! ? ! ?

Who should provide it (public/private/both/other)? How should it be paid for? Exceptions/exclusions?

Edited by retropump on 12/14/2009 17:07:08 MST.

I don't think this discussion should go any further. It wouldn't end in a civilized manner.

"I don't think this discussion should go any further. It wouldn't end in a civilized manner."

Could it end worse than discussing guns/global warming/religion etc...?

I ask because I don't understand the differences between different countries and ideologies/methods of funding and allocation, plus when I Google it all I come up with is advertising from health care companies.

Aside from that, it has already come up in the general backpacking forum, and I had hoped to keep that forum clear of the chaff that could evolve from having the topic come up. It seemed tangential to the OP in that particular thread!

Edited by retropump on 12/14/2009 17:00:44 MST.

"I don't think this discussion should go any further. It wouldn't end in a civilized manner."

That's a shame. Have we really lost the ability to discuss, debate and disagree in a civilized manner? If so, we're truly adrift.

Anyway, I'll give my opinion as to the original question. It's a tough one, really. I'm a big believer in personal responsibility, not enough of it going around. But for health care, I certainly like the European model: socialized health care, for lack of a better term. I also like the Oregon model, which I believe is somewhat based on some European models: health care rationing. I believe everybody should receive taxpayer supported, no cost health care. I think that's the most economical system so far. But not for everything. If you want experimental treatments, or treatments that only work in a very few, then you pay for that yourself. I know that to many rationing is a dirty word, but you can't live forever, and I shouldn't have to pay for your lack of ability to accept your imminent death. We all die.

On a grander scale, I agree with Mario Cuomo's 1984 keynote speech (one of the greatest ever given, IMO): "We believe in a single fundamental idea that describes better than most textbooks and any speech that I could write what a proper government should be: the idea of family, mutuality, the sharing of benefits and burdens for the good of all, feeling one another's pain, sharing one another's blessings -- reasonably, honestly, fairly, without respect to race, or sex, or geography, or political affiliation. We believe we must be the family of America, recognizing that at the heart of the matter we are bound one to another, that the problems of a retired school teacher in Duluth are our problems; that the future of the child in Buffalo is our future; that the struggle of a disabled man in Boston to survive and live decently is our struggle; that the hunger of a woman in Little Rock is our hunger; that the failure anywhere to provide what reasonably we might, to avoid pain, is our failure."

Aaaargh! Health care is extremely frustrating. I had insurance for 10 years, but had to give it up. 15 years ago, premiums for me, my wife, and son, went from $165 per month to $350 per month over a 6 month period. In the 10 years we had it we never filed a claim. The last time we looked, premiums were over $500 per month. Over the 15 year period, we've saved approximately $72,000 in premiums. As long as we don't have a major illness, we're money ahead. Medical bills have been minimal. My son does qualify for basic medical care under a state program.

My major complaint on health care is that you pay different amounts for the same medical service depending on whether you have insurance. For example: we took my son to the doctor for a sinus problem. When we went to pay, the bill was $50 .... until my wife started to write the check. Because we didn't have insurance, they charged $75.

Another example: My grandmother recently had to have a hip replaced. She has medicare plus supplemental insurance, so the cost was fully covered. The total amount billed Medicare and the supplemental company for the procedure....$2,900. If she had no insurance, she would have been billed $40,000 for the exact same procedure. It is absolutely ridiculous to charge over 13 times as much for the same procedure. The doctor's rationale: "We made a deal with Medicare and that's all they will pay, so we have to make up the extra wherever we can." Imagine you went to a store and bought a can of soda. The guy in front of you buys the same soda and pays $1, they then charge you $13 for the same thing. Crazy.

Hey, thanks Douglas and PelePe That's the kind of insightful commentary I was hoping for. I think we all acknowledge there is no "perfect" system. And I don't think it is too controversial to say that Americans in particular seem to get stung with outrageous basic health care costs.

I personally see nothing wrong with rationing. Spend the most money where it will do the most good overall. I watched my father die after 3 months in hospital waiting for a heart transplant. Total cost $300,000 in 1992, and that's without getting any surgery! Even at the time, as much as I loved and wanted my father to live, I thought this was way too much to spend on one person's slim chance of surviving when there are so many folks who would benefit from just visiting their GP for some antibiotics.

Oh yeah, and even back in 1992, I noticed they were charging something like $10 just to give my father two aspirin for his headache. What a racket!!!!!

Edited by retropump on 12/14/2009 17:52:20 MST.

As a former senior accountant for a non-profit health maintenance organization in the US, maybe I can offer a few insights into the US health care "system."

First, on the other thread, Lynn was wondering how the $100,000 bill for Sarah's baby would be subsidized. The answer is that her husband's employer contracts with one or more health insurance companies to cover health care cost for its employees. The rates negotiated will cover the cost of those larger bills (actually, $100K is not all that large these days), and the same premium rates apply to everyone covered by that employer. The portion paid by the employer is part of Sarah's husband's total compensation (wage and benefits) package. If a larger-than-average percentage of the firm's employees incur higher costs than would be expected for a group that size, then premium rates for the group will go up. The firm may decide it's worth the money to retain experienced employees, or it may make the employee pay a larger share of the premiums. Or it may select a health plan with less benefits (i.e., the employer is charged a higher deductible or copayment for each service).

Obviously under this system, larger employers have a far better bargaining position with the insurers than do small businesses. They also have a far larger pool of employees over which to spread the cost. That's one reason why very few small businesses furnish health insurance to their employees. And, of course, a person having to buy their own insurance (either because they work for a small business or are self-employed) has no bargaining position at all with the insurance company. Individuals also are faced with the much publicized problems of no coverage for pre-existing conditions and of having their premiums increase sharply as they grow older.

I'm not going to get into the current health care reform bills before Congress except for a couple of items. The part that puts individuals into a much larger health-care pool (in the Senate's bill, administered by the Federal Personnel Management agency) will greatly increase the bargaining effectiveness of the individual--who will now be part of a large group--in negotiating rates. The bad part is that with these individuals getting lower rates, the large groups will have to pay higher rates. We can't expect the insurance companies--including non-profit ones like the one I worked for--to operate at a loss. The large employers will probably pass this increased cost to their employees.

Left out of the "reform" packages is the large burden on hospital emergency rooms (my son-in-law is an ER physician, so I have "inside" info here, too). Many ER patients have no insurance at all, and a large proportion are undocumented immigrants who will still not have insurance under any of the proposed reform packages. By current Federal law, every ER has to treat these individuals, and already receives some subsidy (but not nearly enough to cover costs) for doing so. A lot of smaller hospitals are already closing their emergency rooms as a result. At least in some localities, this leaves the undocumented with no health care at all. The consequences to public health could be devastating.

The Oregon Health Plan (actually a variation on Medicaid, the program for those on welfare) was cited earlier as a model. Actually, it has fallen apart in recent years. Reimbursement rates are so low that most medical providers will no longer accept OHP patients. The same thing is happening with Medicare (the program for those of us over 65), where reimbursements also do not cover the cost. The Medicare Advantage program (in which the subscriber is enrolled in an HMO, and which pays said HMO a flat premium rather than fee-for-service) is the one exception (and that requires supplemental premium payments from the subscriber). That's the program all the proposed reform bills plan to cut drastically in order to pay for everyone else. That means that my HMO provider will be forced either to drop Medicare patients or to triple or quadruple our premiums.

Edited by hikinggranny on 12/15/2009 14:00:49 MST.

I'm still struggling with the claim of hospitals and doctors that lower medicaid and medicare payments do not cover costs when we pay so much more in the US than in other countries. e.g.






Data source International Federation of Health Plans, an association of insurance plans in different countries.

If were ever going to get control of health care costs in the US these numbers need to change.

Edited by nschmald on 12/15/2009 14:09:55 MST.

Nia,

Because EVERYTHING to do with healthcare in the US is more expensive- including the operating costs of the hospitals and doctors. For just one example, all those to-one-degree-or-another socialized countries on your charts don't have NEARLY the malpractice premiums we do in the US.

There are things Medicare doesn't totally suck at, and there are things it does absolutely horribly. One thing it does horribly is paying for almost any surgical procedure. If you bill only Medicare for any procedure, yes, you are taking a loss. A cardiothoracic surgeon makes less money for a quadruple bypass that takes him all day than a plastic surgeon gets for an augmentation mammoplasty that uses 1/8th of his OR time for the day- because it ain't Medicare paying for the mam aug! I would get reimbursed better for my patient's postop pain management than for his cholecystectomy. (Though I'm currently salaried, so I don't bill- my hospital does.) One learns to code stuff that arguably isn't relevent for one's postop patients- like including their hypertension in the list of things you treated while they were in the hospital, despite the fact that you merely kept them on their usual outpatient medications.

I mean- consider that Mediare's policy is to REDUCE its reimbursement rates for everything periodically. Not increase them, mind you, as if to account for inflation, etc. They reduce them regularly. Logically, eventually that policy must fail. Because, eventually, no doctor will accept Medicare. Unless the government makes it mandatory, at which point medical school enrollments will disappear. Heck, cardiothoracic and trauma fellowships can't fill all their slots NOW! Nobody wants to take that abuse and get paid crap for it.

And, yes, Medicare won't pay one more cent than their "official" reimbursement rates, and they are notoriously miserly and find every possible opportunity to short you, so why bother billing it? All that does is result in the patient getting the excess bill- which will then go into arrears and get sold to a collection agency, and pretty soon Katie Couric will be talking about the heartless hospitals, et., etc. But if you have reasonable insurance then, yes, the hospital will bill the full price- because they have a reasonable chance of actually getting reimbursed, unlike with Medicare. (The average reimbursement rate in the US is something like 33% at the moment. So there's no point in quoting these outrageous bills- they aren't getting paid, anyway. Which should tell you that if the system WORKED CORRECTLY the average bill would be about 1/4 of those outrageous ones.) And, yes, those losses from taking care of Medicare patients DO get passed on to everyone else. That should enrage you- and motivate you to lobby for fixing Medicare. But either way you're going to pay for it- either in your bills as now, or in higher taxes to fund Medicare. So what's the use in complaining? The solution is to fix the things making everything so expensive- not complaining about how reimbursements work. :o)

Personally, I also find the lobbying power of the pharmaceutical and insurance industries rather repugnant. I would like to see political contributions limited to $500 or some other reasonable arbitrary sum per person per candidate per annum. (Recall that corporations are legally people.) I would also specify that a majority-owned subsidiary does NOT get another $500 to give away. That way the rich and the corporations don't get much more say than I do.

Mary is 100% correct that ERs get used like primary care clinics by the uninsured, and that the insured underwrite it. So all of the conservative whining about how they don't want illegal immigrants covered in any public healthcare plan are idiotic. We will all pay for those uninsured illegals anyway. (But it looks good to their equally irrational constituents when they make a show of it. Yet accomplishes nothing.) Further, because of this ERs are simply overwhelmed right now- which leads to complaints about long wait times, etc. Bummer. Solution? Fix the insurance problem.

I also agree that there are large inefficiencies in the US system. But that's sort of what you have to accept with such a distributed system, with so much freedom of choice on the part of the patients. If you don't like it, vote in socialized medicine. I won't argue.

Predictably, I also back malpractice tort reform. The problem is, I will admit, that I have no better idea how to fix it than anyone else does. Patients do need to be able to seek redress through the courts when they've been hurt and have a valid case- but too many are frivolous, or are just a case of trying to blame someone when something bad happens even if no one is at fault. There was a study that showed that the only variable affecting malpractice awards in the US was how badly the plaintiff was hurt. NOT whether it was actually the healthcare provider's fault. I guess juries just think "that poor guy needs SOMETHING, and the only people he can get the money from is the doctor/hospital/etc."

Thus US healthcare providers unequivicollay DO practice defensive medicine, for fear of lawsuits. A good example- even if I am quite certain that I have diagnosed someone correctly, but there is a very low chance something else may be going on and I can rule that out with a CAT scan, I get the CAT scan. Because GOD HELP ME if that happens to be the one time the weird thing is going on. I'd loose everything. And the patient pays for that, as do you all when the patient can't pay the bill and the cost gets foisted off on you.

Is it worth it to spend $400 on abdominal CAT scans to find that 1/10000 thing that might hurt a patient? $4,000,000 to save one guy, and keep me from getting sued into poverty? (Or, keep my premiums down...)

It is to me.

Are their doctors and hospitals who order CAT scans because they own the scanner, and make money off of it? I am certain there are. But I imagine that there are also doctors who are practicing defensive medicine, and figured that if they were ordering all those scans that they may as well make a buck off of it, and bought their own scanner. Don't kid yourself- it is easy to attack doctors. In some ways we are easier targets than lawyers. But most of us DID get into medicine for altruistic reasons.

