this cannot possibly be true

flounder alert..

http://healthcarereform.nejm.org/?p=1790&query=home

but it can't be true..

Really it can't....

Yeah, it can. A lot of the medical folks I talk to say they'd prefer one "bad guy" when they're trying to prescribe treatment/get paid, rather than a hundred different ones with different standards.

It's not a liberal "hearts & butterflies" thing on their part, it's just to reduce the accounting mess.

Then again, there is the piece that supports a single-payer option, with the ultimate goal of completely eliminatng the private insurance option:

http://singlepayernewyork.org/news/comehome.php

Because the federal government has done such a masterful job administering all the other entitlement programs, right?

Big article said: "Survey respondents were asked to indicate which of three options for expanding health insurance coverage they would most strongly support:"

Not-"Do you believe legislating mandatory health insurance is the way to solve the health care crisis?"

Load the survey then misuse the results. Good job!

MrJoshua wrote: Big article said: "Survey respondents were asked to indicate which of three options for expanding health insurance coverage they would most strongly support:" Not-"Do you believe legislating mandatory health insurance is the way to solve the health care crisis?" Load the survey then misuse the results. Good job!

so its not the best designed survey.... but it is the NEJM.. they do carry some weight with DR's..

Off the cuff the folks who buy med mal insurance from my dad( it's all he does) are nearly to a T for government health care. He deals with about 150 docs and maybe 5 have doubts and 2 are against. My dad sells low cost insurance to higher risk docs in the Philly area... Generally they hate insurance companies because they are evil and they hate lawyers as well.

Im confused-what point were you trying to make with the first post? That doctors answer questions semi honestly? That when doctors are asked what type of health insurance they prefer that the answer will include some type of health insurance? There is supposed to be a national push to reform HEALTH CARE. Proving to me that doctors don't always think private insurance is the best insurance tells me nothing about what doctors think should be done to increase the availability of quality health care.

MrJoshua wrote: Im confused-what point were you trying to make with the first post? That doctors answer questions semi honestly? That when doctors are asked what type of health insurance they prefer that the answer will include some type of health insurance? There is supposed to be a national push to reform HEALTH CARE. Proving to me that doctors don't always think private insurance is the best insurance tells me nothing about what doctors think should be done to increase the availability of quality health care.

I edited my comments to more accurately express my feelings. I'm a rather impulsive douche.

ignorant wrote: so its not the best designed survey....

That is a very well designed survey. Remember surveys are not given by unbiased people to figure out what people's opinions are. They are carefully crafted to intentionally skew the results to the desired conclusion.

How the question is asked determines what answer is given. All they want is something that they can make a headline out of to put on the news and then have various political commentators discuss.

Watch some of the Frank Luntz youtube videos if you want to see how the people designing the questions think. It is 100% pure manipulation and the results are meaningless and anyone who cites them to prove a point without acknowledging their suspect nature is either an idiot or a liar - in any case no reason to listen to them.

I do not believe that forcing all of us to have some type of health insurance is the solution to the rising costs of, and therefore lack of access to, quality health care. The article you linked to only addresses which type of health insurance the doctors prefer. Saying that because of the study we can now assume doctors believe government supplied or regulated health insurance is the answer to the health care crisis is reading more into the results than is logically possible. Study can be the best most accurate study in the world, but it can only answer what was asked.

I believe we need:
- Tort reform
- Pharmaceutical cost reduction
- transparency in billing

Mandating health insurance feeds one of the primary causes of health care cost increases and takes away motivation to try to fix the others.

TJ wrote: They are carefully crafted to intentionally skew the results to the desired conclusion.

please start this argument with.. "the liberal media".. and I'd respect it more..

Ugh.. I've done survey design.. This has never happened in my experience.

MrJoshua wrote: I believe we need: - Pharmaceutical cost reduction

IIRC, Rx costs started going up back in the 90's when the FDA allowed Rx advertising. I admit that this is circumstantial and incompleat evidence, just some thing to think about.

oldsaw wrote: Then again, there is the piece that supports a single-payer option, with the ultimate goal of completely eliminatng the private insurance option: http://singlepayernewyork.org/news/comehome.php Because the federal government has done such a masterful job administering all the other entitlement programs, right?

Oldsaw, all I can say is that when my conservative buddies speak of the "problems" with a Euro/Japanese style National Health Care program, all they say is:

1.) Longer waits in the doc's office.

2.) Disinterest in my personal situation from the doc I've been sent to see.

3.) Declined coverage of the best meds/procedures available to treat the disease.

I get all of that from my private industry health care provider, so there's really no difference to me about that kind of stuff.

I have to admit that they're right about what the real "public option" would cost, though..the US has a much bigger population than the European & Asian countries that make public health care programs work. Attempting to do the same thing here would probably bankrupt us.

neon4891 wrote:

MrJoshua wrote: I believe we need: - Pharmaceutical cost reduction

IIRC, Rx costs started going up back in the 90's when the FDA allowed Rx advertising. I admit that this is circumstantial and incompleat evidence, just some thing to think about.

My dad works for a major pharmecutical company, and has been in the field since 1987. He says that the reason that everything costs so high is pretty simple, with two factors playing big roles:
1) Lawsuits, plain and simple. Every lawsuit drives the cost of a drug up, just a little bit. I actually don't think this is much in the grand scheme, but its there.
2) The big one. The pharmecutical companies are in business to make money. They are going to charge when they can; that is before a drug comes off patent. But they still are charging way too much for just the profit you say? YES! The reason for this is that for every drug that you see on the market, there were XX drugs that didn't make it past their own testing, or didn't make it past the FDA, etc. etc. You have to pay for the R&D of those failed drugs as well.

