NHS is the world's best healthcare system, report says

[barbos]

There is no cure to my type of lymphoma yet I am not "slowly dying". Because it can be treated and current treatments provide the result of extended remission every single time it reoccurs or resurges. None of that was ever compromised by "treating smokers" and target research on lung cancers.

Are you in wheelchair? cause that's what MS patients quickly get. And they get it pretty young, around 30,unlike cancers which is over 50

I see that you have NOT addressed this :

You will then need to explain to me how France can pursue target research on gene mutation and testing and with great success considering such research facilitates personalized cancer care, yet will still meet the needs of our medically needy population without having to redirect funds from "treatments" towards supporting such costly target research.

Should I expect a continuous *sound of crickets*?

what is there to explain?

 

[Togo]

Yes, if there were no smokers to treat there would be more money for other uses including research into MS.
that's a simple mathematical fact.

It's not simple. Tobacco consumption is one of the most heavily taxed activities on the planet. Remove all the smokers, and your revenue goes down by more than smokers cost to treat. You'd need to raise the same money some other way. And without smokers, we'd still have lung cancer. It would just be rarer.

 

[Sabine Grant]

Are you in wheelchair? cause that's what MS patients quickly get. And they get it pretty young, around 30,unlike cancers which is over 50

1) you did not read the previous link from the Mayo clinic I had provided for the purpose of correcting the specific of " are (very) slowly dying" in your claim,

And yes, MS has no cure and patients are (very) slowly dying.

Maybe this shorter summary regarding MS patients survival rates will be more accessible to you :

http://www.healthline.com/health-slideshow/multiple-sclerosis-prognosis-and-life-expectancy :

However, there is good news about life expectancy. According to the Multiple Sclerosis Foundation (MSF), MS is not a fatal disease. In fact, those with the condition have essentially the same life expectancy as the general population.

2) Further, "have no cure" does not equate "slowly dying off ". That is why I brought up my type of lymphoma. It is not curable YET does not mean a terminal prognosis. There is a variety of conditions which are not curable YET do not equate " slowly dying off" whether it is " (very) slowly" or not "(very) slowly".

3)

Are you in wheelchair? cause that's what MS patients quickly get.

Being in a wheelchair does not equate " (very) slowly dying off". The fact that some MS patients will be wheelchair bound does not equate "they are (very) slowly dying off". " "dying off" whether slowly or rapidly applies to patients affected by conditions meeting a terminal prognosis. Which is NOT the case for MS patients.

4)

unlike cancers which is over 50

Have you ever heard of the term "pediatric oncology"? I have to also wonder about half of the patients being in the treatment room where I am currently getting infusions not being "over 50".

I see that you have NOT addressed this :

You will then need to explain to me how France can pursue target research on gene mutation and testing and with great success considering such research facilitates personalized cancer care, yet will still meet the needs of our medically needy population without having to redirect funds from "treatments" towards supporting such costly target research.

Should I expect a continuous *sound of crickets*?

what is there to explain?

You are the party who has some explaining to do in view of :

Well, it is quite true that as you launched into remarks specifically focusing on cost, "treatment of smokers" in direct relation to lung cancer versus "research", you polarized on one single cost factor related to health care. Meanwhile, you appear to think that expenditures related to medical treatments deplete funds dedicated to medical research. You will then need to explain to me how France can pursue target research on gene mutation and testing and with great success considering such research facilitates personalized cancer care, yet will still meet the needs of our medically needy population without having to redirect funds from "treatments" towards supporting such costly target research.

Was it not your contention,

The point was about resources which are limited no matter what. Imagine slowly dying from MS while money go into lung cancer research.

All that money which go to treatment of smokers could have gone into research for other non-stupidity caused diseases like MS and other cancers.

I presented the case of a single payer nation, France. Was specific about the high cost of gene mutation research and testing which is no way impaired by "treatments for smokers" in relation to lung cancer and research on lung cancer. Which you still are not addressing.

Oh and I stand firm by having demonstrated the implications (which I believe you did not foresee) when you stated :

All that money which go to treatment of smokers could have gone into research for other non-stupidity caused diseases like MS and other cancers.

 

[untermensche]

Quibbles about the specifics can go on endlessly.

But in the civilized world one thing is clear.

You have the US with it's for-profit approach that leaves millions uninsured. And you have just about everyone else.

Either the US is right, or the consensus of the rest of the world is.

 

[PyramidHead]

Quibbles about the specifics can go on endlessly.

But in the civilized world one thing is clear.

You have the US with it's for-profit approach that leaves millions uninsured. And you have just about everyone else.

Either the US is right, or the consensus of the rest of the world is.

untermensche wins the thread.

 

[doubtingt]

I am a health care worker[/U] and somehow I have managed to never make any distinctions between medically needy persons based on whether they caused their condition. They are medically needy, that's it. The need is there and has to be met. Medical needs will be better met in a nation with a single payer system where financially based discrimination has been eliminated. The more medically needy, the more access.

Yeah, you are paid to treat people, regardless of whether their problem is misfortune or self-inflicted via indulgence. So, I would hope you would do your paid job and treat them all.

