DU Favorite Bill Maher just said that people undergo too many medical procedures

And that doctors prescribe too many.

As evidence, he cited the relative profitability of The Insurance Industry versus the even more profitable Medical Facility Industry.


He also just crapped out another anti-vaccination screed.


AND he just went off on amalgam fillings, declaring that "you're not a nut for asking these things."

:eyes:

Peter Orszag and Atul Gawande have investigated it and found that there was a problem with doctor's prescribing treatments based on a lack of medical transparency or conflicts of interests.

According to Orszag, about $700 billion a year in medical spending goes to interventions that do nothing to make people healthier.

But Bill's using that small truth as a crowbar instead of scalpel.

His tone clearly implied that these extraneous procedures are deliberately and knowingly prescribed as part of a profit-generating scheme, rather than resulting from a lack of transparency or as a function of erring on the side of caution.

As usual, he was going for a soundbyte.

Naaaaaaaw! Couldn't be. Seems like such a benevolent industry.

Here's what I actually wrote:
My statement is very different from the excerpt that you cited simply to scoff at it.

Hey, I wasn't scoffing. But anyway, I'm pretty sure I got the gist of it pretty well. Remember, the titles have limited characters, so some cutting and pasting is always required. That concern superseded your soundbyte about me "trying for a soundbyte"

Upon rereading it, your "scoffing" seems more clearly directed at the industry than at me, so I'd like to withdraw my objection.

Last year I went to the doctor to get officially weighed and get blood sugar testing (because I was applying for permanent residence in New Zealand and if your BMI is over a certain point you need to document weight loss efforts and show you don't have diabetes).

Anyway, I told the doctor I only needed my weight recorded and the blood sugar test and he starts going on about another overweight patient who had sleep apnea. I told him I didn't have sleep problems... don't even snore but he kept pushing the overnight observation test (which is extremely expensive). When I refused that, he started trying to refer me to a nutritionist. I told him I'd been successfully dieting for years but he kept pushing and pushing until I agreed to go.

Biggest waste of time and money of my life! I spent and hour of my life and $1200 being lectured about the friggin' food pyramid. I didn't learn a single thing that isn't available for free online and I even showed the nutritionist a few websites she wasn't aware of.

I didn't have insurance at the time and paid for that bullshit out of pocket.

After that experience, I don't even think it's uncommon for doctors to pressure their patients into unnecessary procedures or consultations. I was gobsmacked that based on no evidence whatsoever (except being somewhat overweight) and totally out of the blue the doctor was trying to convince me I had sleep apnea.

and otherwise healthy and fit?

Because according to Maher and some on DU, fat people, people who drink, people who smoke, should be charged more for health care.

And, frankly, I think that it is this kind of talk that will kill any meaningful reform.

If it's over 35, you have to submit a lot of extra blood tests to prove you're not at risk of diabetes (and you have to submit proof that you've made a good faith effort to lose weight and are making progress). The extra evaluations cost hundreds of dollars and can delay the application for several months (and in the meantime you could lose the job offer that your application was based on).

So if you want to immigrate to a country with universal health care (like New Zealand), you want to get your BMI under 35 (or as close as possible and then provide proof that you've lost weight successfully). I'm sure I can get pretty close to 35 and hopefully a bit under because all the extra paperwork is a hassle.

As for charging people more for high risk behaviors... I don't see it working out. Everyone does something to fuck up their body somehow. Let's charge people more for health care for getting breast implants, eating tuna fish, bungee jumping or choosing to live in the desert and then getting skin cancer. Joggers fuck up their knees, weight-lifters fuck up their joints, bulemics fuck up their teeth. Should women who have babies after 35 pay extra to cover the risk of the child having birth defects? We'd spend a hell of a lot more itemizing everyone's risky behavior and constantly updating the rates with each new scientific study than we would just insuring everyone at a reasonable and affordable flat rate and assuming that it evens out.

it's based on the assumption that you are sedentary, and that the "excess" weight is adipose tissue (iow FAT).

i'm a competitive strength athlete. at my weight and height, i am obese according to BMI. otoh, my bodyfat is 11%.

BMI works ok on a sedentary population, but does not take into account mesomporphic physiques

According to the BMI, a whole lot of very healthy normal people are 'overweight' (as if weight itself is an indicator of overall health :eyes: )

It was invented between 1830 and 1850 by the Belgian polymath Adolphe Quetelet during the course of developing "social physics". I can't remember what he created the BMI for, but it wasn't this. I'll see if I can find it.

