A Hospital Bill Example: Ruptured Appendix Removal

[FutureCTDoc]

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This really is a policy issue, I work hard for what I earn and I don't feel some burning desire to support others. I'm a devotee of Rand say about her what you will, however I think she is right in that is inappropriate to be forced to provide support for others.

 

[FutureCTDoc]

Undoubtedly true, but totally unrelated to my question. You see, I am a pediatrician and if a baby is born in our hospital, this baby, a US Citizen, has certain rights whether you agree with them or not. Now, my question is, should we provide care for this baby whose parents cannot support it, or should we let it die if the parents cannot support it? A simple question, then we can move on to my other questions about when we move to a "pay or die" situation. In making health care policy, we have to deal with the reality that children are not always born to parents who have a half million dollars available cash (or insurance) to pay for their unexpected congenital heart disease. Live or die?

Please hurry, I have to start the PGE in the delivery room since the sats aren't so good. I don't have time to investigate the family background to understand why the parents are "self-pay."

I wouldn't, no other industry elects to self-immolate. Look at fuel, people need fuel, if you don't pay the oil company even in winter they cut you off. It's a business decision, medicine is a business.

 

[FlowRate]

The right vs. privilege argument is a false dichotomy. Maggie Mahar has articulated at least one alternative viewpoint that I find personally appealing.



There is a much better explanation:

Moral obligation is an interesting way of phrasing things. At the same time, they also label healthcare an "entitlement"--don't even get me started on the ridiculousness of the American entitlement complex... holy freakin cow.

So the dichotomy of the language may or may not be false; I would argue that "moral obligation" is a convincing way to sugarcoat "entitlement" which is really almost synonymous in its use to "right."

Anyway. What you posted is both my problem with GOVERNMENT and with healthcare "INSURANCE" both. It's not true insurance and all it does is add middlemen to the mix. I don't understand how it's possible for anyone to claim that removing insurance companies and government from everyday care would make healthcare more accessible. Or, I'll be more precise: if primary care was devoid of healthcare insurance--if people paid out of pocket for their PCP--do you really think that it would be more expensive?

What we are talking about with healthcare "insurance" is similarly a misnomer. As I pointed out earlier in this thread, it is actually group subsidized and mediated healthcare bargaining. Insurance, in concept, should be a wager against an unlikely event. I feel like (I don't know this as fact) most people with Priv. HC Ins. see their PCP several times a year--I know my family does.

Beyond the influence of outside companies/corporations/governments/whathaveyou forcing physicians to do extra paperwork to get paid, you run into the problem that, yeah, maybe the "industrialized world" does have a "moral obligation" to pay for everyone's healthcare in a nation--that's dandy--however, this runs into the core issue of political ideology and economic feasibility.

How do you pay for this? Well obviously through taxes. Everyone hates taxes. Taxes are an outside body saying "you live here, thus you must pay." But in the modern world, it's impossible to move away from taxes. Some may indeed be necessary, but it's a proven-non-fallacious, slippery-slope: government keeps spending more than it earns and wanting more taxes. So the people who are fine with paying 50%+ of their income in taxes are cool with universal healthcare, but people who aren't get screwed.

I dunno, I feel like I could keep talking about this, I don't think it's a ramble; this problem is complex in its language and its different viewpoints. I believe that most intelligent people should understand these problems so it's really not worth my reiteration further. So

tl;dr. different people have different fundamental viewpoints (some consistent, some not) and that is why "universal" healthcare in whatever form is so hotly contested in this country; Europe is obviously either more homogeneous or more oppressed.

 

[RadioCure]

Holy moly has this thread been a trip so far. I would absolutely love to know the socioeconomic backgrounds of a lot of the posters in here; something tells me it would give a lot of clarity to how they've formed their opinions.

I'm curious to know how those who view healthcare as a privilege justify our tax dollars being used for roads, fire, police, and other services that ensure a basic social safety net. Should these services simply be available to only those who can afford it? If so, why?

