EM salary and Obama's plan

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
GeneralVeers said:
I'm remembering Canada from 1997-2000 when my family moved here (mainly because my father, a Physician at the time could make 3X the salary in the U.S.). Obviously things have changed.

Still, in Canada they frequently have discussions about the sustainability (or lack thereof) of their system, and the rationing and waiting periods required to make it work.
Click to expand...
I agree with you about all the problems the system has for elective procedures, but I'd still prefer the faults of this system over the faults of the US system. That said, those wait times are being targeted and a lot of headway has been made into reducing them, because of all the public outrage in this country. I would also argue that this system is sustainable becuase spending per capita is a fraction of the US, and has actually remained stable for the last several decades when adjusted for GDP.

I wouldn't like the idea of making health care decicions based on how much it's going to cost me, or to be worried that X problem wouldn't be covered by my insurance company, or that they could drop me from their plan at any moment, or that they will work their butt off to find any reason to disqualify my claims, or that I have to figure out which hospitals or family physicians I'm allowed to go to. That's what happens when you make health care a business: you get people more interested in dollar signs than patient care (and by people I mean the insurance companies, not doctors).

From the other side of the table as an emergency physician, I'm sure it is equally frustrating for you to have to deal with patients all day who have no insurance and demand free care for their BS complaints, which in turn raises health care costs for other people. I'm sure it's also frustrating for you or your administration if they often fight with insurance companies to try to get your billings approved. I'm sure you also see a lot of patients with problems that could have been prevented if they had proper insurance and a family physician to take care of them on a long-term basis.

Overall, all I'm trying to say is that health care is a huge mess no matter how the system is setup. I don't think you or anyone else is wrong for opposing Obama's policies, but I don't think I'm wrong for being optimistic about them, either. Everyone has their own opinion on what an ideal system is to deliver medical care, and I think the ideal is all subjective to what traits of the system you find are most important. I don't necessarily think what Obama is planning will work, but I'm optimistic that it might make things better. Only time will tell, I guess.
Members don't see this ad.
 
leviathan said:
From the other side of the table as an emergency physician, I'm sure it is equally frustrating for you to have to deal with patients all day who have no insurance and demand free care for their BS complaints, which in turn raises health care costs for other people. I'm sure it's also frustrating for you or your administration if they often fight with insurance companies to try to get your billings approved. I'm sure you also see a lot of patients with problems that could have been prevented if they had proper insurance and a family physician to take care of them on a long-term basis.
Click to expand...

Just a question for you. Have you ever worked, or done clinical rotations in the U.S. system? Most of the propaganda they issue in Canada is wrong. I personally don't worry about the non-payees, because it tends to average out, and typically I know what salary to expect each month. On the other hand I'm free to order tests that I want, including emergent MRI. I realize you can do this in Vancouver, but in the U.S. most of our secondary hospitals have better capabilities than the ones in Canada regarding imaging and procedures.
 
GeneralVeers said:
Anyone want to go to New Zealand with me?
Click to expand...

quideam said:
It's certainly beautiful... but you would definitely get paid a lot less there. Sure it's worth the kayaking? ;)
Click to expand...

coldweatherblue said:
off-topic but seriously is it fairly straight-forward to become licensed in New Zealand if you're a board-certified U.S. MD?
Click to expand...


Two words: Atlas Shrugged.

Can anyone who read that book tell me where I can find reliable data useful in determining what countries I should be considering for my back up plan? I love this country dearly but at the same time I'm the type of guy who hops in the lifeboat when the ship meets the iceberg... I'm not gonna stand around listening to the violins. Although I'd love to practice EM in this country for a few decades (probably someplace friendly like Texas), at the end of the day I'm very flexible. I'll move to whichever country is safe and will let me make the most money. An Emir in Quatar needs an emergency doc for the estate? No problem. I'll learn Arabic. Some private corporation in Hong Kong? I love asian food, it's all good.

So, in short: how does one find reliable international data on incomes and "friendliness" to physicians as far as laws and taxes are concerned? Unlike the book, I don't know if a giant hologram in Colorado is going to save us.

Poor Ayn Rand is rolling around in her grave... ...
 
Members don't see this ad :)
You know, I read Atlas Shrugged. And the Fountainhead. And Anthem.

I thought they were great books. Really deep insight into the human psyche and what makes the world really tic.

