Why Government Healthcare Leads to Rationing

[crb]

http://www.john-goodman-blog.com/why-health-reform-is-bound-to-fail/



Why is Washington having so much trouble reforming health care?

Why, if they do pass a major overhaul, are the problems of cost, quality and access almost certain to get worse?

Answer: Because they don't understand health care. By that I mean, almost no one in Congress understands health care as a complex system. When they campaign, most politicians claim that health care problems could be solved with a few simple reforms. Now that it's time to legislate, they are discovering that health care is very, very complicated. In fact, there is no solution that even comes close to being simple or easy.

As Nobel Laureate Frederick Hayek taught us, a complex system is a structure that is so complicated, that no one person can even begin to grasp it in its entirety. The best each of us can hope for is to master the small part of it we interact with.

The economy, for example, is a complex system. To allow us to think about it — if only imperfectly — economists have developed a highly simplified model over a period of 200 years. In fact, the only reliable model that exists to understand complex social systems is the economic model. Yet we have completely suppressed normal market forces in virtually every aspect of health care. So what we are left with is almost certainly the most complicated market of all and no reliable model with which to understand it.In complex systems, a change in a parameter in one place inevitably causes other — often surprising and unforeseen — changes elsewhere. Perturbations intended to bring about one result inevitably have other unintended consequences as well. In health care the unforeseen surprises are even more palpable because reforms are inevitably designed by people who either deny the existence of economic incentives or in any event routinely ignore them. I suspect that:

Most members of Congress were genuinely surprised to learn that if an SCHIP children's health program is offered for free, half the enrollees would drop their private insurance in order to take advantage of it.
I suspect Sen. Kennedy's staffers were surprised to learn that a highly subsidized "exchange" outside the workplace would cause millions to drop their employer-provided coverage to take advantage of it.
They were probably also surprised that — given the chance — millions would leave Medicaid for highly subsidized private insurance.
They were probably devastated to learn that you can spend $1 trillion over 10 years and ultimately reduce the number of uninsured by only 20%!
One thing economists are confident about is this: No matter how complex the system, the incentives faced by the individual actors matter a great deal. For example, if all the actors in a complex system have perverse incentives, the social outcome is likely to be undesirable in many respects.

In health care, almost everyone faces perverse incentives. This includes almost every patient, every doctor, every nurse, every hospital administrator, every employee, every employer, every insurance company, every government agency….. (did I overlook anyone?). By perverse incentives I mean that when people act in their own interests, they usually impose external (social) costs on others. This means that social cost is likely to exceed social benefit for every actor at every margin.

Take total spending on health care. It is the outcome of about 300 million patients and about 800,000 doctors all interacting in complex ways. But it is also the simple, straightforward sum of what I and my doctors spend on my care plus what you and your doctors spend on your care….. etc., etc.,…..summing over 300 million people. No matter what else happens, if I and my doctors don't change what we are doing for me and you and your doctors don't change what is being done for you….. and so forth….. aggregate spending will not change.

If I am a representative patient, every time I spend a dollar only 13 cents will come out of my own pocket. So my economic incentive is to consume care until it is worth only 13 cents on the dollar to me. This is very wasteful. But I'm wasting your money (you being the other members of my insurance pool), not mine.

Under a reform plan of the type proposed by Sen. Kennedy, third-party coverage becomes much more expansive; and we may have to pay only 4¢ or 5¢ out of pocket every time we spend a dollar. Under this arrangement, I will spend more than I currently spend. So will you. Because this is a complex system, it is very hard to predict how all this new spending will affect the system as a whole. But we can be fairly confident total spending will rise — and probably by a lot.

Now consider the problem of access. Under a Kennedy-type plan, millions of uninsured people will obtain insurance and millions of people who are currently insured will get more generous insurance. As a result, these people will use their newfound coverage to try to obtain more care. But where will they get it?

As you look around the health care system, how many idle resources do you see? How many primary care physicians have empty waiting rooms? How many ERs have no patients waiting to be seen? If there are no significant idle resources, then how will the increased demand for care be met?

Clearly, there will be a rationing problem, and those paying below market rates (Medicaid patients, e.g.) will experience more severe problems than others. This is precisely what is happening in Massachusetts right now. As previously reported here, waiting times to see doctors in Boston are more than twice as long as any other US city. Casual observation suggests that access to care has not improved, even though the number of uninsured has been cut in half.

For more than two decades, scholars associated with the National Center for Policy Analysis have sought to reform the health system by improving the incentives faced by the actors in it. We believe this approach is absolutely essential if real problems are to be solved.

Congress is choosing a different course. Under reforms being considered, almost everyone's incentives will become worse, not better. The tragedy is that Congress is almost completely unaware of the harm it is about to unleash. (At least that's the charitable assumption.) The irony is that this same tragedy has been repeated in almost every other developed country in the world.



When someone says Obamacare will lead to rationing, it isn't because they think Obama et all are going to sit in washington and deliberately ration care. It is going to be an unforseen consequence (for them) of having too little supply for too much demand.

We ALREADY have a doctor shortage. We ALREADY have a nurse shortage.

Meanwhile Obama wants to cut Medicare payments to doctors to pay for his plan to cut the number of uninsured by 20% (CBO analysis). So, his plan to deal with a shortage is to reduce incentive to practice the profession while at the same time increasing the demand for it.

Next time you're in a hospital look around, look at all the brown skinned people in white coats, all the people with funny accents. These are foreigners. These people usually have family living in other countries where they might like to go back to if not for an economic incentive to stay here in the US. You remove that economic incentive, they will go back home, leaving us with even less doctors.

What are the possible outcomes of a doctor shortage?

1. You raise doctor pay, enticing more people into the profession, maybe we'd get less lawyers as a side benefit too. But of course, that'll cost more money.

2. You ration care though difficult access, long wait times, lotteries (a raffle to see who gets appointments, it happens in the countries Obama wants to emulate). This would result in lower standards of care.

3. You lower the standards to become a doctor. Lower school admission standards, reduce the 8 year length of the training (12 years if you count undergrad, 13-15 years if you also count some residencies or specialties that require a fellowship). Letting C student slackers become doctors will result in lower standards of care.


Hospitals are forced to see people in emergency rooms regardless of ability to pay, so they will always take government insurance. But one thing you may see is a dichtonomy develop between doctors who take government insurance and those who do not. Already most will not take Medicaid, forcing such people to go to relatively crappy community health centers. If Medicare payments continue to get cut and a new public health option is created to be like Medicaid and Medicare, you may find doctors stop accepting Medicare. If you can fill your practice with people with better insurance, why accept government insurance? Until of course government uses the proverbial gun-to-head and makes it illegal to not accept their insurance. Yay freedom! Prior to being forced you'd see a far different standard of care for the rich (anyone with employer or private health coverage) and the poor (everyone without it).

You'll also see more hospitals close as a result of reimbursement reductions, resulting in even less access to care. The town where I grew up, recently lost the ability to do OB at their hospital. Now people living up there have to travel an hour if having a baby. It is already happening, it will start happening more. The government can't force you to take Medicaid OB patients if you have no OB services.

Government setting the price of healthcare (and they do) will be like government setting a price on any other limited resource. It has never worked.

http://mklasing.files.wordpress.com/2008/11/080401-obama-gas-line21.jpg

[Warriorbird]

Obama will totally change it if you start a petition and threaten to quit paying taxes.

[ElanthianSiren]

http://www.john-goodman-blog.com/why-health-reform-is-bound-to-fail/



When someone says Obamacare will lead to rationing, it isn't because they think Obama et all are going to sit in washington and deliberately ration care. It is going to be an unforseen consequence (for them) of having too little supply for too much demand.

We ALREADY have a doctor shortage. We ALREADY have a nurse shortage.

Meanwhile Obama wants to cut Medicare payments to doctors to pay for his plan to cut the number of uninsured by 20% (CBO analysis). So, his plan to deal with a shortage is to reduce incentive to practice the profession while at the same time increasing the demand for it.

Next time you're in a hospital look around, look at all the brown skinned people in white coats, all the people with funny accents. These are foreigners. These people usually have family living in other countries where they might like to go back to if not for an economic incentive to stay here in the US. You remove that economic incentive, they will go back home, leaving us with even less doctors.

