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The architecture of the U.S. missile defense program

A hit-to-kill sequence of an EKV colliding with a ballistic missile.  (Source: Raytheon)
Capable of protecting parts of North America from surprise attack, the U.S. finally realizes "Star Wars"

It took nearly 25 years, but President Reagan's vision of a ballistic missile defense to safeguard the U.S. has finally come to fruition. After a final successful test last week, the system's tracking radars and interceptor rockets are now ready for use and capable of responding to an unannounced attack on North America.

General Victor Renuart Jr., senior commander for defense of United States territory, said that while the system is still being upgraded with additional radars and interceptors, it can already guard the U.S. West Coast against a limited attack from Asia. 

As more components come online in California and Alaska, the system will be able to protect larger areas from more complex attacks.

When first proposed, critics originally called the system "Star Wars" and derided "Ronnie Raygun's" scheme as scientifically impossible. Despite repeated criticism, research development that began shortly after Reagan's 1983 speech continued.

Early work focused on exotic beam weapons to knock out incoming missiles. But the development of ultra-high-speed electronics soon enabled the approach used today- - the EKV, or Exoatmospheric Kill Vehicle. The EKV collides directly with incoming missiles, using its own kinetic energy to destroy the target, an approach described as "hitting a bullet with another bullet."

Renuart claims the system, while operational, still has not received the military's claim of "fully operational." He claims in July 2006 parts of the system were tested as North Korea staged missile testing around that time. 

Raytheon reported successful test interceptions on five separate occasions since October 1999.

The most recent test was held last Friday.  A target missile was launched from Kodiak Island, Alaska, and tracked by radar at Beale Air Force Base, outside of Sacramento. The interceptor was launched from Vandenberg Air Force Base, near Santa Barbara, California, and scored a direct hit.

Shortly after the testing, Lieutenant General Henry Obering III, director of the Missile Defense Agency, said, "Does the system work? The answer is yes to that."

Plans for European expansion of the system call for missile interceptors in Poland and a tracking radar in the Czech Republic to defend against the threat of Middle Eastern ballistic missiles.

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M.A.D anyone?
By Combatcolin on 10/3/2007 4:31:45 PM , Rating: 2
The simple but brutally effective concept of your nuke us we nuke you has now been altered.

Russia now have to do something to re-even the balance.




RE: M.A.D anyone?
By KristopherKubicki (blog) on 10/3/2007 4:37:15 PM , Rating: 3
Who said anything about Russia?


RE: M.A.D anyone?
By Polynikes on 10/3/2007 5:20:12 PM , Rating: 5
I saw a program on TV sometime in the past several months about how young Russians are being indoctrinated to hate the US. They worship Putin, an ex-KGB slimebag. Sounds to me like Russia really wants another Cold War. With some of the stuff Putin's been doing, trying to stay in power and such, I wouldn't be surprised if he didn't establish another dictatorship.


RE: M.A.D anyone?
By Amiga500 on 10/3/2007 5:32:18 PM , Rating: 4
Try looking in as well as out. Both sides are pretty much as bad as each other in their manipulation of both their own public, and the rest of the world.

(I'll probably get voted down for this by people either too stupid, or too "patriotic" to open their eyes)


RE: M.A.D anyone?
By mdogs444 on 10/3/07, Rating: -1
RE: M.A.D anyone?
By Le Québécois on 10/3/2007 8:18:35 PM , Rating: 3
Is there something wrong with Canada?


RE: M.A.D anyone?
By mdogs444 on 10/3/07, Rating: 0
RE: M.A.D anyone?
By erikejw on 10/3/07, Rating: 0
RE: M.A.D anyone?
By mdogs444 on 10/3/2007 9:44:29 PM , Rating: 2
All citizens do have access to healthcare. No one is turned down from emergency room treatment, not even illegal aliens.

Everyone in Canada loves the healthcare system - when they aren't sick. But when they do get sick and find out they have to wait 6 weeks to see a doctor, they come to the US.

Hmmm.


RE: M.A.D anyone?
By siberus on 10/3/2007 10:12:07 PM , Rating: 4
Vicious circle?

Americans coming to Canada for drugs and Canadians going to the US for MRI's.


RE: M.A.D anyone?
By mdogs444 on 10/3/07, Rating: 0
RE: M.A.D anyone?
By psychmike on 10/4/07, Rating: 0
RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 1:09:32 AM , Rating: 3
quote:
Drug companies spend far more on advertising in the US than they do on research
Where do people dream up this stuff? The two largest pharmaceutical-only companies in the US are Pfizer and Merck. In 2006, Pfizer spent $7.6B on R&D, and $1.1B on advertising. Merck spent $4.8B on R&D, and $1B on advertising.


RE: M.A.D anyone?
By psychmike on 10/4/07, Rating: 0
RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 1:40:09 AM , Rating: 2
Show your own statistics then. But don't expect us to accept statements like that on faith.


RE: M.A.D anyone?
By psychmike on 10/4/2007 2:18:58 AM , Rating: 3
Good on you for calling me out. It's easy to get lazy but let's try to keep the standard of discourse high.

OK, here goes, the September 2003 issue of the Journal of the Canadian Medical Association, a peer-reviewed publication discusses how direct to consumer advertising costs (cited as comparable to what you stated) do not include sample costs, educational materials for physicians, drug representatives' salaries, or sponsored conference costs.

Paranthetically, the line between advertising and education is really blurry. I point you to the current issue of General Psychiatry (Volume 42, Number 18), hardly a fringe publication, in which Dr. Stone describes how drug research is currently being disseminated in the medical community. Basically, the drug companies produce a paper (with cherry picked subjects and measures, non-responding subjects excluded, and non-significant findings buried), give it to a prestigious researcher who attaches his or her name without involvement, and gets it published in a peer reviewed journal. The drug company gets to cite favorable research, the researchers gets to add a publication credit to his or her CV, and everyone's happy. Oh, except possibly the patient. I kid you not, the good psychiatrists in the bunch are calling the current process nothing less than fraudulent.