Anyway, real science has shown that people who are big can be healthier than people who are small. I'm not talking like, the really really far ends of obesity. But some people are just genetically big, they will never be small, and it isn't even healthy for them to try to be. Health and weight aren't always linked. I have an unfortunate condition that causes me to gain weight and not be able to lose it. Fortunately it's been under control for a while and my weight is going down, but I will never be less than 'overweight' (by BMI standards) yet I am 10x more healthy than at least 4 other people I can think of who have perfect BMIs, and they'll admit it too. They just won the genetic skinny lottery.

Sorry about that, BMI makes me crazy. So many people (not saying you, obviously) seem to think it's this perfect tool and if the BMI says you're overweight well by god you're unhealthy, go lose some weight!! Even DOCTORS think like this! When I switched clinics, I had a doctor start giving me diet advice based solely on my BMI reading. She knew nothing about my condition that causes weight, nothing about my treatments, nothing about my diet or levels of physical activity, the amount of muscle I have, she basically knew shit about me. And she started telling me how badly I needed to lose weight and how I need to work out and eat better!!!!!!!!! I was so pissed off. I eat very, very well. Before I became disabled, I got tons of activity. And at the point she was doing this, I had already lost a fair bit of weight from my condition, I wasn't off the charts fat by any stretch at all. I was so offended. It's total crap, and people are hurting themselves crash dieting and stuff when they're never going to have that perfect body and they should be focusing on HEALTH.

BMI doesn't distinguish between WEIGHT and FAT.

excess fat is bad.

excess WEIGHT is not. because it can be muscle or fat.

Plus, if fat people do not get health insurance they will end up... going to the emergency room which cost more and we are back where we start.

This is the fear and fear mongering of the ones against universal care: "the government will get control over my body."

We need to realize that we are human, and for many of us, indulging in some vice is the only way that we can get through the day.

There was a story about a four months old baby who was refused insurance because he was above the 95% fat. They finally changed their policy to exempt babies, especially one who is breast fed..

Still, what about adults? Again, if they are refused insurance, they will end up in the emergency rooms.

Hope you get to fulfill your dreams, whether in New Zealand or elsewhere.

and to give me sleeping meds...so I can sleep at night..

I have RARELY slept at night...EVER, and I do not work outside the home, so whose business is it if I do laundry, dishes, & grocery shop at 2 AM?

I know that my wacky sleep pattern may be a life-shortener, but hey.. almost everything is, these days. I'd rather catch cat-naps here and there, and occasionally crash for 14 hours than to take drugs that could hurt me more..

perhaps I am just in the wrong timezone & on the wrong continent:rofl:

That's absolutely true. First, they perform the "wallet biopsy" to determine what coverages are available, so they know what they can charge for and how much they can charge.

If you have good coverage, you'd better believe you'll get checked for things you'd never get checked for otherwise.

The profit factor in our medicine is the reason we pay 50% more than UK or Canada pay, and get poorer care.

Just curious.

Your comment has no relationship to the one I made.

Are you impaired?

:rofl: :rofl: :rofl: :rofl: :rofl:

Until then, I'll type slowly so that you can keep up:

You referred to a "wallet biopsy" as a first course of action, suggesting that a course of treatment is determined primarily by the ability to pay. That's a cynical, broad-brush misrepresentation of the process.

As I've stated repeatedly, I don't dispute that such for-profit procedures are indeed prescribed, but I dispute Maher's assertion that these represent the majority of procedures.

Sometimes procedures are not prescribed because, while they might be helpful, they are beyond the ability of the patient to pay. So when the doctor says "I'd like you to get an MRI, but can you come up with the $1800 on your own?" it means that the doctor would prefer to have access to a broader base of information, but the constraints of reality prevent this from happening.

If you have lived without insurance for any length of time, you would be aware of this fact.



Incidentally, it doesn't matter if masturbating thread-stalkers laugh at your faux-cleverness; your post was still idiotic.

I'm not a doctor, but I'll play one online, too.

Either get back on meds, or off the ones you're on.

MMMMkay?


And don't call me tomorrow.


Seriously, chill out. You're being annoying about nothing more than your personal sense of outrage that others don't agree with you.

Bill Moyers is irrelevant unless he agrees with Orrex's preconceived ideas.

Gee. You instructed me to watch Moyers' hour-long program and to listen to an hour's worth of This American Life. That's a lot of programming to absorb in 20 minutes. Sorry if I haven't gotten around to it just yet.


Also, I addressed the relevance of Moyer's program in at least two separate posts.

It is a measure of imbalance of the poster who starts a thread and then labels as a "stalker" one who engages such poster thereafter on the thread.

