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Roger Ebert adds to health care debate on iPhone, Mac use - Page 2

post #41 of 148
He and his wife are good people.

post #42 of 148
Part of my job requires reading a lot of tedious information that, day after day, can really put me to sleep, not to mention strain my eyes.

I've been using the speech utility in OS X for a few months now almost every day and, despite a few mistakes here and there, it's near perfect. There are grammatical nuances that I suspect it won't get right that it usually does and the voices are pleasant enough.
post #43 of 148
[QUOTE=success;1485432]He and his wife are good people.

Really the poor guy has had some pretty drastic surgery and we all wish him well! He has given us some great film advice over a long career and it was always a joy to wait for that theme music and see which way the thumbs went!
post #44 of 148
I'm sure if it was solely up to the health insurance company, they would give you a Mac, because it is cheaper, and they are paying. But as the article says, it is a government rule that forces them to give these locked down $8000 boxes. So isn't this an example of how government involvement is worse than pure private sector?
post #45 of 148
"Critics suggest that any cuts to the status quo of Medicare spending, which would impact a variety of connected companies like DynaVox and Prentke Romich, might instead result in a government euthanasia program that uses death panels to slaughter old people."

Why write, "critics"? Just name them. And it's so ridiculously false, why are journalist repeating this BS propaganda over and over again. Just don't give a voice to the village idiots and lying propagandists.
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post #46 of 148
What "kills" me (pun intended) is that anyone, Dem or Rep., liberal or conservative, would believe and/or repeat anything that Sarah Palin wrote on Facebook. She posted "death panels" and everyone threw up their hands and screamed like a little girl. She's an idiot, a failure (couldn't finish 1 term as Governor), a vapid air-head who "reads everything." God, people. I don't care what side of the argument you're on, but don't quote the village idiot to prove your points.

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post #47 of 148
Quote:
Originally Posted by Neruda View Post

You're welcome, BUT

Just because healthcare system X works in country A does not necessarily mean that system X will work in an entirely different country (B). Healthcare might be great in socialist countries, but if that is the price to pay for universal healthcare than I say no thanks.

The US already spends around 15% of GDP on healthcare. In my opinion, in the US the term government efficiency is an oxymoron (this article is a perfect example of that). Expect the percentage of GDP to increase if any type government run healthcare system is instituted in the US. Let's make the national deficit worse by paying for healthcare with money the government doesn't have.


You're right ... let's just keep bailing out the greedy banking, financial and insurance industries with tax $$$$ we haven't even raised yet, (some of which comes from people with health problems) and say to hell with sick people. After all, what's government for anyway?
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post #48 of 148
Quote:
Originally Posted by enzos View Post

On the contrary, governments can and do run health programs effectively. In most of the *civilized* world, governments guarantee essential healthcare and do so for a small fraction of the per GDP cost that the for-profit private system in the USA can manage. Moreover, it's not just a matter of cost, it's also a matter of quality: people who live under universal healthcare systems live longer than Americans do (look up the WHO tables) and it is widely recognized that life expectancy is predicated by the quality and availability of health-care.

indeed. EVERY developed country has realised this, but america (with its pathological obsession with the "S" word) continues to paint itself into corners, trying to fit square pegs into round holes
post #49 of 148
Quote:
Originally Posted by JavaCowboy View Post

Before making broad-reaching statements, could the Americans in the forums who have convinced themselves that "the government will run health care into the ground" research health care systems in other countries before commenting further?

Thanks!

Wise words. I my self live in The Netherlands and our healthcare is one of the best in the world. It is beyond my comprehension how people can be so against government run healthcare.

In The Netherlands the health insurance is paid by the employee not the company this used to be the other way around. Now a days I pay ±130 euros a month, the medical coverage that I get is unimaginable for about 80% of all US citizens.

Every system has its flaws no system is perfect. But all I can say to the, mainly republicans, come take a look at the system we have. You'll see that the insurance companies are booming and that a system run by both the government and the insurance companies does actually work.
post #50 of 148
Quote:
Originally Posted by crees! View Post

What people fear is gov't running private insurers out of business. And there's plenty of audio and video out there that vaildates those fears. Medicare is in such bad shape because Gov't can't run programs effectively, period. All the mandates and regulations are what brings down the system. To quote a wise man, "Everyday Congress meets we lose a little bit more of our liberty."

