Republicans and democrats don't understand each other

[Alan Goldhammer]

You created a straw man.  We were talking about AOC and the squad being unpatriotic.  Stick to the subject.

In what way, their opposition to President Trump's policies?  I guess that makes a lot of us unpatriotic. 

[Alan Klein]

Alan - if my wife's doing well, she doing it in heaven! She found her lump one November, and four Novembers and umpteen surgeries later she lost the war.

The first few ops were on private insurance and they were excellent people with whom to deal (Mapfre). Six or seven months before she died she fell and broke her hip on the edge of a pavement. The pain forced her to elect to go to the National Health hospital which is only twenty-five or so minutes away, whereas the private one at least double that time. Once there, they discovered that the cancer had returned. The onco. said he did not want to wait more than ten days to get her into surgery. Within ten days she had both a new hip and the cancer operation. The guy who did the hip job was German. She walked out of that hospital without a limp, stick or crutches. She was perfect. Six months later she was gone: nothing more they could do for her.

She was so impressed with the National system that she questioned why we were spending so much every year on private health. I cancelled. Subsequently, I realised that excellent though the national system is, once you are in it, that's the problem: getting appointments for non-life-threatening work such as my cataracts.

Either way, I could not have afforded to keep paying what I was paying those eleven years ago; today's prices would have forced the issue anyway.

Rob

I'm so sorry about your wife Rob. I didn't realize it. Please accept my condolences. Alan

[Rob C]

I'm so sorry about your wife Rob. I didn't realize it. Please accept my condolences. Alan

Don't sweat it, Alan; there nothing in the post that would have led you to think otherwise; but thank you for your kind sentiment.

She's gone physically but still there all day, if you see what I mean. Love never goes away.

:-)

Rob

[LesPalenik]

As to the doctors in Canada, the surgeons are first class.
However, when it comes to GP's, rheumatologists, neurologists and even cardiologists, they are good mainly in ordering the tests and filling out the prescriptions. Also they don't know much about the proper nutrition.

   What do you mean?  What's their problem?

Alan, they don't see any problem, the problem is in the system. If you want to know more details, PM me with the specific question you want to get answered.

For instance, when it comes to nutritional advice, most doctors and nutritionists draw on their limited and outdated education, and will advise you that milk and dairy products are good for you and your bones. Many new studies show fallacy of these recommendations, but dairy industry just pours more money in to continue propagation of the false and useless information. Not only dairy products do not help (unless you want to raise abandoned kittens or puppies), they are actually harmful. That's just one example.

[James Clark]

She's gone physically but still there all day, if you see what I mean. Love never goes away.

:-)

Rob

Rob, that's exactly what my wife says.  She's only 39, but just finished her third bout with cancer.  Whenever one of us has doubts or frustrations, the stronger of us (on any given day) explains it the same way you just did.  I believe it wholeheartedly, and I see it in you whenever you speak of her.

[Alan Klein]

WRONG, they make up for the loss by charging a higher premium to private insurers.

That doesn't make any sense.  They can't take my costs and add them to someone else's bill.  And if I never went to them, they would get exactly the same high rate they charged the patient with private insurance.  Nothing more, nothing less.  The fact is they get less from Medicare so they make less profit on Medicare patients.  That's why 16% of doctors limit the number of Medicaid patient and 15% don;t accept them at all.
https://www.forbes.com/sites/sallypipes/2018/10/15/government-policies-are-driving-doctors-to-quit-health-care/#582ca9832bf3

[amolitor]

People who boost private insurance are generally unclear on how much wastage that system has in it. Government systems are, in comparison, ingenious models of asceticism and simplicity.

When you get your tummy poked to see if you're constipated, there is probably at least one entire corporation buried somewhere in the chain that doesn't do a single thing except employ clerks to print out forms, and to re-type those same forms into another system, to pass information up or down the chain. It is simply mind boggling the sheer number of grifters and filing clerks that are employed by the current American private-insurance based medical systems. It's not the only source of wastage, but it is billions of dollars up in smoke annually (at least).

Even a small private practice, in general, has to employ a full time person simply to interact with the mass of garbage that is medical insurance.

