Dying in the Safety Net.

[Mr Avante]

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At what income level for each region do you draw a line between having enough money with poor financial management and vice versa? How does one know that better money management is more needed than more cash flow? How do we know that our "spending money responsibly" is better than their "spending money responsibly?" The poor knows they have less money to work with, and I think their financial decisions are simply as good (and bad) as ours.

I understand your point, however. Even some doctors often don't know how to manage financially. But in the context of the poor, I am not sure how much their lives will improve simply by managing their money better. How much money do we need to invest in order to educate them on this? How much return will we have if we spend the same amount of money by simply distributing them to each household? Even if we can make them spend money on whatever we want them to, how do we guarantee that their quality of life and life satisfaction will improve? An interesting area to investigate, but this has to be done after understanding why certain people spend their money in a certain way. The book, "Poor Economics," discusses this aspect, and you might find this book very intriguing.





Do you know any unbiased, non-liberal sources you recommend?

I have to agree with you that just because something does not cost much, it does not mean that it is not important. Although litigation costs are not a large pie of healthcare costs, malpractice reform has influences beyond the cost management. Dr. Gawande's "Better" has a chapter about this, and the current malpractice system is so inefficient that it also heavily affects physicians' satisfaction in their practices, among many other areas. It is lucky if they did not lose their licenses. However, when for-profit corporations get sued, they can pay billions of dollars for their penalty, because they can easily recover that cost in a month and keep doing whatever they were doing without ever apologizing to anyone. The negative effect of this inefficient litigation system is much greater on physicians than on institutions.




I can see that hospitals would use that model as another layer of control, taking away more autonomy from physicians. So the people who don't understand medicine (hospital administrations) enact such payment model (as suggested by PPACA) simply in order to maximize the reimbursement rates? Insurance companies work on the other side in order to minimize the reimbursements and maximize the amount of money that they can keep? And physicians are in between dealing with both worlds?

Is there any positive change that we can expect from this current PPACA? It sounds like things will get worse for physicians.





The implementation will be nearly impossible.

As I said before, many presidents advocated universal healthcare for nearly 100 years. It took this long to get to PPACA and Medicare/Medicaid. Republicans will lose a large chunk of middle-class families' supports to Democrats, private insurance companies will heavily lobby against that universal healthcare notion even before being brought up for the potential agenda, and raising tax rates will be a concern (although some people would rather pay much higher taxes if they don't have to pay premiums). Our ideals have almost zero power in the eyes of politicians and corporations.





What would you suggest to change the system as a whole? Who are major participants within political and social movements?





Dr. Gawande's "Better" will be something you might find interesting to read.

Our current legal system is very inefficient, time-consuming, emotionally exhausting, and costly for medical cases. If there is even a formal/informal appealing process, prior to lawsuits, that patients don't necessarily need to find lawyers to understand what happened and why something happened, we can still preserve that protection of patient rights without always relying on courts. But realistically, I am not sure if any malpractice reform will take place anytime soon.

I read your doctoral thesis two weeks ago - Very impressive.

 

[Lya]

I read your doctoral thesis two weeks ago - Very impressive.

I don't have PhD, at least not yet. Only sources I mentioned here are 3 NYT articles and 2 nonfiction books, so not a big deal at all. =P

 

[Mr Avante]

I don't have PhD, at least not yet. Only sources I mentioned here are 3 NYT articles and 2 nonfiction books, so not a big deal at all. =P

hehe

 

[ruralsurg4now]

I have to agree with you that just because something does not cost much, it does not mean that it is not important.

But it does cost a lot. Even if you accept her numbers, it's $145 billion. It doesn't matter if you say "well, as a percentage of the total, that's ..." Hey, it's $145 billion. It's like Everett Dirksen said about government spending, "a billion here, a billion there, pretty soon you're talking about real money." It's amazing how people argue "cutting that would only save $5 million." Are you kidding me? Really, are you kidding me? No wonder we're flat broke and keep spending money.

Although litigation costs are not a large pie of healthcare costs, malpractice reform has influences beyond the cost management.

But they are. As I said, if we want to pretend that they're not, then why not just ban lawsuits? After all, we apparently never have any lawsuits and nobody ever collects, or so the argument goes. So let's do it. See how I take everyone's word for it?

I can see that hospitals would use that model as another layer of control, taking away more autonomy from physicians. So the people who don't understand medicine (hospital administrations) enact such payment model (as suggested by PPACA) simply in order to maximize the reimbursement rates? Insurance companies work on the other side in order to minimize the reimbursements and maximize the amount of money that they can keep? And physicians are in between dealing with both worlds?

It's not hospitals. They're just following the regulations. It's the government because those are Medicare requirements. Insurance companies follow their lead.

 

[Lya]

hehe

I know. I was playing along, pal.

 

[SunsFun]

No, it's not an absolutist approach. It's a reasoned one. If you care about the poor, then the liberal approach is to simply make other people pay for them. It's the same with literally every issue: "I care, so you will pay." If you're an environmentalist, then why shouldn't you move into the woods? You mean I have to listen to some guy blabber at me about fossil fuels while they're driving a car, using electricity, and living in a large house? Why?

I don't think you quite grasp the idea of liberalism. It's not about making hardworking people pay for lazy ones. This is a myth. My personal liberal philosophy steams from a desire for justice, equality, and giving fair chance to everyone regardless of circumstances they were born in. Since you picked up environmentalism here, I will run with it an example.

The concept revolve around recognizing that environment consists of finite resources which are by their nature a public good. No single person has any more rights to it and is entitled to more than any other person. This includes people in other countries as well as maintenance and sustainability to maintain carrying capacity as a form of justice to our future generations. This not only includes fair distribution of the benefits but also costs. Climate change looks much scarier to someone living in Maldives relative to Arkansas. I cannot come up with an ethical explanation to why the average American consumes 50 times more of this resource than people in some African country while someone else is paying the higher price for overconsumption. Does pure luck of being born to one circumstance over another justify some children dying from hunger due to drought while others having anything they've ever wanted and more? From this standpoint nobody is taking something that is truly yours since you don't own the entire planet or more of it than any other person.

The problem with your ideology is that you want this unfair situation to continue while suggesting that someone with similar privileges as you give those up to provide some temporary relief. Individuals and small organizations cannot change the nature of inequality without meaningful policy changes that modify the entire system. Human beings due to their instincts on average will maximize their personal resources and several of us going against this principle will not solve the problem long-term. Therefore I am using my position to influence political climate to create a world that is a little bit more fair to everyone.

I have to listen to someone talk about the need for universal healthcare and lecture me about my salary while they avoid the inner cities or the rural areas? Why?

