Look, medical schools expect a lot of us. They expect us to not only learn just as much (if not more) basic science than previous generations of med students, but also take time to be aware of social determinants of health, cultural competence, biostats and epi, etc. I'm not saying that they go about scheduling things in the right way. Social determinants lectures can be non-mandatory and watched on video at home like the rest of the pre-clinical curriculum for all I care. The part I disagree with is that they should not be included in the curriculum at all and that their inclusion makes us worse off as physicians and as a healthcare system.
Policy Take Two Aspirin and Call Me by My Pronouns
- Thread starter Lawpy
- Start date
Look, medical schools expect a lot of us. They expect us to not only learn just as much (if not more) basic science than previous generations of med students, but also take time to be aware of social determinants of health, cultural competence, biostats and epi, etc. I'm not saying that they go about scheduling things in the right way. Social determinants lectures can be non-mandatory and watched on video at home like the rest of the pre-clinical curriculum for all I care. The part I disagree with is that they should not be included in the curriculum at all and that their inclusion makes us worse off as physicians and as a healthcare system.
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I doubt really anywhere has Uber biased curriculum in itself. But what gets me is when people are persecuted (not literally, just dont have a better word) for not being gung ho on the 'medicare for all' bandwagon, etc. And some of the seminars put on by the school, which aren't mandatory, are super left leaning. I hate politics but there's no other way to describe it. It doesn't matter if students put on events, but these are school sanctioned which kind of rubs me the wrong way. And this is in the middle of the country, I can't imagine what's going on on the coasts. Just my two cents
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deleted407021
Never had anything like that.
Interestingly, the one time there was a class meeting in regards to any political drama, it was because of the behavior of “anti-sjw” people.
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I'm not 'anti-sjw' by any means. I'm very in the middle, which seems to be a dying breed. There's just certain things that kinda are strange to me as a non-trad coming in from the real world back into academia.
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deleted407021
Nah, there’re plenty of centrists.
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first they called it global warming. Now it is climate change. What name will it be next?
First it was Russian collusion, then it was obstruction. What name will it be next?
If at first the evidence doesn't fit your narrative, just pivot.
First it was Russian collusion, then it was obstruction. What name will it be next?
If at first the evidence doesn't fit your narrative, just pivot.
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deleted407021
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Do you think they will address and speak about the rate of single black motherhood?
Or what about the rate of black on black violence?
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No, it really isn't. Its because we're fat.
In my opinion, as future physicians, health insurance coverage is not as much a political topic as it is a healthcare topic. No matter your political leaning, one can't deny that expanded government-sanctioned insurance coverage leads to greater access to care. If one makes the leap that expanded coverage of care will lead to better healthcare outcomes (granted, definitive research still needs to be seen, but it's not an unreasonable leap to make), then it becomes irresponsible as a physician to be against that policy. If a physician were against a drug that was definitively shown to improve health outcomes, they would be laughed out of the profession; why would this be any different?
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Okay, but where is all this money going to come from? Also, it isn't like the government messes up 85% of whatever it touches or anything....
We will agree to disagree. Access to care is one thing, and nobody is denying that. And people will still be noncompliant and not follow up. Affordability and actually having it be financially feasible for people to become doctors is another. But to compare medicare for all to a life saving drug is a stretch to say the least
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Because "that" side believes in the facts and evolving information, not just a one size fits all approach
We're getting into a political argument here, but there are ways to fund greater access to healthcare coverage, and it involves greater taxation on corporations and the wealthy. Maybe that's a philosophical issue that we may not agree on.
I disagree with the assertion that increasing access to healthcare, if it leads to improvements in health outcomes, is different than a drug that leads to improvements in health outcomes. If a cancer drug came out tomorrow that led to a 6-month improvement in a previously unsurvivable cancer, it would be approved by the FDA and lauded as a miracle of modern medicine. If improving access to healthcare did the same, how is that any less valuable to the healthcare community? In fact, I'd argue that it would be more valuable and important than the cancer drug, as more people would probably stand to benefit from it.
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deleted407021
There are sources online at the Senate website with documents laying out the funding source options. While I understand the 85% number is rhetorical, there’s a lot of nuance to government-run systems. The State is a multifaceted entity with differing interests and factions operating within it. What stands to benefit one part of the government can take away from another and there’s conflict. It will never be perfect but climate change is the gravest threat to humans now and largely the result the behavior of international business interests, so I don’t want cooperations in charge of healthcare, either.
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@Dro133 Do you actually read what people write. I have a feeling that you parsed through my initial statement with a heavy filter and what you distilled was not at all what I typed. Which is fine, I just don't know though if what I type actually matters or if you distill it into something that you are familiar with debating. Because if what I type actually doesn't matter, then there's no reason for me to actually respond.
