Comments on: So I’m Blue in the Face http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/ Exposing the ugly truths about the Bush Administration. Fri, 21 Nov 2008 08:45:59 +0000 http://wordpress.org/?v=1.5.1.3 by: Xel http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254878 Wed, 27 Jun 2007 18:17:31 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254878 What Sullivan has done is that he has participated in the transatlantic soccer match that is as boring as it is human. American rightwingers use Europe as a deterring example - basically you toss in an anecdote set in Paris in order to scare away others from left-wing poltics. Vice versa for European lefties. In the middle are American left-wingers who gladly overstate European success and downplay its failures but does this backwards for the US in order to laud everything left-wing and European rightwingers conveniently forget about America's slights and flaws yet wax lyrical about its strengths, supported by facts or not. It would be nice if one took each continent as a unique case and progressed, compared and evaluated from there in order to find what works and what does not. Then my alarm clock rings and it's time for some Müsli. What Sullivan has done is that he has participated in the transatlantic soccer match that is as boring as it is human.

American rightwingers use Europe as a deterring example - basically you toss in an anecdote set in Paris in order to scare away others from left-wing poltics. Vice versa for European lefties. In the middle are American left-wingers who gladly overstate European success and downplay its failures but does this backwards for the US in order to laud everything left-wing and European rightwingers conveniently forget about America’s slights and flaws yet wax lyrical about its strengths, supported by facts or not.

It would be nice if one took each continent as a unique case and progressed, compared and evaluated from there in order to find what works and what does not.

Then my alarm clock rings and it’s time for some Müsli.

]]> by: James http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254500 Wed, 27 Jun 2007 14:03:31 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254500 "Removing the financial incentive from doctors simply means they will provide sloppier treatment. They’re not saints. They’re human beings." Apparently this person doesn't think that doctors actually believe the Hippocratic Oath (you know, the part about "first, do no harm"). If the level of income (or, as he so delicately describes it, "financial incentives") is all that determines whether a person with a medical degree delivers appropriate treatment vs "sloppy treatment", then why doesn't the death rate from medical malpractice vary according to doctor's income levels around the world? Answer: because most doctors become doctors in order to do good for other people; money isn't the prime motivation for most of them(at least on a world-wide basis, regardless of whether this is the case in America). And if financial incentives are required to avoid "sloppy treatment" in everyday non-warzone areas of the world, what about doctors in the world's warzones? Does this person think that doctors, sent by Doctors Without Borders into places where they could be injured/killed while attempting to help people, command $ Billion incomes to compensate for the extra hardships/dangers they wouldn't face in America? What nonsense. This guy has a extremely faulty understanding of human nature, at least that of people who choose to become MD's. “Removing the financial incentive from doctors simply means they will provide sloppier treatment. They’re not saints. They’re human beings.”

Apparently this person doesn’t think that doctors actually believe the Hippocratic Oath (you know, the part about “first, do no harm”). If the level of income (or, as he so delicately describes it, “financial incentives”) is all that determines whether a person with a medical degree delivers appropriate treatment vs “sloppy treatment”, then why doesn’t the death rate from medical malpractice vary according to doctor’s income levels around the world? Answer: because most doctors become doctors in order to do good for other people; money isn’t the prime motivation for most of them(at least on a world-wide basis, regardless of whether this is the case in America).

And if financial incentives are required to avoid “sloppy treatment” in everyday non-warzone areas of the world, what about doctors in the world’s warzones? Does this person think that doctors, sent by Doctors Without Borders into places where they could be injured/killed while attempting to help people, command $ Billion incomes to compensate for the extra hardships/dangers they wouldn’t face in America?

What nonsense. This guy has a extremely faulty understanding of human nature, at least that of people who choose to become MD’s.

]]> by: patrick http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254465 Wed, 27 Jun 2007 13:42:17 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254465 I meant to say NIH not NEH. Maybe that's a Freudian slip: typical Liberal, thinks the Humanities are responsible for funding drug research. There are a number of avenues public funding that support research that leads to health care improvements that become "productized" in the private sector, including just plain old university budgets. I'm using "NIH" to represent those avenues because it's by far the largest, and applying for and managing NIH grants dominates the administrative side of US medical school research, the work that leads to actual health care breakthroughs rather than just new designs of old drugs. I meant to say NIH not NEH. Maybe that’s a Freudian slip: typical Liberal, thinks the Humanities are responsible for funding drug research.

