REAL WORLD EVENT DISCUSSIONS

VENEZUELA : HEALTH CARE REVOLUTION.

POSTED BY: HOWARD
UPDATED: Monday, October 24, 2005 16:11
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Saturday, October 15, 2005 6:22 PM

HOWARD


"I love freedom of speech just as much as you, but I hope that you will post messages that are at least somewhat civil and in good taste."

I fully agree!! The above sentiment is excellent.

Here is another well written, clear and inspirational account of the positive efforts for humanity being made by the government of Venezuela under the leadership of President Hugo Chavez. Who is working hard to undo the damage and injustice done to his country and region by former regimes that operated only for the benefit of the haves never the have-nots. That is now in the process of changing thanks to the Bolivarian revolution.

------

VENEZUELA: HEALTH CARE REVOLUTION.

Author: W. T. Whitney Jr.
10/13/05 10:39


In late August President Hugo Chavez of Venezuela announced a new stage in his country’s fight for health care. The government will spend $2.5 billion. “The first and most important use [of the money] is to purchase necessary equipment, the most modern in the world,” said Chavez. “That’s Barrio Adentro III (‘Inside the neighborhood’): a hospital revolution.”

A revolution may be what’s necessary to make good on health care as a human right. As Fidel Castro declared in 1959, “The peasant’s children were allowed to die, because there were no medicines or doctors for them. Peasants’ wives were allowed to die because there was often neither medicine nor doctors for them. … In rescuing the peasants, the revolution is taking its first step toward making itself a true democracy, a democracy without slaves.”

Health care is very much on the agenda for democratic change unfolding in Venezuela. Utilizing Cuban doctors and expertise, plus oil money, Venezuela’s Bolivarian revolution is on the road toward a new era in health services.

Venezuela’s poor, about 80 percent of the population, are probably better off than Cuban peasants were back in 1959. Theoretically, two-thirds of the Venezuelans have access to health services under social security, and Venezuelan infant mortality rates and life expectancy are better than those of many other Latin American nations.

But for the majority, health care has remained unavailable. Many rural villages and isolated settlements are far removed from facilities. Privatization has closed public health facilities and upped the price of services. Until recently only 3 percent of the gross national product went toward health care, whereas most industrialized nations spend 8 percent to 10 percent. Physicians are in short supply.

Of Venezuela’s 55,000 doctors, 10,000 do not work and 22,000 are public health physicians, many of them working part-time. Cuba has sent 20,000 doctors and dentists to Venezuela in exchange for inexpensive Venezuelan oil at the rate of 90,000 barrels per day. Venezuela pays the Cuban doctors $210 per month for food and transportation and Cuba provides their families at home with $750 every month.

For two years, as a first step, the Chavez government has been encouraging communities in poor and remote areas to build their own health centers and has arranged for Cuban doctors to staff them. Under Barrio Adentro I, over 8,000 such centers now offer primary care, health education, and prevention.

The communities have carried out surveys to determine local health needs and have developed comprehensive health care plans. The centers dispense free medicines provided by Cuba.

On June 10, President Chavez introduced Barrio Adentro II. The government will build 600 new diagnostic centers throughout Venezuela, complete with emergency departments, laboratories and operating rooms. Some of the new facilities will offer specialty care and ambulance services. About 1,200 centers for rehabilitation, physical therapy, acupuncture and health education are also being built.

The health ministry has recruited 1,500 Venezuelan physicians to join the new programs. It has arranged for 17,000 Venezuelans to travel to Cuba for orthopedic or eye surgery.

Under Barrio Adentro III, the existing hospital system will be overhauled. The government will buy top quality equipment from abroad for refurbishing hospitals and for patient care that in the future will be provided free. The money comes from a $6 billion development fund that the National Assembly withdrew last July from foreign currency reserves worth $30 billion.

In view of a shortage of 20,000 practicing physicians, medical education is a priority. This year 887 students from Venezuela are enrolled in Cuba’s Latin American School of Medicine, and 1,050 Venezuelan doctors are studying family medicine in Cuba. All Cuban doctors working in Venezuela have two medical students in tow who are enrolled in a “medical school without walls” developed by Cuban and Venezuelan medical educators.

The program began Oct. 3, with 20,000 entering Venezuelan medical students. Their course will emphasize humanistic values and close integration of basic sciences with clinical medicine. Students are taught even in remote, rural areas, because the need for students to go to cities to study medicine often influences them not to return to practice in their home districts.

Venezuelan and Cuban educators are planning to train 50,000 new Venezuelan doctors over the next 10 years, plus 30,000 others from elsewhere in Latin America. President Chavez recently announced plans to develop in Venezuela a second Latin American School of Medicine.

Author: W. T. Whitney Jr.
atwhit@megalink.net



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Saturday, October 15, 2005 6:53 PM

EYETOOTH


Quote:

Here is another well written, clear and inspirational account of the positive efforts for humanity being made by the government of Venezuela under the leadership of President Hugo Chavez.


Mods, please...you presumably wouldn't long tolerate a poster trying to sell everyone on Jesus, and this guy is scarcely better than that.

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Saturday, October 15, 2005 8:46 PM

CANTTAKESKY


Let me guess, Howard. You really, really, really like Hugo Chavez?

I have a few thoughts on this whole national health care business.

1. Nationalized health care proposals always rest on one assumption: that western, allopathic medicine is a good thing. What if it isn't? What a waste of money then, eh?

Now western medicine indisputably can be very useful. If you get your arm bit off by a shark, surgeons can reattach it. EMTs can resuscitate dying or dead folks, and docs can remove nasty projectiles out of people's skulls. All in all, I'd say emergency/trauma is the field's strong suit.

The usefulness of the rest of medicine is disputable. Mostly, they either sell drugs for people to be dependent on for the rest of their lives, or charge exorbitant sums to cut you open and rearrange your insides. Whether either of these are necessary, or better than their alternatives, is subject to debate.

Is it fair to force everyone to pay for this product (allopathic medicine)? If you love this product, sure it's great. If you prefer an alternative product, then well, it sucks that you have to pay for something you don't believe in.

There are various philosophies and models of healing. To have the government subsidize one over another is just as egregious as having the government subsidize one religion over another. Wouldn't it be better to just let people choose what kind of health care they want?

In Venezuela, as in the rest of South America, they have centuries old, indigenous traditions for healing and health. Who is to say that the govt should subsidize western medicine over those methods?

People who support nationalized health care tend to be liberals who are usually sensitive to multicultural and minority issues and supportive of diversity. Yet when it comes to health care, multicultural philosophies and diversity disappear--in favor of the dominant western (and if I may add, male-centric) paradigm.

2. Speaking of liberals, leftists who support nationalize health care usually have a deep distrust of industry and corporations. They see them as greedy and corrupt and unconcerned for consumers. However, when it comes to the medical industry and pharmaceutical/hospital corporations, that distrust disappears as well.

Let me illustrate. Imagine if gas prices continued to soar. They reach $20/gallon. Only the very wealthy can afford gasoline. Would liberals support a National Gasoline Share system? Force everyone to take a chunk out of his/her paycheck so the industry can keep expanding its profit margin? Or would they challenge the prices, question a CEO's exorbitant salary, and maybe even boycott the industry until they bring prices down? Would they use high gas prices as a springboard for demanding research into alternative fuels? After all, if gas prices are truly that costly, then maybe we should come up with less costly alternatives.

Why do folks want a national health care plan? Because health care is too expensive for average citizens. Now instead of paying the extortionist prices, how about figuring out how to bring those prices down? Examine policies affecting the cost of malpractice insurance and clinical trials for new drugs, for example. Hell, if oil company CEO's should live on a little less, maybe doctors should too? How about figuring out how we can come up with alternative health care that simply costs less? Come up with cures instead of treatments you have to take for the rest of your life.

Somehow, when it comes to doctors and pharmaceuticals, the same standards for challenging greed and corruption don't apply. We need a national plan to help them make their boat and vacation home payments so that they don't let us die.

3. Can all that money be used in better ways for promoting health? In Venezuela, could they be reinforcing the infrastructure for street cleaning, sewer, clean water, pest control, transportation and communication (the last 2 affects costs of products that maintain health, such as fresh food). Would better sanitation keep people from getting sick to begin with, so they don't need to see doctors so much?

