We have yet another child criminally charged for something that at one time would have been treated as a mere conduct issue warranting a note to a parent. In Pikesville, Maryland, a 13-year-old will be charged with second-degree assault for kissing a 14-year-old girl on a dare. This absurd case began with school officials calling police who pursued the minor on criminal assault charges.
The child is now facing a second-degree assault charge as a juvenile.
There is no question that this warrants discipline but a criminal charge?
What do you think?
I actually authored a treatise on the American Healthcare System and why it should not be introduced into a Centre of Excellence that was planned in Dubai.
Apart from logistical problems of duplicate providers and huge waste of resources (each hospital might not need a CAT scanner or MRI scanner for example) and cooperation is a better system than competition. In the planning of services.
From a delivery perspective one of my concerns was the attendence at a specialist clinic without medical referral for reasons that such at tendency might be inappropriate with a self diagnosis by the patient. Also data shows with this system specialists operate outside their speciality.
Regional Centres would be organised as a separate entity along the same lines in University Teaching Hospitals.
From a financial perspective overcharging is bad for business and I would refer you to the snake venom costs that were posted by someone showing a x20 fold difference in cost.
So as a “punter” i.e. a policy holder insurance health insurance does not represent value for money. You are being overcharged for illnesses your policy doesn’t cover. And doctors in response over investigate and over treat in defensive and commercial medicine.
So I agree with David2575 in that the insurance system does not deliver. And it needs to be dismantled.
What are the alternatives apart from socialised medicine which for some strange reason makes Americans feel ill…. although it worked brilliantly in the NHS until Margaret Thatcher got hold of it?
Well one possibility is to join a local hospital healthcare provider as a patient. Cut the middle man insurance out of the equation completely and pay an annual subscription to the hospital / group to cover the cost of care as a sort of local tax.
If you don’t like the care you vote with your feet and go somewhere else. If the hospital / group was set up as a charitable status it would operate with tax relief and that would keep costs down. Also business could invest in a hospital for its work force in a tax free manner.
Staff would be salaried but allowed to supplement their income privately separately from the job contract.
For patients and doctors wanting to opt out of this proposal, let them opt out and manage things themselves.
The main thing is to decrease the administration and running costs of the current white elephant of free market healthcare.
Standards need to be formalised so that all providers work to a common agreed standard. This will simplify risk management and its targets.
I submit that this skeleton proposal has advantages for the provision of equitable care for the majority of Americans and has flexibility which is lacking in the current system
ninian – yours is a pie in the sky proposal. It sounds good but it is not feasible. The last thing you want to do is treat people with a cold in a hospital. That is where germs are. The logistics of running a clinic within a hospital with an emergency room would be nigh on to impossible to put together.
Each of our hospitals has a set of scanners of various kinds, but we also have places that handle non-emergency procedures. Under your proposal a patient would be transported (at some cost to the patient) to another facility to take an MRI, then transported again for a CT, then again for a CAT, etc. Basically, the patient could be on the road all day going to hospitals and lining up for procedures. I had a very mild stroke a couple of years ago and my hospital put me through 4 major tests in less than an hour. They were pushing my wheeled bed as though it were a race car. And each new unit was waiting for me with the doors open. Would that happen with your system? No. I would not even be in the ambulance in an hour.
Paul C. Schilte
Anecdotal criticisms are not appropriate. If you are going to make a counter argument it needs to be based on evidence. I have provided evidence to support my arguments…..
Readers will appreciate a snapshot is all that can be presented on this website on a subject that requires a textbook – but the unassailable fact is that insurance systems don’t work can’t work and will never work in the delivery of a cost effective healthcare system. In order to prove this wrong you have to demonstrate that the US system works….. and the evidence is OVERWHELMING that it doesn’t.
So readers will have to make their own minds up. The time is now right for Americans to think for themselves.
ninian – you have not presented evidence, what you have presented is a theory. I have countered your theory based on anecdotal evidence.
BTW, you do not get to decide what is the best evidence and what is not. That is egomaniacal.
Paul C. Shulte
I’ve presented both. You haven’t presented anything.
ninian – I have already presented evidence on why your hospital model will not work. You must not have read it.
Paul C. Shute
Not true.
See davidm2575 link to a service already in operatipn which is close to what I am proposing.
ninianpeckitt wrote: “Well one possibility is to join a local hospital healthcare provider as a patient. Cut the middle man insurance out of the equation completely and pay an annual subscription to the hospital / group to cover the cost of care as a sort of local tax.”
I like the idea of a subscription or prepaid health membership. Such a model has been successful in the legal profession (e.g., LegalShield) and in computer software services (e.g., HelloHealth [https://hellohealth.com/plans/patient-subscriptions/]). Seems like it could be an adaptable model to health care if it were done right.
Sorry, but my link to HelloHealth had an extra character in it. The link should be:
https://hellohealth.com/plans/patient-subscriptions
Davidm2575 Health Membership
It is maybe a way forward and worth looking at.
It would promote autonomy, choice, resonsibility and accountability.
There might be a way of including the drugs industry in some sort of joint venture to keep a lid on cost’s?
I’m sure there would be all sorts of problems but it should reduce overheads and have a greater chance of sustainability.
It needs to provide financial security for staff for them to back this sort of system. I do know of papers confirming that doctors want to doctor and many are fed up by the financial burden of private practice. So it may be attractive to them.
I’m sure there will be lots of business plans and models.
And it would be competition for private insurers which might be a good thing.
Skip, how nice for your daughter in law, congratulations to her.
David2575
You have eloquently made your case which illustrates the Power of Marketing Propaganda and the ability to control the Masses in the Western Economies.
There is an understanding that financial success equates with excellence and yet Healthcare in the US is accepted as being substandard.
We also see the economic success of the American “Banksters” and their criminal abuse of capitalism and creation of the Global Economic Crisis.
We see the manipulation and propaganda of the NRA and the “genocide” of citizens especially if they are young black males <30yrs old. And can do nothing.
And yet it cannot admitted that the "liberty and freedom" which the constitution has proposed has in fact produced a nation that is tightly controlled by an elite to the detriment of the freedom of its citizens who are oblivious to the situation.
What has been created is not "Freedom" but "Servitude" and an inability to practice what is preached. Yet Freedom and Liberty are drummed into the population with the same degree of comprehension as a Latin Mass.