Anyway- these are the difficult decisions any healthcare plan must make. If you don't want to pay that $4 million, then protect me from the lawyers. Otherwise, stop whining. :o)

End rant.

Edited by acrosome on 12/15/2009 15:04:44 MST.

Thanks for a wonderful post Mary! Information is a wonderful thing.

I wasn't aware that the Oregon plan was suffering so much now. I still agree with the overall concept, that some kind of rationing is necessary. As Steven Wright once said,"You can't have everything. Where would you put it?"

I think as long as medical doctors are asked to swear an oath that includes something like:
"I will treat without exception all who seek my ministrations"
Then there needs to be a way to pay the doctors.

I also think that there should be a basic level of care provided for in the cheapest insurance plan but people should be able to get more/better care by buying a more expensive policy and/or paying the difference directly. I suppose that's "rationing".

Who should pay for it? Everyone who is covered.
How? Either directly, through their employment, or through taxes.

Edited by jimqpublic on 12/15/2009 14:58:30 MST.

Not to get off topic, but aren't CAT Scans recently in the news for causing cancer? How do you defend against that?

But I don't have to defend against it. It is a known risk, and I tell all those patients about that risk, and that the thing I'm trying to rule out is rare, and that it isn't unreasonable to forgo the scan, and if they refuse the CAT scan that is their right and then I'm still covered about the lawsuit. (Frankly this is what I'm usually hoping for, and is very common.)

The point of that paper- which all the media are leaving out- was that well people shouldn't be paying out of pocket for whole-body CAT scans, the way some are. That the risks outweigh the benefits. They were trying to make the point that the larger the area scanned, the greater the radiation dose. I mean, anyone who didn't already know that increasing radiation exposure increases cancer risk is a moron. Duh. This is just a study that the media have decided to sensationalize, in the interests of selling papers and ad time. (But an abdominal CAT scan nowadays gives you less radiation than a chest xray did fifty years ago.) I don't even know if it is a good study or not- it just came out in the last issue of Arch Int Med. If it is, then yes, that is good information to know. I'll wait for peer review before I panic.

I Suppose I'll have to go look it up, now...

But the CAT scan thing was just an example- getting superfluous lab tests is even more widespread. So is sending a patient to a specialist even when you already know what's going on, just to cover your butt. (As a specialist, I get to experience this daily.) Etc.

Heck, every quarter or so I have to get a CAT scan on a PREGNANT woman. You want to talk about radiation risks, try selling THAT one to a patient! But it's the right thing to do. Risks are small, for one study during pregnancy. Even ACOG says to get any one imaging study you want (except fluoroscopy) if you need to, even in first trimester- it's the difference in lifetime leukemia risks for the baby changing from 1/3000 to 1/2000. Significant? Heck, yes! But better than the abortion rate from a ruptured appendix (>30%).

Sometimes you just have to make a hard call, Brother.

Edited by acrosome on 12/15/2009 15:45:27 MST.

Dean don't get me wrong. I'm not attacking doctors. I believe in capitalism and charging what ever the market will bare. I also believe that most doctors, at least all the ones I have met, are sincerely trying to do the best they can for their patients.

I should have addressed malpractice in my first post because it was inevitably coming. From what I can tell the AMA places the cost of our malpractice system at about 10% of total cost. Lawyers predictably say it is much less, about 1%.

The AMAs cost estimate includes defensive medicine. While I agree that many/most doctors practice socialized medicine I think this has more to do with patient desires/demands than worries about getting sued. The recent outcry concerning mammograms for women under 50 is a perfect example. A panel of doctors examining the data suggested that women might be more likely to suffer harm from a false positive than benefit from early detection. The response has resulted in mammograms on demand being added as a right to the health care bills.

But back to malpractice costs, either end of the range only explains a small fraction of the cost difference between us and the "commies".

I don't understand your comments about medicare. The charts I linked show that medicare while paying less than the rest of us still pays significantly more than the other countries sited for every procedure. You mention bypass surgery, where medicare pays 2x vs the others and the rest of us pay 10x more.

Your's and Mary's comments about emergency rooms are well taken. We require doctors both legally and morally to save peoples lives even if they won't be payed for it. I think virtually every doctor agrees with this moral responsibility. That IS socialized medicine. Providing the social safety net in emergency rooms is the most expensive socialized medicine in the world. Seems like we should be doing it smarter and cheaper.

It's good to have input from those in the firing line, but still no one seems to have any solid actionable ideas of how to fix things.

"First, on the other thread, Lynn was wondering how the $100,000 bill for Sarah's baby would be subsidized."

I wasn't really wondering...I know. But to me, the private employment insurance system works just like a social system, it's just applied to a smaller group than a whole nation. The employer pays. Either way, Sarah's healthcare is subsidised by other's labour and money. I don't feel she had the right to lambast someone who uses a free clinic because they don't have private insurance. OTOH, if she bragged that her pregnancy was gonna cost $100K, and she was paying entirely out of her own savings, then perhaps she would be entitled to take the moral high ground.

It is surprising to those of us outside the US that America is the last of the developed countries to adopt a semi-socialised medical care system. Everyone should be entitled to basic preventative and treatment based health care. Like here: you need a new hip? OK, you will be triaged and those that need a new hip the most will go to the top of the list. If you are far down the waiting list but don't want to wait, well you can pay out of your own pocket or buy private insurance to cover it.

And mal-practice litigation is just that...mal-practice. It's a bad practice and doesn't distinguish between doctors who are negligent or criminal versus good doctors who make a plain old human mistake or over sight (or don't order every test on earth to cover their buts). In NZ, these types of human error are called "accidents", and so are covered under our no-blame national accident compensation scheme. Yup, the taxpayer pays, not the doctor. It sure does hack the lawyers off, but helps keep health care costs down. Most docs are good people. They don't deserve to be sued!!

" I think virtually every doctor agrees with this moral responsibility."

While the following is an outlier, and I'm certainly not attacking doctors or hospitals or mom or apple pie (but maybe hugging, sorry Dean), I do remember some expose not too long ago where a hospital (California if memory serves) that was putting indigents into cars and dropping them off on the street instead of treating them. Horrendous.

I think, though, that that points more to the severe financial crunch many hospitals are in these days. Still, horrendous. And I doubt it's an isolated incident. So while we may 'require' emergency rooms to treat, that doesn't mean it's always happening.

Another thing that jacks up the cost of US health care is insurance billing. Find out how many people your medical or dental group hires just to keep track of the different benefits from different companies and to bill the companies. There are two of them in my dentist's office which is a two-dentist practice--in other words, one insurance billing clerk per dentist! This is where a single-payer system would be far more efficient, but don't hold your breath waiting for that to happen!

Another thing, as I understand it (someone please correct me if I'm wrong) that adds to our (American's) cost of healthcare is that in other countries, the educational cost of becoming a doctor is partially underwritten, while here a new doc can graduate with up to $100,000 in college debt. They've got to pay that huge sum off somehow.

Does anyone on the inside know, what percentage of a drug's costs go to cover specifying the shape, coating, color, and packaging of a drug ?

I'm curious.

"Does anyone on the inside know, what percentage of a drug's costs go to cover specifying the shape, coating, color, and packaging of a drug ?"

Don't know, but I'm sure it's a tiny fraction of the costs of discovery, patenting, development, testing, marketing and profit margin.

I imagine it would cost about the same as a box of
Skittles.

"I imagine it would cost about the same as a box of
Skittles."

Funny thing is, if you put some skittles in a prescription medicine container and tell someone it will cure their depression if they take it three times per day, it does!

Lynn, thanks for having the courage and decency to continue this topic over here. While I wish we could all join hands and hit the trail and hike into the sunset, that's not going to solve a thing. This perhaps explains the abysmal performance of our US Senate. We have become complacent in America. In the meantime we have let a small majority of multimillion dollar corporations run away with the keys to our democracy. The do-nothing house/senate has managed to pick apart this healthcare reform bill, making sure all of their "donors" are placated. Lieberman and Co. should be ashamed of themselves.

TR Reid wrote an excellent book on the topic of health care systems around the world: The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. I listened to an interview w/ him on the radio and he outlined the differences rather well.

To all who pointed out the negotiating power of insurance companies, kudos. I don't think many people realize that just because you have insurance, doesn't mean you will pay the same for your healthcare as your insured neighbor. Why in the world would any compassionate human argue against the premise of every working American having the same healthcare? I'm afraid that so many people are stuck in their "ME Bubble" that they fail to acknowledge the plight of their neighbor. Every dollar made in a capitalist system comes at the expense of someone/something else. While, some think that we can create money indefinitely, the fact is that there is a limited amount of resources available. Unfortunately, greed kicks in and people are willing to conceive of all kind of reasons why they are entitled and you "need to pull yourselves up by the bootstraps". For-Profit healthcare will never end well for anyone, but those on top. My wife worked for a small company years ago. The owner was frustrated by the number of "sick" people in his pool and sought out cheaper healthcare. Unfortunately, my wife is a cancer survivor and pretty much gets walked on by any insurance that she applies for. This situation was no different. We spent many angry nights around the table discussing how she was going to get healthcare or even afford the cut-rate policy her employer had pursued. Ultimately, the healthcare she received was adequate, but the process was agonizing and no one should ever have to contend w/ that. Sadly, we have dealt w/ a similar situation w/ her present company who had a bad year and laid a bunch of people off, cut the 401k match, and gave no raises. They also decided to change insurance providers and downgrade to smaller insurer(read: less bargaining power in the market, more expense for policy holders).

Before you judge others, consider that their shoes might be a bit different than yours and that you might want to take few steps down their path first.

As for those who work temporarily and "don't contribute". I'd argue that everyone buys food and basic necessities, thereby contributing to the tax base somehow.

"As for those who work temporarily and "don't contribute". I'd argue that everyone buys food and basic necessities, thereby contributing to the tax base somehow."

Certainly everyone consumes food and other basics, but often that is supplied by government or charity organisations. It doesn't negate the fact that, as consumers, they ARE supporting and creating jobs, and thus in a small way generating more tax. But even if they don't 'contribute' economically to society, it is not a good enough reason IMHO to deny them health care.

If your direct economic contribution to society was the only thing that determined your access to health care, then most people under 18 years should not get health care, as they are more of a burden than a contributor to society...

Lynn, I agree that denial of healthcare based on arbitrary numbers, etc. is foolhardy. A sick pool of citizens ultimately leads to a negative impact on the economy, which "trickles down(up)" to everyone. Isn't it twisted how every discussion here leads back to some economic/money principle?

There was a commentary by a young college student on NPR this morning. She had lost her children's healthcare administered by the state until you're 19. She was now working at a fastfood restaurant while she attended college. Yes she was bettering herself w/ education and yet she had no healthcare, so when a toothache forced her in to the ER, she acquired a nice stack of bills. Is this how we want to treat each other AMerica? No public option = handout to big insurance.

Over on the other thread, they are still beating the dead horse, even though the topic moved over here. I will comment here though. To the proponents of no public option who say competition is the key: Denmark(I believe) has a public plan that allows consumers to pick their hospital, clinic, etc. Therefore the competition is among the hospitals and doctors for who can provide the best care, not the suits behind a desk at some HMO/PPO who can only function behind a spreadsheet.

"No public option = handout to big insurance."

the public option IS a handout to insurance. I FORCES by coercion, healthy people to pay into the system to assure a profit. In other words they need healthy people to pay into the system and not use it to pay for the people who don't take care of themselves.
What we need is a free market and allow insurance to be sold over state lines and allow healthy people to form insurance co-ops where premiums will be low but they will be covered when unexpected accidents/disease happen. People who take care of them selves should be like people who have good credit- they get a better deal. People who could give a d@mn about their health should have have to pay for it, not force me to. We would not have a health crisis now if the Gov didn't tell people its ok to eat junk 'in moderation" what ever that means,and we would not have a health crisis if the Gov didn't tax subsidize sugar,grains,fructose and factory farmed beef making these harmful foods artificially cheap over local veggies and pastured beef.

"People who could give a d@mn about their health should have have to pay for it, not force me to."

Right on Brian. I am not my brother's keeper and do not want to be forced to pay for others. I don't like the gov't re-distributing my income. I work hard for me, and for me alone.

I think that's a kinda sad attitude...
...but I can at least commend you for being honest about it.


Actually, very sad.

Edited by xnomanx on 12/17/2009 09:34:36 MST.

"People who could give a d@mn about their health should have have to pay for it, not force me to."

Wow, Brian....THANK YOU!

I, and my family, help many in need. I prefer to CHOOSE how and when, not be FORCED to do it someone else's way.

Americans are forced to subsidize industry.
We're forced to subsidize corporations.
Forced to subsidize farms and agribusiness.
We're forced (indirectly) to subsidize the destruction of our own environment, as well as our own bodies.
Forced to subsidize a military and national war efforts.
We're forced to subsidize banks.
We're forced to subsidize quite a bit of waste.

