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How American Health Care Killed My Father - http://www.theatlantic.com/doc...

September 16 from Bookmarklet - Comment - Like - Share

Drew Raines, Dimitar Vesselinov, Kohl S Gill and 46 other people liked this

"Would our health-care system be so outrageously expensive if each American family directly spent even half of that $1.77 million that it will contribute to health insurance and Medicare over a lifetime, instead of entrusting care to massive government and private intermediaries? Like its predecessors, the Obama administration treats additional government funding as a solution to unaffordable health care, rather than its cause. The current reform will likely expand our government’s already massive role in health-care decision-making—all just to continue the illusion that someone else is paying for our care. But let’s forget about money for a moment. Aren’t we also likely to get worse care in any system where providers are more accountable to insurance companies and government agencies than to us? Before we further remove ourselves as direct consumers of health care—with all of our beneficial influence on quality, service, and price—let me ask you to consider one more question. Imagine... more... - Paul Buchheit from Bookmarklet

80 more comments

This is a very good article. - Paul Buchheit

My paternal grandfather died pretty much the same way (hospital-borne infection), so this article hits home. But is the proposed solution workable in the current political environment? - Dennis Jernberg

Yeah, unfortunately it may be impossible to actually fix the system due to all of the vested interests, though the author points out that perhaps after the current round of changes fails, perhaps greater change will be possible. Regardless, we should spend some time thinking about what the "right" system would look like instead of limiting ourselves to that which is perceived to be politically feasible. - Paul Buchheit

Great read indeed, thank you Paul for sharing this article which is highly thought provoking and sad all at the same time. Why do we as a country only wake up after Epic Failures?! - Susan Beebe from BuddyFeed

Personally, I want more options for small businesses that want to innovate in healthcare. If we just get rid of the major powers and allow for competition again, I think we'll see serious change. - Jesse Stay

I say this, having worked for UnitedHealth Group, one of the largest health care companies in the world. I learned there that these Health Care companies themselves are too big, and at the same time the government isn't any better. - Jesse Stay

I've consulted to both Gov't and BCBS Heathcare Plan clientele across the U.S. My Govt customers had better operational maturity than BlueCross and way less red-tape and politics. healthcare is deep in the hole. - Susan Beebe from BuddyFeed

Susan, and Gov't Healthcare still has problems! That shows you how bad it actually is. Dealing with Healthcare EDI technologies at UHG the government entities we worked with were always the ones still sending data over dial up, breaking HIPAA rules, and were the hardest to deal with from a technology standpoint. There are huge problems and huge holes in both the big health care and government if you ask me. - Jesse Stay

Maybe on really good health care plans nearly all expenses are covered, but on more basic plans only a minimum might be. - Mike Chelen

You can't order health care a la carte. That's simply not the way medicine is practiced in this country. You also have to get the people who actually provide the health care to play along. Atul Gawande http://www.newyorker.com/reporti... covers a lot of the same ground that David Goldhill covers, but Gawande seems skeptical that a consumer-driven system would actually succeed in keeping costs down. - Victor Ganata

Yeah, I think Goldhill's proposed solutions aren't workable. ( http://friendfeed.com/silas21... ) - Andrew C

The problem with the LASIK vs MRI scenario, is that a consumer knows enough to seek elective LASIK surgery on their own, but what consumer can determine whether they need an MRI, CT, contrast MRI, Ultrasound, etc? Self-referral has its own share of misallocation of resource issues. It's a traditional libertarian model that is simple and appealing, but I'm not sure it solves the problems... more... - Ray Cromwell

sorry people, but I think you are missing the real point: HEALTHCARE IS NOT A BUSINESS! and I would run away from any system that would see me primarily as a customer. Putting a price on something is NOT a way to make it work better for my health and that of my family is priceless to me. Now tell me which economic system will take that into account? The only reasonnable approach is to... more... - Yann Abraham

Ultimately, things do have a price, since we live in a world of scarcity and there will be limits, therefore, some people will encounter economic rationing or time delay, and hence die waiting. The arguments are over the best way to allocate these things, simply ignoring that things do effectively have prices won't solve the problem. - Ray Cromwell