How can their post be conversation and yours stalking? Stalking implicitly requires that one NOT invite the comment from their stalker. If some clown follows you around from thread to thread, attacking you, that is stalking. But if one starts a thread and challenges others to disagree, they're a demonstrating their chronic victimhood when they argue that respondents are "stalking" them by arguing each time they respond to a post.

The stalking didn't occur in this thread; as you note, I started this thread and responded to replies.

The thread-stalking occurred when your compatriot quickly jumped on me in another thread, referencing this one in the process.


I'll work on some more line-drawings for you if you're still having a hard time absorbing it.

You can take turns laughing at what I can only infer are each other's abortive attempts at cleverness.

That ought to help everyone immediately.


And see a shrink about your compulsion to introduce "masturbating" and "stalking" into every day conversation.

Orrex. Just the name is making me laugh now.

:rofl: :rofl: :rofl: :rofl: :rofl:

This is yet another of your increasingly numerous failures to understand.

You seem to be re-using the same text strings now.

Are you actually just a sophisticated outrage simulation program?

Because I'd like to put you back on Ignore, but not before I've read your last bit of nonsense for the evening.

And, since you're apparently feeding off of each other's inanity, it seemed fitting to reference one in terms of the other.

Therefore it seemed fitting to describe your posts in terms of the pointless self-gratification that they are.


Go on with your bad self.

:freak:

Or is pedantry your native language?

Since you're posting for little reason other than your own self-gratification, it seems appropriate to refer again and again to the concept of masturbation--that you were so quick to volunteer--which is likewise is an act of self-gratification.

Got it?


Now go on with your bad self.
:freak:

You can't even BUY an unrec.

I can't tell you how I appreciate your efforts.


Are you done yet? I'm trying--unsuccessfully--to find the last post in this thread in which you made sense.

Bill Maher may have been PARTIALLY wrong in his statement. But he was partially right.

We agree on that.

If you would watch the Moyer special and then come back to this discussion, there would be a better framework for having a conversation than one based upon a COMEDIAN'S "10 syallable statement".

Agreed?

My first post in this thread was meaningful. That the MODEL of "doing procedures" is the only model we have for how to compensate doctors. This leads to problems of the kind I was suggesting.

When you glibly said "So if you break your leg, I guess you don't need it fixed since the body is designed to 'heal itself'", you made it clear to me that you were not interested in nuance.

You made the bed. Now either lie in it, or admit you were a jerk to me too.

You started a thread because you wanted to discuss, no? But then you jumped down my throat before the conversation hardly started.

Check yourself, Orrex, before you wreck yourself.

Twenty-eight, tops.

Okay, maybe thirty-two.


As far as I can tell, your first post in the thread was reply #12. And it came across with a smug snarkiness to which I responded in kind ("Spare me your exhortations.") I'm afraid that sort of set the tone for everything that came after.

Whether Maher was partially right or not isn't quite the point IMO; the point is that he gave a soundbyte summation of a hugely complex issue, and he did it with his characteristic "can you believe these knuckleheads" delivery that he uses to suggest that anyone who disagrees with him is likewise a knucklehead. In tonight's episode this was exacerbated by the fact that he used the exact same tone and delivery to tout his anti-vaccination campaign as well as his anti-amalgam stance, both of which are based in pure nonsense. His choice to link the three subjects (since they were consecutive elements of a single diatribe) makes them equally subject to contention.

My point is that he was irresponsible to scratch the surface of this complicated issue without giving it a more thorough airing. Yes, he's (nominally) a comedian, but his shtick is topical political comedy. I described him in the OP's subject line as a "DU favorite," by which I meant that a lot of what he says is repeated here verbatim, or he's simply cited for its brilliance ("Maher totally trashed so-and-so," for instance). In his chosen role as gadfly, Maher puts himself in the position of a news outlet, however dubious, and it's fitting to call him on it when he misrepresents the issues.

He could have avoided the whole problem if he'd clarified that some procedures are poorly justified, but instead his implication was that doctors across the nation are willy-nilly running tests simply for the sake of profiteering.

I don't watch the guy so I have nothing to add. I don't have HBO.

He is funny sometimes. I like the film he did poking fun at religion. I like that he speaks well of cannabis.

My good friend, HATES him because he thinks that people who talk about 9-11 as a coverup or whatever are loonies.

Lots of people hate him. It is his job to get a rise.

You and I entered the conversation from completely different places.

Today, I have been thinking about bigger issues, like the state of the economy and the massive wealth inequality in our country. And what will happen to us in the future if things don't change -so when I gave my opinion, I really was too tired to argue. I just wanted to offer up a quick opinion and get out without too much trouble. But I tend to rise to challenges, so...

