How many of the 50k applicants a year are just flat-out delusional?

[Ace Khalifa]

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Not my words, but I agree with them:

"I think the basic philosophy of medical treatment has not been correctly understood.

The patients come to a doctor for; advice, treatment, reassurance, etc. Since we live in a free country, the doctors is NOT responsible for the patient following advice.

We do NOT guarantee results, nor should we. If a patient with hypertension does not take their medications, and we have explained to them why they should, it is NOT our fault.

This can be described in many ways; “non compliant”, “free will”, “I am not your mother”, etc.

To make an analogy, if a patient is put on probation and told that he needs to: not use drugs, report to his parole officer, etc. and does NOT do so, is it the fault of the judge?"

 

[Cotterpin]

Once again, I'm not taking the fall for someone else's insipid choices.

I don't really get this attitude. Why are you concerned who "takes the fall" for your patient's well-being? Your job is to help them, not judge them, isn't it?

Also, what do you mean by "insipid choices"? I think your thesaurus might have let you down.

 

[efle]

I don't really get this attitude. Why are you concerned who "takes the fall" for your patient's well-being? Your job is to help them, not judge them, isn't it?

Also, what do you mean by "insipid choices"? I think your thesaurus might have let you down.

Ace is the type to hardcore judge his patients. "Oh you had a heart attack? You deserved it you fat lard" 😉

 

[Ace Khalifa]

Ace is the type to hardcore judge his patients. "Oh you had a heart attack? You deserved it you fat lard" 😉

There's no law that says we can't judge our patients as long as we still give them optimal patient care. But don't expect me to feel bad for you if I tell you, "You need to fill this Rx otherwise your chronic condition will get worse and you might die," and then you come back with major complications because you didn't fill it due to the bullsh** reason, "I didn't fill it because I didn't want to, even tho you told me I should..."

 

[Ace Khalifa]

I don't really get this attitude. Why are you concerned who "takes the fall" for your patient's well-being? Your job is to help them, not judge them, isn't it?

Also, what do you mean by "insipid choices"? I think your thesaurus might have let you down.

I meant ASININE choices. But thanks for that, now I know that definition for sure.

 

[efle]

There's no law that says we can't judge our patients as long as we still give them optimal patient care. But don't expect me to feel bad for you if I tell you, "You need to fill this Rx otherwise your chronic condition will get worse and you might die," and then you come back with major complications because you didn't fill it due to the bullsh** reason, "I didn't fill it because I didn't want to, even tho you told me I should..."

Well, some people plan to shape their practice by what is humane rather than just legal. I've seen people make horrible choices, balloon out to obesity despite warnings over the years and then mismanage their diabetes...and you know what, I still feel bad for them. Grandma is a shortsighted idiot, sure, but that doesn't make it ok to give her less than great, compassionate treatment.

 

[Lucca]

That's total BS and you know it. If a physician educates the patient about their disease and treatment options as well as they possibly can, then it is not the physician's fault if the patient still chooses to be noncompliant. Once again, I'm not taking the fall for someone else's asinine choices. I've seen many frequent fliers in the ED. You know why they're frequent fliers? Because of noncompliance every single damn time. The ER docs I worked with just get tired of having to explain the same things every time they see the patient. It's the same thing for someone asking for advice on SDN. They want help, most likely to improve something, so SDN'ers tell them different options of how to best improve their situation or whatever. If the person who asked for help refuses to listen to the advice because of preconceived notions or laziness or whatever, then that's ON THEM when they later fail/crash and burn/whatever.

I don't think it's BS actually.

If a patient is unwilling or unable to change their behavior then there is a problem there besides the disease itself. Is it the patient's family? Their living situation? Is it your explanation of the disease or treatment? Is it the patient's deeply engrained distrust of the healthcare system? Is it a language barrier? Is it a cost barrier? Is the problem of them coming in repeatedly about their disease or because they like to play the victim and desperately need attention because they feel totally and desperately alone? Is their discontinuation of treatment a symptom of them wanting to have some control over their life which has up to this point been entirely managed by others or by circumstances outside of their control? Is it because they hate themselves? Do they hate you? Do they maintain a problem so that they have a guaranteed admit to the ER twice a week in order to get a bed and some warm food? Are they actually just incapable of taking care of themselves in the proper capacity and need either family or outside resources to take care of them?

