Should medicine be an entitlement?

[gxb]

Individual rights don't impose on other people the obligation to serve you for free. Your rationale is completely arbitrary. You might as well say everyone should be given a free car wash and have government stooges come to their house and walk their dog for free because "it leads to the fulfillment of the life and pursuit of happiness." When the justification is that obtuse, you can literally use it for anything.

You're not the first to mention the "free" argument. I don't know why people assume that. Who said that it should be free? availability of a service should not be equated with compensation. Due to the redundancy of this argument, I think I'll start calling it the "free syndrome."

---

Members don't see this ad.

 

[RJGOP]

Just because something may be a right doesn't mean it has to be free. By that I mean the health care workers have to be paid, but I'm not okay with people dying in the street.

Ignoring all other inevitable health risks/concerns, do you believe that heroine addicts, for instance, deserve equivalent medical care in terms of quantity and quality to law abiding citizens? You can provide care to these people, but you know 99% of them are going to resume their habits ASAP; unless you put them in a rehab facility but those don't always work either.

 

[armoman92]

OP, take a healthcare ethics class.

Read about utilitarianism, Kant & duentology, and Rawl's theory on moral justice.

Honestly, none of us are really qualified to answer these questions. It's takes a life's work to gain the philosophical aptitude to have shot.

picture is unrelated

 

[gxb]

.

 

[touchpause13]

Ignoring all other inevitable health risks/concerns, do you believe that heroine addicts, for instance, deserve equivalent medical care in terms of quantity and quality to law abiding citizens? You can provide care to these people, but you know 99% of them are going to resume their habits ASAP; unless you put them in a rehab facility but those don't always work either.

Yes.
I think that physicians don't get to pick and chose who "deserves" healthcare. For the record that also means that I believe a KKK member deserves just as good of treatment as a human rights activist. I think it's a physician's job to treat every patient to the best of his or her ability regardless of who that patient is.

 

[touchpause13]

Ignoring all other inevitable health risks/concerns, do you believe that heroine addicts, for instance, deserve equivalent medical care in terms of quantity and quality to law abiding citizens? You can provide care to these people, but you know 99% of them are going to resume their habits ASAP; unless you put them in a rehab facility but those don't always work either.

Also I'm really curious how @jdh71 @dpmd or @Winged Scapula would answer this question

 

[deleted480308]

Ignoring all other inevitable health risks/concerns, do you believe that heroine addicts, for instance, deserve equivalent medical care in terms of quantity and quality to law abiding citizens? You can provide care to these people, but you know 99% of them are going to resume their habits ASAP; unless you put them in a rehab facility but those don't always work either.

everyone deserves the level of service they pay for...

 

[Winged Scapula]

Also I'm really curious how @jdh71 @dpmd or @Winged Scapula would answer this question

This was a common issue when doing general surgery/trauma as you couldn't pick and choose who walked/wheeled into the trauma bay.

But now that I have options, I still don't believe I get to choose who deserves health care or to deny it to people with self inflicted disease. However I am going to draw the line at being able to pay the bills: if a heroin user is insured or has the cash to pay for my services, I will see them and offer the same treatment as any one else. If they cannot, they are referred to other local resources for assistance.

 

[touchpause13]

This was a common issue when doing general surgery/trauma as you couldn't pick and choose who walked/wheeled into the trauma bay.

But now that I have options, I still don't believe I get to choose who deserves health care or to deny it to people with self inflicted disease. However I am going to draw the line at being able to pay the bills: if a heroin user is insured or has the cash to pay for my services, I will see them and offer the same treatment as any one else. If they cannot, they are referred to other local resources for assistance.

That seems fair to me.

 

[Psyche Estrelle]

Yes.
I think that physicians don't get to pick and chose who "deserves" healthcare. For the record that also means that I believe a KKK member deserves just as good of treatment as a human rights activist. I think it's a physician's job to treat every patient to the best of his or her ability regardless of who that patient is.

I think I love you.

Why this is so difficult for so many on this board to understand, I'll never know.

 

[touchpause13]

I think I love you.

Why this is so difficult for so many on this board to understand, I'll never know.

Aw shucks.

Yeah I thought that was like med ethics 101, but

 

[armoman92]

...I believe a KKK member deserves just as good of treatment as a human rights activist...

