Armed Polite Society
Main Forums => Politics => Topic started by: HankB on August 12, 2009, 01:22:31 PM
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We're all aware of the protests at various Town Hall meetings, but it turns out that even those on the left are not at all happy with Obamacare.
Take Camille Paglia, who writes at salon.com; she still likes Obama (she must have too much emotional capital invested in him to say otherwise) but she mentions a few things like:
The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made.
House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens.
Wow . . . just wow. We can only hope that with the Left's disenchantment with Obamacare, the plan will die.
Full article at: http://www.salon.com/opinion/paglia/2009/08/12/town_halls/index.html
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I have a very funny feeling that the Democratic party is doing an incredible job at underestimating just how deep the opposition to this is, and just how badly it might hurt them next year.
As I've noted in the other thread, they managed to do that in 1993, and it cost them big in 1994.
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I have a very funny feeling that the Democratic party is doing an incredible job at underestimating just how deep the opposition to this is, and just how badly it might hurt them next year.
The Democratic party believes it's own rhetoric that it's all being faked by the Republican party. While the GOP has done some astro-turfing, I think the vast majority of the outrage is legitimate.
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I concur. I think they will have their butts handed to them in 2010. I'm somewhat afraid that that will learn the lesson of '94 and move to the center, as did Clinton, and we'll end up with a second term. Of course, he may be too arrogant to actually take that medicine.
The middle is fickle, but he seems to be totally misreading the sentiment of the flyover states.
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Those who are saying that the furor will die down are forgetting one very important thing...
The internet as a form of public communication.
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I concur. I think they will have their butts handed to them in 2010. I'm somewhat afraid that that will learn the lesson of '94 and move to the center, as did Clinton, and we'll end up with a second term. Of course, he may be too arrogant to actually take that medicine.
Middle is far better than Socialism.
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The issue as I see it is Pubbies winning big in 2010 and thinking their "kinda socialist but less than Obama" platform is what did it.
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The issue as I see it is Pubbies winning big in 2010 and thinking their "kinda socialist but less than Obama" platform is what did it.
Exactly what cost them so badly in the last couple of elections - they thought that as long as they governed as "Democrat Party Lite" they were in.
They were wrong. And even after repeated defeats, many still refuse to admit it.
There's a reason that the GOP is known as (to quote Ann Coulter) The Stupid Party. :mad:
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Exactly what cost them so badly in the last couple of elections - they thought that as long as they governed as "Democrat Party Lite" they were in.
They were wrong. And even after repeated defeats, many still refuse to admit it.
There's a reason that the GOP is known as (to quote Ann Coulter) The Stupid Party. :mad:
We've got an opportunity to hammer some sense into them. They've got to be reminded that the ole' rules are out the window. People wanted change and got it, but are realizing that the change was simply replacing one group of oligarchs with pet projects for another. Now, people are demanding change that makes sense.
We need to start demanding that any candidate who wants to run for office (including incumbents) publicly get on board with eliminating earmarks, eliminating deficit spending, etc. Anyone who agrees to those things gets our support, regardless of party affiliation. Anyone who refuses or votes another when in office, gets booted, regardless of party affiliation.
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Frankly, earmarks are one of the most beautiful things in US politics. I am constantly stunned by the desire of Americans to kill them.
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Frankly, earmarks are one of the most beautiful things in US politics. I am constantly stunned by the desire of Americans to kill them.
Earmarks are a prime mechanism for both increasing budgets through useless pork, and for carrying out the politican's portion of a bribery scheme. If a politican had to convince others to go along with pet projects via direct legislation, there would far less opportunity to get crap through, and far less incentive to bribe them.
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Consider this, on the other hand:
Congressmen are individually elected and personally responsible for their earmarks. The earmark process gives the public a person who is individually accountable for public spending. Conversely, if earmarks were abolished (how would you abolish them?), then control over the details of spending (for example, deciding which district gets that massive order for Military Widget X) would be given to unelected bureaucrats. Then you would be like a European country, with all the corruption that entails.
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The earmark process gives the public a person who is individually accountable for public spending.
That is the problem that most Americans see. Useless and wasteful projects which are done through earmarks, are usually done to benefit the voters of representative Y. The problem is, the people who are short changed are precisely those people who can't vote for representative Y.
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See, way I see it is:
Consider the alternative.
Either you apportion a large sum of money and let unappointed bureaucrats micromanage it, or you have elected representatives do the micromanaging.
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Either you apportion a large sum of money and let unappointed bureaucrats micromanage it, or you have elected representatives do the micromanaging.
Different incentives (using tax money to buy votes vs buying unelected bureaucratic positions), but the end result is largely the same. People who spend Other People's Money don't care if they're doing the right thing with it.
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unappointed bureaucrats
I don't really understand the difference. If district 1 contributes $300/yr to the fed tax rolls and district 2 contributes $100/yr to the fed tax rolls but district 2 is represented by representative 2, who is really sly, and gets district 2 $250/yr to spend.
From the stand-point of a district 1 resident, representative 2 is unelected and unaccountable to me either way.
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I thought the idea behind no earmarks was that all spending had to be directly relevant to the bill at hand?
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I thought the idea behind no earmarks was that all spending had to be directly relevant to the bill at hand?
Yes. This eliminates that "and for other purposes" language in the bill's title, which is used to get around the requirement that the title of legislation should accurately state what the legislation is about.
As for putting decisions about where money goes in the hands of the unelected, we have a massive procurement structure in place that does that everyday. It comes with criminal penalties for misuse, and dispute systems that allow competitors to have their case heard without bribing someone. Competitors do that routinely, and people go to jail for misuse. Neither of those factors is present in the legislative process.
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As an aside, if I was in the anti-BHO crowd on this issue I would be seriously worried about how wrong some of the anti-NHS comments are.
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Which comments would those be?
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Which comments would those be?
I recall someone with no google-fu writing about how if Stephen Hawking had to rely on the NHS, he'd be dead. <facepalm>
SH commented that he'd be dead without the NHS.
Thing is, BOTH are wrong.
SH has gotten life-saving care from the NHS, showing google-fu-less dude to be incorrect. But, it is not as if in the absence of Brit NHS that there would be NO medical care to be found in the UK. As a member of the academic elite and a best-selling author, SH would have been able to get life-saving care in the absence of the NHS.
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Which comments would those be?
The IBD claiming that Stephen Hawking's life wouldnt be a priority if the NHS treated him is a good start:
http://voices.washingtonpost.com/ezra-klein/2009/08/how_stehpen_hawking_proves_tha.html
I mean, its not as if he is British, works at one of the finest universities in England and has had a long history of being treated by the NHS....
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The IBD claiming that Stephen Hawking's life wouldnt be a priority if the NHS treated him is a good start:
http://voices.washingtonpost.com/ezra-klein/2009/08/how_stehpen_hawking_proves_tha.html
I mean, its not as if he is British, works at one of the finest universities in England and has had a long history of being treated by the NHS....
Wonder how much of a priority he'd be without being world famous...
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SH has gotten life-saving care from the NHS, showing google-fu-less dude to be incorrect. But, it is not as if in the absence of Brit NHS that there would be NO medical care to be found in the UK. As a member of the academic elite and a best-selling author, SH would have been able to get life-saving care in the absence of the NHS.
Which is another point - if you want private healthcare over here then you can get it, either for a one-off operation / treatment or via health insurance. If you dont then you might (depending on the urgency of what is wrong with you) have to wait. Ads like the one below do greatly mislead what the reality of the situation is over here in the UK:
http://www.youtube.com/watch?v=2OU0echxHCs&eurl=http%3A%2F%2Ftimesnews.typepad.com%2Fnews%2F2009%2F08%2Fis-us-right-to-abuse-the-nhs.html&feature=player_embedded
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Wonder how much of a priority he'd be without being world famous...
Probably the same priority as he does now?
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My understanding is that you can opt-out of NHS and use private health care. Does Stephen Hawking actually rely on the NHS or the private system to stay alive? Simply being born British, living in Britain, and staying alive does not prove that the NHS serves you well.
The IBD editorial has been edited to remove all mention of SH, so it's hard to tell exactly what they're were trying to say about him. The editorial does go into some detail about how the NHS judges which people have a life worth spending money to save and which people don't. Apparently the decision is based on some sort of points system, where the more disabilities you have (blindness, needing a wheel chair, etc) the lower your chances of receiving life-saving care. If that much of the editorial is correct, then it's possible that Stephen Hawking, with his physical disabilities, scores low enough to not merit certain forms of care under NHS.
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Also, the NHS example fails in the other way.
Obamacare would effectively kill all private medical care alternatives.
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The IBD editorial has been edited to remove all mention of SH, so it's hard to tell exactly what they're were trying to say about him. The editorial does go into some detail about how the NHS judges which people have a life worth spending money to save and which people don't. Apparently the decision is based on some sort of points system, where the more disabilities you have (blindness, needing a wheel chair, etc) the lower your chances of receiving life-saving care. If that much of the editorial is correct, then it's possible that Stephen Hawking, with his physical disabilities, scores low enough to not merit certain forms of care under NHS.
