Calling a 'spade' a 'spade'...

[Larry Gude]

This is going to delve into healthcare after a bit so, that is why this is in politics, but, first, some digression.

We all know what it means when one calls a spade a spade. No matter your politics, if you're sitting in Vegas playing Blackjack and the dealer plops a an ace on top of a face card in front of you, you know, because you know the game, you have just recieved a 'blackjack' and you're not gonna call it anything else. You're not gonna say 'that is a bad hand and I lose'. It is what it is. A spade is a spade.

If you don't know, it will be explained to you and you either get with the program or you just hand your money over to the dealer one hand at a time.

Tommy Lee Jones famously said in 'Men in Black' that "a person is smart, people are stupid."

While that may ring true, a person cannot move a mountain, people can. A person can work their ass off yet take several years to build themselves a home while 12 people can get together and build a house in a month, one a month, and all have a home in one year; an exponential gain.

Recognizing something for what it is, a problem, a project, the rules of a game, even a single word is key and absolutely fundamental in order for people to get things done together.

A spade must be a spade to us all in order to operate individual vehicles on the road at the same time.

A spade must be a spade in order for the convenience store to function.

School.

Work.

Play.

So, I've uncovered no new truth here. A spade is a spade in any language, in any culture, yes? It has to be, by and large, or there would be no other language or culture. I'd argue the suceess of various groups of people is impacted by how broad based the acceptence and recognition of a spade being a spade is within the group, some being better than others, but by and large, the point stands.

The broad immplications of a spade being a spade is a readily recognizable and digestable concept by all of us as is the converse, ie, it is instantly recognizable what would happen if we all used different rules at a stop light or a card table or at the store.

Moving on now to politics. The arena of competing ideas. No matter your party or ideas, when an issue is presented, everyone sees the problem, high gas prices, smog, taxes, healthcare, sees them the same, a spade is a spade.

Where things get whacky is in the solutions. So, let's move on to healthcare at this point.

The healthcare problem, the issue? Healthcare in this country is too damn expensive. Democrats vote to have someone else pay for it, their employer or the government, anyone but themselves, because every Democrat knows they don't want to pay for it because it's so expensive. Simple. They aren't, by and large, looking for anyone to pay for their potato chips because they are plenty cheap.

Republicans know it's too expensive to and we can tell this because, if they're en employee, they're happy to have the company pay for it or, if they run a business, they're shifting some cost to employees and/or changing to cheaper plans and/or doing without.

The summary is Democrats: Who's gonna pay for this? Republicans: This costs too much. Same problem, a spade is a spade, no one wants to pay too much (or any at all) but different solutions.

Now, I've slogged this far, mundane as it is, because that's how we all know a spade is a spade; repetition and reinforcement. If some of us drift off and start calling a spade a club or a heart or whatever, that's where the problems start.

So, an article in the Post yesterday, Sebastian Mallaby, on Bush and healthcare.

http://www.washingtonpost.com/wp-dyn/content/article/2006/01/15/AR2006011500929.html

The Readers Digest version is that, a spade being a spade, healthcare is WAY to expensive and what is Bush gonna do about it after failing to get anything done on Social Security and tax reform?

We spend some 16% of GDP on healthcare while the Germans, Japanese, the Felnch, the Canadiens and Brits spend a lower number, some 8-11% of their GDP, and they all live longer than us and our higher number supposedly, based on them, represents waste.

The suggestion is we should be around 10% like them and that the fact is that the extra 6% represents about $700 billion, waste or not.

Now we have a number to work with. $700 bil is almost 1.5 times what we spend on the military. More than we lay out for Social Security and Medicaire. It's about a 1/3 of the size of the whole federal budget.

In short, if we're wasting that much money, it's HUGE.

The suggested reasons for this waste range from a failure of the market (big business scewing everyone) to claims that government is in the way (rules, restrictions, tort reform). That about covers the standard left/right responses to most things, right? Now, everyone is still calling a spade a spade, healthcare is too expensive, just different solutions, so, we're still playing the same game.

So, Bush has some guys working on it. The Bush plan is going to be one of, as they call it, empowering the individual by making he/she pay for healthcare out of pocket and for the medical professions to post information about price and quality, thereby educating consumers so they can make good choices.

