oic. personally i’m against unisex bathrooms cause I don’t want to see bloody tampons all over the place. Also I kinda agree vegetarians are pussies and our bodies were designed to be able to consume meat, though it does sorta frighten me the kinds of shit and drugs being pumped into all of the meat we consume these days. but oh well, i still encourage vegetarianism because it will ultimately reduce the demand for meat and therefore lower prices for me :adamsmithsmug:
I support insurance coverage for regular check-ups. Don’t misunderstand me: I applaud the new laws that facilitate that. I see no moral hazard problem with very poor people getting basic, government-sponsored health coverage. These plans are unlikely to contain the frills people would exploit.
What I oppose is the decades-old tax exemption for employer health insurance, which applies to employees of all incomes. As I said,
Surely every college student here knows someone who regularly buys prescription Adderall, Ritalin, Vicodin, Oxycontin, or the like, not because he actually needs it, but because he wants to stay up late studying, or wants more energy, or enjoys feeling no pain. Rich people with expensive insurance often get coverage for gym memberships.
Examples aside, health care as a proportion of the GDP has increased every year for the last four decades. Almost all the increase comes from an explosion in treating minor ailments. Moral hazards and the employer health care deduction offer an obvious explanation for this increased spending on minor ailments. Sinistral, you claim this explanation is “absurd”; if you have a better one, by all means, share it. The point is, we can’t keep spending more treating minor ailments. It’s wasting our GDP and making it impossible for the US economy to keep pace with that of China, where these little luxuries are near-unheard of.
Zeppelin, you mention the value of preventive medicine. As I said, I support insurance coverage for regular check-ups. Beyond check-ups? I have consistently read that doctors test too often for common ailments like breast cancer and prostate cancer, at ages when patients are extraordinarily unlikely to have them, and when detection by testing is unlikely at best. Sinistral can probably speak more on this subject. The testing issue ties back to tort reform: doctors run unnecessary tests because they fear catastrophic tort claims.
Perhaps by “preventive medicine” you mean “healthy lifestyle.” I support this above all, but I don’t think doctors can make people exercise more, eat less, sleep more and drink less. I think the New York City trans fat ban is an excellent example of how the government can help keep people healthy. But the self-destructive American lifestyle is a much broader topic.
This is like saying, “Curing sick patients is much more important than biology minutiae.” Tax benefits are the reason employers began offering health care several decades ago. These “tax minutiae” induce people to spend billions on luxurious health care they wouldn’t spend otherwise, and then to exploit all its frills. You don’t want to descend to the details, because you don’t know the details, but your ignorance does not make those details matter less.
You want “solutions to the high costs of the medical system.” The new laws utterly fail to address high costs, except by cutting Medicare spending. Instead, they increase taxes and fees to pay for expanded coverage. I suggested that tax reform and tort reform could make the system more efficient. Of course, these are dry subjects, and surely the minutiae are very boring. As it happens, these reforms are exactly what economic conservatives and many disinterested law professors are advocating. If you have better suggestions for how the federal government can make health care more efficient, by all means.
Right on cue, Arac arrives to take his bitter potshots, then vanishes under the cover of flippant irony. Years ago, he would argue in long paragraphs with Silhouette, who liked Harold Bloom and the Beatles, but ever since discussing PETA in 2008, Arac seems to have lost heart for extended rhetoric. Perhaps his postmodern Brown education has instilled in him a distrust of chauvinistic “rationality”? Has Arac undergone Barthes’ “death of the author,” wherein the ego behind the text vanishes, leaving only the wordplay itself? Rather than address my arguments, Arac now paints caricatures of my past arguments, then pokes fun at their grotesqueness. Has he not become a linguistic world unto himself?
just sayin’
Quid pro quo. If Arac wants a real argument, I am happy to oblige. But if he wants potshots and irony, I can do that too.
The point is, we can’t keep spending more treating minor ailments. It’s wasting our GDP and making it impossible for the US economy to keep pace with that of China, where these little luxuries are near-unheard of.
