Comments by "whyamimrpink78" (@whyamimrpink78) on "Political Compass Test And Chill" video.
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@lookingforsomething Bernie himself said he will raise taxes on people making $29,000 or more. How many of those in the lower bracket are young and hardly use healthcare? Unless Bernie is not being consistent with his tax law.
"Every year more and more hundreds of thousands of Americans go bankrupt because of medical debt"
Most that do have other outstanding debts as well. Around 100,000 go bankrupt directly due to medical bills. Others have outstanding debt. So the issue is more complex than what you are making it out to be. I will also address this issue later. Also, many rather be bankrupt than dead.
"Obesity doesn't explain the difference in America"
It does as it is exponential. When you have bad health your issues arise exponentially. Also, it isn't just obesity. We also have more diabetics compared to Finland and Denmark. So in relation to Denmark, the US is over twice the obesity rate compared to them, that can very well lead to 4 times the maternal death rate. It isn't a linear relation. Read the article entitled
"The Impact of Maternal Obesity on Maternal and Fetal Health"
Where they say
"Not only does maternal obesity affect the woman, but it also impacts the health of the child, leading to increased childhood obesity and diabetes."
On obesity and infant mortality, read the Stanford article entitled
"Obesity before pregnancy linked to earliest preterm births, Stanford/Packard study finds"
Where they say
"Prematurity can lead to lifelong health problems, such as cerebral palsy, developmental delays and impaired vision or hearing. Babies born before 28 weeks of pregnancy are at especially high risk."
BTW, I don't send links because sometimes they don't post. Just look up the titles.
However, the reality is that the US simply have less healthy practices compared to other nations. 40% of the American food dollar is spent eating out where other nations spend half of that. We have high levels of high fructose corn syrup in our food. So yes, diet and lifestyle matters.
"If the American health care doesn't have it's basics down it should not focus on advanced care."
Why not? Most basic care can be avoided simply by living a healthier lifestyle. But I will address this later as well.
"Being 15th or below on health care rankings is not something we should have"
Healthcare rankings are completely arbitrary. That is why zero academic sources have ever posted one. The only groups who have are special interest groups with a motive. Anyone can play with the stats and come up with any legit ranking they want.
As for accessibility, the US is number one in access to advanced care and testing.
"Infant mortality rates increased from 2.4/1000 among normal weight women (BMI 18.5–24.9) to 5.8/1000 among women with obesity grade 3"
Care to give me a source for that? Also, as the Stanford article said, first time pregnancies are at higher risk. So how much of that was because that was their first kid?
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@lookingforsomething to address this as a whole as I said will be coming back to this. There are two major issues I have with the far left on this. They both are tied to the fact that you only have appeal to emotion arguments. You may take one or two stats, but run with it on a appeal to emotion argument without considering the whole story.
Here is the whole story. Universal healthcare is fine for very basic care such as routine check ups and pregnancies. However, it is short when it comes to advanced care and development. The US leads the world in R&D, access to advanced care and testing, survival rates in advanced illnesses, and quality. Sure, it is expensive, and as such you have issues like bankruptcies. But the advantages are the vast majority have access to the best care in the world.
The reality is that some group has to suffer. In other nations people with advanced illnesses do. They very sick and very old suffer. In the US the very poor do with bankruptcies and maybe even death. However, here are the issues. With the very sick and very old chances of them living a long time is low. As written in the book "Being Mortal", people seek out modern medicine to live another 5 or 10 years but will only live another 5 or 10 months. So if you give them care and they die 5 months later, was that a success? I just had a friend die of cancer. When I heard he had stage 4 cancer I knew he did not have long to live. Stanford medical aided in giving him care and he still died in 3 months. During his last few weeks he was in a wheel chair and a feeding tube. The family and friends spent a lot of time to keep him alive as much as possible. But was it worth it?
Same with my grandma. During here last times she would be fine and then do very poorly. He six kids would constantly drive hours to see her, come back home just to turn around and see her again. They pushed to keep her alive as much as possible. It added a lot of stress to the kids. Was it worth it?
In both cases it was to those friends and family. Other nations would have let them die. With other nations yes the poor get care at the expense of the very sick and very old. However, a counter argument to that is that the poor, especially in the US, simply live less responsible lives. So why should we cater to them? Individual people rather see their grandma live longer as opposed to caring if some poor person avoids bankruptcy.
This leads to the main point that far leftists ignore. Despite the fact that I outlined the pros and cons of both systems. And in both systems someone will suffer in the end. What far leftists fail to realize is that culture plays a huge role. Look up Hofstede cultural dimension. If you look at the Scandinavian nations on the masculinity scale they rank very low. For Denmark, Norway and Sweden they score 16, 8, and 5 respectively. The US is a 62. What does that mean? A high score means a society is driven on competition and success. A low score means society cares about others. With Denmark, Sweden and Norway scoring very low they will value a universal healthcare system. The US citizens won't with a high masculinity score.
Now there are pros and cons to those relative scores. Sure, a low masculinity score will produce nations like Denmark. But you know who else have low scores? Communist nations. Russia, for example, has a low score due to their communist history. When your country calls. With a high masculinity score one may say people are greedy. However, to become successful typically you have provide something. For example, people may criticize Bezos but he became successful by providing a very easy way to shop. Or myself, I am pursuing a PhD. To do that I have to publish research papers that provide more information in science.
So yes, the issue is very complex. But this brings me to an even bigger issue I have. And that is that the far left, as Hickenlooper said, wants to throw a plan out there and let everyone else pick up the pieces. Under M4A changes will have to be made. Healthcare providers will see increases in demand and lower payments. They will have to make the very difficult decisions of who gets care and how much. Now Bernie, not his fans, healthcare provides. People like you and Bernie don't work in the industry so you have no responsibilities. So you don't care. That is why you cannot look at this issue beyond talking points. You don't realize how complex it is and how M4A will created a lot of pressure and stress on healthcare providers in now they will have to do something like go up to a family and say "sorry, the government won't pay for your grandma's care. Unless you have the money she is going to die."
That is the reality.
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@mattellis8429 "yeah Bernie's endgame was healthcare for all and improved standard of living for working class and poor Americans"
Yeah, just like Castro did as Bernie said. As long as the ends justify the means.
"70%-80% of Americans are in debt depending on what study you look at... most of that is from either medical or student loan debt."
Where do you get that from? I have a hard time believing that considering how only around 30% of the population has a college degree to begin with. Also, there is nothing inherently wrong with debt. It is a part of the inverted pyramid.
"the younger generation having massive amounts of student debt is a problem for the entire system"
How so? They become more skilled and, statistically, earn more.
"Millennials aren't buying houses, aren't having children"
That is for many reasons. The country, and the world in general, is becoming more urbanized. In urban areas people are more liking to rent due to higher population densities. Also, as for children, both the husband and wife are career oriented. A reason why people are getting married later and having kids later is, because as I put it, we let women out of the kitchen. Not saying that is bad. Just saying more and more women are pursuing degrees and careers and thus are less likely to have kids.
"I wouldn't expect you to understand any of this nuance based on your response.. but I do hope for your own sake you take some time to "learn or die" LOL"
I feel you have some learning to do bud. You write that millennials not having kids is a bad thing when, again, how much of that is because women are more career oriented?
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@somethingginterestingg4275 he is not considered a moderate. No nation guarantees healthcare. The US healthcare system is strong in many ways and well established. There can be improvements done but to completely dismantle and replace it, especially given our culture, is radical. And that is another point that makes Bernie a radical. He does not consider other factors on these issues. One major reason why Bernie lost worse this time around is that people took time to look into the issues he wants to talk about and found out he has nothing beyond talking points. He has no plan. As Hickenlooper said, he wants to throw a policy out there and have everyone else pick up the pieces.
"We would take away the middlemen"
There will still be a middleman called the government. In other nations government simply refuses to pay which is why access and quality of advanced care is limited in other nations. Government refuses to pay.
"It's sad that you view something that would save tens of thousands of Americans, save hundreds of thousands from bankruptcy as treat healthcare as a fundamental need of everyone in society (like infrastructure, fire department, public education, etc) as "radical""
Infrastructure, public education and the fire department are paid for and ran locally. You cannot look at local entities to justify a federally ran program. Not to be rude but this does show the ignorance of the left. They do not understand the different layers of government we have and how our programs actually function.
As for saving lives, little suggests that is the case. Every healthcare system has amenable mortality. The issue is who's lives do we save? Other nations, with the very old and sick simply deny care to them, drug them up and have them die pain free. In the US we actually give them care a shown by the fact we offer more advanced testing and higher survival rates of advanced illnesses. With bankruptcies it is the same thing. Under M4A bankruptcies may go down to zero, but at what cost? A less efficient system? There is always a trade off. In economics it is called "opportunity cost".
