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Aug 07, 2009

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brandonB

According to hr3200, if I don't have a government approved plan, I will have to pay a 2.5% health care tax that will not be credited to me, and the non-resident aliens who benefit from this are not forced to pay the tax.

As far as killing granny, I really don't think the federal government is capable of organizing a system where everyone receives equal quality care. I'm just looking at the past failures of big government programs.

Didn't we have to reform public health services once, resulting in medicare? Now we are reforming again, and of course, we don't have the time to do it right, we just need it NOW! Who cares if we screw people 50 years down the road. We don't need a sustainable system, we just need ACTION NOW! Right?

Ed Cone

We did create Medicare several decades ago, for a limited segment of the population. Now we're trying to make sure other Americans have similar options.

The system we have now seems unsustainable. Countries with programs similar the ones under consideration tend to have lower costs and better outcomes.

Beelzebubba

bB: if you're elected to do something, you just have to do it, whether it's done with the *winstongator >10 default coefficient or through the madness of crowds. The madness on both sides is so polarizing, no one notices who's getting skimmed. This tactic is for master gamesmen only. Disclaimer: Do not try this at home or without government supervision.

Roch101

Brandon, what is a non-resident alien?

Jeffrey Sykes

Non-resident alien.

Roch101

Judge Haller: "Let the record show the counselor is holding up two fingers."
Vinny Gambini: "Your honor, please!"

Jeff, do you think Brandon knew what a non-resident alien is? It is hard to understand his objections to this provision of the bill with a correct understanding of non-resident alien.

Jeffrey Sykes

I am assuming he is aware of the separate tax provisions for resident status. I don't know.

I would assume in America that a lot of people are opposed to hand outs for people who don't pay into the system.

greensboro transplant

ed,

you keep saying this: "Countries with programs similar the ones under consideration tend to have lower costs and better outcomes."

i haven't seen any data to back it up though. can you post some links?

winstongator

The medicare angle is just one approach to argue for expanding health insurance. Krugman today points to Art Laffer, seemingly trying to paint Medicare as something other than a gov't program.

Many conservatives argue that everyone has access to health care - through ER's. So, much of those bills go unpaid and are absorbed by everyone who pays. You could claim we have catastrophic health insurance - the bankruptcy courts! You get a 200-300k medical bill, have no insurance, you declare bankruptcy, and post-pay the insurance through ruined credit. Is this really the system we want? Do we want people putting off care until it becomes an emergency, or getting primary care at ER's?

If you truly believe people have access to care through ER's, you must acknowledge that the payment gets made up from others. Why wouldn't you want a system that is organized?

Jeffrey Sykes

Gator: That's a big part of the problem, human choices, that switching to a government plan won't solve.

People flooding to the ER because they have a cold is just another symptom of the "me first and damn the consequences" culture we've created.

Ged

I'm sorry but you don't get ongoing care for chronic heart problems in the ER. You don't get chemotherapy or radiation treatments for cancer in the ER. I could list dozens of other similar scenarios but I think you get the picture. Many people can and do receive health care treatment in emergency rooms across the country, but for the kind of care that typically bankrupts the uninsured, the ER is not the solution.

Roch101

"I would assume in America that a lot of people are opposed to hand outs for people who don't pay into the system." -- Jeff

Agreed. Does the proposed House bill give handouts to non-resident aliens?

Ed Cone

GT, here's one source of the info.

winstongator

I never knew it was just people flooding the ER with colds that was the problem. Funny, because there's not a whole lot doctors can give you for a cold, you can't get OTC.

I would claim that most opponents of health care reform follow a 'me first damn the consequences' philosophy. The main grievance that opponents have is that their taxes might go up. How is that not a me-first attitude?

Ged hits the problem with ER treatment. I have linked to a frontline episode in the past that highlighted a woman with lupus. Maintenance care is expensive but reasonable and would keep her healthy. She lost her insurance and couldn't keep up with care. She got emergency care after her health degraded. Care that was extremely expensive. The cost of that care could have paid for many years of her maintenance care.

brandonB

It's funny, the whole "me first" thing. I am an opponent and I do not have any insurance whatsoever. I do not think my employer or the government should be responsible for my insurance. I do think we need to get our economy rolling so more people can pay for their own insurance. Hell, if the govt is going give it to me, why should I bother getting it for myself. Roch doesn't mind paying for mine, do ya roch?

