gdp's Comments

Change.gov : Change.gov: The Obama-Biden Transition Team | General Discussion

Mon, 29 Dec 2008 00:16:04 +0000

Another bonus is that hemp production which is currently impossible - http://www.ncsl.org/statefed/hempletter.htm-will again be feasible. See http://econpapers.repec.org/scripts/search.asp?ft...for economic papers which evaluate the modern potential for commercial hemp production.

Change.gov : Change.gov: The Obama-Biden Transition Team | General Discussion

Sun, 28 Dec 2008 23:40:29 +0000

If you decriminalize marijuana for the consumer but you keep in place a criminal infrastructure for production you have the worse of all worlds-- Unregulated access with a continued funding of a criminal enterprise. Our current prohibition is not a good situation either. Our national parks are being damaged - http://www.cnn.com/2008/CRIME/08/08/pot.eradicati...and the illegal marijuana industry flourishes. Taxation and regulation (no matter what you call it) may very well be the best situation from a societal prospective. Please see http://economics.about.com/gi/dynamic/offsite.htm...

Change.gov : Change.gov: The Obama-Biden Transition Team | General Discussion

Sat, 20 Dec 2008 13:51:01 +0000

I want to support the idea of bringing sincere individuals with different opinions together in dialog and prayer. I have not educated my self sufficiently to say anything intelligent about either of the religious gentleman discussed in Mr. Heyward's comment, however as a physician I have talked with individuals on both sides of the abortion issue. And I can honestly say that the sincere individuals on both sides of this issue share a common concern and in many cases they have a greater interest for others and for their neighbors than most people. For abortion, the decisions to support or not support comes down to whether they believe the embryo is a being or not. For LGBT issues the deciding factor is whether one believes that ones sexual orientation is a choice or not. My purpose here is to support t Mr. Heyward's suggestion to provide equally important roles to people on both sides of this issue. Having these individuals come together might go a long way to showing us all how to respectfully work with each other for the common good. Of course the two individuals must be willing to come together and to set this example of open dialog and respect for well considered and sincere opposing view points.

Conversative Network: People Participating Conversations+Discussions ChangeSolutions : How Will Obama's Proposed New US Health Care System Handle Treatments Which Cost More Than $22,

Tue, 16 Dec 2008 22:54:51 +0000

Thank you for your extremely thoughtful response. I agree that the system is broken which is why I am devoting so much non-work time to this. And I agree we can find solutions. I currently think we need a totally free system for societal cost saving care - communicable disease, prenatal care and mental health. When we don't provide this care as a society we will spend more later either in multiple sick people (communicable disease), premature infants (prenatal care) and/or crime (mental health.) And I think that we as a society should ethically provide cost effective care free to all individuals who contribute to society or the betterment of themselves (students, workers, volunteers and care providers). I make this distinction because some human beings are in a downward spiral. I strongly believe that doing something constructive is important for everyone( if you pay people to stay in bed, their health starts to decline.) If people choose not to help themselves, many other people will resent paying taxes to pick up the pieces ( although as mentioned some things are stupid not to provide everyone even those who don't want it.) But then there is everyone else and I know that we can't possible give everyone everything they want. Nor is it fair to only allow the super rich to get these "enhanced services" especially since some middle class people who live frugally would rather buy insurance then spend money on other things. But it isn't fair to tax everyone for a level of care that many don't want no matter what or would not want if they or their families have to give up other things. Perhaps the solution is in the tax structure for this extra insurance Right now all this extra insurance is tax deducible by the company and tax free to the employee. There clearly should not be any tax benefit and it might even make sense to tax some insurance and services. . The problem is very much like that of schools. If all the rich take their kids out of public schools than who is left to advocate for good public schools. That said who decides. Should the committee that decides be bound to have only the basic insurance for them and their families. I think I would serve on a committee if I had to abide by the decision for myself. But I don't think it would be fair for me to make my family not have the same opportunities to extra insurance as everyone else. When I have ethical dilemmas I sometimes wish I could set down a group of ordinary citizens, explain all of the implications and see what they decide. So perhaps that is what we need - an advisory group that includes experts but also citizens from other areas to make the decisions on what gets provided and how much we pay for it. Hmm I wonder if that is what the Health care community meetings are about - http://change.gov/page/s/hcdiscussion

Conversative Network: People Participating Conversations+Discussions ChangeSolutions : Comment post to: \"What social causes and service organizations are you a part of that make a differ

Tue, 16 Dec 2008 03:07:28 +0000

Mike, My post is the one at http://conversative.net/blog/2008/12/15/in-your-p... During the change.gov I looked at your site www.containedcapitalism.com.and was very impressed by your knowledge and identification of the problems that exist with both government and private insurance solutions. Who are the payers in your proposal? Ginny

Conversative Network: People Participating Conversations+Discussions ChangeSolutions : Why use Appropriate Technology? Less Pollution, More Jobs!

