President Bernie Sanders

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Obviously this is anecdotal, but the vast majority of the patients that I take care of in the outpatient setting are on Medicaid, like 99%.
Yes of course they come in for "unnecessary visits" (not sure exactly what that means), but so do people who have copays that are $25. But in general the patients that I take care of on Medicaid are certainly in general wonderful people who are grateful and not demanding a MRI and the most expensive med they saw in a tv ad. When I explain that xyz isn't indicated if they do ask for a MRI after 1 day of back pain then the vast majority of patients understand and follow my recommendations.

Of course there are patients who are "super-utlizers" but that is not the vast majority of the population. And the patients that I see that are in those situations usually have a variety of socioeconomic complications...homelessness, substance use, domestic violence, etc that complicate the picture, therefore more supports in general would likely improve society overall for people in those situations.

So no, I don't think making healthcare affordable to ALL is a doom and gloom situation in regards to patients wanting everything, right here and right now. People in general don't enjoy sitting in the ED for 8 hours.

Your faith in humanity is more than mine.

There are tons of studies to show, without a doubt, that copays and deductibles (even small ones) reduce healthcare utilization in proportion to what the patient is paying. Just like any other good, the higher the direct price, the lower the demand.

If we have zero price- demand is going to be sky-high. Now it’s true that raising the price reduces BOTH appropriate and inappropriate care indiscriminately which is not an ideal outcome. It’s a blunt tool.

Therefore, the only way to regulate infinite demand (in a zero direct price scenario) is to harshly ration and triage care through a set of rules that cannot be second-guessed and cannot be influenced by either defensive medicine or consummerism , which is how most other nations with “universal healthcare” do it. If we decide to do this then the American people deserve to know EXACTLY how it will be done before voting for it.

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Well screw you buddy!
Mods. Really is this appropriate?

He wasn't directing that at you -

It is that inconceivable. As borne out by other countries which have universal health insurance programs but somehow mysteriously still have people working.

It’s also ridiculously cruel. Unemployed for a while and happen to get sick during that time? Well screw you buddy!

It's just a rhetorical device; he's suggesting that lack of universal health care is society saying 'screw you buddy' to an umemployed person who gets sick.
 
The kids are running the Democrat asylum, and the "adults" (who've been egging on the kids the entire time) are finding it impossible to take back control.
You could have said the same things about the Tea Party during the Obama years. The Republican party took another turn of its own when it nominated Trump.

Other than a tax cut that was perhaps imprudent, virtually the only objectionable aspect of Trump is his personality. The fact that there's such vociferous opposition to his policies is, in itself, evidence of a hard-left turn by the Democrat Party.

I don't know about that. Trump really is different than everyone who came before him.

One more thing: guess who's censoring social media (read: free expression)? 20- and 30-somethings with pink hair and purple lipstick. There's a staggering amount of power in the hands of people who are barely qualified to run pizza shops.

This all ends poorly for Western society. I do wonder how the year 2100 will look, though.

Middle aged and old people have been grumbling about the laziness, naivete, and ingratitude of them darn kids these days since prehistoric times. I'm going to need to see Bernie get elected with Democratic majorities in Congress before I really believe the Bernie movement is more than Twitter-deep.
 
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Healthcare is a human right . You should not have to “buy” the right to live

Again healthcare is a human right and we all have the right to live .

I am entitled to have at minimum my basic healthcare needs met. You are , the poor middle and the rich are.

You keep saying this, but it's not true. Here's why, in one sentence:

Human rights are things humans can do by themselves, like speech, worship, travel, self defense - not things that they must rely on others to provide, like food, shelter, and health care.

vector2 will be along shortly to dispute this definition; his points are not completely without merit, but in the end they don't bootstrap one person's labor into another person's human right. No words or ideas or arguments can. :)


But let's look at what the World Health Organization says, because they're something of a global authority, and they're often cited as saying something they actually don't.

On their web page titled Human Rights And Health there's a long bullet list of statements that use the word "right" but you really need to read it carefully. It boils down to "the highest attainable standard of health as a fundamental right of every human being.” The discussion on that page gets right to the point with
WHO said:
The right to the highest attainable standard of health” implies a clear set of legal obligations on states to ensure appropriate conditions for the enjoyment of health for all people without discrimination.

