383 replies to this topic

[jetboy]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Edit: I may have used to broad of brush. A large percentage, probably half of Americans are fat and lazy. They don't care enough about their own health to put down the twinkie and big mac yet think for some reason the rest of society should care about their health when the consequences of their lifestyle arrive.

[tq2000]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Last I looked Americans put in more work hours per year than most other industrial nations, but don't let reality get in the way of the point you are trying to make.

[NautiGirl]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

[Saorsa]

The problem with not having cable is that I spend rainy nights at hme watching lectures on iTunesU. Last night i watched an interesting Grand Rounds about health care reform.

The US already has "socialist" health care: the VA, and Indian Health for example. Look at the military: the government owns the hospitals, they pay the bills, and they recruit the practioners.

As for public option health care, over 100 million Americans are already covered under what is cosidered "public option" (paid for and administered by government): Armed forces, VA, Medicare, Medicaid, and CONGRESS.

The overhead for the private system (advertising, billing, bonuses, etc) runs about 25%. The overhead to administer the public options listed above is about 3%--one of the most efficient health care systems in the world. Moving to a single payer system (which isn't going to happen there) would cut overhead costs by half, a savings of over $330B, and more than enough to pay for the care of those currently uninsired.

Taking care of the military is a normal function of having a military. That isn't socialist regardless of your need to put quotes around it.

It's extension to non-injured veterans may be but, that doesn't mean it is a good thing. I am a veteran and have never gone to a VA clinic. Those I know who do are either poor or looking for a benefit that the government doesn't necessarily need to be paying.

Indians? Not so sure about them. I'd be more than willing to give them a bit once the bloody english pay me reparations for the Highland Clearances.

Socialist was in quotes because every time someone talks about a government funded single-payer system, that's the label that's thrown at it. It doesn't change the fact that you have a government owned, operated and paid for health care system that has proven to be far more effective and efficient than the private system.

And every time it's put in, it's slipped in from the left side, with or without quotes to make it appear to be an argument from the right.

I guess folks figure that as soon as they can put a label on it, the issue is defined in absolute terms and no further discussion may be permitted.

[tq2000]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Maybe he meant you could access Web MD at the local library, you know pretty much the same thing as you describe.

[jetboy]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Yes. You name me a city, I'll find you a place to have all of that done for free by the end of next week. The myth of access to care being difficult is just that: a myth.

[MoeAlfa]

I don't know how my local VA does in oncology, but it's affiliated with Georgetown and might be OK. Were my mother alive, I know I'd sooner send her there than the shithole of a major private center in Manhattan where they ruined my father's last years. My family and I have put up with military health care for 22 years. Even that was far better and more humane.

[tq2000]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Yes. You name me a city, I'll find you a place to have all of that done for free by the end of next week. The myth of access to care being difficult is just that: a myth.

Jim Thorpe, PA.

[Saorsa]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Sure, all of those are available in the US. I notice that you didn't make any reference to payment though.

I can go to my supermarket and take my weight and blood pressure anytime. The BP drugs are so cheap that Wal-Mart and my local market have several of them on the free or $4.00 prescription list. Many antibiotics too.

From what I see in my insurance bills, the blood tests aren't all that expensive. Lots less than my insurance payments.

As to the rest of it, just watch Dr. Oz.

[NautiGirl]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Yes. You name me a city, I'll find you a place to have all of that done for free by the end of next week. The myth of access to care being difficult is just that: a myth.

York, Nebraska

[movable ballast]

You can opt out of medicare if you like. A single payer system like any monopoly is never efficient.

How can you say that when your own single payer, government owned health care systems in the US are over twice as efficient as the private ones?

The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff.

Not a great comparison.

Efficiency has nothing to do with how expensive a treatment it.

That has to be the single most ludicrous thing posted all day. You clearly have no business experience.

[Sol Rosenberg]

Done that. It was in the early 80s and it was a dump, but I've also seen Dave Cifu's rehab department at the Richmond VA.

Sometimes, Moe, you would benefit from recognizing when you are speaking to someone whose knowledge and experience in government provision of health care exceeds your own.

[NautiGirl]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Sure, all of those are available in the US. I notice that you didn't make any reference to payment though.

I can go to my supermarket and take my weight and blood pressure anytime. The BP drugs are so cheap that Wal-Mart and my local market have several of them on the free or $4.00 prescription list. Many antibiotics too.

From what I see in my insurance bills, the blood tests aren't all that expensive. Lots less than my insurance payments.

As to the rest of it, just watch Dr. Oz.

I prefer to leave my medical care in the hands of trained professionals, not the Wal-Mart blood pressure machine, not Dr. Google, and not Dr. Oz.

(wal-mart gives medications for free down there?)

[jetboy]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Yes. You name me a city, I'll find you a place to have all of that done for free by the end of next week. The myth of access to care being difficult is just that: a myth.

Jim Thorpe, PA.

The 6th street shelter in allentown will see you for a first visit then refer you to The Caring Place or to the Lehigh Valley Physician’s Practice. You can take Susquehanna Trailways routes 10 or 20 for $9.25 to get there.

[NautiGirl]

You can opt out of medicare if you like. A single payer system like any monopoly is never efficient.

How can you say that when your own single payer, government owned health care systems in the US are over twice as efficient as the private ones?

The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff.

Not a great comparison.

Efficiency has nothing to do with how expensive a treatment it.

That has to be the single most ludicrous thing posted all day. You clearly have no business experience.

You couldn't be more wrong!

[movable ballast]

Covering pre-existing conditions without a mandate allows people to wait until they are sick to buy the stuff.

Not if the their insurance policy was not tied to their jobs. They could move from job to job as they pleased without the risk of loosing their insurance. They could only lose their coverage if THEY chose to not pay the premium.

But they would still be locked in to their insurance carrier, and the insurance carriers would have an incentive to give you really good service until you got sick, at which point they would give you really lousy service, but you wouldn't be able to switch because no other carrier would cover your pre-existing condition.

I'm not saying it's just a free for all. You would need some regulation / law to prevent patient "dumping" because we know they'll try it. It could be as simple as if the patient has been a customer for X amount of time the ins co could not dump them.

[jetboy]

If the government values and recognizes the savings in preventative medicine, they can reward those delivering it. (Even if it wasn't in a single payer system, there are other ways the government could do that, such as stipends, assistance with educational debt for those who choose and stay as PCPs).

Problem is politicians only ever look at costs in the sense of "what is this costing now?" They look at how much it costs to deliver polio vaccines, without appreciating how much they'll save down the road by spending that money now. (That is not unique to US politicians, it's the same everywhere of course)

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Yes. You name me a city, I'll find you a place to have all of that done for free by the end of next week. The myth of access to care being difficult is just that: a myth.

York, Nebraska

The People's City Mission or Milkworks in Lincoln. You'll have to find your own bus route. I'm sure it can be done for around $10.

AND I bet you can get an appointment faster there than you can at your Canadian Health System physician. It's also likely faster than you could be seen at most VAs.

[Saorsa]

(wal-mart gives medications for free down there?)

Sorry, misspoke, the free from my local supermarket is because they have a zero co-pay on some drugs.

