Obama: just another puppet

[wil]

Well I'd love to see it!

But I personally still can't do the math until I read the proposals

it must reduce costs, guarantee choice, and ensure quality care for every American

I can see two out of three...but no matter how I imagine it one has to go...

I work in construction we have three things. Cost, Quality and Schedule they have a symbiotic relationship...if you want it faster pick which one to suffer the budget or the quality...if you want higher quality the schedule will lengthen...if you want lower cost....

So I equate what I know to other things (I've built and renovated hospitals, nursing homes, emergency centers, doctors offices etc.) cost, choice, quality...seems I can apply the same issues.

But I've been wrong before and for my children's childrens sake I'd be happy to be wrong again.

[Avi]

Originally Posted by wil

I work in construction we have three things. Cost, Quality and Schedule they have a symbiotic relationship...if you want it faster pick which one to suffer the budget or the quality...if you want higher quality the schedule will lengthen...if you want lower cost....

Wil, there are many examples where, due to technical innovation, quality goes up and cost goes down (schedule may remain the same).

Actually, this was the basis of the quality movement of the 1970s-80s.

Remember when carburators were replaced by fuel injection ? !! How about your digital watch ?

[wil]

Originally Posted by Avi1223

Wil, there are many examples where, due to technical innovation, quality goes up and cost goes down (schedule may remain the same).

Actually, this was the basis of the quality movement of the 1970s-80s.

Remember when carburators were replaced by fuel injection ? !! How about your digital watch ?

To my understanding the reason for the increase in cost of health care in the US is the extensive R&D and technology. Those MRI machines don't come cheap, and we have more in South Dakota than Canada has in their nation. We demand the latest and the best.

Now one thing that could reduce health care costs is some changes to litigation, we get umpteen tests for everything because if the Doc doesn't do the test and he misses something we sue his pants off.

[path_of_one]

Two big problems I foresee with American culture and how it addresses health care is

1) The litigation. Health care is expensive here because we want our doctors to be gods and we sue at every available opportunity if they make an honest mistake. Since doctors are human beings, this means a very high malpractice insurance expense.

2) Lack of preventative care and personal responsibility. Americans are notoriously bad at eating poorly, not exercising, and then later wanting enormous amounts of medical coverage for the results of a lifetime of paying no attention to their own health.

Universal coverage that is high quality has a few features that would be quite different from Americans' expectations- first, it requires everyone to take care of their own health and preventative measures so that it keeps costs on expensive items (i.e., surgeries, hospital stays, etc.) down and second, that it doesn't usually cover experimental or above-and-beyond procedures. Basically, universal coverage is wonderful for low-cost quality care for the stuff most healthy people will face- infections, maternity, injury. However, it operates on a palliative model for those that are terminally ill or suffering from old age. It does not fight to the last, but rather operates on an acceptance that death happens at some point and some things are better to treat the suffering and not try to "fix" the problem. All that keeps cost down while providing much, much better rates overall of public health than we have in the States (i.e., lower infant, child, and maternal mortality rates and such). However, it operates on a different cultural perspective than we currently have- one in which the patient is primarily responsible for their own health (not the doctor) and that is quite unforgiving for patients that fail to take that responsibility. It also typically demedicalizes stuff that we currently hospitalize folks for- notably childbirth, which is typically done with midwives in birthing centers or at home in nations with universal coverage.

So... While I think the three items could go hand in hand, it would require a different cultural understanding of "quality care," recognizing this does not mean "care like we get now" or "use of hospitals and every lab test available" but rather "care that with my own work as a patient, will reduce overall mortality rates."

The statistics don't lie from universal care nations- they are far, far better than our own. But what it means is that you take care of public health and those that need expensive and particularly cutting edge surgery or drugs are on their own. You improve the health care system overall, but that doesn't mean every individual feels their own health care is better than it used to be.

And drat it- we'd have to actually start eating right and exercising. When I've gone to Europe in the nations with universal coverage, you notice that people generally are fit and healthy. We'd need to get with the program here- we have soaring health care costs in part because our lifestyles are awful for the human body. We eat junk, we sit around all day, we barely take any vacation time and stress our immune systems to the max by working incessantly. I am skeptical that any health care system will work cost-effectively in the States until people take responsibility for their own health and put some effort into it, and until we have supportive measures to reduce poverty. You have to remember that many of the universal coverage nations also offer free college education, longer and paid maternity leave, and mandatory 6 weeks of vacation a year, along with higher minimum wages. All of this contributes to a lower-stress, more time for family and healthy lifestyle environment we don't currently have.

Until the entire suite of cultural traits moves together in place to improve public health, I suspect the US will either deal with soaring health care costs or poor public health.

