…here’s a handy-dandy little graphic which touches some of the bases here in the US. This I found referenced in an article by Jim Demaine MD, which is itself worth a read;
In our country, we’ve built up a huge medical-industrial system that can do lots of good but at a huge cost. It seems that we are on the brink of a “health care-cost bubble” because we are now dragging down economic growth with continued double digit rising insurance rates. Individuals, small businesses, corporations, and government entities are all crying for relief from this health care cost burden.
I’ve yet to hear or read a compelling argument for why the whole business of health care delivery needs to be a profit making enterprise at its heart anyway. If the argument is simply an ideological conviction that the private for-profit sector just “does things better”, always and everywhere, than the public sector then how come its apologists are not campaigning fiercely to privatize the Veteran’s Administration? Would they be willing to make the argument that only the best is good enough for our military veterans and their families, and that it’s scandalously un-American for them to be at the mercy of a socialized healthcare delivery system?
The political institutions are colonized, the polling on the issue is distorted, and the whole damn situation is now so polarized that it’s impossible to have a sane national conversation about any of it. I mean, come on, look at that one stat toward the bottom there; insurance premiums have risen 131% in the last decade. Uninsured patients drive just 8% of that increase.
Created by: MedicalBillingAndCodingCertification.net
(h/t Newshoggers)
I got in a spat with Crit awhile ago – he apparently used to be in medical billing. I don’t like the ACA bill here (public option or bust), and he said that we should all just pay up and quit being deadbeats, EMTALA costs everyone too much money. Fair point in a way, but i said, ok, so if ACA passes, does that mean we get to scrap EMTALA then? If not, why not? He never did get back to answer me there.
PS
Only by reason of unintended consequences looks like.
It started life, and is still prescribed as, an anti-depressant. Bupropion
Squirrel, are drug companies in the UK allowed to advertize prescription drugs directly to the public (via TV, magazines etc) the way they are here?
Gunny -
are drug companies in the UK allowed to advertize prescription drugs directly to the public (via TV, magazines etc) the way they are here?
That wasn’t always the case here, was it? I don’t know if it has always been allowed, but i am kind of always appalled at the pimping in my mom’s AARP magazines. Especially when i read about the possible side effects. Dunno what the point of the ads is either, are you supposed to go to your doctor and demand to be prescribed Celebrex?
Pornstar: “But all of the technology that had improved healthcare and longevity doesn’t come cheap.”
Some of it doesn’t; but . . . the first epidurals I had into my spine meant a general anaesthetic, three days in hospital, home by ambulance, and not really being able to move much for a week.
The last one was done under a local anesthetic, and I could go home on the bus an hour later. No restrictions: I went to a concert the same evening.
(The risk is still the same though; still a 1/1000 chance it’ll go badly wrong. That hospital’s done over 2,000 now without a cockup, so fingers crossed for Squirrel’s next, please, as the odds are shortening?)
Squirrel -
Fingers definitely crossed.
A few years ago my mom had spinal column surgery by a pretty top guy, and the recovery time was a month in a nursing home. She had gap insurance from somewhere for that, but again, this is some seriously expensive treatment.
gunnison “are drug companies in the UK allowed to advertize prescription drugs directly to the public (via TV, magazines etc) the way they are here?”
No. Think that applies in most, if not all, of the EU, too.
Doesn’t, apparently, stop some people asking for one they’ve heard about that way, but it’s supposed to be a purely clinical decision. Actually, my own GP’s surgery — possibly because there are quite a few expat (and often temporary) Americans in the area — has a notice saying you shouldn’t.)
Pornamy,
Well, yes, it is, but it doesn’t fit my model (baseball-obsessed as Cuba may be) so I declared it an outlier and excluded it from my study.
Dog,
Whatever makes you think that Europe has anything at all to do with the model I suggested we explore? (“…you first need to plausibly explain why the Europeans lag.”) Was it Europe that financed the whole, decades-long worldwide expansion in microelectronics with their defense spending? That’s the kind of thing I suggested we look at.
Bluth,
Re brain-draining. Evidently this is not the self-evident proposition I’d have thought it was. I grew up amid a polyglot mix of scientists because my old man controlled the toys. Now physicists who used to flock to Fermilab flock to CERN instead, and for the same reasons they’ve always flocked where they flock. The only thing that’s changed is that it’s now wrong to fund science in the US.
Squirrel,
The odds are not shortening. The odds have no memory.
Pornstar: Obviously, I don’t really know how expensive it is here. A hospital administrator I knew then did actually tell me what the ‘internal’ NHS cost of my second one was, but I’ve forgotten.
