Sicko is probably one of the most disturbing films

[mgb_phys]

Engineers make mistakes- I see it every day. The difference is no one dies when you put a decimal in the wrong place or forget a variable(hopefully).

Yes they do, that's why they check values in books. Ever see a doctor look something up?
It's also why designs are reviewed, why we have unit-tests, test-harness etc.
If aircraft engineers got it wrong at the same rate as doctors you wouldn't be able to step outside for falling Boeings.

Of the 8years of training, most of that is just cheap labor - it's not quite the same as 8years of PhD research. Talk to a doctor and you will be amazed how little they know about biology or chemistry. And if you ever receive a drug that involves them doing any sort of calculation to get the dose right - make sure they have got mili and micro the right the way round!

 

[Alfi]

make sure they have got mili and micro the right the way round!

Metric !? - only one country left to convert. On the whole planet. ( ok maybe two ;) )

 

[mgb_phys]

A major medical breakthrough recently reported in the New England Journal of Medicine.
Apparently if you go through a written checklist before cutting into the patient the chance of them dying halves! The 19 point checklist contains little details, like do you have all the equipement needed, do you have the right blood available etc.
Dr. Peter Pronovost won a MacArthur "genius" award for creating the concept of medical checklists!

There have been objections that it reduces the surgeons autonomy - like I suppose that pilot who landed in the Hudson shouldn't need to do checklists anymore because he's a hero.

 

[russ_watters]

Yes they do, that's why they check values in books. Ever see a doctor look something up?

Ever see an engineer look something up while in front of a client? C'mon, you're really not giving doctors enough credit.

 

[nottheone]

If engineers were like doctors, here is what a conversation between doctor and patient might be like:

plane mechanic: Number 623 has a crack in the skin.
engineer: I'll take a look at it.
engineer: hmmmm
plane mechanic: I think a structural problem caused the crack.
engineer: Who is the engineer here? Looks like just a crack in the skin to me.
plane mechanic: But when it's taxied out I can see the crack widening.
engineer: Fill it with Bondo and apply a coat of paint to it before each flight. It will look as good as new.
plane mechanic: I really think it's a structural problem.
engineer (completely ignoring what the mechanic is saying): We will try the Bondo and paint for a while.

 

[Evo]

It is also a very neat educational recording that everyone should hear. Not often that secret recordings of the inner workings of a corrupt government are exposed and made public.

The reason that health care in the U.S. is inefficient is because it was designed to be inefficient. The more inefficient, the more private profit, and so the incentives are to minimize efficiency.

Reagan passed legislation in 1988 changing the HMO Act of 1973. Many Americans are not in HMO's, HMO's are an option. I'm not in an HMO.

 

[drankin]

If engineers were like doctors, here is what a conversation between doctor and patient might be like:

plane mechanic: Number 623 has a crack in the skin.
engineer: I'll take a look at it.
engineer: hmmmm
plane mechanic: I think a structural problem caused the crack.
engineer: Who is the engineer here? Looks like just a crack in the skin to me.
plane mechanic: But when it's taxied out I can see the crack widening.
engineer: Fill it with Bondo and apply a coat of paint to it before each flight. It will look as good as new.
plane mechanic: I really think it's a structural problem.
engineer (completely ignoring what the mechanic is saying): We will try the Bondo and paint for a while.

I usually see this the other way around.

engineer: Why is there bondo on the skin?
mechanic: I saw a crack in the skin so I fixed it.
engineer: You should let me know when you see this happening.
mechanic: *scratches head* Well it's fine now.
engineer: We could have a structural problem, Frank.
mechanic: *mumbles expletive about engineers and walks away*

 

[Al68]

Why not just have gov't compete with private insurance companies instead of complaining about them?
After all, the USPS doesn't complain about the price FedEx charges to deliver a letter.

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

Notice how much Democrats complain about private companies, yet don't advocate trying to compete with them. I say offer something better yourself instead of trying to control others.

 

[BoomBoom]

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

I'm sure they would if republicans didn't block such efforts. Maybe now they can actually get it done...one can hope anyways.