I don't appreciate your metaphor. The hooded KKK members the media conglomerate feeds Americans are propaganda to fuel the illusion of racism. This illusion sustains the prison industrial complex (PIC).

Real KKK grand wizards are extremely educated people, who simply advocate their own race. There is nothing wrong with that.

From Ethics 101, you should appreciate the immorality of causing a single group of people detriment for your personal gain, as your comparative metaphor implicated.

 

[67552931811]

Ugh....

 

[armoman92]

Ugh....

 

[GUH]

This was a common issue when doing general surgery/trauma as you couldn't pick and choose who walked/wheeled into the trauma bay.

But now that I have options, I still don't believe I get to choose who deserves health care or to deny it to people with self inflicted disease. However I am going to draw the line at being able to pay the bills: if a heroin user is insured or has the cash to pay for my services, I will see them and offer the same treatment as any one else. If they cannot, they are referred to other local resources for assistance.

If the patient is not a good fit for your specific area of expertise or there is a difference in personalities which would be best addressed by transferring care to another physician, should you not be allowed to do this? What if you don't feel confident in your ability to treat heroin addicts as effectively as another physician?
There is more to an effective physician-patient relationship than ability to pay, and it is important that physicians are allowed to choose their patients.

 

[cbrons]

I defined the practical purpose of government clearly as increasing the wellbeing of its citizens (a govt. for the people and by the people).

My point is that this rubric is totally arbitrary and therefore dangerous. Certain countries in the Middle East justify the stoning of homosexuals as being something that "increases the well-being of its citizens."

 

[armoman92]

Trying to pick which gif to use in response to this insanity was tough.

So, my observation is "insane" just because it's different? My post is objective.

That sounds a bit intolerant to me.

 

[armoman92]

No, it's insane because its laughably wrong, not different

Why?

Logical fallacies: The Bandwagon Fallacy

 

[armoman92]

First off, it's denialist to the extremely ugly and violent history of the KKK which has been extensively documented by respected writers and journalists not simply whatever conspiracy theorist BS you think about the "modern media"

Second, it's misrepresentative of the "average" KKK member to try and portray them as extremely educated intellectuals on the basis of a couple of fringe nutbags with a BS PhD like David duke. The "average" KKK member is a poor, undereducated southern hick

Third it's misrepresentative of their views to state they are just standing up for white folk, given their also extremely ugly history towards Jews and Catholics.

Fourth, this whole thing started with your off-topic need to stand up for the KKK which has nothing to do with the thread topic. If you want to discuss racial politics I suggest the SPF forum.

I never went off topic. I made a comment in a discussion. I'm allowed to do that. The power of the PIC has a lot to do with healthcare; a lot of money comes from that sector.

--------

Honestly, your attempt to label me as a conspiracy theorist, and accuse me of going off topic are.

If you can't put yourself in other people's shoes, and try to understand a viewpoint, it's hard to remain objective.

I come from a culture that has been ravaged by all the forces we call "conspiracy" today. To my people, these hidden forces are very real, and have shaped our history for the worse.

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

I'll stop here. I don't enjoy this uphill battle. It's not even 7am eastern, and the storm is coming.

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

No disrespect SouthernSurgeon, it's not my intention.

 

[jdh71]

Also I'm really curious how @jdh71 @dpmd or @Winged Scapula would answer this question

I think the ethics are clear and this is the job we sign up for. We take care of people the same (or at least we TRY to - no one is perfect) *even if* some of those people are junkies.

 

[jdh71]

Also I'm really curious how @jdh71 @dpmd or @Winged Scapula would answer this question

I should qualify a bit. Part of my job is taking care of people trying to actively die. As in, if something isn't done NOW they die kind of work. I think everyone deserves the SAME care there at that "zomg do something now or they die" point. However, that same junkie doesn't deserve an organ transplant for instance and the clean cut mom of three does. So. There are things in medicine that are not and should not be offered to everyone "just because".

 

[Winged Scapula]

If the patient is not a good fit for your specific area of expertise or there is a difference in personalities which would be best addressed by transferring care to another physician, should you not be allowed to do this? What if you don't feel confident in your ability to treat heroin addicts as effectively as another physician?
There is more to an effective physician-patient relationship than ability to pay, and it is important that physicians are allowed to choose their patients.

