Saturday, March 27, 2010

Steve, See This One on US Healthcare --by a Brit!


Good stuff in this article --about the uninsured in America, etc.

Actually, the article on healthcare is the 2nd one down.

"God is not willing that any should perish, but that all should come to repentance and have eternal life."--the Bible


Barb said...

What I found interesting was the breakdown about the uninsured.

I didn't like his suggestion that overweight people, by his suggestion, wouldn't get coverage --along with smokers, etc. He thought that would motivate better lifestyle habits. The wallet has never been a big consideration in getting people to stop bad habits, or break addictions, has it?

steve said...

I'm not sure why I'm being singled out, but I did read it and wasn't sure what I was supposed to take away from it. I found many of the assumptions he was making simplistic and one sided. I could go into detail but it's not that important to me any more. Maybe it's just me and I'm some kind of kook, but I don't take any thing at face value. I read and decide for myself any given issue. I read and research and look at it frontwards and backwards. I don't use popular media, I look for scholarly journals and articles and books using a research tool like EBSC host. I don't trust any media outlet anymore as just about 99% of it is propaganda. Blogs are propaganda. This country has become a nation of propagandist pushers, and propaganda users. We've fallen in love with propaganda because it is comforting when our world view is reinforced. But debate is no longer possible because now you just have these screaming feedback loops of self serving propaganda locked into a self perpetuating cycle of narrow opinion to outright lies and distortions.

Barb said...

The guy wasn't from our nation--and he was quoting someone else on the stats of who was uninsured. I had seen those stats other places so I think they are probably accurate.

You were singled out because I believed you supported the healthcare reform, feeling sorry for all those uninsured (the illegal aliens and the ones who could afford it and chose not to.) Also, you are IN health care.

And besides, you are really important --a headliner!

I thought the fellow raised good questions about healthcare as though he were from here.

Christian Apologist said...

Amen Steve. The amount of propaganda out there today would make Stalin quite jealous.

Barb said...

Did you read it, CA? We know there is propaganda but how can we be sure of the difference, so diminished is American ethics even in gov't agencies we rely on for factual data.

I don't pretend to be an expert on economics of healthcare except from the in-office perspective.

Doctors know that gov't and malpractie litigation run up their hours and their costs for documentation, fines by the govt and legal fees.

E.g. Docs used to be able to casually supply free samples to those who needed it when I was a kid --and now docs have to pay someone an increasing wage every year even when the office revenues do NOT increase every year --pay that person to dig up a chart or wait on a screen ---and keep track when the computers are down of the numbers of pills, dosage, etc.--just to make sure every jot and tittle of a drug that's not typically abused (like narcotics are) is marked down in a person's chart --in part, because of the crooks who would sell the free samples. We can't just trust people not to get more pills than they need as in the old days. It would probably be cheaper letting their pill supply overlap than for the doctors to keep track.

Doctors are baby sitters for their patients --having to tell them when they miss appointments, for Pete's sake! Having to remind them by mail or phone to care for themselves and come back in for an app't. so they can't say, "He didn't tell me I should come back!" when, of course, now we tell people to come back unnecessarily after every illness--more money for the doctor, but not because he really wants to be that busy. And gov't does not fairly compensate docs in the long run, because the gov't is BROKE! To make my husband's living, he works the hours of 3 people. Every day "off" he goes to the office to do paper work (or to nursing homes for his 2nd job) and brings a huge stack of tests home to review and sign and date until well past midnight. I don't know and have never known any one who works as hard as he.

Elaborate procedures are in place to catch those who collect narcotics from multiple doctors to abuse or sell.

We do so much police work and baby-sitting of patients in healthcare because people take advantage --and sue doctors for failing to be their nannies.

And all the pt. has to do is sue --he and his attorneys win by default because the doctor doesn't want to go to court and lose and spend tons MORE money to defend himself.

Barb said...

For awhile the gov't wanted the docs to sign their WHOLE name on every lab report, every piece of paper in the charts --to show they had seen it. Now, I guess they've let them go back to "making their mark" on the paper. But they were concerned that underlings might do the doctor's work of reviewing even the NORMAL lab and exam results. I always said it was a shame that someone else couldn't read the reports and separate and sign the completely normals from the abnormals which the doc would address.

So much that is done in a doc's office --which runs up the costs --is to protect themselves from attorneys, gov't and litigious patients.

There are several chart audits every year where relatively unskilled people are paid to find the doctors in error --not having taken and recorded a weight,e.g.

