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Groups > sci.electronics.design > #460129 > unrolled thread
| Started by | Don Y <blockedofcourse@foo.invalid> |
|---|---|
| First post | 2017-05-13 15:10 -0700 |
| Last post | 2017-05-26 13:43 -0700 |
| Articles | 4 on this page of 264 — 26 participants |
Back to article view | Back to sci.electronics.design
What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 15:10 -0700
Re: What's wrong with "national health care"? Cursitor Doom <curd@notformail.com> - 2017-05-13 22:54 +0000
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 15:59 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 00:34 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 17:11 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 08:49 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 02:00 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 10:14 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 08:31 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-14 15:56 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 09:04 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 18:02 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 16:10 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-15 01:12 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-16 10:57 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-18 10:42 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-18 14:10 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 10:19 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-17 15:48 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 13:19 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-17 18:47 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 15:40 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-18 00:03 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 19:39 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-18 08:09 +0100
Re: What's wrong with "national health care"? John Devereux <john@devereux.me.uk> - 2017-05-18 09:13 +0100
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-18 09:37 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-18 04:57 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-19 09:58 +0100
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-17 08:21 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 13:28 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-19 09:13 +0100
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-19 10:14 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-19 13:31 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-19 19:17 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-19 17:47 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-19 23:45 +0100
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-19 19:57 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-19 23:35 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-20 07:42 +0100
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-20 00:48 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-23 09:24 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-23 12:19 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-23 17:44 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-23 16:49 -0400
Re: What's wrong with "national health care"? Clifford Heath <no.spam@please.net> - 2017-05-24 08:29 +1000
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-23 19:26 -0400
Re: What's wrong with "national health care"? Clifford Heath <no.spam@please.net> - 2017-05-24 11:32 +1000
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-24 01:16 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-24 18:04 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-24 07:40 +0100
Re: What's wrong with "national health care"? Jasen Betts <jasen@xnet.co.nz> - 2017-05-31 11:57 +0000
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-31 09:05 -0400
Re: What's wrong with "national health care"? Jasen Betts <jasen@xnet.co.nz> - 2017-06-20 05:12 +0000
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-23 21:07 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-23 19:04 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-23 18:46 -0400
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-24 12:56 +0200
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-24 12:37 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-24 18:12 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-24 16:11 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-24 19:49 -0400
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-26 15:41 +0200
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-23 18:44 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-14 18:18 +0100
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 18:54 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 23:00 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-15 15:32 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-15 15:01 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-16 00:52 +0100
Re: What's wrong with "national health care"? kevin93 <kevin@whitedigs.com> - 2017-05-15 19:17 -0700
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-15 19:26 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-16 12:01 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-16 21:12 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-16 13:51 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-16 20:26 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 15:50 -0400
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 13:27 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 22:00 +0100
Re: What's wrong with "national health care"? kevin93 <kevin@whitedigs.com> - 2017-05-14 18:39 -0700
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 16:20 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 17:05 -0700
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 17:49 -0700
Re: What's wrong with "national health care"? John Larkin <jjlarkin@highlandtechnology.com> - 2017-05-13 18:02 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-13 21:25 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 21:28 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-13 19:39 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 13:05 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-15 20:37 -0400
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 18:19 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-15 21:53 -0400
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-16 09:18 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-16 12:51 -0400
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-20 11:54 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-20 12:05 -0400
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-22 08:58 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-22 11:58 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-15 19:29 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 18:06 -0700
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 18:38 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 18:44 -0700
Re: What's wrong with "national health care"? "dcaster@krl.org" <dcaster@krl.org> - 2017-05-13 17:35 -0700
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 17:56 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-13 21:00 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 18:11 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-13 21:29 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 18:47 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-13 22:37 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 19:56 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-14 00:08 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-13 21:20 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-14 18:02 -0400
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 18:16 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 18:02 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-14 15:58 +0100
