Before the socialism

[edge walker]

From http://zmayhem.livejournal.com/7832.html:

Best Phone Call Ever, as of half an hour ago:

Me: Good morning, Cardiology, this is Zmayhem.

Random Woman: I’m a longtime patient of Dr. S’s. I’m looking for his assistant.

Me: Yes, that’s me. How can I help you?

RW: He usually sees patients on Mondays, right?

Me: Yes; he’s in clinic now.

RW: I need to know if I could slip in to see him this afternoon.

Me: Well [if you’re a longtime patient you already know he’s always booked four or five months in advance, so I’m fairly certain that as of right this minute a melting snowball in hell has a better chance of getting an appointment for this afternoon than you do], ma’am, the clinic would be able to answer that for you; let me give you the number and transfer you.

RW (in winky-winky confidential tones): I’m just very concerned, and I thought I’d better get in to see him while I still can, before socialized medicine happens. I’m used to being able to see my specialists right away. I’m very concerned.

Me (brightly): Well, socialized medicine would be a wonderful thing, but I regret to say that we’re probably at least a decade away at the earliest.

RW: Well, then, single payer. Isn’t that even worse? Anyhow, I want to see him today, before the socialism.

Me: ::brains explode:: “Before the socialsm” is now the new catchphrase (as in “hey dude, let’s hang out tonight, before the socialism”). Please let your friends and family know. Your cooperation in this matter is appreciated.

[Ferrus]

'I'm very concerned that, you know, I might actually get the cancer treated'.

[Limey]

Socialism dances to the arrhythmia of a different drum.

[Anonymous]

You know, I'm actually worried that there will be so much resistance to universal health care that if we do get it in, it'll be really half-assed, thus making a gigantic mess of everything. If that happens, people will be certain to blame it on the nationalization itself, not incompetence.

That's not to say that I'm against it of course, I'm just thinking that it's going to be a gigantic headache to get through.

[drdolittle]

Socialized medicine will be upon us soon. It will not be too bad. It will be a two-tier system with public health offering certain treatment guidelines and protocols and people paying on their own able to buy what they want, like whole body ct scans to detect cancers early.
In medicine many times less is more. Certainly some cancers respond well to treatment and will be included in pupblic care. Some, like advanced lung cancer are treated for financial gain and because it's hard to tell people we can do no more.
The VA medical system is much maligned. The facts are that the VA system has on average a sicker patient with fewer resources and yet they manage to do better (overall longer lives) than traditional medicare patients with less money spent per patient.
The current system cannot continue on its current course. Health care must be rationed. I know noone wants to hear this but unfortunately it's true. The sooner the better and we can do better with our healthcare dollars.

[mancroft]

:rofl:

We've had socialized medicine in the UK for years and it isn't that bad.

[Limey]

Socialized medicine will be upon us soon. It will not be too bad. It will be a two-tier system with public health offering certain treatment guidelines and protocols and people paying on their own able to buy what they want, like whole body ct scans to detect cancers early.
In medicine many times less is more. Certainly some cancers respond well to treatment and will be included in pupblic care. Some, like advanced lung cancer are treated for financial gain and because it's hard to tell people we can do no more.
The VA medical system is much maligned. The facts are that the VA system has on average a sicker patient with fewer resources and yet they manage to do better (overall longer lives) than traditional medicare patients with less money spent per patient.
The current system cannot continue on its current course. Health care must be rationed. I know noone wants to hear this but unfortunately it's true. The sooner the better and we can do better with our healthcare dollars.

VA patient longevity could be down to variables such as the people therin living structured, regimented lives, PT being part of their M.O.
I would imagine there are a higher percentage of SJ veterans than a slice of the general population.

[Limey]

:rofl:

We've had socialized medicine in the UK for years and it isn't that bad.

Your mental illness has gone untreated and don't come running to us if your hip joints fall out and you go gimpy legged.