I am sorry too. I am not a jerk, really. Please accept my handshake.

:evilgrin:


Gladly accepted! :pals:

But I gotta tell you, I am really starting to enjoy imagining your face all scrunched up in anger! All red and blotchy and twisted, trying desperately to think of something to say!

I am loving this! You are an unintentional comedian!


:rofl:

Accusations of anger are an indication of projection. What are you suppressing, I wonder?

Right before the tears.

I've seen it a million times. Bully thinks he's in control and then there's this moment when the lip starts quivering and then the whole face crumbles...

I've been fielding responses from half a dozen posters--and personal attacks from at least two--and I'm the bully.

I was uninsured last year and was having an issue, saw a specialist who treated me, found nothing, and he said that if I had insurance he'd send me to get a CAT scan upstairs just to be on the safe side, but it'd be $1,800. I asked if he thought it was necessary and said that it really wasn't, and that if the symptoms came back to come back in.

If you have insurance doctors are far more likely to toss in scans and tests both to cover their own ass, and to cover yours that are probably not even necessary.

Go Pens!

In Japan, the government buys the MRI machine for the hospital.
MRIs are, by law, priced at $98.

my dear FIL was a victim of an over zealous oncologist...my MIL will never get over her anger at how he was treated :-(

I'm glad that their respective oncologists demonstrated zeal in this regard.

so what.

Glad YOUR parents were saved.

Sheesh :eyes:

I've seen many dozens of posts to this effect in the Health forum and elsewhere on DU, supported only by anecdote.

My point is that chemo does a great deal of good, too.

but there *IS* the profit angle - and unfortunately some people, like my FIL, were/are victims.


"Cancer docs profit from chemotherapy drugs"

NEW YORK — It is a unique situation in medicine: Unlike other kinds of doctors, cancer doctors are allowed to profit from the sale of chemotherapy drugs.

"The significant amount of our revenue comes from the profit, if you will, that we make from selling the drugs," says Dr. Peter Eisenberg, a private physician who specializes in cancer treatment.

more:
http://www.msnbc.msn.com/id/14944098/

All hope of going into remission is damned when you beat down your immune system with this "treatment." I wouldn't inflict it on a pet either. I'm pro-choice and when it comes to cancer I choose *quality of life.*

I'm sorry about your father-in-law. :-(

and are grateful for it.

When the chemo that saved my MIL's life was being administered to her 8 years ago was being administered, she wept while she told me that she wished she could give up her treatment - not for herself, but to go back in time and take that possibility of life back to her first born daughter who died of cancer over 40 years ago at 8 years old.

came to the same conclusion. Insurance companies and some doctors do make lots of money off of ordering too many procedures that are
not needed.

http://www.thisamericanlife.org/Radio_Episode.aspx?episode=391

And it the issue simple enough to be summed up in Maher's ten-syllable soundbyte? I suspect that it's rather more complex than Maher would care to explore.

I don't for an instant doubt that dishonest practices are at work in some cases, but Maher implied that dishonesty and over-prescription is the norm, rather than an unfortunate facet of a necessary industry.

So you should pick up the ball from there.

You have a new idea to consider now.

Play with it. Think about it. Research it. Think some more.

Ideas are not harmful.

Spare me your exhortation to "do the research."

Before you run away, could you draft a quick list of things about which I'm allowed to be outraged? That'd be a big help.


Thanks!

I said what I wanted to say, but it isn't one thing or another.

It is many things. Complexity.

It is ironic that you villify Maher for a simple answer, but you seem to want to boil away all the complexities yourself.

Have fun.

Watch the Bill Moyer special on Money in Medicine. It is excellent.

And I've already devoted more time to the topic than Maher did, so I don't know what you're complaining about.

It will be better than mentally masturbating on this thread.

And unless Moyer's report asserts that a widespread pattern of deliberate over-prescription is going on, it will be irrelevant to Maher's claim.

Talking to you is a waste of time.

On the contrary, my opinion can readily be swayed by convincing evidence to the contrary. However, your assertions and Maher's soundbyte aren't up to the task.

And since you haven't actually responded to any point I've made, it's curious that you would accuse me of closed-mindedness.

Dr. not having "the time" to really get to the root of a medical problem ... chest pain? Order a Electrocardiogram first - spending time with the patient can sometimes eliminate certain tests.

In reality people often want tests and procedures (and drugs) they do not actually need and sometimes (maybe most of the time?) doctors will give in. That was the second segment I think. The first segment was about doctors performing too many procedures because of the fee for service payment system we have now. Sometimes doctors (or groups of doctors) own the testing facility (radiology, MRI centers, whatever) where they send patients, making another profit center for them. One solution I thought might help would be to reimburse by event rather than every single thing they do. I don't know.

