On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

As I said, it is dependent on how free you want to be. How important is
your freedom. Is safety more important than your freedom. You cannot
have
it both ways, you either want to be free, or you do not want to be free.
You are not truly free, when you depend on someone else for ANYTHING.

You aren't capable of gowing most of your food nor building a house, car,
TV, cellphone
or computer. You can't even make a gun. And you certainly can't provide
your own health
care. You depend on others for those things and many more. The only
people who are truly
free are Papuan tribes in New Guinea.

"Robert" <no at (no spam) e.mail> wrote in message
news:8d9ke5tci7g4fcn16999os64q5vcucn9u3 at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:00:40 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:bi2ie5d73qnqpm9eour4dll3ofrfeq0oj0 at (no spam) 4ax.com...
On Wed, 28 Oct 2009 13:25:03 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

When you pay for your own medical needs, what are the odds that anyone
other
than yourself will decide on whether you live or die? When someone else
pays for your medical needs, what are the odds that in order to save
money,
they will decide if you live or die? When you depend on someone else to
pay
for your medical needs CAN they decide not to pay?

Your argument is wholely emotional. You're afraid someone will pull the
plug on you. Not
out of malevolence, just to save money.

Not emotional at all, a simple fact. The person who pays the bill, can
either pay the bill or not pay the bill. When you allow someone to pay
the
bill, you have given them the right to make that decision.

The root cause is you don't trust other people. I suspect your
insecurity
comes from being
neglected or ignored as a child. That's your burden, don't insist
everyone
else pay for
it.

You have got it backwards. I am the one who trusts people to do what is
best for them. I trust people enough to want them to have the freedom to
choose, what is best for them. A child is the one who needs someone to
take
care of them. An adult would prefer to take care of themselves. If you
are
an adult, and you want someone to take care of you, you are saying you
want
to be treated like a child.

What about 38% now on government aid or uninsured who cannot afford to pay
the bill? Would
you have them crawl into the woods to die, like animals?

No, I would provide them with the means to take care of their own needs and
not depend on the government to provide them with what they need. And no
all of the uninsured cannot afford to pay the bill. I am willing to bet
yoou cannot define in any detail who these uninsured are, will you prove me
wrong?

You are right on that point. But your reasons are wrong. The solution
to
controlling cost is to return the rationing decision back to where it
belongs and that is the user of the service. That is the only way you
can
reduce the medical inflation rate, which is the reason we have a cost
problem.

Other countries didn't follow your advice, they went the other way, yet
they don't have a
cost problem.

Spend a little effort and see if your statement is true. You will find, if
you do your research, and you don't put blinders on, that your statement is
not true. Every third party payment system in the world, is under enormose
cost pressures, because of medical inflation.

They ALL have a cost problem, so that is a lie. And they all have a
problem
with medical inflation. Check it out for yourself. Everyone one of those
countries have a medical inflation rate that is higher than their overall
inflation rate.

I found you're right. But you say "the only way you can reduce the medical
inflation rate"
is to take decisions away from government and return them to the people.
Most of Africa
did exactly that in the 1980's. Their medical inflation didn't go down,
but health became
worse because the poor could no longer see doctors.

I said return the rationing decision back to the user of the service. We do
it just about everywhere else, and it works real well. Food is a good
example. The government does not pay for our food, we pay for our food, and
inflation is a whole lot lower than the medical inflation rate.

"Robert" <no at (no spam) e.mail> wrote in message
news:ujeke5h27sjilgelmgbbrdc65rf0iu1i6g at (no spam) 4ax.com...
On Thu, 29 Oct 2009 09:00:45 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:2vlhe5lo7hu40inolpb62o5teupc4ms2nd at (no spam) 4ax.com...
On Wed, 28 Oct 2009 07:44:25 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:c28fe51rvgg3bn77583tvkin5em4pmoqb6 at (no spam) 4ax.com...
On Tue, 27 Oct 2009 07:02:13 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:i7lce5thi3184ich804hof5h0svm6eau4s at (no spam) 4ax.com...
On Mon, 26 Oct 2009 14:36:26 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:skcae5ddt103t3dgim88f835jel5dootcp at (no spam) 4ax.com...
On Sun, 25 Oct 2009 15:39:05 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

Using studies to justify their actions perhaps? Using these
studies,
to
justify why it is okay to take away or restrict a persons freedom,
perhaps?
If the smoker had to pay for their own healthcare needs, how
concerned
would
the government be about the cost of medical care that a smoker
incurs?

In general, Americans DO pay for their own health care. Government
pays
only for Medicare
(over 65) and Medicaid/SCHIP (children and disabled). See my
article
in
alt.smokers about
assigned risk medical insurance, to which government contributes
almost
nothing except in
Massachusetts.