What are the possible outcomes of a doctor shortage?

1. You raise doctor pay, enticing more people into the profession, maybe we'd get less lawyers as a side benefit too. But of course, that'll cost more money.

2. You ration care though difficult access, long wait times, lotteries (a raffle to see who gets appointments, it happens in the countries Obama wants to emulate). This would result in lower standards of care.

3. You lower the standards to become a doctor. Lower school admission standards, reduce the 8 year length of the training (12 years if you count undergrad, 13-15 years if you also count some residencies or specialties that require a fellowship). Letting C student slackers become doctors will result in lower standards of care.


Hospitals are forced to see people in emergency rooms regardless of ability to pay, so they will always take government insurance. But one thing you may see is a dichtonomy develop between doctors who take government insurance and those who do not. Already most will not take Medicaid, forcing such people to go to relatively crappy community health centers. If Medicare payments continue to get cut and a new public health option is created to be like Medicaid and Medicare, you may find doctors stop accepting Medicare. If you can fill your practice with people with better insurance, why accept government insurance? Until of course government uses the proverbial gun-to-head and makes it illegal to not accept their insurance. Yay freedom! Prior to being forced you'd see a far different standard of care for the rich (anyone with employer or private health coverage) and the poor (everyone without it).

You'll also see more hospitals close as a result of reimbursement reductions, resulting in even less access to care. The town where I grew up, recently lost the ability to do OB at their hospital. Now people living up there have to travel an hour if having a baby. It is already happening, it will start happening more. The government can't force you to take Medicaid OB patients if you have no OB services.

Government setting the price of healthcare (and they do) will be like government setting a price on any other limited resource. It has never worked.




So what are yours and Mr. Goodman's solution to the healthcare problem? If 46 million people are uninsured and god knows how many are underinsured and thus unable to have the care they need, you already have a rationing problem.

[Tsa`ah]

Reduce the ungodly debt obtained via the education to become a medical professional, address issues of inadequate pay for those that aren't MDs, and you solve your retarded rationing argument.

[Parkbandit]

Reduce the ungodly debt obtained via the education to become a medical professional, address issues of inadequate pay for those that aren't MDs, and you solve your retarded rationing argument.
Wait... Are you saying that rationing doesn't happen in places that has socialized healthcare... like England and Canada?

[Parkbandit]

So what are yours and Mr. Goodman's solution to the healthcare problem? If 46 million people are uninsured and god knows how many are underinsured and thus unable to have the care they need, you already have a rationing problem.

Throwing a couple trillion dollars and letting our Government manage the process is probably the worst idea.

[AnticorRifling]

Wait... Are you saying that rationing doesn't happen in places that has socialized healthcare... like England and Canada?
Please use real countries in your examples moving forward. Thank you.

[Tsa`ah]

Wait... Are you saying that rationing doesn't happen in places that has socialized healthcare... like England and Canada?

Both the UK and Canada are miles ahead of our supposed "healthcare" system ... but that's not what I implied.

What I am saying is that you reduce the argument of "rationing" when you address the costs associated with becoming a healthcare professional.

[ElanthianSiren]

Throwing a couple trillion dollars and letting our Government manage the process is probably the worst idea.

I didn't insinuate it was the best idea. I simply find it laughable that someone is trying to say we don't already have a problem with rationing.

[Parkbandit]

Both the UK and Canada are miles ahead of our supposed "healthcare" system ... but that's not what I implied.

What I am saying is that you reduce the argument of "rationing" when you address the costs associated with becoming a healthcare professional.

they are... Unless you are old and the gov't determines you've lived a long enough life. My neice lives there and said she likes the system, but she wants to make sure she's back in the US by the time she is 50.

I think Obama is already working on free college for everyone!!

[Tsa`ah]

they are... Unless you are old and the gov't determines you've lived a long enough life. My neice lives there and said she likes the system, but she wants to make sure she's back in the US by the time she is 50.

No one is suggesting that we imitate either.


I think Obama is already working on free college for everyone!!

A justifiable reason to explain why a person who is qualified to attend college and grad/medical school ... can't should be pretty rare instead of very common.

[Parkbandit]

No one is suggesting that we imitate either.


yea, our socialize healthcare is bound to be much better than those countries running it currently.. You do realize that it is a symptom of rationed healthcare, right? I just want to make sure I didn't lose you.



A justifiable reason to explain why a person who is qualified to attend college and grad/medical school ... can't should be pretty rare instead of very common.

What? I had exactly 2 dimes to my name after high school and I managed to put myself through. Granted, I didn't sit on my couch crying that my government isn't paying my way through and I actually had to work for a year and save for it. I realize this concept is foreign to many kids..

[Warriorbird]

Care is already rationed. Most of the uninsured can already get care through various avenues... which I'm sure offends crb already.

[crb]

So what are yours and Mr. Goodman's solution to the healthcare problem? If 46 million people are uninsured and god knows how many are underinsured and thus unable to have the care they need, you already have a rationing problem.
1. Remove stupid government mandates. Special interests lobby government to mandate coverage requirements, such as say, accupuncture, or chiropractic care. Meaning it is impossible to buy insurance without such coverage. There is no chevy of the insurance world, you are given the choice to drive a cadillac or ride a bike. Politicians typically won't touch the mandates because the special interests fill their coffers, and they use the guise of patient safety. Get rid of the mandates, insurance because 70% cheaper. A handful of states have done this.

2. Let the free market work. Comestic procedures have dropped in price because insurance does not cover them, forcing you to pay with cash, forcing you to care if you're getting a good deal or not. If Plastic Surgeon A is across the street from Plastic Surgeon B and both meet your standards for quality, but A is twice as expensive, you'll go to Surgeon B. This price competition forces constant adaptation among providers which results in lower prices for consumers. Now, if you need something like say hip replacement, covered by insurance, you don't give a shit which hospital is cheapest. You're not paying for it.


3. Tax employer provided health insurance, give everyone a tax credit to buy their own health insurance if desired. This will destroy employer provided coverage, and that is the point. Let people get paid more, with no benefits, let them take their extra pay and get their own health insurance, like you do with auto insurance. You'd get much much much more competition, which would lower prices.

[crb]

Reduce the ungodly debt obtained via the education to become a medical professional, address issues of inadequate pay for those that aren't MDs, and you solve your retarded rationing argument.
Does the second part of your statement indicate you think hippy doctors who graduated from "the school of hard knocks" and who'll treat your cancer with beams of colored light on a bed in their extra bedroom deserve to be a legitimate part of our healthcare system?

And... why do you think college is so expensive? Who runs most colleges? Are they... conservatives? Has higher education long been called a bastion of conversatism? Which unneeded liberal campus program is going to get cut to make college more affordable? Which employees are going to be fired?

Or, are we just going to let taxpayers pay for it, which of course takes away any incentive for colleges to be fiscally responsible.

And it isn't just the huge debt burden why doctors deserve to be paid so much. It isn't the stress or the long hours either. Its the intelligence and discipline required. Professions compete for the best and brightest, if you don't want people all going into finance or being yet-another-worthless-lawyer you need to make sure the medical profession offers adequate rewards. Additionally, if you want foreigners to continue to come to this country to provide medical services for our population, you need to reward them as well. This is all basic economics. I know you've got your communist mentality where each according to his ability, each according to his need. But if we relied on people who want to put themselves through medical school (more or less putting their lives on hold for a decade) and then work in a high stress long hour job out of the kindness of their heart, we're going to have an obscene doctor shortage.

Oh, and by the way, Uk and Canada are not miles ahead of us. Both systems are failing, both systems are privatizing slowly.

For those saying we already have rationing. You're right, we do, we ration by price. We could make things cheaper if we got rid of all the bullshit, but we still ration by price.

What rationing by price means is if you need emergency care you'll get it but you might end up in bankruptcy later. Of course, by working hard, getting educated, or reprioritizing your spending you have the ability and responsibility to improve this by obtaining insurance.

What rationing by access means is if you need emergency care you might not get it, and so you die, and, as a person, there is nothing you can do to improve your chances of getting care (other than move to another country I guess). No chance for self improvement.

I'd rather be bankrupt than dead.