If the U.S. had a working health care system, especially one that did not tie into employment, entrepreneurship would boom. Health care costs make up a nice chunk of the fixed costs for start-up companies and the possibility of losing your coverage if you leave certain kinds of jobs increases the risk of setting up your company and makes people cling to shitty jobs where they are not as productive. I mean, the U.S. law enables creating new companies and bankrupting them easily, yet when it comes to healthcare it probably hits the double block of having to pay taxes and not only that, having to pay them for the less well off. It’s not as if successful new companies have an impact on other people, heaven forfend.
In theory, people are all pro-market, yet when you consider that the U.S. healthcare system is both extremely costly and brings poor results for the many, one has to ask what is wrong with the market. Answering just “The govt!!!1” is disingenuous considering that health insurance companies “influence” the government.
You could replace the U.S. healthcare system with almost any other developed country’s and have better results. Americans generally don’t like taxes, okay, you don’t have to become a scandinavian socialdemocracy. However, consider that the Danish hc system is funded by an 8% tax. It’s surely better than the 16% gdp cost and as it’s decentralized it could be probably copied on a state by state basis. I don’t want to pretend that hc systems aren’t terribly complicated and there’s a high percentage out-of-ass talking by everyone who doesn’t do this professionally, but judging by the results, it’s high time the U.S. started to change things.
That’s actually the way the world works right in science and medicine, jsyk. You’d be horrified at what I have to say about how little people know and how much modern medicine is really luck. Modern medicine is not evidence based.
I don’t want to descend into details because a) its not my forte, but mostly because b) priorities: the good outweighs the bad. Keep in mind also that for all the benefits the rich are getting out of it, anyone making over 200k is getting a brand new tax to fund poor people. So they’re having to give some of that money back.
As I said before, yes, this doesn’t address fundamental problems with the medical system itself. Its only 1 facet of health care reform. But its not because it didn’t address all the problems that we shouldn’t address any of the problems. As the philosopher Jagger once said: You can’t always get what you want, but if you try sometimes, you get what you need.
The NYT has essentially been describing the bill as an act of social justice and I think that’s an accurate portrayal. Making health care more efficient is an entirely different debate and I think we should move that argument to another thread, where it would be pertinent.
Regarding “absurd” health care costs: I already explained it, but I guess I need to flesh it out more.
You’re complaining about what you see, for example, people buying new glasses. Your point is that people will now use health care more frivolously. I’m in health care. Hell, I’m in a “free health care” system right now and I’ve lived long enough in both countries to be very well placed to make this statement: the frivolous use of health care amounts to a faction of a fraction of a percent of the slice of the pie. People actively avoid going to the doctor. The people that don’t are in the tiny minority. This reality will not change and you have no precedent to rely on, in or out of the US, to make this claim.
You don’t realize in your complaint that what you see every day is not representative of the condition of the people all this money will go to treating. I estimate at least 80-90% of the money is going to be solely used to fund the extra 30 percent of Americans who do not have health care. I’ve spoken about this in the past: these people come from lower socio-economic backgrounds. A massive number of these people will have chronic illness that will result from obesity and years of neglect from not having health care. The care they will require will be complex and expensive, tens of thousands of dollars per year per person expensive. If that wasn’t enough, 50% of all men and 33% of all women get cancer by age 75. Let’s assume then that ~20-25 million of these people also eventually need to be treated for cancer, at the ADDITIONAL cost of tens of thousands of dollars per year per person. You’ll have to excuse me when I yawn at your complaint that someone somewhere might be saving a few hundred dollars here and there. For every new pair of glasses you have at least 5, if not 10 people needing complex care. When you take into consideration what I said about the individual costs to the newcomers, if you’re suddenly treating ~100 million people, the bottom line becomes astronomical. Its a mouse next to an elephant, which is only ironic since you’re making a fuss at how scary the mouse is. You’re making a mountain out of a mole hill while your back is turned to Mt. Fuji.
I honestly don’t know if the US has enough physicians to take in all these people. I don’t anticipate a flood of people rushing to the doctors all at once but after a few years, I’m certain the pressure will increase on the system.
