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With great thanks to Matt Stoller for tweaking my brain and giving me many of the insights in this diary, most especially, Murder by Spreadsheet.

Matt also gave me an elegant way to frame the health policy debate going forward.

He said, "The simplist story in American politics is to ask, whose fault is it?"

"Once you've done that", Matt continued, "you find the bad people, then you name them.

Stoller was emphatic, "Eve, people will organize around a villan. You really want to know what they're doing? I call it murder by spreadsheet."

A red light went off in my brain.

And apologies, in advance for the length of this diary, but we're dealing with something like a a $ 2 trillion dollar a year industry which represents around 16% of GDP!

We know the villan.

It is a murderous villan, and its weapon is a spreadsheet. It is also a highly successful business model since depending on its medical-loss ratio it diverts approximately 15% of its revenues into administrative costs and profits!

And the murderous for-profit insurance industry is the darling of Wall Street primarily because of their consistently favorable medical loss ratios. That’s Wall Street speak for improving profits by reducing payments for health care services. With lower medical loss ratios, investors gain while patients and doctors lose.

This is Murder by Spreadsheet.

We now have psychic permission to call this depraved and mafia-like/Mafia-lite industry exactly what it is--murderous.

Aided and abbeted every step of the way in its murderous dealings by an army of enablers-- the media, the political class, lobbyists like AHIP, financial institutions, staggering amounts of money,  think tanks, and huge volumes of misinformation fed to an essentially uninformed, though increasingly restive public.

Listen to the voice of the victim.  This morning I woke up to an email from a Kossack asking for help.  I receive lots of these heartbreaking emails.  He directed me to a diary he had posted (which I missed) about the health care tragedy of his friend.

Recently a friend of a friend found out that she is in dire need of medical help. Thanks to the bureacracy of healthcare in the United States, she is now one of millions facing impossible choices about her health -- choices that essentially amount to "give up now or give up in six months."

. .In case you were wondering, you can't get private health insurance when you have a heart transplant looming in your near future.  She will deny wanting one, but I want the option open to her, so I will just ignore that issue altogether. Regardless of her internal battle, a trip to a specialized cardiologist is expensive. More expensive, I am willing to bet, than "cash to meet basic needs for food, clothing, and shelter" can provide. Seeing as how I was unwilling to pay for a doctor to look at a potentially broken finger, I can only imagine what it costs to monitor your heart uninsured (I was given the rough dollar amount of $2, 500 per visit and that is when there is nothing wrong.)

My friend was given 6 months to a year to live.

http://www.dailykos.com/...

Now read what The Manhattan Institute a member of the Murder by Spreadsheet Mafia has to say.

The Manhattan Institute is one of the most evil institutions  operating in America today. It is a spewer of right wing talking points. It is also a highly regarded extremist right wing think tank. The more highly regarded, the more dangerous such an institution becomes, because the MSM is easily seduced and conned by a veneer of respectability.

The Manhattan Institute has already begun to co-opt the idea of murder by spreadsheet. But in their demented world of misinformation and outright lies, they have concocted an argument to support a discredited thesis. If Medicare is required to negotiate drug prices, the pharmaceutical industry will be forced to curtail lifesaving R&D, and this will result in death and misery.

They package their deceit under the rubric:

The Human Cost of Federal Price Negotiations:
The Medicare Prescription Drug Benefit and Pharmaceutical Innovation

In the short run, federal price negotiations would allow some consumers to receive medicines at lower prices, or, alternatively, would yield savings for federal taxpayers. The longer-term human costs of government price-negotiation, however, are likely to be large and adverse. This paper estimates that investment in new drug research and development would decline by approximately $10 billion per year. It estimates as well the effect of reduced pharmaceutical R & D investment on American life expectancies, or expected "life-years". Specifically, this work projects that federal price negotiations would yield a loss of 5 million expected life-years annually, an adverse effect that can be valued conservatively at about $500 billion per year, an amount far in excess of total annual U.S. spending on pharmaceuticals.

. . .That the reduced flow of new medicines, summarized above in Table 6, clearly will not be trivial underscores the stakes for individuals suffering from such specific conditions as cancer, diabetes, or Alzheimer’s disease.

http://www.manhattan-institute.org/...

And more bullshit on the same subject courtesy of  a collaboration between NRO and the Manhattan Institute.

Federal price negotiations will cause sharp price reductions, but this will yield less research and development investment in new and improved medicines over time. Recent economic analysis published by the Manhattan Institute yields projections that the effect would be a reduction of about ten new drugs per year on average, causing a loss of about five million life-years each year, valued conservatively at $500 billion annually, a sum far in excess of total U.S. spending on pharmaceuticals.
http://article.nationalreview.com/...

All of this is simply not true. It's a lie.

Now take a look at how the MSM abets murder by spreadsheet by portraying in the most negative light imaginable the actually very feeble attempts by the Democrats to make prescription drugs just a bit more affordable.  This headline is from Business Week. Notice the headline and the use of the verb, to force.

House Set to Vote on Forcing Medicare to Negotiate Drug Prices

http://www.bloomberg.com/...

And this headline from Forbes.  

When they refer to something as the Democrat Plan (it should be the DemocratIC Plan), this is called dog whistle politics. They're "reporting" the news but using the language of the fundies, which other fundies will recognize. Used in this context the word "Democrat" is a perjorative.

CBO Faults Democrat Drug Plan

http://www.forbes.com/...

And more on the human consequences of Murder by Spreadsheet.

One such medicine is Gleevec, sold by Swiss drugmaker Novartis, which is designed for leukemia sufferers with a genetic disposition to overproduce white blood cells. Another is Herceptin, a highly successful anti-cancer treatment made by Genentech of South San Francisco. It is aimed at breast-cancer patients who share a genetic inclination to overproduce the so-called HER-2 protein, which can trigger tumorous growths.

Yet Gleevec costs a typical patient at least $2,200 a month and Herceptin $3,195. A sudden flood of such expensive medicines might not sit well with insurers, some experts warn.

If insurers won't pay for genetically customized drugs, consumers might have to bear the cost themselves, experts predict. Some say that could lead to growing health care inequities between the rich and poor. Others fear it could subject consumers to a marketing blitz from firms misrepresenting personalized medicines.

http://www.mercurynews.com/...

And speaking of Murder by Spreadsheet, how do you think Wall Street reacted to what amounted to a giveaway to the for-profit insurance industry by the Republican governor of California?  Not well, not well at all because the Schwarzenegger plan actually makes insurers pay for health care. That's bad for profits, bad for Wall Street and bad for the for-profit insurance industry.

The shares of WellPoint Inc. , the biggest U.S. health insurer by membership, slumped nearly 3 percent Tuesday on worries a proposal by California's governor to boost health insurance coverage could eat into industry margins.

The most troublesome aspect of the plan for health insurers, previewed Monday by California Gov. Arnold Schwarzenegger, a Republican, is a proposal to require those companies to spend at least 85 percent of every dollar in premiums on medical care, analysts said.

http://www.msnbc.msn.com/...

Imagine that. An insurance company actually being required  to pay for health care.

WellPoint, which provides insurance for 34 million Americans, is the most at risk because it currently spends the least on medical care out of the premium dollar in the state.

"If approved, (the California plan) would imply reductions in profitability for some, and for all, signal a step toward regulating health insurer profitability," John Rex, an analyst at Bear Stearns, wrote in an investor note, echoing other analyst comments.

. . .Schwarzenegger's plan requires health plans to meet at least an 85 percent medical loss ratio -- an industry gauge of how much of the premium dollar is spent on clinical care.

Wall Street applauds insurers with the lowest medical loss ratio, because it leaves greater room for profit.

WellPoint's average medical loss ratio has recently been less than 80 percent in California, according to analysts.

"If implemented, the proposal would appear to create some problems for WellPoint," CIBC Markets analyst Carl McDonald said.

Problems? Indeed. Murder by spreadsheet is legal in the United States of America.
And the human toll of murder by spreadsheet is enormous.

These merchants of death prey on all of us. Think for a moment of the 1.4 million people in the U.S. who will be diagnosed with cancer, and 565,000 people who will die from the disease. When for-profit insurance companies deny cancer patients lifesaving medication, that is murder by spreadsheet.

When corporate America is deprived of their greatest resource-their people-cancer cost corporate America more than $118 billion in lost productivity in 2005 and resulted in medical costs five times higher than those for employees without cancer, this too is murder by spreadsheet.

There's plenty arrayed against us. But we have the truth which sooner rather than later, the American people will  first begin to understand, then embrace, and ultimately, internalize.

The American people are subjected to an inefficient, fragmented, outrageously expensive and corrupt system. In contrast, Medicare controls fees with virtually no additional administrative costs over the very nominal costs to run the system. A universal, or Medicare for All program would insure that costs would be contained and that fees would be equitable while also insuring administrative efficiency.

Why do our public officials continue to commit health policy murder by insisting that private bureaucratic parasites, the for-profit insurance industry  be included in the health care equation?

But the equally significant question remains, why do the American people tolerate this?

Now return to Matt's original question, whose fault is it?

I can certainly pinpoint the villan(s).

Originally posted to nyceve on Wed Jan 17, 2007 at 05:49 AM PST.

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Comment Preferences

  •  The next time you read or hear about . . . (138+ / 0-)
    Recommended by:
    Canadian Reader, trifecta, Athena, Sean Robertson, eugene, SarahLee, Nina Katarina, TrueBlueMajority, sen bob, Xan, tamens, freelunch, varro, object16, musicsleuth, exNYinTX, bostonjay, opinionated, bronte17, Mary Julia, megs, MD patriot, CoolOnion, highacidity, SCFrog, roses, JuliaAnn, javelina, ornerydad, Jesterfox, bewert, arkdem, antirove, celticshel, BurnetO, TexDem, Winnie, Neighbor2, hazzcon, LeftyLimblog, lcrp, Rxtr2, Noisy Democrat, airshipjones, TexH, Gowrie Gal, tovan, Pokerdad, 3goldens, el dorado gal, Omphaloskepsis, PBen, Cake or Death, Brooke In Seattle, volballplr, wildcat6, Turkana, reflectionsv37, Sharon in MD, GreyHawk, ladybug53, blue jersey mom, Joy Busey, SheriffBart, illyia, wiscmass, sodalis, sbdenmon, Rogneid, Spathiphyllum, Erevann, danger durden, mariva, taracar, Appalachian Annie, esquimaux, keefer55, vigilant meerkat, stonemason, VolvoDrivingLiberal, Ellicatt, Gorette, deha, Luminous Animal, dewey of the desert, Gasonfires, kck, Silent Lurker, jguzman17, HairyTrueMan, A Siegel, Lashe, slothlax, OneCrankyDom, paul2port, justalittlebitcrazy, bleeding heart, totallynext, Turbonerd, ilyana, buckeye blue, va dare, means are the ends, RantNRaven, Dreaming of Better Days, Downtowner, matx, vernonlee, Temmoku, slksfca, PatriciaVa, AmericanRiverCanyon, bigchin, One Pissed Off Liberal, Cronesense, Russ Jarmusch, possum, kmiddle, moodyinsavannah, CT Treehugger, dallasdave, FishOutofWater, Mary Mike, DWG, drchelo, todd in salt lake, malharden, 7November, stratocasterman, sabishi, cyncynical, Dar Nirron, Snakes on a White House, Hens Teeth, gizmo59, Lady Kestrel, TheFatLadySings, mamamedusa

    someone being denied healthcare because they aren't insured, or don't have the funds to pay, or whatever, just remind yourself that this is murder by spreadsheet.  

    And that in the United States, murder by spreadsheet is legal.

  •  Almost sounds like a Agatha Christie book (11+ / 0-)

    but with terror added.  (Those books always seemed like prim and proper affairs, LOL.)

    These greedy bastards have left us such that it is every man/woman for themselves.

    Thanks for continuing your series of diaries on healthcare.

  •  Having insurance is no help. . . (22+ / 0-)

    My firend's wife was diagnosed with phelbitis, a painful condition of the lower leg. She is a Nurse's Aide, and is on her feet all day.

    Her MD told her she needs an operation to repai a vein in her leg. Her insurance company denied the procedure, claiming it was cosmetic surgery. She is now wearing a compression bandage every day. I asked her how long she will have to wear it.  Her reply: "Until I die."

    That is "Murder by Spreadshet." She is now age 57.

    Iraq is Arabic for Viet Nam.

    by sen bob on Wed Jan 17, 2007 at 06:04:26 AM PST

    •  sen bob, this is absolutely correct . . . (16+ / 0-)

      Having insurance is frequently almost worthless, since the business/game plan is to deny coverage, delay payment so the insured person will just go away, give up and [hopefully for the insurance company] just die.

    •  What does the Insurance Company recommend? (7+ / 0-)

      Phlebitis is a serious condition, but I wasn't aware that surgery was the preferred or recommended treatment. It seems to me that another medical opinion would be very helpful for this woman.

      I still have no idea how the insurance company came up with the idea that this was cosmetic surgery -- they appear to have hired a total fool who cannot tell the difference between varicose veins and phlebitis.

      Democrats: Giving you a government that works.

      by freelunch on Wed Jan 17, 2007 at 07:00:17 AM PST

      [ Parent ]

      •  Total Fools Are The Hallmark of Customer Service (18+ / 0-)

        Of course no doctor or medical person made the decision that this was cosmetic surgery.  

        Denying surgery that will allow a person to keep functioning is a high level version of it, but 95% of our interactions with the corporations that strangle are lives are now done through total fools.  They may be really nice people, good to their kids, never kick the dog - but they are deliberately undereducated and they stick to the script.  

