This, from a gushing puff piece in The Advocate:
The man who took on Bush and 9/11 has set his sights on another tragedy-the American health care system. In his latest documentary, Sicko, Michael Moore reveals the dark side of health care in a capitalist system. But the question remains: will he ever make a movie about us?
Yes, if only instead of rancid capitalism with its evil pharma and health care firms, motivated by sordid profits to develop life-saving miracle drugs, we had a system like Cuba's! Of course, all HIV-positives have to live in state sanatoriums unless and until they can convince authorities otherwise. But mentioning that wouldn't make for effective propaganda, would it.
For another more critical take on Sicko, see here.
37 Comments for “Bad Medicine”
posted by Craig2 on
Sorry, while Moore may be correct in terms of public health care accessibility, Cuba has a poor track record on LGBT issues in general. This independent-minded gay leftie probably won’t go and see it once it arrives here for precisely that reason.
Craig2
Wellington, NZ
posted by Bobby on
Michael Moore is a fraud and a liar. God help us if he ever makes a movie about gays. As for the Cuban health care system, I’ve spoken to cubans who lived under Castro, it’s not that great.
posted by The Real James on
Conservatives support the military, which is run by the government. Conservatives support the police and fire department, which are also government-run. Conservatives support the education system, which–OK, maybe that’s going a little far. But the point is, it is possible to support things which are run by the government as a public service.
I think health care should be a government-run public service, like the military, police, public schools, etc. etc. If our best and brightest can sign up to be soldiers and teachers, not out of any profit motive, but out of a desire to serve the public, then they can sign up to be doctors and nurses. The military has the world’s greatest sources for research, so why couldn’t that be a model for medical research?
In the same way we get free military protection, police service, education, roads, food inspection, etc., we, as Americans, should get free health care.
This is not about Michael Moore.
posted by John on
Before the Bushies got ahold of it the Medicare system was the most efficiently run health care system in the nation – far more effective and with massively less administrative overhead than private companies. Universities, subsidized by the feds, come up with more life-saving drugs and medical techniques than Big Pharma (which has no profit motive for a cure – only maintainance drugs). I think the basics really should be dealt with by the government – military, education, energy, water, healthcare.
That doesn’t mean there can’t be private for-profit healthcare, just like there are private for profit schools, but the basics should be guaranteed.
Moore is a populist firebrand who uses humor, satire and exaggeration for effect. he didn’t make a documentary based on historical fact, but an inflammatory film meant to stimulate discussiona nd highlight the serious problems we do have in healthcare – which now is pretty much crap for a large chunk of the nation.
posted by Brian Miller on
I think health care should be a government-run public service, like the military, police, public schools
Yes!
Let’s have health care run like the DMV — nice long waiting lines and lots of forms and fees and surcharges.
We’ll give it the openness of the military, which declares that everything is secret and refuses to cooperate with citizens or the media who inquire looking for basic information. We can have costs kept under control by hiring the same military procurement people who buy $100 toilet seats and $95 screwdrivers.
We’ll give it the efficiency and quality of America’s public education system in the major cities, where in many districts, fewer than half of students make it to graduation — and many of those “graduates” are innumerate and illiterate.
We can polish it off with the officiousness of the New York City police, who respond to individuals who complain about their tactics and services with arrest and intimidation.
Ahhhh, what a glorious system.
Now, the other side: Michael Moore.
Michael Moore is indeed a big old liar (in ever sense of every adjective I’ve used).
But who are the bigger liars? Those who insist that medicine in this country is, in any way, “capitalist” or “free market.”
Medical insurance, the practice of medicine, the provisioning of drugs — every aspect of the “experience” — is regulated (and often priced) by the government. The reality of the situation is that we ALREADY have socialist medical care, which is why the quality’s been going down and costs have been going up for years. The only “missing ingredient” is federal control of the entire system and new taxes to replace insurance fees to pay for it.
The ultimate result will be that everything Americans hate about health care today will be worse, costs will be higher for routine operations, and “average costs” will go down (as in Canada and the UK) because people will die waiting in line for critical cancer and other operations. Not having to give chemo to the recently deceased cancer patient does indeed “drive down cost.”
posted by avee on
“Universities, subsidized by the feds, come up with more life-saving drugs and medical techniques than Big Pharma (which has no profit motive for a cure – only maintainance drugs).”
This is simply not true. If it were, universities would be floating in money because of the profits on their drug developments, and/or the feds would hold the patents. It’s true in one or two high-profile cases, but far, far from the norm by any stretch of the imagination.