It would be a drastic improvement in our health care system if it actually focused on health care instead of profit (at the expense of quality healthcare).

 

[Topher925]

Why not just have gov't compete with private insurance companies instead of complaining about them?
After all, the USPS doesn't complain about the price FedEx charges to deliver a letter.

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

Notice how much Democrats complain about private companies, yet don't advocate trying to compete with them. I say offer something better yourself instead of trying to control others.

This sounds like a good idea. If the government can pull it off then fantastic, people have some affordable options for health care and the private sector will have to get its act together. If it ends up going the way of social security then its good to because then we are not all biffed with a failing nationalized health care system.

Obama seems to have some good plans to help improve the current system. For example, even something as simple as making patient records electronic and having them shared among hospitals will yield massive improvements in the system. Although I still find that the best health care plan is just for people in the US to take care of themselves but this doesn't seem to be a viable option.

 

[Adrock1795]

How would universal health care, lower health care costs? Your simply moving the financial burden to someone else. Has society become that much of a liability, that we must leech of the rich to provide us with security?

 

[BoomBoom]

How would universal health care, lower health care costs?

Easy...by taking the whole "let's maximize our profits and get rich" philosophy out of the equation.

 

[turbo]

How would universal health care, lower health care costs? Your simply moving the financial burden to someone else. Has society become that much of a liability, that we must leech of the rich to provide us with security?

The insurance companies maximize profits by denying claims, and by delaying as many claims as they can while they re-invest the "float". This cost is passed on to medical facilities and small medical practices in the form of delayed or denied payments, and lots of extra overhead to pay a support-staff or coding specialists who have to learn all the arcane coding requirements that each insurance-company demands be met before they will pay for treatments. A real single-payer system would eliminate all that friction and would save the country trillions while extending health-care to all. Not such a bad deal.

 

[mheslep]

... A real single-payer system would eliminate all that friction and would save the country trillions while extending health-care to all. Not such a bad deal.

No doubt such a system would cut some costs, but the evidence from other countries is that while such a system in theory attempts to provide for all, in practice it delays health care to all.

 

[mheslep]

Easy...by taking the whole "let's maximize our profits and get rich" philosophy out of the equation.

In general, the market system is the most efficient way to allocate limited resources. This does not mean efficiency is the only goal, and the state may decide to step in with various controls, but the general principal still holds.

 

[jreelawg]

Why is does a country with such wealth and power rate so low in health care efficiency and quality? Because it is dominated by people who want it that way. All the incentives run that way. How is it that crooks can dominate our health care system? Because of corrupt officials who are in on it. Why would anyone support the crooks that run the show? Because no one cares to do any research. Why is Michael Moore alright in my books? Because while his conclusions may be different than mine, at least he does a huge amount of research and shows us all the sides and facts that aren't shown on the news. You bash him all you want, call him fat, call him a terrorist, whatever makes you comfortable. But to ignore cold hard facts and documentation based on a popular dislike of person who points it out isn't going to help you get any smarter.

 

[mheslep]

Why is does a country with such wealth and power rate so low in health care efficiency and quality?

Its not low in quality. In many ways its the best in the world.

 

[jreelawg]

The U.S. a nation where the Elite free load off of the hard work and services of the lower and middle class. The Elite get top notch health care, but most hard working americans get poor quality health care. War vets for example get poor quality health care. Why should those who work hard and make huge sacrifices to defend the country get the short end of the stick? The least that congress could do is pass legislating cracking down on the shady practices of Insurance companies, and drug companies. If we are going to have a capitalist health care system, let's at least pass laws to protect the consumers.