@Ray I am not ignoring the fact that someone has to pay for doctors, hospitals and drugs; I am questionning the fact that we accept some people will die because those things are expensive. The point is: are we, as a society, wealthy enough to afford it for everyone? Since I think the answer is yes, I think politicians hiding behind cost arguments are just dishonest - Yann Abraham

Yann: the problem is that everybody will eventually die of something. Researchers can keep inventing more and more expensive ways of keeping us alive, but at some point you have to accept that it's not worth it and must cut people off. Right now the cut-off point is determined by what people can afford. How would you determine a cut-off point? - Gabe

@Gabe is this a joke? Are you suggesting it is perfectly fine to let poor people die from a disease because they cannot afford a cure? And if you are asking me for a cut-off point, may I offer that one: http://tinyurl.com/nseyjq ? - Yann Abraham

@Gabe Indeed, choices must be made. But having the cutoff point determined by what people can afford is heartless. Cost/benefit analyses can be made, even in emotionally fraught circumstances. (Witness the 9/11 Victims Fund) What I would argue is that the analysis should be made as a society, as a group, as a family, together-NOT to enrich Aetna's CEO. - Michael

Yann: Who pays? Are you paying? Are you donating your funds to charities? Or do you just think that it's okay to have your say over other people's money instead? The problem with your arguments is that you're not talking about *your* money going to help others, you're talking about everybody else's money. And yes, at some point I would indeed stop paying to keep a person alive. The... more... - Otto

One more comment: Anybody who is for this health-care plan and who does not right now give at least 10% of their income to health care charities or toward health insurance is a hypocrite. The current plan requires everybody to get health insurance, and the estimated cost of that for the average family is around 13%. I agree with the article in that health insurance should be made much... more... - Otto

@Otto I live in a country that has a health care plan (Germany), which means that a percentage of my monthly salary goes to pay for my health insurance and that of my family: so much for the hypocrisy. And, your point goes back to what Michael and myself are saying: I want doctors to decide what to do and when to stop. Not you, me or anyone: doctors, and certainly not 'money'. To quote... more... - Yann Abraham

The point where you withdraw care is going to be different for everyone, but I do agree with the sentiment that when that decision is made, it should be made with the patient's best interests in mind, and not in the best interests of the CEO or the shareholders of an insurance company. - Victor Ganata

And health insurance coverage for only catastrophes strikes me as foolish, because, unlike fires, floods, earthquakes, or tornados, a lot of medical catastrophes are actually preventable--or at least they can be mitigated--if you come in for timely care instead of waiting for the paramedics to wheel you in. - Victor Ganata

@Yann: Well then I'm in full disagreement with you, because under absolutely no circumstances would I want *doctors* in charge of my medical decisions. I want to be in charge of my own medical care. I get to decide when to stop, and I get to take all the relevant factors into account. You just enjoy your medical system over there, and let the government decide when you are not worth saving any more. I'll enjoy my freedom over here instead. - Otto

Well Otto, I don't want you in charge of my healthcare, so why does your opinion matter more than mine? Typical American sense of superiority thinking that this broke ass system is better than any other countries, it must be, BECAUSE LOOK HOW LOUD I AM SAYING IT! I wonder if these people (and Otto I am grouping you with them because they all sound alike) have experienced anyone close to... more... - Andrizzle Gizzle

Why should my life be more important than a schizophrenic person who will never be able to get health insurance because of his pre-existing condition, whose family would have to go broke to have him treated for life, because without treatment he will end up in jail or on the streets, but with treatment could lead a productive life? Who gets to make these decisions? Oh right, some guy... more... - Andrizzle Gizzle

In response to this quote from the article "Imagine my father’s hospital had to present the bill for his “care” not to a government bureaucracy, but to my grieving mother. Do you really believe that the hospital—forced to face the victim of its poor-quality service, forced to collect the bill from the real customer—wouldn’t have figured out how to make its doctors wash their hands?" My... more... - FFing Enigma (aka Tina)

FFing Enigma: that is where the article seems incomplete, it lists a number of legitimate issues, then asserts somehow these would be addressed if patients were billed directly - Mike Chelen

Hypothetical scenario: civilization becomes so rich, that food, water, shelter, transportation, power, and other basics are practically non-scarce. Everything else produced is surplus. In this scenario, why would it be bad if 80% of GDP was spent on HealthCare and Education? You've got to spend the money on something (foreign aid?). What I'm saying is, IMHO, improving health and life... more... - Ray Cromwell