Do they now? What percentage of the American people, pay for their
own
healthcare, using their own money directly?

The federal government pays 35% (Medicare, Medicaid, Military),
state
and
local government
pays 11%. The other 54% is paid by private insurance (36%) and out
of
pocket (15%).


So, the statement that "American DO pay for their own health caee" is
false?

I didn't answer your question about percentage of Americans paying for
their own health
care (or doing without). It is 77%. The 23% subsidized by government
are
elderly,
children, young mothers and officially disabled. An adult,
non-disabled,
under 65 male
cannot get government aid, period (excepting prison and military).


How can it be 77%. Your own posting says that the federal government
pays
35%, state and local government pays 11%.

Because 20% of people consume 80% of health care. The 23% supported by
government are
elderly and disabled, who are more likely to be sick. It's easy to
understand why they
consume 46% of the money rather than 26%.

Around 80% of total healthcare spending is spent on those who will live 2
years or less. That by definition means that the bulk of that cost are
spent on those who are old.

Medicare supplies about 25% of health care spending, not 80%. If your
statement is true,
at least 69% (55/80) of spending on dying people came from other than
Medicare.

I did not say that the cost is totally born by Medicare did I?

"Robert" <no at (no spam) e.mail> wrote in message
news:iijke5ltg82r1af0ckjitl3n5ktc5nhhjp at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

yes, our system does cost more, and we don't have anyone on long waiting
lists either.

Yes we do. It takes months to get an appointment at a free clinic.

When you have to see a doctor, how long does it take you to get an
appoitment? If they say you need to have an operation, how long did you
have to wait to have that operation. When I had my heart problem, I was
admitted to emergency on the same day they found the problem. In less than
one week, I had my bypass surgery.

On Sat, 31 Oct 2009 08:27:02 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:iijke5ltg82r1af0ckjitl3n5ktc5nhhjp at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

yes, our system does cost more, and we don't have anyone on long waiting
lists either.

Yes we do. It takes months to get an appointment at a free clinic.

When you have to see a doctor, how long does it take you to get an
appoitment? If they say you need to have an operation, how long did you
have to wait to have that operation. When I had my heart problem, I was
admitted to emergency on the same day they found the problem. In less
than
one week, I had my bypass surgery.

You are probably one of the over-users of the health care system.

"Robert" <no at (no spam) e.mail> wrote in message
news:qccoe5l2shfkflb0omgfl3qol6fq1tbbbt at (no spam) 4ax.com...

Prevention through coerced lifestyle changes is the main topic in
alt.smokers. As a
champion of freedom, do you think it's right for government to persecute
smokers, fast
food customers or the obese? If your answer is yes, you'll have to explain
the
inconsistancy between freedom to pay versus freedom to act.

Smokers have reduced life expectancy, therefore less chronic diseases of
old age. Given
your belief that old people are a burden, isn't lower life expectancy a
good thing?
Conversely, wouldn't an industry (represented by RWJF) that profits from
chronic disease
have a financial incentive to increase life expectancy?


I will try to make this real simple. If each person pays for their own
healthcare needs, no one other than that person is responsible for how they
live their life. When someone else pays for our healthcare needs, they are
concenred about how you live your life, because how you live your life
can cost them more money.

"Robert" <no at (no spam) e.mail> wrote in message
news:uavme5tgom6tlsm9553djt4ik0pajv8f22 at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

As I said, it is dependent on how free you want to be. How important is
your freedom. Is safety more important than your freedom. You cannot
have
it both ways, you either want to be free, or you do not want to be free.
You are not truly free, when you depend on someone else for ANYTHING.

You aren't capable of gowing most of your food nor building a house, car,
TV, cellphone
or computer. You can't even make a gun. And you certainly can't provide
your own health
care. You depend on others for those things and many more. The only
people who are truly
free are Papuan tribes in New Guinea.

That is a true statement. I did not say that you can be totally free in our
modern day society did I? I said you are not truly free, when you depend on
someone else for ANYTHING. You just proved my point.

"Robert" <no at (no spam) e.mail> wrote in message
news:kmvoe5ta05k88huv8sago3trp054uimpci at (no spam) 4ax.com...
On Fri, 30 Oct 2009 14:17:15 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:8d9ke5tci7g4fcn16999os64q5vcucn9u3 at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:00:40 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:bi2ie5d73qnqpm9eour4dll3ofrfeq0oj0 at (no spam) 4ax.com...
On Wed, 28 Oct 2009 13:25:03 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

When you pay for your own medical needs, what are the odds that anyone
other
than yourself will decide on whether you live or die? When someone
else
pays for your medical needs, what are the odds that in order to save
money,
they will decide if you live or die? When you depend on someone else
to
pay
for your medical needs CAN they decide not to pay?

