patrick.net

curious2 says

bob2356 asks

Where do you get your information?

Admittedly I do rely on the press because I cannot personally count every childhood leukemia on my own, but your quote from cancer.gov is based on data that are at least five years old:

http://www.cancer.gov/cancertopics/factsheet/Sites-Types/childhood

The article below, also from 2007, projected thousands of future cancers caused by the CT scans performed that year alone:

http://archinte.ama-assn.org/cgi/content/abstract/169/22/2071

Since then, CT scan rates have continued to increase.

Also, CT scans are certainly not the only form of radiation:

http://www.gaia-health.com/articles351/000396-xrays-double-cancer-children.shtml

Also your post includes incorrect assumptions and misquotes, with the result that you end up arguing with a straw man. I didn't say anything about how many CT scans children get, I said Americans get 6 times as many as a decade ago.

You said twice as many children get leukemia as a decade ago and Americans get 6 times as many ct scans pretty much in the same sentence. I assumed you were tying that together somehow as well as obliquely referencing the recent reporting of the increase in children's ct scans in emergency rooms. So these were just two totally unrelated statements that had no bearing on each other? Sorry I misread, most people would have assumed they went together.

Both my article and your article both say that leukemia rates are pretty much stable within a fixed range since the mid 80's, so why is this a straw man? The statement that twice as many children get leukemia as a decade ago is simply not true.

As per the thousands of additional deaths from cat scans "study", so what? Without any reference to how many people are helped by cat scans it's totally irrelevant. Just taking the number of cat scans and projecting it out sounds like a senior medical school student doing scut work for some publish or perish professor to me. As opposed to a serious study with meaningful results.

Yes invasive radiation should be avoided whenever possible. Hell, sunlight should be avoided whenever possible. Yes there is more invasive radiation than is absolutely needed, although with the current malpractice climate everyone errs on the side of caution rather than having to stand up in court and explain why they didn't take a ct scan or xray. But overall the benefits far outweigh the risks of cat scans and xrays. If avoiding radiation means dying here and now to avoid a statistical increase in the possibility of cancer later I'll take my chances. You are free to make your own choice.

[...]

Dan, you hit it on the head. Anything short of a nationalized and streamlined system is a bandaid at best. It won't happen any time soon though. The 1% who control both parties in power won't allow it to happen.

simchaland says

Dan, you hit it on the head. Anything short of a nationalized and streamlined system is a bandaid at best.

That is crazy. Can you explain to me how such a system would not be swamped.

Once everyone has health insurance everyone is going to be inclined to use their insurance and hence the demand for medical care is going to go through the roof. There are not enough hospitals, doctors, nurses to handle that kind of load.

curious2 says

First of all, you say that childhood leukemia rates are "pretty much stable," when in fact they have been increasing.

Ok I give up, here is the quote from both your article and mine.

"Incidence of childhood leukemias appeared to rise in the early 1980s, with rates increasing from 3.3 cases per 100,000 in 1975 to 4.6 cases per 100,000 in 1985. Rates in the succeeding years have shown no consistent upward or downward trend and have ranged from 3.7 to 4.9 cases per 100,000"

I don't read "shown no consistent upward or downward trend" or "ranging up and down" for the last 25 years as increasing for the last 10. Could you explain how you do?

The term I have been using is invasive radiation, meaning all types of invasive radiation although I sometimes just say cat scan out of lazyness. You were the one who said C-T scans in the first place, look at your original post.

I agreed there are some some excess. What is the straw man in that? If you really think that concerns about medical malpractice doesn't drive a lot of them you don't know anything about medicine or law.

I read the New Yorker article, I quoted the article extensively here at patrick.net years ago. Did you read far enough to get to the parts where they talk about the cleveland and mayo clinic. Those very tightly run organizations aren't doing any excess anything. The average is somewhere between those McAllen and the Cleveland/Mayo clinics.

My bottom line is that there is some unnecessary invasive radiation procedures, but the vast majority are legitimate diagnostic procedures whose value far, far outweighs the small risk of cancer. I don't know how to make that simple statement any clearer. If you feel invasive radiation exists as profit making scam that will give you cancer then you are free to refuse any and all diagnostic radiation. At 30 that's a pretty easy to stand by, so how you hold out at 70.

