a preview of universal health coverage

[Commodore]

[url="http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs#"]Bloomberg [/url]uncovers some interesting stuff in the stimulus bill:

[quote]Tragically, no one from either party is objecting to the health provisions slipped in without discussion. These provisions reflect the handiwork of Tom Daschle, until recently the nominee to head the Health and Human Services Department.

Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version).

The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.

But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.” ...

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.

Hidden Provisions

If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the U.S. will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later.[/quote]

Unreal.

[Week]

[quote name='Commodore' post='1680981' date='Feb 10 2009, 00.09'][url="http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs#"]Bloomberg [/url]uncovers some interesting stuff in the stimulus bill:

Unreal.[/quote]
Do you try to live up to your title?

It is nice to pretend that the current healthcare system [i]actually [/i]has our best interest in mind. It does not. When my dad was in the hospital a day longer than expected (and it was necessary) he was completely unable to get in contact with a doctor (no change over the last few days), however his health insurance was more than happy to demand as to why he was still in the hospital when he still wasn't well. Greedy POSes.

[EHK for Darwin]

[quote name='Commodore' post='1680981' date='Feb 9 2009, 23.09'][url="http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs#"]Bloomberg [/url]uncovers some interesting stuff in the stimulus bill:



Unreal.[/quote]

Watch Sicko. Seriously.

[Week]

[quote name='EHK for a True GOP' post='1680988' date='Feb 10 2009, 00.16']Watch Sicko. Seriously.[/quote]
Oh noes, we might be stuck with a system where most citizens are happy (as they are in countries that have universal healthcare) instead of having a huge number of people that are both unhappy and uninsured like we currently have. Wouldn't that be fucking terrible? Can't we get some tax cuts somewhere?! Please?

[Lord O' Bones]

I blame ACORN.

[Bittersteel]

Unless Pataki's old underling has begun a second career as an investigative journalist, you've just quoted an opinion column, not an expose. And one that's terribly misleading at that.

The NCHIT already exists, for one. Having scanned the stimulus, I have no clue what she's talking about. The standards that will be introduced are a) voluntary in respect to private entities and b) up in the air (most of the standards language is referring to technology.) All of the goals - conveniently left out of the editorial - are updates of a 2008 health care plan. And most of the section on NCHIT is concerned with technological infrastructure. That's the goal, here, to improve care by streamlining the system and upgrading quality. Given how fucked up our health care system is, this seems like a bizarre (though delightfully wingnutty) nitpick.


Also, has anyone noticed that Republican fear mongering became thoroughly unconvincing when Bush and his "terrorist file cabinets" left office? Somehow, "OH NOES! YOU'RE ALL GOING TO LOSE YOUR EYES" just doesn't have the same ring to it as Threat Level Orange.

[Commodore]

A state council of wise men deciding who deserves what care, and people want to make jokes...

[Andriy Czarchenko]

Of course people are joking. Afterall it´s you who started this thread, once again without any clue of reality.

[Week]

[quote name='Commodore' post='1681007' date='Feb 10 2009, 00.43']A state council of wise men deciding who deserves what care, and people want to make jokes...[/quote]
A collection of greedy fucks that want people to have the lowest health expenditures and spend the least amount of time possible in the hospital and people want the same system to continue to exist? Drug companies coming out with 'new' products that cost as much (if not more) than current ones without any discernible improvements and advertise excessively and we think there is no problem?

[Lord O' Bones]

[quote name='Commodore' post='1681007' date='Feb 9 2009, 21.43']A state council of wise men deciding who deserves what care, and people want to make jokes...[/quote]
I just wanted to beat you to it for a change. This knee-jerk stuff deserves not much else besides. I wonder, did you even consider looking around for articles in opposition to this piece? Or did you just filter for "Democrat BAD!" on google?

Edit: Look man, I don't believe you're wrong all the time, and I enjoy defending some of the points you make when I can do so, but at least try to find the whole truth in these things and stop hanging out solely in those conservative echo-chambers.

[EHK for Darwin]

[quote name='Commodore' post='1681007' date='Feb 9 2009, 23.43']A state council of wise men deciding who deserves what care, and people want to make jokes...[/quote]

We already have a council of greedy fucks whose sole purpose is to minimize costs and maximize profits (which is a nice way of saying denying you as much care as they can reasonably get away with), how is that preferable to a state run agency that actually has a public mandate to provide suitable care and is ostensibly accountable to the voting public if they fuck up too badly?

