From a doctor's perspective, is it better to repeal or keep healthcare reform

[SpecterGT260]

I stopped reading all these posts so I quoted any random one. The bad memories are returning....I feel like I'm back in the unit with the intern. My month went like this...

Intern: "I think we should more lasix"
Me: The SBP is 70 so the answer is no
Intern: But I think we should give more lasix (followed by a 3 minute diatribe about why)
Me: No

And she continued to F'in argue!!!!

And she did this with everyone. Your posts remind me of that month but ou definitely seem much brighter lol

well thanks for that part, at least

and I try to make it a rule not to argue with residents or attendings when it comes to clinical, treatment, or pathophys stuff. Such instances have just never worked out for me but social or political discussions? Game on

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Members don't see this ad.

 

[IMDoc607]

well thanks for that part, at least

and I try to make it a rule not to argue with residents or attendings when it comes to clinical, treatment, or pathophys stuff. Such instances have just never worked out for me but social or political discussions? Game on

Haha nice

 

[startoverat40]

so nice to see the firey compassion that pours out of people for the 50000 who will die due to lack of insurance, and the thousands more who will suffer financial ruin due to illness. let's take the same scorched earth approach that we are taking towards global warming, and let the whole country burn down along with all the forest fires in NM and AZ.

 

[Dave89]

so nice to see the firey compassion that pours out of people for the 50000 who will die due to lack of insurance, and the thousands more who will suffer financial ruin due to illness. let's take the same scorched earth approach that we are taking towards global warming, and let the whole country burn down along with all the forest fires in NM and AZ.

Haha, I like how you took the fire theme and ran with it (despite the fact that I disagree with your opinion on this).

 

[startoverat40]

the Supreme(ly corrupt) court put its final stamp of approval on the wholesale ownership of our government by the multi-gazilionaires. let's see if they will finalize our full conversion to a feudalist society.

 

[Dave89]

the Supreme(ly corrupt) court put its final stamp of approval on the wholesale ownership of our government by the multi-gazilionaires. let's see if they will finalize our full conversion to a feudalist society.

mmmmmmmhhhhhhhhhmmmmmmmmm.... I'm guessing you started calling the SC corrupt around, oh, say, 2000.

You do know what "feudalist" means I presume. What I do not presume is that you are aware of the IPAB's unelected and unaccountable members under the so-called ACA. (I'm assuming your "feudalist society" remark was directed toward the healthcare market.)

 

[startoverat40]

there is nothing there to smile about.

 

[SpecterGT260]

there is nothing there to smile about.

I think the paranoia is worth half a chuckle

 

[startoverat40]

I think the paranoia is worth half a chuckle

why is the G.O.P. so devoted to these doctrines regardless of facts and evidence? It surely has a lot to do with the fact that billionaires have always loved the doctrines in question, which offer a rationale for policies that serve their interests. Indeed, support from billionaires has always been the main thing keeping those charlatans and cranks in business. And now the same people effectively own a whole political party.
Which brings us to the question of what it will take to end this depression we’re in.
Many pundits assert that the U.S. economy has big structural problems that will prevent any quick recovery. All the evidence, however, points to a simple lack of demand, which could and should be cured very quickly through a combination of fiscal and monetary stimulus.
No, the real structural problem is in our political system, which has been warped and paralyzed by the power of a small, wealthy minority. And the key to economic recovery lies in finding a way to get past that minority’s malign influence.

http://www.nytimes.com/2012/05/04/o...cy-paralysis-perplexity.html?_r=2&ref=opinion

100% of one party, and 80% of the other, say "let them eat cake". you can keep your head in the sand if you want to.

 

[Dave89]

100% of one party, and 80% of the other, say "let them eat cake". you can keep your head in the sand if you want to.

Krugman feels comfortable propagating the myth that the GOP is the party of millionaires and billionaires. Probably because this ensures him a steady stream of invites from Rachel Maddow and Chris Matthews types. When one looks at the numbers, the reality is quite different. For a start, look at the donations in 2008.

