Healthcare reform is too late for Joaquin Rivera
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Healthcare reform is too late for Joaquin Rivera
I don't know what kind of medical insurance that Joaquin Rivera -- who was the bedrock of Philadelphia's Puerto Rican community -- had, but that's not really the issue here. The outrageous circumstances of Rivera's death last weekend in a hospital emergency room should be a reminder to everyone that the real reasons so many people in America have been pushing for an overhaul of healthcare in the country for so long. Because the reason we need a new way of doing things isn't only because far too many people are uninsured, although there is that. It's that one of the wealthiest nations on earth has a system that treats millions of its citizens -- solid, God-fearing people like Joaquin Rivera -- like cattle.
Because no one should ever have to die like this in America:
According to police, Rivera walked into Aria Health's Frankford Campus, on Frankford Avenue near Harrison Street, about 10:45 p.m. Saturday.
He was alone, and apparently had walked from his nearby home on Duffield Street near Foulkrod, his son said.
Rivera complained of feeling pain in his left arm and abdomen, and was told to sit in the waiting area, said police spokesman Lt. Frank Vanore.
At some point during the next hour, Rivera, a longtime bilingual counselor at Olney High School, lost consciousness.
Joaquin Rivera was dying -- right there in a hospital emergency room, a stone's throw from doctors and nurses who could have tried to save him. And then while he was ignored, unconscious and losing life, something else happened to him that was so outrageous that it turned Rivera's passing into a local news story: Three heartless bastards stole the watch off the dying man, right there in the waiting room:
He inadvertently became a target, Vanore said, to three other people in the waiting room - a black woman, a 30-something, 5-foot-8 black man in dark pants who limped, and a second man, who was later arrested at the hospital and identified as Richard Alten, 44.
If the charges stick, then Alten and his low-life scum accomplices deserve to have the book thrown at them. But we should also keep our eye on the big picture, which is that a 63-year-old man who walks into a hospital emergency room complaining of chest pains shouldn't be told to sit down and wait, unmonitored, for more than an hour. And yet this is what medical care is like for millions of Americans, especially someone who lives in an urban area like Rivera did. Although as a school district employee it's highly likely that Rivera personally had decent insurance coverage, he was forced to wait in a room that most likely was filled with people, many of whom were not covered, who pack an ER on a Saturday night as their last and only resort to medical treatment.
You know, I listen to a lot of talk radio and the other places where people are talking healthcare reform a lot of the time these days, and these conversations, quite frankly, tend to be dominated by affluent suburbanites who have decent health coverage -- as long as they're not laid off, anyway -- and access to state-of-the-art hospitals in safe communities, people who can't understand why there is a push for changing things in the country. And there are people like Sen. Jim DeMint of South Carolina who thinks that just showing up at the hospital is a perfectly fine way of receiving healthcare.No one is speaking loudly enough for the Joaquin Riveras.
There's also a sense in this one-sided debate that Americans who receive inadequate care or who somehow bring this upon themselves deserve their plight. Nothing could be further from the truth. Rivera was clearly a man who gave so much to his community -- a cherished musician and a mentor to youth.
In 1964, Joaquin moved to Philadelphia from the mountain town of Cayey, Puerto Rico. He started out working in a factory that made laminated fabric, took English courses at night and began studying for his GED.
He also took courses at Community College of Philadelphia and Rutgers University. He then went to work at Olney High as a bilingual counselor. He worked for the school district for more than 30 years.
"He has made a difference here in Philadelphia," Roberto Santiago, executive director of Concilio, told the Daily News. "He comes to a new place, incorporates himself, contributes to the city, takes it upon himself to play folkloric music and brings it to the community."
He gave everything to his community, and his community was not there for him when he needed assistance, not his neighbors who ripped him off rather than calling for help, and not a healthcare system that couldn't help him when he showed up on its doorstep. Over the next couple of weeks, our representatives down in Washington are going to be debating and putting the finishing touches on the first but hopefully not final steps toward healthcare reform in this country. I hope that they're thinking about Joaquin Rivera every second of that debate.
Because no one should be allowed to die like this in America, ever again.
Comments (141)
Thanks for smearing thousands of emergency care workers based on one incident. I'm sure all these people will be delighted to know they are now enemies of the people.— jmc
You are so right! My prayers go out to his family and all the the lives he touched...— lharlan- Ohstop with the moral outrage. These things happen in countries with universal care as well. sometimes a tragedy is just a tragedy, no amount of legislating will change it. And no, Rivera's awful death does not give people the right to take from others in order to subsidize their care. Life isn't fair. And BTW, maybe, just maybe you should ask why this happens in the city and not the 'burbs.— RG
- The ER waiting rooms at Penn and Jefferson are full of poor people, too - but if you walk in there complaining of chest pain, a triage team sees you right away. I wonder what Frankford's ER protocol for heart attacks is.
- Rivera "highly likely" had decent coverage, and the emergency room was "most likely" filled with uninsured, which made Mr. Rivera wait for care. You obviously don't know the circumstances, yet you project what you want on to the situation. What if those others in the ER had health insurance, would Mr. Rivera have been taken right away? What if everyone was on the government plan, would there be no waiting? Your arguing why we need to spend trillions of dollars on "reform", and failing miserably.— jmc
- When was the last time he saw his PCP? Did he have a pre-existing condition (i.e diabetes, high blood pressure, etc..) that went undiagnosed or ignored? Doesn't an employee of the Phila School District have good health care coverage? The fact that Riveras gave so much to his community is admirable, but it conveniently ignores the circumstances that led to his decision to go to the emergency room in the first place. Aside from TPS and SycophantMarge, who reads this drivel and agrees with the author?— A Friend
Comment removed.- Wait I thought dying while waiting in line was supposed to happen AFTER the public plan was in place.— cuso20
- What a tortured way to shoehorn Will's liberal view of health care into a column. This incident had absolutely nothing to do with health insurance. It had everything to do with Frankford's ER protocol, as Susie correctly points out. I last was at a suburban hospital ER one evening having been bitten by a dog while taking a walk. The VERY FIRST thing the duty person at the ER asked me when I walked in - even before starting the paper work - was "Are you having any chest pains or shortness of breath." And while I waited to be stitched up, that was asked of each person who walked in, even of those accompanying the person seeking treatment. Now that's a correct ER protocol.— pj katauskas
- I believe A friend has inadvertently made exactly the point that JMC rails against. JMC says that, "What if those others in the ER had health insurance, would Mr. Rivera have been taken right away? What if everyone was on the government plan, would there be no waiting?" Well actually the point is that if they had been able to see their personal care physician for such minor things as the flu or other common ailments that clog up the emergency room triages, (as A friend so conveniently points out), he might have been able to be seen much more quickly. RG, if you only look at what is potentially spent in the health care debate, you will only see it as a redistribution of wealth, but that ignores so many other factors that allows for considerable savings in the health care industry (and our economy as a whole). What might cost a grand total of a few hundred dollars in treatment at a physicians office ends up costing thousands of dollars in an Emergency Room. From there, those who are too poor to get health care can certainly not pay for an ER bill that will cost them much more than insurance would. The hospital must repeatedly bill, send the file to collections, potentially hire a lawyer to collect, and on and on with no hope of ever collecting a dime from those patients. Meanwhile the hospital, knowing that a certain given percentage of their patients will be unable to pay them back, doesn't just sit back and accept that loss, they will in turn increase the prices of services to everyone (that's you) in order to cover this loss. This causes your premiums to become higher and higher. I mean I dont know about you, but that few hundred dollars to cover a PCP visit sounds pretty good to me, and a much lower "redistribution" of my wealth than the alternative. Just saying...think for a second before making up your mind about "reform".— x7227
