Painful Cuts Coming to Pain...Elections Have Consequences

[Ferrismonk]

Just going to ignore the claims you confidently made about getting high and casual sex as if any if that is relevant.

As stated above, the majority if the country thinks Roe should not have been overturned.

The majority of the country are idiots.

The majority of the country thinks the decision overturning Roe was about the merits of abortion, which is was not. It was about what the constitution actually says. Dobbs was a good and accurate decision. Abortion is not a constitutional or substantive right. If the states or the federal government legislatures wish to permit abortion, they have the freedom to do so. If the country thinks abortion should be legal, then it should be legislated.

You obviously feel differently, but getting high and having casual sex are both decisions that show a lack of personal responsibility and foresight, so thus relevant to the discussion in my opinion.

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[Baron Samedi]

The majority of the country are idiots.

The majority of the country thinks the decision overturning Roe was about the merits of abortion, which is was not. It was about what the constitution actually says. Dobbs was a good and accurate decision. Abortion is not a constitutional or substantive right. If the states or the federal government legislatures wish to permit abortion, they have the freedom to do so. If the country thinks abortion should be legal, then it should be legislated.

You obviously feel differently, but getting high and having casual sex are both decisions that show a lack of personal responsibility and foresight, so thus relevant to the discussion in my opinion.

Are you familiar with the 9th amendment?

Laws aren't written to give rights. Rights are inherent even if they aren't explicitly spelled out. We don't have laws saying that we have the right to wear velcro sneakers, or to listen to modern country music, or any other things that others might find distasteful.

 

[Ferrismonk]

Are you familiar with the 9th amendment?

Laws aren't written to give rights. Rights are inherent even if they aren't explicitly spelled out. We don't have laws saying that we have the right to wear velcro sneakers, or to listen to modern country music, or any other things that others might find distasteful.

Very familiar and I agree 100% with your statement. Did something I say go against the 9th amendment?

Are you familiar with the 10th?

 

[cowboydoc]

Are you familiar with the 9th amendment?

Laws aren't written to give rights. Rights are inherent even if they aren't explicitly spelled out. We don't have laws saying that we have the right to wear velcro sneakers, or to listen to modern country music, or any other things that others might find distasteful.

Can we at least agree those two things shouldn’t be done concurrently?

 

[SSdoc33]

The majority of the country are idiots.

The majority of the country thinks the decision overturning Roe was about the merits of abortion, which is was not. It was about what the constitution actually says. Dobbs was a good and accurate decision. Abortion is not a constitutional or substantive right. If the states or the federal government legislatures wish to permit abortion, they have the freedom to do so. If the country thinks abortion should be legal, then it should be legislated.

You obviously feel differently, but getting high and having casual sex are both decisions that show a lack of personal responsibility and foresight, so thus relevant to the discussion in my opinion.

i understand that abortion is a big issue for you. but you are denying reality as it currently stands.

there were 5 ballot initiatives in the midterms re: abortion, and all 5 ended up coming out in favor of the pro-choice option. including red states like kentucky. same thing happened in Kansas over the summer. something like >60% of women are pro-choice. and more women vote than men

this isnt a matter of "people are stupid" or that democrats sway the media, or that the questions were framed incorrectly.

it is abundantly clear to anyone who really thinks about this that the country wants to be pro choice and the supreme court went against that sentiment. tuesdays results are part of that backlash. yes, abortion should/could be codified into law. but you are splitting hairs with the constitutional argument.


marijuana has nothing to do with it. at all

 

[Vandalia]

Most "conservative" health policy ideas have never seen the light of day. What has been implemented has mostly come from liberal/welfare state advocates.

Just imagine how different things would look for physicians if more "conservative" policies were tried over the last two decades.

https://www.cato.org/making-health-savings-accounts-work-everyone

There is no role for physicians in "conservative" healthcare policies.

In a "free market" healthcare system why would I pay an interventional pain physician $5K for a procedure, when I can go to the NP down the street, pay her $20, and get 120 oxy 30's a month? I can guarantee you as a retiree I would feel a WHOLE lot better with the latter. I am now retired, no reason for me to get up in the morning.

