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Thread: American Healthcare System, Is it up to standard?

  1. #1 American Healthcare System, Is it up to standard? 
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    Hello, im new to the science forum. but from what i have read it is very informative. i have read many posts and think that this issue will be very productive in forming a better understand of modern health care.

    I'll begin the forum with saying that i am an Australian and i recieve Universal Health Care. i am no expert by any means on the American health care system. Although from what i have found out so far, leads me to believe that something appears wrong. How can human health be placed in the hands of private organisations that make money through non-payments?

    Perhaps i just do not know enough about the American health system of infact the culture itself behind personal values, Either way please feal free the elaborate on all aspects of the subject.

    Thank you.


    C D
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    Hi Charlie,

    I have interacted online with many people from Australia about your healthcare system, and from what I can tell it is better than what we have in the US on nearly all counts. As for why our system here is so broken, much of it has to do with incompetence in our congress and the power held by the healthcare industry over the legislation which we produce (not to mention how in the US we have a growing percentage of ignorant people with very poor logic skills and education and yet very strong ideological opinions and surplussed of indignation).

    The outcomes of our care are quality, and we have many "islands of excellence" with our healthcare system, but we are truly drowning in a sea of mediocrity. I am not hopeful that the half-measure bill going through our congress now will help, and I see the current broken system of politics we have as producing nothing better than sub-optimal solutions to just about any problem we face.

    We have a bunch of idiots yelling a bunch of lies, and it's working. It's rather sad, really. I'd rather have what you guys have in Oz, and I see no reason (other than ignorance and special interest groups) why we cannot achieve it here in the US.

    If you can access them, these videos below are really quite helpful in offering an understanding of the topic. Either way, welcome to the forum!


    http://www.pbs.org/wgbh/pages/frontl...aroundamerica/
    WATCH ONLINE: http://www.pbs.org/wgbh/pages/frontl...damerica/view/

    http://www.pbs.org/wgbh/pages/frontl...roundtheworld/
    WATCH ONLINE: http://www.pbs.org/wgbh/pages/frontl...theworld/view/


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  4. #3 Excellent responce 
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    Thank you inow for the informative response :-D .

    You are correct, we in Australia do seem to have better health care then that of the USA, although ours is far from perfect. Many Australians are very unhappy with our current health care system. Given that france, england and sweden to name a few have FREE optical dental and everything else, health care related. We feel as though our goverment could do a considerable amount more. ( also thankyou for the links they were very helpful. )

    For example: I have car insurance, and i have it because just incase my car is stolen or i am involed in an accident i am covered. But God forbid i didnt have car insurance and/or i wasnt paid out on my car insurance, i would be without a vehicle. Now take my physical health and place it under the complete ownership of a private health organisation. the stakes become a lot higher, If God forbid i do injure myself or develope disease, inc cancer HIV.. and i dont have insurance and/or i wasnt paid out on my health insurence. Well thats game over.

    How can America let themselves be ruled by the search for wealth. Basically (correct me if i'm wrong) Private health care, is just a get rich quick scheme that has gone on for longer then it should.

    When people from all over the globe hear about America, its history of Democracy and global supremism (for want of a better word), they picture a vastly superior nation. Yet when facts emerge about their health system and vast internal poverty many wonder how this internal strife can occure.

    Basically the point im trying to reach is that America should have the best health care system in the world. Not one of the worst. When other nations look to the USA they look for an example, and with regards to public health care, an example is not being set, infact a very negative value for its citizens well-being is being produced.

    Please dont get me wrong, As an Australian i personally value the USA with the utmost love and regard, because they are our closest Ally and share many of our beliefs. In saying that a change is severly needed before the American people are at a high enough living standard, to what they deserve. Please as Americans never forget.. The Government should fear its people, The poeple should never fear their Government.
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    I can commiserate with your confusion and uncertainty, Charlie. We like to talk about how awesome we are in the US, but when you look at it objectively, we really are dealing with a bunch of crappy sub-optimal solutions to some serious life changing problems. Our freedom is just a concept, but unfortunately it is our indentured selves which ultimately compose this reality.

    As a general rule, the people of the US want to do what's right. They want to end slavery. They want to allow women's suffrage. They want equal rights for people of all skin colors. They want the elderly to be cared for despite a monetary lack. They want sick children to receive care. They want homosexuals to be treated equally. They want equal playing fields for all, and they want it to mean something when they are themselves successful.

