Comments on: Ir-rationing Health Care http://www.mahablog.com/2009/07/08/ir-rationing-health-care/ Making the World Safe for Liberalism Thu, 18 Mar 2010 22:56:11 -0700 http://wordpress.org/?v=2.9.2 hourly 1 By: Francis D http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624353 Francis D Tue, 14 Jul 2009 17:51:15 +0000 http://www.mahablog.com/?p=6613#comment-624353 Maha, go retake Critical Thinking 101. The QALY - the Quality Adjusted Life Year absolutely is a measure of Comparative Effectiveness. (There are others). And as such it requires Comparative Effectiveness Research, and in a fairly wide-ranging form. In order to assess the cost-benefit ratio of a form of healthcare you need to know the benefits, and the benefits relative to other treatment. And that is CER. (Assessing the cost is the easy part). Maha, go retake Critical Thinking 101.

The QALY – the Quality Adjusted Life Year absolutely is a measure of Comparative Effectiveness. (There are others). And as such it requires Comparative Effectiveness Research, and in a fairly wide-ranging form.

In order to assess the cost-benefit ratio of a form of healthcare you need to know the benefits, and the benefits relative to other treatment. And that is CER. (Assessing the cost is the easy part).

]]> By: Badtux http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624265 Badtux Sun, 12 Jul 2009 02:14:49 +0000 http://www.mahablog.com/?p=6613#comment-624265 The health-industrial complex is bankrupting America just as surely as the military-industrial complex bankrupted the USSR. By the time the USSR collapsed, 40% of their GDP was being consumed by their military-industrial complex. If current increases continue, within twenty years that's going to be the USA -- except we'll collapse long before then, because we don't have a totalitarian government to keep the lid on once medical treatment becomes unobtainable by the majority of Americans. - Badtux the Healthcare Economist Penguin The health-industrial complex is bankrupting America just as surely as the military-industrial complex bankrupted the USSR. By the time the USSR collapsed, 40% of their GDP was being consumed by their military-industrial complex. If current increases continue, within twenty years that’s going to be the USA — except we’ll collapse long before then, because we don’t have a totalitarian government to keep the lid on once medical treatment becomes unobtainable by the majority of Americans.

- Badtux the Healthcare Economist Penguin

]]> By: Andy Waschick http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624224 Andy Waschick Fri, 10 Jul 2009 18:29:42 +0000 http://www.mahablog.com/?p=6613#comment-624224 The spirit of Capitalism is competition. It's a system where there must be a winner and there must be a loser. There must be the chance of failure, because it motivates people to achieve success. This is all well and good, until the consequences of failure are disease, and ultimately, death. Through this reasoning, I would suggest that medicine is incompatible with Capitalism. In fact, I have often wondered how people who practice medicine reconcile their hippocratic oaths with the tenets of scarcity that a for-profit enterprise demands. How does one withhold care in ANY circumstance? What is the rationalization? In response, I have gotten in the habit of withholding my money for healthcare. I pay, eventually, grudgingly, but not before I have recieved something with red ink on it. Yes, this does all sorts of damage to my financial status (a pointless, stupid game in and of itself) but if a person does not agree with how things work, I believe it's his duty to disobey and challenge. The spirit of Capitalism is competition. It’s a system where there must be a winner and there must be a loser. There must be the chance of failure, because it motivates people to achieve success. This is all well and good, until the consequences of failure are disease, and ultimately, death.

Through this reasoning, I would suggest that medicine is incompatible with Capitalism. In fact, I have often wondered how people who practice medicine reconcile their hippocratic oaths with the tenets of scarcity that a for-profit enterprise demands. How does one withhold care in ANY circumstance? What is the rationalization?

In response, I have gotten in the habit of withholding my money for healthcare. I pay, eventually, grudgingly, but not before I have recieved something with red ink on it. Yes, this does all sorts of damage to my financial status (a pointless, stupid game in and of itself) but if a person does not agree with how things work, I believe it’s his duty to disobey and challenge.

]]> By: maha http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624214 maha Fri, 10 Jul 2009 11:52:27 +0000 http://www.mahablog.com/?p=6613#comment-624214 Francis, we're not talking about the same thing. Repeat after me: CER is not about determining a cost-benefit ratio. CER is not about determining a cost-benefit ratio. CER is not about determining a cost-benefit ratio. Now, go write that 500 times on a blackboard. Thanks much. If you want to understand CER, go read the Howard Dean interview linked. Francis, we’re not talking about the same thing. Repeat after me:

CER is not about determining a cost-benefit ratio.
CER is not about determining a cost-benefit ratio.
CER is not about determining a cost-benefit ratio.

Now, go write that 500 times on a blackboard. Thanks much. If you want to understand CER, go read the Howard Dean interview linked.

