Advertisement - Members don't see this ad
Sorry. You lost me at biological differences as a basis for inequality. There is no amount of "unpacking" that works when arguing with someone who is going to a pre-medieval position.
-
CycleTrack and SDN are teaming up to make medical school admissions more transparent and accessible! Read the announcement to learn how we’re supporting the future of CycleTrack’s free application-tracking tools .
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
Sorry. You lost me at biological differences as a basis for inequality. There is no amount of "unpacking" that works when arguing with someone who is going to a pre-medieval position.
Sometimes, it is. At my institution those differences were acknowledged. I apologize if you think that your courses weren't up to par. I still think that courses in which you get a view of how different identities affect your access to certain things or your social standing are beneficial.
Health catastrophes can hit anyone, even the top 1%, and even in magnitudes that far outstrips any single person's ability to pay. Those with good insurance still may charge the system amounts that far outstrip what most would expect insurance companies to have to pay.
Advertisement - Members don't see this ad
I think you're taking my position a little too far. Men and women didn't evolve identically from the neck up -- the assertion is patently absurd. There are differences in behavior, on average, that are a result of our genetics. Some of these differences will lead to different societal outcomes. There is also even more overlap. That's all.
See, here's the thing though- I think we should give because we can, but because the government compels us. The government, an amoral entity, should but be taking over the moral duty one has to care for their fellow man. That's my rub- I'm actually all about providing charity services, but on my terms, not because the government forced me to. It's like the difference between my offering a homeless person a dollar and the government talking that dollar from me and giving it to a homeless person- one exchange is an act of kindness, the other is someone stealing from me in the name of the greater good, and no kindness exists in the exchange.
I'm all for some services and taxes existing and being levied by the government- I just don't believe health care to be one of those things, because government intervention and regulation saps the humanity from the most human of enterprises. Hell, look no further than EMARs and endless charting to see how much they've taken from the patient-physician relationship already, and extrapolate that out to an entirely government controlled system.
No. Someone having a right to receive treatment somewhere within reason doesn't have to obligate you to anything, unless your employer requires you to do so. Just refuse based on religious grounds lol.
Why do you think that these biological differences should lead to different societal outcomes?
Wow. No words.
If I do not believe something to be enough, your forcing me to take it in order to do something I do not want to do for that price does not make it "enough." If I've got a car that means a lot to me and I'm not willing to sell it for over market value, no amount of a guy pointing at Kelley Blue Book can force me to give him the car for that price, nor can I be forced to sell the car at that price. Forcing me to do so would be an unjust violation of my rights.
They may or may not. We would have to take it on a case-by-case basis. Also, I don't really like arguing about "societal outcomes" -- much too vague.
You are a smart man with a PhD. You can't possibly be this sheltered.
I dont think you have a right that is being violated there though. If so, what is it? You have a right to a host of other things. If the amount you are paid allows you to have all of those things + leftover for leisure and private ownership (which I also believe are human rights, falling under the decency and flourishing category) then that is 'enough'. "enough" does not mean "merely enough to survive" but I also do not think it just means "whatever the market is willing to pay". What if my conception of "enough" is 10 billion dollars?
The key here is how we phrase this discussion. Inequality can take on many meanings in a discussion like this and if we dont clarify what we mean and direct the discussion in an appropriate manner, it'll result in lots of confusion, insults being thrown and general discontent.
@ZedsDed initial point was not all inequality is evidence of oppression. I think that's a reasonable statement, if you disagree let's start this discussion by why you disagree with this.
The next statement was that biological differences can create inequality. Obviously this doesnt sound like something you agree with but I think where the source of disagreement started here was mentioning biological differences role in creating inequality. I dont think ZedsDed was saying that there are certain factors where the inequality is driven soley through biological differences(he can feel free to correct me if Im wrong) but it's one factor in some inequality certainly. Whether or not it should be is a separate discussion, but the discussion here for right now was whether or not it is one factor. If you disagree with this, again that's another discussion to have.
Also inequality doesnt necessairly mean disparity of treatment and in relation to healthcare which I think ZedsDed was also trying to state. I think my overall point is let's just slow things down here a little. It's easy on issues like this to put words in other people's mouths and lead to a discussion where people are making arguments against what they think is someone's stance when in reality it's not. We can avoid this by just slowing down and taking the discussion one step/point at a time.