This, by the way, is the single biggest issue with M4A: 10s (100s?) of 1000s of people will be instantly thrown out of work, and that's a massive problem. They're not doing anything useful, but an amazing number of modern jobs are useless and it's generally not the employee's fault.

[Alan Klein]

People who boost private insurance are generally unclear on how much wastage that system has in it. Government systems are, in comparison, ingenious models of asceticism and simplicity.

When you get your tummy poked to see if you're constipated, there is probably at least one entire corporation buried somewhere in the chain that doesn't do a single thing except employ clerks to print out forms, and to re-type those same forms into another system, to pass information up or down the chain. It is simply mind boggling the sheer number of grifters and filing clerks that are employed by the current American private-insurance based medical systems. It's not the only source of wastage, but it is billions of dollars up in smoke annually (at least).

Even a small private practice, in general, has to employ a full time person simply to interact with the mass of garbage that is medical insurance.

This, by the way, is the single biggest issue with M4A: 10s (100s?) of 1000s of people will be instantly thrown out of work, and that's a massive problem. They're not doing anything useful, but an amazing number of modern jobs are useless and it's generally not the employee's fault.

Government regulations have added enormous paperwork requirements to doctor's.  I can't get a medical report sent to me unless I complete a written form.  Then they won;t email it to me.  Government does not allow it.  It has to be faxed or mailed.  So now I have to buy a fax machine.  Meanwhile, faxing documents is slower and takes more time for a doctor's office then emailing documents.  Then when I get it, the clarity stinks.  I have to scan it into my computer to email it.  If the government allowed emailing,  the document would be cleaner and ready to forward immediately without needing a hard copy.  It's crazy.  But it's government regulation causing this. 

But why do you think government simplifies anything.  Asceticism? You gotta be joking.  Have you ever worked for the government?  I have.  Also have worked in private industry which is much more efficient.  Somehow, 99% of industry in the country is run without the government.  But you're convinced that for medicine, the government can run it cheaper and more efficiently.   That's great political hype but not true at all. 

[degrub]

That doesn't make any sense.  They can't take my costs and add them to someone else's bill.  And if I never went to them, they would get exactly the same high rate they charged the patient with private insurance.  Nothing more, nothing less.  The fact is they get less from Medicare so they make less profit on Medicare patients.  That's why 16% of doctors limit the number of Medicaid patient and 15% don;t accept them at all.
https://www.forbes.com/sites/sallypipes/2018/10/15/government-policies-are-driving-doctors-to-quit-health-care/#582ca9832bf3

Guess what - the charity care, or unbillable amounts go to overheads. Guess where the overheads get covered ? Private insurance care patients.

[Alan Klein]

Guess what - the charity care, or unbillable amounts go to overheads. Guess where the overheads get covered ? Private insurance care patients.

Maybe you can explain how that works?

[amolitor]

a) I did not just fall off a turnip truck, stop assuming that I have no experience with anything.

b) your personal experiences, like everyone else's, are irrelevant. they are extremely limited and biased, like everyone's.

c) whenever anyone actually runs the numbers, it turns out that the US government delivers excellent service very cheaply in almost all areas...

d) ... except the DoD, which is the one department that right wing ideologues consider untouchable.

[Alan Klein]

a) I did not just fall off a turnip truck, stop assuming that I have no experience with anything.

b) your personal experiences, like everyone else's, are irrelevant. they are extremely limited and biased, like everyone's.

c) whenever anyone actually runs the numbers, it turns out that the US government delivers excellent service very cheaply in almost all areas...

d) ... except the DoD, which is the one department that right wing ideologues consider untouchable.

I guess we have differing opinions of the government.  I worked for the NYC School Construction Authority for 14 years.  I came up with this great idea how we could save money on a procedure.  So I went to see my boss about it.  He looked me straight in the eye and said, " Alan, what do you care what it costs?"

Maybe your experience with government was different. 

[amolitor]

I've seen 100s of millions of dollars spent in my career, and in my line of work I have to say that I cannot state with certainty that one cent of it was spent for any useful purpose. I mean, maybe? That's government and industry both. The DoD and various spook shops were excellent sources of fistfulls of cash, with which they bought things that.. well, they worked. But was the work they were put to useful? Not that I could see.