- Will, I can't see how this sad story has anything to do with the healthcare reform debate. This isn't the first guy who keeled over in an ER waiting room. Basically he was forgotten by the people at the desk and once he passed out, that was that. Most people who don't have chronic conditions (the ones who flood the ER's) don't go to primary care doctors anyway. You really think the people who went to the ER on a Saturday night would have waited until regular office hours to see a primary care doctor? I fail to see how reform clears these cases out of ER's or makes the ER's foolproof. If this is an example of anything, it is an example of why tort reform is a bad idea.— SteveMG
- It doesn't matter what the last time he saw his PCP was. He went to the emergency room because he probably thought he was having a heart attack. You go to the emergency room when you're having a medical emergency. That's what they're for. The highest level of medical training I got was my first aid merit badge. Mr. Rivera worked in a school system. He was certainly required to get CPR training at one time or another, which would have included the symptoms of heart attacks. Don't you dare try to pin this on Mr. Rivera. He died because of a nurse or doctor made inattentive and callous due to a broken system. If someone starves to death you don't say "Well, why didn't they go work on a farm? They'd have had access to food there", you try to figure out how to make sure no human being starves to death in this day in age ever again, even if you don't or can't completely succeed. Why? Because you're a human being.— Vasily
- PJ Katauskas wrote what I was going to. Maybe a more useful piece would be one examining the ER policies in that and other hospitals. I'd like to see an expose piece comparing and contrasting services / mortality rates among different ERs. Maybe that would effect some change, and would be less like finger-pointing and griping.— whsmith
- x7227, thank you very much for your comment. It is spot on!— formerphilly
- Clearly we have the best of all possible health care systems. Or, at least that's what the marginalized minority would have you believe... How seriously are we supposed to take the Chip Diller Faction of the Hate Americans First crowd wailing "all is well, all is well"?— E.Plebnista
- "From there, those who are too poor to get health care can certainly not pay for an ER bill that will cost them much more than insurance would." Stats show that unreimbursed ER visits equal ~3% of total health care expenditures, so I think this is a bit of a red herring. "Meanwhile the hospital, knowing that a certain given percentage of their patients will be unable to pay them back, doesn't just sit back and accept that loss, they will in turn increase the prices of services to everyone (that's you) in order to cover this loss." The current reform bill looks to expand medicaid to 133% of poverty level, and to keep costs down, it will slash reimbursement rates. A very likely outcome (one we've seen with both medicaid and medicare) is that doctors will either not see these patients, or shift the costs to those with private insurance. In other words, the cost shifting you speak of already happens and will expand.— RG
- "you try to figure out how to make sure no human being starves to death in this day in age ever again, even if you don't or can't completely succeed." And thats what charity, philanthropy, scientific research, innovation, etc are for. When your plan is to lobby pols to impose your will on the rest of the population, to force them to subsidize others, thats wrong.— RG
- Wow, this is such a pathetic arguement. Any sort of universal health coverage would have not changed this situation in the least. You can argue all you want that universal health care would mean the line in the ER would be sorter, but I completely disagree. Many times its easier to go the emergency room than a primary doctor because its such a pain to get an appointment. This has nothing to do with the state of the uninsured or underinsured, it has everything to do with that hospitals ER procedures. And I do not necessarily blame them, as it was likely frantic and unfortunately this sort of thing probably happens far too often.— Greg S
- "he was forced to wait in a room that most likely was filled with people, many of whom were not covered, who pack an ER on a Saturday night as their last and only resort to medical treatment." OK, so how can that be dealt with? First of all, it is a federal law that mandates that emergency rooms cannot turn away those without insurance - is that changed by any of the current legislation before Congress? Second, a large number of those who go to emergency rooms for basic care are illegals - so would cracking down on illegal immigrants make emergency rooms less crowded and reduce the staggering cost of emergency room care for illegals? That's the entire problem here, Will - as you advocate for health care reform and push for the Dem reform agenda, you also push for amnesty for illegals - and they are crowding out the emergency care system. Should this country instead create subsidized clinics in poorer neighborhoods instead of trying to create a health insurance system that forces people to get insurance coverage? If you create such clinics, do you create new disincentives? How much does this dovetail to other debates - if cap and trade passes, will that force more people into the realm of subsidized health care because of increased energy costs?— db_cooper
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- I'm involved in physician malpractice. That is what this is. the hospital will pay. It is a tragedy but tying it to healthcare is insae, which is where we are headed as a country anyway.— sleepy
- Reform or not, ER's will still be crowded on Saturday night. This story simply has nothing to do with the reform debate.— SteveMG
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- This is malpractice, not a basis to overhaul our health system. However, emotionalism rules the day. His family will see a multi-million dollar settlement.— sleepy
- This has nothing to do with health care reform. It was an emergency and he went to the ER. The hospital should have seen him immediately if he was complaining of chest pain. If obama care passes, he would be waiting in line to see his PCP so it wouldn't make a difference. The hospital failed him and not the health care system. You think everyone in the waiting room is uninsured?— palmyra21
Will this happens everywhere , in Britain , you can wait up to eight hours to even get looked at by a nurse let alone a doctor . In the the socialized healthcare dreamland of Britain you can wait ten days just to see your GP , this story is a sad one but its called life Will nothing more .— PAEnglish- Indeed, x7227 hit the nail on the head. Oh, and btw, db, illegal immigrants use the ER at a significantly lower rate than citizens. For example: --snip-- In Santa Clara County, the most recent estimate found that about 250 to 300 illegal immigrants a year are admitted to Valley Medical Center after arriving at the emergency department. That would be about 3 percent of the hospital's 10,000 annual emergency room admissions...Several recent studies confirm this, revealing California's uninsured population to be overwhelmingly citizens and other legal residents. The Henry J. Kaiser Family Foundation reports that "noncitizens are significantly less likely to use the emergency room than citizens" — about 13 percent of those surveyed, compared with 20 percent of citizens. Some stay away for fear of coming into contact with officials who might report them as undocumented. In a report released last week by the UCLA Center for Health Policy Research, surveyors found that two-thirds of the state's uninsured are U.S. citizens; of 51,000 households surveyed, another 15 percent were permanent legal residents, and 19 percent were noncitizens without green cards. "This is a population that is obviously not draining down public services, or even private services," said Shana Alex Lavarreda, director of the nonpartisan center's insurance studies. "They're just uninsured." --snip--— Talking point sleuth
- "Basically he was forgotten by the people at the desk and once he passed out, that was that.....I fail to see how reform clears these cases out of ER's or makes the ER's foolproof. If this is an example of anything, it is an example of why tort reform is a bad idea." Why would this be an examply of why tort reform is a bad idea? Done correctly, the reformation of tort laws would enable compensation to those that are injured/killed due to malpractice, while severely limiting the number of frivolous suits and out-of-line exhorbitant monetary judgements.— legatus
- It really is amazing to see how "fiscal conservatives" line up to defend a system which is inherently inefficient: a system which relies on demonstrably, and unnecessarily, more expensive care than needed for a significant percentage of the population. Yeah. "Fiscal conservatives." LOL! But as long as we have a system that rations care based on ability to pay - such as we have now - why should those who can afford the current system be upset? I mean, it's not like a poor delivery of health care services to the poor has any kind of impact to the larger community? What does it matter to me if caring for the uninsured - which is required by law - happens in a more expensive maner? What does it matter to me if infant mortality rates among poor people is markedly higher than among wealthy people? Life is just unfair sometimes. Those dead infants just need to wake up and smell the bacon.— Talking point sleuth
