Overly Pessimistic (IM) Preceptor...are all doctors like this?

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Interesting article on medscape today about this topic and how documenting noncompliance doesn't keep you from losing in court if a patient doesn't take their recommended treatment.
http://www.medscape.com/viewarticle/818850

Then what are you to do? I know a plastic surgeon who does video recording before procedure. How's that?

Then you support the abolition of it, right?

I support abolishing this welfare system. Truth be told, someone could convince me to fund mentally disabled and congenitally diseased programs. I do have a small soft corner in my right ventricle...which is okay since it doesn't require all that much pressure.

Your Obama comment is telling. Very. Keep at least 20 ft from me. Anyone who finds him extreme is a scary Fox viewer. At worst he's like...ineffective. I care more about America's stance on Israel than I do about welfare, education, or your health. :)

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Then what are you to do? I know a plastic surgeon who does video recording before procedure. How's that?

What the article says is to spell out in detail exactly what you're telling the patient that they're refusing to do. What the consequences of are not taking BP medication. (can lead to death, stroke, MI, etc...) That way they are shown to be at fault and lying when they accuse the physician of not explaining what could happen if they didn't take the medication/treatment.

Documenting "noncompliance" alone is not sufficient to protect from fault in litigation.
 
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What the article says is to spell out in detail exactly what you're telling the patient that they're refusing to do. What the consequences of are not taking BP medication. (can lead to death, stroke, MI, etc...) That way they are shown to be at fault and lying when they accuse the physician of not explaining what could happen if they didn't take the medication/treatment.

Or just hope they get a massive stroke and just go "breeeearrrrgggghhh <drool>" in court.
 
Your Obama comment is telling. Very. Keep at least 20 ft from me. Anyone who finds him extreme is a scary Fox viewer.

Yep. Like I said, her main problem with "liberals" is that she thinks they're not liberal enough. Once again, I'm right.
 
See what I mean about you being a *****? I barely care about welfare...I'd just rather not pay for it. I don't care really why it's being used unless it actually creates some potential benefit to the society as a whole - but I do think only wealthy businessmen and politicians benefit from placation of the poor...not me. Now if I was a Rockafeller and my future children and grandchildren depend on this stability, I might have more appreciation for it. Are you just subconsciously addicted to conflict and rebuking others? You have some issues to look into.
I'm not a proponent of welfare in its current state. I believe it should be a conditional program designed for those that are willing to commit to being re-introduced to the workforce. To collect welfare payments, you should have to be in an apprenticeship, a trade school, or a college program of some sort. If you finish the program and still cannot/will not work, you're on your own. We gave you a chance, with education and social support to become a productive member of society.

Such an approach makes sense, because it accomplishes three goals simultaneously. It reduces the chance of civil unrest by increasing social mobility, it provides a conditional safety net for those who have fallen on hard times, and it guarantees that either the taxpayer will get their money back in taxes once the welfare recipient starts working, or that they will no longer have to provide such services to the recipient if they complete training and fail to make themselves productive afterward.

Social security should be placed in a self-managed account that is not backed by the government and allows the citizen to invest in whatever they want, be it traditional treasuries, stocks, or bonds.

Medicare should be handled similarly, with the money that is taken for Medicare placed in a private account that can be invested, the proceeds of which can be used to purchase private health insurance at retirement.

My beliefs are like, crazy liberal stuff, I know.
 
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To collect welfare payments, you should have to be in an apprenticeship, a trade school, or a college program of some sort.

That's hilarious. Since when is it society's business to support people while they train for anything? Let me guess: is it rooted in British traditions?
 
See, the problem with liberalism is it gets to a point (which we are in now) where the premise is just accepted that "oh, of COURSE we should pay people welfare but I'm not liberal because I'd do it smarter." How about "if you're broke, then it's your own problem?" What? So you want people to die? Hey, if you die as a result of losing your job, you probably shouldn't be part of the gene pool. People love to act like as soon as someone loses their job something happens where they die unless they get a check. It's all very vague, but it's "understood" that's how it works. I think he apparently is struck by lightning or something. I'm not sure how anyone ever lost their job and got another job ever before the advent of welfare -- it's like the art of mummification, only the ancients knew how to do it, but now it's a lost skill.
 