[ClydeR]

Next time you're in a hospital look around, look at all the brown skinned people in white coats, all the people with funny accents. These are foreigners. These people usually have family living in other countries where they might like to go back to if not for an economic incentive to stay here in the US. You remove that economic incentive, they will go back home, leaving us with even less doctors.

I agree with everything except for that statement. Our medical schools are full. They don't have any empty seats. The competition to get into medical school is intense. They way to handle the supply and demand issue is to open more medical schools.

[Geshron]

Doh! That blog there, that blog. I'm sure Obama is going to have to re-think the entire notion since obviously the blogging community has a better idea.

Another pathetic attempt, jesus.

[4a6c1]

LMAO at Obamacare. I cant wait for 10 years from now when all the celebrities who made Obama popular have to go to India for their plastic surgery.

[ElanthianSiren]

1. Remove stupid government mandates. Special interests lobby government to mandate coverage requirements, such as say, accupuncture, or chiropractic care. Meaning it is impossible to buy insurance without such coverage.

2. Let the free market work. cosemetic surgery....


3. Tax employer provided health insurance, give everyone a tax credit to buy their own health insurance if desired. This will destroy employer provided coverage, and that is the point. Let people get paid more, with no benefits, let them take their extra pay and get their own health insurance, like you do with auto insurance. You'd get much much much more competition, which would lower prices.

1. Plenty of people obtain relief from those practices like spinal manipulation, and there have been plenty of studies showing benefits. That means you're rationing the care once again by limiting it or coming between people and their doctors! Duke's medical center usually has a few good reads.

2. Cosmetic surgery isn't necessary care for living. Nobody is going to die without it, and thus providers know they can't get away with scalping like they can for necessary care. Please try again.

3. This I agree with. The only potential problem I see with it is when the market gets flooded with people buying insurance, and companies start involving themselves in price fixing, which is inevitable, given anyone can research anything.

It also doesn't address gouging issues paramount to the health care problem. You can go to 80 health care companies and have as much free market as you like, but if you have cancer, you're just as screwed. Additionally, it doesn't address the issue that insurance companies don't always hire the brightest bulbs. Then, the consumer (the one who is PAYING for the coverage each month as they have to), is inconvenienced into having to deal with employees at companies who simply don't and are incapable of reading a policy.

You shouldn't have to call your provider to argue about your coverage most of the time it's used, so there are ineptivity issues that need to be fixed in the system as well, unless you choose to believe the insurance companies are trying to bill people for things they know they're covered for. Then, those are fraud issues.

[ElanthianSiren]

LMAO at Obamacare. I cant wait for 10 years from now when all the celebrities who made Obama popular have to go to India for their plastic surgery.

Why would it change plastic surgery rates in this country? I don't believe it's covered now, except in cases of injury/disfigurement.

Pretty sure the silicon valley will still be full of silicon and saline for years to come.

[Parkbandit]

1. Plenty of people obtain relief from those practices like spinal manipulation, and there have been plenty of studies showing benefits. That means you're rationing the care once again by limiting it or coming between people and their doctors! Duke's medical center usually has a few good reads.

But why am I paying for things that I have no need for? I am 100% certain I'll never have a need for acupuncture.. and if that need ever arose, I would just pay for it. Why am I forced to carry it as part of my basic care insurance?



2. Cosmetic surgery isn't necessary care for living. Nobody is going to die without it, and thus providers know they can't get away with scalping like they can for necessary care. Please try again.

Cosmetic surgery is more than just a boob job or tummy tuck. There are plenty of surgeries that fall under the cosmetic surgery realm that are necessary care. Correcting birth defects is one off the top of my head.

[ElanthianSiren]

But why am I paying for things that I have no need for? I am 100% certain I'll never have a need for acupuncture.. and if that need ever arose, I would just pay for it. Why am I forced to carry it as part of my basic care insurance?



Cosmetic surgery is more than just a boob job or tummy tuck. There are plenty of surgeries that fall under the cosmetic surgery realm that are necessary care. Correcting birth defects is one off the top of my head.

I'm not aware of plans that allow you to pick and choose what coverage you pay for ala carte (I'd actually support that). However, if the argument is that we should stop necessitating certain services, then what's the line prohibiting us from requiring any service? In short, what will you base it on? I'm sure there are other services that are also required, so why choose those two? AND more importantly, if we deregulate the hell out of the insurance companies, what stops them from issuing policies that are little more than a slip of paper saying, "Have a nice day?" and 70 bucks a month? That doesn't fix the healthcare debacle.

Cosmetic surgeries for birth defects are covered though. Each insurance company negotiates its rates with providers, which are different than if someone just walked in from the street.

edit:
I was responding to this:


2. Let the free market work. Comestic procedures have dropped in price because insurance does not cover them, forcing you to pay with cash, forcing you to care if you're getting a good deal or not. If Plastic Surgeon A is across the street from Plastic Surgeon B and both meet your standards for quality, but A is twice as expensive, you'll go to Surgeon B. This price competition forces constant adaptation among providers which results in lower prices for consumers. Now, if you need something like say hip replacement, covered by insurance, you don't give a shit which hospital is cheapest. You're not paying for it.

[4a6c1]

Why would it change plastic surgery rates in this country? I don't believe it's covered now, except in cases of injury/disfigurement.

Pretty sure the silicon valley will still be full of silicon and saline for years to come.

I think it will take a while but capitalist healthcare is going to go down the drain. Nothing in the system now can stay the same with such drastic changes being made to ALL OF IT.

[Warriorbird]

Replaying GTA4 and the stuff about Republicans' Europe/healthcare hating stays hilarious.

[crb]

1. Plenty of people obtain relief from those practices like spinal manipulation, and there have been plenty of studies showing benefits. That means you're rationing the care once again by limiting it or coming between people and their doctors! Duke's medical center usually has a few good reads.

So go to a DO, an actual doctor who has studied manipulation (along with everything else, their curriculum is the same as an MD's, and they can sit for each other's boards and go to each other's residencies, but DOs learn manipulation as well), but when presented with something that cannot be cured by cracking a back, has more than one tool in their toolbox, like say the ability to prescribe medicine. They'll also, being actual doctors with broader experience, be able to recognize better if manipulation is not what you need, like say if your pain is deferred from something else.

Chiropractors are largely quacks, a few are decent, knowing their limits, and sticking to them. Fixing back and neck pain, so long as you agree to come back three times a week forever. But the rest are largely quacks. This local bitch advertises on TV that she'll crack your back to clear up an infection so you don't have to take antibiotics.

The problem is chiropractors as a profession are insecure about their legitimacy (and rightly so). They get embarassed because they only have 1 tool (manipulation) and so they try to make that tool applicable to any situation. I was watching this show where a chiropractor "diagnosed" a 9 month pregnant woman (who was clueless, obviously) as having a bowel obstruction, and proceeded to crack her back to fix this obstruction.

Then add in every other mumbo jumbo bullshit. Holistic healers who'll wave smoke over you and tell you to go home and eat a weed. Faith healers who'll pray over you. Glorified massage therapists. Insurance does not need to cover these services.

You should be able to go out and buy insurance that covers doctor's (real doctor, ie someone who is licensed to prescribe medicine) visits for injury or illness, plus 1 physical per year. As well as hospital bills if you are seriously injured or sick. Keep the rest of the bullshit out of it.

If someone wants to pay for insurance that covers all the bullshit, fine, but don't force EVERYONE to pay for the bullshit. It is far better for someone to have insurance that just covers real doctors and hospitals than it is to have that option be illegal and so the person is forced to be uninsured because they cannot afford the mandate choked legal policies.

[ElanthianSiren]

Chiropractors are largely quacks, a few are decent, knowing their limits, and sticking to them. Fixing back and neck pain, so long as you agree to come back three times a week forever.

If someone wants to pay for insurance that covers all the bullshit, fine, but don't force EVERYONE to pay for the bullshit. It is far better for someone to have insurance that just covers real doctors and hospitals than it is to have that option be illegal and so the person is forced to be uninsured because they cannot afford the mandate choked legal policies.

So we established that yes, some people obtain relief from chiropractors and manipulation; my father goes for migraines and hadn't had one for 10 years until his employer provided care dropped the minimum visits alloted a month. Prior to chiropractic, he had them weekly most of his life. Isolated case? Possibly. Does he pay for the extra visits out of pocket since? Yes. I'm inclined to believe, however, he legitimately is provided medical relief through that service.