The Indiana University's HR Services HR website has less detailed, but more accessible information "http://www.indiana.edu/~uhrs/benefits/bulletin/200..." on drug costs. They say that total marketing and administration costs (I don't know how much is admin but this likely includes marketing surveys and physician usage tracking) are 3x research costs.

Mike


RE: M.A.D anyone?
By Kanti on 10/4/07, Rating: 0
RE: M.A.D anyone?
By psychmike on 10/4/2007 5:59:49 AM , Rating: 3
Based on your content, I believe that your compliment is in response to my post but it looks like it's attached to Siberus's. If it is indeed in relation to my post, thank you for the complement and for sharing your thoughts as well. It's nice to know I'm not shouting into the wind.

Indeed, the ways that corporations externalize the cost for things like research while claiming the profits is one of the reasons why healthcare is falling apart in both our countries. A recent issue of New Scientist (past 4 months?) described an analysis of pharmaceutical research and found marked differences in probabilities for efficacy and significant side effects when research is conducted in public university settings versus privately-funded research. Very troubling since the trend is certainly towards privately-funded research. A physician-researcher here in Toronto, Dr. Nancy Olivieri, identified potentially life-threatening side effects during a clinical trial of a medication to treat a blood disorder. The drug company shut down the research and threatened her with legal action if she disclosed her findings. To their shame, the hospital and her university took the side of the company. Fortunately, she is someone of great character and courage and got the word out. I wonder how often the opposite happens.

Our healthcare system is just as much in bed with corporate interests as yours. General physicians have to know an incredible amount of information but too often rely on diagnostic tests with high sensitivity and poor specificity, leading to many false positives. These tests have some drug name and logo stamped to the bottom of them. Most GPs simply don't practice medicine as much as they do pharmacotherapy. Where is the line between medicine and advertisement when diagnosis, research, and treatment are all driven primarily not by empiricism but by market forces? Even the effectiveness of the invisible hand of capitalism is predicated on all actors having adequate and accurate information and this clearly isn't happening in many areas.

In all of this, I am saddened by how several American posters on this thread seem deeply cynical of their fellow citizens. It has been said that public healthcare would remove people's incentives to maintain their own health - as if being healthy were not reward enough. It has been said that dollars spent on others' health or education is dollars out of one's own pocket - as if there weren't clear economic and social benefits for providing these services, let alone our moral and ethical obligation to our fellow citizen. Why is it that those folks assume the worst of their neighbours when I assume that most Canadians are generally like me - we require some incentive to work hard but generally don't abuse the system. We try our best but sometimes fall down for reasons beyond our control. We take pride in our work and want to be contributing members of our society. We bend the rules in our own favor but seldom break them. How strong can a country be when there is so much distrust between its citizens?

There is so much that is wonderful about America. It has pioneered ideas of equality and inclusiveness. I hope we all rediscover that the weight of our civic responsibilities is much lighter when we carry it together. I hope we all rediscover that it is not a burden to be a citizen but a privilege.

Mike


RE: M.A.D anyone?
By 1078feba on 10/4/2007 12:56:50 PM , Rating: 5
quote:
I am saddened by how several American posters on this thread seem deeply cynical of their fellow citizens


It's not cynicsm, it's a fundamental difference in morals. Wanting to help is laudable, but looking around and deciding that everyone must is immoral. You are taking away my very fundamental human right to decide on my own & are effectively telling me that I am unfit to think for myself.

It makes no difference what argument is built upon that foundation, no matter how humanely conceptualized or altruisticly intentioned, it is immoral...the road to hell being paved with, as the saying goes.

This is not to say that we can't or shouldn't do better. But let's make sure that the primary reason for doing so is not to allow us to feel better about ourselves when glancing in the mirror.

quote:
It has been said that dollars spent on others' health or education is dollars out of one's own pocket - as if there weren't clear economic and social benefits for providing these services, let alone our moral and ethical obligation to our fellow citizen.


Same argument, same basic flaw. Not only that, as someone who works for the government, I am absolutely dumbfounded by your blithe matter-of-fact tone & forgone-conclusion-esque style in pronouncing that a system of complete gov't managed healthcare is more efficient than private. A point of view that so flies in the face of reality that no matter how much hard evidence can piled in front of you to the contrary, you will never understand because you do not want to.

quote:
I hope we all rediscover that the weight of our civic responsibilities is much lighter when we carry it together.


I see a little further down this thread that someone already mentioned it, so I will just toss this in: we do, in point of fact, carry the weight of our civic responsibilities, by giving to charities. America leads all nations on the face of the planet in this regard, and by a wide margin. I live in NOLA, and I was here for Katrina. I, and many others, actually turned down money from the Red Cross, money that all my fellow Americans, from all walks of life and economic strata, gave, and then probably in some way had make do with less. Name another country that parked an aircraft carrier off the Indonesian coast after the tsunami, capable of producing 900,000 galllons of potable water a day.

quote:
I hope we all rediscover that it is not a burden to be a citizen but a privilege.


On this point, you hit a four-bagger. I quite simply could not agree more. The problem is, you see this as a mandate to enforce on others what you see as the "moral & ethical" thing to do. I see it as allowing my fellow Americans to think for themselves, and doing as they see fit to help when and where they are able.


RE: M.A.D anyone?
By psychmike on 10/4/2007 1:16:33 PM , Rating: 1
Thanks for your thoughtful reply.

We can argue about public versus private enterprise. I am not naive, I know that public employees can drag their heels forever and be inefficient. But I also believe that corporations value efficiency and costs over inclusiveness and fairness and healthcare is simply something too important to deprive someone of.

More interesting is your statement about imposing an obligation on someone else. I think that is a fundamental difference between Canadians and Americans and one with strengths on both sides. I do not think that my fellow citizens are unable to think for themselves. But I do think that we have agreed as a society that this is something that is important to us and that we value and have asked our government to administer it for us, much like any other function of government, like building roads. Our healthcare system is incredibly popular. In most polls and surveys, the majority of Ontarians anyways want services expanded, not curtailed.