That "ensure appropriate conditions" caveat is a big one.

They go on with
WHO said:
The right to health is one of a set of internationally agreed human rights standards, and is inseparable or ‘indivisible’ from these other rights. This means achieving the right to health is both central to, and dependent upon, the realisation of other human rights, to food, housing, work, education, information, and participation.

This is NOT a statement that everyone has a human right to be given food, given housing, given a job, given an education, etc. It's a statement that governments and other people shouldn't prevent people from obtaining these things, and are obligated to establish conditions where people can obtain them.

Note that over and over again they use the phrase "right to health" and not "right to health care". This is an important distinction, and it's not so different than saying people have a right to be happy. That right to be happy doesn't imply another person or the government must provide strawberry ice cream (with sprinkles) to everyone who can't be happy without it. I'm only being a little facetious here. Check out what's declared in one of our nation's founding documents:
Declaration of Independence said:
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed,

The "right to health" as identified by WHO is, in practical terms, not more than the right to the "pursuit of happiness" - it implies that these are things that people can seek for themselves without interference or oppression from governments and other people. Not that one person is entitled to be given these things by another person.

The defense of the right to have these things can be secured by governments, and governments (people) can choose to collectively create systems to provide them if they choose. But it is never, ever, under any circumstance, ever, one person's "human right" to take anything from another human. No matter what you think you're entitled to.

The closest the WHO comes to saying universal government-provided healthcare is a human right is a section that includes the line:
WHO said:
Refers to the need for a sufficient quantity of functioning public health and health care facilities, goods and services, as well as programmes for all.

In context I interpret this to be a statement related to acceptable regulation, as every other point in that section concerns discrimination, gender sensitivity, quality, etc.


It is just, humane, and worthy of admiration for groups of people (governments) to collectively choose to provide some level of food, shelter, security, education, and yes health care to people who are unable to provide those things for themselves. However admirable (and practical) it is to do these things, that doesn't magically turn them into human rights. This is an opinion, grounded in ethics and morality. It is not a natural fact, an emergent property of the universe.

You can support efforts to create a tax-supported healthcare system for all, or even a UBI if you want to go that far, without pretending fundamental human rights exist where they don't. Don't muddy the waters. Words have meaning.


Also, as a pre-med, you don't get to come into a forum full of attendings and spout off about who's a good doctor and who isn't. Welcome to the forum. Settle down.
 
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Also, PNHP has had a detailed and extensively cited single payer proposal in circulation for like 4 years now

They lost me when they specifically want to ban a two-tier system.
 
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This is where we disagree. Healthcare follows similar rules to all other goods. Sure, there are things that patients absolutely *need* or they are going to die - but this not the majority of healthcare.

You think patients never come in for unnecessary visits? You think they won’t come into clinic more if there’s “no copay”? You think there isn’t a grey area about “medically necessary” procedures that might be used more if they are free? You think our culture of consumerism hasn’t led to patients dictating they want the more expensive drug/procedure/diagnostic (or they will raise hell)? You think that abuse won’t get worse when the patient has “zero skin in the game?”

why shouldn’t I get my lipoma removed when it’s free (of course it hurts!)

why shouldn’t every psoriasis patient get the expensive biologic?

bariatric surgery for all!

why shouldn’t I go straight to the orthopedist when my ankle hurts? They know best-right? You think the doctor will play gatekeeper and avoid that free MRI when the patient is “rating” them?

Painful lipoma surgery should be covered. If you're on some base plan and if you gotta wait, so be it, but it's better than no surgery.

Bariatric surgery, biologics, MRIs, and orthopedic surgery? Not even private insurance covers those without failing more conservative therapy/trying less expensive therapy. And before you can get the expensive stuff you still need a prior auth from some bureaucrat at the insurance company. And let's not forget that the price of bariatric and orthopedic equipment, MRIs, and biologics comes down when the entire US govt is negotiating the contract price.

