DebateGate

General Category => 3DHS => Topic started by: Universe Prince on December 31, 2007, 11:39:45 AM

Title: example #7,925,340 why government run health care may not be the best idea
Post by: Universe Prince on December 31, 2007, 11:39:45 AM
From "A Lifesaving Checklist", a New York Times op-ed by Atul Gawande:

      A year ago, researchers at Johns Hopkins University published the results of a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves.

The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.

Yet this past month, the Office for Human Research Protections shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.
      

Ethics regulations. According to the op-ed, the government decided that introducing a checklist is the same as using an experimental drug, and therefore doing so without federal oversight and written permission from each and every patient is unethical. And some people wonder why I think the government isn't qualified to run health care.

Whole op-ed at the other end of this link (http://www.nytimes.com/2007/12/30/opinion/30gawande.html).
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Xavier_Onassis on December 31, 2007, 11:49:18 AM
Ethics regulations. According to the op-ed, the government decided that introducing a checklist is the same as using an experimental drug,

------------------------------------------------
No, the "government" did not make this decision. Some fool made it.

Private companies also hire fools. Just go to the office of Dr. Eng-Gonzales in Palm Springs, FL and you will see a fool of monumental proportions in charge of the offices of five doctors, whose only roll is to ensure that every patient waits at least three hours.

It is just as easy to prevent the employment of fools in a government than anywhere else.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: _JS on December 31, 2007, 11:51:31 AM
I'm not that impressed.

Did they follow the correct procedure to get approval from an IRB?

It is a little misleading as well. It is the tracking of the results and not the checklist itself that violates HIPAA.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Michael Tee on December 31, 2007, 11:53:46 AM
<<Ethics regulations. According to the op-ed, the government decided that introducing a checklist is the same as using an experimental drug, and therefore doing so without federal oversight and written permission from each and every patient is unethical. And some people wonder why I think the government isn't qualified to run health care.>>

Here in Ontario, the guys who set the medical ethics are not the guys who administer the health plan.  I can't think of any jurisdiction where they would be.  The one has nothing to do with the other.

You might as well argue that because the Ontario Ministry of Transport fucked up on a tractor-trailer safety regulation, therefore the Ontario Ministry of Health is incapable of managing the health-care plan.

The government has no monopoly on stupidity, unfortunately.  Mistakes happen in private enterprise, the medical profession and the insurance industry and there's no reason why the government should be immune from them.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Universe Prince on December 31, 2007, 05:41:29 PM

It is just as easy to prevent the employment of fools in a government than anywhere else.


Is it?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Universe Prince on December 31, 2007, 05:48:37 PM

The government has no monopoly on stupidity, unfortunately.  Mistakes happen in private enterprise, the medical profession and the insurance industry and there's no reason why the government should be immune from them.


Yes, but somehow when government makes mistakes, it's excusable. When mistakes happen in private business, it's chalked up to a conspiracy of callous greed. If some private medical establishment had done this, I'd be seeing some post about how it was proof that private medical management was unconcerned with the wellbeing of patients and therefore we need government regulators to take over. But the government has made this decision, and all I see are people saying this is no big deal, this just happens.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Universe Prince on December 31, 2007, 05:49:44 PM

It is a little misleading as well. It is the tracking of the results and not the checklist itself that violates HIPAA.


Just how unethical is it to track the results of a checklist?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Xavier_Onassis on December 31, 2007, 08:11:18 PM
It is just as easy to prevent the employment of fools in a government than anywhere else.


Is it?
====================================
I think it is probably easier.

When your credit card company decides that a payment you sent on time was late, and therefore you owe a $29.95 late fee on a $50 overall payment, you will never, never, get to talk to the moron who decided it was late. Or the other greedhead who decided that a ;late payment was actually worth $29.95 to start with. You will never know even their name. Even if you own stock in the stupid company, you will never know

If the government overcharges you, there are always procedures by which you can appeal, and you can vote them out of office eventually.

Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Michael Tee on December 31, 2007, 11:14:05 PM
<< . . . but somehow when government makes mistakes, it's excusable. When mistakes happen in private business, it's chalked up to a conspiracy of callous greed. >>

All due respect, Prince, but that's really fuzzy logic.  The issue was whether the government is unqualified to run a health-care scheme.    How the errors of government or private business are viewed or indulged by the public has nothing to do with how well or badly they actually perform.

<<If some private medical establishment had done this, I'd be seeing some post about how it was proof that private medical management was unconcerned with the wellbeing of patients and therefore we need government regulators to take over. But the government has made this decision, and all I see are people saying this is no big deal, this just happens.>>

LOL.  Actually, just the exact reverse has happened here.  One goofy mistake by government and right away we see "some post about how it was proof that government was unconcerned with the wellbeing of patients . . . " etc.  Sounds to me like we have some "projection" going on here.  It's not the proponents of government health care who are opportunistically seizing upon a private businesses' error to justify government-run health care, we are actually seeing opportunism of the private-care side capitalizing on a government error to make the point that government is unfit to run health care.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Plane on January 02, 2008, 04:51:35 PM


It is just as easy to prevent the employment of fools in a government than anywhere else.



I wish you were right .
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: _JS on January 02, 2008, 05:17:36 PM
In general, most of the United States swallows the neoliberal perception that private industries run projects more efficiently. Whether that is true or not in varying circumstances is of course another story completely.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Xavier_Onassis on January 02, 2008, 09:27:52 PM
My experience is that UPS is more likely to trash shipments and to deny any compensation than the USPS.
Most HMO's will make you wait longer on hold on the phone than the Social Seciurity Administration, and most HMO doctors will make you wait longer for a scheduled appointment than Social Security.

An HMO doctor will not see you at all without an appointment, but Social Security will.

The UPS and Fedex are both much more inconvenient that the USPS and will make you wait longer than the USPS. They both have many fewer locations, and will make you wait longer. They are also less courteous, as a rule.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Amianthus on January 02, 2008, 09:41:45 PM
An HMO doctor will not see you at all without an appointment, but Social Security will.

ROFL

I've been to HMO doctors without an appointment (indeed, most of my visits have been without appointments) - even on weekends or the middle of the night - and very few government offices are open AT ALL outside of certain hours.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Amianthus on January 02, 2008, 09:44:10 PM
The UPS and Fedex are both much more inconvenient that the USPS and will make you wait longer than the USPS. They both have many fewer locations, and will make you wait longer. They are also less courteous, as a rule.

UPS and Fedex will both pick up your package if you call the 800 number.

Don't know how much more convenient than coming to your house to pick up the package the USPS can get? Do they buy the contents and pack it for you as well?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Michael Tee on January 02, 2008, 09:44:42 PM
<<The UPS and Fedex are both much more inconvenient that the USPS and will make you wait longer than the USPS. They both have many fewer locations, and will make you wait longer. They are also less courteous, as a rule.>>

In Canada, the Postal Service was "privatized" to the extent that it was put into the hands of a Crown corporation.  It's a for-profit business corporation but owned by the Canadian government.  For sure it has many more branches than either Fedex or UPS, but OTOH, Fedex and UPS will pick up, whereas Canada Post will not.

As far as friendliness goes, I found all of them were more or less equally friendly and helpful.  Waiting lines are much longer at Canada Post, but that's because they are by far the cheapest and therefore have many more customers.

The fastest and most reliable is Fedex, then comes UPS and then Canada Post.  The most efficient and hard-working counter servers are from Fedex and UPS, some Canada Post employees are fully their equal, others are not.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 12:05:36 AM


It is just as easy to prevent the employment of fools in a government than anywhere else.



I wish you were right .

Hmmm, I wonder.

Many of the students at the college I teach routinely brag about their DoD civiian jobs at the local AFB. They brag about not having to work very hard and yet getting good pay and benefits. They find it laugable and if you ask most of my students who do not have a job there, they would give their right thumb for a job there.