As for the assetion that Medicare was “the most efficiently run” system before Bush’s allegedly screwed it up, that’s also challenged by the facts. Medicare fraud has been a huge problem for decades, and the system has succeeded in distorting pricing throughout the health care market long before the evil Bush arose to cause all of our problems.
posted by Randi Schimnosky on
I wouldn’t trade Canadian medical care for an american system. I get what I need when I need it and I don’t have to live in fear of not being able to afford it. I can’t imagine why americans want to life in terror over their health.
posted by Hershel on
In this country, we don’t pay taxes for health insurance. We pay them for the cops, firemen, and the military. Who do work for a profit incentive. Military people, which I greatly respect, get a lot of benefits like college tuition and great skills that lead to great jobs when they’re out of the service. And even before serving in the arm forces, some are lucky enough to enter West Point and get a free public college education).
If Americans want free health care, let them pay 50%+ of their income in taxes, and then let’s see how they like all the red tape. In England there’s evil people that want to deny smokers and fat people operations to save their lives. That’s what happens when you let the nazi big state run things.
America was founded on the principles of individualism and self-reliance. Socialized medicine is contrary to those principles. Down with big government!
posted by Craig2 on
Er, if the United States had had a proper public health care system, would there have been quite so many AIDS casualties in the eighties…?
Craig2
Wellington, NZ
posted by Bobby on
Craight, there were many AIDS casualties because at that time the gay community was very hedonistic, people went to bathhouse, had orgies, didn’t wear condoms, people didn’t even know how to prevent AIDS, it was a different time. And I’m pretty sure there’s plenty of AIDS cases in New Zealand as well.
posted by dalea on
AIDS is caused by a virus, not hedonism. Please, let’s stop moralizing.
During the epidemic, there were numerous empirical studies on various health care systems. Consistently, the state run systems in the first world out performed the US ‘free market’ one. PWA’s got better care, lived longer with fewer problems than in the US, and had better long term results. So I think that not only should universal health care be a gay issue, it is a settled one.
Brian, the idea of universal health care focuses in every case I am familiar with on government supplied insurance, not health care. Since insurance is a form of gambling, and health insurance a lottery where you hope not to win anything, there is no particular reason that the government can’t run it efficiently. This point is repeatedly made by the classical liberal journal ‘The Economist’.
posted by Jorge on
I can’t imagine why americans want to life in terror over their health.
I can’t understand it, either, but I’ve run into a couple of people who have chosen it.
After working for the government for about six months, I’m not a particularly big fan of it getting involved in things it doesn’t have to. Too much confusion, and not a little exploitation, too. And the bureaucracy is of course insane. The rules are hundreds of pages long that nobody knows completely, and communication is very fragmented. Only the most important things always get emphasized.
And then, every time a new change or reform occurs, it somehow creates yet another thousand pages of rules.
There are imminent and overwhelming dangers with privatizing the military, public safety, and the treasury, to the extent that our very functioning and survival could be threatened. The same is not true of health care. It’s certainly not true of services like education, sanitation, or mass transit, which all run a lot better when they’re privately run, though they may still be publicly funded.
The choice of whether to have health care publicly run or privately run is a toss-up at best, and hardly a zero-sum game. So let’s stop pretending there’s some kind of apocalyptic black-and-white crisis at stake. The only crisis comes from a lack of imagination and political will.
posted by Craig2 on
There were a fair amount of initial HIV/AIDS exposures in the early days of our epidemic. However, fortunately, we had a centre-left government in power in 1985, which adopted a private members bill to decriminalise male homosexuality, which succeeded (after a long battle with the local Christian Right, aided by California’s Traditional
Values Coalition, Paul Cameron and other US Christian Rightists). We adopted anti-
discrimination laws in 1993, and are actively establishing school safety programmes to encourage
adolescent LGBT educational retention, and moved quite fast when it became clear that crystal meth had a causal relation to the rise of new HIV/AIDS seropositivity.
Our Department of Public Health funds HIV/AIDS prevention programmes for gay men, and our
NZAF is subsidised to support
prevention programmes and research. This has been the case for over two decades.
Craig2
Wellington, NZ
posted by Bobby on
Craig, you can give gays condoms, you can legalize gay marriage, you can do everything you want, but that’s not gonna stop the orgies, the bathhouse romps, the tea rooms, people who do it bare on purpose, etc.
“I can’t imagine why americans want to life in terror over their health.”
