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nitflegal
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On 12/10/2021 at 1:46 PM, Skywalkre said:

I've made countless suggestions in the various health care threads going back a decade... many of which would shift health care to a more Conservative/Free Market approach.  Always heard crickets after those posts (not sure if it's because so many posters on here can't bring themselves to agree with me on something or they're too embarrassed to admit our current system is not this Conservative/Free Market/American dream).

I would say the majority of U.S. posters would agree with you via the "Free Market" approach. We're just not stating the obvious.

I think the more important point is what you underlined in my post - why do Rs not take health care reform seriously?  The Rs never had their own plan for health care reform - back during the Obamacare debate and recently when they tried to repeal Obamacare (the latter was incredibly embarrassing considering they had 8 years to come up with their own plan and had... nothing). 

IIRC, the G.O.P. was one vote away from abolishing "Obama Care." The late Senator J. McCain refused to go along.

The answer, like a lot of things, is likely multifaceted.  In this era of everything being politicized I think a lot of Rs feel they must be against reform since the Ds claim they're all for it (heaven forbid they argue instead D reform is not the right approach and suggest their own... but that's expecting too much from R politicians and their base).  Another, probably the biggest reason, is the Rs are more beholden to the special interests than their D counterparts.  Money is what runs DC... and the health care behemoth has a lot of it... and thus so much to lose if real reform were to happen.

I would say the answer to this is that health care reform is not a big concern, and as far as I can remember, has never been a make or break item for either party, other than team jackass wanting to break the tax-payer via more socialized medicine. 

Not saying its not needed, but its just the can being kicked for future Americas to deal with. 

 

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On 12/5/2021 at 6:32 AM, sunday said:

An European needs to not forget health travel insurance when going to Samland. Curiously, the high premium also covers Canada.

Our Healthcare is very expensive if your not covered, a lot to do with the higher wages paid.

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On 12/10/2021 at 2:07 PM, Skywalkre said:

What a garbage quote.  There absolutely are solutions at times... and the tradeoff is that the robber barons get screwed (such as in this scenario).

I'm reminded of a stat I read a few years back.  It posed a hypothetical - if you could go back in time and invest a small amount of money (I think it was $10k in 1990) what would be the fastest way to get you to a million?  Invest in tech stocks?  Nope... invest in US health care related stocks.

Your wrong. T. Sowell is 100% correct. The noun "solution" definition is a means of solving a problem or dealing with a difficult situation. Your wishing the G.O.P. to come up with an alternative to team jackass is not a solution, much less an absolute solution. 

What T. Sowell means is that in health care we all always loose, via health care costs in premiums/taxes you pay to cover your health or the possibility you have to pay big for an unexpected expense if you choose not to heath insurance. 

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On 12/10/2021 at 2:50 PM, Skywalkre said:

Umm... folks with at least 3 brain cells will point out that even if you have regular insurance of your own and not covered by one of the several US socialized systems that you're still insulated from the effects of paying for a service. 

No, you would not be "insulated from" paying for health care if you have health insurance. Every time I pay a premium via my paycheck deduction I am aware not being insulated. Which is the foundation of insurance; many paying for a few. 

The LASIK example is a rarity in this country.  For the majority of medical services you're simply showing up and paying your copay or whatever... the real cost is hidden from you and worked out between your insurance and the provider.  Hence, as you argue, why our costs keep skyrocketing even if you have regular insurance.

You yourself have given good answers to this in past posts; bureaucracy and poor health decisions by too may folks.

 

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On 12/10/2021 at 2:57 PM, Skywalkre said:

Not... really.  Not all health care needs can be handled with a single visit, surgery, or pill.  Someone can have a life-threatening condition and the hospital won't take them in til it's too late.  There's a poignant example of this at the start of The Healing of America (I highly recommend everyone read this book to get a basic grasp of how our system really works and what's wrong with it).  In short, a young woman with no insurance had odd health issues.  Went to the ER a few times and they directed her to a specialist who she couldn't afford.  Condition worsened til she was finally taken in at the ER for the last time before passing away.

It's also not true that if you can't afford a hospital bill that you just have it written off.  Medical bankruptcy is a thing in this country...

What the fuck...?

Reading the one and two star reviews on the book you suggested was interested reading, especially by the physicians.

