On Sat, 31 Oct 2009 13:35:56 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
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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
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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.

They like to see you. It's been said every time a surgeon does a heart
bypass, he earns
another sports car. Maybe that's an exaggeration, he could buy a 2006 car
or use the
earnings from two operations to buy a new car. Hotshot surgeons make a
million dollars per
year.

"Jerry Okamura" <okamuraj005 at (no spam) hawaii.rr.com> wrote in message
news:QR%Gm.1382$XP2.732 at (no spam) newsfe17.iad...


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.


So what? Thsi has nothing whatsoever to do with who pays for it. The cost
of health care is rising faster than inflation in every country in the
world, INCLUDING yours. In fact MORESO yours. Thats due to 2 factors. 1 -
The baby boomers are now ranging in age from 52 to 66. The exact years
many people start to have major health issues. Their children, the baby
boom echo, have just had children in recent years. Childbitrth and young
children are also huge users of the healthcare system. 2 - medical
technology has advanced to the point where we can treat a significant
number of things we couldn't even a couple of decades ago and these
treatments cost a lot of money.

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.

Costs are not rising as a result. The generally agreed on reasons for
costs rising are as I explained above. No country has ever shown that
costs rise due to over use. Its just silly. Allow me to repeat the
question:

Do you really think that people will start going down to the doctors
office because they find a visit there entertaining?

How is that relevant?



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.


Only because you prefer not to answer it.


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.

It's higher than the overall inflation rate, but its not nearly as high as
in yuur country, which, by your definition, is more free than my country,
and as such, if you were correct, should be showing better results, not
worse.


It does not make any difference, if your inflation rate is lower than ours.

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.

Um, in what world does this increase not take place? People in your world
do not ask for raises every year? Wish I was an employer there...

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.


You are using your hypothesis to justify your hypothesis. You have yet to
show it holds water. the only thing you have demonstrated is that you
yourself hold a religious belief in it, which does not tend to increase
yor credibility.

I keep saying - show me the results. We have had the system I support for
45 years here, as have many other countries and your expected result has
not happened. Anywhere, anytime. The US has a system which is closer to
what you desire than what we have here, and you show WORSE results. Does
your plan only produce results when taken to your described absolute? Or
perhaps it is based on an incorrect premise.

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.

The need is not based on who you are, as I already explained, that does
not enter into the equation. It is based on what illness or injury you
have. Heart attacks get treated right now hangnails get to wait in line.
It works quite well.

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.

You demonstrate here how misguided you can be on issues other than the one
being discussed. Your country (and mine to some extent, because our
leaders cowtow to yours) has a great need for police because your "free"
system has created so much inequality that your people need to be
protected from each other. Your military, on the other hand is the
greatest make work (make profit for the select few) project ever known to
man. If not FOR your military, you would not NEED your military. The US
has no resources that any other country would desire, except perhaps for a
huge market to sell into, which is clearly more beneficial to a non
occupier than an occupier. The only attacks on the US have either been
provoked (1941, 2001) or faked (1898, 1964) in order to sell your
population on entering conflicts they otherwise would not have accepted.

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.

You clearly value --> your definition <-- of freedom above all else,
including common sense. I, on the other hand value my quality of life more
than some artificially trumped up concept of what constitutes freedom.


As Benjamin Franklin said, They that can give up essential liberty to obtain

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.


You avoided the question. I see you also brushed aside almost the same
question in your exchange with Robert. Clearly it makes you uncomfortable.

To be clear - you support rationing by allowing a portion of the
population to fall through the cracks and never be treated? How can you
look in the mirror? You're advocating genocide.





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.

25% of your people have no health insurance. Unless you care to posit that
most of those people are independently wealthy, they are clearly on
infinitely long waiting lists, because they are only eligible for
emergency treatment, their underlying conditions will never be treated.

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.

"Robert" <no at (no spam) e.mail> wrote in message
news:krrpe555sl0387duedb8qbv1o7o2es54ve at (no spam) 4ax.com...


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.

That does not make any sense at all. A person who smokes is more likely to
have a problem with their heart and more likely to get cancer. Either one
of those outcomes, helps the pharmaceutical company sell more drugs, not
less drugs.

