 | Rising Energy Costs and the Future of Hospital Work | The Oil Drum | The U. S. Electric Grid: Will It Be Our Undoing? |  |
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sarcasm on
Wow, that is a real pity. There are so many Americans who burn grain (e.g. corn) for a nice warm and toasty house. They do not burn the cob, or stalk, Oh No! - that creates messy ash, they burn the grain straight. It only costs a couple of bucks for a whole drumful you know.
Now the cost of fertilizer is up and not enough is being planted. The cost may go to $8 for a drum of corn. We cannot pay that, where is my heating fuel assistance. We burn 10 drums a day and shall not go down to 8 drums without a fight.
Oh and we heard that the government (Medicare and Medicaid) was going to limit payments for triple bypass heart surgeries to $5 million for those > 80 years old. What is the world coming to? Rationing of care for Grandma ( sotto voce - the bitch has Alzheimer's anyway). Throw the rascals out!
sarcasm off
Medicare and Medicaid will never be able to ration explicitly-- there is too much politics, too many lawyers. What they do is reduce the payments, and increase the length of time for payment, which has the same effect. (Fewer people want to provide the service.)
I think we may be approaching "peak medicine" as well as peak everything else. There is far too much medical care, and much of it goes to the wrong places, but there doesn't seem to be any greater likelihood of a rational response here than in any other complex social undertaking. Medicine has been completely corporatized, and dominated by need for short term profit.
IMHO there seems to be an irrational obsession with medical care. People realize logically that advanced medical care is not the most important contributor to human health, yet there is still this emotional attachment. Example: Michael Moore is great, and SICKO is a great movie, but logically if the guy is concerned with health he should immediately drop many pounds, because what medical spending can do to help most people is greatly exaggerated.
Absolutely true. But if you can sell people on the need for products to decrease underarm odor or fly-away hair, you can sell them on "better health" a lot more easily. Especially if they don't have to pay directly for it.
Medical care is important at a basic level (probably less so than good public health) -- but it has gone insane because the purpose of it has been forgotten in the rush to make money. "Healthcare" is right up there with "defense" as a money machine.
There was an article in the NYT that said that home oxygen companies were charging medicare twice RETAIL costs for oxygen supply/delivery. When one congressmen tried to change that, they created a whole advertizing campaign that basically made him look like he didn't about old people, and if I remember correctly, the guy lost his reelection. This is endemic in the medicare system. You also had the NY healthcare unions doing the same shtick when Spitzer tried to close underutilized hospitals. And of course, who could forget the $100+ million dollar particle accelerators to diagnose cancer, even though there's no evidence it's any better than a regular CT scan/MRI in all but a few rare cancers, that all of a sudden every hospital needs (the hospital equivilant of a Hummer, basically).
I don't see how we can switch to a universal healthcare system when the existing system in place today rips off the government for untold billions of dollars.
I don't see how we can switch to a universal healthcare system when the existing system in place today rips off the government for untold billions of dollars.
About the only way I can see is that the accounting for the system is 100% transparent.
Transparency is important. But the problem is that we don't live in a world where everybody has perfect information, so if a doctor tells you you need something more expesive (like a proton beam thearpy? from the $100 million particle accelerator) when you don't need it, all the transparcency in the world won't change that.
In the US:
http://www.centerjd.org/MB_2007medmal.htm#_edn31
And yet, it it illegal to set up a database of the doctors and their malpractice rates and sell access to the public.
So yea - far from ANY 'perfect information'. Having information is needed for "the market" to work - yet the jabbering fools call for more of 'the market' as 'the solution'.
Kinda like how Creekstone farms can't advertise how they have tested their meat for BSE.
http://firedoglake.com/2007/05/31/cognitive-dissonance/#comments
Ask Canada, or most of Europe.
Or Harvard Medical School, among a variety of other groups who've done studies.
The short form is that the US system is highly fragmented, which leads to a heavy paperwork load. There's also a heavy advertising overhead, which doesn't really exist in most other countries. Most of that is unnecessary, meaning literally hundreds of billions could be saved even while extending care to the tens of millions of uninsured, and keeping the quality of care as high for everyone.