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post #41 of 193 (permalink) Old 05-13-2009, 06:37 PM
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How did I miss THAT?

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post #42 of 193 (permalink) Old 05-13-2009, 06:59 PM
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Oh my! me too, how did I miss that?
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post #43 of 193 (permalink) Old 05-13-2009, 08:53 PM
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Vindicated. Really. And I just mean 'really'. This time.
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post #44 of 193 (permalink) Old 05-13-2009, 09:37 PM
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Originally Posted by GermanStar View Post
Unless some pretty drastic measures are taken, medicare will go insolvent during our lifetimes. National health care seems a natural remedy, though it won't come cheap.
There are so many inherent contradictions in what you wrote...where do I start?

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post #45 of 193 (permalink) Old 05-13-2009, 09:42 PM
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Originally Posted by mcbear View Post
Social Security would have been sustainable had it not been futzed with so bad in the 1980s. THAT is not the issue as much as rising medicare costs for retirees. One of the biggest problems, and one that everyone ignored was the boomers.

From the article I linked on the Ouch, Pay Cut thread:
"In 2011, the first members of the Baby Boom will reach age 65, and the Baby Boom will have decreased to 25 percent of the total population (in the middle series). The last of the Baby-Boom population will reach age 65 in the year 2029. By that time, the Baby-Boom population is projected to be only about 16 percent of the total population. "

Population Profile of the United States

And we propagated as one would expect and we are all living longer due to better medical research and better nutrition and less abject poverty. So we build a mass of folks who, at 62 shut off their paid insurance and get a little white paper card and start in the system. And we are hitting that number at a million a day.

So we live longer but spend more money on doctors and visits and pharma and dental and glasses and...
Slight correction: one can receive SS at 62, but no one gets Medicare until 65 unless totally disabled. And much of Medicare requires 20% copay which is usually insured separately and privately.

Apology accepted.

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Last edited by bottomline1; 05-13-2009 at 10:06 PM.
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post #46 of 193 (permalink) Old 05-14-2009, 12:06 AM
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New York Times: World’s Best Medical Care?

The U.S. has the World's most expensive health care system, but only ranks 37th in quality of health care World wide.


Editorial
New York Times
August 12, 2007

World’s Best Medical Care?

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.

Michael Moore struck a nerve in his new documentary, “Sicko,” when he extolled the virtues of the government-run health care systems in France, England, Canada and even Cuba while deploring the failures of the largely private insurance system in this country. There is no question that Mr. Moore overstated his case by making foreign systems look almost flawless. But there is a growing body of evidence that, by an array of pertinent yardsticks, the United States is a laggard not a leader in providing good medical care.

Seven years ago, the World Health Organization made the first major effort to rank the health systems of 191 nations. France and Italy took the top two spots; the United States was a dismal 37th. More recently, the highly regarded Commonwealth Fund has pioneered in comparing the United States with other advanced nations through surveys of patients and doctors and analysis of other data. Its latest report, issued in May, ranked the United States last or next-to-last compared with five other nations — Australia, Canada, Germany, New Zealand and the United Kingdom — on most measures of performance, including quality of care and access to it. Other comparative studies also put the United States in a relatively bad light.

Insurance coverage. All other major industrialized nations provide universal health coverage, and most of them have comprehensive benefit packages with no cost-sharing by the patients. The United States, to its shame, has some 45 million people without health insurance and many more millions who have poor coverage. Although the president has blithely said that these people can always get treatment in an emergency room, many studies have shown that people without insurance postpone treatment until a minor illness becomes worse, harming their own health and imposing greater costs.

Access. Citizens abroad often face long waits before they can get to see a specialist or undergo elective surgery. Americans typically get prompter attention, although Germany does better. The real barriers here are the costs facing low-income people without insurance or with skimpy coverage. But even Americans with above-average incomes find it more difficult than their counterparts abroad to get care on nights or weekends without going to an emergency room, and many report having to wait six days or more for an appointment with their own doctors.

Fairness. The United States ranks dead last on almost all measures of equity because we have the greatest disparity in the quality of care given to richer and poorer citizens. Americans with below-average incomes are much less likely than their counterparts in other industrialized nations to see a doctor when sick, to fill prescriptions or to get needed tests and follow-up care.

Healthy lives. We have known for years that America has a high infant mortality rate, so it is no surprise that we rank last among 23 nations by that yardstick. But the problem is much broader. We rank near the bottom in healthy life expectancy at age 60, and 15th among 19 countries in deaths from a wide range of illnesses that would not have been fatal if treated with timely and effective care. The good news is that we have done a better job than other industrialized nations in reducing smoking. The bad news is that our obesity epidemic is the worst in the world.

