US ambassador killed over a film

[FireIceTalon]

One problem: Marxism isn't a philosophy, it is a science, and mode of analysis. Now, if you had said communism, you might sort of have a point, although communism itself isn't really a philosophy either, it's actually an ideology though the context of what you are saying may be applicable to it.

Please point me to the volumes of Marx's reproducible experimentation. One does not become a self-proclaimed scientist merely because they hate philosophers.

I would accept Popper's characterization of Marx/Engels as pseudoscience. "Historicism" is unscientific. Its claims cannot be tested and, in particular, are not subject to being tested as falsifiable.

http://karws.gso.uri.edu/jfk/critical_th...ility.html

Of course you would, much in the same way most Idealists also deny evolution, and think that ideas shape the world we live in - when in fact it is the opposite, the material world is what shapes and necessitates ideas.

Marxism is a soft science, much like the broader fields of sociology and economics are, and in fact, the former had a HUGE impact on the latter two. It is a mode of analysis that doesn't inject any ideology or moralism into the dialectical relationships in the history of class struggles. It scientifically examines and critiques the 'natural (f)laws' of capitalism (and other class relationships within it, or other modes of production), and therefore it uses objective, and observable facts in its observations; as opposed to using subjective moralities to push an ideological agenda, and thus resulting in a slanted, unscientific analysis.

For example, lets take the development of racism in America in conjunction with Capitalism. The Idealist perspective would view capitalism and racism as independent of one another, both their developments and their continual processes, which implies that racism can be reformed out of existence in capitalism. Of course, all solutions would be futile, as history has proven - because they ignore the material laws of how capitalism functions. Idealists want to solve the problem by injecting ideology, morality, universalism, and other reformist nonsense into it. "If only capitalists were more moral, it could work!!" - This is the kind of unrealistic crap that I would find hilarious, if it wasn't so repulsive.

The Marxist analysis shows otherwise though. Racism and capitalism are NOT independent of one another, and in fact have a dialectical relationship. Biological racism as we know it, and the concept of a "superior race" and an "inferior race" are a historical development under and as a result of the development of capitalism. Granted, the form of racism based on an corresponding idea has changed over time in America, but that happens only when material conditions change, and ultimately, it still exists, and necessarily so, because you cannot have a capitalist society without racism. Not scientifically possible - the economic laws of capitalism will prevent this, always. So as with class, revolution is required to eliminate racism as well, because race and class so greatly overlap and because the capitalist system requires many divisions of labor, racial included.

Marxism is a science, and I know it kills you inside that it is more sound than any of your crazy idealist, and irrelevant Ivory Tower philosophies. The lolbertarian philsosophy: "Everyone should be treated equally and fairly, have maximum individual freedom possible, love one another and be one big happy family, and we could if capitalists were more moral and ethical, it could just be the perfect system for everyone!!!!". LMAO. Snap out of your dream world. It won't ever happen, because you cannot have it both ways - not in class based societies anyway. We have tried putting a human face on capitalism for over 2 centuries now, and guess what? It hasn't worked. Cause or correlation? Both, I'm sure. Indeed, the definition of insanity is repeating the same thing over and over again, and expecting a different result.

[kandrathe]

Of course you would...{incoherent ranting}

You rail against me, but you don't refute Popper?

Where is the experimentation? How is the analysis of the past falsifiable?

Snap out of your dream world.

I can't help but snicker whenever you say this. It's just so ironic. You are an ardent fan boi of a failed student, who lived off hand outs by pandering to pseudo-intellectuals, and calling the liberalism/capitalism (the system we have) we have had these past 250 years a fantasy, while the supposed system that is the "savior of the proletariat", has yet to materialize in any distinguishable form. Which is the fantasy? Who is deluded?

I merely need to sit on the shoulders of giants like --> The Fantasy of Marxism -- by Leszek Kolakowski

I won't waste anymore of our time. You are clearly off the deep end.

[FireIceTalon]

Of course you would...{incoherent ranting}

You rail against me, but you don't refute Popper?

Where is the experimentation? How is the analysis of the past falsifiable?

Snap out of your dream world.

