Why not Universal Healthcare?

[markw]

Mark, you seriously underestimate the complexities of governing in Canada. Being 10% the size doesn't make in 1/10 the problem. There are significant cultural, regional, and federal vs. provincial issues.

For starters, you might be interested to know, (or more you aren't), that there isn't a Canadian heathcare system; there are 10 provincial heathcare systems and they are definitely not identical.And, by that token, I think you truly underestimate the ways the tendrils of greed and corruption can become entwined in a system designed to govern well over ten times the population of Canada.

Did you read BR's post? As he pointed out, we have fifty different states, each with it's own rules governing insurance. And yet, everyone expects just one perfect answer to arrive instantly when, in fact, as it now stands, it would be against the law.

so far, this current regime isn't even getting warm...

[Feanor]

And, by that token, I think you truly underestimate the ways the tendrils of greed and corruption can become entwined in a system designed to govern well over ten times the population of Canada.

Did you read BR's post? As he pointed out, we have fifty different states, each with it's own rules governing insurance. And yet, everyone expects just one perfect answer to arrive instantly when, in fact, as it now stands, it would be against the law.

so far, this current regime isn't even getting warm...

I think I can agree with you on that one.

As heard on CNN a couple of days ago, the "public option" as omitted with Democrat support despite 65% approval by the actual population. Of course that's where Nightflier's reference to the insurance industry's funding politicians is so relevant.

As I understand it, everytime there's be a State-side proposal to limit campaign funding by source or amount, it's squelched because is supposedly offends free speech. This is obviously a crock.

[GMichael]

...the party that takes the moral high ground so often (Republicans) are so entrenched in this corruption? I mean I can understand Democrats because they want to please everybody, but Republicans, especially those on the far right, are supposed to stand up to this, no?

During the Carter-Reagan years millions of Democrats switched parties because they thought that Republicans stood for something more respectable, and many of them did. But in the Bush 2.0 years, that same party has embraced doctrinaire corporatism at the expense of competition. Big pharma, Insurance, the HMOs, and the legal vultures that surround them could always rely on centrist politicians to get ridiculously one-sided bills and measures introduced, but with the help of the far right in recent years, they gained significant momentum to get them passed. It's pretty disgusting to hear these same politicians invoke godly virtues in one breath while being bullhorns for the big corporations. Maybe they are so owned that their religious fervor is merely to assuage their guilt.

On that small detail, ClothEars has made a legitimate point. One wonders why the far right is so vehemently opposed to universal healthcare, something good ol' JC would be all for if he were alive today. I know dragging religion into this is not to everyone's liking, but aren't we talking about taking care of the sick and unfortunate? I don't see how that can be done without invoking the one biggest moral influence in our society.

I see just as much crap from both sides. Either side (pick one) says basicly the same crap about the other side. Here you are doing it again. Both sides need to clean their own house up before throwing stones at the other.
The reason that the right is opposed to the universal healthcare is becaue it's made up of mostly older people who have paid into the old system for years. They don't want it to change now.

[GMichael]

I have a simple plan...stop voting for the incumbant. Politicians need to answer to voters and not special interests. We as voters need to send a message, that if want to be re-elected you better jump through your ass for us. Of course, outlawing lobbies would also be a start, but we have too many stuffed suits in state and federal gov't that have made life long careers out of public service and the gov't was never intented to be an industry that propagates itself.

There are far too many crooks in office to even attempt to figure out who is a lesser crook than someone else. There are too many politicians that spend the majority of their terms working on the re-elections of themselves and others. A couple of elections with incumbants being bounced out on their asses would be the first wave. Far too many priviledges being doled out - lets stop those next. Why do politicians get such a greased sled? They get killer salries, let them spend Sunday evening paying bills and balancing their checkbooks. Then reforming salaries and pensions will be the next. Pensions should be earned, not a birthright.

But voting is the place to start. Its not reallistic to think everyone who can register to vote will, no more than its realistic to think voters will put down the remote and actually spend some time reading up on issues. The quickest way to change the face of Washington is to change the faces in Washington.

That may not work, but I'm willing to give it a shot. Spread the word.

[nightflier]

I see just as much crap from both sides. Either side (pick one) says basicly the same crap about the other side. Here you are doing it again. Both sides need to clean their own house up before throwing stones at the other.
The reason that the right is opposed to the universal healthcare is becaue it's made up of mostly older people who have paid into the old system for years. They don't want it to change now.

You're willfully missing the point. I said that I expect this from the center (whether right or left of the isle), but the far right is the one that claims the moral high ground and bases it on religious doctrine. Yet they are the ones most opposed to doing the proper Christian, brotherly thing. Surely there's considerably more hypocrisy in that position.

[GMichael]

You're willfully missing the point. I said that I expect this from the center (whether right or left of the isle), but the far right is the one that claims the moral high ground and bases it on religious doctrine. Yet they are the ones most opposed to doing the proper Christian, brotherly thing. Surely there's considerably more hypocrisy in that position.
I got your point. My point is that the far left claim that they are the moral high ground based on being for the individuals rights instead of for big business. Both sides are just as guilty as the other. There is plenty of hypocrisy to go around.

[blackraven]

Feanor, you take me all wrong. several times I have said in this post that I support universal health care and that I admire the Canadian system and that it would be a good template for our system. (but it seems to me that you cannot take any criticism about the Canadian system when I say its not perfect and has some problems. I guess I'm a liar and all the Canadian Dr's and the few Candian patients that I have taken care of who have come to the Twin Cities for treatment are all liars.) All I'm saying is that the changes that need to be made will not set well with the American public. It needs to be a slow change and it needs to be done right. And yes, we are afraid that the gov't will screw this up. Every thing that the gov't touches is Fk'd up. Social program after program has failed or not lived up to its potential. Politicians are for the most part corrupt or in bed with big business, both republicans and democrats alike. This country is so in debt because of one poor gov't decision after another. Just look at the recent events with the bail out of banks and GM. Look at our involvement in Iraq and the whole weapons of mass destruction. There are too many hands in the pot. The forefathers of this country never meant the gov't to be so intrusive in States and the private citizens business. We have a right to question our gov't. Even Obama is untrustworthy. Earlier in the year he stated that he supported a single payer system and just last week he back tracked and stated he never endorsed a single payer system. WTF is that crap. So don't criticize us for mistrusting the govt when you have not lived here and experienced it first hand on every level from the local level to the state level and the federal level. Currently most people I talk to in the Twin Cities have no confidence in our gov't to make the right decisions. And I come in contact with a lot of people. We see over 40,000 patients a year in our ER!

Just a clarification about my comments about death panels. All I said was that there will be Ethics committee's to deal with end of life care. They are in place all ready. Every one in medicine knows that the majority of the cost savings will have to come from end of life care in the last 6 months of life where 75% of medical costs are incurrred. This does not mean that we are going to kill people, it just means that unnecessary treatments and test will be curtailed if there is no chance at survival or quality of life. Get used to that thought because it is gonna happen and it needs to happen. The public has no clue as to how much money is wasted and how much more pain and suffering is caused trying to keep a terminally ill patient alive usually against their wishes.

[Feanor]

:6:
Feanor, you take me all wrong. ...


BR, I'm sorry if I have misconstrued your remarks on occassion. Certainly I have always taken you for a person of good intent.

The thing is that watching US media, Canadians like me have been higly sensitized, not to criticism of the actual weakness of the system here, but to the exagerations and misrepresentations that have been proliferated by the enemies of progress in the US.

I'm afraid that you are right the US just isn't ready to embrace a universal, single payor system. Obama understands that which is why he back-peddled on the idea. This was in aid of the bipartisanship which he also believed in. However every concilliatory gesture of cooperation has been turned to a sign of weakness. Seemingly the hatred of progressive ideas is so great to conservative Republicans that they have put their need to see Obama fail and thwart the Democrat victory ahead of the good of the country.

[blackraven]

Feanor well said and no hard feelings!

[nightflier]

I got your point. My point is that the far left claim that they are the moral high ground based on being for the individuals rights instead of for big business. Both sides are just as guilty as the other. There is plenty of hypocrisy to go around.

...the far left wants universal healthcare. If anything, they're living by what they preach on this issue.


Seemingly the hatred of progressive ideas is so great to conservative Republicans that they have put their need to see Obama fail and thwart the Democrat victory ahead of the good of the country.

...and ahead of their Christian virtues.

[3LB]

...the far left wants universal healthcare. If anything, they're living by what they preach on this issue.
yes...job security...how noble of them

[Feanor]

...the far left wants universal healthcare. If anything, they're living by what they preach on this issue.



...and ahead of their {the Right's} Christian virtues.

Not necessarily ahead of their Christian virtues, which as I explained a while ago, are less Christian than Pharisee.

[Sir Terrence the Terrible]

:6:

BR, I'm sorry if I have misconstrued your remarks on occassion. Certainly I have always taken you for a person of good intent.

The thing is that watching US media, Canadians like me have been higly sensitized, not to criticism of the actual weakness of the system here, but to the exagerations and misrepresentations that have been proliferated by the enemies of progress in the US.

Be very careful of watching too much of our media, they have an agenda of their own as well. Before I started working in audio and film sound exclusively I was a freelance field cameraman for ABC-TV, and I have watched many a reporter put a spin on a story that completely mis-represented the real picture. The biggest example of that was during the 1992 Los Angeles riots. The news tried to make it a "black" riot, when it was a riot of the have nots, versus the haves with a racial tint to it. They continuously showed images of young black youth looting stores, when I saw poor youths and adults of all races looting.


I'm afraid that you are right the US just isn't ready to embrace a universal, single payor system. Obama understands that which is why he back-peddled on the idea. This was in aid of the bipartisanship which he also believed in. However every concilliatory gesture of cooperation has been turned to a sign of weakness. Seemingly the hatred of progressive ideas is so great to conservative Republicans that they have put their need to see Obama fail and thwart the Democrat victory ahead of the good of the country.

Bingo!

I don't think it is just the progressive ideas that bother them so much, but that progressives actually got an African American to the White House. This country is changing and conservative republicans don't like it, and don't want no parts of it.

[3LB]

...and ahead of their Christian virtues.

What does religion have to do with this issue?

[blackraven]

Ok, time to lighten up a little. Here's a funny (or not so funny to some) article from an Emergency Medicine Magazine from a couple of years ago that most if not all emergency physicians can relate to and pokes fun at part of the problems we face in medicine.

IF COYOTES WERE AS BIG AS MINIVANS-

http://journals.lww.com/em-news/Fulltext/2006/02000/If_Coyotes_Were_as_Big_as_Minivans.8.aspx

[markw]

What does religion have to do with this issue?It goes so well with the "white" and "republican" that the "brain trust" just threw it in for free for a liberal trifecta.

[blackraven]

Ok here's something else to lighten the mood- My next wife in another life!

http://i.cdn.turner.com/si/2009/images/10/02/esti-ginzburg.jpg

[GMichael]

...the far left wants universal healthcare. If anything, they're living by what they preach on this issue.


I'm not seeing it that way. We must not read the same articles.




......and ahead of their Christian virtues.

You really don't have a clue do you.

I'll leave you to your preconceived notions. It is obvious that you refuse to learn.

[3-LockBox]

The biggest example of that was during the 1992 Los Angeles riots. The news tried to make it a "black" riot, when it was a riot of the have nots, versus the haves with a racial tint to it. A racial tint? Are you referring to the riots that came after the Rodney King beating/LAPD verdict? Just a riot of the haves and have-nots, eh...that continued well beyond the point were everyone got their free TV and VCR...that's a very novel and trivial way of reflecting on an event of that magnitutde.

So all the articles and TV reports that have been written and televised on the subject of this event are completely wrong, and we should only take your word, cuz your were like there 'in the trenches and all'. And you were the only cameraman there? You were working for ABC-TV and they decided not to use your footage? And what's this got to do with healthcare again? This type of self-aggrandizing statement is becoming very typical of you. Or, to put in more uncivil, inflammatory, sanctimonious terms (i.e. your words):

"I would like to remind you that YOU are not every cameraman. Your experiences are not reflective of a broader journalist. Keep that in mind. Not everyone thinks like you do, or will agree with what you agree with. The facts and figures bare this out. Is your head so fat, and ego so big, that you think your experience mirrors everyone elses? You think you know what you are talking about, but you know a grand total of nothing. Your world is not everyones world. When you get that through your thick and empty skull, then we can move on and deal with the facts. Is your head so fat, and ego so big, that you think your experience mirrors everyone elses? You think you know what you are talking about, but you know a grand total of nothing. Your world is not everyones world. When you get that through your thick and empty skull, then we can move on and deal with the facts."

"Experience is meaningless in this particular example. That facts are the only thing relevant right now. Your experience does not equal facts. This statement shows just how damn ignorant you are. I will choose the facts over your experience any day. You jumped into this thread throwing your so called experience, and as you can see, it is worth nothing. Next time you bust into a thread throwing around your experience, make sure that experience is relevant in the context of the conversation."

I could post pages of links to support what I just typed but its old news, everyone that posts here knows what happened and doesn't need the history lesson, revisionist (yours) or otherwise. Lets stay on-topic and leave race and religion out of the discussion please.

[audio amateur]

Holy crap 268 posts!! Anything I've missed?

[Sir Terrence the Terrible]

A racial tint? Are you referring to the riots that came after the Rodney King beating/LAPD verdict? Just a riot of the haves and have-nots, eh...that continued well beyond the point were everyone got their free TV and VCR...that's a very novel and trivial way of reflecting on an event of that magnitutde.

Are you going to take every word I post and turn it into a fight? And please, not EVERYONE got a free VCR or TV, give me a break. The point I was trying to make was to not take everything that our media spits out, not twist this into a discussion on race and economics.


So all the articles and TV reports that have been written and televised on the subject of this event are completely wrong, and we should only take your word, cuz your were like there 'in the trenches and all'. And you were the only cameraman there? You were working for ABC-TV and they decided not to use your footage? And what's this got to do with healthcare again? This type of self-aggrandizing statement is becoming very typical of you. Or, to put in more uncivil, inflammatory, sanctimonious terms (i.e. your words):



"I would like to remind you that YOU are not every cameraman. Your experiences are not reflective of a broader journalist. Keep that in mind. Not everyone thinks like you do, or will agree with what you agree with. The facts and figures bare this out. Is your head so fat, and ego so big, that you think your experience mirrors everyone elses? You think you know what you are talking about, but you know a grand total of nothing. Your world is not everyones world. When you get that through your thick and empty skull, then we can move on and deal with the facts. Is your head so fat, and ego so big, that you think your experience mirrors everyone elses? You think you know what you are talking about, but you know a grand total of nothing. Your world is not everyones world. When you get that through your thick and empty skull, then we can move on and deal with the facts."

"Experience is meaningless in this particular example. That facts are the only thing relevant right now. Your experience does not equal facts. This statement shows just how damn ignorant you are. I will choose the facts over your experience any day. You jumped into this thread throwing your so called experience, and as you can see, it is worth nothing. Next time you bust into a thread throwing around your experience, make sure that experience is relevant in the context of the conversation."

I could post pages of links to support what I just typed but its old news, everyone that posts here knows what happened and doesn't need the history lesson, revisionist (yours) or otherwise. Lets stay on-topic and leave race and religion out of the discussion please.

You have got to be the most stupid person on this board next to pix. You took a statement I wrote on not believing everything our press writes about, and turned it into something completely different. This twist of stupidity does not deserve any more of a response than this. And please (and once again) do not tell me what to post, or how to post it. Only an idiot would believe that the 1992 riots was simply a black riot, and it was over just Rodney King. It was far larger than race, and far larger than Rodney King, that is for sure. Rodney King was just the trigger, Latasha Harlins, the growing disparity between the haves and the have nots, Koreans not hiring blacks, police abuse, and the lack of jobs in south central where all reason it occurred.

Secondly, I do not care what you think of me, so this continued crying and complaining about my arrogance, and supposed incivility does not move me one bit. The only think you accomplish by this is confirm that you are a whiney @ss baby. Please 3 IQ points or whatever your name is, press the ignore button and move on, your chasing me around trying to pick a fight at every corner is a bore.

Now back to healthcare.......

[markw]

Are you going to take every word I post and turn it into a fight? And please, not EVERYONE got a free VCR or TV, give me a break. The point I was trying to make was to not take everything that our media spits out, not twist this into a discussion on race and economics.



You have got to be the most stupid person on this board next to pix. You took a statement I wrote on not believing everything our press writes about, and turned it into something completely different. This twist of stupidity does not deserve any more of a response than this. And please (and once again) do not tell me what to post, or how to post it. Only an idiot would believe that the 1992 riots was simply a black riot, and it was over just Rodney King. It was far larger than race, and far larger than Rodney King, that is for sure. Rodney King was just the trigger, Latasha Harlins, the growing disparity between the haves and the have nots, Koreans not hiring blacks, police abuse, and the lack of jobs in south central where all reason it occurred.

Secondly, I do not care what you think of me, so this continued crying and complaining about my arrogance, and supposed incivility does not move me one bit. The only think you accomplish by this is confirm that you are a whiney @ss baby. Please 3 IQ points or whatever your name is, press the ignore button and move on, your chasing me around trying to pick a fight at every corner is a bore.

Now back to healthcare.......Interesting, yet you can clearly see a racist aspect to opposing the health care plan.

Thanks, terrance, you've made your positions and prejudices as clear as spring water.

[Luvin Da Blues]

Ok here's something else to lighten the mood- My next wife in another life!

http://i.cdn.turner.com/si/2009/images/10/02/esti-ginzburg.jpg

I wonder if she gets free health care? Maybe you could give free medical examines for poor homeless waifs like that. :biggrin5:

[3LB]

You have got to be the most stupid person on this board next to pix. You took a statement I wrote on not believing everything our press writes about, and turned it into something completely different. This twist of stupidity does not deserve any more of a response than this. And please (and once again) do not tell me what to post, or how to post it. Only an idiot would believe that the 1992 riots was simply a black riot, and it was over just Rodney King. It was far larger than race, and far larger than Rodney King, that is for sure. Rodney King was just the trigger, Latasha Harlins, the growing disparity between the haves and the have nots, Koreans not hiring blacks, police abuse, and the lack of jobs in south central where all reason it occurred.

Secondly, I do not care what you think of me, so this continued crying and complaining about my arrogance, and supposed incivility does not move me one bit. The only think you accomplish by this is confirm that you are a whiney @ss baby. Please 3 IQ points or whatever your name is, press the ignore button and move on, your chasing me around trying to pick a fight at every corner is a bore.

Yeah yer right...my post was pretty childish...especially the middle two paragraphs in italics. No one deserves to have their opinions berated or twisted just for some self-glorification. But you have been just as guilty of everything you've accused me of in this post. Just wanted to point that out. But I'll stop now...if only JM could figure out why your moniker can't be placed on an ignore list...


Holy crap 268 posts!! Anything I've missed? other than mine and sir Terrence the Tantrum's pissing contest...nope...unless of course you count the on topic stuff ;)

[atomicAdam]

Holy crap 268 posts!! Anything I've missed?


Do we have healthcare reform yet?

[markw]

Do we have healthcare reform yet?
The only thing that a very few agree on is that it's all the fault of White, Christian Republicans. If it wasn't for these, this would be a socialistic utopia, a land of plenty for all and burdens on none.

[Sir Terrence the Terrible]

Interesting, yet you can clearly see a racist aspect to opposing the health care plan.

Mark,
Get your story straight man, I never said anything about racism and healthcare. My only comment on racism would be the Republican demonetization of OBAMA himself, not his policies or what he supports. Is it possible to disagree with somebody's policies without referencing guerrillas and Mrs. Obama? Is it possible to disagree without the signs of Obama dressed in a African witch doctors garb? Sure it is....


Thanks, terrance, you've made your positions and prejudices as clear as spring water.

Ironic coming from you Mark....

[Sir Terrence the Terrible]

Yeah yer right...my post was pretty childish...especially the middle two paragraphs in italics. No one deserves to have their opinions berated or twisted just for some self-glorification. But you have been just as guilty of everything you've accused me of in this post. Just wanted to point that out. But I'll stop now...if only JM could figure out why your moniker can't be placed on an ignore list...

You are damn right it was childish. Nobody has twisted your words, you put them out there poorly that is all, and you didn't want to take responsibility for what you said.


other than mine and sir Terrence the Tantrum's pissing contest...nope...unless of course you count the on topic stuff ;)

That would be Sir Terrence to you 3 pounds (that would be your head minus the brains)

[markw]

Mark,
Get your story straight man, I never said anything about racism and healthcare. My only comment on racism would be the Republican demonetization of OBAMA himself, not his policies or what he supports. Is it possible to disagree with somebody's policies without referencing guerrillas and Mrs. Obama? Is it possible to disagree without the signs of Obama dressed in a African witch doctors garb? Sure it is....You flatter yourself by thinking it's all about you. It may not be.


Ironic coming from you Mark....I've always been consistent, both here and on other sites as well. No apologies.

[Sir Terrence the Terrible]

The only thing that a very few agree on is that it's all the fault of White, Christian Republicans. If it wasn't for these, this would be a socialistic utopia, a land of plenty for all and burdens on none.

Mark, this is a silly immature comment. Michael Steele is not white!

[Sir Terrence the Terrible]

You flatter yourself by thinking it's all about you. It may not be.

It is about all of us of which I am apart of. Its about America which I am apart of.


I've always been consistent, both here and on other sites as well. No apologies.

If you call consistent strident and a bit defensive, you are right, you have been nothing but consistent.

[markw]

I don't think it is just the progressive ideas that bother them so much, but that progressives actually got an African American to the White House. This country is changing and conservative republicans don't like it, and don't want no parts of it.Now, maybe my Engish skills aren't up to yours, but that sure looks like trying to blame this on race more than anything else.

But, hey, what do I know, You said it and perhaps you meant something else. riiiiiight...