Well, we have gov't subsidized healthcare up here in Canada. It isn't perfect, but we wouldn't trade it for anything. We remain in full, wholehearted support of it. You don't need to take out a second mortgage to get surgery. It isn't about losing "liberty", it's about ensuring that there's a level of equality when it comes to healthcare. It's about having government perform its rightful function. This is what government is for. It's a humanitarian principle. Adequate, universal healthcare is a right.

Reserving the best level of healthcare for those who can afford it, is absolutely wrong. It isn't a product. It's not an upper-tier gym membership. It's not a commodity. It's a basic need.

Another example - not related to heathcare:

Our airports used to be gov't subsidized, until around the mid 90's. The National Airports Policy was a program of the Government of Canada involving the privatization or private operation of nearly all of our airports. Many of us were against the idea. A controversial policy, to say the least, because of the resulting huge increases in airport fees that came from the inability of airports to meet infrastructure requirements. For example, the fees charged to carriers and general aviation by the Greater Toronto Airports Authority at Toronto Pearson International Airport are among the highest in the world. The Liberal Transport Minister who oversaw the creation of the policy later said it was the worst decision of his career and that he regretted its implementation.
post #51 of 148
Quote:
Originally Posted by jonnyboy View Post

indeed. EVERY developed country has realised this, but america (with its pathological obsession with the "S" word) continues to paint itself into corners, trying to fit square pegs into round holes

Ah, you brought up the "S" word. And you're right. Just to expand on it a bit . . .

Government subsidization of a particular sector of the economy is not Socialism. It's part of a mixed economy.

In Canada, for example, we have government subsidization of our health care. It's not perfect, but at least we don't need to take out a second mortgage in order to get surgery. Quite frankly, we wouldn't have it any other way. That's about it. Aside from the regular gamut of programs any other Western democracy implements, Canada is just as capitalist as any other country.

In fact:

http://innovate.typepad.com/innovati...ntreprene.html

There are socialist elements at work in many democracies and "Westernized" nations. Most of them have mixed economies.

Every country has elements of socialism and capitalism. For example the 'capitalists' in Japan have much more govt involvement in business than Canada.

There's not a single country in the world that is purely capitalist (even Hong Kong has some government intervention in its economy), just as there's not a single purely socialist country (even at the height of Communism, China had at least some private sector).

Most developed countries have a mixed economy.
post #52 of 148
great article. This is an awesome example of why cost-effectiveness studies are incredibly important.
post #53 of 148
Quote:
Originally Posted by powqjfojqpof View Post

From the article: "Government rules require the PC be disabled from doing anything other than speech"

My question: SO, on what page of Obama's proposed plan does he specifically say he wants to change this rule?

This assumes there is such a rule and this is not some bizarre interpretation.

I worked for the Forest Service back in the mid 1990s in California; our job was to prevent loggers from disturbing archeological sites per the Antiquities Act of 1906. While the Antiquities Act of 1906 itself was sound the interpretation tended to be so Bizzaro World that we jokingly said we worked for the Forest Circus.

For example, we would often survey an area the loggers had already been in and find previous covered neolithics meaning the area was an 'archeological site' and so was protected. Since our bosses names were Tom and Berry any time we had to do this piece of insanity we would jokingly say "it's time for the Tom and Berry show".

To be fair to Tom and Berry they were simply following the interpretation handed down from their superiors. There was and still is nothing in the Antiquities Act of 1906 that requires it ti be enforced in such a loopy way.
post #54 of 148
Quote:
Originally Posted by souliisoul View Post

Stop name calling and get your facts right with concern to comparing healthcare systems with US.

Thank you souliisoul. Personal attacks are unnecessary and are a poor substitute for well reasoned/cogent arguments.

Quote:
Originally Posted by souliisoul

So before you start comparing Thailand's healthcare with USA, just remember what you are comparing, since poor Thai people are NOT getting a good deal, but hey as long as you are happy thats great.

That was part of my original point. Just because a healthcare system in another country supposedly works that does not necessarily mean that this system would work in the US.

