ikol

I think we should institute Ikol's brilliant idea of tracking everyone's intake throughout hteir life and then decide when they get something whether or not they deserve care based on said intake. Shouldnt be too hard to manage.

If they did smoke then they shouldn’t be treated for lung cancer and should suffer and die in the street like the dreg they are. Jeff Tweedy for instance.

I think you have a problem detecting sarcasm. I can treat this condition by bombarding you with sarcastic comments, but it's gonna cost you.

Assuming we do away with Medicare/Medicaid, what would lead one to logically conclude that health care for the poor and aging would be assumed by charitable organizations? Is it because charities already cover anyone who is not covered by another health plan? Is it because charities have eradicated homelessness in this country?

No, it's because the government has eradicated homelessness. How about taking a significant portion of the upper income earners' tax burden and allowing them the option of either donating that money to a healthcare charity of their choice or it goes to the government? Sure, there are deductions on charitable donations, but there are limits on those and eventually the alternative minimum tax kicks in.

The government is not some giant breasted alien that just sort of dropped out of the sky from whose teat we suckle, it’s made up of folks like us. The government would administer the plan, WE, the taxpayers, would fund it through the collection of taxes.

But like half the nation pays no federal income taxes other than payroll taxes.

I’m increasingly sick of this idea that services provided by the government amount to little more than handouts. That would be true if there were no such thing as taxes, and our earnings did not pay into and perpetuate the system, but that’s not the case. I don’t see that big a difference between my employer taking $400 out of my check for health insurance, vs. that money being taken by the federal government. And, I suspect a government administered plan would save most of us money by slashing individual contributions.

The difference is that there's no healthcare reform bill that mandates a certain amount be taken out of people's paychecks to pay for the plan. Not everyone will be paying premiums.

Would the current plan require that I dole out $400 every month, to the tune of (roughly) $5000 dollars a year, or would it decrease that amount substantially?

It depends on what tax bracket you're in. And if it does decrease that amount, it's doing so through cuts in Medicare reimbursements to your doctor.

In October, I came down with bacterial pneumonia and spent a week in the hospital, four of which were spent in the ICU, the total bill came to $20,000 – with a remaining balance of over two grand to be paid by yours truly. So, on top of the $5,000 in premiums, I’m now responsible for an additional $2000 (not counting other fees associated with unrelated visits to the doctor) – for a total of seven grand for the year (though, if we were to add the other aforementioned fees for visits and medication, the total would be closer to nine or ten) – and I HAVE insurance.

Well I guess my question is who should be responsible for that bill? The hospital? The government? Your insurance? Chinese lenders? That $20,000 has to come from somewhere.

15,000 posts and you're finally starting to get a clue. If GON had just contacted a charity, he wouldn't have had to worry about the $4,000 in costs that weren't covered in his health plan. He just lacks the willpower to do so.

No, he lacks education because of the socio-cultural impact of Doritos commercials.

Willpower? Education is also a word that comes to mind. You can't make good decisions if you don't know how to. I read an article recently that stated that a gross, obscene number of people in poverty had limited kitchens - no more than a hot plate or microwave, and few pots and pans. Few know how to cook healthy foods, and relied on processed foods and microwavable dinners out of necessity. Some without kitchens altogether, rely on fast food. Some work long hours, do not have access to vehicles or lack the ability to carry fresh groceries home, so they eat out or eat processed meals.

 

The government has failed the poor. Charity, too, has failed the poor.

 

Did you really just say millions of poverty-stricken Americans are unhealthy because they lack the willpower to make healthy decisions?

You could just read my post, but yes that's exactly what I said. Are some just plain ignorant? Probably. When high school health classes are taught by football coaches, there will inevitably be people out there that think Doritos are healthy. But are you suggesting that the majority of people that eat unhealthily do so because they aren't aware of what is healthy or are unable to afford healthy food? That is ridiculous. Even if you can only afford fast food and pre-packaged, processed food, you can still limit the quantity that you eat, which is 90% of the problem. You can't turn on a TV without hearing about the "obesity epidemic" yet you expect me to believe that education is the problem. And once again, smoking is left out of the equation. There is no way that anyone out there who smokes doesn't realize it's unhealthy, not to mention expensive. Someone who smokes is spending at least one healthy meal's worth of money everyday.