[Sir Terrence the Terrible]

Now, maybe my Engish skills aren't up to yours, but that sure looks like trying to blame this on race more than anything else.

Mark, are all conservatives republicans white? No, I just named one that wasn't. This is your ultra sensitive self trying to project something that wasn't said.

Colin Powell
Alan Keyes
Dr. Condoleezza Rice

Shall I go on....

Since when does "conservative republican" mean white?




But, hey, what do I know, You said it and perhaps you meant something else. riiiiiight...

Perhaps....

[nightflier]

I'm not seeing it that way. We must not read the same articles.

Obviously. How exactly does the far left not want universal healthcare? It's their raison-d'etre, no?


You really don't have a clue do you. I'll leave you to your preconceived notions. It is obvious that you refuse to learn

Why don't you enlighten us?

[3-LockBox]

Now, maybe my Engish skills aren't up to yours, but that sure looks like trying to blame this on race more than anything else...There is nothing progressive about a democrat or republican in the white house...just more same 'ol same 'ol.

who are the "progressives" anyway?

[ForeverAutumn]

who are the "progressives" anyway?

Prog on man! I'm one. :3:



Oh...you're talking about politics.


Never mind. Carry on...

[nightflier]

The only thing that a very few agree on is that it's all the fault of White, Christian Republicans. If it wasn't for these, this would be a socialistic utopia, a land of plenty for all and burdens on none.

You're not the dumbest person on this site, but you sure better hope he doesn't terminate his account.

[Sir Terrence the Terrible]

There is nothing progressive about a democrat or republican in the white house...just more same 'ol same 'ol.
who are the "progressives" anyway?

http://en.wikipedia.org/wiki/Factions_in_the_Democratic_Party_(United_States)#P rogressive_Democrats

Barbara Lee
Barbara Boxer
Russ Feingold
Dennis Kucinich
John Conyers

These would be considered progressive democrats.

[3-LockBox]

Prog on man! I'm one. :3:



Oh...you're talking about politics.


Never mind. Carry on...

yep, wrong subject, wrong thread, wrong forum...

of course the term 'progressive' (as in rock) as you and I know it tends to describe something that supposed to be new, but has already existed before, so you may have a point ;)

[JohnMichael]

But I'll stop now...if only JM could figure out why your moniker can't be placed on an ignore list...





I would like to clarify that I have no interest in putting Sir T or anyone else on an ignore list. My help was requested so an individual member could place Sir T on their own ignore list. Okay back to the discussion.

[3-LockBox]

I would like to clarify that I have no interest in putting Sir T or anyone else on an ignore list.Sorry for the name drop

[Sir Terrence the Terrible]

Boy, somebody here is always apologizing for their mis-steps. Wouldn't have to apologize if one just thinks before pushing the submit button.

[Sir Terrence the Terrible]

yep, wrong subject, wrong thread, wrong forum...

of course the term 'progressive' (as in rock) as you and I know it tends to describe something that supposed to be new, but has already existed before, so you may have a point ;)

So you won't wander through this totally blind.

progressive 3

Definition: a person who favors a political philosophy of progress and reform and the protection of civil liberties

[nightflier]

Well the word "progressive" has the word "progress" in it - that should be a clue.

[Sir Terrence the Terrible]

Well the word "progressive" has the word "progress" in it - that should be a clue.

Ya think! LOL

[markw]

You're not the dumbest person on this site, but you sure better hope he doesn't terminate his account.Hey, all I had to was was read through the last page and a half of the posts of you three stooges hi-fiving and grabbing each others asses to come to this conclusion when people gave up and stopped playing your games.

And then, after a few days, the opposing views started in again...

[02audionoob]

It's like a direct drive vs belt drive debate over at AK. They ebb and flow.

[bobsticks]

Holy crap 268 posts!! Anything I've missed?


About 13 relevent posts...

[pixelthis]

So you won't wander through this totally blind.

progressive 3

Definition: a person who favors a political philosophy of progress and reform and the protection of civil liberties

Progressive...more socialist than most socialist Democrats( Democrats being the
left wing of the Demopublican party that has run this country into the ground over the last
100 years).
When are Democrats just going to come out and admit that they are Socialist ?
Probably never, but if it walks like a Duck and quacks like a duck...
Time to go duck hunting, anyway.
Legalize freedom... VOTE LIBERTARIAN.:1:

[Sir Terrence the Terrible]

Progressive...more socialist than most socialist Democrats( Democrats being the
left wing of the Demopublican party that has run this country into the ground over the last
100 years).
When are Democrats just going to come out and admit that they are Socialist ?
Probably never, but if it walks like a Duck and quacks like a duck...
Time to go duck hunting, anyway.
Legalize freedom... VOTE LIBERTARIAN.:1:

Pix,
It is obvious that you do not know what a Socialist is.

[nightflier]

Well Markw, you can rest safe, it doesn't look like he's going to terminate his account any time soon. But you two have so much in common, it's a neverending suspense to see who wins the crown that day. Hint: today's not your day.

[poppachubby]

I'm going to chime in and say that as American's, you obviously have plenty to work out over this issue. The thing that I find humourous is that somehow this issue is attached to party lines, ie left/right.

In Canada as I'm sure you are aware, we all expect "universal" healthcare in spite of left or right. Conservative and Liberal are all the same on the issue, it's a fundamental right that we all believe in. All this business of "socialism" and such is total nonsense.

It's quite simple, Democrat or Republican, If your arm falls off, wouldn't you like to know that you have help available to you?

That's all I have to say really, slice it and dice it how you will...

[markw]

Well Markw, you can rest safe, it doesn't look like he's going to terminate his account any time soon. But you two have so much in common, it's a neverending suspense to see who wins the crown that day. Hint: today's not your day.And, I'm sure that as long as you're here constipation won't be a problem. You three did a cute little three-way circle jerk the other day that I/we can't wait for another performance.

[Sir Terrence the Terrible]

And, I'm sure that as long as you're here constipation won't be a problem. You three did a cute little three-way circle jerk the other day that I/we can't wait for another performance.

Oh brother.......Surely with all of the dogmatic outbursts you have had you could could better than this....surely.

[markw]

Oh brother.......Surely with all of the dogmatic outbursts you have had you could could better than this....surely.Your three-man tag team back ther pretty well summed up where this thread was headed all along.
The really funny thing is that I predicted it well over two hundred posts prior. ...and you three just proved me correct!

[3LB]

In Canada as I'm sure you are aware, we all expect "universal" healthcare in spite of left or right. Conservative and Liberal are all the same on the issue, it's a fundamental right that we all believe in. All this business of "socialism" and such is total nonsense.

Thing is, there are already mechanisms in place by which people receive treatment they need. Most states have laws preventing anyone be turned away from emergency care based on ability to pay, as has already been pointed out. There are a couple of ways one can qualify for state healthcare that I know of (one example I listed about 10 pages ago) but the impetus is on the individual to pursue and obtain such care (same with foodstamps and other state or federal subsitance), rather than it being a birthright.

[E-Stat]

All this business of "socialism" and such is total nonsense.
Were you required under penalty of law to purchase your own health insurance when you left home?

rw

[E-Stat]

The theme of universal health care should be cost cutting (as you said it is rising exponentialy), and if that is not the goal, then why bother.
Good point. The Safeway Company has a means of promoting good health practices by providing lower health care rates to those for not smoking and not being overweight (two huge underlying causes behind massive health care costs). On NPR's Morning Edition, there was a discussion of that just this morning. I was amazed to hear criticism of the plan:

"It is a back door way of separating those who are healthy...It discriminates"

Hmmm. Isn't that the way auto and life insurance work today? Those who make poor driving choices (and incur higher expenses) are charged higher premiums. What's the difference?

"It will be intrusive for employers to have access to intimate details of your health records".

Nope. It is based simply upon whether or not you smoke and your BMI - body mass index which can be calculated from your height and weight. And proven to relate to health issues. One can easily guess anyone's height and weight simply by looking at someone else. There's no hiding those characteristics. :)

Anyone against promoting good health practices?

NPR Story (http://www.npr.org/templates/story/story.php?storyId=113549864)

rw

[kexodusc]

Were you required under penalty of law to purchase your own health insurance when you left home?

There's actually no purchase involved at all.

[E-Stat]

There's actually no purchase involved at all.
Perhaps you didn't hear Obama's nationally televised speech and proposal:

"And that's why under my plan, individuals will be required to carry basic health insurance -- just as most states require you to carry auto insurance. "

Required. By penalty of law. "Carry" is a euphemism for "buy".

rw

[kexodusc]

Good point. The Safeway Company has a means of promoting good health practices by providing lower health care rates to those for not smoking and not being overweight (two huge underlying causes behind massive health care costs). On NPR's Morning Edition, there was a discussion of that just this morning. I was amazed to hear criticism of the plan:

"It is a back door way of separating those who are healthy...It discriminates"

Hmmm. Isn't that the way auto and life insurance work today? Those who make poor driving choices (and incur higher expenses) are charged higher premiums. What's the difference?

"It will be intrusive for employers to have access to intimate details of your health records".

Nope. It is based simply upon whether or not you smoke and your BMI - body mass index which can be calculated from your height and weight. And proven to relate to health issues. One can easily guess anyone's height and weight simply by looking at someone else. There's no hiding those characteristics. :)

Anyone against promoting good health practices?

NPR Story (http://www.npr.org/templates/story/story.php?storyId=113549864)

rw
Operative words being "good" practices....I sure hope the clumsy BMI isn't used...Adrian Peterson would be penalized for being "overweight"...the guy has 6% body fat.

[kexodusc]

Perhaps you didn't hear Obama's nationally televised speech and proposal:

"And that's why under my plan, individuals will be required to carry basic health insurance -- just as most states require you to carry auto insurance. "

Required. By penalty of law.

rw
Sorry, your question was directed at a Canadian and I construted it literally...did he have to purchase insurance...no he didn't...

[Sir Terrence the Terrible]

Your three-man tag team back ther pretty well summed up where this thread was headed all along.
The really funny thing is that I predicted it well over two hundred posts prior. ...and you three just proved me correct!

Mark, self delusional proclamations are not a valid way of declaring a winner when winning is not the desirable end result.

The only thing you have really won is the title of the most dogmatic and unstable person to contribute to this thread. Here is your trophy, and I am sure it will be good company next to the most willing to lash out paranoid individual trophy you won previously.

[E-Stat]

.Adrian Peterson would be penalized for being "overweight"...the guy has 6% body fat.
You are incorrect on both fronts. Safeway does use BMI and Peterson's 28.6 value falls below the 30 threshold. He would get the discount so long as he doesn't smoke.

rw

[E-Stat]

Sorry, your question was directed at a Canadian and I construted it literally...did he have to purchase insurance...no he didn't...
That goes to the heart of the socialism comment of his I quoted. Governmental control dictating required health insurance.

rw

[Sir Terrence the Terrible]

Nope. It is based simply upon whether or not you smoke and your BMI - body mass index which can be calculated from your height and weight. And proven to relate to health issues. One can easily guess anyone's height and weight simply by looking at someone else. There's no hiding those characteristics. :)

Anyone against promoting good health practices?

NPR Story (http://www.npr.org/templates/story/story.php?storyId=113549864)

rw

Unfortunately BMI is not going to tell you if someone has breast cancer or some other genetic disease.

If you don't smoke at work, then how would the employer know you smoke? They would have to gain access to your medical records, and that is a no no to me. I have seen what a company does when they are armed with an employees health records. No thanks.

I don't smoke, and my last BMI showed 5%. I have lupus though, and though I am generally very healthy, I would be penalized under Safeway's plan. I heard the NPR segment, and I didn't walk away quite as comforted as you did from Safeway's approach. Plus, you have to also take into consideration the valid complaints that Safeway employees have stated as well on this system. For us lean non smoking types with other issues this is no panacea.

[Sir Terrence the Terrible]

That goes to the heart of the socialism comment of his I quoted. Governmental control dictating required health insurance.

rw

They are not requiring it as they allow you to opt out for a price. Not quite socialism as it has no such trigger.

[kexodusc]

You are incorrect on both fronts. Safeway does use BMI and Peterson's 28.6 value falls below the 30 threshold. He would get the discount so long as he doesn't smoke.

rw
No I'm quite correct...
Unless private insurance companies are now more knowledgeable than the American Medical Association on health matters.
25 is the threshold for men.

Sources: http://books.google.com/books?id=4iSoMzkwStMC&pg=PA99&lpg=PA99&dq=american+medical+association+bmi&source=bl&ots=Wu5SSV_0k9&sig=8J35TpEce9dPaf6zTOpmnd-zmuI&hl=en&ei=wPHMSo-vJ9TklQfzsZziBQ&sa=X&oi=book_result&ct=result&resnum=10#v=onepage&q=&f=false

http://www.ama-assn.org/ama/no-index/about-ama/13653.shtml

If we let insurance companies tell us what is and isn't good health...

You've actually helped make my point for me...the 25 is probably too low anyway, which re-enforces my point about its clumsiness.

[poppachubby]

Were you required under penalty of law to purchase your own health insurance when you left home?

rw

Sorry, this is a socialist ideal? I was speaking about the concept fundamentally. It appears to be a left and right issue for you guys. E-Stat, I'm sure much of what is being proposed stinks of all types of political agenda.

[kexodusc]

That goes to the heart of the socialism comment of his I quoted. Governmental control dictating required health insurance.

rw
Kinda like they dictate everyone pay for military and police protection.

I'd like to live in the mid-west and opt-out of paying for military protection.

[E-Stat]

If you don't smoke at work, then how would the employer know you smoke?
The existing Safeway plan does not check with medical records. It is on the honor system. Folks who smoke are not hard to identify.


I don't smoke, and my last BMI showed 5%.
BMI is an index of height and weight, not a percent. You might google the topic and enter your values to find your index. Mine is 24.5.


Plus, you have to also take into consideration the valid complaints that Safeway employees have stated as well on this system.
What were those?

rw

[ForeverAutumn]

That goes to the heart of the socialism comment of his I quoted. Governmental control dictating required health insurance.

rw

This is where I think we hit a philosophical difference. Canadians don't see this as the Government dictating required health insurance. We see it as the right to the same medical care for every Canadian regardless of social class. It's really more of a human rights issue than a socialist issue.

And, even though the system is not perfect, I don't know of any Canadian who would give it up entirely.

[E-Stat]

Kinda like they dictate everyone pay for military and police protection..
Only those who pay income taxes cover those. That would be only half the population.

rw

[kexodusc]

Only those who pay income taxes cover those. That would be only half the population.

rw
Really? So not 1 red cent collected via a consumption tax at any level of government has ever been allocated to either budget?

[poppachubby]

This is where I think we hit a philosophical difference. Canadians don't see this as the Government dictating required health insurance. We see it as the right to the same medical care for every Canadian regardless of social class. It's really more of a human rights issue than a socialist issue.

Thank You FA!! That's all I was trying to say!! I think my comment sounded more like big business democracy than socialism anyhow, if it has to be analyzed that far. Anyhow, I just wanted to point out a quirky difference. You guys are doing a great job at arguing minutae points without a silly Canadian around...back to the igloo I go!

[Feanor]

They are not requiring it as they allow you to opt out for a price. Not quite socialism as it has no such trigger.

Perhaps you are speaking of the US proposal, but in Canada there is no opting out. Also, Canadian insurance companies here are not allowed to cover any procedure that is covered by the provincial health plan.

Of course, a Canadian can go to the US, a private clinic, or where ever, and pay 100% of the cost him/herself. There are few private clinics in Canada because there is little demand excepting for certain expensive, diagnositc treatments such as MIR where waiting lists can be long.

State-side, it seems popular to use "socialist" as scare word. By implication anything so-labeled must be rejected out of hand as "not the American way", i.e. inferior to anything typically American, if not downright evil.

Heads up, folks. Raul Castro is socialist, perhaps Hugo Chavez is socialist, but absolutely nothing proposed by the Obama administration or the Democratic caucus can legitimately be called "socialist".

[ForeverAutumn]

...back to the igloo I go!

Probably a good idea. Some people have made it known that comments from the citizens of a second-rate country are not welcome in this thread...even if the comment is more relevant than 99% of the rest of the thread.

:out:

[Sir Terrence the Terrible]

State-side, it seems popular to use "socialist" as scare word. By implication anything so-labeled must be rejected out of hand as "not the American way", i.e. inferior to anything typically American, if not downright evil.

Heads up, folks. Raul Castro is socialist, perhaps Hugo Chavez is socialist, but absolutely nothing proposed by the Obama administration or the Democratic caucus can legitimately be called "socialist".

The word socialist is being used as a weapon to kill health reform. Unfortunately the folks that use the word the most, have no idea what it really is. How someone can get socialism out of a public plan that competes with a private plan I don't know. The CBC has already concluded that a public plan competing with a private plan will not lead to a wholly run government health plan, but folks just keep hammering away at that point crying out socialism.

I am hoping that logic will over-ride fear as we push forward. We are already seeing a change in tide with some polls suggesting that Americans are backing away from the fear and paranoia, and starting to listen to the facts.

[Sir Terrence the Terrible]

Probably a good idea. Some people have made it known that comments from the citizens of a second-rate country are not welcome in this thread...even if the comment is more relevant than 99% of the rest of the thread.

:out:

FA, It's A person, not some. This American welcomes your opinions and facts regarding the Canadian health care system, and your perspective on our system as well. Yours and other Canadians contribution to this thread has been very enlightening for me. Please do not pay any attention to the lack of finesse of a certain American, he does not represent us all.

[markw]

Probably a good idea. Some people have made it known that comments from the citizens of a second-rate country are not welcome in this thread...even if the comment is more relevant than 99% of the rest of the thread.

:out:My, aren't we feeling a but snippy today. OK, you asked for it.

Simply put, you don't understand the greed in politics here. I don't see where either side is shoring up the problems such as insurance regulation being limited to each state (read blackravens posts). Likewise, I don't see them shoring up the bleeding costs that exist, just forcing another overpriced plan on people.

Believe it or not, 85% of the people have working, albeit expensive, health insurance. A lot of that 85% is not rich. Many are barely hanging on to middle class by a thread. If they tax their insurance, it will surely impact their standard of living and drop many into a poverty level. Likewise, with the administrations plan, they can drop people from their corporate insurance and, for smaller companies, drop entire plans, thereby forcing a market for their new plan which, I'm sure, won't measure up to what they have now.

Nor can you even fathom your country being the "go to guy" whenever a world crisis has developed for the past 65 years or so. You have no idea what that costs. How many working subs do you have? How about world-class icebreakers? If your country had to pay for all it's own protection, you would be bankrupt. Your armed forces are already drastically underfunded and, IIRC, isn't Russia sniffing at your northern oil reserves? Don't worry, the big bad US of A probably won't let it fall into their hands.

Granted, you're always there peeking out from behind us, but it's not you who they come to to resolve the problem, nor do you bare the financial burden of being the world's protector. Now, we don't really mind you guys quietly living off our good will and your fortuitous location, huddled at our northern border, but most at least have the good sense to realize their good fortune and not think you're really more than you are, which is a country living in the shadow of a richer, larger, country with more global responsibilities than you can imagine.

Feel better now that you got that off your chest??

[3LB]

State-side, it seems popular to use "socialist" as scare word. By implication anything so-labeled must be rejected out of hand as "not the American way", i.e. inferior to anything typically American, if not downright evil. Don't know about "evil"... socialism isn't inherently evil. A Farmers Co-op is a form of socialism, so is a credit union. Depends on who is running the show. The former USSR's brand of socialism/communisn imploded under its own weight and corruption. I don't think large scale socialism is the answer for the US, though our brand of capitalism isn't looking too healthy about now.

I don't think anyone here has exhibited a "let them eat cake" attitude with regards to a federally mandated healthcare system. Myself, I think system reform is in order before we could ever expect a healthcare plan to work. Hell, people entering the workforce today are paying for their grandparents' retirement - we're foolish to believe our gov't won't screw this plan up as well. When the citizens of this country actually wield control over our elected officials, and not the special interest lobbies, then I think a national healthcare could work. I agree that party lines should not play a part in this issue, but they do, they play a bigger role in our lives than they deserve to, and we need to fix that sooner than later.

[3LB]

Nor can you even fathom your country being the "go to guy" whenever a world crisis has developed for the past 65 years or so I'm all for getting out of the "policing action" business.

[E-Stat]

Really? So not 1 red cent collected via a consumption tax at any level of government has ever been allocated to either budget?
Certainly not for federal defense. The allocation of sales tax to the other authorities would be determined on a state by state basis if at all. County property taxes typically cover schools.

rw

[E-Stat]

No I'm quite correct...
You are answering the wrong question and have gotten yourself all in a lather because you didn't read my link and my comment. I will repeat for clarification:

Safeway does use BMI and Peterson's 28.6 value falls below the 30 threshold.

We're not talking about what the AMA says. We're not talking about a theoretical concept. We are talking about WHAT SAFEWAY DOES TODAY. Your athlete example is very likely why THEY chose to extend the BMI limit to 30 and NOT use the 25 figure.

rw

[E-Stat]

Sorry, this is a socialist ideal? I was speaking about the concept fundamentally. It appears to be a left and right issue for you guys. E-Stat, I'm sure much of what is being proposed stinks of all types of political agenda.
For our existing situation, it would be a new government mandated tax for all people, whether they want or need it or not. That's the issue and does not reflect the freedom we currently have. Others may fairly disagree. There is no right to health care in any of our founding father's documents.

rw

[E-Stat]

This is where I think we hit a philosophical difference. Canadians don't see this as the Government dictating required health insurance.
Fair enough. It is one part covered by your higher tax burden.

rw

[poppachubby]

My, aren't we feeling a but snippy today. OK, you asked for it.

Simply put, you don't understand the greed in politics here. I don't see where either side is shoring up the problems such as insurance regulation being limited to each state (read blackravens posts). Likewise, I don't see them shoring up the bleeding costs that exist, just forcing another overpriced plan on people.

