Kinnison's last stand

[Lusankya]

Lusankya, would you or would you not agree that keeping the bureaucratic cost overload down is important in any organisation? It's a matter of priorities, really.

Well, yes. What do you think is a higher priority? Spending twice as much per capita on health care as the OECD average, or ensuring that your citizens have better health results in almost every area?

Because the US is going for the former option.

Even if socialised health care was more expensive (which it isn't, as I pointed out in my previous post, and you completely ignored), you would still have to pay attention to the quality of the care before making a comparison. If something costs twice as much as something else, but is three times as good, then your argument from cost alone becomes quite pointless because the value you're getting for your money is much higher.

[Darth Wong]

This has been posted before. But Kinnison clearly needs a reminder:

http://www.consumeraffairs.com/news03/health_costs.html

Per Capita U.S. Health Care Costs Triple Canada's

August 21, 2003
The overhead cost of operating the United States health-care system is more than three times that of running Canada's on a per capita basis, and the gap is getting bigger, according to a study published today in the New England Journal of Medicine.

...

THREE TIMES, asshole. The US has overhead costs THREE TIMES as high as those of Canada. I don't give a flying fuck what your cab driver-based research methodology comes up with; this is the New England Goddamned Journal of Medicine. Now ANSWER THE FUCKING POINTS instead of mindlessly repeating your mantra that government is always less efficient.

[K. A. Pital]

Terralthra: Of course GOOD management can decrease costs. This only matters when costs are important to the managers.

In essence, kinnison knew all along his argument was full of stinking shit, but still used a huge post to speak it out and promptly rescind his statement by covering his ass via half-hearted remarks like the one above.

This is fucking outrageous as far as debating goes.

Lusankya, would you or would you not agree that keeping the bureaucratic cost overload down is important in any organisation?

You see, of course your brain is smaller than a needle pin apparently, because private organizations tend to massively overcharge for healthcare services to get higher profits, thus making your point completely irrelevant and nonsensical given the existing statistics of the massive inefficiency of US healthcare system. Whoop-de-fuck.

[Darth Wong]

You can summarize Kinnison's behaviour as follows:

Kinnison: Government always wastes far more money compared to the private sector.
Others: Evidence?
Kinnison: Everyone knows this.
Others: Evidence?
Kinnison: Wouldn't you agree that it's important not to waste money? That's why government is bad.
Others: Evidence?
Kinnison: Hey I don't know about you, but I care about how my money is spent.
Others: OK fine, here's some evidence AGAINST your position.
Kinnison: Yes, but government wastes money. That's just part of the nature of government.
Others: Are you blind or something?
Kinnison: Let's get back to basics: government is inherently wasteful, and that's why it has no business in health care.
Others: ANSWER THE FUCKING POINT!
Kinnison: <silence>

It's pure stonewalling.

[Terralthra]

Not to put too fine a point on it, but didn't you threaten to ban his ass the LAST time he did this?

[Darth Wong]

Not to put too fine a point on it, but didn't you threaten to ban his ass the LAST time he did this?

I don't recall. My life is so chaotic that I often forget what's happened on the board, or to whom. But it certainly wouldn't surprise me if I had.

[PainRack]

Because the US is going for the former option.

Even if socialised health care was more expensive (which it isn't, as I pointed out in my previous post, and you completely ignored), you would still have to pay attention to the quality of the care before making a comparison. If something costs twice as much as something else, but is three times as good, then your argument from cost alone becomes quite pointless because the value you're getting for your money is much higher.

Technically, US quality of care IS good and amongst the best in the world.
You're talking about the health results of the system, not the quality of care the system puts out.

[PainRack]

Lusankya, would you or would you not agree that keeping the bureaucratic cost overload down is important in any organisation? It's a matter of priorities, really.

I am of course going to get flamed for this. However, here goes: A few years ago, I was being taken by taxi (being at that time unable to drive) for an appointment at my local hospital, which was supposed to be routine (it wasn't). I happened to get talking to the driver; taxi drivers are a source of news, biased as it may be. It happens that around this time my local hospital was having done extensive renovation and expansion - many years overdue, as it happens (some of the wards then in use were built as temporary structures during World War II). I was told that part of the £18,000,000 works were already open and had been for 6 months; the rest had about 3 months still to go. Care to guess which part was 9 months ahead? Right. The new office block. Socialised medicine at its best. I checked later, and the information given was accurate - if not exactly widely disseminated.