I can't help but snicker whenever you say this. It's just so ironic. You are an ardent fan boi of a failed student, who lived off hand outs by pandering to pseudo-intellectuals, and calling the liberalism/capitalism (the system we have) we have had these past 250 years a fantasy, while the supposed system that is the "savior of the proletariat", has yet to materialize in any distinguishable form. Which is the fantasy? Who is deluded?

I merely need to sit on the shoulders of giants like --> The Fantasy of Marxism -- by Leszek Kolakowski

I won't waste anymore of our time. You are clearly off the deep end.

Incoherent is just a short way of saying "this truth is an inconvenience to my ideological agenda, so I won't address it".

Again, you argue against something that I'm not even arguing. Where did I, or Marx for that matter, ever state that capitalism is a fantasy? Oh wait, I didnt. Nor did he.

What IS a fantasy is YOUR lolbertarian ideology and moralistic filled horse-shit - that you think we can all live under capitalism or any class system and all just be one big happy, honky dory family. It is YOU, not I, that lives in some Ivory Tower and has blinders on to how the world really is. Nor does capitalism's mere existence for the past 250 years mean that it is a justified and legitimate system - an appeal to ignorance fallacy. Truth is, capitalism has already failed, and multiple times - the only reason it still exists is because the State always saves it whenever it falls into crisis, as demonstrated in 1929, 2008, and every other economic collapse under it. Or it turns into Fascism as seen in Nazi Germany, Italy and Spain - and as it's slowly doing in Amerikkka and Greece right now. It does NOT exist on its own merits or because it is the best possible system. In fact, it fails everyday, considering about every 3 SECONDS, someone dies from hunger or malnutrition - that's about 29,000 people per day. There is demand for food, and capitalism ain't delivering! How about all the people who lack shelter, adequate clothing, decent medical care/education (both in the first and 3rd worlds)? And what about all the people, soldier and civilian alike, dying in all the wars? Whats up man, I thought this was supposed to be the best system possible? What's going on bro? Slavery existed for a long time too, guess that made it an legitimate system also, right? Your bourgeois logic only shows how hollow and flimsy ruling class rhetoric is, and to be frank, how even they cannot think for themselves. The "free market" does their thinking for them. Yuck.

Bottomline: Marx will be respected by scholars, intellectuals, economists (even non-Marxist ones), and social scientists for a long time to come, and his work will be taught in universities around the world.

Rand will be remembered as that off the deep end, crack-pot nihilistic woman that wrote shitty novels about billionaires going on strike because of high taxes, and worshipping a serial killer who raped, murdered and dismembered a 12 year old girl. Only the most sociopathic, far-right tools like yourself respect her. Ideologically, she is worse than Hitler. At least Hitler cared about SOMETHING, even if it was fucked up, as opposed to Rand, who didn't care about ANYTHING except being as selfish and destructive as possible all in the name of individual freedom. Fascism is bad enough, but she was something much worse: a complete nihilist, whose ideas if literally put into practice would lead to the destruction of humanity faster than a thousand nukes. And you like this piece of shit person? It is YOU that is off the deep end comrade, not I. The sooner she is discarded into the dustbins of history, the better.

Anywhoo, think I'll just put ya on ignore now. Was a pleasure destroying you.

[DeeBye]

http://online.wsj.com/article/SB10001424...48728.html

The US spends FAR more per capita on health care, and somehow cannot manage to provide even basic free health care for everyone.


Which system is more "unsustainable"?

If you were paying for it, I may have opted for the expensive route (with all the risks of complications) with perhaps a worse outcome.

That's not how it works with socialized health care. I've tried to explain it to you in the past, and I'll try yet again. I cannot just walk into my doctor's office and demand a MRI, open heart surgery, and a kidney transplant on the side just because it's "free" and paid for by the government. Doctors are the final arbiters on what health care I receive - not for-profit insurance bureaucrats, and certainly not the government.

Actual doctors decide what medical treatment I require, and I'm really happy with that system.

I understand that you are a pure libertarian that wants everyone to pay their own way, but I'm pretty content in allowing some of my tax dollars go towards providing basic health care to the poorest in my nation that would not otherwise be able to afford such basic care. In fact, I think that's pretty Christian of me.

[kandrathe]

Incoherent is just a short way of saying "this truth is an inconvenience to my ideological agenda, so I won't address it".