Another story; a doctor (yes an MD and even a PhD endocrinologist) told me that I was overweight because I ate too much. I was underweight previous to being diagnosed with type 1 diabetes at age 11. Once diagnosed my weight skyrocketted, and I had hypoglycemic seizures pretty much weekly (emergency BGCs of 11 and 9). It turned out the insulin therapy he prescribed was predictably (when I read studies) making me gain weight. I pared back my insulin myself, switched to a different insulin under the script of a DO, dropped the guy who insisted he knew more than I did about my experiences with my condition, modified my diet, and lost an insane amount of weight very quickly. I haven't had a seizure since 2003.

I'd call the above doctor a quack. My point is that ignorant quacks aren't limited to chiropractic or accupuncture. Seeing as how Duke does reuglar studies on the benefits of chiropractic, accupuncture etc, I'm okay with that being on there. However, I do like the idea of consumers getting to tailor specifically what they're willing to pay for in medical plans. I just hate to see what would happen when someone lacking cancer insurance suddenly gets cancer.

I think we'd find ourselves pretty much in the same scenerio.

[radamanthys]

Not for nothing, but we don't really have capitalist healthcare. Insurance (and associated gvmnt intervention within) sorta booches that.

[crb]

Medicine is an inexact science and there is a difference between someone being wrong, and rampant professional hubris.

Spinal manipulation to relieve back pain may be legitimate, spinal manipulation to fight off cancer or an infection, or so your child doesn't need to be vaccinated, is quackery.

Furthermore, you may be treating a symptom, while leaving an underlying disease unchecked. The chiropractor doesn't realize this though, because he isn't a doctor. They like to talk about how they have rigorous study and whatnot, but it isn't the same, it isn't even close. Even a psychiatrist (who is an actual doctor) has to go through the same medical training as a brain surgeon for the first five years. All doctors do this. They study all of the body's systems, they rotate through a wide range of specialities as disparate as OB/GYN, Surgery, Psychiatry, Radiology, Opthalmology, and lots and lots of internal medicine. This broad base gives them better perspective to treat you once they settle on a speciality, as well as the depth to know when you need a different kind of doctor. Until a chiropractor has such training, until they're knowledgable enough to be trusted by the government with a license to prescribe narcotics, going to a chiropractor for a diagnosis is as useless as going to a pharmacist.

Chiropractic treatment is not completely without benefit, but it is the diagnosis that concerns me. You'll never walk into a chiropractor clinic and be told that spinal manipulation will not fix what ails you. They sell it as a panacea.

So go to a doctor, get your diagnosis, if think manipulation could help, then go to a chiropractor (or better yet, just go to a DO to begin with).

[4a6c1]

Not for nothing, but we don't really have capitalist healthcare. Insurance (and associated gvmnt intervention within) sorta booches that.

WUT. I think that is just a transference of wealth. Luxury doctors still get big bucks for things that people dont need.

I pay outrageous premiums and I hart capitalist superiority. As a result my teeth are blindingly white and my skin is proactiv fabulous. I pay those prices so other people will worry about who gets payed what, while I can be frivolous and vain. It is a system that only works for wealth. And those luxuries wont survive in the new system. That was my point.

WHAT IS A BOOCH.

[CrystalTears]

I refuse to go to a chiropractor, simply because the whole premise of "once you start, you have to keep going back" just doesn't sit well with me. It seems like a band-aid and doesn't resolve the underlying problem, which is why you have to keep applying the band-aid. No thanks.

[ElanthianSiren]

Medicine is an inexact science and there is a difference between someone being wrong, and rampant professional hubris.



Running a type 1's sugars to HbA1c levels of high 4s/low 5%s on NPH insulin is quackery; do recall this indicates swings much lower than the average indicated sugar, due to the nature of NPH (not a reasonably flat insulin like lantus). Blaming the person's weight gain on a growth hormone you are prescribing in excess and refuse to review is quackery, notwithstanding the fact that you're talking about an adolescent girl. Causing neurological damage through negligence of the consequences of your actions is quackery (I have memory issues from the seizures). That's not a question of "inexact" science. The inexact science would be the fact that researchers still can't come up with an insulin that mediates blood sugar to normal on its own. Being wrong repeatedly and denying wrongdoing to the detriment of your patient's health is beyond inexact science IMO.

I don't believe chiropractors should try to treat all ailments; you're correct. That's hubris. However, I also don't believe doctors should consider themselves above their patient's symptoms and bloodwork. That's also hubris.

The bottom line is that both endocrinologists and chiropractors are considered viable practitioners to treat medical conditions. Therefor, whatever nifty basic care floors exist, go to chiropractors also. Until we have ala carte pricing (see arguments for and against earlier), it should rightfully stay that way IMO, as they both provide services often utilized by patients with documented health benefits.

[Tsa`ah]

Does the second part of your statement indicate you think hippy doctors who graduated from "the school of hard knocks" and who'll treat your cancer with beams of colored light on a bed in their extra bedroom deserve to be a legitimate part of our healthcare system?

I doubt you'd have the chops even for the last ditch effort college ... but that's not the conversation.

The point you're missing is that the best and the brightest don't always make it. 10-15 grand per semester is what separates a PHd from UIUC or Northwestern from SIU or ISU ... and sometimes there isn't enough for even those choices.

This is the reason why wait listing occurs.

A person accepted into Harvard, one of 165 seats ... is pretty much the cream of the crop. If you're number 166 to say 265, you came close ... but they deemed other applicants as "better" than you. Going back to my response to PB ... why should 166 (who has the funding) get in when 27 can't come up with the funds?

In fact, what if 27 can't find the loans, grants, or scholarships to cover any medical school ... how exactly do you justify one of the brightest being relegated to something like phlebotomist?


And... why do you think college is so expensive? Who runs most colleges? Are they... conservatives? Has higher education long been called a bastion of conversatism? Which unneeded liberal campus program is going to get cut to make college more affordable? Which employees are going to be fired?

So here we are again ... you making this contrast between political philosophies. Give me a fucking break.

You cut the fucking fat. There's no reason why billions should be spent on sports, let alone the thousands of free rides that will never pan out into anything. Here's a nice conservative saying for you ... Do more with less.

Education shouldn't be a gateway to massive debt. End of story. Education should not be approached from a "for profit" perspective ... after all, that's how we arrived at our current healthcare fiasco.

The rest of your post, much like the portion I responded to is nothing more than the usual slanted drivel with all the talking points ... lacking any sort of solution. .. so come back when you have one.

[radamanthys]

I doubt you'd have the chops even for the last ditch effort college ... but that's not the conversation.

The point you're missing is that the best and the brightest don't always make it. 10-15 grand per semester is what separates a PHd from UIUC or Northwestern from SIU or ISU ... and sometimes there isn't enough for even those choices.

This is the reason why wait listing occurs.

A person accepted into Harvard, one of 165 seats ... is pretty much the cream of the crop. If you're number 166 to say 265, you came close ... but they deemed other applicants as "better" than you. Going back to my response to PB ... why should 166 (who has the funding) get in when 27 can't come up with the funds?

In fact, what if 27 can't find the loans, grants, or scholarships to cover any medical school ... how exactly do you justify one of the brightest being relegated to something like phlebotomist?



So here we are again ... you making this contrast between political philosophies. Give me a fucking break.

You cut the fucking fat. There's no reason why billions should be spent on sports, let alone the thousands of free rides that will never pan out into anything. Here's a nice conservative saying for you ... Do more with less.

Education shouldn't be a gateway to massive debt. End of story. Education should not be approached from a "for profit" perspective ... after all, that's how we arrived at our current healthcare fiasco.

The rest of your post, much like the portion I responded to is nothing more than the usual slanted drivel with all the talking points ... lacking any sort of solution. .. so come back when you have one.

Advocating more government control over the private sector, then?

[Tsa`ah]

What private sector?

Universities accept tax dollars ... thus in my eyes, not the private sector, though attempting to move in that direction with great success.

And why not advocate more government control in the healthcare sector? It's not like they've done a good job to this point in our history. Should we continue to believe that the "free market" will take care of it?