        You can't even have a decent argument with a customer service person anymore; they can't follow it.  Go ahead, call your bank and argue about being charged an overdraft fee, not for overdrawing your checking account, but becuase your balance dropped to $1 and you could have bounced some other check.  

        These days, business relies heavily on the old saw that it is easier to steal $1 from a million people than a million dollars from one person.  The best way to keep that going is to make sure that whoever the public gets on the phone isn't remotely capable of solving your problem.  

        •  yes, yes, yes! (6+ / 0-)

          These days, business relies heavily on the old saw that it is easier to steal $1 from a million people than a million dollars from one person.  The best way to keep that going is to make sure that whoever the public gets on the phone isn't remotely capable of solving your problem.

        •  WOW! Total fools are the PLAN! (4+ / 0-)

          You get it! My friend is trying all the routes to get her surgery approved. She was told by an advocate in the state insurance commissioner's ofice to have the surgery and then sue for the cost.

          The cost? About $15,000 which she does not have. She is worried that she may throw a blod clot, and die.

          Iraq is Arabic for Viet Nam.

          by sen bob on Wed Jan 17, 2007 at 08:40:38 AM PST

          [ Parent ]

        •  Banks have better service than health insurance (1+ / 0-)
          Recommended by:
          mariva

          Companies, in my experience. Often, denials of service are determined by computers, not individuals. Policies are made that certain combinations of diagnoses and treatments will not be covered. What you say about customer service is true, but you omitted the part that  the customer service agent is irrelevant.  they are just a buffer to keep you from talking from the people who make the decisions that are programmed into the computers.

          On the other hand, banks actually respond to complaints, in my experience.  I have recently had a manager take over and fix a problem that the customer service agent wasn't able to handle. I have never had that happen with insurance companies, and I did medical claims billing.

          "It's the planet, stupid."

          by FishOutofWater on Wed Jan 17, 2007 at 11:55:33 AM PST

          [ Parent ]

    •  No kidding,only $8 a month difference for me... (0+ / 0-)

       The cost of health insurance is enough to make a person ill and when they need it,it DOESN'T help. Last month I found out that my insurance was only saving me $8 a month on my insulin. Last year my landlords insisted on taking me to the ER and paid the entire bill,prescriptions included. The total cost was a little over $5,000 which is why I didn't want to go in the first place. I couldn't deal with putting my family that much further in debt but as a result I could have lost my life. It turns out that I had bronchial pneumonia on top of being diabetic and asthmatic. The ER doctor thanked my landlord and went on to say "sir,you saved this womans life." My husband works his butt off,pays out the rear for health insurance and this is what we get for it?! The whole health care system goes well beyond inexcusable!  

      •  Jeez, that's horrible. (0+ / 0-)

        It occurred to me that if Eve decides to write such a book, she should include many stories like these.

        Of course, Michael Moore is already in the process of documenting such stories in his upcoming film, Sicko -- which I'm greatly looking forward to.

        Mariva's Guide: A magablog of fun, useful, interesting stuff.

        by mariva on Wed Jan 17, 2007 at 12:38:59 PM PST

        [ Parent ]

        •  She should write a book... (1+ / 0-)
          Recommended by:
          mariva

           It would be even better if these a**holes in Washington were forced to read it. My story is bad enough but I've heard worse. Eve should[or someone]write a book,the truth needs to be told and the truth is,our President is a miserable failure. He has failed us in every way possible,it has got to stop somewhere and it's up to us to see that it does.

  •  There are other evil spreadsheets. (14+ / 0-)

    These spreadsheets show how denying certain medications (such as Protonix) and recommending a cheaper, less effective drug (such as generic Zantac) save the insurance company money.  Never mind the impact it has on the insured, who can either suffer or find a way to come up with the money for the more expensive drugs.  The evil isn't just limited to the pharmaceutical companies.

    •  HairyTrue, I hope I didn't imply . . . (8+ / 0-)

      that Murder by Spreadsheet is confined to the pharmaceutical industry--it isn't!

      Actually, MBS is spread among various players--and what I called enablers, as I tried to point out.

    •  Pardon my ignorance re Protonix (3+ / 0-)

      My experience of Zantac is in connection with duodenal ulcers although I am aware that it is used in to treat acid stomach conditions in pregant women. Looking at the Protonix web site, it looks like it is being marketed for treating acid conditions.

      For the most part these can be avoided by proper diet, especially in the evening. These are also indicators of the early effects of helicobacter pylori, ie a pre-ulcer condition. Since this can be treated with a three week course of anti-biotics combined with Zantac to reduce acid production, why is a test for this not being suggested along with a diet change. That would eliminate the need for continued medication and medical consulations, which I suppose answers my own question.

      Kneejerk reactions do not come from knees.

      by londonbear on Wed Jan 17, 2007 at 08:11:04 AM PST

      [ Parent ]

      •  All I know is that Protonix works for me. (0+ / 0-)

        I'll ask my doctor about helicobacter pylori and the use of antibiotics.  Thanks for the information.

        •  And there are studies upon studies (3+ / 0-)
          Recommended by:
          nyceve, Fabian, HairyTrueMan

          That show that generic Omeprazole, the first drug in this class, works just as good as Prontonix.
          They all block the Proton Pump, then it's just marketing.

          If you have an ulcer, the antibiotic, PPI, combos will CURE it.
          If you have reflux, smaller meals or Tums are the first line.
          Then H2s, the PPIs.

          24 yrs of Rx clincal experiance.....

          I'm not ready to make nice, I'm not ready to back down, I'm still mad as hell... Dixie Chicks

          by UndercoverRxer on Wed Jan 17, 2007 at 08:52:01 AM PST

          [ Parent ]

          •  You are obviously a good pharmacist. (1+ / 0-)
            Recommended by:
            UndercoverRxer

            It isn't an ulcer; it's acid reflux. I tried almost everything else before my doctor prescribed a PPI. I'm actually using Prilosec because it is over-the-counter and like I wrote, my insurance company will not cover the costs.

            •  I hope that it's working OK for you. (0+ / 0-)

              The cost of drugs is killing me, as this is my choosen profession. I'm in grad school getting a PhD in Pharmacy Econ to teach young pharmacists to be how to manage their patients care better.

              The thing that pisses me off is the the insurance co's will often pay for Prilosec OTC because they are getting kick backs that are invisible to the patient, and the cheap generic Omeprazole gathers dust on the shelves.

              I'm not ready to make nice, I'm not ready to back down, I'm still mad as hell... Dixie Chicks

              by UndercoverRxer on Wed Jan 17, 2007 at 05:46:40 PM PST

              [ Parent ]

        •  Always a good start (1+ / 0-)
          Recommended by:
          HairyTrueMan

          The UK National Health Service has the National Institute for (Health and) Clinical Excellence. They issue guidelines. Although they are intended for health care professionals, they provide useful background reading to indicate what your doctor should be looking for. They include flow-charts which are fairly easy for the layperson to understand how the thought processes should work. The .pdf file for conditions associated with dyspepsia is available from here:
          http://www.nice.org.uk/...

          Kneejerk reactions do not come from knees.

          by londonbear on Wed Jan 17, 2007 at 09:20:57 AM PST

          [ Parent ]

    •  There is a flip side to that (2+ / 0-)
      Recommended by:
      highacidity, HairyTrueMan

      The pharmaceutical companies make the big money by making new drugs that do the same thing as a drug that is off patent and can be acquired as a generic.  Then, convincing as many people as possible that they absolutely must take the shiny new drug instead of the tried and true and less expensive generic.

      This is no indictment of HariyTrueMan's particular situation since I know nothing of his condition, nor the differences between Protonix and Zantac(Ranitidine) that may make Protonix a better choice.

  •  As Long As We Get Our Cut (19+ / 0-)

    I think you correct in calling this a mafia-like mentality.

    "Sure, you can go to the hospital, but as long as we get our cut."

    Beyond this, I think that the statistics show that the system just isn't working out for us.  We are lagging behind other industrialized countries in terms of life expectancy, infant mortality, well-being and overall health.

    If the for-profit insurance and health care systems were giving us the best health care in the world, I would be all for it.

    The thing is, they aren't.

    I recommended your comment. And then I un-recommended it.

    by bink on Wed Jan 17, 2007 at 06:11:15 AM PST

  •  Preventive Care Very Necessary (12+ / 0-)

    Great diary.  Well researched.

    Krugman has also addressed the waste on G&A that is an albatross around the US health system.

    Also, our country does engage in preventive medicine to the degree other industrialized countries do.  While doctors in the UK or Canada have an incentive to ask their patients to exercise more and eat better, our doctors don't.  

    Little known fact, but soft drink consumption increased by 100% over the last 30 years.  100% increase in consumption of, basically, sugar water.  I can guarantee you that, had President Clinton or other Democrats been in office during the last 30 years, this would not have happened.

    Learn about Centrist Economics, learn about Robert Rubin's Hamilton Project. http://www1.hamiltonproject.org/es/hamilton/hamilton_hp.htm

    by PatriciaVa on Wed Jan 17, 2007 at 06:17:58 AM PST

    •  100% per capita increase (6+ / 0-)

      That is, it increased 100% per capita.

      Learn about Centrist Economics, learn about Robert Rubin's Hamilton Project. http://www1.hamiltonproject.org/es/hamilton/hamilton_hp.htm

      by PatriciaVa on Wed Jan 17, 2007 at 06:18:40 AM PST

      [ Parent ]

      •  It makes us obese (6+ / 0-)

        And contributes to development of type II diabetes. Soft drinks have been peddled to children. Schools have cut deals with PepsiCo. We have sold our kids health out to the highest bidder.

        "It's the planet, stupid."

        by FishOutofWater on Wed Jan 17, 2007 at 06:31:38 AM PST

        [ Parent ]

        •  I think of it a little different... (1+ / 0-)
          Recommended by:
          mariva

          The main problem I see with soft drinks is that you are talking ~150 calories per 12oz.  We will call 3 cans or 36oz 450 calories.  An average person might want to eat 2000 calories/day (it varies but lets' pick 2000 for arguments sake). If they have 3 cans of soda in a day, that leave 1550 calories of regular food.  So, consider 3 meals of 500 calories each.  ~8 oz of most meats with maybe a cup of a vegetable. 5 oz of dry pasta.  4-5 slices of bread.  5 tortillas. 5 tablespoons of butter.

          That is where the soft drink screws things up because people drink the 500 calories then eat 2000 on top of the soda.  

          •  That's just a recipe for obseity and heart attack (2+ / 0-)
            Recommended by:
            mariva, RantNRaven

            I presume your list is suggested for a day. Apart from being highly impractical - no puddings or sweet course? The immediate alarm points tho are the lack of fruit and vegetables - removee half the meat and butter and add 5 cups of vegetables or fruit and you are getting closer.

            Sorry but sugar-laden soft drinks (especially if the sugar is "high fructose corn syrup") have no place in any diet. That is particularly the case with children, unless of course you enjoy them bouncing off the walls.

            Kneejerk reactions do not come from knees.

            by londonbear on Wed Jan 17, 2007 at 09:33:36 AM PST

            [ Parent ]

            •  Oops, was not specific.... (2+ / 0-)
              Recommended by:
              mariva, FishOutofWater

              Those were just supposed to be examples of what 500 calories is, since most people do not have a good idea of how many calories are in a given amount of food.  So, if I just said 3 meals a day of 500 calories each some one might say "Hey, that is not so bad."  So, I tried to pick foods that are very common, and show how little of those foods is 500 calories. I threw in the butter because while everyone says fat is fattening when you actually see how many calories are in a little bit of fat it makes a point.  I skipped vegetables because they do not support my argument due to their much lower calorie to quantity ratio.  Saying 10 cups of green beans is 500 calories does not have the impact of 8oz of meat or just over 5oz of pasta.  A vegan might pull it off since the calorie density of fruits and vegetables tends to be much lower (50% or more) than meats and grains, but a vegan probably avoids soft drinks anyways.

              My point was. If you were trying to some how maintain your weight while drinking 3 soft drinks a day, you would be eating hardly anything and definitely not enough to be satisfying.  It was not a recommended diet, but was their to show just how little 500 calories is.  Then, to make the point that no one actually adjusts their diet to account for soft drink calories.

              I did not even get into the problems caused by diet soft drinks with artificial sweeteners screwing up the taste to calorie intake response of the body.

              •  Yes, Basically your body wants water (1+ / 0-)
                Recommended by:
                mariva

                And gets 500 extra (kilo)calories with 3 soft drinks.  It's a way our kids add calories to their diets and get fat. But is also adds sugar or artificial sweeteners which affect insulin production and other processes.

                And the phosphates in soft drinks bind with calcium in the gut leading to lower calcium adsorption and osteoporosis later in life.

                "It's the planet, stupid."

                by FishOutofWater on Wed Jan 17, 2007 at 12:10:23 PM PST

                [ Parent ]

                •  That last paragraph: (0+ / 0-)

                  True about diet soda as well?

                  Sorry to harp on this subject, but it's hard to find accurate info anywhere. Most nutritionists say that drinking diet soda is a good way to stop drinking regular soda.

                  Mariva's Guide: A magablog of fun, useful, interesting stuff.

                  by mariva on Wed Jan 17, 2007 at 12:51:15 PM PST

                  [ Parent ]

                  •  Yes, Phosphate stabilize the bubbles (1+ / 0-)
                    Recommended by:
                    mariva

                    I don't know the chemistry of all soft drinks but I know that most of them have phosphoric acid.