What the article says is to spell out in detail exactly what you're telling the patient that they're refusing to do. What the consequences of are not taking BP medication. (can lead to death, stroke, MI, etc...) That way they are shown to be at fault and lying when they accuse the physician of not explaining what could happen if they didn't take the medication/treatment.

Documenting "noncompliance" alone is not sufficient to protect from fault in litigation.

I know I'm supposed to be on the leniency for doctors side of things but...I totally see the point. Why shouldn't we consider it crucially necessary to spell out the bleakest progression of the patient's disease in the chance that they are not taking matters seriously? If I'm sweetly grinning and not explaining to my patient how grave matters are or the potential risks involved in pursuing fatty foods given their cholesterol level, I'm doing a really **** job as a doctor. Each time I meet with a patient is a dire situation. That's the livelihood of a doctor. I actually think many doctors underexplain and think it's enough to prescribe. No. The patient needs to understand exactly what's at stake the way you do. That seems fair, don't you think? If they are non-compliant after that...well, that's a group of people who are really rolling the dice or doomed.

And really what would it take to have a sheet for each major condition stating exactly what they put at risk if they go against guidance. And maybe have them have the choice to sign that they will comply or what they foresee as obstacles to their compliance?
 
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Another medical student drops wisdom on doctors everywhere.
 
Another medical student drops wisdom on doctors everywhere.

Yes, I suppose I would need to be an electrical engineer or political journalist to drop wisdom on you...given that you're a big doctor. wtf? shut up already, you sound like a twit every time you post in the allopathic section about how "medical student < resident. There's a residency forum I hear. You're like the biggest minus ever. FYI: the juries aren't singularly made up of doctors or Fox news viewers.

As a resident you're more than welcome to offer equal opinions or to offer insight that we don't have yet. You are not welcome to come to Allo to belittle medical students for not being doctors.
 
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Yes, I suppose I would need to be an electrical engineer or political journalist to drop wisdom on you...given that you're a big doctor. wtf? shut up already, you sound like a twit every time you post in the allopathic section about how "medical student < resident. Go away already. There's a residency forum I hear. You're like the biggest minus ever.

As a resident you're more than welcome to offer equal opinions or to offer insight that we don't have yet. You are not welcome to come to Allo to belittle medical students for not being doctors. Bye

Another medical student bleeds into a rag in front of everyone.
 
The best part is that, invariably, what happens is these medical students all become attendings and immediately change their tunes instead of continuing with their juvenile "if I don't do x, then of course I'm a **** doctor" talk. I wish there was some way they were forced to practice like they demanded for a year or something. They'd all end up jumping out of windows.
 
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Yes, I suppose I would need to be an electrical engineer or political journalist to drop wisdom on you...given that you're a big doctor. wtf? shut up already, you sound like a twit every time you post in the allopathic section about how "medical student < resident. Go away already. There's a residency forum I hear. You're like the biggest minus ever. FYI: the juries aren't singularly made up of doctors or Fox news viewers.

As a resident you're more than welcome to offer equal opinions or to offer insight that we don't have yet. You are not welcome to come to Allo to belittle medical students for not being doctors. You're kinda pathetically creepy. Bye
I would really encourage you to just ignore him. My blood pressure dropped ten points after I did. You can't even see when people quote him, it's great.
 
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Yeah, it was probably pretty frustrating to him how I was making fun of his "welfare is rooted in British tradition" argument. So I can see that happening.
 
http://en.m.wikipedia.org/wiki/Poor_Law

Just for those of you not familiar with the origins of poor law and welfare in the British tradition. As all of American law and legal precedent is based on British common law, this is an important frame of reference to have. British poor law has existed since the 1590s and required the wealthy to pay for the care and housing of those that were willing to work but unable to currently find employment. Given that our founding fathers were initially Whigs for the most part, before splitting to the newer parties, it makes sense that the views of the whigs upon the founding of this country were very similar to what the Whigs believed at that time. One of the most important articles passed by the Whigs in the mid 18th century was a massive expansion and formalization of poor law. So there's, ya know, all this history that disagrees with the popular sentiment thrown around by the hard right that everyone should fend for themselves. It isn't the way things have been since shortly after the end of the Dark Ages and it isn't the way they should be today.
 
