nathaniel

The only solution is to spend way less, and the most likely way to do that is more expensive--as in more of the costs coming out of your pocketbook-- and less (in some cases much less) healthcare for nearly everyone. Some of will be fairly painless, like reducing overhead per Billvon's and just about anyone's rational proposal, although don't count on the Capitol Building and the Whitehouse getting even this right. But some of it will be abysmal, exposing the depths of poverty that we have in this country. People dying in droves from treatable conditions like diabetes because nobody, not least themselves nor our gov't, can afford to pay for their treatment. It'll be the best we can do to focus on contagious diseases and prevention to minimize the ripple effects of lower healthcare. Basically the safety net is going to have to get thinner, and won't cover nearly as much as it does currently. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Our population is not like Iceland and Norway and Luxembourg. In addition to having an upper and a middle class, we have a huge class of people that live in poverty. There's ample demographic data to show this. There's also ample research that demonstrates that impoverished people need different and more healthcare than the wealthy and the middle class. For this reason, it's not appropriate to compare the US with either 1st world or 3rd world countries. We are a blend of both. Essentially the same X billions of dollars that Europe spends every year on healthcare wouldn't go as far in the US due to our demographic differences. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

I think so because the safety position for a wingsuit is more like a freefly than a rw dive. One of the nastier things that can go wrong on your early wingsuit dives is to get into a spin. I don't think it's a really big deal but in skydivers I've met who showed interest in wingsuits it's been a pressing concern that they expressed to me. The RW "instinct" I've encountered is to try to counter the spin, which doesn't work in a wingsuit due to the design of the suit and the restrictions it puts on you. Freeflyers, imo, are more likely to find it natural to ball up or fly out with their bodies and not fight the suit with their arms & legs. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Is it real-time? How long till standard procedure becomes "Excuse me, ma'am, I'm going to need to see you shake it." My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

With some filament wire I bet you could turn it on its head, and get a free "massage" from the guards in one fell swoop. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Think of it as a business opportunity to develop clothing that shows up as huge boobies, a disproportionate "package", or a political message when viewed in a backscatter device. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

If you don't have an option you like, your gripe is then with either 1- your employer for squeezing you into a plan you don't want 2- the federal system of tax breaks for health insurance which basically pays companies to obtain and distribute group health insurance as income, instead of paying you the same amount of cash and letting you decide. Your gripe is not with the insurance providers--they operate rather benignly within the confines of our contorted regulatory environment. They're doing what any competitive business would do. We should instead appreciate that they are able to provide any valuable service, and do our best not to ruin their industry because it is in fact valuable to us as consumers--that's why we put up with employer-provided group insurance. Would you prefer that there was no insurance available at all? Historically other countries have destroyed or nearly destroyed their insurance markets with bad regulations. We are currently causing such destructive cycles in various states. Our federal systems are not far behind. Already we are seeing the beginning of outsourcing of healthcare to less (and better) regulated countries, as many other western nations currently outsource to the US. Should federally subsidized healthcare dollars be allowed to flow to places like Vietnam, India, and the Philippines? My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

I think they had one of those magic roundabouts at SDC's 4th of July show. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

I've had the pleasure of driving in the new "improved" mixing bowl where 95 meets the beltway south of DC. I get nightmares about it. It's like those simulations where galaxies collide and bits go flying everywhere. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Why would anybody pay an insurance company if they weren't getting something valuable in return? Insurance is a financial product just like stocks, bonds, annuities, options etc. The main reason you don't see clearinghouses & exchanges in the US is that insurance is regulated by each state instead of by the Federal govt like stocks & bonds, and the contracts are typically a bit more customized. In other countries, like in the UK, insurance and other financial products are often sold by the same company, and generally more "securitized". This has only started recently in the US as a result of diminished regulation in the last few decades. See Lloyd's of London. I suspect you've never tried to return a defective Dell part. This criterion does not distinguish Dell from Wellpoint--Dell's warrantees are in fact a type of insurance. Nobody will patronize an insurance program that does not pay out fully per its terms--the payout is part of the contractual relationship. The friction involved in making a claim is simply part of what you are paying for--offer to pay more up front and you can usually buy a higher level of service. "Gold" or "platinum" service from Dell, it may not named as attractively but good service is surely for sale from any health insurer. HMO, PPO, tiers of service, it's directly analogous. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

I support comprehensive antimicrobial research, particularly as applied to human pathogens. In the long run, insofar as this decision will weaken our defenses against bacteria, it may spur future research into new medicines further down the line. It'll keep us from resting on our laurels--it's a sacrifice of (probably) a few thousand or million lives to the evolution gods, for the benefit of the priests and priestesses of the scientific and medical establishment, and ultimately in turn for the benefit our species in the long run. We must keep the wheels of pharmaceutical advancement spinning! My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

We also have vastly different healthcare needs that most countries, cf our last thread on this subject and poverty. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

