Saturday, November 26, 2005

Privatization vs Big Government: Friedman's Big Lie
Just read a letter that highlights the heart of the problem with "free market forces". Free, in Friedman's thinking, being "free from government regulations, oversight and accountability". This letter comes from a soldier in Iraq:

Paul,

I wish I had the time or energy or memory capacity to describe to you how wrong this whole thing has gone. It's just as you described it a couple years ago. We can make a difference here, and i believe in the mission as it looks on paper. But your president and his brain-dead colleagues aren't even trying to give us what we need to do it. the add-on armor HMMWVs are a joke. The terrorists target them b/c they know they offer no protection. The M1114s have good armor, but every time we lose one (i had one blown up monday, driver had his femoral artery cut -- will recover fully -- b/c there apparently is no armor or very weak armor under the pedals) it's impossible to replace them. So now I have to send yet another add-on armored vehicle outside the wire daily. The M1114s also have certain mechanical defects, known to the manufacturer, for which there is apparently no known fix. For example, on some of them (like mine) if it stalls or you turn it off, you cannot restart it if the engine is hot. We have to dump 3 liters of cold water on a solenoid in order to start it again. Not that much fun when your vehicle won't start in indian country. I wonder if DoD is getting a refund for the contract. Speaking of contracts, KBR is a joke. I can't even enumerate the problems with their service, but I guarantee they do not receive less money based on how many of the showers don't work, or how many of us won't eat in the chow hall often because we get sick every time we do.
There is so much. I could go on forever. the worst thing, which we have discussed, is that they are playing these bull**** numbers games to fool America about troop strength. If they stopped paying KBR employees $100,000 to do the job of a $28,000 soldier, maybe they'd have enough money to send us enough soldiers to do the job. As it stands we have no offensive capability in the most dangerous city on earth. General Shinseki should write an Op/Ed that basically says, "I told you so." Idiots.

Where are the AC-130s? The apaches? They have them in FAR less active AOs (areas of operations). All we ever get is a single Huey and Cobra team, both of which are older than I am. it's such a joke. They're not even trying. At all. They have apaches in Tikrit but Hueys in Ramadi.

I wish every american could see this for him/herself. Registering your frustration at the ballot box isn't nearly enough. There should be jail terms for this.


You get what you pay for and when it comes to not paying for your government, what you get is a national tragedy.

Oh, and his last few comments show us that not only does this administration not want to get out of Iraq, they are actively trying to PROLONG the stay there. It's what they want: neverending war. That's where the money is and when you elect Republicans, you elect Big Business. The very anti-thesis to Good Government.

And Friedman's economic theories continue to be debunked. In a 2004 book, Critical Condition: How Health Care in America became Big Business and Bad Medicine, famed investigative journalists, Donald Barlett and James B. Steele lay out their argument that it is precisely because of "free market forces" with no Government regulation that allowed our problem to become what it is today:

Over the last few decades, American health care has radically changed. A system that was largely not-for-profit has become a field where the profit motive and market forces affect every decision. [snip]

Much of the turmoil is a direct result of a national policy to run health care like a business, a misguided notion promoted by Washington over the last two decades that the free market and for-profit health care would restrain costs and bring high-quality care to all. On both counts, the experiment has failed miserably. In the meantime, tens of billions of dollars--money that could have gone into patient care--has been drained from consumers and corporate subscribers and transferred to investors, executives, and others who have a stake in perpetuating this myth.


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Tuesday, November 08, 2005

Election results coming in look good for the Missus!!

Looks like my very own dearly beloved, significant other has just won her first election!!! Congratulations Kim! It's good to have a liberal on the City Council!


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Friday, November 04, 2005

Privatized vs Socialized medicine: The answer is obvious.

If we ever found a way to tap the energy out of a knee-jerk reaction then we could break our oil dependence by simply going to all the right wingnuts and asking them what they think about socialized medicine. On the other hand, the power surge would probably be so great we'd knock out every grid from Miami to Seattle. Just the whisper of the word socialized could probably power New York City for decades.

