HDTenEightyP/NetNews huggingface dataset:
From: rkaplan@netcom.com (Richard Kaplan)
Subject: Re: Medical Insurance and Cost Efficency
Organization: Netcom - Online Communication Services  (408 241-9760 guest) 
Date: Sat, 21 Nov 1992 04:53:21 GMT

In article <By1qJp.FII@acsu.buffalo.edu> v128pvry@ubvmsb.cc.buffalo.edu
 (Christophe A Stoner) writes:

>The only way to stop the skyrocketing
>costs of Medical Insurance, in my opinion, is to drastically reduce the 
>number of those in need of major medical attention. Only when we have
>become more aware of general health in this country can we expect
>to reduce medical expendeture.

There is a good deal of truth to what you say, particularly
regarding expensive procedures for elderly, terminally ill patients.
However, it would be difficult if not impossible to "drastically
reduce the number of those in need of major medical attention";
no matter how advanced medicine gets, we will all die one
day.  All medicine can do is delay this death or perhaps alter
the cause of death.

On the other hand, increased funding for primary care and
preventive medicine might very well reduce medical costs
significantly by catching, relatively early, non-life threatening
but nonetheless serious and preventable/treatable 
illnesses.

-- 
Richard Kaplan M.D.           Medical Software Exchange BBS
806 2nd St. SW # 104          (507) 281-1989 14,400 HST
Rochester, MN  55902          (507) 281-1689 Voice
PP-ASEL-IA     N4VRB          rkaplan@mayo.edu|netcom.netcom.com  
Newsgroups: talk.politics.medicine
From: bill@ixcim.att.com (Bill Duncan)
Subject: Re: Truth in Labeling and Herbal Remedies
Originator: news@cbnewsf.cb.att.com
Organization: AT&T
Date: Tue, 17 Nov 1992 14:04:13 GMT


In article <1992Nov17.071925.4102@ucsu.Colorado.EDU>, dalton@spot.Colorado.EDU (lizard man) writes:
|> 
|> 
|> 
|> So what's the scoop? Are traditional medicines, herbal remedies,
|> megavitamins, Sleepytime (tm) Tea and nutritional supplements 
|> still legal to use in America? How long do we have?

I'd like to hear what's happening on this also.

How far are they going to take it? I mean even things like
prunes and traditional spices and herbs have medicinal qualities.

Bill
-- 
+----------------------------------------------------+
| Bill Duncan                        AT&T Bell Labs  |
| bill@ixcim.att.com                 Naperville IL   |
+----------------------------------------------------+
Newsgroups: talk.politics.medicine
From: rkaplan@netcom.com (Richard Kaplan)
Subject: Re: health care industry woes
Organization: Netcom - Online Communication Services  (408 241-9760 guest) 
Distribution: usa
Date: Fri, 20 Nov 1992 03:39:25 GMT

In article <1992Nov19.104730.24485@genie.slhs.udel.edu>
 starr@genie.slhs.udel.edu (Tim Starr) writes:

>The best thing to do to the AMA would be to repeal medical licensure laws,
>opening up this cartel to competition.

Liberalization of licensure laws will create many pseudo-scientific
practitioners who will want a piece of the Medicaid/Medicare
budget.  It will in no way reduce medical prices or improve
quality of care.

>When medicine is conducted on the free-market, unlike now in the US,
>there are incentives for cost-effectiveness, as profits depend upon it.

There I agree 100%.  There are currently significant financial
DISINCENTIVES to cost-effective medicine.  To start, Medicare
not only screens doctors for overcharging above their predetermined
fees, but also they screen for UNDERcharging, stating the doctors
who have attempted to do so were trying to create a monopoly in 
their area!

When Medicare insists on paying all doctors in the area the
same fee for a given service, a tremendously inefficient
economic market is created, regardless of whether the fee
itself is too high or too low.  And most doctors I know
(myself included) are FAR, FAR more upset with the 
BUREACRACY required in dealing with Medicare than with
the actual dollar amounts involved.

Add to all this the medicolegal/defensive medicine arguments
discussed previously..... The standard for medical malpractice
is defined ex post facto (this would not be allowed in 
criminal court).  When I see a patient I can order
any tests I feel necessary; if I feel a test is safe
but unnecessary medically, I have no way of knowing what
some lawyer is going to dream up years from now.  So 
do I order the extra (marginally necessary) test for
legal reasons, or do I not order it and take my chances
later?

