I'm Grandfathered in, for now.

Sorta. He was making a point about how small change it was. After all it was *only* six weeks of United's profits. Also claiming that somehow United didn't deserve such huge profits. Lefties always want it both ways.

The larger point is that it's no one's business *how* big a private individual's "profits" are (for a company, it matters to its owners, of course). It *is* our business how much money the government pisses away.

Understood. I was going for a different, larger, point.

No, because the numbers say so. They are what they are, and they are not disputed in the medical field. It is quite similar in other areas, this type of cancer is only one example.

Not a surprise at all. When they do a colonoscopy on people and see polyps these will, if the patient agrees, be snipped out right then and there. It's discomforting but it is known that this will greatly reduce your chance of developing colon cancer later. In countries without such vigorous screening such polyps are not detected. Until it is too late.

Polyps are not considered cancer stage so that won't show up in the numbers.

That has to do with healthier lifestyle. Americans have an unfortunate trend to ruin their bodies via fast food, obesity and too little exercise. They smoke less on average but that doesn't make up fior it and the medical worls is quite powerless against those "diseases".

Heck, I can't even get to some popular places here on my bicycle without resorting to the mountain bike and plowing some rough turf. So the infrastructure is partly to blame.

Colon cancer is something people get at younger ages, which is why I picked that as an example. Same for breast cancer, where the US is (or soon was?) vastly leading. I only know one woman who got that past age

One has to be honest about the numbers. But most of them are simply better in the US. Soon, they may not be anymore.

I know how to read numbers and they speak clearly. Interestingly, they are disputed in the medical world and if they were wrong that is the very first thing that would happen. Med professional do not mince words at conferences, BT.

Mostly urban legend. I have not witnessed one case. They can't do that, fear of a lawsuit is one reason why.

Doctors can decide that, bureaucrats can't.

Like politicans, they are typically not competent to do that. Else they would not have given things like sex change surgery preference.

And what he did not say was that the income from premiums did not cover the payout to health care providers. Or that the individual/business premiums was only 43% (if I remember correctly, low 40's anyway) of the total. A chunk of the profit get's put back into investments to fund the difference.

Or that the profit margin was a lousy 5%. Google was 25%, Microsoft 33%. Google's numbers would have been a little lower but the sweetheart deal with the Fed's for their fleet of jets out at Moffett helped some (it's nice when you can buy Jet-A for a $1.68 a gallon).

Where is the outrage that Microsoft and Google are making too much money?

ada or the UK that it can fail them during serious illnesses. For setting b roken bones and stuff the single payer systems work well but when it comes to cancer mortality the picture is dark.

urance farce.

early stool test os "over-testing". It costs peanuts yet he health system i n Germany when I lived there did not do it.

, is a cheap. and very good defense against colon cancer.

ted, and that there are questions about it's cost-effectiveness in mass-sc reening.

a marginal advantage can you produce statistical evidence for this claim?

they? Neither does Germany. To me it is very clear why.

The numbers don't "say" anything. They have to be understood, and you want to understand as saying that US medicine is perceptibly better than Canandi an or German. Once you've seen that, your brain stops processing.

t is quite similar in other areas, this type of cancer is only one example.

nada, and Germany are substantially higher than they are in the US and the UK. This does suggest that we are looking at different populations.

That's one explanation, which is an unsubstantiated hypothesis until it is back up by an account of the number of polyps snipped, and the subsequent h istories of peole who have had their polyps snipped.

rs.

How convenient.

nd Germany (at 81) than it is the the US (at 79).

Probably not. Colon cancer rates do vary specifically with diet - red meat is bad and lots of fibre, which moves the proto-carcinogens through the col on fast enough that they don't turn into real carcinogens, does help.

In as far as you are comparing different populations with different sorts o f colon cancer, this just means that the statistics that you are quoting ar e comparing apples and pears, rather than the effectiveness of the health s ervice.

All cancers show up more frequently in older patients. The picture can be c omplicated by age limits on screening and the like, but in both your exampl e cancers, the a older people get the cancer more often.

only know one woman who got that past age 70, all others (a lot of women) w ere 30-50.

ufferers, which turned out to reflect the fact that the UK has less fat peo ple and less type 2 diabetes (which is less lethal and easierto treat). The anti-Obamacare statistics managed to bury that significant difference too .

r in the US. Soon, they may not be anymore.

Some of them look better in the US. Quite a few look appreciably worse. The medical technology is exactly the same, but the patients are different.

that the statistics evidence should be readily accessible.

studies are paid access only. In the area of cardiology I sometimes have s uch access.

ated so far.

You may be able to read numbers, but you are depressingly weak on the medic al reality they represent.

ong that is the very first thing that would happen. Med professional do not mince words at conferences, BT.

But they are truly horrible at understanding what statistics actually mean and teasing out the differences that reflect differences in treatment from the differences in the underlying disease being treated.