Oh, it's funny how he ignored me but is still managing to respond to me, eh? What a psychic he must be! By the way, he's trying to equate current welfare to welfare in the 1590s? GREAT ARGUMENT! Bwah ha ha ha!
 
Ooo, good thing I read his link because he's actually lying about what it said. England started out by PUNISHING the poor for being unemployed. He literally just lied about what his article said and hoped nobody would read it.

In fact, I invite everyone to read his Wikipedia article because it's so enlightening. England started out by punishing the unemployed -- up to and including hanging them. That's the actual "origins" of England's treatment of poverty. They later depended on CHURCHES to take care of the poor and then -- this is where he selectively breaks in -- even later had involuntary "donations" collected. But they were from everyone, not "the wealthy" (another lie) and could be "any amount" that the parishioner wanted. And even then, they considered anyone who was able bodied but unemployed to be "of poor moral character" and did not provide welfare to them. It was for orphans and the disabled. But great claim!

Oh, and the "employment" he's talking about is another lie. They didn't get to say "I think I'll go back to college and study this." The English forced people into hard labor (or prison, your choice). So if we "followed English tradition," we'd take all able-bodied unemployed people right now and force them into hard labor or jail them, not "pay them while they went to college to study."
 
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Ooo, good thing I read his link because he's actually lying about what it said. England started out by PUNISHING the poor for being unemployed. He literally just lied about what his article said and hoped nobody would read it.
Unfortunately I discovered the "show ignored" button. I said after the 1590s, which was no lie. There was a less than 60 year period where they attempted punishment, then realized it didn't work, nor was it just or fair. For over 400 years, and longer than our country has existed by far, there has been some degree of a welfare system in place.

A new approach

A system to support individuals who were willing to work, but were having difficulty finding employment was established by the Act of 1576. According to this act “...Justices of the Peace were authorized to provide any town which needed it with a stock of flax,hemp or other materials on which paupers could be employed and to erect a house of correction in every county for the punishment of those who refused work." [6] This was the first time Parliament had attempted to provide labour to individuals as a means combat the increasing vagabond epidemic.

Two years after the act of 1576 was passed, more dramatic changes were made to the methods to fight vagabonding and provide relief to the poor. The Act of 1578, transferred power from the Justices of the Peace to church officials in the areas of collecting these new “imposed taxes” that were established in the Act of 1572. In addition, this Act of 1578 also extended the power of the church by stating that “…vagrants were to be summarily whipped and returned to their place of settlement by parishconstables.”[1] By eliminating the need for the involvement of the justices, law enforcement was streamlined.

You argue with everything and provide no useful opinions. Thank God I can't see your presence in other threads. You're really the worst kind of person.
 
Ooo, he ignored me and then unignored me and then re-ignored me! What a useful thing to do, lol.

By the way, he avoided quoting all the parts of his article that disagreed with him. Everyone should read it, it's a GREAT article. It talks about how they used to hang the unemployed and jail them. We need to follow the origins of British tradition. For real!

Oh, by the way, even the part he quoted contradicted his lies. Notice how the poor were put to hard labor? Yeah, me, too! Let's do it! Oh, and let's whip the vagrants! LOL.
 
This is low even for you.

Nah, it's fine. In fact, if I had written word for word what she wrote to me and directed it towards her, I'd probably be suspended right now. So I have no problem with saying that.
 
Ooo, he ignored me and then unignored me and then re-ignored me! What a useful thing to do, lol.

By the way, he avoided quoting all the parts of his article that disagreed with him. Everyone should read it, it's a GREAT article. It talks about how they used to hang the unemployed and jail them. We need to follow the origins of British tradition. For real!

Oh, by the way, even the part he quoted contradicted his lies. Notice how the poor were put to hard labor? Yeah, me, too! Let's do it! Oh, and let's whip the vagrants! LOL.
The law provided jobs for the poor that wanted to work, allowing them to build jails for those that outright refused to work. Dear
Ooo, good thing I read his link because he's actually lying about what it said. England started out by PUNISHING the poor for being unemployed. He literally just lied about what his article said and hoped nobody would read it.

