Healthcare shocker

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Kilmoll the Sexy
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Healthcare shocker

Post by Kilmoll the Sexy »

Guess at some point you will be switching away from that national healthcare plan if you intend to ever get treatment.

http://www.canada.com/news/national/sto ... 7990A8DC57
OTTAWA (CP) - Canada has one of the lowest ratios of doctors to population in the Western world, according to new figures from an international body.

In 2001, Canada had 2.1 practising physicians for every 1,000 residents, less than half as many as Greece which came in at the top of the scale at 4.4, says a report from the Organization for Economic Co-operation and Development.

The list of countries that out-doctor Canada includes the Slovak Republic (3.6), Hungary and Switzerland (both at 3.5) and the Czech Republic (3.4).

France, Germany and The Netherlands all had 3.3 doctors per 1,000, roughly a third more than Canada, according to figures released Thursday.

Despite a significant increase in health spending since the 1990s, Canada's physician workforce remains far below the OECD average of 2.9.

Researchers have been warning for at least a decade that Canada is facing a shortage of doctors, said Sunil Patel, president of the Canadian Medical Association.

"Canadians face a very serious risk of dwindling health human resources," he said.

"There's been no leadership shown by any level of government and especially the federal government."

Among other things, he has called for the fast-tracking of accreditation for foreign medical graduates.

The OECD average for doctors was 2.9 for each 1,000 of population, and the only countries with a lower number than Canada in 2001 were Mexico (1.5), Korea (1.4) and Turkey (1.3).

The study does not provide 2001 figures for the United States or the United Kingdom but in 1999 the U.S. figure was 2.7 for each 1,000 and the U.K. figure was 2.0.

The scarcity of Canadian doctors is in part the result of deliberate government policy. During the 1990s, provincial governments cut enrolment in medical and nursing schools as a strategy to cut medical costs.

In recent years, the federal government has increased health spending and enrolment, but working conditions remain a major complaint.

Patel said there were 11 doctors in Gimli, Man., when he started practising there in 1973, but now there are only five, even though the population has grown.

He said Canada is losing an average of 250 doctors each year, mainly to the United States. Many of them are leaving because they lack the support and facilities, he said.

"The working conditions are abominable.

"Think of it - three million Canadians do not have access to a family doctor. That is unacceptable in a developed country. We need more hands on deck."

The study found that Canada has more nurses per capita than the OECD average but the ratio has been dropping while in most other countries it has been rising.
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Post by kyoukan »

OH SNAP SOCIALISM HAS FAILED
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Post by Skogen »

Dude, our healthcare system in this country is so fucked up, it's laughable to even try to take shots at another country's system. My wife is a physician, and she tells me stories every other day on how treatment she has ordered for a patient of hers was declined by the HMO insurance company. Here is a recap of a discussion we had just last night. She came home all frustrated, and told me about 64-year-old women she saw, who had profound symptoms of osteoporosis. So, my wife orders a bone density study to be done. The insurance company got back to her on it, and refused to cover on the grounds that the patient was not the minimum of 65 years old to perform the study. Absolutely no regard for the symptoms & recommendations of the doctor. Just "sorry, she's not old enough, we wont pay the $1500 for the study" So my wife spends 45 minutes on the phone with them, and finally convinced them when she said basically "Look, its $1500 now for the study, or $25,000 a few years from now when she has to undergo a hip replacement due to lack of treatment for her osteoporosis" I could go on and on about different stories, and that's only part of the problem!

This country has a tremendous wealth of knowledge, resources, & technology in the medical field. Too bad it all has to bow down to the god of the HMO insurance, the like of which only care about the bottom line: the almighty dollar.
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Post by Chidoro »

It's about the almighty dollar for both sides. Don't let the fact that a hospital does magnanimous work cloud the fact that hospitals are a business. Plain and simple.

Part of the reason HMO companies do what they do is because corporations and small businesses make up the predominant amount of contributions.

Bleh, I'm not going to get into the details as I can type a small thesis on the topic since I've worked on both sides for a better part of 8 years. Suffice to say that a lot of the problems we face in the US have to do with multiple sides pushing and pulling. It ain't just the HMO's, not by a long shot
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Post by Skogen »

Chidoro wrote:It's about the almighty dollar for both sides. Don't let the fact that a hospital does magnanimous work cloud the fact that hospitals are a business. Plain and simple.

