The New National Health Plan Is Texting

theodp writes "With a gushing press release, Federal CTO Aneesh Chopra announced the launch of Text4baby, 'an unprecedented mobile health public-private partnership' designed to promote maternal and child health. Expectant women are instructed to 'Enter the date of the first day of your last menstrual period' to start receiving 'timely and expert health information through SMS text messages' until their child reaches the age of 12 months (limited to 3 free messages/week). The White House Blog has more information on the 'historic collaboration between industry, the health community and government.' Separately, the White House announced plans to spend $3,000 on 'Game-Changing' Solutions to Childhood Obesity. Once again, Dilbert proves to be scarily prescient."

Comments

Uh, rant much?

[hey!]

So you don't like health care reform. Fair enough.

And you don't like this program. Fair enough.

Therefore this program equals health care reform?

WTF?

Re:Uh, rant much?

[Anonymous Coward]

Well, /. editors are libertarians (as should be blindingly obvious to everyone by now) and don't even try to cover it the slightest bit. Which is fine: Most people have some opinion on politics and I like to know the political bias of journalists whose posts I read. Even so, it's a shame they don't even try to be neutral. At all.

I would blame the author of TFA but frankly, I don't know what is TFA. There are seven links in the summary, 6 if you exclude Dilbert. I do like to RTFA every once in a while but I am not going to read 6 articles about this and won't be bothered to try and find the correct one.

Re:Uh, rant much?

[hey!]

Well, most libertarians I know aren't that bad at logical reasoning.

If having a political ideology means accepting any sloppy thinking that comes up with a conclusion your particular herd likes, then what does it mean to have a political ideology? It becomes a kind of irrational brand loyalty. We might as well duke it out in the streets as debate our positions.

Re:Uh, rant much?

[biryokumaru]

Well, I think most stories are reader-submitted. Since the majority of readers are of like-mind, I would presume the majority of stories submitted would have one particular political slant. Even perfectly impartial editors would end up releasing submissions primarily focused toward the political views of the submitter base.

In short: If you want more stories with a specific view-point, submit them.

Re:Uh, rant much?

[jerep]

You know, with each new government action that gets posted here on slashdot, my hope in democracy as it stands now fades away, I thought at one point it would disappears but now it appears I have negative hope towards democracy.

That system is now so corrupt it itself has trouble keeping track of what it stands for and makes decisions like.. texting health plans. That sounds like someone needing mass attention or wanting mass distractions to me.

Re:Uh, rant much?

[pjt33]

I'm not sure that's even the low point of the "summary". The last sentence

Once again, Dilbert proves to be scarily prescient.

equates a private company abolishing its health care provision for employees with a government creating a scheme to provide people with information.

Re:Uh, rant much?

[hey!]

Well, I see nothing a priori wrong with a "texting health plan" so long as we don't intend it to be the only way people can get health information.

Railing against this seems to me to be like railing against a web site with health information on it because people should be getting this kind of information from their primary care physician. That's absolutely true. It's also true that many people don't have a PCP and many family's don't have a pediatrician, and *nobody* has a plan on the table to fix this. Not the Democrats, and certainly not the Republicans.

It seems to me if we have a system that is financially predicated on many people who need health care information not having a physician or family pediatrician, it is not unreasonable to look at other, cheaper ways of getting that information to those people. Ridiculously inadequate? Sure. Better than nothing? Maybe a little, but you'd have to ask an expert in pediatric public health whether it has any useful impact.

I understand that some people have a philosophical position that says that government should not help people who need things like prenatal and postnatal health care information. That's fine, but you ought not sail under false colors, saying "This is obviously an inadequate program." Of course it is! But you can't really pretend to make common cause with people who think *more effective* action ought to be taken.

Re:Uh, rant much?

[hey!]

The implication is that the government is going to take away our private health insurance and make us *all* make do with text messages.

Of course everyone knows that's not true, but it doesn't stop some of us feeling like that is true.

Re:Uh, rant much?

[ojintoad]

Moreover, from the Press Release:

The infant mortality rate in the United States is one of the highest in the industrialized world, and for the first time since the 1950s, that rate is on the rise. Each year in the United States, more than 500,000 babies are born prematurely and an estimated 28,000 children die before their first birthday—signifying a public health crisis. Prematurity is often cited as being leading cause of infant mortality. Key predictors of a child's chances for survival are birth weight and gestational age. (emphasis mine)

Given this, providing information to young mothers with cell phones makes sense. While the Dilbert cartoon brings up valid points on using the internet for self diagnosis because you potentially can't trust the source of the data and might misinterpret it, this program does the exact opposite by creating a trusted source of information. In addition, the Dilbert article is critiquing corporate practices of cutting health care - what the hell does that have to do with limited government sponsored initiative to distribute specific information via cell phone to potentially low income individuals who can afford a cell phone but not health care since they work at a low paying job without benefits? In addition, they're partnering with the commercial sector so the costs are offset from taxpayers in exchange for the advertising and goodwill publicity for those partner companies.

Also, the word "gushing" in the summary should be a big tipoff (potential dogwhistle?) to the bias of the summary writer. If you read press releases at all, you'll know they tend to be either gushing, or defensive, or editorializing in some way. They're press releases, not pieces of journalism.

Spend ?

[arielCo]

Quoth TFS:

Separately, the White House announced plans to spend $3,000 on 'Game-Changing' Solutions to Childhood Obesity.

3,000 bucks sounds amiss. So, quoth the linked press release:

• Incentives: We discussed government limitations on the size of the prize ($3,000 – a purse we’ve awarded in public service announcement contests as well). Design questions focused on the degree to which other stakeholders might supplement the prize with privately raised funds; develop new markets for educational games, including schools, parents, and after-school programs; and recognize finalists at the White House or other venues. What incentives would you recommend we deploy to maximize high quality participation?

(Bold italics mine)

Ah, they mean to give each "winner" kid $3,000 as an incentive/prize for being fit.

Re:Spend ?

[biryokumaru]

Whatever happened to academic ability? Wouldn't this system further reinforce the kids who waste their childhood playing silly games, ultimately instilling a desire to contribute nothing to the development of mankind?

Additionally, I'm all for being healthy, but let's be honest here: no kid is going to be interested in these hollow shells of entertainment. Even at the age of 12 children can differentiate between what essentially amounts to government propaganda and actual entertainment. I'll give you a hint how they know: it's not entertaining.

Re:Spend ?

[BigSlowTarget]

Actually no, the prize is to developers to make a game that promotes nutrition. That is there will be several 'medals' awarded to developer teams and each medal can get up to $3k. They are awarding two medals worth 3k and an undeclared but it looks like small number of medals for lesser competitors.

I would actually expect something more like what you described given how our society seems to work sometimes, but in this particular example it's NOT the case. I'm not sure what level of development they expect for a possibility of $3k, but it will probably end up being bored flash developers and computer-precocious grammar school classes that compete.

Re:Spend ?

[arielCo]

I'm not sure what level of development they expect for a possibility of $3k, but it will probably end up being bored flash developers and computer-precocious grammar school classes that compete.

Thanks for the correction - it was not entirely clear to me with all the buzzwords the measly $3k led me to think that it was for the kids (their families).

Now come to think of it, how on earth is a videogame going to make kids exercise and eat healthier? I remember a silly flash game on Dilbert.com where you caught fruit and other healthy morsels and dodged pizza, burritos, etc. as they fell down the screen.

Equal opportunity?

[Anonymous Coward]

I am a parent, but not a mother, you insensitive clog!

Why do only mothers get this?! They shouldn't be using a cell phone during pregnancy for healthy reasons anyway!

Re:Equal opportunity?

[ShiningSomething]

You can use it too! Text them the day of your last menstrual period and you're good to go.

Remember, slashdot is run by rich white guys

[SmallFurryCreature]

Remember, slashdot is run by young rich white guys whose parents were all well-off. They don't need health-care right now, so screw everybody else.

For those of us on the continent, this whole thing is just another sign of the US tearing itself apart for some reason I at least cannot understand.

I am reminded a bit about the trouble britain went through in the 60/70's wear it was close to falling apart, almost as if the people hated their own country.

In the US it seems people hate so much the idea that someone else might get a penny out of them, they rather spend a dollar even if that someone is themselves.

Really, what is so damned scary about a national health care system. Surely paying less for a system (the US spends more and gets less then any other western nation) would be a good thing? Or is spending 1000 dollars on bad health care to a private company good and 100 dollars on good health care to the government bad?

Re:Remember, slashdot is run by rich white guys

[Bluesman]

The U.S. is one of the most charitable countries in the world. For the most part, however, we don't appreciate coercion.

It's quite simple. Government is not charity, it's legalized theft. If you don't understand the distinction, please read this excellent article.

Re:Remember, slashdot is run by rich white guys

[CrimsonAvenger]

Or is spending 1000 dollars on bad health care to a private company good and 100 dollars on good health care to the government bad?

If it could be clearly demonstrated that we'd get the same healthcare as we're getting now for a lower price on government-run healthcare, I doubt you could find more than a handful of people in this country who'd oppose it.

Alas, so far, not a single proposal for government-run healthcare has met that criterion. Certainly this last go-round didn't. What we keep getting from the government is "we'll improve your healthcare by making it cost more, but not deliver more"....

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

don't appreciate coercion

Your flaky legal system hands out massively excessive prison sentences. Then uses prisoners in forced labour camps.
The US is built on coercion. Slavery is your principle.

Mod this down if you're a nationalist with their head stuck in the sand.

Re:Remember, slashdot is run by rich white guys

[vadim_t]

So, in exchange for the government not taking money from you, you'd rather pay more than the government would take to a third party, to get worse service? That doesn't make sense.

The way I see it, money is money. If in place A getting a good health plan costs $X and in place B a bad one costs $2X, then place A is better regardless of who is getting the money.

Yeah, you can rant about "choice" and "not being forced to", but you don't have any real choice anyway. You're guaranteed to have to pay for medicine at some point in your life, one way or another.

Re:Remember, slashdot is run by rich white guys

[biryokumaru]

Here is some data to support your wild claim of America as the most giving. See figure 1 on the bottom of page 2, figure 2 on page 6 and table 1 on page 9. It should be noted that this data is based on private philanthropy, not government handouts, as other studies often are.

Personally, I think the best table there is on page 13, as it is adjusted against average income level, and not GDP (which may be biased for countries that have a high per capita GDP, like the US). In this table it can be seen that America is still the top giver internationally, but not by nearly as high of a margin.

Unfortunately, I still don't think this is a fair comparison. For example, people who make more money can afford to give a larger percentage to charity, as their cost of living is a lower percentage of their income. Possibly charitable donations over (per capita GDP minus average cost of living) would be a better scale. Regardless, by the given metric, America is the top charitable giver.

Re:Remember, slashdot is run by rich white guys

[TheSpoom]

I give you H.R. 676, a bill which would provide simple, single-payer health care to all legal residents of the United States, but keeps getting buried by Congress in favour of their massive, complex "health reform" bill that ironically does far less for the people. This bill would actually make the US health care system better than that of most Canadian provinces, since it covers things like dental and prescription medication.

It has been shown several times that single-payer care costs far, far less in the long run, and allows you to keep everything you have now, minus the insurance company that wants profit over your own health. Unfortunately, it seems that the right wing has successfully equated the term "single payer" with socialism or communism (OMG THE REDS, RUN AWAY!), so I doubt we'll see anything this sane in the next ten years.

Re:Remember, slashdot is run by rich white guys

[biryokumaru]

I know several Canadian citizens who moved to the states in a large part to escape the inferior national healthcare system up north. I suppose if you work part time at McDonalds, government run health care seems like a good idea, but if you have a job where you can actually afford real healthcare, it's terrible.

[sarcasm]Maybe we should raise the voting age to prevent those pesky poor college kids from voting their silly liberal views. That would eliminate a large portion of the support for this![/sarcasm]

But really, I have no idea what would be a better plan. Maybe not privatizing it, and actually have government employed doctors and government run hospitals. Like that would ever happen.

Re:Remember, slashdot is run by rich white guys

[gujo-odori]

I can maybe answer some of that.

Having lived in countries with national health care systems (someplace in Asia), with private insurance (US), and with no insurance at all but low prices (some other palce in Asia), I have found the highest level of care by far to be in the United States. The worst care, by far, was in the place with no insurance but cheap prices. In most hospitals there, if you're not bribing the staff (and thus raising the price), you'll get almost no care. The place with a national health insurance system was a middle case. Primary care and ob/gyn care is reasonably good (but not as good as the US; our first child was conceived in that country but born in the other place in Asia) and the co-pays were roughly price-equivalent to the US. Hospital stays there, however, fall far short of what you get here. I spend a week in the hospital there, and it was most unpleasant. The national health insurance only paid for a bed in a six-patient room and I was surrounded by people who were far sicker than I, with all the noise, smells, and potential cross-infection that goes with that. The equipment was lousy (I couldn't even get an IV tree with wheels; I had to carry the thing to the communal bathroom; no in-room bathroom or shower). The nursing care was fair, and the food was disgusting. I lived off the convenience store in the basement and a pizza a friend brought me.

Do I want the US health care system to become like the middle case I described? No way. We're way, way better than that now. My wife, who is from one of those other places, agrees that our quality of health care is the best. Going to a national insurance system will probably pull that quality down.

What, then, do we need to fix? A few things:

1) Fix the extremely hostile and litigious malpractice lawsuit industry; it's a major factor in what makes health care and insurance so expensive here. It desperately needs reform. And by "fix" I mean that it needs to be far, far harder to sue someone for malpractice, that you need to really prove they fucked up hugely, along the lines of something that could cause a license suspension or revocation.

2) The way health insurance companies can screw people by doing things like declaring a pre-existing condition uncovered, charging people who actually get sick and use their insurance more money (it's supposed to be a shared risk pool; everyone should pay the same).

3) Get better standardization of forms, etc., so it doesn't cost doctors so much to deal with health insurance. The best thing about the country with national health insurance is that doctors easily knew where they stood and didn't need to employ one or more insurance specialists.

4) Use the forms in points 1-3 to make health insurance cheaper and available to all. Subsidize the cost with tax credits for people who are low income if you have to.

That's how we need to reform health care. What we definitely don't need is national health insurance.

What's so scary about a national health insurance system? To *really* fuck something up requires a government. The US government, in particular is very good at that, and is also very good at ridiculously underestimating what something will cost (or more likely, lying about it). One thing is for certain: spending 100 dollars on government health care will most certainly not get you better health care than spending 100 dollars on private health care. The government never, ever does things better and cheaper. Typically, it's both worse and more expensive.

