Our own Kay has been saying this for months — good to see the point getting a larger platform. Jon Chait at NYMag discusses “large lies and one big truth“:
… Amidst the vast plumes of rhetorical homages to freedom and entrepreneurship and the evils of central planning, there was but one small moment in Paul Ryan’s speech when he actually spelled out what his abstract rhetorical formulations really mean. It came when he assailed President Obama for cutting Medicare — cuts that Ryan now finds unconscionable but had proposed to maintain until a few weeks ago, but never mind — for what he called “a new entitlement we didn’t even ask for.”
This is actually true — one of the few clear truths in a speech sorely lacking them. But what does this mean?
Obama was indeed trying to turn access to health insurance into an entitlement. Ryan and his fellow Republicans have made various gestures toward the notion of some kind of plan of their own to provide access to health insurance for people who can’t afford it, but they have never been willing to devote the necessary resources. Here was Ryan actually assailing not the method but the goal, implicitly conceding his position that health insurance is not an entitlement but a nice thing everybody would like but not everybody can have, like a beach house.
The political logic embedded in Ryan’s formulation was even more telling. He dismissed the goal of providing health insurance to those who can’t afford it as something “we didn’t even ask for.” Who is “we”? We is the majority of Americans who do have health insurance. We outnumber the 50 million who don’t. They can go screw themselves. Ryan actually called Obama’s decision to cut what he deemed wasteful spending in Medicare to cover the uninsured his “coldest power play.” It is a cold power play to give medical care to people who can’t get it, and an act of compassion to take it away from them…
I have one long-time acquaintance — the only rocket scientist I know — whose complaint about the ACA is that, if the Massachusetts version is an indicator, she’s going to have to wait a little longer to get an appointment at her health-care practice. She’d never use the phrase IGMFU, even in her own mind… it’s just that she’s worked hard and been conscious about her financial planning, unlike those other uninsured people. The Republicans are working hard to convince the majority of insured voters that their own convenience outweighs the communitarian value of helping keep everybody healthy, and unfortunately it’s always easier to sell selfish.
OT I need a digital camera that won’t cost an arm and a leg. I’d prefer SLR.
I know nothing about digital cameras, only film ones.
Villago Delenda Est
ZOMG, there are proles in the waiting room!
@Maude: How much is an arm and a leg? A decent (Canon or Nikon) SLR will cost at least $500 new.
ETA: by SLR, I assume you mean a detachable lens camera.
Health insurance has been allowed to become a status symbol because access to health care became an indication of income and class. You knew you had a good job if the job had health benefits. Many people don’t like losing their status symbols. When you make it harder for some people to be able to tell who they are better than, they get angry and resentful. Some people don’t want to sit in a doctor’s office with Medicaid patients because it makes them feel less well off.
He’s trying to turn it into an entitlement because (for whatever the reasons) we, as a society, have decided that insurance is going to be the only gateway to care.
Since we, as a society, appear to have no will to change that gateway system to something more sane, then the only way the lower middle class and poor have to get through the gateway is to make it something resembling an entitlement.
Basically these guys simply can’t accept the idea that any part of human existence should exist outside of the realm of commerce. Money is the only measure of ethics, and by giving poor people access to health care we’re giving them something they “don’t deserve”. How the ‘eff anyone arrives at such a point I have no idea.
John F. Kennedy said this in his July 1960 speech accepting the Democratic nomination for president.
Everyone with health insurance should, for six months, be put on a purely reimbursement plan. Let them see the actual bills rather than just their co-pay, then let them say there’s nothing wrong with having no health insurance.
You might need to define “an arm and a leg,” but maybe check out the Panasonic Lumix DMC-G3. It’s currently $500 with a very good lens. It is either the successor to, or the very close sibling of, the camera (GH2) that Tim F. uses for his great pictures of Max.
@TexasMango: Wow. I’ve never thought of it that way, but you’re dead on.
Don’t know where you’re located, but if there’s a camera store within your range go there. Most of them have used, high-end, digital cameras at affordable prices. The best of them will ask you what kind of pictures you wish to take and they will give you solid advice on which camera and lens would be best for you. Another benefit of going to one of these stores is that you can hold the camera in your very own hands and see if you two will get along in terms of ergonomics.
@Dennis SGMM: One of the sad things about the switch to digital is that you can’t get an old, reasonably well-condition Pentax K1000 or such.
Also, to @Maude: Check out KEH.com for some good quality used equipment if you can’t find what you want locally and you want used.
This one resonates, Anne Laurie, because I’ve a GOP pal who likes to say, “People will always vote for free shit.” I.e., redistribution of wealth.
I’m telling you, they really are the “You’re on your own” party.
Yeah, selling selfishness is an easy sell.
Pretty much like the brand of Christianity they push—–disapproving of others (gays, women who need abortions, drug addicts, unemployed people….) is now the true path to holiness rather than holding one’s self to demanding the requirements of humility, generosity, compassion and patience.
Self-righteousness outsells righteousness in the market place of cheap religion.