Here is the foundation for my thinking:

1) Rational people want to be healthy and don't want to be unhealthy.

2) Rational people have other desires and responsibilities and traits that often conflict with 1.

If a rational person continues to be unhealthy of their own free will then they are either misinformed, misguided, have no motivation to continue being healthy, or are not rational to begin with.

If it is the first three cases then those fall under the responsibility of the healthcare provider to give the patient the power to overcome them. If it is the last then that is a separate issue that also needs to be taken care of by a provider for the mentally ill or a social worker.

Will the healthcare provider succeed? Maybe, maybe not. Even if the provider does everything they can to help the patient help themselves may they still fail in convincing the patient to change their ways? Yes, this is quite possible given the number of systemic issues that drive people towards unhealthy habits ( it's hard to stop being obese when McDonald's every day feeds a family of four and your job can't pay for groceries for all of them, it's hard to quit drinking and smoking when you are homeless and drugs are the only escape you have from your everyday existence ). However, it is still the healthcare providers responsibility. The healthcare provider is an advocate for their patients. If you cannot advocate for your patients to the point that it gets them well then you are unwilling to do so and maybe even unable but regardless you have failed in your duty to help them be well. It is the patient's responsibility to eat better and quit smoking but it is the doctor/nurse's responsibility to convince the patient that doing so is worthwhile for them. If they don't listen, you were not convincing.

Failure as a healthcare provider is inevitable, but this is the best way to keep a system from stagnating and revolving around catering to a demand or a customer and instead incrementally improving the system. If you want to fix noncompliance, help or support initiatives that alleviate the systemic issues that lend to noncompliance on top of what goes on in the clinic. The easiest way to do this is by voting. In my view, the healthcare providers responsibility extends far beyond the clinic.

 

[Lucca]

Furthermore, I think you will find that most noncompliance cases are due to people misunderstanding or misinterpreting their treatment plan. I can almost guarantee that this is true, but I need to find some data.

 

[efle]

Furthermore, I think you will find that most noncompliance cases are due to people misunderstanding or misinterpreting their treatment plan. I can almost guarantee that this is true, but I need to find some data.

There is a huge chunk of people who are fat, have been told why it's bad to be fat, are able to lose weight, but due to the lack of immediate tangible signs continue to be fat out of poor willpower/denial until they're diabetic and have clogged up arteries. You simply can't blame GPs when this is true.

A better example may be smoking. Is there anyone who is unaware of smoking damaging their lungs? And you can't exactly blame poverty forcing them to smoke a pack a day. It's addiction > willpower to quit, and has nothing to do with GPs failing their patients. Providing education and resources to help is all they can do, and seldom is enough.

 

[Lucca]

There is a huge chunk of people who are fat, have been told why it's bad to be fat, are able to lose weight, but due to the lack of immediate tangible signs continue to be fat out of poor willpower/denial until they're diabetic and have clogged up arteries. You simply can't blame GPs when this is true.

A better example may be smoking. Is there anyone who is unaware of smoking damaging their lungs? And you can't exactly blame poverty forcing them to smoke a pack a day. It's addiction > willpower to quit, and has nothing to do with GPs failing their patients. Providing education and resources to help is all they can do, and seldom is enough.

It is not all they CAN do. They could follow around the patient all day and ensure that he never touches a single cigarette. This is impractical not impossible.

Or they could follow up with the patient regularly and have a system to check in which ensures that a patient is attending weekly meetings to help them quit. They could recruit the family to monitor their spending habits and ensure they aren't purchasing cigarettes. If you can't convince the patient, you can convince those who love the patient dearly. Even then it might not work. The patient might be totally alone in the world.