[floid]

Since the legacy of George W. Bush will honored by having a sewage treatment plant in San Francisco named after him it is only fitting that one of his prime movers be appropriately honored also:

Cheney Care (http://www.ueunion.org/ueactionupdates.html?news=361)

[airjaw]

You know, I'm actually worried that there will be so much resistance to universal health care that if we do get it in, it'll be really half-assed, thus making a gigantic mess of everything. If that happens, people will be certain to blame it on the nationalization itself, not incompetence.

That's not to say that I'm against it of course, I'm just thinking that it's going to be a gigantic headache to get through.

I'm worried about this too. Universal health care is a good idea, but actually implementing the system well in the US is a different story altogether. Actually, I think the best course of action would be to do something similar to McCain's plan first, ie. decouple insurance from employers, and then go towards single-payer. I'm not too big of a fan of Obama's plan.

[Ferrus]

Well, it can't be much worse than the current system, at least.

[NoahFence]

In the last 8 years, health insurance for my family has gone from costing us $150/month (and being quite extensive, $15 copay for replacing a liver) to almost as much as our fucking mortgage (for shittier coverage, higher copays too).

At this point, it'd be cheaper for me to get a dual citizenship in England and fucking fly there for medical care when needed.

Bush & Co. have their heads so far up the pharmaceutical industry's ass, they're getting their foreheads licked. Insurance companies, too. Blocking socialized medicine is PURELY to keep raking in the money without a fly's shit of scrutiny or oversight. It will not be the end of the freakin' world, folks, and if it isn't done soon, we won't be able to afford shit anyway. IT DOES NOT MEAN WE WILL BE CHINA. I'm so sick of the chicken little crap, when it's all fear tactics propogated by the bastards at the top trying to get that eleventh boat.

[Helios]

I pay enough for my own health care, now I am gonna have to help pay for everyone else's too. Some how I am not excited about this......

[floid]

I pay enough for my own health care, now I am gonna have to help pay for everyone else's too. Some how I am not excited about this......

Based on the mask you wear online you do do not appear to be a huge fan of preventative medicine either.

Which fairly accurately portends that if you are at all like you appear here and you live long enough, someone other than you will also be paying for your health care one day.

[C.J.Woolf]

I pay enough for my own health care, now I am gonna have to help pay for everyone else's too. Some how I am not excited about this......
In theory, under single-payer the cost of your own health care will be less because there will be no overhead for administration (which costs insurance companies and providers) and insurance company profits, which as far as I know are not disclosed. I'd really like to see their books opened up. I expect a lot more people will be open to the idea of single-payer after they see where their insurance dollars go.

Of course, those of us who are well-off will be contributing to other people's health care. I'm fine with that. You get the best rates with the largest risk pool, and the entire population of the US is the biggest risk pool there is.

[airjaw]

Well the problem in the US is that no one trusts each other. We're a nation of individuals, lets face it. people don't want to care for their neighbors cuz that's the culture we have and... well... we're not one homogenous group.
I'd like to see single payer but I doubt we will have it anytime soon.

[Helios]

Based on the mask you wear online you do do not appear to be a huge fan of preventative medicine either.

Which fairly accurately portends that if you are at all like you appear here and you live long enough, someone other than you will also be paying for your health care one day.


So given that I *may* somehow, someday ask something back from the system, I might as well carry an unfair load my whole life?


If my share is fixed, surpluses taken away, and deficits paid; I think I'd just coast, and ride on the back of some dutiful SJ somewhere.

[joft]

Congressman: Obama wants Gestapo-like force
GOP rep invokes Nazis, Soviets, but Bush backed Obama's civilian corps idea

updated 3:16 a.m. ET, Tues., Nov. 11, 2008

WASHINGTON - A Republican congressman from Georgia said Monday he fears that President-elect Obama will establish a Gestapo-like security force to impose a Marxist dictatorship.

"It may sound a bit crazy and off base, but the thing is, he's the one who proposed this national security force," Rep. Paul Broun said of Obama in an interview Monday with The Associated Press. "I'm just trying to bring attention to the fact that we may — may not, I hope not — but we may have a problem with that type of philosophy of radical socialism or Marxism."