You are absolutely right about the generosity of Americans. Unmatched per capita in charitable donations domestically and internationally and much of it coming from middle-income individuals. When I lived in the US, I was touched by how much personal support and kindness that was extended to me.

Perhaps in the end, Americans are more afraid of governments and Canadians are more afraid of corporations but perhaps we can agree that both of us want to keep greedy powers in check.

Mike


RE: M.A.D anyone?
By Koshi on 10/4/2007 5:30:34 PM , Rating: 1
1078feba

quote:
I see it as allowing my fellow Americans to think for themselves, and doing as they see fit to help when and where they are able.


Your arguments would be completely sound, were everyone decently paid and comfortably insured, employees of the government. In reality however, those of your rank comprise a tiny percentage of your population.

How freeing it must be to be able to choose all your coverage options when you can't afford the coverage in the first place. You aren't acknowledging the reality that a vast amount of your population can't afford proper coverage or worse coverage period. How many hundreds of thousands of your people have to make the choice between having food on the table or being prepared for the chance that they may become ill.

quote:
It's not cynicsm, it's a fundamental difference in morals. Wanting to help is laudable, but looking around and deciding that everyone must is immoral. You are taking away my very fundamental human right to decide on my own & are effectively telling me that I am unfit to think for myself.


That argument makes no sense. You pay taxes I assume, right? How much choice do you have in that? Are you aware or have any control over where those tax dollars go? Your government helps itself to a percentage of your income each pay day. Every time you buy groceries, or clothes, etc (Except Oregon to my understanding), you have to pay a percentage of the total cost to the government. Do you cry foul over your fundamental human rights when you pay taxes? Whats so wrong with having guaranteed health care covered in your tax dollars?

quote:
Same argument, same basic flaw. Not only that, as someone who works for the government, I am absolutely dumbfounded by your blithe matter-of-fact tone & forgone-conclusion-esque style in pronouncing that a system of complete gov't managed healthcare is more efficient than private. A point of view that so flies in the face of reality that no matter how much hard evidence can piled in front of you to the contrary, you will never understand because you do not want to.


Care to back any of that up? I'd be very interested in seeing the hard evidence you've got on the subject. I'm curious, because I work for the Canadian Department of Vital Statistics, and I've got access to heaps of cold statistical information that can back a pretty strong case to the contrary of what you are claiming. Although, I'm taking liberty with your definition of efficient on the matter. ;)

Now, to be fair, as a Canadian, I will certainly admit our system is not without its flaws. Not by a long shot.
But as far as serving every citizen, period? Sorry, but a Universally available system makes way more sense.


RE: M.A.D anyone?
By Ringold on 10/4/2007 2:17:42 PM , Rating: 3
quote:
I hope we all rediscover that the weight of our civic responsibilities is much lighter when we carry it together.


The founding fathers would likely dare suggest it to be much more secure, or at least that personal liberty is much more secure, when we take not the path that is easy (socialism) but the path that is difficult (individual responsibility).


RE: M.A.D anyone?
By Frallan on 10/4/2007 4:58:58 AM , Rating: 2
Damn!!! One of the hard to almost impossible questions again...

Do i vote up or post..

Since im Posting i just want to say that this was a post indicative of why I read Dailytech and the comments - a true golden nugget of knowledge.

Thx
/F


RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 5:03:26 PM , Rating: 4
quote:
"They say that total marketing and administration costs (I don't know how much is admin but this likely includes marketing surveys and physician usage tracking) are 3x research costs"
Unfortunately, this is just the website for a University's HR department. The claim is unsourced, and without any supporting data.

Worse, even if true, it doesn't support your original claim, as "administrative" costs are by far the lions share of drug companies charges. Why? Because that little line item includes the two most expensive charges a drug company faces, a) getting FDC approval for new drugs, and b) the contingency fund for paying settlements for drug liability suits.


RE: M.A.D anyone?
By sxr7171 on 10/4/2007 12:55:45 PM , Rating: 2
Solicitation of professionals is nothing like it was in the 80s. Back then, if you were a doctor you could expect expensive gifts, nice meals, and even vacations courtesy of the drug companies. These days, you might get a pen or a pad of paper.


RE: M.A.D anyone?
By psychmike on 10/4/07, Rating: 0
RE: M.A.D anyone?
By JonnyDough on 10/4/07, Rating: 0
RE: M.A.D anyone?
By Hawkido on 10/4/2007 5:42:54 PM , Rating: 2
Its nice for the government to decide everything for you... like the price of drugs, and the cost of healthcare. They even decide how long you wait to see the heart specialist. My grandma only had to wait 2 weeks out of the suggested 4 week queue to see the heart specialist in Canada(they sent her to the morgue... she musta got tired of waiting.) I know this is an isolated incident... My Grandpa got put in the same queue in Quebec, he lived but they said the heart damage went untreated too long and now his heart is hanging by a thread. It funny because they moved to Canada for the free health care 10 years ago. I guess you get what you pay for.


RE: M.A.D anyone?
By dever on 10/5/2007 1:36:06 PM , Rating: 2
"government negotiates" = forced pricing. Making it illegal to charge above a certain price in Cananda creates higher prices elsewhere.

The problem is a lack of competition and over-regulation. If allowed to thrive in a truly free market, everyone could pay the lowest possible prices for drugs.


RE: M.A.D anyone?
By Targon on 10/4/2007 7:59:51 AM , Rating: 3
And insurance companies allow the drug companies to keep the prices much higher than they should be based on volume produced. In many industries, if the volume of goods sold is very high, and the cost to produce(not develop) the product is low, prices go down. Insurance companies allow people to continue buying overpriced drugs rather than not buying them and forcing the prices to go down.

The government COULD be spending more efforts to regulate the costs of medical procedures and medications which would reduce(not eliminate) the need for insurance just to pay for medications and some medical procedures.


RE: M.A.D anyone?
By psyph3r on 10/3/2007 11:25:10 PM , Rating: 5
i don't think anybody in the us understands how socialized medicine works. It really isn't as bad as america thinks it is. we are the only top 25 country without socialized medicine. we are 37th in the world on health. something wrong with that equation? I believe france is the highest. None of them would trade their citizenship in their country for our health care. they would almost all laugh at you.


