Next US President: Wishes and Expectactions

[Iceman]

Great points JSLTIGER...

one on Hillary seemingly opportunistic and two... the predjudice factor...No Women,No Jews,Nothing that goes too much against the grain...I don't say McCain will win only because I am familiar with him coming from Arizona, I say it simply because of the Lack of Choices with the known pre-determined mindsets of people....pretty sad huh?

[Sea Demon]

Originally Posted by Iceman

Great points JSLTIGER...

one on Hillary seemingly opportunistic and two... the predjudice factor...No Women,No Jews,Nothing that goes too much against the grain...I don't say McCain will win only because I am familiar with him coming from Arizona, I say it simply because of the Lack of Choices with the known pre-determined mindsets of people....pretty sad huh?

Iceman, you are spot on, dude. Despite what some people think of me, I'm no die hard Republican. In fact, I'm registered Independant. But I'm also stuck voting for the lesser of two evils... ....quite sad that third parties can't seem to get a leg up during election time to force better decision making from the two major parties.

[scandium]

Originally Posted by Deathblow

Half of those "measures of quality" have nothing to do with access to healthcare. Last in the the leaving the doctors office with lingering questions? Last in weekend doctor's visits?

The measures in this study have everything to do with the quality of the healthcare and the public health as well. Its not a unique study, nor are its findings. If you look at any study that seeks to comprehensively measure the quality of healthcare and its cost, you will consistently find that its most expensive in the US, which despite that doesn't measure up well next to other industrialized countries - all of which have some kind of comprehensive national healthcare program. And I'm sorry but Medicare/Medicaid doesn't count as neither program has Universal access (which is a pillar of any national healthcare program). Not that they aren't helpful to the people who need them and qualify, just that when we're talking about national healthcare they don't meet fundamental criteria to be counted as such and are therefore not relevant to it.

What I've seen shows me that government funded healthcare are subject to constant waste and abuse. I would say that probably 50% of all the medicaid funded doctors visits are friviolus and really didn't warrant a doctors visit at all, but the fact that the bill is on the governement prompts many to come in for stuff that not even treatment worthy... waiting rooms are often packed with the insignificant and frivilous complaints and doctors constantly sorting thru what really warrents treatment and what's a waste of time. But heck even when the medical complaints don't warrant treatment, the doctors visit itself cost money (billed to the taxpayers), and what worse whenever the doctor comes around to figuring out that this "whatever medical complaint/ache/sore/etc" probably doesn't need any treatment at all, the fact that "heck they're already going to get charged for the doctor's appointment, might as well give them something... they're on medicaid" happens more often than not. The patient gets the satisfaction of getting something, the doctors get to charge for it, and the governement (and tax payer's) get stuck with the bill. Its a sad fact but its the reality.

It would be if it were reality. However I seriously doubt that it is. Just because one doesn't directly pay for something doesn't automatically equate it being abused. I live in a country with nationalized healthcare and I can tell you that I see a doctor no more than I absolutely have to, even though I'm not billed for the visits. Not to burst your bubble but people don't like visiting the doctor. Unecessary doctor visists rank up there with unecessary dental visits for unecessary tooth fillings.

And even when the program isn't being abused, half of the policies and bueracracy doesn't make sense... there are some medicare and medicaid policies that force doctors to provide X drug instead of Y drug... even when X drug is actually 3-4 times more expensive than Y drug and doesn't work any better. And as ridiculous as that sounds the doctors are actually forced to provide the more expensive drugs when the cheaper drugs are the smarter choice... not because it makes sense, but because the incredibly slow and cumbersome beuracracy can't change its policy, or even approve the use of paper clips, without what seems like an act of congress.

You're identifying a real problem but assigning the blame to the wrong culprit. Its a fact that generic drugs are often difficult to impossible to aquire in the US, even where available elsewhere, but that has rather little to do with Medicare/Medicaid and rather a lot to do with a powerful pharmaceutical lobby whose efforts (and campaign contributions, etc) to restrict consumer choice to more expensive brand-name drugs have been very successful.

Similarly, I might add, your undergoing medical training for a career in medicine makes you one of these same vested interests as doctors are part of another powerful lobby who, fearing their income may somehow be impacted, are vocal opponents of any national healthcare system. Which is probably what all of your arguements are really motivated by: you oppose national healthcare, along with the rest of your future profession, for one reason only and that is because you fear it would impact your future earnings. Which is fine, but it makes your other arguements rather disengenous.