You may remember me telling about the employee who set his sandwich down on the lab counter when a gov't person from OCEA? came in and fined that doctor $20,000.
Elk and Elk got 100,000 settlement for a young diabetic who had ruined his own health and tried to sue 3 doctors for neglecting him. The doctor he barely saw for his condition -coming in as he did for non-related sore throat or whatever --didn't remember the guy was a non-compliant diabetic --too young to automatically check for it. The patient knew --he had been told by several other docs to take care of himself and when he didn't, they dismissed him --but the sued doctor --who didn't see the pt. enough to even recognize him, settled out of court --because he had not pored over the chart to notice that the guy was a non-compliant DM who was told twice to come back with is glucometer results and he never got the glucometer nor kept those follow up appointments. The Doc might have won in court --should have --but at what expense and risk?

The insurance companies try to run healthcare in the black; the gov't runs in the red because they don't make any investments with tax and S.S. monies to cover health care as ins. co's do. That's why I wish gov't would get out of the healthcare business except for the non-working indigent and the pre-existing expensive conditions.

I respect our gov't when it preaches sexual abstinance for single people, marriage, family values --because it IS the family breakdown that is our most critical and expensive problem today. Because of father failure and general promiscuity of people, we have a huge need in social programs.

steve said...

In some ways I agree with what you are saying Barb, and in others I disagree. I'm willing to bet that your husband spends more time, effort, and headache dealing with insurance companies, than with the Medicare or Medicaid. At least that is my experience with my own doctor, and with doctors I have overheard talking to patients at the hospital during my clinical rotations. But I agree with you on the tort reform. I think there should always be a right to take somone to court who has hurt you with negligence or malfesiance. But I think our society is completely out of balance in that people are looking for every opportunity to sue and use the legal system as a means to strike it rich. Every little thing the nurse does now has to be documented and documented from the standpoint of protection from liability vs efficacy of treatment for the patient. I'm not even a nurse yet and I'm already kind of disolusioned with the whole CYA environment. In order to administer a narcotic for pain relief, you need two nurses to act as witness to one another and document on the patients chart. I can understand that I guess. But you are right, our lawsuit happy culture has created a monster of professionals concerned more with potential liability traps, vs actually practicing their profession.

Barb said...

It's not the healthcare professionals that are necessarily the monsters (though there are some crooks --nurses who murder patients, too!) --it's the legal eagles looking to make a living off the docs and hospitals. It's easy money to settle out of court when the docs can't risk going to court and losing.

The gripe he has about Medicaid and Medicare is that the pay doesn't let him break even and still make an income himself. He says they won't pay what is charged and that he has to charge more than he needs just to break even --even worse than ins. companies. So he says he can't have 100 per cent gov't patients or he won't make enough.

But I think corporate am. incl. ins. companies are bloated at the top --self-indulgent --fat cats.

However, I did hear that the very over paid president of Pro-Medica is a big benefactor of charity --Christian charity --so that's good! He and the Mercy/st. vincent CEO's make almost 2 million a year --it's ridiculous!!! Do corporate boards really think such fellows won't work for less?

steve said...

I misworded that, I didn't meant that health care professionals become monsters, I meant they now have to deal with a monster of a situation.

I think Medicare and Medicaid only allow fixed rates for services provided because their income is fixed and based on a certain amount of tax income. As the economy fluctuates, The amount of patients serviced by medicare and medicaid fluctuate, as do their income from taxes. Medicare and Medicaid are forced to operate as efficiently as possible because they have to equitably dispense health care with a limited amount of dollars. If you took profit motive out of the equation with a national health care system, then the pool of income would not be wasted on administration (denying people health care and account planning to ensure the CEO gets a fat bonus), but administrative costs would go directly to patient care - and the physicians that serve patients.

I think to make a gov health care system work, it should not be some huge bureaucracy. I think a board should be set up that is made up of physicians, nurses, researchers, scientists, ect. That are elected to office and decide from a tool kit of research based best practices to guide health care in the most cost effective methods of delivering care. This body would also determine fair compensation for health care workers that would be standardized like any other government department. It would be generous compensation that takes into account all that is required to become a doctor or a nurse.. education, blood / sweat / and tears, years of practice, ect.. It would return some autonomy to physicians in determining what is best for patients instead of an insurance company bean counter. But physicians would get guidance on what the most effective route of care is for any particular malady by real time research. To me, health care is one of those things that is perfect for the Government to run. It's a system that needs standardization; It's a system that needs regulation and oversight because peoples lives are at stake; It's a system that shouldn't have a motive of profit involved because it is unethical to put a price on a persons life - as insurance companies do.. it's against the Hippocratic oath "to do no harm" when infact physicians are forced into situation of doing harm by insurance co. bean counters.