- With a health plan in Massachusetts, there actually haven't been any change in the number of ER visits in that state. If we are going to model our healthcare reform after Massachusetts, then I doubt that Rivera would have benefit from it. It comes to show that maybe if he told the ER nurses that he was having chest pain rather than arm/abdominal pain that he would probably have been seen sooner.— udul00
- Very sad......................But 100% of the blame is on OBAMA- just as everything was George Bush's fault.— Manny Trillo
- RG- I dont believe I have argued for or against any form of the current bill or not. In fact in systems such as medicare and medicaid that reimburse doctors proportionate to the amounts of tests they do, the system will be inherently flawed as they promote and reward doctors for performing unnecessary procedures. You have completely failed to address the issue at hand though. You admit, that unrecoverable assets are part of the health care system as it stands right now, while minimizing it to a percentage. However in 2007 the US spent 2.27 Trillion dollars on health care, which if you use your 3% figure results in 68.1 Billion in costs each year alone. You also havent specified if that 3% includes increased administration costs for collections and lawyers fees and any other expenditures needed to try and recover that money. Even if we include those fees, and accept your 3% (which is low, but I'm ceding that to you for arguments sake) 68.1 Billion dollars is enough to buy the mean level of current health care for almost 10,000 folks each year (and that doesnt include any forms of costs savings for the lack of need to collect or over bill others to cover it.) So before spouting rhetoric, please think about the numbers first. And to anyone questioning my political affiliation, I'm actually a registered republican, but I set aside ideological nonsense when it comes to real savings and expanded coverage. If you want to argue that the current bill creates government oversight where it doesnt need to be, thats an argument worth making. However, I've also seen the other side of the coin and ask if the insurance companies are currently doing a job well enough that they dont deserve a new competitor in the market that will force them to be much more competitive with their pricing. If you want to argue ideologies, thats fine. That is not a discussion worth having. If you want to discuss actual real world money savers, then we should continue.— x7227
- ---}}} With a health plan in Massachusetts, there actually haven't been any change in the number of ER visits in that state. {{{--- Do you have a link for that stat? Has the conclusion you've drawn (numbers of ER visits not being a function of numbers of uninsured) been controlled for other influencing variables? In other words, for example, have ER visits in MA tracked the same as in surrounding states without increased insurance coverage?— Talking point sleuth
"Rivera complained of feeling pain in his left arm and abdomen, and was told to sit in the waiting area, said police spokesman Lt. Frank Vanore." Where does it say he complained of chest pain?? This is a tragedy but after spending 12 hours in the ER with my mother yesterday all I can say is that the people at Pennsylvania Hospital are GREAT!!!! Was it a tough day? Yes, it was but the people in the ER weren't doing their nails and blogging on Attytood - they were working their tails off. Rivera obviously had insurance as a school district employee so how this has anything to do with healtchcare reform is tangential at best.— bird11- "Rivera complained of feeling pain in his left arm and abdomen, and was told to sit in the waiting area, said police spokesman Lt. Frank Vanore." Where does it say he complained of chest pain?? This is a tragedy but after spending 12 hours in the ER with my mother yesterday all I can say is that the people at Pennsylvania Hospital are GREAT!!!! Was it a tough day? Yes, it was but the people in the ER weren't doing their nails and blogging on Attytood - they were working their tails off. Rivera obviously had insurance as a school district employee so how this has anything to do with healtchcare reform is tangential at best.— bird11
- "It really is amazing to see how "fiscal conservatives" line up to defend a system which is inherently inefficient:" Its inefficent because the consumer is not the customer. They never see the actual bill for services. This disconnects them from the price mechanism and leads to distortions. They do not have the ability to shop around for best prices, etc. "What does it matter to me if infant mortality rates among poor people is markedly higher than among wealthy people?" Its a shame, but while its the poors right to get pregnant, that doesn't give them a claim on others property to support them. As we talked about last week, if thats they way they want it, then net payers should be consideed stakeholders and have a say on how the subsidized live their lives.— RG
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I read that over half of all emergency room care in the US is uncompensated. Surely this has nothing to do with lousy emergency room care.- ---}}} Its inefficent because the consumer is not the customer. {{{--- It is inefficient because people are being treated in an inefficient manner - because that is their only recourse for medical care, and as a country, we have generally deemed it immoral to deny medical care to those in need. The system would be more efficient if services were delivered in a more efficient manner, with increased preventative care, greater outreach and education, etc., among people who can and will never be able to afford private sector health insurance. None of that will happen at sufficient levels without government involvement. It is an example, as say with funding early childhood education (which elaborate economic studies show brings a 20% return on the dollars invested), where government involvement is fiscally conservative. Fancy that.— Talking point sleuth
- "will be inherently flawed as they promote and reward doctors for performing unnecessary procedures." Because the patients aren't apying for it, insurance companies are. The price mechanism has been removed. "However in 2007 the US spent 2.27 Trillion dollars on health care, which if you use your 3% figure results in 68.1 Billion in costs each year alone." We're a wealthy nation and should be glad we can spend so much on health. How people choose to spend their money is not my concern, its government involvement that distorts the market I'm concerned about. "If you want to discuss actual real world money savers, then we should continue." Please let me know where the govenment has ever cut costs and increased efficiencies. All it can do is cost shift, use subsidies, slash reimbursements, tax more, or ration care by its own arbitrary standards. And all of these have unitended consequences. If you want to save money, competition is the only way. Eliminate interstate boundaries, minimum coverage mandates, unequal tax treatments, and let people vote with their dollars.— RG
- "The system would be more efficient if services were delivered in a more efficient manner, with increased preventative care, greater outreach and education, etc.," The market determines this, not the government. You do relaize you are arguing for central planning, don't you? Your opinion is based on the myth of the wise technocrat(s) who can tell a diverse population how it should be treated. One size does not fit all. Consumer choice allows for individuals to make their own decisions based on their own unique circumstances. Life is all about tradeoffs, and those decisions should be left up to an individual, not gov.— RG
- .."solid, God-fearing people like Joaquin Rivera".. - Bunch - your pomposity is shocking.— michael_b
- "It is an example, as say with funding early childhood education (which elaborate economic studies show brings a 20% return on the dollars invested)," Show me where I got a 20% return on my school taxes. Please. This should be interesting.— RG
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- "Insuring the uninsured is a moral imperative. The problem is that the Democrats have chosen the worst possible method - a $1 trillion new entitlement of stupefying arbitrariness and inefficiency. The better choice is targeted measures that attack the inefficiencies of the current system one by one - tort reform, interstate purchasing, and taxing employee benefits. It would take 20 pages to write such a bill, not 2,000 - and provide the funds to cover the uninsured without wrecking both U.S. health care and the U.S. Treasury."— notojm
- PAEnglish- I dont believe the last time I called up my PCP (GP) that they said I could come in that very day for an appointment, they asked me how's next tuesday for you? Technically I waited almost a week! I didn't die in the interim. Had I been truly sick they could have found a spot for me, just like they could have done in the UK. Please dont obfuscate the debate at hand by spouting off random talking points that only serve to lower the level of discourse to their primal instincts. Even if the US were to go to a single payer system (which theyre not despite some peoples protestations to the contrary) the number of doctors would not suddenly drop by 50% overnight! Wait times should be roughly equal and any increases in GP/PCP patients would be offset by significantly reduced costs elsewhere and fewer specialized docs needed to treat only when cases have progressed to levels far beyond those that can be handled by PCPs. If you believe in supply and demand, the demand for PCP physicians would go up, and thus making it a much more lucrative and intriguing position for a health care provider to have, this increasing the supply to meet the increased demand. Talk specifics, not generalities here people! Don't just say there's a redistribution of wealth, because you're ignoring the one that's in place already. Don't say "obama is ruining everything! socialism! Death Panels!" Try looking at the actual specifics and deciding for yourself. If you decide to take an opposing viewpoint, great! Just make sure you're informed and not just playing whisper down the lane with what you heard on the news, or on the radio, or from your Aunt Vera. Get the facts for yourself and make up your own mind! I'm merely pointing out the facts for you that I've found helpful in my decision, but you shouldnt take my word for it either. Go out and do it for yourself, and so you can be an informed and educated American!— x7227