Honestly, I'm not sure where you're getting the idea that the system just implodes when you have examples like Canada where there are no copays or deductibles.
 
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They lost me when they specifically want to ban a two-tier system.


"The NHP would, like Medicare, ban private insurance that duplicates the public coverage to forestall the emergence of a two-tiered health care system, in which insurers would compete by lobbying to underfund the public part of the system. Moreover, in the NHP, as in Medicare, inclusion of the affluent would serve as an important guarantor of adequate coverage."

It isn't even speculation that this phenomenon would happen and weaken the public aspect. Just look at what's happened with the evisceration of the individual mandate and the addition of non-ACA compliant plans to the exchanges. I would still rather have a two tier plan but the public tier has gotta be bulletproof (lobbyist proof)
 
You keep saying this, but it's not true. Here's why, in one sentence:

Human rights are things humans can do by themselves, like speech, worship, travel, self defense - not things that they must rely on others to provide, like food, shelter, and health care.

vector2 will be along shortly to dispute this definition; his points are not completely without merit, but in the end they don't bootstrap one person's labor into another person's human right. No words or ideas or arguments can. :)


But let's look at what the World Health Organization says, because they're something of a global authority, and they're often cited as saying something they actually don't.

On their web page titled Human Rights And Health there's a long bullet list of statements that use the word "right" but you really need to read it carefully. It boils down to "the highest attainable standard of health as a fundamental right of every human being.” The discussion on that page gets right to the point with

That "ensure appropriate conditions" caveat is a big one.

They go on with

This is NOT a statement that everyone has a human right to be given food, given housing, given a job, given an education, etc. It's a statement that governments and other people shouldn't prevent people from obtaining these things, and are obligated to establish conditions where people can obtain them.

Note that over and over again they use the phrase "right to health" and not "right to health care". This is an important distinction, and it's not so different than saying people have a right to be happy. That right to be happy doesn't imply another person or the government must provide strawberry ice cream (with sprinkles) to everyone who can't be happy without it. I'm only being a little facetious here. Check out what's declared in one of our nation's founding documents:

The "right to health" as identified by WHO is, in practical terms, not more than the right to the "pursuit of happiness" - it implies that these are things that people can seek for themselves without interference or oppression from governments and other people. Not that one person is entitled to be given these things by another person.

The defense of the right to have these things can be secured by governments, and governments (people) can choose to collectively create systems to provide them if they choose. But it is never, ever, under any circumstance, ever, one person's "human right" to take anything from another human. No matter what you think you're entitled to.

The closest the WHO comes to saying universal government-provided healthcare is a human right is a section that includes the line:

In context I interpret this to be a statement related to acceptable regulation, as every other point in that section concerns discrimination, gender sensitivity, quality, etc.


It is just, humane, and worthy of admiration for groups of people (governments) to collectively choose to provide some level of food, shelter, security, education, and yes health care to people who are unable to provide those things for themselves. However admirable (and practical) it is to do these things, that doesn't magically turn them into human rights. This is an opinion, grounded in ethics and morality. It is not a natural fact, an emergent property of the universe.

You can support efforts to create a tax-supported healthcare system for all, or even a UBI if you want to go that far, without pretending fundamental human rights exist where they don't. Don't muddy the waters. Words have meaning.


Also, as a pre-med, you don't get to come into a forum full of attendings and spout off about who's a good doctor and who isn't. Welcome to the forum. Settle down.

Lol, is it just me or has pretty much every conversation on every topic already played out once before on SDN?

When talking about human rights before, I think the important philosophical distinction was the existence of positive vs negative human rights:

 
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"The NHP would, like Medicare, ban private insurance that duplicates the public coverage to forestall the emergence of a two-tiered health care system, in which insurers would compete by lobbying to underfund the public part of the system. Moreover, in the NHP, as in Medicare, inclusion of the affluent would serve as an important guarantor of adequate coverage."

It isn't even speculation that this phenomenon would happen and weaken the public aspect. Just look at what's happened with the evisceration of the individual mandate and the addition of non-ACA compliant plans to the exchanges. I would still rather have a two tier plan but the public tier has gotta be bulletproof (lobbyist proof)
That's impossible to achieve in our governmental system unless something becomes so popular that no one dares to mess with it (like SS).

