Market-Based Medicine: MediBid
The website MediBid describes itself as a new "Marketplace for Self Pay Patients to Find a Doctor or Other Medical Specialist and Deal Direct," and here's some info:
"Patients can find a doctor, family physician, chiropractor, dermatologist, surgeon, dentist, or any other medical specialist on MediBid. The process is simple; patients register as "Seekers" and post a secure, private request for medical care for anything from acupuncture to total knee replacement surgery or stem cell therapy for cancer. With thousands of registered healthcare providers, finding a doctor taking new patients such as a family physician, pain management specialist, orthopedic surgeon, ear nose and throat doctor, or other specialist is easy. Just post a request, then browse through the profiles of qualified medical specialists that offer the procedure you are looking for. While you browse profiles, your request will be emailed to the healthcare providers that match your unique need. These healthcare providers will review your request and submit a custom price quote to you in the form of a Bid. Patients can review their Bids with the profiles of the medical specialists and choose the provider that is right for them based on quality, location, availability, price, credentials, or any other attribute important to the patient.
More than a medical directory, MediBid is a resource where medical consumers can find a doctor, then actively seek bids for the care they need. It gives physicians a direct connection to their patients. MediBid's founders share an unrelenting drive to change the status quo in the field of healthcare financing. Focused on building strong patient-physician relationships, while supporting patients' privacy rights and choice in the medical market place, MediBid's goal is to provide the best opportunity for consumers to self-direct their medical care. Patients who use MediBid's uncompromisingly unique, highly secure, needs-matching technology can acquire the best cost-to-value services anywhere."
144 Comments:
the basic problem that is at the root of health care costs in this country is the fact that the medical community is incentivized to treat "conditions" rather than being outcome-based treatment of the patient where you have a primary care physician monitoring the patient and intervening as soon as things start to go side-ways.
This is how all the industrialized countries systems works.
Everyone has a primary care physician and everyone gets care early in the disease stage.
In this country, people who don't have health insurance, don't have a primary care physician and their diseases do not get discovered and dealt with at a state where it is less costly.
They don't visit the doctor until something happens to them and then because they don't have a primary care physician to start with they go to an urgent care facility - like an ER - where they - have no medical history to see their baseline and history and so s battery of tests and diagnostics are ordered - and then once the disease calibrated - more expensive - later-stage treatments.
The costs are 4-8 times more than if they had a primary care physician who intervened earlier in the process.
These increased costs are absorbed by the hospital and urgent care facilities and then cost-shifted onto the bills of those who do have insurance and this has resulted in a doubling of insurance costs in ten years and projections for them to double again in an similar time frame.
This is why our overall health care costs are about twice per capita what every other industrialized country in the world - pays.
We need to have a system in this country that is first and foremost - cost effective.
Medibid is innovative and perhaps a "keeper" but people without insurance will not benefit from MediBid if they do not have insurance and have not had a regular primary care physician.
Maybe we should go back to shamans.
LG,
It's a supply problem. Not enough doctors. Not enough medical schools. Government is already way too involved.
First step is to unleash the market, so it can increase the supply of all things health-care related.
Medical schools should act like businesses and grow and to meet demand, and accept everyone who wants to learn how to be a doctor, provided they pay their way. Whether they pass is another issue entirely, but getting in should not be such a struggle like it is today.
@hal - check the international states for countries that offer universal access on the number of doctors per population unit.
Nowhere (that I know of) in the entire world does the private sector/free market achieve the goals you say they can.
Other industrialized countries, the govt incentivizes Primary Care and controls specialized care.
In this country that has LESS Govt involvement in heath care that those countries - the reverse happens.
Doctors go into specialized care because it's more lucrative than primary care.
I'm not opposed to free-market approaches - I'd FAVOR them - IF THEY WORK.
We had 15 years after Clinton's approach was shut down - at least half of those years with the Republican party in charge of the Presidency and both houses of Congress and what free-market changes did we see?
I've yet to see an approach that deals with the increased costs of treating those who don't have insurance.
It will take more primary care physicians to deal with the uninsured which will reduce costs by catching diseases earlier (and cheaper).
What incentive does the free-market have - to do this?
Larry, the U.S. health care system is not a free market system. If it were, the quantity and quality of health care would rise, while prices would fall.
The U.S. has a health care system where quality and prices both rise.
Europe has a system where quality and prices both fall.
Overwhelming the U.S. system with more demand will likely raise prices even more and reduce quality.
" Europe has a system where quality and prices both fall."
the rest of the industrialized world (including Europe) pay 1/2 what we do and have a longer life expectancy and lower infant deaths.
My question is if they have lower quality - how come they have longer life expectancies even though most have a much higher percentage of smokers?
I think the answer is that our folks who are not insured receive medical treatment at ERs and Urgent Care facilities which are very expensive and at the same time they don't show up until disease has progressed too far so they require heroic and expensive end-stage health care but they still die early.
I think we pretend in this country that those without insurance - don't get treatment but they really do. It's just that when they get it - it's very expensive and those costs are cost-shifted to those who have insurance.
Isn't this a big part of the problem in this country?
Larry, Europe measures its infant mortality rate different than the U.S..
Also, U.S. life expectancy is higher than in Europe when the U.S. black population is excluded.
There are many other factors, e.g. more Americans own autos and guns.
European hospitals and medical equipment are substantially inferior compared to the U.S..
When you have "free" health care, you'll see a doctor more often, even when its not really necessary, which is costly.
Because the U.S. health care system is not a free market system, some Americans are paying $800 a month for health insurance, while others are paying nothing; some pay little for excellent insurance, while others pay more for poor insurance, etc..
That offer the procedure you are looking for.
======<=====<=
Presumes you know what procdure is best. You may need a consultant, at extra cost.
PT:
There is no free market system, anywhere.
What do we choose for the best " second best"?
All I know, is I paid premiums for 35 years, and when j needed care, got none.
I'm glad my disability insuranc did NOT work lime my health insurance: cut off when you need it.
PT:
Come on. Now that I have a job again, my health insurance is cheap, again.
As long as I am well enough to work, no claims, and low premiums.
Absent a job, no company will cover me, at any price.
Part of being a free market, is being free to walk away and say no.
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One of the reasons Europe has lower infant mortality is because midwives are used for about 75% of births in Europe as compared to about 8% in the U.S. In virtually all studies midwives have better results, lower rates of intervention,lower infant mortality, lower maternal mortality, better birth weights and fewer unnecessary procedures than MD, but the regulations in the U.S. make it more difficult for midwives to practice.
Larry G says:
"It will take more primary care physicians to deal with the uninsured which will reduce costs by catching diseases earlier (and cheaper).
What incentive does the free-market have - to do this?"
What incentive will government offer up in an attempt to balance the scales regarding the number of specialized care physicians versus the number of primary care physicians?
re: Europe measures differently
Lord, folks...
We're talking about Europe, Japan, Australia, Brazil, etc.
the world ...
here's the truth - we have a lower life expectancy and a higher infant death rate - period.
face the facts. Our current system is INFERIOR to the World's Industrialized countries that INCLUDE Europe but by no means just Europe.
To say that our stats are bad because of "blacks" is not only wrong but betrays an attitude that has "problems".
The stats are bad because people of all races who do not have insurance - get sick, don't get treated early on and then go to urgent care and ERs when they are too sick for primary care to deal with and they seek the most expensive forms of treatment because that's the only option we give them.
We are hypocrites.
We "think" that people without insurance do not receive health care nor that we pay for it.
We pay for it.
There's a law that says we will pay for it.
That law is EMTALA.
That law says that you will pay for the urgent and ER care of those who don't have insurance.
and yet we continue to pretend that the free market will fix this problem.
well. it has not and so far, I've yet to see any plan that will other than Obama_Care which won't fix it 100% either.
" What incentive will government offer up in an attempt to balance the scales regarding the number of specialized care physicians versus the number of primary care physicians? "
Virtually in all the other industrialized country, the govt does this - and it works.
There are enough primary care physicians in those countries to see their entire population.
In this country, we say the free market will do that.
Well.. so far.. it has not and there is a high likelihood that the free market - will not
When some say "what incentives do the govt offer" at the same time they say govt involvement in health care is socialism... what does that mean?
Is govt involvement - at any level, in health care - "socialism"?
Bonus Question: Is EMTALA "socialism"?
Here's the reality of what some folks continue to claim is the best health care system in the world - NOT!
"Mortality amenable to health care"
" U.S. Ranks Last
Between 1997–98 and 2002–03, amenable mortality fell by an average of 16 percent in all countries except the U.S., where the decline was only 4 percent. In 1997–98, the U.S. ranked 15th out of the 19 countries on this measure—ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people. By 2002–03, the U.S. fell to last place, with 109.7 per 100,000. In the leading countries, mortality rates per 100,000 people were 64.8 in France, 71.2 in Japan, and 71.3 in Australia."
http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2008/Jan/Measuring-the-Health-of-Nations--Updating-an-Earlier-Analysis.aspx
or
http://goo.gl/zdcOm
so I ask folks again....
how can the private sector, free market fix this - without the govt being involved?
I'd like nothing better than to not have the govt involved - at all - but what is the reality here?
What plan has been offered by Conservatives and free-market advocates to deal with this - effectively?
Last I heard, Mr. Ryans "plan" was to walk away from the problem... despite the fact that health care, including private sector health care consumes 16% of our GDP and has eaten up virtually all the productivity gains in the last decade and yet Ryan and similar thinking folks continue to insist the private sector and the free market will turn this around.
Medibid is a bit of a joke even for folks who have insurance.
Think about this. Your primary care guy sees something and sends you to a specialist who then performs the diagnostic work to calibrate the problem and once he/she does - you say " okay give me your plan of treatment so I can go and get bids on it".
Then think about how this would "work" for someone who has a pre-existing condition and cannot obtain insurance.
That guy is going to be told by a primary care physician (that he cannot afford to go to on a regular basis) that he needs a specialist and the specialist is going to accept him as a patient when he has no insurance?
As I said.
I am ALL FOR a private sector solution to our health care problems but so far, the "ideas" I have seen - all ignore the most fundamental problem which is what do we do about folks who do not have insurance - and who need care?
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@Larry,
You seem to be quite misinformed and ignorant about the TRUE facts. That or you own so much insurance company stock, that you want to use coercion to force people to buy a product that is inefficient due to government intrusion.
Because I am seeing you resort to name calling, I will explain this in very simple terms. Name calling is often a symptom of ignorance. If you are willing to open your mind, you might learn something.
1) Coverage does NOT equal access. In Canada, 96% of Canadians have coverage, yet 17.8% lack access to even a primary care physician.
2) In this country, many are uninsured because they do not see a value in "insurance"
3) Health "insurance" is expensive because medical care is expensive
4) Medical care is expensive because the third party payer system is based on price fixing through a "private-public" partnership of CMS and the AMA. It operates like a union, protecting the earnings of bad "medical providers"
5) Health "insurance" creates incentives to increase consumption (demand), while not increasing supply
The essence of a free market is a direct buyer-sellor transaction. With third party payment, this is negated causing all of the distortions we see today in supply, demand and pricing. Medibid is an attempt to address this root cause problem in modern health care. Obamacare isn't the answer.
@Larry
In regards to your comments re infant mortality and life expectancy, again, you are ill informed.
In the US we include infant deaths of premise, many other nations do not. The definition of a live birth in the US includes "any sign of life", while some nations do not count it as a live birth until 24 or 72 hours, or unless the infant has a certain birth weight, or length. With inconsistent standards, comparisons are useless. It's like saying there are no rich people in a certain country because there are no billionaires there. You might be rich in that country if you have $100,000 US.
In regards to life expectancy, trip out motor vehicle deaths, and violent crime deaths, and the US has the highest life expectancy in the western world.
A better measure of the effectiveness of healthcare is serious illness survival rates.
