Discussion in 'Political Discussion' started by IcyPatriot, Aug 29, 2009.
Terry Anderson: Native Americans and the Public Option - WSJ.com
.................Don't get sick after June ............... the Indian motto.
Some of this may be a side effect on prolonged poverty, poor nutrition(usually associated with Poverty) alcohol issues and other related issues.. American Dreams Include Indians...
Not sure it is a barometer of much of anything except poor health, which probably will not be changed unless there are some lifestyle issues as well..
A better study might be the military medical care system for families, used to be called Champus...
Well the native Americans have been wards of the government longer than any other group....
Yea, they chose their plight.. what a limp dycked response that was.
The Government Can't Even Run The Government Keep The Bastards Away From Your Doctor, They'll Kill You.
They didn't choose anything, which is fo course the problem. They suffer the consequences of the government controlling their lives, As usual the point went above your head.
Why haven't Indian Reservations been abolished and the Indians integrated into society, we treat those f-cking illegal aliens better than we we do the Indians.
Where Are The Do-Gooders
Did not go over my head, comparing the plight of the Native Americans to this Public Option is piss poor at best...
What we did and how it has been perpetuated by every political administration has no comparison to mainstream society... the health problems mentioned in this study for the most part are related to lifestyle issues, poor dietary habits etc.. does not take a brain surgeon to figure out if you are obese, drink, smoke a lot you will not have a long life expectancy..
The government also provides Medicare and virtually everyone who gets Medicare dies while still on Medicare. It's just shocking.
I thought life expectancy and other health care indicators were useless? Or is that just when it supports UHC?
While I agree with your theory Darryl I also would like to mention that part of this healthcare plan is that they believe they can get people to live healthier. Well ... right now they are the care for the military and as in this thread American Indians. Last I checked they have zero influence on people living healthier ... but in the future they are factoring in that people will be healthier. Does not wash to me.
I think what we see with the military, Native Americans, medicare, people on public assistance is reflective of what the care will be. People who have the means to have better do not want to lose what they have. Specialty doctors do not want to earn less than what they earn and so on down the line.
A government that is pretty much inneficient at just about everything compared to the private sector is somehow going to do it different and better this time - I don't buy it - not for a minute. I would rather be raped by the insurance industry at least I know the rules of the game and I get what my family and I need. So I do without in other areas - I can deal with that.
We get raped by the financial industry and the medical industry because we are a capitalist society ... these clowns think they can change that ... not going to happen. Come up with a plan or two for low income, self-employed, un-employed people and pay current rates for care is what the government should do. Let people pay or not pay based on their income like the system in place for public housing. Leave those of us who are happy with the system alone.
Let's think of the expenditure per capita we're willing to assign all Americans, through their various systems of care, $7,000.
That would be about 10% less across the board. It would also be more than triple the per-capita outlay for Native Americans.
It is hard, therefore, to believe that the entirety of the poor health of Native Americans is due either to government inefficiency/ineptiture, or due to their various sins, as enumerated above.
It is a much more likely conclusion that they are chronically underserved, by a factor of 3.
If one were to lay the entirety of the health outcomes of Native Americans on one doorstep, we are responsible to adjust expenditures until that determination can be made on something approaching a level playing field.
That said: the answer to life on the Res as it currently exists is not in the perpetuation of a substandard health system for the nation as a whole.
To Icy, I have to ask, what is it about the American government that is especially inefficient and inept?
I submit to you that the French, who I've never heard of as displaying outstanding competence and industry (except when French society is evaluated by a Frenchman,) are capable of running a national health care system with better outcomes than our own system, and doing so under a single-payer system.
Now granted, what we're discussing is modified and regulated private medicine, not a single-payer system. So if it is actually the heavy hand of government that produces those better outcomes, we will not share in the benefits to as large an extent as many European countries.
But it is worth noting that something must be extremely rotten here, and not in the state of Denmark (just for example,) if the stiplulated government ineptitude and inefficiency operates there, and not here, yet we have the inferior health outcomes.
Is your contention that Americans are just so preternaturally unhealthy, that we pump more money than any nation into health care, have none of the "drag" of inefficient and inept government, and still end up with inferior health products?
Well, with the smallest government service sector of the industrialized nations, one has to wonder: what is it about the private sector that therefore has proven itself as inferior to government service, as regards the provision of health care?
Or is the French government (or German, Danish, Israeli, whatever,) so much more capable and efficient than our own, that their states yield better care than our government would?