—Who says we live in terror? I have nothing to worry about. If I get sick, I have health insurance. And frankly, I don’t live my life worrying about getting sick, neither do most Americans.
America needs health insurance as much as it needs higher taxes. Because that’s the freaking catch, people! You want government health insurance? Get ready to pay through the nose.
posted by ETJB on
I am not surprised that gay conservatives believe that we should simply dismiss the notion of a right to health care and let the magical free market solve all of life’s little problems.
I am certainly no fan of Castro and only like Mike Moore slightly. However, he was not making an endorsement of Cuba’s political system, which is largely responsible for its treatment of PWA/H or LGBT people.
posted by ETJB on
I just found this funny; “America was founded on the principles of individualism and self-reliance.”
No, not really no. Was this the self-reliance of white men letting the African slaves do most of the work? Or the Chinese?
posted by dalea on
You might want to look at some facts and figures before making your statement about the high cost of state run health care Bobby. Here is a link to WHO stats on the subject:
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
A discussion of this:
http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=283969
‘Facts and Figures
In 2002, the United States spent $5,267 per capita on health care?53 percent more than Switzerland, the next-highest-spending country, and 140 percent more than the median OECD country.
The number of hospital beds per capita in the U.S. was in the bottom quartile of OECD countries in 2002.
In 2001, the average malpractice payment in the U.S. was $265,103, which was higher than Australia, but 14 percent below Canada and 36 percent below the United Kingdom.’
This article charts outcomes with spending. The US spends the most but achieves low scores on most outcomes. This is in comparison to the staterun systems.
http://ucatlas.ucsc.edu/spend.php
‘The chart (right) also highlights the sharp contrast between the US and Cuba. With a life expectancy of 76.9 years, Cuba ranks 28th in the world, just behind the US. However, its spending per person on health care is one of the lowest in the world, at $186, or about 1/25 the spending of the United States. There are other cases where high life expectancies are achieved with low spending on health care. The scattergraph (below) shows the relation between per-capita health care expenditure and average life expectancy for 2000. Countries with higher spending generally have longer life expectancy rates, but there are also many countries that perform nearly as well with much lower spending.
One reason for the discrepancy between spending and longevity is that these numbers are average life expectancies and per-capita spending rates, which mask inequalities. For example, the US Health and Human Services department found that people with lower incomes and less education tended to die younger. Life expectancy also varied by ethnicity. In 1998 life expectancy among white Americans was 76.8 years, while African Americans lived an average of 70.2 years. (See Intracountry Inequality). Another reason some countries achieve high life expectancy with low health spending is that clean drinking water and preventive health care can be provided with little spending. If there is near universal clean water and preventive care, life expectancy rates can be high. In the US, however, nearly 40 million Americans lack basic health insurance, and are therefore less likely to receive preventive care. In contrast, Cuba has universal health care and one of the highest doctor-to-patient ratios in the world (See Physicians). Although Cuba has limited resources and many economic problems, it has made health care a priority. It is not alone. Sri Lanka, China and the Indian State of Kerala are considered “low-income, high well-being” countries, which have adopted policies that not only reduce inequality but also increase overall health and well-being. The results of these policy priorities are significant, and can be measured in survival indicators, such as average life expectancy.’
Here is a ranking of infant mortality rates by country. The US is number 37; Cubaa is 35 despite spending less than 1/10th the amount.
http://www.geographyiq.com/ranking/ranking_Infant_Mortality_Rate_aall.htm
posted by Brian Miller on
It’s not surprising that socialist organizations like the WHO would claim that “costs are lower in socialized medical systems.”
Of course costs are lower — because care is nowhere near as good, nor available.
The costs are reduced a number of ways.
First, socialized medical systems don’t invest in the latest technology. Many of the machines and drugs that Americans with insurance take for granted aren’t available at all in the UK or Canada’s socialized systems because they’re “too expensive.” As a result, costs are lower, but modern treatments either must be purchased out of pocket or worse, simply aren’t available at all.
In Canada, this is resulting in Canadians who stream across the border for MRI’s or modern cancer treatment. In the UK, it’s resulting in Britons paying for surgery in India rather than waiting years for the British system to get it to them. The British and Canadian press are filled with outraged editorials condemning increasing deaths and poor quality of life coming from the latest drugs not making government procurement lists, as well as people who die waiting for health care.
As for the comparisons between the US, China, Cuba, and Sweden (the three countries most bandied about in the debate), the WHO doesn’t point out “inconvenient truths.”
