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  1. #51
    O Hushed October Morning Alnitak's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Jack Springer View Post
    If what you're saying is true -- wouldn't medicaid patients be the most healthy in the US today?
    Medicaid patients have difficulty finding doctors, but the drug coverage is good according to my partner who is a pharmacist.

    Medicaid patients are the poorest segment of American society. While they have some health insurance, there will be deficits in their health in other ways, principally diet, but also a tendency to smoke and ignorance about good health practices: exercise, safe sex, etc.
    Last edited by Alnitak; December 29th, 2013 at 12:32 PM.

  2. #52
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    It is that old supply and demand law that you liberals hate so much. The lower the price , the more the demand, and people will stand in line for most anything free or low cost, whether it be food, or medical attention.
    And you're still not talking about the A.C.A. . . . .

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  3. #53
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    The socialism is in the government mandate of the purchase, the mandate of policy provisions, control of prices and fees, taxation of fees and profits and, most clearly, the governmental subsidies for anyone deemed by the government to be unable pay. The subsidies will predictably provide the vehicle for the government, by lowering the threshold and raising the percentage of subsidies, to convert it to a single payor system for a high and growing percentage of the population at the expense of the increasingly small remainder.
    Mandates are not socialism. The closest to socialism this comes is national socialism.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  4. #54

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Kulindahr View Post
    Mandates are not socialism. The closest to socialism this comes is national socialism.
    Read it again. The combination of factors which I listed are, indeed socialism.

  5. #55
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    There is nothing wrong with Obamacare being a Republican plan. There is a lot wrong with its lack of socialization and its reliance on market forces. Caring for the sick is a social function, not a market function. Markets do not and cannot make appropriate medical decisions regarding care. Coronary artery bypass surgery is not necessarily a better treatment for your heart disease than aspirin, just because it is tens of thousands of times more expensive. And aspirin is not necessarily a more cost effective treatment than CABG, just because it is so cheap. The practice of medicine is not analogous to buying a refrigerator.

    We have decided as a society to care for our sick, because we have decided that that is an honorable and noble thing for humans to do. That means that we are committed to allocating some of our community resources to health care. We do not refuse to treat you if your illness is not a cost effective one; and we do not treat you better if you happen to be rich. Health care is not a market function.
    That may be one of the most important comments in this thread. It is a question of whether we are all Randian atoms engaging in cutthroat social Darwinism, or are a people with common ties and a basic modicum of care for one another.

    Quote Originally Posted by T-Rexx View Post
    Yes, exactly.

    Obamacare is requiring many people to purchase health insurance which they cannot afford to use!

    Excuse me, but that is NOT a plan for improving the quality of or access to health care in America. It borders on fraud, in fact.
    A good way to put it!

    Quote Originally Posted by T-Rexx View Post
    This feature of socialized medical systems - that people are inclined to see a doctor for minor concerns - is one of the things that makes the socialized systems so cost effective. Patients come in frequently, their problems get addressed at an early stage, and the consequences of advanced disease (which are staggeringly expensive to treat) are less of a problem there.
    This is true, but our system at the moment is specialist-heavy; we really don't have enough doctors at the "ground level" for that.

    Quote Originally Posted by T-Rexx View Post
    Benvolio, again and again in these fora you argue for the preservation and continuation of the most demonstrably inefficient health care system on earth. And you do so in the name of efficiency! For you, "efficiency" is extremely high cost, poor outcomes, long wait times, low life expectancy, and consumption of more of the nation's GDP than any other country on earth. You seem to believe that sicker Americans spending an outrageous fortune on health care are somehow better for the country, if a black man desires the opposite. You have an ability to ignore facts and reality that are truly astounding.
    It's social Darwinism, and the GOP is in love with it. Social Darwinism is the real name for Randian economic and social policies, though it's a social Darwinism that considers property to be the measure of who should survive. It's very anti-American, actually, because the basic premise is that all men are not created equal, that some are in fact "more equal than others", and that use of government to create a de facto caste system dedicated to funneling wealth upward is not only legitimate but laudable.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  6. #56

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    Yes, exactly.

    Obamacare was designed by the Heritage Foundation, implemented in Massachusetts as Romneycare, and was the Republican health care proposal until President Obama decided to support it. It is as "conservative" a health care plan as it would be possible to come up with. It is even more conservative than our current status quo of health care in the USA, which is heavily (but remarkably inefficiently) socialized. Obamacare removes some of the socialized features of the status quo, to make it even more market-based.

    There is nothing wrong with Obamacare being a Republican plan. There is a lot wrong with its lack of socialization and its reliance on market forces. Caring for the sick is a social function, not a market function. Markets do not and cannot make appropriate medical decisions regarding care. Coronary artery bypass surgery is not necessarily a better treatment for your heart disease than aspirin, just because it is tens of thousands of times more expensive. And aspirin is not necessarily a more cost effective treatment than CABG, just because it is so cheap. The practice of medicine is not analogous to buying a refrigerator.

    We have decided as a society to care for our sick, because we have decided that that is an honorable and noble thing for humans to do. That means that we are committed to allocating some of our community resources to health care. We do not refuse to treat you if your illness is not a cost effective one; and we do not treat you better if you happen to be rich. Health care is not a market function.





    Yes, exactly.