[radamanthys]

What private sector?

Universities accept tax dollars ... thus in my eyes, not the private sector, though attempting to move in that direction with great success.

And why not advocate more government control in the healthcare sector? It's not like they've done a good job to this point in our history. Should we continue to believe that the "free market" will take care of it?

It hasn't been a free market enterprise for a long, long time. When's the last time anyone paid full price for heathcare? Insurance is a form of socialized healthcare. It eliminates the 'consumer' from the decision-making process- invalidating the core principle that the entirety of free-market theory is based on.

The poor already can get governmental coverage- why fuck it up for everyone else?

[Tsa`ah]

It hasn't been a free market enterprise for a long, long time. When's the last time anyone paid full price for heathcare? Insurance is a form of socialized healthcare. It eliminates the 'consumer' from the decision-making process- invalidating the core principle that the entirety of free-market theory is based on.

The poor already can get governmental coverage- why fuck it up for everyone else?

I would hardly call the current state of medical insurance "socialized" by any stretch.

Which "everyone else" are you referring to? Obviously not the indigent through the bottom portion of the working poor. Not those with decent coverage provided or subsidized by their employers ... or the upper middle class to the rich. Obviously not those lacking pre-existing conditions.

Or maybe the "not fucking things up for everyone else" really meant fuck everyone else that can't afford health care, that has a pre-existing condition, and lives in that socioeconomic crack between assistance eligibility and an income level that would allow them to keep their family fed, a roof over their head, and heat in the winter, in addition to healthcare insurance.

All I'm seeing is the shooting down of ideas and potential solutions ... yet as ES pointed out, those doing the bitching and shooting down aren't suggesting anything themselves. Unless you count "leave it alone" and "personal responsibility" as solutions.

[Clove]

Healthcare is essentially a private monopoly; not exactly a free-market.

If it is going to continue to be a monopoly it ought to be converted into a public utility.

[Clove]

But why am I paying for things that I have no need for? I am 100% certain I'll never have a need for acupuncture.. and if that need ever arose, I would just pay for it. Why am I forced to carry it as part of my basic care insurance?Why pay for schools you'll never attend? Roads and bridges and train tracks you'll never travel on?

[Warriorbird]

Wait for it... wait for it...

....why pay for the Iraq War?

;)

[radamanthys]

Wait for it... wait for it...

....why pay for the Iraq War?

;)

by design, it was meant to protect all citizens, not just a select few.

[Parkbandit]

Why pay for schools you'll never attend? Roads and bridges and train tracks you'll never travel on?


Huh? You are comparing the rates insurance companies charge me with taxes I pay the Government?

They aren't the same.. or even close to being the same.

[Clove]

Huh? You are comparing the rates insurance companies charge me with taxes I pay the Government?

They aren't the same.. or even close to being the same.It's the same principle. You're paying into a pool when you pay taxes to cover expenses for the general welfare of the pool whether or not you'll require every service provided. Insurance is exactly the same.

[Fallen]

Are there any fiscal benefits to universal healthcare, or is it more of a humanitarian thing?

[Clove]

Are there any fiscal benefits to universal healthcare, or is it more of a humanitarian thing?Lower cost per capita. The larger the actuarial pool the smaller the average per capita expense.

On the downside time to service increases (waiting period to schedule service).

[radamanthys]

Are there any fiscal benefits to universal healthcare, or is it more of a humanitarian thing?

It's a sunk-cost humanitarian thing. They'd like you to believe that people will be healthier, but with rationing and quotas, people will be sicker.

As a preventable disease makes for a good benchmark, Canada has a 47% higher death rate from colon cancer. It's illustrative of the difference.

[Tsa`ah]

It's a sunk-cost humanitarian thing. They'd like you to believe that people will be healthier, but with rationing and quotas, people will be sicker.

As a preventable disease makes for a good benchmark, Canada has a 47% higher death rate from colon cancer. It's illustrative of the difference.

You just cherry picked a single statistic to support your response. It is not a valid comparison and is does not give an accurate representation of the two systems of care.

I could compare preventable deaths such as those attributed to childhood respiratory diseases ... and the US has a rate almost 23 times higher than the UK and 65 times higher than Canada ... and it would be no more valid. Well yes it would because your colon statistic only accounts for instances of diagnosed and treated cancer. So yes, Canada would have a higher instance of death ... while the US has a much higher instance of undiagnosed, untreated deaths.

It's like the argument that came up a year or so ago about bypass surgeries. The US does considerably more, yet that particular statistic should be an point of embarrassment, not a point of pride.

We perform more because we lack preventative medicine.

While a system prone to rationing has it's downfalls, it still generally beats the shit out of ours simply because of preventive care.

[Fallen]

Isn't it true that if the poor get insurance, they will live longer? Not to sound like Satan, but how is that a good thing? People that cannot afford their own insurance..living longer..Do you think these people have 401k's? Do you think these people could ever retire? Do you think Social Security can handle the average life expectency shooting up? Yes, they wont have as many "crisis" health issues which means they wont be in the E room..but they are going to live longer, thus costing more money in the long run. It isn't like they are going to die at the same age as they did without insurance.

Fiscally, this just seems like a disaster. Talk about the gentrification of America.

[Mikalmas]

Isn't it true that if the poor get insurance, they will live longer? Not to sound like Satan, but how is that a good thing? People that cannot afford their own insurance..living longer..Do you think these people have 401k's? Do you think these people could ever retire? Do you think Social Security can handle the average life expectency shooting up? Yes, they wont have as many "crisis" health issues which means they wont be in the E room..but they are going to live longer, thus costing more money in the long run. It isn't like they are going to die at the same age as they did without insurance.

Fiscally, this just seems like a disaster. Talk about the gentrification of America.

Wow. Are you really arguing that poor people (and its not just poor people who are uninsured) shouldn't get healthcare because they'll live longer and be a drain on society?

The worth of a human being is now measured by how much money they have?

[Fallen]

Wow. Are you really arguing that poor people (and its not just poor people who are uninsured) shouldn't get healthcare because they'll live longer and be a drain on society?

The worth of a human being is now measured by how much money they have?

Sorta?

I just want it to be made clear that providing universal health care will not fiscally benefit society. Even if gains are made in some areas, the detractors will far outweigh them. This is a purely humanitarian issue, and should be discussed only in those terms when considering the benefits.

[Clove]

Isn't it true that if the poor get insurance, they will live longer? Not to sound like Satan, but how is that a good thing? People that cannot afford their own insurance..living longer..Do you think these people have 401k's? Do you think these people could ever retire? Do you think Social Security can handle the average life expectency shooting up? Yes, they wont have as many "crisis" health issues which means they wont be in the E room..but they are going to live longer, thus costing more money in the long run. It isn't like they are going to die at the same age as they did without insurance.

Fiscally, this just seems like a disaster. Talk about the gentrification of America.Awesome.

[CrystalTears]

Isn't it true that if the poor get insurance, they will live longer? Not to sound like Satan, but how is that a good thing? People that cannot afford their own insurance..living longer..Do you think these people have 401k's? Do you think these people could ever retire? Do you think Social Security can handle the average life expectency shooting up? Yes, they wont have as many "crisis" health issues which means they wont be in the E room..but they are going to live longer, thus costing more money in the long run. It isn't like they are going to die at the same age as they did without insurance.

Fiscally, this just seems like a disaster. Talk about the gentrification of America.
Steven Colbert saying something to this effect is comedy. YOU saying it... not so much.

[Dhuul]

free health care for my friends :)

http://www.writaur.com/storypath/read.php?id=2&title=a-visit-to-the-doctor

[Clove]

Why don't we just all get fake Canadian ID's?

[Fallen]

Steven Colbert saying something to this effect is comedy. YOU saying it... not so much.

Wasn't going for laughs. I was having a discussion with co-workers who were trying to spin universal healthcare as somehow profitable. That just isn't the case. Now, does that mean we should not have universal healthcare? Argue yes or no, but you can't say that it will be a fiscally sound move.

[Methais]

None of this even matters because NKorea is gonna wipe us off the map!

[Dhuul]

Yes for free health care in the U.S. for citizens.

Not for Rygel or xcalibur, because they are aliens. Sorry Ryg!

