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Thread: Should We Allow The Uninsured To Die?

  1. #71
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by Pinkie View Post
    First, this is not a one-way street; you'd be cared for as well.

    Second, it's patenetly obvious that universal care is more economical, more humane and gets better overall results.
    Then why are cancer survival, heart disease management, and stroke survival so much higher in the U.S. than in any other country (most of which have universal/single payer health care)?
    "Hmmm...Can't decide if I want to watch "Four Houses" or give myself an Icy Hot pee hole enema..." - Blake Shelton


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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by tessaesque View Post
    Then why are cancer survival, heart disease management, and stroke survival so much higher in the U.S. than in any other country (most of which have universal/single payer health care)?
    Linkiepoodle?

    All the studies I have seen have shown longer lifespans, lower infant mortality rates, etc. coupled with lower costs in nations with universal care.

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by PzKfW IVe View Post
    Neither of these statement answer the challenge. Please try again.
    I can't hit a moving target; what's your underlying objection? You just don't feel you should have to pay taxes of any kind?

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by Pinkie View Post
    I can't hit a moving target; what's your underlying objection? You just don't feel you should have to pay taxes of any kind?
    The target is obvious:

    Make the argument that I should be forced to provide you with goods and services that you, yourself, cannot afford.

    While doing so, be sure to address the fact that while you have the right to life, you are not entitled to the means necessary to exercise that right.

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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by Pinkie View Post
    Linkiepoodle?

    All the studies I have seen have shown longer lifespans, lower infant mortality rates, etc. coupled with lower costs in nations with universal care.
    Cancer Survival Rates Vary by Country
    Most Cancer Survival Rates in USA Better Than Europe and Canada » Secondhand Smoke | A First Things Blog
    Cancer Survival - NYTimes.com

    Heart disease deaths statistics - countries compared worldwide - NationMaster

    You have to do some math on this one. Basically, strokes account for 25 of deaths in America, 7% in Canada, and I couldn't get the numbers for "Europe", which is how this site lumps them. My original claim came from a health book I have in storage, but this site shows the basics:
    Stroke Statistics | Internet Stroke Center
    "Hmmm...Can't decide if I want to watch "Four Houses" or give myself an Icy Hot pee hole enema..." - Blake Shelton


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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by lpast View Post
    Nonesense my wife owned a large salon...all her employees made 40 grand and more 15 yrs ago...and only a couple of them chose to pay for health insurance even when reduced group rates were offered to them through my wife and they all could have afforded it...they didnt think they needed it...they all made good money but if something catastrophic happened only the richest could afford to pay it out of pocket.
    Do you actually believe that anyone is going to follow ron pauls ideas...do you think for a second that they would ever be implemented....your pissing up a rope...hes nuts...not all his ideas are bad and some I agree with ...but the rest are too far out there.
    Stop and think...right now today if doctors and hospitals werent subisidized with our tax money to take care of illegal immigrants health care, there wouldnt be but a couple of hospitals with the doors open out west...they would all be closed and doctors would flee the area in drove...Paul is a weaver...he throws out these great sounding plausible argument that a small segment wants to hear, that will never happen in 2012...pauls been spouting the same things for years and has never taken into acct the changing world.....I have to laugh when the same Ron Paul lovers railed on McCain as being to old and out of touch and the bow before Ron Paul and hes older and waaaaaaaaay more out of touch
    You don't understand the argument and it's not really worth my time explaining it all.
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by tessaesque View Post
    Cancer Survival Rates Vary by Country
    Most Cancer Survival Rates in USA Better Than Europe and Canada » Secondhand Smoke | A First Things Blog
    Cancer Survival - NYTimes.com

    Heart disease deaths statistics - countries compared worldwide - NationMaster

    You have to do some math on this one. Basically, strokes account for 25 of deaths in America, 7% in Canada, and I couldn't get the numbers for "Europe", which is how this site lumps them. My original claim came from a health book I have in storage, but this site shows the basics:
    Stroke Statistics | Internet Stroke Center

    ALWAYS control for population variance if you want to better understand the influence of the health system on outcomes:






    Here is what I wrote in another thread about breast cancer:



    Breast cancers are not all the same in how they develop. One key difference is found in Estrogen Receptors:


    Receptors for the female hormones estrogen and progesterone are another key personality feature of breast cancer.

    These receptors are the eyes and ears of the breast cells, getting messages sent by the hormones and figuring out what to do with these messages. The hormones will tell the receptors to stimulate or "turn on" breast cell growth. Estrogen and progesterone can increase both normal and abnormal breast cell growth.

    If a tumor is estrogen-receptor positive (ER-positive), it is more likely to grow in a high-estrogen environment. ER-negative tumors are usually not affected by the levels of estrogen and progesterone in your body. This is one time when hearing the word "positive" may really mean something good.