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-14 09:19 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 13:29 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 18:40 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-14 18:04 -0400
Re: What's wrong with "national health care"? George Herold <gherold@teachspin.com> - 2017-05-14 11:12 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 12:23 -0700
Re: What's wrong with "national health care"? George Herold <gherold@teachspin.com> - 2017-05-14 10:55 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-14 13:32 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-13 20:44 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 21:03 -0400
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-13 20:17 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 20:57 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 08:55 +0100
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-14 08:11 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 14:25 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-14 23:54 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-15 09:09 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 18:43 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-18 00:05 +0100
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-13 19:30 -0700
Re: What's wrong with "national health care"? John Robertson <spam@flippers.com> - 2017-05-13 16:32 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 17:00 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-13 16:39 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 17:18 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-13 17:31 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-13 17:36 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-13 20:58 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 21:40 -0400
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 12:58 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 21:35 -0400
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 13:17 -0700
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-15 19:04 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-16 09:27 -0700
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-16 19:49 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 21:27 -0400
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 13:13 -0700
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-15 18:53 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-16 09:16 -0700
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-16 19:43 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 18:52 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-17 18:23 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-19 09:59 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 18:47 -0400
Re: What's wrong with "national health care"? Martin Riddle <martin_ridd@verizon.net> - 2017-05-13 20:06 -0400
Re: What's wrong with "national health care"? mrdarrett@gmail.com - 2017-05-17 12:53 -0700
Re: What's wrong with "national health care"? Clifford Heath <clifford.heath@gmail.com> - 2017-05-14 13:33 +1000
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-13 23:53 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-14 00:11 -0400
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 13:24 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-15 20:39 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-15 19:16 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-16 09:29 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 18:58 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-13 21:04 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-14 00:10 -0400
Re: What's wrong with "national health care"? Clifford Heath <clifford.heath@gmail.com> - 2017-05-14 14:29 +1000
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-14 00:48 -0400
Re: What's wrong with "national health care"? Phil Allison <pallison49@gmail.com> - 2017-05-14 00:13 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-14 18:10 -0400
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-18 09:44 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-18 12:34 -0400
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-18 09:34 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-18 09:03 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-18 12:36 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-18 14:12 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-18 14:36 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-18 17:43 -0400
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-18 18:01 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-18 15:18 -0700
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-18 19:39 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-18 21:26 -0400
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-19 09:22 +0200
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-19 13:37 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-19 17:51 -0400
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-22 11:30 +0200
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-22 12:32 -0400
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-23 10:58 +0200
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-23 17:09 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-23 14:30 -0700
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-24 13:30 +0200
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-24 13:01 -0400
Re: What's wrong with "national health care"? David Brown <david.brown@hesbynett.no> - 2017-05-26 15:43 +0200
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-18 21:13 -0400
Re: What's wrong with "national health care"? Clifford Heath <no.spam@please.net> - 2017-05-19 07:50 +1000
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-18 20:03 -0400
Re: What's wrong with "national health care"? Phil Allison <pallison49@gmail.com> - 2017-05-13 20:39 -0700
Re: What's wrong with "national health care"? Rheilly Phoull <rheilly@bigslong.com> - 2017-05-14 12:19 +0800
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-13 22:08 -0700
Re: What's wrong with "national health care"? Phil Allison <pallison49@gmail.com> - 2017-05-13 22:20 -0700
Re: What's wrong with "national health care"? bitrex <bitrex@de.lete.earthlink.net> - 2017-05-18 18:10 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-18 21:31 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-14 10:28 +0100
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-14 10:53 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-16 12:30 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 19:17 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-19 11:49 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-19 12:56 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-19 18:05 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-20 08:36 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-20 15:58 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-23 10:21 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-23 13:26 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-23 17:41 -0400
Re: What's wrong with "national health care"? Clifford Heath <no.spam@please.net> - 2017-05-24 08:37 +1000
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-24 00:45 -0400
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-23 18:52 -0400
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-15 00:52 -0700
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-15 15:16 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-15 08:08 -0700
Re: What's wrong with "national health care"? tabbypurr@gmail.com - 2017-05-15 13:33 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-19 09:50 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-16 01:32 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-16 08:05 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-17 19:19 -0400