Ishmael

Hate to break this to you BB, but the uninsured jack up the prices for the insured and jack up hospital prices for insurance companies and the insured.
Why? Because life happens - people fall off ladders, catch a bad case (sometimes a VERY bad case) of the flu, take their mind off their driving and get into an accident, get hit by a tree limb while walking out in the woods...
You are not doing anyone any favors by not having insurance. You are playing sort of a roulette game with your health. Heck, right now you might have a tumor growing in your body that if you got it checked out in time could be safely removed. If you wait, well, no insurance company is going to want to touch you and that's when the reality hits.
Being a responsible citizen is paying attention to how what you do or don't do affects the lives of other citizens. Yet I can't help but think when I pay my hundreds of dollars of premiums a month that you may someday be a beneficiary of the "extra" built into my bill.
And I guess I could have used that "extra" to buy some things and employ a few people rather than pay for your emergency room visit.

Jeffrey Sykes

Gator: I think everyone agrees that utopia would be a great thing. I would love to see a world where every child has a lollipop and every adult can ride the unicorn of their own desire.

I just don't think it is realistic to say everyone will have access to quality, affordable health care.

I believe the two are mutually exclusive.

I could be wrong, and would love to be proven wrong.

Everyone agrees about the sob stories about lupus and people being cut off the rolls of their insurance company.

But a lot of the arguments in favor of a public option kind of reminds me of the argument 10 years ago that we should extend mortgages to subprime borrowers on the hopes that hundreds of years of banking experience that say subprime borrowers are a credit risk is a corporate lie.

I wonder if you all actually believe that our government will be able to create this wonderful play land where everybody has access to quality, affordable health care and the doctors won't be turned in to DMV examiners and your office visit will be nothing like going to the Social Security Administration.

It will be a blissful existence.

I also wonder where any of you have ever had experience with a government agency and came away feeling something other than as if you lost a quart of plasma?

But if you all feel certain that the same government that brought you Walter Reed Army Hospital and routinely pays thousands of dollars for hammers and toilet seats can create this wonderland of free health care that tops the charts in quality of service then I hope you are right.

When you finish creating this wonderland, I submit that we should next have universal access to season tix for UNC basketball. It's a right. Why should I be denied access to the Dean Dome because of ability to pay? Those lawyers and doctors and alumni legacy folks make way too much money, they can afford to spread the wealth and share their tickets with me.

America is the land of milk and honey. Why should anyone in a country this rich be denied access to Tar Heel basketball?

Surely those rich folks who hog all the good seats can afford to pay a surtax so I can have access to quality, affordable Carolina basketball tickets.

Roch101

"Roch doesn't mind paying for mine, do ya roch?" -- Brandon

brandon, before we change the subject, are you going to tell us why you object to non-resident aliens being exempt from the tax?

Graham Shevlin

I have some bad news. In other countries people do have access to quality affordable healthcare. My Dad, despite chronic emphysema, is alive and functioning thanks to the National Health Service in the UK. Apart from prescription deductibles that care has cost him nothing (although I prefer to see it as a deferred benefit of the taxes that he paid while we was working hard to bring up a family and be a good citizen).
I am constantly being told by people that this is the greatest country in the world. OK, let's see it in action. I refuse to believe that the USA cannot construct a healthcare system that provides affordable healthcare for all residents.
As for the current attempts to disrupt town hall meetings - as somebody who watched old newsreels of the 1930's in Germany and Italy, and studied European history in high school, I know what I am seeing, and it is most certainly not democracy in action. This is fascism, and it needs to be called out for what it is, and the scumbags who are oergnizing and leading in it need to be vilified and ridiculed until they slink away like the bullies and cowards that they are.

bubba

"We did create Medicare several decades ago, for a limited segment of the population. Now we're trying to make sure other Americans have similar options."

And the proposal is to gut Medicare to pay for it.

But what the heck....Medicare is going tango uniform anyway, right?

bubba

"This is fascism, and it needs to be called out for what it is...."