]]> By: Francis D http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624212 Francis D Fri, 10 Jul 2009 09:54:14 +0000 http://www.mahablog.com/?p=6613#comment-624212 <em>The point behind CER is to fund the kind of effectiveness testing that is not being done now and provide that information to doctors and patients, so that doctors and patients can make more informed decisions about what course of treatment to pursue.</em> Factually inaccurate, I'm afraid. It just isn't being done in America now. The treatments paid for by the (British) NHS are determined by NICE - which runs based on the QALY (Quality Adjusted Life Year) and more or less only authorises them if the cost-benefit ratio exceds a certain threshhold (IIRC, 1 QUALY/£30,000). The point behind CER is to fund the kind of effectiveness testing that is not being done now and provide that information to doctors and patients, so that doctors and patients can make more informed decisions about what course of treatment to pursue.

Factually inaccurate, I’m afraid. It just isn’t being done in America now. The treatments paid for by the (British) NHS are determined by NICE – which runs based on the QALY (Quality Adjusted Life Year) and more or less only authorises them if the cost-benefit ratio exceds a certain threshhold (IIRC, 1 QUALY/£30,000).

]]> By: evil is evil http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624200 evil is evil Fri, 10 Jul 2009 01:06:20 +0000 http://www.mahablog.com/?p=6613#comment-624200 Very good post. Now go out and find out who the opponents of single payer are. Rent a HUGE sound system with ENORMOUS speakers, rent a flat bed truck and go to any opposition congress critters and crank the sound up to ten and have someone with a really irritating voice scream at 5 am, "single payer you son of a bitch" or daughter of a bitch if you have LA or AR for a state. This will accomplish more than any petition or calls or the other light weight nonsense that the libs propose. Fuck them, they weren't drafted they sold their souls to be congress critters so waking them and the neighbors up is justified. A youtube of the first one will go viral, have fun and fuck them. Very good post. Now go out and find out who the opponents of single payer are. Rent a HUGE sound system with ENORMOUS speakers, rent a flat bed truck and go to any opposition congress critters and crank the sound up to ten and have someone with a really irritating voice scream at 5 am, “single payer you son of a bitch” or daughter of a bitch if you have LA or AR for a state. This will accomplish more than any petition or calls or the other light weight nonsense that the libs propose.

Fuck them, they weren’t drafted they sold their souls to be congress critters so waking them and the neighbors up is justified.

A youtube of the first one will go viral, have fun and fuck them.

]]> By: Ensign Smith http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624192 Ensign Smith Thu, 09 Jul 2009 19:40:54 +0000 http://www.mahablog.com/?p=6613#comment-624192 I did a bit of number crunching today-- I haven't seen any media mentioning this: The percentage of deaths due to swine flu in the US is 44% of the total swine flu related deaths worldwide. Mexico, for various unsurprising reasons, is 31%. The remaining 25% of all worldwide swine flu related deaths are scattered here & there (Canada 6%, Europe 4%, etc.). The US hasn't even yet hit actual flu season yet. I just find it shocking that the US swine flu fatalities are so high, accounting for almost one half of all the fatalities world wide. Why is that? And why isn't this being reported? I got my numbers from here: http://www.disabled-world.com/health/influenza/swine-flu/cases-statistics.php I did a bit of number crunching today– I haven’t seen any media mentioning this:

The percentage of deaths due to swine flu in the US is 44% of the total swine flu related deaths worldwide.

Mexico, for various unsurprising reasons, is 31%.

The remaining 25% of all worldwide swine flu related deaths are scattered here & there (Canada 6%, Europe 4%, etc.).

The US hasn’t even yet hit actual flu season yet. I just find it shocking that the US swine flu fatalities are so high, accounting for almost one half of all the fatalities world wide. Why is that? And why isn’t this being reported?

I got my numbers from here: http://www.disabled-world.com/health/influenza/swine-flu/cases-statistics.php

]]> By: maha http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624179 maha Thu, 09 Jul 2009 14:55:24 +0000 http://www.mahablog.com/?p=6613#comment-624179 Norris -- Wow, thanks so much for your comment. I'd heard of "medical tourism" but never heard directly from anyone actually doing it. <i>So in essense, we have a rationed healthcare system where those who can afford insurance get good medical treatment..and those who cannot afford it go without.</i> Exactly what I've been saying for years. And you can find right-wingers who will argue that it would be a big mistake to go with a national health care plan, because if everyone has the same access to health care we'll get waiting lines like in Canada. The logic of that always leaves me breathless. Norris — Wow, thanks so much for your comment. I’d heard of “medical tourism” but never heard directly from anyone actually doing it.

So in essense, we have a rationed healthcare system where those who can afford insurance get good medical treatment..and those who cannot afford it go without.

Exactly what I’ve been saying for years. And you can find right-wingers who will argue that it would be a big mistake to go with a national health care plan, because if everyone has the same access to health care we’ll get waiting lines like in Canada. The logic of that always leaves me breathless.

