[ExI] Private and government R&D [was Health care in the USA]

[Mirco Romanato]

Stathis Papaioannou ha scritto:
> 2009/7/20 Mirco Romanato <painlord2k at libero.it>:
> 
>>> Charity is fickle and demeaning, although better than nothing.
>> Charity is fickle mainly because don't give blindly to anyone 
>> asking without minding at the real needs.
> 
> Actually, the government can and does do means tests, while charities
>  can't or don't want to and don't.

Yes. We know how good they are to doing checks.
They are very good at managing our money.
Look at this example:
http://gatewaypundit.blogspot.com/2009/07/government-spends-150-per-pound-on.html

>>> Government Spends Millions On $1.50 Per Pound "Stimulus" Ham That
>>>  Costs $.79 Per Pound
>> 
>>> Agriculture Secretary Tom Vilsack responded to the Drudge Report
>>> item today that the government is spending millions of dollars on
>>> sliced ham.
>>> 
>>> Response to Drudge Item on Recovery Act Funding
>>> 
>>> Statement from Agriculture Secretary Tom Vilsack
>>> 
>>> "Through the Recovery Act, the U.S. Department of Agriculture has
>>>  made $100 million available to the states for The Emergency Food
>>>  Assistance Program (TEFAP), which acquires food that is
>>> distributed to local organizations that assist the needy –
>>> including food banks, food pantries, and soup kitchens.
>>> 
>>> The Recovery Act funds referenced in press reports allowed states
>>> to purchase ham, cheese and dairy products for these food banks,
>>> soup kitchens and food pantries that provide assistance to people
>>> who otherwise do not have access to food. This program will help
>>> reduce hunger of those hardest hit by the current economic
>>> recession.
>>> 
>>> The references to "2 pound frozen ham sliced" are to the sizes of
>>> the packaging. Press reports suggesting that the Recovery Act
>>> spent $1.191 million to buy "2 pounds of ham" are wrong. In fact,
>>> the contract in question purchased 760,000 pounds of ham for
>>> $1.191m, at a cost of approximately $1.50 per pound. In terms of
>>> the dairy purchase referenced, USDA's Farm Service Agency (FSA)
>>> purchased 837,936 pounds of mozzarella cheese and 4,039,200
>>> pounds of processed cheese.
>>
>> Slice ham costs $.79 per pound at Food Lion.

Who guess where the other $.71 per pound went?

>>> In Canada, you pay less tax for public health care per capita 
>>> than you do in the US and you get high quality universal health 
>>> care, with minimal need to rely on charity or private insurance. 
>>> Why is the Canadian system so much more efficient?
>> Because they rationed the health care. 
>> http://edition.cnn.com/2009/POLITICS/07/06/canadian.health.care.system/index.html

> They ration health care so that those with immediate needs can get 
> treated first.

Really?
I'm sure that the immediate relatives of politicians, medics and their
friends have an advantage in this system. I'm sure politicians jump the
queue legally or illegally. The same is for physicians connected.
Do you ever hear a politician lament the fact to be unable to have a
surgery done on time?

Could be a coincidence that from the Health Care Plan of Obama the
lawmakers are exonerated and are able to keep their current plans?



> I don't know the details of the problem you have 
> alluded to: perhaps it was a slow-growing adenoma that didn't require
> immediate surgery, otherwise they would have just done it. And if 
> something like this happens and is in fact medically negligent, it 
> makes the news and there is a public outcry, so the situation may get
>  rectified.

She had no access to a specialist to tell them. Simple as is.
She went to the Mayo Clinic in the United States, the doctors there did
the diagnosis and tell "remove the tumor immediately".
She had vision problem because the tumor pressed against the optic
nerve. As a nurse working in a psychiatric ward I understand that a
tumor pressing against the optic nerve is urgent to treat. Maybe not
tomorrow, but ASAP. Four months and six months are enough time a brain
tumor could grow 50% in size. If is slow growing it could grow 20% in
size. But if it is already pressing against the optic nerve it could be
enough to leave her blind. This is to see the specialists, not to have a
surgery.



> The public health system is *accountable* to its users, 

How much accountable?
The managers are fired? The doctors are fired?
They lose their car, home and go in jail for mismanagement?
Where you live? OZ?

Public health systems are structured so management is irresponsible for
outcome.

> the Canadian population. If she needed the surgery but didn't have 
> the $100,000 (which sounds like a total ripoff to me, but anyway) in 
> a wholly private system, then what would have been the use of 
> complaining to anyone? Rationing on the basis of income rather than 
> on the basis of medical need is still rationing!

This is what private insurances are for.
You insure against big bad outcomes.
Like you insure your car against damages caused to others for 1 Million
or more.

> IN any case, this misses my point about the Canadian *public* health
> system being cheaper than the US *public* health system. If you are
> a Canadian taxpayer and use the US private health system, you are 
> still better off than if you are an American taxpayer and use your 
> own private health system. And yet the cheaper Canadian system is 
> universal, while the US one is not.


> Waiting lists are monitored and if the wait is unacceptable 
> money/people are shuffled around or (as a last resort, usually) extra
> money is provided to rectify the problem.

How fast?
Years after the need surfaced?
How they are able to shuffle money/people around when they are always
severe understaffed and underfunded.

> In the Australian state 
> where I live it is sometimes faster to get a joint replacement in the
>  public than in the private system, but the wait for a cataract 
> operation is much longer in the public system. I guess they may move
>  resources from orthopedics to ophthalmology to compensate, although
>  the respective specialists will argue that their field is more 
> important. In theory you could have teams of surgeons around every 
> corner scrubbed and ready to operate whenever the fancy takes you, 
> but that would be enormously expensive and wasteful, and people have
>  decided they only want to pay so much for health care in total.

People have decided?
Politicians have discovered that they can not extract more money without
consequences for themselves.

Mirco