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This post is about RKBA versus right to health care so I’ll post it in DU’s Guns Fortress.

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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 08:07 PM
Original message
This post is about RKBA versus right to health care so I’ll post it in DU’s Guns Fortress.
GD has several threads with numerous assertions that “health care” is a right and some stress it is not a privilege.

I use “right” above to mean “natural right” as opposed to “privilege” that is often referred to as a “legal right”.

Our Bill of Rights enumerated rights in eight amendments and recognized unenumerated rights in the Ninth Amendment.

IMO our Constitution does not recognize health care as a “right” meaning government is not required to provide health care as I discuss below.

Our nation has $10+ trillion in debt and we have limited funds for any version of so-called universal health care. Society must then make decisions on which patients will receive medical care and who will not. That could be interpreted as establishing a minimum level of health care to which each citizen is entitled as a privilege.

Universal health care laws will require funds and IMO the question of whether health care is a right or privilege; i.e. using PA and VT words natural, inherent, inalienable/unalienable right; that government must fund will require SCOTUS approval.

SCOTUS has said repeatedly that government is not obligated to protect an individual unless she/he is in custody, most recently in Castle Rock v. Gonzales. i.e. self-defense is a personal responsibility.

Since self-defense is a personal responsibility, the right to keep and bear arms for defense against crime is important and protected by the Second Amendment as SCOTUS said in D.C. v. Heller.

More specifically by example, government is not obligated to protect an individual against the threat of death by a criminal and it seems to follow that government is not obligated to protect that same individual against the threat of death by a disease.

Given the battle we pro-RKBA Dems, et al won with D.C. v. Heller, it’s timely to remember that our victory confirms what we have been saying, that each law-abiding citizen has the right to keep and bear arms for self-defense. The decision did not say government is obligated to protect each individual against criminals.

Thoughtful comments on the topic will be appreciated.
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gorfle Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 08:24 PM
Response to Original message
1. A right to health care.
Here's my take: if the government has trillions upon trillions for Iraqi and Corporate welfare, then it better have trillions upon trillions for some health care and social security.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 08:32 PM
Response to Reply #1
2. Agree but the question I posed so poorly was whether health-care is a right or privilege. n/t
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gorfle Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:46 PM
Response to Reply #2
14. Right or privilege?
I don't know.

But with the trillions that have been spent on utter bullshit, I damn well expect my health care and social security and I'll just leave it at that.

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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:52 PM
Response to Reply #14
15. Thanks for the exchange. I hope someone will provide a SCOTUS cite that speaks to the issue. n/t
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 10:21 PM
Response to Reply #15
20. because as everybody knows
Edited on Tue Dec-02-08 10:21 PM by iverglas

this "SCOTUS" channels the old dead white guys who wrote that thing all those centuries ago. Or wears the rings handed down from them. Or something.

They are never political appointees with agendas.

But more importantly, do they control what their society decides is the best public policies to adopt, in the best interests of the population, where those policies do not violate that Constitution?

I'd say no.

Now, if the society were to adopt a policy of universal single public payer health insurance -- i.e. no opting out, no preferential private tier for the rich -- would they have something to say about that? Very likely, since it can be argued that such a policy violates entrenched rights like liberty. It has been argued in Canada. And shamefully, our own Supreme Court decided to thwart the will of the people -- and disregard all of the massively voluminous evidence submitted to the lower courts to demonstrate the wisdom of the policy and establish the justification for it -- and open a chink in the armour of our own public health insurance system to let the profiteers in.

So that kind of public policy is probably a long way away in the US. But making publicly administered health insurance available to all, even if not mandating participation in that plan, is hardly beyond imagining.

And what any court would have to do with that public policy decision, I wouldn't know.
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one-eyed fat man Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 09:29 AM
Response to Reply #20
25. the "golden" opt-out
Those who have the money will always have the ability to opt out. Old enough to remember vividly the Fifties, when abortion in the US was as illegal as could be, if you had the money, a ticket on a SAS, Sabena or even an Air Canada DC-7 flew you to Stockholm where such things were discretely handled.

Those Canadians with the money, who choose not to wait, a short drive across the border gives them access now. Just as surely as the import restrictions encourage busloads of seniors from the US go North for cheap drugs.

Are you saying that the government should prevent or somehow restrict that kind of "voting with your feet" behavior and how would they do it?

Healthcare, like any commodity or service, has always been more available to those who can "pay" for it. Every failed "workers' paradise" I can think of, had another tier accessible to the Party elites, since they controlled the budgets.