Mike, it somehow implies that billing a crying family would make it all more 'real' and 'important' to the doctors giving the care than if they're billing an insurance company. Which is a load of crap: doctors already deal with the crying family, it's the hospital's business office that handles the billing and they don't see the crying family until they can't pay the bill and come in to try and make arrangements after the fact. - FFing Enigma (aka Tina)

Andrea G: Yes, in fact I have experienced that with a family member. Insurance paid for it just fine. Also, fuck you for thinking you know anything about me or my opinions. If you don't like what I say, then learn to disagree with civility instead of with personal attacks and generally being an obnoxious bitch. - Otto

haha A++ response, thank you for proving your toolishness. - Andrizzle Gizzle

Otto, you'll note that I commented on how many people use the I AM THE LOUDEST IN THE ROOM debate technique. You can't respond to me on point, so instead you start throwing out cusses and misogynistic name calling. This is exactly why there is so little reasonable discussion. Instead of saying, "FYI My father had cancer and he was covered 100% by BCBS with no out of pocket expense at all" you just start screaming. That is why I do not take you seriously. - Andrizzle Gizzle

@Otto setting aside your argument with Andrea, could you please tell me what makes you so certain that your judgement is better than the one of doctors, and by the way, how good would you trust your judgement after a stroke that left you with no speech and hemiplegic? And, just to emphasize it once again, I want (and currently enjoy having) doctors deciding what's best for me: it's... more... - Yann Abraham

@Andrea G: When you start throwing personal attacks my way for absolutely no reason (note that I never used caps once, or "yelled", or anything else that you're accusing me of), then yes, I'm going to respond in kind. However, since I did ask you to be civil, and this is apparently not possible for you, then by all means, welcome to my block list. You are user number 2. - Otto

I'd also like to point out that anyone who has had treatment for a serious disease has probably paid less money for their health insurance than the cost of the care they have received. That is really the whole point of insurance - to spread risk. Why is it that the same people who don't want the government option also don't want to get rid of Medicare? - Robert Felty

@Yann: It's my body and my health. That makes everything that happens to it solely my decision. Not yours, not the doctors, not the governments. Mine and mine alone. I may listen to my doctors or I may not, but in the end I'm not trusting anybody else with my health except me. Are you seriously any different? Do you *really* want to give control of your health over to somebody else? That strikes me as frankly insane. - Otto

@Otto: No. Health care decisions involve at least two parties. The patient and the physician. You have no right to compel your doctor to do something against their judgment, either. - Victor Ganata

Which people are you referring to Rob? There are obviously many points of view on this topic (all of them wrong ;). This article does a good job of explaining many of the fundamental problems with all of the present systems. Unfortunately it's very hard to fix because there are so many vested interests and because it's such an emotional topic (as demonstrated by this thread). - Paul Buchheit

@Robert: Your notion is wrong, because you're basically suggesting that insurance is some kind of magical money creation fairy. You cannot get out more than goes in, period. If everybody was to pay less for health insurance than they get out of it, then they'd be negative on funds. - Otto

@Victor: There exists more than one doctor, and I will not give control over choice of my doctor to anybody else either. - Otto

Otto: shouldn't that be a joint decision between the patient and doctor? installing piping in my house is at my discretion, but i'm certainly going to involve a plumber in the discussion - Mike Chelen from IM

Otto, the idea with normal insurance (such as car insurance) is that most people pay in more than they get out so that nobody risks bankruptcy by being unlucky. Health "insurance" is broken in part because it covers all costs, just as car insurance would be broken if it also covered gas. - Paul Buchheit

@Mike: No, it absolutely should not be a "joint" anything. It's MY decision. End of discussion. I will hear input from the doctor and take it into due consideration, but in the end *I* make the call. Period. - Otto

@Paul: Now yes, I agree with that 100%. - Otto

@Otto: yes, you can choose your physician, and yes, you can refuse treatment, but you can't compel anyone to treat you in a certain manner just because you feel like it and are willing to pay. That's all I'm saying. Of course it's your call. Except when you no longer have decision making capability. - Victor Ganata

@Robert, there are public option opponents who oppose Medicare as well. They're usually either fringe nutjobs or keep the latter opinion under wraps because they know it won't fly. - Andrew C