In any case the point is that you failed. Once you have exhausted everything you have and can no longer realistically do anything else to help someone help themselves then that is a systemic failure. If you can acknowledge that, then you can move forward on improving it since the system is entirely made up of individuals.

Consider the alternative of the patient being totally responsible:

Why should any one system's compliance be better or worse than another if it comes down to individuals? Shouldn't there be an even distribution of compliance everywhere? There isn't. Ours is by far much, much worse. If it's a matter of individual culture then isn't that just a different type of system? The provider is equivalent to the healthcare system and is just as responsible for its shortcomings in my view. This kind of idea is not at all popular in the West but it was how things were done in the East for quite a long time and to some extent today as well.

 

[Cotterpin]

As a person who has both quit smoking and lost a significant amount of weight, telling a person their habits are killing them doesn't do any good at all. They already know that. People don't usually change themselves to avoid some consequence in the distant (or so they think) future. People change because they want something. With the right motivation, you can do just about anything. But avoiding an unpleasant possibility is a really weak motivator, even if it's something like losing money or even dying. Nobody ever believes it's going to happen to them.

 

[efle]

It is not all they CAN do. They could follow around the patient all day and ensure that he never touches a single cigarette. This is impractical not impossible.

Or they could follow up with the patient regularly and have a system to check in which ensures that a patient is attending weekly meetings to help them quit. They could recruit the family to monitor their spending habits and ensure they aren't purchasing cigarettes. If you can't convince the patient, you can convince those who love the patient dearly. Even then it might not work. The patient might be totally alone in the world.

In any case the point is that you failed. Once you have exhausted everything you have and can no longer realistically do anything else to help someone help themselves then that is a systemic failure. If you can acknowledge that, then you can move forward on improving it since the system is entirely made up of individuals.

Consider the alternative of the patient being totally responsible:

Why should any one system's compliance be better or worse than another if it comes down to individuals? Shouldn't there be an even distribution of compliance everywhere? There isn't. Ours is by far much, much worse. If it's a matter of individual culture then isn't that just a different type of system? The provider is equivalent to the healthcare system and is just as responsible for its shortcomings in my view. This kind of idea is not at all popular in the West but it was how things were done in the East for quite a long time and to some extent today as well.

If we establish the discussion to be in the realm of the practical, my points stand: what is practical to be done by doctors is education and providing resources. Even when you do this, many disobey. Yes, we should do what we can to fix a culture encouraging unhealthy habits, and we have had success here - look at the smoking rates over the last fifty years. But you can't, practically, place emphasis on the doctors when you want to make improvements. It just isn't enough their fault for that to lead to much. If you want to make improvements, place fault in the lack of aggressive anti-advertising (nasty pictures on cigarettes type of thing), the lack of painfully high taxes on unhealthy habits, and the lack of guidance at school for overweight young children with overweight parents (or rather, the backlash from said parents when schools want to implement healthier policies).

As a person who has both quit smoking and lost a significant amount of weight, telling a person their habits are killing them doesn't do any good at all. They already know that. People don't usually change themselves to avoid some consequence in the distant (or so they think) future. People change because they want something. With the right motivation, you can do just about anything. But avoiding an unpleasant possibility is a really weak motivator, even if it's something like losing money or even dying. Nobody ever believes it's going to happen to them.

Exactly. I went from childhood obesity to captaining a sports team by the end of high school because I wanted to feel better about how I looked to my peers (especially the attractive female ones), not because my pediatrician told me to cut back on the pizza and candy. There's nothing a doctor can really do. You need to start applying pressures socially and financially totally separate from the doctor patient relationship to drive change.

 

[Cotterpin]

There might be something a psychologist could do. I think these motivations and changes come from within a person. So maybe a physician with a really strong background in psychology could be very helpful.

 

[Ace Khalifa]

Hey, @Tired, tell these peeps that it's NOT the provider's fault if the patient continues to be noncompliant. You said once that it is ultimately the patient's decision to listen to our expert medical guidance or not. It reeks of unrealistic, unpragmatic idealism in here.

