News Sicko is probably one of the most disturbing films

[Zantra]

I think a lot of people have a common misperception that doctors are supposed to infallible gods incapable of making mistakes. That's what we build up in our minds to comfort ourselves. But medicine is not a perfect science, and Doctors are simple human beings who decided they'd rather help people, then write lines of code or solve mathematical formulas.

Engineers make mistakes- I see it every day. The difference is no one dies when you put a decimal in the wrong place or forget a variable(hopefully). And while I know my doctor isn't necessarily Einstein or "HOUSE", I know I didn't spend 8 years studying medicine, and jump through the fairly high standards and various hoops it takes to make it in medicine, so I'll give him the benefit of the doubt. Otherwise, I could just have him walk me through my next surgery over the phone.

 

[Evo]

That may be, but the recordings of Nixon don't lie.

Nixon, like in over 30 years ago? What does that have to do with anything? We didn't have handheld calculators, cell phones, personal computers, cable tv, video recorders, video games or the internet then. I'm assuming you know who Nixon is so you know how irrelevant anything he said back then is. He's dead, btw.

 

[mheslep]

... He's dead, btw.

 

[nottheone]

I think a lot of people have a common misperception that doctors are supposed to infallible gods incapable of making mistakes. That's what we build up in our minds to comfort ourselves. But medicine is not a perfect science, and Doctors are simple human beings who decided they'd rather help people, then write lines of code or solve mathematical formulas.
...

I don't think doctors are supposed to be infallible, I think they think they are infallible. I think they should listen to what their patients tell them. Are they taught in med school to ignore what patients tell them? It seems that way since it seems to be universal. There was an article in the NY times science section ( I buy it every Tuesday for the science section) a couple years ago and its conclusion was that a lot of misdiagnosis was caused by them not listening to the patient.

 

[jreelawg]

Nixon, like in over 30 years ago? What does that have to do with anything? We didn't have handheld calculators, cell phones, personal computers, cable tv, video recorders, video games or the internet then. I'm assuming you know who Nixon is so you know how irrelevant anything he said back then is. He's dead, btw.

It is relevant because he was discussing Kaisers HMO plan which he launched via this act.

http://en.wikipedia.org/wiki/Health_Maintenance_Organization_Act_of_1973

His assistant had a deep discussion with Kaiser and then reported to Nixon that the plan was a private enterprise, nixon liked that, then he said it was for profit, and explained that Kaiser was able to do this by providing less health care to maximize profit. Nixon thought that was a great idea, less health care more profit for Kaiser, and so he launched the, "Health Maintenance Organization Act of 1973". It is extremely relevant, it is how our modern HMO system was born. It also exposes without a doubt that the goal was to provide less health service to make more money. Nixon is dead, but HMO's aren't dead.

It is also a very neat educational recording that everyone should hear. Not often that secret recordings of the inner workings of a corrupt government are exposed and made public.

The reason that health care in the U.S. is inefficient is because it was designed to be inefficient. The more inefficient, the more private profit, and so the incentives are to minimize efficiency.

 

[mgb_phys]

Engineers make mistakes- I see it every day. The difference is no one dies when you put a decimal in the wrong place or forget a variable(hopefully).

Yes they do, that's why they check values in books. Ever see a doctor look something up?
It's also why designs are reviewed, why we have unit-tests, test-harness etc.
If aircraft engineers got it wrong at the same rate as doctors you wouldn't be able to step outside for falling Boeings.

Of the 8years of training, most of that is just cheap labor - it's not quite the same as 8years of PhD research. Talk to a doctor and you will be amazed how little they know about biology or chemistry. And if you ever receive a drug that involves them doing any sort of calculation to get the dose right - make sure they have got mili and micro the right the way round!

 

[Alfi]

make sure they have got mili and micro the right the way round!

