Defensive medicine, though from long experience, the use of rule-out tests
rather than differential diagnosis bears a direct relationship to the limit
imposed by the individuals' insurance, regardless the patient load in the
"Standard of care" is what is used in malpractice suits, and the bar rises
with each award. All you can do is hope the outcome, using the current
standard of care, is favorable. A lawyer will create a new one if not.
It may not be likely that had we not withdrawn some of the
Predators from we would have killed bin Laden by now, but
can you sensibly argue that it would not have been MORE
If the resources in Afghanistan were sufficient, why did so
much of the country revert to Taliban control? Why do
we have to rely on NATO troops deployed out of theater?
If you think that is adequate, what might consider deficient
must be terrible indeed were it based on the situation
in theater, rather than in the White House...
No evidence to suggest that.....One can "what if" Ad nauseam .....maybe if
we had mobilized the entire country and fielded a 15 million man army and
invaded Pakistan we might have found him.....somehow that solution might
have a bit to be desired as well.
From the "get go" we did not want to be a foreign occupying force in
Afghanistan .....The Soviet Unions 10 yr. occupation did not work out well,
there is a rather long historical failure of foreign occupiers in that
country.....from the invasion onward we tried to provide assistance with a
very small footprint.....Using NATO or multiple countries is simply to avoid
that imprint......Afghanistan and Iraq are very different situations. Rod
I can't say as I agree that bin Laden's
chances for survival are independent of
the resources dedicated to killing him.
But if that IS your argument then I guess
you don't care how hard Clinton went after
him because it wouldn't have made any
Remember our earlier discussion about false
dichotomies? I assume that this is also not
one, just another exaggeration proffered in lieu
of a serious discussion on your part.
Somebody didn't want to dedicate more
resources to Afghanistan because they
wanted them for the invasion and occupation
NATO stepped in because our NATO allies
understood the importance of the Afghanistan
Yes, that has been precisely my point for the
last five years.
As you know it is a false dichotomy to suggest that we had to
either invade or ignore him. Containment had rendered him
impotent outside of his own borders and even in the Northern
Third of his own country.
IOW, you are well aware that he was NOT being ignored.
No, ignoring al Queda was Republican policy. They
called attacks on bin Laden and his assets 'wagging
the dog.' Clinton made no fewer than four (4) publicly
acknowledged attempts to kill or capture bin Laden.
Bush not only made NO attempts on bin Laden but
his response to the intelligence blaming bin Laden
for the bombing of the Cole was to remove his
name from the State Department's list of 'terrorists'
and to disband the group tasked with hunting him down.
Bush's appeasement didn't end until September 11, 1991
and then Powell had to talk him into retaliating against
bin Laden and the Taliban. Rumsfeld and Wolfowitz
almost convinced Bush to continue ignoring al Queda
and to use the attacks as an excuse to invade Iraq
instead. Ultimately they prevailed, but at least in
the short run Powell got him to do the right thing when
it was needed most.
No false dichotomy but rather simply being facetious....however because of
short term self interest by various parties including the UN oil scandle the
embargoes etc were crumbling and had little long term chance of
survival.....Incidently the U.S. Iraq containment effort was one of Osama's
Of which was almost a sole U.S. effort at U.S. expense.....and still begs
the question of how long we should have continued the
effort.....Incidentally if Saddam was not worthy of removal why was he
worthy of containment?
Four? All of which were half assed and ineffective and in no way lessoned Al
Queda's looming power or organizational growth..... I'm sure when we blew up
the antibiotics plant in the Sudan Osama was shaking in his boots.
Simply BS without actual historical fact, your mistaking the rearrangement
of administrative deck chairs with substantive diminished concern
.....nonetheless soon after Bush's close electoral win he did not have the
publics support for any quick or substantial Middle-East
adventure.....Presidents may be powerful but new Presidents must work their
way up to invasions etc.....
Such silliness Powell never got anybody to do the right thing.....to his
core he was and is a dove. As a administration talking head he did present a
case before the UN to justify invading Iraq albeit a non convincing poor one
at that. Rod
Its good to know you thought about it but I daresay there are
way too many who do think that way.
It is one thing to smuggle out oil for money, it is quite another
to spend than money to violate the import prohibitions. North
Korea is one of the poorest countries on the Planet, yet they
were able to develop nuclear weapons. It is not primarily a
question of finance.
However effective that may have been, have you any
doubt that invasion and occupation are far more effective?
Non Sequitor. Hussein was 'worthy' of removal. The same is
true of Bashir, Mugabe, Kim Jung Il, Musharriff, King Abdullah,
the Burmese junta, or any number of others. There is con-
siderably more to consider.