Isn't that what a debate is -- distilling someone's message and responding with your own?
What I took away from your post is that you believe the negative consequences of teaching public health and social justice in institutions of higher education likely outweigh the positives. I disagreed, and responded with why I think the positives outweigh the negatives. If I misinterpreted your message, please feel free to correct me.
Do you really think the veterans getting their free care in the VA have better outcomes than if treated solely in the private sector? They get such great “access”. So much access that they have to take an ambulance ride to a private community hospital for a MRI scan because the VA hospital didn’t have one.
And I haven’t heard of a community health system restricting lantus and requiring NPH because it is too expensive yet at my VA when I trained that was a thing
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A lot of community hospitals don't have MRI scaners either. That's not necessarily the fault of the VA system in particular
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Lots of patient transfers from community hospitals related to f/u MRI d/t inconclusive CT. Kind of obscene. Also the lack of a neurologist for further CT/MRI evaluation in community settings can make a significant difference in course of treatment when it comes to initial 24-48 hours.
I'm not arguing that veterans wouldn't get better care in the private sector, but who's going to pay for that? Most veterans don't have the privilege of having good private health insurance, which is usually what's required to get care at the top hospitals. Hence the point of the VA's existence.
Also:
Comparing Quality of Care in VA and Non-VA Settings
Veterans Health Administration Hospitals Outperform Non–Veterans Health Administration Hospitals in Most Health Care Markets
One problem with the social activism trend of medical schools is that they are teaching content that is not proven. Our school loves to teach nutrition about which diets are best. The problem being of course that each diet has positive and negative articles written each week.
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My point is granting “access” still limits you to economic reality. That scarcity exists. Rationing will exist even in a 100% government run and controlled program.
The problem is when you add too much government to the mix, you get the usual problems - cover ups and scandals funded by the tax payer.
What about that 2014 VA cover up - that some 1,700 veterans were waiting an average of 115 days for a doctor's appointment at the Phoenix VA hospital, and 40 veterans died while doing so?
The botched colonoscopies in several VA facilities exposing up to 10,000 patients to HIV and hepatitis viruses?
And the VA executives that hid and withheld positive legionnaires test results of an outbreak at their facility to save face?
On and on, I can keep adding more
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Merging the thread from the MD forum to the one in Topics in Healthcare.
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And so the conversation dies.
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The conversation dies if people allow it to die. People are free to continue discussing
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deleted480308
but they are in lieu of other things that students should have the option to do with their time
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deleted480308
"inequality" isn't something that govt should be trying to erase, that's not their job
Who's job is it then?
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Lol exactly who’s going to pay for it? The VA is small scale of what would take for insurance for all. Who’s going to pay for it? Without proper funding, then the VA could become a reality for all Americans.
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I'm always impressed when baby boomers lecture Millenials about being overly sensitive when they come from a generation that complained about drinking from the same water fountain as black people.
I get the impression that OP is either the author of the article, in desperate need of validation or both. It's no surprise that 'some' in the older generation are rebelling against social changes that are threatening to their so-called "hierarchy", it's almost a coming-of-age phenomenon.
So let me break this down for this dinosaur:
"The American College of Physicians says its mission is to promote the "quality and effectiveness of health care," but it's stepped out of its lane recently with sweeping statements on gun control."
--> So here's the thing, snowflake. As physicians, we're expected to not only be effective in treating ailments, but also preventing them. We do this with a variety of other pertinent hazards facing the American public: we advocate a healthy diet to prevent heart attacks, we advocate anti-smoking campaigns to reduce the incidence of COPD and lung cancer, but god forbid we try to prevent gun violence.
"And that isn't the only recent foray into politics by medical professionals."
--> So you're telling us the government can imprison us for performing abortions, regulate how we receive our compensation and monitor what we prescribe, but we can't have a say in how healthcare policy is managed? Sounds like an abusive relationship to me.
"During my term as associate dean of curriculum at the University of Pennsylvania's medical school, I was chastised by a faculty member for not including a program on climate change in the course of study. "
--> And there is the Freudian slip: it's about you. You're threatened. You don't feel powerful anymore. And now you're acting out attempting to justify your views.
"Why have medical schools become a target for inculcating social policy when the stated purpose of medical education since Hippocrates has been to develop individuals who know how to cure patients?"
--> Nevermind the fact that many medical schools in the US don't employ the Hippocratic oath at their white coat ceremonies, there is that tiny part about "therapeutic nihilism", and your views seem to be an extention of that philosophy. "We simply cannot cure gun violence through better gun control" (despite the overwhelming evidence to the contrary).
"A new wave of educational specialists is increasingly influencing medical education."
--> And they aren't you.
"They emphasize "social justice" that relates to health care only tangentially."
--> And that's a problem because?