Take Japan for instance. They have one of the very highest life expectancies in the world. Your logic assumes they have better healthcare, but intelligent thought will prove that a diet of fish, tofu and green tea, is better than Big Macs, fries and diet coke.
There are many people like Larry. When health care costs rise even further and quality falls, the government will finish the job (i.e. nationalize health care).
PT:
All I can tell you is that the current system failed for me, completely. Paid insurance premiums for decades, and the first time I needed service - BAM - out on the street.
I was lucky - it did not totally wipe me out - but a lot of people, it would have, and does.
If the way the insurance companies treated me is the best the Free market can do, then the insuranced companies will get what they deserve.
If that means lesser service and long waits, well, it still beats paying for decades and getting no service.
My Disability insurance advisor actually suggested that I move to Canada...........
Health "insurance" creates incentives to increase consumption (demand), while not increasing supply
========================
I suppose auto insurance creates incentives to have more wrecks, too.
What reason is there that my disability insurance worked fine, but my health insurance was a total rip off?
SGM:
I see opinions, not facts.
Babinich:
"What incentive does the free-market have - to do this?"
=============================
I think you have described the problem: free market isn't working in this case.
Let's go back to letting barbers do surgery, that will improve access.
It is not that insurance is not available to me: I have insurance now, again.
It is only that it is not available to me as an individual. The power of collective bargaining is working for me, where the free market failed.
But, the next time I lose membership in that club, the only way I'm going to get insurance, is to go to another country.
And it can happen to you, too.
"ill-informed"? I wasn't giving an opinion guys, I was reporting the statistics collected and normalized by a number of different organizations and the truth - not what you may want to believe or have an opinion about - the truth - is in those statistics.
We do have some folks in this country he would not buy insurance but we have others that want to - and can't.
Either way - we pay for them because they STILL get medical care and we still pay.
If we did not pay - at all - then you might have a consistent argument - but when you DO PAY and you pay about 4 times as much than if you paid for their primary care it explains why in this country we pay twice as much per capita than any other industrialized country does and rank last in life expectancy (that DOES take into account - all causes of death).
For deaths DIRECTLY amenable to health care - read this:
" The concept of amenable mortality was developed in the 1970s to assess the quality and performance of health systems and to track changes over time. For this study, the researchers used data from the World Health Organization on deaths from conditions considered amenable to health care, such as treatable cancers, diabetes, and cardiovascular disease.
U.S. Ranks Last
Between 1997–98 and 2002–03, amenable mortality fell by an average of 16 percent in all countries except the U.S., where the decline was only 4 percent. In 1997–98, the U.S. ranked 15th out of the 19 countries on this measure—ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people.
By 2002–03, the U.S. fell to last place, with 109.7 per 100,000. In the leading countries, mortality rates per 100,000 people were 64.8 in France, 71.2 in Japan, and 71.3 in Australia."
http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2008/Jan/Measuring-the-Health-of-Nations--Updating-an-Earlier-Analysis.aspx
These are the facts.
Larry, your study uses data from the WHO, which ranks U.S. health care below Cuba.
Excluding significant factors on life expectancy will lead to inaccurate results.
Life Expectancy Hits Record High in United States
June 12, 2008
The Washington Post
Americans' life expectancy reached a record high of 78.1 years in 2006. Life expectancy for women was 80.7 years, and for men, 75.4 years.
White women had the longest life expectancy, at 81 years, followed by black women (76.9 years), white men (76 years) and black men (70 years).
Life expectancy is the calculation of how long a newborn could expect to live if the mortality rates at birth prevailed for a lifetime.
Caution: When Comparing US Life Expectancy/Infant Mortality To Other World Health Systems
July 20, 2009
By "Docs4PatientCare.org (a politically neutral grassroots coalition of physicians)
Conclusion
"Life expectancy and infant mortality are wholly inadequate comparative measures for health care systems. Life expectancy is influenced by a host of factors other than a health care system, while infant mortality is measured inconsistently across nations."
Life expectancy is calculated by a number of different but authoritative entities - that pretty much agree on the definition of it and the world rankings.
http://en.wikipedia.org/wiki/Life_expectancy
http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
check the references on both.
I trust these entities more than your opinion.
You should also.
" Lee Habeeb (born January 21, 1961 in Teaneck, New Jersey) is one of America's leading conservative talk radio producers.
He was the co-creator and Executive Producer of The Laura Ingraham Show (Westwood One, 2001) which cracked the Talkers Magazine Top 5 in America in just 5 years, becoming the #1 Show in its daily time slot 9:00 am–noon ET. His work with Ingraham brought the show national attention on many occasions, unearthing items like Dick Durbin's Pol Pot speech, which made news in The Washington Post and Chicago Tribune.[1] According to Talkers magazine's Talk Radio Research Project in 2004, Ingraham was ranked in the top 10 in total audience among nationally heard talk show hosts, trailing only Rush Limbaugh, Sean Hannity, Howard Stern, Michael Savage and Laura Schlessinger. This ascent was at least partially attributed to the producer Lee Habeeb's adoptions of talk radio techniques of Rush Limbaugh and Howard Stern, mixing hard core politics with pop culture"
....
" Habeeb produced the video "Is Nationalized Health Care a Death Snare?" about the effects a government takeover of health care would have on both beginning of life and end of life issues.[12] Habeeb was also instrumental in helping some prominent Atlanta doctors create and promote an alternative to the American Medical Association called Docs4PatientCare.org"
http://en.wikipedia.org/wiki/Lee_Habeeb
what did you say?
oh yes.
" a politically neutral grassroots coalition of physicians)"
really?
shame. shame.
Hydra, moving to Canada may be worse:
Letter: Doctor says U.S. has best quality of health care
February 15, 2011
I am a Canadian-trained family physician, have practiced in Canada, and have been practicing in the United States for more than 30 years. I had no intention of relocating to this country but very quickly became disillusioned by the Canadian system of socialized medicine.
The way that health care costs are controlled in any socialized system of medicine is by the availability of health care. When I first came to Alabama, there were more CAT scanners in the city of Atlanta than in the entire country of Canada.
My mother, who lived in British Columbia, had to wait a year to have her first cataract surgery. She had to wait six months to be seen for a breast cancer.
The answer to improving health care is to require some element of personal responsibility. This includes being partially financially responsible for our own health care. Anything that is free has no value.
Peak Trader - did you not read this:
" The concept of amenable mortality was developed in the 1970s to assess the quality and performance of health systems and to track changes over time. For this study, the researchers used data from the World Health Organization on deaths from conditions considered amenable to health care, such as treatable cancers, diabetes, and cardiovascular disease.
U.S. Ranks Last
Between 1997–98 and 2002–03, amenable mortality fell by an average of 16 percent in all countries except the U.S., where the decline was only 4 percent. In 1997–98, the U.S. ranked 15th out of the 19 countries on this measure—ahead of only Finland, Portugal, the United Kingdom, and Ireland—with a rate of 114.7 deaths per 100,000 people.
By 2002–03, the U.S. fell to last place, with 109.7 per 100,000. In the leading countries, mortality rates per 100,000 people were 64.8 in France, 71.2 in Japan, and 71.3 in Australia."
http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2008/Jan/Measuring-the-Health-of-Nations--Updating-an-Earlier-Analysis.aspx
you guys kill me.
you say - be informed
so when the stats are brought to fore - you discount the facts and impune the messenger or cite obviously biased sources as your truth.
It's like ya'll on in a different universe sometimes.
Larry, whether one member of the "coalition" is liberal or conservative, are you disputing its statement:
"Life expectancy and infant mortality are wholly inadequate comparative measures for health care systems. Life expectancy is influenced by a host of factors other than a health care system, while infant mortality is measured inconsistently across nations."
Larry, I did read it, but it seems you didn't read my reply.
" The answer to improving health care is to require some element of personal responsibility."
it's called an individual mandate and is employed in a number of other countries including Germany.
Your "personal responsibility" is a joke because you and I will pay for the health care of those who do't have insurance - no if's, ands, or butts.
A principled opponent of providing health care to those who won't buy insurance would openly oppose EMTALA.
- the law that says you and I will pay for those who don't have health insurance.
Does Ron Paul or Paul Ryan advocate the repeal of EMTALA?
" Larry, whether one member of the "coalition" is liberal or conservative, are you disputing its statement:"
I first dispute the dishonest and disengenous portrayal of it as coming from a non-partisan, objective source.
" "Life expectancy and infant mortality are wholly inadequate comparative measures for health care systems. Life expectancy is influenced by a host of factors other than a health care system, while infant mortality is measured inconsistently across nations."
what is the basis for this assertion?
let's see some proof of what they are claiming.
there are MULTIPLE authoritative entities - totally unbiased and non-partisan who develop these statistics - independently - and they results pretty much agree.
you appear to live in a different world guy - one that believes what you wish rather than the realities.
You cite obviously biased sources who have no data to back up their assertions - just assertions ... politically motivated.
Hydra, moving to Canada may be worse:
How can it be worse than NOTHING, which is what I got for what I paid?
Excepting, of course the rude and dismissive responses to my inquiries.
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Lots of thing influence , but sick people get some kind of health care. If it is bad health care more of them will die. Averaged over many people and many countries, how do you explain the increasingly dismal performance indicated by the statistics?
Even if the measures are not perfect, it can't be good to be declining relative to others.
Hydra has tried to obtain health insurance in the US - and had real problems.
In Canada, he WOULD get care - as well as every other industrialized country in the world - he'd get care and he'd get it early enough (at the primary care level) to deal effectively with the threats to his health which in turn would likely lead to a longer life than if he could not get care.
There are MANY people in the US that cannot get the heath care they need - until it is too late. They cannot access Primary Health Care..
Then after their disease progresses, they finally go to ERs and Urgent Care centers where heroic and expensive treatment is rendered often as a lost cause in a last ditch effort to save them.
this is the reality.
But we DO pay for it anyhow about 4 times as much than if they could have accessed primary care from the get go.
In this country, we PRETEND that we are not going to pay their health care costs - but we pay.
EMTALA requires us to pay.
Technically, it requires the hospital to treat them for free but then we let the hospitals cost-shift the extreme costs to people who have insurance.
That's one important reason why the cost of private insurance has doubled in 10 years and is projected to double again - taking us from 16% of our GDP to over 30% of our GDP - our productivity - going wholly to health care costs.
I'd LOVE to have a free market system that provided the best health care in the world - at the lowest cost but we don't have it and there is no sign on it anywhere on the horizon.
One would think that even those who espouse free market principles would admit that our system is a failure by any conventional measure.
unless of course you don't agree to measuring to start with and the truth is what you want it to be no matter how many credible and authoritative organizations keep statistics.
Larry says: "You appear to live in a different world guy - one that believes what you wish rather than the realities."
I live in a world where quality health care doesn't materialize from nothing.
Nothing you've said adds up, which explains why you continue to defend failed systems.
The new health care law:
The Day After
Posted by Alan Orfi
Published: March 23, 2010
As a business owner with 28 employees, I've had much to contemplate after the passage of the "historic" bill. I cannot possibly provide health insurance to my workers as my payroll exceeds 55 percent of total revenue.
I consulted with my crew leaders and have given them the choice of a 12 percent pay cut or we must eventually release three men. Our $1.2 million payroll translates to around $100,000 in annual penalties added to our tax burden because we cannot afford to provide health insurance.
We have decided to proceed with firing three men and will do so within the next few months. We will take shortcuts on the service for our customers to somehow make up for their loss. Our business will survive this setback.
I'm sure the three men who will lose their jobs as a direct result of this bill will be comforted in knowing they now have health insurance.
" Nothing you've said adds up, which explains why you continue to defend failed systems"
it's not what I say - it's what a number of credible and authoritative organizations have kept statistics on - that I am citing.
You don't believe them.
you believe, instead, clearly biased organizations who have a partisan/philosophical ax to grind.