Government is rarely the solution. More government is even more rarely the solution. Mostly, government is the problem. Sure, we have improvements to be made, but a huge, bloated and expensive government health care bureaucracy isn't the way to do it.

Re:Remember, slashdot is run by rich white guys

[I_Voter]

Government is not charity, it's legalized theft.

According to the "centrist" "founding father" James Madison - the principle task of government is economic regulation,
FP #10 Principle Task of Government.

Re:Remember, slashdot is run by rich white guys

[hey!]

Depends on how you define and measure "charity".

We don't cover all our citizens with health care, and private charity does not by any stretch of the imagination come even close to making up that gap. If we include taking care of our own people European social democracies fare better than if we exclude that.

Now with the exception of anarchists, who have an internally consistent position, nobody literally believes that "government is theft." What people mean is that "government taxation to support programs that are morally indefensible is theft." That's a position a Republican stalwart can share with a socialist pacifist who can't abide Democrats because they are too right wing. The only difference is in the details of which programs are considered morally indefensible.

"Government is theft" is the kind of emotional political slogan I can't abide from either side ("TAX WEALTH - NOT WORK"). Such slogans are nearly always in code. There is an underlying paradigm people have in mind when they say them, usually an irrefutable one (the meddling, officious government bureaucrat, the ruthless, well connected crony capitalist who games the system) that by process of synecdoche they stretch to cover a broader class (all government workers, all wealthy people).

It's not possible to have a rational discussion on this kind of basis.

Re:Remember, slashdot is run by rich white guys

[gujo-odori]

P.S. Nice try with the racist reference to rich, young white guys. There's nothing wrong with being rich, young, and white, and it doesn't make you somehow automatically wrong.

P.P.S. We don't spend more and get less than any other western nation. Health care may be tremendously expensive here, but it's also by and large tremendously good. Far better than any other country I've been to. My wife - who is not an American - says the same. She's constantly astounded by how good the health care system is here. That doesn't mean there aren't spending areas to be fixed, but the suggestion that we don't get good health care for the spend is preposterous.

Re:Remember, slashdot is run by rich white guys

[Bluesman]

You'd rather pay more than the government would take to a third party, to get worse service?

It's going to take quite a bit of convincing for me to believe that this is the case, especially considering the traditional efficiency of U.S. government.

Really, you expect that because the government is paying, quality of service will magically increase? And that any possible increase in efficiency would not be offset by the overhead of a single payer system? And you have proof that this will be the case IN THE U.S., whose government cannot even pay for its current obligations, who routinely has annual deficits greater than the GDP of most countries, and whose problems will only compound as the population ages?

Okay....

Re:Remember, slashdot is run by rich white guys

[ObsessiveMathsFreak]

Government is not charity, it's legalized theft.

Thursday is not purple, it's amortized transit.

Re:Remember, slashdot is run by rich white guys

[I_Voter]

Alas, so far, not a single proposal for government-run healthcare has met that criterion.

My rule of thumb: Those without power tend to suffer.

I_Voter

Citizen's Political Power in the U.S.

Re:Remember, slashdot is run by rich white guys

[dylan_-]

I suppose if you work part time at McDonalds, government run health care seems like a good idea, but if you have a job where you can actually afford real healthcare, it's terrible.

Except that's nonsense. Perhaps Canada has a poor system (I really don't know), but why compare with the worst example?

I know the UK isn't the best in the world, but we pay less on public healthcare (per capita) than the USA does.

And I also believe our private healthcare is far cheaper too; I know it would be for me. Look at this and see for yourself how it would work out for you, bearing in mind that most people don't bother with private insurance as they're quite happy with the NHS.

Actually, the most expensive UK option there, Platinum cover with zero excess, was cheaper than the cheapest US quote I could find, but I admit I don't know the ins and outs of the US system.

Re:Remember, slashdot is run by rich white guys

[Bluesman]

Insurance provides management of risk. Using it as a middleman for payment of routine health care costs is an inefficient perversion of its purpose.

And please explain how the overhead of any middleman between me and a doctor would be more cost-effective.

Even a very basic mathematical analysis shows that any of these systems is less efficient than "customer pays."

If your answer is that the government will have none of the problems that using insurance companies as a middleman have, because the government is good and insurance companies are bad, please try again.

It's like this: routine care has a cost x. Redistribution of money to pay cost x has an additional cost y, no matter who does it. If the customer pays cost x, adding cost y will increase costs.

Do you expect your car insurance to pay for your gasoline? Why not? If I offered to provide you with a gasoline payment policy, in which for a monthly fee I'd pay all of your gasoline bills, would you sign up expecting to get a good deal? Would you expect the price or availability of gasoline to change? What if everyone signed up for the same program? Would the incentive be to conserve your usage of gasoline, or to use as much as possible?

If the overhead for my gasoline single-payer program is only 10%, you're worse off in the program unless your gasoline usage is greater than 10% of the average among all users. Essentially, the bottom 60% is subsidizing the top 40%, and the system as a whole is 10% less efficient than everyone paying for their own gasoline.

If you're saying that people should subsidize others who can't afford basic care, fine. We have medicare and medicaid, which a majority of those people already qualify for. If there are 5% that don't, expand that program; don't force me into a single-payer program I don't want.

Re:Remember, slashdot is run by rich white guys

[cinnamon colbert]

since you don't specify the countrys, it hard for /. readers to know if your comments are reasonable as to your "solutions" without malpractice, what saves me from bad doctors - isn't malpractice the free market solution to bad care ? your other cost savings ideas are good, but show a lack of understanding of true costs, which are driven by technology: it is not how (paperwork) that costs money, it is new technology and an aging population that are the true cost drivers; fixing forms will provide a temporary relief and anyway, isn't making evryone use the same form sort of gov't control ? isn't the point of diff forms free market magic, diff companies try diff things ?

Re:Remember, slashdot is run by rich white guys

[CrimsonAvenger]

I give you H.R. 676 [loc.gov], a bill which would provide simple, single-payer health care to all legal residents of the United States, but keeps getting buried by Congress in favour of their massive, complex "health reform" bill that ironically does far less for the people.

I read the bill. It doesn't actually require that you be a legal resident of the USA. Nor does it look to be "simple", with both a National Board, and 50 State Boards used to determine salaries, costs, etc.

It has been shown several times that single-payer care costs far, far less in the long run, and allows you to keep everything you have now, minus the insurance company that wants profit over your own health.

It has certainly been claimed several times. I'm not sure where it's been shown. I'm not, by the by, talking about "well, the British NHS works, so our system will work just the same". I'm talking about someone doing an analysis of OUR system, and showing where the costs would go down with National Healthcare.

Let's see, fine print in that bill...

The part about having to issue T-Bills (which means increasing the National Debt) to pay the entire health system to non-profit.

The part where any Doctor or Hospital doesn't actually have to take part in the system if they don't want. Sure, that might just marginalize those doctors/hosptials, but if there's only one hospital where you live, and it opts out, you're paying for National Health Care without really getting any benefits for same. And if the very best doctors/hosptials decide not to play, then the general quality of care will go down slightly, not up.

Also, I didn't actually see anywhere in the Bill where it mentioned how the system was to be paid for. So there's really no way to say whether it'd be cheaper.

Now, all that said, what I really think of the bill you mentioned is that it's completely unnecessary. If we really want National Healthcare, all we have to do is write a very short (the Table of Contents might be longer than the text) bill which lowered the age of Medicare eligibility to zero (birth). There, simple solution to the problem.

Note that we'd want to add a requirement that any politician in the USA must use the same system as the masses, of course. That'll add an extra line or two to the bill....

Re:Remember, slashdot is run by rich white guys

[biryokumaru]

Well, I compare with Canada because I know a bunch of Canadians, and I don't know any UKians.

Re:Remember, slashdot is run by rich white guys

[Bluesman]

"Government is theft" is the kind of emotional political slogan I can't abide from either side

This is not a political slogan, it speaks to the nature of how government achieves its goals. The power of government stems from the threat of violence and loss of liberty. To deny that is to deny reality.

When people sit in wonderment as to how anyone could possibly oppose *favorite government program*, it's worthwhile to remind them of the ultimate source of government power, because this is the premise of the argument (call it libertarian, conservative, what have you).

The reason the U.S. Constitution was so revolutionary was because it was one of the first times these issues were taken into account. To ignore that and simply argue over a plan's perceived efficiency and pass it because "we want to," rightly gives thinking Americans pause.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

We don't cover all our citizens with health care, and private charity does not by any stretch of the imagination come even close to making up that gap. If we include taking care of our own people European social democracies fare better than if we exclude that.

Exactly. And private charity doesn't work very well if people suddenly decide to cut down their donations. For example, because of an economic crisis.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

If it's legalized, by definition it is not theft.

Re:Remember, slashdot is run by rich white guys

[dylan_-]

We don't spend more and get less than any other western nation.

Yes you do.

Health care may be tremendously expensive here, but it's also by and large tremendously good.

No it isn't.

Far better than any other country I've been to.

Perhaps you should visit more countries.

Re:Remember, slashdot is run by rich white guys

[biryokumaru]

bit.ly? Seriously? Why is it not possible to just include a real link to the actual website? It's not like you're on twitter here, or you're hiding goatse. You're just keeping people who might actually think you're being honest from believing you by hiding your link behind a notorious troll cave.

Re:Remember, slashdot is run by rich white guys

[RicktheBrick]

I was in Nebraska last year with my 7 year old nephew who needed medical assistance. They billed his mother stating that they do not accept out of state insurance. A couple of years ago I was in charge of distributing my mother's money. I made the mistake of giving my niece her money. The government seeing that she had a little bit of money(just $10,000) stripped her of medical and food benefits. While she had that money she had a $2,000 medical expense so they took her state income tax refund to pay for it. Why didn't I just give the money to the government instead? I did have to pay the federal and state governments over $15,000 in taxes. The gross national income is around $50,000 per person in this country and yet we have to take away money from the people who make less than the poverty level. I sure hope the tea party members are enjoying themselves while on their expensive cruise and while they are listening to the $100,000 speech by Sarah Palin. I am sure they can justify taking from the poor so they can spend all that money.

Re:Remember, slashdot is run by rich white guys

[dylan_-]

So you concede that it was wrong to generalise that public healthcare was a bad idea, from your limited experience?

BTW, did you look at the link I gave in my previous post? Was the quote comparable to what you pay now? I really don't know what's "usual" for the USA.

Re:Remember, slashdot is run by rich white guys

[hey!]

Then would you say that "theft" is necessarily morally indefensible?

If so, then anything that the government does must also be morally indefensible. That includes enforcing criminal laws and providing redress in case of breach of contract.

If *anything* the government does is morally defensible, AND if theft is necessarily morally indefensible, then "government is theft" is necessarily wrong in a literal sense. But it could still be right in a poetic sense.

The term for a political statement that is wrong in literal sense but right in a poetic sense is "political slogan".

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

When I read your post, I could see you have an amazing sense of entitlement, which probably comes with the American culture.
You seem to think that a hospital should be like a hotel, where everybody gets their own room and a continental breakfast. Well, surprise -- You're not there on vacation, you're there to get medical treatment.
Space is a commodity; I, for one, will put up with a little less room if it means that the impoverished family down the street's daughter gets necessary treatment.

I live in Canada. Yes, I've been on a wait-list for surgery, and I've had to wait a couple weeks for an x-ray.
Why?
Because the girl with stage III skin cancer should get those things first, regardless of how much money her parents have.

Re:Remember, slashdot is run by rich white guys

[SpeZek]

I'm not sure why that posted anonymously.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Enough with the racist comments SmallFurryCreature
"Rich white guys" are not the problem, maybe rich selfish people are a problem but last I checked a person from any race can be selfish.

You are right, us Americans do pay too much for our health care.
Instead of fixing the cost problem, you advocate replacing the whole system?

The single payer, in a single payer system, will decide what the re-reimbursement rates are, not doctors.
The result of this is obvious, if the doctor is forced to earn less he will be forced to cut corners somewhere.
I would not feel safe visiting a doctor who must think of cost as a more important factor than my health.
Obama said it best "UPS and Fe-Ed are doing just fine. It's the Post office that's always having problems"

I could care less if someone in need gets my tax dollars, as a matter of fact I often help people in need myself without the government forcing me to do so.
What I have a problem with is being forced to help people who will not help themselves.

Sure there are people who are down on their luck looking for work that just is not there. I'm all for helping these individuals and families.
But there are also people who choose not to work and live off the system. These people maybe deserve Darwin Awards but not health care, welfare and food stamps.

Re:Remember, slashdot is run by rich white guys

[TheSpoom]

Even a very basic mathematical analysis shows that any of these systems is less efficient than "customer pays."

You're right, of course. We can just conveniently ignore all the moral implications of that. And comparing people's health to simply fueling their cars? Brilliant. Oh, and let's also pretend that everyone should be covered already since Medicare exists, even though it's heavily restricted and there's a huge subset of working poor that don't qualify for it simply because they work. Those people should totally quit their jobs so they can get on welfare for the health care! Or alternately, pay for a private health insurance plan that they can't afford (somehow). What's that? They should have insurance through their employer? Fat chance for a large percentage of people who work for small companies that don't have employee health insurance plans.

By the way, HR676 doesn't in any way affect your relationship with your doctor and/or hospital other than who they bill. Doctors and hospitals are still private. But feel free to conveniently ignore that and rant on anyway.

I mean really, we could just boil this down to "I've got mine, so fuck the rest of you."

Re:Remember, slashdot is run by rich white guys

[hey!]

If it could be clearly demonstrated that we'd get the same healthcare as we're getting now for a lower price on government-run healthcare, I doubt you could find more than a handful of people in this country who'd oppose it.

When you say "this country", what country are you referring to? I happen to live in America and there are plenty of people who hare happy to cut off their own noses to spite their faces. Just about everybody agrees that is true, too. They just differ on who the people advocating that are.

Re:Remember, slashdot is run by rich white guys

[jcr]

>Really, what is so damned scary about a national health care system.

Rationing by congestion is no walk in the park. You should do a bit of research on it.

-jcr

Re:Remember, slashdot is run by rich white guys

[jcr]

What Madison meant by regulation, and what our government does today, are greatly divergent. To Madison, "regulation" meant to keep commerce regular, by enforcing the rule of law, and providing a court system to adjudicate contract disputes.