                    Check this link

                    "Many general dietary factors have been suggested as a cause of osteoporosis, including: low calcium-high phosphorus intake, high-protein diet, high-acid-ash diet, high salt intake, and trace mineral deficiencies. It appears that increased soft drink consumption is a major factor that contributes to osteoporosis. A deficiency of vitamin K leads to impaired mineralization of bone. Boron deficiency may contribute greatly to osteoporosis as well as to menopausal symptoms."

                    "Soft drinks have long been suspected of leading to lower calcium levels and higher phosphate levels in the blood. When phosphate levels are high and calcium levels are low, calcium is pulled out of the bones. The phosphate content of soft drinks like Coca -Cola and Pepsi is very high, and they contain virtually no calcium."

                    "The United States ranks first among countries in soft drink consumption. The per-capita consumption of soft drinks is in excess of 150 quarts per year, or about three quarts per week."

                    "Soft drink consumption in children poses a significant risk factor for impaired calcification of growing bones."

                    "Of the fifty-seven children who had low blood calcium levels, thirty-eight (66.7 percent) drank more than four bottles (12 to 16 ounces per bottle) of soft drinks per week, but only forty-eight (28 percent) of the 171 children with normal serum calcium levels consumed as much soft drink ... These results more than support the contention that soft drink consumption leads to lower calcium levels in children. This situation that ultimately leads to poor bone mineralization, which explains the greater risk of broken bones in children who consume soft drinks."

                    "Soft drink consumption may be a major factor for osteoporosis as they are high in phosphates but contain virtually no calcium. This leads to lower calcium levels and higher phosphate levels in the blood. The United States ranks first among countries for soft drink consumption with a per capita consumption of approximately 15 ounces a day."

                    "It's the planet, stupid."

                    by FishOutofWater on Wed Jan 17, 2007 at 01:40:28 PM PST

                    [ Parent ]

              •  Wait! Tell me more about diet soda. (0+ / 0-)

                I genuinely want to know. Isn't it a better alternative to regular soda? What are the downsides?

                Mariva's Guide: A magablog of fun, useful, interesting stuff.

                by mariva on Wed Jan 17, 2007 at 12:49:42 PM PST

                [ Parent ]

                •  Wish I could find a good reference (1+ / 0-)
                  Recommended by:
                  mariva

                  I don't know if it was an animal experiment or statistical research on a group of people.  But the results suggest a hypothesis that artificial sweeteners impacts the ability of the animal to distinguish how many calories they are eating because the artificial sweetener is sweet without the calories. Evolution has made us sensitive to sweet things because they are good sources of energy.  If a sweet thing is not a good source of energy it is possible it could screw with that sweetness = energy control.

                  It is currently more of a hypothesis than confirmed data.  And, the thing is modern humans have other ways to keep track of how much energy they are eating.  I think the main point is that diet sodas could be contributing to eating more, so just be aware of how much you are eating, which you should be aware of anyways.

                  •  Thanks for the insight. (0+ / 0-)

                    For me, it's only a "treat" (generally no more than once or twice a week), but I'm wondering if I should give it up altogether. I've given up a lot of things, and it's hard to part with one more.

                    Mariva's Guide: A magablog of fun, useful, interesting stuff.

                    by mariva on Wed Jan 17, 2007 at 10:34:25 PM PST

                    [ Parent ]

            •  londonbear, a question, if I may? (0+ / 0-)

              You seem to be well-versed in nutrition, so may I ask, how do you feel about diet sodas? On one hand, they have few or no calories. On the other, they're full of weird chemicals -- which do who knows what-- and can whet the appetite for "real" soda, so to speak.

              When I asked the trainer at the gym about how he felt about diet sodas, he was ambivalent, but wouldn't go into details (maybe because he thought diet soda was less evil than regular soda).

              I don't mean to hijack this discussion, but I am genuinely curious to know what the downsides might be.

              Mariva's Guide: A magablog of fun, useful, interesting stuff.

              by mariva on Wed Jan 17, 2007 at 12:47:48 PM PST

              [ Parent ]

              •  Not particularly an expert (1+ / 0-)
                Recommended by:
                mariva

                One of the problems is that the formulations can be different here compared to the US as some artificial sweetners are permitted here but not permitted or generally used in the USA. I believe that was in part due to some rather dubious animal testing where possible cancers were produced in extraordinarily high doses - the sorts of levels where if you drank enough to aborb the daily dose given over a period, you would probably die from water intoxication.

                The most common, aspartame, is known to produce headaches in people sensitive to it. In general though the problems with soft drinks fall into three categories.

                The first is purely the sugar content with the problems of obesity. It can also cause hyperactivity with the "sugar rush".

                The second is the high acid content. Osteoporosis is one possible factor but a more obvious shorter term one is the damage to teeth.

                Third are the effects of other food additives, notably the colorings. Again there is some evidence that these can produce abnormal behaviour in children.

                All in all the best way of quenching a thirst is simply tap water (assuming that it is potable in your area) The only reason to buy bottled water is convenience or where the tap water has become contaminated. If you are worried about things like chlorine or flouride added to the water, get a domestic filter system like those jugs that go in the refridgerator. You can ring the changes by getting carbonated water and even use it to dilute fruit juices to make a healthy alternative fizzy soft drink - pure fruit juices can be dehydrating if they are too thick.

                This sounds a bit puritanical but it can be interesting if you wean kids off those colas and then expose them to it again. It is also surprising how quickly you can re-educate your taste buds when you reduce things like sugar and salt.

                Kneejerk reactions do not come from knees.

                by londonbear on Wed Jan 17, 2007 at 06:27:58 PM PST

                [ Parent ]

                •  Thanks so much! (0+ / 0-)

                  I do drink a lot of water (I filter it at home) and have no problem with that. It's just that I'd like a "treat" once in a while and diet soda has no calories.

                  I have been drinking less of it lately, and trying to quench that particular thirst with carbonated water (which I use to dilute pure cranberry juice, exactly as you recommend). So I guess there's no problem with carbonated water, eh?

                  Mariva's Guide: A magablog of fun, useful, interesting stuff.

                  by mariva on Wed Jan 17, 2007 at 10:37:53 PM PST

                  [ Parent ]

    •  ummm...clinton was in office (1+ / 0-)
      Recommended by:
      possum

      within the last 30 years.  dems only lost control of the house some dozen or so years ago and the senate only 2 years ago...

      "Government, like dress, is the badge of lost innocence; the palaces of kings are built upon the ruins of the bowers of paradise." Thomas Paine, Common Sense

      by Cedwyn on Wed Jan 17, 2007 at 06:51:17 AM PST

      [ Parent ]

  •  The Power of Money (5+ / 0-)

    Sadly, much of the coverage problem comes from the attempted reform that allowed insurance companies to parade as HMOs -- and decide what qualifies as medical necessity. Please direct questions about this to Senator Edward Kennedy. Maybe he is now willing to admit his mistake on this.

    I agree that is makes sense to require second opinions on certain recommendations, but we a real doctor to be with the patient to do the review, not merely have someone at the HMO decide.

    There are times that limits to coverage make sense. Just as Oregon came up with a list of covered and uncovered services for their medicaid reform, so we may need that on a national level -- but it has to be done based on which are the most valuable services, not which pharmaceutical company can get their overpriced drugs to be covered by fiat.

    Let's not forget that the governments of the US spend as much per capita as every other developed nation on health care. All of the other governments manage to provide universal health care for the money they spend. We do not. Insurance companies, hospitals, doctors, pharma and medical equipment manufacturers are part of the problem, but it still comes down to the fact that our governments don't get our money's worth in buying health care.

    Democrats: Giving you a government that works.

    by freelunch on Wed Jan 17, 2007 at 06:18:36 AM PST

  •  Wellpoint - (20+ / 0-)

    I'm one of the 35 million Americans who have them and my medication costs $1000.00 a month; so far they've paid every month and I've been on it for almost 3 years.

    I can't function without this medicine, so all I can do is cross my fingers and hope they continue paying and that I don't lose my job.

    What a sad state of affairs when we have to be shackled to a corporation and just hope they do the right thing...it's wrong on so many levels.  

    "Murder by spreadsheet" is quite correct.

    Keep up your important work nyceve!

    If tyranny and oppression come to this land, it will be in the guise of fighting a foreign enemy - James Madison

    by CTLiberal on Wed Jan 17, 2007 at 06:21:43 AM PST

  •  because more drugs are what we need... (19+ / 0-)

    Gah!  By all means, murderers-by-spreadsheet, use the "research and development" line to justify perpetuating our godawful health care system.  Because the very basic access to preventive care that we don't have on a population level can be fixed with newer, better pills.

    Heart disease is still the number one cause of death in this country, and it's nutrition and physical activity that will change that; not pills.  Immunizations.  Public health screenings.  Walkable communities.  Nourishing school breakfasts and lunches.  Prenatal care.  So much suffering is so preventable with materials and techniques that have been around for ages-- but that's just not profitable or sexy.

    Thanks for an opportunity to rant just a little bit.

    •  Amen, mamamedusa! (5+ / 0-)

       So many of the drugs on the market today are what some would call "lifestyle" drugs - for impotence, for sleeplessness, sadness, fatigue, obesity.
      We need more common sense.

      In a time of universal deceit, telling the truth becomes a revolutionary act. - George Orwell

      by drchelo on Wed Jan 17, 2007 at 06:40:29 AM PST

      [ Parent ]

    •  Well, they'd have plenty for R&D (11+ / 0-)

      if they cut out all their TV ads. What do they spend on ads now, many hundreds of millions?

      Wait, it's almost ONE BILLION
      Pharmaceutical Spending Expected to Reach $1.3 Billion

      I suspect that would fund a hell of a lot of R&D, don't you?

      •  Good point, mmacdDE, there's a huge. . . (2+ / 0-)
        Recommended by:
        possum, Snakes on a White House

        problem with what is called direct to consumer advertising within the healthcare industry.

        However we still have something called freedom of speech in the United States, which I believe protects the right of big pharma to advertise.

        So lots of competing interests need to be weighed.

        •  Relatively New (7+ / 0-)

          Until fairly recently it was illegal for pharmaceutical companies to advertise prescription drugs. This wasn't a first amendment problem -- it was considered an appropriate regulation of certain medical goods, just as it is okay to forbid certain cigarette company advertising.

          Still, I wouldn't mind seeing Bayer advertising "Heroin, for when nothing else stops the pain."

          Democrats: Giving you a government that works.

          by freelunch on Wed Jan 17, 2007 at 07:05:58 AM PST

          [ Parent ]

        •  I believe it's worse than direct to consumer (2+ / 0-)

          I think it's like when big defense contractors advertise their fighter planes in the magazines you read. Why? Are you ever going to buy a stealth fighter?

          No, but buying advertising space in a magazine and then threatening to pull it effectively gags the magazine's reporters from criticising the defense contractor. Mission Accomplished!

          •  I'm not going to buy one (0+ / 0-)

            but I might be working for the department that does. And I might even be the decision maker for that department. And even if I'm not, I might take that ad to indicate that the company is patriotic, helping with our country's defense, and feel better about buying other things they make.

            That's why those ads are there. That's the same reason the ads for big medical equipment on the Sunday news shows. I'm certainly not going to buy that equipment, nor am I necessarily going to base my decision of where to get my MRI done on the equipment they have. But I might be a doctor who DOES influence/make those decisions, or I might have a more favorable view of other things the company makes (and I CAN buy those) because they're doing such good work </snark>.

        •  Freedom of speech (4+ / 0-)
          Recommended by:
          Omphaloskepsis, mariva, kck, RantNRaven

          really? Tobacco advertising is banned, and that's a product that's legal AND accessible without a doctor's prescription.

          There are plenty of limits on advertising, including political speech (like this FEC Refuses to Ease Limits on Political Ads)

          There's no reason why the FEC couldn't limit drug ads to OTC drugs.

          Frankly, I don't think there should be any advertising for prescription drugs. OTC drugs, sure.

          •  AMEN!!! (2+ / 0-)
            Recommended by:
            mmacdDE, mariva

            and Amen!   Can anyone tell me just when this inception and escalation of these damned drug ads started???   I'm thinking that it has been within the past 6 years...at least the escalation part.  About the same time that that Big Pharma crawled into bed with our Asshole-in-Chief and began tickling his fancy???  

            OTC drugs have always been advertised and I really see nothing wrong with that because they are accessible to everyone but these Horrible Prescription Drug Ads offend me greatly since the $$$ spent on them could be used to benefit the rest of us in the lowering of drug prices, more R&D, etc.  And the bonuses of the Big Pharma executives is just amoral!  This industry needs regulating in the worst way.  Besides the ads' very offensive list of symptoms are the graphic descriptions of their side effects.   Now I am not a doctor and so I do not have access to these drugs even if I wanted them.   But there are so many doctors out there who will prescribe drugs for Great Aunt Gussie just to appease her whether she needs them or not.  With the myriad of those infernal ads it is easy to see how the industry has such disgusting profit margins.   And we are all paying for it.

            I want those ads OFF t.v. now!  I'm sick of them!!

            This seemd to be my #1 issue lately.....thanks for the opportunity to rant a little!   ;O)

            "What, Me Worry?"...King George Walker Alfred Eusless Newman Bush

            by RantNRaven on Wed Jan 17, 2007 at 12:35:40 PM PST

            [ Parent ]

    •  Some people can't live without certain drugs (0+ / 0-)

      and it's really not their fault. Like people with AIDS (unless you think that's someone's fault), congenital heart problems, cancer, infections, etc.