In the States, we have all that healthy infrastructure. Instead of putting taxpayer money to buy drug dependence for all Americans, could we research cures and chronic diseases instead? Find a way for people in wheelchairs to walk again, for diabetics to not have to use insulin, for asthmatics not have to use nebulizers. Of course the industry would never support that--where's the money in a cure?

Can't Take My Gorram Sky

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Sunday, October 16, 2005 3:01 AM

CITIZEN


Just as a little aside from your post CantTakeSky:
I believe the British NHS actually subsidies some alternative medicine (i.e. thoughs that have shown to have a beneficial effect).
I'm a supporter of national health. Personally I believe that Health care (western or otherwise) is a right, not a privalage of those that can afford the bills/medical insurance.



More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
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Sunday, October 16, 2005 5:30 AM

CANTTAKESKY


Citizen,

You know, health care wouldn't be a privilege of the wealthy if the industry didn't charge exorbitant prices for their products and services.

Everybody needs working cars. Mechanics can be expensive, but most people don't need car care insurance to keep their cars working. Why not? Because mechanics don't charge an arm and a leg so they can live like kings off of other people's misery and desperation.

Wouldn't a better solution be to bring down health care costs so they're affordable, instead of forcing everyone to fork out for some doctor's 3rd vacation home?

Can't Take My Gorram Sky

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Sunday, October 16, 2005 5:45 AM

CITIZEN


I don't think so...
Mainly because in Britian we've tried privatising public sector services and they end up costing more, giving a poorer service, and in some cases actually being far more dangerous (I speak largely of the privatisation of the Train networks).

Further more there's people in society who can't afford mechanics, or even a car. The only way to allow those people to be able to get Health care is to make it free for them, which means either state run where the wealthy (them that can afford to pay more) pay more, or pricing system that accomplish the same thing in the private sector. Which frankly, I doubt would happen.
Why? Because of the nature of buissness. Richer folks will understandably go to the cheapest, and you'll end up getting a system that caters to them, but not less fortunate people (allowing them to keep prices down for richer folks).
I don't think it's unfair to ask people to look after those less fortunate than themselves, and that's essentially how I see public health care.



More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
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Sunday, October 16, 2005 5:56 AM

SIGNYM

I believe in solving problems, not sharing them.


Can'ttake sky- There are a lot of reasons for the high cost of health care, but in fact the health care in the good old USA is at least 50% higher per capita than ANY OTHER industrialized nation- and about 30% of our population is uninsured. I want to make sure that you understand that statistic:

Our health care costs per capita are HIGHER than per capita health care costs of any other undustrialized nation, DESPITE the fact that a large portion of our population has no health care coverage and very little health care service.

The difference between "them" and us is that they all have nationlized health care and we don't. Here's something else to consider- you may have cause and effect bass ackwards. One of the reasons why we have such high health care costs is BECAUSE we have for-profit insurance companies, who not only make a heatlhy 8-15% profit but also suck up approximately 30% in administrative costs. "The industry" does charge exhorbitan prices- but "the industry" is not uniformly making tons of profit. Within the industry, the profit takers are the pharmas and the insurances.

BTW- as far as allopathic medicine is concerned- since my daughter and SO have serious chronic illnesses, I can guarantee you that there are some conditions that don't respond to holy smoke and chanting. I have nothing against traditional medicine, but a lot of it is ineffective. (Too bad we don't have the equivalent of the German Commission E.)

Please do some research on the topic.

Please don't think they give a shit.

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Sunday, October 16, 2005 6:15 AM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

Mods, please...you presumably wouldn't long tolerate a poster trying to sell everyone on Jesus, and this guy is scarcely better than that.
You must be new here. There are people here who post LOOOONG posts about how WMD will eventually be found in Iraq. People are pretty much allowed to post anything.

Furthermore, to compare a news article to preaching is like comparing a Disney cartoon about mermaids to a Science article on cetaceans. I know that you don't like the content of the articles, but unlike religion, news is not a matter of faith. It can be argued with evidence and reason. As I said in my other post, try bringing some of both to the table.



Please don't think they give a shit.

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Sunday, October 16, 2005 6:48 AM

HOWARD


Hi there CANTTAKESKY!

First of all thank you very much for your intelligent and civil and very well written response.

On Hugo Chavez, he is merely the face of a movement to liberate people from American imperialism. I believe he is true of heart but also that he a politician and thus as with all
state figures is liable to flaws and perfectly capable of being wrong sometimes but so far more good, a lot more good than bad. It is also very significant that he is the first Latin American leader who has a face and ethnicity that does not look like a White Spanish guy from Madrid.He is the first leader in the hemisphere and the first in his country to look like the majority. American imperialism has held most of Latin American in a cross between a capitalist version of the Soviet's East Bloc and South Africa under Apartheid. People are fighting back see the DVD of the documentary THE CORPORATION and its supplementary second disc for the story among other issues of what happened in Bolivia between the Bolivian people and Betchel in the struggle over their water supply.

On health care first we need to separate the health care dicussion in terms of 1st and 3rd World. In the poor communities of the South people have been traditonally denied what they have not only needed but have asked for. In Honduras for example under a regime that is a client of the USA the indigenous people officially receive no real health. But working in the rural villages and native people are doctors trained and educated at the Latin America school of Medicine in Cuba and sent to Honduras to provide poor people with health care by Castro's program to promote health care for the people. There are thousands of doctors educated for free of charge from many countries now working with hundreds of thousands of poor people across the region courtesy of the Cuban Revolution.

Now whether or not the lack of any parallel humanitarian effort by the great wealth of the United States is out of inhumanity or stupidity while the demonised enemy Castro does it with so little financial resources; the facts remains the same. Castro is no perfect angel and in constrast Hugo Chavez hss been twice elected but in examination of the record of the likes of Bush and Clinton I am not so inclined to second guess Castro on such good works. There is a reason why the Cuban Revolution (with all its flaws and shortcomings) is so popular with millions of people across the Third World. In countries where American power and its clients has done nothing but hurt people the poor of developing nations are not so convinced by the 1st World sales pitch.
For 50 years American media has promoted the insane notion of US generosity making the average American think that the US gives 20% of such figure of its GNP to the poor nations of the world. In surveys people have been asked about this and they give answers like "Well we give about 20% to the world I would be happy with 10% of our GNP" In fact over the past 50 years under Rep and Dem admins the USA has given/spent about 0:4% of 1% of GNP to the Third World.

Hugo Chavez is first President of an OPEC nation to use oil wealth to benefit the poor. The late Michael Manley PM of Jamaica tried to convince the Saudis to use their money for nothing to help poor countries get out of their debt bind with the IMF and the USA. The Saudi adhered to their agreement with the Americans and the British. That agreement has always been...something like this...You can keep your regime you can chop peoples head off and torture people and oppress your women as long as you direct the capital from oil as inward investment into North America and Europe...As long as the money goes North not South the House of Saud stays in power. So Manley was told by the Saudis that there were not interested in helping debt strangled countries like Jamaica.

Hugo Chavez is the crucial break in the OPEC mould and in the European Conquistador rule of 500 years of rich Spaniards and their gringo masters oppressing the peoples of Latin America.

Chavez is just the face. He can only do what he does because of all the unsung heroes working on the ground.

On the issue of Native medicine. Yes this can be good but Western medicine has its strengths too and that issue will come in the second face first let them get the infrastructure right then they can argue on diversity of approaches after.

On health care in the 1st World we spend so much more money and struggle to cover everyone. We can learn a lot from Cuba where making less money go further is an art.

One thing I wish to remark on the Canadian health care system. The word UNIVERSAL is misapplied to and in Canada. In Canada health care the propaganda is about a national universalm system but in practise it is not univeral. So in Quebec the health care sucks while in Manitoba the quality of care is superb. This reflects the amnount of corruption in the local culture. This has caused Americans on both sides of the arguement to be convinced that they are both right. If Canada just admitted that their health is in fact determined province to province it would enable Americans to understand the cause of the contradictions in regional terms. Americans opposed to public health care site Quebec as the horror story and presume the whole of Canada is just as bad. While Americans who dream of a Canadian system do not seem aware of the black hole of health care that is Quebec.