-jcr

Re:Remember, slashdot is run by rich white guys

[biryokumaru]

Well, presently I pay nothing for first rate healthcare for my entire family in NYC, so I'm not exactly an ideal candidate. Nevertheless that website puts me at around 90 pounds for similar care in the E4 6AA postcode of London (I have no idea where that is, but I don't exactly live in Manhattan, so it seemed comparable), but doesn't cover dental or the cost of anything but out-patient surgery, as far as I can tell (doesn't cover surgery? then what's the point?). But about $140 a month is nearly a tenth of the average per-family cost in the US (presumably it would be higher than average here in NYC, and not cover dental either). That's very impressive.

But then, isn't the UK system government run? I'm fairly certain that most of the proposed US systems are going to still be private, just with Uncle Sam footing the bill. I would hardly say that the UK system is comparable, and by the same token neither is the public hospital system in Canada.

I think the only valid comparison might actually be right here in the US: our defense budget. According to the FY2011 budget, the present spending is about 700 billion dollars per year. Is that going to be enough to cover a $2.5 trillion (same link as "a tenth") industry? Or will people finally stop complaining about DoD spending when healthcare spending totally eclipses it?

That was oddly rambling and rife with parentheticals. My apologies if I got lost somewhere...

But, ya, when I needed surgery, I didn't have to do anything but sign my name somewhere. Is it like that in the UK? Does your healthcare cover the PRK I also got for free?

Re:Remember, slashdot is run by rich white guys

[jcr]

Depends on how you define and measure "charity".

Charity is voluntary, by definition.

-jcr

Re:Remember, slashdot is run by rich white guys

[jcr]

It has been shown several times that single-payer care costs far, far less in the long run, ...Unless you value your life, that is.

-jcr

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Ever heard of medicare? Know any seniors that want to give it up?

Re:Remember, slashdot is run by rich white guys

[I_Voter]

bit.ly? Seriously? Why is it not possible to just include a real link to the actual website

You are correct. I used a bit.ly link from a twitter message, because when using TweetDeck it gives the expanded url to approve or disaprove. I didn't stop to think that slashdot works differently.

Re:Remember, slashdot is run by rich white guys

[misexistentialist]

It's becoming clear that Americans can't afford care better than the "middle case" that the rest of Western world has, and tweaking malpractice liability and medical forms will only reduce costs trivially. Large private companies are just as bad if not worse than governments when it comes to bureaucratic incompetence, and it doesn't make sense to put health care into their hands since it is primarily an entitlement or charitable service to which profit calculations don't apply. The government already pays for most health care in the US, which you claim is the best, so saying it is "the problem" is ridiculous.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

I live in the US without health insurance. I've lived in Asia with a national healthcare system and low cost health care. I've lived in Europe in a communist/socialist country.

Maybe American healthcare is ok if you have insurance. If you don't, it sucks. You get treated like shit, and I can actually afford to pay for it, I just don't have insurance. The health care is slow and expensive.

In Asia, the government hospitals were fast, efficient and reasonably priced whether you had the national insurance or not.

In Europe the government healthcare was fast [and free if you had a job]. They did not have the latest technology, but the doctors wanted to help people. In the states we all know why people choose to be doctors. It's to make money. There is nothing wrong with making money. But there is an qualitative difference between the people who choose to be doctors here and there.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Yes, I do, because the US already has a single payer system: Medicare. It has an overhead of about 1% compared to about 30% for traditional health insurance.

To paraphrase a very good comment I read not too long ago: the issue in this country is that we need health care, not health insurance. Insurance is a small payment that you make on a regular basis to offset the possibility of huge expenses at a later time. However, if you already have a medical condition, then the insurance model doesn't apply to you. You (and your insurance company) know that you already need expensive treatment. Thus, the people who need help paying their bills the most are the least likely to get it.

What we need is a system for care rather than insurance. Just passing legislation to prevent discrimination based on pre-exisitng conditions would be a major start; however, I truly believe that we need a public option if we wish to make our healthcare system comparable to the rest of the developed world.

Re:Remember, slashdot is run by rich white guys

[tjstork]

So, in exchange for the government not taking money from you, you'd rather pay more than the government would take to a third party, to get worse service? That doesn't make sense.

I get better service from Blue Cross / Blue Shield than anyone I know has ever gotten from Medicare. If I don't like Blue Cross / Blue Shield, I can switch to someone I do like, and still get better service than what Medicare gets, for me.

What the left wing always forgets is that health insurance is a risk management tool. I can tailor the coverage that I want, to the risks that I actually have. Things that are not "risk", I can pay out of pocket. That's why the left always screws up insurance by having carriers be mandated to provide things like doctors visits and some prescription drugs... those aren't risks often, and I can do better with myself.

Re:Remember, slashdot is run by rich white guys

[dunkelfalke]

There actually can be an easy solution for the possibly problem of the healthcare quality: basic universal healthcare that covers most important things can be provided. If someone wants more service they can either pay cash or have a private insurance. This combines the best of both worlds.

Re:Remember, slashdot is run by rich white guys

[couchslug]

US public opinion is wilfully uninformed (not you, dear readers, the OTHER ~300,000,000 morons you share space with).

There are only "identity politics", where the morons seek affirmation. The nation being split between religious zealot white bigot conservatives (not to say they don't have some good ideas) and leftists who want complete redistribution of wealth (not to say they don't have some good ideas) along the "forty acres and a mule" promise model.

None of the issues in the US are actually about the issues, they are about stupid mobs who hate each other (and love free stuff ONLY for their pet projects). We relentlessly elect mediocrities because our people are mediocre, we hate the exceptional and gifted, and prefer "leaders" who won't challenge us to think. Each mob is self-righteous and blind to its own numerous defects.

The American public think their country is the center of the world, and since they don't read history they don't remember when it was not. They want to recapture past glories but are unaware of the mechanism and historic context of those successes. They confuse their ignorance and immunity to humility with strength. Decades of being rich (note even our "poor" have cars and are fat as hogs by choice) have removed the challenge that is REQUIRED for humans to rise to greatness. While Americans fap to the glorious Greatest Generation they forget that the "GG" was hardened in (real) poverty and war.

We deserve the periodic train wrecks we create, and we need one to force down our wages to compete with the rest of the world (the Industrial Revolution workplace looked a lot like mainland China today).

PS:
Much of the distrust of national health in the US is based on the absolute certainty that it will be very badly implemented.
Unlike Europe, the US has a vast unproductive underclass swelled by immigration policies that are part of the deliberate demographic war against those who precede the current immigrant groups. Because resources WILL NOT be conserved by access controls, national health funds will be sucked dry.

Re:Remember, slashdot is run by rich white guys

[hey!]

Fixing the litigation problem is a good idea, but it won't make a significant difference to the fact we are heading toward spending 20% of our GDP on health care.

So far as our health care being the best in the world, it depends on how you define and measure that. If you look at customer satisfaction of people who have the means to buy good insurance, that's probably true. For example if you want a particular procedure and have the insurance to cover it, you're probably happier about that procedure.

If you define health care quality by outcomes (e.g. infant mortality, cancer survival, life expectancy) the situation becomes a lot more complex, and it is not at all clear that the US has the same lead in outcomes as it does in spending as percent of GDP. I don't want to oversimplify the case, because there's all together too much of that sort of thing going on. We might pick one measure, such as cancer mortality after initial diagnosis, and we might see some advantage to the US. In other cases, such as life expectancy, there are confounding factors such as the obesity epidemic and the resulting prevalence of metabolic syndrome.

What you can't do is take one person's experience, or even the experience of a class of (privileged) individuals, and make that stand for the whole.

That said, I think it is fair to say that the financial efficiency of the US health care system is low relative to other advanced nations. We clearly spend a lot more for outcomes that aren't clearly better. It's also true that if we imagined doing a perfect job on tort reform (which we should), this situation would not change. It would reduce costs by a few percent, not the 30-50% it would take to put is in line with other advanced nations.

I think the reason we don't have efficient health care as measured by outcomes is because our health care system is not designed around outcomes, it is designed around patient satisfaction for the most profitable segment of patients. This not only excludes unprofitable patients, patient satisfaction is not a perfect proxy for outcomes.

Recently I had elective surgery. I only had to wait about a month. In some countries I might have to wait three or four months for that surgery. So I'm very satisfied with our health care system with regard to this one procedure. If I lose my job and health insurance, and I can't get insurance at my new job because of preexisting conditions, then I'd be very dissatisfied with our health care system.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

I would be in favor of the following medical changes:

• Posted prices at medical facilities (dentist, dr, specialist, whatever)
• Single payer health care (not insurance), so long as private facilities were not banned. Sure private facilities will be expensive as hell, but don't ban them. There will be a lot less people going to the private facilities, meaning less of a wait.
• No minimum insurance coverage. Right now some states mandate things to be in insurance packages, which increase cost. Let insurance companies balance risk pools.
• Buy insurance across state lines. I'll decrease my rates by being able to pool with middle of nowhere, USA and if someone wants to step in and only serve MoN, USA then they'll get even cheaper rates.

Re:Remember, slashdot is run by rich white guys

[dreamchaser]

I pay for my own healthcare and I didn't have wealthy parents yet I'm against publically funded healthcare. Why, you ask? It's because it is NOT the Government's job to be our nanny. People need to care for themselves. If someone truly cannot do so then yes there should be safety nets, but the health care of the bulk of the population should not be paid for by their fellow taxpayers. Get a fucking job and earn some money and care for yourself.

Yeah I'll get modded down but I'm sick of everyone with their hand stuck out wanting 'free' this and that.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

How 'bout you just move there already.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

I would argue that either you've been to some less than exemplary countries, and/or you've fallen prey to "window dressing" in US hospital care. The stats speak for themselves - the US spends way more than other Western countries for worse results. The only winners are the people at the top of the food chain (as in most areas in the US).

The people working to turn the public against public health care in the US are the people who will continue to suck your cash out of your pockets.

I do not understand US anti-government sentiment - it's part of the reason for the faults in your government system. Instead you should all be looking for better government, not less government. I can only assume it is deeply ingrained attitudes from both the experience way way back of British rule, plus the experiences of ancestors who emigrated to the US when things were not so hot in their original country, or they had an attitude of not trying to fix things but just leaving when there were problems.

Anyways, it is very annoying that the US can't sort themselves out because the elite here in Ireland/UK keep looking to the US for ideas of how to screw us plebs here too, and use a lot of the same tactics to turn the populance against more civilised European ideals. Even on the continent there are those working to place more money and control in the hands of the wealthy few, based on following US examples - for example less regulation of business (see where that has got us).

The US, "land of the free" has less social mobility than stuffy "Old Europe", and I sincerely hope that Europe avoids following their examples.

Re:Remember, slashdot is run by rich white guys

[hey!]

Voluntary by *whom*?

You can't look at a nation that has chosen a social democracy model for their society and criticize individuals living there for not spending as much on charity as we do. *We* have chosen a system which allows us to keep more of the money we earn, but at the expense of accepting the existence of charitable needs that don't exist in other countries.

You can't say we are more generous than the Swedes, because they *could*, if they wanted to, elect a government that would implement US style economic policies. They'd then have more disposable income to spend on things like charities giving medical care to the indigent. Instead they have chosen to have less disposable income and in return to have the need not exist at all. In effect, they accept a narrower range of extremes in material wealth than we would.

I understand that there are legitimate philosophical differences here, and you can argue from a certain philosophical stance that the Swedish system is morally wrong. But it's disingenuous to pat ourselves on the back for being so "charitable", when many of our charities address needs that other nations have chosen to address in a different way.

Re:Remember, slashdot is run by rich white guys

[Vaphell]

"You're right, of course. We can just conveniently ignore all the moral implications of that. And comparing people's health to simply fueling their cars?"

Everything has a cost, human life too - somehow we don't treat every cancer in existence with the best newest miracle pills costing 50k each. That's why it's similar to fueling a car, someone has to pay for that or it won't happen.
Sorry to say that, but i absolutely don't care about your health and i am sure you feel the same towards me. Why would you expect me to cover your health expenses especially in cases where you bring nothing to the table? By the way, why only health? Maybe food and shelter too? After all letting people starve and live under bridges is inhumane. Sex by any chance? That sexual tension causes so many unhappiness, tragedies and widespread masturbation.

People have right to live and do whatever they wish with their lives, but that's pretty much it. You can feed and cure other people out of your pocket, but don't ever require others to share your socialist agenda.

Any system where 3rd party pays is destined to fail. People go to the doctor every time they sneeze, because they don't see the costs covered by someone else. Such system can be even 99% efficient (almost no overhead for redistribution and administration) but it will be overused either way inflating total budget which ultimately is fueled by taxpayer's money. It's somewhat similar to the tragedy of the commons - it's 'free' and almost infinite so there is no ethical problem of taking too much out from it until the whole thing falls apart.
Is it fair to tax people who don't want to be included in that system and wish to take care of their own health by themselves? Sign a paper that you'll never want anything from gevernment run healthcare - isn't that a fair deal? (it still isn't because government run healthcare will inflate deficit that will be covered by the increased taxes on everyone and printing money - loss of purchasing power for all, so opt-outers will be affected too)

Re:Remember, slashdot is run by rich white guys

[I_Voter]

To Madison, "regulation" meant to keep commerce regular, by enforcing the rule of law, and providing a court system to adjudicate contract disputes.

-jcr

Really! He does mention that the vast majority of the population should be excluded from political power,( So they could not regulate the economy.) That was earlier, during the Constitutional convention.Is that what you are hinting at? That earlier quote is included in the article.
FP #10 Principle Task of Government.

"A landed interest, a manufacturing interest, a mercantile interest, a moneyed interest, with many lesser interests, grow up of necessity in civilized nations, and divide them into different classes, actuated by different sentiments and views. The regulation of these various and interfering interests forms the principal task of modern legislation, and involves the spirit of party and faction in the necessary and ordinary operation of government."

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Posted prices at medical facilities (dentist, dr, specialist, whatever)

This would change the game so fundamentally I think it would make everyone's head explode and thus just might be profitable for them to do so.
This idea that you the consumer cannot know the cost before your purchase just screams of extortion.

Re:Remember, slashdot is run by rich white guys

[TheKidWho]

No, because what the government does is not theft. The government is giving the right to do what it does by the people.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

You are absolutely wrong. The health care industry is incredibly work-intensive. If you want twice as much health care you need to hire twice as many hands.

Technology is actually what might drive productivity up and cost down in the future, just as it has done in production industries, and other fields.