You're trying to create a dilemma where none exists.

I never said that ability to pay is the sole indicator of whether I would see or care for patients or the indicator of a good relationship.

I do not practice alone in the woods: if there was a medical reason I felt ill equipped to handle all aspects of a particular patients care then I would involve other consultants.

 

[DocVader1990]

My point is that this rubric is totally arbitrary and therefore dangerous. Certain countries in the Middle East justify the stoning of homosexuals as being something that "increases the well-being of its citizens."

Once again those Middle Eastern countries by my definition would fit my simple criteria for a bad govt, actively discriminating against a group of its own citizens and limiting freedom of expression easily goes AGAINST " increasing the well being of its citizens" despite that govt. argument to the contrary.

The criteria is also not arbitrary in any way. it is more subjective, but as I illustrated above that is only an a way for a bad govt to justify action against it own citizens. Those govts like the ones you used to make your point, go against the primary function of govt.

 

[Successful BM]

Yes.
I think that physicians don't get to pick and chose who "deserves" healthcare. For the record that also means that I believe a KKK member deserves just as good of treatment as a human rights activist. I think it's a physician's job to treat every patient to the best of his or her ability regardless of who that patient is.

That's the crux of the problem though. Of course a physician will treat any patient regardless of who they are... as long as they can pay for the services rendered. It's no different than a plumber or a mechanic. The same applies under universal healthcare, except the patient's countrymen are paying the bill instead of the patient. The real question is: are the American people ready to allow me, as a physician, to treat everyone under the sun? Patients will always have the power to govern their own health, regardless of the healthcare system, which is why comparing health outcomes in the US with those in other countries is ridiculous. We have a different culture. Do you think that someone is more or less likely to stop eating cheeseburgers and start doing more cardio if someone else is footing the bill for their healthcare?

I like the analogy of cops and firefighters providing a public service (and being paid for it). If a person constantly requires the attention of cops and firefighters, they're either breaking the law or putting themselves in danger. Either way, I think it's highly likely that the legal system will intervene in their situation. Would it be the same for healthcare if it were a public service? Would we mandate that patients take action to improve their lifestyles to mitigate their use of public-funded healthcare? Would they have to pass annual or bi-annual physicals in order to receive public-funded healthcare?

If we did adopt universal healthcare, would we take (legal) steps to mitigate the effect of our (glutenous) culture on health outcomes so that spending doesn't spiral out of control?

 

[Mad Jack]

Ignoring all other inevitable health risks/concerns, do you believe that heroine addicts, for instance, deserve equivalent medical care in terms of quantity and quality to law abiding citizens? You can provide care to these people, but you know 99% of them are going to resume their habits ASAP; unless you put them in a rehab facility but those don't always work either.

The same could be said of smokers, people who eat unhealthy, those that don't exercise, etc.

 

[touchpause13]

That's the crux of the problem though. Of course a physician will treat any patient regardless of who they are... as long as they can pay for the services rendered. It's no different than a plumber or a mechanic. The same applies under universal healthcare, except the patient's countrymen are paying the bill instead of the patient. The real question is: are the American people ready to allow me, as a physician, to treat everyone under the sun? Patients will always have the power to govern their own health, regardless of the healthcare system, which is why comparing health outcomes in the US with those in other countries is ridiculous. We have a different culture. Do you think that someone is more or less likely to stop eating cheeseburgers and start doing more cardio if someone else is footing the bill for their healthcare?

I like the analogy of cops and firefighters providing a public service (and being paid for it). If a person constantly requires the attention of cops and firefighters, they're either breaking the law or putting themselves in danger. Either way, I think it's highly likely that the legal system will intervene in their situation. Would it be the same for healthcare if it were a public service? Would we mandate that patients take action to improve their lifestyles to mitigate their use of public-funded healthcare? Would they have to pass annual or bi-annual physicals in order to receive public-funded healthcare?

If we did adopt universal healthcare, would we take (legal) steps to mitigate the effect of our (glutenous) culture on health outcomes so that spending doesn't spiral out of control?

I think taking legal steps would be a really bad idea - remember the New York pop bill? People hateddddddd that. This is murica and telling someone they can't order a 64 oz coke isn't going to fly. Also I just don't think it would be all that helpful.