The problem created by lumping type 1 and type 2 diabetes is crude enough t hat even a medical doctor with no statistical training could be expected to see it. More subtle confounds are less obvious.

Doctors can decide whether a particular treatment can work. They are perfec tly useless at working out which treatment is too expensive to be cost-effe ctive, because they all have their private hobby horses, and their emotiona l involvement with previous patients.

would not have given things like sex change surgery preference.

Why not? People who believe that they have been born into a body of the wro ng sex do get miserable about it, and it is a fixable problem.

The bureaucrats wouldn't be supporting this approach if there weren't an ac tive group of doctors who endorsed it.

Sorting out the belief rather than the body would be more elegant, but the former approach doesn't work and the latter does, even if it does disturb t he god-botherers.

"Head in the sand" isn't making them go away.

I have explained to you why the numbers in the US are better and why this can only work through early screening (and polyp removal. You don't believe me and call it "unsubstantiated". Which is flat wrong. You tend to make up this stuff, stuff that clearly contradicts clinical evidence.

No, it is not.

Quote "In a 20-year study of more than 2,500 people, the risk of dying from colon cancer was about 90% lower if people underwent both the initial and follow-up procedures than if they underwent neither".

There are many more studies and they corroborate this. You can go into denial about it but that won't changes these medical facts.

Even sex change operations are mandatory coverage now under this Obamacare. No kidding.

anada or the UK that it can fail the during serious illnesses. For setting broken bones and stuff the single payer systems work well but when it comes to cancer mortality the picture is dark.

nsurance farce.

yearly stool test is "over-testing". It costs peanuts yet the health syste m in Germany when I lived there did not do it.

st, is a cheap. and very good defense against colon cancer.

iated, and that there are questions about it's cost-effectiveness in mass-s creening.

le:

o they? Neither does Germany. To me it is very clear why.

Obviously not, but they don't unambiguously support the conclusion you want them to support. There are other ways of looking at them.

nderstand them as saying that US medicine is perceptibly better than Canadi an or German. Once you've seen that, your brain stops processing.

can only work through early screening (and polyp removal.

No. Early screening and polyp removal are an explanation of the difference. Without numbers for incidence of polyp removal it's just an explanation, n ot the only possible explanation - there are others, and differences in die t and age are equally plausible.

ainly haven't substantiated your polyp-snipping explanation - which would r equire evidence that enough polyps had been removed to explain the differen ce, and even that wouldn't demonstrate that there were other factors in pla y.

ontradicts clinical evidence.

Nothing I've said contradicts clinical evidence. It does question your expl anation of the clinical evidence, which does leap on an obvious explanation and ignores all the alternative explanations with all the confidence of th e converted. Try to think like a scientist for a bit, and see if you can fi nd - and perhaps test - a few alternative hypotheses.

and the subsequent histories of peole who have had their polyps snipped.

from colon cancer was about 90% lower if people underwent both the initial and follow-up procedures than if they underwent neither".

denial about it but that won't changes these medical facts.

All these medical facts demonstrate that polyp-snipping works, which I'm ha ppy to accept.

They don't demonstrate that polyp-snipping is carried out on a large enough scale to explain why US colon cancer rates are around 34.1/25.0 per 100,00

If polyp-snipping was as good and as wide-spread as you seem to be claiming , you'd expect a substantially larger difference.

Yes, that's enlightning, but sex change operations seem to be only covered in life and death situations where the patient might die if he/she doesn't get the procedure. It probably excludes elderly people past 60 years of age who don't care about sex. But they still pay the medical bills and the doc tors and hospitals make money.

-Bill

Fred, That '15%' limit has been around for a while. It is a cost plus limit, so it doesn't reduce costs, it just makes sure that your 'overhead' costs have to be more carefully covered in your accounting practices to make sure that they show up as costs, and not overhead!

And, no, you are wrong. The government is getting more and more in the health insurance business. By providing those 'subsidies' to the insurance customers, they control more and more what can, and can't, be offered.

When they poll about the ACA there's always a big majority in favor of most of the provisions, including allowing children to remain on their parent's policy (which isn't free--the insurer can charge for this). The ban on denying insurance based on pre-existing conditions is also very popular. There's a slight majority against the mandate, but only very slight.

Overall, the Tea Partiers keep insisting that a majority is opposed to the ACA, but they leave out the fact that 16% of those that say they oppose the ACA opposie it because they think it doesn't go far enough--they would prefer single-payer (like most industrialized countries have). Add that 16% to the 43% that say they support ACA and you're at 59%, which would be considered a landslide in presidential politics.

It's not an exaggeration that the only real objection to Obamacare by the right wing is the "Obama" part of it.

