[rollei_list] Re: OT: Health Care Costs
- From: Laurence Cuffe <cuffe@xxxxxxx>
- To: rollei_list@xxxxxxxxxxxxx
- Date: Mon, 22 Mar 2010 07:18:35 -0400
On Sunday, March 21, 2010, at 09:02PM, "Marc James Small"
<marcsmall@xxxxxxxxxxx> wrote:
>Uh, Larry? Why would you suggest that I have not
>seen the movie?
> Are you claiming some sort of
>ESP abilities?
No, and I note that you have avoided stating that you have seen the movie,
hence I conclude that you have not.
>And are you aware of the
>extensive criticism of the movie here in the US,
>poking huge holes in the "factual" basis of the
>flick?
I am aware of such criticism, I'm not aware of valid criticism which calls into
question the issues raised in it.
It is one large pack of lies, as Moore
>himself admitted when he was a guest on the Sean
>Hannity show on Fox News a month or six weeks
>back.
I was not aware of this, and cannot substantiate it.
When Hannity asked him about the "fact"
>content in SICKO, Moore cheerfully admitted that
>it was just political polemic and that the paid
>actors did a fine job at pretending to be "real"
>people. I can only accept Moore at his own word.
>
>My son and his wife had two kids before they had
>health care and paid the tab themselves out of
>their own pockets. He now insures the four of
>them for $150 a month, with no employer side (he
>is a construction foreman, and the insurance is
>through his union). My wife's insurance is $900
>a year and would go up by $500 for each
>additional person covered. She has a "cadillac
>plan", one of those which Obama is intending to
>tax out of existence. No, my wife, the nurse, is
>NOT in favor of Obamacare! Were I to add her to
>Tricare, her insurance would cost an additional
>$240 a year. If I had three kids, the cost would
>just go up by that amount -- for a married couple
>and three kids, the annual tab would run $1200 a
>year. But, as it is, her employer does pay
>about 95% of the cost or so, so she will stay on
>her plan and I on mine. If I went on her plan,
>the $500 would not have an employer-paid part.
>
>I spent 25 years as a slum attorney in
>Roanoke. Few of my clients had health-care
>coverage. When Hillarycare was at the fore, they
>would sign petitions to our Congressman in
>opposition -- they brought them by to ask ME to
>sign. Not a one of them wanted what they called "welfare".
>
I wasn't aware that we were discussing this here.
>The Mayo Clinic is located in one of the
>pronounced Medical Malpractice states in the
>Union, with extremely loose rules.
Pronounced by whom? and your point is exactly what?
> In most
>states, a claim that a doc had "consulted with
>colleagues" would probably not be admissible, as
>the legal standard is that of the "community" and
>not that of a group of other doctors. I do not
>have to worry about that: I am barred from suing
>the VA or the Army hospitals for even outrageous malpractice.
>
And this is fair just and equitable, or what other point were you making here?
>British doctors to practice in the US have to go
>back and attend four years of medical school and
>go through their entire internship and
>residency.
I'm from ireland and don't see the relevance of this. Its as if I criticized
the US system by referring to hospitals in Mexico city.
I do not know the history of this
>bizarre system -- a doctor from, say, Barbados is
>admitted on motion in every US system. However,
>a UK doctor can go to Canada, pay $CN 1,000 to
>join the Canadian Medical Association and to get
>admitted in Canada, and then will be able to go
>to the US and get admitted as a Canadian
>physician on motion. I know five or six UK docs
>who have done this. It is a bizarre system but
>the Canadian Medical Association lobbies actively
>to oppose chaning it, for obvious reasons!
Again, its interesting as a legal lacuna, but how is this relevant?
>
>The largest single lobbying group in Washington
>is the American Medical Association. They speak
>for only a quarter of US MD's, but spend about
>six times a year in lobbying costs as all unions
>combined, and around twenty times that spent by
>the National Rifle Association, the organization
>the Lame-Stream Media love to bash.
>
Again, what's the NRA funding doing in this discussion, as I am unaware of any
direct medical role they may play.
>Larry, you obviously spend a lot more time with
>your doctor than I do with mine. On average, I
>have three routine appointments per year,
>scheduled well in advance. Purely routine check-ups.
I have a young family, so we probably are involved in more pediatric related
visits than you are.
>
>Many US states do not allow nurse
>practitioners. In Virginia, they are not
>permitted to serve as gatekeepers though this is
>not the case in the VA. My primary care provider
>at the Salem VA was a Nurse Practitioner. She
>was excellent. I am not qutie so happy with my
>current PCP at the VA down here, though he is
>adequate. He just has the bedside manner of a dead Cherrystone clam.
>
It was just my impression from my encounters with the american medical system
that nurses had a larger role to play in routine care.
>You may be glad to know that Astra Zeneca know
>advertises that Symbicort is available for free
>for those who cannot afford to pay for it or
>whose insurance does not cover it.
I am aware of this. I wouldn't expect anything less of a European company
operating in the third world.
Every
>anecdote you tell makes it certain that you just
>chose the wrong years in which to live in
>Connecticut, the state which gave us Lieberman
>and Dodd, and enough said on that! (I lived in
>Connecticut from 1958 to 1960 and again from 1972
>to 1974. On the second occasion, my health care
>was through the Yale-New Haven Clinic, a benefit
>of my being a grad student at Yale. Yale-New
>Haven Clinic was the medical facility at play in
>GRISWOLD v CONNECTICUT, the case which
>established "penumbral rights" and which brought
>substantive due process back to life.)
>
>The cost of pharmaceuticals is distinct from the
>cost of medical care. Thanks to the failure of
>the UK to properly vet Thalidomide -- in those
>days, the US just accepted British approval of a
>drug --
Its probably worth checking your history on this. As I understand it the FDA
did not approve it at that time, and Frances Kathleen Oldham Kelsey received
the President's Award for Distinguished Federal Civilian Service for insisting
on further studies.
there were a number of birth-defect cases
>and, as a result, the US over-reacted by
>establishing a crippling series of regulatory
>requirements. In effect, drug companies have to
>invest five years in the development of new drugs
>BEFORE clinical trials can begin, and, of course,
>nine out of ten drugs do not pan out for one
>reason or the other. (For instance, a
>heart-disease specific proved a decade back to
>have no advantage over much older drugs such as
>amyl nitrite -- but it turned out to be a hell of
>a sex drug. It is Viagra.) Drug companies can
>make a huge return on a successful new drug, but
>there are damned few of these. And US patent
>laws are also a problem, as drugs can only be
>patented for eight years or so,
Or so being a period of 17 to 20 years.
meaning that the
>drug companies have to recoup huge overhead costs
>in a ridiculously short period of time.
>
Most of my published work relates to drug development, so I'm not totally
unfamiliar with the field.
>So, the pharmaceutical companies (you probably
>pronounce that "pharmakeutical" in the British
>fashion and not "pharmaseutical" in the US
>fashion!), are forced to charge a lot for the
>short time they can do so in the US before the
>drugs go generic. Many drugs available in the US
>are not marketed outside the US as foreign
>governments, notably the Canadian, put such huge
>price controls in effect that the companies would
>lose 50 cents for every dollar of sales, a sure
>road to bankruptcy.
No. Drug availability has a lot more to do with marketing and market
differentiation than crippling taxation or price controls. As I said my
inhalers in the USA contained half the number of doses, and Connecticare were
charged about twice the price. Wall-marts venture into the ethical drug market
highlights the fact that the markup on some drugs sold in the USA is
significant.
>Drug companies are not all
>that flush: as is the case with oil companies,
>they SEEM to make a lot of money but the return
>on investment is just not that great and many
>stockbrokers are not wild about investing in them.
>
>On another CAMERA note, Schering Drugs bought
>Voigtländer in 1925 when the last direct male
>heir died, leaving three daughters. Women were
>not then deemed capable of running a major
>company, so the firm was sold to Schering (with
>restrictions on the use of the name, which Cosina
>refuses to follow). Schering bought the firm to
>sell film and chemistry, and so there are a
>number of inexpensive Voigtländer cameras, such
>as my first, a Bessa from 1932. By 1951,
>Schering was bankrupt and was planning on
>shutting down Voigtländer. The Zeiss Trust,
>charged with preserving the German optical
>industry, stepped in to buy
>Voigtländer. Rolleiflex, of course, is an outgrowth of Voigtländer.
>
>In very general terms, genetics is not a matter
>of overall "health" but is a matter of resistance
>to diseases. Most folks are naturally resistant
>to sexually transmitted diseases such as syphilis
>and AIDS. There is a neat paper on this
>available from the Center for Disease
>Control. If such were not the case, there would
>have been no one at all alive in Europe or North
>America after 1700 ... My family's genes mean
>that I come from stock which appears resistant to
>cancer and Alzheimer's and, for that matter,
>asthma. My people rarely see doctors other than
>for routine check-ups. We are just naturally
>resistant to diseases and ailments which plague
>others. None of that means that I shall not die
>of a stroke while writing this missive, but it
>makes it pretty unlikely. I am not in really
>good "health", though I did lose 60 pounds three
>or four years back. I suffer from a torn
>rotation cuff and a bad knee and I do have
>chronic sinusitis, but that is about the
>limit. I have ok blood pressure and cholesterol
>and the like. I do not watch my diet and I drink
>and smoke. This is certainly not a "racist"
>argument. My father's family have not a drop of
>Irish blood in them until the last generation,
>and they do every bit as well as my mother's
>Irish stock. (One of my father's sisters married
>an Irishman: he died early, and three of their
>four kids and two of their grandkids are now
>dead, so make what you will of that! It is
>unique within the Small family.) I can go back
>seven generations, and none of my forebears died
>younger than 80. If that is racist, it is
>Scottish racism! Rather, I prefer to simply see
>it as a matter of choosing your ancestors wisely.
>
>There are several studies of Irish twins where
>one came to the US and the other remained behind
>in Ireland. The US twins tended to die earlier
>though living healthier lifestyles. The Irish
>twins all drank and smoked and ate a lot of beef
>and lived longer and died more peacefully. One
>study had to be ended in 1972 -- it started in
>1927 -- as not one of the 54 Irish twins had
>died, while all of the 54 US twins had
>expired. It has been suggested that the Irish
>live lives of lower stress than is the norm in the US.
I'd appreciate references for these, as they do sound intriguing.
Stress is an important factor and may be one reason for the consistently higher
cardiac mortality among former members of the american military, which persists
as a finding even after the propensity for binge drinking has been discounted.
>Beyond that, ich weisse ist nicht. You were the
>one who raised the issue that the Irish tend to
>live as long as do folks in the US. Was that a racist comment?
No, It was an observation that in terms of health care we seemed to be getting
better value for money. I wished to imply that universal health care did not
nescescarily mean that costs were going to go through the roof.
All the best
Larry
>
>Marc
>
>
>
>
>msmall@xxxxxxxxxxxx
>Cha robh bàs fir gun ghràs fir!
>
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