Because (although you don't believe it) your high salary is direct result of over-regulation. You benefit from a set of policy decisions that have left the rest of the country with an enormous bill to pay and a lack of affordable care for millions of people. You don't have to listen to anybody though. You just have to abide by the law which some of us are trying to change to improve the overall outcomes for people while bringing the costs down. Democracy is a political system we use so the elected government (in theory) should represent every single one of us and look out for the most optimal outcome to everyone not just providers and insurance companies. Compromises have to be made. Looking at personal choices of other a is again irrelevant since we care about policy. Diverting attention to people who care and making the case that charity care will solve all out problems let us nowhere. Tried that since Reagan and things have gotten only worse.

No, that's not absolutism. It's an expectation that you put your money where your mouth is. Emphasis on YOUR money. It's why liberalism is so cowardly. One just cares and make fantastic posts and then someone else has to suffer for their caring. Instead of actually helping the poor, they just lap up stories about someone who does and that makes them great people. Nope. It makes them pathetic.

How is voting or taking other political action that can cause much lesser future financial and other material gain not putting your money where your mouth is?

Going back to environmentalism. Our current set up makes decent living without utilities too costly and virtually impossible for most people since we grew up having those things and do not have survival skills to make it in the wild. Also, one person making that effort will be much more futile task that will result in much less environmental benefit than pushing your local community to adopt more efficient transportation options, house developments, and ( in some cases) alternative energy. It is just a smarted, more reasoned option. You can call me a hypocrite for believing in it though. Doesn't bother me at all.

 

[Lya]

But it does cost a lot. Even if you accept her numbers, it's $145 billion. It doesn't matter if you say "well, as a percentage of the total, that's ..." Hey, it's $145 billion. It's like Everett Dirksen said about government spending, "a billion here, a billion there, pretty soon you're talking about real money." It's amazing how people argue "cutting that would only save $5 million." Are you kidding me? Really, are you kidding me? No wonder we're flat broke and keep spending money.

But they are. As I said, if we want to pretend that they're not, then why not just ban lawsuits? After all, we apparently never have any lawsuits and nobody ever collects, or so the argument goes. So let's do it. See how I take everyone's word for it?

It's not hospitals. They're just following the regulations. It's the government because those are Medicare requirements. Insurance companies follow their lead.

That's very true as well.

Some scholars like Dr. Emanuel (Edit: It could have been Dr. Fineberg, I don't remember exactly) would argue that we instead need to address the growth rate of our national spending, rather than cutting that $145 billion drastically, because the total national spending of ~$2.8 trillion will not decrease, realistically speaking, so the only manageable number we can cut is the rate of increase. Would you agree with that?

But what if those Medicare requirements and other regulations are there in order to reduce the number of frauds? With less regulations, Medicare fraud might be more prevalent. Or am I missing something? With the high level of lobbying from healthcare companies in the government, aren't Medicare requirements in part shaped by insurance companies and hospitals' motives as well?

 

[Starry]

Implementation may be difficult, but not impossible. I believe it's all about aligning interests and incentives. People will always make selfish choices (which isn't a bad thing) and corporations are run by people too. At the rate our society is changing, I even dare to say that our health system will be very different 10 years from now.

I did have a thought a few days ago that was striking to me (who knows if it really is or not, maybe it's common sense!) but it may be appropriate to share in this thread. Hospital administrators are responsible for the interest of the hospital. Physicians are responsible for the interest of the patient. Before, I had thought that the interest of the hospital and patients coincide. But I suddenly realized that this may often not be the case. Which is where physicians and administrators may conflict. For some reason this was a revelation to me.

And now I'm realizing the breadth of stakeholders in the healthcare system and can see how it is incredibly daunting. I wish I could become involved in this type of research, if there is even research that seeks to answer these questions.

Thanks for the reading recommendation, Lya. I'll see if I can find that book at my university library 🙂

 

[Lya]

Implementation may be difficult, but not impossible. I believe it's all about aligning interests and incentives. People will always make selfish choices (which isn't a bad thing) and corporations are run by people too. At the rate our society is changing, I even dare to say that our health system will be very different 10 years from now.

I did have a thought a few days ago that was striking to me (who knows if it really is or not, maybe it's common sense!) but it may be appropriate to share in this thread. Hospital administrators are responsible for the interest of the hospital. Physicians are responsible for the interest of the patient. Before, I had thought that the interest of the hospital and patients coincide. But I suddenly realized that this may often not be the case. Which is where physicians and administrators may conflict. For some reason this was a revelation to me.

And now I'm realizing the breadth of stakeholders in the healthcare system and can see how it is incredibly daunting. I wish I could become involved in this type of research, if there is even research that seeks to answer these questions.

Thanks for the reading recommendation, Lya. I'll see if I can find that book at my university library 🙂

According to the thread I mentioned, NickNaylor also agrees with you that those competing interests are not mutually exclusive.

I've read somewhere that all of these new changes like incentives to find cheap, cost-effective approaches are all directly benefiting hospitals and corporations, while patients are simply indirect, unintended beneficiaries. http://www.nytimes.com/2013/11/03/m...-wants-you-to-get-rich-on-obamacare.html?_r=0

It is very sad, though, that even policies intended for patients result in even more revenues and benefits for corporations, instead of patients.

 

[ruralsurg4now]

I don't think you quite grasp the idea of liberalism. It's not about making hardworking people pay for lazy ones. This is a myth. My personal liberal philosophy steams from a desire for justice, equality, and giving fair chance to everyone regardless of circumstances they were born in.

Yeah, I know. And your idea of "justice and equality" involves making hardworking people pay for lazy ones. The only difference is you make all sorts of excuses for the lazy people, so as to make yourself feel good. Basically, anything you don't like, you just label as "unjust" and use that to rationalize using some government agency that you create to force other people to do what you want. No offense, but I didn't read the rest of your post because it's utterly predictable. I don't need to read it to know that you just label anything free market as "unfair" and say that we need the government to regulate things so that you like it.

 

[ruralsurg4now]

Some scholars like Dr. Emanuel (Edit: It could have been Dr. Fineberg, I don't remember exactly) would argue that we instead need to address the growth rate of our national spending, rather than cutting that $145 billion drastically, because the total national spending of ~$2.8 trillion will not decrease, realistically speaking, so the only manageable number we can cut is the rate of increase. Would you agree with that?

That's silly to say that the total spending won't decrease. The only way we got to our current budget and annual deficit is due to people like SunsFun demanding that government do everything for us and to us. Now we have a ridiculous government with a ridiculous budget and we're broke and they don't really mind or care. Then this guy you're referencing says we can't cut it, only slow the rate of growth. That's silly. We could cut most of the government and you wouldn't know or care.

 

[Womb Raider]

At what income level for each region do you draw a line between having enough money with poor financial management and vice versa? How does one know that better money management is more needed than more cash flow? How do we know that our "spending money responsibly" is better than their "spending money responsibly?" The poor knows they have less money to work with, and I think their financial decisions are simply as good (and bad) as ours.