Then I turned 15 and gave up both Ayn Rand and Dungeons and Dragons to live in the real world.

Take care,
Jeff
 
Jeff698 said:
You know, I read Atlas Shrugged. And the Fountainhead. And Anthem.

I thought they were great books. Really deep insight into the human psyche and what makes the world really tic.

Then I turned 15 and gave up both Ayn Rand and Dungeons and Dragons to live in the real world.

Take care,
Jeff
Click to expand...

ouch!
 
StealthNerd said:
Poor Ayn Rand is rolling around in her grave... ...
Click to expand...

yeah, your probably right. This country is doing nothing to help out the rich and successful. I mean, when a country can only scrounge together a measly 2.3 trillion to bailout investment bankers and CEOs while lavishly spending 60 billion on SCHIP to provide healthcare to kids living under the poverty line its time to re-prioritize.
 
futIDdoc said:
yeah, your probably right. This country is doing nothing to help out the rich and successful. I mean, when a country can only scrounge together a measly 2.3 trillion to bailout investment bankers and CEOs while lavishly spending 60 billion on SCHIP to provide healthcare to kids living under the poverty line its time to re-prioritize.
Click to expand...

Actually you are wrong. The original SCHIP was designed for kids under the poverty line. The expansion of SCHIP just signed by Obama extends coverage to children in families making up to $150,000, who are hardly in poverty. It's basically a back-door extension to universal healthcare. Obama realizes that the Clinton plan failed because it was too comprehensive and too detailed. He is thus going to implement universal care by gradually chipping away at it, and slowing giving more individual groups coverage.
 
Speaking of Atlas Shrugged, here's a quote from the book written in 1957. I'm not a huge fan of hers, but honestly, the below quote could be written today on this board. Some of her vents do have a lot of merit, we choose to dismiss Ayn Rand, because otherwise realty turns you into a grumpy old man.

Atlas Shrugged said:
"I quit when medicine was placed under State control, some years ago," said Dr. Hendricks. "Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? THAT was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussion that preceded the enslavement of medicine, men discussed everything – except the desires of doctors. I have often wondered at the smugness with which people answer their right to control my work, to force my will, to violate my conscience, to stifle my mind – yet what is it that they expect to depend on, when they lie on an operating table under my hands? Let them discover, in their operating rooms and hospital wards that it is not safe to place their lives in the hands of doctors whose livelihood they have throttled. It is not safe, if he is the sort of doctor who resents it – and still less safe if he is the sort who does not."
Click to expand...
 
GeneralVeers said:
The salary in Canada is Capped at 430K (which is 300K USD). That is why orthopedic surgeons only work 6 months of the year, hit their cap, and then go on vacation.

The average EP in Canada makes 165K (which is abou 120K USD).

Bear in mind, that 60% of that gets taxed back by the Federal and Provincial governments.
Click to expand...

there is no cap in Canada. And salaries are higher than you think. http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20061004/ont_doctors_061004?s_name=&no_ads

Average canadian specialists salary was around 330 000$ back in 2006 (over 300k USD) http://www.cmaj.ca/cgi/content/full...FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT


The exchange rate at been almost at par for the past 2 years and a half. www.xe.com

Quebec is the province with the highest income tax rate, at about 52%. But now you can get incorporated (company), so the income tax rate on your practice will be taxed as a business, therefore at a significantly lower rate.
 
Last edited:
Methodnike said:
there is no cap in Canada. And salaries are higher than you think. http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20061004/ont_doctors_061004?s_name=&no_ads

Average canadian specialists salary was around 330 000$ back in 2006 (over 300k USD) http://www.cmaj.ca/cgi/content/full...FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT


The exchange rate at been almost at par for the past 2 years and a half. www.xe.com

Quebec is the province with the highest income tax rate, at about 52%. But now you can get incorporated (company), so the income tax rate on your practice will be taxed as a business, therefore at a significantly lower rate.
Click to expand...

There used to be a salary cap in Ontario (but not other provinces) but I've been told that it was eliminated several years ago, as it artificially created a shortage of doctors.

Can any Canadian EPs give us a ballpark range of what they make per year?
 
