OT: I've just become Joerg-asmed ;-)

Not a Kevin Rudd, except perhaps for personality similarities. Malcolm actually was a smart businessman who made a lot of money and understands economics, whereas Kevin was always just a shrewd and manipulative politician and nothing more productive. The Labor movement is made up of two kinds of people; idealists who couldn't run a chook raffle without someone accidentally dying, and crooks who want to rob the rich to make life more "fair".

That's exactly what it is. Anecdotal evidence is better than none, but carefully controlled and constructed studies work a lot better - even if you don't like their results.

But they may not be coming to the US for rationally justifiable reasons

The numbers have to be correctly understood. You and The Daily Mail understand what you see in the light of what you want to see. Academics have to satisfy more critical observers.

We aren't arguing about the numbers, but about the motivation - which is fear and doubt.

Our opinions differ.

The Laffer curve is another right wing myth. At some level it's real. but it changes with phases of the moon and from one side of a street to the other.

Some do. Many don't - even in the Netherlands. Quite a few of the tradesmen we dealt with preferred to be paid through the banking system - it kept the tax people off their necks.

d him as party leader a few years ago.

Julia Gillard and Barry Jones don't fit into either category. The Liberals couldn't find any mud to sling at her that actually stuck.

Barry Jones was a rotten politician, but he could certainly run a chook raf fle, and he wasn't a crook. The Science Policy Research Group at Sussex Uni versty thought that he was great, and his "Sleepers Awake" was a prescribed text for some Cambridge course - my copy got damaged and I found it much e asier to buy a replacement in Cambridge than I'd expected.

You haven't even bothered to look at a study. I have, many times, and gave a link to one.

You may refuse to believe it because it doesn't fit you left-leaning views of health systems: Several I spoke with came because a Canadian doctor suggested it. Typically because the doc was of the opinion that remaining on a lengthy waiting list with their condition was not such a great idea.

The numbers clearly speak volumes. It is a business that is so large that it's part of the grand plan here for many hospitals (and also med devices makers).

No, the motivations are clinical facts. Everybody with a minimal level of an education knows that delaying a cancer treatment or that of a cardiac blockage because of some waiting list is going to greatly increase the risk of death or a debilitating event.

Phhhht. You clearly do not understand Laffer.

Well, I gave you the link with the numbers. Seems your were roughly a factor of two off, meaning it's 2x worse. 9.5% of their economy runs under the table. Here it is again:

It was interesting to see the 60 minutes article last week on disability insurance. Whole regions of the country where rip-off artists have established disability mills to certify you as disabled whether you are or not!

I remember the hoops Pamela had to go through to get her disability certified (and re-certified!) and I wonder how these folks get away with it. But, then I see that the scams go all the way up to the judge who decides on the cases!

Everyone has their priorities. They have theirs and you have yours. As long as yours include taking care of their parents, why should theirs? It's the leftist's way.

Just like everything else, Obama changed the rules.

The judge? It goes all the way up to PotUS. ...or comes down from, actually.

Right. It took me until the second. ;-)

...and the first job, after college that I interviewed for, I took (and left a short 33 years later). ;-)

I see it a bit differently. The problem is that often if you don't jump in they won't either. The ones suffering are then the old folks.

It is something I have even seen with families that are well off.

On the contrary, I came across a British sociological study a few years ago and read it carefully. I've posted the reference here, so - in theory - I should be able to find it again. Every right-wing nitwit here said sociolog y was rubbish and refused to pay any attention.

The Dutch article you posted was in a branch of the thread that appeared af ter I'd gone to bed (which I do - on Australian time - much earlier than yo u do).

It's not a sociological study of the attitudes and actions of the workless, as the British academic study wass, but a study done the credit-card compa ny Visa on the size of the "black economy". My impression has always been t he "black" economy is more about self-employed people failing to put a lot of their business through their books, rather than the unemployed supplemen ting their social support payments by working something close to full-time on the side

The usual reason for a length waiting list is that the treatment is effecti vely palliative, and doesn't pay of well in terms of years of extra surviva l per buck. The patient is likely to value the - usually limited - extra mo nths of life more highly than the health care system, and the doctor's advi ce will be based on the idea that if a patient really wants to spend money, this is way of spending to some advantage.

It's a business that isn't being assessed as offering value for money by me dical insurers or the Canadian health authorities. The wife of my friend wh o died of stomach cancer spent an appreciable amount of money on alternativ e treatments.It made her happier, though it didn't make my friend live a da y longer. Hospitals offering less-than-cost-effective treatments for later- stage cancers are in the same business - their patients often do live a bit longer, but the extra period of life is dearly bought.

