Everyone is telling me not to be a physician because of Obamacare?

[Gut Shot]

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Wow. Ok. Just because he doesn't want the government to force themselves into healthcare makes him anti civilization?

He didn't seem to be limiting it to health care. Odds are he another disaffected young white male who has bought into the comfortable platitudes of Ron Paul and his ilk. They want to limit the Federal government to about five functions under the assumption that utopia will most surely follow. If given the chance, I am fairly certain that one of two things would happen: Either they would quickly find themselves having to write far more rules and regulations than they initially thought, or things would disintegrate into anarchy and chaos. In other words, the opposite of civilization. Which is why nobody has every tried it in the history of mankind. Ever.

 

[plumazul]

He didn't seem to be limiting it to health care. Odds are he another disaffected young white male who has bought into the comfortable platitudes of Ron Paul and his ilk. They want to limit the Federal government to about five functions under the assumption that utopia will most surely follow. If given the chance, I am fairly certain that one of two things would happen: Either they would quickly find themselves having to write far more rules and regulations than they initially thought, or things would disintegrate into anarchy and chaos. In other words, the opposite of civilization. Which is why nobody has every tried it in the history of mankind. Ever.

Well said 👍

 

[Status Sciaticus]

He didn't seem to be limiting it to health care. Odds are he another disaffected young white male who has bought into the comfortable platitudes of Ron Paul and his ilk. They want to limit the Federal government to about five functions under the assumption that utopia will most surely follow. If given the chance, I am fairly certain that one of two things would happen: Either they would quickly find themselves having to write far more rules and regulations than they initially thought, or things would disintegrate into anarchy and chaos. In other words, the opposite of civilization. Which is why nobody has every tried it in the history of mankind. Ever.

You should stop assuming things.
I was clearly talking about the topic at hand, I am not a young white male, and I am not a blind Ron Paul supporter.

While I do enjoy watching Ron Paul school/educate/call out many of the politicians in the various parties, it does not mean that I would support all his decisions. He is an extreme example of libertarianism.

 

[plumazul]

You should stop assuming things.
I was clearly talking about the topic at hand, I am not a young white male, and I am not a blind Ron Paul supporter.

While I do enjoy watching Ron Paul school/educate/call out many of the politicians in the various parties, it does not mean that I would support all his decisions. He is an extreme example of libertarianism.

I sure hope not

http://freebeacon.com/rebel-yell/

As for "an extreme example of libertarianism", there is a name for that, "anarchism".

 

[Radon XP]

The people who don't support universal healthcare are usually those who have never had a sick family member that couldn't pay for medical care/attention. I.e, spoiled brats who don't know what they're talking about and only want what they want because it wouldn't really affect them.

 

[Arkangeloid]

The people who don't support universal healthcare are usually those who have never had a sick family member that couldn't pay for medical care/attention. I.e, spoiled brats who don't know what they're talking about and only want what they want because it wouldn't really affect them.

I would lose the attitude before I went to medical school.

 

[DocCox]

The people who don't support universal healthcare are usually those who have never had a sick family member that couldn't pay for medical care/attention. I.e, spoiled brats who don't know what they're talking about and only want what they want because it wouldn't really affect them.

No.... Just no.

 

[Radon XP]

I would lose the attitude before I went to medical school.

Elaborate

No.... Just no.

Yes, actually.

 

[def1]

I would lose the attitude before I went to medical school.

I'm in medical school and I feel similar.

I'm from an area where its quite common to see people die or endure preventable chronic diseases because they don't have access or money for healthcare, and I feel if more people truly understood how tough it is for people to survive while living in poverty than universal healthcare wouldn't even be an issue.

I don't think anyone who disagrees is a spoiled brat, but a bit out of touch with reality.

 

[Status Sciaticus]

The people who don't support universal healthcare are usually those who have never had a sick family member that couldn't pay for medical care/attention. I.e, spoiled brats who don't know what they're talking about and only want what they want because it wouldn't really affect them.

Actually, I am one of those people against universal healthcare.
My family has a strong genetic predisposition (5 family members) with type 2 diabetes, and one of my close family members actually died due to ulcers/cirrhosis because we couldnt afford a liver transplant.

Would it have been good if we had universal healthcare? Sure.
But is my family to blame for not taking the appropriate measures to prevent catastrophes? Yes.

The problem with many many people is they have misplaced priorities. I have seen many patients on medicaid/welfare/uninsured because they cant 'afford' health insurance but seem to have the latest iPhone or Louis Vuitton bag....
but they cant spend money on health insurance and opt for an older iPhone or non-brand items? Please...

I would lose the attitude before I went to medical school.

👍

No.... Just no.

👍

 

[Radon XP]

Actually, I am one of those people against universal healthcare.
My family has a strong genetic predisposition (5 family members) with type 2 diabetes, and one of my close family members actually died due to ulcers/cirrhosis because we couldnt afford a liver transplant.

The problem with many many people is they have misplaced priorities. I have seen many patients on medicaid/welfare/uninsured because they cant 'afford' health insurance but seem to have the latest iPhone or Louis Vuitton bag....
but they cant spend money on health insurance and opt for an older iPhone or non-brand items? Please...

A few consumer gadgets says nothing about one's overall economic situation, which includes not only income, but also job security, prospects, etc. What, you honestly think forsaking that "iPhone" is going to enable them to do jack ****?

I've noticed that this sort of thinking is a trend among libertarians: victim-blaming of the poor. Apparently, poor people are poor because they want to be, and they just need to work harder! It's that easy!

Also, way to defend the very broken system that caused one of your family to die. You're truly brainwashed.

 

[Status Sciaticus]

A few consumer gadgets says nothing about one's overall economic situation, which includes not only income, but also job security, prospects, etc. What, you honestly think forsaking that "iPhone" is going to enable them to do jack ****?