That argument appears to be based on a minsunderstanding of what the National Institute for Health and Clinical Excellence does in approving / not purchasing treatments on a national level. IIRC the disability of a patient does not come into that calculation, though lifestyle probably does (eg: a chronic alcoholic will usually have to demonstrate they are dealing with their problem before getting a liver transplant, though they will get other treatments) and age can in some cases. The decision of NIHCE can also be overriden by the individual hospital, though they then have to pay for it. Irrespective of what NIHCE says, you remain free to go private and get the treatment that way if you want to.
In any case, what NIHCE does is (or at least appears to be) what your medical insurance companies do all the time.
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"People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."
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That argument appears to be based on a minsunderstanding of what the National Institute for Health and Clinical Excellence does in approving / not purchasing treatments on a national level. IIRC the disability of a patient does not come into that calculation, though lifestyle probably does (eg: a chronic alcoholic will usually have to demonstrate they are dealing with their problem before getting a liver transplant, though they will get other treatments) and age can in some cases. The decision of NIHCE can also be overriden by the individual hospital, though they then have to pay for it. Irrespective of what NIHCE says, you remain free to go private and get the treatment that way if you want to.
In any case, what NIHCE does is (or at least appears to be) what your medical insurance companies do all the time.
Know of any good sources for learning about this NIHCE? I'd like to know just what they do and don't do, because at first glance it looks like just the kind of thing we don't want here in the US.
A quick read of the NICE article on Wikipedia doesn't seem to contradict the IBD assessment. Granted, neither IBD nor Wiki go into much detail.
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Know of any good sources for learning about this NIHCE? I'd like to know just what they do and don't do, because at first glance it looks like just the kind of thing we don't want here in the US.
You appear to already have it, albeit its a company and not a state organization that does it. As for NIHCE, here is its link:
http://www.nice.org.uk/
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You appear to already have it, albeit its a company and not a state organization that does it. As for NIHCE, here is its link:
http://www.nice.org.uk/
We generally don't have anything like that. Obviously it depends upon what kind of insurance plan you buy, but usually the insurance company is obligated to reimburse for any treatment you might need regardless of how many "quality adjusted life years" anyone thinks you might have.
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I skipped over this one with some other stuff going on.
I'd just like to remind our members that calling people loons isn't really productive nor fitting in the APS mindset. Just keep it in mind for the future.
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Loon:
(https://armedpolitesociety.com/proxy.php?request=http%3A%2F%2Fwww.freewebs.com%2Fswiv%2Fcommon-loon.jpg&hash=1e7b45e355ee48fbb841441c5ee93a3ac55b9a75)
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A government agency called NICE, is somewhat Orwellian.....
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A government agency called NICE, is somewhat Orwellian.....
Ironically, it is Lewisian (I may have just coined a term). C.S. Lewis has a government agency bent on the remaking of mankind named NICE in That Hideous Strength.
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I skipped over this one with some other stuff going on.
I'd just like to remind our members that calling people loons isn't really productive nor fitting in the APS mindset. Just keep it in mind for the future.
And must we refer to Republicans as Pubbies? I lose about five IQ points every time I read that.
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Probably the same priority as he does now?
Not likely.
His fame and his money are a package deal. If he were some no-name academic he would most definitely be treated differently. As a Really Famous Guy, NHS knows just how much a stink there would be if they screwed up with his care or made the decision to let him wither without any extraordinary care.
If still alive as a no-name, he'd be some truly piteous creature stashed away in a nursing home, lucky if he didn't have a baker's dozen bed sores.
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It's worth noting that Obama has said he should be judged by the company he keeps, and said company is filled with individuals who have recommended every wacko and evil scheme being remarked upon in this thread. Children and elderly receiving no care because they aren't worthwhile? That's from Emanuel, Obama's health advisor. Of course, the language about needing to make "hard choices" when it comes to providing for the terminally ill, elderly, chronically ill comes straight from Obama himself (in April, before he changed his tune).
Everything we accuse the socialized health systems (including the rationing that British docs have openly discussed) will become reality here, even if it doesn't existe elsewhere, unless this push is stopped cold and the people advocating it taken out of office or any other position where they can do us harm.
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Not likely.
His fame and his money are a package deal. If he were some no-name academic he would most definitely be treated differently. As a Really Famous Guy, NHS knows just how much a stink there would be if they screwed up with his care or made the decision to let him wither without any extraordinary care.
If still alive as a no-name, he'd be some truly piteous creature stashed away in a nursing home, lucky if he didn't have a baker's dozen bed sores.
Um... no. People with similar illnesses to Hawking would get the same level of treatment as he has from the NHS, irrespective of their fame / money. Meanwhile, two of the three people in that anti-NHS ad now regret taking part in it:
http://www.timesonline.co.uk/tol/news/uk/article6795466.ece
Everything we accuse the socialized health systems (including the rationing that British docs have openly discussed) will become reality here
Will it? It isnt even reality over here....
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Um... no. People with similar illnesses to Hawking would get the same level of treatment as he has from the NHS, irrespective of their fame / money. Meanwhile, two of the three people in that anti-NHS ad now regret taking part in it:
http://www.timesonline.co.uk/tol/news/uk/article6795466.ece
Hmmm... and from the article, NOTHING that was said was misrepresented by the ads.
It's just that they support socialized healthcare and don't want their experience to stop it here.
"The NHS let me down and I just wanted to make the point that people should not rely solely on it. But what I said has been skewed out of proportion. I am slightly worried that people might think I am taking a negative position on the NHS. My point was not that the NHS shouldn’t exist or that it was a bad thing. I think that our health service is not perfect but to get better it needs more public money, not less. I didn’t realise it was having such a political impact. I did sign a piece of paper saying they could do what they wanted, so it’s my own fault.”
So, she was failed by the NHS, but didn't want people to think she doesn't support it.
That's fine, the pertinent information to me is:
Ms Spall ('s)... mother died of kidney cancer while waiting for treatment, and Ms Brickell... had cervical cancer diagnosed after being refused a smear test because she was too young.
None of that was untrue, it's just they don't want people to think they don't support socialized healthcare.
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None of that was untrue, it's just they don't want people to think they don't support socialized healthcare.
So lying to them about what the footage was for is ok? Also, surely it would have been more ethical to actually say that they supported the NHS instead of coming out with the OMG DEATH PANEL SAVE US nonsense?
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And must we refer to Republicans as Pubbies? I lose about five IQ points every time I read that.
Two wrongs don't make a right, Fistful. We catch them when we see them, but thanks for bringing that to our attention. ;)
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Not likely.
His fame and his money are a package deal. If he were some no-name academic he would most definitely be treated differently. As a Really Famous Guy, NHS knows just how much a stink there would be if they screwed up with his care or made the decision to let him wither without any extraordinary care.
If still alive as a no-name, he'd be some truly piteous creature stashed away in a nursing home, lucky if he didn't have a baker's dozen bed sores.
This is the problem with this whole debate, and why the twitter world and the rest has gone crazy in defence of the NHS.
People making stuff up. You have no proof of such a thing, no evidence to back up your assertions. I spent a portion of this morning with a man totally confined to a wheelchair, barely able to speak and swallow so advanced is his MS. He lives at home, has carers and gets out and about daily. He has no independent means, nor fame.
It's nothing to do with us caring about the decisions you make, it's entirely to do with us rejecting the outright fictions about the NHS that are being put forward. Hawking started showing symptoms of his disease before he even had a PhD, he was largely paralysed 14 years before the publication of 'A Brief History of Time'.
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This is the problem with this whole debate, and why the twitter world and the rest has gone crazy in defence of the NHS.
People making stuff up. You have no proof of such a thing, no evidence to back up your assertions. I spent a portion of this morning with a man totally confined to a wheelchair, barely able to speak and swallow so advanced is his MS. He lives at home, has carers and gets out and about daily. He has no independent means, nor fame.
It's nothing to do with us caring about the decisions you make, it's entirely to do with us rejecting the outright fictions about the NHS that are being put forward. Hawking started showing symptoms of his disease before he even had a PhD, he was largely paralysed 14 years before the publication of 'A Brief History of Time'.
Exactly.
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So lying to them about what the footage was for is ok? Also, surely it would have been more ethical to actually say that they supported the NHS instead of coming out with the OMG DEATH PANEL SAVE US nonsense?
Point 1: No, I don't support lying to people.
Point 2: For a commercial I have no problem with simply pointing out their experiences as consequences of a socialized health system. Commercials are by their nature short and to the point. Were it a documentary, yes, bring out their full story.
And the OMG DEATH PANEL is what will happen. It's overblown, but experiences like that of Barbara Wagner are what we know will happen:
http://www.kval.com/news/26140519.html
Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved.
Instead, the letter said, the plan would pay for comfort care, including "physician aid in dying," better known as assisted suicide.
She's not being "euthanized", but rather told that extending her life is too expensive.
How is that "compassionate" and "universal"? Sorry, Granny, another year with your grandchildren costs too much. We'll pony up the dough for your suicide pills, though!
Or, maybe better stated by President Obama:
"That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health-care bill out here.”
http://www.bloomberg.com/apps/news?pid=20601070&sid=aGrKbfWkzTqc
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In the meanwhile, across the pond:
Health Secretary Andy Burnham has accused a Tory MEP who attacked the NHS on American TV of being "unpatriotic".
Labour has stepped up its criticism of Daniel Hannan, with John Prescott recording a YouTube message to the American people defending the NHS.
