patrick.net

Patrick says

But then again, Japan can do a lot of things that we cannot, because Japan does not have excessive diversity weakening their national identity like we do. The Japanese probably actually give a shit about each other because of their shared history and culture, and so are willing to cooperate on big issues like healthcare for everyone.

Japanese are also not morbidly obese and act with some degree of rationality.
Diversity as such is neither good or bad, in my opinion. Compare Singapore which is pretty diverse but acts rationally (e.i. everyone has to abide by rules and there is no allowance for PC bullshit, and you will not get preferential treatment because your ancestor 1000 years ago was oppressed) with US/Western Europe which act completely irrationally with illegal immigration, special treatment for everyone who is not productive etc.

The levels of obesity in America are pretty interesting though. Why?

It may not be entirely eating too much, but partly the contamination of our foods with livestock antibiotics, livestock fatteners, and pesticides:

https://www.salon.com/2014/03/13/5_shocking_reasons_why_americans_are_getting_fatter_partner/

I had bad acne in high school, but it went away entirely during the summer I spent in Germany on an exchange program. Conversely, the German kids who came to our high school arrived unblemished, but left looking like a pizza. I'm pretty sure it was something in the food. I've read that dioxins in the milk supply may be responsible.

Patrick says

meritocracy and good governance

This is the key, I think.

I have looked at these diversity studies, and they seem convincing. On the other hand, if we do not go by today's BS diversity definition, then US was pretty diverse in late 1800's - German immigrants were quite different culturally from English, both were different from French or Irish, and somehow they managed to build a prosperous country together.

Patrick says

The levels of obesity in America are pretty interesting though.

We have a huge amount of 1st, 2nd, and 3rd generation Asian Americans here. First generation is never fat, even after living in US for 20 yrs, second is usually not fat, 3rd can be quite fat. Perhaps what/how they eat is the key - 1st and even 2nd generation still live on food they ate in home countries.

drB6 says

Diversity as such is neither good or bad, in my opinion. Compare Singapore which is pretty diverse but acts rationally (e.i. everyone has to abide by rules and there is no allowance for PC bullshit, and you will not get preferential treatment because your ancestor 1000 years ago was oppressed) with US/Western Europe which act completely irrationally with illegal immigration, special treatment for everyone who is not productive etc.

What the hell does all that mean?

You are aware that pretty much everyone in singapore lives in public housing with state mandated ethnic quotas for each neighborhood aren't you? That should work well in the US.

drB6 says

I have looked at these diversity studies, and they seem convincing. On the other hand, if we do not go by today's BS diversity definition, then US was pretty diverse in late 1800's - German immigrants were quite different culturally from English, both were different from French or Irish, and somehow they managed to build a prosperous country together.

You have your history mixed up. German/Irish migration was mostly mid to late 1800's. The first wave wasn't even German since Germany didn't exist until 1871. There was serious prejudice and anti immigration backlash. The American Party (also called the Know Nothing Party) was formed to promote anti immigrant anti catholic agenda. They did quite well and worked to get anti immigrant/german laws passed. There was a considerable amount of violence including "bloody monday" in Louisville KY . Irish need not apply was common. It wasn't until the turn of the century both groups worked up out of the lowest rungs of society and started gaining social respect and political power. At which point they started persecuting the Chinese. Workingmen’s Party leader Denis Kearney, for example, closed his speeches to American laborers with “Whatever happens, the Chinese must go.”

The Italian migration was from the turn of the century until the 1920's. Same anti immigrant anti catholic backlash. Most people don't know the KKK was pretty much non existent by 1915. Membership went from almost nothing to over 4 million between 1915 and 1920 as an anti Catholic organization.

It was far from groups living nicely together and building a prosperous nation.

Patrick says

I do think we fail to have a true market for health care because prices are well hidden from the public, and variable depending on who you are. To have a real market to drive down prices, we need all providers to publish their prices, to present non-emergency bills in advance of treatment, and to charge the same prices no matter who you are or what insurance you may or may not have. Not sure how Kaiser would fit into that plan though.