Yet as soon as our money starts getting spent on another human being, American citizen or not, the lips curl back, the claws come and, and everyone is snarling.

Sad.
Very, very sad.

It also misses the reality of modern living. I think most on this site take advantage of things paid in part by others. Roads, police, fire fighters, national defense etc. are all part of the commons that we enjoy. This internet thing that we're using now is government funded. Not too mention public education, which gives every one a fair shot at being able to take care of themselves.

The fundamental fact is that the health care market is broken. The supply and demand curve doesn't work. No matter how high the price goes I still don't want to die if I get sick. This is what's taking place in the insurance and provider market. There is essentially no check on skyrocketing prices. No option at all for those with preexisting conditions.

Once this happens and the free market breaks down like it has, we as a community have two choices. We can say it's not my problem and let them die. Or we decide we need to fix the problem so that every one can afford to pay for health care and do it in a away that doesn't break the budget.

Edited by nschmald on 12/17/2009 10:29:07 MST.

Very, very sad.,

I am against all the things you list.
The Gov gives us the disease and then people applaud when they try to sell us the cure?

We are taxed to subsidize junk food so the population is disease ridden, Then we are taxed to subsidize big Pharma to sell expensive band aids. Now we are being taxed to pay for the pills and pay for the insurance. I want out of this socialist nightmare! I want a Gov representing the public interest not protecting big business from legitimate competition.
Insurance is for covering an unlikely but possible tragedy. The US population is experiencing an epidemic of preventable nutritionally caused disease. All for profit. I don't want to be part of it.

Brian, god help ya' brother when genetics come back to bite ya' in the @ss. Some folks are going to get bitten no matter how healthy of a lifestyle they live. You gonna say Lance Armstrong grew up on junk food and gov't subsidized food? Man still almost died of cancer though. I'll gladly join your fight to stop subsidizing big corn/soybean/meat production and putting real food in the mouths of the poor. However, we gotta clean up the mess first. We broke it. Yeah, you and I voted for the politicians that pull this shat on us.

>> I don't understand your comments about medicare. The charts I linked show that medicare while paying less than the rest of us still pays significantly more than the other countries

And I don't understand how the fact that medical overhead in the US is much higher escapes you. So we're even. Malpractice is higher; drug costs are higher; you underwrite all the uninsured as well in our jacked up system- which is just plain inefficient; etc. Obviously, though, profit does figure into it. That's not what I was saying. That's a basic difference between "for-profit" medical care and "socialized" medical care, after all. Duh. But it isn't the overwhelming factor that many people believe.

Also, I acknowledged that Medicare does some things acceptably well. However, paying for surgical procedures is not one of them. A final point- my example of how much the doctors get paid for bypasses versus mam augs was exactly that- how much the DOCTORS get paid. I admittedly can't speak intelligently about what the hospitals bill. I'm not an administrator. :o)

I've read a bit about no-fault malpractice, too. I had heard that's now the Kiwis do it, and it does sound interesting- sort of like how workers' comp works here in the US. But the ABA would fight it tooth and nail. (The ABA is the single biggest political contributor in the United States, by the way...)

DO NOT think that I'm talking out of my butt about malpractice suits and the ABA. If you want to find ulterior financial motives in this system , look no further. (And, yes, big pharma, too. I'm no friend of Pfizer.) The US has more lawyers per capita than any other nation on Earth, by a LARGE margin. In fact IIRC it's by almost an order of magnitude.

I live in fear of lawyers. That's no way to practice medicine.

Point of fact- My wife is a lawyer, so don't go thinking I'm just engaging in populist lawyer-bashing, here. But I do think that "bad" lawyers are a big factor in THIS instance.

While I am a capitalist, I have my limits, and medical care is probably one of them. I will tell you that as a doctor I find it repugnant that there are children in this country using ERs as their primary care. We can come up with a better system, and one that's more affordable. Screw the insurance companies. (While we're at it, screw the banks and the credit bureaus, too. These are the three parasitic institutions that I will happily screw at any opportunity.)

And don't think that I don't have my concerns about the "public option." I certainly do. One need only look at the problems the UK had (and indeed still has) to see some of the things that TERRIFY we violently individualistic Americans. But we can find something that works, surely...

That said, the point made by a couple of other posters is a great one- if, for instance, you smoke, I'd be all for you paying much higher taxes into any socialized medicine scheme. Go for it. It might encourage the fools to quit. Or have the program only pay 5% of the cost of treating their lung cancer (since only 5% of lung cancer is sporadic- all the rest are caused by tobacco), and I suppose logically you could expand that to their heart attacks, peripheral vascular disease, strokes, hidradenitis suppurativa, impotence, emphysema, etc. Appropriate ratios would apply to all of the other cancers for which smoking increases the risk- breast, uterine, colon, pancreatic, etc., etc., etc. Bill them the rest. Better yet, outlaw tobacco. Talk about a product with no redeeming qualities, and which if used EXACTLY as intended threatens the user's life... Duh.

We should also limit alcohol purchases to one liter a month, and there should be a 10-day waiting period. :o)

I'll also +1 ending the agricultural subsidies, particularly sugar, grain, and stock. Part of this is the capitalist in me- if they can't compete let them die- but more is just that it is idiotic to enrich these producers at the expense of public health. Heck, I support the taxes that people are proposing for processed drinks that add sugar. Soda-pop does NOT need to be cheap, and such a tax would in NO WAY harm the poor, as the anti-tax nuts keep claiming. If anything they would just buy healthier drinks. Heck, I would propose that they are better off drinking water, if it comes to it. The poor in the US have the worst obesity problems, becasue the cheap food is the LEAST HEALTHY- due to subsidies.

But, again, big lobbies...

Edited by acrosome on 12/17/2009 12:04:23 MST.

We don't have a heath care crisis because every ones genetics came back and bit them in the a@@. Childhood diabetes? Obesity? Autism? colon cancer, lung cancer? Mostly preventable public health problems caused my public subsidies. Lets fix this first. Its more compassionate to cure and prevent these diseases then just treat them and ignore the cause.
And good health right back at ya...

Brian, when you said you where against it where you referring to my post? Do you oppose all these things that the government has funded?

Roads
Police
Fire Fighters
Emergency Responders
National Defense
Public Education

Yeah the subsidies for sugar and corn and agribusiness in general are disgusting. The decisions of democrats and republicans to allow bankers to destroy the global economy while simultaneously enriching themselves is disgusting.

But the libertarian position that says I can take care of myself, usually misses the point that I can take care of myself except for the things I need government to do. Peoples circumstances are different and so are their needs.

Some people can afford to pay for their own health care. Some people can't. Some times this has to do with the choices they made. And some times it does not.

I strongly believe that people should do for themselves and their families to the greatest extent possible. Any effective and sustainable method to reform health care system must demand this.

But I also strongly believe that the ability to live, to be healthy and have a chance to be productive when they cannot do so for themselves, is not simply a matter of charity but a right. The right to life. I believe that government must protect that right.

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men deriving their just powers from the consent of the governed"

No, I was referring to the different banks and industries we are forced to subsidize.
Iam pretty Libertarian but, that dosen't mean I m against all things public. Im saying that private industry can do a better job and we don't need to let gov intrude on our life even more. It has to cost billions if not trillions to do so.
the problem is laws, like not allowing insurance to sell over state lines- that protect companies at the expense of the public/consumer. I believe in intelligent regulation and fair market forces- we have neither.
Of coarse not everyone is Libertarian or capitalist and won't agree.
OH. I should add, that the reason I really detest the public option is that it is just using the gov. to force citizen to patronize private businesses that are also protected from the free market competition. It is not really that "public". Open up the market, put in intelligent regulations and it will work itself out.

Edited by MAYNARD76 on 12/17/2009 11:39:06 MST.

Governments do many things badly, but they also do many good things, as Nia points out. Just because the US government had chosen to subsidise unhealthful practices (both economic and personal health) is not an argument that we should let those affected by these bad decisions just rot by the wayside.

"The US population is experiencing an epidemic of preventable nutritionally caused disease. All for profit."

Undeniably.

"I don't want to be part of it."

Then maybe you should immigrate, or stop paid employment and live off a barter system? Or be part of the solution. After all, a good healthcare system focuses on prevention rather than cure. Good doctors all over the developed world are now handing out green prescriptions. Instead of berating and neglecting those who are less fortunate, or who didn't make the same enlightened choices as you, you could become a personal trainer, or a dietician/nutritionist, or just a motivator. Health, education and welfare are the cornerstones of a decent and happy society. Good nutrition is at the heart of all three.

Its a false choice to say leave home or socialize health care!
I will berate "some" people who let their health go. I know sooo many drug users and people who know that what they eat is crap-and they don't care. Its not about being enlightened- they KNOW!
I'm a big believer in charity too, but the government doesn't do charity, people do.

"Im saying that private industry can do a better job...."

Having worked for private industry, I can tell you that it can be just as bureaucratic and inefficient as the government! As far as I could tell, cutting cost simply meant cutting positions and forcing the rest of us (at least the professionals) to work even longer weeks (like 100 hours instead of 70). That doesn't mean, of course, that government would be any more efficient! Just one person's opinion, here.

Sorry Lynn- I know we've butted heads over the obesity thing, before. (Haven't we ???)

People smoke because they want to- no other reason. Some are actually very asinine about it. Yes, it is an addiction- but we DO in fact have excellent smoking cessation programs in this country. Addictions are always beaten by anyone who really wants to do so. Considering how monumental a drain treating these people is, I have no problem making them pay more into a healthcare program, be it public OR private. Certainly I don't want to pay for their bad behavior.

Problems that people have no control over are an entirely different story. That's the whole point of distributed risk, after all. That's rational. A person with a history of brain cancer should not be denied coverage or charged more. Because, heck, I might be the next guy with brain cancer.

I will NOT be the next guy with tobacco-induced lung cancer. Or needing a fem-pop. Or sucking on a butt while wheeling my O2 cannister into the hospital. Or getting a penile prosthesis.

I have little tolerance for smokers who spout off about their "right" to smoke. Sure, it's a "right." But you're a fool. And you have no right to endanger ME with secondhand smoke in any way. (But, well, that's a different issue...) Certainly, you have no right to bill me (per se) for the consequences of your asinine choices.

Obesity is a tougher one, however. Like smokers, almost all obese people are obese because they want to be. I don't really mean that literally- I'm being a touch metaphorical, here. But they enjoy over-eating more than they dislike the negatives of obesity, or simply lack the willpower to do anything about it. With enough willpower almost all of them could loose the weight, simply by eating less. It's uncomfortable, yes, but it works. I lost 15 pounds in one month, once. But how do you define who are in that small minority of exceptions? That would be VERY tough. Certainly someone with documented hypoparathyroidism should be covered, but what about someone with an injury that precludes exercise? Yes, they could still loose weight with calorie restriction, but it would be orders of magnitude harder. And THEN what if they can't exercise because they are a double-amputee from their PVD from smoking???? Gets complicated, doesn't it?

And, again, I could stand to lose a few pounds. I'm not being populist, here. Lord knows, I break down every once in a while and order pizza, too. But I have done bariatric surgeries, and done the workups, and I'm right about almost all obesity being a choice (or sheer laziness).

Another one that is sticky is diabetes. Someone who simply refuses to manage their diabetes is also a fool who is incurring higher healthcare costs that I am underwriting. (And, yes, some simply refuse to do it- no reason other than that it annoys them.) And, again, it is their right to refuse treatment- but then should I pay the financial consequenses of their amputations, retinal disease, strokes, heart attacks, impotence, and peripheral vascular disease?
But the diabetes itself isn't really their fault. So how can you penalize them?

THEN you get into the sticky issue of vaccinations. I personally- emotionally- think that anyone who doesn't vaccinate their child is committing abuse. AND they are risking everyone else's children, hoping to benefit without risk from the herd immunity that those other children got by accepting the fantastically small risk of the vaccination. (Especially compared to what polio does to you. I mean- have these people LOOKED at the statistics from the 19th century ???) But can you really penalize that? I'm not sure. The parents are fools, but they have a right to be. Then agian, maybe we CAN just bill them for their kid's iron lung. I'm still divided. The KID, on the other hand, is blameles and shouldn't be penalized.

By the way- I use the words "fool" and "foolish" a lot. I am very careful with it. Even intelligent people can behave foolishly- so I'm not questioning anyone's intelligence, here. Please bear that in mind before flaming... :o)

Edited by acrosome on 12/17/2009 12:19:49 MST.