It's all pretty basic, really. There is no way to decrease health costs so long as you have serious issues with malpractice and no one wants to take responsibility for their health and deal with preventable disease early (many forms of cancer, heart disease, etc.).

[Vajradhara]

Namaste avi,

thank you for the post.

Originally Posted by Avi1223

.

So that is why I am surprised, don't some of you have faith that things can get better ?

what does faith have to do with anything?

more importantly, doesn't the whole idea of "get better" indicate some ideal goal wherein things (though how much of things the term "things" may apply to is unknown) have stopped changing, they've reached the end of the journey, so to speak.

i'm pretty sure that isn't how things work and everyone has a slightly different idea of better... i, for instance, would consider things to be better when monotheism is no longer present on our world system yet, for a great many other beings, such an event would constitute things being quite bad indeed.

to the thread:

there are many posts here that are making broad sweeping generalizations about whole swaths of people that are demonstrably incorrect. i suppose it is easier to speaking in generalities but the fact of the matter is we experience life in its specifics. i'm of the view that people should speak for themselves, their actions and thoughts and let others do the same.

metta,

~v

[Pathless]

Originally Posted by Avi1223

I received this e-mail from our President. He is telling us to get ready for Rush Limbaugh to give us a lot of lies about his plan. But I will support Obama

I heard Limbaugh spewing a lot of reactionary drivel over the airways today after Obama's speech regarding the situation with Congress and Guantanamo Bay. I also heard a good portion of Obama's actual speech and thought it commendable.

[Avi]

Originally Posted by Vajradhara

Namaste avi,

thank you for the post.

what does faith have to do with anything?

Hi Metta, thanks for bringing my attention to you question. I had an idea, but I do not think I did a good job explaining it clearly.

What I was trying to say is that the tone that I was reading on this thread was very pessimistic with respect to the future of the US and the world in general.

I was expressing my surprise at this because it seems to me that a group of people that participate in interfaith dialogue, likely have more faith than some other group. And I was wondering why this faith would not lead to some level of optimism ?

I think you are questioning my linkage of faith with optimism, and you are probably correct. On the other hand, if one believes that G-d is good, would that not be a reason for some optimism ?

more importantly, doesn't the whole idea of "get better" indicate some ideal goal wherein things (though how much of things the term "things" may apply to is unknown) have stopped changing, they've reached the end of the journey, so to speak.

I was referring to our situation, in the US, with respect to the economy, Iraq, and other areas which I hope will improve. But I think there are now similiar issues worldwide. I would hope we would always try to make things better, hence we would not reach the end of our journey.

i'm pretty sure that isn't how things work and everyone has a slightly different idea of better... i, for instance, would consider things to be better when monotheism is no longer present on our world system yet, for a great many other beings, such an event would constitute things being quite bad indeed.

It seems you are making a subjectivist type of argument. I like blue and you like red. But it seems to me that in an interfaith dialogue we might agree to respect each others views and perhaps try to understand them more deeply. I, for example, am interested in learning about the interface between religion and philosophy. I think many of the religions represented on this board have interesting philosophical connections as well. In some cases I know little about them and would like to learn more.

[citizenzen]

Originally Posted by Pathless

I heard Limbaugh spewing a lot of reactionary drivel over the airways today after Obama's speech regarding the situation with Congress and Guantanamo Bay. I also heard a good portion of Obama's actual speech and thought it commendable.

It's a very common thing to be lambasted for espousing high ideals... or even merely humane ones.

It has occurred many time in this forum, whose members I hold in higher regard than the oxytocin-popping, gasbag Rush Limbaugh.

So I can't say I'm terribly surprised.

[seattlegal]

Freudean slip?

Originally Posted by citizenzen

It has occurred many time in this forum, whose members I hold in higher regard than the oxytocin-popping, gasbag Rush Limbaugh.

You do mean OxyContin, instead of oxytocin, right?

{Please forgive me, I just had to laugh when I read this.}

[citizenzen]

Originally Posted by seattlegal

Freudean slip?

You do mean OxyContin, instead of oxytocin, right?

{Please forgive me, I just had to laugh when I read this.}

Actually I probably should have Googled it before pulling it out from my behind like that.

Thank you for the correction. Now I'll have to look up what oxytocin is.

If it helps with erectile dysfunction I'm sure Rush swills that as well.

[citizenzen]

SG, I looked up oxytocin and found this...

"It is best known for its roles in female reproduction: it is released in large amounts after distension of the cervix and vagina during labor..."

I'd say that fits Limbaugh's condition perfectly, but I'm afraid a mod will not look at that kindly... so I'd better just keep it in the vault.