I understand your point, however. Even some doctors often don't know how to manage financially. But in the context of the poor, I am not sure how much their lives will improve simply by managing their money better. How much money do we need to invest in order to educate them on this? How much return will we have if we spend the same amount of money by simply distributing them to each household? Even if we can make them spend money on whatever we want them to, how do we guarantee that their quality of life and life satisfaction will improve? An interesting area to investigate, but this has to be done after understanding why certain people spend their money in a certain way. The book, "Poor Economics," discusses this aspect, and you might find this book very intriguing.

Appreciate the reading suggestions, I'll have to give them a look.

In a perfect world, people should be able to spend their money however they want. Unfortunately, this will never happen.

My whole thing is... If the government (taxpayers) are going to be paying for your healthcare, you lost your "right" to eat Big Macs 24/7. If you want to treat your body like s***, you need to pay for it, because it's costing someone somewhere lots of money. How about make food stamps only redeemable for a healthy, well-balanced meal, rather than letting the individual choose. If they want twinkies and ding-dongs, then they better start working.

As far as managing money goes... Yes, changing money management alone probably wouldn't solve all the problems (although, I think it would be a great place to start). Back when I went to high school (I went to a VERY "racially diverse" public high school in hick town) I would constantly see young, almost teenage mothers/fathers come drop their kids off in the morning in their Escalade with chrome rims and a killer system - unfortunately, the kid was given $1-2 for a lunch (that's a coke and a bag of chips from the vending machine) and was wearing dirty, tattered clothing. The parents were deliberately choosing to buy flashy new status icons than spending it on things that actually matter. I'm not making this stuff up...

How much do we need to invest to educate them on this? Rather than educate, we take the choice away e.g. making food stamps only redeemable for healthy meals. If they want to experience the infamous freedom associated with America, they need to put in hard work - hard working individuals built this country, not welfare recipients. Education is good, but like I have said before, you can't teach people that aren't willing to learn.

As far as quality of life goes... How does buying new shiny things improve quality of life when your kid is wearing a dirty pillow case to school? Luxuries are called luxuries for a reason. Now I'm not saying that everyone shouldn't have the chance to indulge in SOME form of guilty pleasure, but if you're living in poverty you better not be driving a Mercedes.

Summary: People's priorities are misguided. Is it necessarily their fault? No. Does something need to be done? Yes. Is the answer to keep throwing money at them and perpetuating their misguided priorities? No. Is everyone equal? No. Are people like SunsFun trying to make everyone think that they're equal? Yes. Is this wrong? Yes.

 

[Lya]

Appreciate the reading suggestions, I'll have to give them a look.

In a perfect world, people should be able to spend their money however they want. Unfortunately, this will never happen.

My whole thing is... If the government (taxpayers) are going to be paying for your healthcare, you lost your "right" to eat Big Macs 24/7. If you want to treat your body like s***, you need to pay for it, because it's costing someone somewhere lots of money. How about make food stamps only redeemable for a healthy, well-balanced meal, rather than letting the individual choose. If they want twinkies and ding-dongs, then they better start working.

As far as managing money goes... Yes, changing money management alone probably wouldn't solve all the problems (although, I think it would be a great place to start). Back when I went to high school (I went to a VERY "racially diverse" public high school in hick town) I would constantly see young, almost teenage mothers/fathers come drop their kids off in the morning in their Escalade with chrome rims and a killer system - unfortunately, the kid was given $1-2 for a lunch (that's a coke and a bag of chips from the vending machine) and was wearing dirty, tattered clothing. The parents were deliberately choosing to buy flashy new status icons than spending it on things that actually matter. I'm not making this stuff up...

How much do we need to invest to educate them on this? Rather than educate, we take the choice away e.g. making food stamps only redeemable for healthy meals. If they want to experience the infamous freedom associated with America, they need to put in hard work - hard working individuals built this country, not welfare recipients. Education is good, but like I have said before, you can't teach people that aren't willing to learn.

As far as quality of life goes... How does buying new shiny things improve quality of life when your kid is wearing a dirty pillow case to school? Luxuries are called luxuries for a reason. Now I'm not saying that everyone shouldn't have the chance to indulge in SOME form of guilty pleasure, but if you're living in poverty you better not be driving a Mercedes.

Summary: People's priorities are misguided. Is it necessarily their fault? No. Does something need to be done? Yes. Is the answer to keep throwing money at them and perpetuating their misguided priorities? No. Is everyone equal? No. Are people like SunsFun trying to make everyone think that they're equal? Yes. Is this wrong? Yes.

I see where you are coming from. Thanks for comments.

Here is a recent table made by USDA listing the monthly benefit of food stamps per person for each state. http://www.fns.usda.gov/pd/18SNAPavg$PP.htm When you divide these numbers by 30 days, you have less than $5 per day to spend on food. When we go to grocery stores with less than $5 budget for food each day, what can we really buy in a healthy way?

(Edit:
http://www.cbpp.org/cms/?fa=view&id=3899

Starting this month, it will be less than $2 per person per month, so even $5 I said above is overestimated.)

Let us say we are relying on food stamps for a long period of time like months and years. We can probably make healthy choices for some time, but making those same choices for months and years, like eating frozen broccoli everyday, is very difficult, especially when we have an obligation to feed the family and prevent children from feeling hungry. When we see these children who cannot fall asleep at night, because they are hungry from not eating enough food in general (because fruits and vegetables tend to be more expensive than fast food or even frozen pizza), it is a difficult choice to keep making "healthy" choices. Many poor families have at least one full-time working adult, and paying for monthly rent, school tuition, and healthy meals all at the same time will be worrisome.

I am curious to see why the families you mentioned made such choices. Maybe they wanted to keep the reputation that they need help and are poor? When children have valuable assets, other peers might steal them in school, not because parents don't care about their children? I am not quite sure. Have you asked them why?


Even some middle- and upper-class families make unhealthy choices, while they can certainly invest more money on fruits and vegetables. But since they are using their money, their choices are acceptable, while the same choices by the poor aren't? What do we do, say, if poverty disappears, everyone is paying their own money, and they justify their unhealthy choices at the expense of increasing other people's monthly premiums? In my opinion, I think those "misguided" choices have further consequences beyond taxpayers' money being wasted, and sooner or later we might need to figure out how to shift such choices towards healthy ones. NYT magazine a few weeks ago discussed how to produce effective marketing for broccoli, and this seems to be one of many steps gradually towards that shift. We'll see.

 

[ruralsurg4now]

When you divide these numbers by 30 days, you have less than $5 per day to spend on food.

When people write stuff like that, however, it distorts perceptions. People will say "wow, $5 a day is nothing." I spend less than $5 a day on food. For example, for meat I eat chicken breasts. I buy one package of chicken breasts for probably something like $8 and it lasts me three to four days. I could also buy cheaper chicken breasts -- the store brand -- but I'm "rich," so I buy Purdue brand. But if I was on food stamps, you can believe that I would buy the cheap kind.