And then there is the overtreatment of certain conditions.

But there is plenty of blame to go around and the patients do bear some of the blame for rising costs. But This American Life did not address the one place I put most of the blame: insurance company profit taking. They failed to take into consideration the bonuses and golden parachutes of insurance company executives. And the huge overhead costs when compared to Medicare for example.

I don't know either way.

Its possible that with half the population receiving inadequate insurance or none at all, that some doctors prey upon the other half to exploit their providers as a way to make a good living.

It is clear that some people definitely do not get the treatment they need. But, there could be another segment encouraged to get too much. Regardless, he is just an entertainer trying to get your panties in a wad.

Our whole model is based on DOING SOMETHING. Therefore, to earn money, doctors have to DO PROCEDURES.

Sometimes it is best to not do something. Procedures do not always lead to the best outcomes.

Currently there is too much of an incentive to intervene and no incentive to provide non-invasive, simple preventative solutions.

Our bodies are designed to heal themselves too.

Since, you know, your body is designed to heal itself.

I don't disagree that procedures are prescribed beyond what is--strictly speaking--required. This occurs for two primary reasons:

1. Protocol: If the standard and accepted practice is to prescribe a procedure, then often this will be done. Maher was suggesting that a conscious effort is made to bilk patients solely for purposes of profit, and he offered nothing--not a single word--in support of this assertion.

2. Liability: If someone dies and afterwards the question arises "why didn't the doctor do a blood test? That's the standard procedure, after all," you can bet that a huge lawsuit will follow.

"Profit" as an incentive comes in somewhere behind those two in the great majority of cases. You may dispute the correctness of protocol or the legitimacy of a liability claim, but that's a different issue.

You can take my statement and do what you want with it, including cherry picking quotes and stretching to the point of absurdity if you want.

The "cherry-picked" quote, if such it was, was only the subject line.

You fail to address the larger point upon which I expanded in the body of the post.

If you'd prefer not to support your statements, that's fine, but then I don't know why you bothered posting in the first place.

It would be a waste of time.

As arguments go, it's equivalent to "you're so closed-minded."

to ward off malpractice actions. You mean the fact that it adds to their incomes matters to them? :sarcasm:

And he plays it well.

Overall though he's right far more than he's wrong.

And people still cite him as a source even on those topics, alas.

of many articles discussing this:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

I'm no fan of managed care or insurance beancounters, but the point of them was to reduce this sort of waste. It just hasn't worked as well as anyone thought it would.


(He's probably wrong on the anti-vaccination screed, though)

Can't say I"m surprised.

like PETA, anti-vaccination, and a few others. On these subjects logic seems to escape him.

I recognize stoners when I see them, as I know my own kind.

The Japanese do more MRIs, but more cheaply, I understand.

The Europeans do less surgery, and do it more cheaply
(doctors make less there). But some of their
reduced surgery rate is because they just need less,
because they have less obesity, better lifestyles,
and therefore have less atherosclerosis and cancer.

So if we could bring down our obesity rate and our prices,
and if we didn't have an imaging center on every corner
of Doctors' Hill, total expenditures might be far lower.

I'm worried that instead we'll turn to the HMO model
(I don't think Gawande really knows his stuff there),
and thus deprive people of needed care,
instead of working on improving health and getting prices down

is preventative care. Even in places with "bad" lifestyles (eating habits, etc) the fact that citizens have access to care no matter who they are or what they earn (universal health care) means that many things are dealt with long before drastic action is needed.

Anti-vaccine. Eastern medicine. HIV/AIDS denialism.

The guy's a fucking nut.

LOL.

the biggest reason why so many people are sick is because of what they eat. He also said it's better to be molested by Michael Jackson than beaten up by a bully on the schoolyard.

He has the nerve to accuse most other people of stupidity.

Did not bother to watch him this evening.

He, and Huffington, and, I understand, Randi are desperately trying to be relevant these days and end up just... desperate.

Yes, he crapped anti vaccination shit last week and this was the last straw for me. Plus, he is not even funny anymore.

Was he talking about people too fat, implying that they should not have the same access to health care as the likes of him, with all the money in the world to be fit?

Read up on your science. Mercury is not stable and the EPA says it's the most toxic non-radioactive substance.

:popcorn:

I got all my fillings replaced with cerex. I got my two root canal teeth removed and got a bridge. I had anaerobic infections in the roots, and in the holes where my wisdom teeth were extracted in 1973, because they were not sterilized.

