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Health Care Reform?
    #1840409 -

In my mind there are two ideas that clash into each other regarding health care reform and I don't have an answer I am satisfied with.

1. The government shouldn't be involved in health care. That clearly isn't their function.

2. Health care costs are extremely high. Some of that is due to government interference but it should be noted that capitalism as a system will limit the amount of good to be had in the form of improved health.

Is there a solution?

Can we insure that people have health care at a reasonable cost?

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Re: Health Care Reform? [Re: ]
    #1840426 -

We should find the Middle Way.


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"It is dangerous to be right when the government is wrong."--Voltaire

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Re: Health Care Reform? [Re: silversoul7]
    #1840443 -

Help me look then. :smile:

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Re: Health Care Reform? [Re: ]
    #1840446 -

I'll try.


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"It is dangerous to be right when the government is wrong."--Voltaire

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Re: Health Care Reform? [Re: ]
    #1841394 -

We seem to be doing something terribly wrong. The US health system ranks a dismal #37 out of 191 countries in the world according to the World Health Organization. According to the World Health Report, of the 191 countries in the study, the U.S. spent the highest percentage (13.7%) of its Gross Domestic Product on health care but still managed only to achieve an overall ranking of 37.

Even the Journal of the American Medical Association ranks the US 12 out of 13 developed countries studied.

France ranks very high in both reports. Maybe we should look to them to see what they're doing right?


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Edited by Cornholio (08/22/03 05:42 PM)

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Re: Health Care Reform? [Re: Cornholio]
    #1842817 -

Those rankings might be a little deceiving.

I took a look at the World Health Report published by the World Health Organization (note that each year their report has a different subject, so the rankings in question are from their 2000 report.  Out of 191 countries, the US was ranked #1 in terms of responsiveness, which seems to be the reason so many people support US style healthcare.  But the US only ranked 24 in level of health, meaning we're not that good at helping people live long lives.  Both of these combined give us a ranking of 15 in the world for overall healthcare.  But this doesn't factor in cost.

Since we have the most expensive healthcare in the world, but we're only ranked 15, we got a 72 ranking in "bang for the buck".  When you combine our ranking of 15 in quality with 72 in bang for the buck, you get our overall world ranking of 37.

So some people might consider the following rankings more significant:

If you're just concerned with living the longest possible life, and you're not concerned about waiting time for less important care, you should use the following healthcare models:

1. Japan
2. Australia
3. France
4. Sweden
5. Spain
6. Italy
7. Greece
8. Switzerland
9. Monaco
10. Andorra
11. San Marino
12. Canada
13. Netherlands
14. United Kingdom
15. Norway
16. Belgium
17. Austria
18. Luxemburg
19. Iceland
20. Finland
21. Malta
22. Germany
23. Israel
24. United States of America
25. Cyprus
26. Dominica
27. Ireland
28. Denmark
29. Portugal
30. Singapore

If you want a long life, with responsive healthcare you should use the following healthcare models:

1. Japan
2. Switzerland
3. Norway
4. Sweden
5. Luxemburg
6. France
7. Canada
8. Netherlands
9. United Kingdom
10. Austria
11. Italy
12. Australia
13. Belgium
14. Germany
15. United States
16. Iceland
17. Andorra
18. Monaco
19. Spain
20. Denmark
21. San Marino
22. Finland
23. Greece
24. Israel
25. Ireland
26. New Zealand
27. Singapore
28. Cyprus
29. Slovenia
30. Czech Republic

Finally, if you want a long life with responsive healthcare and good "bang for the buck", then you should use the overall rankings, (which are the ones you orininally provided in your link):

1. France
2. Italy
3. San Marino
4. Andorra
5. Malta
6. Singapore
7. Spain
8. Oman
9. Austria
10. Japan
11. Norway
12. Portugal
13. Monaco
14. Greece
15. Iceland
16. Luxembourg
17. Netherlands
18. United  Kingdom
19. Ireland
20. Switzerland
21. Belgium
22. Colombia
23. Sweden
24. Cyprus
25. Germany
26. Saudi Arabia
27. United  Arab  Emirates
28. Israel
29. Morocco
30. Canada

31. Finland
32. Australia

34. Denmark

37. United States

Since Mr. Mushrooms hinted at finding a way to make healthcare less expensive, then Cornholio I guess you're right, follow the French model.  :tongue:

Sorry for the long post, I love these kind of statistics.  :grin:     


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:smile:  Just stating my thoughts, not trying to offend  :smile:

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Re: Health Care Reform? [Re: GoBlue!]
    #1844110 -

Wow, even with all our spending, 23 countries are healthier?  I think that makes a pretty strong case against private healthcare, doesn't it???  :shocked: 


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Re: Health Care Reform? [Re: ]
    #1844186 -

tort reform.


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Re: Health Care Reform? [Re: wingnutx]
    #1844245 -

Good point.


