RomneyRyan 2012!

[Aimless]

“I'd make sure that Ahmadinejad is indicted under the Genocide Convention. His words amount to genocide incitation. I would indict him for it.”

— Romney

Romney appears to referring to the Iranian president’s alleged statement that he would “wipe Israel off the map.” But, as we have noted, there is actually some dispute about what Ahmadinejad said, which would make a prosecution difficult. (The Fact Checker even gave himself a Pinocchio for blithely repeating this claim in his book on Condoleezza Rice.)

Indeed, the Convention on the Prevention and Punishment of the Crime of Genocide lists very specific acts, none which include mere threats:

“With intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such killing members of the group; Causing serious bodily or mental harm to members of the group; Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part; Imposing measures intended to prevent births within the group; Forcibly transferring children of the group to another group.”

But there is another interesting wrinkle to this pledge. Presumably such a prosecution would have to be done via the International Criminal Court — which the United States under George W. Bush refused to accept. (UPDATE: Romney aides confirmed he would bring such a case via the ”World Court,” which can only mean the ICC. This is surprising given that one of his top foreign policy advisors, John R. Bolton, is such a foe of the ICC.)

Clever way to steal the internationally minded Democrats' votes

[Flixy]

That's, err, interesting. Not the first time I've seen americans wanting basically the ICC as long as they ignore the USA itself.

[GGT]

My point is that Obama is being dishonest when it comes to people keeping their employee healthcare.

People will keep their employer-subsidized insurance as long as employers can use those costs as tax deductions. That was part of PPACA 'negotiations' with insurance lobbyists, and large employers. But that will change over time -- as tax deductions are limited in order to balance budgets and pay deficits. If the deductions are kept, they'll be for individuals and not corporations. It will also change after 2014 when private insurance exchanges are up and running (also part of the 'negotiations').

Decoupling insurance from employment is a good idea because (a) more people are self-employed or work for small businesses (b) people need to be mobile and flexible and take their insurance with them (c) it levels the playing field in premium pricing between large corporates and individuals, and reduces buried cost-shifting, and (d) will free employers from that expense, hopefully leading to higher wages.

I don't see how it limits employee mobility or sticks them with expenses foreign companies don't have.

US companies can compete for talent with health care and deduct their health care costs. Meanwhile, companies that operate in markets with socialized medicine have to pay higher taxes to support those systems.

Those corporate tax deductions are up for review. Many mega multi-national corporations can/do categorize their subsidiaries or franchises as "independent small businesses", to avoid employer-subsidized insurance for everyone but their executives and CEOs (see hotel industry).

And don't forget the US has lost plenty of big international contracts (see auto industry) to Canada, because it's easier and simpler to pay known taxes that provide health services for everyone....than fiddle with hundreds of insurance vendors, HR liaisons, labor advocates, escalating and unknown costs....for a specific group.

[Dreadnaught]

Job-lock related to insurance portability is probably a bigger problem/concern among those who have anything that can be classified as a "pre-existing condition" and esp. among those who are a little more replaceable. For the more fortunate, portability seems to be more of a short-term concern.

If you have a job with health care coverage, and you are married and you have children, the loss of that health care coverage is a big deal. You might move from one company with benefits to another, but you're not going to do anything risky like start a business. Nor will you take a leave of absence to work on an advanced degree or something. Maybe its more about limiting risk and innovation than portability?

Regarding the socialized medicine - it's more efficient than our fractured for profit health care and that cost is spread over a large base - an entire nation. Our health care system is just not cost competitive with socialist systems.

You're [partially] correct. My statement about job portability was incorrect and inconsistent with my previous views, as I do think employer-based health insurance does have substantial drawbacks. This is why I have always supported eliminating the barriers/distortions to the individual health insurance market.

That said, in a properly functioning insurance market, I think employers offering to subsidize health care could still be a work incentive.

However, to the argument that socialized medicine is more efficient and somehow makes countries with socialized medicine more economically competitive than the US: Sorry, but I find that laughable for reasons we've all gone over before/seen in the streets of Athens and the credit ratings of France.

[Aimless]

You're [partially] correct. My statement about job portability was incorrect and inconsistent with my previous views, as I do think employer-based health insurance does have substantial drawbacks. This is why I have always supported eliminating the barriers/distortions to the individual health insurance market.

That said, in a properly functioning insurance market, I think employers offering to subsidize health care could still be a work incentive.

However, to the argument that socialized medicine is more efficient and somehow makes countries with socialized medicine more economically competitive than the US: Sorry, but I find that laughable for reasons we've all gone over before/seen in the streets of Athens and the credit ratings of France.