But that's just one person's experience, one point of view. It sure looks like all large scale bureaucratic enterprises waste money hand over fist, and to figure out who's wasting more you really have to examine the books.

And even the "waste" is employing people, so there's that. The US military may or may not be doing a single damn thing that's worthwhile, based on your point of view, but one thing is for damn sure: they're transferring a crapload of taxpayer money to some of the poorest regions, neighborhoods, and families in the USA, and thereby feeding a hell of a lot of people who would otherwise go hungry.

So, that's good, right?

[Alan Klein]

I've seen 100s of millions of dollars spent in my career, and in my line of work I have to say that I cannot state with certainty that one cent of it was spent for any useful purpose. I mean, maybe? That's government and industry both. The DoD and various spook shops were excellent sources of fistfulls of cash, with which they bought things that.. well, they worked. But was the work they were put to useful? Not that I could see.

But that's just one person's experience, one point of view. It sure looks like all large scale bureaucratic enterprises waste money hand over fist, and to figure out who's wasting more you really have to examine the books.

And even the "waste" is employing people, so there's that. The US military may or may not be doing a single damn thing that's worthwhile, based on your point of view, but one thing is for damn sure: they're transferring a crapload of taxpayer money to some of the poorest regions, neighborhoods, and families in the USA, and thereby feeding a hell of a lot of people who would otherwise go hungry.

So, that's good, right?

As an ex-USAF airman, I set up a tour of Mcguire AFB for a group of my fellow 55+ retirees where I live in NJ.  A civilian escort took us around to see military dogs, their fire department and a tour of a C17 Globemaster jet.  It can carry a 60 ton tank and about 150 people.  Although we weren''t flown, we did get a tour of the plane and had the crewmembers explain the whole process of what they do.   I was proud to be there and felt good about the 30 or so C17's and other refueler type jets lined up on the runway.  Made me feel great about our military.

But the truth is, the average American doesn't need to fly in a refueler or tank carry cargo plane.  Nor does he need to drive a M1A1 Abrams tank as impressive as it is.  While we need a military to defend the nation, the money would better be spent on civilian use.  Cars, medicine, civilian planes, etc. Those people who work for the defence department directly or indirectly would just have other civilian jobs if we didn't spend all that money on defence, which was around $750 billion, just passed a couple of days ago.  They wouldn't be out of work.

[Alan Klein]

PS:  The picture above shows one of our old guys getting on the back of the C17 with his walker.  They were very accommodating to us. 

[JoeKitchen]

I've seen 100s of millions of dollars spent in my career, and in my line of work I have to say that I cannot state with certainty that one cent of it was spent for any useful purpose. I mean, maybe? That's government and industry both. The DoD and various spook shops were excellent sources of fistfulls of cash, with which they bought things that.. well, they worked. But was the work they were put to useful? Not that I could see.

But that's just one person's experience, one point of view. It sure looks like all large scale bureaucratic enterprises waste money hand over fist, and to figure out who's wasting more you really have to examine the books.

And even the "waste" is employing people, so there's that. The US military may or may not be doing a single damn thing that's worthwhile, based on your point of view, but one thing is for damn sure: they're transferring a crapload of taxpayer money to some of the poorest regions, neighborhoods, and families in the USA, and thereby feeding a hell of a lot of people who would otherwise go hungry.

So, that's good, right?

For clarity sake, please state your line of work.

I'm a photographer; there, you cant claim I did not state mine. 

[Rob C]

Rob, that's exactly what my wife says.  She's only 39, but just finished her third bout with cancer.  Whenever one of us has doubts or frustrations, the stronger of us (on any given day) explains it the same way you just did.  I believe it wholeheartedly, and I see it in you whenever you speak of her.

James I'm so sorry to hear your wife has been touched by this thing too, and at only 39, for heaven's sake.

I was around 65 when my first heart attack came - along with the pension, though whether the shock of the figures had anything to do with it I can't swear; my wife was the same age when she found her lump: 65. Not a brilliant number.