How to reduce health care costs:
1. Limit medical lawsuits and awards, to lower malpractice insurance premiums and unnecessary medical tests.
2. Lower standards to practice medicine (to increase labor)
3. Allow insurance companies to sell health-care policies across state lines (currently, average health care insurance ranges from a low of $1,254 in Wisconsin to a high of $8,537 in Massachusetts).
4. Allow innovation (example below);
Kaiser Microclinics At 50% of the Cost of a Full-Service Hospital
Two doctors working out of a microclinic at a mall could meet 80% of a typical patient's needs. With a hi-def video conferencing add-on, members could even link to a nearby hospital for a quick consult with a specialist. Patients would still need to travel to a full-size facility for major trauma, surgery, or access to expensive diagnostic equipment, but those are situations that arise infrequently. The per-member cost at a microclinic is roughly half that of a full Kaiser hospital.
The alternative would be a health care system similar to Cuba, which the WHO rated higher than the U.S., although the WHO admitted the U.S. is ranked #1 in the world in both labor (e.g. doctors and nurses) and capital (e.g. hospitals and medical equipment).
"A study by Deloitte LLP has found that more than 400,000 non-U.S. residents obtained medical care in the U.S. in 2008, and it forecasts an annual increase of 3%. Some 3.5% of inpatient procedures at U.S. hospitals were performed on international patients, many of them escaping from Canada's supposedly superior health system."
" How to reduce health care costs: "
what?
I THOUGHT you said "free market".
Well guy in the FREE MARKET, Govt does not restrict the right of customers to sue.
"lower standards"
who has set them? Would you have the big, bad govt do this?
selling insurance across state lines?
do govt stop this?
allow innovation?
ha ha ha... who stops it?
the ONLY Alternative is CUBA?
what a triple load guy.
How about Germany?
http://en.wikipedia.org/wiki/Health_in_Germany
Health Reform Without a Public Plan: The German Model
http://economix.blogs.nytimes.com/2009/04/17/health-reform-without-a-public-plan-the-german-model/
Is the U.S. system inferior to those in other developed countries based on life expectancy and cancer survival rates? Not according to economists Robert L. Ohsfeldt (Texas A&M) and John E. Schneider (University of Iowa):
"For unadjusted life expectancy, the U.S. ranks 14 out of 16 countries, but for the adjusted standardized life expectancy the U.S. ranks #1 (adjusted for the effects of premature death resulting from non-health-related fatal injuries).
The U.S. has the best record for five-year survival rates for six different cancers. In some cases the differences are huge: 81.2% in the U.S. for prostate cancer vs. 41% in Denmark and 47.4% in Italy; 61.7% in the U.S. for colon cancer vs. 39.2% in Denmark; 12% in the U.S. for lung cancer vs. 5.6% in Denmark.
Also interesting is the fact that there is often a significant difference between white and black cancer survival rates in the U.S., e.g. prostate cancer - 82.7% for whites vs. 69.2% for blacks. But even in that case, the five-year survival rate for blacks (69.2%) is still higher than for all European countries except Switzerland."
Maybe, Hydra can move to the UK:
'Quarter of a million people waiting more than 18 weeks for NHS treatment'
14 Aug 2009
A quarter of a million people are waiting more than 18 weeks for treatment on the NHS, new figures show...for a range of treatments including oral surgery, rheumatology and geriatric medicine. This means that nearly 10% of patients are not being treated within the government's waiting list target.
Civitas, the think tank, blames the monolithic nature of the National Health Service for “putting the patient last”.
It argues that the “customer” of the NHS business model introduced by Tony Blair and continued by Gordon Brown is the health secretary rather than the patient.
State control: staff pay is set centrally, capital expenditure is constrained, IT is a top-down programme and availability of drugs, such as expensive cancer treatments, is centrally determined.
" availability of drugs, such as expensive cancer treatments, is centrally determined"
yes - and they still outperform us on amenable health care...
so?.....
UK Health Care guy is better than NO health care.
You are saying that people who cannot get health care in the US are better off in Canada and the UK.
well.. DUH.......
what planet did you say you were on?
CNNMoney
By Peter Carbonara
May 1, 2003
According to Medical Liability Monitor, a Chicago publication that tracks malpractice rates, an obstetrician in Miami may pay $210,000 a year, the highest rate in the country. In Alabama, an obstetrician can get the same coverage for $36,000. New Jersey is somewhere in the middle, with base rates for obstetricians of about $70,000.
Dr. Hux says he gets about $1,800 for each delivery. "Most of the time, you're just about breaking even," he says. When one patient had triplets following a risky pregnancy, Hux says, "I think I walked out of there with about 50 bucks."
Most M.D.s in New Jersey have seen their malpractice rates go up. A few have had their rates go up a lot--notably specialists in areas like obstetrics and neurology.
This is a problem for the rest of us, because soaring insurance premiums, on top of rising costs for rent, labor, equipment and everything else, have made it uneconomic for some doctors to practice certain kinds of medicine.
Some obstetricians, for instance, particularly those who specialize in high-risk pregnancies, have given up delivering babies.
In Pennsylvania, several hospitals have recently closed their trauma clinics or maternity wards because the doctors who practice there couldn't afford insurance.
Larry, you continue to base your conclusions on faulty data.
"According to Medical Liability Monitor,"
in a free market - should the govt restrict customers from seeking compensation from harmful actions?
do you really believe in a free market if you want the Govt to intervene on behalf of one side?
" Larry, you continue to base your conclusions on faulty data."
which is.... whatever data you don't like?
PeakTrader - you're not one of those guys that still thinks Obama was not born in this country are you?
:-)
Hydra,
I think you should move to Canada. I left there 6 years ago after my wife was crippled by a 2 1/2 year wait for surgery, and my son could not get a CT. The government picks the winners and losers. In Canada they pay double the out of pocket costs that we do, but you can not pay a doctor for medical care. Only politicians, prisoners, and professional athletes can get timely care. Almost 96% of Canadians are covered by the socialized medicine, but over 827,000 are waiting for procedures as of december 2010 see page 13 http://www.fraserinstitute.org/uploadedFiles/fraser-ca/Content/research-news/research/publications/waiting-your-turn-2010.pdf
How is it you think that car insurance creates incentives for car wrecks? The same way life insurance creates incentives to die?
Modern-day obamacare compliant health plans are not like normal insurance. Car insurance does not cover oil changes, but health "insurance" covers expected routine events with very little out of pocket. This creates an incentive to wastefully consume healthcare.
Larry,
You continue to quote "statistics". Unfortunately statistics are like a lamp post to a drunk, more for support than illumination. Statistics can be manipulated to misrepresent the truth. Some people claim that medicare administrative costs are lower than private insurance administrative costs, which is a complete lie, but they use statistics to perpetuate this lie.
" The Fraser Institute is a conservative and libertarian think tank based in Canada that espouses free market principles. Its stated mandate is to advocate for freedom and competitive markets. It generally opposes public policy solutions based on government spending, taxes, deficits, and regulation. Some of the public policy stands taken by the Institute include: greater free trade throughout the world, privatization of various government services, marijuana decriminalization, competition in primary schooling, and greater private sector involvement in the delivery of healthcare insurance and services. The Fraser Institute opposes Canadian gun control laws,[1] including firearms registry.[2]"
is this an unbiased organization?
On amenable mortality - deaths that could have been prevented by health care...
Canada = 77 deaths per 100,000
USA = 110 deaths per 100,000
http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2008/Jan/Measuring-the-Health-of-Nations--Updating-an-Earlier-Analysis.aspx
waiting for health care in Canada IS Superior to NO HEalth care in the US until you are dying.
you are FREE to obtain MORE health care in Canada if you do't like the basic but everyone is covered as opposed to the US.
Larry,
You state that "Medibid.com is a joke", but you did not talk about your experience with their service. Where is the jocularity? It seems that they allow patients to shop for medical care across state lines and international boundaries, which would further enhance the savings in buying insurance which Peak Trader talks about.
Please tell me what is comical about medibid.com, I am very curious.
" Larry,
You continue to quote "statistics". Unfortunately statistics are like a lamp post to a drunk, more for support than illumination. Statistics can be manipulated to misrepresent the truth. Some people claim that medicare administrative costs are lower than private insurance administrative costs, which is a complete lie, but they use statistics to perpetuate this lie. "
When a number of credible organizations are providing the data and the only data the opponents are providing is from biased sources.... then the "big lie" is a conspiracy...
right?
so... the world health statistics organization are Conspiring to make the US look bad.
they're in cahoots with the climate folks, right?
right?
Larry,
Put your glass of kool aide down for just a moment. Are you saying that there are indeed NOT 827,000 people waiting for procedures?
Larry,
Statistics can be manipulated, facts are facts.
" Larry,
You state that "Medibid.com is a joke", but you did not talk about your experience with their service. Where is the jocularity? It seems that they allow patients to shop for medical care across state lines and international boundaries, which would further enhance the savings in buying insurance which Peak Trader talks about."
I gave it points for innovation but in a country where people don't have health care insurance, what good is MediBid?
Let me ask you - if a Doctor 1200 miles away outbids a local doctor then what?
Can you get doctors to bid on Primary Care?
How do you know - for a given disease what to get bids on until you go to a specialist who diagnoses you?
How can you get a diagnosis from a specialist if you don't know you have a disease because you don't have a primary care doctor?
the concept sounds good until you look at the way it works then you realize that it's only for those who can pay up front and are willing to travel.
That's not your average uninsured person who cannot get insurance.
" Larry,
Put your glass of kool aide down for just a moment. Are you saying that there are indeed NOT 827,000 people waiting for procedures? "
how many people are "waiting for procedures in the U.S.?
What is the percentage of people waiting or procedures in all of the industrialized countries including this one?
You're picking a number which out of context - means nothing.
Put it in context.
" Larry,
Statistics can be manipulated, facts are facts. "
At some point, when multiple credible organizations are providing statistics and data that correlate - you have to start asking yourself who you do believe and what I'm getting is that some of you guys don't believe anyone other than right-wing libertarian folks and everyone else is engaged in a grand conspiracy to lie about the data.
At some point - you're off the ranch...
Larry,
When you have no clue what you are talking about just admit that. We are talking about Canadian single payer healthcare, and your attempt to deflect the argument by comparing a country with 10 times the population is meaningless, and proves your ignorance on the issues
Larry,
If you stop quoting statistics, and start quoting facts, people may listen to you. You continue to demonstrate your ignorance in the issues.
Next you'll say I am racist because I don't believe that statistics which were made up by the WHO demonstrate a point.
" Larry,
When you have no clue what you are talking about just admit that. We are talking about Canadian single payer healthcare, and your attempt to deflect the argument by comparing a country with 10 times the population is meaningless, and proves your ignorance on the issues "
I'm saying you are ignorant guy if you don't compare against other countries and pick one piece of data with no context to prove something.
Your number is meaningless without some context.
A LOT OF PEOPLE - even those with insurance in the US are delayed from getting elective procedures...
and those without insurance, get delayed FOREVER from getting the procedure.
How do you compare people who cannot get the procedure against people who can but have to wait?
And guy - you don't have to wait anyhow.
You are FREE to pay for an immediate operation anytime you want.
It's the basic healthcare that won't provide elective surgery right away but it will provide it whereas in this country - no insurance means no procedure - period.
you don't need no stinkin Kool-Aid to figure that out - just half a brain.
Larry,
Here's a statistic for you.
seven out of every 100 people admitted to a hospital die there, while only four out of every 10,000 people who go to a restaurant die. If I use your logic, that would lead me to the conclusion that if I am having a heart attack, I am better off rushing to McDonalds.
You're starting to tire me
"If you stop quoting statistics, and start quoting facts, people may listen to you. You continue to demonstrate your ignorance in the issues."
ignorance? ha ha ha
statistics are base on FACTS guy.
when MULTIPLE organizations work off of basic facts to come up with statistics that agree.. and someone like you disagrees an the only alternative "facts" are ones provided by right-wing idiots... then I'd say that yes.. there is some ignorance in play.. but not who you think.
