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Author Topic: National Health Systems  (Read 12240 times)
Slobodan Blagojevic
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« Reply #40 on: October 27, 2012, 01:45:46 PM »
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... I'd vote today to issue every child with a single-payer government funded insurance card... I might be swayed to extend that to 25 if still FULL time college...

... I'd allow heath insurance companies to compete across state lines (competition ALWAYS makes the difference), eliminate pre-existing condition clauses...

+1

(See? I am working on my eloquence Wink)

Generally being a pro-free market guy, I was always puzzled by the lack of competition in the insurance industry. And why not foreign competition as well? If we can have, say, Russian gas stations here, why not Russian, Chinese, Canadian, etc. insurance companies?

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...and STOP all care going to those who are not here legally...

As much as I am against illegal immigration, I could not agree with the "all" part. There is a certain floor, simply defined by humanity, that would oblige anyone, let alone Hippocratic Oath signers, to help someone in an emergency.
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Steve Weldon
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« Reply #41 on: October 27, 2012, 02:01:28 PM »
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Lots of things are complicated - that does not put them beyond understanding.
Please don't put words in my mouth - the only objection you provided was that the report was from Canada.  
You seem to be making some kind of insinuation - why don't you just state what you mean in plain terms?
Do you have absolutely no problem with letting adults who will never have your abilities or your opportunities, suffer the consequences?
When health insurance is employer provided, isn't that a problem?



1.  Not beyond understanding, but more hard to understand.  And judging by the simplistic responses it's evident that bar isn't very high.   When I say "it's complicated" what I really mean is "please try and think at least one move ahead."

2.  At the most I reorganized your words.

3.  Fair enough.  It's been my experience that the overwhelming majority of these "research groups" including recently some sterling examples on the global warming side, are bought and paid (financed by or hold allegiances to) special interest or government groups.  In which case they are flawed by design.  Studies (independent of course  Grin) have shown this time and again.  You tell me, who's financing and motivating this research?  Is there some rich billionaire out there who really wants to know, so he finances research?  I'm sure there are some, but they're very few.  Many are financed through special interests, government, or academia which taints them with the politics of their institution.  There is no such thing as a free lunch.  We might get smaller or bigger portions, but it's always paid for by it's  very existence.

4.   Yes I do.  It makes me sad they've been led down this primrose path by those who have used and abused them by telling them the government owes them healthcare, or the police can protect them, or any of those types of promises.  There is no utopia.  I want to help them, but mostly those who would follow, by showing them the truth so they can select alternative routes.  And yes my heart goes out to them.  But not enough to take money from your pocket to buy it for them.  I respect your pockets and what it took for you to fill them however full they might be.   I only ask for the same in return.

5.  Not at all.  Because it shouldn't be. At this time, according to the Census ONLY 55% of Americans get their health insurance through their employer.  It used to be MUCH less than that.   It started out as a fringe benefit during WWII when we had so many men at war, companies needed to compete for scarce labour.  Because of existing caps on salaries and other benefits health insurance was added on as a fringe benefit.  Not a right, not as direct compensation, but as a minor benefit to entice new employees.

The NRLB later found it should be taxed as a "fair part" of their wages because of extreme pressures by special interests groups aligned with.. well.. you can find that answer yourself, I'd had to be labelled a nutcase..

Health insurance as a employee provided benefit would have been dropped right there if not for these same special interest groups who started offering tax breaks to employers to keep it on.  

And it's all history from there..  Employers started health insurance as they would any other promotional means to lure in workers.. and special interest groups turned it into an expected right.  

So.. it's not a problem because it never should have been.  Many who are self-employed and run their own businesses such as photography studios buy 100% of their own health coverage.  I see no reason why, if wages are properly adjusted, we can't do that now.  And I'd prefer it.
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Steve Weldon
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« Reply #42 on: October 27, 2012, 02:03:28 PM »
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As much as I am against illegal immigration, I could not agree with the "all" part. There is a certain floor, simply defined by humanity, that would oblige anyone, let alone Hippocratic Oath signers, to help someone in an emergency.

