Healthcare & rationing

[MSimon]

Yes. France is excellent. Except when the doctors are all on vacation.

http://www.usatoday.com/weather/news/20 ... heat_x.htm

The bulk of the victims — many of them elderly — died during the height of the heat wave, which brought suffocating temperatures of up to 104 degrees in a country where air conditioning is rare. Others apparently were greatly weakened during the peak temperatures but did not die until days later.

The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

Here in America I'm currently at the bottom of the pile. I would be considered in poverty if I didn't feel so rich. Guess what? My apt. has central air. I don't run it much. But if the heat makes me feel ill I just turn it on.

[vankirkc]

Yes. France is excellent. Except when the doctors are all on vacation.

http://www.usatoday.com/weather/news/20 ... heat_x.htm

The bulk of the victims — many of them elderly — died during the height of the heat wave, which brought suffocating temperatures of up to 104 degrees in a country where air conditioning is rare. Others apparently were greatly weakened during the peak temperatures but did not die until days later.

The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

Here in America I'm currently at the bottom of the pile. I would be considered in poverty if I didn't feel so rich. Guess what? My apt. has central air. I don't run it much. But if the heat makes me feel ill I just turn it on.

That's amusing. An unusual heatwave catches Europeans without air conditioning in their homes by surprise, and this is a) not evidence of a need for concern about warming, and b) an indictment of public health care as a system because 20% of the doctors were allowed to go on vacation.

I bet if you dig up stats for the U.S., you'll find that hospitals are down 20% in the summer time also.

[MSimon]

vankirkc,

You must have missed:

The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

BTW I live in a part of America that hardly ever gets above 100 F. Rarely above the mid 90s. And yet I'm poor (according to government statistics) and have air conditioning. I suppose it could be cultural. The French may prefer to sweat.

It could also be that the French don't consider air conditioning for the masses as part of their health care system. In America for those who lack air conditioning we have places set aside for the poor (who don't have or can't afford AC) to go during heat waves. You have to wonder why the French never thought of that.

[MSimon]

A heat disaster in Chicago:

http://www.press.uchicago.edu/Misc/Chic ... 213in.html

But the city did learn from its mistakes. In 1999, when Chicago experienced another severe heat wave, the city issued strongly worded warnings and press releases to the media, opened cooling centers and provided free bus transportation to them, phoned elderly residents, and sent police officers and city workers door-to-door to check up on seniors who lived alone. That aggressive response drastically reduced the death toll of the 1999 heat wave: 110 residents died, a fraction of the 1995 level but still catastrophic. The policy lesson is that there are limits to what any emergency plan can accomplish.

We know that more heat waves are coming.

That report was written in 2002. This year summer temps have been exceptionally low. Yesterday (in August - the hottest month of the year typically) it barely got above 70 F. And as they say in Chicago - it is cooler by the lake. Our hottest month in Rockford was April when we got temps near the mid 90s. Lots of folks reporting stunted tomatoes this year.

[vankirkc]

vankirkc,

You must have missed:

The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

BTW I live in a part of America that hardly ever gets above 100 F. Rarely above the mid 90s. And yet I'm poor (according to government statistics) and have air conditioning. I suppose it could be cultural. The French may prefer to sweat.

It could also be that the French don't consider air conditioning for the masses as part of their health care system. In America for those who lack air conditioning we have places set aside for the poor (who don't have or can't afford AC) to go during heat waves. You have to wonder why the French never thought of that.

Frankly, I don't see why publicly financed emergency cooling centers coupled with a private and costly and exclusive healthcare system beats a publicly financed emergency cooling center coupled with a public and cheap inclusive healthcare system. If we're doing some things better than they are, such as heat centers, let's keep doing that. Nothing says we can't improve on their model. The problem I have with the whole thing is that they're doing some things MUCH better than we are, and yet we're too arrogant to admit that we're botching things. Ideology is standing in the way of reality.

Americans have to divorce themselves from the idea that there is nothing they can learn from the rest of the world. Yeah it's a great place, lots of good ideas and nice qualities, but some things also really suck...like the health care system for example.

Before you start waving the flag again, be advised that I'm actually an American as well.

[MSimon]

vankirkc,

You must have missed:

The new estimate comes a day after the French Parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

BTW I live in a part of America that hardly ever gets above 100 F. Rarely above the mid 90s. And yet I'm poor (according to government statistics) and have air conditioning. I suppose it could be cultural. The French may prefer to sweat.

It could also be that the French don't consider air conditioning for the masses as part of their health care system. In America for those who lack air conditioning we have places set aside for the poor (who don't have or can't afford AC) to go during heat waves. You have to wonder why the French never thought of that.