" Larry,
Here's a statistic for you.
seven out of every 100 people admitted to a hospital die there, while only four out of every 10,000 people who go to a restaurant die. If I use your logic, that would lead me to the conclusion that if I am having a heart attack, I am better off rushing to McDonalds."
any hospital in the world - same statistics?
got a source?
Larry,
"You are FREE to pay for an immediate operation anytime you want."
You can not pay for an operation in Canada, you CAN do it in the US. You have finally admitted my point.
PS. Sorry to hear that you only have half a brain....by the way, it shows
It does not matter WHERE you pay for it guy.
People in the US... WITH Health care will go to India or Mexico.
so what?
" Canada has a federally sponsored, publicly funded Medicare system, with most services provided by the private sector. Each province may opt out, though none currently choose to. Some provinces still charge premiums to individuals and families. Many employers also offer additional health coverage as a benefit. Canada's system is known as a single payer system, where basic services are provided by private doctors, (since 2002 they have been allowed to incorporate), with the entire fee paid for by the government at the same rate. Most family doctors receive a fee per visit. These rates are negotiated between the provincial governments and the province's medical associations, usually on an annual basis. A physician cannot charge a fee for a service that is higher than the negotiated rate — even to patients who are not covered by the publicly funded system — unless he or she opts out of billing the publicly funded system altogether. Pharmaceutical costs are set at a global median by government price controls. Other areas of health care, such as dentistry and optometry, are wholly private although in some provinces, emergency visits to optometrists are partly covered by medicare. In 2005, Canada spent 9.8% of GDP on health care, or US$3,463 per capita. "
We spend MORE than twice as much PER CAPITA and 30-40 million are not covered.
The U.S. has the best health care industry in the world.
The U.S. only needs to scale back the 130,000 pages of health care regulations and allow much more free market flexibility (including limiting medical lawsuits and awards, along with unnecessary treatments; lowering standards to practice medicine, to increase labor; allowing insurance companies to sell health-care policies across state lines; and allowing more innovation) to reduce health care costs by 50% and maintain its huge quality advantage over the rest of the world.
Most economic problems are supply problems, a consequence of inadequate growth and prosperity.
As for 'expensive tests.' These are expensive because the labs have not grown to meet demand. If the labs grew and competed with each-other, having unnecessary tests would be encouraged.
There would be commercials advising you to get tested, just in case, and with the higher volume of tests, the labs, now much bigger, would make more money but charge less.
But the labs don't grow, because they are being paid by a third party usually, often the government, so they instead charge more per test instead of growing and becoming more efficient.
solving the health-care crisis is very simple, we need more doctors, and for that to happen, we need more medical schools. The public doesn't have to build them, they will be built naturally due to market forces, if we let them. But first we must restrain the special interest and their allies in government, who are obstructing their construction.
More doctors = more competition = lower prices.
doctors are also the brokers/gatekeepers/middlemen to most health-care products and services. If there is a bottleneck of doctors, the prices for goods and services is distorted, even with ample supply.
how do we make tests less expensive?
Is that something the free market does and if so, why has it not happened?
more doctors? is that something govt has control over?
Last I heard, the govt does not restrict the number of Medical schools or people who want to become doctors.
Can you name a country that oes not have universal care that operates as a true free market with plenty of low cost doctors and tests so that everyone can afford them even those who cannot buy insurance?
Peak Trader
Yes on tort reform. Unusually high rewards represent cruel and unusual punishment and thus violate the 8th amendment
Hal,
Yes on competition. How about this for increasing competition...post your medical request online, and allow doctors, labs, hospitals to competitively bid on providing your care. MediBid.com is like the Travelocity of healthcare
[Fraser Institute] "is this an unbiased organization?"
Why no, Larry, it isn't. It's biased in favor of the list of things you quoted. They advocate liberty and free markets, but they mean what they say, unlike you who only pretends to be, by saying:
"I'm all in favor of free markets, BUT..."
If you don't think free markets work, it doesn't make sense to claim to be in favor of them.
No one is fooled by this, Larry.
While you question the impartiality of the Fraser Institute, you had nothing to say about the contents of the report cited. Did you read it, or is a bias in favor of free markets and liberty, by the source of the report, all you need to know?
By the way, if you had read a little more of your Wiki source, you would have discovered that an annual survey of "think tanks" by University of Pennsylvania, ranks the Fraser institute #1 of 97 in Canada, for the 3rd year in a row, and in the top 25 of 6480 worldwide.
You have repeatedly pointed to one report by the Commonwealth Fund, claiming: "This is the truth! This is the Truth!". Do you have any idea how silly you sound?
While improving health care is a noble goal, do you consider the Commonwealth Fund's collectivist notions about the issues to be unbiased?
"This is the truth! Don't bother me with data or facts that don't support my view."
You need to do better if you wish to be taken seriously.
" Why no, Larry, it isn't. It's biased in favor of the list of things you quoted. They advocate liberty and free markets, but they mean what they say, unlike you who only pretends to be, by saying:"
some entities collect data and produce statistics from that data.
Other entities do not and they are essentially advocates for their agenda.
We should not confuse the two.
As far as entities that do collect facts and produce statistical representations of them - I don't trust one.
I like to see several and then see what correlates and what does not.
That way the facts and the statistics are not corrupted by entities with philosophical or political agendas.
That's why when you see entities like the Frazer - they are cherry-picking very selected info to reflect their agenda but it's not an honest and objective portray of the fact as a whole.
I say that about ALL groups LIKE Fraser whether they are left or right - progressive or libertarian.
Those who truly want to understand the world and the facts - don't restrict their intake to only the groups that support their views.
That does not lead to an informed opinion much less a good understanding of the realities and therefore choices for change and reforms.
" You have repeatedly pointed to one report by the Commonwealth Fund, claiming: "This is the truth! This is the Truth!". Do you have any idea how silly you sound?"
Not only the Commonwealth Fund but WHO, OCED, the CIA Fact book and the World Bank.
Many entities - none of them with any particular AX to grind ....
that will get you much closer to the truth than these biased organizations who advocate a particular agenda and then use anecdotal and cherry-picked data to support it.
You won't get the truth from them. You'll get their version of it and it does not lead to a better understanding of the realities nor help point to what changes might be good.
You have to want to know the truth - the facts - FIRST.
The more you align yourself with biased organizations - the less you are really accomplishing anything other than hardening your position and opposed to pragmatic compromises.
" While improving health care is a noble goal,"
improving health care is not a noble goal...
NOT wanting to move to a more cost-effective system is DUMB.
When you spend twice as much as other countries and the life expectancy and other statistics are WORSE...
and your stance is to claim a grand conspiracy of world organization "hiding" the facts, you have ZERO credibility.
I do not care what your politics are but when you refuse to recognize the actual realities then how can you say you want a better, more cost-effective system?
The facts are simple right now.
We do not have a free market system.
30-40 million do not have access to health care.
A direct result is people not getting health care when they need it on a cost-effective basis.
We end up giving those folks 4 times as much money as we need to because we continue to believe the fiction that they won't get health care and we won't pay for it.
They get it and we pay for it and we pay 4 times as much for it as it should cost and those folks still die earlier because they do not get health care early in the disease.
this is the reality.
It's not some grand conspiracy portrayal of a different reality.
"When a number of credible organizations are providing the data and the only data the opponents are providing is from biased sources.... then the "big lie" is a conspiracy..."
What number of credible sources? You are repeatedly referring to one report, on one study, that obviously uses multiple sources, as the data is from different countries. These sources don't reinforce each other. The report is not a mega-analysis.
You still haven't addressed the issue of different definitions of live birth in different countries. Are you still confident that the "this is the truth" report you cite has accounted for these differences, or does it just report raw numbers?
"right?
so... the world health statistics organization are Conspiring to make the US look bad.
they're in cahoots with the climate folks, right?
right?"
A juvenile resort to ridicule won't hide your ignorance of this subject, Larry.
I run a blog highlighting the problems of extortion (ie. governemnt) funded treatment rationing.
http://nationaldeathservice.blogspot.com/
"You still haven't addressed the issue of different definitions of live birth in different countries. Are you still confident that the "this is the truth" report you cite has accounted for these differences, or does it just report raw numbers?"
but I have.
I've cited about 1/2 dozen entities that collect this data and they all normalize it and they pretty much agree.
Here's another:
National Center for Health Statistics
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5522a6.htm
whose data and statistics on Life Expectancy and infant deaths is pretty consistent with the other entities.
Instead you choose to doubt something you know nothing about - the statistical methodology itself by parroting the same old lame right wing blather.
These organizations each explain how they do their analysis.
It is provided to receive peer review and they do provide their conclusions and their source data - completely.
You.. accuse them of cooking the books - ALL of them - a Grand Conspiracy - and instead choose to believe an organization with an obviously biased agenda who themselves does not perform due diligence on the data but cherry-pick and distort it to serve their views.
Here's a start:
http://libguides.bc.edu/healthstats
Health Statistics
Centers for Disease Control and Prevention. U.S. CDC
FEDSTATS
Health, United States NCHS
Chartbook from the NCHS indicating Trends in the Health of Americans.
Millenium Indicators Database U.N. Statistics Division.
OECD Health Data
NationMaster.com
WHOSIS- World Health Organization
Undata (United Nations)
State Health Facts-Kaiser Foundation
You can add to these the
CIA Facbook and the
World Bank
and some others...
All of these organizations are pretty much dedicated only to data and statistics not an agenda.
You'll not find Frazer or any other agenda-driven organization in this list.
When a entity with a self-identified (or hidden) agenda who does NOT themselves collect facts or provide statistics
makes an assertion...
it is important to consider the SOURCE of their claims and to make sure that it's NOT just another agenda-driven site making unfounded assertions
or cherry-picked data without context or even anecdotal claims or parroting other sites with similar agendas.
Getting the truth means you actually want to know the facts - that you want to critically examine the information and to seek out other credible and authoritative entities to replicate and correlate
AND recognize and understand when the data does not correlate.
Spurious and unfounded assertions by organizations with agendas are not good sources of the truth.
The data with respect to life expectancy and infant deaths correlates well across several different CREDIBLE entities that deal in ONLY statistics NOT policies.
For myself - that's critical.
Any organization that has a policy position AND is collecting data and providing statistics is down several notches automatically but I don't throw it out totally.
If their data fits the bigger context and correlates with other statistics-only organizations, then it can have credence.
Having said that - most of the policy organizations and think tanks do have a biased view and they do provide data to support their view and ignore data that contradicts their view.
That's fine - as long as you recognize it and don't rely on them for your facts and realities.
That's common sense
"Health "insurance" creates incentives to increase consumption (demand), while not increasing supply
========================
I suppose auto insurance creates incentives to have more wrecks, too."
You continued failure to understand what you read is really sad.
I will once again try to explain something to you, but without much hope that it will do any good.
First of all, when you see the word "insurance" in quotes, you should think: "maybe insurance isn't really what the writer means. Perhaps something like 'pre-paid medical coverage' is the real meaning."
Do you really not understand that if something is "free", you will use more of it?
Let me provide an example using 2 scenarios, and you tell me if you don't agree.
1. You have "insurance", that covers doctor visits: You go to the doctor for an ailment, the doctor treats you, and instructs you to return in one week for a followup.
- do you return for the followup?
2. You have no insurance: You go to the doctor for an ailment, the doctor treats you, and instructs you to return in one week for a followup. On the way out, his office collects $80 from you.
- do you return for the followup?
Both scenarios assume you are mostly, but not entirely, fully recovered by the time of the followup.
If you answered yes and no, it's hard to understand how your comprehension failed on the original sentence that you quoted.
Here's more:
Do you consume more when you visit a restaurant that serves "all you can eat", or when you pay for each item?
Do you drink more beverage when you get "free refills", or when you are charged for them?