Interestingly, and I wish I’d come across this before when the ACA row was raging across CiF, I found this site for a rough idea of what various services cost privately in the UK.
Must say, some of the prices look pretty shocking to me: like a hip replacement between $16-20,000? (But apparently, in the US that costs between 32,000 and 45,000.)
But “At the Kapiolani Medical Center in Aiea, Hawaii, where the full price is about $33,000, an uninsured patient would pay a discounted rate of $20,212 to $23,581.” And “at Dartmouth-Hitchcock Medical Center, a Medicare patient could pay up to $3,957, including deductibles and coinsurance”.
A friend of mine, who has private insurance through a Belgian company because of her husband’s job, would pay somewhere between $1-2,000. If she went through the NHS, which she can, it would cost nothing, of course.
At this point, Squirrel’s brain begins to hurt. How can it be that the same treatment at the same hospital is $10,000 cheaper if the hospital doesn’t have to deal with an insurer? It defies both ordinary logic and economic logic.
Squirrel’s brain isn’t the only one that begins to hurt.
You guys had all (n. american) evening to thrash it out and STILL not a shadow of an argument why extending health insurance to all citizens -and making it impossible for insurance companies to remove insurance for any reason they can find- would in any way reduce medical research.
How on earth does restricting insurance to 70-60% (and rapidly dropping) of the population, plus allowing the insurance companies to dis-insure people at the drop of a hat, encourage medical research? How would taking the profit (as opposed to the overheads) of writing insurance out of the equation discourage medical research?
It’s just that word profit, isn’t it. There’s just no way it cannot always be a really really good thing. That’s what it comes down to, as far as I can make sense of the comments.
Bluthner:
Exactly. That other paper I found (taking cancer research as the example) would suggest it wouldn’t. If the UK’s expenditure per capita is actually, overall, slightly greater than that of the USA (18.5 Euros against 17.98) then if the US system, as it is now, wholly profit-oriented throughout, is ipso facto supposed to encourage more research than one that clearly isn’t, why are they so similar?
If the argument were to hold water as a generalisation, in this instance it ought to be considerably greater, surely? And US cancer research would not rely on government funding to the tune of 94%. Especially as we’re not talking of something that would be peculiarly unlikely to attract funding or is extraordinarily esoteric.
And yes, it must all come down to the great god of profit. It’s like the JP Morgan debacle. According to much of the US media, the orthodoxy appears now to be that “they can afford to lose $3 billion”, it’s not a problem and certainly not a disaster, because somehow they’ll make it back in ‘profits’. (How? From more of the same kind of dodgy gambling? The next Facebook?) But, anyway, if they can, why can’t a Greek or Spanish bank be treated with equal optimism and have their mistakes so easily excused?
Oops. That was me.
Really must try to doze off; too much of what I call my ‘superdrug’ last night. Kept me awake too long.
Red – Only in the sense that buying anything is a subsidy to private industry.
Mind you American health care is a really bad example of how a market should work. It has been thoroughly bastardized over the years and combines the worst of unfunded mandates to provide free care, at or below cost government reimbursments for entitlment programs and exorbitant service charges that would make a hotel mini-bar operator blush.
(That was me back then btw – hope you are feeling well today)
o/t, but Fox News has nothing on the Beast for vile comments. I can’t believe some of the stuff they let stand on there. Don’t even want any part of it, not even worth commenting on there. Poor Tomasky.
ps
Here’s what I think; he was blinded by the prestige of the Newsweek banner, and pictured himself rising to the levels to which it propelled some other pundits who are now household names – George Will etc. I have no clue why he thought Tina Brown was a superlative editor, but apparently he did, and still says she is, though he would have to say that, wouldn’t he?
Over the past year or so he has come to see that ain’t gonna happen. Newsweek is continuing to morph from the mag on every coffee table to something only read in the dentist’s waiting room, and increasingly it’s harder to find even there. The Beast is an aesthetically challenged aggregator/journo site that has probably done all the major growing it will ever do, and has managed to attract a rather ugly and stupid user base.
Tomasky is now re-positioning himself, or trying to, as a prominent blogger, at least so far as his web presence is concerned (he has other irons in the fire) and I’m quite sure he’s got an eye open to make a move Somewhere Else. Somewhere he can do what he does and get some intelligent comment culture, and something that would complement his other work in the NY book review and that liberal mag he edits the name of which escapes me.