There are a number of avenues public funding that support research that leads to health care improvements that become “productized” in the private sector, including just plain old university budgets. I’m using “NIH” to represent those avenues because it’s by far the largest, and applying for and managing NIH grants dominates the administrative side of US medical school research, the work that leads to actual health care breakthroughs rather than just new designs of old drugs.

]]> by: patrick http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254448 Wed, 27 Jun 2007 13:30:47 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-254448 This idea that private pharma funding is responsible for all the great drug breakthroughs is just silly. A great deal of the real work takes place in universities, largely with <b>public</b> funding. Typically, the pharmas come in after the hard work is done and buy the exclusive rights to market any drugs that emerge from the research. It costs them maybe a new building and a couple of endowed chairs, but by then they mostly know what they're dealing with. <b>We</b> provide the risk capital by means of the NEH, which we empower to act on our behalf through our representative government. Then we allow others to profit from our investment at our expense. We pay the universities to do the research and then we pay pharma to market the drugs to us so we can pay doctors to prescribe the drugs to us so we can pay insurance companies to help us pay for the drugs we developed. Obviously, this is an intentional oversimplification. But the real process is even sillier. This idea that private pharma funding is responsible for all the great drug breakthroughs is just silly. A great deal of the real work takes place in universities, largely with public funding. Typically, the pharmas come in after the hard work is done and buy the exclusive rights to market any drugs that emerge from the research. It costs them maybe a new building and a couple of endowed chairs, but by then they mostly know what they’re dealing with. We provide the risk capital by means of the NEH, which we empower to act on our behalf through our representative government. Then we allow others to profit from our investment at our expense. We pay the universities to do the research and then we pay pharma to market the drugs to us so we can pay doctors to prescribe the drugs to us so we can pay insurance companies to help us pay for the drugs we developed.

Obviously, this is an intentional oversimplification. But the real process is even sillier.

]]> by: tim harris http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-253164 Tue, 26 Jun 2007 23:26:42 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-253164 Sullivan pretends to be a Catholic and a Christian. I don`t know how he squares what one supposes to be his agreement with Christ`s moral teachings with the infantile, cynical and mistaken dogma that people will only act or work responsibly if given financial incentives to do so. But as he has shown in the past, he is no stranger to hypocrisy and self-deception. I am English and have lived in Japan for 33 years. Britain`s National Health Service certainly had and has its problems, and Japan`s very good National Health Service has its problems, too, but, where my family has been concerned, the services provided by Britain`s NHS have not been bad (though Thatcherite policies - originally intended of course, despite all the high moral talk about `choice`, `efficiency` and `incentives`, to break the power of nation-wide labour unions - have created something of a confusing hybrid, neither public nor private), and in my experience and the experience of my Japanese in-laws and friends the services provided by Japan's system are generally very good indeed. But it is by their fruits ye shall know them, and even a cursory look at the figures shows that America's system is not providing Americans (unless they are rich) with anything like an adequate service. Sullivan, I suspect, will not want to address this: the reason for his latest rumblings about health and health services has, I suspect, little to do with any genuine concern with truth as with the appearance of 'Sicko', directed by Michael Moore whom he loathes with such a vengeance that he will never seriously address Moore's central points and will pick up any old stick that might serve to beat him. Sullivan pretends to be a Catholic and a Christian. I don`t know how he squares what one supposes to be his agreement with Christ`s moral teachings with the infantile, cynical and mistaken dogma that people will only act or work responsibly if given financial incentives to do so. But as he has shown in the past, he is no stranger to hypocrisy and self-deception.
I am English and have lived in Japan for 33 years. Britain`s National Health Service certainly had and has its problems, and Japan`s very good National Health Service has its problems, too, but, where my family has been concerned, the services provided by Britain`s NHS have not been bad (though Thatcherite policies - originally intended of course, despite all the high moral talk about `choice`, `efficiency` and `incentives`, to break the power of nation-wide labour unions - have created something of a confusing hybrid, neither public nor private), and in my experience and the experience of my Japanese in-laws and friends the services provided by Japan’s system are generally very good indeed. But it is by their fruits ye shall know them, and even a cursory look at the figures shows that America’s system is not providing Americans (unless they are rich) with anything like an adequate service. Sullivan, I suspect, will not want to address this: the reason for his latest rumblings about health and health services has, I suspect, little to do with any genuine concern with truth as with the appearance of ‘Sicko’, directed by Michael Moore whom he loathes with such a vengeance that he will never seriously address Moore’s central points and will pick up any old stick that might serve to beat him.