      Having said that, I do agree with the general point of your argument. If society took a public health approach toward physical well-being (instead of a profit-and-avoid approach), we'd all be better off.

      Mariva's Guide: A magablog of fun, useful, interesting stuff.

      by mariva on Wed Jan 17, 2007 at 12:55:23 PM PST

      [ Parent ]

  •  umm (12+ / 0-)

    we left the country on account of this.  Got what I needed in Mexico for $65, with pure and excellent professionalism.  

    No long, personal/medical histories to be filled out in an ob/gyn's office with invasive questions, once answered, to be posted on the internet (I walked out, forgot about getting help).

    People in the US have, generally, no clue how much less (and often MUCH more professional) services cost in other countries.  And how much more accessible care can be.

    A friend had an ovarian tumor (benign) removed in Venezuela.  Most professional, caring, and CLEAN services she ever saw in a private pay facility.

    Total bill:  $800.  And she's fine now.

    But our own leaders seek to divest us of all our well-being through all of this.  Why, why, why does a government do this to its own people?

    One can't help but wonder if, through "medical care" follies and other gambits, the shadow gummint doesn't simply want to exterminate us, so that they can then run the planet by totalitarian militarized force.  Why else, then, would our own gummnt do this to its own people?

    Those who corrupt the public mind are just as evil as those who steal from the public purse. - Adlai E. Stevenson

    by stonemason on Wed Jan 17, 2007 at 06:22:28 AM PST

  •  Another great diary, nyceve. (12+ / 0-)

    Thanks.

    We all face this situation nearly all the time.  My wife is currently battling the cost issues.  The insurance company (and we have one of the better ones) refused to pay for the doctor recommended drugs since they cost a lot.  She has been many weeks taking lesser courses including over-the-counter medication before she is allowed to be reconsidered for the original prescription.  When a bookkeeper takes charge of medicine we are all in real trouble.  But that is the way medicine works today in this country.

    Never In Our Names "all you have to do to qualify for human rights is to be human."

    by possum on Wed Jan 17, 2007 at 06:26:43 AM PST

  •  This is even more evident when (3+ / 0-)
    Recommended by:
    nyceve, OpherGopher, possum

    you through immigration issues into the mix. Murder by spreadsheet then becomes a racial issue.

    •  Social Safety Net Issues (6+ / 0-)

      As a rough generalization, among wealthy nations the more homogeneous the country, the more likely it is to provide or expand good social services. People aren't always very good at being able to put themselves into the place of others who don't seem to be much like themselves.

      Democrats: Giving you a government that works.

      by freelunch on Wed Jan 17, 2007 at 06:40:23 AM PST

      [ Parent ]

      •  The pattern even shows in the same country... (1+ / 0-)
        Recommended by:
        freelunch

        ...over time. I believe massive immigration had a lot to do with turning post-war Britain away from socialism and towards Thatcherism. The British equivalent of "Reagan Democrats" were formerly Labour-voting working class white people who listened to the Conservatives explaining that their taxes were going to support black "welfare queens".

        It wasn't true, and anyway Thatcherism did far more to divert tax revenue from working people away from their benefit and towards lining the pockets of the Tories and their corporate friends. But it had narrative power.

  •  Great diary! Another potential interesting (15+ / 0-)

    frame is "Diversion of critical drug research dollars into excessive executive compensation and shareholder returns jeopardizes research into new and improved medicines over time."

    Ain't gonna see this in Forbes any time soon...

  •  you could do a whole diary (14+ / 0-)

    on just the R & D bullshit alone.  they're not investing in R & D, or if they are, it's only to add an extra, inert, molecule to an existing product whose patent is about to expire.  the change the structure ever so slightly and bam! new patent for twenty years.

    the next time these parasites start nattering on about the burdens of R & D, i want someone to bust the receipts for all the advertising big pharma does.  for all the freebies - notepads, pens, etc. - they flood clinics with to get their name out there.  all the bonuses and frequent-presriber awards they give doctors.

    R & D my lily-white arse...

    "Government, like dress, is the badge of lost innocence; the palaces of kings are built upon the ruins of the bowers of paradise." Thomas Paine, Common Sense

    by Cedwyn on Wed Jan 17, 2007 at 06:46:15 AM PST

    •  Exactly right, Cedwyn. (6+ / 0-)

      Research today is all about profit.  No basic research of the pipe dream sort by Big Pharma.  They sit around and wait for some small company to find a promising course and buy them out.  Too bad for the industry.  So much could be accomplished if basic research were brought back to the fore, but that would cost money and cut profit.  We can't have that can we?

      Never In Our Names "all you have to do to qualify for human rights is to be human."

      by possum on Wed Jan 17, 2007 at 06:56:04 AM PST

      [ Parent ]

    •  Yes, as Glaxo-S-K did with the cancer drug (4+ / 0-)

      found to also treat blindness. They just had to tinker with the formula so they could jack up the price 100X because they knew they could get more as a blindness-curing drug.

      Shameless Murder by Spreadsheet, and Blindness by Spreadsheet.

      We will never eliminate poverty in America unless we do it comprehensively and nationally....no more incrementalism. - John Edwards

      by Gorette on Wed Jan 17, 2007 at 06:57:01 AM PST

      [ Parent ]

  •  "Murder by spreadsheet"... (11+ / 0-)

    ..is an excellent theme to pound home into the brains of policy-makers.
     When I look at the insurance dollars that are spent in my office, I am reminded of a lecture that hit me up the side of the head in medical school.  A very wise professor of Internal Medicine told us "Ninety percent of the diseases that you will see in practice you cannot cure.  About five percent of diseases, you will be able to cure, and five percent are incurable, no matter what you do".
     These numbers may have changed in thirty years, and we have made enormous strides in making some previously fatal diseases chronic diseases (AIDS), and treatment of certain conditions has certainly improved the lives of many - but too much money is spent on lifestyle treatments, patients come in for the common cold and other self-limited conditions.
     This country needs more grandmothers!  They don't cost as much, they dispense excellent common sense on preventive medicine, they offer solid nutritional advice, comfort and soothing soups for the common cold, cheering up the sad, and insisting that the anxious, nervous go outside and play instead of just grousing around!

    In a time of universal deceit, telling the truth becomes a revolutionary act. - George Orwell

    by drchelo on Wed Jan 17, 2007 at 06:48:24 AM PST

  •  Quote "Murder by Numbers" by Sting & The Police (11+ / 0-)

    Lyrics to "Murder by Numbers" -- copyright owned by the artists:

    Written by Sting & Andy Summers

    Once that you've decided on a killing
    First you make a stone of your heart
    And if you find that your hands are still willing
    Then you can turn a murder into art

    There really isn't any need for bloodshed
    You just do it with a little more finesse
    If you can slip a tablet into someone's coffee
    Then it avoids an awful lot of mess

    It's murder by numbers, one, two, three
    It's as easy to learn as your ABC
    Murder by numbers, one, two, three
    It's as easy to learn as your ABC

    Now if you have a taste for this experience
    And you're flushed with your very first success
    Then you must try a twosome or a threesome
    And you'll find your conscience bothers you much less

    Because murder is like anything you take to
    It's a habit-forming need for more and more
    You can bump off every member of your family
    And anybody else you find a bore

    Because it's murder by numbers, one, two, three
    It's as easy to learn as your ABC
    Murder by numbers, one, two, three
    It's as easy to learn as your ABC

    Now you can join the ranks of the illustrious
    In history's great dark hall of fame
    All our greatest killers were industrious
    At least the ones that we all know by name

    But you can reach the top of your profession
    If you become the leader of the land
    For murder is the sport of the elected
    And you don't need to lift a finger of your hand

    Because it's murder by numbers, one, two, three
    It's as easy to learn as your ABC
    Murder by numbers, one, two, three
    It's as easy to learn as your A, B, C, D, E

    Never, never brave me, nor my fury tempt:
      Downy wings, but wroth they beat;
    Tempest even in reason's seat.

    by GreyHawk on Wed Jan 17, 2007 at 06:48:54 AM PST

  •  (emphasis mine in that previous quote) (12+ / 0-)

    This particular bit fits Bush and the Republicans:

    But you can reach the top of your profession
    If you become the leader of the land
    For murder is the sport of the elected
    And you don't need to lift a finger of your hand

    If nobody beats me to it, I'll diary it tonight.

    Most of the lyrics have real-world examples, unfortunately.

    Never, never brave me, nor my fury tempt:
      Downy wings, but wroth they beat;
    Tempest even in reason's seat.

    by GreyHawk on Wed Jan 17, 2007 at 06:50:51 AM PST

  •  Thanks, eve, for the great diary, again. The (4+ / 0-)
    Recommended by:
    nyceve, javelina, possum, Mary Mike

    frame is so dead-on, it would be great to keep it in front of us so it gets wider play. How to get this out to the media?

    You are doing great work. The WellPoint stuff just sickens me. That they collect these huge amounts for the purpose of care and then intentionally neglect to provide it is murder--for sure.

    It seems that in time the costs will rise and the shameful practices will become known and people will be forced to see the light and demand a program such as Medicare for All. That is what I want to see happen and I thank you for hastening the day.

    How long before you think it will come about? Can it happen while people are focused on an awful war rather than domestic problems?

    From an uninsured kossack.

    We will never eliminate poverty in America unless we do it comprehensively and nationally....no more incrementalism. - John Edwards

    by Gorette on Wed Jan 17, 2007 at 06:53:45 AM PST

  •  Can I just say (3+ / 0-)

    We're getting a bit too sensitive about the semantics over whether the media should say "democrat" or "democratic." Yes, obviously  the republicans use "the democrat party" as a perjorative and yes, it sneaks into the media verbage now and then. But there are times, as in this case

    CBO Faults Democrat Drug Plan

    when Democrat is used in the proper form. It is awkward to say that a plan is "Democratic." Saying that it is a "Democrat Plan" indicates that the plan is represented by the Democratic Party. Clear enough. But to say "Democratic Plan" is to indicate that the plan is a democracy or that the plan itself is "democratic" in nature. Obviously, the plan itself is not a democracy, nor can any plan be a democracy.

    "Keep America beautiful: grow a beard, take a bath, burn a billboard." - Ed Abbey

    by frankzappatista on Wed Jan 17, 2007 at 06:54:05 AM PST

    •  that's why i go out of my way (2+ / 0-)
      Recommended by:
      nyceve, possum

      to phrase things in such a way as to avoid the use of "democrat," even when it's entirely appropriate.

      "Government, like dress, is the badge of lost innocence; the palaces of kings are built upon the ruins of the bowers of paradise." Thomas Paine, Common Sense

      by Cedwyn on Wed Jan 17, 2007 at 07:01:50 AM PST

      [ Parent ]

    •  frank, respectfully disagree . . . (8+ / 0-)

      Mr. Pelly of CBS News on 60 Minutes pulled this shit during the Bush interview. It was deliberate, IMO.

      The way it is used is, IMO, a complete perjorative.

      And BTW, Mr. Pelly didn't do it one time on 60 Minutes, he did it several times.

      He kept referring to the "Democrat Plan".

    •  This usage goes back to Joe McCarthy (3+ / 0-)

      The usage is pejorative, pure and simple, apparently coined by Joe McCarthy.  It should be avoided, and nyceve was absolutely right to call out the CBO for using it.

      For more on the history, see for example, the discussion following a post by Bowers or this recent diary by skippy.

      The climate is changing -- Draft Al Gore for President in 2008.

      by Neighbor2 on Wed Jan 17, 2007 at 08:18:49 AM PST

      [ Parent ]

    •  I (partly) don't agree... (3+ / 0-)

      I do think there's an awful lot of sensitivity on this, but when someone has been disrespected and abused with impunity for a long time, s/he can often insist on rigid parameters of respect in regaining a place in the world. I think that explains some of the touchiness.
      I don't know if this incorrect usage started out with hostile intent or not - maybe it was just the semi-literate bleating of the President that put it in vogue amongst his acolytes, like when you have to choose between agreeing with your stupid boss or exposing to him that you think he's stupid. But after this many requests to correct the misconstruction, I assume its continued usage by the media and their favored Party is intentional - kind of like the second or third time they get "Obama" and "Osama" mixed up.
      Where the usage of "Democrat Party" sneaks in - with hostile intent or not - is that an individual member of the Republican Party is a Republican, but an individual member of the Democratic Party is a Democrat, not a Democratic. (Hmmm. Come to think of it maybe that's why they like it so much. The Bushists have always needed to render their opposition as smaller-than-life, and the "Democrat Party" sounds like a party of one single Democrat...)  
      That said, though, "CBO Faults Democrat Drug Plan" sounds as wrong to my ear as "CBO Faults Republic Drug Plan". The language is full of instances in which context is essential to understanding, and the distinction between Democratic/democratic (especially when written in initial-caps Headlinese) is one of them. And of course the fact that people might read "Democratic plan" and think it could well be more democratic-in-nature than the Republican plans so amply documented in this diary? That's why Republicans need to make us look small.

  •  Hmm... (11+ / 0-)

    The longer-term human costs of government price-negotiation, however, are likely to be large and adverse. This paper estimates that investment in new drug research and development would decline by approximately $10 billion per year. It estimates as well the effect of reduced pharmaceutical R & D investment on American life expectancies, or expected "life-years". Specifically, this work projects that federal price negotiations would yield a loss of 5 million expected life-years annually

    Okay, I'm convinced.  So the way to increase nationwide life expectancy must be to throw money at drug companies.  If we give them more money, they will have more money to do research & save more lives.  

