How did this discussion drift to Iraq? I lost the thread somewhere ...

Posts #124 #126 #136

#218

You're avoiding the point. My point was that if, as you say, the government pursues its goals in pursuit of self interest, why isn't it actively pushing for a healthier public?

And by the way, we have more of most diseases than other Western countries. I don't have the statistics right next to me, I think it was from the BBC though.

EDIT: nevermind, it's from the Journal of the AMA: (emphasis mine)

"The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer." (See also Table 1 - for example, prevalence of diabetes among high-income Americans is 8.2 per thousand, while it's 7.3 among low-income Brits.) Banks, Marmot et al., "Disease and Disadvantage in the United States and in England," Journal of the American Medical Association, 2006;295:2037-2045.

#225

And finally, the point that McCaughey makes is completely unrelated.

Stewart (reading):IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.

McCaughey: Putting pressure on doctors to require patients to go through a consultation that's prescribed by the government, and then penalizing them if the patient or family changes their mind about their living will in a moment of crisis, that's really wrong.

Stewart: That would be really wrong if that was in any way what this really said.

the reporting data is known as PQRI. A blogger who's a physician puts it best: (emphasis mine)

"Medicare has a program called PQRI in which they collect data on quality of care and reimburse physicians who track these measures (many physicians, myself included, believe this really means that we will only be given full payment for tracking PQRI). For example, if I track data on whether my diabetics are offered certain tests, have their blood pressure checked, etc., I get a bonus payment (supposedly). At this point, I don't get penalized for bad blood pressures, or rewarded for good ones. The only reward is in the tracking."

the blog entry: http://scienceblogs.com/whitecoatunderground/2009/08/stewart_v_mccaughey---more_to.php?utm_source=sbhomepage&utm_medium=link&utm_content=channellink

Questions:

For 218, do you think that a US with a lower instance of cancer and other diseases will have to spend less money on medicare? If so, how should that be approached?

For 225, After reading/watching TDS interview and the clarifying comments, do you still believe in the "death panel" claim (if you did in the first place)? Why or why not?

@cuckaroucha

The conclusion of "Disease and Disadvantage in the United States and in England" is that Americans are unhealthier than the English and that there is some variables are causing this.

From the paper:

"Our list of comparably measured behavioral risk factors is incomplete and a fuller set may offer additional explanatory
power. Because the analysis has been cross-sectional, past differences in risk factors may be partially underlying observed differences in health conditions for the older adults in our samples."

While the paper controlled for smoking, alcohol consumption, overweight, and obesity. It did not control for other behavioral risk factors, such as stress, exercise, diet and family medical history.

The difference in diseases is mainly due to lifestyle factors rather than health care. If you want to look at the quality of a health care system it is better to look at survival rates.

As the table above shows the US has a higher cancer survival rate than European countries.

Life expectancy is also higher in the US if you remove the effect of non-health related deaths. (eg murder and car crashes) As the below table shows.

Here's the source. Which is a presentation of this book.

Yeah, I realize that we have higher survival rates for cancer (out of those diagnosed for cancer) and have a higher standardized life expectancy.

But in Britain, for example, doctors get a raise if they have their patients practice a healthier lifestyle. So how would you get the american people to practice a healthier lifestyle?

Personally, if a public option had over 50% of the public on it, I would give tax rebates based on how much a person excercised, and deny said tax rebate if they drank frequently, smoked, or had a vast amount of sugar on a regular basis. In addition, I would tighten food standards to make food healthier in general.

1. When were these Kurds attacked by Saddam? When supporting Iraq during the Iran-Iraq war, Saddam acquired WMDs, but during the weapons inspections, no WMDs were found. "A report from U.N. weapons inspectors to be released today says they now believe there were no weapons of mass destruction of any significance in Iraq after 1994, according to two U.N. diplomats who have seen the document." -- http://www.usatoday.com/news/world/iraq/2004-03-02-un-wmd_x.htm (later US reports concurred with the UN findings. Heck, even Bush admits that his biggest failure was the "intelligence failure in Iraq -- http://www.guardian.co.uk/world/2008/dec/02/george-bush-iraq-interview )

2. 13 years of diplomacy? Oh yeah, that diplomacy was intended to get rid of WMDs, which was successful at doing so.