RE: M.A.D anyone?
By psychmike on 10/4/2007 12:17:31 AM , Rating: 2
You have no idea what you're talking about. We see physicians whenever we want to. I have a GP who can usually see me within the same week but if I want to go sooner I can visit any walk-in clinic I like and wait 15 minutes. How long do you wait in your hospital emergency rooms? I worked in one last year and the average wait time for a non-emergency was about 2 hours with a total visit lasting about 5 hours.

Talk to the Chair of Health Policy at Harvard. He says that the American system is great for developing expensive technologies and treatments but are lousy at delivering services and promoting prevention. How does healthcare work when the only services that are promoted are the ones that make someone a buck? Where's the benefit in spending time with someone and discussing their diet and exercise instead of writing a script for a statin which comes with its own side effects?

If a for-profit healthcare system is so great, why does the US spend more (2x) per capital on healthcare than Canada and most European countries and yet lags on primary indices of health like infant mortality, birth weight, chronic disease?

There are LOTS of things that corporations are good at - generating innovation, finding some efficiencies, etc. But those are at odds with several other factors intrinsic in healthcare delivery - things like accessibility, non-externalization of costs, and accountability. Check out the recent issue of General Psychiatry. Want to know how drug research is done? The pharm companies cherry pick their samples, cherry pick their measures, drop out subjects that don't respond to treatment, and until recently only had to publish the results they wanted. Is THAT likely to produce good medicine?

I don't mean to shame you but you have no idea how foolish you sound to anyone who knows anything about the issues. It's fine to be patriotic but loving one's country means knowing about it and wanting it to be better for all its citizens.

Mike


RE: M.A.D anyone?
By Ringold on 10/4/2007 12:54:58 AM , Rating: 2
quote:
If a for-profit healthcare system is so great, why does the US spend more (2x) per capital on healthcare than Canada and most European countries


I won't counter your cherry picked examples of the time it takes for one procedure or another with examples of my own of equal bias, but I can respond confidently to the above.

The reason is simple. We've got a bastard system; companies and government both hold up parts of the market and a failure to have sensible regulation means that the insured face almost none of the consequences of maintaining their own health and the uninsured have a hard time finding affordable insurance because no measure has been taken to force a little risk-pooling. It's the worst of both worlds. Is anyone actually even defending the current system anyway? What I see is a debate between the Romney/Swiss system and Canadian or Canadian-lite systems, not the status quo.


RE: M.A.D anyone?
By psychmike on 10/4/2007 1:06:37 AM , Rating: 1
Good points but I don't believe I am cherry picking the data - I've acknowledged what a market-based system does well (innovation, local efficiencies) and what it does poorly (provide access, administrative efficiency, prevention). If there's something I'm not seeing, please point it out.

I'm surprised that you identify the lack of individual incentives as a rationale for private healthcare. People make silly decisions all the time but no one wants to be sick. There are quality of life, work, relational, social reasons people should look after their health. By your thinking, people should engage in more risky behaviour in Canada because of socialized medicine but this simply isn't so. In fact, our indices of chronic health issues are better than those in the US so clearly people don't require a cost incentive to try to stay healthy.

I don't know Romney's proposed system but will read up on it. The Swiss system isn't really much more private than what we have in Ontario. Here, the government provides basic healthcare (GP visists, life saving operations) while medication, dentistry, optometry, psychology, physiotherapy is paid for privately but most people have private insurance through their workplace.

Mike


RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 1:19:16 AM , Rating: 3
quote:
"How long do you wait in your hospital emergency rooms? I worked in one last year and the average wait time for a non-emergency was about 2 hours
Well obviously if you're in an emergency room for a non-emergency, you're not going to be seen extremely quickly.

quote:
why does the US [lag] on primary indices of health like infant mortality, birth weight...
Because of drug use among mothers, primarily.


RE: M.A.D anyone?
By psychmike on 10/4/07, Rating: 0
RE: M.A.D anyone?
By psychmike on 10/4/2007 6:24:27 AM , Rating: 2
Masher2, are you being disingenuous are do you simply have reading problems? Clearly, I was responding to Mdogs post that all Americans have access to healthcare via emergency rooms. If that is the base level of accessible healthcare versus the Canadian system where most (certainly not all) people have a family physician, access to free walk-in clinics staffed by physicians, and can visit emergency, clearly we have better access.

Why don't you simply take a poll with stratified sampling for income and ask 10,000 Americans and 10,000 Canadians who is happier with their healthcare system? Let the results speak for themselves. We are more highly taxed than you are but we also appreciate the safety net that public healthcare provides for us. We believe that most of the other citizens in our society are good people who deserve support when they fall on hard times.

As for your comment about drug using mothers, I feel sorry for you if you look around your country and see so many others as being part of the problem and a threat to your welfare. I choose to believe that most Americans are not as cynical, selfish, and afraid as you appear to be.

Mike


RE: M.A.D anyone?
By mdogs444 on 10/4/2007 8:29:35 AM , Rating: 1
quote:
Why don't you simply take a poll with stratified sampling for income and ask 10,000 Americans and 10,000 Canadians who is happier with their healthcare system?


That would all depend on which group you ask. If you ask middle class americans who work hard for their money, and want to maintain their current lifestyle with feeling they have to support people who dont want to work, then they will say the current system. If you ask low income americans, then sure, they will say a universal system. In my opinion, laziness is no longer an excuse to expect other people to support you out of their hard earned money. My father worked two jobs, 85 hrs / week to be able to provide the lifestyle he wanted for his kids, and was taxed in a high income bracket so that his money would go to supporting people who are lazy and dont want to work.

I know thats not all his money went to, and i know that not all people who dont have jobs are lazy, but implementing a larger wealth redistribution method is stupid. It will encourage those who dont have good jobs or high paying jobs to stay as they are because they are getting even more free money, and it will discourage people who want to get great jobs because they will be losing out on even more of their money.