Wal-mart offers about 350 drugs on a $4.00 or $10.00 list of generics they have.

The list can be searched at http://www.walmart.c...arPrescriptions

[movable ballast]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

[MoeAlfa]

Done that. It was in the early 80s and it was a dump, but I've also seen Dave Cifu's rehab department at the Richmond VA.

Sometimes, Moe, you would benefit from recognizing when you are speaking to someone whose knowledge and experience in government provision of health care exceeds your own.

I am dirty and somewhere there is a happy pig.

[tq2000]

Americans are by and large fat lazy slobs. Preventative medicine is more or less free for anyone who wants it. Americans are unwilling to make lifestyle changes that will lead to better health. It sucks, but that's the way it is. Unless we figure out some way to force exercise and healthy eating habits, all the preventative medicine visits in the wold won't make a dent.

Really? Anyone can make an appointment with a doctor annually, have their BP done, weight taken, get comprehensive blood work done, and then make another when the results come back to be told the results, get a script for anti-hypertensives, perhaps further testing, referred to a nutritionist, and have the fear of god instilled in them that they're are walking stroke so they make some lifestyle changes?

I didn't realize those avenues were open to the uninsured in the US.

Yes. You name me a city, I'll find you a place to have all of that done for free by the end of next week. The myth of access to care being difficult is just that: a myth.

Jim Thorpe, PA.

The 6th street shelter in allentown will see you for a first visit then refer you to The Caring Place or to the Lehigh Valley Physician's Practice. You can take Susquehanna Trailways routes 10 or 20 for $9.25 to get there.

BZZZ. Fail. The homeless shelter you mention has some basic health clinic a few times a month for people who live in Allentown, nothing for someone in Jim Thorpe, and certainly not set up to do the follow up and preventive care Nauti describes. It is after all set up to help homeless people. LVPP is most certainly not free, not even close, not even inexpensive or close to inexpensive.

[tikipete]

The problem with not having cable is that I spend rainy nights at hme watching lectures on iTunesU. Last night i watched an interesting Grand Rounds about health care reform.

The US already has "socialist" health care: the VA, and Indian Health for example. Look at the military: the government owns the hospitals, they pay the bills, and they recruit the practioners.

As for public option health care, over 100 million Americans are already covered under what is cosidered "public option" (paid for and administered by government): Armed forces, VA, Medicare, Medicaid, and CONGRESS.

The overhead for the private system (advertising, billing, bonuses, etc) runs about 25%. The overhead to administer the public options listed above is about 3%--one of the most efficient health care systems in the world. Moving to a single payer system (which isn't going to happen there) would cut overhead costs by half, a savings of over $330B, and more than enough to pay for the care of those currently uninsired.

Taking care of the military is a normal function of having a military. That isn't socialist regardless of your need to put quotes around it.

It's extension to non-injured veterans may be but, that doesn't mean it is a good thing. I am a veteran and have never gone to a VA clinic. Those I know who do are either poor or looking for a benefit that the government doesn't necessarily need to be paying.

Indians? Not so sure about them. I'd be more than willing to give them a bit once the bloody english pay me reparations for the Highland Clearances.

Socialist was in quotes because every time someone talks about a government funded single-payer system, that's the label that's thrown at it. It doesn't change the fact that you have a government owned, operated and paid for health care system that has proven to be far more effective and efficient than the private system.

And every time it's put in, it's slipped in from the left side, with or without quotes to make it appear to be an argument from the right.

I guess folks figure that as soon as they can put a label on it, the issue is defined in absolute terms and no further discussion may be permitted.

Now you're a mind reader?

[NautiGirl]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

[jetboy]

BZZZ. Fail. The homeless shelter you mention has some basic health clinic a few times a month for people who live in Allentown, nothing for someone in Jim Thorpe, and certainly not set up to do the follow up and preventive care Nauti describes. It is after all set up to help homeless people. LVPP is most certainly not free, not even close, not even inexpensive or close to inexpensive.

You don't think the 6th street clinic can perform a blood panel and a bp check? Or is it that the physicians there don't have dea licenses for some reason?

The reality is that you simply think you're too good for a free clinic that's available.

There are also free clinics in Hamlin, Waymart, Erie, Honesdale, Lords Valley, Phili, Coalport, Republic, Pitt, Hanover, and the list could go on. There are many available if you really were interested in using them.

Not to mention that if you actually cannot afford a $100 for a visit, you should qualify for medicaid.

[tq2000]

BZZZ. Fail. The homeless shelter you mention has some basic health clinic a few times a month for people who live in Allentown, nothing for someone in Jim Thorpe, and certainly not set up to do the follow up and preventive care Nauti describes. It is after all set up to help homeless people. LVPP is most certainly not free, not even close, not even inexpensive or close to inexpensive.

You don't think the 6th street clinic can perform a blood panel and a bp check? Or is it that the physicians there don't have dea licenses for some reason?

The reality is that you simply think you're too good for a free clinic that's available.

Among other issues, they are there to serve homeless people in Allentown. That is 45 minutes from Jim Thorpe and they don't help non homeless people from Jim Thorpe.

[Saorsa]

BZZZ. Fail. The homeless shelter you mention has some basic health clinic a few times a month for people who live in Allentown, nothing for someone in Jim Thorpe, and certainly not set up to do the follow up and preventive care Nauti describes. It is after all set up to help homeless people. LVPP is most certainly not free, not even close, not even inexpensive or close to inexpensive.

You don't think the 6th street clinic can perform a blood panel and a bp check? Or is it that the physicians there don't have dea licenses for some reason?

The reality is that you simply think you're too good for a free clinic that's available.

Among other issues, they are there to serve homeless people in Allentown. That is 45 minutes from Jim Thorpe and they don't help non homeless people from Jim Thorpe.

If you are homeless, how can you claim to live in Mauch Chunk ?

[President Eisenhowler]

The VA is low cost because it is very efficient in the actual provision of care because it is all done according to a formula and under the formulary rationing. There is no choice on what treatments to give available to VA physicians. 99% of the care is standardized care based on a flow chart. It often is not the "best" care for a patient, but it is usually the cheapest. American consumers want custom built care for their condition, not a factory line model of care like the VA provides. Possibly the consumers will realize that they cannot afford to have a specific care plan tailored to their needs? If that is the case the VA model might work well - so long as you don't need the cutting edge care or have a unique medical need, it's cheap and relatively effective. But let's make no mistake, the VA care is not equal to private hospital care.

With all due respect, you clearly have no idea how medicine is practiced, what evidence-based guidelines are, or the fact that they are or should be in use everywhere. if, God forbid, you get cancer, you had better hope your oncologist isn't just winging it.

If anyone wants to see the VA formulary, it's here. There are plenty of alternatives in each drug category and it looks at least as broad as the one in our fancy research institution.

Incidentally, the VA is a world leader in rehab medicine, has a model electronic medical record system, and funds cutting edge research in several areas. Many VA-based physicians are faculty at top universities and they are paid the going academic rate.

There you go again, with the facts. Can't anyone have a partisan shitfest any more without some guy like you trying to ruin it?