Of course, you don't even have to call it socialized to get a knee-jerk out of them. Call it Universal Healthcare, or Single Payer Healthcare and they'll translate that as "evil librul speak" for socialized and baddabing! you'll have lights brighter than a Seattle strip club.

We've heard it all before: The "legendary" waiting times, the rationing, the lousy doctors, burdensome costs to the taxpayers, you name it. Well, as Rob Stein reports in The Washington Post , a survey, the largest of its kind, was just published in the journal Health Affairs and guess what? All those knee-jerk descriptions of the horror of socialized medicine does a fair job of describing.....America.

The survey was commissioned by The Commonwealth Fund, a nonpartisan, nonprofit foundation. It was the 8th and largest in a series of annual cross nation surveys conducted by Harris Interactive.

Americans pay more when they get sick than people in other Western nations and get more confused, error-prone treatment, according to the largest survey to compare U.S. health care with other nations.

The survey of nearly 7,000 sick adults in the United States, Australia, Canada, New Zealand, Britain and Germany found Americans were the most likely to pay at least $1,000 in out-of-pocket expenses. More than half went without needed care because of cost and more than one-third endured mistakes and disorganized care when they did get treated.

ahh, the wonders of Friedman's "free market forces". Did you catch that? We pay more and we get less. I'd like to hear the righties explain that away without lighting up the entire east coast.

Cathy Shoen, senior vice-president of The Commonwealth Fund, had this to say:

"What's striking is that we clearly are a world leader in how much we spend on health care. We should be expecting to be the best. Clearly, we must do better."


Yes, clearly, or as the WaPo article goes on to say:

...the American healthcare system is quietly imploding...


So what did the survey find? Nearly a third of Americans pay more than $1000 out-of-pocket compared to the next worst countries, Canada and Australia who were at a mere 14%.

The article states that:
The United States often stands out with
high medical errors and inefficient care and has the worst performance for access/cost barriers and financial burdens. In contrast, Germany often ranks high for timely access.


Doesn't Germany have Universal Healthcare? (oops! My neighbor Harrys lights just went on briefly) Aren't they supposed to have the long waits to see doctors that our system avoids?

One interesting result is that ill Americans tended to be more depressed than those in any of the other countries surveyed. Twice as many as in New Zealand. Of course, we have George Bush for Usurper, er, President, so that may explain a lot.

7–10 percent of patients in all but Germany said that they developed an infection while hospitalized

So the Universal Healthcare (Harry's over there cussing about the lights again!) that's supposed to give us to sloppy, less motivated doctors actually results in patients being less prone to infections? Would that be because an infection means more work but not more profit? How does Freidman explain that in his magical "market forces" philosophy? Errr, he doesn't. Germany had only 3% because in their system the incentive is to keep patients safe and healthy. In ours, of course, there's more profit to be made from sick patients.

Now let's be fair and balanced here and also point out that the survey found:
Half of German patients said that there had been no follow-up arrangements.

That is an issue that needs to be addressed by Germany if they want to improve their (glances over at the neighbors house which is finally dark again...sigh, sorry Harry) Universal Healthcare system. Obviously, the incentive is to keep patients out of the hospitals and doctors rooms, but hey, no system is going to be perfect and the list of German problems compared to the US, well, let's just continue with the survey findings and see:

Patients in all countries were often given a new medication when discharged, with U.S. patients the most likely to report new medications. Yet in all but Germany, at least one in four patients said that nobody had reviewed the medications they were taking before their hospitalization.

Yep, let's drug em up and ship em out. That pharmaceutical lobby has really done a great job in getting their drugs into the hands of their consumers here in America haven't they? I guess Friedman's "market forces" DO work, after a fashion. But when it comes to putting the patient at risk by mixing potentially lethal meds, ahmmmmehhemmm, the US pharmaceuticals aren't quite so concerned about your safety and welfare as are (whispers) those countries with Universal Healthcare. (It's just a street light Harry! Chill Out and go back to bed!).

Signaling potential quality concerns as well as transitional care deficiencies, at least one in ten patients in all countries said that they were readmitted to the hospital or visited the emergency room as a result of complications after hospital care. Rates varied greatly across countries: German rates were the lowest and significantly lower than four of five countries, and Australian rates the highest—double the levels reported by German patients.