I've noticed that this sort of thinking is a trend among libertarians: victim-blaming of the poor. Apparently, poor people are poor because they want to be, and they just need to work harder! It's that easy!

Also, way to defend the very broken system that caused one of your family to die. You're truly brainwashed.

Actually yea.... skipping an $800 phone provides you with 5-8 months of individual insurance coverage..... and it was just an example. People purchase frivolous things all the time.

Victim blaming? Hardly...
You get what you work for.
If you cant afford something, work longer and make more money.
An extra $150 a month is 15 hours/week more per month to get your comprehensive insurance.

Its not about being libertarian, democratic, or republican. Most people in America have an attitude that they should be spoon-fed and handed things without working for it.... clearly something that you seem to favor.

The broken system didn't CAUSE him to die. His cirrhosis was the cause which stemmed from poor diet and alcoholism.
And my family member dying could have been prevented through many means...
Universal healthcare is one of them..
But having insurance is also another...
And so was taking preventative measures...

I'm dont blame others (the government or insurance companies) like you for not giving my family handouts. My family member made his decision not to purchase insurance and we suffered the consequences.

 

[Radon XP]

Actually yea.... skipping an $800 phone provides you with 5-8 months of individual insurance coverage..... and it was just an example. People purchase frivolous things all the time.

Victim blaming? Hardly...
You get what you work for.
If you cant afford something, work longer and make more money.
An extra $150 a month is 15 hours/week more per month to get your comprehensive insurance.

Easy to say, harder to do for most Americans, many of whom are unemployed or underemployed.

And yes, you're victim-blaming because you're suggesting that it's easy to just "not be poor", so obviously those who are, are just lazy/stupid/deserve it.

Oh boy, how you are going to hate the real world. Tell all that to the people who break their backs working 60+ hours a week for peanuts and have other family obligations to support.

What fairy tale do you live in where things are that simple? Anybody who has had any experience with grinding poverty scoffs at your suggestion, made from a position of privilege.

Its not about being libertarian, democratic, or republican. Most people in America have an attitude that they should be spoon-fed and handed things without working for it.... clearly something that you seem to favor.

Working class Americans DID work for it. Is it their fault that their wages are stagnant while the fruits of their labor are siphoned off?

Universal health care is deserved by all working people.

The broken system didn't CAUSE him to die. His cirrhosis was the cause which stemmed from poor diet and alcoholism.
And my family member dying could have been prevented through many means...
Universal healthcare is one of them..
But having insurance is also another...
And so was taking preventative measures...

I'm dont blame others (the government or insurance companies) like you for not giving my family handouts. My family member made his decision not to purchase insurance and we suffered the consequences.

How noble!

Not.

The reality has nothing to do with silly idealistic thinking like yours. The reality is that the means exist to prevent pointless deaths, like that of your family member, but they aren't implemented because of your kind of thinking. It's that simple.

 

[plumazul]

Its not about being libertarian, democratic, or republican. Most people in America have an attitude that they should be spoon-fed and handed things without working for it.... clearly something that you seem to favor.

How are you going to practice medicine when you harbor such strong contempt for "most" of the patients you will see? This seems like a recipe for disaster.

 

[GypsyHummus]

A few consumer gadgets says nothing about one's overall economic situation, which includes not only income, but also job security, prospects, etc. What, you honestly think forsaking that "iPhone" is going to enable them to do jack ****?

I've noticed that this sort of thinking is a trend among libertarians: victim-blaming of the poor. Apparently, poor people are poor because they want to be, and they just need to work harder! It's that easy!

Also, way to defend the very broken system that caused one of your family to die. You're truly brainwashed.

Its not that. Poverty stricken people do make it to the top, but there has to be an intrinsic motivation to do so. Look at Dr. Ben Carson. He is someone who became a physician, despite the odds, growing up in extreme poverty and in a single parent household where the mother had less than a 3rd grade education.

Now, I understand people will say that this is very rare and a majority of the poor stay poor. But we must ask ourselves, why are the poor poor? How do they spend their time, what is the education like for them, who are the people who influence them? I dont care what argument anyone brings up, they have to admit to the fact that it can be done. it is not about just working harder, it is about changing the very fabric of morals for a person. If poor people have no motivation to get up every day at 6 am and work to put food on the table, what motivation will they have when the government provides everything for them? And who is footing the bill? I dont know these people, do you? I dont know why they need help or even if they really need help. Every choice someone makes has life altering ramifications.

I am a libertarian, however I will preface that by saying that I am an able bodied person who is unemployed at the moment who was fortunate enough to have college almost paid for with a scholarship. I realize there are people who are better off than me, and people who are worse off. Life is what we make it, and it is up to the individual to liberate the chains of poverty. It takes mind, body, and spirit, just like with Dr. Carson, but it can be done.

steps off soap box

Btw, people die in a universal health care system as well, dont forget, nothing is perfect. Some have to wait six months in canada for an MRI.

 

[Radon XP]

Its not that. Poverty stricken people do make it to the top, but there has to be an intrinsic motivation to do so. Look at Dr. Ben Carson. He is someone who became a physician, despite the odds, growing up in extreme poverty and in a single parent household where the mother had less than a 3rd grade education.

Now, I understand people will say that this is very rare and a majority of the poor stay poor. But we must ask ourselves, why are the poor poor? How do they spend their time, what is the education like for them, who are the people who influence them? I dont care what argument anyone brings up, they have to admit to the fact that it can be done. it is not about just working harder, it is about changing the very fabric of morals for a person. If poor people have no motivation to get up every day at 6 am and work to put food on the table, what motivation will they have when the government provides everything for them? And who is footing the bill? I dont know these people, do you? I dont know why they need help or even if they really need help. Every choice someone makes has life altering ramifications.