Frankly, I don't see why publicly financed emergency cooling centers coupled with a private and costly and exclusive healthcare system beats a publicly financed emergency cooling center coupled with a public and cheap inclusive healthcare system. If we're doing some things better than they are, such as heat centers, let's keep doing that. Nothing says we can't improve on their model. The problem I have with the whole thing is that they're doing some things MUCH better than we are, and yet we're too arrogant to admit that we're botching things. Ideology is standing in the way of reality.

Americans have to divorce themselves from the idea that there is nothing they can learn from the rest of the world. Yeah it's a great place, lots of good ideas and nice qualities, but some things also really suck...like the health care system for example.

Before you start waving the flag again, be advised that I'm actually an American as well.

Americans get the health care they are willing to pay for. It is not the government's business to make those decisions for people.

It seems that a lot of Americans like to make their own decisions and those Americans (about 60%) stand as an impediment to change. No change that fails to account for the satisfied majority is going to pass.

BTW I do agree that there is plenty that Americans can learn from the rest of the world. Premier among that vast array of knowledge is a vital clue:

Socialism Doesn't Work

why is that? Margret Thatcher explained it in a rather pithy phrase:

“The trouble with socialism is that you eventually run out of other people's money.” Margaret Thatcher

BTW we no longer spend 25% of our income on food. (pre- 1930) Currently is is a little under 10%. Does that mean Americans are going hungry? Or did they just get richer and decided to spend the money saved on food on something else? Medical care say?

http://www.ilfb2.org/fff06/51.pdf

My guess is that if we get even richer, we will spend even more on medical care. With a side helping of space travel.

Well any way. I would like to assist Americans in getting richer. So more of them can afford to spend on that last 6 months. I have done some. If Polywell pans out I will have done a little more.

Wealthy people have different spending priorities. An interesting number I read was that rich people only live about 4X better than poor people. So the living gap is not large (except for a very, very, few). So where does all the extra money go? Investment.

BTW we do not have a medical care problem in America. If you want it you can get it. The problem is that if you are poor and uninsured it will break you. And you will probably not recover economically. As long as debts can't be passed on to children I don't see a problem. Plus we do have a tradition of charity in America that is very strong.

===

I'm not waving the flag. I'm explaining why some Americans think differently. They take all that stuff written by our founders seriously. Nothing proposed politically that doesn't take that culture into account has a chance of long term survival in this country.

How do I know? Long ago and far away I discounted all that stuff in my socialist fervor. Just look at me now.

[vankirkc]

vankirkc,

You must have missed:
BTW I live in a part of America that hardly ever gets above 100 F. Rarely above the mid 90s. And yet I'm poor (according to government statistics) and have air conditioning. I suppose it could be cultural. The French may prefer to sweat.

It could also be that the French don't consider air conditioning for the masses as part of their health care system. In America for those who lack air conditioning we have places set aside for the poor (who don't have or can't afford AC) to go during heat waves. You have to wonder why the French never thought of that.

Frankly, I don't see why publicly financed emergency cooling centers coupled with a private and costly and exclusive healthcare system beats a publicly financed emergency cooling center coupled with a public and cheap inclusive healthcare system. If we're doing some things better than they are, such as heat centers, let's keep doing that. Nothing says we can't improve on their model. The problem I have with the whole thing is that they're doing some things MUCH better than we are, and yet we're too arrogant to admit that we're botching things. Ideology is standing in the way of reality.

Americans have to divorce themselves from the idea that there is nothing they can learn from the rest of the world. Yeah it's a great place, lots of good ideas and nice qualities, but some things also really suck...like the health care system for example.

Before you start waving the flag again, be advised that I'm actually an American as well.

Americans get the health care they are willing to pay for. It is not the government's business to make those decisions for people.

It seems that a lot of Americans like to make their own decisions and those Americans (about 60%) stand as an impediment to change. No change that fails to account for the satisfied majority is going to pass.

BTW I do agree that there is plenty that Americans can learn from the rest of the world. Premier among that vast array of knowledge is a vital clue:

Socialism Doesn't Work

why is that? Margret Thatcher explained it in a rather pithy phrase:

“The trouble with socialism is that you eventually run out of other people's money.” Margaret Thatcher

BTW we no longer spend 25% of our income on food. (pre- 1930) Currently is is a little under 10%. Does that mean Americans are going hungry? Or did they just get richer and decided to spend the money saved on food on something else? Medical care say?

http://www.ilfb2.org/fff06/51.pdf

My guess is that if we get even richer, we will spend even more on medical care. With a side helping of space travel.

Well any way. I would like to assist Americans in getting richer. So more of them can afford to spend on that last 6 months. I have done some. If Polywell pans out I will have done a little more.

Wealthy people have different spending priorities. An interesting number I read was that rich people only live about 4X better than poor people. So the living gap is not large (except for a very, very, few). So where does all the extra money go? Investment.