Read up on your science. Mercury isn't toxic, certain concentrations of mercury are toxic.

http://altmedangel.com/mercury.htm

Australasian Society of Oral Medicine and Toxicology


It is appropriate to end this summary with a statement from the National Research Council of the United States of America, which issued a report in 1978 entitled "An assessment of mercury in the Environment".

"Mercury compounds have no known normal metabolic function and their presence in the cells of living organisms, including human beings, represents contamination from natural and anthropogenic sources.

In view of the toxicity of mercury and the inability of researchers to specify the threshold levels of toxic effects on the basis of present knowledge, all such contamination must be regarded as undesirable and potentially hazardous."

No information has come to light since the publication of this statement in 1978 which alters this view.

Thank god we never have to deal with those two lethal substances in combination, because who knows how many lives would be lost?!?!?!?!?!?!?

Sodium combined with chlorine is stable.

Mercury is NEVER stable, either pure or when combined with other elements.

The EPA requires special hazardous material handling of Hg by dentists when they store it, and put it in your mouth, and when they take it out. However, the American Dental Association says that when it's in your mouth in a filling with other elements, it MAGICALLY is stable.

Bullshit. :wtf:

His opinion on things is his opinion on things. Do you seek medical advice from George Lopez or what?

And he only falls back on the "I'm a comic" excuse when he says something fucked up and has to wriggle out of it.

For that matter, there's not much evidence in support of the claim that he's a comic, either. He says lots of things, and he sometimes laughs at some of the things that he says. I suppose that counts for something.

There's nothing wrong with asking questions and wanting to know what, exactly, is in these vaccines before you roll up your sleeve. There's nothing wrong with fighting disease through good nutrition and hygiene practices, either. I'm not getting in line because a handful of government and public health "experts" tell me I have to. The H1N1 vaccine, especially, has been put on an extraordinary fast track from research, to production, to distribution. I think I'll take my chances, thank you very much.

All this claptrap reminds me of 1976.

ON EDIT: And he's right about medical procedures too, and I think a lot of the blame for that lies with both insurance and trial lawyers. I don't blame doctors one bit when they face ruination through malpractice suits.

As one dials down the class of the patients the procedures become rarer, and the circumstances under which the patients will receive or even seek procedures becomes more dire. Working class people view medical procedures as too expensive and often as a marker that one's health is on the wane, while upper class views are that they are worth the good health that they provide.

He even said: "don't take it from a talkshow host" and urged people to look up the numbers for themselves.

Good for Bill. People HAVE died from vaccines. And EVERYTHING should be questioned. I applaud him for going against the 'common knowledge' of the sheeple.

Countless millions of vaccines have been administered, and the incidence of serious complications is remarkably low. Astonishingly low, in fact.

That's what Bill would have said if he possessed a shred of intellectual honesty, but instead he hinted that there's a conspiracy of evil medicos injecting raw poison into the veins of our children for who knows what nefarious purpose?


Bill is a hack, playing to the lowest common denominator; in other words, his target audience is composed largely of uncritical sheeple.

If Bill would be playing to the lowest common denominator, he would be on CNN or Fox News, spewing the 'common knowledge' bullshit that the public is force-fed all day long.

If he would be playing to the lowest common denominator, he would never have raised topics like the American military empire overseas; or the damage that excessive greed has done to America; or the fact that the Democrats are the new Republicans (there's really only one party); or the deplorable state the US is in, compared to other Western countries...

Those are topics that are in urgent need to be discussed, yet it is up to a comedian to raise and debate them, because actual journalists won't do their job. So I am grateful that at least Bill is doing it.

You know, I've come across a lot of flaccid subject lines in my time @ DU, but yours is about the limpest I've seen so far.

Bravo!


And the body of the post wasn't much better. He's a contrarian, so it's only to be expected that he's going to adopt a stance contrary to that of the mainstream. If that means arguing against the Iraq war when all of the media was in favor of it, then that's what Maher will do. If it means claiming that dental amalgam causes neurological damage, even though no credible study supports that claim, then you can be sure Maher will back the junk science.

Whether he's smarter than I am is far from certain, and it's irrelevant in any case. He's spectacularly wrong on a great many issues no matter how smart he might be.

This isn't ideological purity any more than demanding evolution be taught in our schools is ideological purity.

As a stoner, uh, medical MJ user, myself, I recognized the pregnant pauses, the search for words, the things THEY thought were funny but werent, etc. Not that I care, but all three of them seemed loopy.

