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Medical Forum / General / General / July 2005Soaring healthcare costs hurting US economy, driving business to Canada
Motor City Getting Northern Competition By KATHY BARKS HOFFMAN, Associated Press Writer Sat Jul 16, 9:49 AM ET LANSING, Mich. - Ever since the first Model Ts rolled off Henry Ford's assembly line, Detroit and its surroundings have been the capital of the U.S. auto industry. But now, thanks to cheap health care and changing tastes in cars, its Canadian neighbor is challenging it for the title of North America's top producer. Michigan last year alone built roughly 2.6 million Chevrolet Silverados, Ford Mustangs, Jeep Grand Cherokees and a host of other models. But that wasn't enough to hold off neighboring Ontario, Canada, long a car-building center but largely in Detroit's shadow. Separated from Michigan by lakes Huron, St. Clair and Superior and an occasional river, Ontario produced nearly 103,000 more vehicles than Michigan last year. Model changeovers - which forced Michigan plants to close for part of 2004 to retool for producing new models - are partly to blame, according to WardsAuto.com, which tracks industry trends. But there are other, more complicated factors at play, such as health care costs and chronic market- share declines for Detroit's Big Three automakers, experts say. Detroit's Big Three - General Motors Corp., Ford Motor Co. and DaimlerChrysler AG's Chrysler Group - have shed thousands of jobs and closed U.S. plants to remain competitive while foreign automakers beefed up operations in Ontario. "If it was Ford gaining at the expense of GM, it wouldn't matter," said Thomas Klier, senior economist with the Federal Reserve Bank of Chicago. But it's companies such as Toyota Motors Corp. and Honda Motor Co. that are growing, he said, and they're growing outside Michigan. "It comes down to geography," said Klier. Even in Canada, the Big Three face issues with their unionized workers that their nonunionzed foreign competitors largely sidestep. GM, Ford and Chrysler hope during talks beginning next week that they'll be able to negotiate new contracts with the Canadian Auto Workers that will help them trim costs. But CAW President Buzz Hargrove already has told his members the CAW won't accept calls to cut growth in wages, benefits and pensions during negotiations. There's increasing tension and widening perspectives on whether cutbacks are necessary at Big Three operations in Ontario. No such problems plague Toyota, which two weeks ago announced it will open a $650 million assembly plant by 2007 in Woodstock, Ontario to build up to 100,000 small sport utility vehicles a year, saying it chose Ontario in part because of growing demand for SUVs in that region. Skyrocketing U.S. health care bills, which the Big Three cite as one of their biggest obstacles for competing with foreign automakers, are another factor. Canada is attractive because it subsidizes much of workers' health care tabs, said Jim Donaldson, vice president for business development at the Michigan Economic Development Corp. He noted health care expenses for GM's current and retired U.S. workers add about $1,400 to every vehicle it makes. "If all other costs are similar, that would be one of the things that would favor building in Canada," Donaldson said. Ontario's success also is tied to a Canadian $500 million fund the province created to attract automotive projects. In the past year alone, Ford, GM, Toyota and others have committed to Canadian $5 billion in new investments in the province. Ontario also is working hard to attract more research and development and has established a new engineering degree specifically for the automotive field. "We're trying to put our auto sector on the most competitive footing for the next generation of products and the next generation of worker education," said Joseph Cordiano, Ontario's minister of economic development and trade. Michigan already touts a concentration of auto-related businesses, a well- trained work force and an education system set up to turn out automotive engineers, materials specialists and designers and to train workers for sophisticated manufacturing jobs. The state has created a seven-point strategy that includes attracting international automotive investment and helping domestic companies develop international business strategies. Gov. Jennifer Granholm has drawn up a business tax proposal that would lower manufacturers' bills and she and other state officials are aggressively pursuing foreign auto-related firms and suppliers. "It's not the same world as it was 10, 20, 30 years ago. We need to take advantage of the global economy," Granholm said in an interview with The Associated Press. For the moment, Michigan has regained the lead over Ontario in motor-vehicle manufacturing and it might hold the edge for the rest of the year. But WardsAuto.com expects Ontario to retake the title in the next few years. Still, Michigan has its success stories. GM next year will open a new assembly plant west of Lansing that will employ up to 3,000 workers, replacing century-old Lansing plants that closed this spring. And DaimlerChrysler this fall will begin making a new generation of four-cylinder engines at a $700 million plant in Dundee, southwest of Detroit. The state scored a victory earlier this year when Toyota committed to building a $150 million R&D center near Ann Arbor after Granholm and the Michigan Legislature helped secure land for the deal. The state also granted a tax credit worth $38.9 million. "If you want to expand your technical research, you have to be in Michigan because that's where most of the engineers are," said Dennis Cuneo, senior vice president for Toyota Motor North America. "That type of thing builds on itself." Despite the fierce competition, Ontario and Michigan officials say they're happier to see new auto-related work go to each other than to states in the South because it lifts the region's overall economy. "We are our biggest trading partners and each others' biggest allies," Cordiano said. "We never forget that." http://news.yahoo.com/s/ap/20050716/ap_on_bi_ge/chasing_canada On Sat, 16 Jul 2005 23:43:44 -0400, Dave Larder didn't bother to offer original thought of his own, but cut-and-pasted an Associated Press article written by Kathy Barks Hoffman, lamenting the fact that by cost-shifting the provision of employee health care (not "insurance" at all) from the compensation package offered by the employer (and thus the prices paid by the employer's customers) to the Canadian taxpayer (who is pretty much the supine, stunned, and helpless victim of Canadian politicians), Ontario manufacturers in the auto- motive industry have gained a competitive advan- tage over manufacturers in the state of Michigan. Both Ms. Hoffman and Mr. Larder (the latter by implication; he wouldn't have violated AP's copyright to reproduce Ms. Hoffman's article if it were not the case) like the notion of having the U.S. government do the same thing to American taxpayers that the politicians in Ottowa are doing to Canadian taxpayers in order to subsidize the ailing U.S. automobile industry. This would supposedly be good for the people who own the automobile industry, and for the people who work in that industry. In the short run, they would be able to continue as they have, the employers putting into dealer's showrooms cars that people really don't want to buy, the employees getting bigger paychecks (and perks) than their work really justifies. Hm. Didn't we go through that same barn full of horse manure back in the '60s and '70s? And does it smell any better now? "Government," said Frederic Bastiat back in 1850, "is that great fiction by which everybody seeks to live at the expense of everybody else." Ms. Hoffman is full of horse manure. So is Mr. Larder. The reader is invited to shovel that sh.t straight out the door. ------------------------ Gun ownership is a problem, not because it represents any physical danger to [the IRS]. Americans have proven dismayingly forbearing in that regard. But people who own guns often look at the world differently than those who don't. That's the real danger to social and political parasites. Roughly 25% of Americans own guns. The number increases each time there's widespread discussion of more gun control - call