tag:blogger.com,1999:blog-16821859.post113848637464057222..comments2024-03-26T16:03:42.608-06:00Comments on Flares into Darkness: Star Trek and Scienceambisinistralhttp://www.blogger.com/profile/03836786826294202405noreply@blogger.comBlogger51125tag:blogger.com,1999:blog-16821859.post-1138765314397699912006-01-31T20:41:00.000-07:002006-01-31T20:41:00.000-07:00health co-ops--wow--has the ring of truth about it...health co-ops--wow--has the ring of truth about it--a mixed entity with distributed ownership and resposibility. really does sound like an idea for rural counties.buddy larsenhttps://www.blogger.com/profile/17760847873026506988noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138632471664169002006-01-30T07:47:00.000-07:002006-01-30T07:47:00.000-07:00rickIn a perfect world everyone would know everyth...rick<BR/><BR/>In a perfect world everyone would know everything and have prescience about all consequences. Read my lips. Social Security has been with us since before most of us were born. We don't even think about it. <BR/><BR/>It's not that the electorate was blocking govt from changing it, nobody told us until recently it was a ponzi scheme and my god has to be changed. Nobody told us DISASTER COMING DANGER DANGER. And I guess some folks think the soc sec meltdown is akin to overpopulation fears, global warming, and power lines causing cancer.<BR/><BR/>I'm sure those who implemented it didn't believe it was a bad idea.<BR/><BR/><I>the ignorance and gullibility of the electorate. Good hearted, perhaps, but not a group whose decisions provide a positive advertisement for democracy.</I><BR/><BR/>Good grief. Do you have any idea how elitist this sounds?<BR/><BR/>I have news for you. Democracy is for poor as well as rich, stupid as well as smart, doers as well as slackers.<BR/><BR/>A worthwhile mission to pursue is education. But pointing out cynically how pathetically ignorant everyone else is isn't going to help.Sylhttps://www.blogger.com/profile/03069871911665125873noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138631703882150912006-01-30T07:35:00.000-07:002006-01-30T07:35:00.000-07:00Once upon a time doctors did house callsI knew (we...<I>Once upon a time doctors did house calls</I><BR/><BR/>I knew (well, my best friend at the time had cats who were his patients) a vet who was the last known vet in America to make housecalls. <BR/><BR/>He died thirty years ago.<BR/><BR/>He wrote a wonderful book called:<BR/><BR/>All My Patients are Under the Bed<BR/><BR/>Probably out of print.<BR/><BR/>And probably neither here nor there. Except that vet costs are going sky high too while health insurance for pets is still a novelty.<BR/><BR/>So there's something going on independent of our insurance system don't you think?Sylhttps://www.blogger.com/profile/03069871911665125873noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138620842827965252006-01-30T04:34:00.000-07:002006-01-30T04:34:00.000-07:00knucklehead:My point is that for some people the o...knucklehead:<BR/><BR/>My point is that for some people the only options are to give care or refuse it because its cost is so high they can not pay.<BR/><BR/>I mentioned pregnant women because you did. <BR/><BR/>The truth is this economy requires that many people not make a lot of money. I am not a socialist but I understand that cheap labor and low paying jobs help make the economy run and it is just a fact that people like that will not make enough money to afford high price health care.<BR/><BR/>My point about firemen is that not everything is about money. Once upon a time doctors did house calls and they absorbed a lot of costs. First do no harm. Now it is a lot more about money.terryehttps://www.blogger.com/profile/16609746018265953069noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138600815774923862006-01-29T23:00:00.000-07:002006-01-29T23:00:00.000-07:00Remember, government is about what and how much, a...Remember, government is about what and how much, and almost by definition no two people will ever agree, and idealists and realists look to each other like they have fish heads. There IS away, however, to come to a <A HREF="http://www.etext.org/Zines/ASCII/HoltzLusiNation/Photos/1999/1999-08-10%20MSL+BH%20duel%202.jpg" REL="nofollow">complete agreement</A>:buddy larsenhttps://www.blogger.com/profile/17760847873026506988noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138587299683295662006-01-29T19:14:00.000-07:002006-01-29T19:14:00.000-07:00"I disagree with the characterization of Americans...<I>"I disagree with the characterization of Americans trying to get something for nothing...as if they know that's what they're doing."