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Reddit"It is time to come home, America. Time to look within our own borders and within our own souls," Sen. Robert Byrd said Tuesday on the Senate floor. "There are many questions to be answered and many missions to accomplish right here on our own soil."
The disaster in New Orleans has reaffirmed that America's ongoing failure to address racial injustice is our great, unaccomplished mission at home. African-Americans still face unequal treatment in housing, education, the workforce, and perhaps most insidiously, the medical care they receive (or fail to receive). Three recently released studies show that black patients are substantially less likely to receive heart bypass surgery, blood vessel repairs, joint replacements, and other important procedures than whites. According to Asish Jha of Harvard Medical School, these studies indicate that "Overall blacks and whites receive very different health care in this country."
Finally, an organization has emerged to confront the crisis of unequal care. This summer, Massachusetts General Hospital announced the creation of the Disparities Solution Center--the first institution specifically dedicated to bridging the health gap. As Dr. Thomas Inui of the Regenstrief Institute for Health Care, told the Boston Globe, "We're really finished with the time in which we need more studies showing disparities exist. Now, we need to show how to close the gaps."
The Center is being headed by Dr. Joseph Bentacourt, whose landmark study, "Unequal Treatment: Confronting Racial Disparities in Health Care," brought national attention to the issue. With $3 million in initial funding, Bentacourt says the Center will be a "living laboratory" in which doctors, academic researchers, and patients will collaborate on solutions and present their recommendations to hospitals, health care providers, and government officials throughout the country.
This deep-rooted problem won't be solved overnight, but the creation of the Disparities Solutions Center is a crucial first step--the exact sort of national soul searching and forward thinking we need in these devastating times.
We also want to hear from you. Please let us know if you have a sweet victory you think we should cover by e-mailing nationvictories@gmail.com.
Co-written by Sam Graham-Felsen, a freelance journalist, documentary filmmaker and blogger (www.boldprint.net) living in Brooklyn.
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Katrina vanden Heuvel
Thoughts on politics, current affairs, riffs and reflections on what’s in the news and what’s not--but should be.
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Ms. Heuvel....you really are a socialist aren't you.
Posted by LIBSARENUTS at 09/16/2005 @ 1:39pm
LIBSARENUTS, It is a free country. People can be socialists if they want to, right? What is wrong with that?
Posted by ILOVEPHYSICS at 09/16/2005 @ 1:52pm
So it's socialism to give welfare and/or financial breaks to the poor, but good fiscal policy to give welfare and/or financial breaks to the rich?
Posted by Turk33 at 09/16/2005 @ 2:30pm
Your "Liberal Queen" has spoken:
CINDY SHEEHAN CALLS FOR U.S TO 'PULL OUR TROOPS OUT OF OCCUPIED NEW ORLEANS'...
What a wonderful representative of the left. I know you will join me in expressing your pride in her statements
Posted by LIBSARENUTS at 09/16/2005 @ 2:32pm
Turk...
Of course its OK in a right-wing kinda way...it's called Reaganomics. It the rich get fed well enough, then perhpas some scraps will fall off the table to the hungry masses below. Of course, it didn't work then any better thn it does now, but ya gotta give them points for sheer persistence.
Posted by leftofcenter at 09/16/2005 @ 2:35pm
LibsR
Never thought I'd the words would pass my lips but I gotta agree with your view of the "over the top" aspect of that Sheehan statement. However, for the record she ain't my queen, nor my representative.
Posted by leftofcenter at 09/16/2005 @ 2:39pm
Yes I agree....if you dont like to hear other viewpoints or are afraid of the heat....by all means use the ignore button....A great new feature installed by the stalinist Nation magazine to prevent free speech.
Posted by LIBSARENUTS at 09/16/2005 @ 2:58pm
LIBS, Could you provide a link to the Cindy Sheehan story? Thanks.
Posted by ILOVEPHYSICS at 09/16/2005 @ 2:58pm
ZERO, Somebody's gotta be first....
Posted by ILOVEPHYSICS at 09/16/2005 @ 3:00pm
The costs of health care in our nation are insane compared to other industrialized nations....our health stats are just not reflective of the level of medical technology we have and the fact that millions remain without health care is quite frankly atrocious. Read the article here: NY [newyorker.com]
Posted by leftofcenter at 09/16/2005 @ 3:21pm
I don't post here often, but I do read these blogs frequently.
I am glad that a respected medical organization like Mass. General is starting a think-tank that will address health-care disparities. Our health-care system is broken, and we need to start generating some fresh ideas to fix it.
Posted by 9patch at 09/16/2005 @ 3:23pm
Sure, I realize that I will immediately be bashed as a socialist (by Rio or LL or USA), or worse by LibsR. So be it. Socialism is one of many schools of political thought that does have potentially "useful aspects". Is it so odd that we might actually learn (heaven forbid) from other societal models for stuff that works?
Per the posted stats at Nationmaster.com the US is: at the top of (or within)the worst third for: years of ill health, life expectency, number of healthy years, prevalance of circulatory diseases (among the 30 OECD developed nations), yet we have THE highest per capita expenditures of ALL nations and are #1 in child maltreatment deaths.
Here is an article that talks about the Canadian experience, and sure it isn't all roses. But are we not capable of learning how to make a better model? Is our leadership so frigging brain-dead that it is beyond their ken? CAN [theadvocates.org] We could also look to the UK, Germany, Australia, Italy, Belgium, France, Sweden and Finland. All have different models and have pros and cons. However, most have better general health stats than we. How can we be satified with being less than second best in such a fundamental area? We can and should do better and private insurance sure ain't the way cause it ain't working....
By the way: it seems not so many folks (GOP or DEM) are buying into Dubya's Soc Sec or Health Care pipe dreams... see: http://www.businessweek.com/magazine/content/05_20/b3933001_mz001. htm (sorry, URL too long for the blog coder....)
Posted by leftofcenter at 09/16/2005 @ 3:32pm
LibsR
update on Sheehan....as per my other response to this cross-blogged item: your data as usual is full of excrement. Sheehan went to New Orleans for a photo op just like Dubya as well as others pining for media attention.
Posted by leftofcenter at 09/16/2005 @ 3:47pm
Zero
Who are you railing at? Me? I used the term socialist in a light of expected whacks from certain bloggers who pass by and hurl it at thoughts of "SOCIALIZED" medicine...not the same thing although some relation admittedly. But my larger point is...what the hell is wrong with learning from anything including socialism if it has "good bits"?
Posted by leftofcenter at 09/16/2005 @ 3:52pm
For those who asked: Its on your beloved Michael Moore website. I cant wait till the American people get a load of this. I know you liberals are beaming with pride in your little queen
friday, september 16, 2005
Mama Moonbat: "Occupied New Orleans"
Mother Sheehan jumps the shark, at (where else?) MichaelMoore.com.
I don't care if a human being is black, brown, white, yellow or pink. I don't care if a human being is Christian, Muslim, Jew, Buddhist, or pagan. I don't care what flag a person salutes: if a human being is hungry, then it is up to another human being to feed him/her. George Bush needs to stop talking, admit the mistakes of his all around failed administration, pull our troops out of occupied New Orleans and Iraq, and excuse his self from power. The only way America will become more secure is if we have a new administration that cares about Americans even if they don't fall into the top two percent of the wealthiest.
Posted by LIBSARENUTS at 09/16/2005 @ 3:58pm
Libsrnuts: You don't seem to have a "viewpoint", in the sense that you have reasoned contributions to the topic. All I see is bilious rant. It would be nice if some thoughtful conservative (I know they're out there) would contribute some balance to the discussion.
Posted by oscar11:15 at 09/16/2005 @ 4:32pm
Balance is a/the key metaphor. Ever notice how difficult it is to maintain a teeter-totter level? It's practically impossible with disparities of weight at either end of the centered fulcrum.
Leverage then, "power" if you will, is exercised in motion and can never be adequately articulated in static space or prose.
Let the poet's words ring:
"Beauty's Truth, Truth Beauty. That's all we know. All we need to know.
-John Keats
LAWMAN (nascent libertarian socialist)
Posted by lewwelge at 09/16/2005 @ 4:46pm
Zero
Ooops, sorry. My bad. Must have missed their use of the "S" word.
Funny thing is, types like that like to throw big words around lke a little kid with a new dictionary. But when you use the terms inside of an actual idea that requires them to think and then respond intelligibly, they pretend not to hear you and go pout in the corner.
Posted by leftofcenter at 09/16/2005 @ 7:27pm
General message - please consider adding LibsRNuts to your ignore lists. Unlike Rio Bravo, Love Liberty, even CPT, this person adds nothing to the discussion at all. Plus everyone winds up wasting time actually trying to argue with him/her. He/she mostly fires off invective, pastes lengthy BS from one neo-con source or another.
Plus, if more folks don't ignore him/her, I have to wade through all the exasperated responses. Please, don't help a neo-con get their jollies! Turn LibsRNuts off! I know you can do it!
