On 1/10/2024 4:40 PM, John B. wrote:

<snip>

> I believe U.S. death certificates are standard see
> https://www.cdc.gov/nchs/data/dvs/death11-03final-acc.pdf
> Read Section 32 -" Immediate cause"

Deaths due to Covid were significantly under-reported, both in the U.S.
and the rest of the world.

For example, in the Americas, the reported Covid deaths in 2020 were 0.9
million, but the excess mortality rate was between 1.34 million and 1.46
million. Those additional 0.44-0.56 million deaths were almost certainly
due to Covid since there is no other explanation for them.

--
“If you are not an expert on a subject, then your opinions about it
really do matter less than the opinions of experts. It's not
indoctrination nor elitism. It's just that you don't know as much as
they do about the subject.”—Tin Foil Awards

On 1/10/2024 6:14 PM, John B. wrote:
> On Wed, 10 Jan 2024 10:57:41 -0800, sms <scharf.steven@geemail.com>
> wrote:
>
>> On 1/10/2024 4:45 AM, Zen Cycle wrote:
>>> On 1/10/2024 4:46 AM, floriduh dumbass wrote:
>>
>> <snip>
>>
>>>> Seems to me that the majority of people who want taxpayer funded
>>>> health care simply want other people to pay for their health care.
>>>
>>> So I'm guessing you never signed up for medicare?
>>
>> And of course the lack of national health care means that taxpayers
>> still end up paying for those without insurance, only they end up paying
>> a lot more than they would otherwise pay since the health care for the
>> uninsured is delivered in the least cost-effective manner.
>>
>> In 1986, Ronald Reagan signed a law that requires hospitals to treat
>> poor people and undocumented immigrants: "the Emergency Medical
>> Treatment and Active Labor Act requires hospitals to treat patients in
>> need of emergency care regardless of their ability to pay, citizenship
>> or even legal status. It applies to any hospital that takes Medicare
>> funds, which is virtually every hospital in the country."
>>
>> But the cost of not having national health care go beyond the high cost
>> of treating uninsured people. At some point, it became the expectation
>> that employers in the U.S. should be the source of health insurance for
>> their workers. This led to the export of many living wage jobs to
>> countries where there is national health care.
>
> I'm not sure whether the results are measurable but here as the cost
> to see the doctor is only 30 baht, less then 1 hour's pay at minimum
> salary rates , it seem that the average bloke goes to the doctor when
> he feels a bit under the weather rather then wait until he is so sick
> that he has to be carried in on a stretcher.
> I can't quantify it but logically it must be easier to cure a chap
> with a slight cough then when it becomes full scale Pneumonia.
>

You've worked in labor/materials/equipment systems. With
the buildings and equipment, supplies, utilities,
maintenance, cleaners, assistants etc the actual cost is
greater than 30 baht (which as you note above doesn't even
cover a doctor's wage).
--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/10/2024 6:23 PM, zen cycle wrote:
> On 1/10/2024 6:33 PM, floriduh dumbass wrote:
>> On Wed, 10 Jan 2024 17:01:30 -0600, AMuzi
>> <am@yellowjersey.org> wrote:
>>
>>> I think we all understand the concept and its limits.
>>
>> Some still seem confused about it.
>
> Yes, you are, as is proven by
>
>>
>>> I'm more on the side of the grammar nazis on this one; I was
>>> inexact in my composition earlier.
>>
>> Like I said, I prefer to say "Correlation does not prove
>> or imply
>> causation," but I have no problem with "Correlation is not
>> causation."
>
> "Correlation does not prove or imply causation" is in no way
> equivalent to "Correlation is not causation" except in the
> mind of a willfully ignorant floriduh dumbass
>
>

I admitted to sloppy my composition, which started this.

Both of you might lighten up:
https://tylervigen.com/spurious-correlations
--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/10/2024 6:40 PM, John B. wrote:
> On Wed, 10 Jan 2024 19:13:59 -0500, Catrike Ryder
> <Soloman@old.bikers.org> wrote:
>
>> On Thu, 11 Jan 2024 07:01:20 +0700, John B. <slocombjb@gmail.com>
>> wrote:
>>
>>> On Wed, 10 Jan 2024 11:53:04 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> On 1/10/2024 9:54 AM, Catrike Ryder wrote:
>>>>> On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>> wrote:
>>>>>
>>>>>> On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>
>>>>>>> On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>> wrote:
>>>>>>>
>>>>>>>> On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>
>>>>>>>>> On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>> wrote:
>>>>>>>>>
>>>>>>>>>> On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>
>>>>>>>>>>> On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>> wrote:
>>>>>>>>>>>
>>>>>>>>>>>> On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>> On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>> On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>> Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>> are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>> publicly funded health care.
>>>>>>>>>>>>>
>>>>>>>>>>>>>
>>>>>>>>>>>>> Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>> health care simply want other people to pay for their health care.
>>>>>>>>>>>>
>>>>>>>>>>>> I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>> example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>> to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>
>>>>>>>>>>> https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>
>>>>>>>>>> No., disregarding any government interference US prescription drug
>>>>>>>>>> prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>> prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>
>>>>>>>>>> I didn't post a reference but you can easily find one.
>>>>>>>>>>
>>>>>>>> Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>> their medicines through international biding managed by the government
>>>>>>>>>> and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>> government, hospital medicine costs are extremely low.
>>>>>>>>>
>>>>>>>>> Government negotiations (interference) is why drug prices in some
>>>>>>>>> countries are lower.
>>>>>>>>
>>>>>>>> The government here supports more then 900 hospitals and obtains most
>>>>>>>> medicines through bids from international companies. When you are
>>>>>>>> buying in large quantity prices do go down.
>>>>>>>>
>>>>>>>> How is that "interference"?
>>>>>>>
>>>>>>>
>>>>>>> Governments have coersive power.
>>>>>>
>>>>>> And what is that supposed to mean? That the U.S. government somehow
>>>>>> causes medicine prices in the U.SA. to be so much higher then in other
>>>>>> countries?
>>>>>
>>>>> No, that other governments cause medicine prices to be lower in their
>>>>> countries.
>>>>
>>>> As with other economic interventions, for someone to win,
>>>> someone else has to lose. The actual cost of development
>>>> (highly skilled and highly compensated staff, in expensive
>>>> facilities, with regulatory oversight, over often a decade
>>>> or more, with no guarantee of results for any given product)
>>>> has to be borne somewhere and if not Thailand then it will
>>>> be here. Failing a middling ROI, capital will flow to other
>>>> industries which explains the lack of Thai breakthrough
>>>> drugs. (actual manufacture of drugs is another system,
>>>> often outsourced, and not significant to development cost in
>>>> most cases.)
>>>>
>>>> No different from artificially high union wages- that system
>>>> only works with plenty of non-union labor.
>>>
>>> I'm not sure what you are saying but the larger government hospitals
>>> here are "teaching hospitals" and it isn't unusual when you are
>>> examined by the doctor to have a number of students present to watch.
>>>
>>> As for breakthrugh drugs? I can only comment that the Thai deaths due
>>> to Covid were 493/1 million pop. while the U.S. was 3559/1 million.
>>
>>
>> Well, perhaps in Thailand, they only counted the deaths that were
>> actually caused by Covid instead of any death of a person who had
>> Covid.
>
> I don't know and I can only go by what I read -
> some 1,165,118 in the U.S.
> https://covid.cdc.gov/covid-data-tracker/#datatracker-home
> Or maybe Deaths - 1,104,000
> https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/
> or
> Total Deaths - 1,191,564
> https://www.worldometers.info/coronavirus/country/us/
> or
> Deaths - 1,123,836
> https://coronavirus.jhu.edu/region/united-states
> or
> 1,137,641
> https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/
>
> I believe U.S. death certificates are standard see
> https://www.cdc.gov/nchs/data/dvs/death11-03final-acc.pdf
> Read Section 32 -" Immediate cause"