Tory leader David Cameron has insisted the NHS is his "number one priority" and dismissed Mr Hannan as "eccentric".
The MEP described Britain's health service a "60 year mistake" in a debate on Barack Obama's health reforms.
Labour and the Lib Dems have seized on the comments - and others made last week on Fox News - to claim that they represent the views of many in the Conservative Party.
Mr Burnham said: "What has happened within the last 48 hours is what Cameron has feared most because it lays bare the Tories' deep ambivalence towards the NHS."
'Insult'
And he hit back at criticism that the government had not done enough to defend the NHS from attacks in the US, saying: "We will stand up for the NHS and we will make sure that it is properly represented in the international media. And that is why what Mr Hannan has done disappoints me so much.
“ The Conservative Party stands four square behind the NHS ”
Conservative leader David Cameron
"I would almost feel... it is unpatriotic because he is talking in foreign media and not representing, in my view, the views of the vast majority of British people and actually, I think giving an unfair impression of the National Health Service himself, a British representative on foreign media."
He said Mr Hannan's words were an "insult" to the 1.4m NHS workers and "he should not be voicing those views in the foreign media in my view".
Former Deputy Prime Minister John Prescott said he had recorded a video message to the American people, which is currently being uploaded on to the site, defending the NHS, which has come under fire from critics of Barack Obama's health reforms.
But Mr Cameron, who has sought to portray the Conservatives as the party of the NHS, and has said health spending will be protected from cuts under a Tory government, said the health service was a "great national institution".
"The Conservative Party stands four square behind the NHS," he told BBC News in his Oxfordshire constituency.
"We are the party of the NHS, we back it, we are going to expand it, we have ring-fenced it and said that it will get more money under a Conservative government, and it is our number one mission to improve it."
'Worst nightmare'
And he rebuked Mr Hannan, whose trenchant views on Europe and strongly-worded YouTube attack on Gordon Brown have gained him a following among grassroots Tories, saying: "He does have some quite eccentric views about some things, and political parties always include some people who don't toe the party line on one issue or another issue."
HAVE YOUR SAY I totally support the NHS. Emergency care is available for all - not just for those who can afford it Queenie Bishop, East Grinstead
The Leader of the Conservative group in the European Parliament has said he believes Mr Hannan should be disciplined for his comments about the NHS.
Timothy Kirkhope said Mr Hannan should be given a "stern talking-to" by the chief whip in Brussels, although he described the disciplinary process regarding Euro MPs as a grey area in this case, as Mr Hannan was speaking about a policy area not decided by the European Parliament.
Liberal Democrat health spokesman Norman Lamb claimed Mr Hannan's views, far from being "maverick", were shared by "many people within the Conservative Party".
He also hit back at criticisms of the NHS from Republican-supporting critics of Obama's health bill as a "gross distortion" of the truth about Britain's health service.
It comes after Prime Minister Gordon Brown joined a Twitter campaign to defend the NHS.
The welovetheNHS tag has received tens of thousands of messages of support during the past few days from NHS staff and former patients after it was branded "Orwellian" and "evil" by Republican critics of Mr Obama's health reforms.
The prime minister took the unusual step of adding his voice to the campaign in a message posted from Downing Street's Twitter feed, in which he said "thanks for always being there". His wife Sarah, also sent a message of support to the campaign.
Many of the Twitter messages reacted angrily to Mr Hannan's criticism of the NHS, which he attacked on US TV, saying he "wouldn't wish it on anyone".
'Duped'
US critics of the NHS see it as an overly-bureaucratic "socialized" system which rations care.
But one British woman said she felt duped after becoming the unwitting star of an anti-Obama health campaign.
Kate Spall, who appeared in a US free market group's TV commercial opposing Mr Obama's health bill, said her views were misrepresented.
She told the Times: "It has been a bit of a nightmare. It was a real test of my naivety. I am a very trusting person and for me it has been a big lesson. I feel I was duped."
Ms Spall and fellow Briton Katie Brickell's descriptions of poor treatment at the hands of the NHS featured in the Conservatives for Patients' Rights (CPR) advert.
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/politics/8200817.stm
Published: 2009/08/14 14:04:26 GMT
© BBC MMIX
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Point 1: No, I don't support lying to people.
Point 2: For a commercial I have no problem with simply pointing out their experiences as consequences of a socialized health system. Commercials are by their nature short and to the point. Were it a documentary, yes, bring out their full story.
And the OMG DEATH PANEL is what will happen. It's overblown, but experiences like that of Barbara Wagner are what we know will happen:
http://www.kval.com/news/26140519.html
She's not being "euthanized", but rather told that extending her life is too expensive.
How is that "compassionate" and "universal"? Sorry, Granny, another year with your grandchildren costs too much. We'll pony up the dough for your suicide pills, though!
Or, maybe better stated by President Obama:
"That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health-care bill out here.”
http://www.bloomberg.com/apps/news?pid=20601070&sid=aGrKbfWkzTqc
Hang on, doesnt she live in a country with the worlds best healthcare? Surely she could have just got insurance?
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Will it? It isnt even reality over here....
Have you read what Obama's advisors support? What Obama himself wants? What your system is rightly or wrongly accused of, he wants to bring to fruition here.
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Hang on, doesnt she live in a country with the worlds best healthcare? Surely she could have just got insurance?
Yep. And we still have socialized healthcare here too: Oregon healthcare, Medicare, Medicaid. (Edit: Forgot the lovely example of Massachusetts as well.)
And even with those examples we have those that think the government has run those so well, it should take over all of healthcare.
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As a Brit, I've found a lot of the stuff coming out of America pretty odd.
In the first place, there's the very 'exciteable' rhetoric being used on both sides. Then there are the blatant distortions. "Death panels", for instance. Now that is obviously a very emotive turn of phrase and one that has raised eyebrows over here, but it is perfectly true that there is a govenment panel that withdraws your treatment if it costs over a certain amount per quality adjusted year it's expected to extend life. Its decisions are not ridigly enforced, but if NHS Trusts want to fund something NICE doesn't approve of, they don't get to claim the extra cost against the taxpayer, something else has to be cut. This has resulted in a 'post code loddery' for healthcare to some extent. The NHS also tries to restrict people taking up private healthcare. Not only will they not give you back the money you put into the national insurance that has refused to pay out, they will also withdraw all your NHS care if you spend any part of your money on private treatment. There have been cases of people dying because they have been denied drugs by the NHS that they could have afforded to pay for out of their own pocket, but could not afford to pay for all the resulting extra bills when their NHS treatment would have been removed.
This I think illustrates the enormous culture difference between the US and the UK, where we would rather a rich man died so that a poor man dying anyway won't feel 'unequal'. What's most surprising for us is that America is so shocked by this, to the extent that even the proponents of the plan aren't explicitly admitting this will even happen, choosing instead to attack the propagandist, but ultimately not very important names used to describe it. In Britain a fair number of people are aware of NICE, but mostly put up with it despite the outrage some of its decisions have provoked. The NHS is pretty deeply ingrained in the national psyche. The idea that one owns one's own property, and can't morally be soaked for money to fund other people and then have their own care withdrawn because it's "too expensive" is not strong, at least on this issue. The fact that Dan Hannan was called "unpatriotic" by the Labour Party is testament to this. It may be common rhetoric in the US, but almost nothing will get you labelled unpatriotic here, even opposing the monarchy, the flag, the armed forces, etc. which are par for the course in America. It's even rarer to receive such criticism from the Labour Party, which struggles to admit that British patriotism even exists distinct from fascism most of the time.
It's not even that these people are defending state redistribution, as such, but the specific manifestation of it in the NHS. They become just as outraged if you suggest replacing it with a more effective, and just as universal system, such as that of Singapore or France, that includes private co-payments or something of that sort. There was even substantial political controversy when particular NHS hospitals outsourced certain services like cleaning to the private sector, still paid for out of the state's pocket and essentially still state employees - this is what passes for a radical move towards privatisation here.
America would find it very difficult to accept the costs of something like an NHS. Not financially, it is actually cheaper than the US system. The US state alone spends more than the British state per person on healthcare. But in human terms, I don't think the US would accept the waiting lists, the treatment cut offs, or the quality lottery. It's important to know what you're letting yourselves in for, because if Obama makes it illegal for insurers to take into account personal circumstances in offering or pricing insurance plans - in other words, makes it illegal for insurance to operate as insurance - America's health costs are going to spiral further, and Obama has made it pretty clear where he sees the savings come from: the ability of the state to force people who will no longer be able to afford private insurance to impose an American NICE, introduce long waiting lists, and so on.
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Well said, Huzzah and welcome.
I, for one, am not willing to bear the costs of socialism and will oppose being burdened with them STRENUOUSLY.
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And whose sock puppet is this?
As a Brit, I've found a lot of the stuff coming out of America pretty odd.
In the first place, there's the very 'exciteable' rhetoric being used on both sides. Then there are the blatant distortions. "Death panels", for instance. Now that is obviously a very emotive turn of phrase and one that has raised eyebrows over here, but it is perfectly true that there is a govenment panel that withdraws your treatment if it costs over a certain amount per quality adjusted year it's expected to extend life. Its decisions are not ridigly enforced, but if NHS Trusts want to fund something NICE doesn't approve of, they don't get to claim the extra cost against the taxpayer, something else has to be cut. This has resulted in a 'post code loddery' for healthcare to some extent. The NHS also tries to restrict people taking up private healthcare. Not only will they not give you back the money you put into the national insurance that has refused to pay out, they will also withdraw all your NHS care if you spend any part of your money on private treatment. There have been cases of people dying because they have been denied drugs by the NHS that they could have afforded to pay for out of their own pocket, but could not afford to pay for all the resulting extra bills when their NHS treatment would have been removed.