You have no insights in my private life therefor you are in NO position to assume that I have not made choices to provide pro bono services to home bound folks needy of the services of a certified HHA.Again and standing by what I stated : I do not make distinctions based on whether such needy persons have caused their health related predicament or if tgheisr situation is the result of misfortunes. Again, there is a need, I meet it. Clear enough? And you need to know that I am certainly not alone among certified, licensed and registered health care personnel who will provide pro bono services to medically needy persons.

I made no such assumption that you don't provide pro-bono services.

To my stating I make no distinction, you immediately assumed that the "no distinction" has to do with my work ethics while you totally missed the point that contrary to you, there is no mental and emotional process on my part which engages in evaluating whether a medically person deserves my assistance.

You said that as "a healthcare worker" you make no distinction, and since "worker" strongly implies paid services it was beyond reasonable for me to point out that when providing the services you are paid to provide as part of your work, you are obligated to provide paid services without making a distinction is the cause for the needed services.

I merely stated that as a paid healthcare worker, you are obligated to provide all paid for services, regardless of the underlying cause of the problems being treated. That in no way suggests you don't treat people without getting any pay and covering all expenses yourself or via a charity

And I am telling you again that even without being paid, I do NOT dwell on whether a medically needy person deserves my assistance. Again, if there is a need, I will meet it.

Don't pretend you are "telling [me] again", when you did not state to begin with that you meant "without being paid", but in fact strongly implied that you meant as part of your paid employment, thus the word "worker". You only claimed that you meant pro-bono services after I pointed out that paid work requires you to ignore the distinction. You accused me of making assumptions about your life and I am just pointing out that all I did was make the most reasonable interpretation of what you actually said, and if you meant something different then the fault lies with your objectively poor and misleading initial phrasing that would imply to most people that you were referring to what you do as part of your employment.

(which is what I hope you mean by pro-bono and not that you steal from your employer by providing services at their expense on time they are paying you for).

Totally inappropriate passive aggressive crap.

Nothing inappropriate or passive aggressive about it since I did not imply that you did these things, but since you've shown a tendency of poorly conveying what you are referring to and how these acts relate to your "work", I was just clarifying that you meant actual charity on your own time completely outside of what your employer expects you to do. What is inappropriate are your efforts to pretend that my response to your initial comments requires some outrageous assumption on my part totally disconnected from what you said, when in fact my response was based upon the most reasonable interpretation of what you said.

Yes they do, because contrary to your naive fantasyland there is a finite limit to public resources that can be used to help the suffering and every choice to help someone is a defacto choice not to help some others.

My "naive and fantasyland" would be my country of origin and citizenship, France, with a single payer system since 1945 and where the more medically needy, the more access and that without dwelling on whether our medically needy French caused their predicament via "indulgences".

No, your naïve fantasyland is created in your head by your denial of the reality that in France and every single NHC system choices are made that determine the quality of care and cause suffering of people on the wrong side of that choice. Giving more care to the “medically needy” is such a choice. It means that there are millions of people who do not get treatment that would improve their health and well being because it is not deemed “needy” enough. Are you claiming that not a single person in France would in any way have better health if the pool of resources was increased? Are you claiming that no one would be helped if France increased funding of any health related research? Because these are what your position logically presumes. Not to mention there are the finite public resources used for things that impact health but not via healthcare system. For example, there is waste-water treatment, something which France is one of the worst in Europe. The high cost to the finite public funds from the UHC system reduces what is available for water-waste and countless other factors that would improve the health of all people. So, like I said, your choice to support the France system is a choice that causes others to suffer who could otherwise benefit from the resources that you prefer be spent in a different way. Contrary to your objectively wrong quote that started this exchange what really is “that simple” is the fact that every act of using public resources to help one person, harms other people that could have benefitted from those resources. All that is required for this truism is that resources are finite.

Would be "naive" MSF physicians and nurses who volunteer their skills in Sub Sahara Africa ,treating over 300.000 HIV sero positive individuals. Individuals who got contaminated due to the prevalent vector of unprotected and multiple partners sex.
http://www.doctorswithoutborders.org/our-work/medical-issues/hiv-aids

Nothing I said implies that it naïve for people to provide medical care to people with self-inflicted health problems. I said it was naïve to deny the objective reality that doing so directs resources away from others in need of help, such that the choice to help one person is inherently a choice not to help the people who now won’t be helped because there isn’t enough resources to help everyone who needs help with everything. Besides, your choice of AIDS example illustrates my point. It is blatantly obvious that you chose such an example precisely because undiagnosed AIDS leads to more harm to more people. Thus, it is in societies interest to treat AIDS and other contagious diseases aggressively, not merely for the benefit of the people with it, but for exponential number of people who will get it from those who already have it. You own link, prominently talks about preventing the further spread of these diseases as a central mission of the program and one of the first stats it points out is “One tenth of HIV/AIDS sufferers are children (3.4 million) under the age of 15, with over 1,000 becoming infected every day. Without treatment, half of all infants with HIV will die before their second birthday.” Gee, why would they care about that stat so much? The only reason is that children are viewed as innocent and having done nothing to contribute to their having the disease, thus it factors into their motivation to treat and prevent the disease. They recognize what you do not, that resources directed at their mission cannot be spent for other equally noble and generous missions to help those in need. Therefore, people are inherently making a choice of who to help when they give resources, so they want people to know that they are helping innocent children.

Thus, your are choosing who gets help and who doesn't whether you want to be honest enough to acknowledge that or not.

