kapkomet

QUOTE (NorthSideSox72 @ Jun 12, 2009 -> 03:55 PM) There has been a lot of talk lately in the news about the practice of "fracking" (har). This is used by companies looking to drill for natural gas or hydrogen or the like, by flushing compressed air, water and/or chemicals into the ground at very high power, to "bring up" the wanted materials. Some of the discussion has been that this practice has screwed up and possibly contaminated water supplies, and some states and agencies are looking at banning or restricting the practice, which was allowed in a loophole in federal legislation. But here is an interesting one, that Balta could maybe sound off on. An area in Texas, thought to not be geologically risk, has been experiencing regular earthquakes lately. And the locals feel that the fracking and drilling might be causing it. Balta, is that even possible? As I leave my subdivision, I can see no less then 5 gas drilling wells... I live right on top of this.

Holy f***, we get it. Sarah Palin is a ditzy b**** who exploits her family for political gain and David Letterman isn't funny anymore. Most of this was decided months and even years ago. Can we please move on?

Mike Cameron just won the douchebag Ex-Sox award. 11 years later and he's b****ing, STILL? That's classy.

QUOTE (Soxbadger @ Jun 12, 2009 -> 01:25 PM) Are you saying that Letterman is a surrogate for Obama? Last I checked Letterman is a Republican. People need to learn how to take a joke, if they cant handle it, dont get into politics. No, but I understand the sentiment that Obama lets this all go - because it benefits him. It happened in the election cycle, and continues to happen now. This has little do with the "joke".

QUOTE (Athomeboy_2000 @ Jun 12, 2009 -> 12:00 PM) conservative columnist S.E. Cupp: It's Obama's fault Letterman called Palin a slutty flight attendant... You don't want to see it that way, but I do see where she's coming from. Obama's s*** never stinks, because he has all his surrogates play in the s*** for him. That much is true. I think the statement itself is stupid, but I see the bigger point.

QUOTE (BigSqwert @ Jun 12, 2009 -> 11:39 AM) To get people like you, who hate all things government run, to keep coming back so they can overcharge for unnecessary care. Yep... because that happens all the time currently - you talk about straw man - that's all you people want to see is how "BAD" everything is. And the government, which has never been efficient at ANYTHING, is going to make sure that we don't have anything "unnecessary". Right.

QUOTE (StrangeSox @ Jun 12, 2009 -> 09:00 AM) Generally speaking, no and yes. They're not perfect systems. Ours has some advantages that theirs don't. But, I'd say that on the whole, they appear to be more efficient and provide more care to more people than ours does, and at a cheaper price. For all the fear of "bureaucrats deciding your healthcare!", which doesn't really happen, our current system has actuaries and bean counters at Insurance Co, LLC deciding what treatments you get and from whom. edit: I'd never support a plan where you can't opt out of government care, like Britain. There needs to be private options available. And what's the incentive for "private care" to stay in business? Especially when private insurance will most likely be taxed (maybe not this year, but it will), the government will be setting limits on everything anyway, etc.

So what's the over/under on the next test based on these "tough" sanctions? I say 10 days from now.

QUOTE (BearSox @ Jun 11, 2009 -> 10:01 PM) really, how so? Oh, because they never have to ration health care, do they? And you get medical treatment fast as well, right? Get ready, BS. You've opened yourself up to the utopian health care is perfect arguments. Efficient, clean, treatments whenever they want, etc. The problem is, for sniffles and s*** like that, yea. That is the case, and it's the case here too, if people want to seek that. There's several clinics here that do cash visits and prescribe generic WalMart $4.00 scripts. But don't let that get in the way of a good we need utopian health care story.

QUOTE (StrangeSox @ Jun 11, 2009 -> 08:59 PM) Go work for the IRS. They've got a union! Malpractice spending is less than 5% of health care costs. Tort reform won't solve this problem. http://www.cbo.gov/doc.cfm?index=4968&type=0 Yes it will. It has only a little to do with the % spent, it has to do with the threat.