[tq2000]

BZZZ. Fail. The homeless shelter you mention has some basic health clinic a few times a month for people who live in Allentown, nothing for someone in Jim Thorpe, and certainly not set up to do the follow up and preventive care Nauti describes. It is after all set up to help homeless people. LVPP is most certainly not free, not even close, not even inexpensive or close to inexpensive.

You don't think the 6th street clinic can perform a blood panel and a bp check? Or is it that the physicians there don't have dea licenses for some reason?

The reality is that you simply think you're too good for a free clinic that's available.

Among other issues, they are there to serve homeless people in Allentown. That is 45 minutes from Jim Thorpe and they don't help non homeless people from Jim Thorpe.

If you are homeless, how can you claim to live in Mauch Chunk ?

Jeeze Louise, nobody is homeless. If you are going to respond to my posts it would really be helpful if you read them first.

[President Eisenhowler]

Last I looked Americans put in more work hours per year than most other industrial nations, but don't let reality get in the way of the point you are trying to make.

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

As for the rest of the "fat and lazy" argument, the obesity and cardiovascular health statistics pretty much speak for themselves.

[Saorsa]

You don't think the 6th street clinic can perform a blood panel and a bp check? Or is it that the physicians there don't have dea licenses for some reason?

The reality is that you simply think you're too good for a free clinic that's available.

Among other issues, they are there to serve homeless people in Allentown. That is 45 minutes from Jim Thorpe and they don't help non homeless people from Jim Thorpe.

If you are homeless, how can you claim to live in Mauch Chunk ?

Jeeze Louise, nobody is homeless. If you are going to respond to my posts it would really be helpful if you read them first.

Just run down and tell them you don't have a home there. Use some initiative man. I am homeless in Mauch Chunk.

[tq2000]

Last I looked Americans put in more work hours per year than most other industrial nations, but don't let reality get in the way of the point you are trying to make.

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

As for the rest of the "fat and lazy" argument, the obesity and cardiovascular health statistics pretty much speak for themselves.

Value produced per worker would be a management issue, not a worker issue. There is no doubt that America has an obesity problem, but I do not think it is accurate or fair to say that Americans are lazy. In fact, I would say it is pretty much complete and total bullshit.

[movable ballast]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

Well aside from that you never responded to the original question

"The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff".

You state that "Efficiency has nothing to do with how expensive a treatment is". I simply call bullshit.

In my statement I gave valid reasons to why the VA costs less, Efficiency is not one of them. Private hospitals are FAR more efficient than the VA, they have to be they have shareholders. The VA answers to no one hence why single payer healthcare would be a disaster in the US. NO ACCOUNTABILITY!

[tq2000]

You don't think the 6th street clinic can perform a blood panel and a bp check? Or is it that the physicians there don't have dea licenses for some reason?

The reality is that you simply think you're too good for a free clinic that's available.

Among other issues, they are there to serve homeless people in Allentown. That is 45 minutes from Jim Thorpe and they don't help non homeless people from Jim Thorpe.

If you are homeless, how can you claim to live in Mauch Chunk ?

Jeeze Louise, nobody is homeless. If you are going to respond to my posts it would really be helpful if you read them first.

Just run down and tell them you don't have a home there. Use some initiative man. I am homeless in Mauch Chunk.

Closer, but you still clearly did not read the whole post.

[NautiGirl]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

Well aside from that you never responded to the original question

"The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff".

You state that "Efficiency has nothing to do with how expensive a treatment is". I simply call bullshit.

In my statement I gave valid reasons to why the VA costs less, Efficiency is not one of them. Private hospitals are FAR more efficient than the VA, they have to be they have shareholders. The VA answers to no one hence why single payer healthcare would be a disaster in the US. NO ACCOUNTABILITY!

I bet the Minister of Health in any province in Canada would argue quite strenuously otherwise. Trust me, there's accountability.

How is there any more accountability in the private system?

[movable ballast]

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

Got a cite for that? As far as I know American workers are among the best in the world. If your assertion is correct why would Japanise and German build manufacturing facilities in the US? seems counter productive.

[movable ballast]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

Well aside from that you never responded to the original question

"The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff".

You state that "Efficiency has nothing to do with how expensive a treatment is". I simply call bullshit.

In my statement I gave valid reasons to why the VA costs less, Efficiency is not one of them. Private hospitals are FAR more efficient than the VA, they have to be they have shareholders. The VA answers to no one hence why single payer healthcare would be a disaster in the US. NO ACCOUNTABILITY!

I bet the Minister of Health in any province in Canada would argues quite strenuously otherwise. Trust me, there's accountability.

To Whom... When was the last time a minister of health fired? I don't know, just a question...

[President Eisenhowler]

Value produced per worker would be a management issue, not a worker issue.

I disagree. Management wanted to put GPS trackers in the snowplows that the city was paying for. Union fought it tooth and nail. Management can only do so much with that kind of anti-productivity attitude on the part of the worker.

[President Eisenhowler]

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

Got a cite for that? As far as I know American workers are among the best in the world. If your assertion is correct why would Japanise and German build manufacturing facilities in the US? seems counter productive.

Depending whose figures you use, the US comes in fourth of ninth http://en.wikipedia....per_hour_worked

[NautiGirl]

I bet the Minister of Health in any province in Canada would argues quite strenuously otherwise. Trust me, there's accountability.

To Whom... When was the last time a minister of health fired? I don't know, just a question...

They are accountable to the taxpayers and voters.


One need not be fired to be help accountable, but to answer your question, they run the risk of being fired at the ballot box or through cabinet shuffles regularly. If it doesn't happen frequently in practice, it's because the vast majority of canadians are satisfied with their health care and how the system is managed.

[MoeAlfa]

Private hospitals are FAR more efficient than the VA, they have to be they have shareholders.

Actually, I'm not sure that's true and it's hard to measure the widgets produced, since health care outcomes are hard to count. The VA has national purchasing power, doesn't have to do much billing beyond Medicare, its providers are protected by the Tort Claims Act, I assume it doesn't pay many taxes and it probably has other advantages I don't know about.

You also should distinguish between hospitals run by commercial enterprises, such as HCA, and those owned by non-profits, like the Mayo Clinic Foundation, U Penn, or UCSF. However, all of them are trying like crazy to make money, buying each other up, and forming gigantic organizations.

[tq2000]

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

Got a cite for that? As far as I know American workers are among the best in the world. If your assertion is correct why would Japanise and German build manufacturing facilities in the US? seems counter productive.

Depending whose figures you use, the US comes in fourth of ninth http://en.wikipedia....per_hour_worked

4th or 9th out of 40 makes Americans lazy? WTF, are you shitting me? so then what do you call the next 30 to 35 countries that come after us?

[Mark K]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

Well aside from that you never responded to the original question

"The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff".

You state that "Efficiency has nothing to do with how expensive a treatment is". I simply call bullshit.

In my statement I gave valid reasons to why the VA costs less, Efficiency is not one of them. Private hospitals are FAR more efficient than the VA, they have to be they have shareholders. The VA answers to no one hence why single payer healthcare would be a disaster in the US. NO ACCOUNTABILITY!

There was an interesting examination of that by a guy back during the health care debates. "Best Care Anywhere".

http://www.washingto...01.longman.html

The reasons for the VA's relative efficiency are listed out.