On 1/10/2024 6:55 PM, John B. wrote:
> On Wed, 10 Jan 2024 16:59:59 -0600, AMuzi <am@yellowjersey.org> wrote:
>
>> On 1/10/2024 4:30 PM, John B. wrote:
>>> On Wed, 10 Jan 2024 11:56:57 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> On 1/10/2024 11:07 AM, Frank Krygowski wrote:
>>>>> On 1/10/2024 9:34 AM, AMuzi wrote:
>>>>> > On 1/9/2024 9:21 PM, Frank Krygowski wrote:
>>>>> >> On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>> >>>
>>>>> >>> I'm not dismissing your suffering but many people have
>>>>> unreasonable
>>>>> >>> expectations.  Our modern medical arts are very good at
>>>>> setting
>>>>> >>> broken bones and repairing wounds etc. Obesity (and
>>>>> subsequent
>>>>> >>> degradation) is well beyond their purview.
>>>>> >>>
>>>>> >>> There's a big difference between removing an inflamed
>>>>> appendix and
>>>>> >>> promptly, correctly diagnosing appendicitis. My brother
>>>>> the doc has a
>>>>> >>> pet peeve about that; internists who see a lot of them
>>>>> are very good
>>>>> >>> diagnosticians but your average MD is more often wrong
>>>>> than right on
>>>>> >>> an appendix.
>>>>> >>>
>>>>> >>> Short answer= it's complex. Medical services comprise a
>>>>> world of
>>>>> >>> variables and most decisions are made under uncertainty
>>>>> at best.
>>>>> >>> People expect more than is actually possible.
>>>>> >>
>>>>> >> Yes, it's complex. But the data indicates that these
>>>>> complex problems
>>>>> >> are solved more accurately and far less expensively in
>>>>> nations with
>>>>> >> publicly funded health care.
>>>>> >>
>>>>> >
>>>>> > That's unclear.
>>>>>
>>>>> Not to those with less bias.
>>>>>
>>>>> > Correlation is not causation and our US culture shows
>>>>> > decidedly unhealthy aspects for some significant number
>>>>> (perhaps a
>>>>> > majority).
>>>>>
>>>>> "Correlation is not causation" is being taken to extremes in
>>>>> this forum. It's become shorthand for "I don't like all the
>>>>> available data, so I'm going to pretend there's hidden magic
>>>>> at work."
>>>>>
>>>>> You appear to be claiming that Americans are unique in
>>>>> choosing unhealthy behavior. But smoking, drinking and fatty
>>>>> foods are much more common in Europe than in the U.S. Yet
>>>>> European health care results are way better than ours, at
>>>>> far lower costs.
>>>>>
>>>>> If you have studies that prove America's bad habits are the
>>>>> real reason, you should post links.
>>>>>
>>>>
>>>> Peruse population-level death rates of obesity, diabetes,
>>>> heart disease, violence and ODs. We're special.
>>>
>>> Well, as far as obesity, etc., you are certainly correct as the most
>>> noticeable thing about U.S. tourists is that they are FAT!.
>>>
>>> But as for diet I wonder. Growing up in a small New England village I
>>> don't remember anyone that was fat and have always attributed it to
>>> the fact that people walked. I walked a mile to school from the age of
>>> 6. There was a school bus but it didn't stop for anyone who lived 1
>>> mile or less from the school. My father usually, weather depending,
>>> walked to work, about a mile, and so did the other men in the town.
>>>
>>> And yes most families had a car but that was for church on Sunday and
>>> maybe a Sunday afternoon drive with the wife and kids.
>>> Why would want to waste gasoline just to get to work? It was only a 20
>>> minute or so walk.
>>
>> The set of 'people who ride bicycles and discuss them on
>> RBT' may not be representative of all US citizens.
>>
>> Then again 'morbid obesity' doesn't describe all US citizens
>> either, Mr Christie, Mr Pritzger and FatCon attendees
>> notwithstanding.
>
> Yes, of course, but the fact remains that as a whole the U.S. tourists
> I see here are FAT and I read that "more than two-thirds of U.S.
> adults in the United States are overweight or have obesity."

Again I say, we RBT denizens are a distinct small minority!
--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/10/2024 8:55 PM, AMuzi wrote:
> On 1/10/2024 6:23 PM, zen cycle wrote:
>> On 1/10/2024 6:33 PM, floriduh dumbass wrote:
>>> On Wed, 10 Jan 2024 17:01:30 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> I think we all understand the concept and its limits.
>>>
>>> Some still seem confused about it.
>>
>> Yes, you are, as is proven by
>>
>>>
>>>> I'm more on the side of the grammar nazis on this one; I was
>>>> inexact in my composition earlier.
>>>
>>> Like I said, I prefer to say "Correlation does not prove or imply
>>> causation," but I have no problem with "Correlation is not causation."
>>
>> "Correlation does not prove or imply causation" is in no way
>> equivalent to "Correlation is not causation" except in the mind of a
>> willfully ignorant floriduh dumbass
>>
>>
>
> I admitted to sloppy my composition, which started this.
>
> Both of you might lighten up:
> https://tylervigen.com/spurious-correlations

Lightening up is fine; and that website (seen many times before) is fun.

But the Florida tricycle rider hauls that statement out every time he's
confronted with evidence that his views are nonsense. He's using it as
an anti-intellectual crutch, one step away from "Nothing can be known."

--
- Frank Krygowski

On 1/10/2024 6:04 PM, AMuzi wrote:
> On 1/10/2024 4:40 PM, John B. wrote:
>> On Wed, 10 Jan 2024 08:47:42 -0600, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 1/10/2024 6:36 AM, John B. wrote:
>>>>
>>>> Well, I'm not a leftist but my Housekeeper tells me that her total
>>>> cost for 9 visits to the doctor during her pregnancy and 3 days in the
>>>> hospital giving birth cost her a total of 300 baht - at today's
>>>> exchange rate is $8.57 and less then one day's salary at minimum
>>>> salary rates :-)
>>>
>>> Either her MDs are earning 2c per hour or someone else is
>>> bearing the cost.
>>
>> No the government hospital employees work for the national government
>> just as do school teachers, police, military, etc, and receive a
>> salary and retirement when they get old.
>
> Nine pregnancy/delivery hospital visits cannot possibly cost the
> provider $8.57, not even with slavery or robots.
>
> I conclude the price reflects some other source of revenue than your
> housekeeper.

Of course! That point has been covered. John said the employees work for
the government. Their employment costs are spread over the population of
the nation.

It's not that different from the fact that my wife's last ER visit would
have cost us a fortune, but it was paid for almost entirely by our
insurance. The cost was effectively spread over the population of
policyholders.

A main difference between the two cases is this: If my wife's visit had
been in Thailand, the total cost would have been much, much lower, no
matter who paid. Our system is very inefficient.

As an example, which I think I described in detail before: A few years
ago my wife had a routine annual physical, had blood drawn for routine
tests, and the tests were done by some laboratory. It was an annual
insurance benefit, no cost to us.

Except this time I got a big bill from the laboratory. What the hell? I
got on the phone to the doctor's office, then the insurance company,
then the laboratory. The fault was miscommunication involving the
insurance company, whose representative swore the laboratory had not
submitted paperwork. In the long 3 way phone call (me, insurance, lab)
the lab person described multiple tries of submitting by various
methods, usual and unusual. It took two long rounds of phone
conversations before the insurance guy said that OK, he'd found the
records.

All that was professional time, and therefore money, wasted. Any
reasonable estimate of hourly salary - with me "working" on this for
free - means this mess added at least a hundred dollars of expense to a
perfectly routine event.

Our system is very inefficient.

--
- Frank Krygowski

On 1/10/2024 8:51 PM, AMuzi wrote:
> On 1/10/2024 6:14 PM, John B. wrote:
>> On Wed, 10 Jan 2024 10:57:41 -0800, sms <scharf.steven@geemail.com>
>>
>> I'm not sure whether the results are measurable but here as the cost
>> to see the doctor is only 30 baht, less then 1 hour's pay at minimum
>> salary rates , it seem that the average bloke goes to the doctor when
>> he feels a bit under the weather rather then wait until he is so sick
>> that he has to be carried in on a stretcher.
>> I can't quantify it but logically it must be easier to cure a chap
>> with a slight cough then when it becomes full scale Pneumonia.
>
> You've worked in labor/materials/equipment systems.  With the buildings
> and equipment, supplies, utilities, maintenance, cleaners, assistants
> etc the actual cost is greater than 30 baht (which as you note above
> doesn't even cover a doctor's wage).

From a statement I just chose at random regarding one family member here:

Totals for 2022

Amount providers have billed the plan: $8,116.62

Amount the plan has approved: $2642.01

Plan's share: $2415.63

Your share: $334.13

Of course my $334 did not pay for the building and equipment, supplies,
utilities, etc. etc. etc.

Do we really need to explain this in detail?

--
- Frank Krygowski

On Wed, 10 Jan 2024 17:04:24 -0600, AMuzi <am@yellowjersey.org> wrote:

>On 1/10/2024 4:40 PM, John B. wrote:
>> On Wed, 10 Jan 2024 08:47:42 -0600, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 1/10/2024 6:36 AM, John B. wrote:
>>>> On Wed, 10 Jan 2024 12:44:04 +0100, Rolf Mantel
>>>> <news@hartig-mantel.de> wrote:
>>>>
>>>>> Am 10.01.2024 um 10:45 schrieb Catrike Ryder:
>>>>>> On Tue, 9 Jan 2024 22:15:09 -0500, Frank Krygowski
>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>
>>>>>>> On 1/9/2024 1:20 PM, AMuzi wrote:
>>>>>>>> On 1/9/2024 11:06 AM, Catrike Ryder wrote:
>>>>>>>>> On Tue, 9 Jan 2024 11:34:02 -0500, Frank Krygowski
>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>
>>>>>>>>>>
>>>>>>>>>> That's still not an argument in favor of the hyper-inefficient U.S.
>>>>>>>>>> system of health care.
>>>>>>>>>
>>>>>>>>> I've never had any efficiency problems with my health care. Actually,
>>>>>>>>> I've never had ANY problems with my health care.
>>>>>>>>
>>>>>>>> Resolving medical problems is often more effective by avoiding the
>>>>>>>> 'health services' racket.
>>>>>>>
>>>>>>> ... for some value of "often."
>>>>>>>
>>>>>>> U.S. health data is dismal compared with similar countries that have
>>>>>>> publicly funded health care, which is really all similar countries.
>>>>>>> Perhaps part of the reason is that in the U.S. people avoid health
>>>>>>> services because of cost.
>>>>>>>
>>>>>>> People in other countries have far less reason to avoid medical
>>>>>>> treatment. They are much healthier on average than Americans, and they
>>>>>>> spend much less on their health care. Articles documenting this are
>>>>>>> trivially easy to find.
>>>>>>
>>>>>> Easy to find...
>>>>>> ...by looking for leftist propaganda sites...
>>>>>
>>>>> It's a fool's best strategy to claim that all sources of unpleasant
>>>>> information are dodgy.
>>>>>
>>>>> don't look up!
>>>>
>>>> Well, I'm not a leftist but my Housekeeper tells me that her total
>>>> cost for 9 visits to the doctor during her pregnancy and 3 days in the
>>>> hospital giving birth cost her a total of 300 baht - at today's
>>>> exchange rate is $8.57 and less then one day's salary at minimum
>>>> salary rates :-)
>>>
>>> Either her MDs are earning 2c per hour or someone else is
>>> bearing the cost.
>>
>> No the government hospital employees work for the national government
>> just as do school teachers, police, military, etc, and receive a
>> salary and retirement when they get old.
>
>Nine pregnancy/delivery hospital visits cannot possibly cost
>the provider $8.57, not even with slavery or robots.