[path_of_one]

Originally Posted by Vajradhara

more importantly, doesn't the whole idea of "get better" indicate some ideal goal wherein things (though how much of things the term "things" may apply to is unknown) have stopped changing, they've reached the end of the journey, so to speak.

To me, getting better is when things do not cause people so much suffering. I never really think about stopping changing as much as moving toward a state where less people are lacking what would fulfill their basic needs and more people can love one another and find peace.

there are many posts here that are making broad sweeping generalizations about whole swaths of people that are demonstrably incorrect.

I am generalizing, but they are generalizations mostly backed by research and statistics. For example, I generalize that Americans do not, on the whole, care for their health as would be needed to lower health care costs. But this is demonstrated by our rates of obesity, rates of television viewing compared to rates of exercise, etc. I am summarizing what is known and verified in public health circles. They may be generalizations and I agree would be rather pessimistic, but they are not unfounded. Of course, any generalization will have plenty of exceptions, but there are many choices that can be statistically observed in a society.

i suppose it is easier to speaking in generalities but the fact of the matter is we experience life in its specifics. i'm of the view that people should speak for themselves, their actions and thoughts and let others do the same.

How would we ever discuss or generate policy without any statistical generalities? I realize every one of us has a unique life that we experience in its detail, and no other, but at the same time, politics is about how to deal with generalities. I am unclear how a government or policy could work without movement from individual life to group patterns.

[seattlegal]

Originally Posted by citizenzen

SG, I looked up oxytocin and found this...

"It is best known for its roles in female reproduction: it is released in large amounts after distension of the cervix and vagina during labor..."

I'd say that fits Limbaugh's condition perfectly, but I'm afraid a mod will not look at that kindly... so I'd better just keep it in the vault.

Why did you think I had to laugh?

[wil]

Great speech on the closing of Gitmo yesterday...

[Vajradhara]

Namaste Avi,

thank you for the post.

metta is a Pali word which means, roughly, "with loving kindness" and is my signature, so to speak. you call me V or v or vajra or anything along those lines

Originally Posted by Avi1223

What I was trying to say is that the tone that I was reading on this thread was very pessimistic with respect to the future of the US and the world in general.

I was expressing my surprise at this because it seems to me that a group of people that participate in interfaith dialogue, likely have more faith than some other group. And I was wondering why this faith would not lead to some level of optimism ?

i suppose that i don't see the connection betwixt faith and optimism, per se. there are a great many religions, most of the monotheistic ones, that envision a world wherein everything pretty much ends in destruction and death for all but a select group, such a view strikes me as inherently pessimistic yet that outcome is views optimistically by those same groups.

I think you are questioning my linkage of faith with optimism, and you are probably correct. On the other hand, if one believes that G-d is good, would that not be a reason for some optimism ?

i tend to think that there needs to be more context to see if such a view would, in and of itself, generate optimism on anything but a personal level.... which is pretty much what we're talking about.

I was referring to our situation, in the US, with respect to the economy, Iraq, and other areas which I hope will improve. But I think there are now similiar issues worldwide. I would hope we would always try to make things better, hence we would not reach the end of our journey.

i tend to view things cyclically and history seems to bear it out that things flow in waxing and waneing episodes, societies florish, fade and florish again. you're touching something here which i'll address a further down the post.

It seems you are making a subjectivist type of argument. I like blue and you like red. But it seems to me that in an interfaith dialogue we might agree to respect each others views and perhaps try to understand them more deeply. I, for example, am interested in learning about the interface between religion and philosophy. I think many of the religions represented on this board have interesting philosophical connections as well. In some cases I know little about them and would like to learn more.

the idea of "things getting better" as a linear path through history from "terrible ancient past to not so good recent past to well it's not so bad now to it'll be great in the future" is a by-product of Greek philosophical thought and isn't found explicated in the same manner in other philosophical traditions. my own view, as mentioned, is one of cycles and there doesn't seem to be too much value in hoping for the upturn and lamenting the downturn.

in terms of my subjective argument, whilst we can certainly agree or disagree or agree to disagree about aspects of philsophy or religion the idea of "getting better" is intimately tied into such notions and certainly requires us to have a common framework which we can work within and meaningfully communicate.

let's use your example here... you like blue and i like red. when "things get better" in your view that means that there are more blue things. that doesn't make them better for me... that makes them worse. more red things makes them better for me. we can agree that you having blue things and me having red things make us both happy and, to that extent, i would make some of my red things blue for, ultimately, i would like all sentient beings to be happy. so i would make things worse for me to make things better for you.

does that make things better, overall?

metta,

~v