"You don't find it radical that a family who's daughter needs insulin to survive will pay the same for 1 month's worth of insulin in the US, as 12 months if they cross the border to Canada? "
You don't find it radical that in Canada they will decide if your heart surgery is elective or not to make you wait where people have died waiting for "elective" heart surgery. The heart care that Bernie received in the US he would have waited months for as it would have been considered "elective".
" What exactly is radical? That people may have longer wait times? Or is it the saving lives and saving financial ruin? "
Longer wait times have made many people worse off in the long run. Wait times are an issue. Wait times do not exist just for "chin surgery" but also for certain forms of heart surgery. Even for knee surgery it can make people worse off the longer they wait.
Every healthcare system has flaws. When you break it down the US system is just as strong as other systems. We just deal with different issues. We accept them and our system for one major reason, culture. Culture is something the far left seems to continue to ignore. However, culture is a driving force in a lot of our policies. Bernie's ideas will never resonate with our culture, another reason why he is a radical. He does not understand the common man. That is why when approached by the hair salon owner during the debate against Cruz Bernie could not give her an answer. He has no desire to try to understand how the common American works and lives. He is a radical.
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@somethingginterestingg4275 and there are many other credible sources that give varying results. Prof. Katherine Baicker commented on the "deaths" that will be saved. As she said, those individuals are poor and bad healthcare is associated with those in poverty. So the question becomes do they die due to lack of access or due to being in bad health to begin with. Studies on people who die due to lack of access of care has ranged from zero according to a UCSD study, around 18,000, around 45,000 according to a Harvard study, and 60,000 by the Yale study. So why such varying numbers? It is very difficult to determine their actual death as prof. Katherine Baicker said. As with the current virus case, many who are dying are sick or old to begin with. So was it the virus or a collection of things. A written by the book "Being Mortal", people seek out modern medicine to live another 5 or 10 years but will only live another 5 or 10 months. So if you give healthcare to those individuals and they die 5 months later, was that a success? Also, as I said, amenable mortality is an issue every nation faces.
"So I'm basing it off of one of the most prestigious universities in the world and looking at relative stats from literally every other developed nation. Several of which have better health metrics than the us. "
And I pointed to several other sources showing the numbers vary. It all depends on the methods. That is what makes this issue so challenging. And you can't say other nations have better healthcare. In many ways they lag behind us such as limited access to advanced care and lower survival rates in advanced illnesses.
"The truth is a lot of Americans go bankrupt healthcare costs. That's a fact.
I don't understand how people spin their audience to be against healthcare As a guarantee"
Rather be bankrupt than dead. And again, no nation guarantees healthcare to all.
"Someone has to buy the healthcare.
Right now, insurance companies buy it, raise price and sell it to individuals.
They are middlemen. "
And government refuses to pay thus healthcare providers deny care. Take your pick.
Also, that is not how insurance works.
"Do you ever question the profit motive of the people who spout your narrative? Billions. 60 percent of ad revenue across all msm is pharma companies."
Profit margins of insurance companies is around 8%, that is pretty normal for a lot of service companies. Also, pharma leads us to strong R&D and also donates a lot of medication to developing nations.
"I guess if you don't care about those who suffer under our system, I song change your mind.
And you seem pretty convinced that right-wing media always haS your best interests in mind. Shame really."
What makes you think I listen to right wing media? Also, in every system someone suffers. No system is ideal. Also, what makes you think far leftists like Bernie and AOC care about you? Bernie just endorsed Biden. He ran for president, made his millions, and now is enjoying his three homes. AOC got into office and now is kissing Pelosi's ass.
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@somethingginterestingg4275 "We have higher rates of infant mortality, all-cause mortality, premature death, death amendable to healthcare, and overall disease burden. "
I knew you will bring up those stats. There are a few problems with them. One, many factors outside of healthcare influence them. For example, a Stanford study showed that obesity leads to pre mature births which increases the chances of infant mortality. Now consider how the US leads OECD nations in obesity rates. How obesity is higher for the poor and pregnancies, especially unwanted pregnancies, is higher for the poor, you have a huge source weighing the numbers down. Obesity is an issue of lifestyle choices. Also, nations report numbers differently. Take amenable mortality for example. Read the following two articles on it
"Amenable mortality as an indicator of healthcare quality - a literature review."
and
"Using ‘amenable mortality’ as indicator of healthcare effectiveness in international comparisons: results of a validation study"
In short, they both say that amenable mortality is not reliable enough to use as an indicator of healthcare system success.
"The underlining issue is that while we may have the best outcomes for advanced illnesses, that's only for those who can afford it."
The issue is, though, is that most can afford it. That is a reason why healthcare reform is so challenging. As I said, access is also high meaning the vast majority have access.
"Chomsky talks about the pitfalls of unregulated capitalism quite clearly and is leagues more knowledgable than I am. "
Eh, don't give Chomsky too much credit. He is great in his field, outside of it he is foolish. The issue is that he sounds smart and writes well (due to what he received his doctrine in), but trust me, he is foolish outside of his field. I can give many examples as in how he does not understand polling data, or how he called big corporations coercive when they are not, or how he praised Venezuela, etc. That aside, he is not a healthcare expert. What you just pulled is a logical fallacy. He understands very little about healthcare and economics in all honesty.
"And their is a HUGE profit incentive to keep people wanting private healthcare. Huge. There isn't a huge incentive for Medicare for all, except for helping Americans who don't feel they can afford healthcare."
No profit means no progress. Also, in a free market system there is an incentive to actually provide high quality goods and services. With Medicare what incentive does the federal government have? None.
"To be honest, I don't care if people have underlying conditions, are old or if its 18000 dying or 60000 dying. It sounds like ratiomalizing a number that in any other case, would be considered a major loss of American life. If we lost 16000 in a war, a pandemic or anything else, people would go crazy and call it unacceptable. "
Here is the harsh reality, resources are limited. Not to be rude but another major issues is that far leftists think with emotions. Not saying that is all bad. When you go to the core on political sides when dealing with economic issues the political left is driven off of emotions and the political right is driven off of facts and reasoning. Now saying one side is better. We need facts and reasoning but we are human. But when you talk about those dying and being old or sick, at some point you have to ask yourself if it is worth it economically? I believe it was Cuomo that said, during this pandemic, that if we spend $1 trillion dollars and saves someone's life it was worth it. Reality is that it isn't, because chances are that person will never produce $1 trillion throughout their lifetime. That is why I asked if you give healthcare to those individuals and they die 5 months later, was it worth it? These are the very difficult questions many on the far left refuse to have. But that is the reality.
It is the same as this current virus situation. We are now in a situation where we have to ask ourselves who will cause people to suffer more, the virus or the bad economy? That is why there is current talk of opening the economy back up.
Resources are limited. It would be great to keep everyone healthcare and alive as long as possible. But resources are limited.
" Everyone should have access to healthcare if we pay taxes. I believe it should be a right as citizens. We pay taxes for fundamental needs that we all need in society. Healthcare seems to me, to be the most fundamental of anything a government can offer. "
Great, but not everyone agrees. Also, you can't make healthcare a right in this nation. Also, again, resources are limited. You can't give access to all. We pay taxes for a lot of things but everyone does not have access to those goods/services.
"I see it as a moral issue. "
Which is the problem as you are completely ignoring the economic side as well. You are also ignoring a moral side in that other nations just let their very sick and old die. I just had a friend die because of cancer. When I heard he had stage 4 cancer I knew he would not last long. However, the family pushed to keep him alive as long as possible. He died in 3 months. During his last days he was in a wheelchair on a feeding tube and could not produce anything economically. Was that a success? Should we have kept him alive that long? Our society says yes. Others say no. They would have denied him care and he would have died sooner. So there is that moral issue of it as well.
"We can hold the government accountable to some degree with healthcare. We can't hold private companies accountable. "
I beg to differ. At the federal level you almost no control. Consider Congress's approval rating and their retention rating. Corporations you have a lot of control. Just don't give them business. What corporation in the US has a $20 trillion debt?
"but republicans seem to forget that power is still there, it just shifts to corporations"
All a corporation can do is offer you a job and a good/service. That's it. They have no power. As when Chomsky said corporations are coercive, they are not. For as bad as Amazon may be I have never seen them hold a gun to someone's head and force them to do things.
"And corporations by definition and there to maximise profits, which can easily be at the expense of he American people "
The only way they can make a profit is by giving people what they want.
"You don't think every American should have healthcare"
I think they should. I am saying resources are limited. There is a cap in how much we can actually offer. I feel every American should live a great life, but resources are limited. Something has to give.
"You prioritize advanced medical procedures for those who can afford it, over access for all tax paying Americans."
Under a M4A system there will be less access. That is the point. You cannot increase demand and cut pay by 40% and expect the same amount of access to exist. Other nations pay less because they offer less.
"Drug prices are exponentially higher than anywhere else. "
Because of our massive R&D and the fact that our drug companies donate a lot of drugs to developing nations. Those "greedy" drug companies are actually helping out other nations in need. Also, patents exist because where is the incentive to make and expensive drug so that people can copy it afterwards?