Would you say you are pretty happy with the highway system? It's probably the best in the world. Would you say you are happy with our military prowess - best in the world!, how about Nasa? Do you think a private company could have pulled off a moon landing? A private company hasn't even gotten a rocket into orbit 40 years after nasa put a man on the moon! My argument is that there are some things that the government just does better. The government is best at managing huge projects and infrastructure - like a national health care system. They are great at things like that because they have direct access to the countries productivity potential and can leverage that potential to basically do anything under the sun. Government health care works! It works in other countries, and it can work even better here! This health care bill we got, isn't government health care, it's private for profit health care coerced by the Government. The only good thing about it is that it eliminates the worst practices of insurance companies and may, through the massive influx of new premium payers, lower costs. I guess we will see.

Christian Apologist said...

In the end all health care fails. We all die. It is not the quantity of our years that matter but the quality of them. While having good health may effect, to some degree the quality of a persons life, it does not neccessarily define it. Many people who suffer from debilitating disease and sickness lead wonderful, fulfilling lives.

Therefore, it is ridiculous for us to sacrifice our freedom for good health. The more money the government takes out of my paycheck the less freedom I have to spend it as I choose. I would rather be a free parapelegic, than a healthy and robust slave.

steve said...

Ok Braveheart-You win.

I don't want to see anyone take your freedom away. You've convinced me that we are all islands unto ourselves, the rugged individual living free. It's the Darwinian struggle that is in play, an unflinching sterile world of indeference to our fate, no community, no social obligation, that's all a mirage, it's just me that matters.. the Survival of the fittest.

Good luck.

steve said...

C.A. this article might intest you:

steve said...

Jesus cared enough about healthcare to make a parable out of it.

I think modern day evangelicalism needs to be rebuked for making an idol out of Republicanism, Americanism, and the shadowy concept of Freedom. I don't think you will find any of those concepts in the Bible.

Luke 10:30-37 Jesus answered, "A certain (illegal alien, welfare mom, brown skinned person) was going down from Jerusalem to Jericho, and he fell among robbers, who both stripped him and beat him, and departed, leaving him half dead. By chance a certain (Modern Evangelical Christian) was going down that way. When he saw him, he passed by on the other side. In the same way a (Republican, Teaparty person) also, when he came to the place, and saw him, passed by on the other side. But a certain Samaritan, as he traveled, came where he was. When he saw him, he was moved with compassion, came to him, and bound up his wounds, pouring on oil and wine. He set him on his own animal, and brought him to an (hospital / medical center), and took care of him. On the next day, when he departed, he took out (some dollars), and gave them to the (health care system in place), and said to him, ‘Take care of him. Whatever you spend beyond that, I will repay you when I return.’ Now which of these three do you think seemed to be a neighbor to him who fell among the robbers?" He said, "He who showed mercy on him." Then Jesus said to him, "Go and do likewise

One of the points of the parable that people like to ignore, is that Jesus was getting at Everybody is our neighbor, not just the guy next store, or whoever, but Everybody. And what better way to service the health care needs of everybody, than to pool everyones money to make the system viable.

Barb said...

Your conclusion is fine, STeve --if everyone is working and pooling their money into the system. Our problem is that WE ARE IN DEBT!!! and OUT OF WORK. THERE IS NO MONEY TO PROMISE to thE NON-WORKING PUBLIC AS Obama does! He got elected making people think the gov't should do everything for them while they make babies and collect unemployment and/or welfare.

We need to do a better job of making up for these parents who can only teach their kids to follow in their footsteps --goofing around in school, not graduating, not working, making babies, shacking up, not paying child support, etc. etc. etc.

It isn't a lack of compassion to tell the public that they cannot indefinitely ride on the backs of a few who work and impose huge bills on them for their often self-imposed health problems.

I hear my one friend is getting double knee surgery--she has barely worked a day in her life --even in her own home --and she has hung out in medical offices most of her days.

As for compassion, I've had a lot for her and done a lot for her. But was most frustrated when she WOULD land a job and then quit it because of some little complaint.

Don't misuse the parables, Steve.

Christian Apologist said...

Steve. You are misusing the parable badly. I do not oppose the health care bill because I dont have compassion. I oppose it because I dont think it will work. Helping those in need should be the job of individuals not government.

steve said...

The parable teaches us to care for our neighbors - all of them. It doesn't direct the manner of that care, except that if you see someone suffering physical injury, you come to their aid and spare no expense at mending them. How does reform of U.S. health care, that would provide care to more people, not allow insurance to cut people off from healthcare.. just to let them die out of pure economic selfishness; how is this contrary to the parable?