Your argument is wholely emotional. You're afraid someone will pull
the
plug on you. Not
out of malevolence, just to save money.

Not emotional at all, a simple fact. The person who pays the bill, can
either pay the bill or not pay the bill. When you allow someone to pay
the
bill, you have given them the right to make that decision.

The root cause is you don't trust other people. I suspect your
insecurity
comes from being
neglected or ignored as a child. That's your burden, don't insist
everyone
else pay for
it.

You have got it backwards. I am the one who trusts people to do what is
best for them. I trust people enough to want them to have the freedom
to
choose, what is best for them. A child is the one who needs someone to
take
care of them. An adult would prefer to take care of themselves. If you
are
an adult, and you want someone to take care of you, you are saying you
want
to be treated like a child.

What about 38% now on government aid or uninsured who cannot afford to
pay
the bill? Would
you have them crawl into the woods to die, like animals?

No, I would provide them with the means to take care of their own needs
and
not depend on the government to provide them with what they need. And no
all of the uninsured cannot afford to pay the bill. I am willing to bet
yoou cannot define in any detail who these uninsured are, will you prove
me
wrong?

Most are uninsured because insurance companies refuse to cover them, and
they're not
insured through employment. The claim that 25% of them are non-citizens is
irrelevant
because citizenship is not required to buy a policy. The claim that most
could afford to
buy coverage confirms my position. They are not uninsured because they're
stupid or short
sighted, they're uninsured because they can't get coverage.

Your statement is an assertion, back it up with facts.

May people are unaware 35 out of 50 states have assigned risk pools
through which everyone
can buy insurance. They are not subsidized (except in MA). I recently
posted an article in
alt.smokers giving sample rates for a 51 year old ranging from $400/mo to
1,000/mo. Two
states -- FL and TN -- have limited liability plans for $200/mo that have
maximum payout
of $25K per year, in contradiction of the states' own insurance standards.

You are right on that point. But your reasons are wrong. The
solution
to
controlling cost is to return the rationing decision back to where it
belongs and that is the user of the service. That is the only way you
can
reduce the medical inflation rate, which is the reason we have a cost
problem.

Other countries didn't follow your advice, they went the other way,
yet
they don't have a
cost problem.

Spend a little effort and see if your statement is true. You will find,
if
you do your research, and you don't put blinders on, that your statement
is
not true. Every third party payment system in the world, is under
enormose
cost pressures, because of medical inflation.

ALL systems are under pressure from medical inflation, proving it's not
caused by the form
of payment. Areas without third party payment are all Africa (except South
Africa), India
and most of Southeast Asia.

Is the food you buy under enourmous pressue due to inflation?

They ALL have a cost problem, so that is a lie. And they all have a
problem
with medical inflation. Check it out for yourself. Everyone one of
those
countries have a medical inflation rate that is higher than their
overall
inflation rate.

I found you're right. But you say "the only way you can reduce the
medical
inflation rate"
is to take decisions away from government and return them to the people.
Most of Africa
did exactly that in the 1980's. Their medical inflation didn't go down,
but health became
worse because the poor could no longer see doctors.

That does not make any sense at all. If you are poor, you don't have the
money to spend on your own healthcare needs. If you do not have the money,
how can the cost go up?

I said return the rationing decision back to the user of the service. We
do
it just about everywhere else, and it works real well. Food is a good
example. The government does not pay for our food, we pay for our food,
and
inflation is a whole lot lower than the medical inflation rate.

On food, our options range from a .10 bowl of rice to a $300 dinner at the
French Laundry.
When it comes to health care, patients (consumers) have been excluded from
the decision
process. If you offer an opinion, doctors act like you're trespassing on
their turf, akin
to practicing medicine without a license. Moreover, doctors have no clue
what things cost.
I once said to a doctor, "You just prescribed a patented drug costing
$180. Wouldn't this
$20 generic be just as effective?" He quickly agreed, with the comment
"Really?"

Which is relevant to what I said, how?

A centrally managed system would put a stop to that. It would make the
choices patients
aren't knowledgeable enough nor allowed to make. For instance, studies
have found the
least expensive diuretic is just as effective as the most expensive beta
blocker for
hypertension. If I said that to my wife's cardiologist, he'd throw me out
of the office.
If a central manager said it, he'd have to listen. Insurance oompanies
could have been
watchdogs, but they fell down on the job.

I suppose you are right, but the price you pay is you are no longer free.

"Robert" <no at (no spam) e.mail> wrote in message
news:indpe5p40eq4febpvhqs123nk76cc8srsr at (no spam) 4ax.com...
On Sat, 31 Oct 2009 08:27:02 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:iijke5ltg82r1af0ckjitl3n5ktc5nhhjp at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

yes, our system does cost more, and we don't have anyone on long waiting
lists either.