Being retired military, I have some experience with government run healthcare.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 09:34 AM
Response to Reply #25
26. one-eyed fat man, it's not fair to use facts and personal experience against a rant.
:thumbsup:
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Dec-03-08 12:00 PM
Response to Reply #26
36. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Dec-03-08 05:25 PM
Response to Reply #26
43. Deleted message
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Dec-04-08 08:54 PM
Response to Reply #26
51. got something to say, jody?

Got any basis for characterizing the post to which you are referring as "a rant"?

Got a clue? got manners?

Didn't think so.

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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Dec-03-08 11:59 AM
Response to Reply #25
35. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
one-eyed fat man Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 05:11 PM
Response to Reply #35
41. my limited experience with Canadian system.
My uncle, who took me hunting for moose when a kid crossing the border with a rifle on the Greyhound bus was unremarkable, died last summer in Mississauga.

He died of prostate cancer at the age of 87. He got to feeling poorly a couple of years ago, took a number, took a seat and started with his primary care doctor. In the eighteen months it took to get the appointment to THE doctor who correctly diagnosed his malady the disease had progressed. He was also chided for not coming a year earlier. As it turned out, he was basically sent home to die.

Whether his experience was atypical or not, it was in fact how it went and he is most certainly dead. In his case, the system plodded slowly and for whatever reasons, be they bureaucratic inertia, medical misjudgements, or a simple screw up makes no difference to my aunt. I can only go by what she tells me. Admittedly, he was kept comfortable and received excellent hospice care until he died.

You may call it a single-payer system, but, it still makes no difference, "Thems' that's gots the gold, makes the rules." "Government" actuaries decide what procedures get funded and on whom, what drugs are in the formulary, what is covered and what is not. Is it a more efficient means of delivering healthcare, or is it a more equitable way, probably. Is it a panacea, probably not. But the end game, it's "government-run" if they pick up the tab.

I saw you decry folks opting out of the "system" and was curious what you meant and how you proposed to stop it.

My experience with the military healthcare system has been favorable, as long as both the provider and patient were in uniform. On the other hand, the VA has long had a less than sterling reputation, e.g., the hospital in Marion, Illinois. My experience with the VA has been congruent with their billing.

As long as there are people who have the resources to "buy" better, they will, and as long as there are people who don't, there will be those who are envious. There will also be those who will abuse the "system" simply because it is "free." I haven't a solution that convinces me it is the way to go, nor do I see keeping the system as it is.

"Ya pays yer money, and ya takes yer choice!" or "They takes yer money, and ya takes their choice."



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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Dec-03-08 05:24 PM
Response to Reply #41
42. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
SteveM Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-06-08 02:36 PM
Response to Reply #25
54. Or, loaning out one's car for a quick hop down to Mexico...
That's what I did pre-Roe for a friend who faced an unwanted pregnancy.

Hard to say about health care being a Constitutional (or "natural" right). The Preamble to the Constitution contains "We the people of the United States, in order to form a more perfect union, establish justice, ensure... provide... promote the general welfare, and secure the blessing of liberty to ourselves and our posterity, do ordain and establish this Constitution..." These verbs seem to provide a quality of action. "Ensure domestic tranquility" seems extremely obligatory; a duty of the people and its writ; "Provide for the common defense", strangely, allows "common defense" without proscription and command; "Promote the general welfare" is a fairly unique "positive" notion within a "negatively" -couched Bill of Rights within the Constitution (an old criticism by many of the "New Left).

One can loosely read the Preamble as "requiring" a positive, tangible action toward "general welfare;" and general welfare can be loosely read as charging the People, through the Constitution, to accomplish something like guaranteed health care. Perhaps Justice Douglas would have been as swashbuckling about this, and I liked Douglas, but I'm not sure on whether or not the Preamble is fair game in a discussion like this. But "...promote the general welfare" is a powerful positive charge standing out, as it were, from a negativist document.
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gorfle Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 11:28 AM
Response to Reply #20
31. Another question about Canadian health care
Can rich people buy "extended coverage" insurance to cover things not covered by the national plan (assuming something is not covered by the national plan)? Can rich people contract private medical services if they don't want to use "the system"?
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 12:14 PM
Response to Reply #31
37. anybody may on one, no one may on two

Can rich people buy "extended coverage" insurance to cover things not covered by the national plan (assuming something is not covered by the national plan)?

