Author Topic: What a got damn shitshow. [warning politics]  (Read 344564 times)

Weasels wake

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Re: What a got damn shitshow. [warning politics]
« Reply #825 on: March 07, 2017, 01:05:17 PM »
Bean: "Yes, Truman should have called it the Roosevelt Act...

Gore didn't get the appropriate accolades for inventing the internet either."

Or Gorebal warming.
It takes a quiver to do that.

tautologies

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Re: What a got damn shitshow. [warning politics]
« Reply #826 on: March 07, 2017, 01:14:42 PM »
Bean: "Yes, Truman should have called it the Roosevelt Act...

Gore didn't get the appropriate accolades for inventing the internet either."

Or Gorebal warming.

Now you just sounds bitter. LOL.

maxsonic

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Re: What a got damn shitshow. [warning politics]
« Reply #827 on: March 07, 2017, 04:56:57 PM »
Damn.  I'm usually pretty good at killing threads on the Zone. But I couldn't kill this one, not even with an A-10 Warthog video. BRRRRRRRRRRTTTTTT!!!!!

PonoBill

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Re: What a got damn shitshow. [warning politics]
« Reply #828 on: March 07, 2017, 05:15:07 PM »
I did enjoy the warthog video. I built an RC warthog once with two ducted fan motors. Serious fun to fly. Then I turned it into a slope glider and it was even better. Stuffed it into one of the cliffs near Kipahulu. Didn't salvage a thing. BAM.
Foote 10'4X34", SIC 17.5 V1 hollow and an EPS one in Hood River. Foote 9'0" x 31", L41 8'8", 18' Speedboard, etc. etc.

lucabrasi

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Re: What a got damn shitshow. [warning politics]
« Reply #829 on: March 07, 2017, 05:59:29 PM »
Damn.  I'm usually pretty good at killing threads on the Zone. But I couldn't kill this one, not even with an A-10 Warthog video. BRRRRRRRRRRTTTTTT!!!!!
Hell, we got warthogs, that stupid ass honey badger, creature from black lagoon messing shit up, A10 and Pono agreeing (i have too...at times.......shhhhhhhh), Creek explaining he's drunk all the time, pdx quips, stoney saying no mas, stuff referred to from just about any media outlet you can think of and just all sorts and in the end really pretty civil and real tho it has had it's moments. Lots of good stuff here all over.
I ran across this today. I gotta post it somewhere........it's going here. Damn if it don't look like something he should have done.
https://www.youtube.com/watch?v=kOGkmoijhYI

back to your regularly scheduled show.

Weasels wake

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Re: What a got damn shitshow. [warning politics]
« Reply #830 on: March 07, 2017, 06:30:10 PM »
Bean: "Yes, Truman should have called it the Roosevelt Act...

Gore didn't get the appropriate accolades for inventing the internet either."

Or Gorebal warming.

Now you just sounds bitter. LOL.
Not at all!  I'm having a great time, and I'm also generous, so this is for you, it's easy!  ;D
https://www.youtube.com/watch?v=D_RsNjYkOao
It takes a quiver to do that.

maxsonic

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Re: What a got damn shitshow. [warning politics]
« Reply #831 on: March 07, 2017, 07:00:32 PM »
Lots of good stuff here all over.
I ran across this today. I gotta post it somewhere........it's going here. Damn if it don't look like something he should have done.
https://www.youtube.com/watch?v=kOGkmoijhYI

back to your regularly scheduled show.
Now we've got the thread headed in the proper direction! Xlnt post!!!

surfshaver

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Re: What a got damn shitshow. [warning politics]
« Reply #832 on: March 07, 2017, 07:58:25 PM »
I'm with Pono on this.  It's not about the health insurance system.  It's about the fact that we spend 20 cents of every dollar of our GDP on healthcare.  More than twice as much as most large developed countries.  Regardless of what we do with the insurance system, if the cost side can't be changed we will still have major problems.