I am a libertarian, however I will preface that by saying that I am an able bodied person who is unemployed at the moment who was fortunate enough to have college almost paid for with a scholarship. I realize there are people who are better off than me, and people who are worse off. Life is what we make it, and it is up to the individual to liberate the chains of poverty. It takes mind, body, and spirit, just like with Dr. Carson, but it can be done.

steps off soap box

Btw, people die in a universal health care system as well, dont forget, nothing is perfect. Some have to wait six months in canada for an MRI.

Silly idealism at its finest.

I think about material reality. If the means exist, industrially, to support a better quality of life for the vast majority of people, then to refuse to do so because you want to protect these ideals (which is nothing more than the protection of the few people who benefit from them) is absolutely morally bankrupt. Period.

Libertarians never fail to amuse me. Go live in your Ayn Rand paradise and I guarantee you you'd be another nobody making peanuts and living a miserable life, just like people who live in capitalist systems with even fewer protections than the United States (who, by the way, support your standard of living in the First World). The reality is that most "Libertarians" aren't successful or accomplished, but just delusional.

 

[DocCox]

A few consumer gadgets says nothing about one's overall economic situation, which includes not only income, but also job security, prospects, etc. What, you honestly think forsaking that "iPhone" is going to enable them to do jack ****?

I've noticed that this sort of thinking is a trend among libertarians: victim-blaming of the poor. Apparently, poor people are poor because they want to be, and they just need to work harder! It's that easy!

Also, way to defend the very broken system that caused one of your family to die. You're truly brainwashed.

It has nothing to do with "victim-blaming of the poor". It has to do with the freedom of a physician to provide care the way he/she intends to. Requiring physicians to provide everyone with care, even if they disagree with the compensation they are receiving to do so is servitude. Health care can't be a considered a "right" (the implication of UHC) because it would require the infringing of another's rights to implement. I don't see how a person can have a "right" to another person's voluntary services. If a doctor want's to provide care for a person who cannot afford it - that should be the choice of the doctor. If you call the refusal to provide care immoral, that's your opinion. Who are you to decide the moral code of every physician in the country? I look forward to becoming a physician someday and providing care to as many people as I can - even those who are financially unstable. Not because of any outside influences, but because that is the type of person I am, and those are the values I set for myself. But I refuse to impose my beliefs on anyone else's life but my own.

 

[DocCox]

Its not that. Poverty stricken people do make it to the top, but there has to be an intrinsic motivation to do so. Look at Dr. Ben Carson. He is someone who became a physician, despite the odds, growing up in extreme poverty and in a single parent household where the mother had less than a 3rd grade education.

Now, I understand people will say that this is very rare and a majority of the poor stay poor. But we must ask ourselves, why are the poor poor? How do they spend their time, what is the education like for them, who are the people who influence them? I dont care what argument anyone brings up, they have to admit to the fact that it can be done. it is not about just working harder, it is about changing the very fabric of morals for a person. If poor people have no motivation to get up every day at 6 am and work to put food on the table, what motivation will they have when the government provides everything for them? And who is footing the bill? I dont know these people, do you? I dont know why they need help or even if they really need help. Every choice someone makes has life altering ramifications.

I am a libertarian, however I will preface that by saying that I am an able bodied person who is unemployed at the moment who was fortunate enough to have college almost paid for with a scholarship. I realize there are people who are better off than me, and people who are worse off. Life is what we make it, and it is up to the individual to liberate the chains of poverty. It takes mind, body, and spirit, just like with Dr. Carson, but it can be done.

steps off soap box

Btw, people die in a universal health care system as well, dont forget, nothing is perfect. Some have to wait six months in canada for an MRI.

Bingo. Very well said, Gypsy. I share the same sentiments.

 

[Radon XP]

It has nothing to do with "victim-blaming of the poor". It has to do with the freedom of a physician to provide care the way he/she intends to. Requiring physicians to provide everyone with care, even if they disagree with the compensation they are receiving to do so is servitude.

I'm all for higher physician compensation. UHC and higher physician pay aren't mutually exclusive.

Health care can't be a considered a "right" (the implication of UHC) because it would require the infringing of another's rights to implement. I don't see how a person can have a "right" to another person's voluntary services. If a doctor want's to provide care for a person who cannot afford it - that should be the choice of the doctor.

Whether or not healthcare is a right is, to me, an entirely irrelevant discussion. The fact is that the nation has the productive capacity to provide universal healthcare. Therefore, it ought to be done.

It will be no different than how doctors today accept HMO's and what not. Just another program to accept/system in place to work with.

 

[GypsyHummus]

Silly idealism at its finest.

I think about material reality. If the means exist, industrially, to support a better quality of life for the vast majority of people, then to refuse to do so because you want to protect these ideals (which is nothing more than the protection of the few people who benefit from them) is absolutely morally bankrupt. Period.

Libertarians never fail to amuse me. Go live in your Ayn Rand paradise and I guarantee you you'd be another nobody making peanuts and living a miserable life, just like people who live in capitalist systems with even fewer protections than the United States (who, by the way, support your standard of living in the First World). The reality is that most "Libertarians" aren't successful or accomplished, but just delusional.

Thats how people rise out of poverty, through material means. Its only when they change the way of thinking can they transcend the descicions and ramifications that had lead them to poverty.

There are no absolutes, but in America at least, if you truely want something and you are willing to sacrifice everything: family, friends, food, girlfriends, boyfriends, postponing marriage or even not marrying, moving away from distractions, etc; there is nothing holding someone back.

 

[Status Sciaticus]

How are you going to practice medicine when you harbor such strong contempt for "most" of the patients you will see? This seems like a recipe for disaster.