Believe it or not, 85% of the people have working, albeit expensive, health insurance. A lot of that 85% is not rich. Many are barely hanging on to middle class by a thread. If they tax their insurance, it will surely impact their standard of living and drop many into a poverty level. Likewise, with the administrations plan, they can drop people from their corporate insurance and, for smaller companies, drop entire plans, thereby forcing a market for their new plan which, I'm sure, won't measure up to what they have now.

Nor can you even fathom your country being the "go to guy" whenever a world crisis has developed for the past 65 years or so. You have no idea what that costs. How many working subs do you have? How about world-class icebreakers? If your country had to pay for all it's own protection, you would be bankrupt. Your armed forces are already drastically underfunded and, IIRC, isn't Russia sniffing at your northern oil reserves? Don't worry, the big bad US of A probably won't let it fall into their hands.

Granted, you're always there peeking out from behind us, but it's not you who they come to to resolve the problem, nor do you bare the financial burden of being the world's protector. Now, we don't really mind you guys quietly living off our good will and your fortuitous location, huddled at our northern border, but most at least have the good sense to realize their good fortune and not think you're really more than you are, which is a country living in the shadow of a richer, larger, country with more global responsibilities than you can imagine.

Feel better now that you got that off your chest??

Hahaha, you are a funny little man...

[markw]

Hahaha, you are a funny little man...Yes, but truthful, which is what irks her, and a few others. I do see you're still selling them your well-used subs.

[poppachubby]

I do see you're still selling them your well-used subs.

I don't even know what that means. No man, I don't think it irks her. Clearly you're the one who gets irked around here. I think for most, it's just an internet forum. Your anger and bitterness comes off the page like no one else on this site. It's funny, on maybe my second day here, I tried to "befriend" you with a little playful joking and you reacted completely hostile. Since then I have seen your various threads and replies and for the most part, you're pretty much a dik. I take it that you're one of those guys who knows he's a dik, and takes some sort of great ironic pride in it. Anyways, there's not too much you can say to me that will get under my skin bro, but you on the other hand have a big, huge, giant button on your forehead marked "PUSH". Don't get too whipped up, I won't check this until tommorrow at this point, well actually, maybe in a bit, so yes, go on Mark, let me "have it"!! Hahahaha.......

[markw]

I don't even know what that means. No man, I don't think it irks her. Clearly you're the one who gets irked around here. I think for most, it's just an internet forum. Your anger and bitterness comes off the page like no one else on this site. It's funny, on maybe my second day here, I tried to "befriend" you with a little playful joking and you reacted completely hostile. Since then I have seen your various threads and replies and for the most part, you're pretty much a dik. I take it that you're one of those guys who knows he's a dik, and takes some sort of great ironic pride in it. Anyways, there's not too much you can say to me that will get under my skin bro, but you on the other hand have a big, huge, giant button on your forehead marked "PUSH". Don't get too whipped up, I won't check this until tommorrow at this point, well actually, maybe in a bit, so yes, go on Mark, let me "have it"!! Hahahaha.......I just comment appropriately when it's called for. I just let the blowhards who talk down to us out of ignorance have it when they ask for it, no matter where they are from.

As for your "befriending" me in your early days, perhaps your remark would have gone over better had we been face to face but, barring any other means of interpertation, it came off as a rude slap in the face. Ergo, my response.

[Feanor]

Fair enough. It is one part covered by your higher tax burden.

rw

Thus there is a least one area where we feel we're getting our money's worth for our tax dollars.

[02audionoob]

I don't know if this is the right time to interject in this, one of the all-time great polarizing AR threads, but here goes.

You Canadians read what markw says and probably think "typical American" and criticize wiith great zeal. Some of you Americans are unwilling to be lumped in markw and take the opportunity to distance yourselves, saying he doesn't speak for us...he doesn't speak for Americans. Well, pardner...like it or not...he's right in the eyes of many Americans.

The US government is bigger than our founding fathers ever imagined and it's only getting bigger. For those Canadians who think we're all about the conservative/right, please remember
(a) both presidential candidates ran on a platform of change in Washington, (b) we elected the leftward choice between the two, and guess what...(c) the candidate from the right actually lost the popular vote the time before that. But on the other hand, for all you Americans who say markw doesn't speak for us, remember we elected George W. Bush twice. The NRA is alive and well. We buy a great many pick-up trucks in this country and more than a few have gun racks in the back. The great many churches Feanor rails about are full on Sunday.

I like to think as a native Texan I have a little extra insight on the idea Americans are all brash, loud and arrogant. Many Americans think all those things about Texans. How arrogant do we have to be to get that reputation in America...the country with that same reputation? But hey...it's who we are. We here today didn't create the US, but we're it. We live it and breathe it.

I'm learning as I go, but there was a time when I thought Texas was the greatest state in the union. Oh well...maybe I still think that. I was raised here. I can't help it, at least not without some sort or therapy or hypnosis. I didn't invent it. It's just who I am...just like being thrifty, perpetually late, or any of my other foibles. I get better as time goes on...I think. I suppose I must be abusive and ignorant, since that's what Cloth Ears said in that disapproval rep point he gave me...which makes me wonder...am I those things because I don't just turn the other cheek? And now wait a second...isn't calling someone "abusive and ignorant" the perfect example of the pot calling the...oh, but anyway...I'm wandering.

I'd also like to think that since I lean leftward by comparison to my fellow Texans on average, I'm actually learning something from the outside world. I still live in a place where the most popular vehicle isn't the Camry, Accord or Civic...


http://farm4.static.flickr.com/3421/3991811844_8fc3912e51_m.jpg


...and what seems almost like instinct will probably always remind me that while this country needs to move forward about half its voters are still trying to keep a lid on the size of government and how much it controls our lives, including our healthcare and insurance. It's a noble cause, when you consider our history...and a matter of perspective.

So now I suppose I'm repeating myself, but as much you Americans might say markw doesn't speak for you, I'll just remind you...like it or not, he's got more people on his side than this guy...


http://farm3.static.flickr.com/2575/3991861622_41acd55970_o.jpg

[kexodusc]

You are answering the wrong question and have gotten yourself all in a lather because you didn't read my link and my comment. I will repeat for clarification:

Safeway does use BMI and Peterson's 28.6 value falls below the 30 threshold.

We're not talking about what the AMA says. We're not talking about a theoretical concept. We are talking about WHAT SAFEWAY DOES TODAY. Your athlete example is very likely why THEY chose to extend the BMI limit to 30 and NOT use the 25 figure.

rw
You're right I misread your post completely, my apologies. But regardless, that's irrelevant to my point -BMI is clumsy at best and insurance policies can be too arbitrary in its application - the BMI is a function of weight and height, not a function of a person's level of fitness at a given weight, doesn't differentiate between healthy muscle mass and problematic body fat, and has tremendous potential for penalizing healthy individuals and not penalizing unhealthy ones. It's great for its simplicity, particularly in studies that include only or mostly obese people..but heavier, fit people have never been properly accounted for by the figure. A terrible metric for insurance coverage determination.

That's too off topic to the discussion however - I'm actually in agreement with the context you brought it up in...healthy people are not rewarded enough IMO, and there should be greater incentive to look after one's self. This is a big beef I have with the Canadian system...though it has been proven by a few studies that smokers' burden on health care is less than non-smokers, obese individuals (particularly diabetics) are not. Slippery slope to climb though - denying people affordable health care for being ill or unhealthy...Too many difficult decisions to be made there.

[poppachubby]

Noob, I think as Canadians, we know Americans well enough to put stereotypes aside. It's the rest of the world I'm not so sure about.

Personally, I think people's politics are their own business. That said, I don't care if someone is left or right, hick or gay. I don't view Healthcare as a matter of politics. To me, it should be a basic human right.

Of course, we expect the government to provide it via our tax dollars, so it gets filtered through the political system as a platform issue, etc. At the end of the day, in spite of my politics or personal beliefs, if my arm falls off, I want help to put it back on.

Anyhow, I'm done on this thread and I will certainly never comment on anything political or religious here again. So easy to get caught up. It's just not what I come here for...

[E-Stat]

the BMI is a function of weight and height, not a function of a person's level of fitness at a given weight, doesn't differentiate between healthy muscle mass and problematic body fat, and has tremendous potential for penalizing healthy individuals and not penalizing unhealthy ones
Regardless of your comments, BMI has been proven to be a good overall indicator of health. If you think that healthy folks are penalized by BMI, then by all means provide your proof. Safeway's application is in direct conflict with your assertion. As I have already demonstrated, your elite athlete example would NOT be penalized by their criteria. TtT claims he would be penalized, but has not given any proof. I seriously doubt than anyone who claims to be "lean" would have a BMI greater than 30. Like you, he will have to provide his proof in order to support his claim. I am 5' 6" and weigh 152 lbs. In order to exceed an index of 30, I would have to weigh more than 185 lbs! Are you kidding? BTW, I am a regular runner.

rw

[E-Stat]

Of course, we expect the government to provide it via our tax dollars, so it gets filtered through the political system as a platform issue, etc. At the end of the day, in spite of my politics or personal beliefs, if my arm falls off, I want help to put it back on.
"Provide it via our tax dollars". More than likely, you believe that the tax burden here in the states is distributed similarly as it is in Canada. Right? Nothing could be further from the truth. According to 2007 data, 32% of Canadians contributed nothing to income taxes. How about in the US? The answer is 50%! So what is the contribution to the tax burden provided by the top 25% of Canadians? 80% Care to wager a guess on the figure for us in the states? 86% For those of us in the half (not the two thirds) who shoulder all the burden, the health care initiative means here's a way to add $900 Billlion dollars to our existing higher contribution to yours. Do you begin to understand the feeling of those who are already shouldering more of the load than you Canadians? It is very easy for the 50% of Americans who contribute NOTHING - Zilch - Nada - Zero income tax to say, now I want free healthcare to be provided by those who already support us. Do you understand?

rw

[E-Stat]

Thus there is a least one area where we feel we're getting our money's worth for our tax dollars.
Do read my response to Chubby. Are you aware that a far more significant number of Americans pay ZERO income tax than in Canada (50% vs 32%)? Are you aware that a far greater amount of the tax revenue is contributed by the top 25% of filers (86% vs 80%)? And, now Obama wants to add another $900 Billion dollars worth of additional annual expense to those of us who support the entire system. Does that mean anything to you? Would you like to increase your tax contribution by another 20%?

rw

[Sir Terrence the Terrible]

My, aren't we feeling a but snippy today. OK, you asked for it.

Simply put, you don't understand the greed in politics here. I don't see where either side is shoring up the problems such as insurance regulation being limited to each state (read blackravens posts). Likewise, I don't see them shoring up the bleeding costs that exist, just forcing another overpriced plan on people.

Mark, I am sorry, but I don't believe in a all or nothing approach. It is not like you cannot tweak policy after it is instituted. Also, the public option would force insurance companies to compete and thereby saving costs. You don't have to mandate cost containment, the competition would do it for you. The public option would cut across state lines, as it is not a regional concept, but a country wide concept.


Believe it or not, 85% of the people have working, albeit expensive, health insurance. A lot of that 85% is not rich. Many are barely hanging on to middle class by a thread. If they tax their insurance, it will surely impact their standard of living and drop many into a poverty level. Likewise, with the administrations plan, they can drop people from their corporate insurance and, for smaller companies, drop entire plans, thereby forcing a market for their new plan which, I'm sure, won't measure up to what they have now.

Wrong again. The proposal that are are there (there is no administration proposal), the Baucus bill (however imperfect and it really is) would save a family of four 6 thousand dollars a year. Secondly, haven't you been listening? Large corporation CANNOT drop the plan, as they are mandated by their size to cover their employees. If they do drop their insurance, they will be taxed the same amount that they pay in insurance premiums. That would prevent large corporations from dropping their plans, they would save no money in doing so. With the public option in play, cost will go down, and large corporation and small businesses would actually save a lot of money. The cost containment is built in with the public option in play. The problem with the public option is not the plan itself, it is the politic that surround it. In a free market environment, competition is what drives the market. In this market the entity that can provide the most value, wins. The bottom line is the current system provides no value to the consumer. Since the insurance system in this country is private, and they are not really competitive amongst themselves (too much region dominance), the public option benefits the smaller insurance companies by leveling the playing field with the larger insurance companies. The smaller companies cannot afford to pay their CEO's millions of dollars, and the large insurance companies will have to choose between marketing a value oriented product, or paying the boss millions.


Nor can you even fathom your country being the "go to guy" whenever a world crisis has developed for the past 65 years or so. You have no idea what that costs. How many working subs do you have? How about world-class icebreakers? If your country had to pay for all it's own protection, you would be bankrupt. Your armed forces are already drastically underfunded and, IIRC, isn't Russia sniffing at your northern oil reserves? Don't worry, the big bad US of A probably won't let it fall into their hands.

This tripe is how we Americans get such a bad rep.


Granted, you're always there peeking out from behind us, but it's not you who they come to to resolve the problem, nor do you bare the financial burden of being the world's protector. Now, we don't really mind you guys quietly living off our good will and your fortuitous location, huddled at our northern border, but most at least have the good sense to realize their good fortune and not think you're really more than you are, which is a country living in the shadow of a richer, larger, country with more global responsibilities than you can imagine.

Feel better now that you got that off your chest??

This mentality is what has the world hating our guts. Besides, it is outdated. The world has changed Mark. Their are other big boys now, and I am not speaking of Russia either. We are so in debt to the Chinese, we can no longer afford the chest pounding exercises. If they called in that debt tomorrow, the good ole USA would be no better than Iceland financially. Our wars (especially the recent ones) have supported our military industrial complex to the point where we can no longer afford to do anything else. Our military is tired, worn out, and many soldiers have medical and mental issues that will dog them well into the future.

We need world partners, and can no longer afford to go on our own. Canada, Britain, and Australia have always been there for us, and we need to treat them with a little more respect than your chest pounding allows.

[3LB]

I understand that many non-Americans think we spend so much on our military, as well as propping up dictatorships around the globe, that we shouldn't quivel over a noble thing like healthcare. If only it were that easy. You pointed out what most Americans already know or at least think, but you at least bring numbers with you - thanks. I heard a great number of US residents didn't contribute to income taxes, but I didn't know it was 50%. (do you have a link to that - I ask now cuz someone else will anyay)

Nothing will ever change until more people educate themselves and then vote. So many of the voters in this country vote name recognition only, or they vote how they feel. I admit I need to do more reading on most everything discussed here. I didn't realize so many Americans who enjoyed the freedoms we enjoy here didn't pay their share of taxes. I wonder if these same people vote. Of course, now I understand why so many wouldn't vote...they have no real investment in the country anyway.

[Sir Terrence the Terrible]

Do read my response to Chubby. Are you aware that a far more significant number of Americans pay ZERO income tax than in Canada (50% vs 32%)? Are you aware that a far greater amount of the tax revenue is contributed by the top 25% of filers (86% vs 80%)? And, now Obama wants to add another $900 Billion dollars worth of additional annual expense to those of us who support the entire system. Does that mean anything to you? Would you like to increase your tax contribution by another 20%?

rw

Well, according to this fella tax hikes are not all that bad for the economy.

http://www.huffingtonpost.com/larry-beinhart/time-for-tax-hikes_b_156423.html

http://www.huffingtonpost.com/larry-beinhart/tax-cuts-theology-facts-t_b_144281.html

He raises some very good points.

[poppachubby]

More than likely, you believe that the tax burden here in the states is distributed similarly as it is in Canada. Right? Nothing could be further from the truth.
rw

Hey E-Stat, slow down. I was commenting on Canada and really could care less about the American tax burden. How about letting me answer your question (Right?) before you begin a rant. Maybe time to shut er down for the night! I made my point clear to you earlier, why are you shoving statistics down my throat? I was simply responding to my friend audionoob's thoughts. Man oh man...your stats almost look like a good case for socialism...hahahaha

[thekid]

Mudslinging aside....It looks like a version of it is going to move out of committee and to the Senate floor for a vote.

An intersting factoid I heard the other day regarding this issue-So far over 350 million dollars has been spent by lobbyists regarding this legislation. Another factoid there are 6 lobbyists in DC for every member of Congress. So what affect do you think that has had over the final piece of legislation?

People who bemoan about how their tax dollars are spent in Washington should also be questioning who is spending and why this much money has been spent by special interests on both sides of the issue. While what the government spends is somewhat related to the taxes we pay, don't kid yourself if you don't think the cost of lobbying is not also passed onto the consumer in some form.

[kexodusc]

Regardless of your comments, BMI has been proven to be a good overall indicator of health. If you think that healthy folks are penalized by BMI, then by all means provide your proof.


*sigh*...Several articles proving my point:
http://www.medicalnewstoday.com/articles/49991.php
http://www.atypon-link.com/PNG/doi/pdf/10.5555/ajhb.2007.31.6.687?cookieSet=1
http://www.ncbi.nlm.nih.gov/pubmed/17691883
http://www.spiked-online.com/index.php/site/article/7181/
http://www.news-medical.net/news/2006/08/21/19571.aspx


Safeway's application is in direct conflict with your assertion. As I have already demonstrated, your elite athlete example would NOT be penalized by their criteria. TtT claims he would be penalized, but has not given any proof. I seriously doubt than anyone who claims to be "lean" would have a BMI greater than 30. Like you, he will have to provide his proof in order to support his claim. I am 5' 6" and weigh 152 lbs. In order to exceed an index of 30, I would have to weigh more than 185 lbs! Are you kidding? BTW, I am a regular runner.

rw

I confess to being blindsided by the fact Safeway goes against the norm of categorizing 25-29.9 as overweight (even though I wasn't making my comment in reference to one employer's health insurance plan, but in general), but I could easily prove my point by taking another elite athlete...LaDainian Tomlinson...quit dodging the point.

[E-Stat]

I...do you have a link to that - I ask now cuz someone else will anyay
Such is very easy to find at irs.gov. Search for statistics and you will find numerous spreadsheets.

rw

[E-Stat]

Hey E-Stat, slow down... Man oh man...your stats almost look like a good case for socialism...hahahaha
Sorry if you aren't aware of the details before wading into the water. Good case? Well, now the gubmint wants to increase the dependency.

rw

[E-Stat]

*sigh*...Several articles proving my point:
Sigh: Several refuting that point:

http://www.ncbi.nlm.nih.gov/pubmed/10511607

http://cme.medscape.com/viewarticle/543559

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2960318-4/abstract


I confess to being blindsided by the fact Safeway goes against the norm of categorizing 25-29.9 as overweight...
You were blindsided by making assumptions and not reading what I said.


but I could easily prove my point by taking another elite athlete...LaDainian Tomlinson...quit dodging the point.
No one is saying that any single metric is going to be 100 accurate. Nevertheless, It remains a good indicator overall as evidenced by Safeway's success in holding down their health care costs. What fractional percentage of the population is represented by NFL running backs?

rw

[Feanor]

"Provide it via our tax dollars". More than likely, you believe that the tax burden here in the states is distributed similarly as it is in Canada. Right? Nothing could be further from the truth. According to 2007 data, 32% of Canadians contributed nothing to income taxes. How about in the US? The answer is 50%! So what is the contribution to the tax burden provided by the top 25% of Canadians? 80% Care to wager a guess on the figure for us in the states? 86% For those of us in the half (not the two thirds) who shoulder all the burden, the health care initiative means here's a way to add $900 Billlion dollars to our existing higher contribution to yours. Do you begin to understand the feeling of those who are already shouldering more of the load than you Canadians? It is very easy for the 50% of Americans who contribute NOTHING - Zilch - Nada - Zero income tax to say, now I want free healthcare to be provided by those who already support us. Do you understand?

rw

Interesting statistics.

For a start, are the 50% of US citizens who don't pay tax all poor people? From what I hear the US is world-class when it comes to tax loopholes. Anyway, I really have no problem with the rich paying a disproportionate share of taxes -- even a hugely disporportionate share, in the time when a 1% of the population controls 90% of the wealth. I made the point sometime ago to the sadly conflicted Bobsticks, that the rich would not be rich if they lived on a desert island: they are rich because they have the rest of us to server/exploit, (choose your verb).

Tax reform is one thing; healthcare policy another. Of course the latter has to be paid for, but it's illogical to say, "Our tax policy is bad, therefore our healthcare policy must, forever and always, be bad".

On certain issues, (which might include healthcare), the middle class, (say families with income >$100 k.p.a) will have to decide do we want (1) that 60" 240 Hz LED TV, or (2) secure, quality healthcare for everyone. (Consider that the TV is made in China while the healthcare is provided by American workers.)

But WTF? Come we have overall as good healthcare in Canada for about 65% of what it costs in the US? This is because in Canada, (as FA and others have tried to point out), we have decided that quality healthcare will be provided to everyone. That decision made, we've been free to seek the most effective and efficient means to deliver it -- and not without considerable success.

[3LB]

Come we have overall as good healthcare in Canada for about 65% of what it costs in the US? This is because in Canada, (as FA and others have tried to point out), we have decided that quality healthcare will be provided to everyone. That decision made, we've been free to seek the most effective and efficient means to deliver it -- and not without considerable success. How do you react to the statement made by Thekid regarding the massive ever-present lobby in D.C.? Reading that doesn't make the rest of us feel any better. Its one of the reasons we don't trust our gov't.

Its just as illogical to say that Healthcare is so important we must institute it right away no matter what burden it represents to an already over burdened populace. If the 50% E-stat mentioned is all poor, then they won't care about a national healthcare, cuz they already have one - welfare. Its there if a person needs it...they just gotta go get it.