Posted by Fishbite at 09/16/2005 @ 9:09pm
Oh yes!! By all means use your new IGNORE button to protect yourselves. God forbid you might hear alternative viewpoints to your Anti-American Anti-Bush Drivel that passes for "Intellectual Discourse" Yes The Nation Magazine has shown their true colors with this new Stalinist anti-speech feature....Hurry click me off fast!!
Posted by LIBSARENUTS at 09/16/2005 @ 9:30pm
LEFTOFCENTER:
The task of the right, specifically with regards to health care, but generally the corporate entities who pay them, is not to discover how to make the system better, i.e. broaden coverage efficiently, improve care, etc. Their goal is to improve profitability. Period. Profitability and social good are incompatible when dealing with a necessity, therefore, it should be eliminated.
The problem as I recognize it is simple. Progressives (and I am not referring to typical run-of-the-mill liberals) want legitimate, pragmatic improvements in SOCIETY AT LARGE, for the benefit of the LARGEST number of people. The most active and agitative on the right (and the "traditional liberals" in our midst, who are truly nothing more that your average conservative, a la Bill Clinton) represent a very tiny minority of property- and wealth-owners to whose interests the public good is antithetical. Therein lies the rub.
Posted by jorcheim at 09/16/2005 @ 9:33pm
Profitability and social good are incompatible when dealing with a necessity, therefore, it should be eliminated.
Posted by JORCHEIM 09/16/2005 @ 9:33pm
Of course you are looking at the issue as someone with concern for mankind. For the decision-making elites who wield power in this country, profitability is synonymous with social good.
How dare you use non-economic criteria for evaluating what is good? What are you, some kind of wacko people-lover??
Posted by ILOVEPHYSICS at 09/16/2005 @ 10:26pm
ILOVEPHYSICS:
Your sardonic wit never ceases to amuse. :D Sorry I have been away all week. You can thank work for my absence. Good to see you again, ILP.
Posted by jorcheim at 09/16/2005 @ 10:29pm
Jorch:
I would have to disagree with you. Conservatives want to improve the system as much as liberals (or centrists, or progressives or whatever the name du jour is now.) However, we disagree on the means. We believe in the power of the free market system to bring cheaper, better quality health care to the individual. This is the same system that brings you cheaper and better cars, houses, food, you name it. Why would anyone think that the end result would be different for our health care? Just think, in just the last 5-6 years, plasma TVs have dropped 50% in price (and are better quality, to boot). Meanwhile, the cost of an MRI, while decreasing, has not done so nearly as quickly over 20 years. Not to mention having to wait several weeks to get one. Don't you think that that scenario would change if MRI businesses were allowed to open up across the street from each other and patients were allowed to choose the cheapest (and/or quickest) business to go to? This scenario would apply to all other aspects of medicine as well.
The fact is medicine is a business just like any other. Thus, the mission is to provide improved quality at a competitive price. If the quality of care is substandard or the price is outrageous, the customer (patient) will go elsewhere. Hence, the incentive to improve quality and/or decrease prices. Something from which EVERYONE will benefit.
Posted by usc1 at 09/16/2005 @ 10:33pm
You guys have it all wrong. WE are the elite, using our, er, um, brains and stuff to run this country into the ground since we are unable to compete fairly in the marketplace. And...and...we're, uh, jealous of their money, which they use to create jobs, which those poor people can use to make money to buy health insurance, which those people can use to get physicals and get their hearts tested and all. This is the basis of American compassion, not the sissified analysis that finds that the compassion might not be allocated equally among the varied groups of people composing our nation.
Survival. This is the very essence of Capitalism. This is what we are supposed to except as the American way: that certain people choose to be poor, live in a way that will keep them down-and-out, and through bad decisions will never experience the quality of life that most of us on this blog are fortunate enough to enjoy.
At the least, the President and the press are paying attention to people in need again (or for the first time). However, the politicians will pay such institutions as the Disparities Solution Center no attention until they host a fact-finding junket in Nassau.
Posted by tjbehrens1 at 09/16/2005 @ 10:44pm
USC1,
Where I live, the area near the town hospital is littered with MRI/Radiology centers. I am still paying for mine (I am insured) that I had to take in the spring.
Medicine is not like any other business. I had to have my car serviced today. I had no worries. I found out tonight that my father will be having bypass surgery next week. Any knucklehead could have worked on my car for all I care. But if my father's surgeon is not a profoundly gifted surgeon, I'll be more than a little steamed.
Posted by tjbehrens1 at 09/16/2005 @ 10:47pm
JORCHEIM, Good to have you back!
USC1, thanks for a cogent conservative post. We usually just get personal attacks from the right, so it is nice to have some civil debate.
However, I cannot agree with you.
We believe in the power of the free market system to bring cheaper, better quality health care to the individual.
The free market is not as "free" as you presume in this country. A good example of this is the following thought experiment. Let's say someone has a heart attack at work. His coworkers call 911, and an ambulance arrives to whisk the pour soul off to the hospital. To which hospital is he/she taken? Probably the closest hospital. The patient may be unconscious. The paramedics are trying to save his life. Where do economic factors come into consideration? Is anyone taking time out to research the best economic value? I think not. Surely you agree that this is quite different from shopping for plasma TVs?
Why would anyone think that the end result would be different for our health care?.
For precisely the reason I just indicated, plus others.
The fact is medicine is a business just like any other.
Ask yourself this: Should it be a business? Should good health and long life be just another commodity, sold to the highest bidder for the highest profit?
Permit me an analogy. What if your house catches fire, you call 911 and they patch you through to the fire chief. Next thing you know, the fire chief is asking "How much you gonna pay for us to drive out there and quench the flames?" You are at first dumbfounded, then you reply "I don't know, how about $800?" The fire chief laughs and says "Try again, cheapskate!"
Hmmm, maybe the free marked isn't always the best solution after all...
Posted by ILOVEPHYSICS at 09/16/2005 @ 10:54pm
TJB, My best wishes to your father, you and your entire family. I am hoping for the best.
Posted by ILOVEPHYSICS at 09/16/2005 @ 10:57pm
USC1:
Sorry, but you're wrong. The aim in health care is not improved care for less cost. The goal is SOLELY profitability. Period. Any claim to the contrary is simple marketing gimmick.
Posted by jorcheim at 09/16/2005 @ 11:00pm
ILOVEPHYSICS:
Precisely. Sorry about the truncated posts. I am a tired boy...
Posted by jorcheim at 09/16/2005 @ 11:01pm
The other problem with the free market talk about health care is that HMOs have blown it to bits. Who really has total freedom to select a particular doctor? And even tests that seem to be a matter of life or death are impossible for the very poor because insurance will not cover them.
An example: my MRI and other tests this spring were to determine the nature of several lesions in my liver. I took three different tests. The first two successfully identified a couple of the lesions and ruled them out as anything harmful. However, a few remained identified and my primary physician scheduled a final test to determine whether or not they were tumors. They were not. But my insurance company denied the claim. I can accept responsibility for not checking with my insurer, but would I not have had the test done? Hell no! Fortunately I am in a position to cover the cost (over time). Many others would not be so fortunate.
To think that some perceive medicine in such an instance as the difference between some being able to buy the latest HiDef 50" plasma screen and those who have to buy the 13" tv from Wal-Mart--well that's just too scary.
Posted by tjbehrens1 at 09/16/2005 @ 11:08pm
Thanks for your kind words, ILOVEPHYSICS.
Posted by tjbehrens1 at 09/16/2005 @ 11:10pm
Best of luck TJB.
JOR & others....I do defintitely agree. Health care for profit is a losing proposition for the consumer in that the health of the consumer is not in the profit-makers best interest. Altruism and capitalism conflict in the instance of health care. Take a look at the starts of the really "good" hospitals...most all were started by charitable (generally religious or academic) non-profit groups. However the insurance industry plays "wheel-of-misfortune" with you and I.
We need to learn from nations that have figured this out (see my 3:32pm post above) and elevate our delivery of healthcare closer to the level of available technologies....good health cannot and should not be just for those who can afford it.
Posted by leftofcenter at 09/16/2005 @ 11:27pm
TJB:
Best Wishes to your father. If it's any consolation, NO ONE gets to be a heart surgeon who isn't profoundly gifted.
I couldn't agree more about HMOs and it's quite possible that your HMO is the reason your MRIs are so expensive. The HMOs limit your choice, thus reducing competition and raising prices. (We should also factor the influence of Medicare/Medicaid on your price, because you are covering those costs as well. Sorry, didn't mean to open THAT can of worms!)
I did not mean to give the impression that getting an MRI is equivalent to buying a TV. Just that the principles that bring us cheaper TVs can also bring us less expensive health care.
Posted by usc1 at 09/16/2005 @ 11:29pm
JORCH:
Are you saying that your doctor does not have your best interests at heart?
Profit simply is not the greatest concern in medicine. Is it a factor? Of course. After all what good is an out of work physician?
Posted by usc1 at 09/16/2005 @ 11:33pm
USC1
let us take the example of dentistry as a case. I have actually sat in the chair w/out insurance and have had the dentist send the asst. out to get prices on the various "options" for a bad tooth. Invariably, if you are w/out insurance and not possessed of a pocketful of green, the choice comes down to: Do I have enough to have the tooth pulled?" Because fillings, root canals, etc. are a more expensive option, it always come down to "yank it."
