I'm Grandfathered in, for now.

[josephkk]

Only if limited to the kind of very minor patches that could get passed
without problem.

Complete nonsense. Sorry, but that's what it is.

Real tort reform would save over 15 percent easily, but Trial Lawyers
Association and other dedicated interests will assuredly prevent it.

?-/

 

[Joerg]

[...]

You don't believe me and call it "unsubstantiated".
I don't disbelieve you either, but there are other
explanations. You certainly haven't substantiated your
polyp-snipping explanation - which would require evidence
that enough polyps had been removed to explain the
difference, and even that wouldn't demonstrate that there
were other factors in play.
Which is flat wrong. You tend to make up this stuff, stuff
that clearly contradicts clinical evidence.
Nothing I've said contradicts clinical evidence. ...
Sure it does. You said "unsubstantiated" and that is simply
wrong.

It isn't. You are over-interpreting the clinical evidence.

No. Talk to a cancer specialist about it. I have.

Your claim is in two parts - first that enough polyps are clipped in
the US to explain the lower rate of colon cancer there than in
Germany and Canada, adn - second - that this is the only explanation
of the difference in rate.

Since you can't tell me what proportion of the US population has
their polyps snipped, you haven't got to first base on substantiating
the first claim.

I'm happy to believe that polyp-snipping works - I've always believed
this since I first heard the story. I'm a lot less confident about
your claim that there's enough of it done in the US to explain the
difference in the rate of colon cancer. As you say, it's not a
popular procedure.

Here are the (large) percentages of people screened by state:

http://www.cdc.gov/cancer/colorectal/statistics/screening_rates.htm

As for polyp detection and removal:

http://www.nyc.gov/html/hhc/html/pressroom/press-release-20100304.shtml

Quote "The New York City Health and Hospitals Corporation (HHC) today
announced that HHC doctors performed more than 21,000 colonoscopies and
removed pre-cancerous polyps in about 20 percent of the cases at the
city public hospitals last year". They even found 338 hardcore dangerous
ones during those.

20% is a lot. I believe one can safely assume that the remainder of the
US population and also that in Canada isn't all that much different from
New Yorkers. We eat too much bacon, they eat too much poutine, both
pretty bad for the health.

Fact is, if you don't get screening these polyps cannot be detected in a
timely manner because they are nearly all asymptomatic. Once symptoms
set in it is usually too late.

 

[[email protected]]

"In reality tort law is a tiny part of the problem despite the efforts of
the right-wing tea-partiers to portray it as a big problem. "

In essence you are corrrect, however the costs to INSURE against this tort law cost alot more. Malpractice insurance is not cheap. Note though, that the insurance companies ARE indeed making money on malpractice insurance, just like everything else they insure.

I still find it funny how people bitch about the oil companies' profits which run someting like 7 % and think a 20 % cap for the insurance companies is great. They would suck a mile of dick to make that much. The key to thesemassive profits is volume. I want $313 million dollars. I have alot betterchance of getting a buck apiece form everyone than to find someone who will just give it all to me in one lump sum. Actually today it might be easierto get ten bucks apiece from 3 million people.

The problem here is that such industries in a free country should be tightly regulated by the government and treated like public utilities. Now the government regulates the People and industry regulates the government.

Let me tell you all a secret. Every regulation, I mean EVERY regulation thegovernment makes on business in this country is approved by business in this country.

Let's take an example, ridiculous safety and pollution standards on automobiles. Think that was bad for the automakers ? Nope, it protects them from the likes of Tucker. It prevents the import of certain vehicles. When it comes to pharmaceuticals, it justifies higher prices.

If you look hard enough, in (almost) every case, industry has no problem with most regulations. The only exceptions are ones that would blatantly violate public trust and that only applies if the public knows about it.

In Pennsylvania Dr. Alfonso Rodriguez filed a suit on court for clarificatio, interpretation or limitation of a rulke on disclosure. Docrtors are given information on the poisonous liquids used for fracking. Under the ruiles they are not allowed to tell their patients what these chemicals are and therefor are impeded from having intelligent discussions about their conditions, which are a DIRECT result of exposure to fracking liquids.

the case was thrown out of court summarily. Tis tells you soemthing doesn'tit ? this stuff is causing people to go into renal failure. This is not fucking joke anymore and sooner or later there will probably be a huge lawsuit. Again, using the defensive tactic of a class action lawsuit the companies will not pay the full costs for which they are responsible.

In fact they won't pay anything. ALL costs in ANY business are paid either by the customer, or indirectly by the employees or stockholders.

 

[rickman]

I checked on healthcare insurance near equivalent to what I have now.
Family of four, no poor health conditions.

(Bronze Plan)
A BlueOption Essential HSA 1419
$6250 Deductible Individual/$12,500 Family
Annual Maximum Out-of Pocket $12,500
Price $1358 per month
Gov subsidy $47
My Cost $1,311

(Silver Plan)
Plan # 1409P
$3,600 Deductible Individual/$7,200 Family
Annual Maximum Out-of Pocket $7,200

Price $1617 per month
Gov subsidy $47
My Cost $1,570

My Grandfathered Plan
$10,000 Deductible Individual/$10,000 Family
Annual Out-of-Pocket $10,000
Price $633
Gov Subsidy $000
My Cost $633

With all these plans once you hit your deductible
all costs are paid by the insurance company.

A year ago May 2012 I was paying $438, been complaining
loudly since it increased to $633. Obama has made me feel
good about what I pay, compared to all the others having
to buy Obamacare.

Ya, I don't have any pregnancy benefits, but at 54, I don't expect
my wife to have anymore kids. Especially with me, snip/snip.
I also have a $5,000,000 lifetime cap, not an unlimited burden on society.

Mikek

I thought the lifetime cap was one of the features that had to change
even with the grandfathered plans?

I'm not sure what the "burden on society" comment means. But the
elimination of lifetime caps is for your benefit. In some cases the
care required for an illness can exceed that cap at which point the
insurance changes from paying 100% to paying 0%. Not a happy
circumstance.

You don't say what time period the costs cover. Certainly it is not per
year and it sounds too high for per month as well. What state are you
in? Each state regulates their own insurance and the costs are
different, no?

 

[rickman]

Are you assured that you are grandfathered-in?

The rumor mill says

Why are you spreading rumors? That is so BS.

you lose if your grandfathered plane doesn't meet
all of Obama's requirements... i.e. you have to pay for pregnancy
benefits whether you want them or not.