I'm sorry. This is what you are doing. "Incoherent" is my polite way of saying your raving and argument are those of a lunatic. But, I'm glad to see you've dialed back your offensive, misogynist, and Godwin laced rhetoric.

Again, you argue against something that I'm not even arguing.

You did go there when you claimed this pseudo-intellectual prattle you peddle is *cough* based on science.

Where did I, or Marx for that matter, ever state that capitalism is a fantasy? Oh wait, I didn't. Nor did he.

You keep claiming that my position is fantasy -- my position is the classical liberal economy -- liberalism, laissez-faire free market capitalism, and a democratic republicanism. These are the structures that have been in place pretty much for 250 years, until the rise of the Chicago school saw more emphasis on neo-classical. Is it a fantasy or not? I would adjust some minor things, like return to a commodities backed currency to control inflation, and I'd like to see the federal government (both military and domestic) shrink to 1950 Post-WWII levels. From 1950, to 2000 real per capita expenditures grew 800%, or 16% per year.

What IS a fantasy is YOUR libertarian ideology...

In the spectrum of Democrat, Republican or Libertarian, I'd have to choose the latter. I mostly reject the state control and strong central power exercised by the Democrats and Republicans. I'm a classical liberal. My political philosophy is defined by liberty. Do you go to class?

Bottomline: Marx will be respected by scholars, intellectuals, economists (even non-Marxist ones), and social scientists for a long time to come, and his work will be taught in universities around the world.

Huh? In my economics and polysci courses, we studied it as a cautionary tale and discussed it's many flaws. Mostly because in the ivory tower of pseudo-intellectual professors and duped adherents, such as yourself, they dogmatically continue to perpetuate the mistaken romanticized dream that someday, someday, the proletariat will rise up and break their chains. He will be remembered as the inspiration for the suffering and deaths of millions as his socialism was power twisted and perverted in the hands of dictators, such as Stalin, Mao, Castro, Pol Pot, Kim Jon Il, etc.

Rand will be remembered ...

What is your misogynist obsession with her? I'm glad you removed the pejoratives insults of her that would be offensive to ALL women. It's more revealing of your pathos. By the way, she is not the godmother of liberal philosophy. Her thing was objectivism. For a polysci major -- you sure don't know much about your supposed discipline -- broaden your subject matter choices, and start attending/listening to more classes. You are hardly narrowly schooled, need to read what people write, and develop some better critical thinking skills.

Anywhoo, think I'll just put ya on ignore now. Was a pleasure destroying you.

Grow up, huh? If you think you score points here on this gaming hobby site, then your pathos is worse than I first imagined.

[kandrathe]

Which system is more "unsustainable"?

Greece. Ours is only sustainable while we can continue to keep federal borrowing costs at zero% interest. How long do you think we can keep using people money without paying them interest? A lack of investment has dried most of those things that may be worthy investments. Everyone I know in the markets is also pretty leery of "free money" bubble re-inflation going on now.

That's not how it works with socialized health care. I've tried to explain it to you in the past, and I'll try yet again.

Yes, I know. It was the vet who suggested the $5000 worth of procedures -- and we had to refuse.

I understand that you are a pure libertarian...

Not all that pure. First, I believe in some level of safety net, so we take care of sick people who otherwise can't pay. Second, I'm more pragmatic than purist. I realize that most things have lots of "devil in the details" type issues you need to resolve, and that complicates things. Most of the politicians and talking heads we see over simplify things intentionally. If they start to get complicated, then their opponent uses the confusion to declare something idiotic and most people are just snowed.

I'm pretty content in allowing some of my tax dollars go towards providing basic health care to the poorest in my nation that would not otherwise be able to afford such basic care. In fact, I think that's pretty Christian of me.

If you say so. I'd say it's humane. I've said this before too. It's not our social programs for the poor that are expensive, or growing out of control. What is ludicrous is our comprehensive benefits for the middle, upper middle, and wealthy. It's a classic problem of politicians using the treasury to buy votes. Once implemented, they can use it as a hammer -- or "the third rail" -- against anyone who dares question it.

[Jester]

Greece.

Completely missing the point. If the Greeks had the US health care system, they'd be twice as screwed as they are now. If the US had the Greek health care system, you'd be well on the way to long-term sustainability.

