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| 5/17 |
| 2004/7/22-23 [Politics/Domestic/Crime, Politics/Domestic/SocialSecurity] UID:32435 Activity:very high |
7/22 So, the thread got deleted, but I am curious what the people
who thought the fascism essay was well-informed and informative
thought about the author classifying militant anarchists/libertarians
as a proto-fascist movement? No one ever commented on that.
It was a really dumb thing to write.
\_ That is not what he said at all. He stated that they have
political alliances with some extreme right wing groups and
sometimes exchange ideas. I think that is correct. Where do
you think these "income tax is unconstitutional" types get
their thread of argument from? Certainly not from the
usual trailer trash White Patriot guy.
\_ Yeah, must be a right wing conspiracy feeding them these
arguments.
\_ All right I checked and he lump them in with the
\_ All right I checked and he lumps them in with the
"xenophobic right" which is kind of bizarre. But they
certainly deserve some of the credit for making
the Rush Limbaugh anti-government screed more
respectable. Why does it have to be a "conspiracy"?
They all go to the same gun shows, maybe they
realy do listen to each others arguments. What
is so nutty about?
really do listen to each others arguments. What
is so nutty about that?
\_ Wait, are you saying 'going to gun shows' is a stain on
one's character and intellectual integrity? Dude.
People go to gun shows. You know, to buy guns, and
look at pretty old rifles. You are a loon.
\_ No, I didn't say that, you inferred it. I am a loon
because I know that both libertarian types and
anti-government tax freedom nutters go to gun shows?
How do you think that I know that? I sure as hell
didn't find it out reading Salon.
\_ What sort of idiot is in favor of more government? All
intelligent people are anti-government. It's a huge
beaurocracy of the mediocre and uncaring. How can anyone
be in favor of that??
\_ Lots of sorts of idiots, I'd wager. I am personally
for better government and more government where I
I am pretty sure it would do better than private
enterprise, like the health care system, to start with.
Lots of idiots want better schools, roads, more
rapid transit, better fire systems, hospitals,
mental health care, etc.
\_ It never ceases to amaze me how people still believe
government control of any business (like Healthcare)
is ultimately better.
\_ There are plenty of studies that show that
countries with socialized medicine have much
better price/performance ratios on healthcare.
http://www.crookedtimber.org/archives/002173.html
\_ I don't want better price/performance health care
ratios. I want the best health care. Period. Of
course a government run HC facility will have
better *ratios*! You can't get the newest medical
techniques and equipment! So you die but it saves
a lot of money. Brilliant!
\_ you can't afford the best healthcare period.
if you don't want to die, try exercising and
eating right, and not becoming a fat pig.
prevention health care has good price /
performance ratio. fancy equipment just
prolong your miserable suffering.
\_ National Health in the UK is a catastrophe--
it swallows insane amounts of money without
delivering much. Same with Germany. France and
Sweden have obscene income tax rates to support
their habits. Lots of Euro countries also have
massive public pressure to put hospitals in the
furthest corners of nowhere. It's not as obvious
as it seems. -John
\_ People I know in France and England feel
differently. They praise socialized medicine.
Also, speaking of Sweden, I find it very
interesting that on basically every study
related to health care, standard of living,
freedom of expression, happiness,
social tolerance, and other quality of life
issues, Sweden consitently ranks near the
top and usually higher than the US. -!op
\_ I have several friends in the UK, and they
moved to private healthcare the moment they
could afford it. French regional health-
care is high quality, but in cities it is
a calamity. As for Sweden, "quality"
perceptions are also largely a factor of
how much aid you receive. Students will
love it, most upwardly mobile individuals
I know from there try to move out. Not
to mention Norway, with similar services,
but one of the world's higher suicide
rates... -John
\_ This actually fits right in with yesterday's
bureaucracy discussion. Bureaucracies, by
nature, must impose rules over the whole
system. Any rule they put in place,
immediately changes the ecomomics of the
medicine. Suddenly it's not "pleaseing the
customer," it's "applying the rules directly
so I won't get sued," or, even more commonly
"gaming the system so I make more money."
Such rules obviously stifle innovation and
research. For any given problem, a lot of
little groups will solve the problem faster
than one huge bureaucracy grinding through it
with trial and error. Try a throught
experiment. Make up some law that would
probably be passed about new medicines. Then
figure out what that would cause in the market
place. I defy you to come up with a possiable
law that wouldn't screw everything and
ultimately result in either the end of most
medical research or massive corruption, or
both.
\_ I spent most of last night in the ER of
an American private hospital, and I just
want to say a big "fuck you" to anyone who
thinks the US system is anything but fucking
barbaric. I'm not arguing for a european system
or any other particular system, I'm just saying
that if anyone here doesn't think our system is
100% broken they can go fuck themselves.