Charlie Freak had but one thing to call his own. Three weight ounce pure golden ring no precious stone. Five nights without a bite. No place to lay his head. And if nobody takes him in, He'll soon be dead. On the street he spied my face I heard him hail. In our plot of frozen space he told his tale. Poor man, he showed his hand. So righteous was his need . And me so wise I bought his prize For chicken feed. Newfound cash soon begs to smash a state of mind. Close inspection fast revealed his favorite kind. Poor kid, he overdid. Embraced the spreading haze. And while he sighed his body died In fifteen ways. When I heard I grabbed a cab to where he lay. 'Round his arm the plastic tag read D.O.A. Yes Jack, I gave it back. The ring I could not own. Now come my friend I'll take your hand And lead you home— Mr. Smith- ---}}} The market determines this, not the government. {{{--- The market has determined that for people who can't afford private health insurance, the provision of those kinds of services would be a let loss. And so, the market doesn't deliver those services - which is inherently cost ineffective to society as a whole. The same is true for public education. There is no inherent profit in the provision of health care for the poor - but as long as we deem it a moral imperative to, say, treat a poor child with a disease that will be fatal if left untreated, it will be more efficient to provide preventative health care services. We have three choices - (1) let poor people die because our dollars are too precious to go for their care, (2) treat them inefficiently as we do now, on the public dime or (3) treat them in a more efficient manner on the public dime. Simply saying that the market will cure all ills will work just fine for those with money, and not so fine for those without. I, personally, find the moral implications of that stance unacceptable, let alone find specious the notion that just allowing poor people to go without medical care won't have huge fiscal costs to our society long term.— Talking point sleuth
- "Wait times should be roughly equal and any increases in GP/PCP patients would be offset by significantly reduced costs elsewhere and fewer specialized docs needed to treat only when cases have progressed to levels far beyond those that can be handled by PCPs." So overnight the health care provider industry is going to recalculate and docs will switch from specialization to GP? Is that what you are arguing?— RG
- "Consumer choice allows for individuals to make their own decisions based on their own unique circumstances." . . . . Any abortion rights advocate can tell me that. The issue is how do we make sure everyone has those choices?
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- If you have health insurance and you have chest pain, CALL AN AMBULANCE! This is important to remember, even if you are a block away from the hospital. People brought in via ambulance are given top priority in the ER.— Mon_Kie
- "The market has determined that for people who can't afford private health insurance, the provision of those kinds of services would be a let loss." BS, I've said it a million times, state laws set min coverage mandates that raise the cost of insurance, then many have guaranteed risk pools in which everyone is treated the same, which also icnreases premiums. Finally, gov tied insurance to employment, so the under or unemployed suffer most. A catastrophic coverage plan based on individual risk would be affordable to most everyone. They could pay for check ups, etc out of pocket. and finally, if your moral compass tells you that we owe the poor, then what do they owe us? Shouldnt we be able to tell them not to smoke, drink, eat bad foods, get pregnant? We should demand concessions from them if we are to pay for them, should we not? Or should they have no responsibilities to society?— RG
- RG the point you seem to miss is when has a company ever looked out for YOUR best interest. I'm all for NON-PROFIT healthcare cooperatives. When it comes down to someones health, I think the person ultimately making the decision should be the patient and his or her own doctor. As it stands right now its a patient and a doctor and his or her insurance company deciding whether or not a procedure is covered or not. Did you know 7 years ago PET scans were not covered by insurance companies to assist with the staging of cancers? I do, I worked on a study demonstrating the benefits of the usefulness of a PET scan in conjunction with other routine scans used in cancer staging procedures. The only reason we had to do this study? So the doctors I worked for could have something to point to once the insurance companies continually denied their patients a scan that everyone involved knew was effective! Given the choice between the government and a private company, I dunno about you, but I'd actually go for the one thats not looking to maximize profits by denying me care. Again, not that there's anything wrong with making profits, but when it comes to my health, I don't want the person who ultimately decides whether or not something is cost effective to have their own monetary interests, in addition to my well-being.— x7227
- As someone who was recently was in the emergency room with what was considered a life threatening situation, I saw how many non-emergencies there were and this was on a Wednesday afternoon. I have excellent coverage but had to go to the er because of an allergic reaction. Thank godness I had someone there with me to wait and check on how long my wait will be. I was very dizzy and could barely talk. I waited there for 6 hrs to see a dr. This is unacceptable!— chris_mcc_03
- x7227: We don't know whether these people saw a PCP. We don't know anything here. Will sees the world a certain way, so he projects that to this particular emergency room scenario. The article states Mr. Rivera went to the ER, was told to wait, and he unfortunately passed on while waiting. His son said he had been waiting for a hour, an maybe he was, but he went to the ER alone, and the article shows no verification of his wait time. Will wants to use this man's death as an argument for his utopian fantasies, but there are good bit of holes in the story.— jmc
- ---}}} Show me where I got a 20% return on my school taxes. Please. This should be interesting. {{{--- LOL! I've posted links for you before on the topic. I'll see later if I can find some of the better ones, but a simple google search will turn up myriad studies by renowned economists that show a strong return to the dollar on early childhood education. For example, a simple Google search returned this comment by a Nobel Prize winner: --snip-- St. LOUIS — Proponents of early childhood education in Missouri got a boost Monday when a Nobel Prize-winning economist made a lucrative pitch to some 40 business leaders at the St. Louis Federal Reserve. The message: Spend money educating children before their fifth birthday and the financial return in building a future work force will be enormous. --snip--— Talking point sleuth
- "I think the person ultimately making the decision should be the patient and his or her own doctor." And charging their decision to the taxpayers. Think about your statement, in what world would a patient turn down additional tests when cost is not an issue? In what world would a doc not recommend them, if a) they are the one performing them and b) they feared litigation for not asking for them. There needs to be someone looking at costs. I'd prefer it to be the consumer. "Again, not that there's anything wrong with making profits," Profits signal what works.— RG
- LOL! Right, RG. Left to their own devices, and without government subsidies, insurance companies would decide to provide health insurance to poor people that couldn't afford to pay premiums. Those people wouldn't just die if not provided government subsidized healthcare. Private insurance companies would pay for that care at a nest loss. Hilarious.— Talking point sleuth
- "The message: Spend money educating children before their fifth birthday and the financial return in building a future work force will be enormous." My goodness. Now kids need to be indoctrinated for 20+ years of their lives. I'd love to see how he "proves" this nonsense. Lemme get this straight, if you take more money out of my pocket now, I'll get a 20% return later vecause it educated sonmeone else? Does this even take into account the basic concept that a dolalr today is worth more than one tomorrow (inflation)? In other words, if my onvetment returns (a rather nebulous) 20% over some undetermined future timeframe, is it inflation adjusted?— RG