    However, the voices with the greatest weight and the opponents with the most money tend to be those who are against these things. Those with the power are those opposed to changing the status quo. Our ignorant populace has elected an ignorant set of representatives, and those ignorant representatives are selling us out to the highest bidder... those who give them enough money to get re-elected and stay in power so they can continue to advance each other symbiotically.

    There are exceptions, and there are loud voices, but as a general rule the people of the United States are ready for progress, are ready for equal rights, are ready for green energy, and are ready for universal health coverage. Now it's just a matter of those same people abandoning their complacency, going out their front doors instead of merely sitting behind a computer, and demanding these things... finally going to the polls to elect those who can help us to achieve them and removing power from those who refuse to.

    It's easier said than done, though. Too many of the American public think evolution is a big lie, and that human caused climate change is a big conspiracy, and that our president is a secret muslim/marxist/socialist/nazi/communist who was not even born within our borders. Such is what happens when we let education in our country be done by committee instead of by merit.


    As I understand it, passing UHC in Australia was a hard fought battle, too. It seems the liberals put it through and couldn't pay for it very well, but they got it done. Then, when conservatives regained power, people loved UHC and refused to let it be taken away from them, so the conservatives could not revoke it... and instead they were able to tweak it and reduce costs very significantly. What has been your experience?

    No system is perfect, but I can almost guarantee you that what you have available to you in your home country is far superior to what most americans have here in mine... especially for those who have to choose between seeking treatment for their health or buying food their dinner, or between caring for their sick children and paying their rent and bills.

    Cheers.
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    Quote Originally Posted by inow
    and yet very strong ideological opinions and surplussed of indignation.
    I don't believe we have hordes of people with very strong ideological convictions. I believe we have many people whose convictions are shallow and easily swayed; hence the insurance company money buys temporary ideological convictions for as long as they need it to defeat any action that threatens profits.

    Personally, I feel nauseated by the recent developments, the chief nauseator is Lieberman. Convictions? Ya think?

    http://www.huffingtonpost.com/andy-b..._b_393873.html
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    Quote Originally Posted by Bunbury
    I don't believe we have hordes of people with very strong ideological convictions. I believe we have many people whose convictions are shallow and easily swayed;
    A very fair and reasonable observation.
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    Charlie, welcome to the forum, hope you hang around (many like minded folks here, at least on this issue) and please DON"T take offense to my reply.

    You are correct, we in Australia do seem to have better health care then that of the USA, although ours is far from perfect. Many Australians are very unhappy with our current health care system. Given that france, england and sweden to name a few have FREE optical dental and everything else, health care related. We feel as though our government could do a considerable amount more. ( also thankyou for the links they were very helpful. )
    Briefly, there is not much you do on any given day, that dose not affect your health;

    You get up after -X- number hours of sleep. Some say 5-7 or 8 hours is the REQUIRED amount for optimum health, yet there are many (especially in the US) that rarely get 5 hours.

    You eat daily; What you eat/drink, how often you eat, how much and with what nutritional content all make a difference in your health. If you obese or overweight, your likely to develop all kinds of health problems.

    You go to a job every day, or soon will; What that job is can be devastating on health. Work in a new building, with no windows, mine or work around chemicals (Common in Australia), drive a Big Truck or work around them, any stressful activity involved or maybe 100 other things can influence your health.

    Hobbies, pleasures or habits; Drink to much alcohol, or not enough water, party daily, climb mountains or maybe smoke or do drugs. Everything you do is an influence on you health today and most important, when you get older.

    Are you oriental, live the longest and sick the least or maybe black or Aborigines where life expectancy alone is less, or white/mixed, with a genetic background in family heart problems, breast cancer, respiratory problems or one of the many others.