Metric !? - only one country left to convert. On the whole planet. ( ok maybe two ;) )

 

[mgb_phys]

A major medical breakthrough recently reported in the New England Journal of Medicine.
Apparently if you go through a written checklist before cutting into the patient the chance of them dying halves! The 19 point checklist contains little details, like do you have all the equipement needed, do you have the right blood available etc.
Dr. Peter Pronovost won a MacArthur "genius" award for creating the concept of medical checklists!

There have been objections that it reduces the surgeons autonomy - like I suppose that pilot who landed in the Hudson shouldn't need to do checklists anymore because he's a hero.

 

[russ_watters]

Yes they do, that's why they check values in books. Ever see a doctor look something up?

Ever see an engineer look something up while in front of a client? C'mon, you're really not giving doctors enough credit.

 

[nottheone]

If engineers were like doctors, here is what a conversation between doctor and patient might be like:

plane mechanic: Number 623 has a crack in the skin.
engineer: I'll take a look at it.
engineer: hmmmm
plane mechanic: I think a structural problem caused the crack.
engineer: Who is the engineer here? Looks like just a crack in the skin to me.
plane mechanic: But when it's taxied out I can see the crack widening.
engineer: Fill it with Bondo and apply a coat of paint to it before each flight. It will look as good as new.
plane mechanic: I really think it's a structural problem.
engineer (completely ignoring what the mechanic is saying): We will try the Bondo and paint for a while.

 

[Evo]

It is also a very neat educational recording that everyone should hear. Not often that secret recordings of the inner workings of a corrupt government are exposed and made public.

The reason that health care in the U.S. is inefficient is because it was designed to be inefficient. The more inefficient, the more private profit, and so the incentives are to minimize efficiency.

Reagan passed legislation in 1988 changing the HMO Act of 1973. Many Americans are not in HMO's, HMO's are an option. I'm not in an HMO.

 

[drankin]

If engineers were like doctors, here is what a conversation between doctor and patient might be like:

plane mechanic: Number 623 has a crack in the skin.
engineer: I'll take a look at it.
engineer: hmmmm
plane mechanic: I think a structural problem caused the crack.
engineer: Who is the engineer here? Looks like just a crack in the skin to me.
plane mechanic: But when it's taxied out I can see the crack widening.
engineer: Fill it with Bondo and apply a coat of paint to it before each flight. It will look as good as new.
plane mechanic: I really think it's a structural problem.
engineer (completely ignoring what the mechanic is saying): We will try the Bondo and paint for a while.

I usually see this the other way around.

engineer: Why is there bondo on the skin?
mechanic: I saw a crack in the skin so I fixed it.
engineer: You should let me know when you see this happening.
mechanic: *scratches head* Well it's fine now.
engineer: We could have a structural problem, Frank.
mechanic: *mumbles expletive about engineers and walks away*

 

[Al68]

Why not just have gov't compete with private insurance companies instead of complaining about them?
After all, the USPS doesn't complain about the price FedEx charges to deliver a letter.

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

Notice how much Democrats complain about private companies, yet don't advocate trying to compete with them. I say offer something better yourself instead of trying to control others.

 

[BoomBoom]

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

I'm sure they would if republicans didn't block such efforts. Maybe now they can actually get it done...one can hope anyways.

It would be a drastic improvement in our health care system if it actually focused on health care instead of profit (at the expense of quality healthcare).

 

[Topher925]

Why not just have gov't compete with private insurance companies instead of complaining about them?
After all, the USPS doesn't complain about the price FedEx charges to deliver a letter.

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

Notice how much Democrats complain about private companies, yet don't advocate trying to compete with them. I say offer something better yourself instead of trying to control others.

This sounds like a good idea. If the government can pull it off then fantastic, people have some affordable options for health care and the private sector will have to get its act together. If it ends up going the way of social security then its good to because then we are not all biffed with a failing nationalized health care system.

Obama seems to have some good plans to help improve the current system. For example, even something as simple as making patient records electronic and having them shared among hospitals will yield massive improvements in the system. Although I still find that the best health care plan is just for people in the US to take care of themselves but this doesn't seem to be a viable option.