And therein lies the tragedy. An inability to instigate change through fear of change and unshakable conviction in what we know is wrong.
I agree change now will cause turmoil. It is nigh on impossible…
But as Audrey Hepburn said: impossible is easy to change to i'm possible.
But to do this, movers and shakers first have to understand what is going on, and why it is harmful. This not only requires intelligence but insight and the charisma of a Great States(wo)man. And the American Political System does not often produce this type of person….. and remains in denial. Modern politicians have not delivered the goods because they have fallen under the same spell as millions of citizens.
The US still thinks it is the Greatest Country in the World when on fact it isn't really a proper country but a fairly loose federation of States. Remember what happened to other Countries that thought they were the Greatest in the World…..
So my thesis is that the ability to change is linked to survival and we can debate all we want, but if we are unable to change in response to our environment our way of life in the West will be eclipsed to be replaced by something else.
And for the doubting Thomases for those who don't believe look to history and discover the dust of all those civilizations which are now Gone with the Wind…..
ninian – I am not sure how you decide that health care in the United States is substandard. My GP is one of the top GPs in the country, all of my other doctors are known as “Top Docs” selected by their peers as the person they would go to if they needed that specialty. My hospital (4 blocks away) is surrounded by doctors’ offices, including mine.
Paul C. Schulte
You need to remember that self praise is a disgrace.
You have to make your own mind up – not me.
I am just trying to encourage you to think for yourselves.
If I am wrong there will be evidence to support this.
I have provided links that strongly support my arguments.
You are making anecdotal statements.
Being top dog of a failing service doesn’t amount to much I think.
ninian – I have asked YOU to describe the healthcare system, as it works in the US. You have yet to do that. I am quite capable of thinking for myself but you have to depend on the writings of others.
There are few in this world who know how the healthcare system in the country really works. You probably need to ask those within big pharma and the insurance companies who write all the policy. Actually my daughter-in-law, just out of law school, has been working on the Healthcare Affordability program and is the manager of three States.
In exchange for working for the government for 10 years, the remaining balance of her student loans will be paid off. I didn’t know the government could use my tax dollars to pay off other peoples student loans. What a nice enticement to get them to go to work for the government. I cannot find that in the Constitution.
What; General Welfare clause?
The Fed did not raise rates again. Hmmm. Perhaps we are not recovering as much as the lame stream media is suggesting. Now 9 years of “0” interest rates and still very little if any real recovery.
Has 6 rounds of quantitative easing, with 9 years of 0 interest rates and the bank bailouts been a raving success or dismal failure?
Churchill stated: trying to increase economic activity through increased government spending is like standing in a bucket and trying to lift yourself up.
Pauk C. Schulte:
As far as the NHS is concerned since we introduced a pseudo American System in the 1980s the NHS costs have soared and quality collapsed. I have explained this in detail. The problem is you never read anything I post.
US Healthcare failure
http://articles.mercola.com/sites/articles/archive/2014/03/15/bad-american-health-care-system.aspx
Paul C. Shute
Progress at Last ! At least you are admitting a problem exists with the current system and “Obama is making it worse”
Doctors will always be found to treat patients and the ethics will he sorted out later.
Some will argue that something is better than nothing and dying in the gutter.
But to end on a bright note. Japanese scientists have been successful in engineering a functional kidney and testing it in pigs…. this is the best illustrated article I can find….
There is some way to go for human applications but this looks promising and may herald an end to long term dialysis and current transplantation programmes.
http://www.dailymail.co.uk/sciencetech/article-3245473/Transplant-breakthrough-researchers-reveal-working-kidney-grown-lab-stem-cells.html
This is wonderful news and if it can be kept away from American Businessmen it may not be priced out of the market?
ninianpeckitt wrote: “Progress at Last ! At least you are admitting a problem exists with the current system and “Obama is making it worse””
I agree that there is a problem, and the root of the problem involves insurance. As I mentioned before, I consider insurance immoral. It is basically placing a bet with a company that some illness or calamity is going to happen to you more often than it happens to the rest of society. Anybody making that bet is cursing themselves for the sake of their own personal security. The insurance companies become wealthy like Casinos playing this betting game.
Our difference lies in the solution. I believe in local government oversight and no national government involvement. I believe in competition and different levels of care being acceptable. I don’t think insurance companies should be outlawed, but the government needs to adopt a public policy that discourages people from buying insurance the same way it discourages people from smoking cigarettes. They government certainly should not provide monetary bailouts to the insurance companies, which is what the Affordable Care Act is all about.
david – insurance spreads the risk of any venture.
http://www.businessinsider.com/the-american-health-care-system-sucks-2013-10?IR=T
Ten more reasons why American Healthcare sucks
http://www.businessinsider.com/the-american-health-care-system-sucks-2013-10?IR=T
Have a look at costs here
http://www.theatlantic.com/health/archive/2013/09/how-is-us-health-care-bad-chart/279334/
David2575 You are right. insurance is not the way to go.
The problem with running medicine as a business the doctor has a conflict of interests and this leads to problems of over investigation over treatment and overcharging. It’s the same in instructing a Lawyer.
Maybe if doctors were paid in a system similar to paying judges this might improve the situation?
The doctor has a right to earn a living. I have no objections to that. But I disagree in milking the case for unreasonable financial gain. Patients are vulnerable and this is wrong.
But it’s the way medicine is organised that makes this possible.
ninianpeckitt wrote: “The problem with running medicine as a business the doctor has a conflict of interests and this leads to problems of over investigation over treatment and overcharging.”
My educational background is the ecology and evolution of vertebrates. I taught pre-med students at the University of South Florida. I was amazed at how many were going into medicine simply because medical doctors were among the most highly paid professionals. I saw students going through with a mediocre 75% average and thought, “I would never let that guy diagnose my medical condition. How many people are going to trust their lives to this man who only wants a career with prestige and big money?” The love of money has truly damaged the medical profession.