In fact, I invite everyone to read his Wikipedia article because it's so enlightening. England started out by punishing the unemployed -- up to and including hanging them. That's the actual "origins" of England's treatment of poverty. They later depended on CHURCHES to take care of the poor and then -- this is where he selectively breaks in -- even later had involuntary "donations" collected. But they were from everyone, not "the wealthy" (another lie) and could be "any amount" that the parishioner wanted. And even then, they considered anyone who was able bodied but unemployed to be "of poor moral character" and did not provide welfare to them. It was for orphans and the disabled. But great claim!

Oh, and the "employment" he's talking about is another lie. They didn't get to say "I think I'll go back to college and study this." The English forced people into hard labor (or prison, your choice). So if we "followed English tradition," we'd take all able-bodied unemployed people right now and force them into hard labor or jail them, not "pay them while they went to college to study."
The Elizabethan Poor Law (1601) was one of the longest-lasting achievements of her reign, left unaltered until 1834. This law made each parish responsible for supporting the legitimately needy in their community.[6] It taxed wealthier citizens of the country to provided basic shelter, food and clothing, though they were not obligated to provide for those outside of their community.

http://en.m.wikipedia.org/wiki/Elizabethan_Poor_Law_(1601)

http://en.m.wikipedia.org/wiki/Poor_Law_Amendment_Act_1834

http://en.m.wikipedia.org/wiki/National_Assistance_Act

http://en.m.wikipedia.org/wiki/National_Insurance_Act_1946

Please show me how any of these laws support your point of view. Oh wait, you wont. Because aside from being an all-around pretty sad person, you're very bad at sourcing and legitimizing your own arguments.

Okay... I need to stop. I paid the troll toll, hoping I'd discover some sign of humanity or intelligence, but all for naught. You are a terrible person but a good troll. And with that...
47t2114508.jpg
 
The law provided jobs for the poor that wanted to work, allowing them to build jails for those that outright refused to work.

Uh, try reading again, kiddo. It says that they were given a choice between laboring OR going to jail if they refused. And I'm all for that, so bring it on.

Oh, by the way, read about his new post on Queen Elizabeth's Relief Act. It's the same thing. You either did labor or went to jail. Recall, his initial claim was that welfare (as seen today) reflects English traditions. Does that sound like "you get 99 weeks of unemployment payment and welfare checks and food stamps and healthcare subsidized?" Nope. The traditions of England and America were: "work or die." It's pretty simple.
 
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Utilitarianism is a theory in normative ethics holding that the proper course of action is the one that maximizes utility, usually defined as maximizing happiness and reducing suffering. Classic utilitarianism's two most influential contributors are Jeremy Bentham and John Stuart Mill. John Stuart Mill in his book Utilitarianism, stated, "In the golden rule of Jesus of Nazareth, we read the complete spirit of the ethics of utility. To do as one would be done by, and to love one's neighbour as oneself, constitute the ideal perfection of utilitarian morality."

You don't understand utilitarianism if you believe my views are incompatible with this.

thanks for saving us the trouble of going to wikipedia. But seriously, whose utility do you favor maximizing- the local community or the country's? Should preference be given to citizens? (To go back to the Wikipedia reference to Jesus Christ, "Who is my neighbor?") What about trying to improve the world's utility. A billion dollar spent for HIV drugs/tx in Africa would probably do more good than a billion spent on drug/etoh rehab in the US.
 
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thanks for saving us the trouble of going to wikipedia. But seriously, whose utility do you favor maximizing- the local community or the country's? Should preference be given to citizens? (To go back to the Wikipedia reference to Jesus Christ, "Who is my neighbor?") What about trying to improve the world's utility. A billion dollar spent for HIV drugs/tx in Africa would probably do more good than a billion spent on drug/etoh rehab in the US.
I choose to focus on national issues, rather than international ones, because it is hard to help others when your own house is in such disorder. Once we get America right, we can set out to help the rest of the world. If we don't figure out our own issues first, we will just be exporting our mistakes.

Edit: I'm all for helping out overseas, it is just something I believe should be done on an individual level, not on a national policy level. Our national policy isn't yet sufficient for ourselves, we really shouldn't engage in misguided attempts to fix things elsewhere just yet.
 
thanks for saving us the trouble of going to wikipedia. But seriously, whose utility do you favor maximizing- the local community or the country's? Should preference be given to citizens? (To go back to the Wikipedia reference to Jesus Christ, "Who is my neighbor?") What about trying to improve the world's utility. A billion dollar spent for HIV drugs/tx in Africa would probably do more good than a billion spent on drug/etoh rehab in the US.