[kexodusc]

Sigh: Several refuting that point:

http://www.ncbi.nlm.nih.gov/pubmed/10511607

http://cme.medscape.com/viewarticle/543559

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2960318-4/abstract
I don't have access to the 2nd link, but these didn't refute the point at all. They're silent on the criticisms in fact, though one does suggest using alternative measurements. Did you even read them? Just more blanket statements that BMI has positve correlation with causes of mortality. No duh...but it's not strong enough. Particularly a study that pulls data from 1979-85 - when the population was convincingly leaner. I wonder how they'd reconcile the increase in BMI in America from 1985 to now with the increase in life expectancy during the same period?


No one is saying that any single metric is going to be 100 accurate. Nevertheless, It remains a good indicator overall as evidenced by Safeway's success in holding down their health care costs. The problem is there's potential for a reduction in costs generated from excluding what most would consider healthy people. Keep dropping the outliers one side and we skew the mean pretty fast.


What fractional percentage of the population is represented by NFL running backs?


Who cares? I pulled those names because people would recognize them. Step into any gym and you'll see dozens of weight trainers and amateur body builders that would fit this profile, not to mention the number of people on the edge of one of these arbitrary thresholds that could be penalized for having higher higher bone density, or the misrespresentation that seniors will experience.

Look, it's a start in the right direction, but if it's just BMI and smoking, too many fit people are going to be excluded. I guess my standard of "good practice" is higher than yours in this case.

[ForeverAutumn]

How do you react to the statement made by Thekid regarding the massive ever-present lobby in D.C.? Reading that doesn't make the rest of us feel any better. Its one of the reasons we don't trust our gov't.

Not trusting your gov't is nothing new. I don't trust ours either. There have been many scandals in the last few years, both federally and provincially, where tax payers money has been illegally spent. Read this (http://en.wikipedia.org/wiki/Sponsorship_scandal) if you're at all interested in the largest scandal involving the, then in power, Liberal Party. But the thing is, the Liberals lost the next and each subsequent election and they haven't been in power since. Democracy means that you get a vote, but then you have to live with the results whether you like/trust the gov't or not.

But it doesn't change the fact that the right to healthcare has become something that Canadians value.

I've been told by a friend's father, who is very politically astute and is now in his 80's, that Canadians were not happy about the institution of universal healthcare when it was first brought about back in the 60's. But it is now something that we can't imagine living without.

It will be very intereting to see where the U.S. is on this issue in 10 years and, if public healthcare is brought in, how most people will feel about it then. Big changes are never easy, especially when you're dealing with a population the size of the United States on an issue as sensitive as people's health.

Where's my time machine when we need it? :wink5:

[Feanor]

How do you react to the statement made by Thekid regarding the massive ever-present lobby in D.C.? Reading that doesn't make the rest of us feel any better. Its one of the reasons we don't trust our gov't.
Since you ask, massive lobbying, unrestricted campaign contributions, and advertising by interest groups undermine democracy to a huge extent. It's not a problem unique to the US, but the US congress (and courts) has been more than typically resistant to doing anything about it.


Its just as illogical to say that Healthcare is so important we must institute it right away no matter what burden it represents to an already over burdened populace. If the 50% E-stat mentioned is all poor, then they won't care about a national healthcare, cuz they already have one - welfare. Its there if a person needs it...they just gotta go get it.
Well, as I understand the 50% are not all poor. I don't know much about Medicaid but I do hear a lot about people who, having had no preventive care or treatment for chronic conditions, turn up in a bad state emergency rooms, the most expensive form of treatment.

Apparently, it's one of those US myths that the problem is mainly one affecting the poor. In fact, exclusion for preexisting condition, remission of converage, and abuse claims adjudication by insurance companies have ensure that the problem affects the middle class too, especailly the unwell, self-employed, and employees of small employers.

[3LB]

Apparently, it's one of those US myths that the problem is mainly one affecting the poor. I agree. The working middle class will be the most effected by healthcare - its the working middle class that pays all the bills in our country.



In fact, exclusion for preexisting condition, remission of converage, and abuse claims adjudication by insurance companies have ensure that the problem affects the middle class too, especailly the unwell, self-employed, and employees of small employers.
this is a problem among people who are insured privately as well...will handing healthcare over to a gov't that's so swayed by big business solve the problem?

[Feanor]

...this is a problem among people who are insured privately as well...will handing healthcare over to a gov't that's so swayed by big business solve the problem?

Good question! So which is better, to have healthcare run by:

Government swayed by big business, or
Big business directly, motivated as it is soley by profit.You have to have a really unbounded confidence in capitalism and the market economy to accept the latter at face value; (many do, it seems).

[E-Stat]

No duh...but it's not strong enough.
Strong enough for exactly what?


The problem is there's potential for a reduction in costs generated from excluding what most would consider healthy people. Keep dropping the outliers one side and we skew the mean pretty fast.
No one in the Safeway organization was dropped. They paid $318 more per year than the others.


I guess my standard of "good practice" is higher than yours in this case.
The secret to their success is that they are incenting people to be healthy without TtT's unfounded fear of requiring access to medical records.

rw

[E-Stat]

For a start, are the 50% of US citizens who don't pay tax all poor people?
No. Neither for the US nor Canada.

rw

[Feanor]

No. Neither for the US nor Canada.

rw

True, though the situation is a bit worse in the US ipso facto.

But up here in the GWN we decided to go ahead with healthcare despite an imperfect tax policy. The debate still goes on up here of course; there will never be an end to it.

The government of Alberta is proposing heathcare premiums in the province; (they had been abolished a few years ago when oil revenues were higher). Obviously they could just raise other taxes but the Alberta government is a right-wing government so they like the "user pay" concept -- of course lots of poor people, who can't be denied coverage, will be excused from paying premiums because they just can't afford them.

In any case polls show that 90% of Albertans apparently would rather pay the premiums than see heathcare compromised.

[Sir Terrence the Terrible]

How do you react to the statement made by Thekid regarding the massive ever-present lobby in D.C.? Reading that doesn't make the rest of us feel any better. Its one of the reasons we don't trust our gov't.

This answer is easy...it is up to us. We have been the vacant piece that tips the balance of influence. While we have made Walmart rich, the lobby is doing their job replacing our influence with their constituents. When the American public begins to act more like the French, our politicians will listen to us. However, as long as we continue to sit and complain about the situation without doing nothing, is as long as we have to deal with being second instead of first to the punch.


Its just as illogical to say that Healthcare is so important we must institute it right away no matter what burden it represents to an already over burdened populace. If the 50% E-stat mentioned is all poor, then they won't care about a national healthcare, cuz they already have one - welfare. Its there if a person needs it...they just gotta go get it.

We have to institute it right now if we A) expect job growth and B) control our budget deficit. As long as employers face yearly higher premiums, they are not going to hire full time workers which drive our economy. They ship jobs overseas because of the reduced overhead like health insurance costs. Paying living wages to Americans has never been a problem, its the overall benefits package that is so costly. If corporations were not stuck with rising health care costs, they would invest in more jobs in this country.

Welfare does not provide health benefits, so that is not the answer for the poor. Their health care involves the most expensive process in the book, that would be the emergency room, because they cannot be turned away whether insured or not. This drives up costs for everyone, including the middle class and poor. You cannot just go out and get Medicaid, you have to qualify for it. Illegals can get it for their children that are born here, but it does not cover any illegal adult. They go to the emergency room, and that has to be stopped somehow.

This healthcare issue is very complex. The republicans balk at giving illegals any services, but having an illegal with TB, H1N1, or any other communicable disease running around infecting large swaths of people is not a desirable alternative. They want it budget neutral, but you have to cut waste in order to fund it, and Medicaid is extremely wasteful. Any attempts to cut waste are met with a disingenuous howl in the name of protecting granny. If we don't get healthcare cost under control, jobs are going to continue to be outsourced to country's with a cheaper labor supply. This affects long term economic growth, as the fundamental base of full employment will rise from 4-5% to closer to 7-8%. A persistently high employment rate will be a social problem this country does not need, and cannot bare.

The house and the senate really needs to keep pace with the changes that are immediately needed. They should not complain of having too much on the plate, as handling these issues are what they are getting paid for. I personally think that if we were not in two wars which are draining precious resources away from the American public's needs, these issues would be much easier to handle.

[Sir Terrence the Terrible]

I agree. The working middle class will be the most effected by healthcare - its the working middle class that pays all the bills in our country.

this is a problem among people who are insured privately as well...will handing healthcare over to a gov't that's so swayed by big business solve the problem?

Have you heard anyone complaining about Medicare? I have not. What I am hearing is seniors screaming keep the government out of it(such irony). The government must be doing something right if folks on Medicaid want to keep things just the way they are. Now one could argue that Medicaid is trouble financially, but I would counter get rid of the waste within the system, and use the system as a bargaining tool with the pharmaceutical companies (something they gave away). The CBO states that just doing those two things could save the system close to 500-600 billion. This would almost fund the entire Bacus bill, and with competition from the public option contain future costs for everyone. Walmart uses its enormous size to bargain with the Pharmaceutical companies which is why they can charge $4 dollars for a 30 day supply of generic drugs. We need more effective generic drugs on the market, and that can be accomplished by reducing the time the pharma's have on patents.

The fact that our government is doing anything on healthcare is not thrilling the health insurance companies one bit. When our voices drown out the insurance lobby, they will pay attention. As long as WE sit on the sidelines complaining, it is business as usual.

[nightflier]

Estat,

I've always valued your opinion, so don't take this the wrong way, but using BMI is certainly discriminatory for the simple fact that a company cannot draw a line at a certain number and be fair about it. Sooner or later they will get sued and loose. Just wait for the headline where a woman who just had a baby, or a poor chap in with a debilitating illness, has their premiums jacked because they fall outside the arbitrary "limits" set by Safeway.

02audionoob,

Sorry to disagree with your Texan perspective, but you're a bit off. There are a number of people who have PM'd me to let me know that they agree with a more progressive point of view on many of these threads, but don't contribute to the discussion because of how belligerent people are behaving. Yes, lively discussion helps this site, but some comments are just plain injurious and no longer serve the purpose of the discussion. I'll admit that I've been sucked into more than one debate and said some things I'm not too proud of, but I've never done so in anger and repressive bitterness like the kinds of comments that come from the far-right.

The fact is, Markw's point of view is the minority point of view, both here and throughout the country. For your information: Dubya was never elected, not even once - he cheated the first time, and he most certainly cheated the second time. As a matter of fact McCain cheated a bunch too, but the sentiment was so overwhelmingly against the Republicans that even with cheating, they still couldn't steal a 3rd election. Some other details: GM & Dodge truck sales are way down, especially compared to Honda and Toyota cars, the churches are struggling to get their congregations to stay and pay tithes, and if you're wondering, MarkW's biggest fan on the political front is Pixelthis. I don't suppose you'd be OK in that company.

MarkW,

Your comments against FA are both ignorant and xenophobic (I know, big word, might want to look it up). I can poke fun at Canadians and Australians too, but your comments are laced with anger and bitterness that go beyond the pale (as poppachubby correctly pointed out). You should probably ask yourself if your message isn't diluted by the way you put people off. If you really wanted to make a point and win converts, you might want to try and find some common ground first.

And what is this unfounded obsession with subs & icebreakers? Fact is, Canada has been a welcome buffer from Soviet ICBMs and we're pretty friggin glad they have been. The only reason the US doesn't want Russians drilling for Oil isn't because they care that much about Canadians' right to it, but rather because they want it for themselves. Canada is well aware of that, BTW. The US as the world's protector? Aside from the arrogance of the statement, I ask: From what? The cold war is over, in case you haven't noticed. Terrorism? Most people around the world consider the US the biggest instigator of terrorism. We built up Al-Qaeda and Osama was on our payroll, remember? I suggest you pick up a copy of The Power of Nightmares (http://en.wikipedia.org/wiki/The_Power_of_Nightmares) and brush up on your history a bit.

***************************

Back to the topic,

While I still don't have much faith in our politicians delivering anything meaningful, I will change my skepticism of the future of the bill. If/when the bill does pass, we will likely enter a long period of adjustment and amendments to it, and I hope that this will be for the better of it. Canada's system went through the same changes, as Feanor and FA have pointed out. In time, this bill could become much better. If we also take into account that conservatives who oppose this bill have a very short-termed perspective on anything (I suppose that goes with the territory), they will, one can only hope, loose interest in it after it is passed, and move on to more galvanizing, politically-charged topics that will bring them more immediate self-serving rewards. I certainly don''t expect them to read the bill - after all, they never read the Pariot Act either, and they pushed that like gang-busters, LOL.

So if it passes, then it seems to me a pretty simple equation: yes our taxes will go up, but our insurance premiums will go down by a wider margin so the vast majority of the people will have less cost out of pocket. Well, it will benefit pretty much everyone except the inflated portfolios of the CEOs of big pharma, insurance, and the HMOs. That they are lighting unrelated powderkegs like the ubiquitous "socialist threat" is perhaps understandable, but so last century, no?

What is so astounding is the vehement opposition from lower and middle class people who will likely benefit from it all. Socialist? Pluuueeeze, the public option will offer competition to the private sector. Competition is a Republican standard, no? So I guess we're back to Smokey's original question: why all the anger, mud-slinging, and bitterness? The only people who have any reason to complain can afford not to, really. Anyone who's middle or lower class and opposes it, is either desperately hanging onto a single small issue that may not even affect them in the end, or just plainly not the sharpest tool in the ol' shed.

[ForeverAutumn]

Cloth Ears,
I am enjoying your contributions to this thread. Your points are well made and well thought out. You seem to be able to stick to the facts and avoid some of the tangents that others on this board have a hard time avoiding. You seem like an intelligent man (I am assuming the 'man' part since I can't see you).

Welcome to AR. I hope you stick around.

Cheers from Canada!
FA.

Got an anonymous reddie for this one. Evidently I'm "piling it on". Yep, that's me. I'm just a big kiss-ass. LOL.

[E-Stat]

I've always valued your opinion, so don't take this the wrong way, but using BMI is certainly discriminatory for the simple fact that a company cannot draw a line at a certain number and be fair about it. Sooner or later they will get sued and loose.

Thanks for the comments. First of all, this is not my plan so I don't take affront to anyone disagreeing with the Safeway plan. I will point out, however, when someone mis-characterizes what it is. Along with the Mayo Clinic, I was made aware of their plan by President Obama as being a progressive way to encourage folks to a better lifestyle.


Just wait for the headline where a woman who just had a baby, or a poor chap in with a debilitating illness, has their premiums jacked because they fall outside the arbitrary "limits" set by Safeway.
Perhaps you are not aware there are 22,000 employees who have been in this program for over three years. Surely your scenario has already occurred many times over.

rw

[thekid]

What is so astounding is the vehement opposition from lower and middle class people who will likely benefit from it all. Socialist? Pluuueeeze, the public option will offer competition to the private sector. Competition is a Republican standard, no? So I guess we're back to Smokey's original question: why all the anger, mud-slinging, and bitterness? The only people who have any reason to complain can afford not to, really. Anyone who's middle or lower class and opposes it, is either desperately hanging onto a single small issue that may not even affect them in the end, or just plainly not the sharpest tool in the ol' shed.

Night

You seem like an intelligent person so I guess I am surprised that you are "astounded" by the way this issue has played out. Never underestimate the power of politicians, lobbyists and the media to shape the opinion of people even when it goes against their best interests. In some respects this was what this country was founded on when you consider the demographics of the Founding Fathers versus the average colonist at the time. (Please note-this is not an attack on the Founding Fathers. Just read your history and some of the deliberations that went on during the formative years of the country) The Civil War probably being the most tragic example of this; A wealthy minority convinced a mostly poor uneducated majority to go war to ostensible to fight for "States Rights" and "Freedom" when in fact the root cause was to basically maintain or improve the economic status of the wealthy.

The President lost control of this issue when he gave up ownership of it out of fear of not repeating the mistakes of the Clinton administration. When you no longer control the message then the monied interests (on both sides of the issue) begin to shape the issue and we end up with the fairly weak piece of legislation that it looks like we will get. The Dems and the GOP will then use the results as a means of securing additional resources for their respective election campaigns which in the end was their primary goal in the first place. As someone mentioned about Canada the reason they have Universal Healthcare is because the politicians on both sides agreed it was the right thing to do. Sadly that is not the case here where instead the inertia of our election/money cycle killed what is sorely needed because our current health care system hurts us when competing in the global marketplace among other things. Rather than coming at this issue as an moral and economic imperative we have treated it no differently than any other piece of legislation that has come up in the last 35 years.

[Sir Terrence the Terrible]

Night

You seem like an intelligent person so I guess I am surprised that you are "astounded" by the way this issue has played out. Never underestimate the power of politicians, lobbyists and the media to shape the opinion of people even when it goes against their best interests. In some respects this was what this country was founded one when you consider the demographics of the Founding Fathers versus the average colonist at the time. (Please note-this is not an attack on the Founding Fathers. Just read your history and some of the deliberations that went on during the formative years of the country) The Civil War probably being the most tragic example of this; A wealthy minority convinced a mostly poor uneducated majority to go war to ostensible to fight for "States Rights" and "Freedom" when in fact the root cause was to basically maintain or improve the economic status of the wealthy.

The President lost control of this issue when he gave up ownership of it out of fear of not repeating the mistakes of the Clinton administration. When you no longer control the message then the monied interests (on both sides of the issue) begin to shape the issue and we end up with the fairly weak piece of legislation that it looks like we will get. The Dems and the GOP will then use the results as a means of securing additional resources for their respective election campaigns which in the end was their primary goal in the first place. As someone mentioned about Canada the reason they have Universal Healthcare is because the politicians on both sides agreed it was the right thing to do. Sadly that is not the case here where instead the inertia of our election/money cycle killed what is sorely needed because our current health care system hurts us when competing in the global marketplace among other things. Rather than coming at this issue as an moral and economic imperative we have treated it no differently than any other piece of legislation that has come up in the last 35 years.

Kid,
I just wanted to inform you that our President has not lost anything. After his major healthcare speech, and the media blitz following it, his numbers on this issue have risen 8-10 points depending on the poll. The pundits cite that his TAKING ownership of this issue has been key.

Based on what I have read as of today, the momentum on the public option is swinging back his and the Democrats way. With so many respected former GOP house and senate members imploring the republicans in congress and the senate to get with the program, the pressure is now on them to get with the process and stop hampering it. Bob Dole is the latest voice to speak out on this. It is not over till the lady with the high BMI sings the finale.

[02audionoob]

Got an anonymous reddie for this one..

Apologies for the lack of signature.

[thekid]

Kid,
I just wanted to inform you that our President has not lost anything. After his major healthcare speech, and the media blitz following it, his numbers on this issue have risen 8-10 points depending on the poll. The pundits cite that his TAKING ownership of this issue has been key.

Based on what I have read as of today, the momentum on the public option is swinging back his and the Democrats way. With so many respected former GOP house and senate members imploring the republicans in congress and the senate to get with the program, the pressure is now on them to get with the process and stop hampering it. Bob Dole is the latest voice to speak out on this. It is not over till the lady with the high BMI sings the finale.

I hope you are right but I'd like to see a more forceful approach coming from the White House regarding the public option and cost containment initiatives. A little bump today because the numbers released today show the proposed Seanate bill coming in $80 million below the initial projections.

As you can tell I am generally pessimistic about our political process but who knows if this process somehow ends up bringing some of the groups you mention together then maybe the inertia I complained about earlier can be broken......

After all was'nt that the reason so many went to the polls last November

[Feanor]

...
Never underestimate the power of politicians, lobbyists and the media to shape the opinion of people even when it goes against their best interests. In some respects this was what this country was founded on when you consider the demographics of the Founding Fathers versus the average colonist at the time. (Please note-this is not an attack on the Founding Fathers. Just read your history and some of the deliberations that went on during the formative years of the country) The Civil War probably being the most tragic example of this; A wealthy minority convinced a mostly poor uneducated majority to go war to ostensible to fight for "States Rights" and "Freedom" when in fact the root cause was to basically maintain or improve the economic status of the wealthy.

....

Never truer words spoken, Kid.

I know it was presumptuous of me at the time (and still), but I did point out earlier in this thread that the American War of Independance was a quintessential "middle-class" or bourgeois revolution intended to further the mercantile interests of the wealthiest colonists rather than the farmers and backwoodsmen co-opted to support it. And I certainly argee about the American Civil War, fought with blood of hundreds of thousands of poor southern farmers to sustain the interests of plantation owners cotton growing with slave labor.

I dare say that at least 95% of Americans would be personally better off with a universal, single payer system, yet it's not going to happen. Why not? I hear such utterly specious reasons as that a public option would be "unfair" to private insurance companies. What the hell do you owe the private insurance companies? The human race is damned.

[ForeverAutumn]

Apologies for the lack of signature.

See? This is why it's important to own up to these things. I was all ready to blame markw...an innocent man. :yikes:

[nightflier]

Kid, I share your pessimism on this issue, but what made me think a little differently is the history of good bills and ammendments. Take slavery for example, or the women's right to vote. I'm sure at the time there was widespread opposition and plenty of what-if fear mongering, but we're all better for it, now.

I agree that universal healthcare is and should be a basic human right. It really is a travesty that we are the only Western nation that can't muster the political will to pass something, anything, to alleviate the injustice of the current privatized system. Before Canada passed it's version, it wasn't all that popular either, but as you can clearly see, there aren't many Canadians today who would be rid of it.

I do hope something decent passes, so that we can get on with some of the other big issues in our world (like those two wars we're fighting, global warming, world hunger, the economy, Honduras, Cuba, Colombia, Venezuela, Panama, and the Middle East peace process, which is actually closer to some kind of resolution that it has been since the creation of the State of Israel. I'm just naming a few things that come to mind, jeez. After the healthcare bill passes, I also hope it's amended and improved to curb excessive costs, corruption, greed, and graft, and to give it some real teeth. But let's pass it first. The opposition appears to be fading. Yes, Limbaugh, O'Reiley, and the Fox News gang are still crying socialism, but who really believes those loons anymore?

Let's move on already.