This is nonsense. For a start, NIHCE (NICE is a stupid acronym, and is wrong anyway) does not approve what an individual gets treated with, that is left to the doctor and the Trust (apart from transplants, where a body does have to decide who gets an organ, though this is because of the rarity of some donated organs and not cost). Secondly, the NHS does not prevent people getting private healthcare - in fact far from it, the state will pay for people to be treated in a private hospital (http://news.bbc.co.uk/1/hi/health/7742363.stm). Yes, the NHS has on occasion withdrawn treatment from people who have paid for private healthcare (usually because of the scale of what the person has been paying, though this was a very rare occurance), though after the Richards Review this should not be happening (http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/194i/194i06.htm). Yes, there are variations in standards between hospitals in various parts of the country - but what system would that not happen in?
This I think illustrates the enormous culture difference between the US and the UK, where we would rather a rich man died so that a poor man dying anyway won't feel 'unequal'. What's most surprising for us is that America is so shocked by this, to the extent that even the proponents of the plan aren't explicitly admitting this will even happen, choosing instead to attack the propagandist, but ultimately not very important names used to describe it. In Britain a fair number of people are aware of NICE, but mostly put up with it despite the outrage some of its decisions have provoked. The NHS is pretty deeply ingrained in the national psyche. The idea that one owns one's own property, and can't morally be soaked for money to fund other people and then have their own care withdrawn because it's "too expensive" is not strong, at least on this issue. The fact that Dan Hannan was called "unpatriotic" by the Labour Party is testament to this. It may be common rhetoric in the US, but almost nothing will get you labelled unpatriotic here, even opposing the monarchy, the flag, the armed forces, etc. which are par for the course in America. It's even rarer to receive such criticism from the Labour Party, which struggles to admit that British patriotism even exists distinct from fascism most of the time.
More nonsense. If a rich man, or a moderately well-off man, wants treatment he can go to any one of the hundreds of private hospitals in the UK and have it. As for the criticism of Hannan, that was inane (but sadly par for the course when it comes to Labour) but Hannan is wrong on this issue - perhaps after the criticism of Brown he has got too big for his boots.
It's not even that these people are defending state redistribution, as such, but the specific manifestation of it in the NHS. They become just as outraged if you suggest replacing it with a more effective, and just as universal system, such as that of Singapore or France, that includes private co-payments or something of that sort. There was even substantial political controversy when particular NHS hospitals outsourced certain services like cleaning to the private sector, still paid for out of the state's pocket and essentially still state employees - this is what passes for a radical move towards privatisation here.
The controversy was not because they were outsourcing cleaning to the private sector, the controversy was that the cleaning provided by the private firms was so sub-standard that it led to several outbreaks of infection. Had it not been there would not have been a controversy. As for reform of the NHS, I am unaware of any genuine reform (ie: reform that is actually well intentioned and not an excuse for someone to make a quick buck) that has led to serious opposition - most people when questioned (including the two mentioned in the Times article) want a better NHS.
America would find it very difficult to accept the costs of something like an NHS. Not financially, it is actually cheaper than the US system. The US state alone spends more than the British state per person on healthcare. But in human terms, I don't think the US would accept the waiting lists, the treatment cut offs, or the quality lottery. It's important to know what you're letting yourselves in for, because if Obama makes it illegal for insurers to take into account personal circumstances in offering or pricing insurance plans - in other words, makes it illegal for insurance to operate as insurance - America's health costs are going to spiral further, and Obama has made it pretty clear where he sees the savings come from: the ability of the state to force people who will no longer be able to afford private insurance to impose an American NICE, introduce long waiting lists, and so on.
America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?
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America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?
How?
That's the EXACT claim of the Obama administration, as well.
Just how is the government, when it has proven how inefficient and inept it is with: Amtrak, USPS, Medicare, Medicaid, Social Security, inter alia going to provide a better service to more people at a lower cost with less fraud?
HOW? Our government has already proven unfit to run virtually any business. Yet, somehow we are to suppose "it'll get this one right, we promise"?
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How?
That's the EXACT claim of the Obama administration, as well.
Just how is the government, when it has proven how inefficient and inept it is with: Amtrak, USPS, Medicare, Medicaid, Social Security, inter alia going to provide a better service to more people at a lower cost with less fraud?
HOW? Our government has already proven unfit to run virtually any business. Yet, somehow we are to suppose "it'll get this one right, we promise"?
Did you actually read Huzzah's post or did you just agree with it?
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And whose sock puppet is this?
The IP is from Europe and hasn't been seen here before. If it is a sock puppet, it's one who covered their tracks better than many.
Chris
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Did you actually read Huzzah's post or did you just agree with it?
Cute.
In the first place, there's the very 'exciteable' rhetoric being used on both sides. Then there are the blatant distortions. "Death panels", for instance. Now that is obviously a very emotive turn of phrase and one that has raised eyebrows over here, but it is perfectly true that there is a govenment panel that withdraws your treatment if it costs over a certain amount per quality adjusted year it's expected to extend life. Its decisions are not ridigly enforced, but if NHS Trusts want to fund something NICE doesn't approve of, they don't get to claim the extra cost against the taxpayer, something else has to be cut. This has resulted in a 'post code loddery' for healthcare to some extent. The NHS also tries to restrict people taking up private healthcare. Not only will they not give you back the money you put into the national insurance that has refused to pay out, they will also withdraw all your NHS care if you spend any part of your money on private treatment. There have been cases of people dying because they have been denied drugs by the NHS that they could have afforded to pay for out of their own pocket, but could not afford to pay for all the resulting extra bills when their NHS treatment would have been removed.
So, what they're going to do is steal from people and put them into the government plan so that they can't afford private insurance and when they could afford to pay for it outside of the plan, drop them because it's unfair that someone pays for their own healthcare that the government didn't cover. Funny, currently my health insurance doesn't drop me if I pay for something it doesn't cover.
SECONDLY, the U.S. government has already proved itself unable to manage it's "businesses". As I recall, NHS is facing an impending funding crisis as well (My memory serves me well: http://uk.reuters.com/article/idUKTRE5591CB20090610). Again, what in our government makes us think this will be more efficient?
Your response, AGAIN, is "Well, it will be!". HOW!?
I am reminded of what one of your great leaders once said:
"Socialist governments traditionally do make a financial mess. They always run out of other people's money. It's quite a characteristic of them." (Emphasis added)
So, will it be just like Social Security and Medicare? GREAT... while the money lasts at the bottom of the pyramid.... (Social Security, incidentally, was an AMAZING deal for the first beneficiaries... it's young people like me that are ALREADY EXPECTING TO GET SCREWED. Now, I'm supposed to support ANOTHER program that will screw my children? No thank you.)
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FURTHER...
This is the great problem with socialism in general: The problems do not immediately materialize because they are able to leech from the productive in society at first.
Socialism, at first brush, then appears to be a WONDERFUL choice...
Until there's no one left to leech off of.
Related:
I wonder what's going to happen when we kill for-profit US medical research?
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And whose sock puppet is this?
No one's, though I was invited to comment on this by a friend who is a regular on this board as he knows that I am both (1) British and (2) a libertarian opposed to most things socialist. I won't name names as I'm not sure if he would want to be identified.
This is nonsense. For a start, NIHCE (NICE is a stupid acronym, and is wrong anyway)
NICE is the official version, it's even on their own website - http://www.nice.org.uk/ . Though yeah, it leaves out a letter so that it can be just slightly more sinister and Orwellian than otherwise.
does not approve what an individual gets treated with, that is left to the doctor and the Trust (apart from transplants, where a body does have to decide who gets an organ, though this is because of the rarity of some donated organs and not cost). Secondly, the NHS does not prevent people getting private healthcare - in fact far from it, the state will pay for people to be treated in a private hospital (http://news.bbc.co.uk/1/hi/health/7742363.stm). Yes, the NHS has on occasion withdrawn treatment from people who have paid for private healthcare (usually because of the scale of what the person has been paying, though this was a very rare occurance), though after the Richards Review this should not be happening (http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/194i/194i06.htm). Yes, there are variations in standards between hospitals in various parts of the country - but what system would that not happen in?
Your first point - I did say that in my post. It doesn't mandate exactly what is allowed and disallowed. However its 'price for life' is what sets the funding allocations, so if your Trust is allowing stuff NICE doesn't approve, they are almost certainly withholding other stuff that it does (or withholding treatment from smokers, or fat people, both of which have happened here). If you really are British you presumably have heard of the post code lottery. This is the cause, not random variations that would happen regardless of the system.
Second point - I'm pleased to see that this ban was (eventually) repealed. I was not aware that it had been, probably because it has only happened in the last couple of months of the NHS's 60 year existance.
More nonsense. If a rich man, or a moderately well-off man, wants treatment he can go to any one of the hundreds of private hospitals in the UK and have it.