Yeah, but either way, it's liberal because you're positioning yourself (or him, or whoever) as being able to unilaterally decide for everyone what has the most utility and then to confiscate our money to spend it in that manner. As I said to him (and which he totally failed to grasp), being a utilitarian means YOU can personally be utilitarian with your own resources, but it doesn't mean you get to be utilitarian for me.
 
Yeah, but either way, it's liberal because you're positioning yourself (or him, or whoever) as being able to unilaterally decide for everyone what has the most utility and then to confiscate our money to spend it in that manner. As I said to him (and which he totally failed to grasp), being a utilitarian means YOU can personally be utilitarian with your own resources, but it doesn't mean you get to be utilitarian for me.

I was just trying to nail down Mad Jack's position; personally I am a conservative who believes in limited government- especially at the federal level. I believe the safety net should be provided primarily by charities, and to some extent local government.
 
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I know I am going to get flamed for it but let's not all jump on patients. Yes it is frustrating but people are people. They will always take the path of the least resistance and prefer short term gratification to a long-term payout. If you want people to eat healthy you have to create an environment that makes it more difficult for people to eat junk and easier to get healthy food. Unfortunately it is outside the locus of control of individual physician. He can do very little if anything to change those circumstances.
 
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I was just trying to nail down Mad Jack's position; personally I am a conservative who believes in limited government- especially at the federal level. I believe the safety net should be provided primarily by charities, and to some extent local government.
I err on the side of fiscal conservatism. The ultimate goal of everything I view as "good" is that what I view to be good policy is designed to turn people into responsible citizens. Nothing should be free. If you want welfare because you are unable to work, you have one to two years to acquire a skill that will allow you to work. After that, you're on your own. Medicare and social security should be personally managed accounts that you are forced to save, tax deferred, and not allowed to collect until you are of retirement age (or take the payout in substantially equal payments, as with 401k early retirement). This makes a retirement a very personal responsibility that the government only ensures you take part in. I view it as highly preferable to the current system, in which the government takes your money, invests it in poorly returning treasuries (then loots the account in the mean time), and then is on the hook to pay out the funds when you retire. Welfare should be a path to work, nothing more. SNAP should be abolished and replaced with a food bank, like it used to be. This would provide the poor with adequate nutrition and prevent misuse of SNAP funds. Because this food would be provided at cost, it would have a far better cost to benefit ratio. By limiting the choices available at the food bank, you could reduce unhealthy food choices and reduce obesity and other poor outcomes. The military should be largely cut. Putting our nose in the business of others does us few favors while making us few enemies. We spend far too much on our military, with almost one out of every two dollars of military spending in the world being spent by the United States at 44% of the world total. Russia and China each spend about 5%. If we cut back to say, double what Russia and China spend combined, we'd still be cutting back our military funding by more than half.

Sentencing reform and prison reforms are another big issue for me. We incarcerate far more people than we need to, ruining their lives and turning them from potentially productive citizens into criminals that are unemployable and damaged from their experience on the inside. We need to have a rehabilitative system for nonviolent offenders, and seriously curtail what we view as a crime worthy of doing time for. It is a waste of people's live sand taxpayer dollars the way we currently do things.

Ideally, charities could fill in the gaps. But the problem with this idea is that America used to be more homogenous, more about being a part of the great institution that is America. You would donate to lend a fellow American a hand, or a fellow Christian, or what have you. With the rise of our increasingly self-centered culture, we now view those not like us not as fellow Americans, but as leeches, or rich people that skim off the work of those less fortunate, or as radical leftists or hard right nutcases. Within the framework of our current fragmented society, making charity work for a large number of people that are in need would be difficult to impossible. However, were it possible, I would view it as preferable to government intervention.

Basically I don't really fit the left or the right, I just have a particular vision of what would work best for the country that sort of spans both sides. I'd certainly piss a lot of people on either end of the isle off if I were running things, but I would also save the taxpayers piles of money and -maybe- run things in a way that makes people a little bit better off overall.
 