[MoeAlfa]

You couldn't be more wrong!

So you stand by efficiency having nothing to do with cost huh... Your business must have people just sitting around waiting for something to do.

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

Well aside from that you never responded to the original question

"The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff".

You state that "Efficiency has nothing to do with how expensive a treatment is". I simply call bullshit.

In my statement I gave valid reasons to why the VA costs less, Efficiency is not one of them. Private hospitals are FAR more efficient than the VA, they have to be they have shareholders. The VA answers to no one hence why single payer healthcare would be a disaster in the US. NO ACCOUNTABILITY!

There was an interesting examination of that by a guy back during the health care debates. "Best Care Anywhere".

http://www.washingto...01.longman.html

The reasons for the VA's relative efficiency are listed out.

That went more to issues of quality, but Don Berwick is a known communist who loves the NHS, the NEJM is a hotbed of radicals, and the VA hospitals are hellholes where you wouldn't send your least favorite cat for an elective pedicure. Please stop confusing us with facts.

This is anecdotal, but this winter we finished studying about 200 guys with penetrating brain wounds from Vietnam for the third time. Virtually all of them have now spent most of their lives under VA care. We heard very few complaints about the modern VA system and they seemed to be getting pretty good care. Many qualified for Medicare and could go elsewhere.

When I retire early next year, I'll have to schlep down to the local VA to get my poor old ass checked over and rated for compensable disabilities. We'll see if I survive.

[Saorsa]

I stand by my assertion that the VA runs a more cost efficient opertaion than private hospitals, yes. For every dollar put into the VA, significantly less is diverted from patient care to administration and overhead than in a private hospital. That is efficiency.

Private hospitals cost more, but the are certainly not more efficient.

Well aside from that you never responded to the original question

"The VA is exempt from the regulations forced upon private institutions. that goes a long way to reducing costs, they also are not required to meet the needs of every clinical condition and outsource most of the really expensive stuff".

You state that "Efficiency has nothing to do with how expensive a treatment is". I simply call bullshit.

In my statement I gave valid reasons to why the VA costs less, Efficiency is not one of them. Private hospitals are FAR more efficient than the VA, they have to be they have shareholders. The VA answers to no one hence why single payer healthcare would be a disaster in the US. NO ACCOUNTABILITY!

There was an interesting examination of that by a guy back during the health care debates. "Best Care Anywhere".

http://www.washingto...01.longman.html

The reasons for the VA's relative efficiency are listed out.

That went more to issues of quality, but Don Berwick is a known communist who loves the NHS, the NEJM is a hotbed of radicals, and the VA hospitals are hellholes where you wouldn't send your least favorite cat for an elective pedicure. Please stop confusing us with facts.

This is anecdotal, but this winter we finished studying about 200 guys with penetrating brain wounds from Vietnam for the third time. Virtually all of them have now spent most of their lives under VA care. We heard very few complaints about the modern VA system and they seemed to be getting pretty good care. Many qualified for Medicare and could go elsewhere.

When I retire early next year, I'll have to schlep down to the local VA to get my poor old ass checked over and rated for compensable disabilities. We'll see if I survive.

Is the fact that the study is in regard to penetrating head wounds indicative?

[MoeAlfa]

Is the fact that the study is in regard to penetrating head wounds indicative?

Do you mean, could that sample that bias my impression of the VA? It almost certainly does, but there are several possibilities for how. Most of these guys were or had been employed and had a variety of medical issues. These were also the 200 still able to get on a plane with their spouses or a friend and spend a week with us. 3/5 of the original sample had fallen by the wayside since the 80s.

[Saorsa]

Is the fact that the study is in regard to penetrating head wounds indicative?

Do you mean, could that sample that bias my impression of the VA? It almost certainly does, but there are several possibilities for how. Most of these guys were or had been employed and had a variety of medical issues. These were also the 200 still able to get on a plane with their spouses or a friend and spend a week with us. 3/5 of the original sample had fallen by the wayside since the 80s.

No, it was a feeble attempt at humor along the lines of "If you like the VA hospital you must have a hole in your head."

I had one exposure. My neighbor suggested that my prescription might be cheaper if I used the VA for it. I called them to check the price. No help, I had to come in. Ok, pick up the old paper file with my DD-214, etc. and went in. Nope, didn't need that, just take this financial disclosure home and fill it in, then bring in your DD-214 and then we will schedule an appointment for a physical for you.

I decided I didn't need 'free' healthcare that bad and left it for those who do.

[Mark K]

That went more to issues of quality, but Don Berwick is a known communist who loves the NHS, the NEJM is a hotbed of radicals, and the VA hospitals are hellholes where you wouldn't send your least favorite cat for an elective pedicure. Please stop confusing us with facts.

This is anecdotal, but this winter we finished studying about 200 guys with penetrating brain wounds from Vietnam for the third time. Virtually all of them have now spent most of their lives under VA care. We heard very few complaints about the modern VA system and they seemed to be getting pretty good care. Many qualified for Medicare and could go elsewhere.

When I retire early next year, I'll have to schlep down to the local VA to get my poor old ass checked over and rated for compensable disabilities. We'll see if I survive.

A brave man you are, sir. You will be missed.

You will find the offer of a home cooked meal will be highly prized by your fellow inmates, should you manage to survive long enough to be one yourself. Might be useful in gaining fellow escapee candidates in the death camp.

[MoeAlfa]

Is the fact that the study is in regard to penetrating head wounds indicative?

Do you mean, could that sample that bias my impression of the VA? It almost certainly does, but there are several possibilities for how. Most of these guys were or had been employed and had a variety of medical issues. These were also the 200 still able to get on a plane with their spouses or a friend and spend a week with us. 3/5 of the original sample had fallen by the wayside since the 80s.

No, it was a feeble attempt at humor along the lines of "If you like the VA hospital you must have a hole in your head."

I had one exposure. My neighbor suggested that my prescription might be cheaper if I used the VA for it. I called them to check the price. No help, I had to come in. Ok, pick up the old paper file with my DD-214, etc. and went in. Nope, didn't need that, just take this financial disclosure home and fill it in, then bring in your DD-214 and then we will schedule an appointment for a physical for you.

I decided I didn't need 'free' healthcare that bad and left it for those who do.

Sorry, thanks for reminding me it's 1930 and I'm still sober.

[President Eisenhowler]

When I retire early next year, I'll have to schlep down to the local VA to get my poor old ass checked over and rated for compensable disabilities. We'll see if I survive.

See, right there's the difference. In the private sector, they check over your whole body.....

[ease the sheet!]

the rest of his body is fine. all those tests are a waste of money!

[Saorsa]

I bet the Minister of Health in any province in Canada would argues quite strenuously otherwise. Trust me, there's accountability.

To Whom... When was the last time a minister of health fired? I don't know, just a question...

They are accountable to the taxpayers and voters.


One need not be fired to be help accountable, but to answer your question, they run the risk of being fired at the ballot box or through cabinet shuffles regularly. If it doesn't happen frequently in practice, it's because the vast majority of canadians are satisfied with their health care and how the system is managed.

