CFLs vs LEDs vs incandescents: round 1,538

[Pete C.]

~350M I believe.

[Van Chocstraw]

I've had them for many years. Never burned out out. Broke a couple in my drop cord. Too late for recycle after broken. Into the garbage it goes.

[Pete C.]

Our health care system works well, 86% of our ~350M population has health insurance and of the remaining 14% a good number have it available, but choose not to take it.

Our health care system is far from broken and while you can readily come up with a few percent of the population with health care horror stories in the US, Canada, UK, etc. and make emotional news stories out of them, the fact is that the number is an extremely small percentage of the population.

What US health care needs is refinement, not reform. Tighter controls on insurance companies, more consumer protection, and a bit better method for handling the bottom few percent of the population than the current emergency room strategy. Doctors also need to rationalize the fact that theirs is no longer a gold mine career path and they may need to live with a smaller yacht and house.

[Clot]

Made me curious. 304M (July 2008) according to this:

[Clot]

Interestingly, this came out today:

I've always used the rule of thumb that the US population is five times the UK and don't see a reason to change it!

[Pete C.]

The UK is less that 1/3 the size of TX, so think of what that means for population density and why just about nothing can be compared across the two countries.

[Clot]

Quite. It's one of the reasons we tend to have smaller vehicles! We each have an eighth of the space over here.

[David Nebenzahl]

On 8/27/2009 9:23 AM Pete C. spake thus:

How do you figure that recycling glass is a "net negative environmentally"?

Not necessarily challenging that, but I am interested in the details. I've always thought that recycling glass is basically picking some of the lowest-hanging fruit, environmentally and economically speaking. It requires little processing other than remelting (along with some separation of dross) to make new bottles, etc., out of it. Certainly better than recycling plastic, which I assume must be a horrible net negative.

Enlighten me, please.

[me]

Fuck all it is !!!!

It is the biggest cluster f*ck ever!!!

[Pete C.]

It varies with the particular commodity being recycled, with glass being about the worst example.

Glass is basically made from sand, there is no shortage of sand on the planet, glass is entirely inert in landfills and the energy required to re-melt glass to recycle it is nearly the same as that required to make new glass from raw materials. Therefore the energy, typically diesel fuel, and other overhead required to transport glass to be recycled is a net negative environmentally.

Aluminum is probably one of the best examples since while the raw material is abundant, the energy required to refine useable aluminum from the raw material vastly exceeds the energy required to collect, re-melt and recycle it.

Recycling plastic used to be pretty negative back when about all you could do with it was burn it to run a generator. Technology improved and they were able to take mixed plastic and re-melt it to form non critical items like shipping crates and palettes. The latest recycling technology can separate mixed ground plastic into the different types of plastic which allows it to be recycled into higher grade applications.

[Pete C.]

That's why the bone heads in either "wing" trying to compare the US health care system with the UK health care system are just comparing apples and brussel sprouts, there just isn't much valid comparison.

Clearly delivering health care to a high density population is more efficient and less costly than delivering the same health care to a population spread over a much larger area. With low population density, more medical facilities, doctors, nurses and support staff are required to serve the same number of people.

The low population density in much of the US is also why mass transit isn't viable in much of the US. In the areas where the density is sufficient *gasp* we do have mass transit in the US.

[CSquared]

Yeah, but we tend to bunch up pretty badly, so having all that space doesn't really help a whole lot of us too much. :) Later, Charlie Carothers

-- My email address is csquared3 at tx dot rr dot com

[Pete C.]

Those are the facts, whether you like them or not.

[Clot]

>

I was thinking the same way when reading Pete's view, but I think there are more communities of say ballpark 5, 000 to 10,000 people that are at a further distance to larger communities than here in the UK which would result in more local facilities being required in smaller communities than here in the UK.

[Pete C.]

>>

Yes, and there are plenty of areas in the US where you can drive for many miles passing through town after town with triple digit populations. Providing services to people in these areas is substantially more expensive than people in a large city. Transportation issues are a big issue for the poorer folks, you could give universal coverage to them (which already exists anyway in emergency rooms), but they still need to somehow get to the medical center that might be 50 miles away.

[Clot]

>>>

Precisely so.

[sligoNoSPAMjoe]

..

Or maybe can't afford it. They end up with poor healthcare (the emergency room) and we all end up paying for their care which is delivered at a much higher cost than normal care and since they don't get preventative care, they are less healthy and therfor cost even more while recieveing less care.

That is the way compition has worked in this non-free, non-competitive market.

...

I would agree that current regulations need major revisions.

I would like to take the profit motive out of the system as much as possible.