@Robin G.: The battle over health care and the reasons why the US has not been able to create a universal system is rooted in the same resentment towards to civil rights movement, the women’s rights movement and event the LGBT rights movement. When you attempt to shift the social hierarchy and level the playing field many who benefit from the existing inequality will of course resent it. I’m of the personal belief that we would have created a universal health care system after WWII if one of white America’s main priorities wasn’t keeping racial minorities, especially black people, from having access to the same stuff that they did. This included jobs, housing, schools, government programs targeted to growing the middle class and health care.
It’s just like the Voting Rights Act – something that the Ku Klux Klan didn’t even ask for! They are always screwing us with something!
I’ll check it out. I’m not sure there is a camera store around here.
I need a used and detachable lens.
Nothing fancy, just basic photos.
I;d prefer a film camera, but I need to transfer the pictures to my computer.
If tens of millions of additional people all at once have access to health care, then yeah — there will inevitably be longer waits in non-emergency situations. It’ll take years for the system to catch up; we’ll need more primary care physicians, more nurses, more clinics. So what say we all suck it up just a little, and remind ourselves that, while we’ll have to schedule a physical four months in advance instead of six weeks, some family that had been getting no health care at all will actually be able to see a doctor.
It all boils down to regarding health care as a right versus regarding it as a privilege. Most developed nations around the world view it as a right, which results in universal health care and contributes to a higher standard of living overall. God evidently hasn’t seen fit to grant that right to people in the US, however. Regarding health care as a privilege here has made our society more dystopian. Regarding any right as a privilege will have that effect (see voting as another example).
I just went to a better laptop, refurbished. It’s like going from horse and buggy to a car.
Belafon (formerly anonevent)
You know, Anne, I would love to know how hard your acquaintance actually worked. I often hear that and yet, when I find out what their hard work was, it generally amounted to working while in college. Which, while a lot of work, doesn’t even come close to all of the things a lot of poorer families I knew had to do just to eat each day.
Great blog post about the insanity that pre-ACA US healthcare can cause:
@Hungry Joe: Does the ACA include incentives for medical students to go into primary care, especially in less-served places? I know that kind of thing was discussed. Can’t remember how it turned out.
I have had the “IGMFU” talk with so many of my upper class MA friends about the ACA. The wealthiest fucking woman I know–truly in the 1 percent and bipolar to boot–complained that she had been “warned” that there were not enough doctors available for all the people who would now need access to them. I asked her this:
“Isn’t that a problem you are having with the free market system in medicine, not with the ACA? You are saying there’s a problem of supply and demand. Not enough doctors for the demand. Well, isn’t that something that creating a paid for pool of clients should, in the long term, be solved? Pay doctors more, educate more doctors in fields where there is demand, and there will be enough so everyone can get seen. Your solution, which is to limit the number of patients who can afford doctors, is not a real solution.”
Buy the way a commenter over at Kos has a great way to explain the Medicare “savings” issue in the 716 billion. She tells people “Its like if I usually pay 1000 dollars in groceries every month but then I start coupon clipping and shopping for deals. My bill goes down to 800 dollars a month and I’ve saved that 200 and can spend it elsewhere. That’s what the ACA does. The Obama administration and the health care providers agreed to take lower reimbursement, like a lower price for a coupon sale item, in exchange for more shoppers. And now we can use the extra money we’ve saved to close the donut hole or provide more services.”
As long as some folks have a straightened out coat hanger on which to roast the road kill they’re better than the folks who don’t have a coat hanger. They will fight to the death any effort by society to provide coat hangers to all.
Once you make the transition, I think you will like a digital camera. If you get one like the Lumix, you’ll have access to interchangeable lens–including any you currently have (adapter rings are available, if needed)–and you will love the instant gratification of not having to wait for your film to be developed. Plus you can do aftereffects on the computer.
Mike in NC
Orwell would have loved Paul Ryan.
Just an additional tease for a real heart tug link above.
It’s about a $23,800 bug bite!
When first exposed to using RomneyCare as opposed to the real pleasure of just clicking online and buying some with less questions asked than buying a plane ticket, I had that “waiting delay” moment. It takes adjustment in thinking. Especially if you’ve been used to having easy access.
It’s a serious delay. 6 to 8 weeks to see a Primary Care Physician. That’s if you can find one taking new patients. I had two say no.
True, you can go straight to the emergency room if needed and know that the bill is “only” going to be the price of your deductible. Which is a big hit, but still, you got insurance if serious condition develops. Just dropped 2K as my part of a 1 night hospital stay. But amortized out over the $650 per month premium versus the 1K premium in another state, it’s still better. But if I had been able to find a PCP, might not have had to go.
But it’s a different kind of medicine. It is definitely “something good for everyone” rather than just “only good for me.” Which, in a way, reflects the difference in thinking of the two parties. Repubs seem to often put individual over community. Dems more likely to put community over individual.
The delay and inability to find a PCP will happen in 2014 across the country. But people will adjust. Because almost all of it is so vastly better. Like the peace of mind your insurance can’t go away.
And the transparency is good. The people at the state overseeing group – Commonwealth Choice – couldn’t be nicer. The bills are clear. There is not that prevailing sense of the insurance company only wants to jerk you around. The providers all know the rules, they look at your card when you arrive, you pay your copay, discussion over. No bill comes, because that “you pay more because I charge more than your insurance” thing doesn’t happen, as I’ve had in other states.