Broun cited a July speech by Obama that has circulated on the Internet in which the then-Democratic presidential candidate called for a civilian force to take some of the national security burden off the military.

"That's exactly what Hitler did in Nazi Germany and it's exactly what the Soviet Union did," Broun said. "When he's proposing to have a national security force that's answering to him, that is as strong as the U.S. military, he's showing me signs of being Marxist."

Obama's comments about a national security force came during a speech in Colorado in which he called for expanding the nation's foreign service.

"We cannot continue to rely only on our military in order to achieve the national security objectives that we've set," Obama said in July. "We've got to have a civilian national security force that's just as powerful, just as strong, just as well-funded."

Obama's idea endorsed by Bush
The Obama transition team declined to comment on Broun's remarks. But spokesman Tommy Vietor said Obama was referring in the speech to a proposal for a civilian reserve corps that could handle postwar reconstruction efforts such as rebuilding infrastructure — an idea endorsed by the Bush administration.

Broun said he believes Obama would move to ban gun ownership if he does build a national security force.

Obama has said he respects the Second Amendment right to bear arms and favors "common sense" gun laws. Gun rights advocates interpret that as meaning he'll at least enact curbs on ownership of assault weapons and concealed weapons. As an Illinois state lawmaker, Obama supported a ban on semiautomatic weapons and tighter restrictions on firearms generally.

"We can't be lulled into complacency," Broun said. "You have to remember that Adolf Hitler was elected in a democratic Germany. I'm not comparing him to Adolf Hitler. What I'm saying is there is the potential of going down that road."

Helios: wahhh

[Ferrus]

Historically, making hysterical comparisons about centre left wing politicians is one of the least successful means of besmirching them, generally, as it alienates centrists.

[Helios]

Helios: wahhh


:rofl:




edit-


making hysterical comparisons


I like that!! May borrow it later :D

[C.J.Woolf]

So given that I *may* somehow, someday ask something back from the system, I might as well carry an unfair load my whole life?
You may get back more than you put in, you may get back less. That's insurance.

[Madrigal]

So given that I *may* somehow, someday ask something back from the system, I might as well carry an unfair load my whole life?


Oh yeah??? Try saying that with a different avatar and I'll...


(don't change it ;))

[ApeTheDog]

In Belgium it's your boss who pays for the lion share of your health care bill. Benefits of the system include:
- paying nearly nothing for a doctors visit (you don't need to make an appointment to see one)
- hardly any waiting lists for surgery

[airjaw]

That's the system in Belgium. I think we should be clear here and make that distinction: not all socialist healthcare systems are the same. Also, there are long waits in both systems. In the US I've had to wait months just to see specialists, and then months again to get surgery. All in all I waited about 5 months total. Apparently the wait to get an MRI is like 6 months in some socialized healthcare systems.

[ApeTheDog]

I had to have my gall bladder removed. I went into the hospital on friday night when it suddenly started to hurt really badly, got a scan on saturday and it had been removed on monday. For less life-threatening surgery it does takes longer, naturally.

I don't know how doctors visits differ from other countries but our government made a commerial praising our system once, so I just assume it has to be good. When we fall ill we call a doctor and they drive over to our house. A doctor's visit costs about 20 euro but you get paid back almost all of it, I believe. I'm fairly unaware of the true cost of most such things to be honest...

I mostly wanted to make the point that it's your company which pay for the lion share of your health care in Belgium - it's very taxing on them, not so much on the individual who is still guaranteed a competitive wage compared to the rest of the world. I don't know how well this would work in the US.

[Dark Razor]

In Germany the system is such that technically half the insurance costs are payed by the employer and half is payed by the employee, though of course in the end this means that the total is substracted from your potential wage. Currently we pay about 15% of our income (7.5% of your actual gross income) for health care.

If you are the sole provider for a family, then this includes insurance for your wife/husband and your children, as long as they are below a certain age (25 I think) and receive no income themselves.

The health insurance for the unemployed is payed for by the government (every employee also pays into a mandatory unemployment insurance scheme, which covers some of the costs.) So it is basically impossible to be without health insurance.