He can now, it seems, but 6 months ago he couldn't. Still, I don't think that I was far wrong with the difference in mindset. Take this article, for instance, in a private healthcare industry journal, that says:
"However, there are fears that, if patients can top up their treatment, only wealthier people who can afford such treatments will benefit."
http://www.privatehealth.co.uk/news/november-2008/nhs-top-up-ban-removed-30091/
I really do not understand this sort of thing at all. Only the wealthy (or really the moderately wealthy, I suppose, as the very rich could have afforded to leave the NHS entirely even before the repeal), will be saved, therefore it's preferable that the wealthy die and the poor die, so that it's equal? It's madness. I don't know a single person who would say they're comforted by the fact that, as they lie dying, someone else is being forced to die for no good reason but to make them feel better. I think this is a repulsive thought.
As for the criticism of Hannan, that was inane (but sadly par for the course when it comes to Labour) but Hannan is wrong on this issue - perhaps after the criticism of Brown he has got too big for his boots.
I disagree. Even if you like universal healthcare (and personally I have problems with it - I would much rather a charitable system), the NHS is a pretty mediocre universal system, one of the lowest ranked in the OECD. Countries like Singapore, that spend less and get better results, while still being universal, have much greater private involvement and private funding.
The controversy was not because they were outsourcing cleaning to the private sector, the controversy was that the cleaning provided by the private firms was so sub-standard that it led to several outbreaks of infection. Had it not been there would not have been a controversy. As for reform of the NHS, I am unaware of any genuine reform (ie: reform that is actually well intentioned and not an excuse for someone to make a quick buck) that has led to serious opposition - most people when questioned (including the two mentioned in the Times article) want a better NHS.
That is the stated reason, but plenty of nationalised parts of the NHS are subject to similar failures and this, while provoking criticism of their particular actions, is never presented as an attack on the idea of nationalised healthcare. Usually it is presented as a justification for giving the nationalised system even more money and control.
America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?
It doesn't make sense that a programme that offers insurance at a low, equal price regardless of a person's actual requirement for treatment should be cheap. The only way it could be cheaper than what the US has now is by taking over part of the private market, and then reducing the quality of coverage.
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America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?
On what planet will this system be cheaper? Taxes will be raised on the middle class, health benefits, small businesses, and the wealthy. That is not cheaper.
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Have we actually established yet whether Stephen Hawking uses NHS to pay for his health care or private alternatives?
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Cute.
It seems you still havent read it. I will re-quote it, and embolden the relevant text just so you have the best possible chance to read it:
America would find it very difficult to accept the costs of something like an NHS. Not financially, it is actually cheaper than the US system. The US state alone spends more than the British state per person on healthcare.
As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.
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It seems you still havent read it. I will re-quote it, and embolden the relevant text just so you have the best possible chance to read it:
As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.
I did read that.
YET, you've not provided an indication of HOW THAT WILL HAPPEN HERE.
I grant that your government spends less per person. My question is how that correlates to what will happen here.
Your response is unrelated to the question. Your response is "We spend less!".
That's great. How would reforming our system cause us to spend less? Obama's plan adds $1,000,000,000,000 to the debt over the next 10 years. (edit: My guess is even that is under-estimating the cost)
Now, let's say we adopt the NHS style plan. HOW are we going to cut waste, fraud, and abuse when our government has already proved it can't do that?
My question isn't: "No one can spend any less than the US does on healthcare per person!!!1111"
My question is: How would a universal plan in the U.S. actually lower costs. Responding with "It DOES!" doesn't quite answer that question, no?
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Have we actually established yet whether Stephen Hawking uses NHS to pay for his health care or private alternatives?
Hawking has responded
‘I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.’
Course IBD responded:
"We accept this testimony and good fortune. We will note, however, that in talking about his disability on his own Web site, Hawking makes no mention of NHS and instead says that since 1985, when he had a tracheotomy, he has had ‘24-hour nursing care … made possible by several foundations.’
Many other Britons may not be as fortunate, and we wonder how they might fare under similar circumstances in their later years.”
I can speculate too - would an insurance company have paid out for 24hr nursing care at home for the last 24 years?
A significant level of care is entirely possible through social programs such as Direct Payments, Individual Budgets and the like. I know of a young guy with terrible cerebal palsy and extreme learning difficulties that lives independently with live-in carers through schemes like this.
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As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.
The fact that we Americans don't do cost-benefit analysis on saving lives argues strongly against your assertion that you get better service and more coverage.
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Hawking has responded
‘I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.’
Course IBD responded:
"We accept this testimony and good fortune. We will note, however, that in talking about his disability on his own Web site, Hawking makes no mention of NHS and instead says that since 1985, when he had a tracheotomy, he has had ‘24-hour nursing care … made possible by several foundations.’
Many other Britons may not be as fortunate, and we wonder how they might fare under similar circumstances in their later years.”
I can speculate too - would an insurance company have paid out for 24hr nursing care at home for the last 24 years?
A significant level of care is entirely possible through social programs such as Direct Payments, Individual Budgets and the like. I know of a young guy with terrible cerebal palsy and extreme learning difficulties that lives independently with live-in carers through schemes like this.
Ah... I note this is one point where we are arguing PAST one another.
I do not think private healthcare is the solution for ALL the problems either country faces with their healthcare.
However, I think it is the solution for MOST of the problems. I would FAR rather have private charities deal with those who "fall through the cracks" than the government.
I don't want poor people to die. In fact, my wife and I give quite a bit to charities (her brother is a Marine, so much of that is to veterans groups). We have NUMEROUS charities devoted to helping children, veterans, terminally ill, etc...
If we're going to talk about misrepresentations, how is it that those pro-government run healthcare can get away with claiming we want people to die since we don't want the government to pay for their care?
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As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.
I don't think it has been established that the NHS offers a better service. The evidence I have seen indicates the opposite. It offers some care to a greater proportion of the populace, though, yes.
I think that America's healthcare problems could be alleviated by the following:
- Removal of subsidies for employer insurance policies, preferably by removing tax on all medical activities - having something purchased for you by someone else rarely results in the best choice being made, while taxing something that you're going to provide out of tax revenue for people who can't afford it is self-defeating.
- Removal of mandatory medical licencing requirements - as it stands, the AMA is able to act as a closed shop union, driving up prices for the benefit of its members.
- Allow health insurance to be traded across state borders - fewer, larger companies is generally preferable in this industry, as there are substantial economies of scale in administration, and competition between a few readily identifiable firms for reputation is likely to result in less frivolous and fraudulent refual of claims.
- Remove mandatory items to be included in insurance - a lot of people will probably only want catastrophic insurance, and pay for 'comprehensive' items out of their own pocket. This further results in greater incentive to reduce costs through competition.
As for those who are uninsured, if you must insist on state provision there are far better ways. One would be to simply give people money. The US state spends enough on medicare and medicaid to afford NHS-standard treatment for everyone in the country, even though the majority of people have insurance. This is absurdly wasteful, but not a surprising outcome of having essentially a bottomless pit of insurance. They would be able to use this money to purchase private, probably only catastrophic health insurance, and it would certainly cost less than now. Alternative, it could adopt a system much like the UK's student loans system: healthcare is paid off by the individual, but the recipient receives an interest free state loan with repayments fixed to a % of their income. This would discourage wasteful spending and drastically reduce costs for the state, while ensuring universal provision.
The present system isn't exactly great. Going to an NHS model is merely swapping one mediocre system for another, though, with a new set of problems everyone will hate.
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I don't think it has been established that the NHS offers a better service. The evidence I have seen indicates the opposite. It offers some care to a greater proportion of the populace, though, yes.
I think that America's healthcare problems could be alleviated by the following:
- Removal of subsidies for employer insurance policies, preferably by removing tax on all medical activities - having something purchased for you by someone else rarely results in the best choice being made, while taxing something that you're going to provide out of tax revenue for people who can't afford it is self-defeating.
- Removal of mandatory medical licencing requirements - as it stands, the AMA is able to act as a closed shop union, driving up prices for the benefit of its members.
- Allow health insurance to be traded across state borders - fewer, larger companies is generally preferable in this industry, as there are substantial economies of scale in administration, and competition between a few readily identifiable firms for reputation is likely to result in less frivolous and fraudulent refual of claims.
- Remove mandatory items to be included in insurance - a lot of people will probably only want catastrophic insurance, and pay for 'comprehensive' items out of their own pocket. This further results in greater incentive to reduce costs through competition.
As for those who are uninsured, if you must insist on state provision there are far better ways. One would be to simply give people money. The US state spends enough on medicare and medicaid to afford NHS-standard treatment for everyone in the country, even though the majority of people have insurance. This is absurdly wasteful, but not a surprising outcome of having essentially a bottomless pit of insurance. They would be able to use this money to purchase private, probably only catastrophic health insurance, and it would certainly cost less than now. Alternative, it could adopt a system much like the UK's student loans system: healthcare is paid off by the individual, but the recipient receives an interest free state loan with repayments fixed to a % of their income. This would discourage wasteful spending and drastically reduce costs for the state, while ensuring universal provision.
The present system isn't exactly great. Going to an NHS model is merely swapping one mediocre system for another, though, with a new set of problems everyone will hate.
Once again, these are reforms I can whole-heartedly support.
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The fact that we Americans don't do cost-benefit analysis on saving lives argues strongly against your assertion that you get better service and more coverage.