These types of services are not made available to people in the same way that socialized medicine is. Even with welfare people are given small amounts of money in order to get by, but in socialized medicine, everyone pretty much has the same unlimited treatment.

If you are to have anything but anarchy, a justice system (including a police force) is necessary to enforce laws and uphold the government. This is also why it's reasonable to provide defendants with an attorney. The police force is not something that you have the "right" to whenever it pleases you. You can't call up the police and have them be your personal bodyguard, for example. Police make themselves present when a crime has been committed or there is reasonable suspicion that a crime may be committed.

The large majority of fire departments in the US (around 75%) are volunteer-based, and almost all departments are funded both privately and by small government organizations like cities or towns. If your municipality wants to start a socialized healthcare program, be my guest.

Roads pose an interesting question because you start to deal with property and zoning issues. At some point, government intervention is probably necessary, but not necessarily on the funding side. I don't know how road construction is in your state, but PennDOT is one of the slowest, most wasteful, and most ineffective organizations imaginable. With technology the way it is today, I imagine we could do better with private road construction (probably responsibly zoned by the government) and charge people electronically on some basis like per year or per mile. Why should someone who walks everywhere have to pay for your roads?

What makes those with money inherently more deserving of health care or other basic-needs services than those without? Does the child of rich parents somehow deserve medical treatment more than one who has poor parents?

It has nothing to do with "deserving" and everything to do with ability to justify. Healthcare requires resources and manpower to provide. Nobody "deserves" anyone else's time, effort, or money. If you have something to trade for healthcare and other services, you can use it to justify others giving those services to you.

 

[FlowRate]

I would like to make one other point, separated from my previous post because it's a rather different topic:

One must admit that libertarian ideology is resolutely logical and consistent. I would simply like to add that libertarians are NOT against charity and most believe that charity will increase with increased economic freedoms.

 

[chman]

I wouldn't, no other industry elects to self-immolate. Look at fuel, people need fuel, if you don't pay the oil company even in winter they cut you off. It's a business decision, medicine is a business.

The need for life saving procedures and medication is nothing like the need for fuel. Please, this is a ludicrous argument.

 

[FutureCTDoc]

I would like to make one other point, separated from my previous post because it's a rather different topic:

One must admit that libertarian ideology is resolutely logical and consistent. I would simply like to add that libertarians are NOT against charity and most believe that charity will increase with increased economic freedoms.

I support charity with both money and time, I do it because I receive a benefit, I derive pleasure from supporting good causes. If I'm pressured by the government, and by pressured I mean taxed, I don't care how great the cause, I object on a matter of a principle. The ideal government is the nightwatchman state as was put forth by the preeminent libertarian philosopher Robert Nozick. Beyond police, fire, a military and a judiciary it's impossible to justify more government.

 

[FutureCTDoc]

The need for life saving procedures and medication is nothing like the need for fuel. Please, this is a ludicrous argument.

Why not, if you live in somewhere cold i.e. New England, the upper Midwest, this is a huge issue. If you can't heat your home you can quite honestly suffer hypothermia and die. Do people have a right to that fuel?

 

[sustentacular]

This really is a policy issue, I work hard for what I earn and I don't feel some burning desire to support others. I'm a devotee of Rand say about her what you will, however I think she is right in that is inappropriate to be forced to provide support for others.

You work hard for what you've earned? Seeing as you won't be getting a bachelors until 2013 I have no doubt you're on your parent's insurance still. If you weren't the child of a physician from Connecticut you might have a different perspective on life, maybe a perspective that included the ability to empathize with those less fortunate than you.

 

[chman]

I would like to make one other point, separated from my previous post because it's a rather different topic:

One must admit that libertarian ideology is resolutely logical and consistent. I would simply like to add that libertarians are NOT against charity and most believe that charity will increase with increased economic freedoms.

I respect Ron Paul quite a bit (just as an example of libertarian philosophy). I really agree with his foreign policies. However, I think that a lot of you guys live in a make believe world where the free market will save everything. There are a multitude of examples that point otherwise. In a perfect world there would not be people who need social programs of any kind, but here in the real world they are necessary in many cases. Efficient and not in need of improvement? Not at all. Many of them are in great need of improvement. Others have been used as scare tactics; such as social security, which has a sizable surplus. Whether we like it or not we need taxes to pay for roads, security, etc.