</I><BR/><BR/>The two greatest political frauds committed in this country were whooped through Congress by the same generation and the same party. I've never written about the "Greatest Generation" as such and I never shall. I can't even see it written without laughing. The plea of ignorance that you enter on behalf of those guilty is probably at least partially true but the pols who wrote and proposed Social Security and Medicare knew precisely what they were doing and they played on the ignorance of the electorate as skillfully as if they were concert pianists playing Chopsticks. <BR/><BR/>If you think me cynical, what do you think of the greasy pols who concocted the Ponzi schemes in the first place and sold them based upon the known ignorance of the electorate? I'm reasonably evenhanded in my condemnation of the phonies and hustlers we pay for governance. I wish I had a 'rent a backbone' concession on Capital Hill but I fear that if I had, I would be bankrupt within a year due to lack of trade. On a need basis a years income would set me up for life.<BR/><BR/>The people get the government they want - and the government that they deserve. The "health care crisis" has been ongoing since the day medicare passed (over the vociferous objections of the AMA).<BR/><BR/>The villains in this low drama/farce are not doctors or attorneys (mebbe insurers should get handlebar mustaches) but the main villain is - as you pointed out - the ignorance and gullibility of the electorate. Good hearted, perhaps, but not a group whose decisions provide a positive advertisement for democracy.Rick Ballardhttps://www.blogger.com/profile/11082425215912372067noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138585998559908622006-01-29T18:53:00.000-07:002006-01-29T18:53:00.000-07:00Knuck and Terrye,I think you should both go back a...Knuck and Terrye,<BR/><BR/>I think you should both go back and reread what the other has posted. From where I sit it looks like you both are misreading the other and being a bit touchy.<BR/><BR/>And now I will shut my mouth and go feed the cats.chuckhttps://www.blogger.com/profile/15164145672293455823noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138581438079848562006-01-29T17:37:00.000-07:002006-01-29T17:37:00.000-07:00Knucklehead:How much does a fireman make for runni...Knucklehead:<BR/><BR/>How much does a fireman make for running into a burning building? I work in health care and I know plenty of doctors who are not struggling.<BR/><BR/>I live in a small town and doctors here are not that rich either, but then again there are very few doctors in places like this.<BR/><BR/>They would rather be specialists and live in a place where they can make enough money that someone like my brother can build them a seven car garage to go with the mansion he just built them in the gated community where they live with other highly paid professionals.<BR/><BR/>And as for the pregnant woman being delivered whether or not she has money...would you prefer she be turned out to have the baby in the parking lot?<BR/><BR/>I mean really. This is the kind of attitude that pisses me off. If that woman had wanted an abortion eight months earlier conservatives would have been right there doing everything they could do to stop it.<BR/><BR/>But hey, once labor starts she and the kid are on their own.<BR/><BR/>I have a client who was an exercise freak. He worked hard and was a middle class guy. Then he had an accident on a mountain bike. He ended up a quad and on medicaid. It was not his plan. He did not want something for nothing.<BR/><BR/> The problem with the high costs is not just that people on medicaid get help, it is that the high costs are responsible for people being on medicaid in the first place. Their insurance and other resources only go so far.terryehttps://www.blogger.com/profile/16609746018265953069noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138573558187912642006-01-29T15:25:00.000-07:002006-01-29T15:25:00.000-07:00The Average Bear does not undergo 4 years of rigor...<I>The Average Bear does not undergo 4 years of rigorous undergruate school + four years of even more rigorous graduate school for the prospect of making $32K/year...</I><BR/><BR/>I was making a comparison to folks in the sciences, not engineering. Someone headed for a research position will be doing just as much work, academic and in the lab, while spending a number of years as post-docs with salaries in the 30K-40K range. Then again, their graduate education will usually be financed by working as a TA or through employment by professors who have grants, so they will not be greatly in debt but will only have suffered from deferred earnings -- more so than the physicians as their professional salaries are likely to be less.chuckhttps://www.blogger.com/profile/15164145672293455823noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138568234363956282006-01-29T13:57:00.000-07:002006-01-29T13:57:00.000-07:00Knucklehead,One way the demand for more doctors is...Knucklehead,<BR/><BR/>One way the demand