Thread: Universal care cheaper and better than private insurance.

Originally Posted by gunnut

Incorrect. Shek used the hotdog analogy to explain the diminishing returns principle. This principle applies to everything in everyday life regarding human desires.

You are using a sob story with an unnamed person who may or may not exist, disregarding all statistics, to elicit an emotional response. Anecdotal stories are not analogies.

Please click on the link at eh end of my post. he no longer exists. plenty of blame for it

Originally Posted by ba1025

Please click on the link at eh end of my post. he no longer exists. plenty of blame for it

Most of it lays with the mother. Notice that when she finally took him to a hospital, care wasn't withheld. They were not kicked out. He was given 2 operations and rehab that the hospitals surely knew they would never see money for.

Seems the system worked, the parent failed.

Alyce Driver did not know Deamonte had an abscessed tooth when she took him to the hospital for a headache in January. The infection from the tooth spread to his brain, requiring two operations at Children's Hospital and weeks of rehabilitation in another hospital.

How the hell do you not know about something this bad? And her younger son had 6 abscessed teeth. Disgusting example of a parent. I feel sorry for the kid.

Originally Posted by Shek

I take it that this is a figure of speech?

It is. Loosely used, it means any kind of carpentry, but nail pounders around here means framers. In my case, I was checking on a job and I usually help out a bit when I'm there.

I bought a finish nailer when I was putting some crown in my house a few years back, and after finishing, I wondered how you could have done it before the day and age of the air compressor

[/QUOTE]

Even now we sometimes don't use an air nailer. Some wood has alternating wood grain-hard, soft, hard, and they tend to deflect nails. So we drill a hole just big enough to slip the finish nail thru. If you want to skip the drilling, you can blunt the point of the nail so it won't split the wood when you drive it. That's for softwoods. We always drill hardwoods like oak and maple. More than you wanted to know...

[QUOTE=Shek;487037]I just haven't figured out what I want to do when I grow up

lol...that fits me to a tee. I'll never get rich--not that I wouldn't like to be--because I always went after jobs that interested me. Cowboy, chemical refinery worker, TV writer, advanceman...I was all over the place.

In seriousness, because of the experience that one gets in the military as an officer*, it is actually a pathway to getting rich if one so desires, although I'd agree that very few people join with this particular path being the main motivator, but it is in the back of not an insignificant amount of minds, I believe.

At the Pentagon I saw an AF Lt.Col. go from horse holder to Assistant Secretary of Defense and then to VP at McDonald-Douglas. He was sharp. You're probably right about NCOs, although I saw a retired AF master sgt make it to Deputy Assistant Secretary of Defense (Public Affairs). He went on to a top contractor. When I was there I saw a lot of revolving door. I think the attraction for defense contractors is having someone who knows where the bodies are and how the system works. And contrary to popular belief most ex-military who go to the contracting side don't bring in much business, but they do dress up the place.

Medical school is typically not a stepping stone to another profession, but an end in and of itself. So, I wouldn't take the analogy too far.

Well, the analogy had to do with aspirations of service as opposed to fixation on riches. I'll end it there.

I think that senior NCOs get shorted because they often don't have the sheepskin hanging on the wall. Many have the same or better skills than their officer peers at the company and field grade levels, but corporate American often doesn't see it this way, and so they don't get the lateral opportunities that officers do - the other factor is that a 30 year old captain has a lot more time to be productive for a company than a 40 year old first sergeant.

True. They're more likely to stay retired or, if they have any milage left in them, join law enforcement.

Originally Posted by Gun Grape

Funny little tool. Some of the better are made by Estwing. Come in various sizes from 16 - 28 oz. Called a hammer.

Everything over 20 oz is usually a framing hammer, AKA, waffle maker. Ive seen guys who could drive a 12d sinker in one swing and a 16d in 2. Up here they use 12d for framing and call 16ds hero nails--you gotta be a hero to want to use them. Don't ask me why. But I am with you; nothing like a nail gun for all day framing. For those little jobs we use a gas Paslode guns or the good old pouch and hammer.