Nope the 9 visits cost 9 x 30 baht - 270 baht at today's exchange rate
$7.71. then 3 days in the hospital for the birth at 30 baht, Total 300
baht., today's rate $1.00 = 35 baht.

Note that while minimum salaries vary from province to province here
it is 340 baht a day.

>I conclude the price reflects some other source of revenue
>than your housekeeper.

As I said above this is a "Government Hospital" and the employees and
staff are government employees.

I had part of my ear lobe trimmed off due to sun cancer - common in
Caucasians in tropical countries - so every morning I had to go to the
hospital and have the wound cleaned and a new bandage, Cost about US
$1.00.

--
Cheers,

John B.

On Wed, 10 Jan 2024 19:58:39 -0600, AMuzi <am@yellowjersey.org> wrote:

>On 1/10/2024 6:55 PM, John B. wrote:
>> On Wed, 10 Jan 2024 16:59:59 -0600, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 1/10/2024 4:30 PM, John B. wrote:
>>>> On Wed, 10 Jan 2024 11:56:57 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> On 1/10/2024 11:07 AM, Frank Krygowski wrote:
>>>>>> On 1/10/2024 9:34 AM, AMuzi wrote:
>>>>>> > On 1/9/2024 9:21 PM, Frank Krygowski wrote:
>>>>>> >> On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>> >>>
>>>>>> >>> I'm not dismissing your suffering but many people have
>>>>>> unreasonable
>>>>>> >>> expectations.  Our modern medical arts are very good at
>>>>>> setting
>>>>>> >>> broken bones and repairing wounds etc. Obesity (and
>>>>>> subsequent
>>>>>> >>> degradation) is well beyond their purview.
>>>>>> >>>
>>>>>> >>> There's a big difference between removing an inflamed
>>>>>> appendix and
>>>>>> >>> promptly, correctly diagnosing appendicitis. My brother
>>>>>> the doc has a
>>>>>> >>> pet peeve about that; internists who see a lot of them
>>>>>> are very good
>>>>>> >>> diagnosticians but your average MD is more often wrong
>>>>>> than right on
>>>>>> >>> an appendix.
>>>>>> >>>
>>>>>> >>> Short answer= it's complex. Medical services comprise a
>>>>>> world of
>>>>>> >>> variables and most decisions are made under uncertainty
>>>>>> at best.
>>>>>> >>> People expect more than is actually possible.
>>>>>> >>
>>>>>> >> Yes, it's complex. But the data indicates that these
>>>>>> complex problems
>>>>>> >> are solved more accurately and far less expensively in
>>>>>> nations with
>>>>>> >> publicly funded health care.
>>>>>> >>
>>>>>> >
>>>>>> > That's unclear.
>>>>>>
>>>>>> Not to those with less bias.
>>>>>>
>>>>>> > Correlation is not causation and our US culture shows
>>>>>> > decidedly unhealthy aspects for some significant number
>>>>>> (perhaps a
>>>>>> > majority).
>>>>>>
>>>>>> "Correlation is not causation" is being taken to extremes in
>>>>>> this forum. It's become shorthand for "I don't like all the
>>>>>> available data, so I'm going to pretend there's hidden magic
>>>>>> at work."
>>>>>>
>>>>>> You appear to be claiming that Americans are unique in
>>>>>> choosing unhealthy behavior. But smoking, drinking and fatty
>>>>>> foods are much more common in Europe than in the U.S. Yet
>>>>>> European health care results are way better than ours, at
>>>>>> far lower costs.
>>>>>>
>>>>>> If you have studies that prove America's bad habits are the
>>>>>> real reason, you should post links.
>>>>>>
>>>>>
>>>>> Peruse population-level death rates of obesity, diabetes,
>>>>> heart disease, violence and ODs. We're special.
>>>>
>>>> Well, as far as obesity, etc., you are certainly correct as the most
>>>> noticeable thing about U.S. tourists is that they are FAT!.
>>>>
>>>> But as for diet I wonder. Growing up in a small New England village I
>>>> don't remember anyone that was fat and have always attributed it to
>>>> the fact that people walked. I walked a mile to school from the age of
>>>> 6. There was a school bus but it didn't stop for anyone who lived 1
>>>> mile or less from the school. My father usually, weather depending,
>>>> walked to work, about a mile, and so did the other men in the town.
>>>>
>>>> And yes most families had a car but that was for church on Sunday and
>>>> maybe a Sunday afternoon drive with the wife and kids.
>>>> Why would want to waste gasoline just to get to work? It was only a 20
>>>> minute or so walk.
>>>
>>> The set of 'people who ride bicycles and discuss them on
>>> RBT' may not be representative of all US citizens.
>>>
>>> Then again 'morbid obesity' doesn't describe all US citizens
>>> either, Mr Christie, Mr Pritzger and FatCon attendees
>>> notwithstanding.
>>
>> Yes, of course, but the fact remains that as a whole the U.S. tourists
>> I see here are FAT and I read that "more than two-thirds of U.S.
>> adults in the United States are overweight or have obesity."
>
>Again I say, we RBT denizens are a distinct small minority!

Yes, I agreed with you :-)
--
Cheers,

John B.

On Wed, 10 Jan 2024 19:51:59 -0600, AMuzi <am@yellowjersey.org> wrote:

>On 1/10/2024 6:14 PM, John B. wrote:
>> On Wed, 10 Jan 2024 10:57:41 -0800, sms <scharf.steven@geemail.com>
>> wrote:
>>
>>> On 1/10/2024 4:45 AM, Zen Cycle wrote:
>>>> On 1/10/2024 4:46 AM, floriduh dumbass wrote:
>>>
>>> <snip>
>>>
>>>>> Seems to me that the majority of people who want taxpayer funded
>>>>> health care simply want other people to pay for their health care.
>>>>
>>>> So I'm guessing you never signed up for medicare?
>>>
>>> And of course the lack of national health care means that taxpayers
>>> still end up paying for those without insurance, only they end up paying
>>> a lot more than they would otherwise pay since the health care for the
>>> uninsured is delivered in the least cost-effective manner.
>>>
>>> In 1986, Ronald Reagan signed a law that requires hospitals to treat
>>> poor people and undocumented immigrants: "the Emergency Medical
>>> Treatment and Active Labor Act requires hospitals to treat patients in
>>> need of emergency care regardless of their ability to pay, citizenship
>>> or even legal status. It applies to any hospital that takes Medicare
>>> funds, which is virtually every hospital in the country."
>>>
>>> But the cost of not having national health care go beyond the high cost
>>> of treating uninsured people. At some point, it became the expectation
>>> that employers in the U.S. should be the source of health insurance for
>>> their workers. This led to the export of many living wage jobs to
>>> countries where there is national health care.
>>
>> I'm not sure whether the results are measurable but here as the cost
>> to see the doctor is only 30 baht, less then 1 hour's pay at minimum
>> salary rates , it seem that the average bloke goes to the doctor when
>> he feels a bit under the weather rather then wait until he is so sick
>> that he has to be carried in on a stretcher.
>> I can't quantify it but logically it must be easier to cure a chap
>> with a slight cough then when it becomes full scale Pneumonia.
>>
>
>You've worked in labor/materials/equipment systems. With
>the buildings and equipment, supplies, utilities,
>maintenance, cleaners, assistants etc the actual cost is
>greater than 30 baht (which as you note above doesn't even
>cover a doctor's wage).

You don't seem to get it although I've mentioned it a number of times.
The 30 baht medical system used by a majority of the Thai population
is a government agency. Just as is the police, basic education
through high school, the Army, the Navy, and all the other various
government agencies.

In addition we have the private hospitals which are available. As I
mentioned, I went to an eye clinic at a private hospital, St. Mary's,
the other day. But even there costs are extremely low compared to what
I see mentioned here. Complete eye examination included pressure check
and medicine for "Dry Eyes" 2,000 baht - $57.00.
--
Cheers,

John B.

On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
wrote:

>On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
><Soloman@old.bikers.org> wrote:
>
>>On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>wrote:
>>
>>>On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>><Soloman@old.bikers.org> wrote:
>>>
>>>>On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>wrote:
>>>>
>>>>>On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>><Soloman@old.bikers.org> wrote:
>>>>>
>>>>>>On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>wrote:
>>>>>>
>>>>>>>On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>
>>>>>>>>On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>wrote:
>>>>>>>>
>>>>>>>>>On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>
>>>>>>>>>>On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>wrote:
>>>>>>>>>>
>>>>>>>>>>>On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>
>>>>>>>>>>>>On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>><frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>>On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>
>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>
>>>>>>>>>>>>>Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>publicly funded health care.
>>>>>>>>>>>>
>>>>>>>>>>>>
>>>>>>>>>>>>Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>health care simply want other people to pay for their health care.
>>>>>>>>>>>
>>>>>>>>>>>I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>
>>>>>>>>>>https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>
>>>>>>>>>No., disregarding any government interference US prescription drug
>>>>>>>>>prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>
>>>>>>>>>I didn't post a reference but you can easily find one.
>>>>>>>>>
>>>>>>>Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>their medicines through international biding managed by the government
>>>>>>>>>and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>government, hospital medicine costs are extremely low.
>>>>>>>>
>>>>>>>>Government negotiations (interference) is why drug prices in some
>>>>>>>>countries are lower.
>>>>>>>
>>>>>>>The government here supports more then 900 hospitals and obtains most
>>>>>>>medicines through bids from international companies. When you are
>>>>>>>buying in large quantity prices do go down.
>>>>>>>
>>>>>>>How is that "interference"?
>>>>>>
>>>>>>
>>>>>>Governments have coersive power.
>>>>>
>>>>>And what is that supposed to mean? That the U.S. government somehow
>>>>>causes medicine prices in the U.SA. to be so much higher then in other
>>>>>countries?
>>>>
>>>>No, that other governments cause medicine prices to be lower in their
>>>>countries.
>>>
>>>???? I'm told that medicines used in Thai Government Hospitals are
>>>purchased through bidding for large quantities from international
>>>suppliers.
>>>How is this causing medicine costs to be lower? Sounds like good
>>>business practice to me.
>>
>>"negotiating" with an entity that has the power to burden your
>>bushiness may not be entirely fair.
>
>How is offering to buy a large quantity of a medicine, sufficient to
>supply 900 hospitals, from the lowest bidder, "negotiating"?
>

You said there was bidding. I assumed there was more than one supplier
with different bids. That seemed like a negotiation to me.