Example - years ago I was having gastrointestinal issues and the doctor ordered a sigmoidoscopy. It was negative, so he ordered a colonoscopy. Putting aside the nightmarish prep for both tests, I could have avoided the first one and just had a colonoscopy. Of course, the doctor would have been out a fee.

Do you believe that the doctor was wrong to prescribe it? Or do you call it unnecessary in hindsight because it happened to come up negative? What did the colonoscopy reveal?

What if the sigmoidoscopy had been positive? Would you still call it unnecessary?


If the doctor was erring on the side of caution, then that's very different from deliberately prescribing an unnecessary procedure, even if he happens to collect a fee in both cases.

I still trusted doctors were promoting drugs and tests in the interest of my health and not their bank accounts. I forgot to mention my extensive family history of colon cancer. He should have ordered a colonoscopy first. Editing to add the results of the colonoscopy: several benign polyps removed. That, of course, is a medical gold mine since I'm forever on the colonoscopy list.

Maher is just one good example. He's on our side 99% of the time, but he goes off the chain on two or three issues and he instantly becomes persona non grata with cooties.

I've always found him smarmy, insincere, and opportunistic, and I flatly disagree with your suggestion that "he's on our side 99% of the time."

In every monologue and bit I've ever heard him do, there's a none too subtle undercurrent of the exact pseudoscientific, conspiratorial nonsense-thinking that I'm attacking in the OP. Maher is 100% full of shit on quite a few subjects, but he gets a free pass from too many here because he knows which bandwagon to jump on.

Note he never spearheads any movements in this regard; he's often quick enough to say "yeah, me too!" but he never leads the way. Instead, he waits until he's read the zeitgeist, and then he hops on board and acts as though he's been fighting the good fight since the first round.


Sorry if you mistake my dislike of the man for a demand for ideological purity; in fact I'm asking for nothing of the kind.

His brand of humor and persona is not everyone's cup of tea. But not only do you still watch his show, what he says is important enough to you that you come here to complain about it. Why do you increase the ratings of someone whom you clearly hold in contempt?

I watched this episode because Grayson was on. I've seen a lot of Maher's shtick online and in other venues; I am not a fan of his show, nor do I watch it with any frequency.

What he says is of no importance to me personally, but it's quite important on the national level, because people take his bullshit to heart, including a distressing number of DUers eager to salivate over any one of Maher's diatribes that happens to mesh with the Left's current sensibilities.

Rush Limbaugh's ramblings are likewise of little direct importance to me, but the consequences of his ramblings can be quite significant indeed. The same is true of Maher, even if his rhetoric leans to the Left more often than not.

For Christ's sake, this thread is proof to the contrary.

The "unnecessary procedures, prescribed for profit" mantra has been going around for quite some time, and in fact it meshes quite neatly with Maher's anti-vaccination platform, too.

By repeating the chant on last night's show, Maher was stepping in line with an ongoing trend, however dubious.

His view is no where close to mainstream or even "not fringe".

And there's a huge, media-driven contingent that believes in the profit-driven evil of both vaccinations in particular and medical procedures in general.

Forgive me for being insufficiently literal for your satisfaction.

The zeitgeist of whom? If you use the word without qualification, most people will quite reasonably assume you mean the general public.

And even if he waits until his peer group has accepted a movement before he jumps on board, that doesn't change the fact that he jumped on board before the rest of the country.

Being the latest lunatic to enter the asylum doesn't mean that you're sane, even if you enter it voluntarily because you like what the other lunatics have to say. So even if Maher "jumped on board before the rest of the country," he's still a trend-follower, and he's still full of shit.

So, regardless of the value of a cause, if I don't think of it first, I'm just a trend-follower for supporting it?

And do those soundbytes offer little in the way new and insightful commentary? If so, then you have no business posturing yourself as a commentator ahead of the curve, as Maher does.

It can be objected that Maher doesn't portray himself in this fashion, but of course he does. He doesn't state it explicitly, because he's not an idiot, but it's unmistakable in his delivery.

There's nothing wrong with being a follower of a noble cause, as long as you're not hypocritically claiming to be doing more than that. Maher's cause isn't noble, his execution is dishonest, and he certainly likes to pretend that he "gets it" long before "it" becomes conventional wisdom--even if it (rightly) never does.


Out of curiosity, are you actively defending Maher, or are you just picking at my rhetoric?

And that is part of what makes him valuable to me.

As most people do. Hell, Taco Bell tacos were valuable to me tonight...yum.

We opted for pizza instead.

And we got duped into thinking we could get 69 cent tacos...but were told that is a Sunday-only thing.

They did get the order right though, which seems to be a very rare thing for me.

:grr:

...for next to nothing!

