NYU Emergency department VIP issues

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quite a read. more proof that absolute power corrupts absolutely. it is horrifying how some people in such positions of power can be so amoral and abusive with others livelihoods. I hope NYU and the defendants write very large dollar amount checks to Dr. Carmody if what is written in the complaint is true. I also hope the defendants are all fired and forced to move their families similar to what happens to physicians and their families when they are wrongfully terminated. but I won't hold my breath waiting for that to happen.

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I have long held that NYU and USC are criminal enterprises scamming the public and catering to the rich.. at least NYU does something good with free medical school tuition


They have systemic issues all around
 
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Manhattan absolutely is not underserved. In the 5 mile stretch up and down the east side there are literally 4 quartenary care hospitals, including two Level 1 trauma centers.

The outer boroughs desperately need more hospitals. Manhattan having more trauma centers than the Bronx despite having less than half the penetrating trauma makes absolutely zero sense.

Maybe because half the city and New Jersey commutes to Manhattan to work every morning?
 
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I have been to Canada, Europe, and Asia. Just from an observational standpoint, there was not one country I visited that has the obesity level of the USA. It is not even close. Also there are no country in the world that I have visited with so many fast food places within a mile radius. Any medium size to large city, drive a mile down a main road and count how many fast food places you encounter.

There are some countries that everywhere I look, most people are fit. Yes, there are some people that are obese, but in general they all look healthy. They look similar to people I see when I go to my Gym. Overall, most are healthy and I bet you anything that people who regularly frequent the gym have much better health outcomes than the general US population.

Americans just want to find a quick fix without really looking at what the true problem is or blaming societal disparity for our unhealthy population. We can continue to look to other countries better metrics but can't see that our poor eating habits/easy access to food is what makes our system appear so broken. American's just love fast food, love giant portions, and love to eat throughout the day.
The US is high, not the highest

 
I have been to Canada, Europe, and Asia. Just from an observational standpoint, there was not one country I visited that has the obesity level of the USA. It is not even close. Also there are no country in the world that I have visited with so many fast food places within a mile radius. Any medium size to large city, drive a mile down a main road and count how many fast food places you encounter.

There are some countries that everywhere I look, most people are fit. Yes, there are some people that are obese, but in general they all look healthy. They look similar to people I see when I go to my Gym. Overall, most are healthy and I bet you anything that people who regularly frequent the gym have much better health outcomes than the general US population.

Americans just want to find a quick fix without really looking at what the true problem is or blaming societal disparity for our unhealthy population. We can continue to look to other countries better metrics but can't see that our poor eating habits/easy access to food is what makes our system appear so broken. American's just love fast food, love giant portions, and love to eat throughout the day.
I find it quite disguising that they serve fast food starting in elementary school. Unlimited refills on soda and mega sizes of everything.. the American way. Tbh I too have struggled with healthy eating/ not putting on weight and just finding healthy options. When you live in Europe (and I would imagine South America and rest of the world) you can go outside and find something healthy to eat everywhere, whereas, it is a major challenge here and also very expensive. It is actually hard to find crap food in Europe and no one is gonna give you unlimited fills on soda.

Also McDonalds in hospitals.. WTF??
 
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NO, No there is not. NYC desperately needs more hospitals as the city outgrew its hospital structure. Closing a hospital does nothing to help a community.

I like the rest of your post. They should have substantial fines.
NYC desperately needs better operations management in its hospitals, more up to date medical care, better nursing, faster discharges, less of an obsession with admitting patients for care that is standard outpatient in the rest of the country, expedited outpatient follow-up, an end to the segregated, two-tiered hospital system, among other things. It does not need more hospital beds except for psych.
 
I have long held that NYU and USC are criminal enterprises scamming the public and catering to the rich.. at least NYU does something good with free medical school tuition


They have systemic issues all around
Many places are. Lots of nonprofits have tens of millions going to the CEOs. Like Goodwill
 
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Due to emtala we cover illegals too. The money comes from somewhere
We wouldn’t need EMTALA with a new system.
Everyone would be insured.

EMTALA would become null and void
 
Americans just want to find a quick fix without really looking at what the true problem is or blaming societal disparity for our unhealthy population. We can continue to look to other countries better metrics but can't see that our poor eating habits/easy access to food is what makes our system appear so broken. American's just love fast food, love giant portions, and love to eat throughout the day.
You are correct. Lowering people's BMI, and reducing drug/alcohol use would do vastly more to improve health incomes than any amount we could spend on a Universal Care.
 