You keep chanting this time and time again like it came down from the mount as the 11th commandment. . My question still stands with you dodging it time after time. How on a nuts and bolts level is posting prices going to make anything more than a token impact on the system as it exists now?

Curiosity totally overwhelms me as to how someone can present a bill until you determine what is wrong and what needs to be done to fix it. Do you go to a garage and say present me with a bill then check what's wrong with my brakes?

Patrick says

America's health extortion racket is not extending our lives at all

How can it? We go through life saving medical procedures, and when the bill comes, we die of a heart attack.

Patrick says

The levels of obesity in America are pretty interesting though. Why?

It may not be entirely eating too much, but partly the contamination of our foods with livestock antibiotics, livestock fatteners, and pesticides:

https://www.salon.com/2014/03/13/5_shocking_reasons_why_americans_are_getting_fatter_partner/

I had bad acne in high school, but it went away entirely during the summer I spent in Germany on an exchange program. Conversely, the German kids who came to our high school arrived unblemished, but left looking like a pizza. I'm pretty sure it was something in the food. I've read that dioxins in the milk supply may be responsible.

We don't eat natural foods our bodies were designed for anymore. The problems we face today, which were not a problem for our ancestors, is due to man made additives, preservatives, and excessive use of sugar and fat.
I remember reading an article many years ago about the high levels of obesity and diabetes among Native Americans in the reservations. Their ancestors ate what they could grow and hunt like corn. Today, they eat burgers, fries, and sodas. The side effect of this man made junk can never be good.

anon_e144f says

What the hell does all that mean?

You are aware that pretty much everyone in singapore lives in public housing with state mandated ethnic quotas for each neighborhood aren't you? That should work well in the US.

First, I am not aware that everyone in Singapore lives in public housing. Most (about 3/4) do. Second, my point is that Singapore has rational policies, is diveres, and diversity does not handicap them. US is not rational and hence diversity here comes off negative. Singapore has specific rules for hiring which say that "Employers are advised to follow a system of meritocracy while selecting and recruiting candidates for employment. Skills, experience and ability to perform the job should take precedence over age, race, gender, religion, family status or disability". How does it compare with the situation in US? Which country is more rational? Third, I am not suggesting quotas for housing in US which you imply. I am suggesting, however, that rational attitude prevail.

Hope that next time you can comprehend a little better.

drB6

bob2356 says

You have your history mixed up. German/Irish migration was mostly mid to late 1800's. The first wave wasn't even German since Germany didn't exist until 1871.

I am aware of all of that, and I am not sure where you get that I am mixed up. At the end of 19th century, which is what I am talking about, all groups that I mentioned were in US in reasonably large amounts. Even if they did not get along very well initially (beer riots in Milwaukee, for example), the result of their immigration was probably overall positive. And what is the point of the well-known fact that Germany did not exist until 1871? It was called German confederation or something like that since early 19th century, which is irrelevant to discussion here. There are some ethnic groups which can not learn English for three generations, do not integrate, and demand special treatment nowadays.

drB6

Singapore has problems with the Malays. In fact, the reason Chinese-majority Singapore left Malaysia and became an independent city state is anti-Kuffar sentiment and racism from the Malays.

I have to speak candidly to be of value, but I do not want to offend the Muslim community... I think we were progressing very nicely until the surge of Islam came, and if you asked me for my observations, the other communities have easier integration – friends, inter-marriages and so on – than Muslims... I would say, today, we can integrate all religions and races, except Islam.
from his book 'Lee Kuan Yew: Hard Truths to Keep Singapore Going' (Asia One, March 08 2011 [28])

Patrick says

yet have worse outcomes

Try being a doctor, and extend a 250 lb ghetto queen' s life as she eats her Cheetos and little Debbie donuts. Life expectancy is far more about life choices than health coverage.

