Cancer in America Is Way Down, For the Wealthy Anyway (bloomberg.com) 240
The good news is that cancer in America was beaten back over the 25 years ending 2016, with death rates plummeting, particularly when it comes to the four most common types of the dreaded affliction. From a report: There's a caveat, however. Those gains have been reaped mostly by the well-off. While racial disparities have begun to narrow, the impact of limited access to treatment for the poorest Americans has increased wealth-based inequality, according to the American Cancer Society's annual update on trends and statistics. "Any time you have a disease as serious as cancer, when you have a substantial reduction in deaths, that's a notable achievement," said Len Lichtenfeld, the interim chief medical officer for the American Cancer Society. "But there are still a lot of areas for improvement."
Health insurance and access to care can be an issue in some poor and rural portions of the country, where there are higher death rates of colon, cervical and lung cancers, according to Cancer Statistics 2019. While poverty was actually associated with lower rates of cancer mortality prior to the 1980s, that trend has since reversed, due in part to changes in diet and smoking as well as screening and treatment rates, the health organization said.
Health insurance and access to care can be an issue in some poor and rural portions of the country, where there are higher death rates of colon, cervical and lung cancers, according to Cancer Statistics 2019. While poverty was actually associated with lower rates of cancer mortality prior to the 1980s, that trend has since reversed, due in part to changes in diet and smoking as well as screening and treatment rates, the health organization said.
True for all medical conditions (Score:5, Insightful)
Nuclear workers (Score:4, Interesting)
One group with low rates of cancers are people who work in the nuclear industry or on navy ships. They don't have shocking better healthcare plans than most middleclass folks so it may not just be wealth buying better health care. One guess is that by the nature of the work they are industrious people self selected to have otherwise healthy lifestyles but even studies trying to control for that still find lower cancer rates. Another possibility of course is that low level nuclear radiation is good for you. Since life evolved in a higher radiation level environment than today, it might not be shocking if multi-cellular animals figured out some way to differentially profit from radiation over their single cell parasites. But that's a stretch too. An even more likely hypothesis is apparently nuclear material environments actually are less toxic than others. That too would not be surprising since Nuclear is all about safety and avoiding accidents so hazards are controlled carefully. A final hypothesis remaining is that it's not that bad for you in low doses compared to the variability in life itself.
Re:Nuclear workers (Score:4, Insightful)
How about due to increased cancer tests and screening of the workers? Also wondering if cancer gets you reassigned out of that area. The radiation released (unless the is an accident) is lower than natural sources so I don't think it is possible this is a direct result of radiation.
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Not sure what you are saying, but man can easily make a far more radioactive object than a natural object, including a similar-sized piece of the sun.
The reason the workers are exposed to less radiation is because of the shielding put around the reactor (overkill for normal operation as it is supposed to protect things in case of an accident), plus the fact that they are inside a building or ship and thus also shielded from more natural sources.
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One group with low rates of cancers are people who work in the nuclear industry or on navy ships. ... Another possibility of course is that low level nuclear radiation is good for you.
I wouldn't assume that the level of ongoing, background, exposure to radiation is higher for nuclear workers than the general population. Nuclear workers are in an environment where nuclear exposure is carefully monitored and minimized, while the general population is, or has been, wandering around radiation-blind and unmoni
It's probably just cleaner air (Score:2)
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Or maybe they don't get much radiation and the job is otherwise low-risk for cancer.
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You may have meant it as a joke, but it is shocking that people get better medical care because they are richer. Better "pampering" - not shocking; better actual medicine - shocking.
But then, the viciousness of US capitalism is shocking in general.
Re:True for all medical conditions (Score:5, Funny)
I am shocked that people with money get better services.
I'm planning on starting a meth lab in a camper if I get cancer so that I can afford the better services.
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Well you should be.
Yes the rich will always get better service. However as medical advancements improve the poorer should be getting the trickle down of these services, and we should see their rate to be proportionally better as well.
But the problem is Medicaid rates are imposed to be extremely low, roughly 1/3 what people are with insurances are paying. Where the government thinks they are being tough negotiators on Medicaid prices, they are actually just pushing the buck to us who are paying for insuran
inmates get better medical then poor diabetes is b (Score:2)
inmates get better medical then poor people. If you have diabetes and the GOP cuts off medicaid you may be better off in jail vs only having the ER.
