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

[Gut Shot]

I see, so what happens to me if I manufacture and sell a similar product at a lower price?

Not sure, haven't every really looked into the consequences of pharmaceutical patent infringement. Although my guess would involved a large number of lawyers.

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[Marcus Brody]

Not sure, haven't every really looked into the consequences of pharmaceutical patent infringement. Although my guess would involved a large number of lawyers.

Do you think that's right?

 

[Dave89]

I'm not a Republican or Democrat, but Ryan's budget is sounding better everyday.

We certainly can't continue to work up volumes of debt, Medicare needs some huge cuts. America will be a failed experiment if we don't change our direction.

Found a pretty good summary below:



http://wisconserve.com/2011/05/01/p...h-care-medicare-medicaid-and-social-security/

[YOUTUBE]jwDai5NtXa0[/YOUTUBE]

Not sure how you can argue with the common sense of this plan.




Good question... because it looks like that's where we're headed.

Sadly, his plan does nothing about the deficit for 28 years. The country will not last that long, given our enormous debt and the inevitable rise of interest rates. The fact that his plan is considered "radical" demonstrates just how doomed America is.

Rand Paul's plan is better: http://thenewamerican.com/usnews/politics/11128-senator-rand-paul-unveils-fy2013-budget-proposal

 

[Dave89]

It's actually pretty easy to argue with it, once you turn away from the promotional materials.

Ryan's budget isn't serious, and neither you nor I would come out winners under his plan.

I agree with you that it's not a good plan. But not based on talking points based on the politics of envy.

It simply does too little, too slowly. Rand Paul has a better idea of what needs to be done.

 

[TAWS]

Sadly, his plan does nothing about the deficit for 28 years. The country will not last that long, given our enormous debt and the inevitable rise of interest rates. The fact that his plan is considered "radical" demonstrates just how doomed America is.

The "country will not last the long". Really? So a country of 300 million people will just cease to exist? People like you need to stop exaggerating.

 

[JackShephard MD]

It's actually pretty easy to argue with it, once you turn away from the promotional materials.

Ryan's budget isn't serious, and neither you nor I would come out winners under his plan.

I read through this, interesting:

Chairman Ryan says these changes in domestic programs are necessary due to the nation's severe fiscal straits. The nation's fiscal straits, however, surely do not justify massive new tax cuts for its wealthiest people alongside budget cuts that would cast tens of millions of less fortunate Americans into the ranks of the uninsured, take food from poor children, make it harder for low-income students to get a college degree, and squeeze funding for research, education, and infrastructure. Under Chairman Ryan's budget, our nation would be a very different one — less fair and less generous, with an even wider gap between the very well-off and everyone else (especially between rich and poor) — and our society would be a coarser one.

I'm against widening the socioeconomic gap, but as far as squeezing funds from research, education, and infrastructure... who cares? Honestly, I'm grateful for all my education, yet more often than not, I learn very well from well-written concise textbooks or review books. There are nations being educated for free by Khan Academy, likely better than poorer performing American schools. I think it's a mistaken assumption that, the more money we spend on education the better results we will get.

Americans to lose their health insurance or become underinsured. It would also impose severe cuts in non-defense discretionary programs—much deeper than the across-the-board cuts ("sequestration") that are scheduled to take place starting in January — thereby putting core government functions at still greater risk. Indeed, a new Congressional Budget Office analysis that Chairman Ryan himself requested shows that, after several decades, the Ryan budget would shrink the federal government so dramatically that most of what it does outside of Social Security, health care, and defense would essentially disappear.
(See CBO Shows Ryan Budget Would Set Nation on Path to End Most of Government Other Than Social Security, Health Care, and Defense By 2050)

Hmm, the government really hasn't proven itself to be thrifty, good at making progress, or effective. Minimizing or reducing government to the essential, based upon their waste and inefficiency, may be a boon.