-Jester

Back of the envelope: If the US managed to get its health care expenditure/GDP ratio down to the levels of even France or Switzerland, with lavish and expensive programs, you'd save enough money to pay for the entire department of defense...

[Hammerskjold]

Yes, I know. It was the vet who suggested the $5000 worth of procedures -- and we had to refuse.

Now when you say vet, do you mean the Dr. Doolittle kind of vet?

Because I don't know what you're trying to say here, and what an anecdote of a vet trying to 'up-sell' has to do with Canadian healthcare for bipedal humanoids.

[kandrathe]

Completely missing the point. If the Greeks had the US health care system, they'd be twice as screwed as they are now. If the US had the Greek health care system, you'd be well on the way to long-term sustainability.

Back of the envelope: If the US managed to get its health care expenditure/GDP ratio down to the levels of even France or Switzerland, with lavish and expensive programs, you'd save enough money to pay for the entire department of defense...

The issue is one of system sustainability -- you can have an efficient health care system, but still be unable to afford it. Or, like the US, an inefficient one, and be unable to afford it over the long term.

Now when you say vet, do you mean the Dr. Doolittle kind of vet?

Pretty much, except this one couldn't talk to animals. The anecdote has to do with deciding a point when you cannot afford to save the patient. When emotions are involved, a billion dollar procedure may seem reasonable if Canada were paying, and not Deebye.

[Hammerskjold]

The anecdote has to do with deciding a point when you cannot afford to save the patient. When emotions are involved, a billion dollar procedure may seem reasonable if Canada were paying, and not Deebye.

It's more than a stretch however to compare that to what you think Canadian health care is.

I can tell you from what my own dad went through, 2 procedures to remove a cataract, during the SARS panic days even.

And a couple of years ago for a bypass surgery.

What you are implying, does not happen. My dad's bypass procedure was not a billion dollar surgery. If anything I think the first hospital rushed his recovery time, and discharged him prematurely because we had to go back to ICU 3 days afterward.

The cataract procedure was almost a comedy of errors, mixed in with a bad zombie movie vibe due to the SARS panic, it'd be hilarious if it wasn't so fucking serious.

'Billion dollars procedures' is a myth. At least in Canada. Whoever\whatever is feeding you that garbage, try not to swallow it.

*And don't take my post as proof that somehow Canadian health care is 'broken'. It's not perfect. But it's pretty far from the bleak imaginings of some 'merkins.

People who peddle in doom (Death Panels kills grammas!), 'we must cut the fat and gravy of health care blar blar blar', and or 'free healthcare = free MRI for everyone!' is usually trying to sell or swindle something\someone anyway.

If you have doubts about how socialized medicine would work in -your- country, that's one thing. But don't imagine a hypothetical bizarre scenario that has little to NO bearing on reality, other than a vet tried to upsell you on medical services. Then imply that's how Canada works.

Christ was this vet even a canuck or something, I don't even...

edited ps. Congrats on getting the triple reverse honor list of Commie-dian's ignore list. You've joined such luminaries as Pete, Deebye, I'm not sure if Jester is in there but I'd hazard a guess he's at least an honorary member emeritus?

[DeeBye]

(Death Panels kills grammas!)

Actually, a Death Panel killed my grandfather. In his early 90s, he developed congestive heart failure. His doctors (the Death Panel) REFUSED to perform a life-saving heart transplant, and as a result he only lived for another 2 years.

[kandrathe]

It's more than a stretch however to compare that to what you think Canadian health care is

Er, but I wasn't. The incident just laid bare the choice I had to make. Thankfully it was a cat. With people we wouldn't have. If there is a way, we mostly try it.

'Billion dollars procedures' is a myth. At least in Canada.

I just pulled a really big number out of the air. I don't know what the most expensive procedures cost.

Then imply that's how Canada works.

Well, good, cuz I didn't. I said, " Yes, it's a cat. But, it made me think about the economics of the care we'd like, versus the care we can afford. If you were paying for it, I may have opted for the expensive route (with all the risks of complications) with perhaps a worse outcome." I couldn't afford it and I was pretty sure the cat would die. If someone ( a rich uncle, or Deebye) had offered to pay for it, when we might have gone with the surgery. It turned out for the better without it. It had nothing to to with Canadian health care, except for Deebye's nationality -- if he would have forked over the $5000 to save my cat.