Re: What's wrong with "national health care"? Spehro Pefhany <speffSNIP@interlogDOTyou.knowwhat> - 2017-05-25 08:57 -0400
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-25 11:49 -0400
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-25 18:04 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-25 13:15 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-26 09:15 +0100
Re: What's wrong with "national health care"? Tom Gardner <spamjunk@blueyonder.co.uk> - 2017-05-26 09:28 +0100
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-26 04:40 -0400
Re: What's wrong with "national health care"? dagmargoodboat@yahoo.com - 2017-05-31 06:19 -0700
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-31 18:08 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-25 18:30 -0400
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-25 13:15 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-26 09:54 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-26 12:23 -0700
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-26 13:44 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-26 13:47 -0700
Re: What's wrong with "national health care"? Jasen Betts <jasen@xnet.co.nz> - 2017-06-24 00:18 +0000
Re: What's wrong with "national health care"? Jasen Betts <jasen@xnet.co.nz> - 2017-06-24 00:24 +0000
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-06-24 09:20 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-06-24 12:38 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-06-24 12:11 -0700
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-06-24 13:04 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-06-29 14:20 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-06-29 15:37 -0700
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-06-30 11:05 +0100
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-06-30 08:13 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-06-30 12:26 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-06-30 03:43 -0700
Re: What's wrong with "national health care"? rickman <gnuarm@gmail.com> - 2017-05-26 21:07 -0400
Re: What's wrong with "national health care"? Lasse Langwadt Christensen <langwadt@fonz.dk> - 2017-05-26 18:59 -0700
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-26 22:17 -0400
Re: What's wrong with "national health care"? Martin Brown <'''newspam'''@nezumi.demon.co.uk> - 2017-05-27 09:37 +0100
Re: What's wrong with "national health care"? krw@notreal.com - 2017-05-27 09:30 -0400
Re: What's wrong with "national health care"? bill.sloman@ieee.org - 2017-05-27 18:23 -0700
Re: What's wrong with "national health care"? Spehro Pefhany <speffSNIP@interlogDOTyou.knowwhat> - 2017-05-26 08:47 -0400
Re: What's wrong with "national health care"? Don Y <blockedofcourse@foo.invalid> - 2017-05-26 13:43 -0700
Page 14 of 14 — ← Prev page 1 … 12 13 [14]
| From | krw@notreal.com |
|---|---|
| Date | 2017-05-27 09:30 -0400 |
| Message-ID | <unviicdlurp5eb8s4uf4ib1jqilridsbal@4ax.com> |
| In reply to | #461966 |
On Sat, 27 May 2017 09:37:12 +0100, Martin Brown <'''newspam'''@nezumi.demon.co.uk> wrote: >On 27/05/2017 03:17, krw@notreal.com wrote: >> On Fri, 26 May 2017 18:59:39 -0700 (PDT), Lasse Langwadt Christensen >> <langwadt@fonz.dk> wrote: >> >>> Den lørdag den 27. maj 2017 kl. 03.07.15 UTC+2 skrev rickman: >>>> Lasse Langwadt Christensen wrote on 5/26/2017 4:44 PM: >>>>> Den fredag den 26. maj 2017 kl. 21.22.57 UTC+2 skrev Don Y: >>>>>> On 5/26/2017 1:54 AM, Martin Brown wrote: >>>>>>> On 25/05/2017 21:15, Don Y wrote: >>>>>>>> On 5/25/2017 5:57 AM, Spehro Pefhany wrote: >>>>>>>>> On Sat, 13 May 2017 15:10:31 -0700, the renowned Don Y >>>>>>>>> <blockedofcourse@foo.invalid> wrote: >>>>>>>>> >>>>>>>>>> So, for the folks who live/work in places with "national health care" >>>>>>>>>> (whatever THAT means), what's *wrong* with it? I.e., what would you >>>>>>>>>> wish was different/better? How are your "death panels" implemented? >>>>>>>>>> How is care "rationed"? What have you NOT been given (by way of care) >>>>>>>>>> that you feel you ought to have? >>>>>>>>>> >>>>>>>>>> I.e., if you were starting from scratch to reinvent YOUR system, what >>>>>>>>>> would you change? >>>>>>>>> >>>>>>>>> I think it's pretty good here (Ontario, Canada). Some of the newest, >>>>>>>>> most expensive, and of dubious efficiacy treatments are apparently not >>>>>>>>> covered. >>>>>>>> >>>>>>>> Sovaldi is a pharma treatment for HepC -- something like 90% cure rate >>>>>>>> in a 12 week treatment plan. So, I'd consider that an "effective" >>>>>>>> treatment. Esp in light of the worst-case alternative (liver transplant). >>>>>>>> >>>>>>>> And, at $1000/dose (i.e., $84K/12 weeks), its definitely "expensive" (US). >>>>>>>> How would the Canadian system deal with this? >>>>>>> >>>>>>> I can't comment on the Canadian system, but the UK system has looked at the >>>>>>> cost benefit analysis high price and very high cure rate and set up a special >>>>>>> funding stream to permit its use for Hep C treatment ahead of NICE approval >>>>>>> based on the international evidence already available: >>>>>> >>>>>> Amusing that it magically costs *half* as much -- for the same drug -- there >>>>>> than it does, here! :> >>>>>> >>>>> >>>>> I just google it, and it seems the price for the Danish health system is ~$50K >>>>> >>>>> apparently you can get the same treatment in India for $900 >>>> >>>> Around here the supermarkets in more affluent neighborhoods charge more >>>> too. The company makes less money per item in some neighborhoods as >>>> long as the sales are high to keep the store profits high. If prices >>>> and/or sales fall off enough to reduce profits, the store gets closed. >>>> >>>> What's your point? >>> >>> that things cost what people are willing/capable of paying, I think the >>> company argues that if 50K treatment saves the system from a +150K transplant >>> it is not an unreasonable price. which isn't so far out >> >> You don't consider competition in that equation. > >There is no competition. The makers of Sovaldi have it locked by patents >for a fixed term. Your choice is to pay the price they want to charge >for it or do without (or risk finding dodgy grey imports). For that specific case. I was talking more generally. >>> if you can't get someone to else pay, I guess a vacation in India is the cheap >>> option >> >> Our system is designed (by government) to prevent competition from >> increasing productivity and reducing prices. India (outside federal >> control) is the competition, though it has no effect on domestic >> prices. > >The international Patent system is designed to permit originators of IP >to benefit from their novel inventions for a fixed period of time. Given >the huge investment in developing and testing new drugs and the large >proportion that fall by the wayside there is a perfectly good >justification for new highly effective drugs that solve a serious >problem to carry a price that is a fair proportion of the long term >costs of treating the condition some other way. > >What is entirely unjustified and is rampant in America is for some >jumped up spiv to buy up small pharma companies making well out of >patent drugs and then multiply the price for the single sourced drug by >30-100x overnight (and 750x the original GSK price). > >https://rewire.news/article/2015/09/29/hiv-drug-price-increase-brings-price-gouging-forefront/ > >That is the brutal truth of US corporate greed and immorality. Corporations are amoral. They can neither be moral or immoral.
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| From | bill.sloman@ieee.org |
|---|---|
| Date | 2017-05-27 18:23 -0700 |
| Message-ID | <26416dc7-c013-448c-b443-47c1f88d29d6@googlegroups.com> |
| In reply to | #461982 |