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The summary is misleading. Cancer incidence and mortality rates the world over have dropped pretty dramatically. In the US, they've dropped in the rich AND the poor. They've dropped more in the rich. From the report:
https://wol-prod-cdn.literatum... [literatumonline.com]
Some of the difference is undoubtedly due to access to cutting edge care, but most of it (the report emphasizes this repeatedly, as does the article) is due to public health issues: primarily diet, exercise and smoking.
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Sure, there's a difference: almost all low income families in industrialized nations can afford food and some sort of housing (sometimes they receive assistance to provide those day-to-day needs, even in
Re:True for all medical conditions (Score:5, Informative)
But will you actually get any care? I thought that to keep it affordable, you only get treatment if you meet certain criteria.
You thought wrong.
In other words, if you're 90 years old, no heart transplant for you, no matter how healthy you may otherwise be.
Guess what? No heart transplant for 90 year olds in the US either. The eligibility criteria for getting on the transplant list would exclude an otherwise-healthy 90 year old.
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While I suppose it is hypothetically possible for a 90 year old to get a heart transplant, at least in any Western country, getting that heart would require breaking laws.
As to "free care", no it isn't free. It costs a good deal of money, but if the OECD data is any indication, Canada is spending less per capita for health care than the US, and is getting better results, at least if longevity is the metric. I dunno, maybe the US's sick and impoverished are happier than Canada's.
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Re:True for all medical conditions (Score:5, Informative)
You've bought the anti-"socialized" medicine story. Most metrics, from longevity down, suggest that countries with modern health care systems (ranging from mostly public ones like in the UK and Canada, to the mostly private systems in Switzerland and Singapore) provide better care at a cheaper cost than does the US system.
In public systems care is prioritized by need. You generally have to wait for elective procedures, unless they would resolve a problem related to mobility or employment, but you don't have to wait for emergency or time-sensitive problems (broken bones, fast growing cancer). There's also fairly little medical tourism to the US. If you want to pay, you can find a private clinic in Canada that will do the job, still cheaper than an American one would.
Interestingly, mostly private systems ALSO seem to be more efficient than the US system, so it's not as simple as a public versus private system.
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A substantial amount of the medical service in the northern part of the U.S. is provided to Canadians, paying out-of-pocket in order to get treatment in a timely fashion or to U.S. standards. So even with Canadians the rich get better treatment. (They just don't get it in Canada.)
That's an excellent point.
The rich in countries with socialized medicine either have their own private pay tier (so literally their own special rich tier of health care), or if that isn't allowed they fly to other countries where it is.
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My wife broke her ankle last year, and the care was both timely, and at no cost. Just like in Canada.
What good is "free" medical care if you can't get a broken bone set for a week, or progress from testing to treatment on a rapid cancer until the cancer has progressed to be beyond treatment?
None of those things happen to those of us who have proper socialised healthcare. If you need treatment, you get it.
Do we have to worry about "co-pays" or "deductables" or paying an ambulance $5,000? No.
Your healthcare system is the worst of all possible worlds.
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Seriously though, I will remind you that the same thing happens with private insurance. A person who has cancer twice will never pay back the full amount of the treatment. The money from that doesn't come from the insurance company.
Equality (Score:3, Insightful)
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Social Darwinists rejoice! (Score:2)
Slowing winning the battle to misunderstand and misapply basic science into a political philosophy... because it fits the belief in a meritocracy measured by wealth, which happens to largely be generational. We have to keep maintaining the status quo, can't destabilize those with the wealth.
Never mind the evolved tribalism and social skills that were proven successful, lets literally act like Neanderthals despite that their nuclear family approach led them to extinction despite larger brains.
Rationing he
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Re:Equality (Score:5, Interesting)
And highly trained medical staff shouldn't be forced into slavery, to take care of every health issue for people who can't or won't pay anything for it.
If only there was some other entity that would pay those medical staff. You know, like the single-payer system in virtually every other developed country. Then it wouldn't be slavery.
Honestly, I'm tired of people going on, constantly, about equality in America, as though it's something we're obligated to try to achieve, or even a worthy goal?