Yes we do. It takes months to get an appointment at a free clinic.

When you have to see a doctor, how long does it take you to get an
appoitment? If they say you need to have an operation, how long did you
have to wait to have that operation. When I had my heart problem, I was
admitted to emergency on the same day they found the problem. In less
than
one week, I had my bypass surgery.

You are probably one of the over-users of the health care system.

I do not like to see the doctors.

On Sat, 31 Oct 2009 09:15:56 -1000, "Jerry Okamura" <okamuraj005 at (no spam) hawaii.rr.com> wrote:

"Robert" <no at (no spam) e.mail> wrote in message
news:uavme5tgom6tlsm9553djt4ik0pajv8f22 at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

As I said, it is dependent on how free you want to be. How important is
your freedom. Is safety more important than your freedom. You cannot
have
it both ways, you either want to be free, or you do not want to be free.
You are not truly free, when you depend on someone else for ANYTHING.
You aren't capable of gowing most of your food nor building a house, car,
TV, cellphone
or computer. You can't even make a gun. And you certainly can't provide
your own health
care. You depend on others for those things and many more. The only
people who are truly
free are Papuan tribes in New Guinea.

That is a true statement. I did not say that you can be totally free in our
modern day society did I? I said you are not truly free, when you depend on
someone else for ANYTHING. You just proved my point.

This notion of 'free man' is a ROMANTIC one from cowboy movies and female pulp fiction
writers such as Ayn Rand. Don't ask the rest of us to pay for your fantasies.

"Other people have no right, no hold, no interest or influence on him. And this is not
affected or chosen -- it's inborn, absolute, it can't be changed, he has 'no organ' to be
otherwise. In this respect, he has the true, innate psychology of a Superman. He can never
realize and feel 'other people.' " -- Ayn Rand

The word describing such people is sociopath, not hero.

Prevention through coerced lifestyle changes is the main topic in
alt.smokers. As a champion of freedom, do you think it's right for
government to persecute smokers, fast food customers or the obese?

Including the profit motive shows how right wing philosopy can be
detremental to freedom. Slavery was a blatant case that took 200 years and
a bloody civil war to eliminate. More subtle cases like antismoking will
never rise to that level.

Is there any system that we can devise that will not have
unnecessary overuse? If you do not pay for what you want or need,
are you more or less likely to "overuse" the system? If you paid
for what you need or want, aren't you less likely to "overuse" the
system?

A single payer system with doctors still operating as private
entities but all billing the same place. No fault insurance type of
thing. Cover whatever happens. No disputes over who pays for it just
fix it. No such thing as "pre-existing, you're either sick or you're
not. The fees are fixed and reviewed by government and medical
people. Doctors still become wealthy people in this country and
nurses have been known to make a decent living as well. And you don't
end up paying huge dollars to solve problems which would have been
cheap if they were treated when they began.

How does your proposal reduce the medical inflation rate?

It reduces the overall cost.

"If" it reduced the overall cost, then the cost per person over time
would be lower rather than higher. Is the overall ocst lower rather
than higher?


Your question is unclear. Do you mean here or there?

I mean everywhere, that has a medical inflation rate that is higher than
their overall inflation rate. If you do not reduce the medical inflation
rate, you cannot possibly reduce the cost of healthcare. And when that
medical inflation rate is higher than your overall inflation rate, that
means the cost of that care is rising faster than the average cost of
everything else.

I'm assuming by Medical inflation you mean the
rising cost of treatment.

The rsing cost of healthcare, that is due to medical inflation. If the
medical inflation rate was zero, we would not have a cost problem we do
have with healthcare. When someone else is paying for our medical care,
that person does not care what the cost of that care is, they will use
the service regardless of how much it cost.

Thats a good thing. Do you think its preferable for people to NOT use
health care when they need it? Do you honestly think people will begin
taking a trip down to the doctors office because they find it
entertaining? Wanting people to NOT use health care reveals a
particularily mean spirited motivation.


It is unsustaingable, when cost are rising as a result.

The ultimate effect is that there will be more and more rationing, which
means your goal cannot be achieved, because more and more people will not
get the care they need or want, when they want it.


When that happens, you have lost
the most effective means to controllling cost, and costs will rise.


Thats an assumption. If it was true then why are health care costs not
HIGHER in my country than in yours? We have had universal health care for
45 years, you would think by now your theory would have kicked in.

Wrong question.

Right question, is the medical inflation rate in your country lower than
the overall inflation rate, or is it higher than the overall inflation
rate.

When it
rises, the payer only has two options, either come up with the money to
pay for that increase, or resort to some form of rationing. But neither
one, addresses the reason cost are rising, so cost will continue to
rise. Which in turn means, they have to constantly find the money to pay
for that increase, or resort to some form of rationing. But like price
controls, it does not work over a long period of time, which means that
over time, more and more rationing has to occur, or they have to collect
the money to pay for that increase from someone else.