]]> By: Norris Hall http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624175 Norris Hall Thu, 09 Jul 2009 14:10:16 +0000 http://www.mahablog.com/?p=6613#comment-624175 For the past 4 years my wife and I been saving up all our medical and dental problems and making the journey to a Thai hospital where the care is excellent and the cost…just a fraction of what I would have to pay out of pocket in the US. For example, last November I had an Endoscopic balloon dilation for a condition known as dysphagia. The specialist in the US said the operation would cost me $2500. (His bill for the 15 minute consultation was $250.) I decided to wait until I got to Thailand and had it done in at Chulalongkorn public hospital…cost $100 including biopsy. (all I needed for ID was my US passport. No questions asked!!) 7 months later I am happy to report that I am doing fine. Why do we have to travel half way around the world for a procedure that we could have done here in America. Cost. My wife and I are in our 60’s and self employed. Unlike most Americans who work for someone else who foots a large portion of their health care premiums, we pay 100% of everything. And at our age, the best policy we’ve been able to find so far is a Blue shield plan that costs $900 a month and has a $8000 deductible. So we are basically “self insured” America is divided into two groups. Those who have adequate health insurance and those who don't. So in essense, we have a rationed healthcare system where those who can afford insurance get good medical treatment..and those who cannot afford it go without. I highly recommend any American who can’t afford US medical care to look into going overseas. Countries like Thailand, India and Singapore are gearing up to provide top notch medical care at a fraction of the cost in the US citizens like me who are either uninsured or underinsured. For the past 4 years my wife and I been saving up all our medical and dental problems and making the journey to a Thai hospital where the care is excellent and the cost…just a fraction of what I would have to pay out of pocket in the US. For example, last November I had an Endoscopic balloon dilation for a condition known as dysphagia. The specialist in the US said the operation would cost me $2500. (His bill for the 15 minute consultation was $250.) I decided to wait until I got to Thailand and had it done in at Chulalongkorn public hospital…cost $100 including biopsy. (all I needed for ID was my US passport. No questions asked!!)
7 months later I am happy to report that I am doing fine.

Why do we have to travel half way around the world for a procedure that we could have done here in America. Cost.
My wife and I are in our 60’s and self employed. Unlike most Americans who work for someone else who foots a large portion of their health care premiums, we pay 100% of everything. And at our age, the best policy we’ve been able to find so far is a Blue shield plan that costs $900 a month and has a $8000 deductible.

So we are basically “self insured”

America is divided into two groups. Those who have adequate health insurance and those who don’t. So in essense, we have a rationed healthcare system where those who can afford insurance get good medical treatment..and those who cannot afford it go without.

I highly recommend any American who can’t afford US medical care to look into going overseas. Countries like Thailand, India and Singapore are gearing up to provide top notch medical care at a fraction of the cost in the US citizens like me who are either uninsured or underinsured.

]]> By: biggerbox http://www.mahablog.com/2009/07/08/ir-rationing-health-care/comment-page-1/#comment-624157 biggerbox Thu, 09 Jul 2009 01:07:29 +0000 http://www.mahablog.com/?p=6613#comment-624157 The right-wing's opposition to comparative effectiveness research is particularly galling in view of their previous support for Bush's health "plan", health care savings accounts, which supposedly would enable "consumer-driven" health care because we'd all be making our own decisions about what treatments to get. Assuming they all think that would still be a good idea, just HOW do they think we consumers are supposed to make decisions about which treatment to spend our hard-earned money on, if we don't do research into what is most effective for the money? Is it more of that famous right-wing "going with your gut" thing or something? Of course, logical consistency is not something they worry about, which is how they can currently be complaining that private insurance will be put out of business by people all rushing into a public plan that won't pay for a whole bunch of treatments that people want to have. (There would be no way for private insurers to get people to opt for their plans which WOULD cover the treatments people want, presumably? It's confusing.) Lying scumbags, that's what they are. The right-wing’s opposition to comparative effectiveness research is particularly galling in view of their previous support for Bush’s health “plan”, health care savings accounts, which supposedly would enable “consumer-driven” health care because we’d all be making our own decisions about what treatments to get.

Assuming they all think that would still be a good idea, just HOW do they think we consumers are supposed to make decisions about which treatment to spend our hard-earned money on, if we don’t do research into what is most effective for the money? Is it more of that famous right-wing “going with your gut” thing or something?

Of course, logical consistency is not something they worry about, which is how they can currently be complaining that private insurance will be put out of business by people all rushing into a public plan that won’t pay for a whole bunch of treatments that people want to have. (There would be no way for private insurers to get people to opt for their plans which WOULD cover the treatments people want, presumably? It’s confusing.)

Lying scumbags, that’s what they are.

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