1. whenever you ask the question "are all doctors like this?" the answer is always no

2. you are a MS1 and your preceptor is an attending.

I know I am going to get flamed for it but let's not all jump on patients. Yes it is frustrating but people are people. They will always take the path of the least resistance and prefer short term gratification to a long-term payout. If you want people to eat healthy you have to create an environment that makes it more difficult for people to eat junk and easier to get healthy food. Unfortunately it is outside the locus of control of individual physician. He can do very little if anything to change those circumstances.

i love how your justification is "people are people" then you remove all personal accountability. apparently people can't eat healthy by making better decisions, society has to create an environment where they are forced to eat healthy food. liberals think that all the world's problems stem from society, the media, the rich, and old white men.

if you don't have a trust fund, nothing in life is your fault. "people are people" LMAO
 
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People are people, but sure we don't have to fund their weaknesses - until it is a threat to stability. then you might sing a new tune.
 
1. whenever you ask the question "are all doctors like this?" the answer is always no

2. you are a MS1 and your preceptor is an attending.



i love how your justification is "people are people" then you remove all personal accountability. apparently people can't eat healthy by making better decisions, society has to create an environment where they are forced to eat healthy food. liberals think that all the world's problems stem from society, the media, the rich, and old white men.

if you don't have a trust fund, nothing in life is your fault. "people are people" LMAO
Look I was not trying to play the blame game here. I am just saying that expecting people to not go for immediate gratification and not follow the path of the least resistance is not a prudent logic for policy decisions. Arguing for personal accountability simply doesn't work.
 
Nope. I think it's an opiate orchestrated by rich dinguses who placate a good portion of people to keep them docile and keep a revolution from happening in their front yard. Very cleverly done, I might add given the average person is footing the bill. Down with welfare.

Ummm... despite how vilified by the media, the rich pay essentially all the taxes in this country.
The top 10% of US citizens pay 70% of the taxes. The top 40% pay 106 percent of the taxes. Yes that's right, the bottom 60% which includes part of the middle class pays negative 6 percent in taxes according to the CBO.

When the media says the rich should pay their "fair share", does it surprise anyone they forget this little fact?
 
I'm not a proponent of welfare in its current state. I believe it should be a conditional program designed for those that are willing to commit to being re-introduced to the workforce. To collect welfare payments, you should have to be in an apprenticeship, a trade school, or a college program of some sort. If you finish the program and still cannot/will not work, you're on your own. We gave you a chance, with education and social support to become a productive member of society.

Completely agree but instead of just giving people money after the training programs, perhaps the gov't should employ them like the TVA did back in the day.
 
Look I was not trying to play the blame game here. I am just saying that expecting people to not go for immediate gratification and not follow the path of the least resistance is not a prudent logic for policy decisions. Arguing for personal accountability simply doesn't work.

That doesn't mean that the doctor should be responsible for a failure of personal accountability which is going to happen anyway as administrators, insurance companies, and government officials keep being obsessed with unfair measures of "outcome" along with a misplaced emphasis on "customer satisfaction". My salary and job security shouldn't be jeopardized because of your inability to stop binging on pasta and coca-cola shoots your ha1c into the stratosphere.


Ummm... despite how vilified by the media, the rich pay essentially all the taxes in this country.
The top 10% of US citizens pay 70% of the taxes. The top 40% pay 106 percent of the taxes. Yes that's right, the bottom 60% which includes part of the middle class pays negative 6 percent in taxes according to the CBO.

When the media says the rich should pay their "fair share", does it surprise anyone they forget this little fact?

Yeah that's because the rich are the ones who make all the money. When 95% of income gain in the past few years go to the top 1% who now take home 20% of income and income for most households is decreasing in real terms, it's not a surprise that the rich are the only ones who can afford to be pay tax. It's not about how many people are paying how much money. It's about how many dollars are being hoarded by people without any real benefit to society. I'm all for earning money and being paid what you're worth. I'm not going to be happy when my money is taken to support people I don't even know. But society isn't about me; it's about us. I'm just unhappy that we're wasting all our money on other countries and keeping old people alive rather than investing in education and opportunities for the young.
 
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Benefit to society?
My labor is not society's. My work product is not society's. My income is not society's. My property is not society's. These things are guaranteed to me by right. You can't "hoard" what is by right your own.
 