An MRI is still going to increase in cost as is a
heart transplant, thats just reality, you can't change that unless you
force the suppliers of the service to work for free. Thats not going to
happen. What is going to happen is the waste will be reduced. How much
does it cost to deliver a baby when the mother has not been under care
until the last minute because she couldn't afford the co-pay? How much
does it cost to fix an injury which was left to fester until
intolorable? How much does it cost a doctors office to sort out which
of a dozen insurers to bill for each patient? How much time and money
is wasted determining if insurance will cover a particular problem
before treament is commenced? All the above spinning of wheels is
eliminated in a single payer, universal system. The cost of taking care
of the odd patient who "overuses" is a drop in the bucket compared to
what will be saved.


No. The cost of the MRI does not increase over time. It remains the
same.

Sure. And neither will cars increase in price. nor milk. What are you
babbling about?

Wrong example. The cost of the MRI will only increase over time, if the
cost of labor for the people who run the MRI machine rises over time.

The cost of the machine does not rise, it will most likely cost less over
time, since they will figure out how to build it at a lower cost than they
did before. Everything increases with price inflation. It is a quetiton
of how fast will it increase due to inflation.






Ah, but then we get the dreaded "people dying on the wait list"
syndrome. The horror sories you've been told by insurance companies
and some of your government who have vested interests in the status
quo. Doesn't happen, its a myth.

It is not a "myth" as you put it. It is a fact.

Now you know more about what happens where I live than I do???
I respectfully suggest you haven't a clue what you are talking about.


If you do not know that to be a fact, then I would suggest you don't
understand the issue. It is really simple. When you pay for what you
want or need, you decide whether to pay or not pay. When someone else
pays for what you want or need, they decide to pay, they decide when to
pay, and they can decide not to pay. You have little to no control over
that decision. And the incentive not to pay is very high, because the
costs for providing that care, is rising due to a large degree by medical
inflation.

In Canada for example, the
government puts a cap on the amount of money they will spend in any one
year. When you do that, once the money is spent, you have no more money
to spend for that year, regardless of how much money is actually needed
to treat everyone who needs the treatment. That is a form of rationing.
Another form of rationing are waiting list, which Canada does have. In
the State of Oregon, they have developed a list of services they will
pay for and services they will not pay for. Those who are not on the
list, are shit out of luck, unless they pay for it themselves.


The way it works is if you are in greater need you get moved up in
priority. It happened twice last year in my own family. That woman
from Canada you heard about in the news a few months back who had a
"tumour" and would have died had she not gone to the US - she lied
from beginning to end. She didn't have a tumour she had a cyst and
she was neverr in danger of anything other than a little discomfort.
The wait list is how the system limits delivery. People who really
don't need something fixed in a hurry get to wait. Some of them get
better on their own, some of them get to wait a long time to get
their hangnail treated. The odd person with trivial problems does sit
on the wait list and eventually use resources, but theres not many
willing to do that. Wealthy people with trivial problems they are
willing to pay for are still free to go outside the system if they
choose.


Yep, but someone else not you, are the ones who are deciding if you have a
greater need. If you are among those that the government does not think
is the greater need, it does not matter if you think they are wrong, you
won't get the care you want or need.

It is a question of which is more important, your freedom or your
safety. If your safety is more important than your freedom, then you
want someone to take care of you. If your freedom is more important
than your safety, you want to take care of yourself.


If we believe your theory we should also do away with the police and
military. After all who is more free than the man who takes care of
himself?

That is also a true statement. It is always a tradeoff between your
safety and your freedom. But there is a difference even in your example.
For instance, you do not need the police to protect you, if you can
protect yourself. But your military example is a good one, since
obviously you cannot protect your country without a strong military. So,
in that case, your safety is more important than your freedom. But you
are not surrendering very much of your freedom, by having a strong
military.

When you pay for your own medical needs, what are the odds that anyone
other than yourself will decide on whether you live or die? When
someone else pays for your medical needs, what are the odds that in
order to save money, they will decide if you live or die? When you
depend on someone else to pay for your medical needs CAN they decide
not to pay?

No, they can't. What are the odds you might not have enough money to
pay for your treatment?

That is the price of freedom. There is no guarantee of anything.

The same odds that you will not have enough money to live on when you
are no longer working. It boils down to the same problem. There is no
free lunch.

What are the odds your surgeon might get a better offer from
a richer patient and take care of him ahead of you?

What are the odds that when you call a plumber to come to your home to
do some repair work for you, that they will go to the person who is
richer?

I'm sure it happens all the time.
Do you really want to operate health care on that same principle?

Yes, because I put a very high value on our freedom.

