Sicko

[Michel]

Who has seen it?

Silly American philosophy of healthcare.

[Danny]

I saw it.  We had wine and cheese before the showing, and then gobs and gobs of Alfredo pasta with all sorts of other tasty treats after it was over.

Delicious it was.

[Michel]

Do Americans not like to hear the reality of their unfair system?

[Mozart]

Do Americans not like to hear the reality of their unfair system?

The best system isn't to make it universally free, it's to completely get rid of health care and make doctors compete. It's not that Americans don't care, not that I care, but Americans think that Michael Moore is a complete idiot. Watch him in a serious interview...he is a doofus.

[MishaK]

The best system isn't to make it universally free, it's to completely get rid of health care and make doctors compete.

How would that prevent the best doctors from being unaffordable, thereby forcing the less well-heeled to go to cheap quacks? NB: a single-payer universal coverage system is not "free".

[david johnson]

The best system isn't to make it universally free, it's to completely get rid of health care and make doctors compete. It's not that Americans don't care, not that I care, but Americans think that Michael Moore is a complete idiot. Watch him in a serious interview...he is a doofus.

amen! doofus-ism run amok!

dj

[Gurn Blanston]

Do Americans not like to hear the reality of their unfair system?

I'm sure you aren't enough of a guppy to equate Michael Moore with a reality check. If you do, then you NEED a reality check. I think "doofus" is much too kind...




----------------
Now playing: Academy of St Martin in the Field / Marriner - Beethoven - Bia 088 WoO 7  Minuets (12) for Orchestra #09 in G

[Catison]

How would that prevent the best doctors from being unaffordable, thereby forcing the less well-heeled to go to cheap quacks?

Don't people with more money deserve to pay more for better care?  Don't better doctors deserve to get paid more?

[MishaK]

Don't better doctors deserve to pain more?

Now, if a better doctor had more pain, I would question whether he's indeed the better doctor. 

Don't people with more money deserve to pay more for better care? 

Does wealth somehow indicate human value? Why would a poor cancer patient deserve less care than a wealthy cancer patient? Ever heard of the Hippocratic oath?

[Catison]

Now, if a better doctor had more pain, I would question whether he's indeed the better doctor. 

Ooops. corrected. What do you think now?

Does wealth somehow indicate human value? Why would a poor cancer patient deserve less care than a wealthy cancer patient? Ever heard of the Hippocratic oath?

Notice I didn't say poor people should be left to die or have worse care.  I'm saying heath care isn't free, and therefore, the people who are willing to pay more for health care should get better care.

[MishaK]

Notice I didn't say poor people should be left to die or have worse care.  I'm saying heath care isn't free, and therefore, the people who are willing to pay more for health care should get better care.

Willingness is not the same as ability. If I had an excruciatingly painful kidney stone I, too, would be willing to pay billions in those moments of excrutiating pain. But I can't. Does that mean I don't deserve the same quality service as King Fahd?

[Hollywood]

I am so glad I live in Austria when it come to health insurance coverage. Last Nov. I had an operation and was in hospital 3 days. All we had to pay when I was being discharged was €12 ($10). Also we have a standard price for perscriptions which is €4.70 ($4).

I am looking forward to seeing "Sicko" as soon as I can afford to buy it on dvd. I want my Austrian husband to see how screwed up health insurance can be in the USA. I must admit that when I was still living in Calif. I had great health insurance only because I was a hospital employee (I was a hospital pharmacy technician for 10 years). It wasn't too expensive to pay monthly and as long as I saw the doctors that worked at the hospital I worked at, I didn't have to pay out-of-pocket any expenses. But if you weren't lucky enough to work in a hospital or have tons of money to pay for good health insurance, then it could cost a person an arm and a leg to be able to afford medical insurance in the USA. Even more if that person has dependents. 

[Catison]

Willingness is not the same as ability. If I had an excruciatingly painful kidney stone I, too, would be willing to pay billions in those moments of excrutiating pain. But I can't. Does that mean I don't deserve the same quality service as King Fahd?

You deserve to have your kidney stone removed with as little pain possible.  Anything more?  No.  Not if you can't pay for it.

