Views of Health Care Economics from a CEO Named Bush

[RandBlade]

Your questions do not establish any kind of qualifier on the amount of demand. They're simply building the framework. As such, they're strawmen. You do not seem to understand your own argument.

No, they are not strawmen. You claimed that you got unlimited medicine free thus negating my claim, I said that there are limits to what you get thus not invalidating my claim. Your claim that your situation "refuted" what I said is wrong.

[Aimless]

Disagreed with the idea its easier to say no when its free, its easier to say no when its not free - because people don't ask.

When it's not free people don't have to ask, they just have to pay.

Don't worry about the availability of healthcare, Science will keep us ahead of the game

[Aimless]

If so are all drugs available to you? EG regularly in the UK there are stories about drugs, especially expensive experimental drugs or drugs with low success rates (but higher than not having the drug)

Yeah look issues of costs aside there are good reasons for not paying through the nose for drugs of dubious efficacy with that said consider how many suffer from the problem you describe compared to how many more suffer because they don't have the time or money for basic health care. Also consider just how many would have access to the unmagic drugs you describe without your NHS

Can you get IVF etc on-demand whenever you feel you need it?

Why would you? Waiting for IVF has both medical and economical reasons.

Ditto for any forms of cosmetic surgery?

Why would you? What does that have to do with healthcare, in the general case?

Hell even just 1 or 2 I doubt you really get.

Sometimes I get upset because I can't give birth to a panda but then I remember that it doesn't matter

[Lewkowski]

By physicians' expert advice. For example, that means I want doctors to know how much it costs to keep a terminal patient alive for just two more weeks, and can discuss the pros and cons with the patient, and what costs mean. I also want doctors who don't give up on patients who could live two more years, just because insurance won't pay for their care. And I don't want them to punt to another service, because they're no longer being compensated.

So who pays the physicians?

[Aimless]

The Europeans

[Hazir]

IVF on demand? Half of these people wouldn't have a problem getting children if they wouldn't have put their careers before their reproductive desires. Then, when they've made enough money to satisfy their material 'needs' they turn around and want society to pay up for their inability to make children. Incredible really.

[Nessus]

Uhhh

If one wants an academic career or any higher education, really, having kids isn't a realistic (or sensible) option until one's past 30

And not everyone does it out of some 'material need' or whatever Manichean bull-crap

[earthJoker]

I mostly agree with Khendraja'aro here. Health care is a very inelastic good at least for treatments that are really needed.

[Khendraja'aro]

No, they are not strawmen. You claimed that you got unlimited medicine free thus negating my claim, I said that there are limits to what you get thus not invalidating my claim. Your claim that your situation "refuted" what I said is wrong.

I didn't claim that I got "unlimited medicine". I even said that medicine is a limited ressource and that demand is probably higher than what is available.

I spoke against your argument that demand for medical procedures was infinite.

Because at the moment, I have neither the desire nor the need to visit a physician. I expect that other people feel the same due to having absolutely no health complaints. Thus here we have a boundary: If you're feeling healthy, you have next to no medical demand (aside from my semi-yearly visit to the dentist and a yearly checkup with a dermatologist (to prevent skin cancer)).

When I am ill, I go to the doctor and ask for her opinion, choosing from and accepting the treatment options she gives me. As of the present, I have yet to feel inadequately treated. Again, we find a boundary: As soon as I feel treated, my demand sinks to zero.

My mother was in the ICU after giving birth to my youngest brother. Did that mean that she put an infinite demand on the hospital's ressources? Nope, again a boundary: There's only so much you can do, even in the ICU.

All examples of people with a limited demand on medical ressources, even when the limit can be set pretty high. And now you're telling me that when we add up all those people (even going so far as to add elective cosmetic surgery into the equation!), the demand will be infinite?

Last time I looked, adding up finite numbers a finite time still doesn't make the result infinite.

Hell, even if I got access to unlimited medicine I wouldn't know what to ask for - because I don't need it.

[Aimless]

Of course you know what to ask for, Khen. Search your pants, you know it to be true...