Maybe Ryan's plan isn't the best, but I don't know what is. Robert Greenstein wrote some compelling criticisms, what are his serious suggestions to change the path the nation is on?

Things like this blow my mind:
http://www.bloomberg.com/news/2012-...add-to-674-billion-u-s-pension-shortfall.html

Congress's Six-Figure Benefits Add to $674 Billion Pension Gap
Almost 15,000 federal retirees, including former leaders of Congress, a university president and a banker, are receiving six-figure pensions from a system that faces a $674.2 billion shortfall.

Congressmen who don't even need pensions receiving 100-200k a year, we just write checks to these people.

 

[Dave89]

The "country will not last the long". Really? So a country of 300 million people will just cease to exist? People like you need to stop exaggerating.

As much as I despise the cliche "as we know it", I'll use it to explain my statement. If and when the dollar collapses (as the intelligent economists predict as an eventual certainty), this country, if still unified, will be radically different. As will its systems.

 

[ppfizenm]

As much as I despise the cliche "as we know it", I'll use it to explain my statement. If and when the dollar collapses (as the intelligent economists predict as an eventual certainty), this country, if still unified, will be radically different. As will its systems.

I was wondering what happened to Glen Beck after they took him off the air.

 

[Dave89]

I was wondering what happened to Glen Beck after they took him off the air.

That's cute.

 

[SteinUmStein]

That's cute.

You're being ridiculous. The dollar is not in any danger of disappearing, nor is our country's economic system.

 

[Dave89]

You're being ridiculous. The dollar is not in any danger of disappearing, nor is our country's economic system.

I would urge you to look into the possibilities. I've evaluated both sides of the argument; watched MSNBC and Fox and the rest of them. Read WSJ and NYT (but NEVER Rolling Stone and other trash). Blogs.

Numbers don't lie, and right now they paint a very bleak picture.

Can a crisis be averted? Possibly, but don't expect Social Security, Medicare, and the rest of it to be left unblemished.

 

[SteinUmStein]

I would urge you to look into the possibilities. I've evaluated both sides of the argument; watched MSNBC and Fox and the rest of them. Read WSJ and NYT (but NEVER Rolling Stone and other trash). Blogs.

Numbers don't lie, and right now they paint a very bleak picture.

Can a crisis be averted? Possibly, but don't expect Social Security, Medicare, and the rest of it to be left unblemished.

I read far too much WSJ and NYTimes as it is. I'd like to see a few articles by the "intelligent economists" that you mentioned a few posts ago though. I'm a big fan of post-apocalyptic fiction.

Edit: sorry if I sound snarky, I'm actually interested in reading the articles you're referring to.

 

[ResIpsaLoquitur]

Since the patient in question has polycystic syndrome, I'm not really sure how condoms are indicated for that.

Or are you just blindly throwing out talking points without actually reading anything?

I believe you hit the head on that proverbial nail! God help us all...sorry...they have God and the bible on their side, too

 

[Dave89]

I read far too much WSJ and NYTimes as it is. I'd like to see a few articles by the "intelligent economists" that you mentioned a few posts ago though. I'm a big fan of post-apocalyptic fiction.

Edit: sorry if I sound snarky, I'm actually interested in reading the articles you're referring to.

No, I took your post good-humoredly. But I'm a bit swamped right now; I'll link to them later.

 

[notbobtrustme]

I'm against widening the socioeconomic gap, but as far as squeezing funds from research, education, and infrastructure... who cares? Honestly, I'm grateful for all my education, yet more often than not, I learn very well from well-written concise textbooks or review books. There are nations being educated for free by Khan Academy, likely better than poorer performing American schools. I think it's a mistaken assumption that, the more money we spend on education the better results we will get.