 

[FutureCTDoc]

You work hard for what you've earned? Seeing as you won't be getting a bachelors until 2013 I have no doubt you're on your parent's insurance still. If you weren't the child of a physician from Connecticut you might have a different perspective on life, maybe a perspective that included the ability to empathize with those less fortunate than you.

I work during summers and during school. My background doesn't preclude me from holding an opinion. Nice ad hominem attack. It's not a lack of empathy, it's that I have no moral obligation to them. "I swear, by my life and my love for it, that I will never live for the sake of another man, nor ask another man to live for mine." This is my credo. I ask no more of anyone than I expect out of myself. I'm not giving them anything for free nor am I asking for anything free in return.

 

[sustentacular]

Why not, if you live in somewhere cold i.e. New England, the upper Midwest, this is a huge issue. If you can't heat your home you can quite honestly suffer hypothermia and die. Do people have a right to that fuel?

Actually there are a number of home heating assistance programs for people who cannot afford to pay for heat/electricity in the winter. Depending on who lives in your house it may even be illegal to shut off electricity in the winter for non-payment.

 

[RadioCure]

I respect Ron Paul quite a bit (just as an example of libertarian philosophy). I really agree with his foreign policies. However, I think that a lot of you guys live in a make believe world where the free market will save everything. There are a multitude of examples that point otherwise. In a perfect world there would not be people who need social programs of any kind, but here in the real world they are necessary in many cases. Efficient and not in need of improvement? Not at all. Many of them are in great need of improvement. Others have been used as scare tactics; such as social security, which has a sizable surplus. Whether we like it or not we need taxes to pay for roads, security, etc.

What libertarian thinks there should be no taxes at all? You're confusing libertarianism with anarchy.

 

[FutureCTDoc]

Actually there are a number of home heating assistance programs for people who cannot afford to pay for heat/electricity in the winter. Depending on who lives in your house it may even be illegal to shut off electricity in the winter for non-payment.

You should be allowed to turn off the electricity for non-payment. It's a service and there is an expectation if a good or service is delivered as promised then compensation should be handed over. If someone breaches the agreement then people should be allowed to not follow through on their end.

 

[sustentacular]

How about doing something crazy, something radical. Having a years worth of savings, so that you can deal with the fact you might be laid off?

Quite frankly I'm of the opinion pony up or die.

Old enough to lack empathy for people who elect to self immolate themselves.

My bad. I don't know where I came up with that ridiculous assumption that you might lack empathy... 🙄

 

[chman]

What libertarian thinks there should be no taxes at all? You're confusing libertarianism with anarchy.

Ron Paul has stated this a number of times, along with getting rid of the FBI, IRS, etc.

 

[TFS]

.

 

[FutureCTDoc]

My bad. I don't know where I came up with that ridiculous assumption that you might lack empathy... 🙄

I'm empathetic towards some, however if a person put their foot into the bear trap knowing what would happen I don't empathize with them. I'm sorry that in the real world that not everyone can do well, however it is neither my fault nor my problem.

 

[ILikeDrugs]

I work during summers and during school. My background doesn't preclude me from holding an opinion. Nice ad hominem attack. It's not a lack of empathy, it's that I have no moral obligation to them. "I swear, by my life and my love for it, that I will never live for the sake of another man, nor ask another man to live for mine." This is my credo. I ask no more of anyone than I expect out of myself. I'm not giving them anything for free nor am I asking for anything free in return.

You still live off of mommy and daddy. Mr. Big Man here works a part time 15-hour-a-week job and works during the summer!? *GASP* Don't make me laugh lil boy. Seriously, stfu, kid.

 

[Dr McSexy]

How come the person didn't opt in to COBRA if he/she knew he/she would be without health benefits while between jobs?