Quality. In a comparison with five other countries, the Commonwealth Fund ranked the United States first in providing the “right care” for a given condition as defined by standard clinical guidelines and gave it especially high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients. But we scored poorly in coordinating the care of chronically ill patients, in protecting the safety of patients, and in meeting their needs and preferences, which drove our overall quality rating down to last place. American doctors and hospitals kill patients through surgical and medical mistakes more often than their counterparts in other industrialized nations.

Life and death. In a comparison of five countries, the United States had the best survival rate for breast cancer, second best for cervical cancer and childhood leukemia, worst for kidney transplants, and almost-worst for liver transplants and colorectal cancer. In an eight-country comparison, the United States ranked last in years of potential life lost to circulatory diseases, respiratory diseases and diabetes and had the second highest death rate from bronchitis, asthma and emphysema. Although several factors can affect these results, it seems likely that the quality of care delivered was a significant contributor.

Patient satisfaction. Despite the declarations of their political leaders, many Americans hold surprisingly negative views of their health care system. Polls in Europe and North America seven to nine years ago found that only 40 percent of Americans were satisfied with the nation’s health care system, placing us 14th out of 17 countries. In recent Commonwealth Fund surveys of five countries, American attitudes stand out as the most negative, with a third of the adults surveyed calling for rebuilding the entire system, compared with only 13 percent who feel that way in Britain and 14 percent in Canada.

That may be because Americans face higher out-of-pocket costs than citizens elsewhere, are less apt to have a long-term doctor, less able to see a doctor on the same day when sick, and less apt to get their questions answered or receive clear instructions from a doctor. On the other hand, Gallup polls in recent years have shown that three-quarters of the respondents in the United States, in Canada and in Britain rate their personal care as excellent or good, so it could be hard to motivate these people for the wholesale change sought by the disaffected.

Use of information technology. Shockingly, despite our vaunted prowess in computers, software and the Internet, much of our health care system is still operating in the dark ages of paper records and handwritten scrawls. American primary care doctors lag years behind doctors in other advanced nations in adopting electronic medical records or prescribing medications electronically. This makes it harder to coordinate care, spot errors and adhere to standard clinical guidelines.

Top-of-the-line care. Despite our poor showing in many international comparisons, it is doubtful that many Americans, faced with a life-threatening illness, would rather be treated elsewhere. We tend to think that our very best medical centers are the best in the world. But whether this is a realistic assessment or merely a cultural preference for the home team is difficult to say. Only when better measures of clinical excellence are developed will discerning medical shoppers know for sure who is the best of the best.



With health care emerging as a major issue in the presidential campaign and in Congress, it will be important to get beyond empty boasts that this country has “the best health care system in the world” and turn instead to fixing its very real defects. The main goal should be to reduce the huge number of uninsured, who are a major reason for our poor standing globally. But there is also plenty of room to improve our coordination of care, our use of computerized records, communications between doctors and patients, and dozens of other factors that impair the quality of care. The world’s most powerful economy should be able to provide a health care system that really is the best.
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post #47 of 193 (permalink) Old 05-18-2009, 01:14 PM
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Originally Posted by bottomline1 View Post
Slight correction: one can receive SS at 62, but no one gets Medicare until 65 unless totally disabled. And much of Medicare requires 20% copay which is usually insured separately and privately.

Apology accepted.
You are correct. I have always tied that age to the SS age, mainly out of "rounding" habit. It hasn't been a detail issue until this past year.

I should be looking at all the Medicare supplement ads that I seem to get in the mail daily closer.

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Being smart is knowing the difference, in a sticky situation between a well delivered anecdote and a well delivered antidote - bear.
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post #48 of 193 (permalink) Old 05-18-2009, 05:39 PM
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^Explains the propagation of avalons.
Hey, that hurt!

The biggest problems we are facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all and that’s what I intend to reverse.

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post #49 of 193 (permalink) Old 05-18-2009, 05:44 PM
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Back to the OP's post, are you suggesting that people who promote socialization of healthcare might pursue it to address a problem of personal medical debt, shifting their debt burden over onto taxpayers?

I'd be shocked except of course, that's the premise of social security, too, and we (voters) accept it without a moment's hesitation. So long as people can shift the actual burden off of themselves why would they not? Put it another way, where is the incentive to develop personal responsibility and initiative when the burden is all shifted onto other folks?

The biggest problems we are facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all and that’s what I intend to reverse.

~ Senator Barack H. Obama
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post #50 of 193 (permalink) Old 05-18-2009, 09:04 PM
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Back to the OP's post, are you suggesting that people who promote socialization of healthcare might pursue it to address a problem of personal medical debt, shifting their debt burden over onto taxpayers?

I'd be shocked except of course, that's the premise of social security, too, and we (voters) accept it without a moment's hesitation. So long as people can shift the actual burden off of themselves why would they not? Put it another way, where is the incentive to develop personal responsibility and initiative when the burden is all shifted onto other folks?
Those penniless sick bitches should just quietly die, no?
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