Or why would I pay a board certified surgeon to do a procedure when an NP could do it for a fraction of the cost? Keep in mind we tried this in the past: Before, say, 1970, give or take, the vast majority of surgeries in the US - including significant procedures like gastrectomies, colectomies, etc. - were done by "GP's" with only a one year internship. People did just fine.

Yeah, those GP's went to medical school, but that was also over 50 years ago. They also didn't have modern antibiotics, anesthesia, CT, ultrasound, etc. etc.

If you want a "free market" solution you have to get rid of government involvement, and the biggest one is professional licensure. At that point you are competing on cost. A Rolls Royce is far better than any equivalent vehicle, but people still prefer cars that are a tenth of the price.

We can do your kid's surgery with an NP, and there is a 95% chance there won't be any problems, and it will cost you $500 total.

Or, we can do it with a board-certified surgeon who has an ACS fellowship, there is a 99% chance there won't be any problems, we can't guarantee no bad outcomes, but it will cost you $5K.

What do you think people will go with?

Here is the dark truth - but a truth none the less: malpractice lawyers and healthcare regulation are the best friend's physicians have. When people complain about "mid-level intrusion" what they are complaining about is there is not enough regulation (of them).

"Malpractice reform" opens the doors for NP's and physicians with that "state minimum training" - and the FP doing interventional pain on the side a a specific example here. Same with regulation. Sure that happens now, but it would open the floodgates. Heck there are women who pay cash to get people to inject silicon caulking into their derrieres to save a few bucks on a cosmetic surgeon.

You really don't want to be competing on cost, because as the last several years have shown, people are not good at understanding probability and risk. Which means they won't pay for slightly less risk: "95%, 99% what is the difference?"

Be careful what you wish for.

Or are you really saying, "Yeah, I want strong government regulation and involvement, just only the ones that benefit me."

No real problem with that, but just be clear about it.

 

[Ducttape]

i understand that abortion is a big issue for you. but you are denying reality as it currently stands.

there were 5 ballot initiatives in the midterms re: abortion, and all 5 ended up coming out in favor of the pro-choice option. including red states like kentucky. same thing happened in Kansas over the summer. something like >60% of women are pro-choice. and more women vote than men

this isnt a matter of "people are stupid" or that democrats sway the media, or that the questions were framed incorrectly.

it is abundantly clear to anyone who really thinks about this that the country wants to be pro choice and the supreme court went against that sentiment. tuesdays results are part of that backlash. yes, abortion should/could be codified into law. but you are splitting hairs with the constitutional argument.


marijuana has nothing to do with it. at all

the issue for many is not just with the "right to abortion" but the right to self-determination of ones own healthcare.

my understanding is that most women are disgusted that a bunch of primarily male politicians have the power to determine what they have to do, if they accidentally become pregnant or are forced to become pregnant, or require abortion to protect their own health.

...
the constitution was meant to be a living document, not a specific set of rules that are inflexible and can never change with time. originalism was a concept that grew in popularity as a counter to civil rights movement. that is part of the basis for Dobbs.


in addition, abortion occurred during the era of the Founding Fathers, and it may have been thought as a private matter, not privy to constitutional law.

https://www.washingtonpost.com/made-by-history/2022/07/19/1792-case-reveals-that-key-founders-saw-abortion-private-matter/

Ben Franklin’s Abortion Recipe

"The next Morning drink a Quarter of Pint of Pennyroyal Water, or Decoction, with 12 Drops of Spirits of Harts-horn."

slate.com

 

[Ducttape]

You're reading the shorthand that was on the ballot, not the actual proposal. Here it is with explanations. Key parts are what the legal definition of "individual", "someone", "healthcare provider" and "an individual's autonomous decision making" are.

forgot to mention please dont post biased "sources" of information.

you can see the full proposal in my second link.



addendum - do you really think that the Michigan Catholic Conference is nonbiased regarding abortion?

 

[drusso]

There is no role for physicians in "conservative" healthcare policies.

In a "free market" healthcare system why would I pay an interventional pain physician $5K for a procedure, when I can go to the NP down the street, pay her $20, and get 120 oxy 30's a month? I can guarantee you as a retiree I would feel a WHOLE lot better with the latter. I am now retired, no reason for me to get up in the morning.