My effort is to merely neither pompous or condescending. I am grateful to live in a country built on both the values of limited government and the free market. But when it comes to healthcare issues of fairness and efficiency trump my concerns about Government involvement in healthcare and overcome any doubts I have that this should all be left to the free-market.

Just because I arrive at different conclusions from you doesn't mean I'm anymore blinded by ideology than you are. If you don't think your posts are pompous or condescending, you should read them again.

Oddly enough, none of my posts have advocated any of these scenarios, have they? All I've said is that the government should assume the costs of health care, and that it is in the interest of health and public safety to do so. Plenty of countries have instituted successful government-run health care, several of which I have mentioned in this thread, and none of these doomsday scenarios have played out. Eerily, quality of life surveys show that people are actually quite happy in these societies.

My post didn't suggest that you advocated any of those scenarios. My point was that you could do all kinds of things to promote a healthy society, but there is a point where the ends don't justify the means. Obviously, that point is different for us.

2009 -

 

OKLAHOMA CITY — A woman has been fined $1,142 after pleading no contest to prostitution charges after she was accused of accepting a box of chips for sex.

 

Police say they arrested 36-year-old Lahoma Sue Smith in southeast Oklahoma City after finding her in her car with a man who told officers he knew he could find a prostitute in the area.

I guess she's all that and a box of chips.

Wow. You, like, pay no regard to socio-cultural impact on health, do you? Like, at all.

OK, I guess since a healthy society is a burden worth carrying, we should also outlaw Doritos commercials. I don't really understand the point you're trying to make. Of course, I'm aware that there are nasty hyphenated sociology terms (or hyphen-nasty-sociological terms as I like to call them) that impact people's behavior. I'm also aware that people have (somewhat) rational minds and are capable of making (somewhat) rational decisions if they have the willpower.

So you're telling me that mental illnesses among the poor might not be more treatable/treated early/treated at all if they had annual check-ups - something many of them do not have access to? And addiction is of course an extremely difficult disease to treat, but a willing patient can go a hell of a lot further if they are able to go through detox/treatment in a safe, comfortable environment - something many drunk tanks do seem short on.

No, I'm telling you that I don't think it would be enough to affect the crime rate very much. It would certainly help the small percentage that are highly motivated. If you're wanting to lower the crime rate, decriminalize drugs.

Again, to me it's a public health and safety issue, and I'll be damned if I want public safety left up to charity. If a healthy society is something we all benefit from (and it is), then I don't see why we shouldn't all assume the burden.

You say that like charity is a lesser institution. There are many burdens we could assume to have a healthier society. We could make tobacco products illegal. We could enforce strict diets. We could make it illegal to have unprotected sex without first screening both partners for STDs. Somehow, I think a healthy society could be worse than a free society.

... and the poor will always be less healthy, in part, because Doritos are so much cheaper than apples. And Coca-Cola is cheaper than Grapefruit Juice. So, sure, lifestyle plays into it, but it's not as simple as saying that people who eat Doritos sleep in the bed they've made. Even if I get your point (and agree with it) (i.e., people need to take responsibility for their own health and often dont).

 

ETA: the people who can't afford health insurance also probably can't afford to live a healthy lifestyle -- even if they want to. So it becomes circular.

A bag of doritos is cheaper than 2 bags of doritos. Water (at least tap water) is cheaper than coke. Not smoking is cheaper than smoking. I agree that lifestyle isn't everything, but it is a whole lot.

I don't understand how you think your system will possibly work in a society where we don't (usually) let people drop dead because of their apparent inability to be able to pay their hospital bills. For your way to work, people who are poor and sick will have to accept (or be forced to) that that is their tough shit, and their poverty is a fatal disease. (Maybe you can do some PSAs along the lines of, "Can't afford health care? Then you can't afford to live. Please, don't trouble your betters with your agony and sad stories. Find a quiet, out-of-the way place to die!") I don't know what you call that, but it ain't civilization.

Indeed that's not civilization, and it also happens to not be "my system." I suppose if a perfectly evil world adopted my system, you would be correct (though the same would be true if a perfectly evil world adopted socialism, Socialism, communism, Communism, capitalism...well you get the idea). But there are actually a lot of good people out there, and there is such a thing as charity. I am just not of the mentality that everything worth having should be provided by the government. Also, it's not as black and white as you portray it (and it pains me that the "conservative" is the one bringing gray into the argument). If someone spends thousands of dollars a year on cigarettes for several decades and ultimately can't afford a lobectomy for their lung cancer, did they really die of poverty?