[DeepSix]

Originally Posted by scandium

Not to burst your bubble but people don't like visiting the doctor. Unecessary doctor visists rank up there with unecessary dental visits for unecessary tooth fillings.

Not to burst yours, but people make unnecessary visits to the doctor all the time. Have you ever been in an American ER waiting room? Many of the waiting patients are not emergency cases, but they all have to be seen.

Deathblow's comments, examples, and facts are spot on. He isn't preaching an agenda and he's not sniping at everything your country does.

I agree with you completely about generics, but that complaint should be addressed to the Food and Drug Administration and the pharmaceutical companies, not doctors. It's the FDA that restricts generics.

As far as medical professionals having a "vested interest," I find that remark to be *WAY* out of line, insinuating as it does that American doctors have no ethical standards. My father is an opthalmologist and I've known dozens of doctors well. To be sure, they all want job security, but they don't fleece people to do it. Staying in practice is incredibly expensive and taxing of one's personal energy. You have overhead in the form of staff salaries, building maintenance, and equipment purchasing and maintenance. You have malpractice insurance. You have the costs of staying certified. Nowadays, most new doctors in practice also have to pay for the money they've already spent on their education - that comes out of earnings, too. You (and your family) have ungodly hours. You have uncooperative insurance companies. Medical professionals do not choose the career because it's easy (it's not) or because they want to "get rich," or because they only want to help some people but not others.

I can't tell you how many times my dad never charged patients who could not pay for their treatment. I've also seen him unable to collect from tightwads who could have afforded it ten times over. When he started in practice, his hours were from 7 a.m. to 8 p.m. He took call at least one week a month, and very often every week a month because no one else was available. He took call and performed surgery for 30 straight years and in all that time I can think of two days he missed because he was sick. Weekend outings planned weeks or months in advance were cancelled at the last minute because a patient "had to be seen." More often than not, they weren't really emergencies, but after a week and a half of ignoring their problem, they finally decided they had to be seen, "right now!"

Excuse me for going off on an anecdotal tangent, but I FIRMLY believe that your characterization - entitled to your opinion though you are - of the U.S. healthcare system is grossly oversimplified and in part inaccurate. If you (the general "you," not you personally) aren't involved with it you don't have a complete enough picture to be able talk about the reality of it.

[scandium]

Originally Posted by DeepSix

Not to burst yours, but people make unnecessary visits to the doctor all the time. Have you ever been in an American ER waiting room? Many of the waiting patients are not emergency cases, but they all have to be seen.

You're confusing cause and effect. These non-emergency "unenecessay visits" are due to the country having millions of uninsured people who cannot afford to see a regular doctor, therefore they wind up in ER waiting rooms where they have to be seen. They're not there because they have nothing better to do, or because they enjoy hanging out in ER waiting rooms, they're there because its the only care they can get.

Deathblow's comments, examples, and facts are spot on. He isn't preaching an agenda and he's not sniping at everything your country does.

His facts ecompass many myths. They coincidentally are part of an agenda against a national healthcare policy that the American Medical Association is very much opposed to (and who coincidentally promote these very same myths). And his lengthy post on 'why national healthcare sucks' was a response to my mentioning Hillary Clinton's promotion of a national healthcare policy while First Lady. Nobody was "sniping" at anyone's country.

I agree with you completely about generics, but that complaint should be addressed to the Food and Drug Administration and the pharmaceutical companies, not doctors. It's the FDA that restricts generics.

I hadn't placed the blame for that on doctors.

As far as medical professionals having a "vested interest," I find that remark to be *WAY* out of line, insinuating as it does that American doctors have no ethical standards.

Of course they have a vested interest. To believe otherwise is naive. Likewise they also have ethical standards, but the two aren't mutually exclusive. The world, after all, is not a black and white place.

[TLAM Strike]

Originally Posted by *[FOX

* Bort]And overtime, getting paid extra for working more than you're supposed to! Geez! What is this country coming to?

You should work at a DOT repair shop like my dad. He gets 'Time plus a little' for overtime not 'Time and a Half' like the most of men, only because he can fix county trucks and buses. Yea they can do work others can't so they get paid less.