it what it is: "victim disarmament". If the figure ever rises to 50%, I suspect the widespread discussion will be about repealing the 16th Amendment. -- L. Neil Smith "Vermont Fudge" (http://www.sierratimes.com/members/files/02/03/18/lneilsmith.htm) > On Sat, 16 Jul 2005 23:43:44 -0400, Dave Larder > didn't bother to offer original thought of his own, but [quoted text clipped - 14 lines] > copyright to reproduce Ms. Hoffman's article > if it were not the case) COMMENT: Not a safe assumption. In any case "Dave Larder" has no posting history on the internet and is probably yet another new booster and posting shill for Canadian health articles. We have several pseudonymious ones here. Any country can be highly competetive on the international market by using taxpayor money to subsidize one of its industries in subtle ways. But of course, since money is a fixed quantity, subsidizing one export industry hurts the others. Does spending a lot of money on your workers health as a business cost hurts you with respect to countries where they spend little? Probably. If you mistreat your workers overall, you get China or sweatships in South America. But you're competitive globally since your work product is cheap, and that will eventually price you out of the market in free trade. Canadian vacuum cleaner and TV makers would get good health benefits if these workers existed in Canada. Except they don't. If you merely use a different mix in care for your workers than other countries, you'll help some relatively, and hurt others relatively. Canada's health care system probably makes it's blue collar job produced exports relatively competitive with the US, and its white collar produced exports relatively less competitive. There's not free lunch. SBH >> On Sat, 16 Jul 2005 23:43:44 -0400, Dave Larder >> didn't bother to offer original thought of his own, but [quoted text clipped - 26 lines] > But of course, since money is a fixed quantity, subsidizing one export > industry hurts the others. If you are saying that the medical INDUSTRY would be hurt by trying to stop runaway costs, you are correct. It is the most bloated sector of the economy, able to continue the bloat by laws which limit entry to the jobs they have, and by the fact that most patients are not yet going abroad for medical care. >> If you are saying that the medical INDUSTRY would be hurt by trying to > stop runaway costs, you are correct. It is the most bloated sector of the > economy, able to continue the bloat by laws which limit entry to the jobs > they have, and by the fact that most patients are not yet going abroad for > medical care. COMMENT: There is bloat in the medical industry, but it has little to do with limited entry on jobs, because the bloat money is not going to physicians. The bloat goes up 12% a year and has been for a long time (this includes medicare and medicaid in the US), while physician salaries are actually falling. Nor are hospitals getting the extra money-- their profits are falling also (mostly due to the large about of unfunded care they are forced to provide). The studies I've read indicate that the "bloat" in medicine, if you'd like to call that rapid cost increases that, is driven by two major factors: new fancy technology (angioplasty, MRI scanners, new expensive drugs-- which means pharma and the med instrument people get it), and an aging population. The use of fancy tech is somewhat out of control, but that's at least partly because the system in the US is designed with every profit incentive to use it, whether it saves money down the line or not. As for the aging population, I'm afraid you're stuck there, unless you'd like to go back to 5 kid families. But what you save in medical costs, you'll then just end up paying in K-12, inflated real estate, energy shortages and over pricing, polution cleanup, etc, etc, etc. At some point you MUST have a stable population, and then you end up with the funny age structure anyway. So unless you euthanize and frail elderly, or perhaps find ways to ration or withdraw treatment from them, the only thing you can do is makes sure you spend your medical money wisely. Fancy tech has its place. Just make sure it does so much good that most people agree it's worth it, before you let the government pay for it. But otherwise, let rich people be your guinnea pigs. They're happy to do it, and you learn from what happens. If some drug extends terminal lung cancer victims' lives by 2 months, from 4 to 6 months, but costs $20,000, should the government pay for it? How about if it costs $2000? $200? If you put 100 people in a room and made them write down a number, you'd get a wide spread. And if you got the numbers from people with lung cancer and their families, it would be a spread with a different mean. That's the kind of thing you're faced with in medicine ALL the time, when it comes to tech. Finding people (doctors, businesses, politicians, patients, etc) to accuse of criminality for this problem (which blame-finding aka "activism" seems to be the penchant of the Left, over and over again), doesn't help much. Recognizing that it's an inherent ethical conundrum of economics and the human condition, starts getting you somewhere. Then you can decide on the methods (which hopefully include science and local decision making) which will get you the most bang for the limited resources you always have. SBH SBH > >> If you are saying that the medical INDUSTRY would be hurt by trying to > > stop runaway costs, you are correct. It is the most bloated sector of the [quoted text clipped - 54 lines] > > SBH Another of Steve's masturbatory rants in need of edit: Blame the left by Steve Harris Zee >> >> If you are saying that the medical INDUSTRY would be hurt by trying to >> > stop runaway costs, you are correct. It is the most bloated sector of the [quoted text clipped - 59 lines] >Blame the left >by Steve Harris Gee, and you have the gall to complain about the reading skills of others. -- David Wright :: alphabeta at prodigy.net These are my opinions only, but they're almost always correct. "I believe The Battle of the Network Stars should be fought with guns." -- Steve Martin > >> >> If you are saying that the medical INDUSTRY would be hurt by trying to > >> > stop runaway costs, you are correct. It is the most bloated sector of the [quoted text clipped - 62 lines] > Gee, and you have the gall to complain about the reading skills of > others. Subtext: Blame Canada by Steve Harris Zee >>>Blame the left >>>by Steve Harris [quoted text clipped - 8 lines] > > Zee You are the martyr aren't you? I contend that David Wright was...um right.... and your reading skills leave much to be desired. Your own post also infers that ALL Canadians are left - wing liberals. Well I guess most are so........ "Bryan" <cyberbmcd@optonline.net> wrote in >>>>Blame the left >>>>by Steve Harris >>> >>>Gee, and you have the gall to complain about the reading skills of >>>others. >> Subtext: >> [quoted text clipped - 5 lines] > also infers that ALL Canadians are left - wing liberals. Well I guess most > are so........ Government care projects, like zee, rarely respond to cogent critiques of the material they post with anything but irrelevant insults. But, hey, I await evidence to the contrary. C'mon zee, just pick one point in the post you're criticizing and discuss it. < chirp > moo > "Bryan" <cyberbmcd@optonline.net> wrote in > > [quoted text clipped - 22 lines] > > moo Look at what the Canadians are doing with THEIR trash. Blame Canada, sh.t yea. Canadian Trash Truck Arrives in Michigan Dripping Blood Last October, a Canadian trash truck from Toronto was denied entry into Michigan because it contained broken bags of untreated blood and hospital waste. The truck was literally dripping blood and leaking contaminants. This was in direct violation of Michigan and Ontario law, which requires medical waste to remain contained in secure containers and that non-decontaminated medical waste not get mixed with other waste. Canadian Trash Trucks Carry Radiological and Medical Waste into Michigan U.S. Senator Debbie Stabenow authored legislation earlier this year to ensure that the Ambassador and Blue Water bridges be equipped with detection equipment called portals and that staff be trained to use them. These portals search for the presence of radiological and nuclear