:toast:

:toast:

I think I'll turn in on this high note. Have a good evening/morning depending upon your spot on the rock.

Through arm twisting HMO's, insurance companies have slashed the amount of money that a doctor can make from a patient to the bone. A $500 procedure may only yield $10 to $20 for the doctor. When those doctors have offices to pay for, nurses to support, med student loans to payoff, and their own liability insurance to cover, that $10-$20 just isn't enough. So what can they do? Increase the number of procedures being performed to increase the amount of money they make. If you're just in the office for a 30 minute checkup, that doctor will probably only make about $20 off your visit. If, during that visit, he can convince you to submit for a full panel of bloodwork, two mole removals, and an MRI because you've been complaining about headaches, he can substantially increase the amount of money he makes. He might profit a few hundred dollars from you that day. That may sound like a lot, but it's not once you realize how many employees he has to pay for out of that money.

The big problem here is for the insurance companies. The payout for the doctor may be a few hundred bucks, but the actual costs of those procedures can easily run into the thousands.

If the HMO's paid the doctor enough money in the first place, he wouldn't need to prescribe so many extraneous procedures.

every problem needs a test and or a drug to solve. Unnecessary surgeries are popular too.

that there is an active conspiracy of doctors deliberately and knowingly prescribing procedures specifically for the purpose of profit?

If that's not your assertion, then your post has nothing to do with what Maher was saying.

have great monetary incentive to do so in some cases. They also know what the guidelines are and how to bend the rules if need be.

my mother has been on a statin for years. When she started it, her cholesterol was only moderately high, but her doctor never suggested she change her diet. Ridiculous.

but here in steerage lots of people have no coverage at all and most others aren't taking off from work to play at a medical center.

and he just as apparently, doesn't read all that much.

:eyes:

GO BILL!!!! :yourock:

Thanks for padding my paycheck!

to be fair, i haven't seen him oppose all vaccinations, but the way in which he casts doubt some is unscientific.

I'm surprised the OP chose to highlight this aspect of the show as he said things that were much worse.

Here's what he said Friday:

"...I do understand the theory of inoculation. Yes, you give someone a little bit of the disease and it fools your body into providing antibodies which fight it. Brilliant! Bravo! Maybe there is some occasions where inoculation is a wise thing to do. I hope not. I hope I would never have to have one because, you know, to present it just as this genius medical advancement, no, it's actually a risky medical procedure that begs long term cost-benefit analysis."

And this is not a new stance for him. He actually said THIS a couple of years ago. This is just flatly untrue:
"I don't believe in vaccination either. That's a... well, that's a... what? That's another theory that I think is flawed, that we go by the Louis Pasteur theory, even though Louis Pasteur renounced it on his own deathbed and said that Beauchamp(s) was right: it's not the invading germs, it's the terrain. It's not the mosquitoes, it's the swamp that they are breeding in."

And it always ends up with me being attacked as a shill for Big Pharma and a science dogmatist.


Maher should keep his trap shut regarding matters about which he has little or no understanding.

Is it a good thing for 70% of women over 40 to get mammograms
every year or so? We're at almost that rate now.
But the science is not quite compelling.
There's the study out of Norway finding 22% higher
rate of cancer in the mammogram-every-2-years group, vs
the ones who only had a mammogram after age 55.

This is not medical advice, of course. But at this point
neither the average patient nor the average doctor
knows that much about the science.

So we could be seriously overdoing it. It's not clear.
It's quite possible, in ambiguous cases
(especially in cases of cancer and heart disease),
for doctors to err on the side that makes them money,
just as patients might err on the side that saves money,
if they had that option.

(Oh, I just checked. Internists taking home $176,000 in 2007.
http://www.bls.gov/oes/current/oes_nat.htm)

He could help move the discussion in the right direction, as we very may have too many procedures, and we may just to prescription remedies too fast. But then he goes into parody territory, with the conspiracy stuff.

Ugh.

It is statements like these and Obama's imfamous tonsillectomy statement harm the public option more then help it. No one wants the government to get between them and their doctor, at least most don't. I believe doctors are good people with a desire to help others, and when I find one who doesn't seem that way I get out of their office as soon as possible. I want to get whatever the doctor desires to give me, be it medicine, procedures, or God forbid operations. When people involved in politics (especcially the President) start speaking of doctors as villians it scares me, and probably many others.

to discuss these things openly and honestly. I've had experience with this personally--when switching doctors or looking for the right specialist, the first thing the doc does is re-order the same test/x-ray/scan that the last doctor already did. In a way this is good (in case the situation has mysteriously changed for the better or worse), in a way it's wasteful.