I have no quarrel at all with the people in the NHS who actually work at the sharp end; at their best they can hold their heads up high among the best. Unfortunately, they are commanded by people who don't give a shit. To use a simile from another government organisation; lions led by donkeys.

lol. That's because offices ARE easier to rennovate than hospital rooms. Ever decanted a hospital ward so that you can begin rennovations, or move around countless beds and equipment while partial rennovation is being done?
I HAVE. It takes fucking WEEKs of planning so that said decantment could be done, and partial rennovations(actually, more maintenance than rennovation) where movement of beds around are done on weekends.

[Lusankya]

Technically, US quality of care IS good and amongst the best in the world.
You're talking about the health results of the system, not the quality of care the system puts out.

Even if you're only talking about the quality of care that you get when you' have access to the system, is it twice as good as in (say) Australia or the UK? i.e., is it worth twice as much money?

[Darth Wong]

Technically, US quality of care IS good and amongst the best in the world.
You're talking about the health results of the system, not the quality of care the system puts out.

The system puts out shitty quality of care to the people who are uninsured or underinsured. You can't ignore that when discussing the performance of a system.

[PainRack]

The system puts out shitty quality of care to the people who are uninsured or underinsured. You can't ignore that when discussing the performance of a system.

Technically, that means the system isn't accessible to those who are uninsured. Quality of care refers to morbidity and mortality rates for various procedures, as well as the success rates of surgeries. In that area, US health care is top because of its education, investment in technology and other reasons.

If you can get enough people to donate enough money so you can enter the system, you know your quality of care is going to be superb.
The argument that increasing access will cause quality of care to be diluted is true. The amount of resources that's expended over a small client base is now going to be spread amongst a much larger populace. Of course, what conservatives ignore is that this means on average, more people will be enjoying access to quality care, as opposed to the current situation where only a part of the populace do so its an overall benefit.

[Darth Wong]

The system puts out shitty quality of care to the people who are uninsured or underinsured. You can't ignore that when discussing the performance of a system.

Technically, that means the system isn't accessible to those who are uninsured.

Wrong. It means that "the system" is failing to fully perform its job, which is to provide health care to Americans. People are talking about "the American health care system", which is a national concept and should therefore be evaluated on a national scale.

In the most recent election, both sides conceded that one of the goals of the health-care system should be to provide care to all Americans. It is therefore extremely dishonest not to penalize its score for failing to perform that job.

[PainRack]

Wrong. It means that "the system" is failing to fully perform its job, which is to provide health care to Americans. People are talking about "the American health care system", which is a national concept and should therefore be evaluated on a national scale.

In the most recent election, both sides conceded that one of the goals of the health-care system should be to provide care to all Americans. It is therefore extremely dishonest not to penalize its score for failing to perform that job.

Errr, since when did I argue that the American Healthcare system shouldn't be penalised for being accessible?

I'm just pointing out that the technical term Louisana is using, quality of care is being used in the wrong context here. What she's looking for is accessibility. In terms of quality of care, the US system is still tops.

[PainRack]

Even if you're only talking about the quality of care that you get when you' have access to the system, is it twice as good as in (say) Australia or the UK? i.e., is it worth twice as much money?

That's a biggie. How are you going to measure that?
The Commonwealth Fund ranked the US as first against the other 5 industrialised countries in terms of providing "right" care.... Their score did get dragged down however, because their methodology considered coordination of care and etc, which they scored poorly due to the fragmented nature of the US system causing them to end up in last place.

Their real problems lay in terms of chronic diseases and mental health though. Apparently, the Gotham Arkham Asylum reputation still holds strong in the US. Makes sense though. Chronic diseases are areas where easy access to primary care makes a huge difference, and in the US, insurance just doesn't do the job.

Other statistics from procedures like coronoary bypass surgeries, breast cancer and etc show that the US scores better off in terms of mortality and morbidity rates.

Ultimately, its easier to look at other factors. Number of doctors/beds to population, Infant Mortality Rate, Life Expectancy, you know, all the hard facts that shows the US health system isn't doing its job.

[aimless]

What can I say to refute these statements and is it even worth trying?

Well the first part of the question has been covered really well but the second part has been sort of left alone except for a loldismissal of the friend based on some of the more absurd positions. It does bring up an interesting point though (at least to me), about how easy it is to change someone's political opinions and the best methods for doing so.