Techstud: You asked me what I thought of people that believed in this.
Three points:
1. Anyone who seriously views President Obama in that way is clearly ignorant, IMO (see my comments above on personal attacks). But this is a free country and the free expression of ideas will produce some ideas that most would consider distasteful.

2. Why ask me that question? Do you automatically associate those who oppose Obama's policies with that image? Everyone who opposes Obama's healthcare policy is a racist kook?

3. I actually agree that some aspects of the healthcare system needs to be reformed, but a large % of Americans (around 80% by most estimates) are satisfied with the healthcare that they already have. I am in that majority and I don't want the government "fixing" what doesn't need to be fixed. Leave what works alone and fix what needs fixing.
post #55 of 148
Quote:
Originally Posted by crees! View Post

What people fear is gov't running private insurers out of business.

The company that I pay $100s pewr month just to be told that I cant get the drug I need for a rare condition? the company that made me participate iin a test experiment, telling me that if the test drug didnt work I could get what the doc ordered? the company that denied me even after I did the test drug program and got no results? thecompany that literally told me "call the drug maker and get on their charity program"?

I say fuck them, burn the place down and I will piss on the ashes...
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post #56 of 148
Quote:
Originally Posted by crees! View Post

What people fear is gov't running private insurers out of business. And there's plenty of audio and video out there that vaildates those fears. Medicare is in such bad shape because Gov't can't run programs effectively, period. All the mandates and regulations are what brings down the system. To quote a wise man, "Everyday Congress meets we lose a little bit more of our liberty."

Wow! Deep. Dropping some knowledge.
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post #57 of 148
Quote:
Originally Posted by a_greer View Post

The company that I pay $100s pewr month just to be told that I cant get the drug I need for a rare condition? the company that made me participate iin a test experiment, telling me that if the test drug didnt work I could get what the doc ordered? the company that denied me even after I did the test drug program and got no results? thecompany that literally told me "call the drug maker and get on their charity program"?

I say fuck them, burn the place down and I will piss on the ashes...

Wow! They did you dirty. That's messed up
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post #58 of 148
Quote:
Originally Posted by jonnyboy View Post

indeed. EVERY developed country has realised this, but america (with its pathological obsession with the "S" word) continues to paint itself into corners, trying to fit square pegs into round holes

As a conservative, former republican, the use of the S word in this debate offends me. Was it socialist when the government backed and largely financed the intercontenental railroad? how about the interstate system? and airports, sure the airlines are not government companies, but the airports are run by their respective cities, with massive support from FAA.

We have the best higher ed in the world here, and it is a mix of public and private universities, has Penn State put Harvard out of business? I dont thinkl so...Has Indiana University put Notre Dame under? nope...

also, lets stop government run tap water! having teh city manage the water and charge each user a fee equal to their use is socialism! it is anti competitive! we need Evion taps in every house. get the government out of our toilets!!

The republicans are just trying to protect their puppet masters...er uh...donars, the insurance companies.
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post #59 of 148
Quote:
Originally Posted by Quadra 610 View Post

It isn't about losing "liberty", it's about ensuring that there's a level of equality when it comes to healthcare. It's about having government perform its rightful function. This is what government is for. It's a humanitarian principle. Adequate, universal healthcare is a right.

I don't think it's as clear cut as you make out. How do we know equality is moral? Some people would say that taking money off someone who earned it (to create the equality) is immoral.

And how do we know what is and is not a proper function of government? It's a grey area and I don't think either side is *obviously* wrong.
post #60 of 148
Quote:
Originally Posted by Neruda View Post

You're welcome, BUT

Just because healthcare system X works in country A does not necessarily mean that system X will work in an entirely different country (B). Healthcare might be great in socialist countries, but if that is the price to pay for universal healthcare than I say no thanks.

The US already spends around 15% of GDP on healthcare. In my opinion, in the US the term government efficiency is an oxymoron (this article is a perfect example of that). Expect the percentage of GDP to increase if any type government run healthcare system is instituted in the US. Let's make the national deficit worse by paying for healthcare with money the government doesn't have.

