Healthcare Reform Thread

[Ramo]

I could live with it, but wouldn't be terribly enthusiastic. It's similar to what the conservative Dems are pushing. It requires extracting more savings from Medicare than the other plans (which would be fine in principle, but makes it less likely to be deficit neutral than if it were funded through other sources). The Medicaid expansion would be more limited than Kennedy (HELP), but I'm not sure where it is wrt Baucus (Finance) - probably to the right. The public option is somewhat to the left of co-ops: you have a weak state-specific plan (functionally equivalent to co-ops), that triggers a national plan. It should be noted that no one really knows how weak the public option will be in HELP and Finance (but it's guaranteed not to be any stronger than the "strong option" described earlier by Klein).

[Ramo]

And a note about bipartisanship. The Republicans in question are Bob Dole and Howard Baker. The current party is so blinkered, they're well to the left of the median Republican Senator. You've got some of the more "reasonable" guys like Gregg calling fundamentally similar legislation "Marxist."

[Jon Miller]

Basically, Jon: you are claiming MAJOR inefficiencies in the behaviour of most people when it comes to preventative care (particularly that they don't get enough) and that a relatively minor amount of money will fix this. That seems pretty absurd to me. Unless you're going to provide some numbers to back yourself up then I'm going to have to call bull**** on this. For an experimentalist you seem damn fond of theorizing with no evidence when it comes to economics and related fields.

No one has studied anti-obesity care as far as I can determine.

So I have to go on the studies which show that huge health differences between the obese and non-obese.

The most underutilized prevention according to one particular study (and other studies seemed to be in general agreement): tobacco-use screening and brief intervention, screening adults aged 50 and older for colorectal cancer, immunizing adults aged 65 and older against pneumococcal disease, and screening young women for Chlamydia. The best that was studied were discussing aspirin use with high-risk adults, immunizing children, and tobacco-use screening and brief intervention according to the study.

JM

[Patroklos]

o I have to go on the studies which show that huge health differences between the obese and non-obese.

You seem to be under the impression that obesity is driven health care access, why is that?

[Wezil]

Single-payer that is grossly underfunded as in Canada is total crap.

Are you saying the "fix" for our system is more money?

[KrazyHorse]

No one has studied anti-obesity care as far as I can determine.

So I have to go on the studies which show that huge health differences between the obese and non-obese.

The most underutilized prevention according to one particular study (and other studies seemed to be in general agreement): tobacco-use screening and brief intervention, screening adults aged 50 and older for colorectal cancer, immunizing adults aged 65 and older against pneumococcal disease, and screening young women for Chlamydia. The best that was studied were discussing aspirin use with high-risk adults, immunizing children, and tobacco-use screening and brief intervention according to the study.

JM

I think you're completely failing to misunderstand me; I want evidence that IN GENERAL a relatively low cost program to finance public use of primary services would lead to some sort of LARGE net health benefit. Not whether or not a couple of primary care techniques are effective and underutilised. The difference between those two questions is STAGGERING.

You seem to want to fund primary care based solely on your assertion of what I stated with absolutely no available evidence of ANY of the steps that you'd have to demonstrate. That's irresponsible in the extreme, and smacks of post hoc ideological reasoning.

[Jon Miller]

Obviously some preventative measures will be worth it, and some won't?

The biggest gains would be in an anti-obesity program, is my hypothesis. This hasn't been studied, except that a large portion of health problems that people have are related to obesity.

JM

[Patroklos]

The biggest gains would be in an anti-obesity program, is my hypothesis.

Do you seem to think that people don't understand that a big mac is bad for them? These problems are driven by life style choices which are themselves driven by culture. While these may in fact have a great effect on health care, it is not within the scope of health care to fix them and confusing the two is probably one of the single quickest ways to have heath care reform go down in flames.

Mission creep

[KrazyHorse]

Obviously some preventative measures will be worth it, and some won't?

The biggest gains would be in an anti-obesity program, is my hypothesis. This hasn't been studied, except that a large portion of health problems that people have are related to obesity.

JM

What does this have to do with Ramo's question about dislocated knees? Your initial comment regarding preventative care was in direct response to that line of inquiry.

[Jon Miller]

I wasn't directly responding to Ramo, I hadn't posted in the thread yet and was referring to things in general.

I did have the idea, which is perhaps wrong, that the total loss in productivity and cost in health for going in to get a dislocated knee treated over and over again were higher than cost of going in to get it repaired. I know of a number of people who have gone in to get it repaired, so that they could do their work properly.

That was a separate issue from my general thoughts on prevention (which is heavily invested in lifestyle changes and anti-obesity).

JM

[Arrian]

I could live with it, but wouldn't be terribly enthusiastic. It's similar to what the conservative Dems are pushing. It requires extracting more savings from Medicare than the other plans (which would be fine in principle, but makes it less likely to be deficit neutral than if it were funded through other sources). The Medicaid expansion would be more limited than Kennedy (HELP), but I'm not sure where it is wrt Baucus (Finance) - probably to the right. The public option is somewhat to the left of co-ops: you have a weak state-specific plan (functionally equivalent to co-ops), that triggers a national plan. It should be noted that no one really knows how weak the public option will be in HELP and Finance (but it's guaranteed not to be any stronger than the "strong option" described earlier by Klein).

1. Thanks for the response.

2. Wow, a lot of that was gibberish to me. I think I'm a bit behind in this. Next time I have a few hours I want to kill, I know how to kill them.

-Arrian

[KrazyHorse]

Wow, a lot of that was gibberish to me

Ramo is being very obtuse in expressing himself on this, Arrian. Press him to define his terms.

[Arrian]

Maybe once I've done a modicum of my own research on it first, I will. But for now, I really haven't examined the issue in depth, so calling out someone else for being obtuse seems... childish.

-Arrian

[Drake Tungsten]

Ramo is being very obtuse

QFT

[Drake Tungsten]

As health care reform legislation moves forward in Washington, the political environment is somewhat different than the last time a major overhaul of the health care system was attempted sixteen years ago. In early 1993 the sense of a health care crisis was far more widespread than it is today – a 55% majority in 1993 said they felt the health care system needed to be “completely rebuilt” compared with 41% today. Health care costs were also a broader problem in 1993 – 63% of Americans said paying for the cost of a major illness was a “major problem” for them, compared with 48% currently.

The issue of limiting overall health care spending is also more prominent in 2009 than it was in 1993. Somewhat fewer today say the country spends “too little” on health care, and a larger share believe that limiting the overall growth in health care costs is a higher priority than expanding coverage. But overall, public support for guaranteed access to medical care for all Americans remains widespread.

http://people-press.org/report/?pageid=1534

Good news.