So, yay RomneyCare. Yay, Massachusetts. Plus getting to have a meaningful Elizabeth Warren bumper sticker on your car is also good.
@Maude: Echoing what folks here have said: the mirrorless cameras are smaller and lighter than DSLRs. Both have interchangeable lenses; DSLRs allow you to view through the lens with an optical viewfinder (i.e., you see what the camera sees, more or less) as well as electronically, on a little screen. Mirrorless cameras (the Panasonic G3 mentioned above and some others I’ll get to in a sec) let you see what you’re going to shoot on the same kind of little screens the DSLRs have, and, in some cases, through an electronic viewfinder — which is a viewfinder just like the optical ones on DSLRs, but instead of getting the same light that the lens passes to the sensor (optical) you get an electronic (tv) image sent to your viewer.
Used to be, electronic viewfinders were clearly inferior to optical ones in terms of letting you see what you were going to be taking a picture of. Now, the distinctions are really much less — and I’d say either one works great.
The advantage of the mirrorless systems is that (as said above) getting rid of all the stuff needed to divide the light path from the lens between the sensor and the viewfinder lets you make a lighter, smaller, and sometimes cheaper camera and lens system. Also, such cameras usually allow you to use whatever old lenses you may have or get, whereas the major DSLR systems lock you into one lens mount or another. (I.e., Nikon mount lenses for Nikons and so on). This isn’t absolutely true (you can adapt Leica R lenses for Canons but not (easily) for Nikons, for example) but it’s basically true.
The advantages of DSLRs are better viewfinders — even with the gap closing, that’s a very important issue for some — and in many cases, somewhat better image quality/$, though folks who are better photographers than I (Tim F., for one) would argue, correctly I think, that you don’t actually see that difference in real world use.
Depending on what you want to do — and it sounds like you want a genuinely straightforward shooter that gives you a bit more control and ability to mount good glass than a point and shoot — the best deals are cameras that are being sold as refurb or overstock from a generation or two old.
Right now there are very good deals on such cameras in m43 system — Panasonic and Olympus cameras. For example — I have the Olympus E-PL2, and you can get it with the standard short zoom lens via Amazon for $350. (Note — this camera doesn’t have a viewfinder; you can attach one, or, as I do, just use the screen.) The E-PL1 — the same camera as far as its innards go, with a slightly different set of features and physical shape, is down to $250 with a kit lens; $150 for just the body. It’s still a fine camera, for all of its being a couple of years old.
As someone else noted, the Panasonic G3, with a built in viewfinder and lens runs $500. Lots of other choices that vary in size and thises and thats, but are all capable of great output.
In the DSLR range — I hear great things about the Nikon D3200, which would run you 700 bucks with the kit lens — but the nearly as good 3100 runs $500 with the same lens.
This is becoming a Moby Dick comment, so one last thought: you should, if you can, actually hold any camera your seriously thinking of buying — which I’m sure you know from your film experience. When I bought my Olympus a little over a year ago, I finally paid the extra $100 for the “2” over the 1 because my hand kept cramping when I held the slightly older camera.
And last — don’t sweat any of the detailed stats or obsessive gear sites. Just about any camera made by a major company these days takes great photos — or rather is capable of meeting whatever skill and eye its user brings to it. Sony, Olympus, Nikon, Panasonic, Canon, Pentax, others — they really are all good.
For a new patient? That’s exactly the same as the system we have now. No “added delay” at all.
Guaranteed health care sounds like a sweet deal all around.
Not to mention that without that guarantee, more and more physicians are going to start saying “no” to anyone with health insurance.
It sounds good. I don’t think I can do $500. That’s high.
I’d never leave the apt again, I’d be playing with the photos.
@Maude: I have posted a comparison chart of interchangeable-lens cameras here. There’s quite an array of options out there, but it’s hard to put together a new ILC kit for less than $600 (camera with lens, plus storage, spare batteries, a UV filter, and camera bag). If you can’t afford that and want something new, the Panasonic DMC-FZ47K is probably the best super-zoom.
Healthcare could easily be interpreted as contributing to the general welfare. Flintlocks were single shot, so if we can deduce support for 100 round drums on Ak-47 in the second amendment, the good health of our citizenry should apply to the preamble.
We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.
@MazeDancer: I live in MA. I recently saw my Primary Caregiver in three days.
I have no idea where people get their information.
The other issue is that the “free market” as she believes it to be (i.e., the “market” we have now where private health insurers write the laws and cook the books) – that sort of “market” doesn’t produce enough primary care physicians, and it never will.
Because in that “market”, the money is in surgical specialists, like liposuction doctors. So that’s what people coming out of medical school (with staggering, ridiculous debt, by the way) choose to do. This is that famous “market failure”.
Half a century of policy and economic research have proven that a middle-class market consisting solely of private health insurance screws both doctors and patients.
It doesn’t achieve the “market outcomes” that (unread) right-wingers fantasize about, because it can’t.
Direct your Republican friends to start their reading with Kenneth Arrow (and head off the Google results by reminding them that Avik Roy and Megan McArdle aren’t experts in the field, but are known frauds).
Yes, 6 to 8 weeks for new patient. After you find a doc that is taking new patients. Four to six weeks for follow-up. Have had delays for specialists before, but not PCP, so my previous experience was different.