Most annual visits in the US are also free. The system sucks though and frankly we are entitled so many don’t show up. I would also say I don’t think physicians influence obesity, smoking or addiction. People have to want to change. A doctor talking to someone about it imo has nearly no influence.
I think if someone is motivated to stop smoking or lose weight the doc can provide support and suggestions to help and can also prescribe pharmacological support - ie my dr talked to me about losing weight and it was a time I was receptive to this and prescribed me some meds to help and I have lost and kept off weight now for 2 years. Same with chantix. The doc definitely can’t effect lifestyle changes by themselves with 1-4 15 minute conversations per year, but it’s not like they have no effect either IMO
 
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I think it's tempting to think that that's a typical story. That way you can see a person like that and walk by without shuddering too much because you get to comfort yourself that this could never happen to you. Because after all, YOU would never do meth. But in reality that's just not the case.
I’ve had the thought experiment of homelessness many times, pre dating attending life.
How does one end up homeless?
What would I do if I lost my job? I’d look for a different job.
What would I do if I couldn’t find one? Time for my husband to work FT, cut back on lifestyle, etc
What if he dies, I still can’t find a job? Then we’d (myself and four kids) move in with my mom
If she threw us out, we could go to my in laws, we could probably shuffle between relatives for a few years, if we got thrown out of everywhere we’d get a small apartment and go on public aid
To end up actually on the street homeless with no access to bathing, not just couch-surfing, you have to have no resources, be unable to find or hold down a job that pays enough to maintain a household, run out of relatives and friends who will help you. I think most of the time that does not happen without a significant mental health or substance abuse component.

I’m not saying everyone who is homeless uses drugs , or is mentally ill , but in my experience in 3 poor urban area hospitals almost all homeless people are homeless because of some combination of bad luck, substance abuse , and mental illness - I can’t remember a homeless person who was just unlucky although I’m sure it can happen. I think it is disingenuous to suggest that people start using drugs because they are homeless. Because most people who use drugs are not homeless.

I do think that once someone is homeless it’s harder than it should be to recover and regain housing - and if you don’t have stable housing how can you get clean off drugs or take your psych meds reliably. Maybe California will figure it out for the rest of us 🤷🏻‍♀️
 
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Not a good look for NYU to have all men named in that lawsuit LOL
 
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I think if someone is motivated to stop smoking or lose weight the doc can provide support and suggestions to help and can also prescribe pharmacological support - ie my dr talked to me about losing weight and it was a time I was receptive to this and prescribed me some meds to help and I have lost and kept off weight now for 2 years. Same with chantix. The doc definitely can’t effect lifestyle changes by themselves with 1-4 15 minute conversations per year, but it’s not like they have no effect either IMO
Some influence in motivated people. Sure. But that’s far from cause and effect for a population of people.
 
We wouldn’t need EMTALA with a new system.
Everyone would be insured.

EMTALA would become null and void
Like it is in other socialized countries like India? Do you have any idea what healthcare is really like in those countries? How much will your panacea cost taxpayers? All the illegals will be covered too? Show me the numbers.
 
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I’ve had the thought experiment of homelessness many times, pre dating attending life.
How does one end up homeless?
What would I do if I lost my job? I’d look for a different job.
What would I do if I couldn’t find one? Time for my husband to work FT, cut back on lifestyle, etc
What if he dies, I still can’t find a job? Then we’d (myself and four kids) move in with my mom
If she threw us out, we could go to my in laws, we could probably shuffle between relatives for a few years, if we got thrown out of everywhere we’d get a small apartment and go on public aid
To end up actually on the street homeless with no access to bathing, not just couch-surfing, you have to have no resources, be unable to find or hold down a job that pays enough to maintain a household, run out of relatives and friends who will help you. I think most of the time that does not happen without a significant mental health or substance abuse component.

I’m not saying everyone who is homeless uses drugs , or is mentally ill , but in my experience in 3 poor urban area hospitals almost all homeless people are homeless because of some combination of bad luck, substance abuse , and mental illness - I can’t remember a homeless person who was just unlucky although I’m sure it can happen. I think it is disingenuous to suggest that people start using drugs because they are homeless. Because most people who use drugs are not homeless.