Mon, 15 Dec 2008 12:47:19 +0000

Thank you. I sent up my question under a new category- Health Care Policy. The question is now a stand alone post at: http://conversative.net/blog/2008/12/15/in-your-p...

Conversative Network: People Participating Conversations+Discussions ChangeSolutions : Why use Appropriate Technology? Less Pollution, More Jobs!

Sat, 13 Dec 2008 23:41:11 +0000

I loved your post and am trying to fuel a people economy instead of an oil economy. But I am fortunate that I live less than one mile from a supermarket and so going to the supermarket is a form of exercise for me. I have a cart if I really have to buy a lot but while my kids are at college I usually just carry what I need home (building stronger bones and better muscles.) I also now walk to a far bus stop and use heavy hands on the way. So instead of driving I am getting more valuable exercise. At the store I am trying to purchase more local products. Why eat oranges that are transported from South Africa? Unfortunately none of this is helping increase jobs (except perhaps for the bus driver) but I am trying to make use of as many services as possible . I eat out a lot (but bring my own reusable container for the left overs) and tip well. And of course my weekly yoga class improves my health, employs someone and doesn't hurt the environment. I think another people economy we can help fuel is more paraprofessionals to help the elderly and those who can not afford expensive health care. And we can have more urban produce production and helping on local farms to decrease dependence upon oil for our food production. It is just a matter of changing what we think is important.

Change.gov : Change.gov: The Obama-Biden Transition Team | Join the Discussion: Service

Sat, 13 Dec 2008 16:00:24 +0000

Participation in Internet based organizations can also help in the local community -http://dkms.ghinet.info/and https://sbs.upmc.com/portal/wps/portalare two that I have participated in both professionally and during my "free" time. During the health care discussion someone commented that they were physically disabled and unable to volunteer. It occurs to me that this individual was sitting at a computer and participating in a valuable community discussion. They are most likely capable of helping with web based public services. Perhaps they can become a certified content expert in their own or another disease and be available by Internet or voice over internet to telephones and cell phones.

Change.gov : Change.gov: The Obama-Biden Transition Team | Join the Discussion: Service

Sat, 13 Dec 2008 15:41:10 +0000

I have been active in the Western Pennsylvania Humane Society http://www.wpahumane.org/index.htmlHumane societies makes a very big difference in people's lives even for those who are not animal lovers. These programs get salvageable animals off of the street and therefore greatly lower the risk of rabies in a community. In addition they provide low cost healthy pets and veterinarian services to the community. My involvement has been through helping my daughter fostering animals when they are too young or too sick to be permanently adopted. Although "Foster parents" must be 21 or over, there are programs where older high school students can foster under the supervision of a parent. Like many other service projects I benefited greatly through a better relationship with my daughter and a better understanding, knowledge and appreciation of animals.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Wed, 10 Dec 2008 03:09:37 +0000

Mike Slyder, I googled "contained capitalism " and went to you website. Your research on the problems with government and employer health care are excellent but what I can't figure out with your proposal is " who pays ?"Is it all fee for service and if so what happens if an individual can't pay. If it is sliding scale who decides and what happens if enough funds don't come in?Is there a tax? .

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Sun, 7 Dec 2008 15:03:03 +0000

Ami, In response to your comment that health care should be strictly non-profit I would like to make the analogy to water. Water is essential and a well functioning government should make sure that everyone has access to clean basic water. But once the basic need is supplied, individuals should be able to enhance and improve water and make a profit doing it. Why a profit? Because innovation and the development of ideas take risk and success should be rewarded to encourage additional innovation. That is the concept behind the patent system - You get to profit for a while but then the ideas become public domain and the really good innovations make their way into the public system. That is why I currently support a hybrid system (a good public systems for cost saving and cost effective care with the current insurance system as competition for the basic care and as sole provider of the very expensive). This does mean that there are some things that could extend or save a life that the basic public system will not pay for. And although it sounds cruel your example of the poor family mortgaging their house and selling everything they own is an appropriate analogy for society. Health care is just one societal need which includes the education, public safety and vital infrastructure (e.g. our water supply). Providing health care must be balanced against these other needs. This is why there must be some rationing in a publicly provided system. During the last political cycle, the story of a 17 year old California resident was made public as an argument for a single payer system. Tragically this 17 year old had leukemia and was treated. The she had a bone marrow transplant but then goes into liver failure and the insurance company denies a liver transplant. A number circulating was that there was then only a 65 percent chance of a 6 month survival. Would this young lady have gotten the procedure in Canada or England? I don't think so but I would love to be educated. Does her age make a difference? Many pointed out that the US is quite wealthy and I can see us doing more for children so may be a public health care system could pay for this level of care for children. But what if she were 80 year old? Or if providing it meant not providing prenatal care to one hundred other women? I am 51 and the bulging end of the boomer generation. I would much rather see OUR future children have an good education and live in a healthy society then for me to live extra months with money siphoned off from those efforts. On the other hand I have no problem with individuals who have saved millions of dollars over their lifetime or have paid into a special insurance fund using it all to prolong their lives for even one day (unless it uses a scarce organ that is needed for someone with better odds.) It may even be that these millionaires will help develop something that can be mass produced and paid for by the public system to help the rest of us. As for me I have a living will (somewhere) which expresses my individual preference.. My grandfather, when diagnosed with cancer, chose not to pursue uncertain and risky procedures. The family called me. Talk grandpa into the surgery and the radiation they said. How could he be doing this? I talked to my grandfather. He was rational and articulate. I would have made the same decision. His only wish was to make to my wedding and he did. That was the last time I saw my grandfather and I cherish the pictures of an extraordinarily happy jaundiced elderly man surrounded by a loving family.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Sun, 7 Dec 2008 00:16:40 +0000