Anything that is not covered by the provincial plans (under the federal rules) can be covered by supplemental private insurance.

All major employers have such plans -- dental and prescription where not covered by the provincial plan, long-term disability, life insurance. Dental and prescription are the most popular of course.

I'm self-employed. I can buy my own as part of a variety of group packages offered. Not worth it for me. ... I'll just pay the $4000 dental bill I have coming in the new year ...

But the provincial plans cover all actual medical services -- including lab work, xrays and other diagnostic procedures, all services in hospitals (including all the little accessories, any drugs, all nursing and physician services), surgeries, etc. The service must be "medically necessary". Vasectomies and tubal ligations are medically necessary; reversals are not. ;)


Can rich people contract private medical services if they don't want to use "the system"?

The answer is fuzzy. Until a couple of years ago: no. Then a right-wing jerk went to the Supreme Court of Canada and got them to agree that his fundamental rights were being violated because he could not take out private insurance to cover an air ambulance should he take ill and not want to wait for the provincially-covered service. Now, Quebec's system was in a bit of a mess and shortages of services of some kinds were a problem. But destroying the public system -- and the evidence is overwhelming that allowing a private tier will eventually do just that (viz. the UK's NHS after Thatcher) -- isn't the answer. It isn't quite clear what's going on in Quebec in that regard at the moment, but so far the malady hasn't spread.

The prohibition is actually against private insurance rather than private health care, but there are provincial variations on that theme too, generally involving doctors having to pick one or the other (and few doctors are going to give up income from the public plan), and again, although I did a bunch of work that involved becoming intimately familiar with the details of that Quebec case, some of it is just beyond my ken.


The main thing that so many people in the US just don't get is that the vast overwhelming majority of Canadians have absolutely no problem with the way our system works, and well beyond that, would not dream of allowing it to be altered in a million years.

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gorfle Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 02:12 PM
Response to Reply #37
39. Sounds like a great system.
I hope we can get something similar.

The problem is going to be fighting the insurance lobby. You think the NRA is powerful - they are peanuts compared to those guys. There is a lot of money and jobs at stake.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 02:40 PM
Response to Reply #39
40. absolootely

I think the road from where you are to a universal scheme is going to be a long one. And in fact it was for us. It started in one province (Kiefer Sutherland's grandpa, Tommy Douglas, "father of Canadian medicare", was premier of Saskatchewan and fought the doctors there -- they struck and he brought in British MDs). It started with limited coverage -- hospital only. A couple of decades later a national scheme covering all medical care in all provinces was adopted. It was another couple of decades before "extra billing" (co-pays) was banned. Some 40 years all told. I certainly hope you make it a little quicker than that.

Joe Biden's thoughts (rambling as they are) seem on target to me:

http://www.youtube.com/watch?v=3OgcKGWwWlE&mode=related&search=

(I've been a huge Biden fan for decades, even though I find some of his positions obnoxious and I wouldn't actually want him for my own head of govt.)

*Regulation* is the first step, as it is with every other aspect of your (and to a lesser extent our) economy. Deregulation is the source of many of your current economic woes. Health insurance has never been regulated to any reasonable degree. Biden's remarks include that -- things like not permitting insurance companies to exclude from coverage and so on.


http://www.tommydouglas.ca/tommy
Tommy Douglas: The Greatest Canadian

As Tommy Douglas said...

"I felt that no boy should have to depend either for his leg or his life upon the ability of his parents to raise enough money to bring a first-class surgeon to his bedside. And I think it was out of this experience, not at the moment consciously, but through the years, I came to believe that health services ought not to have a price tag on them, and that people should be able to get whatever health services they require irrespective of their individual capacity to pay."

Did you know...

...that Tommy's government enacted Canada's first Bill of Rights?

He was also a Baptist clergyman. Gasp. The social gospel is us, up here.


Here's what I've been looking for:

http://scaa.sk.ca/gallery/medicare/en_timeline.php

Medicare timeline - excerpts:

1944 – North America’s first social democratic government.
Act of the legislature proclaimed that residents of the province were eligible for free services relating to the diagnosis and treatment of cancer.

1945 – First comprehensive health plan for pensioners and widows.
Formation of the Saskatchewan Health Services Planning Commission.

1947 – First universal hospitalisation insurance program in North America.

1948 – National Health Program of Grants initiated by the federal government

1959 – Premier T.C. Douglas announces plan to introduce a prepaid medical–care program.