[...]

gromitmpl says

simchaland says

Dan, you hit it on the head. Anything short of a nationalized and streamlined system is a bandaid at best.

That is crazy. Can you explain to me how such a system would not be swamped.

Once everyone has health insurance everyone is going to be inclined to use their insurance and hence the demand for medical care is going to go through the roof. There are not enough hospitals, doctors, nurses to handle that kind of load.

All systems are finite and require allocation of finite resources to users who have infinite demand. If we can manage the Internet, we can manage health care.

A nation-wide health care system does not imply that people don't pay for health care. You are confusing health care reform with the idea of insurance that pays 100% of the costs. A nation-wide health care system does not even require an insurance function. Hell, people buy health insurance not as insurance but simply as a way not to get fucked over by unreasonable overcharging. A $100 bill to an insurance company would be a $10,000 bill to an uninsured person.

Can a national and streamline system be sustained. Of course it can. You have to be an ignorant fool to argue otherwise since such systems do exist and run in other countries like the U.K. and Canada. Will such a system make everybody happy all the time? Of course not. People wouldn't be happy with a health care system unless they never got sick, never aged, and never died. But that doesn't mean you cannot create an optimal system.

Even without any insurance function, a nation-wide single payer system with streamlining of the medical industry would reduce health care costs considerably. Administrative costs alone account for a good chuck of health care costs. Advertisements of drugs accounts for another large chunk, and ads are a zero-sum game that serve no legitimate medical purpose as the doctor, not the patient, should be deciding what drugs to use in a treatment.

Add to those savings the elimination of price gouging -- the real reason people get insurance -- by having fix prices for services at a given location, and the typical American could afford a high level of health care without any freaking insurance. So insurance is just the icing on the cake.

"This is how it works.

It's a center-right nation."

No, it's a center-right government, the nation is considerably to the left of the politicians.

monkframe says

No, it's a center-right government, the nation is considerably to the left of the politicians.

Agreed. Most Americans are for gay rights, legalized marijuana, social safety nets, the single payer system, and free speech.

Restricting the freedom of individuals is more of a government interest than a citizen interest.

The way medicare works is people pay for supplemental policies, that cover premium cost services. I think even if you want bare bones, you pretty much need a minimal supplemental policy.

So "medicare for all" would not have killed the insurance companies. But it would have forced them to limit their business to the supplemental policies.

I do tend to agree that Obama has been a wimp. Politically, the whole Tea Party movement (which was possible because he was a black President with a middle name of Hussein), might have made it impossible. But I would have like to see him try and fail, I think.

Although the preexisting conditions coverage is an important breakthrough.

monkframe says

No, it's a center-right government, the nation is considerably to the left of the politicians.

I agree too. We drift toward fascism.

monkframe says

No, it's a center-right government, the nation is considerably to the left of the politicians.

Not sure about that. Is there evidence for that?

Seems our recent national elections have been very close.

monkframe says

"This is how it works.

It's a center-right nation."

No, it's a center-right government, the nation is considerably to the left of the politicians.

No.

The governments are corporatist serving defense contractors, mortgage bankers, real estate agents, health insurers, the California Correctional Peace Officers Association, the California Federation of Teachers, and other large groups willing to spend money on politicians to furthur their group's common economic interests.

The majority of people are not members of such groups.

"Left" and "right" are more marketing labels than relevant reality.

drew_eckhardt says

monkframe says

"This is how it works.

It's a center-right nation."

No, it's a center-right government, the nation is considerably to the left of the politicians.

No.

The governments are corporatist serving defense contractors, mortgage bankers, real estate agents, health insurers, the California Correctional Peace Officers Association, the California Federation of Teachers, and other large groups willing to spend money on politicians to furthur their group's common economic interests.

The majority of people are not members of such groups.

"Left" and "right" are more marketing labels than relevant reality.

This is true at the same time. The best evidence of this is the fact that the five largest banks not only live, but are taking larger gambles in the markets than ever. They should have been broken up after the collapse, but instead, they got all the money!

tekkierich says

wthrfrk80 says

At this point I'd rather go to all "out of pocket" like it was a long ago, or full-bore socialized medicine. What we have now is a Frankenstein combination of the worst aspects of both.