No idea where that could be. Won’t be back to the G, if I had to guess, since their editorial direction seems to be all over the map, to the degree that there is any discernible direction at all.
He was led astray by dreams of grandiosity — he’s certainly ambitious — and now he’s in a bit of a jam. There is no way he can create the kind of comment culture he enjoyed at the G with that bunch of cut-and-paste knuckledraggers weighing him down, not to mention the comment architecture itself, which actually enables such dross rather than discourages it.
He’ll figure something out, I reckon. But it won’t be easy.
I’m waiting for him to get desperate, then we can invite him over here, eh?
I still feel bad for him. It was obvious even when he told us he was making the move that the Beast was a total rag and Newsweek was decades past its heyday, and well into toilet paper territory by that time. but i also understand wanting to write for a wider and primarily American audience. Seeing how CiFA has morphed gutterward, contentwise anyway, it still may not have been a bad call for at least a transitional move.
I’m waiting for him to get desperate, then we can invite him over here, eh?
He’s still only ever be good enough for second banana
Well I can’t believe what they let stand on the Beast, either.
Those guys are like a ball and chain around his neck.
I reckon Mike must be writing a book that he hopes will break wide. And I do wish him well. Somehow I can’t imagine the G gig paid him all that much. The Beast was probably offering triple or more. He had a young child, and he isn’t all that young himself.
That little community we had going below the line with Mike at the G meant a lot to me. It got me through a bloody hard time. I think there were a fair few readers who didn’t comment but who logged on just for the btL craic. Even so, I don’t think he was reaching the size of an audience that he felt he needed to reach.
I doubt he is reaching the audience he wants to reach at the Beast, either.
He does reach that audience at the NYRB, and his articles there are top notch.
He’s not going to make it front of camera on the television. I really liked his videos, but they weren’t ever going to go mass market.
And yeah, he really does seem to be caught up in the 24hr news cycle at the moment. But not with his heart. It doesn’t feel like that’s where he wants to be. Just where he’s supposed to be on his blog. I mean, who gives a shit about ‘Who won the week’?
But he does give a shit about plenty that really matters. That is clear, and that is why we were all there.
Bluth -
yep, that’s about the measure of it.
I love Mike. But I agree with Gunny. His current gig does not seem to be working out.
and lefthalfback let him know in no certain terms that a BTL community such as we had at the G was never going to happen at the DB, mainly due to the comment architecture. The trolling is really very dispiritng too.
If Mike does make a move then he will let us know where he is going. I am sure of that.
Absolutely.
Me too, Bluthner.
Me too.
Elena -
Yeah, a couple of folks over there let him know it wasn’t going to happen there – Gunny and i for 2 more. Kevin still doesn’t seem to have given up there, he was still wrestling alligators over there this morning.
If Mike does make a move then he will let us know where he is going. I am sure of that.
Which would be very nice, i just hope he isn’t contractually hamstrung. Ng was saying something on CiF that it looked like MT didn’t sign a non-competition agreement with the Graun. I said that i though he may well have done, his new format started a year to the day since he left. Which would imply either a new or extended contract i would think.
If he’s in with the NYRB, the NYT would be maybe not suck too badly a bad format, but for the paywall, and too tight moderation. Keeps out a lot of trolls, but keeps out a lot of fun too.
I wish I knew more about how this “getting paid for eyeballs” thing actually works out for everyone involved. It may well be true that (this year, anyway) the G makes more money with its endless stream of “Fucking Yanks!” and “USA! USA! USA!” and “Obama sucks!” and “Go Obama!” comments than it could or did make with fewer but better comments on better pieces. But if so I think it just has to be a transitory anomaly. I can’t believe that the people visiting there now actually purchase a lot of what those advertisers are paying to sell. But it certainly does seem that a whole lot of sites seem to think that drawing the most comments (and now tweets) is the new path to profitability.
That’s unquestionably true. People were clearly reading those comments. But I don’t think Google can measure that. I think they can only count comments, hits on a page (hence CiF going from 50 to 20 comments per page) and maybe the length of time people stay on a page. At that rate, whoever replaces old time circulation managers — who, after all, only had to count the number of papers sold to know how well they were doing — can only aim to copy the Sports Illustrated swinsuit issue business model, and then only until advertisers get tired of buying “eyeballs” who aren’t really “targeted” by all this precisely “targeted advertising.”
.
Amy, wonderful expression.
Cif didn’t stick very long with the 20 comments per page. Maybe it backfired because it was so annoying that people stayed away.
Elena -
Like so many other wonderful turns of phrase, credit for that one goes to Gunny.
