How can Obamanomics play out?

[birdog1960]

When you say you're an internist, are you "speaking figuratively" again?

 

Because when you argue that, because the US is 31st in mortality statistics, yet first in health care spending, therefore the solution is government regulation and control of health care because "that's what the countries ahead of us do", and completely ignore such simple facts such as the number one cause of death in the US - cardiovascular disease - is almost directly lifestyle-related, one can only conclude that you have absolutely no clue what you're talking about, and no real ability to put together anything resembling a coherent thought. You'd do better arguing that the government should regulate what people eat - that would go much further towards reducing health care costs and increasing lifespan than regulating health care would.

have you ever considered that lifestyle counseling might be an important part of the success of the systems beating the pants off of us. you seem to have excluded this possibility. things like home nursing education/monitoring visits for newborns and first time mothers. working to ensure the availability of healthy foods and knowledge of basic nutrition principles. wearing seatbelts and smoking cessation counselling. you exclude these things from being part the healthcare system when in fact they are more important to mortality data than having 100s of thousands of $50000+ bypass surgeries done each year.

[GG]

have you ever considered that lifestyle counseling might be an important part of the success of the systems beating the pants off of us. you seem to have excluded this possibility. things like home nursing education/monitoring visits for newborns and first time mothers. working to ensure the availability of healthy foods and knowledge of basic nutrition principles. wearing seatbelts and smoking cessation counselling. you exclude these things from being part the healthcare system when in fact they are more important to mortality data than having 100s of thousands of $50000+ bypass surgeries done each year.

 

Yeah a top down strategy that has never worked, as opposed to old fashioned public shaming of the unhealthy lifestyle.

 

Just like smoking, you may think that raising taxes, limiting advertising or introducing overly graphic ads are responsible for smoking's decline. Or you can believe the more likely cause that more people think it's a disgusting habit and you're a social pariah if you light up in public.

 

Which one do you think had a bigger effect?

[DC Tom]

have you ever considered that lifestyle counseling might be an important part of the success of the systems beating the pants off of us. you seem to have excluded this possibility. things like home nursing education/monitoring visits for newborns and first time mothers. working to ensure the availability of healthy foods and knowledge of basic nutrition principles. wearing seatbelts and smoking cessation counselling. you exclude these things from being part the healthcare system when in fact they are more important to mortality data than having 100s of thousands of $50000+ bypass surgeries done each year.

 

Ah, so you ARE arguing that lifestyles should be government-run.

 

You're an even bigger idiot than I first thought.

[Magox]

I can tell you this, If indeed we are 31st in the mortality rate, it has VERY VERY little to do with healthcare, but more so lifestyle. I believe for any rational thinking person that goes without saying.

[DC Tom]

I can tell you this, If indeed we are 31st in the mortality rate, it has VERY VERY little to do with healthcare, but more so lifestyle. I believe for any rational thinking person that goes without saying.

 

"But lifestyle is dependent on health care, which is why the government needs to run it!"

[Dave_In_Norfolk]

Yeah a top down strategy that has never worked, as opposed to old fashioned public shaming of the unhealthy lifestyle.

 

Just like smoking, you may think that raising taxes, limiting advertising or introducing overly graphic ads are responsible for smoking's decline. Or you can believe the more likely cause that more people think it's a disgusting habit and you're a social pariah if you light up in public. Which one do you think had a bigger effect?

A lot of that is because the government came in and forced the tobacco companies off the public airwaves and stopped them from doing mass fraudulent advertising about how 9 out of 10 doctors smoke Kent Cigarettes. The other cultural factor has been the movie industry not showing everyone and their brother constantly smoking. Government and Hollywood!

 

I can tell you this, If indeed we are 31st in the mortality rate, it has VERY VERY little to do with healthcare, but more so lifestyle. I believe for any rational thinking person that goes without saying.

You don't think the ability of people to have regular checkups to catch illnesses early would have an affect on mortality?

[DC Tom]

Government and Hollywood!