(This is the point at which I broke my leg and spent three months in hospital -- and my parents were very fortunate that my father had health insurance at work, because we didn't live in Saskatchewan.)

1962 – First universal Medicare in North America.

Drat, that's as far as that one goes ...

http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2005-hcs-sss/time-chron-eng.php

1962
Saskatchewan creates medical insurance plan for physicians' services, July 1; doctors in province strike for 23 days.

... Throughout the 60s and 70s all provinces established plans, with federal cost-sharing.

1984
The Canada Health Act, federal, passes (Royal Assent April 17), combines hospital and medical acts; sets conditions and criteria on portability, accessibility, universality, comprehensiveness, public administration; bans user fees and extra billing.
Provincial/territorial reciprocal billing agreement for out-patient hospital services provided out-of province/ territory.


Throughout the late 80s and 90s the feds cut funding continually, and some provinces (e.g. Ontario under a right-wing govt) made massive cuts, closing hospitals, cutting nursing staff, etc., along with cutting welfare and the like, all in the name of tax cuts. These are the sources of what problems we do have now. It ain't the system, it's who's running it.
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HALO141 Donating Member (425 posts) Send PM | Profile | Ignore Tue Dec-09-08 01:18 PM
Response to Reply #37
65. re. the second part of your post...
If I read that correctly it sounds like one can go wherever they will unless they're sick or injured. In that case one must wait on government provided transportation which may or may not be available.

If that's the case then, yes, I would agree that the individual's rights were being usurped.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 08:54 PM
Response to Original message
3. since jody puts anybody who looks at his posts sideways on ignore

why would anybody even bother pointing out what a load of bollocks this entire post is?

Oh well. I said it.

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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 08:57 PM
Response to Original message
4. How are the two related?
This is silliness. Potatos are not radios.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 08:59 PM
Response to Reply #4
5. Perhaps you are correct so please provide a SCOTUS case supporting health-care as a "right". n/t
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:05 PM
Response to Reply #5
7. I don't have any such case...
but the two things are still not related in any way.

Is health care a right? Well, in every state I know of, emergency rooms are required to treat emergency health needs, at least to the extent that the patient is stabilized. If you wish, you could consider those laws as establishing some sort of right.

Of course, a guy could take the ill patient to the hospital and hold the staff at gunpoint until the patient was treated and cured, I suppose. It has happened. It rarely turns out well.

Bearing arms is a constitutional right. You are correct, there, although the SCOTUS has ruled that the right may be subject to legislative restrictions in some situations.

Health care is governed by legislative action. I expect that basic medical care will be a right by legislation fairly soon.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:06 PM
Response to Reply #7
9. See my post about potatoes used as radios. n/t
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:08 PM
Response to Reply #9
11. Seen and replied to. A potato cannot be a radio...
only part of a power source. The radio in your automobile or house is still a radio if it is disconnected from the power source. It won't function, but it is still a radio.

Logic's a tough thing.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:18 PM
Response to Reply #11
13. #7 "two things are still not related in any way" but in both cases they address protecting an
individual against a threat.

In the case of a threat by a criminal, SCOTUS says protection is a personal responsibility.

In the case of a threat by a disease, SCOTUS has not said, has it?
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 10:13 PM
Response to Reply #13
18. jody sees things the way they are

and doesn't even bother saying "why?", let alone dreaming about how things might be and saying "why not?"

Imagine how much nicer some people's lives might be, even if not his own, if he and others did.

Why should public authorities not be accountable if they are negligent in performing the duties assigned to them and someone suffers harm as a result?

Why should the public as a whole not assume a responsibility to provide adequate basic health care for all members of a society, if that is what the consensus of that society is?

What's jody's problem??
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:03 PM
Response to Reply #4
6. See link below for using potatoes as radios.
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:06 PM
Response to Reply #6
10. Nope...the potato merely serves as the
electrolyte vessel for a single cell of a battery.

The radio is something else, powered by that cell.

Sorry.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:09 PM
Response to Reply #10
12. The cited article claimed potatoes were radio wave detectors. Perhaps it was wrong. n/t
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one-eyed fat man Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 10:11 AM
Response to Reply #10
27. the potato is used as a diode, NOT a battery
The article discusses simple "crystal sets" as used in the earliest days of radio, about a century ago. Basically,a set of very high impedance headphones are hooked between and antenna and the ground. The "detector" allows the RF energy captured by the antenna to be converted to an audio signal in the headphones. A coil in parallel tunes the radio. You'd have made one of these as a kid watching Mister Wizard on TV 50 years ago.