Some years back as a student I got hit by a van while riding my bicycle. Nothing lethal, but it did shatter cartilage in my knee and separated my shoulder (as well as some textbook "bullseye" contusions from bouncing off the road at 40+ mph) Oh sure, the emergency room patched the road rash and such...and then the real fun began.
The guy's insurance wouldn't pay my medical until "it was all done"...the hospital wouldn't touch me without an insurance company saying that they would be responsible. My student health was considered to be a "rider" so it wouldn't kick in until the "main" (the guy's car) insurance company paid. In the 6 months it took to get someone to agree to look, my knee went all to hell. I of course had to sue (didn't want to, but they forced it on me) and was eventually seen by doctors....but this sort of thing in ridiculous - and it happens ALL THE TIME.
Posted by leftofcenter at 09/16/2005 @ 11:46pm
Moral of the story USC1 is that the insurance industry directs the focus of health care....it is for profits and treatment cuts into profit. So minimize treatment, make more money. Of course, some folks die and such, but hey...people die all the time...
Posted by leftofcenter at 09/16/2005 @ 11:48pm
"After all what good is an out of work physician?" I've met two doctors recently with different sad stories. One was a GP, who after 25 years gave up his practice because the cost of insurance was cutting so much into his income. He was still making a tidy sum, but the costs were eating into a very large amount of his revenue. He is now a painter.
The second doctor is the foremost neurosurgeon in my area. Unfortunately he is the only neurosurgeon at his hospital. He is overwhelmed and has been begging the hospital to hire a second surgeon. It declined. For his own sanity, he is resigning. Tuesday is his last day. I don't blame him, but now my town of 80,000 has no neurosurgeon.
Profits first? If not first, then always a close second.
Posted by tjbehrens1 at 09/16/2005 @ 11:50pm
USC1:
Actually, my PCP is my chiropractor, and as such cannot prescribe drugs, or do surgery on me, so he does, in general, have my best interests at heart.
Regarding profit and health. Have you ever spoken to even 1 nurse? If you would, they will tell you how unsafe hospitals are, due to understaffing... why are they understaffed? PROFITABILITY!!! Drugs? If you can't afford them, you don't get them. The bottom line is profit. Simple.
Posted by jorcheim at 09/16/2005 @ 11:52pm
ILP:
It's a nice try, but it doesn't affect my opinion much on this particular matter. If there is more than one ER, you can be fairly certain that prices will be comparable. That's just the way competition is. And if you're life is on the line, are you going to quibble over a couple hundred dollars (or even thousand)? Economic value is not your main concern. Keep in mind I am talking about true emergencies, not the young lady who complains of "funky discharge for 6 months." :-D
Posted by usc1 at 09/16/2005 @ 11:57pm
USC1:
I don't know if you are aware, but when someone with no medical insurance goes to the hospital, they are charged on average 3 times what someone with health insurance is charged. The reason is simple. The hospitals, run by HMOs now, get their bills negotiated down by health insurance companies, and they try to soak those who have no one negotiating on their behalf.
The bottom line is, insurance is designed to spread risk over a population. The larger the population, the more you can spread the risk, hence the lower the costs. Does it not make sense to make the population for insurance as large as possible? Hence, a single payer system would have, statistically the lowest risk factors, the largest number of contributors, and by definition, the lowest costs. Along with that, remove the profit motive on that, and guess what? The lowest cost available. Are there problems with this idea? Sure... the lack of competition is an issue. With no competition, there is a propensity to largesse. However, I believe that oversight (TRUE oversight, not the revolving door government/private sector oversight of the Bush or Clinton Administration) would solve the bulk of those issues and problems.
Posted by jorcheim at 09/17/2005 @ 12:10am
Of course, getting back to the original essay, the study showed not that health care was imbalanced because of economic issues, but of racial ones. On the one hand, this is an argument against the profit-hunger of the health care industry. Since the patients studied (white and black) had equal access to health care and coverage, there are issues beyond pure profit that must explain the difference in the treatments offered to whites and blacks.
This is just really ugly. I mean, it's awful to think that all things being equal, a black patient might not receive the same attention that I receive. To think that neither good will nor the pursuit of money is enough for doctors to do what's right, what's humane--this is one, f**ked up system.
Posted by tjbehrens1 at 09/17/2005 @ 12:13am
Wow! So many replies, so little time. I shall do my best.
First, and this might cut through a lot of the fat: If you're arguing AGAINST insurance companies and HMOs, I AGREE ONE HUNDRED PERCENT!!! They are turning medicine into an abomination. Not only nurses, but doctors, pharmacists, lab techs etc. are all understaffed.
However, where I imagine we will part ways is how to pay for health care. I am all for the HSAs/catastrophic coverage model. Patients would still be responsible for the small things (e.g. colds) while ER visits that you have mentioned earlier would be covered under the catastrophic insurance.
Posted by usc1 at 09/17/2005 @ 12:14am
TJB:
Someone might have mentioned this earlier, but often times what seems like racism in medicine is actually cultural differences. (e.g. many Asian people don't get treated for depression because it is not something they seek treatment for)
Posted by usc1 at 09/17/2005 @ 12:17am
USC1, First of all, please no more "funky dischare" remarks while I am eating my popcorn.
Second of all, I will forego my quite long reply since JORCHEIM has posted a lot of what I was going to say with his 12:10 reply.
Pardon me while I make a not-so-funky discharge. A gesundheit is in order, people...
Posted by ILOVEPHYSICS at 09/17/2005 @ 12:20am
JORCH:
You hit the nail on the head on one point. The uninsured get reemed because they are making up the cost difference created by HMOs and insurance companies.
Posted by usc1 at 09/17/2005 @ 12:20am
USC1,
Follow Katrina VDH's link. The study is not a matter of choice on the part of the patient; rather it appears to be on the part of the physicians who do not pursue the same procedures/tests for a particular ailment as vigorously for black patients as they do for white ones.
Posted by tjbehrens1 at 09/17/2005 @ 12:21am
So here's a question to all:
would you be satisfied with a dichotomy in medicine? When a socialized system is implemented, the wealthy will simply pay cash for health care. Bear in mind the best physicians will be part of the "cash" system for obvious reasons, leaving the lesser physicians to handle the other system (and TJB's dad's bypass, for instance (I don't know his financial situation, but just for example))
Posted by usc1 at 09/17/2005 @ 12:27am
USC1,
Thanks for your posts tonight. It's late on the east coast and my mind has turned to mush (or is mushier than usual). I hope you continue to visit this site.
Posted by tjbehrens1 at 09/17/2005 @ 12:36am
TJB:
One point about KVH's links. Buried deep in the interview with the doctor, Dr. Satcher states that they do not know WHY there is a difference and offers three hypotheses. However, none are conclusive. Furthermore, Dr. Jha stated that NONE of the studies looked specifically at the question of racism.
Posted by usc1 at 09/17/2005 @ 12:47am
I do think there is a fundamental disconnect between our philosophies, but this might help me understand:
Can someone explain to me why the cash-paying/competition-based system would NOT bring an overall decrease in health care prices? (This is assuming HMOs and insurance companies are not a factor) You all have mentioned examples of specific problems, but those problems mostly involved insurance companies. However, no one has refuted the idea as a whole.
Posted by usc1 at 09/17/2005 @ 01:10am
.
More baloney. More studies of well understood problems. The real problem is that the dominant ethos does not permit the implementation of the well understood solutions.
The statistics have ever shown significant disparities in the amount, timeliness and thoroughness of the medical care blacks receive as against whites. There is however no evidence that that is due to restricted access to the medical system, or to racism by physicians.
It is largely a problem of people neglecting their health, not going to a doctor in time, not getting tested or vaccinate, not faithfully taking their medicines and not following prescribed regimens.
The disparities are especially high for black preemies, infants and toddlers. A disproportionate number of problematic births are due to very young mothers who smoke, drink and do drugs while pregnant. Their infants are often raised, without regard to regular hours, proper nutrition, a calm and disciplined setting. That has medical repercussions.
The problem is not money. The affected population largely qualifies for Medicaid and would not have to pay the doctor or druggist out of their own pocket.
The problem is social. People in need of tight control flounder in a setting prepared to tolerate everything. The problem is a society that shrugs with indifference at young mothers and their boyfriends riding the subway at midnight with their toddlers. The problem is that a significant part of the population cannot deal with freedom.
The problem is brainless do-gooders who deem this a victory.
Betancourt, even with hundreds of millions of dollars, will change nothing, and he knows it. It is the culture that has to be tackled, the mores, the mind set, the climate of opinion.
As a start we have to stop tolerating well meaning morons.
.
Posted by nacl at 09/17/2005 @ 02:00am
Firstly, thanks Fishbite for the good, timely and economically beneficient advice to assign "Libsrnuts" to my "ignore list," a new, in my experience, and valuable blogging tool. Thanks again, Katrina, et al, at The Nation! Libs-r-nuts displayed the irrational "emotional reactivity" I've been studying over a year now: Murray Bowen's Family Systems Theory. Thanks for tolerating a brief plug.