In 2014, when many new people get covered, don’t know what the delays will be as they try to enter the system. Imagine it will be considerable as there are not enough Primary Care docs. But hope the emotional benefits abound.
It really feels different to be in a state where basically everyone has insurance. The “what if I get sick” factor is less. People have money worries, of course, but it’s not the same.
Oh thank you so much. I don’t need it right away, so I can look around. I have an account at Amazon and would go through BJ as I did the laptop. It was a great experience with the laptop.
I just need to take simple pictures. Nothing fancy.
In film cameras, I;d use a 55mm lens.
This is great. A learning experience.
The mirror less is the way to go.
I’ve taken notes and will look around Amazon tomorrow.
I saw cameras for well over $1,000. That’s why I came here.
I know how to make movies, but still cameras are something I know little about.
“Well, that is that”, said Baba Fats, sitting back down on his stone
Facing another thousand years of talking to God alone.
“Seems, Lord”, says Fats, “They’re all the same, old man or bright-eyed youth;
It’s always easier to sell them some shit than it is to give them the truth.”
I’d like a bumper sticker spelling this out:
@different-church-lady: That’s great. Yay, for your doc.
My experience was personal. I had the delay. And the search for a doc that would take me in the first place.
I bookmarked the site and thank you.
I have a question about the zoom type lenses. Is the range around 50 to 60mm okay? Some zoom lenses on movie film cameras stink except for close ups.
I don’t know why I ask. I will be taking simple pictures, not a full length movie of some sort.
I’d like to go $200 to under 400.
@MazeDancer: 6-8 weeks? It took me twenty. I have insurance; it just took that long to get in.
The nurse at the doctor’s office I went to last week said that the Dems would cut down on the number of doctors. I didn’t answer. I won’t see her again because I fired the doctor in that practice.
From the preamble to the Declaration of Independence: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain inalienable rights, that among these are life, liberty and the pursuit of happiness.”
If you don’t have health care, do you have life? Or are all animals equal, but some are more equal than others?
@Maude: Most of the kit lenses are optically fine. I use the 14-42mm kit lens on my E-PL2 often, and in what would be the “normal” 50mm range for a film camera — around 25mm for the micro 4/3s system used by Olympus and Panasonic, about 35mm for so-called APSC systems like the entry level of Canon and Nikon, and the Sony mirrorless NEX system — the optical qualities of most kit lenses in that normal range are just fine.
The limitation is that the lenses are slow — maximum aperture around F3.5, which means you need light, or willingness to push up the ISO sensitivity of the camera, compared to the glorious film “nifty fifty” f1.4 or f1.8 lenses. Also, you won’t be able to get the narrowest depth of field that you may be used to from your film days. But just in terms of taking a sharp, basically distortion free image with appealing contrast and color transmission — just about all the kit lenses are fine. The Olympus certainly is, and some folks assert a particular pleasure in the Olympus color palatte. Panasonic’s first m43 kit lens, a 14-45 version still available in kits with their first m43 camera, the G1, is seen as superlative, and I have a very good photographer friend who has that combo and uses it with great pleasure. I have an older Nikon D80 with their 18-55 kit lens, and same thing — it’s just fine.
In other words — there is just first class gear available, and if you don’t care about the latest/greatest you can get a genuinely excellent package for short money.
@Maude: Do you mean zooms for ILC cameras? I don’t know how good any specific lens is, but the typical range for a kit zoom is 35-85mm or 35-135mm (equivalent). The lenses in any super-zoom (aka bridge) fixed-lens camera won’t be as good, but they are typically something like 25-600mm these days, which is a stupendous range.
If your budget is less than $400, that rules out anything but the oldest used DLSRs, most of which lack any movie capability.
I’ve had that same conversation with co-workers who were furious that more people would have access to the same doctors they were using. The solution of course, would be more doctors, not denial of healthcare. Unfortunately, at no point did it occur to them that more doctors would be better than more uninsured people. They want things to stay the same and for those icky uninsured losers to stay out of their waiting rooms.
I’m amazed that any law got passed when people can’t even agree that being able to go to the doctor is a good thing.
The answer to that argument is one that the Dems need to make more loudly: that it is in everybody’s selfish best interests to bring the cost of healthcare as a percentage of GDP down. That means lower costs for everyone, including the people who are already insured. And if these rocket scientists (or their HC plan) still have extra money to cough up for healthcare, they can pay extra for a premium level of care (like it’s done in France.)
And keep hammering home “covers pre-existing conditions” and “no coverage caps”, which appeals to their selfishness, because almost every one of them at least knows someone who was financially crippled by health care debts, and it can happen to them.
@aimai: Re access to care. I’ve got one of those “cadillac” plans in MA, thanks to my employer MIT. (It’s actually the Blue Cross managed care plan — which is hardly what one thinks of as boutique care, but still.)
We have fairly substantial wait times from first phone call to routine appointments — it can take me a few weeks to get a physical scheduled for example. My wait time for even non-emergency urgent care is minimal to none: I always get in next day; if I call in the morning, I usually get in that day. Example: a few months ago I started developing problems in my knee. After it buckled a couple of times, I called to be seen. I had my choice — my doc the next day, or her resident that day. I went in that day. The resident looked me over, then my doc came in for a detailed consult. They came to a conclusion, but decided that they wanted back-up from a rheumatologist. They busted that schedule open so I could see the specialist the next day. She came to a different conclusion — that I had “rug layer’s syndrome” — an infection of my bursa that got its way in through an abrasion on my knee. I was out with a perscription that proved to work. all within 26 hours of my first call.