No, this is fascism, and we ARE calling it out for what it is.

bubba

"My Dad, despite chronic emphysema, is alive and functioning thanks to the National Health Service in the UK."

You left out the comma and the "no" between "functioning" and "thanks".

Deroy Murdock:

"Look what you're missing in the U.K.:

* Breast cancer kills 25 percent of its American victims. In Great Britain, the Vatican of single-payer medicine, breast cancer extinguishes 46 percent of its targets.

* Prostate cancer is fatal to 19 percent of its American patients. The National Center for Policy Analysis reports that it kills 57 percent of Britons it strikes.

* Organization for Economic Cooperation and Development data show that the U.K.'s 2005 heart-attack fatality rate was 19.5 percent higher than America's. This may correspond to angioplasties, which were only 21.3 percent as common there as here.

* The U.K.'s National Institute of Health and Clinical Excellence (NICE) just announced plans to cut its 60,000 annual steroid injections for severe back-pain sufferers to just 3,000. This should save the government 33 million pounds (about $55 million). "The consequences of the NICE decision will be devastating for thousands of patients," Dr. Jonathan Richardson of Bradford Hospitals Trust told London's Daily Telegraph. "It will mean more people on opiates, which are addictive, and kill 2,000 a year. It will mean more people having spinal surgery, which is incredibly risky, and has a 50 per cent failure rate."

* "Seriously ill patients are being kept in ambulances outside hospitals for hours so NHS trusts do not miss Government targets," Daniel Martin wrote last year in London's Daily Mail. "Thousands of people a year are having to wait outside accident and emergency departments because trusts will not let them in until they can treat them within four hours, in line with a Labour [party] pledge. The hold-ups mean ambulances are not available to answer fresh 911 calls. Doctors warned last night that the practice of ‘patient-stacking' was putting patients' health at risk."

Dave Ribar

Bubbs:

Since you bring it up, here is a comparison of vital statistics in the U.K. and the U.S.:

U.S.:
Infant mortality: 6.26 per 1,000 births
Life expectancy at birth: 78.11 years
GDP per capita: $47,000.

U.K.:
Infant mortality: 4.85 per 1,000 births
Life expectancy at birth: 79.01 years
GDP per capita: $36,6000.

We have substantially greater wealth yet worse health outcomes. What wankers the Brits are.

Dave Ribar

Bubbs:

BTW: This is what your champion Deroy Murdock wrote on Nov. 10, 2008:

"Governors Mark Sanford of South Carolina and Louisiana's Bobby Jindal are attractive young reformers with lots to offer through at least 2012. Ditto former Maryland lieutenant governor Michael Steele, author of 2008's best slogan: 'Drill, baby, drill!'"

A shrewd judge of horseflesh he.

This would be the same

bubba

Well, Davie-Boy, channeling Krugman and trotting out the infant mortality numbers again is no less misleading and inaccurate regarding the quality of American health care now than it was before.

Your lack of understanding about US infant mortality figures is further illustrated by the information here.

On the other hand, it's doubtful you'll admit that the way you present the numbers neglects to tell the full story.

Apparently willfully misrepresenting statistics must no longer be an issue anymore in the the Ivory Tower world of economics in which you exist.

One thing is clear from your post: You are QUITE the authority when it comes to statistical wanking.

bubba

"A shrewd judge of horseflesh he.'

And the relevance of your reference in regard to the facts Murdock presented in the health care article is.......?

Oh, wait. I get it.

Relevance, like the misrepresentation of statistics, must no longer be an operative requirement in the World According to Davie-Boy.

bubba

The astute reader will also note that Davie-Boy fails to address the information contained in Murdock's post.

Why is that?

greensboro transplant

ed,

no doubt you understand that while health care is one factor in the mortality and life expectancy measures, mortality and life expectancy are not measures of the effectiveness of a health care system.

please give me more than this.


bubba

Here's more on infant mortality statistics.

Noteworthy:

"Life expectancy and infant mortality are wholly inadequate comparative measures for health care systems. Life expectancy is influenced by a host of factors other than a health care system, while infant mortality is measured inconsistently across nations.