[kholemann]

Huge 'dittos' to you Sea Demon! No idea who Tom Tancredo is but where I am from Bobby Jindal would be a great VP candidate. Here in Louisiana, the folks here keep electing idiots and hopefully Katrina and Rita have shown them up for what they are, incompetent! So...

Democrats should nominate Liebermann for Pres and Hillary for VP because it would grab the votes of the most number of voters that haven't a clue.

Republicans should nominate George Allen with an excellent young VP candidate like Bobby Jindal.

If the Democrats could just do everyone a great favor and nominate Hillary Clinton for President, they would ensure a Republican victory in '08.

[bradclark1]

Talk about a rabid republican.

[TteFAboB]

Originally Posted by bradclark1

TteFAboB must of grown up in the 1930's. Thats the only reason I can think of for his stupid comments.

Are you dirt-poor?

I don't know about the lot of you, but I come from a family of immigrants, only. Most of my family came to the new world late, but no I didn't had to convince a captain at the age of 14 to take me aboard in pitty and cross the Atlantic ocean alone, arriving at a strange land, without speaking the language or knowing anyone to seek for help back in the 1930's, without anything at all in his pockets. And that's only one of them.

What I know is that we had to settle and survive starting from scratch, from what to eat, to what to wear, to how to stay alive. Yes, I believe someone who has shelter, clothes, warm food and whines of being dirt poot doesn't know poverty nor misery. Glad someone as poor as that doesn't have the money to pay a visit to the 3rd world, eh? To some, it is better to live in illusion, it's comforting, oh look how poor I am! Also gives you plenty of excuses right? I will die of cancer -> because I'm poor.

I suppose this is some sort of big secret, never spoken before in the Poor's Club, well, who am I to spoil your party and tell you a man is only as rich as he can tell, and that if you put all your pennies on modern medicine for health you deserve to die, because a hospital can't cure your leukemia or your basketball-sized brain tumor, nor will it rescue you when you have a heart-attack alone with no one to dial 911. I won't tell you any of that, have a nice death and live in poverty.

[bradclark1]

You are living in the U.S.A. in the year 2006. You are not living in a third world country. You did not come into this country at the age of 14 in the 1930's so stop being ignorant and imagining you are.
How much does the internet cost monthly? Not much so stop acting like it's criminal for someone to be on the internet when they say they are poor.
Being poor in a third world country is obviously different then being considered poor in the U.S. If you feel that much about the third world poor go live their.
Speaking of the internet, in the high school in the town I live in you have to have access to the internet, a word processor and a printer or you will be dropped points from your assignment. To me thats bs but thats the way it is. So here being poor is not an excuse not to have internet access. If you don't have access you have to go to the next town over to use their library set-ups. But wait! Public transportation doesn't go their.
You have to have a car. But if you are too poor to own a car then you will have to pay over $30.00 for a taxi to get their and back. So tell me smart guy is it cheaper to have internet access or is getting a taxi however many times a month to get to the library.
This country has a different standard of living then one of your third world countries so take a damned reality check.
Or in your opinion should poor people be kept down and trod on to meet your expectations of what poor means.
You have issues pal.

[TteFAboB]

I have issues because I'm not getting an off-topic derail medal.

My reply will arrive in your PM box.

I apologize to those actually interested in the next presidential candidate.

[Deathblow]

Originally Posted by scandium

The measures in this study have everything to do with the quality of the healthcare and the public health as well. Its not a unique study, nor are its findings. If you look at any study that seeks to comprehensively measure the quality of healthcare and its cost, you will consistently find that its most expensive in the US, which despite that doesn't measure up well next to other industrialized countries - all of which have some kind of comprehensive national healthcare program. And I'm sorry but Medicare/Medicaid doesn't count as neither program has Universal access (which is a pillar of any national healthcare program). Not that they aren't helpful to the people who need them and qualify, just that when we're talking about national healthcare they don't meet fundamental criteria to be counted as such and are therefore not relevant to it.