[Catison]

I am so glad I live in Austria when it come to health insurance coverage. Last Nov. I had an operation and was in hospital 3 days. All we had to pay when I was being discharged was €12 ($10). Also we have a standard price for perscriptions which is €4.70 ($4).

Of course, you didn't pay only that much.  Your taxes, which are much higher than in the USA, go toward paying for the care of a lot of other people.  So you are paying into a system, a lot more than you make it sound, and then getting cheaper care later.  That sounds like health insurance to me, except it's compulsory and you pay more if you have more money.

In America, it is unlikely that you have insurance unless you work, and that makes sense to me.  I don't want to pay for bad choices lazy people make to become unhealthy.  Health care is a privilege you earn.

But then health care now costs too much, because there is no incentive to keep prices down.  And that's because to the horrible regulation in the insurance and health care industry.  And also the ease of litigation for malpractice.  And also hospitals are forced to treat the uninsured by the government, so they have to increase their prices in order to stay in the black.

There isn't an easy solution.  But the solution shouldn't be, "let the government take care of it".

[Mozart]

Willingness is not the same as ability. If I had an excruciatingly painful kidney stone I, too, would be willing to pay billions in those moments of excrutiating pain. But I can't. Does that mean I don't deserve the same quality service as King Fahd?

Yes that is how the system works, the more you pay the better treatment you receive. King Fahd...might have a 200 inch tv, but I am just as happy with my 27 inch. If he can afford the best doctor in the world and I can only afford an average one so be it at least I will still get treated. But when people have to compete for business they will try to do things better and cheaper or else no one will want to get treatment from them.

[Hector]

And what happens when you need multiple heart by-pass surgery and your insurance company says 'Go f..k yourself.'

Then what, ay?

Take out a loan?

[Daidalos]

Yes that is how the system works, the more you pay the better treatment you receive. King Fahd...might have a 200 inch tv, but I am just as happy with my 27 inch. If he can afford the best doctor in the world and I can only afford an average one so be it at least I will still get treated. But when people have to compete for business they will try to do things better and cheaper or else no one will want to get treatment from them.

You seriously think an even more capitalistic system is the answer? Somehow, I don't think your idea would work very well at all.

[MishaK]

You deserve to have your kidney stone removed with as little pain possible.  Anything more?  No.  Not if you can't pay for it.

What more do you think a better doctor would provide? We are talking different prices for the same service.

Of course, you didn't pay only that much.  Your taxes, which are much higher than in the USA, go toward paying for the care of a lot of other people.  So you are paying into a system, a lot more than you make it sound, and then getting cheaper care later.  That sounds like health insurance to me, except it's compulsory and you pay more if you have more money.

That is inaccurate. On a per capita basis (taxes included) Americans pay much more for health care than other countries with comprehensive health coverage systems. Also the tax rates in Europe are exaggerated. I have lived and worked in both Germany and the US and the bottom line was not that different for me. And: healthcare was less bureacratic in Germany.

Yes that is how the system works, the more you pay the better treatment you receive. .... But when people have to compete for business they will try to do things better and cheaper or else no one will want to get treatment from them.

That is precisely what's wrong with the system. Health is not something that should be left to whether or not you can afford it. Diseases that are not treated properly and preemptively in all members of society spread to others. Injuries that are not treated properly because people cannot afford it cost society in terms of lost productivity, lost consumer demand and lost tax revenues. You do yourself no favor by advocating for a system where the rich can afford good healthcare but the poor have to postpone or not get treatment because they cannot afford it. BTW, the last sentence is also plain wrong. In healthcare systems with large government subsidized healthcare programs, prices for medications and treatments are lower because of the lower overhead and greater bargaining power of government providers. In largely privatized systems like the US they are sky high. The US system is a racket that benefits the insurances and the pharmaceutical industry and nobody else.

A little something for your reading enjoyment: http://www.nytimes.com/2007/11/09/opinion/09krugman.html?n=Top/Opinion/Editorials%20and%20Op-Ed/Op-Ed/Columnists/Paul%20Krugman

[Catison]

What more do you think a better doctor would provide? We are talking different prices for the same service.