First, Cuba and China provide their government data for analysis. Both Cuba and China are notorious for fudging their numbers to make things look much better than they are — just like the Soviet Union’s centrally planned economy. The people who believe China and Cuba’s statistics on mortality and health spending are just like the people who believed fabricated eye-popping Soviet economic growth statistics in the 1980s (and believed in a “missile gap” with the Soviets in the 1960s).
This numbers game also continues in other statistics. One of the favorite statements of health care socialists is “the US has high infant mortality compared to Sweden, Denmark and even some Central American countries.” Sounds awful, right?
Except that the way the infant mortality statistics are calculated is different. In the USA, if the newborn infant dies within two weeks of the birth due to birthing complications, it’s considered birth-related mortality. Whereas in most of the other countries that “rank higher,” teh same child dying the same way wouldn’t be considered “birth mortality” because they didn’t die while their mothers were in labor.
I’ve lived under socialist medicine in both the UK and Canada, and get extremely bored of people who have never lived under those systems explaining to me how “superior” they are and what a great job they do “managing costs.” To get any sort of meaningful care in the UK’s NHS or Ontario’s OHIP program is a full-time job of filling out forms, fighting bureaucracy, etc. They “save money” by not providing timely care. Bringing that sort of system into the USA, and increasing the taxes of the average person and replacing effective private care to do so, is worse than nasty — it’s a crime against Americans who are responsible enough to be insured.
And that brings me to my final point — responsibility. How many people whining about not being able to afford doctors have $150 a month cell phone bills, $750 a month car payments, etc.? Quite a few, in my experience. They don’t want to pay Kaiser Permanente $1,400 a year for a basic health plan that would cover their needs (and reduce their health care costs massively). But they are perfectly happy to pay T-Mobile, Chrysler Financial and Comcast an order of magnitude more per year to text their friends, watch Pay per View movies, and drive around in a Chrysler 300C.
posted by Brian Miller on
Brian, the idea of universal health care focuses in every case I am familiar with on government supplied insurance, not health care.
You’re obviously not too familiar with how typical systems work, then.
“Universal” systems provided by government charge more in taxes and pay less for services than private systems (or individuals). As a result, most skilled physicians go private (as in the UK).
This was such a problem in Canada that Canada banned all private medicine and mandated that medicine must be provided only to government-paid patients. As a result, many Canadians stopped studying medicine, and many other practitioners moved out of the country, exacerbating that country’s medical crisis even further.
In the UK, so few doctors have been willing to provide NHS socialized insurance care, that the government has taken over the hospital system and most of the doctors are now paid by government-administered “NHS trusts.”
The same situation exists in continental Europe, and indeed in every country where socialist medicine was introduced with a “it’s just a government insurance program” line. Once government started distorting the market by offering below-market payments for services (and charging above-market rates for that insurance through taxation), they had to take over the market to force it to accept the government’s terms. It’s happened in literally every industrialized country where socialist medical insurance has been introduced.
posted by Brian Miller on
As a side note that I forgot to mention in my prior message, the UK is now paying its medical professionals so little money for their services that it’s not only losing medical professionals to the USA, but it’s also importing huge masses of lower-paid, less qualified nurses and doctors from Africa and south Asia.
A great deal of that country’s increased welfare spending comes from the dependents and family members who accompany those medical doctors — not to mention over 90% of the country’s Islamic terrorism/extremism.
The recently thwarted bombings in Glasgow and London were planned and executed by Pakistani and Indian doctors who were paid by the NHS, and one of the 7/7 tube bombers was also trained as a medical professional (and the son of a Pakistani doctor who migrated to the UK).
This is a consequence of British socialized medicine — income destruction and national security compromises — that is explosive to even talk about (pun fully intended).
Ironically, protectionists in this country tend to be socialists — either on the left or the right — but all a socialist approach to medicine in this country will do is deliver the same income destruction and invitation to extremists to enter the US that the European systems have introduced.
posted by ETJB on
‘Socialized’ health care leads to terrorism? All Muslims are evil because a handful are violent? Well, I could have seen that right-wing bumbper stick slogan a mile away…
Most of the Americans who cannot afford health care and not running around with lots of luxorious cars and cell phones (sounds like the welfare queen b.s.).
Maybe it is not a simple solution as ‘no government’ or ‘all government’.
Yet, lets not forget that for many Americans the reality is no health care or going bankrupt for paying medical bills.