No, I do not. When I visit on my own a time a home bound needy person who is unable to do their own perineal care, I do not give a rat's behind about "indulgences" or "misfortunes".

I didn’t say you choose based upon “indulgences”, I said you choose. That choice can be on any criteria you want, and you can pretend that your criteria of “need” is objective and clear cut so that you can pretend all people “in need” are being helped, but the reality is that there are people who want and need help and cannot get it because of your choice to help someone else instead and your choice to support a healthcare system that uses very finite resources they way it does.

Providing universal healthcare does not help all those in need. Their are those in need of help outside of healthcare issues, and the amount of help they get will be less the more public resources go into healthcare. It may not be practical to be able to determine the source of health issues or to make choices of who to help based upon that, but it certainly is compassionate in principle.

You are communicating with a citizen of a nation who has had UHC since 1945. Try to remember that. The French health care system is designed to cover medically needy persons and meet their medical needs. And it does.

So not one single person in France could be in any way healthier if there were unlimited resources to help them? The French government shouldn’t consider spending a single Euro more on anything that impacts anyone’s health? Unless the answer is “no”, then the French system fails to help all those who need help to be healthier. You just invent a mental fiction that there is an objective category of “need” and that your system completely helps every person perfectly who fits that category. If you admit your system does not do this, then that is admitting that your system chooses who gets help for their needs and who does not.

Rational and compassionate adults willing to accept reality acknowledge this, so rather than have on the choice be random and arbitrary, they are inclined to help those most the victims of misfortune or harm by others before those who willfully put themselves at risk. Blindly ignoring the reality that we make implicit choices and where to direct finite assistance is a selfish act in which one is not being more compassionate but merely trying to maintain a self-serving self-image of being more compassionate than those willing to accept the reality. A guy in a bar starts a fight with another, and the other guy defends himself resulting in both guys being equally seriously hurt and bleeding out. You cant help both at the same time? Who do help first? Does your naive worldview make you view the bystander who first helps the victim risking the death of the aggressor a "detaches" and "uncompassionate" person?

Medical attention should be based on clinical need, not perceived merit

IOW, your evading the question because you cannot answer it without exposing the absurdity of your claim that considering merit
Clinical need is often equal, not to mention highly subjective. Also, it isn’t just whether a person needs treats but how much treatment they need and whether they need the most resource demanding treatment available. Every treatment has a wide range from minimal treatment to spending unlimited resources on a single person. So your empty platitude is just evasion. Answer the question I posed. Which of those people would you help and would you judge those who help the victim first as “uncompassionate” or “detached”?

 

[barbos]

Yes, if there were no smokers to treat there would be more money for other uses including research into MS.
that's a simple mathematical fact.

It's not simple. Tobacco consumption is one of the most heavily taxed activities on the planet. Remove all the smokers, and your revenue goes down by more than smokers cost to treat. You'd need to raise the same money some other way. And without smokers, we'd still have lung cancer. It would just be rarer.

It is simple, smokers spend their money supporting utterly stupid and harmful business activity.
And from my perspective it does not matter how much money they pay in taxes, overall effect is negative.
And you can always make people pay regular taxes more, especially when they stop spending money on smoke.
Lung cancer is almost exclusively due to the smoking and and environmental causes. So if you don't smoke and breath some crap chances of cancer are pretty much zero.

 

[barbos]

I presented the case of a single payer nation, France. Was specific about the high cost of gene mutation research and testing which is no way impaired by "treatments for smokers" in relation to lung cancer and research on lung cancer. Which you still are not addressing.

Oh and I stand firm by having demonstrated the implications (which I believe you did not foresee) when you stated :

Relax with France already.
I am for Universal health care. But you are not gonna convince me that France does more medical research than US.
You can not deny the fact that for profit system tend to spend more on research. Yes is sometimes stupid research but it's not more stupid than smoking.
I am for Universal Health Care, but I think even within that system there should be some explicit ways to deter smokers and such from it

 

[Sabine Grant]

I presented the case of a single payer nation, France. Was specific about the high cost of gene mutation research and testing which is no way impaired by "treatments for smokers" in relation to lung cancer and research on lung cancer. Which you still are not addressing.

Oh and I stand firm by having demonstrated the implications (which I believe you did not foresee) when you stated :

Relax with France already.
I am for Universal health care. But you are not gonna convince me that France does more medical research than US.

Re read what I stated and now quoted twice which did not contain any claim that "France does more medical research than the US". The point I developed on was to demonstrate that France can still conduct extensive research on gene mutation and testing(costly) while still delivering "treatments for smokers" and conduct research on lung cancers. The later not having impaired in any way costly target research on gene mutation and testing.

You can not deny the fact that for profit system tend to spend more on research.

Is that why the US health care industry focusing on research was deprived of state subsidies for 8 years regarding funding for ESC research under the GWB administration? The ban also restricting the number of embryos which research centers/labs could use. That because it is was not an economical factor which governed medical research in the US rather a cultural mentality determined to impair/obstruct anything not compatible with religion motivated beliefs. And when legislative and executive power has been granted to politicians influenced by religious myths, it deprives scientists from the means to conduct innovative research.

And again, I am not sure why you are responding to a claim of " France does more medical research than the US" which I never made and was not even part of the point I have now quoted twice.

Yes is sometimes stupid research but it's not more stupid than smoking.

