I was in the middle of doing something and scanned your piece quickly, planning to return later. So I didn't catch that. Sorry.

Why do we label some drugs prescription only? Because we don't believe the consumer has enough background to make informed choices about them.

I have a different idea, and it has to do with the AMA being the best union in the world. Despite this, I don't think you have made a case that prescription drugs should not be advertised. I like the restraint of saying," ask your doctor about Crestor."

The positives may be a more informed populace, although if the drugs are still prescription, I don't see how that changes anything - it's the doctor who needs to be informed.

This reminds me of two things. First, I always wince when reading business type things wherein they say that advertising is good because it informs people. I always thought that a little glib. On the other hand, and secondly, the trend in medicine is away from the doctor as authoritarian know-it-all to patient responsibility for their own care.

What you go on to say is true:

Expense of specialized procedures.

In my little town, the kindly but gruff town doctor provided all the medical care. He was his own social system. He took anything from nothing to chickens to $5 for an office call, $10 for a house call. But he charged the rich people in the big Victorian houses on the end of Main St. $75 for an office visit. In return, he might agree to see them that day for a minor illness that the rest of us might wait a day to see him for. And he was generally available for fundraisers they may have, or even a few social events. (btw, he never missed one funeral of a patient of his.)

But it was understood by all in town that the rich people in town had access to specialized care that others did not, mostly at the bleeding edge of research. Where the average person might be told that their cancer was not curable, one of the rich peopole might be able to buy their way into a new treatment being tried in Cleveland. No one resented this. It was just reality. That rich person probably had a Cadillac, while you were content with a five year old Ford.

Since, we have been infected by the crazy notion that everyone deserves the best care, something impossible. So, logically speaking, we now seek to make it fair by taking money out of it, and sort of having a lottery system. In a total socialized system, you and the rich guy would have equal chances of drawing the best or the worst doctor in the system. That seems to be an improvement in fairness, but it doesn't allow any longer for the rich to pay for new treatments which will eventually bleed down to the poor. In fact, that happened all the time when I was young. That rich person who went to Cleveland had a good result, and it soon became available at the nearest hospital. The lag was usually a few years.

Maybe we should socialize our system, but in order to keep our system generating new drugs and treatments, we should demand that other systems pay for the costs of our developments. American drug companies should no longer allow European countries to set the price of drugs; rather, it would be fair for all developed countries to pay the same for them. And that includes Canada.

Short thought is: there will always be discrepancies in the delivery of health care, and wishing will not make them go away. We have to be careful that our solutions to these discrepancies don't negatively effect pother goals of our health system.

Circumstances. Healthcare is, by its very nature, the thing we need when we're least in a position to pay for it.

That's the old cunundrum. I remember one of my teachers, 29 years old, in a funk one day because he was denied health coverage due to his having a congenital heart defect. (Underneath his eyes was always blue.)

Of course, the usual answer is to spread the risk through some social measure. In the 1800s, social organizations began having members pay into a health fund for the purpose of providing at least some care when it was needed by a member. Then some enterprising people formed what they called s"social organizations" which would sell the rights to such care to any citizen who would pay. Insurance companies were born, and they were often mutal companies, that is, owned by the premium payers.

What we realize after a century and a half is that no company can afford to insure all of its members against every medical happening. mental health is largely uncovered, and we are all psychiatrically indigent (and states have traditionally provided mental health care). We in Oregon tried to provide health care for the poor, and quickly found out that we couldn't afford it. So a lineup of procedures was made based on their seriousness, times the cost and the number of times they were likely to be needed, and at the point on the list where the state money for the program ran out, a line was drawn, and nothing below that line would be funded. (There was a little play, because right below the line was a procedure which saved lives, and the crap hit the fan.) But without the ability to make these hard decisions, no plan can work.l And the dreamers never want to talk about these hard decisions. What kills programs is the reluctance to ask "what can we afford" rather than just saying that we should fund everything.

As for the pre-approved ambulance, that is not a surprising story. it works that way. Usually it is because people abuse the system. I knew mental patient who arrived at the County hospital by ambulance about twice a week for no particular reason because her family happened to have generous insurance. But even they ended up paying for the ride most of the time. (Most of the time, the woman was lonely, and just wanted to talk to somebody. The crisis entry center would talk to her for a while, and then call her a cab.) One of the crisis centers I worked at almost went bankrupt from being stuck with ambulance bills! From the city fire department! We made a deal with the city that they could use our office building at night to train police dogs to settle the bills.

The point is to eliminate the middle man, being the for profit company with all the glitter of CEO stock options, private jets and millions per year in annual salary, pecking at the money you pay for your insurance which raises your health care costs.

A government service like the VA, for the public good and not for profit serving the people, including business. That doesn't mean money isn't changing hands, or that people aren't working, it means that the third rail is removed therefore costs go down. Cost incentives or bonuses for staying healthy would be a plus.

I haven't heard too many folks complain about the service they have gotten from the VA until it was underfunded by our current administration.

As I pointed out, my issue with Moore's claim is simply that he doesn't explain it - and it required a graph from another website to explain it to me.

Yeah, I see your point there.

Granted, if Moore's documentaries were loaded down with graphs, it's likely no one would watch them.

From what I understand, Gore did alright converting his slideshow to a movie.

HPV has a really nasty way of spreading throughout the population, and even if your daughter is engaging in 100% safe behavior, the lack of symptoms means it's far more widespread than most people think.

I did not know one could buy into Medicare except under certain conditions.

overall I favor a system like Medicare as it certainly is very EFFICIENT , everyone , esp doctors agree , IT WORKS.... and with computers and electronic records now we can make it even more efficient.
Once we shift the focus from trying to get out of covering a treatment ( current mode of HMO's ) to prevention and a universal system it will be so much easier .