You would have a point if your country actually didnt do cost benefit analysis when it comes to saving lives, or if ours did do it. Unfortunately neither statement is true.
My question is: How would a universal plan in the U.S. actually lower costs. Responding with "It DOES!" doesn't quite answer that question, no?
Thats your business. I am here on this thread to point out that the vast majority of what you lot are being told about the NHS is either misleading, or an outright fabrication.
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Hawking has responded
‘I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.’
Course IBD responded:
"We accept this testimony and good fortune. We will note, however, that in talking about his disability on his own Web site, Hawking makes no mention of NHS and instead says that since 1985, when he had a tracheotomy, he has had ‘24-hour nursing care … made possible by several foundations.’
Many other Britons may not be as fortunate, and we wonder how they might fare under similar circumstances in their later years.”
OK, so Hawking has used both NHS and private care to keep himself alive.
But this leads to more questions than it answers. He got some care from NHS, and that care kept him. Could he have gotten that care without the NHS? Would he have gotten better care through the private system? Worse care through the private system? If the NHS was caring for him, why did he bother involving "several foundations" in his care? Was there something available through the foundations that wasn't available through NHS?
I can speculate too - would an insurance company have paid out for 24hr nursing care at home for the last 24 years?
A significant level of care is entirely possible through social programs such as Direct Payments, Individual Budgets and the like. I know of a young guy with terrible cerebal palsy and extreme learning difficulties that lives independently with live-in carers through schemes like this.
My grandfather needed at-home nursing for about 15 years before he passed away. His insurance paid for the bulk of it.
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Thats your business. I am here on this thread to point out that the vast majority of what you lot are being told about the NHS is either misleading, or an outright fabrication.
Thank you for answering my question.
Apparently, like the other supporters of universtal healthcare, you have no idea how that will happen either.
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Thank you for answering my question.
Apparently, like the other supporters of universtal healthcare, you have no idea how that will happen either.
What nonsense. I have a great idea of how universal healthcare works, how it is paid for and the pros and cons of it because I live in a country that has such a system. How it would work, or not work, in your country is your business, not mine.
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What nonsense. I have a great idea of how universal healthcare works, how it is paid for and the pros and cons of it because I live in a country that has such a system. How it would work, or not work, in your country is your business, not mine.
Sorry, perhaps I should have said "You have no idea how that will happen HERE, either."
My point isn't that you don't know what you're talking about. My point is that no one has been able to explain how such savings would be brought about here.
I wasn't attacking you by repeating my question, I honestly want to know how the supporters over here expect to bring costs down.
They haven't been able to answer my questions.
I don't expect you to know the workings within the U.S. anymore than I expect to know the workings within the UK beyond a broad brush understanding. I had thought that perhaps you might have an explanation that I could analyze.
I'm perfectly content to accept that you are happy with your healthcare system. I am not advocating destroying the NHS- as you said "That's your business." I will, however, get animated when speaking about the US because I don't want it forced upon me and have no where left to go if the U.S. adopts a fully socialist system as well.
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Well, we know it's all sweetness and light Over There, but speaking of Cambridge, here are some remarks from a friend of mine, American, a molecular biologist, who paid a visit to that lovely spot last year:
"What I do know is that when I was visiting Cambridge, England in
May 2008, one prominent article in the local daily was about an
outbreak of "C diff" (Clostridium difficile):
http://en.wikipedia.org/wiki/Clostridium_difficile
in Addenbrooke's:
http://www.cuh.org.uk/addenbrookes/news/2009/june/infection_control_success.html
which happens to be the main hospital in Cambridge, affiliated with
the University and its medical school.
To get a sense of how preposterous that really was, imagine a
similar outbreak being tolerated in any of the Boston hospitals
associated with Harvard Medical School -- Massachussetts General
Hospital, Beth Israel, the Dana Farber Cancer Center, Brigham and
Women's, or *any* of them.
There are decent, hard-working doctors in the British system.
But I have a feeling that a lot of them are probably as frustrated
as this one was:
http://en.wikipedia.org/wiki/Anthony_Daniels_%28psychiatrist%29"
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You would have a point if your country actually didnt do cost benefit analysis when it comes to saving lives, or if ours did do it. Unfortunately neither statement is true.
With the rapid advances in modern medicine, most people accept that no publicly funded healthcare system, including the NHS, can possibly pay for every new medical treatment which becomes available. The enormous costs involved mean that choices have to be made.
...
Each drug is considered on a case-by-case basis. Generally, however, if a treatment costs more than £20,000-30,000 per QALY, then it would not be considered cost effective.
...
Patient x has a serious, life-threatening condition.
* If he continues receiving standard treatment he will live for 1 year and his quality of life will be 0.4 (0 or below = worst possible health, 1= best possible health)
* If he receives the new drug he will live for 1 year 3 months (1.25 years), with a quality of life of 0.6.
The new treatment is compared with standard care in terms of the QALYs gained:
* Standard treatment: 1 (year’s extra life) x 0.4 = 0.4 QALY
* New treatment: 1.25 (1 year, 3 months extra life) x 0.6 = 0.75 QALY
Therefore, the new treatment leads to 0.35 additional QALYs (that is: 0.75 –0.4 QALY = 0.35 QALYs).
* The cost of the new drug is assumed to be £10,000, standard treatment costs £3000.
The difference in treatment costs (£7000) is divided by the QALYs gained (0.35) to calculate the cost per QALY. So the new treatment would cost £20,000 per QALY.
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Nice to see Fox and its fair and balanced reporting:
http://www.youtube.com/watch?v=2c-JEx-Kfvc
;/
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Obama has officially sunk so low as to get into an argument with the citizens of the United States of America.
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IBD editorials just don't stop:
"The new law also contemplates end-of-life counseling. With this approach, it is only a matter of time before your children will be offered bounties for persuading you to take an early exit."
http://www.investors.com/NewsAndAnalysis/Article.aspx?id=503472
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I haven't yet seen an IBD editorial that was actually false.
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I haven't yet seen an IBD editorial that was actually false.
Thats because they edited the Hawking one.
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If government death panels are created, I want to get on one immediately.
(I have a list . . . )
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Thats because they edited the Hawking one.
The gist of the IBD editorial was that if Hawking had had to rely solely upon NHS, and not upon some private health care and/or his prestige, he wouldn't have fared so well. This appears to be true, so far as it goes. Nothing we've seen so far refutes it.
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The whole Hawkings debate doesn't make sense any since he got sick near the peak of his quality adjust life years.
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The gist of the IBD editorial was that if Hawking had had to rely solely upon NHS, and not upon some private health care and/or his prestige, he wouldn't have fared so well. This appears to be true, so far as it goes. Nothing we've seen so far refutes it.
Thats a remarkable reinterpretation of what the IBD article said. The editorial initially opined:
People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
Now for a start the NHS has had multiple chances to bump Hawking off as a waste of resources, most recently in April when he was both disabled and a pensioner. How on earth can you honestly extract that sentence to say what you claimed it said? Interestingly, they have now edited it to remove every reference to Hawking, beyond to an initial clarification that says:
Editor's Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.
http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877
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We simply don't know whether Hawking would have had a chance to remain alive if he had had to rely solely upon NHS. We know that Hakwing has received some life-saving care from NHS, but we also know that he felt the need for non-NHS care as well. Unless we can identify the exact nature of care he received from both sources, we cannot identify whether NHS care alone would have been fully sufficient to keep him alive.
I covered this previously, perhaps you didn't see it.
OK, so Hawking has used both NHS and private care to keep himself alive.
But this leads to more questions than it answers. He got some care from NHS, and that care kept him alive. Could he have gotten that care without the NHS? Would he have gotten better care through the private system? Worse care through the private system? If the NHS was caring for him, why did he bother involving "several foundations" in his care? Was there something available through the foundations that wasn't available through NHS?
IBD went into some specifics on the how the "quality adjusted life years" cost-benefit-analysis is done in NHS. Based on that, IBD seems to have a point. If a given treatment is too expensive, and the patient's quality of life is deemed too low, then the NHS doesn't provide the treatment. This forces the patient to find private sources for the treatment. We don't know this for certain, but this is a plausible explanation for why Hawking needed to get some of his care from private sources.
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We've seen that Hakwing has received some life-saving care from NHS. But we've also seen that he felt the need for non-NHS care as well. Unless we can identify the exact nature of care he received from both sources, we cannot identify whether NHS care alone would have been fully sufficient to keep him alive. We simply don't know whether NHS alone would have served Hawking well, which is what IBD was speculating on.
I am sorry, but that is an absolute lie when viewed against what the IBD actually said, which I repeat below:
People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
How you can honestly extrapolate what you claim the IBD meant from what they actually said is a mystery to me; the original editorial clearly suggested that Hawking would not have a chance in the UK because of his disability - something both utterly wrong and with precisely no basis in fact, at all. Hawking himself has said:
"I wouldn't be here today if it were not for the NHS," he told us. "I have received a large amount of high-quality treatment without which I would not have survived."
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All we know is that Hawking received some of his care from NHS and some of his care from the private system. You cannot honestly claim, based on what we know here, that the NHS care he received was the only care he needed to stay alive. The NHS care saved his life at some points, but based on what we know you can't say that his private care didn't save or prolong his life as well.