I'm paying 40k a year to attend school. It would be a lot more if taxpayers weren't helping to subsidize my education. When I was born, my mother had an emergency c-section and it was paid for by charity care because my family had no money. The research I did in various labs were funded by government grants. The roads I drive on are well designed and safe thanks to research and funding from the state. I can eat food from the supermarket without dying thanks to government inspectors. I drink water from my tap without getting cholera. The police and the legal system work to help ensure that no one takes my property without fair compensation. I'm okay with the government taking a few dollars out of my paycheck. No man is an island. I'm not looking forward to seeing a smaller paycheck but it's worth it in general.
 
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The police and the legal system work to help ensure that no one takes my property without fair compensation.

Unless of course it is the police and the legal system doing the taking...
 
That doesn't mean that the doctor should be responsible for a failure of personal accountability which is going to happen anyway as administrators, insurance companies, and government officials keep being obsessed with unfair measures of "outcome" along with a misplaced emphasis on "customer satisfaction". My salary and job security shouldn't be jeopardized because of your inability to stop binging on pasta and coca-cola shoots your ha1c into the stratosphere.

.
I am not trying to hold doctors responsible as I mentioned the very first time I replied to this thread. Many physicians do have a limited locus of control over the people they see. I was just trying to shift the focus of this discussion from blaming everything on the patient, which is IMO useless and will not help anybody, and try to think about possible policy decisions that can be made to make healthy living a default an easy option to make. Basically, if we were to move the majority of out obese people into environment that resembled Japan, do you not think that would make a difference?
 
I'm paying 40k a year to attend school. It would be a lot more if taxpayers weren't helping to subsidize my education. When I was born, my mother had an emergency c-section and it was paid for by charity care because my family had no money. The research I did in various labs were funded by government grants. The roads I drive on are well designed and safe thanks to research and funding from the state. I can eat food from the supermarket without dying thanks to government inspectors. I drink water from my tap without getting cholera. The police and the legal system work to help ensure that no one takes my property without fair compensation. I'm okay with the government taking a few dollars out of my paycheck. No man is an island. I'm not looking forward to seeing a smaller paycheck but it's worth it in general.

Follow me here for a bit:
An individual has rights to life, liberty and property. These were negative rights (such that no one could take these away) not positive rights (these did not have to be given to the person). Society was created to better protect these things and hence government was formed to protect the rights of individuals so that they are left to their own devices and provide public goods (infrastructure including education) that all people benefit from and help protect the property and liberty of individuals. Then at the turn of the century there was a paradigm shift where instead of society protecting the individual, society protected "society" itself. So, taxation turned from providing public goods to providing positive rights for certain individuals on the labors of others.

This became a violation of the rights of the individual as you cannot have positive rights without violating the rights of property or liberty of another person. You cannot give one person a house without forcing someone else to provide the labor to build that house or the money to pay for the construction. Looting under the guise of egalitarianism is one of the largest spread violations of individual rights that has been committed in this country (behind slavery).

When you start to work you will realize that "smaller paycheck" involves roughly 40% of your income as you pay property tax, income tax, state income tax, county/city income tax. What is worse is that you will realize that the largest chunk of that does not go to public goods like roads, education but rather to providing for property to another person who is too lazy or stupid to provide it for themselves.

Think about this. You pay a large portion of your salary to fund medicare/medicaid which then pays your salary. You become literally a slave where your labor is free. What is worse is the young people have been brainwashed to ignore it. If they become successful enough to be the ones footing the bill, they realize just how ridiculous the system is.
 
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The police and the legal system work to help ensure that no one takes my property without fair compensation.

Actually, not true. They call that taxes. And what's worse if you refuse to let them loot your property, they send you to jail. It is a wonderfully elegant system of legal robbery.
 
Follow me here for a bit:
An individual has rights to life, liberty and property. These were negative rights (such that no one could take these away) not positive rights (these did not have to be given to the person). Society was created to better protect these things and hence government was formed to protect the rights of individuals so that they are left to their own devices and provide public goods (infrastructure including education) that all people benefit from and help protect the property and liberty of individuals. Then at the turn of the century there was a paradigm shift where instead of society protecting the individual, society protected "society" itself. So, taxation turned from providing public goods to providing positive rights for certain individuals on the labors of others.