For those who truly believe tort reform would do a lot to decrease the cost of healthcare, what's your responce to Atul Gawande's recent article in the New Yorker on McAllen, TX? Specifically his observation that in two Texas towns (one of the more physician friendly states) that have nearly identical patient demographics and geography, you still find one town costing twice as much per patient in medicare/medicaid expenses.

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

I hear a lot of people argue that healthcare is so expensive because outsiders are interfering in medical decisions. It seems far more intuitive that the real problem is the people making the decisions have no incentive to keep costs down. Is an MRI really being ordered because a lawyer might take you to court or because the patient gets piece of mind, the physician gets piece of mind and wallet, and the person footing the bill has no say?

I just don't get how as a society we can, on one hand, not even allow drugs reps on medical school campuses, but on the other we directly tie physician payment to the way they practice medicine...
 
Last edited:
I don't think tort reform is necessarily going to reduce significantly the current cost of healthcare. I do believe that tort reform will dampen the spiraling cost rise. Without tort reform, costs will be much more in a couple of decades than they would be without it. As someone said above, threat of legal action has impacted medicine to a point that defensive medicine and standard of care are inseparable.

I for one, don't get paid more for more of a work-up. I get an hourly wage that doesn't vary if I see 4 patients or if I see none. I do not get more money if I order a CT. I have never, ever thought, "If I order more tests on this person, I could bill a higher level of care." I find it offensive that you would broadly imply that physicians only make patient-care decisions based on reimbursement.
 
Last edited by a moderator:
Jarabacoa said:
I find it offensive that you would broadly imply that physicians only make patient-care decisions based on reimbursement.
Click to expand...

I did not mean to imply that and if it seems as though I did, I apologize. My point is not that physicians are the greedy Ferrari driving money-grubbers the media would like the public to believe. My point is that:

a) Physicians are human. At some level, money is going to affect decisions if those decisions affect money.

b) The current system generally ties money into treatment decisions without either side of the decision being impacted by the cost (or even more concerning, being positively impacted by the cost).

I need a car for work. Someone is helping me choose a car (either a salesman or a car-saavy friend). Work is paying for the car, gas, and maintenance. Now do I buy the BMW 6-series or the Honda Civic? I get the BMW, because there is a fraction of a percent chance that the added acceleration and top speed may allow me to escape death in an emergency and that is easilly worth someone else's $60k.

Now in the best case, I've brough along a friend who supports this decision because there is a clear benefit and no financial loss to anyone of their concern. In the worst case, it's a salesman who benefits directly or indirectly from the sale. We have both systems in the US, but both have the inherrent flaw that the real decision makers have no reason to carefully concider the costs of the options.

Now is buying a car a perfect analogy? No, but it gets the point accross. Do we want a healthcare system run by accountants? No. But when no one involved in decision making has a vested interest in keeping things efficient, it's hard to be surprised when costs are high. How do you balance doing what's best for the individual patient while getting the most from our medical resources? I don't know.
 
Members don't see this ad :)
I know exactly what Obamacare is going to mean for ER doctors....the same thing it's going to mean for all doctors. You're going to work harder for less money. Its already happening at my group. Horrendously inefficient computer system specifically designed to meet Obamacare's electronic medical record requirement. It's 10% less efficient, so we bring in 10% less RVUs and therefore we make 10% less money while working harder. It practically makes me cry that so many intelligent people fell for this scheme. Obamacare "insurance" will pay so little $$s that the amount you collect is no higher than trying to collect the cash from the uninsured. This is already the case for medicaid.
 
GeneralVeers said:
The salary in Canada is Capped at 430K (which is 300K USD). That is why orthopedic surgeons only work 6 months of the year, hit their cap, and then go on vacation.

The average EP in Canada makes 165K (which is abou 120K USD).

Bear in mind, that 60% of that gets taxed back by the Federal and Provincial governments.
Click to expand...

- i'm pretty sure the cap is only for family physicians. I personally know 2 who make ~300k/year

-the Canadian dollar is on par with US dollar

- they are allowed to become "incorporated" or something like that which decreases their income tax significantly.

Canadian doctors make good money. and in my opinion work in a better system.
 