[dean_martin]

In catching up on this thread, SirT's suggestion of an incremental approach jumped out at me. Indeed, we are discussing a fundamental change without an historical model to follow. An example of just how fundamental this is can be seen in the law. In 1944, the US Supreme Court determined that insurance is a business that can be regulated by Congress pursuant to the commerce clause of the Constitution. In response, Congress passed the McCarran-Ferguson Act in 1945 which essentially leaves the regulation of insurance to the states. This wikipedia link provides a very simple description of the Act http://en.wikipedia.org/wiki/McCarran-Ferguson_Act


Is this thread locked yet?

The Senate is finally discussing the McCarran-Ferguson Act in the context of health insurance companies' anti-trust exemption (probably in response to the insurance companies' release of a suspect and almost threatening report on Monday). I didn't think the debate would get this far before the health care effort died, but this could be the trump card that gets things moving.

(Is it bad form to quote yourself? If I have to ask, it probably is.)

[markw]

Is this thread locked yet?

The Senate is finally discussing the McCarran-Ferguson Act in the context of health insurance companies' anti-trust exemption (probably in response to the insurance companies' release of a suspect and almost threatening report on Monday). I didn't think the debate would get this far before the health care effort died, but this could be the trump card that gets things moving.

(Is it bad form to quote yourself? If I have to ask, it probably is.)By loking into these contradictary acts this could be a good first step in unblocking the process that might allow better and cheaper insurance.

Again, a lot depends on what legislation is drafted to take it's place, but it could be a good start.

[bobsticks]

Anyway, I really have no problem with the rich paying a disproportionate share of taxes -- even a hugely disporportionate share, in the time when a 1% of the population controls 90% of the wealth. I made the point sometime ago to the sadly conflicted Bobsticks, that the rich would not be rich if they lived on a desert island: they are rich because they have the rest of us to server/exploit, (choose your verb)..

I am not sadly conflicted....my point of view is derived from mercy and caring...but, I refuse to be taken advantage of...

I suspect that if you were in my tax bracket you would also resent the"hugely dispropportionate" rate of taxation if you were in a situation of ridiculous litigiousness, unfair immigration rules and class warfare.

If I were on a deserted island I would still be dominant....cuz that's how I roll..."Rich" is a term derived from the belief that you can place a monetary value on social dominance....there'll always be winners and losers...

We should all take care of each other....ALL...but that's not what's happening in America...

...feel free to disagree, but given your experiences, I can guarantee that your perspective would be different if you were in a different environment or circumstance....

[Feanor]

I am not sadly conflicted....my point of view is derived from mercy and caring...but, I refuse to be taken advantage of...

I suspect that if you were in my tax bracket you would also resent the"hugely dispropportionate" rate of taxation if you were in a situation of ridiculous litigiousness, unfair immigration rules and class warfare.

If I were on a deserted island I would still be dominant....cuz that's how I roll..."Rich" is a term derived from the belief that you can place a monetary value on social dominance....there'll always be winners and losers...

We should all take care of each other....ALL...but that's not what's happening in America...

...feel free to disagree, but given your experiences, I can guarantee that your perspective would be different if you were in a different environment or circumstance....

That really is the crux of the conservative, middle class dilema. Yes, in some real sense very many, like you, 'Sticks, who genuinely believe that they are merciful and caring ... but don't want to be taken advantage of. They are on moral quicksand.

You know I'm not a religious believer, but I will point out that this is what Christ was talking about when he said the it as as easy for a rich man to get into heaven as for a camel to pass through the eye of a needle.

In simple terms so many of the wealthy believe that the biggest portion of the less well-off are "undeserving". I've always believed in equal social responsibility. Let me assert that the huge majority of ordinary, working people are not lazy & shiftless, they are eager to pay their own way and serve society, (e.g. put their lives at risk in the military), but they get little credit from the smug wealthy and upper middle classes. Sure, there is bottom rung of the population who sherk their responsibility at every opportunity -- but they aren't all ,or even predominently, poor.

'Sticks: get past your self-delusional hypocracy. Shoulder your social responsibility and drop the "don't want to be taken advantage" line. It's old, stale, wrong, and you're kidding yourself.

[blackraven]

I'm playing devil's advocate here. Why should universal health care be called a human right? Health care is a service you pay for that is provided to you by a trained person. Human rights are free, like free speech, right to bear arms, etc. You don't pay money for a human right. What people mean is that they want FREE HEALTH CARE and UNLIMITED ACCESS TO IT, SO LETS STOP USING THE TERM-BASIC HUMAN RIGHT! Its a service that is provided, just like education, municipal water and sanitation. We have to pay for those services either through taxes or fee's.

[3LB]

Its a service that is provided, just like education, municipal water and sanitation. We have to pay for those services either through taxes or fee'sYou mean we can't just cross our arms and blink?

While we're at it, isn't shelter a basic human right?
and what about jobs? transportation? clothing?
food? to think that in our civilized world people still
have to pay for something as essential as food...:rolleyes:

[blackraven]

Well, in a communist state, its all free!

[Feanor]

Well, in a communist state, its all free!

Not in China. But China today is a rigorously capitalist though non-democratic state. They aren't concerned about human rights and maybe on that account they let the people put up with pay-or-die healthcare.

BR, as you know quite well, even where healthcare is considered a human right, you don't get unlimited access on demand. There has to be some mechanism to allocate healthcare as any other scare resource. In the case of government healthcare, the allocation mechnism is some form of rationing. But consider that no HMO or any other insurance scheme can provided unrestricted access either: some combination of the following must be used:

Strict underwriting, viz. no pre-existing conditions, age restrictions, etc.
Coverage limitation: viz. include/excluded procedure, annual limits, lifetime limits, etc.
Scurrilous practices such as time-of-claim underwriting and retraction of coverage
Cost control over delivery, e.g. dictating which doctors and facilties may be used, (some much for "choice")
Exorbidant premiums.The moral issue is whether the rich, young, and healthy deserve better healthcare than the poor, old, and sick. If your fine this, then there is no need for public healtcare. Bear in mind that the US has already decided that some mitigation of the principle is necessary in the form of Medicare and Medicaid. Why not go the whole way?

Will it cost too much? That's rubbish. We know that equivalent healthcare is cheaper per capita in countries with universal coverage. No, the real reasons are:

Less significantly, those who imagine themselves to be rich, young, and/or healthy are afraid that their coverage won't be as good as now; (this is largely an illusion), but
Primarily, those with a vested interest fear that they won't make the profits they're making now. (I'm always amazed when I hear that a public option would be "unfair competition" for private insurers. WTF!?!)

[3LB]

Well, in a communist state, its all free!mmmm....yeah....about that

Every Ruskie I ever met hated their system

[blackraven]

Jeez, lighten up! I was just being sarcastic! My point was, that health care is not a human right, its a basic service that should be available to every one.

Feanor, as far as private insurer's go, I agree, they are greedy and unscrupulous and they have played a role in driving the cost of health care up. And speaking of the cost of health care, the main cost is not Dr.'s fee's which is minuscule in the big scheme of things. The main cost is the technology and the fact that in our culture it is not ok to die late in life and that we must do every thing we can to keep terminal patients with no quality of life alive at all costs. Feanor, in the U.S. just about every hospital has an MRI scanner, not so in countries with universal healthcare. Technology, product and medical liability and the cost of drugs in the U.S. as well as inflated hospital fee's (Due to the fact that most hospitals only collect about 30% of what they bill due to people with no insurance and only partial reimbursement by insurers. We collected only 28% last year in a nice suburban community hospital) are the main reasons why health care is more expensive here.

Its not an easy fix. You just can't say tomorrow, every one will have universal health care.

As far as a 2 tiered system goes. I'm ok with it. Our county hospital system is just that. I have no problems with government run hospitals for people that can't afford or choose not to pay for private health insurance. You would get just as good medical care in a well run gov't medical facility as you would in a private hospital if they revamped the system. Let me say this. I trained in some of these facilities and that if I was critically ill that I would rather be in one of these facilities in an academic setting (which almost all are) then in a private suburban hospital where I might have to wait hours for a specialist to come and see me.

[Feanor]

Jeez, lighten up! I was just being sarcastic! My point was, that health care is not a human right, its a basic service that should be available to every one. ...
Ok, I'll lighten up.

And OK, but you're kind of splitting hairs re. "human right" vs. "basic service available to everyone". Quelle différence?


...
Feanor, in the U.S. just about every hospital has an MRI scanner, not so in countries with universal healthcare. ...
That's quite true: case in point, Canada.

And there are two reasons that complement each other: (1) overall funding for health care resources which is a political decission, (keep our taxes low), and (2) allocations made based on (we presume) objective cost vs. medical benefit criteria -- not popular demand for glamorous and therefore profitable procedures.


...
As far as a 2 tiered system goes. I'm ok with it. ....
Well, I'm not. Two-tier invariably results two levels of quality with the higher quality inevidably being the paid, for-profit tier.

[3LB]

Its not an easy fix. You just can't say tomorrow, every one will have universal health care. This is a fact that seems to be of little value for some people, who believe the nobility of the act far outweighs any problems associated with implementing and maintaining such a system. They believe that certain ideas are so noble they deserve immediate action and implementation and any problems that could (will) arise will take care of themselves because its the right thing to do.

There is not a "let'em eat cake" attitude here. I doubt there are too many Americans who would deny anyone needing medical treatment for disease or injury, self-inflicted or otherwise. But I think its foolhardy to believe a national healthcare system won't be just as bankrupt and Social Security or anything else in 5 or 6 years. New taxes will have to be created associated with healthcare. And that wouldn't be a big deal, if taxes collected for a specific purpose were used only in the name of the program it was created for in the first place. More often than not, that's not the case.

How many states have opened the floodgates of lotteries and gambling casinos in the name of education and/or other noble intent? Just as an example, Washington supposedly uses tax revenue collected from the gambling industry and Lotto to support its education system...except the part were it gets lumped into the general fund. Washington used to collect a sky-high vehicle registration tax (equivalent to state sales tax on bluebook value) every year in the name of roadway improvement. Within a year or two of implementing that tax, it was lumped into the general fund. As its been explained by both sides of the isle, putting monies into the general fund eliminates costly legislation time, time that can be used for other important issues. Any revenue surpluses can be allocated more easily when it doesn't require legislative action to procure funds (duh). Back in the day, those 'surpluses' in the highway improvement fund were allocated for education - allegedly. But as you might have guessed by now, many of those funds went to all kinds of projects, and since the funds were now in the general fund, state officals could "allocate" to their hearts content, without permission of the public. (WA eventually, by overwhelming majority, repealed the vehicle tax).

The medical industry is just as bad as the military when it comes to waste and price gouging. The military contractors charge the gov't $200 for an adjustable wrench, the hospital charges the insurance company $50 for a plastic water pitcher, and so on and so forth.

Besides overcharging, there's a ton of inefficiency. The dental insurance won't pay for sealants on your kids baby teeth, nor will pay for extensive work of any kind on your kid's baby teeth, but they will pay for extraction and spacing device for the same, which equates to about the same money as a rootcanal, when the sealant was only $75-$85 per tooth in the first place. Stupid - no? I understand that's an extreme case, but these things happen more and more. (Incase anyone is wondering, its an inherited condition on my side that our teeth are dentin defficient. Why go through that much trouble for baby tooth that's gonna last only another year or so anyway? The dentist pulled the tooth and then expalined it to us - we changed dentists)

I know I know... we should do what's "right" and stop with these 'what if' senarios. Laws are a pretty permanent thing. Some problems won't simply fix themselves.

[blackraven]

3LB, the reason the hospitals charge $5 for a tylenol or $50 for a palstic catheter is because of the no pay patients and partial payments from insurance companies as well as 10-25cents on the dollar reimbursement from medicaid and poor reimbursement from medicare. Running a hospital is a business and bills need to be paid, employee's need to be paid. People don't realize what it takes to run a hospital. There are hundreds to thousands of employee's depending upon the size of the hospital. We have a staff of over 100 in our emergency department alone. I guess they should all work for free!

And Feanor, your mistaken if you think that private insurance would be better than gov't run insurance and hospitals. Insurance companies like HMO's already limit treatments and tests. It would only get worse it they had to lower their prices to compete with the gov't. Lower cost of insurance will = worse coverage! And I can honestly say, I'll be one of the first to sign up for gov't run insurance if and when it becomes available!

And as far as limiting resources, its won't be easy. Already we get patients in the ER daily wanting and demanding that a CT or MRI be done or they come into the ER wanting us to do the their MRI that is scheduled a week later as an out patient because they don't want to wait. The american public is so FKING spoiled and demanding because they want every thing done immediately. The public is in for a rude awakening when Health Care changes are put in place.

[Feanor]

...
And Feanor, your mistaken if you think that private insurance would be better than gov't run insurance and hospitals. Insurance companies like HMO's already limit treatments and tests. It would only get worse it they had to lower their prices to compete with the gov't. Lower cost of insurance will = worse coverage! And I can honestly say, I'll be one of the first to sign up for gov't run insurance if and when it becomes available!

....

So, you concede that government can do it cheaper??

But I agree to the extent that government and private insurers covering exactly the same coverages, it ain't going to work. Where two-tier is kicks in is where private insurance covers, in effect, enhanced versions of standard procedures.

In Canada (i.e. most Canadian provinces) it is illegal for a private insurer to cover a procedure that is covered by government insurance. The rules are more complex than I can explain: private insurers exsist here, but they cover only what is not covered by government, e.g. semi, or private hospital accomodation, or prescription drugs (in most provinces).

If private covers enhanced procedures, people who can afford it will start to buy it. These are the same people who pay most of the taxes that are funding the free-version procedures. It is human nature that the former group will constantly fight to keep taxes low, thereby reducing funding for the free, standard-version procedures. Thus there is downward preasure on the quality of the free tier of healthcare. Thus a two-tier system inevidably undermines the objective of providing everyone with good-quality healthcare.

[blackraven]

So, you concede that government can do it cheaper??

.


Lets just say that the Gov't could do it cheaper with lots of regulation and major changes that the public will not like. The real question should be do I have confidence in the American gov't to do it the right way and not screw it up. The answer is no I don't. There is too much at stake to so many people and interest groups. These days the gov't never gets it right. Too many cooks in the kitchen if you will.

I have no problems with private insurance enhancing a gov't program. I certainly do not believe that the Gov't should be paying for breast augmentation and the like. Certainly private insurance could cover procedures like this. And I don't see why pvt insurance could not cover procedures that the govt would pay for. I think that 2 systems would make each other better and give people more options. I don't buy into the whole redistribution of wealth concept. If you can afford a better product then so be it. Your are of the assumption that a 2 tier system would provide inferior coverage and thats a false assumption. You tell me what constitutes good health care Feanor. Good health care should cover preventive care, emergency care, and treatment of acute and chronic illnesses. Its not rocket science that we are talking about. Maybe from a lay persons stand point it seems complex but from my point of view as a physician its not complex to provide comprehensive health care. The complex part will be to change peoples expectations of medical treatments and limiting end of life care to keep costs down.

[thekid]

I'll chime back in here a bit...

A common tactic for Liberals is to label what some would consider a service such as Health Care as a "Human Right" because this approach gives a sense of a univeral truth and to some degree paints those who might be opposed as uncompassionate oafs. The Anti-Tax/Anti-Government side also over reaches by calling any form of universal or public program Socialistic or Communistic. Supporters of government programs or spending are oddly enough often called unpatriotic by the opposition.

As with most extremes the truth normally lies somewhere in between.

Should "basic" health care or education be considered a "human right"? Probably since society as a whole benefits from it in a variety of ways. Those who look at it in terms of dollars and cents also need to truly look at all the costs that are associated with having a large portion of your population without regular "basic" health care and other services that should not be or can not be provided strictly on the basis of a market based model.

The question then becomes what are the "Basic Human Rights" people are willing to pay towards. Should our "Health Care system provide minimum care from common diseases and ailments or should it include care for rare forms of cancer or heart disease? Should public education prepare sudents to be able to function in society or be able to attend a Ivy League institution? Should our Defense budget be one that prevents our enemies from attacking us directly or one that "projects" our power when our economic interests are threatened abroad?

These types of decisions in a democratic society (free of special interest groups) need to made by the people and their elected representatives on what/where they want their money spent. Once those decisions are made the amount of taxes paid or the size of government are more or less set.

Unfortunately in our country the two sides have pretty much stopped talking to each other Critical decisions are either not made (see status quo), avoided entirely or when one side has a overwhelming majority they steam roll the opposition and pursue their own self interests

[blackraven]

There already is basic free health care in this country. Its called the emergency department and the multitude of free and low cost family clinics and dental clinics as well as the low cost minute clinics. Any one can go into any emergency dept and get evaluated and treated and not be turned away based on ability to pay! I've said it before and I'll say it again, the emergency department is this countries safety net.
Why do you think it is taking so long to get to universal health care. The gov't knows that people can go to the emergency dept for care, even cardiac care with heart catheterizations and angioplasty. We dont and cant turn any one away ever! It's the law and its called EMTALA!

[3LB]

the reason the hospitals charge $5 for a tylenol or $50 for a palstic catheter is because of the no pay patients and partial payments from insurance companies as well as 10-25cents on the dollar reimbursement from medicaid and poor reimbursement from medicare.
I figured as much, but isn't that the crux of the matter, most people don't want to have to overpay so that others don't have to pay at all?

[blackraven]

I figured as much, but isn't that the crux of the matter, most people don't want to have to overpay so that others don't have to pay at all?

EXACTLY, FINALLY SOME ONE BESIDES MYSELF SAID IT!!!!!!!!!!!

[Feanor]

EXACTLY, FINALLY SOME ONE BESIDES MYSELF SAID IT!!!!!!!!!!!

No, 3LB wasn't first to say it. In fact it was me: I quote myself:


Will it cost too much? That's rubbish. We know that equivalent healthcare is cheaper per capita in countries with universal coverage. No, the real reasons are:

Less significantly, those who imagine themselves to be rich, young, and/or healthy are afraid that their coverage won't be as good as now; (this is largely an illusion), but
Primarily, those with a vested interest fear that they won't make the profits they're making now. (I'm always amazed when I hear that a public option would be "unfair competition" for private insurers. WTF!?!)But the notion is invalid that the middle class must necessarily be worse off on account of subsidizing healtcare for the poor. Yes, it might be true that the sort of half-measures presently under consideration by Congress. However at least 95% of Americans would personally have better health care for lower cost under a universal, single-payor system.

[blackraven]

http://www.comcast.net/articles/news-general/20091031/US.Health.Care.Public.Plan/

I wonder how they arrived at the 2%, I have to believe that the actual numbers would be much, much higher.

[bondsam123]

Hi guys,
Some good points made here today. i would like to add that i have tried to stay non-partisan in this and believe blame is to be laid at the feet of both political parties.

I am not buying the arguement that alot of the medical testsare "defensive' because of the fear of malpractice suits. I think it is a redherring to deflect the fact that alot of the labs who conduct these tests are either directly or indirectly owned by many of the doctors who use them. They are just lining their pockets further.

[blackraven]

Bondsam, your dead wrong about defensive medicine. I'm saying this as an insider as a physician. We could save a few hundred million if we did not practice defensive medicine. I would venture to say that 50-75% of tests that are ordered in ER's and to a lesser extent in clinics are CYA tests due to fear of malpractice. Hell, even referrals to the ER by nurse care lines and Dr's clinics are CYA because they can't diagnose over the phone. We see about 5-10 patients a day sent in to us that do not need to be there.

If you don't think Dr's are scared about being sued, just look at states like Florida which has a shortage of OB-GYN Dr's because they are sue happy there and Malpractice insurance is over $100,000. They along with Nevada and Arizona also have trouble with emergency Neurosurgical Care because these Dr's have pulled out of those states due to high malpractice rates.

As far as lab goes, most lab is done by a hospital lab and hospital labs are owned by the hospital and usually run by the pathology group. Many hospitals do outpatient lab for physicans clinics. And a lot of lab is sent out to Specialty Hospitals like Mayo of John Hopkins where they do speacialty testing for certain diseases because the equipment is too technical and expensive for every day hospitals.

I won't dispute the fact that some Dr's may own shares of out of hospital private labs but it is generally illegal and there must be full disclosure. I have been in practice since 1986 and my brother has been in practice since 1980 and we have never run across your scenario. It is a drop in the bucket compared to the other factors that drive up the cost of medicine.

The majority of costs come from END OF LIFE CARE OR CARE IN THE LAST 6 MONTHS OF LIFE, new technology costs, product liability, drug costs and hospitals and Dr's clinics trying to recoup the losses of people not paying a dime for their care or receiving only 10 cents on the dollar reimbursement from state and federal health care.
Hospitals have 100's if not thousands of employees that need to pe paid. Dr's offices overhead typically run 50%. People forget that, but they sure don't forget to complain when they have to wait an hour in the clinic to see their overworked and underpaid family Dr.. Or complain when they have to wait 2 hours in the ER for a non emergent complaint. I guess we should hire double the employees and DR's and just double the cost!

But go a head and blame the DR's for everything. It's easy to make us the scape goats. Every one know's we only went into medicine to do 4yrs of college, 4 years of medical school 3-8yrs of residency training at minimum wage and come out $200,000 to 400,000 in debt with high interest loans at age 30-35 and then have to pay thousands of dollars of malpractice insurance and work 60hour work weeks. It just could not be that we want to do something as noble as taking care of the sick and injured. But honor and nobility has gone the way of the dinosaur in this country as evidenced by the high number of malpractice suits especially nuisance suits which are usually settled out of court.

[Sir Terrence the Terrible]

I am stunned that the house passed the health care reform bill yesterday, just shocked. After all the posturing and doubt, the Democrats actually work together to get the job done. The next step, the Senate!

[nightflier]

I figured as much, but isn't that the crux of the matter, most people don't want to have to overpay so that others don't have to pay at all?


EXACTLY, FINALLY SOME ONE BESIDES MYSELF SAID IT!!!!!!!!!!!