If your water is from a municipal supply, supported by your taxes, Do you use more, or less water if you are also metered and charged for usage?
You have a large mole on your neck, which doesn't bother you, but looks bad. are you more or less likely to have it removed, if your "insurance" covers it or if it doesn't?
Why don't you understand this stuff?
insurance is not "all you can eat".
Insurance requires that you pay a regular premium.
If you don't pay it and keep it in force, you not only do't get all you can eat - you get nothing.
Even if you keep your premiums in force, you do't get "all you can eat".
You may well have a hefty co-pay for some things - some real "skin in the game".
you may be denied coverage - 100% - you get nothing.
you might get your costs paid and then they cancel you and you cannot get insurance anywhere after that - because insurance companies share info about you with each other.
So the insurance companies do not provide "all you can eat" policies to start with.
It's a myth. It's a bad example.
Once you do not have insurance - you'll not likely be visiting a doctor to start with unless that mole grows and looks really bad.
But he won't take you without you signing a contract to pay for all charges within 30 days or whatever an the first time you don't pay - you don't go back.
Besides if it turns out it is a cancer and the doctor wants a $1000 to cut it out, then what?
So, you watch the mole on your neck turn into cancer but you're not sure it really is and you cannot afford to pay the doctor to find out.
Then when it turns out it IS cancer - you then go to the ER where they will charge 4-times what the doctor would but they cannot turn you away even if they suspect you won't pay.
This - courtesy of EMTALA - the law that libertarians and free-market types don't like to talk about.
Then the Hospital turns around and bills the folks who DO have insurance an additional amount to cover the guy who did not pay.
again - courtesy of EMTALA
We WOULD HAVE a genuine free-market system if the Hospital could turn you away like the doctor can.
and .. the hospital was legally stopped from transferring charity costs to those with insurance.
this is were the "free market" theory hits the real-world realities.
If you are a true free-market advocate then you should be openly and vociferously opposed to EMTALA and put it at the top of the list the things you'd want your candidate to promise to repeal.
Larry
"We had 15 years after Clinton's approach was shut down - at least half of those years with the Republican party in charge of the Presidency and both houses of Congress and what free-market changes did we see"...
Amazing! Larry G as bad as George W was did we have the problems we have now, now that we have even more federal government interference in the market place?
"Everyone has a primary care physician and everyone gets care early in the disease stage"...
Hmmm, where are these alledged countries?
I have relatives in both Germany and Norway and no such system exists as you describe it...
Oblivious to reality Larry G continues on: "Nowhere (that I know of) in the entire world does the private sector/free market achieve the goals you say they can"...
Sure it does right here in the US...
Just look at the fields of medicine that have little if any interference by the insurance companies and the federal government...
Consider certain types of eye surgery and cosmetic surgery...
Have you ever heard of direct primary care?
Larry,
Here's something that many people are trying to help you with, but you are ignoring them, and looking like a real fool because of it.
Let's say that there are 4 doctors who smoke Camel cigarettes out of one million MD's in the US. If you wanted to spin this into a statistic, you would think about those 4 MD's, and one more, and you would say; "Four out of five doctors smoke Camels"
The above is not a lie, it is a statistic.
There are 4 doctors who smoke Camels.
The above is a fact.
Do you understand the difference? Then you'll understand why quoting statistics is useless.
I note that Mr. Gingrich was on TV today and admitted that he was in favor of an individual mandate then - and it sounds like now.
So is Romney.
" Hmmm, where are these alledged countries?
I have relatives in both Germany and Norway and no such system exists as you describe it..."
nice try but it's a lie:
here's the truth:
" Germany has Europe's oldest universal health care system, with origins dating back to Otto von Bismarck's Social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. As mandatory health insurance, these bills originally applied only to low-income workers and certain government employees; their coverage, and that of subsequent legislation gradually expanded to cover virtually the entire population.[2]
Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage. The remainder opt for private health insurance, which frequently offers additional benefits. According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.[3]
The government partially reimburses the costs for low-wage workers, whose premiums are capped at a predetermined value. Higher wage workers pay a premium based on their salary. They may also opt for private insurance. This may result in substantial savings for younger individuals in good health. With age and illness, private premiums will rise and the insured will usually cancel their private insurance, turning to the government option.[4]
Reimbursement is on a fee-for-service basis, but the number of physicians allowed to accept Statutory Health Insurance in a given locale is regulated by the government and professional societies."
http://en.wikipedia.org/wiki/Health_in_Germany
" Do you understand the difference? Then you'll understand why quoting statistics is useless."
so the truth is what you want to believe?
@juandos,
I think Larry is talking about Atlantis
Atlantis?
ha ha ha
how about credible organizations who independently collect data and produce statistics that agree as opposed to right wing blather idiots who spout anything that fits their narrative?
"so the truth is what you want to believe?"
Yes Larry, if I learn a verified truth, then yes, it has more value that a statistic. You obviously do ot care about the truth based on the above comment
"verified truth"?
how do you do you do that dude?
there are at least a dozen organizations - worldwide who have no policy view, no policy agenda and whose sole mission is to collect data and generate statistics ...
and the statistics replicate....
and youse guys think that that is a grand conspiracy... and instead choose to believe what you want..
which is mostly right-wing ideological blather than you think if enough sites repeat it - makes it the truth.
and ya'll want the country to operate that way...
whooooeeeee
Larry,
Ron H is right when he said "Your continued failure to understand is sad".
It is people like you who are ignorant of the issues, and remain so by conscious choice who are the cause of our current situation.
What is scarier than the current administration, is people like you who enable the administration through your inability for critical thought, and your propensity to be brainwashed.
@Ron -
I was first informed here that I needed to provide references to substantiate the statements.
I did that.
I provided about 1/2 dozen authoritative sources - organizations who have no policy agendas and whose primary mission is facts and how to represent them.
I'm most assuredly NOT ill-informed unless you and others believe none of these organizations are generating valid data and statistics.
If you believe otherwise - then I'd ask you what organizations you do believe .....in terms of providing the facts....on which to form an INFORMED OPINION.
I've provided you the ones that I believe and their data.
You continue to say that I am ill-informed and I continue to ask WHERE you get your data and who you believe.
Sorry guy - you've pretty much proven that you really don't believe the organizations who are considered by most to be credible and instead choose to believe organizations who have policy agendas instead.
I do not believe the right-leaning NOR the left-leaning groups, think-tanks, etc unless I see WHERE they are getting their data because these groups typically are not interested in the facts near as much as their ideology.
I do not believe you can begin to understand if you summarily reject the data that is available UNLESS you can provide data from a legitimate source that contradicts.
The truth is that virtually all of the International and National organizations that deal with this data - AGREE and unless you are into Grand Conspiracies then it is what it is.
The ability to accept the truth even when it contradicts your most deeply-held views is a virtue not a flaw.
Otherwise - you're just another one of those "us against them" types an we have way too many of them already.
The 3 key issues with regard to comparing healthcare across countries are cost per capita, life expectancy and infant deaths.
There are probably others. I'd certainly listen to others if backed up by authoritative sources.
but for these 3:
1. - per capita health care costs
1 United States 7,290 16.0
2 Norway 4,763 8.9
3 Switzerland 4,417 10.8
4 Luxembourg ... ...
5 Canada 3,895 10.1
6 Netherlands 3,837 9.8
7 Austria 3,763 10.1
8 France 3,601 11.0
9 Belgium 3,595 10.2
10 Germany 3,588 10.4
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita
2. - Infant Mortality
The United States ranks 43rd in lowest infant mortality rate, down from 12th in 1960 and 21st in 1990. Singapore has the lowest rate with 2.3 deaths per 1000 live births, while the United States has a rate of 6.3 deaths per 1000 live births. Some of the other 42 nations that have a lower infant mortality rate than the US include Hong Kong, Slovenia, and Cuba. Source: CIA Factbook (2008)
Approximately 30,000 infants die in the United States each year. The infant mortality rate, which is the risk of death during the first year of life, is related to the underlying health of the mother, public health practices, socioeconomic conditions, and availability and use of appropriate health care for infants and pregnant women. Sources: CDC and National Center for Health Statistics
Life Expectancy
3. - Life expectancy at birth in the US is an average of 78.14 years, which ranks 47th in highest total life expectancy compared to other countries. Source: CIA Factbook (2008)
if you don't like that source, try this one:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5522a6.htm
it says the same thing with slight differences.
None of these organizations could be legitimately accused of messing with the data or if they were - they'd all have to be accused of a grand conspiracy and that's just beyond the pale for me.
At some point, you need to accept the realities that are present and admit that your own views were - in error - and you need to go back to rethink your positions.
Otherwise - you become a person who simply rejects data that you don't agree with.
and if you are one of those folks who do that at the same time you are accusing others of being "uninformed". then... whoooeee
At this point, we know that discussing the facts as provided by credible and trusted entities is not going to be accepted...
and we move on...
there is nothing more to dwell on.
"insurance is not "all you can eat"."
Geez! How can this be so hard? You too fail to understand the concept of higher consumption due to third party payment. It must have something to do with collectivist thinking.
OK, lets throw out the "all you can eat example. Do you want to have a go at any of the others? How about the 2 scenarios about doctor visits with and without insurance?
[mole on neck]"Once you do not have insurance - you'll not likely be visiting a doctor to start with unless that mole grows and looks really bad."
Remember that I said the mole didn't bother you? Reread that example & see if you can understand the point I'm making. If your "insurance" will cover having the mole removed, will you do it? If you have to pay out of pocket, will you do it?
Are all collectivists good at creating straw men?
""But he won't take you without you signing a contract to pay for all charges within 30 days or whatever an the first time you don't pay - you don't go back."
Why would you expect a doctor to treat you without charge? Actually he would ask you to pay at the time of service, and why shouldn't he? If you need to borrow money, go to your bank. Do you get your oil changed without paying? Do you eat in a restaurant without paying? What is about medical treatment that you think should be different?
"This - courtesy of EMTALA - the law that libertarians and free-market types don't like to talk about."
What is this fixation you have on EMTALA? It's one more misguided government intrusion into the running of private businesses.
It only applies to hospitals that accept medicare/medicaid, which means almost all hospitals. So, there you have it: If a hospital takes any payments from government, they must treat everyone, regardless of ability to pay.
In reality, this isn't as big a financial burden as you think. People are still billed for service, perhaps sued, and may have wages garneshed. It's not entirely a free ride. Yes, it increases overall costs, and is some cases has caused ERs and hospitals to close. Is this good intentioned idea having an opposite effect? You bet.
"We WOULD HAVE a genuine free-market system if the Hospital could turn you away like the doctor can."
You're funny. That's only one of thousands of obstacles to free market medical care.
"This is were the "free market" theory hits the real-world realities."
There is no free market, Larry. There is on;y government intervention at every turn.
And once again you haven't addressed the issue. You just refuse to get it. Listing dozens of agencies that provide statistical data is not what's needed here. Some of them don't even provide the data you think they do. Do you really think people will be satisfied with that shotgun approach?
Of course these agencies produce similar results,They're all using the same data. Presenting it multiple times doesn't add to it's veracity. The problem isn't with the reporting agencies, Larry, it's with the data itself.
What's needed here is a link to the explanation of how the various data are reconciled for differences in the definition of live birth, for example. That's what you have been unable to provide, because it doesn't exist.
"or cherry-picked data without context or even anecdotal claims or parroting other sites with similar agendas."
Reference please. You are making a serious accusation
"Getting the truth means you actually want to know the facts - that you want to critically examine the information"
But you haven't done that. you are presenting lists of agencies that report statistics, all using the same data. How many sets of data do think there are for life expectancy in Australia?
Multiple agencies reporting on the same data isn't correlation, it's identity. Get a clue.
This type of thinking leads to a belief that there's correlation when 30 climate models show the same results, therefore they must be correct.
"and to seek out other credible and authoritative entities to replicate and correlate"
It's all the same data, Larry.