Read my wording. "The markers of quality have nothing to do with *access* to healthcare." You've read poorly. Also did you even look at the data in these studies? The US ranked #1 in the "effectiveness" of healthcare, the bottom line of medical care. The second largest spender in healthcare, Canada, is the 2nd best healthcare in "effectiveness". The country that spent the least in healtcare had the least effective healthcare. Interesting to note that the country that is the best and "patientcenterness" probably a rough measure in "bedside manner" was the 2nd worst in equity. Thank you for failing to provide that data and proporting half-truths.

http://www.cmwf.org/publications/pub...?doc_id=364436

But anyway, these types of data are often over-interpreted, and only so much can be assumed from rough, subjective estimates. Even more quantitated estimates of "quality of care" (for example life expectancy, death rates, etc) can be easility misskewed because they depend significantly on the characteristics of the population, cultural beliefs and lifestyles, environments, etc.

Originally Posted by Scandium

It would be if it were reality. However I seriously doubt that it is. Just because one doesn't directly pay for something doesn't automatically equate it being abused. I live in a country with nationalized healthcare and I can tell you that I see a doctor no more than I absolutely have to, even though I'm not billed for the visits. Not to burst your bubble but people don't like visiting the doctor. Unecessary doctor visists rank up there with unecessary dental visits for unecessary tooth fillings.

No Scandium, your showing complete and utter igorance here,... child-like ignorance even. I *live* the reality of healthcare, I work the clinics, cure the sick, and listen to the complaints of the not-really-sick. I see their pain, and symptoms, or complete lack of it, and provide their treatments, working long 80+hour work weeks doing so. I'm not telling you what *might* be going on, I'm telling you *is* the reality. I hate to burst such child-like naivity, but you don't see what managing a doctors office is like, all the wasted doctor's visits, frivilous complaints, and probably never will. And reading a few poorly written newspaper articles won't inform you to the naunces of patientcare. Billions are wasted each year, that is fact. And expanding federal control over everything will amount to wasted sums many times greater. That is reality, and anyone that thinks otherwise is foolish.

Originally Posted by Scandium

You're identifying a real problem but assigning the blame to the wrong culprit. Its a fact that generic drugs are often difficult to impossible to aquire in the US, even where available elsewhere, but that has rather little to do with Medicare/Medicaid and rather a lot to do with a powerful pharmaceutical lobby whose efforts (and campaign contributions, etc) to restrict consumer choice to more expensive brand-name drugs have been very successful.

No, your failing to comprehend. I'm not talking about the *availability* of generic drugs, I'm talking about choices between drugs that are already equally available. Make sense? Your reaction will problably be... "But that doesn't make sense? Why would the government force doctors to use a more expensive drug when an equally effective, but cheaper drug is available?"...Exactly, it doesn't make sense at all. They are policies handed down by a large government agency that is so many ways is inefficient and inflexible and should not be in ultimate control of all things healthcare. Your assumption that giving beuracratics more control of healthcare will result in an improvement of trends like the ones reported about is like believing that the FDA should take direct control of all pharmacies and will do a better job. Maybe FEMA should take over local law enforcement?(j/k)

Originally Posted by Scandium

Similarly, I might add, your undergoing medical training for a career in medicine makes you one of these same vested interests as doctors are part of another powerful lobby who, fearing their income may somehow be impacted, are vocal opponents of any national healthcare system. Which is probably what all of your arguements are really motivated by: you oppose national healthcare, along with the rest of your future profession, for one reason only and that is because you fear it would impact your future earnings. Which is fine, but it makes your other arguements rather disengenous.

No, your assumptions about my motivation are unfounded and incorrect. I like many doctors will probably pursue positions of healthcare that are already government funded and have been for years. I train at a large state hospital, in which the doctor's are state employees and hospital salaries are government controlled/state funded. My own personal aspirations are to work for a large state run hospital with a large indigent care program (something that's important too me); the institution of federal control will not likely effect my income much, whether my salary will be state controlled as they are already or become federally controlled is not particularly significant and is not the real issue. But thank you for your poor, unfounded assumptions about my character.

Originally Posted by Scandium

His facts ecompass many myths. They coincidentally are part of an agenda against a national healthcare policy that the American Medical Association is very much opposed to (and who coincidentally promote these very same myths).