Or why would I pay a board certified surgeon to do a procedure when an NP could do it for a fraction of the cost? Keep in mind we tried this in the past: Before, say, 1970, give or take, the vast majority of surgeries in the US - including significant procedures like gastrectomies, colectomies, etc. - were done by "GP's" with only a one year internship. People did just fine.

Yeah, those GP's went to medical school, but that was also over 50 years ago. They also didn't have modern antibiotics, anesthesia, CT, ultrasound, etc. etc.

If you want a "free market" solution you have to get rid of government involvement, and the biggest one is professional licensure. At that point you are competing on cost. A Rolls Royce is far better than any equivalent vehicle, but people still prefer cars that are a tenth of the price.

We can do your kid's surgery with an NP, and there is a 95% chance there won't be any problems, and it will cost you $500 total.

Or, we can do it with a board-certified surgeon who has an ACS fellowship, there is a 99% chance there won't be any problems, we can't guarantee no bad outcomes, but it will cost you $5K.

What do you think people will go with?

Here is the dark truth - but a truth none the less: malpractice lawyers and healthcare regulation are the best friend's physicians have. When people complain about "mid-level intrusion" what they are complaining about is there is not enough regulation (of them).

"Malpractice reform" opens the doors for NP's and physicians with that "state minimum training" - and the FP doing interventional pain on the side a a specific example here. Same with regulation. Sure that happens now, but it would open the floodgates. Heck there are women who pay cash to get people to inject silicon caulking into their derrieres to save a few bucks on a cosmetic surgeon.

You really don't want to be competing on cost, because as the last several years have shown, people are not good at understanding probability and risk. Which means they won't pay for slightly less risk: "95%, 99% what is the difference?"

Be careful what you wish for.

Or are you really saying, "Yeah, I want strong government regulation and involvement, just only the ones that benefit me."

No real problem with that, but just be clear about it.

"Free markets" are abstract economical constructs. No markets are truly free.

What patients need are transparent markets and access to comprehensible information. Just imagine what patients would do if they understood how PBMs work, how "non-profit" hospitals work, how SOS works, etc. And, imagine if they used their own money to pay for health care up to an indemnified amount. Some of my hight deductible health plan patients are the most thoughtful and conscientious I know because they are on hook for their health care.

 

[Baron Samedi]

Trump has a special announcement planned for the 15th. Will that be the date on the tombstone of the GOP?

 

[Agast]

Trump has a special announcement planned for the 15th. Will that be the date on the tombstone of the GOP?

His daughter is getting married this weekend and he’s busy being an @ss

 

[hyperalgesia]

my understanding is that most women are disgusted that a bunch of primarily male politicians have the power to determine what they have to do, if they accidentally become pregnant or are forced to become pregnant, or require abortion to protect their own health.

It's mildly amusing that post-menopausal women feel they have more at stake in the abortion debate than men who are actively dating reproductive-age women.

 

[hyperalgesia]

Trump has a special announcement planned for the 15th. Will that be the date on the tombstone of the GOP?

In essence, yes!

 

[hyperalgesia]

There is no role for physicians in "conservative" healthcare policies.

In a "free market" healthcare system why would I pay an interventional pain physician $5K for a procedure, when I can go to the NP down the street, pay her $20, and get 120 oxy 30's a month? I can guarantee you as a retiree I would feel a WHOLE lot better with the latter. I am now retired, no reason for me to get up in the morning.

Or why would I pay a board certified surgeon to do a procedure when an NP could do it for a fraction of the cost? Keep in mind we tried this in the past: Before, say, 1970, give or take, the vast majority of surgeries in the US - including significant procedures like gastrectomies, colectomies, etc. - were done by "GP's" with only a one year internship. People did just fine.

Yeah, those GP's went to medical school, but that was also over 50 years ago. They also didn't have modern antibiotics, anesthesia, CT, ultrasound, etc. etc.

If you want a "free market" solution you have to get rid of government involvement, and the biggest one is professional licensure. At that point you are competing on cost. A Rolls Royce is far better than any equivalent vehicle, but people still prefer cars that are a tenth of the price.

We can do your kid's surgery with an NP, and there is a 95% chance there won't be any problems, and it will cost you $500 total.

Or, we can do it with a board-certified surgeon who has an ACS fellowship, there is a 99% chance there won't be any problems, we can't guarantee no bad outcomes, but it will cost you $5K.