But really I think you are comparing apples to oranges with the cop/dr thing here because some people are just going to be sick a lot for whatever reason, and cops/firefighters are there to help with acute problems - healthcare is not.

Also I feel like you are trying to imply that public funded healthcare is this new thing, it's really not. Medicare and Medicaid have been programs for a very long time. To me it already is viewed as a public service to some level. And about your cardio thing - I don't think money is a good motivator for health. When people make drastic changes to their lifestyle it's most likely going to be because they think they will die if they don't. I don't think anyone is going to be like, "let me totally wreck my health and shorten my lifespan because someone else has got the bill"

 

[charmiedermie]

I don't appreciate your metaphor. The hooded KKK members the media conglomerate feeds Americans are propaganda to fuel the illusion of racism. This illusion sustains the prison industrial complex (PIC).

Real KKK grand wizards are extremely educated people, who simply advocate their own race. There is nothing wrong with that.

From Ethics 101, you should appreciate the immorality of causing a single group of people detriment for your personal gain, as your comparative metaphor implicated.

@touchpause13 's point is that you treat patients the same way even if you vehemently disagree with their views and not withhold care based on that.

I was willing to give u the benefit of the doubt with your "unrelated picture" of an older black man as a whale at a resort, but now after your defense of the KKK it makes a lot more sense.

 

[touchpause13]

Another example that the dean of our college actually brought up was that he was working as an ER doc and there was a school shooting. The victims and the shooter came into the ER. He treated both the victims and the shooter. You don't get to deny care because you disagree with something that person has done.

inb4 someone says I'm being disrespectful to people who shoot up schools.

 

[Roxas]

That's the crux of the problem though. Of course a physician will treat any patient regardless of who they are... as long as they can pay for the services rendered. It's no different than a plumber or a mechanic. The same applies under universal healthcare, except the patient's countrymen are paying the bill instead of the patient. The real question is: are the American people ready to allow me, as a physician, to treat everyone under the sun? Patients will always have the power to govern their own health, regardless of the healthcare system, which is why comparing health outcomes in the US with those in other countries is ridiculous. We have a different culture. Do you think that someone is more or less likely to stop eating cheeseburgers and start doing more cardio if someone else is footing the bill for their healthcare?

I like the analogy of cops and firefighters providing a public service (and being paid for it). If a person constantly requires the attention of cops and firefighters, they're either breaking the law or putting themselves in danger. Either way, I think it's highly likely that the legal system will intervene in their situation. Would it be the same for healthcare if it were a public service? Would we mandate that patients take action to improve their lifestyles to mitigate their use of public-funded healthcare? Would they have to pass annual or bi-annual physicals in order to receive public-funded healthcare?

If we did adopt universal healthcare, would we take (legal) steps to mitigate the effect of our (glutenous) culture on health outcomes so that spending doesn't spiral out of control?

And this is exactly why there is such staunch opposition to universal care, because ideally it shouldn't matter anyone else what lifestyle I live as long as I'm willing to own up to the consequences both physically and financially. But as soon as we adopt this "we're all in it together" mentality, you're now footing the bill for someone else's health problems, and their lifestyle (seemingly) becomes yours and the government's business. To save money, legislation against such behavior becomes the next logical step, and freedom dies a little more.

 

[Roxas]

Another example that the dean of our college actually brought up was that he was working as an ER doc and there was a school shooting. The victims and the shooter came into the ER. He treated both the victims and the shooter. You don't get to deny care because you disagree with something that person has done.

inb4 someone says I'm being disrespectful to people who shoot up schools.

Gunmen are people too TP....

 

[touchpause13]

Gunmen are people too TP....

Shouldn't you be studying STIs?

 

[Roxas]

Shouldn't you be studying STIs?

I can only look at so many infected penises before my eyes need a break

 

[charmiedermie]

Another example that the dean of our college actually brought up was that he was working as an ER doc and there was a school shooting. The victims and the shooter came into the ER. He treated both the victims and the shooter. You don't get to deny care because you disagree with something that person has done.

inb4 someone says I'm being disrespectful to people who shoot up schools.

Yup or another example would be the Boston Marathon Bombing, in which u have a flood of patients coming in and the next one who comes in is the perpetrator himself. As a physician, do u not treat him or maybe don't do your best to treat him? The answer is u treat him just like u would the victims in the hospital.