It seems that there are so many different varieties of cancer that it is almost impossible for a layman to know what he's talkiing about on that topic, and there is a danger in, and of extrapolating one person's experiences as being relevant to those of another. For example: my wife's began as breast cancer, yet I know several women who have survived that for as long as I've known them, decades, and the question always comes to this: were they lucky; did they find the problem earlier than others; were the types completely different?

Again, there is the pesonality of the patient: Ann kept it all bottled up, and the only time she complained was during the hour's drive back home from a chemo session, when she remarked once that she didn't think she could keep doing it. I told her it was her only chance, which of course she knew, but apart from that, she never mentioned it in the way of complaint. She always read a helluva lot; I believe that partly provided the mental escape she needed. I believe her reluctance to go into it vocally was for my benefit: I don't think she thought I could hack it. As pretty much always, I think she was right, if that was indeed her thought.

I wish you both the very best; all that I can offer is that medical experience grows all the time and so do treatments change and improve. The grimness of being hit young also brings with it the fact that young people are stronger and more resilient.

Rob

[JoeKitchen]

I just find it laughable that any one could actually claim that the government make efficient systems.

I have an ongoing project with a rather large government agency.  I enjoy the work and it is a great project photographically, but it takes them 90 to 120 days to pay my invoices once submitted.  I have never had anyone else even come close to that payment term. 

A lot of architects I know that work with the government have the same issue, and some have gone a year before getting paid.  Many architects choose not to work with government agencies just due to this. 

Another great example is the post office.  How long did UPS and FEDEX have online tracking before the USPS implemented it.  On top of that, they cant make any changes, like raising the cost of a stamp or utilizing more efficient sorting machines, without congressional approval, which means everything becomes political.  It's a mess. 

Sorry, but I don't want my healthcare dictated by political talking heads. 

To justify these systems by saying it keeps people employed is also ludicrous.  It's actions like that which stagnate innovation.  Government is always the last one to implement any kind of new technology.  I know you could still find government offices printing with continuous stationary, the kind with the little holes on the side.  That was outdated in the 90s, but 25 years later you still see government offices using it.  Same thing with carbon paper.  I would not be surprised if some architect somewhere still had to made real blueprints for a government project. 

[amolitor]

I cannot imagine how my line of work could possibly bear on anything, but as it is not a secret, I will mention that it was various things in IT security.

a) the USPS is a corporation.
b) it delivers letters for 50 cents, somewhat lower than the lowest rates available from FedEx or UPS.

etc etc, I could rebut all day, and you could rebut back all day and nothing would change.

[Alan Klein]

I just find it laughable that any one could actually claim that the government make efficient systems.

I have an ongoing project with a rather large government agency.  I enjoy the work and it is a great project photographically, but it takes them 90 to 120 days to pay my invoices once submitted.  I have never had anyone else even come close to that payment term. 

A lot of architects I know that work with the government have the same issue, and some have gone a year before getting paid.  Many architects choose not to work with government agencies just due to this. 

Another great example is the post office.  How long did UPS and FEDEX have online tracking before the USPS implemented it.  On top of that, they cant make any changes, like raising the cost of a stamp or utilizing more efficient sorting machines, without congressional approval, which means everything becomes political.  It's a mess. 

Sorry, but I don't want my healthcare dictated by political talking heads. 

To justify these systems by saying it keeps people employed is also ludicrous.  It's actions like that which stagnate innovation.  Government is always the last one to implement any kind of new technology.  I know you could still find government offices printing with continuous stationary, the kind with the little holes on the side.  That was outdated in the 90s, but 25 years later you still see government offices using it.  Same thing with carbon paper.  I would not be surprised if some architect somewhere still had to made real blueprints for a government project. 

When I had my own firm, the NYC Comptroller held up all City payments to contractors until every invoice could be reviewed in detail by her office.  She was trying to make political points.  Her action delayed my payments for over 9 months.  I lost my company's credit line with the bank because of that as I couldn't make payments to them I promised.  That hurt us a lot because construction contracting is already a big cash flow problem. You need a credit line to help stay afloat. It's bad enough to have to put up with private developers like Trump who are lousy payers.