 

[DrBowtie]

there's a basic level of human decency involved here.

the oil industry is for-profit. medicine isn't...yet...and do we really want it to go down that road?

Uhhhh....private practice = for profit medicine.

 

[deleted307836]

.

 

[FutureCTDoc]

FutureCTdoc, why do you want to become a physician? You are an advocate of a system of laissez-faire capitalism that puts the right to be compensated above all other considerations -- even the homeless man who just broke his leg, and would therefore be disregarded in your system by virtue of his inability to pay. Do you think private charity will be able to support his and the medical bills of others like him?

Also, it is clear that you do not pay for your own health insurance -- you are fortunate enough to be covered on your parents plan (no, you did not state this but it IS glaringly obvious) yet you spout off on how everyone not lucky enough to be in your position shall, like the homeless man, be disregarded.

So, why do you want to become a physician?

American medicine is the field least conducive to compensation based on market forces. Compensation is driven by insurance, which is driven by medicare rates (the government -- your enemy).

Your views come off incredibly sophomorish given your position. (Oh wait, you're going to be a sophomore!)

BTW, we probably have very similar views in most areas of politics. But if you really think those that can't pay shouldn't be given care in any circumstances save for what charities can provide... it just makes me incredibly interested in learning about your motivations for becoming a doctor.

It's lucrative and my DO is only a stepping stone to healthcare M&A. Is there anything wrong with choosing medicine due to the good compensation?

 

[TFS]

.

 

[DrBowtie]

making a salary is different than having the attitude that people either need to pay up or go die.

Most PP groups don't take set salaries. They split the profit after paying for overhead. Obviously more profit = more money in their pockets.

For profit isn't a dirty word.

 

[justaregularmed]

FutureCTdoc, why do you want to become a physician? You are an advocate of a system of laissez-faire capitalism that puts the right to be compensated above all other considerations -- even the homeless man who just broke his leg, and would therefore be disregarded in your system by virtue of his inability to pay. Do you think private charity will be able to support his and the medical bills of others like him?

Also, it is clear that you do not pay for your own health insurance -- you are fortunate enough to be covered on your parents plan (no, you did not state this but it IS glaringly obvious) yet you spout off on how everyone not lucky enough to be in your position shall, like the homeless man, be disregarded.

So, why do you want to become a physician?

American medicine is the field least conducive to compensation based on market forces. Compensation is driven by insurance, which is driven by medicare rates (the government -- your enemy).

Your views come off incredibly sophomorish given your position. (Oh wait, you're going to be a sophomore!)

BTW, we probably have very similar views in most areas of politics. But if you really think those that can't pay shouldn't be given care in any circumstances save for what charities can provide... it just makes me incredibly interested in learning about your motivations for becoming a doctor.

Actually his views really more come of as not yet brainwashed by the liberal education machine to be totally honest with you, give him a few years see if he breaks.

 

[chman]

It's lucrative and my DO is only a stepping stone to healthcare M&A. Is there anything wrong with choosing medicine due to the good compensation?

Many would say yes...and those would be reasons other than you might be sourly disappointed.

 

[justaregularmed]

Many would say yes...and those would be reasons other than you might be sourly disappointed.

Oh boy I love this. Please if you are not in it for the money (not in the slightest, not even on your radar) you should sign a contract that requires you to work for the VA. I was bored I saw a job posting for a full time CT surgeon, salary 94-124k(lower number is right the upper number may be a tad higher).

For those who don't know thats 4+5+2or3 OR 4+6(if you don't mind not being BE for GS).

If you didn't pay any interest your loans would be >350k by the time you ended your training. (assuming fed rates @ 160k debt)

You Enjoy that.

 

[deleted307836]

.

 

[FlowRate]

I respect Ron Paul quite a bit (just as an example of libertarian philosophy). I really agree with his foreign policies. However, I think that a lot of you guys live in a make believe world where the free market will save everything. There are a multitude of examples that point otherwise. In a perfect world there would not be people who need social programs of any kind, but here in the real world they are necessary in many cases. Efficient and not in need of improvement? Not at all. Many of them are in great need of improvement. Others have been used as scare tactics; such as social security, which has a sizable surplus. Whether we like it or not we need taxes to pay for roads, security, etc.