I do think that once someone is homeless it’s harder than it should be to recover and regain housing - and if you don’t have stable housing how can you get clean off drugs or take your psych meds reliably. Maybe California will figure it out for the rest of us 🤷🏻‍♀️
50 percent of kids 18 to 29 are living with their parents. They don't have their own homes
 
They live with their parents bc kids are not motivated to be independent and parents coddle their kids. Hell, if my parents did my laundry, cleaned, cooked, I prob would stay too.

I would be if the parents didn't allow them to come back home, they would not be homeless but live within their means.

If someone took away all of my possessions/degrees but money for 1 month rent and left me with a driver license/clean criminal record, I could easily get myself a place.

Everyone is hiring. You could go into a restaurant and make $15/hr. Work 60 hrs/wk and that is 3600/mo. Get a 1k/mo apt, live tight, and you could save 1k/month easily.
 
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In a theoretical thought exercise, if you got rid of all fast food joints and all hospitals at the same time, would you have better overall population health outcomes within 10 years?

America’s main health problem lies within the food industry and sedentary lifestyles.
If you just got basic min healthcare and everyone was required to have a BMI under 25, I would bet that almost every outcome metric would improve with 10% of the current costs.

One Obese diabetic going on dialysis for 20 years costs about 2M just for dialysis. If no one was obese, renal failure would plummet.

Americans overall are just fatter/sedentary compared to most industrialized countries who expect healthcare to cost less with similar outcomes.
 
If you just got basic min healthcare and everyone was required to have a BMI under 25, I would bet that almost every outcome metric would improve with 10% of the current costs.

One Obese diabetic going on dialysis for 20 years costs about 2M just for dialysis. If no one was obese, renal failure would plummet.

Americans overall are just fatter/sedentary compared to most industrialized countries who expect healthcare to cost less with similar outcomes.
I would say diabetes and lack of control of it and HTN is the real culprit in ESRD and i know the connection of DM and obesity but my experience is it is the young HTN patients and the t1DM who as kids didnt care for themselves.

Otherwise agreed. People point out our health outcomes but dont look at the initial package of goods we are starting with.

I remember a while back seeing some graph and it compared life expectancy of different ethnic groups in the US vs their home countries. All but the japanese did better and lived longer in the US than their native countries.

Public health people will point to the shorter life expectancy of black people in the US vs whites, asians, hispanics but never consider how it compares to their life expectancy from where they come from.

Its like doing a patient based outcome and not controlling for disease severity. Genetics are a real thing and really do impact care.
 
They live with their parents bc kids are not motivated to be independent and parents coddle their kids. Hell, if my parents did my laundry, cleaned, cooked, I prob would stay too.

I would be if the parents didn't allow them to come back home, they would not be homeless but live within their means.

If someone took away all of my possessions/degrees but money for 1 month rent and left me with a driver license/clean criminal record, I could easily get myself a place.

Everyone is hiring. You could go into a restaurant and make $15/hr. Work 60 hrs/wk and that is 3600/mo. Get a 1k/mo apt, live tight, and you could save 1k/month easily.

Where are you finding apartments for 1k/month? Not in my city, or even close.
But yes, I agree with your overall sentiment of "kids need to get a grip".
 
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What a ridiculous argument, it's not like cataracts pop up overnight and cause sudden blindness. Come back w/ an example of delays for actual time dependent conditions.
He waited over a year and then waited 8 months for the specialist to fix what the first guy has done to make his vision far worse. Yup just anecdotes.
 
Where are you finding apartments for 1k/month? Not in my city, or even close.
But yes, I agree with your overall sentiment of "kids need to get a grip".
Probably the same place where Mickey-D's lets their employees put in 60 hrs/week. In reality they cap you to avoid OT and bennies. Which is the problem with all of these horatio alger hypotheticals--they're divorced from the realities on the ground. Try working 60 hours a week when you've got tenuous housing, a 2 year old kid, an hour-long commute and aren't that smart or motivated to begin with.
 
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They live with their parents bc kids are not motivated to be independent and parents coddle their kids. Hell, if my parents did my laundry, cleaned, cooked, I prob would stay too.

I would be if the parents didn't allow them to come back home, they would not be homeless but live within their means.

If someone took away all of my possessions/degrees but money for 1 month rent and left me with a driver license/clean criminal record, I could easily get myself a place.