You elect a minister of health? Perhaps in his district but, folks loyal enough to the party to 'deserve' a ministerial position are generally steered to the safe seats. if enough people in enough districts vote to throw the party out, the minister goes too.

Yes, the Governor General can appoint non MP ministers of the majority party (or coalition) but, how often does that happen?

[ease the sheet!]

when was the last time a health executive was fired?
ministers dont earn anywhere near what health executives earn, nor do they get a bonus. that is a big saving there.

shareholders? the shareholders are the citizens, they get a dividend.

[MoeAlfa]

when was the last time a health executive was fired?
ministers dont earn anywhere near what health executives earn, nor do they get a bonus. that is a big saving there.

shareholders? the shareholders are the citizens, they get a dividend.

Richard Scrushy

[ease the sheet!]

moe, don't take this the wrong way but i love you.

[NautiGirl]

I bet the Minister of Health in any province in Canada would argues quite strenuously otherwise. Trust me, there's accountability.

To Whom... When was the last time a minister of health fired? I don't know, just a question...

They are accountable to the taxpayers and voters.


One need not be fired to be help accountable, but to answer your question, they run the risk of being fired at the ballot box or through cabinet shuffles regularly. If it doesn't happen frequently in practice, it's because the vast majority of canadians are satisfied with their health care and how the system is managed.

You elect a minister of health? Perhaps in his district but, folks loyal enough to the party to 'deserve' a ministerial position are generally steered to the safe seats. if enough people in enough districts vote to throw the party out, the minister goes too.

Yes, the Governor General can appoint non MP ministers of the majority party (or coalition) but, how often does that happen?

From what you've written above, your grasp of the parliamentary system of government is quite weak.

The Minister of Health is appointed by the leader of the government, not the GG or LGs (sworn in by GG or LG yes, but not appointed by). I, and every Canadian only ever vote for the person to represent me, based on where I live, in the legislature. The party with the most representatives forms the government. The leader appoints, from the elected representatives, his cabinet, including a minister of health. If the minister of health performs poorly, they are "fired" in the sense they are removed from that portfolio. Cabinet shuffles are not that uncommon--we will have a federal one this summer, and in New Scotland, we had one earlier this month.

If a minister of a high profile portfolio like health, which affects EVERYONE in the the province, performs poorly, the party itself is certain to suffer in the next election, so there is great pressure to have a good person there, and a person who is making good decisions. Additionally, it's not uncommon for this Minister to come under significant media scruitny. I've seen many cases of policy being ammended or altered as a result of pressure by taxpayers and media exposure (the addition of coverage of Lucentis is one example that comes to mind) . That's a good thing in my opinion, because it means they are responsive and, oh, ACCOUNTABLE to the folks who pay the bills.

The GG (and LGs) act on the advice of the Prime Minister (or Premiers). They DO NOT select cabinet ministers.

[Saorsa]

I bet the Minister of Health in any province in Canada would argues quite strenuously otherwise. Trust me, there's accountability.

To Whom... When was the last time a minister of health fired? I don't know, just a question...

They are accountable to the taxpayers and voters.


One need not be fired to be help accountable, but to answer your question, they run the risk of being fired at the ballot box or through cabinet shuffles regularly. If it doesn't happen frequently in practice, it's because the vast majority of canadians are satisfied with their health care and how the system is managed.

You elect a minister of health? Perhaps in his district but, folks loyal enough to the party to 'deserve' a ministerial position are generally steered to the safe seats. if enough people in enough districts vote to throw the party out, the minister goes too.

Yes, the Governor General can appoint non MP ministers of the majority party (or coalition) but, how often does that happen?

From what you've written above, your grasp of the parliamentary system of government is quite weak.

The Minister of Health is appointed by the leader of the government, not the GG or LGs (sworn in by GG or LG yes, but not appointed by). I, and every Canadian only ever vote for the person to represent me, based on where I live, in the legislature. The party with the most representatives forms the government. The leader appoints, from the elected representatives, his cabinet, including a minister of health. If the minister of health performs poorly, they are "fired" in the sense they are removed from that portfolio. Cabinet shuffles are not that uncommon--we will have a federal one this summer, and in New Scotland, we had one earlier this month.

If a minister of a high profile portfolio like health, which affects EVERYONE in the the province, performs poorly, the party itself is certain to suffer in the next election, so there is great pressure to have a good person there, and a person who is making good decisions. Additionally, it's not uncommon for this Minister to come under significant media scruitny. I've seen many cases of policy being ammended or altered as a result of pressure by taxpayers and media exposure (the addition of coverage of Lucentis is one example that comes to mind) . That's a good thing in my opinion, because it means they are responsive and, oh, ACCOUNTABLE to the folks who pay the bills.

The GG (and LGs) act on the advice of the Prime Minister (or Premiers). They DO NOT select cabinet ministers.

True the minister is appointed by the leading members of the party. The prime minister makes the announcement and the GG, as representative of the queen in parliament does the swearing in. Ten years or more living in countries with parliamentary systems has given me enough of a grasp of the system to know that you do not elect the minister of health unless you live in their district. I'm also sure that anyone appointed will be in or from a safe seat for the party unless you are putting up a scapegoat for one election cycle.

I have also noted that much of the world is becoming affected by the quaint belief that seeing a lot of american politics being fed to them on TV has given them some misconceptions about their own electoral and processes of government. As an example, I would point to the fellow in the UK who told me he would never vote for Tony Blair again. I asked him if Tony was MP for his constituency. He told me no. When I asked him who he would vote for, he named the incumbent Labour MP.

[NautiGirl]

They are accountable to the taxpayers and voters.


One need not be fired to be help accountable, but to answer your question, they run the risk of being fired at the ballot box or through cabinet shuffles regularly. If it doesn't happen frequently in practice, it's because the vast majority of canadians are satisfied with their health care and how the system is managed.

You elect a minister of health? Perhaps in his district but, folks loyal enough to the party to 'deserve' a ministerial position are generally steered to the safe seats. if enough people in enough districts vote to throw the party out, the minister goes too.

Yes, the Governor General can appoint non MP ministers of the majority party (or coalition) but, how often does that happen?

From what you've written above, your grasp of the parliamentary system of government is quite weak.

The Minister of Health is appointed by the leader of the government, not the GG or LGs (sworn in by GG or LG yes, but not appointed by). I, and every Canadian only ever vote for the person to represent me, based on where I live, in the legislature. The party with the most representatives forms the government. The leader appoints, from the elected representatives, his cabinet, including a minister of health. If the minister of health performs poorly, they are "fired" in the sense they are removed from that portfolio. Cabinet shuffles are not that uncommon--we will have a federal one this summer, and in New Scotland, we had one earlier this month.

If a minister of a high profile portfolio like health, which affects EVERYONE in the the province, performs poorly, the party itself is certain to suffer in the next election, so there is great pressure to have a good person there, and a person who is making good decisions. Additionally, it's not uncommon for this Minister to come under significant media scruitny. I've seen many cases of policy being ammended or altered as a result of pressure by taxpayers and media exposure (the addition of coverage of Lucentis is one example that comes to mind) . That's a good thing in my opinion, because it means they are responsive and, oh, ACCOUNTABLE to the folks who pay the bills.