Maybe it's time we American realize that we actually should overpay so that others who can't pay don't have to. I know this is about as abhorrent to people as it sounds, but isn't that what society is about? Are we a society or a collection of individuals who only care about themselves? The fact is that if we don't care about others, it will mean more misery for us all and we as Americans just can't bring ourselves to realize that. Lack of adequate health care for all, opens us to greater risk from disease, slower response to care, overcrowded care facilities, higher costs, more people out of work longer because of illness, and if you're a true Darwinian, a necessary shrinking of communities as they consume more resources than the environment can sustain. And if you're a true capitalist, you'll also realize that in the long-run this is also bad for the growth of business and the corporation. IMO, that's why it just barely squeezed by in the house.

The way we've been doing things worked off-and-on while we were still fulfilling our manifest destiny in one way or another. But at some point, we need to realize that we have to live together and share our resources, all of them. As we crowd ourselves into bigger and denser metropolitan environments, the libertarian ideals that got us there, will not sustain us now that we've arrived with more an more people crowding in behind us. Maybe we need to look and see how other folks around the globe are dealing with that transition and learn from them. And guess what? They have better universal health care than what we are about to offer our own people.

At this point, I will return to my cynicism and say that whatever finally gets passed in the Senate will be so whittled down that it will not solve our health care problem. Obama needs a victory, any victory, and this bill will be just that: a political victory. It will be universal health care in name only and everybody will go home and move onto other thoughts. Kind of sad really, because in a few years when this universal health care becomes to expensive and unsustainable (like that's going to be a surprise!), it will be the right that will be saying: see we told you this wasn't going to work - when they were the ones who hobbled it in the first place (mostly Republicans and a few closet Republicans called Blue Dogs). It's even more ironic that most of them call themselves good Christians, too.

[E-Stat]

Maybe it's time we American realize that we actually should overpay so that others who can't pay don't have to.
We already do. If you are a physician, then you are in the top 10% of taxpayers who contribute 70% of the tax revenue. Nearly half of taxpayers contribute zilch.


As we crowd ourselves into bigger and denser metropolitan environments, the libertarian ideals that got us there, will not sustain us now that we've arrived with more an more people crowding in behind us.
Speak for yourself. That's one of the reasons I live on an acre and a half in a small college town.


... it will not solve our health care problem.
The current proposals will never address the systemic problems that constitute much of the problem - poor discretionary choices made by folks. The town hall meeting that ABC hosted with the President flashed some factoids about the issue. Fully half of our expenses relate to preventable conditions relating to smoking and obesity.


It's even more ironic that most of them call themselves good Christians, too.
Good Christians care for folks by encouraging them to make good decisions and support them when they choose to help themselves. Good Christians don't encourage further dependence upon making poor life choices.

rw

[Feanor]

....
Good Christians care for folks by encouraging them to make good decisions and support them when they choose to help themselves. Good Christians don't encourage further dependence upon making poor life choices.

rw

Listen to yourself, 'Stat. Same stale, old, hypocritical, Pharisiac conservative crap about self-reliance and personal responsibility.

The "poor life choice" Americans are making is to live with healthcare system that is at best no better than that of most other developed nations and a lot more expensive.

[blackraven]

We could save hundreds of millions of dollars in health care money if people quit smoking and watched their diet and alcohol intake.

You can't believe how many people we see a day that have severe emphysema, asthma, heart disease, cerebrovascular disease, peripheral vascular disease, cancer and diabetes and still smoke, eat poorly and drink heavily. It has to be at least 20-30 patients a day.

I just love it when a person comes in with a severe asthma flare and they smoke. Or they have severe emphysema, cardiovascular disease and they continue to puff away. And its not just Americans, lets be realistic here. Its world wide. Look at the Europeans. They smoke like chimneys there.

[E-Stat]

Listen to yourself, 'Stat. Same stale, old, hypocritical, Pharisiac conservative crap about self-reliance and personal responsibility.
Please explain the hypocrisy of expecting others to make good choices that require precious little in the way of intelligence. Do you honestly think that smokers have not heard of emphysema and cancer? I ran a half-marathon last weekend.

Do you find good judgment to be a vice? Or do you think its ok to do just WTF you want without a single care as to the consequences? Are you serious?

rw

[blackraven]

Preventative medicine is all about people making the right choices for their health. And the government is betting big money on preventative medicine to help curb the cost of health care. They kidding themselves unless they heavily raise taxes on tobacco to force more people to quit.

[E-Stat]

Preventative medicine is all about people making the right choices for their health. .
No $hit. Does anyone here NOT understand that simple truth?

rw

[blackraven]

Doctors can help guide you to make the right choices and they can do yearly physicals and milestone tests but they can't make the choices for you.

[Auricauricle]

I won't spend much time villifying or condoning tobacco. I find it amazing that while so much hue and cry has been raised over these products, while other products, with ingredients and processes of manufactring applied to them, have managed to slip through with nary a fleeting glance. Let's face it, there's alot of sh*t on the shelves at your local grocery store. Even if one is wary and prudent, (he) risks ingesting something that is potentially harmful or detrimental to his health.

Cigarette smoking is quite risky, but what about the risks associated with breathing in the "clean air" outside? Sure, compared to smoking a cig, it is far more salubrious, but we all know that the air is replete of any possible toxin, carcinogen or organism imaginable.

And why are other ingestible toxic and habit-forming substances, like alcohol, not paraded out in the hall of shame? Why not sugar? Why not Red Dye No. 5? Is it because it's more PC to drink bourbon than to smoke? Is it because the alcohol lobby has deeeeper pockets? I don't know.

I realize that this rant sounds like the froth-filled diatribes I am wont to post every now and then, but I do so to point to a fundamental and (maybe)ridiculous point: that health is a shared responsibility. As consumers (in every sense of the word), we ought to be aware that certain substances are quite dangerous to use. On the flip side, manufacturers should own up to the fact that many of their products are quite awful in terms of quality and provision of health and growth.

It's hard to say where, let alone when, the blade will fall, but increasing our awareness of these issues not only here, but bringing it to our loved ones, friends and acquaintances in frank, non-partisan, non-aggressive dialog should go a long way. In the meantime, we can go much further in making sure that our markets provide us with food that is not only life-sustaining but health-promoting. In turn, we can dig in and leave that extra drink alone and not buy that candy bar when our child starts having a tantrum.

And now, I would like a nice cigar....

[Sir Terrence the Terrible]

I won't spend much time villifying or condoning tobacco. I find it amazing that while so much hue and cry has been raised over these products, while other products, with ingredients and processes of manufactring applied to them, have managed to slip through with nary a fleeting glance. Let's face it, there's alot of sh*t on the shelves at your local grocery store. Even if one is wary and prudent, (he) risks ingesting something that is potentially harmful or detrimental to his health.

Cigarette smoking is quite risky, but what about the risks associated with breathing in the "clean air" outside? Sure, compared to smoking a cig, it is far more salubrious, but we all know that the air is replete of any possible toxin, carcinogen or organism imaginable.

And why are other ingestible toxic and habit-forming substances, like alcohol, not paraded out in the hall of shame? Why not sugar? Why not Red Dye No. 5? Is it because it's more PC to drink bourbon than to smoke? Is it because the alcohol lobby has deeeeper pockets? I don't know.

I realize that this rant sounds like the froth-filled diatribes I am wont to post every now and then, but I do so to point to a fundamental and (maybe)ridiculous point: that health is a shared responsibility. As consumers (in every sense of the word), we ought to be aware that certain substances are quite dangerous to use. On the flip side, manufacturers should own up to the fact that many of their products are quite awful in terms of quality and provision of health and growth.

It's hard to say where, let alone when, the blade will fall, but increasing our awareness of these issues not only here, but bringing it to our loved ones, friends and acquaintances in frank, non-partisan, non-aggressive dialog should go a long way. In the meantime, we can go much further in making sure that our markets provide us with food that is not only life-sustaining but health-promoting. In turn, we can dig in and leave that extra drink alone and not buy that candy bar when our child starts having a tantrum.

And now, I would like a nice cigar....

I would go as far as to say we could really help ourselves get healthy if they just banned the use of high fructose corn syrup or any other fattening sweetener on the market. The amount of products with this ingredient is staggering. I had to give up some of my most favorite things like ketchup, and other turkey burger toppings because they are filled with it. Americans are just plain fat, and you can see it everywhere. You cannot even ride BART these days without having to sit all over each other. Airplanes rides are uncomfortable not just because they stuff more seats into a plane, but because our butts have gotten quite a bit larger over the years. The funny thing is, as we get bigger, we tend to gravitate towards foods that make us even bigger. One of the things that makes me cringe is when an overweight person is walking into a Wendy's or MacDonald's.

[blackraven]

We can debate all day about the toxic substances we take in every day, but the fact is that smoking is the number 1 killer world wide and costs us billions of dollars each year.

http://www.hsph.harvard.edu/news/press-releases/archives/2003-releases/press09122003.html

http://www.vahealth.org/cdpc/TUCP/documents/2008/pdf/Data%20and%20Statistics/Smoking-Attributable%20Deaths%20in%20Virginia_2008.pdf

http://drugwarfacts.org/cms/?q=node/30

Now don't forget that these numbers are just for deaths, not the total amount of people that are afflicted with co-morbid disease caused by tobacco. The numbers for these patients are staggering.

[Feanor]

We could save hundreds of millions of dollars in health care money if people quit smoking and watched their diet and alcohol intake.

You can't believe how many people we see a day that have severe emphysema, asthma, heart disease, cerebrovascular disease, peripheral vascular disease, cancer and diabetes and still smoke, eat poorly and drink heavily. It has to be at least 20-30 patients a day.

I just love it when a person comes in with a severe asthma flare and they smoke. Or they have severe emphysema, cardiovascular disease and they continue to puff away. And its not just Americans, lets be realistic here. Its world wide. Look at the Europeans. They smoke like chimneys there.
Maybe we need death panels empowered to deny treatment to these self-abusers. :smilewinkgrin:

[GMichael]

Maybe we need death panels empowered to deny treatment to these self-abusers. :smilewinkgrin:

Maybe we could ask them to pay for their own healthcare.:devil:

[Feanor]

I would go as far as to say we could really help ourselves get healthy if they just banned the use of high fructose corn syrup or any other fattening sweetener on the market. The amount of products with this ingredient is staggering. I had to give up some of my most favorite things like ketchup, and other turkey burger toppings because they are filled with it. Americans are just plain fat, and you can see it everywhere. You cannot even ride BART these days without having to sit all over each other. Airplanes rides are uncomfortable not just because they stuff more seats into a plane, but because our butts have gotten quite a bit larger over the years. The funny thing is, as we get bigger, we tend to gravitate towards foods that make us even bigger. One of the things that makes me cringe is when an overweight person is walking into a Wendy's or MacDonald's.

I wonder if the high-fructose-corn-syrup lobby is as powerful as the tobacco lobby or the health insurers lobby?

[Feanor]

Maybe we could ask them to pay for their own healthcare.:devil:

It would be techically very easy to calculate the excess premium for smokers over non-smokers. The actuarial data exists and is already used by the insurance companies.

[dean_martin]

Please explain the hypocrisy of expecting others to make good choices that require precious little in the way of intelligence. Do you honestly think that smokers have not heard of emphysema and cancer? I ran a half-marathon last weekend.

Do you find good judgment to be a vice? Or do you think its ok to do just WTF you want without a single care as to the consequences? Are you serious?

rw

Wow, I thought good Christians feed the hungry, welcome strangers, clothe the naked, and visit the sick and imprisoned. It's certainly easier to say "get a job" or "you did that to yourself" or stand on the sideline and either applaud or condemn the choices of others.

If you want to talk about sensible human behavior, that's one thing, but bringing up what "good Christians" do or don't do opens a different can of worms.

[GMichael]

It would be techically very easy to calculate the excess premium for smokers over non-smokers. The actuarial data exists and is already used by the insurance companies.

Will the new health plan?

[Feanor]

Wow, I thought good Christians feed the hungry, welcome strangers, clothe the naked, and visit the sick and imprisoned. It's certainly easier to say "get a job" or "you did that to yourself" or stand on the sideline and either applaud or condemn the choices of others.

If you want to talk about sensible human behavior, that's one thing, but bringing up what "good Christians" do or don't do opens a different can of worms.

Christian do, but Pharisees don't. The just like the New Testiment Pharisees, so many Christian conservatives self-righteously proclaim, "Thank you God that I am not as other men". Jesus condemned the Pharisees as hypocrits; where he here today, he'd do the same for the Christian Right, (an oxymoron, by the way).

[Feanor]

Please explain the hypocrisy of expecting others to make good choices that require precious little in the way of intelligence. Do you honestly think that smokers have not heard of emphysema and cancer? I ran a half-marathon last weekend.

Do you find good judgment to be a vice? Or do you think its ok to do just WTF you want without a single care as to the consequences? Are you serious?

rw
Were it strictly up to me, even here in Canada, I would consider charging a premium to smokers and possibly others such as the obese, that would consist of difference in cost for them versus others who better life-style choices. Like I said to Bobsticks, (where is he?), I believe in equality of social responsibility. But the fact that there are so many self-abusers shouldn't be used road-block progress on the healthcare issues.

There is the other matter: equating self-reliance with Christian virtue; that is a spurious connection. Worse, suggesting that it is Christian to not help people because they lack self-reliance and personal responsibility is totally wrong. It is "Pharisaic", as I said, or anti-Christian if you'd rather put it that way.

[Auricauricle]

Can we leave out some of these remarks about religiosity, etc. when we get into these discussions?

BR, you are quite right: the number of deaths and co-morbid illnesses associated with smoking is quite alarming. Simultaneously, I subscribe to the notion that tobacco users are an easy target for the study of self-abusive behavior: it is observable, quantifiable (packs/cigarettes per day), and manageable. Anybody who has taken a course in research design and/or statistics can set up a program and submit it to any number of journals. In spite of this, I am concerned that Tobacco has become the whipping boy for those looking to target behaviors that endanger life and livelihood (and waste so much money that could/should have been spent elsewhere).

At the same time, there are other behaviors and products that should share some of the scrutiny. Sir T's remarks about obesity addresses one of America's (and rapidly become the world's--ask the Japanese) most intransigent issues. While some awareness has been paid to this problem, companies like MacDonald's continue to pump out insanely large, cholesterol-filled burgers that are consumed by the millions every day.

I mentioned earlier the sense I have that while tobacco has its associated risks, there are other exposures we are subject to that are, at least, potentially as dangerous. Manufacturers of plastics and solvents know the hazards of producing these products, but we continue to be exposed to them, if passively.

In short, I want to point out that if we think that laying the brunt of attacks on Big Tobacco will solve our problems, there are many more exposures that will continue to endanger us. While cigarettes, etc. are a direct means of ingestion and not as insidious or passive as smog inhalation, I submit that the ingestion of any substance bears some risk.

So what is the solution? For starters, I would like to see manufacturers of these products held more accountable for their wares. While industries have been waylaid for the production of Greenhouse Gases, they should also be held to account for the production of toxic/harmful products/by-products. Likewise, I would like to see industries like the fastfood vendors and high-fructose "food" vendors take some responsibility for their products. No one forces people to consume many of these products, but for many people who don't have the means to shop at the local market, let alone buy Organic Products, junk food fills a hungry tummy and doesn't break the bank. Vendors who cater to these people full-well know the demographics of their customer base, and continue to pump the sh*t out. Like drug-pushers, they should share some of the responsibility and accountability.

Consumers should likewise pay some of the price for their behavior (as Feanor suggests). If obesity and cigarette smoking (or whatever) has been detected, certainly people who participate in certain behaviors should be urged to lose weight, stop smoking, or whatever, or pay the price for doing so. An argument may be made that such a policy attacks certain people, while others, who continue to be exposed to and use certain products, walk away scot free. This is a red-herring argument and should be quashed for the nonsense it is.

Responsibility is the key, and these I think are a few ways we can approach these issues reasonably and efficiently for the benefit of all of us....

[E-Stat]

Wow, I thought good Christians feed the hungry, welcome strangers, clothe the naked, and visit the sick and imprisoned. It's certainly easier to say "get a job" or "you did that to yourself" or stand on the sideline and either applaud or condemn the choices of others.
Wherever did you get that? The topic on which I commented is smoking and obesity. Don't spend your money on tobacco. Don't overeat. Take a walk. Exercise. What does any of that have to do with getting a job?


If you want to talk about sensible human behavior, that's one thing, but bringing up what "good Christians" do or don't do opens a different can of worms.
Look again at post 404 to find the source of who brought up Christians.

rw

[E-Stat]

Worse, suggesting that it is Christian to not help people because they lack self-reliance and personal responsibility is totally wrong. It is "Pharisaic", as I said, or anti-Christian if you'd rather put it that way.
You missed the context of my comment. Nightflier says that objections to the completely whacked, impractical, expensive non-solution to our problem is "even more ironic that most of them call themselves good Christians, too. "

It has nothing to do with being a bad Christian. Christians help folks today without endorsing such a cluster of a plan.

rw

[dean_martin]

Wherever did you get that? The topic on which I commented is smoking and obesity. Don't spend your money on tobacco. Don't overeat. Take a walk. Exercise. What does any of that have to do with getting a job?


Look again at post 404 to find the source of who brought up Christians.

rw

I know who brought it up but didn't you say this: "Good Christians care for folks by encouraging them to make good decisions and support them when they choose to help themselves. Good Christians don't encourage further dependence upon making poor life choices.

rw"

Here's what I said: " Wow, I thought good Christians feed the hungry, welcome strangers, clothe the naked, and visit the sick and imprisoned. It's certainly easier to say "get a job" or "you did that to yourself" or stand on the sideline and either applaud or condemn the choices of others.

If you want to talk about sensible human behavior, that's one thing, but bringing up what "good Christians" do or don't do opens a different can of worms."

I'll retract the "get a job" language from my original post, but the rest is a direct response taken from Jesus's "least of these" directive which isn't qualified by how the sick became sick. Your list of dos and don'ts is a good one but it's neither Christian nor non-Christian.

[E-Stat]

I know who brought it up but...
You continue to ignore the context of smoking and obesity.

rw

[dean_martin]

You continue to ignore the context of smoking and obesity.

rw

Sorry, your comments seemed broader than that upon first read.

I've been subjected to the moral majority's pandering and admonissions in the name of Christianity (as one of its loud-mouths gets busted for sleazy sex or drug use) for years here in the deep south. I'm warped.

[Auricauricle]

Okay, what is this? A discussion on the issues surrounding Universal Healthcare or on Christian Ethics? God, lemme get a beer!

[thekid]

Regarding the discussion about how lifestyle affects health care;

They have a saying in the insurance industry. There are no bad risks only bad premiums.

People who are smokers overweight etc should be charged the appropriate premium for the anticipated greater pay-out. I would argue that because more people will be covered now by some sort of private/public policy their is slightly more of a chance that people will be charged a premium in line with their risk. I say slightly since even under the proposed plan we still tend to favor employer based health care and these plans tend not to underwrite people as strictly for health risks such as smoking and obesity. People whose life-style habits affect their health tend to be older when their lifestyle choices begin to take their toll. At that point a high percentage of them get their coverage through Medicare/Medicaid which is when the taxpayers really pay for people life choices. I do not see how the proposed health care reform addresses that situation.

[dean_martin]

Bondsam, your dead wrong about defensive medicine. I'm saying this as an insider as a physician. We could save a few hundred million if we did not practice defensive medicine. I would venture to say that 50-75% of tests that are ordered in ER's and to a lesser extent in clinics are CYA tests due to fear of malpractice. Hell, even referrals to the ER by nurse care lines and Dr's clinics are CYA because they can't diagnose over the phone. We see about 5-10 patients a day sent in to us that do not need to be there.

If you don't think Dr's are scared about being sued, just look at states like Florida which has a shortage of OB-GYN Dr's because they are sue happy there and Malpractice insurance is over $100,000. They along with Nevada and Arizona also have trouble with emergency Neurosurgical Care because these Dr's have pulled out of those states due to high malpractice rates.

As far as lab goes, most lab is done by a hospital lab and hospital labs are owned by the hospital and usually run by the pathology group. Many hospitals do outpatient lab for physicans clinics. And a lot of lab is sent out to Specialty Hospitals like Mayo of John Hopkins where they do speacialty testing for certain diseases because the equipment is too technical and expensive for every day hospitals.

I won't dispute the fact that some Dr's may own shares of out of hospital private labs but it is generally illegal and there must be full disclosure. I have been in practice since 1986 and my brother has been in practice since 1980 and we have never run across your scenario. It is a drop in the bucket compared to the other factors that drive up the cost of medicine.

The majority of costs come from END OF LIFE CARE OR CARE IN THE LAST 6 MONTHS OF LIFE, new technology costs, product liability, drug costs and hospitals and Dr's clinics trying to recoup the losses of people not paying a dime for their care or receiving only 10 cents on the dollar reimbursement from state and federal health care.
Hospitals have 100's if not thousands of employees that need to pe paid. Dr's offices overhead typically run 50%. People forget that, but they sure don't forget to complain when they have to wait an hour in the clinic to see their overworked and underpaid family Dr.. Or complain when they have to wait 2 hours in the ER for a non emergent complaint. I guess we should hire double the employees and DR's and just double the cost!

But go a head and blame the DR's for everything. It's easy to make us the scape goats. Every one know's we only went into medicine to do 4yrs of college, 4 years of medical school 3-8yrs of residency training at minimum wage and come out $200,000 to 400,000 in debt with high interest loans at age 30-35 and then have to pay thousands of dollars of malpractice insurance and work 60hour work weeks. It just could not be that we want to do something as noble as taking care of the sick and injured. But honor and nobility has gone the way of the dinosaur in this country as evidenced by the high number of malpractice suits especially nuisance suits which are usually settled out of court.

