Ted Kennedy to be succeeded by a toolbag

[MattZ]

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.

 

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.

 

I really don't want that to sound like the standard retort in political arguments of this nature, like "if you don't like it, go to [iNSERT COUNTRY]!!" That's not my point at all. And like I said, I am trying to walk a fine line here without knowing your situation and without being judgmental. This really is academic for me.

 

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?

[Guest Speed Racer]

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.

 

True enough (I worked summers in a university system that had me running packages to the VA several times a day, and it was definitely my least favorite trip), but I believe that to be more of a referendum on how we regard our veterans than the sole direct result of public funding.

 

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 said.

[Oil Can Boyd]

Here we go: Scott Brown makes his first endorsement.

 

He has endorsed a candidate who has asserted that President Obama was born in Kenya rather than the United States, and who drew complaints from his neighbors during the 2008 presidential campaign for putting up signs on his property depicting Obama as Osama bin Laden.

[Sir Stewart]

Salem News with the scoop! Score one for MeDave! Not that he works there, but still.

[Good Old Neon]

Here we go: Scott Brown makes his first endorsement.

 

He has endorsed a candidate who has asserted that President Obama was born in Kenya rather than the United States, and who drew complaints from his neighbors during the 2008 presidential campaign for putting up signs on his property depicting Obama as Osama bin Laden.

 

Sweet, it’s nice to know that Brown is a card carrying member of the reality based community. (/sarcasm)

[bjorn_skurj]

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.

Yeah.

[ikol]

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.

[Guest Speed Racer]

There's nothing pitiful about charity. It's far more noble than government entitlements.

 

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

 

Well my situation right now

 

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.

[ikol]

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.

[Guest Speed Racer]

Obviously you don't agree with me, but what's not to understand?

 

Generally speaking, all of the explanations I have heard prior to this one include this sentence, and none of the ones preceding it, and usually a few extra sentences about people wanting handouts. And to me, a government that ensures the health of its citizens is a government with that much more quality of life, happiness, and therefore productivity.

[Tweedling]

ikol for prez

[bjorn_skurj]

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 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.

[Guest Speed Racer]

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.

 

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. Seems to me a no brainer that the more people that have access to healthcare, the fewer other costs the government will have to assume - not enough to make a giant dent, but a noticeable one definitely.

[ikol]

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.

[Guest Speed Racer]

Seeing as both of those rely on a high level of a patient's self-motivation, probably not much.

 

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.

 

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.

 

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.

[MattZ]

... 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.

[ikol]

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.

[Guest Speed Racer]

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.

 

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

[Guest Speed Racer]

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.

 

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.

[u2roolz]

 

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.

 

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.

[ikol]

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.

[ikol]

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.

[Guest Speed Racer]

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.

 

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?

[auctioneer69]

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.

 

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.

[ikol]

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.