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Scott--Pls do not misunderstand. I am not saying that our healthcare system is cost efficient. I am a believer that most anything we as humans do can be done less expensively and with equal effectiveness. Now, as for supporting my hypotheses, I put them out to be challenged. so far no one has. If bookkeeping here is more expensive, it leads one to ask why, no? With 140,000 different codes required by Medicare that could (!) be a small hint.
Do you feel up to trying a couple of answers? What is the cost saving and quality of life change through denying a transplant due to age, only? What is the cost savings and quality of life sacrifice by delaying artificial joint replacement for a couple of years? What is the cost savings if a portion of your patients leave the country for treatment? Life expectancy and infant mortality are both subject to easy manipulation. What is the life expectancy of Scandanavians in the US vs in their original homes? BTW I personally have experienced healthcare in multiple countries and had in depth conversations with natives in those countries, so I have more than a passing knowledge of comparative healthcare.
Scott--the third issue, think in terms of three orthogonal axes, is the quality of healthcare, and not measured by easily manipulated numbers like the health outcomes you mention above. Look at my questions to Dan and answer them for us. And, recall sometime above I was looking for an incomes statement for a typical medical practice, and opined at what would be found. So far no one has challenged my hypotheses with data. Cheers.
Dan--So, we can't ask you to support your assertions? Hmmm.
Cheers, have a good Sunday.
Dan-Pls tell us what constitutes an 'emergency' so you can get an MRI immediately in Canada. A hip replacement? Spinal surgery? Possibility of brain tumor? -Pls tell us how hip replacements are allocated in Canada, since you are a student of their system. Pls tell us the cut-off age for kidney transplants in Canada too. Pls tell us of all the 'innovations' in medical practices that have happened in Canada. Pls tell us about all of the Americans that are rushing to Canada and Europe for their 'emergency' healthcare. Pls tell us why, if 'universal' healthcare is such a great thing, that parallel systems are growing in Europe, that governments are running out of money to support their healthcare systems. Provide some facts rather than unsupported opinions and maybe you can get a dialog going.
Can anyone out there provide us with an Income Statement for a typical medical practice--a group of docs working together, sharing overheads, that sort of information? This shotgunning about MRI's and Tylenol, etc, is entertaining, but greatly distracting, avoiding what may be the real issues around health-care costs. I am going to put out a few hypotheses, that can be examined if we have an Income Statement. One, the overhead (bookkeeping, bill collecting, that sort of thing) for a typical medical practice is a significant piece of the cost. Two, medical malpractice insurance is another significant piece. Three, paying off medical school is another significant piece. Four, essentially immediate availability, even in a small town like SS, is another piece. For example, how long does it take to get an MRI in Canada. Here we can call one day and have it the next. Anyone help?
Steve--Yes, narrow, but not necessarily as you define it. What is left out, I think is the acknowledgement that we, in the US, are used to electricity availability somewhere in the eight 9's range, every day, every week, every month, every year, everywhere! As I understand, somewhat poorly, wind may have a 30% or so availability, on average. Thus, there is a giant question of just how much of a 30% supply we may wish to mix into an essentially 100% supply before unacceptable deleterious effects take place. The first way to look at this is to acknowledge the price of a very low quantity of a somewhat capriciously supplied utility may not be very important at all to the customer. It sure may be to the supplier of that capricious utility. A humorous example--it is relatively meaningless to you and me that the cost of water supplied to our homes may be zero, between the hours of midnight and 00:01 on alternate Sundays! Another way to look at the question would be to take a very large greenfield (grass-roots) electric power generation grid, and cost it as an essentially 100% reliable wind facility--in other words, sufficient capacity to allow for both windless times and maintenance, as well as power storage facilities, and the necessary grid. An example might be say half of China or India's planned coal generation capacity. This gives an upper bound, perhaps, on how much wind really costs. Then we can begin to answer the mix questions--in other words--acknowledge that there may well be a very significant amount of fossil fired electricity generated in the future. Right now, it seems to me what we are doing is saying, oh we can add some undefined percentage, and the available fossil facilities, etc. will take the swings. To an extent, wind gets a free ride.
Scott--OK, once more, only. Then the floor is yours, and I am positive you will use it. Surely you realize your argument that power contracts are a proxy for true costs is essentially tautological. And, given your regular advocacy for improved demographic analysis (requiring assumptions) and against the airline tax (requiring assumptions), your unwillingness to delve deeper into wind costs is unfathomable. Neither one of us know what is buried in those contracts, in their force majeure clauses, in their take or pay clauses, in their interruption of service clauses, continuation of subsidy clauses, maximum purchase clauses, etc, etc etc. Several years ago wind was largely a play on government credits and clever financing. I was interested to see just how much real costs may have been reduced. I thought that you would have had that answer. My error. And, again, have a good day.
Scott--Thank you. I will drop the issue with you since it is obvious to me, with this non-response that you are unwilling to acknowledge the real cost and thus the level of subsidization in wind energy production. As a result, you have caused someone, me, who was relatively open-minded about the progress wind energy may have made towards competitiveness with fossil fuels, to become very much more doubtful. Have a good day.
Scott says "at current pricing, renewables can be installed without seriously affecting utility rates."
Scott, I would be interested in seeing the calculations for the comment above. In particular the assumptions say for a 20 year life, and coal, natural gas and oil pricing for the same period. I assume you have something like that to base your comment upon. Thanks.
Scott F--Keep up the coffees and the ideas! It is one very good way for all to get a better sense of what this community is about! And the more they know the more they may want to participate.
Scott W--using your example of speeding, there is an inherent assumption that at either speed the driver is licensed and has the ability to control his / her vehicle in a responsible manner. Unfortunately, that is not true with respect to some dog owners. Even with dogs on leashes, parents of small children have reason to be concerned about their child's welfare.
All--And, the leash law is merely one subset of a more general issue, and that is respect for others. Dog ownership does not confer with it rights, but rather responsibilities. And the first is respect for others, their children, their property, their environment, their persons. Carrying this one step further, in addition to the normal positive respectful behaviors which are so evident around Steamboat Springs, such as the polite chats with folks you recognize in the markets and the polite acknowledgements on the Core Trail, there is also the avoidance of negative behaviors, such as cyclists blowing thru red lights or drivers blowing stop signs, or something as simple as leaving your cart for someone else to return in the market parking lot, that in part make SS, SS. Many locals have acknowledged to me how easy it is to distinguish a local from a visitor by just those negative behaviors, or lack of positive ones! So, in my rather uncomplicated mind, it's less about signs, and complex rules requiring added administration and more about teaching and encouraging respectful behaviors, from an early age. I believe, for this little town of ours, there is no reason to import the disrespectful behaviors so apparent on TV or in parts of our big cities!
Last login: Saturday, April 23, 2016
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