You could speculate about drastically making healthcare more efficient. What happens when you expand healthcare? The demand shoots through the roof, yet if there are no incentives (salary) to increase the supply of physicians reimbursement prices WILL increase. You wanna switch to a single payer system, artificially set reimbursements across the board? your supply of physicians is gonna keep dropping @Mad Jack isn't alone. To increase the pool of physicians your going to need to substantially drop the standards of admission, deal with the shortage, and/or adjust standards of care
Healthcare has to come from somewhere, it can be a right. Rights don't pay for themselves
I'm not going to comment on the other parts of this discussion you're having but what is vague about something like "homelessness" or "prison recidivism" or "food desert" or "more black men are misdiagnosed with schizophrenia than other ethnicities" or "more white women are misdiagnosed with bipolar disorder than other genders or ethnicities" etc etc
Advertisement - Members don't see this ad
Yes, exactly. I have to sign off for a couple hours
Why should they? There are biological differences, but I don't think any should lead to significantly different outcomes (and worse outcomes for women). Plus I think we should just be accommodating with any differences. I think our culture plays a much, much larger factor in determining outcomes than biological differences.
I understand all of that, my point was that healthcare being a right or not has nothing to do with the healthcare payment structure. You can say "yes healthcare is a right BUT how are we going to pay for such a system?" that is a valid statement. However, the question "how are we going to pay for such a system" is essentially different and separate from the question "is healthcare a human right"
The term simply encompasses too much to allow for substantive conversation. And again, we have to take it on a case-by-case basis. Why are there less women who are chemical engineers than men? Why are their less men who are comparative literature professors than women? It may have something to do with the higher visual-spatial skills of men or the higher verbal skills of women, on average. Homelessness? Probably not so much.
And I never mentioned race, please do not misrepresent my position.
What other field does the government determine what is an adequate maximum to pay an individual for their services? To do so would be considered unjust government intervention by the majority of people. Now, if your conception of "enough" is 10 billion dollars, the market is not willing to pay that, so you will go unemployed. That's how markets work. I want a reasonable sum for the amount of time and effort I've put into this career, enough to build a decent real estate portfolio and hopefully retire in my 50s, something I easily could have done had I not entered medical school. But I chose to do something more worthwhile with my life, and I expect not to have done it only to never be able to retire without government assistance.
He(she) had multiple chances to clarify and can do so now. I heard him as insisting that biological differences are a reasonable basis for inequality of treatment. His view on women's studies classes didn't help either.
OK, GoR, want to explain how the above is defensible?
I'm asking you how you can provide a right that infringes upon the rights of a second party. I still haven't received a reasonable answer to that.
As to the bolded: the entirety of the military and every other government job that exists, including the salaries of Congress and the President.
Let me rephrase my argument this way:
If Healthcare is a human right then How much should a physician be paid?
How can you answer this question? You cannot. The if and then statements have nothing to do with eachother. They are separate issues to be addressed separately. You have a problem with government mandated salaries? Great! Awesome. Advocate for a free market system, make that argument instead. But that argument has nothing to do with whether healthcare is a human right or not.
I never said people should be treated differently. Only that differences in outcome are not evidence of institutional oppression, per se.
Are you or are you not suggesting that disparities in treatment can be justified based on biological differences?
What do you mean by treatment? Healthcare? If so no.
I have no idea why you are so outraged btw.
Ah okay, now you are asking a much clearer question.
First, I dont think any other party's rights are being infringed upon; I dont think people have a right to decide what their "worth" is. The floor is set by what they need to live decent lives, the ceiling is set by a competitive and well regulated market, in my own personal opinion.
To answer the more interesting philosophical question of "how you can provide a right that infringes upon the rights of a second party?": You don't. There is no ab initio way to formulate all rights in a hierarchical order of precedence without being arbitrary. That's the philosophical counter-argument to Kant's second formulation of the categorical imperative.
To not use annoying philosophy jargon: You need a separate framework for deciding what is the best way to act that does not rely on singular ethical formulations entirely. You cant just have a bunch of singular rights floating around and expect them not to conflict. You need a deeper and further system to connect them and decide how they are to interact and exchange in a society. That is a far more complicated problem. The answer humans have come up with thus far is the legal system. Conflicts are resolved by compromise and decree or by arbitration on an individual case basis.