 

[Adrock1795]

How would universal health care, lower health care costs? Your simply moving the financial burden to someone else. Has society become that much of a liability, that we must leech of the rich to provide us with security?

 

[BoomBoom]

How would universal health care, lower health care costs?

Easy...by taking the whole "let's maximize our profits and get rich" philosophy out of the equation.

 

[turbo]

How would universal health care, lower health care costs? Your simply moving the financial burden to someone else. Has society become that much of a liability, that we must leech of the rich to provide us with security?

The insurance companies maximize profits by denying claims, and by delaying as many claims as they can while they re-invest the "float". This cost is passed on to medical facilities and small medical practices in the form of delayed or denied payments, and lots of extra overhead to pay a support-staff or coding specialists who have to learn all the arcane coding requirements that each insurance-company demands be met before they will pay for treatments. A real single-payer system would eliminate all that friction and would save the country trillions while extending health-care to all. Not such a bad deal.

 

[mheslep]

... A real single-payer system would eliminate all that friction and would save the country trillions while extending health-care to all. Not such a bad deal.

No doubt such a system would cut some costs, but the evidence from other countries is that while such a system in theory attempts to provide for all, in practice it delays health care to all.

 

[mheslep]

Easy...by taking the whole "let's maximize our profits and get rich" philosophy out of the equation.

In general, the market system is the most efficient way to allocate limited resources. This does not mean efficiency is the only goal, and the state may decide to step in with various controls, but the general principal still holds.

 

[jreelawg]

Why is does a country with such wealth and power rate so low in health care efficiency and quality? Because it is dominated by people who want it that way. All the incentives run that way. How is it that crooks can dominate our health care system? Because of corrupt officials who are in on it. Why would anyone support the crooks that run the show? Because no one cares to do any research. Why is Michael Moore alright in my books? Because while his conclusions may be different than mine, at least he does a huge amount of research and shows us all the sides and facts that aren't shown on the news. You bash him all you want, call him fat, call him a terrorist, whatever makes you comfortable. But to ignore cold hard facts and documentation based on a popular dislike of person who points it out isn't going to help you get any smarter.

 

[mheslep]

Why is does a country with such wealth and power rate so low in health care efficiency and quality?

Its not low in quality. In many ways its the best in the world.

 

[jreelawg]

The U.S. a nation where the Elite free load off of the hard work and services of the lower and middle class. The Elite get top notch health care, but most hard working americans get poor quality health care. War vets for example get poor quality health care. Why should those who work hard and make huge sacrifices to defend the country get the short end of the stick? The least that congress could do is pass legislating cracking down on the shady practices of Insurance companies, and drug companies. If we are going to have a capitalist health care system, let's at least pass laws to protect the consumers.

 

[Alfi]

Its not low in quality. In many ways its the best in the world.

in other ways it's 37th
http://www.photius.com/rankings/healthranks.html

There is room for improvement in Canada too. Ranked 30th.http://www.photius.com/rankings/who_world_health_ranks.html

 

[mheslep]

in other ways it's 37th
http://www.photius.com/rankings/healthranks.html

There is room for improvement in Canada too. Ranked 30th.

http://www.photius.com/rankings/who_world_health_ranks.html

For some kind of serpentine social policy discussion perhaps the WHO rankings can be entertaining, given WHO metrics like "Fairness in financial contribution". If one actually gets sick, then it is simple, the first thing you want to know is what are my chances for survival, and where do I go for the best chance? Sorry, the WHO rankings won't help you there. For actual diseases like cancer, or hip replacements, and not 'fairness measurements', very frequently the answer is the United States.
http://www.ncpa.org/images/1703.gif

The US health system has some serious problems (cost,coverage,IT), but the quality of actual medicine is not one of them. So I wish these misleading 'Cuba has great health care!' or 'France is #1!' red herrings would stop, so we don't trash what we have when fixing the real problems.