I think a lot of it depends on the strength of your relationship to this person. If prior to this ideological clash you were good friends and he respects you, it makes your job a lot easier. I'm going to throw out some stuff based on a couple experiences I've had with friends taking wrong/silly/extreme opinions. It seems to be more effective to show someone the error of their ways in a roundabout way, instead of a confrontational "you're wrong!" ("idiot"! implied). Utilize humor and such, avoid getting them on the defensive because then it'll all go to hell probably. And if you do successfully sway them in this manner, don't be concerned with the satisfaction of them explicitly saying "i was wrong, you were right". More likely they'll just quietly stop espousing that opinion and later on maybe say things more in line with yours.

Of course if you're not particularly good friends with them then I doubt this could be pulled off since it's slow and subtle and requires a lot of contact.

[Darth Wong]

Wrong. It means that "the system" is failing to fully perform its job, which is to provide health care to Americans. People are talking about "the American health care system", which is a national concept and should therefore be evaluated on a national scale.

In the most recent election, both sides conceded that one of the goals of the health-care system should be to provide care to all Americans. It is therefore extremely dishonest not to penalize its score for failing to perform that job.

Errr, since when did I argue that the American Healthcare system shouldn't be penalised for being accessible?

By repeating right-wing verbal trickery. Do you honestly not understand that the entire reason right-wingers treat accessibility as a completely separate issue from quality of care is to downplay the scope of the problems with the US health care system?

AVERAGE quality of care MUST include those who get NO care. If I ask about the customer service at any other kind of corporation, you can't say "it's good for those who don't get kicked out the door and ignored" by referring to all of those other people as a mere "accessibility" problem rather than a customer service problem.

[PainRack]

By repeating right-wing verbal trickery. Do you honestly not understand that the entire reason right-wingers treat accessibility as a completely separate issue from quality of care is to downplay the scope of the problems with the US health care system?

AVERAGE quality of care MUST include those who get NO care. If I ask about the customer service at any other kind of corporation, you can't say "it's good for those who don't get kicked out the door and ignored" by referring to all of those other people as a mere "accessibility" problem rather than a customer service problem.

Except that technically, the terms used here IS about accessibility and NOT about quality. How the fuck would you feel if some trektard started talking about power and began using newton as the units of measurements?

The correct method here would then to educate people that accessibility is not a dirty word, and that any healthcare system has as its goal accessibility built in as part of its goal, thus, the US system failure to meet that goal IS a valid strike against it and explains its 37th position.

[kinnison]

PainRack - It wasn't a renovation job at all, it was a completely new building. Offices given priority. Incidentally, did you miss the bit about the wards being replaced having been originally intended to be TEMPORARY structures for use during WWII and still in use - despite the inevitable and obvious problems caused by that - sixty years later? And my local hospital is actually one of the good ones - the Third World conditions in some UK hospitals are a disgrace in any Western nation. Hospital infections are rampant just about everywhere, and so on and so on ad nauseam. (A good phrase to use, in this case.) It's all very well having good access to hospital care - but what if you have a pretty high probability of coming out worse than you went in, with a totally unrelated disease? What then?

Government financing of health care is not the problem. Government control is - or to be even more specific, centralised government control. The organisation is just too big to work properly if it has to be run from Whitehall. Various governments have attempted to correct this by decentralising control into the local areas where it belongs, and been frustated at every turn by the "civil service". It doesn't just apply to the health service either. Why do you think that "Yes Minister" was so popular?

[K. A. Pital]

Government financing of health care is not the problem. Government control is - or to be even more specific, centralised government control.

It works in other nations. So the onus is on you to prove that either the US government is so much worse than all other governments in the world that it can't be entrusted with healthcare (but why then give it such important matters like Defense, anyhow?), or concede that your point is non-existent.

[Lusankya]

PainRack - It wasn't a renovation job at all, it was a completely new building. Offices given priority.

Would it surprise you if offices are easier to build as well as renovate?

Incidentally, did you miss the bit about the wards being replaced having been originally intended to be TEMPORARY structures for use during WWII and still in use - despite the inevitable and obvious problems caused by that - sixty years later?

The Eiffel Tower was only intended to stand for 20 years, but it's still in use today. Should the citizens of France be complaining about what was originally intended to be a TEMPORARY structure for use during the World's Fair still being in use - despite the inevitable and obvious problems caused by that - a hundred years later?

