Obama bowing againFollow

Women in the US are supposed to have professional breast exams yearly. Just because they aren't mammograms doesn't mean that they can't detect stuff. And if a lump is detected in a routine exam, then a biopsy and mammogram are in order.

The self breast exams are no longer recommended because most women can't tell the difference between a lump and a lymph node.

The point was that women were paying for yearly mammograms, and doctors were finding stuff that kinda sorta looked like cancer, but there were no external symptoms - no lumps or discoloration or breast pain - and when they dug around in the mammary tissue, they found out it was not cancer and they just wasted several thousands of dollars on nothing.

My mom had a biopsy and a mammogram done on a lump once. It turned out to be a clogged pore. (They removed it anyway.) I keep an eye out on my pores in case one does grow aggressive like that, and my husband already found one on my back that had grown to the size of a dime. (It has also since been "removed" although by a non surgical method, because really, it's just an overgrown blackhead, and some squeezing followed by Clearasil does wonders.)

I retched a little bit when I read that. And I spend a chunk of my working life in operating theatres.

I hate that part too! Actually, I hate that they're actually working on "Health Insurance Reform" and not "Health Care Reform." But I also realize that this can only lead to further changes that I look forward to.

Edited, Nov 17th 2009 6:19pm by AshOnMyTomatoes

The use of an insurance mechanic to pay for things which are neither rare nor particularly expensive is exactly what makes it cost so darn much. You're correct that insurance is essentially a reverse gamble. You're paying money into a fund which you only get back if you end up in the hospital, or get into a car accident, or your house burns down. Odds are those things will not happen at a sufficient rate in your lifetime to make the insurance worth paying for, but you pay anyway because you just might be one of the unlucky ones who ends up in the hospital, or has his car totaled, or has his house burn down. You're paying against the odds.

The entire mechanic of insurance only makes financial sense if the event you are insuring against is rare and expensive. If you can afford it, there's no point insuring against it. If it's common, there's no odds that it wont happen to you to justify paying more into the insurance than you get out on average. If those conditions are not met, then insurance is just a straight increase to the total cost. And that's more or less exactly where we are right now.


True health care reform in the US would consist of eliminating insurance as a payment mechanism for all health care except those involving expensive hospitalization or treatment. The decrease in cost for regular health care would put it in range of virtually everyone, and the insurance cost for the remaining stuff would come down and become a reasonable choice for people to make (and for companies to provide as a benefit). The very idea of paying insurance for "preventative care" is oxymoronic...

I agree - but the problem is that most people don't care enough to bother about preventative care. So: what do you propose be done on that front? Your options are basically "continue the current system, as dysfunctional as it is" or "your taxes go up, but you get free preventative care". (There's probably a third option that I'm not coming up with at this point. I figure you can point out what it is, while Varus is more likely to make a claim that it's X when X, as he's putting it, is option 1.)

Nothing. Why is it the government's concern if someone chooses to obtain preventative care or not?

See. If we don't get the government involved in paying for people's care in the first place, then the government has no reason to concern itself with choices like that. It's a slippery slope process. You get the government involved in providing health are, and then you have to make sure people take care of themselves in order to keep costs (to the taxpayers) down. One leads to the other.

Why not just let people make up their own minds and allow their outcomes to result from those choices? Let's also be clear, "preventative care" isn't really that expensive if you don't use insurance to pay for it. How much does it really cost to get a check up? It's a self-created problem. The health insurance mechanic creates an "all or nothing" effect on health care. You either have it, or you don't. If you don't, the cost is prohibitively high for that care (and it is if you do, but the insurance mechanic hides this from you). But if we didn't use insurance and just let general practitioners work out of private offices like they used to, the costs for each individual would be very small.

More importantly, health choices could be made by the individual, not by some large insurance company.





I'm talking about chucking the whole process though. It has nothing to do with the choices we're being presented with. See. We don't get to create an alternative. We can only support or oppose the bill being pushed forward in Congress right now. And that bill moves us in the exact wrong direction. It's just more of the same. It's predicated on an assumption that if we can just cover more people, we'll make up the cost difference in volume or something...


That's not likely to work. Look. I could explain at length how I think our health care system should work. But that's not the issue before us. The one before us is a choice of doing nothing and perhaps in a few years someone will propose something similar to what I'm advocating, or doing something which everyone will praise as "fixing" health care, while in reality they're just playing some monetary games to make it look like things are better for awhile. Then, in 15 or 20 years, as the costs catch up to us, and the people realize that they're not really any better off in terms off health care itself, we'll get another round of push for reform. But this time we'll have entrenched the insurance mechanic even more into the system and people will once again not likely be even presented with the idea that maybe there's a better way to do things.


So yeah. This bill moves us in the wrong direction. It's going to cost us tons of money, and while it might make some statistical difference in total coverage numbers, it doesn't really fundamentally fix the core flaws. And in some cases, makes them worse. Costs will go up for consumers in the long run. They have to. You can't require the insurance companies to cover people at a loss. And that's what will happen with the current approach to the issue of denying coverage for pre-existing conditions. Couple in the silly fines for not having health insurance and the whole thing is a disaster waiting to happen.


Yes. I'd much rather stick with what we have now, which doesn't work well, but at least doesn't make things worse.

Edited, Nov 17th 2009 6:21pm by gbaji

The same argument could be made about a lot of other things that are mandatory (well, according to the government, anyway).