It would only be profitable if it somehow taxed the private plans everyone not buying into the government gets...and uses that money to fuel it and The Beast that is Obama Drama.

[AnticorRifling]

Somehow the illegals would leech the system dry before those of us paying into it ever got a chance to use it...oh wait that's kind of like now.

[Mikalmas]

I think one of the major issues here is the fundamental preconceived notion that healthcare should be "profitable" in the first place. Healthcare should be nonprofit, period. The United States is the only wealthy industrialized nation that doesn't have universal healthcare. I'm currently using a nasal spray that costs $285 a bottle. My allergy serum is $700 a vial, and each injection is $30 (I get 4 a week right now). How does this make sense to ANYONE? Costs are insane and are unsustainable.

And, just for the record, the poor people in this country contribute to the vast majority of the infrastructure that creates the skeleton of this country. Without those "burdens," many of whom don't have healthcare, our great nation would not sustain. There would be no one to build the buildings that corporations occupy, or to build the roads and bridges and mass transit systems that we use daily. Or grow or harvest the foods we consume, build the cars we drive, build the homes we live in, etc.

[Fallen]

And, just for the record, the poor people in this country contribute to the vast majority of the infrastructure that creates the skeleton of this country. Without those "burdens," many of whom don't have healthcare, our great nation would not sustain. There would be no one to build the buildings that corporations occupy, or to build the roads and bridges and mass transit systems that we use daily. Or grow or harvest the foods we consume, build the cars we drive, build the homes we live in, etc.

They contribute those things now without universal healthcare.

How will universal health care, as it is now being proposed, work? Will people making X amount of money or below be given a card or something, and the government will cover their costs for whatever health needs they have? Is the healthcare being proposed now completely unconditional? I imagine you will at least have to prove you are a legal citizen. Will there be any sort of scaling costs?

[Parkbandit]

I think one of the major issues here is the fundamental preconceived notion that healthcare should be "profitable" in the first place. Healthcare should be nonprofit, period. The United States is the only wealthy industrialized nation that doesn't have universal healthcare. I'm currently using a nasal spray that costs $285 a bottle. My allergy serum is $700 a vial, and each injection is $30 (I get 4 a week right now). How does this make sense to ANYONE? Costs are insane and are unsustainable.

I agree about the condition of the current healthcare in this country.. I just don't think looking towards our government to run it is the answer.

Our country is out of money. Period. We can't afford to continue to spend, spend, spend, spend on every socialist's pipe dream and hope that someday someone will just pay for it. There has to be a time where even someone like you stands up and realizes we simply don't have the money and that we have to first get our economy back on track before talking about changing the world and bankrupting our country.

[Tsa`ah]

Isn't it true that if the poor get insurance, they will live longer?

Without getting into the disturbing lack of compassion displayed at the heart of your post, I'll just point out that the cross section of the population you're referencing already has public health care available to them. When we talk about the uninsured that can't afford coverage, we're talking about the working poor and the lower middle class. Tax paying citizens left out in the cold.

[crb]

I think one of the major issues here is the fundamental preconceived notion that healthcare should be "profitable" in the first place. Healthcare should be nonprofit, period. The United States is the only wealthy industrialized nation that doesn't have universal healthcare. I'm currently using a nasal spray that costs $285 a bottle. My allergy serum is $700 a vial, and each injection is $30 (I get 4 a week right now). How does this make sense to ANYONE? Costs are insane and are unsustainable.

And, just for the record, the poor people in this country contribute to the vast majority of the infrastructure that creates the skeleton of this country. Without those "burdens," many of whom don't have healthcare, our great nation would not sustain. There would be no one to build the buildings that corporations occupy, or to build the roads and bridges and mass transit systems that we use daily. Or grow or harvest the foods we consume, build the cars we drive, build the homes we live in, etc.
Drug research is not cheap, fast, or easy, and you can have a drug be safe for a decade, have the government say it is safe, and turns out if you're wrong you have to pay lawyers a couple billion (with a B) dollars.

Drug patents last for 14 years, deal with it. If you're using a drug still under patent that means, pretty much, that drug did not exist 14 years ago. 14 years. It isn't as if 14 years ago was the stoneage. The generics available are only 14 years out of date.

Maybe you'd rather drugs were given away? Well then, instead of paying $700 for your serum or whatever, you'd not have to, because it wouldn't exist, because no one would have researched it.

Is it so much to ask for that drugs be expensive for 14 years as payment for their research so they can be relatively cheap from there on out to eternity? If you cannot afford it, use the older drug. Like when you cannot afford a new car, you buy a used one.

And it isn't as if the drug companies do nothing. They have programs to help people afford their medications, and they give away tons of stuff to charities that help the third world (africa etc).

It is better drugs be temporarily expensive than have them never exist at all.


And oh... we're the only western country blah blah blah? I'm tired of that bullshit. We have the best medical care in the world here. The statistics liberals like to toss around are usually either public opinion polls (managing expectations is not a measure of discrete results) or simple life expectancy, as if nothing other than the access to healthcare governs life expectancy.

If you look at actual statistics for the healthcare system such as survival rates for conditions or diseases, time for access to specialists, available of advanced testing and imaging. We're #1. In those other countries you so want us to emulate people wait months and months for care, or even now have to enter a lottery for appointment slots.

[crb]

Without getting into the disturbing lack of compassion displayed at the heart of your post, I'll just point out that the cross section of the population you're referencing already has public health care available to them. When we talk about the uninsured that can't afford coverage, we're talking about the working poor and the lower middle class. Tax paying citizens left out in the cold.
Incorrect. If you're talking about people in poverty (really, I believe the bottom 40% of earners in this country), they do not pay taxes.

They pay FICA, which goes to fund their share SS & Medicare (and really, just a portion of their share), and that is it. They pay no actual income taxes to fund any of the rest of our government. The only actual taxes they pay are sales taxes, gas taxes, sin taxes. No income tax. And in fact most now get refundable income tax credits.

Didn't you know this?

[crb]

I doubt you'd have the chops even for the last ditch effort college ... but that's not the conversation.

The point you're missing is that the best and the brightest don't always make it. 10-15 grand per semester is what separates a PHd from UIUC or Northwestern from SIU or ISU ... and sometimes there isn't enough for even those choices.

This is the reason why wait listing occurs.

A person accepted into Harvard, one of 165 seats ... is pretty much the cream of the crop. If you're number 166 to say 265, you came close ... but they deemed other applicants as "better" than you. Going back to my response to PB ... why should 166 (who has the funding) get in when 27 can't come up with the funds?

In fact, what if 27 can't find the loans, grants, or scholarships to cover any medical school ... how exactly do you justify one of the brightest being relegated to something like phlebotomist?


I'm all in favor of accessible student loan programs and I've never seen someone who could not get access to college if they had the grades AND the time to attend. Harvard is even easier than most because of their massive endowment they have really good tuition grant programs, lots of Ivy league schools do (though, with their investment losses, they may start paring those back).

If the student loan system needs more help, give it more help. If some genius cannot get the help needed to attend medical school. That is a problem. I've known a lot of people who have attended college on their own steam, and many of them are pretty low quality, and they got the loans and grants and everything else. Doogie Houser probably has no problem.





You cut the fucking fat. There's no reason why billions should be spent on sports, let alone the thousands of free rides that will never pan out into anything. Here's a nice conservative saying for you ... Do more with less.


For the record, Men's Basketball and Football tend to be net contributors to the university. Additionally, many of their material needs are funded with boosters. This is at big schools anyways. The school makes a profit on the athletic program.

Niche sports, lacrosse, swimming, any of the olympic events, those do cost money, and are usually funded by the Men's Basketball and Football revenue.



Education shouldn't be a gateway to massive debt. End of story. Education should not be approached from a "for profit" perspective ... after all, that's how we arrived at our current healthcare fiasco.

Almost all college and universities, even private ones, are non-profit. So you're rant against profit would seem misplaced. Perhaps you don't realize the penchant of large bureaucracies to self perpetuate, not for profit, but for job security. This behavior is why much of government spending is so wasteful.