Birdstrike said:
I know exactly what Obamacare is going to mean for ER doctors....the same thing it's going to mean for all doctors. You're going to work harder for less money. Its already happening at my group. Horrendously inefficient computer system specifically designed to meet Obamacare's electronic medical record requirement. It's 10% less efficient, so we bring in 10% less RVUs and therefore we make 10% less money while working harder. It practically makes me cry that so many intelligent people fell for this scheme. Obamacare "insurance" will pay so little $$s that the amount you collect is no higher than trying to collect the cash from the uninsured. This is already the case for medicaid.
Click to expand...

in my opinion if you don't like the way something is, be proactive in changing it. It's called progress, it takes patience, hard work, will power, and a sense of purpose.
 
MB333999 said:
in my opinion if you don't like the way something is, be proactive in changing it. It's called progress, it takes patience, hard work, will power, and a sense of purpose.
Click to expand...

Working on it. However, the populace and media seem to be against me. There are reams of articles right now about how Republicans in Wisconsin are taking away the unions' rights to BE AMERICAN and bilk taxpayers out of more money. There was significantly less about how the AHA was rammed through without Republican approval. Imagine if all those senators and congressmen at the federal level simply left town so there wouldn't be quorum?

I vote based on my best interests. People who don't have jobs do the same.
 
Dr.McNinja said:
Working on it. However, the populace and media seem to be against me. There are reams of articles right now about how Republicans in Wisconsin are taking away the unions' rights to BE AMERICAN and bilk taxpayers out of more money. There was significantly less about how the AHA was rammed through without Republican approval. Imagine if all those senators and congressmen at the federal level simply left town so there wouldn't be quorum?

I vote based on my best interests. People who don't have jobs do the same.
Click to expand...

good to know.

It seems to me like EM docs are on the same page with each other.
Mainly what i've noticed is that they want to protect their pay and become less liable for mistakes bound to happen when one has to look after multiple patients at once.

All i have to say is together you are strong, dont just sit back and accept what you dont believe is right.
 
Dr.McNinja said:
I vote based on my best interests. People who don't have jobs do the same.
Click to expand...

I vote based on the better interests of society as a whole, not my own best interests.

As a society, we should be ashamed that when budget cuts come down the pipe, a large portion of the population has no trouble cutting funds that most help those with the least.

Now, whether said programs in place to help the disadvantaged are properly implemented and not subject to abuses is another topic for debate - however, there are plenty of good people out there lumped in with our chronic abusers we see every day. Government reform should be less about shuffling poorly spent money from one bucket to another, and more about making the money spent more effective.
 
xaelia said:
I vote based on the better interests of society as a whole, not my own best interests.
Click to expand...

Get ready get to give over 50% of your hard earned money to the "better interests of society" (which, when you're an attending will no longer include you). Yep, you'll keep much less than half. After federal income tax, state income tax, FICA tax, Medicare tax, property taxes, gas tax, energy tax, sales tax, license fees, registration fees, you'll keep well under half.
 
MB333999 said:
in my opinion if you don't like the way something is, be proactive in changing it. It's called progress, it takes patience, hard work, will power, and a sense of purpose.
Click to expand...


The vast majority of doctors fought Obamacare tooth and nail despite our "representative" societies (AMA, etc) refusal represent us. The majority of the American people were against Obamacare, and still are, yet they steamrolled all of us. "From each according to his ability, to each according to his needs". It's the called Socialism, and you voted for it. It's very much like the "host/parasite" system you learned about in pre-med biology. You're the host, they're the parasite. It wasn't a secret. The guy ran on it.

If you're going to be an EM physician, >50% of the care you give will be free, donated. Of that remaining portion you actually are paid, the majority (as I stated above) will go to taxes. You should never, ever, feel like you haven't given "enough".
 
Birdstrike said:
Get ready get to give over 50% of your hard earned money to the "better interests of society" (which, when you're an attending will no longer include you). Yep, you'll keep much less than half. After federal income tax, state income tax, FICA tax, Medicare tax, property taxes, gas tax, energy tax, sales tax, license fees, registration fees, you'll keep well under half.
Click to expand...

I have less of a problem with taxation than the mismanagement of appropriated funds. There is egregious waste built into the bureaucracy, and very little congressional motivation with taking substantial action. We can't even cut a measly $100 billion from a multi-trillion dollar budget? And all the airwave pundit focus is pointless superficial bickering. Pathetic.