"Robert" <no at (no spam) e.mail> wrote in message
news:mk0qe5tchffpljmh9370bhl95hqbc586o7 at (no spam) 4ax.com...
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.

So? In other words, you did not continue with the insurance policy you did
have becuase you were too cheap to pay for the increase? So, you made a
"choice" that the extra cost of the insurance was not worth the protection
that the insurance would have given you. You mean you couldn't find some
other insurance company that would sell you a policy at a price you were
willing to pay, don't you?

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.

No!!! You don't NEED insurance. You only need insurance if you get sick
enough to need the insurance. You can pay for your own needs, with your own
money.

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.

No, I said that the only way to control prices effectively is to return the
rationing decision back to the user of the service. The only way the user
of the service will make the rationing decision is when they use their own
money to pay for the service. And I doubt if the people in Africa are
paying for their own medical care, most of them are too poor to be able to
do that. And since they are too poor to pay for their own needs, it is hard
to see how there can be a high level of inflation, since that only means
they are less likely to be able to afford to pay for their healthcare. And
if they cannot afford to pay for their own healthcare, how can prices rise?

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.

I did not say privatize healthcare, I said return the rationing decision
back to the person needing that care.

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.

yes, but that is not solely or even mostly due to the healthcare system. It
has more to do with the simple fact that they struggle just to put food on
their table.

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

Apples and oranges. The governments of Africa would find that their people
would do a whole lot better, if the government helped people to help
themselves, rather than ourtright helping them. It is an age old question.
Is it better to feed a person, or is it better to teach a person to feed
themselves.

You have more freedom when you are able to take care of your own needs.
Anytime you depend on someone else to provide you with what you need or
want, you have less freedom. When you allow the government to provide you
with what you need or want, you have said your safety is more important than
your freedom. Benjamin Franklin said it best when you make that choice,.
"They that can give up essential liberty to obtain a little temporary safety
deserve neither liberty nor safety".

I didn't say anything about safety.

Antismokers are the ones bleating
safety wrt second hand smoke.

On Sun, 1 Nov 2009 10:27:45 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:krrpe555sl0387duedb8qbv1o7o2es54ve at (no spam) 4ax.com...


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.

That does not make any sense at all. A person who smokes is more likely
to
have a problem with their heart and more likely to get cancer. Either one
of those outcomes, helps the pharmaceutical company sell more drugs, not
less drugs.

You wouldn't say that if you'd read the Manning study, discussed earlier.
Here's another:

"Health care costs for smokers at a given age are as much as 40 percent
higher than those
for nonsmokers, but in a population in which no one smoked the costs would
be 7 percent
higher among men and 4 percent higher among women than the costs in the
current mixed
population of smokers and nonsmokers. If all smokers quit, health care
costs would be
lower at first, but after 15 years they would become higher than at
present."
http://content.nejm.org/cgi/content/abstract/337/15/1052

Which is relevant to what I said....how? I said that the pharmaceutical

On Sun, 1 Nov 2009 10:57:41 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:mk0qe5tchffpljmh9370bhl95hqbc586o7 at (no spam) 4ax.com...
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.

So? In other words, you did not continue with the insurance policy you
did
have becuase you were too cheap to pay for the increase? So, you made a
"choice" that the extra cost of the insurance was not worth the protection
that the insurance would have given you. You mean you couldn't find some
other insurance company that would sell you a policy at a price you were
willing to pay, don't you?

The premium was exorbitant, $1,500 per month. They were telling me to go
away.
In round two, I couldn't buy insurance at any price.

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.

No!!! You don't NEED insurance. You only need insurance if you get sick
enough to need the insurance. You can pay for your own needs, with your
own
money.

You may not be aware that most private non-group coverage has a deducable
of at least
$5,000, sometimes $10,000. It's not first dollar, it's catastrophic
coverage. The premium
is about $500/mo, even though you get to pay the first $5,000 with your
own money.

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.

No, I said that the only way to control prices effectively is to return
the
rationing decision back to the user of the service. The only way the user
of the service will make the rationing decision is when they use their own
money to pay for the service. And I doubt if the people in Africa are
paying for their own medical care, most of them are too poor to be able to
do that. And since they are too poor to pay for their own needs, it is
hard
to see how there can be a high level of inflation, since that only means
they are less likely to be able to afford to pay for their healthcare.
And
if they cannot afford to pay for their own healthcare, how can prices
rise?

