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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 05:57 PM
Original message
for discussion: is anything too important to be left to the vagaries of the market?
If so, what? Maybe more importantly, what isn't?
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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 05:59 PM
Response to Original message
1. Food, shelter, healthcare, etc. The market does okay with Pet Rocks.
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leftofthedial Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 05:59 PM
Response to Original message
2. only the market itself is too important (too big to fail)
to be left to the vagaries of the market
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:04 PM
Response to Original message
3. If by "vagaries of the market" you mean letting consumers buy what they want rather than what a
central planning committee says they can have, then not very much.

IMO government however has a key role to play in protecting naive consumers against the lies that are entangled in typical marketing hype.
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:27 PM
Response to Reply #3
5. not quite. I mean more, "letting consumers get what they need, not what's
cost effective".

Didn't mean to scare up ghosts of commissars.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:40 PM
Response to Reply #5
9. Ok but you changed my "what they want" to "what they need". Who determines that, consumers or a
central planning committee?
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:57 PM
Response to Reply #9
12. or an HMO?
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:59 PM
Response to Reply #12
13. OK but it's out of the hands of the patient and decided by central committees based on cost
effectiveness.
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 07:08 PM
Response to Reply #13
14. I'd like to hear your preference, then.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 07:19 PM
Response to Reply #14
15. I wish I had an answer. I'm conscious of problems re whether given limited funds, society benefits
more by paying for open-heart surgery of a 70 year old person or uses that money to treat several children in their pre-teens.

That's one example of the moral dilemma society faces under any form of socialized medicine with limited funds.

I find the UK program NICE worth reading in trying to understand the issue, National Institute for Health and Clinical Excellence.
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 07:23 PM
Response to Reply #15
16. is it even the right question to be asking?
I'm not much down with cost/benefit analyses regarding whose life is more important, and given the conundrum, I'm not sure we're not following a rabbit hole.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 07:37 PM
Response to Reply #16
17. IMO it's the right question because with any version of socialized medicine, we will have a limited
budget and I don't like the idea of a central committee of appointed bureaucrats determining who will and who will not receive a given medical procedure.

My interest in this topic was heightened because I had a cardiac arrest in 2007 in which I died. The ER doc told my family I probably would not survive the night but I did and I had open-heat surgery a few days later.

Now nearly two years later I'm alive but haunted by the question, couldn't that money be better used to save a few pre-teens?

I don't know the answer and perhaps you are correct that's not the right question but for me it is a life-altering question.
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 07:58 PM
Response to Reply #17
19. false dichotomy.
There is more than enough money to save both you and a few pre-teens. What's lacking is the will.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:02 PM
Response to Reply #19
21. We disagree, there is not nearly enough money to fund every medical procedure that people might need
I've never read a single statement by anyone that supports your assertion.

Please correct me by citing an informed source that shows we have enough money to fund all medical procedures as well as other education, welfare, etc. programs.
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:08 PM
Response to Reply #21
23. we have enough money to fund the war in Iraq.
(Or not, but if we did...) We have enough money to fund all procedures that people need.

Sorry, I'm not in a mood to do research tonight. Believe as you will.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:10 PM
Response to Reply #23
24. Have a good evening. n/t
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readmoreoften Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:11 PM
Response to Reply #17
25. RW talking point nonsense. A central planning committee already decides your fate.
They say "we only have enough money for one transplant and two people need them, but neither of them can have it because we deserve a profit, so we're going to take the money and no one gets a transplant."

There will always be LIMITED RESOURCES in any sort of economy. Just because some insurance company comes in and takes a cut of the profit for no purpose whatsoever does not eliminate "central planning committees."

We have the WORST health care system of any industrialized nation. And you're afraid of socialized medicine? They really got to you, didn't they....

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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:13 PM
Response to Reply #25
26. "central planning committee already decides your fate". Not in my case. n/t
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:15 PM
Response to Reply #26
27. well hell, who *does* your health insurance?
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 07:32 AM
Response to Reply #27
31. I'm interested in health care for all, not myself. n/t
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readmoreoften Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:22 PM
Response to Reply #26
28. So you paid out of pocket? Who do you think approved your doctor's orders?
Just because you get APPROVED by a central planning committee doesn't mean they didn't DECIDE. You really need to watch SICKO. Or travel out of this country and talk to a few people.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 07:32 AM
Response to Reply #28
32. I'm interested in health care for all, not myself. n/t
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 08:59 AM
Response to Reply #17
34. No board ever decides that. They decide what procecdures are covered
--and anyone needing that procedure gets it. If open heart surgery is covered, everyone gets it. Given that we now spend twice as much as any other industrialized country per capita, we could afford to be quite generous in establishing what is covered.