On Saturday, May 27, 2017 at 11:30:43 PM UTC+10, k...@notreal.com wrote: > On Sat, 27 May 2017 09:37:12 +0100, Martin Brown > <'''newspam'''@nezumi.demon.co.uk> wrote: > > >On 27/05/2017 03:17, krw@notreal.com wrote: > >> On Fri, 26 May 2017 18:59:39 -0700 (PDT), Lasse Langwadt Christensen > >> <langwadt@fonz.dk> wrote: > >> > >>> Den lørdag den 27. maj 2017 kl. 03.07.15 UTC+2 skrev rickman: > >>>> Lasse Langwadt Christensen wrote on 5/26/2017 4:44 PM: > >>>>> Den fredag den 26. maj 2017 kl. 21.22.57 UTC+2 skrev Don Y: > >>>>>> On 5/26/2017 1:54 AM, Martin Brown wrote: > >>>>>>> On 25/05/2017 21:15, Don Y wrote: > >>>>>>>> On 5/25/2017 5:57 AM, Spehro Pefhany wrote: > >>>>>>>>> On Sat, 13 May 2017 15:10:31 -0700, the renowned Don Y > >>>>>>>>> <blockedofcourse@foo.invalid> wrote: > >>>>>>>>> > >>>>>>>>>> So, for the folks who live/work in places with "national health care" > >>>>>>>>>> (whatever THAT means), what's *wrong* with it? I.e., what would you > >>>>>>>>>> wish was different/better? How are your "death panels" implemented? > >>>>>>>>>> How is care "rationed"? What have you NOT been given (by way of care) > >>>>>>>>>> that you feel you ought to have? > >>>>>>>>>> > >>>>>>>>>> I.e., if you were starting from scratch to reinvent YOUR system, what > >>>>>>>>>> would you change? > >>>>>>>>> > >>>>>>>>> I think it's pretty good here (Ontario, Canada). Some of the newest, > >>>>>>>>> most expensive, and of dubious efficiacy treatments are apparently not > >>>>>>>>> covered. > >>>>>>>> > >>>>>>>> Sovaldi is a pharma treatment for HepC -- something like 90% cure rate > >>>>>>>> in a 12 week treatment plan. So, I'd consider that an "effective" > >>>>>>>> treatment. Esp in light of the worst-case alternative (liver transplant). > >>>>>>>> > >>>>>>>> And, at $1000/dose (i.e., $84K/12 weeks), its definitely "expensive" (US). > >>>>>>>> How would the Canadian system deal with this? > >>>>>>> > >>>>>>> I can't comment on the Canadian system, but the UK system has looked at the > >>>>>>> cost benefit analysis high price and very high cure rate and set up a special > >>>>>>> funding stream to permit its use for Hep C treatment ahead of NICE approval > >>>>>>> based on the international evidence already available: > >>>>>> > >>>>>> Amusing that it magically costs *half* as much -- for the same drug -- there > >>>>>> than it does, here! :> > >>>>>> > >>>>> > >>>>> I just google it, and it seems the price for the Danish health system is ~$50K > >>>>> > >>>>> apparently you can get the same treatment in India for $900 > >>>> > >>>> Around here the supermarkets in more affluent neighborhoods charge more > >>>> too. The company makes less money per item in some neighborhoods as > >>>> long as the sales are high to keep the store profits high. If prices > >>>> and/or sales fall off enough to reduce profits, the store gets closed. > >>>> > >>>> What's your point? > >>> > >>> that things cost what people are willing/capable of paying, I think the > >>> company argues that if 50K treatment saves the system from a +150K transplant > >>> it is not an unreasonable price. which isn't so far out > >> > >> You don't consider competition in that equation. > > > >There is no competition. The makers of Sovaldi have it locked by patents > >for a fixed term. Your choice is to pay the price they want to charge > >for it or do without (or risk finding dodgy grey imports). > > For that specific case. I was talking more generally. > > >>> if you can't get someone to else pay, I guess a vacation in India is the cheap > >>> option > >> > >> Our system is designed (by government) to prevent competition from > >> increasing productivity and reducing prices. India (outside federal > >> control) is the competition, though it has no effect on domestic > >> prices. > > > >The international Patent system is designed to permit originators of IP > >to benefit from their novel inventions for a fixed period of time. Given > >the huge investment in developing and testing new drugs and the large > >proportion that fall by the wayside there is a perfectly good > >justification for new highly effective drugs that solve a serious > >problem to carry a price that is a fair proportion of the long term > >costs of treating the condition some other way. > > > >What is entirely unjustified and is rampant in America is for some > >jumped up spiv to buy up small pharma companies making well out of > >patent drugs and then multiply the price for the single sourced drug by > >30-100x overnight (and 750x the original GSK price). > > > >https://rewire.news/article/2015/09/29/hiv-drug-price-increase-brings-price-gouging-forefront/ > > > >That is the brutal truth of US corporate greed and immorality. > > Corporations are amoral. They can neither be moral or immoral. Corporations are run by people, who can be either. US corporations have been known to behave badly - Ralph Nader nailed a bunch of US car companies in "Unsafe at Any Speed". https://en.wikipedia.org/wiki/Unsafe_at_Any_Speed Krw is too dim to appreciate this. -- Bill Sloman, Sydney
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| From | Spehro Pefhany <speffSNIP@interlogDOTyou.knowwhat> |
|---|---|
| Date | 2017-05-26 08:47 -0400 |
| Message-ID | <o86gichpg7duju92gdghveeo9ht5jriqft@4ax.com> |
| In reply to | #461719 |
On Thu, 25 May 2017 13:15:11 -0700, the renowned Don Y
<blockedofcourse@foo.invalid> wrote:
>On 5/25/2017 5:57 AM, Spehro Pefhany wrote:
>> On Sat, 13 May 2017 15:10:31 -0700, the renowned Don Y
>> <blockedofcourse@foo.invalid> wrote:
>>
>>> So, for the folks who live/work in places with "national health care"
>>> (whatever THAT means), what's *wrong* with it? I.e., what would you
>>> wish was different/better? How are your "death panels" implemented?
>>> How is care "rationed"? What have you NOT been given (by way of care)
>>> that you feel you ought to have?
>>>
>>> I.e., if you were starting from scratch to reinvent YOUR system, what
>>> would you change?
>>
>> I think it's pretty good here (Ontario, Canada). Some of the newest,
>> most expensive, and of dubious efficiacy treatments are apparently not
>> covered.
>
>Sovaldi is a pharma treatment for HepC -- something like 90% cure rate
>in a 12 week treatment plan. So, I'd consider that an "effective"
>treatment. Esp in light of the worst-case alternative (liver transplant).
>
>And, at $1000/dose (i.e., $84K/12 weeks), its definitely "expensive" (US).
>How would the Canadian system deal with this?
There is an "Exceptional Access Program" that covers a bunch of those
drugs (didn't know about it actually). Sovaldi is covered as of
February 2015. They negotiated a bit lower price with the manufacturer
but it's still quite expensive.
>> Relatives who have needed critical care and emergency care
>> have been treated well.
>
>Emergency is a red herring -- people in desperate need of IMMEDIATE
>care seem to always be able to get it, in any system. There may be some
>issues regarding the number of such people and any externalities that
>are driving those up/down that can be debated.
>
>Most medical care is NOT dispensed in an emergency setting. So,
>that's where the details are more pronounced. How do I *stay* healthy
>in the face of the myriad of threats encountered in day-to-day living.
>
>> It would be nice if there were more GPs- it takes a while to get an
>> appointment sometimes with mine,
>
>If you have to wait a week to get an appointment for a URI, then your
>health is at risk AND, at the very least, you spend a week "uncomfortable"
>relying only on your "natural defenses".
I can go into a walk-in clinic and walk out with a prescription for
something ordinary pretty quickly and it costs nothing (maybe a few
dollars for parking). If I need to get a referral to see a specialist
that's going to take time unless I'm pretty sick- I think some clinics
have some specialists (eg. dermatologist) show up on certain days.
They have your medical history on file from the card so it's not that
necessary to see the same person every time.
There is allegedly some trend, allegedly introduced from the US, to
have a paid consultant to help navigate the system, for example for a
working person with ailing parents who have a lot of contact with the
health care system. I read this anyway- but it might be publicity from
people trying to sell the service.