Not to mention the huge public health and safety risks of not treating people who are ill. I didn't post this in my first response, but I wonder what would happen to our violent crime rates if access to mental health and substance abuse care were widely available and accessible to everyone.

Seeing as both of those rely on a high level of a patient's self-motivation, probably not much. Addiction is a tough thing to treat, and I suspect that access to treatment is not the main limiting factor. In fact, the VA is a great example of this.

I still don't understand why someone (not just you, but in general) would think people should have unequal access to healthcare.

Many reasons: Because people utilize healthcare unequally. Because people treat their own bodies (regardless of what healthcare they have access to) unequally, and those decisions cost money. Because taxes are levied unequally. Because government coverage of healthcare (even if that coverage is simply paying for healthcare within a private system) inevitably leads to government control of healthcare. Because government cannot easily reduce the cost of healthcare, but they can instantly reduce the price they pay. Because my general philosophy is that the government should not exist to provide everyone's basic needs. Obviously you don't agree with me, but what's not to understand?

I'm really not trying to pick nits (like Matt, for this part at least I'm taking this at more of a removed, "academic" debate), but your situation right now is the direct result of many choices you have made which, like you said, is a result of choosing your battles.

Then we agree. I've chosen my battles and have decided to work in an imperfect system. I decided that working in a field that I like was more important than having a job aligned with my political views (something that would have been nearly impossible anyway). If I hadn't gone into medicine, I probably would've gone into craft brewing, a field where government involvement is even more fucked up.

Seriously, charity as a healthcare option for the wealthiest country and biggest economy in the world at the start of the 21st century? Pitiful. Let's bring back the workhouse for debtors who can't pay their medical bills at the same time. As a man of science you might prefer a more reasoned approach. Take your pick of umpteen different health-care models that work well in any number of different countries and based on their results add the best parts to what is offered here. Of course that would force you to take of your ideological blinders.

There's nothing pitiful about charity. It's far more noble than government entitlements. And enough with all this "ideological blinders" bullshit. I get it. You've obviously thought about the issues more than me and arrive at all your conclusions without letting those pesky pre-formed values and principles cloud your judgment. I'm sure that such unbiased and pragmatic thinking is what allows you to write with such condescension and pomposity.

I see your point, but only to a point. And here's why. We all choose where we work. Doctors too. Now, I won't be so presumptuous as to pretend that I know your situation, and without getting too metaphysical here, there are different levels of "choice." But the fact remains, that a doctor opposed to Medicare, can either open his/her own clinic (as you suggest), or go work for a clinic that someone else owns that doesn't take insurance. It's true, as you say, that Medicare isn't going anywhere. But you can go somewhere.

Well my situation right now is that I have at least 5 years of residency (funded by Medicare ironically enough) plus probably a couple more of fellowship, all of which will be at teaching hospitals. After that, I'm not sure what my options will be as far as Medicare goes (and whatever "public option, etc." that might or might not exist by then). As I'm going into radiology, a specialty that is largely affiliated with hospitals, it's probably going to be pretty difficult to find a job that doesn't involve Medicare. And I'm not too sure about starting my own imaging center either. One thing that kind of sucks about med school and residency is that they offer very little education as far as the business of medicine goes.

With that all being said as a caveat, the doctor who is opposed to Medicare on moral grounds, but wants higher payments from Medicare because "it's only fair," reminds me of the fiscal conservative who rails against unemployment insurance and government handouts until he/she gets laid off from his/her job in the private sector and begins cashing his/her unemployment checks. And then maybe even complains about how ridiculous it is that those unemployment checks are so small. I mean, after all, how can anyone really live on those checks, right?

I really do get your point, but sometimes you just have to be pragmatic and pick your battles. It's the same thing with Social Security. I think it should be privatized or at least reduced to where it actually is a safety net instead of an entitlement. However, if it still exists when I reach retirement age, after decades of making contributions, I probably won't turn down my SS checks.

You should be happy because those people who don't have insurance in this are in affect charity cases.