QUOTE (Balta1701 @ Jun 11, 2009 -> 06:51 PM) You still have to break the government employee unions first. I just can't win. I'm an educated, white, suppressed non-union American male. The world sucks for me.

QUOTE (mr_genius @ Jun 11, 2009 -> 06:35 PM) India is a pretty closed economy, they probably wouldn't let kap in if he was going to take a job that an Indain could possibly fill. but of course, they demand free access to the US economy. thats fair though, globalization at it's finest. everyone in the United States works at Walmart, or works for the government, or gets welfare checks, or dies in the street. a successful economy. Right on!

QUOTE (mr_genius @ Jun 11, 2009 -> 04:54 PM) Walmart just announced a billion dollar outsourcing deal with India. they actually said that people can get cashier jobs at their stores to replace their IT, accounting, and management positions they lost to the outsourcing. I just need to go to India and get it over with, or work 29.9 hours a week at Wal-Mart for minimum wage.

You have got to be kidding me - yet another lie from Obama. So that 60 Minutes bulls*** about not giving them miranda rights was yet another lie? I'm glad to know that NON-CITIZENS get afforded the same rights as a US Citizen even on a foreign battlefield. You have to be careful what you say. And yes, I see Bush did it too, and it doesn't make me like it any better. Gee, I guess that makes Sarah Palin right when she talked about this in the campaign. That's kind of scary.

QUOTE (bigruss22 @ Jun 11, 2009 -> 03:32 PM) And alot of those people arent really lazy people or unqualified workers, theres a s***load of talented, well educated workers on the unemployment list right now. Hi.

QUOTE (bigruss22 @ Jun 11, 2009 -> 03:16 PM) Of the pharma companies I know, many have overseas operations. Without giving to many specifics, the company I work for is based out of Japan and has large operations here in the US and in Europe. Hell yes they do. Most have shell companies in Switzerland. Why? 12.5%, baby. There's a whole other side of this I'm not even going into.

QUOTE (Balta1701 @ Jun 11, 2009 -> 02:26 PM) In terms of malpractice there's actually a lot that can be done as well. There are some simple steps, like better standardization of procedures at hospitals for cleanliness, that can cut those sorts of issues in half. And...I'm not going to be able to find the data for the whole country, but a significant %age of malpractice claims are actually made against a fairly small number of repeat offenders, who medical boards typically will not discipline. Since patients have no access to that type of data, there's really no punishment for being bad at your job. And for me, that's where the "reform" needs to take place. Not turn it over to the government, or "universal coverage". As I said last night as well, I do want to see more on the "co-op" idea that's being floated around. I wonder if that's window dressing or if it is a real compromise of sorts.

QUOTE (bigruss22 @ Jun 11, 2009 -> 02:28 PM) Doesnt sound crazy to me, sounds like a business trying to keep profits high and keep the return coming on their investment. Like I said, I'm a free market guy - let things go as they go... but pharma is one industry that I have some integrity issues with... because at whose cost is a reformulation going to come from. Drug A - $300 for 30 pills Drug A generic - $45 for 30 pills Drug AB (redformulated) - $330 for 30 pills (with all sorts of new marketing campaigns to allow for the "degradation" of drug A and drug A generic (which provides the same result as drug AB)). The reality is most times, marketing spend for "Drug A" and "Drug AB" will be the same in the budgets once the switch is made, so they're making 10% more off of the reformulation for no reason other then a name change - all because of a patent expiration. The other thing I'll say - pharmas COULD do it different with generic companies - they could have agreements (some do, most don't) in place to maintain control over the generics - but they don't because the profits aren't enough.