\_ This is the result of HMOs fucking everything
up. Our health care system has already been
destroyed. We're arguing about bringing it
back to the way it used to be instead of
going even further towards the failed
socialist model.
\_ You're right. The problem is right now
we've got a kind of half and half
system. It's sorta private, but it has
a number of bureaucracies (HMOs,
Medicaide) that act like little
socialized Healthcare systems. Lawyers,
Liberals, and insuracemen have been
pushing in this direction for a long
time, and it's screwed us up. What I
don't is understand why so many people
think the solution to the problem is
MORE socialization. "Socialism didn't
work, obviously it wasn't enough! We
need communism!" Huh?
\_ Compare and contrast the Canadian model
with the American model. The Canadians
pay less and get more, no matter how
you slice it. They live longer, healthier
lives, with less infant mortality and
better health outcomes. And they pay
much less than US patients, both in
overall dollars and as a percentage
of GDP. Yet you refuse to even consider
that this might be because their
socialist system is superior in this
area. Faith based economics, anyone?
\_ Socialism makes baby Jesus cry.
\_ How did these words get in my
mouth? _I_ didn't put them
there... OH! you did! I'm sure
it's better in that area. Never
said it wasn't. But I think
you're leaving out a lot of
variables and important factors.
For example, how much medical R&D is
done by Canadian compaines? How
many Canadian crack fiends are
there per capita? What's the
average wait for important care? etc.
\_ Fewer crack fiends, more beaver
junkies.
\_ Which words did I put in your
mouth? "Socialism didn't work..."
But you said that! OH!
I have studied where money is
spent in health care, in both
countries. In niether one do
crack babies count for even
1/10 of 1 percent. In the US
50 percent of lifetime spending
occurs in the last three months
of life.
\_ It's interesting how people who are in favor of
open source and the whole "lots of eyes" concept
to solve problems are so often in favor of big
government one-stop-fits-all 'solutions' to
real world problems. I don't get it. I guess
it really comes down to they want free stuff,
and don't really believe the rest of the open
source philosophy.
\_ I don't know about this private or public thing.
One thing I know is that health insurance should
all have higher deductibles and have the customer
pay a percentage of the charges up to a
significant limit. I see too many colleagues
abuse health insurance by visiting doctors,
chiropractors day in and day out for very minor
conditions, and their doctors are happy to comply.
American natives are especially good at bilking
the system like this. They also eat like pigs
and don't exercise, increasing health insurance
costs for everyone. Just look at Rush Limbaugh
or Dick Cheney, both too fat! Health INSURANCE
should be an INSURANCE, not free healthcare! |
| 5/17 |
|
| www.crookedtimber.org/archives/002173.html Wall Street Journal is concerned about ever-rising health care costs in the United States. I've been looking at data on national health systems for a paper I'm trying to write. It turns out that there's a lot less theoretical work done on comparative health systems than you might think, certainly in comparison to the huge literature on welfare state regimes. Here's a figure showing the relationship between the "Publicness" of the health system and the amount spent on health care per person per year. Data points are each country's mean score on these measures for the years 1990 to 2001. Update: I've relabeled the x-axis to remove a misleading reference to ratios. As you can see, health care in other advanced capitalist democracies is typically twice as public and half as expensive as the United States. Now, this picture doesn't resolve a whole bunch of arguments about the relative efficiency of public vs private care or the right kind of health system to have. But a picture like this makes it easy to see that mainstream debate about health care in the US happens inside a self-contained bubble, and that one of its main conservative tropes -- the inevitable expense of some kind of universal health care system -- is wholly divorced from the data. Posted on July 14, 2004 03:58 AM UTC Comments The US figures must be inflated to at least some extent by R&D costs, on which the rest of the world gets a free ride. Even if all "pure" research is chopped out, expensive experimental procedures available only here should cause a slight bump, and free market drug prices inflated by price controls elsewhere are going to account for a much bigger part of the discrepancy. Dylan July 14, 2004 04:22 AM the echo chamber is already ahead of you on this one. it goes something like, public systems are only cheap and sustainable because the american system assumes most of the costs of drug discovery, medical research, technological advancement. Shai July 14, 2004 04:49 AM I think what you're seeing is that the more economic power is concentrated on one entity, the more it can control per-capita costs; the flip side of that is that this control is essentially rationing. Give all the economic power to a single US HMO/PPO (Sherman aside) and I suspect you'd have the same result as giving it all to the NHS or provincial medicaid boards. I'd be curious, though, what the graph would look like if you stripped out catastrophic care due to violent crime; patching up gunshot victims due to drug turf wars is not cheap and rarely paid for by the victim (or the perp, for that