Similarly, for vegetables, I can buy a few heads of broccoli and some spinach for maybe a total of $6 and it'll last me actually over a week. The broccoli at my rural supermarket -- which is not a farmer's market, as some people tried to say -- is sold for $10 for 10 heads and each head lasts me three days. You know what costs me the most? Junk food. Buying a bag of Skittles costs me $3. Some potato chips will cost me about $4 (if I get it on sale, it's 2 for 1, but those deals are infrequent). So I could buy meat for four days or get some Skittles and Lay's, if I was poor.

Besides, the main issue is how we have expanded food stamps to millions of people more. You realize that food is the most basic requirement, right? So if you can't afford food, you should be totally devoid of possessions. I mean, if I told you that you get no food, you should be feverishly selling off your clothes, your jewelry, your electronics ...everything. And using that money to buy food. But instead, the way we do it in modern, liberal times is we say "oh, just keep living just like you always have, we'll give you unemployment and welfare and food stamps and WIC and ..." And then we wail about how little we do because we're only supporting literally millions of people completely. That's incredible.

 

[Harpsx]

Appreciate the reading suggestions, I'll have to give them a look.

In a perfect world, people should be able to spend their money however they want. Unfortunately, this will never happen.

My whole thing is... If the government (taxpayers) are going to be paying for your healthcare, you lost your "right" to eat Big Macs 24/7. If you want to treat your body like s***, you need to pay for it, because it's costing someone somewhere lots of money. How about make food stamps only redeemable for a healthy, well-balanced meal, rather than letting the individual choose. If they want twinkies and ding-dongs, then they better start working.

As far as managing money goes... Yes, changing money management alone probably wouldn't solve all the problems (although, I think it would be a great place to start). Back when I went to high school (I went to a VERY "racially diverse" public high school in hick town) I would constantly see young, almost teenage mothers/fathers come drop their kids off in the morning in their Escalade with chrome rims and a killer system - unfortunately, the kid was given $1-2 for a lunch (that's a coke and a bag of chips from the vending machine) and was wearing dirty, tattered clothing. The parents were deliberately choosing to buy flashy new status icons than spending it on things that actually matter. I'm not making this stuff up...

How much do we need to invest to educate them on this? Rather than educate, we take the choice away e.g. making food stamps only redeemable for healthy meals. If they want to experience the infamous freedom associated with America, they need to put in hard work - hard working individuals built this country, not welfare recipients. Education is good, but like I have said before, you can't teach people that aren't willing to learn.

As far as quality of life goes... How does buying new shiny things improve quality of life when your kid is wearing a dirty pillow case to school? Luxuries are called luxuries for a reason. Now I'm not saying that everyone shouldn't have the chance to indulge in SOME form of guilty pleasure, but if you're living in poverty you better not be driving a Mercedes.

Summary: People's priorities are misguided. Is it necessarily their fault? No. Does something need to be done? Yes. Is the answer to keep throwing money at them and perpetuating their misguided priorities? No. Is everyone equal? No. Are people like SunsFun trying to make everyone think that they're equal? Yes. Is this wrong? Yes.

I think Lya did an excellent job replying to your post so I'm just going to address your last paragraph mainly.
If you recognize that people's priorities can be misguided and that it is not necessarily their fault, then why should we insist on forcing changing individual choices, when you recognize that there may be a larger force at work? It's been widely regarded in literature now that societal level changes are more effective than attempting to change personal choices. Societal infrastructure framing how people make decisions is much more influential than the decisions they make themselves.

I recommend this great documentary "Unnatural Causes: Bad Sugar" which talks about the rise of diabetes and obesity in a small aboriginal town. Watch how societal level policy/environmental changes drastically change the health of a population (unfortunately, you may have to do some digging/rent the video as I believe it's not readily found on the internet).

My other related issue with this type of viewpoint is that you are making a rather large assumption that, for the most part, people's poor circumstances are because of personal choice (i.e. you bring up the lazy bum who spends irresponsibly and plays CoD all day quite often as a an example). I'm just curious as to why you believe the majority of people are like this and whether you have any evidence to back this view up? Yes, there are probably people like you describe out there, but they are on the trailing end of the bell curve for the socioeconomic class in question. You should not punish an entire social group for a minority of people.

 

[Womb Raider]

If you recognize that people's priorities can be misguided and that it is not necessarily their fault, then why should we insist on forcing changing individual choices, when you recognize that there may be a larger force at work? It's been widely regarded in literature now that societal level changes are more effective than attempting to change personal choices. Societal infrastructure framing how people make decisions is much more influential than the decisions they make themselves.

Societal level changes? Ha, I'm sure that would be more effective! Gee, if everyone was wealthy, educated and cultured wouldn't that just be dandy? I still fail to see how this would ever become a reality.

My other related issue with this type of viewpoint is that you are making a rather large assumption that, for the most part, people's poor circumstances are because of personal choice (i.e. you bring up the lazy bum who spends irresponsibly and plays CoD all day quite often as a an example). I'm just curious as to why you believe the majority of people are like this and whether you have any evidence to back this view up? Yes, there are probably people like you describe out there, but they are on the trailing end of the bell curve for the socioeconomic class in question. You should not punish an entire social group for a minority of people.

I haven't clumped these "lazy" in the same group as the "hard working" poor people - although you guys keeps trying to tell me otherwise. I'm trying to get you guys away from clumping all the poor people in the same group, because some people will, and do, take advantage of the system.

Do you have any evidence to back up the contrary? I see it every day. I know people that take pride in their "ability" to live off others.

Hard work is hard. When one is born into a life of poverty, it is much easier to simply accept the impoverished state of your life/family instead of trying to get out of it. It's easier to sit there, blaming other people for your problems and demanding things because you are poor. What makes it worse, is these people rally behind people like Obama and will vote for whoever promises to give them the most free stuff - great!!!! If we keep going in this direction the differences between the hard working and lazy will become indistinguishable and our country, the great USA, will waste away into a huge mass of mediocrity.

Yes, I think people have a strong tendency to follow the path of least resistance, as described above.

 

[DR MOM]

Another good article:

Inequality is (Literally) Killing America
Zoë Carpenter on November 20, 2013 - 5:04 PM ET
Only a few miles separate the Baltimore neighborhoods of Roland Park and Upton Druid Heights. But residents of the two areas can measure the distance between them in years—20 years, to be exact. That’s the difference in life expectancy between Roland Park, where people live to be 83 on average, and Upton Druid Heights, where they can expect to die at 63.

Underlying these gaps in life expectancy are vast economic disparities. Roland Park is an affluent neighborhood with an unemployment rate of 3.4 percent, and a median household income above $90,000. More than 17 percent of people in Upton Druid Heights are unemployed, and the median household income is just $13,388.