Another friend, who died of leukemia a few years ago probably died a few mo nths early because he signed up for an aggressive treatment that was very l ikely to kill him - as it did - but did offer a low chance of a cure. His f riends and family pressured him to try for the cure, despite the fact that it was gong to make his last days more painful and unpleasant than a more p assive course would have done.

lth-care-in-2011/

Clearing a cardiac blockage has to be prompt if it's going to be useful. Th e clinicians used to talk about the "golden hour". With early stage cancers , prompt treatment is vital. With later stage cancers, treatment is more a matter of delaying the inevitable and the exercise doesn't buy all that man y "quality adjusted years of life" per dollar.

Everybody does - at the basic level. Sadly, when academics have tried to na il it down to precise numbers, all that beautiful simplicity gets lost in a mass of detail which changes - as I said - much too rapidly from time to t ime and from situation to situation to make the concept useful.

A few years ago the Wikipedia article on the Laffer curve mentioned a few e mpirical studies which had demonstrated it uselessness in practice, but the se have now vanished.

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You are assuming that 5% of the population (my claim) can't be responsible for 9.5% of the economic activity (your evidence). This is obviously untrue . My claim is not incompatible with your claim, and if you'd thought about it for a minute you'd recognise that this was another case of apple and pea rs.

Not differently. If you do something for someone that they should do themselves (take care of parents), there is a lower probability that they will do it for themselves in the future. That's the whole problem with government handouts.

I agree that sometimes one has to act but the unintended consequence is that things will generally get worse because of it and you will have to do more. It's the nature of socialism.

Yeah, I know and essentially agree. For me the guidance is the bible and it also says that people must take respnsibility for their parents, shall not act as freeloaders to society and so on. But it says we must jump in if others don't care. Can't let people suffer because they don't get their meds or something. Even if they may have caused the problem themselves, by non-ideal parenting decades ago.

Absolutely not. They were people with coronary blockages where sometimes they'd wake up with a scream in the middle of the night and thought "This is it". Others were folks with cancer where it is well known that it can metastatize if left unchecked while on a waiting list, and then game's over, usually.

Quite frankly, the people I spoke to gave a rats behind about what the Canadian authorities thought about it. So would I. It does not matter.

A friend of ours who was literally on her death bed is like a new person, totally active, volunteering, without pain. It's been about a year now when she had a humongous surgery at one of those centers. Yeah, it cost a lot of money. But boy was it worth it. My hat goes off to that cancer surgeon.

Should be left to each one to decide. But it should _not_ be left to some bureaucrat.

Exactamente! That's what I am saying the whole time.

In Manitoba it's the golden 3-5 days even for regular angioplasty:

By that time you may be in a pine box. For "non-urgent" cases it's over a month. That is sad.

It's an older document but from what I heard things haven't drastically changed.

Great, huh? Would you still say these women would behave "irrationally" or whatever if the ones with enough money go to the US and have it done there?

It isn't at all. People who work under the table do not miraculously have 16h workdays where everyone else is 8h.

EBT (electronic food stamps) is the OPM of the masses.

Cheers, James

In fact electronic food stamps keep people alive, and more or less in a state where they can look for work, if there's any around.

Opium kills them, less painfully than starvation, and keeps them in a state where they don't mind that the Tea Party has destroyed any chance that there might be work around for them to find.

Most cancers aren't found before they've started to metastatise. Back when I knew anything about this stuff, you mostly need at least a cubic centimet re3 of cancer for it to be detectable, and for it to be that big it had hav e worked out how to get it's own blood supply. That's most of the way down the track.

If you've got the money to spend, you can set your own valuation on extra y ears of life. The people running the system have got an obligation to spend the finite amount of money they've got in the way that will save the maxim imum number of quality-adjusted years of life.

Making the optimal use of a finite resource isn't going to matter to indivi dual patients - they have more urgent matters on their minds. It should mat ter to the people distributing these finite resources.

Some people get lucky.Spontaneous remission actually happens, if not very o ften, and if it happens to coincide with with some kind of alternative trea tment, lots of patients can be misled.

ealth-care-in-2011/

If you can get clot busting drugs into the heart within an hour of the bloc kage, they do some good. After that it's pretty much as waste of time.

Once the chunk of heart muscle that was being fed by the blocked coronary a rtery has died there's not a lot you can do about it. Doing by-pass surgery to improve the blood supply to the adjacent muscles helps, but it's very r arely a life-or-death thing.