    Obamacare is requiring many people to purchase health insurance which they cannot afford to use!

    Excuse me, but that is NOT a plan for improving the quality of or access to health care in America. It borders on fraud, in fact.





    And why are you so enamored with "supply and demand" as such a perfect model for the apportionment of community health care resources?

    Do you believe we should not treat the expensive diseases? Should we stop treating AIDS in the USA because it consumes such a disproportionate share of our health care dollars? Should we just let it spread rampantly through the population because markets cannot address the complexities of epidemiology?

    Do you not understand how disastrous is the market as an administer of health care resources?





    This feature of socialized medical systems - that people are inclined to see a doctor for minor concerns - is one of the things that makes the socialized systems so cost effective. Patients come in frequently, their problems get addressed at an early stage, and the consequences of advanced disease (which are staggeringly expensive to treat) are less of a problem there.

    Health care outcomes, life expectancy, wait times, and cost effectiveness of therapies all appear to be substantially better under Canada's socialized system than under the USA's socialized system.

    http://en.wikipedia.org/wiki/Compari..._United_States

    Benvolio, again and again in these fora you argue for the preservation and continuation of the most demonstrably inefficient health care system on earth. And you do so in the name of efficiency! For you, "efficiency" is extremely high cost, poor outcomes, long wait times, low life expectancy, and consumption of more of the nation's GDP than any other country on earth. You seem to believe that sicker Americans spending an outrageous fortune on health care are somehow better for the country, if a black man desires the opposite. You have an ability to ignore facts and reality that are truly astounding.
    The law of supply and demand and market forces are not optional. They operate whether you want them or not. It is a primary reason why socialism/ liberalism/ communism do not work.
    The primary reasons US medical care is more expensive is because we spend more for research and because, for those with insurance, we have the quickest, the best, and latest testing and treatment. The vast welfare class relies upon the charity of others and does less well. But even so, it is the result of our intentional hiring of women to breed illegitimate children and remain unemployed, while we simultaneously import millions and millions of additional poor and unemployed. Those other countries you are so fond of comparing systems with do not create poverty in the large numbers that we do.

  7. #57
    JUB Addict T-Rexx's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    The law of supply and demand and market forces are not optional. They operate whether you want them or not. It is a primary reason why socialism/ liberalism/ communism do not work.
    No, they don't. Supply and demand does not operate within the medical industry in the way you claim.

    If a cholera epidemic sweeps through Haiti, the cost of treating an individual case does not go down, just because there are so many of them. And, as a patient, the cost of your therapy does not increase just because so many other people are seeking therapy as well. Market forces do not apply, because civilization has decided that they should not. In stark contrast to your claim "They [market forces] operate whether you want them or not," they do not operate because we do not allow them to. The world can and does control this because it has learned that reliance on market forces in the treatment of disease is a disastrous proposition. You cannot manage an epidemic by treating only people with the ability to pay. Bacteria do not care how rich or how poor you may be.

    And in sharp contrast to your claim that "socialism/ liberalism/ communism do not work," by far the most cost-efficient and best outcomes in medicine are achieved in socialized systems. This is not actually debatable, as the data are clear. "Socialism/liberalism" not only works - it is by far the most efficient and effective health care management system the world has yet seen.


    Quote Originally Posted by Benvolio View Post
    The primary reasons US medical care is more expensive is because we spend more for research and because, for those with insurance, we have the quickest, the best, and latest testing and treatment.
    You have been debunked on this claim before. You persist in advancing it, even though you know it to be false, because you do not care for truth. Your conservative beliefs do not hold up to the scrutiny of the real world. So, you create an imaginary world in which they do.

    Medical research costs are NOT factored into the cost of American medical care, a fact of which you are well aware. And if America has "the quickest, the best, and latest testing and treatment" why do we have such poor outcomes, compared to the socialized world? And even if the (presumably more expensive) testing and therapies were somehow better, why would you advocate such an approach when the consequences of doing so are so demonstrably poor? Do you think that spending money on worthless technology is advisable? Do you Republicans routinely look at studies and deliberately select the approaches with the worst outcomes as the approaches you will support? Why?


    Quote Originally Posted by Benvolio View Post
    The vast welfare class relies upon the charity of others and does less well. But even so, it is the result of our intentional hiring of women to breed illegitimate children and remain unemployed, while we simultaneously import millions and millions of additional poor and unemployed. Those other countries you are so fond of comparing systems with do not create poverty in the large numbers that we do.
    If there was any logic here, I would respond.

    All of America's problems are not caused by our tiny immigration phenomenon. That impression is a manifestation of your xenophobia. You certainly are entitled to carry the bigoted, intolerant views you frequently bring to this forum. But, I do not regard it as healthy for you. Devoting so much energy to making sure that people who are not like you remain miserable is not a prescription for your own happiness.
    Last edited by T-Rexx; December 29th, 2013 at 02:44 PM.

  8. #58

    Re: So has anyone used the new Health care sites?

    My point was that low prices increase the demand. Your example of the epidemic is not in point, but in fact, in an epidemic, the increased demand would enabe both doctors and pharmacies to increase prices shoul they choose to do so.
    It is silly for you to think the research costs are not a large part of the reason for high prices for drugs and newer devices and tests. Other countries control the costs so developers need to charge more in the US to recover their investments in research.
    Your assertions about poor results are not true of those with insurance, which have better results, and the large majority of Americans have insurance. that is why the majority want to keep our system.