 

[startoverat40]

the myth that the GOP is the party of millionaires and billionaires.

http://www.rollingstone.com/politics/news/right-wing-billionaires-behind-mitt-romney-20120524

When one looks at the numbers, the reality is quite different.

http://www.twincities.com/ci_20927211/wealthy-romney-donors-access-thats-up-close-and

There's a billionaire party in Utah.....

[YOUTUBE]http://www.youtube.com/watch?v=Bs4y6fu6_GA[/YOUTUBE]

For a start, look at the donations in 2008.

I did say 80% of the other...

 

[deleted103644]

Krugman feels comfortable propagating the myth that the GOP is the party of millionaires and billionaires. Probably because this ensures him a steady stream of invites from Rachel Maddow and Chris Matthews types. When one looks at the numbers, the reality is quite different. For a start, look at the donations in 2008.

I think you really don't know much about Krugman.

He is far too critical of Obama for MSNBC.

That's not sarcasm, he really is critical of Obama.

Just because he thinks Republican politicians are all either liars or clowns doesn't mean he's happy with the saner alternative.

 

[SpecterGT260]

100% of one party, and 80% of the other, say "let them eat cake". you can keep your head in the sand if you want to.

Its so easy to validate your position when you label any dissenters as sheeple

 

[startoverat40]

it's so easy to swindle people when you lable anybody who tries to warn against your actions as paranoid.


here, let me help you remove the wool covering your eyes.


[YOUTUBE]http://www.youtube.com/watch?v=5OA-KgruEEg[/YOUTUBE]

 

[Dave89]

it's so easy to swindle people when you lable anybody who tries to warn against your actions as paranoid.

I, for one, don't think you're being paranoid - I just think you perceive the wrong side as being dangerous.

Influential and wealthy people will always work to effect their political agendas as best they can (see Bill Maher). The only way to really limit just how much of our lives can be controlled is to limit the government's ability to encroach. If you are really concerned about a "feudalist society", supporting the ACA hardly seems the right course to take.

 

[startoverat40]

i don't think our problem is limiting government's ability to encroach. our problem is to prevent our government from being encroached upon and preempted. the government is our only means of democratic effect. the gazillionaires have stripped our government of all its regulatory power, and have directed all of our rage towards our own democratic institutions. whereas all the rage should be directed towards the gazillionaires.

I don't support the ACA, I support single payer!

 

[Dave89]

http://www.rollingstone.com/politics/news/right-wing-billionaires-behind-mitt-romney-20120524



http://www.twincities.com/ci_20927211/wealthy-romney-donors-access-thats-up-close-and

There's a billionaire party in Utah.....

[YOUTUBE]http://www.youtube.com/watch?v=Bs4y6fu6_GA[/YOUTUBE]





I did say 80% of the other...

I can call and raise you George Soros, Bill Gates, Steve Jobs, and Warren Buffett. Oh, and those $35,000/plate dinners President Obama has with celebrity guests.. And oh yeah: http://www.huffingtonpost.com/dan-treul/fortune-500-ceos-favor-de_b_74017.html

Small business owners tend to vote Republican.

Perhaps you ought to switch around your 80%/100% split.

 

[Dave89]

i don't think our problem is limiting government's ability to encroach. our problem is to prevent our government from being encroached upon and preempted. the government is our only means of democratic effect. the gazillionaires have stripped our government of all its regulatory power, and have directed all of our rage towards our own democratic institutions. whereas all the rage should be directed towards the gazillionaires.

I don't support the ACA, I support single payer!

Excellent. Would that others of your persuasion were as forthright as you are.

 

[deleted103644]

Excellent. Would that others of your persuasion were as forthright as you are.

Most are. I agree, except I'm not mad at gazillionaires, and would like to be one. But I think they should pay 70% of that income in taxes, not 15% (or less). 30% of gazillion is still a lot.

Doctors are hit hardest by the tax system in the US. We should be fighting for lower taxes on our bracket and many more brackets above us with progressively higher rates.

 

[Dave89]

Most are. I agree, except I'm not mad at gazillionaires, and would like to be one. But I think they should pay 70% of that income in taxes, not 15% (or less). 30% of gazillion is still a lot.

Doctors are hit hardest by the tax system in the US. We should be fighting for lower taxes on our bracket and many more brackets above us with progressively higher rates.

