The great Health Care debate!
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by Selkie » March 18th, 2009, 6:32 am
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I come and go as I please--it's a free country.  Thanks Selkie, Ebree, and Swimmer-thanks for clearing up my use of the term "immortality." haha Getcha some glasses--doh!  Bu-Bye for now!!
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I would like to point that I don''t feel the need to personally attack individual posters for their views, but if you do, then perhaps you have some insecurity issues that you need to address. If I don''t agree with someone, I engage in intellectual debate without resorting to personal attacks, but it seems that some posters here on PS are not mature enough (or don''t have arguments strong enough) to be able to keep the conversation purely intellectual. The reason that I posted the statistics on obesity and smoking is because a lot of the same people that are clamoring for free health care are not willing to take basic, common sense actions to protect their own health - like don''t be fat, and don''t smoke, which cause most of the health problems (and health care expenses) in the US today. Of course those people also get some diseases that aren''t caused by their bad habits, but mostly we end up paying for their choices to be fat and to smoke (type II diabetes, heart disease, lung cancer). And I''m not going to apologize for my husband being successful. He actually started out as an electrician who educated himself to work his way to the top. He works 14 hour days, and worked incredibly hard to earn his MBA, so I think that he deserves everything that he has earned. It''s people like us who work hard, pay our mortgage and live within our means that are keeping the economy afloat right now. But I guess maybe you would have more respect for us if we were part of the irresponsible hordes who maxed out our credit cards and took out subprime mortgages causing the foreclosure debacle. |
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I actually didn't notice much resistance to CAFTA when Bush decided to pass it, which is ironic, because the Bracero program of the 40's was pretty unpopular by the time it was dismantled... And notice, I said nothing about illegal doctors, so illegal workers are not really germane to the conversation. But I digress... Funny that irony of my commentary was lost on you.And the only eyeroll that I inserted was a copy and paste from your original comment. I won't copy those, since you don't seem to do well with mirrors.  The point is, we can come up with creative homegrown solutions, which MAY include pay reductions, or we can treat health care like any other industry and import and outsource our way out of our problems. I'm sure it is only a matter of time before we are teleconferencing in Dr's into patient rooms for consultations, while a nurse or PA does the exam, and then space/time/distance will be a very low barrier. And PA's are already competition for GP's and GNP's. The point is that the system needs to change, and histrionics about debt and long hours and years of training do not move the conversation forward. If you checked the links that I included, they discussed options for doctors to go to school for free, or have their debt paid off through service obligations. That is certainly one thing to consider, whether we move towards national health care or not. I was offering solutions, rather than eyerolls and complaints. Sorry that that was lost on you. |
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Coati, I just wanted to highlight your offensive posts and let you know that I reported you to the moderator because you are violating forum rules with these personal attacks. Here are the rules for the ATW threads as described by Ali: Example of inappropriate exchange: 1st post- "I think Sarah Palin should wear new glasses every day because it makes her look resourceful" 2nd post- "You must be the most wasteful person on the planet. Do you leave your water running while you brush your teeth too?" While the second post is an opinion, it is an opinion of the person making the statement, not an opinion of the issue. We want to make sure that everyone sticks to facts or opinions on the ISSUES not of each other. |
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Are you serious??? You really believe being fat is a choice? |
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For most people, yes, I do. In 1962, research statistics showed that the percentage of obesity in America’s population was at 13%. By 1980 it has risen to 15% -- by 1994 to 23% -- and by the year 2000 the obesity progression in America had reached an unprecedented 31%. http://www.americansportsdata.com/obesityresearch.asp Did Americans somehow genetically evolve to become obese over the last 40 years? How else do you explain the tripling of the overweight and obese population except for lifestyle choices? |
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Vesper I am glad you and your husband are now Atlas and holding up the world/US economy. There are plenty of other people working long hours, being responsible, and THEY DON'T HAVE INSURANCE! Just because you ended up in the lucky 80% doesn't mean that the other 20% are worthless individuals. Further, Obesity is the largest public health problem in the world, maybe second to AIDS (not sure), but preventative medicine and mass education would save us a LOT of money in the long run. Pretty much ANY procedure you have is far more risky if you are obese, the recovery time is much higher, as is the chance of complication. Other countries that have universal coverage have far less of a problem with this than we do, probably for a reason, but if we had universal coverage, I would bank on a LOT more emphasis on preventative medicine. Information is power, and access to information is the first step. People can't make better lifestyle choices if they don't know how. And it might seem like commonsense to you, but clearly it is not for everyone, just like taking care of a kid is not commonsense to everyone. |