>[OTOH, for the 25% of visits where the Rx is "do nothing", then you can
>potentially find yourself "cured" before seeing the provider! :< ]
>
>My PCP is moving steadily towards retirement. So, is aggressively
>cutting his working hours. For many of his Pt's, a call for an appointment
>would probably see a week or two wait -- with a referral to the
>nurse-practitioner if need be.
>
>As I've cultivated a relationship with him, his assistant and his office
>staff -- and, as I tend to have THOUGHT about my need for care before
>asking for it -- I can usually get in to see *him* when he is next
>available, instead of incurring that wait.
One of the advantages of the same person is that they *know* you and
how much you are a hypochondriac or bullshitter or whatever. Some
people head to the doctor with a sniffle, others (typically male) are
about on their deathbed before they darken their door. Of course they
can be wrong in their assessment of you as well- the difference
between someone who decides they definitely have a rare form of cancer
via google and someone who researches on the net may not come across
in a 10 minute visit.
>> but they've dealt with long waits at
>> hospital emergency with a lot of walk-in clinics for minor stuff.
>> Waiting times for things like hip replacement are in the months, but
>> you've probably been putting that off for years, so not all that bad.
>>
>> If you show up at emergency with something that isn't killing you at
>> the exact moment on a Saturday night you might spend hours- it would
>> be nice if they could triage some of those idiots I see (like the
>> Russian young guy who busted his arm up doing something stupid -
>> involving alcohol) right out the door to a clinic.
>
>I've visited the ER twice in ~25 years (I can't recall EVER visiting
>one in any other municipality). In each case, I was triaged as "#1".
>In each case, it was a 5 hour visit. Despite the "problems" being
>things that an MD could probably handle in his office (if it had
>been during "office hours").
>
>I.e., the ER is an inefficient way of delivering care. *But*, is a very
>CAPABLE way of delivering it as damn near EVERY sort of tool and technology
>is available, WAITING to be used! (In an MD's office, he'd have sent me off
>to another place for films, etc.)
Dentistry, which isn't covered (by the government, here) at all for
most people, has gotten very good that way- a crown requiring a root
canal is just one visit. They have all the latest equipment on hand.
>> Sometimes they cheap out a bit on things like casts- but you can pay
>> extra and get the spiffy new ones and most working people have some
>> kind of supplimentary insurance like Blue Cross that covers a private
>> room, drugs, dental, etc. that the basic plan every resident gets
>> doesn't cover.
>
>So, there's a difference between the role your "(private) insurance" plays
>and that described by Martin/Tom. I.e., yours is a *supplement* (coinsurance)
>and not an ALTERNATIVE. Like using airline miles to get an *upgrade* on
>a seat instead of paying for the whole seat with those "miles".
>
>> AFAUI, the standards are set federally but it's administered on a
>> provincial basis, and hospitals etc. are privately run so the actual
>> government employees are minimized. I think it would be a mistake to
>> have it run federally.
>
>That's similar to how our insurance and Medicare/Medicaid are delivered.
>Private providers *contract* with the payers (insurers/gummit) to deliver
>the care and then bill the payers. Some self-insured companies may
>contract with an insurer to process their *paperwork* (claims) and
>"bill" the company for the services that its members consumed -- plus
>a fee for the administrative overhead (but, the RISK remains with
>the self-insured company).
>
>The (big) difference, IMO, is that, here, the provider has no idea
>what your "payer" will cover by way of treatments AND what conditions
>there may be ON those treatments (e.g., your provider may need to have
>tried X and Y before he can try Z -- else your payer might not cover
>the payment for Z, even if it solves your problem!).
With dentistry sometimes they have to check with the insurance
company- a 'weak' tooth repair proactive repair might not be covered
for example. With regular medical, if the doctor prescribes it you get
it and there is never a payment IME (of course the doctor might know
some things are not covered...).
>And, as your "payer" may change from visit to visit, this is an
>ongoing administrative effort ("Can I make a photocopy of your CURRENT
>insurance card(s)...?"). The provider's response to you isn't solely
>driven by an assessment/understanding of your symptoms (and personal
>knowledge of you, as an individual) but, also, conditioned by the
>CURRENT terms of his financial relationship with you (assuming he
>wants to minimize the costs that you incur by keeping his treatment
>plan to the guidelines preestablished in your payer's plan).
>
>> Death panels? Not so much though I've seen doctors question whether
>> the quality of life that a severely impaired person has justifies
>> heroic measures to restart their heart etc.
>
>Historically, that is rarely done, here. And, if even "mentioned",
>it is with a very light touch -- the Pt (or his legally appointed agent)
>has control over the care received. I think the provider is only "off
>the hook" (in withholding additional care/procedures) when he has
>made every effort to preserve the Pt's life. E.g., tried repeatedly
>to resuscitate and the Pt simply isn't responding.
This is a very subtle and sensitive thing, as you say. If the *family*
thinks the person is suffering horribly I think they will find some
way to take that into account to some extent, especially with people
that are highly impaired and have not made their desires known
otherwise. How much value to the patient is there in lying in a
semi-vegetative state in a hospital ward for a couple more weeks
before shuffling off this mortal coil?
Of course there are separate hospices for terminally ill patients,
when all that can be done has been done.
>This is indirectly reflected in other ways (depending on locale).
>E.g., I am under no obligation (as a private citizen without medical
>license) to try to resuscitate "you" if you aren't breathing, etc.
>OTOH, if I *start* to do that, then I *assume* the responsibility
>for it -- both in terms of if I injure you in the process AND if
>I prematurely WITHDRAW that treatment!
>
>I.e., you continue providing that treatment until you are relieved
>(by another) *or* "exhausted". You can't just opt to "give up"
>cuz you don't think it is working, etc.
>
>Only fools *don't* have living wills, medical PoA, etc. here.
There's a lot of fools then.