 

[mk04447]

That's total BS and you know it. If a physician educates the patient about their disease and treatment options as well as they possibly can, then it is not the physician's fault if the patient still chooses to be noncompliant. Once again, I'm not taking the fall for someone else's asinine choices. I've seen many frequent fliers in the ED. You know why they're frequent fliers? Because of noncompliance every single damn time. The ER docs I worked with just get tired of having to explain the same things every time they see the patient. It's the same thing for someone asking for advice on SDN. They want help, most likely to improve something, so SDN'ers tell them different options of how to best improve their situation or whatever. If the person who asked for help refuses to listen to the advice because of preconceived notions or laziness or whatever, then that's ON THEM when they later fail/crash and burn/whatever.

Spot on. Most patients present because they **** too much or not enough, because they pass out when they fart or passing gas no longer makes them pass out. We give them advice about their blood pressure or sugar, they don't listen because they don't feel bad. By the time they do, it's too late. Similarly, a doc isn't responsible for patient who refuses to take their psych meds because they make them feel like ****. Anyone who suggests non-compliance is the docs fault hasn't moved past the delusional "boy I want to be a doc to save the world phase."

 

[Cotterpin]

Hey, @Tired, tell these peeps that it's NOT the provider's fault if the patient continues to be noncompliant. You said once that it is ultimately the patient's decision to listen to our expert medical guidance or not. It reeks of unrealistic, unpragmatic idealism in here.

While that's true that the patients make their own decisions, your attitude sucks and you apparently have no compassion.

 

[Ace Khalifa]

In my view, the healthcare providers responsibility extends far beyond the clinic.

You wanna try telling that to every single provider out there? That's laughable. ER docs come in to their shift, work hard, and then clock out and don't worry about work/patients when they're done. It is not a requirement to be a bleeding-heart liberal or SJW to be a good doctor. All you have to do is get your job done, and done really well. Why fight the system so adamantly when the system dictates how you get a job in medicine in the first place and can very easily end your career if you show so much backlash?

 

[Grace184]

Noncompliance is a failure of the healthcare provider, not the patient.

This is ridiculous. Do you hold a professional healthcare degree? Do you participate in patient counseling and compliance monitoring?

 

[skooper]

trying too hard @Lucca
2/10

 

[NeuResurgens]

It's called Burnett's Law

Bahahaha. I'm surprised socialized medicine didn't work its way in there!

But guys, seriously..

 

[Lucca]

You wanna try telling that to every single provider out there? That's laughable. ER docs come in to their shift, work hard, and then clock out and don't worry about work/patients when they're done. It is not a requirement to be a bleeding-heart liberal or SJW to be a good doctor. All you have to do is get your job done, and done really well. Why fight the system so adamantly when the system dictates how you get a job in medicine in the first place and can very easily end your career if you show so much backlash?

You don't have to be a bleeding heart liberal or a SJW. You can clock in, do a great job and then clock out and be a great doctor. But if you have that attitude then never complain about your job. If you work in primary care and you don't feel like you have enough time with each patient to do a good job then you have a set of choices: 1) Take more time with each patient anyway, do a better job and then be replaced by a doc willing to comply with that employer's volume demands. 2) Open a private practice and sink or swim 3) Be in denial about doing your job to the best of your ability 4) Give up and be a part of the system because you like your job and would like to not be unemployed 5) suck it up but do everything you can to change the current status quo.

Taking responsibility as a healthcare professional to me means choosing option 5 every single time.

 

[Lucca]

trying too hard @Lucca
2/10

-_😵_- sry to disappoint. It's what I believe and I dont have a compelling reason to believe otherwise.

 

[efle]

You don't have to be a bleeding heart liberal or a SJW. You can clock in, do a great job and then clock out and be a great doctor. But if you have that attitude then never complain about your job. If you work in primary care and you don't feel like you have enough time with each patient to do a good job then you have a set of choices: 1) Take more time with each patient anyway, do a better job and then be replaced by a doc willing to comply with that employer's volume demands. 2) Open a private practice and sink or swim 3) Be in denial about doing your job to the best of your ability 4) Give up and be a part of the system because you like your job and would like to not be unemployed 5) suck it up but do everything you can to change the current status quo.