  9. #59

    Re: So has anyone used the new Health care sites?

    Equality of health care necessarily means degrading the care of those who pay the most for it, including taxes. Equality is the democrat/socialist goal. But there is no reason more why the welfare class should have the best health care at someone else's expense than they should have equal houses, equal autos, equal food, equal vacations at others expense.

  10. #60
    JUB Addict T-Rexx's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    My point was that low prices increase the demand. Your example of the epidemic is not in point, but in fact, in an epidemic, the increased demand would enabe both doctors and pharmacies to increase prices shoul they choose to do so.
    No, neither doctors nor pharmacists are permitted to raise prices under such circumstances, because of ethical constraints within their professions. The ethical constraints exist (in part) because raising prices in accordance with market forces would promote the spread of the very epidemic they are trying to treat. It isn't just about money. It's about doing the job you purport to be doing, without deliberately making the situation worse.

    This is NOT capitalism. It is health care. You seem incapable of understanding that health care does not operate according to market forces, for lots and lots and lots of reasons. It simply cannot. Health care is not a market phenomenon.

    Treating the rich preferentially in an epidemic actually makes it MORE likely that even rich people will get sick! Market forces negate the effectiveness of the therapy. Good medicine requires that every possible soul involved in an epidemic be treated as quickly and effectively as possible. It does not matter who that person is, what is his insurance status, or how much money he has. The health of every person in the community depends on the willingness of the community to treat everyone in the community equally.

    AIDS therapy in the USA is almost entirely paid for by public expense. We do that because the drugs are so outrageously expensive that if we did not, most of the patients would not get treated. And that means that a lot more people would get the infection. Which would be way more expensive than paying for the expensive drugs. Which illustrates the futility of markets to deal with problems in health care.

    I suppose you Republicans would say that good medicine is communism. Is that why you are so opposed to good medicine in the USA?


    Quote Originally Posted by Benvolio View Post
    It is silly for you to think the research costs are not a large part of the reason for high prices for drugs and newer devices and tests. Other countries control the costs so developers need to charge more in the US to recover their investments in research.
    Medical research in the USA is primarily paid for with government grants to universities and medical schools. That is not factored into calculations of the cost of medical care. It is not even technically part of "health care" in the USA.

    The vast majority of drug research and development in the world occurs in Europe, by European companies. America does get screwed by the Republican Party's long-standing refusal to permit the US government to negotiate drug prices with the manufacturers. But that is not why the USA spends two to three times as much as anybody else on health care.


    Quote Originally Posted by Benvolio View Post
    Your assertions about poor results are not true of those with insurance, which have better results, and the large majority of Americans have insurance. that is why the majority want to keep our system.
    And so your Republican response to this problem is to try to prevent more people from buying insurance!

    The fact that so many Americans are so sick that American outcomes on average are so comparatively poor does not bother you people. Because, after all, only the rich deserve to be treated for disease.



    Quote Originally Posted by Benvolio View Post
    Equality of health care necessarily means degrading the care of those who pay the most for it, including taxes.
    That statement is internally contradictory.

    Equality means equality. It means treating everyone alike. It does not mean "degrading" the care of anybody.


    Quote Originally Posted by Benvolio View Post
    Equality is the democrat/socialist goal.
    Equality in health care is not just the democratic/Democratic goal, it is the goal of every nation on earth.


    Quote Originally Posted by Benvolio View Post
    But there is no reason more why the welfare class should have the best health care at someone else's expense than they should have equal houses, equal autos, equal food, equal vacations at others expense.
    This is just a staggeringly stupid statement.

    There is EVERY reason that EVERY class should have the best health care. Your attitude that only a few of the world's people may be kept healthy at any given time (and that such health must come at the expense of other economic classes) is hard for me to find polite words to discuss.

    This world is capable of providing a reasonable level of health care to every human in existence. It is capable of doing so without consideration of who that person is. It is not harmful to rich people if the world should achieve a modicum of universal health care. This is not a situation where there is only so much health to go around, and we must save as much of it as we can for rich people. A broadly healthy population makes rich people healthier, too. The rich do not lose by supporting universal health care, they gain by it.

    No, I don't expect you to agree that making life better for some of mankind makes life better for all of mankind. The thoughts you express here are consistent: that the only way for some people to be happy is for most people to be miserable. I don't agree.
    Last edited by T-Rexx; December 29th, 2013 at 05:02 PM.

  11. #61
    Virtus in medio stat JUB Admin opinterph's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    This is NOT capitalism. It is health care.

    … the drugs are so outrageously expensive
    Why do you suppose the drugs are outrageously expensive?

    The total average treatment cost per patient for antiretroviral treatment and supportive services under PEPFAR is about $2 per day.

  12. #62
    O Hushed October Morning Alnitak's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    Equality of health care necessarily means degrading the care of those who pay the most for it, including taxes. Equality is the democrat/socialist goal. But there is no reason more why the welfare class should have the best health care at someone else's expense than they should have equal houses, equal autos, equal food, equal vacations at others expense.
    You can have supplemental insurance in each of the countries with socialized medicine.

  13. #63

    Re: So has anyone used the new Health care sites?