There is also private insurance which runs parallel to the socialized system, though these companies are regulated. They, for example, have to accept anyone, so that they cannot pick all the young and healthy people and leave the old and sick for the governmental system. Though private insurance is often much more expensive if you have family because you have to insure every family member individually,and it also becomes much more expensive as you grow older.

To discourage people from exploiting the system by insuring themselves privately while young and then later switch to the socialized system it is illegal to change back into the socialized system once you are privately insured, except if you can prove that you can no longer pay for private insurance now and in the forseeable future.

[Ferrus]

There is also private insurance which runs parallel to the socialized system
Yes, this is how it works here. The NHS is paid for by taxes, whilst there is an additional private healthcare system running concurrently for those who can afford it, and always have been ever since the doctors kicked up a fuss over the nationalised health care system in the late 1940s - demanding they could spend a certain number of hours in private work.

[Vagabond]

A doctor's visit costs about 20 euro
WHAT?! Those thieving, bastardish Greek doctors - it costs about 50 euros over here, if you're lucky!

*makes plans to move to Belgium, while :banghead:ing for not going to the docs while she was in Brussels*

[Limey]

I accidentally the whole thing....before the socialism....

[edge walker]

I accidentally the whole thing....before the socialism....Is that bad?

[Ferrus]

I accidentally the whole thing....before the socialism....
All your base are belong to us. Forsooth.

[Limey]

Is that bad?

Yes, The whole thing!
BEFORE the socialism

[hardkar]

There have been some whining here about the healthcare system. But I thought it was quite quick when my father accidently almost sawed his foot of with the chainsaw. Ambulance -> Surgery -> Rest -> 2 days later home jumping around on crutches.

[bluebell]

In the last 8 years, health insurance for my family has gone from costing us $150/month (and being quite extensive, $15 copay for replacing a liver) to almost as much as our fucking mortgage (for shittier coverage, higher copays too).

I just did the maths on this. In my country's socialised health care, we pay 1.5% of our income as a levy for health care. That works out as costing us less (in $US) now than your insurance costs 8 years ago. It costs me around $US33 to see the doctor of my choice (and that's for a 20 minute appointment with my current doctor) and I get around $US25 of that back. I have to take two prescription medications every day, probably for the rest of my life. That costs me about $US40 per month for both. Nearly every single prescription drug costs $US20 or less per prescription (there are a few where you have to pay more but that's extremely rare).

I don't see why people get upset about the thought of socialised medicine.

Edit: If I was unemployed or disabled, then seeing my doctor would be free and my prescriptions would cost me $US2 each.

[mancroft]

I don't see why people get upset about the thought of socialised medicine.

The main problem with socialised medicine like the NHS is that it is a financial bottomless pit.

You could put all the money in the country into the NHS and still find things to spend even more money on.

[C.J.Woolf]

I don't see why people get upset about the thought of socialised medicine.
Neither do I. Americans fancy themselves rugged individualists and all that shit.

The special interests opposing health care finance reform have more effective propaganda. I've wondered why no one has tried selling it as "extending Medicare to everyone".

[Dark Razor]

Neither do I. Americans fancy themselves rugged individualists and all that shit.

The special interests opposing health care finance reform have more effective propaganda. I've wondered why no one has tried selling it as "extending Medicare to everyone".

Oh but then I have to pay for THEM their health care, it is much better to let ME keep my money and let THEM die in the streets. Of course THEY don't die in the streets, though, but come to the emergency room if they are really sick, might have been cheaper to fund some preventive care with MY money, but nah I'd rather spend the money on some more ammo for when They come and try to take my guns away

[Ferrus]

I just did the maths on this. In my country's socialised health care, we pay 1.5% of our income as a levy for health care. That works out as costing us less (in $US) now than your insurance costs 8 years ago.
Yes, I read a report which suggests that Americans are paying twice as much for healthcare as they are in Britain. Now... as Mancroft said - it is not 'that bad'. Certainly not half as good as the US.