Additionally, I have no issue with those who push healthcare as a "right" - however, like the other fundamental rights to life and liberty, it should be forfeit if you abuse the system.
 
xaelia said:
I have less of a problem with taxation than the mismanagement of appropriated funds. There is egregious waste built into the bureaucracy, and very little congressional motivation with taking substantial action. We can't even cut a measly $100 billion from a multi-trillion dollar budget? And all the airwave pundit focus is pointless superficial bickering. Pathetic.

Additionally, I have no issue with those who push healthcare as a "right" - however, like the other fundamental rights to life and liberty, it should be forfeit if you abuse the system.
Click to expand...


Eliminating "wasteful" government spending, and keeping the "good" spending is impossible. Government spending is inherently wasteful and no one thinks their government grant or check is the wasteful one.

By the way, if we are going to add "health care" to the Bill of Rights, can we please start with adding "food" and "water".

Can you walk into a grocery store and say "I need food and water to live." "Food is a right" and walk out without paying? No. If you don't pay your water bill, what happens? It gets turned off. Is water important, critical, life saving? Yes. Is it a "right"? Free speech is a right, because your exercising it doesn't violate any one else rights (until it does, then its no longer a "right", ie, inciting a riot or stampede) and your "opinion" is no one elses to own.

Something is not a "right" if you have to violate someone else "rights" to get it. You and I have a right to work and get paid for our services. If someone else can claim that your services is their "right" then what does that make you?
 
The Declaration of Independence does indeed guarantee a right to life. Food and water are necessary to sustain life. Therefore, our civilized society has a responsibility to its citizens to provide these basic necessities to those in need. Food stamps and government assistance allow individuals to walk into a grocery store and leave with food without paying.

You could argue healthcare as a necessary element towards the right to life.

Individuals capable of paying for healthcare should compensate us for our work when they utilize our services. For individuals incapable of paying for healthcare there are two reasonable options: provide them no healthcare, or provide them appropriately comprehensive care to minimize their negative impact on society. Whether "Obamacare" exists or not, taxpayers indirectly inherit the costs of their care. I prefer a formalized system - "Obamacare" or some equivalent - in which we are compensated by the government for providing services (especially when we are mandated by federal law to do so) for those who are unable to pay for their own.
 
Last edited:
xaelia said:
The Declaration of Independence does indeed guarantee a right to life. Food and water are necessary to sustain life. Therefore, our civilized society has a responsibility to its citizens to provide these basic necessities to those in need. Food stamps and government assistance allow individuals to walk into a grocery store and leave with food without paying.

You could argue healthcare as a necessary element towards the right to life.

Individuals capable of paying for healthcare should compensate us for our work when they utilize our services. For individuals incapable of paying for healthcare there are two reasonable options: provide them no healthcare, or provide them appropriately comprehensive care to minimize their negative impact on society. Whether "Obamacare" exists or not, taxpayers indirectly inherit the costs of their care. I prefer a formalized system - "Obamacare" or some equivalent - in which we are compensated by the government for providing services (especially when we are mandated by federal law to do so) for those who are unable to pay for their own.
Click to expand...

No, wrong. You can't walk in to a store and get food and water for free. Food stamps are money, taken from someone else, me the taxpayer. Nice try, but theres no free lunch and were out of money and I don't want to give more. You're welcome to give more, but I vote no. Now, my favorite recent celebrity quote: "I've got tiger blood"- Charlie Sheen
 
xaelia said:
The Declaration of Independence does indeed guarantee a right to life. Food and water are necessary to sustain life. Therefore, our civilized society has a responsibility to its citizens to provide these basic necessities to those in need. Food stamps and government assistance allow individuals to walk into a grocery store and leave with food without paying.
Click to expand...

I disagree. The Declaration doesn't guarantee anything. It was a statement of the philosophy behind our revolt against Britain. It's the Constitution that guarantees rights and it delineates them as well. More importantly the intent of the founders was to limit the power of government over citizens. The philosophical basis of revolting in the name of "life, liberty and the pursuit of happiness" was not to establish a government that would provide these things but rather to establish one that could not take these things away by fiat and the colonists felt King George had been doing.

The overarching problem with any entitlement is that by redistributing wealth you limit the rights of those from whom you confiscate it.
 
docB said:
I disagree. The Declaration doesn't guarantee anything. It was a statement of the philosophy behind our revolt against Britain. It's the Constitution that guarantees rights and it delineates them as well. More importantly the intent of the founders was to limit the power of government over citizens. The philosophical basis of revolting in the name of "life, liberty and the pursuit of happiness" was not to establish a government that would provide these things but rather to establish one that could not take these things away by fiat and the colonists felt King George had been doing.
Click to expand...

