Understanding the US - Again

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Lilo
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Re: Understanding the US - Again

Postby Lilo » 16 Mar 2019 17:43


Singha
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Re: Understanding the US - Again

Postby Singha » 17 Mar 2019 13:06

https://freerepublic.com/focus/f-news/3735107/posts

more and more US cities stop recycling and just landfill or burn stuff due to cost and china declining.

---
goes to show the pahle aap & lawful myth of goradom is based on
- abundance of resources per capita
- someone else cleans the shit

if either or both break down, its back to their normal scheduled militant self serving meme which enabled them to "conquer new lands"

Karan M
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Re: Understanding the US - Again

Postby Karan M » 17 Mar 2019 14:34

The abundance of resources is mindblowing though. Our publics crazy produce 10x children logic even if unable to afford them is what is causing half of our problems.

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Re: Understanding the US - Again

Postby Zynda » 17 Mar 2019 17:53

Karan M wrote:Our publics crazy produce 10x children logic even if unable to afford them is what is causing half of our problems.

^10+

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Re: Understanding the US - Again

Postby abhik » 17 Mar 2019 21:23

https://www.aljazeera.com/news/2019/03/ ... 33901.html
The United States will revoke or deny visas to International Criminal Court (ICC) personnel seeking to investigate possible war crimes by US forces or allies in Afghanistan, Secretary of State Mike Pompeo has said.

"The ICC is attacking America's rule of law," Pompeo told reporters in Washington on Friday.

"I'm announcing a policy of US visa restrictions on those individuals directly responsible for any ICC investigation of US personnel.

Something to learn from.

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Re: Understanding the US - Again

Postby Primus » 18 Mar 2019 18:57

Suresh S wrote:
Vayutuvan wrote:
neurosurgeons make a million dolla PA while malpractice insurance premium is a mere 100k. let us cry a bucket for these "poor" folks.


This statement is completely wrong. the premium for malpractice in neurosurgery is close to half a million dollars per annum. Most neurosurgeons can not even practice independently . They have to get a job in a hospital to survive. I would not recommend anyone to get into this speciality.


Sigh......Suresh is absolutely correct.

So many people think they know but really do not. The healthcare system in the US is driven by three main engines in order of power and influence:

1. People's expectations: where anyone walking into an ER with a headache demands and gets a CT scan or an MRI, where a 100 yr old woman with dementia is kept alive on a ventilator with tube feedings going through a gastrostomy.

2. Malpractice laws: Where a pathologist is sued for 'causing death through negligence' when all she did was an autopsy on an already dead person and that too because she was 'on-call' for the hospital which employed her.

3. Fee for service: You come to see a physician with diarrhea, he charges you his usual and customary for taking care of your problem, but gets paid a fraction of it because that is the contracted rate with the insurance carrier. He has no options to change this - it is either take it or leave it. Fee for service is the standard of business in the world since time immemorial. It is the smallest of factors influencing healthcare.

All these are actual examples from my own experience. In the US you cannot change or stop any of these engines because of the intense lobbying on the part of the lawmakers themselves - who guess what, are all lawyers almost without exception and are heavily supported by their own trial-lawyer groups. The poor politician who tries to alter the system faces severe opposition and ridicule - as Hillary and Obama found out.

As for malpractice premiums, yes, neurosurgeons have among the highest load. OB/GYN in New York pays $150K. If you add an average cost of $100K for running the practice, he has to make $250K before taking any money home. I know so many physicians who have abandoned their practices and joined hospitals or other large organizations just to survive. Medicine is still a decent job but all things considered, a consultant in the UK is probably better off in many ways, not just economically than his counterpart in the US which is quite the reverse from what it used to be two decades ago.

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Re: Understanding the US - Again

Postby Mort Walker » 19 Mar 2019 01:57

^^^You could not be more wrong.

If it wasn’t for the rule of law and lawsuits, then public safety would have taken a backseat. Cars were very unsafe up to the 1970s when several lawsuits forced manufacturers to fix safety issues. The same can be said about any industry including medical care. In India and the developing world, life is cheap where many people die due to a lack of safety. It isn’t malice that causes this, but not having the rule of law where negligence has no consequences.

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Re: Understanding the US - Again

Postby Primus » 19 Mar 2019 03:07

^^

The same rule of law applies in the UK, Canada, Germany, Japan etc. There is no 'malpractice' of the kind there is in the US. The cost of providing healthcare is so much lower.

I know there have been so many debates on NPR and such, however, they conveniently brush aside the statistics that denote the health status of a given nation. In almost all aspects the US falls behind many EU nations and Japan in Infant mortality, maternal mortality, Life-expectancy etc.

Nobody is denying the value of laws that protect consumers or, in the case of healthcare, patients. But these laws are not what malpractice lawyers make money on. Negligence is so dependent upon whose version you believe, the jury or a coroner.