BTW we do not have a medical care problem in America. If you want it you can get it. The problem is that if you are poor and uninsured it will break you. And you will probably not recover economically. As long as debts can't be passed on to children I don't see a problem. Plus we do have a tradition of charity in America that is very strong.

===

I'm not waving the flag. I'm explaining why some Americans think differently. They take all that stuff written by our founders seriously. Nothing proposed politically that doesn't take that culture into account has a chance of long term survival in this country.

How do I know? Long ago and far away I discounted all that stuff in my socialist fervor. Just look at me now.

Ok then. Why not take the same approach to law enforcement, water, air quality, product liability, military and everything else? You want it? Pay for it yourself!

Is there any room for government spending in your world view? It doesn't seem so from where I'm sitting.

[Skipjack]

TallDave
I had my appendix removed the very same day, I was diagnosed. I had no wait time for the removal of my tonsils when I was 6. I had the best(!) treatment for my heart attack when I had it. I had almost no lasting damage. I would have probably died in the US. It is a known fact that healthcare in the US is much worse than e.g. here in Austria, or in Germany. I got the best treatment known of, provided without any delay and for free. I have to take 200 USD worth of medication every month and it does not cost me a dime.
Also read my earlier post. We have almost no malpractise suits here. In the US you have so many that a topic at a recent conference for uroligists was, that doctors are meanwhile affraid of their patients!!!!
Your system is so broken, it is a joke, but you guys never get out of your four walls so you dont see it. I have been traveling back and forth between the US and here a lot. My wife is an US citizen and has been living here in Austria with me for 4 years now. We both can see the difference.
Yes, here you lie 3rd class (means you share a room with up to 5 others, depending on the station you are on), but you can always get an additional private insurance to lie first class and the medical treatment is always the same!
Here you do not have to worry about loosing your insurance ever. Even if you lost your job because of a prolonged illness, you would still be insured. In the US you are out of your luck, because the insurance company is of course happy to kick you when you are sick (because then you cost them money).

Dont even get me started on how crappy the medical support for your veterans is. That is shamefull! Here the few veterans that we have (we only do UN- peace missions in foreign countries) are treated just the same as a politician would be (unless said politician had an additional private insurance).

CTs and MRIs are done routinely whenever a doctor requests one. It just has to be signed of by the insurance company (unless it is an emergency).
I had an MRI before I got my nose polyp removed and my mother has had several MRIs for multiple injuries (spine, hip joint etc).

Dont take GB and France as examples. Their healthcare is among the worst in Europe. Take Austria and Germany instead.
And yes, our system is not ideal either. As I mentioned, I think that 25% of my income is to much to pay for what we get (that is healthcare, retirement and social insurance together). But then in the US you can pay A LOT more for much less and you will always have to worry about loosing your insurance.

[Skipjack]

I would also like to add, that I am not a socialist. I just want healthcare in the US to be as affordable and as excellent as it is here. Why, because I would really like to move to the US, but that would be really hard with your healthcare system at the moment. My healthcare bills would be way to high. In contrast, moving to Germany would be easy for me.

[Skipjack]

On the heatwave thingy quoted by MSimon.

Most buildings in Europe are much older than the ones in the US (in the US few are older than 50 years). It is very difficult to install airconditioning into old buildings (would be considered historic in the US). Plus, electricity here is much more expensive. So people dont invest into air conditioning.

But maybe I missunderstood something:
Does your healthcare pay for your airconditioning?

[MSimon]

Is there any room for government spending in your world view? It doesn't seem so from where I'm sitting.

Try reading instead of sitting. I think I have explained my position. There is a very limited place for government. Health care is not one of them.

No doubt the private sector is in some respects corrupt. The government - because you have no recourse and because they can command resources - even more so. The less government does the better. In fact collusion between the private sector and government is the worst of all possible worlds.

Should there be a minimum safety net. Yes. Very minimum. Should there be a War Dept. Yes. And it should be dominant. Should government be doing very long lead and unknown payoff research. Probably. But as you well know Government even does that stupidly.

If the US Government was really concerned about the money the people send to other countries for oil, Cash To Destroy Good Used Cars is not the answer. Drilling for American oil is. People say: well it is just a stopgap measure. My estimation is that a stop gap is all we need. About 20 or 30 years to get new technologies developed and economically deployed. In the mean time put a brake on rising oil prices.

And bloody hell. The enviros have a new trick: stopping the deployment of wind turbines.

http://wattsupwiththat.com/2009/08/26/t ... ken-fight/

Pretty slick - coal and natural gas pollutes the air (with plant food), nuclear is dangerous, solar destroys desert habitat, and wind kills birds. OH. Yeah. Fusion - which will make lots of stuff glow in the dark - is not even here.

I'm wondering where these guys think the TeraWatts are coming from?