Congrats on getting the triple reverse honor list of Commie-dian's ignore list. You've joined such luminaries as Pete, Deebye, I'm not sure if Jester is in there but I'd hazard a guess he's at least an honorary member emeritus?

I was thinking that it might not be right to yank away his crutches. Then I thought, "Hell, these crutches are bringing him nothing but pain in his life anyway."

[shoju]

I have always been curious to try and find a way to understand what my father would have gone through, had he lived in Canada instead of the United States regarding his health care.

In 1999, he was involved in a car accident. He was uninjured, but in the resulting CT's, and MRI's, they found 2 Cranial AVM's. They believed the largest of the two to be about the size of an orange if Smashed flat and shoved between the two hemispheres of your brain, and the smaller to be about Golf Ball Size, and located in the frontal Lobe of his brain, just above / behind his eyes.

This, was sort of a "Miracle" my father had been experiencing problems for as long as I could remember, but the doctors could never figure out what was causing it. They ran through so many "Ideas" that they had exhausted what it could be. By 1999, imaging technology, and understanding had moved to a point where they could pinpoint it.

So, they started the arduous process of embolization, and preparing for surgery. They told my father, that based on his history, and the condition of the AVM's, he was looking at just a few years of life left if untreated. The large AVM was showing signs of rapid deterioration.

With the embolization complete, surgery was scheduled, and proceeded with. After opening him up, they realized that the AVM located in the middle of his brain (near the hemispheres) was about 60% larger than they expected, and surrounded by far too much healthy tissue to consider removal.

So they closed him up, and told him that he probably had somewhere between 12 and 28 months to live. Radio Surgery for the front AVM (near the eyes) was ruled out because they were unsure what it would do to the larger AVM.

At this point, my parents were financially devastated. Even with treatment my dad began having more symptoms related to the AVM's. Work was out of the question. Disability took years to get sorted out, and my father was not medically cleared to go back to work. Even after Medicare (from the disability) and my father's dr not charging my parents over what medicare paid him, the price for everything up until this point was horrendous. It drained his retirement, and their savings, and they even took a second mortgage on the house to make it all work.

about 3 years later, my father (who I must add is the type of guy who never lets you know when he is in pain. I watched him break his hand once, and he never uttered a word) woke up in the early morning screaming in pain. He was screaming so loud that he could be heard several houses down the street (I could hear him from my porch as I was heading to my parents house, I live 2 houses away, on the street "behind" them). when they got him to the hospital, they found that he had developed an Aneurysm on the large AVM, which had ruptured. 18 hours of surgery later, he was in a coma, as stable as one could be in that situation.

Several days later, he woke up, was conscious, and ended up being in the hospital 64 days. 46 of them in ICU. Cue Financial Destruction Round 2.

The Doctor gave my father the grim news that they did all they could for the Aneurysm and AVM, during surgery, but it was looking bad. How my dad had now survived 7 and a half years since the original diagnosis, was a mystery.

And now, here we are, 13 years since they found the AVM's. Close to 6 years after the "best case" scenario of time left has expired. My dad has a host of health problems. He can't find a family doctor that will take him because of his condition (he still sees the same specialist), and because he is on medicare. So he is forced to see the only doctor that will see him, a neurosurgeon, for everything. Honestly, had my dad not been his first patient when he moved to the area, I don't know if he would see him under the circumstances.

I live, knowing that at any point during my day, the phone call I get from my mom, or my sister, could be that something has happened, and that my dad is dead. Even now, my parents are still whittling away at the doctor bills, and I'm left to wonder, what would be different if he lived in Canada? Would they still be financially ruined? Would he have survived the Aneurysm rupture? Would Disability have been such a terribly hard fight?

I don't know. I don't live in Canada, I've never spent an extended amount of time in Canada.

[DeeBye]

Even now, my parents are still whittling away at the doctor bills, and I'm left to wonder, what would be different if he lived in Canada? Would they still be financially ruined?

They wouldn't have had to worry about medical costs whatsoever.

[NuurAbSaal]

My sympathies.

