OT - ACORN "Pimp and Prostitute" video edited to present a falseimage

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."

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.

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.

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.

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

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

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."

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.

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.

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?