for more doctors is attempting to be met is to have many functions traditionally undertaken only by MDs be done by other personnel, such as nurses, physician's assistants, etc. In my profession of psychology, the American Psychological Association has been lobbying for years (and is now winning) prescription privileges for psychologists (something I'm against but I'll be on the losing side of that and that's another story). I also suspect we'll do some outsourcing of things that can be done via internet (e.g., reading Xrays by Indian MDs, etc.). Whether this will work is another thing altogether.Barry Dauphinhttps://www.blogger.com/profile/15808109325931309525noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138565247786785802006-01-29T13:07:00.000-07:002006-01-29T13:07:00.000-07:00you can start working 80-100 hours per week for th...<I>you can start working 80-100 hours per week for the princely sum of $32,000.</I><BR/><BR/>I think the whole internship thing is more like hazing, or an initiation rite, than education. If there are too few doctors to lower the hours, then supply more doctors (sounds simple, I know).<BR/><BR/>I would also say that many folks in technical/scientific fields work just as hard for just as long, or longer. Some of the technical people may do better than $48K at age 32, some worse, but however you look at it, it is not that bad a salary.chuckhttps://www.blogger.com/profile/15164145672293455823noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138564857958075392006-01-29T13:00:00.000-07:002006-01-29T13:00:00.000-07:00meaninglesshotair,I'm hoping that our different un...meaninglesshotair,<BR/><BR/>I'm hoping that our different understandings of what we will and won't put up with aren't submitted to an empirical test, but it might be (i.e., I don't want socialized medicine as the experiment to test our different predictions). I don't think that Americans, on the whole, will put up with long waits for routine procedures, but I could be wrong. I think Americans prize liberty more than our neighbors to the North or the Euros.<BR/><BR/>Yet, the amount of GDP that healthcare consumes is going to result in some kind of changes to the system at some point, even if we kick the can down the road for a while longer. I don't think Americans, on the whole, are aware of the entitlement feelings that I described in earlier comments. I think it is extraordinarily difficult for anyone to receive something valuable (like healthcare) which is paid for indirectly (for the most part) and to not feel somewhat entitled to receive it. I think that is human nature. The Canadians and Euros feel entitled to free healthcare, only they do not seem to value liberty to the same degree that Americans do, so they wait or ignore the fact that they have shortages that inevitably accompany anything that is rationed. In that situation equality means some misery for everyone.<BR/><BR/>Many people don't understand that the health insurance actually means a lower wage than they otherwise would receive, as they don't receive it in the first place. And our educational system does not do a very good job of explaining the nuts and bolts of social security and healthcare.Barry Dauphinhttps://www.blogger.com/profile/15808109325931309525noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138560565815404972006-01-29T11:49:00.000-07:002006-01-29T11:49:00.000-07:00I see we still don't have a grip on why costs are ...I see we still don't have a grip on why costs are so high. Or even if they *are* high relative to services rendered.<BR/><BR/>In that regard, I recall paying someone's bill at the hospital counter and noticing the charge for a box of kleenex: $10. And that was some 20 years ago. Clearly something wasn't quite right even then, and don't get me started on hospital food.chuckhttps://www.blogger.com/profile/15164145672293455823noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138557139082579132006-01-29T10:52:00.000-07:002006-01-29T10:52:00.000-07:00RickI have nothing against means testing. I disagr...Rick<BR/><BR/>I have nothing against means testing. I disagree with the characterization of Americans trying to get something for nothing...as if they know that's what they're doing.Sylhttps://www.blogger.com/profile/03069871911665125873noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138555701642952402006-01-29T10:28:00.000-07:002006-01-29T10:28:00.000-07:00Syl,Means testing implies hatred? Where?There is a...Syl,<BR/><BR/>Means testing implies hatred? Where?