Secondly, and to the point many writers have been discussing, consider Voltaire's response to the cynic's query (stage direction: read with a churlish French accent): "What good is 'dis philosophy of yours?"
After a "pause for the cause" of reason, Voltaire said, "what is good is an infant?"
Obviously, the value, economic as well as aesthetic, is all in the potential.
Of course, we skeptics know "the road to hell is paved with good intentions." Still, we dogged optimists choose to emphasize the potential for good. The pessimists, generally hurting themselves, usually find some personal comfort in pessimistic assessments.
Thank you for reading and for seeing the glass as half full.
LAWMAN
Posted by lewwelge at 09/17/2005 @ 05:58am
The Chris Farley part of me is saying "stupid, stupid, stupid!"
Voltaire's rejoinder was "what good IS an infant?"
I'll preview in the future.
Thanks for your tolerance, friends.
LAWMAN
Posted by lewwelge at 09/17/2005 @ 06:01am
USC1..
You wrote a few things I would like to reply to.
Would you be satisfied with a dichotomy in medicine? We already have one, between the insured and the uninsured.
Can someone explain to me why the cash-paying/competition-based system would NOT bring an overall decrease in health care prices? (This is assuming HMOs and insurance companies are not a factor)
I am not an economist, so I cannot answer this directly. Looking around the world, though, I can't help but note that comparable industrialized nations with a single-payer system pay about half per capita for health care than we do, and have better health, as measured by -things like life-expectancy, lost work days, and infant mortality rates.
Personally, I believe that the catastrophic insurance model is the wrong way to go. It puts economic pressure on individuals at the wrong place of a disease cycle. The best way to lower health costs is to stay healthy; the second-best way is to catch illnesses in the early stage, before that cold turns into pneumonia, before that "nasty discharge" turns into a full-blown uterine infection, and before that small cancerous lump grows and metastasizes.
Individuals already avoid seeing a doctor for minor illnesses and for screening tests, even when their out-of-pocket expense is trivial. Going to the doctor is always inconvenient; depending on the circumstance, it can also be embarassing and painful as well, and most of us are optimistic by nature and beleive that minor cough will go away, that discharge is no big deal, and we won't get cancer. Add economic pressure to this mix, and you have a recipe for nationwide procrastination on preventitive medicine. The result would be still higher health-care costs and poorer health.
Posted by 9patch at 09/17/2005 @ 07:48am
NACL
There are 45 million Americans without health insurance. (A number that varies by study, but still around 15% of the US population) Effectively these folks are without access to health care. I would posit that there is likely a racial statistic to this number, but by and large it is economic coincidence with race. For instance; as a non-trad (read: middle-aged, but NOT a minority) student I have health insurance from the college. However, my children do not. They furthermore do NOT qualify for medicare because (as many of those 45 million are painfully aware) if you are 12 dollars over, you get NADA. And of course, being a whole $12 over the poverty line means you can afford nothing basically.
So while I agree with the argument that racism among physicians is rare, the "most of them qualify for Medicare" argument is indeed without substance... The working poor, the "top of the have-nots" in many ways have less than the bottom rung. Not poor enough for a hand-out, but too poor to get what is needed.
Posted by leftofcenter at 09/17/2005 @ 08:36am
Hey Katrina has a commercial from a Keanu Reeves movie. Another reason to like her. Get your but back on AAR.
Posted by behonest at 09/17/2005 @ 10:48am
Aludra/Libsarenuts--I've corrected this w/you before. I do get that you just ignore inconvenient truths but just one more time for fun:
Our relatively new "ignore" feature on these comment fields, far from being a "Stalinist anti-speech feature," was an idea we borrowed from the rightwing Town Hall site's discussions. So pls take up your complaints with them. To us, the feature works well b/c it takes the ability to censor anyone out of our hands and gives that power to people like you to employ it as you see fit. If that's how you see Stalinisn, I cd recommend a few possibly edifying books for you to read.
Posted by Peter Rothberg at 09/17/2005 @ 11:34am
"Our relatively new "ignore" feature on these comment fields, far from being a "Stalinist anti-speech feature," was an idea we borrowed from the rightwing Town Hall site's"
I dont care who uses it or invented it. Its purpose is to squash free speech. So be it. Proves again who has the open mind and is not afraid of other viewpoints and who is not
Posted by LIBSARENUTS at 09/17/2005 @ 11:48am
The Summer of Cindy is over, and just in time. The mainstream media have drawn a discreet curtain over the activities of the woman they followed breathlessly for weeks, milked for all the anti-administration propaganda she was worth, and then dropped like a hot potato. Maybe no one cares about Ms. Sheehan any more. Many, of course, never cared about her in the first place. But, given the Madonna-like status that she was accorded during her "vigil," it seems only fair to shine a bit of sunlight on Sheehan's current activities. Sheehan is still blogging on Michael Moore's web site. Today she wrote from New Orleans, where she has taken her traveling road show: After we arrived at Camp Casey III, we took the Veterans for Peace "Impeachment Tour Bus" into New Orleans after stopping at the distribution center to pick up some supplies in Covington. I saw in the paper that George Bush said the recovery in the Gulf States would be "hard work." That's what he said about sending troops to Iraq and looking at the casualty reports everyday: "It's hard work." That man has never known a day of hard work in his life. The people on the ground in Covington scoffed at George's little junket to Louisiana yesterday. He stayed in the French Quarter and a Ward that weren't even damaged a bit. Malik Rahim, a new friend of ours and resident of Algiers, told us stories of the days after the hurricane. ...People were running out of food and water and they were being forced to go to the Superdome. They didn't want to go to the Superdome. Who is Cindy's "new friend" Malik Rahim? He is conventionally described as a "veteran of the Black Panther Party in New Orleans," and was recently a Green Party candidate for local office there. But the truth is somewhat worse. Rahim is a Communist. Here is a speech he gave to the Communist Manifesto conference in December 1998; it begins: I'm here on behalf of two revolutionary freedom fighters that have spent the last 26 years in solitary confinement in Angola, a state prison in Louisiana. I met these freedom fighters as a political prisoner in 1970. I was in a shoot-out with the police in New Orleans as a member of the Black Panther Party. The Communist Manifesto conference was reported on by the Workers World Party ("Workers & oppressed peoples of the world unite!"). The Workers World Party is currently the most active Communist group in the United States, in its own name and through its subsidiaries International ANSWER and the International Action Center, which is headed by former attorney general Ramsey Clark. See this critique of the Workers World Party and its affiliates by fellow far-leftists. We have commented on the Workers World Communist network here and elsewhere. As we noted in the linked post, the Workers World Party is the result of a schism following the 1956 Russian invasion of Hungary: the Workers World Party supported the invasion. Cindy Sheehan's association with these Communists is no fluke. They are among her most fervent supporters (or, perhaps, manipulators). Sheehan has announced that she will participate in a climactic anti-Iraq war protest in Washington on September 24. Who is the co-sponsor of the September 24 demonstration? International ANSWER. Who has promoted the "Camp Caseys" that have sprung up here and there? the Workers World Party. Who has a special web page devoted to "supporting Cindy Sheehan"? the International Action Center. What makes these associations doubly sick is that the International Action Center, International ANSWER and the Workers World Party were, prior to the Iraq war, staunch supporters of Saddam Hussein and his Baath regime. See, for example, this tirade by Ramsey Clark, leader of the IAC, who later volunteered to represent Saddam. Cindy Sheehan has staunchly aligned herself with the enemies of her country, even with those who murdered her own son ("freedom fighters," as she calls them, or "Minutemen" as her patron Michael Moore says). She has gone even beyond that perverse outrage: she has sought out and lent support to the very most extreme, twisted, hateful remnants of the Communist movement, and the last survivors of the Black Panthers. Cindy Sheehan is a hater: nothing more, nothing less. The question is, why is she not just a hater, but a famous hater? Obviously, because she was a mainstream media darling throughout the summer. But where are the media, now that her cover has been blown? A curtain of silence has descended. Once again, the American press accepts no accountability for misleading the American people, and it has no intention of correcting the fictitious record that it, alone, created.
Posted by LIBSARENUTS at 09/17/2005 @ 12:12pm
A liberal with some sense:
I Will Rebuild With You, Mr. President
By Donna Brazile Saturday, September 17, 2005; A21
New Orleans is my hometown. It is the place where I grew up, where my family still lives. For me, it is a place of comfort and memories. It is home.
Now my home needs your help, and the help of every American. Much of my city is still underwater. Its historical buildings have been wrecked, its famous streets turned to rivers and, worst of all, so many of its wonderful people -- including members of my own family and my neighbors -- have lost everything.
On Thursday night President Bush spoke to the nation from my city. I am not a Republican. I did not vote for George W. Bush -- in fact, I worked pretty hard against him in 2000 and 2004. But on Thursday night, after watching him speak from the heart, I could not have been prouder of the president and the plan he outlined to empower those who lost everything and to rebuild the Gulf Coast.