My belief is that the way to handle this in America is to expand Medicare to cover all ages and add the additional coverages that everyone seems to want (dental, long term care, alter the drug coverage, you get the idea) but with no mention of private coverage in that expansion so that we do end up with a solid two-tier system. If the Medicare part is popular enough, it will become untouchable.

I'd also like, as I previously mentioned, to be able to balance bill like they do in Australia but I know that's a pipe dream.
 
We wouldn't even argue whether or not healthcare is a right if it were simply affordable. Well, okay, maybe we would, but defending whether or not it is would be tougher.

I know what I pay for myself and my family, all healthy, and it's absurd. I mean truly ridiculous. I have a problem with the pure libertarian argument because it is not realistic. That argument doesn't care what the cost of service is - if you want it, pay for it. If you don't, go without. That's not really an option with regards to healthcare in this day and age. Especially for responsible adults who wish to avoid bankruptcy. To go without means to pay fines levied by the government via the ACA, or to simply go bankrupt if something serious happens to you while you roll the dice, being unable to afford healthcare, all while working a job.

I also can not tell you what a single, working mother with kids, earning poverty level wages, pays for healthcare. All I know is that I want my first world, developed nation with the best and brightest working in healthcare to offer her and her family a product that takes care of her basic needs but doesn't bankrupt her in the process.

Is that really all that difficult to ask?
 
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Painful lipoma surgery should be covered. If you're on some base plan and if you gotta wait, so be it, but it's better than no surgery.

Bariatric surgery, biologics, MRIs, and orthopedic surgery? Not even private insurance covers those without failing more conservative therapy/trying less expensive therapy. And before you can get the expensive stuff you still need a prior auth from some bureaucrat at the insurance company. And let's not forget that the price of bariatric and orthopedic equipment, MRIs, and biologics comes down when the entire US govt is negotiating the contract price.

Honestly, I'm not sure where you're getting the idea that the system just implodes when you have examples like Canada where there are no copays or deductibles.
Not entirely true. If you find the places that offer cash-only discounts they are almost universally way cheaper than Medicare rates.
 
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All I know is that I want my first world, developed nation with the best and brightest working in healthcare to offer her and her family a product that takes care of her basic needs but doesn't bankrupt her in the process.

Is that really all that difficult to ask?
Maybe?

One of the problems you have is that talent follows money. There's a real risk that if we socialize medicine then income will plummet, especially for the higher earners. Look at the problems the UK is having finding and retaining physicians. Now this doesn't have to happen, but it requires that you pay well which is often a problem when the government is picking up the tab.
 
We wouldn't even argue whether or not healthcare is a right if it were simply affordable. Well, okay, maybe we would, but defending whether or not it is would be tougher.

I know what I pay for myself and my family, all healthy, and it's absurd. I mean truly ridiculous. I have a problem with the pure libertarian argument because it is not realistic. That argument doesn't care what the cost of service is - if you want it, pay for it. If you don't, go without. That's not really an option with regards to healthcare in this day and age. Especially for responsible adults who wish to avoid bankruptcy. To go without means to pay fines levied by the government via the ACA, or to simply go bankrupt if something serious happens to you while you roll the dice, being unable to afford healthcare, all while working a job.

I also can not tell you what a single, working mother with kids, earning poverty level wages, pays for healthcare. All I know is that I want my first world, developed nation with the best and brightest working in healthcare to offer her and her family a product that takes care of her basic needs but doesn't bankrupt her in the process.

Is that really all that difficult to ask?
It’s a difficult steal, it’s not an ask. There is no ask in the govt solution, there is “give us this money or we send guys with guns”.

You can do all the charity you want (I do). But you don’t have a right to access a third party’s wallet just because you feel bad for someone else.
 
You keep saying this, but it's not true. Here's why, in one sentence:

Human rights are things humans can do by themselves, like speech, worship, travel, self defense - not things that they must rely on others to provide, like food, shelter, and health care.

vector2 will be along shortly to dispute this definition; his points are not completely without merit, but in the end they don't bootstrap one person's labor into another person's human right. No words or ideas or arguments can. :)


But let's look at what the World Health Organization says, because they're something of a global authority, and they're often cited as saying something they actually don't.

