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"The goal, everyone agrees, is to maximize coverage, heighten competition and cut costs. Good goals, all." No, the goal is to save lives and provide EVERY Amer

"The goal, everyone agrees, is to maximize coverage, heighten competition and cut costs. Good goals, all." No, the goal is to save lives and provide EVERY American with health care in order to improve the quality of their life. This isn't about being "cost effective," it's about doing what is right,

yummyfajitas 18y ago
If you want to save lives, you are wasting your time with medicine. http://hanson.gmu.edu/CutMed.htm http://hanson.gmu.edu/CutMed.htm To save lives and improve the quality of life, you'd be better off providing EVERY American with access to a gym. Exercise adds 15 years to your life. It's pretty difficult to show statistically that marginal medical treatments (medical treatments that people purchase if they are cheap, but not if they are expensive) do anything.
- Retric 18y ago
  Early healthcare tends to reap huge benefits. AKA prevent someone dieing at birth and you add ~70 years. Older patents and random accidents reduce the possible gains. The second cheapest group to save is emergency room patents where minimal treatment can have dramatic effects. Exercise falls into the next group where huge investments in time reap huge long term benefits. (Someone making 50$/hour * 3 hours a week * 50 weeks a year = 7500$ / year.) A 5$ per month medicine is a lot cheaper than exercise so it's long term benefits don't need to be on the same magnitude to be vary worthwhile.
  - yummyfajitas 18y ago
    Well first, the link I provided discusses marginal medicine, or medicine people choose not to buy if it will cost THEM lots of money. Emergency care tends not to be marginal. As for the opportunity cost of exercise, it is only $2850 (average wage is about $38,000/year, http://www.ssa.gov/OACT/COLA/AWI.html http://www.ssa.gov/OACT/COLA/AWI.html) if people substitute exercise for productive work. It's not obvious that that is what would happen. I suspect most people would substitute exercise for TV. Lots of people watch 3 hours of TV per day. Squeezing out 3 hours/week would be easy. For gods sake, 9.9 million people sit on their asses watching The Biggest Loser (a weight loss game show). People can exercise more.
- iamelgringo 18y ago
  If you want to save lives, you are wasting your time with medicine. http://hanson.gmu.edu/CutMed.htm http://hanson.gmu.edu/CutMed.htm To save lives and improve the quality of life, you'd be better off providing EVERY American with access to a gym. I whole heartedly disagree. Why then do you suppose that people who live in the Third World (where I grew up) tend to die younger and die of easily curable/preventable diseases? Is it because they got more exercise working in the sugar cane fields swinging a machete for 16 hours? I've read other studies that show that if you exercise 1-2 hours, 3 times a week, you end up living 5-7 years longer, but then, the extra 5-7 years that you live, you've spent in the gym exercising. The article you quoted has a fundamental flaw in that it assumes that we can simply reduce an ICU stay at the end of life by 1-2 days. When a person is in the ICU, it's not quite so clear that a person is only going to live 1-2 days and then die. People want their family in ICU, because they want that person to have any and every chance at living. Certainly he raises some good points about cost effective health care. No on would disagree that a bunch of low cost primary health clinics are going to be a much cheaper way to treat people than an ER or ICU. But, dismissing ER or ICU treatment as unnecessary is absurd.
  - yummyfajitas 18y ago
    >Why then do you suppose that people who live in the Third World (where I grew up) tend to die younger and die of easily curable/preventable diseases? The vast majority of those diseases are prevented in the developed world by non-medical means. A doctor didn't prevent me from dying of malaria, DDT eliminated malaria in the US before I was born. Doctors didn't cure my cholera, other people flushing preventing me from being exposed to it. The NY/NJ water utilities prevented me from being exposed to water-born diseases and my refrigerator/consistent food supply protected me from spoiled food. >The article you quoted has a fundamental flaw in that it assumes that we can simply reduce an ICU stay at the end of life by 1-2 days. When a person is in the ICU, it's not quite so clear that a person is only going to live 1-2 days and then die. People want their family in ICU, because they want that person to have any and every chance at living. True, which is why the ICU study alone isn't conclusive. However, the RAND health insurance experiment (discussed in the article) doesn't have that flaw. Randomly chosen people consumed different levels of health care, and few statistically significant differences were observed.