Bush called on every American to stand up and support the rebuilding of the region. He told us that New Orleans and the entire Gulf Coast would rise from the ruins stronger than before. He enunciated something that we all need to remember: This is America. We are not immune to tragedy here, but we are strong because of our industriousness, our ingenuity and, most important, because of our compassion for one another. We are a nation of rebuilders and a nation of givers. We do not give up in the face of tragedy, we stand up, and we reach out to help those who cannot stand up on their own.
The president called on every American to reach out to my neighbors in New Orleans and throughout the Gulf Coast. The great people of this country have already opened their hearts in the immediate aftermath of the storm, and their tremendous generosity has done more than just provide extra comfort -- it has saved lives. Now the crisis of survival is over. But the task of rebuilding remains, and the president made it clear that every single one of us has a role to play.
Each of us belongs to some group -- a church, a union or a fraternal organization, or even a book club -- that can make a difference. It is those groups that can pool resources and then reach out to their counterparts in the stricken states and ask, "What can we do?" Schools, Girl Scout troops, Rotary clubs -- this is the time for every community group to step forward to lend a helping hand. We need it.
The president also laid out the federal government's goal for rebuilding. It is unprecedented in its scope and ambition, matching destruction that is unprecedented as well. He made the challenge clear: This will be one of the biggest reconstruction projects in history. But he also made it clear that we can and will do this. New Orleans, Biloxi, all of the Gulf Coast will rise again. And the residents are ready to pitch in and do their part.
I know, maybe better than anyone, that there are times when it seems that our nation is too divided ever to heal. There are times when we feel so different from each other that we can hardly believe that we are all part of the same family. But we are one nation. We are a family. And this is what we do. When the president asked us to pitch in Thursday night, he wasn't really asking us to do anything spectacular. He was asking us to be Americans, and to do what Americans always do.
The president has set a national goal and defined a national purpose. This is something I believe with all my heart: When we are united, nothing can stop us. We will not waver, we will not tire, and we will not stop until the streets are clean, every last brick has been replaced and every last family has its home back.
Bush talked about how we bury our family and friends. We grieve and mourn. We march to a solemn song and then we rejoice and step out and form the second line. That line is now open to every American to join us in rebuilding a great region of this country. New Orleans will rise again. My hometown is down but not out, and with the help of every American, it will be back on its feet, bigger and brighter than ever.
Mr. President, I am ready for duty. I am ready to stir those old pots again. Let's roll up our sleeves and get to work.
Posted by LIBSARENUTS at 09/17/2005 @ 2:46pm
Nice pithy comment/analysis of our health care system's obsession with catastrophic circumstances, necessitating the gods of science/medicine heroically rescuing us/them, 9patch!
And yeah, anyone who hurls the terms Stalinist, Nazi, Communist, even Socialist or "Natural Born Killer" is descending to calumnious ad hominem invective and is, essentially, removing THEMSelves from the debate/argument.
Have great/healthy Saturday evenings, friends.
LAWMAN
Posted by lewwelge at 09/17/2005 @ 2:59pm
Corrupt Liberals...imagine that??!!
Louisiana Officials Indicted Before Katrina Hit # Federal audits found dubious expenditures by the state's emergency preparedness agency, which will administer FEMA hurricane aid.
By Ken Silverstein and Josh Meyer, Times Staff Writers
WASHINGTON -- Senior officials in Louisiana's emergency planning agency already were awaiting trial over allegations stemming from a federal investigation into waste, mismanagement and missing funds when Hurricane Katrina struck.
And federal auditors are still trying to track as much as $60 million in unaccounted for funds that were funneled to the state from the Federal Emergency Management Agency dating back to 1998.
The problems are particularly worrisome, federal officials said, because they involve the Louisiana Office of Homeland Security and Emergency Preparedness, the agency that will administer much of the billions in federal aid anticipated for victims of Katrina.
Earlier this week, federal Homeland Security officials announced they would send 30 investigators and auditors to the Gulf Coast to ensure relief funds were properly spent.
Details of the ongoing criminal investigations come from two reports by the inspector general's office in the U.S. Department of Homeland Security, which oversees FEMA, as well as in state audits, and interviews this week with federal and state officials.
The reports were prepared by the federal agency's field office in Denton, Texas, and cover 1998 to 2003. Improper expenditures previously identified by auditors include a parka, a briefcase and a trip to Germany.
Much of the FEMA money that was unaccounted for was sent to Louisiana under the Hazard Mitigation Grant program, intended to help states retrofit property and improve flood control facilities, for example.
The $30.4 million FEMA is demanding back was money paid into that program and others, including a program to buy out flood-prone homeowners. As much as $30 million in additional unaccounted for spending also is under review in audits that have not yet been released, according to a FEMA official.
One 2003 federal investigation of allegedly misspent funds in Ouachita Parish, a district in northern Louisiana, grew into a probe that sprawled into more than 20 other parishes.
Mark Smith, a spokesman for the Louisiana emergency office, said the agency had responded to calls for reform, and that "we now have the policy and personnel in place to ensure that past problems aren't repeated."
He said earlier problems were largely administrative mistakes, not due to corruption.
But federal officials disagreed. They said FEMA for years expressed concerns over patterns of improper management and lax oversight throughout the state agency, and said most problems had not been corrected.
They point to criminal indictments of three state workers as evidence the problem was more than management missteps. Two other state emergency officials also were identified in court documents as unindicted co-conspirators.
"The charges were made after some very extensive reviews by FEMA investigators and other authorities, who identified issues they felt were of the severity and magnitude to refer them to the U.S. attorney's office," said David Passey, the spokesman for FEMA's regional office in Texas.
Passey, while acknowledging that the state had made some administrative changes, said it had not completed the kind of overhaul FEMA said was needed.
"It concerns us a lot. We are devoted to the mission of helping people prepare for, prevent and recover from disasters and we want these federal funds -- this taxpayer money -- to be spent and used well and in accordance with the rules," he said.
Keith Ashdown of Taxpayers for Common Sense, a Washington watchdog group, said recent Louisiana history showed that FEMA "money earmarked for saving lives and homes'' was instead squandered in "a cesspool of wasteful spending."
Louisiana's emergency office receives money directly from FEMA. It passes on much of the funding to local governments that apply for assistance.
The audit reports said state operating procedures increased the likelihood of fraud and corruption going undetected.
Posted by LIBSARENUTS at 09/17/2005 @ 3:48pm
I know you will pay no attention this plea, LIBS, but I think I can write for all when I say, "please, please summarize and provide links." Your posts are way too long to be read in this format. My eyes are not old, but they want to leave my head when they spy your massive pastes. A brief summary can give us the option of reading the citation in a more reader-friendly format.
Thank you.
Posted by tjbehrens1 at 09/17/2005 @ 5:29pm
I will consider your request when I see evidence the same standard and request applies to the long driveled posts liberals frequently post on here as well
Posted by LIBSARENUTS at 09/17/2005 @ 5:47pm
9Patch:
Yes, a dichotomy already exists between insured/uninsured, but the divide is exaggerated by the very existence of HMOs/insurance companies for reasons discussed previously. Do away with those entities and prices will decrease. The dichotomy that I was mainly referring to, though, was one in which the best physicians/surgeons worked only with cash-paying patients. From my experience, when a situation such as this exists, it's not long before someone comes along talking about "levelling the playing field."
With regards to socialized medicine: I would like to know where you get your data and what countries you're referring to. I find it hard to believe that our health care costs will go down, given that it already makes up a GI-NORMOUS chunk of our expenditures, and that's just Medicaid/Medicare. And you want to add to that: the costs of ~360 million more Americans (for those of you keeping score at home, this number is a guesstimate), their hospital bills, office visits, tests, AND medicines. Where are you going to get the money for this? The costs would far exceed "taking back tax cuts for the rich."
I would hypothesize that the costs would be even higher than anticipated for yet another reason: a service/product that is "free" is the one that is most likely to be abused.
And another thing (sorry, but I'm on a roll): It stands to reason that in a system such as the one you propose, the salaries of physicians would be "controlled." Not an attractive option for someone who has racked up $100-200,000 in debt. Unless you plan on subsidizing medical school as well.
sorry so long-winded. must go now. wife getting angry. but i'll be back (JOY!)
Posted by usc1 at 09/17/2005 @ 9:16pm
.
If you thought for half a minute you would not talk such drivel. Those 45 million get into automobile accidents, have appendectomies, give birth, break their legs, suffer gun shot and knife wounds, have heart attacks, etc., etc. It happens to tens of thousands of them every day.
Are they left to die or to lie in agony outside the doors of hospitals? You know they are not. They are not without access to health care. A hospital will lose its accreditation, a physician will lose his/her license if they withhold necessary medical services because a patient hasn't insurance or a fat wallet.