Look your touristy cherry-picked anecdotes have no value here. Overall modern western nations with heavily socialised systems tend to make much more efficient use of their healthcare budget. This is not simply an opinion, it's about as close to a fact as you can get in this area. In many/most important ways they are also equally or more effective, but that's more controversial a claim. It's possible that this does not make those other countries more competitive, but that's a tangential issue. The US isn't more competitive as a nation because of its extraordinarily wasteful healthcare system; if anything, it's competitive in spite of its healthcare system. The appropriate comparison is not with a failed state like Greece, it's with the US itself.

[Aimless]

And it's possible you misread Chacha's post. If not, then, like, wtf :-O

[Dreadnaught]

We've agreed to disagree on this on this in the past. No need to pretend you have a monopoly on "facts" that support your view.

[Aimless]

We've agreed to disagree on this on this in the past. No need to pretend you have a monopoly on "facts" that support your view.

We have not agreed to disagree, although you may have unilaterally agreed with yourself to pretend that these particular facts are matters of opinion.

Some may say that socialised healthcare systems have unfair advantages that let them be more efficient and get more bang for the buck, and some may highlight aspects that they see as unjust or otherwise terrible. But the matters of efficiency and efficacy have been thoroughly examined by many, many researchers and it is no longer a matter of opinion among people in the know that even wasteful socialised healthcare systems use their money more efficiently than the US as a whole (including the socialised portions of the American healthcare system) and usually at least as effectively.

There is considerable disagreement about the hows and whys and the solutions (eg. who should pay, or if that even matters), but wrt the first two questions there is a fair amount of consensus too. We may agree to disagree on realistic solutions to these American problems, but its ridiculous for you pretend that the problem itself doesn't look the way it really does.

[Timbuk2]

Largely irrelevant in terms of the upcoming election, but for your digestion:






France is the most strongly pro-'Bama.

Pakistan is the only country that would prefer to see Romney win.

[Catgrrl]

Those Romney supporters claim "We don't care what the rest of the world thinks!" Ugh.

[Steely Glint]

I like that Kenya is the most pro Romney out of all the foreigners.

[Loki]

Those Romney supporters claim "We don't care what the rest of the world thinks!" Ugh.

Do you really want to elect a president based on some vague international surveys?

[GGT]

My statement about job portability was incorrect and inconsistent with my previous views, as I do think employer-based health insurance does have substantial drawbacks. This is why I have always supported eliminating the barriers/distortions to the individual health insurance market.

That said, in a properly functioning insurance market, I think employers offering to subsidize health care could still be a work incentive.

But we don't have a 'properly functioning insurance market'. We have an insurance industry with a monopoly over our healthcare industry. Employer subsidies are used as lures because people KNOW the individual market is unaffordable. And that's (in part) because large employers have out-sized influence in negotiating premiums and coverage at special group rates. Groups that individuals can't join. That's a rigged market.

It's crazy that workers are forced to choose an employer based on benefit packages (teh goodies) instead of career opportunities, work environment, or wages/salary.

However, to the argument that socialized medicine is more efficient and somehow makes countries with socialized medicine more economically competitive than the US: Sorry, but I find that laughable for reasons we've all gone over before/seen in the streets of Athens and the credit ratings of France.

Dude, the US already has socialized medicine. Don't kid yourself. Your premiums and employer-subsidies don't begin to cover all the true costs of care, but are shifted into the greater pool of unfunded reimbursements, where everyone else picks up the slack.

Look your touristy cherry-picked anecdotes have no value here. Overall modern western nations with heavily socialised systems tend to make much more efficient use of their healthcare budget. This is not simply an opinion, it's about as close to a fact as you can get in this area. In many/most important ways they are also equally or more effective, but that's more controversial a claim. It's possible that this does not make those other countries more competitive, but that's a tangential issue. The US isn't more competitive as a nation because of its extraordinarily wasteful healthcare system; if anything, it's competitive in spite of its healthcare system. The appropriate comparison is not with a failed state like Greece, it's with the US itself.

[Loki]

Some may say that socialised healthcare systems have unfair advantages that let them be more efficient and get more bang for the buck, and some may highlight aspects that they see as unjust or otherwise terrible. But the matters of efficiency and efficacy have been thoroughly examined by many, many researchers and it is no longer a matter of opinion among people in the know that even wasteful socialised healthcare systems use their money more efficiently than the US as a whole (including the socialised portions of the American healthcare system) and usually at least as effectively.

I call BS.

[GGT]

He probably means data like infant/maternal mortality, vaccinations programs, access to Family Planning, general health/co-morbidity, longevity....

[GGT]

[Loki]

He probably means data like infant/maternal mortality, vaccinations programs, access to Family Planning, general health/co-morbidity, longevity....

Yeah, the factors that are influenced far more heavily by environmental factors than by the quality of healthcare. How about looking at the factors directly affected by healthcare (medical outcomes)?