Tell me, do you know the condition that those temporary structures were in for all of those 60 years? Because if they were in an acceptable condition to use, then not only would there be no point in replacing them, but it would also be a pointless waste of money, wouldn't you agree?

And my local hospital is actually one of the good ones - the Third World conditions in some UK hospitals are a disgrace in any Western nation. Hospital infections are rampant just about everywhere, and so on and so on ad nauseam. (A good phrase to use, in this case.) It's all very well having good access to hospital care - but what if you have a pretty high probability of coming out worse than you went in, with a totally unrelated disease? What then?

I suppose you have stats for this "hospital infections are rampant" fact? And you are aware that people in hospitals are more likely to pick up infections than people outside of hospitals, because you generally enter a hospital when your immune system is already weakened, aren't you?

Government financing of health care is not the problem. Government control is - or to be even more specific, centralised government control. The organisation is just too big to work properly if it has to be run from Whitehall.

So why does the UK health system have better results than the US health system, then? In fact, why do the health systems in all of the countries that I listed before have better results than the US health system? (You know - the ones with universal health care) Are you going to address that point or continue ignoring it because you don't have anything to counter it with?

[Edi]

Except that technically, the terms used here IS about accessibility and NOT about quality. How the fuck would you feel if some trektard started talking about power and began using newton as the units of measurements?

The correct method here would then to educate people that accessibility is not a dirty word, and that any healthcare system has as its goal accessibility built in as part of its goal, thus, the US system failure to meet that goal IS a valid strike against it and explains its 37th position.

You fail to grasp the most salient point:

1) The American healthcare system is supposed to serve all Americans
2) It does not
3) 0 access = 0 quality of care
4) 50 million out of 300 million = 16% and some of the population who get 0 access

This means that the overall quality of the system is complete shit, because of that 16% is not getting any service out of it, and in this case access is directly equivalent to quality of care. We are talking about averages, not individual cases.

[Lagmonster]

Kinnison, on this board, in order to maintain our standards of debate, we expect you to directly answer arguments when challenged, or else clearly concede the debate. I'm sending this thread to the Hall of Shame because your debating skills and tactics are, basically, shameful in this regard.

[Darth Wong]

I don't think he's honestly unaware that he's ignoring points. He is DELIBERATELY ignoring points. There's no way he could be honestly unaware that people are challenging him to back up his claims.

KINNISON, I'VE HAD ENOUGH OF YOUR BULLSHIT. ANSWER THE POINTS AGAINST YOU BY TOMORROW.

See this post in particular:
https://bbs.stardestroyer.net/viewtopic ... 9#p3078919

You literally are acting exactly the way I caricatured you: when challenged to back up your claim that government is less efficient 100% of the time, you simply repeat that claim. When confronted with evidence which directly contradicts that claim, you simply repeat the claim. When it is repeatedly pointed out that you never produce sources or evidence for anything you say, you just do it again.

You're trolling, and I've had enough of it.

[mr friendly guy]

I just want to comment on Kinnison's statement about hospital infections. If a hospital saw less people then you would expect hospital acquired infections to decrease all other things being equal. Patients can acquire infections from other patients who come into the hospital because they (other patients) are sick (not necessarily from that particular bacteria as its possible to carry microbes without getting sick from them).

Thats why hospitals routinely screen and eradicate things like MRSA, VRE etc and have things like single rooms to isolate infected patients from others. Other sanitary measures include washing hands (ie alcohol hand washes are easy to get hold off, ie just outside each room) and disinfecting the rooms.

I don't see this relates to government controlled vs private control since the problem is intrinsic to any hospital which actually has to treat patients, and worsens if that particular microbe has a high prevalence in the community.

[The Spartan]

You fail to grasp the most salient point:

1) The American healthcare system is supposed to serve all Americans
2) It does not
3) 0 access = 0 quality of care
4) 50 million out of 300 million = 16% and some of the population who get 0 access

This means that the overall quality of the system is complete shit, because of that 16% is not getting any service out of it, and in this case access is directly equivalent to quality of care. We are talking about averages, not individual cases.

Don't forget that roughly the same number are unable to afford adequate coverage. So there's roughly another 16% who have to wait until something is really serious before going to the doctor. So that's a third of the country receiving substandard or nonexistent care.