It’s no secret that this sort of economic inequality is increasing nationwide; the disparity between America’s richest and poorest is the widest it’s been since the Roaring Twenties. Less discussed are the gaps in life expectancy that have widened over the past 25 years between America’s counties, cities, and neighborhoods. While the country as a whole has gotten richer and healthier, the poor have gotten poorer, the middle class has shrunk, and Americans without high school diplomas have seen their life expectancy slide back to what it was in the 1950s. Economic inequalities manifest not in numbers, but in sick and dying bodies.

On Wednesday, Senator Bernie Sanders convened a hearing before the Primary Health and Aging subcommittee to examine the connections between material and physiological wellbeing, and the policy implications. With Congress fixed on historic reforms to the healthcare delivery system, the doctors and public health professionals who testified this morning made it clear that policies outside of the healthcare domain are equally vital for keeping people healthy —namely, those that target poverty and inequality.

“The lower people’s income, the earlier they die and the sicker they live,” testified Dr. Steven Woolf, who directs the Center on Society and Health at Virginia Commonwealth University. In America, people in the top 5 percent of the income gradient live about nine years longer than those in the bottom 10 percent. It isn’t just access to care that poor Americans lack: first, they are more likely to get sick. Poor Americans are at greater risk for virtually every major cause of death, including cancer, heart disease, and diabetes. As Woolf put it, “Economic policy is not just economic policy—it’s health policy.”

Tracing health disparities back to their socioeconomic roots adds context to growing calls for pro-worker policies like raising the minimum wage and providing paid sick leave. Lisa Berkman, director of Harvard’s Center for Population and Development Studies, presented a range of evidence indicating that policies supporting men and women in the labor force—particularly low-wage and female workers—lead to better health for themselves and their families.

The experts also identified education as a “key lever” for improving health outcomes, as education is closely linked with economic mobility and in turn, health. The mortality risk has risen for less educated women in recent years, while diabetes death rates are three times higher among Americans without a high school diploma than those who graduated. With 22 percent of American children living in poverty, several witnesses pointed to the expansion of early childhood education as policy that would have a profound effect on the nation’s health.

Witnesses also highlighted the importance of the social safety net to shield families from the adverse health effects of poverty. As Republicans and Democrats alike contemplate billions of dollars of cuts to the food stamp program, nearly 50 million people, or nearly 1 in 6 Americans, face “food insufficiency.” Hunger has particularly severe health effects for children, leading to a higher risk of learning disabilities, conditions like anemia and asthma, and increased hospitalization.

Many other wealthy countries have a more robust buffer for poor families, which helps to explain why America’s health statistics are so much worse. (The fact that the US has higher poverty rates and greater inequality than our peers has a lot to do with it, too.) “Our relative investment in those social programs, social services, is striking,” said Woolf. “We are an outlier in the proportion of our dollars we spend on healthcare relative to those social programs, whereas the countries who spend more much more on social programs than on health care are the ones that are living longer.”

“And presumably saving money on healthcare as well,” interjected Sanders, raising another important point: the social and economic programs that promote individual health could have profound effects on healthcare spending and the economy overall. “When you hear statistics about low-income people having much higher incidences of diabetes, which is costing this country hundreds millions of dollars, then to my mind the answer is to invest to prevent diabetes, to prevent other illnesses, rather than just spending more than any country on earth trying to treat these illnesses,” Sanders told me after the hearing.

Woolf noted that it is chronic diseases like diabetes, which are correlated with socioeconomic inequality, that are driving up the cost to the government of programs like Medicare and Medicaid. Overall, policymakers underestimate the costs of not prioritizing preventative care, and underestimate the long-term benefits of social spending programs.

“The social and economic policies that the government has developed over the years that may be health-promoting, aren’t counted as being health-promoting,” explained Berkman. “We don’t think about that in the benefits side of the equation. We only think about them in terms of short term economic turnaround or employment or labor when in fact the spillover to health may be enormous.”

Once it becomes clear that the determinants of health and illness are in neighborhoods, schools, and worksites, Berkman pointed out, a wealth of policy solutions present themselves. The problem is in the politics.

“With the Republicans controlling the House and wanting to cut virtually every program that advances human health in this country and wellbeing, it’s going to be a very tough struggle,” Sanders told me when I asked him about the prospects for advancing policies discussed in the hearing.

“What you heard today was the apex of a great philosophical divide, in that what we are saying is that if you invest in the children, if you invest in the environment, if you invest in education, if you invest in decent housing, not only do you create people who are healthier and happier, but you end up saving money.” The House, he noted, would prefer to cut nutrition and education. “We’re living on different planets in terms of what the debate is about.”

 

[ruralsurg4now]

I ignored that article because I predict it's going to be another liberal sob-fest about "OMG, THIS PERSON IS POOR AND I FEEL SOOOO BAAAAAAAAADDD! DON'T YOU FEEL BAD, TOO? I DO!!!"

 

[ruralsurg4now]

By the way, the way this works is that DR MOM will just keep on cutting and pasting stuff that she finds on any liberal website. I think if it continues, I'll just counter by relentlessly cutting and pasting hundreds of articles from conservative websites. Ball's in your court, DR MOM.

 

[DR MOM]

I didn't post that article for you ruralsurg. Feel free to skip my posts - they are resources for people who find them useful/relevant.

 

[ruralsurg4now]

I didn't post that article for you ruralsurg. Feel free to skip my posts - they are resources for people who find them useful/relevant.

Good, and I will also post resources for people who find them useful. I also want to help people learn about things. Are you opposed to that?

 

[DR MOM]

Go for it buddy.

 

[BlueLabel]

Well, I didn't expect to change your mind. I have to admit that your disregard for an evidence-based conclusion is disappointing, but then again it's my fault for expecting anything from you. I just hope some readers of this thread would find the statistics I presented convincing.

 

[SunsFun]

Thanks for a good read Dr. Mom. I like how this article articulates well many of the points we have brought up separately in our comments. Thumbs up!

I ignored that article because I predict it's going to be another liberal sob-fest about "OMG, THIS PERSON IS POOR AND I FEEL SOOOO BAAAAAAAAADDD! DON'T YOU FEEL BAD, TOO? I DO!!!"

You don't need to post that you're ignoring another person's comment. You can simply ignore it. This way the discussion is focused on the issue at hand rather than on personal attacks.

P.S. If you had read the article you would've seen that it is actually not a sob story.

 

[ruralsurg4now]

P.S. If you had read the article you would've seen that it is actually not a sob story.

Yeah, it is. It's another lame story about how the poor die younger than the rich -- MINDBLOWING STUFF!! And then at the end, you find out it's because of Republicans.