First of all, there are doctors of different skill, as in any profession.  Second of all, I think you should be provided the minimum service possible if you don't pay for your own care.  By minimum, I mean that a doctor should do just enough so that a reasonable person wouldn't suspect the doctor let their patient die. 

That is inaccurate. On a per capita basis (taxes included) Americans pay much more for health care than other countries with comprehensive health coverage systems. Also the tax rates in Europe are exaggerated. I have lived and worked in both Germany and the US and the bottom line was not that different for me. And: healthcare was less bureacratic in Germany.

Where are you getting this information?  Your personal circumstances are relevant, but only to an extent.  For instance, it is quite common for employers to offer their employees significantly higher pay if they are working in a metropolitan area, because of higher taxes and cost of living.  Is that the same for you?

Here is something that I do know.  Americans subsidize foreign health care by paying a lot more for their medicine.  Foreign markets demand they have access to the medicine, but they can't pay enough for it.  So instead of refusing to sell pills to Africa or Europe or wherever (to avoid the obvious political fallout such a decision would bring), they sell them at a discounted rate.  But someone has to pay, and because of the ridiculous health care system we have here, American do pay through their insurance companies.

But, someone says, why are the drug companies so concerned with making money?  Why can't they just sell their pills for cheap everywhere?  That because it takes enormous amount of money to get a new drug to market.  There are about 5 roadblocks along a drug's journey, and only 10% make it though each.  That's because the FDA has made it difficult to release new drugs (more difficult than it needs to be).  And so drug companies must finance this research with big prices.  That's a simple fact.

That is precisely what's wrong with the system. Health is not something that should be left to whether or not you can afford it. Diseases that are not treated properly and preemptively in all members of society spread to others. Injuries that are not treated properly because people cannot afford it cost society in terms of lost productivity, lost consumer demand and lost tax revenues. You do yourself no favor by advocating for a system where the rich can afford good healthcare but the poor have to postpone or not get treatment because they cannot afford it. BTW, the last sentence is also plain wrong. In healthcare systems with large government subsidized healthcare programs, prices for medications and treatments are lower because of the lower overhead and greater bargaining power of government providers. In largely privatized systems like the US they are sky high. The US system is a racket that benefits the insurances and the pharmaceutical industry and nobody else.

There are many things wrong here.  Health is something that should be left to only those who can afford, just like everything else.  These horror stories of spreading disease are overexaggerated.  In the rich world, e.g., North America and Western Europe, there are very few contagious diseases.  And in the event of an epidemic, then I could see there being a distribution of medicine, but the rare epidemic is no excuse for throwing money at poor people all the time, it just means there needs to be preparation.

And loss of taxes and consumer demand?  That implies we are talking about people who have jobs.  If someone has a job, it is highly likely they have health care.  I honestly couldn't care less about losing the slugs of society, those jobless but with a sense of entitlement.

By what right does a government have to set prices for the industry?  And who has ever talked about the lower overhead of a government?  What company has ever decided to model its bureaucracy after a government?  Surely governments have great bargaining power, but they can only do a better job if you think a government somehow understands the healthcare industry better than the industry itself.  Its not their money, so I doubt they do.  It is precisely because of this "bargaining" that there is corruption in government.

No, I think the solution is to let the health care companies produce drugs with less regulation and sell them at a lower price.  The pharmaceutical industry would benefit and hence, their consumers.  Insurance would be cheaper.

And that last sentence is just plain revolting.  Each patient has the will to just not take the pills, to just not accept insurance.  But that would be a bad decision.  Why?  Because patients benefit from them.  It is an entirely different question whether an industry is a "racket".  If it is, then it should be stopped.  But if that is the excuse for more regulation, then I don't accept it.

[MishaK]

By minimum, I mean that a doctor should do just enough so that a reasonable person wouldn't suspect the doctor let their patient die. 

That goes against the hippocratic oath. If you don't know what that is, you should look it up as a very basic foundation for even having this discussion in the first place.

Where are you getting this information?  Your personal circumstances are relevant, but only to an extent.  For instance, it is quite common for employers to offer their employees significantly higher pay if they are working in a metropolitan area, because of higher taxes and cost of living.  Is that the same for you?