On their web page titled Human Rights And Health there's a long bullet list of statements that use the word "right" but you really need to read it carefully. It boils down to "the highest attainable standard of health as a fundamental right of every human being.” The discussion on that page gets right to the point with

That "ensure appropriate conditions" caveat is a big one.

They go on with

This is NOT a statement that everyone has a human right to be given food, given housing, given a job, given an education, etc. It's a statement that governments and other people shouldn't prevent people from obtaining these things, and are obligated to establish conditions where people can obtain them.

Note that over and over again they use the phrase "right to health" and not "right to health care". This is an important distinction, and it's not so different than saying people have a right to be happy. That right to be happy doesn't imply another person or the government must provide strawberry ice cream (with sprinkles) to everyone who can't be happy without it. I'm only being a little facetious here. Check out what's declared in one of our nation's founding documents:

The "right to health" as identified by WHO is, in practical terms, not more than the right to the "pursuit of happiness" - it implies that these are things that people can seek for themselves without interference or oppression from governments and other people. Not that one person is entitled to be given these things by another person.

The defense of the right to have these things can be secured by governments, and governments (people) can choose to collectively create systems to provide them if they choose. But it is never, ever, under any circumstance, ever, one person's "human right" to take anything from another human. No matter what you think you're entitled to.

The closest the WHO comes to saying universal government-provided healthcare is a human right is a section that includes the line:

In context I interpret this to be a statement related to acceptable regulation, as every other point in that section concerns discrimination, gender sensitivity, quality, etc.


It is just, humane, and worthy of admiration for groups of people (governments) to collectively choose to provide some level of food, shelter, security, education, and yes health care to people who are unable to provide those things for themselves. However admirable (and practical) it is to do these things, that doesn't magically turn them into human rights. This is an opinion, grounded in ethics and morality. It is not a natural fact, an emergent property of the universe.

You can support efforts to create a tax-supported healthcare system for all, or even a UBI if you want to go that far, without pretending fundamental human rights exist where they don't. Don't muddy the waters. Words have meaning.


Also, as a pre-med, you don't get to come into a forum full of attendings and spout off about who's a good doctor and who isn't. Welcome to the forum. Settle down.

I can state my opinion on forum wherever and whenever I please as you just did. If I don’t think someone is a good doctor it is my opinion. Just like one supposed attending on here believed that my apps should be thrown out. Again just his opinion. Just because I’m a “pre-med” does not mean I lack the experiences and not aware of what our healthcare is today. And also I have the “right” to share my opinion. I do believe in affordable healthcare and I do think it’s a right. Im not stating that I know all the answers but what I do know right now that our healthcare system is not good And many many people are avoiding proper care because they simply can’t afford it or seeking care and being charged large bills and sometimes go bankrupt. Attending is on here stating basically you can’t afford this treatment or diagnostic test oh well get a job work harder is concerning.

My mindset will not change once I am a doctor . So Thank you ...
 
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I can state my opinion on forum wherever and whenever I please as you just did. If I don’t think someone is a good doctor it is my opinion. Just like one supposed attending on here believed that my apps should be thrown out. Again just his opinion. Just because I’m a “pre-med” does not mean I lack the experiences and not aware of what our healthcare is today. And also I have the “right” to share my opinion. I do believe in affordable healthcare and I do think it’s a right. Im not stating that I know all the answers but what I do know right now that our healthcare system is not good And many many people are avoiding proper care because they simply can’t afford it or seeking care and being charged large bills and sometimes go bankrupt. Attending is on here stating basically you can’t afford this treatment or diagnostic test oh well get a job work harder is concerning.

My mindset will not change once I am a doctor . So Thank you ...
We all cling to some things but this process does change people, for better or worse

Again, good luck. We can talk more through out the years
 
Your faith in humanity is more than mine.