I can’t believe that the people visiting there now actually purchase a lot of what those advertisers are paying to sell.
I think i’ve said this before – but for a site as big as the Graun, it probably is eyeballs – ie CPM (cost per 1000 pageviews) as opposed to CPC (cost per click). May or may not depend on unique visitors. ( ie refreshed pages, and new visitors). Cost being roughly what the advertisers pay the Graun. For the actual products – books, clothes, gardening shit, etc – that’s affiliate sales. So they get a percentage of any sales that result from a Graun link, with zero cost to the Graun.
Anyone else here used Ghostery yet? I have it on Firefox (where i usually read the Graun) as opposed to Safari (which i use for here, tdb, etc.) It’s an eye opener for sure -
http://www.ghostery.com/
Natty -
You still probably know more about running websites that i do. I don’t do work for hire, but if you want some info about setting up a website for your book (if you haven’t yet) – i might be heplful there if you need some info.
One thing Tomasky totally has going for him is a work ethic. The man stands out for that, and he has my infinite respect. Especially in comparison to the slacker(s) on CiFA. As i would be very surprised if the Beast required that sort of output from him, i can only conclude that it’s because he likes it. And misses having a community. We all lost out there.
I probably visit Huffpo a lot more that is warranted these days, just because of a lack of non-paywalled current content elsewhere. I was a hard core defender of the unpaid writers there when Arianna (i still think she’s total scum) sold out to AOL. But seeing the absymal quality of articles there, i have rethought that position a bit.
I think they can only count comments, hits on a page (hence CiF going from 50 to 20 comments per page) and maybe the length of time people stay on a page.
They can also trace the path – ie the page preceeding the current page, as well as the page that they exit to. So if the Graun’s stats show that they’re getting a lot of hits from Splatter links, then they’re going to put some effort into splatter. If people land on a page via a google search – that will show up to, as well as the specific keywords that they used in the search bar.
If people seem to be exiting the Graun for, say, the Telegraph or the Mail, that will give them some info as well.
My (totally unscientific) theory is that CiFA tanked due an attempt at imposition of views. In other words – the Graun (substitute specific names as you see fit) commissioned articles on topics and by authors that focused on what we should be and what we should consider important and what we should think, as opposed to who we actually are and what we actually do care about. Even the dumbest of us aren’t all that dumb. Tomasky was at least a yank
who knows what it’s like to actually live and grow up here, pay the taxes and vote.
Richard Adams is a total trouper, young Harry, Pratap Chatterjee, Sabdbh and Michael Wolff are very good. But most essentially suck.
Dept of Declensions:
Communist=Nazi=Socialist=Liberal=Moderate. Dumb, dumber, dumbfounded. . . ?
Speaking of Richard (who I think is doing traditionally-Guardian sterling work: you can’t be serious about this stuff any more, can you?).
Aux Armes, Citoyens! ! Man the barricades! The Moderates are coming and will steal your wives, rape your daughters, disembowel your sons and burn your houses . . .
What are we waiting for, assembled in the forum?
The Moderates are coming today.
Why isn’t anything going on in the senate?
Why are the senators sitting there without legislating?
Because the Moderates are coming today.
What’s the point of senators making laws now?
Why have our bankers and property millionaires come out today
wearing their suits, their colourful ties,
Their golden rings and hairpieces?
Because the Moderates are coming today
And things like that dazzle the Moderates.
Why don’t our distinguished orators turn up as usual
To write on Cif or HuffPo, say what they have to say?
Because the Moderates are coming today
and they’re bored by rhetoric and public speaking.
Squirrel -
What’s going on in congress is essentially ignorable. It’s what’s going on in the courts, and those eventual pending decisions, that are of interest here now.
Amy,
Website for a book?
Lord.
Most days I wonder if maybe I’ve lived long enough, but some days I’m sure.
Natty, Natty. That ain’t the half of it. Your book needs a splatter profile and an arsebook page too. And a Huffpo article. (sadly, I’m not entirely joking.)
Anyone bored? Well, i’m bored with working, doing some especially tedious stuff. No relief from the Graun. or any of the usual outlets. But that’s ok, cause i’m laughing my tail of at Cracked mag now. And like, learning stuff too. Historical stuff i never knew. Hey, maybe it could be bullshit. But then so is most stuff in the msm too.
I too have become weary of pundit-recycling. Instead of actually doing the hard graft of going out and talking to people, and finding things out, foe months they’ve all been chasing each others’ tales (pun intended).