As far as the current discussion, it was going fine. But DR MOM didn't like the direction it was taking, so she just wandered in and copy-pasted another article. If you look at the thread, it's basically a troll because all DR MOM does is say "hey, guys, read this!" and then pastes an article from some liberal Internet site. Then she leaves and after a few days she comes back and says "hey, here's some more to read!" and then dumps another paste job. Fine, then I'll just do the same and we'll see where this goes, shall we?

 

[BlueLabel]

Yeah, it is. It's another lame story about how the poor die younger than the rich -- MINDBLOWING STUFF!! And then at the end, you find out it's because of Republicans.

As far as the current discussion, it was going fine. But DR MOM didn't like the direction it was taking, so she just wandered in and copy-pasted another article. If you look at the thread, it's basically a troll because all DR MOM does is say "hey, guys, read this!" and then pastes an article from some liberal Internet site. Then she leaves and after a few days she comes back and says "hey, here's some more to read!" and then dumps another paste job. Fine, then I'll just do the same and we'll see where this goes, shall we?

I agree with some of the stuff you've said in this thread, but I have to ask:

With all due respect, why is this so important to you? Not the issue per se but this specific argument? I mean at the end of the day, if some premeds on a website disagree with you, are overly idealistic, pie-in-the-sky progressive, etc why does it matter so much? I'm not saying this to put you down at all, you just seem to be pouring a good amount of time and effort into this and similar threads, and I'm not sure why convincing these people matters so much.

I do respect and appreciate the fact that a more experienced adult who is further along in his career than we are is here sharing his viewpoint, as I said I'm just curious as to why this setting has become such a battleground for you.

 

[ruralsurg4now]

I agree with some of the stuff you've said in this thread, but I have to ask:

With all due respect, why is this so important to you? Not the issue per se but this specific argument? I mean at the end of the day, if some premeds on a website disagree with you, are overly idealistic, pie-in-the-sky progressive, etc why does it matter so much? I'm not saying this to put you down at all, you just seem to be pouring a good amount of time and effort into this and similar threads, and I'm not sure why convincing these people matters so much.

I do respect and appreciate the fact that a more experienced adult who is further along in his career than we are is here sharing his viewpoint, as I said I'm just curious as to why this setting has become such a battleground for you.

Because it's irresponsible. People on here and in America think "oh, well, I'll do this and all it means is that some rich guy just won't be able to buy his third house, lol, oh well." No, all of the silly policies people idealistically support with no regard to the consequences have real world effects. You vote in Obamacare, next thing you know everyone's losing their insurance policies. And everyone's like, "oooooooopsie! Oh, well, gotta have some pain for gain, nyuk nyuk." Or some doctor gets deluged with patients and gets burnt out and everyone who DOESN'T have to deal with that is like "hey, just work harder, what's your problem? Sheesh, rich doctor crying? Richie rich doctor??" Or some family has been trained to live on government support for three generations and we treat them like they're incapable of doing any better and congratulate ourselves on our false compassion.

You think this stuff doesn't matter? It's the most important thing.

 

[BlueLabel]

Because it's irresponsible. People on here and in America think "oh, well, I'll do this and all it means is that some rich guy just won't be able to buy his third house, lol, oh well." No, all of the silly policies people idealistically support with no regard to the consequences have real world effects. You vote in Obamacare, next thing you know everyone's losing their insurance policies. And everyone's like, "oooooooopsie! Oh, well, gotta have some pain for gain, nyuk nyuk." Or some doctor gets deluged with patients and gets burnt out and everyone who DOESN'T have to deal with that is like "hey, just work harder, what's your problem? Sheesh, rich doctor crying? Richie rich doctor??" Or some family has been trained to live on government support for three generations and we treat them like they're incapable of doing any better and congratulate ourselves on our false compassion.

You think this stuff doesn't matter? It's the most important thing.

I'm not saying the actual issue at hand doesn't matter. Of course it does, it's critical to the future of the profession. I'm referring to this specific setting.

I guess what I'm trying to say is, if a bunch of SDN know-it-all premeds disagree with you about this, is it really any skin of your nose? It just seems like you're taking this very seriously/personally, given the length and volume of your posts. Is this really the best setting to make such a passionate argument?

Again this isn't coming from someone who is necessarily disagreeing with you, I'm just curious as to the reason for your fervor in this particular setting.

 

[ruralsurg4now]

I'm not saying the actual issue at hand doesn't matter. Of course it does, it's critical to the future of the profession. I'm referring to this specific setting.

I guess what I'm trying to say is, if a bunch of SDN know-it-all premeds disagree with you about this, is it really any skin of your nose? It just seems like you're taking this very seriously/personally, given the length and volume of your posts. Is this really the best setting to make such a passionate argument?

Again this isn't coming from someone who is necessarily disagreeing with you, I'm just curious as to the reason for your fervor in this particular setting.

The reason is because a lot of the reason this stuff works is peer pressure, where people are like "oh, if I don't agree, then I'll be unpopular." You see it here, for example, where just because I disagree someone will go "hey, guys, he's a troll, ignore him." I think so far something like three people have written that. In other words, the mere fact that I don't agree constitutes "being a troll." It's a not-so-subtle implication that "only stupid people and jerks don't believe in liberalism." But guess what? If you allow that to go unopposed, then it becomes de facto true.

Did you see the last few pages? People were actually having civil discussions about the topic raised. But we weren't drinking the liberal Kool-Aid, so what happened? DR MOM dropped by with another load, hoping that it would nudge the conversation back to where it needed to be.

 

[BlueLabel]

The reason is because a lot of the reason this stuff works is peer pressure, where people are like "oh, if I don't agree, then I'll be unpopular." You see it here, for example, where just because I disagree someone will go "hey, guys, he's a troll, ignore him." I think so far something like three people have written that. In other words, the mere fact that I don't agree constitutes "being a troll." It's a not-so-subtle implication that "only stupid people and jerks don't believe in liberalism." But guess what? If you allow that to go unopposed, then it becomes de facto true.

Did you see the last few pages? People were actually having civil discussions about the topic raised. But we weren't drinking the liberal Kool-Aid, so what happened? DR MOM dropped by with another load, hoping that it would nudge the conversation back to where it needed to be.

I mean I don't think you actually answered my question about why the super important e-premed Internet forum matters so much to you, but okay. I will say that in my limited experience attitude and presentation are huge part of making a compelling argument, maybe that's something to think about.

Again thank you for being willing to come here and share your experience and perspective with us. Involvement of higher-ups on the medical totem pole in preallo is never something I would discourage.

 

[ruralsurg4now]

I will say that in my limited experience attitude and presentation are huge part of making a compelling argument, maybe that's something to think about.

Yeah, but it's logic versus emotion. All a liberal has to do is find some sob story and then write "doesn't this make you feel bad??? Awwwwwwwww ....!" Then if anyone disagrees, it's like "oh, well, clearly you want people to die. Boooooo!" There's nothing actually compelling about their argument, it's just basically emotional manipulation.