Really? Did I just read this coming from a medical student? Today's treatments exist because a generation of scientists were funded by the government to develop such treatments. The private sector has absolutely dropped the ball in comparison. Nearly every major pharm company has cut R&D spending drastically over the last decade. Medical device companies have consolidated and focused on incremental upgrades to software instead of new technologies. The biggest source of new drugs/techniques/treatments comes from universities who's researchers are usually (if not always) funded by the various government authorities. These scientists are the ones who are filling the pipelines with new advances, not the private sector.

 

[ResIpsaLoquitur]

So replace the mandate with a limited enrollment period for health insurance that only opens up every, say, 3 years. Outside the enrollment period, you could enroll, but premiums would be steeply higher. Boom, free-rider problem solved.

That should keep this creaky system chugging along for another 15 years or so..

This is definitely one of the most constructive suggestions I have seen thus far. However, you would have to tweak the enrollment period to accommodate people who lose insurance outside the 'fixed window' through no fault of their own, eg. lost employment, adoptions, new baby in the family, etc.

I think, one should also be able to see diminishing premiums based on longevity of the policy so that people who have been in the system longer or used it less/kept themselves healthy get an incentive to keep coverage. This is the type of brainstorming we need...not the vile simplistic rhetoric on 'freedom' and 'socialism'.

 

[ResIpsaLoquitur]

Really? Did I just read this coming from a medical student? Today's treatments exist because a generation of scientists were funded by the government to develop such treatments. The private sector has absolutely dropped the ball in comparison. Nearly every major pharm company has cut R&D spending drastically over the last decade. Medical device companies have consolidated and focused on incremental upgrades to software instead of new technologies. The biggest source of new drugs/techniques/treatments comes from universities who's researchers are usually (if not always) funded by the various government authorities. These scientists are the ones who are filling the pipelines with new advances, not the private sector.

Completely agree!

 

[SteinUmStein]

Really? Did I just read this coming from a medical student? Today's treatments exist because a generation of scientists were funded by the government to develop such treatments. The private sector has absolutely dropped the ball in comparison. Nearly every major pharm company has cut R&D spending drastically over the last decade. Medical device companies have consolidated and focused on incremental upgrades to software instead of new technologies. The biggest source of new drugs/techniques/treatments comes from universities who's researchers are usually (if not always) funded by the various government authorities. These scientists are the ones who are filling the pipelines with new advances, not the private sector.

Exactly this. I just cannot bring myself to support a political party so myopic that they are willing to cut NIH funding, education, etc. I'd rather see Medicare/Medicaid/defense/Social Security cut to the bone than sacrifice the future of the country. 30, 40, 50+ years down the road medicine and society in general will be most benefited by money spent on research and education, without a doubt.

 

[JackShephard MD]

Really? Did I just read this coming from a medical student? Today's treatments exist because a generation of scientists were funded by the government to develop such treatments. The private sector has absolutely dropped the ball in comparison. Nearly every major pharm company has cut R&D spending drastically over the last decade. Medical device companies have consolidated and focused on incremental upgrades to software instead of new technologies. The biggest source of new drugs/techniques/treatments comes from universities who's researchers are usually (if not always) funded by the various government authorities. These scientists are the ones who are filling the pipelines with new advances, not the private sector.

Don't try to polarize my stance, I never said all spending is bad. Regardless, there is a lot of waste in our educational system. Which includes much more than mere research.

http://www.examiner.com/scotus-in-w...education-spending-results-waste-not-stimulus

Today, vastly more money is spent on education than was spent on education in President Roosevelt's day, and a much higher percentage of it is wasted, so cutting education spending might actually be good for America over both the short run and the long run. "Over the last few decades," education spending "per student has nearly tripled" in inflation-adjusted terms "while test scores at the end of high school are flat." Cutting education spending would help the economy by redirecting money that is currently wasted on useless degree programs, diploma mills, and ideological fads to more productive sectors of the economy that are currently starved for cash. It would also result in some young people getting a useful job rather than wasting years getting a government-subsidized degree in a useless college major (thanks to an educational arms race for credentials fueled by government subsidies, 5,057 janitors now have advanced degrees like Ph.D's; 317,000 waiters and waitresses have liberal arts degrees; and"17,000,000 Americans with college degrees are doing jobs that . . . require less than the skill levels associated with a bachelor's degree." Due to credential inflation, the "master's degree has become the new bachelor's degree," serving as the entry-level degree in some occupations that once didn't even require a college degree).