Is this a problem in human nature or ????
Is this a surprise?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 12:07:18 AM
In general, most of the United States swallows the neoliberal perception that private industries run projects more efficiently. Whether that is true or not in varying circumstances is of course another story completely.

My experience tells me that private industry is more efficient as profits, etc. are on the line.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 12:10:18 AM
An HMO doctor will not see you at all without an appointment, but Social Security will.

ROFL

I've been to HMO doctors without an appointment (indeed, most of my visits have been without appointments) - even on weekends or the middle of the night - and very few government offices are open AT ALL outside of certain hours.

And try to get many Govt workers to work over 40 hours in a week. When I was in the IRS, I got comp time on a 1:1 basis for any work over 40 hours in a week, I NEVER got that in the private sector. EVER.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Xavier_Onassis on January 03, 2008, 12:15:16 AM
My experience tells me that private industry is more efficient as profits, etc. are on the line.

========================
Your brain ought to tell you that the private industry will fail if it does not turn a nice profit, at least 15% annuallly and needs to grow or perish, while a government provides its services at cost, and has no need to grow at all.

If a government enterprise is i9nefficient, it is most often because some politicians decide to stuff some pork in the mix.

Agfa film was run by the government for over 30 years by the government and sold film for less than Kodak.
The Alaska railroad was run at a profit as a government corporation for years, until statehood gave Alaska politicians to screw it up.

Compare UPS service and cost with the USPS, and USPS wins hands down: better and more convenient service at a lower cost and with higher wages for its workers.



Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Michael Tee on January 03, 2008, 12:17:08 AM
<<And try to get many Govt workers to work over 40 hours in a week. When I was in the IRS, I got comp time on a 1:1 basis for any work over 40 hours in a week, I NEVER got that in the private sector. EVER.>>

Aren't you glad that 100% of the value of your overtime labour went directly into the pockets of your bosses without one cent of it coming to you?  I'm sure that they must have really deserved every penny of it.  You must have felt real good about it, donating the value of your labour over and above what you were paid to perform, to such a great cause.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Xavier_Onassis on January 03, 2008, 12:21:07 AM
And try to get many Govt workers to work over 40 hours in a week. When I was in the IRS, I got comp time on a 1:1 basis for any work over 40 hours in a week, I NEVER got that in the private sector. EVER.

===========================
So your model for success involves screwing the workers?

If I taught at a public college I would make half again as much, and my students would pay less than half as much. And the president would not call me into his office and tell me that I had an obligation to kick back a part of my meager salary to the institution as a charitable do9nation so HE (who was making four times my salary) would not look bad in front of other college presidents. So please, take that sorry asshole tale elsewhere: I am not buying it for a nanosecond.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 11:38:44 AM
<<And try to get many Govt workers to work over 40 hours in a week. When I was in the IRS, I got comp time on a 1:1 basis for any work over 40 hours in a week, I NEVER got that in the private sector. EVER.>>

Aren't you glad that 100% of the value of your overtime labour went directly into the pockets of your bosses without one cent of it coming to you?  I'm sure that they must have really deserved every penny of it.  You must have felt real good about it, donating the value of your labour over and above what you were paid to perform, to such a great cause.

????
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: _JS on January 03, 2008, 11:40:57 AM
In general, most of the United States swallows the neoliberal perception that private industries run projects more efficiently. Whether that is true or not in varying circumstances is of course another story completely.

My experience tells me that private industry is more efficient as profits, etc. are on the line.

My experience tells me otherwise.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 11:41:48 AM
And try to get many Govt workers to work over 40 hours in a week. When I was in the IRS, I got comp time on a 1:1 basis for any work over 40 hours in a week, I NEVER got that in the private sector. EVER.

===========================
So your model for success involves screwing the workers?