    I always thought that supplemental insurance was part of the agreement between Obama and insurance companies when they met and planned Obamacare. If only 60%, 70% or 80% of your medical expenses are paid and there is a high deductible won't people have to have supplemental insurance to survive bankruptcy? Selling supplemental insurance was the insurance companies' payback for keeping their mouths shut during the passage of the law.

    If a senior does not have supplemental insurance with Medicare the 20% they are personally responsible for would deplete most of their savings.

    ... as I have said in the past, this is a huge MESS and will continue to be a larger MESS.

  14. #64
    O Hushed October Morning Alnitak's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Jack Springer View Post
    I always thought that supplemental insurance was part of the agreement between Obama and insurance companies when they met and planned Obamacare. If only 60%, 70% or 80% of your medical expenses are paid and there is a high deductible won't people have to have supplemental insurance to survive bankruptcy? Selling supplemental insurance was the insurance companies' payback for keeping their mouths shut during the passage of the law.

    If a senior does not have supplemental insurance with Medicare the 20% they are personally responsible for would deplete most of their savings.

    ... as I have said in the past, this is a huge MESS and will continue to be a larger MESS.
    Which is why we need socialized medicine, just like everyone else, so that crushing debt is NOT incurred.

    Except Congress and Obama are corporate prostitutes, and the rest of the country is literally in a deathgrip by corporate lies as well. We wanted a public option. Everyone forgets how popular that provision was. But Aetna, Blue Cross, et al. threatened Ben Nelson with losing his seat if he went along with it, and he probably would have because conservative Nebraskans all holed up in their little towns and farms believe in American exceptionalism, are not educated about what the outside world really is like, and the belief that corporate greedy capitalism - which robs everyone of their health, has real death panels itself, and tells us which doctors we're allowed to go to - can do no wrong.
    Last edited by Alnitak; December 29th, 2013 at 07:23 PM.

  15. #65
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Alnitak View Post
    Which is why we need socialized medicine, just like everyone else, so that crushing debt is NOT incurred.

    Except Congress and Obama are corporate prostitutes, and the rest of the country is literally in a deathgrip by corporate lies as well. We wanted a public option. Everyone forgets how popular that provision was. But Aetna, Blue Cross, et al. threatened Ben Nelson with losing his seat if he went along with it, and he probably would have because conservative Nebraskans all holed up in their little towns and farms believe in American exceptionalism, are not educated about what the outside world really is like, and the belief that corporate greedy capitalism - which robs everyone of their health, has real death panels itself, and tells us which doctors we're allowed to go to - can do no wrong.
    Do prostitutes get free health care?

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

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    JUB Addict T-Rexx's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by opinterph View Post
    Why do you suppose the drugs are outrageously expensive?
    The short answer is, of course, that the manufacturers charge what they can get away with charging.

    When I say that that is not "capitalism," I mean that the prices are not being determined by market forces. They are being set by other factors, such as the ability of municipalities to pay, public fear of the epidemic, the duration of patents, constantly changing research regarding which drug combinations may be most effective, etc.

    Of course medicine costs money, and consumes community resources (~18% of GDP in USA). But prices are not primarily driven by the market. That is why, in the same hospital on the same day, one patient might pay $1,500 for an appendectomy and another $16,000 for the same procedure. I know of no other industry where you see that kind of variability in pricing.


    Quote Originally Posted by opinterph View Post
    The total average treatment cost per patient for antiretroviral treatment and supportive services under PEPFAR is about $2 per day.
    When PEPFAR was signed into law in 1998, the cost of AIDS therapy in the USA was ~$10,000/patient/year!

    At about the same time, however, Cipla in India began manufacturing anti-retrovirals for just $365/patient/year ($1 per day)! The willingness of some countries (like India and Thailand) to look the other way regarding patent royalties really drove down the cost of therapy for Africa dramatically. Although it took a while for African countries to permit the generic drugs to come in, their availability nevertheless encouraged the mainline ARV manufacturers to negotiate radically on price.

    http://theejbm.wordpress.com/2013/10...ted-in-africa/

    I'm not trying to make a value judgement regarding the fairness of any of this. But the price of AIDS drugs varies greatly, depending on who you are, where you are, and who is paying.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    When PEPFAR was signed into law in 1998...
    Oops! I meant 2003, of course.

    But the cost of AIDS therapy in 1998 really was about $10,000/patient/year.
    Last edited by T-Rexx; December 29th, 2013 at 09:25 PM.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    When PEPFAR was signed into law in 1998, the cost of AIDS therapy in the USA was ~$10,000/patient/year!