On the contrary, Medicare waste, fraud and abuse is about 33% of every dollar spent, on the other hand Private insurance waste, fraud and abuse is about 50%. Also, 62% of all bankruptcies are due to medical expenses, 50% of all bankruptcies are due to medical expenses where the person HAD insurance!

Something is amiss, afoot, alas! All those bankruptcies that are 'written off' are paid by the rest of us (Republicans and Democrats, Conservatives and Liberals) through higher premiums and higher costs per procedure or hospital stay.

Let's let the banks run our mortgages that went well! Home Equity down 60%

Let's let Wall Street run our 401K's that went well! 401K's down 40%-50%

Now let's have the Insurance Companies run our health insurance, er...anyone see a pattern here where insurance companies are making record profits but 50% of bankruptcies are due to medical expenses where the person HAD insurance?
post #61 of 148
As the old saying goes (in politics any ways), "It's not who you know, but who you blow."

All you have to do, is ask your father, your brother, your mother (which ever one is a politician) - to help get funding for "This product" they sell.

Tell the politician -"It will bring jobs to the area" (even if it is only one in the end)

To any one,and I mean ANYONE who thinks politicians aren't ALL crooked wake the f&uck up!

Yes, they all try and make it seem real, and honest "I'll vote for your bill, if you help me get mine past". It doesn't matter what the bills are for or about!

If you REALLY want to get pissed off at these folks, and our government (you and me), then look at what these folks make for pensions. If that doesn't piss you off, nothing will.

I think, a politician should make the same amount as the folks they represent. They should get the same pension as the folks that the represent get.

And this comes out of each and everyone of OUR pockets!

- http://www.snopes.com/politics/socia...y/pensions.asp


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post #62 of 148
This could go on forever and probably will...
On one side we have Republicans who are basing decisions on opinions, fear of the unknown and Ideology. On the other side we have democrats basing decisions on numbers, examples from around the world and reality.

No one really knows how things would turn out if we had a public option but based on the decision making process above, i will go with the latter.

Contrary to what someone posted early in this thread, there actually isnt a mass of audio and video evidence that shows a public option wont work. This is a myth started by the GOP that has never been backed up.
post #63 of 148
Quote:
Originally Posted by a_greer View Post

The republicans are just trying to protect their puppet masters...er uh...donars, the insurance companies.

Funny, the insurance companies are on board with the Obama admin and going to spend hundreds of millions this fall on campaigning for Obamacare. They don't like the public option but why support insurance reform? Easy, think of the Billions they can rake in if a mandate passes and 20 million young people and/or well off people who choose not to have insurance are mandated to buy insurance. You have to ask yourself why the insurance companies would be perfectly happy to be publicly excoriated in this whole debate yet be willing to spend millions to support it.

As to Medicare being the model to go by and all this money we can save in inefficiencies and fraud, why not do this for medicare right now? If it is so easy to gain billions just by doing some simple steps why not reform Medicare now and once the government has shown it can actually fix something in the healthcare industry then move on to "fixing" the rest of the system? The simple answer is they don't expect they can actually fix anything so they had better "fix" the whole system before it gets exposed that that can't fix anything to make it work better.
post #64 of 148
I'm a foreigner, so of course I'm evil and red.

Sometimes, when I'm evil, I hope you will keep your old dated medical system and all the crazy corporate schemes and cost. because, a stronger and better America would be too much awesome for my little country to absorb.

Federal regulations will not strip liberty to pay whatever you want for anything you want. It will keep stealth at bay and help to spend money MORE EFFICIENTLY (translation : to help and save more people).

Another thing, I know it's sometime unbelievable but in some foreign country, people can be happy, the state is not a malevolent entity and children are laughing. yeah. Ho! and yes, we have huge debate about politics too.


Good Luck.
post #65 of 148
Quote:
Originally Posted by newbee View Post

You're right ... let's just keep bailing out the greedy banking, financial and insurance industries with tax $$$$ we haven't even raised yet, (some of which comes from people with health problems...

Way to jump to conclusions. What makes you think that I was/was not opposed to the government bailouts (I made no mention of this)? I was against it (for similar reasons). But at least there is a better chance that government will get its money back from the TARP bailouts.
post #66 of 148
Ebert writes "Its stupid of insurance companies to insist on an inferior device costing 10 times as much."