I appreciate what you do, what you've gone through to get where you are today and your informative input, but I have to respectfully disagree regarding the "high number of malpractice suits especially nuisance suits which are usually settled out of court". It makes no economic sense to file a lawsuit if you are not prepared to take the case to trial and continue on appeal. "Nuisance suits" = potential monetary sanctions against the lawyer and suspension of license. The typical medical malpractice lawsuit costs $150,000.00 to pursue due to the cost of hiring one or more experts at least one of which has to be a doctor practicing or who has recently practiced in the same specialty or area of medicine as the defendant doctor. Therefore, a patient who has been wrongfully harmed (as defined by the state's medmal laws), but whose damages are minimal may never be compensated. This usually includes children and the elderly who cannot claim damages for lost wages. Only 2 to 3% of incidents of medical errors result in a lawsuit.

We should be able to say there is a direct and definitive relationship between medical malpractice insurance premiums and number/amount of lawsuit payouts but I've yet to find that direct relationship. We've had medmal insurers in our state (there are only two now and there's no reason for this lack of competition) who have successfully lobbied for legal reforms based on exaggerated threats of doctors leaving and then turned around and said we're not lowering premiums. The medmal insurance problems are not based soley on medmal lawsuits. Something else is at play here and it may have to do with insurance companies being regulated state-by-state. I don't know the answer, but like you, I don't want my profession (lawyer) to be scapegoated in the health care debate. I do know we don't help our self-image with those tasteless tv ads and the propensities of some of our ranks to be *******s when dealing with non-lawyers. Our state bar put a civility program into effect not long ago and it seems to be working with reminders now and then. Our state bar also regulates advertising, but it can only do so much because "commercial speech" is protected by the First Amendment.

Here's an opinion piece from the NY Times that reviews most of the data regarding medical malpractice liability. I don't agree with all the author's conclusions, but at least he attempts to stick to data that isn't tainted (and there are a lot of "psuedo studies" out there).

http://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=2&scp=1&sq=%2b%22American+Medical+Association%22&st=nyt

[blackraven]

I'm not necessarily target big tobacco, but you could make one life style change in society that would have the greatest impact on our health, it would be to not smoke. I agree, obesity is a huge problem (no pun intended). Not only is it our poor diet but also lack of exercise. TV, video games and computers have helped play a big role. When I was growing up all we did was play sports and a few board games. We were much more active than people and kids today.

[blackraven]

I appreciate what you do, what you've gone through to get where you are today and your informative input, but I have to respectfully disagree regarding the "high number of malpractice suits especially nuisance suits which are usually settled out of court". It makes no economic sense to file a lawsuit if you are not prepared to take the case to trial and continue on appeal. "Nuisance suits" = potential monetary sanctions against the lawyer and suspension of license. The typical medical malpractice lawsuit costs $150,000.00 to pursue due to the cost of hiring one or more experts at least one of which has to be a doctor practicing or who has recently practiced in the same specialty or area of medicine as the defendant doctor. Therefore, a patient who has been wrongfully harmed (as defined by the state's medmal laws), but whose damages are minimal may never be compensated. This usually includes children and the elderly who cannot claim damages for lost wages. Only 2 to 3% of incidents of medical errors result in a lawsuit.

We should be able to say there is a direct and definitive relationship between medical malpractice insurance premiums and number/amount of lawsuit payouts but I've yet to find that direct relationship. We've had medmal insurers in our state (there are only two now and there's no reason for this lack of competition) who have successfully lobbied for legal reforms based on exaggerated threats of doctors leaving and then turned around and said we're not lowering premiums. The medmal insurance problems are not based soley on medmal lawsuits. Something else is at play here and it may have to do with insurance companies being regulated state-by-state. I don't know the answer, but like you, I don't want my profession (lawyer) to be scapegoated in the health care debate. I do know we don't help our self-image with those tasteless tv ads and the propensities of some of our ranks to be *******s when dealing with non-lawyers. Our state bar put a civility program into effect not long ago and it seems to be working with reminders now and then. Our state bar also regulates advertising, but it can only do so much because "commercial speech" is protected by the First Amendment.

Here's an opinion piece from the NY Times that reviews most of the data regarding medical malpractice liability. I don't agree with all the author's conclusions, but at least he attempts to stick to data that isn't tainted (and there are a lot of "psuedo studies" out there).

http://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=2&scp=1&sq=%2b%22American+Medical+Association%22&st=nyt


Dean, there are many cases of of nuisance suits that are settled out of court because the lawyers of the malpractice insurance companies find it cheaper to settle than to take the case to court.

My concern with malpractice is that almost all Dr's fear being sued and therefore we practice defensive medicine which costs millions of dollars each year. There needs to be some reform protecting Dr's who are practicing standard of care. Malpractice legislation is a tough issue because the lawmakers are usually lawyers. I have no problem with punishing Dr's who are grossly negligent, but to be able to sue for a bad outcome that was out of the Dr's control is BS! Medicine is an art and is not perfect as much as we try to make it be. Do you know how many times per year we hear patients say they are going to sue! Its more than you think. Most are threatening us to try and get what they want and it goes no where, but it has you looking over your shoulder and wondering why am I even doing this job.

Now if I really want to start a debate, lets talk about lawyers fee's! $250-over $400 per hour and charging for every stamp, paper clip, phone call, copies of documents.

Sorry, I couldn't resist. About 15years ago we had an ex partner sue our group. He lost! But lawyer fee's were $400 per hour. Thats robbery!

[dean_martin]

Dean, there are many cases of of nuisance suits that are settled out of court because the lawyers of the malpractice insurance companies find it cheaper to settle than to take the case to court.

My concern with malpractice is that almost all Dr's fear being sued and therefore we practice defensive medicine which costs millions of dollars each year. There needs to be some reform protecting Dr's who are practicing standard of care. Malpractice legislation is a tough issue because the lawmakers are usually lawyers. I have no problem with punishing Dr's who are grossly negligent, but to be able to sue for a bad outcome that was out of the Dr's control is BS! Medicine is an art and is not perfect as much as we try to make it be. Do you know how many times per year we hear patients say they are going to sue! Its more than you think. Most are threatening us to try and get what they want and it goes no where, but it has you looking over your shoulder and wondering why am I even doing this job.

Now if I really want to start a debate, lets talk about lawyers fee's! $250-over $400 per hour and charging for every stamp, paper clip, phone call, copies of documents.

Sorry, I couldn't resist. About 15years ago we had an ex partner sue our group. He lost! But lawyer fee's were $400 per hour. Thats robbery!

I'm not sure how you're using the phrase "nuisance suits". Are you saying they have no merit or that it makes better economic sense to settle? We're often offered settlement amounts based on the cost of defense which the defense lawyer characterizes as nuisance value. Many times these offers are nothing more than posturing. They're trying to send a message that the case isn't worth anything so we better take what we can get while we can get it. Again, it's posturing and an attempt to intimidate.

We have many consultations regarding bad outcomes. Of course we (father and sons law firm) know that a bad outcome rarely means there was a breach of the standard of care. Most of the time if there was an apology along the lines of sympathy from the doctor (I'm not talking about an admission of fault when there is none) or a better bedside manner, the patient would not have come to see us. That's no reason to sue, of course, but they feel better after we talk them through it. We refer almost all potential medmal cases to larger firms. But we reject most ourselves and of those we refer for further evaluation maybe one out of three per year are strong enough to file suit. Needless to say, medmal is not our bread butter, but we do hear a lot of complaints.

As far as lawyer's fees go, we do not charge by the hour. Our clients can't pay by the hour. We take cases on a contingency fee. Some special interest groups know that most regular folk can't hire a lawyer on an hourly fee basis so they continue to attack the concept of contingency fee contracts. In your example, if the lawyer for the doctor who lost was hired on a contingency fee contract, that lawyer was paid nothing and had to eat his/her expenses.

I don't think doctors should be afforded some special protection from lawsuits (not anymore than they already have). In fact, I hear more about tests doctors should have ordered but didn't than I do about "defensive" tests. Besides, if tests, referrals and treatments were purely defensive, not medically necessary and not reasonable under the circumstances, then the patient's health insurance company wouldn't pay for them. (I'm not suggesting every patient has health insurance, but there are enough who do to draw this conclusion.) Seriously, if the medical community/medmal insurance industry goes too far with this "defensive medicine to cover their own butts" BS then aren't they basically admitting to fraud on the health insurance companies and medicare? And why should we legislate against paranoia in any profession? I'm always concerned about the ethical standards I have to live by and take steps to protect myself which ultimately means I'm doing more for my client. But I'm not asking for immunity from legal malpractice lawsuits.

[blackraven]

Your totally mistaken about defensive medicine and tests. We order xrays, cat scans and lab work all the time that we know is going to be normal. Its because people want it and demand it even when we explain it is not indicated. We do it because in the 1 in a million chance the patient is right and we would miss something instigating a law suit. People come into the ER with all sorts of compliants and chronic recurrent complaints and we keep ordering the same tests because it like the little boy who cried wolf. Practicing medicine, especially in the ER is like walking through a mine field.

And yes we are admitting to fraud when we admit to defensive medicine. But its not fraud in the sense that we are trying to make money off of it. We are just trying to protect ourselves and also trying to give patients what they want and not piss them off.


Concerning malpractice reform and liability-
Spoken like a true lawyer. God forbid there should be reforms in malpractice and product liability where it would cut into your income.
Why do you think that when you buy a lawn mower, it says in the instructions to not use to trim your hedges or bushes. Because some schmuck did this and severely injured himself and some lawyer and sympathetic jury ruled in his favor.

Or years ago there was an anti nausea drug called Bendictin. It was the only drug that truly worked for morning sickness in pregnancy. Millions of women took this drug and it helped them. But some women had babies with birth defects and they sued the company and won, costing the drug company millions of dollars, even though the incidence of birth defects in women taking the drug was less than the general poplulation. The drug company took it off the market and women were left with no anti nausea medication during that time period. A sympathetic jury and a good law firm can go a long way.



One thing you dont understant about defensive medicine is that we are doing tests that apply to a patients chief complaint, thats why insurance companies pay. We dont order and ankle XRAY for a injured wrist. If some one comes in complaining of abdominal pain and we have seen them several times before for the same problem, we will go ahead and repeat tests knowing that we will find nothing just to cover our asses in case it is like the boy who cried wolf.

I'm not asking for malpractice reform to protect us from gross negligence but I am asking for it to protect Dr's who are practicing standard of care like I said in an earlier post that you completely ignored.



Concerning nuisance suits. They are suits brought about for minor complaints and they are settled out of court because its cheaper for the insurance company to pay out a $5000-50,000 award than go to court. You should know that! Some states are passing legistlation against them.

And many lawyers charge by the hour. When our ex partner sued our group, our lawyer charged $400/hr. We were defending ourselves and not looking for a monetary award where the lawyer would take a percentage.

http://en.wikipedia.org/wiki/Attorney%27s_fee Highway FKG robbery.

If you come into my ER and have a cardiac arrest and I resuscitate you and save your life, I get reimbursed about $300-400. The hospital fee's would be 10 times that!

[dean_martin]

Your totally mistaken about defensive medicine and tests. We order xrays, cat scans and lab work all the time that we know is going to be normal. Its because people want it and demand it even when we explain it is not indicated. We do it because in the 1 in a million chance the patient is right and we would miss something instigating a law suit. People come into the ER with all sorts of compliants and chronic recurrent complaints and we keep ordering the same tests because it like the little boy who cried wolf. Practicing medicine, especially in the ER is like walking through a mine field.

And yes we are admitting to fraud when we admit to defensive medicine. But its not fraud in the sense that we are trying to make money off of it. We are just trying to protect ourselves and also trying to give patients what they want and not piss them off.


income.Concerning malpractice reform and liability-
Spoken like a true lawyer. God forbid there should be reforms in malpractice and product liability where it would cut into your
Why do you think that when you buy a lawn mower, it says in the instructions to not use to trim your hedges or bushes. Because some schmuck did this and severely injured himself and some lawyer and sympathetic jury ruled in his favor.

Or years ago there was an anti nausea drug called Bendictin. It was the only drug that truly worked for morning sickness in pregnancy. Millions of women took this drug and it helped them. But some women had babies with birth defects and they sued the company and won, costing the drug company millions of dollars, even though the incidence of birth defects in women taking the drug was less than the general poplulation. The drug company took it off the market and women were left with no anti nausea medication during that time period. A sympathetic jury and a good law firm can go a long way.



One thing you dont understant about defensive medicine is that we are doing tests that apply to a patients chief complaint, thats why insurance companies pay. We dont order and ankle XRAY for a injured wrist. If some one comes in complaining of abdominal pain and we have seen them several times before for the same problem, we will go ahead and repeat tests knowing that we will find nothing just to cover our asses in case it is like the boy who cried wolf.

I'm not asking for malpractice reform to protect us from gross negligence but I am asking for it to protect Dr's who are practicing standard of care like I said in an earlier post that you completely ignored.



Concerning nuisance suits. They are suits brought about for minor complaints and they are settled out of court because its cheaper for the insurance company to pay out a $5000-50,000 award than go to court. You should know that! Some states are passing legistlation against them.

And many lawyers charge by the hour. When our ex partner sued our group, our lawyer charged $400/hr. We were defending ourselves and not looking for a monetary award where the lawyer would take a percentage.

http://en.wikipedia.org/wiki/Attorney%27s_fee Highway FKG robbery.

If you come into my ER and have a cardiac arrest and I resuscitate you and save your life, I get reimbursed about $300-400. The hospital fee's would be 10 times that!

OK, so you order tests, x-rays and lab work because patients request them. Isn't that part of providing a service? It's like that old saying, "this job would be great if it weren't for the people." Sure, you know more about their health and bodies than they do but you're dealing with the public. Hypothetical: What would you tell a patient who asked for or demanded a particular test that you believe would be negative if that patient had no right to sue? Would you refuse the test?

"Concerning nuisance suits. They are suits brought about for minor complaints and they are settled out of court because its cheaper for the insurance company to pay out a $5000-50,000 award than go to court. You should know that! Some states are passing legistlation against them"

Almost every state in the union has heightened standards for filing medical malpractice lawsuits and somebody's blowin' smoke up your bum if you think a lawyer in one of those states (46 out of 50) would file a medical malpractice lawsuit with the expectation of getting $5,000. Like I said, you can't file a medical malpractice case without expecting to spend $150,000.00 developing the case through trial and in most of those 46 states you have to pay an expert up front for an affidavit stating an opinion that the standard of care was breached. That's $3000 to $5000 up front. BTW, the two medmal carriers in my state don't settle in the cases where liability is clear. They make you try it hoping to wear you down and break your bank. So here's what I know: I've NEVER seen a "nuisance" medical malpractice lawsuit. I've NEVER heard of one in the state in which I practice.

"I'm not asking for malpractice reform to protect us from gross negligence but I am asking for it to protect Dr's who are practicing standard of care like I said in an earlier post that you completely ignored."

I didn't ignore your earlier post. The very definition of medical malpractice/ medical negligence is a breach of the standard of care. First, the plaintiff has to prove the standard of care (by expert testimony), then a breach of the standard (also by expert testimony) and then damages caused by the breach. Therefore, by definition, doctors practicing within the appropriate standard of care are protected.

"And many lawyers charge by the hour. When our ex partner sued our group, our lawyer charged $400/hr. We were defending ourselves and not looking for a monetary award where the lawyer would take a percentage.

http://en.wikipedia.org/wiki/Attorney%27s_fee Highway FKG robbery.

If you come into my ER and have a cardiac arrest and I resuscitate you and save your life, I get reimbursed about $300-400. The hospital fee's would be 10 times that"

Yeah, I know many lawyers are paid by the hour - most are paid by insurance companies with detailed contracts requiring detailed billing. These companies perform audits. They go into law offices and take over the books and files for days. I couldn't work in a firm that represents insurance companies. That's just me. I understood what you were saying about your group getting sued by a former partner. I was pointing out what the lawyer for the losing side was probably paid - nothing.

"Concerning malpractice reform and liability-
Spoken like a true lawyer. God forbid there should be reforms in malpractice and product liability where it would cut into your income."

I explained that medical malpractice is not a big part of my law practice. "Reforms" are not going to cut into my income. But we've had "reform" under the guise of doctors leaving because of jury awards and malpractice premiums once in the 80s and twice in the 90s. To borrow your phrase, it truly was the boy crying wolf. Premiums didn't go down. The insurance lobby behind the campaign admitted AFTER successfully pushing Draconian legislation that premiums weren't going to be lowered. So no, so-called reforms in this area won't effect my bottom line much but I can't reconcile them with my sense of fairness and civil justice. People can be duped into giving up whatever rights certain interests don't want the people to have. If you don't want your Constitutional right to a trial by jury in a civil case, that's fine, but I took an oath to support the Constitution when I became a lawyer. My clients depend on that right for justice which is monetary compensation for injuries most of the time. If you don't like it then your beef is with the founding fathers and hundreds of years of common law, not me. This is not an income issue with me.

[E-Stat]

Your totally mistaken about defensive medicine and tests. We order xrays, cat scans and lab work all the time that we know is going to be normal. Its because people want it and demand it even when we explain it is not indicated. We do it because in the 1 in a million chance the patient is right and we would miss something instigating a law suit.
That is exactly what a brother-in-law of mine tells me who is a family practitioner. He says the practice requires it. BTW, he is also a big believer in exercise and is a marathon runner himself. Last weekend, he and I ran a local half-marathon while our wives walked it. He only did the half because he is running a full one this weekend!

rw

[Feanor]

Okay, what is this? A discussion on the issues surrounding Universal Healthcare or on Christian Ethics? God, lemme get a beer!
Very largely the healthcare debate in the U.S. is a moral debate. Fundamentally universal healthcare works very well in most other juristictions and -- from a practical perspective -- would work well in the U.S. too. Apart from frank self-interest, the objections aren't practical but philosophical, ethcal, and moral. In as much as they are these, they are also religous in that religion underlies all of these (for many people).

So no, personally I will not avoid religious commentary where religion conditions peoples' attitudes on healthcare of other issues.

[GMichael]

But religions are not against healthcare. They are only against changing the healthcare before we know what the changes will be. The plan needed to be laid out for everyone to view before it could be accepted.

[markw]

Very largely the healthcare debate in the U.S. is a moral debate. Fundamentally universal healthcare works very well in most other juristictions and -- from a practical perspective -- would work well in the U.S. too. Apart from frank self-interest, the objections aren't practical but philosophical, ethcal, and moral. In as much as they are these, they are also religous in that religion underlies all of these (for many people).

So no, personally I will not avoid religious commentary where religion conditions peoples' attitudes on healthcare of other issues.For that half of the US citizens that actually pay any taxes at all, that's quite a burden on them. They can barely pay for temselves.

And while we're at it, it's only your hatred for religions that causes you to drag it into the argument and into the dirt every chance you get

Let's be honest, shall we? If you weren't forced to subsidize it by your country, you wouldn't be for it either. The religious and moral aspect is simply icing on the cake for you and a chance to try to look like you are taking the high road by choice, which you are not. You have no choice.

[Auricauricle]

Feanor, I agree with you in the sense that many of the decisions and discussions in this forum are of great moral importance, I see religion as being an issue that should be left out. I also agree that much morality is informed by religious sentiment, piety and philosophy are different sides of the same coin.

Since it looks like the mire of medico-legal quandries will hold us fast, is there another way to address the concerns of patients/lawyers and medical-professionals/hospitals? How about addressing such needs with a realistic appraisal? Increasingly, we are finding patients who are more intelligent and informed than before. These patients are often quite savy to the current state of the art technologies available, but are reluctant to embrace the fact that even these have their limitations. In other words, how much dialog with patients that looks at prognosis and outcome is frank and honest and how much of it is sugar-coated with false expectations?

[Feanor]

...
Let's be honest, shall we? If you weren't forced to subsidize it {healthcare?} by your country, you wouldn't be for it either. The religious and moral aspect is simply icing on the cake for you and a chance to try to look like you are taking the high road by choice, which you are not. You have no choice.
Nonsense.

[Feanor]

Your totally mistaken about defensive medicine and tests. We order xrays, cat scans and lab work all the time that we know is going to be normal. Its because people want it and demand it even when we explain it is not indicated. We do it because in the 1 in a million chance the patient is right and we would miss something instigating a law suit. ...
Wow, great! Doctors & lawyers squaring off: I love it.

It would seem to me a serious obstacle to a US healthcare system. An economical healthcare system will require some constraint on frivilous lawsuits. It might also require constraints on procedures that are costly but unproven in terms of medical benefit. These are two different things but have in common that they require standards of practice that can override the whim of doctors or patients. Is this socialism or just good governance?

But getting back to the lawsuit issue, I suspect US culture is a big factor. Apparently the US is among the most ligious nations in the world; accordingly it has one of the world's highest lawyer to general population ratios. What's to be done?

Well maybe a 50% cull of lawyers would help -- just joking (humm...or not). Now lawyers can jump in and correct me where I'm wrong, but I can think of two or three things that encourage litgiousness:

Percentage-defined conditional fees
Unlimited pain-and-suffering awards
Punative damages paid plaintiffs and their lawyers.Perhaps lawyers and doctors are alight in this respect: they can generate demand for their own services, not just respond to it. Lest there be any doubt, doctors can do this by booking return visits, indicating unnecessary tests, and prescribing superfluous treatments. (You can see how doctors & lawyers work hand-in-glove on this.)

With regard to the doctors, at least one Canadian province notoriously limited the number of medical licenses as a means to control medical costs there. Does it sound counter intuitive? Greater supply ought to reduce prices, right? Not it the suppliers can create their own demand.

[dean_martin]

Wow, great! Doctors & lawyers squaring off: I love it.

It would seem to me a serious obstacle to a US healthcare system. An economical healthcare system will require some constraint on frivilous lawsuits. It might also require constraints on procedures that are costly but unproven in terms of medical benefit. These are two different things but have in common that they require standards of practice that can override the whim of doctors or patients. Is this socialism or just good governance?

