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	<title>Comments on: If It&#8217;s Broke You Gotta Fix It &#8211; Healthcare, Part I</title>
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	<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/</link>
	<description>Start 'em up</description>
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		<title>By: Max Damage</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1135</link>
		<dc:creator>Max Damage</dc:creator>
		<pubDate>Thu, 22 Mar 2007 06:57:02 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1135</guid>
		<description>Michelle, what I meant by saying giving insurers more rights/say into health care would be a bad idea is that I think it&#039;s universally true that bean-counters have no business second-guessing doctors, or the patients, when it comes to care.  I&#039;m an engineer, you&#039;re a lawyer (not entirely accurate, but good enough for the purposes of comparison) -- I don&#039;t tell you what the law is, you don&#039;t tell me how to build bridges.  We have room to work together, of course -- I have to build bridges according to law and you can tell me what those laws mean, but all in all we each have an area of speciality and it&#039;s best to let those with expertise in an area to have the final say when it comes to policy in that area.

As I noted, bean-counters have determined a human life is worth a specific amount of money.  That&#039;s what reducing human life to an actuarial table or a statistic does.  That&#039;s a reasonably good thing to know when formulating a strategy, but it&#039;s useless when formulating a tactic for treating an individual.

Letting insurers bargain for services is an entirely different thing.  Most dental insurance requires the insured to pay (I&#039;m not looking it up, so I&#039;ll generalize) $15 for a filling, $500 for a crown and $2000 for an implant.  The dentist who accepts that insurance gets a fixed rate per job, and gets a large potential customer base.  Here the insurance company basically raises the costs for the customer to promote early care, and promotes a large customer base to the provider in return for a lower, fixed rate.  That works a treat for some types of standard care, particularly the diagnostic and preventative kind.  Mammograms, colonoscopies, flu shots, annual checkups, eye exams, fillings and the like.  It is not a good model when designing a chemotherapy treatment for cancer.

My neighbor is cured, by the way -- cancer-free for three years and hopefully forever.  A relative didn&#039;t make it, died in his early 30&#039;s from a rare cancer.  At that time there were maybe a dozen cases in the journals to draw notes from, chemo for it had to be invented.  In the case of my relative his contributions to the knowledge of that cancer led to others being cured, to new chemotherapy and advances in radiation treatment.  I *still* get calls from the physicians who treated him, so closely did we bond over those agonizing years between diagnosis and death.  To a one they each tell me of the knowledge gained by the experiments and the names of people they&#039;ve successfully treated because of  them.  And I dare say no bean-counter in an insurance company or in a government office will ever stop looking at his spreadsheets long enough to ponder the potential benefits a non-standard treatment today may have 30 years down the road.

That is the fear of socialized medicine, that my choices will be limited and some faceless bean-counter will tell my doctor what he can and cannot do, and I&#039;ve no recourse to appeal that decision.  Nothing annoys a person like having somebody else tell them what they deserve.

 - Max</description>
		<content:encoded><![CDATA[<p>Michelle, what I meant by saying giving insurers more rights/say into health care would be a bad idea is that I think it&#8217;s universally true that bean-counters have no business second-guessing doctors, or the patients, when it comes to care.  I&#8217;m an engineer, you&#8217;re a lawyer (not entirely accurate, but good enough for the purposes of comparison) &#8212; I don&#8217;t tell you what the law is, you don&#8217;t tell me how to build bridges.  We have room to work together, of course &#8212; I have to build bridges according to law and you can tell me what those laws mean, but all in all we each have an area of speciality and it&#8217;s best to let those with expertise in an area to have the final say when it comes to policy in that area.</p>
<p>As I noted, bean-counters have determined a human life is worth a specific amount of money.  That&#8217;s what reducing human life to an actuarial table or a statistic does.  That&#8217;s a reasonably good thing to know when formulating a strategy, but it&#8217;s useless when formulating a tactic for treating an individual.</p>
<p>Letting insurers bargain for services is an entirely different thing.  Most dental insurance requires the insured to pay (I&#8217;m not looking it up, so I&#8217;ll generalize) $15 for a filling, $500 for a crown and $2000 for an implant.  The dentist who accepts that insurance gets a fixed rate per job, and gets a large potential customer base.  Here the insurance company basically raises the costs for the customer to promote early care, and promotes a large customer base to the provider in return for a lower, fixed rate.  That works a treat for some types of standard care, particularly the diagnostic and preventative kind.  Mammograms, colonoscopies, flu shots, annual checkups, eye exams, fillings and the like.  It is not a good model when designing a chemotherapy treatment for cancer.</p>
<p>My neighbor is cured, by the way &#8212; cancer-free for three years and hopefully forever.  A relative didn&#8217;t make it, died in his early 30&#8217;s from a rare cancer.  At that time there were maybe a dozen cases in the journals to draw notes from, chemo for it had to be invented.  In the case of my relative his contributions to the knowledge of that cancer led to others being cured, to new chemotherapy and advances in radiation treatment.  I *still* get calls from the physicians who treated him, so closely did we bond over those agonizing years between diagnosis and death.  To a one they each tell me of the knowledge gained by the experiments and the names of people they&#8217;ve successfully treated because of  them.  And I dare say no bean-counter in an insurance company or in a government office will ever stop looking at his spreadsheets long enough to ponder the potential benefits a non-standard treatment today may have 30 years down the road.</p>
<p>That is the fear of socialized medicine, that my choices will be limited and some faceless bean-counter will tell my doctor what he can and cannot do, and I&#8217;ve no recourse to appeal that decision.  Nothing annoys a person like having somebody else tell them what they deserve.</p>
<p> &#8211; Max</p>
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		<title>By: unkawill</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1131</link>
		<dc:creator>unkawill</dc:creator>
		<pubDate>Thu, 22 Mar 2007 05:36:21 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1131</guid>
		<description>Thanks Michelle, I&#039;ll go check it out! Oh BTW one of my sisters is named Michelle also. You are much nicer than HER! 