It defeats the purpose of the "american dream" unless you your dream is to be a pantywaist mooch.


RE: M.A.D anyone?
By psychmike on 10/4/2007 12:33:47 PM , Rating: 3
Hence my statement about polling a stratified sample.

I know how you feel. My dad worked very hard too, from literal homelessness to making a good life for our family. People do need incentives to work. I would never advocate a welfare system that had no incentives for people to try to better themselves. BUT healthcare is one of those things like education where I believe access is crucial to a well-functioning society. People don't choose to get sick and often illness has huge consequences for the whole family and for society. As I mentioned earlier, if I may also offer a personal example, my own mom received a kidney transplant when I was much younger. She likely wouldn't have been able to get coverage for this due to early risk factors. If we would have had to pay for this, it would have bankrupted our family. We would have had to sell our house, forgo university, and lived in debt for decades. Instead, she got her operation, got better, went on to go back to work, and my sister and I finished graduate school and are now professionals who pay our share of that higher tax bracket too. If you're a pragmatist, health is just one of those things that has wide ranging social and financial costs and I'd rather help pay for someone's GP visit before they develop an acute condition that takes 10x more to treat, affects their employability, and the lives of many people. But more than that, I guess us Canadians feel morally and ethically that healthcare is something that all of our citizens should have access to.

Mike


RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 11:21:55 AM , Rating: 2
quote:
As for your comment about drug using mothers, I feel sorry for you if you look around your country and see so many others as being part of the problem and a threat to your welfare. I choose to believe that most Americans are not as cynical, selfish, and afraid as you appear to be.
You type this, then have the gall to call me disingenuous?

You asked why the US lags certain other nations in infant mortality and birthweight, attempting to link that to problems with our healthcare system. You ignore the fact that problem has a much more immediate cause-- illicit drug use among mothers, at a rate well above other industrialized nations.

Then you attack me as "selfish and afraid" for merely pointing out that link? Where did I say or even imply that it was a "threat to my own welfare"? Nowhere of course, and you and I both know that.

Your "misconcomprehension" was clearly intentional, and intended as a personal slur. You should be ashamaned of yourself.


RE: M.A.D anyone?
By psychmike on 10/4/2007 12:55:26 PM , Rating: 2
I honestly do not mean to offend you. You seem like a very intelligent person but you have been responding to my other posts very selectively and in a way that seems to oversimplify and even mock the issue (e.g., suggesting that I do not understand that non-emergency wait times would be longer in an emergency setting, stating that implementing a healthy lifestyle is simply common sense - are so many people just stupid in your mind?).

When you bring up the example of drug using mothers, it is simply inflammatory to pick a group of people who likely won't garner much sympathy to illustrate your fear that the healthcare system would be abused. You state that this population is responsible for the poor health statistics that I cite. Well, please back up YOUR statements. Show me your data that this sample contributes in a statistically significant way to overall population healthcare costs or outcomes. As you state, I do not doubt that the US likely has a larger population of this kind than many industrialized nations but I still do not know that it is very large overall. MY hunch is that lower birth weights, etc. are better accounted for by lower access to prenatal care for the general population.

As for my statement that you seem selfish and afraid, let us put the lie to it. Do you believe that drug using mothers should receive health benefits or would you prefer to let them fend for themselves? What of their children? Much more likely to be born prematurely, with complications, some form of pervasive developmental disorder. Should we just deal with the mess for a lifetime or do we try to mediate these harms?

Again, practically, I've described how private healthcare works. You pay your premiums and then require services. The adjuster who decides if you should get that benefit is typically not educated in healthcare and almost never at an advanced level. They have personal financial incentives to keep the benefits that they allow low. If they deny your claim they then send you to an insurer's examiner. Often, this is someone who gets paid largely on insurance work. They also have personal financial incentives to disallow the benefit. If they deny the claim, it may go to lengthy arbitration or mediation or court. Does THAT sound like a fair system for someone who is ill to have to go through? At what point is an objective expert making a decision based on your welfare? At what points can corporate biases wreck the process?

You seem like someone who is concerned with fairness. Does that sound very fair to you either? I understand that there are some new proposals being put forward and I hope they work better than this model.


RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 5:21:01 PM , Rating: 1
> "When you bring up the example of drug using mothers, it is simply inflammatory to pick a group of people who likely won't garner much sympathy "

You selected the group, not me, when you singled out infant birth weight and mortality as a critical metric. The root of that problem is drug use among mothers, and no amount of your shucking and jiving will hide that fact.

Here's a study on expectant mothers who agreed to a substance abuse program. The results are astounding. Premature deliveries dropped by 70%! Low birthweight dropped by 84%! Infant mortality by 67%. There's no denying statistics like that:

http://pn.psychiatryonline.org/cgi/content/full/36...

Now, how about you stop selectively replying to my posts? Do you still deny that any substantive number of adults in the nation don't already know that exercise and diet will improve their health? What's the source of your belief that physicians don't already spread this knowledge? (Mine certainly does...he hasn't missed a beat in 11 years yet).

You accuse me of calling people stupid, yet you call them ignorant. People already know the advantages of diet, exercise, and moderating in alchohol and tobacco use. Many simpy don't want to give up these pleasures, and live a more ascetic lifestyle. Simple fact, and it is not calling anyone "stupid" to point it out.

> "[The insurer] also have personal financial incentives to disallow the benefit.."

Misleading and inaccurate as usual. An insurer attempts to disallow noncovered benefits. There is a strong disincentive to disallowing ones which are covered. First, you open yourself to an expensive civil suit...possibly even a crushing class active suit if the action is widespread. Secondly, you risk annoying your paying customers and the root source of all your income.

In 20+ years, my various insurance providers have paid countless hundreds of claims all without a quibble. Over all those years, only one was ever improperly denied. I issued a complaint; they investigated, and paid it. End of story.


RE: M.A.D anyone?
By howtochooseausername on 10/12/2007 2:09:53 PM , Rating: 2
quote:
Because of drug use among mothers, primarily.


