Fafhrd on 28/8/2009 at 01:41
Quote Posted by CCCToad
It isn't unreasonable to infer that the improvement was a direct result of the political fallout surrounding the negative coverage of Walter Rood.
Except Walter
Reed isn't a VA hospital, and the article is about improvements made to the system since Kenneth Kizer's appointment in 1994.
BEAR on 28/8/2009 at 02:31
Quote Posted by Fafhrd
By turning it into (
http://health.usnews.com/usnews/health/articles/050718/18va.htm) the best hospital system in the country? The reason vets don't get the care they need is because most don't live within easy access of VA hospitals and are dependent on the military paying their benefits for private care, which runs out after a set amount of time dependant on the care they need.
If an eligible veteran (which is most) can get to a VA hospital, he's practically guaranteed better care than he'd get in any private hospital.
Thats a good point. My dad is a disabled combat veteran of Vietnam, and he thinks VERY highly of the care he's received. The VA hospital near us is one of the best equipped and best run, I've not heard a single bad thing about it from him. He didn't start using any VA benefit type things (since right after he got out of the army) until 5 years ago maybe, because the impression was so bad of it. After he did, he started telling all the veterans he knew to take advantage of it.
CCCToad on 28/8/2009 at 02:33
Quote Posted by Fafhrd
Except Walter
Reed isn't a VA hospital, and the article is about improvements made to the system since Kenneth Kizer's appointment in 1994.
Granted, but in this case its appearance that counts, not reality. Most people don't know that, and it still created a lot of political fallout in regards to the treatment of veterans.
Part of it may also be the work culture. In my experiences, the military has a much stronger work ethic than most other government services. I think this has a simple explanation. In most government jobs, there really isn't any consequence for mediocre performance, as job security is high and wages are typically set in stone. The military, on the other hand, has an aggressive and competitive work culture based in very real consequences: if you aren't competent, you will get yourself killed. It is a somewhat contagious work culture that spills over to those personnel working in the medical services and those civilians who work with the military alot.
Its the same reason police and firefighters tend to run a bit more smoothly than the average government agency. (Key word is tend to, I've seen more than a few goofy, small Georgia town police units)
BEAR on 28/8/2009 at 02:36
Quote Posted by Thief13x
I would just like for someone to tell me just one fucking thing the federal government
hasn't completely failed at.
medicare?
medicade?
tax reform?
border security?
cyber security?
social security?
The war on terror?
H1N1?
Stimulus?
the postal service?
The fucking DMV?
please, someone....even the tap water I fucking drink 2 gallons of a day (yes I'm a "heavy drinker") is supposedly now tainted with anti depressants and viagra...thanks uncle sam! Let me give you my health care decisions because I'm a dee dee dee!
I need a cigarette...oh wait, the governments fucked that for my broke ass too!
Yeah, like water treatment is ENTIRELY the federal government? And as if that isn't a worldwide issue? Come on man, you are hurting your own argument pretty badly there. And you guys act if liberals were naive. We don't expect any of that stuff to run without a hitch, and some industries DO work well as for-profit. But when you are talking about healthcare, where service costs money, its not really that hard to put together.
SD on 28/8/2009 at 02:42
Quote Posted by Subjective Effect
Now I love the idea of the NHS and tbh I would never, ever become a 100% private doc, but there is something about this financial model that's just a little messed up.
People who have more should contribute more - seems entirely reasonable to me and not remotely messed up.
Quote Posted by ZymeAddict
WE CAN'T FUCKING AFFORD IT RIGHT NOW!UHC is cheaper you fucking nincompoop, it cuts out the insurance middleman and allows the government to use its dominant market position to barter down the cost of medical supplies.
Quote Posted by Thief13x
I would just like for someone to tell me just one fucking thing the federal government
hasn't completely failed at.
Apparently they've had some success in helping retards use the Internet.
Tocky on 28/8/2009 at 03:18
Best laugh I've had all day. Thanks SD. I needed that. The strings from town hall meetings to conservative radio and TV and then straight into the pockets of corporate medical industry/insurance had me feeling down on this puppet show. The fact the WHO ranks the US 37th in health care should tell my countrymen something but no. WE trust pill popping Rush Limbaugh and pals.
Hitler gonna take mu guuuuun!
SubJeff on 28/8/2009 at 06:00
Quote Posted by SD
People who have more should contribute more
Why? First off just why? Why should one have to give more because they have more? You don't just have more by chance, one tends to have worked harder to achieve it and will already pay more income tax anyway.
Secondly why should they pay more if they are using the service less? It's not like normal taxes where you can argue that you pay more and everyone gets the same; with the NHS you pay more and you tend to use the service less.
To compound things you are using it less because you are being sensible, whilst those that use it more need to do so because they are not being sensible. Part of the reason that the heavy users are heavy users is due to bad choices on their part. Its almost like you're being punished for their stupidity.
SD on 28/8/2009 at 10:27
Quote Posted by Subjective Effect
Why? First off just why? Why should one have to give more because they have more?