You know, I THINK I could be convinced to support a public option if it was done real well.
Like for instance- I could see paying for serious surgery/treatments for diseases that are out of peoples control.
But we could make things that are the fault of the individuals decisions more of their own burden. Or require that people get extra insurance if they participate in high risk activities like drugs or eating pudding all day.
This way instead of forcing people to patronize insurance company X we would have a municipal heath care center. This strangely doesn't seem like a bad idea. I don't see this on any bill though! And it could be paid for partially by ending subsidies to big Pharma and big Agra.
This way I don't feel like Im being robed by people who didn't care about their health because they pay more and I get insurance as well.

""Im saying that private industry can do a better job....""

Well it SHOULD, considering how much more it costs Americans to get healthcare.

"Its a false choice to say leave home or socialize health care!"

I dunno. My father always said "if you don't like, it's a free country and you are free to leave". As Dean points out, by purchasing private insurance you are already subsidising those who don't, so why not make it more transparent and less stigmatising to those in need?

Anyway, I can see it's a typically useless use of words, as someone who strongly believes in each man for himself is not going to be swayed.

"I know sooo many drug users and people who know that what they eat is crap-and they don't care. Its not about being enlightened- they KNOW!"

Although absolutely true, I would rather subsidise, eg, methadone programs and needle exchange programs for heroin addicts than have them on the streets spreading disease and stealing for a fix. Any country where they've done the maths can show you this is a cost effective health and social intervention. Some of them even go on to have real jobs paying real taxes. It benefits us all, whether we disapprove or condone their choices.

Ditto smoking. I'm assuming it's the same in America as here, where cigarettes are taxed so heavily that they actually subsidise other health care. Take $5-$10 every day in cigarette taxes from an adult who will not likely need major medical attention for their habit until they are much older. That money accrues to the point that smokers are profitable even taking out their end of life health costs. Do I condone the behavior? Heck no. Is it a good excuse to deny them health care? Heck no.

>> I dunno. My father always said "if you don't like, it's a free country and you are free to leave".

And if you don't like something you are also free to campaign to change it, Lynn. The "if you don't like it- leave" argument is indeed an invalid one. It makes the assumption that the status quo is always correct. Surely you must acknowledge that it is not. :o)

Intelligent people CAN disagree.

Edited by acrosome on 12/17/2009 12:25:10 MST.

Oops, cross posted both Brian and Dean.

Dean, all the things you mention are absolutely tricky, and to me argue very well for a system that doesn't try to apportion blame as it's rarely clear cut. Better to tax the habit. I would fully support a tax on any food that needs a label! This would be an indirect way for future obese and diabetic people to fund their health care, and would provide a stronger incentive to live a more healthy life style. There are always ways and means to treat every human humanely.

Dean re vaccines: "Especially compared to what polio does to you. I mean- have these people LOOKED at the statistics from the 19th century ???"

Gee, Dean, I'm not THAT old!

While I was growing up, I was never allowed near a public swimming pool for fear of catching polio. It wasn't just my parents; none of my playmates were allowed to go to public pools, either. While I was in college in the early 1950's, there was a big polio epidemic that really hit teenagers and young adults. A number of my friends caught it. Two of them died and several others were left partially paralyzed. It was pure luck that I didn't catch it. One of my more recent friends has been in a wheelchair for 15 years due to post-polio syndrome.

When the Salk vaccine was first released, at my university there was a long line outside the student health service waiting to get it. I was there!

That's not unreasonable, Lynn. I'll buy the taxation argument- on purely financial grounds- as long as it is indeed one HECK of a tax.

But professionally, I'd rather just discourge smoking and obesity in any way possible. After all, you yourself are using a moral and humanitarian argument in favor of socialized medicine. Isn't preventing the disease- and thus the suffering- indeed the moral and humanitarian thing to do- even if you profit by it?

Wow. Turned that one around on you, didn't I? :o)

Edited by acrosome on 12/17/2009 12:29:38 MST.

Of course, dean, it was just one of those assanine comments my father liked to make. As above, I support change rather than the status quo if the status quo doesn't provide for humane treatment or, better yet, prevention. Anyone who has studied the issues in depth will recognise that obesity is, like, a 1000 times easier to prevent than to cure. Likewise most other addictions. But being an addict does not IMHO make you so worthless that you should be allowed to just die in the streets if you actually ask for help and want to change.

So are people somehow more or less honest, greedy, or self-motivated based on whether they work for private industry or government?

I think people are people regardless, still subject to the same positive or negative motives.
At least with government- in a theoretical representative democracy- there is a requirement of transparency and checks and balances.

Private is private- therefor under absolutely no obligation to disclose its means and methods to the public...which sounds to me like a perfect recipe for exploitation, fraud, and questionable profit-driven motives.

See if Monsanto will let you know what they're putting in your food.

But we didn't say to let them die. We said to make them take responsibility for their behavior- in this case financially. And, I did mention the cessation programs. The benefit of such programs- relieving suffering and returning a productive member to society- obviously far outweighs the costs. From a practical perspective I must support them.

But, yes, I can indeed blame an addict who DOESN'T want to change. Sorry. And no smoker truly wants to change. If they truly wanted to they would be able to stop.

(Yes, there are exceptions to that last statement- please don't cite them to me- I probably know them better than you do.)

Edited by acrosome on 12/17/2009 12:33:49 MST.

Dean, most of my professional life I have been the one at the table saying "yeah, but what about prevention?". It mostly falls on deaf ears as there's not a lot of profit in prevention. No one is gonna give you a bonus because they DIDN'T grow up obese, or addicted, or depressed or whatever. But the fact is, until society and individuals figures out how to prevent these diseases, we are stuck with addicts (including food here) who are now living with the consequences of a lack of prevention. Prevention is key for future generations, but is too late for the present.

I'm not arguing that, Lynn. Heck, I agree. (Look at what I just posted.)

But, obviously, you had to get it off your chest.

You go, girl.

PS- what about government subsidies for 99% male castration?? :o)

Edited by acrosome on 12/17/2009 12:36:10 MST.

"Im saying that private industry can do a better job and we don't need to let gov intrude on our life even more."

Maybe. Switzerland (or is it Sweden) has a system of regulated private insurance. They've achieved universal coverage and the people are generally happy with their health care. On the other hand their health care costs are the second highest only trailing the US.

The most successful systems at controlling costs has been single payer where a single entity manages insurance but the providers, hospitals and doctors, are private and compete with each other for businesses. But there are drawbacks to this too.

"like not allowing insurance to sell over state lines- that protect companies at the expense of the public/consumer. I believe in intelligent regulation and fair market forces- we have neither."

It might surprise you to hear that I agree with this. Unfortunately the Republican proposals along this line would likely result in regulations being completely gutted.

There is a proposal on the table in the Senate (not currently in the bill) that I like which would allow private insurers to sell as part of a regulated national market. The regulations would be the same as those that currently govern the health care of federal employees and congress critters. This system provides for much greater competition while still maintaining rational regulation. Members of congress and all federal employees have a choice of about 15 insurance providers. I have a choice of 2 and that is better than many people in the US. More competition is always a good thing.

"the reason I really detest the public option is that it is just using the gov. to force citizen to patronize private businesses that are also protected from the free market competition."

I think this is a misstatement of the the public option. I think you are actually talking about the mandate. As it stands now in the Senate the public option is dead and the mandate lives on. It's the mandate that requires people to buy insurance which meets a minimum standard. I'm not a big fan of the mandate either. I understand the rationale for the mandate in terms of dealing with preexisting conditions. If we require insurers to cover those with preexisting conditions than the best strategy is to wait until I get sick and then buy insurance. The mandate prevents this by requiring people to buy insurance when they are still healthy. But I still don't like it.

The public option is completely independent from the mandate. The public option would have the federal government create a insurance company, funded only by it's paying subscribers, that would compete with private insurance. Individuals would have the choice of a public option or private insurance as they do today. Subsidies for poor people could be used to either buy public or private insurance.

If as some say the private insurers provide better, cheaper coverage than the public option, then no one will choose the public option. If lefties like myself turn out to be right, then the public option will be cheaper and better and most will choose it. The essential idea is that the choice is still up to the individual.

What I really like about this idea is that it allows a single payer system to compete on the open market with private health insurance. The winners would be determined by competition.

I find it interesting that some people (haven't seen it on this board yet) simultaneously claim that the private and free market is the only and best way while simultaneously saying that if the private market has to compete with a public option every one will choose the public option and the private insurers will die. It's got to be one or the other.

Of course this is all moot. The public option is dead. At least for now.

Edited by nschmald on 12/17/2009 12:41:45 MST.

"PS- what about government subsidies for 99% male castration?? :o)"

Now you're talking about something close to my heart. Think about all that preventable disease and injury ;)

Add female sterilisation to the equation and we might live in a disease free modestly populated nirvana :)

Juts don't get me going about the anti-depressant industry!!!!

So are people somehow more or less honest, greedy, or self-motivated based on whether they work for private industry or government?"

No I think it has more to do with the fact that a gov has more power over you ( in some cases -you make a da@mn good point about Monsanto)

Ok, Im not as agaisnt the idea -in theory- as I was at first.

But some things still worry me. Like how the feds will have every ones medical records and such. But maybe we can use some good ole' checks and balances in the system?
I still think the firSt order of change needs to be public nutritional health. Campaigns against sugars or very high taxes on sugar combined with ending subsidies for corn,soy,wheat ect.

Hey Nia

"If as some say the private insurers provide better, cheaper coverage than the public option, then no one will choose the public option. If lefties like myself turn out to be right, then the public option will be cheaper and better and most will choose it. The essential idea is that the choice is still up to the individual."

The experiment has already been done here and elsewhere. We have a choice. We can use the public system which is sometimes slower for non-urgent stuff, means you will probably have to share a room with 3-5 other people, and doesn't cover any enhancement surgery. Or you can buy private insurance and have better meals, faster elective surgery and your own room with a TV. The two compliment each other actually, and those that can afford will usually choose private. It's most notable however that really serious stuff like major orthopedic trauma, cancer, heart attack etc..can only be had in the public system. All the big teaching hospitals with the facilities to do major surgery and ICU are public, but this may just be because we are a pretty small country.

>> we might live in a disease free modestly populated nirvana

Yeah, wasn't it you and I versus all comers in a population-control debate a while ago? We should resurrect THAT thread! :o)

And, yeah, you and Iceland have amazing freedom to try interesting things because your size makes it practical. I can't say that I'm not envious.

Edited by acrosome on 12/17/2009 12:52:29 MST.

Lynn,

That actually does not sound like what has been proposed in the US. You seem to be referring to public hospitals. This is not being discussed in the US. The public option proposed here would sell health insurance not health care. The insurers would then as they do today pay the bills of private doctors and hospitals, usually under a fee for service model. Different payment schemes have been proposed and there are some experimental programs to try them in the bill.

Edited by nschmald on 12/17/2009 13:00:24 MST.

There is no such thing as "affordable" health care for most of our population.

Even when I had what is considered a great insurance plan, I couldn't afford regular doctor visits, hospital visits, or medication co-pays. So what if I had "access?" I couldn't use the access.

For a while I was unemployed and on a county health plan. That particular plan was the only positive long-term health-care experience I've had. If I was sick I could go see the doctor. If I had a nagging problem, I could go see a doctor. I could do preventative care. Medication co-pays were $3, so I could afford to fill prescriptions. (Only thing that stunk was I couldn't get specific allergy meds, which can make it hard for me to prevent sinus infections.) I was the healthiest I've been in a long time. And it was done with essentially no cost to me, and in a price-conscious way by my providers.

When I found new employment I didn't get benefits, but I made $1/hr more than the county plan allowed for. No insurance. I do have some relatively minor recurring health issues, and my dad now pays for a basic policy for me (hard to admit for a highly-educated, 30-something guy). I can't afford any health care, though, because the co-pays are so high. I have to pay 50% of any prescriptions. I have to pay at least 30% of any other charges. If you made a solid 6-figures a year, maybe that's not a big deal. But I'm far from that. I'm more worried about getting gas in the car for the commute, and getting food on the table, than I am about health care. It's basic triage. What is critical, now?

For the past several years I've been getting blood clots in my legs due to varicose veins. I'm not going to get into treatment options in this discussion. But my best fix to the problem would basically be to have the veins removed. Surgery estimates I've gotten are $12-15,000. So I'm looking at a $5000 copay. That's absurd. I struggle to pay my basic bills. My only hope in this is a solid public option plan, or moving to a country that values the welfare of its citizens more than the welfare of its corporations.

Access is nothing when you can't afford to use it.

"That actually does not sound like what has been proposed in the US. "

Oh, I see. That doesn't sound like a good plan, unless, like in NZ, the insurers and the hospitals are a not-for-profit organisation. I think that as soon as you put share-holders into the equation, health care takes a nose dive. It seems only fair that the people who work in and run the hospitals get a fair wage (profit if you will), but for investors to profit off of others ill health is at the heart of the problems in the American system IMHO.