Given the fact that we pump lots of public money into research and development for private drug companies, it would at least be nice if the meds that people needed were affordable in exchange for the welfare.
posted by dalea on
Thank you for the anecdotes about health care, Brian. Do you have confirming information that supports this. What are the numbers of physicians leaving Canada for careers in the US? This is surely knowable. And how many cancer patients are there who use facilities in the US? It would seem that boarder cities like Detroit and Seattle would be having a boom in oncology centers. Can this be documented? I will do some searching and see if this actually can be happening.
MedicineNet.com gives what is apparently the standard definition, used throughout the world as:
‘Mortality, infant: The death of an infant before his or her first birthday.
The infant mortality rate is, by definition, the number of children dying under a year of age divided by the number of live births that year. The infant mortality rate is also called the infant death rate.
The infant mortality rate is an important measure of the well-being of infants, children, and pregnant women because it is associated with a variety of factors, such as maternal health, quality and access to medical care, socioeconomic conditions, and public health practices.’
I don’t see anything about ‘birth mortality’. There is a concept called ‘maternal mortality’, but that applies to mothers. In reporting terms, there are only two possible outcomes for a term pregnancy: live birth or still birth. All live births are counted into the infant mortality rate. Your example of ‘birth mortality’ would under your statements mean that the US rate is understated. A discussion of the topic and the internal problems with the numbers is here: http://en.wikipedia.org/wiki/Infant_mortality
What evidence is there that WHO is a socialist organization? Other than wingnut propaganda.
The problem with Socialist, and Capitalist, numbers games, is something that does exist. But I doubt that this can be done for any length of time. The Soviets were always quickly uncovered. And the reason for that is simple: changing one number accomplishes nothing.
If you downplay the number of children who die in their first year, there is an immediate problem. This number then has to reset the number of pregnancies reported. Or increase the number of stillbirths. Which is also an alarming signal that will bring even more scrutiny.
Cooking the books brings even more problems down the road. At age 5 the number of children entering school must equal the number born 5 years earlier minus the infant mortality deaths and the later child mortality deaths. And the number of children should correlate to the fertility rate for a given population. All of which demographers can figure out.
Can you provide evidence that WHO has been letting socialist countries cook their health books for the last 3 generations? Or that this happens at all.
Do the posters who live in single payer health care have any thoughts on this topic. Please share.
posted by Brian Miller on
What evidence is there that WHO is a socialist organization?
WHO is a socialist organization, just like its sponsor organization, the United Nations. You do know that the UN Declaration on Human Rights declares that health care, housing, and employment are “human rights,” right? Doesn’t get much more socialist than that.
Do the posters who live in single payer health care have any thoughts on this topic.
I just moved back from four years in Great Britain, and lived for several years in Ontario and Quebec. In fact, over half of my adult life has been living under the socialist medicine you seem to be desperately hoping to implement in this country, and it’s total shit, as anyone of reasonable responsibility who has lived in both places will tell you.
Hate to burst your religious fervor for socialized medicine, but it doesn’t work, and all the WHO propaganda in the world isn’t going to change that.
posted by Brian Miller on
Incidentally, Paul Dvorak of Medical Design Magazine was scathing in his critique of the WHO’s report, and notes its socialist undertones as well.
posted by Last Of The Moderate Gays on
This discussion illustrates why the health care crisis will continue unabated. On one side, we have those who feel that the current system is perfectly fine, despite spiraling costs, declining care and increasing numbers of uninsured. On the other side, we have those who have romantic notions of government solving all of our problems. Until all sides are willing to “gut their own fatted calves a little,” things won’t change. We need new thinking and new ideas if we’re going to truly solve this crisis. For what it’s worth, here’s what I propose:
1) Make as much of the health care system nonprofit as possible. This would include insurers, hospitals, etc. The results would be a maintenance of the current private system while eradicating the profit motives that seem to be out of place in health care.
2) Reinstate the ban on marketing by providers and suppliers. As a marketing communications professional, I realize this would be “gutting my own fatted calf a little,” but we don’t need Lilly & Sanofi Aventis spending countless millions on convincing us to run to our physicians to get the latest “miracle pill.”
3) Place a cap on all punitive damages in malpractice cases. I find it interesting that Moore, a delusional leftie, did not showcase any of the plethora of greedy trial lawyers (like John Edwards) who have amassed fortunes by raping the health care system and creating “CYA medicine,” which has also driven up health care costs. Pay for damages, yes, but stop making the courts a de facto jackpot for those looking for someone to soak.