So, yeah, maybe I have somewhat longer wait times for purely routine stuff — or more accurately, I have to remind myself to call a few weeks earlier than in the past to get my preventative stuff taken care of. But having found a good practice, I find that they have clearly structured their approach to care to make sure that when they are needed, they are there.
I do think that my family’s is an exemplary practice group. We left our old, cheaper plan to reunite with a doctor that had been at MIT and is now in this group. But that’s a best-practices issue, not an ACA problem.
Shorter: those who kvetch about having to wait a month or two for a physical have their priorities all wrong.
Short variation on your comment: “It’s *always* cheaper to let them die.”
Assuming rational self-interest unfortunately isn’t a good bet with the human race. One of the Sadly, No! posts from the days of the health care debate pointed out that paying more for less was the very definition of inefficiency, yet somehow people happily accepted the delusion that the American health care system was more efficient than its European counterparts.
(I don’t want to lean too much on “only in America” explanations, but the fact that people can say with a straight face that “America has the best health care on Earth” should be almost as scary as the number of people who reject evolution. It’s as much of a fucking delusion as if Slovakian politicians said “we have the best army on Earth,” and vast segments of the Slovakian public approved and cheered and proceeded to vote and judge policy based on that ludicrous assumption).
Hey, now, St. Ronaldus didn’t invade Grenada and liberate that medical school[sic] for nothing. We can simply turn on the medical school spout and manufacture all the healthcare professionals we need.
We can also raid India, Thailand, Korea, etc. and grab up all their doctors and nurses as a temporary measure–a medical “Bracero” program.
Teh Markets(pbut) will not be denied.
Gonna be tough to get under $500 with interchangeable lenses, but good luck.
It’s the same kind of attitude of a conservative when they suddenly need something they want to deny to others. An abortion, social security disability or other assistance. It’s okay for them, it’s different; they’re not like ‘those other people.’
Judas Escargot, Acerbic Prophet of the Mighty Potato God
US Doctors are overpaid (w.r.t. their counterparts in other countries), largely because the barriers to entry in the field (ie costs) are too high.
In a sane world, the Govt would be allowed to create some sort of a loan program (or incentives) to increase the number of doctors to meet the demand, but most existing doctors and the AMA won’t have it.
Our other big problem is the sheer number of middle men (many with salaries in the tens of millions range) that come between you and your health care. Other countries just don’t have that burden.
It’s just amazing how many of our collective problems (and not just in health care) stem from parasites, middlemen and grifters sucking funds out of the system.
@PeakVT: re movie capability. In m43 and NEX cameras — pretty much all of them that are still available have at least basic video capability.
Also, you can get gear that is just months or a year old for not much. Panasonic’s much praised GX1 with lens (and full HD video) is $500 at Amazon now — and it is still a current model.
Similarly, the Olympus E-PL3 is under $500, and the electronically identical E-PM 1 is under $400; both of these are still current (though likely to be replaced very soon). Both have movie capability, I believe, though the PL3 is likely to be much easier to use for that purpose.
Similar stories obtain in the entry-level DSLR world. One and two year old cameras can do tons. The Nikon 5100, thought to be a good choice for non-pro movie use, is a year or a bit past its launch, and it goes at $550 with a lens for a refurbished camera.
I repeat: there is a ton of good, cheap gear out there for anyone who does not need or hunger for the most wonderfully up to date gear.
If you’re wondering why I have all this gear-head sh*t to hand it’s (a) because I recently had to buy some video stuff for my class and (b) because I’ve been trying to decide whether or not I can justify an update to either my 5 year old Nikon or my 1 1/2 year old Olympus. I’ve looked around at a lot of stuff as a result, and the answer is that until I put more time into working with the photographs I can take right now with the gear I’ve got, there is no point in getting anything new. The improvements folks are making are real — but as a practical matter, making photo albums for use on the computer and printing out a few images — no larger than 8×10 — I’m better off working on my chops and/or (maybe!) buying a used lens or two to compliment what I’ve got on hand.
That is: the limitations to good and happy shooting are not the gear; not anymore.
@Steeplejack: Not so. See too many words above. If you go close out/refurb, there are on the order of a dozen cameras from several major makers that get you in with a body and a kit zoom for $500 or under.
@jehrler: Yes, it is a great blog post. I had to tweet it and hope it’ll get passed along.
I’ll start with one lens, no DSLR.
Can’t do a lot of money on this.
I don’t care about new, just something that works. I am not a photographer. Thank you.
Decided against DSLR. Just a simple type camera with a usable lens.
The zoom lenses I used were incredible. I don’t need anything like that. I’m not doing anything that needs it.
If a lens that comes with the camera is 35 to 85, it is more than enough.
Great comment. I have been eyeballing the G3, and you reminded me that last year I was eyeballing the E-PL2. Might need to go back and look at that, since prices have dropped.
All this in the context that I have a chronic case of low-grade consumer lust.