Just my .02 on this particular point of the issue.

oldsaw wrote: Then again, there is the piece that supports a single-payer option, with the ultimate goal of completely eliminatng the private insurance option: http://singlepayernewyork.org/news/comehome.php Because the federal government has done such a masterful job administering all the other entitlement programs, right?

That's a pretty worn out arguement, but one I have to agree with. The private sector could do alot better than the government. Only thing I would add is that they sure aren't trying to prove it. The private sector has done a shoddy job for quite a while. Alot of us could do no worse if the government takes over. Crappy gubment health care>what I have now (not a thing).

Joey

ignorant wrote:

TJ wrote: They are carefully crafted to intentionally skew the results to the desired conclusion.

please start this argument with.. "the liberal media".. and I'd respect it more.. Ugh.. I've done survey design.. This has never happened in my experience.

Is there anything you haven't done? It seems you always manage to dredge up your own past experience and expertise on any subject you need to.

mtn wrote: ...YES! The reason for this is that for every drug that you see on the market, there were XX drugs that didn't make it past their own testing, or didn't make it past the FDA, etc. etc. You have to pay for the R&D of those failed drugs as well....

You are entirely correct. You also have to consider that the development process for some of these drugs can be in the order of 10 years!!! That's a LOT of money.

There is also only a limited time that the companies have to sell the drugs until a generic version is legally allowed. The generic will of course be MUCH cheaper because they didn't have to pay any of the development costs (or the cost of the failed attempts). So the drug company not only has to cover its development costs, it has to anticipate being undercut by generics, both of which make the drugs cost way more then the production cost (which of would be an unreasonable price point to start with).

aircooled wrote:

mtn wrote: ...YES! The reason for this is that for every drug that you see on the market, there were XX drugs that didn't make it past their own testing, or didn't make it past the FDA, etc. etc. You have to pay for the R&D of those failed drugs as well....

You are entirely correct. You also have to consider that the development process for some of these drugs can be in the order of 10 years!!! That's a LOT of money. There is also only a limited time that the companies have to sell the drugs until a generic version is legally allowed. The generic will of course be MUCH cheaper because they didn't have to pay any of the development costs (or the cost of the failed attempts). So the drug company not only has to cover its development costs, it has to anticipate being undercut by generics, both of which make the drugs cost way more then the production cost (which of would be an unreasonable price point to start with).

Which I did mention in my above post as well. I forget the figure, but the amount of money a drug company makes on a generic is really small, I want to say its similar to a gas station making money on gasoline.

MrJoshua wrote: I believe we need: - Tort reform

Never happen. The people who will clamor loudest for "free" (publicly-funded) health care are the very same people who believe everything is someone else's fault/problem. They would never consider giving away a potential scapegoat/money source.

Possibly true, but those screaming for "free" healthcare (they really shouldn't use that phrase, it shows a lot of ignorance) are not the ones making the laws.

The ones that are making the laws, a lot of them are lawyers...

ignorant wrote:

TJ wrote: They are carefully crafted to intentionally skew the results to the desired conclusion.

please start this argument with.. "the liberal media".. and I'd respect it more.. Ugh.. I've done survey design.. This has never happened in my experience.

It is not just the liberal media. If you don't think this type of manipulation is done by both sides you are living up to your screen name. Frank Luntz is a master and he works for Fox, he just happened to let his guard down and get videoed talking about it.

Hmmm. Government health care. Anybody remember the docs in Russia (now THERE's government health care!) who couldn't get anesthesia supplies? They developed a technique to lower the body's core temperature so the patient would basically go into shock and not feel pain.

http://asianannals.ctsnetjournals.org/cgi/content/full/10/1/3

Sure it works, but it carries an increased risk of brain damage when compared to more mainstream methods. If that's what centralized government run medicine will mean, count me out.

In reply to Jensenman:

that's ok, when they're all gov't employees, they won't have to worry about malpractice insurance since you can't sue the gov't

Jensenman wrote: Hmmm. Government health care. Anybody remember the docs in Russia (now THERE's government health care!) who couldn't get anesthesia supplies? They developed a technique to lower the body's core temperature so the patient would basically go into shock and not feel pain. http://asianannals.ctsnetjournals.org/cgi/content/full/10/1/3 Sure it works, but it carries an increased risk of brain damage when compared to more mainstream methods. If that's what centralized government run medicine will mean, count me out.

Right. Because that's directly related. Sensationalist and irrelevant BS like this from both sides does absolutely nothing to help.

aircooled wrote: Possibly true, but those screaming for "free" healthcare (they really shouldn't use that phrase, it shows a lot of ignorance) are not the ones making the laws. The ones that are making the laws, a lot of them are lawyers...

And they are going to recast current laws that encourage litigation and suits into cleaner, more sensible laws that do not? [Cosby] Riiiiiiiiiiiiight... [/Cosby]

Jensenman wrote: Hmmm. Government health care. Anybody remember the docs in Russia (now THERE's government health care!) who couldn't get anesthesia supplies? They developed a technique to lower the body's core temperature so the patient would basically go into shock and not feel pain. http://asianannals.ctsnetjournals.org/cgi/content/full/10/1/3 Sure it works, but it carries an increased risk of brain damage when compared to more mainstream methods. If that's what centralized government run medicine will mean, count me out.

Wow. You think thats what's going to happen? Will the same doctors get to be on the list to decide when I get to die in my old age?

Joey