I don’t know if you realize this, but your first link to Dr. Mercola’s article is actually geared toward people like me who choose to live healthy and avoid medical doctors. I always say that medical doctors have a license to kill. We never scrutinize over their failures, but the public is sure to praise their successes. Their license to practice medicine gives them excuses when people die. The presumption is that they did everything they could to save the life. But as the article you linked to points out, half of medical procedures are of no benefit and some actually cause harm. One-fourth of hospital patients are harmed by medical mistakes. There are 1,000 deaths every day from medical mistakes. Yet, so many people put their full faith in medical doctors. Some of us who embrace rationalism avoid the medical profession and stay healthy. It has been many years since I have had any type of illness. Not even a common cold. People I know who go to the hospital always develop some kind of sickness or infection from going there. I always tell them, sick people go there, so expect to get sick when you go. I cringe when an employee of mine brings their child to the health clinic. They seem to always get sick within the next few days. I will still go to visit people at the hospital, but I am cognizant of the dangers and I wash thoroughly before and after. I am very careful to avoid touching things unnecessarily while I am there. I know the hospitals try hard to have a sterile environment, but they are on the losing end of that fight.
David2575
What you describe is a symptom of the US system and its effect on doctors, who work primarily to make money. I’m not saying everyone is like this in Amercan Medicine. Far from it. But I am saying that in other countries, that run on a different system of socialised healthcare, doctors tend to have a vocation related to care of the sick.
So I understand your fears but I think you are going somewhat to the extreme.
It is quite difficult for a doctor to kill a patient if the truth be told. It does happen but the events leading up to this are usually bizarre involving extremes of abnormal behaviour of involved parties, rather than lack of experience. This of course is reported with ulterior motives and this has produced a culture of distrust and suspicion. This does not help the promotion of good practice.
All I am saying is that it doesn’t have to be like this and it isn’t like this in other countries.
But it is like this in America and the reason is multifactorial but in essence related to US commercial culture. The UK is also following in thos pathway. Business is what makes America tick and with it there develops a lack of compassion – not in everyone but in sufficient numbers to make a difference.
The difference between my arguments and opposing views is that I am advocating a Service rather than a Business. And in America health care doesn’t work this way as a general rule.
Attitudes of British doctors of my generation are very different than those of today on either side of the Atlantic. As a student I used to go on ward rounds where the consultants cracked medical jokes in Latin ! That’s how old I am…. We were taught by example and this created a culture of vocation and fierce protection of patients.
And this has got me into a lot of trouble with the “New Order” as I have a history of speaking out in defence of patients and expose corruption.
The disintegration of trust between doctor and patient is a modern phenomenon and it is a reflection of society. Familiarity breeds contempt and the lack of professionalism that we see throughout the working world affects most if not all professions. Doctors Lawyers Judges Teachers “Banksters” are all under the microscope in the bear pit of modern life.
This makes the great concept of the pursuit of happiness so cherished in America and elsewhere an illusive target. In the words of Lennon and McCartney: “Money can’t buy me love”.
ninianpeckitt wrote: “The difference between my arguments and opposing views is that I am advocating a Service rather than a Business. And in America health care doesn’t work this way as a general rule.”
Our country does have the service aspect in county run clinics and in religious based medical groups that go into the housing projects and other impoverished areas and provide healthcare for free. You also find it in religious based hospitals. But most of the medical community is awash in big business, and the middle class and wealthy flock to those medical businesses. They see them as more trustworthy. I know many who would NEVER set foot in a county clinic, yet the physicians there are the ones who obviously are not in it for the money. The problem is that people look at wealth as signs of success. They would rather walk into a beautiful expensive building for treatment, and come out bragging about the huge financial success and luxurious lifestyle of his physician than into a drab county clinic where the physician makes not much more money than his patient.
I hear your points, but I can’t help but be just as skeptical of socialized medicine as I am of those with a capitalistic foundation. I do applaud your ideal of physicians doing what they do because of their inherent love for the art of helping people heal. I just do not think taking away the business model is the way to get there. Maybe education and values is more key to the solution.
Ninina – I saw that the NHS killed another 50 patients because it decided not to operate on them. That was this last week. The problem is that Obama and the Democrats took something that was not broken and broke it.
Just to be sure we understand each other, tell me what the healthcare system is in the US
Paul C. Schulte
What is the Healthcare System like in the US?
It’s crap
ninian – so you are incapable of describing the healthcare system in the US? Well, no sense talking about it with you any more.
Healthcare rationing in the United States exists in various forms.
An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. cancelled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period. It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.
These illnesses can strike down anyone and the conduct of the insurance system in the USA is unacceptable. Patients are stressed and vulnerable when disease strikes and callous management of their health insurance is NOT what the doctor ordered.
This isn’t about Un-American Socialism / Communism or Red White and Blue, as American as Apple Pie, Capitalism……
It is about Decency…..
ninian – we did not need Obama and the Democrats (no Republican voted for it) to mess up the healthcare system more than it was.
Paul – That was sarcasm – the very people society deems to ignorant, thus needing government to protect them from unlicensed health care practitioners, are free to elect the politicians like George Bush and Barrack Obama.
You cannot legislate against ignorance. Actually you can, it just doesn’t work. If you take the time to understand what affects licensure laws have on society, you would conclude that they do a great deal of harm, perhaps even more harm than good. But here’s the problem, the arguments in favor of licensure laws, like many government interventions, can be quickly articulated. The negative ramifications require a much greater in-depth analysis, requiring reading of often times multiple pages or even books to acquire the knowledge and evidence. Those in power have always relied on this ignorance and/or laziness of the Citizens. The average person just doesn’t have the time and energy to keep up with all the aspects of government and free enterprise simultaneously and surely you cannot rely on politicians, bless their honest souls.
As an example using another issue. I don’t know how many times I’ve heard the saying, “whose going to build the roads”. People just don’t know that many roads are built by private enterprise using private funding. These folks are called land “developers” and they have build the majority of roads and railroads in the country and then are forced to turn them over to the various governments. Even turnpikes have been built using private funds and no one placed tolls on them. That’s the argument, even though we have a bunch of toll roads today under government controls.
Explain to a socialist how an automobile is built, starting with the mining of the ore to build the mining equipment. That’s just for the steel used. Then there’s the plastics, electronics, glass, etc. etc. etc.IT JUST HAPPENS and if you elect government to do things such as this, it will fail miserably. You can tell people why but that takes a bunch of time and effort also.
I hear people rail against private enterprise, yet say to me “who is going to build the roads”. They don’t ask me who is going to build the cars, the planes, the trains, etc. Almost everything of value is built by private enterprise and if you what something screwed us, let government get involved. It will just be a matter of time.