Inequality is inefficient. You don't get the "best and brightest", you get the richest and most-connected. And >90% of the time, those rich people got their wealth from their parents, so they're not actually good at anything.
For example, Trump. His dad made a crapload of money in NY real estate, because he was good at it. Trump has lost enormous amounts of money in NY real estate because he isn't any good at it. That's why he was on a TV show instead of doing more real estate.
it's really all about giving people a framework of opportunities to better THEMSELVES, if they wish to make the effort.
What you fail to understand is the effort to benefit from that framework is not equal. The wealthy give their children many advantages that put them ahead within that framework. Again, this means we get massive inefficiency because the person didn't actually make the effort, mom and dad bought their place. So they don't know what the hell they are doing and go bankrupt running a casino. Twice.
Between doctors and dentists who willingly volunteer some of their time to provide these services
The last Doctors without Borders event in the US had a line about 3x longer than they could serve. Many were turned away. Charity will not get this done.
Also, did ya notice the irony of bemoaning "medical professionals working for free" at the start of your post, and "medical professionals working for free" as your preferred solution?
Finally, Medicaid doesn't cover an enormous swath of uninsured people, thanks to Republicans blocking Medicare expansion from the ACA. Which means they don't get any insurance coverage and thus no medical treatment beyond Emergency Rooms.....which means you are paying a shitload more money in insurance premiums and taxes because the poor can't get preventative care.
Single-payer is much cheaper than our current system. You would save a hell of a lot of money. Your taxes would go up, but your insurance premiums would disappear. Netting you a lot more in each paycheck. I don't know about you, but I really don't care if the deduction on my paycheck is labeled "Cigna premium" or labeled "Medicare". But some of those people might not suffer enough for your liking.
Cancer treatment is HUGELY expensive, though - to the point where many insurance policies even put a "cap" on the amount they'll spend for it over your lifetime
Nope. One of the things the ACA eliminated was lifetime caps.
You can't just demand America provide the "best care possible" to everybody
Sure we can. Every other developed nation pulls it off. Are you saying we can't do what the Canadians can?
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Don't worry, the highly trained medical staff are doing okay. I do medical research. I have more training than the vast majority of physicians. They make a LOT more money.
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What's interesting is that when clamoring for rules to impose upon "the rich" you use examples like trump.
But when it comes to implementing the rules, you re-define "the rich" to mean folks barely into the middle class.
Alternatively, you're pulling this out of your ass since I supplied exactly zero numbers.
And I don't want what the Canadians have imposed on me.
Don't worry, you're free to pay your own way in Canada. You'd be an idiot and paying way more for crappier service, but you can feel all rugged while doing it.
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Class warfare for nerds (Score:2, Interesting)
I suppose "Cancer death rates plummeting" might not have generated quite as many clicks.
Come on, editors. You're better than this.
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I suppose "Cancer death rates plummeting" might not have generated quite as many clicks.
Come on, editors. You're better than this.
They are?
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They are. Here's the graph from the actual report that breaks it down by rich and poor:
https://wol-prod-cdn.literatum... [literatumonline.com]
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Like automobiles, cell phones, and other things once considered luxury items for the wealthy, new forms of treatment will become more affordable and more available over time.
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Is this a good thing? (Score:2)
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Also, increased cancer screening doesn't reduce cancer as the summary incorrectly states. Increased screening increases cancer cases on statistics, because a non-zero segment of the population will be found to have cancer but die of other causes. If it weren't found, it would never have showed up in the statistics.
It reduces deaths from cancer, which is a different thing altogether than reducing cancer, as the summary incorrectly assumes was meant.
Anyhow, if we live long enough, all of us will get cancer
Cancer going away for wealthy soon (Score:5, Interesting)
I have a friend who works in oncology (he is a surgeon). He basically said that immunotherapy is incredible, and within 5 years he believes that those with enough money will be treated for many types of cancer by customised immunotherapy. They will go in every two weeks and a team will adjust the therapy based on the cancer's response until the cancer is gone. Add to this the work being done on early detection, and cancer could soon become nothing more than a strain on your bank account.
Everyone else will continue to get cut, burn and poison. Having said that, this is how the economy has always progressed, and in 20 years when patents have run out and the treatments have become more mature, we can all look forward to this sort of thing.
Certainly an exciting time to be alive.