"Oh, I see. That doesn't sound like a good plan, unless, like in NZ, the insurers and the hospitals are a not-for-profit organisation."

The government run "public option" insurer would be not for profit. We already have a mix of for profit and non-profit insurers. The reality is that there's not much difference. The profit margin for insurers is about 3.3% for the numbers I've seen quoted today. The administration and marketing costs are about 20% for both non-profits and for-profits. Looks like there's quite a bit of inefficiency there.

We also have a mix of private for profit and public (funded by states and counties) and private non-profit hospitals. You're description there sounds similar.

The real goal of the "public option" insurance is to see if it can be run with much less overhead and has enough subscribers to negotiate lower rates from the doctors and hospitals. Medicare which is basically a public option for old people, has significantly lower admin costs and pays significantly lower fees to doctors. Doctors don't like that last bit of course. See the discussion I and Dean had above.

Yeah most countries seem to demonize the profit motive. I don't have a problem with rewarding innovation even in health care with money. I think profit has proven to be a very good motivator to move things forward. What I have a problem with is the system we currently have which rewards the insurance industry for staying the same. In a functioning market stagnation should lead to increased competition and lower costs and lower profit. We in the US do not have a functioning market.

Edited by nschmald on 12/17/2009 14:14:19 MST.

Well....if we want to bring up what I commented about my current health care let us define a few things:

We have paid into the system of health insurance for a long time. Health insurance works in that most will not need it and those that do...so I am milking a system by any means. We are fortunate that my husband works for a large company that subsidizes the health insurance as part of the benefit package. Trust me on this, that is part of his yearly compensation and was part of the salary negotiations. Due to him working for a large company our deductible for each year is low - $300. We have a $2,500 out of pocket as well. With his previous job he worked for a smaller company and we paid triple the premiums, had a $1,500 yearly deductible and a considerably higher yearly out of pocket.

I pay $35 co-payment for Dr. appts. and $50 for specialists. Maternity care is different. I don't pay any co-pay's.

I have no idea until the end what it will cost. The cost is projection. It depends on MANY things. I see my regular OB every 2 weeks and will go to weekly in a couple weeks. This excessive amount of visits will most likely keep the actual end bill lower IF they can control everything.

For example if I have an ultrasound with my Fetal Maternal OB it runs around $2500 for it. If I can see the Imaging Department instead they charge $400 to 600. Why the difference? All in the techs they use. The FM one uses highly trained techs who are looking for markers that an average tech might not see.

I know that the cost of the Fetal Maternal OB visits are around $200 each. We are talking about a doctor though that is highly skilled and only works with high risk patients. My husband after meeting him remarked that the man didn't have a lot of charm. My reply was "would you if all you did all day was deliver bad news?". He is paid that much due to his intensive training and expertise.

If I have to deliver early (I did with my son Ford) the cost goes up quickly depending on his age when born. Consequently even though we live in an area with over a dozen hospitals to choose from I can only go to 2 of them, due to my risk of premature birth. I had to choose one that had both a neo-natal and a perinatal department.

If I stay healthy and they get me to full term, then the cost to the health insurance pool is much smaller. If I can go to term it will be very affordable for all. If though I develop any issues in the next month or two and the baby is delivered early it will go up quickly, based on what week I deliver. If I have to have a C-section the cost goes up even more.

Is it worth it? Yes. After this we will go back to paying in our premiums and rarely using once again. It is our term to take a payment from the system.

And no, I don't feel guilty. I am creating another little tax payer currently in my lil' oven ;-P

While certain drugs are indeed very expensive (due to having patents on them) many drugs in the US are extremely affordable.

My monthly out of pocket cost for what I take is around $5. So low I don't use insurance to pay for them. Heck, my monthly allotment for prenatal vitamins costs more ;-p

Granted, there was one drug I had to buy this year that was $150 for a tiny bottle (it was for a bad ear infection in the family and was a name brand only). That one did cause me to fan myself.

The issue is asking carefully as a patient if there are similar choices that might work the same or similar that cost less to name brand. And then go get it filled at the bad Wally-World. There are ways around high cost.

My mother was on Medicare for years and her dialysis supplies were not covered 100% - but in the US the companies do take on patients as tax write-offs. So by going on the program with them they supplied certain things. Good company to deal with. Always polite and nice to people.

Further notes on my comments on charity and seeking handouts:
If a person is able bodied and CAN work, they should. If they can afford to pay for health care, they should.

Charity and hospitals/drug companies writing off bills should be reserved for those that need it. My mother being a believer of personal responsibility only took the few things she needed to live. Due to renal failure she couldn't work anymore - but had her whole adult life before it took her vision and her kidneys.

My issue lies with health adults between 18 and retirement age who choose to not work to their potential and want others to pay for them if they do get sick and go to an ER! That isn't right and it taxes the system for people who truly need a hand up.

Sarah, the comments on you were centered around the concept that someone who does not have health insurance and pays no income tax is milking the system by using a free clinic. You are philosophically and morally no better than the free-loader in the respect that YOU personally have obtained your health cover by marrying well. I have no problem with you using the benefits to which you are entitled, but I do have a problem with you treating others who have contributed as much as you have, but did not marry well, or don't work for a big company, or suffer ill health or job loss due to circumstances beyond their control. In terms of contribution to society, a 'professional' backpacker deserves health care as much as you do. Is it fair that an unborn child should suffer just because her mother married the wrong person?? You may think so, in which case we can at least agree to disagree.

Insurance is all about shared risk. My family's policy currently costs about $14,000 per year. Over the 17 years under this coverage the policy has paid an average of less than $2,000 per year. For costs related to our daughter's birth in 2000 the insurance company paid about $4,000; for our son in 2003 they paid less than $2,000.

I expect that there will come a time when I'm glad to have insurance, but for now I'm happy to have a healthy family and willing for my contributions to help offset others whose health care costs are higher.

This is beginning to get a little out of bounds with some posters claim others are irresponsible, morally wrong, or whatever. Can we calm down a bit? So far things have gone pretty well.

Lynn, you may not approve of health insurance for either an individual or a dependent being part of a person's total compensation package, but that is how it works in the USA. I'm not saying that I approve of this, but that's how things work here. If you don't have insurance as part of your compensation and are not poor enough to be eligible for welfare, then you get to go to charitable clinics or, more likely, the emergency room, where the cost (if you can't pay it) ends up being charged to the people who can pay for it in the form of higher costs. The people left uninsured are the self-employed, those working for small businesses, those working (often at two full-time jobs, if they can get them) for low wages, and undocumented (i.e. illegal) immigrants. Oh yes, and those who have lost their jobs in the current economy.

It appears that under the proposed bills, there will still be plenty of uninsured. One group will be, as now, the undocumented immigrants, whose health care (mostly in the ER) has to be paid for but who will not be part of the "reform." The other will be those with just barely too much income to receive a subsidy for their health insurance premiums but for whom the fine for not having insurance will be less than the premiums they will have to pay. Remember that with lots more people insured, demand for services will rise sharply and so will prices and therefore premiums.

Lynn, I have a former colleague (she's still there; I retired) who married a New Zealander and moved there for several years. While there, she became pregnant with their second child. Despite the fact that a c-section was mandatory in her case, the New Zealand health care system would not pay for it. As a result, they moved back to the US. Her husband is now a US citizen. Government-run medical systems aren't all that great, either.

Edited by hikinggranny on 12/17/2009 15:16:03 MST.

Sarah, I hardly know how to respond. Congrats, I guess. I always ask for generics, but even the bloody generics can easily run $60 (or more) per script. That's just reality.

I work to my potential... as much as I can given our economic state. I've applied to hundreds of better-paying jobs to no avail. I've considered starting a couple businesses, but keep running into significant roadblocks... like start-up capital. I'm not some slacker. Tons of Americans work hard, many at more than one job, just to try to pay their basic bills. There is no money left over to also pay for insurance and co-pays.

If you want to talk about handouts, how about government subsidies of most major businesses? Bottled water and beverage companies pay essentially nothing for the water they use, which is a public resource. Loggers, at least in my home state, get the lumber for one step over free, and we help them build the roads they use, etc. The trees belong to the public. Government subsidizes businesses of all kinds (except, most notably, many small businesses...) Is it fair that so many businesses get free hand outs? Should their businesses not reflect the true cost of their product? Why is the government... and apparently a part of society that you relate to... more interested in caring for the welfare of business than caring for the well-being of its people?

EDIT: I guess it sounds like Sarah thinks that if you're working 40 hours a week and can't quite make ends meet, let alone pay exorbitant health care costs, then you should work 80 hours a week. Funny, I seem to recall this little thing about life, liberty and the pursuit of happiness. Hard to do much of any of that working 2 or 3 jobs, and you're more likely to wear yourself down and make yourself less healthy. Oh. And to the slacker comment? I've worked 60 hour weeks while taking over 20 credits. But I still didn't have health insurance, or extra money to pay for a policy.

Edited by 4quietwoods on 12/17/2009 15:52:27 MST.

"My issue lies with health adults between 18 and retirement age who choose to not work to their potential and want others to pay for them if they do get sick and go to an ER!"

Tell that to small business persons who can't get insurance for themselves or their employees, low wage workers, temp workers...I could go on, but I think my point is clear. And who defines working to "one's potential"?

Lots of uninsured folks out there working their butts off who can't afford insurance. What do you propose we do with them, Sarah? Send 'em off to the Soylent Green factory?

"My issue lies with health adults between 18 and retirement age who choose to not work to their potential and want others to pay for them if they do get sick and go to an ER!"

The proposal currently in congress, requires folks to pay a percentage of their wages for health insurance. The difference between that percentage and the actual cost is the subsidy.

So what this does is make it affordable. Not free.

How about we start in kindergarten and continue on through high school:

1) 1 hour of mandatory physical education every day

2) At least one hour of classwork in nutrition/week,
including learning how to read labels for those
situations where processed food must be used.

Moved from another thread-

So if you make the "right" decision and hitch your wagon
to a larger corporation for your employment, you can "earn"
good health insurance?

If you decide to work for a small
business or be self employed, you MAY be able to "earn" some insurance coverage, but because you don't have the
bargaining power of the larger companies you end up
subsidizing $100,000 pregnancies.

I used to have to pay property taxes to a private for profit
hospital (Truckee), but it was so expensive I couldn't go there.

Even the highest paid hospital administrative staff couldn't
use the hospital, their insurance plan shipped them off
to a hospital in another state.

So the taxpayers got to pay for a nice facility used only
by the wealthiest and the poorest.

Edited by oware on 12/17/2009 16:07:47 MST.

The percentage of income required to be dedicated to pay for health insurance is very high. I don't have the number in front of me, but I was shocked.

It certainly isn't affordable. Most people after taxes just flat out don't have that money.

I would like to get rid of PE in school (and PE teachers) and have all the kids do a morning calisthenics session. Teachers would rotate the supervision chores. I think this idea will help kids get in the habit of exercising. Who knows, they might keep it up for ever.

As it is now, PE seems like a waste of time. Change clothes, assemble in the field, wait around for a ball to be hit to you for twenty minutes, change back.

"As it is now, PE seems like a waste of time. Change clothes, assemble in the field, wait around for a ball to be hit to you for twenty minutes, change back."

I agree, David. What I had in mind was more along the lines you suggest plus some cardio thrown in. Definitely no sitting around waiting for a ball.

"The proposal currently in congress, requires folks to pay a percentage of their wages for health insurance. The difference between that percentage and the actual cost is the subsidy."

If I understand what you are saying this sounds much better and simpler than the system we have in Massachusetts.
Here you have ( by law) to pick an insurance company, then by tax time you have to prove that you have insurance or they fine you. I don't have insurance because I can't afford it- its just another bill I didn't want. Luckily I made so little money that The state decided not to bother with me.
But if it was taken out of our paychecks the same way state/federal/social security was and it wasn't a large amount I think most people could be for it.
Also there could be some kind system that separates preventative care and serious surgery/treatments? Like one could be private and one covered by tax payers. probably the more expensive surgerys would be covered by a "health tax" and preventative visits could be run more in the private sector out of pocket- but with more free market competition and better regulations.

"The percentage of income required to be dedicated to pay for health insurance is very high. I don't have the number in front of me, but I was shocked."

It's a sliding scale based on income. Off the top of my head, senate numbers a family of 4 making $32000 would pay 2.8% of income or about $900. The high end of the subsidy range is a family of four making $88000. They would pay 9.8% of income or $8600. The average cost now to insure a family of four is about $12000. Below $32000 would be eligible for medicaid.

Edited by nschmald on 12/17/2009 21:47:59 MST.