What libertarian thinks there should be no taxes at all? You're confusing libertarianism with anarchy.

Pretty much this. The world of libertarianism is just as varied as any other part of the political spectrum. The line I usually draw is between "libertarians" and "libertarian-anarchists", which is a hard line to draw. I've never been an extremist of any party; I believe that the government is too overreaching right now.

 

[chman]

Oh boy I love this. Please if you are not in it for the money you should sign a contract that requires you to work for the VA. I was bored I saw a job posting for a full time CT surgeon, salary 94-124k.

You Enjoy that.

There is nothing wrong with making money, but it should certainly not be the only reason for wanting to become a doctor. That will just work out poorly all around.

 

[DrBowtie]

It's lucrative and my DO is only a stepping stone to healthcare M&A. Is there anything wrong with choosing medicine due to the good compensation?

Better couple that with a high powered MBA. Wall street will LOLz at your NSU DO degree.

 

[chman]

Pretty much this. The world of libertarianism is just as varied as any other part of the political spectrum. The line I usually draw is between "libertarians" and "libertarian-anarchists", which is a hard line to draw. I've never been an extremist of any party; I believe that the government is too overreaching right now.

Fair enough, and I can actually certainly agree on that. The first amendment, and especially the fourth amendment has gone in the toilet. I will try to look it up, but if I remember correctly there is a new addition to homeland security that takes up multiple football fields and is for the purpose of intercepting and storing citizen communication. The military industrial complex is far reaching, and far bigger problem than social programs if you ask me, which I'm sure you are.

 

[VicodinMan]

The right vs. privilege argument is a false dichotomy. Maggie Mahar has articulated at least one alternative viewpoint that I find personally appealing.

Interesting article, but it seems to be a lot of cut and pasted stuff from Rand without properly reasoning out her logic, which is already contradictory to begin with. But I'll go through it anyways.

Rand considers the "right to life" to be the ability to enjoy one's life without outside interference (I can provide citations to where she says this upon request). However, rights violations always occur in the real world. We are constantly infringed upon by our government and individuals around us. The only way we can resolve these violations in a reasonable and uncomplicated amount of time is by evaluating the intensity of their impact, since some violations are less harmful than others (ie. Paying your taxes vs being killed by terrorists). Therefore, it seems logical that the violation of one's life through death from lack of healthcare outweighs the violation of having to pay more in taxes. Besides, Rand's doomsday scenarios are empirically false. Have we seen the end of human society simply because of Medicare and Social Security?

This should counter Meher, Rand, and hopefully anybody else who tries to quote Rand in this thread.

 

[VicodinMan]

I support charity with both money and time, I do it because I receive a benefit, I derive pleasure from supporting good causes. If I'm pressured by the government, and by pressured I mean taxed, I don't care how great the cause, I object on a matter of a principle. The ideal government is the nightwatchman state as was put forth by the preeminent libertarian philosopher Robert Nozick. Beyond police, fire, a military and a judiciary it's impossible to justify more government.

You say Nozick, I say Rawls. Btw, I haven't read Nozick but what's his justification for having a police, fire, military, and independent judiciary?

 

[smq123]

hemotology....suspect.

Meh, I've seen worse spelling mistakes at big-name university centers. <shrug>

Quite frankly I'm of the opinion pony up or die. I don't believe there is a right to healthcare. I also believe the US spends way too much on chemo for terminal onc patients. Insurers shouldn't have to pay for life extending but non-lifesaving treatments. As to CT surg most of that is brought on by a lifetime of poor decisions, most healthy, svelte people don't need quadruple bypasses.

* It is easy enough to say "pony up or die" when you're a relatively healthy 22 year old with wealthy parents. It is harder when you are a 22 year old with no family support trying to make ends meet.