We have Medicare and Medicaid in this country. Both began in 1965 as titles under the 1935 Social Security Act. Medicare insures the disabled and aged. Medicaid covers the indigent regardless of age. Unlike Medicare it is administered by the states. That is why its name varies from state to state, and also its eligibility standards. But it is not true that, "if you are $12 over, you get nada." All the programs have spend down features. If your income disqualified you you have the option of paying for your care up to the point where your remaining income or assets allow you to qualify. Moreover there is a catastrophic features which kicks in when medical bills grab a large percentage of annual income.
All that is not to say that our health care system isn't sick. The problem is hemorrhaging costs. The average per diem hospital rate was under $100 before 1965. Now the average hospital stay is four days and $16,000. In short, $4,000 per day. This skyrocketing began the moment Medicare/Medicaid entered the picture. Once the govt had its wallet out and was paying, everything from hospital sheets and paper cups to aspirins and surgical theaters shot up in price. Whatever new equipment and staff hospitals and doctors acquired could be billed to Medicare/Medicaid. The private insurers had to go along and soon were forced to raise their premiums. Today the elderly are actually spending more for medical care than they were before 1965. The govt insurances did some good but also immense harm. It created a swollen, money mad medical industry. Among other things it induced doctors to stop making house calls. The traveling was the one thing for which the govt was not paying.
Medical costs will before long be eating a third of our earnings. There is a solution to this cost hemorrhage and a way to make insurance premiums affordable. But that answer is not uncle Sam.
.
Posted by nacl at 09/17/2005 @ 10:04pm
NACL wrote:
"Once the govt had its wallet out and was paying, everything from hospital sheets and paper cups to aspirins and surgical theaters shot up in price."
Do you apply this to farmers? If you do, I say good for you for being consistent. If not, why are you for high food prices?
Posted by urmygyro at 09/17/2005 @ 10:25pm
NACL re: They are not without access to health care
That is emergency care...not normal health care. Different creature. Plus, the hospital will send a bill. Most likely a very large bill. (Even though they may not receive payment from some people.) Here's a little light reading from the Kaiser foundation on the subject. HERE [kff.org] Is is well-known fact that tens of millions of Americans are without normal and reasonable healthcare (aka uninsured).
But it is not true that, "if you are $12 over, you get nada." All the programs have spend down features.
Unless you've been there, don't think to school me on this because its crap my friend. My children remain uncovered because my income is $12/month too high and Medicare told me to piss off. Try it some time and see the miracles of modern health care in Dubya's America. And next month I get to start trying to figure out how to afford my medication (a single scrip that runs almost $200 for 30 tablets). For the past year I have been in a clinical trial and they have been buying it. Next month I am on my own.....without it, my health will no doubt suffer. But (as many Americans do) if it comes down to a choice between a prescription and rent...guess which one wins. Also, as Medicaid calculates off of the gross income...this won't alter my circumstance one bit.
Welcome to healthcare for profit where only those can pay get access to "real" healthcare.
Wake up and smell the coffee NACL. Its been this way for a while now. Health care for profit is doomed to failure because paying claims cuts on the bottom line. That is why every other industrialized nation on the planet uses a socialized system. They aren't perfect either, but they are a damn site closer than the mess we have.
Posted by leftofcenter at 09/18/2005 @ 12:13am
I have to agree with Oscar on this. LIBS never says anything original but instead is the first to post with some degrading remark or Cuts and Pastes from other websites becuase he can't make any original statements of his own.
While I enjoy reading opposing viewpoints (since that is the purpose of blogs), at least try to make them original, LIBS.
Posted by ChiroDoc at 09/18/2005 @ 01:16am
Nacl, you remain a racist parrot. And, a punkass. Nobody except your fellow punkass parrots buy your slimy "cut and paste" bullshit. Your underwear needs a scrubbing, and so do you. Get out of the barcalounger and be a real man. I suppose that is asking a bit too much. Your bad-ass image is that of a hopeless pussy.
See you around punkass.
all of my best,
Bloppy
Posted by bloppy at 09/18/2005 @ 01:39am
9Patch:
Sorry about the aborted post yesterday.
With re: to the person who doesn't want to see the doctor whether out of fear, optimism, etc--that is not an attitude or behavior that is likely to change regardless of where payment is coming from. You also did not consider the concept of HSAs with catastrophic coverage. These accounts would allow individuals to pay for those minor or preventive visits with tax-free (and therefore comparatively stronger) dollars to avoid the "catastrophe." If they do not do so, they will undoubtedly see their premiums (and possibly deductibles) go up, thus creating the incentive to seek treatment sooner rather than later (when was the last time you contacted your home-owners insurance for minor repairs? most likely, you didn't because you don't want your premiums to go up or get dropped altogether.). Most importantly, the system, IMO, would leave the decision-making and responsibility where it belongs--between the patients and doctors, themselves.
I would agree with you strongly in one area, though, and that is that our health in most cases is a result of what we do to ourselves, which is another area where HSAs are likely to help. When we are responsible for our own health care, we are more likely to take care of ourselves. The fact is, we are not guaranteed a right to health or even health care in this country, just the right to life (although I would posit that that right is no longer protected as it should be, but I digress), and thus it is up to us to take care of ourselves, not depend on the government to do it.
Posted by usc1 at 09/18/2005 @ 12:15pm
Before I forget, NACL is right about one thing and that is health care costs didn't really start ballooning until government got involved with Medicaid/Medicare. Unfortunately, it seems most on this website view the government as the solution (or worse, the only solution) instead of as part of the problem.
Posted by usc1 at 09/18/2005 @ 12:23pm
.
Medicaid has a "spend down" provision. I am not making it up. It is exists precisely for situations like yours. For a start check out this site: Heal th and Human Services Download or have them send you the precise rules that govern your state's Medicaid program. Then reapply with those rules in hand, and don't allow some ignorant clerk to brush you off.
The site I linked you too says the following half way down the page:
.
Posted by nacl at 09/18/2005 @ 2:02pm
You liberals should take a lesson from this...Liberalism & Socialism are dead and on their way to the scrapheap of history....So much for America & Bush Bashing...Didnt help your socialist bretheren Schroeder too much did it!!
Exit Poll: Germans Oust Schroeder's Party
By DAVID RISING, Associated Press Writer
Sunday, September 18, 2005
* Printable Version * Email This Article
(09-18) 10:23 PDT BERLIN, Germany (AP) --
Exit polls showed conservative challenger Angela Merkel's party leading in German parliamentary elections Sunday, but falling short of the majority she needs to form a center-right coalition even as voters ousted Chancellor Gerhard Schroeder's government.
Still, Merkel claimed her party had received a mandate from voters to form a new coalition government, and she would talk to all parties with the exception of a small left-wing group as she tried to become Germany's first female chancellor.
"What is important now is to form a stable government for the people in Germany, and we ... quite clearly have the mandate to do that," she said.
Left Party leader Oskar Lafontaine ruled out forming an alliance with Schroeder's party, shutting out the chance of an all-left coalition.
Sunday's vote centered on different visions of Germany's role in the world and how to fix its sputtering economy. Schroeder touted the country's role as a European leader and counterbalance to America, while Merkel pledged to reform the moribund economy and repair ties with Washington.
An exit poll by ZDF public television showed Merkel's Christian Democrats at 35.9 percent, considerably worse than expected and short of a majority with her preferred coalition partners, the pro-business Free Democrats, at 10.4 percent.
Her party had consistently polled above 40 percent during the campaign.
Without a majority, Merkel may be forced as chancellor into a coalition with the Social Democrats, probably without Schroeder.
Schroeder's Social Democrats were at 33.6 percent, according to ZDF.
Posted by LIBSARENUTS at 09/18/2005 @ 3:22pm
NACL
Thanks for the tip, but my state apparently doesn't feel the urge to allow "spend down" or other options. (Note the "states MAY") They also refuse to disallow non-optional payment of child support as an income adjustment. Go figure. Been there, tried that. But again, don't you see the inequity of a medical delivery system that requires such gyrations to receive care? Many folks like us juggle multiple part-time jobs and have fluctuating incomes and basically live paycheck to paycheck with no benefits of any kind. The economic power of the PT work-force is MUCH less than the FT workforce in practical terms. MOST job creation in the Bush economy is PT or contract labor....no benefits in either case.
LibsR
Progressives don't want socialism, but does that mean we can't learn from nations that have socialized health care? Health of the population IS a social good. It thus behooves the powers that be to have the most efficient health care possible for the largest number of people. That is why Germany (irrespective of who's in charge) HAS socialized health care and has had for years!
Do your homework or don't come to class!
Posted by leftofcenter at 09/18/2005 @ 5:36pm
USC1
What then would you posit as the "solution" to health care if not a single-payer / socialized structure? Please enlighten us....you do relaize though that we are the ONLY First World nation that does NOT have universal health care? Health stats-wise...we are "middlin" at best among our peers.
Posted by leftofcenter at 09/18/2005 @ 5:39pm
"Another one bites the dust, another one bites the dust, and another one gone and another one gone...."
Bye Bloppy!
Thanks NACL, LOC, USCI, 9Patch, et al, for continuing to submit thoughtful contributions.
Is it Proverbs that includes "the love of money is the root of all evil"?