No, you don't "lose" the grandfathered plans. You plan is not
grandfathered if it changes significantly since the ACA was passed in
2010. Many insurance companies have significantly changed their plans
in the intervening time and so some plans will *not* be grandfathered.
It has nothing to do with the ACA requirements.

I got the "sports conversion" 40 years ago, and my wife is past
menopause, yet I won't be surprised if Obama doesn't force my Medicare
supplemental plan to cover birth control and maternity benefits.

The only good that will come of this is that so many Democrat
politicians will lose their ass in the 2014 mid-terms.

Do you understand how insurance works? You sign up for coverage and
everyone pays for all of the costs. That spreads the risk and costs
across *all members* of a plan. If you want to belong to a plan that
only has members who can't get pregnant, I expect your rates will be
even higher because it will have a lot of *older* people which, as we
all know, is the single biggest risk factor in health insurance... not
the ability to conceive.

 

[Joerg]

Only if limited to the kind of very minor patches that could get passed
without problem.

Real tort reform would save over 15 percent easily, but Trial Lawyers
Association and other dedicated interests will assuredly prevent it.

Yup, that's about the correct range, and 15% is major. But we all know
whose campaigns get financed by these guys, ergo ...

 

[Joerg]

Why are you spreading rumors? That is so BS.



No, you don't "lose" the grandfathered plans. You plan is not
grandfathered if it changes significantly since the ACA was passed in
2010. Many insurance companies have significantly changed their plans
in the intervening time and so some plans will *not* be grandfathered.
It has nothing to do with the ACA requirements.

It does:

http://www.kaiserhealthnews.org/Stories/2012/December/17/grandfathered-plans-faq.aspx

Quote "A grandfathered plan has to follow some of the same rules other
plans do under the ACA. For example, the plans cannot impose lifetime
limits on how much health care coverage people may receive, and they
must offer dependent coverage for young adults until age 26 (although
until 2014, a grandfathered group plan does not have to offer such
coverage if a young adult is eligible for coverage elsewhere)".

They don't have to comply with all rules but they the do have to with
many of them. We got that in writing for our plan. For example, that it
now covers strange elective stuff such as sex change operations and this
was after 2010. With the consequential cost increase, of course.

A lot of catastrophic plans were also banned by Obamacare. They were a
perfect fit for people with financial discipline, who have saved enough
to pay for setting broken bones and stuff out of pocket. So now they
must buy a much more expensive Obamacare plan they don't need. Because
Obamacare has built-in age discrimination and only lets young people buy
catastrophic-only coverage. The government essentially assumed people
are incompetent. Which is despicable.

[...[

 

[Bill Sloman]

Bill Sloman wrote:
[...]

You don't believe me and call it "unsubstantiated".

I don't disbelieve you either, but there are other explanations. You certainly haven't substantiated your polyp-snipping explanation - whichwould require evidence that enough polyps had been removed to explain thedifference, and even that wouldn't demonstrate that there weren't other factors in play.

Which is flat wrong. You tend to make up this stuff, stuff that clearly contradicts clinical evidence.

Nothing I've said contradicts clinical evidence. ...

Sure it does. You said "unsubstantiated" and that is simply
wrong.

It isn't. You are over-interpreting the clinical evidence.

No. Talk to a cancer specialist about it. I have.

I'll talk to my cancer specialist acquaintance next time I see him. He's out of town a lot regulating breast cancer trials, but we do seem to catch upwith him and his wife (who is a retired expert on cancer statistics) from time to time.

Here are the (large) percentages of people screened by state:

http://www.cdc.gov/cancer/colorectal/statistics/screening_rates.htm

That's between 50% and 60% of the affected population screened - which is to say that they have all had fecal occult blood tests (FOCT). In fact that's the percentage of the people sampled who responded, but the New York datadoes suggests that the respondents aren't wildly different from the non-respondents.

The same URL also demonstrates that there's appreciable difference in the rates of colorectal cancer from state to state - more than between the US average and the German and Canadian average, and that this doesn't correlate with the percentage of the affected population screened.

http://www.cdc.gov/cancer/colorectal/statistics/state.htm

As for polyp detection and removal:

http://www.nyc.gov/html/hhc/html/pressroom/press-release-20100304.shtml

Quote "The New York City Health and Hospitals Corporation (HHC) today announced that HHC doctors performed more than 21,000 colonoscopies and removed pre-cancerous polyps in about 20 percent of the cases at the city public hospitals last year". They even found 338 hardcore dangerous ones during those.

20% is a lot. I believe one can safely assume that the remainder of the US population and also that in Canada isn't all that much different from NewYorkers. We eat too much bacon, they eat too much poutine, both pretty badfor the health.

New York is a 40.9 to 43.6 per 100,000 - appreciably higher than Canada as a whole.

21,000 colonoscopies isn't a lot for a state with a population of 19.5 million people. 20% of that is 4,000 sets of polyps snipped, about 40 per 100,000 (since only about half the population is FOCT screened) which is about the same as the colorectal cancer rate. Only about 10% of these patients (338) had polyps that were actively cancerous, so the rest wouldn't have gotten into the cancer statistics.

The underlying colorectal cancer rate for New York has to be even higher than the 40.9 to 43.6 per 100,000 shown on the map, outstripping Canada and Germany even further, and again suggesting that US colorectal cancer is different breed of cat to the US/Canadian one - or rather a different range anddistribution of of cancers to the range and distribution that the the Canadians and Germans have to cope with.

Fact is, if you don't get screening these polyps cannot be detected in a timely manner because they are nearly all asymptomatic. Once symptoms set in it is usually too late.

On this point you are preaching to the converted. Not converted enough to go out and buy a FOCT test kit from my local chemist, but probably convertedenough to talk to my GP about it next Monday during my regular every-six-months appointment.

And thanks very much for digging out the statistical information I was after. I've now got a much clearer picture of what the US does in this area, and it's good. Your health system is still grossly over-priced for what it does, and only does it for the fully insured 70%, but at least it seems to get colorectal cancer screening as close to right as is humanly practical.

 

[Lasse Langwadt Christensen]

Den onsdag den 6. november 2013 17.00.32 UTC+1 skrev Joerg:

Yup, that's about the correct range, and 15% is major. But we all know

whose campaigns get financed by these guys, ergo ...

politicians?

from what I can find about half of them are lawyers and pretty much even spread on both sides of the mud slinging fence

-Lasse

 

[amdx]

Bill Sloman wrote:
[...]