    An insurance policy, can be constructed to fit your life style, job and expected problems or your family. One person with many of the few listed, may pay a little more or if has already developed major problems a lot more, but the people least likely to be sick very often, will pay less. Government, can only insure all the same and in no way will they ever get away with the common argument for limitations on service, in the US. Why;

    The US has 307 Million people (Australia 22), in 50 States with Concentrations in distant places under every imaginable environment possible (Australia primarily in the SE). We have about 20/30 major urban areas, NYC/LA, very much different than Philadelphia/Washington DC/Detroit, even Houston, Austin/San Antonia and Dallas, all in Texas have very different demographics with different medical problems. Then we have 7 States with far less people than in Sydney (4.2M) alone, some with less than one million. All any US National Health Care program can do is equalize cost, between these different places, which even today with an already 100 million on some form of Government Program (Medicare/Medicaid/CHIP's) can very many dollars per, from State to State.

    Then the results; As with SS, where most everyone is now covered, the quality of SS or about 1200/1300 per person/ month, Nationwide is meaningless in many places and life sustaining in others.

    Given that france, england and sweden to name a few have FREE optical dental and everything else, health care related.
    Do you honestly believe the health care you receive has come free? You are probably paying for most of your own, but by other means. Some kind of Tax, reduced coverage or loss in quality. As I recall, in most case you pay for service and are rebated for most procedures. Are you sure, those rebates haven't been coming down?

    In the US, most of US do feel we have the best and highest quality medical system on the planet, apparently quite a few from around the world do as well. We train folks here from around the world, most stay after the 8-12 specialized training/education and practice here, whether nursing or Neural Surgery. What we are concerned with is the cost and going Single Payer (won't happen anytime soon) will not solve this problem. Cost of everything involved to the end cost charged to the patient (or government), starts from the ground breaking of the Clinic, Hospital or facility, the training of personnel, cost of the equipment to operate the building, diagnostic equipment, to the INSURANCE cost of all these and the persons involved are much higher here, than in Australia or most anyplace on Earth. Then we have 1300+ that Insure Health in some way, many with cost under 100.00 per month for a person or 300.00 per family and near full coverage, including dental, optical and the rest. States and in some cases the Federal Government have restrictions or demands that won't allow these Companies to compete for several reasons.

    Any comments, before I rattle on....
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    Coverage for people's health should not be a profit driven business, Jackson. That's my take. It should be a care and outcome driven business. I'm not saying reductions in costs should be avoided, just that such an industry inherently fails the moment the motive is one of profit and not one of health outcome.
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    inow;
    Coverage for people's health should not be a profit driven business, Jackson. That's my take. It should be a care and outcome driven business.
    A business develops out of a need. Protection from a possible loss of property or in the event of something, is/was that need. Competition is the restraining force from greed by any business. Government, especially the US FEDERAL Government is not designed to control cost, cannot compete and the two can't exist, and should not try, especially when peoples HEALTH is the issue.

    Government claims its revenue through taxation or confiscation of the public wealth. In order for that source to grow or be stable, that source is limited to access. Insurance Companies, along with most all fields in Medicine are a 16-18% part of that source. Insurance Companies, restrained by competition are financed through investors, people who feel one or the other can properly redistribute funds, while meeting that competition, yet show a profit. I believe food today, is as vital as health care to any society and works just fine under Capitalism.

    I'm not saying reductions in costs should be avoided, just that such an industry inherently fails the moment the motive is one of profit and not one of health outcome.
    Health outcome, is 99% caused from Genetics, lifestyle IMO, or for all of us, aging. Millions over the years in anticipation, for any reason, of future health problems have worked hard to educate themselves and get jobs where Group or Job related policies were part of the pay. Insurance Policies are issued under the notion of eventual use, the price being to that time for when used the most (statistical probabilities).

    Think about this; The US Government has had payroll taxes of 14 to 19% for anyone employed for near 20 years at that rate. Taking a rough mean average over twenty years that's about $100,000 (Employer/employee, SS& Med) from those those making the maximum taxable (much higher for Medicare, taxed on total earned income). Even if the Federal did what they were supposed to do, place in a lock box, nothing would have been earned on the dollars taken. If that money had been received by Business, invested (which they do naturally) the value of that 100,000 would be valued at 300,000, while the lock box had devalued to around 50,000. Even our annual budget has been based on revenue including payroll taxes, what until this year (income fell below income) was then income to be spent and/or budgeted. Said another way, they are having to make up my monthly payments, from dollars (1950-1960), that were worth 5/6 times todays dollar, while in the meantime IBM has made 25-50 times my investment, including inflation. Please tell me you at least understand this difference.
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    Yeah. Again, you missed my point. My take is that health insurance should not be treated like a business. We're not talking about selling sneakers or computers. We're talking about peoples access to care and life saving treatments.
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    Yeah. Again, you missed my point. My take is that health insurance should not be treated like a business.
    No, I believe I addressed your point. Whether Government provides the insurance or the private sector, Health Care is, and operates as a Business. Things get built, people get hired, taxes paid and a need is serviced. Your point is Government should be more efficient, less subjective, more compassionate than the Insurance Companies, while making the decisions, allocating payments and determination of acceptable practices. I believe competition (public choice of more places) should determine these policies, not the temporarily elected officials of Government.