In most European countries your parents would not have had to worry about the financial aspects of your dad's condition. I can only assume that it would be the same if they were Canadian. One of the Canucks is going to answer that, I imagine.

take care
Tarabulus

EDIT: I guess I type too slowly.

[FireIceTalon]

I have always been curious to try and find a way to understand what my father would have gone through, had he lived in Canada instead of the United States regarding his health care.

In 1999, he was involved in a car accident. He was uninjured, but in the resulting CT's, and MRI's, they found 2 Cranial AVM's. They believed the largest of the two to be about the size of an orange if Smashed flat and shoved between the two hemispheres of your brain, and the smaller to be about Golf Ball Size, and located in the frontal Lobe of his brain, just above / behind his eyes.

This, was sort of a "Miracle" my father had been experiencing problems for as long as I could remember, but the doctors could never figure out what was causing it. They ran through so many "Ideas" that they had exhausted what it could be. By 1999, imaging technology, and understanding had moved to a point where they could pinpoint it.

So, they started the arduous process of embolization, and preparing for surgery. They told my father, that based on his history, and the condition of the AVM's, he was looking at just a few years of life left if untreated. The large AVM was showing signs of rapid deterioration.

With the embolization complete, surgery was scheduled, and proceeded with. After opening him up, they realized that the AVM located in the middle of his brain (near the hemispheres) was about 60% larger than they expected, and surrounded by far too much healthy tissue to consider removal.

So they closed him up, and told him that he probably had somewhere between 12 and 28 months to live. Radio Surgery for the front AVM (near the eyes) was ruled out because they were unsure what it would do to the larger AVM.

At this point, my parents were financially devastated. Even with treatment my dad began having more symptoms related to the AVM's. Work was out of the question. Disability took years to get sorted out, and my father was not medically cleared to go back to work. Even after Medicare (from the disability) and my father's dr not charging my parents over what medicare paid him, the price for everything up until this point was horrendous. It drained his retirement, and their savings, and they even took a second mortgage on the house to make it all work.

about 3 years later, my father (who I must add is the type of guy who never lets you know when he is in pain. I watched him break his hand once, and he never uttered a word) woke up in the early morning screaming in pain. He was screaming so loud that he could be heard several houses down the street (I could hear him from my porch as I was heading to my parents house, I live 2 houses away, on the street "behind" them). when they got him to the hospital, they found that he had developed an Aneurysm on the large AVM, which had ruptured. 18 hours of surgery later, he was in a coma, as stable as one could be in that situation.

Several days later, he woke up, was conscious, and ended up being in the hospital 64 days. 46 of them in ICU. Cue Financial Destruction Round 2.

The Doctor gave my father the grim news that they did all they could for the Aneurysm and AVM, during surgery, but it was looking bad. How my dad had now survived 7 and a half years since the original diagnosis, was a mystery.

And now, here we are, 13 years since they found the AVM's. Close to 6 years after the "best case" scenario of time left has expired. My dad has a host of health problems. He can't find a family doctor that will take him because of his condition (he still sees the same specialist), and because he is on medicare. So he is forced to see the only doctor that will see him, a neurosurgeon, for everything. Honestly, had my dad not been his first patient when he moved to the area, I don't know if he would see him under the circumstances.

I live, knowing that at any point during my day, the phone call I get from my mom, or my sister, could be that something has happened, and that my dad is dead. Even now, my parents are still whittling away at the doctor bills, and I'm left to wonder, what would be different if he lived in Canada? Would they still be financially ruined? Would he have survived the Aneurysm rupture? Would Disability have been such a terribly hard fight?

I don't know. I don't live in Canada, I've never spent an extended amount of time in Canada.

My condolences comrade. Unfortunately, that is our capitalist society for you - profits before human need. The whole system is breaking down, and with extreme austerity many of these social programs, including the healthcare, even in some European nations are in jeopardy. They have it better for now but not sure how much longer that is going to last as the crisis of capitalism worsens - just look at the situation in Greece, and they now have a very active fascist party (Golden Dawn) to make things even more worrisome. There has been strikes and the workers are fighting back though, so there is some evidence that they are radicalizing (something most American workers are too scared, or perhaps not smart enough, to do) and hopefully will form a party of solidarity to counter the fascists and the troika policies of austerity, racist, and homophobic philosophy they spout.