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Wow, again with the sarcastic personal attacks. Is anyone on PS capable of having an intellectual debate without resorting to juvenile personal attacks? I think that the reason some other countries don''t have the same issues with obesity may be lifestyle reasons - people walk or bike more than we do, and they prepare their own foods and don''t eat the junk foods that Americans do wiith the frequency that we do. And I really don''t believe that there''s anyone left in this country that doesn''t know that if you eat less and exercise more, you''re going to lose weight. For the most part, people just don''t want to do it. |
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Nah..let''s absolve everyone of responsibility for their own weight and the self control to put the fork down. While I know it''s difficult to loose after a certain point and no one "wants" to be obese, no person who gets to that point would ever tell you they''ve been force fed. If it''s not a personal choice to eat the food that puts the weight on in the first place, then how come some make the choice to loose it..and do.? I realize that for some there are physical issues that prohibit even moderate exercise and meds that can add weight. But that''s not what we are talking about here. You can choose to continue eating too much, or you can choose not to. Eating too much is not a disease or a mental illness. It''s usually just a case of gluttony. |
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For some, this is true, but not all. And when you say 'prepare their own fresh foods,' you do realize that fresh foods cost more and take more time to prepare than the greasy, bad-for-you stuff. For families that work 'round the clock to support their families, this is often their only choice or at least the more attractive one. Smart? No, but when you've got a single mother working two jobs, she may not have the time or the money to grill up a lean burger and cut fresh veggies to top it. The 'absolutes' in this thread are starting to get old. The poor are lazy, the obese are lazy, and they're the ones draining the system. Sorry, but it just isn't that black and white. |
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I apologize if you felt that that was a personal attack, or if you felt that my response was juvenile. In my estimation, an intellectual debate is one that moves a conversation forward, which is what many of us consistently have been trying to do. Your responses have primarily consisted of saying (paraphrase) "that you and your husband work hard and other people do not, therefore they don't (in some way) deserve what you have." I suppose that is frustrating for some. I also don't consider it intellectual debate. You say that diet and exercise are important for health, how would universal health care hurt our ability to address these issues? |
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I feel very badly for people who are really heavy. And I can sympathize with their struggles. I will not however absolve them of the responsibility for getting themselves in the situation to begin with. (And I said in my last post, this excludes those who have real physical or medical issues that caused the gain). I''d be willing to bet that if you got someone to be brutally honest about their weight, they''d tell you the same thing. That they made bad choices. I didn''t hear Oprah blaming anyone else for her weight issue when she talked about it recently. And I didn''t hear her say it was beyond her control to fix it. |
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There are actually a lot of interesting studies on genetic causes of obesity. Though usually its phrased more as a ''genetic predisposition'' meaning that environmental factors are also important in triggering the genetic predisposition. There is a strong genetic compenent to obesity - and the increase in obesity in recent times is not sufficient to ''prove'' that there is no genetic component. Environmental factors that contribute to obesity might not be things under the conscious control of people that end up obese or overweight. They might result from the change in foods available, the change in portion sizes in a restaurant, the change in typical amount of physical activity in the job of an average worker, the decrease in the amount of recess and outdoor play in the average schoolchild''s day, the change in air quality (!) or changes in the relative pricing of certain foods. For example, if you are trying to feed a family on a very limited budget, calories per dollar makes fast-food a pretty attractive option. Sure, you can argue that people can ''choose'' to exercise on their spare time, but its an environmental change that some people don''t get more exercise as part of their 9-5 day. People can ''choose'' not to watch TV or play videogames, but there was no need to make that choice 100 years ago. They might have had the same genes but those genes were in a different environment and so they had a different obesity level. And in terms of obesity being a ''choice'' or ''smoking'' being