In those jobs, the people work as employees. The government is not setting the pay for a field. Private military contractors, for instance, earn four to five times (and often more) what an active duty soldier is paid. The government has senators and congressman, but does not centrally control how much state senators and congressman are paid. If there is a universal system with a coexisting private system, I'd be fine with that I suppose- let the people with money have access to higher quality care without forcing physicians to accept a particular wage by allowing them to work outside the national insurance system. That would be the most effective compromise- you have the right to use the government system of care, but not to any individual physician's services, as they can choose to operate outside of that system. That would technically fulfill both your "right" to access to care while preserving the actual rights of people to not be forced to engage in transactions to which they do not agree to the terms.
What I have been saying all along is that you can protect the right to access to healthcare while imagining a system that adequately adheres to a market structure. What I want to show you and the other posters in this thread is this: Most people really do agree that healthcare is a human right. People disagree about how the healthcare system should be set up. The structure of the healthcare system does not affect whether the right does or does not exist. But you need to affirm that the right exists in order to build the best system that morally ought to exist.
Advertisement - Members don't see this ad
I don't think we have the answer to this. It's easy to say that biological differences cause this, but we don't know how much biological differences even factor into this. Society does gear women away from STEM fields like cheg (and maybe men from literary fields to a lesser extent), so we don't know how the male to female ratio would be if this didn't happen (it could very well be 50-50). And if it turned out to be 50-50 then maybe the biological differences aren't so different that it makes a big impact on the outcome.
Because you introduced biological differences as a justification for something (even if we allow that what that something is has yet to be determined) in the middle of a discussion about whether people have a right to health care where you were one of the two primary parties arguing against health care being a right. So your decision to insert biological differences was either relevant and purposeful in terms of that argument OR, less likely it seems to me, you decided to interject an irrelevant, provocative freebie that has nothing at all do with your overall position against health care as a right.
To answer the original question, no, your political views should not be a major issue. Some classmates will not like it if you are outspoken about it but won't be able to do anything about it.
The militant leftist PC microaggression safe space social justice white guilt nonsense that has infiltrated other academic settings has not crept in to medical education yet. At least not in my experience.
It's started to in the form of fluff lectures during preclinical, but fortunately those aren't taken seriously.
The militant leftist PC microaggression safe space social justice white guilt nonsense that has infiltrated other academic settings has not crept in to medical education yet. At least not in my experience.
It's started to in the form of fluff lectures during preclinical, but fortunately those aren't taken seriously.
Who are you to tell me what is a "decent wage?" Or what is needed to "get by and live a decent life?" Some of us have other goals in life than merely getting by, such as providing estates to our children and family that will allow them to prosper and not struggle as we have. I work hard so that my descendent family will not have to, essentially, and so that I can retire well before 65. The point of work should be to earn enough money to never work again, not to subside and continue your existence. That's the problem with people asking "how much is enough?" Because enough for me is enough to retire. Enough for you is enough to enjoy life now. If I'm only making enough to get by right now, I'll never be able to pack up my stethoscope and leave the system, providing free care off in the Philippines or some other developing country where I never have to clock in and clock out or worry about malpractice and paperwork ever again.
Exactly, and why women can score just as high or higher on the MCAT as their male counterparts. Biological? Not socially constructed? I'm outraged because of all the things supposed "biological differences" have been used to justify in horrific ways throughout history. And hence, why there has been a need for womens studies departments in virtually every major university in the United States.
Who said I think "decent" means enough to just get by? I think people have other needs which they require to live a decent life. Ability to retire. To afford education. To afford a family. To afford leisure time and vacation. To afford time off to raise children. To afford a downturn in the market or a sudden catastrophe in the family, nature, their city, country, etc. We have the prices for those things, they have market values and given that we know what people need to live "decently" by a formulation which we can agree on. We already decide this. That's why we have things like a minimum wage.
If health care is a right, then I still believe that the negative rights of physicians hold over the positive rights of patients, much as they do in any other situation, from abortion to assisted suicide, in which a patient demands something a physician is unwilling to offer for whatever reason. Hence, you may have a right to health care, but I am under no obligation to provide it.
This thinking only works if there is a system in place to guarantee that everyone has access to care even though you as an individual physician are unwilling to provide it.
Yeah, but "decent" to most people is not "decent" to many physicians. And minimum wages apply to minimums, not maximums- America has never established maximum wages for good reason, as they are inherently unjust and deny one's right to the liberty and pursuit of happiness (as, for many of us, money is liberty- the liberty to not work for another, to invest, to do as one pleases,- and happiness stems from that liberty).