@Victor: You're not making any sense. You don't need to "compel" anybody to do anything. If one doctor won't do it, you find one that will. Simple. - Otto

@Paul, I think making people pay for checkups has as big a downside as upside. ... see Victor's comment from yesterday. - Andrew C

I oppose Medicare, mainly because it's hemorrhaging cash and is highly inefficient, like any government run bureaucracy. - Otto

How inefficient is it? - Andrew C

@Otto: Trust me, there are lots of things people ask for that no doctor who had an interest in keeping their license and not going to jail would ever perform. Obviously, there are those who are willing to cross that line, like Conrad Murray. - Victor Ganata

Medicare has been far more successful than private insurance at keeping costs down. - Victor Ganata

@Victor: I assumed that *I* was the one making the decisions here. I am not a crazy person who would ask for stupid medical procedures. - Otto

Medicare keeping costs down? Are you out of your bloody minds? You have the internet, people. Use it. Medicare regularly pays *twice* the cost of any other means of obtaining the same services. - Otto

@Otto: Sorry, but I don't know anything about you. But all I'm saying is that, in the bigger picture, the idea that only the patient and no one else has any say in the treatment they receive is simply flawed. - Victor Ganata

"You have the internet, people. Use it." ... Thing is, "I don't have my supporting evidence at hand, please google it for me" is never convincing. - Andrew C

The reimbursements from private insurance and from Medicare are usually pretty close, since most private insurance companies peg their payments to Medicare RVUs. But most physicians will say that Medicare pays them less than private insurance does. - Victor Ganata

So Medicare sucks because it pays double what private insurance pays AND because it pays less than private insurance. This is better than having tea and no tea at the same time. - Andrew C

According to CMS, since 1970, the cost per Medicare beneficiary has gone up by 8.8% every year. In contrast private insurance premiums have gone up by 9.9% every year. http://www.cms.hhs.gov/Nationa... - Victor Ganata

@Andrew C: "I'm too lazy to look it up myself, so I'll just argue complete nonsense and force you to continually disprove me" doesn't really work well either. Again, you have the internet. Use it before writing commentary. Learn the facts yourself, don't expect other people to continually set you straight. - Otto

@Victor: No, it's not flawed, it's the only ethical way to operate. I mean, are you seriously suggesting doctors should perform procedures on a patient without their consent? The patient must sign off on everything, every step of the way. Anything less is simply abhorrent, and I find it hard to believe that anybody could possibly argue against this. The patient is the only person *allowed* to make medical decisions for themselves. Nobody else can override him. Nobody else can overrule him. - Otto

@Otto You still have not answered this very basic question: how do YOU know what is good for you when anybody else is taking the opinion of someone who was trained for at least 5 to 6 years before even coming close to a patient with a simple cold?!? I mean you sound a little extreme when you claim that you know better, and again, what if you suffer from a stroke or other disabling disease that takes your judgement away? - Yann Abraham

@Otto and last but not least, I disagree with you as much as you disagree with me, but in the end, my position does not deny you the right to die your way, while your position is denying me the right to be cured regardless of what I can pay for. Sorry to say but I would favor the position that gives most people the most options - Yann Abraham

Paul, I can't cite anyone in particular who opposes a public option and supports medicare, but I haven't heard many people arguing that we should get rid of Medicare (mostly because people on Medicare would have a fit, and old people like to vote). Unless I am mistaken, I think that health insurance functions under the same principal as auto or home insurance. People who are healthy pay... more... - Robert Felty

If I had to decide how to cure my cancer, I think I would try bloodletting. I have heard that works pretty well. - Robert Felty

@Yann: What in the hell are you talking about? I never said that every person had to know how to self-diagnose. I said that they have to make their own *decisions*. "Making your own decision" is not the same thing as "not taking your doctors' advice". I mean, get a grip dude, you act as if I'm saying that listening to doctors is a bad idea. I'm not saying that at all, I'm saying that... more... - Otto

On a more serious note - thanks to Victor for pointing out that Medicare actually does keep costs down more than private insurance. On a related note, Canada spends about half as much per capita on health insurance than the U.S., and has lower infant mortality rates and longer life expectancies. http://www.yesmagazine.org/issues... - Robert Felty