One of the Bush guys met with Mallaby and asked him to imagine what would happen if employers paid for their peoples groceries;

Employees would load up with more food than they needed; supermarkets would seize the chance to mark up groceries; pretty soon, they wouldn't even bother posting their prices. So it is today with medicine. You don't know the cost of your hospital visit until a few days later, when the bill arrives.

Now, a spade is still a spade, right? Nobody doubts this outcome. This is EXACTLY how it is today with healthcare.

But then, Mallaby. I've brought us to the top of the rollercoaster and now, here we go!!!:

There's a weakness in this thinking. The country has moved far enough already toward out-of-pocket payments, which promise hardship for low-income people without much reduction in waste.

Weakness? A weakness in a perfect analogy? He is making a statement of opinion, not fact. Moved far enough? By what measure? Promises of hardship? By what measure? We're wasting $700 billion and fixing it, not wasting it, is gonna hurt ANYONE besides those receiving the largess?

Thus:

Health is simply too complex for people to make smart, waste-reducing decisions; when you go to the hospital with screaming stomach pains, you have no idea how many tests you need -- and you're not in a fit state to embark on comparative shopping.

Spades are, at this point, no longer spades. They are now anything, ANYTHING you want them to be. Replace 'health' with 'food' or 'drink' or 'house' or 'car' or 'entertainment' or 'sex'. Or anything. Stick the word 'politics' in there one time. How about 'speech'? You just don't know, you dumb ass.

Healthcare cost has no more to do with people going to the hospital with screaming stomach pains that driving does with life threatening accidents; it happens, yes, but by and large all of us go through the day, day after day after day, without a crash. Most car insurance costs are small dings and dents and broken windshields, not major crashes. A deer attacked me; $2,600 to fix damage I could have lived with if not for the car being leased.

We move a mountain, have car insurance, and drive pretty safely together because we all have the same goal; getting there as safe as possible as cheap as possible. Imagine if someone else paid our auto insurance.

Plus, if screaming stomach pains and daily fire ball crashes were the problem none of us would drive and we'd all be dead.


END PAGE 1

 

[Larry Gude]

Page 2...

So now, Mallaby; we, the people, are too stupid to handle this.

Mallaby tries to rationalize and prove it thusly:

A celebrated study by the Rand Corp. showed that out-of-pocket payments deter needed health consumption as much as wasteful consumption, confirming the point that ordinary people aren't going to become savvy health shoppers.

Now, I'll give him his defintion of 'needed' whatever that may be, but I can't imagine to many people with his screaming stomachs suddenly leaving the ER after they looked at the price on the menu. I CAN imagine, on the other hand, people driving safer, so to speak, in an effort to not get a screaming stomach.

Now, this is where statistics are used to argue what they are not. A spade is now being called something else.

Out of pocket payments detered NEEDED health consumption AS MUCH as wasteful consumption. Think about that.

To the spade; that could mean that, suddenly, zero dollars are being spent on 'needed' healthcare and, thus, zero dollars are being spent on wasteful healthcare. We know that not to be the case but maybe it could mean a 10% reduction in needed and thus a 10% reduction is wasted. How aobut 20%/20%? Pretty soon we've whacked that extra 6% of GDP, huh?

Mallaby was looking for us going from 16% to 10% so we can be like the French. Mallaby is using his study, the very fact that both 'needed' and 'wasted' expenses went down due to a stimulus, out of pocket payments, to argue that this way does not do what it does; reduce dollars spent on healthcare; the stated goal.

Now, the catch is that he would say his goal is to reduce only WASTEFUL spending, not 'needed' spending. I would say...that's exactly what that study shows, they, and Mallaby, are just calling a spade something else, that it CAN'T be.

The French and German and Brits all have a well known stimulus to take better care of themselves; even though healthcare is 'free', the catch is that for all but the 'screaming stomachs' you're gonna have to wait. Wait for tests. Wait for procedures. Wait for physicals. Wait for prescriptions. The French are not living longer because their government spends less on healthcare by GDP than we do. They live longer because they have motivation, a reason, to take better care of themselves; they won't get the care we get so they don't behave like we do. Burrito, anyone? Sour cream? X cheese?