I dont harbor contempt. Im just concerned that people have disillusioned themselves into thinking that healthcare in the US will ever be socialized, especially since the passage of the ACA. I am not against Obamacare in principle, just how it attempts to make budget cuts at the level of the physician by undercutting insurance reimbursements.

Will I be treating uninsured patients? Sure I will, and gladly so.
But will I be treating someone for free when I see that they drive an Escalade and look like they can clearly afford my services but choose not to? Probably not.

The good thing about working for a hospital is that I dont have to make those decisions. The hospital just tells me who to treat, and I do it. Simple as that.

Easy to say, harder to do for most Americans, many of whom are unemployed or underemployed.

And yes, you're victim-blaming because you're suggesting that it's easy to just "not be poor", so obviously those who are, are just lazy/stupid/deserve it.

Oh boy, how you are going to hate the real world.



Working class Americans DID work for it. Is it their fault that their wages are stagnant while the fruits of their labor are siphoned off?

Universal health care is deserved by all working people.



How noble!

Not.

The reality has nothing to do with silly idealistic thinking like yours. The reality is that the means exist to prevent pointless deaths, like that of your family member, but they aren't implemented because of your kind of thinking.

Actually, I have been in the real world... I spent the majority of my time in a third world country so I have seen the true impact of poverty.

Have you actually been in the real world... to that degree? I doubt it.

My family was on medicaid/WIC and if we managed to do it, I dont see how others cant. And my parents didnt even graduate high school.

 

[DocCox]

I'm all for higher physician compensation. UHC and higher physician pay aren't mutually exclusive.

Whether or not healthcare is a right is, to me, an entirely irrelevant discussion. The fact is that the nation has the productive capacity to provide universal healthcare. Therefore, it ought to be done.

It will be no different than how doctors today accept HMO's and what not. Just another program to accept/system in place to work with.

Out of curiosity, in this system where would the money come from to pay for care for those who can't afford it?

 

[Status Sciaticus]

Its not that. Poverty stricken people do make it to the top, but there has to be an intrinsic motivation to do so. Look at Dr. Ben Carson. He is someone who became a physician, despite the odds, growing up in extreme poverty and in a single parent household where the mother had less than a 3rd grade education.

Now, I understand people will say that this is very rare and a majority of the poor stay poor. But we must ask ourselves, why are the poor poor? How do they spend their time, what is the education like for them, who are the people who influence them? I dont care what argument anyone brings up, they have to admit to the fact that it can be done. it is not about just working harder, it is about changing the very fabric of morals for a person. If poor people have no motivation to get up every day at 6 am and work to put food on the table, what motivation will they have when the government provides everything for them? And who is footing the bill? I dont know these people, do you? I dont know why they need help or even if they really need help. Every choice someone makes has life altering ramifications.

I am a libertarian, however I will preface that by saying that I am an able bodied person who is unemployed at the moment who was fortunate enough to have college almost paid for with a scholarship. I realize there are people who are better off than me, and people who are worse off. Life is what we make it, and it is up to the individual to liberate the chains of poverty. It takes mind, body, and spirit, just like with Dr. Carson, but it can be done.

steps off soap box

Btw, people die in a universal health care system as well, dont forget, nothing is perfect. Some have to wait six months in canada for an MRI.

👍👍👍👍

It has nothing to do with "victim-blaming of the poor". It has to do with the freedom of a physician to provide care the way he/she intends to. Requiring physicians to provide everyone with care, even if they disagree with the compensation they are receiving to do so is servitude. Health care can't be a considered a "right" (the implication of UHC) because it would require the infringing of another's rights to implement. I don't see how a person can have a "right" to another person's voluntary services. If a doctor want's to provide care for a person who cannot afford it - that should be the choice of the doctor. If you call the refusal to provide care immoral, that's your opinion. Who are you to decide the moral code of every physician in the country? I look forward to becoming a physician someday and providing care to as many people as I can - even those who are financially unstable. Not because of any outside influences, but because that is the type of person I am, and those are the values I set for myself. But I refuse to impose my beliefs on anyone else's life but my own.

👍👍👍👍

 

[ToldYouSo]

How are you going to practice medicine when you harbor such strong contempt for "most" of the patients you will see? This seems like a recipe for disaster.

You just activated Godwin's Law

 

[ToldYouSo]

Are physician's ever going to be forced to accept insurance? Looks like concierge family medicine could be a good solution to expensive insurance plans. Read this in the FM section: $10-100 a month based on age only and each doc in this practice is making ~200k net.


This along with a catastrophic health insurance plan could save the average person a lot of money.

my 2 cents - concierge family practice will grow to become the standard, drop the concierge, and will be the new "family medicine". Health reform will drive this b/c the current insurance based model (regardless of who resides in the oval office) is unsustainable and unaffordable.

my model of "concierge" is more aptly described as "direct primary care":

by going 100% ins free, and working directly with the patients, then the incentives are appropriately aligned so that my first and last responsibility is to them. now that doesn't mean i rx pain meds or abx when they don't need them...the customer is usually right...and the patient is usually wrong about abx.

The avg practice has 7-10 employees per doc to play the ins game. crazy! http://goo.gl/FvPBu

We have 1 staff/RN for 3 doctors. Overhead is less than 30% and income is up 40%.