Of course it is ... and the government is much worse, paying far more for inexpensive items.

On the other hand, Ebert makes enough money to afford the iPhone, so why should the insurance company pay for it in the first place? Oh, that's right ... he was paying premiums for years, like many others.

Sometimes the simple approach is the best, and Ebert has for his condition, found that solution. There are thousands of others in the same situation which makes the whole health care debate complicated.

But what is not complicated is using technology to reduce the cost of health care significantly. This is one example, and eliminating the huge administrative expense (20% I believe) would help even more.

We can fix health care without bankrupting the country (which is what Obama's plan is likely to do).

Let's fix the waste and administrative part first before we spend a trillion dollars "hoping" a plan put together by a group of people who haven't held a real job in years (politicians). Medicare and Medicaid are in bad shape? Does anyone wonder why? They are government managed programs, that's why. The government is not the solution. They can barely keep pot holes fixed, let alone manage the complexities of health care.
post #67 of 148
Quote:
Originally Posted by freeny View Post

This could go on forever and probably will...
On one side we have Republicans who are basing decisions on opinions, fear of the unknown and Ideology. On the other side we have democrats basing decisions on numbers, examples from around the world and reality.

Riiiiiiight. It really is that simple. Belittle whomever you disagree with. There are legitimate arguments on both sides of this debate, pro & con. That does not mean that one side is stupid and the other is rational (based solely on your ideological predilections). I don't agree with all of the healthcare reform proposals that are being suggested by Congress and the President, but there are things that I do agree with. It is not all black and white.
post #68 of 148
Quote:
Originally Posted by justbobf View Post

One more thought...

While Roger Ebert may be able to use an iPhone, I'll bet many people with speaking disorders also have other problems that would prevent them from using a tiny keyboard. I'm guessing that that $8,000 "device" has software that allow quicker access to common words and even sentences, so that those people can "speak" as well as hear. They may even come with something that allows for input with a stylus.

I remember Stephen (sp?) Hawking had some sort of contraption hooked up to his wheelchair.

Check out Apple's iPhone accessibility video. They've designed so that even people who are blind can use it. To use the keyboard, you drag your finger around the keyboard and it speaks the letters. You let go once you find the letter. Not as fast as using it visually, of course, but if you watch the video, it works pretty well.
post #69 of 148
Quote:
Originally Posted by Neruda View Post

Just because healthcare system X works in country A does not necessarily mean that system X will work in an entirely different country (B). Healthcare might be great in socialist countries, but if that is the price to pay for universal healthcare than I say no thanks.

Ah, I see the U.S. is such a special country, it really cannot be compared with other countries. There is the U.S. and then there are the 'socialist' countries. And what for you defines whether a country belongs to the second category?
If we look at one simple measure of state involvement in the economy, tax revenue as a percentage of GDP, the U.S. comes in at 28%, the EU-15 at 40%, and the UK at 37%, 2006 data (http://stats.oecd.org/Index.aspx?datasetcode=SNA_TABLE1). So when does socialism start for you, at 30%? Ups, the U.S. hit that in 2000, or at 35%. Then the UK stopped being a socialist countries for a few years in the early nineties. And Switzerland never exceed 30% but everybody has health insurance there.

I would be really careful to call European countries socialist. If you had ever lived in a truly socialist country (eg, eastern Europe up to 1989), you would probably feel insulted by the notion of calling today's European nations socialist.
post #70 of 148
DynaVox and Prentke Romich make me sick.

It's funny that frequently the people complaining (loudly!) about government excess and waste are the same asshats that that run companies that overcharge the government for products, like $500 hammers and $8,000 PCs that suck horribly compared to modern Macs.

Way to be a part of the solution, asshats!
post #71 of 148
May I just interject and say for this public healthcare thing, while of course you cannot just import systems directly from other countries, many countries have worked out a system where the government healthcare is to provide a baseline "safety net", while private health insurance helps as a "premium".

Both public and private health insurance can coexist well and private health insurance can still be profitable and those companies can succeed.