QUOTE (Soxbadger @ Jun 11, 2009 -> 02:18 PM) In another thread I posted about Dr. malpractice being one of the greatest myths. In order for a Dr to even be sued for malpractice another Dr. must certify that there was negligence. That is why so many malpractice cases settle, because before the case can even be filed an expert needs to independently state that there was malpractice. If a Dr is negligent, why should the victim not be able to fully recover? If we cap medical malpractice torts, we should cap every tort because no victims should ever be able to fully recover. /shrugs I made a much better post on this topic before, so im not going to rehash it all, its some where in this forum. So what? This is part of the equation. Once the case gets to a lawsuit, which is whre your point lies, I agree. More thoughts that was triggered by this post and others before it. A ton of doctors order crap just to cover their butts. Just on the CHANCE that there's a lawsuit going to happen. And as I said earlier in this thread, there's too many different standards depending on the licensing board - that's ultimately where a lot of the power lies. It's a problem... because it's gotten too far out of hand, and now there's a lot of stuff just being done for the sake of being done. Remember, (here comes Balta's counter), the original doctor often refers to another place (diagnostics, lab, scans, xray, whatever) - and they don't get paid on these ICD9 (dx) codes or CPT codes (services provided for billing). When I worked in medical (not pharma), I personally instructed clinicians how to code to get more money. They could only spend 30 seconds asking a certain set of questions and put a CPT code down which would get reimbursed at a higher rate. That's part of the problem, and a huge overhaul of dx and reimbursement codes needs to be done so it's more uniform and consistent.

QUOTE (bigruss22 @ Jun 11, 2009 -> 02:01 PM) I work at one currently. I am only an intern, and Im not in the R&D side, Im in the IT part, but from what Ive heard you only get a few years of actual selling time because of FDA requirements and testing. Pharmas are constantly trying to improve their rate and speed of getting out their products, but the chances are small for many of their products and the obstacles a numerous, with many of them unknown until the FDA tells you so. You can prepare your documents as best you can for the FDA but if they feel any slight discomfort in allowing the drug on the market, they'll ask for more testing and you can easily see a year or two knocked off your time frame of the patent. Luckily the one I am working at specializes in transplant medicine and it is much harder to make a generic copy. Most of the time, you know what the FDA is going to request. Of course speed to market is the whole thing and yes, you only have a short window. With that said, moving an end of a chain on a molecule and then selling the drug as a new formulation to keep the insane profits down is crazy. And you know exactly what the FDA is going to do with those reformulations because you've already been down the path with the original molecule.

QUOTE (bigruss22 @ Jun 11, 2009 -> 01:54 PM) Oh yea, its really fair that a product you invest millions of dollars into is only under your protection for a few years before generic companies come in and steal your patent and make a ridiculous amount of money with very little R&D costs. Thats fair alright. I worked at a pharma company. I know how this game is played. Generic companies "steal" your business? OK. If you have a good product, you'll make billions off of it before the patent expires anyway. You have a lot of years of patent protection. And if the pharma company can't get it to market and make money off of it, it's their own fault.

QUOTE (Balta1701 @ Jun 11, 2009 -> 01:28 PM) Then why haven't states that have put caps on malpractice settlements seen huge drops in healthcare spending? I will certainly agree that doctors order a lot of stuff that doesn't need to be done, but I'm going to go with a different reason why; profit. It's a symptom of a broken market. There is no downside to a doctor ordering too much treatment; there is only upside, in that it drags more money in to the system. It's like that article about the highest per capita health care costs in the country spot in Texas i cited a week or two ago...doctors down the road order dramatically less stuff and spend less money. It's not because the high expenditure area is more scared of malpractice suits; the costs are capped in both places, it's that the extra providers there are making a killing offering more and more expensive and unnecessary treatments. This is why something called "Comparative effectiveness research" is so important. It's something the insurance and medical industries are strongly against, because the more they can keep doctors in the dark about how effective the treatments they order actually are, the more they can rake people over the coals. The problem is, right now, the anti-reform folks have decided that denying someone a prescription for a product that is more expensive and less effective than something on the market as generic (i.e. Clarinex vs. Claritin) is a form of rationing, and that's an evil word that we'd never consider doing (as long as "we" aren't an insurance company, for them it's ok), so we always have to pay for the highest cost treatment...because for the people with the best lobbyists, the highest cost treatment is the highest profit treatment. One thing I will say is "rationing" is ok, as long as it's not "rationing" for providing services. The doctors thing: one of the biggest challenges is there are at least two (if not more) standards the docs are held to. Their license may require different expectations (read: treatment outcomes) depending on which medical board it goes through. This does cause a difference in how they treat a dx. I think that's wrong, and a big problem. (I.e. an internist goes through a different treatment then a general practitioner). Then you tie that in to malpractice, insurance, etc. You can't forget that when you're talking about the malpractice stuff. That cap is really just a bs thing - because it only comes into play at rare cases. Another pharma trick is the reformulation of things just to escape patent renewals. I think that's horses***. Let's move the carbonate molecule from one branch to another, call it something different (when in fact it's the same drug) and remarket it. Yea, that's fair.