Yak at you later, Will</description>
		<content:encoded><![CDATA[<p>Thanks Michelle, I&#8217;ll go check it out! Oh BTW one of my sisters is named Michelle also. You are much nicer than HER! </p>
<p>Yak at you later, Will</p>
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		<title>By: Michelle</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1127</link>
		<dc:creator>Michelle</dc:creator>
		<pubDate>Thu, 22 Mar 2007 04:00:43 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1127</guid>
		<description>There you go unkawill. Just for you. And anyone else who&#039;s fooish enough to read it. I am, at least, a woman of my word. For what that&#039;s worth.

&lt;em&gt;I am hereby providing notice that I am taking a vacation from blogging. [BEEP]&lt;/em&gt;</description>
		<content:encoded><![CDATA[<p>There you go unkawill. Just for you. And anyone else who&#8217;s fooish enough to read it. I am, at least, a woman of my word. For what that&#8217;s worth.</p>
<p><em>I am hereby providing notice that I am taking a vacation from blogging. [BEEP]</em></p>
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		<title>By: The Flight Deck &#187; Finding the Balance - Healthcare Part II</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1126</link>
		<dc:creator>The Flight Deck &#187; Finding the Balance - Healthcare Part II</dc:creator>
		<pubDate>Thu, 22 Mar 2007 03:56:49 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1126</guid>
		<description>[...] than that.Â  But I really only came to this conclusion in the last couple of days (after I wrote If Its Broke You Gotta Fix It and then looking at some statistics in preparation for writing this [...]</description>
		<content:encoded><![CDATA[<p>[...] than that.Â  But I really only came to this conclusion in the last couple of days (after I wrote If Its Broke You Gotta Fix It and then looking at some statistics in preparation for writing this [...]</p>
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		<title>By: unkawill</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1125</link>
		<dc:creator>unkawill</dc:creator>
		<pubDate>Thu, 22 Mar 2007 03:43:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1125</guid>
		<description>I have always thought so myself!</description>
		<content:encoded><![CDATA[<p>I have always thought so myself!</p>
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		<title>By: Michelle</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1124</link>
		<dc:creator>Michelle</dc:creator>
		<pubDate>Thu, 22 Mar 2007 03:36:55 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1124</guid>
		<description>Whatever. Sounds good. Make it a double :)
And thanks. A friend in need is a friend indeed but a friend with beer...... is a very good thing!</description>
		<content:encoded><![CDATA[<p>Whatever. Sounds good. Make it a double <img src='http://www.neptunuslex.com/Wiki/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /><br />
And thanks. A friend in need is a friend indeed but a friend with beer&#8230;&#8230; is a very good thing!</p>
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		<title>By: unkawill</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1123</link>
		<dc:creator>unkawill</dc:creator>
		<pubDate>Thu, 22 Mar 2007 03:31:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1123</guid>
		<description>&quot;Come on, people, this one unkawill is so anxioulsy waiting for took some work.&quot;
 What? Dear Michelle, Please clarify. Beer on the way!

How about an Exotic Export? Lone Star Light?

It&#039;s what I drink.</description>
		<content:encoded><![CDATA[<p>&#8220;Come on, people, this one unkawill is so anxioulsy waiting for took some work.&#8221;<br />
 What? Dear Michelle, Please clarify. Beer on the way!</p>
<p>How about an Exotic Export? Lone Star Light?</p>
<p>It&#8217;s what I drink.</p>
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		<title>By: unkawill</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1122</link>
		<dc:creator>unkawill</dc:creator>
		<pubDate>Thu, 22 Mar 2007 03:23:33 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1122</guid>
		<description>doorkeeper  says &quot;Unkawill, wish we could sit down with a Guinness, sounds like we have way more in common than different, the biggest thing which leaps out at me is that I type faster than I think! &quot;

doorkeeper, I would love to buy you and  everybody else, who hangs out here a Guinness, or three.