You don't believe me and call it "unsubstantiated".
I don't disbelieve you either, but there are other
explanations. You certainly haven't substantiated your
polyp-snipping explanation - which would require evidence
that enough polyps had been removed to explain the
difference, and even that wouldn't demonstrate that there
were other factors in play.

Which is flat wrong. You tend to make up this stuff, stuff
that clearly contradicts clinical evidence.
Nothing I've said contradicts clinical evidence. ...
Sure it does. You said "unsubstantiated" and that is simply
wrong.

It isn't. You are over-interpreting the clinical evidence.

No. Talk to a cancer specialist about it. I have.

Your claim is in two parts - first that enough polyps are clipped in
the US to explain the lower rate of colon cancer there than in
Germany and Canada, adn - second - that this is the only explanation
of the difference in rate.

Since you can't tell me what proportion of the US population has
their polyps snipped, you haven't got to first base on substantiating
the first claim.

I'm happy to believe that polyp-snipping works - I've always believed
this since I first heard the story. I'm a lot less confident about
your claim that there's enough of it done in the US to explain the
difference in the rate of colon cancer. As you say, it's not a
popular procedure.

I was looking for info like The incidence of colon cancer is 1,000
per 100,000 for unscreened people and 500 per 100,000 for those getting
colonoscopy with polyp removal. But I didn't find it.
I have seen stats where this screen will reduce your chance of getting
X by 50%, That sounds good, but then find that reduces your incidence
from 1 per 100,000 to 1/2 per 100,000. 50% but not a great risk to begin
with.
Got a letter from my insurance company urging me to get a colon cancer
screening. The only test mentioned is FIT, Fecal Immunochemical Test.
I'm 58yrs old, so a colonoscopy is in my near future, I'm sure many
have had one by my age. Others never get one.
Mikek

 

[amdx]

I thought the lifetime cap was one of the features that had to change
even with the grandfathered plans?

Yes, I have seen the cap is eliminated.

I'm not sure what the "burden on society" comment means.

It means that once the insurance company coffers are emptied of
$5,000,000, (paid for by society) Which is the "burden on society"

But the

elimination of lifetime caps is for your benefit. In some cases the
care required for an illness can exceed that cap at which point the
insurance changes from paying 100% to paying 0%. Not a happy
circumstance.

Yep, but is it really worth it to spend $5,000,000 on one life.
If you say yes, ponder this.
Lets just take 200 lives that spent $5,000,000 in healthcare.
Save that $1,000,000,000 and spend it wisely in Africa to supply
proper nutrition.
I bet 500,000 lives could be saved vs a measly 200 here.
So, what is a life worth?

You don't say what time period the costs cover. Certainly it is not per
year and it sounds too high for per month as well. What state are you
in? Each state regulates their own insurance and the costs are
different, no?

I'm not sure what you are referencing with your question. If you mean
the insurance plans under Obamacare those are Monthly premiums for a
family of four. Bronze $1,358 and Silver $1,617 Bay county, Florida.
Yes different costs for counties and states. I went through F.O.A.D.s
Maryland Healthcare website and found very similar prices.
That's the RATE SHOCK that people are talking about.

 

[Joerg]

Bill Sloman wrote:
[...]

You don't believe me and call it "unsubstantiated".
I don't disbelieve you either, but there are other
explanations. You certainly haven't substantiated your
polyp-snipping explanation - which would require
evidence that enough polyps had been removed to
explain the difference, and even that wouldn't
demonstrate that there weren't other factors in play.

Which is flat wrong. You tend to make up this stuff,
stuff that clearly contradicts clinical evidence.
Nothing I've said contradicts clinical evidence. ...
Sure it does. You said "unsubstantiated" and that is simply
wrong.

It isn't. You are over-interpreting the clinical evidence.

No. Talk to a cancer specialist about it. I have.

I'll talk to my cancer specialist acquaintance next time I see him.
He's out of town a lot regulating breast cancer trials, but we do
seem to catch up with him and his wife (who is a retired expert on
cancer statistics) from time to time.

In breast cancer the situation is similar, the mortality rate there is
also lower in the US than countries with socialized medicine such as
Canada or the UK.

That's between 50% and 60% of the affected population screened -
which is to say that they have all had fecal occult blood tests
(FOCT). ...

In the US they also do colon scans in addition past a certain age. It's
efficient, works almost like a conveyor belt. Pretty modern technology
and they let me witness my own scan via a patient-side monitor. I was
surprised how fast the technician was speeding the probe through the
intestine. But a doctor looks at that later and can slow down or zoom in
when he/she suspects something.

... In fact that's the percentage of the people sampled who
responded, but the New York data does suggests that the respondents
aren't wildly different from the non-respondents.

The same URL also demonstrates that there's appreciable difference in
the rates of colorectal cancer from state to state - more than
between the US average and the German and Canadian average, and that
this doesn't correlate with the percentage of the affected population
screened.

http://www.cdc.gov/cancer/colorectal/statistics/state.htm

In some states there are more people who refuse scanning or treatment.
Beats me why. It's sad, I know a person whose cancer spread because of
that and it does not look good right now.

Also, they can't force you to do a colonoscopy. But they are pushy, for
good reasons.

New York is a 40.9 to 43.6 per 100,000 - appreciably higher than
Canada as a whole.

Nope, the incidence rate is much higher in Canada:

http://www.cancer.ca/en/cancer-information/cancer-type/colorectal/statistics/?region=on

21,000 colonoscopies isn't a lot for a state with a population of
19.5 million people. 20% of that is 4,000 sets of polyps snipped,
about 40 per 100,000 (since only about half the population is FOCT
screened) which is about the same as the colorectal cancer rate. Only
about 10% of these patients (338) had polyps that were actively
cancerous, so the rest wouldn't have gotten into the cancer
statistics.

You misunderstand that. The 20% who had polyps snipped now have a
greatly reduced chance of ever developing colon cancer. Because it was
caught at a very early stage where you don't even know whether they
would become malignant. But as the saying goes, an ounce of prevention ...

The 338 cases are those who literally came in five minutes to twelve.
Had they not been screened those people would most likely have died soon.

Polyp-snipping has a substantial longterm benefit. It can save you 20 or
30 years from now. Ask the wife of your breats cancer specialist friend,
she should know.

The underlying colorectal cancer rate for New York has to be even
higher than the 40.9 to 43.6 per 100,000 shown on the map,
outstripping Canada and Germany even further, and again suggesting
that US colorectal cancer is different breed of cat to the
US/Canadian one - or rather a different range and distribution of of
cancers to the range and distribution that the the Canadians and
Germans have to cope with.