Obama care was a huge step backwards, but we do still have the best doctors and most accessible healthcare in the world.

bob2356 says

How on a nuts and bolts level is posting prices going to make anything more than a token impact on the system as it exists now?

I sell medical/life/supplemental insurance. People ask about prices ALL THE TIME. It would help A TON to know how much a doctor would charge for a procedure. Most clients w preexisting conditions know exactly what they need done. A large portion even know the medical code for the procedure they need.

TwoScoopsPlissken says

Singapore has problems with the Malays. In fact, the reason Chinese-majority Singapore left Malaysia and became an independent city state is anti-Kuffar sentiment and racism from the Malays.

Best thing that ever happened to them.

HEYYOU says

Cash or DIE!
No free market entity should have to deal with the added cost of your insurance paperwork because you are a failure.
If one wants to use insurance,the price should immediately increase 10 fold.

Almost all doctors do this. Most Hospitals do as well.

They will both pick and choose which type of insurance they accept based largely on how difficult it is to get paid from that insurance. It's one of the reasons why they hate Obama care.

Also try this next time you are at a doctors office... tell them you have insurance but would like to instead pay in cash, then ask them how much they could discount the bill. Watch as 40% of the bill evaporates before your eyes. This also works with dentists.

Patrick says

The levels of obesity in America are pretty interesting though. Why?

The sad reality is, obesity and diet is a cultural issue. We are fatter than Europe mostly because we have more blacks. Same answer for lower life expectancy, gun violence, etc.... our black communities arent doing so hot. Unfortunately us racist crackers aren't allowed to point out statistics.

Do you remember freakonomics wherein that black economist named PC culture in universities as the single biggest impediment to studying and helping black communities?

Malcolm says

Patrick says

But then again, Japan can do a lot of things that we cannot, because Japan does not have excessive diversity weakening their national identity like we do. The Japanese probably actually give a shit about each other because of their shared history and culture. Diversity is our weakness, and we should be honest about that. We need to get our culture back into melting-pot mode. E pluribus unum!

OK, whoever hijacked Patrick's account better stop it!!!!!!!!!!!!! LOL

Our host has changed a lot in the years since you were last active. It's been a fascinating metamorphosis to observe...

CBOEtrader says

HEYYOU says

Cash or DIE!
No free market entity should have to deal with the added cost of your insurance paperwork because you are a failure.
If one wants to use insurance,the price should immediately increase 10 fold.

Almost all doctors do this. Most Hospitals do as well.

They will both pick and choose which type of insurance they accept based largely on how difficult it is to get paid from that insurance. It's one of the reasons why they hate Obama care.

Also try this next time you are at a doctors office... tell them you have insurance but would like to instead pay in cash, then ask them how much they could discount the bill. Watch as 40% of the bill evaporates before your eyes. This also works with dentists.

So pay cash, get a 40% discount, and then make a claim with the insurance, eliminating copays and deductibles? Please advise.

bob2356 says

Do you go to a garage and say present me with a bill then check what's wrong with my brakes?

Do you go to a garage and say "Charge me whatever you want" or do you get an estimate after the initial diagnosis?

bob2356 says

The Italian migration was from the turn of the century until the 1920's. Same anti immigrant anti catholic backlash. Most people don't know the KKK was pretty much non existent by 1915. Membership went from almost nothing to over 4 million between 1915 and 1920 as an anti Catholic organization.

It was far from groups living nicely together and building a prosperous nation.

And yet, the dominant ethos was that we should all assimilate into a common culture - the melting pot. And it worked damn well. Immigrants tried hard to be "American" and that meant learning English, playing baseball, eating American food (at least in public). They were rewarded with acceptance and we all benefitted from the feeling of unity as Americans.

Now we have divisiveness driven by "diversity". I suspect that the near-religious worship of diversity is a deliberate strategy by the billionaire elite to weaken national unity and thus make it easier to outsource jobs and insource illegal aliens, because this creates power and profit for themselves.