The GG (and LGs) act on the advice of the Prime Minister (or Premiers). They DO NOT select cabinet ministers.

True the minister is appointed by the leading members of the party. The prime minister makes the announcement and the GG, as representative of the queen in parliament does the swearing in. Ten years or more living in countries with parliamentary systems has given me enough of a grasp of the system to know that you do not elect the minister of health unless you live in their district. I'm also sure that anyone appointed will be in or from a safe seat for the party unless you are putting up a scapegoat for one election cycle.

I have also noted that much of the world is becoming affected by the quaint belief that seeing a lot of american politics being fed to them on TV has given them some misconceptions about their own electoral and processes of government. As an example, I would point to the fellow in the UK who told me he would never vote for Tony Blair again. I asked him if Tony was MP for his constituency. He told me no. When I asked him who he would vote for, he named the incumbent Labour MP.

"Safe seats" really have nothing to do with it. It's not uncommon for a party to go from third position to winning an election, which means a whole whack of new MLAs, and few "safe seats". It's in the best interest of the Prime Minister/Premier to appoint the most suitable MLAs to match their cabinet posts.

The fellow in the UK was not entirely incorrect. Most election campaigns, especially at the federal level, revolve around the leader, particularly when the candidates in the riding are not incumbants.

So no, I don't vote for Stephen Harper, but Stephen Harper certainly affects who I vote for at the local level.

[Saorsa]

They are accountable to the taxpayers and voters.


One need not be fired to be help accountable, but to answer your question, they run the risk of being fired at the ballot box or through cabinet shuffles regularly. If it doesn't happen frequently in practice, it's because the vast majority of canadians are satisfied with their health care and how the system is managed.

You elect a minister of health? Perhaps in his district but, folks loyal enough to the party to 'deserve' a ministerial position are generally steered to the safe seats. if enough people in enough districts vote to throw the party out, the minister goes too.

Yes, the Governor General can appoint non MP ministers of the majority party (or coalition) but, how often does that happen?

From what you've written above, your grasp of the parliamentary system of government is quite weak.

The Minister of Health is appointed by the leader of the government, not the GG or LGs (sworn in by GG or LG yes, but not appointed by). I, and every Canadian only ever vote for the person to represent me, based on where I live, in the legislature. The party with the most representatives forms the government. The leader appoints, from the elected representatives, his cabinet, including a minister of health. If the minister of health performs poorly, they are "fired" in the sense they are removed from that portfolio. Cabinet shuffles are not that uncommon--we will have a federal one this summer, and in New Scotland, we had one earlier this month.

If a minister of a high profile portfolio like health, which affects EVERYONE in the the province, performs poorly, the party itself is certain to suffer in the next election, so there is great pressure to have a good person there, and a person who is making good decisions. Additionally, it's not uncommon for this Minister to come under significant media scruitny. I've seen many cases of policy being ammended or altered as a result of pressure by taxpayers and media exposure (the addition of coverage of Lucentis is one example that comes to mind) . That's a good thing in my opinion, because it means they are responsive and, oh, ACCOUNTABLE to the folks who pay the bills.

The GG (and LGs) act on the advice of the Prime Minister (or Premiers). They DO NOT select cabinet ministers.

True the minister is appointed by the leading members of the party. The prime minister makes the announcement and the GG, as representative of the queen in parliament does the swearing in. Ten years or more living in countries with parliamentary systems has given me enough of a grasp of the system to know that you do not elect the minister of health unless you live in their district. I'm also sure that anyone appointed will be in or from a safe seat for the party unless you are putting up a scapegoat for one election cycle.

I have also noted that much of the world is becoming affected by the quaint belief that seeing a lot of american politics being fed to them on TV has given them some misconceptions about their own electoral and processes of government. As an example, I would point to the fellow in the UK who told me he would never vote for Tony Blair again. I asked him if Tony was MP for his constituency. He told me no. When I asked him who he would vote for, he named the incumbent Labour MP.

"Safe seats" really have nothing to do with it. It's not uncommon for a party to go from third position to winning an election, which means a whole whack of new MLAs, and few "safe seats". It's in the best interest of the Prime Minister/Premier to appoint the most suitable MLAs to match their cabinet posts.

The fellow in the UK was not entirely incorrect. Most election campaigns, especially at the federal level, revolve around the leader, particularly when the candidates in the riding are not incumbants.

So no, I don't vote for Stephen Harper, but Stephen Harper certainly affects who I vote for at the local level.

Which just goes to show that Canadians are as fucking stupid about Party Politics as Americans.

[NautiGirl]

Which just goes to show that Canadians are as fucking stupid about Party Politics as Americans.

Not really.

It's not unusal for Dems or Repubs to vote against party lines. It's far more unusual for Canadian politicians to vote against their own party, except on the few votes which could be considered "matters of conscience". If I had voted for Bruce Pretty, the CPC candidate in my riding in the last election, I know that he would vote in support of whatever legislation Stephen Harper brings forward. Keep in mind, the party leader has far more influence and control over the elected members in Canada than in the US. If I'm not buying what Stephen harper is selling, then I'm not going to vote for a member of his party who I know is going to support those policies.

You don't have different visible factions inside the parties. The leader is setting the agenda, so if you agree with the leader, you vote for his candidate. Especially with the current government, dissent is tightly controlled. Dear Leader doesn't take kindly to members disagreeing with him in public.

[jetboy]

Last I looked Americans put in more work hours per year than most other industrial nations, but don't let reality get in the way of the point you are trying to make.

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

As for the rest of the "fat and lazy" argument, the obesity and cardiovascular health statistics pretty much speak for themselves.

Value produced per worker would be a management issue, not a worker issue. There is no doubt that America has an obesity problem, but I do not think it is accurate or fair to say that Americans are lazy. In fact, I would say it is pretty much complete and total bullshit.

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese. They are generally the fattest and usually also the laziest. Motivated people with self control are rarely obese. Almost 75% of Men and 50% of women in the US are expected to have some level of type II diabetes which is almost entirely due to being obese. 3 of 4 men and 2 of 3 women in the US are already overweight.

How hard is it to spend 30 minutes a day exercising? Too hard for most Americans. So yes, I'm sticking with my premise that most Americans are lazy and do not have adequate incentive to be healthy. Why would we want to provide free care to someone who is unwilling to make minimal effort for their own health.

[tikipete]

Guilty on all counts. Except I've managed to avoid any health problems so far.

Exercise is good but you can't lose weight without controlling intake.

Exercise proved ineffective for me. Calorie counting and a little will power is amazing. Losing 7 lbs in 5 weeks is pretty much a no brainer on a decent calorie counting regimen.

Imo, most Americans have not idea how calorie rich our diet is.

[d'ranger]

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese. They are generally the fattest and usually also the laziest. Motivated people with self control are rarely obese. Almost 75% of Men and 50% of women in the US are expected to have some level of type II diabetes which is almost entirely due to being obese. 3 of 4 men and 2 of 3 women in the US are already overweight.

How hard is it to spend 30 minutes a day exercising? Too hard for most Americans. So yes, I'm sticking with my premise that most Americans are lazy and do not have adequate incentive to be healthy. Why would we want to provide free care to someone who is unwilling to make minimal effort for their own health.