For example no doctor should recieve any benefit from sending a paticent for a test, or procedure. They should be isolated from the profit of MRI's and perscriptions etc.

As an example: I have a back problem. When it comes up I need help now.

In the US I end up in the emergency room. There they start with my insurance card, I see three or for people, all taking information over the first 20 minutes or so that I am there. I finally see the doctor and each time, the send me to get one of those fancy X-ray test that cost a ton. Each time I am taking up a room in the emergency area of the hospital. Each time they come back with the same conclusion, and prescribe several perscriptions.

In the UK I get to the emergency room, talk to the lady behind the desk and I am asked to wait. I was infromed that they knew what the problem was, but they needed to find a doctor free to write the prescription. Doctor came we talked while he examined me and within

15 minutes of arriving, I was on a stretcher in the hallway waiting for the drugs to take effect. I was out of there in less time than it took to finish the text in the US. Yea, I did not have a private room, and I was not on an IV and I did not get more X-rays and I had no bill to pay, nor did they even care that myUS insurance covered me there.

Let's see, US more time more test and more cost to me and my insurance company vs faster care, less X-Ray exposure and less than thirty minutes total vs two to three hourse in the US.

Why in the world would you want the public medical service when you can get much more expensive care in the US. Of course I can see where a lot of our commerical medical industry might want to keep things as they are.

[Pete C.]

No, it's been documented that in that uninsured 14% there are a good number of mostly young and healthy folks who choose to take the gamble and use the funds that would be their contribution to health insurance coverage for other purposes. It would be good if those other purposes were a down payment on a house or something else good, but most of the time it's for something silly like a new car or ipod. Either way, it's their life and their right to take that risk.

So you're saying that the emergency room, the same emergency room that handles those with health insurance, provides substandard care?

Well, this applies to the portion of that 14% who do not have health insurance available, difficult to quantify, but perhaps it's 8% or so of the total population. This is where the system needs refinement, not reform, to better target preventative care at those 8% who do not have access to health insurance.

You bring up two basic issues here:

The first is the efficiency of records access in the UK public health system, vs. the US. In the US, unless you are going to see your regular doctor, the people treating you won't know didly about your past medical history. This is one of the reasons for the longer wait time and additional test.

They have been trying to streamline medical records in the US, but keep running into the privacy issue (we have more privacy rights in the US generally). I think they will eventually settle on some form of standardized medical ID card to keep in your wallet with a chip containing your records.

A standardized chip card with records would ensure they are in your custody, not some central server subject to hacking, and can be provided to any medical personnel treating you for the duration needed. In the case you don't have the card with you, it's no worse than it is today, so no disaster, just a bit less efficiency.

The second issue is that doctors in the US are currently incentivised to order extra tests for a number of reasons. They get additional payment for ordering those tests, and with insurance companies paying rather low, they try to get as much as they can by ordering more tests. The next incentive for extra tests is for protection from the insanely litigious US population, who will sue for the tiniest error and those extra tests help to cover the doctors posterior. And of course the third reason for those extra tests was covered above, lack of access to previous medical records which leads to redundant testing.

Again, all this points to a need to refine the US system, not "reform" it by ripping it out and starting over.

[me]

Link?

Besides who the hell trusts stats from Repubs!

[HeyBub]

Or maybe they're illegal aliens (~15 million). Or maybe they're incarcerated (~2.6 million). Or maybe they're between jobs (~2.2 million). Or maybe they're between 18 and 27 and choose to spend their money otherwise (~3.3 million) Or maybe they're eligible for Medicaid or S-CHIPS and will apply when they get sick (?) Or maybe they're self-insured (?)

Try to wrap your mind around this fact: It is the profit incentive that drives innovation. Without the profit motive, we wouldn't have breast implants and all manner of other wonderful advances.

If the referral is to another company, that practice is already illegal.

That's you. I place a call to my doctor and drive to the pharmacy. There I pick up a bottle of 60 Vicodin and hand over $5.00. I'm done.

I'm glad I'm not you.

Look up. Do you see a black cloud following you around? Sure sounds like it.

Because I CAN GET more expensive medical care in the U.S.

I read about a case recently involving an 82-year-old woman from the UK who had suffered for several years with pain in her finger joints. Many visits to her local GP all resulted in the same diagnosis and treatment: This happens when you get old and take Tylenol.

She visited her granddaughter in rural New Hampshire and had an episode. In fact, her left hand even swelled a bit. Her relatives took her to their local doctor, who, within two hours had X-rays, blood work, and an MRI. Diagnosis: GOUT!

She got some pills.

Mind you, all this was at a small hospital in rural New Hampshire. Oh, the whole episode cost a few hundred dollars, but years of suffering went away.