- --snip-- Rate of Return: The report considered several studies of model programs and, when considering the Perry Preschool program, found a return on investment of 16 percent, with 80 percent of the benefits going to the general public. The data about model programs—such as Perry Preschool yielding more than $8 for every $1 invested—is one way of describing the investment. Rolnick and Grunewald’s use of the rate of return clearly shows the benefits of the investment compared to other investments. --snip--— Talking point sleuth
- "Left to their own devices, and without government subsidies, insurance companies would decide to provide health insurance to poor people that couldn't afford to pay premiums." Why couldn't they afford premiums on a basic, bare bones plan that covers catastrophic care and is based on individual risk (i.e. smokers, etc)? Are you truly arguing that the poor shouldn't be responsible for any costs?— RG
- "So overnight the health care provider industry is going to recalculate and docs will switch from specialization to GP? Is that what you are arguing?" Did I ever say that? I actually said that market forces will drive that change...but far be it for you to read my entire post. You want to make this into a referendum about the poor, and about redistribution of wealth. But that completely misses the issues that I've been trying to point out. Those poor/uninsured that youre so worried about covering are already costing you (by your estimations) 68.1 Billion dollars a year! You want to make their getting coverage contingent on "tell[ing] them not to smoke, drink, eat bad foods, get pregnant? We should demand concessions from them if we are to pay for them, should we not?" If you want to do that, fine, but you're required to do the same thing (that whole equal protection under the law thing...I forget what the document that coined that phrase was called again, could you help me?) Dont deal in hyberbole, talk about the real here and now.— x7227
- Leggy, most frivolous malpractice suits never see the courtroom. Also, you would be surprised to know that many malpractice cases are not pursued. My wife and I have seen enough malpractice from her peers to know who the hacks are. You try to avoid referrals and consults from those guys. Both of our fathers got butchered by surgeons. My father didn't pursue the malpractice because he felt it was pointless in light of his age and health. My fatherin law, however, was pssd! It turned out the surgeon had been going from state to state leaving a trail of settlements behind him every time. Far from being frivolous, one of the discovery issues went all the way to SCOTUS, and he prevailed. All tort reform will do is protect the bad doctors by making them insurable.— SteveMG
- LOL! You don't have a clue, do you RG? Long term, government investment in early childhood education reduces unemployment, reduces crime, reduces health care costs, increases productivity and competitiveness. But yeah, you're probably right, a Nobel Prize winning economist probably didn't consider inflation when determining return on investment. Absolutely hilarious.— Talking point sleuth
- ---}}} Why couldn't they afford premiums on a basic, bare bones plan that covers catastrophic care and is based on individual risk (i.e. smokers, etc)? {{{--- Uh, because they're poor?— Talking point sleuth
- "Those poor/uninsured that youre so worried about covering are already costing you (by your estimations) 68.1 Billion dollars a year!" Yes, cause there's no chance that a) non poor are free riding off this (ie the young who decided it was cheaper not getting insurance) b) going forward, covering the medical costs of an additional 20-40 mil will cost LESS that that. Isn't the bill $900 bil over ten years, of which, coverage is only expanded for 6? You simply cannot expand coverage and hope to control costs with this bill. "If you want to do that, fine, but you're required to do the same thing (that whole equal protection under the law thing...I forget what the document that coined that phrase was called again, could you help me?)" YAY! colelctivism at its finest, lets all trade some freedom for security, just like in China.— RG
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- JMC- I completely agree, this article goes far outside the box in making assumptions. I dont believe I've cited it once for that very reason. However, I was merely attempting to argue that just because Mr. Bunch has not completely fleshed out this particular story, does not mean that health care reform should not be a good idea. Mr. Bunch has done a piece of opinion journalism, which has omitted several key facts, for that this is not a piece of reputable journalism. However, as a blog post and one that represents his opinion, I feel that his post has a message and attacking his lack of journalism in a blog post muddied the discussion, hence I decided to wade into these rather turbulent waters.— x7227
- "Long term, government investment in early childhood education reduces unemployment, reduces crime, reduces health care costs, increases productivity and competitiveness." Gee that explains away the unemployment and rising health care costs in Europe. Seriously, do you think before you post? And your appeals to authority, "B-b-but a Nobel Prize winner said it", are pathetic.— RG
- ---}}} Are you truly arguing that the poor shouldn't be responsible for any costs? {{{--- No. I have no idea where you got that from. What I'm arguing is that the current system we have for providing healthcare to the poor is inefficient, and more costly to us as a society as long as we feel there is a moral imperative to provide health care to people that can't afford to pay for it. To say that the private sector would resolve that problem is beyond laughable. If you're content with allowing, say, an poor elderly person to die because of a treatable disease, so be it. That's your right. I would disagree. I have absolutely no problem with parting with more of my expendable income to provide care for the poor - it is just that in doing so, as a "fiscal conservative," I'd like to provide that care in the most efficient manner possible.— Talking point sleuth
- ---}}} Are you truly arguing that the poor shouldn't be responsible for any costs? {{{--- No. I have no idea where you got that from. What I'm arguing is that the current system we have for providing healthcare to the poor is inefficient, and more costly to us as a society as long as we feel there is a moral imperative to provide health care to people that can't afford to pay for it. To say that the private sector would resolve that problem is beyond laughable. If you're content with allowing, say, an poor elderly person to die because of a treatable disease, so be it. That's your right. I would disagree. I have absolutely no problem with parting with more of my expendable income to provide care for the poor - it is just that in doing so, as a "fiscal conservative," I'd like to provide that care in the most efficient manner possible.— Talking point sleuth
- "Uh, because they're poor?" Do we buy them hosuing, food, etc? These are arguably more necessary. How do you define poor, people with no income?— RG
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- ---}}} Do we buy them hosuing, food, etc? {{{--- We have government subsidies for those, also. But regardless, the American people (during Reagan's administration, no less) determined that turning away people from healthcare on the basis of their ability to pay was not consistent with American values. You may have a problem with that notion. I don't.— Talking point sleuth
- "What I'm arguing is that the current system we have for providing healthcare to the poor is inefficient," Ineffecient how? You just don't like the results, thats all. "and more costly to us as a society" Yes, more costly than a $900 bil bill that's primary mechanism for controllign costs is to slash reimbursement rates. Please explain to me how the bills being bandied about increase delivery efficency. or change the system. They don't, instead its a giant subsidy of the rich to the poor, and the healthy to the sick. "I have absolutely no problem with parting with more of my expendable income to provide care for the poor" Thats what VOLUNTARY charity is for.— RG
- ---}}} that explains away the unemployment and rising health care costs in Europe. {{{--- LOL! Because there are no other variables in play, right RG? Laughable. Feel free to read any of the myriad studies that back up the study by the Nobel Prize economist, RG, and get back to me with your explanation of the flaws in their analysis. LOL! But your assumption that said laureate most likely failed to account for the (apparently in your mind, sophisticated concept of) inflation, is, again, laughable.— Talking point sleuth
- "We have government subsidies for those, also." You've already said the poor cant afford basic premiums, so you are not arguing for a aprtial subsidy, but rather a full blown, open ended commitment that we will cover all of their health costs, regardless of whether or not they were the result of their individual actions (cancer from smoking, pregnancy, alcoholism).— RG
- ---}}} You've already said the poor cant afford basic premiums, so you are not arguing for a aprtial subsidy, but rather a full blown, open ended commitment that we will cover all of their health costs, regardless of whether or not they were the result of their individual actions (cancer from smoking, pregnancy, alcoholism). {{{--- Huh? LOL! Never said anything like that, RG. I'm saying that we have varying levels of subsidization for health care now - because as a society we have agreed (apparently without your consent) that turning people away from treatment would be immoral - and so we should provide those subsidies in a more efficient manner. Who do you suppose will provide those "partial subsidies" if not the government, RG? The tooth fairy? Santa Clause? Sasquatch?— Talking point sleuth