If I taught at a public college I would make half again as much, and my students would pay less than half as much. And the president would not call me into his office and tell me that I had an obligation to kick back a part of my meager salary to the institution as a charitable do9nation so HE (who was making four times my salary) would not look bad in front of other college presidents. So please, take that sorry asshole tale elsewhere: I am not buying it for a nanosecond.


I am not sure what you mean, XO. What is your point here? I work at apublic college and we are "highly encouraged" to pay to thecollege Foundation. I kick in $25 a pay period. The faculty and staff participation rate on campus is near 100%. But, how does that deal with the issue of overtime, etc?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 11:47:04 AM
In general, most of the United States swallows the neoliberal perception that private industries run projects more efficiently. Whether that is true or not in varying circumstances is of course another story completely.

My experience tells me that private industry is more efficient as profits, etc. are on the line.

My experience tells me otherwise.

A colleague of mine recently went to Tennessess to run their welfare agency IT operations or something similar. He indicates it is a mess of uninspired Government workers. He says if they are in the middle of a project, they will just get up and leave if their eight hours are up instead of staying and finishing. I would NEVER have been allowed that latitude in the private sector. At EDS, for example, our standard workweek was 60 hours. They were honest enough to tell you in the job interview and they stuck to it. Typically, it was much more than that. In the years I worked for them, they were NEVER, read this carefully, NEVER late or over-budget on a project. Now, is that a good thing? Yep. Except they acheived this on the backs of their workers. So, a balance msut be observed. But, how do we determine this balance? Who determines this?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: _JS on January 03, 2008, 11:58:42 AM
I currently work in the private sector. I have before and I've worked in the public sector as well.

The differences are amazing. Yes, I work longer hours now...

But I stand by my comment.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Plane on January 03, 2008, 12:32:11 PM
a government office sets its own standards of service , for many government offices repeat customers are not especially wanted.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 12:41:36 PM
I currently work in the private sector. I have before and I've worked in the public sector as well.

The differences are amazing. Yes, I work longer hours now...

But I stand by my comment.
And your rationale is?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: The_Professor on January 03, 2008, 12:42:42 PM
Good point, Plane.

If a recessino deos in deed come, will even more employess flock to the public sector due to job security issues?
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: _JS on January 03, 2008, 12:45:42 PM
I currently work in the private sector. I have before and I've worked in the public sector as well.

The differences are amazing. Yes, I work longer hours now...

But I stand by my comment.
And your rationale is?

I've seen much more efficiency in the public sector than in the private sector. I've seen people do more with much less. Yes, they take their breaks and their working hours seriously, but for the lower amount of pay and the ridiculously lower amount of spending on non-personnel items it is simply amazing what the public sector can do in my experience. As Mike said, they do even better when they can work around the legislature's politics. And I've never seen politics as brutal as in the private sector.
Title: Re: example #7,925,340 why government run health care may not be the best idea
Post by: Xavier_Onassis on January 03, 2008, 12:48:39 PM
I am not sure what you mean, XO. What is your point here? I work at apublic college and we are "highly encouraged" to pay to thecollege Foundation. I kick in $25 a pay period. The faculty and staff participation rate on campus is near 100%. But, how does that deal with the issue of overtime, etc?

=============================================================
YOu apparently do not understand what a job is all about. You have a job to do your work and, in exckhange, to BRING MONEY HOME. The purpose of a job is not to kick back the money you earn to the people paying you. The have no right to "highly encourage" you to give them a dime. If you would not give it to them if you didn't work there, you are only giving it back to them because you are intimidated to do so, or you just don't understand the purpose or the meaning of a job. You are being browbeat into kicking back about $650 per year. The fact that "nearly everybody does it" only indicates that the Fascists in charge are really efficient Fascists. If youare going to be a sucker, at least know that you are a sucker.

Kicking back your salary to the employer, whomever they are, is like those "voluntary labor brigades" in Cuba. It's just intimidation.

It is one thing for them to screw you, but for God's sake, understand please that you are being screwed out of your hard-earned money. Administrators are the overpaid ones at any college. Let them donate their salaries.