Realize that the standard for malpractice is doing
something different from what the "average" doctor
in the community would do.  So if my above-average
reading of the medical literature indicates that a
CT scan is not necessary and therefore I do not
order one, what happens if 5 years later the patient
comes down with an UNRELATED tumor?  Some fancy
lawyer will bring in some doctor in the community
who will testify that he would have ordered the
CT scan years ago and this cancer would have been 
detected and cured...... Medical nonsense, but
the jury doesn't understand.  They just see a deep
pocket who could have saved someone's life if only
he had taken the time to order a simple x-ray
like some other doctor would have done.

-- 
Richard Kaplan M.D.           Medical Software Exchange BBS
806 2nd St. SW # 104          (507) 281-1989 14,400 HST
Rochester, MN  55902          (507) 281-1689 Voice
PP-ASEL-IA     N4VRB          rkaplan@mayo.edu|netcom.netcom.com  
Newsgroups: talk.politics.medicine
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: Canadian Health Insurance (was: health care industry woes)
Organization: UDel, School of Life & Health Sciences
Distribution: usa
Date: Sun, 22 Nov 1992 06:48:15 GMT

In article <1992Nov21.223424.8996@news.columbia.edu> gld@cunixb.cc.columbia.edu (Gary L Dare) writes:
}starr@genie.slhs.udel.edu (Tim Starr) writes:
}>gld@cunixb.cc.columbia.edu (Gary L Dare) writes:
}>}Canada has a public health insurance system ("PHI" in Americanese)
}>}funding private doctors, and public and private hospitals.
}>
}>This "public" bit contradicts your claim that Canada has separation
}>of medical service delivery and State.
}
}Getting around the "just one drop/just one penny" aspect for a moment,
}is this better? (-;

What are you talking about?  I meant the public hospitals.  You said that
Canada didn't have them.  Then you said they do.  Which is it?

}we never had Prohibition in Canada, by the way).

Never had alcohol prohibition, that is.

}The need for insurance grew in all countries with progress, and that
}is why we have the situation that we have now.

The need didn't grow, the demand did.  There's a difference.  I need a
motorcycle, a beautiful masseuse, a hot tub, etc., but I can't afford them.

Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Voltaire
From: roth@math.washington.edu (John Roth)
Newsgroups: talk.politics.medicine
Subject: Re: health care industry woes
Date: 20 Nov 92 19:45:12 GMT
Organization: "University of Washington, Mathematics, Seattle"

In article <1992Nov19.105115.24695@genie.slhs.udel.edu> Tim Starr writes:

>In article <1992Nov17.210153.27422@u.washington.edu> 
>roth@math.washington.edu (John Roth) writes:
>}Those who say we need more GP's must put forward some acceptable alternative
>}to fee-for-service.  And sell this alternative to providers, payers and those 
>}who believe doctors are not to be trusted.  Anyone seen such a proposal?

>Why must we provide this?  Why must we have the government mandate a one-
>size-fits-all policy for medical pricing?  Why not leave it up to the parties
>to the contract, the providers, payers, etc.?  What business is it of the
>government's to meddle with this?

Leaving pricing to the parties involved is an alternative.  Mind you, I don't 
have particular philosophical affection for government involvement in the 
health insurance business.  But it has happened, and were not going to 
our collective mind, so let's make it work.

However, Libertarianism is an already tried-and-failed philosophy of health
care in general.  I'm not saying there is at all a plain need for governement
insurance, but there is an obvious need for licensing of physicians and 
regulation of drugs and treatments.  Medical fraud is widespread now, it is at 
least avoidable by carefully choosing a liscenced physician.  One can be sure 
that prescribed drugs are proved safe and effective.  There is no alternative 
to government standards for medical practice, except to educate everyone as a 
physician.