QUOTE (lostfan @ Jun 11, 2009 -> 11:30 AM) kap, you seem to be acknowledging that the current system is broken and something needs to be done, and I'm guessing you're just opposing the idea of the government running it or extending healthcare to uninsured. What are you proposing be done? It's like this: You take your car in - you get a quote for services. You know what will be fixed and at what cost. You go to the doctor, and you have no clue what it costs because you have insurance taking care of it, on a predeterminded basis... symptoms are XYZ, we have to run ABCDEFGH tests. Are all of these tests needed? NO! The biggest problem is doctors are held to a standard that should not be. They order so much crap that is unneeded because they have to cover their ass for insurance and liability reasons. Talk about wasteful spending. That's where a lot of it goes right there. There has to be a way to reform this part so that a doctor doesn't order crap just to CTA. This would help immensely. This is where tort reform comes in. There's lawyers that just sit and wait for a dx to be made that is in error so they can start the lawsuits. There MUST be some reform in this area. These two concepts go hand in hand. The other part, as I alluded to, people have no concept of health care costs unless they're self pay. Then it becomes painfully obvious. There's a huge disconnect here and it is one that needs to at least be bridged. Then there's the "usual and customary" clauses (gross revenues). IMO, this whole thing is collusion on the parts of the insurance companies. This whole area needs to be reformed. That's driving up costs so sky high it's ridiculous. Pharma companies should have caps on how much they can raise prices in a year. I do NOT favor restricting the amounts of drugs sold in a year, like they do in Europe. But they should have limitations on how much they sell. The place I worked - corporate needs more money - we'll just raise prices! Woot! There's no justification needed beyond that, and that's a sham of a system. I'm a free market guy - and notice what I'm saying. For me to say this, it's a problem that needs to be addressed. So, I've talked about doctors, insurance, pharma, lawyers. This should be the start of a good conversation, if people actually participate this time. (you can move this if you deem it worthy enough for its own thread - the whole health care thing - this is obviously only the beginning of this debate)

QUOTE (Balta1701 @ Jun 11, 2009 -> 11:14 AM) See, this is a great example of why our current system is broken...this argument focuses so much with the short term costs that we're willing to pay 5x more down the road to avoid them. The data is quite simple; preventative care saves a crapload of money over the long term. But you're trying to say that because adding in 100 million extra people actually focusing on preventative care would cost a decent chunk of money in the short term, you're willing to ignore the dramatic long-term savings. It's like arguing that no one should go to college because those extra years of school are expensive...yeah they are, but when you get paid back several times over, it's a smart strategy. I knew that you were going to say this. Now that you have a lot more people in the system, I will argue that the costs will dramaticallty go up. It's purely a numbers thing - there's going to be a lot more volume, which will raise costs, including the long term. The only single way to "cut costs" is to cut services (ration). Period. And that's exactly what they will do.

Oh boy! I have the same injury as Paul Konerko. I jammed my thumb while reaching over for a pop foul playing softball. It's not the easiest to grip a bat when you have a jammed thumb. This post was full of obvious and useless information. Carry on.