"I'm assuming you don't believe in Medicare when your too old to work? Because the same arguments we're made for Medicare. "
Medicare is a contributing factor to our quickly increasing healthcare prices.
"I have issues with people suffering because they have to decide between bankruptcy or not getting treated. "
But you don't have issues with people suffering because of wait times? Read the article entitled
"A messy reality: an analysis of New Zealand's elective surgery scoring system via media sources, 2000–2006"
they write
"Research has also considered the impact of waiting on patients, with findings that those awaiting necessary treatments often face considerable costs. These may be financial if the ability to work is affected and if there is a need to pay for additional care and therapeutics while awaiting treatment. Costs for the health system may arise if patients are not treated in a timely manner and develop more serious conditions or co-morbidities as a consequence of waiting. There may also be quality-of-life impacts, as well as impacts on family or caregivers "
So long wait times do have people suffering. It goes both ways.
"Their are several countries that aren't perfect and have varying models of supplying healthcare to all citizens. "
Again, they all limit how much healthcare one can receive. They don't provide healthcare to all.
"I don't understand how we can be the richest country in the history of the world and refuse to figure out a way to do it even better than other countries. "
In many ways we arguably do it better than other nations.
And we do have great minds. If you listen to them you will see that the issue is very complex. Listen to the experts in the field. Not Chomsky. Remember, he is not an healthcare expert. He is a guy who writes and speaks well thus people become blinded in how he is saying and do not listen to what he says.
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@J4535-b9p ok, here is the issue. You are clearly over emotional and if you are a medical student you won't last long in as a doctor because the second a patient of yours dies in your care you will cry and than your other two patients will die.
Here it is, you say I am a right wing extremist even though I have, many times, argued in favor for a universal healthcare system as I say they do many things well. But so does the US system which you deny and so do others here despite the plethora of evidence I give. That is why I call you and others far leftists. They ignore the other side of the argument.
Now I will break down your comments here like I always do but me, as a moderate, is going to give you another very important variable why a M4A system will not work in this nation. That is because, as a moderate, I look at this issue in many ways and not myopically like you do.
A very important reason why a universal healthcare system won't work in the US is because of culture. Hofstede Cultural Dimension is used in academics a lot. He developed several cultural measures such as uncertainty avoidance, power distance, individualism, and one I will discuss here, masculinity. When you compare the US to Sweden, Denmark and Norway in masculinity there is a stark difference. The US scores a 62. Sweden, Denmark and Norway score a 5, 26, and 8, respectively. What does that mean? A more masculine a nation is the more the competitive a culture is and the more individual success is rewarded. As the website says
"A high score (Masculine) on this dimension indicates that the society will be driven by competition, achievement and success, with success being defined by the winner/best in field "
A more feminine nation (lower masculine score) values society success more. As the source says
"A low score (Feminine) on the dimension means that the dominant values in society are caring for others and quality of life. A Feminine society is one where quality of life is the sign of success and standing out from the crowd is not admirable"
The US is a masculine society. You showed that yourself when you threw your credentials out there saying you were a med student to "stand out from the crowd". Feminine nations will value a universal healthcare system much more than a masculine one will.
On characteristic is not better than the other. One can say feminine nations care about each other. But nations with communist histories, like Russia, are also feminine as well as they have a history of being comrades and acting when the nation calls without question. One can say that being masculine is being greedy. But in many ways in order to succeed as an individual you have to produce that people want. For example, Jeff Bezos became rich by providing citizens what they want, an easier way to shop. Or myself, as a PhD student. To earn a PhD I have to publish original research to carve out more information in science.
If you are a med student it won't be surprising. Typically people who go really deep in a field ends up being that is all they know. So healthcare is all you know. But you don't understand economics, i.e., healthcare economics, where M4A is driven more on the economics of healthcare and not healthcare itself. You don't understand statistics. You don't understand business. You don't understand variables like culture that explains why a society acts the way it does.
You see, many like you and others here are far leftists because you completely ignore legit, and important variables, like culture, to try to fit a round peg through a square hole.
Now I started with this because when I respond you usually only respond to the first couple comments and run away. You take a few jabs and run away so you don't get beaten into submission. But if you are so intelligent, tell me how our culture will ever accept a universal healthcare system like I just laid out. Or why do you ignore a variable like culture?
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@GeneriicUsername498 "You know, for someone who tries to sound informed. When you say "Under him the economy is strong" you really gotta think about what you're saying. In reality, the "economy" is only good for the top 1% while the middle class (if it even still exists) and others are getting shafted. "
The middle class was doing better. Wages were up, home ownership was up, worker participation was going up.
"We are humans and there are thousands of problems that we should change."
What change? I agree things can improve, but change should be minor. There are no major issues.
"Why do I never see far-right supporters bring up the environment? This isn't some hoax anymore, it is real (don't even try to argue this)."
Who denies climate change where I assume that is what you are talking about? Those on the right do care about the environment. The issue is that they don't fear monger. Scientists like Myles Allen of the IPCC and Mike Hulme have argued that the dooms day propaganda pushed by the left is dangerous and not productive. Read Mike Hulme's nature paper entitled
"Why setting a climate deadline is dangerous"
Also, read up on the comparison of Al Gore's home to George Bush's home and how the latter is more environmentally friendly. But why is it that the left listens to Gore and Greta as opposed to scientists on the issues of the environment as opposed to scientists?
"Nature takes a long time to react to the velocity of our impacts."
What do you base that off of?
"Really the main issue is that governments only look at short term problems and when I say short I mean very short term (just look at how long it took for Trump to say it was just the flu, to treating it as an actual virus). "
And Bernie, in March, said we should not shut down the border and simply said that Trump, by shutting down the borders, was using the virus as an excuse to simply ban immigration. Or how Pelosi was going to China town hugging chinese people. Trump did all he can do. He can't force states to do anything due to the 10th amendment. You guys have been calling Trump a dictator for years. This was a time where he can act like one but instead he left the issues up to the states and did all he was allowed to do, close the borders.
"the creeping of climate change is gradual but deadly."
Based on what? Climate change is a very complex issue we know very little about. That is why scientists have been critical of the alarmists and disagree with their messages.
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@J4535-b9p "Please stop calling everyone far left who disagrees with you. Especially when it is clear that you are extremely right on the issues who literally appeals to emotional arguments constantly by misrepresenting a vast array of information. "
No, i am a moderate. I look at the entire issue. I have praised universal healthcare a lot in prior comments and said, as a whole, that both the US system and other developed nations are all on par with each other. They all face issues that are different and, by my recent comment to you, it is simply want the society accepts. Other nations accept the fact that grandma is old and thus those nations drug them up and have them die pain free. In the US we push to keep grandma alive. And as I pointed out with culture, the US is a more masculine culture. You acted that way yourself by throwing out your credentials. So I am a moderate as I look at the entire issue where you ignore legit arguments against your point of views.
"To start off This is simply incorrect since you are trying to argue that in other nations they don't get advanced care or the "sick suffer"
"
The very sick suffer as the amount of care you can receive is capped. Again, as I pointed out in the book "In Excellent Health" by Stanford prof. Scott Atlas, the US offers the most advanced testing and care and thus has the highest survival rates in advanced illnesses. With the heart attack Bernie had he would have had to wait months in a nation like Canada to receive care where in the US he received immediate care.
"The sick AND poor are many times united because they sick are also poor and die without the treatment.
"
And the poor in the US have bad lifestyle habits with higher rates of smoking, type II diabetes and obesity, all self inflicted. And as pointed out by Prof. Katherine Baicker in her NEJM article entitled
"The Oregon Experiment — Effects of Medicaid on Clinical Outcomes"
She wrote
"This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years"
So even with access to healthcare they did not improve physically. And in fact, let us consider culture here again. The US in long term orientation is scored at a 26 where the other nations I mentioned, Denmark, Norway and Sweden, score higher. When scoring high a society looks to the future. With a low score our society does not look long term and thus short term. Thus people rather enjoy unhealthy food now as opposed to thinking long term. So there is that to consider. But hey, you feel I am an extreme right winger despite me looking at a ton of different variables.
"because the ones who suffer in our system are the really sick since they can't afford care at all for many items due to the insane cost. If you are born with a condition here(The really sick), you are in a horrible position compared to other nations. "
And other nations will deny you care even if you are middle class or poor. That is the point. Other nations have issues as well.
"Why don't you tell me what chemotherapy drugs they don't have in Germany, or France, etc?
Are you saying they don't have cisplatin? Paclitaxel? Cyclophosphamide? Trastuzumab? Etc."
I never said they don't have that type of care. I am saying the citizens there have less access. Healthcare economics seem to be a weak subject to you so I will use an analogy of person income. I have around a few thousand dollars in my checking account. It is safe to assume Bezos has a lot more in his checking account. By you standard I am just as rich as Bezos because I have money. No matter how much more he has, I simply have money thus I am just as rich as he is.