Prrometheus 18y ago
>This isn't about being "cost effective," it's about doing what is right. There are a finite number of resources in this world and an infinite number of wants and needs. It is ALWAYS about being "cost effective". Money used on health care cannot be used on other things, such as education, transportation, or investment in a company that provides jobs and useful services. How much medical care should everybody get? Should we be willing to spend $1 million to extend an elderly citizen's life for a year? Should EVERYONE have access to that quality of medical care? These are important questions. Cost and benefit must be weighed in health care, just like anywhere else. Life is more complex than leftist soundbites, my friend. If spending $1 trillion extra on medicine would save a thousand lives, I would contest that it would not be worth it. The question is, how much of a reduction in the quality of life in America are you willing to accept for an improvement in the average quality of health care?
- Retric 18y ago
  From a resource perspective basic medical care is cheep and effective. EX: The cost benefit ratio of free vaccinations is varying positive. We can efficiently have basic universal healthcare without spending huge piles of cash on every patent. The problem is we obligate institutions to treat everyone without funding them to do so which destroys the free market. We don't have huge efficient hospital chains because it's not profitable to create them. I say we use the Japanese approach of basic universal insurance and private medical system for the best of both worlds. PS: Would you rather the government pay ~50$ per MRI in Japan or your private insurance pay ~1500$ in the US for the same procedure?
  - gunderson 18y ago
    Are you saying that people in the US don't get vaccinated already with or without "health insurance"? BTW, the reason that someone can't sell a $20/month insurance policy that gets you the kind of basics you're talking about is b/c it's illegal. By law health insurance plans have to abide by all kinds of rules, one of which is that they must insure against the possibility that you develop a drug problem and all kinds of improbable things. The end result is that even the cheapest health insurance is quite expensive. The problem is that government is already regulating the private market significantly. Add to that the tax loophole that lets employer-provided plan fees be taken from pre-tax income, and you have a set of incentives that have resulted in the mess we're in. Also, top notch care at a level that was very elite in 1990 is now significantly cheaper than it was in 1990. The problem is that the average person wants cutting edge 2007 medicine, which is a lot more expensive. Think about it this way, the more effective healthcare is, the more people will spend on it (not less). As procedures have a higher chance of succeeding, more people will decide to get them (who in the past would have gone to hospice).
gunderson 18y ago
What about: - Free glasses for those who don't have 20/20 vision. - Why not give free glasses for those who don't have 20/30 vision? - What about free contact lenses? - Wait, why not make daily disposables a right? - While we're at it, what about nutritional counseling? - Or what about a Federally funded delivery service for fresh organic produce? My point is that if you are willing to define a "right" then you also have the burden of having to define "healthcare". What if person A would rather spend $10K of personal income on a motorcycle or home theater, but person B would rather spend it on extra long doctor visits? What if person C would settle for inferior healthcare b/c she practices some form of alternative medicine? Bottom line is that if you are thinking of it as right and wrong then you haven't thought about the ramifications of the issue very deeply.
- elai 18y ago
  Glasses are horribly, horribly overpriced in North America. They only really cost $15 dollars max to get a decent looking frame with anti-reflective & anti-scratch coating with a prescription as high as -8. (zennioptical.com)
mhartl 18y ago
One problem is that there's no such thing as 'health care'. It's like saying everyone should have 'transportation'. Does that cover bicycles? A Ford Focus? A Rolls Royce? To 'do what is right', 'transportation' should include air travel, too, right? So, free coach? First class? A Gulfstream? And so it goes with 'health care'. The many products under the umbrella term 'health care' are scarce goods. Long experience shows that in virtually every respect the best way to allocate scarce goods is on a market. All systems (including the present one) used to distribute 'health care' that ignore or distort markets are doomed to frustration and failure. Alas, creating a truly free market in health care is on no mainstream politician's agenda. I don't expect our situation to improve much soon.