* There may not be a right to healthcare, but there IS a responsibility to take care of your citizens. A ruptured appy, unlike the other examples that you cited, is not affected by lifestyle. (The last person I saw with a ruptured appy was an 8 year old girl!) Not all medical problems are caused by lifestyle choices - just the ones that you hear people complain about the most. I have a number of patients who, despite doing EVERYTHING right, still have unfortunate diseases - the 50 year old LIFELONG NONSMOKER who had lung cancer. The 3 year old with congenital heart defects. The 70 year old lifelong exercise fanatic who now has aortic stenosis and needs a valve replacement. The 45 year old kindergarten teacher with metastatic liver cancer. These people...they didn't "deserve" their diseases. So we should just let them die?

* Whether the US pays too much for terminal onc patients is another story. But what you are forgetting (or are ignorant of) is that the primary rule in medical ethics is recognition of the fact that mentally competent patients CAN decide their own treatment. If a patient says, "Do everything," it would be unethical to deny them that. As a provider, if you're not comfortable doing that, well, then you have to refer them to someone else. But you can't just say, "no, we don't do that" and shut them down.

If you're not comfortable with that aspect of medical ethics, and don't plan on even practicing, then why become a doctor? Do something that requires less schooling and allows you to be as capitalistic as you feel like.

I'm not a surgical resident or attending, but in this case, for an acute case... I don't believe you'd be doing a laproscopic procedure. It would probably be open so the abdomen can be flushed, etc. I don't think there is time for ports to be placed.

Anyone care to comment/correct?

Yes, most ruptured appys are done open. Not because there isn't enough "time for ports to be placed," but with that kind of infection/peritonitis, it should be done open.

Some ruptured appys that I have seen have gone to IR for drainage, allow things in the belly to settle down, and then go to the OR some time later to remove the appendix.

 

[FlowRate]

Fair enough, and I can actually certainly agree on that. The first amendment, and especially the fourth amendment has gone in the toilet. I will try to look it up, but if I remember correctly there is a new addition to homeland security that takes up multiple football fields and is for the purpose of intercepting and storing citizen communication. The military industrial complex is far reaching, and far bigger problem than social programs if you ask me, which I'm sure you are.

You're preaching to the choir. American corporatism etc. is scary.

 

[FutureCTDoc]

Better couple that with a high powered MBA. Wall street will LOLz at your NSU DO degree.

Already am interning at a well known boutique M&A firm. Also my family friend is a Managing director at BarCap. I'm already in with offers.

 

[FutureCTDoc]

You say Nozick, I say Rawls. Btw, I haven't read Nozick but what's his justification for having a police, fire, military, and independent judiciary?

A brief summary of Anarchy, State and Utopia. http://en.wikipedia.org/wiki/Anarchy,_State,_and_Utopia

 

[morning]

This really is a policy issue, I work hard for what I earn and I don't feel some burning desire to support others. I'm a devotee of Rand say about her what you will, however I think she is right in that is inappropriate to be forced to provide support for others.

Whether health care is A RIGHT is not really relevant to the discussion. Obviously we all lose if people are getting sick and dying with no recourse.

Why have police and fire departments if we have no right to life? That's something I don't understand. Those things cost money. If we don't care who lives and who dies, why bother? Why provide a public defender in a trial if a person is that unimportant, and we have no right to a civil existence?

Maybe we SHOULD transition to a system where everyone pays cash for every service they use, and taxes only go to support our military endeavors and whatever else is deemed necessary for the basic functioning of the country. When people get old, they either keep working to pay for their living costs, or they die. No more federal student aid. No more grants, Stafford loans or Grad PLUS loans. No more in-state college tuition. You get a nice big bill when the firefighters come to put out a fire (which, of course, will cause people to try to put out fires themselves, delaying the fated call until it's too late to save anything...), or when the police arrive after a bump in the night. If someone was murdered or raped, well, hopefully you have a lot of money to pay for the investigation and the prosecutors. After all, there's no cost to society if thieves, murderers, and rapists run free, any more than there's a cost to society when people are injured and killed by diseases they couldn't pay to treat. If it happens down the line, well, we can pretend it doesn't happen!