Mind you, American hospitals supposedly have a distinctive smell in contrast to most of the world, it having been prettied up somewhat.

[ApeTheDog]

The main philosophical benefit of socialized health care, as I can see, is that nobody makes a profit out of it. If you have companies trying to bleed you out of your money this ensures that, no matter what, some of the cash put into the system doesn't get spent on medical care. As far as I'm concerned health-care should be a basic human right.

[Lateralus]

I don't know how doctors visits differ from other countries but our government made a commerial praising our system once, so I just assume it has to be good.
LOL

The problem is that we have health insurance, at all. Insurance only works for uncontrollable catastrophes (ie. life, home, auto). Even catastrophic health insurance is affordable. What we have with general health insurance is similar to insuring your house to cover the cost of cutting the grass or insuring your car to cover the cost of new tires. Insurance is the source of the market inefficiency.

[Ferrus]

The market for gold watches is effcient enough - doesn't mean everyone can afford it. Whilst for frivolities these negative externalities may be fine, for social necessities such as education and health, it is an intolerable strain on a state's coherence.

[Lateralus]

The market for gold watches is effcient enough - doesn't mean everyone can afford it. Whilst for frivolities these negative externalities may be fine, for social necessities such as education and health, it is an intolerable strain on a state's coherence.
There are plenty of watches that function adequately, that almost anyone can afford. I haven't seen anyone complaining because gold plated wheel chairs aren't affordable.

[Ferrus]

There are plenty of watches that function adequately, that almost anyone can afford. I haven't seen anyone complaining because gold plated wheel chairs aren't affordable.
Ah, yes excellent idea, let's revert to barber-surgeons.

[ApeTheDog]

A gold plated wheelchair is jewlery.

[Lateralus]

A gold plated wheelchair is jewlery.
And so is a gold watch. Ferrus' comparison was not a good one. And his latest response is hyperbole.

[ApeTheDog]

I thought that was his point.

Gold watches and jewlery = make a profit off them, there are never going to be enough to supply everybody with and you don't need them anyway.
Water, Electricity, Health Care = morally corrupt to turn this into a profit venue.

[Lateralus]

I thought that was his point.

Gold watches and jewlery = make a profit off them, there are never going to be enough to supply everybody with and you don't need them anyway.
Water, Electricity, Health Care = morally corrupt to turn this into a profit venue.
Yet we still have affordable non-gold watches.

[ApeTheDog]

We still have affordable non-gold watches? Do you expect that to change in the future, then?

[Thevenin]

What's the difference whether I'm screwed by the GOVERNMENT or the insurance company? Morons are morons whether they work for the GOVERNMENT or an insurance company (whose CEO makes $75 million a year). You'll not find a rational system associated with healthcare anywhere in the world.

Exercise, avoid excess calories, relax and get plenty sleep.

[edge walker]

Exercise, avoid excess calories, relax and get plenty sleep.
Yeah man, just don’t get sick. What’s so hard about that. I don’t understand why people make a fuss.

[Ferrus]

Yet we still have affordable non-gold watches.
My actual point was - standards can be reduced when it comes to tables and chairs. With healthcare, unless you actually want to be cured, more often than not there is a minimum standard needed as treatment and that minimum is often expensive (look at anti-retroviral drugs, for example).

[jyakulis]

likely outcome of socialized medical care:

government insures everyone, greatly increases demand of medical care thus increasing price, government says health care costs are too high, government price fixes what health care practicioners can make, lack of incentive to get into health care is created leading to shortage in supply of medical care.

[ApeTheDog]

likely outcome of socialized medical care:

government insures everyone, greatly increases demand of medical care thus increasing price, government says health care costs are too high, government price fixes what health care practicioners can make, lack of incentive to get into health care is created leading to shortage in supply of medical care.

It has not happened in any European country with socialized medical care, so I have to question your useage of the word "likely".

[jyakulis]

It has not happened in any European country with socialized medical care, so I have to question your useage of the word "likely".


well, i have no idea how it works elsewhere. i still fail to see how what i said would be false. how would prices not rise when you have an additional 45 million people getting health care. i mean it's basic supply and demand economics.