Model: low monthly membership, $10-100/mo/pt based on age only (not on pre-existings) for unlimited home/work/office/tech visits, no coapys, all procedures free and up to 95% discount on medicines and labs = then they can find insurance up to 30-50% cheaper.
doesn't work? too good to be true? drunk? yes only to #3 🙂
simple math: $50/pt/mo x 600 pt x 12 mo = $360 - 30% overhead - 240k - employer taxes/benefits - $200ish take home per doc.

oh and does it help that i only saw 25 pts last week? WEEK

wholesale meds = HUGE value, more than pays for the membership for many patients. the poor need this the most. prilosec is $2.49 per month. HCTZ is $0.01/pill. Zofran $3.75/bottle. leflunomide $11 mo for us, $120 generic at pharm and $950 brand at pharm.....uhhhhh...easy call for every pt [with RA that is]
wholesale labs = cbc $2, cmp $4.5, lipids $3, tsh $3, T3/4 $4/ea, etc etc.

included procedures: laceration repair, bx, joint injections, ultrasound (non-dx ob), ekg, holter, spiro, audiometry, UA, rapid strep, dexa (yup, i bought a dexa in residency, long story), home sleep apnea screening, minor surgical procedures, medical laser treatments (aerolase.com).----think about it, all that stuff is cheap to do after you have the equipment. If it keeps the pts coming back, who cares how often they get a $0.40 ekg?!

THEY ABUSE IT -- i'll just address it now b/c it'll be asked. No. They. Don't. they have my cell phone, they text, they tweet, they facebook, [few] skype, they email. But they DON'T abuse it. For 1) its only 600 people, 2) they are very gracious in returning the trust you give them. 3) it drops in their chart (mind blown?)

INSURANCE WILL SQUASH THIS - nope, wrong again. we've shown insurance companies how to rethink their business model. they save so much $$$ when they work with us that its silly. They are working WITH us now b/c it lets them lower their premiums. Ok ok, by now if you're still reading, you think i'm drunk on my own koolaid (flavor: delusions of grandeur). True.

ONLY FOR THE RICH - really? come on, now you're not even trying. $10/mo/kid for unlimited care? for the rich?

ok, thats good for now
thoughts?

 

[IL Pre Med]

I know discussing physician pay is a sensitive topic, but I wouldn't rag on doctors before I'd focus on all the actors, athletes, and "personalities", among CEO's and executives, who make hundreds of times more money for doing far less.

I couldn't agree more. Doctors contribute to society's well-being, what do entertainers do? It's insane how overpaid they are.

 

[TheWeeIceMan]

Are physician's ever going to be forced to accept insurance? Looks like concierge family medicine could be a good solution to expensive insurance plans. Read this in the FM section: $10-100 a month based on age only and each doc in this practice is making ~200k net.


This along with a catastrophic health insurance plan could save the average person a lot of money.

I bet they will eventually, but who knows.

 

[Gut Shot]

You should stop assuming things.
I was clearly talking about the topic at hand, I am not a young white male, and I am not a blind Ron Paul supporter.

Sure you aren't, premed Libertarian future elected official amateur constitutional scholar GandalfTheWhite. Sure you aren't.

I am not against Obamacare in principle, just how it attempts to make budget cuts at the level of the physician by undercutting insurance reimbursements.

Seriously, please explain this. Methinks you don't entirely understand how the ACA is supposed to work.

 

[Gut Shot]

Now, I understand people will say that this is very rare and a majority of the poor stay poor. But we must ask ourselves, why are the poor poor?

Fortunately for you this very question has been studied intently for decades, and a lot of progress has been made in understanding it, and there is an enormous body of literature surrounding it. You should find a library and do some dry, dispassionate, objective research on the subject.

I would also recommend "The Republican Brain" by Mooney. He does a nice dissection, so to speak, illustrating how folks of some political stripes (like you, I would say) are essentially hardwired into an authoritarian mindset,; they think people would be fine if the would just do as they're told. It's as simple as it is divorced from reality. Conversely, others tend to be wishful thinkers, which has its own set of problems.

 

[fourhumours]

Sure you aren't, premed Libertarian future elected official amateur constitutional scholar GandalfTheWhite. Sure you aren't.



Seriously, please explain this. Methinks you don't entirely understand how the ACA is supposed to work.

you cannot be serious (I sure hope not at least....I hope its one of those WOOSH moments for me)? I don't agree with Gandalf but pointing out his username (which is a quote from the book) to say he is white is patently dumb.

however all this talk about poor people being able to come out of poverty and achieve and the poor being poor and what not is sorta silly. of course you can cherry pick people who came out of poverty to achieve and reach either middle class or upper class lifestyles, but that is probably a very small percentage. I can't fathom anyone arguing that if you work hard, have reasonably good luck (no unfortunate out of their control circumstances like disease, criminal activities against them or other such things) and are capable you cannot pull yourself out of poverty. in my mind the bigger question is why should it be more difficult for someone born into poverty to be successful than someone born into privilege. we are essentially telling people that because of something completely beyond your control (the situation you are born into) that you now have a much more difficult road to travel and your work ethic and skill must be that much better than someone else to achieve the same thing. to me that is the greatest issue and where government should play a role. if we want a true meritocracy (coincidentally, as many libertarians and conservatives will tell you this is the reason to end Affirmative action) then we need to have institutionalized ways of eliminating advantages due to birth circumstances (i.e. more punitive inheritance taxes, stronger anti-nepotism laws, more support for poverty and lower class citizens).

if we truly want to be a country with the ideal that every person goes as far as their talents take them then we need to find ways to eliminate barriers that have arisen through no fault of the individual. I think in this context some form of healthcare insurance for all is a good step forward.

focusing on anecdotes and retread statements about how anyone can make it irregardless about the situation you were born into is takes us away from the fact that, while these statements and anecdotes may indeed be true, it leaves out important qualifiers about the relative difficulty in achieving these outcomes.

 

[thesauce]

This is a vastly oversimplified analysis. Whereas it is true that residency positions in FM, pedi and IM are virtually all filled, that does not mean that there is no way to increase the number of PCPs without increasing residency slots. First of all, about 80% of IM and 50% of pedi trainees will do a specialty fellowship and are therefore not ultimately practicing primary care. In pedi, many of these subspecialty slots are never filled as hospitals are decreasingly willing and able to offer these positions to those who did residencies outside the US. Although doing most fellowships in pedi does not benefit salary, it is not true that nothing could be done to encourage pedi residents (and IM residents) to practice primary care and thus increase the number of PCPs.