Check the link above.

On this point you are preaching to the converted. Not converted
enough to go out and buy a FOCT test kit from my local chemist, but
probably converted enough to talk to my GP about it next Monday
during my regular every-six-months appointment.

Well, ours comes in the mail for free and when not back within 14 days
there will be a phone call. And another, and another ...

And thanks very much for digging out the statistical information I
was after. I've now got a much clearer picture of what the US does in
this area, and it's good. Your health system is still grossly
over-priced for what it does, and only does it for the fully insured
70%, but at least it seems to get colorectal cancer screening as
close to right as is humanly practical.

Same for numerous other cancers. If a woman doesn't show up for the
Ob/Gyn tests or the mammogram it's the same, they keep calling. Then
there are regular blood sample tests for males and females. It's like at
an airport. You sign in, pick a number, a monitor shows when it's your
turn and to which stall to go, you stretch out your arm, and it'll be
done. At home you can go online and see the results trickle in as they
come back from the various labs. At the end you receive a letter with
all details summarized (but you can opt out and go paperless).

This will also tell you other valuable things, like what your
cholesterol levels are, liver values, and so on. Kind of important to
know, yet most people in countries with socialized medicine don't get
that screened. They are tested for this only after an event. Which is
sometimes too late.

Overpriced, yes, absolutely. But that requires tackling tort law. What
is being done in Obamacare will not make anything less expensive, on the
contrary. Since it adds a layer of bureaucracy it will make everything
go up in cost.

You are also right about the 70%. But that is not going to change much,
despite all the hype about it. Because the penalties are ridiculously
low and youngsters rather plunk down their money towards a new Dodge
Challenger with mag wheels rather than seeing it being slurped up by
health premiums. The vast majority of people without health care that I
know have no health care because they chose to spend all their money on
fun stuff. Boats, trailers, electronics, sports gear, cars, you name it.

There are also regular commercial mass screening events where you get
the whole enchilada done in one visit for a fixed price of $199 or
something like that. We also have that for cardiac screening. A huge
tractor-trailer pulls up, after some whirring this that and the other
things slide out and, whoopdidou, you have a doctor's office right in
the parking lot of a church, supermarket or big company. Then they start
piping people through there. Therefore, sorry to say, it is not an
excuse if you don't have insurance. Those people should spend the $199
on themselves rather than a big-screen TV. And you do not need a $100/mo
gym membership, I just got a full workout in the Pine Hill Preserve
right here on my cheap mountain bike. Took it and myself to the limits.
It's simply a matter of priorities.

 

[Joerg]

Den onsdag den 6. november 2013 17.00.32 UTC+1 skrev Joerg:

politicians?

from what I can find about half of them are lawyers and pretty much
even spread on both sides of the mud slinging fence

Mostly on one side. Republicans have spearheaded many efforts towards
tort reform but it was always shot down:

http://thehill.com/blogs/healthwatc...makers-blast-medical-malpractice-reform-bill-

Time for more poltical change, I'd say. With some luck we'll get that in
the next election, when people are really miffed about Obamacare.

 

[Joerg]

[...]

You don't believe me and call it "unsubstantiated".
I don't disbelieve you either, but there are other
explanations. You certainly haven't substantiated your
polyp-snipping explanation - which would require evidence
that enough polyps had been removed to explain the
difference, and even that wouldn't demonstrate that there
were other factors in play.

Which is flat wrong. You tend to make up this stuff, stuff
that clearly contradicts clinical evidence.
Nothing I've said contradicts clinical evidence. ...
Sure it does. You said "unsubstantiated" and that is simply
wrong.

It isn't. You are over-interpreting the clinical evidence.

No. Talk to a cancer specialist about it. I have.

You haven't provided all the evidence necessary to make your
explanation convincing. It is merely plausible, and there are
other plausible explanations available for the difference in the
colon cancer incidences in the US Canadian and German
populations.

Frankly, I don't care whether you believe it or not. Medical
doctors know better, even European ones.

https://www.lef.org/news/LefDailyNews.htm?NewsID=14112&Section=Disease


Fact is, polyps are routinely snipped over here because we perform
preventative colon cancer screening. In countries that don't screen
via colonoscopy it is, obviously, impossible to even detect which
people have intestinal polyps and how many. Therefore, obviously,
there cannot be large scale statistics about it in those countries.


Your claim is in two parts - first that enough polyps are clipped in
the US to explain the lower rate of colon cancer there than in
Germany and Canada, adn - second - that this is the only explanation
of the difference in rate.

Since you can't tell me what proportion of the US population has
their polyps snipped, you haven't got to first base on substantiating
the first claim.

I'm happy to believe that polyp-snipping works - I've always believed
this since I first heard the story. I'm a lot less confident about
your claim that there's enough of it done in the US to explain the
difference in the rate of colon cancer. As you say, it's not a
popular procedure.

I was looking for info like The incidence of colon cancer is 1,000
per 100,000 for unscreened people and 500 per 100,000 for those getting
colonoscopy with polyp removal. But I didn't find it.

Some of the studies I mentioned or linked bear that out but they are
much smaller groups. It is nearly impossible to do this for larger
groups because polyp removal has benefits on a time scale if decades.
Until very recently we did not have any meaningful central databases,
people change jobs and locations on average every 7 years. You can't
really follow them. Here is a link to one of the studies:

http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22356322/

I have seen stats where this screen will reduce your chance of getting
X by 50%, That sounds good, but then find that reduces your incidence
from 1 per 100,000 to 1/2 per 100,000. 50% but not a great risk to begin
with.

Mortality from colon cancer is much higher, 30-40 per 100k. More in
other countries. That's pretty serious. I have seen first hand what that
kind of cancer did to people very dear to me. So has Jim Thompson. All
those people are now dead.

I prefer not to be among the 30-40 per 100k. And this is only the
mortality. In addition, there are all those who had small or large parts
of their intestines removed and often must wear port and bag for the
rest of their lives. That puts a serious crimp in someone's lifestyle.

Got a letter from my insurance company urging me to get a colon cancer
screening. The only test mentioned is FIT, Fecal Immunochemical Test.
I'm 58yrs old, so a colonoscopy is in my near future, I'm sure many
have had one by my age. Others never get one.