So what's your source for that statement? It seems awfully callous if not just mean.


RE: M.A.D anyone?
By anonymo on 10/4/2007 6:58:51 AM , Rating: 3
6 weeks, lol I would be dead!

At least I don't have to pay $100k for a broken limb.


RE: M.A.D anyone?
By InsaneGain on 10/4/2007 12:56:30 PM , Rating: 4
quote:
Everyone in Canada loves the healthcare system - when they aren't sick. But when they do get sick and find out they have to wait 6 weeks to see a doctor, they come to the US.

Typical ignorance. It is a well published fact that the US spends double per capita on health care than other industrialed nations, yet actual quality for the average American is worse. http://www.msnbc.msn.com/id/18674951/
Informed Americans all know there is a major problem with their health care system.
"Congress, President George W. Bush, many employers and insurers have all agreed in recent months to overhaul the U.S. health care system"
health care costs in the U.S. a major issue for their economic competitiveness. Did you not read about the huge problems the U.S. auto sector is having with health care costs??? Did you not hear about the desperate negotiations GM is having with the UAW regarding health care costs? The US health care system is bankrupting US Industry.
BECOME MORE INFORMED BEFORE SPOUTING YOUR MOUTH OFF ABOUT OTHER COUNTRIES HEALTH CARE SYSTEMS.


RE: M.A.D anyone?
By onelittleindian on 10/3/2007 10:06:28 PM , Rating: 2
quote:
Healthcare for all citizens is a real problem.
Its not a problem if health care grew on trees. But it doesn't.

It has to be paid for by other people. That means "free" health care for all is nothing but forcing Person A to work so that Person B can have health care.

Sounds like slavery for me, however nice you dress it up.


RE: M.A.D anyone?
By mdogs444 on 10/3/2007 10:12:23 PM , Rating: 1
Thank you. Universal Healthcare = Distribution of Wealth.

I make more than someone else, so I should give them some of my money. It completely throws out what this country was founded on - land of opportunity. The ability to be as successful as you can be.


RE: M.A.D anyone?
By treehugger87 on 10/3/07, Rating: 0
RE: M.A.D anyone?
By onelittleindian on 10/3/2007 10:24:38 PM , Rating: 5
> "Haha, you pay taxes. Wonder where those go"

Most of them already go to redistributing wealth. Does that make it right?

I know the world would be a much better place if we just let our paternalistic government spend all our money for us, but I can't help but want to keep at least a little of my own money now and then.


RE: M.A.D anyone?
By mdogs444 on 10/3/2007 10:35:47 PM , Rating: 1
Our taxes go for everything in our country - things we want the money to go to, and things we dont.

National security (you should pay us for yours), funding our military (RCAF - thats like our local air show), welfare system (which i think sucks), healthcare, police, fire department, etc, etc, etc.

But hey, we prefer to keep Canada around - we like your beer.


RE: M.A.D anyone?
By myhipsi on 10/5/2007 12:24:15 PM , Rating: 2
quote:
But hey, we prefer to keep Canada around - we like your beer.


.... and our oil, coal, electricity, softwood, zinc, uranium... shall I go on?

Here's a tip. Try being a little less arrogant and pompous and try to learn a little more about your northern neighbor instead. Contrary to what you may believe, there's more to Canada than Beer and Hockey.


RE: M.A.D anyone?
By derwin on 10/3/2007 11:51:55 PM , Rating: 1
Infact, Universal Healthcare would probably reduce your healthcare costs... If you didnt need to pay shareholders a slice of the pie, it would be cheaper for you, as you are only paying for services provided, not also so someone somehwere can make a buck off of your brain tumor.

I don't see people complaining when we keep our citizens alive by manning the walls with gunmen, why can't we line our streets with doctors too, and keep our people more than alive, but healthy too?

P.S.
Any aspect of a large government = Redistribution of Wealth.

Another part of this great country (beyond our ability to make vast amounts of personal wealth) is that we CARE about eachother- you know, "proud to be an American," and all that? Thats what I think a lot of people have lost. You really would rather have a new car than pay an extra 2000 a year to ensure your fellow AMERICANS have adequate health care?

You are not the kind of american that I feel I should really care about, but I do anyway.


RE: M.A.D anyone?
By Ringold on 10/4/2007 12:08:43 AM , Rating: 1
quote:
Infact, Universal Healthcare would probably reduce your healthcare costs...


Go away, find a community college, take ECO2001 while sober, and ponder that again.

If you can't part with $300 for a university course or $150 for a cheap CC, then a library works.. might even have Bernankes textbook; double bang for your library buck. Removal of willful ignorance and insight in to the mind of the worlds most important central banker.


RE: M.A.D anyone?
By psychmike on 10/4/2007 12:38:26 AM , Rating: 3
I guess you disagree with the Chair of Healthcare Policy at Harvard. You're so smart, why don't you explain how a company that has to generate a profit can deliver services for less money than an organization which does not? Currently, the administrative costs for private healthcare range from 20-30% above which socialized medicine costs to deliver. You also seem to believe in economic incentives. Why don't you tell me the economic incentive for working with patients for an hour around preventative care (diet, exercise) instead of taking 5 minutes to write them a script that produces side effects. Physicians in your country have a disincentive towards providing effective service because they are paid for the number of services provided, not the effectiveness of the service. This encourages brief visis requiring multiple return visits. Canada is no different in this regard - we have a publicly funded system but most services are provided by for-profit physicians.

If American healthcare is so wonderful, why do you spend 2x per capita what other industrialized countries do and lag on primary indices of health? It's because your system is great at producing expensive technological systems that generate profit (that's why we come down to use your MRIs) but lousy at providing accessible service.

Mike


RE: M.A.D anyone?
By Ringold on 10/4/07, Rating: 0
RE: M.A.D anyone?
By psychmike on 10/4/2007 1:14:11 AM , Rating: 1
Nice to spar with you again!