materials and weapons; trucks found with radioactive cargo are not allowed into Michigan. As a result of these searches, truck loads of trash are regularly sent back to Canada. These portals were installed in June -- we may never know how much radioactive waste was dumped in Michigan before then. http://stabenow.senate.gov/stoptrash/dangers.htm Robert <Robertitsme@hotmail.com> wrote > http://stabenow.senate.gov/stoptrash/dangers.htm You certainly are one of those right wing kook's, aren't you! A dubious account which received no attention in the news or from the Governor of Michigan's office and was likely just a fabrication created by the anti-trash advocates because all medical waste in Ontario is incinerated. Considering the hundreds of deaths that Michigan's air pollution causes in Ontario every year, a truck with hospital waste doesn't sound so bad. Toronto Blames Surge in Smog on Factories in Ohio, Michigan June 23 (Bloomberg) -- The Canadian province of Ontario has a clear message about its smog problem for Ohio and Michigan: What's yours shouldn't be ours. Factories in America's industrial heartland of Ohio, Michigan and other states generate more than half the pollutants inhaled by the 12.5 million people in Ontario, Canada's most populous province, according to a government report. ``We can only do so much on our own because air pollution knows no borders,'' Ontario Premier Dalton McGuinty said at a June 20 conference on air quality held in Toronto, the country's biggest city and capital of the province. Toronto has issued a record 21 smog alerts this year, recommending the city's 3 million residents stay indoors. That already exceeds the previous high of 20 alerts in 2001. Air pollution from the U.S. contributes to more than 2,700 deaths in Ontario each year and generates C$5.2 billion ($4.2 billion) in health-care costs and environmental damage, the report said. The perception U.S. factories and power plants are to blame has been reinforced by stories in Canada's biggest newspapers. ``U.S. Smog Batters Ontario,'' read the headline in the June 17th edition of the Toronto Star. The Globe and Mail, the second- largest paper after the Star, ran a front-page story the same day entitled ``U.S. Pollution is Killing Ontarians.'' ``I've lived here for 50 years and it has never been this bad,'' said Elli Broschinski, a 79-year-old Toronto widow who blames the U.S. for the bronchitis that makes it painful to breathe and talk. ``I hear on the radio that many people die.'' The province isn't blameless. Ontario generates as much as 20 percent of the pollutants wafting over New York state, and 7 percent of the unhealthy air floating above Vermont and New Hampshire, the report said. The report bases its findings on more than three decades of air quality data and weather patterns, along with computer modeling of pollution in the atmosphere. Ranking Ontario ranks second among the 50 U.S. states and 10 Canadian provinces in releasing industrial waste into the environment, according to a study released last month by the Commission for Environmental Cooperation of North America, a research group of experts from Canada, the U.S. and Mexico. Only Texas is worse. Ontario and Toronto say they're doing all they can to reduce auto emissions, a major source of the carbon monoxide and other gases that cause smog. Last week Mayor David Miller instructed by- law officers to step up enforcement of municipal rules that prohibit drivers from idling for more than three minutes each hour. Toronto has the worst air of any Canadian city, according to Ontario's environmental ministry. Miller, 46, who won office on his opposition to expansion of a downtown airport, has ordered 160 hybrid buses, which cut emissions because they run partially on electricity. The city is also spending C$32 million to retrofit buildings with energy- saving equipment. ``We're aiming to double the tree canopy of Toronto over the next 20 years,'' he said in an interview. Coal Plants Laura DeGuire, an environmental specialist for the state of Michigan, said she wasn't surprised that Ontario blames others for its smog. New England states blame coal plants in the U.S. Midwest for their pollution and New York complains that Ontario's coal plants are adding to its smog. McGuinty, 49, has closed one of Ontario's five coal-fired plants and plans to have all but one shut by 2007 to reduce greenhouse gas emissions. The premier has offered to help New York state fight legal battles with the U.S. government in Washington over air quality, and is trying to put the issue on the agenda of a group of governors and premiers who discuss environmental issues affecting the Great Lakes. McGuinty opted to keep open North America's largest coal- fired power plant, the biggest single polluter in Canada. The plant at Nanticoke, about 60 miles southwest of Toronto, was supposed to close in 2007, and is now slated to shut down in 2009. ``We're in no position to lecture the U.S. unless we start doing something,'' said Bruce Cox, the head of the environmental group Greenpeace in Canada. Last Updated: June 23, 2005 00:08 EDT PrintPrint > > http://stabenow.senate.gov/stoptrash/dangers.htm > > You certainly are one of those right wing kook's, aren't you! Let's see, I am a right wing kook because I don't want radioactive waste and infectious waste from Canada coming in to the US. > Look at what the Canadians are doing with THEIR trash. Blame Canada, sh.t > yea. Canada is sending the trash to Michigan under a contract with a Michigan landfill, do you have a problem with free enterprise? > Canadian Trash Truck Arrives in Michigan Dripping Blood You're already lost the argument right there. Using a worst case anecdotic episode among the hundreds of garbage loads shipped on a daily basis is a weak and alarmist argument which one would expect of a right wing extremist like you. Better luck next time. > Another of Steve's masturbatory rants in need of edit: > > Blame the left > by Steve Harris > > Zee Gee, I read it pretty close, and from here in the trenches (as opposed to criticizing from the outside without a shred of practical experience of what's involved in the practice of medicine), I think he's exactly on target. That IS where the money is going these days. Technology is great, but much of it is overused, and the system does indeed reward for that overuse, making MRI scanners, for example, a good investment. I know that our clinic has just entered a joint venture for an in-house MRI scanner with the hospital and the radiology group, and the pro formas look pretty impressive. We should make a lot of money on that over the next 10 years. Thank you all very much. But it goes beyond stuff like MRI, CT, DEXA, PET scanners and their overuse. Much of surgery is now technology-dependant. There are many, many operations that simply couldn't be done 5 years ago until somebody engineered the tools to do it. Go back to laparoscopic cholecystectomy as the index example. Few would argue its benefits to the population, but now every hospital in America had to order a whole new set of instrumentation and imaging electronics. So many people here on sci.med rant on about medical records and their availability and security, but a system wide EMR is enormously expensive to implement. PACS systems, telecommunications, security, HIPAA...that stuff all adds up and doesn't return a dime. I realize that it's a natural tendency to want it both ways, but that rarely works out. HMc > > Another of Steve's masturbatory rants in need of edit: > > [quoted text clipped - 29 lines] > > HMC I'm not "so many people". I think I have a pretty good idea of what's involved in the practise of medicine; where I live. Should we meet in the no-man's land between your trenches and my trenches and exchange gifts? Zee > > > Another of Steve's masturbatory rants in need of edit: > > > [quoted text clipped - 34 lines] > I think I have a pretty good idea of what's involved in the practise of > medicine; where I live. I think you have a better idea on the politics of socialized medicine rather than the practice of medicine. > Should we meet in the no-man's land between your trenches and my > trenches and exchange gifts? > > Zee Keep your medical waste in Canada, please. > I think you have a better idea on the politics of socialized medicine rather > than the practice of