To be honest, there's a slippery slope both ways on this one - you use this as an argument that the government shouldn't require people to take care of themselves, and you can continue slicing things off the government because the government shouldn't require that until, well, you don't have a government. (I don't necessarily disagree with this idea, though. I'm pointing it out for the sake of completeness.)

On that note, I'll segue into something that isn't health care: in a semi-ideal world (that is, we'll disregard the viability of the idea for the sake of generating interesting discussion, but people behave exactly as they do at present), how would you have government be funded?

We're all subject to the same rules.

Unless of course you're gay.

The fact that the government maintains a military itself does not intrude on my life.

That depends a lot on where that military is stationed and the opinion of the people who are living under its influence.

Etc. etc.

(A) The GOP had years to do something about health care. Anything. About health care costs or about coverage or about... anything. They chose to do nothing. Nothing at all. The most ambitious thing the GOP did with years to do it was Bush's Medicare prescription plan. Perhaps if the GOP had cared about this years ago, there wouldn't be a bill being "pushed forward" today.

(B) The GOP has made a conscious decision to simply oppose in this debate. That's the position they staked out and that's the hill they want to die on. They could have gone from the start and been more instrumental in forming a bill but they never wanted that. No, of course it wouldn't have been the bill they wanted but that's what happens when you're no longer the majority party. It certainly could have been a bill with more GOP influence. But you can't very well sit down and put your name on a bill if your master plan is to get town hall meetings riled up and Tea Party people wavin' their "Socialism!" signs around. So the GOP picked opposition over collaboration. Their choice, though.

Something's going to get passed. I will bet on it. It would be worse for the Democrats to pass nothing at this point than to pass basically anything. Whatever's passed, be it a bill I like or one I'm disappointed in, it'll be a foot in the door.

The notion that "states rights" are or have even been about effecting more individual control in the government is a ******* farce.

You're replacing one hegemonic bureaucracy with fifty, and pretending that the same problems you revile in the federal government will not be reflected in the states. You are pretending that individual citizens would have demonstrably more control (they won't), and pretending that the same problems won't arise (they will.) You do nothing but trade an unpopular governmental dictate for a popular one, and end up with people, deluded that they have more control, embracing perversions of justice with total impunity.

The only conceivable reason to give more power to states or reduce federal power is if you wanted people to have even less of a guarantee to their rights and privileges than they do now.

I think that is probably the stupidest thing I've heard in a while, because it's logically equivalent to "the ends justify the means".

This isn't to say I necessarily disagree with you. (For the most part, I don't, though I agree with Pensive's point that dumping things onto the states to fund doesn't really change anything other than increasing the amount of bureaucracy, unless you seriously expect it to continue to get dumped down to the county and city levels. At that point...)

I think I'll take a stab at answering the question I pointed at you, though, on the grounds that it probably won't help anything at all:

The government should be funded from two sources - a minimal amount of taxes, which people have some (not complete, as that leads to communal services being underfunded) control over where that money goes, and the remainder made up through companies mandated to be profitable. (In the US, I'd actually lean towards these being involved in alcohol, tobacco, and similar drugs. The options are either [1] the government-owned companies are present to dissuade people from entering the field in question, and then to dissuade people from using said product; or [2] the government-owned companies are present to provide a large source of capital for initial development of a field that would then be diversified in the future by non-government-owned, smaller, companies.)

Really, the ideal situation here is that, effectively, the entire voting population is a shareholder in these companies, and they form the entirety of the government. (No taxes at this ideal endpoint because you basically fund government actions by, surprise, paying for related products. Or even unrelated products.)

I'm aware that this is, essentially, "communism by a really obscure back road". It's also the end point of unbridled capitalism, though...

And yet, according to the CIA World Factbook, the USA ranks 50th in the world for length of life expectancy, whilst the UK ranks 36th. Canada comes in at 8th, and Australia at 7th.

Maybe we should be asking Macau, Andorra, Japan, Singapore, San Marino and Hong Kong how they organise their healthcare?


1 Macau
84.36


2 Andorra
82.51


3 Japan
82.12


4 Singapore
81.98


5 San Marino
81.97


6 Hong Kong
81.86


7 Australia
81.63


8 Canada
81.23


9 France
80.98


10 Sweden
80.86


11 Switzerland
80.85


12 Guernsey
80.77


13 Israel
80.73


14 Iceland
80.67


15 Anguilla
80.65


16 Cayman Islands
80.44


17 Bermuda
80.43


18 New Zealand
80.36


19 Italy
80.20


20 Gibraltar
80.19


21 Monaco
80.09


22 Liechtenstein
80.06

23 Spain
80.05


24 Norway
79.95


25 Jersey
79.75


26 Greece
79.66


27 Austria
79.50


28 Faroe Islands
79.44


29 Malta
79.44


30 Netherlands
79.40


31 Luxembourg
79.33


32 Germany
79.26


33 Belgium
79.22


34 Saint Pierre and Miquelon
79.07


35 Virgin Islands
79.05


36 United Kingdom
79.01

2009 est.
37 Finland
78.97


38 Jordan
78.87


39 Isle of Man
78.82


40 Korea, South
78.72


41 European Union
78.67


42 Puerto Rico
78.53


43 Bosnia and Herzegovina
78.50


44 Saint Helena
78.44


45 Cyprus
78.33


46 Denmark
78.30


47 Ireland
78.24


48 Portugal
78.21


49 Wallis and Futuna
78.20


50 United States
78.11

2009 est.

8th eh? Who knew that all that cold in Canada is good for your health?