Part of the reason HMO companies do what they do is because corporations and smalls businesses make up the predominant amount of contributions.

Bleh, I'm not going to get into the details as I can type a small thesis on the topic since I've worked on both sides for a better part of 8 years. Suffice to say that a lot of the problems that we face in the US have to do with multiple sides pushing and pulling. It ain't just the HMO's, not by a long shot
This is the core problem. Our healthcare system is run like a business. A business' no. 1 concern is the bottom line. Not saying I have a solution, but as long as a money is going to be put ahead of people in the magnitude that it is with our exsisting system, it is flawed.
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Post by Chidoro »

What you ask for is utopia then.

Seriously. Even a universal healthcare system counts their nickels.
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Post by Skogen »

Chidoro wrote:What you ask for is utopia then.

Seriously. Even a universal healthcare system counts their nickels.

Of course, money is always going to play a factor. There is a big difference between watching your spending, and racking in profits. HMO profits have been going up and up as claims fall, and rates rise. Rate hikes (25% ave, last year) are FAR in excess of costs increase.
They manage their profits quiet well, but not the money they pay out for the care it gives. Corporate GREED is driving this. Make no bones about it.

Even with that, it seems to be that the decision makers in the insurance companies need to have a little more foresight, and more knoweledge in the medical field. Take the example I gave, the woman with osteopersis. Save $1500 now or pay $25k later...did they even consider this? They deny care time and time again based on techicalities. I sure there is a lot of corporate bureaucracy that can be looked at.
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Post by Ennia »

cute avatar Skogen

carry on about healthcare now...
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Post by Chidoro »

HMO profits overall may or may not be on the rise, but I think you'd be surprised to find out how many are actually non-profit. The largest in NJ and one of the largest in NY is. In fact, about 80% of the people that walk into our hospital network (largest and most prominant in NJ) belong to a non-for-profit provider.

Just out of curiosity, who do you think reviews claims that are contested between a hospital and a provider? More often then not, it's a MD. There's a lot more understanding of what they pay out and why than just saying that person is going to need a new hip in a few years. Care time is denied based on a ton of factors, both a hospital's failure to follow procedure and providers looking for loopholes alike.

I also think you'd be surprsied how many doctors think they are doing something that is a cost saving procedure but actually ends up costing the hospital far more. Why don't doctors release patients that are stable according to their charts?

I think you are oversimplifying the problem by blaming the HMO's as they are one of three major parts to this industry and what makes it tick. HMO's were a monster created by hospitals trying to vie for business. Companies want to provide their employees with reasonable rates so they don't have to contribute their entire paycheck to cover their family. How do they do that?
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Post by Aaeamdar »

Looking forward to a long future of healthcare in the U.S. being run like a business. Business provide customers with services comensurate with profit. As long as healthcare remains a business out to protect its bottom line, I can remain fairly certain that I can get good healthcare by makingsure my healthcare provider makes a nice profit. As soon as the government takes over, my last bit of control over my own healthcare goes out the door.
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Post by Xzion »

hey if we didnt attack iraq, we would almost have enough $ for it to be free as well
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Post by Skogen »

Xzion wrote:hey if we didnt attack iraq, we would almost have enough $ for it to be free as well
If we didnt attack Iraq, the money spent could cover the deficits of all 50 states combined, but that's a another thread!
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Re: Healthcare shocker

Post by Legenae »

Kilmoll the Sexy wrote:Guess at some point you will be switching away from that national healthcare plan if you intend to ever get treatment.

http://www.canada.com/news/national/sto ... 7990A8DC57
OTTAWA (CP) - Canada has one of the lowest ratios of doctors to population in the Western world, according to new figures from an international body.

In 2001, Canada had 2.1 practising physicians for every 1,000 residents, less than half as many as Greece which came in at the top of the scale at 4.4, says a report from the Organization for Economic Co-operation and Development.

The list of countries that out-doctor Canada includes the Slovak Republic (3.6), Hungary and Switzerland (both at 3.5) and the Czech Republic (3.4).

France, Germany and The Netherlands all had 3.3 doctors per 1,000, roughly a third more than Canada, according to figures released Thursday.