Duly corrected.

Aside from the continued philosophical debate regarding what to actually _do_ with all these individuals whose inability to provide for themselves infringes upon the rights of us working stiffs - it doesn't look like healthcare reform, as passed in the prior congress, is going to survive in enough meaningful form to substantially change current salaries.
 
docB said:
The philosophical basis of revolting in the name of "life, liberty and the pursuit of happiness" was not to establish a government that would provide these things but rather to establish one that could not take these things away by fiat and the colonists felt King George had been doing.
Click to expand...

I had a fiat once. You couldn't take much away in it. Not much cargo room... Fun though. :D
 
xaelia said:
Duly corrected.

Aside from the continued philosophical debate regarding what to actually _do_ withall these individuals whose inability to provide for themselvesinfringes upon the rights of us working stiffs - it doesn't look like healthcare reform, as passed in the prior congress, is going to survive in enough meaningful form to substantially change current salaries.
Click to expand...

After my last post, I was sure I was done with this thread, but I just can't resist. Do you really work in an ER? Inability to provide for themselves? I can't tell you how many times I've had this conversation:

Sir, would you mind turning off the cell phone? (FYI: cell phones cost money)

"No problem"

What brings you in here today sir?

"(fill in chief complaint and rest of HPI/PMH/PSH/MEDS/ALL)"

Do you drink alcohol?

"A lot" (costs money)

Do you smoke?

"Oh yeah" (costs money)

Any drugs?

"Just a little marijuana" (costs money)

You live here in town?

"Nope, on vacation (hotels costs money). Hey doc, you mind some samples, a cab voucher and a turkey sando before we hit the road."

Sadly, this person outnumbers the tragically unlucky person 10:1.

Unable to provide for themselves?:laugh:

No. Too smart and resourceful to waste money on things that they can get the gullible tax payers to pay for.
 
xaelia said:
Yes, unable or unwilling to provide for themselves - and not an easy task to separate the two populations with legislated programs.
Click to expand...

You are correct. That difficulty leads conservatives to argue that legislators shouldn't try as they will invariably not only just change the population that is forced to pay for the problem, it will lead to a myriad of unintended consequences.
 
“I quit when medicine was placed under State control, some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? THAT was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussion that preceded the enslavement of medicine, men discussed everything – except the desires of doctors. I have often wondered at the smugness with which people answer their right to control my work, to force my will, to violate my conscience, to stifle my mind – yet what is it that they expect to depend on, when they lie on an operating table under my hands? Let them discover, in their operating rooms and hospital wards that it is not safe to place their lives in the hands of doctors whose livelihood they have throttled. It is not safe, if he is the sort of doctor who resents it – and still less safe if he is the sort who does not.”
Click to expand...

Wow! This is exactly how I feel.
 
Anyone else looking forward to the Atlas Shrugged movie? Just read the book this year, and it explains exactly (though somewhat verbosely) my views and how society should be structured.

Definitely a book worth a read if you're a budding socialist and think it's okay to spend the wealth of others for the "common good".
 
WilcoWorld said:
Well, it's a good thing that so many people on this forum list "Mountain Man" as their dream job...
Click to expand...
Oh cr@p! I am a mountain man, and I listed EM physician as my dream job. I'm going the wrong direction! :eek:
 
GeneralVeers said:
Not compelled under any circumstances. Voluntary donations of wealth are another story.
Click to expand...

So, absolutely no tax dollars should be spent on maintaining roads and highways, public transportation, schools, hospitals, the military, police, or fire department...
 
bravotwozero said:
So, absolutely no tax dollars should be spent on maintaining roads and highways, public transportation, schools, hospitals, the military, police, or fire department...
Click to expand...
My advice, dude: Don't do this. Arguing with a libertarian on Ayn Rand buzz is like hitting a speedballing UFC fighter with narcan.

You're entering a world of pain, my friend. :D
 
bravotwozero said:
So, absolutely no tax dollars should be spent on maintaining roads and highways, public transportation, schools, hospitals, the military, police, or fire department...
Click to expand...