What would have happened to Hawking if he had been an average British person?
Would he still be alive if he had used NHS care alone?
Would the NHS 20,000 pound per QALY limit have been exceeded, and would he have been denied important care? Would his disabilities and their attendant lower QALY have disqualified him for certain NHS-funded treatments that he could have benefited from?
Why did Hawking feel the need for some private care? Was it due to some inadequacy or deficiency in the NHS care he was already receiving?
We don't know. Perhaps you have some more information about this case that you haven't posted here...?
Nothing in the Hawking quote you keep repeating answer the questions I've asked. The gist of the IBD editorial was that NHS rations care, and as such Hawking wouldn't have survived under NHS alone. This may or may not be true, we just don't know based on that quote you keep repeating.
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All we know is that Hawking received some of his care from NHS and some of his care from the private system. You cannot honestly claim, based on what we know here, that the NHS care he received was the only care he needed to stay alive. The NHS care saved his life at some points, but based on what we know you can't say that his private care didn't save or prolong his life as well.
No, thats not what we know. We know that Hawking is British, and that he has said that but for treatment from the NHS he would not be here. The statement - which was abundantly clear - in that IBD editorial said that in the UK he "would not have a chance" because of his disability. One would have thought that would be enough to say that the IBD article was entirely wrong, but of course we are discussing the UK here and so it must mean something else that avoids admitting an American perspective on the NHS might, just might, be entirely wrong.
What would have happened to Hawking if he had been an average British person?
As has been explained already, he was "an average British person" when he was diagnosed with (and for much of the treatment of) this illness.
Would he still be alive if he had used NHS care alone?
Yes.
Would the NHS 20,000 pound per QALY limit have been exceeded, and would he have been denied important care? Would his disabilities and their attendant lower QALY have disqualified him for certain NHS-funded treatments that he could have benefited from?
No.
Why did Hawking feel the need for some private care? Was it due to some inadequacy or deficiency in the NHS care he was already receiving?
We don't know. Perhaps you have some more information about this case that you haven't posted here...?
Nothing in the Hawking quote you keep repeating answer the questions I've asked. The gist of the IBD editorial was that NHS rations care, and as such Hawking wouldn't have survived under NHS alone. This may or may not be true, we just don't know based on that quote you keep repeating.
The questions you have asked are irrelevant when talking about the IBD editorial. The IBD editorial did not discuss them, it did not weigh carefully the effect that public and private healthcare had on Hawking, whether all of his needs were met by one or the other. It limited itself to saying:
People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
That is entirely wrong. It would be nice if you would admit it.
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The only other thing to say is that not all care that someone like Hawking needs is necessarily provided by the NHS, but can instead come through social care. Still state funded. People I know get things like Direct Payments, there is also something called an Individual Budget. The way these can work ranges from all being done for you - care packages are provided and the burden of employing someone to care for you falls on the state or on state-funded organisations like the Penderels Trust. Alternatively you can be given the money and purchase your care solution by yourself, take responsibility for making the National Insurance payments for your employee, your carer. There are various in-between options too.
http://worcestershire.whub.org.uk/home/wccindex/wcc-social-buyingfreedom/wcc-social-bf-wdavies.htm - watch the video, this guy is a trustee at an organisation I do some work for.
Direct payments are cash payments given to service users in lieu of community care services they have been assessed as needing, and are intended to give users greater choice in their care. The payment must be sufficient to enable the service user to purchase services to meet their needs, and must be spent on services that users need.
Like commissioned care, they are means-tested so assume that, in many cases, people will contribute to the cost of their care.
Direct payments confer responsibilities on recipients to employ people or commission services for themselves. They take on all the responsibilities of an employer, such as payroll, meeting minimum wage and other legislative requirements and establishing contracts of employment.
Some of these services can be contracted out and many councils have commissioned support organisations to help service users handle these responsibilities.
- http://www.communitycare.co.uk/Articles/2009/04/08/102669/direct-payments-personal-budgets-and-individual-budgets.html
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Cool. It sounds like you do have some more information about this case, something I haven't seen yet. I'd love to see it. Can you please share it?
Would he still be alive if he had used NHS care alone?
Yes.
Ok. Based on what?
Would the NHS 20,000 pound per QALY limit have been exceeded, and would he have been denied important care? Would his disabilities and their attendant lower QALY have disqualified him for certain NHS-funded treatments that he could have benefited from?
No.
Ok. Based on what?
If we now have some solid evidence behind these answers, then I'd be willing to agree that the one sentence in the IBD editorial about Hawking is in fact wrong.
Why did Hawking feel the need for some private care? Was it due to some inadequacy or deficiency in the NHS care he was already receiving?
We don't know. Perhaps you have some more information about this case that you haven't posted here...?
Nothing in the Hawking quote you keep repeating answer the questions I've asked. The gist of the IBD editorial was that NHS rations care, and as such Hawking wouldn't have survived under NHS alone. This may or may not be true, we just don't know based on that quote you keep repeating.
The questions you have asked are irrelevant when talking about the IBD editorial. The IBD editorial did not discuss them, it did not weigh carefully the effect that public and private healthcare had on Hawking, whether all of his needs were met by one or the other. It limited itself to saying:
You did read the IBD editorial, right? I mean, you read the whole editorial and not just the one poorly written sentence about Hawking, right?
The main point of the IBD editorial had nothing to do with Hawking. It was about end of life counseling, rationing of care, and the sort of life or death cost-benefit analyses that take place under NHS and NICE. It was about what these sorts of things might mean Americans if they were to become the norm here. The Hawking remark was entirely incidental, a poorly written example inteded to illustrate the main point.
I've not seen any evidence that the substance of the IBD editorial (claims about rationing, QALYs, NICE, or the prospects of something similar coming to the Unites States) is wrong or false. In fact, the more I learn the more satisfied I become that IBD is right on the mark. I was willing to discount the prospect of life and death CBAs as sensationalism, but I've now seen from NICE directly that it's true.
And, truth be told, when I look at the Hawking sentence in the context of the entire editorial, I'm not completely sold on it being wrong either (pending confirmation of the answers you've provided above). I suspect it's a case of shoddy writing, saying "in Britain when what was meant was "under the NHS system".
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The only other thing to say is that not all care that someone like Hawking needs is necessarily provided by the NHS, but can instead come through social care. Still state funded. People I know get things like Direct Payments, there is also something called an Individual Budget. The way these can work ranges from all being done for you - care packages are provided and the burden of employing someone to care for you falls on the state or on state-funded organisations like the Penderels Trust. Alternatively you can be given the money and purchase your care solution by yourself, take responsibility for making the National Insurance payments for your employee, your carer. There are various in-between options too.
http://worcestershire.whub.org.uk/home/wccindex/wcc-social-buyingfreedom/wcc-social-bf-wdavies.htm - watch the video, this guy is a trustee at an organisation I do some work for.
- http://www.communitycare.co.uk/Articles/2009/04/08/102669/direct-payments-personal-budgets-and-individual-budgets.html
Can you explain these systems, social care, direct payments, individual budgets, and the like? Is the "Penderels Trust" the sort of thing that Hawking might have referred to when he said he received care from "several foundations" in addition to the NHS care?
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The community care link explains some of it.
The Penderels Trust, amongst others, is a service that will deal with some of the paperwork of being an employer.
Some of these services can be contracted out and many councils have commissioned support organisations to help service users handle these responsibilities.
- from communitycare link above
Basically it works something like this (this is an approximation of the case of J, who I did some work with two years ago):
J had an accident and was rendered paralysed from the waist down. Lives with his father who doesn't make a substantial wage, live in a very very modest house. After being discharged from hospital they needed services and adaptations.
GP refers to Occupational Therapy who come out and fit ramps to the steps up the front and install a wheelchair accessible platform lift in the lounge because stairs are an impossibility. Also there is a referral to social services, who come out and make an assessment of what J's needs are, they also assign him a worker who is tasked with helping him return to a normal life, look for social and educational opportunities. This worker also calls me in to help with the benefit situation.
I help him fill in forms for Disability Living Allowance, because he is paralysed he gets the highest rate of mobility component, which can be used to purchase an adapted car, or not, up to you. Because he is not continent and needs substantial help with his toilet needs, day and night, he also gets the highest rate of the care component of DLA. In total that's about £110pw, non-means tested.
Because he is getting above the middle rate of care, and his father is no longer working so is earning below the ceiling, his father can get Carers Allowance for looking after him. That's £53.10pw. Then there is Income Support, with various disability premiums added on to it. Housing Benefit too. If the person was working and making National Insurance contributions for a qualifying period then Incapacity Benefit (now called Employment and Support Allowance) is a possibility. Doesn't add up to a lot of money, but it's not bad, helps people a great deal.
Going back to the social services assessment - you have two basic options. You never see the money involved and social services purchase services for you. Alternatively, as in Direct Payments or Individual Budgets, you are given the money, you have to spend it on social care. You then employ people yourself, taking on the employers responsibilities, or you can pay some of the Direct Payment money to someone like Penderels who do the paperwork and take responsibility for making sure that the employers responsibilities and duties are met. Direct Payments give you the freedom to purchase the services you want and employ the people you want.