medicine. POT KETTLE BLACK. You're incredibly narrow minded. Are you a shill for the HMO's who fear the competition of socialized medicine? You certainly appear to be one. >>I think you have a better idea on the politics of socialized medicine rather >>than the practice of medicine. > > POT KETTLE BLACK. You're incredibly narrow minded. Are you a shill for the > HMO's who fear the competition of socialized medicine? You certainly appear > to be one. BWAHAHAHAAHAHAHAHAAHAHAHAHAHAHAHAHAHAAHAHAHHAAHAHAHAHAHAHAHAHAHAHAHAHAH competition? there is no competition from socialized medicine, that would be like saying there is competition between a BMW and a bicycle Get this straight and in no uncertain terms there will NEVER , ever under any circumstances ever (ever?, no never) be socialized medicine in the US. Every CABG pt I take care of makes me happy of that, since I actually have CABG pt's to care for and wouldn't under socialized medicine. The newspapers would need to add a little ink to the obits though.... > >>I think you have a better idea on the politics of socialized medicine rather > >>than the practice of medicine. [quoted text clipped - 5 lines] > > competition? there is no competition from socialized medicine, And George W. Bush was a Vietnam war hero. > > >>I think you have a better idea on the politics of socialized medicine > rather [quoted text clipped - 10 lines] > > And George W. Bush was a Vietnam war hero. And you want to put the medical system under George Bush. The logic of you socialist is pretty pathetic. > > I think you have a better idea on the politics of socialized medicine rather > > than the practice of medicine. > > > POT KETTLE BLACK. You're incredibly narrow minded. Are you a shill for the > HMO's who fear the competition of socialized medicine? You certainly appear > to be one. Hear we go again and now I am a shill for HMO's. I don't care in general for HMO's. I do care about options and don't believe in outlawing any options such as what happens in Canada. It's that mentality that will be the end of your Canadian system. Inability to hold on to doctors, nurses, and other healthcare workers because of your zealots socialistic fervor will be the end of it. Let me repeat here that there is no such thing as fear of competition between HMO's, private insurance and socialized medicine. You simply don't have any competition by law. It is the other way around, it is the socialized system that is afraid of competition which is why private insurance is illegal. Your argument is? > Let me repeat here that there is no such thing as fear of competition > between HMO's, private insurance and socialized medicine. You simply don't > have any competition by law. > It is the other way around, it is the socialized system that is afraid of > competition which is why private insurance is illegal. Well, it sure seems that way. Every suggestion that certain services be readily available for those who wish to pay is met with a barrage of socialist objection. moo > > Let me repeat here that there is no such thing as fear of competition > > between HMO's, private insurance and socialized medicine. You simply don't [quoted text clipped - 7 lines] > > moo Why do you discuss things that you know nothing about? Narrow mined ignorance is one of the reasons why our system is headed down the drain and you are doing your damndest to help it along. > I'm not "so many people". > [quoted text clipped - 5 lines] > > Zee Gifts are always nice, but I'd settle for hearing your take on the contribution of advancing technology in medicine, its positive effect on patient care and its negative effect on health care economics. Surely you don't advocate, for examples, abandoning minimally invasive surgery or the move to EMR? I'm not talking about overused diagnostic technology like MRI - let's set that aside FTM. I'm referring to expensive therapeutic technologies like laparoscopy/arthroscopy and mandated expenses such as HIPAA, EMR... HMc > > I'm not "so many people". > > [quoted text clipped - 17 lines] > > HMc Technology in medicine is great; when it's adjunct, and doesn't become a thing unto itself. Zee >> > I'm not "so many people". >> > [quoted text clipped - 23 lines] > > Zee I don't know what that means. Even adjunctive technology is expensive. If people want the improved medical care that such "adjunctive" technology provides, they're going to have to pay more for it that they did as that technology becomes more important, the costs rise concomitantly. It's a very large factor in increasing medical costs in the US. In fact, that technology and the convenience factor in health care demanded by US health care consumers are the main reasons for the high cost of health care here. HMc >>> > I'm not "so many people". >>> > [quoted text clipped - 38 lines] > > HMc Every technology used in medicine is overpriced by huge amounts. Further, most of it just gives us the best documented deaths, not a better life. > Every technology used in medicine is overpriced by huge amounts. > Further, most of it just gives us the best documented deaths, not a better > life. Laparoscopic surgery, most of it anyway, represents a very significant benefit to the patient. George, how do you keep escaping my killfile? At least your demonstration of ignorance has been consistent over all these years. Nice to plonk you again... HMc > > Every technology used in medicine is overpriced by huge amounts. > > Further, most of it just gives us the best documented deaths, not a better > > life. > > Laparoscopic surgery, most of it anyway, represents a very significant > benefit to the patient. Have Zee comment on robotic heart surgery in Canada. >> > Every technology used in medicine is overpriced by huge amounts. >> > Further, most of it just gives us the best documented deaths, not a [quoted text clipped - 5 lines] > > Have Zee comment on robotic heart surgery in Canada. If you want to see about price differentials, just look at the ads for surgery in Canada, which undercuts the USA by about half for various eye surgeries. Similar countries, but Canada does not overprice its medical care the way we do. > >> > Every technology used in medicine is overpriced by huge amounts. > >> > Further, most of it just gives us the best documented deaths, not a [quoted text clipped - 10 lines] > surgeries. Similar countries, but Canada does not overprice its medical > care the way we do. You like to look at the price tag and that the medical toll on patients and doctors alike. Those sayings in dollar amounts are a transfer of funds. They do not have many post grad medical surgical specialties residencies as they were cut to save money. They are not reinvesting money into medical care but shifting that money out of medical care into other governmental programs. The gross national product they spend on healthcare is down. It is not level or the same as it was before the system started. It was cut. You need to use common sense when somebody cuts something then it will not be the same. These are specific cuts in services. If things are so cheap in Canada then why are they afraid of allowing private healthcare to compete with them? > If you want to see about price differentials, just look at the ads for >surgery in Canada, which undercuts the USA by about half for various eye >surgeries. Similar countries, but Canada does not overprice its medical >care the way we do. Of course somewhere around 20% is merely the difference is because of the differences in exchange rates. You can buy sweatshirts in Canada for less, too. -- "No nation would be so dumb as to say that we all want to go one point, we just don't know how to get there. What we are finding is some want to go to San Diego, some to Seattle. We are ashamed to admit this so we pretend we all want to go to San Francisco." Uwe Reinhardt on the health care debate. >> Every technology used in medicine is overpriced by huge amounts. >> Further, most of it just gives us the best documented deaths, not a >> better life. > > Laparoscopic surgery, most of it anyway, represents a very significant > benefit to the patient. Irrelevant comment. It can be useful but overpriced, and IS. > George, how do you keep escaping my killfile? At least your demonstration > of ignorance has been consistent over all these years. Nice to plonk you > again... > > HMc That is