On Thu, 11 Jan 2024 05:57:23 -0500, Catrike Ryder
<Soloman@old.bikers.org> wrote:

>On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
>wrote:
>
>>On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
>><Soloman@old.bikers.org> wrote:
>>
>>>On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>>wrote:
>>>
>>>>On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>>><Soloman@old.bikers.org> wrote:
>>>>
>>>>>On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>>wrote:
>>>>>
>>>>>>On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>
>>>>>>>On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>>wrote:
>>>>>>>
>>>>>>>>On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>
>>>>>>>>>On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>wrote:
>>>>>>>>>
>>>>>>>>>>On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>
>>>>>>>>>>>On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>wrote:
>>>>>>>>>>>
>>>>>>>>>>>>On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>>On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>><frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>>On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>>are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>>publicly funded health care.
>>>>>>>>>>>>>
>>>>>>>>>>>>>
>>>>>>>>>>>>>Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>>health care simply want other people to pay for their health care.
>>>>>>>>>>>>
>>>>>>>>>>>>I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>>example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>>to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>
>>>>>>>>>>>https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>
>>>>>>>>>>No., disregarding any government interference US prescription drug
>>>>>>>>>>prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>>prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>
>>>>>>>>>>I didn't post a reference but you can easily find one.
>>>>>>>>>>
>>>>>>>>Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>>their medicines through international biding managed by the government
>>>>>>>>>>and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>>government, hospital medicine costs are extremely low.
>>>>>>>>>
>>>>>>>>>Government negotiations (interference) is why drug prices in some
>>>>>>>>>countries are lower.
>>>>>>>>
>>>>>>>>The government here supports more then 900 hospitals and obtains most
>>>>>>>>medicines through bids from international companies. When you are
>>>>>>>>buying in large quantity prices do go down.
>>>>>>>>
>>>>>>>>How is that "interference"?
>>>>>>>
>>>>>>>
>>>>>>>Governments have coersive power.
>>>>>>
>>>>>>And what is that supposed to mean? That the U.S. government somehow
>>>>>>causes medicine prices in the U.SA. to be so much higher then in other
>>>>>>countries?
>>>>>
>>>>>No, that other governments cause medicine prices to be lower in their
>>>>>countries.
>>>>
>>>>???? I'm told that medicines used in Thai Government Hospitals are
>>>>purchased through bidding for large quantities from international
>>>>suppliers.
>>>>How is this causing medicine costs to be lower? Sounds like good
>>>>business practice to me.
>>>
>>>"negotiating" with an entity that has the power to burden your
>>>bushiness may not be entirely fair.
>>
>>How is offering to buy a large quantity of a medicine, sufficient to
>>supply 900 hospitals, from the lowest bidder, "negotiating"?
>>
>
>You said there was bidding. I assumed there was more than one supplier
>with different bids. That seemed like a negotiation to me.

Perhaps a matter of semantics. But the usual method of conducting a
bid to supply a product is to publicize the required product,
specifications and quantities to various entities that are capable of
providing said item in the desired quantities and specifications and
the cheapest one gets the contract. Whether this is a negotiation or
not is, I guess what you want to call it.
--
Cheers,

John B.

On Wed, 10 Jan 2024 21:21:56 -0500, Frank Krygowski
<frkrygow@sbcglobal.net> wrote:

>On 1/10/2024 8:55 PM, AMuzi wrote:
>> On 1/10/2024 6:23 PM, zen cycle wrote:
>>> On 1/10/2024 6:33 PM, floriduh dumbass wrote:
>>>> On Wed, 10 Jan 2024 17:01:30 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> I think we all understand the concept and its limits.
>>>>
>>>> Some still seem confused about it.
>>>
>>> Yes, you are, as is proven by
>>>
>>>>
>>>>> I'm more on the side of the grammar nazis on this one; I was
>>>>> inexact in my composition earlier.
>>>>
>>>> Like I said, I prefer to say "Correlation does not prove or imply
>>>> causation," but I have no problem with "Correlation is not causation."
>>>
>>> "Correlation does not prove or imply causation" is in no way
>>> equivalent to "Correlation is not causation" except in the mind of a
>>> willfully ignorant floriduh dumbass
>>>
>>>
>>
>> I admitted to sloppy my composition, which started this.
>>
>> Both of you might lighten up:
>> https://tylervigen.com/spurious-correlations
>
>Lightening up is fine; and that website (seen many times before) is fun.
>
>But the Florida tricycle rider hauls that statement out every time he's
>confronted with evidence that his views are nonsense. He's using it as
>an anti-intellectual crutch, one step away from "Nothing can be known."

I only "bring it up" when somebody suggests that correlation does
imply causation.

https://time.com/6183881/gun-ownership-risks-at-home/

On Thu, 11 Jan 2024 18:20:05 +0700, John B. <slocombjb@gmail.com>
wrote:

>On Thu, 11 Jan 2024 05:57:23 -0500, Catrike Ryder
><Soloman@old.bikers.org> wrote:
>
>>On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
>>wrote:
>>
>>>On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
>>><Soloman@old.bikers.org> wrote:
>>>
>>>>On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>>>wrote:
>>>>
>>>>>On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>>>><Soloman@old.bikers.org> wrote:
>>>>>
>>>>>>On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>>>wrote:
>>>>>>
>>>>>>>On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>
>>>>>>>>On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>>>wrote:
>>>>>>>>
>>>>>>>>>On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>
>>>>>>>>>>On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>wrote:
>>>>>>>>>>
>>>>>>>>>>>On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>
>>>>>>>>>>>>On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>>wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>>On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>>On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>>><frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>>>are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>>>publicly funded health care.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>>>health care simply want other people to pay for their health care.
>>>>>>>>>>>>>
>>>>>>>>>>>>>I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>>>example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>>>to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>>
>>>>>>>>>>>>https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>>
>>>>>>>>>>>No., disregarding any government interference US prescription drug
>>>>>>>>>>>prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>>>prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>>
>>>>>>>>>>>I didn't post a reference but you can easily find one.
>>>>>>>>>>>
>>>>>>>>>Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>>>their medicines through international biding managed by the government
>>>>>>>>>>>and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>>>government, hospital medicine costs are extremely low.
>>>>>>>>>>
>>>>>>>>>>Government negotiations (interference) is why drug prices in some
>>>>>>>>>>countries are lower.
>>>>>>>>>
>>>>>>>>>The government here supports more then 900 hospitals and obtains most
>>>>>>>>>medicines through bids from international companies. When you are
>>>>>>>>>buying in large quantity prices do go down.
>>>>>>>>>
>>>>>>>>>How is that "interference"?
>>>>>>>>
>>>>>>>>
>>>>>>>>Governments have coersive power.
>>>>>>>
>>>>>>>And what is that supposed to mean? That the U.S. government somehow
>>>>>>>causes medicine prices in the U.SA. to be so much higher then in other
>>>>>>>countries?
>>>>>>
>>>>>>No, that other governments cause medicine prices to be lower in their
>>>>>>countries.
>>>>>
>>>>>???? I'm told that medicines used in Thai Government Hospitals are
>>>>>purchased through bidding for large quantities from international
>>>>>suppliers.
>>>>>How is this causing medicine costs to be lower? Sounds like good
>>>>>business practice to me.
>>>>
>>>>"negotiating" with an entity that has the power to burden your
>>>>bushiness may not be entirely fair.
>>>
>>>How is offering to buy a large quantity of a medicine, sufficient to
>>>supply 900 hospitals, from the lowest bidder, "negotiating"?
>>>
>>
>>You said there was bidding. I assumed there was more than one supplier
>>with different bids. That seemed like a negotiation to me.
>
>Perhaps a matter of semantics. But the usual method of conducting a
>bid to supply a product is to publicize the required product,
>specifications and quantities to various entities that are capable of
>providing said item in the desired quantities and specifications and
>the cheapest one gets the contract. Whether this is a vor
>not is, I guess what you want to call it.
>

My assumption is that most governmnts are corrupt and that the bidding
process has "negotiations" other than cheapest price.