    At about the same time, however, Cipla in India began manufacturing anti-retrovirals for just $365/patient/year ($1 per day)! The willingness of some countries (like India and Thailand) to look the other way regarding patent royalties really drove down the cost of therapy for Africa dramatically. Although it took a while for African countries to permit the generic drugs to come in, their availability nevertheless encouraged the mainline ARV manufacturers to negotiate radically on price.

    http://theejbm.wordpress.com/2013/10...ted-in-africa/

    I'm not trying to make a value judgement regarding the fairness of any of this. But the price of AIDS drugs varies greatly, depending on who you are, where you are, and who is paying.
    My sister said something about this once when she was studying in the area of quality control: some overseas manufacturers allowed more impurities in the process, on the order of one part in ten or a hundred thousand, and thereby cut the manufacturing process by a significant fraction, sometimes even half. At the same time, the difference in negative reactions and side effects for most medications were indistinguishable from the purer form. In quality control terms, it was an exercise in deciding how much quality should be enough. But for health care, it's a matter of deciding that and more -- as in how many more people can be helped.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  19. #69
    Rambunctiously Pugnacious JayHawk's Avatar
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    Was your Mother buying a Medicare Supplemental policy?
    Nope. Not hitting Medicare for a few more years.
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  20. #70

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    Equality of health care necessarily means degrading the care of those who pay the most for it, including taxes. Equality is the democrat/socialist goal. But there is no reason more why the welfare class should have the best health care at someone else's expense than they should have equal houses, equal autos, equal food, equal vacations at others expense.
    [Text: Removed] poor people have a right to live and be treated with humanity. and why do the rich need any breaks? the top 5% control 95% of america's money, they can help out with the fuckin health insurance a bit.

    the very idea that capitalism is the best solution to every problem is completely blown apart by healthcare- everywhere else in the world healthcare is completely socialized, and everywhere else in the world the healthcare is significantly better and significantly cheaper on the whole
    Last edited by opinterph; December 30th, 2013 at 03:30 PM. Reason: removed personal insult

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by naglfarii View Post
    [Text: Removed] poor people have a right to live and be treated with humanity. and why do the rich need any breaks? the top 5% control 95% of america's money, they can help out with the fuckin health insurance a bit.

    the very idea that capitalism is the best solution to every problem is completely blown apart by healthcare- everywhere else in the world healthcare is completely socialized, and everywhere else in the world the healthcare is significantly better and significantly cheaper on the whole
    The strange thing is that it would be in the best interest of the top 0.5% to have themselves taxed to support the general health of society. They would still have the wealth to be in charge, but they would have much higher probability of favorable outcomes to their wishes and desires if the rest of the country was sufficiently wealthy to provide a healthy workforce. Most Americans don't begrudge them being much more wealthy, but the imbalance we have is dangerously shifting us toward a metastable situation where society becomes far more fragile and susceptible to catastrophic collapse.

    In fact it would be in their interest to just bypass Congress entirely and found a hundred new teaching hospitals and medical schools, to increase the general supply of doctors -- thus making it even more possible to have the attentions of the best all to themselves.
    Last edited by opinterph; December 30th, 2013 at 03:30 PM. Reason: removed verbiage quoted from another poster

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

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    *the number is now forty

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Kulindahr View Post
    My sister said something about this once when she was studying in the area of quality control: some overseas manufacturers allowed more impurities in the process, on the order of one part in ten or a hundred thousand, and thereby cut the manufacturing process by a significant fraction, sometimes even half. At the same time, the difference in negative reactions and side effects for most medications were indistinguishable from the purer form. In quality control terms, it was an exercise in deciding how much quality should be enough. But for health care, it's a matter of deciding that and more -- as in how many more people can be helped.
    In the USA, it is illegal (with rare exception) to import pharmaceuticals. Laws here require that foreign drugs (e.g., Provigil, a French drug) be licensed to an American company and manufactured here, if they are to be sold here.

    The argument is always that foreign companies cannot produce drugs as pure as can American companies. Those dirty Swiss or Germans or French or Italians will always muck up the process with their cooties and throw in a few ppm of something that will give you cancer. And Indians, of course, cannot begin to comprehend the wonders of pharmaceutical manufacture. They are a third world nation, for chrissake. Don't be ridiculous.

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    Re: So has anyone used the new Health care sites?

    So wish the states had what the UK has. I live here with my partner. We have dual citizenship here is my cost after 11 years living here let me detail it ....Prescription £0.00 Doctor £0.00 Hospitals £0.00 Over here our tax rates are higher as follows.
    Up to £10,000 a year as of next year £0 tax after that it ranges from 20% to a high of 40 % if you earn over £150,000. But all medical is free. I broke a shoulder falling in my gym I went to a nearby hospital. They said I had to go to another I aske the directions they said we have ordered a Taxi we pay for it. The U.S. spends so much money on Defence we wont even discuss that Iraq and Afghan to together cost in todays terms more than WW2 and yet republicans do not want us to have the health care they have for free and for live so sad. Obama care may not be the best but a start as for the Ins Companies F them

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Kulindahr View Post
    My sister said something about this once when she was studying in the area of quality control: some overseas manufacturers allowed more impurities in the process, on the order of one part in ten or a hundred thousand, and thereby cut the cost of the manufacturing process by a significant fraction, sometimes even half. At the same time, the difference in negative reactions and side effects for most medications were indistinguishable from the purer form. In quality control terms, it was an exercise in deciding how much quality should be enough. But for health care, it's a matter of deciding that and more -- as in how many more people can be helped.
    Quote Originally Posted by T-Rexx View Post
    In the USA, it is illegal (with rare exception) to import pharmaceuticals. Laws here require that foreign drugs (e.g., Provigil, a French drug) be licensed to an American company and manufactured here, if they are to be sold here.

