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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?


To: Lane3 who wrote (8701)8/26/2009 8:05:52 AM
From: Brumar891 Recommendation  Read Replies (1) | Respond to of 42652
 
We already have the government involved. I don't see how that can be stopped. We may escape Obamacare but we will continue to have Medicare and Medicaid.

I realize that too. At least we can stop a total takeover and preserve the 40-50% of our system which isn't government controlled.

You didn't answer my question, which was "are you just opposed to the whole notion that in a pooled funding environment decisions are made that the pool won't shell out $20K for an extra week of life?"

I will question whether thats the case, except when patients, doctors and families voluntarily agree to limit treatment as futile near apparent death. It certainly wasn't the case for Obama's grandmother because she got a hip operation and died two weeks later.

As I pointed out, we don't have clocks on us and so the folks who run any "pooled funding environment" can't reliably guage exactly how long someone has left.

I infer from your response, then, that you think that pooled payment systems should pay for whatever the doctor orders/bills.

Obama's grandmothers case suggests that is happening now. I know my cousin received expensive cancer treatment shortly before he died of pancreatic cancer a year + ago. No one said the outlook for pancreatic cancer is so bad we just won't bother to try.

Which means that there would be no controls on cost effectiveness.

Does it mean that? I think families, individuals and doctors make decisions not to pursue futile courses of action all the time.

Are you sure that's what you want? If he orders taxol for a cold, the insurance company or Medicare should pay?

Please lets not dream up extreme situations. No one is ordering taxol for a cold.

If he orders a hip replacement for someone circling the drain, Obamacare should pay? Really?

I would assume a doctor, patient and family would only order a hip replacement when they believe there is hope it would be worthwhile. I don't think anyone would go through an operation when they know or believe it would be a futile action. I think Obama's grandmother and he and presumably her doctors had hopes for her eventual recovery when she had her operation. I don't think anyone could have predicted that she'd die two weeks later. No, I don't think Obama's grandmother should have been denied a hip replacement if she, her doctors and her family thought she had hopes of recovery.

Or is it just bioethicist input your object to and economist input is welcome?

Neither "bioethicists" or economists should be involved in making health care decisions for people. Patients, families, and doctors should do that.

If you have "bioethicists" or economists, the only thing they'll be able to do is set down broad rules .... like no hip operations for anyone over XX. Because they can't make decisions for individual cases, they'll have to make decisions for broad classes of people.

And btw, I don't believe insurance companies are enforcing those sorts of rules ie. no hip operations for folks over XX now. The argument that rationing (which will always have to be based on broad rules of the sort I just used as an example - couldn't be done otherwise) by government is okay cause its being done now by insurance companies is imo not true.



To: Lane3 who wrote (8701)8/26/2009 11:12:37 AM
From: longnshort1 Recommendation  Respond to of 42652
 
Since the US spends more on education than any other country. With these results it's time for reform. Funny how the libs want to keep throwing money at Education but don't talk about wanting to throw money at health care, until they take total control of it. It's about power not the people.

SAT exam scores extend downward trend for '09

By Justin Pope ASSOCIATED PRESS | Wednesday, August 26, 2009

Through the early 1990s and early 2000s, average scores on the SAT college entrance exam moved steadily upward. Now, for the past five years, they've been drifting back down.

The reason? Unlike on the multiple-choice sections of the test, there's no one right answer. But a big factor is the larger, more diverse group of students taking the tests, combined with a widening scoring gap between the best-performing groups and those whose numbers are growing fastest.

Results released Tuesday show the high school class of 2009 earned a combined score of 1,509 on the three sections of the exam, down two points from last year. The average reading and writing scores dropped one point each, while math scores held steady.

Analysts caution against reading too much into the national average SAT score, given the test-taking pool changes over time and can vary widely among states. Still, the average score is now down nine points since 2006, when the writing section was first included and the test moved to a combined 2,400-point scale.

Math scores are higher over the past decade, but reading scores are four points below their 1999 level.

The College Board, which administers the exam, emphasized the growing diversity of SAT-takers. Minorities made up 40 percent of last year's group, and more than a quarter of the 1.5 million test-takers reported English was not their first language at home.

That's good news in that more students aspire to college, but it also weighs down the overall scores because, on average, students from most minority groups score lower.

The exception is Asian-Americans, whose average combined score surged 13 points to a combined 1,623, while scores for whites fell two points to 1,581. For black students, average scores dropped four points to 1,276. Average scores for two of the three categories the College Board uses for identifying Hispanics also declined, and overall ranged from 1,345 to 1,364.

Male students also widened their advantage over their female counterparts by three points; scoring 1,523 on average compared with 1,496. The difference comes mostly from math scores.

Students reporting their families earned more than $200,000 scored 1,702, up 26 points from a year ago. That group is comparatively small, but the sharp increase could fuel further criticism the exam favors students who can afford expensive test-prep tutoring.

The SAT remains the most common college entrance exam, though the rival ACT has nearly caught up in popularity. Most colleges accept either, and a growing minority no longer require either one.

Still, fewer than half of high school graduates take the three-hour, 45-minute SAT, and the group is tilted toward higher-achieving, college-bound students.

"I just don't think it's a good gauge of what's going on nationally," said Tom Loveless, senior fellow at the Brookings Institution, who said the SAT remains a useful tool, when combined with high school grade-point average, for evaluating whether individual students are prepared for college.