 

[mcloaf]

Yes.
I think that physicians don't get to pick and chose who "deserves" healthcare. For the record that also means that I believe a KKK member deserves just as good of treatment as a human rights activist. I think it's a physician's job to treat every patient to the best of his or her ability regardless of who that patient is.

It makes me sad to see how many people in this thread are already deciding which patients deserve their care before they've even graduated from medical school.

 

[Roxas]

Another example that the dean of our college actually brought up was that he was working as an ER doc and there was a school shooting. The victims and the shooter came into the ER. He treated both the victims and the shooter. You don't get to deny care because you disagree with something that person has done.

inb4 someone says I'm being disrespectful to people who shoot up schools.

But for srs, I don't claim to be a saint, but I'd like to think in that situation I would be a good enough human-being and physician to treat that person despite what they did. It's not my job to play judge and jury.

 

[Señor Chang]

I have recently read and seen some conversations of healthcare professionals and policymakers expressing their "concerns" about the idea that medicine is becoming a "right or entitlement." My first reaction was..why is this even a topic? I've always believed that every human (and living beings) are entitled to access to medicine as it leads to the fulfillment of the "Life" and "pursuit of happiness" principles set forth by the Deceleration of Independence. Yet, I really want to understand why some people, particularity physicians, might oppose such such a notion. Is it a fear of regulation,reduced revenue, decreased autonomy, or what? Approximately 60 countries in world have Universal Health Care systems (UHC), including almost every European country, Japan, Australia, New Zealand, and Canada. While these systems vary widely in their characteristics, services, and structures, they function based on the principle that every citizen is entitled to healthcare. These countries, of course, have private sectors, that run parallel to the UHCs but there is still a choice for those who cannot afford private medical service. Please understand, I'm NOT trying to debate the efficiency of ANY healthcare system because I know that no system is perfect and each has it's own pros and cons. However, I just marveled at the fact that some debate whether medicine should be a right in the first place and wanted to know the reasons behind such a stance.

EDIT: Which books, articles, or studies would you recommend that cover both sides of the issue?

Say someone repeatedly rides a motorcycle without a helmet and repeatedly uses tax payers dollars to pay for insanely expensive emergency room visits. Now ask yourself: does this person have a right to keep using hundreds of thousands of tax payer dollars for this reason?

I think that is the reason why a lot of people are opposed. I also think this perspective becomes much more apparent when people are older (or making money) and see nearly half of there salary go to taxes. Kids like us, we are still blind to that part of the game.

In my personal opinion, I like the model where each citizen gets a certain amount of money they can use (or donate) towards healthcare every year. Instead of the Canada model where there is one giant bucket and anyone can grab, each person has their own small bucket.

 

[touchpause13]

It makes me sad to see how many people in this thread are already deciding which patients deserve their care before they've even graduated from medical school.

Hopefully someone shuts that ish done before they graduate.
I can't imagine telling an attending on an ER rotation, "No I won't treat that patient, they are an icky junkie" would yield good results.

 

[touchpause13]

Say someone repeatedly rides a motorcycle without a helmet and repeatedly uses tax payers dollars to pay for insanely expensive emergency room visits. Now ask yourself: does this person have a right to keep using the emergency room for this reason?

I think that is the reason why a lot of people are opposed.

Yes.

 

[touchpause13]

But for srs, I don't claim to be a saint, but I'd like to think in that situation I would be a good enough human-being and physician to treat that person despite what they did. It's not my job to play judge and jury.

Exactly.
If that's what you wanted to do, then you picked the wrong profession IMO

 

[Señor Chang]

Yes.

Then I suppose you don't mind when these emergency room visits take funding away from schools or state hospitals that serve the poorest in society?

When discussing the right to healthcare, I think it is critical to remember at least this rule:

There is a finite supply of resources.
What we give to one person, we take away from another. ​

 

[touchpause13]

Then I suppose you don't mind when these emergency room visits take funding away from schools or state hospitals that serve the poorest in society?

When discussing the right to healthcare, I think it is critical to remember at least this rule:

There is a finite supply of resources.
What we give to one person, we take away from another. ​

Why does it have to be taken from schools? Why can't we take from the defense budget or the salaries of congress?
Regardless the whole point is moot because you can't turn away someone at an ER. If someone shows up at the ER in an emergent condition (aka a motorcycle accident) you CAN NOT turn them away.