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The article didn't include much in the way of statistics - "Operations expe cted to be scheduled within four weeks are now taking up to 12" and didn't give any reference to where it's statistics came from. The journalist had a fixed idea about what was going on, but didn't go to any trouble to let an ybody else know why they should share that point of view. It looks more lik e political propaganda than informed comment.

Roughly half the population doesn't work at all. By the time you have facto red out those who are too young to work, those who are still in higher educ ation, those who are retired, and the full-time mothers, about 50% of the p opulation is responsible for pretty much all the economic activity.

Within the active groups there is also a distribution of economic activity.

One would expect that people who were working black wouldn't be doing it fo r sub-average earnings. Making and distributing illegal drugs is a business with a high mark-up at every stage.

Your argument doesn't hold water.

That is where a properly working HMO system in the US excels. If we don't send in our stool samples within two weeks after receipt they will bug us. If someone doesn't react then they will really begun to bug people. In Germany the insurance never required stool samples. If te doctor didn't order one it didn't happen. At our HMO here it's on the preventative care checklist and must be done.

That's just one example. If you think that's excessive testing I will disagree, I've seen too many people go down with colon cancer and I am sure many case would have been preventable or curable if detected earlier.

Yeah, and now that our government is running it, guess what? You can get a sex change operation on the health plan's and the taxpayer's dime! Couldn't believe it when I read the plan change notices from my HMO (they were forced by the government).

Correct, and the government should get out of that decision process because obviously they are not good at it.

It wasn't luck. It was a major surgery that in most health system would not be covered and thus not be done except for people with the financial resources to have it done outside the country.

Stenting often is a life or death thing. People come in with very serious chest pains, a blockage is suspected, and (in the US) they are sent right on to the cardiology department of a hospital. Happened to several people I met. Some were really close to another and this time debilitating or fatal episode and they did the procedure right then and there. In Canada, many of them are put on a waiting list and then have that 2nd episode.

You can go into denial about it and say the Fraser Institute, the Canadian Medical association and all the others are not telling the truth. It does not change the fact that it is the truth and there are hard numbers for Canadian waiting lists.

When a patient up there sued because the Canadian system wanted to block him from seeking a private insurance path the judge said "Access to a waiting list is not access to health care". Don't believe it? Here:

All the folks I met there that talked about it were able-bodied working age people.

I know differently, and so does the government there.

Plenty of both, around here. Of course, there are quite a few horse farms.

Colon cancer is pretty much unique there - it starts as polyps, which shed cells directly into the food waste going past, making them detectable in st ools samples at a very early stage.

And pretty much unique, as early detection schemes go.

I certainly don't think that that is excessive testing. I can't understand why the German, Dutch and UK medical services aren't more enthusiastic abou t it.

In Australia you can buy a test kit from the chemist. My new GP hasn't yet encouraged me to do it - presumably the Australian protocols call for some sort of reason to suspect increased susceptibility, like a near relative wh o has tested positive.

A controversial decision, but for people who are totally convinced that the y have been born in a wrong-sex body, it can buy a lot of quality-adjusted years of life. The people who are crazy enough to want the operation are re puted to be a lot happier after it has been done.

I'm sure it does. But there are other patients who also want help - providi ng expensive help to one patient means that you haven't got the resources t o help two others who are cheaper to treat. Triage is a nasty business.

Who would you replace them with?

Could you be more precise? Major surgery doesn't always succeed, least of a ll with advanced cancers. What doid the surgeons say about the changes of s uccess before the operation?

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What a journalist prints out of a report doesn't always convey the point of view embodied by the original report.

Find the actual Fraser Institute Report so that we can see what they had in mind.

There's no reason to believe that it is "the truth".

Re-prioritising operations can mean that over-all waiting times go up while genuinely urgent surgery happens earlier. Reporters won't pay any attentio n to that kind of detail if they can use the braod-brush figures to paint t he kind of picture that will engage the reader.

It wasn't Canada, but Quebec,and it sounds as the francophile inhabitants o f Quebec have embraced the worst features of French bureaucracy.

What's that got to do with what they might earn if they "worked off the boo ks"?

I said something about the proportion of the population who might work "bla ck". You made a claim about the extent of the black economy, which has to i nvolve the amount of money being turned over by the people who are working "black". Most of the money in the "black economy" seems likely to be in the recreational drugs business, which wasn't the kind of "off the books activ ity" we'd been talking about,

Your "knowledge" in this particular area doesn't seem to based on any kind of rational appreciation of what's going on. I'm sure I've got similar blin d spots.