At 58 you should at least get a sigmoidoscopy. That in conjunction with
regular fecal tests is supposedly about as good. If your insurance won't
cover it you could obtain a quote from a hospital, it isn't super
expensive. It's perfectly ok to haggle about the price. But get that
quote in writing, else they might try to pull a fast one.

 

[Bill Sloman]

Yep, but is it really worth it to spend $5,000,000 on one life.
If you say yes, ponder this.
Lets just take 200 lives that spent $5,000,000 in healthcare.
Save that $1,000,000,000 and spend it wisely in Africa to supply proper nutrition. I bet 500,000 lives could be saved vs a measly 200 here. So, what is a life worth?

http://en.wikipedia.org/wiki/Quality-adjusted_life_year

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC317370/

http://mdm.sagepub.com/content/20/3/332.abstract

The rule of thumb seems to be that QALY is worth about $50,000, which values a full 80-year life at $4,000,000.

<snip>

 

[Bill Sloman]

Bill Sloman wrote:
On Wednesday, 6 November 2013 02:35:15 UTC+11, Joerg wrote:
Bill Sloman wrote
Bill Sloman wrote:

[...]

You don't believe me and call it "unsubstantiated".
I don't disbelieve you either, but there are other
explanations. You certainly haven't substantiated your
polyp-snipping explanation - which would require
evidence that enough polyps had been removed to
explain the difference, and even that wouldn't
demonstrate that there weren't other factors in play.

Which is flat wrong. You tend to make up this stuff,
stuff that clearly contradicts clinical evidence.

Nothing I've said contradicts clinical evidence. ...
Sure it does. You said "unsubstantiated" and that is simply wrong..

It isn't. You are over-interpreting the clinical evidence.
No. Talk to a cancer specialist about it. I have.

I'll talk to my cancer specialist acquaintance next time I see him.

He's out of town a lot regulating breast cancer trials, but we do
seem to catch up with him and his wife (who is a retired expert on
cancer statistics) from time to time.

In breast cancer the situation is similar, the mortality rate there is
also lower in the US than countries with socialized medicine such as
Canada or the UK.

The U.K.s National Health Service is cheaper than Canada's or Germany's andit's probably not sensible to lump those three together as "socialised medicine". Keep in mind that "national insurance" approach which underlies allthree was invented by Bismark to under-cut the appeal of his socialist political rivals.

http://mdm.sagepub.com/content/20/3/332.abstract

suggests that ten years ago breast cancer survival rates were better in Canada than the US.

http://scienceblog.cancerresearchuk...careful-when-comparing-us-and-uk-cancer-care/

suggests that some of the statistics used by the anti-Obamacare campaignerswere wrong.

In the US they also do colon scans in addition past a certain age. It's efficient, works almost like a conveyor belt. Pretty modern technology and they let me witness my own scan via a patient-side monitor. I was surprisedhow fast the technician was speeding the probe through the intestine. But a doctor looks at that later and can slow down or zoom in when he/she suspects something.

In some states there are more people who refuse scanning or treatment. Beats me why. It's sad, I know a person whose cancer spread because of that and it does not look good right now.
Also, they can't force you to do a colonoscopy. But they are pushy, for good reasons.

Nope, the incidence rate is much higher in Canada:

http://www.cancer.ca/en/cancer-information/cancer-type/colorectal/statistics/?region=on

It may be now, but this web-site presents estimated rates for 2013 of 60/40for males and females. Your earlier data for 2008

http://appliedresearch.cancer.gov/icsn/colorectal/mortality.html

gave 45.4/31.8 which is - average over the sexes - 38.6 and lower than the New York State figure (which is after polyp-snipping on half the population).

You misunderstand that.

I don't see how. Perhaps you are misunderstanding what I'm saying.

The 20% who had polyps snipped now have a greatly reduced chance of ever developing colon cancer. Because it was caught at a very early stage where you don't even know whether they would become malignant. But as the saying goes, an ounce of prevention ...

The 338 cases are those who literally came in five minutes to twelve. Hadthey not been screened those people would most likely have died soon.

Polyp-snipping has a substantial long-term benefit. It can save you 20 or

30 years from now. Ask the wife of your breast cancer specialist friend,
she should know.

She ran the NSW cancer register for some years, before polyp-snipping became widely popular, so she may not know. I'm already perfectly convinced thatpolyp-snipping has a substantial long-term benefit, but if you had polyps now, there's every reason to suppose that you might develop new ones in a few years.

Check the link above.

Which presents "estimated rates" estimated by cancer specialists with a vested interest in scaring patients into their consulting rooms.

Well, ours comes in the mail for free and when not back within 14 days there will be a phone call. And another, and another ...

As there should be.

Same for numerous other cancers. If a woman doesn't show up for the Ob/Gyn tests or the mammogram it's the same, they keep calling. Then there are regular blood sample tests for males and females. It's like at an airport. You sign in, pick a number, a monitor shows when it's your turn and to which stall to go, you stretch out your arm, and it'll be done. At home you cango online and see the results trickle in as they come back from the various labs. At the end you receive a letter with all details summarized (but you can opt out and go paperless).

This will also tell you other valuable things, like what your cholesterol levels are, liver values, and so on. Kind of important to know, yet mostpeople in countries with socialized medicine don't get that screened. They are tested for this only after an event. Which is sometimes too late.

My cholesterol level was first screened by my GP in the UK around 1990 - I can remember the date fairly exactly, because it immediately preceded a herniated intervertebral disk.

My wife got routine mammograms and Pap tests there as well. UK's socialisedmedicine was getting that right more than twenty years ago. They are more picky about less cost-effective mass screenings.

Overpriced, yes, absolutely. But that requires tackling tort law. What isbeing done in Obamacare will not make anything less expensive, on the contrary. Since it adds a layer of bureaucracy it will make everything go up incost.

Obamacare isn't going to impose any bureaucracy that you haven't got in Germany, where health care costs per head are about two-thirds of the US level.. That and the Dutch system run via a number of private health insurance firms which operate under close government supervision, which is presumably where Obamacare would eventually end up, if the Tea Party doesn't end up in power.

You are also right about the 70%. But that is not going to change much, despite all the hype about it. Because the penalties are ridiculously low and youngsters rather plunk down their money towards a new Dodge Challenger with mag wheels rather than seeing it being slurped up by health premiums. The vast majority of people without health care that I know have no health care because they chose to spend all their money on fun stuff. Boats, trailers, electronics, sports gear, cars, you name it.

They'd opt out of paying for defense and law and order if they could. A bigpart of health care is preventing communicable diseases turning into epidemics, and there's strong argument for making health insurance compulsory (as it is everywhere else).