Despite a significant increase in health spending since the 1990s, Canada's physician workforce remains far below the OECD average of 2.9.

Researchers have been warning for at least a decade that Canada is facing a shortage of doctors, said Sunil Patel, president of the Canadian Medical Association.

"Canadians face a very serious risk of dwindling health human resources," he said.

"There's been no leadership shown by any level of government and especially the federal government."

Among other things, he has called for the fast-tracking of accreditation for foreign medical graduates.

The OECD average for doctors was 2.9 for each 1,000 of population, and the only countries with a lower number than Canada in 2001 were Mexico (1.5), Korea (1.4) and Turkey (1.3).

The study does not provide 2001 figures for the United States or the United Kingdom but in 1999 the U.S. figure was 2.7 for each 1,000 and the U.K. figure was 2.0.

The scarcity of Canadian doctors is in part the result of deliberate government policy. During the 1990s, provincial governments cut enrolment in medical and nursing schools as a strategy to cut medical costs.

In recent years, the federal government has increased health spending and enrolment, but working conditions remain a major complaint.

Patel said there were 11 doctors in Gimli, Man., when he started practising there in 1973, but now there are only five, even though the population has grown.

He said Canada is losing an average of 250 doctors each year, mainly to the United States. Many of them are leaving because they lack the support and facilities, he said.

"The working conditions are abominable.

"Think of it - three million Canadians do not have access to a family doctor. That is unacceptable in a developed country. We need more hands on deck."

The study found that Canada has more nurses per capita than the OECD average but the ratio has been dropping while in most other countries it has been rising.
We may be losing doctors here in Canada, but our healthcare system is still better than in the States.
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Post by Aaeamdar »

maybe next time you can add your one liner without quoting the entire opening post...
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Post by vn_Tanc »

Seriously. Even a universal healthcare system counts their nickels.
Yeah. But we have a special tax to pay for ours. I've paid 9-10% of my wages my entire working life to provide money for the NHS and I'm happy to do so.

Perhaps it's coming from an upbringing where we have and use the NHS, but the thoughts of running hospitals for profit makes my skin crawl. Prolonging human suffering in the name of a few dollars is sickening.

So yeah, we may have long waiting lists for non-essential (and some essential) services but at the end of the day everyone gets treatment. And if you need vastly expensive, cutting edge, world-leading treatment you get it. For free at the point of care.

I used to work for a private mental hospital run by a US health corporation. They would shut down any hospital that made less than 32% profit per year. Thirty fucking two percent.

Diverting money meant for treating the sick into shareholders pockets instead of providing that treatment. I just can't get my head around the idea that this is acceptable.
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Post by Chidoro »

Don't fool yourself into thinking that healthcare doesn't cut corners in a UHS.

In addition, a hospital is obligated to give healthcare so long as you enter through their ER. They don't check everyone's card at the door even though they try to sort it beforehand.

The two hospitals I have worked for are both non-profit as well. Stop assuming that a private healthcare system=profit because it just isn't in a lot of cases.
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Post by Metanis »

/sarcasm on

I love the youngster's attitude that there is only ONE correct way to accomplish a goal.

/sarcasm off

In the larger picture there are many more similarities than differences between Canada's system and the USA's. Both are good faith efforts to deliver reasonable health care. Both will continue to evolve. Neither meets the needs of their entire population.

Life goes on... (or not), get over it.

(Chidoro is by far the more persuasive poster in this thread!)
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Post by Skogen »

Metanis wrote:/sarcasm on

I love the youngster's attitude that there is only ONE correct way to accomplish a goal.

/sarcasm off

In the larger picture there are many more similarities than differences between Canada's system and the USA's. Both are good faith efforts to deliver reasonable health care. Both will continue to evolve. Neither meets the needs of their entire population.

Life goes on... (or not), get over it.

(Chidoro is by far the more persuasive poster in this thread!)
"Life goes on, get over it"
The problem will just take care of itself. It kinda sucks, but oh well!