College students seem to learn less and less each year: 36 percent of college graduates learn little or nothing, many courses require little reading, and today's students spend "50% less time studying compared with students a few decades ago."

I found this quote interesting too:
http://www.openmarket.org/2011/07/2...claim-that-spending-has-been-cut-to-the-bone/

College students are learning, reading, and studying less and less with each passing year than they once did. Even elite schools often teach their students little. I learned more practical law in six weeks of studying for the bar exam and a couple summers of working for law firms than I did in three years of law school. I spent much of my time at Harvard Law School watching "Married With Children" or arguing with classmates about politics, rather than studying (much of what I did study was useless). Even students who were frequently on drugs had no difficulty graduating.

My experience hasn't been too far from these individuals. I even heard medical residents utter similar comments of the above Harvard Law grad. Our efforts to educate have brought the need to fill time with meetings, activities, classes, group work, etc. just for the sake of filling time. Is this why medical education today costs $50,000 per year? Staffing wasteful activities.

We're funding these entities with enormous sums of money and as many students can attest, they don't do a great job.

To quote Mark Twain,

I have never let my schooling interfere with my education.

 

[SteinUmStein]

The answer to a dysfunctional educational system is not slashing its funding. There's a lot of work to be done reforming every aspect of American education, but it's going to take resources and time to get there. Simply reducing its funding will get us nowhere.

 

[dyeguy21]

In terms of budgeting Social Security is one of the worst offenders.

It was enacted in 1935, the average life expectancy at birth was 61.7 years of age (the life expectancy after attainment of adulthood was 65). You could also start collecting social security at age 65.

So a lot of people died before they could even get at social security funds, and some barely made it past 1-2 years of collection.

Now the life expectancy is 78.7 at birth, and around 80 for expectancy after adulthood. That's 13.7 years on average of collected benefits from a system that was never really meant to give you anything.

Also, there is no means testing for social security. Arguably, if you have saved during your employment and have a lot left over, there is no reason for you to need to collect on SS. This is annoying because "I paid into that my whole life", well you are still better off than people who are relying on that as their sole income and not as supplement as it was intended.

Finally, If you are making over $109,000 dollars a year, everything above $109,000 is not taxed towards social security. This is simply ridiculous. Most of us do/will make more than that and there are plenty of multi-millionaires and sports players that aren't getting taxed on 75-99% of their income. Think about that, 1 million dollar/yr sports contract doesn't pay taxes towards social security on 89% of income.

To fix it it's simple:
1. People are working longer or at least should be able to, thus, raise the retirement age for full benefits. (The reason this doesn't happen: Old people vote way more than youths and have already planned for that money and don't want it taken away when they are so close)
2. Means testing. (People will argue that they paid in and therefore should receive)
3. Raise the taxable level of income. (People will argue this is a penalty for success as above)

1. and 2. means less money going out (i.e. spending cuts) and 3. means more money coming in (i.e. "higher taxes")

If both sides could just agree and not spend so much time defining why they are't the other guy, it could get done. Compromise = success.

 

[SteinUmStein]

Agreed. I think any Social Security-like system not linked to average life expectancy is ultimately going to fail. I don't think anyone in our generation can responsibly plan to receive any SS benefits when they retire, you'd be begging to be left high and dry when the money's gone and your insufficient nest egg runs out.

What's that, homeless old man? You were a doctor back in your day? Of course you were...

 

[ijn]

People were saying the same thing about social security in the 50's, 60's, 70's, 80's, 90s', 00's, and guess what, the '10s too! Social security isn't going anywhere. It's as tired of an argument as old people decrying the morals of the newest generation.