    We're not talking about selling sneakers or computers.
    Maybe not, but we are talking about necessities, which include food, shelter, clothing and or items for warmth and the many things needed daily by people.

    We're talking about peoples access to care and life saving treatments.
    People die every day, usually by a previously made choice, or for treatment denied. Millions around the world will die with full knowledge a transplanted organ, could sustain their life to what could be a normal aged death. Technically most people entering a hospital could be kept alive for an indefinite period of time. This is not the point, and what I'm pointing out is that Government if in control, will be forced to limit access to more and more as less and less access to a revenue source is available.

    For the record, I've noted "my take" or opinion and offering only my own. I do have a question, since I've noticed a softening of your opinions on a couple issues. Do you believe "Health Care" as an issue, is a politically driven agenda or the desire of a real majority, without the cost factor?
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    Quote Originally Posted by jackson33
    Your point is Government should be more efficient, less subjective, more compassionate than the Insurance Companies, while making the decisions, allocating payments and determination of acceptable practices.
    No, that is NOT my point. My point is that health coverage is a sector where money should not go to profit, and that profit is poisonous to healthcare outcome. I think every single dollar in this sector should go toward care and outcome.

    If health insurance operates as a profit driven business, then they will seek to maximize profits. To maximize profits in this sector, insurers must maximize revenues and minimize costs. Revenues come from the premiums of the insured. To increase premiums, by definition, the insured must pay more. To maximize profits, insurers must also reduce costs. Costs come in the form of payments on claims, and to reduce those outbound dollars, insurers must reject the sickest, must decline coverage for those with the most serious ailments, must rescind coverage for those who have chronic illness, and must avoid paying the claims of the insured in every instance possible. Carried to its logical extension, insurers ultimate desire is to collect premiums and never pay a single dollar toward a claim.

    We're not talking about producing cogs and widgets. We're talking about peoples lives and health being negatively impacted because companies currently want to make a few extra bucks by denying their claims or charging them more for a service... A service that any moral nation should provide to its people as a collective and shared benefit (just like we do with roads, clean drinking water, public universities and libraries, the police force, fire fighters, and the countless other services we all share and pay for at minimal costs to ourselves).

    In sum, the profit motive in health coverage is antipodal to care and health outcome. THAT is my point... not that government is always better than the private sector, but that profit should be completely off the table as pertains to this topic.

    I hope that has helped to clarify for you and others what I am saying.



    Quote Originally Posted by jackson33
    Do you believe "Health Care" as an issue, is a politically driven agenda or the desire of a real majority, without the cost factor?
    I believe you're presenting a false dichotomy, as those things are not mutually exclusive. I believe that health care availability should be provided to ALL members of an advanced society such as ours, and that by pooling our resources collectively we can minimize costs and maximize outcomes. I believe that our ridiculous focus on short-term profit and market economies has caused us to lose sight of the need to care for our people, both those with money and those without. I believe that... much like the freedoms which we enjoy as guaranteed in the first amendment to our constitution... healthcare should not be a privilege for the few, but a benefit available to all citizens in a great nation.

    I believe that those who are fortunate enough to have coverage should not be burdened with policies which force huge deductibles and cover practically nothing. I believe that there are too many people who contribute their hard-earned money to policies and... despite paying into the system regularly and responsibly... are despicably UNDER-covered, and that too often (despite their coverage and regular payments) are unable to use their coverage because it is so weak. I believe that those aforementioned weaknesses in coverage are a DIRECT result of the profit motive currently in place in this business. It saddens me that one out of every two bankruptcies in our nation are the result of healthcare costs and that 70% of those who went bankrupt as a result of medical costs HAD existing health care coverage.