Most government policy is designed to benefit special interests at the expense of everyone. I have to believe it is big pharma and the insurance companies behind socialized healthcare. With the middle class being squeezed so hard by excessive taxation and regulation, they need to get more money from the public treasury.
The biggest problem that licensure laws have created is unaffordable costs. Just check out the Doctors bill after a brief stay at the hospital. as a result, people are going to other countries for both medical and dental care. Lawyers who have enforced the policy, make 8 to 10 times more then the average blue collar worker with advanced technical skills. I not really begrudging Doctors, it is the licensure social policies that are allowing them to charge such exorbitant rates, allowing them to have a cartel the AMA, limiting the amount of competition. When you limit competition, prices rise. Simple economics 101.
Issac
“Great people and great countries criticize themselves. When they don’t you get things like Vietnam, Segregation, Iraq, etc. America’s greatness does not come from resting on its laurels.”
The “great” Americans on here refuse to believe anyone should actually be held accountable for those brutal “things” as you call them (they are actually orchestrated policies).
The Founding Fathers committed genocidal acts according to the current use of the word genocide. Why would JT risk losing his job to be so forward with the facts??
Let’s ruin this kid’s life over a stupid prank. Maybe there’s a sexting charge or two we can throw in.
DAVIDM2575
Now it’s not really true that the Civil War failed. The Rebellion/Cessation was stopped. The Union prevailed. But not as before. The engine of the economy of the Confederate States changed radically.
“There was a land of Cavaliers and Cotton Fields called the Old South. Here in this pretty world, Gallantry took its last bow. Here was the last ever to be seen of Knights and their Ladies Fair, of Master and of Slave. Look for it only in books, for it is no more than a dream remembered, a Civilization gone with the wind”.
“Police Charge 13-Year-old Boy With Assault for Kissing Girl On A Dare”
= = =
Is this Saudi Arabia?
Isaac:
Such rational thought seems to have fled in the current “zero tolerance” academic environment. And you’re right about the very real danger to children. Rural areas are dumping grounds for pedophiles because it’s easier to find housing away from schools and parks. I was shocked and appalled when I looked up neighboring towns on the Megan’s Law database. I don’t know if times have changed, or now we just have access to more information on who does what in our neighborhoods.
David
Great people and great countries criticize themselves. When they don’t you get things like Vietnam, Segregation, Iraq, etc. America’s greatness does not come from resting on its laurels.
September 17, 1862
Posted on September 17, 2015 by stevengoddard
On this day in 1862, 23,000 soldiers died at Antietam, Maryland. That was one soldier killed every two seconds for 12 hours. It was the bloodiest battle in US history, and the beginning of the end for the Confederate Army.
David, Florida even enacted an entirely new State Constitution.
Ninian Peckitt wrote: “You have to remember that the United States is not yet 300 years old. Other countries have had parliamnets for a millennium and this has resulted in the development of political systems. The USA has only just started to walk this road.”
You have some odd views of history. What other government has existed continuously without significant reforms longer than the USA?
The top contenders:
San Marino
Vatican City
Iceland
England
Isle of Man
Switzerland
USA
It is debateable, but I think USA wins as the longest running continual government without interruption either violent or nonviolent. Just claiming a parliament has existed for a millennium is not significant if its functioning has been interrupted by war or major reforms. Iceland has a parliament hailing from 900 AD, but it was not an independent country until 1918.
davidm2575
If there is anything odd it is the police going into a school and leading a boy away in handcuffs for kissing a girl.
If there is anything odd it is an American Judge pronouncing a sentence of marriage on a defendant.
If there is anything odd it is leading a Muslim boy out of school in handcuffs for making a clock
If there is anything odd it is a Texts Judge saying he wanted to shoot a police officer
If there is anything odd it is schoolchildren being massacred with automatic weapons and no gun reform
If there is anything odd it is the dichotomy between individual rights and human rights and advocates of this unworkable system
But the oddest thing of all is that people think that all of this is normal.
Well it isn’t……
David. you forgot the Civil War.
Skip wrote: “David. you forgot the Civil War.”
No, the Civil War failed, so the federal government continued as it had from the beginning.
David that is a cheesy answer. The southern states officially seceded, thus requiring a civil war to reunite the States. And yes, the Federal Government abrogated our constitution to do so. Nothing knew.
Skip wrote: “The southern states officially seceded, thus requiring a civil war to reunite the States. ”
You can’t “officially” do something that the law does not allow you to do. Nowhere in the Constitution is there a right to secession. From an official perspective, the South rebelled and the rebellion was forcibly put down. There was never any change in government. There was no need for a new Constitution. The federal government governed just as it did before.
David2575
The Constitution and Ammendments did not suppress the Rebellion. And it won’t suppress the next one.
It is an anachronistic document that needs revision to meet the needs of the modern world.
Conservative Reactionaries will only hasten a division within the United States. America is no different to anywhere else.
ninianpeckitt wrote: “It is an anachronistic document that needs revision to meet the needs of the modern world.”
The ‘modern world’ is exactly what our founding fathers were fleeing from when they created our founding documents. We do need some revision, but only to restore what was taken for granted at the time. Modern thinking has led us into too much government taxes and too much government involvement in our everyday life. We need to secure again our liberties concerning health care which was lost with Obama’s signature legislation. We also need to lower taxation rates and decrease all the services that the government attempts to provide. They have destroyed the family with medicare and social security. Yes, we do need some revision, but probably not in the way that you think.
David2575
The Founding Father’s weren’t fleeing anything. They were opportunists who seized power and wanted colonial taxes paid to them without representation except for the people they chose to be “free”.
If freedom means dying in the gutter because of “Peri(credit)carditis” then you can keep it.
The US Market System of Health care doesn’t work, has never worked and can never work. It just elevates costs to an unsustainable level and reduplicates resources. Every country adopting this system has run into problems.
If the US System delivered why was the Affordable Care Act proposed in the first place?
The US System of Insured Health care will continue to collapse as more and more patients seek treatment abroad.
ninian – your postal code system of medicine is killing people daily. The scandals of the NHS are over the top. Your health care system is a mess. Right now you are importing doctors from Eastern Europe who speak little English to kill your citizens.
Our social medicine system was abolished in the 1980s.