3. So we stayed in Germany mostly because of the Cold War, not because of Nazi Germany, which I have admitted, was the reasoning for the "just war."

4. You're gonna have to give evidence for this in order for me to believe it. If by "civil war" you mean saddam's oppression, then okay, but it's clear that forces in Iraq played a definite role in creating an atmosphere for sectarian violence. A US report says "violence between Sunnis and Shias is being driven by increasing polarisation within Iraqi society, compounded by a weak government and security force." (paraphrased by http://news.bbc.co.uk/2/low/middle_east/6324767.stm )

I really don't know where you read that there were still WMDs. Out of curiousity, where do you get your news?

It's still inconsequential because the WMD point was just ONE of may reasons to invade. (And note that it was the only reason that could be used at the UN because "Saddam murders his people" is not a crime according to the UN.)

No, it wasn't. During those years Saddam refused to allow the inspections to happen and fired at US and British aircraft protecting the Kurds and Shiites.

I guess Germany was lucky that Hitler murdered Jews and not Kurds. Or what was the reason invading Germany was "just" while invasing Iraq was "unjust"?

I cannot give evidence and neither can you.

I can only go by what Iraqis told me and what I saw. The difference is that my opinion is based on what I saw, and your opinion is based on that I cannot convince you.

I saw that pretty much every single building in north-eastern Iraq that was older than 2003 featured bullet holes the size of soda cans. This arguably means that there was some kind of war going on, which is incidentally what the locals remember happening.

I have heard stories of Saddam's armies attacking and people fleeing to the mountains, several times. It was better after 1990, of course, but only the airspace was protected by the coalition (what you called "diplomacy"), the ground was not.

The civil war was first between Saddam and the Kurds, then between two Kurdish factions, then between both Kurdish factions and Al-Qaeda (who as you recall the media claim had no presence in Iraq, but that's not what Iraqis remember). Al-Qaeda were finally beaten near Sulimeiniya by Kurdish forces with American air support in 2003 after the invasion.

If you want evidence, I suggest you go there and ask people. Reading articles written by journalists based in the Green Zone in Baghdad, who get paid for writing certain things won't do it. Or you can safe yourself some time and believe me. But am I as trustworthy as someone who is getting paid to write what his boss wants him to write? It's your choice.

When in doubt, I always think, it's safes to support whichever side wants to get rid of the dictator with the moustache who gasses people. Life's too short to help those.

And if helping them is the only way to avoid war, as some people think, one should take a good look at the world. Maybe there are other wars one can try to stop, wars that are NOT designed to get rid of an evil dictator.

It's a happy world where US forces violently removing a fascist dictator is the worst problem one can think of! I wish I lived in that world. But I don't. So I do what I can to help Sudanese refugees (I am mentioned here, name is Andrew Brehm) and explain to people that removing Arab nationalist dictators from power is not the problem, but the solution.

On location: http://web.mac.com/ajbrehm/Home/Blog/Entries/2008/10/9_Erbil.html

I talked to people who were attacked by Saddam's forces and who remember his WMDs. So I know they existed. Since Saddam was supposed to prove that he destroyed them and didn't, I figure they could still be somewhere. Or is that too easy?

Another possibility is that he did destroy them and lied about it in order to pretend to be strong. But in that case it's hardly George Bush's fault that the lie was told and it's an unfortunate detail, for Saddam, that America believed those Iraqi lies.

I also get some information from Kurdish separatists, but these days they don't have much to say on Iraq any more.

Some people believe that weapons just vanish. I don't. They were either destroyed or not. Saddam made sure that we never learned that they were destroyed. But it was a risk not worth taking.

Whenever you find yourself thinking something like "The fascist dictator who gasses people said he destroyed all his WMDs, why not trust him?" you should not that there is something wrong with your reasoning.

Only greedy insurance companies and the conservative politicians in bed with them are against health care reform. Simple as that.

Derp, derp, derp, I'm smart, look at my logic.

Try again, please.

You wish it were as simple as that. If you were right then all persons here ranting against the reform must be lobbyists for insurance companies or a terminally stupid.

While I'm surprised and a bit appalled by the vehemence (and occasional ruthlessness) of the opposition, I can't simply write them off as stupid or as paid cronies for greedy coorporations. For one, the posts are too coherent. And for the other, the posts usually look original and not copypasted.