@Yann: Furthermore, you seem to be saying that people should not have a choice. That they should be forced to do everything any doctor tells them, ever, and that all of society should be forced to pay for it. That's the only interpretation of your words that makes any sense. Otherwise I cannot possibly understand why you're opposed to the idea of making your own decisions. - Otto

@Otto: I don't dispute the fact that patients are entitled to autonomy in their decision-making (unless, of course, they don't have the capacity to make decisions.) All I'm saying is that a patient can't just demand whatever the hell they want and expect to get it. That would be just as abusive to the doctor-patient relationship as the doctor trying to force the patient into undergoing some procedure or treatment. - Victor Ganata

@Otto well if I go to doctor and he tells me I am going to die in a month, however much I disagree with him does not make a single difference and going to a different doctor will not change the diagnosis. What kind of decision am I supposed to make when I do not have a single clue about what is going on? And please, don't try to tell me that you would ask a doctor to cut your life support simply because it's getting too expensive... - Yann Abraham

Otto: patients have a right to refuse treatment which supersedes the doctor's suggestion, still the medical opinion is crucial to the process - Mike Chelen

Paul: probability is a relative measurement, on a reasonable timeline all events can be determined to occur at a statistical rate - Mike Chelen

Health insurance no longer works in the presence of side information like family history, genetic predisposition, and pre-existing conditions. Even if the insurer isn't allowed to use some (or all) of these in determining rates, there is nothing keeping the consumer from using it. As a result, there will be an inevitable trend for those likely to need more medical converge to choose the... more... - Eric Borisch

@Victor: If the patient wants one thing and a doctor refuses to provide it, then the patient should seek out a new doctor. Duh. If you want your plumbing fixed a certain way, then you find a plumber who will do it your way. Doctors are no different. @Yann: Second opinions are critical to all fields. Doctors are not magical fairies that are incapable of error. Judgment is involved in... more... - Otto

@Eric: Players at the high roller tables *are* the ones most likely to win. "Streaks" are a real and statistically valid phenomenon. Thus, large winnings can only occur in the short term play, as the law of averages means that the house always wins in long term play. So, if you're betting more, then you're likely to win more in the short term. Success at gambling is all about knowing... more... - Otto

@Otto: *shrug* All I'm saying is that just because you pay good money for your health care doesn't mean you can order health care providers around like you own them. It's a partnership, and if you don't accept that fact, all your encounters with health care professionals are going to be adversarial, and you're probably not going to get very good care. - Victor Ganata

@Victor: Speak for yourself. I do not pay anything for health care, as I have not been to a doctor in ~20 years, nor do I expect to see one for around another 15 or so. I do not have, and have no current need for, health insurance. - Otto

@Otto: so basically you're talking a lot of trash about something you have no experience with even as a consumer. Excellent. - Victor Ganata

@Victor: Not once did I talk any trash, of any sort. I think you're reading subtext into my words that is simply not there. I would request that you go back and read them again, only this time without your pre-existing bias. Thanks. - Otto

@Otto: At this stage I think it's pretty disingenuous to be disavowing your stance on the health care debate. Of course, maybe I'm wrong, and you don't really think doctors (and other health care professionals) should always do as you say. - Victor Ganata

Manish Mohan

What is Connectivism? - http://docs.google.com/Doc...

September 17 from delicious - Comment - Like - Share

Janet Clarey liked this

Doc that uses Ertmer’s and Newby’s “five definitive questions to distinguish learning theory” (Distinguishing One Learning section, para 1) to provide a framework to organize various theories - Behaviourism, Cognitivism, Constructivism, Connectivism. - Manish Mohan

Josie Fraser

Playing with @readtwitapp RT @mrch0mp3rs: readtwit - publishes the links from your twitter stream as an RSS feed http://www.readtwit.com

September 18 from Twitter - Comment - Like - Share

Janet Clarey liked this

Claire Thompson

Who nicked my picture - took me ages to find one that didn't have a tongue poking out, silly grin or double chin

September 18 from Twitter - Comment - Like - Share

Janet Clarey liked this

MLx

My feet are dragging and I've got big dark circles under my eyes. Let's pretend it's International Zombie Day, mmkay?