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Re: Health Care Reform? [Re: Cornholio]
    #1844276 -

Quote:
Cornholio said:
Wow, even with all our spending, 23 countries are healthier?  I think that makes a pretty strong case against private healthcare, doesn't it???  :shocked: 


Not really.  Health Care and the pharmaceutical industries are HEAVILY regulated.

Much health care is already paid for by the government, ever heard of Medicaid and Medicare?  Since Medicaid and Medicare patients pay little or nothing for health care, they demand more of it than they would otherwise causing expenditures to increase above what a truly private system would.

Tax breaks for businesses not enjoyed by individuals create incentives for employers to use HMOs.  By doing this the costs and decisions are taken away from the consumers, they don't see the true cost of things and are shielded from making informed decisions. 

The prices for pharmaceuticals are driven up by government regulation.  If a drug has been approved and used in Europe for years and the manufacturer wants to sell it in the U.S., they still must go through all the same FDA testing requirements as if it were a new drug.  Data from European trials and testing is not allowed.  This drives up prices and restricts competition from medications which may be cheaper and more effective.

Alternative medical practices are also frowned upon and prohibited.  In other countries, such things as homeopathy and herbal medicines are not considered quackery and are even paid for by insurance.  Patients avail themselves of these services and pay less for them than the drugs and invasive procedures of conventional medicine, many with very good results.  Excessive government regulation in this sphere (driven by the medical establishment and large pharmaceutical concerns) can be seen to be another cause of increased costs for medical care.

The U.S. also has a terrible tort system in which all sorts of frivolous and unsubstantiated lawsuits are brought up, eating up enormous sums of money on the legal end of medical care.  Not only are the legal fees added to the cost of medical care, but the insurance fees to protect against legal actions are added.  This raises prices and is an issue that should be dealt with. (I know a local doctor who is thinking of closing her practice because she can't afford the insurance and provide reasonably priced quality care at the same time.)

I think a better term to describe most of the medical care in the U.S. would be 'Regulated and Corporatized.'  We do not have a true standard of private healthcare that would allow us to make a valid case against it.  There are too many distortions in the market. 


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"In religion and politics people's beliefs and convictions are in almost every case gotten at second-hand, and without examination."
-- Mark Twain

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Re: Health Care Reform? [Re: Autonomous]
    #1844331 -

Another thing about those rankings. The results can quite definately be skewed by lifestyles (in other words, diet and exercise) of the peoples of the various nations. Americans probably travel less by walking or riding bikes than any other people and in their leisure activities are extremely sedentary. The American diet is notoriously bad and Americans probably consume more excess calories than any other people. These factors themselves can also lead to higher medical costs, in addition to lowering lifespans.


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"In religion and politics people's beliefs and convictions are in almost every case gotten at second-hand, and without examination."
-- Mark Twain

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Re: Health Care Reform? [Re: Autonomous]
    #1844529 -

Actually, the 24 ranking doesn't take cost into consideration (the 37 ranking does). So even ignoring costs, we still only rank 24.

I agree with you, however, that lifestyle and exercise may be a factor as to why we rank so low. I wonder why (if?) our diets and exercise aren't as good as those in other "modern" countries???


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Edited by Cornholio (08/23/03 10:46 PM)

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Re: Health Care Reform? [Re: Cornholio]
    #1846295 -

I have a few ideas on health care reform.Keep in mind I'm just throwing out ideas,some may be very immpratical.

Tort reform is a good start,as long as it's fair.By fair I mean if a doctor goes blatantly outside of standard medical procedures and shows neglect,and it's life costing or similar big fuckup,people deserve some good compensation.But on the other hand,money will not bring someone back to life or in most cases reverse a severe malpractice injury.Also,keep in mind that medical science is far from perfect,doctors have limited knowledge,and like all humans they make mistakes.People should not get compensation for minor fuckups and high risk procedures.

I think the next thing would be pharm company reform,specifally the way they market and advertise drugs and medical products. Direct to consumer advertising (ie Zoloft commericials) should be totally illegal and companies should not be allowed to bribe doctors with fancy dinners and cruises and office matterials. I understand that drug companies need to make money and that's it's an inncentive to develop new drugs,but taking a drug is not like buying a fucking bag of potato chips.If their drugs are as good as they say,they should stand on their own merits. Advertising and promotion are expensive,and these costs get passed on to the consumers.
The next thing is greedy doctors.Of course doctors should be able to make a decent living-they have expensive loans to pay off and they go through years of rigerous training,but if they want to be rich,they should be business men. You should be a doctor because you want to help people and because you're interested in the knowledge you learn.Profiting off of people's pain and suffering is disgusting. I see doctors as public servants. People would raise a ruckus if their firemen were buying yachts and mansions,why should it be different for doctors?