The bang-for-the-buck is more or less completely decided by how productive the average doctor or nurse is. That's why you can charge so much for health care technology. A new x-ray machine might have a price tag in the millions, but it probably saves one order of magnitude more if it increases the productivity of the hospital, even if only by fractions of a percent...

Re:Remember, slashdot is run by rich white guys

[StopKoolaidPoliticsT]

I was in Nebraska last year with my 7 year old nephew who needed medical assistance. They billed his mother stating that they do not accept out of state insurance.

And there is the case for insurance portability across state lines. We can do that easily with private insurance by simply passing a law that lets them compete across state lines.

A couple of years ago I was in charge of distributing my mother's money. I made the mistake of giving my niece her money. The government seeing that she had a little bit of money(just $10,000) stripped her of medical and food benefits. While she had that money she had a $2,000 medical expense so they took her state income tax refund to pay for it. Why didn't I just give the money to the government instead? I did have to pay the federal and state governments over $15,000 in taxes. The gross national income is around $50,000 per person in this country and yet we have to take away money from the people who make less than the poverty level.

Government programs aren't free, someone has to pay for them. Every time you advocate for a government program, you are advocating raising taxes on more people. The wealthy literally can't afford to pay for all the government programs various peoples want. You can confiscate 100% of their income and 100% of their wealth and it would barely dent the current national debt.

If you want to reduce taxes on the poor, advocate less governemnt spending. As an anecdote, I've taken care of my dad for the last decade+ ever since he had a brain aneurysm and stroke in the late 90s. I had to give up finishing college and spent the majority of that time managing a small family restaurant for a whopping $9/hr since they let me bring him to work with me. I haven't worked in a little over 3 years now because I need a job where I can either bring him to work or I can get home on a moment's notice. He makes less than half of your per capita average, I make nothing. We both still have to pay taxes, lots of taxes, especially when you factor in property taxes (they alone consume 10% of our income and we live in a very modest 100+ year old home).

I had to drop my health insurance when I lost my job. I don't qualify for Medicaid (see, I worked for a while so I own a home, vehicle, etc and thus, I have too many assets). So, I went to the doctor yesterday for an eye infection. It cost $69 with no insurance, compared to $15 (BCBS Medicare advantage co-pay) + $120 (insurance's part) when I take my dad. It's roughly half the cost without the insurance. The antibiotics were another $40 (it is a more expensive antibiotic, pen-vk pills are dirt cheap and some places like Wegmans give them out free). I'm dirt poor, but it's a HELL of a lot more efficient for me to pay my own routine medical bills than pass the cost onto third parties that pass the cost onto you. I'd love to buy catastrophic insurance (which would be cheap since it doesn't cover everyday booboos), but my state won't let me because they want to either force me into a high cost health management plan (with mandatory coverage for stuff I don't want or need) or onto the state plan. They force you to choose between two horrible options in an effort to control your life. It's a false dichotomy.

I sure hope the tea party members are enjoying themselves while on their expensive cruise and while they are listening to the $100,000 speech by Sarah Palin. I am sure they can justify taking from the poor so they can spend all that money.

I'm part of the tea party movement myself, have helped organize 3 protests and have given several speeches. I don't advocate taking from the poor OR taking from the rich. I advocate a smaller government that lets people make their own choices by getting out of their way and letting them keep their own money, rather than forcing them to benefact an unjust duopoly.

We're $12 trillion in debt with another $100 trillion in obligations hanging over our head. M

Re:Remember, slashdot is run by rich white guys

[ColdWetDog]

Thursday is not purple, it's amortized transit.

It is neither fair not polite to post on Slashdot after dropping acid.

Re:Remember, slashdot is run by rich white guys

[10101001 10101001]

You'd rather pay more than the government would take to a third party, to get worse service?

It's going to take quite a bit of convincing for me to believe that this is the case, especially considering the traditional efficiency of U.S. government.

Really, you expect that because the government is paying, quality of service will magically increase?

Nope. But then, clearly the health care system isn't magically increasing qualify of service on its own, either. If we acknowledge that quality won't improve magically, we then have to acknowledge that work must be done, system wide, for improvement. Government is basically the only entity with a reasonable chance of enacting such change. The issue, then, is enough people investing themselves into the enactment so it's done right instead of bitching and moaning that it can't work, sitting back, contributing nothing to what is needed, and watching it fail to fulfill their needs.

And that any possible increase in efficiency would not be offset by the overhead of a single payer system?

Actually, a single payer system would be a lot less overhead. Instead of having to hassle multiple companies with multiple claim form types and hoping that insurance company X actually covers the procedure you just performed (since even if they say up front they will, they might renege based upon "preexisting conditions") or that some lowly person saved up to ahead of time to pay a massive bill (monthly payments aren't desirable), you'll know who to bill, how to bill, and what's covered ahead of time. In short, administration costs drop substantially. Does it solve other wastes in the system (over testing, multi testing, referrals for nearly everything, etc)? No. But, that's something that needs to be worked on over time and it would be if the government were footing the bill.

And you have proof that this will be the case IN THE U.S., whose government cannot even pay for its current obligations,

Well, the US routinely spends more on military spending (not even counting specific spending for actual wars being engaged in) than the rest of the world combined. So, that might have something to do with it.

who routinely has annual deficits greater than the GDP of most countries,

And? The US has a much more massive economy than most countries, combined. Is it any surprise our spending is more massive than most countries as well? Now, does this mean a growing deficit is a good thing? No. But, raw numbers aren't nearly as important as percentages. And it's in percentages where we have to make consideration. Currently, our total debt of ~60% of GDP is bad but not terrible. Truthfully, spending should go down and taxes should go up. To that end, entitlement reform, military spending reform, and tax increases are necessary. That holds true regardless of the health care debate. If anything, however, having a single-payer health care system will reduce the risk in the system. It's the risk of the government defaulting that's the primary reason that huge deficits are bad. Similarly, unstable health care coverage and/or health care rates induce risk, for small businesses especially.

and whose problems will only compound as the population ages?

So...we should stop funding Medicare and let old people die? Or do you acknowledge that we're currently taking care of the elderly and will likely do so, so the real issue is how to reform the system to cost less? The reason France, Japan, etc can fund their system is precisely because a large percentage of their population is hardly using medical services yet they all pay into the system (basically, the same way people have "universal" internet access). Even with an aging population, this isn't a problem for Japan.

Now, there is something to say about the obesit

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

We're all very impressed, not only by your low UID, but by your stunning use of "Nuh uh" as a rhetorical device. I happen to agree with you, but show some sources.

Re:Remember, slashdot is run by rich white guys

[Mephistro]

...but i absolutely don't care about your health and i am sure you feel the same towards me. ...

Wrong, ohhh, so wrong.

I'd rather help you with your health, through taxes, than having you around with an undiagnosed and/or untreated case of Tuberculosis, AIDS, severe depression or Schizophrenia.

Also, your poor health could mean that your children would have less opportunities in life, and stand more chances of becoming criminals, creating huge costs for the rest of the society, including me. I don't think, either, that "Let the sins of the father fall over his children" is morally correct. Not in a million years.

Re:Remember, slashdot is run by rich white guys

[Belial6]

I'm not sure what you mean by you pay nothing. If you mean that it is covered by your employer, then you are wrong. You have just been tricked by a shell game. When an employer hires people, they consider the cost of that employee. That includes both salary as well as all of the employer side payments. This includes health care.

Re:Remember, slashdot is run by rich white guys

[sjames]

You speak of the "overhead of a single payer system". Where is your logic? I see no logical reason to expect a single payer system to be LESS efficient than dozens of arbitrary payer systems all with their own different rules, limits, forms and codes for the very same thing.

You then demand proof that it can work in the one place on earth you know it has never been tried. In other words, you say prove it! I point to several places where it works well and you retort, "well besides the entire western world, where does it work?". I point out a few more and you retort "yeah, it works all over the world but how do I know it will work here?"

Next, we'll be treated to the anecdote about some guy who for reasons unfathomable chose to wait 6 months for a free band-aid for his shaving nick rather than just get one from the drug store as proof that people having a heart attack right in the emergency room will be put on a 6 month waiting list.

Re:Remember, slashdot is run by rich white guys

[scottv67]

Amen.

MOD PARENT UP.

Re:Remember, slashdot is run by rich white guys

[Mephistro]

...People go to the doctor every time they sneeze, because they don't see the costs covered by someone else...

Well, I read somewhere that doctors are aware of this issue, and have invented some thing called 'Triage' ( http://en.wikipedia.org/wiki/Triage ) for -amongst other uses- filter out these cases. I live in a country with a NHS, and doctors here are quite apt at discovering these patients and sending them home with some placebo and a good advice or two, in less than ten minutes per patient.

Of course, errors happen sometimes, but It sure beats having people going to the doctor only when they fear for their lives.

Re:Remember, slashdot is run by rich white guys

[sjames]

but if there's only one hospital where you live, and it opts out, you're paying for National Health Care without really getting any benefits for same.

It won't opt out! As soon as it discovers that nobody can afford it's services unless it opts back in, it will because no customers means out of business. Just as likely, as soon as it discovers that the emergency patients it treated under the existing must (minimally) treat laws can't or won't pay any other way, it will happily reach for the check being held out to it by the national health care system.

It's opt-out in the same way that breathing is opt-out. Why should I argue endlessly about the ethics of mandatory breathing when I know you'll soon enough pass out and start breathing again anyway if I just say "fine, suit yourself"?

Re:Remember, slashdot is run by rich white guys

[10101001 10101001]

And please explain how the overhead of any middleman between me and a doctor would be more cost-effective.

Even a very basic mathematical analysis shows that any of these systems is less efficient than "customer pays."

If your answer is that the government will have none of the problems that using insurance companies as a middleman have, because the government is good and insurance companies are bad, please try again.

It's like this: routine care has a cost x. Redistribution of money to pay cost x has an additional cost y, no matter who does it. If the customer pays cost x, adding cost y will increase costs.

Average Price = a; Routine care cost = x; Overhead cost from insurance/government = o; Overhead of debt collection = d; Probability customer won't pay = c; Probability insurance won't pay = i; Probability government won't pay = g

• For customer pay only: a = (x + d) / (1 - c)
• For insurance pay only: a = (x + o + d) / (1 - i)
• For government pay only: a = (x + o + d) / (1 - g)

The average price is based not only on overhead but the costs to collect on a debt and the actual payment rate. Customers are more likely to pay in installments while insurance/government is more likely to pay in bulk. Insurance companies are less capable of dealing with short-term dramatic claims (look no further than Hurricane Katrina). Insurance companies are also more risky because there is a lack of standardization on what is covered by insurance. Governments may well force lower payment rates even below the actual cost of a procedure which in the long term will reduce service.

In short, there's more to the issue than a bit of simple math.

Re:Remember, slashdot is run by rich white guys

[sjames]

Consider, if there is health insurance that makes sure basic needs are covered, supplemental insurance that upgrades you to a private room and better food would be a lot cheaper (since you could just say no otherwise). Problem solved.

I have yet to see any proposal in the U.S. that would forbid choosing to pay more for a private room or supplemental insurance to cover that for you.

Re:Remember, slashdot is run by rich white guys

[CrimsonAvenger]

As soon as it discovers that nobody can afford it's services unless it opts back in, it will because no customers means out of business.

The existence of a National Healthcare System does not, in fact, imply that people can't afford to pay for a hospital's service.

While I consider it unlikely that a hospital would opt out, I don't consider it impossible. Especially if it's a captive audience sort of hospital.

Re:Remember, slashdot is run by rich white guys

[saforrest]

I know several Canadian citizens who moved to the states in a large part to escape the inferior national healthcare system up north. I suppose if you work part time at McDonalds, government run health care seems like a good idea, but if you have a job where you can actually afford real healthcare, it's terrible.

Amazing isn't it, how everyone has an ex-girlfriend's former roommate's Canadian cousin who has some unpleasant anecdote the public health care system, isn't it? I almost wonder sometimes if these are all the same person.

Well, I am Canadian. And I can say that while our system isn't perfect I honestly can't see it being vastly inferior to whatever you have down there, unless maybe you get wine & cheese and digital television in every waiting room.

I'm still fairly young with no major health problems, but of course I have friends and relatives have had serious medical issues (e.g. heart attacks, liver & stomach trouble, cancer) and by all accounts got perfectly acceptable treatment. Of course we have the occasional scandal: for example some doctors in Newfoundland a few years ago misdiagnosed a lot of breast biopsies, missed a number of cancer cases, and some women died, but that was pure incompetence and there's no obvious reason why a private system would've avoided that.

Canadian immigrants to the U.S. are not a statistically valid sampling of the Canadian population. I have a friend who's now in the U.S. who badmouths our healthcare system regularly, but that has more to do with his being a libertarian than from any actual bad experience, which he grudgingly admitted to after a long argument.

Re:Remember, slashdot is run by rich white guys

[JackDW]

It looks like you haven't watched enough Michael Moore documentaries. Rich and stupid white men are to blame for all problems. That's not racist, it's just a fact :).

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Complaining? Seriously? Why is it not possible to just not bitch and moan about every little thing on the web? It's not like you're debating standards here, or you're hiding your own insecurities. You're just keeping people who might actually think you're being honest from believing you by being overly aggressive on a slashdot thread.

Re:Remember, slashdot is run by rich white guys

[sjames]

If everyone only has the insurance they won't accept, the odds are nobody will be able to afford their services. Practically nobody can afford to pay out of pocket these days.

Re:Remember, slashdot is run by rich white guys

[FiloEleven]

nobody literally believes that "government is theft." What people mean is that "government taxation to support programs that are morally indefensible is theft." That's a position a Republican stalwart can share with a socialist pacifist who can't abide Democrats because they are too right wing. The only difference is in the details of which programs are considered morally indefensible.

In my mind it is a question of legality rather than morality. This nation claims its constitution as the supreme document. Whenever government does something that according to the Constitution it is not authorized to do, then its use of my tax money is not legal. To adapt your phrase, "government taxation to support programs that are unconstitutional is theft." Of course, if there is an unconstitutional program desired enough by the public, an amendment can be pursued to make it constitutional, but the willy-nilly disregarding of the constitution that began early in the 20th century and continues at an ever-increasing pace today is untenable.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

The correct term is "legal plunder," that is, the taking of goods by force that is sanctioned by law.

Re:Remember, slashdot is run by rich white guys

[HiThere]

You don't remember the postal service we had before it was privatized. It was much better. It's true there are advantages in parcel delivery now, but UPS already existed. It's just that almost nobody was willing to pay their higher prices. Now that their prices aren't higher (because postal rates are higher, they and their competitors do a better job.