I used a Brownie camera. Anything is better than that.
When I do get the camera, I’ll set up a site and post the stills.
@Judas Escargot, Acerbic Prophet of the Mighty Potato God:
Or open immigration and licensing to doctors from countries that have as good or better health outcomes as the US. It would cut costs and harvest the best and brightest.
Plus the current system doesn’t produce enough doctors in general. I’m too lazy to look up the details right now, but the number and capacity of U.S. medical schools have not kept up with population growth for quite a while. Some people see a dark AMA conspiracy. I don’t know that I would go that far, but we’re definitely not seeing the efficient market’s “supply and demand” equation at work.
@Judas Escargot, Acerbic Prophet of the Mighty Potato God:
It takes your breath away. It seems that half the “financial services” industry is based just on this. I’ve seen it personally in my IT contract work for the federal government. The entire health insurance industry fits this mold. CPA’s depend on the tax code being impossible for the average person to navigate on their own (this one particularly sticks in my craw; I don’t mind paying taxes, but I really, really hate how complicated calculating my taxes is).
But they’re no longer trying to sell how universal healthcare will be the end of America as aggressively.
They’re moving the goal posts a bit to scare people, since the original scare of what Obamacare would mean – death panels and what not – has not materialized. You just have a few million parents keeping 20-somethings on their insurance, while a few thousand other people, who were denied coverage for pre-existing conditions have been able to get insurance.
2014 should be interesting, because we’ll see what happens when Obamacare goes into effect and people realize the world hasn’t ended and millions of people have benefited.
2016 should be more interesting assuming people are satisfied with Obamacare like they are satisfied with Social Security and Medicare.
The advantage Obamacare has over SS and Medicare is you don’t have to wait until your in your 60’s to benefit from it. This should make it harder for right-wingers to talk about how younger folks, like myself, shouldn’t expect to receive benefits from Obamacare.
And they say the private sector’s inherently more efficient. The American one’s created a bureaucratic clusterfuck of a maze that easily rivals whatever the Soviet public sector was throwing up.
I’m not in MA, I’m in a red state known for poor insurance coverage. I live where there are plenty of doctors. I have insurance. I was referred by my primary care doctor to a specialist to follow up on something last fall. When I called to make the appointment, the first available appointment they had was two months out.
I don’t think waiting times for new patients is limited to states with better insurance coverage.
I lived in MA when Romneycare was passed. I’d love to be able to comment on how it affected wait times, but I didn’t actually get health insurance coverage until after it went into effect, and concordantly I did not actually go to the doctor beforehand.
However, I never found myself waiting an unreasonable amount of time to see my doctor, when I did go. Nor was my doctor’s office ever particular crowded. There would be maybe one or two other folks waiting around every time I went in.
So I don’t know WTF that woman is talking about. Either her doctor was way busier than mine, for whatever reason, (in which case, fuckin’ free market and shit — find a less busy doc) or she was indeed running her experiences through an IGMFU filter.
Heard on the radio a large part of it was a budget balancing bill from the mid-1990’s that capped federal funds to med-schools and the Fed money has been kept frozen at 1990’s levels ever since, so med-schools have hiked tuition to offset their increased costs and aren’t able to expand.
I don’t mind using software, but why does it have to so damn complicated that I need a specialist to develop it, maintain it and fix it? :-)
There’s always something that’s too complicated for somebody, so we end up with specialists for it.
Such is life.
I think waiting time for specialists is usually a couple of months out for a new patient.
Matches what I went through in NJ for an appointment with a nephrologist.
Of course, in Canada, the backlog must be 2 years out…I mean they put pregnant women on a one year waiting list to see an OB/GYN :-)
I heard about the med schools on Bloomberg radio. What a problem they have set up.
Part of the solution may be to push the country in the direction of the Kaiser model – a fully managed care system where the physicians work for the most part as emoyees of the HMO and most care is provided at soup to nuts centralized healthcare facilities. I technically had a PCP through Kaiser when Iived in Cali, but I rarely saw him. Whenever I needed to see a PCP I just made an appointment with whoever was available, often within 24 hours of calling for an appointment.
@Goblue72: A lot of doctors like being employees instead of being paid per patient. Allows them to spend the necessary time with each patient.
For right-wingers this is one of the most “abused” parts of the Constitution that liberals have expanded beyond “original intent” and we should go back to whatever standards of welfare were available to the public in 1789.
pseudonymous in nc
I think that’s about right. What’s needed, structurally, is to stuff the mouths of PCPs with gold, and have specialists make do with just a summer house, not a summer house and a ski cabin. The vicious cycle right now is to regard general practitioners as med-school failures who couldn’t get into the lucrative specialities that went to better students. That way lies a fucked up system. The carrot is to start forgiving tuition debt aggressively in exchange for primary care work, especially in regions and communities with limited access.
The GP is the mainstay of a functional healthcare system.
What this also requires, though, is for Americans with health insurance to get into their collective skulls that they aren’t being fobbed off if they don’t get to see a bloody specialist for that cough, or that they don’t automatically get to play on the Magic MRI Ride when they have a headache, or they don’t get to bring in pharma ads from their magazines and get a prescription on demand.