Being a reasonable guy I can compromise on this to the extent we treat them to STABILIZE so they have every expectation of a safe return to their own country for further treatment if required.   
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Steve Weldon
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« Reply #43 on: October 27, 2012, 02:07:37 PM »
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The US medical system would be wonderful but for one, major, cancer. That is malpractice attorneys and their frivolous malpractice suits. Physicians are forced to practice CYA medicine - cover your ass medicine - ordering countless tests and studies to protect themselves against a lawsuit should their patient have a very unexpected, statistically remote disease that would not be addressed or picked up with "normal" studies and tests.

Literally, physicians are forced to order at least 50% more studies and tests than they need to in order to protect themselves against these leaches known as malpractice attorneys.

I swear to you, if we could get any sort of reasonable tort reform passed on a nationwide scale, costs would plummet 50-70% in the course of 6 months.

We could deal with the rest of the problems later.

It is not the physicians that are to blame here; their very homes are at stake should they have the misfortune of missing a .01% condition.

Of course tort reform will never happen, because Washington is run by these very same leaches called attorneys.

I'm not sure on the numbers, but they are high..   Good post!
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Ligament
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« Reply #44 on: October 27, 2012, 02:14:10 PM »
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I'm not sure on the numbers, but they are high..   Good post!

Unfortunately, as a physician myself, and seeing how the system works, I honestly think a minimum of 50% healthcare spending would be eliminated with good tort reform. This is the sentiment of every single EVERY single physician I have discussed this with. The physicians in this country know what the problems are with the system, yet nobody listens to us or even asks our opinions.

BTW, we do not profit from all these excessive tests and studies. We actually lose money as 99% of us do not own these labs or imaging centers, and we have to pay our staff to schedule these studies, get the records and reports from these studies which takes significant manhours.
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Steve Weldon
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« Reply #45 on: October 27, 2012, 02:23:35 PM »
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Steve,
Let's not exaggerate. I'm not trying to equate America with India where, in my experience, poor people are frequnetly left to die on the streets without any help at all.

The words I used were, "die due to a lack of proper treatment". By proper, I mean the standard, accepted procedures for the treatment of any particular life-threatening illness.

There are always situations of malpractice that can occur in any hospital, public or private. However, the principle that applies in Australia, is that no-one should be disadvantaged regarding availability of best-practice medical care if he is in a life-threatening situation. But there are always non-essential medical procedures for which there may be a long waiting list for the uninsured.

That's certainly a move in the right direction. But I'd still be very concerned about additives such as fructose, which I've never seen listed amongst any food indredients. It's always hidden under the general heading of 'sugar'.

Fructose is about twice as sweet as ordinary table sugar, or cane sugar, (known as sucrose) and as Jeff Schewe mentioned, it's cheaply available from processed corn syrup. It's the cheapest and most effective way of sweetening food, which is why it's widely used in the food-processing industry.

However, recent research, is beginning to reveal that excessive fructose, which is also the natural sugar of fruit, can have serious health consequences. There are strong indications that it can contribute towards the following conditions:

Gout, High Blood Pressure, High Cholesterol and High Triglycerides,  Kidney disease, Heart disease, Fatty liver disease, and Alzheimers.

I guess you are referring to the vegetables and stuff which are fried in the wok.

Again, recent research is revealing that saturated animal fat, lard and real butter is actually better for you than polyunsaturated fats from sunflower seed and canola, provided you don't eat too much of the saturated fats, of course. Margarine and skimmed milk is not recommended. The rationale for this modern view is that we are animals and have to produce our own fat and cholestrol which is very similar to the saturated fat and cholestrol in real butter, lard and meat. The human body struggles to generate its required fat and cholestrol from these highly processed margarines and fat-free milks.

There's emerging evidence that such artificial, fat-free foods can increase the risk of cancer.

However, one gripe I have about Asian countries is their insistence on using white rice all the time. In the West (not sure about America, though) we've long since realised the benefits of wholemeal bread. Go into any supermarket in Australia, and most brands of bread are varieties of wholemeal. White loaves are still available on the shelves, but in very small quantities. They're almost extinct, as they should be.

I've only ever come across one restaurant in all my travels that offers a choice of brown rice or white rice. And that's a restaurant by the name of Moon Dance in the city of Pokhara in Nepal.

So, for all you landscape-loving photographers, when you visit Nepal to take fantastic photos of the Himalayas, don't forget to visit the Moon Dance restaurant and experience their fine brown rice, if you also happen to visit Pokhara, which is a great centre for trekking.