A lot of people on the edges or in the middle get lost in the fray, and if the above numbers are accurate I suspect that they're misleading. For example, I'm single-not a family of four. You have to make a whole lot less to qualify for medicaid... like under $20,000. Also, 3% of take-home or gross? There's a significant difference. But either way, it'd be under $100/month for me w/the above figures. Problem is, although insurance companies are prohibited from refusing people, they're not prohibited from charging them exceptionally high fees. Got asthma? Perhaps your input rises 100%. And remember, any way you slice these numbers, you're taking more money out of people's pockets to give them access... but they won't be able to afford to do anything with the access. It's like I said earlier, sure, I have insurance. But it doesn't really do me any good.

I was listening to "On Point" last night, NPR... good discussion on health care. Extrapolating from various figures they were bouncing around, the current "health care reform" policy mandates that all Americans buy insurance. Even if you were to figure that people only had to pay in 140/month (and estimates I heard were closer to COBRA pay-ins, IIRC... ie $450+), this comes out to an over $50 Trillion dollar gain-per year-for the insurance industry. (Estimates ranging 18-50 mil uninsured, calc'd w/30 mil.) Good thing we're taking care of insurance executives. Now how about taking care of the actual health of the people in our nation?

"I have a former colleague (she's still there; I retired) who married a New Zealander and moved there for several years. While there, she became pregnant with their second child. Despite the fact that a c-section was mandatory in her case, the New Zealand health care system would not pay for it. As a result, they moved back to the US. Her husband is now a US citizen. Government-run medical systems aren't all that great, either."

No system is perfect. Maybe your colleague wasn't a resident? Even so, the cost of paying for a caesarean would have been less than the cost of two flights to the US, so something is fishy about that story. The only pregnancy costs not covered in NZ are:

• Birthing in a private hospital
• Some tests e.g. ultrasound scans undertaken by certain facilities
• Childbirth education classes (although these are sometimes free)
• All pregnancy, labour and birth care for non-New Zealand residents i.e. the public hospital will charge
• An antenatal visit for advice to a private obstetrician may cost approximately $100-150 per visit.
• LMC care from a private obstetrician will cost around $2500-$4,000 (latter figure for Auckland).
• An elective Caesarean section with a private obstetrician (in a public hospital) will cost around $1800.

Lynn, this is about all I can tell you about my former colleague.

She married a New Zealand citizen in the mid 1990's. They stayed here for about a year and a half (he was finishing university in the US) and then decided to move to New Zealand. In the meantime they had a child, by emergency C-section. Even though the OB specialists at the HMO we both worked for have long encouraged vaginal birth after c-section, they said this definitely was not possible in her case.

They moved to New Zealand and the husband got a job there. Wouldn't she be a NZ resident after living there a year, and with her husband a NZ citizen working in NZ? I know her visa status allowed her to work in NZ.

She told me that the main reason her husband decided to apply for a US immigrant visa so they could move back to the US was because the NZ health system would pay for a vaginal delivery for child #2 but not for a C-section. After what they'd been told by their OB specialists here in the US, they didn't want to risk a vaginal delivery. It helped that she was promised her old job back, so her insurance here would pay the full cost.

It was definitely the denial of the C-section that made them decide to move back to the US permanently. It wasn't cost so much as the standard of medical care in her case that concerned them. Actually, it cost them a lot more than the airfare because it took nearly a year after they returned for the husband to get his green card so he could work. And of course with her family in the US and his in NZ, they were flying back and forth at least yearly anyway.

Edited by hikinggranny on 12/20/2009 20:48:33 MST.

Hi Mary

It does indeed sound an expensive proposition to go back to the states just for a c-section. They are so cheap here if done through the public system, even if you pay out of pocket. As to why they thought they weren't eligible for a free c-section in NZ, it may remain one of those unsolved mysteries. It's definitely not the norm, unless they were trying to do it through the private system.

That doesn't change the fact that there is no 'perfect' health system. We have co-pays, treatments and drugs that are not subsidised, and sometimes long waiting lists for non-urgent cases. We have mistakes made (our doctors are human too), and even worse, sometimes those mistakes are covered up. It's not the standard of care that is critical. It's the spirit of humanity that says everyone, regardless of income, bad parents, bad genetics, or poor life choices, is equally entitled to adequate healthcare treatment and prevention. Prevention includes free mammogram screening and cervical smears, mole checks, immunisation and prostate cancer screening. In this day and age, it's an area of human rights where America really seems to be dragging the chain. I hope the upcoming (and apparently unpopular) reforms are at least a move in the right direction.

As I've been backpacking the last week, I've been thinking about this topic some more, especially as it relates to the Christmas season. I am a non-Christian in the sense that I don't believe that Jesus was the son of God. However, I DO believe that Jesus (and many other prophets of the past) was a very enlightened and spiritual person (and charismatic!). To the extent that America was founded on Christian principles, and so many Americans are up in arms because of the loss of phrases such as "in God we trust" and "one nation under GOD", it amazes me and disturbs me that America struggles with universal health care. All you really need to do WRT health, education and welfare is to ask yourself "What would Jesus do?" He was all about healing the sick, feeding the hungry and educating the ignorant. He put others first, and did not seek material wealth for himself. Compassion was the name of the game. Of course, it ended up getting him murdered, but that gave us a reason for another holiday!

Anyway, Happy holidays to you all, and may 2010 find you healthy and happy.

Lynn, wow, what a light-hearted and delightful well-wishing for the new year! ;-)

Happy New Year to you all! (it will be in 15 hours here)

I don't know enough about the American system to be able to contribute a lot of facts, but I do know that I would probably not be able to afford to take care of my Type 1 diabetes if I lived in the States. The stress alone from having to deal with such high costs would be sure to add to my disease getting worse, thus driving costs up even more.

In reading a lot of the comments about big companies and preventative care I wondered, albeit more in fantasy land than reality, if those big companies ought to be charged for any practices they engage in that cause a lot of today's health care problems... things like pollution (cancer, asthma, emphysema), bad nutrition (Type 2 diabetes, obesity, cardiovascular disease), bad living environments (ADHD, hypertension, depression, addiction to cottage manufacturer UL gear). Surely the average taxpayer shouldn't have to shoulder the burden of practices that the big companies insist on that cause all the health problems?

Would that ever happen? Hah! Not in a million years!

I agree with the requirement that every citizen should do exercise one hour a day or they pay out of their own pockets for any lifestyle diseases. I always get annoyed with people who complain they can't do exercise because it is too hard. Personally I have no choice; diabetes can only be controlled if exercise is an unquestioned part of my daily life. I don't have any excuses. It's not always easy, but if I don't want to get the awful complications that diabetes threatens me with I have no choice.

Preventative medicine should be a part of every health care plan in the world. And so should proper and comprehensive education on the subject of prevention.

Edited by butuki on 12/30/2009 17:37:54 MST.

"Preventative medicine should be a part of every health care plan in the world. And so should proper and comprehensive education on the subject of prevention."

+10!

Proper nutrition + proper, consistent exercise, and teaching of same beginning in grade school, would cut medical costs in the USA by at least 50%, IMO.

America was founded by men of the enlightenment, deist, Freemasons and the like. Democratic Republics are a pagan idea. Look to the Vatican or medieval feudal Europe to see a nation built on Christianity.
Christmas is not "Christian" its roots are ancient (Yule Tide) and its modern variation was meant to be a more or less secular family holiday. Religious people just like to make everything religious. And "God" In God we trust is not any one religions "God" it was to show our freedom of religion in contrast to marxist states which has no such freedoms. And every one in the US knows we have a problem with our health care -no one believes there should be people who suffer because they can't afford it- nobody. Thats just political propaganda like -the other side has no compassion my side is more enlightened ect... People just disagree on how it should be done.
Happy New Year!

""God" In God we trust is not any one religions "God" it was to show our freedom of religion in contrast to marxist states which has no such freedoms."

As a buddhist who does not believe in God, I would disagree, as I'm sure would many of the folks from polytheistic religions (any Hindus in the crowd?)or atheists.

For better or for worse, the morality and therefore laws that the US operate under, are Christian based. Americans have rights as far as they do not break the moral code of Christians as set out in US law.

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights . . ."

So we have creationism in the very fabric of the constitution.

And then there are the polygamy laws...

"And every one in the US knows we have a problem with our health care -no one believes there should be people who suffer because they can't afford it- nobody."

Perhaps, but this thread was spawned by another thread where a poster implied that those who don't pay taxes should not sponge off free clinics, and where that poster rubbed the likes of unemployed folks noses in it by letting us know that they we OK due to her husband's good health cover. This certainly came across as "I'm OK therefore the system is OK, shame on you if you're not OK".

"People just disagree on how it should be done."

Yeah, I get that. My belief is that, as a predominantly Christian nation with Christian morals this should be the easiest social problem for America to solve. Heal the sick. Educate them to stay well. Pay for it out of taxes. As Miguel suggests, a lot of those taxes can come directly from bad habits and foods. Give people bonuses for good health, tax junk foods, subsidise healthy choices, especially for the poor etc...and throw money at prevention from day one at school. Please don't leave health care to the private sector! Giving folks compulsory health insurance is not the same as giving them health care.

" And "God" In God we trust is not any one religions "God" it was to show our freedom of religion in contrast to marxist states which has no such freedoms."

I didn't know Karl Marx was that old! :)

I didn't know Karl Marx was that old! :)'

Ah, yes I got our money mixed up with the changes in our National Anthem in which "under God was added..


But no, saying "Creator" does not make it Christan. Creator can be the big bang if you choose. The US has a majority religion but no state religion and most Christian are nominal only. Again you have to look at Medieval feudal society to see a Christian government (or a Buddhist).
Our Gov buildings and structure are modeled after the ancient Greeks not the Cathedrals. Sure you can find terms that fit nicely with Christianity like "God" instead of "Goddess" or "universal power" but lets be realistic how else would an 18th century person put it? And its strange that we Americans are trying to find a way to fix our sytem because we can see that the system is flawed and yet people treat us like we don't think we have a problem and need convincing?

Read this story below. See the interesting thing is that I work with a few Canadians who have said many times their health care system is terrible. They could not get appointments, poor care, and plenty of rationing. Plus, the backroom deals, i.e. Nebraska and Ben Nelson are against our Constitution. Why should one state get a deal so their Senator will vote for the bill? Obviously because the bill is a piece of garbage that cannot stand on its on merit. Oh yeah, I the military system, that I have heard is a shining example, sure if you have a cold. Good luck with major problems, my son was misdiagnosed for two years. Anyway, to each your own, but remember, if you don't get any health care, you can go to jail!

The article:
Liberal MP Belinda Stronach, who is battling breast cancer, travelled to California last June for an operation that was recommended as part of her treatment, says a report.

Stronach's spokesman, Greg MacEachern, told the Toronto Star that the MP for Newmarket-Aurora had a "later-stage" operation in the U.S. after a Toronto doctor referred her.

"Belinda had one of her later-stage operations in California, after referral from her personal physicians in Toronto. Prior to this, Belinda had surgery and treatment in Toronto, and continues to receive follow-up treatment there," said MacEachern.

He said speed was not the reason why she went to California.

Instead, MacEachern said the decision was made because the U.S. hospital was the best place to have it done due to the type of surgery required.

Stronach was diagnosed last spring with ductal carcinoma in situ (DCIS). The cancer is one of the more treatable forms but Stronach still required a mastectomy -- which was done in Toronto -- and breast reconstruction.

Stronach, who announced last April she would be leaving politics before the next election, paid for the surgery in the U.S., reports the Star.

"As we said back in June when we confirmed the surgery, this is a personal and private matter between Belinda, her family and her physicians. I think you'll understand that because of respect for Belinda's privacy, we refrained from offering specific details around her medical treatment," said MacEachern.

While it is rare for MPs to seek treatment outside Canada, MacEachern said Stronach was not lacking confidence in the system.

"In fact, Belinda thinks very highly of the Canadian health-care system, and uses it when needed for herself and her children, as do all Canadians. As well, her family has clearly demonstrated that support," MacEachern told the Star.

MacEachern did not offer any other details regarding what type of surgery Stronach had or what she paid for it.

Not to get into a tit for tat. I think very highly of American doctors. But having traveled over seas and receiving very fine and in some cases better medical care I think this point is sometimes exaggerated. This article was published in the SF chronicle a couple of weeks ago. Link here.

Medical tourism: '5-star' care at a discount
Carolyn Lochhead, Chronicle Washington Bureau

Monday, December 21, 2009

Critics of health care reform often point to desperate Canadians who head south for surgery to escape waiting lists. But a bigger trend points in the opposite direction: Americans heading overseas to escape the exorbitant cost of U.S. care.

Former Mill Valley resident John Freeman, 61, now living in Reno, needed a coronary bypass. He had dropped his catastrophic insurance coverage because the $320 monthly premium was eroding his retirement savings and the $5,000 deductible left him with big bills.