[earthJoker]

We ruled out plastic surgery several times already. And I suppose Khen is to young for the blue pills.

[RandBlade]

Yeah look issues of costs aside there are good reasons for not paying through the nose for drugs of dubious efficacy with that said consider how many suffer from the problem you describe compared to how many more suffer because they don't have the time or money for basic health care. Also consider just how many would have access to the unmagic drugs you describe without your NHS

This is not an argument against an "NHS" of some form, its an argument that even with the NHS there will always be limits and there will always be demands of some form that fall outside those limits.

As for "costs aside" the point is you can't put "costs aside", drugs like herceptin which there's been controversies over regarding the NHS denying to patients who needed it were not denied because (A) they don't work, (B) there are too many side-effects or (C) they're not proven but (D) because they cost too much for the possible benefit making it "uneconomical". People have died who wouldn't have died due to that drug because the NHS can't afford it. Had the drugs cost 50p each you can bet they'd have been available.

Why would you? Waiting for IVF has both medical and economical reasons.

On the NHS you can now get IVF but there are restrictions on it. Infertility is reasonably an illness that can be treated via IVF, almost without limits.

Why would you? What does that have to do with healthcare, in the general case?

"Defects" can be regarded an illness. EG you can get breast or penis enlargements on the NHS if yours are considered very small and that it is affecting your mental wellbeing. Saw a documentary once on Channel 4 of an adult male with a 1" penis undergoing the operation. Well, where do you draw the line then? Technically abortion in the UK is only supposed to happen for those who have medical reasons to need it, but abortion on demand is essentially available here because anyone who wants it is classed as having some form of medical need for it because of mental reasons. If cost were not an issue again, anyone who wants any form of plastic surgery ... or sex change or anything related whether cosmetic or not could be classed on some form as 'needing' it.

If you have smaller breasts than your friends and its making you unhappy and bigger breasts will make you happy, do you need it? You can make a medical case for it and we already do, the point is where to draw the line ... and like abortion you can stretch that line out to "on demand".

IVF on demand? Half of these people wouldn't have a problem getting children if they wouldn't have put their careers before their reproductive desires. Then, when they've made enough money to satisfy their material 'needs' they turn around and want society to pay up for their inability to make children. Incredible really.

Irrelevant, old people wouldn't die of old-age if they weren't old but we still try to save them. Again, infertility is a medical condition that can be treated ... even if the mother and father are both in the 60's, we have the science to treat the illness.

Last time I looked, adding up finite numbers a finite time still doesn't make the result infinite.

Again, the word used was not literally.

[Aimless]

As for "costs aside" the point is you can't put "costs aside", drugs like herceptin which there's been controversies over regarding the NHS denying to patients who needed it were not denied because (A) they don't work, (B) there are too many side-effects or (C) they're not proven but (D) because they cost too much for the possible benefit making it "uneconomical". People have died who wouldn't have died due to that drug because the NHS can't afford it.

Herceptin was approved by NICE and is covered by the NHS in cases where it's actually likely to do some good assessing its benefits wasn't easy at the time of this controversy.

On the NHS you can now get IVF but there are restrictions on it. Infertility is reasonably an illness that can be treated via IVF, almost without limits.

Again, infertility is a medical condition that can be treated ... even if the mother and father are both in the 60's, we have the science to treat the illness.

Infertility isn't a single illness and neither is sub-fertility. Proper assessment might take a couple of years, and in that time it's entirely possible that the couple has a baby. That's not uncommon in couples who finally give up and try to adopt, either. There are reasons why it's not recommended to resort to IVF right from the start. As for the age restrictions, er, what's the problem?

"Defects" can be regarded an illness. EG you can get breast or penis enlargements on the NHS if yours are considered very small and that it is affecting your mental wellbeing. Saw a documentary once on Channel 4 of an adult male with a 1" penis undergoing the operation. Well, where do you draw the line then? Technically abortion in the UK is only supposed to happen for those who have medical reasons to need it, but abortion on demand is essentially available here because anyone who wants it is classed as having some form of medical need for it because of mental reasons. If cost were not an issue again, anyone who wants any form of plastic surgery ... or sex change or anything related whether cosmetic or not could be classed on some form as 'needing' it.