Everyone is hiring. You could go into a restaurant and make $15/hr. Work 60 hrs/wk and that is 3600/mo. Get a 1k/mo apt, live tight, and you could save 1k/month easily.
Yeah right these kids will work even 40 hours a week much less 60. It would cut into their social media and video game time. And how would they pay for their pot?
 
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Probably the same place where Mickey-D's lets their employees put in 60 hrs/week. In reality they cap you to avoid OT and bennies. Which is the problem with all of these horatio alger hypotheticals--they're divorced from the realities on the ground. Try working 60 hours a week when you've got tenuous housing, a 2 year old kid, an hour-long commute and aren't that smart or motivated to begin with.

Yep. Have several friends singing this very tune, and they're not blowing money on weed and Fortnite lootboxes. They want to work more and have it make sense, but EvilCorp won't give them the hours, or even a modicum of respect.
 
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Why work 60 hours when you can live with parents?
 
Where are you finding apartments for 1k/month? Not in my city, or even close.
Truthfully had no idea but in sought after City I live in I see lots of studio apts for under 1k. Also, Airbnb shows rooms for rent well under 1k/mo. For a college student or if I were homeless, I could easily get back on my feet.
 
This thread is totally off topic at this point can you guys talk about this somewhere else
 
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I find it quite disguising that they serve fast food starting in elementary school. Unlimited refills on soda and mega sizes of everything.. the American way. Tbh I too have struggled with healthy eating/ not putting on weight and just finding healthy options. When you live in Europe (and I would imagine South America and rest of the world) you can go outside and find something healthy to eat everywhere, whereas, it is a major challenge here and also very expensive. It is actually hard to find crap food in Europe and no one is gonna give you unlimited fills on soda.

Also McDonalds in hospitals.. WTF??

A former NYC mayor( I think Bloomberg), tried to ban restaurants and businesses from selling mega-sized sodas to the public. Businesses sued and won in court. Apparently, obesity is good for American businesses.
 
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I trained at a residency with the busiest Mcdonalds in the country (who knows if true) under the same roof that was 24hrs. That place literally had a perpetual 5+ cashiers with long lines.

What a sight to be seen and the people who ate there were the unhealthiest demographics. People literally waiting in the ER eating Mcdonalds, bringing food upstairs for family members.

I think I ate at the Mcdonanlds 2 times in my 3 yrs of residency.
 
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I think I ate at the Mcdonanlds 2 times in my 3 yrs of residency.
I did my clerkships at a hospital that called itself the cardiology center of excellence’. Their sign was literally next to the McDonald’s in the hospital. I remember eating their once and only because our IM rounds took a little too long that day and the cafeteria was closed by the time we got done.

Would rather eat out of a garbage can, food is probably healthier.
 
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I did my clerkships at a hospital that called itself the cardiology center of excellence’. Their sign was literally next to the McDonald’s in the hospital. I remember eating their once and only because our IM rounds took a little too long that day and the cafeteria was closed by the time we got done.

Would rather eat out of a garbage can, food is probably healthier.

Maybe that's why it's a center of excellence? The volume of metabolic syndrome patients they see each day keeps them busy and....pays for the vacation home.
 
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My town has a burger place with funky plate names - one of them is called defibrillator “your cardiologist loves this! It affords him his yacht”
 
I dont know man, I think peoples tendency to blame those durn youngsters for being lazy/entitled are a tad out of touch, grossly generalizing, and showing their age. I dont think things are that simple. Theres legit issues younger generations are facing that they didnt create, have zero control over, and “we” didnt face.
 
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That proves the point that Canada doesn’t have VIP healthcare for the wealthy or "party members", if a very wealthy politician thought it was necessary to go to the U.S. instead of attempting to get VIP treatment in Canada.

Danny Williams decision led to a public outcry, and he ultimately resigned in that same year.
Or…just treatment…
 
I trained at a residency with the busiest Mcdonalds in the country (who knows if true) under the same roof that was 24hrs. That place literally had a perpetual 5+ cashiers with long lines.

What a sight to be seen and the people who ate there were the unhealthiest demographics. People literally waiting in the ER eating Mcdonalds, bringing food upstairs for family members.