Now with healthcare, those nations have that type of care, they just have less of it. For example, they also have MRIs and CT scans, per capita they offer less compared to the US. That is the point. I never said they don't have that care. I am saying the citizens have less access to it thus the lower survival rates with those illnesses.
You try to sound smart but you have to make things up to try to debunk me. Shows how little you know and understand and poor of an argument you have.
"You are painting a picture where the US has superior drugs and technology and it isn't demonstrated by the reality. The US/Germany/Japan/France/Canada has the same chemotherapy drugs as offered to their patients alongside a drugs for all other diseases. The US is not 50 years ahead or whatever nonsense you think we are in terms of drugs."
No, I said they simply have lower access to those drugs. I never once suggested that those nations lack those drugs and care. I am saying the have less of them and thus the citizens have less access to them. I am not painting that picture, you are. Please learn how to read. I said the US has higher survival rates in those illnesses. That means in other nations the citizens survive as well as there is care for those illnesses as well, they just have less of them.
Again, you making things up shows how poor your arguments are. If you want to have an honest debate please try to represent your opponent fairly.
"And for the love of god, please please PLEASE stop referencing being mortal since you are completely misrepresenting what the book is.
The idea of being mortal was when doctors have to understand when individuals may not live and their last few months may be utterly destroyed by medications doctors are using to try to keep them alive. Its about coming to terms with death.
It is NOT about individuals who want treatment and want to live and many diseases are surely treatable but die or get far far sicker and die due to the economic basis of the healthcare system.
If you are going to reference a book, please please please READ IT.
"
I actually read the book and fully understand it. You clearly haven't. The entire book was about the challenges of dealing with human life near the end of their life. In healthcare there are several objective and moral arguments to be made. For example, the story of a patient who was told not to drink as it will not work well with their medication. They did anyway. The question was why not allow them to drink? Have them enjoy the final days of their lives as opposed to being hopped up on drugs. And yes, one point of the book was an economics argument on how people view modern medicine to live another 5 or 10 years but will only live another 5 or 10 months. The part you are referring to about people coming to terms with death is one of many parts of the book. You are cherry picking one part of it which leads me to believe you never read it. There were other parts about how shoving the old in a nursing home is not the best and the innovation of placing animals in there and having kids visit led to less medication use and longer life.
However, there is a part where many times doctors will consult with patients saying "if you take this medication or have this surgery you can live, but the changes are low". Some people will take the medication or surgery hoping to live longer but don't. So yes, I am quoting and representing the book correctly. I recommend you read it, it is a good book.
Also, it does bring up the point where in the US people do push to keep the elderly alive a long as possible where in other nations they simply drug them up and tell them it is their time. We see it here with the coronavirus. We are shutting down an entire economy so the virus kills less people where most who are dying are old and don't work to begin with. Is that a success?
"They also mention the fact that the fetus is increased risk for macrosomia, still birth, diabetes in the future, etc. Essentially putting large amounts of risks into the children.
So whats the issue with the article posted?
One of the main conclusions drawn from the article is the entire idea of preventative care with physicians. Essentially stating that physicians are not doing a proper job in caring for the patients since many do not stress the weight issue."
As I mentioned even if physicians stress weight issues people don't follow. I referenced a NEJM article on that. My point was that we have an obesity issue in this nation and obesity leads to premature births. But way to completely ignore that. We teach about obesity in our schools at a young age. So why do we continue to have an issue? Because of poor lifestyle choices. You do not need access to healthcare and a doctor to tell you that you are obese and need to eat healthy. That is very basic stuff. At that point you are too far gone. So you are making excuses. The I represented the article correctly. You assume that a doctor telling someone to lose weight will be the magic light that will have them do it when eating healthy is a common thing to know.
"And then one of the main conclusion issues was that many Americans don't have access to healthcare. "
And again, as I pointed out in the NEJM article, even with access to healthcare people are still in bad physical shape. You don't need a doctor to tell you to eat healthcare and exercise and that you are obese. That is very basic stuff. You are making excuses at this point. Many people never see a doctor and are very healthy as it is very basic to know what food is healthy and what isn't.
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@J4535-b9p "
J4535
1 hour ago (edited)
@whyamimrpink78 whyamimrpink78 Continued
Furthermore this is also problematic in its own sense because medically speaking, the argument is trying to put the issue on the person and saying it is due to poor lifestyle choices.
I have already posted this in the past and this is already a issue in the medical community. Genetic and epigentic predisposition make it more difficult for individuals to lose weight. Therefore, it is a massive problem trying to blame patients that it is their fault for being fat and therefore they do not deserve any medical care. "
I agree genetics can play a role and I have brought that up on the issue of heart disease and the black community where genetically they have a higher chance of heart disease. However, many people it does come down to life style choices. That is a problem we have, many simply choose a poor lifestyle and that weighs down the system. If we did not have so many doing a poor lifestyle choices than those who actually need help will get it. And even with genetic factors a healthy lifestyle can make a big difference. But ignore that.
"I mean you literally have no idea what I am speaking about yet you are posting articles and points that are either completely incorrect or misleading. "
I do know what I am talking about which is why I am a moderate and you are a radical. I fully agree genetics play a factor. I have brought up genetics a lot as I said with heart disease and blacks. My point is that a lot of poor health can be avoided with better lifestyle choices. 40% of the American food dollar is spent eating out where in other nations that is half that. In the US we eat more junk food. That is the reality. Even with genetic issues one can alleviate the situation by eating healthy. If you deny that than you a very poor doctor. I never once denied genetic issues. I am saying that, compared to other nations, we have a less healthy lifestyle.
But go ahead and make things up about me and ignore a very important factor here, lifestyle choices. To you it is always one issue and nothing else. Why do you ignore lifestyle choices? So you are saying I can drink gallons of soda a day and not exercise and the only determining factor in if I become obese is my genetics?
" mean look at this statement.
Leads the world in advanced care and testing?
How do we lead the world in advanced care? Can you name some drugs the US has that every other modern natiob does not have? cisplatin? Paclitaxel? '
Again, never said those nations don't have those drugs. I say we have higher access to them. I referenced a book by a Stanford professor on that. But again, you are making things up about me showing you have a very poor argument.
Again, by your standard I am just as rich as Bezos as I have money and so does he.
"And they argue that these "between-country differences probably reflect largely wasted overuse" in the United States""
And I agree with that argument and, if you read all my posts in all these videos, I have brought that up.
Here is the issue. By offering those testing we play a "better safe than sorry" case. As I pointed out to you, and we have argued before, the case of Natasha in the UK, a 16 year old girl who complained about headaches, saw over 10 doctors many times over many months and they said they were simply said they were migraines. She was finally given an MRI but had to wait months for it. It was a tumor and she died. In the US she would have been offered an MRI sooner and would be alive.
However, this is where the economics and statistics argument comes into play. I know those are two weak subjects for you so I will do my best to be detailed. Statistically yes, she most likely just had migraines. But by providing an MRI you eliminate the possibly of something more severe. But that ends up costing a nation more. So it comes down to a game of statistics and economics.
Gov. Cuomo said that if we spend a trillion dollars and save one life that was worth it. Was it? You, by what you are saying, is no. It is related to the advanced testing. We offer these advanced testing to say, keeping the numbers simple, 1000 people. Out of them 1 of them has a severe case and we save them. Was it worth the money? It is a fair question. The US says yes. Other nations say no.
Now I know economics is not your strong point along with healthcare economics but I will use the example of driving to point out two important economic terms, the law of diminishing returns and opportunity cost.
Around 40,000 die a year in traffic accidents. Most will agree that lowering speed limits will lower that numbers. With the law of diminishing returns say we lower free speed limits 5 MPH and it saves 5,000 lives. Ok, so we lower it again 5 MPH but only 1000 lives were saves. That is the law of diminishing returns. That eventually you reach a point where no matter how far you go you are not gaining much. Compare it to studying for a test. Say zero studying you receive a 50%. Say 5 hours of study you receive an 85%. Say 5 more hours you receive an 88%. The gain is dropping.
It is also opportunity costs. In study you could have done something else with those last 5 hours and gained more. Or with traffic accidents. Capping speed limits to 20 MPH will lead, most likely, to zero traffic deaths. However, commute times will increase harming our economy.
So with healthcare those laws apply. You, and other far leftists don't seem to understand that and that is what I am constantly trying to drive home. Sure, giving all that advanced testing can be seen as a waste and does drive up our healthcare costs, but it will save a life or two. Was it worth it? Some will say yes, others will say no. But you are not willing to have that difficult discussion which is why I call you a radical. I am willing to discuss those issues.
As we are facing now with the virus. We are not on a path of what will do more harm, the virus or the economy being shut down? That is why people want the economy re-opened. Many don't have jobs. Many can't pay rent. And we are at the point of picking the lesser of two evils. That is the difficult situation when it comes to healthcare that the left refuses to talk about.