I'm not referring to those who are merely liberal/progressive - those are usually vocal. But those who want to direct their "rage" toward "gazillionaires" - those people I'd like out in the open. Oh, and no sharp objects near them.

 

[startoverat40]

everyone should read these reports, lest their eyes be covered by the curly white.

http://www.sourcewatch.org/index.php?title=Citigroup#Sourcewatch_resources_on_plutonomy
http://www.box.net/shared/9if6v2hr9h

 

[startoverat40]

I. But those who want to direct their "rage" toward "gazillionaires" - those people I'd like out in the open. .

they have preempted our democratic government and rendered it neutered and paralyzed. tell me, who else should we direct our rage at?

Oh, and no sharp objects near them.

don't worry, those who are most likely to use sharp objects refer to themselves by an afternoon drink!

http://www.splcenter.org/get-informed/publications/terror-from-the-right

 

[Dave89]

they have preempted our democratic government and rendered it neutered and paralyzed. tell me, who else should we direct our rage at?

Chill. Just... chill.

don't worry, those who are most likely to use sharp objects refer to themselves by an afternoon drink!

http://www.splcenter.org/get-informed/publications/terror-from-the-right

That's right, Republicans are terrorists. We should place them in internment camps like iconic Democrat FDR. Or maybe use fire hoses and police dogs on them like Democrat Bull Connor.

 

[startoverat40]

Chill. Just... chill.

is that what you do when your house is being burglarized?

That's right, Republicans are terrorists. We should place them in internment camps like iconic Democrat FDR.

I didn't say republicans per se, you brought up "sharp objects" first. the evidence shows that if anybody has been using violence as a political tool, 99% of the time it has been the far right.

Or maybe use fire hoses and police dogs on them like Democrat Bull Connor.

or the Mayors of new york, Oakland, and many others. coordinated suppression of people's descent against the plutocracy.

 

[Dave89]

is that what you do when your house is being burglarized?




I didn't say republicans per se, you brought up "sharp objects" first. the evidence shows that if anybody has been using violence as a political tool, 99% of the time it has been the far right.


or the Mayors of new york, Oakland, and many others. coordinated suppression of people's descent against the plutocracy.

Aha. You're an Occupier.

 

[startoverat40]

Aha. You're an Occupier.

"All that is necessary for the triumph of evil is that good men do nothing"

.

 

[startoverat40]

The ACA: We Can Do Better

http://www.democratandchronicle.com...-Act-We-can-do-better?gcheck=1&nclick_check=1

No matter what the Supreme Court decides, we have the opportunity as a country to embrace a solution to this problem, if we have the political will to do so. Two-thirds of the population and 59 percent of physicians support the establishment of a national health insurance program. It is the right thing to do and, increasingly, it is imperative that we do so.

Dr. Laurence S. Jacobs is Professor of Medicine Emeritus at the University of Rochester and Vice-Chair of the Finger Lakes Chapter of Physicians for a National Health Program.

 

[Lysinee]

Last day for predictions. Do you think Obamacare will be......

A) Upheld
B) Partial repeal
C) Complete repeal

 

[SurfingDoctor]

Last day for predictions. Do you think Obamacare will be......

A) Upheld
B) Partial repeal
C) Complete repeal

I'm going with B. Given that recent Supreme Court rulings have stated that corporations are individuals and that racial profiling is cool, I can't imagine them saying that taxing people for something everyone eventually will use will be Kosher. Most of the rest of the act will probably stay (except maybe the Medicaid expansion), but obviously, there will be no financial support of the rest of the bill without the individual mandate and I bet premiums will skyrocket becoming unaffordable for most.

All in all, whatever expedites the collapse of the system to reach actual reform of the insurance companies and provides universal coverage is okay with me.

 

[Marcus Brody]

Rooting for the "collapse of the system." Classy.

 

[SurfingDoctor]

With or without the ACA, the system itself is not sustainable. You think there is some legistlation out there waiting to make the system sustainable so that it covers everyone fairly and that everyone will agree on? Well, okay. I hope there is too, but the reality is not there. Maybe I don't read enough history books (or maybe too much), but things only really change when the [insert expletive] hits the fan.