This became a violation of the rights of the individual as you cannot have positive rights without violating the rights of property or liberty of another person. You cannot give one person a house without forcing someone else to provide the labor to build that house or the money to pay for the construction. Looting under the guise of egalitarianism is one of the largest spread violations of individual rights that has been committed in this country (behind slavery).

When you start to work you will realize that "smaller paycheck" involves roughly 40% of your income as you pay property tax, income tax, state income tax, county/city income tax. What is worse is that you will realize that the largest chunk of that does not go to public goods like roads, education but rather to providing for property to another person who is too lazy or stupid to provide it for themselves.

Think about this. You pay a large portion of your salary to fund medicare/medicaid which then pays your salary. You become literally a slave where your labor is free. What is worse is the young people have been brainwashed to ignore it. If they become successful enough to be the ones footing the bill, they realize just how ridiculous the system is.
Oh here we go again. Let's cut all the welfare for poor people who are obviously too stupid and lazy to provide for themselves.
 
I'm against social security, medicare and welfare when money goes to people who didn't pay into the system. I don't see why the young should subsidize the old. I'm also against people who use their money and power to abuse the system for their own benefit. But I think that having some sort of safety net is valuable because there are plenty of people who are unemployed because of circumstance, not because of their laziness or stupidity. Before I got into medical school, I had no idea what I was going to do. I applied to tons of jobs and got rejected from everything. I'm just saying that there are things that are worth paying for and that there are many useful functions of government that we benefit from everyday. A strong society is built on the backs of the productive. The line where it becomes exploitative is up for debate.
 
I'm against social security, medicare and welfare when money goes to people who didn't pay into the system. I don't see why the young should subsidize the old. I'm also against people who use their money and power to abuse the system for their own benefit. But I think that having some sort of safety net is valuable because there are plenty of people who are unemployed because of circumstance, not because of their laziness or stupidity. Before I got into medical school, I had no idea what I was going to do. I applied to tons of jobs and got rejected from everything. I'm just saying that there are things that are worth paying for and that there are many useful functions of government that we benefit from everyday. A strong society is built on the backs of the productive. The line where it becomes exploitative is up for debate.
What about mentally disabled? People with genetic abnormalities who are confined to asylums? They aren't and never will be productive. Do you also advocate throwing them out on the street to fend for themselves like the elderly?

It sounds like the only people deserving government assistance are someone like you who are going to produce in the future.
 
What about mentally disabled? People with genetic abnormalities who are confined to asylums? They aren't and never will be productive. Do you also advocate throwing them out on the street to fend for themselves like the elderly?

It sounds like the only people deserving government assistance are someone like you who are going to produce in the future.

Can you explain why we should take care of them?
 
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I know I'm supposed to be on the leniency for doctors side of things but...I totally see the point. Why shouldn't we consider it crucially necessary to spell out the bleakest progression of the patient's disease in the chance that they are not taking matters seriously? If I'm sweetly grinning and not explaining to my patient how grave matters are or the potential risks involved in pursuing fatty foods given their cholesterol level, I'm doing a really **** job as a doctor. Each time I meet with a patient is a dire situation. That's the livelihood of a doctor. I actually think many doctors underexplain and think it's enough to prescribe. No. The patient needs to understand exactly what's at stake the way you do. That seems fair, don't you think? If they are non-compliant after that...well, that's a group of people who are really rolling the dice or doomed.


Or after thousands of patient encounters, they've come to realize the futility of counseling patients on lifestyle choices. It's nothing but "shut up and refill the dozen medications that counteract my poor lifestyle choices," because a patient set in his habits for decades on end is not going to act on the advice of a person they see once a month, at most.
 
Can you explain why we should take care of them?
This is where my personal moral philosophy comes into play. I am an egalitarian so I believe that the right decision to make is the one that prioritizes the interests of the most vulnerable populations.
 
This is where my personal moral philosophy comes into play. I am an egalitarian so I believe that the right decision to make is the one that prioritizes the interests of the most vulnerable populations.

So how much have you done in the interest of these vulnerable populations to provide for this supposed equality? Or is the time and money required simply someone else's problem which must be performed to assuage your feelings?
 
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