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I have a friend who works in oncology (he is a surgeon). He basically said that immunotherapy is incredible, and within 5 years he believes that those with enough money will be treated for many types of cancer by customised immunotherapy. They will go in every two weeks and a team will adjust the therapy based on the cancer's response until the cancer is gone. Add to this the work being done on early detection, and cancer could soon become nothing more than a strain on your bank account.
Everyone else will continue to get cut, burn and poison. Having said that, this is how the economy has always progressed, and in 20 years when patents have run out and the treatments have become more mature, we can all look forward to this sort of thing.
Certainly an exciting time to be alive.
It's certainly an exciting time to be alive if you're rich.
Seems you forgot that rather important caveat, which is hard to believe since your entire post was centered around the fact that cancer could be reduced to "nothing more" than a $500,000 expense in the near future. Needless to say, those who can't afford that will die, which is still the overwhelming majority of humans.
And customized immunotherapy will most likely be designed so treatments will never end. If you can afford treatments, you can aff
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At least it (is about to) exist, so that's better than nothing. Costs will get wrung out, insurance rates go up to pay for it and so on.
The choice isn't between new expensive treatments and new cheap trestments. It's between new expensive treatments and no, or greatly delayed treatments.
As with the latest iPhone, so too, medicine. You want this to drag into existence new wonders, both for medicine and consumer electronics (and everything else) and as rapidly as possible. This swamps all other considerat
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Your whine is how do we roll it out to everybody. Murdering the profit motive murders yourself.
Murder? I wonder if you are you aware that medical error kills almost as many Americans every year as tobacco does. The very industry who purports to save lives should not also be one of Americas leading causes of death, and yet it is. Pretty sad when you have to weigh the risks of entering a hospital against whatever malady is driving you there. Are cancer treatments more about saving lives or making money? Since you or I cannot easily answer that question, you know why we should question motive.
Regar
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And you seem to have missed the part where, when the rich have paid for the R&D, the treatment comes off patent and is available to the majority of the population.
I fail to see your point here. At all. You and I both know the total cost of eradicating cancer in a human far exceeds any argument related to patents expiring on drugs, which is akin to being handed a 10% off coupon on your cancer bill.
And when medical error ends up killing as many Americans as cigarettes do, I question the actual value of R&D no matter who is paying for it.
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I fail to see your point here. At all.
OK, let me try to make an analogy.
The first commercially-available computer was the UNIVAC I [wikipedia.org] priced at $159,000 in 1951 ($1.5M 2018 dollars). Compare that cost to the computer you're using now. ANY new technology starts prohibitively high-cost and decreases as the state of the art improves, or patents expire, or competition increases.
It's a shame that cancer treatments are so expensive, and it's a shame that the costs aren't decreasing more quickly, but that's how it is.
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I fail to see your point here. At all.
OK, let me try to make an analogy.
The first commercially-available computer was the UNIVAC I [wikipedia.org] priced at $159,000 in 1951 ($1.5M 2018 dollars). Compare that cost to the computer you're using now. ANY new technology starts prohibitively high-cost and decreases as the state of the art improves, or patents expire, or competition increases.
It's a shame that cancer treatments are so expensive, and it's a shame that the costs aren't decreasing more quickly, but that's how it is.
Your analogy is invalid for one very obvious reason; the price of treating cancer is not going to decrease to any reasonable level that still doesn't amount to financial death for 99.999% of humans. Ever. You know this, and so do I. This is also the reason we'll never cure cancer.
And competition is not the goal; eradicating it via patents is. Sure patents will eventually expire, but your insurance company isn't going to support those "old" patent-expired treatments anymore, because the Cancer Industrial
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Someone has to create these drugs and they are not doing it out of charity.
On the flip side, someone is also profiting from selling the many causes of cancer, but oddly I don't see much research going into eradicating that.
We've gone from trying to cure cancer to now marketing cancer as some kind of human inevitability. Cancer existed in 1 out of 100 humans a century ago. Yes, I understand advancements in cancer research and detection has obviously affected that statistic, but it's now down to 1 in 3, and we blindly accept this, and pour trillions into the Cancer Industrial Comp
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Immunotherapy is incredible. Someday in the not too distant future you will go into the hospital for treatment, they'll create an antibody tailored to kill whatever is causing the problem (cancer, out of whack immune cells, whatever) and you'll be fixed. It's currently hideously expensive, far too expensive for even billionaires to afford that kind of personalized care, but improved design techniques are likely to make it much cheaper. You-could-do-it-in-your-garage kind of cheap.