 

[Dave89]

I'm going with B. Given that recent Supreme Court rulings have stated that corporations are individuals

I expect you to be fully consistent on this point and take the view that

1) Corporations need not follow the laws of our nation (seeing as they are not people)

2) Unions also should not be able to direct money to political causes

and that racial profiling is cool, I can't imagine them saying that taxing people for something everyone eventually will use will be Kosher.

I'm assuming you're referring to Section 2(B). What you said is silly, for several reasons:

1) If one is looking for a fat, white suspect, is it "racial profiling" to only be on the lookout for white people? Yes, I suppose so, but in this case there's nothing wrong with such profiling because the reality is that the suspect is white - it's not racism. Similarly, the reality in Arizona is that there is a problem with illegal Mexicans, and so it's not objectionable to be on the lookout.

2) When exactly did the SC rule that "racial profiling is cool"? I didn't read that in the opinions.

3) Less on the legal side, Arizona never wanted to be in this position. If the federal government actually enforced its own laws, AZ wouldn't have to. All they are trying to do is act in full compliance with federal law.

4) Clearly you did not read about the details of the decision. The vote to uphold 2(B) was 8-0. Kagan recused herself, but Sotomayor, Breyer, and Stevens (all of whom are just about considered automatic votes to uphold ACA - but for some reason this does not infuriate liberals; only judges who employ the original intent approach manage this feat) all voted for upholding 2(B). So it seems you're just lashing out at the Court because you didn't like some decisions. Hey, I think the SC has major problems, too. But at least I know
the numbers and have read the opinions.

Most of the rest of the act will probably stay (except maybe the Medicaid expansion), but obviously, there will be no financial support of the rest of the bill without the individual mandate and I bet premiums will skyrocket becoming unaffordable for most.

All in all, whatever expedites the collapse of the system to reach actual reform of the insurance companies and provides universal coverage is okay with me.

I say A or C, but almost definitely not B. There is no severability clause, and it would have been political suicide for the Democrats to pass a bill that would collapse the system. Too easy to (rightfully) point the finger at them.

 

[SurfingDoctor]

Yep, you caught me. I editorialized. I will also not claim that I know all the ins and outs of law or the courts or yada yada. I am not a lawyer and I have not read all of the documents in the Supreme Court cases referenced nor the documents associated with the original bills or laws enacted or arguments of the circuit courts (my hats off to you if you have). Thus my expertise is zero.

However, it is my opinion that the Supreme Court attempts to interpret laws based on what is written in the constitution, but the flaw there is that the laws they interpret (constitutionality of mandated insurance, gun rights, corporation rights, right to search people suspected of being here illegally) are not in the constitution. I don't recall in Article X, Section Y it explicitly states any of the aforementioned "rights" or lack there of. The Supreme Court forms political or individual opinions, its all a matter of arguments and not facts.

I'm not sure why I would care who voted for what "Sotomayor, Breyer", etc if I don't agree with them or their decision. And if people think unlimited corportion contributions to political organizations to help their own cause is good for the people, good for them. If you want to point fingers at Democrats because you think they are at fault for everything, that's cool too (BTW, I am not a registered Democrat, I'm Independent... in thought too). As for the severability issue, an article in NEJM disagrees (http://www.nejm.org/doi/full/10.1056/NEJMp1201951), but that's your opinion and you are welcome to it.

Either way, tomorrow will be an interesting day, though personally, I don't think it will change things in the long run either way.

 

[Dave89]

Yep, you caught me. I editorialized. I will also not claim that I know all the ins and outs of law or the courts or yada yada. I am not a lawyer and I have not read all of the documents in the Supreme Court cases referenced nor the documents associated with the original bills or laws enacted or arguments of the circuit courts (my hats off to you if you have). Thus my expertise is zero.

However, it is my opinion that the Supreme Court attempts to interpret laws based on what is written in the constitution, but the flaw there is that the laws they interpret (constitutionality of mandated insurance, gun rights, corporation rights, right to search people suspected of being here illegally) are not in the constitution. I don't recall in Article X, Section Y it explicitly states any of the aforementioned "rights" or lack there of. The Supreme Court forms political or individual opinions, its all a matter of arguments and not facts.