- "Because there are no other variables in play, right RG?" Just idiotic. when I point out that countries that have spent more on education are still showing high ue, low productivity, and rising health care costs, you then decide there are other variables. YOU claimed that specific investment pays off with a 20% return. You treat it like a simple issue, spend more, get more return. When challenged, you now mention there may be other variables and the results for one place might not scale to another. When will you stop relying on the state, and by proxy, other peoples money, to solve the world's ills?— RG
- RG, heres the problem. You say "a) non poor are free riding off this (ie the young who decided it was cheaper not getting insurance)" but the point is that they too would have insurance if reforms are enacted, thus their costs can be offset with preventative medicine! You're trying to frame this as a bunch of freeloaders coming in and mooching off you. Its a persuasive argument. The only problem is theyre already mooching off you by not being able to pay their hospital bills and increasing your premiums. Ditto those who go into bankruptcy because they reach their policy limits and are forced to pay the rest themselves. Now would you rather them mooch off you a lot like it is now, or mooch less when they get that $100 PCP visit to treat the congestion instead of the $8,000 dollar ER visit for pneumonia. The only problem is the first is hidden costs, the second is up in your face, theres no difference in the levels of mooching. Oh and your collectivism at its finest comment, hilarious! Laughing at the constitution (that'd be the fourteenth amendment btw, HOORAY for the constitution, its only the codification of the pinnacle of what America stands for...but youre right, HOORAY FOR COLLECTIVISM! Next stop on the constitution express, CHINA)— x7227
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- "because as a society we have agreed (apparently without your consent) that turning people away from treatment would be immoral" We've also apparently agreed that the Iraq war was morally just, that subsidizing Israel's military is just, that bailing out Wall street was necessary, etc, etc. If you ahven't gotten it by now, i'm not one for the power exercised by the majority over the minority.— RG
- Funny, TPS, a lot of emergency rooms around the nation have to write off millions in charity care - even if the utilization of emergency rooms by illegals is 3 percent, that's a lot of expense. Now, if you could quit your usual political posturing long enough to read up on alternatives, you might want to peruse this article about a clinic set up to receive non-critical ER referrals and the money it is saving ERs (and, in the long run, all taxpayers and consumers). The article mentions the usual battle over illegals getting taxpayer-funded services - but even though I am against amnesty, if people are here and need medical care, we need a better process than just counting on expensive ERs to provide basic care: http://online.wsj.com/article/SB125027261061432585.html— db_cooper
- "but the point is that they too would have insurance if reforms are enacted, thus their costs can be offset with preventative medicine!" First, I'm not always a big fan of studies, but some have shown that preventative care actually costs more in the long run, since it extends lifetimes. Second, the bills don't handle the freeloader issue, you get a whopping $96 fine if you don't buy insurance, but you are guaranteed coverage. So you pay fine, get sick, then enroll. Viola adverse selection! As for collectivism, nowhere in the Constitution does it say we are obligated to pay for others with our own money. You are arguing the opposite. I made a snide remark that if we do, why can't we tell them what to do?— RG
- Hmm, Longshanks, lets see if I paid attention in school. This article was posted at 9:23 am, at least from all the information I have available to me. To me, that seems a bit past the printing deadline for todays paper, making this a blog post. I dunno, maybe its all the deductive reasoning skills Im having to use for the LSATs, I just make logical inferences with the information I have available to me. Just because Mr. Bunch is a columnist at the newspaper, does not require him to act with complete journalistic integrity at all times and in all writings. Had he said something that was libelous on this particular blog, sure he and the paper could be sued, but as I read it, this was a piece of opinion expressed via his blog entitled "attytood". If this was run in the daily news today, thats a different story, I dont have a copy in front of me, so I cannot know. But from all the pieces of information here on this page, its a blog post and one that represents the opinions of the writer. I just wanted to make sure the conversation stayed on the opinion of the writer and wasnt obfuscated by rhetoric of those who parrot what theyve heard.— x7227
- RG- You're absolutely right, that there is nothing expressly in the constitution that says people are required to pay for others. But the congress does have the power to raise and levy taxes, and its been the opinion of almost every supreme court dating back to the 1930s that it is indeed completely constitutionally OK for states to require motorists to have auto insurance. Also if you say youre not a big fan of studies, then cite an unnamed one...thats not really proving anything. Thats like saying all people are idiots, except for that guy who agrees with me! Please cite specifics, and where you've gotten this information from, then everyone can decide if its reputable or not (BTW, everything I've said so far has come out of the non-partisan CBO...so just for what its worth)— x7227
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- TPS: "Feel free to read any of the myriad studies that back up the study by the Nobel Prize economist" Nobel laureate economist? You mean like Paul Krugman, who claimed Fannie Mae didn't hold subprime debt when it is documented they held $4.3 trillion in such? http://www.realclearmarkets.com/articles/2009/11/10/how_did_paul_krugman_get_it_so_wrong_97499.html Or maybe Nobel laurate Joseph Stiglitz: As Congress lumbers toward creating a systemic-risk regulator, it's worth a look back—to 2002, when an economist named Stiglitz and a duo named Orszag wrote a paper with the droll title, "Implications of the New Fannie Mae and Freddie Mac Risk-Based Capital Standard". We won't keep you in suspense. The paper, written the year after Joseph Stiglitz won the Nobel Prize for economics, concludes that "on the basis of historical experience, the risk to the government from a potential default on GSE debt is effectively zero." Their analysis has recently been making the rounds on the Web to a chorus of chortles. But the real lesson of the paper is not that Mr. Stiglitz, or Peter Orszag, the current White House budget director, and his brother Jonathan are dupes or rubes. The paper is notable because it represents the almost universally held view of the two government-sponsored mortgage giants at the time and for years afterward. http://online.wsj.com/article/SB10001424052748704204304574543503520372002.html The point is, having a Nobel on your bookshelf does not make you immune to making facts up (Krugman) or being dead wrong (Stiglitz). And it's important to note that Stiglitz represented a large consensus, so just about EVERYONE was wrong regarding GSEs - so that is why a self-reinforcing concensus (like we also see in the AGW movement) can be so problematic.— db_cooper
- Ahh, TPS, I finally spotted the 'trick' in your cite from Kaiser: "In Santa Clara County, the most recent estimate found that about 250 to 300 illegal immigrants a year are admitted to Valley Medical Center after arriving at the emergency department. " Admitted. That has utterly no bearing on how many illegals use the ER as a replacement for primary care - if you go to the ER when you have a sore throat because the ER has to see you, in most cases you are NOT going to actually be admitted to the hospital - instead, such a stat would skew towards those who have insurance and only go to the ER for bona fide emergencies.— db_cooper
- First I would like to extend my sympathies to the Rivera family. Secondly,it is outrageous that a 63yr old man walks into a Emergency complaining of chest pains and he doesnt get sent back to triage. Thirdly, why didnt anyone check on him to see if he was still experiencing symptoms. This is total neglect on the part of the hospital. I hope the hospital disciplines whomever did not follow protocol and although this wont bring Mr. Rivera back I hope they retain a good attorney and sue the pants off the hospital! What a disgrace! Also to the nit wit who stated when was the last time Mr.Rivera saw his PCP..are you serious..like someone posted when it's an emergency at 11:00pm you go to the Emergency Room. Oh I almost forgot to the low lives that robbed Mr. Rivera where was security. Was everyone sleeping on the job at this Hospital?— kimtores
- One of the more disgusting articles written by Will. Take a tragedy, and use it as a political hammer to hit people over the head with.— Tom813
- Add 47 million people into the system without adding any Dr's and this incident will make every visit to your local Dr a similar nightmare. Other than that I dont see how this piece is at all relevant to the health care reform debate since he had good insurance. Would someone please explain that to me.— tr88