Originally Posted by JAD_333

Everything over 20 oz is usually a framing hammer, AKA, waffle maker. Ive seen guys who could drive a 12d sinker in one swing and a 16d in 2. Up here they use 12d for framing and call 16ds hero nails--you gotta be a hero to want to use them. Don't ask me why. But I am with you; nothing like a nail gun for all day framing. For those little jobs we use a gas Paslode guns or the good old pouch and hammer.

Here we determine "framing hammer" by the shaft length. And just about everyone around here carries a 22oz ripping hammer on their belt.

Did know a guy that could swing a 28oz hammer all day long and not break a sweat.

You pre-drill all your hardwood?

True. They're more likely to stay retired or, if they have any milage left in them, join law enforcement.

Until the wife makes us get a job. But your right about retired enlisted guys becoming cops.

That Blue ID card does keep one from getting tickets

The key for us enlisted types is the duty station and billet that we are holding when we retire. When I was instructing at Ft Sill the job offers were pouring in from various defense contractors. Same when I was at Nuc Ord Platoon. But once you are back in the "Fleet" its hard to convince a recruiter from IBM that as a career counselor you recruit and ensure the command is following all fed laws concerning civilian and military employees, equal opportunity, ect for a 850 person unit even though you don't have a degree in Human Resources

But I'd much rather work for myself

Originally Posted by Gun Grape

Here we determine "framing hammer" by the shaft length. And just about everyone around here carries a 22oz ripping hammer on their belt.

shaft length and the claw direction...lol...this is real technical stuff...I frame with a 20oz smooth head when I frame, and find a rubber handle more comfortable over the long run...

You pre-drill all your hardwood?

Depends. Oak or maple crown on kitchen cabs and anything beaded where you have to tack the bead to a jamb, yes; that is, when hand driving. Poplar, which I use a lot because it hold paint so well, I might not. It doesn't split usually, but I still blunt the nail point first.

Until the wife makes us get a job.

They seem to have a thing about security.

The key for us enlisted types is the duty station and billet that we are holding when we retire. When I was instructing at Ft Sill the job offers were pouring in from various defense contractors. Same when I was at Nuc Ord Platoon. But once you are back in the "Fleet" its hard to convince a recruiter from IBM that as a career counselor you recruit and ensure the command is following all fed laws concerning civilian and military employees, equal opportunity, ect for a 850 person unit even though you don't have a degree in Human Resources

Maybe the problem is that too few recruiters have a military background and consequently aren't able to evaluate how military retirees would fit in. I'd expect defense contractors are more tuned in.

But I'd much rather work for myself

ditto.

The High Price of A Medical Miracle

The High Price of A Medical Miracle
If Health-Care Costs Are Trimmed, Who Will Be Deprived of Treatment?

By Darshak Sanghavi
Special to The Washington Post
Tuesday, May 27, 2008; HE06

A few weeks ago in central Massachusetts, a previously healthy 15-year-old named Alex Hall awoke in the middle of the night because his chest hurt. Initially Alex thought the feeling would pass, but when it continued, his worried parents drove him to a local emergency room. There a blood test suggested that -- incredibly -- he was having a heart attack. An ambulance quickly took Alex to a tertiary care center staffed by pediatric specialists, and as the on-call pediatric cardiologist, I was paged to help out.

Alex's heart probably had been attacked by a virus, making him the latest victim of a small but worrisome epidemic in the area. Over the next two hours, the inflammation spread like wildfire through his heart, and the orderly spikes on Alex's cardiac monitor soon became disorderly seismic waves. "I'm scared," he whispered, looking at the monitor. Soon after, his lungs began filling with fluid and he started gasping for air.

Critically ill with a rare condition, Alex needed the kind of specialized but pricey care that is frequently blamed for busting health-care budgets.

The same week Alex came to the hospital, a team of researchers led by John E. Wennberg at Dartmouth Medical School reported massive state-by-state variations in Medicare spending, with New York and New Jersey spending almost 50 percent more per person than North Dakota and Iowa without, on average, having people live longer as a result. A lot of the discrepancy was chalked up to more intensive inpatient care in high-cost states. Wennberg argues that because health care is paid for in a piecemeal fashion (the more doctors do to people, the more they earn), states with lots of specialists and hospital beds are rewarded for overusing them. Health care, he concludes, is perversely "supply-sensitive."