how people who bankrupt the nation deal with comments. > Every technology used in medicine is overpriced by huge >amounts. Further, most of it just gives us the best documented >deaths, not a better life. Being old enough to remember when we were performing pneumoencephalograms on patients in order to evaluate conditions we now routinely assess via computerized axial tomographic (CAT) or nuclear magnetic resonance imaging (MRI) scans, and having also read my share of blurry "cuts" on plain old uncomputerized chest tomography, my first impulse is to blow you a huge razzberry. But, of course, you lack that sort of experience and you're obviously unwilling to study the subject in sufficient depth to mitigate the completely bankrupt fund of knowledge upon which you're now drawing. Instead of just dismissing you as a know-nothing, let's see if you're educable. Like the good Associate Professor of Family Medicine I used to be, let me set you a thought- provoking research assignment. I'd like you to study up on the regulations pertinent to medical device manufacture and marketing since the U.S. Food & Drug Administration (FDA) got involved in the field, with particular attention paid to the appointment of David Kessler as Commissioner in 1990, and his policies as they impacted the medical device sector of the health care industry. See http://www.fff.org/comment/ed0597b.asp as one of many possible helpful guides to an understanding of why "technology used in medicine is overpriced by huge amounts." Oh, yeah. I almost forgot. You say that such technology is "overpriced." Relative to what comparator? How might it be brought to market at lower cost (and if it *can* be brought to market at lower cost, what is preventing competitors from doing so)? ---------------------------------- We are born naked, wet, and hungry. Then things get worse. >Instead of just dismissing you as a know-nothing, let's see >if you're educable. Like the good Associate Professor of >Family Medicine I used to be, let me set you a thought- >provoking research assignment. George has been on sabbatical recently so you may not know him. He is pretty much completely uneducatable. -- "No nation would be so dumb as to say that we all want to go one point, we just don't know how to get there. What we are finding is some want to go to San Diego, some to Seattle. We are ashamed to admit this so we pretend we all want to go to San Francisco." Uwe Reinhardt on the health care debate. > George has been on sabbatical recently so you may not >know him. He is pretty much completely uneducatable. Hm. Well, perhaps we can hold him up as a bad example. I'd nonetheless like to know if he's any relation to SF editor (Edward) Groff Conklin. As a youngster, I very much enjoyed the various anthologies Mr. Conklin edited and/or co-edited. ---------------------------- The art of economics consists in looking not merely at the immediate but at the longer effects of any act or policy; it consists in tracing the consequences of that policy not merely for one group but for all groups. -- Henry Hazlitt > Every technology used in medicine is overpriced by huge amounts. COMMENT: That's a value judgement, and of course subject to subjective disagreement. I personally think that diamonds and Lamborghinis and even new cars in general are "overpriced." Which means I don't think they are as valuable as the prices the market charges for them. Other people disagree with me, which is why they continue to sell (to others). So? > Further, most of it just gives us the best documented deaths, not a better > life. COMMENT: Again, many people diagree, including those willing to pay for the medical care. These arguments are all rather pointless unless I'm forced to pay for your new car, or something else I regard as your frills and waste, and vice versa. But so long we each get to choose what's worth paying for, there's no problem. My problem here with you, is two fold. There are people like you who think that some things in life have some kind of INTRINSIC and OBJECTIVE value, and can therefore be said to be intrinsically "overpriced" or "underpriced" in this place or that place. Which is nonsense. But then you go and want to make these decisions for everybody, so that your "value system" for medical care would be forced upon everyone in your society. How perfectly egotistical of you. You wouldn't do that with your tastes in wallpaper or houses or flowers or women or neckties. But you want to do it as regards your taste in cancer or heart disease treatment. I don't really know what to say to that. My other problem with you is that I think your tastes in what's worth what would change drastically in medicine if you had the benefit of having most of the diseases you're talking about, or at least being in close contact with people who do. If you were an ICU nurse or a SNF caretaker or some kind of other health worker, that would be one thing. But I have the impression that you're some kind of university wonk who probably hasn't seen even one person die slowly of cancer, or rapidly of sepsis, let alone a hundred. So what makes you think you know what you're talking about? Your tastes are your tastes, but at least let them be well-informed ones. SBH > >> > I'm not "so many people". > >> > [quoted text clipped - 35 lines] > > HMc It isn't such a pervasive factor here Howard. I am not against technology per se. But perhaps my view can be summed up this way. Yes I know it's the ubiquitous MRI, but fill in whatever for your answer: ~~ A letter to the editor decried the long wait to have a simple knee injury iagnosed with MRI. There should be more MRIs, said the writer. He shouldn't have to wait. Healthcare was a mess. People needed to be diagnosed now. A folliwing letter to the editor asked: when did physcians stop knowing how to diagnose a simple knee injury by touch? When MRIs came in. ~~ Technology if it will do the job better. Used judiciously and with this caveat; in whose hands. We just don't go the tech route here, by and large, as much as is done in the States. So I'm told. Of course, I have no personal experience of healthcare in the States. Zee >> >> > I'm not "so many people". >> >> > [quoted text clipped - 52 lines] > He shouldn't have to wait. Healthcare was a mess. People needed to be > diagnosed now. funny.....I was able to get an MRI on my kneee the next day > A folliwing letter to the editor asked: when did physcians stop knowing > how to diagnose a simple knee injury by touch? sorry toots...there is NO way any doc can accurately diagnose a knee by touch?? yikes..ever try it... OR...the alternative is to have an "open" knee repair..so the doc can search around for the injury...all the while creating a much more difficult surgery and recovery for the patient having knee surgery when the doc knows EXACTLY where the injury is(by MRI) actually costs the system much less!!! as follow up care...hospital stay..etc...not to mention reducing surgical risks by having the patient "under" for as short a time as possible.... but I know...you also think I can 'cure" my degenerated ankle tendon with witchcraft > When MRIs came in. > ~~ [quoted text clipped - 7 lines] > > Zee >>> >> > I'm not "so many people". >>> >> > [quoted text clipped - 57 lines] > > funny.....I was able to get an MRI on my kneee the next day Quiet. You will upset the ranters on Usenet who thrive on lies. >> A folliwing letter to the editor asked: when did physcians stop knowing >> how to diagnose a simple knee injury by touch? [quoted text clipped - 13 lines] > but I know...you also think I can 'cure" my degenerated ankle tendon with > witchcraft But do you need a diagnosis on a sore knee the same day? I know people who have sore knees and when they want a diagnosis, often after years and years of delay, do they need it tomorrow? "george conklin" <george@nxu.edu> wrote in > But do you need a diagnosis on a sore knee the same day? I know people > who have sore knees and when they want a diagnosis, often after years and > years of delay, do they need it tomorrow? Gee George, I don't know. Do YOU? Who would you pick to decide for you? moo > >>> >> > I'm not "so many people". > >>> >> > [quoted text clipped - 81 lines] > who have sore knees and when they want a diagnosis, often after years and > years of delay, do they need it tomorrow? People should not be treated