If you REALLY want to find something to complain about, complain about how the tens of millions of people that will be treated as a result of their obesity, are being treated as a result of their incontinence. People overeating has the direct result of being much more expensive than a few white girls getting new glasses.
I grew up. By “grew up” I mean “got my heart broken and stopped authentically believing in much of anything.” Post-modern condition, blah blah blah, I’m sure you would understand if you were more interesting.
Hey guys… did anyone else notice Sin being optimistic? Somebody oughta take a screenshot.
Now all we need is you to have something nice to say and Charle to post something relevant to the discussion and we’ll have a hat trick.
.
Congress extensively debated cutting costs as part of this bill. The new laws aim at overhauling health care, not just redistribution. This is one of the most on-topic debates I’ve seen on RPGC.
Your point is that people will now use health care more frivolously.
Not so. I’m arguing that people already use health care excessively for minor ailments, because the existent legal structure encourages them to do so. In 1960, 5.2% of the GDP went to health care. By 2007, that rose to 16%. Increased spending on minor ailments explains most of the growth. The new laws do nothing to worsen this trajectory, except by extending coverage.
I’m complaining that a bill stylized as a health care overhaul does nothing to address this serious cost problem, which economic conservatives have pointed out for decades. To say “this is a social justice bill, not a cutting costs bill,” is disingenuous, because Democrats rejected dozens of thoughtful cost-cutting proposals while crafting the bill, but chose instead to include education loan reform. This bill was whatever they chose to make of it. They chose on strictly political grounds not to cut costs, even though they could have won moderate Republican votes thereby.
As I said, the new laws do little to worsen the status quo, but we are already on pace to have health care consume the GDP. A health care overhaul should have addressed that.
I’m not sure what “white girls” have to do with this. Obesity is the elephant in the room, in any discussion of rising health care costs, but I don’t think health care is the best way to deter obesity. I mentioned New York City’s trans fat ban. NYC also requires take-out restaurants to post calorie counts on all their menus, which I think is brilliant. Studies show this induces people to eat 100-150 calories less on average per meal. I support removing unhealthy foods and pop machines from school cafeterias. I read an article arguing that most dietary habits and a child’s likelihood of obesity are established before elementary school; I would support an educational campaign directing parents to monitor young children’s diets. Maybe doctors could play a part by warning parents of toddlers against overfeeding.
The only reason U.S. health care has become employment-based is the tax deduction for health care. As I explained, both the employer and the insured employee can save money by implementing employer health care. Both sides can use the tax deduction to their advantage.
One problem arises with small businesses, for whom the flat costs of maintaining employer health care exceed the aggregate per-employee savings. Employers need lots of employees to make it worthwhile. Take away the tax deduction (and the new tax credit for small businesses), and employers have no incentive to waste time and effort on health care. The system moves back to individual health care – which people will buy, because the law now requires it.
Insurance companies also prefer to reject the unemployed. They figure, “If you were healthy, you’d be employed.” So rates on individual, non-employment-based plans significantly exceed employment-based rates. Again, eliminate the tax deduction, and this goes away.
Perhaps if I watch robots kissing in Bjork’s music videos for long enough, this will break my heart so I grow worthy of your interest, that is, its shattered but authentic remnants.
A point that Sin didn’t mention (but that some of you can probably deduce from his post) is that primary care physicians (PCPs) and preventive medicine are horribly underfunded and under-emphasized. Preventive medicine, including areas like epidemiology and public health, only get boosts in funding in the wake of some kind of scare, like community-acquired diseases, plagues, foreign transmissible diseases, and outbreaks of pandemics and epidemics (Legionnaire’s diseases, cholera, salmonella, AIDS, SARS, avian flu, in order of least to most recent).
Part of the problem is that the results from public health is negative - that is, if the department does a fantastic job, then the overall budget saves money, epidemics don’t happen, and there are zero results to show for it. If they don’t do a good job because they have few people and fewer resources, then an outbreak happens, and people attribute that to nature, shrug their shoulders, and assume that nothing could have been done about it, and maybe shovel a few more pennies into the CDC.