Some of the greatest need in pedi is providing care to underserved populations, whose needs are great but whose ability to pay isn't. There is plenty of room to enhance the number of pediatric residency graduates that fill this role. Improving the financial aspect of taking such a job would increase the number of PCPs providing such care. In addition, such an improvement might be very helpful in getting some pediatricians who are near retirement or working part-time to provide such care to increasing number of children.

As noted before, despite the awful thoughts of many on this board about it, the AAP and many pediatricians support universal coverage for children so that those who serve medicaid and low income children can be more readily covered for this type of care, especially community based PCP pediatric physicians.

These are good points. We could kick it up a notch and de-incentivize going through specialty training. I'm not sure how well it would work (there are more attractions to certain specialties than just money), but it's worth considering.

 

[thesauce]

you cannot be serious (I sure hope not at least....I hope its one of those WOOSH moments for me)? I don't agree with Gandalf but pointing out his username (which is a quote from the book) to say he is white is patently dumb.

however all this talk about poor people being able to come out of poverty and achieve and the poor being poor and what not is sorta silly. of course you can cherry pick people who came out of poverty to achieve and reach either middle class or upper class lifestyles, but that is probably a very small percentage. I can't fathom anyone arguing that if you work hard, have reasonably good luck (no unfortunate out of their control circumstances like disease, criminal activities against them or other such things) and are capable you cannot pull yourself out of poverty. in my mind the bigger question is why should it be more difficult for someone born into poverty to be successful than someone born into privilege. we are essentially telling people that because of something completely beyond your control (the situation you are born into) that you now have a much more difficult road to travel and your work ethic and skill must be that much better than someone else to achieve the same thing. to me that is the greatest issue and where government should play a role. if we want a true meritocracy (coincidentally, as many libertarians and conservatives will tell you this is the reason to end Affirmative action) then we need to have institutionalized ways of eliminating advantages due to birth circumstances (i.e. more punitive inheritance taxes, stronger anti-nepotism laws, more support for poverty and lower class citizens).

if we truly want to be a country with the ideal that every person goes as far as their talents take them then we need to find ways to eliminate barriers that have arisen through no fault of the individual. I think in this context some form of healthcare insurance for all is a good step forward.

focusing on anecdotes and retread statements about how anyone can make it irregardless about the situation you were born into is takes us away from the fact that, while these statements and anecdotes may indeed be true, it leaves out important qualifiers about the relative difficulty in achieving these outcomes.

First you would need to define those barriers, which will not be easy. Most of the benefits of an "upper class birth" can't really be controlled through legislation. You can't eliminate job/scholastic connections that parents have or control how parents spend their money on their children. True, you could tax the heck out of inheritance, but there will always be ways around that.

Most people don't believe that giving more money to the lower class is the answer - we've been doing that for decades and have only built a more entitlistic society. Regardless of how many regulations you pass, you can't change the fact that life isn't fair. But as you said, it's possible to break the cycle with a lot of hard work.

 

[Dave89]

Sure you aren't, premed Libertarian future elected official amateur constitutional scholar GandalfTheWhite. Sure you aren't.

You've really outdone yourself this time. 🙄

 

[Status Sciaticus]

You've really outdone yourself this time. 🙄

His powers of deduction are truly something to be reckoned with.

And BTW Gut Shot, Gandalf the White is actually the name of a character in Lord of the Rings.

you should stop ASSuming things.

 

[Dave89]

His powers of deduction are truly something to be reckoned with.

And BTW Gut Shot, Gandalf the White is actually the name of a character in Lord of the Rings.

you should stop ASSuming things.

Clearly, you're racist against gray people. 😉

 

[Bamfu]

Most people don't believe that giving more money to the lower class is the answer - we've been doing that for decades and have only built a more entitlistic society. Regardless of how many regulations you pass, you can't change the fact that life isn't fair. But as you said, it's possible to break the cycle with a lot of hard work.

It is definitely not the answer. I understand the thought that we should look after each other the best we can, but the sad, sad reality is that welfare, medicaid, and other government assistance programs are broken in that they are incredibly taken advantage of.

A lot of the bleeding hearts I've run into in college or on the interwebz have this romanticized persona of the lower SES that just isn't representative of the majority. I get it, but the reason "seasoned" professionals tend to go conservative isn't necessarily because of their interest in protecting their pocketbooks (though I'm sure that's a factor). I think it's more about experience with the lower SES population.

In teaching, I've seen it with students on free lunch decked out in brand-name clothing, backpacks, and a new pair of $100+ Nikes every other month.

For a medical example, one need only spend a couple hours in a pharmacy. Some good friends and my wife are pharmacists, and the stories I get to hear at dinner are incredible. Everyday I hear at least three examples of some 400 pound lady coming in with her 6 kids to pick up her diabetes medication. She complains about her <$5 Medicaid copay for 15 minutes, before finally paying for it with a $100 bill while also picking up 3 bags of chips, a couple cokes, a couple packs of smokes, and then leaving with her kids in her new 2013 escalade.

NOT WORKING AS INTENDED

 

[Status Sciaticus]

It is definitely not the answer. I understand the thought that we should look after each other the best we can, but the sad, sad reality is that welfare, medicaid, and other government assistance programs are broken in that they are incredibly taken advantage of.

A lot of the bleeding hearts I've run into in college or on the interwebz have this romanticized persona of the lower SES that just isn't representative of the majority. I get it, but the reason "seasoned" professionals tend to go conservative isn't necessarily because of their interest in protecting their pocketbooks (though I'm sure that's a factor). I think it's more about experience with the lower SES population.