Well any way. I'm encouraged at the progress Polywell is making. I think if the grid gets erratic enough all the stupid impediments will fall away. And we will use what we have to. IFRs. Thorium reactors. HTGRs. Whatever. Coal, gas, and oil if needed. How about 10 million solar roofs? Say 3 KWh a day. That is 30 GW hours of electricity. Now consider that the USA probably averages about (strictly SWAG) 300 GW hours a day with a power peak of 1 TW. Even with batteries and inverters to supply the peak load you are 270 GWh short.

And then neither the storage nor the production of wind and solar are any where near competitive. Combined they are even worse. We should be throwing gobs of money at Halbach arrarys, super flywheels, high temperature batteries, Lithium batteries, larger Inductrack experiments, carbon transistors, tons of stuff that is languishing. Not to mention paying to develop 12 MW (the economics look good for this size) wind turbines that are quiet. More money into solar cell research. New ideas in terms of efficiency and pilot manufacturing to improve processes. We could get a better bang for the buck than we do by subsidizing manufacture of devices that can't stand without significant subsidy.

And not to mention the fact that I can get superconducting magnets for experimental purposes pretty cheap because the USA has "too many" MRI machines. With 3 T machines standard and some experimental 9 T machines in the works.

[pfrit]

And not to mention the fact that I can get superconducting magnets for experimental purposes pretty cheap because the USA has "too many" MRI machines. With 3 T machines standard and some experimental 9 T machines in the works.

Thread highjack! Have you talked with Dr Nebel about the size and shape of these magnets? I would think that they could work, but I am NOT Dr Nebel and I don't play him on TV. Could there be issues that would render MRI magnets a non-starter? Too wide, too thick, too much insolation, etc. ? How much would a special order from a company that makes MRI SCMagnets cost? Say, you wanted one that was thinner or narrower?

Just asking.

[gblaze42]

I know I'm not the most liked person on the board but I can live with that.

But if you listen to anything, please listen to this.

My mother who lived in Canada died from cancer this year at the age of 82 due to the fact that she was to old, and the doctors pretty much said so. Even though they had caught the cancer early and it never spread from the bladder where it was found, it was considered a very aggressive cancer. It could have been easily removed by surgery, they didn't get her into the hospital until four months later, of course by then the cancer was to large and her had kidneys shutdown.

Now compare that to a fellow I work with here in the states, who was diagnosed with esophageal cancer and received chemo-therapy a week after his diagnosis and now is cancer free.

Is this where the US should be going? like Canada and how valueless life is when you get older?


People knock the US medical system but all in all it's the best system I've seen in any of the G8 countries.

[TallDave]

An unusual heatwave catches Europeans without air conditioning in their homes by surprise,

It's often a surprise to we Yanks just how much poorer our friends across the pond actually are; by PPP per capita GDP we are generally 30% wealthier than the large countries like France, Germany, and the UK. This shows up in odd places. For instance, in the Harry Potter books Privet Drive is supposed to be a relatively well-to-do area in modern times yet no one has air conditioning. That's unthinkable here in the U.S., where even people in trailer parks can usually afford a window unit, and central air is standard even in temperate zones like Illinois.

It's interesting that so many people try so hard to ignore the basic fact pointed out above: socialism doesn't work. More specifically, it creates inefficiencies and disincentives that make everyone poorer. We keep hearing the same arguments we heard from the Communist bloc last century (greedy private industries are less efficient because of profits) even though everyone now agrees those arguments were wrong. Even the Chinese Communist Party has embraced the superiority of free markets and profit motives.

Yet people somehow think health care is immune to these forces.

How much of America's greater wealth is due to a relatively free health care market? Hard to say, but it's a big chunk of the economy.

[TallDave]

I had my appendix removed the very same day, I was diagnosed. I had no wait time for the removal of my tonsils when I was 6. I had the best(!) treatment for my heart attack when I had it. I had almost no lasting damage. I would have probably died in the US. It is a known fact that healthcare in the US is much worse than e.g. here in Austria, or in Germany.

It's amazing how people cling to this belief in the face of actual facts. The idea of getting something for nothing has a very powerful allure.

It's nice you got prompt treatment for several common conditions. Socialist systems do pretty well at these -- because of course doing common procedures delivers the highest cost-effectiveness.

OTOH, should you have a difficult to diagnose problem where an MRI or a highly specialized procedure is needed, you would be in much worse straits (there is a necessary tradeoff between efficiency and risk; do you do an MRI for a 5% chance of finding something, or only 25% or more? do you train doctors for a procedure that is rarely needed?). More diagnostics and more specialists means you find and treat problems sooner, when they can be addressed more effectively, albeit at greater expense. This is why the U.S. has the best cancer survival rates.

But at least your delayed treatment is free, right? Well, you get what you pay for.