When it comes the MEDICAL target research, I cannot think of current fields of such specific research being "sometimes stupid".

I am for Universal Health Care, but I think even within that system there should be some explicit ways to deter smokers and such from it

There you go again with a wording which implies excluding smokers from health care. I hope that it is just clumsy wording on your part and that what you actually meant to convey is that preventative medicine needs to be more involved in detection and addressing unhealthy life styles rather than leaving it to the food industry, tobacco industry and alcohol industry to "warn" consumers about the health related hazards their products present.

 

[fromderinside]

So here I am at the end of our medical tether, still attached. I sense the NHS hasn't really got very much of a tether system at all.

What do I mean by tether? I mean I'm 150 miles from hospital and I can get choppered there within the hour 24/7.

 

[Togo]

Yes, if there were no smokers to treat there would be more money for other uses including research into MS.
that's a simple mathematical fact.

It's not simple. Tobacco consumption is one of the most heavily taxed activities on the planet. Remove all the smokers, and your revenue goes down by more than smokers cost to treat. You'd need to raise the same money some other way. And without smokers, we'd still have lung cancer. It would just be rarer.

It is simple, smokers spend their money supporting utterly stupid and harmful business activity.
And from my perspective it does not matter how much money they pay in taxes, overall effect is negative..

Ok, so when you said it was a mathematical fact, what you meant was it was your subjective opinion?

 

[bilby]

So here I am at the end of our medical tether, still attached. I sense the NHS hasn't really got very much of a tether system at all.

What do I mean by tether? I mean I'm 150 miles from hospital and I can get choppered there within the hour 24/7.

I don't think there is anywhere in England that is 150 miles from a hospital. Perhaps the remote southwestern tip of Cornwall. Maybe.

In other parts of Britain such remoteness is possible - the Outer Hebrides, I would guess, might qualify, and perhaps parts of Snowdonia.

Nonetheless, helicopters are used to deliver people to hospital in emergencies in the UK; and they don't stop to ask for proof of insurance or ability to pay first.

 

[Sabine Grant]

I am a health care worker[/U] and somehow I have managed to never make any distinctions between medically needy persons based on whether they caused their condition. They are medically needy, that's it. The need is there and has to be met. Medical needs will be better met in a nation with a single payer system where financially based discrimination has been eliminated. The more medically needy, the more access.

Yeah, you are paid to treat people, regardless of whether their problem is misfortune or self-inflicted via indulgence. So, I would hope you would do your paid job and treat them all.

You have no insights in my private life therefor you are in NO position to assume that I have not made choices to provide pro bono services to home bound folks needy of the services of a certified HHA.Again and standing by what I stated : I do not make distinctions based on whether such needy persons have caused their health related predicament or if tgheisr situation is the result of misfortunes. Again, there is a need, I meet it. Clear enough? And you need to know that I am certainly not alone among certified, licensed and registered health care personnel who will provide pro bono services to medically needy persons.

I made no such assumption that you don't provide pro-bono services.

To my stating I make no distinction, you immediately assumed that the "no distinction" has to do with my work ethics while you totally missed the point that contrary to you, there is no mental and emotional process on my part which engages in evaluating whether a medically person deserves my assistance.

You said that as "a healthcare worker" you make no distinction, and since "worker" strongly implies paid services it was beyond reasonable for me to point out that when providing the services you are paid to provide as part of your work, you are obligated to provide paid services without making a distinction is the cause for the needed services.

Health care worker is a designation of individuals who have the necessary and mandated credentials to be legally employed in the health sector. I suppose had I said "health care provider", you would not be nitpicking on the term "worker" attempting to justify your previous diatribe. Further, I stand by the reality that I undergo no mental and emotional process as an individual with a certification in unskilled nursing which makes any distinction between "indulgences" and "misfortunes". Surely, you are not going to venture in claiming to have more knowledge on which mental and emotional processes I undergo than I have. Your mind-reading based speculations are getting tiresome.

I merely stated that as a paid healthcare worker, you are obligated to provide all paid for services, regardless of the underlying cause of the problems being treated. That in no way suggests you don't treat people without getting any pay and covering all expenses yourself or via a charity

And I am telling you again that even without being paid, I do NOT dwell on whether a medically needy person deserves my assistance. Again, if there is a need, I will meet it.

Don't pretend you are "telling [me] again", when you did not state to begin with that you meant "without being paid", but in fact strongly implied that you meant as part of your paid employment, thus the word "worker". You only claimed that you meant pro-bono services after I pointed out that paid work requires you to ignore the distinction. You accused me of making assumptions about your life and I am just pointing out that all I did was make the most reasonable interpretation of what you actually said, and if you meant something different then the fault lies with your objectively poor and misleading initial phrasing that would imply to most people that you were referring to what you do as part of your employment.

It is your mistaken interpretation of what "health care worker" designates which led to one of the most bizarre exchanges I have had on the topic of health care. The point which you missed is that as a person who has the necessary and mandated certification to be employed in the health care field, I am far more susceptible to interact and communicate with folks affected by various conditions than someone who is not a health care worker or provider. YET, and despite of my being aware of what caused their conditions, I do NOT undergo a mental and emotional process dwelling on "indulgences" versus "misfortunes". My focus is on relief applied to suffering. That is how I am wired in many instances of my life. That you cannot accept that is frankly your problem not mine.