There are also regular commercial mass screening events where you get thewhole enchilada done in one visit for a fixed price of $199 or something like that. We also have that for cardiac screening. A huge tractor-trailer pulls up, after some whirring this that and the other things slide out and, whoopdidou, you have a doctor's office right in the parking lot of a church, supermarket or big company. Then they start piping people through there. Therefore, sorry to say, it is not an excuse if you don't have insurance. Those people should spend the $199 on themselves rather than a big-screen TV.. And you do not need a $100/mo gym membership, I just got a full workout in the Pine Hill Preserve right here on my cheap mountain bike. Took it and myself to the limits. It's simply a matter of priorities.

When I was a kid, the mass X-ray vans used to come around and check everybody out for TB - which was epidemic back then. If you had it you got shuntedinto the sanatorium where you wouldn't infect anybody else. Back then streptomycin cured it in about a year or so, if it didn't kill you first.

Betty MacDonald's once-famous book "The Plague and I" is about her time in a US sanatorium in 1937-38.

Commercial health testing services are available here and in the Netherlands. The advertising is built on making you unreasonably nervous, and the tests offered aren't exactly cost-effective.

 

[Joerg]

Bill Sloman wrote
Bill Sloman wrote:
[...]

You don't believe me and call it
"unsubstantiated".
I don't disbelieve you either, but there are other
explanations. You certainly haven't substantiated
your polyp-snipping explanation - which would
require evidence that enough polyps had been
removed to explain the difference, and even that
wouldn't demonstrate that there weren't other
factors in play.

Which is flat wrong. You tend to make up this
stuff, stuff that clearly contradicts clinical
evidence.
Nothing I've said contradicts clinical evidence. ...
Sure it does. You said "unsubstantiated" and that is
simply wrong.
It isn't. You are over-interpreting the clinical evidence.
No. Talk to a cancer specialist about it. I have.
I'll talk to my cancer specialist acquaintance next time I see
him. He's out of town a lot regulating breast cancer trials, but
we do seem to catch up with him and his wife (who is a retired
expert on cancer statistics) from time to time.

In breast cancer the situation is similar, the mortality rate there
is also lower in the US than countries with socialized medicine
such as Canada or the UK.

The U.K.s National Health Service is cheaper than Canada's or
Germany's and it's probably not sensible to lump those three together
as "socialised medicine". Keep in mind that "national insurance"
approach which underlies all three was invented by Bismark to
under-cut the appeal of his socialist political rivals.

The UK and Canada clearly have socialized health systems. Germany does
only in part, there are two tiers. You get better treatment and wider
options in the private one. I've lived there long enough to personally
know the difference.

http://mdm.sagepub.com/content/20/3/332.abstract

suggests that ten years ago breast cancer survival rates were better
in Canada than the US.

http://scienceblog.cancerresearchuk...careful-when-comparing-us-and-uk-cancer-care/


suggests that some of the statistics used by the anti-Obamacare
campaigners were wrong.

Quote from your link above "the age-standardised figures are 24 deaths
per 100,000 Britons, and 19 per 100,000 Americans".

That is a rather substantial difference, isn't it?

[...]

the rates of colorectal cancer from state to state - more than
between the US average and the German and Canadian average, and that
this doesn't correlate with the percentage of the affected population
screened.

As I said before, there is a difference in behavior between people and
much of this depends on heritage and profession. For example, where I
grew up, it was mostly farmers. Tough guys who would never go to a
doctor unless they were unconscious and somebody called an ambulance. No
ten horses would get them into a CT machine for screening, regardless of
whether it's free or not. What counts are the country-wide averages and
that's where there is a stark difference between the (former) US system
and socialized medicine.

It may be now, but this web-site presents estimated rates for 2013 of
60/40 for males and females. Your earlier data for 2008

http://appliedresearch.cancer.gov/icsn/colorectal/mortality.html

gave 45.4/31.8 which is - average over the sexes - 38.6 and lower
than the New York State figure (which is after polyp-snipping on half
the population).

You need to look at the whole country.

about 40 per 100,000 (since only about half the population is FOCT
screened) which is about the same as the colorectal cancer rate. Only
about 10% of these patients (338) had polyps that were actively
cancerous, so the rest wouldn't have gotten into the cancer
statistics.

No. The 338 were hardcore "Oh s..t!" events, where they found cancers
that were just about ready to go off. That's not what I meant with polyp
removal, although these patients will sure be glad that in the US we
have such intense screening. Because otherwise they'd likely have died
within a year.

I don't see how. Perhaps you are misunderstanding what I'm saying.

Polyps are very early stages. They may never go off. But around 50% of
them do, years or decades down the road. This is why early detection and
removal are important, yet it is not done in many countries with
socialized health care. Again, talk to a cancer specialist that knows
about intestinal cancer.

30 years from now. Ask the wife of your breast cancer specialist
friend, she should know.

She ran the NSW cancer register for some years, before polyp-snipping
became widely popular, so she may not know. I'm already perfectly
convinced that polyp-snipping has a substantial long-term benefit,
but if you had polyps now, there's every reason to suppose that you
might develop new ones in a few years.

Not necessarily. But even in people where that is true, not screening
them would mean they and their doctors would never know about polyps.

Normally, people that had an "eventful" screeing will be monitored more
closely and may be called in for more colon tests down the road than
people with an uneventful screening. And that's the key: Prevention at
an early stage. It simply does not happen in many countries with
socialized health systems.

Which presents "estimated rates" estimated by cancer specialists with
a vested interest in scaring patients into their consulting rooms.

No, you are making an accusation without any proof whatsoever. This
stuff is thoroughly reviewed. Because of my job I had to follow many
such studies in the cardiac field. They are very meticulous and honest.
There is no reason to believe that this is different in cancer research.

As there should be.

So why is it not done in Australia or other countries?

was after. I've now got a much clearer picture of what the US does in
this area, and it's good. Your health system is still grossly
over-priced for what it does, and only does it for the fully insured
70%, but at least it seems to get colorectal cancer screening as
close to right as is humanly practical.

My cholesterol level was first screened by my GP in the UK around
1990 - I can remember the date fairly exactly, because it immediately
preceded a herniated intervertebral disk.

My wife got routine mammograms and Pap tests there as well. UK's
socialised medicine was getting that right more than twenty years
ago. They are more picky about less cost-effective mass screenings.

http://www.cancerresearchuk.org/can...stions/what-the-breast-screening-review-means

Quote "The UK breast screening programme uses mammograms to screen for
breast cancer in women every 3 years between the ages of 50 and 70".