 

[Catman21]

I agree with some of the stuff you've said in this thread, but I have to ask:

With all due respect, why is this so important to you? Not the issue per se but this specific argument? I mean at the end of the day, if some premeds on a website disagree with you, are overly idealistic, pie-in-the-sky progressive, etc why does it matter so much? I'm not saying this to put you down at all, you just seem to be pouring a good amount of time and effort into this and similar threads, and I'm not sure why convincing these people matters so much.

I do respect and appreciate the fact that a more experienced adult who is further along in his career than we are is here sharing his viewpoint, as I said I'm just curious as to why this setting has become such a battleground for you.

My uncle reminds me of ruralsurg. His life fell apart and hes devoted himself 100% to social policies he disagrees with. Arguing with anyone he can get close enough to talk to. I cannot count the number of christmas and thanksgiving holidays he has single handedly ruined due to his constant combative disposition. No one really likes him because all he talks about is how the modern medicine is killing people, AMA promotes ineffective chemo treatments for financial gain, doctors are evil, vaccines are the cause of cancer and down syndrome, and that grass fed beef should be only thing anyone should ever eat...ever. Him being so hellbent on "educating" anyone within yelling distance, has ultimately perpetuated the already, complete downward spiral, that is his life. Its hard to watch really, but... you can't fix stupid.

 

[BlueLabel]

My uncle reminds me of ruralsurg. His life fell apart and hes devoted himself 100% to social policies he disagrees with. Arguing with anyone he can get close enough to talk to. I cannot count the number of christmas and thanksgiving holidays he has single handedly ruined due to his constant combative disposition. No one really likes him because all he talks about is how the modern medicine is killing people, AMA promotes ineffective chemo treatments for financial gain, doctors are evil, vaccines are the cause of cancer and down syndrome, and that grass fed beef should be only thing anyone should ever eat...ever. Him being so hellbent on "educating" anyone within yelling distance, has ultimately perpetuated the already, complete downward spiral, that is his life. Its hard to watch really, but... you can't fix stupid.

Your mom's brother or your dads?

 

[Harpsx]

Societal level changes? Ha, I'm sure that would be more effective! Gee, if everyone was wealthy, educated and cultured wouldn't that just be dandy? I still fail to see how this would ever become a reality.

No, it will not become a reality that everyone will be rich and cultured, because I think most people understand that not everyone is equal. But that doesn't mean we shouldn't strive for equity, which has been shown time again in research to be better for society as a whole.

I haven't clumped these "lazy" in the same group as the "hard working" poor people - although you guys keeps trying to tell me otherwise. I'm trying to get you guys away from clumping all the poor people in the same group, because some people will, and do, take advantage of the system.

Do you have any evidence to back up the contrary? I see it every day. I know people that take pride in their "ability" to live off others.

Hard work is hard. When one is born into a life of poverty, it is much easier to simply accept the impoverished state of your life/family instead of trying to get out of it. It's easier to sit there, blaming other people for your problems and demanding things because you are poor. What makes it worse, is these people rally behind people like Obama and will vote for whoever promises to give them the most free stuff - great!!!! If we keep going in this direction the differences between the hard working and lazy will become indistinguishable and our country, the great USA, will waste away into a huge mass of mediocrity.

Yes, I think people have a strong tendency to follow the path of least resistance, as described above.

How do you propose to pick out those who are lazy and those who are hard working then? Do you assume everyone who is on welfare is lazy? How would you execute this from a policy level? Are you willing to screw over those people who you define are hard-working in order to prevent a "lazy" person from accessing resources? Or from another point of view, do you think it is OK to put a group of innocent people in jail for the sake of ensuring that one guilty person is not free? I think SunsFun said something like this before, but I too would rather help someone, even if they may not deserve it, for the sake that I do not miss helping someone I could have helped who actually needed it.

With regards to the bolded, I have lived in an extremely diverse and lower-income community for the majority of my life. My family is thankfully very much middle class, but I went to school in a low-income, predominantly immigrant community which has given me a lot of perspective. These people do not want to be low income, face racism and classism and be essentially powerless. They don't want to but that is the life they were born in and it is difficult to get out of. You are a fool if you think that breaking the cycle of poverty is as easy as getting off your ass and working (edit: I think I should clarify, I don't mean 'you' as in "womb raider" but 'you' as in speaking generally). Although both our anecdotes are pretty useless, unless you can say you've had a similar life experience, than I'd rather believe that it's human nature to not want to be at the 'bottom'. And life at the bottom sucks a lot. You keep describing it as if it is a paradise and 'least resistance' which just tells me you are delightfully misinformed. It isn't hard to imagine: You don't have powerful friends who can help you with your vested interests, you don't have the resources to access better things in life, you face classism and being looked down upon by the rest of society, you're marginalized, you can't fight for your rights as easily (can't hire the best lawyer, can't access the best education so that you're informed)....etc. If you think this is a life of 'least resistance' that people want to live, think again.

 

[Jabbed]

The reason is because a lot of the reason this stuff works is peer pressure, where people are like "oh, if I don't agree, then I'll be unpopular." You see it here, for example, where just because I disagree someone will go "hey, guys, he's a troll, ignore him." I think so far something like three people have written that. In other words, the mere fact that I don't agree constitutes "being a troll." It's a not-so-subtle implication that "only stupid people and jerks don't believe in liberalism." But guess what? If you allow that to go unopposed, then it becomes de facto true.

This isn't the case at all. Honestly, most people probably ignore your opinions because you're hostile and condescending. If you dismiss everyone else's arguments and opinions as "liberal trash," are you really so surprised that people turn around and call you a Republican troll?

There's absolutely nothing wrong with being a contrarian, and no one's attacking you for that reason.

 

[ruralsurg4now]

My uncle reminds me of ruralsurg. His life fell apart and hes devoted himself 100% to social policies he disagrees with. Arguing with anyone he can get close enough to talk to. I cannot count the number of christmas and thanksgiving holidays he has single handedly ruined due to his constant combative disposition. No one really likes him because all he talks about is how the modern medicine is killing people, AMA promotes ineffective chemo treatments for financial gain, doctors are evil, vaccines are the cause of cancer and down syndrome, and that grass fed beef should be only thing anyone should ever eat...ever. Him being so hellbent on "educating" anyone within yelling distance, has ultimately perpetuated the already, complete downward spiral, that is his life. Its hard to watch really, but... you can't fix stupid.

That's a great anecdote, but I could just as easily write a rambling post about you and how you remind me of an uncle whose life fell apart and then he became an activist who railed against corporations while his mental health spiraled out of control. Eventually, he found himself homeless and covered in fecal matter and he would accost people in the streets with his rantings about social justice and he joined an Occupy movement. He stole someone's laptop and now spends his days banging out posts about how other people remind him of his relatives in satisfaction and considers himself witty, all while dreams of his pre-med days pass by idly.