To be fair to your numerous posts on this subject you have stated correctly much of the costs of healthcare is related to poor choices. "Socialized medicine" via Medicare and Medicaid is here to stay, it will never go away. Let me give you a few reasons why.

Our office is a retina sub-specialist(eyeballs) WE ARE ORDERED BY THE GOVERNMENT OR ELSE THEY WILL REDUCE OUR REIMBURSEMENTS TO DO THE FOLLOWING:

1. Date and where a patient acquired a pneumonia vaccine. In my 39 years of working with eyeballs I have yet to see one acquire pneumonia. 

2. Get an email address from each patient so they can access a "medical portal." Never mind that in ophthalmology, especially retina, a very large percentage of the patients are elderly and do not have a computer. Now the fun thing is they can name a friend or relative as an email source, hence no patient privacy, a big H.I.P.P.A no-no.

3. B.M.I. (Body Mass Index). Other than the rare Visudyne treatment, not needed for eyeballs

We have two people in a solo doc office who spend the majority of their time on government bureaucracy with another one spending almost half her time on this. 

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5 hours ago, Rick said:

2. Get an email address from each patient so they can access a "medical portal." Never mind that in ophthalmology, especially retina, a very large percentage of the patients are elderly and do not have a computer. Now the fun thing is they can name a friend or relative as an email source, hence no patient privacy, a big H.I.P.P.A no-no.

My 70+ uncle gets irate at the doctors offices pushing him to use a portal. He just wants patient records and someone to talk to him. 

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Totally unrelated to anything except for maybe Federal largess==I was listening to that 'static-y' radio station in the morning during my early morning shift on one of my righty talk stations (supposedly the news bloc is by 'Fox' but it's the same news slot that reported 5 policemen killed on January 6); anyway, one of the stories it made mention to was that California has a thirty BILLION Dollar budget surplus this year--which makes me wonder, given 'productive/taxable' people are fleeing Cali in droves and 'drones on the dole' are pouring in. Where the HELL is Cali getting the money?

Edited by NickM
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While I' m on my health care cost soapbox in the U.S., "Socialized Healthcare" via Medicare and Medicaid is, morally and financially wrong as they are, are here to stay. Both of these programs could very well lower their costs by doing the following:

Increase Medicare premiums for those using tobacco and for obesity. For those on Medicaid, decrease their benefits they receive from other government programs if using tobacco and for obesity. 

Issue tax credits for those medical institutions who provide care to the poor instead of Medicaid. You would be surprised on how many doctors like this idea. 

While on the subject of poor health choices the same goes for those who made the choice of drug and alcohol addictions. They are forced to sell any assets, paycheck deductions, government benefit deductions, etc.,  to help cover the costs of their choices. The same goes for diseases "caught" while engaging in homosexuality and prostitution, or injuries sustained while driving without a seatbelt or riding a motorcycle without a helmet. Pet peeve, in the state of Indiana, you have to wear a seatbelt but can ride a motorcycle without a helmet. 

I finally would add that "sin taxes", ie, alcohol, gambling, tobacco be used only for health care costs. 

To save those of you who are painfully rolling your eyes around while reading this. I'll shut up now.

 

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11 minutes ago, bd1 said:

what about sugar tax?

In the US, we are already paying an ersatz sugar tax, due to the whole tariff thing.

 

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10 hours ago, NickM said:

Totally unrelated to anything except for maybe Federal largess==I was listening to that 'staticy' radio station in the morning during my early morning shift on one of my righty talk stations (supposedly the news bloc is by 'Fox' but it's the same news slot that reported 5 policemen killed on January 6; anyway, one of the stories it made mention to was that California has a thirty BILLION Dollar budget surplus this year--which makes me wonder, given 'productive/taxable' people are fleeing Cali in droves and 'drones on the dole' are pouring in. Where the HELL is Cali getting the money?

They taxed the federal benefits that everyone was getting. It's a self licking icecream cone. 

Edited by rmgill
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5 hours ago, Rick said:

While I' m on my health care cost soapbox in the U.S., "Socialized Healthcare" via Medicare and Medicaid is, morally and financially wrong as they are, are here to stay. Both of these programs could very well lower their costs by doing the following:

Increase Medicare premiums for those using tobacco and for obesity. For those on Medicaid, decrease their benefits they receive from other government programs if using tobacco and for obesity. 