Neither of these measures provides the United States with conclusive guidance on health care policy, let alone serve as reliable evidence that a system of universal health care 'should be implemented in the United States.' "

Joe Guarino

Measures like infant mortality and life expectancy can be heavily influenced by variables such as health behaviors and genetics and nutrition in a given population. These variables are not necessarily the same from one nation to the next. In fact, they can vary quite a bit, so it is a bit difficult to compare one nation to the next from the standpoint of the influence of medical care on measures like life expectancy and infant mortality.

The efficacy of a nation's health care likely will only explain part of outcome measures like life expectancy and infant mortality.

Ged

Not sure where some people are getting their statistics from on this thread, but the latest figures from the United Kingdom for 2007 show the five year survival rate for women with breast cancer to be 82%.

So no, 46% of women in the UK do not die from breast cancer.

brandonB

"OK, let's see it in action. I refuse to believe that the USA cannot construct a healthcare system that provides affordable healthcare for all residents."

--So, this bill is the only way? It doesn't matter the quality of the care, as long as every has equal access to the same shitty system, right? Funny thing is, I know a lot of you bloggers are middle aged types, and you would looove for this to pass because you know medicare is unsustainable, and if this bill, ANY bill passes, you'll be taken care of for the next 10-20 years. Me? Will this current bill ensure quality, affordable care for me in 30-40 years? hmmm? Or will we be fixing this potential screw up? No no no, we need reform NOW!!! Anything!!! Just do something!!! Forget sustainability!!! We just tax and tax and tax until we are all working for our govt rationed everything.

brandonB

The emergency like characterization on part of the libs is amusing. Everone I hear from its "we are just wasting time! this needs to pass so we can all move on." Right, remember libs, what happened the last time we let Uncle Sam do whatever the hell he wants without thinking it through, because, it was after all, an "emergnecy". I think we are still involved in taking care of that emergency in Iraq all these years later.

Ed Cone

Dr. Guarino is correct -- and I hope my link to the chart did not suggest otherwise -- that infant mortality and life expectancy are not definitive measures of a health system's efficacy. Neither are they meaningless.

Note the cost figures in that data set, which show that the US pays far more per capita than the other countries listed.

Ged, thanks for the cancer stats. More here.

BB, health reform has been a hot issue for more than half a century. It was a stated priority of the Obama campaign. I agree that we don't want to rush into something half-baked, but it's not like this is coming out of the blue.

Roch101

"So, this bill is the only way?" -- BrandonB

Well, you are the only one saying that, so argue with yourself if you will.

And thanks for explaining why we should object to the provision that exempts non-resident aliens from the 2.5% tax, that was real big of you and a clear demonstration of the depth of your knowledge and your thoughtfulness on the subject.

Kim

From what I understand-some 40 million Americans are "uninsured". 25% are illegals, 25% are eligible for Medicaid, but do not participate, 25% can afford insurance, but choose not to, 25% want to be insured and can not afford it. Why can't we first focus on the 10 million who need help, rather than overhaul the entire system in 30 days time, not knowing how it will work out?

Ed Cone

Other issues, including portability and selectivity of coverage, need to be addressed as well.

And again, it's hard to look back on decades of discussion and conclude that we're doing this in haste.

bubba

"So no, 46% of women in the UK do not die from breast cancer."

And you draw that conclusion by what statistical evidence?

Ged

From the links that both I and Ed posted. Stop being obtuse.

bubba

"....but the latest figures from the United Kingdom for 2007 show the five year survival rate for women with breast cancer to be 82%."

Well, golly gee whiz.....You neglected to read this, didn't you?

"The study showed the US had the highest five-year survival rates for breast cancer at 83.9% and prostate cancer at 91.9%.

Japan came out best for male colon and rectal cancers, at 63% and 58.2% respectively, while France fared best for women with those cancers at 60.1% and 63.9%.

The UK had 69.7% survival for breast cancer, just above 40% for colon and rectal cancer for both men and women and 51.1% for prostate cancer.

....Since that time, cancer survival rates in England have been steadily improving for but we accept that there is further work to do to reduce the gap between us and the rest of northern and western Europe and America."

Of course, you may want to make a modified version of the remark Davie-Boy made above: "What wankers the BBC are."

Ed Cone

"Japan came out best for male colon and rectal cancers, at 63% and 58.2% respectively, while France fared best for women with those cancers at 60.1% and 63.9%."