On Thu, 11 Jan 2024 07:00:45 -0500, Catrike Ryder
<Soloman@old.bikers.org> wrote:

>On Thu, 11 Jan 2024 18:20:05 +0700, John B. <slocombjb@gmail.com>
>wrote:
>
>>On Thu, 11 Jan 2024 05:57:23 -0500, Catrike Ryder
>><Soloman@old.bikers.org> wrote:
>>
>>>On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
>>>wrote:
>>>
>>>>On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
>>>><Soloman@old.bikers.org> wrote:
>>>>
>>>>>On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>>>>wrote:
>>>>>
>>>>>>On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>
>>>>>>>On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>>>>wrote:
>>>>>>>
>>>>>>>>On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>
>>>>>>>>>On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>>>>wrote:
>>>>>>>>>
>>>>>>>>>>On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>
>>>>>>>>>>>On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>wrote:
>>>>>>>>>>>
>>>>>>>>>>>>On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>>On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>>>wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>>On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>>>><frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>>>>are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>>>>publicly funded health care.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>>>>health care simply want other people to pay for their health care.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>>>>example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>>>>to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>>>
>>>>>>>>>>>>>https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>>>
>>>>>>>>>>>>No., disregarding any government interference US prescription drug
>>>>>>>>>>>>prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>>>>prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>>>
>>>>>>>>>>>>I didn't post a reference but you can easily find one.
>>>>>>>>>>>>
>>>>>>>>>>Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>>>>their medicines through international biding managed by the government
>>>>>>>>>>>>and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>>>>government, hospital medicine costs are extremely low.
>>>>>>>>>>>
>>>>>>>>>>>Government negotiations (interference) is why drug prices in some
>>>>>>>>>>>countries are lower.
>>>>>>>>>>
>>>>>>>>>>The government here supports more then 900 hospitals and obtains most
>>>>>>>>>>medicines through bids from international companies. When you are
>>>>>>>>>>buying in large quantity prices do go down.
>>>>>>>>>>
>>>>>>>>>>How is that "interference"?
>>>>>>>>>
>>>>>>>>>
>>>>>>>>>Governments have coersive power.
>>>>>>>>
>>>>>>>>And what is that supposed to mean? That the U.S. government somehow
>>>>>>>>causes medicine prices in the U.SA. to be so much higher then in other
>>>>>>>>countries?
>>>>>>>
>>>>>>>No, that other governments cause medicine prices to be lower in their
>>>>>>>countries.
>>>>>>
>>>>>>???? I'm told that medicines used in Thai Government Hospitals are
>>>>>>purchased through bidding for large quantities from international
>>>>>>suppliers.
>>>>>>How is this causing medicine costs to be lower? Sounds like good
>>>>>>business practice to me.
>>>>>
>>>>>"negotiating" with an entity that has the power to burden your
>>>>>bushiness may not be entirely fair.
>>>>
>>>>How is offering to buy a large quantity of a medicine, sufficient to
>>>>supply 900 hospitals, from the lowest bidder, "negotiating"?
>>>>
>>>
>>>You said there was bidding. I assumed there was more than one supplier
>>>with different bids. That seemed like a negotiation to me.
>>
>>Perhaps a matter of semantics. But the usual method of conducting a
>>bid to supply a product is to publicize the required product,
>>specifications and quantities to various entities that are capable of
>>providing said item in the desired quantities and specifications and
>>the cheapest one gets the contract. Whether this is a vor
>>not is, I guess what you want to call it.
>>
>
>My assumption is that most governmnts are corrupt and that the bidding
>process has "negotiations" other than cheapest price.

On Thu, 11 Jan 2024 19:21:37 +0700, John B. <slocombjb@gmail.com>
wrote:

>On Thu, 11 Jan 2024 07:00:45 -0500, Catrike Ryder
><Soloman@old.bikers.org> wrote:
>
>>On Thu, 11 Jan 2024 18:20:05 +0700, John B. <slocombjb@gmail.com>
>>wrote:
>>
>>>On Thu, 11 Jan 2024 05:57:23 -0500, Catrike Ryder
>>><Soloman@old.bikers.org> wrote:
>>>
>>>>On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
>>>>wrote:
>>>>
>>>>>On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
>>>>><Soloman@old.bikers.org> wrote:
>>>>>
>>>>>>On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>>>>>wrote:
>>>>>>
>>>>>>>On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>
>>>>>>>>On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>wrote:
>>>>>>>>
>>>>>>>>>On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>
>>>>>>>>>>On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>>>>>wrote:
>>>>>>>>>>
>>>>>>>>>>>On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>
>>>>>>>>>>>>On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>>wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>>On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>>On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>>>>wrote:
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>>>>><Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>>>>><frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>>>>>are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>>>>>publicly funded health care.
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>>>>>health care simply want other people to pay for their health care.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>>>>>example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>>>>>to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>>>>
>>>>>>>>>>>>>No., disregarding any government interference US prescription drug
>>>>>>>>>>>>>prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>>>>>prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>>>>
>>>>>>>>>>>>>I didn't post a reference but you can easily find one.
>>>>>>>>>>>>>
>>>>>>>>>>>Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>>>>>their medicines through international biding managed by the government
>>>>>>>>>>>>>and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>>>>>government, hospital medicine costs are extremely low.
>>>>>>>>>>>>
>>>>>>>>>>>>Government negotiations (interference) is why drug prices in some
>>>>>>>>>>>>countries are lower.
>>>>>>>>>>>
>>>>>>>>>>>The government here supports more then 900 hospitals and obtains most
>>>>>>>>>>>medicines through bids from international companies. When you are
>>>>>>>>>>>buying in large quantity prices do go down.
>>>>>>>>>>>
>>>>>>>>>>>How is that "interference"?
>>>>>>>>>>
>>>>>>>>>>
>>>>>>>>>>Governments have coersive power.
>>>>>>>>>
>>>>>>>>>And what is that supposed to mean? That the U.S. government somehow
>>>>>>>>>causes medicine prices in the U.SA. to be so much higher then in other
>>>>>>>>>countries?
>>>>>>>>
>>>>>>>>No, that other governments cause medicine prices to be lower in their
>>>>>>>>countries.
>>>>>>>
>>>>>>>???? I'm told that medicines used in Thai Government Hospitals are
>>>>>>>purchased through bidding for large quantities from international
>>>>>>>suppliers.
>>>>>>>How is this causing medicine costs to be lower? Sounds like good
>>>>>>>business practice to me.
>>>>>>
>>>>>>"negotiating" with an entity that has the power to burden your
>>>>>>bushiness may not be entirely fair.
>>>>>
>>>>>How is offering to buy a large quantity of a medicine, sufficient to
>>>>>supply 900 hospitals, from the lowest bidder, "negotiating"?
>>>>>
>>>>
>>>>You said there was bidding. I assumed there was more than one supplier
>>>>with different bids. That seemed like a negotiation to me.
>>>
>>>Perhaps a matter of semantics. But the usual method of conducting a
>>>bid to supply a product is to publicize the required product,
>>>specifications and quantities to various entities that are capable of
>>>providing said item in the desired quantities and specifications and
>>>the cheapest one gets the contract. Whether this is a vor
>>>not is, I guess what you want to call it.
>>>
>>
>>My assumption is that most governmnts are corrupt and that the bidding
>>process has "negotiations" other than cheapest price.
>
>In my experience not as much as you might think. Or at least the
>projects that my company undertook over 30 years in S.E. Asia. One
>reason is that normally the bids were opened publicly so all the
>bidders could see the bottom line numbers that other companies bid.

Am 10.01.2024 um 18:53 schrieb AMuzi:
> On 1/10/2024 9:54 AM, Catrike Ryder wrote:
>> On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>> wrote:
>>
>>> On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>> <Soloman@old.bikers.org> wrote:
>>>
>>>> On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>> wrote:
>>>>
>>>>> On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>> <Soloman@old.bikers.org> wrote:
>>>>>
>>>>>> On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>> wrote:
>>>>>>
>>>>>>> On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>
>>>>>>>> On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>> wrote:
>>>>>>>>
>>>>>>>>> On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>
>>>>>>>>>> On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>
>>>>>>>>>>> On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>
>>>>>>>>>>>> I'm not dismissing your suffering but many people have
>>>>>>>>>>>> unreasonable
>>>>>>>>>>>> expectations.  Our modern medical arts are very good at
>>>>>>>>>>>> setting broken
>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent
>>>>>>>>>>>> degradation) is
>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>
>>>>>>>>>>>> There's a big difference between removing an inflamed
>>>>>>>>>>>> appendix and
>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the
>>>>>>>>>>>> doc has a
>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are
>>>>>>>>>>>> very good
>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than
>>>>>>>>>>>> right on an
>>>>>>>>>>>> appendix.
>>>>>>>>>>>>
>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a
>>>>>>>>>>>> world of
>>>>>>>>>>>> variables and most decisions are made under uncertainty at
>>>>>>>>>>>> best.  People
>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>
>>>>>>>>>>> Yes, it's complex. But the data indicates that these complex
>>>>>>>>>>> problems
>>>>>>>>>>> are solved more accurately and far less expensively in
>>>>>>>>>>> nations with
>>>>>>>>>>> publicly funded health care.
>>>>>>>>>>
>>>>>>>>>>
>>>>>>>>>> Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>> health care simply want other people to pay for their health
>>>>>>>>>> care.
>>>>>>>>>
>>>>>>>>> I think it is more complex then the simple "somebody else pay".
>>>>>>>>> For
>>>>>>>>> example I believe that some people actually travel to Mexico or
>>>>>>>>> Canada
>>>>>>>>> to buy medicines as the same pill is cheaper there then in the
>>>>>>>>> U.S.
>>>>>>>>
>>>>>>>> https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>
>>>>>>> No., disregarding any government interference US prescription drug
>>>>>>> prices were 218% of prices in Canada, 170%of prices in Mexico,
>>>>>>> 779% of
>>>>>>> prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>
>>>>>>> I didn't post a reference but you can easily find one.
>>>>>>>
>>>>> Here, for example, there are over 900 public hospitals who obtain
>>>>>>> their medicines through international biding managed by the
>>>>>>> government
>>>>>>> and open to makers world wide with the result that the Public, i.e.,
>>>>>>> government, hospital medicine costs are extremely low.
>>>>>>
>>>>>> Government negotiations (interference) is why drug prices in some
>>>>>> countries are lower.
>>>>>
>>>>> The government here supports more then 900 hospitals and obtains most
>>>>> medicines through bids from international companies. When you are
>>>>> buying in large quantity prices do go down.
>>>>>
>>>>> How is that "interference"?
>>>>
>>>>
>>>> Governments have coersive power.
>>>
>>> And what is that supposed to mean? That the U.S. government somehow
>>> causes medicine prices in the U.SA. to be so much higher then in other
>>> countries?
>>
>> No, that other governments cause medicine prices to be lower in their
>> countries.
>
> As with other economic interventions, for someone to win, someone else
> has to lose.