[Atlanteax]

Obama's answer to everything:

[Tsa`ah]

Incorrect. If you're talking about people in poverty (really, I believe the bottom 40% of earners in this country), they do not pay taxes.
Well, I guess this proves that you're capable of pulling an endless amount of bullshit from your ass and posting it on a message board.
It's actually the bottom 32% (2005 stat) with 61% of those being single income head of household and EIC (single moms and dads) ... these people either pay nothing, or receive returns in the form of tax credits to offset a very large economic disparities.


They pay FICA, which goes to fund their share SS & Medicare (and really, just a portion of their share), and that is it. They pay no actual income taxes to fund any of the rest of our government. The only actual taxes they pay are sales taxes, gas taxes, sin taxes. No income tax. And in fact most now get refundable income tax credits.
Well as usual, you're throwing around a good deal of vagaries in an attempt to establish your drivel as factual. The bullshit pertaining to FICA I'll skip, simply because anyone with half a brain can see through it.
We can go by what the census bureau defines as the working poor ... at or below 200% poverty. So what you're trying to tell me is that a single person at the edge of 200% poverty, making 21,574, doesn't pay taxes?
Well assuming said person takes no time off (because you would have to work every week of the year just to barely survive), the federal tax liability comes to 1,016.

So let's assume this person works a job that doesn't benefits of any sort (outside of a paycheck that doesn't bounce), how well does he/she survive with average costs throughout the year. Let's assume this person owns his/her car has a policy that will potentially cover his/her ass.

Rent (no real national average figure so lets low ball it) 400/mo
Health insurance 400/mo
Auto Insurance 85/mo
Renter's Insurance 15/mo
Utilites 160/mo
Grocery 80/wk
Fuel 1,200/yr

So we're at 18,080 in expenses thus far, leaving this person with 2,478 in "disposable" income ... so long as he/she doesn't have to go to the doctor, get a headache/cold/flu or any other illness/symptom that would require OTC or prescription meds. Also providing he/she doesn't need to replace clothing, maintain the car, repair the car, or communicate with anyone that isn't right in front of his/her face.

Now this person is likely in the position of needing more per year than he/she earns ... and has saved nothing for anything. In 42 years you're going to bitch that this person is now on medicare and has to use SSI as the sole means of retirement income. To put the icing on the cake ... this person will be eligible for exactly 0.00 in assistance from any government program because of earnings in excess of established poverty guidelines and will likely sink into debt because of the ever rising cost of living.

I'd rather see realistic poverty definitions, especially in reference to the working poor. The French standard is much more realistic, 60% of median.


Didn't you know this?

I don't make a habit of taking some slanted and scewed factoids that are beyond my comprehension, mangling them, and then spewing them to and fro as readily as one would squirt out a meal that utilized salmonella as the protein. So no ... I didn't know.

But let's continue with more of your drivel.


I'm all in favor of accessible student loan programs and I've never seen someone who could not get access to college if they had the grades AND the time to attend. Harvard is even easier than most because of their massive endowment they have really good tuition grant programs, lots of Ivy league schools do (though, with their investment losses, they may start paring those back).

If the student loan system needs more help, give it more help. If some genius cannot get the help needed to attend medical school. That is a problem. I've known a lot of people who have attended college on their own steam, and many of them are pretty low quality, and they got the loans and grants and everything else. Doogie Houser probably has no problem.

Half of all incoming freshman can't afford college ... after available aid and loans they qualify for are figured. Though let's focus in on graduate school. The number one reason students don't attend ... cost/lack of funds.

About 10 wait listers to Harvard Medical, per class, end up attending because .... anyone? Anyone? Because 10 dropped likely because they can't afford it, the aid and loans did not cover the expense. Despite the massive endowment you mentioned, students still decline to enroll because of the financial constraint.
Endowments only go so far and only so many are eligible. So every year, 6% of the incoming med students are from the wait list.

Hell my wife is a good example. She applied to three grad schools (Stanford, UIUC, and UMA/A) and was accepted to all three. She was only able to attend UIUC because of a fellowship.Stanford, much like Harvard, has a number of large endowments used to aid financially disadvantaged students. The more disadvantaged you are, the better your chances. She wasn't as disadvantaged as others before her.

That you can only use a fictional character as an example only shows how out of touch you and your's are ... just like the latest republican healthcare proposal of ... tax cuts and tax credits.


For the record, Men's Basketball and Football tend to be net contributors to the university. Additionally, many of their material needs are funded with boosters. This is at big schools anyways. The school makes a profit on the athletic program.

Niche sports, lacrosse, swimming, any of the olympic events, those do cost money, and are usually funded by the Men's Basketball and Football revenue.

You say this if I don't know it and then you provide examples of fat that could be cut. Nice to see you're able to follow along in your own oxygen deprived way. Yet there isn't any justification for full ride sports scholarships.


Almost all college and universities, even private ones, are non-profit. So you're rant against profit would seem misplaced. Perhaps you don't realize the penchant of large bureaucracies to self perpetuate, not for profit, but for job security. This behavior is why much of government spending is so wasteful.

Moronic statement of the day ... not to mention you just fail to follow along. Universities are indeed non-profit ... my point was that higher education is approached from a for profit perspective that it currently is.
So I'll say it again. If you're capable of college and graduate school ... you should be able to attend.

[Parkbandit]

Well, I guess this proves that you're capable of pulling an endless amount of bullshit from your ass and posting it on a message board.

HUGE ASS WALL OF TEXT TO FOLLOW

Are you that threatened by crb that you just had to prove who could throw more endless amounts of bullshit from your ass (and google) and post it up on a message board?

Relax Francis.. you are the king of endless and useless shit storms on this forum.

[crb]

Well, I guess this proves that you're capable of pulling an endless amount of bullshit from your ass and posting it on a message board.
It's actually the bottom 32% (2005 stat) with 61% of those being single income head of household and EIC (single moms and dads) ... these people either pay nothing, or receive returns in the form of tax credits to offset a very large economic disparities.


So I said 40%, you say 32%, but how does that invalidate my point? You said the poor pay taxes, they do not, you just admit it, in your mind 32% of people don't pay taxes.




We can go by what the census bureau defines as the working poor ... at or below 200% poverty. So what you're trying to tell me is that a single person at the edge of 200% poverty, making 21,574, doesn't pay taxes?
Well assuming said person takes no time off (because you would have to work every week of the year just to barely survive), the federal tax liability comes to 1,016.


You know, I once earned that little, and I lived. So did my wife, so did my brothers, actually my brothers still do. I once earned 11k in a year and I lived.



So let's assume this person works a job that doesn't benefits of any sort (outside of a paycheck that doesn't bounce), how well does he/she survive with average costs throughout the year. Let's assume this person owns his/her car has a policy that will potentially cover his/her ass.

Rent (no real national average figure so lets low ball it) 400/mo
Health insurance 400/mo
Auto Insurance 85/mo
Renter's Insurance 15/mo
Utilites 160/mo
Grocery 80/wk
Fuel 1,200/yr


1. A car is a luxury, my sister in law works at mcdonalds and rides the bus.
2. Health insurance is a hell of a lot cheaper than that. Anyone under 30 in Michigan can get it for about $54 a month. Over 30 the cheapest policy I know is $150. These policies accept everyone regardless of medical conditions.



Now this person is likely in the position of needing more per year than he/she earns ... and has saved nothing for anything. In 42 years you're going to bitch that this person is now on medicare and has to use SSI as the sole means of retirement income. To put the icing on the cake ... this person will be eligible for exactly 0.00 in assistance from any government program because of earnings in excess of established poverty guidelines and will likely sink into debt because of the ever rising cost of living.


Well shit, I guess they should have spent their life improvement their lot. It isn't like there are not opportunities in this country. You can't absolve a 50 year old making minimum wage from all blame for their situation. Sorry, they fucked up, so they get to have a shitty life.







Half of all incoming freshman can't afford college ... after available aid and loans they qualify for are figured. Though let's focus in on graduate school. The number one reason students don't attend ... cost/lack of funds.


For non-law-medicine-vet-business grad school it is free here at nearby MSU. Actually more than free. If they accept you they pay you. You help teach entry level classes or help with research of course, it is a job, but you get free tuition, student insurance, and a stipend. My brother is in the doctoral sociology program, it works for him.

For those professions where you expect to earn more after graduating, loans are available.