The system we now have in the UK is based on the US concept of the Free Market.
The result has been a disaster with creation of markets we don’t need, business systems we don’t need, management systems we don’t need, corruption we don’t need, spiralling costs and bankruptcy.
The problem in America is that you have no understanding of these things.
You are in the business of making money and you do it very well. This is the only thing you understand.
But the patients have to pay for it and your system is financially not viable.
American Health care is in serious trouble and you will find more and more patients getting their health care abroad. Why? Because no one is doing anything about it.
ninianpeckitt “US concept of the Free Market”?
Sadly, it is only a concept here as well. We have long ago disbanded the free market with more government interventions than anyone can even rationally contemplate. Have you tried to study our health care system(s)? You will not find any free markets here and you will find regulations so expansive that few can possibly rape their heads around them and that does not take into consideration the State regulations. Even the Doctors have their little cartel/special interest group called the AMA, a political machine extraordinaire, which hounds alternative practitioners as if they devils even though AMA doctors kill way more people than alternative practitioners.
Of course you’re from England and really don’t have privy to all this so I will excuse your lack of knowledge.
Apologies – I don’t think I made myself very clear. By managed market I mean health care is sold at a profit to the patient through competetive tendering.
In the 1980s the word, “healthcare”, did not exist; we spoke of a National Health Service, a “not for profit” concept. The Health Service, was provided not sold and there were no contracts for clinical care. I accept this is alien to American thinking but this was how it was done.
This System was a brilliant success and provided high standards of care at low cost. It was a Service not a Business.
As far as I am aware the US system has never worked in this way. The oroginal NHS was the system Don Berwick thought so highly of….. I was in correspondence with him to explain that the NHS has not worked in this way for 35 years and he was yearning for a system made extinct by the planned dismantling of the UK Welfare State, motivated by a desire to reduce taxation and a misconception that the Private Sector could match the standards and costs. The Thatcher government of the day rejected the concept of Society and looked to America for a business model and then adapted it to create a system with government control. In other words it was a fudge and proved to be a disaster.
It couldn’t and didn’t.
But the amazing thing is that once this was realised it made no difference to the plan. £billions were wasted on setting up a managed market business infrastructure and this bankrupted the NHS.
I am advocating that this system cannot provide cost effective national healthcare – it provides costly healthcare for profit that the patient has to fund. So it has to inflate the cost of healthcare.
The USA, like many countries, is in financial crisis and this sort of health system is unsustainable. But this will never change because of the American Psyche and the cost of healthcare will spiral out of control to the extent that insurance will be worthless as diseases and their treatment will not be covered. This is already starting to happen and treatments are being withheld. Patients have died as a result.
So your bad guys who censor healthcare are not the government but the insurance company which decide the cover.
There is no point of insurance that doesn’t fund the treatment of your illness.
This is conveniently ignored in a commercial system which must profit to survive…..
…..whilst the patient sometimes pays with their life.
ninianpeckitt wrote: “The Health Service, was provided not sold and there were no contracts for clinical care. I accept this is alien to American thinking but this was how it was done.”
It is not really alien to us because we have this model at the local level. County budgets include health clinics where they hire doctors and nurses to provide health service just like you describe. People using the service pay on a sliding scale based upon their income. Many people get health service at no charge. We never talk about this health service because the middle class and upper class snub their noses at it. They never use it. They don’t trust a doctor who is earning less than they earn. They want their doctor well paid, and they try to use insurance companies to finance it.
I have never had a problem with our health system because for the most part I don’t use it. I have had two of my five daughters break an arm at different times. I used health service then, but I paid for whatever services were rendered. When my children got sick, I never took them to the doctors. They always recovered fine. When they were born, I delivered them at home myself. No need for doctors or midwives. I realize I am unusual in this way, but I love the freedom my country provides for me to make these choices. I greatly fear now that government has its fingers in health services that I will lose my right to make these decisions. I resent having to pay a $1900 fine every year because I choose not to fund insurance companies who I believe prey on the fear of consumers. For me it is immoral to pay for health insurance, and I am fined by my government now for abstaining from that immoral behavior. I fear my right to continue thinking this way about insurance will soon be taken away by a government that thinks it knows better about the services I need for staying healthy than I do.
Free markets would do the same thing if people were willing to except its imperfections. Meaning low costs and high quality. The AMA and Government will not allow various health providers to compete such as giving Doctors the privilege of treating patients, which is denied to other health provided. Nurses do most of the shots such as a tetanus shots yet cannot charge for it. Only the doctors can charge which drives up the prices from $35.00 to $85.00 Of course they price fix. You would also if you wanted a Mercedes and the licensure laws, specifically practicing medicine without a license are driving prices to where many cannot afford them. Of course people are deemed to stupid to be able to choose a good health care provider, yet they vote.
Commercially based health care exists by virtue of profit. And with respect to business the driving force is profit. This is why the cost of healthcare is higher with this system to the extent that care is unaffordable. The point I am making that a national health service does not have to be funded this way and delivers high quality care at the lowest cost. Our NHS proved this and since it’s reform to the market system it has failed spectacularly. Just at the US System and every other system run this way has failed.
ninian – I know the doctors and nurses used to get paid under the old NHS system and still do today. Some make a lot of money. Is it your position that they should work for free?
Under the current NHS Market System some Trusts are unable to pay wages. This never happened under the old system. I am owed monies, which will never be paid. Some nurses also owed monies to the extend mortgages could not be paid. When you complain you are targeted.
ninianpeckitt wrote: “Just at the US System and every other system run this way has failed.”
You still don’t get it. The US never had a national health care system until President Obama. The insurance companies are not even allowed to compete across State lines. It doesn’t make any sense to hear you talk about how our the US System failed.
David2575
It failed for the reasons I have posted. Worthless insurance cover with exclusions. Funding being with held for treatment. Litigation for personal injury and death against insurance companies for refusing cover.
Your insurance system is just as bad as government sponsored healthcare. But you can’t admit it because it does not fit your model.
If the US system was so good, why have an affordable health care act?
Your argument is flawed…..
ninianpeckitt wrote: “If the US system was so good, why have an affordable health care act?”