After four years and about 60 posts you decide to grace us with your brilliance.

edit: I have a couple of follow up questions:
Fat people are fat because they are lazy. So, all fat people are lazy?
Are all lazy people fat? If not, why not? Is there a point where they are too lazy to eat?

TIA

[tikipete]

Not to mention in a rude and condescending manner. But, what goes around comes around...

[tq2000]

Last I looked Americans put in more work hours per year than most other industrial nations, but don't let reality get in the way of the point you are trying to make.

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

As for the rest of the "fat and lazy" argument, the obesity and cardiovascular health statistics pretty much speak for themselves.

Value produced per worker would be a management issue, not a worker issue. There is no doubt that America has an obesity problem, but I do not think it is accurate or fair to say that Americans are lazy. In fact, I would say it is pretty much complete and total bullshit.

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese. They are generally the fattest and usually also the laziest. Motivated people with self control are rarely obese. Almost 75% of Men and 50% of women in the US are expected to have some level of type II diabetes which is almost entirely due to being obese. 3 of 4 men and 2 of 3 women in the US are already overweight.

How hard is it to spend 30 minutes a day exercising? Too hard for most Americans. So yes, I'm sticking with my premise that most Americans are lazy and do not have adequate incentive to be healthy. Why would we want to provide free care to someone who is unwilling to make minimal effort for their own health.

Is it true what they say about it being bliss?

[jetboy]

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese. They are generally the fattest and usually also the laziest. Motivated people with self control are rarely obese. Almost 75% of Men and 50% of women in the US are expected to have some level of type II diabetes which is almost entirely due to being obese. 3 of 4 men and 2 of 3 women in the US are already overweight.

How hard is it to spend 30 minutes a day exercising? Too hard for most Americans. So yes, I'm sticking with my premise that most Americans are lazy and do not have adequate incentive to be healthy. Why would we want to provide free care to someone who is unwilling to make minimal effort for their own health.

After four years and about 60 posts you decide to grace us with your brilliance.

edit: I have a couple of follow up questions:
Fat people are fat because they are lazy. So, all fat people are lazy?
Are all lazy people fat? If not, why not? Is there a point where they are too lazy to eat?

TIA

Yes, fat people are fat because they are lazy - with a few exceptions that are a very small percentage including those with real health problems. Every fat ass says they have a thyroid problem or some BS excuse - no you have an eating and exercise problem. Very few people have real physical limitations causing them to be overweight. It's simply easier to ignore if you claim that it's not your fault. The other exception are those who choose to be overweight on purpose for certain athletic competitions.

Not all lazy people are fat. Some may simply not consume a large calorie diet.

[MoeAlfa]

Well, if there were a famine, we could criticize the very thin and deny them health care for being too lazy and stupid to eat enough...or exercising too much...or something.

Do fat people like being fat? I'm asking because I've never talked to one.

Chris Christie is one lazy muv.

[jetboy]

Last I looked Americans put in more work hours per year than most other industrial nations, but don't let reality get in the way of the point you are trying to make.

Yep. More hours nominally "at work" but far less value produced per worker per year than some other countries.

As for the rest of the "fat and lazy" argument, the obesity and cardiovascular health statistics pretty much speak for themselves.

Value produced per worker would be a management issue, not a worker issue. There is no doubt that America has an obesity problem, but I do not think it is accurate or fair to say that Americans are lazy. In fact, I would say it is pretty much complete and total bullshit.

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese. They are generally the fattest and usually also the laziest. Motivated people with self control are rarely obese. Almost 75% of Men and 50% of women in the US are expected to have some level of type II diabetes which is almost entirely due to being obese. 3 of 4 men and 2 of 3 women in the US are already overweight.

How hard is it to spend 30 minutes a day exercising? Too hard for most Americans. So yes, I'm sticking with my premise that most Americans are lazy and do not have adequate incentive to be healthy. Why would we want to provide free care to someone who is unwilling to make minimal effort for their own health.

Is it true what they say about it being bliss?

Are you going to give me some sob story about how your bad knee means that you have to eat two whoppers at Burger King 5 days a week?

[tikipete]

Let me guess, you're skinny. You're also clearly an ass hole. Are all skinny people ass holes? Tell me you're the exception.

[jetboy]

Well, if there were a famine, we could criticize the very thin and deny them health care for being too lazy and stupid to eat enough...or exercising too much...or something.

Do fat people like being fat? I'm asking because I've never talked to one.

Fat people make a choice to be fat. The "cure" is free, readily available, and almost universally known. It's not easy to lose weight. That's why a lot of people don't put forth the necessary effort to do so.

[Saorsa]

Let me guess, you're skinny. You're also clearly an ass hole. Are all skinny people ass holes? Tell me you're the exception.

No, the asshole is the same size. It just looks proportionally larger.

[jetboy]

Let me guess, you're skinny. You're also clearly an ass hole. Are all skinny people ass holes? Tell me you're the exception.

I'm not particularly skinny. I compete in the clydesdale class in most events. I do ride my bike to work every day - 20 mile round trip, I swim 3 days a week, and I distance run. There are plenty of days when I think "man I should just drive today" but I don't because I know I need to exercise for my health. It's good for me. The same reason I don't eat doughnuts at work. It's not hard to do. It just takes a little effort. Not a lot - just a little.

If it makes me an asshole when someone says, "you need to join my insurance pool to pay for my health care because I didn't give a shit and chose to life an unhealthy life for 30 years and now I have heart disease" and I say "fuck no, you made your bed - you get to sleep in it" so be it. I'm an asshole.

And to be clear, I don't give a shit if someone is overweight. If they're happy, good for them. It's when I'm now being forced to be responsible for the outcome of their decisions that I have a problem. That is what the universal health care model boils down to. I'm more than willing to join a pool of people who are responsible with their choices and want to pool risk of unexpected medical needs even if I never use it. I'll even accept paying for health care for folks that have done the best they can but simply can't afford to buy the health care they need. I abhor the idea of paying for care for those who simply chose to be unhealthy and live an unhealthy lifestyle. And unfortunately that group tends to consume a very large portion of our healthcare dollars. Obesity is more expensive than smoking.

[tikipete]

" I'm an asshole."

We agree, that's good.

[President Eisenhowler]

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese.

I'd want to see some sort of statistics on that. I don't doubt that obese people run up much more health bills than the non-obese, but off the top of my ignorant head, I would imagine that lifelong complications of premature birth, various cancers, and other conditions suck down a lot more dollars than obesity-related illness.

[President Eisenhowler]

Well, if there were a famine, we could criticize the very thin and deny them health care for being too lazy and stupid to eat enough...or exercising too much...or something.

Do fat people like being fat? I'm asking because I've never talked to one.

Fat people make a choice to be fat. The "cure" is free, readily available, and almost universally known. It's not easy to lose weight. That's why a lot of people don't put forth the necessary effort to do so.

People with depression make a choice to have a gloomy outlook. The cure is obvious: just quit being so damn gloomy. It's not easy; that's why a lot of depressed people don't put forth the necessary effort to improve their lot.