(which is what I hope you mean by pro-bono and not that you steal from your employer by providing services at their expense on time they are paying you for).

Totally inappropriate passive aggressive crap.

Nothing inappropriate or passive aggressive about it since I did not imply that you did these things, but since you've shown a tendency of poorly conveying what you are referring to and how these acts relate to your "work", I was just clarifying that you meant actual charity on your own time completely outside of what your employer expects you to do. What is inappropriate are your efforts to pretend that my response to your initial comments requires some outrageous assumption on my part totally disconnected from what you said, when in fact my response was based upon the most reasonable interpretation of what you said.

Again, the poorly here applies to your interpretation of "health care worker" where you jumped to speculative conclusions. And yes, your remark was passive aggressive crap. Attempting to rationalize it does not help your case.

Yes they do, because contrary to your naive fantasyland there is a finite limit to public resources that can be used to help the suffering and every choice to help someone is a defacto choice not to help some others.

My "naive and fantasyland" would be my country of origin and citizenship, France, with a single payer system since 1945 and where the more medically needy, the more access and that without dwelling on whether our medically needy French caused their predicament via "indulgences".

No, your naïve fantasyland is created in your head by your denial of the reality that in France and every single NHC system choices are made that determine the quality of care and cause suffering of people on the wrong side of that choice. Giving more care to the “medically needy” is such a choice.

The MORE medically needy as in 100% coverage on "catastrophic illnesses" requiring long term medical treatments and monitoring to extend survival to a condition known to meet a terminal prognosis if not treated. Surely you are not going to argue that cancer diagnosed patients are not more medically needy than someone diagnosed with GERD or are you? If GERD is not 100% covered under UHC in France, a diagnosis of cancer certainly means access to 100% coverage. It certainly does not mean that a GERD diagnosed patient is left with reduced care. Not at all. Only that it does not benefit of 100% cost coverage.

You seem to not comprehend what "the more medically needy, the more access" means when referring to UHC. It means that the UHC coverage for the cost incurred by the patient is HIGHER based on the nature of the illness and resulting VITAL treatments and monitoring/testing.

It means that there are millions of people who do not get treatment that would improve their health and well being because it is not deemed “needy” enough.

No, it does NOT. Another example of you being the party with a "poorly" factor at play. Again and for the last time, the more medically needy the more access in the French UHC system means that coverage increases to 100% when addressing chronic and if not treated, fatal ailments, such as cancer. Meaning that the patient is 100% covered with NO co pay and NO cost out of pocket. No just that but there is a "prise en charge" during post care such as in home skilled nursing visits at NO cost to the patient.

Versus your hyper privatized US system which does restrict access to vital treatments based on private insurance coverage. I managed to survive under insured for 5 years under that system at the cost of accumulating medical debts resulting from oncology based treatments/tests and vital I will add. Not only carrying the burden of being diagnosed with an incurable and chronic blood cancer periodically resurging but also the burden of accumulating debts, maxing out credits cards for the sole purpose of making sure that in 2010, we could delay the progression of the disease to an advance stage as it reoccurred. Since we certainly could not afford out of pocket the cost of the approved and recommended pharma infusion protocol for my type of lymphoma, we had to settle for just the surgical excision of the malignant inguinal lymph nodes while bypassing the monoclonal protocol which would normally be the choice of efficient treatment applied to my type of lymphoma. End result is that left without the long term effects of the monoclonal Rituxan, lymphoma resurged 3 years later and this time in 2 locations.

Had I been residing in France at the time of the 2010 recurrence, Rituxan would have been the choice of treatment and 100% covered without my having incurred long term medical debts which will take my husband and I several years to resolve.

Your hyper privatized system does NOT deliver based on medical needs. It delivers based on how much you and I can afford. It is undeniable.

Are you claiming that not a single person in France would in any way have better health if the pool of resources was increased?

Pool of resources "increased" by excluding from UHC coverage patients whose conditions are the result of "indulgences"? Let's see how that would apply to a smoker developing pulmonary carcinoma related to the long term abuse of tobacco smoking : Pierre Dupont would then be excluded from coverage and have to assume the cost of treatments out of pocket. Certainly a terminal prognosis if Pierre cannot afford those treatments. Basically, a "pooling of resources" based on the concept of a triage based health care system which would eliminate all patients falling under the category of emergent ailments deemed to be the result of unhealthy lifestyles. Might as well eliminate all HIV and HP-V sero positives identified as falling under the category of contamination due to the use of injected recreational drugs or unprotected sex/anonymous/multiple partners vectors, might as well eliminate diabetic patients falling under the category of unhealthy life style acquired obesity, might as well eliminate cardiovascular diseases affected patients falling under the category of long term unhealthy diets etc etc... What we are left with is a health care system dwelling on "merit and reward" rather than delivering health care to all medically needy persons. Do not call it "health care" any longer then.

Are you claiming that no one would be helped if France increased funding of any health related research? Because these are what your position logically presumes.

hmmm.... since I support and am certainly glad that France increased funding on gene mutation research and testing (probably a field of research I am not that sure you comprehend what its pluripotent importance is), why would anyone draw the conclusion you drew? While I keep myself informed on the increasing and successful progression of target research in France thanks to the publications of the INSERM ( Institut National de la Sante et de la Recherche Medicale). Do you? How would you know whether or not the current target researches in France are designed to address a multitude of health issue unless you keep yourself informed?