In teaching, I've seen it with students on free lunch decked out in brand-name clothing, backpacks, and a new pair of $100+ Nikes every other month.

For a medical example, one need only spend a couple hours in a pharmacy. Some good friends and my wife are pharmacists, and the stories I get to hear at dinner are incredible. Everyday I hear at least three examples of some 400 pound lady coming in with her 6 kids to pick up her diabetes medication. She complains about her <$5 Medicaid copay for 15 minutes, before finally paying for it with a $100 bill while also picking up 3 bags of chips, a couple cokes, a couple packs of smokes, and then leaving with her kids in her new 2013 escalade.

NOT WORKING AS INTENDED

👍👍👍

 

[Status Sciaticus]

Clearly, you're racist against gray people. 😉

That name was taken 🙁

GandalfTheGrey flows so much better than GandalftheWhite

 

[GypsyHummus]

It is definitely not the answer. I understand the thought that we should look after each other the best we can, but the sad, sad reality is that welfare, medicaid, and other government assistance programs are broken in that they are incredibly taken advantage of.

A lot of the bleeding hearts I've run into in college or on the interwebz have this romanticized persona of the lower SES that just isn't representative of the majority. I get it, but the reason "seasoned" professionals tend to go conservative isn't necessarily because of their interest in protecting their pocketbooks (though I'm sure that's a factor). I think it's more about experience with the lower SES population.

In teaching, I've seen it with students on free lunch decked out in brand-name clothing, backpacks, and a new pair of $100+ Nikes every other month.

For a medical example, one need only spend a couple hours in a pharmacy. Some good friends and my wife are pharmacists, and the stories I get to hear at dinner are incredible. Everyday I hear at least three examples of some 400 pound lady coming in with her 6 kids to pick up her diabetes medication. She complains about her <$5 Medicaid copay for 15 minutes, before finally paying for it with a $100 bill while also picking up 3 bags of chips, a couple cokes, a couple packs of smokes, and then leaving with her kids in her new 2013 escalade.

NOT WORKING AS INTENDED

👍👍👍

I work in a clinic for the underserved and we have cases of this. People complain about how slow the doctor is, when in reality they should be thankful that they were able to get seen in the first place for free! That is what will happen if people perceive healthcare as a "right"

 

[fourhumours]

It is definitely not the answer. I understand the thought that we should look after each other the best we can, but the sad, sad reality is that welfare, medicaid, and other government assistance programs are broken in that they are incredibly taken advantage of.

A lot of the bleeding hearts I've run into in college or on the interwebz have this romanticized persona of the lower SES that just isn't representative of the majority. I get it, but the reason "seasoned" professionals tend to go conservative isn't necessarily because of their interest in protecting their pocketbooks (though I'm sure that's a factor). I think it's more about experience with the lower SES population.

In teaching, I've seen it with students on free lunch decked out in brand-name clothing, backpacks, and a new pair of $100+ Nikes every other month.

For a medical example, one need only spend a couple hours in a pharmacy. Some good friends and my wife are pharmacists, and the stories I get to hear at dinner are incredible. Everyday I hear at least three examples of some 400 pound lady coming in with her 6 kids to pick up her diabetes medication. She complains about her <$5 Medicaid copay for 15 minutes, before finally paying for it with a $100 bill while also picking up 3 bags of chips, a couple cokes, a couple packs of smokes, and then leaving with her kids in her new 2013 escalade.

NOT WORKING AS INTENDED

While I totally agree with your point with regards to handing out money, we run the issue of lumping the "I've seen students with $100 Nikes..." as the majority and not a minority (even if it is a large minority) of SES people and thus dooming them because of the actions of others in their group. I couldn't agree more that handing money out is a terrible idea, but there are plenty of ways the government can provide assistance to people of a lower SES that is not a handout. incentivizing (spelling?) teachers to work in those areas, creating much more comprehensive support systems for children in those areas (daycare, extend school hours through before and after school activities, etc.). as for handouts I think things that are restricted like the SNAP program are good examples of how a handout that can be good (assuming lobbyists are not successful in arguing alcohol or potato chips are food staples and it is kept to legitimate food stuffs). school lunch is another good thing because you can't expect a kid or teenager to be mature enough to challenge how their parents spend the family's money. medicaid is also good in theory because it provides healthcare, but the current system does need a change (I am personally in favor and don't see an issue with universal child healthcare even if we do not do it for adults).

what I said earlier did not mean to imply straight money handouts but using government to create an atmosphere and culture in low SES areas that, at the least, lessen the disadvantage the some people are born into.

 

[Bamfu]

👍👍👍

I work in a clinic for the underserved and we have cases of this. People complain about how slow the doctor is, when in reality they should be thankful that they were able to get seen in the first place for free! That is what will happen if people perceive healthcare as a "right"

Truth. I dare someone to answer the why medicine in an interview like this: to ensure that myself and my family can see a doctor within 6 months of being sick.

 

[Status Sciaticus]

👍👍👍

I work in a clinic for the underserved and we have cases of this. People complain about how slow the doctor is, when in reality they should be thankful that they were able to get seen in the first place for free! That is what will happen if people perceive healthcare as a "right"

👍

Truth. I dare someone to answer the why medicine in an interview like this: to ensure that myself and my family can see a doctor within 6 months of being sick.

👍

 

[Dave89]

Truth. I dare someone to answer the why medicine in an interview like this: to ensure that myself and my family can see a doctor within 6 months of being sick.

If I ever interview prospective med students, I will get instant acceptance for someone who gives this answer

 

[Bamfu]

If I ever interview prospective med students, I will get instant acceptance for someone who gives this answer

👍

I, too, make this pledge.

 

[circulus vitios]

Actually yea.... skipping an $800 phone provides you with 5-8 months of individual insurance coverage..... and it was just an example. People purchase frivolous things all the time.