For teh richest 10% of
the population your system works. Another 50% or so has been convinced
by the industry that it is working but it isn't. Where I live I CAN'T
be refused treatment. For anything. I know it works because I live with
it already. Someone else deciding if I live or die is not possible
because refusing treatment is not part of the equation. Its just not
one of the lines on the form. The only way I can ever have treatment
stopped is by a DNR order. In most cases that requires both my family's
and my prior approval. They can't let me go unless I say so and I can't
commit medical suicide without their say so. You are still listening to
people who have an interest in keeping your money. Or perhaps you are
one of them, who knows?



NO!!! There is a simple solution to the problem. Help people to help
themselves, rather than helping them directly.

How are you "helping people to help themselves"?


The quesitin is not how are you "helping people to help themselves", the
question is how "do" you help people help themselves. In the case of
healthcare, you help people help themselves, by helping them pay for the
their own needs.
When you are able to take care of yourself you have a whole lot more
freedom, then when you depend on someone else to take care of you.

Are you ensuring they have an adequete income? or are you babysitting
them to make certain they don't spend it on frivolous things like clothes
for th ekids?


No one can guarantee that you will make enough money to take care of your
needs. But that is the price of freedom. To be free means you are taking
the risk that you can indeed take care of yourself.



Every system has some way to limit how treatment happens. Yours
currently limits it by how much money or insurance you have at your
disposal, ours limits it by how badly you actually need it. The
Canadian system is not perfect, its still being underfunded by neocon
politicians for ideological reasons, but in spite of their
interference it still works reasonably well. There are examples of
systems in Europe which work even better.

I did not say the solution was health insurance, did I?

It is a question of what happens in the future. Medical inflation
that is higher than the overall inflation rate means the total cost of
healthcare will rise. When it rises, and someone else is paying for
your medical needs, they have two choices. Either come up with the
extra money (and like taxes, we like the free benefit, we just don't
like paying for it) or ration care. That is the only two options the
"payer" has.

Your care is rationed by cost now. That cost is going to increase
regardless of what happens. If you are well off you migth be sheilded
from it. For a while. What happens when you run out of money? or need
to change employers? What about the large segment of the population who
don't have unlimited funds? Throw them to the wolves? Let them eat
cake?

Rationing always occurs. But there is a big difference between the
indivdual making that rationing decision and someone else making that
rationing decision for you. One way you are in control, the other way you
are not in control.

Rationing occurs all the time. When you make a decision to spend money
on one thing and not something else you want, you have made a rationing
decision. But that was your decision that you made. When you depend on
someone else to pay for what you want or need, they make the rationing
decision to give you want you want or need, and when you do that, you
have also given them the right not to give you what you want or need.
And when that happens, and you depend on that person to give you what
you want or need, you are shit out of luck, when they don't give you
what you want or need, because you won't get what you want or need.



Obama's solution does not go far enough. It still allows a hodgepodge
of payers which will maintain the confusion and still cause too much
expense overall. He's afraid to confront the insurance companies who
are making a fortune and tell them its over. I suppose he has to
start somewhere but I fear its going to be so timid a start that it
won't be effective and it will give the opposition the chance to say
see we told you so.



As I said, it is dependent on how free you want to be. How important is
your freedom. Is safety more important than your freedom. You cannot
have it both ways, you either want to be free, or you do not want to be
free. You are not truly free, when you depend on someone else for
ANYTHING.

I assume you are posting from a tent in the wilderness?

I am posting from the great state of Hawaii.





You are right on that point. But your reasons are wrong. The
solution to controlling cost is to return the rationing decision back
to where it belongs and that is the user of the service. That is the
only way you can reduce the medical inflation rate, which is the
reason we have a cost problem.

Vacation travel or automobile sales might respond to supply and demand
but health care does not. When you need something you need it
regardless of the cost. That is why 50% of the personal bankruptcies in
your country are due to medical costs. Thats barbaric. Health care
should be a right, not a privilege. Further, its not nly about
controlling the cost, its about a fairer system for everybody, not just
the wealthy.


EVERYTHING reposned to supply and demand. The medical bankruptcy excuse
is as phony as a three dollar bill. When people know that there will be
no one to pay for their medical bills, they are more likely to be
prepared to pay for their medical bills, if they need to use the
service. But when people think they someone esle is going to pay for
their medical bills, they are less likely to have the money to pay for
their medical needs, when and if they need that medical care.

How do you "prepare" for a situation that might cost you hundreds of
thousands? Be serious and think this through.

The same way you prepare for anything that could cost you a ton of money,
that you may not have. If your house is destroyed, and you do not have
insurance or the money to rebuild the house, you won't have a house. Is
you have a spouse and children and you are the principle breadwinner, and
you die, your spouse and children will suffer, unless you have provided
for the possiblity you might die. You can do that eithe by having enough
money for them to survive on without you, or you can buy life insurance.


