Obama!!!

The entire argument seems redundant to me, as Golgot put it; in the private sector insurance companies deny live-sustaining medicines and procedures because of cost. The government would most likely do the same. This is what irritates me so much about our culture, the disingenuous sentiment that life is sacred and of utmost importance. If life were really so important to us, then would any of us give up a year's salary to save several, or better yet one individual? Not just some hot girl or cute kid, I mean like a middle-aged man or woman. How about a hooker or a drug dealer? So life is really only important when it's a life we approve of, or believe should flourish, the scientists, supermodels, and athletes. Did you ever notice that over 99 % of the major missing person's cases it's usually a hot, overachieving girl, or a cute kid?

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...uh the post is up there...

Barack Obama is very good with words...that's about the only thing he's shown to he's good at.

Being a candidate is all about what you say, while being a President is all about what you do. To this point, Obama has shown himself to be a fantastic candidate and a poor President.

Certainly true. The obesity & violent mortality rates in the US are famously 'above average' and must play their role. The former you'd think could be partially addressed via preventative/informative healthcare (although there's less money in that ), but the latter is really a patch-up job after the event and not their remit. Ditto the automotive, & to an extent the infrastructure angles, which seem reasonable assessments.

At the end of the day the disparity between the US's mortality rates & the rest of the developed world isn't huge, especially when taking into account none-healthcare factors that you mention, and aspects like the uninsured 16% or so of the populace. It's just a bit surprising.



What's more striking though is just how much more is being spent on healthcare per capita, for very little apparent gain (see my previous giant posts for some other possible reasons for this )

Not sure precisely how population size affects per capita health cost/effectiveness, beyond the infrastructure issue you've mentioned (and remember there's probably 'economy of scale' benefits as well of being a large 'consumer' - not to mention that you manufacture a large proportion of the world's pharmaceuticals locally etc, i believe).

You seem to have comparative doctor and bed numbers to the UK, for example, according to the above stats. The question remains, given how much money is being spent, of why you lag in any areas. (There are lots of caveats here as everywhere - the quality/specialisation of the doctors can be more important than the quantity of them etc).

PS i imagine international aid will be included in healthcare spending stats.

About 50-60 years in the UK all told, and there have been varying forms of opposition to it since its inception. Aspects like dentistry got levered out to an extent early on (no stereotyping at the back), and there's been plenty of public-private-partnership crossover during the last decades etc. Possibly why it's more efficient, on a surface statistical level, than some of our 'socialist' cousins . [Not that all the 'outsourcing' etc has been effective. A drop in cleaning standards after privatisation was a more obvious recent example of poor implementation].

Not sure how/why this should effect current comparisons with the US tho. Are you suggesting that the US is moving towards a nationalised system (and that, if that were to entail improvements in service, they would take time to kick in)? I'm a bit confused by the claims of nationalisation in the US. It seems to me that the state insurance angle has been dropped in the first place, and it didn't seem like it was going to be anything comparable to the UK's National Insurance (cordoned-off 'welfare tax') system, with contingent nationalised infrastructure. Is the admin pushing for some form of say over how insurance money is spent within the healthcare system? (One of the theoretical benefits of a nationalised system, if done right).

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Virtual Reality chatter on a movie site? Got endless amounts of it here. Reviews over here

I'm so tired of the misplaced moral regard placed on the disabled in this country. When someone who is born severely aesthetically compromised, it is then necessary to force feed this false pride; "I'm handicapable," just for you to feel like you're being so compassionate and merciful. Then you hear people talk about it like you can compensate; "Well, Bill's completely paralyzed, but he sure can play harmonica," in a feeble attempt to justify their existence, to reconcile your own conscience. Yeah, that really makes up for being crippled. Then most of these people who feed these delusions act repulsed by the thought of such individuals accepting government support. They believe disabled people should always live, but they don't like the burden that results. I guess they like cripples in theory, not practice.

The rule of thumb is the cuter/more attractive you are, the more coverage you'll get. That's also the reason that you're more likely to hear about a missing girl than boy. My advice to any parent is, make sure you've got good pics of your kids, the cuter the better. Don't just have school pics, but get good posed pictures. For anyone who doesn't think there's any evidence for this or flat out just don't believe me, I've got two words for you - Maddy McCann. Worldwide coverage, parents met the Pope, not only did they have cute pics, but great video too.

Just found this 'fun' little interactive graph of spending/mortality stats that you can tailor to suit your level of intrigue. (Those who don't care, don't click, for example )

I think ruf's points about extenuating factors in the US (obesity, murder rate, travel impact) should all be born in mind (even if they do raise questions of their own) - along with the issue of reduced access due to cost. The disparities still look bizarre for the world's leader etc tho. My own 'fave' was the controlled-for-GDP look at money per capita spent. Thought maybe that might make the level of spending look not quite as bad, but doesn't really make a dent. Does suggest there's either big overspend, or big 'lifestyle' overheads being covered (or most likely, a bit of both).