a choice, they can both be darn difficult ''choices'' to stop. One study on obesity found that when you put obese people on a strict diet in a controlled environment and force them to lose weight, and then restrict them to a maintenance diet to maintain healthy weight, these people actually feel like they are starving. They experience the same sensations and chemical signals as normal weight people subject to starvation. Their metabolism slows down dramatically like people conserving calories because their environment is not providing them. So whether or not obese people can ''choose'' to lose weight, its not as simple as just choosing to wear a green sweater one day and not a red sweater. It actually involves overriding the signaling mechanisms your body has developed through our evolutionary history - one in which continuous times of plenty were rare. Starvation was much more common, and some people have genes that emphasize survival in a starvation environment over maintaining a healthy, slim weight in times of plenty. If you have any doubt, read about some people that choose gastric bypass. Sure, some people do it as the easy way to lose weight, but many others have tried and tried and tried for years to loose weight and they consider the surgery fairly risky. But they weigh the risks of staying obese, and find in favor of the surgery. |
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My responsibility to other Americans (and humans generally) is to help in the ways that I can, and withhold judgment. Whatever personal issue that someone is dealing with in regards to their weight is not for me to know or judge. If a girl is raped when she is 10, then subconsciously turns to food to gain weight to be less attractive and therefore less vulnerable to the attention of men, that is not for me to know or judge, but she deserves access to health care regardless. And if she is still obese when she is 25, that is not my business either. She still deserves health care. People are so very complex, it is ridiculous and impossible to come up with every plausible scenario for a person and evaluate it "good or bad". However, it is amazing how radically people can change their lives when they are healthy and given the care that they need. |
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Vesper I am glad you and your husband are now Atlas and holding up the world/US economy. The above statement is proof positive that you have no interest in "intellectual debate". If you want to argue about that, at least be honest about it. |
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I know someone that got a gastric bypass. She was 400lbs. She lost 150lb and is now a svelte 250! She has very little capacity to eat, and she is plateaued out at 250, which is not small by any means. |
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BB, A.) Wasn't talking to you B.) Already apologized for that. Scroll up. C.) I wasn't the one saying "intellectual debate" this and that. I was responding to her charges of anti-intellectualism. D.) And my comment proves one thing, that sometimes debates get frustrating. 7+ pages of intelligent posts by myself and other posters are not nearly negated by one sentence, but nice try. As you were children! Hopefully someone will say something that pertains to Health Care...
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The World Health Organization's ranking
of the world's health systems. 1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland 21 Belgium 22 Colombia 23 Sweden 24 Cyprus 25 Germany 26 Saudi Arabia 27 United Arab Emirates 28 Israel 29 Morocco 30 Canada 31 Finland 32 Australia 33 Chile 34 Denmark 35 Dominica 36 Costa Rica 37 United States of America 38 Slovenia 39 Cuba 40 Brunei 41 New Zealand 42 Bahrain 43 Croatia 44 Qatar 45 Kuwait 46 Barbados 47 Thailand 48 Czech Republic 49 Malaysia 50 Poland Suddenly American exceptionalism doesn't seem that exceptional...  Other interesting links http://www.photius.com/rankings/world_health_performance_ranks.html life expectancy by country |
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Hear, hear! |
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What is the difference between eyerolls  and passive aggression?I guess together we are the pot and the kettle. For the last time, I believe that we need change, but I do not think that modeling the Canadian system will work for us. I don''t believe your suggestions will work either, but THIS just might. But then again, I was routing for Ron Paul... |
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Thank you for offering a solution that you think is worthwhile. Reading...  ETA: The idea of negative outcome insurance is interesting and novel. I also like the idea of inspecting and disentangling superfluous laws and regulations so that we have better transparency about the medical system. My dad has worked for and helped manage several HMO's and they can be quite odious. He has walked away twice from disgust at their practices (he is an amazing and principled Dr.!  ) I still have questions about what Mr. Paul considers "low cost and affordable". I also still have some issue with the idea of Medicine and health care being a for-profit business. Medicine does not strike me as the appropriate place for social or economic darwinism... Thanks for the link! |
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Just an issue I wanted to raise. I learned about this in medical school and was shocked by this comment. But this is how some people think about things, and some of these people are in charge of our health care (government and private).