We didn’t need that Act. The socialists here who believe that everybody should have healthcare insurance passed it with backroom deals that lined the pockets of those who would go along with it. Not a single member of my political party voted for it. They barely had enough votes. Signing the bill late Christmas eve indicates how desperate they were to pass it. Hopefully we will repeal it when the next President is elected. Your information is based upon propaganda in the media, not on actual experience here with our health services.
hskiprob – being able to vote has nothing to do with healthcare systems.
Litigation is not just involving patients and class actions are underway.
http://www.managedcaremag.com/archives/0902/0902.litigation.html
Who pays for all of this in the end?
The policy holder…..
So the reality of all of this is that you are all being duped.
Don’t fall for this…. it will destroy health care. These people have no interest in you or your welfare.
They are just after your dollars
ninanpeckitt – at least with private enterprise, I can choose who I use for the products and services I need and desire. We need to be better consumers by once again creating quality consumer groups, get government out of the way and let the service providers truly compete for our business. It is we who should choose which people are the better providers of healthcare, not the government. A centrally controlled system ends up misallocating the resources and everyone is harmed by it. Don’t get me wrong, there are always those well off under any system, but for the majority, it is not central planning, it is liberty and free markets that provide the greatest health and welfare to the Citizens and US history has proven this. In 1900 we were the wealthiest per capita nation on earth. Now we are the largest debtor nation on earth. The printing presses cannot be run without affect; there is always a cost.
Hskiprob
I can’t argue about rights to choose. And in a state system you can always opt out.
What I question is your ability to choose in particular your ability to choose wisely in relation to the complexities of health care.
You are open to being abused into buying policies that are worthless and having to pay twice for treatment. Or not get treatment at all if you haven’t extra funds.
The main issue of concern is that Americans cannot access care with your current system and if you are taken ill your insurance cover might end up being useless. This does not happen with a national system that is not based on a free market system of provision.
To understand this you have to stop thinking in the traditional American way take a deep breath and think about what I am saying.
With a State System you are still at liberty to waste your funds on other health policies if you wish.
I think disaster will have to strike before you understand my thinking and you have to sell your home to fund a shortfall in health care costs.
ninianpeckitt wrote: “The main issue of concern is that Americans cannot access care with your current system and if you are taken ill your insurance cover might end up being useless. This does not happen with a national system that is not based on a free market system of provision.”
I think you exaggerate the problems in health care here, but your point is certainly valid. In a national system, costs can be controlled by cutting out the wealthy insurance companies which siphon off the wealth that would otherwise be earmarked for providing actual health care.
What you perhaps are overlooking is the close collusion that government has with insurance companies. That is much of the problem. Government blocks competition between insurance companies in different States. Take away all the government regulations with insurance companies, and you might just get back to a system that can work much better. My personal preference would be for people to wake up and stop buying health insurance. Communities can build their own financial pools to care for their neighbors who cannot afford treatment. History has proven that many times our communities pitch in for a person who has suffered calamity. If people trusted in that, the goodness of their neighbors, rather than trusting in insurance companies, we would do much better.
What experience shows us is that nationalizing a system concentrates a great amount of wealth into the hands of a few. This is the primary thing that breeds corruption, and a national health system will suffer from this. I see no logical reason to nationalize health care. I think each State should control its health services, putting the immediate budget responsibilities at an even lower political level: the county. Furthermore, the door should be open wide to encourage charity health services run by churches, religious organizations, and other groups committed to altruistic reasons for providing health care: for example, Mercy hospitals of the Catholic Church, St. Joseph’s Hospitals, St. Jude’s, Baptist Medical, Methodist Hospital, St. Luke’s, etc.
Our experience has shown that the most expensive health care is in for-profit hospitals and clinics, but they also seem to be the most sought after. The health service of last resort always has been government provided health services. That doesn’t mean such service is poor, but it points out that people will choose to pay more for health services they perceive to be more trustworthy. Some of this is related to physicians having less of a workload in private for-profit organizations and thereby being able to give more personal attention to those who choose to pay for it.
Ultimately, the health system is much more complicated than you seem ready to acknowledge. Perhaps that is because you have not experienced the kind of system that we have had in America. Our move toward adopting the European model does not make discussing it easy.
David2575
Expense in health care is case dependent. Life long chronic care costs are huge. Specialist hospitals excluding high cost cases are more economical to run.
I think the issue of insurance is that it is a business and can only survive if profit is made. But in a competitive system there is no overall plan to meet the requirements of the catchment area. Providers duplicate facilities equipment high tech services which increases cost without appropriate benefit. Because competition is the business modus operandi until you achieve monopoly status and then you have NO choice. The insurance companies end up calling the shots. But for reasons of profit not because they care for the sick. They just want to charge the highest premiums they can. Because that’s business.
I am not against private enterprise but the moment the customer takes second place to the money, that’s when it falls apart.
In health care this results in costs spiralling out of control and American Business succeeds in health care by putting the frighteners on the General Public to gain it’s support. It is a tactic seen in many industries.
So some original thinking is required to address these issues. We had a system in the UK that worked better than anything else until it was modernised and now it doesn’t work at all. In America it is seen as a failed system of socialised medicine. But it isn’t socialised medicine; that was abolished in the 1980s by Margaret Thatcher. It is a system loosely modelled on the US System of a free or managed market that is anything but free and certainly not managed, and which doesn’t work either.
The difficulty in health logistics is in its organisation, not in its delivery – and we all seem to have forgotten that.
david – We have a rattlesnake problem here in the Valley of the Sun. After a minor pricing scandal the local paper did a survey to see which hospital gave the best price for the anti-venom. The one closest to me (4 blocks) is $1300, the most expensive was $26000. Same anti-venom.
Paul C. Schulte
Rattlesnake venom costs illustrate what I am trying to explain. The difference in cost is an example of exploitation, in the same way as jacking up the price of HIV Drugs.
It is business….. and in the US this is how it works. And more impirtantly how you want it to work.
ninianpeckitt wrote: “The difference in cost is an example of exploitation… It is business….. and in the US this is how it works. And more impirtantly how you want it to work.”
It is not the way I want it to work. Insurance companies have caused this problem because services are not rendered like when you fix your automobile. With an automobile, a diagnosis is done and you are shown options of repair and how much it will cost. You then decide what you will pay. If the mechanic tries to exploit you, then you go to another mechanic. Eventually those mechanics that try to exploit you go out of business.