Not to mention there are the finite public resources used for things that impact health but not via healthcare system. For example, there is waste-water treatment, something which France is one of the worst in Europe. The high cost to the finite public funds from the UHC system reduces what is available for water-waste and countless other factors that would improve the health of all people.

And the ratio of health issues in France directly related to/caused by the claim of "something which France is one of the worst in Europe" is? Surely, such " France is one of the worst in Europe" related to the treatment of water-waste (which by the way is divided into 2 separately funded systems, collective and non collective) should result in a substantial manifestation of ailments related to poor water-waste management unless my fellow French men and women have become immune to :


-bacterial infections still from waterborne pathogens.
-parasitic infections
-viral infections still from waterborne pathogens.
-protozoal infections.

Now looking at the incidence of only waterborne infections related ailments for 2012 and 2013 in Europe, it does not appear that France shows any substantial amount of such poor sanitation related ( the term sanitation including water waste management) ailments compared to other European countries :

http://ecdc.europa.eu/en/ESCAIDE/Ma...sentations-topic/Pages/presentations_fwd.aspx

So, like I said, your choice to support the France system is a choice that causes others to suffer who could otherwise benefit from the resources that you prefer be spent in a different way.

Well, so far you have made no documented case that the French UHC system "causes others to suffer who could otherwise benefit from the resources" I "prefer be spent in a different way" What you keep doing is speculating on and on and confusing your speculations for meaning you have built a documented case supported by reliable sources linked to in your posts to escort your avalanche of claims.

Contrary to your objectively wrong quote that started this exchange what really is “that simple” is the fact that every act of using public resources to help one person, harms other people that could have benefitted from those resources. All that is required for this truism is that resources are finite.

When it come to public safety and well being, how high do you rank human health and resulting intervention known as "health care? Do you think it should be conceived of like a profit centered industry which discriminates who receives health care and who does not based on the medically needy's person ability to afford the cost or conceived of like a publicly funded service which will not discriminate among the medically needy based on ability to afford? Which of the 2 systems do you think has a greater potential to address a higher percentage of medically needy persons? That is of course if you rank human heath as the top priority. If you do not, you will treat health care as a commodity. Which the US privatized health care system does. It is not about medically needy persons but "consumers".

Keep in mind that my potential for covered access to the best available oncology protocols designed for my type of blood cancer is much higher in the UHC system than it is in the US privatized health care system.I am rather certain that such higher cost covered access does not cause any of my fellow French men and women to "suffer" or to be "harmed". Speaking of suffering and harm, I find it disconnected from existing realities in the US, that anyone would attempt to make a case against UHC based on your type of speculations. Have you been at all in touch with the millions of your fellow Americans who have developed acute conditions which could have been detected early enough to prevent an acute phase if only they had not been restricted from accessing health care based on their financial inability.

You are probably not in a touch with a quad fellow American who can only receive one bowel care visit per week unless he can afford out of pocket the cost of privately hiring an LPN who will come twice. And if a twice a week visit, he would not have ended up with a colon impaction necessitating we had to call for a medical 911 intervention, transport to the nearest hospital and admittance for an emergency procedure. J. was one example among millions of medically needy of your fellow Americans who still today have restricted access to health care.

I did not just get off the boat when it comes to the harm and suffering your privatized health care system has caused to millions of your fellow Americans.

Would be "naive" MSF physicians and nurses who volunteer their skills in Sub Sahara Africa ,treating over 300.000 HIV sero positive individuals. Individuals who got contaminated due to the prevalent vector of unprotected and multiple partners sex.
http://www.doctorswithoutborders.org/our-work/medical-issues/hiv-aids

Nothing I said implies that it naïve for people to provide medical care to people with self-inflicted health problems. I said it was naïve to deny the objective reality that doing so directs resources away from others in need of help, such that the choice to help one person is inherently a choice not to help the people who now won’t be helped because there isn’t enough resources to help everyone who needs help with everything. Besides, your choice of AIDS example illustrates my point. It is blatantly obvious that you chose such an example precisely because undiagnosed AIDS leads to more harm to more people. Thus, it is in societies interest to treat AIDS and other contagious diseases aggressively, not merely for the benefit of the people with it, but for exponential number of people who will get it from those who already have it. You own link, prominently talks about preventing the further spread of these diseases as a central mission of the program and one of the first stats it points out is “One tenth of HIV/AIDS sufferers are children (3.4 million) under the age of 15, with over 1,000 becoming infected every day. Without treatment, half of all infants with HIV will die before their second birthday.” Gee, why would they care about that stat so much? The only reason is that children are viewed as innocent and having done nothing to contribute to their having the disease, thus it factors into their motivation to treat and prevent the disease. They recognize what you do not, that resources directed at their mission cannot be spent for other equally noble and generous missions to help those in need. Therefore, people are inherently making a choice of who to help when they give resources, so they want people to know that they are helping innocent children.

Infectious diseases control stats and percentage of affected populations always mention which groups present a higher vulnerability factor to the discussed infectious/contagious disease. Infants are totally unable to protect themselves from exposure to an infectious disease such as HIV. Same with toddlers especially in an impoverished culture where the prevalent mean of feeding infants and toddlers is going to be...breastfeeding. Once more you are speculating and drawing conclusions attributing a mind reading based motive to MSF regarding their report. The highest vulnerability category is what is commonly cited not because MSF *thinks* that they need to consider "innocence" among the over 300.000 HIV victims they treat to be motivated to treat and control the disease.

