"O Lord, make my enemies ridiculous!"

Ceili! I haven't seen you in ages -- what a pleasant surprise!

Good to be seen Thomas, I hope you've been keeping well.

i liked your post quite a bit. thanx!

Slight tangent, but not entirely - Anyone read Atul Gawande's article in the New Yorker back in early June, "The Cost Conundrum"? He was investigating disparities in medical costs in Texas. Or, "What a Texas Town Can Teach Us About Healthcare."

That was a useful wakeup for me, and I'd appreciate others' take on it if you read it.

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

Here's one of the starter paragraphs -
"McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami"which has much higher labor and living costs"spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns."
Gawande explores similar markets with different numbers, and looks into the 'whys'. I found it quite worth reading to the end.

My own vague take is that no reform can really happen until there is some kind of control on these kinds of disparities in functionality and costs.

I read of the situation, though not in New Yorker. Somehow, I'm unsure of the phrase Too cynical perhaps, but does that mean they paid claims in the amount of $15.000.00? Could the figure be what was paid to HMOs with a group in a very high risk classification, i.e. very old? I recall that the total premium for the health insurance I had while employed ran a bit over $7,000.00 per month per employee, and that was a fairly youthful and healthy population. An area in which the general retired population is older than the average age of retirees is going to have higher premiums.

I'm naturally suspicious of general numbers from people with points to prove.

Edit: I meant to say $7,000.00 per year.

The point is what is one's definition of "work better"? Work better in your mind may be work worse in another's mind. Remember, we are a heterogenous society with differing levels of concern for our fellow citizens. A national health care system that is ultimately a single payer system is just the medical version of Robin Hood, in my opinion. Very expensive to take care of everyone, so tax the wealthy, and give to the poor.

If national health comes to fruition, I wonder if many of those that will benefit are past the point of gratitude, since I suspect that many believe all are entitled to medical care as part of some God given right. I would hope there would be some that would have some gratitude to the country, since there are countries that have societies that are the back-drops to Slum Dog Millionaire movies.

I suspect that there could be an unsuspected consequence of national health. That might be that people's social identity is threatened, if they have to be in a medical waiting room with people that they previously have insulated themselves from. In other words, neighborhoods may become more class conscious, as opposed to today's urban environment where many classes live within the same radius of some HMO. Going to a private doctor, based on one's better paying private insurance was part of one's social strata. If that is threatened, I would think people will just try to cloister themselves away from those that may now be at the doctor's office that they used to feel privileged in having.

ya know, foofie, parts of your post really rub me the wrong way.

just saying...

Only parts, Rocky? You're far more tolerant than I am.

his first sentence was ok...

(and he uses the quote function nicely)

Which means what? You do not like my insight? It might be quite true for some people. True, I might rub many people the wrong way (for them), since I usually do not pander to people's sensitivities. I accept MY social pariah status in some circles. This has not had a negative effect on my self-esteem. I hope my insight has not really bothered you, since it was not directed at you at all. But, if you insist on taking my post personally, I guess that is your right.

i think it's a good thing you are a rich snob, because you would So not like it if we were neighbors...

have a nice life.

I have to admit that there are some conservative activitivist who seem to becoming unhinged since Obama has become president.

Local Fox Reporter Attends Town Hall And Finds ‘Some Attendees Admit They Don’t Live In The District’



YAF organizer kicks progressive intern out of right-wing conference: ‘Why don’t you move to Canada?’

Where did you get the idea I am rich? And, you are confusing snobbery for my willingness to not be alienated from the social strata in this society that might find me anathema. In other words, I have no desire to take over this society, and change it for my self-serving needs. I can accept the status quo better than most people, perhaps, since I have a thick skin.

I do not expect to have a nice life, since there are so many people of mediocre intellect where I live. That is the bane of educated secular Jews like myself that must live amongst the mediocre, since the truly elite find me and my ilk pariahs of sorts. Any pity you can spare will be appreciated.

the status quo is strangling rural America.

had an interesting thought...(hmmm...)

the house down the road from me is up for sale, can be purchased for less than a new Escalade (no clunker rebate available)

you would have to be a very quiet obnoxious secular jew if you was to live here long...

JSM wrote:



Me too, Thomas, me too!

Here we go... why not get political advantage from all this.

"i won't be quiet" - course not. yer being paid to go there and be a disruptive a-hole.

"i won't sit down!" - and yet, there he is; sitiing down while being a disruptive a-hole. do you think he shakes his head when he says "yes" ?

"and i won't let this happen on my watch!" - and who's timeclock are you taking that watch on, mr. professional disruptive a-hole? sure as hell ain't mine sonny boy.

"why are yooooo ignoring his birth certificate??" - because even Townhall.com acknowledges the validity of his birth certificate.


The real question is; "why did people like her ignore the incompetence of the bush administration?

That's not the differentiation. Gawande is a careful writer. I'm reluctant to summarize a fairly complex article.

You should make the offer to someone that is truly deserving. I am not.