In health services industry, it is very different. You are treated without any options. The doctors do not even adequately explain what they are doing. There is total trust that they are helping you. Then a bill is presented. When you yell OUCH! then they reduce the bill.
Here is an example where the bill went from $80,000 to $20,000.
http://www.dailymail.co.uk/news/article-2547013/Man-charged-80-000-18-hour-hospital-trip-snake-bite-anti-venom-costs-little-750.html
You make some good points about how a single payer system can be better, but you neglect to explain how the quality of service goes down because there is not the profit incentive for providing the best care possible.
David2575
There is little point going to the hospital with angina pectoral and then dying of a myocardial infarction when they present you with the bill.
Or going from HMO to HMO trying to get care to find out your disease isn’t covered.
There has to be a better way. Sick people are vulnerable and shouldn’t be treated like this. When you are really sick financial decisions should not really be made. Your arguments are coming from an agile mind. What if the patient is not as switched on as you are because of illness or because of ability.
I don’t think a dog eat dog approach is right for health care. Patients should not be financially exploited.
I think you are right insurance companies have caused problems but to pick and choose what treatment to have on the basis of your insurance cover does not amount to best practice.
For example you would not use a Heimlich Manoeuvre to deliver a baby at term if delivery was not covered by your HMO or insurance 😨 And yet parallel choices are possible with the American System. The patient doesn’t necessarily get the appropriate treatment in this system which also encourages doctors to work outside their area of expertise.
ninian – I just went to my doctor today for my annual physical. It is included in my insurance payment, as is my flu shot (which I need to get soon). I paid $15 for 90 days worth of medication
Paul C. Schulte
I’m very pleased to hear that you are well. I wish it was like this for everyone.
Here’s just one example of the mess that exists
http://epmonthly.com/blog/refuse-medicaid-patients-get-sued/
It’s a problem of the system and of organisation
ninianpeckitt, there is nothing wrong with clinics refusing Medicaid patients. This is what a free market means. Let other clinics that pay their doctors less accept Medicaid if they want to. What the article is not telling you is that there are government clinics that the medicaid recipients can go to.
For example:
http://www.cookcountypublichealth.org/
Also, check out all the free health clinics we have here in just the State of Illinois:
http://www.freeclinics.com/sta/illinois
I wish you would wake up and realize that you are buying into Obama propaganda hook, line, and sinker.
david2575
I’m not buying into anything.
Obama care is based on insurance which is the only system America understands. And we all know this doesn’t work because it doesn’t work in the private sector. It provides hyperinflationary health care and wastes valuable resources.
I am trying to explain to you that the current system doesn’t work. Otherwise Obama care would not have been created.
But my message is unacceptable because it does not fit in with preconceived ideas.
If the American System was good everyone would agree that thi’s is the case.
But they don’t…..
ninian – Obamacare decided that its insurance would be a one size fits all, which does not work and is causing huge inflation in costs. It also decided to cut payments to doctors and hospitals. So some doctors decided they would not take Obamacare patients at all, some would continue with their old patients and some set a percentage on the amount they would take in their practice.
hospitals are half the problem. we’ve so busy fending of the government, we have no time to coral businesses. We’re being slaughtered from both directions.
Hskiprob
Being slaughtered by the government is an interesting concept. But it’s a bit of an overstatement.
And yet the same sentiments are not expressed about guns…..
So you will understand why this is all very confusing.
ninian – the NHS does it part to kill off a number of patients every year. Some by accident. Some on purpose.
Paul C Schulte
NHS killing patients.
You have obviously read my comments on this in the media from my letters to Ann Clwyd MP.
NHS killing more patients than Shipman
http://www.thefreelibrary.com/'NHS+caused+more+deaths+than+Shipman‘.-a0338821239
Remember this is our New Reformed “American Style” Free Market NHS…..
ninian – you Brits have to take responsibility for the screwups in the NHS.
hskiprob – here hospitals are required to treat any emergency patient, regardless of cost. Since we are on the route for illegal immigrants and they get into a lot of medical emergencies, they run up the costs for the hospitals which are supposed to get help from the government. They don’t. Our former governor complained about it before she was selected by the Obama administration for a useless job where she stopped complaining
Skip wrote: “In 1900 we were the wealthiest per capita nation on earth. Now we are the largest debtor nation on earth.”
You seem to be making up statistics on the fly. In 1900, we were ranked 3rd. In 1950, we were ranked number 1 for per capita wealth:
http://www.nationmaster.com/country-info/stats/Economy/GDP-per-capita-in-1900
But statistics are a funny thing. What does per capita really tell you about a nation? We still are the wealthiest nation on earth if you look at nominal GDP. Who cares that Qatar and Luxembourg have a higher per capita GDP when their populations are so much smaller?
As for the largest debtor nation, that distinction belongs to us only if you do not divide by population size. You used the per capita statistic for wealth, but the nominal statistic for debt. You could have made the opposite conclusions by reversing those methods. If we are interested in truth, we should be more consistent to use statistics that compare apples with apples, and even then, do it with an understanding of what it means. Clearly Greece is in much more economic trouble from debt than the United States.
https://en.wikipedia.org/wiki/List_of_countries_by_external_debt
Hskiprob
“It is liberty and free markets that provide the greatest health and welfare to the Citizens and US history has proven this. In 1900 we were the wealthiest per capita nation on earth. Now we are the largest debtor nation on earth”.
How is this a success to be the largest debtor nation on Earth? There is a flaw in this argument.
You are in debt because you have spent your resources unwisely. Your business and banking systems failed through greed and corruption. And this wrecked the Economic System of the West.
You need to take a step back, take a deep breath and think originally about what you are saying.
The American System has failed. This does not mean capitalism has failed but the American application of it has failed as I described in the posting on American version of democracy.
You need to stop living in Hollywood and enter the Real World. When you can do this you will succeed and cease being at War with yourselves.
The whole of America will benefit when this happens. At the moment your choice is no choice. It is just a matter of which business screws you the most. Because American Business is designed this way.
That’s why you are in debt. The largest debt that has ever existed……
We are no longer a free market economy but a fascist one. Our defense spending is higher than the next 11 countries combined according to Jane’s. We have some of the highest tax rates in the world considering allowable deductions and total taxation.