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People think that if you just say the word "hallucinations" it explains everything you want it to explain and eventually whatever it is you can't explain will just go away.It's just a word,it doesn't explain anything...
Douglas Adams

Edited by grandmasterfat (08/24/03 07:03 PM)

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Re: Health Care Reform? [Re: monoamine]
    #1846370 -

another case of the fat ass lazy american rears his ugly face. the sad truth is that people gorge themselves on absolute shit while watching sports on TV. it's a sick sad country.

go running you fattys! do some yoga!


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The ultimate meaning of our being can only be fulfilled in the paradoxical leap beyond the tragic-demonic frustration. It is a leap from our side, but it is the self-surrendering presence of the Ground of Being from the other side.
- Paul Tillich

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Re: Health Care Reform? [Re: Malachi]
    #1846551 -

I am just getting an education here.

Thanks guys! :smile:

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Re: Health Care Reform? [Re: Malachi]
    #1846582 -

Haiwaiians are notoriously fat due to their native diets so i dont know wtf you are talking about


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I'm a nihilist. Lets be friends.

bang bang

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Re: Health Care Reform? [Re: d33p]
    #1846586 -

Malachi only eats poi lite.

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Re: Health Care Reform? [Re: monoamine]
    #1846598 -

Good points on healthcare reform ideas grandmasterfat.  If anyone doesn't believe the part about pharmaceutical companies bribing doctors with fancy dinners and cruises and office matterials, it's absolutely true.  My girlfriend is a social worker who sees this happen constantly and notices that the doctors always seem to prescribe the products of the companies that bribe them the best to their patients.

Interestingly, she's always spoken out against this, until a pharmaceutical company just flew her to a conference of theirs this past weekend, where they put her in a Ritz Carlton hotel ($400/night), and gave her "the fanciest dinner she's ever eaten" (and we've often spent $300 on a dinner between the two of us).  Now she says "I can get used to this.  So long as their product works, I guess there's no harm in me recommending it to the doctors and patients"!!!  :wtf:  What the fuck, she's more liberal than I am!?!?!

Edit:  Oh, and they also gave her $500 cash just to listen to them pitch their product.  There were a lot of people at that conference.  Guess who pays for all this???  :mad:

And malachi, be careful who you reply to!  grandmasterfat usually takes the liberal side to arguments (which I think you would usually agree with maybe???) and he never even mentioned anything about being fat.  Yet you say "another case of the fat ass lazy american rears his ugly face."  Sometimes, I just don't understand you man.     


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Edited by Cornholio (08/24/03 10:19 PM)

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Re: Health Care Reform? [Re: Cornholio]
    #1846604 -

I know a couple of pharma sales reps. They do stuff like that all the time.

They also dump off cartloads of free samples.


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Re: Health Care Reform? [Re: Cornholio]
    #1846863 -

The pharm advertising is getting to absurd levels.

My psychiatrist's office has brochures sitting around,but they only put one seperate brochure for one drug in each class out (ie Zoloft for the SSRI's,Xanax for benzos, Zyprexa for antipsychotics). They also have drug tissue boxes,stationary,pens, and psychiatric mags full of ads. And I know full damn well the reps don't do this out of the kindness of their hearts,the costs get passed on in drug prices,which includes "free" samples.

My older psychiatrist used to be in cahoots with Forest Labs. Probably every other visit a would see a Forest rep. One day I had enough balls to fuck with him.
Let me explain something,or this story won't make a lot of sense.Forest owns the patent to two SSRI antidepressants,Celexa and Lexapro. The citalapram (Celexa) molecule displays what chemists called "chirality",which basically means the drug has perfect symetry-it has two halves that are mirror images of each. However,only one half is active.The other half just doesn't really do anything. Escitalopram (Lexapro) is the isolated active half. Forest invented Lexapro basically because the patent on Celexa was running out. They claim that Lexapro is somehow more effective,which is a crock of shit They are exactly the same thing,just that Lexapro doses are half of Celexa doses. My fear is that misinformed doctors (there are a lot of them) that are going to prescribe Lexapro when the generic citalopram hits the market soon.
Anyways,I questioned the Forest rep about this right in the middle of the office and we got into a pretty fierce debate.All the rep did was spew out word for word crap from the pamphlets (reps generally have little medical training).
He must have told the doctor about me or something,because the next month when I came for my appointment,out of the blue my doctor told me he wouldn't see me anymore. He gave me some garbage about how I was a drug abuser,which didn't seem to bother him for the last six months (the only thing I was doing at the time was maybe once a week weed sessions), and that I was abusing my medication (Ativan),which wasn't true either-I was taking it exactly as prescribed.
Because of that fucker,I went through benzo withdrawal,which is absolute hell,because it took me a month and a half to get another appoitment with another psychiatrist and get more meds. I still feel waiting for his office to close and kick the shit out of him.


--------------------
People think that if you just say the word "hallucinations" it explains everything you want it to explain and eventually whatever it is you can't explain will just go away.It's just a word,it doesn't explain anything...
Douglas Adams

Edited by grandmasterfat (08/24/03 10:15 PM)

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