Your response here is what I was trying to get to in our "what we distrust" thread. You are astute enough to know that you'd rather trust an industry than a government, which puts you ahead of the curve hereabouts. You at least do not assume that the industry has your best interests at heart, but are adamant that you prefer the trusted industry to the untrustworthy government.
All I want to know is why, since the evidence is all to the contrary.
One of the reasons would be that medical technology advances are the product of our capitalist system. People invest in medical technology companies because they expect a profit. There is incentive to create the latest and greatest, in part because fees can be charged for use of that equipement. So the hospital buys it based on need and the ability to create excess income from it's use. The government will want to reduce the fees for that service which will spurn investment which will spurn advances.
Our countries economic system is based partly on the advances of technology. We see this across the board in all industries. The government will effectively intrude upon this system which will have a negative effect on the economy - something that is not being discussed.
I would rather trust industry to furthur healthcare advances because they have the incentive of profit. The government cannot Constitutionally force people to purchase healthcare. So - they either must tax to fully fund it or print money to maintain it. I think Americans would be better served if the government interjects competition to the system. That will still affect investment in the industry but the financial industry will factor in the constants and move on.
If the government takes over the system the financial industry will not look upon that favorably and I think that will inhibit care as opposed to enhancing it. Was healthcare better when we were younger and our doctor was really a primary care physician - that can be debated.
But the healthcare bill will more represent care of the past than care of the future as specialists and specialty technology will decline. Also - the advances that do present themselves will become available to the 1st pay first use system.
I just do not see how you can factor out investment into the system. Already Obama's administration is trying to cut specialists income in favor of paying more to internal medicine doctors. Those doctors are fine people - but they are not specialists.
If people look at this idea from an investment angle then they will see that it is near impossible for there to be more advances in care ... they will decline unless the government futhur funds the system which they will not and/or cannot have the capacity to do.
There are reasons people from across the world come here for treatment. Investment and profits fuel those advancements and without that incentive advancements will decline as industry shifts to other endevours to reap their profits.
Okay, that's an angle I can respect.
So in a nutshell we have these simple mechanics (stipulating for this post to the omnipresent claim about the US leading the world in new discoveries/inventions/treatments/etc.):
1. We need to have investors to produce treatments at the technological cutting edge
2. Investors invest in said treatments based on a desire for profits
3. Therefore, those Pharma and Med tech companies must continue to make healthy levels of profit for the innovation to get done.
4. We know, however, that society-wide, US health care fails its people, as compared with most developed nations.
5. We know also that the American people pay more than any other nation's peoples for health care.
6. We can therefore surmise that the American people pay more, at least in part, to subsidize advanced medicine that will be the most profitable.
7. Side note: It should be remembered that very serious innovations like the MRI machine (for example), are not the only place this subsidy goes. It also goes to innovative cures such as rogane and viagra. Now, while these may improve quality of life to an extent, they are hardly the sorts of things that will show up in any sensible survey of health outcomes.
8. The benefits reaped by Americans from the procedures and products in question, of course, are not reaped solely by Americans.
So the overall picture I see developing, is a contention that not only America, but indeed the entire world, needs one long-suffering pure free-market health care system, to continue medical innovations.
Other nations, meanwhile, will continue to have longer-lived, healthier citizens, who also have access to those innovations, perhaps with some delay.
The models out there that effectively address bad health behaviors, deliver care that saves more lives, etc., are fine for countries that only want the society as a society to thrive, using whatever has already been developed or invented.
But they depend on having an America out there that can do the bold work out there on the frontier.
It strikes me that an optimal arrangement would be for us to have a system of care that delivers care, using the delivery strategies of more successful models -- yet somehow retain a way to produce medical advances.
I have heard the claim that most primary research on the innovations we care about -- new treatments and equipment -- gets done via grants to universities, independent researchers, and the corporations we feel are dependent on investors. I do not know the extent to which this is true. My gut says that the profit motive (via markets) is an important end-product from the corporation's point of view, but that government seed money gets the corporations to direct development efforts with diminished or nonexistent downside risk.
So, laying aside the current debate, what would that system look like? I see your point regarding innovation. I do not think that innovation without investment is proven to work. I do think that providing that investment to the detriment of the boring, routine business of delivering generally successful health outcomes is misguided.
So what's the answer? Let's cut through some crap and do some work. I'll stipulate that investment is necessary for advanced treatment, for the sake of this conversation, if you stipulate that said investment is recouped through higher-priced, lower-quality overall quality of care.
That's just for the sake of this conversation, mind you. I think there's a pretty good case to be made for both these starting positions. So if these are the poles of the conversation, what would get us both objectives? How could that be done?