September 18 from Twitter - Comment - Like - Share

Janet Clarey liked this

i pretend that a lot days :) - Sir Shuping

Myrna to Myrna's feed, Foods, friendf00d

The Rubix Cubewich (via http://friendfeed.com/foods...) cute idea

August 6 - Comment - Like - Share

Mustafa ♮ Sadedil, mahyar, welee and 65 other people liked this

Very interesting :-) *now me thinks: how to make it without meat*...hm...? ;-) - Hanna Wiszniewska

21 more comments

I'm about to vom-bomb. Going to hide this entry. - Johnny

more different cheeses, but please please do'nt ruin the beauty of it with *shudders* tofu.. - Rasmus Lauridsen

you can also add more colours with some vegetable (spinach, potato, peppers, etc.) frittata/omelette cubes. The original is really nice & yummy though :-> - Stefaniav

You could make that with tofu or jello too. - Adrian

The cubes are perfect, I'm still astonished - Stefaniav

Thanks for the suggestion Adrian :-) - Hanna Wiszniewska

Hanna, what about switching meat for tempeh? Wonder if Rasmus shudders from tempeh lol but anyway, its your cubewich to do with it what you want. :))) - Myrna

beautiful - sorina_gt

Looks awesome although you will need a very big mouth in order to eat it :-) - outofmyarse

Very classy. I could spend hours rearraging the cubes. Hey! New dieting idea. - Bob

I can help solve this puzzle! *pulls all the ham pieces out* - Daynah

LOL Daynah, what about the other meat. It has the chemical preservatives...ugly causes cancer. And what to put instead? - Myrna

Never tried Tempeh, I might have to go hunting for it. Anyone know a store in Denmark that carries it? - Rasmus Lauridsen

Try an Indonesian, Malaysian or Thai market. - Bob from email

Awesome! - Mitchell Tsai

Do I detect some Spam in that? - Arleen Anderson

Rasmus, you know what tempeh is, yes? Of course you have health food stores? - Myrna

Yeah I wikipedia'd it :-P So yeah I'll have to try the local health food stores - Rasmus Lauridsen

رونوشت به خودم :) - 1Fathi

Great idea! I would love to make this with vegetables!! I don't now how though:) - Konstantina (exei gousto)

or with fruits?.. - AgentRouge

Konstantina, I can think of boiled sweet potatoes and pumpkin as some of the vegetables that can be cut in such cubes O_o also carrots maybe... and definitely more cheese. plus some mangoes?.. - AgentRouge

Nancy White

RT @dlnorman: Rebirth of radio as a deep, meaningful curated experience. Sounds like education to me #opened09 (Interested in curation - nw)

August 13 from Twitter - Comment - Like - Share

Janet Clarey liked this

Tawny Press

What is happening to the creative peeps? The guys avatars are looking ganster lately :)

August 13 from Twitter - Comment - Like - Share

Janet Clarey liked this

Bill

RT @sairy: RT @TechnologyGeek ReadWriteWeb - iGoogle is Now Social: Google Launches Social Gadgets http://www.readwriteweb.com/archive... #socialmedia

August 12 from Twitter - Comment - Like - Share

Janet Clarey liked this

Jesse Stay

Twitter may be down, but my RSS reader still works - isn't that all that really matters?

August 6 - Comment - Like - Share

localr, Moved to Facebook, Mac Sharp and 14 other people liked this

No, FriendFeed needs to be working as well. - Rob Diana

6 more comments

Rob, FriendFeed *is* my RSS reader :-) - Jesse Stay

My twitter is back up, but I'm off to Google Reader. - Wallace

Actually, I've not used RSS feeds for some time; hooked on real-time - Robert J Taylor from iPhone

RSS always works, Rob. It's like saying you breathe oxygen. - Louis Gray

Robert, I actually use a combination of both. I've found there is still some great information I can get from blogs I can't import into FriendFeed, along with the social nature of Google Reader. I still need Google Reader to fully complete the experience. - Jesse Stay

Louis, isn't that what @jack wants Twitter to be? - Jesse Stay

I didn't miss it. Go FriendFeed! - Skyler Call

Jesse Stay

2009 Facebook and Twitter Growth by Age Group - http://www.ignitesocialmedia.com/2009-fa...

August 6 from Google Reader - Comment - Like - Share

Stuart Miniman, Atul Arora and Janet Clarey liked this

http://www.actweo.com/twitter... - Actweo.com