 Let&#039;s plan on Kris&#039;s Bunker dedication ceremony, it should happen in the Fall,which is the best time of the year to be in New England. By the way where is the En- Gland located anyway? And what happened to the Old En-Gland?
 I unfortunately type much slower than I think.   Orders of Magnitude slower!</description>
		<content:encoded><![CDATA[<p>doorkeeper  says &#8220;Unkawill, wish we could sit down with a Guinness, sounds like we have way more in common than different, the biggest thing which leaps out at me is that I type faster than I think! &#8221;</p>
<p>doorkeeper, I would love to buy you and  everybody else, who hangs out here a Guinness, or three.</p>
<p> Let&#8217;s plan on Kris&#8217;s Bunker dedication ceremony, it should happen in the Fall,which is the best time of the year to be in New England. By the way where is the En- Gland located anyway? And what happened to the Old En-Gland?<br />
 I unfortunately type much slower than I think.   Orders of Magnitude slower!</p>
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		<title>By: Michelle</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1121</link>
		<dc:creator>Michelle</dc:creator>
		<pubDate>Thu, 22 Mar 2007 03:12:24 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1121</guid>
		<description>Wanna bet? Wanna bet?! I am a moonbat at the moment.

And DO NOT push your luck, good sir. I do believe I said &quot;sometime tomorrow&quot; which would be &quot;sometime today&quot;. And I am taking full advantage of the East Coast time difference here. Cuz its only 7:55 in Lex Land..........

Don&#039;t push it. Uh uh. No way. No how. See? Told you I am feeling like a moonbat tonight. This is worse than trying to get a paper done for school.
And BTW....and this is significantly important.........IF I don&#039;t start actually working soon (the kind that pays $$), well I won&#039;t have a health care crisis (heh, take that!) but there will be severe consequences for my family!

And I am giving up blogging after this sucker. Which is not a blog. Its a treatise. And you will be sorry cuz you will have to read it!

okay, I&#039;m think I&#039;m done. Thanks for the chance to vent - really needed it. In case you couldn&#039;t tell. Anyone got a beer?

PS One more thing - the majority of the readers of this fine.....blog.......have been conspicuous in their absence. Come on, people, this one unkawill is so anxioulsy waiting for took some &lt;em&gt; work&lt;/em&gt;.</description>
		<content:encoded><![CDATA[<p>Wanna bet? Wanna bet?! I am a moonbat at the moment.</p>
<p>And DO NOT push your luck, good sir. I do believe I said &#8220;sometime tomorrow&#8221; which would be &#8220;sometime today&#8221;. And I am taking full advantage of the East Coast time difference here. Cuz its only 7:55 in Lex Land&#8230;&#8230;&#8230;.</p>
<p>Don&#8217;t push it. Uh uh. No way. No how. See? Told you I am feeling like a moonbat tonight. This is worse than trying to get a paper done for school.<br />
And BTW&#8230;.and this is significantly important&#8230;&#8230;&#8230;IF I don&#8217;t start actually working soon (the kind that pays $$), well I won&#8217;t have a health care crisis (heh, take that!) but there will be severe consequences for my family!</p>
<p>And I am giving up blogging after this sucker. Which is not a blog. Its a treatise. And you will be sorry cuz you will have to read it!</p>
<p>okay, I&#8217;m think I&#8217;m done. Thanks for the chance to vent &#8211; really needed it. In case you couldn&#8217;t tell. Anyone got a beer?</p>
<p>PS One more thing &#8211; the majority of the readers of this fine&#8230;..blog&#8230;&#8230;.have been conspicuous in their absence. Come on, people, this one unkawill is so anxioulsy waiting for took some <em> work</em>.</p>
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		<title>By: unkawill</title>
		<link>http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/comment-page-2/#comment-1120</link>
		<dc:creator>unkawill</dc:creator>
		<pubDate>Thu, 22 Mar 2007 02:55:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.neptunuslex.com/Wiki/2007/03/18/if-its-broke-you-gotta-fix-it-healthcare-part-i/#comment-1120</guid>
		<description>And Part II is..... sorry to prod, but, We Still WUV You! AND YOU ARE NOT A &quot; MOONBAT &quot;.</description>
		<content:encoded><![CDATA[<p>And Part II is&#8230;.. sorry to prod, but, We Still WUV You! AND YOU ARE NOT A &#8221; MOONBAT &#8220;.</p>
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