Issue tax credits for those medical institutions who provide care to the poor instead of Medicaid. You would be surprised on how many doctors like this idea. 

While on the subject of poor health choices the same goes for those who made the choice of drug and alcohol addictions. They are forced to sell any assets, paycheck deductions, government benefit deductions, etc.,  to help cover the costs of their choices. The same goes for diseases "caught" while engaging in homosexuality and prostitution, or injuries sustained while driving without a seatbelt or riding a motorcycle without a helmet. Pet peeve, in the state of Indiana, you have to wear a seatbelt but can ride a motorcycle without a helmet. 

I finally would add that "sin taxes", ie, alcohol, gambling, tobacco be used only for health care costs. 

To save those of you who are painfully rolling your eyes around while reading this. I'll shut up now.

 

So where do you stand with masks and vaccinations for covid? Both reduce the risk of getting covid.

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3 hours ago, MiloMorai said:

So where do you stand with masks and vaccinations for covid? Both reduce the risk of getting covid.

Wife and I both got vaccinated x2 which is good enough. Covid is just another type of flu. 

Masks -- masks are not about viruses as they are about governmental control. Viruses are to small to be stopped by most masks with the single use ones being used repeatedly and the cloth ones not being washed daily. 

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39 minutes ago, Rick said:

Wife and I both got vaccinated x2 which is good enough. Covid is just another type of flu. 

Masks -- masks are not about viruses as they are about governmental control. Viruses are to small to be stopped by most masks with the single use ones being used repeatedly and the cloth ones not being washed daily. 

The of asked question, If masks work, why aren't they working?

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How do you know that masks don't work?

2 hours ago, Rick said:

Masks -- masks are not about viruses as they are about governmental control. Viruses are to small to be stopped by most masks with the single use ones being used repeatedly and the cloth ones not being washed daily.

So why do S Koreans, Chinese and Japanese wear masks then?

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12 minutes ago, MiloMorai said:

How do you know that masks don't work?

So why do S Koreans, Chinese and Japanese wear masks then?

Bad teeth. Same with West Virginia.

Edited by 17thfabn
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As so often the case,t his argument is entirely too one-dimensional.  "Oh, the Obese are the death of the rest of us!"

Let me share an example of the problem with this nonsense.

When my wife was 28, she developed a Giant Cell bone tumor in her right femoral neck and head.  Within a year, she had to have the joint partially replaced and then a total replacement revision.  Twice thereafter, at approximately ten-year intervals, the joints had to be replaced again.

Then, in 2018, she had THREE replacements in one year.  The first two failed for various reasons, including the wear-and-tear on the musculature around the joint.  She currently has a double-acting joint with extension that is meant to compensate for for these factors.  During the course of the year, when the joints failed, there were ER visits and therapies.

These surgeries were not done by newbies:  some of the best bone docs in the Washington University system in St. Louis were involved.

Now we have never bothered to total up the coast for even the singular year 2018, but there is no way we could have afforded even a fraction of it without some kind of insurance.  there is no shopping for the "Best Value" version of this kind of medicine.

And the October 2018 revision won't be the last--though we pray it will last longer than the previous 10-year average.  And the walking issues and attendant problems have contributed to a genetic disposition toward spinal stenosis.  She has two instances, one in her neck, which has choked off not only spinal but also arm nerve pathways, and another in her lower back that has done the same with her legs.

One effect of the whole thing is that she has put on weight, being unable to exercise in almost any significant way for years.  That inability has also aggravated her diabetes, once under control by diet.

It is very easy to pontificate about general health and ideal conditions when you are essentially healthy.  You gain another perspective when health suffers from circumstance beyond your control.  Some of you could use a does of that perspective, but I wouldn't wish it on my worst enemy. 

So maybe you might to do some *real* thinking rather than parroting infomercials and actuarial tables.

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Coronavirus Face Masks & Protection FAQs

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-face-masks-what-you-need-to-know

 

Mask-wearing linked to 53% cut in Covid incidence, global study finds.