"The necessaries of life occasion the great expense of the poor. They find it difficult to get food, and the greater part of their little revenue is spent in getting it. The luxuries and vanities of life occasion the principal expense of the rich, and a magnificent house embellishes and sets off to the best advantage all the other luxuries and vanities which they possess. A tax upon house-rents, therefore, would in general fall heaviest upon the rich; and in this sort of inequality there would not, perhaps, be anything very unreasonable. It is not very unreasonable that the rich should contribute to the public expense, not only in proportion to their revenue, but something more than in that proportion."
- Adam Smith, the guy on our £20 notes, 1776
The arguments in favour of progressive taxation are as old as modern economics. What Adam Smith is arguing for above is called
vertical equity - people with more should pay more because that's just naturally
fair. I think most people would see the natural fairness in the above, but even if you don't, there are other reasons why it's a good idea.
* In a capitalist system, wealth disproportionately accumulates among the wealthy. This is because the more money you have, the higher the rate of return (Example: go to any bank. You'll see that bank accounts with balances of more than, say, £20,000 earn a better rate of interest than bank accounts with just £200 in them). Progressive taxation is desirable to redress this imbalance, or you end up with the rich getting richer and the poor getting poorer - increased economic inequality and all of the associated problems that that brings (everything from an increase in petty theft right up to outright revolution).
* People with less money spend a higher proportion of their income, a phenomenon known as
higher marginal propensity to consume. Spending money stimulates the economy, so from a utilitarian perspective, it is better to take money from people who aren't going to spend as much of it (the rich) than it is to take it from people who are (the poor).
* Wealthy people, by virtue of the fact that they have more wealth, have a bigger vested interest in maintaining the fabric of society. Therefore they should pay more towards its upkeep. If I have £10m in the bank and live in a big mansion with a moat around it, you bet your ass I want to make sure that the proles are happy enough that they don't storm my house, nick all my stuff and drown me in the moat.
There are more arguments (as a cursory glance at an introductory-level economics textbook will demonstrate) but those are, for my money, the most persuasive.
Quote Posted by Subjective Effect
Secondly why should they pay more if they are using the service less? It's not like normal taxes where you can argue that you pay more and everyone gets the same; with the NHS you pay more and you tend to use the service less.
Everyone has a vested interest in a healthy population. If I'm wealthy enough to afford top healthcare, great, but if everyone else isn't and they're getting sick, then that affects me too: there are fewer taxi drivers to ferry my moneyed ass around the city, fewer hotel porters to carry my luggage, and fewer hookers to party with me into the night. This has a negative effect on the economy, and to top it all, more sick people = bigger chance of me catching something off them.
Quote Posted by Subjective Effect
To compound things you are using it less because you are being sensible, whilst those that use it more need to do so because they are not being sensible. Part of the reason that the heavy users are heavy users is due to bad choices on their part. Its almost like you're being punished for their stupidity.
Not all illness or injury is as a result of stupidity. Sensible people break legs and get cancer too.
SubJeff on 28/8/2009 at 10:57
Quote Posted by SD
The arguments in favour of progressive taxation are as old as modern economics.
* stuff
There are more arguments (as a cursory glance at an introductory-level economics textbook will demonstrate) but those are, for my money, the most persuasive.
I'm all for progressive taxation comrade. Notice I haven't made any comment about income tax. And I think your list makes a lot of sense.
Quote:
Not all illness or injury is as a result of stupidity.
I never said it was.
Don't start a strawman here please.
However - there are large portions of the population who do just what I have said:
Quote Posted by me
who smoke lots, drink lots, have poor diets and then don't want/can't be bother to keep follow up appointments/take their medication when they get diseases related to their lifestyle.
I'm not saying we should have a private system (far from it), nor am I saying that the system we have is completely broken.
What I am saying is that because people here think the NHS is a right they have a blase attitude to it, and a lot of people have the same ideas about their heath. Because they know that no matter what they will be treated the same as anyone else I think that people take less care. You'll find obese lifelong heavy smokers with a strong family history of diabetes and high blood pressure unhappy that they cannot have treatment x because it won't help them unless they make some effort. I doubt you have the same issues in the US (though I'd love to hear things from a US perspective).
In the long run you have the situation I'm referring to - that a lot (not all) of "frequent fliers" to hospital have done something to contribute to their ill health, that a lot of these people are the less well off and subsequently they are the bigger drain on the NHS pocket.
I'm sure you'll find this anywhere there is a system like the NHS.
On my few trips to Taiwan I saw a very interesting alternative. I guess it's like Canada. Everyone pays a yearly subscription and gets a health care card. Treatment up to a certain point is free and then gets progressively more expensive. However, sufferers of chronic illness get discounted/free treatment (like the free prescriptions for diabetics here). But people know that if they abuse themselves and become frequent fliers because of it they will end up footing the bill. The downside is, of course, that some people stay away to avoid paying.
Tocky on 28/8/2009 at 12:17
Quote Posted by Subjective Effect
You'll find obese lifelong heavy smokers with a strong family history of diabetes and high blood pressure unhappy that they cannot have treatment x because it won't help them unless they make some effort. I doubt you have the same issues in the US (though I'd love to hear things from a US perspective).
.
Have you seen the lol thread? I don't have time to go into it just now but I'll bet my paycheck we have more. Stupid lazy people will always exist but we can't shoot them in the head no matter what benefits to society that might acrue. In the current US system we still pay for thier negligence through higher hospital bills to cover thier no pay asses. It aint fair but the current system is more aint fair savy?