I think I ate at the Mcdonanlds 2 times in my 3 yrs of residency.
Duke had a Hardee's in it, on the children's hospital side. I don't know if it is still there. Elmhurst in Queens had a Burger King. All the HHC city hospitals had either a BK or Mickey D's.
 
Duke had a Hardee's in it, on the children's hospital side. I don't know if it is still there. Elmhurst in Queens had a Burger King. All the HHC city hospitals had either a BK or Mickey D's.
How long ago was the BK in Elmhurst? I remember during residency they had a Panera and then a McDonalds.

Apparently people didn’t like Panera 😮
 
How long ago was the BK in Elmhurst? I remember during residency they had a Panera and then a McDonalds.

Apparently people didn’t like Panera 😮
My first attending job the hospital had a McDonald’s. They finally got rid of it. Few years later my wife and I took the kids to one across town for happy meals after a birthday party. The old hospital McDonald’s manager had transferred there after it closed.

He came out from behind the counter and gave me a hug. My wife was like, how much effing McDonald’s did you eat during those years?

A lot baby. A lot.
 
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I dont know man, I think peoples tendency to blame those durn youngsters for being lazy/entitled are a tad out of touch, grossly generalizing, and showing their age. I dont think things are that simple. Theres legit issues younger generations are facing that they didnt create, have zero control over, and “we” didnt face.
I’m not saying it’s not harder now than it was 30 years ago. I’m saying, you won’t end up actually on the street without some reason you can’t maintain decent employment ( , be that substance, mental health, physical health problems etc,) PLUS every friend or family member not being able or willing to take you in. It’s not like a person would lose their job on Monday and they’d be homeless on Thursday unless they had already burned through all their friends, had no emergency savings and was living in a hotel room
 
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I’ve had the thought experiment of homelessness many times, pre dating attending life.
How does one end up homeless?
What would I do if I lost my job? I’d look for a different job.
What would I do if I couldn’t find one? Time for my husband to work FT, cut back on lifestyle, etc
What if he dies, I still can’t find a job? Then we’d (myself and four kids) move in with my mom
If she threw us out, we could go to my in laws, we could probably shuffle between relatives for a few years, if we got thrown out of everywhere we’d get a small apartment and go on public aid
To end up actually on the street homeless with no access to bathing, not just couch-surfing, you have to have no resources, be unable to find or hold down a job that pays enough to maintain a household, run out of relatives and friends who will help you. I think most of the time that does not happen without a significant mental health or substance abuse component.

I’m not saying everyone who is homeless uses drugs , or is mentally ill , but in my experience in 3 poor urban area hospitals almost all homeless people are homeless because of some combination of bad luck, substance abuse , and mental illness - I can’t remember a homeless person who was just unlucky although I’m sure it can happen. I think it is disingenuous to suggest that people start using drugs because they are homeless. Because most people who use drugs are not homeless.

I do think that once someone is homeless it’s harder than it should be to recover and regain housing - and if you don’t have stable housing how can you get clean off drugs or take your psych meds reliably. Maybe California will figure it out for the rest of us 🤷🏻‍♀️

Please don't take what I am about to say as an attack, because the thinking you outline is pretty common, but it shows a misunderstanding of basic realities of how poverty works and how its a multigenerational trap.

It doesn't make sense to start thinking from your point of view in life now. While I am sure you experienced your fair share of challenges, so many things had to line up ok for you to end up where you are in life. Even assuming you didn't have any of the privileges that are typical for people who end up in medicine, odds are that you weren't exposed to high levels of led in gestation and early childhood. Or experienced personal and communal violence growing up. Or grew up in a shelter because your parents were homeless.

To address some specifics:
-I'd look for a different job: you're qualified to do a lot of things, most people aren't
-My husband would work more: many people don't have a partner to fall back on, full time minimum wage is barely survivable for one person
-Move in with my mom: your network is part of your safety net, for most people in poverty their network is equally poor
-Go to in laws: again, many people don't have in laws, and/or their network is too poor to help
-Public aid: I've spent some time volunteering to help people apply for various forms of aid. As a proficient English speaker with a fairly good understanding of the system and the time to try to figure it out (because I wasn't working a minimum wage job to support myself), I had so much difficulty getting food stamps for people who clearly needed them, and that was in a relatively easy state from that perspective.