I do agree that Western industrialized medicine
is in itself a branch of the corporate system and that the resources are often spent on the wrong things while lacking for the right things. Plus the way in which children are being pumped with
psycho-narcotics to adjust behaviour is in my opinion, insane and immoral as well stupid. In most cases with a few exceptions changing the kid's diet should impact at least 80% of the problem. Our lifestyle driven by corporations creates the problems just so other corporations can profit on a claimed solution. This is true in both the public and private health sectors as they both get their drugs and equipment from the same corporations and the latest science from University labs funded by those same corporations.

PS CANTTAKESKY as you can see from the other above response the low level of thought and mentality in equating Chavez with North Korea. This is why I appreciate your intelligent response and critique of my offering as such as contrast to the other's utter ignorance.




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Sunday, October 16, 2005 8:12 AM

CITIZEN


Quote:

Originally posted by Howard:
PS CANTTAKESKY as you can see from the other above response the low level of thought and mentality in equating Chavez with North Korea. This is why I appreciate your intelligent response and critique of my offering as such as contrast to the other's utter ignorance.


Howard, please refrain from personal attacks against other posters, they will NOT be tolerated here.



More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
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Sunday, October 16, 2005 4:00 PM

RUE

I have a vote and I'm not afraid to use it!


Having spent many years working in the health care system, both private and public, I'd like to offer some perspective:

The US has the lowest life expectancy of any developed nation.

The US has the highest infant mortality rate of any developed nation.

The US has the highest per capita expense for health care of any developed nation.


But why stop there?

Andorra has the longest life expectancy in the world (83.51 years). Aside from the usual winners Japan, Sweden, Australia, Switzerland, Canada, Italy, France, Germany and the UK, surprising winners against the US are Macau (82.12), Iceland (80.19), the Cayman Islands (79.95), Aruba (79.14), Guam (78.40), Puerto Rico (78.29), and Bosnia/Herzegovina (77.83), with the US trailing (77.71).
http://www.cia.gov/cia/publications/factbook/rankorder/2102rank.html Some of this is due to the unusually violent nature of US society, some of this is cultural (dietary preferences), and much, regrettably, is due to lack of access to medical care, lack of treatment for chronic conditions, and overall poverty rates that undermine health.


Singapore has the lowest infant mortality rate in the world (2.29/100). The Czech Republic (3.93/1000), Macau (4.37), Slovenia (4.45), Portugal (5.05), Aruba (5.89), South Korea (6.28) and Cuba (6.33) are among the many nations that do better than the US (6.50) on infant mortality. From the other side, the US is just barely ahead of Croatia (6.84), Lithuania (6.89) and Guam (6.94). http://www.cia.gov/cia/publications/factbook/rankorder/2091rank.html Now, you may be tempted to dismiss these numbers, but averaged over thousands of births, they represent a statistic that would be hard to change without large-scale investment.


The US spends 4,631.00 per capita on health care, Switzerland $3,222.00, Germany $2,748.00, Iceland $2,608.00, Canada $2,535.00, and so on. http://www.nationmaster.com/printable-T/hea_hea_car_fun_tot_per_cap&in
t=-1
But you have to remember that in the other countries ALL people are covered by national health care. In the US (in 2004) 59.8% were covered through some type of work-based insurance, 27.2% were on a government insurance program, and 15.717% had no insurance at all. (Don't ask me why the numbers don't add up, they are according to the US Census Bureau.) http://www.census.gov/prod/2005pubs/p60-229.pdf Unfortunately, it is difficult to come by figures on those who are underinsured, but it is logical to assume that of those with insurance, there are those with marginal coverage.


So, when it comes to health care in the US, too much is being spent for too little. The cause is arguably the profit margin of the insurers and drug companies. But hey, that's what makes the free market system so great, eh?



Nearly everything I know I learned by the grace of others.

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Sunday, October 16, 2005 5:22 PM

CANTTAKESKY


Quote:

Originally posted by SignyM:
Please do some research on the topic.

Dear, dear SignyM. I can always count on you to come up with a different way to say, "Canttakesky, you're ignorant" on just about every thread.

I am not unaware of the statistics you cited or the fact that some sections of the medical industry are more greedy and corrupt than others (i.e. pharma and insurance).

One way to bring health care costs down is to implement nationalized health care, to be sure. But there are other ways to bring down prices, such as simply not charging as much. All I'm saying is, I'm much more in favor of the latter method.

In normal market dynamics, if you charge too much for your product, people stop buying from you. They go to your competitors or they simply do without. At that point, you have to lower your prices or you go out of business. That's how you know you're charging too much. That's the way the market is supposed to work.

The American medical/pharmaceutical/insurance complex has circumvented the market by 1) virtually eliminating all competitors, and 2) hiding prices from consumers through insurance, and 3) convincing people to become dependent on insurance. At the risk of oversimplification, one way to fix this problem is to open up the market to competitors and eliminate insurance altogether. It is, of course, more complicated than that, but that is the thrust of it.

This is one out of many possible solutions. I happen to like it best, but am willing to entertain debate on it. If nothing else, I simply think it is a mistake to immediately conclude that nationalized health care is the only way, or the best way, to solve the crisis without examining less forceful alternatives.

Can't Take My Gorram Sky

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Sunday, October 16, 2005 5:31 PM

CANTTAKESKY


Quote:

Originally posted by rue:
But hey, that's what makes the free market system so great, eh?

There is nothing "free" about this market system.

Competition, a cardinal feature of the free market, is not allowed. Both govt and mass media are in the backpockets of the industry, which incidentally already receives generous amounts of taxpayer subsidies. It is one of the most extensive cases of corporate welfare we have in the country.

Cut them loose from govt apron strings, and let them try to stand on their own 2 feet. Then we'll see just what happens to unbridled greed and corruption in a free market.

Can't Take My Gorram Sky

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Sunday, October 16, 2005 6:04 PM

CANTTAKESKY


Quote:

Originally posted by Howard:
The word UNIVERSAL is misapplied to and in Canada....While Americans who dream of a Canadian system do not seem aware of the black hole of health care that is Quebec.

I used to live in Vancouver briefly, and my father-in-law still lives there. We're not too impressed with them either. Their equipment is old and too few, their staff appears to be poorly trained, and there are of course, long wait times for services. Ironically, they've lost a lot of their personnel to better paying jobs in the US.
Quote:

I do agree that Western industrialized medicine is in itself a branch of the corporate system and that the resources are often spent on the wrong things while lacking for the right things...

Our lifestyle driven by corporations creates the problems just so other corporations can profit on a claimed solution. This is true in both the public and private health sectors as they both get their drugs and equipment from the same corporations and the latest science from University labs funded by those same corporations.

Yep, yep, yep. This is my beef exactly. I have a really hard time supporting a taxpayer plan to keep these people in business without seeing a major overhaul in this and related industries first.

Then, I imagine that such a major overhaul would make a national health care plan unnecessary. In other words, I would rather see the overhaul as a solution than a national health care bandaid.

Can't Take My Gorram Sky

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Sunday, October 16, 2005 6:40 PM

INEVITABLEBETRAYAL


Whew! Good thing the opening of the BDM is behind us! I was getting so sick of us being united behind something. Sure is good that we can get back to squabbling amongst ourselves about the leaders of South American countries, socialism vs. capitalism, and the evils of the US government. I was so tired of all that good will...

_______________________________________________
I wish I had a magical wish-granting plank.

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Sunday, October 16, 2005 7:29 PM

KELLAINA


Quote:

Originally posted by Howard:

One thing I wish to remark on the Canadian health care system. The word UNIVERSAL is misapplied to and in Canada. In Canada health care the propaganda is about a national universalm system but in practise it is not univeral. So in Quebec the health care sucks while in Manitoba the quality of care is superb. This reflects the amnount of corruption in the local culture. This has caused Americans on both sides of the arguement to be convinced that they are both right. If Canada just admitted that their health is in fact determined province to province it would enable Americans to understand the cause of the contradictions in regional terms. Americans opposed to public health care site Quebec as the horror story and presume the whole of Canada is just as bad. While Americans who dream of a Canadian system do not seem aware of the black hole of health care that is Quebec.