Japan and France have national health plans. The French system is one that we might do well to emulate.

Ged

No, Bubba, you failed to read your *own link*. According to that BBC story - "A Department of Health spokesman said the report covered patients diagnosed between 1990 and 1994."

My data was from 2007. Yours was from 1994. Pay better attention next time.

Ishmael

What possible reason would someone want to cite data nearly 20 years old?

Bubba

"My data was from 2007. Yours was from 1994. Pay better attention next time.'

No, Ged. It's a story from July 2008 discussing historical results and medium term health care trends. As usual, you ran your mouth not knowing what you were talking about.

I'll repeat part part of the excerpt I posted:

"Since that time, cancer survival rates in England have been steadily improving for but we accept that there is further work to do to reduce the gap between us and the rest of northern and western Europe and America."

You obviously were in too big a rush to slobber out your response to comprehend what was actually written.

I'm not responsible for your learning disability.

Ged

Bubba,

Once again you prove that your stubbornness and inability to admit you are wrong clouds your thoughts and writings. You originally stated the following for why health care in the UK wasn't on par with that of the US:

"Breast cancer kills 25 percent of its American victims. In Great Britain, the Vatican of single-payer medicine, breast cancer extinguishes 46 percent of its targets."

That fact, was from a story dating from 1990-1994 and yet you held it up as an example of why the UK health system is worse than ours. When I called you out on it, you couldn't even admit that you were wrong and the stats that I and Ed both linked to are correct. That BBC story doesn't show current data, but the link I provided did.

46% of women in the UK don't die from breast cancer, at least not in 2007. You distorted the facts to suit your own liking as you often do, which is typical of what the right is doing in this country as we speak regarding insurance reform.

If you can't admit to plain and simple facts, stay out of the debate.

Bubba

I'm going to be charitable here by refraining from labeling you with the description that you deserve.

Here's what you said that started this whole thing off:

"Not sure where some people are getting their statistics from on this thread, but the latest figures from the United Kingdom for 2007 show the five year survival rate for women with breast cancer to be 82%.

So no, 46% of women in the UK do not die from breast cancer."

And what do you subsequently do? You link to A FIVE YEAR SURVIVAL RATE CHART FOR SURVIVAL RATES.

Do you not understand the difference between that, and a MORTALITY RATE chart?

Then you completely fail to comprehend, not once but twice, the material contained in the BBC link. It was NOT a "story dating from 1990-1994".

Here's what the link said and what you said: "A Department of Health spokesman said the report covered patients diagnosed between 1990 and 1994." The study did not stop in 1994. Can you understand that?

Don't give up your day job for this type of thing.You're not very good at it

The fact remains that the US is ahead of the UK in positive outcomes for women victims of breast cancer.

There are significant reasons for that, not the least of which is that our current medical care program holds a distinct advantage.

Ged

I understand what we're talking about all too well Bubba, I survived cancer myself. You're digging yourself a hole and there's no one there to pull you up.

Once diagnosed, women in the UK have an 82% survival rate of beating breast cancer after 5 years.

That means the MORTALITY rate from breast cancer for women in the UK is 18%, not 46% which is what you originally posted with the Murdock quote.

How does this compare with the United States 5 year survival rate for women with breast cancer? According to the American Cancer Society, it compares pretty much the same:

US Younger than 45: 81%
US Ages 45-64: 85%
US Ages 65 and older: 86%

So women younger than 45 actually have a better survival rate in the UK than they do in the US. We beat them once you take into account women 45 and older. All of which plainly disputes the original portion you quoted from Deroy Murdock and the old 1990's BBC piece as well. And incase anyone's forgotten the original point, its that the UK has just about as good health care coverage for women with breast cancer as the United States does.



Cunningham

Age 65 is when Medicare kicks in, I believe.

seatofpants

So, what's the mortality rate of women with breast cancer without health insurance in the UK versus the US? Oh, that's right, the ladies in the UK all have insuranc. How's the emergency room visits helping US women with breast cancer? I'm betting, not so hot.

Steve Harrison

Cunningham, I believe the increased survival rate in older women is due more to the absence of estrogen post-menopause than the availability of treatment.

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