 

Either you were dropped on your head too much as a child, or not enough.

[Dave_In_Norfolk]

have you ever considered that lifestyle counseling might be an important part of the success of the systems beating the pants off of us. you seem to have excluded this possibility. things like home nursing education/monitoring visits for newborns and first time mothers. working to ensure the availability of healthy foods and knowledge of basic nutrition principles. wearing seatbelts and smoking cessation counselling. you exclude these things from being part the healthcare system when in fact they are more important to mortality data than having 100s of thousands of $50000+ bypass surgeries done each year.

Absolutely. So many of our children are born with two strikes against them at birth. No reason at all there shouldn't be more invested in going in and giving these kids a healthier and more enlightened environment to flourish in.

 

Either you were dropped on your head too much as a child, or not enough.

Already back from your two martini lunch I see

[birdog1960]

why is it so difficult to comprehend the main point here (i understand why it's difficult to accept)? the us system in it's totality is failing miserably if we rank 31st in life expectancy. of course much of it's cultural. why do we have such a self destructive culture? why such a high infant mortality? why such huge racial and ethnic disparities (when they are much less evident in some other countries)? and can the healthcare system be part of answering these questions and solving them. i say yes. d/c says no. fundamental, philosophical difference.

[Magox]

I've always argued that if you want to lower the cost of healthcare and improve peoples health, that the changes have to be structural and not touched up on the surface. Attempting to address these problems by reforming the payment method (health insurance companies) makes very little sense. If you want people to live longer and want healthcare costs (which these two go hand in hand) to go down, you have to promote healthier living. Meaning that we have to smoke, drink and eaty less fatty food than we have before. We also have to educate the public to do their routine checkups with their doctors and to be conscience of their own well-being.

 

Also look to have the doctors have more say in what tests are necessary and which ones arent, meaning capping potential litigation costs.

 

We also need to have a central medical data base for medical file sharing amongst doctors, clinics and hospitals.

 

School lunches shouldnt include unhealthy fatty foods. I mean for christs sakes, if its public tax payer money, lets at least give them healthy food as opposed to giving fatty foods where sometime down the road we'll eventually have to end up paying for their medical costs partially because of the funds we provided for them to eat these fatty foods .

 

Fine, for the anti tax zealots, if you dont want to tax fatty foods (like we do cigarrettes or alcohol), then give tax breaks to those who comply with legislation that promotes lower calories, fat grams, cholestoral etc.

 

 

For all those that have pre existing conditions, we should setup a government exchange that covers these people, that way no one can get denied for pre existing medical conditions, which in turn would lower the cost of everyone elses health insurance premiums simply because many of the sick people have now left the health insurance pools, thereby lowering the cost of peoples premiums.

 

There should also be clinics across the nation for people who cant afford health care. This way you wont have so many people going to the regular hospitals who dont have health insurance, increasing the cost of health care for everyone else.

 

 

These are just a few ideas, but these are sensible structural changes that would improve peoples well-being and lower the cost of healthcare. Not this stupid Obamacare bill that doesn't effectively address these issues.

[birdog1960]

I've always argued that if you want to lower the cost of healthcare and improve peoples health, that the changes have to be structural and not touched up on the surface. Attempting to address these problems by reforming the payment method (health insurance companies) makes very little sense. If you want people to live longer and want healthcare costs (which these two go hand in hand) to go down, you have to promote healthier living. Meaning that we have to smoke, drink and eaty less fatty food than we have before. We also have to educate the public to do their routine checkups with their doctors and to be conscience of their own well-being.

 

Also look to have the doctors have more say in what tests are necessary and which ones arent, meaning capping potential litigation costs.

 

We also need to have a central medical data base for medical file sharing amongst doctors, clinics and hospitals.

 

School lunches shouldnt include unhealthy fatty foods. I mean for christs sakes, if its public tax payer money, lets at least give them healthy food as opposed to giving fatty foods where sometime down the road we'll eventually have to end up paying for their medical costs partially because of the funds we provided for them to eat these fatty foods .