About 10 wait listers to Harvard Medical, per class, end up attending because .... anyone? Anyone? Because 10 dropped likely because they can't afford it, the aid and loans did not cover the expense. Despite the massive endowment you mentioned, students still decline to enroll because of the financial constraint.

You assume that they couldn't afford it. It is just as likely those 10 decided to attend another medical university, maybe to be closer to friends or family. Show me something saying loans aren't available, because every last person I have ever met has been able to get a loan to go to college. My wife just graduated medical school, so I've met a shit ton of medical students, from all walks of wife. Immigrants from Africa, Asia, Europe. A single dad (widow) with 2 kids, a 50 year old former English professor grandfather who wanted to change professions. Every one was able to get loans and afford medical school. In fact after admission they told all students that if they were accepted that funds were available, that any student accepted was guaranteed enough loans to cover tuition AND living expenses. They could take however much they needed.



Endowments only go so far and only so many are eligible. So every year, 6% of the incoming med students are from the wait list.


Again, you ASSume that people on the wait list get to go because of money, but really, most med students apply to multiple hospitals and then end up picking one, so if you get accepted to multiple places (very common) you create a waitlist opportunity. Others drop out because it is too hard, one guy in my wife's class got kicked out for cheating.




You say this if I don't know it and then you provide examples of fat that could be cut. Nice to see you're able to follow along in your own oxygen deprived way. Yet there isn't any justification for full ride sports scholarships.


You're like a dweeb aren't you? Some like vegetarian 5'4 120 pound dude who got picked on in school by all the jocks so you're perpetually bitter about athletics?

When a school does well with a men's football or basketball program and makes it to a bowl game or the NCAA tournament it is MILLIONS of extra dollars for the university. Especially basketball with the <a href = "http://www.newsobserver.com/sports/story/559082.html">NCAA tournament</a>.

For major universities the athletic department is a net contributor to their finances. It is also used as a recruiting tool, and many of the facilities are multi-use. A basketball facility for instance can be rented out for concerts or figure skating or monster trucks, providing more revenue for the university.

Some of the sports within the athletic department cost money, others generate money, but on a whole the athletic department is a net contributor, at major universities. At small places without any TV coverage or large facilities for thousands of spectators, this is likely not the case.

[Tsa`ah]

Are you that threatened by crb that you just had to prove who could throw more endless amounts of bullshit from your ass (and google) and post it up on a message board?

Relax Francis.. you are the king of endless and useless shit storms on this forum.

The double irony obviously escapes your limited intelligence.

What's the matter, did my post overload your brain? You were only able to get off a google insult.


So I said 40%, you say 32%, but how does that invalidate my point? You said the poor pay taxes, they do not, you just admit it, in your mind 32% of people don't pay taxes.

That you stopped at this particular point, ignoring what followed, to declare some sort of victory, says it all. 32% of the working class does not pay taxes, and indeed a portion of them get a return via credits.

You're using the IRS/Census measure of poverty and not a measure based in reality ... which is likely the reason you stopped where you did, ignoring the original remark of "working poor".


You know, I once earned that little, and I lived. So did my wife, so did my brothers, actually my brothers still do. I once earned 11k in a year and I lived.

And here's the intentional disconnect on your part. The example was that of a person defined as "working poor" that indeed pays taxes. Who cares if you earned that little at one time, or anyone else. The point is that a good number people will {and have} earn at this level for their entire lives. This is effectively "the crack" where you earn too much for assistance but are in actual need of assistance.


1. A car is a luxury, my sister in law works at mcdonalds and rides the bus.
2. Health insurance is a hell of a lot cheaper than that. Anyone under 30 in Michigan can get it for about $54 a month. Over 30 the cheapest policy I know is $150. These policies accept everyone regardless of medical conditions.

Not everyone lives within range of a mass transit system, and most of those who don't have already calculated the costs of living near one vs commuting to work.

Not everyone lives in MI, not to mention those policies are pretty much a waste of cash unless you need a major operation or are involved in an accident that puts you into an ICU for a few weeks.

And no, the national average for a single individual policy doesn't change because you say so ... Though I used the average for employer provided single coverage. Average individual coverage is higher.


Well shit, I guess they should have spent their life improvement their lot. It isn't like there are not opportunities in this country. You can't absolve a 50 year old making minimum wage from all blame for their situation. Sorry, they fucked up, so they get to have a shitty life.

And we come full circle in PB logic. You have not lived the same life as others. Your opportunities and hardships are not the same and visa versa.

In short ... go fuck yourself. The response was retarded and I'm all the dumber for reading it ... let alone responding to it.


For non-law-medicine-vet-business grad school it is free here at nearby MSU. Actually more than free. If they accept you they pay you. You help teach entry level classes or help with research of course, it is a job, but you get free tuition, student insurance, and a stipend. My brother is in the doctoral sociology program, it works for him.

That's doubtful, but I'll give you the benefit of the doubt.

Unfortunately for your argument, MSU wouldn't hold such standards if demand doubled. Also ... not everyone lives within range of MSU and MSU's capacity for incoming freshmen is pretty limited.

That still doesn't negate the fact that half of graduating HS seniors can't afford college. I really don't know where you get your information from, but it's been all over the news for YEARS.


For those professions where you expect to earn more after graduating, loans are available.

There are limits in an up economy ... what do you think happens to those limits in a down economy?


You assume that they couldn't afford it. It is just as likely those 10 decided to attend another medical university, maybe to be closer to friends or family. Show me something saying loans aren't available, because every last person I have ever met has been able to get a loan to go to college. My wife just graduated medical school, so I've met a shit ton of medical students, from all walks of wife. Immigrants from Africa, Asia, Europe. A single dad (widow) with 2 kids, a 50 year old former English professor grandfather who wanted to change professions. Every one was able to get loans and afford medical school. In fact after admission they told all students that if they were accepted that funds were available, that any student accepted was guaranteed enough loans to cover tuition AND living expenses. They could take however much they needed.

First we're talking about people accepted into Harvard medical. You don't decline acceptance to Harvard or JHU without a really good reason. Acceptance into another medical program indicates cost. Acceptance into a program closer to home (we're talking about the 22-25 crowd) indicates cost. About the only reasons for not attending one of THE top med schools that doesn't have to do with cost .... personal tragedy or the desire to be anything but a MD.

Sorry, try again.


Again, you ASSume that people on the wait list get to go because of money, but really, most med students apply to multiple hospitals and then end up picking one, so if you get accepted to multiple places (very common) you create a waitlist opportunity. Others drop out because it is too hard, one guy in my wife's class got kicked out for cheating.

To a top program? There's no assumption. Those that get in off the wait list do so because they have the cash/support to do so. They're in because someone dropped (most common reason being cash) and they can pay to play and have no problem being better off financially even if they're second string.


You're like a dweeb aren't you? Some like vegetarian 5'4 120 pound dude who got picked on in school by all the jocks so you're perpetually bitter about athletics?

LOL ... I was offered an athletic scholarship to play football at Northwestern. I declined because I was given a pass (mathematically) in HS and because my wife to be was going to attend IL Wesleyan. I was a red shirt at ISU and later worked as a physical trainer at UIUC. My opinion of the collegiate system comes from experience.


When a school does well with a men's football or basketball program and makes it to a bowl game or the NCAA tournament it is MILLIONS of extra dollars for the university. Especially basketball with the <a href = "http://www.newsobserver.com/sports/story/559082.html">NCAA tournament</a>.

The operative word being "when" ... though "if" would have been better. How many schools regularly make it to bowl games? How much will the average team spend to make single bowl appearance in a decade? How many teams, across all divisions, are there for each collegiate sport?

The math only works for a few ... the rest just pump out millions for a lottery ticket.


For major universities the athletic department is a net contributor to their finances. It is also used as a recruiting tool, and many of the facilities are multi-use. A basketball facility for instance can be rented out for concerts or figure skating or monster trucks, providing more revenue for the university.

Operative word ... major.


Some of the sports within the athletic department cost money, others generate money, but on a whole the athletic department is a net contributor, at major universities. At small places without any TV coverage or large facilities for thousands of spectators, this is likely not the case.

Yet you focus only on sports and use a relatively small sampling as reference to success.

The only thing that separates you and PB ... a vocabulary.