The core problem especially for mental health problems (eg. poor, homeless, etc.) in the US as I observe (as an outsider, admittedly) is that there is no baseline "safety net" for those who are really down and out.

Australia and Europe, etc. are not perfect systems. But Australia for example, government assistance is focused on giving you that last line in the sand before you go from poor to totally f*ed and destitute. For those with income, better jobs, fine, you can still have private health insurance for dental, paying for other medication that is not covered under government schemes.

A weird analogy, but perhaps think of it as government gives you a Macbook-level of coverage, to almost everyone, while if you decide to "top up" with private health insurance you can get a MacBook Pro 13" or 15" level of coverage.

Now of course whether or not Obama is implementing/ communicating all this, I do not know, as I am not up to date. I do think his next term will be quite dependent on whether this healthcare reform thing goes "well" for him.
post #72 of 148
BTW, I've heard starting outrageous wars in foreign countries on thin evidence are more likely to bankrupt a nation than trying to provide basic, "developed nation" healthcare for its citizens.
post #73 of 148
Quote:
Originally Posted by axual View Post

...But what is not complicated is using technology to reduce the cost of health care significantly. This is one example, and eliminating the huge administrative expense (20% I believe) would help even more.

We can fix health care without bankrupting the country (which is what Obama's plan is likely to do).

Let's fix the waste and administrative part first before we spend a trillion dollars "hoping" a plan put together by a group of people who haven't held a real job in years (politicians). Medicare and Medicaid are in bad shape? Does anyone wonder why? They are government managed programs, that's why. The government is not the solution. They can barely keep pot holes fixed, let alone manage the complexities of health care.

If the government is not the solution, and private health insurance doesn't provide all the answers, what is the solution? Trimming administrative expenses are of course essential in any overhaul but maybe like a Windows machine you could defrag and antivirus but sometimes you just need to format-reinstall.

I still think there needs to be a simple thrust to the healthcare thing. Government provides the basic level support while private health is there for those who want more "premium" services.

A "government hospital" provides essential services. If you want something fancier, eg. a room for yourself to recover after surgery instead of sharing with 5 other people, then you can go to a "private hospital".

Again, let me know if I'm making sense or not.
post #74 of 148
Quote:
Originally Posted by axual View Post

...On the other hand, Ebert makes enough money to afford the iPhone, so why should the insurance company pay for it in the first place? Oh, that's right ... he was paying premiums for years, like many others.....

I'm not sure what you are getting at here. If I have been paying premiums for years for private health insurance, and then a situation arises where I can make claims, then I should be eligible to claim for it, whether I am earning $1 a year or $1 million... Isn't that the whole purpose of "insurance", to "ensure" that you *will* be covered in any situation that meets the terms of coverage? An income test is not usually applied for private health insurance.

If the government had to pay for it then income tests should apply. Yes OMFG socialism we r punish the rich! ... For the government, healthcare should not be insurance as such (which is a kind of gamble of paying a certain amount with a view to recouping that amount at later dates) but a basic right for residents that cannot afford basic healthcare themselves.

Again, feel free to debate my points. Just laying out a few thoughts and feelings here.

That thing about society will be judged on how it treats the lesser of its members.
post #75 of 148
Quote:
Originally Posted by bedouin View Post

Part of my job requires reading a lot of tedious information that, day after day, can really put me to sleep, not to mention strain my eyes.

I've been using the speech utility in OS X for a few months now almost every day and, despite a few mistakes here and there, it's near perfect. There are grammatical nuances that I suspect it won't get right that it usually does and the voices are pleasant enough.

I've always thought (no disrespect to the man) that Stephen Hawking's chair-voice thing was pretty lousy. Shouldn't he just cruise around now with a MacBook Pro and the chair? Surely he would be happier and more productive and more genius-like. He could do all the fancy Unix stuff (if Cocoa programming is "beneath" him) to enhance his Mac-driven Hawkingmobile.

The Leopard voice (the new one they introduced in Leopard) is one of the most pleasant and humane (sic) of any speech synthesis I know of.
post #76 of 148
I find some of this debate laughable every time I hear the word socialism. If some of you are so afraid of it then you should also kill any government run program like Medicaid, Social Security, taxes, defense spending, etc. The truth is that pure democracy and pure socialism are wrong and it is the mixture of both that works.