I'm not sure why I would care who voted for what "Sotomayor, Breyer", etc if I don't agree with them or their decision. And if people think unlimited corportion contributions to political organizations to help their own cause is good for the people, good for them. If you want to point fingers at Democrats because you think they are at fault for everything, that's cool too (BTW, I am not a registered Democrat, I'm Independent... in thought too). That's your opinion and you are welcome to it.

Either way, tomorrow will be an interesting day, though personally, I don't think it will change things in the long run either way.

The reason I mentioned them is that you said something along the lines of "the Court that did this will likely do that" and I'm pointing out the issues are totally different.

Also, I don't fault Democrats for everything, but the fact of the matter is, it was a Democrat bill.

 

[SurfingDoctor]

Sorry just one more point, because it is interesting to me how people really only get things done as reactionaries and never as visionaries, listen to this argument:

http://www.cnn.com/video/?iid=artic...raso-healthcare-van-hollen-06-17-12-obama.cnn

Summary: Question (to both sides): "What is the future hold and what is plan B?", Answer (from both sides): "Turn around in the mirror, bend over and kiss what you see 'goodbye'"

 

[SpecterGT260]

so when is this thing supposed to drop?

 

[DrAwsome]

so when is this thing supposed to drop?

Tomorrow morning (June 28)

 

[Lysinee]

10 am EST.

 

[startoverat40]

once we get to replace the wack jobs in the court, then we'll start getting something sensible coming out of it...


http://www.washingtonpost.com/opini...hould-resign/2012/06/27/gJQApkO06V_story.html

http://www.slate.com/articles/news_...up_his_claims_about_illegal_immigration_.html

 

[deleted103644]

The reason I mentioned them is that you said something along the lines of "the Court that did this will likely do that" and I'm pointing out the issues are totally different.

Also, I don't fault Democrats for everything, but the fact of the matter is, it was a Democrat bill.

Why is it that conservatives always make that mistake?

It should be "Democratic bill", not "Democrat bill".

It's the Democratic Party, not the Democrat Party. There are Democrats in it, but that's a noun, not an adjective.

Republican, however, is both.

 

[deleted103644]

so when is this thing supposed to drop?

Who cares?

I really don't understand why anyone on the left or the right should get too excited about this thing.

It basically does nothing.

Even the "mandate" is optional - there is no authority to enforce.

 

[Dave89]

Why is it that conservatives always make that mistake?

It should be "Democratic bill", not "Democrat bill".

It's the Democratic Party, not the Democrat Party. There are Democrats in it, but that's a noun, not an adjective.

Republican, however, is both.

I was being quick and dirty.

I would call you out on your grammar-enforcing ways, but it's understandable given that you're right - many people incorrectly use Democrat as an adjective.

 

[Dave89]

once we get to replace the wack jobs in the court, then we'll start getting something sensible coming out of it...


http://www.washingtonpost.com/opini...hould-resign/2012/06/27/gJQApkO06V_story.html

http://www.slate.com/articles/news_...up_his_claims_about_illegal_immigration_.html

The authors of those articles are idiots. Posner (the Slate article) says absolutely nothing in a whole lot of words. Dionne (of WaPo) has several more functioning neurons, but that's not saying much. His complaint is that Scalia ought not to have mentioned the fact that the Obama administration is refusing to enforce its own law. But the fact of the matter is this was a crucial point. Sovereign entities have the right of exclusion. Now, states are supposed to be sovereign entities, but in the case of the US, this responsibility is given to the federal government. However, in this case, the fed. govt. is refusing to follow its constitutional task. So AZ, as a sovereign state, must have the right of exclusion.


It's absolutely laughable that WaPo is criticizing anyone for being political, when they are the most disgusting group of suck-ups to liberal Democrats there is in the media (yes, they're even worse than NYT!).

I urge you to consider broadening your base of news/opinion sources. Check out Breitbart.com, DrudgeReport, or National Review. You definitely are not on their side of almost any issue, but it'd be healthy to get both sides of the debate.