    The argument is always that foreign companies cannot produce drugs as pure as can American companies. Those dirty Swiss or Germans or French or Italians will always muck up the process with their cooties and throw in a few ppm of something that will give you cancer. And Indians, of course, cannot begin to comprehend the wonders of pharmaceutical manufacture. They are a third world nation, for chrissake. Don't be ridiculous.
    Reading your post, I realized that my fingers failed to type some words my mind had thought. I made the correction above, in colored bold.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  25. #75

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Alnitak View Post
    You can have supplemental insurance in each of the countries with socialized medicine.
    But do they get better care. No, the people who subsidize the rest get at the back of the line like everyone else. They will pay more to have their care degraded.

  26. #76

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    The short answer is, of course, that the manufacturers charge what they can get away with charging.

    When I say that that is not "capitalism," I mean that the prices are not being determined by market forces. They are being set by other factors, such as the ability of municipalities to pay, public fear of the epidemic, the duration of patents, constantly changing research regarding which drug combinations may be most effective, etc.

    Of course medicine costs money, and consumes community resources (~18% of GDP in USA). But prices are not primarily driven by the market. That is why, in the same hospital on the same day, one patient might pay $1,500 for an appendectomy and another $16,000 for the same procedure. I know of no other industry where you see that kind of variability in pricing.




    When PEPFAR was signed into law in 1998, the cost of AIDS therapy in the USA was ~$10,000/patient/year!

    At about the same time, however, Cipla in India began manufacturing anti-retrovirals for just $365/patient/year ($1 per day)! The willingness of some countries (like India and Thailand) to look the other way regarding patent royalties really drove down the cost of therapy for Africa dramatically. Although it took a while for African countries to permit the generic drugs to come in, their availability nevertheless encouraged the mainline ARV manufacturers to negotiate radically on price.

    http://theejbm.wordpress.com/2013/10...ted-in-africa/

    I'm not trying to make a value judgement regarding the fairness of any of this. But the price of AIDS drugs varies greatly, depending on who you are, where you are, and who is paying.
    Prices are largely driven by the market, BUT Federal law, pursuant to the Constitution, grants a monopoly by patent to those who develop new drugs, for the purpose of providing an incentive for research and development of new drugs. Patent Monopolies give the developing company a chance to recover their investment which they would not have if others could immediately begin copying the drug without having the cast of development. It is still supply and demand but the monopoly limits the supply and creates the demand for a better ptreatment nor otherwise available..
    It may sound great that countries like India ignore the patent to copy the drug cheaply, but who will spend the money to develop new drugs if they have no chance to recover their investment, much less make a profit.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    But do they get better care. No, the people who subsidize the rest get at the back of the line like everyone else. They will pay more to have their care degraded.
    Yes, they do.

    The government pays 70% of health costs in Japan, which everyone knows has the highest life expectancy in the world.

    The US is not in the top ten, not even the top 20 or 30. No, the US ranks 33rd in life expectancy behind every developed country with socialized medicine.

  28. #78

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Alnitak View Post
    Yes, they do.

    The government pays 70% of health costs in Japan, which everyone knows has the highest life expectancy in the world.

    The US is not in the top ten, not even the top 20 or 30. No, the US ranks 33rd in life expectancy behind every developed country with socialized medicine.
    Lots of things contribute to life expectancy, including genetics and diet. The UK has had free health care for half a century, but their life expectancy is only a year more than that of Americans. Wikipedia, life expectancy in countries. There is no proof that even that year results from their health care system. No reason to go socialist.
    Last edited by Benvolio; December 30th, 2013 at 03:48 PM.

  29. #79

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by opinterph View Post
    Why do you suppose the drugs are outrageously expensive?

    The total average treatment cost per patient for antiretroviral treatment and supportive services under PEPFAR is about $2 per day.
    How much did it cost to research and develop the drugs? I remember reading that when Merck developed their protease inhibitor it cost the company a billion dollars, and that did not include building a plant to make it. Then they were demonized for not selling it cheap. Getting regulatory approval, including clinical trials, often costs hundreds of millions.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    How much did it cost to research and develop the drugs?
    Low ROI (Return On Investment) is a major factor causing almost all drug manufacturers to stop research and development of new antibiotics -- And that is happening as increasing numbers of bacteria are appearing that are resistant to currently available drugs.

    If private industry doesn’t want to invest in research for a particular need, how should the problem be resolved?

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Kulindahr View Post
    Reading your post, I realized that my fingers failed to type some words my mind had thought. I made the correction above, in colored bold.
    But the cost is not in manufacturing.

    It's in the licensing.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    Lots of things contribute to life expectancy, including genetics and diet. The UK has had free health care for half a century, but their life expectancy is only a year more than that of Americans. Wikipedia, life expectancy in countries. There is no proof that even that year results from their health care system. No reason to go socialist.
    Furthermore, the parts of America dragging down its health ratings are in the most conservative and cynical parts of the country, exactly those state that have rejected expansion of Medicaid, and Texas which has the worst health coverage.

  33. #83

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Alnitak View Post
    Yes, they do.

    The government pays 70% of health costs in Japan, which everyone knows has the highest life expectancy in the world.

    The US is not in the top ten, not even the top 20 or 30. No, the US ranks 33rd in life expectancy behind every developed country with socialized medicine.

    Quote Originally Posted by opinterph View Post
    Low ROI (Return On Investment) is a major factor causing almost all drug manufacturers to stop research and development of new antibiotics -- And that is happening as increasing numbers of bacteria are appearing that are resistant to currently available drugs.