 

[Alfi]

Its not low in quality. In many ways its the best in the world.

in other ways it's 37th
http://www.photius.com/rankings/healthranks.html

There is room for improvement in Canada too. Ranked 30th.http://www.photius.com/rankings/who_world_health_ranks.html

 

[mheslep]

in other ways it's 37th
http://www.photius.com/rankings/healthranks.html

There is room for improvement in Canada too. Ranked 30th.

http://www.photius.com/rankings/who_world_health_ranks.html

For some kind of serpentine social policy discussion perhaps the WHO rankings can be entertaining, given WHO metrics like "Fairness in financial contribution". If one actually gets sick, then it is simple, the first thing you want to know is what are my chances for survival, and where do I go for the best chance? Sorry, the WHO rankings won't help you there. For actual diseases like cancer, or hip replacements, and not 'fairness measurements', very frequently the answer is the United States.
http://www.ncpa.org/images/1703.gif

The US health system has some serious problems (cost,coverage,IT), but the quality of actual medicine is not one of them. So I wish these misleading 'Cuba has great health care!' or 'France is #1!' red herrings would stop, so we don't trash what we have when fixing the real problems.

 

[Evo]

For some kind of serpentine social policy discussion perhaps the WHO rankings can be entertaining, given WHO metrics like "Fairness in financial contribution". If one actually gets sick, then it is simple, the first thing you want to know is what are my chances for survival, and where do I go for the best chance? Sorry, the WHO rankings won't help you there. For actual diseases like cancer, or hip replacements, and not 'fairness measurements', very frequently the answer is the United States.
http://www.ncpa.org/images/1703.gif

The US health system has some serious problems (cost,coverage,IT), but the quality of actual medicine is not one of them. So I wish these misleading 'Cuba has great health care!' or 'France is #1!' red herrings would stop, so we don't trash what we have when fixing the real problems.

Exactly, I just watched two healthcare documentaries where patients in the UK had to travel to the US to get life saving medical procedures. One was an infant with brain lessions, the UK would not even allow the procedure she needed, so the parents brought her to the US where they repaired the lesions and saved the baby's life. The Uk also did not cover the expense. But they don't even ALLOW cutting edge research or treatments because it's too costly. You can't even get the treatments you need in other countries. The number of people that are flown to the US each year for treatment they can't get anywhere else is staggering.

I'll gladly pay a bit more to cover research and treatments not available anywhere else in the world.

Socialized medicine in Italy killed my fiance's father. First they only diagnosed his lung cancer with an x-ray, guessed it was the wrong type of cancer and gave him the wrong treatment. They made no diagnostic tests to see which type it was. Then they almost killed him by giving him the wrong treatment at 10 times the normal dose. After I had a fit, my fiance raised hell and got his father on a SIX MONTH WAITING LIST to get an MRI, one of TWO machines in the entire country and required a plane flight across country. Here in America you'd get an MRI the same day. You'd also get tested to see which type of cancer you have. Socialised medicine is mediocre at best and only good if you have run of the mill illness.

His father died in terrible agony, they figured out what he had too late AND it required a trip to another country to even be diagnosed, by then it was too late.

If Michael Moore gets sick, where do you think he's going to go for medical care?

 

[Al68]

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

I'm sure they would if republicans didn't block such efforts. Maybe now they can actually get it done...one can hope anyways.

Republicans can't block those efforts because those efforts don't exist. Democrats have no interest in trying to compete with private companies to sell health insurance. They're smart enough to know better.

Having a government controlled entity competing with private insurers would completely undermine their real agenda of gaining gov't control of private companies. It would be like trying to take over Fedex or UPS.

It's simple, if they don't think they can compete with private insurers, they have no business complaining about them. Put up or shut up.

Democrats just oppose private business in general. Assuming that the word private means not under gov't control.

 

[ThomasT]

No doubt such a system would cut some costs, but the evidence from other countries is that while such a system in theory attempts to provide for all, in practice it delays health care to all.

Does a single-payer system necessarily have to increase delays? This isn't a rhetorical question. I haven't studied the health care system at all, and am curious.

 

[TheStatutoryApe]

within the last year I heard several stories on the news about insurance companies attempting to dump their clients when they made expensive claims based on supposed unreported preexisting conditions that had nothing to do with the claim. last I heard I believe they were working on legislation to prevent this practice.

I've heard occasionally about medical tourism too. it apparently works out well in many cases. at the same time regulations in other countries aren't as stringent as in the US and the likelihood of something going wrong is greater, though not perhaps significantly. the worst part is that if something goes wrong an american citizen has little to no recourse in the case of fraud or malpractice while receiving medical care in another country. so people going out of country for treatment ought to be very careful about who they go to.