However, after having pretty well abandoned US media, on the way to depress myself with the outpourings of the most recent Tomasky haters, I discovered Andrew Sullivan who in turn has discovered this:
“Our Father in Heaven planned the coming forth of the Founding Fathers and their form of government as the necessary great prologue leading to the restoration of the gospel. Recall what our Savior Jesus Christ said nearly two thousand years ago when He visited this promised land: “For it is wisdom in the Father that they should be established in this land, and be set up as a free people by the power of the Father
I reverence the Constitution of the United States as a sacred document. To me its words are akin to the revelations of God, for God has placed His stamp of approval upon it. I testify that the God of heaven sent some of His choicest spirits to lay the foundation of this government, and He has now sent other choice spirits to help preserve it.
this is a land which is choice above all other lands; wherefore he that doth possess it shall serve God or shall be swept off.”
(Ezra Taft Benson. President of the Mpormon Church, 1987.)
I never did really comprehend why Romney found such pleasant bedfellows among the lunatic religious right, never could quite accept it was no more than mere hypocritical expediency. But here we have it: not so dissimilar to all the ‘America First’, Christian Founding Fathers’, American
Exceptionalism, Dominionism and all the rest, is it?
And on the punditry front: I think the Grauniad more or less abandoned its kind of ‘whole page US Comment’ thing because they simply can’t find anybody who can combine a broad knowledge, an enquiring and informed mind, and most important of all contacts. (Any contacts that aren’t fellow fucking pundits would do.)
When I was in the journo business, the first thing an editor wanted to see that you had was your contact book. If you didn’t have a thick notebook full of names, addresses and phone numbers; if people didn’t ring you before you rang them, if you didn’t know where or how to (or couldn’t through it) find everybody and anybody who mattered for what you were writing about, you weren’t any good at your job.
I once got stung into asking Tomasky where his was, because I rather suspected, if he had one at all, it was a bit thin. For all the others (not just on the Grauniad, but even more so in the US media) I’ve concluded they’re non-existent. So all they can do is read each other and write about what they each write about. And that’s somehow become ‘professional’ when it’s dilettante and amateur.
And it don’t tell you nuffin and it ain’t worth reading, innit?
Right you are Squirrel, about the contacts. If recycling other bullshit was all i needed to do to be a journalist, well, if i could write i’d be one. For all anyone wants to trash the NYT these days, they do some genuine stuff there still. As did Mr. Davies for the Graun.
Nope, I’m sticking to Cracked for awhile.
http://www.cracked.com/article_19864_6-ridiculous-lies-you-believe-about-founding-america.html
” I think the Grauniad more or less abandoned its kind of ‘whole page US Comment’ thing because they simply can’t find anybody who can combine a broad knowledge, an enquiring and informed mind, and most important of all contacts.”
I think they just didn’t have the money. The big US launch of Graun America didn’t go too well for them i don’t think. Most of us on both sides of the pond could have probably told them that. Too bad though.
Squirrel – Why does that remind me of Kenneth Williams voicing J Peasemoud Gruntfuttock on Round the Horne nearly 50 years ago?
Oh god almighty, the state of American ‘journalism’. In case you’ve missed it, Richard and the Grauniad have accidentally started ‘Romney Birtherism’:
“As The Guardian points out, the certificate was filed March 17, 1947, five whole days after Romney was born: “How can Mitt Romney explain this mysterious five day gap during which time he may (or may not) have been smuggled in from Canada? – the foreign country bordering on Michigan.”
The Atlantic: “The Atlantic Wire: What Matters Now”; Elspeth Reeve.
OK; and now we’ll review Jonathan Swift’s Irish Baby Cookbook. No 4,852 on Amazon! Only $23 for the Kindle edition! And there’s an iPad App!
It’s going to be a long five months Squirrel.
BTW – The system is designed to restrict action and therefore harm – and by default just about everything else – it isn’t meant to promote good. Good is up to us. It’s easier to understand that way.
Er, Expat,
To which system do you refer?
The US
But you knew that….
….and my 2 cents observation to Red.
Sorry, Expat, but you’ve got me utterly confused. The US as a whole is a system? Or the US healthcare system? Or the US system of journalism?
The US political system – are you being deliberately obtuse?
…Red was commenting on US election – well – commentary. And therefore US politics.
EP,
I took him at his word and thought he was talking about US journalism, but now I stand corrected. I’m pleased to learn that the US political system is “designed to restrict action,” though. Missed that day in Civics class.
I’m an outside observer basing my opinions on what I see. There is an awful lot of nothing happening. How would you describe the system?