<BR/><BR/>There is a percentage of the population that cannot care for themselves (for whatever reason). Applying societal resources to care for them appears to me to be a moral duty unworthy of discussion. It just <I>is</I>, as the those unable to care for themselves just <I>are</I>. <BR/><BR/>I have to leave now but I'll return with a longer response later.Rick Ballardhttps://www.blogger.com/profile/11082425215912372067noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138554971774529562006-01-29T10:16:00.000-07:002006-01-29T10:16:00.000-07:00RickYou are brutal. You seem to hate the recipient...Rick<BR/><BR/>You are brutal. You seem to hate the recipients of social security and medicaire. Please. Get a clue. Social Security has been in existence for the entire lives of most Americans. One doesn't even think about it. It's just there.<BR/><BR/>Ah! But people should just KNOW that they are demanding something for nothing. How? Money has been taken out of their paychecks forever, it barely registers in their consciousness. Where were you 40 years ago educating the masses about it? Huh?<BR/><BR/>Ah! I know the answer to that. The Democrats were in power so your message couldn't get through. That's understandable. But it doesn't make it the recipients fault.<BR/><BR/>And constantly blaming the people for being stupid and selfish does nothing to advance solutions.Sylhttps://www.blogger.com/profile/03069871911665125873noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138554066231361062006-01-29T10:01:00.000-07:002006-01-29T10:01:00.000-07:00But you Brits have not perfected the illusion of e...But you Brits have not perfected the illusion of entitlement that allows a voter to feel that he should receive 100% of a service, the value toward which he has contributed only 40%. That's the trick - sell it as "insurance" or an "annuity" and charge the masses a fraction of the cost while promising that "they" (those evil "others") will be wrung out like a wet dish towel to provide the balance.<BR/><BR/>It really works well politically (as you know).<BR/><BR/>Until...<BR/><BR/>PS How on earth is one to assure oneself of an unending supply of clients if one does not promote illegitimacy?Rick Ballardhttps://www.blogger.com/profile/11082425215912372067noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138551256881929442006-01-29T09:14:00.000-07:002006-01-29T09:14:00.000-07:00Buddy & Peter,I can't think of any government enti...Buddy & Peter,<BR/><BR/>I can't think of any government entitlement program that has been eliminated in a democracy. Once the electorate transfers theoretical responsibility for a "problem" to the government they have created eternal life.<BR/><BR/>Medical care and "social (in)security" are headed towards means testing (where they should have been since inception) but getting there is going have a political cost that politicians will turn away from with great resolution until their socks are in flames.<BR/><BR/>A capped means tested program would resolve both issues in an economic sense but are simply not feasible in a democracy where the ability to think is not a prerequisite for suffrage. A (un)significant plurality always has the imagination to concoct scenarios where output is unrelated to input and can always find a subset of pols willing to promise to extract additional input from "them". <BR/><BR/>Something for nothing and passing the buck are the heart of democracy (with open suffrage), we may not have bought a ticket but we're definitely along for the ride. <BR/><BR/>My bet is that we are at least ten years from imposition of means testing in the US. I'd bet on bottom of the next harsh recession but the valleys seem to be smoothing out over time.Rick Ballardhttps://www.blogger.com/profile/11082425215912372067noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138547975770396012006-01-29T08:19:00.000-07:002006-01-29T08:19:00.000-07:00Well... why don't drug costs come down over time? ...Well... why don't drug costs come down over time?<BR/><BR/> There is supposed to be a learning curve in economics. In other words after awhile prices come down on a product. This does not happen with a lot of meds. They just get higher and higher.<BR/><BR/> I think the drug companies deliberately keep the patents alive by tinkering with the meds so that they can maximize their profits and use that money to make new drugs. It is a cycle that keeps drug prices inflated.terryehttps://www.blogger.com/profile/16609746018265953069noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138523578495116332006-01-29T01:32:00.000-07:002006-01-29T01:32:00.000-07:00I don't even wish to weigh in on this. There's a l...I don't even wish to weigh in on this. There's a lot of blame the victim mentality going on. All I will say is that it has gone beyond crisis and has become a disaster for many.Sylhttps://www.blogger.com/profile/03069871911665125873noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138518047514619372006-01-29T00:00:00.000-07:002006-01-29T00:00:00.000-07:00Barry,Au contraire, I believe that people can and ...Barry,<BR/><BR/>Au contraire, I believe that people can and will put up with queues for the doctors, provided they believe that everybody is getting the same treatment. That's where we're headed, whether we elect Hillary to sock it to us in two years, or whether we wait another 10 years or so.