Patrick says

Now we have divisiveness driven by "diversity". I suspect that the near-religious worship of diversity is a deliberate strategy by the billionaire elite to weaken national unity and thus make it easier to outsource jobs and insource illegal aliens, because this creates power and profit for themselves.

Ofc it is.

Globalisation solidifies power into the hands of whoever is currently winning the power game. When people no longer have localized autonomy, but rather defer to a centralized power. Become that centralized power and you control the world while pulling up the rope ladder of competition.

Bim. Bam. Boom. GS, KSA, and Amazon.com run the world. End of story.

#maga is about the individual over the collective. Localized power over centralized power. This is why the #fakenews controlled by billionaire wanna-be tyrants hate Trump so much.

anon_e401a says

Skills, experience and ability to perform the job should take precedence over age, race, gender, religion, family status or disability". How does it compare with the situation in US? Which country is more rational? Third, I am not suggesting quotas for housing in US which you imply. I am suggesting, however, that rational attitude prevail.

Hope that next time you can comprehend a little better.

I comprehend just fine. Singapore's rationalism is the result of an all pervasive nanny state government. Housing quotas are just one part. It works but there is a heavy cost of living under one of the more authoritarian governments. Which at the moment is relatively benevolent, but could radically change very quickly. Let the economy really tank in Singapore and race based conflicts will explode no matter what the government says or does.

Comparing a small island of 5 million people to a vast country of 330 million people isn't very realistic. A country that is 60 years old filled with people who were already living side by side more or less socially equal isn't a a very valid comparison with a country of ongoing waves of immigrants that had 100 years of slavery followed by 100 years of legal state sponsored racism and then another 50 years of not at all subtle racism that wasn't state sponsored that is still going on.

Affirmative action is to level the playing field to provide equal opportunity to pursue positions, not to provide preferences. The laws are specific about that. Under Title VII of the Civil Rights Act, you cannot base a hiring decision, in whole or in part, on a person's race or gender. It is illegal and can be prosecuted if someone feels they are more qualified but passed over for race reasons. There is nothing irrational about that.

Does it all work perfectly, of course not. Does Singapore work perfectly, of course not.

anon_e401a says

There are some ethnic groups which can not learn English for three generations, do not integrate, and demand special treatment nowadays.

What groups are those? I lived in the RIo Grande Valley for years. The parents speak Spanish and the kids answer back in English. I know a bunch of third generation that don't speak Spanish at all. The whole not learn English for 3 generations is pure race baiting bullshit.

CBOEtrader says

I sell medical/life/supplemental insurance. People ask about prices ALL THE TIME. It would help A TON to know how much a doctor would charge for a procedure. Most clients w preexisting conditions know exactly what they need done. A large portion even know the medical code for the procedure they need.

CBOEtrader says

Also try this next time you are at a doctors office... tell them you have insurance but would like to instead pay in cash, then ask them how much they could discount the bill. Watch as 40% of the bill evaporates before your eyes. This also works with dentists.

You can't have it both ways. Either doctors offices can tell you how much or they can't. Of course they can tell you how much. So why would I put my cash out of pocket, do all the work of submitting a superbill to the insurance company and then struggle to get paid for it when I can just let the doctor bill the insurance company? How much becomes the insurance companies problem not mine. Does it affect my deductible, not at all. Will it be less than my copay. No way. So why do it? That's the whole problem.

You guys keep saying post prices, post prices. But why is anyone going to ;bother to look at them if the insurance company pays anyway? Crickets chirping every time I ask that.

Patrick says

Do you go to a garage and say "Charge me whatever you want" or do you get an estimate after the initial diagnosis?

See above. If an insurance company was paying for it no way I would ask anything. I'd just say do it. Ever wreck a car? You go to a body shop your friends recommend and let the shop haggle it out with insurance, you don't shop around for the best deal for the insurance company. That's the whole problem with this idea that posting prices will matter. You keep saying it will. How? Crickets chirping.