Bottom line is your system costs more. Much more than any other system
being used anywhere in the world. Talk to any Canadian. Even though we
have our share of right wingnuts here as well, you would have to talk
to an awful lot of them to find any who would seriously consider
trading places.



yes, our system does cost more, and we don't have anyone on long waiting
lists either.


Yes you do. You have a significant segment of your population on
INFINITELY long waiting lists. The difference is you yourself are alright
(so far) so you just don't care. Thats typical of the wild west mindset
that has the US in the position they are now. Your time will come sooner
than you might think.

Prove your assertion.

On Sat, 31 Oct 2009 09:07:38 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:qccoe5l2shfkflb0omgfl3qol6fq1tbbbt at (no spam) 4ax.com...

Prevention through coerced lifestyle changes is the main topic in
alt.smokers. As a
champion of freedom, do you think it's right for government to persecute
smokers, fast
food customers or the obese? If your answer is yes, you'll have to
explain
the
inconsistancy between freedom to pay versus freedom to act.

Smokers have reduced life expectancy, therefore less chronic diseases of
old age. Given
your belief that old people are a burden, isn't lower life expectancy a
good thing?
Conversely, wouldn't an industry (represented by RWJF) that profits from
chronic disease
have a financial incentive to increase life expectancy?


I will try to make this real simple. If each person pays for their own
healthcare needs, no one other than that person is responsible for how
they
live their life. When someone else pays for our healthcare needs, they
are
concenred about how you live your life, because how you live your life
can cost them more money.

You overlooked people who can profit from lifestyle change. The
pharmaceutical industry
has an incentive to make everyone live to 100, because old people are its
best customers.
They don't care much who pays, so long as someone pays. Their incentive is
to increase,
not decrease, the cost of healthcare.

The antismoking movement was, until recently, organized and financed by
the pharmaceutical
industry, not public health advocates in government. Pharma did it to make
a buck off the
ill health that comes with longevity. Thus, your hypothetical 'free man'
has his freedom
diminished even though he pays 100% of his own healthcare. He loses
because there's profit
in taking his freedom.

Including the profit motive shows how right wing philosopy can be
detremental to freedom.
Slavery was a blatant case that took 200 years and a bloody civil war to
eliminate. More
subtle cases like antismoking will never rise to that level. Freedom will
be eroded so
some company can profit. I suppose being a stockholder of that company
would turn it into
a zero sum game. Losers will be the poor buggers who weren't smart enough
to invest.

On Sat, 31 Oct 2009 09:13:53 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:kmvoe5ta05k88huv8sago3trp054uimpci at (no spam) 4ax.com...
On Fri, 30 Oct 2009 14:17:15 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:8d9ke5tci7g4fcn16999os64q5vcucn9u3 at (no spam) 4ax.com...
On Thu, 29 Oct 2009 08:00:40 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:bi2ie5d73qnqpm9eour4dll3ofrfeq0oj0 at (no spam) 4ax.com...
On Wed, 28 Oct 2009 13:25:03 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:

When you pay for your own medical needs, what are the odds that
anyone
other
than yourself will decide on whether you live or die? When someone
else
pays for your medical needs, what are the odds that in order to save
money,
they will decide if you live or die? When you depend on someone
else
to
pay
for your medical needs CAN they decide not to pay?

Your argument is wholely emotional. You're afraid someone will pull
the
plug on you. Not
out of malevolence, just to save money.

Not emotional at all, a simple fact. The person who pays the bill,
can
either pay the bill or not pay the bill. When you allow someone to
pay
the
bill, you have given them the right to make that decision.

The root cause is you don't trust other people. I suspect your
insecurity
comes from being
neglected or ignored as a child. That's your burden, don't insist
everyone
else pay for
it.

You have got it backwards. I am the one who trusts people to do what
is
best for them. I trust people enough to want them to have the freedom
to
choose, what is best for them. A child is the one who needs someone
to
take
care of them. An adult would prefer to take care of themselves. If
you
are
an adult, and you want someone to take care of you, you are saying you
want
to be treated like a child.

What about 38% now on government aid or uninsured who cannot afford to
pay
the bill? Would
you have them crawl into the woods to die, like animals?

No, I would provide them with the means to take care of their own needs
and
not depend on the government to provide them with what they need. And
no
all of the uninsured cannot afford to pay the bill. I am willing to bet
yoou cannot define in any detail who these uninsured are, will you prove
me
wrong?

Most are uninsured because insurance companies refuse to cover them, and
they're not
insured through employment. The claim that 25% of them are non-citizens
is
irrelevant
because citizenship is not required to buy a policy. The claim that most
could afford to
buy coverage confirms my position. They are not uninsured because
they're
stupid or short
sighted, they're uninsured because they can't get coverage.