- "it is indeed completely constitutionally OK for states to require motorists to have auto insurance. " That is a state power, not a federal one.— db_cooper
- Why is this being made a healthcare reform issue? This man was robbed by three scumbags while he was ill in the hospital. That is the real tragedy. Where was the security to prevent this? Hospitals have security guards in the ER's where was the person at this time? Sad as Mr. Rivera's death was he not a School District employee? Did he not have healthcare? How would this travisty for healthcare reform have prevented this?— junethe4th
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- You can't expect much just because you pay double what every other country in the world pays for health care.— MikeP
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- "Not to mention, DB -- that no one forces you to have auto insurance if you do not drive" Well, they create a catch-22 by prohibiting companies from denying coverage for pre-existing conditions. If there is no insurance mandate, someone could just simply not carry insurance but then run out and get it if they get a serious illness. Which turns the very notion of insurance on its head. I think a better approach would be catastrophic insurance and medical savings accounts that can be rolled over - and there could be some kind of match for poorer consumers akin to the EITC. And for those that don't have any income, or for those who cannot manage their own health care finances - create low-income clinics. Instead, the proposed legislation, from what I can see, takes the current problems and just adds more bureaucracy - and having too many parties and decision-makers involved IMO is what is causing many of the current problems, we don't need more of such. I currently have a HSA that cannot be rolled over. But when I use it, I have pretty broad leeway, I don't have an insurance company looking over my shoulder, and the HSA carrier just ensures that the expenses are for legit health care expenses as determined by the IRS - I might have to submit documentation 2-3 times a year, the rest is built into the card usage process. Very low overhead. I think such a program should be expanded and insurance downplayed - your car insurance doesn't pay for your oil changes, your health insurance should protect against catastrophic problems and a tax-exempt MSA/HSA could cover the day-to-day kind of stuff.— db_cooper
- "I guess if those fictional people in the waiting room had health insurance, they somehow whould not have been sick on this particular night, and Joaquin would still be alive? " Yeah, now that you bring that up, how many people who normally would go to a doctor during normal hours if they had insurance are going to be in an emergency room on a Saturday night? It's not like private doctor's offices are going to be open then. The more this is discussed, the more it appears Will is right back to jumping to conclusions after his mea culpa for doing such with the census worker suicide. I guess we can see just how heartfelt that mea culpa actually was - it got tossed right out the window the very next time a story rolled around from which Will thinks he can make a political point without bother to wait for those annoying details.— db_cooper
- "Seven "LOLs" in one thread, all by TPS. Apparently he missed the announcement that LOLing makes one sound like a Twilight-loving 13-year-old girl." - Wrong again Bryanc - TPS did not miss the announcement. There is nothing wrong with him wanting to be a Twilight-loving 13-year old girl - you go, TPS!!!! Live your dream.— bird11
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- Arthur H. Kaplan, 64, lawyer, activist .......John N. Zallie, 92, entrepreneur .........Vincent Dell'Osa Jr., instrument 'doctor'............ Leon Hunter Jr. | Insurance executive, 88 ............Lizanne LeVine, a Philly Kelly.......Robert A. Clancy, 75, of Ambler, a Navy aviator and corporate lawyer.....Kathryn Sobey Leslie, 94, an award-winning artist who worked in oil paint and watercolors and also did sculpture and textile design.............Jane Mather Sullivan, 83, of West Chester, the third generation of her family to be master of the Brandywine Hounds, a foxhunting club she ran for decades.........Judson Free Vogdes III, 74, of Haddonfield, a civil engineer and educator.........Fred Joseph, 72, who as chief executive officer of the investment bank Drexel Burnham Lambert Inc...... I guess healthcare reform was too late for all of them too since they all shared the same obit page as Joaquin Rivera. Guessing by their obits all of these people had at least two things in common with Mr. Rivera - they all had health insurance and they all are currently dead. For a fuller list of people's deaths to blame on anybody who opposes Obama's healthcare plan please go to http://www.legacy.com/obituaries/philly/ .....don't concern yourself with trying to figure out if the people listed had healthcare because regardless of them having coverage or not their deaths are 100% the fault of people who oppose healthcare reform.— bird11
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- I still absolutely find it hilarious when someone who posted "Oh my god, are you mental," criticizes me for posting LOL! Hilarious.— Talking point sleuth
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- ---}}} Ahh, TPS, I finally spotted the 'trick' in your cite from Kaiser: (((--- No "trick," db. I posted the rest of the excerpt also, which stated that 13% of illegal immigrants use the ER (albeit, a smaller percentage than citizens), and that 19% of the uninsured are illegal immigrants. No doubt, the relative percentage that are treated would be greater than the relative percentage that are admitted.— Talking point sleuth
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- "I posted the rest of the excerpt also, which stated that 13% of illegal immigrants use the ER (albeit, a smaller percentage than citizens), and that 19% of the uninsured are illegal immigrants." That is an entirely different aspect of the study - I was calling into question the validity of 3 percent admissions number. Beyond that, how many illegals are not reachable for survey purposes? How well-adjusted is any such survey the fact that a lot of illegals only have cell phones, and that surveys by phone typically reach only older Americans who still have a landline. Also, a lot of Latinos culturally are not inclined to respond to prodding from strangers, that comes straight from my wife's experience who is Latina. So all of that data is suspect. Instead, try looking at the amount that unreimbursed medical care is costing hospitals, and where the highest amounts are concentrated.— db_cooper
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- great news everyone, the health care plan will stop old people from dying and young people from stealing!!!!!!! we truly live in a magical time.— egmetzjr
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- ---}}} I was calling into question the validity of 3 percent admissions number. {{{--- Let me get this right. You have no idea how the data were collected, yet you have determined that all those data are "suspect." LOL! That's almost as good as RG saying that a study done by a Nobel Prize winner is obviously flawed, because RG assumes that the guy never controlled for inflation in his calculations. You boyz are hilarious.— Talking point sleuth
- Oh. Wait. I get it now, db. You didn't like the 3% number because it undermines the validity of your argument. Therefore, although you have no idea how the data were collected, the study is suspect simply because you don't like the implications of the outcome. My bad.— Talking point sleuth
- Oh, and db, kudos for your deep analysis on why extensive studies, one of which was buy a Nobel Prize winner, which show an excellent return on investment in early childhood education, are also obviously flawed, Because Krguman and Stiglitz both once wrote something that you disagree with. I mean, obviously, early childhood education has been shown to be causal to cognitive development, and cognitive development can obviously be linked to economic return to our society - but there MUST be something wrong in the Nobel Prize winner's analysis - so we might as well just assume that it is because he was a Nobel Prize winner. After all, as I just acknowledged, two other Noebl Prize winners also wrote things that you disagree with. Astounding analysis there, db. Just astounding.— Talking point sleuth
- ---}}} when I point out that countries that have spent more on education are still showing high ue, low productivity, and rising health care costs, {{{--- There are other countries which have increased spending on education and shown the opposite results - which shows that spending on education is not the only relevant variable. But that, in no way, proves that spending on education doesn't bring a net positive in return on the investment. The basic logic is quite simple, RG. Spending on early childhood education has demonstrable, and unequivocal, benefits in cognitive development of children. Aside the moral implications of that FACT, there are also, clearly, reasons to speculate about a positive relationship to economic benefits. Economists, well respective in your beloved private sector, have done studies to evaluate that relationship, and found it to be unambiguously positive. Why don't you read just a few of those studies and get back to me with your analysis of their methodological flaws, or the logical problems with their conclusions? Or maybe you can site some studies which invalidate their findings? You can't come up with anything substantial, so instead, you say the clearly a study is flawed because it was authored by someone who won a Nobel Prize in economics. LOL! Hilarious.— Talking point sleuth