First off, I admit I haven't read the original article yet, I've just been skimming through the responses.

In Canada health care is administered province by province but the majority of the funding for it comes from the federal government which requires the provinces to conform to the Canada Health Act. That's where the universality clause comes in. I've never heard of anyone claiming it wasn't administered by the provinces.

The 'black hole of health care' is the one province that routinely disobeys the Act (by allowing private clinics) while the feds turn a blind eye. I'd argue that since Quebec is considered a special case by the Liberal government comparing it to any other province isn't really fair.

I don't mean to sound nit-picky here, I am genuinely curious as to what sources you have for Americans views of the Canadian health care system, in particular this part:

Quote:

Quebec as the horror story and presume the whole of Canada is just as bad. While Americans who dream of a Canadian system do not seem aware of the black hole of health care that is Quebec.


As I said, I'm curious, not attacking your opinion .

If nothing we do matters, then all that matters is what we do. -"Angel"

Browncoat? Canadian? Join us:
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Sunday, October 16, 2005 7:53 PM

HOWARD



Kellaina:

Well I am a British guy who has lived in
the USA and has Canadian friends and I
listen to Radio Canada International via
satellite. In the constant arguement between
Americans both those who pour scorn on the
Canadian system and those who worship it as
a dream for the USA do use the term "universal
health care". I have also heard presenters on
CBC use the term and I have heard guests on
the CBC argue that it is not a true universal
system. In diregard of your federal
legislation I have heard of cases of Canadians
from other provinces walking into to a
hospital in Montreal on to have a verbal
fight and to threaten legal action just to
get the people on the otherside of the desk
to recognise their health care ID card.
I will say one thing for our flawed British
system and that I may live in Manchester but
I would be treated anywhere in the UK
without an arguement. obviously on-going
treatment would continue back in one's own
area but my immediate needs would be attended
to without question.

I wonder why sometimes my text ends up shifted
to one side in a narrow block on some but not
all my posts.




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Sunday, October 16, 2005 8:00 PM

HOWARD




Canttakesky:

A friend of mine has a sister who has been
going through cancer treatment in Winnipeg
and the care was/is superb. Manitoba does not
have the glamour but maybe they put their
emphasis on what really matters. Other places
in the world spend their money on showcase
architecture and Olympic Games and look where
that gets them!!

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Sunday, October 16, 2005 8:07 PM

HOWARD



citizen:

Firstly I did not attack anyone by name.
Secondly if you are so concerned about
offensive attacks against anyone then
please check out my other posts and see
how unlike the good and intelligent
responses on this thread, I have been
subjected to some very nasty name-calling.
Though I did my best to refrain as much as
possible and maintain a higher level of
discourse. It is interesting that those
who went straight into the nasty against
me, wrote nothing worthy. That they did so
in response to articles that I did not even
write but merely wanted to share with others.

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Sunday, October 16, 2005 8:14 PM

HOWARD



Rue:

Good stuff. Thanks for all the effort.
It is interesting that the UK, US, Canada
and France all have different systems but
in a short-term crisis they all start to
cave-in under pressure. On a daily basis
they suffer many of the same short-comings
and some different short-comings.

I think this implies that it is the
intelligence of individual people that
makes any system work. That systems in
themselves do not do the thinking.

Even if you remove the USA from the list
for the shortcomings you cited the other
countries still have constant failings of
their own. Just the US has more at more
cost.

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Monday, October 17, 2005 6:38 AM

CITIZEN


Howard:
Firstly please notice that I also requested people attacking you on those other threads to not do so. Lynch didn't attack you, he expressed an opinion, and too solely attack him out of hand is as bad as what the other posters directed at yourself.
Quote:

Origianlly posted by Howard:
I will say one thing for our flawed British
system and that I may live in Manchester but
I would be treated anywhere in the UK
without an arguement.


Exactly. Anyone, anywhere in the UK can get health care. That's a nationalised health service. Health care is a right, not a privalage. No matter how cheap private Health care is some people won't be able to afford it, and therefore will not have it.

As for the flaws in the NHS I would argue a lot of that comes from the miscare of the Conservative goverment, who wished to privatise it, probably to the companies/individuals who just happened to fund their campaigns.

Quote:

It is interesting that the UK, US, Canada
and France all have different systems but
in a short-term crisis they all start to
cave-in under pressure.


I recognise the failings of the NHS, but I think they did pretty well during the bomings on the 7th of July, which was a pretty strong test.
Quote:

Originally posted by INEVITABLEBETRAYAL(who's name I can never spell...):
Whew! Good thing the opening of the BDM is behind us! I was getting so sick of us being united behind something. Sure is good that we can get back to squabbling amongst ourselves about the leaders of South American countries, socialism vs. capitalism, and the evils of the US government. I was so tired of all that good will...


Yeah, good will! ...



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Monday, October 17, 2005 7:19 AM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

Dear, dear SignyM. I can always count on you to come up with a different way to say, "Canttakesky, you're ignorant" on just about every thread.I am not unaware of the statistics you cited or the fact that some sections of the medical industry are more greedy and corrupt than others (i.e. pharma and insurance).
Sorry for the impression. I was responding to your very global statements about the "health care system". One of the indicators that the entire health care system is not equally robust is the fact that hopsitals are going bankrupt. Another inidctor is that medical school applications are going down. Just out of curiosity I some quick inet research on insurance, pharma, hospital, medical practice profitabiltiy, and the insurances and pharmas are clearly well ahead. Due to serious family illnesses, I have far far too much contact with the health care industry at all levels, and I know by talking to doctors and nurses that they are overbooked. And while their pay isn't bad, it certainly deosn't compare to that of... say... an insurance salesperson. The whole hospital system would fall aprt if it wasn't for slave-wage interns and residents working 80-hour weeks. So it doesn't seem to be a fault of the actual providers so much as the middle-men. Just my impression.

I do agree that the health care industry is clearly a case of corporate welfare on steroids. Two of the biggest props to pharmas are ridiculous patent laws and the latest Medicaid giveaway. The whole system DOES need to be reformed. But taking away medical insurance is like taking away automobile insurance- there is no way that anyone could pay for a medical catastrophe, not matter HOW cheap medical care became. The point of insurance is to spread the risk so that each individual family doesn't have to save up $100,000 for the illness that may never come.

Please don't think they give a shit.

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Monday, October 17, 2005 7:32 AM

SIGNYM

I believe in solving problems, not sharing them.


My impression of the British health care system is that it... in a word... sucks. I have numerous cotnacts with parents in Britain through my involvement in the Mass General bbx, and it sounds like a nightmare of long waiting lists, scanty care, and doctors with a serious god complex. I mean, I know one kid who suffered permanent brain damage while waiting for resective epilespy surgery; another kid who was sent home to die w/o either a trache or morphine; another kid who was seen by a doctors who was (in essence) a quck and who had been mis-medicating her for years. Getting a second opinion is tantamount to treason, and since there seem to be far fewer available doctors and far fewer options, its well-nigh impossible. The one good thing about the insurance companies in the USA: it has taken that god-complex sheen off the doctors.

I don't think there's anything inherently wrong with the British system, but it remains terribly underfunded per capita compared to France of Germany. Perhaps that originated with Maggie Thatcher but it remains a problem under Tony Blair.

Please don't think they give a shit.

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Monday, October 17, 2005 8:19 AM

HOWARD


Just like Canada or any country
the UK and the NHS is both good
and bad per location.

I live in Manchester and I do have
confidence but if I lived in Bristol
which I wouldn't do I would be
terrified!!

Here in Manchester it is excellent.
Yes there are problems at the GP
and waiting on minor complaint
appointments but when it comes to
big surgery (hip operations) or
cancer treatment etc I would put
our hospitals and our surgeons
and nurses against anything a
Hollywood superstar has access to
at a super-exclusive private hospital
in Beverly Hills.

The damage done to our NHS by Thatcher and
Blair manifests in the MRSA virus contamination
of hospitals. Caused by low wage low educated
private contrator cleaners. In the old days
medical staff supervised cleaning. The creeping
privatisation of essential services putting low
costs before health and protecting people has
caused the in-hospital virus plague.