"AND recognize and understand when the data does not correlate."
What are you talking about?
"Spurious and unfounded assertions by organizations with agendas are not good sources of the truth."
Give me an example here, please. Be specific, if you can, don't just list some organization.
"The data with respect to life expectancy and infant deaths correlates well across several different CREDIBLE entities that deal in ONLY statistics NOT policies."
Of course they do, Larry, You just don't understand the problems with it.
"I do not believe the right-leaning NOR the left-leaning groups, think-tanks, etc unless I see WHERE they are getting their data because these groups typically are not interested in the facts near as much as their ideology."
Does that include the left-leaning Commonwealth Fund?
You have quoted them repeatedly.
Incidentally, there are a number of problems with that study, would you like to know what they are?
Larry, one major problems with many of the reports you refer to is that part of the ranking results from measuring not actual quality of medical care, but how 'fairly' it is delivered. In other words, despite indications that medical care in the US is some of the best in the world, those pesky 45 million uninsured cause a lower rating. Is that really what you believe should be measured?
"I note that Mr. Gingrich was on TV today and admitted that he was in favor of an individual mandate then - and it sounds like now.
So is Romney."
Romney? Gingrich? Who cares what they favor. Why do you mention them? Romneycare in Mass. is a good example of how NOT to get good medical care. Ask residents there how they like a system very similar to the one you think we should all have.
"Geez! How can this be so hard? You too fail to understand the concept of higher consumption due to third party payment. It must have something to do with collectivist thinking."
the 3rd party payment is restricted and rationed. It's "all you can eat" until they say no.
"OK, lets throw out the "all you can eat example. Do you want to have a go at any of the others? How about the 2 scenarios about doctor visits with and without insurance?"
I get your premise but your premise does not address the restrictions that insurance places on your use.
"Remember that I said the mole didn't bother you? Reread that example & see if you can understand the point I'm making. If your "insurance" will cover having the mole removed, will you do it? If you have to pay out of pocket, will you do it?"
"bother" is not the same as having someone who knows - verify that it's not a problem. You cannot make such a determination as a lay person.
"Are all collectivists good at creating straw men? "
I think it was your strawman,no?
"Why would you expect a doctor to treat you without charge? Actually he would ask you to pay at the time of service, and why shouldn't he?"
He should but this is how people don't see a doctor when they should and the disease progresses and get's more expensive to treat and sometimes results in early death despite very expensive late state heroic care.
" If you need to borrow money, go to your bank. Do you get your oil changed without paying? Do you eat in a restaurant without paying? What is about medical treatment that you think should be different?"
most will use credit cards not go get loans.
"What is this fixation you have on EMTALA? It's one more misguided government intrusion into the running of private businesses."
I'm pointing out that one of the major barriers to a true "free market" system is EMTALA but you never hear the free market folks say so much less make the repeal of it a priority - like they have ObamaCare.
"It only applies to hospitals that accept medicare/medicaid,"
in practicality it applies to virtually all hospitals ...
"In reality, this isn't as big a financial burden as you think."
more than 50% of ER care is charity care..
it DOES result in cost-shifting and other distortions in the market.
"You're funny. That's only one of thousands of obstacles to free market medical care."
it's a major one and yet few "free market" folks mention it, why?
"There is no free market, Larry. There is on;y government intervention at every turn."
then why do we pay twice as much in this country, have shorter life expectancy and higher infant deaths?
"Getting the truth means you actually want to know the facts - that you want to critically examine the information"
"But you haven't done that. you are presenting lists of agencies that report statistics, all using the same data. How many sets of data do think there are for life expectancy in Australia?"
there are DIFFERENT SOURCES of the base data guy. you are being ignorant now. Read the CIA caveat.
"Multiple agencies reporting on the same data isn't correlation, it's identity. Get a clue."
It's not the same data and it's better than what you are doing which is basically relying on totally biased and corrupt misrepresentations.
"This type of thinking leads to a belief that there's correlation when 30 climate models show the same results, therefore they must be correct."
basically an anti-science attitude while relying on totally unscientific folks with policy agendas.
The "grand conspiracy". eh?
"AND recognize and understand when the data does not correlate."
"What are you talking about?"
read the CIA explanation which is similar to most of these sites - the source data and the statistical analysis are anything but identical guy. You don't read or if you do you don't comprehend.
"Spurious and unfounded assertions by organizations with agendas are not good sources of the truth."
Give me an example here, please. Be specific, if you can, don't just list some organization.
it's rampant in this thread.
here's the CIA Factbook explanation of their sources and methods.
Every independent authoritative entity provides a similar explanation.
" Why are there discrepancies between The World Factbook's demographic statistics and other sources?
Although estimates and projections start with the same basic data from censuses, surveys, and registration systems, final estimates and projections can differ as a result of factors including data availability, assessment, and methods and protocols.
Data availability Researchers may obtain specific country data at different times. Estimates or projections developed before the results of a census have been released will not be as accurate as those that take into account new census results.
Assessment Researchers can differ in their assessment of data quality and in their estimates based on the available country data. They often need to adjust their estimates due to such factors as undercounting in a census or underregistration of births or deaths.
Methods and protocols Differences in methods and protocols can shape the way estimates and projections are made of fertility, mortality, and international migration, and how these data are integrated with the population data. For example, the US Census Bureau uses a model that projects the population ahead by single years of age, a single year at a time (population statistics used in the Factbook are based on this model), whereas the United Nations model projects five-year age groups forward, five years at a time."
You'll see NO EXPLANATIONS of this type on ANY of the right-wing blather-butt sites because they are obviously biased and obviously not interested in the actual facts but rather just the things that support their view.
That's not an honest approach to issues.
that's a dishonest and ignorant approach to truly understanding the facts and data.
it promotes ignorance.
Larry, why is it that you continue to stick your head in the sand, rather than be enlightened. You are acting like a little child plugging her ears screaming "I DON'T HEAR YOU", when to become enlightened shatters the false myths you seem to hold so dear.
re: using the same data.
lord.. you're a hard case
Here's the World Bank data
(another left wing site, I'm sure):
Country name 2006 2007 2008 2009
San Marino 82 83 83 83
Liechtenstein 81 81 83 83
Japan 82 83 83 83
Hong Kong SAR, China 82 82 82 83
Switzerland 81 82 82 82
Israel 80 81 81 82
Australia 81 81 81 82
Spain 81 81 82 82
Iceland 81 81 81 81
Italy 81 81 81 81
Sweden 81 81 81 81
Singapore 80 80 81 81
Canada 81 81 81 81
France 81 81 81 81
Macao SAR, China 80 80 81 81
Norway 80 80 81 81
Belgium 80 80 80 81
Netherlands 80 80 80 81
New Zealand 80 80 80 80
Korea, Rep. 79 79 80 80
Greece 79 79 80 80
Luxembourg 80 80 80 80
Austria 80 80 80 80
United Kingdom 79 79 80 80
Germany 79 80 80 80
Malta 79 79 79 80
Cyprus 79 80 80 80
Finland 79 79 80 80
Ireland 79 79 79 80
Bermuda 79 79 79 79
Virgin Islands (U.S.) 79 79 79 79
Costa Rica 79 79 79 79
Slovenia 78 79 79 79
Cuba 78 79 79 79
Portugal 78 78 79 79
Chile 78 79 79 79
United States 78 78 78 79
the US is 37th - 3 ranks lower than Cuba.
here's their sources and methods:
Source Derived from male and female life expectancy at birth. Male and female life expectancy source: (1) United Nations Population Division. 2009. World Population Prospects: The 2008 Revision. New York, United Nations, Department of Economic and Social Affairs (advanced Excel tables), (2) Census reports and other statistical publications from national statistical offices, (3) Eurostat: Demographic Statistics, (4) Secretariat of the Pacific Community: Statistics and Demography Programme, and (5) U.S. Census Bureau: International Database.
Catalog Sources World Development Indicators
http://data.worldbank.org/indicator/SP.DYN.LE00.IN?order=wbapi_data_value_2009+wbapi_data_value+wbapi_data_value-last&sort=asc
you folks are a STITCH!
anti-govt, anti-science, anti-any agency that does statistics that you don't like.
... and what you do believe is what comes from the organizations with specific policy advocacies....who don't disclose their sources and methods - as a rule.
... and you call others "uninformed".
" Measuring The Health Of
Nations: Updating An Earlier
Analysis
One measure of the health of Americans—deaths from treatable
conditions—still does not compare well with rates in other industrialized countries."
" ABSTRACT: We compared trends in deaths considered amenable to health care before
age seventy-five between 1997–98 and 2002–03 in the United States and in eighteen
other industrialized countries. Such deaths account, on average, for 23 percent of total
mortality under age seventy-five among males and 32 percent among females. The decline
in amenable mortality in all countries averaged 17 percent over this period. The United
States was an outlier, with a decline of only 4 percent."
Study Data And Methods
Data.We compared the United States with fourteen countries in western Europe
plus Canada, Australia, New Zealand, and Japan, selected for comparability
with earlier work. Mortality and population data were extracted for the period
1997–2003 from theWorld Health Organization (WHO) files.7 Data include deaths,
coded according to the ninth and tenth revisions of the International Classification of
Diseases (ICD), by sex and five-year age bands (with infant deaths listed separately).
Selection of ages and causes of death. The selection of causes of death considered
amenable to health care is based on our previous systematic review.8 In brief,
for this paper we considered conditions such as bacterial infections, treatable cancers,
diabetes, cardiovascular and cerebrovascular disease, and complications of common surgical procedures.We also included ischemic heart disease (IHD); however,
in linewith accumulating evidence suggesting that only up to half of premature
mortality from IHD may be potentially amenable to health care, we here considered
only half of IHD deaths to be “amenable.”9 Throughout this paper, the term “amenable”
mortality always includes half of IHD deaths.
A general age limit was set at seventy-five years, because the extent to which
deaths can be prevented by health care and the reliability of death certification become
increasingly questionable at older ages.10 To be consistent with other research,
we set different age limits for diabetes mellitus (under age fifty) because
the preventability of deaths at older ages from diabetes, and in particular the effectiveness
of good diabetic control in reducing vascular complications, remains controversial.
For some other causes (intestinal infectious diseases, whooping cough,
measles, and childhood respiratory diseases), we set a limit of under age fifteen,
because deaths other than in childhood from these causes are likely to reflect the
presence of other disease processes. For leukemia,we set the age limit at age fortyfour
because of recent evidence showing improvements in mortality from leukemia
in the European Union up to age forty-four since 1960, largely attributed to
advances in treatment.11"
You'll notice that the authors of the study have carefully explained their sources and methods and analysis including footnotes.
http://pnhp.org/PDF_files/Measuring%20the%20Health%20of%20Nations%20-%20Updating%20An%20Earlier%20Analysis.pdf
finally - this is not just ONE STUDY.
this is one of dozens of studies done by different groups using different sources and methods that all come the same consistent conclusion.
and that conclusion is that our health care system does not produce the best outcomes for the nation as a whole.
People die earlier and infants die that don't die in similar circumstances in other countries because people and moms do not have equivalent access to health care.
It's not one result from one agency nor is the same data used by the multiple groups that essentially replicate the conclusions - using different sources and methods.
This comment has been removed by the author.
I was first informed here that I needed to provide references to substantiate the statements"...
You were asked for 'credible references' Larry G and somehow neo-socialist government sources or wiki are credible to you?
"Bonus Question: Is EMTALA "socialism"?"...
Hell yes! Its pandering to the parasites on a massive scale...
Again Larry G is befuddled by reality: "nice try but it's a lie:
here's the truth:"...
The only truth there is there have been socialist laws on the books for a long time in Germany...
"Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage"...
Ahhh, the reality stumbling block rears its ugly head...
That hasn't been the case in Germany for at least thirty years, just ask the Turks...
"" Why are there discrepancies between The World Factbook's demographic statistics and other sources?