 

[BoomBoom]

Having a government controlled entity competing with private insurers would completely undermine their real agenda of gaining gov't control of private companies. It would be like trying to take over Fedex or UPS.

You mean like the USPS?

Maybe if private companies behaved in a more responsible manner and didn't continually try to bleed the people dry in order to maximize profits, then we wouldn't need any government control or regulations. Unfortunately, that is not the case and they must be forced to behave responsibly.

I'd be all for government competing in this market by providing affordable and quality healthcare. That would force the private companies to do the same or perish.

 

[turbo]

No doubt such a system would cut some costs, but the evidence from other countries is that while such a system in theory attempts to provide for all, in practice it delays health care to all.

The whole thrust of the private health-insurance industry is to not only delay, but deny health-treatment to as many people as possible. Insurance companies make most of their money on the "float" between premiums paid and investments they make on claims that are delayed or denied. I was the network administrator for a fairly large medical practice, and I can attest that this is how medical insurance companies operate. They are not in the business to protect individuals from financial loss - quite the opposite.

 

[Vanadium 50]

I think we need to ask ourselves "what problem are we trying to solve here?" If, as BoomBoom and to a lesser extent Turbo-1 suggest, it's that without the profit motive more treatment could be provided, let's look at the data and see how much more.

Blue Shield of California is a pretty big outfit. Their 2007 10-K says they had $318M of income on $8364M of revenue. That's 3.8%. Assuming they are representative, that's the sort of potential improvement we are talking about: 3-4%.

Of course, the same motivation that causes the insurance companies to cut operational costs also motivates them to cut administrative costs. So it's far from certain that this 3-4% actually goes to health care and not to employing somebody's brother-in-law.

 

[Al68]

You mean like the USPS?

Maybe if private companies behaved in a more responsible manner and didn't continually try to bleed the people dry in order to maximize profits, then we wouldn't need any government control or regulations. Unfortunately, that is not the case and they must be forced to behave responsibly.

Private companies only exist to make profits. Their goal is to maximize profit. That results in the best possible deal for consumers. (Despite how counter-intuitive this is to a Democrat).

I'd be all for government competing in this market by providing affordable and quality healthcare. That would force the private companies to do the same or perish.

That assumes that gov't could offer a better deal. Of course Democrats know they can't, so they don't suggest it.

And they wouldn't even need to pass a law. There is nothing stopping the Democratic Party from just starting an insurance company to compete with the others. The simple fact that they don't shows how full of baloney they are.

They want to complain about the deal consumers get from companies they are unwilling to compete against.

Democrats obviously don't think they can do better, but that's not their goal. Power is their goal. Why compete with private companies when they can just take control of them instead?

 

[turbo]

Private companies only exist to make profits. Their goal is to maximize profit. That results in the best possible deal for consumers. (Despite how counter-intuitive this is to a Democrat).

Do you really think that Democratic politicians are any different from Republican ones? That's ridiculous.

They are no different than Coca-Cola and Pepsi or Time and Newsweek. The US would be better off with a parliamentary form of government with multiple parties, but I fear that this would require a revolution more violent than our founding one.

 

[cristo]

Exactly, I just watched two healthcare documentaries where patients in the UK had to travel to the US to get life saving medical procedures. One was an infant with brain lessions, the UK would not even allow the procedure she needed, so the parents brought her to the US where they repaired the lesions and saved the baby's life. The Uk also did not cover the expense. But they don't even ALLOW cutting edge research or treatments because it's too costly.

I'm sure I've said this before, but that's just one case. There are bound to be the odd case that medicine here in the UK cannot cater for: especially because we are a tiny island with far fewer hospitals than the US. The important thing (at least in my opinion) is not the availability of the specialist procedures for the odd case every decade that requires them, but the availability of basic medicine for run of the mill illnesses, that is provided free of charge on the NHS (albeit with a little wait), but that isn't available to some Americans because they simply cannot afford it.