What's really going to be on voter's minds in 2014, assuming they haven't forgotten about it by then, is the way the Republican House behaved and forced the government shutdown and how they allowed the U.S. to come to the brink of default. Hopefully that will translate into the Democrats winning the control of the House of Representatives as well as retaining the Senate. The only hope to move the country forward is to get rid of the obstructionist Tea Bagger Republicans. Normal Republicans would be okay if they were not being forced to do stupid things by the Tea Baggers.

Those numbers I had given. See links below.

A better diet? In the US? You've got to be kidding.

Sure it does. You said "unsubstantiated" and that is simply wrong. Before I'd make such lofty statements I'd have looked up the topic and would be ready to back up such claims.

In medical, we think in clinical studies and base our strategies on those. That has worked well for at least a century. You are welcome to ignore that, it won't make a difference.

It is standard practice here and the clinical studies clearly bear out the benefits.

There is a simple reason: Many Americans dread the thought of a colonoscopy and push that out. "I can always do that next year ... or the year after that". Some never get one. Our health care plan folks are very pushy on this. others are not so pushy. If you are even a few weeks overdue on some screening procedure you get a call. But in a free country you cannot force people to report for their colonoscopy on Thursday morning at 8:00am sharp.

Ultimately the U.S. is going to have to follow the lead of all other western industrialized democracies and move to single payer. The ACA is the best that could be done for now, but as the demographics change in the U.S. and Republicans are voted out of office there will be an opportunity to introduce a better system. It's not going to be an option because the present system is not sustainable. Eventually big business, other than insurance companies of course, will force this change.

What's ironic is that independent senator Joe Lieberman once proposed what made the most sense--expanding the age range of Medicare. The system is in place, it's highly efficient (much more so than private insurance), and it keeps costs very low. The problem occurred when the insurance companies in Connecticut told Lieberman to stop pushing for this.

If we were serious about erasing the deficit we'd expand Medicare into a single payer health care system for everyone. That would bring medical costs down to those in other countries. As it is now, we spend the most but don't achieve the results other countries achieve at far lower cost.

The Tea Baggers are concerned about the individual mandate penalty:

As the Tea Baggers have been about NOT paying any taxes, they really dislike the "IRS act of 2010" also known as ACA.

The ACA act gives new powers to the IRS to track and penalize those without insurance.

Don't you think the IRS will not only penalize a taxpayer who does not have insurance, but will also check if there are any outstanding taxes due.

Every time a taxpayer goes to see a doctor or into a hospital, the IRS will be given your data to "check".

The Tea Baggers have been around long before the Koch Brothers gave it a White Wash.

Even though the media seems to think it new:

Of course the facts are radically different.

It was only a matter of time before sex change operations became mandatory. I guess we'll be calling you Joelle.

--sp

"Facts"? From a blog? The reality has long since started:

"Shifting" is code for "dumping". Even unions joined the fray:

Then there is the rapidly growing group of 29h-workers. I have met many whose hours were already cut to 29h or less. That will escalate next year.

Nope. Germany does not have a siongle-payer system yet has one of the better health systems. At slightly above half the cost of the US system. But they don't have a screwed-up tort law which is a major chunk of our problem, something Dems will never deal with for obvious reasons.

It is not. It's one of the worst attempts of health reform I ever saw, and being in the med biz and having lived in different parts of the world I have seen a few.

Dream on. Obamacare could become the big hammer causing "Shellacking 2.0".

Way it was explained in our plan under mandate changes was that it's a "benefit" to everyone.

In reality tort law is a tiny part of the problem despite the efforts of the right-wing tea-partiers to portray it as a big problem.

The non-partisan CBO stated that tort reform would save 0.5% in total medical costs. The problem is that a few high profile cases lead naive people to believe that there are far more malpractice suits than actually exist and the right wing uses these high profile cases to spread their misinformation because their handlers have a vested interest in the issue.

"A report by the consumer advocacy group Public Citizen demonstrated that the total value of malpractice payments (money paid to resolve claims) on behalf of providers has been decreasing since 2001 and was the lowest on record in 2011. While malpractice payments decreased, healthcare spending nearly doubled over the same period, negating the claim that malpractice litigation contributes to rising healthcare costs.

An examination of the impact of tort reform in Texas supports this perspective. In 2003, Texas imposed a cap of $250,000 on noneconomic damages for medical liability claims. Since then, total malpractice claim payments have declined 65 percent, but health insurance rates and per-patient Medicare spending has increased faster in Texas than the national average." Of course the reason that Texas's costs increased faster after tort reform could be coincidental and due to other factors, you can't claim causation when it could just be correlation.

Nor is it clear that so-called "defensive medicine" actually adds to overall health care costs.

Some health economists believe that the fear of malpractice lawsuits is actually a good thing because it forces hospitals to be more efficient and to set up systems for things like infection control and drug verification. One thing you'll notice in U.S. hospitals is that new hospitals have mostly single rooms because rooms with multiple patients cause more problems than is worth the savings in cost.