- Perhaps I need to spell it even more to make it even more painfully obvious, RG? When children's cognitive development is advanced (as happens through early childhood education) there is reason to speculate that early childhood education brings beneficial returns to society. Studies show that it does. As I said, feel free to offer some more of your in-depth analysis of why those studies are flawed. Your speculation that they forgot to factor in inflation was a real winner. I'm still laughing.— Talking point sleuth
- Here's one study by the RAND corporation, RG. I don't believe any nobel prize winners were involved, and I can't verify whether they remembered to control for inflation. LOL! --snip-- The Costs and Benefits of Universal Preschool in California Key findings: A one-year, universal, high-quality preschool program in California would, for a $4,300-per-child cost beyond current public preschool spending in the state, generate * $11,400 in benefits per child for California society, for a net benefit of over $7,000 per child, or $2.62 for every dollar expended, under the baseline assumptions of the research * between $2 and $4 in benefits for every dollar expended, under a range of different assumptions * other potential benefits for the California labor force, the competitiveness of the state’s economy, and economic and social equality. Research has shown that well-designed preschool education programs serving disadvantaged children can generate benefits to government and the rest of society that outweigh program costs. As a result of such evidence, there has been a growing conviction among U.S. business leaders, policymakers, and the public that children benefit from structured programs preparing them for school entry. That conviction has been accompanied by increasing enthusiasm for public-sector investment in preschool. --snip-- http://www.rand.org/pubs/research_briefs/RB9118/index1.html— Talking point sleuth
- Here's one by the Director of Research for the Federal Reserve Bank of Minneapolis. Hopefully, he remembered about inflation. http://www.ncld.org/at-school/general-topics/early-learning-aamp-literacy/early-education-the-best-investment-we-can-make— Talking point sleuth
- Here's one by ROBERT G. LYNCH, the Everett E. Nuttle professor and chair of the Department of Economics at Washington College. Do you think they know about inflation at Washington College? --snip-- Research is increasingly demonstrating that the policy of investing in early child-hood development, particularly high-quality prekindergarten, provides a wide array of significant benefits to children, families, and society as a whole. Empirical research shows that all children, regardless of whether they are from poor, middle-, or upper-income families, benefit from prekindergarten programs. In addition, higher quality prekindergarten programs provide greater benefits than lower quality prekindergarten programs. Children who participate in high-quality prekindergarten programs require less special education and are less likely to repeat a grade or need child welfare services. Once these children enter the labor force, their incomes are higher, along with the taxes they will pay back to society. Both as juveniles and as adults, these children are less likely to engage in criminal activity thereby reducing criminality overall in society. High-quality prekindergarten benefits government budgets by saving government spending on K-12 education, child welfare, and the criminal justice system, and by increasing tax revenues. Thus, investment in high-quality prekindergarten has significant implications for future government budgets, both at the national and the state and local levels, for the economy, and for crime. This study breaks down these benefits at the national level and state-by-state. --snip-- http://www.epi.org/publications/entry/book_enriching/#exec— Talking point sleuth
- "Because Krguman and Stiglitz both once wrote something that you disagree with." Disagree with? Wrong, TPS. Krugman clearly was wrong about Fannie not holding subprime debt. And if Stiglitz was incorrect about no government risk in GSE's such as Fannie, that financial meltdown thingy over the last couple of years must have just been my imagination. The real point sailed right past you - that a Nobel on the shelf is no guarantee that a given work is sancrosanct.— db_cooper
- " Let me get this right. You have no idea how the data were collected, yet you have determined that all those data are "suspect." LOL! " Wrong. A three percent admission rate from the ER to the hospital gives utterly no indication how many ER visits were for what normally would be primary provider care - because such visits rarely results in admissions. You really are tossing up the strawmen furiously lately, TPS. I guess you don't have any other choice but to engage in such tactics, tho, especially with climategate, so I guess I can't really blame you.— db_cooper
- Keep the government out of Medicare!— SteveMG
- }}}--- that a Nobel on the shelf is no guarantee that a given work is sancrosanct. ---{{{ Who ever said it was, db? Now, why don't you get back to me with your analysis of why the research, done by a nobel prize winner in economics, is wrong? That is, if you have anything deeper to provide than RG's "analysis," that a nobel prize winner in economics forgot to factor in inflation in his conclusions?— Talking point sleuth
- }}}--- A three percent admission rate from the ER to the hospital gives utterly no indication how many ER visits were for what normally would be primary provider care - because such visits rarely results in admissions. ---{{{ You indicated that "large number of those who go to emergency rooms for basic care are illegals." That was a sufficiently vague statement, and completely unsubstantiated. While no direct way of measuring the phenomenon in question, the fact that only 3% of the admissions to the hospital were of illegal immigrants, in a community with a lot of illegal immigrants, is likely a relevant way of further quantifying your "large number" statement. As is the fact that studies showed that fewer illegals go to the ER for treatment (as opposed to 20% of citizens), as is the fact that illegals made up only 19% of the uninsured in the survey. And I excerpted all those stats. If you have some actual, valid, methodological criticisms of the surveys, bring them. If you have some contrasting evidence, bring it. But all you offered was a completely unsubstantiated criticism of the studies' methodology, with absolutely no knowledge of what their methodologies were. Now why would that be? LOL!— Talking point sleuth
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- TPS, you're idiocy is outstanding. From your Washington College study: "The governmental costs and benefits of both publicly funded prekindergarten programs, measured as year-by-year expenditures, budget savings and revenue impacts, are estimated from program implementation in 2007 through the year 2050. In addition to the long-term budgetary consequences to governments that follow from such investment, the earnings and crime implications for individuals and society are calculated for the same years." In other words, this study is nothign more than a prediction with no tangible evidence. Of course when you to the taxpayer to ask for more money, you're going to tell them they will benefit from it.— RG
- And way to use a California study. With their budget mess, I guess they should just wait around for those magical "benefit to society" returns to show up any day!— RG
- x7227 Just a little information for you , when I post about the UK I use personal experiances of either of myself or my family . You seem to beleive I'm 'hearing' these things , those of you on the left never cease to amaze me at your arrogance that because you googled something you know more about my country and its state of affairs than I do . Fact its not uncommon to have to wait up to ten days to see your GP , my own daughter two years ago was sick could not get an appointment at the GPs office went to the ER ( or Casualty as we call it ) was told you have to see your GP before coming here . She collapsed in the street and spent five days in hospital . Fact in Britain they now trumpet as a success that cancer sufferers only have to wait 18 weeks to see a specialist . Fact 60% of the population have no access to dental care . Fact a significant number of people waiting for heart by pass surgery die waiting as the lists are so long . Fact many people waiting for surgeries such as hip or knee replacement may wait ten years . Hope that clarifies a few misconceptions you have about universal health care , I have lived with it , it sucks , it will always suck , health care here is not perfect and there are things that need to be done such as passing laws banning insurance companies from refusing care or dropping people when they need care , passing a huge bill that socializes medicine is not going to fix anything other than forcing us all into a system that swallows huge ammounts of money , is innefective and reduces the quality of care to whats the most ecconomic way not the best way .— PAEnglish
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Ah America! Home of NOT the best health care system in the world, but certainly the most expensive.- Comment removed.
- That man did not c/o CP. He saw his PCP that day, nothing was done, he then walked to the hospital without his "beloved" family. bad luck. you dumb sh1ts dont know anything.— Dr. Who
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