Wrong. There are zero-sum interventions where somebody has to lose for
somebody else to win, and there are 'win-win' interventions where
everybody wins and nobody loses.
The simplest example for a 'win-win' intervention is when one company
has to pay for waste collection. Then a whizz-kid designs a way to make
money with some of that waste by separating out some valuable parts for
recycling. The first company has the benefit of reduced waste bill, the
second company make money with a new business opportunity.

On 1/10/2024 8:36 PM, Frank Krygowski wrote:
> On 1/10/2024 6:04 PM, AMuzi wrote:
>> On 1/10/2024 4:40 PM, John B. wrote:
>>> On Wed, 10 Jan 2024 08:47:42 -0600, AMuzi
>>> <am@yellowjersey.org> wrote:
>>>
>>>> On 1/10/2024 6:36 AM, John B. wrote:
>>>>>
>>>>> Well, I'm not a leftist but my Housekeeper tells me
>>>>> that her total
>>>>> cost for 9 visits to the doctor during her pregnancy
>>>>> and 3 days in the
>>>>> hospital giving birth cost her a total of 300 baht - at
>>>>> today's
>>>>> exchange rate is $8.57 and less then one day's salary
>>>>> at minimum
>>>>> salary rates :-)
>>>>
>>>> Either her MDs are earning 2c per hour or someone else is
>>>> bearing the cost.
>>>
>>> No the government hospital employees work for the
>>> national government
>>> just as do school teachers, police, military, etc, and
>>> receive a
>>> salary and retirement when they get old.
>>
>> Nine pregnancy/delivery hospital visits cannot possibly
>> cost the provider $8.57, not even with slavery or robots.
>>
>> I conclude the price reflects some other source of revenue
>> than your housekeeper.
>
> Of course! That point has been covered. John said the
> employees work for the government. Their employment costs
> are spread over the population of the nation.
>
> It's not that different from the fact that my wife's last ER
> visit would have cost us a fortune, but it was paid for
> almost entirely by our insurance. The cost was effectively
> spread over the population of policyholders.
>
> A main difference between the two cases is this: If my
> wife's visit had been in Thailand, the total cost would have
> been much, much lower, no matter who paid. Our system is
> very inefficient.
>
> As an example, which I think I described in detail before: A
> few years ago my wife had a routine annual physical, had
> blood drawn for routine tests, and the tests were done by
> some laboratory. It was an annual insurance benefit, no cost
> to us.
>
> Except this time I got a big bill from the laboratory. What
> the hell? I got on the phone to the doctor's office, then
> the insurance company, then the laboratory. The fault was
> miscommunication involving the insurance company, whose
> representative swore the laboratory had not submitted
> paperwork. In the long 3 way phone call (me, insurance, lab)
> the lab person described multiple tries of submitting by
> various methods, usual and unusual. It took two long rounds
> of phone conversations before the insurance guy said that
> OK, he'd found the records.
>
> All that was professional time, and therefore money, wasted.
> Any reasonable estimate of hourly salary - with me "working"
> on this for free - means this mess added at least a hundred
> dollars of expense to a perfectly routine event.
>
> Our system is very inefficient.
>

Om that last point I (and probably everyone who is not in
the racket nor their regulators) agree.
--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/10/2024 9:28 PM, John B. wrote:
> On Wed, 10 Jan 2024 17:04:24 -0600, AMuzi <am@yellowjersey.org> wrote:
>
>> On 1/10/2024 4:40 PM, John B. wrote:
>>> On Wed, 10 Jan 2024 08:47:42 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>
>>>> On 1/10/2024 6:36 AM, John B. wrote:
>>>>> On Wed, 10 Jan 2024 12:44:04 +0100, Rolf Mantel
>>>>> <news@hartig-mantel.de> wrote:
>>>>>
>>>>>> Am 10.01.2024 um 10:45 schrieb Catrike Ryder:
>>>>>>> On Tue, 9 Jan 2024 22:15:09 -0500, Frank Krygowski
>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>
>>>>>>>> On 1/9/2024 1:20 PM, AMuzi wrote:
>>>>>>>>> On 1/9/2024 11:06 AM, Catrike Ryder wrote:
>>>>>>>>>> On Tue, 9 Jan 2024 11:34:02 -0500, Frank Krygowski
>>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>
>>>>>>>>>>>
>>>>>>>>>>> That's still not an argument in favor of the hyper-inefficient U.S.
>>>>>>>>>>> system of health care.
>>>>>>>>>>
>>>>>>>>>> I've never had any efficiency problems with my health care. Actually,
>>>>>>>>>> I've never had ANY problems with my health care.
>>>>>>>>>
>>>>>>>>> Resolving medical problems is often more effective by avoiding the
>>>>>>>>> 'health services' racket.
>>>>>>>>
>>>>>>>> ... for some value of "often."
>>>>>>>>
>>>>>>>> U.S. health data is dismal compared with similar countries that have
>>>>>>>> publicly funded health care, which is really all similar countries.
>>>>>>>> Perhaps part of the reason is that in the U.S. people avoid health
>>>>>>>> services because of cost.
>>>>>>>>
>>>>>>>> People in other countries have far less reason to avoid medical
>>>>>>>> treatment. They are much healthier on average than Americans, and they
>>>>>>>> spend much less on their health care. Articles documenting this are
>>>>>>>> trivially easy to find.
>>>>>>>
>>>>>>> Easy to find...
>>>>>>> ...by looking for leftist propaganda sites...
>>>>>>
>>>>>> It's a fool's best strategy to claim that all sources of unpleasant
>>>>>> information are dodgy.
>>>>>>
>>>>>> don't look up!
>>>>>
>>>>> Well, I'm not a leftist but my Housekeeper tells me that her total
>>>>> cost for 9 visits to the doctor during her pregnancy and 3 days in the
>>>>> hospital giving birth cost her a total of 300 baht - at today's
>>>>> exchange rate is $8.57 and less then one day's salary at minimum
>>>>> salary rates :-)
>>>>
>>>> Either her MDs are earning 2c per hour or someone else is
>>>> bearing the cost.
>>>
>>> No the government hospital employees work for the national government
>>> just as do school teachers, police, military, etc, and receive a
>>> salary and retirement when they get old.
>>
>> Nine pregnancy/delivery hospital visits cannot possibly cost
>> the provider $8.57, not even with slavery or robots.
>
> Nope the 9 visits cost 9 x 30 baht - 270 baht at today's exchange rate
> $7.71. then 3 days in the hospital for the birth at 30 baht, Total 300
> baht., today's rate $1.00 = 35 baht.
>
> Note that while minimum salaries vary from province to province here
> it is 340 baht a day.
>
>> I conclude the price reflects some other source of revenue
>> than your housekeeper.
>
> As I said above this is a "Government Hospital" and the employees and
> staff are government employees.
>
> I had part of my ear lobe trimmed off due to sun cancer - common in
> Caucasians in tropical countries - so every morning I had to go to the
> hospital and have the wound cleaned and a new bandage, Cost about US
> $1.00.
>
>

No disagreement on your reporting nor what you both paid.

We may have a semantic separation. The hospital system's
cost is not even remotely reflected in the price (which is
what you paid).

Hope that helps.
--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/10/2024 10:23 PM, John B. wrote:
> On Wed, 10 Jan 2024 19:51:59 -0600, AMuzi <am@yellowjersey.org> wrote:
>
>> On 1/10/2024 6:14 PM, John B. wrote:
>>> On Wed, 10 Jan 2024 10:57:41 -0800, sms <scharf.steven@geemail.com>
>>> wrote:
>>>
>>>> On 1/10/2024 4:45 AM, Zen Cycle wrote:
>>>>> On 1/10/2024 4:46 AM, floriduh dumbass wrote:
>>>>
>>>> <snip>
>>>>
>>>>>> Seems to me that the majority of people who want taxpayer funded
>>>>>> health care simply want other people to pay for their health care.
>>>>>
>>>>> So I'm guessing you never signed up for medicare?
>>>>
>>>> And of course the lack of national health care means that taxpayers
>>>> still end up paying for those without insurance, only they end up paying
>>>> a lot more than they would otherwise pay since the health care for the
>>>> uninsured is delivered in the least cost-effective manner.
>>>>
>>>> In 1986, Ronald Reagan signed a law that requires hospitals to treat
>>>> poor people and undocumented immigrants: "the Emergency Medical
>>>> Treatment and Active Labor Act requires hospitals to treat patients in
>>>> need of emergency care regardless of their ability to pay, citizenship
>>>> or even legal status. It applies to any hospital that takes Medicare
>>>> funds, which is virtually every hospital in the country."
>>>>
>>>> But the cost of not having national health care go beyond the high cost
>>>> of treating uninsured people. At some point, it became the expectation
>>>> that employers in the U.S. should be the source of health insurance for
>>>> their workers. This led to the export of many living wage jobs to
>>>> countries where there is national health care.
>>>
>>> I'm not sure whether the results are measurable but here as the cost
>>> to see the doctor is only 30 baht, less then 1 hour's pay at minimum
>>> salary rates , it seem that the average bloke goes to the doctor when
>>> he feels a bit under the weather rather then wait until he is so sick
>>> that he has to be carried in on a stretcher.
>>> I can't quantify it but logically it must be easier to cure a chap
>>> with a slight cough then when it becomes full scale Pneumonia.
>>>
>>
>> You've worked in labor/materials/equipment systems. With
>> the buildings and equipment, supplies, utilities,
>> maintenance, cleaners, assistants etc the actual cost is
>> greater than 30 baht (which as you note above doesn't even
>> cover a doctor's wage).
>
> You don't seem to get it although I've mentioned it a number of times.
> The 30 baht medical system used by a majority of the Thai population
> is a government agency. Just as is the police, basic education
> through high school, the Army, the Navy, and all the other various
> government agencies.
>
> In addition we have the private hospitals which are available. As I
> mentioned, I went to an eye clinic at a private hospital, St. Mary's,
> the other day. But even there costs are extremely low compared to what
> I see mentioned here. Complete eye examination included pressure check
> and medicine for "Dry Eyes" 2,000 baht - $57.00.