You could construct such a radio some rainy Saturday, using a 1N34A diode instead of a freshly cut spud, but it is nowhere near as impressive to the grandkids.
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 10:48 AM
Response to Reply #27
28. I don't think so...
The writer of that article is misinformed, I believe. Having built many radios, using detectors made from galena, razor blades, and even silicon crystals, I have never heard of a potato being able to be used as a detector.

I believe the writer of that article remembered the fairly common potato-powered single transistor radio. I built one of those as a 12-year-old boy, using a Raytheon CK-722 transitor in 1957.

I've done a search for potato radio detector, and have only found that single article mentioning it.

However, I have a working crystal set here in my house. I'll get a potato and see if I can make it work, but I don't believe it will.

A single reference on Google does not a fact make.
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 11:00 AM
Response to Reply #27
30. OK. Experiment with potato done.
Nope. I first tested my crystal radio, using both a galena detector and a 1N34 diode. It is working just fine, and receives a local station quite loudly.

I went to the kitchen and found two potatos. One was a Yukon Gold and the other a regular russet baking potato. I cut each in half to expose a fresh face. I removed the diode from the radio circuit, then used two copper wires, as indicated in the erroneous article, inserted into the Yukon Gold potato as a replacement for the diode. No reception. I experimented with the wires at several distances from each other, from 2mm apart to 2.5cm apart. I repeated the experiment with the russet potato, with the same negative results.

I believe the gentleman who wrote that short piece was confused. The potato can be used as a power source, but not as a detector.

Again, a single source from the internet is not necessarily factual.

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one-eyed fat man Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 11:42 AM
Response to Reply #30
33. I will have to experiment myself
Having built several foxhole radios using razor blades, it seemed detection occurred in areas where there was some corrosion. I wonder if corrosion or lack of it is a factor on the potato detector.

I missed making the single transistor battery rig. 1957 I was busy keeping key clicks from a single 6V6 out of my parents TV while hoping to hear something on a surplus BC-224. A whopping 8 watts DC input!
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 11:50 AM
Response to Reply #33
34. I think the potato
doesn't work as a detector for a lot of reasons. Galena is lead sulphide. You can also use cuprite, which is copper oxide. It seems that there is a need for an oxide, sulfide or other -ide of a metal that is needed for a crude semiconductor that can be used as a radio detector. Hence the corrosion deal on the razor blade. I think the potato's organic nature keeps it from working. It's just not in the cards.

Sounds like we're about the same age. I spent my childhood messing with radio and other circuitry. That lasted until I discovered that my own detector worked on girls. I found them more entertaining that moving a cat whisker around on some crystal.

Now that I'm an old fart, I play with those old circuits again from time to time. It amuses my great-nephews and nieces, too.
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one-eyed fat man Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 05:46 PM
Response to Reply #34
44. spuds might be duds
Might be just a crummy oxide layer on the copper wire responsible if any detection occurs. The foxhole radio would work using a safety pin alone as the whisker, but sure was easier to find the "sweet spot" with a chunk of pencil lead wired to it. I wonder exactly what the graphite did to have that effect.

Between 1963 and 1991 most of the radios I used were mounted in a tank turret. Tinkering with tubes is one of things this old fart still enjoys.
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one-eyed fat man Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Dec-04-08 09:19 AM
Response to Reply #30
50. Red Bliss
Clean shiny copper wire, no joy. Using a grungy, green and deliberately sulfated wire, noise, but no coherent detection, so suspect the sulfated wire got me a battery.

Looks like you got it pegged.
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madville Donating Member (743 posts) Send PM | Profile | Ignore Tue Dec-09-08 12:12 AM
Response to Reply #4
64. The two are related
Even if health care was a right spelled out in the constitution like the RKBA it would be treated the same as RKBA is today. You have the right to own the best, most accurate, fanciest firearm you can afford to pay for, just like you have the right to the best, most advanced health care that you can afford to pay for.

Just because something is a "right" doesn't mean you still don't have to pay for it.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:05 PM
Response to Original message
8. here's a starter
Edited on Tue Dec-02-08 09:06 PM by iverglas

http://www.pnhp.org/publications/nejmadmin.pdf

Costs of Health Care Administration in the United States and Canada

BACKGROUND
A decade ago, the administrative costs of health care in the United States greatly exceeded those in Canada. We investigated whether the ascendancy of computerization, managed care, and the adoption of more businesslike approaches to health care have decreased administrative costs.