    This is amazing bullshit that fails to consider three major facts: 1) pharma spends scads more money on marketing than they do on r&d; 2) most r&d is already subsidized by U.S. taxpayers; and 3) pharma is the most profitable industry in the country.

    What would enable them to spend more money on r&d?  Cutting their fucking profit margin!

    I would rather be exposed to the inconveniences attending too much liberty than those attending too small a degree of it. -- Thomas Jefferson [-4.25, -5.33]

    by GTPinNJ on Wed Jan 17, 2007 at 06:54:32 AM PST

    •  Really? More on marketing than R & D? Wow. (4+ / 0-)
      Recommended by:
      eugene, opinionated, nyceve, possum

      I never have heard that before. I knew that they spent huge obscene amounts on advertising but never heard a comparison. That should be made common knowledge because it a huge and simple weapon against listening to them at all in any debates on health care issues. It shows they are all about profits. Period.

      We will never eliminate poverty in America unless we do it comprehensively and nationally....no more incrementalism. - John Edwards

      by Gorette on Wed Jan 17, 2007 at 07:04:07 AM PST

      [ Parent ]

      •  Big Cost of Marketing (5+ / 0-)
        Recommended by:
        eugene, nyceve, UndercoverRxer, possum, chigh

        Detail men, seminars on cruise ships, dinners, and anything else to make the doctor willing to prescribe the drugs that cost ten times as much but don't really matter in this particular case. The only thing they haven't admitted to trying is direct kickbacks to the doctor. Robin Cook had all the gory details in one of his novels a couple of decades ago.

        Democrats: Giving you a government that works.

        by freelunch on Wed Jan 17, 2007 at 07:10:08 AM PST

        [ Parent ]

        •  surreal pharma marketing (6+ / 0-)

          I once happened across a local pharma event for the area's doctors.  It was being held in a local diner-- we went there for a family dinner, and most of the place was cordoned off for this absolutely surreal scene with an Elvis impersonator and someone in a giant red stomach suit-- seriously, a big foam walking stomach complete with an esophagus and a bit of duodenum.

          I recognized a number of local physicians with their spouses and kids enjoying what looked to be a free meal and this unreal entertainment event.  I wish for the life of me I could remember the featured medication-- maybe Prevacid?  

          Yeah, that's the best possible application of America's health care dollars.

      •  You note there is not a link (1+ / 0-)
        Recommended by:
        MarketTrustee

        nor is there any truth to it.  The top 50 Pharma companies spent over $66 billion in 2005 on R&D.

        The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries.

        by deathsinger on Wed Jan 17, 2007 at 07:35:34 AM PST

        [ Parent ]

    •  No.... (1+ / 0-)
      Recommended by:
      kck

      Throw it at the university researchers who are trying to figure out how to cause a calorie restriction response in humans without the 30-40% calorie restriction.  That will increase life expectancy 20-30%.

  •  The other side of the coin (8+ / 0-)

    The concept of murder by spreadsheet is a powerful way to get the general population to recognize a problem.  However, the opposite side of this argument can be used to attain the ultimate goal.

    Most businesses (theoretically) are looking for ways to be more cost effective.  Using statistics to publicize the COST of poor medical care would convince the "money people" to join the fight.

    I've read arguments about the cost to hospitals to treat the uninsured and potential cost savings of preventative medicine.  I've not seen any statics about this.  There are companies that do offer decent medical benefits.  I assume they have found some financial gain - such as lower absenteeism, better productivity.  Putting this information in spreadsheets and arguing with facts about the horrendous cost of this country's lack of insurance coverage would increase the number of people fighting for a positive change.

    The spreadsheet arguement has two sides - a great deal can be gained by using both the negative and positive sides of this argument.

    •  absotively! (5+ / 0-)

      this approach, coupled with the self-evident idea that american companies cannot compete against foreign entities who don't have that cost burden is the only thing that will make some people listen.  it's sad, but true.

      "Government, like dress, is the badge of lost innocence; the palaces of kings are built upon the ruins of the bowers of paradise." Thomas Paine, Common Sense

      by Cedwyn on Wed Jan 17, 2007 at 07:04:31 AM PST

      [ Parent ]

    •  Cost to whom? (0+ / 0-)

      It only works if the cost of poor medical care can be shown to lie on the money people themselves. And even then you have to make a better case for the cost of an externalized expenditure rebounding on them than the cost of internalizing the original expense, because money people are like that. They'll chance a large future cost if it saves a small present cost.

  •  If the $10B figure is true, then it would... (6+ / 0-)

    be worth it to match the anticipated loss to research in new NIH research grants to Pharmaceutical companies to make up the difference.  Why should we have people pay high drug prices in Medicare just to support research.

    So I say, call their bluff.  In the bill, promise to match dollar for dollar of lost investment capability by the drug companies based on the % of profit that goes into R&D.  

    So if Pharma companies invest 20% of their pre-tax profits into R&D and their pre-tax profit falls by $1B then they would eligible to recieve a $200MM grant for R&D.  The benefit of doing it this way is then the funds are targeted for research, not for executive salaries.

    I don't think it would ever amount to a hill of beans but some companies, particularly the ones who are living high off the hog of a popular drug could be individually hurt.

    BTW, This would not help companies that do not do significant R&D.

  •  asking for trouble (0+ / 0-)
    • the spreadsheet. nobody's going to abandon capitalist economics any time soon. "that's unamerican." building wealth is the creed, the spreadsheet is an organizational tool. how do you define wealth? that is one of the "assumptions" required to build a spreadsheet model.
    • the spreadsheet. so be prepared to display your alternative. are you working with bonddad and others to develop or explain a plausible "financial" model for single-payer?
    • murder a hyperbolic characterization of health care that forestalls examination of the facts, assumptions, AND your projection of "wealth", what is good. is your message of social "justice" fundamentally punative or reconstructive? we all need to keep in mind how gains and losses on paper, in the "spreadsheet" model, are manifest in ordinary individual lives. you illustrate very well what is bad and to great affect. perhaps it is time to illustrate what is and would be better.
    • villains. another hyperbolic characterization, one that traps individual health care providers in its net. doctors, nurses, home aides, PTs, technicians, researchers: these are employees of the corporate managers who choose to extort loyalty and profits from basic needs. are they villains as well or are they "victims"? are they represented in your spreadsheet?

    i don't know stoller. i don't read his blog. but i do know this: jingoism doesn't simulate humanism. this is the language of antagonism, undirected anger.

    you don't need this kind of help. your empathy is authentic and resonates with millions of people. at this stage of the ideologic, political battle to recognize a single-payer mandate the hardest thing to do is present an empirical argument.

    use the spreadsheet.

    Diversity is the key to economic and political evolution.

    by MarketTrustee on Wed Jan 17, 2007 at 07:31:21 AM PST

    •  single-payer is democratic. (2+ / 0-)
      Recommended by:
      kck, Snakes on a White House

      one cost levied to employer and employee alike.

      Diversity is the key to economic and political evolution.

      by MarketTrustee on Wed Jan 17, 2007 at 07:37:29 AM PST

      [ Parent ]

    •  You don't need a fucking spreadsheet (5+ / 0-)

      To determine that the US is paying more for health care and getting less of it than other developed countries. It's all in the bottom line.

      Look at how the US ranks in the world on health care WHO Ranking

      1         France
      2         Italy
      3         San Marino
      4         Andorra
      5         Malta
      6         Singapore
      7         Spain
      8         Oman
      9         Austria
      10        Japan
      11        Norway
      12        Portugal
      13        Monaco
      14        Greece
      15        Iceland
      16        Luxembourg
      17        Netherlands
      18        United  Kingdom
      19        Ireland
      20        Switzerland
      21        Belgium
      22        Colombia
      23        Sweden
      24        Cyprus
      25        Germany
      26        Saudi Arabia
      27        United  Arab  Emirates
      28        Israel
      29        Morocco
      30        Canada
      31        Finland
      32        Australia
      33        Chile
      34        Denmark
      35        Dominica
      36        Costa Rica
      37        United  States  of  America
      38        Slovenia
      39        Cuba
      40        Brunei
      41        New Zealand
      42        Bahrain
      43        Croatia
      44        Qatar
      45        Kuwait
      46        Barbados
      47        Thailand
      48        Czech Republic
      49        Malaysia
      50        Poland

      Quite simply, we pay more and get less. No wonder so many Americans are retiring to Costa Rica. The health care is better and the cost of living is less.

      Aren't you embarrassed that Costa Rica has better health care than the United States?

      "It's the planet, stupid."

      by FishOutofWater on Wed Jan 17, 2007 at 08:21:32 AM PST

      [ Parent ]

      •  yes, one does need a fuckin spreadsheet (0+ / 0-)

        to organize and calculate exactly how one intends operationalize single-payer.

        you could use pencil and paper, i suppose.

        you could hope someone else will do it for you.

        you could copy some other UHC financial model.

        i wouldn't recommend a wholecloth port. some modification of the assumptions is required as the USA has a significantly larger population than any other OECD state.

        Diversity is the key to economic and political evolution.

        by MarketTrustee on Wed Jan 17, 2007 at 09:12:12 AM PST

        [ Parent ]

        •  Operationalize? (2+ / 0-)
          Recommended by:
          MarketTrustee, FishOutofWater

          Die.  You have defiled the language.

          What the fuck is wrong with a perfectly good $5 latinate word like "implement"?  Why create a three-eyed, quacking lame goat like operationalize?

          UHC in Europe is by nation-state.  UHC in Canada is by province.

          There's absolutely no reason that it couldn't be organized by state, with substantial federal baseline requirements about minimum levels of care, transferability of coverage among the residents of the states, etc.  And some funding mechanisms to help ensure that the blue states help bail the red states out, as usual.

          There.  Are any of the states larger than any of the OECD nations?  Any smaller?  I suspect that Germany's population is as large as California's and Luxembourg is no more populous than Rhode Island... or Wyoming.  That ought to deal with any monsters under the bed caused by the scale of the Union.

          "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

          by ogre on Wed Jan 17, 2007 at 09:59:30 AM PST

          [ Parent ]

          •  i didn't invent it. (0+ / 0-)

            to capitalize and to operationalize are two different verbs describing two equally important of requirements in organiziang and transforming, respectively, ideas into people, places and things.

            people implement, which is almost always the same thing as saying execute tasks that comprise the operations of an organization to make or produce goods and services.

            too precise for you?

            Diversity is the key to economic and political evolution.

            by MarketTrustee on Wed Jan 17, 2007 at 12:08:47 PM PST

            [ Parent ]

            •  Bad words with equivalents (0+ / 0-)

              have no excuse.

              What's this one mean? What's it mean that implement doesn't?

              The opposite of precision is, in operation, obfuscation.  And this word doesn't express itself. I can grasp what finalize means, for example.

              -ize is added to adjectives and nouns to form transitive verbs with the general senses "to render, make

              So operationalize would mean to make or render (something) operational.

              (operational) -- able to function or be used; functional

              So we're talking about making something functional.

              Make single payer operate.

              Or implement single payer.

              It's a clunky word that replicates the meaning of existing words.  Its sole attraction is that it's perfect bureaucratese--it's passive.  Bleh.

              Don't use it in trying to sell single payer; brains will shut down on hearing it.  They'll be so caught up in WTF? that they won't hear and follow what's being 'operationalized'.

              "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

              by ogre on Thu Jan 18, 2007 at 09:20:40 PM PST

              [ Parent ]

              •  lol. you got me! (1+ / 0-)
                Recommended by:
                ogre

                we know better than to toss that word into MSM.

                we know just as well the first question will be
                "how will we pay for it?"

                the second question will be
                "how will it work?"

                we cannot answer either however without some kind of estimation of all the people, places, processes, and things that comprise american single-payer health care--as well as the parts that don't.

                otherwise commercial insurance will push single-payer off the radar again.

                's all i'm sayin.

                (and my favorite bad equivalent is "to privilege.")

                Diversity is the key to economic and political evolution.

                by MarketTrustee on Fri Jan 19, 2007 at 07:10:12 AM PST

                [ Parent ]

                •  Yep. (0+ / 0-)

                  We don't disagree.

                  Answers:

                  1.  We already do pay for it--we just aren't getting what we pay for.

                  The USA pays much more for health care than any nation on Earth.  That's true both for the total number, and for the amount we spend per person--if we just took how much we spend to cover only some of us, now, under a broken and inhumane system.  (If we just took all the money we spend and gave it to the French, Danes, Germans, Canadians or the British, and asked them to provide health care for us just like they do for themselves... we'd get excellent health care, for everyone (not perfect, but no system is perfect) AND we'd get a rebate too.)

                  We already pay.

                  We already pay.

                  Already.

                  It'll work just fine.  It's really not that hard, and if you think about it, it's really a no brainer.

                  All that's proposed is that instead of paying money to for profit insurance companies (who promptly take about 15%... unless they can take even more, for their profits), we pay that money into a government-overseen fund.  We administer it as we do Medicare and other programs--at an overhead cost of about 2-3%.  Note that there's no national health scheme here; no nationalized hospitals.  This is just changing how we fund and pay for health care (and making sure that everyone gets covered.  Everyone).

                  Instead of your doctor billing to umpty-seven different insurance companies, some of whom treat him or her as being "on plan" and some as "off plan" and pay differently because of it... and who all have different forms, different schedules, different requirements, different reporting needs (which makes for a bureaucratic nightmare for the office help who try desperately to bill correctly...), they'll only have one set of forms they need to understand.  That'll make it vastly easier for them to understand and get right.  It'll make it certain that billing problems and errors are far less common.  That means that we save money in two places on the overhead, first at the national funding level, and second, the office help level.  So costs will go down in doctors' offices.