To keep the thread related to photography, I'll now show a couple of pictures for the very discerning, of that brown rice being threshed. Looks like thrashing to me. "Oh! No! Please don't thrash me. I've done no wrong."  Grin



1.  Ray, I wasn't exaggerating.  I was trying to find your bar, where you thought the problem to be.

2.  So your bar is one person?  Okay, but can you tell me if this happens any more/less than in any other westernized country?  I can't.  It's very easy for one person to slip through the cracks because of a less than skilled or motivated worker..   To me where the real problems are is when POLICY allows this to happen and policy stops being enforced.  This has not happened in America.  I would read different newspapers or internet sites..

3.  Non-essential medical procedures.. wow.  But I hear this a lot from single payer systems.   It really says it all doesn't it?  Healthcare is being rationed.

4.  Frutose is on our ingredients here.. and many people shop by if a product (say orange or fruit juice) contains frutose or regular sugar.   Though, it's been amusing listening to our politicians be lobbied by special interest groups who are telling us that frutose is just as safe and healthy, in fact more so, than cane sugar..

5.  But  will they flip on the next study?  It seems like every day some study is showing us without a doubt that we're being killed by our favorite foods.  Seems a shame.  The bar for "research" or "studies"  needs to be set a lot higher and I've got a plan on how to do this.  Don't base policy on research funded by special interests, government, or academia.  Too bad we can't trust our own governments.

6.   Enjoyed the pics!
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Steve Weldon
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« Reply #46 on: October 27, 2012, 02:25:18 PM »
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Unfortunately, as a physician myself, and seeing how the system works, I honestly think a minimum of 50% healthcare spending would be eliminated with good tort reform. This is the sentiment of every single EVERY single physician I have discussed this with. The physicians in this country know what the problems are with the system, yet nobody listens to us or even asks our opinions.

BTW, we do not profit from all these excessive tests and studies. We actually lose money as 99% of us do not own these labs or imaging centers, and we have to pay our staff to schedule these studies, get the records and reports from these studies which takes significant manhours.
Two of my best friends are doctors and they're telling me the same thing.  I worked for several years as the department head of prosthetics in a VA hospital and saw enough to convince me as well.
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Slobodan Blagojevic
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« Reply #47 on: October 27, 2012, 02:26:45 PM »
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... It is not the physicians that are to blame here...

... leaches called attorneys.

Ok, how would we deal with, say a dentist employing totally unskilled labor as a technician and letting her administer and monitor anesthesia (a recent Chicago case)? His profit-increasing method resulted in death of a little girl.

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Steve Weldon
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« Reply #48 on: October 27, 2012, 04:29:37 PM »
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Ok, how would we deal with, say a dentist employing totally unskilled labor as a technician and letting her administer and monitor anesthesia (a recent Chicago case)? His profit-increasing method resulted in death of a little girl.



What comes immediately to mind is charge them criminally.  If there are laws that say "thou shall" and if "thy don't" then make the punishment criminal rather than civil.  

I know.. but what about the poor parents who want?   Want what?  Justice or compensation?   I wonder if we started letting the injured parties decide "you get so much money or the person who broke the rules gets 10 years in jail, structured upwards for more serious injuries to death..

Compensation originally started out as a means to compensate survivors or their family for their lost potential.  If the little girl was say left injured by alive, what would it cost to provide her car during her lifetime?     If she died, what income would a kid in her social strata be expected to give their parents?    That's one type of compensation and I think reasonable.

But this "punitive" stuff is what's killing us.  Punitive is meant to punish the system, the police department, the city, the hospital.. and it's bankrupting us in many places.  

I can support criminal charges and payment for compensation.  I do not support punitive judgements.   They're about as useful in today's world as Affirmative Action, Green Stamps, Film, or heck even a Ford Pinto..
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Isaac
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« Reply #49 on: October 27, 2012, 06:39:18 PM »
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3. ... Many are financed through special interests, government, or academia which taints them with the politics of their institution.
You wrote "I would be surprised if a biased article for Canada would give any better of a grade to the US..  We can all see why ?"

As far as I can tell, you still have no specific reason to think the report biased.

In particular, you have no specific reason to think the report biased to show US health outcomes to be worse than those of other nations.