And you might reduce the quantities delivered by 75% or more, and unevenly throughout the country so that care can only be delivered in major population centers. There is no accounting in such a proposal, and it is plain to see that any accounting would ruin it. You seem to have a negative perception of health insurance providers. Insurance providers are just companies like Dell or GE. Despite what you may think, insurers provide an actual service. It is odd that on one hand you demand insurance for everybody, then criticize the value of insurance. You can't have it both ways. Is insurance valuable and worth paying for, or not? The biggest health insurance providers have had net incomes of around a couple billion per year recently, per their annual statements and SEC filings. By contrast, Dell's net income was around $3B in 2005. Is Dell more or less evil than Wellpoint, and why? The fact is that nobody on the supply side of healthcare is out of control these days, and none of them has strong prospects for the near future. The insurers are lumbering, although they have increased profitability since the '90s they are raising prices, reducing coverage, leaking customers, shafting providers, and generally scrambling to figure out how to offer insurance inside our perverted and shifting regulatory environments. The drug companies are quitting research out of cost vs profit concerns, and the doctors are leaving in droves due to insurance costs such that many types of procedures are unavailable in entire states. Even the providers that are making money today face drastically reduced prospects over the next ten years--they're literally running up against the ability of our overally economy to support them. On the other hand, high-end, highly subsidized consumers like me are doing extremely well but most of us do not understand that our contemporary gains are baldly unsustainable. We're juicing the entire system with our regulations and subsidies, and any solution that preserves both healthcare and our economy as we know it today will necessarily cut off the flow. For as much as healthcare already costs, squeezing the providers and the infrastructure will only siphon more out of a leaky system. We must come to terms with the fact that we cannot afford all of the healthcare that we want, that we currently get and perversely feel entitled to unlimited quantities of. The market will always provide some newer, more expensive regimen that is out of reach, often impossibly so, this is human nature. It's the entrepreneurial spirit and the embodiment of market economics that makes it so--it is the manifestation of hope. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

While there is in fact inefficiency in our system (and necessarily, ins anything thrown together and operated by such imperfect creatures as humans), no contemporary proposal is "just streamlining" because just streamlining is nowhere near enough to close the gap between how much money we have and the market costs of the goods we want to deliver. Economics teaches us that in any market economy, the most any one player can do is control the quantity or the price of a good (as in a monopoly or a monopsony). Every proposal on the table today that purports to advance the quantities of healthcare rendered whilst simultaneously lowering the price is fiction. Proponents of this, that or the other plan believe that there is an economy of scale in healthcare, that it's somehow like automobiles or software where most of the cost is up front in factories and development, that the healthcare system we have can be scaled and that it will function more efficiently when we do so. The difference between software / autos and healthcare is that economies of scale have been empirically validated for software/autos, but there's ample reason not to believe that equivalent scaling factors exist for healthcare, such as limited supply of doctors, nurses, organ donors, drugs, sterilized / disposable apparatus, various maintenance costs for hospital facilities, contamination & isolation requirements, and the sheer complexity of human physiology. In fact there are reasons to believe that healthcare acts simply as a traditional good, that throwing more money at healthcare will cause the prices to rise (healthcare inflation) and may change the ultimate amounts consumed only in scant proportion. Think of it this way, if that $500 NYT proposed tax were redistributed back to the taxpayers individually, so that everybody had a self-funded use-it-or-lose-it $500 medical savings account, healthcare suppliers could (and would) just jack up their prices across the board such that that $500 would not increase the resultant healthcare consumption particularly much. It'd probably introduce some inefficiency, even, because healthy people like me who consume well under $500 in healthcare per year might seek to extract some value at all from their accounts with needless scans and procedures rather than face a total loss of the account due to underuse. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Yes, and any affordable solution involves cutting down on what we get for free, not giving out more. Our present entitlement system is doomed in several years' time because it is drastically too expensive. It's sheer fantasy to talk about expanding entitlements. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

In other news, most Americans would pay $500 in additional taxes if everybody could get new car every year. I want a Ferrari! My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

oh oops, missed the per year bit on the 37500 number. It's a shoo in then hold on a sec tho, reading further into that paper I linked, the vaccines they tested had slightly reduced effect after 4 years and after 36 months. I don't think it's safe to conclude a lifetime of immunity (the vaccine isn't 100% effective to start off with, it only works against certain strains), but your point is taken nonetheless. It wouldn't take more than a few years of effect to cross the threshold of economic viability. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Indeed, have you got any information on that? I have no idea what it costs to get treated for cervical cancer, or what quality of life a survivor has afterward. I just found this site which puts the cost of treating hpv in the US at $1.5B / year, so that would be $10 / woman / year. You'd have to get into the distribution of age of onset, and also tabulate the effectiveness of the vaccine...but at first blush this could tip the scales back in favor of the vaccine. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Neglecting survivors, that makes it about $13.5 million per life saved, if the vaccine were 100% effective (which it's not). That's on the high end on the estimated value of a life, afaik. If the price could be brought down to UK levels, $120 or so, then it'd be $4.5M per life saved, which is an entirely reasonable amount to spend. You still have to factor in the effectiveness of the vaccine tho. I don't know what it is, but I do recall reading that the current vaccine is not equally effective against all strains, which could result diminishing effectiveness as the affected strains are winnowed out and the unaffected strains continue to thrive. All in all the vaccine is probably just on the far side of too expensive. Wait till the patent runs out, then it'll be worth it if / when prices drop. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

In a repeat game, society loses again and again. There's nothing different about the repeat game because the perps have a winning strategy that induces the police not to chase. They already demonstrate their willingness to risk injury for the probability of escape, this is empirical. That's tough luck (or good brinksmanship, your choice), our response should not be to play our hand badly. Our long term goal as a society should be to reengineer the game so that the perp's winning strategy is aligned with ours lawful action. Until then we should play for our own interest, not for the perp's loss. edit: the perp's winning strategy is already aligned with ours, duh, just it happens to wind up with the perp escaping right now... My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

I think common sense has been thoroughly debunked. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

We're not talking about prohibiting pursuit, but restricting it to real emergencies, not speeders. And we're not talking about making evading arrest a lawful practice. Grab his plate number and bust him when he gets home / shows up at his girlfriend's house. It's not worth the risk to the PO's life to encourage them to escalate situations disproportionately like this, neither the suspect. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

You were proposing chasing speeders for only the reason that they might have outstanding warrants. That is random, and disproportionate. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

that's not random, is it My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

Indeed, we are talking about pulling over essentially random people to see if they have outstanding warrants. There's good reason this doesn't happen (that much--roadblocks are ostensibly for DUI anyway) and there you have it. My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?