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More opinions please.
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Dude, WTF? Nobody forced them to come here?! So you'd be cool with ****ting in an outhouse and not having any running water? With being so poor you eat the same ****ty meal 6 times a week? People come here for a better life. Believe it or not Taco Bell pays a lot better than some jobs in developIng countries. Nobody forces them to take certain jobs? They don't have the privilege you do to be able to go to college or med school. Why the **** did you even go into medicine?
Well . . . at the expense of being terribly cliche' . . . we'll have to agree to disagree for now.
You have the kind of rhetorical skills that would make this conversation too time consuming right now!
Maybe we can do this again when I've got more time. Or not.
Health care is an unalienable right
Well, "life, liberty, and the pursuit of happiness" is in the Declaration. And I would say no healthcare = no happiness, possibly no life.
I just can't relate to these hardass lines of not wanting to see everyone get healthcare. I mean, wtf?
So people with colon cancer who can't afford chemotherapy should just crawl into a corner and die?
Histrionics much? The Supreme Court may or may not strike the individual mandate which was a Republican idea before Democrats incorporated it into the bill.
Either way, the individual mandate will not make or break the United States. While this law adds extra federal expenses in terms of subsidies to individuals and families buying health insurance, the much larger spending decisions regarding Medicare, Medicaid, Social Security, and defense will ultimately dictate the solvency of the US government.
The Affordable Care Act makes some tentative, bashful attempts at cost control for Medicare & Medicaid. However, even if the law stands as written, we'll see very real changes in government in our lifetimes.
Here it is again. The constitution does NOT gurantee "happiness", it gurantees "the pursuit of happiness". Denying medical coverage to someone on the basis of payment is not denying them the pursuit of anything other than complimentary medical service. The individual is still free to pursue treatment, and thereby happiness, either by finding a way to get the money for payment or seeking alternative treatment plans.
The constitution was not meant to create a utopian society where everyone is equal all the time, it was designed to give everyone the OPPORTUNITY to achieve whatever they want. If you're being denied medical treatment because you're broke, it's no different than a store refusing to let you walk out without paying for that dress you want.
Nobody forced them to come here. Nobody forces people (immigrants or not) to take certain jobs. Just like nobody forced me to study medicine. So, it's society's job to have to care for everyone? Sorry...Not My Problem. People have to realize that decisions have consequences.
Yes, and the consequence of your decision to not cover these people will result in a public health disaster because one of them had some infectious disease (I don't know lets say TB) and could not afford to go to the doctor and their disease will spread throughout the community and then you have to spend 10000x what you would've originally spent to do one CXR and cover few pills a day to cover everyone and their mother who is sick now, thanks to your decision.
This is a silly example seeing as a public health disaster is just as likely without universal coverage. Your argument is based on the premise that everyone would go to the doctor if they could, which is obviously not the case.
Last post about books from me, I promise -
If you want a really fun read of the grown-up Harry Potter variety, I highly highly recommend The Name of the Wind by Patrick Rothfuss. Check it out.
http://www.amazon.com/Name-Wind-Kingkiller-Chronicles-Day/dp/075640407X
Wrong. The mandate will break the United States, as it is an affront to the principles the country was founded upon. The fact that the Republicans supported it at one time makes not a whit of difference.
Wrong. The mandate will break the United States, as it is an affront to the principles the country was founded upon. The fact that the Republicans supported it at one time makes not a whit of difference.
Fun fact of the day: the Constitution says nothing about an 'air force'. I expect the Supreme Court to decommission all of our fixed-wing aircraft.
The most... interesting part about divining the Founders' intent is that medicine did not, in any meaningful sense, exist at the time.
Fun fact of the day: the Constitution says nothing about an 'air force'. I expect the Supreme Court to decommission all of our fixed-wing aircraft.
The Air Force originated as the Army Air Corps, a branch of the Army. The constitution provides for the establishment of an army and all things encompassing it. It is pefectly constitutional, and would be even if it didnt start out as a branch of the Army. The constitutional term "army" is just another term for military, and thus anything would be constitutional so long as it was a branch of the military.
Next time, pick a better example to use as the foundation for your weak argument. I say "weak" because the issue at hand is not a relative one but an absolute one. There are three unalienable rights in the constitution and no more have ever been added. They have been extended to more people over the years, but no knew unalienable rights have been created. None of the three unalienable rights could in any way be logically taken to mean that healthcare is a right guranteed by any legislation.