If you're going to privatize something, you must ensure that the barriers to entry are low, and the rewards for quality are high. Otherwise you're better off not privatizing it.

So... I've just described being a doctor as a suitable field for privatization. But I've also described being a hospital as a field that's NOT suitable.

Next we come to the matter of essential access. Were access is nice, but not something essential, then it's better if the government doesn't do it. (N.B.: This is independent of the prior argument. Things can be better along one dimension and worse along another.) If the thing can determine the quality of your life, then it's better if the government ensures that it's available to everyone. Examples here are safe food & water, shelter, and health care. This is where the situation gets complex:
        Food safety is supposed to be regulated by the FDA. It "sort of" is, but the FDA does a lousy job. Unannounced inspections rarely occur. Unsafe practices are tolerated, and safe (on a small scale) but inexpensive practices are forbidden. OTOH, most water utilities do a good to excellent job. And ensure that anyone can get enough water. (Partially this is because water is cheap enough that people don't guard it, even though they do pay by the gallon.)
      Shelter is insufficiently available. Only in case of disaster does the government even attempt to ensure that everyone has a place to get out of the weather. This has it's good and bad aspects, and I haven't been able to decide among them. But it clearly undermines any assertion that the government is caring for the people. (N.B.: Undermining doesn't prove it false. It just raises questions about it that are difficult to answer.)
        Then there's health care. U.S. health care is, frankly, lousy. Even if you can pay you are likely not to get the service you need in an emergency. (Sometimes not even after a planned surgery, but that I lay at the foot of the surgeon rather than on the system. But the time I waited in an emergency, raving out of my mind [much of this I never remembered and had to be told about], because my leg was inflamed with infection for over 12 hours I lay on the system. And I had health coverage.)
P.S.: They didn't take me out of the public waiting area until after a few hours I started vomiting. Then they still didn't show me to a doctor, they just moved me to a screened off waiting area with a bed.
        FWIW: I had much better health care during the 1950's as a military dependent than I do in an emergency room today. Only NOW I'm paying for it...but to a health insurance company that wouldn't even listen to any complaints I made about the quality of hospital service.

Re:Remember, slashdot is run by rich white guys

[HiThere]

That's only consistent if you also consider printing money to be counterfeiting. (A reasonable argument if you believe in the gold standard.)

I offer a definition for your consideration. I wouldn't assert that it was true, but I'd be willing to defend it in debate:

Government is the monopoly on the use of force. Most governments sub-license this to various other entities (e.g. states, municipalities, police departments, armies).

Re:Remember, slashdot is run by rich white guys

[jcr]

From Federalist #62:

Every new regulation concerning commerce or revenue; or in any manner affecting the value of the different species of property, presents a new harvest to those who watch the change and can trace its consequences; a harvest reared not by themselves but by the toils and cares of the great body of their fellow citizens. This is a state of things in which it may be said with some truth that laws are made for the few not for the many.

-jcr

Re:Remember, slashdot is run by rich white guys

[alphaseven]

You know, a lot of what you're proposing, (aside malpractice reform), sounds an awful lot like Obamacare (if the Senate bill passes).

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Congratulations. You've asserted that the American health care system is the best when compared to the health care system of two unidentified "asian" countries. I bow down to your superior reasoning abilities.

In related news, I'm the richest person in the world because I have a nicest car when compared to the two people who live beside me.

Re:Remember, slashdot is run by rich white guys

[As_I_Please]

I've never understood this argument. Listing prices helps a consumer make a choice about what to buy, but in health care, there often isn't a choice. Can it really make a difference to know what an appendectomy costs? It's not like you can opt for a cheaper treatment if you can't afford the one that cures you. Market solutions only work if a consumer has a choice about what to buy.

Re:Remember, slashdot is run by rich white guys

[gink1]

Remember: we ALL need quality Healthcare, rich white guys included.

It's just that a "Healthcare Reform Bill" built around a basis of mandatory Insurance using the services of a legal Heath Insurance monopoly, with almost no cost controls, will only give you a little of what you need!

And while you are getting a little Healthcare, this solution will be reaching behind you and picking your pocket!

With all the smart people and the examples of so many other countries that do it right, how could we have got things so wrong?

The answer is corruption. The Health Insurance Cartel spent > $560 Million on Congressmen alone. Who know if they invested in Obama too? It certainly seems possible.

Re:Remember, slashdot is run by rich white guys

[Crimsonjade]

You act like it is a zero-sum game. The "the impoverished family down the street's daughter" can get the same treatment as GP via subsidized cost. Any national health care system will have opt-out policy too. So anyone with money will continue to get a higher standard of health care. This is the main complaint I hear from England all the time. The best doctors and care are still only accessible to those with money.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

The power of government stems from the threat of violence and loss of liberty.

Yup. One of the main reasons that governments exist is the threat of violence and loss of liberty. By providing for a common defence against other governments - not to mention free-lance gangs, who would otherwise invade and enslave. Which they do by levying funds and/or manpower from those they agree to protect. And, since not all enemies of the common good are external ones, the system expands to include criminal and civil regulation as well, necessitating yet more levying (or, "theft", as you would have it. Then some genius decided that floods, fires and famine were threats as well, followed by age and infirmity, and, well we end up where we are today. Lots of "theft" and "threats of violence". You want threats of violence, got down to the airport and take a glim at those who we've appointed to keep up safe. It's like the terrorists have their own army of occupation there. And all done with the blessing of self-named "conservatives". Who say that All Government is theft and threats of violence.

Moms-basement libertarians are such a pain....

Re:Remember, slashdot is run by rich white guys

[I_Voter]

Every thing in the Federalist paper #62 relates to the nature on the U.S. Senate. You have taken a quote out of context.

Madison was not arguing against economic regulation at all, he was arguing that short terms for politicians would provide bad economic regulation! Also many other thing such as the appointment of senators by the State legislatures would protect small states. He is also claiming that a Semator's longer terms will provide stability in all things including economic regulation. That is were your quote came from. SO WHAT!

I repeat: James Madison accepts that economic regulation is the primary function of government.

Re:Remember, slashdot is run by rich white guys

[gemada]

overhead in our publicly run system in Canada is under 3%. Whereas in private systems such as the US it around 30%.

Re:Remember, slashdot is run by rich white guys

[rts008]

I happen to live in America ...

America?
North, Central, or South America?

Let's assume North America...
Canada, USA, or Mexico?

What was your point?

Re:Remember, slashdot is run by rich white guys

[pydev]

Really, what is so damned scary about a national health care system

I have private insurance and I'm well covered; any national health care system would probably mean longer waits, more rationing, and worse service for me. About 50% of Americans are in the same situation. We vote, and you need to do a lot of convincing to get me to vote for any change of the status quo. Another 30%, including most elderly, are covered through public plans. A public health care system that extends to additional groups would also mean a lot of changes for them, and potentially crowding. Again, they vote and they'll be hard to convince too. Of the uninsured, a significant percentage are young people who don't believe they need health insurance and don't want to pay for it. They aren't going to be too happy about the extra expense of mandatory health coverage either. So, between those, that's most of the US voting population, and that means that any reform is going to face an uphill battle.

I would kick any politician who proposes a UK/Canada-style system out of office; apart from resulting in much worse services than I currently receive, I think they infringe on my (and everybody's) essential liberties to make medical decisions. You may think it's the greatest thing since sliced bread, I think it's morally wrong, and so do a lot of other Americans.

People like me do realize that there is a problem with the US health care system: prices are out of control, people are falling through the cracks, etc. But I think those can be addressed with specific legislation: regulation of drug prices, tighter regulation of insurance companies in areas like pre-existing conditions, etc. There probably should be a limited public option for people who otherwise fall through the cracks and aren't 65 yet.

Re:Remember, slashdot is run by rich white guys

[StopKoolaidPoliticsT]

yeah, lots of seniors. That's why they buy Medigap or Medicare Advantage plans which convert their standard Medicare into an HMO run by one of the private HMOs around the country, usually at an extra cost to themselves. My dad pays an extra $1212 a year on top of his Medicare A and B premiums for it. Medicare A covers basic hospitalization and is paid for through taxes during your working years. Medicare B covers things like durable medical equipment, doctor visits, physical/occupational therapists, etc and costs extra on top of Medicare A ($1157 a year in my dad's case).

Now, you can't have Medicare AND private insurance. So, if you opt for Medicare A, which you've already spent decades paying your premiums for, you'd better opt for Medicare B. And Medicare B is woefully inadequate, with LOTS of extra expenses that kick in if you use it too much (the notion that it is single payer is a joke), so you convert A and B, usually picking up D (prescription drugs) and end up in a private HMO that is regulatd by CMS (Center for Medicare Services).

The government basically locks you into Medicare by forcing you to pay for it. It further restricts your access to buy other insurance, so you either forgo the premiums you've paid for decades to opt for private insurance or you have to double down on what you were already forced to pay for to get hospitalization coverage. On top of that, you have to double down again if you want prescription drugs and/or the extra services provided by the HMO (including reduced hospitalization fees). On the other hand, if you go the HMO route, you no longer have nationwide coverage but are restricted to coverage in a region like a traditional HMO.

Medicare is a HUGE mess, deliberately constructed to force people into it and make them dependent upon the government. Every time the Democrats (today) or the Republicans (back in the 90s) try to modernize Medicare and cut out the huge fraud (as much as 25% annually), you get the other party going "look, they're trying to kill the old people!" Thus, the system will NEVER get fixed... and yet, this is your ideal? You should really investigate Medicare before you advocate it as anything really beneficial.

Re:Remember, slashdot is run by rich white guys

[pydev]

you'd rather pay more than the government would take to a third party, to get worse service? That doesn't make sense.

But your assumption is wrong. Many Americans are happy with their health plans; they get good service from competent doctors, and they don't ever really see how much it costs because their employer health plan takes care of it. Why should I vote for politicians who want to change a health plan that works for me? The reason US governments keep having such a hard time to pass health care reform is that the voters are not convinced.

Yeah, you can rant about "choice" and "not being forced to", but you don't have any real choice anyway.

I do have a choice in health plans, style of coverage, and coverage amounts, and so do many other people. Furthermore, I get credit for healthy living, and I don't want to subsidize people who choose to live unhealthily.

You're guaranteed to have to pay for medicine at some point in your life, one way or another.

If you live a reasonably healthy life and get regular checkups, you probably won't ever need expensive treatments. A lot of the expenses of the medical systems come from preventable chronic conditions (obesity, heart disease, diabetes, high blood pressure) and from needless end of life care, and both of those are under your control.

Re:Remember, slashdot is run by rich white guys

[pydev]

I give you H.R. 676 [loc.gov], a bill which would provide simple, single-payer health care to all legal residents of the United States,

And why would I want that? I have full coverage and competent doctors, and a choice in health plans. And many voters are in the same boat as me.

It has been shown several times that single-payer care costs far, far less in the long run, and allows you to keep everything you have now, minus the insurance company that wants profit over your own health

The single payer health systems I have seen are worse than what I have right now. And any increase in my salary would probably be eaten by having to pay in post-tax dollars and probably losing various credits, so that in the end, I'd have worse coverage and no more money.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

If someone truly cannot do so then yes there should be safety nets, but the health care of the bulk of the population should not be paid for by their fellow taxpayers. Get a fucking job and earn some money and care for yourself.

Yeah! Fuck those people with pre-existing conditions! They deserve to be denied healthcare.

You lazy bastards should've gotten healthcare before you got that pre-existing condition.

Fuckers.

Re:Remember, slashdot is run by rich white guys

[StopKoolaidPoliticsT]

and I forgot to add, on top of all of that, Medicare is due to go broke in 2017. Again, that program is a real winner...

Re:Remember, slashdot is run by rich white guys

[pydev]

By the way, HR676 doesn't in any way affect your relationship with your doctor and/or hospital other than who they bill.

As I see it, it changes the amounts my doctor can bill, it changes what is covered, and it changes my contributions. All of that changes my relationship with my doctor significantly.

I mean really, we could just boil this down to "I've got mine, so fuck the rest of you."

Call it what you want, I'm not going to vote for a change from the status quo unless I can be reasonably assured that my coverage doesn't get worse and that what you're proposing actually is effective.

Re:Remember, slashdot is run by rich white guys

[pydev]

You seem to think that a hospital should be like a hotel, where everybody gets their own room and a continental breakfast.

No, I don't think everybody should get it. I think I should get it if I'm willing to pay for it. You may, instead, prefer to spend your money on a bigger car or house (things I don't care about).

Space is a commodity; I, for one, will put up with a little less room if it means that the impoverished family down the street's daughter gets necessary treatment.

That kind of either/or choice occurs with Canada-style systems. In a more flexible system, the fact that I pay for nicer accommodations doesn't prevent other people from getting their necessary treatments.

Re:Remember, slashdot is run by rich white guys

[jcr]

James Madison accepts that economic regulation is the primary function of government.

You're glossing over the difference between regulation and seizing control. Government should be the referee if people can't resolve their disputes. It shouldn't be telling people what to do otherwise, and that's the position that Madison and Jefferson held to.

-jcr

Re:Remember, slashdot is run by rich white guys

[amightywind]

I made the mistake of giving my niece her money. The government seeing that she had a little bit of money(just $10,000) stripped her of medical and food benefits.

The modern liberal welfare state at its worse. The State pays the poor a pittance, and punishes them for improving there life. If you were smart you would have given her cash. By the way, people with incomes below $50K pay 2% of federal taxes in the US. Tea Partiers pay the rest. One would think you Bolsheviks would figure that out by now.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

Government should be the referee if people can't resolve their disputes. It shouldn't be telling people what to do otherwise, and that's the position that Madison and Jefferson held to.

-jcr

We may not disagree all that much. I think we have been commentating on different subjects.

It is my perspective that the government ( unlike a corporation apparently ) is not a person, and cannot seize anything! However; the people who control the government can. Obliviously citizens will disagree about what is "regulation" and what is "seizing". They are subjective value judgments. You have every right to your opinions.

It may clarify things if I state that I am a democrat (small d), and favor proportionally representative legislatures. I also favor negative forms of democratic power such as jury nullification, or voting none of the above. I also favor "real" or private member based political parties, which have been effectively outlawed in the U.S.

As you can probably guess I tend to view many forms of government regulation as seizure. At the very least, the government has helped bankers and the military industrial complex seize my money, However I am certain that others will disagree with me.

Re:Remember, slashdot is run by rich white guys

[drsmithy]

...Unless you value your life, that is.

Really ?