    I believe that we as a country need to implement universal health care, and I believe that we as a country are smart enough to improve the system and reduce the costs once we have. I believe that our populace will all be better off under a system of UHC, and that once in place nobody would allow it to be removed because they desire that personal security more than they care about how they obtain it. If we pool our resources, there is no reason we cannot achieve this, and there are countless other advanced countries on this planet who do this already and who serve as a direct example in evidence of my point that this is hardly some unobtainable goal or pipe dream.

    Again, we need to place our focus on care and on outcome. The current focus on profit and bottom line is killing us, is filling the coffers of the few with the blood and deaths of the many, and I think we as a proud and moral nation can do far better.
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    They can't beat Canadian health care, they are the best for any age and race. I hope US government could implement the same.
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    Glad to see this forum resurrected. Both inow and Jackson have valid points. The fact remains that unless there is a sensible way to control greed either system is bound to collapse under the weight of self-interest. Inow is right that the private insurer backed by investors can only profit by collecting money and not paying out claims. That is the essence of Capitalism. The US government does not have a reputation for controlling the costs and equitable distribution of its programs. A significant portion of the US population expects Universal Healthcare to be “free”. With those three things in mind how do we proceed to provide health care equitably to all our citizens? We do not live in a society that places a high value on sharing, so any program would have to appear to benefit the individual more than the collective society. The notion that in America you can achieve anything you set your mind to is not usually tempered with looking out for your fellow human. At one extreme of the health care problem you have those people who will use it and refuse to pay for it, on the other extreme you will have those people who will try to profit from other people’s misfortune and in the middle you will have a group that is willing to pay their fair share but nothing for those who cannot afford it. I love the thought of Universal Health Care but have serious doubts that it could be trusted to our government for the long term. You tell me how to design, administer, and manage a health care system for nearly 350 million people. I will listen intently.
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    Quote Originally Posted by inow
    Hi Charlie,

    I have interacted online with many people from Australia about your healthcare system, and from what I can tell it is better than what we have in the US on nearly all counts. As for why our system here is so broken, much of it has to do with incompetence in our congress and the power held by the healthcare industry over the legislation which we produce (not to mention how in the US we have a growing percentage of ignorant people with very poor logic skills and education and yet very strong ideological opinions and surplussed of indignation).

    The outcomes of our care are quality, and we have many "islands of excellence" with our healthcare system, but we are truly drowning in a sea of mediocrity. I am not hopeful that the half-measure bill going through our congress now will help, and I see the current broken system of politics we have as producing nothing better than sub-optimal solutions to just about any problem we face.

    We have a bunch of idiots yelling a bunch of lies, and it's working. It's rather sad, really. I'd rather have what you guys have in Oz, and I see no reason (other than ignorance and special interest groups) why we cannot achieve it here in the US.
    What we have is a bunch of idiots who don't even understand capitalism screaming "free market!!!" "deregulation!!!" because they've been indoctrinated to believe that it all magically comes together to create prosperity without any effort to steer it in that direction.

    In an ideal free market, every worker would live at exactly the subsistence level, because that is exactly what market theory predicts. It predicts that every business will compete to offer the highest possible quality at the lowest possible price (at the break-even price, to be specific)..... and treats workers as businesses each consisting of exactly one employee. Health care would technically count as a luxury, because a worker can offer a more competitive price (demand a lower wage) by choosing to assume the risk, rather than pay someone else to assume it for them.

    Hence, free market theory predicts that most workers should be unable to afford health care, unless they were to collude (which is the absolute worst taboo in free market theory) by gathering together and demanding it together with one voice.
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    inow said:
    "We have a bunch of idiots yelling a bunch of lies, and it's working. It's rather sad, really. I'd rather have what you guys have in Oz, and I see no reason (other than ignorance and special interest groups) why we cannot achieve it here in the US."
    kojax said:
    "What we have is a bunch of idiots who don't even understand capitalism screaming "free market!!!" "deregulation!!!" because they've been indoctrinated to believe that it all magically comes together to create prosperity without any effort to steer it in that direction."