Yeah, what a wonderful outlook & approach to the situation. Let's wait until you are faced with an accident, disease or debilitation. I am sure your attitude will change. Its all very fun and nice to say crap like that when you don't have to deal with it.
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Post by Skogen »

Chidoro wrote:HMO profits overall may or may not be on the rise, but I think you'd be surprised to find out how many are actually non-profit. The largest in NJ and one of the largest in NY is. In fact, about 80% of the people that walk into our hospital network (largest and most prominant in NJ) belong to a non-for-profit provider.

Just out of curiosity, who do you think reviews claims that are contested between a hospital and a provider? More often then not, it's a MD. There's a lot more understanding of what they pay out and why than just saying that person is going to need a new hip in a few years. Care time is denied based on a ton of factors, both a hospital's failure to follow procedure and providers looking for loopholes alike.

I also think you'd be surprsied how many doctors think they are doing something that is a cost saving procedure but actually ends up costing the hospital far more. Why don't doctors release patients that are stable according to their charts?

I think you are oversimplifying the problem by blaming the HMO's as they are one of three major parts to this industry and what makes it tick. HMO's were a monster created by hospitals trying to vie for business. Companies want to provide their employees with reasonable rates so they don't have to contribute their entire paycheck to cover their family. How do they do that?
There profits are on the rise. BIG TIME. Especially Kaiser, which gives the poorest care imaginable. Just do a search on Google, and look at the amount of links that come up on the subject.

My point is that trying to take care of people via profitable business do not go hand in hand.
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Post by Metanis »

Skogen wrote:My point is that trying to take care of people via profitable business do not go hand in hand.
And you're an idiot.

Life goes on :)
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Post by Skogen »

Metanis wrote:
Skogen wrote:My point is that trying to take care of people via profitable business do not go hand in hand.
And you're an idiot.

Life goes on :)
Metanis wrote:/sarcasm on

I love the youngster's attitude that there is only ONE correct way to accomplish a goal.

/sarcasm off
Yeah, your right. Taking care of people via profitable business is the only way to do it.

/sarcasm off
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Post by Metanis »

A really long discussion of Canadian health care system.

http://www.mackinac.org/article.asp?ID=5863
The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t
Of the many ways that are available to tackle the question of what we all need to learn from Canada’s 30-year love affair with the government monopoly, single-payer health care system that we call Medicare, I think the model of that great health care analyst and public policy guru, David Letterman, serves our purposes best. I am therefore going to entitle my talk today, The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t.
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Post by Metanis »

Skogen wrote:Yeah, what a wonderful outlook & approach to the situation. Let's wait until you are faced with an accident, disease or debilitation. I am sure your attitude will change. Its all very fun and nice to say crap like that when you don't have to deal with it.
FYI Skogen

I am a big consumer of health-care services, deep into 6 figures at this point. When you spend 40 days in ICU the bills get kind of steep. My hospital bill had to be delivered by parcel post... it was too heavy for regular mail...
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Post by Legenae »

Even in that list, the Canadian health care system is ranked higher than the US. Hence the reason that Skogen pointed out that the US has no room to criticize another country's health care.

Most Canadians are happy with having the government in charge of the health care instead of it being privatized so only the rich can get treatment.
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Post by Skogen »

Metanis wrote:
Skogen wrote:Yeah, what a wonderful outlook & approach to the situation. Let's wait until you are faced with an accident, disease or debilitation. I am sure your attitude will change. Its all very fun and nice to say crap like that when you don't have to deal with it.
FYI Skogen

I am a big consumer of health-care services, deep into 6 figures at this point. When you spend 40 days in ICU the bills get kind of steep. My hospital bill had to be delivered by parcel post... it was too heavy for regular mail...
That makes your standpoint even sadder...
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Post by Forthe »

The US view on public health systems has always puzzled me because

1)The US has other public service systems that nobody seems to mind not being market driven.

Imagine a market driven police system rather than a public one where if you don't have crime issurance the police won't respond to your calls.

Imagine a similar deal with fire departments allowing your house to burn down if you don't have fire insurance.

I wouldn't want either of these public services being run by free market profit driven moraless forces and as a Canadian not subjected to PR forces of for-profit medical companies I feel the same way about health care.

2) The US could cut it's military budget (still spending way more than any other country in the world) and easily provide universal health care to all its citizens.

I don't understand how using tax payer's dollars to produce tactical nukes is a wiser use of your dollars than paying for your health care needs.