You sir, summed up the entire debate and I am entirely in agreement with you.

My former family doctor from Dallas said the exact same thing.

monkframe says

the five largest banks not only live, but are taking larger gambles in the markets than ever. They should have been broken up after the collapse, but instead, they got all the money!

Yep. I realized all the "free market" talk from the right was bullshit when the bailouts happened.

The reality is that we don't have a "free market" party.

Democrats = socialism for the masses
Republicans = socialism for well-connected Big Banks

[...]

wthrfrk80 says

Yep. I realized all the "free market" talk from the right was bullshit when the bailouts happened.

The reality is that we don't have a "free market" party.

Right.

Democrats = socialism for the masses

Wrong. The Republicans are the bed-wetting liberals. Republican House Speaker Dennis Hastert introduced Medicare Part-D and Republican 41st president George Bush signed it. His son was responsible for America's income tax system becoming the most progressive out of the OECD-24 where the ratio between share of tax burden and share of income among the top earning decile is higher than in Australia, Austria, Belgium, Canada, The Czech Republic, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, The Netherlands, New Zealand, Norway, Poland, The Slovak Republic, Sweden, Switzerland, and The United Kingdom.

Republicans = socialism for well-connected Big Banks

Wrong. The Democrats are in bed with the bankers with things like the revolving door between Goldman Sachs and the White House. They were responsible for the S&L bailout in the form of the Financial Institutions Reform Recovery and Enforcement Act which created the Resolution Trust Corporation that had "resolved" 747 insolvent banks by 1995 for $394 billion.

A better way of looking at it is that both parties pass legislation to benefit powerful corporatist interests (banking, mortgage, real estate agents, defense contractors, California prison guards, California teachers, etc.) although the rest of us get a few scraps thrown our way like the seniors who benefited from the Medicare Part-D federal funds funnel to the drug companies.

Ok, I stand corrected:

Both parties = socialism for the rich

Medicare Part-D doesn't mean shit for everyone below the age of 65. Doesn't mean shit.

The problems can be summed up like this

1) Any business that has significant profits and significant training will defend itself against reforms. It is natural as to defend amounts

2) As people age more and lifespan grows so do various aliments. Did anyone really know what Alzheimer was 100 years ago?

3) Population expands more so of course that means more coverage and more demands on medical staff.

We cannot make healthcare cheap but subsidizing demand. Nothing is ever made cheaper by subsidizing the demand.

States need to grant more licenses for doctors and nurses. More assistance for those that want to get in those professions.

Outright denials need to be established for government programs to get people off of bad items. If someone is a drug addict they need to enter rehab before medicare. This goes for all illegal and legal substances. If someone is excessively obese as defined by a doctor that would need to be corrected as well.

If we think that somehow habitual actions have no general effect on health then that is wrong. 10% of people in Kentucky have no teeth. When you combine high smoking rates, high chewing tobacco rates, well water (no flouride), high soda consumption, high hard alcohol consumption and poverty and it takes a back seat.

St. Teresa: 'More tears are shed over answered prayers than unanswered ones'.

I think the USA just needs to hit the "reset" button.

Not sure how that would ever happen, short of a major meteor/comet impact. Maybe we'll get lucky and the Yellowstone volcano will finally blow...

wthrfrk80 says

I think the USA just needs to hit the "reset" button.

Not sure how that would ever happen, short of a major meteor/comet impact. Maybe we'll get lucky and the Yellowstone volcano will finally blow...

Zombie Apocalypse

The Obamacare thing was designed to cloward-piven collapse the system to get to single payer. A cursory look at the numbers involved should reveal this. At the end of the day it bread and circus for our dying republic. Prepare to go from middle to lower class or figure out how to be part of the 1%.

"1) Any business that has significant profits and significant training will defend itself against reforms. It is natural as to defend amounts(.)"

Agreed, and we need the government to defend the people, not the business. I'm so fucking tired of hearing the business interests defended against the people's interest, specifically in regards to health care. Business and its employees need to have this whole subject removed from the debate to a government program like Medicare, and be done with it.

The HMO executives can go have a nice bonfire with their departure bonuses, as they try and find a new career as corporate bloodsuckers.

