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#201
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OT - ACORN "Pimp and Prostitute" video edited to present a false image
In article ,
* Still Just Me * wrote: On Thu, 1 Apr 2010 17:39:24 -0700 (PDT), Jay Beattie wrote: The simple truth is that you *always* help pay for someone else's health care one way or another, unless you don't use any health care at all. * So we might as well step up with a system that will make that more equable. I also happen to think there should generally be some cash out of pocket for health care (e.g., copayments) to deter excessive use and to remind people that this *does* cost money. I was really hoping that the Democratic death panels would get rid of the excessive users and non-payers. That's the only reason I supported Obamacare. -- Jay Beattie. Give it time. The reason the neo-Republicans were so concerned about the death panels is that most of them are ancient (...well, at least most of them they think like people from the dark ages, so they appear to be ancient). The Republicans *are* a death panel these days. Without having the huevos to come out and admit it, the basic stance of the Republicans on health care reform really is "you can't afford health insurance? Tough. Die." |
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#202
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OT - ACORN "Pimp and Prostitute" video edited to present a falseimage
On Apr 2, 11:20*am, Tim McNamara wrote:
In article , *Peter Cole wrote: Jay Beattie wrote: On Apr 1, 3:24 pm, Tim McNamara wrote: big snip The simple truth is that you *always* help pay for someone else's health care one way or another, unless you don't use any health care at all. *So we might as well step up with a system that will make that more equable. I also happen to think there should generally be some cash out of pocket for health care (e.g., copayments) to deter excessive use and to remind people that this *does* cost money. I was really hoping that the Democratic death panels would get rid of the excessive users and non-payers. That's the only reason I supported Obamacare. -- Jay Beattie. The elephant in the room is that something like 80% of medical costs in this country are the direct result of bad habits. We may have a crappy system (bloated and unfair) for paying for things now, but even after cutting out the middlemen and the gouging, medical care is still a blight on the economy and a potential croaker when the boomers enter their "Depends" era. One of the worst aspects of the current system is there is little prophylactic treatment. Smoking cessation, weight management, exercise programs, diet/food counseling, stress reduction, etc. would all have large potential returns on investment. Cycling is a perfect example. If the government completely underwrote the costs (even provided bikes gratis), according to stats out of Denmark, it would be a money maker once the government was picking up the health tab. Copenhageners (Copenhagites) ride an estimated million kilometers a day. * In the city proper something like 30% of all trips are done by bike. *If that happened in every US city it'd just about save the world. Similar to Tim's story, my wife was diagnosed with a heart valve problem (congenital) 20+ years ago. The initial prognosis was 5 years max before valve replacement surgery. My wife asked the cardiologist whether a vigorous aerobic exercise program might forestall the inevitable, he was skeptical. She became a regular cyclist (commuter, etc.). Now, more than 20 years on, the prognosis is "perhaps never" for a valve replacement, and her (78 year old) cardiologist is himself a regular cyclist. Not saying it's a panacea or a cure for valve defects, just that it can only help, and in some cases help significantly. I know others who have similar stories controlling diabetes and severe arthritis. What a great outcome! *For my wife, with a severe atrial septal defect plus cleft leaflet in her mitral valve and and tricuspid regurgitation (or was that the other way around?) due to the left to right shunt through the ASD causing enlargement of the heart on the right side, surgery was the only viable treatment option. *However, her walking, bicycling and hiking activities plus having started Weight Watchers and losing 45 lbs- all prior to the discovery of her ASD at age 40- were big contributors to her good outcome. * Your wife she found a less invasive and very proactive option which has obviously worked very, very well. *I suspect there are many candidates for this sort of approach. *Surgery is sometimes best avoided if less intrusive measures can be used, not merely for benefits in costs but in quality of life, the health risks of surgery, etc. *Great for her! Totally OT, but you should read "King of Hearts" -- http://www.amazon.com/King-Hearts-Ma.../dp/0609807242 It's a great read, particularly for a heart patient in Minnesota. What I love is the revelation that the guy who started Medtronics -- the great giant of medical device manufacturers -- was basically a handiman at the University of Minnesota hospital. He came up with a portable pacemaker, meaning something that was smaller than an Electrolux vacuum cleaner and that didn't need to be plugged in to the wall. If you want to talk about curbing medical costs, one place we need to look is at medical devices. -- Jay Beattie. |
#203
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OT - ACORN "Pimp and Prostitute" video edited to present a false image