Deaths, not cancer (Score:3)
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No, it's not. Because cancer incidence and mortality rates are way down. In an absolute sense, in everybody, rich and poor. Everything else is quibbling about whether this line is down *more* than that line.
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I'm always unsure of the stat of improvement for this reason; Cancer "survival" is measured as years after detection of the disease. So if you have earlier detection -- you have a longer survival rate. The REAL stat we need is; at what age do people die, on average, from Cancer? If the rich and poor die on average about the same age that they always have, that tells you that we've progressed on early detection, and have done bupkiss for Cancer. Having less access to get a diagnosis and an expensive placebo
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And we now know why so many rural folk are dying of cancer.
Predominantly because rural folk get older than in the past, and with age comes cancer.
Smoking is also down for the wealthy (Score:3)
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You're right. And this is a key reason why minorities and the lowest 25% of incomes are dying more of cancer: incidence in the poor of cancer is much higher.
Yes, cancer detection and treatment is better as income increases, but this effect is smaller than you might think. The poor are exposed to so many cancer risk factors, from smoking, ambient air exposure, excessively processed foods, etc, so the baseline risk is significantly higher even before you get to any difference in treatment.
This cartoon intro explains why (Score:2)
Full Episodes
https://www.youtube.com/watch?... [youtube.com]
Factors other than healthcare access (Score:2)
In addition to less access to healthcare, I suspect that people in lower-income groups have additional risk factors. Blue-collar workers and the casually employed are probably more likely to be exposed to higher levels of carcinogens in their workplaces. I would guess that they also, on the average, eat a higher percentage of processed foods such as nitrate-laden meats. And I bet they're less likely to have the same kind of access to fresh fruits and vegetables. Plus, quality and level of education are a fa
Don't Forget The "Stupidity" Correlation (Score:2)
wealthy? well off? lolz (Score:2)
You mean normal people who took responsibility for their own life and are educated and have normal job live longer, instead of being a parasite on someone else.
not about being "rich"....
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I am an asshole (Score:3)
Two points make a line (Score:2)
Steve Jobs and Paul Allen.
I recall an episode of 60 Minutes about 5 years ago where Leslie Stahl said that they stopped doing cancer cure breakthrough stories for a while, because inevitably the hype wouldn't pan out. But the story they were doing on day was extraordinary (something about using gold nano particles and then heating them using a CAT scan) so they broke their own rule and went nuts on the telecast. Of course that also didn't pan out....
Cancer cure, AI, autonomous driving...things that are a
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Canada has private insurance (Score:2)
Canada allows people to enter the private market for health insurance because they found it was against human rights to force people to only have a government option.
The rich are always better off. Trying to make life more difficult for them just compounds on those who don't have the money.
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Re:How dare those well-off do better! (Score:4, Interesting)
Wow, you have got to be kidding me! Canada? Yup, they have it right. Just like my friends Grandma who was told by the very same Canadian health care system: Yes you have cancer, but according to the Canadian government you're too old to start treatments. Here is a bunch of pain pills. Please go home and die, and that is just what she did.
Oh it's the evil insurance companies... wait it's the evil doctors making all the money, uh it's the evil.... Government. In Canada the one stop shop for your medical needs. Can't blame anyone else.
Yes this is a true story. You should see my friend deliver it. You would be a bit bitter too if this is how your Grandma was treated.
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And where did the government get this guideline from?
Actuaries, most likely.
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That was probably the best option, irrespective of cost. Treatment for cancer may in some cases provide only a very short increase in lifetime (and in some cases, no increase), while destroying quality of life.
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My mother is a medical doctor and when her mother had cancer at the age of 89, my mother actually advised her to get pallative care instead of surgery and chemo. Well, my grandmother decided to start treatments and died within a few months in pain and in a hospital, not at home.
So yes, I wish my grandmother was told by our health care system to go die at home.
