Bush's 4th veto of his presidency is a good one

[bobman0330]

ymu,

Do you have any evidence to support the idea that the US could get comparable results from a European-style HC systems? The believe of many (myself included) is that the very high degree of medical innovation in this country is closely related to the large amount of money spent on HC. If this is so, cutting spending might also result in decreased innovation, which would hurt outcomes both here and abroad.

[pvn]

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I can't see how any sane person could argue that it makes more sense to pay $30 for a filet minioninstead of $1 for ramen noodles

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ROFL. And so we come full circle. I'll continue paying $15 for my steak and you can carry on paying the same and adding a $30 tip for a guy to take your check to the waiter for you. [img]/images/graemlins/wink.gif[/img]

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The willingness of people in the US to pay more to a middleman than purchase directly is bemusing. Why do US voters willingly spend so much for so little?

This is the top 30 countries in the world ranked by life expectancy with spending on health care plotted over it (year 2000). You're spending 3 times as much on average to come 27th. And you mostly seem happy about it. Huh?


From: http://ucatlas.ucsc.edu/spend.php

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Yeah, because it's exactly the same thing, right? "Healthcare" is some magical fixed quantity, like "a pencil" - they're all interchangable!

If this were true, why would there be people travelling from countries with socialized (zomg not that word again!) healthcare to the US in order to pay out-of-pocket for treatment?

As you approach the newest treatments, the costs increase dramatically compared to the incremental benefit gain. That doesn't mean people who pay the high premiums for the incremental benefit are getting "ripped off" even though YOU personally may not find the incremental benefit to be worth the extra money.

There are a lot of problems with the US healthcare system that distort incentives and induce people to consume expensive healthcare for small incremental benefits when they would decide to go with something much, much cheaper and very nearly as effective if they were paying out of their own pocket. But these problems are not problems due to free market policy - on the contrary, they're almost exclusvely the result of various government interventions.

[BuddyQ]

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your faith in the fundamental goodness of a multi-billion dollar industry is touching, but what do you think the universities and public sector research bodies do? We don't need a bazillion me too drugs and armies of reps swamping medics with misleading information and billions wasted on advertising. Public sector medical research is far more valuable and a lot cheaper. The major medical journals won't even publish industry funded "research" any more unless the authors had certain contractual arrangements in place to safeguard the scientific integrity (rare to date). It's ridiculous to suggest that they don't lie, cheat and put peoples' lives at risk because they demonstrably do. That's why most countries are putting better systems in place to catch them at it and examine the true value of treatments instead of relying on information the companies stick on the advertising leaflets.

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Competition in a free market motivated by profit drives innovation, efficiency and discovery. (also creates wealth but that is another topic) I know European socialists frown on such things, then again you have no problem in gobbing up the latest in medical advances, mainly coming from the US.

Had medicine been always left up to the prerogative of government collectives, we would still be using leaches to cure 'the vapors.'

[tame_deuces]

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Had medicine been always left up to the prerogative of government collectives, we would still be using leaches to cure 'the vapors.'

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And if the market believed they worked, they would still be sold. Come on, silly little statements such as these are meaningless.

Both applied and basic research is drives the field forward.

[BuddyQ]

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Had medicine been always left up to the prerogative of government collectives, we would still be using leaches to cure 'the vapors.'
"And if the market believed they worked, they would still be sold. Come on, silly little statements such as these are meaningless."

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I think it is full of meaning.

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Both applied and basic research is drives the field forward.

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Yup, applied and basic research under competition in pursuit of profit in a free market does drive the market forward.

[CORed]

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The Dems actually have a shot at overriding this veto. It passed the Senate with a veto-proof majority and they need 15 more GOP votes in the House (they have 40) to override.

As for the merits, you all know my view on health care. If grandstanding and blowharding results in more accessible health care, I'm all for it.

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I'd say the chances of overriding are pretty slim. Any vote switching in an override in the president's party is usually to sustain, not override, the veto.

[CORed]

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I'm still waiting for the "Cute ethnically diverse children and small fluffy animals act" Which will probably be proposing a mass genocide of some kind.

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We want to commit this genocide for the children? How can you oppose it?

[tame_deuces]

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Both applied and basic research is drives the field forward.

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Yup, applied and basic research under competition in pursuit of profit in a free market does drive the market forward.

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Basic research in pursuit of profit? [img]/images/graemlins/confused.gif[/img]

That is close to being an oxymoron.

[ymu]

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Both applied and basic research is drives the field forward.

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Yup, applied and basic research under competition in pursuit of profit in a free market does drive the market forward.

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Basic research in pursuit of profit? [img]/images/graemlins/confused.gif[/img]

That is close to being an oxymoron.

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It depends how you measure "profit". Not everything is measured in financial terms - if it was there wouldn't be any scientists working for far less than a sales rep. The problem we have now is that the universities and other non-profit research groups doing that basic research are increasingly starved of public funding and are forced to do service work for industry, which is necessarily motivated by profit. This massively distorts research priorities away from genuine innovation and the public interest. More focus me-too drugs, palliative treatments for chronic illnesses and lifestyle interventions, less on treatments for rare diseases, simple affordable interventions and curative procedures (especially if the latter don't require drugs or medical devices).

This idea that innovation can only come from "competition" is another propaganda use of a complex word. It is definitely true that competition can and does drive innovation and improvement, but only when this is the only way to win. Competition itself is about beating the rest, not necessarily raising the bar to do so.

So, for example, in the UK we have Starbucks and PC World setting up loads of loss-leading retail outlets in a new area, starving the "competition" out and then closing most of their outlets once they have established a local monopoly. The supermarkets aren't allowed to build as many outlets as they would like, so they buy up the available land to prevent their competitors from moving in. This is certainly "competitive", but it leads to worse rather than better outcomes for individual consumers and the local area.

The enormous amount of money spent on advertising stuff we'd buy anyway surely demonstrates how vacuous this particular bit of propaganda is. A huge proportion of my monthly bills goes to pay ad men to ruin TV, the internet and the landscape in order to persuade me that I need to buy gas or food or soap powder. Gee, thanks for that; I'd never have got there on my own...

If you accept that "competition" within a "free" market is judged solely on who makes the most money, you must realise that it's ridiculous to suggest that this automatically drives standards up (VHS vs Betamax, anyone?). It so obviously doesn't act in this way, and it's easy to find examples of it being harmful, and you're gonna have a really hard time explaining why the key innovators have largely remained in the badly paid public sector if profit is the best motivator.