I too am perplexed by everyone always talking about insurance. We need health care not health care insurance. We need a means to provide health care to the population and not everyone can or has the foresight to get preventive or early health care. Consider our young adults who have aged out of their parents insurance. Often they can only get low paying jobs and some have large educational loans. They have a tough enough time paying for food, housing and transportation. There is no money left either for cost saving preventive care, cost effective treatment or insurance. And if they did have money it is quite possible that might choose to have a little fun sometimes. And the irony is that the kids who need it most, those who have are too poor or not educationally gifted enough to go to school full time are the ones who get kick first (at the age of 19 for my employer). My kids are lucky - they have a mom and dad who are doctors but what about the children of blue collar workers. These kids are literally our future and they deserve basic health care. Think about it selfishly if you like, our retirement funds depend upon a healthy and productive society and that requires a healthy work force. We need to give our young adults basic health care.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Sat, 6 Dec 2008 23:28:14 +0000

There aren't enough doctors with the current system but a lot of care can be provided efficiently and effectively by individuals with less education but with the same if not more training. Consider colonoscopy http://digestive.niddk.nih.gov/ddiseases/pubs/col... It is recommended every 10 years for individuals over 50 years. It is not just early screening it is early treatment. Right now individuals with 4 years of medical school, 3 years of internal medicine and additional years of GI sub specialty training do it. But it really doesn't need all that education to be done successfully. It takes someone with a very good eye, who is reliable and has a steady hand. I'll take a good technician over a clumsy doctor any day (provided the technician is working with appropriate oversight, backup and training.)

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Sat, 6 Dec 2008 23:05:14 +0000

SAY YES to ELECTRONIC MEDICAL RECORDS. I agree that there are security issues but if done right far more lives will be saved though error checking, computer enhanced diagnosis, improved communication, accessibility in an emergency and improved risk communication. I think instead of saying no to electronic medical records we need to say how. I would like a system where a password that I can designate is needed to get into the specific parts of my record in addition to the password of the health care provider. (In an emergency, if I am in an automobile accident etc their should be a work around where access is approved for the physician by a third party.) I think the record should be distributed with certain elements going into a central repository and certain elements staying at the clinical site. The record should track who looks at it and of course information should be transmitted in a secure manner. I would like to see it open source so that we are not held hostage to a software provider which decides to change operating systems and make everyone re-write the program or make minor changes and make everyone to re-purchase software. I would like to be able to access parts of my record by myself (and in fact have started a google health record www.google.com/health so that I can keep track of my preventive procedures and immunizations. ) As a board certified preventive medicine physician I prefer the US Preventive Services Task Force recommendations http://epss.ahrq.gov/PDA/index.jsp. Google health does not yet meet my security requirements for other people's records but I believe in modeling good behavior so if my google health record were made public I would just hope that it might inspire other individuals in their 50's to get a colonoscopy every 10 years.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Sat, 6 Dec 2008 22:22:07 +0000

MedWebHead I agree with your comment that we should have priorities
but I am not sure that "equal" healthcare for everyone is what the US
needs because everyone does not have "equal" needs. Instead I think we
can give everyone basic good health care with an emphasis on cost
saving and cost effective care (without regard to whether it is
traditional or integrative). For the best care without regard to
money, for care of uncertain effectiveness, for amenities and for
extremely expensive care individuals will need to be wealthy or
purchase insurance. And I would put a very high priority on prenatal
care and early childhood. CHIP is great but you still have to sign up
in advance and those in the most need are the least able to. Why not
save money on administration, enrollment, collecting fees etc and just
provide basic care automatically for this important group? And if
middle class and wealthy individuals benefit too it is okay. After
all they pay taxes. Could you imagine if we had to require that
parents pay tuition for kids to go to school?
(I am posting this by replying to the Intense Debate Notifications.
If it works it means that indeed we can respond to comments without
attempting to find the original thread.)