I liken our economy to a physical organism.  For any living being, certain body parts and organs aren't crucial while others are.  You can live without an arm or a leg or even a lung or a kidney, but once your circulatory system or your immune system goes, it's over.

Think of capital/money as blood.  Wall St and the banking system are the heart and circulatory system.

Think of people/labor as muscle and bone.  The healthcare industry is the immune system of our economic organism -- preventing people from breaking down.

Now think of government as the brain (don't laugh). 

What if the privileged organs/systems, the ones the body cannot do without, essentially come to realize their privileged status?  They could influence the "brain" to send certain signals and capture the brain's ability to control them.  They could grow larger and larger, becoming hypertrophic, sucking energy and resources from the rest of the body.

Other muscles and bone would weaken as the system would send more and more nutrients to those enlarged organs.

Eventually this would weaken the body as a whole -- it wouldn't be able to move or function well.

This is the state of our economy today.  Wall Street and Healthcare have captured our government, serving to inflate their share of the lifeblood of our economy at the expense of everything and everybody else.

Until these organs are somehow cut down to size/brought back under control, the body will continue to suffer.

In economic terms, this means prolonged sub-standard growth.

Area 10

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Re: What a got damn shitshow. [warning politics]
« Reply #833 on: March 07, 2017, 11:49:41 PM »
Ok so the stats definitely support what you guys are saying here: it's pretty clear that the US is spending much more on healthcare per capita than any other country in the world. It looks like you are spending roughly twice as much as an average European country, or Canada or Australia. That is indeed a truly enormous amount, and the US looks like an outlier amongst the countries of the world.

So, the general feeling here is that it is because the tail is wagging the dog? In other words that your healthcare providers are doing what private companies exist to do: screw as much money out of you as they can whilst minimising their outlay? And you believe that pharma and healthcare providers/insurers are able to use powerful lobbying abilities to minimise government control over them, right?

Presumably there are other factors also at work here? For instance I'm always amazed at how much medical intervention you guys talk about as routine. Take a broken rib: in the UK you won't generally be given a scan (unless maybe you are a child) if you have broken ribs because the results won't alter the treatment. But as I understand it, you would expect to get a scan, right? So someone has to pay for that expectation to be filled, i.e. you. It also sounds like you guys have many more routine check-ups than we do, judging by the discussion on the zone about skin conditions, especially cancer prevention. So, who decides for you guys what constitutes a reasonable level of healthcare, and what procedures and interventions are allowed or recommended? (In England we have a quango (NICE) that advises on what is safe, effective, and economically justified. You can get medical treatment beyond what they recommend, but you would have to pay for it.)

Or maybe you guys don't receive anything different than you would if you were Canadian, but just pay twice as much for everything? Again, if that is the case, why is it?

So, finally, what is the solution? It sounds like you all mostly agree that the system is not providing you with a fair, transparent, and economical solution. But at the same time you are generally distrustful of government intervention. Now, obviously, for something to change, something is going to have to change - and change really quite radically. So what would that change look like?

Again, sorry for the naive questions.




PonoBill

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Re: What a got damn shitshow. [warning politics]
« Reply #834 on: March 08, 2017, 12:43:31 AM »
There are a huge number of answers to that question and all the implied questions. Healthcare is more of a business in the USA than it is in most places. I think it's demonstrably true that the most advanced medicine is practiced here, a disproportionate amount of new equipment, methods, drugs and treatments are developed here. But that doesn't translate into longer lives or better health. It translates into higher cost and strange utilization driven as much by the need to amortize equipment cost as patient needs.

Part of that is expectations. People sprain an ankle and want an MRI. Part of it is utilization. A lot of it is what surfshaver said.

The USA also spends $596 billion per year on "defense" which is about 3% of GDP. More than the next eight countries combined. As a percent of GDP, it's not quite so out of whack, but it's a lot of bucks.