METHODS
For the United States and Canada, we calculated the administrative costs of health insurers, employers’ health benefit programs, hospitals, practitioners’ offices, nursing homes, and home care agencies in 1999. We analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies. In calculating the administrative share of health care spending, we excluded retail pharmacy sales and a few other categories for which data on administrative costs were unavailable. We used census surveys to explore trends over time in administrative employment in health care settings. Costs are reported in U.S. dollars.

RESULTS
In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada’s national health insurance program had overhead of 1.3 percent; the overhead among Canada’s private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers’ administrative costs were far lower in Canada.

Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations’ figures exclude insurance-industry personnel.)

CONCLUSIONS
The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.


That's not to mention the benefits of universal health care to the economy, in terms of eliminating a lot of the loss of productivity from illness, loss of entrepreneurial activity because of the insecurity of not having insurance when starting a business, constraints on businesses when large sums go into paying for employees' health insurance, personal bankruptcies arising from medical expenses, etc. And that's not to mention the non-economic costs of inadequate health insurance and health care.


Framing the issue as "right" vs. "non-right" is really quite pointless.

Nonetheless, in this 21st century, people in many places do have notions about the rights they have as members of their societies, as part of their social contract. Health care is looked at that way by people in a whole lot of places that don't have their heads stuck up the bums of a bunch of old dead white guys who owned human beings and had control over every aspect of their wives' and children's lives and lived in a society where people routinely went to prison or became temporary slaves because of debts. To mention just a few of that society's charming features.

Amazingly, a lot of people in the world today feel quite entitled to set their own priorities for their own societies, and decide the terms of their social and political consensuses for themselves. Not tolerating 1/7 of their population having no insurance against the costs of illness and injury, and all of the economic and non-economic costs that such a situation entails, is one of the things we out here in the outer darkness kind of insist on these days.
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gorfle Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 09:53 PM
Response to Reply #8
16. I agree.
While I'm not willing to toss the wisdom of our founders simply because they are a bunch of old dead white guys, I certainly agree with you on health care.

As a member of this society that is footing the bill for trillions of dollars spent on utter bullshit, I expect my end of the social contract to be upheld.

I don't ever want to hear another word from my politicians that there isn't enough money for Social Security or at least some basic level of health care afforded to everyone.

So whether it's a right or a privilege doesn't really matter anymore. They have screwed us over to the tune of probably 10 trillion dollars or more. They fucking owe me. And I don't want to hear about not having enough money. Go print it, or rip it out of the ass of some CEOs some place. I don't care.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 10:10 PM
Response to Reply #16
17. but do you have a preference?

And I don't want to hear about not having enough money. Go print it, or rip it out of the ass of some CEOs some place. I don't care.

;)

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gorfle Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-02-08 10:18 PM
Response to Reply #17
19. LOL
Yes, actually, I do. :) I spent some 5 minutes formulating my outrage in text in a manner that wouldn't get my post deleted or have people knocking on my door.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Wed Dec-03-08 01:34 AM
Response to Original message
21. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
jody Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 06:37 AM
Response to Reply #21
22. Good morning fingrpik, as usual you say less with more words than most beetles. Have a good day. n/t
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jeepnstein Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 08:21 AM
Response to Reply #21
23. I see him more...
as our resident Devil's Advocate. Just as iron sharpens iron, we need people like him to stir the pot in a civil manner. In some parts of the country, he'd be a pretty fair representation of what passes for a Democrat. I'd almost be willing to bet he lives in "fly-over land".
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 08:30 AM
Response to Reply #23
24. Interesting point re "fly-over land" because people on the East Coast and West Coast forget voters
in between.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 12:17 PM
Response to Reply #24
38. interesting point re "fly-over land" indeed

Which coast is Arizona on?
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 11:40 AM
Response to Reply #23
32. "in a civil manner"

Now that's an intersting characterization. It had never occurred to me, I must admit.

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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Fri Dec-05-08 11:23 PM
Response to Reply #23
53. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
SteveM Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-06-08 02:48 PM
Response to Reply #21
55. See #54 where I bring up the Preamble. May be of use.
Of course, in any discussion of social policy, one doesn't need to have a special Constitutional "promo," only that the policy not be in violation. Guaranteed health care, in my view, does not violate the Constitution, and is long overdue.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-08-08 11:09 AM
Response to Reply #55
63. in a nutshell

Of course, in any discussion of social policy, one doesn't need to have a special Constitutional "promo," only that the policy not be in violation. Guaranteed health care, in my view, does not violate the Constitution, and is long overdue.