Now for some broader context:
My partner is a community school administrator for a community based organization that runs several schools, mostly in the Bronx. 25% of her kids live in shelters. Their schools have a trauma counselor because so many kids are traumatized by violence (abused, seen their parents murdered, etc). The majority of her students suffer food insecurity. Their school meals are the only warm food many of them ever eat. What do you think one's chances of academic success are in that kind of situation? Now consider that a third grading reading level is so highly predictive of not just being able to graduate from high school but of going to jail that it has long been suggested as a way of predicting future jail bed needs. The general concept is referred to as a school to prison pipeline. Also this kind of situation is not extreme or exotic in any way. About 16% of children in the US live in poverty, though the rates are much higher in some communities.

Do you have some familiarity of how easy it is to go to jail? Too large of a separate topic to tackle, but let's just say that between all the things that count as a violent crime (more than you'd think), laughably underfunded public defenders, and >90% conviction rates, it is extremely likely that a relatively minor mistake early in life absolutely destroys the rest of it. About 3% of the population have been to jail. While some have been successfully rehabilitated, given how hard it is to get a job or housing with that hanging over you, a lot of people just don't stand a chance.

With all that being said, do you still think if you were born to different circumstances that it couldn't happen to you?

"There but for the grace of God, go I."
 
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Please don't take what I am about to say as an attack, because the thinking you outline is pretty common, but it shows a misunderstanding of basic realities of how poverty works and how its a multigenerational trap.

It doesn't make sense to start thinking from your point of view in life now. While I am sure you experienced your fair share of challenges, so many things had to line up ok for you to end up where you are in life. Even assuming you didn't have any of the privileges that are typical for people who end up in medicine, odds are that you weren't exposed to high levels of led in gestation and early childhood. Or experienced personal and communal violence growing up. Or grew up in a shelter because your parents were homeless.

To address some specifics:
-I'd look for a different job: you're qualified to do a lot of things, most people aren't
-My husband would work more: many people don't have a partner to fall back on, full time minimum wage is barely survivable for one person
-Move in with my mom: your network is part of your safety net, for most people in poverty their network is equally poor
-Go to in laws: again, many people don't have in laws, and/or their network is too poor to help
-Public aid: I've spent some time volunteering to help people apply for various forms of aid. As a proficient English speaker with a fairly good understanding of the system and the time to try to figure it out (because I wasn't working a minimum wage job to support myself), I had so much difficulty getting food stamps for people who clearly needed them, and that was in a relatively easy state from that perspective.

Now for some broader context:
My partner is a community school administrator for a community based organization that runs several schools, mostly in the Bronx. 25% of her kids live in shelters. Their schools have a trauma counselor because so many kids are traumatized by violence (abused, seen their parents murdered, etc). The majority of her students suffer food insecurity. Their school meals are the only warm food many of them ever eat. What do you think one's chances of academic success are in that kind of situation? Now consider that a third grading reading level is so highly predictive of not just being able to graduate from high school but of going to jail that it has long been suggested as a way of predicting future jail bed needs. The general concept is referred to as a school to prison pipeline. Also this kind of situation is not extreme or exotic in any way. About 16% of children in the US live in poverty, though the rates are much higher in some communities.

Do you have some familiarity of how easy it is to go to jail? Too large of a separate topic to tackle, but let's just say that between all the things that count as a violent crime (more than you'd think), laughably underfunded public defenders, and >90% conviction rates, it is extremely likely that a relatively minor mistake early in life absolutely destroys the rest of it. About 3% of the population have been to jail. While some have been successfully rehabilitated, given how hard it is to get a job or housing with that hanging over you, a lot of people just don't stand a chance.

With all that being said, do you still think if you were born to different circumstances that it couldn't happen to you?

"There but for the grace of God, go I."

The amount of excuses gets tiring.

Why is it that poor non English speaking immigrants from East and South Asia seem to do alright when they get a chance to get to the US?

I'm not even talking about the ones who are engineers or physicians etc. I'm talking about the ones who work at gas stations and take on other various unglamorous jobs.

They barely speak English but they have enough common sense to work hard, avoid drugs and committing crime and promote educating their kids. Then within a generation, you have a well off family that is contributing to society. I've seen it happen time and time again.

If someone can't get a job in today's current market, they just don't want to work. Every single place I go to is hiring. Supermarkets, restaurants, warehouses etc. No skills needed. They advertise benefits packages and even retirement packages. Again, not glamorous but it's honest work.