    If private industry doesn’t want to invest in research for a particular need, how should the problem be resolved?
    The patent period should start when it is approved for sale, after clinical trials, not before. The process and composition should not be required to be disclosed as part of the patent process, as now. That would make pirating more difficult or impossible. Companies should not be allowed to sell the drugs in other countries at a price lower than the US. All these changes would provide the companies with the needed incentive. One of the best objections to Obama care and socialized medicine is the chilling effect on research and development.
    Last edited by Benvolio; December 31st, 2013 at 05:31 AM.

  34. #84

    Re: So has anyone used the new Health care sites?

    Liberals fail to see that the US policy of not controlling drug and device prices has been a huge incentive for research and development not only here, but in countries with socialism, since foreign companies can make big profits here, if not in their own countries. But liberals always think they can kill the goose and still collect the golden eggs.

  35. #85

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Alnitak View Post
    Yes, they do.

    The government pays 70% of health costs in Japan, which everyone knows has the highest life expectancy in the world.

    The US is not in the top ten, not even the top 20 or 30. No, the US ranks 33rd in life expectancy behind every developed country with socialized medicine.
    Quote Originally Posted by Alnitak View Post
    Furthermore, the parts of America dragging down its health ratings are in the most conservative and cynical parts of the country, exactly those state that have rejected expansion of Medicaid, and Texas which has the worst health coverage.
    Texas also has the worst invasion of illegals. Better Medicaid would make that problem worse. Immigration is an important factor in our lower life expectancy.
    Last edited by Benvolio; December 31st, 2013 at 06:00 AM.

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    Quote Originally Posted by Benvolio View Post

    Texas also has the worst invasion of illegals. Better Medicaid would make that problem worse. Immigration is an important factor in our lower life expectancy.
    Because you're the only country with infraction. Got it.

    Did you actually compute his post that you were responding to? People in THIRTY THREE countries live longer and healthier than Americans.
    That we are capable only of being what we are, remains our unforgivable sin.
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    The process and composition should not be required to be disclosed as part of the patent process, as now.
    The essence of that information must be revealed in order to obtain FDA approval to market the drug. (FDA; CFR – Code of Federal Regulations Title 21)


    Quote Originally Posted by Benvolio View Post
    All these changes would provide the companies with the needed incentive.
    Problem is that patients only take antibiotics when they are at risk of infection. The drug companies would rather develop products that consumers will need to take for long periods of time, so they can sell more of their magic potions. It’s ultimately about profit – not what’s best for the consumer.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    One of the best objections to Obama care and socialized medicine is the chilling effect on research and development.
    I don't get it.

    You object to BOTH Obamacare AND socialized medicine?

    You don't believe in medicine at all?

    Are you a homeopath?

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by opinterph View Post
    Problem is that patients only take antibiotics when they are at risk of infection. The drug companies would rather develop products that consumers will need to take for long periods of time, so they can sell more of their magic potions. It’s ultimately about profit – not what’s best for the consumer.
    Yes, exactly.

    There are so many, many ways in which market forces do not mix with quality medical care. I'm not saying people should not be permitted to make money in the medical industry, just that it is insane to attempt to structure the care model around a market. And that's really what Obamacare is about.

    What we need is to decide the best ways, medically and scientifically, to treat people. And then figure out ways to allocate the resources we have to do as much treatment as we can afford.

    Obamacare, regrettably, is not what America needs. It is better than the Republican alternative of doing nothing, but only slightly.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    Texas also has the worst invasion of illegals. Better Medicaid would make that problem worse. Immigration is an important factor in our lower life expectancy.
    My high school history teacher had a master's degree in history.

    For his thesis, he wrote a defense of immigration in America. His premise was that the great immigration tide of the late nineteenth and early twentieth centuries had strengthened America, not weakened it.

    I used to be embarrassed for my history teacher. I thought that thesis was like defending the idea that the sky is blue, or that water is wet. How could they have given him a master's with such a puff piece?

    Because of you Benvolio, I now (sorta) understand why such "research" is still useful.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Rolyo85 View Post
    Because you're the only country with infraction. Got it.

    Did you actually compute his post that you were responding to? People in THIRTY THREE countries live longer and healthier than Americans.
    I'm sure that-- as with gun deaths, violent crime, poverty and inequality... conservatives have no problem consigning this discrepancy as being due to "culture" and to floating intangibles that can't be addressed so we shouldn't even try. Not due to the structure of our institutions, laws and society.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    Yes, exactly.

    There are so many, many ways in which market forces do not mix with quality medical care. I'm not saying people should not be permitted to make money in the medical industry, just that it is insane to attempt to structure the care model around a market. And that's really what Obamacare is about.
    I still remember the argument about market forces and medical care and (I believe it was you) your point about how nobody is going to drive further away to where a hospital is offering buy-one-get-one-free cardiac emergency care, lol.

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    Re: So has anyone used the new Health care sites?

    ^ Yeah, that was me.

    Hospitals are legal monopolies. (I'm not saying that's a bad thing, that's just the way it is).

    What I said was that if you are having chest pain, you don't drive to the hospital 30 miles away that is having a special on myocardial infarctions.

