From: Peter on
"David J. Littleboy" <davidjl(a)gol.com> wrote in message
news:headnfGgW-s2h0XWnZ2dnVY3goSdnZ2d(a)giganews.com...
>

> If the choice is a bureaucrat or an insurance company making health care
> decisions, you want the bureaucrat. When push comes to shove, the
> bureaucrat may be trying to save money, but s/he is also committed to
> getting good results from the system (and the decisions on what to cover
> are a priori and public). Insurance companies only care about the bottom
> line and thus impose silly "rules".

I was referring to insurance companies whose payment policies would be
strictly regulated. Including, but not limited to{
Not allowing the carrier to refuse based upon a preexisting condition;
Mandating that everyone have coverage;
Making the carriers legally responsible for bad failure to pay decisions;
Giving realistic and prompt right of review of denial of coverage;


>
> Not only are the overall results of health care in Japan substantially
> better than in the US, there is none of the amazing garbage that the
> insurance companies inflict on people in the US. Everyone is covered.
> Period. No one is refused care. Ever. Essentially no one goes bankrupt
> from medical costs. If you get to an available doctor, you are treated.
> There was a case here of a foreign woman who had been living here years
> without paying her premiums. When she needed emergency surgery, she got
> it. The charge? She had to pay her unpaid premiums (which came to a lot
> less than the cost of the surgery). (Then the idiot foreigner activists
> went ballistic claiming that that was unfair. ROFL. But I digress.)

I agree that our current system sucks. We do not agree on how to fix it.

>
>> Most people here will also disagree. Third party pay should be
>> truly competitive.
>
> But it can't be competitive. When you need care, you can't change
> insurers; it's too late.
>

Policies need to be written in plain language. Rates can be easily compared.
What protection do you have against unecessary claims by healthy people.
(hyopcondriacs.)
For Example: Here certain tests are limited as to the number of times it is
permitted.
Under Medicare, physical therapy is limited to about $1,750 per year, unless
given in a hospital. Why! Too many people were going to physical therapists,
instead of a gym. The result, people who really need extensive therapy
cannot get it free. A lot of expense is incurred when people become
hypocondriacs. (this is especially common with people older than 50. A lot
of people use the hospital ER when they should be going to a primary care
physician. This problem can be alleviated by ambulatory care centers.



> Since single-payer just works, there's no need for letting the capitalist
> pigs get their grubby paws on your life.
>

All capitalists are not pigs. Many are small business people who started
their own business. BTW, ever look at who controls business in Japan? unless
you are Japanese and a descendant of the Sumari, you could not start your
own business.

>> With a single payer, my life is in the hands of some bureaucrat. I will
>> not accept that.
>
> You should not only acept it, but jump at it. That bureaucrat's main job
> description is to make sure that you get the best care science can prove
> works. As soon as there's an insurance company, the company's bottom line
> becomes an issue. There really isn't time for that sort of BS when one is
> sick.
>

See above. Also, think incompetent bureaucrat. I certainly do not intend to
put down government workers, I agree that most are sincere and dedicated.
But think "good job Brownie."

>> Yes, that type of system works very well
>> in Japan. I'm sure you understand that, in many respects, Japanese people
>> have different cultural characteristics than Americans.
>
> Actually, I don't. At least in the sense that I've never seen an argument
> based on "different cultural characteristics" that was anything other than
> somewhere in the clear wrong to very silly to downright racist range of
> things.

Stating that there are cultural differences in the context of this
discussion is definitely not racist.

BTW Ever hear the word "ginja?"

>
> And cultural characteristcs hardly apply to the delivery of medical
> servuces. There are things, like the lower level of obesity, that make it
> easier to achieve better results. But
>

We disagree.

>> e.g. How often have you heard of an American being decapitated by a train
>> because he was bowing when getting off his cell phone. Another perhaps
>> more
>> relevant example: how many lawyers per capita are in Japan.
>
> Americans can be pretty stupid, too. For example, this American almost got
> decapitated by a Japanese train photographing it as it came into the
> station. (Keeps this thread on-topic<g>.)

No one group of people has a monopoly on stupidity. I almost tumbled down a
slippery set of rocks photographing a lighthouse, because I wanted to get a
lower angle.

>
> And while Japan has about 1/10 the number of lawyers they need, the US has
> ten time what we need: we're both off by an order of magnitude. (I think
> the US is erring on the right direction in this, though.)

In Japan it is considered a shame to need a lawyer. Yet they rely heavily on
accountants.

>
>>> The reason that there are so many malpractice cases is that there's so
>>> much malpractice and so many patients are hurt:
>>
>> There is a vast difference between malpractice and honest error in
>> judgment,
>> or failure to perform some obscure test.
>
> I'm not sure what your point is. Every serious study over the last 40
> years has concluded that malpractice is a major problem in the US (and
> that frivolous cases are almost always rejected).
>
Just an example: malpractice premiums for an orthopedist run in excess of
$150,000, per year. An internist will pay over $80,000. I am not familiar
with the curent rates for other specialities.