Understand also that the USA has a GDP of 18 Trillion for 320 million people, making comparisons to other countries challenging.  Canada has a population of 36 million people and a GDP pf 1.5 Trillion. Different set of issues.
« Last Edit: March 08, 2017, 12:56:13 AM by PonoBill »
Foote 10'4X34", SIC 17.5 V1 hollow and an EPS one in Hood River. Foote 9'0" x 31", L41 8'8", 18' Speedboard, etc. etc.

Area 10

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Re: What a got damn shitshow. [warning politics]
« Reply #835 on: March 08, 2017, 01:29:27 AM »
Thanks very much. But where else in business would you argue that there would be no economies of scale? Surely the far larger US market should allow better bang-for-buck than your neighbours?

I'm still not hearing any solutions. I'm not sure what it is that Trump voters expect him to actually do. Obama had a go at change and everyone seems to hate him for it. Where is Trump's incentive to enter the brawl? Could it just be that crazy expensive healthcare is one price you pay for your cultural expectations? You almost certainly don't need to be spending anything like as much on defence as you do (no-one is ever going to seriously challenge you as the world's military superpower even if you cut spending by half) but in fact you are just about to increase defence spending by a large amount. That's just a product of your culture, as is the fact that you have more places to buy a gun than a Big Mac.

Anyway, as I say, I have no idea about any of this. But it sounds like healthcare may have been one reason why Trump is now POTUS, and since that affects the rest of us outside the US, I'm just trying to understand the situation. It's not clear to us outsiders how Trump might provide a solution to your healthcare problems -or even if it would be fair to expect him to be able to.

Wow - I never thought I'd end up defending Trump...what on earth is going on??? :) :)
« Last Edit: March 08, 2017, 01:38:10 AM by Area 10 »

yugi

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Re: What a got damn shitshow. [warning politics]
« Reply #836 on: March 08, 2017, 07:04:19 AM »
hey, look on the bright side...

https://youtu.be/22uvRSqFj98

Quickbeam

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Re: What a got damn shitshow. [warning politics]
« Reply #837 on: March 08, 2017, 08:17:42 AM »
I’m Canadian, so while I live closer to the U.S. than you Area 10, I still don’t really understand the U.S. health care system. I think what Pono says though is true, when he states:

“Healthcare is more of a business in the USA than it is in most places. I think it's demonstrably true that the most advanced medicine is practiced here, a disproportionate amount of new equipment, methods, drugs and treatments are developed here. But that doesn't translate into longer lives or better health.”

Before she retired my wife was a nurse and she had a good friend, who was also a nurse, who moved to the U.S. When my wife’s friend was up visiting us a number of years ago (this is before Obamacare) I asked her which health care system she preferred, as she had been a part of both. She said the U.S. system. I was surprised as I had expected her to say the Canadian system. Then a few years later (still before Obamacare), my wife’s friend got sick. She had a degenerative eye disease. She lost her job and her husband had been laid off. She came up for another visit and this time she liked the Canadian system better.

So again, I don’t pretend to understand the U.S. system, and I know it’s changed since Obamacare, but it struck me at the time that the U.S. system probably has a better system as far as advanced medicine and medical research goes, but if you don’t have a really good insurance plan you may not have access to all that advanced care. I know this is a real generalization, but it’s how it struck me at the time.

One other thing I’ll mention, and I’m really not trying to insult any of my U.S. neighbours. It’s just an impression, and in fact I’d like some of the U.S. posters to let me know if they think this is correct. I just get the impression that the U.S. is more of an individualized society than either Canada or Europe. By that I mean there is more emphasis in the U.S. on the individual than on the collective.