    Medicine is not driven by market forces. It is routinely monopolistic, massively influenced by patent concerns, massively socialized (at the demand of Ronald Reagan, BTW), influenced by America's propensity for litigation, influenced by frequent updates in scientific research, suffers from the fundamental market problem that the utilizer of services is not the payer, etc., etc., etc. This industry is NOTHING like what you studied in "Capitalism 101" in college. It is something else entirely.

    The reason that medical costs for so many years have spiraled so disproportionately out of control with respect to the cost of living generally is that medicine is not regulated by markets, generally. It is a phenomenon unto itself.

    What Obamacare attempts to do is to use traditional capital markets to reduce the cost of care. That might be reasonable if these were traditional capital markets, but they are not.
    Last edited by T-Rexx; December 31st, 2013 at 01:03 PM.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    But do they get better care. No, the people who subsidize the rest get at the back of the line like everyone else. They will pay more to have their care degraded.
    What does it take to have better care than none?

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Benvolio View Post
    The patent period should start when it is approved for sale, after clinical trials, not before. The process and composition should not be required to be disclosed as part of the patent process, as now. That would make pirating more difficult or impossible. Companies should not be allowed to sell the drugs in other countries at a price lower than the US. All these changes would provide the companies with the needed incentive. One of the best objections to Obama care and socialized medicine is the chilling effect on research and development.
    So pharmaceutical companies could foist off anything they wanted and count on the placebo effect to generate profits.....

    How the stuff is made has to be disclosed to some entity, so there can be review. A UL-type organization would be my recommendation.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by Kulindahr View Post
    So pharmaceutical companies could foist off anything they wanted and count on the placebo effect to generate profits.....

    How the stuff is made has to be disclosed to some entity, so there can be review. A UL-type organization would be my recommendation.
    I'm also bemused at how without batting an eye, our resident Free Market Capitalist espoused price fixing for what private drug companies decide to do with their salepoint prices in different countries.

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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by T-Rexx View Post
    Hospitals are legal monopolies. (I'm not saying that's a bad thing, that's just the way it is).
    Not quite; in a large urban area where there are a number of hospitals, people will choose between them based on a variety of factors. The only time they really resemble a monopoly is in emergency situations where a few minutes transit time can make a difference. like...

    Quote Originally Posted by T-Rexx View Post
    What I said was that if you are having chest pain, you don't drive to the hospital 30 miles away that is having a special on myocardial infarctions.
    Or one that's five minutes farther when you're having an allergic reaction that's shutting down your breathing.

    Quote Originally Posted by T-Rexx View Post
    Medicine is not driven by market forces. It is routinely monopolistic, massively influenced by patent concerns, massively socialized (at the demand of Ronald Reagan, BTW), influenced by America's propensity for litigation, influenced by frequent updates in scientific research, suffers from the fundamental market problem that the utilizer of services is not the payer, etc., etc., etc. This industry is NOTHING like what you studied in "Capitalism 101" in college. It is something else entirely.
    A telling point is that even where market forces can make a difference in medical care, Republicans didn't propose them. Where were the bills aimed at getting more medical schools, to increase the supply of doctors? Where were the bills aimed at building a thousand immediate-care clinics, to reduce the cost of dropping in for treatment? Where were the amendments aimed at breaking up the AMA's monopoly on just about the entire medical system?

    Quote Originally Posted by T-Rexx View Post
    The reason that medical costs for so many years have spiraled so disproportionately out of control with respect to the cost of living generally is that medicine is not regulated by markets, generally. It is a phenomenon unto itself.

    What Obamacare attempts to do is to use traditional capital markets to reduce the cost of care. That might be reasonable if these were traditional capital markets, but they are not.
    One of the biggest reasons medical costs have spiraled is that suddenly every hospital around had to have the newest and best equipment. Setting aside discussion about that as good thing or not, it definitely drove up costs because even when a certain device is only used once a week, it still has to be paid for. For individual hospitals, that became a market force all by itself, just not a helpful one.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  48. #98
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    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by xbuzzerx View Post
    I'm also bemused at how without batting an eye, our resident Free Market Capitalist espoused price fixing for what private drug companies decide to do with their salepoint prices in different countries.
    Benvolio is no free market capitalist -- he's a laisse-faire capitalist, and that's a different thing entirely: the latter believes that coercion by economic power is a legitimate tool in business.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

  49. #99

    Re: So has anyone used the new Health care sites?

    Once a patent is granted it is a public record, including the details of how the drug is made. That is the trade off for the temporary monopoly, but it makes it possible for others to pirate it in countries which do not observe our patent laws. Of course, it must be disclosed to the FDA and the patent office, but it should otherwize be cinfidential for the patent period.
    Yes drug companies do it for the profit. But if we rely upon non profit organizations, it may never gat done. I was responding to your question of how to the antibiotics developed. Profits are the answer.
    Last edited by Benvolio; December 31st, 2013 at 04:14 PM.

  50. #100

    Re: So has anyone used the new Health care sites?

    Quote Originally Posted by xbuzzerx View Post
    I'm also bemused at how without batting an eye, our resident Free Market Capitalist espoused price fixing for what private drug companies decide to do with their salepoint prices in different countries.
    The problem is that other countries are now setting the price at which drug companies can sell, and often do not allow a recovery for R-and D, with the result that Americans pay more than in other countries. My solution is not setting the price, but prohibiting price discrimination.

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