In article ,
* Still Just Me * wrote: On Thu, 01 Apr 2010 17:24:34 -0500, Tim McNamara wrote: OTOH, a plumber coming out to my house charges more per hour than I do as a psychologist. My auto mechanic's shop rates are about 25% less than mine. My LBS charges a labor rate of about half what my clinic charges. When I had my house resided and painted, the labor cost for the crew was about $200 an hour. Health care is not unique in being expensive, but the siding crew did not need $20,000,000 worth of equipment to get the job done, whereas a cardiac surgery team does. Yes... when did plumber and electrician become a skill comparable with professional engineer??? Holy crap... I taught myself most of both professions with less effort than I used to learn to maintain my first bike. Old story: Guy has a plumber over to do some repairs. After just a half hour and soldering a fitting, the plumber announces, "that'll be $215". "WHAT?", the man says, "That's over $400/hour!. I can't charge those kind of rates and I'm a Doctor!". The plumber looks him in the eye and says "Neither could I when I was doctor". LOL. Of course, what one really pays for is expertise. I bring a bike in to Andy's shop for repairs it's because I can't fix it myself. I am really paying for his 40 years of experience and knowledge. If he charges me $30 it's not because it took 30 minutes of his time, it's the 40 years it took him to get ready to fix my bike. There is a probably apocryphal story about Daniel Rebour. A customer had ordered a picture of a bicycle and after waiting for a month is called to come and get the drawing. The customer comes in, Rebour sits down and whips out the drawing in five minutes. He charges 1000 francs. The indignant customer demands to know why when it only took five minutes. Rebour replies, "you're not paying me for that one, you're paying me for these" and shows the customer a pile of dozens of rough drafts. When I do inservicing in nursing homes I charge $150 for a one hour presentation. $150 an hour seems pretty good and sometimes nursing homes balk at that. It's not what they are paying me for- they are paying me for the six to eight hours I spent at home during the evening and weekends researching and writing up the presentation. The same thing happens in health care. Doctor's services are expensive because they spent four years in college, four years in medical school and three to seven years in residency and possibly one to three years in a fellowship program (the lengths vary by specialty, to an extent)- longest case scenario is 18 years from high school graduation to being qualified to practice independently. Then there is further training and education to become board certified in one's area of practice and annual ongoing education and training to keep up with changes in the field. Doctors are the most highly (and expensively) trained people in our society. I can't think of anything else than comes close. Much of the reason for the costs of health care are not evident in the interaction between doctor and patient. |
#204
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OT - ACORN "Pimp and Prostitute" video edited to present a false image
In article ,
* Still Just Me * wrote: On Thu, 01 Apr 2010 17:27:45 -0500, Tim McNamara wrote: As a health care provider I can tell you I'd be happy to negotiate rates with a cash-paying client. That is not a problem. My dentist, OTOH, doesn't seem to much want to negotiate... Dentists do not traditionally make all that much money. There are some that a more "business oriented" (read slightly sleazy) who make more and the specialist (orthodontists, oral surgeons, etc) make a bundle. My regular dentist seems to price pretty fairly and is very customer service oriented. I am in the middle of having an implant done (right upper incisor) which will total about to about $4,500 between the oral surgery and dental costs. The oral surgery was about $2,800 to remove the damaged old tooth, place the implant, do a bone graft, suture and then all the follow ups to monitor the implant and then to open the tissue, place a healing cuff and get me ready for the final placement of the tooth. This was all included in the up-front price. I wondered about the cost, since the procedure took well under an hour. However, there was the oral surgeon and two complete teams of assistants- one set for the extraction and a different set for the implant and bone graft. There was an RN anesthetist to monitor me throughout the procedure (which was good, I developed an irregular heart beat due to the epinephrine in the lidocaine and had to be monitored with an EKG), even though a general anesthetic wasn't done. The surgeon paid a lot of money to provide the service, presumably less than he charged me of course. The dentist's bill will end up being $1500 or so on top of the oral surgeon's fees. This, BTW, is all the consequence of being assaulted by a gang of "youths" in 2003 while I was riding my bike on the Cedar Lake Trail near downtown MPLS. |
#205
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OT - ACORN "Pimp and Prostitute" video edited to present a falseimage
On Apr 2, 9:32*am, Peter Cole wrote:
My wife asked the cardiologist whether a vigorous aerobic exercise program might forestall the inevitable, he was skeptical. She became a regular cyclist (commuter, etc.). Now, more than 20 years on, the prognosis is "perhaps never" for a valve replacement, and her (78 year old) cardiologist is himself a regular cyclist. Not saying it's a panacea or a cure for valve defects, just that it can only help, and in some cases help significantly. I know others who have similar stories controlling diabetes and severe arthritis. For years, I've been telling my wife - half joking - that cycling cures all ills. (I guess I'm not sure about skin cancer, though.) She'll be interested in your wife's experience. - Frank Krygowski |
#206
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OT - ACORN "Pimp and Prostitute" video edited to present a false image
Jay Beattie wrote:
If you want to talk about curbing medical costs, one place we need to look is at medical devices. -- Jay Beattie. Instead, Obama is taxing them. BS |
#207
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OT - ACORN "Pimp and Prostitute" video edited to present a falseimage
On 02/04/10 2:40 PM, Bill Sornson wrote:
Jay Beattie wrote: If you want to talk about curbing medical costs, one place we need to look is at medical devices. -- Jay Beattie. Instead, Obama is taxing them. It's going to be a net gain to the manufacturers of medical devices. The 2.3% excise tax will be more than offset by the increased sales of these devices as at least another 10% of Americans obtain health insurance coverage. And of course many of those 30 million that will now be covered are people that are sicker than average because they could not get health insurance in the past. You can't just look at the 2.3% excise tax and proclaim that it's going to result in decreased profits for medical device makers. Well if you're a tea-bagger you can. You can also believe in death panels and that Obama was born in Kenya--it's a free country. If the Republicans had actually decided to participate in the crafting of the health care bill rather than behaving like two year olds, then they might have been able to come up with alternative ways of funding the expanded coverage, though, has been pointed out by even conservative publications, the health care bill did incorporate over 200 Republican proposals. "The problem is that Republican leadership believed their own lies. They forgot that they knew there weren't actually Death Panels in the bill, that it was still illegal to get federally-funded abortions, that everyone can really keep their private insurance, that the new proposals actually brought deficit down - by eventually trillions of dollars." |
#208
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OT - ACORN "Pimp and Prostitute" video edited to present a falseimage
Jay Beattie wrote:
Totally OT, but you should read "King of Hearts" -- http://www.amazon.com/King-Hearts-Ma.../dp/0609807242 It's a great read, particularly for a heart patient in Minnesota. What I love is the revelation that the guy who started Medtronics -- the great giant of medical device manufacturers -- was basically a handiman at the University of Minnesota hospital. He came up with a portable pacemaker, meaning something that was smaller than an Electrolux vacuum cleaner and that didn't need to be plugged in to the wall. If you want to talk about curbing medical costs, one place we need to look is at medical devices. -- Jay Beattie. My father was an early developer of cardiac pacemakers and held some of the early patents cited later by Medtronic: http://www.google.com/patents/about?...BAJ&dq=3678937 As a child, I watched my dad, his engineers and a research cardiac surgeon develop some of the first generation of implantable devices in the late 50's/early 60's. Even then, the device was smaller than a deck of cards. His first units were potted in silicone, poured in a vacuum chamber to prevent air bubbles -- the production setup was a laboratory bell jar with a Erector Set built motorized tipper to pour the silicone into the mold. The first units all failed when body fluids got into the electronics. Later attempts used some of the first flexible/foldable circuit substrates and a welded stainless housing (about the size & shape of a large Zippo). Those failed when the outgassing from the discharging mercury cells developed enough pressure to swell the case. A fix for that was found -- and so on. The Wikipedia article mentions an early patient who lived to 2001 but had 26 devices implanted. My dad had a story of a guy who just got tired of the implant surgeries and decided to not have any more done. I asked what happened. He died, my dad said. It was a tough business and there was really no money in it in those days. Medtronic was not held in high esteem in my house. Like they say, the winners get to write the books. |
#209
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OT - ACORN "Pimp and Prostitute" video edited to present a false image
On Fri, 02 Apr 2010 09:32:50 -0400, Peter Cole
wrote: [---] Not saying it's a panacea or a cure for valve defects, just that it can only help, and in some cases help significantly. I know others who have similar stories controlling diabetes and severe arthritis. Definitely works for me, on both counts. |
#210
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OT - ACORN "Pimp and Prostitute" video edited to present a false image
Andrew Price wrote:
On Fri, 02 Apr 2010 09:32:50 -0400, Peter Cole wrote: [---] Not saying it's a panacea or a cure for valve defects, just that it can only help, and in some cases help significantly. I know others who have similar stories controlling diabetes and severe arthritis. Definitely works for me, on both counts. What does? |
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