[President Eisenhowler]

That is what the universal health care model boils down to. I'm more than willing to join a pool of people who are responsible with their choices and want to pool risk of unexpected medical needs even if I never use it. I'll even accept paying for health care for folks that have done the best they can but simply can't afford to buy the health care they need. I abhor the idea of paying for care for those who simply chose to be unhealthy and live an unhealthy lifestyle. And unfortunately that group tends to consume a very large portion of our healthcare dollars. Obesity is more expensive than smoking.

I'm with you. I don't want to pay for the consequences of people with bad genetics choosing to reproduce; we should exclude inherited diseases from coverage, so that those of us who are lucky responsible in our choices don't need to pay for the mistakes of those who aren't.

[tikipete]

I particularly don't want to pay for all those dumb asses who got run down by drunks, or those whose kids chose to become injured playing sports, or were stupid enough to live in the snow belt and were subsequently injured in an accident. Let's not forget all those volunteer wounded warriors who chose to serve.

Come to think of it, I resent having to pay for anything that doesn't benefit me exclusively.

[jetboy]

The segment of Americans who use the majority of our healthcare dollars - and especially the majority of government provided health care - are the obese.

I'd want to see some sort of statistics on that. I don't doubt that obese people run up much more health bills than the non-obese, but off the top of my ignorant head, I would imagine that lifelong complications of premature birth, various cancers, and other conditions suck down a lot more dollars than obesity-related illness.

Obese people cost roughly $2,700 per year more in direct medical spending per person. A family of 4 obese members would therefore average about $10,000 per year MORE than a typical family of 4 healthy persons.

http://www.news.cornell.edu/stories/April12/ObesityCosts.html

Interestingly obese men only cost about $1600 per year more, while obese women cost $3600 per year more.

Even more telling w/respect to this issue of uninsured is that uninsured obese use roughly $3,271 per year of medical care while healthy weight uninsured use only $512 per year. - If we do a little math taking the 34% obesity average and assuming that the uninsured are average weight spectrum, Out of every $100 spent on the uninsured $75 will be spent for one obese person as compared to $12.50 each for two healthy weight people.

[Mark K]

Is getting fat a "right"?

[jetboy]

Is getting fat a "right"?

I would say it yes. Unfortunately once you become directly financially responsible for my fat ass, then you probably ought to have a say in how fat I get. And I'm not sure I want you to decide how fat I can be. You can't have one without the other, so would you prefer to monitor my waistline or allow me to manage my affairs as I see fit? (including financing my own health care)

[HardOnWind]

Health care is a "right" if you are in one of America's prisons.

http://www.thedailyb...s-thinking.html

Why shouldn't someone who has not committed a crime deserve as much?

[Gouvernail]

Health care is a "right" if you are in one of America's prisons.

http://www.thedailyb...s-thinking.html

Why shouldn't someone who has not committed a crime deserve as much?

NO it is not.


It is necessary to provide a sufficeint level of health care to avoid imposing cruel and unusual punishment.



There are many of you who ahve posted in this thread who ahve difficulty comprehending some of waht I consideer to be relatively simple principles.







We all seem to share in objecting to being forced by our government top support people who make no effort to support themselves.


eatements for ANYBODY who has smoked or pay for new livers for people who have consumed way too much alcohol...



But.



I also do not want to see a kid with half his teeth rotted out because his parents are incapable of ropelry funding that kid's healthcare.



I do not know how to make certain that evereybody who does his dead level best to earn enough to pay for his own care gets all teh care he needs ...without...simply payin g for all teh lazy good for nothing scumbag politicians healthcare at teh same time ( and lazy poor folks ehalth care too)



The unfortunate thing??



A lot of people actually believe there is some MAHOR p[ercentage of our health care dollarr that goes to pay for lazy good for nothing lowlife scumbage ho didn't even try to support themselves.


Considering teh cummincable natuire of most disease, Muy bet is it is cheaper to take care of teh lazy than to let them just be sick and spread their illnesses.

[Mark K]

Is getting fat a "right"?

I would say it yes. Unfortunately once you become directly financially responsible for my fat ass, then you probably ought to have a say in how fat I get. And I'm not sure I want you to decide how fat I can be. You can't have one without the other, so would you prefer to monitor my waistline or allow me to manage my affairs as I see fit? (including financing my own health care)

Nobody is proposing anything that would force you to stop working out or go to a doctor. The AHCA and the problem it attempts to address is about establishing a coherent insurance system.

[jetboy]

Is getting fat a "right"?

I would say it yes. Unfortunately once you become directly financially responsible for my fat ass, then you probably ought to have a say in how fat I get. And I'm not sure I want you to decide how fat I can be. You can't have one without the other, so would you prefer to monitor my waistline or allow me to manage my affairs as I see fit? (including financing my own health care)

Nobody is proposing anything that would force you to stop working out or go to a doctor. The AHCA and the problem it attempts to address is about establishing a coherent insurance system.

That's fair enough. There is often a discussion of both an unversal care model and the ACA in one thread and it's not always clear which argument is with respect to which rationing model.

The current act is certainly not a universal health care system being created. It does insure many uninsured - (primarily through expansion of medicaid not private purchasing of insurance). And it forces the states to pay for it. That's where the a big issue is, states will have to tax in order to pay for the requirements of ACA's medicaid expansion. Which then goes back to the nature of having no incentive to make good choices when someone else is paying for the results.

The individual mandate will be gone tomorrow or Friday. Love or hate it, it is simply not a power that the federal government possesses. And so that leaves us again with what is likely an incoherent insurance system.

[Mark K]

Is getting fat a "right"?

I would say it yes. Unfortunately once you become directly financially responsible for my fat ass, then you probably ought to have a say in how fat I get. And I'm not sure I want you to decide how fat I can be. You can't have one without the other, so would you prefer to monitor my waistline or allow me to manage my affairs as I see fit? (including financing my own health care)

Nobody is proposing anything that would force you to stop working out or go to a doctor. The AHCA and the problem it attempts to address is about establishing a coherent insurance system.

That's fair enough. There is often a discussion of both an unversal care model and the ACA in one thread and it's not always clear which argument is with respect to which rationing model.

The current act is certainly not a universal health care system being created. It does insure many uninsured - (primarily through expansion of medicaid not private purchasing of insurance). And it forces the states to pay for it. That's where the a big issue is, states will have to tax in order to pay for the requirements of ACA's medicaid expansion. Which then goes back to the nature of having no incentive to make good choices when someone else is paying for the results.

The individual mandate will be gone tomorrow or Friday. Love or hate it, it is simply not a power that the federal government possesses. And so that leaves us again with what is likely an incoherent insurance system.

It doesn't really matter to me if the mandate in the AHCA, as it has been termed (it's really toothless) stays or goes. The point being that some sort of nearly universal participation is essential, or existing conditions can not be covered. I suspect a mandate is necessary, just don't see any other way to keep people from waiting until they are sick to buy the stuff.

If we want a system like many third world countries have, where the ER is always staffed by a couple of heartless bouncers who will toss those who can not pay into the street to die, I haven't seen much call for it. The guy that cheered Ron Paul's open suggestion of that was pretty much declared to be just an isolated moron.