But getting back to the lawsuit issue, I suspect US culture is a big factor. Apparently the US is among the most ligious nations in the world; accordingly it has one of the world's highest lawyer to general population ratios. What's to be done?

Well maybe a 50% cull of lawyers would help -- just joking (humm...or not). Now lawyers can jump in and correct me where I'm wrong, but I can think of two or three things that encourage litgiousness:

Percentage-defined conditional fees
Unlimited pain-and-suffering awards
Punative damages paid plaintiffs and their lawyers.Perhaps lawyers and doctors are alight in this respect: they can generate demand for their own services, not just respond to it. Lest there be any doubt, doctors can do this by booking return visits, indicating unnecessary tests, and prescribing superfluous treatments. (You can see how doctors & lawyers work hand-in-glove on this.)

With regard to the doctors, at least one Canadian province notoriously limited the number of medical licenses as a means to control medical costs there. Does it sound counter intuitive? Greater supply ought to reduce prices, right? Not it the suppliers can create their own demand.

How do percentage-defined conditional fees (contingency fee agreements) encourage litigiousness other than by providing a person/individual an oppurtunity to access the court system? The lawyer who takes a case on a contingency fee has to advance all expenses of litigation and if the case is lost the lawyer eats those expenses and gets no fee. No lawyer can stay in business if he/she does not evaluate/screen cases very carefully before taking them. In other words, the case has to have merit. Our courts are clogged with cases of business against business in which lawyers on both sides are paid by the hour, but we don't hear about that until one reaches the U.S. Supreme Court like the Victoria's Secret case a couple of years ago in which Victoria's Secret tried to put a sole proprietorship out of business because it was using a variation of their name.

You have to track cases all the way through to the appellate decisions. Damages for pain and suffering and especially punitive damages are almost always reduced, if not outright reversed, by the appellate courts. Admittedly, there are no hard and fast rules for a jury's award of damages for pain and suffering, but there must be some evidence that the plaintiff actually experienced/experiences pain and suffering. Then 12 adults (or 6 in Federal Court) decide on an amount based on the strength of the evidence and their common sense. Punitive damages require evidence of intent to harm or defraud or a reckless disregard for the health and safety of others. Such damages are intended to punish and deter. The jury has discretion in awarding the amount, but on appeal there is a very complex, multi-tiered analysis to determine whether the amount violates the defendant's due process rights. Claims for punitive damages often don't even make it to the jury because the evidentiary burden is so high. The evidence of intent or reckless disregard must be clear and convincing to support an award. This is just below the "beyond a reasonable doubt" standard in criminal cases. Only claims that are supported by "substantial" evidence ever make it to the jury. Substantial evidence is evidence of such weight and quality that fair minded persons can reasonably infer the fact sought to be proved.

What's to be done, you ask? If you want to do away with civil lawsuits or severly limit them, then amend the U.S. Constitution and/or every state constitution that preserves the right to trial by jury in civil cases (all 50) and overturn hundreds of years of English and American common law. Then, folks can settle their disputes in back alleys rather than in a civilized manner. In fact, our civil justice system can be traced back to the Law of Moses which imposed civil liability for digging a pit but failing to cover it, allowing animals to cross and damage another's property, starting a fire and allowing it to get out of control, and, most interestingly, building a flat roof for gatherings but failing to construct protective rails to prevent people from falling off. Heck, they had the one-gore rule for oxen. The first time your ox gored someone you were in the clear, but if your ox had displayed propensities to gore and subsequently gored someone, then the ox was destroyed and you were sentenced to death. HOWEVER, you could pay money damages in lieu of execution. As a group, we trial lawyers have been demonized so we've had to back up what we do with the Bible:

You shall not pervert the justice due to your poor in his suit. Exodus 23:6.
Maintain the rights of the poor and needy. Proverbs 31:9
Seek justice, correct oppression, defend the fatherless and plead for the widow. Isaiah 1:17

And again, this notion that there is a problem with "frivolous lawsuits" is propaganda. I've never filed one and I've never seen one filed by a lawyer. If a truly frivolous lawsuit is filed it's generally filed pro se by an individual and most often by an inmate/prisoner. If a lawyer files a "frivolous" lawsuit procedural rules are in place so that it will be dismissed within 60 days and the lawyer who filed it is personally subjected to monetary sanctions. Eventually, license suspension and disbarment are possibilities. Every lawyer, law professor, judge, and lawmaker (and non-lawyers if they think about it) knows that no lawyer can make a living filing frivolous lawsuits.

I have nothing against doctors and love my own. I respect several who often treat clients of mine. I respect them and respect and rely upon their opinions to help my clients. In this health care debate there are certain interests who will use this as an oppurtunity to severly limit lawsuits citing false or skewed data to support their position. I'm trying to argue the other side and say be skeptical. On the other hand I'm not opposed to some reasonable limitations on lawsuits against doctors, but are they necessary to bring down health care costs when most states have already adopted reforms to protect doctors from lawsuits and lawsuits represent such a small portion of the total health care costs? Less than 4% of the total annual health care costs are attributable to lawsuits and defensive medicine. Why are we focusing so much attention and energy (much of it negative) on this small percentage? If you already hate lawyers then you probably haven't read this far and you're not going to listen to me anyways.

[Feanor]

Thanks and well argued, Dean, no doubt you're a good lawyer.

So if the items I mentioned aren't valid, I guess you'll just have to go with the cull, right? :yesnod:


How do percentage-defined conditional fees (contingency fee agreements) encourage litigiousness other than by providing a person/individual an oppurtunity to access the court system?
....
Well I guess you could say that that's part of the problem in-and-of itself. With all the risk shifted to the lawyer, who wouldn't go for it?

I don't think lawyers invented the contingent fee approach out of altruism. It stands to reason the with %-based fees, if you feel your chances aren't not so good, you just improve the odds by increasing your percentage. And also of course, going for absurd pain-and-suffering and punative damages just increase the payoff.

Here's my though on pain-and-suffering. How do you quantify what P&S is worth? And how much can it be worth over and above substantive damages? Something, but I think it ought to be limited. I once heard that in Canada (or perhaps one province or another) it was limited to $100k.

As for punative damages, I certainly believe in them. But I believe they ought to be paid to the public receiver, not the plaintiff or his/her lawyer. If I'm not mistaken, (and admittedly I might be), punative damages do (or did) not exist in Canada.

[dean_martin]

So if the items I mentioned aren't valid, I guess you'll just have to go with the cull, right? :yesnod:


Well I guess you could say that that's part of the problem in-and-of itself. With all the risk shifted to the lawyer, who wouldn't go for it?

I don't think lawyers invented the contingent fee approach out of altruism. It stands to reason the with %-based fees, if you feel your chances aren't not so good, you just improve the odds by increasing your percentage. And also of course, going for absurd pain-and-suffering and punative damages just increase the payoff.

Here's my though on pain-and-suffering. How do you quantify what P&S is worth? And how much can it be worth over and above substantive damages? Something, but I think it ought to be limited. I once heard that in Canada (or perhaps one province or another) it was limited to $100k.

As for punative damages, I certainly believe in them. But I believe they ought to be paid to the public receiver, not the plaintiff or his/her lawyer. If I'm not mistaken, (and admittedly I might be), punative damages do (or did) not exist in Canada.

I wasn't going to touch the cull plan. I'd only dig a deeper hole.

I see your perspective on %-based fees and what you say plays a role sometimes, but it is an acceptable contract arrangement for those who couldn't pay to hire a lawyer otherwise. Upping the percentage doesn't improve your odds of winning, but it can make the risk more palatable.

Quantifying P&S is debated in the legal community as well. It's largely discretionary with the jury and the law doesn't provide them much in the way of guidance. A young person who is expected to suffer a lifetime of p&s from injuries caused by someone else should be awarded more than the person who is able to return to work and function at the same level as pre-injury. The only measuring sticks are certainty, degree and duration and it's up to the jury to decide how much it's worth. Some states have capped p&s damages, but it's not the jury that applies the cap. It's the judge who reduces the award after the jury returns its verdict.

The concept of paying all or part of a punitive award to the state has been discussed and attempted as well. In my state, the legislature passed a law that included a provision for payment of part of a punitive award to the state. The law was struck down as unconstitutional. I'm can't remember what part of the statute was found unconstitutional and why. I'd have to look it up.

[nightflier]

Feanor, I agree with you in the sense that many of the decisions and discussions in this forum are of great moral importance, I see religion as being an issue that should be left out. I also agree that much morality is informed by religious sentiment, piety and philosophy are different sides of the same coin.

I must apologize for bringing religion into this discussion. My only point was that there seems to be some hypocrisy from those who oppose universal healthcare the most.

The reality is that a good Christian should not judge, but just offer help where it is needed, even to Pharisees. Isn't that the Samaritan lesson? But what I've heard more of than anything else, is the libertarian argument that the sick and unfortunate find themselves where they are by choice. I think there is a good argument to be made against that, but even if that is were case, it is not the Christian way to judge, but rather to offer help in spite of how badly we Christians may perceive the unfortunate to have contributed to their own misery.

Given that a good number of us Americans do let our Christian values determine our political opinions, I don't think it is out place to bring it up here. After all, we are talking about the one behavior that is most lauded in our religion. Likewise it is a founding principle of Judaism as well as Islam. I am not as familiar with non-Judeo-Christian beliefs, but I imagine that this is true there as well. In any case, for us Americans who are mostly Christian, this definitely does bear on the discussion.

Leaving the Christian argument aside, I am a bit troubled by the other libertarian argument that some people make about living in isolated small towns or having the liberty to run marathons. While this is great for those of us that can make those choices, the vast majority of Americans can not. The vast majority of us don't have those luxuries. Moreover, the potential risks for not addressing our healthcare shortcomings will also be felt the most in those same environments. The worst cases like epidemics, natural disasters, and catastrophes will most severely affect them. In turn, these mergencies be much worse because we failed to address them there as a result of an opposition that is rooted largely in a reality that only a few of us can boast of.

Interestingly, I also consider having the time to run marathons, eating expensive organic foods, and having the means to live far from others, a rather non-Christian argument to make, when used in the context of this discussion.

Regarding smoking, I agree that it is bad for people and that it is also an over-vilified bête noire, when so much else in our environment is also bad for us and gets nary a mention. But just like obesity, the current system already has penalties for these personal life-choices. There is no reason to believe that the proposed healthcare legislation will too; I can't really imagine it won't. I therefore simply don't agree that these factors should weigh so heavily on the discussion.

What I do consider quite relevant (although I must admit I don't enjoy reading about it), is the discussion related to the way that our litigiousness imparts such a significant cost on the healthcare system. Certainly this is one factor that separates American society from any other Westernized society. I know from experience that people in Europe, Latin America, and North Africa just don't sue each other as much. This gives medical care more breathing room to do it's job unfettered by fear of litigation. It is quite possible that we could make the whole healthcare debate obsolete by addressing this larger issue. But I'm pretty sure that our love of lawsuits is so rooted in our ideals, our culture, and dare I say, our mores, that this just isn't possible.

I suppose this leaves us with the question: will healthcare reform assist in addressing the larger issue of our cultural proclivities, or will it be dwarfed by it?

[GMichael]

I must apologize for bringing religion into this discussion. My only point was that there seems to be some hypocrisy from those who oppose universal healthcare the most.

The reality is that a good Christian should not judge, but just offer help where it is needed, even to Pharisees. Isn't that the Samaritan lesson? But what I've heard more of than anything else, is the libertarian argument that the sick and unfortunate find themselves where they are by choice. I think there is a good argument to be made against that, but even if that is were case, it is not the Christian way to judge, but rather to offer help in spite of how badly we Christians may perceive the unfortunate to have contributed to their own misery.

Given that a good number of us Americans do let our Christian values determine our political opinions, I don't think it is out place to bring it up here. After all, we are talking about the one behavior that is most lauded in our religion. Likewise it is a founding principle of Judaism as well as Islam. I am not as familiar with non-Judeo-Christian beliefs, but I imagine that this is true there as well. In any case, for us Americans who are mostly Christian, this definitely does bear on the discussion.

Leaving the Christian argument aside, I am a bit troubled by the other libertarian argument that some people make about living in isolated small towns or having the liberty to run marathons. While this is great for those of us that can make those choices, the vast majority of Americans can not. The vast majority of us don't have those luxuries. Moreover, the potential risks for not addressing our healthcare shortcomings will also be felt the most in those same environments. The worst cases like epidemics, natural disasters, and catastrophes will most severely affect them. In turn, these mergencies be much worse because we failed to address them there as a result of an opposition that is rooted largely in a reality that only a few of us can boast of.

Interestingly, I also consider having the time to run marathons, eating expensive organic foods, and having the means to live far from others, a rather non-Christian argument to make, when used in the context of this discussion.

Regarding smoking, I agree that it is bad for people and that it is also an over-vilified bête noire, when so much else in our environment is also bad for us and gets nary a mention. But just like obesity, the current system already has penalties for these personal life-choices. There is no reason to believe that the proposed healthcare legislation will too; I can't really imagine it won't. I therefore simply don't agree that these factors should weigh so heavily on the discussion.

What I do consider quite relevant (although I must admit I don't enjoy reading about it), is the discussion related to the way that our litigiousness imparts such a significant cost on the healthcare system. Certainly this is one factor that separates American society from any other Westernized society. I know from experience that people in Europe, Latin America, and North Africa just don't sue each other as much. This gives medical care more breathing room to do it's job unfettered by fear of litigation. It is quite possible that we could make the whole healthcare debate obsolete by addressing this larger issue. But I'm pretty sure that our love of lawsuits is so rooted in our ideals, our culture, and dare I say, our mores, that this just isn't possible.

I suppose this leaves us with the question: will healthcare reform assist in addressing the larger issue of our cultural proclivities, or will it be dwarfed by it?

You are confusing being against changing to a health plan that we don't know enough about with being against healthcare. They are not the same thing.

[dean_martin]

What I do consider quite relevant (although I must admit I don't enjoy reading about it), is the discussion related to the way that our litigiousness imparts such a significant cost on the healthcare system. Certainly this is one factor that separates American society from any other Westernized society. I know from experience that people in Europe, Latin America, and North Africa just don't sue each other as much. This gives medical care more breathing room to do it's job unfettered by fear of litigation. It is quite possible that we could make the whole healthcare debate obsolete by addressing this larger issue. But I'm pretty sure that our love of lawsuits is so rooted in our ideals, our culture, and dare I say, our mores, that this just isn't possible.

I suppose this leaves us with the question: will healthcare reform assist in addressing the larger issue of our cultural proclivities, or will it be dwarfed by it?

Significant cost? 3% of annual health care costs spent on defensive medicine due to fear of lawsuits. 0.5% of annual health care costs spent on settlements, jury awards and associated administrative costs. (3% + 0.5% = 3.5%) Be reasonable and make reasonable rather than Draconian reforms based on reliable data is all I'm saying.

When our founding fathers left Europe, they thought it was important to include a right to trial by jury in civil cases in our Bill of Rights. But I guess we can exempt health care providers from our cultural proclivities.

[blackraven]

Dean, Dean, Dean, you miss my whole point. I'm just asking for protection for practicing standard or care medicine. But you want Dr's to be able to be sued for a complication that is totally out of our control when we practice good standard of care medicine. Like I said your a true shark hiding behind what many lawyers say that they are protecting the public. WTF are you protecting them from when someone brings a suit against a Dr. for a complication from practicing standard of care medicine or do you not understand what standard of care medicine is? Maybe we should sue lawyers when they lose a case! Why dont we sue auto mechanics when they misdiagnose a problem with a car. Because there's no money! And I'll repeat myself, I'm not asking for protection from negligence, but I guess you think its ok to sue innocent Dr's. Why dont you look up at how many Dr's have committed suicide over losing cases in where they did no wrong. I'm talking about cases that have been reviewed by medical boards. Losing a malpractice case can destroy one's life, but it seems your ok with that.

I'm not saying that law suits account for a large portion of health care dollars, but defensive medicine does and amounts to hundreds of million dollars.

And I guess saving a few hundred million a year in defensive medicine costs and product liability is a drop in the bucket when you consider that health care is a trillion dollar, yes trillion dollar problem.

We have to try and cut the cost of health care in many area's not just one. I for one don't want to hand over 50% of my income to the government to pay for this trillion dollar problem. I'm not willing to become a socialist country just yet. What is the government going to do when they spend all the publics money and it runs out!

[dean_martin]

Dean, Dean, Dean, you miss my whole point. I'm just asking for protection for practicing standard or care medicine. But you want Dr's to be able to be sued for a complication that is totally out of our control when we practice good standard of care medicine. Like I said your a true shark hiding behind what many lawyers say that they are protecting the public. WTF are you protecting them from when someone brings a suit against a Dr. for a complication from practicing standard of care medicine or do you not understand what standard of care medicine is? Maybe we should sue lawyers when they lose a case! Why dont we sue auto mechanics when they misdiagnose a problem with a car. Because there's no money! And I'll repeat myself, I'm not asking for protection from negligence, but I guess you think its ok to sue innocent Dr's. Why dont you look up at how many Dr's have committed suicide over losing cases in where they did no wrong. I'm talking about cases that have been reviewed by medical boards. Losing a malpractice case can destroy one's life, but it seems your ok with that.

I'm not saying that law suits account for a large portion of health care dollars, but defensive medicine does and amounts to hundreds of million dollars.

And I guess saving a few hundred million a year in defensive medicine costs and product liability is a drop in the bucket when you consider that health care is a trillion dollar, yes trillion dollar problem.

We have to try and cut the cost of health care in many area's not just one. I for one don't want to hand over 50% of my income to the government to pay for this trillion dollar problem. I'm not willing to become a socialist country just yet. What is the government going to do when they spend all the publics money and it runs out!

I understand standard of care. I've already replied as to how the legal system views it. Here's what I said earlier:

"I didn't ignore your earlier post. The very definition of medical malpractice/ medical negligence is a breach of the standard of care. First, the plaintiff has to prove the standard of care (by expert testimony), then a breach of the standard (also by expert testimony) and then damages caused by the breach. Therefore, by definition, doctors practicing within the appropriate standard of care are protected."

You don't want doctors to be sued in the first instance when it is shown that their treatment was within the standard of care. I understand that and some states have enacted laws to address that by requiring an affidavit from another doctor (expert witness) that the standard of care was breached. Our legal system is adversarial by design. It makes for a messy and unpleasant situation sometimes. The defendant doctor will have his experts too who say that the standard of care was not breached. The jury will decide based on the evidence and the weight they give to the opinions of the experts. Each party has a right to appeal so there is another level of review available.

My state doesn't have a requirement that an expert's affidavit be filed with the lawsuit but a plaintiff must prove his case with expert testimony. The expert doctor must practice in the same field as the defendant doctor. No lawyer that I know who handles medmal cases files one without having all the medical records reviewed by a doctor and an opinion from that doctor that the standard of care was breached.

Is it a perfect system? No. Pre-screening cases by a medical board or some other entity takes the fact-finding perogative from the jury. In the context of the legal system it places the cart before the horse. I can see where your concerns may ultimately lead. For example, a system where a medical board decides whether the standard of care was breached and then if so a jury can determine damages. But that's such a fundamental change to the legal system that I don't think it will become law. I think where we have a fundamental difference of opinion is on the question of who determines whether the standard of care has been breached.

Maybe some satisfactory middle ground can be reached (hopefully, without resort to name-calling).

Edit: BTW, I have read your posts as thoroughly as my time allows and I have noticed that you have pointed out where the significant costs of health care lie. I almost quoted you in an ealier response to NF who obviously didn't read your post where you addressed the costs of end-of-life care. But since we've butted heads, I wasn't sure that you would appreciate that.

[blackraven]

Peace!

[ForeverAutumn]

Dean and BR, that has got to be the most civilized argument I've ever read on this site. Good on ya both.

[E-Stat]

I am a bit troubled by the other libertarian argument that some people make about living in isolated small towns or having the liberty to run marathons. While this is great for those of us that can make those choices, the vast majority of Americans can not. The vast majority of us don't have those luxuries.
Luxuries? Living in Mayberry is a luxury? Last time I checked, you are free to live wherever you choose. As for running, here's what you need to do:

1. Buy some running shoes. I have $50 Nikes.
2. Go run. I average about 2-3 hours a week.

Don't be troubled. Exercise!

rw

[Sir Terrence the Terrible]

Luxuries? Living in Mayberry is a luxury? Last time I checked, you are free to live wherever you choose. As for running, here's what you need to do:

1. Buy some running shoes. I have $50 Nikes.
2. Go run. I average about 2-3 hours a week.

Don't be troubled. Exercise!

rw

Exactly. runny is not a luxury as it costs little to do so. Americans are lazy and prefer weight loss pills and useless gadgets(that do cost money) to lose weight. When you tell them all you have to do is walk or run for 30 minutes a day, they completely freak out and say they don't have time. BS, if you have time to fill your fat face, you have time to walk or take a jog.

I do two marathons a year at the least, and often three in a year. Full marathons not half marathons. I run 7-8 miles four times a week even with a very busy schedule, and quite a bit of travel. In every city I visit, I have a place to run. If you are interested in staying healthy and keeping your weight down, you will do what is necessary. If you are lazy and want to eat and not excersize, then expect your weight to be high and have all of the negative health issues of being overweight. The obesity rate in this country is disgusting. The fact that MacDonalds, Burger King and Wendy's has gotten so filthy rich off making folks fat is equally disgusting. I tell my friends, if you just HAVE to do fast food, go to El Pollo Loco. Their chicken is healthy, most of the sides are healthy(if you choose wisely) and their meals are filling without being over filling.

Running is basically free as you can do it without a gym membership. All you need to do is stretch, work your way up, buy running shoes and change them every 6 months, and that is all there is to it.

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