Everyone has access to the emergency room. Of course, you still get billed, so it's not as if it's free (nor would it be free if we were all TAXED for it...) They just have to treat you. Then you'll start receiving the bills you can't pay, making it impossible for you to participate in the economy in any other way. Essentially, you're unemployed, because you have no purchasing power and all your money is spoken for. Or maybe you're just too sick to work, period, and then you really are unemployed. If you don't understand that foreclosures, repossessions, and less money flowing into local businesses hurts the economy, I don't know what to say to you. Visit Michigan?

Or maybe you'll just die, and cost everyone money anyway - from your unfulfilled car loan, your mortgage, your unpaid student loans, your children now left in the public system. Your job will have to train someone new.

 

[FutureCTDoc]

Whether health care is A RIGHT is not really relevant to the discussion. Obviously we all lose if people are getting sick and dying with no recourse.

Why have police and fire departments if we have no right to life? That's something I don't understand. Those things cost money. If we don't care who lives and who dies, why bother? Why provide a public defender in a trial if a person is that unimportant, and we have no right to a civil existence?

Maybe we SHOULD transition to a system where everyone pays cash for every service they use, and taxes only go to support our military endeavors and whatever else is deemed necessary for the basic functioning of the country. When people get old, they either keep working to pay for their living costs, or they die. No more federal student aid. No more grants, Stafford loans or Grad PLUS loans. No more in-state college tuition. You get a nice big bill when the firefighters come to put out a fire (which, of course, will cause people to try to put out fires themselves, delaying the fated call until it's too late to save anything...), or when the police arrive after a bump in the night. If someone was murdered or raped, well, hopefully you have a lot of money to pay for the investigation and your lawyer. After all, there's no cost to society if thieves, murderers, and rapists run free, any more than there's a cost to society when people are injured and killed by diseases they couldn't pay to treat. If it happens down the line, well, we can pretend it doesn't happen!

Everyone has access to the emergency room. Of course, you still get billed, so it's not as if it's free (nor would it be free if we were all TAXED for it...) They just have to treat you. Then you'll start receiving the bills you can't pay, making it impossible for you to participate in the economy in any other way. Essentially, you're unemployed, because you have no purchasing power and all your money is spoken for. Or maybe you're just too sick to work, period, and then you really are unemployed. If you don't understand that foreclosures, repossessions, and less money flowing into local businesses hurts the economy, I don't know what to say to you. Visit Michigan?

Or maybe you'll just die, and cost everyone money anyway - from your unfulfilled car loan, your mortgage, your unpaid student loans, your children now left in the public system. Your job will have to train someone new.

The minimum needed for a state to exist is a military, police and judiciary. Grants are generally provided with the exception of Pell grants are funded by private universities. I oppose Medicare/Medicaid as well as social security. I plan to save for retirement, as I expect neither Medicare/Medicaid or social security to exist. The government shouldn't subsidize student loans and don't get me started on the issue of public schools. I didn't attend them and if I have kids neither will they.

 

[morning]

The minimum needed for a state to exist is a military, police and judiciary. Grants are generally provided with the exception of Pell grants are funded by private universities. I oppose Medicare/Medicaid as well as social security. I plan to save for retirement, as I expect neither Medicare/Medicaid or social security to exist. The government shouldn't subsidize student loans and don't get me started on the issue of public schools.

No firefighters?

WHY the police and judiciary? What is the difference, in your mind, between someone dying because the police refused to show up and someone dying because the hospital refused to admit them? Between someone dying because they couldn't receive chemo, and dying because 911 brushed off their call? I'm curious what the differences here are. Why do we have a right to be protected from criminals, because our lives are sacred when it comes to crime, but not a right to be treated for diseases? (No one ever fell victim to and helped increase the impact of any epidemics because they weren't treated for disease, right? I mean, HIV isn't THAT serious...no mothers were transmitting it to their babies or anything...)

Why should we allow public defenders? Certainly many defendants in criminal trials are there because of extreme stupidity and poor decisions, the very thing you think we should allow people to die for.