matter). Chris Lawrence July 14, 2004 04:59 AM I can't help feeling that the devil is in the detail. What about a chart on the comparative cost of some healthcare examples: a) Fixing a broken arm of a child, b) 1 hour counselling, c) "Nosejob" d) Chorionic Villus Sampling (CVS), e) Abortion, f) Surgery for removal of benign stomach cancer, g) 1 month care for person dying of lung cancer? q July 14, 2004 05:22 AM There's certainly not a linear trend in that figure. If anything, expenditures seem to rise toward the higher end of the public/private ratio with a minimum around 07 And if the US is pulled out as an anomaly, there seems to be very little, if any, correlation. This figure tells us nothing about the relationship between expenditures and public/private expense ratios. Just for instance, in the US, 80% of the health care expenditures are used for the last 30 days of life. Is that a result of less public spending or is that a self-contained cultural bubble? eudoxis July 14, 2004 05:49 AM Is there anything comparing costs of the non-medical support services that figure in the health care system--clerks pushing paper, processing 100 different kinds of insurance forms, duplicated administrative structures for various HMOs, etc? Posted by h e baber July 14, 2004 06:22 AM There's certainly not a linear trend in that figure. If anything, expenditures seem to rise toward the higher end of the public/private ratio with a minimum around 07 And if the US is pulled out as an anomaly, there seems to be very little, if any, correlation. Yes, the point of the post was that the US is a giant anomaly. eudoxis July 14, 2004 07:26 AM I think the R&D difference/effective world subsidy on drug prices can certainly be a factor. Not just the cost of settling and defending lawsuits, but the very difficult task of protecting yourself as if you were going to be sued every single time you treat a patient. I'm not sure how to quantify it, but doctors in the US spend a lot of time talking about how annoying it is to have to cover their asses every time they do anything. Sebastian Holsclaw July 14, 2004 07:35 AM Almost all medical research in the US takes place in government funded institutions. In the specific case of the pharmaceutical industry, the major companies devote themselves solely to incremental improvements in existing chemicals for which they hold patents, rather than investing research dollars in developing riskier new drugs. Given that the taxpayer already bears most of the burden of providing funds for genuinely new medical research, it's difficult to see how R&D costs have any bearing on the public/private health funding debate. Zak Catem July 14, 2004 08:05 AM It's not common knowledge in the US that Canadians spend half as much on health care, nor that the average Dutch male is nearly 6'1". Since the Brits have nearly the same problem with obesity, it might not be entirely beside the point to blame it on the unwillingness to use the metric system. I'd rather blame it on soft drinks (pop or soda, if you'd rather). Forty years ago, "Pepsi Cola hits the spot, twelve full ounces, that's a lot." These days twelve ounces are children's portions, and adults get 16-64 oz. bad Jim July 14, 2004 08:32 AM I wouldn't wager serious money on it, but I'd bet small amounts at reasonable odds that the cost figures in that chart don't include any R&D-related costs. a) the UK looks much too low to have the entire research cost base of the UK biotech industry plus GlaxoSmithKline and b) I happen to know that the most commonly quoted headline series for the USA strips out research costs because I remember looking it up the last time I had an argument with someone on the internet. dsquared July 14, 2004 08:53 AM Of course the mainstream debate about health care in the US happens inside a self-contained bubble. It's a domestic political issue - someone is going to have to tell the drug companies that they aren't going to get what they're asking for their latest and greatest drug, and someone is going to have to tell Americans that they're not going to get the treatment they want because it's too expensive for the benefit it gives, and that there's no one they can sue to make it better. These are all American domestic political concerns, and what the rest of the world does is possibly enlightening but of limited relevance in terms of actually getting things done here. Research and development (along with food hygiene, hospices, cash benefits, education, etc, etc) is included in "Health-Related Items", but that is not the series graphed here. Perhaps you could put a small edit to this effect, KH, in order to forestall this particular talking point? dsquared July 14, 2004 09:04 AM Although direct R&D costs are not included, purchases of pharmaceuticals are included. pdf One small point in defence of the conservative trope: although universal public systems are often fairly cheap, it's hard to see how the US could move towards such a system given its starting position. Such a move would imply a large reduction in the capital to labour ratio and the labour to output ratio in US healthcare, as well as a big contraction in the health insurance industry. It seems to me that the US system, while not delivering a significantly higher average level of health outcomes than Europe, does deliver a much higher level of average care - essentially, Americans are paying quite a lot for the consumption good aspects of healthcare (private, clean rooms, plump pillows, fruit baskets), not just the health outcome aspects. Of course, the inequality o... |