Re:Remember, slashdot is run by rich white guys

[drsmithy]

I pay for my own healthcare and I didn't have wealthy parents yet I'm against publically funded healthcare. Why, you ask? It's because it is NOT the Government's job to be our nanny. People need to care for themselves. If someone truly cannot do so then yes there should be safety nets, but the health care of the bulk of the population should not be paid for by their fellow taxpayers. Get a fucking job and earn some money and care for yourself.

I agree. We should also immediately disband the Police, Fire Services and Armed Forces.

Re:Remember, slashdot is run by rich white guys

[ajlisows]

I think the parent (at least for the majority of his post) trying to make a point against comprehensive health coverage. Need a physical? Pay the $120. It is actually only $100 more after the $20 co-pay. Need a generic medication (say...amoxicillin)? Pay cash for it. Heck, I often take generics like that to a pharmacy that doesn't have insurance on file for me, as a Co-Pay would be $10 and I can fill the prescription for $8.50. Yup. Cheaper than with "insurance". Funny thing about that is that if you take the prescription to a pharmacy WITH your insurance on file, they will insist you cannot pay cash. Allowing for a system with more a la carte coverage where you can choose to only pay for huge dollar items seems reasonable.

The end of his post...yeah. I think he was saying "Fuck the poor".

Re:Remember, slashdot is run by rich white guys

[shutdown -p now]

Remember, slashdot is run by young rich white guys whose parents were all well-off. They don't need health-care right now, so screw everybody else.

My experience shows that it's not the main social group of libertarians. Quite the opposite, in fact: libertarians, especially the more radical ones, who will easily produce two pages of drivel explaining how their views are the only rational and moral ones, and everyone living on welfare would be better off dead for all they care, tend to be poorer than average. About the only thing that matches with your profile is that it is, for the most part, indeed a white thing.

It shouldn't really be surprising, because libertarianism - just as any extreme ideology - is more emotional than pragmatic, and its practitioners are guided more by their sense of justice, and vision of how things should be made right, rather than personal gain. They're revolutionaries just as much as various extreme socialist and communist parties are, with fire in the eyes, and hatred and no remorse to any and all who would stand in their way.

Young rich white guys who vote pragmatically (i.e. considering their personal interests first and foremost) tend to vote either centre-right or centre-left, depending on their leaning.

Re:Remember, slashdot is run by rich white guys

[shutdown -p now]

What the left wing always forgets is that health insurance is a risk management tool.

As it has been repeated so many times already, you need health care, not health insurance. The latter is inherently workable only in a market place. It's not insurance anymore when you come to them needing treatment already, and they have to provide it to you.

That's why your present healthcare reform is a blunder, by the way. It tries to patch up the existing private, for-profit system by over-regulating it. Instead, it would be much better off left alone, alongside with a proper public heathcare system (with which it would then have to compete, hopefully driving the overhead and prices down).

Re:Remember, slashdot is run by rich white guys

[shutdown -p now]

I know several Canadian citizens who moved to the states in a large part to escape the inferior national healthcare system up north. I suppose if you work part time at McDonalds, government run health care seems like a good idea, but if you have a job where you can actually afford real healthcare, it's terrible.

Canadian system is not the best in the world, but it's nowhere nearly as terrible.

It's biggest flaw (because of which so many people actually go to U.S. for treatment) is that it forbids private, freely priced competition to public services (mostly on provincial level). Hence, even if you have money, you cannot use it to purchase better and/or faster treatment. There are private insurance plans that are supplementary to the basic public system coverage (dentists, optometry etc), but that's about it. Which is pretty stupid, IMO, as I see nothing wrong with people being able to purchase better service for money, so long as everyone in the country has access to the basics.

Re:Remember, slashdot is run by rich white guys

[shutdown -p now]

Any national health care system will have opt-out policy too. So anyone with money will continue to get a higher standard of health care.

People who "opt out" by not using the public healthcare services still fund them by paying taxes.

Re:Remember, slashdot is run by rich white guys

[shutdown -p now]

Do I want the US health care system to become like the middle case I described? No way. We're way, way better than that now. My wife, who is from one of those other places, agrees that our quality of health care is the best. Going to a national insurance system will probably pull that quality down.

Is "we" in your assertion a reference to all Americans, regardless of their income, or to you and your wife personally?

Re:Remember, slashdot is run by rich white guys

[ajlisows]

I think another factor not taken into account much of the time is the fact that hospitals cannot refuse emergency treatment to people who need it. Uninsured individual goes to the hospital after some sort of brutal accident. Individual racks up Tens of Thousands of dollars in medical bills (they add up really quickly). Person either recovers or dies. If they recover they will be presented with a bill they cannot even begin to imagine settling up. They are forced into bankruptcy or just completely ignore the bill. In any case, that bill gets eaten by the hospitals, government, or somebody else. Of course, the hospital needs to recover that money so they bump up all of their costs. Insurance companies start getting bills which are higher and tell the companies that carry their insurance that premiums will be going up next year. Your company informs you that premiums are being raised so you will have to pay more money from your pocket.

I also have personally known two doctors who juggled patient billing between the insured and uninsured. I'd find procedures that were billed to my insurance company that I never had done. I found it really hard to blame the doctor for simply trying to get a hepatitis workup on someone who couldn't afford it (although what they were doing was illegal). Same scenario as above. Insurance notices higher bills, premiums go up, money comes out of your check. If I met two doctors like this...how many else do it? It might be easier to count those that do not.

So the way I see it, we currently have a poor "Socialized" health care system that requires all sorts of little dancing around rules, collection agencies, bankruptcies, and whatever else. In the end this little charade provides barely adequate health care to the poor and gives us an increasing number of companies/people who can not afford care (which in turn compounds the problem).

I'm not really a big advocate of many government programs and I am usually in the "Keep your hands off my fucking money" camp, but this is different. Maybe I don't necessarily care about some nebulous "other person's health" but when I see people suffering greatly and cannot afford to go get it taken care of I really find it hard to play the "You should have went to college and gotten a better job" card. I am totally fine with that attitude when it comes to a better place to live, better vehicle, better gadgets, better vacations, and better entertainment. Denying someone life, sanity, or the lack of chronic pain seems fairly barbaric.

Re:Remember, slashdot is run by rich white guys

[gujo-odori]

Give me some examples of those worse results.

Window dressing? I doubt it. There are bad hospitals in the US, surely (King Drew, in LA, for example), but typically, hospitals here are very, very good.

As far as better government goes, having less of it is one of the main points to getting good government. Good government is government that keeps its nose out of your business. Why is the US anti-government? Look at how we got started, for an answer to that one. The founders quite correctly understood that government needs to be severely controlled to prevent it from trampling on the rights of the people. Our government today is out of control and doing an awful lot of trampling these days.

The US has less social mobility than Europe? I personally know a large number of immigrants who came here with nothing but the clothes on their backs and who are now prosperous middle-class homeowners who would certainly disagree with you about that. There's a reason why everybody wants to go to the United States. Granted, the US isn't as good a place to live as it used to be, not by a long shot, and yeah, excessive and over-spending government is a lot of why, but it's still where everybody wants to go.

When I lived in Asia, I worked with a German guy who was so happy to be living in Asia because it meant he didn't have to pay 50 percent of his income in taxes anymore. Great social mobility, that.

Europe is so far from having its act together in so many areas that it can hardly afford to throw stones at us.

Re:Remember, slashdot is run by rich white guys

[Anonymous Coward]

I know several people who trade their brand new BMW SUV's in every year for a brand NEWER BMW SUV. I bet they know your anecdotal Canadian ex-citizens too!

Re:Remember, slashdot is run by rich white guys

[ducomputergeek]

Here is what needs to be done:

1) Put a cap on punitive damages for malpractice at $500,000. This is not a cap on economic damages.

2) Hospitals and Doctors must have a 1 Price policy and have those prices publicly available. None of this Open Heart Surgery for Insurance A is $18,000, Insurance B $24,000, but if you walk in off the street with no insurance it's $45,000.

3) Government Defines 5 health insurance plans that insurance companies must offer and it is nationwide. Each plan will have a different level of features so you can have economy/minimum coverage all the way up to the Cadillac plan. The model for this is Medicare Advantage. Supplement B covers the same things no matter the company, the only differences between companies are premiums and co-pays. Then we're comparing Apples to Apples.

4) Defined plans must include pre-existing conditions. Again, shared risk pool is the point of insurance.

Re:Remember, slashdot is run by rich white guys

[tjstork]

As it has been repeated so many times already, you need health care, not health insurance.

And, the folks repeating it are wrong. I do not need health care, I need health insurance. I only need health care if I'm sick, and if it costs too much, I use health insurance to manage the risk of paying for it.

Re:Remember, slashdot is run by rich white guys

[shutdown -p now]

I wasn't referring to you in particular, but to your nation as a whole.

Anyway, I was actually wrong in an important way in my previous post. Your country as a whole doesn't need anything like that on Federal level, because it would further bloat the mammoth that is your government (which is unsurprising, as when you have a single government that deals with so many matters for over 300 million people, that's what you inevitably get). Any such healthcare systems should really be state-level, if citizens of a particular state feel like they need them, and can afford them.

Re:Remember, slashdot is run by rich white guys

[tjstork]

Because it would further bloat the mammoth that is your government (which is unsurprising, as when you have a single government that deals with so many matters for over 300 million people, that's what you inevitably get).

Tell me about it. I'm working on a budget widget for the USA for my site, not done yet, and I've got like a thousand things that are a few hundred million a pop, and a couple that are more... and it all actually sounds "reasonable" once you start digging into it. Like, look at Social Security Disability. I broke it down into beneficiaries by the kinds of reasons... and I've got like a billion for retarded people, a few billion for the blind, and you know, at some level, the whole of it, the 150 billion a year, its getting ripped off, but you can't really cut any particular item, lest suddenly people are in an uproar because the blind and the retards are starving - the key is really, the doctors who say who is blind, and who is not, that is the real problem, and its untouchable.

Re:Remember, slashdot is run by rich white guys

[dylan_-]

but doesn't cover dental or the cost of anything but out-patient surgery, as far as I can tell (doesn't cover surgery? then what's the point?)

It's difficult to explain without explaining the whole system. The UK has the NHS providing healthcare, so the health insurance is really providing "top-ups". Private rooms, skipping waiting lists, paying you extra money while you're in hospital, etc. Surgery is "free" already* so it's not counted. Other things are capped [for example, any prescriptions in Scotland are now £4 per item]. Dental insurance seems to be sold separately for the most part, but it's only about £8 a month, probably because dental treatments' costs are also capped, so most folk just pay as they go.

Excuse the square brackets, my "0" key is broken.

[* of course it's not free, it's paid in taxes, but as I've already mentioned we pay less in taxes per capita than you pay in the US for your public health service]

Re:Great.

[malkavian]

Demographically, most people have a mobile phone.
Now, you have a nice, efficient, easy way to get a big win with about 90% or more of the population that could help stave off a lot of resource being spent in treatment down the line, and you gripe that it doesn't cover 100% of the population? Wow.

Being part of the NHS in the uk, I get to see a lot of initiatives rolled out. Some politically driven, and they're frequently not so great. Some well thought out. There's always discussion on who gets left out, or missed, and how they can be brought into the system effectively. There's a (much derided) program that has a web, and phone presence that gives you the general idea of whether or not you should go see a GP, or head to the hospital (or in some cases, take a paracetamol, and wait for a day to see what happens).
Though it's not the greatest system, in the majority of cases, it does the job. Now, for this, you need an internet access point, or a telephone. If you don't have either of those, then you can't use the service, and have to go to see your General Practitioner to see if you have a problem.

This isn't a "you take this service, or you have no support", it's a method of aleviating the load on the system by offering a lightweight alternative that you can use if you have the resources to use it, having a low cost on both sides (provider and client), rather than much higher resource cost (time and/or money) otherwise.

Moderate parent up.

[Futurepower(R)]

SmallFurryCreature, I agree with what you said: "... this whole thing is just another sign of the US tearing itself apart for some reason I at least cannot understand."

WHAT

[goldaryn]

'Enter the date of the first day of your last menstrual period'

I'M NOT TELLING YOU THAT! YOU MEN YOU'RE ALL THE SAME!

Re:WHAT

[Anonymous Coward]

Since you've not been through sex ed or haven't had a child, you should become educated. The due date is calculated based on the the first day of the last menstrual cycle. It's 10months. All care is based on this date.
Due date.

Re:WHAT

[biryokumaru]

Yes, we all want desperately to know every detail of your menstrual cycle... *cough*

Re:WHAT

[Anonymous Coward]

Written like a man who has never had to spend significant time around a woman.
One quickly learns to avoid being around them during PMS days if at all possible.
Best case you can get them to recognize that they are PMSing and the good ones will try to tone it down. Worst case, they couldn't care less what day it is and its all your fault anyway so what does it matter?!!?

Re:WHAT

[Anonymous Coward]

'Enter the date of the first day of your last menstrual period'

I'M NOT TELLING YOU THAT! YOU MEN YOU'RE ALL THE SAME!

So ... today, then.

Re:WHAT

[kms_md]

unfortunately, not all pregnancies are dated by the first date of the last menstrual period (LMP). first date of LMP roughly assumes regularly occurring 28 day cycles with ovulation/conception occurring around day 14. not all cycles are regular or 28 days in length. a significant number of pregnancies are dated by first trimester ultrasound.

Re:WHAT

[Anonymous Coward]

Until the fetus is large enough to measure by ultrasound, everything runs on the LMP. Nearly every doctor revises their timeline once they perform that ultrasound. The ACOG labor & delivery sheets and most laboratory requisitions are all designed to deal with this.

Re:WHAT

[couchslug]

"I'M NOT TELLING YOU THAT! YOU MEN YOU'RE ALL THE SAME!"

That's rather harsh. We're not all like that.

Pics with timestamp will do.

Re:WHAT

[kms_md]

true, but the texting app asks for LMP not EDC (estimated date of confinement). gestational age is determined from EDC (when it is known and confirmed) not by LMP.

Not just rich, out of touch and reading challenged

[Futurepower(R)]

Slashdot criticism: "Once again, Dilbert proves to be scarily prescient."

From the article, Text4baby founding partners include:
National Healthy Mothers
Healthy Babies Coalition (HMHB)
Voxiva
CTIA - The Wireless Foundation
Grey healthcare group (a WPP company)
Founding corporate sponsor Johnson & Johnson
WellPoint
Pfizer
CareFirst
BlueCross
BlueShield
"... wireless carriers are distributing free text messages."
White House Office of Science and Technology Policy
Department of Health and Human Services
Department of Defense Military Health System
BabyCenter LLC
Danya International
Syniverse Technologies
Keynote Systems
The George Washington University
"MTV Networks is a media sponsor."