At the very least, unlike the invasion and occupation of
Iraq, those actions did not contribute to the growth of
"The State Department officially released its annual terrorism report
just a little more than an hour ago, but unlike last year, there's no
extensive mention of alleged terrorist mastermind Osama bin Laden. A
senior State Department official tells CNN the U.S. government made a
mistake in focusing so much energy on bin Laden and 'personalizing
terrorism.'" -- CNN 4/30/2001
Especially after the attacks on the US on September 11, 2001
he should have finished in Afghanistan and Pakistan instead of
diverting resources and attention to the Middle-East.
Do you also think he is a liar?
He said that on the evening of September 11-12, 2001 he
convinced Bush to retaliate against Afghanistan and not
Yes, he made the best argument possible without
making statements he knew to be lies, though
some of the information he as given were lies.
As you note, that argument was not convincing.
You need to get out and about a bit more. Here in rural WV bingo
fundraisers are a common affair for people with all sorts of medical
problems and no cash to treat them. Last year there was a fund raiser
for a woman, cancer, no insurance, no treatment until she could come
up with her share of the bill. Needless to say she is now gone.
There are people who die daily because they cant afford the treatment.
There are people who's cancer metastasises while they are trying to
find a facility that will administer charity care. There are people
who are simply refused payment unless they can come up with a major
percentage of the costs and then put there property up against the
The koolaid colored glasses may allow you to think people arent dying
in the streets, and of course there arent actual bodies in the
streets, but none the less people are going in the ground daily while
profit taking abounds in the medical profession.
Have you never heard of Medicaid? The fundraisers could very well be for
living expenses, when sick it is hard to pay the rent.
Who are these people when Medicaid is available?
I don't need to get out....My 79 yr. old mother passed away from
cancer....Medicare and my dad's medical supplement picked up the $100,000
tab..... my father-law(86) and mother-in-law(80) both died from cancer and
Medicare/Medicaid picked up the entire tab, surprisingly the kids inherited
the house. A 59 yr. old cousin died of Kidney cancer on Medicaid's tab and
his millionaire brother got his house(again surprised) a 60 yr. old aunt
fought cancer for nearly a decade again on Medicaid's tab......The reason
people are dying daily is simply cancer kills and true cures are few and far
and death at best is often simply delayed......In fact many or most working
or insured people once sick enough cannot maintain insurance or employment
anyway, the existing Medicaid program is the ultimate coverage for
most....at least before pronouncing such koolaid accusations you should know
what your talking about...... Rod
I wont make another sugary glasses references but having to post this
in the first place is rather sad.....
The ease of eligibility is very far from your spin. Eligibility varies
wildly from state to state and there are basic criteria that, within
minutes of sitting down at DHHR, flatly disqualify many individuals
any from coverage. It is not called one of the biggest bureaucracy's
for no reason and furthermore its not there to insure the uninsured in
the first place. The simple fact is many people dont come close to
qualifying period, but of course I shouldnt have to explain this to
you as you are well versed in Medicare.
Young, single, no young children, asset issues, a working spouse or
able to work, own land, have savings, and so on. Even with spending
down (if you have even been able to stack up bills to qualify)
eligibility can be difficult and in many cases impossible.
Pertaining to our area:
WV's eligibility criteria:
Except in the case of pregnant women and children up to age 19 years,
eligibility for Medicaid is based on categorical relatedness, income
Categorical relatedness means that an applicant must be a member of a
family with a child who is deprived of support due to the absence,
incapacity or unemployment of a parent(s). If the applicant has no
children under age 18, the individual must be age 65 or over, blind or
The second factor considered is an applicant's income and assets.
Income is any money a family or individual receives such as wages,
pensions, retirement benefits or support payments. Assets include
money in the bank, property other than the homestead, and the cash or
loan value of certain life insurance
**Read above**: "If the applicant has no children under age 18, the
individual must be age 65 or over, blind or disabled." Start doing the
In WV AFDC Limits assets to $1000.00, In spend down it is increased to
2k for one person and 3k for two. More math.
These criteria alone render the vast majority of those under 65 and
uninsured ineligible. The fact that I even have to spell this out is
ludicrous. If medicaid were a viable option for the uninsured we
wouldnt even be having a political debate on health care. My OP never
said anything pertaining to age, or income level. The woman I spoke of
was in her 40's, children over 18. She was not disabled and up until
the end she was able to work and therefore had income. If she were
eligible she would have been enrolled. These simple criteria exclude
you from most options for care unless you have insurance. Once you
exhaust the facilities willingness to cover your expenses its pay or
play. But again, I shouldnt have to tell you this.