Facing a $100,000-plus operation, he thought he had two choices: "submit or die."

A friend pointed him to a third: World Med Assist of Concord, which lined him up with a heart surgeon in Turkey. The all-inclusive cost: $18,000. He had the surgery last spring and "unreservedly" recommends the care.

...

Deloitte Consulting estimated that 560,000 U.S. residents went abroad for care last year. The firm thinks that number will rise to 1.6 million by 2012, with patients getting discounts of up to 90 percent on procedures from liver transplants to hip resurfacing.

...

Edited by nschmald on 01/01/2010 01:35:21 MST.

To follow up, the American medical system works well for those who can afford it. It works very well for the rich and powerful. I recently heard a story on NPR about a member of the Yakuza (Japanese mafia) who came to the US for a liver transplant. Rather than being arrested he was bumped ahead of all the American's who were waiting for a liver.

Also missed is the fact that care is rationed in the US by insurance companies. When my grandmother was in the hospital with back surgery it was an insurance company rep who came not a doctor who had final say in approving care.

Not to mention the 20000 people per year who die in large part because they lack health insurance.

So we already have rationing imposed by unaccountable insurance executives.

No system is perfect and I'm sure Canada has it flaws. Brian said that nobody was arguing that we should do nothing. Well, the Republicans did just that when they controlled the white house and both branches of congress. The Republican counter proposal released a few months ago would insure less than 10% of the currently uninsured. I would call that doing nothing.

The mandate requiring everyone to buy insurance is a tough pill to swallow. But most would say that someone with a preexisting condition should be able to get insurance, and someone who has insurance should not lose it just because they got sick. If we put those laws in place without a mandate there is no reason for anyone who is healthy to buy insurance. Cheaper to wait until your sick. This would explode costs and bankrupt health insurance companies. So the mandate is the trade off. I haven't heard anyone come up with an alternative workable solution.

The Republicans didn't include a mandate in their proposal. They also didn't include a provision for those with preexisting conditions to get insurance. Again basically doing nothing.

Happy New Year Everyone!! I hope it finds you in good health!

My point, which is easily lost in a chaff forum, is that Jesus was someone I think is worth emulating, even if you don't worship him. Same could be said of Buddha or many other prophets. You do not need to be Christian to do the Christian thing, and if you ARE a Christian then it is your moral obligation to do the Christian thing.

"But no, saying "Creator" does not make it Christan. Creator can be the big bang if you choose. The US has a majority religion but no state religion and most Christian are nominal only."

Christianity is responsible even for secular institutions such as democracy and science. It has fostered in our civilization values such as respect for human dignity, human rights and human equality that even secular people cherish. The preciousness and equal worth of every human life is a Christian idea. We are equal because we have been created equal in the eyes of God. This is an idea with momentous consequences. In ancient Greece and Rome, human life had very little value. The Spartans, for example, left weak children to die on the hillside. Greek and Roman culture was built on slavery.

Christianity banned infanticide and the killing of the weak and "dispensable," and even today Christian values are responsible for the moral horror we feel when we hear of such practices.

Consider finally modern notions of human rights — the right to freedom of conscience, or to property, or to marry and form a family, or to be treated equally before the law — as enshrined in the United Nations Universal Declaration of Human Rights. The universalism of this declaration is based on the particular teachings of Christianity. The premise is that all human lives have equal dignity and worth, but this is not the teaching of all the world's cultures and religions.

America's Christian Roots

52 of the 55 signers of America's Declaration of Independence were orthodox, deeply committed Christians. The other three all believed in the Bible as the divine truth, the God of Scripture, and His personal intervention.


It is the same Congress that formed the American Bible Society. Immediately after creating the Declaration of Independence, the Continental Congress voted to purchase and import 20,000 copies of Scripture for the people of this nation.

Patrick Henry, who is called the firebrand of the American Revolution, is still remembered for his words, "Give me liberty or give me death." But in current textbooks the context of these words is deleted. Here is what he actually said: "An appeal to arms and the God of hosts is all that is left us. But we shall not fight our battle alone. There is a just God that presides over the destinies of nations. The battle sir, is not to the strong alone. Is life so dear or peace so sweet as to be purchased at the price of chains and slavery? Forbid it almighty God. I know not what course others may take, but as for me, give me liberty, or give me death."

These sentences have been erased from our textbooks. Was Patrick Henry a Christian? The following year, 1776, he wrote this "It cannot be emphasized too strongly or too often that this great Nation was founded not by religionists, but by Christians; not on religions, but on the Gospel of Jesus Christ. For that reason alone, people of other faiths have been afforded freedom of worship here."

Consider these words that Thomas Jefferson wrote on the front of his well-worn Bible: "I am a real Christian, that is to say, a disciple of the doctrines of Jesus. I have little doubt that our whole country will soon be rallied to the unity of our Creator." He was also the chairman of the American Bible Society, which he considered his highest and most important role.

On July 4, 1821, President Adams said, "The highest glory of the American Revolution was this: it connected in one indissoluble bond the principles of civil government with the principles of Christianity."

Calvin Coolidge, our 30th President of the United States reaffirmed this truth when he wrote, "The foundations of our society and our government rest so much on the teachings of the Bible that it would be difficult to support them if faith in these teachings would cease to be practically universal in our country."

In 1782, the United States Congress voted this resolution: "The Congress of the United States recommends and approves the Holy Bible for use in all schools."

William Holmes McGuffey is the author of the McGuffey Reader, which was used for over 100 years in our public schools with over 125 million copies sold until it was stopped in 1963. President Lincoln called him the "Schoolmaster of the Nation."

Listen to these words of Mr. McGuffey: "The Christian religion is the religion of our country. From it are derived our notions on the character of God, on the great moral Governor of the universe. On its doctrines are founded the peculiarities of our free institutions. From no source has the author drawn more conspicuously than from the sacred Scriptures. From all these extracts from the Bible I make no apology."

Of the first 108 universities founded in America, 106 were distinctly Christian, including the first, Harvard University, chartered in 1636. In the original Harvard Student Handbook, rule number 1 was that students seeking entrance must know Latin and Greek so that they could study the Scriptures: "Let every student be plainly instructed and earnestly pressed to consider well, the main end of his life and studies is, to know God and Jesus Christ, which is eternal life, John 17:3; and therefore to lay Jesus Christ as the only foundation for our children to follow the moral principles of the Ten Commandments. James Madison, the primary author of the Constitution of the United States, said this: '"We have staked the whole future of our new nation not upon the power of government; far from it. We have staked the future of all our political constitutions upon the capacity of each of ourselves to govern ourselves according to the moral principles of the Ten Commandments."

Today, we are asking God to bless America. But, how can He bless a Nation that has departed so far from Him? Prior to September 11, 2001, He was not welcome in America. Most of what you read in this article has been erased from our textbooks. Revisionists have rewritten history to remove the truth about our country's Christian roots.

RE: Canadian health care
Those most resistant to humanistic health care love to point out the Canadian or NHS in Britain as reasons why socialised health can't work. Why pick the worst examples to make the point? Why not look at Japan, or Australia, or New Zealand where universal health care is guaranteed and funded out of taxes, but Private health insurance can still be bought or used as a non-taxable employment incentives if you want shorter waiting times or a private room with sky TV. It works, and costs a lot less than what Americans (those that can afford it) are paying. It is a very fair system in that those with spare money have the option to buy better healthcare, but the basic care on offer to everyone for free/cheap is pretty good most of the time. There may never be a 'perfect' system, especially as technology continues to push the costs of health care up faster than the general cost of living. Rationing will always be needed at some level, whether you have an insurance system of health care or a government funded system.

Edited by retropump on 01/01/2010 04:37:06 MST.

Understand both points that were made, however, my focus in this discussion is more of the current bill that is trying to be forced through our Congress. If anyone asks me, I will give a yes to the question that everyone in the US needs health care. However, I do not think that it is a right. I do not think I should have to pay more money in taxes to cover others (Yes, I know, others can make the arguement that I am already paying for those without insurance.)
It is mainly this bill that leaves 25,000,000 still uninsured, ensures that my taxes go to cover abortions (which I find immorale), and is loaded with a bunch of payouts to bribe reps to pay for it. If it is so important to get this bill passed because we need health care reform immediately, then why don't most of the benefits start until 2014? Why is there no medical malpractice reform?
Why would Congress not want the same plan as the one they pass for the citizens they supposedly represent?

This bill needs to be done away with. We need serious people who actually care about reforming health care and not just making the public more dependent on the government to devise a plan that works. My opinion, let capitalism run its course. Get rid of some of the laws that prohibit selling insurance across state lines. You want affordable health insurance, open up the market for everyone to select the plan they want to buy. That is what I do for my car and life insurance. I want to be able to compare plans, companies, rates, everything about the plan and then make an intelligent decision. Open this opportunity up to everyone. If you choose to not purchase health care by your own free will, then you must pay for your treatment, if you cannot pay, then you don't get the treatment. That is your choice. Can't afford it, okay, I have no problem with a government hand out, but only if you want it. If you pass this up to, well.......sorry about your decisions in life. The most important thing to me is the freedom to choose how I live my life.

Anyway, that is my two cents fwiw. The best thing about this country is the fact we can disagree, have a civil discussion, and still hit a trail together.

I hope everyone has a wonderful new year with a lot of great new gear and plenty of long hikes.

Some thoughts. Yes, the laws preventing selling insurance across state lines should be done away with. You should be able to shop around for the best plan for your needs, whether that's coverage or costs.

The big issue I see is that insurance companies, the drug companies, and hosiptals are all for profit and the you are the tool to make lots of money for their true customers - the stock holders. I know there are lots of arguments against this especially drug development. Drug companies don't give a rats @ss about you or me, they develop drugs that they can sell to everyone one and make the most money. Just look at all the TV commericals - if you have these symptons you may have x disease, ask your doctor for y drug and you will be well. If I have something is a real health or quality of life issue, you are already seeing a doctor and getting medication, if its available (and you have insurance). How many people go to see a doctor about something they may have because they saw a drug company ad and don't have it. That cost you, your insurance company money and waste the doctors time. Not good for anybody, but hey the drug companies may make another sale!

Yes, they need to recoup their development costs, but they research drugs that make them the most money, not necessarily the ones that may make the biggest difference in peoples lives. They don't even want to make drugs that are good for everyone if doesn't make enough money. Look at the almost complete loss of vacine manufacturing in the US. We don't have the ability to make the drugs that could save a large group of people if there was a big outbreak. H1N1 could have been much worse.

Companies can be non-profit and make lots of money and then spend it better, without having to answer to the shareholders. Pay your employees better, put money into helping your true customer - the sick person, and to the community. We have a local non-profit hosipital that makes so much money it doesn't know what to do with it all. It's exapanding it's clinics, building speciality hospitals, and even paying it's fair share to the local municipalities, by paying in-lieu payments because they are non-profits and don't have to pay taxes. They believe in helping the community. The Mayo clinic is also a good example of what a non-profit can do.

I have a friend who has to use a significantly higher priced HMO over her company's other plan due to lifetime caps. She takes a very expensive medication (+$25K/year) that really eats into her lifetime max. Being in her mid-40's she wouldn't use all of her lifetime max, but if she had one expensive disease (read cancer) that eats a good chunk of it in one shot, she could. Since this is a lifetime medicine and it's cost will surely rise, she has to be very cogizinat of hitting that number.

Both bills eliminate the lifetime maximum, so she will be able to go to her employer's lower cost insurance and save big $$/year. Will her employer's lower cost insurance go up to do the changes - yes, but only to the cost of actual coverage to all members. It's an employer owned insurance company - that doesn't make a profit! Only needs to cover it costs and no more.

Edited by gmartell on 01/01/2010 10:35:15 MST.

I don't understand. Why are Americans so unwilling to pay for social health care, but seem to have little problem paying far higher taxes for the military? In fact, I have almost never heard anyone complain about the "socialist" nature of the American military, but a great number of people won't even consider a basic social health care system. The irony is deafening.

But, Lynn, democracy predates Christianity by at least half a millenium. I must agree that Christianity's "all men created equal" ethos did (eventually) contribute to the development of liberal western philosophies such as the Enlightenment.

Out of curiosity, who are the three founding fathers who weren't orthodox Christians? Because I would put that number a lot higher than three. Many wouldn't even "qualify" as Christians according to modern Evalgelicals and Fundamentalists because many were deists but, like you, did not believe that Jesus Christ was (a) God. Washington and Jefferson, among others, were deists. Heck, Jefferson had the audacity to edit his own version of the Bible in which he removed anything that seemed magical or miraculous. (I mentioned that before, didn't I?) In fact, Lynn, the very Jefferson quote you mentioned above was if read in it's entirety and in context an affirmation that Jesus Christ was NOT (a) God. Instead, Jefferson was defining a "True Christian" as someone who followed the TEACHINGS of Jesus as opposed to someone who thought that he was (a) God. His surviving letters are VERY explicit about this. Thus he was primarily interested in established historical facts about Jesus and records of the actual words he spoke, without all of the mysticism- and thus his edition of the Bible.