What you say is that you are politically opposed to health care reform because it is un American in your view. But if health care reform can provide a more compasionate means of delivering care than we currently have, aren't you placing your political views above your ability to provide compassion - as the parable demands?

Barb want's to limit compassion and care to only those she feels worthy of that care, but the Parable doesn't make ANY moral judgements on the worthiness of the victim of the robbers.

steve said...


Why don't you think health care reform won't work?

Christian Apologist said...

Health care reform will not work for the simple fact that what a man does not earn, he does not value. Instead of fixing the overpriced health care system the bill is requiring everyone to use it. By the law of supply and demand that means the cost of health care will probably skyrocket soon.

Furthermore, the federal government simply cannot afford it. Taking on debt should only be done in a crisis and there is no crisis in health care. If someone is in urgent need they get the care they need regardless of whether they can pay or not.

Barb said...

Barb want's to limit compassion and care to only those she feels worthy of that care,

There you go. That is muck-raking. because it's untrue and judgmental, what you've said. I don't want anyone to starve or suffer.

I have had endless compassion on someone who is truly, factually, a self-indulgent, lazy, comfort and pleasure seeker who hardly lifted a finger in her own or her kids' behalf --all her life --and expected others to give her aid at their hard-earned expense. And public health care is going to give her Cadillac knees that working people are going to borrow thousands for.

We are to be compassionate people --we are also to do what we can to help ourselves and have good goals, starting in youth.

I have never said to cut off gov't welfare or social security or disability benefits or medicaid/care for self-imposed miseries --nor to expect charity to do it all--but we should be preparing the next generation to realize that it is WRONG to depend on gov't thru the hard work of others for what we SHOULD and CAN do for ourselves.

INSTEAD we really do have people who have a "cottage industry" of "working the system," finding every freebie they can. Who get angry if the freebies are threatened --that's the "sense of entitlement."

The victim in the parable, BTW, did not inflict his own misery!!! Therefore, he deserved help.

As for the undeserving, (and there are such people) I don't say, cut them off --but I do say, let's find a way for the able-bodied among them to do work for their gov't benefits --keep the roadsides clean, e.g. Paint over graffiti. Tend the roadside flowers. Clean park rest rooms. I understand that one of our southern states has such work projects. I believe recipients of welfare would resent this! But if you said, from now on, welfare requires work from the able-bodied, it should at least seem fair. But maybe they'd resent it enough to find a job on their own! My friend and her kids could have picked up road-side, park and subsidized housing trash, shovel snow, e.g. for a few hours a week --and helped to beautify and maintain the city that way, saving it money. But I would've been just as pleased if they had minimally maintained their own gov't subsidized housing unit without my help.

When I was younger and more agile, I really liked to pitch in and help someone else with a big challenge, tried to cheer my friend up and give her the restaurant outings and trips for her kids that I could afford --tried to help her with her problems, car need and repairs, bills, etc. --with advice rarely heeded.


I think it's good when Obama preaches fathering and responsibility --just as when the GOP preaches "family values." But we are afraid to get the message of self-reliance and the value of chastity to the young, apparently, because their elders have failed abysmally in this area. And youth follow parental example -and need parental chaperonage throughout youth.

steve said...

I think all our problems go back to slavery and the 100 years of Jim Crow laws.

They had a fantastic program schedule last night on PBS dealing with our nation's prison crisis and the relating crisis in the black and minority community. In your paragraphs above, what you are saying is that you want to front load investment in these disadvantaged communities so that you don't have to backload aid to these communities later (prison, healthcare, welfare) Just look at prison for example. Say an 18 year old black kid, who basically has had no investment into his life from cradle till now, decides to slang some crack on the corner so he can earn a couple of bucks to eat. (typically the foot soldiers of the drug trade make less than minimum wage - according to freakanomics) So this kid gets picked up and winds up in prison for 10 years. Our tax money has to support this person at 50,000 dollars a year for the next 10 years - so A 500,000 dollar price tag for you and me. He won't be reformed, if anything, prison is just an education on BETTER ways to get away with slanging crack. So as soon as this kid, now 29 hits the streets, he's back at it.. and the cycle repeats. But what if we invested in this kid's future from an early age with education programs, daycare programs for mom, ect.. a college trust fund so this kid has a future? It would probably cost next to nothing in comparison to supporting the kid the rest of his life in prison.