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@J4535-b9p , I doubt you will reply but to sum up the last part of my comment, as it is the basis I am arguing for. It is about healthcare economics. You seem knowledgeable, to a degree, in healthcare. But you seem to not know much in economics. I recommend you read the last part of my recent comment. As you correctly pointed out a lot of that advanced testing is pointless, but it may save a life or two. So is that worth it? Some will say yes, others will say no. In other nations they say it is not worth it. Statistically chances are people don't have a severe case so they deny advanced care. In the US we are not willing to take that chance.
That is the economics of it. There is opportunity cost. Denying advanced care will lead to lower healthcare prices, but the cost will be those few who die for a undetected illnesses. Same with what we are dealing with now. Our economy is shut down and tanking, but people are dying because of the virus. Now what is doing more harm? The bad economy or the virus? These are the difficult discussions related to healthcare the far left, like you, are not willing to make. And that is the core of all my arguments. It is the economics of it. I have said many times a universal healthcare system will solve some of our underlying problems such as bankruptcies and the poor not receiving care. But other issues will arise such as limited access to care and lower quality. It comes down to what does our society accept.
As with driving, our society accepts the 40,000 deaths, whether they know it or not, for higher speed limits. We can lower speed limits to 20 mph to have zero deaths, but the economy will suffer and other people will suffer in other ways.
That is the underlying theme of my arguments. These issues are complex, not simple like the far left makes it out to be. The economics of it are complex and comes with cost of some kind. The fact you cannot see that shows to me you lack understand of economics. Which is why you cannot see my underlying message. I recommend you read up on economics and the economics of healthcare and the difficult decisions people have to make.
This current situation should show that. Right now ask yourself, what will do more harm to more people? The bad economy or the virus? And also consider who is being harmed? Most dying because of the virus are either very old or very sick with other issues. People suffering because of the economy are healthy, productive people. So consider that.
I doubt I get a response but overall, and for others, this is the underlying argument in healthcare, the economics of it and the difficult, complex decisions that need to be made both financially and morally.
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@J4535-b9p "You are definitely not a moderate. You have argued for extreme free market captalism for the healthcare system and state the most ridiculous things. "
No, I argue that a free market system where we can choose our own healthcare insurance where insurance is insurance, and have local communities such as charities or a local public option is the best. Noticed how I brought up a local public option?
Right now we don't have a free market system. We have a heavily regulated and subsidized system. For example, the payroll tax has it so you cannot choose your own insurance plan. I suggest eliminating the payroll tax so there employers pay with a higher wage and the employee can by an insurance plan they want forcing companies to compete. You can thus get the plan you want and have insurance be insurance and pay for everything else out of pocket. Just like care insurance pays for an accident which is unplanned and expensive but does not pay for oil changes which is needed for a safe car. Healthcare insurance can pay for unplanned, expensive situations and the rest if out of pocket. The issue is that since healthcare insurance is a form of payment it pays for all of healthcare. Also, you cannot choose your plan and when you switch jobs you have to switch insurance. That creates problems.
You see, you do not even know what I support. And as I said, local sources such as charities and a local public option can fill in the gaps.
Again, if you are going to criticize me you have to understand my position fairly.
"Again cite something because there is no evidence demonstrating that. Unless you are speaking about pallative and end of care treatment which is also here in the United States. "
They have lower survival rates and offer less access to advanced care. That is how they spend less. In the US the most expensive part of a person's life is their last 6 months. There is a reason for that. We offer them that much care.
"Does this study actually demonstrate that there is absolutely no change in preventative care? Of course not, because it only measures 3 variables where numerous diseases are caught and life saving if caught early."
Oh, so now other variables matter to you. Why now? I never denied that other variables don't matter. Also, I will admit that article brought up some advantages to expanding medicaid such as lower stress for example. You see, as a moderate I am willing to look at the whole issue. The issue is that when I bring up poor physical health people bring up preventative care when lifestyle choices and aid in that. BTW, the NEJM has the highest impact factor of any peer reviewed journals. And the lead author of that paper in a speech to Congress brought this up in comparing a free market system to a universal healthcare system
"Focusing on the underlying issues discussed here suggests that the fundamental problems facing our health insurance system are unlikely to be cured by the extremes of either a single payer system or an unfettered marketplace. On the one hand, the unregulated marketplace is unlikely to provide long-run stable insurance. Private insurers will always have an incentive to try to shed their highest cost enrollees, so without regulatory safeguards even the insured sick will be at risk of losing the insurance protections to which they are entitled. Private insurance fundamentally cannot provide the kind of redistribution based on underlying health risk or income that social insurance can. On the other hand, a single payer system does not automatically provide high quality care: the provision of low-value care is as pervasive in the single payer Medicare system as it is elsewhere. Single-payer systems are also slow to innovate – as suggested by the fact that it took Medicare 40 years to add a prescription drug benefit, long after most private insurers had done so. Nor do calculations of the costs of a single-payer system measure the utility loss from forcing people with different preferences into a monolithic health insurance plan. The private facilities that have sprung up in Canada to meet the demands of those who want more health care than the public system provides fundamentally undermine the “single payer” nature of the system."
You see, the issue is complex which is what I am saying. There are pros and cons to both systems. So I am going to keep repeating this but it comes down to the economics of it. What is the cost, and what our society, and ultimately our culture is willing to accept.
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@J4535-b9p "This study is simply indicating a few lab values that did not change and pink is attempting to argue ALL preventative care is not making a difference."
Never said it would not make a difference. Just saying there is more to it. Again, you do not need a doctor to tell you to eat healthy.
"No they don't for non-elective procedures. They don't just deny you care, you continue to state this without evidence."
Define an "elective" procedure. In places like Canada and Australia that can be certain forms of heart and neurosurgery. Or it can be that advanced testing you need that will detect a more severe situation. Or even something like knee surgery. If I have a bad knee I want it fixed quickly as my jobs and activities have me on my feet often. So that is not "elective" to me. Also, wait times have had bad results. As mentioned in the paper entitled
"A messy reality: an analysis of New Zealand's elective surgery scoring system via media sources, 2000–2006"
Where they write
"Research has also considered the impact of waiting on patients, with findings that those awaiting necessary treatments often face considerable costs. These may be financial if the ability to work is affected and if there is a need to pay for additional care and therapeutics while awaiting treatment. Costs for the health system may arise if patients are not treated in a timely manner and develop more serious conditions or co-morbidities as a consequence of waiting. There may also be quality-of-life impacts, as well as impacts on family or caregivers"
Also, it begs the question who decides what is elective and what isn't? Based on what? And why? Hickenlooper was critical of Bernie saying he wants to throw a plan out there and have others pick up the pieces. Bernie, no where in his bill, defines what is elective and what isn't. That places the pressure on medical personal to decide. And again, will our culture accept it?
"That's good right? Actually no, you see many times in the medical community unnecssary scans are done which have no indication, end up costing more and doing more damage."
Which I admit is an argument that you completely ignored I made. And again, this comes back to the economics of it. Sure, if we offer less care we will spend less. However, there will be cases of people dying for an undetected situation that an advanced test could have found. As I pointed out in that story of the UK girl. She was denied an MRI for months. She had a tumor. Now statistically chances were it was nothing. But that was a case where it was.
And again, it comes down to the underlying argument I am making, the economics of it. If, in all those testings, we save 0.02% of the population, is that good? Well, many argue in that M4A it will save 45,000 people a year who die due to lack of access. That is around 0.02% of the population. But as a trade off less advanced testing is offered.
Are you seeing the economics of it now?
"= better healthcare is simply wrong. It shows your lack of knowledge in the field which is beyond laughable to me a med student let alone a doctor who may see this. "
And there is an argument to be made there as well. You see, I can look at all sides. But again, it comes down to the economics of it and what our culture is willing to accept.
"They don't, that is my entire point. They don't have lower access to those drugs. Because the only thing you can point to is CT/MRI scans which I demonstrated above does more damage than good, has no statistical significant increase, and why it isn't an argument. "
Again, if you end up saving 0.02% of the population, is that good? Again, many argue that 45,000 people die a year due to lack of access. That is around 0.02% of the population. So what is better? This is, again, the complex nature of this issue that you are completely ignoring. Instead you call me a far right winger when I have argued for both sides.
"It is very clear that you have not read the book, especially pulling 2 random examples out. And that is literally what I said above. It's about doctors coming to terms with death, understanding what you should do for the last couple of months. How destroying someones last months with medications may not be best."
Uh, more to the book than that. It is also about giving people a choice. If they want medication and surgery they should be offered it. Clearly you have not read it. I recommend you do, it is a good read.
"THEY DON'T, that is my point. I literally posted cancer survival rates above and amendable mortality overall"
Uh, amenable mortality. Read the paper entitled
"Amenable mortality as an indicator of healthcare quality - a literature review."
Where they say
"No study has explicitly used a healthcare activity or quality variable in their analyses. This implies that the evidence that amenable mortality is an indicator of healthcare quality is far from overwhelming or clear."