@pseudonymous in nc: The vicious cycle right now is to regard general practitioners as med-school failures who couldn’t get into the lucrative specialities that went to better students.
@Violet: I get the vast majority of my health care through a physician owned clinic system that is essentially a huge pool for all the doctors. It’s extremely efficient and flexible plus medical records are all very easily accessed. And one billing department handles all of them so they’re not wasting staff on dealing with insurers. As far as I can tell all the docs love it. I’m not certain if they get a salary from it. None of them seem to be starving though.
This is spot on in terms of the IGMFU attitude and the worry of waiting in lines. In my conversations with my friends on the right it inevitably comes down to this. I’m looking for pragmatic solutions. There has to be some basic level of health insurance for all I argue and a higher level perhaps for those that can pay for that type of access. We do this in many other types of things in our society and perhaps thats where the compromise lies short of full single payer which I’m on board with long term. We have to win these people over with pragmatic compromise they are almost half the country at this point and it will put us on the path to single payer in the end IMO.
@SmallAxe: In the UK everyone is covered by the NHS. However, you can go private if you have insurance or funds. That will get you faster and sometimes more up to date treatment. It’s somewhat of a two tier system, but no one will go bankrupt because they get sick and basic stuff is covered for everyone.
I’m with you V, I’m a dual with Canada so I’m well aware of how Single payer works (broken bones in both countries) but we as a country aren’t there yet and I’ve got $ family in Canada that still bitch about it. The 50M without in the US need basic level care, there should be a mid level for everyone that can afford it and a cadilac level for the wealthy perhaps, just brainstorming ways to get to Single payer in the end.
It’s just unrealistic to think we can bring that 48% of the other side over in one fell swoop conversion IMO. We’ve got to bridge the gap to get there and while ACA is a step it’s a small one and props up private insurance too much. But again it’s better than what we had. I have a great job with good health insurance and still worry how much it will cost when I’ve had injuries etc. that is ridiculous as I’m sure you agree. There’s got to be a better way forward and we’ve got to get others on board.
@SmallAxe: I’m not fully convinced about single payer. I like the Netherlands solution where everyone buys their own health insurance, but the companies are heavily regulated. There is a minimum coverage requirement and some assistance for those who are truly poor. What that means is that people can buy whatever level they think they need but everyone is covered for a basic level of stuff.
Phoenician in a time of Romans
It’s a serious delay. 6 to 8 weeks to see a Primary Care Physician. That’s if you can find one taking new patients. I had two say no.
Interesting. We operate a single payer health system in NZ, which costs me about $40 a visit when I go to the GP (with poorer people partly or fully subsidised), and I’m able to get an appointment within a day or two. Do you simply not have enough GPs per head, or are they wasting too much time on paperwork for insurance companies?
Sounds like a reasonable solution, I’m unfamiliar with the Dutch system, will check it out thanks.
This is similar to Santorum’s condemning Obama as a snob for wanting everyone to get an education. I think Republicans are just steps away from the “Let them eat cake” campaign promise.
Part of what many seem to be missing is that many uninsured people DO have docs already. Especially people like my family; we are self-employed, can’t afford the absurd cost of insurance, so we self-pay. We don’t see a doctor for everything, but (especially for the kids) if one is really sick, we generally have the $120 or so for the visit. I imagine, in 2014 when ACA kicks in, our doc will still see us. And maybe we’ll be able to get regular check ups & testing, which is not in the budget right now.
There aren’t black & white areas here: the insured, for whom all is great vs the uninsured (deadbeats, dirt poor, no $$ at all). Health care has lots & lots of grey areas in it.
@SmallAxe: It’s also the solution in Switzerland and Japan, so not all countries do a single-payer model. Regs in both countries are much tighter than in the US though.
This. My dad is on Medicare, his primary care doc found a mass on his kidney the size of an apple; turned out to be cancer. It took 9 weeks to get surgery booked. If it had been fast-growing, he’d be dead.
Any time people tell the crap tales about wait times for Canada or England, I tell them this story. Most don’t believe it happens here. Idiots.
@Phoenician in a time of Romans:
There is a shortage of Primary Care Physicians all over America. Mostly, as noted by others here, because there is little money in it when compared to specialties. Also, it’s a harder lifestyle with people needing you 24/7.
But in MA, after RomneyCare, the demand went up because everyone has to have insurance. Mandated. And like ACA, with RomneyCare, everyone gets “Free” preventative care. (Only costs 12 x your monthly premium)
So with people all wanting their “free” physical, plus people entering the system for the first time, plus people who had things they had been ignoring before the mandate, plus many policies requiring a primary care doc referral to go to specialists, there are more patients than there are doctors.
When you buy RomneyCare online you see every policy there is, click on the ones you want to see more about, can compare, and can download all the info about the details of the policies before you click and buy one. I chose one of the few that didn’t require primary care doc referral to go to a specialist. It’s a small state. And in Boston – which is only 3.5 hours away at maximum from as far west as MA goes – is world class care. So if, heaven forbid, something happens where one needs a great specialist, one goes to Boston. Otherwise, for more routine stuff and emergenices, there are excellent small hospitals around the state.
@SmallAxe: A couple of years ago it was determined to be the best system in Europe. Like Yutsano said, other countries use it too and it works well. I think it is a better system than single payer. Even the UK has headed to something similar where people can go private, which is similar to buying more expensive insurance.