You have some interesting stats. I'm surprised at some of the countries that have more hospital beds per capita than we do. Of course, there are hospitals and there are hospitals. People from all over the world come to Houston for heart transplants and cancer treatment because we have hospitals and staff here who are the world's leaders. But about 300 miles down the Gulf Coast in Corpus Christi is a hospital I wouldn't trust a dog to based on people I know (including some relatives) who had what should have been routine surgeries but then came down with life-threatening infections as a result of poor and careless treatment by the hospital staff.

One thing I've noticed, particularly in Houston, is the large number of doctors and nurses who have come here from other countries. There has been a large immigration of doctors and nurses from Canada who tell horror tales of nationalized medicine in that country. One of the best doctors who ever treated me was a woman who came to this country with her husband, also a doctor, from Poland. A great many doctors, nurses and hospital specialists in Houston are of Asian descent but speak English better than I, so likely were born here or immigrated as children. A lot of Vietnamese fled to this area when the communist took over the southern portion of that country.

I don't know enough about what health programs are being proposed here or to what degree European health programs are nationalized or "socialized" or what that even involves. Never been treated over there on the national economy. But I have read there was resistance to nationalized medicine when it was first established in the UK and have heard both good and bad about it since. I'm not qualified to say what would be best for most people here or there.

My one experience with nationalized/socialized medicine was three years as a medic in the US Army. My daughter was born in Irwin Army Hospital at Fort Riley, Kan. Her mom got good pre-natal care, and they both were well cared for while in the hospital and in the regular check-ups later. My only out-of-pocket cost was for my wife's meals while she was in the hospital. (On the other hand, Army pay was so poor that we couldn't even afford the food she should have been eating. There were weeks when we lived on rice and gravy made with instant milk--or sometimes just water-based gravy.)

When I was on duty, we ran hundreds of GIs through sick call in just 3-4 hours. Very efficient. No one got the treatment they wanted but they usually got enough of the treatment they needed. Of course, there were gaps. When I was in basic training, I tore up my ankle when I stepped in a hole while our executive officer, a former all-American football player who liked to take us on runs, was double-timing us through an unbroken field of snow, lined up all abreast so we all had several inches of fresh snow to run through. Even a blindman could see my ankle was plumping up like the Pilsbury doughboy, so my sergeant dismissed me to limp alone for several blocks to the dispensary and go on sick call. After waiting for awhile, I and some other foot-injury cases were called to a backroom, handed a dishpan and told to fill and soak our injured feet. The dishpan wasn't deep enough to reach my ankle, which really didn't matter since it was cold anyway. Sat there with my foot in the water for maybe 2 minutes then was called to see the doctor. He eyeballed the swelling, said I likely had a spring, and dismissed me with a note for "light duty" for 24 hours. Then I hobbled back to my barracks. Ankle was still swolen the next morning but I jammed it in a GI boot and fell out to march to the rifle range. The 24-hours of light duty started from the time of my injury so had run out by then. Yet my sergeants were very solicitus and told me I could ride out to the range on the ammo truck. What they didn't tell me until I reached the ammo dump was that I had to low the truck with ammo first! Later after a few hours on the rifle range, I shoulder my M-1, slung on my pack turned up the collar of my field jacket, tilted my helmet down over my eyes and marched off the range with the rest of my company while in the background sergeants and officers were calling for me to go back in the ammo truck, with crates of brass casings and unused ammo. I never again went on sick call in the Army, although when I was trying to quit smoking, I asked one of the Turkish doctors under contract to the Army to give me a tranquilizer while I was trying to quit smoking. He gave me a pill from samples he had been given by a drug company to test on the troops. Damn thing knocked me unconcious for 2 days!

Now that's one example of government medicine.

I was interested in your remark about dental service apparently not being part of the government care package in the UK. Apparently it also was excluded from nationalized care in Germany, too, because the women in that country have the worse teeth I've ever seen! German men probably do too, but I never got that close to them.

Nothing can ever make up for being crippled, but I've had occasion to spend time in polio wards and at a state rehab center here in Houston for babies with brain injuries and paraplegics and quadraplegics of all ages. I enjoyed my time with these folks because they all had a magnificient zest for life. I could go there with a bad mood and they'd cheer me up! But then my second wife, one of the prettiest women I've ever seen, was crippled with polio when she was just 2 years old and wore braces on both legs. My current wife has suffered from rheumatoid arthritis since age 16 that distorted her joints and twisted to one side all the fingers of both hands. She now has plastic knuckles in both hands and an artificial knee in one leg. And both of these women are better people and more fun to be with than any of the "normal" people I know.

One of the many oddities, ay, given your world-leader status.

Absolutely. (And i'm sorry to hear about your relatives' experiences incidentally).