I remember when Obamacare was being debated in the U.S. I obviously wasn’t part of that debate, and while I didn’t follow it closely, it was in our news broadcasts. And I remember a sentiment from at least some of the population that “why should I pay for someone else who is sick”. Now maybe that was just those specific individuals. But in Canada, and I’m assuming in European countries as well, we just take for granted that we pay for each others health care, but in the U.S. it seemed to be an issue. Would the U.S. posters agree with this, or do you think I’m off base? Funny that I don’t really get this sentiment, at least for the most part, from the posters on this site. But I’m wondering more about the population at large in the U.S.
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surfshaver

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Re: What a got damn shitshow. [warning politics]
« Reply #838 on: March 08, 2017, 08:50:44 AM »
For those who are more interested in understanding the dysfunction of the US healthcare system in terms of costs, read Steven Brill's work.  He wrote a lengthy feature piece in Time Magazine a few years ago that covers a lot of it.  And he has written several books on the subject.

I agree with Pono that part of it is state of the art care, and part of it is utilization.  If you have a brand new shiny MRI machine, you are going to be inclined to use it as much as possible even if you could make an effective diagnosis without it.

But it is demonstrably clear, especially in the hospital setting, that a very large amount of the additional costs in our system is what economists call "Economic Rent."  Rent, instead of the everyday definition of monies paid for the use of an asset, in this context means profits that are not earned by work or value creation.

The term was originally used to describe the income gained by the landed aristocracy who took a vig or percentage on the labor of farmers working their land.  Since landowners didn't pay for the privilege but had it handed down over generations, they were essentially getting free money from the system.  They have been referred to as the "Rentier Class."

I would argue that the new Rentier Class are bank executives like Jamie Dimon who can take huge risks with government-insured consumer deposits (FDIC) and then get bailed out by taxpayers if they lose.

The other Rentiers are the CEOs and shareholders of hospitals.

Let me give you an example from my own life.  I have suffered my whole life from sinus disorders.  My sinus doctors are a part of USC's hospital and have their offices there.  I have been seeing them for 15 years.

I had a recent visit where my doctor performed a "debridement" where he used the endoscope to wash out my sinuses.  I did not ask for this procedure, the doctor decided to do it on the spot.

When the bill came, the procedure cost was $1500.  For something that took 3 minutes.

But more importantly, in addition they charged a "facility fee."  The facility fee was $4500.

That's right.  A doctor visit that cost $6000.

I have very expensive private insurance, and my out of pocket cost for this doctor visit was close to $2000.

I had never seen this "facility fee" before and was flabbergasted.  I spoke to the hospital, who said they instituted this fee in the last year to "defray the costs of operating the hospital."  I pointed out that I hadn't used the hospital, but simply went to my doctor's office.   They replied that since the doctor's office was physically housed within a building that was considered to be a part of the hospital complex, that it was in fact part of the hospital.

I researched facility fees and found this to be something done by hospitals around the country and has been a subject of protest.

This is the classic definition of economic rent.  A vigorish or tax excised by a property owner for no other reason than they can get away with it.

What made it even more egregious is that this fee was 3 times the cost of the actual treatment itself.

How can hospitals get away with this?  Because there is no one stopping them.

freetobeme

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Re: What a got damn shitshow. [warning politics]
« Reply #839 on: March 08, 2017, 08:52:10 AM »
One other thing I’ll mention, and I’m really not trying to insult any of my U.S. neighbours. It’s just an impression, and in fact I’d like some of the U.S. posters to let me know if they think this is correct. I just get the impression that the U.S. is more of an individualized society than either Canada or Europe. By that I mean there is more emphasis in the U.S. on the individual than on the collective.

Good observation. This I think is the root of many of our problems. Whether it pertains directly to our health care issues or not. Nationalism, lines in the sand, the quest for the "American dream", fragmented family dynamic, keeping up with the joneses, irrational consumption, elitism. These are all very real and part of the American human condition.   

Trump, with his continent sized ego, in many ways is a true portrayal of the American society regardless of politics.

As Joe Rogan often suggests, maybe the problem is simply that we no longer have to hunt for our food. 
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