                  How will it work?  You'll hardly notice any difference. Here's why.

                  You'll be covered.  You'll go to your doctor, who'll treat you.  There will probably be a modest co-pay, just like now (only it might be more modest).  And they'll bill... just like they do now.  Only... they won't need to send you a copy of the bill, reminding you that you're responsible for it if the insurer refuses to pay it, or delays payment for some inane reason... for months.  Less hassle and worry for you, but you won't notice that you're not getting those worrying, incomprehensible, vaguely threatening letters, will you?  You won't notice, because you won't have to do paperwork to get or keep insurance when you get a new job, or lose one.  You won't have to, because you're covered when you have a job, when you leave or lose one, and when you get one.  No song and dance about pre-existing conditions.  No delays waiting for insurance to become effective.  But you'll be busy... and you won't notice.

                  Or perhaps you meant, how will we pay for it--with the same money, yeah, but how?  Rather than paying premiums, and hoping that you sent it in time, or that your company did, we'll pay (remember, it's the same money already...) a tax.  It'll come from several sources.

                  Companies will pay some percentage of what they pay in wages and salaries--shifting insurance premiums to a tax.  Call it what you like; the money's the same, and going to be spent on the same things--except there's not 15% taken out in profits first.  Individuals will pay something as well--and again, almost everyone who gets health insurance through work pays for part of their health care now, so that's not different.

                  But if you're out of work... or poor... you won't be without health care.  If you have some health problem, the system won't drop you like a hot coal, which is what the insurers do now.

                  With the money we already spend, we can provide health care better than any place on earth, to every person, every man, woman and child in the country.  All we have to do is spend those dollars wisely.  The first step is to take the profit out of your being sick, the profit out of your going to see a doctor... or rather, the profit out of your not getting the health care you need and deserve.

                  (Re: "to privilege"  aaaaaaaaaaaiiiiiieeeee!  My eyes!  It's a term I don't favor.)

                  "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

                  by ogre on Sat Jan 20, 2007 at 12:38:27 AM PST

                  [ Parent ]

                  •  thank you for a thoughtful, comprehensive (0+ / 0-)

                    reply. alas, i didn't see that you had replied until today.

                    so i am reminded of how the unitary asshole's "health care" proposal, announced in the SOTU addresse last night, will be brandished (favored?) by MSM before the public's imagination, while H.R. 676 and S. 2229 languish in congress.

                    Diversity is the key to economic and political evolution.

                    by MarketTrustee on Wed Jan 24, 2007 at 06:30:27 AM PST

                    [ Parent ]

        •  Well, Medicare covers the whole country (1+ / 0-)
          Recommended by:
          MarketTrustee

          by using a regional approach. Medicare for all, one approach to universal care could build on the existing regional structure and existing Medicare program.

          I'm not against using solid management methods. I think you realize that. I favor honest accounting, not Bush brand enronomics. Spreadsheets don't kill people. People using spreadsheets kill people by denying health care services.

          "It's the planet, stupid."

          by FishOutofWater on Wed Jan 17, 2007 at 02:08:11 PM PST

          [ Parent ]

    •  Wall Street takes succor from hyperbole+emotion (3+ / 0-)

      I don't know, I kind of like the spreadsheet as landscape. Remember Big Tobacco and other bloated companies in the '80's? Once the fundamental moral issue on tobacco was established in citizen/consumer/investor minds, the stock prices went down and the corporate raiders went to work - Reynolds became Nabisco (not the perfect example since cigs are still sold). The market moved toward hostile takeovers and liquidation and the overall market (i.e., 401k's) improved.

      Transformational reform of health care is basic business oversight and reenginering. The spreadsheets tell the story, we just have to make sure the WHOLE spreadsheet is in view.  

      Your good point - punitive vs. reconstructive - works here. No one want to punish insurance companies (well, some may, but that's not the objective) but to reconstruct the market to adapt to the current demand in a sustainable structure.

      Wall Street takes succor from hyperbole and emotions. Once the market prices are down, any decent move, no matter how hostile, no matter how many jobs are at stake, will suddenly be seen as brilliant albeit aggresive capitalism.  Yes, it works for me.  

      > 518,000 American children are in foster care. Got any bandwidth?

      by kck on Wed Jan 17, 2007 at 08:31:43 AM PST

      [ Parent ]

      •  the objective. exactly. (1+ / 0-)
        Recommended by:
        kck

        lose sight of object, lose the audience, lose potential allies. and allies within gubment, within insurance industry, and within financial market is exactly what single-payer needs.

        single-payer has no shortage of enemies.

        Diversity is the key to economic and political evolution.

        by MarketTrustee on Wed Jan 17, 2007 at 09:27:24 AM PST

        [ Parent ]

    •  Yes, look how badly demonising "socialized" (1+ / 0-)
      Recommended by:
      nyceve

      ...worked out for the right. Oh no, that's right, it actually worked out very well for them.

      I'm amazed at the people on this thread saying don't say socialized, it'll make us look bad, and the other people saying don't say villains, it'll make us look hyerbolic. There's a bit of an inconsistency there, if Democrats could only get over their decades-long trauma enough to see it.

      •  i'm not criticizing socialism at all (2+ / 0-)
        Recommended by:
        ogre, Snarcalita

        i merely attempted to share an observation about effective marketing communications based on my experiences. i'll admit, i've no experience as a political blogger.

        antagonizing people doesn't sells anything. when's the last time you saw "deaf by ipod. buy a home audio"?

        antagonism is a barrier to communication.

        there are other ways to "frame" opposing concepts of wealth and health -- from the point of an individual or the nation.

        Diversity is the key to economic and political evolution.

        by MarketTrustee on Wed Jan 17, 2007 at 09:22:43 AM PST

        [ Parent ]

        •  However... (1+ / 0-)
          Recommended by:
          katiebird

          a spreadsheet is a tool that very, very few people feel warm and fuzzy about.  It is in that sense utterly different from a consumer good like an iPod.

          Spreadsheet?  Hey, I use them, I know their value.

          But when I hear spreadsheet, I don't think warm thoughts.  I think Murder by Spreadsheet's a great meme--because it communicates in the way that advertising does at its most effective.  Spreadsheet? It does have mental associations for the vast majority of Americans... with the accountants and "beancounters" who are the necessary bane of existence.  Kinda like lawyers.  Listen to the mutter in their minds... Damned beancounters.  Killin' babies by squeezin' 'nother cent out for the corporate bottom line.

          No, it's effective.  And it doesn't even define spreadsheet as evil--it's the tool that the murders are being done by.  

          "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

          by ogre on Wed Jan 17, 2007 at 10:04:34 AM PST

          [ Parent ]

          •  "kinda like lawyers." (0+ / 0-)

            accountability is "the necessary bane of existence".

            let's do infantalize a BIG middle-class of consumer/patients hanging on to employer-based insurance by their finger nails.

            murder: the adversarial impulse more "effective", more stimulating, than the explaining the common goal of single-payer health care.

            will that message convey "warm and fuzzy" single-payer benefits? not that i can imagine, not in any ad agency i've ever worked. not in any focus group i've ever designed or observed.

            but it is frightening! yeah. that's the ticket. another "meme" of our times. let's shout from the mountain top:

            let's get the bastards!

            now, about single-payer health care. you were sayin ...?

            Diversity is the key to economic and political evolution.

            by MarketTrustee on Wed Jan 17, 2007 at 11:59:48 AM PST

            [ Parent ]

    •  Simple empirical argument + legislation: (2+ / 0-)
      Recommended by:
      katiebird, MarketTrustee

      Medicare for All (H.R. #whatever). Extending eligibility to everyone using a proven system with existing infrastructure and an overhead of approximately 3%, when it replaces the current system of rationed partial insurance with 31% overhead should save over 25% of the national healthcare budget (did someone say $2 Trillion). I think that is compelling.
      If the inherent conflict between health insurers and their shareholders on one side, and patients and providers on the other isn't convincing, there is the simple actuarial logic of spreading the costs and risk among the largest pool to create the most efficient solution to the problem of keeping the nation healthy.  Spreadsheets are the natural friends of single-payer solutions, and think about all the columns you can save....

  •  The mean nation (9+ / 0-)

    As I've grown older I've begun to realize a thing or two. America is, arguably, touted as one of the greastest countries on the planet and one of the best places to live. You'll hear that spewed at you directly or indirectly by the MSM, the government and a sizeable percentage of the US population. But increasing I see America as just plain mean spirited. This above diary is an example of what I'm talking about. There is no concern for people anymore, only profit. I realize that commercial profit is necessary for the well being of any country, but American corporations have hit new lows in their attempt to wring every last dollar from the people they are supposed to serve. And the mean-spritedness is everywhere. The medical industry, the communications industry, the entertainment industry, the energy industry and more. Everywhere you turn profit takes precedence over humanity. That isn't to say that big business isn't aware of the fact that we want something better and more human. They spend billions on advertisements that show us beautiful, happy, healty well off people in them. They KNOW this is what we really want and try to make us believe that if you buy item A instead of B, then you can have it. What a joke, what a fraud. It's funny that whenever I see or hear American corporations implying that they like us, respect us, and are on our side I think of that song "Smiling Faces Sometimes" http://en.wikipedia.org/...
    It's the most accurate description of corporate America I can think of.

    The greatest threat to personal freedom comes from ones own government.

    by Mark701 on Wed Jan 17, 2007 at 07:32:18 AM PST

  •  the slide into the current Healthcare Crisis (5+ / 0-)

    coincided with the systematic assault on union workers.

  •  It's just like war (5+ / 0-)

    Profit, money (lots and lots of money) is the motive. Not peace, not health, not happiness. Just money. And people are dying in Iraq so the war machine can make several hundred percent profits and people are dying all around us for lack of adequate health care becuase of...money. Meanwhile, the insurance companies just rake it all in.
    For profit health cannot work. For profit war cannot work.
    I am tired of those who say, well, that's what this country is about - profit! No, no it's not. It's about us "tired, poor, huddled masses yearning to breathe free" and helping each other in that struggle.
    Everything I see about insurance companies makes me ill. They are inefficient, wasteful behemoths. There are so many layers of people with their hands out for cash (like the new Health Insurance Savings Accounts - what bull) that it rarely trickles to where it's needed. And there's so much paperwork involved that it's created its own industry. What a waste of time and effort and resources. Plus, it's wide open to fraud.
    We need to stop the war mongers and save the people.

    All Truth is non-partisan

    by MA Liberal on Wed Jan 17, 2007 at 07:56:57 AM PST

    •  Yes! Milton Friedman and other economists (2+ / 0-)
      Recommended by:
      nyceve, MA Liberal

      who preach that everything will be for the best if we only let Return On Investment stand in as proxy for every other good, have been very well funded by wealthy corporations. ROI instead of health, ROI instead of national security, ROI instead of any actual moral value.

      But why should that be so? Why, especially when the evidence is that the acid corrosion of ROI-uber-alles actually damages the values the United States constitution was written to secure?

  •  Insurers are thugs and criminals (5+ / 0-)

    It's like going to the doctor and having some of Tony Soprano's meanest and ugliest people waiting there to shake you down.

    Except they wear dress casual clothing and talk in soothing voices, so that we don't see them for the murderers they are.

    Great diary.

    I'm not part of a redneck agenda - Green Day

    by eugene on Wed Jan 17, 2007 at 08:14:12 AM PST

  •  Regrettably (2+ / 0-)
    Recommended by:
    nyceve, means are the ends

    some profits had to be made. (We wanted to do it just for charity).

    -- Signed, the Insurance Industry

    X O X

  •  anyone with an IQ above room temperature, (0+ / 0-)

    and a passing knowledge of the insurance industry (which exempts most politicians and "single payer advocates"), will know that the administrative cost of handing individual and small group policies is far greater as a percent of premium than it is for a large policy, where those expenses can be leveraged over a larger premium base.

    The only thing a minimum loss ratio is going to do, is force insurers like Wellpoint who focus on individual and small groups to leave the market...

    ...Leaving even more people without health insulation options (note I said insulation not insurance, as the vast majority of what people spend on health coverage fails the basic test of insurance).

    Unintended consequence.

    Hard core Libertarian: +6.63 / -4.41

    by jimsaco on Wed Jan 17, 2007 at 08:50:55 AM PST

    •  BS (1+ / 0-)
      Recommended by:
      nyceve

      the administrative cost of handing individual and small group policies is far greater as a percent of premium than it is for a large policy

      These policies are boilerplate with just some numbers flexed. The claims are the same cost to process no matter the size of the plan. It's the constant denials and appeal of denials that raise the cost.

      And the golden parachutes and the new office building campuses, etc etc etc

      I'm not ready to make nice, I'm not ready to back down, I'm still mad as hell... Dixie Chicks

      by UndercoverRxer on Wed Jan 17, 2007 at 08:56:36 AM PST

      [ Parent ]

      •  False. (0+ / 0-)

        "Constant denials" - false.  The vast majority of claims are approved, usually without question.  How many claims are denied or deferred into infinity in Paradise Canada.

        "Golden parachutes and new office buildings" -- eliminate All the administrative expense -- all of it -- and you will lower health spending by 1% of GDP. One percent.