In case you didn't get my point, all you did was say "he reminds me of my uncle ..." and then proceeded to write a lengthy insult that I suppose you consider yourself clever for doing. You should also know that the opinions that your supposed uncle espouses are actually ones held by many liberals, who accuse doctors of merely profiting off illness (sound familiar? Obama actually used that line), rail against vaccinations for children as a root cause of autism, and say that free-range chicken is better because the chicken is happier before it dies.

 

[ruralsurg4now]

This isn't the case at all. Honestly, most people probably ignore your opinions because you're hostile and condescending. If you dismiss everyone else's arguments and opinions as "liberal trash," are you really so surprised that people turn around and call you a Republican troll?

There's absolutely nothing wrong with being a contrarian, and no one's attacking you for that reason.

That's great, but I didn't actually dismiss people's arguments and opinions as "liberal trash," so your use of the "quotes" doesn't actually mean much. What happened was that you didn't like me disagreeing with you and so therefore I became a "troll."

In fact, if you look at the last couple of pages of the thread, I was having a very good conversation with a couple of posters (none of whom included you) and all you've done is re-interject yourself into the conversation without any meaninful contribution to it, merely to throw some generic insults my way.

 

[j2kkdkke]

Then you still don't know what Communism is. According to Marx, an educational system that was designed the brainwash the masses was one of the tools that the bourgeoisie used to stay in control.

 

[ruralsurg4now]

How does Obamacare help the patients?

It doesn't. The end. And the problem is that it's not incumbent on you or anyone else to force others to do things. For example, let's say -- and this isn't true, but let's just say -- that redistribution of goods and services was better for all of society. I'd still say "big f**king deal" because that doesn't give you the right to take what belongs to others out of some false sense of "societal justice." That's the bottom line. If you want, YOU could redistribute YOUR property and work all you want. And since people claim that "everyone" believes in the liberal societal justice model, why, then everyone should be happy to voluntarily redistribute their property.

 

[ruralsurg4now]

I don't care if the solution is free market or socialist as long as it works.

Good because socialism won't work. The end.

 

[Lya]

It doesn't. The end. And the problem is that it's not incumbent on you or anyone else to force others to do things. For example, let's say -- and this isn't true, but let's just say -- that redistribution of goods and services was better for all of society. I'd still say "big f**king deal" because that doesn't give you the right to take what belongs to others out of some false sense of "societal justice." That's the bottom line. If you want, YOU could redistribute YOUR property and work all you want. And since people claim that "everyone" believes in the liberal societal justice model, why, then everyone should be happy to voluntarily redistribute their property.

So why does it not help the patients?

 

[deleted128562]

I don't think you quite grasp the idea of liberalism. It's not about making hardworking people pay for lazy ones. This is a myth. My personal liberal philosophy steams from a desire for justice, equality, and giving fair chance to everyone regardless of circumstances they were born in.

Yes, liberals are simply interested in pursuing justice and equality.... with other people's money of course.

You'll hear your liberal med school professors rail at you about how medicine should not be about money.... but they won't seem in too much of a hurry to give up their own $500,000 house, their nanny, and their summer cabin in the mountains.

You'll hear the D.C. and Marin County progressives go on and on about the plight of the poor.... as they sit in their 3 million dollar mansions with the Mercedes in the driveway and their kids in private school.

You'll hear Nancy Pelosi screech about social justice.... but of course she and her husband are exempt from giving up their multi-million dollar enterprise, their private plane access, and their lavish lifestyle.

There's a reason liberals give far less to charities than do conservatives. They don't want to spend their own money to help the poor when they can readily spend other people's money.

 

[ruralsurg4now]

So why does it not help the patients?

Because all it does is balance out the "injustices" by making everyone's healthcare mediocre at best. Which is what liberalism always does. Rather than have "rich" and "poor," it just makes us all "semi-poor" and then calls it a day.

 

[ruralsurg4now]

"Because socialism," according to ruralsurg.

That would be the Cliff's Note version for someone like you, yes.

 

[ruralsurg4now]

Yes, liberals are simply interested in pursuing justice and equality.... with other people's money of course.

You'll hear your liberal med school professors rail at you about how medicine should not be about money.... but they won't seem in too much of a hurry to give up their own $500,000 house, their nanny, and their summer cabin in the mountains.

You'll hear the D.C. and Marin County progressives go on and on about the plight of the poor.... as they sit in their 3 million dollar mansions with the Mercedes in the driveway and their kids in private school.

You'll hear Nancy Pelosi screech about social justice.... but of course she and her husband are exempt from giving up their multi-million dollar enterprise, their private plane access, and their lavish lifestyle.

There's a reason liberals give far less to charities than do conservatives. They don't want to spend their own money to help the poor when they can readily spend other people's money.

That's why it's hilarious that liberals are often very wealthy. They act like it's conservatives who are these "greedy old men who hoard money that they stole from the poor." Then you go to most wealthy communities and it's like "oh, wait ...you're all liberals. Huh, that's odd." Yes, but they did it by being part of government, where they force you to give them your money as "public servants" without providing you any service ...so it's totally different.

 

[ruralsurg4now]

And what does the national distribution of wealth have to do with patient care?

Because universal healthcare is the redistribution of healthcare dollars and services. No offense, but the parallel isn't that difficult.

 

[ruralsurg4now]

Yes, but I don't care if Obamacare or Romneycare or NHS or whatever redistribute dollars. I only care if they produce results.

Right, but they don't. They just make everyone's care equally bad. I went over this already.

 

[ruralsurg4now]

Facts and figures? I don't see any so far in the thread, but I may have missed them. Could you link to them?

Facts and figures? Why don't you just pay attention to current events?

Or how about this: why don't we just run a real world experiement where I match your family up with a poor person and we just redistribute your family's wealth to them and see what happens? Surely you'd be fine with that, right? If not, why not? I know it makes you sad that you can't just talk in hypotheticals and have to actually experience the consequences of your silly beliefs, but that's the test.

 

[ruralsurg4now]

Every time we get close to having a legitimate discussion about healthcare, you fall back on these ridiculous scenarios as if they prove a point. Here's my challenge to you: why don't you go live in your libertarian fantasy world of Somalia?

Wow, talk about self-ownage. You seem to think that I'm advocating for anarchy with pockets of tyranny run by warlords. That's really smart. Sounds like you're falling back on ridiculous scenarios as if they prove a point.

 

[ruralsurg4now]

If you couldn't even understand that that post was meant to imitate your style, than I don't know what to think. I even ended it with the same sentence you used to make it extra obvious, but apparently that was a little too highbrow. "Satire." You can find it in any dictionary.

Except that you actually do advocate redistribution whereas I don't advocate anarchy. I mean, other than that, it was a great post.