I don't know about their affect, because I can't see their facial expressions, and I also don't understand what your point is.

Also in your ideologically-driven fog you've forgotten that those under Medicare are indeed treated by private healthcare. It is merely the funding that is public.

I have ideologically-driven foglights, so I should be alright, plus I haven't forgotten that at all. My issue with Medicare is the public funding. Pay better attention!

The only doctors that work for the Government are those in the VA system. Wouldn't it be a good idea and in keeping with your fine principles if we could dismantle that system also? Perhaps we could give every member of our armed service past and present a voucher that they were free to spend on health insurance or any non health-related item.

That might not be a bad idea, though I suspect they might spend most of the money on cigarettes. And I'm glad that you find my principles to be fine.

Funny that in this whole false debate about a Government takeover of healthcare that we've heard no news on the ills of the only government run healthcare system in this country (the VA).

Actually, I'm pretty sure that I brought this up the last time we had this debate here. As someone who has rotated through the VA several times in med school, I will vouch for the fact that pretty much everything (from the building design to the nursing staff) is worse at the VA.

Plenty of doctors don't accept insurance. If you are anti-Medicare, can't you simply refuse to accept insuance? (I realize this doesnt apply to someone coming to you in an emergency).

 

I am out of my league a bit here because I am far from an expert on these topics, but this seems like an intriguing paradox. Rail against government provided healthcare while insisting that you get paid more from it? What am I missing?

That depends on where you work. If you own your own clinic, you can refuse Medicare, but if you work in a hospital that takes Medicare, you pretty much have to take it. I don't see the paradox. If there was a national referendum on Medicare, I would vote against it, but that's not a realistic situation. Medicare is not going anywhere, so if it is going to exist, it should reimburse doctors fairly.

So by telling a little bit about my story with healthcare and reading stuff here and seeing stuff on the news I wanted to ask something. Isn't it a bit ironic that some Americans want to help donate money to Haiti, but some Americans won't stand for universal health care because they don't want to "help those bums or (insert your group of choice)? I understand some people milking the system, but surely these people can think outside the welfare box and think about other people in such humbling experiences. I guess we react well in such tragedies and give from the heart.

There's a difference between voluntarily donating your money to a charitable cause and paying for something with tax money that is not optional. I can decide what charity I want to donate to and how much to donate. The same cannot be said for government programs.

So you are against Medicare in principle, but even moreso, against Medicare cuts?

I am against Medicare in principle but recognize the reality that it exists and thus think it should reimburse fairly to the extent that it can. I would love to see Medicare abolished and replaced by private healthcare and charity, but it's not going anywhere anytime soon. If it's going to be paying for a large percentage of healthcare, then it should pay physicians a fair price for their services. Doctors should not be overbooking their clinics just to stay open because Medicare arbitrarily tells them that their service is worth less than it actually is.

Yes, but uncool2pillow, my point is that this is exactly what is happening with capitalism. Wall Street bailout, Health Care bill w/o public option, etc. Wealth continues to be concentrated at the top, and it is being funded by the people (ie, taxpayers). This is being branded as socialism. It isn't socialism.

While we're getting our terminology straight, can we agree that the Wall Street bailout is not free market capitalism?

And that, by the way, is the main reason we need healthcare reform. What you have described here is Socialism, the big-S version that was instituted in regimes where people didn't get to vote; socialism is the one where people in Switzerland and Canada get to spend QT with their doctor when they need it.

Except that in my example, the government (and one in which people do get to vote) is the problem. They refuse to increase Medicare reimbursements and in fact constantly advocate Medicare cuts (as they do in currently proposed healthcare reform legislation). So whatever your opinion is on how healthcare should be reformed, the proposed legislation will not result in more QT with physicians. In fact, it will likely result in many physicians retiring early, thus making the problem worse.

I’m not so sure – the “c” word, or the even more popular, “s” word, didn’t enter popular thought spontaneously, it was intentionally planted by the right and its spokesmen and women. I understand and share the nation’s frustration, but if we’re going to find a way out of this mess, we have to deal with hard cold facts, and not an agenda based on almost entirely on all fear, all the time. Voting is important, but what’s even more important, is being an educated voter – learning how to filter out the spin from both parties and the media is vital to being a responsible and informed citizen/adult - it admittedly takes a lot of hard work and effort, but if folks aren’t willing to take the time, perhaps it would be best if they just stayed home on election day.