If you have smaller breasts than your friends and its making you unhappy and bigger breasts will make you happy, do you need it? You can make a medical case for it and we already do, the point is where to draw the line ... and like abortion you can stretch that line out to "on demand".

You can in la-la land, but in the real world you have mental health professionals and multiple alternatives for treatment that may all come before surgery, while abortions are far safer than both pregnancies and deliveries which makes them legitimate medical treatments. Regarding the 1" penis, it's not easy to have sex with one of those. Micropenis is a more legitimate medical condition than is infertility at 60.

[Khendraja'aro]

Again, the word used was not literally.

And? Do you now get to make your own definitions? That's a pretty shady tactic: Simply make up your own definitions, then move the goal post by saying: "That's not what I meant!"

That way you don't have to worry about pesky things like reality and such and get to make your own world, free of restrictions.

I don't buy it. If you're unable to post arguments without over-the-top hyperbole and redefinitions of words, then you have no business discussing here.

I'll help you here: If something is "essentially infinite" then for all intents and purposes it is to be viewed as being "infinite". And "infinite", last time I looked, means "without boundaries". I already named several boundaries, I'll name them again:

"Healthy people place no demand on healthcare."
"Most sick people are content as soon as their cases are treated as prescribed by the doctor."

However, you insist on naming some FRINGE procedures and try to paint them as being the core, center and epitome of ALL procedures. Again, dishonesty at its best.

[Hazir]

Rand, infertility in older women is not a medical condition any more than it is a medical condition that their skins don't look as fresh as when they were 20.

And Nessus, the fact that society isn't willing to own up to some simple truths doesn't make those thruths any less true.

[Nessus]

And Nessus, the fact that society isn't willing to own up to some simple truths doesn't make those thruths any less true.

Which truths might those be, then

[Hazir]

Which truths might those be, then

That women at 40 are past their prime when it comes to having children where women at 20 are not.

[Nessus]

That women at 40 are past their prime when it comes to having children where women at 20 are not.

...Yes, hence the medical assistance Though currently anything past ~43 is pretty stupid

[Aimless]

...Yes, hence the medical assistance

yes, in order to get pregnant, stay pregnant, and deliver a healthy baby without anyone getting hurt too badly. only problem is, medical assistance will only get you so far these days.

and then you'll still be stuck with a baby at age 40 although granted that doesn't HAVE to be so bad

[GGT]

Those added costs are already there and they're not going away. Congress deliberately turned its back on cost-containment as too scary for them to attempt *and in choosing to focus on expanding an already cost-accelerating system, they made it much much harder for anyone else to try and contain costs in the future* So what I see is you objecting to someone who built a business on minimizing a preexisting administrative cost.

I have little sympathy or empathy for someone who has had a revelation about the massive overheard in the industry, after screaming about how many people lacked coverage in the health-care discussions over the last few years, despite the numerous claims by others on how cost-containment needed to come first. It's a bit late.

You must have missed my criticism of both the Insurance industry AND the medical community, for letting insurance hi-jack standards of care in the name of cost containment. I've "screamed" about costs a long time, as well as physicians' reluctance to evaluate the models of delivery and payment, the business end of medicine. I've advocated for medical ethics and SOP boards for a long time, filled by medical professionals, with input from insurance adjudicators and actuarials as consultants, as technology and capability increases over time. Docs and hospitals took a "more intervention is better medicine" stance, and a reactionary response from Insurers rejecting their claims. The AMA and AHA and JCAH dropped the ball years ago.

This venture isn't really medical cost-containment. It's another layer of funds funneled to another middle man, reacting to Insurers, advising doctors how to find insurance loopholes and get more claims paid.


As for NHS----is the UK still paying for IVF for prisoners because they can't have conjugal visits, and their incarceration is interfering with what's considered a human right to start a family?