I said that to a woman in an airport once and she countered,"jealosy is the root of all evil."
I've not yet synthesized these two postulates.
Thinking it healthy to think/converse though, what say ye distnguished and distinguishing participants?
LAWMAN
Posted by lewwelge at 09/18/2005 @ 7:00pm
LOC:
Thanks for asking. First, let me say that if the LA riots taught us anything, it's that "just because everyone is doing it, doesn't make it right." And with regards to "socialists" having better results--don't confuse better health care with better health. They are not the same. And while I would grant you that the latter is probably true (better health), I am not so certain about the former (better health care). I have a few European friends (granted, a small sample size), and their observations are that Europeans simply live healthier--they eat a MUCH healthier, more moderate diet and get more exercise (they walk everywhere).
As I stated before, I support the HSA/catastrophic insurance model. However, as I thought about my 12:23 post a bit more, I realized that, while Medicaid/Medicare are IMO primarily responsible for the drastic surge in health care costs (HMOs came later to add to the problem), they do not necessarily need to be eliminated. The problems as I see them are 1) reimbursement is abyssmal (30 cents on the dollar) and 2) the bureaucracy and resulting burdensome paperwork are prohibitively expensive. These could be remedied easily by having the programs pay full price just like everyone else, and streamlining the bureaucracy (OK, that one is probably not so easy) and let doctors do their job without all the "oversight", for lack of a better term. While this may seem like it would increase costs, I believe OVERALL costs would come down, since the rest of us would no longer be "making up the difference." Maybe. I am not an economist and this could all be just fuzzy math.
As I was writing this, another thought occurred to me. Insurance companies/HMOs base their reimbursement rates on those of Medicaid/Medicare. So if M/M was paying "in full" , this could force HMOs to ante up and pay their "fair share." Thus, they could still have a place in the system. Maybe.
Posted by usc1 at 09/18/2005 @ 8:52pm
USC1
Good thoughts, but I suspect in order to maintain their cash flow, HMOs and other insurance entities would pass along the disincentives to you and I.
I don't necessarily think that taking another nations model and using it is the solution either. As I have said, I think we should be able to learn from it. Because even though there is a bit of truth in the "just because everyone is doing it, doesn't make it right" , by the same token perhaps there is some right in it. After all, not all of these nations are socialist, yet they adopt social health care programs. Why? Well, let me take a wild guess. Because shortcomings aside, they tend to work. My argument is why in sam hell do we refuse the possibility that we might be able to learn from working models instead of slapping more band-aids on the failing one we have?
I have a sneaking suspicion that the insurance industry is dumping tons of cash lobbying against such thoughts *as it would entail wholesale change of that economic sector*. I am no economist either, but the ones I know (in academia) favor the social model as well - by and large.
Posted by leftofcenter at 09/18/2005 @ 10:31pm
LEW...
thanks,& keep on, keepin on!
Posted by leftofcenter at 09/18/2005 @ 10:31pm
Must go now. My wife has taken to calling herself the "Blog Widow." What a kidder. I just hope she doesn't plan on killing me during mating.
Posted by usc1 at 09/19/2005 @ 12:32am
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Which is your state? I bet that it has a - spend down - provision. The Medicaid title is a basic program with a menu of options. For example, the states may choose to include dental and or drug coverage. The feds will contribute to the cost of the dental or drug coverage, if the state pays for the balance. Eligibility standards are also a state prerogative. That causes Medicaid to vary from state to state. But none of that explains the absurd situation you describe.
Your statements are consistently ignorant, misleading and presumptuous.
Progressives are largely some shade of socialists who after the Berlin wall came down dyed their coat a different color, but everything inside remained the same. The German system is based on around 1200 non-profit insurance funds. Employers and employees (and pensioners) share the cost of the premiums. That amounts to 13% of gross income. About 11% of the population pays for its own private insurance. While someone is unemployed the federal and local govt pay the premiums.
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Posted by nacl at 09/19/2005 @ 01:51am
Why do you say Progressives are socialists?From what I've read they are Dems fed up with Dem politicians who have become frequent joiners in king George's pep rallies.It sounds like they don't like the dictatorship that's evolving and are trying to do something about it.How does that make them socialists?And I agree with whoever said if the socialists have a good idea about health care why not learn from them.We certainly can't brag about our health care in this country.I personally know of many children of working parents who only see a doctor for emergencies.They go to the health dept. for vaccinations and some broken bones have been handled at home with splints.Children of single working parents who make a few dollars too much to qualify for state aid or they are too proud to accept it but the kids are out there.We NEED a universal health plan and if it's socialist then so be it.
Posted by BusyHands at 09/19/2005 @ 04:18am
NACL
Your statements are consistently ignorant, misleading and presumptuous.
And just when we starting to talk like civilized folk...and yet you go on to describe "not-for profit" socialized healthcare in Germany. I am unsure how you can fly an insult my way and then make my argument? Oh...and for the record, Progressives believe in (wait, for it) "Progress!" Perhaps our idea of what progress is is different, but it does not invalidate our belief, just because you choose not to agree.
Again I will state, I am not advocating a specific "socialized" model for health care....just decrying our inability to learn from other nations who have managed to make working universal health care.
Posted by leftofcenter at 09/19/2005 @ 07:50am
BTW NACL --- Have you ever TRIED to go thru the Medicaid mill? I think you might find the insane gyrations, debasing treatment and redundant bullshit instructive.
Posted by leftofcenter at 09/19/2005 @ 07:54am
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I outlined the German system. I said the various insurance funds are not for profit. Don't you realize that our biggest medical insurers, like Blue Cross Blue Shield are also non profit?
Exactly: that is govt insurance, and you want it for the entire country!
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Posted by nacl at 09/19/2005 @ 11:01am
NACL
you want it for the entire country!
No...never said that, but something that works would be nice. And for the record, MANY of the Blue-Cross, Blue-Shield organizations in the US are FOR PROFIT see: HERE [consumersunion.org]
BTW: how large a % of YOUR income is spent annually on healthcare?
Personally (figuring in dental insurance, dental costs beyond, vision, and the student health plan for myself and spouse - mandatory if no other coverage...and figuring in a bit for the uncovered but generally healthy children) my expenditures are around 10% of our gross ..and that is without plan coverage for the kids. Next year, I expect it will rise if I elect to purchase my one main prescription. (Something I am dreading at a cost of ~$1900 / year and raise my medical expenses to ~$15 of our gross...for substandard coverage taking the family into account.)
Posted by leftofcenter at 09/19/2005 @ 11:42am
USC1..
I have seen the statistics for comparative health care costs and outcomes in many places. Most recently, Malcolm Gladwell wrote an excellent article in the New Yorker describing our health-care problems. http://www.newyorker.com/fact/content/articles/050829fa_fact
Here is a relevant quote:
Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world's median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations. Doctors here perform more high-end medical procedures, such as coronary angioplasties, than in other countries, but most of the wealthier Western countries have more CT scanners than the United States does, and Switzerland, Japan, Austria, and Finland all have more MRI machines per capita. Nor is our system more efficient. The United States spends more than a thousand dollars per capita per year--or close to four hundred billion dollars--on health-care-related paperwork and administration, whereas Canada, for example, spends only about three hundred dollars per capita. And, of course, every other country in the industrialized world insures all its citizens; despite those extra hundreds of billions of dollars we spend each year, we leave forty-five million people without any insurance.
At the risk of sounding pedantic, I did not propose 'socialized medicine,' just pointed out that industrialized countries with socialized medicine are healthier and pay less for health care than we do. It is obvious that countries with 'socialized medicine' are doing SOMETHING better than we are. We should analyze their systems with a clear head and find out why they are beating us. My gut feeling is that we could vastly improve our health-care system without wholesale adoption of 'socialized medicine' - but we can't do that until we correctly diagnose the problem.
On to your second post..middle class people with good health insurance already pay a relatively trivial amount for "minor or preventive visits." For example, In my health-care plan, co-pays to primary care physicians are about $15, and diagnostic tests are free. Co-pay costs can be reduced even further through our existing tax-free MSA accounts. Despite this, I STILL see co-workers putting off diagnostic tests and letting minor illnesses fester into serious infections, before they will take time off and go to a doctor. I don't believe that my co-workers are particularly unusual in this way, either. Raise the cost of these visits, and all you do is give people another reason to procrastinate -- and raise the cost of health care, as more minor problems are left to fester.
It may be possible to construct an effective, low-cost market based system for health care -- but we cannot do this unless we have a good model of how people will respond to such a sytem. This is jist of our disagreement. You believe that people treat health care like any other expense, and conventional insurance systems can be applied. I believe the that the fear of doctors, pain, and embarassment, and the desire to remain in denial about our own mortality, make the psychnology of health care spending unique. Consequently, conventional insurance systems that work well for homes or cars will not work for health insurance.
Posted by 9patch at 09/19/2005 @ 1:48pm
9patch
Bravo! More elegant than my own....and some points I missed to boot.
Posted by leftofcenter at 09/19/2005 @ 2:07pm
Is it Proverbs that includes "the love of money is the root of all evil"?