Bottom line, average Africans got excluded from the system. They're not
getting ANY
medical care becase they can't afford it. Setting aside humane and
altruistic, is that an
EFFICIENT way to deal with illness that can be fixed for a few dollars?

We're told market economies create efficiency due to competition. This is
a case where
market economy created INEFFICIENCY. People are dying from infectious
diseases that could
inexpensively be prevented.

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.

I did not say privatize healthcare, I said return the rationing decision
back to the person needing that care.

Your idealism is contradicted by facts.

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.

yes, but that is not solely or even mostly due to the healthcare system.
It
has more to do with the simple fact that they struggle just to put food on
their table.

People in all third world countries struggle to put food on the table.
They don't all have
substandard health care.

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

Apples and oranges. The governments of Africa would find that their
people
would do a whole lot better, if the government helped people to help
themselves, rather than ourtright helping them. It is an age old
question.
Is it better to feed a person, or is it better to teach a person to feed
themselves.

You mean work for multinational companies at subsistance wages. You mean
make clothes for
WalMart at $1-2 per hour. That's not teaching people to feed themselves,
that's teaching
them to be slaves.

The people of northern Mexico used to be self sufficient on rice, corn and
beans.
Multiinationals convinced them to switch to asparagus and strawberries for
shipment to the
US. Now, the price of rice and beans, grown elsewhere, has more than
tripled. They went
from self-sufficient to unable to meet basic needs.

You have more freedom when you are able to take care of your own needs.
Anytime you depend on someone else to provide you with what you need or
want, you have less freedom. When you allow the government to provide you
with what you need or want, you have said your safety is more important
than
your freedom. Benjamin Franklin said it best when you make that choice,.
"They that can give up essential liberty to obtain a little temporary
safety
deserve neither liberty nor safety".

I didn't say anything about safety.

hand smoke.If you think that's a good thing, you've confirmed idealism is
a question of
whose ox is being gored. If it's your ox, your position is based on
morality. If it's
someone else's ox, it deserves whatever it gets.

"Robert" <no at (no spam) e.mail> wrote in message
news:2i5qe5pnqfagrp6dg3hmtq9v6v5nb5rlen at (no spam) 4ax.com...
On Sat, 31 Oct 2009 13:35:56 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:indpe5p40eq4febpvhqs123nk76cc8srsr at (no spam) 4ax.com...

They like to see you. It's been said every time a surgeon does a heart
bypass, he earns
another sports car. Maybe that's an exaggeration, he could buy a 2006 car
or use the
earnings from two operations to buy a new car. Hotshot surgeons make a
million dollars per
year.

How much does he earn when you performs a heart bypass surgery? Does he
make as much money today from doing that surgery, or would he have made a
heck of a lot more money, had that operation been available fifty years ago?

"Robert" <no at (no spam) e.mail> wrote in message
news:k3vue5l4i9a5jr49q9rpd5p8smdjivij5a at (no spam) 4ax.com...
On Sun, 1 Nov 2009 10:27:45 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:krrpe555sl0387duedb8qbv1o7o2es54ve at (no spam) 4ax.com...


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.

That does not make any sense at all. A person who smokes is more likely
to
have a problem with their heart and more likely to get cancer. Either one
of those outcomes, helps the pharmaceutical company sell more drugs, not
less drugs.

You wouldn't say that if you'd read the Manning study, discussed earlier.
Here's another:

"Health care costs for smokers at a given age are as much as 40 percent
higher than those
for nonsmokers, but in a population in which no one smoked the costs would
be 7 percent
higher among men and 4 percent higher among women than the costs in the
current mixed
population of smokers and nonsmokers. If all smokers quit, health care
costs would be
lower at first, but after 15 years they would become higher than at
present."
http://content.nejm.org/cgi/content/abstract/337/15/1052

Which is relevant to what I said....how? I said that the pharmaceutical
companies make more money if more people smoke.

"Norm" <normgrant999 at (no spam) yahoo.ca> wrote in message
news:OujHm.2103$X77.3 at (no spam) newsfe24.iad...