Thus, your are choosing who gets help and who doesn't whether you want to be honest enough to acknowledge that or not.

No, I do not. When I visit on my own a time a home bound needy person who is unable to do their own perineal care, I do not give a rat's behind about "indulgences" or "misfortunes".

I didn’t say you choose based upon “indulgences”, I said you choose. That choice can be on any criteria you want, and you can pretend that your criteria of “need” is objective and clear cut so that you can pretend all people “in need” are being helped, but the reality is that there are people who want and need help and cannot get it because of your choice to help someone else instead and your choice to support a healthcare system that uses very finite resources they way it does.

Have you not noticed we are discussing health care thus we are bound to speak in term of MEDICAL needs and MEDICALLY needy? My choices, again and again, are based on the clinical need since we are discussing health care. If you wish to discuss the moral consequences of failing to help everyone in need OUTSIDE of MEDICAL needs, please start your own thread in the Moral Foundations and Principles Forum.

I stand by my conclusion : The French UHC system as well as other European nations UHC cover and deliver MEDICAL care to MORE medically needy persons than the privatized US health care system does.

Providing universal healthcare does not help all those in need. Their are those in need of help outside of healthcare issues, and the amount of help they get will be less the more public resources go into healthcare. It may not be practical to be able to determine the source of health issues or to make choices of who to help based upon that, but it certainly is compassionate in principle.

You are communicating with a citizen of a nation who has had UHC since 1945. Try to remember that. The French health care system is designed to cover medically needy persons and meet their medical needs. And it does.

So not one single person in France could be in any way healthier if there were unlimited resources to help them? The French government shouldn’t consider spending a single Euro more on anything that impacts anyone’s health? Unless the answer is “no”, then the French system fails to help all those who need help to be healthier. You just invent a mental fiction that there is an objective category of “need” and that your system completely helps every person perfectly who fits that category. If you admit your system does not do this, then that is admitting that your system chooses who gets help for their needs and who does not.

Last time I checked, the French UHC was still addressing the medical needs of our medically needy populations. We are talking about a HEALTH CARE system in this thread which is designed to MEET the specific needs known as MEDICAL needs. I find myself having to capitalize for the purpose of emphasis several times as you seem to have lost track of what health care is designed to do and which specific needs it meets.

Rational and compassionate adults willing to accept reality acknowledge this, so rather than have on the choice be random and arbitrary, they are inclined to help those most the victims of misfortune or harm by others before those who willfully put themselves at risk. Blindly ignoring the reality that we make implicit choices and where to direct finite assistance is a selfish act in which one is not being more compassionate but merely trying to maintain a self-serving self-image of being more compassionate than those willing to accept the reality. A guy in a bar starts a fight with another, and the other guy defends himself resulting in both guys being equally seriously hurt and bleeding out. You cant help both at the same time? Who do help first? Does your naive worldview make you view the bystander who first helps the victim risking the death of the aggressor a "detaches" and "uncompassionate" person?

Medical attention should be based on clinical need, not perceived merit

IOW, your evading the question because you cannot answer it without exposing the absurdity of your claim that considering merit

I am not evading anything. But I feel like "sticking needles in my eyes" when I have to be subjected to the torture of reading replies which are disconnected from what was stated :

"MEDICAL attention should be based on CLINICAL need, not perceived merit". Do you or not understand what a CLINICAL need means and what MEDICAL attention means?

Clinical need is often equal, not to mention highly subjective.

Non. Clinical need is not "highly subjective". There is no "highly subjective" involved in a CPR certified person to attend FIRST the victim of a traffic accident with no pulse and respiration over attending the other victim complaining of a broken limb. And non, clinical need is not "often equal". A surgeon does not consider the clinical need for operating on a hernia to be equal to the clinical need for removing a malignant tumor. I could go on and on for pages covering a multitude of clinical needs of vastly different levels which all necessitate distinct evaluations from each other and with applied documentation that they are not "highly subjective" and "often equal".

Also, it isn’t just whether a person needs treats but how much treatment they need and whether they need the most resource demanding treatment available.

And? Do you think you are somehow enlightening me about the variety of pharma protocols, procedures and tests personalized to each condition? How do you think a medical assessment is made regarding whether a patient needs "the most resource demanding treatment available"? If not based on a specific diagnosis and further prognosis of the expected response to the said treatment. Do you think that clinical data does not play a major role when it comes to the prognosis of the expected response?

Before you go on babbling : how do you think my onco/hemato assessed which treatment would be most effective on a NHD Lymphoma Tybe B follicular, low grade, stage III ? Do you think that as a health care professional he somehow did not draw the conclusion that a monoclonal based treatment would be more effective than C.H.O.P alone by relying on clinical data reflecting the higher rate of remission with Rituxan versus C.H.O.P. And that even though Rituxan was definitely cost wise considered "the most resource demanding treatment available" in 2005.

Every treatment has a wide range from minimal treatment to spending unlimited resources on a single person.