like children. Adult should have the right and option do as they feel appropriate. In a socialistic system they lose the right to make choices. If a person is in pain then yes they should have the correct remedy in hours and days. I don't want you George determining how long a person lives with pain. If a person wants to save money and go with single payer or private insurance knowing all the consequences then some people will go with living in pain for months or years to get an Xray but that should be a choice and not imposed by government. Once that is left to government then there is no choice and no accoutability. >>>>>>>>I'm not "so many people". >>>>>>>> [quoted text clipped - 121 lines] > Once that is left to government then there is no choice and no > accoutability. You act as if most people in the US have any choices. In the US, unless you are rich, or have very good insurance, you first have to go to your FP, THEN you need a referral, THEN you get sent to a hospital for the procedure. At no where along the way is their any choice. A FEW things, like some eye treatments are not covered by any insurance - (except the insurance that members of Congress have) The prices of these few competitive things consistently FALL, not rise, and patients have a real choice.  Signature"...in addition to being foreign territory the past is, as history, a hall of mirrors that reflect the needs of souls observing from the present" Glen Cook >>>>>>>>>I'm not "so many people". >>>>>>>>> [quoted text clipped - 130 lines] > have to go to your FP, THEN you need a referral, THEN you get sent to a > hospital for the procedure. no...not very good insurance...simply PPO coverage rather than HMO coverage(yes that will cost you a tad more )... with PPO...one can call ANY specialist listed in the voluminous book that takes their PPO coverage....and most will once you get to the ortho (in this case)...he writes the referral..you get a slip..and you call and make the appt...the specialist is NOT a gatekeeper,,as in HMO..so he has no stake in whether you get that MRI or not...he needs it to diagnose you..so he orders it(around here I can get in for an MRI of a joint within a day or two) > At no where along the way is their any choice. yes there is...using my PPO ..I pull out the trusty book with its list of providers,,etc that accept my PPO..and call directly..first ?? "do you accept XXXX PPO?" if they say no...I call the next one > A FEW things, like some eye treatments are not covered by any insurance depends upon WHICH eye treatment??? LASIK,,,eye glasses are not covered if one's carrier doesn't include vision coverage(actually I don't know of a plan that covers LASIK...glasses yes)...but other eye treatment...cataracts,,,infections..hemorrhages...etc are all "medical conditions"...they are covered > - (except the insurance that members of Congress have) The prices of these > few competitive things consistently FALL, not rise, and patients have a > real choice. >> People should not be treated like children. Adult should have the right >> and [quoted text clipped - 24 lines] > few competitive things consistently FALL, not rise, and patients have a > real choice. Ted, I'm nowhere near 'rich' and not really sure what yours or others definition is of 'rich'. What I do know is if you can show you have the ability to pay, kinda like instant credit to buy a car or living room set or major credit card, you will very likely be able to see a doctor of choice. Now IIRC the # 1 reason for being in major debt in this country (USA) is healthcare debt. We seem to not blink an eye to buy a $65,000.00 SUV or Lexus, but become less comfortable 'buying healthcare' even when said healthcare services could allow you better health and even when the buyer can afford it. My eyecare "insurance" costs annually as much as I would pay out of pocket for my yearly full eye exam. But if something more ivlolved comes along, I might have an edge on covering the cost, just like car insurance. Major health issues requiring hospitalization, that's something totally different. Now you've involve a ho$ipital. I choose all my doctors. SWC >>> People should not be treated like children. Adult should have the right >>> and [quoted text clipped - 34 lines] > said healthcare services could allow you better health and even when the > buyer can afford it. how true how true!! did some reading last night on this issue of "medical bankruptcy"...and was amazed and appalled how many folks live so close to the edge...yep same folks with those Lexus ans SUV even for their teenagers...then bitch and moan when an illness comes around..and they have not had the forsight to SAVE for the deductibles and copays..etc.. the dollar amount for these medical bankruptcies was $13,000 or less (for copays...etc)...as one poster stated "these folks were already in financial doo doo if a $13,000 bill (over a year) would cause them to file bankruptcy...ever think of selling one of your overpriced cars.??? or paying off the debt on the installment system??? nah...get a shyster lawyer...and the rest of us have to support your folly by OUR increased costs... I have a family member who thinks this is the way to go....charge everything in sight..cars,,cell phones,,computers...etc...then "oh wait...I owe $75,000 "..yikes I cannot pay that back...get a "debt counselor who makes deals with each payor..and voila..that debt is settled for maybe 30 cents on the dollar...all the while the cell phones,,cars and computers are left unscathed... personally I think it is reprehensible ..not to mention fiscally irresponsible....also a total lack of personal responsibility...teaches your kids nothing about the concept of "saving for a rainy day".. > My eyecare "insurance" costs annually as much as I would pay out of pocket > for my yearly full eye exam. But if something more ivlolved comes along, [quoted text clipped - 6 lines] > > SWC >>>> People should not be treated like children. Adult should have the right >>>> and [quoted text clipped - 73 lines] >> >> SWC No pouring it on the needy justifies the cost of health care, nor does not having universal coverage mean that people should sell their houses when they get sick. You can give up luxury goods and still spend it all in 1 day in a hospital. >>>>> People should not be treated like children. Adult should have the >>>>> right and [quoted text clipped - 77 lines] > having universal coverage mean that people should sell their houses when > they get sick. firstly...bankruptcy protects your home...at least in the us... so forget that argument You can give up luxury goods and still spend it all in 1 day > in a hospital. again....this "issue" concerned insured folks who could NOT afford the deductibles, copays...etc not to mention that health insurance has what is called "max out of pocket"... the bankruptcy bs concerned those "with" luxuries who had NOT saved a cent towards a rainy day... again..no insurance...and even in the usa...health care..free health care...is available...visit an ER sometime(and see BTW the numbers of SUV's in the parking lot!!) my point being...do NOT expect a free ride...yet MY ride costs more because YOUR ride is on me >>>>>> People should not be treated like children. Adult should have the >>>>>> right and [quoted text clipped - 82 lines] > > so forget that argument I actually know one person who goes after those who cannot pay their hospital bills. They bankrupt themselves and most of their relatives and children, and many loose the farm. > You can give up luxury goods and still spend it all in 1 day >> in a hospital. [quoted text clipped - 7 lines] > the bankruptcy bs concerned those "with" luxuries who had NOT saved a cent > towards a rainy day... I am glad you have so much saved up. Few people can afford or get $13,000 together on one day's notice. > again..no insurance...and even in the usa...health care..free health > care...is available...visit an ER sometime(and see BTW the numbers of > SUV's in the parking lot!!) > > my point being...do NOT expect a free ride...yet MY ride costs more > because YOUR ride is on me Those who do get free care are getting a free ride. The problem is that without universal health coverage, they do not put anything into the pool. Further, the so-called free ride is not free at all. They deny on-going things such as cancer