The US could substain a universal health care system with much less effort or sacrafice than Canada does.
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Post by Kilmoll the Sexy »

Forthe wrote:The US view on public health systems has always puzzled me because

1)The US has other public service systems that nobody seems to mind not being market driven.

Imagine a market driven police system rather than a public one where if you don't have crime issurance the police won't respond to your calls.

Imagine a similar deal with fire departments allowing your house to burn down if you don't have fire insurance.

I wouldn't want either of these public services being run by free market profit driven moraless forces and as a Canadian not subjected to PR forces of for-profit medical companies I feel the same way about health care.

2) The US could cut it's military budget (still spending way more than any other country in the world) and easily provide universal health care to all its citizens.

I don't understand how using tax payer's dollars to produce tactical nukes is a wiser use of your dollars than paying for your health care needs.

The US could substain a universal health care system with much less effort or sacrafice than Canada does.

I can also imagine people abusing the healthcare because it costs them nothing. The abuse alone would put the cost of healthcare here beyond anything you could even imagine. There are people here who would injure themselves purposefully so they could get medication to sell on the street. We would also begin losing doctors as it would no longer be an attractive profession.

I do agree with you partially. If the US would just end giving aid to countries, we could have the deficit gone inside of 10 years and still be able to actually put money into the Social Security fund.
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Post by Kilmoll the Sexy »

To back this up with numbers for you:

64% of Americans are either overweight or obese. Highest rate ever. That is up 8% from the 1988-1994 time frame and 17% from 1976-1980 period. The health problems from this is going to increase as time goes on. Emergency visits are up to 62 visits per 100 people on average. The quality of our care has gone up in spite of the climbs in problems.
Infant mortality rate is at an all time low of 6.9 deaths per 1000 births. Life expectancy is 76.9 years...also an all time high. Births for the year of 2000 are at a 30 year high.

Take away incentives for quality doctors and the numbers are going to drop as the visits per 100 people climbs to an astronomical number.
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Post by vn_Tanc »

Take away incentives for quality doctors and the numbers are going to drop as the visits per 100 people climbs to an astronomical number
You can still reward doctors in a non-profit all-access healthcare system.
Sure, they might not become multi-multi-millionaires for 2 days a week work and play golf the rest of the time but they'll still do very nicely.
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Post by Kilmoll the Sexy »

I play golf and basketball with people in the medical field. They are fairly well off, although I would not say they are anything near "multi-millionaire" status. They also worked incredibly hard and were in quite a bit of debt just so they could become a doctor. I would sure not want to endure the hours they put in. They are definitely earning every penny they make (for the most part).

I would never want to see a government controlled health care here. I would be more interested in federal watchdog groups stepping in to control the rise of some of the costs that are almost criminal in some situations.
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Post by Chidoro »

vn_Tanc wrote: You can still reward doctors in a non-profit all-access healthcare system.
Sure, they might not become multi-multi-millionaires for 2 days a week work and play golf the rest of the time but they'll still do very nicely.
Unless you're in an elective field like plastic surgery, that isn't going to happen. Don't mistaken my point that because I know the problem in America is due to a lot of factors and not just the HMO's to mean that doctors don't bust their ass in this country. Believe me, they do. It's a very difficult profession, very difficult. The point of entry alone leaves no room for underachievers. You don't go somewhere in the medical profession w/out having a solid background. It's not the same thing as becoming a lawyer where there can be many of them running around bleeding the country dry with a degree from Bob's Law School. There isn't a Bob's Medical College out there I find that opinion of doctors to be pretty insulting and very ignorant.

The problem with doctors is that they don't always understand the guidelines. I'll give two examples.

A patient may come to terms and have to move to a hospice unit. There is minimal care at a hospice unit as it's, essentially, a comfortable place to pass on. However, there are procedures that can be done to make the stay more comfortable. One procedure involves the insertion of a cath to someone so they can drain certain fluids themselves. Pateints are already deemed hopeless and the insurance company will usually only reimburse for minimal care, maybe $500-550 per day at most. This hospice procedure that can be done for certain patients can run over $50k. Doctors want the patient to be comfortable but they don't understand that the hospital eats mostly all of the cost.