Taking responsibility as a healthcare professional to me means choosing option 5 every single time.

Or, you could do your best while at work and then vote for the far more effective means of public health improvement like I mentioned...

 

[Lucca]

Or, you could do your best while at work and then vote for the far more effective means of public health improvement like I mentioned...

That is option number 5.

 

[efle]

That is option number 5.

Ah, I read it more as everything in your capacity as a healthcare provider, rather than voting

 

[Grace184]

So when a patient comes in with 5 randomly scribbled down BGLs for a week, not marked as fasting or post prandial (this happens all the time) would you adjust the lantus or the humalog? I mean, considering you did fail the patient when they didn't keep a log of their insulin levels using the free machine the glucose sticks they receive.

 

[Lucca]

Ah, I read it more as everything in your capacity as a healthcare provider, rather than voting

The statement I made earlier about responsibilities as a healthcare provider extending past the clinic apply here. I don't believe that one can be a good healthcare provider and vote in such a way that does not align with your idea of a more effective healthcare system.

 

[Lucca]

So when a patient comes in with 5 randomly scribbled down BGLs for a week, not marked as fasting or post prandial (this happens all the time) would you adjust the lantus or the humalog? I mean, considering you did fail the patient when they didn't keep a log of their insulin levels using the free machine the glucose sticks they receive.

Idk, I don't have an MD. If the patient failed to follow their treatment, or you failed the patient...does it make a difference what the response should be? I don't understand what you are saying here.

 

[efle]

So when a patient comes in with 5 randomly scribbled down BGLs for a week, not marked as fasting or post prandial (this happens all the time) would you adjust the lantus or the humalog? I mean, considering you did fail the patient when they didn't keep a log of their insulin levels using the free machine the glucose sticks they receive.

What's your point here? Nobody doubts that patients are idiots a lot. This is no different than someone continuing to smoke despite knowing how terrible it is for you.

 

[efle]

The statement I made earlier about responsibilities as a healthcare provider extending past the clinic apply here. I don't believe that one can be a good healthcare provider and vote in such a way that does not align with your idea of a more effective healthcare system.

I dunno, when you have a fat paycheck and want economically conservative ideas pushed in government, good chance you end up voting against broadening healthcare...

 

[Lucca]

I dunno, when you have a fat paycheck and want economically conservative ideas pushed in government, good chance you end up voting against broadening healthcare...

Just because the incentives favor a certain action does not mean that those incentives should allow you to betray your ideals. To take responsibility is to assert that you won't let extraneous incentives betray your ideals or instead let yourself betray your ideals but also be honest about who you are serving when you do so; that is, not ideals, a goal or a profession but yourself. And even then...is it really doing you any service?

 

[efle]

Just because the incentives favor a certain action does not mean that those incentives should allow you to betray your ideals. To take responsibility is to assert that you won't let extraneous incentives betray your ideals or instead let yourself betray your ideals but also be honest about who you are serving when you do so; that is, not ideals, a goal or a profession but yourself. And even then...is it really doing you any service?

Heh. I wish you the best of luck in convincing all your future colleagues to take up your Kantra with you

 

[jl lin]

This is ridiculous. Do you hold a professional healthcare degree? Do you participate in patient counseling and compliance monitoring?

I kindly submit that your statement is totally illogical to say that as a general statement. What's more, it's often enough out and out untrue. You can practically stand on your head teaching some people. You can get them every resource available, go the extra mile and then more than a few more. You can try different approaches or use other people to influence. Still, sometimes and with certain folks, more than sometimes, it just comes down to this: "That dog ain't gonna hunt."

I will say, however, that it often is easier to take the quick out of writing that the patient was/is noncompliant and attempt to demonstrate it with their statements and actions--or lack thereof. It takes a huge amount of patience to get some folks to change their behaviors--and even after you have done all you can to help them or after you have gotten others and different things for them in order to increase compliance. It gets beyond frustrating when you've done all that can be done, and guess what? That dog still doesn't hunt.

