But "universal access" is (IMO) a deliberately vague term. Who could be opposed to "access" whether we are talking about allowing people "access" to food, "access" to the library, or "access" to the truth. Everyone has "access" to healthcare. What is being discussed is payment for that care. So, it seems more straightforward and honest to say that, and we can then turn our attention to the issue at hand: Determinig how to allocate resources, not "access."
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Old 02-11-2009, 09:41 PM   #58
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Old 02-11-2009, 09:42 PM   #59
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My brother gets his health care at the Portland Or VA facility and it has been excellent. They are focusing on preventing illness and have gotten a couple issues managed (weight, blood pressure). He had surgery there with good outcome.
My Dad had pretty good luck with the VA hospital in Jackson, MS back in the 70's-80's. He had 2 hip replacements and some eye surgery. The main problem he ran into was the hospital would lose his records from time to time. Plus when he had a doc appointment, he might have a different doctor. So when they couldn't find his records, he would have to give his history to the new doctor. But as far as the care goes, it was good.

He quit going mainly because of the records issue and he got tired of driving 90 miles for an appointment.
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Old 02-12-2009, 12:12 AM   #60
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Everyone can go round and round on this but in essance it all comes down to everyone's desire to do what they believe is in their own best interest.

I have the solution, DO BOTH.

Those that want something like the current healthcare system get to keep it and those that want nationalized/socialized/whatever heathcare go for it. Just dont expect the folks outside of your system of choice to subsidize it, after all it is YOUR CHOICE. Give both some time and we shall see which remains viable, affordable, and provides the optimum service. That will be the one that remains.
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