Patrick says

bob2356 says

The Italian migration was from the turn of the century until the 1920's. Same anti immigrant anti catholic backlash. Most people don't know the KKK was pretty much non existent by 1915. Membership went from almost nothing to over 4 million between 1915 and 1920 as an anti Catholic organization.

It was far from groups living nicely together and building a prosperous nation.

And yet, the dominant ethos was that we should all assimilate into a common culture - the melting pot. And it worked damn well. Immigrants tried hard to be "American" and that meant learning English, playing baseball, eating American food (at least in public). They were rewarded with acceptance and we all benefitted from the feeling of unity as Americans.

That is not what happened in real life. Germans, Irish, Italians all took 50-70 years to really assimilate even though they were white christians. I notice they still didn't become Protestants yet like real Americans. Looking at some NJ and NY area's I've spent time in I'm not sure the Italians have assimilated to this day.

bob2356 says

Affirmative action is to level the playing field to provide equal opportunity to pursue positions, not to provide preferences. The laws are specific about that. Under Title VII of the Civil Rights Act, you cannot base a hiring decision, in whole or in part, on a person's race or gender. It is illegal and can be prosecuted if someone feels they are more qualified but passed over for race reasons.

That is not how it works. We got strict oral orders to hire a woman/minority in our last search. One of my colleagues at a different school spoke against this type of hiring, and was never on any hiring committees from that time. With respect to tenure decisions, I know of 5-6 cases where minority person got tenure with 1-2 publications, while a white or Asian male would need 8-10. Logically you can not have two equally important factors that decide hiring - race/gender or qualification. It has to be one or another, and nowadays in US qualification is less important.

My sad conclusion is that people on left live in a bubble/alternative reality with respect to affirmative action, just like people on right live in bubble with respect to US Debt.

bob2356 says

What groups are those? I lived in the RIo Grande Valley for years. The parents speak Spanish and the kids answer back in English. I know a bunch of third generation that don't speak Spanish at all. The whole not learn English for 3 generations is pure race baiting bullshit.

I did not mention race anywhere, so this can not be race-baiting in any way, shape, or form. And yes, it is Spanish-speaking people which sometimes do not learn English and form enclaves with interesting traditions.

Patrick says

That's the whole problem with this idea that posting prices will matter. You keep saying it will. How?

A lot of consumers either don't use insurance, or are within their deductible and therefore they WANT to shop around for a better price. Posting prices would help a lot.

bob2356 says

You can't have it both ways. Either doctors offices can tell you how much or they can't. Of course they can tell you how much. So why would I put my cash out of pocket, do all the work of submitting a superbill to the insurance company and then struggle to get paid for it when I can just let the doctor bill the insurance company? How much becomes the insurance companies problem not mine. Does it affect my deductible, not at all. Will it be less than my copay. No way. So why do it? That's the whole problem.

This is an interesting problem. There is legit extra expenses and risk of charging a bill to an insurance provider, which is why they are willing to cut your price if you pay in cash. Would it be legal to post 2 prices per procedure? If it was pure tit for tat, could healthcare providers post different prices for different insurance providers? I am imagining MRI's: "Obamacare policy, $1200, United Healthcare policy $900, cash $700"

Long story short, our govt interference in healthcare has destroyed its efficiency.

CBOEtrader says

Try being a doctor, and extend a 250 lb ghetto queen' s life as she eats her Cheetos and little Debbie donuts. Life expectancy is far more about life choices than health coverage.

Obama care was a huge step backwards, but we do still have the best doctors and most accessible healthcare in the world.

Exactly.

Now socialize the cost of keeping that fat ghetto welfare queen latifa alive for the next 30 years.

anon_4480e says

Patrick says

That's the whole problem with this idea that posting prices will matter. You keep saying it will. How?

A lot of consumers either don't use insurance, or are within their deductible and therefore they WANT to shop around for a better price. Posting prices would help a lot.

Feel free to quantify "a lot". What percentage of people don't use insurance and strictly pay cash for medical care? That aren't getting their care in the ER that is.