People have free agency, and thus they are allowed to be noncompliant.
No healthcare professional has the right to make anyone be compliant. They may be able to set certain boundaries; but they don't have the right to make them comply. One of the hardest things to face is that people have to want help. They have to want health and wellness. They have to accept accountability for what that entails in so much as they are able.

 

[Lucca]

Heh. I wish you the best of luck in convincing all your future colleagues to take up your Kantra with you

I dont expect to have much success. If I can at least convince others to see patients as patients instead of as enemies then I'll consider that a win. I would also like to convince young people that being cynical isn't cool.

 

[Ace Khalifa]

I kindly submit that your statement is totally illogical to say that as a general statement. What's more, it's often enough out and out untrue. You can practically stand on your head teaching some people. You can get them every resource available, go the extra mile and then more than a few more. You can try different approaches or use other people to influence. Still, sometimes and with certain folks, more than sometimes, it just comes down to this: "That dog ain't gonna hunt."

I will say, however, that it often is easier to take the quick out of writing that the patient was/is noncompliant and attempt to demonstrate it with their statements and actions--or lack thereof. It takes a huge amount of patience to get some folks to change their behaviors--and even after you have done all you can to help them or after you have gotten others and different things for them in order to increase compliance. It gets beyond frustrating when you've done all that can be done, and guess what? That dog still doesn't hunt.

People have free agency, and thus they are allowed to be noncompliant.
No healthcare professional has the right to make anyone be compliant. They may be able to set certain boundaries; but they don't have the right to make them comply. One of the hardest things to face is that people have to want help. They have to want health and wellness. They have to accept accountability for what that entails in so much as they are able.

And therefore, providers should neither feel bad nor take the blame when a patient has bad outcomes due to their noncompliance. They chose not to be compliant, that's on them, plain and simple.

 

[efle]

I dont expect to have much success. If I can at least convince others to see patients as patients instead of as enemies then I'll consider that a win. I would also like to convince young people that being cynical isn't cool.

You sure you don't want to get a doctorate in philosophy and just get paid to think and teach the youths? Pretty sure medicine turns almost everyone cynical or at least jaded

 

[Lucca]

You sure you don't want to get a doctorate in philosophy and just get paid to think and teach the youths? Pretty sure medicine turns almost everyone cynical or at least jaded

I'm sure it'll get to me someday too but academic philosophy departments are worse lol. Those guys tear each other up every day, no way I could deal in that kind of environment.

 

[blackroses]

It is not all they CAN do. They could follow around the patient all day and ensure that he never touches a single cigarette. This is impractical not impossible.

Or they could follow up with the patient regularly and have a system to check in which ensures that a patient is attending weekly meetings to help them quit. They could recruit the family to monitor their spending habits and ensure they aren't purchasing cigarettes. If you can't convince the patient, you can convince those who love the patient dearly. Even then it might not work. The patient might be totally alone in the world.

In any case the point is that you failed. Once you have exhausted everything you have and can no longer realistically do anything else to help someone help themselves then that is a systemic failure. If you can acknowledge that, then you can move forward on improving it since the system is entirely made up of individuals.

Consider the alternative of the patient being totally responsible:

Why should any one system's compliance be better or worse than another if it comes down to individuals? Shouldn't there be an even distribution of compliance everywhere? There isn't. Ours is by far much, much worse. If it's a matter of individual culture then isn't that just a different type of system? The provider is equivalent to the healthcare system and is just as responsible for its shortcomings in my view. This kind of idea is not at all popular in the West but it was how things were done in the East for quite a long time and to some extent today as well.

Wat.

1. How do you propose to "ensure" a patient is attending weekly meetings? Tie them to a chair and drag them in? What if they just choose not to go? Do you refuse to offer them care? What is the punishment if they refuse to comply with your "requirement" that they attend weekly meetings?

2. No you can't "recruit the family", because that would be a violation of HIPAA.

Any other suggestions on how physicians can make choices for their patients?