yummyfajitas 18y ago

If you want to save lives, you are wasting your time with medicine. http://hanson.gmu.edu/CutMed.htm http://hanson.gmu.edu/CutMed.htm To save lives and improve the quality of life, you'd be better off providing EVERY American with access to a gym. Exercise adds 15 years to your life. It's pretty difficult to show statistically that marginal medical treatments (medical treatments that people purchase if they are cheap, but not if they are expensive) do anything.

Retric 18y ago
Early healthcare tends to reap huge benefits. AKA prevent someone dieing at birth and you add ~70 years. Older patents and random accidents reduce the possible gains. The second cheapest group to save is emergency room patents where minimal treatment can have dramatic effects. Exercise falls into the next group where huge investments in time reap huge long term benefits. (Someone making 50$/hour * 3 hours a week * 50 weeks a year = 7500$ / year.) A 5$ per month medicine is a lot cheaper than exercise so it's long term benefits don't need to be on the same magnitude to be vary worthwhile.
- yummyfajitas 18y ago
  Well first, the link I provided discusses marginal medicine, or medicine people choose not to buy if it will cost THEM lots of money. Emergency care tends not to be marginal. As for the opportunity cost of exercise, it is only $2850 (average wage is about $38,000/year, http://www.ssa.gov/OACT/COLA/AWI.html http://www.ssa.gov/OACT/COLA/AWI.html) if people substitute exercise for productive work. It's not obvious that that is what would happen. I suspect most people would substitute exercise for TV. Lots of people watch 3 hours of TV per day. Squeezing out 3 hours/week would be easy. For gods sake, 9.9 million people sit on their asses watching The Biggest Loser (a weight loss game show). People can exercise more.
iamelgringo 18y ago
If you want to save lives, you are wasting your time with medicine. http://hanson.gmu.edu/CutMed.htm http://hanson.gmu.edu/CutMed.htm To save lives and improve the quality of life, you'd be better off providing EVERY American with access to a gym. I whole heartedly disagree. Why then do you suppose that people who live in the Third World (where I grew up) tend to die younger and die of easily curable/preventable diseases? Is it because they got more exercise working in the sugar cane fields swinging a machete for 16 hours? I've read other studies that show that if you exercise 1-2 hours, 3 times a week, you end up living 5-7 years longer, but then, the extra 5-7 years that you live, you've spent in the gym exercising. The article you quoted has a fundamental flaw in that it assumes that we can simply reduce an ICU stay at the end of life by 1-2 days. When a person is in the ICU, it's not quite so clear that a person is only going to live 1-2 days and then die. People want their family in ICU, because they want that person to have any and every chance at living. Certainly he raises some good points about cost effective health care. No on would disagree that a bunch of low cost primary health clinics are going to be a much cheaper way to treat people than an ER or ICU. But, dismissing ER or ICU treatment as unnecessary is absurd.
- yummyfajitas 18y ago
  >Why then do you suppose that people who live in the Third World (where I grew up) tend to die younger and die of easily curable/preventable diseases? The vast majority of those diseases are prevented in the developed world by non-medical means. A doctor didn't prevent me from dying of malaria, DDT eliminated malaria in the US before I was born. Doctors didn't cure my cholera, other people flushing preventing me from being exposed to it. The NY/NJ water utilities prevented me from being exposed to water-born diseases and my refrigerator/consistent food supply protected me from spoiled food. >The article you quoted has a fundamental flaw in that it assumes that we can simply reduce an ICU stay at the end of life by 1-2 days. When a person is in the ICU, it's not quite so clear that a person is only going to live 1-2 days and then die. People want their family in ICU, because they want that person to have any and every chance at living. True, which is why the ICU study alone isn't conclusive. However, the RAND health insurance experiment (discussed in the article) doesn't have that flaw. Randomly chosen people consumed different levels of health care, and few statistically significant differences were observed.