 

[jdh71]

Look people. We live in a free society. Life is dangerous. We ALL subsidize each other's freedom and the possibility for things that go bad on daily basis. If it was all pay to play then no one would be able to afford to play. So it's time to get over the notion that because some people are more destructive in their behaviors that they don't deserve the same general protections and safety nets that everyone else gets. This is part of our social contract that we don't let people just die in the street. You don't get to pick and choose. And I promise you really don't want to live in a place where this occurs.

 

[Señor Chang]

Why does it have to be taken from schools? Why can't we take from the defense budget or the salaries of congress?
Regardless the whole point is moot because you can't turn away someone at an ER. If someone shows up at the ER in an emergent condition (aka a motorcycle accident) you CAN NOT turn them away.

I am not saying that I would turn anyone away. I would do my job to the best of my power in any case. I am only speaking from a policy standpoint. And to answer your question: I don't know, but unfortunately, it usually is not. At this point in the conversation, I feel like I cant really keep going because I don't have an good understanding of how the budgeting policy works...

 

[Successful BM]

I think taking legal steps would be a really bad idea - remember the New York pop bill? People hateddddddd that. This is murica and telling someone they can't order a 64 oz coke isn't going to fly. Also I just don't think it would be all that helpful.

True, everyone did hate it, but that's because they didn't have a choice. I'm not talking about instituting a nanny-state. I'm saying they should be given a choice: public-funded healthcare or an unhealthy lifestyle. You can't ask someone else to take care of you if you're not willing to take care of yourself.

But really I think you are comparing apples to oranges with the cop/dr thing here because some people are just going to be sick a lot for whatever reason, and cops/firefighters are there to help with acute problems - healthcare is not.

There would be exceptions that would be at the discretion of the physician. No physician is going to tell someone that they have breast cancer because of their unhealthy lifestyle. Obesity, hypertension, DMII, on the other hand, are highly influenced by a person's lifestyle. If it becomes evident to a physician that the patient is not taking responsible steps within their control to become healthier, then there should be consequences. And you're right that cops/firefighters are there to deal with acute problems, but my point is that when it becomes obvious that they're really dealing with chronic problems, such as recurrent domestic violence or something else, then the legal system gets involved. I think the comparison is a apt. EDs are only supposed to deal with acute problems, but they're notorious for spending an egregious amount of money dealing with exacerbations of preventable, chronic illnesses because the patient doesn't take care of themselves. Sometimes this is the patient's fault, sometimes it's due to something out of their control, like finances. I wouldn't mind eliminating the financial concerns as long as patients are held responsible for their own motivation and action.

Also I feel like you are trying to imply that public funded healthcare is this new thing, it's really not. Medicare and Medicaid have been programs for a very long time. To me it already is viewed as a public service to some level.

I'm well aware. And my own opinions can (and do) extend to the current implementation of medicare and medicaid. I think they're abused to some extent by both practitioners and patients. But that's a separate topic. I'm trying to stay within the scope of the thread.

And about your cardio thing - I don't think money is a good motivator for health. When people make drastic changes to their lifestyle it's most likely going to be because they think they will die if they don't. I don't think anyone is going to be like, "let me totally wreck my health and shorten my lifespan because someone else has got the bill"

This is exactly my point. Money isn't a motivator. So why would universal healthcare alone make us healthier? At best, it would do nothing. At worst, it would do nothing and drive up the cost of healthcare beyond the point of sustainability. There are people who want to be healthier, but can't because of finances. IF we institute universal healthcare, these are the people you want to benefit. If someone isn't motivated to take care of themselves when a doctor explains to them very clearly that their lifestyle will kill them, then they should be cut loose. It's not fair to ask the taxpayers to pay for someone else's unhealthy habits.

 

[Señor Chang]

Look people. We live in a free society. Life is dangerous. We ALL subsidize each other's freedom and the possibility for things that go bad on daily basis. If it was all pay to play then no one would be able to afford to play. So it's time to get over the notion that because some people are more destructive in their behaviors that they don't deserve the same general protections and safety nets that everyone else gets. This is part of our social contract that we don't let people just die in the street. You don't get to pick and choose. And I promise you really don't want to live in a place where this occurs.