I have always been about preventive medicine. I am a very strong believer in preventive medicine, because I want people to have a good quality of life. We had a lecture in my second year of medical school about preventive medicine. The speaker made a statement that went something like this. "Prevention does not save money, in fact is is more expensive. Prevention saves lives." What he was saying that if you have a preventive approach, keep people healthy, treat their high cholesterol so they don''t get heart disease ect, they live longer. But eventually they will get something that could not be prevented, so they will need treatment for that. So now you have them costing money in both the costs put forward to prevent treatable illness, and than after they have lived a longer life than the guy who had no preventive services, they still need money to treat the disease that ends up talking their life. I didn''t want to believe this at first, but my mother sadly is a case in point. She exercised, she ate well, she did not drink a lot, she quit smoking in her mid 20''s. And she got stage 4 breast CA that required 3 years of aggressive chemo, surgery, before she passed. Nobody (including medicare or Medicade) pays much in the way of preventive services for lifestyle changes. And the thing is, you have go get the whole family on board for a lifestyle change to work. The doctor works with the individual. We are very good at immunizations and other forms of prevention (in SD, a family with no access to care can get free immunizations, no questions asked. These parents come right on schedule as if it were a well visit). But that is easier than a lifestyle change. I am saying this, because it is not in the payer''s best interest to prevent disease from a finical standpoint. I believe that prevention is much more effective than the treatments we have, but getting someone to pay me to take the time talk about diet changes isn''t someone anyone is interested in doing. My point is that if you want to make the argument about preventive services saving money, it is not a good one, as it is not entirely accurate. But it is morally and ethically the right thing to do and we need the time and resources to do it. |
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First of all, the heritability of the body mass index (BMI) is 82% in our study sample. This means 82% of body mass variability is explained by the genetic effects. Aside from the genetic predisposition, other risk factors for obesity include stress, central and peripheral actions of hormones, gene-environment interaction, depression, and social-economic status to just name a few. And yes, even the “self-control” you and BB focus so much on, is under the influence of our genetic make-up (genes that regulate multiple neurotransmitter systems). Unless you want to start abort all the babies that carry risk alleles which predispose them to obesity and impulse control disorders, they deserve just as much respect and healthcare right as the rest of us. |
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Very interesting contribution! I wonder the cost difference, though, between paying for chronic care of preventable things and emergency care of non-preventable things (quality of life notwithstanding). And not everyone is going to die of something non-preventable, of course. It would be interesting to read a paper and see some numbers on this phenomenon. |
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I am very healthy - and I run A LOT. I often get sports related injuries. Not treating someone because they are obese would be the same as telling me I cannot be treated because of my personal choice or lifestyle. I CHOOSE to run. I CHOOSE to run a lot - this is a lifestyle choice.
Granted these sports injuries, aren''t the same as $$ spent for BP medication, Type II Diabetes medication, Cholesteral Medication, Sleeping pills, or medication for depression - as exercise can help reverse the effects of all of these things - however, my exercise is what some could say, at an extreme level- but I run, swim, and lift weights because I enjoy it. But I often have to get PT due to issues and I am often seeing specialists... Just a different side to the argument. |
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 Can't tell you how many people I know that have had knee-surgery and ACL surgery due to sport injuries. They should all be insured/covered too. Thank god I didn't injury myself running the LA Marathon, LOL!!!
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