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Thread: To those against Obamacare -

  1. #61
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    Re: To those against Obamacare -

    Quote Originally Posted by whysoserious View Post
    No, I don't think there is any evidence of that. Those places operate on a triage basis, just as our hospitals do. Also, as in many countries that operate with UHC, you can still buy privatized insurance. So hell, if you want to make sure you are getting A1 care and you can afford it, go ahead. No one is stopping you. But this idea that we're all going to get horrible care is unfounded and has no basis - in fact
    GAO: Children on Medicaid have worse Physician Access than Children with no Insurance whatsoever


    A 2010 study of 1,231 patients with cancer of the throat, published in the medical journal Cancer, found that Medicaid patients and people lacking any health insurance were both 50% more likely to die when compared with privately insured patients—even after adjusting for factors that influence cancer outcomes. Medicaid patients were 80% more likely than those with private insurance to have tumors that spread to at least one lymph node. Recent studies show similar outcomes for breast and colon cancer...

    A 2010 study of 893,658 major surgical operations performed between 2003 to 2007, published in the Annals of Surgery, found that being on Medicaid was associated with the longest length of stay, the most total hospital costs, and the highest risk of death. Medicaid patients were almost twice as likely to die in the hospital than those with private insurance. By comparison, uninsured patients were about 25% less likely than those with Medicaid to have an "in-hospital death."..

    A 2011 study of 13,573 patients, published in the American Journal of Cardiology, found that people with Medicaid who underwent coronary angioplasty (a procedure to open clogged heart arteries) were 59% more likely to have "major adverse cardiac events," such as strokes and heart attacks, compared with privately insured patients. Medicaid patients were also more than twice as likely to have a major, subsequent heart attack after angioplasty as were patients who didn't have any health insurance at all...

    A 2011 study of 11,385 patients undergoing lung transplants for pulmonary diseases, published in the Journal of Heart and Lung Transplantation, found that Medicaid patients were 8.1% less likely to survive 10 years after the surgery than their privately insured and uninsured counterparts. Medicaid insurance status was a significant, independent predictor of death after three years—even after controlling for other clinical factors that could increase someone's risk of poor outcomes.

    In all of these studies, the researchers controlled for the socioeconomic and cultural factors that can negatively influence the health of poorer patients on Medicaid...


    these countries have higher life expectancies than we do
    yes. until, of course, you start actually doing apples to apples comparisons, in which case not so much.

    And again, none of this even has to do with cost or law of large numbers. There is literally no arguing that law of large numbers reduces uncertainty, which makes something like health care cheaper. That is what is called a fact.

    Ohhh, ok, so the only reason it appears to be cheaper is because they are doing the comparison wrong, at least according to LaMidRighter. Whatever. Ok ok, let me change the phrasing so it is easier for you to understand:

    Fact: The more people insured, the cheaper the insurance because of less uncertainty.
    really. so if I took a pool of 100,000 average Americans, and added in 50,000 smokers, many of whom were obese, and half of whom were on drugs, the price of insurance would go down due to the fact that 150,000 people were now "in the pool"?

    I think you are assuming "uncertainty" only travels in one direction.

  2. #62
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    Re: To those against Obamacare -

    Quote Originally Posted by Boo Radley View Post
    The difference in speed isn't all that different. We wait quite a bit here. This has been linked many times showing that the difference is minimal. Also, it depends on which particular type of system we're talking about. They are not all the same. There are many types. And even if you pick one, say a single payer system, there are several different single payer systems.

    And here, we would ahve different teirs. At a minimum, it would be two tiered.

    Of course to examine these, we would have to have an honest discussion. And this topic has not lent itself to honest discussions.
    Ya, and they are all B.S. We only have a handful of cities (11) with wait times over 2 weeks. Canada, on the other hand, has an average wait time of 18 weeks.

    Wait times to see doctor are getting longer - USATODAY.com
    Doctors' group reports 'spotty progress' in easing patient wait times - Canada - CBC News
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  3. #63
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    Re: To those against Obamacare -

    here's a question. if the theory is that by putting everyone in the same program we can reduce the growth of costs, is that what we are seeing with Medicare? or are costs growing by leaps and bounds?