There are tons of studies to show, without a doubt, that copays and deductibles (even small ones) reduce healthcare utilization in proportion to what the patient is paying. Just like any other good, the higher the direct price, the lower the demand.

If we have zero price- demand is going to be sky-high. Now it’s true that raising the price reduces BOTH appropriate and inappropriate care indiscriminately which is not an ideal outcome. It’s a blunt tool.

Therefore, the only way to regulate infinite demand (in a zero direct price scenario) is to harshly ration and triage care through a set of rules that cannot be second-guessed and cannot be influenced by either defensive medicine or consummerism , which is how most other nations with “universal healthcare” do it. If we decide to do this then the American people deserve to know EXACTLY how it will be done before voting for it.

I guess in a realistic world that’d be great.
The politician could say all doctor visits will be $20, all ED visits will be $30, etc.
But by the time lobbyists, interest groups, pharmaceutical companies and congress put their influence then things will be different unfortunately.
But like I said Warren has a pretty detailed plan if what you are looking for are details. Biden’s healthcare plan certainly does lack details, but many will argue that’s a better strategy to keep things more open since things change very easily depending on the outside influences like I said above. That’s politics!

But overall care is already being rationed for millions of people, insurance companies, the VA, Medicare and Medicaid already get to decide what care we get, so rationing won’t be anything new.
 
I guess in a realistic world that’d be great.
The politician could say all doctor visits will be $20, all ED visits will be $30, etc.
But by the time lobbyists, interest groups, pharmaceutical companies and congress put their influence then things will be different unfortunately.
But like I said Warren has a pretty detailed plan if what you are looking for are details. Biden’s healthcare plan certainly does lack details, but many will argue that’s a better strategy to keep things more open since things change very easily depending on the outside influences like I said above. That’s politics!

But overall care is already being rationed for millions of people, insurance companies, the VA, Medicare and Medicaid already get to decide what care we get, so rationing won’t be anything new.
Well there would still be some complaining that $30 was too much despite the fact that it’s not remotely enough to cover actual costs
 
It’s a difficult steal, it’s not an ask. There is no ask in the govt solution, there is “give us this money or we send guys with guns”.

You can do all the charity you want (I do). But you don’t have a right to access a third party’s wallet just because you feel bad for someone else.

Charity care has its limit/futility. It makes you feel good and may do relatively little to nothing for your patient. You can see that uninsured working poor patient for free, write all the $4 prescriptions they need, but if they get an acute appendicitis and require a night in the hospital along with a $10k bill they could never pay, you’ve done nothing. Your outlook of ‘meh, they must pay what the 3rd party asks because nothing in life is free and that’s just life in this errrmg awesome libertarian world’ is neither realistic nor helpful for this society.
 
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Charity care has its limit/futility. It makes you feel good and may do relatively little to nothing for your patient. You can see that uninsured working poor patient for free, write all the $4 prescriptions they need, but if they get an acute appendicitis and require a night in the hospital along with a $10k bill they could never pay, you’ve done nothing. Your outlook of ‘meh, they must pay what the 3rd party asks because nothing in life is free and that’s just life in this errrmg awesome libertarian world’ is neither realistic nor helpful for this society.
In what world do you live in where the uninsured pay the massive hospital bill??
 
I can state my opinion on forum wherever and whenever I please as you just did. If I don’t think someone is a good doctor it is my opinion. Just like one supposed attending on here believed that my apps should be thrown out. Again just his opinion. Just because I’m a “pre-med” does not mean I lack the experiences and not aware of what our healthcare is today. And also I have the “right” to share my opinion. I do believe in affordable healthcare and I do think it’s a right. Im not stating that I know all the answers but what I do know right now that our healthcare system is not good And many many people are avoiding proper care because they simply can’t afford it or seeking care and being charged large bills and sometimes go bankrupt. Attending is on here stating basically you can’t afford this treatment or diagnostic test oh well get a job work harder is concerning.

My mindset will not change once I am a doctor . So Thank you ...
You do not, in fact, have the right to share your opinion wherever and whenever you please on this forum. Posting on SDN is not a right in any way.

Its not your beliefs on healthcare that are so objectionable its your mistaken belief that one's political stances determine whether or not they are a good physician. That belief is offensive and has no place here.
 