>Otherwise, you leave your treatment to the actions/wishes of
>others when you are incapable of directing them yourself. Even
>then, you risk providers imposing their own "religious beliefs"
>on your care -- despite the legal requirement that they honor
>your directives ("Oh, he didn't give them to us; they were misplaced;
>the nursing staff was unaware that they were on file; they were
>written 10 years earlier so we weren't sure they represented his
>CURRENT thoughts on the matter; etc.")
>
>So, how is *your* care "rationed" (as rationed it must be, lest it
>consume your entire GNP!)
It's only available to residents, and it takes some time to get new
treatments approved, but really I don't get the feeling it's that
heavily 'rationed'. Things that are 'only' annoyances tend to be slow
or difficult to deal with- requiring persistence- so that limits the
costs. As end-of-life approaches, I assume things like a heart
transplant become less likely for everyone under the system.
There is a (politically motivated) initiative to want to expand it to
cover drugs for all (not just the elderly and those in hospital), but
I don't think that's a very good idea personally. Next after that
would be dental I guess. I'd rather they concentrate on eliminating
the worry from major health crises and (especially) cover preventative
and early detection to maximize bang for the buck. For example, they
send me a card in the mail every few years so I can send some
'samples' back in the mail (inside a little foil pouch) for early
detection of colon cancer (probably solely based on my age). Since
they do scads of them it's cheap and much cheaper (not to mention
better) than surgery and a colostomy bag. A colleague gets regular
colonscopies based on her family history, which is more intrusive and
can cause harm in itself, but presumably deemed justified in such
cases.
--sp
--
Best regards,
Spehro Pefhany
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| From | Don Y <blockedofcourse@foo.invalid> |
|---|---|
| Date | 2017-05-26 13:43 -0700 |
| Message-ID | <oga3qv$fms$1@dont-email.me> |
| In reply to | #461794 |
On 5/26/2017 5:47 AM, Spehro Pefhany wrote:
> On Thu, 25 May 2017 13:15:11 -0700, the renowned Don Y
> <blockedofcourse@foo.invalid> wrote:
>
>> On 5/25/2017 5:57 AM, Spehro Pefhany wrote:
>>> On Sat, 13 May 2017 15:10:31 -0700, the renowned Don Y
>>> <blockedofcourse@foo.invalid> wrote:
>>>
>>>> So, for the folks who live/work in places with "national health care"
>>>> (whatever THAT means), what's *wrong* with it? I.e., what would you
>>>> wish was different/better? How are your "death panels" implemented?
>>>> How is care "rationed"? What have you NOT been given (by way of care)
>>>> that you feel you ought to have?
>>>>
>>>> I.e., if you were starting from scratch to reinvent YOUR system, what
>>>> would you change?
>>>
>>> I think it's pretty good here (Ontario, Canada). Some of the newest,
>>> most expensive, and of dubious efficiacy treatments are apparently not
>>> covered.
>>
>> Sovaldi is a pharma treatment for HepC -- something like 90% cure rate
>> in a 12 week treatment plan. So, I'd consider that an "effective"
>> treatment. Esp in light of the worst-case alternative (liver transplant).
>>
>> And, at $1000/dose (i.e., $84K/12 weeks), its definitely "expensive" (US).
>> How would the Canadian system deal with this?
>
> There is an "Exceptional Access Program" that covers a bunch of those
> drugs (didn't know about it actually). Sovaldi is covered as of
> February 2015. They negotiated a bit lower price with the manufacturer
> but it's still quite expensive.
The important fact:
From the payer/patient/provider's point of view, this is a CLEAR WIN!
I.e., you WANT to adopt such treatment plans -- despite their cost -- as
they are COST EFFECTIVE (*if* you assume there is a value to the Pt's life
and quality thereof!)
Imagine a similarly expensive treatment for something more widespread
(e.g., hypertension, diabetes, etc.) to offset other costs that would
likely be incurred by those populations. When do you step back and
start questioning addressing the *root* of the problem, instead of
the symptoms? When do you start giving away hypodermics and condoms
instead of expensive antiretroviral drugs?
Or, do you impose price controls on the vendors? Perhaps, force them
to shift their profit making to other markets?
>>> Relatives who have needed critical care and emergency care
>>> have been treated well.
>>
>> Emergency is a red herring -- people in desperate need of IMMEDIATE
>> care seem to always be able to get it, in any system. There may be some
>> issues regarding the number of such people and any externalities that
>> are driving those up/down that can be debated.
>>
>> Most medical care is NOT dispensed in an emergency setting. So,
>> that's where the details are more pronounced. How do I *stay* healthy
>> in the face of the myriad of threats encountered in day-to-day living.
>>
>>> It would be nice if there were more GPs- it takes a while to get an
>>> appointment sometimes with mine,
>>
>> If you have to wait a week to get an appointment for a URI, then your
>> health is at risk AND, at the very least, you spend a week "uncomfortable"
>> relying only on your "natural defenses".
>
> I can go into a walk-in clinic and walk out with a prescription for
> something ordinary pretty quickly and it costs nothing (maybe a few
> dollars for parking). If I need to get a referral to see a specialist
> that's going to take time unless I'm pretty sick- I think some clinics
> have some specialists (eg. dermatologist) show up on certain days.
> They have your medical history on file from the card so it's not that
> necessary to see the same person every time.
Part of Obamacare was the push to standardize and make electronically
accessible the records of Pts. E.g., if I want to see a different *dentist*
(not addressed by Obamacare), I have to get my previous/current dentist to
FAX the records (often at my cost) to the new one. A dentist still using film
Xrays is at a disadvantage vs. one using digital Xrays, etc.
[I don't think our medical records are in a "national" database whereby
they could be accessed by a GP in another state if I presented, there.
But, I'm sure they could be accessed with far less hassle than they
could have, just a few years earlier. Likewise, I can walk away from
any visit with a LEGIBLE record of my Dx and care just by asking!]