[Dark Razor]

well, i have no idea how it works elsewhere. i still fail to see how what i said would be false. how would prices not rise when you have an additional 45 million people getting health care. i mean it's basic supply and demand economics.

You can exclude coverage of fancy, unnecessary stuff. Additionally you can have private insurance run concurrently with the socialized system, that way doctors can compensate for fixed government budgets by making additional money off private patients.

Remember, the US has the most expensive health care system in the world, while some countries with socialized health care, like France for example, rank higher in quality of care provided and lower in costs.

[ApeTheDog]

I don't think your economics make sense.

They're not all paid out of the same pool of money that is there right now. The amount of money being put into the medical system increases as well. If anything, you're probably going to get more healthy people into the system who don't end up profiting from it (but still profit from the peace of mind that being insured brings), and so the percentage of the people paying but not taking money out is likely going to be higher, even.

There's also no short-supply of medication... it's not like uranium or scarse mineral resources where there's a limited amount of it to serve everybody. Pharmaceutical companies can increase production so instead of increasing the price they do that.

[edge walker]

well, i have no idea how it works elsewhere. i still fail to see how what i said would be false. how would prices not rise when you have an additional 45 million people getting health care. i mean it’s basic supply and demand economics.
Emphasis on the word “basic”. Do you really think an analysis as simplistic as that one can do any sort of justice to a system as complex as health care? How about the fact that most countries that have socialised health care tend to do so by regulating insurance and mandating it under a broad set of conditions? End result is what can be thought of as a health insurance tax on everyone, the key being that most of the money paid by individuals goes into actual health care rather than into the profit bottom line of a corporation.

Roughly. That’s not even close to doing the subject justice, and there are umpteen different variations on the theme, some of which barely fit the above description at all. But it’s at least a start of how socialised health care might actually work under “basic supply and demand economics”.

“I have yet to see any problem, however complicated, which, when you looked at it in the right way, did not become still more complicated.” —Paul Anderson

[jyakulis]

I don't think your economics make sense.

They're not all paid out of the same pool of money that is there right now. The amount of money being put into the medical system increases as well. If anything, you're probably going to get more healthy people into the system who don't end up profiting from it (but still profit from the peace of mind that being insured brings).

There's also no short-supply of medication... it's not like oil or other resources where there's a limited amount of it to serve everybody. Pharmaceutical companies can increase production so instead of increasing the price they increase production.

there is a finite supply of doctors to administer it.

[Dark Razor]

there is a finite supply of doctors to administer it.

Yea but that doesn't really matter if you consider the upper half of his post. If the market is bigger, maybe you're going to have more doctors.

[jyakulis]

Comparison countries in Canada and Europe were much more willing to exert monopsony power to drive down prices, whilst the highly fragmented buy side of the U.S. health system was one factor which could explain the relatively high prices in the United States.


http://cthealthcareblog.com/story.aspx?id=28

on innovation:
http://fraser.stlouisfed.org/publications/ERP/page/8649/download/47455/8649_ERP.pdf

[thod]

there is a finite supply of doctors to administer it.


The majority of doctors are not worth the money they receive. Its silly to say that because they fix bodies they are more skilled than people that fix cars.

Your average doctor never treats anyone. He sits in an office and diagnoses then writes a prescription. Train someone to recognize the top 100 ailments and lookup the drug, you have a doctor. The surgeons have some manual skill but no more than others that manipulate things. They too are a production line working on a single area.

The whole thing is set up the restrict the number of doctors to keep up pay. They will try to argue its about standards. Its not though. There are lots of people that want a doctors pay but they cant get trained. We need to double the numbers and make them compete until pay is so low people stop entering the trade. All this hokum about training costs and time spent doesn't convince me. I can do the numbers and see the ludicrous return on investment same as anyone else. If it costs $100k to train for a 40 year career then he need only make 2.5k a year more than the average man to recoup his costs. In fact he makes 5x or more.