So do you support or oppose requiring physicians to provide services even if they do not want to provide them for the compensation offered?
And you shouldn't, especially if you are going to be doing so from such a resentful framework. May retirement come swiftly and very successfully.
Hey, that's on you to figure out. Myself and the massive number of fiscally conservative physicians out there are under no obligation to participate. Give people nurse practitioners or something I guess, while we work outside the system in private hospitals.
I have no resentment toward providing care at the moment. It's if the government forces me to that that resentment will stem. I actually want to provide nothing but free care after retirement, preferably outside of the rules and regulations of this country, where I can practice medicine as it was meant to be practiced- a physician and a patient, not piles of paperwork and computer screens.
Kind of-ish. Because I say should out of decency, not that it is a right. Like I disagree with what you said above in your comment "by any means necessary." I think if a physician finds whatever sacrifices come with treating someone who can't pay for their treatment to be too costly, he/she should have a right to say no. And if the gov't puts up too many hoops to jump through to treat patients without private insurance, I support physicians saying peace out and going to concierge medicine. What I would like to see happen is making a system that limits the cost it takes for health providers to treat these patients because that is the compassionate thing to do and it is something possible to accomplish.
I guess our disagreement comes with the fact that I think a right means that it is a right no matter the system in place. Maybe that definition is too nuanced, but that how I always viewed a right.
Don't provide them, but interesting that the discussion hasn't included denying services to those with private insurance. Are you going to refuse based on the major insurance carriers not paying enough? And where are you going to draw the line? Emergency treatment after a stab wound or car wreck but no chemo for cancer? Where exactly?
Advertisement - Members don't see this ad
You do realize that the move to EMRs and such is as much a result of technological advances as government involvement, right? And accreditation bodies.
Yes, actually, to the bolded. There are plenty of physicians that drop poor payers all the time, and refuse to see patients with that insurance, both public and private. If it gets bad enough, some physicians might stop taking insurance entirely and take cash only.
So I guess Ill respond here by posing some questions, you dont have to answer all of them but they can frame the discussion that will ensue
1) Using the example he listed do you think that the difference in the number of chemical engineers we have who are women vs men is due to factors that are "unjustifiable"? Are the differences due to "unfair discrimination" in your mind?
2) Do you believe each gender has certain strengths and weaknesses that differ? If so, isnt it possible that these manifest themselves in such a way that more men are deemed desirable for chemical engineering jobs than women?
Look I know very little about chemical engineering specifically and what a successful Chem engineer entails but that's largely besides the point here. Each gender has their strengths and their weaknesses. If you dont like the idea specifically that "one gender has better visuospatial skills" and that is the reason for why one gender should be picked above the other that's fine. But other factors that arent as simple as "visuospatial skills" can be found to be different between genders and if the male gender is found to be more likely to have those desirable skills for a ChemE position, shouldnt it then be justifiable that more men are chosen than women?
Likewise in a more relevant example to medicine, 75% of pediatricians and 85% of OB/GYN doctors are female. Part of this is females are more likely to be comfortable with such positions. But do you think this gap is just due to women being more comfortable than men in OB/GYN or are there other factors at play such as maybe women are more likely to have skills needed for the field than men? My guess is there are multiple factors at play.
The key thing here is not to speak in absolutes. Do I buy there is some discrimination against women in the field of engineering and getting jobs? Yes, I think there is a fair chance that is true. But is it possible there are multiple factors at play that the reason for the gap in ChemE men vs women? Ie that it isnt just due to pure discrimination against women but also due to the idea that men might be more likely to have characteristics needed for success in the field than women? I think the answer to these questions is potentially yes as well. Again, I dont really know enough about the field to answer unequivocally but I dont think the gap is due just to "unfair discrimination".
At the end of the day you have to also ask yourself what value do you see in their being equal representation of men and women in a job like chemical engineering? What are the values to the field of chemical engineering itself for this, particularly if there is evidence(and Im not saying there is I have no idea) that men are more likely to have characteristics necessary for success in the field than women?
Are you saying EMR is good? Have you read about what physicians think about it?
Accreditation bodies implemented those standards at the behest of the government care of mandates in the Affordable Care Act. And it is the VOLUME of paperwork and charting that is a problem, not necessarily EMRs themselves. EMRs have caused an explosion in the amount of charting one must do, it's completely insane.