OK, but further government takeover of healthcare is a step in the direction of socialism. You may agree with that step -- and there are many well-intentioned, smart people on this board that have no problem with socialism -- but it is not inaccurate to say that the Democrats' healthcare reform proposals are socialist-leaning. Maybe the government is not explicitly owning the means of production as would be required for a strict definition of socialism, but controlling the way that healthcare is paid for has the same end result. Do you think that a family practice doctor that can barely cover his overhead because Medicare has not increased reimbursements for a decade is not de facto owned by the government? That, by the way, is the main reason that you have to wait hours to see your doctor and then only get 15 minutes with him/her: the only way that they can cover their overhead in the face of low reimbursements is to increase patient volume to ridiculous levels.

When did people my age become so conservative?

When I was your age.

I think by that you mean most politicians, etc. as I am pretty sure there's a lot more out there than just the Obama administration folks. Or maybe it is that those that came before them had other skeletons in their closest that were much more note worthy. of course, everything i just said is biased wild speculation.

That definitely applies to most politicians, including those in the "Hope! Change! Yes we can!" administration.

Can you provide examples in which the Democrats made similar, whacked out, entirely fear-bred claims against McCain?

I think the fear of Palin being Vice President was a major reason that McCain lost the election. Apparently, people have forgotten that our nation has a time-honored tradition of being run by incompetent morons. Hell, most of the Obama administration can't even properly file an income tax return.

I added the ill-informed part, and as your reply was a reply to my reply, I was really quoting myself. I agree, the slogans surrounding Obama’s campaign were, by and large, every bit as hollow – the distinction being, and I think it’s an important one, he didn’t run a campaign based almost entirely on fear, and not only fear, but false fears. The fear that the US is being run by socialists and communists – which, by any metric, is entirely false.

Given that we're talking about Massachusetts and not one of them red states, it's not like the constituency has some deep-seeded fear of socialism. Maybe there's a legitimate concern that is causing people to favor the Republican.

Given what the Republican Party has become, ideologically pure, yet batshit insane, you could say that.

 

Edit: His platform, when he actually has a platform outside of lowering taxes, appears to amount to little more than, “Take back America”, which, as has been noted, from whom exactly? For the answer to that, see my previous post – it’s not what I’m saying, it’s what they are, and that’s the platform on which he’s chosen to run – and if that’s why you’re voting for him, well, as ikol pointed out, you’re an ill informed fuckhead (I’m not referring to you of course).

I never said ill-informed, and you apparently missed the sarcasm in my reply. I don't know much about Brown, so I have little to add, but "take back America" is no less vague of a platform than "hope, change, yes we can!". He's a politician. They always run on vague, emotionally-rooted slogans.

Yeah, because anyone that would vote for Scott Brown is automatically a kook.

No, they're a fuckhead. Duh!

Totally. I'm still pissed about the government interfering with their damn child labor laws.

Some jobs require small hands.

On a more serious note, the fact that people don't complain about all those other regulations is part of the problem. Sure they're all well-intentioned, but should the government really be dictating how many hours people are allowed to work? And every new regulation that gets added makes it that much harder to start up a small business, which gives yet another advantage to big businesses. I couldn't even imagine starting up a business. I would probably have to hire a lawyer to wade through all the regulations and red tape and would probably end up deciding it's not worth the trouble.

And there's no such thing as a single-payer healthcare system.

Merry fucking Christmas everyone....who would you rather wake up to this morning, Barack Obama or Sarah Palin (insert John McCain here or any other right wing tool.....)

I couldn't care less. I'm certainly not gonna let whatever tool (right or left wing) that is in office ruin my Christmas.

The thing that's always puzzled me is the Immaculate Conception is on my birthday (Dec. 8), and yet it only took 17 days after that for the baby J to be born.

 

Someone please explain this to me.

The Immaculate Conception actually refers to Mary being conceived without any original sin. Thank you 9 years of Catholic school!

In more bad news for gays, straights, atheists, theists and decent folk in general, Creed has apparently reunited. I think there is some language relating to this in Revelation.

I hate to admit it, but this may actually be proof that there is no God.