Sorry, in the US this would be called seriously sub-par.

Obamacare isn't going to impose any bureaucracy that you haven't got
in Germany, ...

It already has. For example, in Germany the employer reports the income
directly to the HMO and that sets your payment. Their tax authorities
are never involved in this while here in the US they have hired scores
of people for that. As a self-employed (which I was most of the time in
Germany) you self-declare. Obamacare insists on formal agency
verifications and AFAIK that's one of the bureauuratic procedures that
got their web site unglued.

... where health care costs per head are about two-thirds of
the US level. That and the Dutch system run via a number of private
health insurance firms which operate under close government
supervision, which is presumably where Obamacare would eventually end
up, if the Tea Party doesn't end up in power.

Here's hoping that the latter happens, else we'll go over the financial
cliff ;-)

They'd opt out of paying for defense and law and order if they could.
A big part of health care is preventing communicable diseases turning
into epidemics, and there's strong argument for making health
insurance compulsory (as it is everywhere else).

Well yeah, and Obamacare mandates free contraceptives. Ever thought what
that will do to the morale of school kids? Now they can do it without
fear of getting into a pregnancy "situation". It'll also increase the
spread of communicable diseases.

When I was a kid, the mass X-ray vans used to come around and check
everybody out for TB - which was epidemic back then. If you had it
you got shunted into the sanatorium where you wouldn't infect anybody
else. Back then streptomycin cured it in about a year or so, if it
didn't kill you first.

Betty MacDonald's once-famous book "The Plague and I" is about her
time in a US sanatorium in 1937-38.

Commercial health testing services are available here and in the
Netherlands. The advertising is built on making you unreasonably
nervous, and the tests offered aren't exactly cost-effective.

Here they are very cost-effective because such commercial operations are
streamlined for maximum patient through-put and optimized machine usage
rates. No scare tactics. IMHO it is important to know about your risks
of getting a particular disease, be it coronary issues or potential
cancer. If it is caught early on, which it often is in those mass
screenings, it can make all the difference for a family. They may avoid
losing mom or dad.

 

[sms]

the right-wing tea-partiers to portray it as a big problem. "

In essence you are corrrect, however the costs to INSURE against this tort law cost alot more. Malpractice insurance is not cheap.

What's happened is that medical specialties that have taken malpractice
seriously and made changes to their practices and procedures have
greatly reduced the cost of malpractice insurance.

It's too bad that it took malpractice suits and the resultant increase
in premiums to cause them to take the issue seriously, but probably
there was no other way.

Even the New England Journal of Medicine debunked the whole myth of
excessive malpractice costs and the myth of meritless lawsuits resulting
huge damage awards. The only real issue that they found was that the
overhead costs caused the victims to receive only 54% of the awards with
overhead and lawyers taking the rest.

The bottom line is that the whole myth of tort reform having an effect
on medical costs has been fabricated by right wing Republicans whose
real issue is that lawyers are more likely to give money to Democratic
candidates than Republican candidates.

There is absolutely nothing to back up the claim that tort reform would
reduce medical costs by 15%. That figure was created out of thin air by
those whose handlers have told them to make up these stories.

"Do you keep hearing crazy voices in your head? Turn off Fox News."

 

[Bill Sloman]

Bill Sloman wrote:
Bill Sloman wrote
Bill Sloman wrote:

[...]

You don't believe me and call it "unsubstantiated".

I don't disbelieve you either, but there are other explanations. You certainly haven't substantiated your polyp-snipping explanation - which would require evidence that enough polyps had been removed to explain the difference, and even that wouldn't demonstrate that there weren't otherfactors in play.

Which is flat wrong. You tend to make up this stuff, stuff that clearly contradicts clinical evidence.

Nothing I've said contradicts clinical evidence. ...

Sure it does. You said "unsubstantiated" and that is simply wrong.

It isn't. You are over-interpreting the clinical evidence.

No. Talk to a cancer specialist about it. I have.

I'll talk to my cancer specialist acquaintance next time I see him. He's out of town a lot regulating breast cancer trials, but we do seem to catch up with him and his wife (who is a retired expert on cancer statistics)from time to time.

In breast cancer the situation is similar, the mortality rate there is also lower in the US than countries with socialized medicine such as Canada or the UK.

The U.K.s National Health Service is cheaper than Canada's or
Germany's and it's probably not sensible to lump those three together as "socialised medicine". Keep in mind that "national insurance" approach which underlies all three was invented by Bismark to under-cut the appeal of his socialist political rivals.

The UK and Canada clearly have socialized health systems. Germany does only in part, there are two tiers. You get better treatment and wider optionsin the private one. I've lived there long enough to personally know the difference.

http://mdm.sagepub.com/content/20/3/332.abstract

suggests that ten years ago breast cancer survival rates were better
in Canada than the US.

http://scienceblog.cancerresearchuk...careful-when-comparing-us-and-uk-cancer-care/

suggests that some of the statistics used by the anti-Obamacare campaigners were wrong.

Quote from your link above "the age-standardised figures are 24 deaths
per 100,000 Britons, and 19 per 100,000 Americans".

That is a rather substantial difference, isn't it?

It might be. The point of the quote was that the American propaganda was selective and incomplete. You need much more complete picture of the incidence of breast cancer in the US and the UK before you cam safely attribute thedifference to a difference in the quality of health care. For a start, youneed to known the difference in the rate of breast cancer, at what stage abreast cancer gets into the cancer statistics and so forth.

Remember that the US has a much lower proportion of deaths from prostate cancer than the UK because the US detects "prostate cancer" with the PSA testwhich picks up a lot of prostate cancers which are otherwise asymptomatic and never kill the patient.

[...]

As I said before, there is a difference in behavior between people and much of this depends on heritage and profession. For example, where I grew up, it was mostly farmers. Tough guys who would never go to a doctor unless they were unconscious and somebody called an ambulance. No ten horses would get them into a CT machine for screening, regardless of whether it's free or not. What counts are the country-wide averages and that's where there is a stark difference between the (former) US system and socialized medicine.

Blaming all the differences on the health care system leads to a lot of wrong conclusions.

You need to look at the whole country.

No. That clearly lumps together different populations with different problems, and different reactions to health advice. One of the tricky things about cancer is that every cancer is different - cancer cells only get to be cancerous after their genotype has been extensively screwed up. The "six" crucial changes required to make them malignant happen in different ways in different cells, and are only a small part of a much larger collection of mutations.