treatments, since that is not a stabilization, which is all that is required. >>>>>>> People should not be treated like children. Adult should have the >>>>>>> right and [quoted text clipped - 86 lines] > hospital bills. They bankrupt themselves and most of their relatives and > children, and many loose the farm. it is called homesteading...it "protects" the family home from Calif Dept of Consumer Affairs "what is a homestead declaration?" A homestead declaration is a legal domument that claims and registers a particular house as the owner's homestead...When the document is signed ...it helps to protect the house against loss to creditors...The legal effect is to immunizie the house and the land on which it is located from many legal enforcement measures...For instance..if a homeowner files a petition in bankruptcy..it may be possible,,because of the declared homestead..to retain the family home instead of losing it to creditors..." snip >> You can give up luxury goods and still spend it all in 1 day >>> in a hospital. [quoted text clipped - 10 lines] > I am glad you have so much saved up. Few people can afford or get > $13,000 together on one day's notice. never mentioned ONE day's notice....IF one has unreimbursed medical bills of $13,000(according to the article posted)...no one expects their pound of flesh in one day...again..this "medical bankruptcy" issue concerned those WITH health insurance who could not meet the ANNUAL expenses..out of pocket..copays etc..in a year BEFORE rushing to lawyers and screaming bankruptcy..one needs to contact those they owe money to ..and make good faith gesture to begin re payment...even $10 a month towards a hospital bill is accepted... personal responsibility... >> again..no insurance...and even in the usa...health care..free health >> care...is available...visit an ER sometime(and see BTW the numbers of [quoted text clipped - 8 lines] > on-going things such as cancer treatments, since that is not a > stabilization, which is all that is required. on going cancer treatement IS provided...where DO you get this info?? "george conklin" <george@nxu.edu> wrote in message news:mPCDe.2176$6f.1445@newsread3. >> the bankruptcy bs concerned those "with" luxuries who had NOT saved a >> cent towards a rainy day... > > I am glad you have so much saved up. Few people can afford or get > $13,000 together on one day's notice. And only an idiot would think they'd never have to. moo > "george conklin" <george@nxu.edu> wrote in message > news:mPCDe.2176$6f.1445@newsread3. [quoted text clipped - 7 lines] > > moo thank you ....at times I think "we" are the only ones around who live within our means... novel concept,,huh?? > > "george conklin" <george@nxu.edu> wrote in message > > news:mPCDe.2176$6f.1445@newsread3. [quoted text clipped - 12 lines] > > novel concept,,huh?? Please do not forget that there is a major industry aimed at promoting folks to spend beyond their means. The notion of style which denotes no substance is everywhere. Going thru this here life with out an image promoting consumption is impossible almost. We are weak and insignificant unless our shoes are of a special type usually those made in sweat shops. A minute of ad time at super bowls cost a lot for a reason. Seems us human's like to mimic. Takes a lot to break free of this. Stuart Ewen in his book "All Consuming Images" ISBN 0-465-00100-9 touches on this. Paul Wachtel in " The poverty of Affluence " along with Andrew Bard Schmookler's "Fools Gold" offer more reading adventures. PS Schmookler is a personal hero ! ;)) Bill SignatureGarden Shade Zone 5 in a Japanese Jungle manner. FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit. >> > "george conklin" <george@nxu.edu> wrote in message >> > news:mPCDe.2176$6f.1445@newsread3. [quoted text clipped - 32 lines] > > Bill Bill....funny you should mention this...as hubby and I discussed the very same thing dilemma last night ie...WHY and HOW does a loan/credit place even SELL a car costing 50K to a man making 65 K?? do they want to reposses it?? not sure how one figures the amount one should finance exactly (houses being a different subject,,since most will appreciate in value..and the payback is over a much longer period of time) but vehicles lose..how much..about 25% of value when they are driven off the lot...so by the time it is paid off...assuming a 5 year loan..it is probably not worth much.. > >> > "george conklin" <george@nxu.edu> wrote in message > >> > news:mPCDe.2176$6f.1445@newsread3. [quoted text clipped - 46 lines] > lot...so by the time it is paid off...assuming a 5 year loan..it is probably > not worth much.. My guess is we live in a fragmented society. The loan providers do their thing the repro folks do theirs if needed. Neither talk to each other just do their tasks well. Push Push aka Buy Buy the main thing of import. Frugality....Sorry I typed it ;)) Rent the movie Repro Man for escape. Bill SignatureGarden Shade Zone 5 in a Japanese Jungle manner. FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit. "William Wagner" <Nonsence_here_B2wagner@Snip.net> wrote in >> >> I am glad you have so much saved up. Few people can afford or get >> >> $13,000 together on one day's notice. >> > >> > And only an idiot would think they'd never have to. >> thank you ....at times I think "we" are the only ones around who live >> within [quoted text clipped - 4 lines] > Please do not forget that there is a major industry aimed at > promoting folks to spend beyond their means. Sure. Blame them. Have the government step in and regulate them. There is also a major industry aimed at promoting folks to save money and buy insurance. < snip whining > moo > "William Wagner" <Nonsence_here_B2wagner@Snip.net> wrote in > >> >> I am glad you have so much saved up. Few people can afford or get [quoted text clipped - 19 lines] > > moo Who is "them"???? SignatureGarden Shade Zone 5 in a Japanese Jungle manner. FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit. > > Please do not forget that there is a major industry aimed at > > promoting folks to spend beyond their means. > > Sure. Blame them. Have the government step in and regulate them. COMMENT: That would be ironic, since the government is about the worst offender in this regard. The only difference is it dares not declare bankruptcy. If we had a balanced budget requirement at the fed level (as the states do), so that we had to pay for our stupid wars year by year, not only would we avoid killing ourselves with national debt, but we'd be a lot less likely to get into stupid wars. I keep talking to super-patriots on net who have the idea that we should just "clean up" Iraq on general principles to give the Iraqies the precious gift of freedom and save ourselves (maybe) future problems from Saddam's regime. But if all these people got a separate $1000 a year charge on their 1040 as a "war tax" to do all this neat stuff, methinks they'd be a little less patriotic and aggressive come April 16. > There is also a major industry aimed at promoting folks to save money and > buy insurance. COMMENT: There is, but you know what? I hardly ever hear from them, as opposed to the "What's in YOUR wallet" Capital One vandal team. Why do you suppose that is? You know, I've talked about the history of life insurance, and it's a history which is damned fascinating. The idea that you should be able to bet on the death of a loved one, was initially so goulish that society reacted to it rather like they react to the idea of cryonics now. It took GENERATIONS for life insurance to become respectable. Really. Think of the stigma that tampon and condom commercials had to face-- for life insurance it was far, far worse, and it took a lot longer. When you buy life or medical insurance, you're forced do think about your own vulnerability or mortality for a while, while you fill out papers. Most people cannot do that. And when you have to fill out detailed forms about exactly what you want done with your body after you die (unless it's something really conventional where you don't have to think about it or make any choices), the mental circuit breakers really go. This is one of the basic reasons the medical insurance problem is not so neatly solved with an advertising campaign like that for credit cards. There just no way to make getting sick or getting dead, sexy. People tend to avoid