This is a silly example seeing as a public health disaster is just as likely without universal coverage. Your argument is based on the premise that everyone would go to the doctor if they could, which is obviously not the case.
But certainly more people go if they can afford it versus when they can't afford it. It is a very real argument/possibility....
The problem is that people talk as if we currently don't have universal coverage and all of a sudden with ACA we are going to cover everyone. What we currently have is a very expensive and inefficient universal coverage. Anyone who goes to the ED gets treatment (that's universal coverage). However, it costs 10-100 times more than what it would if they just had a way to go to a PCP/out patient clinic (obviously talking about chronic conditions and non-emergencies here). Who do you think pays for the uninsured/underinsured when they go to the ED? Let me give you a hint, the taxpayers and private insurance when they are charged 10x higher for other services which results in higher premiums for the insured. Also, unfortunately ACA doesn't cover undocumented aliens which will still cause the same problem with the expensive ED care for that population; but at least it will greatly reduce the number of uninsured/underinsured.
Ya know what? Using your logic, let's just lock up or deport all the people that are "likely" to commit crimes. Cheaper than letting the crimes happen, right?
Not only that, but in many cases it's just easier to treat the emergencies than to put forth preventative care for everyone. We can't afford it!!!
Not only that, but in many cases it's just easier to treat the emergencies than to put forth preventative care for everyone. We can't afford it!!!
Ya know what? Using your logic, let's just lock up or deport all the people that are "likely" to commit crimes. Cheaper than letting the crimes happen, right?
His logic is actually closer to paying for some sort of crime prevention service.... U know where we pay individuals to do things like protect the public, keep the peace... That actually doesn't sound half bad.... We should do that! People to protect peace amirite? We could call them proteace!!!!1!! No.... That's not a good name...
Are you telling me that it is easier to treat a stroke or amputate a leg than it is to check someone's HbA1c every now and then, give them a pill or two and counsel them about their diet? Which one do you think is cheaper/easier?
I refer you to Specter's post below just in case you missed it...
For a lot of docs it is easier to cut an unconscious person's foot off than it would be to talk to a patient and try to understand why they aren't doing X and coming up with ways to help them do X.
His logic is actually closer to paying for some sort of crime prevention service.... U know where we pay individuals to do things like protect the public, keep the peace... That actually doesn't sound half bad.... We should do that! People to protect peace amirite? We could call them proteace!!!!1!! No.... That's not a good name...
In theory a good idea, but you know this would never work.My argument to you regarding Taco Bell is that people should then pressure Taco Bell to offer better medical care if they aren't happy (by boycotting, etc).
Although unfortunately you are absolutely correct, I think we were talking about societal and financial impact of universal coverage and the term "easier" was used in that context... However, you never know on SDN....
Are you telling me that it is easier to treat a stroke or amputate a leg than it is to check someone's HbA1c every now and then, give them a pill or two and counsel them about their diet? Which one do you think is cheaper/easier?
I refer you to Specter's post below just in case you missed it...
I am having trouble deciphering their Bar graph...Well, thanks for asking. I would say YES it it probably easier to just do that and solve the problem than constantly checking HbA1c and wasting RVUs trying to counsel noncompliant patients for the 14th time.
So, let me answer your question w/ evidence, since you so kindly asked me about my beliefs.
According to the Congressional Budget Office (http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/104xx/doc10492/08-07-prevention.pdf):
"Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness. An article published last year in the New England Journal of Medicine provides a good summary of the available evidence on how preventive care affects costs."
You can also check the following NEJM article here:
http://www.nejm.org/doi/full/10.1056/NEJMp0708558
Joshua T. Cohen, Ph.D., Peter J. Neumann, Sc.D., and Milton C. Weinstein, Ph.D. "Does Preventive Care Save Money? Health Economics and the Presidential Candidates." N Engl J Med 2008; 358:661-663February 14, 2008
Note this quote:
"Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not."
lmfao
In theory a good idea, but you know this would never work.
It happened w/ Planned Parenthood funding and the Susan G. Kormen Foundation.
unless I missed something the Komen foundation wasn't boycotted, they flipped their decision to save face after several other people stepped up and filled the gap while publicly criticizing them
but in a general sense you are right.... public opinion can effect change.