 

[dyeguy21]

People were saying the same thing about social security in the 50's, 60's, 70's, 80's, 90s', 00's, and guess what, the '10s too! Social security isn't going anywhere. It's as tired of an argument as old people decrying the morals of the newest generation.

So were the people bemoaning the power of the king from the 6th century till 1215 till 1776. Guess what? Stuff doesn't change unless you whine about it for a long time.

 

[pkwraith]

Agreed. I think any Social Security-like system not linked to average life expectancy is ultimately going to fail. I don't think anyone in our generation can responsibly plan to receive any SS benefits when they retire, you'd be begging to be left high and dry when the money's gone and your insufficient nest egg runs out.

What's that, homeless old man? You were a doctor back in your day? Of course you were...

I really, really hope that there's not a single doctor in the US that is planning on using SS as their mode of retirement.

The biggest problem with SS is the fact that Congress uses it as a slush fund and haven't paid it back. If it was not for the fact that it's filled with IOUs, SS would be sustainable for a significantly longer time, even taking into account life expectancy.

 

[SteinUmStein]

People were saying the same thing about social security in the 50's, 60's, 70's, 80's, 90s', 00's, and guess what, the '10s too! Social security isn't going anywhere. It's as tired of an argument as old people decrying the morals of the newest generation.

With reform it may be around when we retire. Without reform it may be around in a more diluted form, as in much lower monthly payouts to recipients. I don't think it's outrageous to suggest that people currently in their 20's and 30's plan for a retirement that does not include a Social Security check coming every month. At the worst you'll have a little extra spending money to go golfing or take a nice trip...

 

[MT Headed]

The biggest problem with SS is the fact that Congress uses it as a slush fund and haven't paid it back. If it was not for the fact that it's filled with IOUs, SS would be sustainable for a significantly longer time, even taking into account life expectancy.

So, prior to these IOUs the massive amounts of money collected and saved by SSI was sitting idle. It was collecting no interest at all. Congress decided to improve things by purchasing the safest dollar-denominated investment known on planet earth, US government bonds. Now that money is collecting interest. Massive, unbelievable amounts of interest, saving the SSI contributors a bloody fortune (obviously this is being paid for by federal income tax payers instead, which is different pool of payers). Are you seriously advocating going back to the non-IOU system where the money sits under a proverbial mattress until it is needed years (perhaps decades) in the future, collecting zero interest?

Also, do you have a link to congress defaulting on the US government bonds issued to SSI? I'd like to read up on that.

 

[scarshapedstar]

In terms of budgeting Social Security is one of the worst offenders.

It was enacted in 1935, the average life expectancy at birth was 61.7 years of age (the life expectancy after attainment of adulthood was 65). You could also start collecting social security at age 65.

So a lot of people died before they could even get at social security funds, and some barely made it past 1-2 years of collection.

What? Are you really thinking this through?

You're saying that hardly anybody born in 1935 survived until 2000? Not only are plenty of them still alive in 2012, but the actuaries at the time kinda expected lifespans to increase. They weren't idiots.

 

[dyeguy21]

What? Are you really thinking this through?

You're saying that hardly anybody born in 1935 survived until 2000? Not only are plenty of them still alive in 2012, but the actuaries at the time kinda expected lifespans to increase. They weren't idiots.

http://www.infoplease.com/ipa/A0005148.html

http://en.wikipedia.org/wiki/Life_expectancy

I based it on public domain information. Don't take your personal life to mean the truth, you need to use statistics. Thus, most people (taking into account a standard deviation) died before the year 2000, if they were born in 1935, based on statistical data.

The expectancy after adulthood was 65 years old, which matters more when you're talking about the year it was enacted.

 

[crmellon]

That was the life expectancy at birth, but each year that individual is alive, their life expectancy changes. Which is why we have a significant population of people > 75.