Edit: I'm not sure why you (apparently someone who is not too enamored with powerful corporations) are rooting for this bill. The bill is absolute poison to small businesses.

 

[xf3rn4nd3sx]

Most are. I agree, except I'm not mad at gazillionaires, and would like to be one. But I think they should pay 70% of that income in taxes, not 15% (or less). 30% of gazillion is still a lot.

Doctors are hit hardest by the tax system in the US. We should be fighting for lower taxes on our bracket and many more brackets above us with progressively higher rates.

Sorry, but this makes no sense. First off, "We should be fighting for lower taxes on our bracket and many more brackets above us with progressively higher rates." Doctors most certainly ARE NOT hit hardest by the tax system. This is biased thinking. EVERYONE wants lower taxes on their own bracket. What makes us special as physicians? Second, there is no sense in raising taxes if we cannot control spending. The additional revenue from raised taxes is quite insignificant relative to our expenditures. Wasteful spending: this is the problem.

Regarding the first point you made. "70% of that income in taxes...30% of a gazillion is still a lot." A business owner and friend from a town I used to live in explained this best. He said, "If a marginal bracket of say 60+% percent were to suddenly spring up, what would be my motivation to enter that bracket? There is an increased level of risk and work required to enter this bracket, yet I only keep 3/10 of it (less with all the small business taxes)? Currently my business brings home about 25% of what it produces after considering all taxes. My policy is now to hire as few workers as possible. Hell, I'll buy machinery to do the work. I'd love to hire people and provide jobs, but it simply does not make sense from a financial standpoint. With health care insurance requirements, ballooning costs, and outrageous taxes, it is risky to expand my business." This is coming from a business owner with companies having total net revenue of $6-7 million per year. He has fired workers and moved a lot of business overseas. This is in a small community, and the impact this has had on the community is apparent.

Additionally, just thought that I would add that income taxes were historically illegal. Remove deductions and flat tax everyone at 25% (except for those below poverty level). This would actually generate more tax revenue than the current system despite lower tax rates. 47% of Americans pay no federal income tax. This is absolutely ridiculous. I don't care if you pay 2%, but if you are taking advantage of public goods in this country, you should pay something. Many of these people paying no taxes are the ones demanding that others pay 70% income tax. I can guarantee that if these people were in such a high bracket, they themselves would complain of the injustice of this proposition. This is not targeted at any particular income group. There are in fact several millionaires that paid no income tax. This is downright criminal.


EDIT: Dave I agree to you. This is poison to small businesses. Moreover, it is especially dangerous to communities with medium sized business owners who can afford to downsize and move their business elsewhere.

 

[deleted103644]

Sorry, but this makes no sense. First off, "We should be fighting for lower taxes on our bracket and many more brackets above us with progressively higher rates." Doctors most certainly ARE NOT hit hardest by the tax system. This is biased thinking. EVERYONE wants lower taxes on their own bracket. What makes us special as physicians? Second, there is no sense in raising taxes if we cannot control spending. The additional revenue from raised taxes is quite insignificant relative to our expenditures. Wasteful spending: this is the problem.

Didn't specifically mean us - just our income range. Many of us will fall into the bottom percentiles of the highest income tax bracket.

Someone earning $350k should not have the same (or or even a greater %) tax burden than someone earning $350m.

 

[Hanguk]

Didn't specifically mean us - just our income range. Many of us will fall into the bottom percentiles of the highest income tax bracket.

Someone earning $350k should not have the same (or or even a greater %) tax burden than someone earning $350m.

Not to be off topic but you're not the same johnnydrama that runs allkpop.com are you?

 

[deleted103644]

Not to be off topic but you're not the same johnnydrama that runs allkpop.com are you?

Nope, we just both watched entourage at some point.

 

[SurfingDoctor]

Individual mandate struck down... all around the mulberry bush...

Edit: Or maybe not... seems to be mixed answers. Maybe it got converted into a tax?

 

[Lysinee]

The Supreme Court backs all parts of President Obama's signature health care law.

What are your thoughts?

 

[Dave89]

The Supreme Court has struck down the individual mandate for health care.

What are your thoughts?

can i get a link