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Monday, October 17, 2005 8:55 AM

CITIZEN


Quote:

Originally posted by SignyM:
I don't think there's anything inherently wrong with the British system, but it remains terribly underfunded per capita compared to France of Germany. Perhaps that originated with Maggie Thatcher but it remains a problem under Tony Blair.



Quote:

Radical reform is needed - perhaps along the lines suggested by Deepak Lal, who points out that the planned expenditure by the NHS per capita in 2005-6 is no greater than the premium charged by the Kaiser Permanente insurance scheme (which has a spread of liabilities similar to that of the NHS) for much better healthcare. Why doesn't the government just decide to buy everyone comprehensive health insurance? The failings of Britain's healthcare system can no longer be blamed on under-funding, because our funding levels are rapidly catching up with those of France and even Germany.

http://society.guardian.co.uk/nhsplan/comment/0,8005,1147236,00.html

To my mind the current problems with the NHS are the gross mismanagement of the conservative party, who, IMHO wanted to privatise it, just like the railways.
The problem is compounded by the current Labour governments desire to fix all the problems by hiring more and more administrators and less and less doctors/nurses.

NHS funding figures:
http://www.bma.org.uk/ap.nsf/Content/Current+issues+in+NHS+funding+flo
ws~current+issues+in+nhs+funding+flows+-+nhs+funding


Transcript of Tony Blair's speech on the NHS 2001:
http://www.number-10.gov.uk/output/Page1674.asp




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Monday, October 17, 2005 7:17 PM

SGTGUMP


Quote:

Originally posted by citizen:
...there's people in society who can't afford mechanics, or even a car.



Maybe that's because they pay half of their salary to taxes for health care. Health care for poor people who have too many children. Who have too many children because they aren't afraid of the burden of feeding and caring for them because it's placed on you, Taxpayer. And I don't see a lot of people flocking to Cuba or Venezuela so they can live in this Socialist utopia.

Socialism and communism work well on paper but in practice, it is the people that make such an idea unviable.

I think you are looking up to the wrong people.

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Tuesday, October 18, 2005 7:21 AM

CITIZEN


Yes because in America, the land of low taxes, milk, and indeed honey, everyone can afford Health care, everyone can afford a car, everyone can afford a mechanic for said car and there are no homeless...

I'm not advocating Socialism over anything else. I'm saying it's a right, in a civilised society, to have access to a doctor, and health care, whether you can afford it or not.
Obviously you think otherwise. I hope you never find yourself in the situation where you can't afford your Health insurance bills...

And as a last addendum, I can guarantee that my National Insurance payments are a lot lower than what I'd have to pay for private health care, here or anywhere else.




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Tuesday, October 18, 2005 4:42 PM

RUE

I have a vote and I'm not afraid to use it!


Quote:

That Canadian Healthcare is so efficient because it saves money by denying care to those who need it long enough that they die off cheaply. Same thing with other relatives with heart conditions. No wasted resources but those who need it most go without until they die.
The true tests of a health care system are: 1) how long do people live, 2) how many infants die, 3) how much is spent.

EVERYONE can cite horror stories. Having worked in a US county hospital for 7 years, I probably saw one every day, on average. Story for story, I could match any medical nightmare from any country with one from the US, and then some. But the important questions aren't answered with anecdotal stories, but statistics.

It takes A LOT of health improvement for many millions of people in order to move average lifespan a few months. Heroic care, or lack of it, for exceptional cases (and by that I mean rare) just won't do it. Similarly, infant mortality is a difficult statistic to change w/out widespread changes in maternal and pre/peri-natal care. The US was abysmal just a few short years ago (appx 9/1,000) until the Federal government changed its policy to mandate fortifying cereal with folate. That one change alone, over the entire country, dropped infant mortality (by about 3/1,000).

Per capita spending is by its very nature a difficult statistic to change.

The sum is that these figures are robust and provide the best measure of care.


And for those who've been reading the news lately, GM was about to be brought down by - health care costs. Many other large and small employers are looking for ways to drop or reduce coverage to reduce the bottom line burden. The inefficiency of healthcare corporate bureaucracies (a private bureaucracy is STILL a bureaucracy) and the size of their profits are a major factor bleeding global US competitiveness.

Standing in contrast are the health systems of all other developed countries in the world. More coverage, better outcomes, and cheaper. Who can argue with that?


Nearly everything I know I learned by the grace of others.

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Tuesday, October 18, 2005 5:46 PM

SGTGUMP


Quote:

Originally posted by citizen:
I hope you never find yourself in the situation where you can't afford your Health insurance bills...



Your damn right. I hope I can continue to afford it also, because it is no one's responsibility but my own.

And a right? No one has any rights but what they secure for themselves. We can speak freely because people fought and killed to earn that right and would do it again. But then again, it doesn't cost you a dime if I speak, regardlees of what I say or how much I say it.

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Wednesday, October 19, 2005 5:08 AM

RUE

I have a vote and I'm not afraid to use it!


More coverage, better outcomes, and cheaper. Who can argue with that? Well at least one person. And before us: on the one hand - results. On the other - ideology.


Nearly everything I know I learned by the grace of others.

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Wednesday, October 19, 2005 7:22 AM

CITIZEN


Quote:

Originally posted by sgtgump:
And a right? No one has any rights but what they secure for themselves.


Ok, lets go with that.
Quote:

We can speak freely because people fought and killed to earn that right and would do it again.

So other people fought for your right of freedom of speech?
In that case what is wrong with other people securing your right to good health?

So is it alright if someone is left to die from an easilly curable ailment because they can't afford the treatment?

Isn't it a good thing that the strong (or well off) protect/help the weak (or the less well off).
Isn't the concept of the strong protecting the weak one of the very basis of society/civilisation?



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Wednesday, October 19, 2005 2:06 PM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

Isn't it a good thing that the strong (or well off) protect/help the weak (or the less well off).
Isn't the concept of the strong protecting the weak one of the very basis of society/civilisation?

Eh- but some people prefer the dog-eat-dog model, where we start out at barbarism each generation and work our way down from there!



Please don't think they give a shit.

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Thursday, October 20, 2005 2:55 AM

SGTGUMP


Quote:

Originally posted by citizen:


So is it alright if someone is left to die from an easilly curable ailment because they can't afford the treatment?




If you feel like helping people that's great. But to force others to help people by stealing their money is wrong.

And as I said earlier, I would fight for the right to speak if I had to. And whenever I speak it doesn't cost anyone else anything.

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Thursday, October 20, 2005 7:14 AM

CITIZEN


Uhuh, maybe you should go to the senate and tell them to stop stealling your money to build roads and finance the military, pay for unemployment benefits...

I mean, some of these roads you don't even drive down.

Or, and here's a really good case, the police. I mean, hey you never committed a crime, so why the hell should you pay for the police.
Even if you've been a victim of crime it's not like it's everyday, yet you pay for the police everyday, why should you?

Man, their stealing YOUR money to protect these OTHER people who are probably just leeching scum anyway. Let the bastards die, they deserve it. If they can't afford their own private security force, then they deserve to be robbed/murdered.

You can afford your own private security force, so 'em.

So what if it costs more than the Police in the first place. Least your money isn't going to help anyone else.
And that's the main thing.

EDIT:
In fact privatising the police sounds like a really good idea.
You pay on a call out basis. Say, your mugged well you personally have to pay for the police responce. You can't pay, well, just try not to bleed there, cause your gonna have to pay the street cleaner to mop it up.

I mean why should anyone else pay for the police time, man power and equipment because you were mugged.
Just doesn't make sense.

Oh and sometimes, freedom of speech does cost money. Even yours, in fact.

You want to live in an anarchistic society, no problem, I can suggest a few if you like.



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Thursday, October 20, 2005 9:31 AM

CANTTAKESKY


Quote:

Originally posted by rue:
More coverage, better outcomes, and cheaper. Who can argue with that? Well at least one person. And before us: on the one hand - results. On the other - ideology.

I'll argue with that. I know it won't make a dent in Rue, but it may help other readers of this thread see that evaluating health care is a lot more complicated than this.