As to a post earlier on this thread that said universal health care will bankrupt this country, this is untrue and is currently a reality already for tens of thousands of America every year who go broke from medical costs.
post #77 of 148
Quote:
Originally Posted by TBell View Post

Not sure what you mean by Medicare being in Bad shape. If you ask most people who are on Medicare they will tell you that they prefer it over private insurance. The reality, however, is many people don't understand the government runs Medicare. The above example of not using cheaper technology just because it has other benefits if true, however, is plain outrageous. I suspect this has more to do with a certain companies lobbying efforts then anything. If true, that really is the problem: private and political greed.

I also do not see how the government can ruin the heath care system much more then it already is. In the very least, all insurance companies should be required to be made non profit. It is outrageous that CEO are raking in billions, while many people are going without insurance.

Most people can't afford private insurance nowadays. It used to be employers would pay for it. That more an more is becoming not the case as employers look there first to cut costs.


A single payer system is the way to go. People shouldn't have to worry about health care. It should be a right. Society would be much better off.

Its clear that you have not worked with Medicare on the provider side - I have. It is in very bad shape. On the consumer side, at the moment, it can indeed be a very good program. On the consumer side, one reason it works is that it is basically an 80/20 system which insures that the users have a reason to try and control costs. Those you love it have a co-plan (which are in danger of being eliminate in current proposals) which pick up the 20 %. Please note that most people today won't put up with an 80/20 plan from their employer, they want very small co-pays which eliminated an market control on prices and use of the system.

Getting back to the provider side, the reason Medicare seems to work is that they dictate prices on a cost+ basis (and due to gaming of the system on both sides its actually cost-). At its basic level the formula for setting the price Medicare is based on cost numbers provided to CMS (Center for Medicare and Medicaid Services) by providers (hospital, physicians, etc.) CMS then takes geographic averages, multiplies by some factor around 1.0 and the says this is what the official price for this service will be. Medicare administrators, like Blue Cross, Aetna, etc. (yes Medicare at the consumer level is usually administered by private contractors) then negotiate a reduced payment (typically 80% of this number) to providers.

You might say 'Wow this should control costs' and you would be hideously wrong. If this system actually worked this way the providers would go out of business as their costs would end up being larger than their payments. What do they do - they artificially raise their costs estimates to survive, or they simply overcharge medicare and then accept a reduced payment, which is more than the official prices. Take any physician that will be honest with you and ask them how consistent their charges are to different patient groups. Usually, if you go in without insurance they will charge you significantly less - why? Because they're nice guys? Hardly, they know you will pay 100% of what they charge while insurers will only pay in part.

Now, look at the future of Medicare. President Obama himself, in the same speech in which he held up Medicare as a shining example on one hand, called Medicare the biggest stone around our neck with over $30 Trillion (yes trillion) in unfunded future liabilities. Why is this? because the 'insurance' your paying in your paycheck (which, by the way lowers your ability to get better insurance for yourself as it is funded by the Company by lowering your take home) is being used to pay for today's care for others which is unsustainable in the long run. It is, in any other venue, a ponzie scheme

As to a single payer system, even if the most extreme version of this legislation is passed, it will never exist in the US (nor does it in any other country). The wealthy, powerful, elite, politicians of any system will always (and do always) have access to private care. Congress has already provided for this as Congress' healthcare had been made basically exempt from this legislation. This private care will be even more accessible to those that can afford it once the rest of the population is taken care of by the more restrictive single payer. This now exists is Spain, where everyone one of the high net-work individuals I worked with always went to the system of private clinics when they needed care. Also consider that most of the good physicians in Spain consider it essential to work at least part time in the private system as that is where the physicians actually make money. This same duality exists in the UK as well ( at a higher level) and I suspect elsewhere as well.

Are there solutions, of course. The first is to get the right cart before the right horse. All current proposal follow this pattern - get everyone insured (by force if necessary) and lower costs will follow. The right order is - get costs lowered and the number of insured will increase. It will take longer and is therefore less politically acceptable but is will end up with a better, sustainable system.