I can walk into an Urgent Care facility to get care without an
appointment. But, it is much more costly than seeing my own PCP.
(OTOH, much LESS costly than the ER!).
> There is allegedly some trend, allegedly introduced from the US, to
> have a paid consultant to help navigate the system, for example for a
> working person with ailing parents who have a lot of contact with the
> health care system. I read this anyway- but it might be publicity from
> people trying to sell the service.
"Middlemen". There are innumerable opportunities for this sort of
"value added" service in all aspects of life. And, as people become
more insular in their connections with those around them, I suspect
a growing need (you haven't ASKED your "friends" about their experiences
with Hospice, Doctor X, Hospital Y, etc.)
>> [OTOH, for the 25% of visits where the Rx is "do nothing", then you can
>> potentially find yourself "cured" before seeing the provider! :< ]
>>
>> My PCP is moving steadily towards retirement. So, is aggressively
>> cutting his working hours. For many of his Pt's, a call for an appointment
>> would probably see a week or two wait -- with a referral to the
>> nurse-practitioner if need be.
>>
>> As I've cultivated a relationship with him, his assistant and his office
>> staff -- and, as I tend to have THOUGHT about my need for care before
>> asking for it -- I can usually get in to see *him* when he is next
>> available, instead of incurring that wait.
>
> One of the advantages of the same person is that they *know* you and
> how much you are a hypochondriac or bullshitter or whatever. Some
Of course! But, there is a *cost* to that "relationship". It means
"you" need/want to see provider X and not "equivalent provider Y".
That affects provider X's scheduling/availability which can manifest
as delays in when you *can* see him/her.
It also depends on the peoples involved and their attitudes towards
that interaction. My PCP spends exhorbitant amounts of time with me
because he enjoys teaching (educating) and finds a "willing student"
in me. I *push* him, intellectually, instead of just settling for
"take two and call me in the morning".
Finding ANOTHER provider who will be willing to engage me in that way
will be a crap shoot (my PCP is ready to retire). How will that "new"
relationship affect my attitude regarding the quality of the care I
then receive? How will the "efficiency" change? (How long will it
take for NewDoctor to realize that the information that I volunteer
is *probably* relevant to the Dx and not just casual anecdotes?)
> people head to the doctor with a sniffle, others (typically male) are
> about on their deathbed before they darken their door. Of course they
> can be wrong in their assessment of you as well- the difference
> between someone who decides they definitely have a rare form of cancer
> via google and someone who researches on the net may not come across
> in a 10 minute visit.
>
>> I.e., the ER is an inefficient way of delivering care. *But*, is a very
>> CAPABLE way of delivering it as damn near EVERY sort of tool and technology
>> is available, WAITING to be used! (In an MD's office, he'd have sent me off
>> to another place for films, etc.)
>
> Dentistry, which isn't covered (by the government, here) at all for
> most people, has gotten very good that way- a crown requiring a root
> canal is just one visit. They have all the latest equipment on hand.
But there isn't a wide variety of equipment needed to practice dentistry.
You don't need a lab, MRI, XRAY, CAT/PET, full surgery, on staff
anesthesiologist, cardiologist, orthopaedic man, etc. AND the staff
to maintain all that kit ("Come back next week; we can't do your FMX
this week cuz our XRAY machine is down")
I broke a bone in my youth. Within hours of presenting at the ER, I was
in surgery.
>>> AFAUI, the standards are set federally but it's administered on a
>>> provincial basis, and hospitals etc. are privately run so the actual
>>> government employees are minimized. I think it would be a mistake to
>>> have it run federally.
>>
>> That's similar to how our insurance and Medicare/Medicaid are delivered.
>> Private providers *contract* with the payers (insurers/gummit) to deliver
>> the care and then bill the payers. Some self-insured companies may
>> contract with an insurer to process their *paperwork* (claims) and
>> "bill" the company for the services that its members consumed -- plus
>> a fee for the administrative overhead (but, the RISK remains with
>> the self-insured company).
>>
>> The (big) difference, IMO, is that, here, the provider has no idea
>> what your "payer" will cover by way of treatments AND what conditions
>> there may be ON those treatments (e.g., your provider may need to have
>> tried X and Y before he can try Z -- else your payer might not cover
>> the payment for Z, even if it solves your problem!).
>
> With dentistry sometimes they have to check with the insurance
> company- a 'weak' tooth repair proactive repair might not be covered
> for example. With regular medical, if the doctor prescribes it you get
> it and there is never a payment IME (of course the doctor might know
> some things are not covered...).
Is the decision to treat SOLELY that of the MD? Or, is he operating under
guidelines imposed by your health care system? I.e., does he ever have to
justify (to the gummit) his decision to aggressively (expensively) treat
the 92 year-old's Ca?
Here, if your policy covers a particular treatment, your age and other
health issues aren't a factor in whether or not your provider will be
reimbursed for your care.
E.g., my neighbor's wife was a "consequence" (victim?) of a medical
screwup. Her doctor suggested (to her husband) that she be allowed
to die as the quality of her life would be "poor" (how does one determine
the quality of someone ELSE's life?). Yet, the husband decided to
let her live. So, monies were spent keeping her alive (10 years?)
despite the fact that she was essentially a lump of flesh (unable to
eat, defecate, sit up, etc.)
>>> Death panels? Not so much though I've seen doctors question whether
>>> the quality of life that a severely impaired person has justifies
>>> heroic measures to restart their heart etc.
>>
>> Historically, that is rarely done, here. And, if even "mentioned",
>> it is with a very light touch -- the Pt (or his legally appointed agent)
>> has control over the care received. I think the provider is only "off
>> the hook" (in withholding additional care/procedures) when he has
>> made every effort to preserve the Pt's life. E.g., tried repeatedly
>> to resuscitate and the Pt simply isn't responding.