[...]

curious2 says

I forgot to mention another net effect of ObamaCare, in addition to more spending and worse results. It cost Democrats their House majority in 2010, and looks likely to cost them the Senate in 2012.

Ironically, the statute's namesake may benefit politically from its unpopularity. This is because, with the Republicans taking both houses of Congress, President Obama sounds like the lone voice of sanity. He lied about health insurance, but he isn't crazy like Romney, who anyway signed the same plan in Massachusetts (where it produced more spending and worse results).

Yes, right up until the House impeaches him. For what? For whatever they can think of. With a Republican Congress and the Tea Party folks pulling the strings, it's very likely.

If you're white, middle class and live in the burbs, hang on tight. Things about to get very bumpy.

They already have.

monkframe says

bankr

Bankruptcy is not the end of the world. I would prefer a system where the government gets out of insurance regulation and we have a system of private contracts. It is better for a few folks to go BK than to have any of the horrible problems that modern healthcare and insurance regulations have bought us. People have an odd sense of what BK does. It really is not the end of the world. Credit is over-rated, just as mortgaging a house it.

berational says

I would prefer a system where the government gets out of insurance regulation and we have a system of private contracts.

Isn't that what got us into this problem?

drew_eckhardt says

Republican House Speaker Dennis Hastert introduced Medicare Part-D and Republican 41st president George Bush signed it. His son was responsible for America's income tax system becoming the most progressive out of the OECD-24 where the ratio between share of tax burden and share of income among the top earning decile is higher than in Australia, Austria, Belgium, Canada, The Czech Republic, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, The Netherlands, New Zealand, Norway, Poland, The Slovak Republic, Sweden, Switzerland, and The United Kingdom.

You really don't know what the fuck you're talking about.

For one, Part D was passed in the 2000s (Part C was the late 1990s).

I can't even parse what you're trying to assert about 'progressivity' in the current tax arrangement, but http://motherjones.com/kevin-drum/2012/04/rich-arent-so-different-you-and-me-after-all shows how we already have essentially NO progressivity in the top 4 quintiles.

wthrfrk80 says

Both parties = socialism for the rich

Democrats stand for bullshitting the poor. Republicans stand for liquidating them.

Choose wisely this November!

berational says

I would prefer a system where the government gets out of insurance regulation and we have a system of private contracts. It is better for a few folks to go BK than to have any of the horrible problems that modern healthcare and insurance regulations have bought us.

How about we stop doing what we're doing and start doing what the rest of the civilized world is doing wrt health insurance -- heavy government involvement.

The system works well all throughout Europe, Japan, Canada, Oz, NZ.

Your preferred solution works exactly nowhere in the real world; it's perplexing to me why you even think you have proposed a serious idea and not just the typical libertarian reality-challenged bullshit that is so common on the internet.

berational says

monkframe says

bankr

Bankruptcy is not the end of the world. I would prefer a system where the government gets out of insurance regulation and we have a system of private contracts. It is better for a few folks to go BK than to have any of the horrible problems....

Actually it is more than just a few bankrupcies... Some estimates are around 60% of all bankrupcies in the US.

http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH

[...]

The sick and the elderly must become gladiators for our amusement. Have them fight it out in a modern day coliseum. Since our pie is apparently fixed in size, the winner will get treated while the loser will be incinerated in the ocean beach bonfire. This is sure to stimulate the economy. And after a 3 month reprieve, the winner must fight again to remain so.

dublin hillz says

The sick and the elderly must become gladiators for our amusement. Have them fight it out in a modern day coliseum. Since our pie is apparently fixed in size, the winner will get treated while the loser will be incinerated in the ocean beach bonfire. This is sure to stimulate the economy. And after a 3 month reprieve, the winner must fight again to remain so.

Apocalpysfuck, you are hilarious.

Whoa whoa...that's not Apocalpysefuck...oops...

[...]

curious2 says

No, they must remain profit centers for the medical industrial complex and captive constituencies for politicians. They must neither get well nor die, they must remain on as many pills as possible for as long as possible.

God Bless America.

curious2 says

In the old economy, Americans used to make things. Then, in the new economy, Americans made dot-cons and sold stock to gullible "investors" (speculators). Then, in the housing bubble, Americans sold each other houses with money borrowed from the Chinese.

That's the best summary of the last 30 years I've seen so far.