How much do you plan on saving? Do you think you'll have roughly 30k a year for 20 or so years, and then 75k if your appendix ruptures, and then 400k if you get cancer, and then another 400k if it comes back? What if you need a hip replacement? Dental implants? What if your kidneys fail? Do you have ~6000 a week for dialysis?

I didn't attend them and if I have kids neither will they.

I can tell.

 

[298609]

omg guys awesome

 

[Janieve]

You know, at this point the most constructive thing I can say is:

 

[NickNaylor]

blah blah blah

I'm not even going to bother responding to your post, because you're simply badgering me to explain things that are really quite simple. When did I say, or even infer, that increased government expenditures and thus increased demand would lead to higher prices? That doesn't even make sense, and if you actually read my post you would see where I was going.

Sorry, I'm not going to hold your hand and walk you through my points.

 

[deleted307836]

.

 

[equios]

Arguments with pampered 19-year-old know-it-all's are always amusing. If you ask me, I think it ought to be mandatory that someone takes several years off after undergrad and work before they go to MD school, just as most MBA programs require. You at least have lived long enough to know what's what in life.

Its one of those things that, while you're under your parent's wings, life always seems nice, fluffy and dandy. When you finally move out from under that shelter, the cold bleak reality is a bitter wake-up call.

FutureCTDoc: So, why are you throwing more than a decade of your life away for a DO when you can get a MBA+MPH and be done in about 3 years, and go on to do what you say you want to do? Why are you looking to take on over $350k of debt when you can make $350k+ in your first year right out of JD or an MBA program? Are you prepared to slog through residency working 50-100 hour weeks for 4+ years for about $50k a year? For that matter, have you ever even worked more than 40 hours in a week? My current job easily reaches 70 hours a week. Are you prepared to have NO leisure (or even personal) time for almost a decade of your life?

 

[VicodinMan]

When did I say, or even infer, that increased government expenditures and thus increased demand would lead to higher prices? That doesn't even make sense, and if you actually read my post you would see where I was going.

My mistake. So what you were trying to say was that Medicare has no incentive to improve because it has unlimited funds?

I'm not even going to bother responding to your post, because you're simply badgering me to explain things that are really quite simple.

Sorry, I'm not going to hold your hand and walk you through my points.

Ok. I'll just pretend in the meantime that what you actually didn't run away from this argument. I don't blame you. Rebuttals and counter-arguments are so passe nowadays. I mean, why bother arguing when you call your opponent stupid.

 

[FutureCTDoc]

Arguments with pampered 19-year-old know-it-all's are always amusing. If you ask me, I think it ought to be mandatory that someone takes several years off after undergrad and work before they go to MD school, just as most MBA programs require. You at least have lived long enough to know what's what in life.

Its one of those things that, while you're under your parent's wings, life always seems nice, fluffy and dandy. When you finally move out from under that shelter, the cold bleak reality is a bitter wake-up call.

FutureCTDoc: So, why are you throwing more than a decade of your life away for a DO when you can get a MBA+MPH and be done in about 3 years, and go on to do what you say you want to do? Why are you looking to take on over $350k of debt when you can make $350k+ in your first year right out of JD or an MBA program? Are you prepared to slog through residency working 50-100 hour weeks for 4+ years for about $50k a year? For that matter, have you ever even worked more than 40 hours in a week? My current job easily reaches 70 hours a week. Are you prepared to have NO leisure (or even personal) time for almost a decade of your life?

I feel that doing an analyst program and then going to medical school and completing an internship and potentially residency, offers better career options. I will have zero debt and the reality is that investment banking has worse hours than residency, the average is between 80 and 110 hours a week. You will not make 350 out of a JD, even the best firms offer 160 plus a small bonus, perhaps with some luck and an MBA you might, that being the exception rather than the rule.

 

[RadioCure]

Ron Paul has stated this a number of times, along with getting rid of the FBI, IRS, etc.

No, he is for no income tax. Big difference from no taxes at all. You can't have a government without taxes, silly goose.