>
> This is a very subtle and sensitive thing, as you say. If the *family*
> thinks the person is suffering horribly I think they will find some
> way to take that into account to some extent, especially with people
> that are highly impaired and have not made their desires known
> otherwise. How much value to the patient is there in lying in a
> semi-vegetative state in a hospital ward for a couple more weeks
> before shuffling off this mortal coil?
What if the Pt is competent and just doesn't WANT to "let go"?
My CHF friend KNEW he was circling the drain -- yet, couldn't
bring himself to opt for hospice care and the (expedited?)
exit that it provided. His wife and kids had no say in the matter.
Nor did the hospital at which he would present each time he'd
find himself in respiratory distress.
The hospital staff would tell his wife "don't bring him back".
But, there's no way to ENFORCE this; *if* he reappears, they
will "welcome" him back and go through the same routine, again.
Conversely, my esophageal Ca friend refused the esophagectomy
that could have prolonged his life a bit more (beyond the
2 years that the chemo/radiation had given him). Despite his
family's desire to keep him around a bit longer, there was
nothing THEY could do to force the treatment plan on him.
> Of course there are separate hospices for terminally ill patients,
> when all that can be done has been done.
One has to *elect* to go into Hospice, here. I.e., many folks
will, instead, end up dying in a hospital bed (ER, ICU, regular
room) because they didn't opt for the Hospice option.
Again, the Pt has to essentially (effectively) say, "I know that
I am dying. That it is only a matter of time. And, that I
don't want to delay the inevitable -- by any sort of artificial
means (including resuscitation, etc.). Keep me comfortable
until that time..."
>> I.e., you continue providing that treatment until you are relieved
>> (by another) *or* "exhausted". You can't just opt to "give up"
>> cuz you don't think it is working, etc.
>>
>> Only fools *don't* have living wills, medical PoA, etc. here.
>
> There's a lot of fools then.
And, a certain group of politicians who don't want providers
discussing these options with their patients! (at the same
time, grumbling about how expensive it is to keep these folks
alive -- often on the gummit dole/medicare)
Folks seem terrified of The Inevitable and hope that by
not acknowledging it, it will magically go away! :>
>> Otherwise, you leave your treatment to the actions/wishes of
>> others when you are incapable of directing them yourself. Even
>> then, you risk providers imposing their own "religious beliefs"
>> on your care -- despite the legal requirement that they honor
>> your directives ("Oh, he didn't give them to us; they were misplaced;
>> the nursing staff was unaware that they were on file; they were
>> written 10 years earlier so we weren't sure they represented his
>> CURRENT thoughts on the matter; etc.")
>>
>> So, how is *your* care "rationed" (as rationed it must be, lest it
>> consume your entire GNP!)
>
> It's only available to residents, and it takes some time to get new
> treatments approved, but really I don't get the feeling it's that
> heavily 'rationed'. Things that are 'only' annoyances tend to be slow
> or difficult to deal with- requiring persistence- so that limits the
> costs. As end-of-life approaches, I assume things like a heart
> transplant become less likely for everyone under the system.
SWMBO's mom was offered a kidney transplant. Then, dialysis (since
she refused the transplant). Despite the fact that she was well
into her 90's.
How much "life" are you entitled to? And at what (who's!) expense?
I haven't met anyone who disliked the CARE they received under Obamacare.
Their complaints were related to the *costs* and the idea that it was
"mandated" (I suspect that if you allowed them to opt out FOR LIFE
they'd be reluctant to exercise *that* option! :> )
Trumpcare -- which is what we have as of 1/20/2017 -- will leave folks
complaining about their cost *and* care. Something the Republicans
are only starting to realize...
> There is a (politically motivated) initiative to want to expand it to
> cover drugs for all (not just the elderly and those in hospital), but
> I don't think that's a very good idea personally. Next after that
> would be dental I guess. I'd rather they concentrate on eliminating
> the worry from major health crises and (especially) cover preventative
> and early detection to maximize bang for the buck. For example, they
Yet another issue that Obamacare attempted to address -- pushing for
coverage for *preventive* care. Of course, folks not needing those
tests (really??? how do you know that you *don't* need them?)
complain because their premiums have increased -- to cover the
tests administered to "others".
There is apparently an elevated risk of folks in my age group
to have "silent" hepatitis so the CDC recommended a one-time
test for everyone in that age group (no other risk factors).
I wonder how many *actually* got tested? For those who
didn't get tested, what cost will The Healthcare System incur
for their care when they become symptomatic?
How many folks actually KNOW they are "clinically obese"?
Vs. how many who just think they've "put on a few pounds"?
<grin>
> send me a card in the mail every few years so I can send some
> 'samples' back in the mail (inside a little foil pouch) for early
> detection of colon cancer (probably solely based on my age). Since
Test for occult blood. You can buy these OTC as well as have
a doctor "prescribe" the test for you.
> they do scads of them it's cheap and much cheaper (not to mention
> better) than surgery and a colostomy bag. A colleague gets regular
> colonscopies based on her family history, which is more intrusive and
> can cause harm in itself, but presumably deemed justified in such
> cases.
Colonoscopy is recommended, here, at 50. And, every 10 years thereafter
if "clean"; 5, otherwise. After 76, "routine" screenings are contraindicated
unless the Pt has a predisposition to colorectal Ca. After 85, nothing.
Of course, if you are 86 and want to "pay cash" and can find someone
willing to assume the *risk* of performing it, you won't be turned away!
Another aspect of Obamacare was to move towards *science* based medicine.
I.e., proving/quantifying the benefits of particular treatment strategies
instead of "winging it". And, trying to mandate coverage for things "known"
to yield positive results instead of covering more dubious procedures
(a friend with MS had all the Hg fillings removed from his mouth in the hope
that *that* was a contributing factor to his illness)
IMO, you can take two approaches to healthcare:
- whatever YOU can afford given your PERSONAL resources
- whatever SOCIETY can afford, given some constraints placed on the resources
it wants to dedicate to that
We seem to have no problem throwing a few trillion dollars away in
ammunition...
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