How to lower costs - 1) Tort reform. It is agreed by all parties that this action will significantly lower costs ($65 - $200 billion/year) but congress (Both Sides) will not take on the the Tort lobby, as was admitted to by Howard Dean in one of his town hall meetings. This is simply shameful conflict of interest on the part of lawyers in congress. 2) Allow cross-state competition for health insurance. This is an artificial barrier to competition. 3) eliminate co-pays and go back to an 80/20 (or whatever percentage you want to pay for) system. In reality your costs of health care won't go up as you will have more disposable income to pay your 20% as insurance costs go down and the actually consumer of the product will have incentive to control the costs. 4) Eliminate the tax differential between employer provided and self provided insurance. Either tax it all or none of it, I wouldn't care.

Even if you support the current approach being debated (and realize that at this point the majority of American don't) you should be lobbying heavily to have the above provisions added. The current legislation has no real solutions to lower costs. Getting 'Industry' to commit to lowering costs is a red-herring unless there are specifics provided as to method, of which there are none.
post #78 of 148
You couldn't get public libraries through Congress today. That's how low we've sunk.

The Medicare trust fund isn't going broke because the program is inefficient. In fact it's far more efficient than private medical insurance. It's going broke because Uncle Sugar doesn't want to raise taxes to pay for it. It's much easier for our friends in Congress to pretend that we don't actually have to pay for services rendered by the government. Nobody really wants to talk about this issue.
Please don't be insane.
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Please don't be insane.
Reply
post #79 of 148
Quote:
Originally Posted by nvidia2008 View Post

May I just interject and say for this public healthcare thing, while of course you cannot just import systems directly from other countries, many countries have worked out a system where the government healthcare is to provide a baseline "safety net", while private health insurance helps as a "premium".

Both public and private health insurance can coexist well and private health insurance can still be profitable and those companies can succeed.

The core problem especially for mental health problems (eg. poor, homeless, etc.) in the US as I observe (as an outsider, admittedly) is that there is no baseline "safety net" for those who are really down and out.

Australia and Europe, etc. are not perfect systems. But Australia for example, government assistance is focused on giving you that last line in the sand before you go from poor to totally f*ed and destitute. For those with income, better jobs, fine, you can still have private health insurance for dental, paying for other medication that is not covered under government schemes.

A weird analogy, but perhaps think of it as government gives you a Macbook-level of coverage, to almost everyone, while if you decide to "top up" with private health insurance you can get a MacBook Pro 13" or 15" level of coverage.

Now of course whether or not Obama is implementing/ communicating all this, I do not know, as I am not up to date. I do think his next term will be quite dependent on whether this healthcare reform thing goes "well" for him.

Good points and especially about Australia, lived there for nearly 2 yrs, after leaving USA and I much prefer the top up system, then ever you pay for it all or get screwed (okay, you don't pay for it all, but you know what I mean).

Quote:
Originally Posted by nvidia2008 View Post

BTW, I've heard starting outrageous wars in foreign countries on thin evidence are more likely to bankrupt a nation than trying to provide basic, "developed nation" healthcare for its citizens.

Probably more to be called a 'liar' as well.

Anyway my beloved Apple will save the day, we will provide an innovative healthcare system that uses iPod/iPhone to undertake at home diagnosis and transmit that to doctors in different location. The Apple Store will send out immediate medication to the patients in less than 20 minutes from any location.

The macbook tablet can act like CT scan, X-Ray etc and provide on the spot scans for any part of the body
post #80 of 148
Quote:
Originally Posted by nitewing98 View Post

What "kills" me (pun intended) is that anyone, Dem or Rep., liberal or conservative, would believe and/or repeat anything that Sarah Palin wrote on Facebook. She posted "death panels" and everyone threw up their hands and screamed like a little girl. She's an idiot, a failure (couldn't finish 1 term as Governor), a vapid air-head who "reads everything." God, people. I don't care what side of the argument you're on, but don't quote the village idiot to prove your points.

Next

I would like to second this notion. Sarah Palin is not what Republicans should be looking for in a leader. There is no way, no how, that she will ever be elected again to any office. She's washed up, and if my fellow Republicans think she is the future, we are all in big trouble.
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