So, your comment, "Remember, Slashdot is run by rich white guys" could be changed to read "Remember, Slashdot is run by rich, out-of-touch white guys who didn't read the story they posted."

Improving the NHS

[OldEarthResident]

I agree with you that the NHS provides some good things and for a routine or otherwise well known illness I have found the NHS to do a good job.

However, when you have a unusual condition, as I apparently do, and which standard testing doesn't reveal any insight into, then you can be basically ignored by the NHS until your condition becomes debilitating. Unfortunately, by that time, it's generally too late to do something about it.

I have no real idea why the consultants will not spend any extra time trying to track down the problem, but I suspect it has to do with the NHS been very target driven and getting people through the door as quickly as possible. To any NHS workers here, I am sorry if that seems harsh, but it's how I currently feel.

The opinion of this patient is that the NHS needs to develop procedures for been able to spend time diagnosing patients with unusual conditions and not leaving it until it's too late to do any good about it, because right now, my only real hope is that this condition (whatever it is) stabilises before my vision gets too dim to be of use.

(BTW Slashdot, if anyone here has any ideas about why a person's perceived brightness level would dim without any MRI or VEP tests been positive, I would be very interested in any suggestions you may have.)

Re:Improving the NHS

[malkavian]

Often, it's down to the consultant. I've been to see one or two for various things, and they just haven't been interested, and I've seen some who pull out all the stops.
If you have no result from the consultant you've seen (having the condition marked as ideopathic), and you know that the problem is ongoing or worsening, as to be referred to another more senior consultant. If they refuse, to and talk to the Patient Liaison service (ask at the front desk of the hospital; they're a good avenue to follow to make a complaint of that nature).

The chances are that although your hospital has an opthalmology department, and a neurology department, they're not research/specialist places (you'll find that there are some hospitals that have real specialities; ask for a referral to another hospital with a research department in that area). The patient Liaison service would again be a good place to check out to see what can be done about that. Alternatively, you could ask the GP for a referral to a specialist hospital. If you really want to go to town, do a little research of your own to find out which hospital has the closest speciality match to your condition, and use "choose and book" to your preferred choice.

I may be telling you things you already know, so rather than keep posting here, I'll drop you a line on the details mentioned on your blog, and start communications properly. I'll see if I can leverage any channels in the hospital where I am to find out the best methods of getting you to where you need to be..

Re:Improving the NHS

[jcr]

you can be basically ignored by the NHS until your condition becomes debilitating.

Political medicine sucks when you're only one voter.

-jcr

/ dotted at 9am saturday

[Anonymous Coward]

quote
The connection has timed out

The server at blog.ostp.gov is taking too long to respond.

Great; the national CTO's blog can't handle /dot traffic at 9am saturday eastern time

us most charitable ?

[cinnamon colbert]

This is a really complicated thing - defining "charity' and doing cross country comparisions the wikipedia article shows the us as having low official aid and high private aid however, see the thread here http://www.jonholato.com/2007/06/26/us-more-charitable-than-any-other-country/ for some perspective

Re:Great.

[biryokumaru]

You're likely right, people who can't afford healthcare in the US (15% are uninsured) probably don't buy cellphone plans (82% have plans).

ignoring the real problems

[cinnamon colbert]

1) the health care debate is about how to ration care currently, we ration care by income (largely) - good income, less rationing you are working class, with problems, to bad for you bub. single payers like me want to ration care fairly; basically on a doctor decided need to basis for those of you about to howl about socialized medicine, you want some gov't doc rationing your care or you want a private insurance company, which is what we have now 2) Costs are driven by technology It is new technology, an aging population, and our changing standards of what is "good care" that drives costs, eg, super $$ new drugs like those offered by Genzyme all this discussion about how much money we are going tosave by having electronic records, or making averyone use the same form, or better diets, sure we will save some - maybe a lot - in the short term, but over the next 10-15 years, gains in $$ technology will wipe out any of these savings 3) nurses will be replaced by robots where is the cost ? having a 60K a year RN take your temperture is ludicrous; you may laugh, but you heard it hear 1st as soon as robots are available, nurses are going to be toast as soon as better robots are available, doctors are toast it will take a while, but given how much people costs , especially when you need them on call 24/7 they will be replaced - it is a question of when not if (VCs, u listening, this is whre to put your money)

Re:Not just rich, out of touch and reading challen

[kms_md]

where is the american college of obstetrics and gynecology or the american academy of pediatrics (you know, the national bodies whose members actually take care of these ladies and their babies)?

HIPAA privacy regulations are problematic

[techentin]

Haven't these people heard about HIPAA? You can't just transmit personal health information over arbitrary text message networks. It doesn't matter if they have a "secure server" somewhere(*). The whole network needs to be secure and auditable. And something tells me that this isn't the case for text messages.

(*) Google can find exactly two mentions of text4baby and HIPAA, both of which just say that there is a secure server.

Re:HIPAA privacy regulations are problematic

[0100010001010011]

You fail to understand how HIPAA works:
A) you signed up for it
B) It's not specific, it's generic "Hey by the way" messages.
"You're 3 months along, you should expect morning sickness"
"Your child is 4 months old, he or she should start rolling over"

It's basic information that most people SHOULD know, but don't.

HIPPA only prevents personal identification. Drs can talk all they want about you, in front of others, but can't say your name. (Or vice versa, Guess who came to the office today, but can't say anything about their visit).

Needless to say, texting you generic information about where you or your child is in the development phase is in no way considered a HIPAA violation. It's like a newsletter... but for texts.

*Hurray for Dr Girlfriend for explaining this.

Text4Baby advice

[Anonymous Coward]

The advice that would help the babies the most would be something like:

1) Stop getting drunk and high

2) Stop using crack

3) Eat proper meals (WIC can help if you need it)

If these simple rules were followed there would be a huge drop infant mortality. Without following them no amount of "free" health care will make any difference.

Re:Text4Baby advice

[couchslug]

The advice that would help is not to breed what you can't care for, but the people who have the most brats are the least intelligent.

Fanastic

[physburn]

Seeing as a new born baby is a worry bomb for most parents, and the infact morality rate in america is trival, all mums and dads need is some text service to baby babble, until they get used to it, (some 20 years later). Capitalism does pretty well out of this sort of stuff, so i don't think the government need pay for it, and its the sort publc guesture that goes down well, until looked into.

---

Baby Care Feed @ Feed Distiller

"Historic"

[electrosoccertux]

Love how everybody's been throwing this term around lately.
This is not historic.

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[account_deleted]

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[account_deleted]

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What is wrong with USA health care reform?

[Midnight Thunder]

Coming from a country where we have public and private health care, I can't seem to understand why people are so against it in the USA. Worse yet, it appears that the people who it would benefit seem to be against it!? Can someone explain to me the issues?

Re:What is wrong with USA health care reform?

[Anonymous Coward]

Very few people trust the Democrats, and especially the Obama administration, to get it right.

Medicare and Medicaid are atrocious money pits; Obamacare would make it much, much worse without solving the real problems. Yet another wealth transfer/entitlement program is not what the country needs or can afford now.

Re:What is wrong with USA health care reform?

[amightywind]

In the US there are two kinds of people. Those who take responsibility for their and their dependent's health, and those who have their hand out. Unfortunately, the number of deadbeats has increased over the years. It is easy to see what kind you are.

Re:What is wrong with USA health care reform?

[Midnight Thunder]

Very few people trust the Democrats, and especially the Obama administration, to get it right.

Medicare and Medicaid are atrocious money pits; Obamacare would make it much, much worse without solving the real problems. Yet another wealth transfer/entitlement program is not what the country needs or can afford now.

This may be the case, but who can we trust to get it right? Is a partially good solution better than no solution at all? I come from a belief that everything is about balance, and helping out the less fortunate actually helps the more fortunate. What I mean by that is that even if I pay for my healthcare, providing the basic support for those who get excluded or treated unfairly by private healthcare helps avoid people having to steal or use other dishonest ways to find the necessary funding. By reducing crime here actually helps me by reducing the chance of getting mugged to help someone pay for healthcare they wouldn't have otherwise got. The balance is about finding ways to prevent the 'low-end' of society being too bad, yet providing just the right incentives to not ask for government hand outs at every turn.

Re:Great.

[TimHunter]

I'm not convinced this is true. Healthy young people may decide to forego health insurance, but at the same time couldn't live without a cell phone.

Re:Great.

[biryokumaru]

You're absolutely right, and I personally know people who make that choice. Cell phones are much cheaper, even with the crazy prices we pay in the US.

there goes the racism...

[tjstork]

Remember, slashdot is run by young rich white guys whose parents were all well-off. They don't need health-care right now, so screw everybody else

So basically, anything a white guy has to say doesn't count? That's pretty racist to me.

Really, what is so damned scary about a national health care system

Those who have good medical care already, will get less medical care, as a national health care system really means rationing. That's pretty much what it is. If you have the money and a good job in the USA, you get the best health care in the world. Everyone says "the USA as a whole gets less", but a lot of that is because our doctors can get sued for just about anything. If you wanted to make health care reform like the rest of the world, let's get rid of malpractice lawsuits, as is the case in Britain, and you'd watch costs fall dramatically, and then, other people -could- afford health insurance.

The right national health care reform was the one proposed by John McCain. He would have had tort reform to lower costs, unlinked health insurance from employers and moved that to individuals, which would have gotten rid of some huge social problems (like pre-existing conditions, etc), and then, we could have taxed the benefits to help those in need.

All Dems have to offer, instead, is that everybody who is young must take their tiny paychecks and buy health care they don't need, or go to jail or face fines. Sounds like a dumb ass plan to me.

Re:Great.

[Anonymous Coward]

Yes, actually. It's called the Safelink program, it's been around for years, and it's immensely beneficial to a large number of working poor.

https://www.safelinkwireless.com

Those who say "cellphones aren't a necessity" obviously haven't worked with the poor in this country. For most folks I know who use Safelink, it's their only means of communication with employers, social services, etc. How do you apply for a job when you don't have a phone number for the employer to call you back at?

Dilbert Comic

[Anonymous Coward]

I misread 'it's' on the line "A quick search on my blackberry tells me it's..." as 'tits'...

I think that would have made a better punchline.

don't understand your compaint or tone

[Anonymous Coward]

the point of the link is the discussion, which suggests reasons why the simple "fact" that the us contributes more dollars per capita is not so simple
as to your tone, why are u so mean ? isn't it mor likely that i am just lazy, or find html tags hard to use ?

France already has this, but it does something

[Animats]

France already has a benefit system for pregnant women. There's a sort of "coupon book", with coupons for various tests and examinations. Of course, France has a Government health care system.

inferior national healthcare

[Anonymous Coward]

but if you have a job where you can actually afford real healthcare

As a Canadian whose daughter has cancer, I am extremely thankful that my "inferior national healthcare system" means that I haven't had to pay the $2400 per day that it would have cost me for the sixty-five days she has been in hospital thus far. She is not even halfway through the part of the chemotherapy administer in-hospital.

That's just the hospital room and associated nursing care thus far. Then there's the diagnostic scans: CT scans, bone scans, MIBG scans, ultrasounds, almost daily blood tests, urine tests; and the cost of the pain killers; and the cost of the actual chemotherapy itself; and the cost of the six different anti-nausea medications; and the cost of diagnosing and treating the various infections that happen because of the immunosuppression that the chemo causes. And the cost of surgery, which is likely to be required. And the possible cost of radiation, which hopefully won't be necessary. I can't be bothered to google actual numbers for all of those, but, as an example of one of the costs that I do know, the per dose cost of G-CSF is almost $200; times ten to fourteen days per course, times six courses. That's just one of literally dozens of drugs.

I notice on rereading, that I left out the physiotherapy.

So I rejoice that my "inferior national healthcare system" means that I don't have to worry about making the choice between treating my daughter and feeding the rest of my family.

And given the importance of the patient's mental state in the treatment of cancer, I am glad that my "inferior national healthcare" includes mental health support for both patient and parents in the form of therapists and social workers and, if necessary, psychologists. (The clowns aren't covered by my "inferior national healthcare system".)

You are not a lawyer.

[westlake]

A couple of years ago I was in charge of distributing my mother's money. I made the mistake of giving my niece her money. The government seeing that she had a little bit of money(just $10,000) stripped her of medical and food benefits.

I am not sure you understand what it means to be an executor.

You are there to manage your mom's money. Not to play Lord Bountiful to your niece.

This is why you take estate planning to the pros - the banker, the accountant, the lawyer.

Transfer of assets to family members about the time a senior applies for Medicaid and Food Stamps raises red flags everywhere you look.

 

Re:You are not a lawyer.

[jayveekay]

Transfer of assets to family members about the time a senior applies for Medicaid and Food Stamps raises red flags everywhere you look.

Why would a senior citizen apply for Medicaid? I thought that all U.S. senior citizens had universal government run health care insurance called Medicare.

Not a rich white guy

[Anonymous Coward]

Yes, I do, because the US already has a single payer system: Medicare. It has an overhead of about 1% compared to about 30% for traditional health insurance.

...

What we need is a system for care rather than insurance. Just passing legislation to prevent discrimination based on pre-exisitng conditions would be a major start; however, I truly believe that we need a public option if we wish to make our healthcare system comparable to the rest of the developed world.

And Doctors are limiting and turning away Medicare patients now because they only get paid pennies on the dollar for procedures. They can not afford to serve an all Medicare patient base, most doctors would go out of business.

Yes that's what I want, just like the Kaiser commercials. The guy is about to sit down to a nice hamburger and along comes someone with a white lab-coat and at stethoscope to replace his chosen meal with a salad. I like salads as much as the next guy, and I don't get hamburgers all that often, but hands off my food choices.

You want a healthcare system like Canada or Britain where people wait (some times too long) for important procedures. Where a hospital has three operating rooms, but two of them stand unused because the government healthcare will not pay for the operations.

Re:Not a rich white guy

[ahabswhale]

Unfortunately for your argument, there are facts that completely contradict it. Please read this article for an appropriate attitude adjustment: http://www.physicianspractice.com/index/fuseaction/articles.details/articleID/1434.htm

Oh, and that's from a 2009 fee schedule study -- not ancient history.

So, in the end, Medicare pays as well as the insurance companies do while being 30 times more efficient.