The modern Fundamentalist movement wasn't founded until the nineteen centuery. Thus the Congressional Bible resolution that you mentioned. But the U.S. wasn't FOUNDED that way. It may have de facto operated as a Christian nation early in its history, but the Enlightenment was definitely present in the way the Constitution and other documents were phrased. I do not consider MINISTER William H. McGuffey an authority on this matter. He obviously had his biases- as do we all. :o) But I think that he was talking about American society more than American government, anyway. Undoubtedly, the U.S. has strong Christian roots- but its government, while a child of the (arguably Christian) Enlightenment, was never meant to be a watered-down theocracy.

Patrick Henry, OTOH, was indeed a bit of a Christian crusader- and in fact he annoyed a lot of the other Founding Fathers with his zealotry. But then he didn't sign the Constitution, did he? He refused to attend, because he didn't like the way that he saw the Convention heading. Though in his defense he WAS instrumental in forcing the adoption of the Bill of Rights, because he thought that the Constitution gave too much power to the federal government and feared that the presidency would devolve into a monarchy. But he was a orator and firebrand more than a politician, though, despite serving (badly) as governor of Virginia at one point.

Almost all of the surviving writings of the Founding Fathers affirm that the U.S. was not meant to be a Christian nation, per se, though it's populace was majority Christian. This was, in fact, written into law (again) in the form of the Treaty of Tripoli in 1797, signed by President Adams, and duely ratified by congress:

"...the Government of the United States of America is not, in any sense, founded on the Christian religion..."

Of course, several of the other Barbary Treaties mention God incessantly- but those ones were composed by the Barbary States involved rather than a U.S. diplomat, and usually in Turkish... But most of the quotations thrown about that are meant to support the proposition that the U.S. was meant from its inception to be a Christian nation are almost always taken out of context, or were musings upon American society and NOT government. When one examines the musings actually regarding the establishment of the U.S. government this house of cards collapses.

Speaking of Adams, he was indeed a devout Unitarian, as you mentioned. But, recall, Unitarians don't believe in the divinity of Jesus Christ. They believed he was a divinely inspired prophet, like Moses- a majority belief among Christians until the fourth century. Or, alternately, some believed that he was some demigod-like entity superior to humans and angels but still subordinate to God. (Adams, it appears, was in the "human prophet" camp.) As their name implies, they believed in a Unity, and denied the Trinity. They believe that the doctrine of the Trinity does violence to the proposition that there is but one God. In fact they have been defined as "Christian deists." There are some modern branches of Unitarianism that don't consider THEMSELVES Christians. Adams once wrote that the world might be better off with no religion in it- then admittedly backed down from that statement a bit, because as bad as was a world with religion, he feared that one without it might be worse.

Well... Honestly, all of the Founding Fathers were undoubtably devout at one Christian sect or another. They couldn't be powerful men if they weren't. It's just that many of those sects had belief systems that are a bit... unexpected... to our modern Evangelical/Fundamentalist-influenced sensibilities.

Washington was almost certainly a deist, despite self- serving propaganda to the contrary spead by parson Mason Weems in his fraudulent biography and propagated ever since. When put to the question after Washington's death, one of Washington's own pastors said that though it pained him to admit it he had to answer honestly- Washington was a deist.

Speaking of honesty- for the record- in addition to Patrick Henry a few more Founding Fathers who were very orthodox Christians include John Jay, Samuel Adams, and Elias Boudinot. In addition, a lot of the deistic Founding Fathers had, oddly, extremely orthodox spouses. (It has been proposed by scholars- very convincingly- that social forces of the time tended to push women of that social stratum heavily towards orthodoxy. They could gain some small influence through their churches, but were otherwise almost powerless in public life.) But these were still almost all men of the Enlightenment- thus no established religion in the U.S. (Several states, OTOH, did have established state religions. In Virginia it was Anglicanism and in much of New England it was the Congregationalist Church of the Puritans, for instance. Rhode Island and Pennsylvania stand out as bastions of tolerance.)

Can you tell that colonial and revolutionary American history is one of my little hobbies? :o)

Anyway, I remain a BIG Bill of Rights guy- tip of my hat to ol' Patrick Henry- to include Freedom of Religion. I will die to defend any American's right to believe what they want to believe. But I'm also a stalwart champion of the Separation of Church and State, because it is the only possible way that a non-theocracy can operate fairly. (Yes, capital letters.) And I do not wish to live in a theocracy. They tend to be brutal and repressive.

So, in brief, IMO the U.S. government is more accurately thought of as based upon Enlightenment thought than based upon Christian thought, per se.

I LOVE talking about religion. I find it fascinating. And, often, I learn something new that fits in with my personal beliefs. I understand if others refrain, though, for fear of fanning flames...

I'll back you up, though, that a LOT of people who call themselves Christian behave in an exceedingly un-Christian fashion. Usually, they are the superior, obnoxious, self-righteous ones, too. I generally try to annoy them at any opportunity, but it never works, because they KNOW that they are righteous...

Edited by acrosome on 01/01/2010 18:45:24 MST.

I live in MA where Universal health care was started ( by the Republican Romney). Its basically just a law that said you must get health insurance or you will be fined. So I don't have insurance because I can't afford it and just don't want the extra bill every month. Lots of people do the same especially the young and healthy. Now I know I could have a fatal disease as I type no matter how much I try to take care of myself. But you can't afford what you can't afford.
Needless to say I really didn't like this universal health care for those reasons. It seems like a scam to force the poor ( or those who just don't want it) to pay into insurance companies largely to pay for the indigence in junk food and drugs as well as the apathy of the public at large.
Now they do have a state insurance for those that can't afford it but its just a low rent low quality insurance and why bother when there are free clinics for us anyways?
But I m coming around to this idea of a universal Government health plan. I know people say they fear bureaucrats taking control over their health care -but is it any different in private care? The problem is recently citizens who had concerns and questions about how it would work where demonized in the media and politicians simply wouldn't or couldn't answer some of them. And I think this is why if failed.
I still like the idea of a private insurance for preventative medicine and a tax paid system for expensive surgery and medications. This way the bill is split between private and government insurance and citizens don't go broke because they get sick.

Message deleted. Sorry for the outbust, folks.

Happy New Year and Happy Hiking to one and all.

Edited by ouzel on 01/01/2010 20:21:03 MST.

There have been a number of points raised that I would like to agree with.

The first is that we should be able to buy insurance across state lines. There have been 2 basic proposals for doing this.

One is to simply allow insurance companies from another state to sell insurance in other states. The insurance company would be subject to the laws in their home state. This would allow insurance companies to shop for the most hospitable state regulators. I'll sell from your state if and give you my tax dollars if you stay out of my way. Insurance regulators from the home state of the insured would have no authority to do anything since it's not in their state.

The bill passed by the House sets up a national exchange regulated by the federal government. One of the key regulations would be disclosing certain information such as:
(i) Claims payment policies and practices.
(ii) Periodic financial disclosures.
(iii) Data on enrollment.
(iv) Data on disenrollment.
(v) Data on the number of claims denied.
(vi) Data on rating practices.
(vii) Information on cost sharing payments with respect to any out-of-network coverage.
(viii) Information on enrollee and participant rights under this title.
(ix) Other information as determined appropriate by the Secretary.

I personally would like very much to know the percentage of claims denied when I'm shopping for health insurance.

Having complete and comparable information on a wide range of plans would make the increased competition meaningful in a way that the state based plan outlined above does not.

Is it really in the interest of a states population to have their access to health care controlled by a panel of corporate bean counters in another state ?

Once all the insurance companies are located in the state with the best tax breaks and fewest regulations, will health care really improve ?

"Needless to say I really didn't like this universal health care for those reasons. It seems like a scam to force the poor ( or those who just don't want it) to pay into insurance companies largely to pay for the indigence in junk food and drugs as well as the apathy of the public at large."

Brian, that is NOT universal health care, it's just compulsory insurance. Insurance is not health care. And that is why the current health reform bill is destined to fail, as it makes no provision for health care. However I agree with your sentiments that you do not want to subsidise others unhealthy lifestyle choices, but rather than deny them health care, I say tax those bad habits to the hilt.

Dean, your intimate knowledge of American political history simply astounds me. I should just simplify my earlier sentiment and say that "Jesus is the reason for the season" and that America, as a predominantly "Christian" nation, could do a lot better than spend it's tax payers money on warfare at the expense of health care. To be honest, Christianity has nothing to do with my opinion, I just think that Jesus had some very good ideas that any country could benefit from observing. I would hope, as a medical doctor, that you would agree that more tax money spent on health care and less on killing is in your professional best interest!

Lynn says: "...I say tax those bad habits to the hilt."

I'll add, "Then make sure all that money goes directly into the health care arena."

As it stands, most of those taxes are being tossed into the states' general funds during this economic downturn. In Colorado, there was a fine-print clause that allowed the state to confiscate all of its tobacco settlement money in the event of a financial calamity. So the community health centers are now left stranded, as is the University's health science center. That's where that money was supposed to go.

"Then make sure all that money goes directly into the health care arena"

Absolutely.

"As it stands, most of those taxes are being tossed into the states' general funds during this economic downturn."

I was thinking of a Federal tax. People move, they change states, but their health care needs stay the same. I can't believe you can't sell heath insurance across state lines. Does that mean every time you move states you have to take out new insurance? What about employers who have employees nationally? How does that work? And yes, Make sure the money doesn't go to Afghanistan or bailing out criminal investment firms or propping up failed companies. 100% health care.

"I would hope, as a medical doctor, that you would agree that more tax money spent on health care and less on killing is in your professional best interest!"

Well, er, actually... I do trauma surgery, too...

:o)

"Well, er, actually... I do trauma surgery, too..."

Funny you should mention that. I was talking to a general surgeon on a recent hike, and he said that if we banned alcohol, he would be out of business. He said that normal, sober people very rarely run off the road or into other cars, or take unbelievably stupid risks, or pick fights, or just fall over and hit their head or break their leg. He said the other money winner for him was obesity-related surgery. Of course, he also said he would be "happy to be out of that job" and prefer preventative medicine. I'm not sure about that Hypocratic oath...does "first do no harm" include not wishing harm to happen so you could keep your job??

PS: I know you were just joking ;)

Oooo! Oooo! Lynn, are you ready ?!? I'm going to turn this into a gun thread!

First, on a serious note, I will +90 the thing about alcohol. Even more disappointing is that it is SO rare that the boozer kills himself. Usually it is the family of five that were on their way to church that he HIT that dies, and the boozer is merely drunk and gets admitted until he sobers up enough to tell us that nothing hurts.

I admit that this is not literally true, but the occasional emotional case is what lodges in one's memory.

Speaking from a preventive medicine viewpoint, if I could pick one susbtance to banish from the Earth by magical fiat it would be a tough call between tobacco and alcohol. But I think alcohol would win.

Alcohol-related misadventures and disease processes kill, cripple, or maim many more people per annum than guns do. Thus, any bleeding-heart who wants to ban all guns because "guns kill people" and who is not also a prohibitionist is a monumental hippocrit, and thus generally beneath my notice.

Sorry. These holy wars are all starting to look alike to me. I can't keep them straight... :o)

(For those of you who are humor-impaired, that was not an invitation to a flame war. It was a joke vis a vis internet holy wars. David Ure- please restrain yourself.)

Now. How can I fit abortion in, here?

I can also prove that socialized medicine causes global warming. And makes Baby Jesus cry.

Edited by acrosome on 01/06/2010 09:01:39 MST.

"Now. How can I fit abortion in, here?"

Easy. Perform them with a gun. ;}

"Thus, any bleeding-heart who wants to ban all guns because "guns kill people" and who is not also a prohibitionist is a monumental hippocrit, and thus generally beneath my notice."

Now Dean, we all know that alcohol doesn't kill people, shot glasses do.....

"Easy. Perform them with a gun. ;}"

Ouch! You are SO gonna ...... I don't know, but you most likely are!

"Ouch! You are SO gonna ...... I don't know, but you most likely are!"

??

Dean-Banished from Earth in a magical Fiat!? Does it have a gun rack?

"Does it have a gun rack?"

Absolutely. And a 4-inch lift, and twin pipes. :o)

Edited by acrosome on 01/07/2010 11:40:54 MST.

"Now. How can I fit abortion in, here?"

Easy. Perform them with a gun. ;}

Only if you are Pro-Choice. If you are Pro-Life, then it's gotta be a ShotGun wedding instead ;)