Though she didnt work there, a good example would be "welcome to the
world of a Walmart employee". While the company is pulling down
$20,000.00 per minute in shear profit (fact) their average employee
will likely be denied any form of medicare, freecare, or charity care,
at any hospital due to their whopping 16K/year income. Now please dont
start about Walmart beginning to extend availability of benefits to
workers (only after years of scathing PR). They have gotten rich off
the backs of their workers and now in their ultimate benevolence will
offer the 16k/yr employee an insurance plan they can never afford.
here are some others:
"Medicaid does not provide medical assistance for all poor persons.
Even under the broadest provisions of the Federal statute (except for
emergency services for certain persons), the Medicaid program does not
provide health care services, even for very poor persons, unless they
are in one of the designated eligibility groups. Low income is only
one test for Medicaid eligibility; assets and resources are also
tested against established thresholds."
Medicaid limits access to quality care. Due in part to Medicaid's low
reimbursement rates and burdensome bureaucracy, fewer physicians are
agreeing to accept Medicaid patients. A 2002 Medicare Payment Advisory
Commission (MedPac) survey found that "approximately 40 percent of
physicians restricted access for Medicaid patients
Derek Hunter, "Government Controls on Access to Drugs: What Seniors
Can Learn from Medicaid Drug Policies,"
In order to control spiraling costs, many Medicaid programs restrict
access to treatments and services. This is particularly visible in how
states ration access to prescription drugs within Medicaid. States
have devised a variety of approaches, such as restricted formularies
and monthly limits, to impede enrollees' access to prescription drugs.
This can be especially problematic for enrollees with multiple health
problems. Those with mental illnesses, for example, may find that the
limited formulary restricts their ability to find the best choice for
them within a class of similar drugs. Policymakers should find ways to
give enrollees, and their physicians, greater control over treatments
Sort of makes you wonder why Enormous General Hospital up north of here has
so many social workers on the payroll. Their primary job is to "help
families through difficult times," which normally translates into filling
out applications for medicaid, special child coverage and such. They must
recover enough through such means to cover the cost of the employees, though
social workers are pretty cheap, as they should be, and a bit more. Never
known them to waste a nickel. Counseling is free through the clerics, and
the social worker fees are not line items in the bill.
Of course, we're pretty generous up here. Woman from our town had a gastric
bypass (for health reasons) on the state, then, after losing all that
weight, some reconstructive surgery to remove skin and sag (for
self-esteem), courtesy the same taxpayers. Her girls were looking pretty
good after their state-funded braces cured an unhealthy overbite, too.
Not to diminish the tragedy of your cancer patient in a higher post, but
I've seen too many people who are told in two or three consults of the
inoperability and untreatability of their condition having spaghetti dinners
to help them try another therapy or get another diagnosis. Guess I'd do the
same, since Kevorkian isn't around anymore. Wouldn't blame the medicos,
Interesting. Over the last few years, I've had a chance to see how the
poor people are left dying in the streets.
In 2005, my wife went through a near death experience as she had a 95%
blockage in her right carotid artery. The reason it was a near death
thing was that about 17 years before she suffered a stroke and unknown
to us, her left carotid was blocked and had calcified over the years -
no blood to the brain isn't a good thing. But I digress. She ended up
having an operation which opened the carotid, stripped it out and put it
back together with a patch as her veins/arteries are very small. There
is more to the story, but that doesn't matter as she had great care and
is doing well.
The interesting part is that during her recovery, she shared a room with
several people, one of which was a 350-400 lb poor female person. This
person was only there for 3 days, and had no apparent medical problems
other than complaining incessantly. After she was discharged, the nurse
explained that she was a regular - every time it got too warm outdoors,
she showed up at the emergency room and was admitted. She was checked
out thoroughly and spent her mandatory three days at our expense. My
question was if she had mental problems. The answer was no, she was
checked out each and every time and was determined to be in reasonable
phsical and mental health before she was discharged. In fact, she was
given bus fare to get wherever she needed to go. I can't figure out how
she maintained her bulbous dimensions being so poor?
The next room-mate my wife shared her room with spoke no english.
Neither did her obvious family visitors. She did have real problems and
they were treated and she was transferred to a rehab center. Guess what
country she was a citizen of, and guess who picked up the tab?
My wife and I have great medical insurance. The reason is that starting
about 40 years ago, I started putting away 10% of my gross earnings. I
was never rich as my first professional job in 1966 paid $450/month. By
the time I took early retirement in 2001, I managed about $95K/year.
Because of a little discipline and not living week to week, I was able
to invest in US markets/corporations and accumulated a low 7 digit
portfolio, so paying health insurance premiums is no problem.
I could tell you much more from personal experience, but the point is
that unless you are too spaced out or ignorant or believe the liberal
propaganda and refuse to go to a hospital, you will get health care in
the US. As well, if you don't plan your future and instead think that
other folks will pick up your tab, you will probably not suffer too much
for being such a friggin drag on society.