No ambush planned. I can go back and say "no no no, investment doesn't provide those interventions," and you can go back and say, "no no no, our health outcomes are generally okay AND we have innovation."
But just for the sake of exercising our brains, what would a system that delivers the best health outcomes in the world, and preserves innovation, look like?
I think the best scenario is for the government to add competition to the health insurance industry.
- -Allow health insurers to operate beyond state borders.
- - Allow foreign health insurers to operate in the USA (will need some regulation).
- - Allow people to shop for insurance by choosing group plans.
(Think Amica - where good health would be rewarded).
- -Co-op several new insurers to inject healthy competition.
- - Allow citizens to apply for government coverage funds - health coverage welfare.
- - Make health insurance payments tax deductible up to a limit. Right now they are factored into pay so they are not taxed as wages. People's paychecks would rise pre-tax but that they are tax deductible will allow for choice.
The wealthy would enjoy better coverage under this scenario but they would pay extra taxes to receive that coverage effectively paying for the uninsured. The wealthy will pay out of pocket for better coverage anyways and the federal government does not have the power to deny this right to its citizens.
The wealthy as well as foreign $$$ flowing into the system would maintain the for profit nature of technological advances that investment companies need to market their financial baskets of investments to investors.
- -Add a small tax to foreigner use of the United States medical system.
the tax would not apply to illegal aliens that reside in this country. Not my wishes here but Obama wants funding for illegal aliens.
- - Add incentives (tax breaks) to companies producing medical technology and equipement produced 100% in the USA. Part of an effort to offset the lowering prices they may receive for their product. Also would satisfy Obama's pledge for tax reduction to American manufacturing companies.
- - Decrease ... not increase government regulation of the healthcare industry. This will also have to be done on the state level. too many laws on the books protecting health insurers from competition. We allowed financial companies to act like banks. Why not let healthcare facilities market their own brand of insurance. For instance Hasbro Childrens Hospital in Providence RI ... let them sell their own insurance to individuals (government funding welfare type insurance to the needy as before).
The Cleveland clinic model is a good start ... what if they also could sell insurance for their product. Develop a way that rewards health insurance buyers with tax incentives when they purchase healthcare through such approved clinics. health insurers would then merge with these clinics. As time went by healthcare would be more a function of these large clinics than the individual doctors and test facilities we have now.
This would integrate over time naturally and nobody would be forced out of business ... think a healthy merger environment. The clinics would not have share physical location - merely share electronic patient servicing. So a Boston Clinic could have a Martha's Vineyard satelite location(s) and so on (think like bank branches).
- - Governments on the state level will have to regulate these insurers somehow to prevent fraud as they currently do for home & auto insurance. It might take time but it's workable as it's already being done in those industries.
- - Most of all let people shop for the care they require beyond the federal/state mandated requirements. We have minimal coverage in our automobiles and our homes - minimal coverage for your body.
I'll sleep on some more for tomorrow.
Do not disagree with your premise, but the notion that things will get better if everyone is insured is a fallacy at best, not all that confident in the "public option"... my best comparison for this is lasik surgery.. which is not covered by private insurance, but remarkably the cost has gone down consistently. The same for a lot of plastic surgery as well.. the free market works, while all the insured procedures have gone up... this is anecdotal, but interesting.
A recent story, is that a couple of weeks ago I went on a Thurs. to see my podiatrist ( I have some bone spurs on my heel) and commented on how my achilles hurt, she immediately thought it was torn and ordered an x-ray... then they called for an MRI which I had 45 mintues later... the next day I was seeing an orthopedist for injections in my knee... and he gave me a plastic boot to wear for the weekend, told me to relax and referred me to a specialist... on Monday I saw the specialist, who confirmed the partial tear, and wanted me to go to PT again... after a while I realized that this was a chronic problem, and just a flair up and decided to just live with it. While very thankful for the response, care and concern, must have racked up about 5K in medical bills in less than 72 hours... always wonder if I did not have such a good ins plan, if the response would have been the same..
Yea, don't you just hate all those "Injuns stay out of our hospitals!!!!" signs you see everywhere in America!!! Really shameful.
"Someday, Agnes, everybody will find a life."
Some posters have been trying to have a serious discussion about this, and then along comes someone who is so infatuated with himself and his need to engrandize himself resulting in making a comment that is really stupid..
Does the need for attention, outweigh the need for intelligence?? Appears so.
Oh, yea, so "serious". Why so serious?
If you were "serious", you'd answer the question: "Don't you hate all the 'Injuns go home' signs you see all throughout America??"
Not hard to answer, .... if you are genuinely "serious".
Separate names with a comma.