And
"Using ‘amenable mortality’ as indicator of healthcare effectiveness in international comparisons: results of a validation study"
Where they say
"Given these gaps in knowledge, between-country differences in levels of mortality from amenable conditions should not be used for routine surveillance of healthcare performance. "
Also, it goes beyond cancer. There are other forms of advanced illnesses as well. But you are a doctor, you should know that.
You also capitalize the words because you are acting like an immature child. Again, too emotional to be a doctor. Feel bad for your patients.
"There are a variety of reasons many individuals are obese(one of which i pointed out above was genetics) but even emotional issues that many individuals have. This is the issue, your own article again argued against your premise. The point of the article was demonstrating proper help from physicians to work with it."
And I am not denying any of that. However, stress can lead to weight loss and exercise and proper diet can reduce stress as well. Again, this issue is complex. My point is that there are a collective group of people who life poor lifestyle choices and it limits care of those who actually need it.
"Based off of what? You are saying many peoples faults are lifestyle choices. Where is that from? Again there is a huge emphasis on lifestyle but there is tons of evidence demonstrating many individuals have terrible points due to genetics, epigenetics and environmental issues"
Again, I never denied that. Again, so I can drink gallons of soda a day and not exercise and the only way I will become obese is based on my genetics? I bet you think smoking is not bad for you either.
"Again this is where your lack of statistical and medical understanding come into play. This is because you simply don't understand how scans work, and indications.
You believe if you have a headache, and just go back for headaches, they just give you an MRI. This is FALSE. You do not get MRI's just for headaches, you need to have an indication for the scan.
So what that means is, a headache is to generic of a symptom, you need to have something called alarm or red flag symptoms. This is something indicating that something else is likely occurring. "
And this is the point I am making. Also, why are you ignoring a lot of my comments? I brought up statistics and how statistically it was nothing. But now here is the point, you are placing a finite value on a human life. You are going to deny her expensive care because, chances are, what she has is not serious. Thus you are saying she is worth X amount. And that is the entire point of my arguments. Something has to give. You are now placing a value on a human life.
So I highly understand the stats and brought it up numerous times. Why do you ignore that?
"Again these analogies are terrible because we constantly do things to ensure traffic accidents are minimized. Making cars safer, seatbelts being law, and traffic checkpoints. The argument you are making is simply moronic because the example you gave was actually stating decrease 5MPH = save 5000 lives.
However if I said statistically there was no difference in the number of deaths by decreasing the speed limit, would you say lower it? That is the point, there is no statistical differences in lives saved by doing the scans. Stating 1 person more is saved is not a statistical difference."
I am talking about at this point in time. And you say
"That is the point, there is no statistical differences in lives saved by doing the scans. "
And the same can be said about going to a M4A system. The highest value of deaths due to lack of access was a Yale study of 60,000. Is that significant? That is less than 0.02% of the total population. Is that significant? Now consider other studies with varying results like a Harvard one that said 45,000, a UCSD one that suggested almost zero, and another one that says 18,000. Now you have varying numbers as a result.
So you are literally proving my point.
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@J4535-b9p , at this point you are literally proving my point in two ways. To start, you ignore a plethora of my comments. But the two points are
1. The economics of the issue. I agree one can argue that all these advanced testing can be unnecessary. But it has saved some lives. Now it may be very little, but it has save some. But now you are placing a finite value on a human life. You are saying that a human life is worth X amount and thus no pre-cautions will be taken and thus no advanced testing unless it is absolutely clear we need to do it.
This is a major point I have argued a lot. There is an economic point to it. Yes, statistically those advanced testing are not necessary. But now you placed a value on human life that no "better safe than sorry" test is need.
As I said with opportunity cost. As people said, some people die due to lack of access. That number has ranged as little as 18,000 to 60,000. So few points there. One, that number ranging that much shows it is difficult to obtain an accurate value. But if M4A saves those lives, how many lives will it cost?
The second point you made for me is that yes, statistically it is not significant. Even at 60,000 deaths that is still around 0.02% of the population. Now consider how much that value ranges, and how other experts question those values such as them being in poor health to begin with, so even with access to care they are at a high chance of dying. Now you have a statistic that is not significant.
So I thank you for making my points for me. Too bad you ignored them when I made them.
And why are you ignoring culture?
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@J4535-b9p "I don't understand how explaining disease processes, linking massive amounts of resources to you that medical students and physicians use, and breaking down papers show I am over-emotional. Why don't you just listen to people who know more than you in the field? Why is that so hard? "
You write in all caps. You label me and extreme right winger even though everything I write shows I am a moderate. You ignore a plethora of my comments such as the advanced testing comment. I even admitted that arguably we offer too much advanced testing. And in the case of that UK girl statistically it was most likely nothing. You ended up making that comment but ignore the fact I made it.
I see it now, you are in ICU with three patients. One dies, you cry and in doing so you are not focused and your other two patients die. You get sued and lose your job.
I recommend you try to be more mature from now on. As in my recent comments you are literally proving my point. One is on economics in that you literally placed a value on a human life. The second is statistics where you claim that the advanced tests do not lead to significant results where I argue that, with 60,000 deaths at best, less than 0.02% is not significant.
As for culture, Japan is a more collective culture, so that plays a role. So is the UK and 2 points, as studied in my international business course, that is significant. There is also long term orientation as well.
The US with being a masculine nation, with low LT, and high individualism will not accept a M4A system.
"I don't understand why you make it seem like universal healthcare would suddenly make the country lazy or non-competitive"
Never said it would. Saying our society won't accept such a system.
"Well I'm sorry pink, I do care about people. Hell I even want you to have access to everything you need in the nation.'
I beg to differ. If so why do you ignore a massive amount of my comments such as how I argued, in the case of that UK girl, that statistically chances were she did not have a severe case. Why?
Out of all of that, why do you ignore the massive amount of my comments?
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@J4535-b9p I have read your posts. You do not read mine. Again, on the UK girl I have argued that, statistically chances were high that all she had were migraines. In the US we play a better safe than sorry route. In other nations they cap how much care you receive. Statistically there is an argument to be made there. In that offering all these advanced testing and saving a very small portion of lives, was it worth? But the same can said about M4A and the 18000-60,0000 deaths a year due to lack of access. That is 0.02% of the nation. And considering the multiple variables it becomes even less significant. But of course you will ignore that side of the argument due to your firmly held, religious like belief.
Bottom line is this. Despite you not reading my arguments where I said the exact same things you did prior to you saying it. Despite you completely misrepresenting me and not realizing I stand for, when I make these arguments it comes down the three things of this complex issue.
1. Economics. You yourself admitted there is a finite value on life. You admitted that when you said that those advanced care is not necessary and the people who die due to lack of access of it was not statistically significant. Thus you are placing a value on human life. The reality is that there is a value of human life and it varies. For example, there are reasons why some earn the min. wage and others earn six figures. That is the harsh reality. Gov. Cuomo said something along the lines of if we spend a trillion dollars to save one life it was worth it. Reality is that it isn't.
Right now us, as a nation, have to make a choice in what will do more harm to more people. This virus or the poor economy. Do we keep the economy shut down where people are unemployed, can't pay bills, can't pay rent to keep people from getting the virus? Or do we re-open the economy so people have jobs and some people get the virus? Now add in that, statistically the people who will most likely die due the virus are either old or sick. Where people suffering due to the poor economy are productive people trying to pay rent, bills, buy food, etc. So what do we do? Something has to give. So there is an economics side to healthcare.
Also, as one of the authors of the Koch brothers' study said. Sure, M4A may cost less with a 40% less payment. But you have to now bring up access and quality issue. That is called "opportunity cost" in economics.
2. Statistical significance. You brought it up in the relation of advanced testing and how the deaths due to lack of it was not significant statistically. I agree. But also the 18,000 to 60,000 deaths due to lack of access are also not significant as I said earlier as one, the range is large as it is hard to obtain accurate number. Two, at worse it is around 0.02% of the population, And three, many variables are involved. Or medical bankruptcy. A NEJM paper suggests that there are only around 100,000 bankruptcies due to medical bills alone. That is 0.03% of the population. You are suggesting completely dismantling the entire US healthcare system to cater to 0.03% of the nation. Is that wise?
Or other stats. When you run through them and completely break them down the US is on par with other nations. For example, life expectancy. This is a few years old but the world average is 71±7 years. The US is around 79 year, over one standard deviation. Now add in other factors the influence overall life expectancy and you see that the difference of a few years between nations is not significant and cannot be blamed on a healthcare system.
3. Culture. The US has over 327 million people. Good luck convincing a nation as large as us to accept higher taxes and government control healthcare.
You are grossly over simplifying this issue. You are ignoring the issues I brought up as you feel your the solution is simple. It is not. That is why when challenged by me you become highly offended. Your beliefs are religious like.