Your statement is an assertion, back it up with facts.

Personal experience. I had private insurance for ten years until my wife
(#1) had a
non-repeatable surgery costing $10K. My premium tripled and I couldn't buy
insurance from
any other company. Round two. I had private insurance for ten years until
my wife (#2) was
diagnosed with diabetes. That company (Mutual of Omaha) got out of the
health insurance
business and I couldn't buy insurance from any other company.

Now I need private insurance and am forced to shop states for affordable
coverage.
Massachusetts is the best by far. It should be a model for the whole US.
I'm not moving
there because the weather sucks and housing is expensive. I'm going with
the FL limited
liability plan. If she needs a $50K heart bypass, she's SOL.

May people are unaware 35 out of 50 states have assigned risk pools
through which everyone
can buy insurance. They are not subsidized (except in MA). I recently
posted an article in
alt.smokers giving sample rates for a 51 year old ranging from $400/mo
to
1,000/mo. Two
states -- FL and TN -- have limited liability plans for $200/mo that
have
maximum payout
of $25K per year, in contradiction of the states' own insurance
standards.

You are right on that point. But your reasons are wrong. The
solution
to
controlling cost is to return the rationing decision back to where
it
belongs and that is the user of the service. That is the only way
you
can
reduce the medical inflation rate, which is the reason we have a
cost
problem.

Other countries didn't follow your advice, they went the other way,
yet
they don't have a
cost problem.

Spend a little effort and see if your statement is true. You will find,
if
you do your research, and you don't put blinders on, that your statement
is
not true. Every third party payment system in the world, is under
enormose
cost pressures, because of medical inflation.

ALL systems are under pressure from medical inflation, proving it's not
caused by the form
of payment. Areas without third party payment are all Africa (except
South
Africa), India
and most of Southeast Asia.

Is the food you buy under enourmous pressue due to inflation?

We're talking about the cause of medical inflation, which you claim is
third party
payment. You change the subject when confronted with evidence it's not
caused by third
party payment.

They ALL have a cost problem, so that is a lie. And they all have a
problem
with medical inflation. Check it out for yourself. Everyone one of
those
countries have a medical inflation rate that is higher than their
overall
inflation rate.

I found you're right. But you say "the only way you can reduce the
medical
inflation rate"
is to take decisions away from government and return them to the
people.
Most of Africa
did exactly that in the 1980's. Their medical inflation didn't go
down,
but health became
worse because the poor could no longer see doctors.

That does not make any sense at all. If you are poor, you don't have the
money to spend on your own healthcare needs. If you do not have the
money,
how can the cost go up?

The cost per 'unit' of healthcare is going up, independant of who pays.
There are fewer
buyers because the World Health Organization, in the 1980's, urged
countries to privatize
healthcare, as you advocate. Most governments did it eagerly. Their
contributions went
from 5% of GDP to well under 1%. The form of payment became, and still is,
insurance or
out of pocket. Problem is, the dirt poor people cannot afford either. As a
result they do
without.

The median age of death in industrial countries is around 70; in Africa,
it's 5. Half of
African deaths occur before the age of 5. The rate of women dying during
childbirth is
more than five times the rate elsewhere.

That's the outcome when countries follow your advice to get government out
of healthcare.

I said return the rationing decision back to the user of the service.
We
do
it just about everywhere else, and it works real well. Food is a good
example. The government does not pay for our food, we pay for our food,
and
inflation is a whole lot lower than the medical inflation rate.

On food, our options range from a .10 bowl of rice to a $300 dinner at
the
French Laundry.
When it comes to health care, patients (consumers) have been excluded
from
the decision
process. If you offer an opinion, doctors act like you're trespassing on
their turf, akin
to practicing medicine without a license. Moreover, doctors have no clue
what things cost.
I once said to a doctor, "You just prescribed a patented drug costing
$180. Wouldn't this
$20 generic be just as effective?" He quickly agreed, with the comment
"Really?"

Which is relevant to what I said, how?

Consumers are excluded from the rationing decision process. Decisions are
being made by
doctors who know nothing about cost. It's the blind leading the blind.

A centrally managed system would put a stop to that. It would make the
choices patients
aren't knowledgeable enough nor allowed to make. For instance, studies
have found the
least expensive diuretic is just as effective as the most expensive beta
blocker for
hypertension. If I said that to my wife's cardiologist, he'd throw me
out
of the office.
If a central manager said it, he'd have to listen. Insurance oompanies
could have been
watchdogs, but they fell down on the job.

I suppose you are right, but the price you pay is you are no longer free.

The rich have always been free. Aspiring to freedom is a middle class
idea. The American
middle class is being destroyed by corporate greed. Their dream of freedom
is dying along
with their dream of success.