Prrometheus 18y ago

>This isn't about being "cost effective," it's about doing what is right. There are a finite number of resources in this world and an infinite number of wants and needs. It is ALWAYS about being "cost effective". Money used on health care cannot be used on other things, such as education, transportation, or investment in a company that provides jobs and useful services. How much medical care should everybody get? Should we be willing to spend $1 million to extend an elderly citizen's life for a year? Should EVERYONE have access to that quality of medical care? These are important questions. Cost and benefit must be weighed in health care, just like anywhere else. Life is more complex than leftist soundbites, my friend. If spending $1 trillion extra on medicine would save a thousand lives, I would contest that it would not be worth it. The question is, how much of a reduction in the quality of life in America are you willing to accept for an improvement in the average quality of health care?

Retric 18y ago
From a resource perspective basic medical care is cheep and effective. EX: The cost benefit ratio of free vaccinations is varying positive. We can efficiently have basic universal healthcare without spending huge piles of cash on every patent. The problem is we obligate institutions to treat everyone without funding them to do so which destroys the free market. We don't have huge efficient hospital chains because it's not profitable to create them. I say we use the Japanese approach of basic universal insurance and private medical system for the best of both worlds. PS: Would you rather the government pay ~50$ per MRI in Japan or your private insurance pay ~1500$ in the US for the same procedure?
- gunderson 18y ago
  Are you saying that people in the US don't get vaccinated already with or without "health insurance"? BTW, the reason that someone can't sell a $20/month insurance policy that gets you the kind of basics you're talking about is b/c it's illegal. By law health insurance plans have to abide by all kinds of rules, one of which is that they must insure against the possibility that you develop a drug problem and all kinds of improbable things. The end result is that even the cheapest health insurance is quite expensive. The problem is that government is already regulating the private market significantly. Add to that the tax loophole that lets employer-provided plan fees be taken from pre-tax income, and you have a set of incentives that have resulted in the mess we're in. Also, top notch care at a level that was very elite in 1990 is now significantly cheaper than it was in 1990. The problem is that the average person wants cutting edge 2007 medicine, which is a lot more expensive. Think about it this way, the more effective healthcare is, the more people will spend on it (not less). As procedures have a higher chance of succeeding, more people will decide to get them (who in the past would have gone to hospice).

gunderson 18y ago

What about: - Free glasses for those who don't have 20/20 vision. - Why not give free glasses for those who don't have 20/30 vision? - What about free contact lenses? - Wait, why not make daily disposables a right? - While we're at it, what about nutritional counseling? - Or what about a Federally funded delivery service for fresh organic produce? My point is that if you are willing to define a "right" then you also have the burden of having to define "healthcare". What if person A would rather spend $10K of personal income on a motorcycle or home theater, but person B would rather spend it on extra long doctor visits? What if person C would settle for inferior healthcare b/c she practices some form of alternative medicine? Bottom line is that if you are thinking of it as right and wrong then you haven't thought about the ramifications of the issue very deeply.

elai 18y ago
Glasses are horribly, horribly overpriced in North America. They only really cost $15 dollars max to get a decent looking frame with anti-reflective & anti-scratch coating with a prescription as high as -8. (zennioptical.com)

mhartl 18y ago

One problem is that there's no such thing as 'health care'. It's like saying everyone should have 'transportation'. Does that cover bicycles? A Ford Focus? A Rolls Royce? To 'do what is right', 'transportation' should include air travel, too, right? So, free coach? First class? A Gulfstream? And so it goes with 'health care'. The many products under the umbrella term 'health care' are scarce goods. Long experience shows that in virtually every respect the best way to allocate scarce goods is on a market. All systems (including the present one) used to distribute 'health care' that ignore or distort markets are doomed to frustration and failure. Alas, creating a truly free market in health care is on no mainstream politician's agenda. I don't expect our situation to improve much soon.