  4. #64
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    Re: To those against Obamacare -

    [QUOTE]
    Quote Originally Posted by whysoserious View Post
    Yeah, and you're talking to a student of actuarial science. I have the life tables in the same room as me right now. Those risks you are talking about exist no matter what - you just want to shove them in a dark corner and forget about them. But that doesn't mean we don't pay for them, and by trying to ignore the problem we actually make it more expensive. Guess what? High risk candidates still go to the hospital. Guess what? High risk candidates still have surgery. Guess what? High risk candidates take medication. They just don't pay for them.
    Actuarial science is cool, not for everyone to be sure and you guys impress the hell out of me with the accuracy, especially morbidity predicitions. Here is the kicker, yes the risk exists no matter what and that is undeniable fact, the difference is that when all risk is included in the same economic table it skews towards the risk averse end. The idea that many companies have is to split off the risk into different coverage models and adjust prices accordingly. However you cannot do that in a tax subsidized system as the models simply provide a universal coverage, this means the most critical care falls under arbitrary numbers tabulations which can be less beneficial to those in the most need.

    The other problem is that rationing is has no appeals process, in other words if surgery quota is filled and you are in need at that point you are screwed, with insurance company models or even a first party payor system the monetary decisions are on an individual basis, i.e., not every company has to fulfill every surgery so it is easier to make the payments in smaller bites, thus the system allows for more costs to be absorbed rather than a collective pool having to absorb the sum total of all surgeries or procedures. The reason we spend more as a collective figure is because more services and better technologies are provided faster. I will also tell you that in my years I have seen some competitive high risk policies for individuals that looked pretty good, the biggest "problem" with high risk is that people tend to give up on being accepted for coverage, in a competitive market there are options.

    All UHC does is take the risk, shine a light on it, and use law of large numbers to minimize overall exposure. You can hide it all day if you want, but unless you want to start turning people away from hospitals, those "high-risk candidates" are going to **** you either way.
    Well, it does more than that. If anything UHC consolidates sum total cost to the taxpayers which causes grievous expense rather than individual companies or payers taking smaller bites of the total cost. What happens is that UHC doesn't "hide" the risk any more or less than a decentralized system but rather it prolonges problems until they matasticize into something worse and treats symptoms rather than problems which is the path of least expense, so yes, both systems show the risk but UHC actually hides the problems of cost and provides less advanced treatment. Let's not forget that end of life discussions are mandated in this latest D.C. turkey rather than treatment options.
    Last edited by LaMidRighter; 12-01-11 at 02:32 PM.
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    Re: To those against Obamacare -

    Quote Originally Posted by Boo Radley View Post
    Not likely. The slippery slope is often called a fallacy for a reason. You would have to show that you not eating your weaties harms soeone else. We can show that with lack of insurance. You don't have it, get hurt, treated and the cost is passed on to all of us. We pay for you. This is a fact.
    Choosing not to carry insurance doesn't hurt other people. The government forcing institutions to provide goods and services to people who cannot afford it is what passes on the costs to those who already pay. The problem isn't a lack of insurance, it's a lack of accountability. What Obamacare does is blame the shifting of healthcare costs onto others for a program that shifts the cost of healthcare onto others.

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    Re: To those against Obamacare -

    Quote Originally Posted by cpwill View Post
    here's a question. if the theory is that by putting everyone in the same program we can reduce the growth of costs, is that what we are seeing with Medicare? or are costs growing by leaps and bounds?
    A cursory glance at public education can answer this question for you. One-size-fits-all government solutions decrease quality and increase costs. That's just the way intervention in the marketplace works whether we're talking about health care, education or what-have-you.

  7. #67
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    Re: To those against Obamacare -

    Quote Originally Posted by Blackstone View Post
    Choosing not to carry insurance doesn't hurt other people. The government forcing institutions to provide goods and services to people who cannot afford it is what passes on the costs to those who already pay. The problem isn't a lack of insurance, it's a lack of accountability. What Obamacare does is blame the shifting of healthcare costs onto others for a program that shifts the cost of healthcare onto others.
    They go hand in hand. We the people pushed for the law that people be cared for. There was a time when that was the law. People died and suffered. We must remember history if we're going to tackle these problems.

    And others pay for this before reform. It is important to realize this.

    As for accountability, having insurance is being accountable. It is about personal responsibility. If you are running around without insurance and don't have the ability to pay, you are the definition of irresponsibility.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

  8. #68
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    Re: To those against Obamacare -

    Quote Originally Posted by ksu_aviator View Post
    Ya, and they are all B.S. We only have a handful of cities (11) with wait times over 2 weeks. Canada, on the other hand, has an average wait time of 18 weeks.

    Wait times to see doctor are getting longer - USATODAY.com
    Doctors' group reports 'spotty progress' in easing patient wait times - Canada - CBC News
    Yeah, we could do dueling sources:

    * Canada had the highest percentage of patients (36%) who had to wait six days or more for an appointment with a doctor, but the United States had the second highest percentage (23%) who reported that they had to wait at least this long. New Zealand, Australia, Germany, and the U.K. all had substantially smaller numbers of people reporting waits of 6 days or longer. Canada and the United States, in that order, also had the lowest percentage of persons who said they could get an appointment with a doctor the same or next day.