        Hard core Libertarian: +6.63 / -4.41

        by jimsaco on Wed Jan 17, 2007 at 10:57:53 AM PST

        [ Parent ]

        •  How misleading can you get? (0+ / 0-)

          you will lower health spending by 1% of GDP

          Even if I were accept your understatement of the cost of insurance administration, your decision to couch it in terms of GDP shows a serious lack of integrity in your method of presentation.

          Democrats: Giving you a government that works.

          by freelunch on Wed Jan 17, 2007 at 11:37:20 AM PST

          [ Parent ]

          •  how, exactly? (0+ / 0-)

            If health care is 15% of GDP, how is it inaccurate to express admin expenses as a percent of GDP.  Using Eve's numbers, it is 2%, which I think is on the high end.  

            Fine.  I'll give you 2%.  So you're still best case at 13% GDP.  Until you of course start denying and deferring treatments, which will happen with great frequency under any single payer scheme.

            As I have said here before, the fact that no single payer advocate here even remotely acknowledges that care will be rationed under a single payer system (as it is now), and that not everything will be covered, and that things will be denied with some frequency, simply illustrates the unreality of the health care discussion here.

            Hard core Libertarian: +6.63 / -4.41

            by jimsaco on Wed Jan 17, 2007 at 12:22:55 PM PST

            [ Parent ]

            •  Why assume denial of treatment? (1+ / 0-)
              Recommended by:
              kck

              Care is rationed today. You know it. The problem is the way it is rationed. I support explicit coverage limits based on the value of the treatment and the money available in the pool -- similar to the method Oregon uses. What we should not tolerate is the arbitrary rejection of appropriate medical care based on the whim of an insurance company or the lack of ability to pay for any health care.

              What causes you to think that rationing will become more severe with more money (10% or more, your misleading 1%) available for payment of treatments and fewer people seeking inappropriate treatment at emergency centers or putting off treatment until it is more expensive?

              Democrats: Giving you a government that works.

              by freelunch on Wed Jan 17, 2007 at 12:44:01 PM PST

              [ Parent ]

    •  Single Payer = One Huge Group (5+ / 0-)

      If the larger groups have lower administrative costs then the largest group, residents of the United States, would have the lowest costs of all, wouldn't they? Two of the lowest admin costs today are Medicare and VA.

      Wellpoint and the other Blues that were converted to for-profit companies, to the profit of their executives, had years of special tax treatment. Many things happened to the Blue Cross and Blue Shield plans to make them change, but the worst began when community rating lost its lead role in pricing.

      Democrats: Giving you a government that works.

      by freelunch on Wed Jan 17, 2007 at 09:17:45 AM PST

      [ Parent ]

  •  Excellent diary, Nyceve. Death by spreadsheet! (2+ / 0-)
    Recommended by:
    nyceve, means are the ends

    Death by spreadsheet is the essence here isn't it. Get's you focused on the real tangibles - infants, mothers, families, Americans. Very effective focus. I sure would love access to the spreadsheets...

    I think that PNHP has done the business case for UHC/SP but haven't been able to find actual numbers. If you come across them please share.

    Thanks so much. You're a great writer.    

    > 518,000 American children are in foster care. Got any bandwidth?

    by kck on Wed Jan 17, 2007 at 09:13:20 AM PST

  •  I posted part of this as a Comment but I think (0+ / 0-)

    everyone should have a chance to read it.

    If you think Single Payer is better than Socialized Medicine, then that should mean that you would like to see the Current Social Security System replaced with one where you had to buy "Old Age Insurance" from some one.

    Do you think your benefits would go up or go down.

    And on top of that Single Payer pretends to offer more than it delivers.

    It ignores the fact that while there might be one single payer, that payer would be paying admin costs and profit for

    Testing Labs
    Hospital, and
    Excessive wages for Doctors

    as well as over paying for the price of drugs.

    If we ran Socialized Retirement like we run Privatized Health Care and like we want to run Single Payer Health Care, very little would "trickle down" to the intended recipient.

    The Dirty Word shouldn't be Socialized Medicine, it should be Single Payer.

    •  You appear to be poorly informed here (1+ / 0-)
      Recommended by:
      kck

      By the way, the taxes you pay in payroll taxes are already called old age, survivors, and disability insurance.

      The problems of administrative cost are primarily from the health insurers. Part of the cost is borne by providers who have to hire additional staff to make claims that meet insurers specs. Staff-model HMOs don't have this problem.

      Democrats: Giving you a government that works.

      by freelunch on Wed Jan 17, 2007 at 10:26:41 AM PST

      [ Parent ]

      •  Not really (0+ / 0-)

        You are right it is called OASDHI from the name of the Act in 1933 whichh created it but there is no insurance company in the system

        As regards the insurance companies being the biggest scammers, I imagine that is true

        But

        Testing labs are also in the picture and they make a profit and they reduce cost and maximize profit by not investing in new testing equipment and by running old outdated testing procedures instead of newer up to date ones. And they save further by hiring minimum wage people to run  the tests and the bottom line is that if you go to a hospital with chest pain and some one runs Troponin I on you it will no doubt come back "okay" because virtually no lab is currently using a 5 year old test that has ten times the sensitivty of the 15 year old test they are using.

        The result is if you are really having heart related chest pain you will not know it and will therefor die very contentedly - thinking you are "okay".

        Also the Hospitals themselves make a profit and they do weird stuff to maximizze that profit and all of that is detrimental to good health care and increases the cost

        And doctors make far more money than they would if they did not ration the supply of Doctors and that raises the cost too and all these are sucking off the same cow as the Insurance companies.

        People who think Single Payer is a the answer are the ones who are misinformed.

        Single Payer preserves all the cost and inefficiency except that caused by the Insurance companies.

        •  You might have an argument (0+ / 0-)

          If it wasn't for the fact that 28 of the 30 countries included in OECD reports have single payer systems, often with optional private insurance, and every single one has lower costs and better outcomes than the US. We pay over twice the average of other countries for outcomes that don't even get into the top 30--we rank close to Cuba.

          See http://www.oecd.org/... for an overview of the real facts.

          "Our lives begin to end the day we become silent about the things that matter." Dr. ML King, from a jail cell in Birmingham, Alabama in 1963.

          by bewert on Wed Jan 17, 2007 at 02:28:52 PM PST

          [ Parent ]

          •  You are exactly right (0+ / 0-)

            on the performance of the European Health Care systems and just going to a single payer will improve both costs and quality of service.

            But the Europeans  and Canada and Japan are unhappy with the cost situation and are looking for ways to cut down even though they are far less expensive than we are.

            I believe they will ultimately adopt a system like our VA system where the government owns the hospitals and the labs and hires the personnel.

            If it is going to be human right they must provide it and if they must provide it, it only makes sense to provide it in the most cost effective way possible.

            That is 100% Socialized Medicine - No Profit Centers whatever, One set of Admin costs not 4 or 5. Huge leverage with big Pharma.

            If Europe must move this way and I believe they must, it would be silly for us to get to the same place in two steps.  better to go all the way and lead the way.

            After all this is the greatest country in the entire history of the world.

            We should treat our citizens far better than we do.

  •  Correction (4+ / 0-)
    Recommended by:
    katiebird, nyceve, Ari Mistral, kck

    Murder by spreadsheet is legal in the United States of America.

    Remember, these are corporations.

    So this should read:

    Murder by spreadsheet is mandatory in the United States of America.

    Corporations are supposed to follow the law.  But the most fundamental legal requirement--the one that really leans on the directors and senior management of any corporation--is their legal obligation to maximize profits (and shareholder value).  The latter's sort of nominal in most cases, since it's rare for any shareholder to complain about obscene profits, even if a cold analysis would suggest that there's long term damage to the value of their stock that's taking place.

    Not just legal, but obligatory.  Corporations are obliged to make the maximum profit out of your health care dollar, and as a result, Murder By Spreadsheet is effectively mandatory.  

    "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

    by ogre on Wed Jan 17, 2007 at 09:39:39 AM PST

    •  Wow. Wow. This comment is stunning. (1+ / 0-)
      Recommended by:
      nyceve

      Even in a diary like this that was stunning in the first place.

      Eat 4 Today: Defeating Republicans through diet and exercise!

      by katiebird on Wed Jan 17, 2007 at 09:46:24 AM PST

      [ Parent ]

      •  Katie, which comment exactly . . . (0+ / 0-)

        is a wow wow?

        Thanks. Eve

        •  Unless katiebird's comment (1+ / 0-)
          Recommended by:
          nyceve

          got attached to the wrong parent (happens to all of us, now and then.  You look up at the hand you're holding and gasp, you're not my mommy!)... that would be mine.  Observing that Murder by Spreadsheet is mandatory, by law, at least for for-profit corporations.

          "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

          by ogre on Wed Jan 17, 2007 at 10:13:01 AM PST

          [ Parent ]

        •  Murder by Spreadsheet is mandatory, by law (2+ / 0-)
          Recommended by:
          nyceve, kck

          That Murder by Spreadsheet is mandatory, by law -- it's an incredible climax to your diary.

          And reading it was like a bullet through my heart.

          I should have quoted it, but I'm not functioning very well (It turns out, I've got a "true sinus infection" and it's making me sort of stupid)

          I almost thought of this myself though when someone commented on one of the Health Care diaries that people are investing in other peoples' illness.  But it didn't jell for me until I read ogre's comment here.

          Are we ready to raise the rabble yet?

          Eat 4 Today: Defeating Republicans through diet and exercise!

          by katiebird on Wed Jan 17, 2007 at 10:33:23 AM PST

          [ Parent ]

          •  A bit of an exaggeration (1+ / 0-)
            Recommended by:
            kck

            The board of directors and executives and employees of a business have a duty to do what is in the best interests of the shareholders. Clearly, killing your customers and getting a reputation for doing so is not in the best interest of the shareholders.

            Ted Kennedy may have made a big mistake in shielding insurers from direct lawsuits, but these insurers are still regulated in every state that they do business in. If you have a problem with any insurance company and don't know how to contact your insurance regulatory body, you can start at the NAIC's list. Generally, phone calls tend to be faster and more convenient for followup, but writing down the problem you have is helpful.

            Democrats: Giving you a government that works.

            by freelunch on Wed Jan 17, 2007 at 10:56:17 AM PST

            [ Parent ]

            •  When people are defined as uninsurable.... (0+ / 0-)

              When people are defined as uninsurable, it's generally because they are considered to be at risk for illness.

              I assumed that was the point of this phrase -- that some people die because of lack of affordable insurance or because the out of pocket expenses are more than they can imagine spending.

              And, by the way, sick people and their families are often so absorbed in the health battle, they don't have time to take on the additional legal fights.

              Is there another reason besides "spreadsheet" reasons that result in people being denied insurance.

              I honestly don't think the phrase "Murder by Spreadsheet is mandatory, by law" is an exageration.  Otherwise wouldn't everyone get the insurance they apply for?

              Eat 4 Today: Defeating Republicans through diet and exercise!

              by katiebird on Wed Jan 17, 2007 at 11:11:59 AM PST

              [ Parent ]

              •  Affordability is a separate problem (0+ / 0-)

                As far as I am aware, all states have a pool for people who cannot otherwise get health coverage. It is not cheap, but it is generally subsidized by the other insurers in the state.

                Yes, it makes a lot more sense to have a tax funded program to deal with this, but the cost of health care is beyond the ability of many to deal with, no matter how hard the insurers try to be accomodating. This is a political issue.

                Democrats: Giving you a government that works.

                by freelunch on Wed Jan 17, 2007 at 11:45:53 AM PST

                [ Parent ]

                •  I don't know what you mean. Sorry. (0+ / 0-)

                  I've got a sinus infection and I think it's making me stupid.  Because I don't know what you're talking about.  

                  Eat 4 Today: Defeating Republicans through diet and exercise!

                  by katiebird on Wed Jan 17, 2007 at 11:48:31 AM PST

                  [ Parent ]

                  •  As the example that follows shows (0+ / 0-)

                    It is technically possible to buy insurance no matter who or where you are, but if you have problems the insurance price will be shockingly high or include exclusions for prior conditions that make it uneconomic.

                    Insurance companies don't write new insurance to folks who live on a barrier island 6 hours before the hurricane hits, either. It's not insurance at that point.

                    Single payer isn't insurance, it's pooled costs.

                    Democrats: Giving you a government that works.

                    by freelunch on Wed Jan 17, 2007 at 12:36:28 PM PST

                    [ Parent ]

                    •  I still don't get how what I said was ... (0+ / 0-)

                      I still don't get how what I said was "A bit of an exaggeration"

                      Eat 4 Today: Defeating Republicans through diet and exercise!

                      by katiebird on Wed Jan 17, 2007 at 12:40:28 PM PST

                      [ Parent ]

                    •  Technically? (0+ / 0-)

                      Maybe.

                      But my son, who has literally no health problems and no health concerns that exist, was rejected.  He had a badly sprained foot this summer and was treated (chiropractic and ultrasound) to help the discomfort and to help the inflammation that was, briefly, "plantar fascitis."

                      That is it.  His entire health history of note, and literally the entire and complete extent of the cause of his rejection.

                      They didn't offer the insurance "uprated" to a higher premium.  They just rejected him.  Period.

                      Me, they accepted, though I have allergies and actually once sought a doctor's attention for them... and also get chiropractic treatments when my back's out of whack.

                      Our other son, who has even less health history... they still haven't responded about him.  At all.  No queries, nothing.  Just no response.  And the broker who was going to check... hasn't been heard from.  

                      Technically possible is practically meaningless.