No, the *greatest myth* is proported by those that believe giving federal government control of their healthcare won't be without detriment or consequences. Second, I don't know what the AMA's official policies and/or arguments are. (On a side note, the vast majority of doctors choose not to join the AMA, about 70-80%). And the assumption that the controversy over federally controlled healthcare is primarily over salaries is the second greatest *myth* perpetuated. It is not. The issue is over who will control the healthcare decisions, those that provide the care and treatments, or a federal agency that hands downs policies from Washington.

This issue has come up in the past..."who makes healthcare decisions?", in the private sector. The similar controversy began about 10-15 years ago when private health insurance companies began enacting policies geared at taking control of healthcare decisions more away from patients/doctors; policies that were handed down from their boardrooms and not from those patients and doctors that were ungoing/providing the treatments; often these policies were denying diagnostic test, medicines, or need treatments and it took years of law suits, cries of the patients, and doctors to curb these insurance practices. Now the issue rises again, "who will ultimately controls healthcare decisions". The man or woman standing in front of you that talks to you and hears your symptoms and complaints, or a large federal program and hands down policies from Washington, ultimately controlled by politicians in Congress. National healthcare programs will have expanded coverage, but definant pittfalls, that is fact....Ted Kennedy ultimately in charge of your healthcare.... ... ... ... I don't think so.

[DeepSix]

Originally Posted by Deathblow

...
I'm not talking about the *availability* of generic drugs, I'm talking about choices between drugs that are already equally available. Make sense? Your reaction will problably be... "But that doesn't make sense? Why would the government force doctors to use a more expensive drug when an equally effective, but cheaper drug is available?"...Exactly, it doesn't make sense at all. They are policies handed down by a large government agency that is so many ways is inefficient and inflexible and should not be in ultimate control of all things healthcare.
...
Now the issue rises again, "who will ultimately controls healthcare decisions". The man or woman standing in front of you that talks to you and hears your symptoms and complaints, or a large federal program and hands down policies from Washington, ultimately controlled by politicians in Congress. National healthcare programs will have expanded coverage, but definant pittfalls, that is fact....

Precisely, and the example of the FDA's handling of prescription drugs highlights perfectly what we could expect from government-run healthcare. Expanded coverage is not synonymous with improved quality. An assembly line improves speed but not necessarily quality or attention to detail - as the Soviets discovered after they'd performed radialkerototomy (r/k) surgery on hundreds of people. In the U.S., doctors found r/k to be unsatisfactory and were free to move on to better practices.

The ethical standards and intelligent decisions of doctors, made in consultation with patients they are familiar with, are far better than any blanket policy can be, which by their nature cannot accommodate individual needs. Doctors treat people as individual patients; the government treats them as statistics.

Let me put it this way - as far as the United States government is concerned, I am merely a social security number. All they care about is whether or not I've paid my taxes. On the other hand, my doctor knows me personally; to him I am not just another case. Let's say that down the road I develop heart problems. The government looks at me as a case and says, "Put him on such-and-such a drug for his blood pressure and give him a pacemaker." Right. On they go to the next case. My doctor, on the other hand, looks at my personal circumstances and says, "At age 99, a pacemaker will do him little good, especially if he should suffer some other malady of old age. I do not want to risk making him a vegetable for the sake of keeping his heart pumping. Therefore I will make him as comfortable as I can, but - unless he wishes it so - I do not think the pacemaker or the stresses of surgery would be best for him." The government solved the arithmetic with amazing efficiency; the doctor treated a human being after considering his quality of life.

[ABBAFAN]

Originally Posted by Neal Stevens

All right, Bush is going into his last 2 years.

1. Who do you think you would support for President (US citizens only)?

2. Who do you think has the best chances (everyone)?

3. And who did you vote for last election (US and Canadian citizens only)?

1. Guliani
2. McCain, Guliani, Powell
3. Bush!

curiosity.. why has guliani been mentioned twice?Do in what way did these elections affect canada?just interested.

[Onkel Neal]

Healthcare: it's your health, you should care. Be responsible for yourself.

It's easy to say the govt should pay for healthcare, but where does the govt. get its money? From the taxpayers. Why should one taxpayer have to subsidize his own health care and his neighbor's? I want to help the truly needy but I define needy as someone who cannot hope to take care of himself; mentally ill, the completely disabled.

IMO that mean setting good priorities, you pay for the essentials first, luxuries next. Internet access, ring tones, car, cable TV, magazines are not essentials. One should take care of his medical needs first.