There’s also a problem with PCPs getting paid less for their work than IM specialists, which is ridiculous, since not only is there a shortage of PCPs, there is also little economic incentive for anyone to go into it.
What the reform bill was about when it started and what it was when it ended are 2 entirely different things. It started with reforming the industry, became about increasing access. The current discussion has to do with the actual bill that was passed. I propose you bring the debate of reforming the system to a different discussion. If you’re not happy the system wasn’t reformed, I present you the Republican Party. I’m not a fan of the democrats or partisanship, but the Republicans made it nevertheless extremely difficult to have this little done.
White girls was a reference to middle upper class people/your gf buying glasses, that you used as an example.
The concept of health care costs is complicated and I’m not going to add anything more to this in this discussion. Briefly, you can’t compare medicine in the 1960s to medicine now. Yes costs have gone up. But our understanding of biology and chemistry has undergone SEVERAL revolutionary shifts since then. The failure of medicine and science is that doctors have failed to translate the benefits at the same rates costs have gone up. Cancer is a pretty good example of this. Richard Nixon declared the war on cancer 40 years ago and where are we now? Trillions of dollars down the pipe and not much farther. Despite this, life expectancy is at its highest ever (or nearly since the obesity complications are starting to bring this down) because of extensive intervention in other fields. The health care system is composed of a lot more than people visiting outpatient clinics for minor ailments.
My argument is that what you call “frivolous” use is a drop of water in a pond. Mountain out of a mole hill. Over-reaction. Big picture. My point is clearly made in the previous post. Edit: a 20 dollar bottle of antibiotics does not compare to a 10 000 dollar round of rituximab.
You’re right that eating habits start very early. Doctors shouldn’t talk to toddlers. They need to target the parents/MOMs who are feeding the toddler and getting him rolling on this path to begin with. But people already know all these things anyway. The approach the establishment has taken regarding this is that “the beatings will continue until morale improves”. Its obviously not working. New methods need to be brought forward to change people’s behavior.
Basically, this is almost completely wrong. The increase is definitely NOT explained by people, en mass, all simultaneously being clever lawyer-types and exploiting minor benefits from loopholes in the system. That will probably account for less than 0.1% of the growth. The big costs come medicine becoming inherently more expensive as procedures and technology are developed for more and more conditions (if you want to talk about low-cost solutions - before some breakthroughs in brain circuitry, we used to treat seizures by putting people into a room and hoping for the best, and if they didn’t die in the morning then everything went better than expected), and from things like AIDS resulting in weeks-long stays in hospitals followed by eighty billion different drugs being subscribed to take daily so that you can have a reasonable life expectancy instead of going “i dunno, guess you shouldn’t have shared needles”.
A large chunk of the costs also from people coming into a clinic and saying “doctor i’ve got this lump on my breast for a while and it’s been getting bigger.”
“how long ago did you notice it?”
“oh awhile ago.”
“how long is ‘awhile’?”
“oh like 8 years LOL”
or “hey doctor i’m feeling chest pain”
“yeah no shit it’s because you weigh as much as a baby beluga whale”
I noticed that too. WHO ARE YOU, AND WHAT HAVE YOU DONE WITH SIN? D:
Arac and X-Wing: You two should just start dating already. I can tell you want to feel the gentle caresses of each other’s tongues whilst one of you (probably Arac) makes the brave move and sticks his hand down the other’s pants. This will start the torrid lovemaking that will last 14.3 hours, after which you’ll collapse in a puddle of sperm and possibly feces. I know you only argue because you love.
Sin isn’t actually that bad in person >_>; Honest.
I don’t really want to read anyone’s arguments since the posts in this thread are extremely long and seem kinda bullshitty, but I’m gonna go ahead and arbitrarily side with X-Wing here. I like his avatar better.
I see problems, though. Does NYU law still treat you like the bourgey infants you are and make you sign in all of your visitors? Because, as a Brown student, I am a multiplicity and signing up all of my selves, not to mention the fragments of Barthes, Derrida, Deleuze, and Guattari inside of me who I have authored through my reading would probably far exceed your limit. I’m afraid we must always be apart.
Most people in this thread:
