The Sucess of Socialized Medicine

[gojujay]

Originally Posted by jeff

Inq: there's a substantial pattern - too substantial to be ignored - that suggests that those countries with universal healthcare do better. Of course there are national differences, but there are substantial differences between those countries as well. It is at least a good working hypothesis that their policy works and is the differentiator between their results and ours. We should be open to learning from what is at first and second looks a more effective and lower cost system, rather than reject it out of dogmatism.

Dogmatism or idealism, you be the judge.

Originally Posted by jeff

As far as their rising costs: their numbers still are far lower than ours, and we have no proof that they will not level off at lower costs than we have. We can only deal with observed present and past spending. For Great Britain, I know it's deliberate policy change under Blair that is pumping money into NHS.

Still a cause for concern, to see their costs rising after a few generations. Reminds me of certain parallels to other socialistic trends...

[jeff]

Originally Posted by gojujay

Gimme a break it was late and I felt I had to answer. Kinda' like the suicide fleche.

You know I was teasing, right?

[jeff]

Originally Posted by gojujay

After a few hours sleep and some rumination on this issue, the profit to be made is not high enough to attract the requisite investment for SOME things. As such you will not have the innovation and energy that the market provides to a sector. Could be why some people see the public sector employees as people who couldn't make it in the "real" world of the market. Obviously I don't believe the medical trade to be a place where the market can't make enough profit for its' participants. Maybe this clears my position a little.

I think in our country, where there is such a strong tendency to disparage the government and ways to make much more money elsewhere, there is a tendency for motivated people to go elsewhere, but this isn't true everywhere. Yes, if your primary goal is to make money, then the government is not where you're going to go. However, I dispute the idea that it's where the less talented go. That, by the way, was the stereotype about Wall Street, until the 1960s. Believe It Or Not. It's really just stereotyping.

What is relevant isn't the talent pool (talented people go into medicine in Europe, so the effect you suggest doesn't actually happen) but that there are important things that can't be big money makers. Let's face it: there's not a lot of money to be made providing any service (medical, legal, etc) to poor or even middle class people for the obvious reason that they don't have a lot of money. No matter how important or valuable it is to them. That's why I said several days ago that there are important things that aren't profitable

[jeff]

Originally Posted by gojujay

Dogmatism or idealism, you be the judge.

I think that it's dogmatism if you refuse to even consider an alternative that very clearly operates at lower cost (especially for people who emphasize economics! ) and provides superior outcomes as well.

Originally Posted by gojujay

Still a cause for concern, to see their costs rising after a few generations. Reminds me of certain parallels to other socialistic trends...

So, maybe in a few generations, they'll be as expensive as we are now? That's hardly an argument against doing it their way!

[gojujay]

Originally Posted by gojujay

Gimme a break it was late and I felt I had to answer. Kinda' like the suicide fleche.

Speaking of suicide fleches, last practice I practiced jump, fletch at least 30 times with nary a problem. First bout I try it in, SNAP! It feels like someone just shot my calf muscle... and I go down and tell my coach, "I'm done." Next day at the doctor, I'm informed that I managed to tear some of the muscle. Not bad, mind you but bad enough to put me out of work for a week and a half (my job requires running), and, joy of joys, CRUTCHES!!! I go back in about a week. Did I mention that this is three days before a long planned trip on the train to visit my brother and his wife in Washington for a week? If I were a Demoncrat I'd say, "It's Bushes fault!!" If I were a Republicon, I'd say, "Clinton is responsible!!" I'm a Libertarian, I guess I've none to blame but myself.

I don't even want to hazard a guess as to how long I'll be out of fencing

[gojujay]

Originally Posted by jeff

I think in our country, where there is such a strong tendency to disparage the government and ways to make much more money elsewhere, there is a tendency for motivated people to go elsewhere, but this isn't true everywhere. Yes, if your primary goal is to make money, then the government is not where you're going to go. However, I dispute the idea that it's where the less talented go. That, by the way, was the stereotype about Wall Street, until the 1960s. Believe It Or Not. It's really just stereotyping.

I'm confusalated, the less talented went to Wall Street?

Originally Posted by jeff

Let's face it: there's not a lot of money to be made providing any service (medical, legal, etc) to poor or even middle class people for the obvious reason that they don't have a lot of money. No matter how important or valuable it is to them. That's why I said several days ago that there are important things that aren't profitable

I'm not sure how this fits, but this reminds me of a saying an old boss told me, "Sell to the rich, live with the masses; Sell to the masses, live with the rich."

[gojujay]

Originally Posted by jeff

So, maybe in a few generations, they'll be as expensive as we are now? That's hardly an argument against doing it their way!

Ah, but we have identified the problem, now. Many of them still don't realize there exists a problem. We at least have the option of fixing the problem. If we stop trying to take credit for fixing it, that is.

[jeff]

Originally Posted by gojujay

Speaking of suicide fleches, ... (snip)

Wow, what a bad break! I hope it's not too painful. Don't be crazy and fence on it till it's ready, huh?

[jeff]

Originally Posted by gojujay

I'm confusalated, the less talented went to Wall Street?

Strange but true. For decades, Wall Street was a sleepy, clubby place. The cliche was that it was where the not-too-bright son of a well-connected family would go to make a comfortable living after graduating with a gentleman's C from Yale or Princeton, and go get a job selling bonds or stocks. This has largely changed in the past few decades, yet there's still culture clash between the sharp guys on the trading floors, the quants, and IT guys on the one hand, and the country club types doing sales on the other.

Originally Posted by gojujay

I'm not sure how this fits, but this reminds me of a saying an old boss told me, "Sell to the rich, live with the masses; Sell to the masses, live with the rich."

Well yeah, if you can find a commodity product you can sell millions of units, with even a tiny markup you can become very rich (think: Henry Ford). But that hardly applies to custom, personal attention by skilled individuals on a one-to-one basis, like medical care.

[jeff]

Originally Posted by gojujay

Ah, but we have identified the problem, now. Many of them still don't realize there exists a problem. We at least have the option of fixing the problem. If we stop trying to take credit for fixing it, that is.

Huh? We have? You're saying that we're more successful at identifying and controlling the root causes of cost in healthcare than the countries with universal healthcare? That's the opposite of the truth. There is no basis for saying that other countries don't realise there's a problem with healthcare, when they have coherent government policies that provide universal coverage at lower cost than the partial coverage provided here.

[Robert Smith]

Geting back to the original quoted article, go see

http://www.economist.com/World/afric...ory_id=1280587

for a more detailed write up. It's not so much in how much money is spent on health care in this case, as in identifying needs at a regional level and applying what funds there are in a fashion appropriate to those needs - less waste, better identification of where money should be spent, and more localized administration. The way it reads, the offer of money was conditional on it being spent appropriately, and this condition is being met, in spades. Pretty amazing bang:buck ratio.

[Amadeus]

Originally Posted by jBirch

The current definition is that Universal Health Care means that all emergency and routine maintenance is provided for every citizen. Supplementary health services, such as premier nutrition, massage, cosmetic and holistic health are not included in "Universal Health Care".

Easier said than done, i think. I was reading a book by andrew wilde (sp?) about health recently, and he mentioned that you can get your health insurance to pay for massages if you get your doctor to presribe them.

In other words, i think that such a system is unrealistic in the US today.

[gojujay]

Originally Posted by jeff

Strange but true. For decades, Wall Street was a sleepy, clubby place. The cliche was that it was where the not-too-bright son of a well-connected family would go to make a comfortable living after graduating with a gentleman's C from Yale or Princeton, and go get a job selling bonds or stocks. This has largely changed in the past few decades, yet there's still culture clash between the sharp guys on the trading floors, the quants, and IT guys on the one hand, and the country club types doing sales on the other.

Goes hand in hand with the Keynesian view of government. That's where the bright decisions were made. Trust me I'm from the government, govt. agents widely viewed as experts in their field. Vietnam changed a lot of perceptions didn't it?

[gojujay]

Originally Posted by jeff

Huh? We have? You're saying that we're more successful at identifying and controlling the root causes of cost in healthcare than the countries with universal healthcare? That's the opposite of the truth. There is no basis for saying that other countries don't realise there's a problem with healthcare, when they have coherent government policies that provide universal coverage at lower cost than the partial coverage provided here.

Identifying, not controlling. And how many decades did Europe follow controlled markets blindly marching into the economic morass they have now?

[jeff]

Originally Posted by gojujay

Goes hand in hand with the Keynesian view of government. That's where the bright decisions were made. Trust me I'm from the government, govt. agents widely viewed as experts in their field. Vietnam changed a lot of perceptions didn't it?

I do not understand how the transformation of Wall Street from a preppy, wealthy, but dull
good old boys club can be attributed to Keynesian views of government, or the aftermath of Vietnam. Care to elaborate?

What it actually had to do with was increased meritocracy and need for analytics, brought on by the technology changes from the 1970s and from dropping fixed rate commissions. A few law-suits too, of course.

[jeff]

Originally Posted by gojujay

Identifying, not controlling. And how many decades did Europe follow controlled markets blindly marching into the economic morass they have now?

Whoa... it's obvious that the Europeans (by which I mean shorthand for "all the 1st world nations except us") have done a superior job of identifying the causes of high cost in health care. And, it's we who have the economic morass for healthcare, not us. Remember: we are the ones who pay more while covering less, and have an inefficient overhead-full system, not them.

[gojujay]

Originally Posted by jeff

I do not understand how the transformation of Wall Street from a preppy, wealthy, but dull
good old boys club can be attributed to Keynesian views of government, or the aftermath of Vietnam. Care to elaborate?

After WWII, there was great faith in the ability of governments to "get things done". Government officials were seen to be above the pursuit of personal wealth (perception, not reality). Keynesian, command economies were able to quickly rebuild a war-torn Europe. A regulated form of capitalism even took hold in the U.S. Where Europe did it with nationalization, the U.S. used regulation to accomplish a managed growth. Along comes Vietnam, and the veneer comes off. Government cannot be trusted, ergo government agencies and employees are denigrated as incompetents. People who work for the government must not be the best and brightest bulbs. Where to go? Why not Wall Street?

Originally Posted by jeff

What it actually had to do with was increased meritocracy and need for analytics, brought on by the technology changes from the 1970s and from dropping fixed rate commissions. A few law-suits too, of course.

Synergistic effect. Many things coming together at the same time. Without the change in the Zeitgeist, the change would not have been so profound.

[gojujay]

Originally Posted by jeff

Whoa... it's obvious that the Europeans (by which I mean shorthand for "all the 1st world nations except us") have done a superior job of identifying the causes of high cost in health care. And, it's we who have the economic morass for healthcare, not us. Remember: we are the ones who pay more while covering less, and have an inefficient overhead-full system, not them.

What are the high costs in healthcare? Is it the healthcare worker? In other industries, the biggest expense is labor. Is the healthcare field different? I'll try and find some wage data for the various European countries as opposed to the U.S. Thanks, Jeff. You've just given me homework. Like I don't have enough to do already.

[jeff]

Originally Posted by gojujay

After WWII... (snip) ... Where to go? Why not Wall Street? (more snipped, too)

Interesting theory, that Wall Street became a destination for brainpower because the government stopped being the place to go, but it's not consistent with widely observed and noted changes in the market and how candidates were selected. Wall Street used to be very clubby, and "outsiders", no matter how smart, were not valued the way you would expect today. Post-Vietnam disillusionment with government had nothing to do with it (and the timing was wrong for it to have been a factor). The real story is that the market became a dramatically more active way to make or lose money than it had in the sleepy earlier days, so there was a much bigger premium on brain power. Cute theory, with Keynes and all, but not what happened.