Lightning round

[oddlots]

Here's a silly idea: a thread called Lightning Round where we get to ask of our opponents (and they of us) what topics we think they (we) are avoiding in a simple challenge. Here goes:

My anti-government American friends, I am frankly mystified by why, when you have, for instance an average (that might be key) life expectancy roughly that of Albania (34th or something) as well as health expenditure as a percentage of GDP among the highest in the world (bad results, big expenditure - never good) no-one seems at all curious about how better performance is achieved in various countries around the world. Instead wagons are circled and it becomes some bizarre ideological argument. What gives?

Could be fun? (I'll regret that.)

[ThePythonicCow]

Re: Lightning round

My anti-government American friends ... health

Perhaps it is not insufficient government involvement that ails Americans, but

• fraudulent government involvement with a few large corporations making too much money on sick care,
• with profits in proportion to how many fear mongering symptoms can be identified and symptomatically treated in perpetuity,
• avoiding identifying or removing the actual causes of illness,
• promoting practices (such as high fructose corn syrup, mercury fillings, fluoridated water, abusive GMO, ...) that cause further illness,
• funding research to support the above,
• suppressing research to the contrary,
• subsidizing unhealthy (but profitable) farming and nutrition, while
• suppressing healthy farming and nutrition alternatives.

I'll regret that

[ThePythonicCow]

Re: Lightning round

what topics we think they (we) are avoiding

The biggest two elephants in the room:

• 11 Sep 2001, and
• The ongoing theft of Trillions.

[jpatter666]

Re: Lightning round

1 ) An out of control legal system which rewards frivolous lawsuits with outsized awards (thus encouraging more of the same)
2 ) A population indoctrinated with a "not my fault -- I'm going to sue someone" mentality (thus abetting #1)
3 ) Political manipulation decrying any restriction on "choice" -- while placing everyone in highly restrictive HMOs and PPOs (I love this one, you put your chains on yourself....)
4 ) More indoctrination about how America's freedoms automatically make it the best for *anything*. Lots of bragging about how our medical care is the best (and it is -- just only for that top 1%)
5 ) Lack of exposure to other systems. This actually is important -- many Americans never go to other countries (size of US and really requires a major trip to do so)

[thriftyandboringinohio]

Re: Lightning round

1 ) An out of control legal system which rewards frivolous lawsuits with outsized awards (thus encouraging more of the same)
2 ) A population indoctrinated with a "not my fault -- I'm going to sue someone" mentality (thus abetting #1)

I would respectfully argue that jury awards for medical malpractice are well-proven to be not important.

Malpractice insurance rates for physicians skyrocketed in about 2001, but not because jury awards went wild. The insurance premiums jumped because the tech stock bubble burst, and insurers rasied rates to replace former stock market earnings.

In my state we passed a laws capping juy awards , and healthcare costs and malpractice insurance rates were largely unaffected.

[jpatter666]

Re: Lightning round

I would respectfully argue that jury awards for medical malpractice are well-proven to be not important.

Malpractice insurance rates for physicians skyrocketed in about 2001, but not because jury awards went wild. The insurance premiums jumped because the tech stock bubble burst, and insurers rasied rates to replace former stock market earnings.

In my state we passed a laws capping juy awards , and healthcare costs and malpractice insurance rates were largely unaffected.

Interesting, thanks for the comment. Speaking from my own experience in that I'm seen several of these cases locally where all I could do was shake my head at the innate lunacy....

[D-Mack]

Re: Lightning round

I wonder how this DTC advertising has affected costs and effectiveness, since it's uncommon here in Europe. 14% doesn't sound too bad

DIRECT TO CONSUMER

Direct to consumer advertising (“DTC”) is the name given to advertising prescription drugs in magazines, newspapers and television. Prior to 1997, the FDA rules said, “Advertisements promoting the medical use of prescription drugs must contain a "brief summary" of all important information about the advertised drug, including its side effects, contraindications and effectiveness. In addition, advertisements broadcast over radio, TV or through telephone communications systems must include a "major statement" prominently disclosing all of the major risks associated with the drug.”