<BR/><BR/>After that at some point there will be a story about how the Republican congressmen are opting out of national health and sending their children to private medical care. There will be great outrage, a vast public hue and cry, and the fact that the Democratic congressmen are doing exactly the same thing will be ignored, because they care about the "little people" in flyover country while the Republicans are heartless. By definition.MeaninglessHotAirhttps://www.blogger.com/profile/11767916621253839341noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138513857651013272006-01-28T22:50:00.000-07:002006-01-28T22:50:00.000-07:00TerryeSorry I wasn't able to respond sooner, but I...Terrye<BR/><BR/>Sorry I wasn't able to respond sooner, but I understand and agree with your addition to what I said. Part of the large cost is due to people not literally feeling the connection between the service and their wallet. The high deductible might be a way some folks would have to pay for more of the routine procedures and that might lead more people to take better care of themselves in the first place.<BR/><BR/>The increase in cost is partly doctors' salaries, but I've met physcians who are not making what people think doctors make. Specialists make a tremendous amount of money, but pediatricans often don't make outrageous salaries but do a lot of heavy lifting in the healthcare industry.<BR/><BR/>Part of the increase in cost is due to care in the last 6 months of life which is incredibly expensive. Part is due to the pharmaceuticals. Part is due to procedures being available for things that never were before (treatments for balding, plastic surgery, etc.). Part is due to trials lawyers and the need to practice "defensive" medicine. Part is due to lifestyle choices of people, e.g., there are far too many cases of diabetes that are basically self inflicted wounds. I don't think there is a silver bullet cause, except for the development of technology which allows the wonder procedures but also makes it easier to sue (by enabling the more elaborate distribution of information of all sorts) and makes it easier to sit on the couch and pig out. National health care will lead to waiting lines and people will tolerate that at Micky Ds but not M.D.s Also it won't lead to better medicine.<BR/><BR/>There is a disconnect, as you said. We want to live forever in youthful vigor and we want it to come at virtually no cost. Solutions to problems involve trade offs or advantages/disadvantages. We are so wealthy and powerful, I think that too often we can "forget" that there are "costs" to our way of life. Eternal vigilance is the price of liberty. Actually I have a book coming out later this year that touches upon this theme in various areas of American life.Barry Dauphinhttps://www.blogger.com/profile/15808109325931309525noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138510877489284042006-01-28T22:01:00.000-07:002006-01-28T22:01:00.000-07:00Seneca's new find has two great comments on this t...Seneca's <A HREF="http://marketcorrection.powerblogs.com/" REL="nofollow">new find</A> has two great comments on this topic (near bottom): "Is Government Divine?" and "Pity the Poor Hospital Owner".buddy larsenhttps://www.blogger.com/profile/17760847873026506988noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138506621600282322006-01-28T20:50:00.000-07:002006-01-28T20:50:00.000-07:00If an MD's career is 40 yrs, at 15k/835k we're rep...If an MD's career is 40 yrs, at 15k/835k we're replacing a 55th of the profession every year, while losing 21k to retirement. Wonder what 25% more new MDs would do to the economics? <BR/><BR/>Now, *there's* a good gov't program for ya--Uncle Sam buys you the degree, and you work where he sends you, for a set compensation, for a set number of years, in return. <BR/><BR/>Horrors! Indentured servitude!buddy larsenhttps://www.blogger.com/profile/17760847873026506988noreply@blogger.comtag:blogger.com,1999:blog-16821859.post-1138502953056813652006-01-28T19:49:00.000-07:002006-01-28T19:49:00.000-07:00PeterUK,I expect that the extension of life expect...PeterUK,<BR/><BR/>I expect that the extension of life expectancy from the 50's up to the 80's also comes at a cost, we older folks get more expensive year by year. Not that I am complaining, mind you, but it does cost and we older farts start to need naptime and all, so we aren't as productive as hardy youngsters old enough to have some experience.<BR/><BR/>On the other hand, a place like Germany or France where many retire before 55 (numbers?) is just asking for trouble.chuckhttps://www.blogger.com/profile/15164145672293455823noreply@blogger.com