What do you think people will go with?

Here is the dark truth - but a truth none the less: malpractice lawyers and healthcare regulation are the best friend's physicians have. When people complain about "mid-level intrusion" what they are complaining about is there is not enough regulation (of them).

"Malpractice reform" opens the doors for NP's and physicians with that "state minimum training" - and the FP doing interventional pain on the side a a specific example here. Same with regulation. Sure that happens now, but it would open the floodgates. Heck there are women who pay cash to get people to inject silicon caulking into their derrieres to save a few bucks on a cosmetic surgeon.

You really don't want to be competing on cost, because as the last several years have shown, people are not good at understanding probability and risk. Which means they won't pay for slightly less risk: "95%, 99% what is the difference?"

Be careful what you wish for.

Or are you really saying, "Yeah, I want strong government regulation and involvement, just only the ones that benefit me."

No real problem with that, but just be clear about it.

I think there should be two healthcare systems that are kept separate by design - a socialized system and a private system. The socialized system has the goal of "population healthcare", value, etc, but it can't lean on and exploit private resources to attain that. For example, it can't routinely employ private docs and facilities (aka Medicare). This completely distorts the private market when you have a govt monopoly calling the shots and setting prices.

For the private side, it also shouldn't be able to exploit government resources. For example, private hospitals can't bill Medicare.

You don't have to get rid of licensure. That could still be a requirement in both systems but it should be illegal for a state to make licensure contingent on anything other than competence.

 

[Pain Applicant1]

We can do your kid's surgery with an NP, and there is a 95% chance there won't be any problems, and it will cost you $500 total.

Or, we can do it with a board-certified surgeon who has an ACS fellowship, there is a 99% chance there won't be any problems, we can't guarantee no bad outcomes, but it will cost you $5K.

Are you sure about the 5% vs 1% difference. For some reason, I bet that's not the case. I bet after the appropriate training, regardless of the primary degree, the complication rate difference is negligible or even non existent.

I'd like to think that as a physician I'm so much better because of my training but I don't think it's true. Poor ego of mine 😢

 

[hyperalgesia]

Are you sure about the 5% vs 1% difference. For some reason, I bet that's not the case. I bet after the appropriate training, regardless of the primary degree, the complication rate difference is negligible or even non existent.

I'd like to think that as a physician I'm so much better because of my training but I don't think it's true. Poor ego of mine 😢

They're just saying there won't be problems with the surgery itself. But what about the medical judgement on deciding whether to do this particular surgery? Do NPs have MEDICAL judgement?

Also, when using percentages, if a population healthcare model boasts a 95% success rate using mid-levels instead of MDs. Can we just write off rare cancers as the cost of doing business? Maybe we should just write these out of the med school curriculum if we want o go down this road of "cost effective population healthcare"...

 

[lobelsteve]

They're just saying there won't be problems with the surgery itself. But what about the medical judgement on deciding whether to do this particular surgery? Do NPs have MEDICAL judgement?

Also, when using percentages, if a population healthcare model boasts a 95% success rate using mid-levels instead of MDs. Can we just write off rare cancers as the cost of doing business? Maybe we should just write these out of the med school curriculum if we want o go down this road of "cost effective population healthcare"...

Val should come up with data. I can claim outlandish things too.
Private pilots who can fly a Piper Saratoga can also take the captains chair on MD-88 and Boing 737’s and issues will arose 5% of the time. But no big deal.

 

[DOctorJay]

Are you sure about the 5% vs 1% difference. For some reason, I bet that's not the case. I bet after the appropriate training, regardless of the primary degree, the complication rate difference is negligible or even non existent.

I'd like to think that as a physician I'm so much better because of my training but I don't think it's true. Poor ego of mine

I like to think that every single second year Med student in this country would have recognized this diagnosis and would have saved this life.

What happens when hospitals replace physicians with NPs?

In the book Patients at Risk, we discuss the tragic case of Alexus Ochoa, a 19-year-old woman who died when a nurse practitioner failed to diagnose the blood clot in her lungs. The nurse practitioner was unprepared to treat emergency room patients and there was no physician on-site, even though...

www.patientsatrisk.com

 

[Ferrismonk]

i understand that abortion is a big issue for you. but you are denying reality as it currently stands.

there were 5 ballot initiatives in the midterms re: abortion, and all 5 ended up coming out in favor of the pro-choice option. including red states like kentucky. same thing happened in Kansas over the summer. something like >60% of women are pro-choice. and more women vote than men

this isnt a matter of "people are stupid" or that democrats sway the media, or that the questions were framed incorrectly.

