Re: The value of shopping local

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bittersweet.
5 Hankies, heh ;)
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(Amazon.com product link shortened)96998376&sr=8-1
Sounds like blasphemy meets the Honeywood File. ( http://tinyurl.com/225msq )
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MichaelB
www.michaelbulatovich.ca
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More to the point, when I used to pay my doctors directly, they didn't overcharge - they cwertainly didn't starve <LOL!>, but they couldn't get away with overcharging, because then, people would just go to a differnt doctor.
The whole HOMo nonsense caused a price inflation.
ALso, there is a difference between having helath insurance, and being forced to go through this halfasses HMO crap system that they invented during, what was it, the Nixon years? Doctors are manipulated into over- charging by the HMO system. Now, it's called "health insurance", but what it actually is, is a series of gigantic HMOs.
We used to pay the physician directly, and the insurance was there for "the big stuff". As above, it helped keep costs down. Now, everyone is forced into this bureaucratic nightmare - rather than paying th ephysician, we have to pay the bureaucracy, which then pays the physician, so the doc almost *has* to overcharge just to get what s/he *should* get. It's lunacy.

Yup. As far as I know, the AMA has nothing to do with it, unless what he's going on about is specialist training - and that's just common sense; you don't want a family practice doc, or an orthopedist, doing brain surgery - you want someone who has trained, and continues to train, in the methodologies of brain surgery.

Well, it's also dang hard to cope with more than one or maybe two specialties - there isjust so much knowledge... But malpractice insurance *is8 a killer. What it is, is that the good physicians are forced to pay for the few bad apples, plus those people who do consider lawsuits a form of retirement plan, and *everyone* suffers because of it.

Exactly. THe determiner is the HNMO/"Insurance" groups. THey decide what is considered a "fair and customary" price, I think that's the term. But ifthe Doc charges you that price, they don't get it all from the HMO - they get a percentage. So they charge more, so that they get the fiar price doled out to them by the HMO.
ALso, salary is one thing, the cost of doing business is another. In some places, obstetritians have become an extict species because they have to pay out *more* (in insurance, and business costs) than they earn.

The worst is socialized medicine. I lived in Canada for 10 years, and between the waiting times to see specialists, the fact that you couldn't get any testing that wasn't approved (meaning, common and average, IOW, if you had an unusual condition, you were prob out of luck), and so on - well, if there is one thing that makes me shudder, it's the talk of socializing the US system. I'd prefer to see vouchers given to low- income folks...
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To be honest, what I think the biggest problem is, is lack of attention to detail. A lot of the jobs associated with medical careare fundamentally about keeping focus on the mundane detail-oriented tasks - in the pharmacy, much of this is related to reading and keeping records, reading labels, double-checking whether the medicines are the correct ones. Oh yeah, and counting units of medicines (pills, vials, whatever).
Same is true in pharmaceutical manufacturing - increasingly, people resist taking correction, or even following protocols, because they see their jobs as a matter of their own personal egos, as opposed to what the jobs actually are (a matter of human helath). If they don't want to do the job, they ought to get out of the field. ((No, I don't have paper references - I get much of this stuff first-hand from people who work in teh biomedical and/or phamaceutical fields.))

I disagree about worker skill - success has to be a blend of *both*. After all, a worker has to have enough skill to work in accordance with protocols/methods, and thosear epart and parcel of business practices. If part of the business calls for the sterilization of a 10,000 gallon fermenting tank, and all plumbing etc. associated with it, between every product run, you have to have workers who both understand *why* this needs to be done, and how to do it. Also, the quality control department's protocols are useless if people are incapable of comprehending and carrying-out those protocols.
What it is, is that people have to know how to do what they're supposed to/need to, and they also have to give enough of a damn about what they're doing (and why) so that they'll do it correctly.
Why do you think, for example, there are so many recalls of meat recently? The manufacturing protocols are well-known - what's lacking is worker skill and/or worker attitude (i.e., whether they give a damn about making sure they follow the protocols).

Why would a neurosurgeon allow the nurse to write a prescription? That's simply not a good practice. But your point was mainly that:

Again, when it comes to the fields of medicine and pharmaceutical development and manufacturing, there is no mystery as to what are the best principles and protocols. THe main pitfall is corner- cutting/carelessness. SOmeone is spending more time on the job thinking about going out to the bar with freinds that evening, rather than concentrating on the job (and, subsequently, the possible harm that their laziness/carelessness can cause to others).