I’m not offering these as a panacea; I simply hope that it will get people thinking in another dimension, instead of the current two dimensions we now have. OK, now those on both sides can rip away, and try to convince all of us why one of the “two failed choices” is the answer to all of our problems . . .
posted by Bobby on
“we don’t need Lilly & Sanofi Aventis spending countless millions on convincing us to run to our physicians to get the latest “miracle pill.”
—Why not? If you’re an advertising professional, then you know that things don’t just sell itself. If I’m a drugmaker and I make a great drug, doctors aren’t going to find out about it unless I advertise in the magazines they read. And if they ignore those magazines, I have to go on TV to get their patients to ask questions. And then the doctor would tell those patients if that drug is right for them.
And frankly, why shouldn’t Prozac advertise when there’s all kinds of crap without FDA approval advertizing?
The beauty of America is that people have power, not just their doctors. And I see nothing wrong with people who need to lose weight, quit smoking, go to sleep or whatever get the pills they need.
The profit motive is always the best motive, it’s what created the gold rush that populated the west, it’s the reason why we have so many cars to choose from instead of just a Lada like in the old USSR.
There’s nothing wrong with that. What we need is less regulation. In fact, I think pharmacies should hire doctors. Not everyone has time to go to a regular doctor. There’s certainly improvements that can be made, but there’s no need to take profit out of the picture.
posted by John on
The last time I was at the DMV it took all of five minutes to complete my needs, and cost me less than $15. But that was yearas ago. All I’ve nneded since was address updates which were happily taken over the phone in a professional and timely manner. Perhaps your government sucks, but mine gets things done.
posted by Brian Miller on
All I’ve nneded since was address updates which were happily taken over the phone in a professional and timely manner. Perhaps your government sucks, but mine gets things done.
Those who insist that life is impossible without socialist medicine can take heart — both Canada and the UK are starving for immigration.
The UK’s “highly skilled migrant program” can make you a permanent British resident, replete with wonderful NHS health care, in less than three months.
Canada’s immigration program has been missing its targets for years and takes only about 6 to 8 months from start to finish.
Most Americans with college degrees who are under 50 can qualify. If you have savings and/or a spouse/partner, you’re in like sin unless you have a chronic condition of astronomical implications (i.e. cancer, HIV).
One wonders why Canada and the UK haven’t exactly been filling up with people who are seeking out a socialist health care utopia. Hmmm.
posted by Brian Miller on
On one side, we have those who feel that the current system is perfectly fine, despite spiraling costs
Au contraire, you’re trying to make a binary dichotomy that doesn’t exist.
I don’t believe the US system is fine at all. I just believe it to be less bad than the fully socialized systems in the UK or Canada.
The reform that the US system needs is less government, fewer regulations of the type that established the HMO system that’s causing most of the problems, and a more liberal practitioner environment.
Instead, the “dichotomy” being presented is the present big government system versus a future even bigger government system. The virtues of less government aren’t even considered by those complaining about the “lack of nuance in the debate.”
posted by Craig2 on
In reply to Bobby’s point about HIV/AIDS above, we still have gay bath houses (or saunas) in this part of the world. They all provide free condoms to patrons, they host free medical checks for HIV and STIs, and safe sex information brochures are easily visible, as are wall posters.
Safe ‘promiscuity’ is better than negotiated unsafety, which is being preached amongst some gay community analysts of bare-backing. Always use a condom.
Craig2
Wellington, NZ
posted by Brian Miller on
Safe ‘promiscuity’ is better than negotiated unsafety
That’s not also necessarily true.
Promiscuity increases one’s risk of all sorts of STDs, including herpes, gonhorrea, syphilis, chlamydia, etc. Having those STDs increase the risk of seroconversion during intercourse — safe or otherwise — with another person.
Negotiated safety with a seronegative monogamous partner is *always* safer than promiscuous intercourse with strangers — “protected” or otherwise — since the sexual networks (and disease vectors) found in promiscuous circles are considerably more complex (and offer far more opportunities for transmission and infection).
The level of HIV infection found in sex clubs is rather higher than that found in the general queer population, and no matter what people say, protected sex with an HIV+ person is always higher risk than unprotected sex with a monogamous HIV- partner.
posted by Bobby on
Craig, all the education in the world doesn’t stop people who want to have sex without condoms, people who get high on drugs and have unsafe sex, people who think it’s a badge of honor to have HIV/AIDS, people who think AIDS is no big deal since you get all those cocktails.