Getting government benefits isn't that bad. Calfresh ( California form of food stamps) has a quick online application in several languages ( Spanish, Chinese, Vietnamese).

I work at an FQHC. We have so many people ready and willing to get patients enrolled in some type of coverage for health insurance, WIC etc.

I'm nearly 40 and am a minority and have never been to jail or arrested. Neither has anyone in my immediate or extended family. Not a difficult concept to avoid drugs and committing crimes.

I know the narrative is that cops are roaming the streets looking to arrest any minority they see but you'll be happy to hear that isn't true.

-----------------------------------------------------

Other than being a minority, I grew up privileged. My parents certainly didn't. They came to this country with nothing but used some common sense to make a better way of life for them and their kids. My dad didn't even have running water at the village he grew up in. That's true poverty.
His form of food insecurity meant he would go to bed hungry and be rail thin.

Not the food insecurity here where kids still end up being obese/overweight like in the Bronx.
 
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The crux of the matter in the debate over causes of poverty is nature vs nurture here, with both sides making some valid points. The only question is to what extent is each side correct, something that can and has been argued until the cows come home and I don’t think is getting resolved here.
 
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Nothing that hasn't been debated but at the end of the day, it essentially takes hard work no matter your lot in life. Some people are not willing and will end up poor/homeless no matter if they grew up rich. Some people will be successful even if their parents are druggies.

Some are born requiring little to be successful (my kids) and some require ALOT of work to be successful (My parents) and some more in the middle (me).

Bottom line is, the only person that can make you successful is yourself. No matter the amount of aid, help, gov assistance, etc will overcome your will to succeed. Assistance helps makes it easier to succeed, but only you have ultimate control on your destiny.

All reasons for are valid but that only adds to increasing the amount of work you need to overcome.

No diff than someone with a learning disability becoming an academic star vs someone with a high IQ. Requires more work, but its possible.
 
Nothing that hasn't been debated but at the end of the day, it essentially takes hard work no matter your lot in life. Some people are not willing and will end up poor/homeless no matter if they grew up rich. Some people will be successful even if their parents are druggies.

Some are born requiring little to be successful (my kids) and some require ALOT of work to be successful (My parents) and some more in the middle (me).

Bottom line is, the only person that can make you successful is yourself. No matter the amount of aid, help, gov assistance, etc will overcome your will to succeed. Assistance helps makes it easier to succeed, but only you have ultimate control on your destiny.

All reasons for are valid but that only adds to increasing the amount of work you need to overcome.

No diff than someone with a learning disability becoming an academic star vs someone with a high IQ. Requires more work, but its possible.
That's a useful retroactive personal narrative. Working hard when you're in situational poverty tends to be useful and adaptive. Telling kids growing up in generational poverty to work hard doesn't seem to be the cure-all that we'd like. Low SES kids who excel in high school, achieve equivalent grades as their more affluent peers, often while working to help support their family are still significantly less likely to graduate than their middle and upper class colleagues. Working hard works when you know the rules of the game, otherwise it's just wasted effort.
 
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The amount of excuses gets tiring.

Why is it that poor non English speaking immigrants from East and South Asia seem to do alright when they get a chance to get to the US?

I'm not even talking about the ones who are engineers or physicians etc. I'm talking about the ones who work at gas stations and take on other various unglamorous jobs.

They barely speak English but they have enough common sense to work hard, avoid drugs and committing crime and promote educating their kids. Then within a generation, you have a well off family that is contributing to society. I've seen it happen time and time again.

If someone can't get a job in today's current market, they just don't want to work. Every single place I go to is hiring. Supermarkets, restaurants, warehouses etc. No skills needed. They advertise benefits packages and even retirement packages. Again, not glamorous but it's honest work.

Getting government benefits isn't that bad. Calfresh ( California form of food stamps) has a quick online application in several languages ( Spanish, Chinese, Vietnamese).

I work at an FQHC. We have so many people ready and willing to get patients enrolled in some type of coverage for health insurance, WIC etc.

I'm nearly 40 and am a minority and have never been to jail or arrested. Neither has anyone in my immediate or extended family. Not a difficult concept to avoid drugs and committing crimes.

I know the narrative is that cops are roaming the streets looking to arrest any minority they see but you'll be happy to hear that isn't true.