Just had more evidence about how great socialized medicine is. My fiancee (who lives in England) had a severe ear pain for a month, went to see her doctor about 4 times and to A&E several times. They haven't figured out what's wrong but are unwilling to have her undergo a single test. I have relatively minor pain in my toe. Went to see doctor. Got an X-Ray and blood test within 2 hours. In case you're wondering, that trip (along with some painkillers that I received) cost me a grand total of nothing.

[Aimless]

I call BS.

You've tried to call bs before and have on the whole been shown the error of your ways. There are many areas of American healthcare that are bizarrely unjustifiably ineffective, not only from the public health perspective but from the individual perspective. That's not to say that other countries don't have many problems too but your attempts to whitewash American healthcare in this way is misguided and does no-one any favours. The potential is there for extraordinarily effective healthcare, and there is a movement towards spreading effective healthcare strategies while cutting out ineffective ones, but it's not as widely available as it can/should be. This should not be a surprise to you given the many competing goals, where the drive to provide effective care may have to be balanced against the drive to eg. effectively make more money. I will concede that having a decent insurance and good doctors and good waiting times and a good employer and a good salary and a good disease may come with advantages. A number of problems can probably be solved more effectively in the US and well done on those, but let's not lose sight of the big picture.

[Loki]

The big picture being that if you're insured and get sick in the US, you're going to get a world class treatment, even though it might bankrupt you. In many European countries, you will never get a world class treatment for a complex disease, whether you're willing to pay for it or not. I know which of the two I'd prefer.

[Aimless]

Yeah, the factors that are influenced far more heavily by environmental factors than by the quality of healthcare. How about looking at the factors directly affected by healthcare (medical outcomes)?

Just had more evidence about how great socialized medicine is. My fiancee (who lives in England) had a severe ear pain for a month, went to see her doctor about 4 times and to A&E several times. They haven't figured out what's wrong but are unwilling to have her undergo a single test. I have relatively minor pain in my toe. Went to see doctor. Got an X-Ray and blood test within 2 hours. In case you're wondering, that trip (along with some painkillers that I received) cost me a grand total of nothing.

So what tests and procedures are you keen on for your fiancée and what was the outcome of your workup?

[Loki]

So what tests and procedures are you keen on for your fiancée and what was the outcome of your workup?

They mentioned an MRI would help, but didn't want to have her undergo go it for what are presumably cost reasons. Apparently, it's preferable to see a patient come back time and time again and use up the doctor's time because the doctor is unwilling to do anything useful.

My tests didn't point to a specific problem, but they ruled out many possibilities.

[Aimless]

The big picture being that if you're insured and get sick in the US, you're going to get a world class treatment, even though it might bankrupt you. In many European countries, you will never get a world class treatment for a complex disease, whether you're willing to pay for it or not. I know which of the two I'd prefer.

I call BS. I call BS esp. because I live in a European country and work at a clinic that routinely has to offer world-class treatment at great expense to the county. I invite you to consider the significant geographical variation that exists in the US and also seriously consider whether or not you're obsessing over outliers. The latter esp. because in any other context you'd be the first to throw out a snarky/condescending/arrogant comment to punish someone who's obsessing over outliers at the expense of the real big picture.

[Flixy]

The big picture being that if you're insured and get sick in the US, you're going to get a world class treatment, even though it might bankrupt you. In many European countries, you will never get a world class treatment for a complex disease, whether you're willing to pay for it or not. I know which of the two I'd prefer.

Just a few quick thoughts here - first of all you keep comparing the US to the UK. I've said it before, as have many others, even over here we look down on the UK's healthcare I think Obamacare is closer to Swiss/Dutch (and possibly other) systems, so you might want to compare to that. Second, how rare and complex diseases are you talking about? For example, it would be nice if you get a cure for an extremely rare disease, but to be honest I think it's more important that a larger portion of the entire population has access to more basic healthcare. Probably saves more lives, too. Figures are hard to compare anyway, some nations are better at certain areas than others, and there's also cultural differences (e.g. childbirth problems are bigger here because people prefer to give birth in their own home). And I would, again, like to point out that in our system you're always free to pay extra for better treatment/service, or take extra insurance for better coverage on stuff like that. But my point is: is it better to have the best healthcare for a portion of your society, or to have nearly the best, but for everyone?

Would also like to add that when I had a relatively minor (but lasting) pain in my ankle a while back, I went to see the doctor and also got an immediate X-ray (no blood test, but in my case that was unneeded anyway since it was from a fall), also within 2 hours, also for the grand total of nothing.And in my socialized medicinal paradise, I do have insurance at a private insurance company, with added benefits through my dad's employer, so that can still exist. And both the doctor and the hospital I visited are privatized, too.

edit: and we can change doctors, too, if we are unhappy with ours.