And health care professionals who are the parties legally accredited to practice medicine and prescribe treatments/procedures and tests will discuss with their patient(s) which treatments/procedures/ tests are needed to reach the goal of treating their patient (s) condition efficiently. What type of data do you *think* they rely on to medically assess which condition needs a "minimal treatment" and which requires "spending unlimited resources" on a single person. Tell you what.... I have no issue with some of my fellows, in our treatment room while we are hooked to our "lifeline" IVs, facing a poor prognosis yet fighting their illness with every possible resource. Do you?

So your empty platitude is just evasion. Answer the question I posed. Which of those people would you help and would you judge those who help the victim first as “uncompassionate” or “detached”?

Give me a specific status for both persons because my answer can only be based on a clinical evaluation of which of the 2 wounded parties would need an immediate intervention. You still do not get the point that people who are trained to intervene in such situations will PRIORITIZE based on the physical/clinical status of each affected person. Because we(HC field) are all trained to think CLINICALLY. There is an automatic mental triage going on based on the clinical need of any potential patient.

Oh what I had actually stated is that we detach ourselves from the person suffering when we start dwelling on whether they caused their own health issue.

 

[barbos]

Yes, if there were no smokers to treat there would be more money for other uses including research into MS.
that's a simple mathematical fact.

It's not simple. Tobacco consumption is one of the most heavily taxed activities on the planet. Remove all the smokers, and your revenue goes down by more than smokers cost to treat. You'd need to raise the same money some other way. And without smokers, we'd still have lung cancer. It would just be rarer.

It is simple, smokers spend their money supporting utterly stupid and harmful business activity.
And from my perspective it does not matter how much money they pay in taxes, overall effect is negative..

Ok, so when you said it was a mathematical fact, what you meant was it was your subjective opinion?

Yes, from my perspective of mathematically exact and objective observer.

 

[Canard DuJour]

So here I am at the end of our medical tether, still attached. I sense the NHS hasn't really got very much of a tether system at all.

What do I mean by tether? I mean I'm 150 miles from hospital and I can get choppered there within the hour 24/7.

I don't think there is anywhere in England that is 150 miles from a hospital. Perhaps the remote southwestern tip of Cornwall. Maybe.

A guy I know was knocked unconscious by his surfboard on a remote Cornish beach. His partner phoned 999 and he was airlifted to hospital (where he made a full recovery). I forget how long exactly they said it took, but pretty damned quick.

 

[barbos]

Here is an argument against NHS:
http://www.dailymail.co.uk/news/art...-shocking-new-details-paedophiles-crimes.html

 

[prideandfall]

Ok, so when you said it was a mathematical fact, what you meant was it was your subjective opinion?

Yes, from my perspective of mathematically exact and objective observer.

these words... i do not think they mean what you think that mean.

here's an objective mathematical fact:
Total annual public and private health care expenditures caused by smoking: around $132.5 - 193 billion, depending in the source you check.
Total tax revenue collected from tobacco in 2011: somewhere in the general vicinity of 17 trillion, for both state and federal combined.

so the objective mathematical fact is that smokers generate what can charitably be described as a metric fuckton more medically dispensable income than they utilize.

 

[bilby]

Here is an argument against NHS:
http://www.dailymail.co.uk/news/art...-shocking-new-details-paedophiles-crimes.html

No, that is an argument against the Daily Mail being allowed to masquerade as a newspaper.

 

[barbos]

Ok, so when you said it was a mathematical fact, what you meant was it was your subjective opinion?

Yes, from my perspective of mathematically exact and objective observer.

these words... i do not think they mean what you think that mean.

here's an objective mathematical fact:
Total annual public and private health care expenditures caused by smoking: around $132.5 - 193 billion, depending in the source you check.
Total tax revenue collected from tobacco in 2011: somewhere in the general vicinity of 17 trillion, for both state and federal combined.

so the objective mathematical fact is that smokers generate what can charitably be described as a metric fuckton more medically dispensable income than they utilize.

By that logic, heroin should be taxed. People will die from it even faster than from smoke.

 

[bilby]

Ok, so when you said it was a mathematical fact, what you meant was it was your subjective opinion?

Yes, from my perspective of mathematically exact and objective observer.

these words... i do not think they mean what you think that mean.

here's an objective mathematical fact:
Total annual public and private health care expenditures caused by smoking: around $132.5 - 193 billion, depending in the source you check.
Total tax revenue collected from tobacco in 2011: somewhere in the general vicinity of 17 trillion, for both state and federal combined.

so the objective mathematical fact is that smokers generate what can charitably be described as a metric fuckton more medically dispensable income than they utilize.

By that logic, heroin should be legalized and taxed. People will die from it even faster than from smoke.

Why do you think it shouldn't be? Prohibition certainly doesn't seem to be working any better than a legalised and taxed model could work.

Indeed, most heroin addicts who die do so because their drug supply is not of consistent strength, and/or because it is cut with toxic or infectious contaminants.

A regulated supply of heroin, of defined dose and purity, would be much safer for addicts. If the price was somewhat lower (as it might well be in a legal market, even after tax - it isn't expensive to make, most of the cost on the streets is the risk premium inherent in supplying an illegal product which law enforcement are well funded and motivated to interdict), the level of crime committed by addicts would likely also fall.

There may be some good arguments for prohibition of heroin, but I am not sure what they are; Certainly it is not reasonable to present the very prospect of legal, regulated and taxed Heroin as an example of something that is self evidently a bad idea.