]]> by: A.L. http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-253121 Tue, 26 Jun 2007 22:57:33 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-253121 The idea that pharmaceutical companies would reduce spending on research &#38; development if their profits were marginally reduced is total nonsense. The U.S. accounts for only 1/3 of total drug sales and that number will likely go down as the market in developing countries expands. Regardless of how the U.S. reforms its health care system, there will still be a massive, expanding global market for pharmaceutical products, and companies will be competing to develop the next big drug. The nature of patent laws ensures this. A pharmaceutical company is only as good as its next big drug. Its business model is built around innovation. If the U.S. pays marginally less every year for drugs, it will not do anything to alter the underlying dynamic that drives innovation in the drug industry. The idea that pharmaceutical companies would reduce spending on research & development if their profits were marginally reduced is total nonsense. The U.S. accounts for only 1/3 of total drug sales and that number will likely go down as the market in developing countries expands. Regardless of how the U.S. reforms its health care system, there will still be a massive, expanding global market for pharmaceutical products, and companies will be competing to develop the next big drug. The nature of patent laws ensures this. A pharmaceutical company is only as good as its next big drug. Its business model is built around innovation. If the U.S. pays marginally less every year for drugs, it will not do anything to alter the underlying dynamic that drives innovation in the drug industry.

]]> by: biggerbox http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-253002 Tue, 26 Jun 2007 21:43:18 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-253002 If funding drug research is the only obstacle to universal health care, I'm sure we have very smart people who could figure out how to fund research by expanding the government grants and university research system. That already provides the basis for much of that research. I hardly think we should let people die untreated in emergency rooms, or getting sicker because they couldn't afford a doctor visit, just because we have a haphazardly evolved, historically accidental approach to funding drug research. And I don't know about Andy and his doctors, but I prefer to be treated by someone who is doing it because she wants me to get better, not because she can make a buck off me, particularly if the system is rigged to generate more profit if she diagnoses and prescribes within 3 minutes of entering the room. Profit motive is a silly motivator to use for patient care. Oh, and Altace was developed by Hoechst in Germany. If funding drug research is the only obstacle to universal health care, I’m sure we have very smart people who could figure out how to fund research by expanding the government grants and university research system. That already provides the basis for much of that research.

I hardly think we should let people die untreated in emergency rooms, or getting sicker because they couldn’t afford a doctor visit, just because we have a haphazardly evolved, historically accidental approach to funding drug research.

And I don’t know about Andy and his doctors, but I prefer to be treated by someone who is doing it because she wants me to get better, not because she can make a buck off me, particularly if the system is rigged to generate more profit if she diagnoses and prescribes within 3 minutes of entering the room.

Profit motive is a silly motivator to use for patient care.

Oh, and Altace was developed by Hoechst in Germany.

]]> by: terry http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-252951 Tue, 26 Jun 2007 21:10:00 +0000 http://www.mahablog.com/2007/06/26/so-im-blue-in-the-face/#comment-252951 I am not convinced either. The way I see it the U.S. pays twice as much per capita for health care that is only fair to middling compared to all those government run programs. Cutting out the insurance companies would free up another 10% of the bill. We would have more money to spend on doctors and drugs, we would cover everybody and both business and people would save a ton of time fighting with insurance companies. Throw in some minor gatekeeping functions on end of life care and we would have enough money to even treat our poor elderly and the disabled with some dignity. Who knows maybe with a rational, single payor system GM and Ford could get out of the health care business and get back to building cars. Seldom have such a greedy few been able to block change which would benefit so many so greatly. I am not convinced either. The way I see it the U.S. pays twice as much per capita for health care that is only fair to middling compared to all those government run programs. Cutting out the insurance companies would free up another 10% of the bill. We would have more money to spend on doctors and drugs, we would cover everybody and both business and people would save a ton of time fighting with insurance companies. Throw in some minor gatekeeping functions on end of life care and we would have enough money to even treat our poor elderly and the disabled with some dignity. Who knows maybe with a rational, single payor system GM and Ford could get out of the health care business and get back to building cars. Seldom have such a greedy few been able to block change which would benefit so many so greatly.

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