Analysts generally pay closer attention to the National Assessment of Educational Progress, because, unlike college entrance exams, it represents the entire population of students.

On those exams, K-12 black and Hispanic students have made bigger gains than whites since the 1970s. Since 2004, they've made improvements in reading and math at every level or age tested, but the achievement gap between minority and white students has remained wide because whites have also done better.

College Board officials don't attribute the widening SAT scoring gap directly to race but to factors that correlate with race, such as the likelihood of exposure to a rigorous high school curriculum. Students taking a core curriculum - including four years of English and three each of science, social science and history - scored 44-46 points higher on each section of the SAT.

"Our data suggest the gap is widening as academic preparation widens," said Wayne Camara, the College Board's vice president of research and development.



To: Lane3 who wrote (8701)8/26/2009 12:01:41 PM
From: Road Walker  Read Replies (1) | Respond to of 42652
 
Health Care Debate Based on Total Lack of Logic
Jeanna Bryner
Senior Writer
Wed Aug 26, 8:35 am ET

Heated partisan debate over President Obama's health care plan, erupting at town hall meetings and in the blogosphere, has more to do with our illogical thought processes than reality, sociologists are finding.

The problem: People on both sides of the political aisle often work backward from a firm conclusion to find supporting facts, rather than letting evidence inform their views.

The result: A survey out this week finds voters split strongly along party lines regarding their beliefs about key parts of the plan. Example: About 91 percent of Republicans think the proposal would increase wait times for surgeries and other health services, while only 37 percent of Democrats think so.

Irrational thinking

A totally rational person would lay out - and evaluate objectively - the pros and cons of a health care overhaul before choosing to support or oppose a plan. But we humans are not so rational, according to Steve Hoffman, a visiting professor of sociology at the University of Buffalo.

"People get deeply attached to their beliefs," Hoffman said. "We form emotional attachments that get wrapped up in our personal identity and sense of morality, irrespective of the facts of the matter."

And to keep our sense of personal and social identity, Hoffman said, we tend to use a backward type of reasoning in order to justify such beliefs.

Similarly, past research by Dolores Albarracin, a psychology professor at the University of Illinois at Urbana-Champaign, has shown in particular that people who are less confident in their beliefs are more reluctant than others to seek out opposing perspectives. So these people avoid counter evidence all together. The same could apply to the health care debate, Albarracin said.

"Even if you have free press, freedom of speech, it doesn't make people listen to all points of view," she said.

Just about everybody is vulnerable to the phenomenon of holding onto our beliefs even in the face of iron-clad evidence to the contrary, Hoffman said. Why? Because it's hard to do otherwise. "It's an amazing challenge to constantly break out the Nietzschean hammer and destroy your world view and belief system and evaluate others," Hoffman said.

Just the facts you need

Hoffman's idea is based on a study he and colleagues did of nearly 50 participants, who were all Republican and reported believing in the link between the Sept. 11, 2001 terrorist attacks and Saddam Hussein. Participants were given the mounting evidence that no link existed and then asked to justify their belief.

(The findings should apply to any political bent. "We're not making the claim that Democratic or liberal partisans don't do the same thing. They do," Hoffman said.)

All but one held onto the belief, using a variety of so-called motivated reasoning strategies. "Motivated reasoning is essentially starting with a conclusion you hope to reach and then selectively evaluating evidence in order to reach that conclusion," explained Hoffman's colleague, sociologist Andrew Perrin of the University of North Carolina, Chapel Hill.

For instance, some participants used a backward chain of reasoning in which the individual supported the decision to go to war and so assumed any evidence necessary to support that decision, including the link between 9/11 and Hussein.

"For these voters, the sheer fact that we were engaged in war led to a post-hoc search for a justification for that war," Hoffman said. "People were basically making up justifications for the fact that we were at war."

Their research is published in the most recent issue of the journal Sociological Inquiry.

Hot health care debate

The proposed health care plan has all the right ingredients for such wonky reasoning, the researchers say.

The issue is both complex (no single correct answer), emotionally charged and potentially history-changing, while debates often occur with like-minded peers in town hall settings. The result is staunch supporters and just-as-staunch critics who are sticking to their guns.

"The health care debate would be vulnerable to motivated reasoning, because it is, and has become, so highly emotionally and symbolically charged," Perrin said during a telephone interview, adding that images equating the plan with Nazi Germany illustrate the symbolic nature of the arguments.

In addition, the town hall settings make for even more rigid beliefs. That's because changing one's mind about a complex issue can rattle a person's sense of identity and sense of belonging within a community. If everyone around you is a neighbor or friend, you'd be less likely to change your opinion, the researchers say.

"In these one-shot town hall meetings, where you have an emotionally laden complex issue like health care, it's very likely you're going to get these ramped up emotionally laden debates. They're going to be hot debates," Hoffman told LiveScience.

Two-sided discussion

To bring the facts from both sides to the table, Hoffman suggests venues where a heterogeneous group of people can meet, those for and against the proposed health care system overhaul. And at least some of these gatherings should include just a handful of people. In groups of more than about six people, one or two members will tend to dominate the discussion, he said.

For either side, logical arguments might not be the key.

"I think strategically it's important that the Obama administration and advocates of a health care plan really pay attention to how people feel and the symbolism they are seeing, and not just the nuts and bolts of the policy," Perrin said. "People don't reason with pure facts and logic alone."