such decisions, and whent they do, the government winds up with them by default. SBH "Sbharris[atsign]ix.netcom.com" <sbharris@ix.netcom.com> >> There is also a major industry aimed at promoting folks to save money and >> buy insurance. [quoted text clipped - 11 lines] > face-- for life insurance it was far, far worse, and it took a lot > longer. There was no lack of people willing to sign up for whole life rip-off policies a few decades ago. Whole life insurance sales made many brokers very rich and they did it by appealing to the things you claim people shy away from. It is a huge business and, up until a decade or so ago, a bit of a scam. A person could do better buying term insurance and banking the difference. Whole life is still sold as an estate planning strategy. And, there's actually some real value in it now. > When you buy life or medical insurance, you're forced do think about > your own vulnerability or mortality for a while, while you fill out [quoted text clipped - 7 lines] > dead, sexy. People tend to avoid such decisions, and whent they do, the > government winds up with them by default. In the case of medical insurance, that may well be. moo "ted rosenberg" <tedrosenberg@iname.com> wrote in message > > You act as if most people in the US have any choices. As an immigrant from a third world country you have many choices. The problem is your state of mind. I left my country in order to have a choice. You were born into it and can't really appreciate it. > In the US, unless you are rich, or have very good insurance, you first > have to go to your FP, THEN you need a referral, THEN you get sent to a > hospital for the procedure. ?? I am not rich and can go directly to a specialist if I want. I just have to pay a higher deductible. If you feel it is important enough to you then find a job that you are able to do that in. If you want a big house with a swimming pool and a nice insurance then get a good job. If you don't want to work then expect to cardboard box for housing and the county hospital or medicaid programs. Just don't expect to eat lobster and have the tax payers pick up the tab. > At no where along the way is their any choice. There is no free lunch in life. If you don't like your choices then improve your status and it will provide you with more choices. I think you want people to hand you things as though it is your right to have them. >>>> >> > I'm not "so many people". >>>> >> > [quoted text clipped - 83 lines] > who have sore knees and when they want a diagnosis, often after years and > years of delay, do they need it tomorrow? no of course not...actually it had been bothering me for quite some time before I actually went to an ortho.. my point was...once seen...I got in for an MRI the next day... arthroscopic knee repair is a piece of cake when compared to "open"....and YES...my ortho probably did "think" it was meniscus...but having the techie documentation made MY experience,,repair...etc soooo much easier... > >> >> > I'm not "so many people". > >> >> > [quoted text clipped - 84 lines] > > > > Zee Touch, means the kind of diagnosis of "simple" knee injuries with something other than MRI. It includes eyes and experienced judgement, and less expensive technolgoy if necessary but also MRI if then needed. But just throwing the most expensive technology at an illness or injury first thing is not the best way to practise medicine. It is probably the best way to practise business. >> >> >> > I'm not "so many people". >> >> >> > [quoted text clipped - 105 lines] > first thing is not the best way to practise medicine. It is probably > the best way to practise business. and HOW do YOU know what my doc did or did not do?? were you in the exam room?? no doc...no not even in Canada the great....can SEE inside a knee joint...to evaluate the significance of an injury...or whether or not surgery is indicated ....you must have missed where I stated that the knee pain had persisted for months...and also that said knee had been totally wrecked in a car accident 29 years ago..no patella,,,multiple breaks to below and above the knee... actually NOT doing an MRI to evaluate the extent of MY injury would be tantamount to malpractice.. but then what would YOU know?? oh yes...forgot all your dinner friends are doctors... BFD <Hawk...@sbcglobal.net> wrote: > >> >> >> > I'm not "so many people". > >> >> >> > [quoted text clipped - 123 lines] > > BFD I wasn't aware the topic of discussion was your knee and your MRI. Zee > <Hawk...@sbcglobal.net> wrote: >> > [quoted text clipped - 152 lines] > > Zee good one...change the subject what a twit > > >> >> > I'm not "so many people". > > >> >> > [quoted text clipped - 91 lines] > first thing is not the best way to practise medicine. It is probably > the best way to practise business. The best way to practice business is to keep costs down. Ordering doctors do not get a kickback on the number of MRI's they order. HMO's have incentives on keeping the groups costs down and not up so they tend to order less. There are malpractice concerns so more and not less are ordered in an acute hospital setting. With outpatient settings Hawki gave some good reasons why they are necessary. We are a level I trauma center which means it is also teaching and research so the cost of teaching and using technology is increased. >> > >> >> > I'm not "so many people". >> > >> >> > [quoted text clipped - 134 lines] > >thanks Robert sometimes I feel talking to Zee is akin to a brick wall... >> >> > I'm not "so many people". >> >> > [quoted text clipped - 65 lines] > in the States. So I'm told. Of course, I have no personal experience of > healthcare in the States. More stupid excuses. We pay physicans twice as much, and then blame technology. You can read ads for eye surgery in Canada, asking Americans to come there for half-priced eye surgery. > Zee >>> >> > I'm not "so many people". >>> >> > [quoted text clipped - 72 lines] > technology. You can read ads for eye surgery in Canada, asking Americans > to come there for half-priced eye surgery. stupid analogy... in MY experience..."cheap" can equate with "not enuf experience"...ie...even in the US there are ads for "half priced eye surgery"...do the research..find out how much (liitle actually)...training and experience and how many procedures these docs doing "cheap" eye surgery actually have.... when I chose my LASIK surgeon..I did the research...chose a doc who was trained to do LASIK by whoever invented the technology (somewhere outside the US)..at that time..he had also performed..successfully..MORE LASIK procedures than any other guy in the states... sorry..would not let an amateur laser my eyes...so Price is not the chosen way to decide who to go to...experience,,expertise,,training..number of procedures...etc... now don't ask me to comment on the charlatans doing "plastic surgery"....docs who never did more than a hernia or c section in med training... those that are charging more...are most often worth every penny (also remember that LASIK and plastic surgery is a cash business...so the charlatans,,poorly trained practitioners..are coming out of the woodwork) >> Zee > More stupid excuses. We pay physicans twice as much, and then blame > technology. COMMENT: As noted, total medical spending has been rising rapidly in both Canada and the US for the last decade, but physician salaries have not. So we are NOT getting the extra money in *either* place. Try again. SBH >You can read ads for eye surgery in Canada, asking Americans to > come there for half-priced eye surgery. COMMENT: Well, SOME of you can read the ads... :) > >> > I'm not "so many people". > >> > [quoted text clipped - 35 lines] > > HMc Decisions such as those are made for the people by government officials. It's like voting for the best socialist in the group. There is no vote on the system and only who you want running the system. "outrider" <outrider@despammed.com> wrote in message >> I'm not talking about overused diagnostic technology like MRI - let's set >> that aside FTM. I'm referring to expensive therapeutic technologies like >> laparoscopy/arthroscopy and mandated expenses such as HIPAA, EMR... >> > Technology in medicine is great; when it's adjunct, and doesn't become > a thing unto itself. Give some examples of what you mean by this. |
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