    As ER-positive cancers are more likely to respond to anti-estrogen therapies. If you have an ER-positive cancer, you may respond well to tamoxifen (Nolvadex), a drug that works by blocking the estrogen receptors on the breast tissue cells and slowing their estrogen-fuelled growth


    The question that needs to be asked is whether there is population variance seen for the distribution of ER+ and ER- breast cancers.


    Estrogen Receptor Breast Cancer Phenotypes in the Surveillance, Epidemiology, and End Results Database

    ERN was correlated with premenopausal disease, black race, and poor prognostic factor groups, whereas ERP was associated with postmenopausal disease, white race, and favorable tumor characteristics.


    Oh oh, there is population variance. Now the question shifts to "what does this mean?"



    Black women may be at increased risk for aggressive, difficult-to-treat triple-negative breast cancer, independent of their age and weight, researchers found.

    Tumors that did not express estrogen or progesterone receptors or HER2 were three times more common among black women than among white women (P=0.0001), Carol L. Rosenberg, M.D., of Boston University Medical Center, and colleagues reported online in Breast Cancer Research.

    The effect of race or ethnicity in the single center cohort did not vary with age and body mass index, suggesting that triple-negative disease "likely contributes to black women's unfavorable breast cancer prognosis," the researchers said.

    Black women in the U.S. have an overall lower risk of developing breast cancer overall than their white peers, but their cancers are diagnosed at a higher stage, with a greater risk of recurrence and worse prognosis.

    Prior studies have found a higher rate of triple-negative breast cancer in minorities including blacks. . . .

    Overall, 20% of the women had triple-negative tumors while 72% expressed estrogen, progesterone, or both types of receptors. Some 13% were HER2 positive.

    However, triple-negative breast cancer was not evenly distributed among racial and ethnic groups. Black women had a 30% rate of these aggressive tumors compared with just 11% to 13% in the other groups.

    In a multivariate regression analysis, triple-negative status was three times more likely among black than white women (95% confidence interval 1.6 to 5.4).


    So, when black women develop breast cancer they tend to develop a more aggressive type which is more difficult to treat and which results in higher rates of mortality. International comparisons on breast cancer treatment outcome don't account for this at all. What's happening with a US-Norway comparison on breast cancer treatment outcomes is not a comparison of the financing systems of the two countries, but a comparison of white Norwegian women being treated successfully for predominantly ER+ breast cancers and US women, who are a mix of white women suffering from ER+ breast cancer with a more successful treatment regime in place and black women who have higher rates of ER- breast cancers which are more aggressive and result in higher mortality, and the outcomes for both groups (I'm leaving out Asian, Hispanics, Natives, etc just to simplify the point here) are mashed together and we look at American outcomes and then we presume that the difference in mortality arises from how we structure our health care model.

    Breast cancer is just one example of how population variance skews international health comparison reports. Disease related population variance is seen for most diseases. This is why you need to control for population variance in these international comparisons, and that's not just for health reporting, you need to do it for things like poverty, for infant mortality, for educational outcomes, for crime, etc. Compare Norwegians to Norwegian Americans and you get a better understanding of how social programs, the focus of your study, are affecting outcomes. Don't do that and all you get is gibberish.

    Two graphs from the CDC on Breast Cancer incidence rates and mortality



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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by RiverDad View Post
    ALWAYS control for population variance if you want to better understand the influence of the health system on outcomes:






    Here is what I wrote in another thread about breast cancer:



    Breast cancers are not all the same in how they develop. One key difference is found in Estrogen Receptors:


    Receptors for the female hormones estrogen and progesterone are another key personality feature of breast cancer.

    These receptors are the eyes and ears of the breast cells, getting messages sent by the hormones and figuring out what to do with these messages. The hormones will tell the receptors to stimulate or "turn on" breast cell growth. Estrogen and progesterone can increase both normal and abnormal breast cell growth.

    If a tumor is estrogen-receptor positive (ER-positive), it is more likely to grow in a high-estrogen environment. ER-negative tumors are usually not affected by the levels of estrogen and progesterone in your body. This is one time when hearing the word "positive" may really mean something good.

    As ER-positive cancers are more likely to respond to anti-estrogen therapies. If you have an ER-positive cancer, you may respond well to tamoxifen (Nolvadex), a drug that works by blocking the estrogen receptors on the breast tissue cells and slowing their estrogen-fuelled growth


    The question that needs to be asked is whether there is population variance seen for the distribution of ER+ and ER- breast cancers.


    Estrogen Receptor Breast Cancer Phenotypes in the Surveillance, Epidemiology, and End Results Database

    ERN was correlated with premenopausal disease, black race, and poor prognostic factor groups, whereas ERP was associated with postmenopausal disease, white race, and favorable tumor characteristics.