John Roth
roth@math.washington.edu
Newsgroups: talk.politics.medicine
From: roth@math.washington.edu (John Roth)
Subject: RE: Medical Insurance and Cost Efficency
Organization: "University of Washington, Mathematics, Seattle"
Date: Mon, 23 Nov 1992 07:38:38 GMT

Chris Stoner writes <By1qJp.FII@acsu.buffalo.edu> 
>In this contry we must come up with a 
>modified health plan which is prevenative rather than corrective in 
>an attempt to stem the increase in medical expenses. If we could prevent the
>renal, cardiac and liver dysorder we would not have to spend hundreds of 
>man(or women) hours chasing down viable organs and hundred of thousands
>on operating equipment and drugs.  The only way to stop the skyrocketing
>costs of Medical Insurance, in my opinion, is to drasticly redure the 
>number of those in need of major medical attention. Only when we have
>become more aware of general health in this country can we expect
>to reduce medical expendeture.

Two points:
1) The techonology exists to solve the renal/cardiac/liver disorder 
(I think you mys-spelled it) problem in the large: ban tobacco and
alcohol.  And don't say prohibition failed, because from a public health 
standpoint it was a success, and it was also never really implemented.

2) Is there any evidence that preventative medicine reduces medical costs?
I am not asking if there's evidence that taking care of yourself improves
your health or longevity-- I don't doubt that.  But it's not at all clear 
to me that you save money this way.  It *maybe* money better spent, but it's 
comparable money.  I wouldn't be surprised if it's more money, even.
People will still get sick, still need bypass operations and transplants,
still get cancer, even if they live longer healthier lives.  Nor is 
preventative care cheap.

A related point: are there any successful large scale preventative medicine
plans?  I'm skeptical that you can get Americans to cooperate.

I'm afraid the only way to "drasticly redure the number of those in need of 
major medical attention" is to kill them while they're healthy. ;)

John Roth
roth@math.washington.edu
Newsgroups: talk.politics.medicine
From: hack@arabia.uucp (Edmund Hack)
Subject: Re: health care industry woes
Organization: Lockheed ESC, Houston
Date: Tue, 17 Nov 1992 22:59:10 GMT

In article <1992Nov17.210153.27422@u.washington.edu> roth@math.washington.edu (John Roth) writes:
>The reason that medicine has gone in the specialized, assembly line direction
>is because government insisted on paying on a fee-for-service basis.  A general
>practitioner can not bill insurance (particulary government plans) for
>the time it takes to discuss or reasearch a patients problem.  One can only
>bill for performing a procedure.

Absolutely.  This is part of the Gordian knot that is holding up health
care reforms.
>
>Why did the government choose this policy?  To protect against fraud.  One
>must ask if the savings was worth the cost.  I doubt it.

I have seen figures that show that most fraud prevention programs are
a real joke.  The insurance companies have large computer systems, but
really don't know how to "mine" their databases for knowledge to be used
for fraud prevention.
>
>Those who say we need more GP's must put forward some acceptable alternative
>to fee-for-service.  And sell this alternative to providers, payers and those 
>who believe doctors are not to be trusted.  Anyone seen such a proposal?

One proposal that is being implemented by Medicare/Medicaid is called a
relative value guide: Each type of procedure and office visit is
assigned a number of "points".  A bill is calculated by multiplying the
number of points by a dollar amount that is based on the office
or place of service zip code.  The problem is that while the HCFA
promised that it would be "revenue neutral", they slipped in a 10% cut
in payments to doctors.  This has organized medicine really POed, as
they cooperated with the studies in order to get a fair and balanced
system in place.  In general, specialists got rate cuts and primary care
docs got fee increases.

Other parts of the knot: oversupply and undersupply of doctors,
malpractice insurance problems, defensive medicine (due to malpractice
concerns), absurd paperwork problems, etc.


-- 
Edmund Hack - Lockheed Engineering & Sciences Co. - Houston, TX
hack@aio.jsc.nasa.gov - I speak only for myself, unless blah, blah..
Newsgroups: talk.politics.medicine
From: starr@genie.slhs.udel.edu (Tim Starr)
Subject: Re: Medical Insurance and Cost Efficency
Organization: UDel, School of Life & Health Sciences
Date: Sat, 21 Nov 1992 12:56:30 GMT

In article <By1qJp.FII@acsu.buffalo.edu> v128pvry@ubvmsb.cc.buffalo.edu (Christophe A Stoner) writes:
}The only way to stop the skyrocketing
}costs of Medical Insurance, in my opinion, is to drasticly redure the 
}number of those in need of major medical attention. Only when we have
}become more aware of general health in this country can we expect
}to reduce medical expendeture.