In Malaby's view, this is not possible because his study shows, in his view, that people do not become savvy. If this were true, that people don't become savvy, then the French living longer would necessarily be because French healthcare is not only cheaper but better. It would have to be. If the French are not taking better care of themselves, their care MUST be better as they use less and waste less. Simple equation.

And horseshit. Where's the study that Mallaby must show to back up his claim that French or German or Canadian or Brit health care is better? Can anyone argue or has anyone even heard that our healthcare is not the best, by far? I know a Canadian. He says it's cheap, it's free, but you better be real sick or forget it.

confirming the point that ordinary people aren't going to become savvy health shoppers

Don't you just love that? A study was done. Results were interpreted and, viola, people who may not have been 'savvy' during the study period are NOT going to EVER become savvy. These sheep are NEVER going to get it. A person might, these people won't.

It's worth repeating:

confirming the point that ordinary people aren't going to become savvy health shoppers

Mallaby really puts his foot in it towards the end with HIS prescription:

Beyond the imperative of restraining prices, the biggest challenges in health care are to get insurance to everyone and to create incentives for preventive treatment -- even though prevention may pay off 30 years later, by which time the patient will have gone through multiple switches in health plans.

I would call anyone who took advantage of an incentive to engage in preventative treatment, of which putting down the Twinkies is surely one, a savvy person.

Sebastian Mallabys sheep, the un-savvy, are suddenly going to take advantage of an 'incentive' to take care of themselves better?

Pray tell, what might some of these incentives be? Fish and Chips? A baguette? Perhaps some Sushi or a nice Rhine wine? Certainly nothing so gauche as...money?

Then, his closer which put me right over the edge:

The most plausible subsidizer of universal insurance is government, and the only entity with a stake in lifelong wellness is the government. Is the administration ready to see that?

Back to the sheeple we go. Does the person, the individual, have, perhaps, a tiny little stake in his health?

So, while having someone else pay for your groceries is a bad idea that leads to waste, health care is not.

A spade is not a spade because you are too stupid to see that it is, in fact, a freaking spade. No amount of calling it something else is gonna change that fact.


Do yourself a favor. Pay for your own health care. You'll will live longer, feel better and have more money and you won't have to learn French.

It's all up to you.

Card?

 

[ylexot]

So, Bush has some guys working on it. The Bush plan is going to be one of, as they call it, empowering the individual by making he/she pay for healthcare out of pocket and for the medical professions to post information about price and quality, thereby educating consumers so they can make good choices.

Really? That sounds like....MY PLAN! Damn I'm good!

 

[ylexot]

BTW, I always wondered about the etymology of that phrase, so you prompted me to look it up. I found this on wordorigins.org...

Call a Spade a Spade

Several people have emailed me and questioned whether or not the phrase call a spade a spade is racist in origin. It is not. Spade is a derogatory term for a black person, but that is not the spade referred to in the phrase in question.

The phrase dates to at least 1542 and the spade in question is a shovel. The phrase simply means to speak directly, without euphemism. The British phrase to "call a spade a bloody shovel" is derived from this, not vice versa. This British phrase means the same, only it is more forceful.

The racist usage of spade dates from the 1920s and is American in origin. It probably derives from the card suit, as in black as the ace of spades.

Even though "call a spade a spade" is not racist in origin, it is probably best to avoid using it in situations where it could be misinterpreted. In fact, since it is so hackneyed it is probably best to avoid using it altogether. But that is a stylistic and not a racial reason.

So, you're using it wrong Larry

 

[2ndAmendment]

BTW, I always wondered about the etymology of that phrase, so you prompted me to look it up. I found this on wordorigins.org...So, you're using it wrong Larry

No he isn't.

"Health care" is "health care". "Necessary care" is "necessary care" and not waste, but if "necessary care" isn't needed then it really isn't "necessary care" and must have been "waste" in the first place.

How many people run to the doctor for a simple cold or other stupid stuff? Lots. My ex wanted to run to doctor every time our daughter skinned her knee. I was more pragmatic. Is it bleeding profusely? Can you see the bone? Is the wound deep? No to all of those; put a band aid on it. Can the doc help with a cold. No. He can prescribe some cough medicine that has more narcotics in it. You don't get better; you just don't care. I guess there is something to say for that, but paying, or rather having the insurance company pay over $100+ to get some cough syrup that cost $65 because it is a controlled substance that is also paid for by some prescription plan is just waste. Period.