Generalising over "breat cancer" or "colorectal cancer" can be misleading simply because the individual cancers can be very different, as can the individula cancer cells within a cancer (which is why chemotherapy eventually stops working in a lot of cases.

No. The 338 were hardcore "Oh s..t!" events, where they found cancers

that were just about ready to go off. That's not what I meant with polyp removal, although these patients will sure be glad that in the US we have such intense screening. Because otherwise they'd likely have died within a year.

Polyps are very early stages. They may never go off. But around 50% of them do, years or decades down the road. This is why early detection and removal are important, yet it is not done in many countries with socialized health care. Again, talk to a cancer specialist that knows about intestinal cancer.

I certainly know that, and knew it quite a while ago. There's nothing aboutsocialised medicine that stops it doing FOCT tests or colon-snipping. As the wikipedia article makes clear, it's a relatively new technique, and there is still some discussion about exactly how cost-effective it is, but I'm fairly confident it will be widely adopted - probably even in the UK where they are already good on mammograms and Paps smears.

Not necessarily. But even in people where that is true, not screening them would mean they and their doctors would never know about polyps.

Absolutely. But polyps are a fairly late stage precancerous state, and if you've got them you probably got a lot more cells that aren't quite so far down the road. My guess is that polyps now are pretty reliable indicator or more polyps later.

Normally, people that had an "eventful" screeing will be monitored more closely and may be called in for more colon tests down the road than people with an uneventful screening. And that's the key: Prevention at an early stage. It simply does not happen in many countries with socialized health systems.

The UK is particularly cautious about spending money on mass screening, butif it looks cost effective, it does it - it certainly does mammograms and Pap smears and has for many years. And I got my cholestrol level checked there by my GP in 1990.

No, you are making an accusation without any proof whatsoever.

You've presented two different sets of numbers for the Canadian male and female colorectal cancer rate. The 2013 "estimates" were 30% higher than the 2008 figures. Which would you believe?

This stuff is thoroughly reviewed.

2013 "estimates" are thoroughly reviewed? 2013 still has seven weeks to go!

Because of my job I had to follow manysuch studies in the cardiac field. They are very meticulous and honest. There is no reason to believe that this is different in cancer research.

Be your age. "Estimates" for 2013?

So why is it not done in Australia or other countries?

The testing is certainly available in Australia, and the sigmoidoscopy. Oneof my remoter cousins got colon cancer and both my brothers promptly took themselves in to get checked. My younger brother was not enthusiastic aboutthe procedure. By the time I got to hear about it, none of the relaitves scanned had come up positive, so I figured that it wasn't worth the trouble.

The wikipedia article suggests that it's a relatively new technique and that there's still discussion about it's cost effectiveness. US medicine is more influenced by malpractice suit phobia, which is one of the reasons it's half again more expensive per head than anybody else's even through it isn't universal.

http://www.cancerresearchuk.org/can...stions/what-the-breast-screening-review-means

Quote "The UK breast screening programme uses mammograms to screen for breast cancer in women every 3 years between the ages of 50 and 70".

Sorry, in the US this would be called seriously sub-par.

The UK is a lot pickier about "cost-effective" than the US. In the UK younger women were advised to self-examine (which doesn't involve a cancer-encouraging dose of X-rays). Breast cancer is a lot less frequent in younger women, so there aren't that many cancers available to be detected, which does make early mammograms less cost-effective.

It already has. For example, in Germany the employer reports the income directly to the HMO and that sets your payment. Their tax authorities are never involved in this while here in the US they have hired scores

of people for that. As a self-employed (which I was most of the time in Germany) you self-declare. Obamacare insists on formal agency verifications and AFAIK that's one of the bureauuratic procedures that got their web site unglued.

Teething troubles.

Here's hoping that the latter happens, else we'll go over the financial cliff.

Since the Tea Party has already tried to drive the US economy over the financial cliff, you do seem to be backing quite the wrong horse.

The Tea Party's financial ideas - as championed around here by James Arthur- are the financial equivalent of the flat earthism.

Well yeah, and Obamacare mandates free contraceptives. Ever thought what that will do to the morale of school kids?

It will probably cheer them up no end. It won't help their morals, but someschool age kids have been having sex since schools were invented, and if they are going to have sex, it's better that they use contraceptives - the girls won't get pregnant, and there's less chance that the kids will share sexually transmitted diseases (STDs).

"Just say no" is a good slogan, but an ineffective policy.

Now they can do it without fear of getting into a pregnancy "situation". It'll also increase the spread of communicable diseases.

Condoms would slow the spread of STDs. School girls have been getting pregnant for a long time now. Making it happen less often would be a good thing.

Here they are very cost-effective because such commercial operations are streamlined for maximum patient through-put and optimized machine usage rates. No scare tactics. IMHO it is important to know about your risks of getting a particular disease, be it coronary issues or potential cancer. If it is caught early on, which it often is in those mass screenings, it can makeall the difference for a family. They may avoid losing mom or dad.

The commercial operations are optimised to suck in the maximum number of customers. The local news services exploit them from time to time in new health technology stories, and their reports suggest definite - if subtle - scare tactics, and a serious shortfall on cost-effectiveness.

 

[Bill Bowden]

amdx wrote:






Some of the studies I mentioned or linked bear that out but they are

much smaller groups. It is nearly impossible to do this for larger

groups because polyp removal has benefits on a time scale if decades.

Until very recently we did not have any meaningful central databases,

people change jobs and locations on average every 7 years. You can't

really follow them. Here is a link to one of the studies:



http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22356322/













Mortality from colon cancer is much higher, 30-40 per 100k. More in

other countries. That's pretty serious. I have seen first hand what that

kind of cancer did to people very dear to me. So has Jim Thompson. All

those people are now dead.



I prefer not to be among the 30-40 per 100k. And this is only the

mortality. In addition, there are all those who had small or large parts

of their intestines removed and often must wear port and bag for the

rest of their lives. That puts a serious crimp in someone's lifestyle.

Wearing a port and bag isn't that bad. I save money on toilet paper and don't waste much time in a restroom, but showers take a little longer. But nowthat I'm on the high risk list, I get a colonoscopy every 3 years, and recently they found 3 polyps which were benign. But the whole thing was my fault since I ignored symptoms of blood streaks in the stools and waited too long to see the doctor.

-Bill