Victim blaming? Hardly...
You get what you work for.
If you cant afford something, work longer and make more money.
An extra $150 a month is 15 hours/week more per month to get your comprehensive insurance.

Its not about being libertarian, democratic, or republican. Most people in America have an attitude that they should be spoon-fed and handed things without working for it.... clearly something that you seem to favor.

The broken system didn't CAUSE him to die. His cirrhosis was the cause which stemmed from poor diet and alcoholism.
And my family member dying could have been prevented through many means...
Universal healthcare is one of them..
But having insurance is also another...
And so was taking preventative measures...

I'm dont blame others (the government or insurance companies) like you for not giving my family handouts. My family member made his decision not to purchase insurance and we suffered the consequences.

No one buys phones off contract. Kaiser Permanente did a national study on the average price of private health insurance, and the figure they came up with was closer to $220 a month. You can't really "work an extra 15 hours a week. If it's a full time job, that would be considered overtime and employers are really stingy with overtime. If it's a part time job, employers want to keep you under the 32 hour/week limit to maintain part-time status. Getting a second job isn't always an option because of the scheduling conflicts inherent to working two jobs at once.

 

[Pacna]

I think this whole argument is silly. The idea that people have a right to medical care is just morally wrong.

A right is something you have innately. That is to say, if you and 9 other people exist on an island, you all have all the same rights and NO MORE rights than you would in a modern society. Rights are broad principles like the right to do whatever you want so long as it doesn't hurt someone else. You don't have a right to a phone, but you have the right to trade freely and be secure in your property. If somebody falls over bleeding in the street, you have a moral imperative to go help them, but they don't have a right to your help. You can't have a right to someone else's time or service.

If medical care is a right, then doctors, nurses, PA's, etc are slaves. If you have a right to their service, they cannot deny you, EVEN if you refuse to pay. Mandatory work w/o pay = slavery.

It's much farther flung to say that people have a right to health insurance. That's just f'ing ridiculous.

 

[circulus vitios]

I think this whole argument is silly. The idea that people have a right to medical care is just morally wrong.

A right is something you have innately. That is to say, if you and 9 other people exist on an island, you all have all the same rights and NO MORE rights than you would in a modern society. Rights are broad principles like the right to do whatever you want so long as it doesn't hurt someone else. You don't have a right to a phone, but you have the right to trade freely and be secure in your property. If somebody falls over bleeding in the street, you have a moral imperative to go help them, but they don't have a right to your help. You can't have a right to someone else's time or service.

If medical care is a right, then doctors, nurses, PA's, etc are slaves. If you have a right to their service, they cannot deny you, EVEN if you refuse to pay. Mandatory work w/o pay = slavery.

It's much farther flung to say that people have a right to health insurance. That's just f'ing ridiculous.

Government employment is not slavery, and private practice still exists in countries with socialized medicine.

 

[Status Sciaticus]

No one buys phones off contract. Kaiser Permanente did a national study on the average price of private health insurance, and the figure they came up with was closer to $220 a month. You can't really "work an extra 15 hours a week. If it's a full time job, that would be considered overtime and employers are really stingy with overtime. If it's a part time job, employers want to keep you under the 32 hour/week limit to maintain part-time status. Getting a second job isn't always an option because of the scheduling conflicts inherent to working two jobs at once.

Again, the phone was an example... i could just as easily have said an iPad that costs 400-500 which covers someone for 2-4 months.

to earn the extra 200, you would need to work 15-20 hours/month which comes out to an extra 4 hours a week.

Full time is 40 hours/week.

I think this whole argument is silly. The idea that people have a right to medical care is just morally wrong.

A right is something you have innately. That is to say, if you and 9 other people exist on an island, you all have all the same rights and NO MORE rights than you would in a modern society. Rights are broad principles like the right to do whatever you want so long as it doesn't hurt someone else. You don't have a right to a phone, but you have the right to trade freely and be secure in your property. If somebody falls over bleeding in the street, you have a moral imperative to go help them, but they don't have a right to your help. You can't have a right to someone else's time or service.

If medical care is a right, then doctors, nurses, PA's, etc are slaves. If you have a right to their service, they cannot deny you, EVEN if you refuse to pay. Mandatory work w/o pay = slavery.

It's much farther flung to say that people have a right to health insurance. That's just f'ing ridiculous.

+1

 

[oldbearprofessor]

I think this whole argument is silly. The idea that people have a right to medical care is just morally wrong.

Just to clarify and avoid semantics that miss the point.

If an infant is born and isn't breathing, does he have a right to be resuscitated (in a situation in which this is readily possible)? Do I have a right to refuse to care for him if the parents can't and won't pay me? Lets assume that I'm otherwise at his delivery and capable of doing this.

Just curious.

Personally, I tend to go with the WHO on this one.

http://www.who.int/mediacentre/factsheets/fs323/en/

You are entitled to think that I and the WHO are morally wrong.

 

[Radon XP]

I think this whole argument is silly. The idea that people have a right to medical care is just morally wrong.

You're still thinking about it wrong. Whether or not it's a right is a completely pointless debate. The fact is that the nation has the capacity and ability to provide it, and that it is good for the people.

I don't care if healthcare isn't a "right". It still needs to be universal and accessible by all. Look at this from a material perspective, not a moral one.

Again, the phone was an example... i could just as easily have said an iPad that costs 400-500 which covers someone for 2-4 months.

to earn the extra 200, you would need to work 15-20 hours/month which comes out to an extra 4 hours a week.

Full time is 40 hours/week.



+1

Again: easy to talk, harder to do. Go give your advice to struggling people. They'll laugh in your face. This is why libertarianism is a joke everywhere outside the United States.

Ya, go tell the 12-year old Vietnamese girls who work in shoe factories to just "work harder". ROFL