    Oh oh, there is population variance. Now the question shifts to "what does this mean?"



    Black women may be at increased risk for aggressive, difficult-to-treat triple-negative breast cancer, independent of their age and weight, researchers found.

    Tumors that did not express estrogen or progesterone receptors or HER2 were three times more common among black women than among white women (P=0.0001), Carol L. Rosenberg, M.D., of Boston University Medical Center, and colleagues reported online in Breast Cancer Research.

    The effect of race or ethnicity in the single center cohort did not vary with age and body mass index, suggesting that triple-negative disease "likely contributes to black women's unfavorable breast cancer prognosis," the researchers said.

    Black women in the U.S. have an overall lower risk of developing breast cancer overall than their white peers, but their cancers are diagnosed at a higher stage, with a greater risk of recurrence and worse prognosis.

    Prior studies have found a higher rate of triple-negative breast cancer in minorities including blacks. . . .

    Overall, 20% of the women had triple-negative tumors while 72% expressed estrogen, progesterone, or both types of receptors. Some 13% were HER2 positive.

    However, triple-negative breast cancer was not evenly distributed among racial and ethnic groups. Black women had a 30% rate of these aggressive tumors compared with just 11% to 13% in the other groups.

    In a multivariate regression analysis, triple-negative status was three times more likely among black than white women (95% confidence interval 1.6 to 5.4).


    So, when black women develop breast cancer they tend to develop a more aggressive type which is more difficult to treat and which results in higher rates of mortality. International comparisons on breast cancer treatment outcome don't account for this at all. What's happening with a US-Norway comparison on breast cancer treatment outcomes is not a comparison of the financing systems of the two countries, but a comparison of white Norwegian women being treated successfully for predominantly ER+ breast cancers and US women, who are a mix of white women suffering from ER+ breast cancer with a more successful treatment regime in place and black women who have higher rates of ER- breast cancers which are more aggressive and result in higher mortality, and the outcomes for both groups (I'm leaving out Asian, Hispanics, Natives, etc just to simplify the point here) are mashed together and we look at American outcomes and then we presume that the difference in mortality arises from how we structure our health care model.

    Breast cancer is just one example of how population variance skews international health comparison reports. Disease related population variance is seen for most diseases. This is why you need to control for population variance in these international comparisons, and that's not just for health reporting, you need to do it for things like poverty, for infant mortality, for educational outcomes, for crime, etc. Compare Norwegians to Norwegian Americans and you get a better understanding of how social programs, the focus of your study, are affecting outcomes. Don't do that and all you get is gibberish.

    Two graphs from the CDC on Breast Cancer incidence rates and mortality


    I've defended you in the past, by why in the holy hell must you make EVERY SINGLE POINT about race? It is neither pertinent nor relevant to my point in any way.
    "Hmmm...Can't decide if I want to watch "Four Houses" or give myself an Icy Hot pee hole enema..." - Blake Shelton


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    Re: Should We Allow The Uninsured To Die?

    In the days before Medicare and Medicaid, the poor and elderly were admitted to hospitals at the same rate they are now, and received good care. Before those programs came into existence, every physician understood that he or she had a responsibility towards the less fortunate and free medical care was the norm. Hardly anyone is aware of this today, since it doesn’t fit into the typical, by the script story of government rescuing us from a predatory private sector.
    The above has to be the biggest load of bull**** I've ever seen. It's not surprising there isn't even a citation for it. It's simply untrue. 100 years ago if you had money, you had no healthcare. That's the way it has been for the overwhelming majority of modern medicine's existence. Want a source? All you have to do is ask me the name of the country in question and I'll find 10-20 books on the subject.
    Last edited by Hatuey; 09-14-11 at 05:45 PM.
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    Re: Should We Allow The Uninsured To Die?

    Quote Originally Posted by Hatuey View Post
    The above has to be the biggest load of bull**** I've ever seen.
    The Kerr-Mills program covered elder care before Medicare.
    Not sure why you'd call it bull when it existed.

    Ohh and a citation.

    Before 1965, federal assistance to the states for the provision of health care was provided through two grant programs. The first program was established in 1950 and provided federal matching funds for state payments to medical providers on behalf of individuals receiving public assistance payments. In 1960, the Kerr-Mills Act created a new program called "Medical Assistance for the Aged." This means-tested grant program provided federal funds to states that chose to cover the "medically needy" aged who were defined as elderly individuals with incomes above levels needed to qualify for public assistance but in need of assistance for medical expenses.
    http://www.policyalmanac.org/health/medicaid.shtml
    Last edited by Harry Guerrilla; 09-14-11 at 05:53 PM.
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    —Adam Shepard

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