Hskiprob
The USA isn’t really a “proper country”. It’s more like the EU than the United Kingdom and this is part of the problem. As far as facsism is concerned a system based on individual freedom can promote power of minority views over the majority and this is the door to a Fascist System and ruling elite. And in the USA the ruling elite is unelected Commerce. They are the ones calling the shots.
I think the system will continue to evolve and hopefully “real” democracy will be the outcome.
The aim at the moment I think is to be able to think originally for ourselves and not to accept things just because we are told to…..
ninian – Hollywood is actual a very small section of L.A.
Paul C Schulte
“Holly wood small part if LA”
And that’s the point…..
A small elite should not hold sway over the majority in a Democracy.
ninian – to the best of my knowledge, no elites live in Hollywood. The live in various places in the L.A. area. depending how rich they are.
Paul C. Schilte:
Elites and Hollywood
Maybe the elites own Hollywood, Congress and House of Representatives? Maybe the Big Deal is that no one voted for them?
ninian – you have no real concept of America. Only one major film studio (of six) is still based in Hollywood. The rest are in the L.A. area. Hollywood is not the home of the elites since the 30s. The big deal is there is not big deal.
ninian – would you like to point out the English Constitution and Amendments?
Paul C. Schulte
We have more sense than to have a written constitution.
The UK has no single constitutional document. This is sometimes expressed by stating that it has an uncodified or “unwritten” constitution. Much of the British constitution is embodied in written documents, within statutes, court judgments, works of authority and treaties.
So we have a seemless system of continuous modernisation and are not handicapped by the US System that is reactionary to sensible change.
ninian – you stumble along in your legal system. You have secret trials for the wealthy and gag orders for parents who the legal system has harmed. That is sensible change?
We have some common sense and don’t arrest school children for making a clock or kissing a girl.
We don’t have any judges threatening to shoot policemen or sentencing defendents to marriage.
We attempt to have a dignity in our Courts to create an atmosphere of respect for the legal system and try not to make things up as we go along. We are truly multicultural and do our best to tackle prejudice if/when this occurs.
We don’t always get things right and when we fail we try to correct the error.
But like the USA we are badly led; our government and economic system is riddled with corruption. But people like me are able to speak out….. although change us difficult there are mechanisms to correct injustice.
In the UK we have so much liberty anyone can become Prime Minister. And with the greatest if respect the US falls short of our freedoms. Fir a nation of immigrants not to allow an immigrant to be President unless born on US soil just takes the biscuit – sorry cookie.
But you are only 300years old and still a young country. I have a wardrobe which is older than the US Constitution….
You need to understand that the USA of today is not the final outcome and I have every faith that democracy will become a reality – one day…..
david – if you can join an organization you can unjoin the same organization. Remember that the Constitution was set up so that all of the 13 states did not have to approve for it to go into operation.
hskiprob – the North was not REQUIRED to invade the South. There are all manner of things that could have been done, including leaving them alone.
If they wanted to maintain their power to tax and regulate them, would they have not had to invade. They lost legal jurisdiction and thus had to invade or lose their legal controls. It was a political power grab from the very beginning. The southern states had no were near the political power as the northern states. Two to one in population and I might add in military personnel. You wonder why the north won; two to one odds. The Republicans knew this and why they started substantially increasing tariffs, long before the war, on southern goods being shipped around the world. It forced the southern farmers to sell to the northern industrialists at cheaper prices and gave revenue to the federal government to subsidies railroad expansion to their favored corporations. This was the beginning of the Republicans love affair with corporate welfare, many of them once being Whigs, before the party imploded.
It’s always about the money and power, always. Slavery was just a great trade off because most of them were in the south. Many New Englanders didn’t even want them living in their towns, especially our beloved Yankees, many of whom were white separatists.
Thankfully my family left Boston in the 1720s, interestingly enough due to religious persecution through the Bennington Grants. This created a physical conflict between York and New England and a precursor to the revolution. They were Green Mountain Boys and my Uncle Moses Robinson was the 2nd Gov. of the Vermont Republic prior to the Constitution. My uncle was Silas, and one of 6 sons of Captain Samuel Robinson, who I think should be considered the real Father of Vermont. A Judge has written a recent book “Moses Robinson and the founding of Vermont”, who did help VT become a State as well as some other important things.
http://www.montpelierbridge.com/2014/10/book-review-moses-robinson-and-the-founding-of-vermont-by-robert-a-mello/
I was asked to see the principal once when our son was in the third grade, Alameda, California. He was an intelligent, rational, and reasonable man. First he explained that our boy, along with another, had ‘mooned’ some girls. Then we had to explain to him that this was not fair to the girls, that it was disrespectful, and that it was not permitted to flash your private parts around. Both the principal and I then hit our boy with the big guns. We each in turn explained that there are idiots out there in the world in positions of power that would punish him unnecessarily hard for doing stuff like this. We explained that what he and his friend did was not acceptable but some people might even put him in jail for this. We both managed to keep straight faces throughout.
Kids need to know about the sickos lurking out there, in their own school, perhaps in their own classroom, and certainly in the halls of justice. Some of them even run for public office. We constantly read about the innocent lives ruined by these sickos.
there is a key figure here who was mentioned near the very beginning of the comments.
To the effect—“The police officer…should have turned around and left.”
If he had done so, the boy wouldn’t have been arrested and the Nanny State issue would blow over, right?
Well, ……imagine the furor over the officer’s refusal. In a very small way, this is like the start of the WW I mobilization. Once the forces were called up, in those days, there was no way to call them back.
God forbid that we played Mumbly Peg with small buck knives during recess or lunchtime. Actually carried them on our belts as Sputnik scared the stuffings out of us. Steal a kiss? Standby for the slap that followed…..teacher oversight?.?.. Just smiled ….. Then there were the duck and cover drills and sirens.
So now we have a youngster who may be branded a sex offender for a stolen kiss. This country needs a real honest to god external mortal threat to its being and the whole citizenry needs to feel it. We are so complacent that we are now “eating” our young.
If I’m thought to be an extremist, there is a basic business principle: an organization cannot change until it hits its chaos. On a smaller scale-the addicted family with the addict(s) hitting bottom
And FYI, the topic of this blog post is the boy kissing the girl on a dare( forcefully as it turns out) not boys rough housing. Try to stay on topic.
Inga – this has more to do with him taking a dare than anything else. I am sure he was getting so sexual or social pleasure from it.