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The Democrat Thread


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QUOTE (BigSqwert @ Feb 22, 2011 -> 12:06 PM)
It might be hard to prove that.

To use a line from another debate...it's nearly impossible to prove that a single test was unnecessary if recommended by a doctor. However, on the aggregate, the data are overwhelming.

 

We have 50 states and however many municipalities we can compare on the matter. If every test was necessary, then there should be a direct correlation between spending on health care and health care outcomes, which is absolutely not the case. There is essentially no correlation in this country between increased health care spending and improved health care outcomes at the state or municipality level.

 

You can do case studies, like the 2 towns in Texas we looked at back during the ACA debate, which have similar levels of disease but 1 city spends 2x as much as the other, per capita, on health care. You can look at individual hospitals/providers and get the same conclusion; spending more or doing more tests doesn't translate to better outcomes.

 

Great case example; the U.S. screens heavily for prostate cancer. Much more heavily than the UK. The US spends more on doing so, and spends a ton more removing any abnormalities when they're found. However, the death rates from prostate cancer between the US and UK are nearly identical. This data strongly argues that the U.S. catches and spends a ton of money to detect and remove non-threatening prostate conditions that the UK does not.

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QUOTE (StrangeSox @ Feb 22, 2011 -> 12:09 PM)
Ok, that's a good example of a system with potential for abuse if not outright fraud. There's financial incentives for them to perform unnecessary and expensive treatment (and a small fraction of that is related to defensive medicine). How do you reform medicare/medicade to reduce or eliminate that potential? Can it be done without harming patients' care?

Worth your time to read...

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QUOTE (BigSqwert @ Feb 22, 2011 -> 12:15 PM)
Balta, are you Watson?

Y'all want to know why I enjoy serious discussion in places like this forum? Half the stuff I can pull off the top of my head or find with 1-2 google searches is stuff I know about because I've brought it up in here before. Then I get the nice added benefit of being able to pull the same statistics and studies out of my head in other conversations, and I've already practiced trying to put it into non-technical language.

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QUOTE (Cknolls @ Feb 22, 2011 -> 09:57 AM)
Should they pay for their own retirements? Healthcare?

You can't look at it that narrowly. Its a total compensation issue. If you want them to pay into their retirement like private workers do and get a match, and pay more typical rates for health care, I'm all for that... but you have to understand the consequences of that. If you do that, and don't bump up their base pay, you will start to send those jobs further down in the level of quality you fetch. And the further down you go on that route, if you keep the base requirements the same, you start to have more and more problems even filling the jobs.

 

I'm in favor of the 401k model over pensions, without a doubt, because its just much less risky for government (and also less risky for the investors who have a few brain cells). But I'd suggest that some of the savings be put into better pay for those careers, because I'd rather not have cops and teachers be the bottom of the barrel for basic skills.

 

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QUOTE (StrangeSox @ Feb 22, 2011 -> 11:09 AM)
Ok, that's a good example of a system with potential for abuse if not outright fraud. There's financial incentives for them to perform unnecessary and expensive treatment (and a small fraction of that is related to defensive medicine). How do you reform medicare/medicade to reduce or eliminate that potential? Can it be done without harming patients' care?

 

The problem with the pay for performance method is that health care isn't a system that always achieves the desires result even when you attack the problem in the proper way. People can lead a life strictly by the book and still develop various ailments because diseases/disorders are passed down genetically and because there are so many variables at play. I don't think we should screw hospitals or doctors out of payment because they didn't cure someone 100%.

 

Maybe set up independent administrative bodies that review medical care decisions of hospitals and their doctors on a periodic basis? Make doctors personally liable for any unnecessary treatment (as voted on by said body). Obviously you'd have to err on the side of more care is better, but maybe you can get a self-policing situation going. This is probably a good idea anyway. Most of our health care is bulls*** that's fabricated by the medical community and driven by the pharma industry (restless leg syndrome, etc).

 

I'm also a huge fan of crippling penalties for doctors (licenses stripped/barred from practicing medicine and huge fines) and hospitals (since fines just pass the cost off to the patient, maybe create a licensing system for certain types of care and then strip those from the hospital).

 

I think it's already exists, but putting caps on the cost that medicare will pay is another check and make those caps reasonable (i.e., i still don't understand how an ambulance ride costs 600+ or an xray costs 300+).

 

 

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QUOTE (StrangeSox @ Feb 22, 2011 -> 01:33 PM)
Indiana Democratic Senators are fleeing the state over similar bills there.

 

http://www.indystar.com/article/20110222/N...ehouse-showdown

In this case, the bill is much more specific, per the article:

 

Today’s fight was triggered by Republicans pushing a bill that would bar unions and companies from negotiating a contract that requires non-union members to kick-in fees for representation.

 

I actually would agree with that law. Non-union people should not have to pay into a union's membership. This Indiana law doesn't seem to be the outright attack on unions that the Wisconsin law is, its more like protecting those not in a union.

 

And for the record, although I applaud the protestors and their zeal, I find the behavior of the legislators irresponsible. Its really no different than the procedural filibusters that US Congressional Republicans were so fond of recently.

 

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QUOTE (Balta1701 @ Feb 23, 2011 -> 11:57 AM)
I'm really uncomfortable with the fact that this was done. Does WI have laws against recording phone conversations without the other party's permission?

No idea. Can this be an example of entrapment or am I confusing the term?

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QUOTE (BigSqwert @ Feb 23, 2011 -> 01:05 PM)
No idea. Can this be an example of entrapment or am I confusing the term?

I don't think entrapment is the right word there, that's sorta convincing someone to commit a crime.

 

Many states do have laws that forbid a party from recording conversations, especially phone conversations, without the consent of the person on the other end of the phone. Especially public figures.

 

What if he'd started talking about his constituent, person x, and gave away personal information about them? "I was speaking to this person yesterday, ___ ____, she told me how the union forced her to have an abortion..."

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