>> A screening panel should be
>> established to distinguish between the two.
>
> Oops: You are advocating for more bureaucrats! (And you have a good idea.)

Maybe. I didn;t say it should be government run. I could be a private
organization similar to hte American Arbitration Association, but with a
different mission.

>
>> Sorry about your father. Since I really don't know the facts, I cannot
>> comment. However, most likely you sincerely believe what you say. You
>> should
>> ask if that colors your judgment on how best to reform the system.
>
> It doesn't color my attitudes, at all (since father had Medicare, he had
> single-payer). As you note below, it turns out that dealing with the
> medical system requires that you or a relative or partner take charge,
> figure out the problems involved, and make sure the doctors are doing
> their job. This doesn't change with single-payer.

Err! Medicare may be single payer, but Medicare supplemental coverage is
not.

>
>> Also, people must be proactive in dealing
>> with their health care professionals. About a year ago my wife had a
>> stroke. I suspected a stroke but the local ER doctor said they could not
>> do
>> a scan until Monday morning. (This was a Saturday night.) I insisted in
>> immediate transfer to a
>> different facility and after a somewhat heated discussion in which I
>> threatened to take her in my car, they finally agreed. At the new
>> hospital she received a proper
>> diagnosis and prompt treatment. She has fully recovered and except for a
>> slight limp has no signs of her stroke. Had she not received prompt
>> treatment, the result may very well have been different.
>> Did I mention that the argument used by the first ER was that the
>> insurance
>> would not pay for two ER visits in the same evening? I said I didn't care
>> and no @#$! insurance company was going to dictate a medical decision.
>
> Which, of course, proves my point. You really don't want commercial
> interests involved in your medical care. Sure, the bureaucrat's job is to
> keep costs down. But they do it a priori and transparently: what will be
> covered is defined in advance (and is subject to public discussion), and
> all you need is a doctor to sign off on it being necessary, which isn't a
> problem since they get paid for running the procedure.
>


I have dealt with bureaucrats my entire professional career and differ. What
you are saying is good in theory, but is not reality. We have a rule that a
Medicare provider may not accept private payment and Medicare from the same
patient. The rule is designed to protect the patient from gouging.
Unintended side effect. I am unable to get a medically indicated treatment
that is not sanctioned by Medicare, from my regular doctor. Another rule
forces me to come back the following day for a procedure that is ancillary
to the primary treatment, even though before Medicare I could go through
both procedures the same day and doing so is considered better medical
practice.




--
Peter

From: David J. Littleboy on

"Peter" <peternew(a)nospamoptonline.net> wrote:
>>
>> And while Japan has about 1/10 the number of lawyers they need, the US
>> has ten time what we need: we're both off by an order of magnitude. (I
>> think the US is erring on the right direction in this, though.)
>
> In Japan it is considered a shame to need a lawyer.

Just a quick note: you are badly misinformed about Japan (although it's not
your fault). In particular, lawyers are highly respected and there's no
stigma in using a lawyer. You've been fed a bunch of shaggy dog stories
(like the bit about companies being only "samurai" owned: that's so out of
date it's painful (and misses a few minor companies like Honda and Sony;
oops)), so it really isn't your fault. There are lots of such sillinesses
about Japan flying around. The reality over here is both more interesting
(since it's real) and less interesting (since it's nowhere near as nuts)
than the stories.

> Yet they rely heavily on accountants.

And it's a real pain debunking the silliness. For example, what's the per
capita number of accountants in the industrialized countries? I don't know*.
Is there any basis to the above claim? Off hand, I'd guess not. There's a
thing called a "legal scrivner" over here that does a lot of what lawyers do
in the US (legal scrivners fill out legal forms). They're a different thing
from accountants. I use an accountant here since I started a company
(actually, my wife is the legal owner since it would have been too much of a
pain to tell the IRS about it, as I'd be required to), but most Japanese
employees don't have to file income tax returns (their company does it for
them), so I'd think there'd be less use of accountants over here.

*: http://visar.csustan.edu/aaba/rule.htm
"Britain has more qualified accountants per capita than any other
industrialised nation. Certainly, more than the rest of the European Union
put together."
....
"Japanese and Germans, with a superior record of economic prosperity and
family life, appoint engineers and designers to their company boards.
Britain�s major companies appoint accountants who are pre-occupied with
controlling and cutting costs rather than maximising investment, production
and value added."

Also:
http://blog.vdare.com/archives/2009/01/27/price-waterhouse-coopers-satyam-and-h-1b/
"Countries like Japan outperform the US with about 5% as many accountants
per capita as the US has."

Of course, these themselves may be shaggy dog stories<g>.