Our hospital has a new cancer institute. The rooms are fully private(not semi which is normal)and very nice for a hospital room. Patients that no longer require the higher level care need to be moved to a normal semi-private room with standard observation. Patients don't want to move though because they know the room they are currently in is superior. If the cancer institue was at 30-50% capacity, this wouldn't be too much of an issue but if it's at 95% like it typically is for us, it's not only unfair for the new patients, the hospital is only going to be reimbursed a nominal rate as opposed to the cancer institute rate. You can bleed through over $2k a day in over 50 beds if you have just a couple of doctors not willing to move the patients. That equates to over 30 million a month the hospital doesn't get reimbursed.

It's scary stuff however, it's not as if these types of problems are unique to a privatized system. Do you think that people in Canada or GB are receiving certain treatments/products first? No way. If there's no money in it, no way. Is it fair that so many hard working people in America can't afford health insurance because their employer can't afford to do the contributions required? No way. Hell, it ends up costing hospitals a ton of money in charity care. And that's only for people entering through the ER. I can't tell you how many people come to my office just to APPLY for charity care because they gave birth but don't have insurance. I have no clue how many actually get it and that's terribly unfair as well.
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Post by Kylere »

Forthe wrote:I don't understand how using tax payer's dollars to produce tactical nukes is a wiser use of your dollars than paying for your health care needs.
Just on a side note, the US Military got rid of it's tactical nukes in the early 90's. It now relies on much larger Tomahawk delivered devices to support that role.
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Post by Forthe »

Kylere wrote:
Forthe wrote:I don't understand how using tax payer's dollars to produce tactical nukes is a wiser use of your dollars than paying for your health care needs.
Just on a side note, the US Military got rid of it's tactical nukes in the early 90's. It now relies on much larger Tomahawk delivered devices to support that role.
I guess you are not aware of Rumsfield's latest brainchild.
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Post by Aaeamdar »

Even in that list, the Canadian health care system is ranked higher than the US.
"That list" is the same list that put France #1. We discussed this in some depth when the people in France were dying due to lack of air conditioning. One of the big components of "that list" (the WHO list) is how evenly the costs of health care are distributed over the populace. It should be very clear that the list itself values socialism. That's fine as long as you are not debating the value of socialism. It should be obvious, however, that when debating whether a socialized form of helthcare is better than a less socialized (sadly, we are no where close to freemarket healthcare, just closer than most others) healthcare, you can't use the rankings of a study that values socialism in and of itself.

EDIT:
A pre-empetive edit. I suspect some people are not going to understand. I hope I am wrong, but since I almost certainly am not - here is an example. I say that Bear is better than Water and you disagree, so we conduct a study of drinks. The study ranks various drinks and among the few factors considered is "Percent content of Water in Drink." It should be obvious that the study is already valuing water in and of itself and thus clearly cannot be used to help determine whether water is better than any other drink.

The study, however, could be used to compare two drinks, neither of which was water. People still might look at the study and say "yeah, but look, it uses water % as a factor - who cares about water %?" That is, you might not agree on the meathodology, but at least the meathodology was not unfairly weighed towards a particular result.

Likewise, if you want to compare Healthcare systems in the abstract, you can include "equality of distribution of costs." then, someone like me would say "well that study is flawed. I do not care about the equality of distribution of costs." But, again, we are just arguing about the meathodology and what is important in a healthcare system.

Obviously, however, if we are arguing about whether equality of distribution of costs makes a healthcare system better, a study that already inculdes equality of distribution as a positive (or negative, for that matter) factor in its ranking is pointless.
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Post by Kargyle »

But does it really matter that Country X has doctors so good they can resurrect the dead if no one can afford to go see them? That is where the value of measuring the distribution of the cost of health care becomes important. How good is the health care in a country, no matter how good their doctors and equipment are, if only 35% of the population can actually afford to get treated?

(note 35% is an arbitrary number that I picked. It is not meant to be a representation of the number of people in America that can afford health care)
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Post by Aaeamdar »

O.K. , less ambigous example, I guess.

Is this a fair study?

You and I want to know whether Blue light is better than Red light. Our study ranks colored lights using the following criteria.

1. Amount of Red.

2. Amount Green.

The shocking result of the study is that Red ranks higher than Blue! Who would have guessed?
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