Well said. What if there is a middle ground though? Like if we all subsidize each other's freedom, but only to some generous, but not preposterous, degree?

 

[Señor Chang]

Also I feel like you are trying to imply that public funded healthcare is this new thing, it's really not.

For our culture, I think it is. And I would also like to point out that US culture is one that uses resources very very generously.

 

[Successful BM]

Look people. We live in a free society. Life is dangerous. We ALL subsidize each other's freedom and the possibility for things that go bad on daily basis. If it was all pay to play then no one would be able to afford to play. So it's time to get over the notion that because some people are more destructive in their behaviors that they don't deserve the same general protections and safety nets that everyone else gets. This is part of our social contract that we don't let people just die in the street. You don't get to pick and choose. And I promise you really don't want to live in a place where this occurs.

No. I will never advocate that it's my responsibility to take care of someone that doesn't want to take care of themselves. Ever. It's not in the social contract. Not even the fine print. And why exactly wouldn't I want to live in a place where people are held responsible for their own actions?

 

[touchpause13]

True, everyone did hate it, but that's because they didn't have a choice. I'm not talking about instituting a nanny-state. I'm saying they should be given a choice: public-funded healthcare or an unhealthy lifestyle. You can't ask someone else to take care of you if you're not willing to take care of yourself.



There would be exceptions that would be at the discretion of the physician. No physician is going to tell someone that they have breast cancer because of their unhealthy lifestyle. Obesity, hypertension, DMII, on the other hand, are highly influenced by a person's lifestyle. If it becomes evident to a physician that the patient is not taking responsible steps within their control to become healthier, then there should be consequences. And you're right that cops/firefighters are there to deal with acute problems, but my point is that when it becomes obvious that they're really dealing with chronic problems, such as recurrent domestic violence or something else, then the legal system gets involved. I think the comparison is a apt. EDs are only supposed to deal with acute problems, but they're notorious for spending an egregious amount of money dealing with exacerbations of preventable, chronic illnesses because the patient doesn't take care of themselves. Sometimes this is the patient's fault, sometimes it's due to something out of their control, like finances. I wouldn't mind eliminating the financial concerns as long as patients are held responsible for their own motivation and action.



I'm well aware. And my own opinions can (and do) extend to the current implementation of medicare and medicaid. I think they're abused to some extent by both practitioners and patients. But that's a separate topic. I'm trying to stay within the scope of the thread.



This is exactly my point. Money isn't a motivator. So why would universal healthcare alone make us healthier? At best, it would do nothing. At worst, it would do nothing and drive up the cost of healthcare beyond the point of sustainability. There are people who want to be healthier, but can't because of finances. IF we institute universal healthcare, these are the people you want to benefit. If someone isn't motivated to take care of themselves when a doctor explains to them very clearly that their lifestyle will kill them, then they should be cut loose. It's not fair to ask the taxpayers to pay for someone else's unhealthy habits.

Look people. We live in a free society. Life is dangerous. We ALL subsidize each other's freedom and the possibility for things that go bad on daily basis. If it was all pay to play then no one would be able to afford to play. So it's time to get over the notion that because some people are more destructive in their behaviors that they don't deserve the same general protections and safety nets that everyone else gets. This is part of our social contract that we don't let people just die in the street. You don't get to pick and choose. And I promise you really don't want to live in a place where this occurs.

JDH said it better than I can at the moment, so I'm deferring to him.

 

[Mad Jack]

Another example that the dean of our college actually brought up was that he was working as an ER doc and there was a school shooting. The victims and the shooter came into the ER. He treated both the victims and the shooter. You don't get to deny care because you disagree with something that person has done.

inb4 someone says I'm being disrespectful to people who shoot up schools.

We had to take care of a patient that straight up recently murdered a nurse once. I don't want to get into details, because HIPAA, but let's just say we all would have been happier if the guy were dead, but we did our best to care for him anyways, because he's the monster, not us.

 

[touchpause13]

No. I will never advocate that it's my responsibility to take care of someone that doesn't want to take care of themselves. Ever. It's not in the social contract. Not even the fine print. And why exactly wouldn't I want to live in a place where people are held responsible for their own actions?

must.... not.... use.... Burnett's Law.....