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In what world do you live in where the uninsured pay the massive hospital bill??

In a fee for service model you care greatly about your payor mix. You also care whether or not people can pay their bills. Our system isn’t setup well to incentivize the working poor to pay their bills. It’s setup for them to declare bankruptcy. People who work but can’t afford the cost of health insurance. Or they simply go without and gamble they stay healthy. There are millions like this in our country. I’m not talking the medicaid population. I’m talking the people who make too much for medicaid but not enough to easily afford the cost of today’s health insurance and the bills that come with it. We used to call this the lower middle class and health care didn’t used to be the biggest contributor to their risk of bankruptcy.

I’m simply saying health care should be affordable for everyone in this country. And everyone should be insured. And yes everyone should be forced to hold a job and work for it. And that job should provide a living wage for people
to have food, shelter, and the ability to care for their children.

Not asking for much, right?
 
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Charity care has its limit/futility. It makes you feel good and may do relatively little to nothing for your patient. You can see that uninsured working poor patient for free, write all the $4 prescriptions they need, but if they get an acute appendicitis and require a night in the hospital along with a $10k bill they could never pay, you’ve done nothing. Your outlook of ‘meh, they must pay what the 3rd party asks because nothing in life is free and that’s just life in this errrmg awesome libertarian world’ is neither realistic nor helpful for this society.
It’s only an error if you don’t accept the consequences of the policy. I do
 
In what world do you live in where the uninsured pay the massive hospital bill??

Put another way, while you’re signing all those CRNA charts (your words, not mine) do you pay attention to the cost of your care and whether or not a lower middle class family could afford it? Or whether the charges from insurance companies and hospitals are even remotely reasonable?
 
You say bankruptcy like it's a bad thing. Bankruptcy is not a bad thing at all. Like all financial tools, it isn't inherently good or bad. It's just a technique that can be good or bad for your individual situation.

Financial institutions have tried to convince us that bankruptcy is some sort of moral failure, but they don't actually view it that way. The cost of bankruptcy is already built into every loan they underwrite.

More people should take advantage of it, rather than fighting, tooth and nail, to avoid it, thereby putting themselves in an even worse financial situation.

Of course most people in this country are financially illiterate, so they would mostly out themselves right back into the situation that caused them to be overwhelmed with debt in the first place.

I considered a tactical bankruptcy, but I did a bad job of setting myself up for it to be successful. Had I graduated with a view of bankruptcy, through the lens of finance guys, I would have done things a little differently.
 
Not entirely true. If you find the places that offer cash-only discounts they are almost universally way cheaper than Medicare rates.

Medicare currently is not negotiating the supply cost of drugs, machines, and DME incurred by hospitals, right? All of those things I mentioned have lower supply side cost in integrated single payer systems.
 
Medicare currently is not negotiating the supply cost of drugs, machines, and DME incurred by hospitals, right? All of those things I mentioned have lower supply side cost in integrated single payer systems.
I can't speak to DME and I specifically didn't bold the part about drugs, but imaging can be found for way less if you know where to look.
 
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I think ppl may be underestimating the chances that Biden just runs away with this now.

Or that Sanders does (and then loses horribly in the general election).

I’m fine voting for Biden. Not so much Sanders.

To put it simply - our current system (including Medicare) is SO messed up, SO wasteful and SO bloated - why on Gods green earth would I trust the government to double down with our tax money and not mess it up more? Government never “takes over” anything and makes it more efficient... never.

If it’s so true that we already spend an obscene amount of our GDP on healthcare... the answer is not to pour more money in to get “universal coverage” just to say we did it! The government should first show they can fix some of the problems we already have and use the money more efficiently. For example - fix the pharma industry problems which is a single issue but they are unable to solve. Reduce red tape / billing efficiency for medical offices. Break up mega corporations meddling in health care. Let’s see them do ONE of those things before blindly pouring 30 more trillion dollars into a black box that likely will be wasted.
 
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Lol, is it just me or has pretty much every conversation on every topic already played out once before on SDN?