                      "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

                      by ogre on Thu Jan 18, 2007 at 10:53:49 PM PST

                      [ Parent ]

                •  Really? (1+ / 0-)
                  Recommended by:
                  katiebird

                  I know a guy who is worth millions but can't get decent health insurance because he's self employed and has an insignificant heart issue. He's very healthy and he's waiting for military retirement health insurance to kick in.

                  He calculated that the blue X insurance he was offered was so expensive that he was much better off self insuring. He pays cash and goes to doctors that will give him a cash discount.

                  "It's the planet, stupid."

                  by FishOutofWater on Wed Jan 17, 2007 at 12:22:12 PM PST

                  [ Parent ]

            •  The point is that what you've written is accurate (0+ / 0-)

              and yet it re-obscures the salient point.

              And that is that the very nature of for-profit corporations is that they exist almost exclusively (legally speaking) for the purpose of doing what's in the interest of the shareholders.

              Which is defined as making more money, pretty much.

              Yes, you don't want to really foul your brand and damage long term income... but in practice, that's a tertiary concern.  If you can make a killing now, you take it and you pay the fines, apologize sorta...

              So making the extra money is obligatory unless it's demonstrably a VERY BAD thing to do to the corporation.  And for a health insurer... that's directly in contradiction with paying for necessary health care.

              Thus, in effect, murder by spreadsheet becomes mandatory--because if you don't, you'll injure profits, lose your job... or get sued for failing to meet your fiduciary responsibilities to the shareholders.

              "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

              by ogre on Thu Jan 18, 2007 at 09:26:00 PM PST

              [ Parent ]

      •  Thanks. (1+ / 0-)
        Recommended by:
        katiebird

        I've been a fan of single payer, universal health care for... years.  Reading nyceve's diaries rips my heart out... and then a few days ago, my very active, skinny, extremely healthy 12 year old son was rejected for coverage (completely rejected) over what was nothing more than a badly sprained foot (in August!) and treatment for that injury... and he's entirely healed and doing martial arts again.

        But this makes him a risk that Blue Shield won't even cover.

        So there's a very personal anger which is crystalline, sitting at the heart of my view these days.  I've seen the utter banal evil that our current system is.  I know the demon, and I'm going to name it as clearly as I can, in language as blunt and shocking as I can.

        "I desire what is good. Therefore, everyone who does not agree with me is a traitor." King George III

        by ogre on Wed Jan 17, 2007 at 10:10:33 AM PST

        [ Parent ]

  •  OPED ... OPED!!!! (3+ / 0-)
    Recommended by:
    nyceve, kck, means are the ends

    Nice Eve -- You bring a deep passion and knowledge to health issues. You move emotionally as well as educate and motivate.

    This one, in particular, screams out to me OPED in the MSM.  The title, alone, will get this published:

    MURDER BY SPREADSHEET

    I would hope that you will take the time to write 500-750 words and try to get this into the MSM.

    The Energy Conversation: Learn - Connect - Share - Participate: For a new dialogue on Energy issues.

    by A Siegel on Wed Jan 17, 2007 at 09:44:37 AM PST

    •  A Siegel, great idea . . . (1+ / 0-)
      Recommended by:
      A Siegel

      But I should live to see the day the MSM would publish something like this.

      They read Kos, they could contact me, they ain't interested--they have big insurance and big pharma as advertisers.

      •  Actually ... (1+ / 0-)
        Recommended by:
        kck

        I would disagree with you on this ... You might not be able to break down the doors into the NYTimes but there are many newspapers around the country and in the NYC area.

        And, I do not consider true the "They read Kos, they could contact me, they ain't interested ..."  Unless you are a BIG name, it is very rare in my experience for editors to seek out authors re an item.  I've published in The Washington Post, USA Today, other papers (national/local -- such as DC Examiner:  : McLean’s rich and famous also get tax advantages) and otherwise (something like over 40 newspapers and journals with 100s of items). I don't recall, at this moment, ever receiving a "I saw your item there, would your write something for me" cold call. Now, I'm no Rich nor Albright nor X, but I do publish a bunch.

        I do not think this would be that hard to take to get published in some paper/such ...

        I think that this is workable into an OPED.  If you are not inclined to do so, if I have the time, I might try to do so for something in my area.  But, really, the idea and the 'catchy title' are yours to claim.

        The Energy Conversation: Learn - Connect - Share - Participate: For a new dialogue on Energy issues.

        by A Siegel on Wed Jan 17, 2007 at 12:14:26 PM PST

        [ Parent ]

  •  Let them buy insurance=let them eat cake. (5+ / 0-)
    Recommended by:
    katiebird, elfling, nyceve, Ari Mistral, kck

    Our gilded Political Class seems to have no clue what life is like for average Americans these days. When my husband was fired after 20 years of exemplary professional work, we got a great "deal" from COBRA, which covered our family's health insurance for only $1,000 a month! Wow, what a deal for a family with no income!

    We actually had savings with which to pay it (since we got screwed on severance, and couldn't use that). Then when COBRA ran out, and our insurer wasn't required to carry us, I was uninsurable! Wow, I really loved having no insurance for a few months! What a fantastic experience knowing every morning when I woke up that as my children's mother I could die or bankrupt the family. What adventure might happen that day?

    Kind of keeps life from getting boring, right?

    Somehow, I don't think that this happens to anyone in the Political Class. Or their families.
    So with what money are minimum wage workers supposed to buy their insurance? The same "extra" money they are using for their mythical (and let me tell you--confusing and difficult to use moneymaking insurance scam) health savings accounts?

    This system is so broken, and the national discussion about it is so dishonest and divorced from reality, that I often despair. Then I read another diary by you, Nyceve. Thank you.

    Brilliant diary, and brilliant, true framing of health care issues. Americans are being murdered by spreadsheet.

    We need a National Health Security Plan, or whatever you want to call it, and we need it now!

    Every day delayed is a day of death, despair and bankruptcy for more Americans.

    Thank you again. I leave you with this Murphy's Law corollary, called Andrew Young's Rule:

    Nothing is illegal if a hundred businessmen decide to do it.

    But we outnumber them. And it is time to get our country back.

  •  Just (2+ / 0-)
    Recommended by:
    katiebird, nyceve

    Just get rid of insurers all together. They do not belong in the equation of the doctor/patient. They are NOT NEEDED at all, they are just scum sucking middle men that take money and bring nothing to the patient.

    Every employer and every citizen should simply have a deduction into a huge pool like social security in which all bills are paid.  Every single american gets a card and simply shows uses it any hos healthcare provider.

    Of course this huge pool should ot be touchable or it will be raided like the ss pool was.  SS would be fine if the politicans didn't take the cash and leave worthless IOUs.

    If insurnace made fiscal sense on the whole, there would be no insurance industry.  They are just a bunch of evil middle men making a buck at the expense of people's lives.

    Generals gathered in their masses Just like witches at black masses.. Evil minds that plot destruction Sorcerers of deaths construction..........

    by pissedpatriot on Wed Jan 17, 2007 at 10:05:30 AM PST

  •  It is our fault! (0+ / 0-)

    We Americans don't take responsibility for ourselves. We don't take care of our health. We don't know how to take care of our health. We trust "authorities" such as the government and commercial entities to tell us what we need, what we should want in life.

    I mean, come on, we inject botulism into our bodies.

    We don't partcipate in our political system, but instead watch television.

    There is no civic spirit.

    This morning, on the local NPR station, they were talking about some big public issue, I forget what it was. They mentioned that the issue was moving out of the public sphere and into discussions in the halls of government. When did the halls of government stop being the public sphere? I'll tell you when... When Americans stopped visiting the halls of government: to observe, to pay attention, to make themselves heard.

    We got where we are today, not because Americans stopped giving a damn, but because Americans paid less and less attention. We care about the problems that plague our society, but we keep waiting for them to be solved by government or private industry, or in some cases the NGO sector.

    If Marx were alive today he wouldn't say that religion is the opiate of the masses, he'd have substituted the word "entertainment", instead. American Idol had a 21 rating last night. Sure, it's a good show, but I'm just sayin'...

  •  We really shouldn't be bitching to (0+ / 0-)

    each other about this horrible mess.

    We should be bitching to our representatives in the newly elected Congress

    Oops ! I forgot.

    Nancy says Health Care Reform is off the table.

    Wonder who she is representing?

  •  Gleevec (n/t) (0+ / 0-)

    For the scientifically anal, Gleevec is the trade name of imatinib mesilate, which targets the fusion product of BCR-ABL mutations found frequently in sufferers of Chronic Myelogenous Leukemia, so while there's a genetic component, anyone can get it.  I haven't seen much data exploring the genetic vs. environmental causes of CML, but my understanding is that it isn't a genetically targeted drug in that its better for particular people, but that its better for particular subsets of a disease.  That may only be different in my eyes, but when I see genetically targeted disease I imagine that its somehow personalized or only relevant to a small group, whereas gleevec is targeted at a fairly massive patient population.  The same is true of herceptin, although I don't know much about it.
    These drugs are expensive because of the patent system, not because the market is small.
    Chronic Mylogenous Leukemia

  •  murder, nyceve wrote (n/t) (0+ / 0-)

     

    It is amazing how much can be accomplished when you don't care who gets the credit - Harry Truman
    PoliticalCompass Scale: -2.13, -2.97

    by floundericiousMI on Wed Jan 17, 2007 at 11:19:47 AM PST

  •  We need to take the profit motive (1+ / 0-)
    Recommended by:
    katiebird

    out of health care.  There is just something wrong about hospitals being run by giant corporations who care more about the bottomline than about patients' wellbeing.

    I have no problem with doctors making money--they've put in long years of training,  end up with enormous debt by the time they finish,and incur more whent hey set up an office because of the necessity of purchasing equipment, etc.  

    U have problems with insurance companies who will allow you to pay for health insurance for years--then cancel as soon as you actually use more than the minimum amount for healthcare.  They make money  refusing to cover  their insured. Deregulation under Reagan is where it started,a nd it's responsible for much of the mess today.

    The last time we mixed religion and politics people got burned at the stake.

    by irishwitch on Wed Jan 17, 2007 at 11:24:13 AM PST

  •  I was just poking around (0+ / 0-)

    & I noticed that frequently salespeople get as much as a TEN PERCENT COMMISSION on medical accounts.  That's enough argument to nationalize it right there.  Health insurors maximize profits by avoiding "bad risks" (the human collateral of the business) and minimizing health care.  It's time for them to go.

    Prosperity ripened the principle of decay; the causes of destruction multiplied with the extent of conquest... Gibbon

    by Dinclusin on Wed Jan 17, 2007 at 11:28:01 AM PST

  •  Eve, I hate your diaries (1+ / 0-)
    Recommended by:
    3goldens

    I'm married to a physician who is completing her Fellowship in Pediatric Oncology and I hear the stories she tells me and I read the stories you write and I despair.

    You're so right on about what's wrong with our health care system.  And I feel like we've known this is what's wrong with our system for decades, but we don't do anything about it because of the money spent by the insurers and the money spent by the drug industry and all the money spent on buying the press and the money spent ridiculing sane proven solutions to our health care challenges.

    I hate your diaries because you're right and because I don't see how we get from here to where we need to be.

    Investigate now. Impeach later. Then Extradite. Then, something involving wolves...

    by nightsweat on Wed Jan 17, 2007 at 11:28:33 AM PST

    •  Liberal Doctors need to work with Dems (1+ / 0-)
      Recommended by:
      nightsweat

      To deliver health care for all.

      I'm starting to think that John Edwards is the presidential candidate who understands our health care problems the best. He knows the dark side and he knows what good doctors can do to save lives.

      And Elizabeth Edwards will make sure he does the right thing.

      "It's the planet, stupid."

      by FishOutofWater on Wed Jan 17, 2007 at 11:44:05 AM PST

      [ Parent ]

      •  Doctors don't always have much say (1+ / 0-)
        Recommended by:
        3goldens

        In a research setting, so much money is required from corporate donors and government programs that the administrators and grantors get too much influence over the process.

        I don't know that anyone in the field yet has the answer.

        Investigate now. Impeach later. Then Extradite. Then, something involving wolves...

        by nightsweat on Wed Jan 17, 2007 at 11:57:04 AM PST

        [ Parent ]

  •  You also won't qualify for a heart transplant (0+ / 0-)

    if you don't have health insurance.  Catch-22.

    Democrats give you the Bill of Rights; Republicans sell you a bill of goods!

    by barbwires on Wed Jan 17, 2007 at 11:51:02 AM PST

  •  where are the journalists (1+ / 0-)
    Recommended by:
    beemerr90s

    I thought this was a story for the journalists out there,then I realized they don't exist anymore.You better contact Jon Stewart and Keith Olbermann.They're the only ones in the mainstream that have the balls to run with a story like this.

  •  It's a lot more than Murder by Spreadsheet (2+ / 0-)
    Recommended by:
    katiebird, SarahLee

    It is murder by a Racketeer Influenced and Corrupt Organization and that brings it under the Organized Crime Control Act of 1970 or under what we famously now call the RICO Act.

    This is an Act that not only allows for prosecution of people commiting criminal acts, it allows for the confiscation of all the ill-gotten gains.

    Think about it.

    This ought to be enough money to fund Universal Health Care without any citizen input for the next 50 years.

    Fiat Justitia Ruat Coelum !

    Let justice be done though the Heavens may fall.

  •  More murder by spreadsheet (1+ / 0-)
    Recommended by:
    SarahLee

    A potentially life saving cancer drug that will not get research funds because it is not patentable. Fortunately it has already been approved for treating mitochondrial disorders. So maybe some doctors will prescribe it to their cancer patients anyways.

    http://www.ctv.ca/...

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