Although estimates and projections start with the same basic data from censuses, surveys, and registration systems, final estimates and projections can differ as a result of factors including data availability, assessment, and methods and protocols.
Data availability Researchers may obtain specific country data at different times. Estimates or projections developed before the results of a census have been released will not be as accurate as those that take into account new census results."
Thank you. That is a very clear explanation, and that is exactly my point: Same data, different statistical methods. why don't you understand your own reference?
That's exactly what I wrote previously, and now it seems you have finally agreed, but I don't think you understand that you have done so. It's really sad that you struggle so hard with this.
"Every independent authoritative entity provides a similar explanation.
Yes, and every one will explain that they start with THE SAME DATA.
"estimates and projections start with the same basic data from censuses, surveys, and registration systems"
Please read carefully, with comprehension turned on. This SAME BASIC DATA Is collected from government entities in the respective countries, by census workers, survey takers, etc. Neither the CIA nor any other reporting agency has people in France, for example, going door to door counting French people, or monitoring live births. Each country collects its own data, for its own purposes, perhaps using different methods and definitions, which are not the same worldwide.
This data, collected by French government bureaucrats, is the SAME DATA used by the CIA, and every other reporting agency you list.
"Measuring The Health Of
Nations: Updating An Earlier
Analysis"
Ah, yes, That same flawed report is dredged up YET AGAIN!
Notice what they say:
"Mortality and population data were extracted for the period 1997–2003 from the World Health Organization (WHO) files."
So again, this is the SAME DATA, Larry, get it? The WHO report and the Commomwealth Fund report are using the SAME DATA. Please spend some time now, rereading if necessary, so we can go on, knowing you understand what I've just explained.
Additionally, as you didn't respond to my offer to explain the flaws in the Commonwealth Fund report, I won't.
Are you alright so far? OK, next point: I've asked you to explain how live births in one country can be ranked against those in another country, when the definition of a live birth isn't the same.
You keep saying you have addressed this question, but you haven't come close. It should be obvious at this point, even to a slow thinker like yourself, that agencies such as the the CIA and WHO, can't compare live births accurately, using only the data available to them. Therefore, infant mortality can't be ranked accurately. Is this too much at once for you? I'll stop now, so you can catch up. Don't overtax your brain, Larry, as headaches are no fun.
We can go on when you feel comfortable with this, and you've had a chance to rest.
the same TYPE of data collected from DIFFERENT Census, systems, etc.
" You were asked for 'credible references' Larry G and somehow neo-socialist government sources or wiki are credible to you?"
the sources are not Wiki.
Wiki presents the information that COMES FROM THE footnoted references.
wiki does not source data; it requires the supporting info.
and apparently EVERY organization in the world that deals in data and statistics is, by definition, "neo-socialist"!!!!
you guys are ANTI-INFORMATION as well.
unbelievable.
you live in your own little world and reject anything that contradicts your own isolated world-view which is primarily based on obviously biased sources.
ugly!
" basic data from censuses, surveys, and registration systems"
Ron - it's the same basic KINDS of data from DIFFERENT CENSUSES, SURVEYs and registration systems.
They identify the specific sources on many and they are not the same sources.
but ever if they are - where is your data/interpretation from you think-tanks and policy groups that differs in conclusions but references the SAME DATA?
you don't have any guy because the groups you believe don't have any or do any.
You're basically playing the "grand conspiracy" game here.
Larry,
You'll never learn if you don't listen. Repeating a lie, does not make it a truth
Ron - if you look at the studies - SOURCES - you will SEE that they classify the data according to type... but the sources of it vary widely... and that's why they disclose their sources and their methods of processing and analyzing the data.
It's the required scientifically-accepted way to do the study.
If they were using the SAME EXACT Data - you'd see the SAME EXACT SOURCES.
you're being ignorant- again.
it's a self-imposed ignorance where the implications of the study don't jive with what you want to believe so you essentially reject it - ALL OF IT - ACROSS the board - no matter who does it..
Name the groups that do these studies that you trust.
Any?
CDC
National Center for Health Statistics
CIA Factbook
World Bank
OCED
WHO
United Nations,
others?
do you trust ANY?
Larry, as I said before, the data does not lead to the conclusions you think it does.
If 7 out of 1,000 people who go t a hospital die there, and 4 out of 10,000 people who go a a restaurant die there, then will you go t a restaurant when you are sick?
It's not MY CONCLUSION guy.
Any way you cut it - you deny the results you don't like and that's ignorant.
I don't buy ALL the results.
In fact unless I see replication of results, I'm not convinced.
but for the results that are replicated, I start to accept them as having merit.
The studies do all warn not to assume more than what they say - which is wise.
but when you don't accept ANY of the studies from ANY of the different agencies what does that mean?
it means you subscribe to a grand conspiracy of all these agencies together conniving to cook the books and guy.. that's a bad place to be.
"Ron - it's the same basic KINDS of data from DIFFERENT CENSUSES, SURVEYs and registration systems."
But that's not what it says, is it. You can't make stuff up as you go along to suit your narrative. At some point, you have to admit you're talking out of your ass.
Here's the question:
"Why are there discrepancies between The World Factbook's demographic statistics and other sources?"
And here's the answer:
"Although estimates and projections start with the same basic data from censuses, surveys, and registration systems, final estimates and projections can differ as a result of factors including data availability, assessment, and methods and protocols."
This is your source, you pasted it here, but you don't understand what it means. Pretty pathetic.
You just can't wiggle out of this one. Man up & admit you were mistaken. Have some integrity.
"They identify the specific sources on many and they are not the same sources."
Some specific examples please.
"...but ever if they are - "
This is a good start. Admit you were wrong!
"...where is your data/interpretation from you think-tanks and policy groups that differs in conclusions but references the SAME DATA?"
Which think tanks and policy groups do you mean, Larry? I haven't cited any, except to point out that your low opinion of the Fraser Institute - based on nothing - isn't shared by those who , unlike you, actually know what they are talking about.
Please identify which obviously biased right-wing blather-butt sites you mean.
An example or two of what you claim would go a long way toward repairing your damaged credibility.
Aren't you out of straw yet?
But I'm forgetting: Your comments indicate you don't understand what a strawman fallacy is. Your favorite go-to site, Wikipedia, can help you.
By the way, you have lumped the descriptors right-wing and libertarian in the same sentence on occasion . You do understand the difference, right? If not, you should be very careful with your attributions, so people elsewhere might believe you know what you're talking about. It's too late here, of course.
"...then the "big lie" is a conspiracy...
right?"
Another strawman! Keep knocking them dead, Larry, you da man!
"that will get you much closer to the truth than these biased organizations who advocate a particular agenda and then use anecdotal and cherry-picked data to support it."
Some examples of this, please!
"the 3rd party payment is restricted and rationed. It's "all you can eat" until they say no."
This is important. Pay close attention. Why would I want a healthcare system in which my care is rationed and restricted? Who, other than my doctor & I, should decide how much I get, what I get, or, when I get it? Think hard about what you wrote.
Why can't I decide for myself, as I would with clothing or groceries?
I know, this concept is beyond your little collectivist brain to deal with.
Also, would I eat all-I-can-eat if I paid for each item myself? You failed to understand this question the first time, is it any easier now?
"I get your premise..."
No you don't, your comments here prove you don't have a clue.
Your lack of thinking ability is really pathetic. What's scary to me, is that you probably vote. You, and people like you, will be the end of us all, and you don't even realize it.
Ron, my man.
when they post DIFFERENT SOURCES it's DIFFERENT DATA but the SAME TYPE of data.
that's why they identify/disclose the SOURCES of the data so you know it's not the same data but the same kind and then they will further disclose how they go about adjusting/normalizing/standardizing the data to maintain apple-to-apple comparisons especially when doing cross-country comparisons.
Why would all these dozens of organizations use the SAME DATA to produce similar reports if they are were using the same exact data?
it makes no sense guy.
" Please identify which obviously biased right-wing blather-butt sites you mean"
you know them when you see them. they have obvious one-sided bias in their words and narratives and they are identified as to their leanings by themselves and by others.
libertarians and right wing?
same church..different pews
Ron Paul is a PRINCIPLED libertarian because he DOES acknowledge the truth and the reality but he sticks to his positions.
I respect him for the consistency and honesty of his views but not you guys who just deny the realities.
" Some examples of this, please!"
sites that reference PARTS of other studies that support their bias and ignore the PARTS that contradict it to produce a conclusion that misleads and is not the reality.
These sites seldom reference multiple studies that replicate the results - to prove their point because their point is often not substantiated by legitimate data collection sites to start with.
They, like you, ignore the facts and the realities and continue with a narrative that is insular and in abeyance to the realities.
" Why would I want a healthcare system in which my care is rationed and restricted? Who, other than my doctor & I, should decide how much I get, what I get, or, when I get it? Think hard about what you wrote."
your care IS restricted and rationed Dude if you have 3rd party insurance of any kind - public or private.
the only folks whose health care is not restricted and rationed are those wealthy enough to buy as much of it as they want.
" Also, would I eat all-I-can-eat if I paid for each item myself?"
if you are wealthy enough, yes.
otherwise, no.
there are, in fact, all you can eat services for some things but usually not health care.
" Your lack of thinking ability is really pathetic. What's scary to me, is that you probably vote. You, and people like you, will be the end of us all, and you don't even realize it. "
ha ha ha... my lack of "thinking"
I reference DOZENS of independent non-biased sites that go through the data to produce standardized comparisons - that replicate - and these I consider credible and useful in describing the realities.
You, on the other hand apparently believe these sites are engaging in a grand conspiracy to mislead while you yourself rely on sites and organizations that are openly biased and you are concerned about MY lack of thinking?
ha ha ha
you are a RIOT.. guy.
I rely on common sense, pragmatism, recognizing accepting realities (even the ones I do not like), and unbiased organizations who provide information and statistics with no policy advocacies.
Common sense tells you that if people don't have health care, they won't visit the doctor, who won't catch the disease they have early and they will often die prematurely from it.
This reality is reflected in the data that is collected by a wide group of national and international organizations ....
lower life expectancy and sooner than expect deaths for some groups - like infants.
this is what happens when 30-40 million people so not have a primary care physician and do not visit the doctor on a regular basis.
other countries where everyone has access to basic health care DO visit the doctor - frequently enough to catch disease earlier and treat it to help them live longer.
Diabetes TYPE II is an example of a disease that does tremendous cardiovascular damage if it is not caught at the point where the sugar levels become elevated.
Cancer is another.
it takes a doctor to determine if a mole or a pap smear is pre-cancerous or not.
If you do't go to the doctor - moles and other routinely tested things go without being detected.
This is the truth - the reality.
No amount of right-wing / FAUX libertarian misrepresentation of the facts can change it.
If you refuse to look at the facts and the realities and pretend that all the organizations that do are engaging in a grand conspiracy to lie ....
you are pretty much out of it in my view.
you cannot begin to know what needs to be one to the current system if you refuse to recognize the realities that we have right now.
recognizing the realities does not mean you automatically support things you do't like or want but it does leave you with the problem - to deal with.
refusing to acknowledge the problem relieves you of any responsibility to deal with what you won't admit...eh?
people do live their lives that way...
but they rarely have anything useful to say in dealing with solving problems - they just dismiss them - as not real.
these folks do vote but they represent about 10% of the electorate.
You'll find me with a larger percentage of the electorate.
"you know them when you see them. they have obvious one-sided bias in their words and narratives and they are identified as to their leanings by themselves and by others."
So you can't? Just as I thought. You were just pulling things out of your ass - again?
" sites that reference PARTS of other studies that support their bias and ignore the PARTS that contradict it to produce a conclusion that misleads and is not the reality."
So, you don't know of any? More stuff from your ass? You are such a clown.
You say things you can't support. Why should anyone take you seriously? At other blogs, I mean, it's too late for you here. doesn't it bother you that people are laughing at you?
chip, chip, how can anyone break through that shell of ignorance you are in?