 

Fine, for the anti tax zealots, if you dont want to tax fatty foods (like we do cigarrettes or alcohol), then give tax breaks to those who comply with legislation that promotes lower calories, fat grams, cholestoral etc.

 

 

For all those that have pre existing conditions, we should setup a government exchange that covers these people, that way no one can get denied for pre existing medical conditions, which in turn would lower the cost of everyone elses health insurance premiums simply because many of the sick people have now left the health insurance pools, thereby lowering the cost of peoples premiums.

 

There should also be clinics across the nation for people who cant afford health care. This way you wont have so many people going to the regular hospitals who dont have health insurance, increasing the cost of health care for everyone else.

 

 

These are just a few ideas, but these are sensible structural changes that would improve peoples well-being and lower the cost of healthcare. Not this stupid Obamacare bill that doesn't effectively address these issues.

and you were doing so well til the last sentence... "obamacare" is a means to an end. it's just the jumping off point for everything else you mentioned. will it work as envisioned? maybe not but it's a work in progress and will certainly require both major and minor tweaks over time. magox, you seem to actually want a better system with better outcomes. to me that desire seems obvious and natural. i'm not so sure about d/c or rob. it's all about "what's in it for me" and "i'm alright jack, pull up the ladder". unfortunately there are plenty of americans that think this way and that has much to do with the appalling life expectancy statistics.

Edited July 12, 2011 by birdog1960

[Doc]

and you were doing so well til the last sentence... "obamacare" is a means to an end. it's just the jumping off point for everything else you mentioned. will it work as envisioned? maybe not but it's a work in progress and will certainly require both major and minor tweaks over time. magox, you seem to actually want a better system with better outcomes. to me that desire seems obvious and natural. i'm not so sure about d/c or rob. it's all about "what's in it for me" and "i'm alright jack, pull up the ladder". unfortunately there are plenty of americans that think this way and that has much to do with the appalling life expectancy statistics.

Creating a gigantic entitlement and then expecting to "tweak it" is a fantasy. Again look at Medicare/Medicaid and Social Security. But if by "jumping off point," you meant "a cliff," I agree with you.

 

As for counseling an education, that's another fantasy. The American public wants to hear none of it, and I'd bet your patient population is no healthier than that of your peers, despite your belief that Obamacare is a step in the right direction (and you've no doubt adopted many of the guidelines in it).

Edited July 12, 2011 by Doc

[birdog1960]

from the CIA website: "life expectancy at birth is also a measure of overall quality of life in a country and summarizes mortality at all ages. it can be thought of as indicating the political return on investment in human capital and is necessary for the calculation of various actuarial measures."

 

so how we doin? the CIA ranks the US 50th worldwide by this measure.

 

Creating a gigantic entitlement and then expecting to "tweak it" is a fantasy. Again look at Medicare/Medicaid and Social Security. But if by "jumping off point," you meant "a cliff," I agree with you.

 

As for counseling an education, that's another fantasy. The American public wants to hear none of it, and I'd bet your patient population is no healthier than that of your peers, despite your belief that Obamacare is a step in the right direction (and you've no doubt adopted many of the guidelines in it).

it won't happen in a vacuum. it will take cultural change although there's no harm in trying. i've cited you evidence previously about the effectiveness of smoking cessation counseling and i have plenty of anecdotal evidence.

[Doc]

from the CIA website: "life expectancy at birth is also a measure of overall quality of life in a country and summarizes mortality at all ages. it can be thought of as indicating the political return on investment in human capital and is necessary for the calculation of various actuarial measures."

 

so how we doin? the CIA ranks the US 50th worldwide by this measure.

 

 

it won't happen in a vacuum. it will take cultural change although there's no harm in trying. i've cited you evidence previously about the effectiveness of smoking cessation counseling and i have plenty of anecdotal evidence.

Why do you need Obamacare to effect cultural change?