YOUR private schools produce better results than your public schools. Private service providers must ALWAYS offer something that the public system does not provide - better teachers, smaller classes, more computers - in order to compete. That means that the private system will always have higher costs than the public system. It does, however, produce a profit by being able to exclude students, ahem, customers who cannot pay. If the goal of education is to produce an informed electorate, good citizens, or a well-trained workforce, not providing education has huge costs for your society.

Our public schools do just fine thank you. Your university system is a little different. There is something very admirable about how your best schools produce amazing innovations and discoveries but that is a much more complex issue involving patents, foreign scholarships, etc.

Mike


RE: M.A.D anyone?
By Ringold on 10/4/2007 2:22:31 PM , Rating: 2
quote:
YOUR private schools produce better results than your public schools.


Sadly, because of America's backwards attitude towards encouraging competition, most of the private school studies that show positive results happen to be those done internationally. Much to my own shame, some come out of Europe.

It's not just ours that do better, therefore, but it appears to be universally better. Which makes sense, seeing that economic principles apply universally..


RE: M.A.D anyone?
By psychmike on 10/4/2007 3:06:58 PM , Rating: 2

It's an easy argument to compare a private system in the same community favorably to a public system in the same community. The private system must offer some advantage or why would people pay? The point is that the private system isn't doing better simply because of competition, it is pulling the best resources (teachers) from the public system. The only fair comparison that can be made is between a private system and a public system in unrelated but similar communities in order to control for the interaction between the systems. So, you are the one who brought up education. Show me one study that shows that private American grade schools outperform public Canadian schools.

Whatever studies you produce that show public schools outperform private schools does not address the issue of whether it is either practical, responsible, or ethical to neglect those who cannot afford the service. If people opt out of public education and pay for it privately, what happens to the public system? It crumbles. What happens to the children who can't afford a better education? They go to schools with poor infrastructure, worse teachers, larger classes. It just perpetuates the status quo rather than creating a fair base by which all people can reach their full potential based on their merits (not the wealth of their parents).

Mike


RE: M.A.D anyone?
By psychmike on 10/4/2007 1:24:37 AM , Rating: 4
I completely agree with you about how private enterprise generates local efficiencies and is great at promoting innovation. Where you and I will have to disagree is where it is appropriate to apply economic principles.

To me, these things fall apart when socially, morally, we do not want to exclude people from the system. To me, things like healthcare and education are basic rights of citizens, not just those that can afford it. I'm not just idealistic about it, I'm also practical. By and large, I don't see people abusing the system - running into the hospital for unnecessary services, trying to learn too much in school - but I see lots of people benefiting from it who otherwise would have a much worse quality of life. General access to education and healthcare promotes healthy citizens who can work, participate in democracy, and become productive members of society. I just don't see the good in the alternative.

I don't want to get too personal, but my mom had a kidney transplant when I was a kid. If we had to pay for it, it would have absolutely ruined our family. We would have had to sell our house, forgo an advanced education, and worked for years to get out of debt. I doubt that she would have been able to get private insurance because she had diagnosed renal problems from childhood. Because she got the operation for free, she got better, went back to work for 20 years and my sister and I both attended graduate school and have become professionals. For that, I am very grateful to live in Canada. It gives me no pleasure to suggest that a family in the US in exactly the same situation may not have had such a happy ending to their story.

Mike


RE: M.A.D anyone?
By masher2 (blog) on 10/4/2007 1:44:28 AM , Rating: 3
> "...for working with patients for an hour around preventative care (diet, exercise) instead of taking 5 minutes to write them a script..."

Is there anyone in the US who doesn't already know that exercise and a good diet will better their health? Those who don't do it don't WANT to do it...and having a paternalistic doctor lecture them isn't going to change things.


RE: M.A.D anyone?
By psychmike on 10/4/2007 2:24:42 AM , Rating: 3
No, it's not as simple as that. In fact, very little is as simple as you often describe. There's a whole field of research involving treatment non-compliance of which I am sure you are unaware. Regardless, my point is that private healthcare does not create incentives for outcomes, only services delivered.

Mike


RE: M.A.D anyone?
By Spivonious on 10/4/2007 9:18:42 AM , Rating: 2
quote:
Regardless, my point is that private healthcare does not create incentives for outcomes, only services delivered.


That's pretty much up to the doctor. A good, morally-centered doctor doesn't just prescribe medicine to get the patient out the door, doesn't schedule repeat visits when one longer visit could help the patient more. Why do you think doctor's offices are always running behind schedule? Emergency rooms have a 2+ hour wait for non-emergency patients. Well, duh! If it's not an emergency, then wait until the family doctor's office opens and go see him; he knows more about you than some ER doc anyway! If you can't afford the family doc, then go to one of the many free clinics available! The city I live in has under 200,000 people and it has three clinics.

Since you live in Canada, you have no personal experience with the U.S. healthcare system. You are basing your entire argument off one article in a psychiatrist's journal.

I would much rather prefer to have my place of business pay for my healthcare rather than raising taxes even higher to support those who refuse to support themselves. Welfare doesn't encourage people to get jobs, so why would free healthcare encourage people to be healthier? We already have programs in place to help those who can't afford healthcare (Medicare, Medicaid). Don't make me throw away any more of my hard-earned money.


RE: M.A.D anyone?
By psychmike on 10/4/2007 1:02:06 PM , Rating: 2
I have no doubt that there are good physicians out there. I simply ask you if a system in which physicians are paid to deliver services (effective or not) is likely to work as well as one in which they are paid for improved health outcomes.

As for my not having experience living in the US, you are simply wrong. I lived and worked in Rochester, NY for a year. I've worked in both private and public healthcare settings. Now, your turn. Have you ever lived in Canada? If not, can I discredit your opinion as to which system is better?

I hope that gives me some credibility to offer my opinion but I don't require it. I stand on the internal consistency of my argument, the moral and ethical basis of my perspective, and the research I have cited in the many posts above.

Mike


RE: M.A.D anyone?
By psychmike on 10/4/07, Rating: 0
RE: M.A.D anyone?
By mdogs444 on 10/4/2007 8:35:36 AM , Rating: 2
quote:
You really would rather have a new car than pay an extra 2000 a year to ensure your fellow AMERICANS have adequate health care?