Well at least us Americans did well here. We had the same amount (6%) being readmitted into the hospital after discharge as Germany. Unfortunately, we had twice as many making subsequent visits to the ER (8% vs Germany's 4%).

Unfortunately, in patient safety, America trails the rest of the world. Americans were the most likely to receive the wrong dosage or medications, the most likely to suffer from a medical mistake during treatment or care, and by far the most likely to be misdiagnosed or received erroneous results on a lab test.

And if you're tests come back abnormal? Your three times more likely to experience delays in being notified than in Germany!!! In fact, Americans are more likely to have to wait to learn about abnormal test results than any of the 6 countries surveyed. Wouldn't abnormal test results be the one thing you'd want to hear back about the soonest? I guess us Americans are expected to just wait and stress out about how that test for cancer turned out.

But hey, even if the results turned out to be bad, there's still hope: Americans are 5 times more likley than the British and nearly twice as likely as the Germans to get back incorrect lab results so maybe if you take the test three times you can go with the best two out of three. Of course, in America that could take some time....and money.

The only conclusion to draw from the survey is that compared to the other 5 nations surveyed, the American healthcare system is rife with imcompetence.

But what is the biggest knee-jerk response of the right wingnuts when you mention socialized medicine? (I'll probably have to cut this article short; I think the wingnuts just knee-jerked the lights on in the whole city.) That old standby: long waiting lines to see a doctor.

Asked about waits to see their doctors when sick, sicker adults in Canada and the United States were significantly less
likely to report rapid access
and more likely to wait six days or longer for an appointment than patients in the other countries. The percentage receiving same- or next-day appointments ranged from a high of 70 percent or more in Germany and New Zealand to below half in Canada and the United States.
Ease of access to care after hours or on weekends also varied widely, with 70 percent or more New Zealand and German patients and more than half of U.K. patients saying that access is “easy.” In contrast, more than half of sicker adults in the United States, Canada, and Australia said that it is difficult to get after-hours care.


So the Canadian healthcare system seems to be bogged down as badly as the American but the Germans? They are doing just fine compared to us. In fact, the survey had more glowing praise for the Germans:
The relatively positive German patient experience with rapid access to specialized care as well as physician visits and after-hours care places Germany among the country leaders for timely access


So they get better, faster care than we do. But is it truly Universal? Don't MORE Americans get healthcare than that "socialized" system?

As found in past surveys, the United States is an outlier for financial burdens on patients and patients forgoing care because of costs. Half of sicker adults in the United States said that they did not see a doctor when sick, did not get recommended
treatment, or did not fill a prescription because of cost. On each access/cost question, the U.S. rate was 1.5 to double the forgone care rates reported in the next-highest country. Moreover, the percentage of U.S. sicker adults forgoing care because of costs was much higher on all three indicators compared with the 2002 survey of sicker adults. Despite these high rates of care forgone, one-third of U.S. patients spent more than $1,000 out of pocket in the past year, a level rare in the other countries. Insured and uninsured U.S. patients were about equally likely to report expenditures this high (34 percent insured and 32 percent uninsured; data not shown). U.S. patients were also the most likely to pay $100 or more each month for medications.

U.K patients were the most protected against costs.


So to sum it up, the report tells us:

Confirming spending data from the Organization for Economic Cooperation and Development (OECD), the United States also stands out for its patient cost burdens, with consequences for access.27 U.S. physician visit rates are already low by OECD standards.28 To the extent that U.S. insurance continues tomove toward higher front-end patient deductibles, these rates could go up, as increasing numbers of insured patients become “underinsured,” lacking access or adequate financial
protection.29 Contrasts between theUnited States and Germany, in particular, indicate that it is possible to organize care and insurance to achieve timely access without queues, while ensuring that care is affordable at the point of service. There are clear opportunities for the United States to learn from other countries’ insurance systems.


That is, if we can turn off the right wings knee-jerk reactionary response to the very idea of "socialized" medicine.

Ooops! Power surge just blacked out New York.


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