--
David J. Littleboy
Tokyo, Japan


From: Ray Fischer on
Peter <peternew(a)nospamoptonline.net> wrote:
>"Ray Fischer" <rfischer(a)sonic.net> wrote in message
>news:4bd7d490$0$1667$742ec2ed(a)news.sonic.net...
>> Peter <peternew(a)nospamoptonline.net> wrote:
>>>"David J. Littleboy" <davidjl(a)gol.com> wrote in message
>>
>>>> No, it really is quite simple: single-payer (with all the power and
>>>> control that implies, and that power and control being used to protect
>>>> patients and keep costs in control) and progressive (income-based) rates
>>>> so everyone is covered. Works great. But the political pitfalls bit is
>>>> true.
>>>
>>>Sorry. We disagree. My doctor friends and former clients will also
>>>disagree. Most people here will also disagree.
>>
>> Why not simply annonuce that everybody agrees with you and skip the
>> bother of actually trying to justify your lunacy?
>>
>>> Third party pay should be
>>>truly competitive.
>>
>> And you "should be" a lot smarter.
>>
>>> With a single payer, my life is in the hands of some
>>>bureaucrat.
>>
>> Wingnut propaganda. Single-payer systems allow people to choose their
>> doctors and allow people to pay for extra services that they want.
>>
>>> I will not accept that.
>>
>> Unless that bureaucrat works for a corporation.
>>
>> The difference is that the government employee ultimately works for
>> you while the corporate employee works for the shareholders.
>>
>>> Yes, that type of system works very well
>>>in Japan.
>>
>> It works very well in Canada and in Europe quite well also. In fact
>> the US system is the most expensive, by far, of any industrial nation
>> but with measurably poorer results.
>
>Once you start the name calling, the discussion discussion is over.

"Declare victory and run away."

You lied, and now you're getting pissy about it. A typical wingnut.

--
Ray Fischer
rfischer(a)sonic.net

From: Ray Fischer on
Peter <peternew(a)nospamoptonline.net> wrote:
>"David J. Littleboy" <davidjl(a)gol.com> wrote in message
>news:headnfGgW-s2h0XWnZ2dnVY3goSdnZ2d(a)giganews.com...
>>
>
>> If the choice is a bureaucrat or an insurance company making health care
>> decisions, you want the bureaucrat. When push comes to shove, the
>> bureaucrat may be trying to save money, but s/he is also committed to
>> getting good results from the system (and the decisions on what to cover
>> are a priori and public). Insurance companies only care about the bottom
>> line and thus impose silly "rules".
>
>I was referring to insurance companies whose payment policies would be
>strictly regulated.

LOL!

So the solution is to impose government bureaucracy on top of
corporate bureaucracy in order to avoid goernment bureaucracy?!?

Not very clever.

--
Ray Fischer
rfischer(a)sonic.net

From: Peter on
"Ray Fischer" <rfischer(a)sonic.net> wrote in message
news:4bd87057$0$1624$742ec2ed(a)news.sonic.net...
> Peter <peternew(a)nospamoptonline.net> wrote:
>>"Ray Fischer" <rfischer(a)sonic.net> wrote in message
>>news:4bd7d490$0$1667$742ec2ed(a)news.sonic.net...
>>> Peter <peternew(a)nospamoptonline.net> wrote:
>>>>"David J. Littleboy" <davidjl(a)gol.com> wrote in message
>>>
>>>>> No, it really is quite simple: single-payer (with all the power and
>>>>> control that implies, and that power and control being used to protect
>>>>> patients and keep costs in control) and progressive (income-based)
>>>>> rates
>>>>> so everyone is covered. Works great. But the political pitfalls bit is
>>>>> true.
>>>>
>>>>Sorry. We disagree. My doctor friends and former clients will also
>>>>disagree. Most people here will also disagree.
>>>
>>> Why not simply annonuce that everybody agrees with you and skip the
>>> bother of actually trying to justify your lunacy?
>>>
>>>> Third party pay should be
>>>>truly competitive.
>>>
>>> And you "should be" a lot smarter.
>>>
>>>> With a single payer, my life is in the hands of some
>>>>bureaucrat.
>>>
>>> Wingnut propaganda. Single-payer systems allow people to choose their
>>> doctors and allow people to pay for extra services that they want.
>>>
>>>> I will not accept that.
>>>
>>> Unless that bureaucrat works for a corporation.
>>>
>>> The difference is that the government employee ultimately works for
>>> you while the corporate employee works for the shareholders.
>>>
>>>> Yes, that type of system works very well
>>>>in Japan.
>>>
>>> It works very well in Canada and in Europe quite well also. In fact
>>> the US system is the most expensive, by far, of any industrial nation
>>> but with measurably poorer results.
>>
>>Once you start the name calling, the discussion discussion is over.
>
> "Declare victory and run away."
>
> You lied, and now you're getting pissy about it. A typical wingnut.
>


If and when you learn to be civil I will discuss. Meanwhile,
Bye

--
Peter