1. More coverage. Does more coverage actually result in more health care? Does national health care actually result in more doctor and hospital visits, more drugs being dispensed, and more surgeries being performed (per capita, of course)? Do we have data on how many people go without health care because of lack of coverage vs. those in countries with national coverage? I haven't researched this, so I don't know. But one has to question the assumption that national health automatically means more health care.

Then there is the question of quality of care, because more doesn't necessarily mean better.
To illustrate, let me share an anecdote. When we were living in Vancouver, Canada, my husband witnessed EMTs arriving to help a man who had had a heart attack in the lobby of an apt building. They did about a minute of CPR on him, pronounced him dead, covered him up, and leisurely loaded him up in the ambulance. My husband was shocked. In the USA, EMTs would have taken the man to the hospital immediately, doing CPR on the way, and let the hospital staff try to resuscitate him before a doctor pronounces someone dead. Quality matters.

2. Better outcomes. There are many other measures of health besides life expectancies and infant mortalities. Who is healthier for example? A 72 year old man who uses a wheelchair, is dependent on dialysis machines, and eventually dies slowly of pancreatic cancer; or a 32 year old man who runs marathons, never catches a cold, but dies in a car accident? That is to say, the number of years one lives is not necessarily a good indication of health, let alone a primary indication of health. We have to also consider other variables such as disease rates, number of days lost from work because of illness, productivity (amount of work able to be done), mobility, amount of health care interventions needed (drugs, surgery, life support, home health care devices), etc. Better outcomes can't just be measured by one factor.

3. More coverage caused better outcomes. Just because X and Y often go together, doesn't mean X causes Y. In science, people say "correlation does not equal causation." Just because national health plans happen in countries that also have high life expectancies, doesn't mean the health plans caused the higher life expectancies.

For example, it could be that lower pollution levels cause higher life expectancies. And maybe it just so happens that countries that control environmental pollution are also ones that provide national health care. Or another example. Maybe lower infant mortality occurs because those other countries allow midwives to attend births, and not just obstetricians--so the variety of health care caused the better outcome, not the coverage itself. (Not saying this is necessarily the case. Just arguing that logic dictates we must consider many other variables that also influence health.)

4. There is a saying often attributed to Mark Twain: "There are 3 types of lies: lies, damn lies, and statistics." Statistics are extremely malleable creatures. The way you can tell a statistic is a lie is when a statistic is used to justify policy--which describes about 99% of statistics floating out there. Statistics used to serve an agenda automatically leaves out other facts and numbers that do not serve the agenda. Honest statistics can only decribe what was found in a specific situation (with methodology revealed and critiqued), while putting it in context of many other findings and acknowledging there is so much more to find. So really, are there any arguments that don't rest on ideology?

-------

Incidentally, I just spent 6 weeks in Chile, South America. As I understood it, Chileans have a single-payer system (national health coverage), but it is entirely voluntary. That is, the insurance coverage is available to all citizens, but not all citizens are required to buy the coverage. People can choose to do without if they want. I am with SgtGump--I don't like force. The Chilean model might offer an acceptable compromise between the objection to force and the desire for more accessibility to health care.

Can't Take My Gorram Sky

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Thursday, October 20, 2005 9:42 PM

RUE

I have a vote and I'm not afraid to use it!


Quote:

I'll argue with that.

1. More coverage.

2. Better outcomes.

3. More coverage caused better outcomes.

4. Statistics

Cant - before I became an atmospheric chemist, I spent over a decade working in US health care - in the VA, in a large county hospital, in large private hospitals, small private clinics, and small non-profits. And I know a little bit (very little) about the Indian Health Service on the Navajo reservation. And I've spent a lot of time in Canada, have Canadian friends from Toronto to Vancouver, and have had decades to evaluate their health system up close and personal, as well as from professional research.

Your questions smack of severe ignorance about medical practice, protocols, health care in general, and the US and Canadian systems in particular. And this is reflected in the statement: "I haven't researched this, so I don't know". If you haven't bothered to look it up - and relevant figures are easy to find through Google though they takes weeks to study - I can see why you are not embarrassed at your own statements. But they are shamefully glib and hollow. Does the word 'sophistry' mean anything to you? Look it up.


But, to address your questions, and show why they are so seriously off the mark:

1) "Does more coverage actually result in more health care?"

Inevitably, more coverage (of more people) results in more care (for more people). But this is not the only vital question to ask.

Then you mis-direct by asking about specific medical interventions. You question "Does national health care actually result in more doctor and hospital visits, more drugs being dispensed, and more surgeries being performed", and then you go on to conflate those with better care.

So to look at some specific examples: Doctor and hospital visits - the tiny impoverished island of Puerto Rico has put the US to shame on infant mortality. They send out basically-trained health workers (and I mean minimally educated with checklist training) to all expectant mothers. Those workers supply vitamins, provide basic pre-natal tests (for diabetes, proteinuria, and pre-eclampsia; and check weight), give routine vaccinations, campaign against smoking and drinking, and teach the mothers-to-be essentials such as providing clean water and how to breast feed. Such brick-simple but well-researched and vital care, widely provided, brought Puerto Rico up to nearly first-world infant mortality rates. In that case, better preventative coverage avoiding doctor and hospital visits made for vastly better care. The necessity of doctor and hospital visits, OTOH, means people have become ill and are now 'patients'.

Looking at the general category of "more drugs": Vaccinations are a cheap, mass-care interventions that have revolutionized childhood survivability. Antibiotics on the other hand, have created monster bacteria and should have been used much more sparingly. More vaccinations - better care. More antibiotics - worse care. Basic cheap diuretics for heart failure - longer healthier survival. Expensive modern drugs - shorter debilitated survival. Etc. More 'drugs' does not generally equate to better medicine.

Surgeries - When surgeons went on strike in one state to protest insurance premiums, the death rate went - down. Analysis revealed that while critical life-saving surgeries were still being done, elective surgeries and their associated "morbidity and mortality" were halted. Hence, the lower death rate resulted quite ironically from reduced surgeries.

Is 'more' health care a measure for good health care? Are more surgeries, drugs, and doctor and hospital visits adequate measures for good health care? Mostly, no. Is getting the RIGHT care where it is needed important for good health care? Yes.


In the same breath you ask the unrelated question "Do we have data on how many people go without health care because of lack of coverage".

In a word - yes. In the US there is an obvious percentage of people going without any routine health care at all because they completely lack either private or government insurance. (Census figures) And inevitably, when a chronic or easily treatable condition goes without care long enough, it becomes a life-threatening crisis that takes a lot of technology and money to treat, if indeed it can be treated. An ounce of prevention etc. People in medical crisis without insurance end up in county hospital. I imagine you have not spent much time in one. If I call it medical care of last resort, it is NOT a slam on the people who work there. But they are understaffed and underfunded, and people can and do die waiting on gurneys out in the hall. Or in their rooms, waiting for tests, or treatments. Or after they are sent home without follow-up. That whole aspect of medicine - economic denial of routine and critical care - is something of which you are blissfully unaware. Unless you equate being poor with not being 'people'. In which case there is no problem.


I am so glad you brought up the question of quality. And I see you of course have a single anecdote which you even shamelessly call an anecdote to back up your prejudices.

Of all the ER codes I attended (let's see, roughly 2/week, 52 weeks/yr, 4.75 yrs is, uhm roughly 494, more or less) I saw two brought into the ER under full CPR who were stabilized sufficiently to make it to an acute-care unit. Granted, the protocols have gotten better, but currently 90%+ of 'codes' die even with immediate, continuous CPR followed by advanced ER treatment and surgery.

And, having gotten my EMT license, I am familiar with the protocols and duties out in the field. You treat those you can help. You do not waste your time on those you cannot. Scary, but all EMTs have the authority to decide your fate. Now, in the US the dictum was (paraphrasing) once you start CPR you do not stop until help arrives, a doctor declares the person dead, or you become too physically exhausted to continue. However, that has changed in the last five years. Perhaps it is a legal nicety, but someone realized that the person whose heart has stopped is, well, dead. Therefore, terminating CPR is not killing someone. (This interpretation is cross-border, from California rescue units to the RCMP.) That whole protocol goes along with the information that defibrillation in the first few minutes of a heart attack is most likely to save a person, and not much else will do it. And too, the years worth of data on the very poor survival rates of those whose CPR goes longer than a few minutes. Of course there are other reasons besides heart attack for a person to stop breathing and beating - poisoning, drowning, electrocution, stroke, bloodloss/trauma, anaphylactic shock etc. That's why you have trained people in the field. You help those you can help.