    * The United States had the largest percentage of persons (61%) who said that getting care on nights, weekends, or holidays, without going to the emergency room, was “very” or “somewhat” difficult. In Canada, it was 54%, and in the U.K, 38%. Germany did the best, with only 22% saying that it was difficult to get after-hours care.

    Wait Times For Medical Care: How The US Actually Measures Up - Better Health

    Footnote: In the ad, Dr. Day correctly refers to a 2005 Canadian Supreme Court case, Chaoulli v. Quebec, in which the court found that "delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care." The United States also has preventable health-care-related deaths, though not necessarily from delays. A Commonwealth Fund study found the U.S. leading 19 industrialized countries in the number of deaths that could have been prevented by better health care – 110 deaths per 100,000 people, versus 103 in the U.K. and 77 in Canada. For more on U.S. versus Canadian health care speed and quality, see our Ask FactCheck on the subject.

    FactCheck.org : Government-Run Health Care?

    But you complwetely missed part of my post.. Let me repeat:

    Quote Originally Posted by Boo
    Also, it depends on which particular type of system we're talking about. They are not all the same. There are many types. And even if you pick one, say a single payer system, there are several different single payer systems.

    And here, we would ahve different teirs. At a minimum, it would be two tiered.

    Of course to examine these, we would have to have an honest discussion. And this topic has not lent itself to honest discussions.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

  9. #69
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    Re: To those against Obamacare -

    Quote Originally Posted by cpwill View Post
    here's a question. if the theory is that by putting everyone in the same program we can reduce the growth of costs, is that what we are seeing with Medicare? or are costs growing by leaps and bounds?
    No it isn't. Everyone isn't in the same program. Only those most likely to need care. This is a significant difference. Also, no one is proposing we put everyone in the same program. Mostly we're talking about a two teired single payer system in which basic needs and adequated care is covered by a government insurance policy. You are free to pay for more, either more care or more inusance. I think not understanding this leads to a lot of misinformation being posted.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

  10. #70
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    Re: To those against Obamacare -

    Quote Originally Posted by cpwill View Post
    In all of these studies, the researchers controlled for the socioeconomic and cultural factors that can negatively influence the health of poorer patients on Medicaid...
    Yes, that's horrible, but I know you aren't suggesting that UHC is comparable to Medicaid, right? Mr. Gottlieb summed up each study, but he didn't post the researchers findings or conclusions. For instance, can we assume that a big reason why there was an 80% greater chance for the spreading of cancer was because those with Medicaid caught the symptoms much later? Can we assume they did not receive good treatment because doctors are paid next to nothing for Medicaid treatment?

    You do realize that comparing Medicaid to UHC in general is a faux pas, right?

    Quote Originally Posted by cpwill View Post
    yes. until, of course, you start actually doing apples to apples comparisons, in which case not so much.
    You mean apples to apples like how you just unfairly compared medicaid to medicare? In the end, if the birthing rate and life expectancy in those countries is as good and better than ours, obviously they must be received decent health care, yes?

    Quote Originally Posted by cpwill View Post
    really. so if I took a pool of 100,000 average Americans, and added in 50,000 smokers, many of whom were obese, and half of whom were on drugs, the price of insurance would go down due to the fact that 150,000 people were now "in the pool"?

    I think you are assuming "uncertainty" only travels in one direction.
    You mean risk? Exposure is better if you are aware of it. That's why law of large numbers is so crucial in these calculations. First of all, let's be clear that those 50,000 Americans are going to get treatment. It may not be good treatment, it may not be for long, but they will receive treatment and it will be expensive. Those people will have paid $0 into the system as well. Also, since they are not part of any insurance plan and do not visit any sort of medical establishment on regular basis, they are not accounted for. No one is aware that they smoke or do drugs, that they may or may not have this disease, or really any thing about them. That's difficult to budget for and significantly raises uncertainty. I think were people get confused is that they assume these people are not going to get treatment. You're still paying for them! So here are your options:

    1) Every American can get treatment, regardless of payment, except some will have to wait until zero hour and suffering great symptoms before treatment is begun.
    2) Every American can get treatment, and all have access to family practitioners who can identify negative trends, spot early warning signs, and practice prevention rather than treatment if possible.

    I choose #2, because I think it will be beneficial to the general will of Americans, because I do think it will be cheaper per capita, and I think the ability for every man, woman and child to see a general practitioner on a regular basis is a good thing.
    Last edited by whysoserious; 12-01-11 at 07:58 PM.
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