    A “free market” is Capitalism. That is the capital and markets are controlled privately without government interference. By its very nature capitalism promotes greed. Since there is no effective way to regulate greed then capitalism itself must be regulated and steered in the direction that benefits the most people. The regulation of capitalism seems to promote indolence so how do you balance greed and indolence? Since providers and consumers are not univerally motivated by altruistic principles an effective government would not let one run roughshod over the other. In a democratic society how do you get both sides to agree to place constraints on each other’s activities? In a money based global economy guess who gets the upper hand?
    The “idiots” you refer to are the ignorant and apathetic electorate. They want to reap what they do not sow. Does that not also sound like the definition of a modern capitalist?
    I think that a “vote of confidence” for elected leaders and a way to remove them quickly if they do not deliver to the electorate what they promise. The people would then truly have to live with their own decisions (universal health care or not), good or bad. They could make changes and adjustments to their programs much more expediently.
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    Being French, any foreign Healthcare system is total crap...

    That being said, the US system is of course subpar, 90% of it seems to be private initiative, but hey, it's the US and it's always been that way.

    And to those who say : "we'll never have OMG!§!111&§1! deficit like France, no communism for us"... guess what, you're way ahead of us.
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    Quote Originally Posted by Indigo450
    i

    A “free market” is Capitalism. That is the capital and markets are controlled privately without government interference. By its very nature capitalism promotes greed. Since there is no effective way to regulate greed then capitalism itself must be regulated and steered in the direction that benefits the most people. The regulation of capitalism seems to promote indolence so how do you balance greed and indolence? Since providers and consumers are not univerally motivated by altruistic principles an effective government would not let one run roughshod over the other. In a democratic society how do you get both sides to agree to place constraints on each other’s activities? In a money based global economy guess who gets the upper hand?
    The “idiots” you refer to are the ignorant and apathetic electorate. They want to reap what they do not sow. Does that not also sound like the definition of a modern capitalist?
    I think that a “vote of confidence” for elected leaders and a way to remove them quickly if they do not deliver to the electorate what they promise. The people would then truly have to live with their own decisions (universal health care or not), good or bad. They could make changes and adjustments to their programs much more expediently.
    Some people think greed is good. Others think greed is bad. I think greed is a tool. It just depends how you use it. It's like using the wind to sail a boat. If you cast your sails skillfully, the wind will carry you where you want to go. If you just randomly cast your sails however/wherever you feel like, then probably the wind will batter your vessel until it sinks.

    Now.... in my metaphor, the "sails" are your laws and regulations. If you set them right, then people's amibtions (which is the wind) will do the rest. Unfortunately, correct sail-setting is not simple enough to describe in just one line or paragraph. The guiding principle is to asses where the wind is blowing, and then compare that with where you want to go, then make corrections to your course to harness the portion of the current that is going where you want, and not the portion that isn't.

    Correct sailing does not consist in trying to create new wind currents of your own. Nor does it consist in trying to push against the wind.
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    Kojax wrote:
    “Some people think greed is good. Others think greed is bad. I think greed is a tool. It just depends how you use it.”

    Greed is defined by Webster’s dictionary as “A desire to acquire more than one needs or deserves.” It carries a negative connotation in everyday English. You could substitute Capitalism for your metaphor but I was using greed in the negative sense for my argument.
    You are right to infer that Capitalism and the state of health care is not a simple problem and I hope that I left that opinion.
    I believe you could use Capitalism to provide the wind for your sails but if you have others on your boat their needs to be some controls and a method of enforcement for the benefit of their lives. If you were overseeing the whole operation you would not want the captain to order the sails in a way that jeopardizes the others on board. You would also want to make sure that the others on the boat (crew or passengers) did not interfere with the smooth operation of the boat AND to help when needed (WORK).
    You must certainly be a more knowledgeable sailor than I so I hope my references to sailing weren’t too ridiculous. Just trying to keep consistency in the argument.
    Would like to hear more of what you think.
    "Somewhere, something incredible is waiting to be known."
    Carl Sagan
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  21. #20  
    Forum Professor arKane's Avatar
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    I really enjoyed reading this thread and believe the Health care system we have is only going to get worse before it gets better if it ever does.

    Indigo450 and kojax, both of you added a great deal of useful positive information to the dialog, but for my money if inow was running for office he would have my vote hands down. Attitude with knowledge is a main issue where my health care is concerned.
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