The article i linked to in my mammoth post suggested a favourable trend which seems worth harping on about - the idea that hospitals with salaried doctors (or equivalent payment systems) were outperforming standard 'pay per procedure' hospitals (& were cheaper to boot). I'd suggest that those are the ones to seek out, if you have the choice locally. (The article also suggested that bad practices can cluster - in terms of profit-over-care dynamics. For many reasons, i can understand if choice is limited geographically)

Yods and i were discussing this aspect in a PM. Apparently the US imports about 1/4 of its medical staff, and most 'nationalised' systems import up to 1/2. We then got on to the question of the morality of this, given the likelihood that we're depriving many developing countries of doctors. Ran into this study, which suggests there are win-win aspects, but we almost certainly are taking up more than our 'share' of doctors too globally.

As for your Canadian doc, state health systems definitely do come with downsides (altho many can be sidestepped if you have the cash to go to private institutions). However, you seem to have some horror stories of your own. Seems no one's found the perfect system yet

And you didn't even mention their armpit hair. Good for you

Okay, as far as this whole CIA interrogation situation is concerned, my thoughts are as follows; I am fairly certain that we have been engaged in practices at least similar to this well before 9/11, but that the neoconservative ilk simply brandished it like a kid who's found his Dad's gun. The argument that's constantly asserted is that no other attacks have taken place since the supposed disposal of these practices, which to me, is the dumbest argument ever. Yeah, and after Pearl Harbor we weren't attacked on our soil again until 1993, so really the argument kind of dissolves there. I mean maybe it makes you feel better knowing the extremes authorities will go to, just to ensure a little bit of peace of mind. What gets me is that you base your trust on the word of extremist murderers, who are under duress, as if they are speaking the Gospel truth. Hey, if it makes you feel better, have a ball. I personally don't think it matters to a massive degree.

This is quite an eloquent statement. It teases the "balance" of things, and at the same time uses the prefix "neo". In the end it is a bit wishywashy.
You distance yourself and at the same time try to be focused.

Fail.

I'm not sure what is meant by "balance." Wishy washy perhaps in the sense that I acknowledge that most likely that the methods that are being argued over are not entirely new. As far as the "Neo" comment, are you saying there aren't neoconservatives? I wasn't aware that I was distancing myself from anything, at least consciously. I certainly hope that my posts are focused, otherwise what's the point.

I was baiting, sry, I do that now and then. All good.

Okay

k

Speaking of wishy washy and wee wee'd - what is up with the Dem's trying to ignore Mass law that was put in place by the same people who now oppose it? It does not really matter to me I guess, but it is kinda wish washy.

[quote=Golgot;562306]Apparently the US imports about 1/4 of its medical staff, and most 'nationalised' systems import up to 1/2. We then got on to the question of the morality of this, given the likelihood that we're depriving many developing countries of doctors. Ran into this study, which suggests there are win-win aspects, but we almost certainly are taking up more than our 'share' of doctors too globally.

I don't think the US is going overseas to recruit doctors and nurses so much as medical personnel are coming to the US because a) it's a big market and b) it's much more lucrative than the medical industries in their countries.

I've got a lot of respect for foreign doctors myself: the Army dispensary to which I was assigned in Germany had only one US doctor on duty, an Army captain attached to the 68th Armored (or one of those tank units). The rest were civilian doctors working under contract to the US Army--including 1 German, 1 Egyptian, 2 Poles, and probably some others I've forgotten. I liked them as people and trusted their medical experience to the point that they treated me and my dependents. Others didn't feel that way. I remember one emergency call we got--some lifer sergeant had a heart-attack and we rolled one of our ambulances to pick him up late at night. Brought him into the dispensary on a gurney and rushed him back to the single doctor on night duty, who happened to be the German, I think. The sergeant had a fit, wanted us to get him an "American" doctor. When we refused, he jumps off the table and storms out. I and the ambulance driver both offered to give him a ride home in the ambulance, cause the guy was obviously sick, but he was PO'd and refused. The idiot walked by to his on-base housing and dropped dead just inside his apartment. There was an investigation, but we documented the whole thing and had plenty of witnesses, so nothing came of it.

Another time, I had some officer--a captain, as I recall--come in wanting to see the doctor. I suspected he wasn't really an emergency, but I pulled his records and sent him back to the doctor's office. Again, one of the international doctors was on that night. So the officer comes storming back up to the desk and demands to see an American. Told him I was only authorized to call another physician if we were swamped with patients from a disaster, not just one picky patient. SOB braces me to attention and tells me, "I'm giving you a direct order to call me an American doctor."

Yessir! Its 2-3 a.m. and I dial up the unit commander, a major--don't think he was a doctor, just an administrator. Anyway, I apologize for waking him and told him the captain ordered me to make a call. He says, "I'll be right down." Few minutes later he comes roaring into the parking lot, storms into the dispensary, pulls out his ID card and slaps in on the desk in front of the captain, and roars, "I'm Major So-and-So. Now who the hell do you think you are?" Man, he gave that captain an ass-chewing that a drill sergeant would have envied! Not supposed to do that in front of enlisted men, but I was at my station behind my desk, pretending to look through files, and doing my best not to burst out laughing. When he finally spit the officer out, the guy just saluted and left as fast as he could. He'd had all he wanted of our dispensary!

I love Obama!

Really?

then here's a video just for you.