This is fucking nuts. We pay twice as much as most western nations for healthcare, can't cover 40 million people, and hundreds of millions more with insurance get fucked left and right by the insurance companies looking to cut costs. Your position is no longer defensible. Anyone not in favor of universal healthcare is either ignorant or willfully stupid.

[The Anti-Targ]

[quote name='Triskele' post='1681055' date='Feb 10 2009, 19.57']I know Mrs. Rand said this couldn't happen but it has.[/quote]

Ahh, but you have only partially adopted Mrs. Rand's ideological prescription. The current form of capitalism only allows the virtue of selfishness limited freedom, not total freedom. I think she would look at US capitalism and curse at the corruption of it in comparison to her ideal.

Of course what has not been said is that you only have to be part of the state funded "rationing" if you can't afford insurance, or you don't want to pay for it.

I'm more than happy to wait 6 months to have my gallbladder removed for free (well paid for by my taxes). All it costs me is the ability to eat cheese, creamy desserts and fatty sausages for 6 months or so to avoid any further excruciating attacks until the surgery. Luckily there are a few varieties of 3% fat ice cream, a 3% fat sausage, and well I do miss the cheese, but it's only a short term thing.

I chose not to buy health insurance, and I'm choosing not to pay to have it done privately. But the choice was mine to make, not forced on me. However if there are any significant delays beyond 6 months I still have the option of paying the 8Gs to get it done privately. Fortunate I am well enough off to be able to come up with 8K at short notice; though I won't be able to go to our family reunion in Aussie if I have to pony up for the surgery. Also if I don't get the surgery before September I might have to miss out on a work trip to Morocco, though that would be by choice since I don't want to run the risk of an attack while I'm in Morocco. And I might miss out anyway with all the belt tightening going on around here because of those damned financial issues going on all over the place.

Of course I might have a harder time finding the dough for a 35K bypass surgery if that ever comes to pass. Still I'm willing to take the risk and remain part of the public system.

I've been to the emergency department twice with gallbladder attacks, enjoyed the morphine, had the ultrasound to confirm the diagnosis, and guess how much it cost me? Zilch baby.

My dad has had all the diagnostics, pre-treatments and radiotherapy for his prostate cancer, and all it cost him was gas money to drive to and from hospital.

That's the reality of "rationed" health care in a free market society.

It ain't perfect, there are some major screw ups from time to time, and cost overruns. But all in all we are pretty happy campers when it comes to our health system.

I really really hope you guys get UHC, and soon. And don't throw your toys out of the cot if you have to pay a % or 2 more tax, it is so worth it. I just hope you can improve on the models that are already out there.

Good luck, and thanks to Commodore for giving me another chance to promote the virtues of [s]socialised[/s] *oops* the S-word that dare not speak its name medicine.

[Lyanna Stark]

Well, I used the services of the NHS yesterday and it was swift, efficient and cheap. :) For a visit to a GP (wait time 30 seconds) and antibiotics for my nasty sinus infection, I shelled out exactly £6.

[Hereward]

My daughter had to go to hospital last week for a ultrasound scan on her kidneys and a 30-minute examination with a paediatric consultant and another 30-minute session with a renal consultant. We waited a week and paid £3.80 for car parking. The horror.

[mormont]

"welcome to rationed care"

As opposed to the systems that deliver unlimited care to everyone, such as... um... I'm sure I'll think of one eventually, hold on. :unsure:

Healthcare, like any other good, has a limited supply and a virtually unlimited demand. Rationing is the result. The only issue is the mechanism you use to ration it.

[Stubby]

I paid $81 for an extended visit to the GP last week. Once I fill in an on-line form I will get a cheque back (or a direct debit if I so choose) for about 3/4 of that. I was seen on time to the minute. The script I got will cost me $32 each time I fill it - and it would be over $150 a fill if it were not subsidised by the Federal Govt. I do not qualify for special assistance either - people with less self-funding ability than I would probably pay much less.

A close relative had two separate ultrasounds last week. They didn't cost a cent and they were done and dusted in minutes.

[Crazydog7]

I've never blamed Commodore for his loopy posts because god knows I've posted a few in my time years of listening to Master Rushy have worn down his resistance. Socialized medicine? Why the hell not? If the banks and auto companies can get a bailout why not the health care system?

Its hilarious that the few people of my acquaintance that still consider themselves Republicans are chanting the same old slogans about the need for conservative fiscal spending when it was a Republican president that got the ball rolling in the first place.