2) "There are many other measures of health besides life expectancies and infant mortalities."

Ahhh, such a wealth of ignorance in one short sentence.

When epidemiologists measure population health, two ESSENTIAL figures are life expectancies and infant mortality.

Life expectancies are one ESSENTIAL measure of population health. One of the surprises of recent population studies is that populations that live longer, live healthier.

Infant mortality is another ESSENTIAL measure of population health. First-world infants who die usually have something wrong with them at birth - most often premature birth and/or low birth weight and/or stroke. These tend to go together BTW. It's a depressing triad. Then there are CNS malformations like spina bifida, usually caused by folate deficiency. It's not like there is a majority of healthy newborns who die for something trivial like obstetrician v midwife. The infants who die start out life undermined by lack. And the measures to prevent most infant mortality are clear. No amount of heroic high-tech rescue - NO breathing treatments, low pressure ventilation, head-cooling, can adequately make up for the fragile nature of the very sick infant. High tech won't fix it. Widely available basic (very basic) care does prevent it.

Other figures have too many confounding factors to use. Work lost due to illness - depends on how much care is family-provided. Disease rates - easy figures to look up, similar for developed nations. Productivity - mostly the product of work-technology. Amount of health care interventions - statistic that can and has been argued several ways. Etc.

So while you fatuously argue for generic logic, you strenuously avoid real information. And you argue sophistry as some pathetic substitute for real-life complications.

4) Statistics. I have made a study of US and Canadian 'life tables' with statistics and methodology exhaustively detailed. Have you?


"Some of the most important contributions to human capability may be hard to sell exclusively to one person at a time. This is especially so when we consider the so-called public goods, which people consume together rather than separately.

This applies particularly in such fields as environmental preservation, and also epidemiology and public health care. I may be willing to pay MY share in a social program of malaria eradication, but I cannot buy MY part of that protection in the form of 'private good' (like an apple or a shirt). It is a 'public good' - malaria-free surroundings - which we have to consume together." Amartya Sen



Nearly everything I know I learned by the grace of others.

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Friday, October 21, 2005 4:22 AM

CANTTAKESKY


(Oh crap. I don't know how it happened, but my original response to Rue was accidentally deleted. I don't have time to rewrite it, so I will summarize as follows.)

There is a reason why I use "generic logic" more than "real information," as Rue puts it. I've had a good amount of graduate training in scientific research methodology and statistics; I know how easy it is to mold statistics to advocate whichever position one wants. A forum like this is best suited for opinion and reasoning, rather than statistical soundbites that I believe are easily misleading (whichever position they support). Anyone who wants to research the facts properly can do so from sources much more extensive than anonymous posters on Fireflyfans.net.

Yes, Rue, I know you think I'm ignorant. I'm just this side of a prehistoric human. When I speak, all you hear is, "Grunt, grunt. Blah, blah." I get it already.

I could pursue this dispute with "real information," but what's the point? Inevitably, you end up nitpicking my wording or my examples rather than address the thrust of my "generic logic." Speaking goes on, but communication--not so much.

However, against my own better judgment, I will grunt-grunt and blah-blah one more time.

You make a good point to distinguish different TYPES of health care, vs simply "more" or "better." There is preventative health care vs. crisis health care. In the USA, we have too little of the former, and make most of our money from the latter. I definitely support a shift towards preventative health care in any health care reform package.

Having said that, I believe that a shift towards prevention and cure can and should happen, regardless of who pays for it. A national plan might make the shift easier, simply because of the centralized control. But I would rather explore more autonomous and less forceful ways to make this change.

(And Rue, I would appreciate it if you could refrain from calling me ignorant again. We may not think alike or communicate well, but we can at least be civil.)

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Friday, October 21, 2005 10:13 AM

CITIZEN


CantTakeSky:
Your right. Statistics can be misleading.
Case in point, Women drivers (don't flame me yet)...
People say Women drivers are safer because they have less accidents than Men, yet the statistics also show that Women drive less miles than Men, and that per-mile driven they have more accidents.

This indicates that infact on average Women drive less miles than Men do on Average, and therefore are likely to be less experienced than your 'average' Man. Not that Women are safer drivers.

So yes, statistics can be misleading.

So lets just assume for a moment that neither public nor private health care are better than the other.
With a private system, no matter how cheap it is, there will be some people who can't afford it, and therefore don't have it.

So my question is:
Is it okay that these people don't get health care?

and...

If not, how would you suggest we deal with this through a private system?



More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
I can't

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Friday, October 21, 2005 4:07 PM

RUE

I have a vote and I'm not afraid to use it!


Cant,

I called your statements ignorant b/c you frankly admitted you hadn't looked up that on which you were opining. What else can I say? You qualified your own position.

Argue as you will about the use of statistics, you also haven't looked up the data and analysis to see if your objections apply. Maybe you have little regard for epidemiology and that is why you generically and without basis cast aspersions on it, but the people who do the work (described in exhaustive detail in every report) are experts. I have studied the reports. I invited you to do the same. That way we could be on equal footing, doing more than exchanging "sound bites" as a form of advertisment for our positions. We could actually be using scientific shorthand to educate and debate each other. But you seem you would rather not.

In case you are interested, you can get US "life tables" and other reports from the CDC http://www.cdc.gov/nchs/products/pubs/pubd/lftbls/lftbls.htm; in Canada you can find information through Statistics Canada http://www.statcan.ca/start.html

If you could pursue the debate with 'real information' I'd welcome it. I just haven't seen any from your end. So please, bring some on board rather than just blah blah blah.


Nearly everything I know I learned by the grace of others.

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Friday, October 21, 2005 11:11 PM

CANTTAKESKY


Quote:

Originally posted by citizen:
Is it okay that these people don't get health care? ...If not, how would you suggest we deal with this through a private system?

Excellent questions. I have so many thoughts on this I need some time to organize and summarize them. Please let me get back to you.

Let me say though, that I am not unconcerned about poor people or lack of access to health care. I used to be a social worker in a former life and spent years working with the poorest of the poor in the US. I am obviously concerned about poverty issues, or I wouldn't have chosen that line of training/work.

Can't Take My Gorram Sky

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Friday, October 21, 2005 11:37 PM

CANTTAKESKY


Rue,

All you did was reiterate, "Cant, you're ignorant. I can't talk to you." While I appreciate your toning down the hostility, I did ask you to not say it yet again.

(rolling eyes) Fine. Be that way.

I am frankly astounded. Your ability to misinterpret me by zeroing in on phrases and examples out of context is unmatched, in all the years I've been discoursing online.

Let's make this our last exchange, shall we?

Can't Take My Gorram Sky

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Saturday, October 22, 2005 1:36 AM

CITIZEN


Quote:

Originally posted by CantTakeSky:
I have so many thoughts on this I need some time to organize and summarize them. Please let me get back to you.


I look forward to hearing them.

I'd just like to say that I expected that your reply to the first question would be a no, or at least words to that effect.



More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
I can't

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Saturday, October 22, 2005 7:19 AM

RUE

I have a vote and I'm not afraid to use it!


Cant -

As to personal attacks, I did not appreciate it when you said I was misleading people.

I did much, much more than call your statements ignorant. I provided my cv in the area, plus information about policies and statistics, and provided links to essential information. All of which you blew past.

I keep inviting you to examine a large body of facts so we can reasonably discuss our relative positions. You seem resistant to looking at them.

You're right. Until you bring some facts into the discussion, we should probably not communicate.




Nearly everything I know I learned by the grace of others.

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Sunday, October 23, 2005 5:45 AM

CANTTAKESKY


First, let me qualify that I don't have the magic answer. What I propose are solutions consistent with my personal values and experiences--what I would vote for. It doesn't mean I think everyone else should vote for the same thing.

