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August 18, 2009 8:00am by David Farrar

General Debate 18 August 2009

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Redbaiter

Its just so good to know I can piss him off that much.
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August 19, 2009 1:28am
Haiku Dave

57 votes?!?!
could russell be, in real world,
more superfluous?
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August 19, 2009 1:51am
racer1

Haiku Dave, you once wrote a pretty funny haiku about christ and extraordinary rendition, I cannot for the life of me find it though. Are you able to track it down/ remember what you wrote?
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August 19, 2009 2:11am
Sonny Blount

Something I found elsewhere:

America has the best health care in the world: a startling claim perhaps but one that can indeed be supported for one definition of “best”.

The controversy will come, of course, from whether you agree with the specific metric used to measure best or not.

I should mention that while I am indeed a right wing lunatic, fully equipped with the ability to scream “Commies!” with the best of them, even to froth at the mouth upon demand while doing so, I’m not going to invent any strange measurement device to prove this point.

No, rather, I’m going to use the numbers from the World Health Organisation (WHO), the very ones that they themselves use to determine which is the best health care system in the world.

At one level, of course America has the best health care system in the world. We spend more on it than anyone else, both as an amount of money and as a percentage of the total economy. If we were to be both complacent and stupid about it we would, in common with a certain strand of leftish thinking, say that because we are spending more money, because the inputs are higher, then we must be doing the right thing (there really are people for example who support green energy precisely because more people have to work to provide it, that is, it’s good because inputs are higher).

However, we can be a tad more intelligent than that and have a look at what it is that we actually get for those inputs. At first glance it doesn’t seem like much: life expectancy isn’t noticeably different: it’s a little lower than some other countries at birth, a little higher than those same at age 65. Indeed, the WHO rates the US health care system as a whole as being only 37th, which isn’t all that good an outcome for spending the most money.

We need to go behind those numbers though and have a look at how they are calculated. It’s not all that unusual for international statistics of these kinds to contain some, well, how to put this, odd assumptions. The answers to that are here. This is what the WHO uses to calculate those numbers and the weightings they put upon them.

1. Health Level: 25%
2. Health Distribution: 25%
3. Responsiveness: 12.5%
4. Responsiveness Distribution: 12.5%
5. Financial Fairness: 25%*

As you can see, there’s a great deal of assuming going on there about what makes a decent health care system. In fact, only 37.5% of the weighting is actually about health care itself: the other 62.5% is about distribution and fairness, how equal or unequal it all is.

These may be fair things to worry about, of course, but it does seem a little odd to assume that we must judge health care by equity. Judging it more (rather than only very much in part) by how good the actual health care is might seem more sensible.

What happens if we take a step further and look at the numbers for each of those five measurements that make up the total system ranking?

In terms of the health level, the US is 24th, distribution 32 nd, responsiveness 1st, responsiveness distribution joint 3-38th and financial fairness, joint 54- 55th.

I take it from that that what the (yes, hugely expensive) US health care system actually offers is responsiveness. That when we desire to be looked at, we get looked at. When we need or desire treatment then we get it faster than any place else on the planet. That’s simply an extremely expensive thing to provide.

Note that this isn’t a series of he said she said tales about waits at free clinics, or 18 weeks to get an operation in Britain, nor I fell over and had an MRI scan in the ambulance on the way to the hospital. These are the straight international statistics about which health care system does what around the world. The US, averaging out over all of us, those with private insurance, government insurance or no insurance, responds to our need to treatment faster than any other.

Now it might be that we don’t need the system to react to our desires that quickly: it might also be that we’re quite happy to pay for it to do so. This is something that needs to be discussed: and preferably before we go changing the system itself.

Is responsiveness something we value? Or not?

My own take on this is that it is indeed the responsiveness that we’re actually paying for. The way in which if your doctor thinks there’s something wrong he can fire off all manner of diagnostic tests immediately, get the results and then get you into whatever (or none) treatment is needed. That’s what makes the system cost so much, makes us the number one spenders. And if we want to continue to have that responsiveness then we’re not going to be able to cut costs that much. If at all in fact, for if we lower those two distribution numbers by insisting upon high quality insurance for the 47 million currently without it, the resouces required to maintain the slack in the system which allows that responsiveness will simply have to increase.

As I say, this is my own take at the end here, not something proven by those international statistics. But I do not see how we can maintain that number one position, that facet where the American health care system is the best in the world, and not increase costs when we extend that best in the world system to those who do not currently enjoy it.

Either we’re going to end up introducing the waiting that the system currently doesn’t have or it’s going to cost us all more money.

* Of course any actual analysis of medical outcomes from treatment is far too obvious and right wing for the WHO to bother examining.
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August 19, 2009 4:22am
Glutaemus Maximus

From order-order.com

Gold Plated Interns. I always thought that the meaning of an Intern was different from this.

But what can you reasonably expect from a Labour Party with no Moral Compass.

“Interns are a plenty with graduate unemployment high. Only this government would pay someone with little to no experience more than the average national salary:

Departmental Work Experience
Mr. Willis: To ask the Secretary of State for Energy and Climate Change how many interns work in his Department; what terms of reference apply to their appointment; what remuneration they receive; and how long on average an intern appointment lasts. [286823]

Joan Ruddock: DECC currently has one intern. DECC’s terms of reference for interns are still being developed, and are based on giving an individual a personal development opportunity and introducing them to the civil service, while completing a meaningful piece of work.

Remuneration for this contract is based on £29,191 (pro rata) which is in line with the DEFRA HEO starting salary.

This contract is for three months.”

Source: Hansard, Column 1630W, 21 July 2009,
Not as if the government has a budget deficit or anything…

Er, the biggest in History. Yet still they keep spending on pet projects.

at August 18, 2009 at 5:38 pm
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August 19, 2009 4:59am
Haiku Dave

thanks, you’re a lovely
audience, the haiku in
question is here mate:

http://www.kiwiblog.co.nz/2009/03/vatican_rejects_apology.html
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August 19, 2009 6:07pm
Haiku Dave

ideology
is what you bring to table,
russell, not ideas
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August 19, 2009 6:10pm

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