You are correct, abortion IS a big issue for me, but that's not the point I'm arguing.

I understand what you're saying about most people being "pro-choice", but I really think it's more nuanced than that. If you dig deeper most pro-choice people are fine with 1st trimester abortions, have some uneasiness but compassionate understanding for the occasional need of second trimester abortions, and in general don't approve of 3rd trimester abortions. For the second and third trimester abortions, they usually are fine with them if there are concerns about fetal viability or disease, but are mostly against 3rd trimester abortions for purely elective reasons.
When given the choice between "women's health" and "no abortions", they vote "women's health". It doesn't mean they actually are understanding the specifics of what they're voting for.

it is abundantly clear to anyone who really thinks about this that the country wants to be pro choice and the supreme court went against that sentiment. tuesdays results are part of that backlash. yes, abortion should/could be codified into law. but you are splitting hairs with the constitutional argument.

That's the thing though. The supreme court wasn't saying anything bout the merits of abortion at all. They were interpreting constitutional law, which IS their job. People don't seem to understand that which, in my opinion, makes them stupid at worst and woefully uninformed at best.

 

[Ferrismonk]

forgot to mention please dont post biased "sources" of information.

you can see the full proposal in my second link.

addendum - do you really think that the Michigan Catholic Conference is nonbiased regarding abortion?

If the source was arguing about the merits of abortion, yes I'd say it's biased. It's no secret that Catholics view fetal life as human life. However, it's not biased to point out the specific language in a bill, the legal definitions of that language, and the expected effect of such a bill.

 

[deleted875186]

You are correct, abortion IS a big issue for me, but that's not the point I'm arguing.

I understand what you're saying about most people being "pro-choice", but I really think it's more nuanced than that. If you dig deeper most pro-choice people are fine with 1st trimester abortions, have some uneasiness but compassionate understanding for the occasional need of second trimester abortions, and in general don't approve of 3rd trimester abortions. For the second and third trimester abortions, they usually are fine with them if there are concerns about fetal viability or disease, but are mostly against 3rd trimester abortions for purely elective reasons.
When given the choice between "women's health" and "no abortions", they vote "women's health". It doesn't mean they actually are understanding the specifics of what they're voting for.


That's the thing though. The supreme court wasn't saying anything bout the merits of abortion at all. They were interpreting constitutional law, which IS their job. People don't seem to understand that which, in my opinion, makes them stupid at worst and woefully uninformed at best.

I agree that most people draw a line at what they think is a reasonable cuttoff for abortion, usually around the first trimester.

Before labeling many pro choice people as idiots, you might consider that most people see the Supreme Court decision as a slippery slope towards banning all abortions, which is not a ridiculous thing to think given how heavily conservative the Supreme Court has become, and how many states are dominated by conservative officials in their local governments.

 

[callmeanesthesia]

I agree that most people draw a line at what they think is a reasonable cuttoff for abortion, usually around the first trimester.

Before labeling many pro choice people as idiots, you might consider that most people see the Supreme Court decision as a slippery slope towards banning all abortions, which is not a ridiculous thing to think given how heavily conservative the Supreme Court has become, and how many states are dominated by conservative officials in their local governments.

Those who argue “it’s just returning power to the states” are either naive or deliberately deceitful. A Republican-controlled legislature and presidency would immediately force through a Federal-level abortion ban.

 

[MitchLevi]

A Republican-controlled legislature and presidency would immediately force through a Federal-level abortion ban.

How exactly would they do that?

 

[hyperalgesia]

It would be interesting to see how the SCOTUS would respond to a constitutional challenge to national abortion legislation in either direction. My guess is they would not hear the case.

It's terrifying how little respect liberals have for the separation of powers. If they want something, they expect the courts to give it to them.

 

[SSdoc33]

It would be interesting to see how the SCOTUS would respond to a constitutional challenge to national abortion legislation in either direction. My guess is they would not hear the case.