 

[ylexot]

No he isn't.

Yes he is. Larry's usage of the phrase took a spade to mean a suit in a deck of cards when it actually means shovel. However, his use of the general meaning of the phrase (call something what it is) was correct.

 

[FromTexas]

Yes he is. Larry's usage of the phrase took a spade to mean a suit in a deck of cards when it actually means shovel. However, his use of the general meaning of the phrase (call something what it is) was correct.

Now you are just making a mountain out of a spade hill.

 

[vraiblonde]

I would like you lefties on the board to check France, Germany and Russia's unemployment rates, then compare them to the US's. After you do that, you can tell me why we would want to emulate them in any way, shape or form.

 

[2ndAmendment]

Yes he is. Larry's usage of the phrase took a spade to mean a suit in a deck of cards when it actually means shovel. However, his use of the general meaning of the phrase (call something what it is) was correct.

Watch it. I'm going to sic the Road Runner on you.

 

[ajhkmr97]

ylexot
Does it really matter if Larry used the phrase/word out of it's origional context? Your input into this discussion is doing nothing more than attempting to distract readers from the true point that Larry was making.

Thanks, however, for the true understanding of what "spade" meant but it just dosent fit here. Perhaps you should have started a seperate discussion thread for your post.

 

[ylexot]

ylexot
Does it really matter if Larry used the phrase/word out of it's origional context? Your input into this discussion is doing nothing more than attempting to distract readers from the true point that Larry was making.

Thanks, however, for the true understanding of what "spade" meant but it just dosent fit here. Perhaps you should have started a seperate discussion thread for your post.

Shut up newbie.

 

[2ndAmendment]

Shut up newbie.

I didn't know I was in Chit Chat.

 

[ylexot]

For the record, IT WAS A JOKE! That is why this smilie appears in the post ->

I didn't expect the Spanish Inquisition...

 

[ajhkmr97]

I would like you lefties on the board to check France, Germany and Russia's unemployment rates, then compare them to the US's. After you do that, you can tell me why we would want to emulate them in any way, shape or form.

I would agree with you but regardless if I did or if the US truely did attempt to emulate other countries - it simply could not. The US is the only country that imports more than it produces. 80% of all exports are in the form of raw materials. Now, you may ask what import/exporting has to do with employment. Consider who is performing the labor for the comsumed products in the US. Do a bit of researching into Wal-Mart for example. The company is encouraging more and more manufacturers to relocate to China because the common wage for a worker is around $100 a month. There is more to it than that but the point is that the US economy has its hands too deep into foreign markets. France, Germany, etc - their economies cannot afford to invest into foreign markets as the US can.


Now, dont go quoting me on all this - I'm still learning a lot of the economics of the US via my online business class i'm taking. If anyone has a better insight on this - please share your knowledge and set me straight if you perceive my understanding is off.

 

[2ndAmendment]

For the record, IT WAS A JOKE! That is why this smilie appears in the post ->

I didn't expect the Spanish Inquisition...

Quit taking yourself so seriously. You sound like me.

 

[ajhkmr97]

For the record, IT WAS A JOKE! That is why this smilie appears in the post ->

I didn't expect the Spanish Inquisition...

Sorry, wasnt trying to rub ya the wrong way

 

[Kerad]

For the record, IT WAS A JOKE! That is why this smilie appears in the post ->

I didn't expect the Spanish Inquisition...

NOBODY expects the Spanish Inquisition!

Monty Python rules!

 

[vraiblonde]

Quit taking yourself so seriously. You sound like me.

2A made a funny and I quoted it for posterity

 

[Larry Gude]

It's the simplest, easiest...

Really? That sounds like....MY PLAN! Damn I'm good!

...best way to go.


Imagine: Many people have employer paid family plans that run as much as $1,000 a month.

How long would it be, if that money was simply handed to you in your paycheck, for companies to be beating themselves to death, like phone service and any other free market product, to offer healthcare plans that might cover big items for, say, $200-400 a month and you pocket the rest AND start taking better care???

 

[Larry Gude]

I'll make...

BTW, I always wondered about the etymology of that phrase, so you prompted me to look it up. I found this on wordorigins.org...So, you're using it wrong Larry

...a note of it!