Yes, Thailand cost of living is different than here, which
reflects in all services:
https://www.numbeo.com/cost-of-living/in/Bangkok

Basic rent for example 24709 bhat ($703.68)

compare Chicago*:

https://www.numbeo.com/cost-of-living/in/Chicago
Basic rent $2499.56 (87,877.52 bhat)

*IMHO NYC would be an exceptional outlier even for USA

--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/11/2024 5:26 AM, Catrike Ryder wrote:
> On Wed, 10 Jan 2024 21:21:56 -0500, Frank Krygowski
> <frkrygow@sbcglobal.net> wrote:
>
>> On 1/10/2024 8:55 PM, AMuzi wrote:
>>> On 1/10/2024 6:23 PM, zen cycle wrote:
>>>> On 1/10/2024 6:33 PM, floriduh dumbass wrote:
>>>>> On Wed, 10 Jan 2024 17:01:30 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>>>
>>>>>> I think we all understand the concept and its limits.
>>>>>
>>>>> Some still seem confused about it.
>>>>
>>>> Yes, you are, as is proven by
>>>>
>>>>>
>>>>>> I'm more on the side of the grammar nazis on this one; I was
>>>>>> inexact in my composition earlier.
>>>>>
>>>>> Like I said, I prefer to say "Correlation does not prove or imply
>>>>> causation," but I have no problem with "Correlation is not causation."
>>>>
>>>> "Correlation does not prove or imply causation" is in no way
>>>> equivalent to "Correlation is not causation" except in the mind of a
>>>> willfully ignorant floriduh dumbass
>>>>
>>>>
>>>
>>> I admitted to sloppy my composition, which started this.
>>>
>>> Both of you might lighten up:
>>> https://tylervigen.com/spurious-correlations
>>
>> Lightening up is fine; and that website (seen many times before) is fun.
>>
>> But the Florida tricycle rider hauls that statement out every time he's
>> confronted with evidence that his views are nonsense. He's using it as
>> an anti-intellectual crutch, one step away from "Nothing can be known."
>
> I only "bring it up" when somebody suggests that correlation does
> imply causation.
>
> https://time.com/6183881/gun-ownership-risks-at-home/

As the famous exchange with Andrew Cuomo who, as HHS
Secretary, proposed banning firearms in public housing. A
perspicacious interviewer asked, "Is public housing
dangerous because the residents are armed, or do they arm
themselves because public housing is dangerous?

The rule was quietly dropped.
--
Andrew Muzi
am@yellowjersey.org
Open every day since 1 April, 1971

On 1/11/2024 6:00 AM, Catrike Ryder wrote:
> On Thu, 11 Jan 2024 18:20:05 +0700, John B. <slocombjb@gmail.com>
> wrote:
>
>> On Thu, 11 Jan 2024 05:57:23 -0500, Catrike Ryder
>> <Soloman@old.bikers.org> wrote:
>>
>>> On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
>>> wrote:
>>>
>>>> On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
>>>> <Soloman@old.bikers.org> wrote:
>>>>
>>>>> On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>>>> wrote:
>>>>>
>>>>>> On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>
>>>>>>> On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>>>> wrote:
>>>>>>>
>>>>>>>> On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>
>>>>>>>>> On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>>>> wrote:
>>>>>>>>>
>>>>>>>>>> On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>
>>>>>>>>>>> On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>> wrote:
>>>>>>>>>>>
>>>>>>>>>>>> On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>> On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>>> wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>> On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>>>> are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>>>> publicly funded health care.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>>>> health care simply want other people to pay for their health care.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>> I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>>>> example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>>>> to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>>>
>>>>>>>>>>>>> https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>>>
>>>>>>>>>>>> No., disregarding any government interference US prescription drug
>>>>>>>>>>>> prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>>>> prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>>>
>>>>>>>>>>>> I didn't post a reference but you can easily find one.
>>>>>>>>>>>>
>>>>>>>>>> Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>>>> their medicines through international biding managed by the government
>>>>>>>>>>>> and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>>>> government, hospital medicine costs are extremely low.
>>>>>>>>>>>
>>>>>>>>>>> Government negotiations (interference) is why drug prices in some
>>>>>>>>>>> countries are lower.
>>>>>>>>>>
>>>>>>>>>> The government here supports more then 900 hospitals and obtains most
>>>>>>>>>> medicines through bids from international companies. When you are
>>>>>>>>>> buying in large quantity prices do go down.
>>>>>>>>>>
>>>>>>>>>> How is that "interference"?
>>>>>>>>>
>>>>>>>>>
>>>>>>>>> Governments have coersive power.
>>>>>>>>
>>>>>>>> And what is that supposed to mean? That the U.S. government somehow
>>>>>>>> causes medicine prices in the U.SA. to be so much higher then in other
>>>>>>>> countries?
>>>>>>>
>>>>>>> No, that other governments cause medicine prices to be lower in their
>>>>>>> countries.
>>>>>>
>>>>>> ???? I'm told that medicines used in Thai Government Hospitals are
>>>>>> purchased through bidding for large quantities from international
>>>>>> suppliers.
>>>>>> How is this causing medicine costs to be lower? Sounds like good
>>>>>> business practice to me.
>>>>>
>>>>> "negotiating" with an entity that has the power to burden your
>>>>> bushiness may not be entirely fair.
>>>>
>>>> How is offering to buy a large quantity of a medicine, sufficient to
>>>> supply 900 hospitals, from the lowest bidder, "negotiating"?
>>>>
>>>
>>> You said there was bidding. I assumed there was more than one supplier
>>> with different bids. That seemed like a negotiation to me.
>>
>> Perhaps a matter of semantics. But the usual method of conducting a
>> bid to supply a product is to publicize the required product,
>> specifications and quantities to various entities that are capable of
>> providing said item in the desired quantities and specifications and
>> the cheapest one gets the contract. Whether this is a vor
>> not is, I guess what you want to call it.
>>
>
> My assumption is that most governmnts are corrupt and that the bidding
> process has "negotiations" other than cheapest price.

On Thu, 11 Jan 2024 08:15:47 -0600, AMuzi <am@yellowjersey.org> wrote:

>On 1/10/2024 9:28 PM, John B. wrote:
>> On Wed, 10 Jan 2024 17:04:24 -0600, AMuzi <am@yellowjersey.org> wrote:
>>
>>> On 1/10/2024 4:40 PM, John B. wrote:
>>>> On Wed, 10 Jan 2024 08:47:42 -0600, AMuzi <am@yellowjersey.org> wrote:
>>>>
>>>>> On 1/10/2024 6:36 AM, John B. wrote:
>>>>>> On Wed, 10 Jan 2024 12:44:04 +0100, Rolf Mantel
>>>>>> <news@hartig-mantel.de> wrote:
>>>>>>
>>>>>>> Am 10.01.2024 um 10:45 schrieb Catrike Ryder:
>>>>>>>> On Tue, 9 Jan 2024 22:15:09 -0500, Frank Krygowski
>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>
>>>>>>>>> On 1/9/2024 1:20 PM, AMuzi wrote:
>>>>>>>>>> On 1/9/2024 11:06 AM, Catrike Ryder wrote:
>>>>>>>>>>> On Tue, 9 Jan 2024 11:34:02 -0500, Frank Krygowski
>>>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>
>>>>>>>>>>>>
>>>>>>>>>>>> That's still not an argument in favor of the hyper-inefficient U.S.
>>>>>>>>>>>> system of health care.
>>>>>>>>>>>
>>>>>>>>>>> I've never had any efficiency problems with my health care. Actually,
>>>>>>>>>>> I've never had ANY problems with my health care.
>>>>>>>>>>
>>>>>>>>>> Resolving medical problems is often more effective by avoiding the
>>>>>>>>>> 'health services' racket.
>>>>>>>>>
>>>>>>>>> ... for some value of "often."
>>>>>>>>>
>>>>>>>>> U.S. health data is dismal compared with similar countries that have
>>>>>>>>> publicly funded health care, which is really all similar countries.
>>>>>>>>> Perhaps part of the reason is that in the U.S. people avoid health
>>>>>>>>> services because of cost.
>>>>>>>>>
>>>>>>>>> People in other countries have far less reason to avoid medical
>>>>>>>>> treatment. They are much healthier on average than Americans, and they
>>>>>>>>> spend much less on their health care. Articles documenting this are
>>>>>>>>> trivially easy to find.
>>>>>>>>
>>>>>>>> Easy to find...
>>>>>>>> ...by looking for leftist propaganda sites...
>>>>>>>
>>>>>>> It's a fool's best strategy to claim that all sources of unpleasant
>>>>>>> information are dodgy.
>>>>>>>
>>>>>>> don't look up!
>>>>>>
>>>>>> Well, I'm not a leftist but my Housekeeper tells me that her total
>>>>>> cost for 9 visits to the doctor during her pregnancy and 3 days in the
>>>>>> hospital giving birth cost her a total of 300 baht - at today's
>>>>>> exchange rate is $8.57 and less then one day's salary at minimum
>>>>>> salary rates :-)
>>>>>
>>>>> Either her MDs are earning 2c per hour or someone else is
>>>>> bearing the cost.
>>>>
>>>> No the government hospital employees work for the national government
>>>> just as do school teachers, police, military, etc, and receive a
>>>> salary and retirement when they get old.
>>>
>>> Nine pregnancy/delivery hospital visits cannot possibly cost
>>> the provider $8.57, not even with slavery or robots.
>>
>> Nope the 9 visits cost 9 x 30 baht - 270 baht at today's exchange rate
>> $7.71. then 3 days in the hospital for the birth at 30 baht, Total 300
>> baht., today's rate $1.00 = 35 baht.
>>
>> Note that while minimum salaries vary from province to province here
>> it is 340 baht a day.
>>
>>> I conclude the price reflects some other source of revenue
>>> than your housekeeper.
>>
>> As I said above this is a "Government Hospital" and the employees and
>> staff are government employees.
>>
>> I had part of my ear lobe trimmed off due to sun cancer - common in
>> Caucasians in tropical countries - so every morning I had to go to the
>> hospital and have the wound cleaned and a new bandage, Cost about US
>> $1.00.
>>
>>
>
>No disagreement on your reporting nor what you both paid.
>
>We may have a semantic separation. The hospital system's
>cost is not even remotely reflected in the price (which is
>what you paid).
>
>Hope that helps.