“This systematic review and meta analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence of Covid-19,” the researchers wrote in the BMJ.

https://www.theguardian.com/world/2021/nov/17/wearing-masks-single-most-effective-way-to-tackle-covid-study-finds

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27 minutes ago, JWB said:

Coronavirus Face Masks & Protection FAQs

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-face-masks-what-you-need-to-know

 

Mask-wearing linked to 53% cut in Covid incidence, global study finds.

“This systematic review and meta analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence of Covid-19,” the researchers wrote in the BMJ.

https://www.theguardian.com/world/2021/nov/17/wearing-masks-single-most-effective-way-to-tackle-covid-study-finds

As is usual with the media, that is not what the article says.  It's not a bad summary paper and it's unsurprising that there is a grad student as an author.  This is very typical of a data mining make work paper to get a quick and easy publication credit for everyone else and the grad student will be grateful to have something for their CV in return for hours of boredom.  That doesn't mean it's a bad paper (although it kind of is) but it is limited in what it can convey.  Many of the confidence intervals in the study are ambivalent at best; eg 53% reduction but not statistically significant.  That's a big red flag on the reliability of the source data (though good on our grad student for catching that in the stats).  Where it verges on being a bad paper is if you then go into the source studies.  Specifically with masks much of the supporting documentation has masks but they are not separated from distancing, hand washing, limited interpersonal contact, and even vaccine use.  There is way too much grey area in there for me to be comfortable hanging my hat on any of the conclusions.  Waaaay too muddy.  However, that's separate from the fact that the paper does not say masking is most effective in the data, the closest is this "Current evidence from quantitative analyses indicates a benefit associated with handwashing, mask wearing, and physical distancing in reducing the incidence of covid-19."    " It also does not specifically say masks, rather it compares countries with mandatory mask wearing to those that don't.  That on its face adds a crap-ton of variables.  That aside, the cited paper doesn't say what the article claims and the underlying studies don't support it either.  If one of my students wrote a suggestive article that willfully mis-interpreted the data to this extent I'd disown them.

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If the paper is actually concluding that the combination of the three items in your highlighted text appear to be effective, then that is a useful conclusion, don't you think? 

Sure, there are people who don't follow any of this guidance, but the majority of people are attempting to follow the guidance with varying levels of competence and I'm sure you appreciate that the effects are cumulative - three mitigations that are each 30% effective would be dismissed as ineffective, but together they could provide between 60 and 70% effectiveness. (The calculator tells me 65.7%, but spurious precision invites a justifiably raised eyebrow.)

Even 20% effectiveness yields a 50% reduction, so they really don't have to be individually very good to "work", provided they're all observed.

There was a fourth item in the guidance, which people often didn't/don't manage so well - reducing exposure time.

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4 hours ago, DB said:

If the paper is actually concluding that the combination of the three items in your highlighted text appear to be effective, then that is a useful conclusion, don't you think? 

Sure, there are people who don't follow any of this guidance, but the majority of people are attempting to follow the guidance with varying levels of competence and I'm sure you appreciate that the effects are cumulative - three mitigations that are each 30% effective would be dismissed as ineffective, but together they could provide between 60 and 70% effectiveness. (The calculator tells me 65.7%, but spurious precision invites a justifiably raised eyebrow.)

Even 20% effectiveness yields a 50% reduction, so they really don't have to be individually very good to "work", provided they're all observed.

There was a fourth item in the guidance, which people often didn't/don't manage so well - reducing exposure time.

Honestly?  Not really.  It's pretty well established that these work well (and note in the paper the thing that actually had the highest rate of mitigation was disinfection.  There have already been several of these aggregate papers so unless they suddenly incorporate a new study that moves the needle it's at best a circle jerk and at worst borderline plagiarism.  The paper itself is basically "some of this stuff helps probably to some unknown extent and we haven't bothered to tease out the actual variables."  That's the problem with these survey style papers, they only get published when you want journal pages on the hot topic du jour and nobody has an actually insightful study to report.  It's akin to publishing a paper that says brushing your teeth, flossing, sugar mitigation, mouthwash, and stopping smoking may promote oral health to some unknown degree and we don't know which are more impactful or in what combination you would have the best effects.

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1 hour ago, nitflegal said:

Honestly?  Not really.  It's pretty well established that these work well (and note in the paper the thing that actually had the highest rate of mitigation was disinfection. 

By disinfection, do you mean surface disinfection? I thought fomites where shown to be a not particularly effective vector.

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