According to the Congressional Budget Office (http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/104xx/doc10492/08-07-prevention.pdf) ..."
That's the same CBO that said Obamacare would reduce the deficit by $314 billion over the coming decade. For some reason, the CBO study showing major deficit reduction doesn't get quoted much by opponents of Obamacare.
http://www.cbo.gov/sites/default/fi...21xx/doc12119/03-30-healthcarelegislation.pdf
Well, thanks for asking. I would say YES it it probably easier to just do that and solve the problem than constantly checking HbA1c and wasting RVUs trying to counsel noncompliant patients for the 14th time.
So, let me answer your question w/ evidence, since you so kindly asked me about my beliefs.
According to the Congressional Budget Office (http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/104xx/doc10492/08-07-prevention.pdf):
"Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness. An article published last year in the New England Journal of Medicine provides a good summary of the available evidence on how preventive care affects costs."
You can also check the following NEJM article here:
http://www.nejm.org/doi/full/10.1056/NEJMp0708558
Joshua T. Cohen, Ph.D., Peter J. Neumann, Sc.D., and Milton C. Weinstein, Ph.D. "Does Preventive Care Save Money? Health Economics and the Presidential Candidates." N Engl J Med 2008; 358:661-663February 14, 2008
Note this quote:
"Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not."
.One key question is should all Americans have the right (be entitled) to health care?.
Assuming the NEJM article is correct, then a lot of the Obamacare savings must be coming from elsewhere. Center for Budget Priorities has a short summary of the cost savings and revenue increases (with data from before the 2011 CBO revisions). http://www.cbpp.org/cms/index.cfm?fa=view&id=3178 a lot of savings come from Medicare cuts that aren't specified by the CBP, but one of the cost biggest savings comes from the elimination of Medicare Advantage, the semi-private Medicare alternative that costs about 12% more per beneficiary than does traditional Medicare.
NO! Health care is NOT a right, at least not as definied by the Constitution. However, eople should be free to PURSUE to have health care if they so wish (and have the resources).
You DO realize that cutting Medicare Advantage would result in lower payouts to providers (i.e. physicians)? There's only so much more that can be cut....we're already at the bone....
We can't afford it!!!
To quote an earlier post:
We seem to have come full circle, with you arguing for more expensive government-funding of health care.
No one here is going to convince anyone else to change their mind. It's not about the mandate--I bet 95% of the people who oppose Obamacare would still oppose it if it were no mandate--it's not about preventive care--probably 95% of the people who oppose Obamacare would still oppose it even if the savings from preventive care could fund the whole subsidy system--it's about the welfare state and government benefits. And people's minds are pretty well set on. It's been fun.
No...I'm arguing for letting the free market take care of things.
IMHO, the belief that health is or isn't a right is irrelevant. EMTALA essentially decided that some base level of access to care was, in fact, a right. Interestingly enough, it was passed by a Democratic House, Republican Senate, and signed into law by Pres. Regan.
That said, the increasing legislation of healthcare since then has been a foregone conclusion. Once the government made the decision that something was so important that businesses have to provide it regardless of the customer's ability to pay, eventually the government (taxpayers) end up paying for it.
As the government has legislated more and more access to care, specific services, etc, via numerous medicare/medicaid acts and regulations implemented in various ways, the healthcare system has moved further and further from the free-market model. It has now become so regulated that the free-market doesn't control the costs.
I believe there are two possible outcomes.
1. The government gets out of healthcare regulation and allows the free market to control costs. This is never going to happen, as the perpetual solution of government is more regulation, not less.
2. The government enacts a single payer system after realizing that the Affordable Care Act doesn't control the rising costs of health care.
I could go on about how it doesn't control costs, but various posters above have made that point.
Medical professionals & students trying to logically reason................
Medical professionals & students attempting to interpret the law...................
Medical students whose arguments make less sense than an 8th graders first book report..................
This **** is classic. Keep up the good work guys
unalienable, inalienable, mars attacks, area 51, will smith. This is just too cute.
NO! Health care is NOT a right, at least not as definied by the Constitution. However, eople should be free to PURSUE to have health care if they so wish (and have the resources).