"Jerry Okamura" <okamuraj005 at (no spam) hawaii.rr.com> wrote in message
news:QR%Gm.1382$XP2.732 at (no spam) newsfe17.iad...


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.


So what? Thsi has nothing whatsoever to do with who pays for it. The cost
of health care is rising faster than inflation in every country in the
world, INCLUDING yours. In fact MORESO yours. Thats due to 2 factors. 1 -
The baby boomers are now ranging in age from 52 to 66. The exact years
many people start to have major health issues. Their children, the baby
boom echo, have just had children in recent years. Childbitrth and young
children are also huge users of the healthcare system. 2 - medical
technology has advanced to the point where we can treat a significant
number of things we couldn't even a couple of decades ago and these
treatments cost a lot of money.


That is the problem. Medical inflation is increasing the cost of
healthcare. If there was no medical inflation the cost problem would be
much less. And if medical inflation only increased at the same level as
the overall inflation rate, it would be more manageable.









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.



I think that people should be free to determine how they spend their
money. I believe that people should be responsible for their own lives and
not depend on anyone else for their lives to the greatest degree possible.
I believe that government should help people help themselves, rather than
helping people directly. I believe in giving the "people" as much freedom
as possible, not less freedom. When someone pays for what you want or
need, you are not truly free.

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

Costs are not rising as a result. The generally agreed on reasons for
costs rising are as I explained above. No country has ever shown that
costs rise due to over use. Its just silly. Allow me to repeat the
question:

That is downright silly. Are you going to argue that inflation is not
causing overall costs to rise?

Do you really think that people will start going down to the doctors
office because they find a visit there entertaining?

How is that relevant?



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.

It is not an ASSUMPTION, it is a fact. As for your question, tell me
where you live, and I will be able to answer your question. If you have
had universal healthcare in your country for 45 years, then you have had
more and more rationing of care over that time.

Wrong question.


Only because you prefer not to answer it.


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.

It's higher than the overall inflation rate, but its not nearly as high
as in yuur country, which, by your definition, is more free than my
country, and as such, if you were correct, should be showing better
results, not worse.


It does not make any difference, if your inflation rate is lower than
ours. What counts is, the medical inflation rate is higher than the
overall inflation rate. That means that total costs are rising as a
result of medical inflation and it is rising faster than the overall
economy.







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.

Um, in what world does this increase not take place? People in your world
do not ask for raises every year? Wish I was an employer there...

When there is no control over the marketplace, the market place determiens
how much money a person makes. When the government pays for medical care,
they decide how much that person makes.



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.


Becuase all it requires is common sense. A third party payment system is
one in which someone like the government pays for your care. If they were
willing to pay whatever the cost for the service is, there would be no
rationing. But they do not want to pay for whatever the cost for that
service is, and the end result is rationing.

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.


You are using your hypothesis to justify your hypothesis. You have yet to
show it holds water. the only thing you have demonstrated is that you
yourself hold a religious belief in it, which does not tend to increase
yor credibility.

Cop out. Tell me exactly why you think my hypothesis is not valie.
Besides, any first year student of economics should have learned that.

I keep saying - show me the results. We have had the system I support for
45 years here, as have many other countries and your expected result has
not happened. Anywhere, anytime. The US has a system which is closer to
what you desire than what we have here, and you show WORSE results. Does
your plan only produce results when taken to your described absolute? Or
perhaps it is based on an incorrect premise.


No, the US system is NOWHERE close to what should happen. It has
continued expanding the third party payment system since after the Second
World War. Which is when the problem all started. You can say that we are
like someone who is half pregnant, but you cannot say that we do not have
a third party payement system in the United States. But I will give you
something to think about. You can easily confirm if what I say is true or
false, simply by searching the Internet. Prior to 1950, the medical
infaltion rate was consistently lower than the consumer price index.
Since 1950, the medical inflation rate has been consistently above the
consumer price index. I say that changed occured because this country
started moving to a third party payment system at the end of WWII. By the
way, if the data is available in your country you can verify my statement.
Because if I am right, and the data is available, the relationship between
the overall inflation rate in your country, and the medical inflation rate
should be the same as in this country. And if it isn't, then you just
blew a big hole in my argument. All you need to know is when did you
implement the third party payment system, then find out what the
relationship between your overall inflation indicator is, and the medical
inflation rate, prior to moving to that third party payment system and
what happened after you moved to the third party payement system.