Dismissing a report as biased simply because you don't know who paid for the research is not a sign of healthy scepticism -- it's outright cynicism.


There is no utopia.  I want to help them, but mostly those who would follow, by showing them the truth so they can select alternative routes.
For those who will never have your abilities or your opportunities, "alternative routes" seem a figment of your utopia.

Many who are self-employed and run their own businesses such as photography studios buy 100% of their own health coverage.  I see no reason why, if wages are properly adjusted, we can't do that now.
If wages are properly adjusted -- and there's the reason why.
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Ligament
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« Reply #50 on: October 27, 2012, 08:17:04 PM »
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Ok, how would we deal with, say a dentist employing totally unskilled labor as a technician and letting her administer and monitor anesthesia (a recent Chicago case)? His profit-increasing method resulted in death of a little girl.



That is irrelevant to the discussion. That is a criminal case.

Dentists are not involved significantly in the health care costs of this country.
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« Reply #51 on: October 27, 2012, 08:34:12 PM »
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You wrote "I would be surprised if a biased article for Canada would give any better of a grade to the US..  We can all see why ?"

As far as I can tell, you still have no specific reason to think the report biased.

In particular, you have no specific reason to think the report biased to show US health outcomes to be worse than those of other nations.

Dismissing a report as biased simply because you don't know who paid for the research is not a sign of healthy scepticism -- it's outright cynicism.

For those who will never have your abilities or your opportunities, "alternative routes" seem a figment of your utopia.

If wages are properly adjusted -- and there's the reason why.


1.  Are we hung up on the USA vs. Canada way I wrote that sentence?  I'll agree it was vague and looking at it I now wish I would have spent a few more seconds writing it differently, but I think I've paid my debt to the society of poor sentences by clearly explaining what I was thinking and what I meant.  To clear up any further questions allow me to address this again:

I would be surprised that an article written by a Canadian research group is anything but biased based on what I know and continue to learn about research group/study funding.  I think such a report would be biased on a level with Canada's political interests (I'm thinking of the typical Canadian politician criticism on US policies which are mostly half-truths and almost all self-serving) to not exclude countries other than the USA, but with an emphasis on the USA to be sure.

2.  Yep, any reasonably educated person will mark research/studies as biased when they lack information on who is paying for them.  Well, reasonably educated or unreasonably indoctrinated.  You choose.  

It's common knowledge that biased and outright corruption run deep in our research community.  And unfortunately it hurt to learn our scientific community as well.  But then, they both have in common that their livelihood, professional future, and more depends on a steady stream of incoming grants and other funding mostly brought on by our most controversial topics of the time.   Heck, we even have equipment reviewers disclosing their review Ipod was provided by Apple to keep their head above the taint.  Most of us here on this forum are reasonably educated reasonable photographers who know enough about the game to know how it works.  As such we know it would be an exception for a research or study group to be independently funded either by someone in government, academia, special interests.. or someone not connected to them.  As an exception it would seem mandatory a disclosure statement would preface any release from such research/study groups.  I didn't see one.

3.  Since you don't know I was a disadvantaged ethnically challenged kid from the wrong side of the tracks can we assume you're assuming there is always someone more disadvantaged than ourselves, and this is what you're basing this specific opinion on?  If so you're coming from the pits of pessimism on this one no?  Not a very realistic position to say the least.

4.  I agree it would take some doing and probably a decades worth of adjusting.. but it's doable.  And ultimately less corrupt and pure than artificially assigning employers as the default payers of health insurance for the rest of our days as we know them.. just because they tried to do a good thing at the wrong time i history. (this stuff requires a degree of humor..)


I've yet to figure out your position on all this.. but I'm listening when you're ready.  Hit me with your best solutions.  (but please not the Robin Hood scenario, it's been done to death).
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Slobodan Blagojevic
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« Reply #52 on: October 28, 2012, 12:50:31 AM »
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That is irrelevant to the discussion. That is a criminal case.

Dentists are not involved significantly in the health care costs of this country.


That is just plain stupid, on all three points.
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« Reply #53 on: October 28, 2012, 05:39:25 PM »
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I would be surprised that an article written by a Canadian research group is anything but biased based on what I know and continue to learn about research group/study funding.  I think such a report would be biased on a level with Canada's political interests (I'm thinking of the typical Canadian politician criticism on US policies which are mostly half-truths and almost all self-serving) to not exclude countries other than the USA, but with an emphasis on the USA to be sure.

