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189 comments on DrumBeat: May 11, 2008

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NeverLNG on May 11, 2008 - 11:35am Permalink | Subthread | Parent | Comments top

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.

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BrianT on May 11, 2008 - 11:42am Permalink | Subthread | Parent | Comments top

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.

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NeverLNG on May 11, 2008 - 11:52am Permalink | Subthread | Parent | Comments top

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.

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Daxtatter on May 11, 2008 - 4:39pm Permalink | Subthread | Parent | Comments top

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.

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eric blair on May 11, 2008 - 5:07pm Permalink | Subthread | Parent | Comments top

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.

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Daxtatter on May 11, 2008 - 5:36pm Permalink | Subthread | Parent | Comments top

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.

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eric blair on May 11, 2008 - 6:43pm Permalink | Subthread | Parent | Comments top

In the US:

From 1991 to 2005, only 5.9 percent of doctors were responsible for 57.8 percent of malpractice payments. Each of those doctors made at least two payments.

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

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Pitt the Elder on May 11, 2008 - 10:58pm Permalink | Subthread | Parent | Comments top

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.

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.

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