People of independent means have the freedom to bypass all this completely and purchase the care they want directly from their own pockets. Also, there are trusts, foundations and charities set-up to help people, usually something specific like a spinal injuries trust etc. There's a local trust that I know of that only makes payments to other small charities to help fund core admin costs, something that can be difficult to recover from projects funded by govt or big national organisations. Someone like Hawking may well have had a trust set up in his name to help cover some costs, the one area that fame may well have influenced his care - something that J doesn't get.
Bear in mind though that we are purely talking about social care and care at home. The care that Hawking receives in an NHS hospital is not dependent on any of the above.
On the subject of the IBD editorial - we haven't established where exactly the day to day care he is getting now comes from or how it is funded. The above should show that a very significant level of social care is possible without being independently wealthy, the govt's care agenda is all about independent lives and choice, but this is not the NHS it's a different structure.
We have established though that Hawking developed his ALS long before he was well-known, he was still a graduate student, much NHS care would have been necessary. He did survive.
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Does it really matter that much about one single example...?
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The community care link explains some of it.
The Penderels Trust, amongst others, is a service that will deal with some of the paperwork of being an employer. - from communitycare link above
Basically it works something like this (this is an approximation of the case of J, who I did some work with two years ago):
...
And all of these services are separate from NHS?
On the subject of the IBD editorial - we haven't established where exactly the day to day care he is getting now comes from or how it is funded. The above should show that a very significant level of social care is possible without being independently wealthy, the govt's care agenda is all about independent lives and choice, but this is not the NHS it's a different structure.
We have established though that Hawking developed his ALS long before he was well-known, he was still a graduate student, much NHS care would have been necessary. He did survive.
This is what I'm trying to understand. IBD seemingly made a mistake, either assuming that Hawking didn't get any medical care from NHS, or writing a piss-poor sentence that made it look like they assumed he didn't get any care from NHS. This led all sorts of critics to pounce on IBD, basically saying "Hawking is British, therefore he got all of his care from NHS, duh!". But this isn't correct either, as it's entirely possible, even likely, that Hawking received important care from non-NHS sources.
In order to get to the bottom of it, we'd need to know just what care Hawking has received over the years and where it came from. All we know is that he got some care from NHS and some other care from non-NHS sources, and that's not enough to either prove or disprove IBD's contention that Hawking wouldn't have survived if he'd had to rely on NHS alone.
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And all of these services are separate from NHS?
And, if so, does that mean that the reported cost of medical care does not take these services into account?
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Ok, some of this is 'talking past each other'
Here are the facts:
1. Hawking developed ALS young, well before he was famous.
2. Hawking himself has stated that he received life saving care from the NHS
3. In terms of personal care* it is possible that a person like Hawking could receive what I have described, but quite likely he is paying for it himself.
* - personal care is the care that someone like Hawking needs on a day to day basis - help with changing, washing, toilet, cooking. Depending on things like pressure sores, or stoma or tube feeding there may be a medical element to it, but it's not medical care that is beyond the wit of a relatively untrained person, family do most of this stuff, my mother used to put butterfly needles into me every three weeks. If someone needs daily attention from a medically trained person, then that will be NHS funded, or perhaps funded by set-ups like the Macmillan nurses who seem to be part state and part charity-funded. There's actually not that much that carers or family members can't be trained to do. If you wish to refer to this as an 'unreported medical cost' then remember it goes unreported almost everywhere. Social care costs certainly are reported on.
Now for my sober reflections - because of the single payer, single provider system (which is not what is on the cards for you) it is quite rare that significant medical emergencies or complicated operations happen in the private sector. My dad had a stroke two years ago, had BUPA through work. The NHS hospital he was in had a private hospital in the grounds, but he wasn't cared for there at all. Instead BUPA paid us £50 a day for each day he was in the specialist neuro ward in the NHS hospital. You probably should be wary of this, and I suspect that my father would have done at least as well under your model, because he was working, had always been healthy and had medical insurance.
(BUPA didn't actually fund anything directly, all his physio was funded by the NHS. The only thing BUPA has directly funded was physio on an unrelated shoulder problem)
4. (which isn't a fact but a reasonable deduction from the facts) It is very likely that in cases like Hawking's bout of pneumonia a few years ago, he did receive care in NHS hospitals. At the very least, as far as I am aware, all ER's in this country are NHS. You need a broken bone seen to you are going to an NHS ER.
(Quick bit of research indicates that there are two private neuro facilities in the UK, Oxford and London. Oxford seems to share the same facilities with an NHS hospital. London is a private hospital. Because of the way consultant and surgeon pay is structured it is more than likely that the surgeons working at this two places are also NHS employees, you can do a certain amount of private practice in addition)
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I'm not trying to be adversarial here, I'm trying to provide a picture of an imperfect system that is not allowing people to rot. What made me bridle in Palin's comments was the use of the word 'evil'.
Let's take Palin's baby, Down Syndrome. We are correcting heart defects young now, we haven't always, which was wrong. Now that life expectancy in Downs is in the 60s, there is an increasing issue with heart transplants in Downs patients, and where pulmonary function has been affected then heart-lung transplants are also an issue.
Because of a lack of availability of organs a figure I just read suggest that we only do about 40 heart-lung transplants a year. That had better improve before I need mine. Our first series of Big Brother hit the headlines in part because the winner used his £250,000 winnings to pay for a Down syndrome girl to fly to the US for a transplant. It was a controversial issue, and he shed much needed light on it. Frankly it is wrong to assign a lower preference to Downs patients, although it isn't as simple as thinking they are worth less, there are also issues of post-surgery medical compliance that are not simple issues to resolve. Everyone has to have a track record of compliance with drugs, except George Best.
Which brings me to my dilemma over state-funded and private-funded healthcare. Wrongly we have been questioning the ability of Downs patients to cope with and comply with medical regimes post-transplant. I'm saying this as someone who will effectively be competing with Downs patients for the rather limited sets of lungs available. I'd posit that the dilemmas are not solved by leaving it to be a matter of who can pay and who can't. George Best drank himself to death, as a former footballer he had a huge following and massive reputation as an alcoholic. In 2002 he had a liver transplant, which it seems was privately done. He continued to drink and in 2005 he died.
These are complicated medical and ethical questions, and I'd be very surprised if the ethical factors and associated quality of life and reasonable expectations of success are not being assessed over there. The NHS I suspect is getting beaten with a stick for doing something that is only avoided elsewhere by the power of green, which is not something that very many people have. George Best and little girls who are given £250,000 are the exceptions.
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Now that I've tried to be straight-forward and not particularly partisan about I how view this issue, I'd like to hear about your concerns about your own model. I'm sure you have some.
Also - this quote from the Economist:
Though it has a shameful history, the insurance industry has done a U-turn of late. It now accepts the need for a radical overhaul of insurance markets through measures such as guaranteed issue of coverage and the creation of health insurance "exchanges". But its leaders are increasingly unhappy about the shrill attacks. Can Mr Obama continue to bash the insurers one day and rely on them the next?
Can anyone give me an outline of what guaranteed issue of coverage and these exchanges would change?
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And must we refer to Republicans as Pubbies? I lose about five IQ points every time I read that.
Huh? How is that an insult?
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http://www.armedpolitesociety.com/index.php?topic=11378.0
Its childish and unnecessary.
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http://www.armedpolitesociety.com/index.php?topic=11378.0
Its childish and unnecessary.
I'm so confused. It's just a way of shortening the party name, like saying Dem's. Except you can't say Rep's because that leads to confusion with Representatives. It's not an insult, or any kind of commentary. I had no idea people thought it was.
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It only saves you typing a couple characters. When I first saw it, it looked like a play on the word "pube".
You could always use GOP or (R)'s.
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It only saves you typing a couple characters. When I first saw it, it looked like a play on the word "pube".
You could always use GOP or (R)'s.
Really? I can honestly say that never occurred to me.
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Really? I can honestly say that never occurred to me.
I also thought it was a play on pubic hair too.
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As did I.
I agree with keeping it even across the board.
The rule's been in place for some time, and if we're going to appear impartial...
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In Balog's defense, I have never used that word but each time it crossed my screen I thought it was just an abbreviation ('cutesy' as the wife would say) and never associated it with any form of body hair.
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Also in Balog's defense, had he spelled it with one 'b', I might have thought pubic hair. However, he spelled it with two 'b's and I knew exactly what he meant. Like FTA84, I thought it more "cutesy" than insulting.
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On the one hand, I'm glad to be defended. On the other, I was apparently being cutesy. D'oh! =)
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I never thought of it as an insult. I just hate words like shotty, hoodie, etc. Probably because they are "cutesy."
Doggy, of course, is thoroughly acceptable. Just don't say "dawg," 'cuz that's dumb. I'm looking at YOU, Mr. Grisman. =)
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When I first saw it, it looked like a play on the word "pube".
I also thought it was a play on pubic hair too.
As did I.
It's official. Our mods are all pervs. :laugh:
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I only wish to add that I am not picky, persnickety, arbitrary or difficult, no matter how much it may appear that way. :angel:
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Are you claiming you actually refer to that article of clothing as a "hooded sweatshirt" in casual conversation?
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It's official. Our mods are all pervs. :laugh:
Want us to be prudes?
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Want us to be prudes?
I prefer the term, "bluenose."
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Are you claiming you actually refer to that article of clothing as a "hooded sweatshirt" in casual conversation?
Well, yeah. =|