[MinDonner]

[quote name='mormont' post='1681140' date='Feb 10 2009, 09.26']"welcome to rationed care"

As opposed to the systems that deliver unlimited care to everyone, such as... um... I'm sure I'll think of one eventually, hold on. :unsure:

Healthcare, like any other good, has a limited supply and a virtually unlimited demand. Rationing is the result. The only issue is the mechanism you use to ration it.[/quote]

^This. Currently, rather than "wise men" deciding who can be treated and for what, we have the mailed fist of the free market, which comes down hardest on the poorest and the sickest. It's baffling to me why some people see rationing-by-urgency (ie. waiting lists) as a greater evil than rationing-by-income (ie. the poor can fuck off).

I've linked [url="http://loosechickssinkships.blogspot.com/2008/08/fifteen-days-of-blogging-for-health_26.html"]this[/url] before, but it's a very interesting read.

[quote]Rationing is the hobgoblin under the bed, the Commie in the closet, that is yanked out to be puppetted around every time the prospect of a national health care plan arises. Do you know how long it takes to get an MRI scan in Canada?! - it threatens (and actually, I have no idea at all how long it takes to get an MRI in Canada; I suspect it depends on the same variables that drive wait times here: distance from nearest tertiary care center, relative wealth of the region, staffing issues, and the like). Because in America we use rationing as a strawman to promote the glories of capitalism over the evils of…well, just about everything else, we tend to be blind to the fact that there are actually two forms of rationing - one of which terrifies us to our very core (Commie plot that it is, of course), and one of which we live with so commonly that we fail to notice its sinister existence, the way we forget to notice the sky is blue after too many sunny days.

The first form of rationing - the one that invokes such terror - is rationing by wait time. These are the communist breadlines of old Russia, the gas lines of the 1970s, the apocryphal wait times to get that MRI scan in Canada (it also explains the way you have to put your name on the list now if you want to get a private permit to run the Grand Canyon by river raft some ten to fifteen years into the future - even in the good ol’ USofA, rationing by time has its well-worn time and place). If you stand there long enough, you’ll get your goods. The goods aren’t even necessarily any more expensive for your troubles; you just have to wait for them.

The other means of rationing is by cost - that is, you just raise the price until the right number of buyers drops out, and there you have your trade. This is the absolute fundament of free-market capitalism; a certain quantity of goods is out there, a certain demand is placed on that supply, and the winners are those whose cash and values come into best alignment with the available quantity of desired stuff. This is also what you see modeled in simple Cartesian form in every freshman econ class, with the supply on one axis, the demand on the other axis, and economic efficiency at that magical price where the two meet in the middle (I never saw rationing by time modeled on a two-axis graph - I suppose it‘s possible, but not so much the subject of talk in countries where the free market is the order of the day). This functions well for goods like luxury cars, designer jeans, concert tickets hawked on the day of the show, and artwork; it falters clumsily in the face of health care products which are not optional, and have great social consequence if they are not distributed with some efficiency of manner.[/quote]

[VarysTheSpider]

[quote name='Weekapaug' post='1680991' date='Feb 10 2009, 05.18']Oh noes, we might be stuck with a system where most citizens are happy (as they are in countries that have universal healthcare)[/quote]
Heh, not really, we just have different things to complain about, like waiting in accident and emergency for four hours with pissheads and chavs to be told by a med student that you probably shouldn't have come anyway, or the impossibility of trying to get hold of your doctor after 6pm or on the weekend, or the latest tabloid scandal about long-suffering 95 year old Mrs Jones who really needs some magic pill the NHS won't give her because they're meanies, or having to fill out about three different bloody forms to claim the £10 you spent on medicine only to find out that because you worked some shitty summer job you earned too much that year to be entitled to a refund, or etc etc.

Not without its problems, just different ones.

[litechick]

That's the problem, isn't it? The American system is mired in fear of litigation, entitlement, and capitalism. Common cold? Better request an MRI just to be safe. My head hurts! Do something! OK, do a CAT scan. A citizen's quality of life is significantly diminished by embarrassing yellow toenail fungus. How dare you deprive them of expensive drugs to cure it? I can't possibly provide a plush waiting room, superior test equipment and a prime location without charging $150 for a routine eye exam.

[yes, this is hyperbolic with the intent of making a point. either you get it or you don't. either you agree or you don't.]

The only way that UHC is gonna work is if people accept that they can't milk a car accident for 5 years worth of massages, not everybody needs a power chair, and the soothing decor at their preferred doctor's office costs more than what the government will allow.