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@J4535-b9p I have very little knowledge on the topic? Really? Again, it comes down to three issues, culture, economics and statistics. I took time to think about all you write. You just write medical terms here and there but ignore statistics, the culture and the economics where those are the main concerns of this issue. You entire comment completely ignores all that I said because, as usual, you have a firmly held, religious like belief on what you think that you just ignore anything that goes against that. So I will try again, starting with the easiest one, culture.
Culture: We have a nation of over 320 million people who, for decades, used the system we have now where most have no problems. Good luck convincing them to support a M4A system that raises their taxes and takes away their healthcare insurance.
Statistics: I brought up significance like you did with the 60,000 deaths and you just, while displaying a high level of ignorance, dismissed it. My point is that 60,000 is less than 0.02% of the overall population. You are demanding that we radically change our healthcare system to cater to 0.02% of the population. 0.02% is not significant. To give a perspective I am submitting a paper for publication (to let you know that means it gets peer reviewed and published, I know you don't know that process but in academics that is the standard) and some of my error bars are around 24%. But the data is still considered reliable. 0.02% is not significant and is due to many variables as we saw that number, from numerous studies, ranges from essentially zero to 60,000. So with statistics there is nothing significant to suggests that a M4A system will be better than what we have.
Economics: You completely ignored this one. But you admitted that there is a finite value on a human life. You admitted that tests are denied as the lives saved are not statistically significant. You are placing a value on a human life. As Gov. Cuomo said, if we spend a trillion dollars and save one life that is worth it. In reality that isn't worth it. This is the economics of it. Healthcare economics does not seem to be your strong point so I will, again, use the case of traffic deaths. Around 40,000 people die a year due to traffic deaths. We can, right now with the technology we have, reduce that number to basically zero by capping all speed limits to 20 MPH. However, that means commute times will be greater causing harm to the economy such as longer shipping times, people wasting time in their cars when they can be doing something productive, etc. Thus us, as a society, accept 40,000 deaths a year to have higher speed limits. The same is in healthcare. While our healthcare system has flaws, it does many things well such as more R&D, higher survival rates in advanced illnesses, and it fits our culture. We can go to a M4A system but other flaws will arise. And again, in every system lives are lost because, in the end, there is a finite value set on them.
You seem to be somewhat knowledgeable on healthcare. But you seem highly ignorant on culture, statistics and economics. I recommend that one, you tone down your emotions. As I said, if you are working in ICU and one of your patients dies, you can't become over emotional as then your other two patients will die. And next, do not talk about issues you know nothing about. I will be the first to admit I am not an expert on healthcare, or economics, but I know enough about them, compare to people on these comment sections, to have an opinion and guide people in the right direction. You just throw around healthcare terms but continue to completely ignore the points I am making.
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@J4535-b9p in your entire ramble you once again completely missed the points I am making. You claimed you know what peer reviewed means and then cite the Commonwealth Fund which is not an academic source but a private organization that is a special interest group. You are making that too easy. Also, in your description of statistics you showed you do not know what you are talking about. But here we go.
"Most Americans depise the US healthcare system. I have no idea where you are getting this information."
From reality and not from opinion polls. As Prof. Andrew Gelman said (I know you don't trust professors but I do this anyway)
"Finally, the 3 percent margin of error is an understatement because opinions change. On January 3, 2004, the Gallup poll included 410 Democrats, 26 percent of whom supported Howard Dean for president. The margin of error was 5 percent, and so we can be pretty sure that on that date, between 21 percent and 31 percent of Democrats supported Dean. But a lot of them have changed their minds. A poll is a snapshot, not a forecast."
Also, as one of my former boss said, who has a masters in statistics, when she see a poll was done via phone polling she dismisses it. The reason why is because with phone polling you cannot see the expression on someone's face, you do not know who you are polling, you do not know how passionate they are about a topic. Someone may say they support M4A but do not feel too passionate about it. Also, Actual Justice Warrior did a video on this talking about how Kyle does not understand polling data. He broke down the exit polls showing that democrats support more of a public option. That brings me to a point that I have always said about polling, they are vague questions on complex issues being asked to non experts. If you asked about M4A and brought up losing their insurance and higher taxes support drops a lot, even with democrats. But go ahead and ignore that.
Also consider how the democrats could not get 60 democrat senators to agree on one healthcare bill in 2009. Fact is that you are not going to convince our culture to accept M4A as written by Bernie. But go ahead and point to polls and ignore everything else.
"Except this is why I explained statistical significance. Because you are using it incorrectly. I explained what it meant statistically(which you still apparently don't understand) and studies do demonstrate statiscal significant increases in survival rates with medications. Because what you need to look at is medications, and what overall statistically increase.
Example for blood pressure, many americans are denied medications to treat it and it statistically significantly increases the survival rate. "
I do not see any statistical analysis in that paper, so what are you saying? Also, you did not explain statistical significance (which is why you posted a paper with zero statistical analysis). I am talking about how many people preach that M4A will save lies and that up to 60,000 deaths occur a year because of lack of access. However, numerous other studies range from essentially zero to 60,000 showing that any changes in the methods can lead to varying numbers creating a high degree of uncertainty begging the question should we radically change our system when, at best, it will save less than 0.02% of the population, and that comes with high uncertainty. That is my point on the stats which you seem to struggle with.
"I mean I don't get why you keep saying this over and over again. I have literally explained to you what peer review meant in other videos numerous times. I have defined it, linked to papers(for example the common wealth fund) and showed how they did their peer reviewed process. Then you explained the error bars but that has nothing to do with statistical significance.
Statistical significance is demonstrated through confidence intervals and can have large error bars. The 60k you gave was not in reference to any statistical methodology. You simply keep stating the stat without understand what it means. You have literally no idea what you are speaking about statistically. Please demonstrate a study if you'd like"
The fact that you point to the Commonwealth Fund to try to show understanding of the peer reviewed process is funny. I am talking about the standard in academics. As I said the Commonwealth Fund is a private organization and is a special interest group.
As for stats, it goes beyond confidence intervals and error bars. A lot of times those numbers simply come as a result of the math. Stats you seem to struggle with so I will go a simple route. Consider averages and standard deviation. You can have an average with a low standard deviation with only 5 data points. You can have 500 data points and have a higher standard deviation. What average is more reliable? The 500 data point one despite a higher standard deviation.
The 60,000 death stat is from a recent Yale report. Besides that I have stated that other studies show varying numbers which creates doubt in the accuracy of the numbers as several variables are involved. Prof. Katherine Baicker even brought that up, but I know how you do not trust academic sources. And again, 0.02% is small. 40,000 die a year in traffic accidents but I do not see us taking the radical approach in banning driving. So with 60,000 deaths why take a radical approach in going to M4A?
"No it does, because you increase access to medications, access to surgeries, save Americans in the process, decrease the cost, and overall have statistically no changes in results in most departments."
Do you increase access? That is questionable. The researchers who did the Koch Brothers' study on the cost of M4A said it will only cost less as it pays 40% less. But, as the authors say, you start getting into access issues, quality issues, etc. So does it increase access? You sound so certain but have no evidence for that. As I mentioned in there nations they limit how much care people receive. In Canada people die due to being denied "elective" heart surgery. You sound so certain in your claim with no actual evidence. Also, as I said in the past, people who typically die due to healthcare complications have many issues and are at high risk of dying to begin with. So even if you give them access to care and they die in a few months, was that a success?
You also don't seem to understand statistics, so I will keep this simple. Say M4A does save those 60,000 lives. Now say it cost a crap ton of money and they die in a few months, now it cost a lot for little results. Say also that 80,000 die now being denied "elective" care? We are worse off in two ways. One, we are spending more on a group that produce nothing, and two, more people are dying. You have yet to convince me, or anyone really beyond far left wingers that M4A will not come with problems that I described.
"Unfortunately not only is that not what I am saying(as explained above by statistical significance) but this again is telling me you don't understand more scans can be worse and hurt more people."
And a M4A system can be worse for our economy and others as well as I just described. People who die of healthcare complications have many problems typically. If we give them expensive care and they die in 5 months producing nothing in the economy, that is, economically, a waste. Now our economy is worse off. Economics does not seem to be your strong point but that is the reality. You are saying that under M4A the benefits will be significant there the drawbacks will not with zero details in why nor zero support. This is why M4A is not winning anywhere, your arguments are that weak.
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@J4535-b9p "I am not putting a finite value on human life rather explaining that doing more cause actually causes more harm and leads to fewer lives saved.
It is extremely complex which is why I am stating that you can't simply deny individuals on the fact that you feel that they are not living good lifestyles. You have many misconceptions about the nature of medication, how they function, and how they work. "
I agree it is complex, but you are the one over simplifying by pointing to unreliable opinion polls and ignoring the economics of it. You point to mammograms, but how are MRIs dangerous? I do not see it. Also, in your over simplifying it you claim that M4A will have significant benefits with no significant drawbacks with zero details in how. I explained to you some drawbacks that will be significant to our economics and healthcare outcomes. Or, at least, on par with the benefits. This is, overall, the bottom line that I always say. All things consider the US healthcare system is on par with other nations. We have issues, but so do other nations. But we do many things very well, so do other nations. For example, people complain about drug prices here but in the US we lead the world in R&D and our drug companies donate drugs to developing nations and donate resources to train people there. That was a case study we had to read up on in my international business course.