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You always have rationing of supplies when people are competing for limited resources. The only question that remains is how to determine who receive
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A) Every time I have gone to the hospital (including life threatening issues) I have never been turned away and I have been seen in a timely manner, and
B) I haven't gone bankrupt because of it
Yes ACA got rid of lifetime caps or their ability to penalize for pre-existing conditions, blah blah blah. But for how long? The long and short of it is that these companies are blood thirsty sharks and will continue to lobby for these rules to be lifted. Their solitary goal i
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"Better" is difficult to quantify, and each side is better in some situations.
The healthcare equivalent to a Canadian Girlfriend (Score:2)
My mom died of Lung cancer. The treatment didn't stop the cancer, but it did make her last 4 years of life hell. Doctors have gotten a lot better at understanding what treatments are worthwhile. Me? I have no intention of going through that if I'm ever diagnosed.
Here's a more benign example: My
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Venezuela? Nah. Sweden. Germany. France. Austria. That's more like it.
I know Venezuela is the poster child for "socialism" for the "I got mine, screw you" crowd, but from over here you look like some sort of one-joke clown.
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Why do you insist that we only look at the failure implementation of ideas, and not look at successes, especially as the successes are better aligned with the size and wealth of America?
Look at John Doe, who went bankrupt because he bought a Testla. So if you buy a Testla you will go bankrupt.
Well John Doe, had other expenses, and didn't make the salary that would allow him to buy a Testla,
while Jane Doe, has a higher salary and less expenses, so the Testla is a better fit for her, and the saving on gas co
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Tell me again why I'd want that system over here in Europe? Seriously, your healthcare system sucks and blows at the same time. When I need medical treatment, I go to a doctor or hospital because I KNOW that it's covered.
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I must have missed that being part of the unalienable rights part in the declaration of independence.
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What does the Declaration of Independence have to do with anything?
The Universal Declaration of Human Rights, article 25 states: "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services."
It's ironic that this part, which in large parts was drafted by Eleanor Roosevelt, is so blatantly disregarded by a single western country, the United States of America.
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Yeah, the US ain't what they used to be.
Ya know, when I was young, the US was THE country. Anything and everything came there first. If you wanted to know where the world is heading, look over there. Anything you'll have in 10 years, they already do.
Today it's more something we look at if we need to feel better about ourselves, since, well, we might not be doing too well anymore, but at least we're not the US.
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Wasn't Obamacare taken back by the current administration?
Re:Not possible (Score:5, Informative)
we had to pass the bill to see what was in it
The bill was available and debated for almost a year.
Obamacare fixed all of this
The way the ACA would have fixed this particular problem is Medicaid expansion. Which Republicans sued over. And are blocking in every state they can.
Why do they lie?
Why do you?
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Lie of the year [politifact.com] was claims by Obama on the ACA. All news outlets agreed.
Yet, here we have someone 5 years later still telling us it was the truth.
Hey look! You're lying again.
The "lie of the year" was a mistake by Obama. He left out "and if your insurance company wants to continue issuing the insurance". All those people who couldn't keep their plan? Their insurance company ended the plan.
But if you actually look at your own link, that "lie of the year" has nothing to do with how long the bill was available or debated. Which is what you lied about in your previous post.
Liberals are currently encouraging the death of 300 US citizens a DAY due to drugs coming from Mexico
You mean by the 4000 terrorists who actually turned out to be 6 people?
Also,
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I hope it wasn't someone who one would usually take serious when they say bullshit like that.
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Yes, it's well known that the poor have ample money to pay for high-priced "alternative" medicine out of pocket.
Oh wait.....
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"Alternative" quackery needn't be expensive. You can make a shitload of money by selling bleach, just sell a few milliliters for 10s of dollars (where you buy a few gallons for 5 bucks) and you're set.
You don't have to sell for a lot if you can sell a lot. All that matters is that you yourself pay pennies for what you sell for dollars.
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Then don't buy celery ... buy frozen pees, frozen broccoli, dried lentils etc in bulk. Supplement with fresh if it's affordable, or don't, there's enough variety without it.
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lies and B.S. Stop spreading nonsense. I take it you don't cook or shop for food.
You are shopping at the wrong store if celery was $4, more than 3 times what you can get that (lousy choice for nutrition anyway).
The very cheapest food can be homemade. Processed crap is more expensive.
Those of us who cook and provide for families know these things.