The only decisions about who gets coverage would relate to transplants, where organ supply is an issue. I say that is in order of medical need, and then you get in line.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 09:20 AM
Response to Reply #34
35. If you are correct, why would Obama include $1.1 billion for "comparative effectiveness" research in
the stimulus bill?

You do now of course that Obama signed the "American Recovery and Reinvestment Act" that funded "Comparative Effectiveness Research" (CER) and established the Federal Coordinating Council for Comparative Effectiveness Research?
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 09:40 AM
Response to Reply #35
36. That will be used to decide which procedures will be covered
Once it's covered, everybody gets it. Sorry, but copper bracelets for arthritis are on your own dime.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 09:46 AM
Response to Reply #36
37. I understand that's not how it works in UK with its NICE cost-effectiveness threshold.
See post #9.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 05:29 PM
Response to Reply #37
39. They have the cheapest health care system in the industrialized world
We are currently spending nearly three times what they do. If we spent it on CARE, instead of bullshit "coverage," there would be no need to limit treatments.

Diagnostic tests are another matter. At my current HMO, women get mammograms after age 50 depending on calculations on their risk factors. If you want more than that. it's on your own dime.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 06:09 PM
Response to Reply #39
40. Then your post #34 "anyone needing that procedure gets it" is wrong? n/t
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 08:04 PM
Response to Reply #40
41. There is a difference between a procedure and a diagnostic test
The public should not be paying for tests for low risk people that yield too many false positives. If people want a test because they saw an ad for it on the teevee, that's their lookout. However, if open heart surgery will help your artery problems, you get it. You just don't get stress tests on demand.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 08:37 PM
Response to Reply #41
42. You said "anyone needing that procedure gets it" and that statement is without limits. That means if
a 99 year old man serving a life sentence needs ANY MEDICAL PROCEDURE he will get it as one example of applying your assertion.

I've made the point that society will have a limited health care budget for any form of socialized medicine and therefore must decide whether to give that 99 year old prisoner all medical care or decide to spend that money on other more deserving people where "more deserving" has to be determined by society through its representatives.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 09:28 PM
Response to Reply #42
44. Excuse me, but twice what every other country in the world spends on health care
--is no way in hell a "limited" budget. Even under our current system, deliberately committing a crime in order to get health care is a common thing. Just last year one guy got chemotherapy that he would otherwise not have gotten that way.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 09:36 PM
Response to Reply #44
45. You did however say "anyone needing that procedure gets it" and that's not true. Have a peaceful
evening and thanks for the exchange. :hi:
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-09-09 07:27 AM
Response to Reply #44
46. If you don't get the difference between tests, drugs and surgery, this is pointless n/t
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Chemical Bill Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 08:58 PM
Response to Reply #3
43. Single payer health care means that...
government pays for the doctor to do what you and s/he decide. No central committee involved (unless you count the AMA).

Bill
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Deja Q Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:19 PM
Response to Original message
4. 'vulgarities', surely?
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:29 PM
Response to Reply #4
7. well, there's that.
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Captain Hilts Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:28 PM
Response to Original message
6. Adam Smith certainly thought so. He lists transit, among other things.
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supernova Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:33 PM
Response to Original message
8. The basic functions of life and society
Food (more food safety than production or distribution)
Shelter
Access to information, usually manifest as libraries
transportation and highways
health care
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rucky Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:46 PM
Response to Original message
10. If you're going to live in modern society...
You need food, shelter, healthcare, transportation, utilities. Those are basics.

If our minimum wage can't cover those things (which they can't in most cases), the government needs to either raise wages, regulate and/or provide assistance.
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kestrel91316 Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 06:56 PM
Response to Original message
11. Everything except cheap Chinese plastic crap.
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LWolf Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 07:42 PM
Response to Original message
18. Yes.
education
health care
shelter
food
energy
communications
public health and safety
other infrastructure: roads, bridges, libraries, etc..