I watched a Panorama programme on this a couple weeks ago which depicted a scene at a football stadium in Kentucky. Families were heading there at 4am, traveling from miles around, to obtain free healthcare from a third world charity simply because they couldn't afford health insurance. It was a really moving scene, one which you would not expect to see in the world's richest country. I mean, one image showed a table of reading glasses that people could take home since they obviously could not afford to visit an optician.

If you look at something like that you cannot possibly argue that the US has a healthcare system which serves its people better than a public healthcare system like, for example, the NHS.

I'll gladly pay a bit more to cover research and treatments not available anywhere else in the world.

I think this is the fundamental problem: the US has the best healthcare in the world... if you're able to pay for it. The fact is that there is a huge proportion of people living in the US who cannot afford healthcare, and a large number of those that are dying because of it. That programme gave a figure of 23,000 people dying a year because they cannot afford basic healthcare.

You can watch the programme here http://www.bbc.co.uk/iplayer/episode/b00gvflg/Panorama_What_Now_Mr_President/ , though that may be a UK link only. It should be on youtube, though...

 

[Al68]

Do you really think that Democratic politicians are any different from Republican ones? That's ridiculous.

Well, since most votes are along party lines, yes.

I don't hear Republicans advocate more gov't control over insurance companies, so on this issue, yes there is an obvious difference.

Just because they have some things in common doesn't mean there's no difference. That's ridiculous.

 

[Al68]

If you look at something like that you cannot possibly argue that the US has a healthcare system which serves its people better than a public healthcare system like, for example, the NHS.

I think this is the fundamental problem: the US has the best healthcare in the world... if you're able to pay for it.

I think different issues are getting confused here. It's like saying Long John Silvers has the best fish...if you're able to pay for it.

Just logical gibberish.

 

[Al68]

Why is does a country with such wealth and power rate so low in health care efficiency and quality? Because it is dominated by people who want it that way. All the incentives run that way. How is it that crooks can dominate our health care system? Because of corrupt officials who are in on it. Why would anyone support the crooks that run the show? Because no one cares to do any research. Why is Michael Moore alright in my books? Because while his conclusions may be different than mine, at least he does a huge amount of research and shows us all the sides and facts that aren't shown on the news. You bash him all you want, call him fat, call him a terrorist, whatever makes you comfortable. But to ignore cold hard facts and documentation based on a popular dislike of person who points it out isn't going to help you get any smarter.

What makes me comfortable is calling him a fraud. His documentaries are frauds. He was caught when his uncut tapes leaked out. He hires people to read from a script, then cuts and pastes to make his "documentary".

And it's just plain faulty logic to blame a provider of a service for their service not being good enough, if it's the same service they agreed to provide and you agreed to take.

 

[BoomBoom]

That assumes that gov't could offer a better deal. Of course Democrats know they can't, so they don't suggest it.

And they wouldn't even need to pass a law. There is nothing stopping the Democratic Party from just starting an insurance company to compete with the others. The simple fact that they don't shows how full of baloney they are.

They want to complain about the deal consumers get from companies they are unwilling to compete against.

Democrats obviously don't think they can do better, but that's not their goal. Power is their goal. Why compete with private companies when they can just take control of them instead?

Hehehe...you make me laugh!

You will find out in time because it will be done (simply because it must be done).

Out of control healthcare costs are not just hurting the unfortunate people that can't afford it, but it hurts everything. The tremendous costs to business who want to provide this service for their employees effects us all. This is probably the main reason for companies to outsource jobs overseas, or shut down factories here to open them elsewhere...not to mention these costs are passed on to the price of the products as well.

You are already paying for the healthcare of others, don't you know?

 

[mheslep]

Does a single-payer system necessarily have to increase delays? This isn't a rhetorical question. I haven't studied the health care system at all, and am curious.

The allocation or rationing of limited resources can generally be done in two ways: rationing by price or rationing the supply (queues, shortages). If a single entity fixes the price, the only alternative is to ration the supply. Experience with nationalized health systems demonstrates this. Note that the number of countries where most people actually get most of the medical care from the government, like the UK, is declining. France has 85% private coverage, Ireland 45%, the Dutch are going to 100%, and private providers are popping up all over Canada now.
http://www.euro.who.int/document/Obs/EuroObserver6_1.pdf