Yes, i would. I already pay over 35% of my income in taxes. If i want to support more people, then it should be my choice, not my duty. If people on or below the poverty level want my help, then they'll have to show that they are trying to work harder to get to where they need to be, not just standing on the corner with their hands out asking for a free ride. I volunteer much of my time after work at the non-profit hospital system that i work for, i make donations several times a year for kids who cannot afford to have a good christmas. People need to start earning their keep around here instead of living with the mentality that they are "entitled" to more of what i work for. Entitlement is the form of selfishness that hurts this country, not people who want to keep what they actually earn.


RE: M.A.D anyone?
By blaster5k on 10/4/2007 10:17:50 AM , Rating: 2
It's worth pointing out that Americans give more money per capita to charity and other causes than any other nation -- and by a pretty wide margin.

http://abcnews.go.com/2020/Story?id=2682100&page=2

Many of us who pay taxes (50% of our population pays 96% of taxes) aren't too wild about automatic income transfers, but that doesn't mean we don't care.


RE: M.A.D anyone?
By psychmike on 10/4/07, Rating: 0
RE: M.A.D anyone?
By Keeir on 10/4/2007 1:08:20 PM , Rating: 2
quote:
Infact, Universal Healthcare would probably reduce your healthcare costs... If you didnt need to pay shareholders a slice of the pie, it would be cheaper for you, as you are only paying for services provided, not also so someone somehwere can make a buck off of your brain tumor.


Something to keep in mind is that with the advent of globalized companies, the internet, cheap airfare, etc. Healthcare and Healthcare costs are now a global market. A global market that is criss-crossed with tarrifs, local laws, "entitlements", and subsidies. There is almost no way to know what the effect on the entire world healthcare system would be if a major money supplier (the US) tried to force thier balance into a even or par basis (IE only pay exactly what they consume).

One noteable example would be in the development and sale of pharm. drugs. Pfizer, a world-wide drug company with operations pretty much everywhere in the world, financial statement

http://media.pfizer.com/files/annualreport/2006/fi...

check page 77 for info. Pfizer makes roughly 50% of its revenues on the United States, year after year. Pfizer also has revenues from the United States that are a better match with long term assists. Reducing the United States contribution to revenues by 1/3 by having volume pricing/controled pricing would reduce pfizers revenue by around 9 billion (more than what they spend on R&D). This loss of revenue would fall heaviest on R&D, profits, and growth of business. None of these things would be desirable in the long-term future of healthcare.

quote:
Another part of this great country (beyond our ability to make vast amounts of personal wealth) is that we CARE about eachother- you know, "proud to be an American," and all that? Thats what I think a lot of people have lost. You really would rather have a new car than pay an extra 2000 a year to ensure your fellow AMERICANS have adequate health care?


I see this as silly. I already pay a significant amount so other Americans can have healthcare. I pay it in the form of higher drug costs, higher insurance priemiums, medicare taxes, general taxes, etc. Taxing me -more- to provide services that I don't agree with is not patriotic or intelligent. I also see most "public" systems in the United States being run into the ground. The public schooling system, the public transportation systems, the public road systems, the army/national defense, etc based on these experiences, a public healthcare system would be 1. overbudget, 2. easy to exploit/wasteful, 3. Not provide benifical services.


RE: M.A.D anyone?
By psychmike on 10/4/2007 12:23:23 AM , Rating: 3
Only if one sees things as being zero sum which is simply not true. Investing in your fellow citizen's healthcare means reducing long term costs due to unemployability, emergency care, etc. It's not a coincidence that all other developed countries have socialized medicine programs. You don't have to be an idealist - it's simply practical.

Besides, I thought the idea of civil society was to care about the welfare of your fellow citizen - something that brings people together instead of breeding resentment and selfishness. Americans have a reputation for being incredible generous and compassionate people. I hope they continue to live up to that great history.

Mike


RE: M.A.D anyone?
By Ringold on 10/4/2007 12:31:52 AM , Rating: 2
All developed countries have socialized medicine?

Really then? Switzerland is down there with Zimbabwe, is it?

What we (and I refer generally to conservatives, though definitely not a monolithic group) rail against is full-scale government take-over of the industry. A free-market approach, like that implemented by Romney and like that implemented by Switzerland, I believe, would be widely accepted here.

The problem is that it doesn't expand federal government power enough; in fact, it could be a significant reduction in the scope of government power if implemented properly. Hence plans that look very little like the aforementioned successes, and hence the staunch resistance.


RE: M.A.D anyone?
By psychmike on 10/4/2007 12:48:19 AM , Rating: 2
That's not accurate and you know it. Switzerland operates a mixed system where the private insurers are heavily regulated and required to provide accessible and affordable coverage. Switzerland also has very high healthcare costs compared to other industrialized countries. Citizens are required to have basic coverage which is standardized across the country.

It may surprise you that Ontario (programs are run provincially) operates a mixed system as well. Basic health coverage (GP visits, serious operations, diagnostics) is universal but medication, dentistry, optometry, psychology is not covered. Most people have private insurance for these costs. The costs of administering the public system are significantly below those for the private system and there is increasing scrutiny and cynicism about how private insurers are dealing with their clients, much like in the US.

Mike


RE: M.A.D anyone?
By Ringold on 10/4/2007 1:05:20 AM , Rating: 2
quote:
Switzerland operates a mixed system where the private insurers are heavily regulated and required to provide accessible and affordable coverage. Switzerland also has very high healthcare costs compared to other industrialized countries.


They also are the last bastion of biotech research and production in the Old World.

I don't see how it's a mixed system any more than MA. now is. They get large tax rebates and get to choose their plan, level of coverage and provider. Providers can compete on price with a given level of services (heavily regulated, as you point out). This is in fact virtually the same system advocated by conservative king of thrift talk show host Clark Howard for the better part of a decade. Free market elements aplenty that retains many of the mechanisms that control costs while maintaining quality, insuring widespread availability, and not doing undue harm to present system.