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Other than being a minority, I grew up privileged. My parents certainly didn't. They came to this country with nothing but used some common sense to make a better way of life for them and their kids. My dad didn't even have running water at the village he grew up in. That's true poverty.
His form of food insecurity meant he would go to bed hungry and be rail thin.

Not the food insecurity here where kids still end up being obese/overweight like in the Bronx.

Nothing that hasn't been debated but at the end of the day, it essentially takes hard work no matter your lot in life. Some people are not willing and will end up poor/homeless no matter if they grew up rich. Some people will be successful even if their parents are druggies.

Some are born requiring little to be successful (my kids) and some require ALOT of work to be successful (My parents) and some more in the middle (me).

Bottom line is, the only person that can make you successful is yourself. No matter the amount of aid, help, gov assistance, etc will overcome your will to succeed. Assistance helps makes it easier to succeed, but only you have ultimate control on your destiny.

All reasons for are valid but that only adds to increasing the amount of work you need to overcome.

No diff than someone with a learning disability becoming an academic star vs someone with a high IQ. Requires more work, but its possible.

That's a useful retroactive personal narrative. Working hard when you're in situational poverty tends to be useful and adaptive. Telling kids growing up in generational poverty to work hard doesn't seem to be the cure-all that we'd like. Low SES kids who excel in high school, achieve equivalent grades as their more affluent peers, often while working to help support their family are still significantly less likely to graduate than their middle and upper class colleagues. Working hard works when you know the rules of the game, otherwise it's just wasted effort.

I think this is a situation where everyone can be correct at the same time because there is so much nuance to this issue, and one size certainly does not fit all.

I usually come down on the more unsympathetic side of this, but I was raised in a middle-class home where my mom got to stay home to raise me because my dad had a good job, and where education was prioritized; I am inherently biased.

The generational poverty we see so often in the ED is so built into these family lines, that poverty almost becomes an inheritable trait.

This reminds me of a discussion I had with my dad over Christmas about why some people act out in the ED. He can't believe the stuff we see happen. I said "Dad, the thing you gotta realize is, that if you yourself went to the ER with a heart attack, that would be the worst day of your life. For some of my patients, every day is the worst day of their life. Their lives just suck...every day."

This is not an absolution of the behavior, but a possible explanation for it.

The politicians of 2022 cannot or will not solve it. The Republicans largely ignore it, and the Democrats just tax and throw money at it. I'm no public policy expert, but I think to improve things, a bottom-up approach is needed: investing in neighborhood infrastructure (which includes safe places to play outside, paying teachers more, etc), availability of healthy food, revitalization of police-community relations, removal of children from substance addicted families, etc. You won't see the results for 1-2 generations probably.

All these "woke" initiatives like affirmative action, reparations, etc., just try to temporarily plug the problem, without addressing the underlying cause, and also manufacture intra class/race strife, which if I'm going to put my tinfoil hat on, I think the politicians enjoy and benefit from.
 
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Working hard works when you know the rules of the game, otherwise it's just wasted effort.
I can agree with alot you said but completely disagree with this. Hard work and outworking others is the only way you can almost guarantee improvement. I am not saying you will be top 10% successful, but you will take a step up on the financial rung.

Hard work is never wasted, there are always benefits. I can tell you many free gov programs that are a complete waste and in many ways makes it worse.
 
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That's a useful retroactive personal narrative. Working hard when you're in situational poverty tends to be useful and adaptive. Telling kids growing up in generational poverty to work hard doesn't seem to be the cure-all that we'd like. Low SES kids who excel in high school, achieve equivalent grades as their more affluent peers, often while working to help support their family are still significantly less likely to graduate than their middle and upper class colleagues. Working hard works when you know the rules of the game, otherwise it's just wasted effort.
My family were immigrants that got here with nothing more than 2 suitcases for the whole family, and we had 5 people in a 1 bedroom apartment.
Clothes were donations, food was what we could get

I worked my butt off, had 2 jobs, school, maintained straight A’s and went to medical school.

My parents didn’t have a vacation in 22 years (whole family never had a vacation). No sick days, worked 2 jobs etc…

Their first vacation was when I could afford it after becoming an attending.

Now I get extremely frustrated when people think things should just be given to them, Or the government should solve all these issues. Especially those that can’t get it straight for generations.

Also frustrating when the government now wants to tax me, after working so hard, to give to those that don’t.

Enough with the self pity and entitlements and work your butt off
 
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