I worked in India and in UK for years before the US. I know the system is so different in each place. Without a close understanding of how malpractice affects healthcare in the US it would be difficult for anyone to compare. Let us leave it at that.

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Re: Understanding the US - Again

Postby Mort Walker » 19 Mar 2019 05:45

^^^The US spends the most and has the lowest health status of all the developed nations with the exception of cancer survival. Cost of procedures, treatment, medicine and hospitalization are the big culprits. The hidden insurance billing practices between hospitals and drug companies to insurance companies is a scam in the US.

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Re: Understanding the US - Again

Postby Primus » 19 Mar 2019 06:30

^^

There is a lot of spin about insurance/pharma/hospital scams. Yet, so many hospitals are barely surviving or depending on charities and donations. Physician practices are struggling, especially solo and small groups. As I said, there are many factors why the US spends the most on healthcare and yet has the lowest health parameters among the top industrialized nations. The main reasons I have outlined in my post earlier. We can debate this forever, but will cause a major thread drift. Suffice it to say you have to be a part of the system for many years before you can understand what is really going on.

The differences will be obvious if you were to compare the number of long term ventilated patients in the US vs Europe, or Compare the number of feeding gastrostomies placed in UK vs US, compare the number of patients hospitalized from 'long-stay' units for trivial urinary infections or pneumonias, compare the number of patients undergoing cardiac bypass surgery in their 80s, compare the number of patients receiving dialysis over age 80. The list is endless. In the UK, you will not get fem-pop bypass if you are an active smoker, while you would in the US. This stuff just goes on.

As I said, I've worked in both systems for years. I am deeply involved in the process, running a healthcare business myself. Don't want to get into details, and will not continue this further. I will let you have the last say if you wish, this argument is not worth my time.

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Re: Understanding the US - Again

Postby Mort Walker » 19 Mar 2019 09:47

^^^No problem Primus-ji. I'm all for letting people make money. The whole of America is a scam. At some point the system will break as US health care costs are getting out of hand even for people who are in the upper middle class when they get older. The calls for socialized medicine are getting louder and will see the push toward it after the next financial crisis.

It really is my fault and my wife's for going into the sciences as opposed to applying for medical college. Perhaps we just aren't smart enough.

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Re: Understanding the US - Again

Postby chetak » 19 Mar 2019 14:52

twitter

Must watch video:

Joint Chiefs Chairman says Google refuses to work with US military but provides “direct benefit” to China’s military



https://twitter.com/HawleyMO/status/1106247367177764865

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Re: Understanding the US - Again

Postby Primus » 19 Mar 2019 16:32

Mort Walker wrote:^^^No problem Primus-ji. I'm all for letting people make money. The whole of America is a scam. At some point the system will break as US health care costs are getting out of hand even for people who are in the upper middle class when they get older. The calls for socialized medicine are getting louder and will see the push toward it after the next financial crisis.

It really is my fault and my wife's for going into the sciences as opposed to applying for medical college. Perhaps we just aren't smart enough.


The bolded part I agree with completely. I've been saying this from the day I landed in the US, need a single payor system, with Crown (Federal) Indemnity. The entire system needs a major overhaul, but there are too many vested interests that prevent it from happening.

And don't be too hard on yourself, you took the road less traveled and given a choice to live my life again, I would do it too, money be damned.

ramana
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Re: Understanding the US - Again

Postby ramana » 20 Mar 2019 06:08

Wonderful statement. I chose to be an engineer and love my work.
Important thing is to do what you like.

Gus
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Re: Understanding the US - Again

Postby Gus » 20 Mar 2019 21:11

visa and GC people...stay clear of trouble

https://www.npr.org/2019/03/19/70495333 ... immigrants

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Re: Understanding the US - Again

Postby ramana » 21 Mar 2019 00:15

Yeah. As Orange seeks to make up with Eleven, his target will be desis.

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Re: Understanding the US - Again

Postby Zynda » 21 Mar 2019 14:24

Why are Americans falling back in love with SUVs & Trucks

ramana
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Re: Understanding the US - Again

Postby ramana » 21 Mar 2019 19:36

I think there is something wrong with Federal Reserve.
It looks like it was politicized after Bernanke left.

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Re: Understanding the US - Again

Postby saip » 21 Mar 2019 21:45

The Orange monkey threatened the Federal donkey and this time he obliged.

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Re: Understanding the US - Again

Postby disha » 21 Mar 2019 23:12

The fedonkey really messed it up last year. Inspite of tame inflation, jacked up the interest rate (to satisfy chorporates) and slowed down the economic growth into 2019. So now had to suck up its thumb and announce no more rate hikes till next year (or not even then), since the inflation is non-existent and growth has slowed down.

At this point, the fedonkey has lost complete credibility. They are totally clueless on what actually drives the economy!


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