Deductibles rarely apply to routine visits, prescription drugs, or preventative treatment. How does the accounting work that being within the deductible makes it desirable to pay cash? If you pay cash then it doesn't go against the deductible. You would not only have to go shopping for prices but calculate if your total cash payments will exceed your deductible or not. Probably over multiple years. Which means you need to know exactly the course and length of your treatment would be, something that frequently only god knows Pretty complex stuff. How many people do you suppose will be doing this while being sick enough to go outside of routine visits? If they are that sophisticated then they are sophisticated enough to call doctors right now and ask prices.

I keep asking for nuts and bolts details of how this will save money. How many people, who they are, how the accounting would work, how much savings would actually be involved, etc., etc., etc... All I get is either platitudes or crickets chirping. But guaranteed that the next discussion of health care it will be posted again like some moony mantra chanted endlessly.

Posting prices will make the right wing the free market will fix everything think tanks happy, but it won't save any substantial money in the real world.

drB6 says

I did not mention race anywhere, so this can not be race-baiting in any way, shape, or form. And yes, it is Spanish-speaking people which sometimes do not learn English and form enclaves with interesting traditions.

Feel free to present examples of third generation Hispanics that don't speak English. I'll be waiting. and waiting, and waiting.

Try reading The Integration of Immigrants into American Society from the National Academies of Sciences, Engineering, and Medicine. Which utterly debunks this immigrants don't integrate nonsense. But hey it's tough when facts interfere with a good rant.

bob2356 says

Feel free to present examples of third generation Hispanics that don't speak English. I'll be waiting. and waiting, and waiting.

Looked up and I am wrong about 3rd generation - 2nd generation sometimes has problems with English but not 3rd. However, I am not wrong about affirmative action, and I am not race-biting. With respect to affirmative action, a rare place where it can be quantified is by looking at SAT scores for medical school acceptance by race. So for those topics you have a good leftist rant.

MCAT scores, not SAT scores.

drB6

Quality over Quantity

Always

Well if you don't like our healthcare then you are racist.


Hehehe it's really all Liberals have is calling everyone racists when they fail time and time again like they always do.
I'm a racist right now for pointing out their propensity for abject Failure.

Here is US life expectancy by race:

https://www.kff.org/other/state-indicator/life-expectancy-by-re/

Whites live to about 78.9 years, blacks to 74.6. Honestly I thought the gap would be larger.

Also surprising that Hispanics live longer than whites at 82.8. Not surprised that Asians live to 86.5 though.

Patrick says

Also surprising that Hispanics live longer than whites at 82.8.

Interesting, given that Hispanics seem to be more overweight than whites. Perhaps, since they appear to be more family-oriented, they do not ship their elderly off to elderhouses to die, but keep them in family and so old people feel useful (look after grand-kids) and have some purpose to live.

Start with the AMA and Rockefeller. Since then American medicine has silo-ed to treatment only. Prevention isn't taught, isn't understood, and isn't profitable. The good news is everyone, EVERYONE can avoid going bankrupt, and start getting healthier right now! You just have to assume responsibility for yourself, start eating healthy, eliminate dangerous chemicals from your life, and exercise.

bob2356 says

You guys keep saying post prices, post prices. But why is anyone going to ;bother to look at them if the insurance company pays anyway? Crickets chirping every time I ask that.

@bob2356 If all providers had to stick to their own price list whether the patient has insurance or not, and all insurers had to treat every provider the same, then insurance rates would be a nice proxy for that price list.

So yes, we need a little bit more than published price lists. But publishing the list would still be a massive help in driving down costs, because people would in fact choose the better value, given that their insurer is going to cover only some fixed amount of any given billing code.

Look at it this way: if procedure X costs $1000 from one provider, and $2000 from another, and your insurer pays $700 for procedure X either way (treating all providers the same), then the provider who is more cost efficient at procedure X will win, and prices will fall.