"1) I have literally posted numerous stats showing we do NOT have higher survival rates in the United States. We don't and you have provided no evidence to this claim. We on average have equal or worse survival rates in most departments.
Again this is not difficult to understand why. You have large segments of the population not able to access medications.
2) Furthermore, the vast majority of Americans now approval of the notion of universal healthcare. Whether looking at gallop, pew research, exit polls. The reality is the country is changing. The younger generations(less than 45) especially overwhelming support it. Likely when the older generations pass, it will become overwhelming popular. And its already popular now according to most polls. "
1: You posted data on cancer, that's it. I am talking about all advanced care as a whole. I also cited a Stanford professor on that topic. The book is "In Excellent Health" by Scott Atlas. Again, I know professors are people you don't agree with, but he breaks it down well.
2: Again, read the exit polls. It shows that people do not understand M4A as written and support more of a public option. And it wasn't people but democrats. Do independents and republicans feel the same way? Actual Justice Warrior has a great video on it where he breaks down the polling data. For a guy who claims to understand stats you really suck at polling data. The polls show what I say all the time, polls are vague questions on complex issues being asked to non experts. And if M4A is so popular why did it fail in Colorado? Oh, I know you will make excuses about misinformation. But that begs the question, if people are so easily persuaded by the media and counter arguments, it really begs the question if it was that popular to begin with. Or as I said earlier it begs the question on how passionate people are about it.
"I mean your example of the car accidents again was a terrible example because as I explained above, it isnt that decreasing the speed limit saves lives.
It would be as if you decreased the speed limits, saved lives here and lost more lives overall since people sped more and caused more traffic collisions. It is extremely complicated which is why I am trying to explain it to you. '"
No, we mandate that all cars cannot go faster than 20 mph. It isn't so much about setting a speed limit but designing cars that can only go so fast. But hey, let us go farther and ban driving. That will guarantee zero traffic deaths. So my car example is legit. It was discussed in my economics course.
"I've explained all 3 to you. Using polling, "
And I explained to you how polling is unreliable. I even cited a statistics professor in Andrew Gelman in how opinions change over time and polls are a snapshot, not a forecast. Again, stats is not your strong point.
That UMass study has many flaws which is why it is a report and not an actual paper. One flaw is that they assume that healthcare, economically, exists in a vacuum. They have a portion where they give a cost in aiding people in finding a job. One of that is them having to move to get a new job. That creates problems in housing prices. If you force the market where certain people have to move from one location to another, housing prices change that do not benefit the consumers. Those homes people are leaving will drop in value to where the home owners lose out on their investment where typically a home increases in price. The homes they end up buying, due to increases in demand, go up in price. So many people will have to down size. There is also the psychological effects in moving, especially with kids.
Another flaw is property taxes. With home prices dropping and insurance companies going under, the value of property, such as offices of the insurance companies, will drop leading to less property taxes for a local community. That means less money for schools. So that study has many flaws to it. They also admitted that doctors will be earning less but assume they will still provide the same level of care. That is completely foolish. Almost anywhere in the market when payment is cut productivity drops unless it was agreed upon by the workers. And what about malpractice insurance? That is not included as well. That study has way too many holes for my taste. The economics of healthcare do not reside in a bubble. Also, it is a report, not a paper published in any journal. So even with reviews it would still exist online. You do not seem to understand the peer reviewed process so I will explain it. The peer reviewed process means some of my peers have to approve the paper for publication. I cannot have it floating around online (well I can, no one will take is seriously) until it gets approved. That is why that report is on the university website and not in an actual journal.
"Anyways, the point is I am truly trying to educate you. You have such hardcore beliefs that you continue to state the same things over and over and over and over. You used the car analogy over and over again even though I have attempted to explain to you the difference. "
It is more of I am educating you. The car analogy is used in economic courses. You cite polling data while claiming to understand statistics even though statisticians understand the major flaws in polls and why they are unreliable.
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@J4535-b9p Here is the major road block with you, again, you do not understand culture, economics and statistics. So I will do it again.
Culture: Again, our culture will not accept higher taxes and losing their healthcare insurance. I know you point to polls but again, they are unreliable as I explained. And even the exit polls of democrats show that one, they do not under what M4A even is, and two, they support more of a public option. I recommend you watch Actual Justice Warrior's video on it. He breaks down the same polls you are referring to. Also, that is of democrats, it does not mean independents and republicans feel the same. Also, as I showed you with Coloradocare, people's excuse was that misinformation was given. Well, if people are so easily persuade, how can we take their opinion seriously? It is the point that I bring up of how passionate these people are of a topic. But you ignore all of that. You pointing to polls shows you lack of understanding of them
Statistics: You claimed that the benefits will be statistically significant and that the drawbacks won't be but provided zero evidence in doing so. I explained to you that 60,000 deaths, at most, might be saved, but that is 0.02% of the population. Is it worth radically changing our healthcare system for so little? And again, that number ranges from essentially zero to 60,000, thus there is a lot of uncertainty in the numbers. Also, there will still be drawbacks. Every nation suffers from amenable mortality. The Commonwealth Fund, which you so support, even admits that. So there are still deaths due to lack of access to healthcare. All of that you seem to completely ignore. And as with the car example that, again, economists look at. A guaranteed way to go from 40,000 deaths to 0, right now, is to ban driving.
Economics: You really do not understand the economics of this issue. As I pointed out healthcare economics is not in a vacuum. It will influence the entire economy greatly as it is 1/6 of our economy. The housing market is 5% of the economy. When it crashed look what happened. Now consider healthcare. Consider property taxes lost. Consider how businesses will have to freeze hiring as they adjust for the higher payroll tax. Consider how a higher payroll tax means lower wages and so on.
Now consider the elephant in the room, the value of a life. Harsh reality is that there is a set value on a life. We do have our objective value which is our income per year. There is also the subjective value of how others view us. That is really complex. But bottom line there is a set value on a life. If we spend five hundred thousand dollars to keep a man alive for 5 more months, was that worth it?
Going a more direct route consider what is going on now. We are now on the path on what is worse, the virus or the bad economy. With the virus we, directly see people die. But also consider who is dying? Typically the old who don't work to begin with or the very sick. You also have a collective group of people who died and whose bodies were not claimed as they had no loved ones in their life. With the bad economy we are seeing people protest because they want to work. Small businesses are shutting down. People are unemployed. This causes stress, psychological issues, depression, etc. So that is the economics of it.
You claim you are trying to educate me when in reality it is the other way around. Maybe you are studying to become a doctor. In my experience in graduate school people who go that far are myopic. That is all they know. I see it in my field of physics and chemistry. They have strong opinions on other topics but are typically wrong. I am different as I am a nerd that is also getting my MBA. I also have activities, such as being a sports official, where I interact with lawyers, doctors, nurses, engineers, school teachers, construction workers, etc. So I am well rounded. You, on the other, are not. Not saying that is wrong, just saying the truth. You show that by not understand culture, not understanding statistics (this is really big when you point to polling data), and not understanding economics. For your sanity I recommend you just stick to healthcare and not have an opinion on healthcare economics such as M4A. You will be happier as, while M4A continues to lose badly, you won't go insane and make up excuses in why.
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@J4535-b9p and here you are, punching and running away while ignoring the plethora of points I made. If it is so easy to embarrass me than address my points. I will break it down to you again the main issue
Culture: Our culture will not accept a M4A system. Even the exit polls of democrats favor a public option and not M4A as written by Sanders. The exit polls also show how little people know about M4A. But considering how 80% voted against Coloradocare, and how multiple attempts to reform healthcare has been meant with failure, it is clear our society will not accept M4A, period. Your only sources are polls where I told you how unreliable they are. My sources are the history of this nation. Look at how people voted out democrats when they passed Obamacare. And look at how much push back now republicans got when they tried to repeal Obamacare. People do not want to see drastic changes in healthcare.
Statistics: I pointed to you, in detail, the issue with the stats. Again, the number of people who die due to lack of access has ranged to essentially zero to 60,000. That creates a lot of doubt in those numbers alone. Now consider how amenable mortality is an issue every system faces, what system will lead to less deaths? We cannot say with high certainty. So I find it foolish to radically change a system with such high uncertainty.
Economics: I can go into detail on this one but again, there is a finite value on a human life. Using the current situation we are on a path on what is worse, the virus or the bad economy? People are dying because of the virus, but people are also worse off because of the bad economy and are suffering that way. Eventually we have to make a choice and either accept the deaths from the virus and let people work so they can pay bills, or save people from the virus while people suffer in building up debt and having to move back with their parents as they can't pay rent.
Those are the three issues you have a very difficult time grasping. I noticed that every time I bring them up you ignore them, especially the economics part.
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