 

[dyeguy21]

That was the life expectancy at birth, but each year that individual is alive, their life expectancy changes. Which is why we have a significant population of people > 75.

You are correct your life expectancy does change....it goes down.

http://www.infoplease.com/ipa/A0005140.html

You are probably referring to the differences in life span and life expectancy. One is not equal to the other. However, as shown above, for white males in 1939-1941 (later than 1935; thus, higher) who were 20 they had a life expectancy of 47.76 meaning 67.7 years total.

 

[Dave89]

I read far too much WSJ and NYTimes as it is. I'd like to see a few articles by the "intelligent economists" that you mentioned a few posts ago though. I'm a big fan of post-apocalyptic fiction.

Edit: sorry if I sound snarky, I'm actually interested in reading the articles you're referring to.

http://theeconomiccollapseblog.com/...y-impossible-to-pay-off-the-u-s-national-debt

http://www.beaconequity.com/peter-schiff-brace-for-“abrupt”-dollar-collapse-2011-10-17/

http://seekingalpha.com/article/269992-jim-rogers-dollar-is-a-total-disaster

http://www.nationalreview.com/articles/294304/sun-also-sets-mark-steyn?pg=1

The fourth link is best to start with if you want some light, easy reading. Mark Steyn is a great writer. The others are more depressing.

 

[Dave89]

Exactly this. I just cannot bring myself to support a political party so myopic that they are willing to cut NIH funding, education, etc. I'd rather see Medicare/Medicaid/defense/Social Security cut to the bone than sacrifice the future of the country. 30, 40, 50+ years down the road medicine and society in general will be most benefited by money spent on research and education, without a doubt.

I agree with you on scientific research, but absolutely not on education. In the age of Wikipedia and correspondence courses, we really should not be spending as much money on public schools as we do, especially when most kids come out dumb as bricks anyway.

http://www.foxnews.com/politics/201...t-spending-increases-state-funding-decreases/ : $10,499 average per student

Yes, Medicare/caid and SS must be drastically cut (and ultimately completely done away with). But we should certainly be funding research and scientific education.

I simply cannot understand why public universities subsidize art history and other useless majors. It's time for thrift to become fashionable.

BTW if anyone responds please don't give me the standard claptrap about "FauxNews (hahaha I'm so funny)" It was just a convenient link.

 

[Gut Shot]

I'm against widening the socioeconomic gap, but as far as squeezing funds from research, education, and infrastructure... who cares?

Anyone with more than twelve functioning neurons.

 

[Dave89]

The answer to a dysfunctional educational system is not slashing its funding. There's a lot of work to be done reforming every aspect of American education, but it's going to take resources and time to get there. Simply reducing its funding will get us nowhere.

Will slashing spending improve results? Perhaps not directly.

(Although I think if that were to happen, more private schools would pop up out of necessity, and competition would make private schools cheaper. And better, but there's already no contest between private and public schools.)

But we must slash spending regardless, because we have no money. Things may not improve, but ask yourself this: can they get any worse?

 

[Dave89]

People were saying the same thing about social security in the 50's, 60's, 70's, 80's, 90s', 00's, and guess what, the '10s too! Social security isn't going anywhere. It's as tired of an argument as old people decrying the morals of the newest generation.

That logic doesn't really work. No artificial system lasts forever, and there is always a final straw. Rick Perry was right, at least about this; it really is a Ponzi scheme.

 

[Gut Shot]

Do you think that's right?

Do I think what is right?

 

[SurfingDoctor]

Anyone with more than twelve functioning neurons.

Well its hard to talk about the realities of practicing medicine, when few in this discussion topic actually practice medicine.

 

[DoctwoB]

What? Are you really thinking this through?

You're saying that hardly anybody born in 1935 survived until 2000? Not only are plenty of them still alive in 2012, but the actuaries at the time kinda expected lifespans to increase. They weren't idiots.