Re:Not a rich white guy

[Anonymous Coward]

You want a healthcare system like Canada or Britain where people wait (some times too long) for important procedures.

That happens here too. My mom's last husband died of a treatable condition because they couldn't afford treatment.

Re:Not a rich white guy

[Miseph]

"You want a healthcare system like Canada or Britain where people wait (some times too long) for important procedures.'

As opposed to an American healthcare system where we don't wait? Which one is that? I've never had any experience with such a system, despite having multiple experiences in multiple parts of the country. I've had to wait in the Northeast, I've had to wait in the mid-Atlantic, I've had to wait in the Northwest, I've had to wait in the South, I've had to wait in cities, I've had to wait in suburbs, I've had to wait in the country, and I once had to wait 45 minutes on the side of a major thruway with a bleeding compound fracture just for an ambulance to show up and bring me to the hospital (where, guess what, I got to wait some more).

Try again.

Re:Not a rich white guy

[Anonymous Coward]

In Canada the "waits" are just triage so people who need more immediate treatment get it.
Interesting that all Western nations with nationalized health care have higher life expectancies than the US.

.

It depends

[istartedi]

Really, you expect that because the government is paying, quality of service will magically increase?

It depends. When looking for weather information online, it's the National Weather Service for me, and that's about it. Anything else is ad-laden, Java/flash crippled, and generally not serious about the weather, and more serious about generating ad revenue or trying to direct you to some site that will install spyware. Cable weather? Don't get me started on how when I was living back east, the slot usually reserved for The Weather Channel was showing a baseball game while an F4 tornado ripped up close enough for me to see the cloud top. The local ABC affiliate covered that storm nicely, however.

So. Weather. Government does a good job.

Same deal with the USGS, BTW--can you imagine their earthquake response site, with its cool maps broken down by ZIP codes, if it were done privately?

These programs are tremendously valuable, yes, life saving, and not running up the national debt AFAIK. They're probably a drop in the bucket. It's corporations that have given us the current system, and yes--they actually tried to destroy the National Weather Service too; but that was so ridiculous that even the politicians couldn't justify caving in.

Now, these are the good examples. Yes, there is the DMV, public schooling, my own personal experience with tenants rights in DC (totally broken) the Santa Cruz County permitting process (OMG, don't get me started on that) etc.

So. It breaks both ways. Plainly though, we are failing and need change--not the complex, half-hearted change that the current reform is either. Real change. Teddy Roosevelt, trust-busting, socialism is not a dirty word, CHANGE. Someone who can tell the corporations to piss off. Insurance companies don't add value here. That's the elephant in the room nobody would tackle. We needed a TR. Instead we got a GWB with good grammar. There's always 2012.

People are not cars.

[Estanislao Mart�nez]

It's like this: routine care has a cost x. Redistribution of money to pay cost x has an additional cost y, no matter who does it. If the customer pays cost x, adding cost y will increase costs.

The problem with this logic is that you're assuming that the total amount of care provided (routine + extraordinary) is independent of the amount of routine care. But on the contrary, more routine care means that conditions are dectected early on while they're easier and cheaper to treat, leading to less extraordinary care (which is the really costly item: something like 80% of health costs are spent on treating 20% of the people).

By this logic, an honest health insurer should make it as cheap as possible for their policyholders to go get routine care, because $100 of routine care today will often save $100,000 of extraordinary care 5 years later. There is overhead to providing that care through a third party, sure, but the overhead is the lesser evil.

But of course, this assumes that the insurer truly intends to pay the $100,000 health bills that do arise. Here in the USA, our private, lightly regulated health insurers have a business model that basically consists of charging the healthy for insurance and kicking out the chronically sick. Given this, there is no incentive for the insurer to make routine care affordable.

Do you expect your car insurance to pay for your gasoline? Why not? If I offered to provide you with a gasoline payment policy, in which for a monthly fee I'd pay all of your gasoline bills, would you sign up expecting to get a good deal?

Arguments about health insurance that make analogies to car insurance tend to be flawed because people are not cars.

First of all, going back to the point above, the amount of gasoline that you consume is, if anything, positively correlated with your risk of a car accident, because people who drive more have more accidents. This is the opposite to the health situation, where more routine care tends to result in less extraordinary care. So in fact, car insurers should disincentivize their policyholders from driving; it makes the routine and extraordinary event costs higher.

Second, the financial structure of car accident and health risks are different. Car accident risks are all episodic; you have an accident today, make a claim, and there's a one-time payout that covers the damages for that accident for all time. Health risks, on the other hand, come in a range from episodic to chronic. There's the folks who need an appendix removal once and never again, and then there's the folks who discover at age 34 that they have a chronic congenital condition that is going to require expensive specialized care for the rest of their lives.

Health insurance needs to work differently from auto insurance because it needs to cover the latter, chronic risks (which, I will remind you, actual American health insurers bank on not covering). Suppose you want to be insured against that second sort of risk that I mentioned (congenital disease discovered at age 34). How does one implement an insurance scheme that protects against that risk? Well, the premiums for the guy who is diagnosed with the condition must not go up after the diagnosis (relative to the healthy policyholders). So for this to work financially, the people who end up not having a congenital disease have overpay for their health care all their lives so that the very few who do have it can underpay for the rest of their lives. Any alternatives that try to make the healthy pay less than the chronically sick will simply fail to protect the policyholders from that sort of risk, because it means that if you get chronically sick your premiums go up, which is precisely what you wanted the policy to protect you from.

What Choice ? What Open Market ? On which planet?

[speedlaw]

I get a great kick out of reading the arguments about health care. I don't want "free", but I don't want a screwing, either...which is what is happening. Health care is a utility. In my area, there are 3 companies that write individuals. They all price the same. There is no "free market", and you have no "choices". You live in a box of rules they make, and have to argue with them when they deny services (did you know you can't sue a health care insurance company in most states ? surprise !!!!) In 2003, the family plan was $675. Today, the same plan with bigger copays is $1700 per month. For (fortunately) healthy people, no pre exisiting conditions. My income didn't triple, and my doctor's income didn't triple....where did that money go ?? So, those who argue that it's free market or socialism are missing the point. It is NOT a free market. It is more like a utility, that needs regulation, since like water and electricity, we all use and need health care. What we have is just like Enron, though for health care-capitalism run amok, choices limited and controlled by the existing players. The current health care system, from here in NY, is like the railroads that the Plains Farmers had to use in the 1800's. Yes, it's a free market, but you and they know there is no actual choice, so they charge (screw) you accordingly. The "public option" (RIP) was another choice. Which would be the LAST thing the monopoly capitalists want. I finally found a disaster insurance plan, and now pay cash for most doctors. Not a big deal, but you'd be amazed that my $180 allergy shot is $38, and my spouse's physical therapist is $65, which used to be billed @ $250 with a copay of $50. Most disaster plans are also themselves a disaster. If you actually use the 5k deductable and need to use them, and they only cover 80% of your bills, you are still bankrupt if you get cancer, heart issues or need any sort of ongoing work. So they are not a solution either. If there were a choice, a real free market, then we'd have an arguement. The short answer is yes, I would prefer "socialist health care" to having a "choice" of three monopolist providers. The "exchanges" in the proposed bill with a standardized plan were a great idea, but the monopoly players pulled out all the stops to prevent even competition from other private players. I finally found a disaster plan that is not an 80% plan...for pretty much what I paid in 2003 for "real" insurance. I am almost looking forward to Medicare, even though I don't want to get old any faster than needed.

Everyone is a little right and wrong

[Anonymous Coward]

What bothers me the most about this discussion is how extreme everyone's views are. Just like everything else in our country now, attitudes and perceptions have been polarized. And we have the media to thank for that; all media regardless of supposed political affiliation.

And, in fact, this is about extremes. Our society has also become polarized in terms of wealth. The middle class has all but disappeared. But again, this has been caused by the behavior of both parties.

I feel the ones that do not want nationalized health care have a legitimate concern re cost and efficiency. If the insurance companies are middle men then putting the gov't in the middle is not going to reduce cost or improve efficiency.

However, if we nationalize health care, we must be very careful because we could seriously compromise our existing quality of health care. Also we could very likely take another step toward eliminating the middle class altogether.

Almost every system of socialized medicine in the world today appears to be worse than what we currently have in the US. I believe that health care systems in one or two of the Scandinavian countries are actually very good, but I also seem to remember that they are taxed at a phenomenal rate.

I consider myself to be sort of conservative, but do not identify with Republicans or Democrats. Both parties have completely lost touch with the people that they are supposed to represent.. I also believe in the free market economy, but we must remember that the primary driving force is to maximize profit. I think economists refer to it as the primal desire to improve one's condition. This is not a bad thing. However, some people can not control their desire and end up becoming greedy. That IS a bad thing. Greed clearly is a very destructive force within our society.

So now we have a country filled with people that have extreme attitudes AND we are dangerously close to having two classes; those that have and the ones that do not have.

The truth of the matter is that the solution lies in between. Our focus should be on the determined, self-reliant person who continues to try to remain self-reliant against ever-increasing odds (aka, costs). But I don't think it is the role of gov't to address the problem; it is business' responsibility. If business does not manage their markets, they are doomed to lose them. Not to a competitor, but to anarchy which at best will lead to socialism. So I see business as the entity that must make the adjustments and sacrifices to solve this problem.

I know that this sounds very idealistic. But when people become desperate, the solution they need the most will naturally take on the appearance of the ideal.

And in other places.....

[speedlaw]

I have relatives in Germany and Canada. They are all cared for by the govt. system. It works for them. My parents and my wife's parents all are covered by Medicare. It works well for them too. In my personal experience, "socialized" health care is a far, far better deal than the private limited player monopoly system I suffer under. These are not anecdotes, these are real people-"socialist" health care, at least in those two places, works...better than the botch we get...Auto companies build plants in Canada because they don't have to worry about health care costs. Now if you want to morph into a Palin-esque (Sarah, not Michael) rant about creeping socialism, here, in this one case, I'm all for it. I'm willing to pay, but when rates triple in six years with no other changes, I know someone's just gotten over on me and those like me, hugely. One last time...there is NO FREE MARKET in "free market" health care...and that's the way they like it.

Re:And in other places.....

[RobinH]

Canadian here... I think the "one case" you're referring to (where gov't options work better than private) is insurance in general. Take a moment to understand what insurance is to begin with, and you'll see why. Imagine 10 people sitting around a table and deciding none of them by themselves could cope with their house burning down, so they enter into a mutual agreement to split the cost if any of their houses burn down. Perhaps they all start pitching some money in monthly into a pot to make sure some will be available in the future. Your risk of having to pay out is multiplied by 10, but the amount you have to pay is reduced by a factor of 10. With so few people, extra expenses are kept to a minimum.

As you add more people to this plan, and not everyone knows each other, obviously you start to incur administrative expenses. Someone needs to make sure everyone's paying, etc. So a small percentage of the money you pay has to go to pay this person's salary. But note that the insurance fund itself is non-profit. Your expenses to be part of the system are your share of the expenses incurred when peoples' houses burn down, plus the expense of this person's salary to administer it.

If you scale this all they way up, you get gov't run insurance. (Unfortunately then each person pays a different amount, but still). What I mean is that under a government insurance plan, your taxes pay for the payouts and the administrative cost.

Now contrast that with a for-profit insurance company. It's run for the benefit of the shareholders, not the subscribers. Therefore the company does everything possible to increase profit. You do this by a) increasing the number of subscribers by spending huge amounts on marketing, and b) reducing payouts by fighting cases in court and arguing over each one. All the money for marketing expenses, court costs, and shareholder profits comes out of the pockets of the subscribers.

So insurance is one of those things where we don't need market pressure to keep prices low. In a non-profit insurance plan, the costs are as low as they can possibly be. Contrast a US doctor's office, which has an army of administrative staff to handle all the paperwork associated with the various insurance plans, with a Canadian doctor's office which has one or maybe two administrative staff. As a percentage of the money spent on healthcare, the % spent on administration is MUCH higher in the US.

I'm not advocating the lack of competition in medical services. In Canada, you can choose your doctor. You can choose which hospital you go to. I'm just saying you don't need or want for-profit insurance.

Is that just a coincidence?

[Futurepower(R)]

The people who make money when women have trouble with pregnancy are missing from the list of supporters.

Re:Is that just a coincidence?

[kms_md]

is your suggestion that obstetricians would prefer to have unhealthy patients so we have "something to do"? i get reimbursed the same regardless of a patient's risk status. besides, i am pretty sure that most of the information texted by this program is readily available to the patient at her routine visits.

Good points

[sgt_doom]

This guy, Aneesh Chopra, I'm not familiar with him. Is he from the TaTa Group? Or one of the others from India? Is he here on an H1B, or H2B, or H2C, or L-1, O-1, or P-1, P-2, or P-3?

Inquiring minds (who don't bother following Sarah (the space cadet) Pallin) want to know?????

Hate to be the bearer of bad news, but...

[sgt_doom]

any semblance to democracy in America has long since expired, Jerep, and we've long been living in a Socialist Plutocracy, socialism for the ultra-rich, and everyone else on their own.

The tax and legal system have long since been restructured to favor the rich. Anyone who hasn't figured it out yet: there is no economy --- the American economy, over a forty year period, was disassembled and sold off by all those billionaires we have here today.

The nanny state

[amightywind]

The nanny state indeed. The Obama administration is about to come to a spectacular end this fall. The country will effectively be run by a GOP congress. The President will be a lame duck, reviled by his own party. And none too soon. The decision making of this Whitehouse is bazaar beyond description.

Don't be racist

[Anonymous Coward]

A) Don't be racist. I'm sure plenty of rich black guys, asians, etc., have the same bad attitude.

          B) The current health care reform is dead in the water, and I hope it fails. I'm a libertarian, but a proper national health care system would be OK. What they have now is a massive pork-filled cash grab -- Obama and those Deomcrats have "compromised" by dropping national health coverage, and any public option, but have NOT dropped the taxes and fees they intended to charge. So they intend to charge for a national health care system, while not providing one? Where is the money going?!? Democrats and Republicans both have no care about civil rights, and they both want HUGE, lumbering, cash-hungry and inefficent governments... they just argue why.. the Reps say it's for "defense" while the Dems have other excuses, but with the same result of wanting a bloated, useless, gov't that just wants to spy on everyone.

          I really don't see a problem with providing medical info via text. It's dead cheap to do, and relevant to today's people. You slashdotters are showing your age -- I doubt very many would think an E-Mail service would be silly. Well, a lot of people now prefer texts over E-Mail.