It's terrifying how little respect liberals have for the separation of powers. If they want something, they expect the courts to give it to them.

SCOTUS is not legitimate in the eyes of many americans

Confidence in U.S. Supreme Court Sinks to Historic Low

Confidence in the U.S. Supreme Court is down 11 percentage points this year, falling to a new low of 25%.

news.gallup.com

 

[deleted875186]

It would be interesting to see how the SCOTUS would respond to a constitutional challenge to national abortion legislation in either direction. My guess is they would not hear the case.

It's terrifying how little respect liberals have for the separation of powers. If they want something, they expect the courts to give it to them.

Really? I would say it go both ways.

 

[10KHertz]

If you subscribe to BLM and CRT, American society is illegitimate. SCOTUS just another obstacle to destroy. Let’s burn it down and start from scratch. First order of business, free Tik Tok access for all…

 

[deleted131481]

If you subscribe to BLM and CRT, American society is illegitimate. SCOTUS just another obstacle to destroy. Let’s burn it down and start from scratch. First order of business, free Tik Tok access for all…

Musk's Twitter free speech brigade will save us. Just pay $8/month. And don't parody Musk or you will be banned.

 

[Agast]

Let’s burn it down and start from scratch. First order of business, free Tik Tok access for all…

Tik Tok is already free….?

 

[hyperalgesia]

SCOTUS is not legitimate in the eyes of many americans

Confidence in U.S. Supreme Court Sinks to Historic Low

Confidence in the U.S. Supreme Court is down 11 percentage points this year, falling to a new low of 25%.

news.gallup.com

This is my point. Liberals think the SCOTUS is another populist institution. If it doesn't represent their current values, it's not legit.

 

[callmeanesthesia]

This is my point. Liberals think the SCOTUS is another populist institution. If it doesn't represent their current values, it's not legit.

So every time Trump, his ilk, and the right wing media railed against the legitimacy of courts that didn’t rule their way that was what? Legitimate complaints about the balance of power because it was a viewpoint you agree with? Give me a break.

 

[10KHertz]

Tik Tok is already free….?

No free lunch.. you still need access, ie phone , internet access.

And yes , thank you Musk for paying me back $54/share and then bankrupting Twitter , please acquire tik tok next . My kids are zombies…

Also a poll question: don’t people believe in balanced political party representation ? The markets and independents do.

 

[cowboydoc]

No free lunch.. you still need access, ie phone , internet access.

And yes , thank you Musk for paying me back $54/share and then bankrupting Twitter , please acquire tik tok next . My kids are zombies…

Also a poll question: don’t people believe in balanced political party representation ? The markets and independents do.

All of this!!!

 

[Pain Applicant1]

They're just saying there won't be problems with the surgery itself. But what about the medical judgement on deciding whether to do this particular surgery? Do NPs have MEDICAL judgement?

Also, when using percentages, if a population healthcare model boasts a 95% success rate using mid-levels instead of MDs. Can we just write off rare cancers as the cost of doing business? Maybe we should just write these out of the med school curriculum if we want o go down this road of "cost effective population healthcare"...

Like all entities, med school will have to evolve with the times or it will die out and get replaced. It will have to become less wasteful and more efficient. Does all of that minutia really make a difference? I don't know.

Are rare cancers missed more often by non physician HCPs? Is their medical judgment worse? I don't know.

Does med school training improve outcomes? That's all that really matters.

PS. I don't care to hear about anyone's personal anecdotal experience with a crna, lol

 

[Pain Applicant1]

I like to think that every single second year Med student in this country would have recognized this diagnosis and would have saved this life.

What happens when hospitals replace physicians with NPs?

In the book Patients at Risk, we discuss the tragic case of Alexus Ochoa, a 19-year-old woman who died when a nurse practitioner failed to diagnose the blood clot in her lungs. The nurse practitioner was unprepared to treat emergency room patients and there was no physician on-site, even though...

www.patientsatrisk.com

I'd like to think that too but I'm not sure it's true. I've seen plenty of missed VTEs. I even published an article on it at Hopkins because we were successfully able to reduce the incidence of them but that's another issue.

If our outcomes are in fact better we better be able to prove it, otherwise as a profession we're in trouble.