I wouldn't contest the claim that an ounce of prevention is worth a pound of
cure, but I don't think that the fastest-rising area of health care costs in
the USA is what you cite, but rather administrative costs, which Milton
Friedman (probably among others) has correlated with Medicare/Medicaid.  It
follows Gammon's Law, that government involvement tends to increase the
amount of paperwork too much (as I mangle it in paraphrase).

I also see sings of greater awareness of general health, yet our costs are
still skyrocketing.


Tim Starr - Renaissance Now! - Think Universally, Act Selfishly
starr@genie.slhs.udel.edu

"True greatness consists in the use of a powerful understanding to enlighten
oneself and others." - Voltaire
From: v128pvry@ubvmsd.cc.buffalo.edu (Christophe A Stoner)
Newsgroups: talk.politics.medicine
Subject: Re: What's the state of the art in computer simulation?
Summary: Biological System Complexity.
Date: 23 Nov 92 21:15:00 GMT
Organization: University at Buffalo
News-Software: VAX/VMS VNEWS 1.41


> Herman Rubin writes: 
>I doubt that we will ever be able to completely eliminate testing on
>live subjects, and not even on human subjects.  Computers can help far
>more than Mr. Stoner believes; there are times that they are good enough
>for many purposes even though they might not be able to simulate the 
>biological functions.  We were doing a fairly good job of predicting
>weather before the present quite poor simulations of global weather
>became possible in real time, and we are still doing it more-or-less
>the old-fashioned way.
> 
>There are other things which computers can do, but artificial intelligence
>is not likely to be reached in the foreseeable future.
>-- 

I am sure that computers can do amazing things, I've seen some of them
and read of others, but they are limited by the knowlage of the individual
who programs it. Predicting weather behavior is possible because of this is
a reaccuring phenomanon. There is data which can be analyzed for patterns 
and theories on weather behavior can than be made. With a biological
system the computer can help to analyze data but to make a complete 
model of a cell is impossible. Many scientists spend their entire lives
analyzing why certain reactions occure in the living cell and others do not.
The fact is that no matter how well programmed a computer is it can no more
understand the intricate workings of the body then we can. It's like asking
a biologist what a new drug will do just by giving him the name of it.

Computers are a fascinating field and they can greatly improve the testing
and analyzing of drugs but they can not, in the near future, replace the
painstaking research of scientist in the field.

		-Chris Stoner
From: timi@mendel.berkeley.edu ( Tim Ikeda)
Newsgroups: talk.politics.animals
Subject: Re: steaming lobsters
Date: 19 Nov 92 20:29:23 GMT
Organization: /etc/organization
NNTP-Posting-Host: mendel.berkeley.edu

From: welchb@woods.ulowell.edu
>1) Is this a normal way of preparing lobsters?
>
>2) I am thinking of protesting to the management (the store is part of a
>fairly large chain).  Any suggestions on how to do it, other than
>simply write a letter to customer service?


#1 - Yes. Both boiling and steaming are commons ways to prepare
     crustaceans.  Steaming can be much faster (higher temperatures).
     Some people, like myself, kill lobster first by lancing the "brain"
     with a pick.  This stops the thrashing and in the case of crabs,
     reduces the chances that a claw will come off during cooking.

     BTW - Lobsters are part of the phylum Arthropoda, which also includes
     insects, arachnids (spiders) and crustaceans.  I personally do not
     consider the boiling of lobsters to be particularly cruel especially
     with respect to the ways in which pesticides (synthetic, "organic"
     or "natural" - which wipe out billions of insects, but slowly)
     work. (Others will disagree - and I can respect their sensitivities.)

#2 - A letter is fine. Get lots of signatures. Stage a picket.
     In addition to the lobsters, why not protest the produce in the
     adjacent meat counter, as well as the fish, clams, mussels, 
     natural sponges, caviar  and shrimp (processed or otherwise)?
     Consistancy gets more respect.


BY NO MEANS SET FIRE TO THE GROCERY STORE IN PROTEST!!!!

Ted Robinson would approve of having you arrested for such an act
but would reserve ethical judgement for future generations.  I would
consider the arson both unlawful and unethical even before you did it.
<Swood> would probably shoot you in the act.