 

[Evo]

For some kind of serpentine social policy discussion perhaps the WHO rankings can be entertaining, given WHO metrics like "Fairness in financial contribution". If one actually gets sick, then it is simple, the first thing you want to know is what are my chances for survival, and where do I go for the best chance? Sorry, the WHO rankings won't help you there. For actual diseases like cancer, or hip replacements, and not 'fairness measurements', very frequently the answer is the United States.
http://www.ncpa.org/images/1703.gif

The US health system has some serious problems (cost,coverage,IT), but the quality of actual medicine is not one of them. So I wish these misleading 'Cuba has great health care!' or 'France is #1!' red herrings would stop, so we don't trash what we have when fixing the real problems.

Exactly, I just watched two healthcare documentaries where patients in the UK had to travel to the US to get life saving medical procedures. One was an infant with brain lessions, the UK would not even allow the procedure she needed, so the parents brought her to the US where they repaired the lesions and saved the baby's life. The Uk also did not cover the expense. But they don't even ALLOW cutting edge research or treatments because it's too costly. You can't even get the treatments you need in other countries. The number of people that are flown to the US each year for treatment they can't get anywhere else is staggering.

I'll gladly pay a bit more to cover research and treatments not available anywhere else in the world.

Socialized medicine in Italy killed my fiance's father. First they only diagnosed his lung cancer with an x-ray, guessed it was the wrong type of cancer and gave him the wrong treatment. They made no diagnostic tests to see which type it was. Then they almost killed him by giving him the wrong treatment at 10 times the normal dose. After I had a fit, my fiance raised hell and got his father on a SIX MONTH WAITING LIST to get an MRI, one of TWO machines in the entire country and required a plane flight across country. Here in America you'd get an MRI the same day. You'd also get tested to see which type of cancer you have. Socialised medicine is mediocre at best and only good if you have run of the mill illness.

His father died in terrible agony, they figured out what he had too late AND it required a trip to another country to even be diagnosed, by then it was too late.

If Michael Moore gets sick, where do you think he's going to go for medical care?

 

[Al68]

If Democrats really think gov't could sell insurance at a better deal than private insurers, then do that and stop trying to control private companies. If not, then they have nothing to complain about.

I'm sure they would if republicans didn't block such efforts. Maybe now they can actually get it done...one can hope anyways.

Republicans can't block those efforts because those efforts don't exist. Democrats have no interest in trying to compete with private companies to sell health insurance. They're smart enough to know better.

Having a government controlled entity competing with private insurers would completely undermine their real agenda of gaining gov't control of private companies. It would be like trying to take over Fedex or UPS.

It's simple, if they don't think they can compete with private insurers, they have no business complaining about them. Put up or shut up.

Democrats just oppose private business in general. Assuming that the word private means not under gov't control.

 

[ThomasT]

No doubt such a system would cut some costs, but the evidence from other countries is that while such a system in theory attempts to provide for all, in practice it delays health care to all.

Does a single-payer system necessarily have to increase delays? This isn't a rhetorical question. I haven't studied the health care system at all, and am curious.

 

[TheStatutoryApe]

within the last year I heard several stories on the news about insurance companies attempting to dump their clients when they made expensive claims based on supposed unreported preexisting conditions that had nothing to do with the claim. last I heard I believe they were working on legislation to prevent this practice.

I've heard occasionally about medical tourism too. it apparently works out well in many cases. at the same time regulations in other countries aren't as stringent as in the US and the likelihood of something going wrong is greater, though not perhaps significantly. the worst part is that if something goes wrong an american citizen has little to no recourse in the case of fraud or malpractice while receiving medical care in another country. so people going out of country for treatment ought to be very careful about who they go to.

 

[BoomBoom]

Having a government controlled entity competing with private insurers would completely undermine their real agenda of gaining gov't control of private companies. It would be like trying to take over Fedex or UPS.

You mean like the USPS?

Maybe if private companies behaved in a more responsible manner and didn't continually try to bleed the people dry in order to maximize profits, then we wouldn't need any government control or regulations. Unfortunately, that is not the case and they must be forced to behave responsibly.

I'd be all for government competing in this market by providing affordable and quality healthcare. That would force the private companies to do the same or perish.