 

[hyperalgesia]

So every time Trump, his ilk, and the right wing media railed against the legitimacy of courts that didn’t rule their way that was what? Legitimate complaints about the balance of power because it was a viewpoint you agree with? Give me a break.

Questioning the legitimacy of the courts, explicitly because the decision doesn't represent the popular view, is absurd no matter who does it.

 

[Ducttape]

Questioning the legitimacy of the courts, explicitly because the decision doesn't represent the popular view, is absurd no matter who does it.

well.... for 49 years, the Court has repeatedly noted that Roe v Wade was the correct decision.

irrespective of the popular view - why was precedence not honored? what huge change, especially with respect to advancement of our knowledge - could suddenly result in a change in the Court's opinion?


if you said "supermajority", then you are correct.

 

[hyperalgesia]

well.... for 49 years, the Court has repeatedly noted that Roe v Wade was the correct decision.

irrespective of the popular view - why was precedence not honored? what huge change, especially with respect to advancement of our knowledge - could suddenly result in a change in the Court's opinion?


if you said "supermajority", then you are correct.

Advancements came in the realm of fetal viability, which was at the crux of the RvW decision. With that premise undermined, the Court was then in a position to revisit the decision. They could either set another timetable, consistent with the vast majority of the developed world, or they could acknowledge this is NOT explicitly a matter of "interpreting" our constitution.

 

[Ferrismonk]

SCOTUS is not legitimate in the eyes of many americans

Confidence in U.S. Supreme Court Sinks to Historic Low

Confidence in the U.S. Supreme Court is down 11 percentage points this year, falling to a new low of 25%.

news.gallup.com

To wit, many Americans are idiots.

 

[Ducttape]

Advancements came in the realm of fetal viability, which was at the crux of the RvW decision.

er... no, that had nothing to do with it.

https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf

now, truth be told, i did not read the Opinions, by Alito, Thomas, Roberts or the opposing Opinion by Breyer et al, but nowhere in the Syllabus is comments about medical science or change in fetal viability.

the syllabus detailed that Alito et all thought their predecessors were wrong and stare decisis does not exist in these circumstances.

 

[hyperalgesia]

Advancements came in the realm of fetal viability, which was at the crux of the RvW decision.

er... no, that had nothing to do with it.

Roe v. Wade, 410 U.S. 113 (1973)

Roe v. Wade: A person may choose to have an abortion until a fetus becomes viable, based on the right to privacy contained in the Due Process Clause of the Fourteenth Amendment. Viability means the ability to live outside the womb, which usually happens between 24 and 28 weeks after conception.

supreme.justia.com

 

[Ducttape]

non sequitor.

that is original Roe v Wade, not Dobbs vs Jackson's Womens Health.
Dobbs ruling was not about fetal viability:

Held: The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives.

 

[BobLoblaw78]

marijuana has nothing to do with it. at all

I disagree and think Ferris makes a great point. People make irresponsible and poor decisions then lament that they are not better off. Instead of improving their decision-making, they want to share the rewards of other's good decision-making. I would venture a guess that 90% of the people that showed up to vote for legalized marijuana would not have otherwise voted. I don't trust the wisdom of these people one iota, but their vote is equal to my vote, so there you have it. It reminds me of the movie gladiator where they essentially said "entertain the people and you will own them."

I think we need to pass every law they want. Then when it is time to vote next they will all stay at home high as a kite and the working people can make some grown up decisions. I say this tongue in cheek. But this segment of people do trend liberal just as conservatives have segments that I wish didn't trend conservative.

 

[BobLoblaw78]

There is no role for physicians in "conservative" healthcare policies.

In a "free market" healthcare system why would I pay an interventional pain physician $5K for a procedure, when I can go to the NP down the street, pay her $20, and get 120 oxy 30's a month? I can guarantee you as a retiree I would feel a WHOLE lot better with the latter. I am now retired, no reason for me to get up in the morning.

Or why would I pay a board certified surgeon to do a procedure when an NP could do it for a fraction of the cost? Keep in mind we tried this in the past: Before, say, 1970, give or take, the vast majority of surgeries in the US - including significant procedures like gastrectomies, colectomies, etc. - were done by "GP's" with only a one year internship. People did just fine.

Yeah, those GP's went to medical school, but that was also over 50 years ago. They also didn't have modern antibiotics, anesthesia, CT, ultrasound, etc. etc.