Twenty-one firearm salute, please.

We have said the same thing.

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hoplophile Donating Member (72 posts) Send PM | Profile | Ignore Wed Dec-03-08 10:56 AM
Response to Original message
29. As someone on COBRA right now
I can say that I sure wish there was some form of government assistance for health care. I understand that it is not a right, yet health care for serious problems cannot be refused. This of course has led to hospitals going bankrupt in California. I'm not sure what the answer is but we ARE headed toward a cliff in a very big ambulance.

As for as the 2A goes, it is written in very plain english, listed as item number 2 on the Bill Of Rights.
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Indy Lurker Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 08:59 PM
Response to Original message
45. In general, rights are freedoms
Freedom of speech
Freedom of Religion
Freedom to keep and bare arms
Freedom from having troops stationed in your home.

In general rights are freedoms from government encroachments. They don't require effort or labor from other citizens.

The one exception is the right to a trial by jury. Citizens are compelled to serve jury duty.

But jury duty is very short term and infrequent.

It would be entirely different to compel doctors to see patients at a reduced rate on a regular basis.


That doesn't mean government doesn't have a large role to play in health care, It's just not a right, much like education.

Both are very important, but not something you are inherently born with.

And in the end, it boils down to money. An ER doctor in th US makes $190K, and ER Doctor in Canada makes $100K CAD = $80K USD.






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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 09:05 PM
Response to Reply #45
46. Thanks. n/t
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 10:05 PM
Response to Reply #45
47. Ah, open the door on that cave

and join us in the light of the 21st century ...

Rights are many things, grasshopper.

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tucsonlib Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-03-08 11:53 PM
Response to Reply #45
48. Or, To Put It Another Way ~
"Rights" are about selfishness. "I have a right to do this!"
"Obligations", on the other hand, are selfless - We, as human beings, are ethically and morally obligated to take care of one another. In every "civilized" country; every "Christian" nation, if you like, universal health care is naturally accepted as a social imperative. Except for here in the U.S. of course.
You say that it "all boils down to money". No, it all boils down to our callous disregard for the plight of the less-fortunate. It's perfectly summed up in that familiar, self-righteous whine spewed from the maws of the "jodys" among us, "Why should my tax dollars pay for their health care?"
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Indy Lurker Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Dec-04-08 06:35 AM
Response to Reply #45
49. I retract my comments
Canada is responsible for defining rights under US law.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-05-08 12:07 AM
Response to Reply #45
52. oh yeah ...

It would be entirely different to compel doctors to see patients at a reduced rate on a regular basis.

That would be because somebody is compelling them to be doctors ...
... and to seee patients ...


And in the end, it boils down to money. An ER doctor in th US makes $190K, and ER Doctor in Canada makes $100K CAD = $80K USD.

Assuming you have a sound source for that ... and your point is?

The enormous salaries of doctors in the US are part and parcel of the huge and widening gulf between the rich and the poor in that country. What reason would someone have for defending and wanting to perpetuate that disparity?

Isn't it one of those root causes of crime, after all?

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Wickerman Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-06-08 03:38 PM
Response to Original message
56. Economics is not a viable argument
to say healthcare is NOT a natural, inherent, inalienable/unalienable right.

1. In the US we find some way to pay for what we find important. The examples are myriad, but of late one could look at the assorted bailouts and the war in Iraq as examples. The cash isn't there for either of those examples and it never will be, nor will it be repayed, nonetheless, we got 'em both.

B. The US wastes billions monthly on inefficient and greed-driven ineffective health care. Were it to be re-aligned quality healthcare could be afforded to all. When the poor need healthcare they go the E.R. Who pays? If they are MA eligible the govt picks up the tab. If they are not and don't pay then you and I absorb it through higher costs in our hospital and doctors bills. MA, of course, doesn't actually cover the true cost of services so the ER has to pick up that overage and pass it on to you and me again. Hospital Administrators and Doctors alike, in large number, are coming to support some single-payer type system.


The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 47 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

http://www.pnhp.org/



Costs aside, IMHO comparing RKBA and Healthcare to one another is good in rhetoric, unfeasible in practice. They are not the same creature. If they would be, Jody, I'm afraid I do not see that you have made your case that health care is not a right as much as RKBA. Ultimately, RKBA is about defense of life. Same so with healthcare.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-06-08 03:51 PM
Response to Reply #56
57. Interesting opinion. SCOTUS says self-defense is a personal responsibility not governments.
IMO health care is also a personal responsibility and not a claim against government.