BTW, my insurance paid for by me and the US health care system saved me
from colon cancer - as it would have any walk in from the streets if
they didn't wait too long before seeking treatment.
First,let me say I'm glad to see your wife has recovered.
Your experience with the medical insurance program points out a lot of
what is wrong with the present system, IMHO.
The present system focuses on paying for care AFTER the medical
problem has been identified rather than paying for preventative health
care BEFORE the problem develops.
This is the most expensive form of medical care that can be provided.
Also, allowing the insurance providers to "cherry pick" the customers
they will insure doesn't help problem since it results in a group of
uninsured who probably have the highest need for medical care.
Socialized medicine such as found in the UK isn't going to get the job
done here in the US; however, using the US gov't as a guaranteeritor
of plans developed by the private sector that cover 100& of the
population has some merit.
Yes there would need to be some limiting controls or you end up with
the "fox in the henhouse" type of
part D program presently in place.
Spreading the risk across 300 million (The US population) has a way of
minimizing the risk problems.
Private enterprise is just not capable of handling something that
large without gov't involvement.
Computerizing and standardizing a secure data base of medical records
would also reduce overhead costs.
What? My insurance program stresses preventative medicine. I see
nothing wrong with my program or the entire system (other than folks who
won't see far enough in advance to take care of themselves) - it did and
does exactly what I expect it to. I pay for coverage and they take care
of medical issues that arise with me and mine - and the same system
takes care of those who don't have a clue or a plan and won't think far
enough ahead to do the same as I have - and you and I get to pay for it
already as it's included in the cost of medical care. Do you really
think that adding more government will reduce the cost?
I have no problem taking care of those who through no fault of their own
are unable to do what I and many others have done - plan ahead, but I
have zero compassion for those who expect to be taken care of even
though they won't plan ahead far enough to take care of themselves.
Especially those minimum wage workers in a place like SoCal where the
rent for a one bedroom apt can often be $1K/mo, or those who have
regularly paid their health insurance premiums, only to be denined
payment when medical services were required.
As a matter of fact, it will probably be a wash, especially when the
necessary reforms are implemented.
Reforms such as competitive bidding for drugs and secure
computerization of medical records as a beginning.
Think of it as a investment, just as you would any infrastructure
investment such as a bridge, highway, etc.
Yes, the overall health care investment will increase; however, the
unit cost will decrease and the benefits will help to create new
wealth in the process.
Providing the environment that allows a healthy and well educated work
force to grow and flourish is a function of gov't.
That healthy and well educated work force provides the business that
chooses to locate in that environment a competitive advantage.
Those businesses grow the GNP, create new wealth, and yes, pay taxes.
Providing that environment requires an investment, an investment that
provides significant returns to the overall society.
Getting the health care mess cleaned up is going to require gov't
intervention, which in the overall scheme of things, will provide a
more efficient program.
Having the gov't become a service provider makes no sense at all;
however, providing standards and oversight is quite another matter.
Sounds like you are willing to underwrite WalMart among others health
- plan ahead, but I
I'm reminded of the old saying:
"It's tough to remember your objective is to drain the swamp when you
are up to your ass in alligators"
Of course. Few people deny that those of us with insurance have
access to great care.
The issues that was raised was preventive care for people without
insurance. The laws that require treatment only require it for
acute care. The system will pay to treat a patient dying from
metastacized breast cancer but not for routine mammograms
to catch the cancer early.
I couldnt agree more with regards to personal responsibility and
accountability. While your examples are framed in a context that
surely angers all of us who work for a living and pay our way, there
is a shear lack of detail as to why they were there, free care,
disabled, child born in the US even though the parent is not a
citizen, on and on. What was the facilities charter. You may not agree
with it but if they were rightfully there enrolled in some part of the
system then thats the system.
The simple fact of the matter is even most with coverage should
clearly be able to see that there are hundreds of thousands of
individuals out there who will likely have a very difficult time
paying todays insurance premiums. Forget about the ones who flat out
cant. The Walmart employee in my last post is a perfect example. Deal
with it, they are there, in that store, daily, to deliver you your
cheap goods, and for the forseeable future they will continue to be
there. They are paid at a rate that allows those goods, they are given
or not given access to benefits to ensure your cost of goods. At 16K/
yr ($8/hr 40hr/wk) almost everyone is going to have a hard time
breaking off 300 a month (a weeks pay gross) for health care if they
can even get it for that. It just aint gonna happen.
Perhaps you should look at paying there way as part of the cost of
those cheap goods. Some one has got to pay it. At their current
payscale they cant, their employer is clearly not interested in paying
it,...... Cheap goods, or a slightly higher priced goods in trade for
an insured workforce that is not a burden on the health care system.
I dont buy a thing from Walmart, but they are still getting my money
as I am subsidising their employee healthcare plan.
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