In Luxembourg they put condom dispensors in the park. That’s great, not only are they rewarding criminal behavior that they should be prosecuting, but the likelyhood of that sort of person wearing a condom in the park is minimal.
The only thing I disagree with is what Brian said about immigration to Canada and the UK. The UK is flooded with eastern europeans that are willing to work for next to nothing, making it very hard for people to find good paying jobs.
Canada gets a lot of arab immigration.
America on the other hand, rewards illegal aliens by not protecting the borders while punishing legal aliens with lots of red tape.
posted by North Dallas Thirty on
Reinstate the ban on marketing by providers and suppliers. As a marketing communications professional, I realize this would be “gutting my own fatted calf a little,” but we don’t need Lilly & Sanofi Aventis spending countless millions on convincing us to run to our physicians to get the latest “miracle pill.”
This is a bit like the gay left’s filing of lawsuits against Pfizer based on the claim that Viagra advertising causes gay men to have unsafe sex; it ignores the fundamental underlying problems.
The problem is that insurance companies are caught in a catch-22; if they reimburse for a patient who demands the latest, greatest, and most expensive drug or a doctor who prescribes it unnecessarily, they lose their shirt, but if they don’t, the patient whines and cries to the obese leftists like Michael Moore that they’re being “denied care”.
What drives this is the simple fact of patenting. Competition is what drives down the cost of drugs, i.e. aspirin versus Cialis, but our current system ensures that the newest and best drugs will always be shielded from competition — and thus be the most expensive. At the same time, though, companies do deserve what a patent offers — which is a reward for innovation.
In my opinion, there are two logical ways around that. One would be to exchange drug patents for copyrights; other companies could produce the drug, but they would have to pay licensing fees and royalties to the original company. The other option would be to eliminate patents for drugs altogether, but provide drug companies a tax rebate equal to the development and testing costs for new drugs.
Place a cap on all punitive damages in malpractice cases.
I am not as supportive of a cap on damages as I am in a complete ban on and enforcement of laws against champerty.
Bluntly put, the United States is one of the only, if not THE only, country in the world that allows the practice of champerty — that is, providing help to a lawsuit in which you are not a party in exchange for a share of the proceeds. This is the so-called “contingency fee”, in which Johnnie Edwards and other ambulance-chasers file lawsuits on behalf of plaintiffs who have made a deal with them; if you lose, it costs you nothing in legal fees, and if you win, you give us 40 – 50% of the judgment.
The way to deal with that is simple; pass a law making champertous contracts unenforceable and publicize the fact. Johnnie Edwards may still manage to find a few stupid clients who don’t realize they don’t HAVE to pay him, but most people will recognize right off the bat that any binding contract requiring them to give any specific portion of a judgment to another person or individual can be ignored.
Then add to that an automatic requirement that not only forces the loser to pay court costs and legal fees for both parties, but that extends that to plaintiffs who file lawsuits that are dismissed and/or do not make it to trial.
What this does is to put in place a strong disincentive to file a frivolous lawsuit; the lawyer cannot play jackpot, since s/he has no claim to the award, and if you lose or have your lawsuit dismissed, you are responsible for the bills of the party you frivolously sued, plus what you owe your own lawyer.
Finally, for those of you who are worried about people who can’t afford a lawyer, the answer is simple; the lawyer either works pro bono, or you set up foundations/organizations/whatnot that are willing to give people money to file lawsuits.
posted by Craig2 on
I’m sorry, but negotiated unsafety sends mixed messages about condom utility, and dilutes the message of protection and responsibility for consequences of one’s actions.
In terms of sex club vectors of HIV exposure, I’d have to say that’s only part of the story. Is it neccessarily higher than online hookups, or non-sex club
venues where crystal meth is
available? Some more recent HIV social research indicates that is becoming a major problem.
Is it neccessarily higher than sex in parks or public toilets?
Gay men have highly variable levels of sexual partner frequency, and relationship skills to cultivate monogamous relationships. Such is life.