Anywhoo, my best to your dad and your family comrade. Hope it all works out.

[LochnarITB]

They wouldn't have had to worry about medical costs whatsoever.

I can't express how sad this makes me for Shoju, myself and our country. I am living within our system and am of the opinion that ObamaCare has not gone far enough. I believe that our system is going to, sooner or later, crash and burn and we will finally adopt a universal care system modeled on our socially aware neighbors to the north.

My story. I have been living with multiple issues for 15+ years. I'm in a doctor's office at least weekly, have been in the hospital at least 3-4 times in that period and even spent 10 months in acute care in a nursing home. Even with insurance, in that time I burned through tens of thousands of dollars meant to be working toward retirement. As I was unable to work, I eventually was forced to go onto Social Security Disability which qualified me for medicare. Even with medicare, I need to have additional insurance to cover what medicare wouldn't. I have a good plan which, along with medicare and extra help for low income, covers almost everything except co-pays on prescriptions (I take a pharmacy so they are still $1-200/month). Even so, the cost of Medicare, supplemental insurance and co-pays eats 40+% of my fixed SSD income. I then have to pay rent and groceries and all the odd day to day expenses on top of that (actually part of the reason WoW had to finally go ). My SSD is more than many other folks on Social Security. I just don't know how they survive. I certainly understand when I hear of folks having to choose between medication and food.

The expenses that are such a hardship for folks is a game between the medical providers and insurance providers. The medical providers bill the insurance company. The insurance company negotiates down what portion is actually required. The medical provider increases its pricing the next round. The insurance company again negotiates. The medical provider increases pricing. On and on. I see supplies charged 20 to 30 and more times prices I could get the exact same things myself. I see charges of several hundred, even thousands, for 15-30 minutes of office time. I've talked to providers about it and they readily admit to the game but it goes on. Further evidence of the game is that people that inform them before service that they are without insurance are billed at a lower rate than is a billing to insurance. Even those bills are inflated because of the game.

Both medical and insurance providers need to be reined in. I have very little belief that either of our main presidential candidates will be able to do so. Although I see a slight possibility in one over the other, my voice doesn't even matter in trying to back them as I am not in a swing state. I hope those of you who are in swing states get it right. I am anxious to get through this election and on to 2013 to see what comes. I feel that jobs and the deficit are huge problems for country. However, I feel healthcare is the biggest crisis and in most need of correction. Much of our country does not realize the scope of the crisis. It has only marginally affected them. They have not been hit hard by the need but I guarantee that they, or someone close to them, will find themselves in that position and they will wish for better than what they get.

[ShadowHM]

They wouldn't have had to worry about medical costs whatsoever.

This may be nit-picking, but I would rephrase that to: They would not have had to worry about the costs of the medical procedures.

Drugs administered while in the hospital would also be covered. But the costs of most prescription drugs taken while not in the hospital would be their responsibility. Many of us have benefits (via our employers or via private insurance) that cover such costs. Many do not. The costs of such prescriptions are eligible tax deductions but that doesn't completely offset their costs.

I feel healthcare is the biggest crisis and in most need of correction. Much of our country does not realize the scope of the crisis. It has only marginally affected them.

I know the above is cherry-picking (and I apologize for that) but I want to use it as a springboard to mention that I feel the same way about the system here in Ontario.

In this province, 43 cents of every dollar raised by my provincial government are spent on health care. These costs have been rising faster than other components of our government spending for some time.

The number of baby boomers over 65 will double in the next 25 years; by 2030, there will be 40 retirees for every 100 working persons - up from 21 in 2003. This means a decrease in taxpayer dollars to fund government services, including healthcare. In addition, people over the age of 65 access the healthcare system more frequently and thereby cost five times as much compared to the rest of the population.

Medical technology continues to become more innovative and thus, more expensive. Because diseases and illnesses are being diagnosed even earlier than before, there are more patients being treated. While this is good news for patients, costs must also increase to meet that need.

A further challenge to our ability to keep funding healthcare comes from the cost of cancer drugs. Many cancer drugs are covered by the province. And that cost is not insubstantial. It can be as high as $10,000 per month.