I posted the OP hoping someone would cite a SCOTUS decision that health care for an individual means an individual has a claim against government and that claim is a right either enumerated in the Amendments or un enumerated and covered a=by the 9th.

Absent such a cite, health care is a privilege granted by government.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-08-08 12:34 AM
Response to Reply #57
61. "health care is a privilege granted by government"

Yeah.

Let's see jody repeat that if his government decides he is not entitled to a heart transplant. Even if he pays for it himself.

Health care is a right, just like eating pizza is a right.

Whether there is a right to have health care paid for by the public is a public policy decision to be made by the society in question. Not all rights are listed in constitutions. Really.

I believe that in most places in the US, the indigent have a right to have counsel provided to them at public expense when they are charged with serious criminal offences.

Does the U.S. constitution say that?

Nope. But the public, through their governments, did.

Heck. I think maybe even some courts might have said it.

Surely when an individual has a right to counsel, s/he still has the personal responsibility of retaining, instructing and paying counsel -- ??

Just like the individual who has a right to "keep and bear arms", and yet doesn't expect the government to issue the arms free of charge. Just like jody says.

Of course, I'll never know whether jody agrees with the right to have counsel provided at public expense ...



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tucsonlib Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-06-08 05:46 PM
Response to Original message
58. See This "Greatest Thread" For An INTELLIGENT Argument,
as well as a thorough debunking of jody's "costs too much" rant:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x4590639
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madville Donating Member (743 posts) Send PM | Profile | Ignore Sun Dec-07-08 11:11 AM
Response to Original message
59. Health care is a right and not much different than the RKBA
If you want/need a gun you go into a store, pick one out and pay for it.

If you want/need health care, you go to a hospital or doctor, decide on a treatment and pay for it.

How are the two different? The RKBA is alot more restrictive than your right to healthcare, for example you don't need a background check to get health care.

If health care is a right that the government should be providing for me then shouldn't the government be providing me a government firearm so I can exercise my RKBA if I choose or need to?

I don't like the use of "Right to Health Care" as a talking point. Everyone does have the right to health care if they can pay for it, just like the RKBA. So you already have a right to healthcare. What people don't have is a right to free health care, just like they don't have a right to exercise RKBA for free. In those ways they are similar.

I would like to see something happen to bitch slap the insurance companies, pharmaceutical industry and hospital corporations. They have made billions, if not trillions off of illness and suffering. They are way too expensive and greedy. I wish I knew the answer but I do know that there is no such thing as a free ride, we will have to pay for what we get in some way, shape or form.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Dec-07-08 12:15 PM
Response to Original message
60. UK’s NICE cost-benefit analysis to determine eligibility for health care, US may also.
British Balance Benefit vs. Cost of Latest Drugs
RUISLIP, England — When Bruce Hardy’s kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British, and the British health authorities refused to buy the medicine. His wife has been distraught.

* * * ** * * * * *

But at that price, Mr. Hardy’s life is not worth prolonging, according to a British government agency, the National Institute for Health and Clinical Excellence. The institute, known as NICE, has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen’s life.

* * * ** * * * * *

For years, Britain was almost alone in using evidence of cost-effectiveness to decide what to pay for. But skyrocketing prices for drugs and medical devices have led a growing number of countries to ask the hardest of questions: How much is life worth? For many, NICE has the answer.

* * * ** * * * * *

Even in the United States, rising costs have led some in Congress to propose an institute that would compare the effectiveness of new medical technologies, although the proposals so far would not allow for price considerations. At the present rate of growth, medical costs will increase to 25 percent of the nation’s gross domestic product in 2025 from 16 percent, with half of the increase coming from new drugs and devices, according to the Congressional Budget Office.
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iverglas Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-08-08 12:37 AM
Response to Reply #60
62. did someone prevent this gentleman from buying the drug himself?

Not so far as I can see. I don't think it's even preventing him from taking out private insurance to cover that expense. (In fact, I know it isn't, since the UK permits a private insurance tier alongside the public plan.)

It seems that jody is seriously suggesting that the fact that one national health insurance plan does not cover one particular extremely expensive treatment at public expense is some sort of argument against a national health insurance plan ...

Boggles the mind, don't it?

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