Anyway, the motive of greed is suspected often enough on behalf of the opposers. What motives could the Obama administration have?

Also, these are the off-topic boards of a software company. I mean, would agents of insurance companies or politicians really waste their time here? You give us too much credit, sir.

Thank you, Aroddo, for trying to ground his comments in the rational world.

sure, if they can reach enough people. Let's check the blizzard forums.

Even then, you're grasping if you make that claim. If said agents were voluntary, perhaps. But who would volunteer to spread misinformation for these EVIL insurance companies? It's not like there are dozens of unemployed anti-war hippies to take up the cause. However, assuming the readership of these forums, it would be especially laughable for interest groups to deploy their agents here.

Depends on how you define "reform".

HR 3200, which is the bill in question, is not "Reform" in my opinion.  I'm against it on many different grounds including:

1. The plan really has no clue on how it's really going to pay for itself so there's really no control over expenses.

2. The "public option" will (not might, will) lead to many companies dumping their expensive private insurance programs to let people pick up on the "public option".  This in turn will lead to the government having a great deal of power over what gets covered by said insurance. 

History has shown that when the government is paying for something it's rarely what any objective person would say "is best for society as a whole" but rather which special interest groups are loudest and most influential with the right politicians.

3. Moving from a system that is paid for by the people who use it to a system in which the costs are paid for by one group and the users include people of a separate group is likely to lead to an unhappy ending. As a general principle, I think there should be a financial connection between what programs a citizen supports and that citizen.  It's easy to support "universal healthcare" for instance if, like 40% of the American adult population, you pay no net federal taxes. 

4. Presently, there are 40 million people in the US who don't have insurance.  If you take away illegal immigrants, people who are switching jobs, people who make over $65,000 a year, and people who qualify for Medicaid but haven't signed up you're left with 10 million people. It seems a bit hasty to redo the whole system for 10 million people who are mostly people with pre-existing conditions and as a result can't reasonably afford healthcare.

5. HR 3200, the actual bill again, does little to curb the actual problems in the United States with its health care such as the fact that the government limits private competition by not allowing insurance companies to compete in every state which greatly limits competition.

It also does nothing to eliminate the plethora of ridiculous requirements that various state governments have already mandated that private insurance companies must cover which drives up the cost. A 25 year old looking for catastrophic insurance should not be forced to pay for insurance that covers, amongst other things, psychological therapy, propecia (hair growth), lasik, and any other number of things that different states have inserted due to the lobbying of special interests.  

The one good thing about this stuff being state by state I guess is that the crapola that gets inserted into health insurance is on a per state basis.  Wait until the federal government starts to get going and soon catastrophic insurance begins to have to cover all kinds of items that most people would consider non-catastrophic.

HR 3200 also does nothing for tort reform which is a major driver of costs. We Americans love to sue people.  Not just medical but everywhere.  Heck, we're a software company and 2% of our budget is dedicated to legal fees because there's always "something" to deal with.  Americans love to take people to court, especially doctors.

6. HR 3200 and people in general have not addressed the #1 reason Americans pay so much for health insurance. It's not mainly, like conservatives say, due to lawyers (though it's an issue) and it's not mainly due, like liberals say, due to greedy insurance companies.  The main reason is that Americans culturally are in love with medical treatment.  In the US, we will spare no expense to get an extra 3 months.  2/3rds of our medical expenses occur in the last 6 months of life.  No other country is like this and it's not just because socialistic governments won't allow it. Europeans and Canadians in particular do not culturally embrace the idea of living at all costs.

I'm not saying either culture is right or wrong on that. What I am saying is that Americans fundamentally believe that medical technology will save them.  

Lastly:

HR 3200, the actual bill, is not that similar to the UK system or the Canadian system. Debating the pros and cons of Britain's system or Canada's system is academically interesting but not very relevant to what is actually put together.

One country, in all of history, finally gets it right, and we fuck it to hell inside 200 years.

This used to be why the US really was the land of the free.  This is the only country on earth where that shit is prevented by a limited government framework, the Constitution.

There are hundreds of more dictatorial governments that will tell you how to live your life on this planet.  All you have to do is pick one at random.  Stop fucking up what used to be the only free country in existence and just pick one to move to.  If enough of you sheeple leave, we can halt the progress of collectivism.