Craig2
Wellington, NZ
posted by dalea on
Checking around, there is quite a bit of information on Canadian doctors leaving. Here are a few links to peer reviewed academic studies of the issue.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=493284
http://pcerii.metropolis.net/Virtual%20Library/ProgressReports/1999/hgrant99.pdf
http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20070502canadiandocs.html
http://www.cmaj.ca/cgi/content/abstract/154/2/171
http://www.cmaj.ca/cgi/content/full/176/8/1083
http://www.cmaj.ca/cgi/content/full/176/8/1083
http://www.chsrf.ca/mythbusters/pdf/myth19_e.pdf
http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20070502canadiandocs.printerview.html
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=9538850
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1229095&blobtype=pdf
http://www.medecine.uottawa.ca/tfg/pdf/A/CanadasphysicianworkforceChan%20(1).pdf
Interestingly, none of them find a clear link to socialized medicine as a major cause. Difficulty in dealing with government regulations is mentioned as one part, but there are others. Dark cold winters seems to be a leading reason. Lack of openings for specialists is another one. As is better research opportunities in the US. Then is the phenomena of doctors approaching retirement age going off to Florida to establish practices they can persue part time when retired. Additionally, the CMA had a hand in this 25 years ago. The organization predicted declining demand and forced medical schools to sharply reduce enrolment. This was recognized for the disaster it caused about 12 years ago. Now the push is one to expand medical school enrollment. In 2004, the most recent year we have data from, the tide turned: more doctors returned to Canada than left.
If socialized medicine were driving doctors out of Canada, one would expect this to show all across the board. It does not. Most who leave are anglophones; francophones generally stay in Canada. The outflow comes heavily from three rural provinces: Labrador, Newfoundland and Saskatchewan. Quebec, Ontario and British Columbia mainly see underemployed subspecialists leave. Rural areas are hit much more severely than urban.
QED. Socialized medicine is not the primary cause of doctors leaving Canada. It may be a minor reason, but there are other considerations.
posted by dalea on
Brian, where did I ever say I wanted to herd people into state run systems against their wills?
My own preference is to make Medicare available to anyone who wants to buy its services. A government run program, which has an overhead burden of 1%, would compete against privately insurors with overheads of 24 to 30%. This seems to be a widespread program pushed by most socialized health proponents.
OK, how do you respond to the experience of gay people with the private health system? Less than 25 years ago many of us began to loose insurance we had carried for years. It was not available at any price. One common practice was to cancel policies for unmarried men by zip code. The other was to declare HIV a pre-existing condition and refuse to pay for any treatments. Or to classify any treatment as ‘experimental’ and refuse to pay. More than one libertarian gay man gave up on the free market in medicine during this period. I am one of them. Watching friends with insurance suffer without medical care, and die agonizing deaths has an effect on some people. The only thing that saved gay lives was the public health sector, the public hospitals and Medicaid/Medicare. The private system was quite content to see us die in the streets. What ‘socialized medicine’ was available was all we had. How do you respond to these experiences? Or do you just ignore them and recite right wing libertarian mantras?
Also, as we age our health insurance premiums go up. The idea seems to be to toss us out of the insured population. One friend of mine found at 52 her monthly payment tripled. At 55 it quadrupled, to a point where it would take 80% of her income. She had to drop it. So when diagnosed with cancer she paid out of pocket. Eventually she pledged her house to get care. During her last month, while she was under home hospice care her house was taken from her. She ended up on the front yard in a hospital bed while the foreclosure continued. There are lots of stories like this out there. They drive the push for socialized medicine. How would you respond?
posted by North Dallas Thirty on
A government run program, which has an overhead burden of 1%, would compete against privately insurors with overheads of 24 to 30%.
That is beyond amusing.
I would have no problem with Medicare competing with privately-held insurors — provided that the 2.9% tax assessed on each individual’s income for Medicare Part A (self-employed pays the full amount, employers and employees split it at 1.45% each) is repealed AND that the program be required to fund itself through premiums like private insurors, rather than its current state in which premiums only cover 25% of its cost and the government makes up the remaining 75%.
But something tells me that, without the subsidy, Medicare wouldn’t stand a snowball’s chance in hell against private insurance on either a cost or a services basis.
How do you respond to these experiences?
About the same way I do to smokers or extreme-sports participants who complain about having to pay higher premiums.
There are lots of stories like this out there. They drive the push for socialized medicine. How would you respond?
First, I would point out that the numbers are interesting.
The average cost of health insurance in this country for an individual as of last year was $4,242 a year. Assuming that your friend was assessed a premium far larger, i.e. $8,000 per annum, for that to have been “80% of her income”, she would have had to have been making $10,000 per annum; at that level of income, she would have qualified for Medicaid in most states (definitely in California), and especially if she had breast cancer.
Since the Medicaid and Medicare systems, both of which you cite as models of socialized medicine, are supposed to catch people like your friend, why are you pushing for their expansion?