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Fri, 5 Dec 2008 00:55:35 +0000

Great example. What is wrong with the US Postal Service? The delivery mail very inexpensively and to every house. But I do admit to using other providers at time. I would not want to give up the US postal service or the private providers of delivery services.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Fri, 5 Dec 2008 00:23:28 +0000

I agree. We as a society should base what we pay for on its effectiveness not on the body part, or discipline that provides it.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Fri, 5 Dec 2008 00:18:02 +0000

I agree that the US as a nation is not ready for a single payer health system . In addition to the point you make about the perception of socialization, we would have the very real issue that some care is extremely expensive AND limited in supply. Who gets to see the world expert in disease X? Who gets the very expensive medication that can only be supplied in a small amount. And we have the issue that some care is just marginally effective. Some people want everything possible done even if the potential benefit is minimal at best. Or they want the convenience of a pill taken once per day then a cheaper one that is taken 6 times per day. Shouldn't they be entitled to use their own money or pay into insurance to have the option? And what about people who want and are willing to pay for a higher level of service (no waits or an extra long visit or a third opinon) than society can afford as a whole. And consider the economic upheaval of laying off a whole industry and the loss of the most highly paid health care workers to other countries who would start catering to the Americans who only want what they perceive to be the best. That is why I advocate a hybrid system. We should provide good basic health care to the millions who don't have it but allow the insurance system to complete at the basic level and fulfill all need at the expensive level. The two systems can exist together. In a sense Canadians have that system since they just fly to the US if they want and can pay for different care. I did my pediatric residency in New York City from 1983-1986. At the public hospital I trained at my patients walked out the door with the medicine they needed.I didn't have to worry about whether they could afford to pay for a follow up visit. I didn't have to worry And we didn't prescribe marginally effective medicine because doing so decreased the money we had for everyone else. At the private hospital next door some who were willing to fork over what is a life savings for most could get the best care in the world. People vary greatly in how much health care they want. With a hybrid system those of us who only want the basics, who don't want to die with needles in our veins and tubes down our throats, who prefer to exercise they take the lastest greatest designer medications can get good basic care even when we are unemployed, going to school or starting a business. And those who want the best of everything can give up other stuff to either pay directly or to pay for insurance. There will be some who can't afford the level of care they desire but under the current system their are many people who can't afford any level of care. And not giving that care costs us all in terms of lost productivity and increased emergency room charges later on. Think of this like the educational system. Everyone can and should get a basic education. But expensive private schools are still allowed to exist.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Thu, 4 Dec 2008 03:54:13 +0000

KFD, When I took economics in graduate school (back in the early 90's) I distinctly remember a study that showed that smokers paid their own way through a combination of taxes on cigarettes, deaths from relatively inexpensive diseases like heart attacks and lung cancer, and the fact that they often collect less social security due to these early deaths. Make no mistake smokers die younger, they just aren't necessarily a financial burden on the system. And I absolutely agree that alcoholism is a disease, however tobacco is also very addictive. If you want to stop, you can use some of the available services - http://1800quitnow.cancer.gov/ . Many of these services are funded through a tobacco settlement http://www.tobaccofreekids.org/reports/settlement...which the tobacco companies pay for by an increase in the price of cigarettes. So effectively you are paying for these services every time you buy a pack of cigarettes.

Change.gov : Join the Discussion: Former Sen. Daschle responds on health care | Change.gov: The Obama-Biden Trans

Thu, 4 Dec 2008 03:36:08 +0000

There has to be a balance between providing sufficient profit to encourage innovation in the development of pharmaceuticals and making them affordable. In a hybrid solution, the public system would only pay for the most cost effective medicine which very often are the older generic medications. Pharmaceutical companies would have an incentive to lower costs in order to supply the expanded public market. And I should point out that the high cost of new medications isn't all greed and isn't all do to wasteful marketing. It is very expensive to do the necessary studies to to ensure that medication is both safe and effective. Even after studies are done some rare side effects may only be evident when 1000's of individuals are treated. Companies will stop developing new medications if they can not get back the research and development costs not just for the successful medications but for the unsuccessful medications as well. I don't think we can or should stop pharmaceutical companies from developing new medications and I don't think we can or should use price controls. But I do know that no society can pay unlimited sums of money for expensive medication. So a hybrid system would be a compromise. A lot of very good medication would be available to everyone and only those who are wealthy or have insurance will have access to the rest. I would love to have everything available to everyone but I don't think it is possible if we still want to have schools, roads etc. I think I read that health care currently takes up 16 percent of our gross national product and health care costs are growing faster than inflation. Human beings like all living things die. Would it be worth giving up your child's access to higher education to extend your life a couple of days or weeks through using very expensive medication?