To some, the Dartmouth data encourage the notion that if the supply of specialists and hospital beds were suddenly cut, doctors might reserve fancy care for patients who really needed it, and thus costs would fall. But as Alex's case suggests, these cost controls will require hard choices -- and, inevitably, haphazard rationing of health care.

As the boy's heart continued to fail, our team realized that the only hope for survival was a machine that would bypass his heart and lungs entirely and deliver oxygen to Alex's brain and body. Called extra-corporeal membrane oxygenation, or ECMO, this technology required further escalation: We'd have to send him to another specialized center, at Children's Hospital in Boston.

The resources mobilized to save Alex were staggering. A specialized, fully staffed intensive-care truck from Boston arrived to transport him to the ECMO center, where a team of cardiac experts worked to surgically connect Alex to the device. For eight days, Alex lay connected to the artificial heart and lungs under general anesthesia to buy time for his real organs to recover.

ECMO is very expensive, available only in certain centers and not standard therapy, making it just the kind of care that causes geographic disparity in medical costs. But as reported last year in the journal Circulation, ECMO has been used worldwide in about 700 cases in which even the most advanced resuscitation had failed because of a child's severe heart failure, infection or lung disease. The lead author (who, incidentally, helped care for Alex) wrote that ECMO "rescued one-third of patients in whom death was otherwise certain." In short, the treatment snatched hundreds of children like Alex back from the dead. But no one could tell ahead of time exactly which ones would live.

Critics of American health care sometimes point out that high-cost regions have higher mortality rates and conclude that too much medicine is harmful. But that's like noting that obese people are on diets and deciding that low-calorie foods cause fatness. Centers that offer ECMO, for example, will have the highest costs and highest mortality since they attract the desperately ill. And while life expectancy in the United States supposedly places 42nd among developed countries, it's hard to imagine how a boy like Alex could have survived in such places as Guam or Jordan, which rank ahead.

Of course, America lags behind many countries in providing a basic level of service for all citizens, since we lack universal health care. But for many, the system offers almost unlimited resources, which are often taken for granted. (In the March/April issue of Health Affairs, a former editor at the British Medical Journal whose daughter failed to get proper care in England writes how American health care "can replace a sense of resignation and futility with action and hope.")

Still, the estimated $2 trillion that Americans spend on health can't continue to grow. Indeed, health-care costs may need to come down. But these cuts will never be painless, since they can almost never be targeted only at useless expenditures. We've known this since the 1970s, when the Rand health insurance experiment found that patients cut back equally on both superfluous and necessary visits when asked for small co-payments.

It's unclear whether doctors given limited resources would be any better at rationing care. For now, they can't always tell when ECMO is necessary or futile. The same is true for many other expensive therapies, such as new cancer drugs, organ transplants and innovative psychiatric care. That's why cuts will always be somewhat arbitrary, no matter who's making the decisions: In the end, some people won't get the treatment that may save them.

Alex survived and continues to recover. Because of a minor paperwork error, however, his name remained on a heart transplant wait list, and a transplant coordinator called his home to check on him. You can take him off the list, his dad told the coordinator: Alex was one of the lucky ones.

Darshak Sanghavi is an assistant professor of pediatrics at the University of Massachusetts Medical School and the author of "A Map of the Child: A Pediatrician's Tour of the Body."

The resources mobilized to save Alex were staggering. A specialized, fully staffed intensive-care truck from Boston arrived to transport him to the ECMO center, where a team of cardiac experts worked to surgically connect Alex to the device. For eight days, Alex lay connected to the artificial heart and lungs under general anesthesia to buy time for his real organs to recover.

I'm sure Michael Moore can find this level of care in Cuba for all Cuban citizens.

But you can find them here. There have been several post here describing the German model. I would like to know what you dislike (if this is the case) about it.