Again, this pre-judgement is an expression of cynicism, not of sound reasoning.
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Steve Weldon
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« Reply #54 on: October 28, 2012, 10:10:46 PM »
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Again, this pre-judgement is an expression of cynicism, not of sound reasoning.


We'll just have to agree to disagree.  I gave you supported reasoning and just because you reject it doesn't make it not given.   And you pretty much sit alone if you don't automatically consider the funding of any research/study as a vital piece of information to be used in it's evaluation.  I had a half dozen professors in my universities warn us of the same thing.. not that I'm now giving academia credit, but they're not all bad.  We just need to take the time to sort them out so we know how to rate their input to our educations.

 Well, I think we can agree I've been polite and answered your questions the best I could.  How about my questions, don't I deserve the same courtesy?

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« Reply #55 on: October 29, 2012, 12:18:37 AM »
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... if you don't automatically consider the funding of any research/study as a vital piece of information to be used in it's evaluation.

Considering funding as information to be used in evaluation of the research would be reasonable -- but that is not what you have done.

You have repeatedly claimed the research is biased without having any knowledge of the funding source, or showing anything that suggests bias.

That cynical dismissal is just as much an enemy to reason as na´ve approval.
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« Reply #56 on: October 29, 2012, 05:05:52 AM »
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Considering funding as information to be used in evaluation of the research would be reasonable -- but that is not what you have done.

You have repeatedly claimed the research is biased without having any knowledge of the funding source, or showing anything that suggests bias.

That cynical dismissal is just as much an enemy to reason as na´ve approval.

I agree with you Isaac.  But, what knowledge do you have that precludes the presence of funding induced bias in the research? 

As I have gotten older, I have come to the opinion that often when two opposing groups are very loudly stating that the other side is completely wrong, then the truth is probably somewhere in the middle.  Not always true, but very often, in my opinion. 
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« Reply #57 on: October 29, 2012, 05:16:09 AM »
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1.  Ray, I wasn't exaggerating.  I was trying to find your bar, where you thought the problem to be.

2.  So your bar is one person?  Okay, but can you tell me if this happens any more/less than in any other westernized country?  I can't.  It's very easy for one person to slip through the cracks because of a less than skilled or motivated worker..   To me where the real problems are is when POLICY allows this to happen and policy stops being enforced.  This has not happened in America.  I would read different newspapers or internet sites..

3.  Non-essential medical procedures.. wow.  But I hear this a lot from single payer systems.   It really says it all doesn't it?  Healthcare is being rationed.

4.  Frutose is on our ingredients here.. and many people shop by if a product (say orange or fruit juice) contains frutose or regular sugar.   Though, it's been amusing listening to our politicians be lobbied by special interest groups who are telling us that frutose is just as safe and healthy, in fact more so, than cane sugar..

5.  But  will they flip on the next study?  It seems like every day some study is showing us without a doubt that we're being killed by our favorite foods.  Seems a shame.  The bar for "research" or "studies"  needs to be set a lot higher and I've got a plan on how to do this.  Don't base policy on research funded by special interests, government, or academia.  Too bad we can't trust our own governments.


Steve,
Ultimately, one can only go along with what makes sense and what seems credible. I don't claim any special insights into the American health-care situation. I can only draw conclusions from reports mentioned on the internet and other sources.

Wikipedia is certainly not an infallible source of information, but at least it allows corrections and amendments to its articles from people who think they have a more reliable or more in-depth understanding of the subject.

I'll quote the following fairly long extract from Wikipedia because I find it quite revealing of the difficulties in getting accurate information. If you disagree with the position represented in the article, why not amend it or add to it with more reliable information?

Essentially, what I understand from this Wikipedia article is that the number of uninsured Americans who die each year as a result of a lack of insurance is roughly equal to the minimum estimate of the number of insured Americans who die as a result of medical errors. But no-one has of course a reliable and accurate estimate of the true number of deaths each year due to medical error. Some estimates are in the hundreds of thousands. How could anyone possibly determine what the actual figure is. If every medical practitioner were to admit or confess when he/she had made a mistake or had been negligent, then we wouldn't need such an expensive legal system to try to get to the truth.