Secondly, let me relate 2 personal experiences so you know where I am coming from. I suffered from a disabling condition for 10 years. Suddenly, I had lost my ability to walk, stand, drive, read, sleep, and work. Having spared no expense to seek experts all over the country, I understand the desperation behind not being able to afford health care. In my case, I borrowed to procure services my insurance refused to pay. My health care costs, together with my loss of income, eventually destroyed my credit history. What did I get for the tens of thousands of dollars I ended up incurring in costs? Nothing. Nothing at all. Eventually, I started to look into alternative medicine. Finally, with some self-treatment borne out of my research and some luck, I was cured. I am now able to work and lead a normal life.

The second example was a gallbadder attack I had almost a year ago. I felt I was going to split open from the pain, and went to the ER. After lying in a bed there for 4 hours and a 2 minute visit from the doctor, my pain eventually subsided on its own and they told me I could go home. The treatment? They took one blood test and gave me some pain meds on the way out in case it happens again. The cost? $700, which my insurance paid. It did happen again, 2 weeks later. This time, I took an aspirin and endured the wracking pain at home. Conventional treatment would have called for more tests and eventually, gallbladder surgery. I researched and treated myself with alternative remedies, passed a bunch of gallstones, and haven't gotten another attack again. The cost? About $10.

I share these 2 experiences to illustrate that in MY personal experience, I have found the "health care" covered by insurance to be quite worthless. Every time I used it, I incurred large costs in hope that it would have answers to my suffering. Every time, I ended up having to find answers on my own for a fraction of the cost. I don't want to be forced to buy a product that has, in effect, scammed me. (Paid a lot for nothing.) Now my attitude is, You like it? *You* buy it.

Quote:

Originally posted by citizen:
Is it okay that these people don't get health care?

My answer is yes and no. If a poor person doesn't get to see a doctor for a severe cold, I'd say he's not missing anything anyway. If a poor person is refused an ambulance after a heart attack, I'd be furious.

I believe the appetite for doctor visits, drugs, and surgery has been artificially inflated by aggressive marketing. People are desperate for "health care" because they are told it is the ONLY way they can find relief for their ailments. But what if people found out that gallbladder surgery is not the ONLY way out of the pain? What if they find out that they can pass gallstones and stop the pain for $10 worth of ingredients at the grocery store? Then it wouldn't be so bad that they couldn't afford gallbladder surgery, would it?

I would answer that it depends on the type of care. The more alternatives there are for a particular type of care, the less necessary it is that people have access to the "authorized" version.

Quote:

If not, how would you suggest we deal with this through a private system?


The intrinsic, tried and true method of keeping costs down in a market system is competition. The more options a consumer has, the less desperate he is, and the more leverage he has for demanding higher quality and lower cost. So I say bring on the competition.

When I consult alternative health practitioners now, the fees are eminently affordable to the middle class. I pay $125 for the first month's worth of weekly consultations, and about $50 a month after that. We give them cash for the service--that's it. No hidden costs, no third party payment. The quality of care is better. The practitioner spends 1-2 hours with me in the first visit to get a good, in-depth history. More importantly, I get results. I once consulted a practitioner who charged $200 per ailment. That is, he gets the $200 and he works with you until that ailment is cured--however long it takes. It behooves him to cure you sooner, since he is not getting paid by the hour. Now these alternatives won't work with all ailments, so I emphasize it is important for a diversity of options to be out there.

Once doctors, hospitals, and drug companies no longer have a monopoly on health care, once they have to compete with lower cost alternatives, they would have no choice but to bring their costs down in order to stay in business. Some types of health care would be less threatened by competition than others. Consumers can decide what works for them and what doesn't, what's worth paying for and what isn't. But a lot of care that is currently out of reach without insurance would become affordable.

What about care (such as trauma) that doesn't come within reach? What if someone chooses a brand of care that he can't afford? What about poor people who can't afford affordable care? What about high risk, chronically ill people?

(To be continued...)

Can't Take My Gorram Sky

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Monday, October 24, 2005 4:11 PM

CANTTAKESKY


Competition. But for true competition--the kind that can result in a revolutionary reduction in costs--we need less government interference in requiring expensive licensing, malpractice insurance, and clinical trials. What?! you say. Get rid of them? No, not get rid of them--just don't require them. Give consumers the option of going to either a licensed doctor or an unlicensed one, one insured for malpractice and one not insured; buying drugs that either have been tested in a clinical trial or have not. Options can only empower consumers. They don't have to visit unlicensed or uninsured doctors; they don't have to buy unstudied drugs. But they can if they wanted to.

The alternative practitioners I have consulted often have had extensive formal training, but aren't required to. They are unlicensed and uninsured, but they stay in business from recommendations by previous customers. The remedies they use have never gone through a formal clinical trial, but they have been tested throughout history. For consumers who don't value official stamps of approval, they offer a more efficient, less wasteful option. Consumers who DO want trappings of formality can always still pay for them. Without forced hidden costs, the health care industry can provide affordable routine and preventative care.

Speaking of preventative care, perhaps the most valuable effect of competition is patient responsibility for their own health care. With empowerment of competition comes responsibility to choose wisely. With all the new choices, we need to become more educated about just what kind of health care we want--and indeed what kind of health we want. Ultimately, we are the only ones who can provide care for our own health--eating right, sleeping well, exercising routinely, etc. When we have to pay to fix ourselves when we break down, we might take better care to not break down to begin with.

But even true, unfettered competition and educated, responsible patients won't solve access problems for catastrophic care (ambulances, surgery, or other equipment/skill-intensive interventions). Competition alone won't solve access problems by disabled / chronically ill people or poor people with little to no income.

As much as I dislike insurance, it is an expedient way to share costs. When competition makes routine health care an affordable expense, like oil changes for cars, health insurance will be overhauled as well. Health insurance will no longer be cost-sharing for all medical care, but cost-sharing for RISK--the way a real insurance policy is supposed to work. Premiums for catastrophic insurance will be cheaper and much more affordable, because not everyone will get cancer, or get into a car accident, or get bitten by a shark. It could even be divided up into cancer insurance, ER insurance, or limb reattachment insurance. People will be able to buy health insurance--really, it should be called sickness insurance--the way they buy car collision or hurricane insurance.

As a supplement or alternative to insurance, medical savings accounts (MSA's) can given tax-deductable status by the government. That means you can save your own money for a medical emergency, without having to pay taxes on it. Even better, allow MSA's to be able to be shared and inherited. That means parents' MSA's can be used by their children who have none, for example.

Disabled and chronically ill people use a lot more health care services than can be covered by their premiums. This is no longer cost-sharing of risk, but cost-sharing of a sure thing. Currently, there are about 30 states that have high-risk pools that charge sick people a higher premium than normal, but not higher than a state-imposed cap of 150-200%. High-risk pool insurance carriers lose money. Their losses are reimbursed by equal payments from other insurance carriers in the state. In essence, healthy insurance consumers pay a hidden sales "tax" when they pay their premiums to help buy insurance coverage for their less fortunate neighbors.

Poor people--well poor people will always have problems no matter what system they are in. They can't afford oil changes, they can't afford reasonable insurance premiums, they can't even afford food or housing. How do poor people afford food? Well, instead of govt taking over the entire food market to solve the problem, most govts leave the market alone and simply empower the poor to buy food like everyone else. They give out cash stipends and cash-equivalents (like food stamps). When they pass out food itself, the govt buys the food in the market. Private charities do the same. In countries where the government controls food production and distribution entirely, shortages, rationing, and long waits are not uncommon. I think it is safe to say most folks like being able to buy food in a quasi-free market vs. in a government-controlled monopoly. There should be no reason why we can't buy health services in the same way.

Medicaid is the medical equivalent of Food Stamps. It can be formatted to offer routine medical care and catastrophic sickness insurance to everyone under a certain income bracket. Charities can buy policies for the poor, as well as simply foot the bill for folks who can't pay. The govt can allow tax write-offs to hospitals who provide pro bono services. As always in a civilized society, everyone chips in. And with the exception of Medicaid, everyone chips in voluntarily.

(For more info about MSA's and lowering costs in health care, here is a good article.
http://www.cato.org/pub_display.php?pub_id=1472&full=1 )

Just my humble opinion,

Can't Take My Gorram Sky

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