@Phoenician in a time of Romans:
I believe MazeDancer’s delay was for an initial appointment with a new physician. In that context, six-eight weeks is not outlandish. I had to wait about that long to get an appointment with a new dentist last year.
@Steeplejack: I generally have to wait weeks to see my primary care doc if it isn’t an emergency. If it is something urgent they fit me in right away. Seems to me that’s how it should work. I don’t mind waiting if it’s not urgent.
@cckids: Chances are that if it had been fast-growing, he’d have been seen sooner. The people who schedule the doctors’ time are not idiots after all. They know what needs to be seen sooner.
I have had two kinds of cancer, and I am sure that if I had a recurrence of colon cancer symptoms I’d be seen within a month or two, but if it was the bladder cancer, I’d be in there within a couple of days. One progresses a lot faster than the other.
@gene108: “budget balancing bill from the mid-1990’s that capped federal funds to med-schools”
This may be a large part of the problem.
We changed primary care doctors several times in a few years (they kept leaving town for family reasons), but it was before the mid-1990’s.
Since then we tried only once and couldn’t manage it. We could find only one doctor who was accepting new patients, and the initial experience was bad — seemed like she didn’t really want our business after all. The first appointment consisted of about five minutes of conversation. The next was supposed to be scheduled by the doctor’s assistant, but he/she never called, so we decided we would stay with our current guy rather than bother the new one with our troublesome presence.
We’d have tried a different new one, but as I said, there were none accepting new patients.
@Maude: An Olympus Pen is a great value and the Micro 43 format is a real winner. http://www.bhphotovideo.com/bnh/controller/home?Q=&A=endecaSearch&InitialSearch=yes&N=0&O=&Ntt=Olympus+E-PM1
@different-church-lady: I recently moved to central MA. There’s only one female primary care physician nearby that accepts my plan, and I have to schedule my annual exam 4-6 months in advance, but I can get in to see her or the nurse within a day or two for unexpected problems (which I rarely have, fortunately). I am happy with the cost, though, and I like the general mood here in MA–more of an all-in-it-together sense of community that was sorely lacking in California (where I lived for decades). My sister just moved here as well, and is thrilled that she’ll finally be able to afford health insurance (she plagued with chronic health problems), and that her hideously expensive meds will finally be affordable as well.
pseudonymous in nc
It’s a very very constrained sandbox, and the regulator’s powers extend to redistributing monies from one private insurer to the others if there’s an actuarial blip in the ratio of premiums to claims. The competition exists on the fringes of wellness provision and the amenities offered in facilities. The Dutch system also excludes long-term care, disability care, treatment for severe mental illness and other “exceptional” needs (including abortion) from those sandboxes and covers them out of a separate public insurance scheme which is funded by a payroll tax.
It’s still too soon to tell whether the new Dutch system — which reformed and straightened out a slightly messy set of legacy systems — is on a sound long-term footing, but it’s not going to be heading anywhere near the American way.
It’s a model that I’d be comfortable seeing in the US, but then again, I can count half a dozen national models or variants that would be better, because they’re actual systems, instead of raggedy patchwork quilts.
Another Halocene Human
@MazeDancer: I have trouble getting access to care now. Unless I decided to just go with a DO or ND or chiropractor instead of a real doctor. Then I would get seen right away. I might even have my copays waived (illegal, but who’s counting) and get a sweet disability tag for my car because the chiropractor will hook.you.up.
So my experience is few people with health insurance = shitty physicians and not enough of them.
Maybe I will have better access to care with Obamacare. I mean in several years but wtf. I’ve been waiting years to see the doctor about shit as it is.
Another Halocene Human
@Phoenician in a time of Romans: Our problem is that medical schools are private and they cost too much. We also have a 1930’s Nazi era law that bars accepting overseas MDs. (This was to keep Jews out. Back then, Austrian and German MDs were much better than US and the US docs didn’t want new competition.) The AMA in the past was mainly concerned about keeping their wealth by restricting the number of doctors, and the medical schools in recent years have decided to “charge what the market will bear” and “recapture” the “future earnings” of their students, meaning that med students who do NOT come from wealthy families are pretty much forced into specialties in order to pay their student loans back, which are not dischargeable in bankruptcy, thanks to new Bush-era bankruptcy laws.
That is why nobody who doesn’t already have a PCP locked in can find a good PCP accepting new patients, at least not without a 6-month wait.
Has anyone ever asked Ryan why this is so? Has he gone on record explaining why health insurance is not a necessity? Is it because he believes that the present system of caring for those too poor to have health insurance–hospital treatment for non-critical illness–works, or is it simply that those too poor to get well are too poor to matter?
Seriously, what is this guy’s problem?
Somehow I feel like we’ll be waiting for hell to freeze over before someone in the media gets to or thinks to ask that question.
I’m in Virginia, which is about as far from MA and Romneycare as can be. The extended delay to see ones GP or a specialist is just as common here. I don’t know who doesn’t have this experience – it’s been the case in my life for better than 15 years now, starting back when I lived in South Florida. If you’re somewhere that you don’t have an extended wait, congrats, but it doesn’t seem to have any real connection to health care regulation that I can see.