<grin> - An inside joke and probably not funny for everyone.

Regards, 
Tim Ikeda
Newsgroups: talk.politics.animals
From: russ@wpg.com (Russell Lawrence)
Subject: Re: animals in research
Organization: WP Group
Distribution: usa
Date: Tue, 17 Nov 1992 01:07:37 GMT

From article <1992Nov9.223222.10233@athena.cs.uga.edu>, by hulsey@athena.cs.uga.edu (Martin Hulsey):
mh> When I exchanged "letters to the editor" with Barnard in our 
mh> local newspaper (The Athens Observer 4/2/92), he said that John 
mh> Orem's research had "nothing of clinical value," and was "macabre 
mh> and useless." I replied (ibid., 4/16/92) that Barnard was not 
mh> qualified to make such judgements against Orem, because his 
mh> publication record (two papers in Medline since 1986 when I last 
mh> checked) would not qualify him for a position at a second-rate 
mh> university, much less at UGA.  I never heard back from him or 
mh> PCRM's lawyer.  What I said was true, and therefore not libelous.  

I would agree that such a record of publication might not qualify 
a person for a position at a second-rate university.  On the 
other hand, it certainly wouldn't disqualify him/her for a 
position at a top-rate university.  The ivy league institution 
that I occasionally call "alma mater" has, for the past twenty 
years or so, been turning it's back on the cretinous notion that 
a thinker's qualifications can be judged by the sheer number of 
his publications.  

BTW, I'd strongly recommend _Betrayers of the Truth: Fraud and 
Deceit in the Halls of Science_, by William Broad and Nicholas 
Wade, which explores the role that the "publish or perish" 
mentality has played in cheapening scientific exploration and 
scientific honesty in the United States.  

> ...
mh> I already told you what sort of research I would allow.  Why 
mh> can't you return the favor?  All you have indicated was that you 
mh> would like to review proposed experiments on a case-by-case 
mh> basis.  Did you mean that you wanted to review every experiment 
mh> personally, or did you just want them reviewed by someone?  How 
mh> would you modify the _status quo_ to simultaneously protect the 
mh> interests of human and non-human animals?  Would failing to 
mh> perform a critical experiment be worse than performing one that 
mh> proved trivial?  How do we determine, in advance, which 
mh> experiments are critical and which are trivial?  

PCRM member, Henry Heimlich, appeared on a recent episode of _The 
Nature of Things_, to discuss his fervent opposition to a 
proposed animal research project in the early 1980's, wherein a 
prospective researcher wished to study the use of the Heimlich 
maneuver on drowning victims by deliberate drowning 42 healthy 
beagles.  Heimlich pointed out that the efficacy of the famous 
maneuver bearing his name had already been demonstrated on 
drowned humans and that the deliberate drowning of dogs would 
have been useless.  The project was eventually cancelled, thanks 
to public pressure as well as Heimlich's opposition.  Was 
Heimlich qualified to make such an assessment?  

-- 
Russell Lawrence, WP Group, New Orleans (504) 443-5000
russ@wpg.com   uunet!wpg!russ
Newsgroups: talk.politics.animals
From: russ@wpg.com (Russell Lawrence)
Subject: Re: Anti-AR movie goers - Please read
Organization: WP Group
Distribution: usa
Date: Tue, 17 Nov 1992 21:11:15 GMT

From article <swood.722017047@vela>, by swood@vela.acs.oakland.edu (Scott Wood - EVENSONG):
sw> Oh no - here we go again.  And I suppose that you feel that your 
sw> arguements on my private views of Jane Fonda's involvement in 
sw> Vietnam as well as the tangents you have spun it off into on 
sw> historical debate of the conflict relate to animals-rights 
sw> discussions?  

I realize that you don't think non-human animals should be 
allowed to live their lives without the fear created by human 
technology.  How about dark-skinned human animals on the other 
side of the world?  Should they have the right to adopt religions 
and economic systems of their own choosing?  Or do they need 
"right-thinking" folks like you to dictate the conduct of their 
lives?  

> Yeah right...

Right.

-- 
Russell Lawrence, WP Group, New Orleans (504) 443-5000
russ@wpg.com   uunet!wpg!russ
Newsgroups: talk.politics.animals