I am quite worried that this level of spending is not sustainable and the rate of increase in those costs even more so. We, as a society, need to discuss this, but, unfortunately this is a conversation that, thus far, has been impossible to have in this province. Every political party in the last election declined to even mention it.

To be blunt, I would still rather be here than there. I have been extremely lucky thus far and have needed to use very little in terms of healthcare access costs. But there are people around me who have been in need and were able to access the health care they needed without catastrophic effects on their finances, and without having to make painful choices between healthcare and other costs. I remain cheerful about paying the taxes that make it so and so do most of my fellow citizens.

But I am not cheerful about the long term and how this will work out for my sons.





P.S. I love how the conversations here can and do morph through so many topics in a single thread.

[ShadowHM]

I am quite worried that this level of spending is not sustainable and the rate of increase in those costs even more so. We, as a society, need to discuss this, but, unfortunately this is a conversation that, thus far, has been impossible to have in this province. Every political party in the last election declined to even mention it.

Another aspect of the 'is this sustainable' question is discussed in this news article in the Toronto Star today:
A wife wants her husband kept alive at all costs

I can't pretend to know how the ethics of this one really should be managed. I do know that, when put in the exact same position as this woman, I made the opposite decision and for the same reasons - I know what my husband would have wanted. I 'know' I did the right thing. She 'knows' she is doing the right thing too. Except that the right thing, in her case, is costing a lot of public money.

Difficult decisions and uncomfortable discussions need to take place in our society.

[kandrathe]

Difficult decisions and uncomfortable discussions need to take place in our society.

< awkward silence >

... Absolutely.

My position would be that when "we" are paying we should be humanely willing to contribute a certain amount, and I'm not sure how you measure that. It could be per incident, or lifetime.

Here is an interesting article that resonates with me; The Rise In Health Care Spending And What To Do About It - by Kenneth E. Thorpe

He says, "The growth in real per capita health care spending is simply the growth in spending per treated case times the number of medical conditions treated (treated disease prevalence). Elsewhere my colleagues and I have apportioned the rise in spending over time into these two categories and concluded that approximately 63 percent of the rise in real per capita spending is traced to a rise in treated disease prevalence."

I think a key observation he makes that we all forget in the health care expense model is our individual responsibility for our own health. Frankly, based on the numbers he cites for morbidity, we've done a horrible job as keeping ourselves healthy.

What alarms me most about our current deficit spending (as describe in the article and the expanding elderly population) is not the money being spent on those without means, but the vast amounts being (blindly) spent on all people without regard to their outcome, or their means. So, the other side of this is that people need to be more accountable for their own health, and our focus on health care does nothing to address our unhealthiness and its societal cost.

I'm in the middle-middle class, and I'm probably not alone in observing that recent economic trends have put us in a much less favorable position. Even so, I don't as much mind being taxed to give a hand out to those that need a hand up. But, it chafes me a bit to think I'm feathering the nests of those in the US who are better off. I think we also hemorrhage money on stuff like foreign aid, wars and interventions.

Then, a close second would be the excessive amount of administrative overhead we endure. (One of numerous costs studies by Alan Sager, Ph.D. and Deborah Socolar, M.P.H.) "One-half of health spending goes to clinical and administrative waste, excess prices, and theft. Physicians can identify clinical waste. Careful cost controls should rest on physicians’ decisions about services needed by each patient. Pathology is remorseless but resources are finite, so trade-offs are essential. There are no blank checks. Trustworthy methods of paying doctors should minimize incentives to over- or under-serve. Variations on this approach have been called “bedside rationing” or “professionalism within a budget.”

I'd favor a rationed per treatment approach for both acute and chronic cases (heart disease, diabetes, etc.). Where possible, I believe there should be a standard care regime approved by general medical practice -- exceptions and variations would also need to be handled somehow. I don't think anyone should be denied any care they need. But, if they have the means, they should be expected to pay for the care they receive above and beyond a norm (even if they are old). This approach of shared accountability for patient and treatment works for private insurance or publicly funded -- I don't see that the issue of cost is related to who is paying, but rather that those who are paying are not holding the process accountable for the costs. We also need to tie some incentives for the patient back to the patients health -- It's probably too harsh to link it directly to payments, but health costs to BMI is an insightful study.