"This reality is reflected in the data that is collected by a wide group of national and international organizations ...."
One more try: The data may not mean the same thing from one country to another. It's hard to compare data when it doesn't mean the same thing.
"these folks do vote but they represent about 10% of the electorate."
Do you have a source for that?
No, of course not. This is something else you just pulled out of your ass.
"You'll find me with a larger percentage of the electorate."
That's what worries me. That there may a lot of stupid people voting.
What about my 2 scenarios of doctor visits with insured & uninsured patients? Do you not like the answer you would have to give? Do you still not understand the moral hazard of 3rd party payer? Your responses tell me you do not.
Learn some economics.
"So you can't? Just as I thought. You were just pulling things out of your ass - again?"
I can tell unerringly without fail.
You say things you can't support. Why should anyone take you seriously? At other blogs, I mean, it's too late for you here. doesn't it bother you that people are laughing at you?
chip, chip, how can anyone break through that shell of ignorance you are in?
lord!
"This reality is reflected in the data that is collected by a wide group of national and international organizations ...."
One more try: The data may not mean the same thing from one country to another. It's hard to compare data when it doesn't mean the same thing.
this is why they go through the process of normalizing and standardizing because there are known differences that have to be properly accounted for.
They disclose this up-front and tell you ..... and this is another reason why you compare their results without other organizations to get some level of confidence that they did calibrate properly.
It's NOT the same data - it's the same TYPE of data but you cannot directly compare it as-is in some cases because of the differences in the way it is measured and collected even within the same country where different agencies might use different methods.
this is pro-forma at authoritative and credible organizations who also have no policy positions on the data.
They are independent and separate from advocacies with respect to the data.
...continue
....continue
but... You have yet to name a single one of these organizations that you say you trust and you've done a ton of blathering to attack ALL of them and to crawl back into your little hole of what you wish to believe... which is
you believe NONE of them and you think they are all engaging in a conspiracy to tilt the data against free market principles...etc...
"these folks do vote but they represent about 10% of the electorate."
Do you have a source for that?
well I know your type and I know you more than likely belong to the fringe which is about 10% of the electorate and have no chance to really influence policy because of your unwillingness to deal with simple realities.
"You'll find me with a larger percentage of the electorate."
That's what worries me. That there may a lot of stupid people voting.
yup....
...continue
"What about my 2 scenarios of doctor visits with insured & uninsured patients? Do you not like the answer you would have to give? Do you still not understand the moral hazard of 3rd party payer? Your responses tell me you do not."
I understand the 3rd party moral hazard but you do not because health insurance is not really insurance in the typical sense.
you are essentially arguing against insurance but I bet dollars to donuts that you yourself also have insurance.
there is no moral hazard to basic insurance to cover potential disasters. It's actually required for autos and mortgages.
it makes perfect sense economically.
Life Insurance is a good example but so is homeowners insurance.
health care is not basic insurance unless it is for catastrophic only.
The solution to over-utilization of health care is the same whether it is private or public and that is higher premiums, higher co-pays and limited cover and/or much higher co-pays for non-essential, discretionary services.
rationing if you will.
private insurance rations you big time if you have not noticed and the ultimate "rationing" is denial of coverage - no insurance.
You are not "entitled" to insurance in a free-market economy. companies are allowed to turn you down for any reason they wish and charge you as much as they can.
The choice about whether to have universal care or not is one in which you choose the less of the two evils.
If you are not really serious about denying health care to those who do not personally arrange for it or can afford it - then your choice is how to give the most cost-effective care.
This is why I asked you about EMTALA.
If you are a serious Libertarian then you openly and vociferously oppose EMTALA because it IS a Moral Hazard and it proves to everyone that we are NOT serious about personal responsibility.
When I say you represent 10%, I can prove it easily because only about 10% will openly advocate for the repeal of EMTALA and the reality is that not a single person can be elected to any national office if they openly oppose EMTALA - not even Ron Paul.
Not a single candidate for national office, even Paul supports the repeal of EMTALA which is, in fact, the most socialist program in the history of the country.
What they ALL say is that they WILL pay for health care for those who will not pay for it themselves.
Once you've crossed that line, you've crossed the Rubicon.
From that point on - the argument is not about libertarian principles - it's instead about the most cost-effective way you can provide care to those who fail to provide for themselves.
That's the reality you won't deal with.
That's the reality that every other industrialized country in the world - DID DEAL WITH.
And the data proves their case.
We have a dysfunctional system here where we PRETEND that people who do not take personal responsibility will not be helped but we help them - with EMTALA.
So you're caught guy.. and by refusing to say which organizations who report the realities you do support - you drop out and say "none" - that they're all wrong and all in cahoots with each other to prove that socialism is superior to our system which we say - at the same time - that's it's a free market system and it's not a free market system.
It's a Cluster F__K - right?
It PRETENDS to be a free-market but even you admit it is not but there is absolutely no candidate who you can support who openly advocates repeal of the the most important thing that corrupts a free-market approach - EMTALA.
So you're screwed up bad.
You won't believe the facts.
you don't have a candidate to support.
and there is no viable path to what you advocate for.
that puts you in the 10% group.
correct?
my view is we are never going to kill EMTALA so we should work towards the most cost-effective approach that we can - and that is going to be universal care.
Here's a video with a Canadian talking about infant mortality statistics, the number of uninsured, and wait times in Canada
http://www.youtube.com/watch?v=EWci9hCmCVY
here's an interesting chart:
Chart 2.
Percentage change in the death rate for male Social Security–covered workers, by selected age and earnings group from birth years 1912–1941
http://www.ssa.gov/policy/docs/workingpapers/wp108_chart02.gif
or page 14 of the PDF:
http://www.ssa.gov/policy/docs/ssb/v67n3/v67n3p1.
basically what it shows is that from age 60 on that high income males live longer than low income males.
one interpretation is that even though both get Medicare starting at age 65 that the higher income group spends extra on doctors and care.
there are a number of charts that compare life expectancy in the US only - but based on income.
I have not yet found one that compares those with access to regular health care and those who do not.
if someone finds one, please post. thanks.
The second link does not work.
If oyu are on medicare, participating doctors are not allowed to take money for covered procedures.
So if higher income males live longer, it is likely due to a couple of factors:
1) More money, better diet
2) Less money, possibly live in higher crime area
3) Higher income people would have a higher propensity to be better educated, and better educated people make better life decisions
and you do not have to take Medicare part B.....
Everyone is free to pay for their Medical providers.... with their own money - as much as they want.
Not completely true. A doc who accepts Medicare, may not accept money from a covered patient for a covered procedure. It's almost as restrictive as Canada
If someone does not have Medicare part B.. there are quite a few top tier docs available....
I'm not clear (convinced) that a Doc who does accept Medicare cannot accept cash for more/better more thorough, more tests, procedures not covered by Medicare etc.
It's pretty clear that the top tier incomes are not restricted only to Medicare docs.
this is what is not totally understood even with universal care especially in some of the European Countries (like Germany).
You are FREE to buy up.....if you want... but everyone gets the safety net... just like they do in this country with Medicare.
Medicare Part B premiums are ridiculous.
$100 a month for most... and it covers 3-4 times what most may in premiums over time.
75% is funded from Income Taxes and this is why Medicare Part B is in trouble - right now.
Docs who accept Medicare are prohibited from accepting cash from Medicare covered enrollees for covered procedures.
You are correct that medicare is a mess. Because it's a way to bribe people with their own money to get votes
" Docs who accept Medicare are prohibited from accepting cash from Medicare covered enrollees for covered procedures. "
this is simply not true.
There are a wide variety of things NOT COVERED by Medicare that you can pay for out-of-pocket.
In addition there are doctors and providers you can go to that will accept cash and not Medicare.
You can have Medicare, for instance and have oral surgery or dentistry done and Medicare pays none and you pay all.
These are LIES basically designed to confuse and mislead folks as to the truth.
What do you think MediGap policies are?
" You are correct that medicare is a mess. Because it's a way to bribe people with their own money to get votes "
Medicare is a mess PRIMARILY ...for the SAME REASONS that health care in general is a mess public or private because of a higher utilization rate than we can pay for.
Medicare is going up at 6-7% a year. Pvt insurance is going up at 10% a year...currently is 16% of our GDP and projected to be 30%.
Why do we focus ONLY on Medicare when the problem clearly includes ALL health care?
Larry,
You're showing your ignorance and immaturity again. You sound like a child whose parent just told her that there is no tooth fairy.
It is an absolute truth that a medicare provider may not accept cash from a medicare covered beneficiary for a covered procedure. Plugging your ears and saying it's not true, does not make it untrue. Call a medicare doctor yourself and ask.
Yes, Medicare and insurance are growing due to high utilization. Both programs create an incentive for this. However, Medicare costs are growing at a much higher rate. In fact, since 1965 when Medicare started, the per enrollee costs have grown at 3 times the rate of private insurance according to CMS.
" Larry,
You're showing your ignorance and immaturity again. You sound like a child whose parent just told her that there is no tooth fairy."
more horse manure from the horses butt...
"It is an absolute truth that a medicare provider may not accept cash from a medicare covered beneficiary for a covered procedure. Plugging your ears and saying it's not true, does not make it untrue. Call a medicare doctor yourself and ask."
for a "covered" procedure - I agreed with that.
but I pointed out what "gap" policies do. they WILL PAY more and it is LEGAL.
I know this for a FACT DUDE.
"Yes, Medicare and insurance are growing due to high utilization. Both programs create an incentive for this. However, Medicare costs are growing at a much higher rate. In fact, since 1965 when Medicare started, the per enrollee costs have grown at 3 times the rate of private insurance according to CMS. "
provide your cite -
here's mine:
https://www.cms.gov/NationalHealthExpendData/25_NHE_Fact_Sheet.asp
do NOT use one of your right-wing idiot sites guy..use a CREDIBLE SOURCE
Larry, your uncontrollable love of liberalism makes you sound like a real idiot. I quoted CMS as a source which proved Medicare expenditures are growing faster than private insurance, and you call it a "right-wing idiot site". Then you use CMS as a source which you claim demonstrates your made up numbers of "10% for insurance and 6-7% for medicare"
But when I go to the link you provided, which is CMS, it says that in 2009 private insurance spending grew by 1.3% and Medicare grew by 7.9%, and that over the next decade medicare is expected to grow by 6.9% while private insurance is expected to grow by 5.2%.
You used the same source that I did, and it reinforces that I am right and you are wrong, but you're just to damned stupid to understand that.
" Larry, your uncontrollable love of liberalism makes you sound like a real idiot. I quoted CMS as a source which proved Medicare expenditures are growing faster than private insurance, and you call it a "right-wing idiot site". Then you use CMS as a source which you claim demonstrates your made up numbers of "10% for insurance and 6-7% for medicare"
But when I go to the link you provided, which is CMS, it says that in 2009 private insurance spending grew by 1.3% and Medicare grew by 7.9%, and that over the next decade medicare is expected to grow by 6.9% while private insurance is expected to grow by 5.2%."
correct. you did not provide a link. I did. How did I know you were referencing the same?
and the facts are with you,
conceded.
2010, and 2011 look different which is what I thought would be shown in the CMS report but it is for 2009.
Here are two reputable sources that show the numbers I was quoting for private insurance:
"U.S. employers can expect to see health-care costs rise by 8.5% in 2012, up a tick from this year's 8% climb, according to a new report from PricewaterhouseCoopers."
http://www.cfo.com/article.cfm/14576734/c_14577574
http://www.usatoday.com/money/industries/health/2009-06-18-health-care-costs_N.htm
I cannot explain the variance between CMS.. but I'm looking.
It is not "stupid" to want to use the facts and to understand why there are conflicts with the data.
I ASSUMED the CMS data would replicate the other data I was seeing .. and that was a mistake and I admit it.
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