Prior to August of 1997, print advertisements for prescription drugs were able to meet the "brief summary" requirement by including the risk-related sections of drug labeling together with the advertising copy. As the drug companies looked wistfully at the enormous marketing potential of television, they saw that there was no way to provide the required information about the drug in 30 second or one minute television ads.

Did Congress act? No, the FDA made the August 1997 rule change quietly and without consulting Congress or really anyone else. Their change allowed the drug companies to “...include information about any major risks, as well as instructions for how consumers can easily obtain more detailed information about the drug's approved uses and risks.”

FDA Lead Deputy Commissioner Michael J. Friedman, M.D was one of the driving forces behind this change long sought by the drug companies. Dr. Friedman said in 1997, "Today's action can help promote greater consumer awareness about prescription drugs. By describing realistic standards for television advertising of prescription drugs, we hope to end the uncertainty which has plagued both consumers and industry about the use of this medium. The FDA is committed to making sure that accurate and complete information is available to consumers."

In the 1997 rule revision, the FDA “...presumes that the broadcast ad is truthful, not misleading, and contains information about the major health risks associated with the drug.


...

RESULT

According to the Government Accounting Office (report no. GAO-07-54, December 14, 2006):

“In the past decade, drug companies have quadrupled expenditures on ads aimed at consumers. Spending on direct-to-consumer advertising increased by 296.4% from 1997 to 2005, during which time spending on promotion to physicians increased by 86.0% and spending on pharmaceutical research and development increased by 103.3%.”

In an article entitled, Direct-to-Consumer Advertising of Prescription Drugs published in the August of 2007 issue of Journal Watch, Dr. Allan S. Brett, MD summarized the findings of his study of DTC advertising of prescription drugs on television. Dr. Brett concluded that:

Total spending on DTC advertising in the U.S. increased from about $1 billion in 1996 to $4 billion in 2005; DTC advertising represented about 14% of drug company promotional expenditures in 2005.

..

http://novusdetox.com/press/dependen...include=138402

[Starving Steve]

Re: Lightning round

Perhaps it is not insufficient government involvement that ails Americans, but

• fraudulent government involvement with a few large corporations making too much money on sick care,
• with profits in proportion to how many fear mongering symptoms can be identified and symptomatically treated in perpetuity,
• avoiding identifying or removing the actual causes of illness,
• promoting practices (such as high fructose corn syrup, mercury fillings, fluoridated water, abusive GMO, ...) that cause further illness,
• funding research to support the above,
• suppressing research to the contrary,
• subsidizing unhealthy (but profitable) farming and nutrition, while
• suppressing healthy farming and nutrition alternatives.

The human-body and all living-things have evolved through a billion of years of evolution to tolerate and thrive on this planet, even with oils, radiation, germs, viruses, heavy metals, salts, fluorine, asbestos-like substances, uranium, lead, chlorine, potassium, plutonium, radium, plutonium, arsenic, mercury, plant cyanides, selenium, iodine, dust, dirt, filth, acids, etc.

Everything is a health-risk. Even living is health-risk. And guess what: no-one comes out of this game of life living beyond death. Everyone is a loser in this game.

The entire eco-movement is nuts, and it always was nutty. The eco-bunch is un-scientific and illogical in the sense that almost everything on this planet, nearly all of the poisonous elements included, are needed to sustain life on this planet.

[D-Mack]

Re: Lightning round

dosis facit venenum

[flintlock]

Re: Lightning round

It is very hard to measure fully the impact of malpractice on medicine. The degree of sometimes ridiculous steps taken just to avoid lawsuits is an example. How much time will a lawsuit cost a well paid doctor OFF the job? Malpractice has created a huge industry in just avoiding lawsuits. Medicines and procedures are over prescribed at times, in an attempt to CYA. It's not as simple as just looking at Malpractice insurance premiums. And its not just medicine, but a lot of industries are affected by the high cost of our legal system. This ridiculous quest for a Utopian world of perfection leaves us were less can actually afford decent care. The road to Hell as they say, is paved with good intentions.

[thriftyandboringinohio]

Re: Lightning round

It is very hard to measure fully the impact of malpractice on medicine. The degree of sometimes ridiculous steps taken just to avoid lawsuits is an example. How much time will a lawsuit cost a well paid doctor OFF the job? Malpractice has created a huge industry in just avoiding lawsuits. Medicines and procedures are over prescribed at times, in an attempt to CYA. It's not as simple as just looking at Malpractice insurance premiums. And its not just medicine, but a lot of industries are affected by the high cost of our legal system. This ridiculous quest for a Utopian world of perfection leaves us were less can actually afford decent care. The road to Hell as they say, is paved with good intentions.