Oooh I'm studying for step1 and I know this one!

This is the example for a late-look bias, in which you are predisposed to belief that life expectancies are longer then are because everyone who did not have such a long life span is unavailable for interview.

 

[JackShephard MD]

Anyone with more than twelve functioning neurons.

Oh great. Time to insult those you disagree with.

It appears the more you know about politics, the less class you have.

 

[Gut Shot]

Oh great. Time to insult those you disagree with.

It appears the more you know about politics, the less class you have.

Forgive me if I don't smile blankly and nod as people suggest we relinquish our status as a first world nation.

 

[Dave89]

Oh great. Time to insult those you disagree with.

It appears the more you know about politics, the less class you have.

At first, I agreed with you only on research and infrastructure. Politicians of a certain stripe like to refer to these as "investments", but we never seem to see the return on those investments, do we?

Now, after reading your post carefully, I note you were talking about "squeezing" funds from research, education, and infrastructure. In this context, I think it's perfectly reasonable to include research as well.

I don't see how a fiscally responsible person could disagree with the idea that we must cut funding in ALL areas.

 

[JackShephard MD]

Forgive me if I don't smile blankly and nod as people suggest we relinquish our status as a first world nation.

No you don't, you insult people.

Politics, where conduct, class and respect are all secondary to the day's pursuit.

At first, I agreed with you only on research and infrastructure. Politicians of a certain stripe like to refer to these as "investments", but we never seem to see the return on those investments, do we?

Now, after reading your post carefully, I note you were talking about "squeezing" funds from research, education, and infrastructure. In this context, I think it's perfectly reasonable to include research as well.

I don't see how a fiscally responsible person could disagree with the idea that we must cut funding in ALL areas.

My only point was that we need to spend less to survive. Obviously, in cutting wasteful spending there will be some productive programs lost. That's the nature of progress.

 

[Gut Shot]

No you don't, you insult people.

Is it an insult if I truly believe that to take such a position one has to be functionally anencephalic?

Politics, where conduct, class and respect are all secondary to the day's pursuit.

Thankfully we can all still spout off and feel important.

 

[pupster]

Ah, so you're into MILFs and cougars. To each his own.

I guess you don't know that even women in their late 20s can use botox and fillers...oh wait...that's right...you're a bitter attending probably tooling away in some primary care specialty who has to deal w/ chronic diseases that never get fixed...guess I would be jaded too....

 

[Dave89]

I guess you don't know that even women in their late 20s can use botox and fillers...oh wait...that's right...you're a bitter attending probably tooling away in some primary care specialty who has to deal w/ chronic diseases that never get fixed...guess I would be jaded too....

I swear, I'd give good money to know which specialty Gut is in, so I could run to a specialty far, far away. I'll give the benefit of the doubt and blame his/her environment. You seem to be pretty upbeat, though? Care to share your specialty?

 

[Gut Shot]

I guess you don't know that even women in their late 20s can use botox and fillers...

Well aware, thanks. It's just that I prefer women who don't look like Play-Doh. I've known some who wanted Botox in their 20's. I think they all had IBS. No thanks.

oh wait...that's right...you're a bitter attending probably tooling away in some primary care specialty who has to deal w/ chronic diseases that never get fixed...

Sorry, try again.

 

[officedepot]

.

 

[Dave89]

funding is up and performance is down. More funding is clearly not the answer. The answer is to get rid of public school teacher's unions who force governments to retain terrible teachers. There should be no teacher's unions. Teachers should be rewarded based on how well their students perform on standardized exams not given by the school where they will try and cheat.

Obviously it isn't all the teacher's fault. I also heavily blame parents for not being involved with their children's work. Lots of parents simply do not care. There's nothing you can really do about it but these parents hurt their children's future by not instilling good values.

What are those?

 

[Marcus Brody]

Do I think what is right?

Preventing competition, ie not allowing someone else to sell the same product for less.