In fact, some states are seeing the light and are creating comprehensive rehabilitation programs to help these people who wind up in prison for minor drug offenses, or have drug problems, get educations, get cleaned up, etc.. and these states are finding that it is saving them a BOATLOAD of money, because they don't have to keep re-incarcerating these folks. This would also save on health care, because productive, well educated people, tend to be happier and healthier.

In the book "Then New Jim Crow"

Author Michelle Alexander examines how the war on drugs, as a way to attract dixiecrats to the Republican Party, is actually a new form of Institutionalized racism designed to keep the black community disenfranchised. Because once you become a felon, You're life as a United States citizen is over. Statistics don't lie, and her statistics are startling in that it mathematically shows the organized racism against blacks in our nation.

So the first thing we need to do, is treat drug addiction as a health issue, not a crime issue. The next thing we need to do is invest in these broken communities. Since slavery ended, there has never been a comprehensive acceptance by white America for the slaves and their subsequent generations. Black America has always been marginalized, ghettoized, and herded into Balkanized inner city slums. Sure, we emancipated them, but we never have absorbed them into the fabric of America. I don't think God will ever bless our nation until our nation does right by our forced black emigrants - and our Latin American emigrants, whom we want picking our vegetables and nanny our households, we just don't want to see them otherwise. But we better hurry because demographically white people are on the decline in relation to our brown skinned people. I think in 2012, I read, year on end, white births will be superseded by minority births.

Barb said...

I suspect the only thing that can make up for deficient parenting is Christian people really mentoring the at risk kids --really investing time. And it is hard to get even the church folks to do enough of this. I thought there should have been after school transportation for after school activities for the at risk kids --because their parents weren't doing it at Libby--too many kids couldn't stay for after school rehearsals, etc. because they had no way home --and the teacher wasn't allowed to take them home.

Jeanette said...

Jesus never told us to give our money to the government so they can fund social programs.

He told us to help those in need. In as much as you help them you help Me. (Paraphrased)

I'll give every last nickel I have to my name to anyone who is down on their luck and needs a hand up, but I resent the government telling me how to spend my money.

If you go to a stock broker one of the questions he will ask you is if there is something you do not wish to have your money invested in.

My stock answer is I don't want to invest in any company that supports abortion.

Maybe we've lost a lot of money on that stand but it's our principles.

The government doesn't give us that option but takes our money and spends it where they think is the best place.

This from the people who have a tax cheat in charge of writing our tax laws and a tax cheat in charge of collecting our taxes.

Congressional districts that don't exist are getting money for programs that can't possibly exist since there is no congressional district there.

One of the congressmen who voted for the health care bill actually said he had read a 2700 page bill three times. When it was pointed out that at the rate of one minute per page it would have taken him about 6 straight days to read it he got offended. He said he didn't care about the constitution in this case. The very constitution he has sworn to uphold. His name is Hare and he's from Illinois.

Let me decide how to give my money as I know better how to do it.

We didn't have this welfare mentality and sense of entitlement until LBJ's Great Society. Since then the Democrats have kept the African Americans "on the plantation" so they can get their votes.

We all agree something needs to be done, but when your car needs an oil change you don't get an engine overhaul. This is a bad bill.

Barb said...

I'll give every last nickel I have to my name to anyone who is down on their luck and needs a hand up,

I believe you would, Jeanette, but don't tell Whynot! : D

And I can't profess to such generosity myself! We are generous --but my husband wants us to be secure in old age by his labors, come what may. That's that old Yankee self-reliance that we think everyone should strive to have --attitudinally, anyway.

About the sense of entitlement of "have nots"--it is WRONG to have such a sense. On the other hand, it is RIGHT for the "haves" to feel an obligation of compassion --and I don't object to gov't helping people avoid poverty, helping the ill, etc. --I don't object to ANY generosity--but the recipients are wrong to think it's their DUE and complain when they don't get all they need --they think the workers OWE them. And our gov't even helps motivate the lower-income workers to work by GIVING them tax credits --so they won't figure that they'd get more by NOT working.

what a government! I'd be fine with all of it, if we weren't doing this "in the red." If we enabled the economy to be robust.

and the reality is that NO recipients or potential recipients want the gov't to back down on what they do --say Social Security and Medicare. All our parents who voted against FDR's Social Security are collecting it now --but just as they predicted, it's bankrupting us. Never before have the lower income elderly had such perks as retirement homes in Fla. and new knees and open heart surgeries for all! and nursing homes are SO much nicer than they used to be. I remember there was a "county home" for the elderly and it seemed like an awful place.

I want all that gracious living for us elderly folks --but I want to see the country having national defense and a robust economy also.

If the private sector makes money, the public sector thrives.