:hi:
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:00 PM
Response to Reply #18
20. socialized eduation? who ever heard of such crap???!!?
:hi:
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LWolf Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:41 PM
Response to Reply #20
29. I guess you're right.
We can't have that, can we?

:hi:

I hope your district has the budget to finish out the year without any draconian measures.
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ulysses Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:48 PM
Response to Reply #29
30. it's been comical.
We were told a couple of weeks ago that there would be no more paper, copy toner, etc. through the end of the school year. When parents started bringing in reams of paper for us (especially in title school areas), and then started writing the local paper, the shit started flying. Evidently we in the teaching field "misunderstood" what was plainly said to us, and there's plenty of paper available. :D They're talking about furloughs for full-year folks.

How about with you?
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LWolf Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 10:19 AM
Response to Reply #30
38. Funny how PR affects the juggling, isn't it?
First we had all our supply budgets for the year, what was left in them, taken back. Then all field trips were canceled. Then all staff development, and all subs for any kind of district meeting or activity.

Then the admins took a pay "freeze," giving back the raise they got in September until September of '11.

The district announced that our student body funds, which we, our families, and students do fund raisers throughout the year to earn, to be used for "extras" that the normal budget doesn't cover, can be accessed with a requisition. A committee will now approve our expenditures of money that doesn't really belong to them.

Meanwhile, our governor announced to the public that teachers should "work for free" to make sure we could finish the school year. Whenever our district runs out of money, we ought to show up to finish the year from that point "for free."

We said NO.

So the district compiled a committee of certified and classified reps to meet with them to come to consensus on what we'd cut further to finish the year.

It looks like we are cutting the teacher work day at the midpoint of the 3rd trimester, and not sending out progress reports (that's the point of the work day.) Then we're cutting the work day at the end of the year that we spend on cums, cleaning up the room, and all those other duties. That's probably a day that will be worked for free, unless we can manage to get it all done WITH students. Then we are cutting one day off the end of the school year; a minimum day.

That leaves the students with a half-day cut, and us with 3 days paid, plus 1.5 work days to wrap up end-of-year duties. Which we will still be responsible for. There's currently some confusion over the official, state-required portfolio of work samples that we keep. We're told that we just file the work samples into the portfolio, but don't report the scores to the data base. If they are looking to save some of that end-of-year work time, the gathering of, scoring, and filing of work samples takes a lot more time than reporting the scores.

In addition, there might be a fraction cut from our salaries in addition to the lost days. So far, they're talking about 1%.

They will divide it up over the 6 checks from April - September. As of now, it could be anywhere between $160 -$300 per month cut for that period.

They are concurrently looking at balancing the budget for next year. Positions will be lost, class sizes will be raised, and days will again be cut. Our students only attend 168 days, so those cuts are harsh for them as well as for our budgets.
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Greyhound Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Mar-07-09 08:04 PM
Response to Original message
22. Of course. Many have been listed already but I didn't see justice among
them. Access and quality of justice must not be determined by connections and wealth, or it is nothing but a cruel joke, and will inevitably corrupt the rule of law.

Education is an absolute necessity, but in addition, we have to redefine education to accommodate the portion of our population for whom college is not the appropriate answer through apprenticeship programs for example.

Out currency system must be re-taken by us, the government, to ensure it serves it's purpose instead of being turned against our interests to profit those entrusted with it as has happened throughout most of our history.


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Chemical Bill Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Mar-08-09 08:43 AM
Response to Original message
33. The vageries of the market can suppliment...
a base level, but they can also harm the general good. Public schools are drained of good students by private schools, leaving them vulnerable to * and his every child left behind act. Both types of schools have their place. I can buy food imported from areas where the local farmers are forced off of the land by multinational corporations. This food is transported at a cost to the environment. I would have a hard time banning food, but regulating these practices would be easier philosophically. People without health insurance go to the emergency room, where they wait for hours to be seen by overworked staff. Meanwhile people with insurance go to private clinics or their own doctor, and wait but a few minutes for better care. This one's easy for me, single payer. But I won't shut down the private care for the monied few, nor the herbalist in the little storefront.

Anyway, to answer your question, health care, education, food, roads, and the court system are but a few that need some level of public control. How about the financial sector? Wouldn't it have been nice to have had some kind of zealous overseer of that the last eight years?

Personally, I have a hard time with absolutes at either end on this question.

Bill
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