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.


That is part of the problem. Someone other than you decides that your
need is greater or less than someone else. That someone else is acting
like a god, deciding who needs the care first and who should wait. And of
course like everything we humans do, no one can do that perfectly, so
someone dies because they made the wrong decision.

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.

The need is not based on who you are, as I already explained, that does
not enter into the equation. It is based on what illness or injury you
have. Heart attacks get treated right now hangnails get to wait in line.
It works quite well.


I did not say it was.







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.

You demonstrate here how misguided you can be on issues other than the
one being discussed. Your country (and mine to some extent, because our
leaders cowtow to yours) has a great need for police because your "free"
system has created so much inequality that your people need to be
protected from each other. Your military, on the other hand is the
greatest make work (make profit for the select few) project ever known to
man. If not FOR your military, you would not NEED your military. The US
has no resources that any other country would desire, except perhaps for
a huge market to sell into, which is clearly more beneficial to a non
occupier than an occupier. The only attacks on the US have either been
provoked (1941, 2001) or faked (1898, 1964) in order to sell your
population on entering conflicts they otherwise would not have accepted.

Blaming the "system" and not the people.











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.

You clearly value --> your definition <-- of freedom above all else,
including common sense. I, on the other hand value my quality of life
more than some artificially trumped up concept of what constitutes
freedom.


As Benjamin Franklin said, They that can give up essential liberty to
obtain a little temporary safety deserve neither liberty nor safety.






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.


You avoided the question. I see you also brushed aside almost the same
question in your exchange with Robert. Clearly it makes you
uncomfortable.

To be clear - you support rationing by allowing a portion of the
population to fall through the cracks and never be treated? How can you
look in the mirror? You're advocating genocide.





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.

25% of your people have no health insurance. Unless you care to posit
that most of those people are independently wealthy, they are clearly on
infinitely long waiting lists, because they are only eligible for
emergency treatment, their underlying conditions will never be treated.

On Tue, 3 Nov 2009 07:38:00 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:k3vue5l4i9a5jr49q9rpd5p8smdjivij5a at (no spam) 4ax.com...
On Sun, 1 Nov 2009 10:27:45 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:krrpe555sl0387duedb8qbv1o7o2es54ve at (no spam) 4ax.com...


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.

That does not make any sense at all. A person who smokes is more likely
to
have a problem with their heart and more likely to get cancer. Either
one
of those outcomes, helps the pharmaceutical company sell more drugs, not
less drugs.

You wouldn't say that if you'd read the Manning study, discussed
earlier.
Here's another:

"Health care costs for smokers at a given age are as much as 40 percent
higher than those
for nonsmokers, but in a population in which no one smoked the costs
would
be 7 percent
higher among men and 4 percent higher among women than the costs in the
current mixed
population of smokers and nonsmokers. If all smokers quit, health care
costs would be
lower at first, but after 15 years they would become higher than at
present."
http://content.nejm.org/cgi/content/abstract/337/15/1052

Which is relevant to what I said....how? I said that the pharmaceutical
companies make more money if more people smoke.

You ask for substantiation proving you wrong. When it is presented, you
pretend to not
understand or simply ignore it and repeat your error. That's not how
reasoned discussion
works. You're supposed to defend your mistaken assertion with evidence.

If that's too much work, an alternative is name calling and emotional
ranting. We have
experts on that technique, as I'm sure you do.

On Mon, 2 Nov 2009 07:58:35 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:2i5qe5pnqfagrp6dg3hmtq9v6v5nb5rlen at (no spam) 4ax.com...
On Sat, 31 Oct 2009 13:35:56 -1000, "Jerry Okamura"
okamuraj005 at (no spam) hawaii.rr.com> wrote:


"Robert" <no at (no spam) e.mail> wrote in message
news:indpe5p40eq4febpvhqs123nk76cc8srsr at (no spam) 4ax.com...

They like to see you. It's been said every time a surgeon does a heart
bypass, he earns
another sports car. Maybe that's an exaggeration, he could buy a 2006
car
or use the
earnings from two operations to buy a new car. Hotshot surgeons make a
million dollars per
year.