Sometimes, tho', I think that it's the insurance that leads to a greater acceptance of carelessness, at least in some cases. IOW, if someone ucks fup, the thought is, "Well, at least the insurance would cover it".
IMO, the *root* of the problem (in all fields) is that epople spend more time thinking about how to avoid taking responsibility for their foul- ups, than they spend trying to be carefult to not foul-up in the first place. The cuirrent notion seems to be taht saying "Oops, I'm sorry" somehow fixes things like malpractice, vehicular manslaughter, rape, and pretty much everything else. All that regret does is possibly indicate whetehr the person is likely to repeat the action (that is, assuming the perp isn't faking it, whcih really is not a difficult thing to do).
Ultimately, the solution is for people to think less about childish egotism, and more about taking pruide in doing their jobs well - and, for that matter, pride in living responsibly. In recent years, "responsibility" has become a dirty word - people are **FAR** happier being told "suck my a**" than they are with being told "take some responsibility for your actions".
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Guess again. The big meat aggregators and the USDA have no interest in a safe food supply http://www.axisoflogic.com/cgi-bin/exec/view.pl?archive6&numB48&printer=1
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[snipped for bandwidth and brevity]

Insurance is a problem unto itself - part of the mess has to do with peole not reading contracts (and getting independent advice regarding the parts they don't understand), an dpart of it is the company not keepign to its contracts, or else making contracts deliberately vague in some areas.
But a fundamental problem, which also realtes to insurance, is that it sued to be considered wise to keep enough in savings and investments to pay off at least *most* of one's debt in case of an emergency. Nowadays, it seems that if you do so (as opposed to conspicuously wallowing in a seemngly-endless cacaphony of material posessions), most people consider you to be a freak, a psycho, or some just plain dangerous =8-O
It also seems to me that the increased reliance (usually due to being forced into fthat reliance by governemntal policies established, IIRC, during the Nixon administration) upon insurors/HMOs has played a hug epart, and IMO the largest part, in creating the current combination of inflated costs and inflated insurance rates - and concommitant decreasing coverage, because those inflated costs are exceeding even the insurance companies' ability to keep up with them.
I never paid my doctor with a chicken (I'm not THAT old!! <LOL!>) but I do remember the days of "cash up front". And, even though $20 back then took much longer to earn than does $20 today (due to the deflated value of the dollar), the fact is that we did manage - and my family was by no means well-off. THe otehr fact is that family physicians were more willin gto let a patient either pay by installments, or even, on some occasions, provide service to the children of people who had fallen on particularly hard times and accept payment whenever the people could pay.
Yeas, I know full well that medicine is more advanced now (I worked in medically-related fields for several years, so I'm not a total ignoramous about the subject), but the problem is not only with advanced diagnostics - it's with a system that encouraces overcharging and has inflationary practices pretty much built into it.

Most people either cannot or will not learn from history or past wisdom, but what pops into my "Jurassic" mind is Aesop's fable about the grasshopper and th eants. What it is, is that there are currently *far* more grasshoppers than there are ants, and when Winter comes, trouble will follow.
It might be that enough people are trying to figure things outm, and a disaster might be avoided, but it's just as likely that the "grasshoppers" will learn to organize, not to do anything constructive, but rather, to pillage the ant colonies.
THere is a science-fiction book titled "The Postman" - there was a bad movie adaptation fo it with Kevin Kostner as the lead, but go back to the original book. It deals with the same sort of opposing forces (constructive action versus destructive action).
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We pay doctors about three times what Europe does. We have similar costs built into the entire system.
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wrote:

Because you're out of district?

Pretty cool. How high are the runs near you- top to bottom? More than 800ft?
Parents of kids, whether in private or public schools, have to be involved in their kid's education, and be advocates for their kids. A well known private school near here has been known to have a history of abuse in it. Just because you're spending $30K/annum doesn't mean you don't have to check in once in a while.
http://www.google.com/search?q=%22upper+canada+college%22+sex+abuse+teacher
I know guys who went there, and they all said it was widely known what was going on, and they are all now big supporters of diverse, co-educational, public schools. (Like me. I went to a rival private school back then for a very short time, and would never put my kid through a private school environment either.)
A few years ago we moved our kid out of a plainly mediocre school led by a plainly mediocre principal to a great one led by a great one. This happens all the time despite the 'official version' of things they tell you at the board of education. (This second *principal* doubled as the school's hockey coach...7 a.m. practices...how cool is that? I've never known an administrator to volunteer like that.)
We are still dealing with the shadow cast by the poor teaching she got at the other place. People tell us we're crazy when the find out how she's doing, but we have high expectations to suit her abilities.
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