No, that would be appropriate, even according to Rand. The people paying the taxes also use the highways, hospitals and the protection of the police and fire departments and military. It's taking the taxpayer money to give to people who don't pay taxes (forced charity) that she had a problem with.
 
ATLAS SHRUGGED: a must read for all physicians.
 
xaelia said:
Yes, unable or unwilling to provide for themselves - and not an easy task to separate the two populations with legislated programs.
Click to expand...

Yeah it is. To get money you have to work. If you can't perform physical work you can do clerical work. At least then we will be getting something for unemployment checks. Each week they draw, make them work more until they either have a job, or are working full-time for the unemployment office.
Also, mandatory drug tests for people on social programs. If I have to take them, and everyone in the military has to take them, then so do welfare recipients. If you fail you are put into rehab. If you fail again, no welfare. If you're supporting kids with it they are taken away.
 
Long video but worth it.
[YOUTUBE]http://www.youtube.com/watch?v=661pi6K-8WQ[/YOUTUBE]
Or you could read it at iowahawk
 
Dr.McNinja said:
Also, mandatory drug tests for people on social programs. ... If you're supporting kids with it they are taken away.
Click to expand...

1. Taking kids away for this would just punish the kids for their parents' behavior, which is immoral by almost any standard.

2. Why do you care so much about drug use? What difference does it make? I suspect you wouldn't be in favor of banning tobacco, which would save $100 billion a year in direct federal costs for medical care, so why get so hung up about the life choices of others in this case?
 
pseudoknot said:
1. Taking kids away for this would just punish the kids for their parents' behavior, which is immoral by almost any standard.
Click to expand...
So leaving them with drug using parents isn't abusive?
2. Why do you care so much about drug use? What difference does it make? I suspect you wouldn't be in favor of banning tobacco, which would save $100 billion a year in direct federal costs for medical care, so why get so hung up about the life choices of others in this case?
Click to expand...
Tobacco isn't illegal, but yeah, if you want to test for tobacco and refuse to pay for tobacco related illnesses then sure, I'm all for it. And banning tobacco would work almost as well as banning alcohol. I'm for legalizing everything, but if you use it, you pay the consequences of not getting other stuff for free.
Since we obviously will never get rid of the programs, we should at least prevent abusers of the system from using it. Ideally we wouldn't have the programs at all.
The reason I care is because a)drugs are illegal, b)they cost money and c)if you require government assistance for needs such as housing, food, and healthcare, then you shouldn't have discretionary income. Government assistance shouldn't be there for you to use your money for other unnecessary things, regardless of what they are.

Think of it like car insurance. Sure, you can choose your car, but if it's not safe, or gets stolen frequently, you have to pay more. Sorry, but money doesn't grow on trees and has to come from somewhere (see post above yours).
 
Dr.McNinja said:
So leaving them with drug using parents isn't abusive?
Click to expand...

Sadly, no, it's not as bad. Kids in foster care, group homes, and the like do much worse than kids who stay with their parents, unless the parents are spectacularly awful. (Foster care is also more expensive for the state, which may be an argument that would appeal to republicans. I guess neither is as cheap as letting them starve on the street though.)
 
pseudoknot said:
Sadly, no, it's not as bad. Kids in foster care, group homes, and the like do much worse than kids who stay with their parents, unless the parents are spectacularly awful. (Foster care is also more expensive for the state, which may be an argument that would appeal to republicans. I guess neither is as cheap as letting them starve on the street though.)
Click to expand...
Having been there to take kids away from parents, I will tell you that no kid likes to be removed. Even the ones with bruises and broken bones from the beatings will cry when taken away. But it is better for them.

I'm not sure what in the hell point you were trying to make about letting them starve on the street, but congratulations, you've identified your lack of rationality on this topic and merely emote about things.
 
You must log in or register to reply here.
Next unread thread

Similar threads

R
EM to palliative/hospice?
Replies
16
Views
1K
Frazier
Frazier
E
EM & Medicine - Plans to take today
2 3 4
Replies
161
Views
10K
sloh
S
R
How to deal with EM anxiety
Replies
30
Views
2K
EmergentMagician
E
petomed
EM part time
2
Replies
57
Views
4K
Arcan57
Arcan57
Jball43
Help the lady leave EM
Replies
35
Views
3K
cyanide12345678
cyanide12345678
Top