[Aimless]

They mentioned an MRI would help, but didn't want to have her undergo go it for what are presumably cost reasons. Apparently, it's preferable to see a patient come back time and time again and use up the doctor's time because the doctor is unwilling to do anything useful.

My tests didn't point to a specific problem, but they ruled out many possibilities.

There are a lot of reasons for holding the MRI beyond simple cost, chief among them being that it's almost certainly not "best practice" at this stage and for this young otherwise healthy woman (without knowing more details of the sort that eg. her PCP may know) even in the US. There are several steps before actually ordering the MRI, one of which is watchful waiting and another effective information about eg. pain-relief (if possible), provided she's had a basic ear exam. If she's bothered she can and should request advice on pain-relief and get an explanation for why she hasn't been referred for an MRI. Dollars to donkey-poop there's more to the waiting beyond simple cost and possible laziness, more likely that the MRI at this stage simply isn't a good tool for ruling anything in or out.



Without knowing more about your particular case it's hard to say whether or not those tests are effective at ruling anything in or out but I've certainly never had a problem getting a swift x-ray and basic bloodwork except when we've been swamped with true life-threatening emergencies, which is always a possibility whenever you go to the ER in any country :P

[Aimless]

Yeah, the factors that are influenced far more heavily by environmental factors than by the quality of healthcare. How about looking at the factors directly affected by healthcare (medical outcomes)?

Some of the most important causes of preventable infant mortality in the US are indeed directly affected by healthcare, even if socioeconomic factors play part (as they do in healthcare that involves people). An illustrative albeit perhaps not always relevant example is the negative impact in outcomes you get when there's a proliferation of highly profitable neonatal ICUs that individually get too little volume.

[Ominous Gamer]

The big picture being that if you're insured and get sick in the US, you're going to get a world class treatment, even though it might bankrupt you.

This should say "until it bankrupts you." Cancer treatments take years, plenty long enough for those expecting checks to figure out when payment has stopped.

[Nessus]

Theology of Wealth says Loki wouldn't be bankrupt under any circumstances, and FYGM

Never mind that the idea a budding cancer patient could just walk into an ER somewhere and receive "world class treatment" and oh hey they only got bankrupt in the exercise, what is this nonsense. Okay maybe when you're counting out change to Charon you might end up somewhere with "world class treatment" but how about some preventive care bitches, how about having avenues to explore your general condition before MAYDAY MAYDAY I AM BLEEDING OUT OF SEVERAL ORIFICES. Like Loki says, I too would surely like "world class treatment" when I am bleeding out of several orifices, but maybe, just may be, a whole bunch of poor folks would like to avoid bleeding out of several orifices to begin with.

[Loki]

I call BS. I call BS esp. because I live in a European country and work at a clinic that routinely has to offer world-class treatment at great expense to the county. I invite you to consider the significant geographical variation that exists in the US and also seriously consider whether or not you're obsessing over outliers. The latter esp. because in any other context you'd be the first to throw out a snarky/condescending/arrogant comment to punish someone who's obsessing over outliers at the expense of the real big picture.

Do you not realize the massive selection bias you're dealing with? The only people you see are the ones getting treatment. You don't see the people who need treatment but don't get it.

There are a lot of reasons for holding the MRI beyond simple cost, chief among them being that it's almost certainly not "best practice" at this stage and for this young otherwise healthy woman (without knowing more details of the sort that eg. her PCP may know) even in the US. There are several steps before actually ordering the MRI, one of which is watchful waiting and another effective information about eg. pain-relief (if possible), provided she's had a basic ear exam. If she's bothered she can and should request advice on pain-relief and get an explanation for why she hasn't been referred for an MRI. Dollars to donkey-poop there's more to the waiting beyond simple cost and possible laziness, more likely that the MRI at this stage simply isn't a good tool for ruling anything in or out.

Without knowing more about your particular case it's hard to say whether or not those tests are effective at ruling anything in or out but I've certainly never had a problem getting a swift x-ray and basic bloodwork except when we've been swamped with true life-threatening emergencies, which is always a possibility whenever you go to the ER in any country :P

They didn't even want to give pain relievers. She's also had a different problem recur in the US and UK. In the US, the medical office did a quick test ($300 that was waived) and figured out the problem (and dealt with it); in the UK, they refused to do any tests and told her to go home on multiple occasions.

I know for a fact that X-Rays are given only in hospitals/large A&Es in England, and getting one could take anywhere from weeks to months (unless it's a very clearly broken leg or something).

[Nessus]

Can't see my death panel, foo, I'm a panel yo ass to wait what

[Loki]

They already have death panels in the UK; google for BBC articles where people aren't given access to existing treatments just because the government decided that their chance of survival isn't great (i.e. 10%, not 0.1%).