 

[mathnerd88]

You just need to give people more immediate signals. Another example from Scandinavia: high taxes on very unhealthy food. I didn't buy soda or candy at all while i was there because it cost 5x what it does here. Same goes for cigs and alcohol, you can reduce consumption by making it painfully expensive to mistreat yourself.

The problem is that there will probably be a lot of lawsuits regarding this. The government controlling what we can eat now? USA would be thrown into chaos.

In general, cheaper food IS unhealthy. The healthy stuff costs more.

 

[mathnerd88]

Wat.

1. How do you propose to "ensure" a patient is attending weekly meetings? Tie them to a chair and drag them in? What if they just choose not to go? Do you refuse to offer them care? What is the punishment if they refuse to comply with your "requirement" that they attend weekly meetings?

2. No you can't "recruit the family", because that would be a violation of HIPAA.

Any other suggestions on how physicians can make choices for their patients?

I think @Lucca is failing to understand that there is a law regarding how mentally competent patients can make their decision whether to accept or refuse medical treatment. Not doing so is already tramping on our Bill of Rights.

 

[jih]

The problem is that there will probably be a lot of lawsuits regarding this. The government controlling what we can eat now? USA would be thrown into chaos.

In general, cheaper food IS unhealthy. The healthy stuff costs more.

Not taking sides, but that only applies if you look at premade food. You can get all kinds of produce for very little compared to fast food and snack food, although it takes time to cook, and it is hard to cook for just one person at times..

 

[mathnerd88]

Not taking sides, but that only applies if you look at premade food. You can get all kinds of produce for very little compared to fast food and snack food, although it takes time to cook, and it is hard to cook for just one person at times..

True...getting fast food is a big convenience factor for many. Unfortunately that's what's popular in America these days...

 

[blackroses]

Not taking sides, but that only applies if you look at premade food. You can get all kinds of produce for very little compared to fast food and snack food, although it takes time to cook, and it is hard to cook for just one person at times..

And this assumes that unprepared food is somehow cheaper than premade food. Please tell me what kind of produce meal I can make for 69 cents or less (the price of a pack of ramen noodles).

 

[efle]

The problem is that there will probably be a lot of lawsuits regarding this. The government controlling what we can eat now? USA would be thrown into chaos.

In general, cheaper food IS unhealthy. The healthy stuff costs more.

well we already seriously mess around with whats on the market through subsidies, it's not that outlandish. But yeah, it would be a painful adjustment period for sure

 

[mathnerd88]

And this assumes that unprepared food is somehow cheaper than premade food. Please tell me what kind of produce meal I can make for 69 cents or less (the price of a pack of ramen noodles).

You can even get tacos at Taco Bell for just a few cents more!

 

[efle]

You can even get tacos at Taco Bell for just a few cents more!

Yet another wonderful thing in Scandinavia: organics are so heavily subsidized they're the same price as regular. For a lot of items organic is the only kind! Makes it so easy to eat well

 

[mathnerd88]

Yet another wonderful thing in Scandinavia: organics are so heavily subsidized they're the same price as regular. For a lot of items organic is the only kind! Makes it so easy to eat well

How are the income taxes there? VAT?

 

[efle]

How are the income taxes there? VAT?

At least in the country I was in yes, 25% VAT, unsure about the other Nordics

Edit: and the income taxes were insane compared to US standards and there was very little difference in salary between jobs (again relative to US). But hey they get a lot for their money - free healthcare, free education, insanely good vacation and maternity/paternity, great unemployment, you name it.

 

[Ace Khalifa]

At least in the country I was in yes, 25% VAT, unsure about the other Nordics

Edit: and the income taxes were insane compared to US standards and there was very little difference in salary between jobs (again relative to US). But hey they get a lot for their money - free healthcare, free education, insanely good vacation and maternity/paternity, great unemployment, you name it.

It's not "free" if you have to pay more taxes for it.

 

[efle]

It's not "free" if you have to pay more taxes for it.

Oh darn, you got me, guess their system is all nonsense!

You know what I meant, smart***