Posted by LEWWELGE 09/18/2005 @ 7:00pm
It was St. Paul who wrote:
"love of money is the root of many kinds of evil..."
1 Timothy 6:10, NIV
Posted by ILOVEPHYSICS at 09/19/2005 @ 2:20pm
MAMA MOONBAT AT IT AGAIN!!I KNOW YOU LIBERALS ARE PROUD
Visiting New York City for the first time since leaving her campsite outside President Bush's vacation ranch in Crawford, Texas, Ms. Sheehan told a packed audience in a Brooklyn church that Mrs. Clinton "knows the war is a lie" but because of her political ambitions refuses to voice any opposition.
Mrs. Clinton is "waiting for the best political moment to say" she opposes the war, Ms. Sheehan said during a 15-minute speech. "You say it or you're losing your job," she said, provoking a roar of approval from the audience. Mrs. Clinton, believed to be a possible presidential contender in 2008, has said she supports the war in Iraq and has pushed for a greater troop presence in the country.
In an interview after her speech, Ms. Sheehan said she has requested a meeting with Mrs. Clinton but has not gotten a reply. Mrs. Clinton's office was not immediately available for comment last night.
Ms. Sheehan, who has demanded a second face-to-face meeting with Mr. Bush to discuss the war, suggested that there was little the president could say at this point to appease her. She called his administration "reckless" and "insane" and said "maniacs" are running America.
She also seemed to broaden her stance against America's military presence in Iraq to an opposition to war in general, saying, "We want to make sure it never happens again." She said she was motivated not just by the grief caused by the death of her 24-year-old son Casey, a soldier killed in Baghdad in April 2004, but by an effort to save the world's children.
"The children of the world are not safe," she said. "We have to do it for them."
She also criticized the press for picking on her and said it has corrupt motives in its coverage. "If you look at who owns most of the mainstream media, they all profit off of this war. We have to stop making war profitable."
Ms. Sheehan spoke to about 300 people inside the sanctuary of the Civil War-era Lafayette Avenue Presbyterian Church, located on the corner of South Oxford Street and Lafayette Avenue in the heart of the Fort Greene neighborhood. The audience was a mixture of Brooklyn residents, anti-war protesters, and a handful of politicians, including City Council members David Yassky and Letitia James. Also in the audience was television personality Phil Donahue, who said he was "very, very impressed with this woman's courage." In an interview outside the sanctuary, he described Ms. Sheehan as a "lightening rod of an important effort to stop this immoral war." The reverend of the church, David Dyson, called Ms. Sheehan "one of the bravest women in the United States of America."
Arriving more than an hour late apparently because of traffic and bad directions, Ms. Sheehan stepped out of a white recreation vehicle and entered the church. An ecstatic audience had risen to its feet. As the Lafayette Inspirational Ensemble chanted "Ain't gonna study war no more," Ms. Sheehan sat down, crossed her legs, and slowly nodded to the choral music.
Ms. Sheehan's month-long vigil outside Mr. Bush's vacation ranch propelled her to the national stage as the symbolic face of an anti-war movement that had lost some of its force. Thousands of opponents of the war joined her at her "Camp Casey" in Texas, as did a large contingent of pro-war demonstrators who staged rallies in support of the Bush administration. As a grieving mother seeking answers, Ms. Sheehan has won sympathy from Americans who have reservations about Mr. Bush's handling of the war, but she has also alienated others, including families of other American soldiers killed in Iraq, who say a partisan political agenda has corrupted her message.
While her protest began as a simple demand to meet with the president, her criticisms of Mr. Bush have expanded beyond foreign policy. After touring parts of Louisiana last week, Ms. Sheehan wrote a letter posted on filmmaker Michael Moore's Web site in which she accused the federal government of evacuating people unnecessarily in the days after Hurricane Katrina struck the Gulf Coast. "George Bush needs to stop talking, admit the mistakes of his all around failed administration, pull our troops out of occupied New Orleans and Iraq, and excuse his self from power," she wrote.
Ms. Sheehan is to speak today at St. John the Divine in Manhattan, with much larger crowds expected to attend. Organized in part by the anti-war group United for Peace and Justice, her stop in New York is part of what is billed as "The Bring Them Home Now Tour," which concludes on September 21 when three buses traveling along regional routes converge in Washington, D.C., three days before an anti-war rally on the National Mall. Ms. Sheehan has said she plans to set up a vigil near the White House that will resemble the Crawford campsite.
Posted by LIBSARENUTS at 09/19/2005 @ 2:25pm
To USC1..
I missed this in one of your original posts..
You also did not consider the concept of HSAs with catastrophic coverage. These accounts would allow individuals to pay for those minor or preventive visits with tax-free (and therefore comparatively stronger) dollars to avoid the "catastrophe." If they do not do so, they will undoubtedly see their premiums (and possibly deductibles) go up, thus creating the incentive to seek treatment sooner rather than later.
A fraction of Americans live with this system now. Many self-employed individuals who are not eligible for a group insurance program buy individual catastrophic health insurance. They pay through the nose for it, and for all practical purposes, it covers one serious illness -- after that, the insurer drops their coverage or raises their premiums so much that they become unaffordable. I've not seen any studies exploring the diligence of these individuals in seeking out health care early-on in the disease progression, whether they purposefully live healthier lifestyles, or whether they and their families are healthier than individuals in a typical group-insurance system. Have you?
Posted by 9patch at 09/19/2005 @ 3:44pm
To LOC --
Thanks for the compliment! It does seem like we have similar thoughts in this area. This subject intrigues me, and I keep coming back to The Nation's boards hoping for some fresh progressive ideas.
Posted by 9patch at 09/19/2005 @ 3:45pm
9Patch:
Still here, but will have to respond later.
Posted by usc1 at 09/19/2005 @ 6:37pm
9Patch:
Didn't mean to accuse you of "Socialism", but I'm accustomed to others here advocating that brand of health care (well, they call it single-payer health care, which to me is little more than yet another domino in the downward spiral to socialized medicine) and you sounded like you were headed in that direction as well.
With re: to the article in New Yorker, LOC linked to it earlier in this thread and it is not exactly what I'd call unbiased information. Throughout, I kept thinking "did you take this into account, did you think of this?" For example:
"Americans spend $5,267 per capita on health care every year"--does this take into account millions spent on illegal aliens? ridiculous number of unnecessary ER visits with their high prices? vast overprescription of medications? (on that note, one main reason our medicines are so much more expensive is because we make up the costs for the socialized systems' bargaining power)
also:
"We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries."--well, is this good or bad? the article seems to present it as a negative, but I would not agree.
You will get no argument from me that our system is inefficient and overburdened with paperwork, but it seems most on this site don't acknowledge that it is precisely because of government involvement that this is happening. And now HMOs are just as bad.
Also, (as I said to LOC) when we look at these statistics, we should not confuse better health care with better health. They are two different animals. If memory serves, the citizens of the countries referenced in your quote in general live much healthier lifestyles than we do here. Moreover, the lifestyle component receives even more validation, IMO, when you look at other regions that have adopted "Westernized" diets and lifestyles and their health statistics begin to mirror our own. Two other factors that just occurred to me: many Europeans eschew medicine for more natural and OTC remedies (in my limited exposure). And were OTC remedies or just prescription meds included in that "per capita" number, as many medicines that are available here only by prescription are OTC in Europe?
Posted by usc1 at 09/19/2005 @ 11:26pm
9Patch:
When I think of Americans and their health care, it reminds me of the old Seinfeld Joke about the invention of helmets--that apparently we were engaged in activities that caused cracking of skulls. Instead of STOPPING those activities, we invented somthing to allow us to continue with our head-cracking ways.
Posted by usc1 at 09/19/2005 @ 11:34pm
9Patch:
While the above joke is funny, it's also true--Americans don't worry about their health until there is a problem, and then the assumption is that something exists that will allow them to continue with their unhealthy habits.
This is why I believe HSAs will work. When it's your money, you tend to be more responsible. Thus, people would get a financial kick in the arse to "GET THEE TO A DOCTOR" before the problem gets worse and more expensive, or to change their lifestyle as the case may be. Granted, it might take a few hard lessons, but people would eventually learn. I don't think this lesson gets learned in the HMO system, because even if the problem gets worse (and more expensive) people don't actually pay for all of it anyway (like you stated: $15 co-pay and tests are free).
The catastrophic insurance adjunct, IMO, is still viable. I just don't think its utilized in large enough numbers yet. As someone pointed out earlier (when advocating for single-payer insurance), the more people that are involved, the more risk and cost gets distributed, and the cheaper insurance gets for everyone. Same goes for catastrophic insurance, but at least you retain competitive advantage. Thus, if you have a serious illness/accident, premiums will rise, but (hopefully) not enough to force dropping coverage.
To answer your last question: I don't know of any study that researches your question (but it is a good one). I doubt it will ever get done--at least properly anyway. It would have to be such a large-scale, epidemiological undertaking as to be prohibitive.
Posted by usc1 at 09/20/2005 @ 12:12am