If you want a "free market" solution you have to get rid of government involvement, and the biggest one is professional licensure. At that point you are competing on cost. A Rolls Royce is far better than any equivalent vehicle, but people still prefer cars that are a tenth of the price.

We can do your kid's surgery with an NP, and there is a 95% chance there won't be any problems, and it will cost you $500 total.

Or, we can do it with a board-certified surgeon who has an ACS fellowship, there is a 99% chance there won't be any problems, we can't guarantee no bad outcomes, but it will cost you $5K.

What do you think people will go with?

Here is the dark truth - but a truth none the less: malpractice lawyers and healthcare regulation are the best friend's physicians have. When people complain about "mid-level intrusion" what they are complaining about is there is not enough regulation (of them).

"Malpractice reform" opens the doors for NP's and physicians with that "state minimum training" - and the FP doing interventional pain on the side a a specific example here. Same with regulation. Sure that happens now, but it would open the floodgates. Heck there are women who pay cash to get people to inject silicon caulking into their derrieres to save a few bucks on a cosmetic surgeon.

You really don't want to be competing on cost, because as the last several years have shown, people are not good at understanding probability and risk. Which means they won't pay for slightly less risk: "95%, 99% what is the difference?"

Be careful what you wish for.

Or are you really saying, "Yeah, I want strong government regulation and involvement, just only the ones that benefit me."

No real problem with that, but just be clear about it.

It would not be good. I could see competition bring physician salary down. Then physicians would not aid their competition the way they do now. I think the tide would turn in 10-20 years when physicians stopped helping and bailing out their competition. Then things would be better. The problem is that middle aged physicians won't sacrifice the rest of their career to make this happen. They want to ride the current situation off into the sunset. Then hand off the downwardly spirally situation to the next generation.

(I love the idea of medicare for all just so I don't have to feel guilt about the insane bills patients get. But I disagree on the principle that able-bodied people are owed free healthcare, etc)

 

[BobLoblaw78]

To wit, many Americans are idiots.

Oldie but still good:

When Illinois Gov. Adlai Stevenson was running for president in the 1950s, a supporter purportedly said to him: "Every thinking person in America will be voting for you." Stevenson replied, "I'm afraid that won't do — I need a majority."

 

[Doctodd]

Oldie but still good:

When Illinois Gov. Adlai Stevenson was running for president in the 1950s, a supporter purportedly said to him: "Every thinking person in America will be voting for you." Stevenson replied, "I'm afraid that won't do — I need a majority."

that used to be my signature here, but i decided to change it

 

[Ferrismonk]

I disagree and think Ferris makes a great point. People make irresponsible and poor decisions then lament that they are not better off. Instead of improving their decision-making, they want to share the rewards of other's good decision-making. I would venture a guess that 90% of the people that showed up to vote for legalized marijuana would not have otherwise voted. I don't trust the wisdom of these people one iota, but their vote is equal to my vote, so there you have it. It reminds me of the movie gladiator where they essentially said "entertain the people and you will own them."

I think we need to pass every law they want. Then when it is time to vote next they will all stay at home high as a kite and the working people can make some grown up decisions. I say this tongue in cheek. But this segment of people do trend liberal just as conservatives have segments that I wish didn't trend conservative.

That's why they've pushed same-day voter registration and no-reason-needed absentee voting.

 

[Status Sciaticus]

LMAO why do people care about whether others are getting high or having casual sex? Mind your own damn business and stfu. For being the party of limited government, Republicans sure do like to get up in everyones business.

Not really sure republicans are doing the math on abortion vs 18 years of raising a ward of the state.

 

[Baron Samedi]

Pretty excited for all the debauchery we are going to codify once Trump gives the Dems a Supermajority in 2024. Going to stock up on Penicillin while I can!

 

[hyperalgesia]

Pretty excited for all the debauchery we are going to codify once Trump gives the Dems a Supermajority in 2024. Going to stock up on Penicillin while I can!

TBH I think a bigger liability than Trump is religious Republicans threatening to curtail abortion rights NATIONALLY.

For both sides, the concept of state law is just totally lost on many. Liberals in CA just can't sleep knowing what's going on in Mississippi and vice versa. It's pathetic. Mind your own business people.