No, of course not. It is a service provided by the State. Just as the
road that you drive to work on, or any of the other services provided
by the government.
--
Cheers,

John B.

On 1/11/2024 6:21 AM, John B. wrote:
> On Thu, 11 Jan 2024 07:00:45 -0500, Catrike Ryder
> <Soloman@old.bikers.org> wrote:
>
>> On Thu, 11 Jan 2024 18:20:05 +0700, John B. <slocombjb@gmail.com>
>> wrote:
>>
>>> On Thu, 11 Jan 2024 05:57:23 -0500, Catrike Ryder
>>> <Soloman@old.bikers.org> wrote:
>>>
>>>> On Thu, 11 Jan 2024 07:47:02 +0700, John B. <slocombjb@gmail.com>
>>>> wrote:
>>>>
>>>>> On Wed, 10 Jan 2024 18:27:27 -0500, Catrike Ryder
>>>>> <Soloman@old.bikers.org> wrote:
>>>>>
>>>>>> On Thu, 11 Jan 2024 06:07:37 +0700, John B. <slocombjb@gmail.com>
>>>>>> wrote:
>>>>>>
>>>>>>> On Wed, 10 Jan 2024 10:54:11 -0500, Catrike Ryder
>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>
>>>>>>>> On Wed, 10 Jan 2024 22:44:31 +0700, John B. <slocombjb@gmail.com>
>>>>>>>> wrote:
>>>>>>>>
>>>>>>>>> On Wed, 10 Jan 2024 08:57:01 -0500, Catrike Ryder
>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>
>>>>>>>>>> On Wed, 10 Jan 2024 20:12:43 +0700, goodsoldierschweik@invalid.junk
>>>>>>>>>> wrote:
>>>>>>>>>>
>>>>>>>>>>> On Wed, 10 Jan 2024 07:36:58 -0500, Catrike Ryder
>>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>>
>>>>>>>>>>>> On Wed, 10 Jan 2024 19:29:08 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>> wrote:
>>>>>>>>>>>>
>>>>>>>>>>>>> On Wed, 10 Jan 2024 06:53:51 -0500, Catrike Ryder
>>>>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>
>>>>>>>>>>>>>> On Wed, 10 Jan 2024 18:26:43 +0700, John B. <slocombjb@gmail.com>
>>>>>>>>>>>>>> wrote:
>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> On Wed, 10 Jan 2024 04:46:05 -0500, Catrike Ryder
>>>>>>>>>>>>>>> <Soloman@old.bikers.org> wrote:
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> On Tue, 9 Jan 2024 22:21:30 -0500, Frank Krygowski
>>>>>>>>>>>>>>>> <frkrygow@sbcglobal.net> wrote:
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> On 1/9/2024 1:32 PM, AMuzi wrote:
>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>> I'm not dismissing your suffering but many people have unreasonable
>>>>>>>>>>>>>>>>>> expectations.  Our modern medical arts are very good at setting broken
>>>>>>>>>>>>>>>>>> bones and repairing wounds etc. Obesity (and subsequent degradation) is
>>>>>>>>>>>>>>>>>> well beyond their purview.
>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>> There's a big difference between removing an inflamed appendix and
>>>>>>>>>>>>>>>>>> promptly, correctly diagnosing appendicitis. My brother the doc has a
>>>>>>>>>>>>>>>>>> pet peeve about that; internists who see a lot of them are very good
>>>>>>>>>>>>>>>>>> diagnosticians but your average MD is more often wrong than right on an
>>>>>>>>>>>>>>>>>> appendix.
>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>> Short answer= it's complex. Medical services comprise a world of
>>>>>>>>>>>>>>>>>> variables and most decisions are made under uncertainty at best.  People
>>>>>>>>>>>>>>>>>> expect more than is actually possible.
>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>> Yes, it's complex. But the data indicates that these complex problems
>>>>>>>>>>>>>>>>> are solved more accurately and far less expensively in nations with
>>>>>>>>>>>>>>>>> publicly funded health care.
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>> Seems to me that the majority of people who want taxpayer funded
>>>>>>>>>>>>>>>> health care simply want other people to pay for their health care.
>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>> I think it is more complex then the simple "somebody else pay". For
>>>>>>>>>>>>>>> example I believe that some people actually travel to Mexico or Canada
>>>>>>>>>>>>>>> to buy medicines as the same pill is cheaper there then in the U.S.
>>>>>>>>>>>>>>
>>>>>>>>>>>>>> https://ashpublications.org/ashclinicalnews/news/1748/Medicare-Drug-Price-Negotiation-Plan-Continues-to
>>>>>>>>>>>>>
>>>>>>>>>>>>> No., disregarding any government interference US prescription drug
>>>>>>>>>>>>> prices were 218% of prices in Canada, 170%of prices in Mexico, 779% of
>>>>>>>>>>>>> prices in Turkey, and 209% of prices in Japan.Feb 3, 2021
>>>>>>>>>>>>>
>>>>>>>>>>>>> I didn't post a reference but you can easily find one.
>>>>>>>>>>>>>
>>>>>>>>>>> Here, for example, there are over 900 public hospitals who obtain
>>>>>>>>>>>>> their medicines through international biding managed by the government
>>>>>>>>>>>>> and open to makers world wide with the result that the Public, i.e.,
>>>>>>>>>>>>> government, hospital medicine costs are extremely low.
>>>>>>>>>>>>
>>>>>>>>>>>> Government negotiations (interference) is why drug prices in some
>>>>>>>>>>>> countries are lower.
>>>>>>>>>>>
>>>>>>>>>>> The government here supports more then 900 hospitals and obtains most
>>>>>>>>>>> medicines through bids from international companies. When you are
>>>>>>>>>>> buying in large quantity prices do go down.
>>>>>>>>>>>
>>>>>>>>>>> How is that "interference"?
>>>>>>>>>>
>>>>>>>>>>
>>>>>>>>>> Governments have coersive power.
>>>>>>>>>
>>>>>>>>> And what is that supposed to mean? That the U.S. government somehow
>>>>>>>>> causes medicine prices in the U.SA. to be so much higher then in other
>>>>>>>>> countries?
>>>>>>>>
>>>>>>>> No, that other governments cause medicine prices to be lower in their
>>>>>>>> countries.
>>>>>>>
>>>>>>> ???? I'm told that medicines used in Thai Government Hospitals are
>>>>>>> purchased through bidding for large quantities from international
>>>>>>> suppliers.
>>>>>>> How is this causing medicine costs to be lower? Sounds like good
>>>>>>> business practice to me.
>>>>>>
>>>>>> "negotiating" with an entity that has the power to burden your
>>>>>> bushiness may not be entirely fair.
>>>>>
>>>>> How is offering to buy a large quantity of a medicine, sufficient to
>>>>> supply 900 hospitals, from the lowest bidder, "negotiating"?
>>>>>
>>>>
>>>> You said there was bidding. I assumed there was more than one supplier
>>>> with different bids. That seemed like a negotiation to me.
>>>
>>> Perhaps a matter of semantics. But the usual method of conducting a
>>> bid to supply a product is to publicize the required product,
>>> specifications and quantities to various entities that are capable of
>>> providing said item in the desired quantities and specifications and
>>> the cheapest one gets the contract. Whether this is a vor
>>> not is, I guess what you want to call it.
>>>
>>
>> My assumption is that most governmnts are corrupt and that the bidding
>> process has "negotiations" other than cheapest price.
>
> In my experience not as much as you might think. Or at least the
> projects that my company undertook over 30 years in S.E. Asia. One
> reason is that normally the bids were opened publicly so all the
> bidders could see the bottom line numbers that other companies bid.
>