But Bill

Post #324,351 by jake123 4/10/10 1:10:18 AM Reply	But Bill Those things that you cite as having been lost have nothing to do with comprehensive social insurance. Civil liberties and social insurance are orthogonal. The sensible thing for the US to do is to look at social insurance schemes around the world and use the experience of others to design one that meets the goals. There's nothing wrong with replacing SS with something better; there is a problem with turning it into an atomic market for individuals in a market of sharks. Social insurance is by its nature a pay as you go... I pay today for the people that need it, and when the day comes that I need, other people will pay for me. The recognition is understanding that the day will come when I do need it. I can't help but point out that the US is far from the only place where people discover new things about health. And the point of social insurance is that it is a limited set of freedoms. Social insurance neither helps nor hinders questions of state power over the individual. If the state is bugging my phone, that's outside the scope. That's not to say it's not a problem... but it's not a social insurance problem.
Post #324,367 by crazy 4/10/10 8:07:44 AM Reply	I hate to do this, but Those things that you cite as having been lost have nothing to do with comprehensive social insurance. Civil liberties and social insurance are orthogonal. Not here. And not there. You have civil liberties that are different from ours. Part of ours is a serious belief that our personal and medical information is VERY private. We get to choose who sees what. Of course, this crumbles when you have a medical issue that is dealt with via a large insurance company, but that is part of a required process that an individual agreed with. But some people don't agree with it. Some people see that once their medical information is part of a vast government database, then a huge portion of unknown people will have access to it. And they are being forced to join this. If they don't, then the feds will be allowed to fine them some serious cash. And don't bother talking to me about the various support they can get, that's just one more tool for the omnipresent (and possibly malevolent) government to get their hooks into you. These a reasonable fears. Who among us (in the IT / database side) really sees a correctly designed and administered field by field, record by record, ACL protection system, with each VIEW (as well as modification) of each record tracked, and any abuse of system by any employee (including simply reading a record that is not part of their job) gets them canned and possibly prosecuted. Not me. I see some minimal multi-tier security. And it'll end up that the help-desk functionality gets farmed out to india, with the ability for them (really, any random IT guy) to suck out the whole database and sell it to the highest bidder. And that's just one of many examples, they really just go on and on.
Post #324,374 by scoenye 4/10/10 11:31:04 AM Reply	Over there One does not have anything to do with the other. Elsewhere on the planet, the government pays the bills, the doctors keep the records. In Belgium's case, payments are handled by an intermediary of the patient's choosing. Those organisations see a fair amount of detail but that is as far as it goes. The government only sees coded diagnosis data (coupled to length of stay if a hospital is involved.) There is a push going on to towards digital records, but those still reside at the doctors offices. Hospitals do manage all the data for their specialists. AFAIK, the Brits are the only ones pushing for a central medical database as you describe and it is not going very well. Besides, what do you see the government do worse with your medical data than a profit motivated insurer already does today?
Post #324,417 by jake123 4/11/10 1:01:28 AM Reply	The state doesn't hold my medical records my doctor does.
Post #324,380 by beepster 4/10/10 2:27:51 PM Reply	Go back to the article you seem to be discussing something else with me I will choose a path that's clear. I will choose freewill.

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