How much does he earn when you performs a heart bypass surgery? Does he
make as much money today from doing that surgery, or would he have made a
heck of a lot more money, had that operation been available fifty years
ago?

The first open heart surgery using a heart-lung machine was done in 1960,
as was the first
arterial graft. Their fiftieth anniversaries will be in a few months.
Arterial grafts
using today's techniques began in 1967, 42 years ago.

OK Jerry,now you're responding to posts 2 or 3 out of cycle, and your
responses bear litlle resemblance to the posts you are responding to..
I've decided you're either a bot or you're posting while drinking. Or
you're simply trying to pretend you haven't noticed your position on this
issue is completely out of touch with reality.

I do, in fact believe in free enterprise. Not the unrestrained, greed
rules all brand that you practice in the US of course, but a common sense
mix of freedom and sensibility.

However -

Health care is a basic human right. Not a commodity. It is far too
important to leave to the whims of the "free market".
More than important enough to completely transcend your silly fairy tale
about what constitutes freedom. My government administering my health care
does not by any stretch of the imagination make me any less free, it makes
me more so. Every person should have a right to adequate health care when
he needs it without checking his wallet to see if he can afford it.
Anything less is uncivilized. All your malarkey about "medical inflation"
has absolutely no relevance whatsoever to this issue.

It is no more a basic human right than the right to eat. And no, you are

willing to pay, don't you?

The premium was exorbitant, $1,500 per month. They were telling me to go
away.
In round two, I couldn't buy insurance at any price.

Inconsistent. You start out by saying the premium was "exorbitant" and in
the next sentence you said you couldn't buy the insurance at any price.
Which is the correct statement?

We're told market economies create efficiency due to competition. This is
a case where
market economy created INEFFICIENCY. People are dying from infectious
diseases that could
inexpensively be prevented.

NO!!! It has nothing to do with market economics. It has everything to
do with the fact that the people in Africa cannot survive on their own
without help from other countries.

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.

How can that happen, if you don't have the money, is the question I asked.

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.

I did not say privatize healthcare, I said return the rationing decision
back to the person needing that care.

Your idealism is contradicted by facts.

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.

Another irrelevant point. The death rate in African countries is due to
the fact that the "people" living in these countries, are not able to take
care of their own needs.

yes, but that is not solely or even mostly due to the healthcare system.
It
has more to do with the simple fact that they struggle just to put food
on
their table.

People in all third world countries struggle to put food on the table.
They don't all have
substandard health care.

Yep, and if you do not have enough food, you can have the best healthcare
in the world and you will still die at a young age.

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

Apples and oranges. The governments of Africa would find that their
people
would do a whole lot better, if the government helped people to help
themselves, rather than ourtright helping them. It is an age old
question.
Is it better to feed a person, or is it better to teach a person to feed
themselves.

You mean work for multinational companies at subsistance wages. You mean
make clothes for
WalMart at $1-2 per hour. That's not teaching people to feed themselves,
that's teaching
them to be slaves.

I said if government would help people help themselves. When you do that,
it is up to the "people" to decide who they are going to work for, or if
they are going to work for anyone at all.

The people of northern Mexico used to be self sufficient on rice, corn
and beans.
Multiinationals convinced them to switch to asparagus and strawberries
for shipment to the
US. Now, the price of rice and beans, grown elsewhere, has more than
tripled. They went
from self-sufficient to unable to meet basic needs.

Apples and oranges. No one "forced" them do to what they did do. If they
did what they did do, and what they did was wrong, then they made the
wrong choice. But it was their decision to make.

You have more freedom when you are able to take care of your own needs.
Anytime you depend on someone else to provide you with what you need or
want, you have less freedom. When you allow the government to provide
you
with what you need or want, you have said your safety is more important
than
your freedom. Benjamin Franklin said it best when you make that choice,.
"They that can give up essential liberty to obtain a little temporary
safety
deserve neither liberty nor safety".

I didn't say anything about safety.

No, you did not say anthing about safety, but that is the question before
us. Is freedom more important than safety, or is safety more important
than freedom....you cannot have both at the same time.