Your point could be correct to some degree, even to a large degree.
But when studies examine the growth rate of medical malpractice awards, they find them pretty steady. Such jury awards aren't growing like crazy.
The cost of medical insurance, malpractice insurance, and medical services ARE growng like crazy.
Therefore lawsuits aren't the driver for soaring healthcare costs.

But to insurance companies and physicians, the lawsuits are infuriating, even if they aren't getting worse.
At every chance physicians and insurers raise the issue and try to get relief -I would, too, if I were them.

But that doesn't mean it's important to the overall soaring cost for healthcare, and we shouldn't consider it an effective solution that will control the the rising price of healthcare.

[Munger]

Re: Lightning round

Med. mal. is dead / dying, thanks to various state-level tort reforms. God forbid, if you should get catastrophically injured from true negligence, you will quickly learn that it is a struggle to even find a good attorney who will take your case. It just isn't worth it. Might as well stick with commercial litigation -- at least the damages aren't capped.

There are always anecdotes / horror stories (often made up). I would also advise you to hold your criticism until you see some of the heartbreaking cases of true negligence that are out there that get turned down now.

(Also -- why does it seem like the so-called libertarians the ones also advocating tort reform? You do realize that in the libertarian fantasy-land, damages between private parties are supposed to be taken care of through such a system, correct? And that "tort reform" is just code for "arbitrary damages cap"? Or do you not actually care about equal justice under the law, but rather your own ephemeral gut-feeling of "justice"...)

[mooncliff]

Re: Lightning round

1 )
5 ) Lack of exposure to other systems. This actually is important -- many Americans never go to other countries (size of US and really requires a major trip to do so)

When I was in New York, I was astonished at how many people had never been out of the New York New Jersey Connecticut area. These were 20-somethings who were by no means poor. The had never even been to Philadelphia, just an hour or two away by car. I thought this was very strange.

I think 90% of Americans don't have passports? In many ways the biggest island in the world. We never actually go to see what the rest of the world is like. Something like China in 1500, we are the center of the world and no one else has anything to offer. Which was more or less true for a short period after WWII, but surely from the 70s it was clear that that would not last. But if all you do is watch US TV, that still seems tenable.

Japan's NHK broadcasts news programs from around the world daily, with audio translation or running subtitles. Fascinating to watch because suddenly all dem fureners seem real... and human...

In Japan, a few things that are happening that I guess get zero airplay in the US:

The bullet train line was extended to the northern end of Honshu so now runs from there to Kagoshima, which is over 2,000 km, I think.
http://www.google.com/hostednews/afp...e9c9b81c86.441
http://en.wikipedia.org/wiki/Shinkansen
http://www.yomiuri.co.jp/dy/business/T101125005000.htm

Tokyo Sky Tree tower nearly finished
http://www.japantoday.com/category/n...g-construction

I went to the Opening Ceremony of the Beijing Olympics. The new construction is unbelievable. The air is unbreathable. The row houses on the west side of the Forbidden City still have dirt floors. The new shopping mall is bigger and better than any I have seen. The younger people are tall and in glowing good health. They have cell phones.
You just can't understand those things by flipping through National Geographic.

[oddlots]

Re: Lightning round

So far so good (trepidation)...

Regarding the health care story in the US I found these pieces incredibly rewarding:

http://www.thisamericanlife.org/radi...1/more-is-less

http://www.thisamericanlife.org/radi...ne-elses-money

(You can listen to them for free on the net; it only costs to download them.)

Spectacularly good, honest journalism IMHO. (The idea that anyone could oppose NPR and PBS given the quality of the work is testament of how mad politics has gotten. Lunacy: Frontline is the gold standard of investigative journalism. So give Goldie some money.)

[oddlots]

Re: Lightning round

But back to the original question, what are the arguments or behaviour amongst those you feel politically or philosophically opposed to that seem the most perplexing, suspect or dishonest? Could generate some progress.