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A comment on How to Charge $546 for Six Liters of Saltwater. Parent comment

Re:How to Charge $546 for Six Liters of Saltwater by moocowduckquack on Sunday August 25, 2013 @09:24PM (#6274606)
You are severely misrepresenting that study as it is about the backgrounds of people who say they forgo healthcare on money grounds and pointing out that there are other factors other than whether someone can actually afford healthcare that affect whether people think they can afford healthcare.

It also appears to not look at ethnicity at all in that study.

It is basically saying that it isn't enough to make healthcare available, you also have to get people to use the service in other ways than mere affordability as even if something is affordable a lot of people will still not bother and claim that they think it will be unaffordable.

Results: After making adjustments for numerous individual socio-economic and health characteristics, we observed a higher occurrence of reported forgone healthcare among people who have had financial worries during adulthood, a life-course experience of physical, sexual or psychological abuse; who have experienced childhood difficulties; who have expressed a low degree of sickness orientation, a high worry/concern about and a low self-esteem

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Re:How to Charge $546 for Six Liters of Saltwater by dnautics on Monday August 26, 2013 @04:16AM (#6275777)
forget ethnicity for a moment (there is a separate biological argument that is not sociological in nature), although we know what 'socio-economic' is a codeword for. The point is that posters above are saying things like "There is no discrimination in the public service." I can say for sure there is no way that is possible. If there were no discrimination, then there would be no reason why people are systematically avoiding the healthcare system. One ostensible goal of the French system is to rid itself of healthcare inequality. In that aspect it has failed. The numbers show that. And it doesn't matter that, maybe, the problem is 'education' or whatever, because that's still all a part of the state system.

I happen to believe the french system is better than the US system (as the US system is right now) but I don't personally believe that it is fundamentally the best system or in any way fundamentally better than a free market system (to include medical charities). But what I think is completely misguided is to think that the French system is absolutely equitable, infallible, or transposable to the US.

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Re:How to Charge $546 for Six Liters of Saltwater by moocowduckquack on Monday August 26, 2013 @10:14AM (#6277146)
forget ethnicity for a moment (there is a separate biological argument that is not sociological in nature), although we know what 'socio-economic' is a codeword for. The point is that posters above are saying things like "There is no discrimination in the public service."

You started with a comment about killing off 90% to achieve ethnic homogeneity and when pressed on the point said that the French health system can't possibly manage to treat poor people of Arabic extraction. Forgetting ethnicity for a moment would seem to be to remove the prior context that people were replying to.

Also, you then after saying to forget ethnicity start saying that we know socio-economic is a codeword, presumably meaning that you have no intention of leaving the subject of ethnicity.

Also you are claiming systematic avoidance of the French healthcare system and that it has failed in it's attempt to treat people fairly. Now, it obviously is not perfect, nothing is, however to paint that study as evidence of systematic avoidance and failure, rather than room for improvement seems churlish.

Failure is when you spend the most money, but still rank thirty eighth, rather than when you are the fourth biggest spender and rank first.

Personally I just think that you are an ideologue on this. Show me a country that gets good results from unregulated private medical care plus charities. Who builds the network of A&E departments in that case?

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Re:How to Charge $546 for Six Liters of Saltwater by dnautics on Monday August 26, 2013 @03:08PM (#6279205)
No doubt, the US medical system is a failure. It wasn't, 50 years ago. Nobody here is suggesting that medicine be completely unregulated. You bet I'm an ideologue on this, but so are you. Here is part of my point: The question of who pays is a moral one. Should a person who has huntington's, and will lead a highly productive life through the late 30s and chooses to die quickly (in lieu of dying slowly painfully), be forced to subsidize the life of a person who smokes through their youth and chooses to milk the system for expensive, extended life support through their 50s-100s? Who gets to make that call? Corner cases are important.

I am also not convinced that the French medical system is sustainable. We are getting a snapshot in time, and since no economy today is based on a system that doesn't borrow money on interest, (versus spending only what it takes in through taxes), kicking payments to the future could mask unsustainability, ultimately resulting in a spectacular collapse of the system. In other words, today's French citizens could be living in borrowed luxury that will absolutely slaughter tomorrow's. Again, this is not to say that the US system is sustainable (it obviously isn't).

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Re:How to Charge $546 for Six Liters of Saltwater by moocowduckquack on Monday August 26, 2013 @06:54PM (#6280435)
Should a person who has huntington's, and will lead a highly productive life through the late 30s and chooses to die quickly (in lieu of dying slowly painfully), be forced to subsidize the life of a person who smokes through their youth and chooses to milk the system for expensive, extended life support through their 50s-100s?

Either of those people could get hit by a bus at age 20 and need life saving surgery and massive help learning to walk again. This isn't particularly about morals of ownership, this is about pragmatic ways of spreading risk.

I don't personally care what the political setup is and I think there are numerous ways to achieve spreading medical risk, but I have yet to see a country that is getting good results from just private industry plus charity.

If you think you know how it could work and that there would be an improvement in medical outcomes and general equitability from your plan over the other systems now in effect, then that is excellent news and you should detail it in an academic paper and tell the world.

However, given that you are stating that you are an ideologue on this, then you are starting with the answer you want to end up with and just trying to work out how to argue it.

If you want to say that is all I am doing as well, then fair enough, all I can say is that I am fairly certain that is not where I am coming from on this, while noting that you openly admit it.

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