I lived and worked in a number of diferent metropolises, comparable in each nation in their importance and cost of living and premium on salaries. Also, I have a number of friends and relatives who are doctors on both sides of the Atlantic and a friend who used to work for a biotech/pharma hedge fund. So, yes, I am quite evidently far better informed about the topic than you.

Here is something that I do know.  Americans subsidize foreign health care by paying a lot more for their medicine.  Foreign markets demand they have access to the medicine, but they can't pay enough for it.  So instead of refusing to sell pills to Africa or Europe or wherever (to avoid the obvious political fallout such a decision would bring), they sell them at a discounted rate.  But someone has to pay, and because of the ridiculous health care system we have here, American do pay through their insurance companies.

Source please. This is total fiction. We aren't even talking price of pills. We are talking price of treatment and price of isurance. You are getting less for your money in the US than you do in other OECD countries. And it all goes to insurance and administration overhead.

But, someone says, why are the drug companies so concerned with making money?  Why can't they just sell their pills for cheap everywhere?  That because it takes enormous amount of money to get a new drug to market.  There are about 5 roadblocks along a drug's journey, and only 10% make it though each.  That's because the FDA has made it difficult to release new drugs (more difficult than it needs to be).  And so drug companies must finance this research with big prices.  That's a simple fact.

That's not the issue.

Health is something that should be left to only those who can afford, just like everything else. 

I will let this sentence stand uncommented as a manifest of your total lack of humanity and reason.

These horror stories of spreading disease are overexaggerated.  In the rich world, e.g., North America and Western Europe, there are very few contagious diseases.  And in the event of an epidemic, then I could see there being a distribution of medicine, but the rare epidemic is no excuse for throwing money at poor people all the time, it just means there needs to be preparation.

You missed something crucial in my post. I wasn't talking about deathly epidemics. I was talking about preventable diseases and injuries, which cost all of us a ton of money if left untreated, through lost productivity, lost consumer spending and lost tax revenue. In the US, health care expenses are a leading cause of personal bankruptcies. By not having comprehensive health coverage, you are sending lots of people who could be productive members of society into poverty and dependence on welfare. Whether you are conservative or liberal, that is just plain idiotic.

And loss of taxes and consumer demand?  That implies we are talking about people who have jobs.  If someone has a job, it is highly likely they have health care. 

Not the case in the real world. Most jobs don't provide sufficient health care. Any more serious accident or illness that requires extensive time off the job and you lose your job and your coverage (assuming your coverage even covers treatment for such injury). Off they go into bankruptcy.

By what right does a government have to set prices for the industry? 

Non sequitur. I never talked about government "setting prices". No European government I am aware of "sets prices" for any healthcare items.

And who has ever talked about the lower overhead of a government?  What company has ever decided to model its bureaucracy after a government?  Surely governments have great bargaining power, but they can only do a better job if you think a government somehow understands the healthcare industry better than the industry itself.  Its not their money, so I doubt they do.  It is precisely because of this "bargaining" that there is corruption in government.

Medicare and VA administrations have far lower overheads than private healthcare administrators in the US. This has to do with them being non-profits. Likewise, European health care administrations have lower overhead than US private health care providers.

No, I think the solution is to let the health care companies produce drugs with less regulation and sell them at a lower price.  The pharmaceutical industry would benefit and hence, their consumers.  Insurance would be cheaper.

Interesting theory. Except that in the real world, wherever there is less regulation of the economic aspects of the medical industry, the higher are the costs of medical care.

And that last sentence is just plain revolting.  Each patient has the will to just not take the pills, to just not accept insurance.  But that would be a bad decision.  Why?  Because patients benefit from them.  It is an entirely different question whether an industry is a "racket".  If it is, then it should be stopped.  But if that is the excuse for more regulation, then I don't accept it.

You live in a fantasy world. In this country, there is insufficient regulation of campaign donations and lobbying. The result is a legislature beholden to the interests of large corporations and do not serve the public at large. The system is messed up. Sure, my last sentence was hyperbolic. But the fact that so many other countries manage to do far better than we do speaks for itself. I will provide you later with links to data to support what I have written above. Now I have to run to go see Agrerich/Dutoit/Verbier and that takes precedence over arguing with someone so stubbornly ideological as yourself, sorry to say.