[birdog1960]

Why do you need Obamacare to effect cultural change?

who is better positioned than health care providers to effect it? without the incentives included in health care reform for preventive care it's highly unlikely to happen.

 

 

Do you have an idea for a better way?

[Adam]

Nope, because it won't work. You can take that to the bank. I'll tell you what's killing Obama more than anything regarding the economy, it's all these stupid nonsensical regulations and uncertainties of these massive Bills that will be coming down the pipeline. The Dodd Frank Bill is gonna crush what it is that I am doing right now. MOst of my business in Metals is in leveraged products and now we won't be able to offer those products any longer. My little business is a microcosm of how the Obama administration is changing the landscape of America.

 

Between Dodd/Frank, Obamacare and the EPA's overwhelming powers and new regulations, this alone is going to account for hundreds of thousands of lost jobs over the next few years, and that is just the tangible losses, the indirect losses caused by the uncertainties of these laws and regulations combined with the belief of higher taxes on the job producers that the liberals so desperately want, will account for hundreds of thousands of more lost jobs.

 

 

Combine these idiotic pieces of legislation, nonsensical regulations, fear of higher taxes and uncertainty along with the devastatingly poorly crafted "stimulus" bill which was the wrong strategy to go with in the first place, you can pretty much figure that as a result of all these missteps, that the economy over the next few years won't be reaching as Mohammed El Erian says "escape velocity". Meaning that the economy won't see that sort of liftoff you normally see of 5-6% GDP growth right after the recession.

 

To be fair, I honestly don't believe anyone could of gotten us to that 5-6% GDP growth. THe "Stimulus" did have a quarter or two of good strength of above 4% growth, but that was to be expected. I mean, of course, if you spend Billions of dollars of free giveaways, and producing jobs just for the sake of producing jobs, then you will obviously see growth. But it wont be sustained. Which is what we are seeing today, NO SUSTAINED GROWTH.

 

Did I not say this would happen? Yeah yeah I know, I'm tooting my own horn, but !@#$ it, I said this would happen, only because it was painfully obvious.

 

I'm being serious here, the best thing that could happen to this economy is for Obama to lose to Romney in 2012. He would repeal Obamacare, most likely look to tear apart Dodd Frank and all the damage the EPA's regulations are causing.

 

In other words undo all the harm that Obama has done to this economy. I think you guys know I'm not a real partisan even though I consider myself to be an economic conservative (even though I agree that sometimes taxes need to be raised), I just speak it how it is, and the reality is that Obama's economic policies have been atrocious.

He will try to repeal the Affordable Health Care Act, as he said he would. He will fail in the attempt.

[Doc]

who is better positioned than health care providers to effect it? without the incentives included in health care reform for preventive care it's highly unlikely to happen.

 

Do you have an idea for a better way?

Incentives...for whom?

 

He will try to repeal the Affordable Health Care Act, as he said he would. He will fail in the attempt.

Doubtful. Barring a major miracle, the Repubs look all but assured of taking congress and the presidency. Which means buh bye to Obamacare.

 

That is, assuming Obamacare survives SCOTUS.

[Adam]

Incentives...for whom?

 

 

Doubtful. Barring a major miracle, the Repubs look all but assured of taking congress and the presidency. Which means buh bye to Obamacare.

 

That is, assuming Obamacare survives SCOTUS.

It took the democrats forever to get a healthcare bill, I don't see them giving it up without a major fight. They probably will have enough to filibuster.

 

I don't care if we keep the bill or not- if we open state lines to state competition, it shouldn't matter either way. But we know that the healthcare industry.....errr, Congress will vote that down. And America's stupidity will continue as usual!

[Rob's House]

After several days and almost 100 posts I still haven't seen one liberal give a reasonable explanation of how the Obama approach to our economic situation can play out favorably. So it seems to me, they arrogantly cast dispersions among us for not believing in a plan they themselves can't explain. Brilliant.

[birdog1960]

arrogantly cast dispersions among us Brilliant.

yes, we would like to disperse you into shadow energy, arrogantly or not.