When talking about human rights before, I think the important philosophical distinction was the existence of positive vs negative human rights:

:) just passing the time. I remember you posting that the last time we had this discussion. As I said, your points aren't devoid of merit, but that line of reasoning obfuscates a core truth relevant to the discussion - No human has a right to another human's labor.

I could write another thousand words on the subject but I don't think I could make a stronger argument than those nine.
 
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I prefer

...the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.

seems to me it follows that the moral test of a citizen is how that citizen votes for a government to treat ... you get the idea - I'm no poet.
 
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I prefer

...the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.

seems to me it follows that the moral test of a citizen is how that citizen votes for a government to treat ... you get the idea - I'm no poet.
What if the citizens vote accordingly and that government consistently fails to pass the moral test you describe?
 
What if the citizens vote accordingly and that government consistently fails to pass the moral test you describe?
we keep trying, looking for a worthy candidate I suppose.
it seems more and more that the morally bankrupt pitching to human nature's worst traits are successful ... but every now and again we get lucky.

we get the leaders we as a society deserve I suppose.
 
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We could get significantly better presidential candidates if we changed the primary system, or just eliminated it outright. Even better would be if we could bust the strangle hold the two parties have on our entire political system.

I'm hoping for a brokered convention that permanently, and irreparably, splits the Dems into the Socialist Party and the Democrat Party.

So far, Trump has been able to maintain a fascade of Republican unity, but his second term may split the Republican party into the Trump/ Republican Party, and something more akin to a Conservative/ Libertarian party.

It almost certainly won't happen, but it would be one of the better things to happen to politics.
 
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I prefer

...the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.

seems to me it follows that the moral test of a citizen is how that citizen votes for a government to treat ... you get the idea - I'm no poet.
The govt doesn’t need to “treat” people at all. It largely needs to leave them alone and not violate their rights
 
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The govt doesn’t need to “treat” people at all. It largely needs to leave them alone and not violate their rights

Exactly!! The government should end Medicaid/Medicare and employer-sponsored insurance tax breaks and watch physician incomes sink like a rock!!

Or maybe you should be grateful the government subsidizes your income. No physician would make money with free market insurance.
 
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The govt doesn’t need to “treat” people at all. It largely needs to leave them alone and not violate their rights

If you include Medicare, Medicaid, Tricor, employees of federal, state, counties, and cities, the “government” pays for most of the healthcare provided in the country already.


Sent from my iPhone using SDN mobile
 
Sb27 you do realize that the character Ron Swanson is satire, right cheif?
 
Exactly!! The government should end Medicaid/Medicare and employer-sponsored insurance tax breaks and watch physician incomes sink like a rock!!

Or maybe you should be grateful the government subsidizes your income. No physician would make money with free market insurance.
First, you are wrong about that. Cash primary care makes money and the OK surgery center does well

Second, the salaries would likely drop some. That’s ok. The govt shouldn’t prop us up
 
Exactly!! The government should end Medicaid/Medicare and employer-sponsored insurance tax breaks and watch physician incomes sink like a rock!!

Or maybe you should be grateful the government subsidizes your income. No physician would make money with free market insurance.


I know of a couple of orthopedists at HSS who do very well without participating in Medicare. But you need a great reputation in a wealthy market to do this. It is probably not possible in most areas.

The rest of us would be paid in eggs and produce.
 
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First, you are wrong about that. Cash primary care makes money and the OK surgery center does well

Second, the salaries would likely drop some. That’s ok. The govt shouldn’t prop us up

LOL, and now you reveal why people don't support libertarianism. It leads to the same outcomes as socialism, with more risk for most.
 
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If you think about it, Medicare is a massive transfer of wealth from the general public to the healthcare industry. As anesthesiologists we complain about poor direct reimbursement from Medicare but we still benefit because many of the hospitals where anesthesiologists work wouldn’t even exist without Medicare. If they didn’t pay the hospitals and the surgeons, we wouldn’t have jobs.
 
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LOL, and now you reveal why people don't support libertarianism. It leads to the same outcomes as socialism, with more risk for most.
It is true that many people prefer being a subject with less freedom to freedom with more risk
 
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