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Enjoyed the pics!

At least you have impeccable taste. Grin

Quote
A study published in the American Journal of Public Health in 2009 found that lack of health insurance is associated with about 45,000 excess preventable deaths per year.[27] One of the authors characterized the results as "now one dies every 12 minutes."[28] Since then, as the number of uninsured has risen from about 46 million in 2009 to 48.6 million in 2012, the number of preventable deaths due to lack of insurance has grown to about 48,000 per year.[29]

A Hearst Newspapers investigation called medical error "far more deadly than inadequate medical insurance."[30] The number of Americans with access to care who are killed by medical errors is estimated from 44,000[31] to hundreds of thousands each year,[32][33][34] and the New England Journal of Medicine published a study finding that American hospitals injured around 20% of all patients every year from 2002-2007.[35] Notably, Representative John Murtha, who had voted for the House healthcare reform bill in 2009, died from a surgical error in 2010.[36] Moreover, the best predictor of longevity is education; in study after study, money and health insurance "pale in comparison."[37]

A survey released in 2008 found that being uninsured impacts American consumers' health in the following ways:[38]

More of the uninsured chose not to see a doctor when were sick or hurt (53%) vs 46% of the insured.

Fewer of the uninsured (28%) report currently undergoing treatment or participating in a program to help them manage a chronic condition; 37% of the insured are receiving such treatment.

21% of the uninsured, vs. 16% of the insured, believe their overall health is below average for people in their age group.

The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost-shifting and higher health insurance premiums, or paid by taxpayers through higher taxes.[39]

On the other hand, the uninsured often subsidize the insured because the uninsured use fewer services[40] and are billed unfairly.[41] 60 Minutes reported, "Hospitals charge uninsured patients two, three, four or more times what an insurance company would pay for the same treatment."[42] On average, per capita health care spending on behalf of the uninsured is a bit more than half that for the insured.[17]

A study published in August 2008 in Health Affairs found that covering all of the uninsured in the US would increase national spending on health care by $122.6 billion, which would represent a 5% increase in health care spending and 0.8% of GDP. The impact on government spending could be higher, depending on the details of the plan used to increase coverage and the extent to which new public coverage crowded out existing private coverage.[43] Massachusetts' law requiring everyone to buy insurance has reportedly caused costs there to increase faster than in the rest of the country.[44]
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« Reply #58 on: October 29, 2012, 06:43:40 AM »
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I was a bit leery about jumping in on this one, but thought it may begood to clear a few things up.

First, Canada is not a single payer system.  Health care is administered by the provinces.  While there are minimum requirements for service provision laid out in federal law, not all provinces are the same.

Second, I don't know if Michael pays for any supplementary health insurance, but there is a limit to what is covered by the government.  Once the 'normal' treatment regimen associated with a particular diagnosis or procedure is finished then any additional costs are, indeed, borne by the patient or the supplementary insurance policy.

Most supplementary insurance policies offered as part of a benefits package by employers will not have exclusions for existing conditions.  But it is common to have deductibles or co-pays.  If an individual pays for his/her own supplemental policy, there will also be exclusions for existing conditions as well as co-pays/deductibles.  Many supplementary policies, whether employer provided or self paid will also have annual and/or lifetime caps on coverage.

Lastly, and most importantly, I hope for you a speedy and complete recovery, Michael.
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Steve Weldon
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« Reply #59 on: October 29, 2012, 10:39:45 AM »
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Considering funding as information to be used in evaluation of the research would be reasonable -- but that is not what you have done.

You have repeatedly claimed the research is biased without having any knowledge of the funding source, or showing anything that suggests bias.

That cynical dismissal is just as much an enemy to reason as na´ve approval.
We have no knowledge of funding because they have selected to provide none.  This is unacceptable and irresponsible considering the current climate of their industry.   It doesn't take a genius to surmise why.  They have a responsibility to do so lest their studies appear tainted.  As a responsible consumer of their product how can I ignore this?

"As information to be used in evaluation", and considering they elected to  give none, wouldn't we consider the driver who refused a Breathalyzer to be under the influence (in fact most laws close this loop for us), or the person on trial who refused to speak in their own behalf to at least be hiding something?   This is no cynicism my friend.  It is due diligence.   
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