"These educators focus on eliminating health disparities and ensuring that the next generation of physicians is well-equipped to deal with cultural diversity, which are worthwhile goals. But teaching these issues is coming at the expense of rigorous training in medical science."
--> You spend the whole article complaining, but don't seem to explain HOW this is detrimental to our "rigorous training".
"The traditional American model of medical training, which has been emulated around the world, emphasizes a scientific approach to treatment and subjects students to rigorous classroom instruction."
--> No, it's not. We fare poorly in outcomes on a variety of illness compared to our developed western counterparts. They don't emulate our style: they spend less time in undergrad and more time in medical school, have more rigorous, evidence-based treatment standards that aren't influenced by pharmaceutical companies, have more accessible healthcare systems and don't require students to take a half-million in debt to become a physician.
"Students didn't encounter patients until they had some fundamental knowledge of disease processes and knew how to interpret symptoms. They were expected to appreciate medical advances and be able to incorporate them into their eventual fields of practice. Medical education was demanding and occasionally led to student failure, but it produced a technically proficient and responsible physician corps for the U.S."
--> Again, no, it's not. Schools are charging more and providing less by the year. Medical education has become formulaic and almost entirely dependent on resources like uWorld, USMLE First Aid, and Kaplan. Our first two years are geared entirely for Step I and nothing else. Schools are also increasingly becoming reliant on for-profit hospitals and groups for clinical rotations while continuing to charge an arm and leg for tuition.
"The traditional American model first came under attack by progressive sociologists of the 1960s and '70s, who condemned medicine as a failing enterprise because increased spending hadn't led to breakthroughs in cancer treatment and other fields. The influential critic Ivan Illich called the medical industry an instrument of "pain, sickness, and death," and sought to reorder the field toward an egalitarian social purpose. These ideas were long kept out of the mainstream of medical education, but the tide of recent political culture has brought them in."
--> No, friend. There were American physicians long before and long after your boogeyman that advocated for greater accessibility, flexibility, and efficiency in healthcare. Doctors aren't stupid, they're also capable of altering and influencing their surroundings. And since when did treating patients equally every been outside of the "mainstream".
"As concerns about social justice have taken over undergraduate education, graduate schools have raced to develop curricula that will steep future educators in the same ideology. Today a master's degree in education is often what it takes to qualify for key administrative roles on medical-school faculties. The zeitgeist of sociology and social work have become the driving force in medical education."
--> What does this even mean? Having a masters in education will help you administer education more effectively? You don't say.
"This fits perfectly with the current administrator-rich, policy-heavy, form-over-function approach at every level of American education. Theories of learning with virtually no experimental basis for their impact on society and professions now prevail. Students are taught in the tradition of educational theorist Etienne Wenger, who emphasized "communal learning" rather than individual mastery of crucial information."
--> Yes, let's have an unregulated, unregimented, highly functional approach to American education. Who the hell cares about standards? It's not like we use those in everyday practice. What theories exactly?
"Where will all this lead? Medical school bureaucracies have become bloated, as they have in every other sphere of education. Curricula will increasingly focus on climate change, social inequities, gun violence, bias and other progressive causes only tangentially related to treating illness. And so will many of your doctors in coming years."
--> How? How is having a 20-minute lecture on how global warming-related droughts are causing an influx of Subsaharan African refugees in my city a detriment to my education? How is knowing their cultural practices so I can best understand how to approach their treatment a detriment to my education? How is working to reduce gun violence in my city more of a burden on the hospital i work at? How, Sway?
"Meanwhile, oncologists, cardiologists, surgeons and other medical specialists are in short supply. The specialists who are produced must master more crucial material even though less and less of their medical-school education is devoted to basic scientific knowledge. If this country needs more gun control and climate change activists, medical schools are not the right place to produce them."
--> No, it's not. For all your bit*ing and complaining about a lack of evidence, you haven't sufficiently provided evidence to the contrary or anything to support the above statement.
I get the impression that OP is either the author of the article, in desperate need of validation or both. It's no surprise that 'some' in the older generation are rebelling against social changes that are threatening to their so-called "hierarchy", it's almost a coming-of-age phenomenon.
So let me break this down for this dinosaur:
"The American College of Physicians says its mission is to promote the "quality and effectiveness of health care," but it's stepped out of its lane recently with sweeping statements on gun control."
--> So here's the thing, snowflake. As physicians, we're expected to not only be effective in treating ailments, but also preventing them. We do this with a variety of other pertinent hazards facing the American public: we advocate a healthy diet to prevent heart attacks, we advocate anti-smoking campaigns to reduce the incidence of COPD and lung cancer, but god forbid we try to prevent gun violence.
"And that isn't the only recent foray into politics by medical professionals."
--> So you're telling us the government can imprison us for performing abortions, regulate how we receive our compensation and monitor what we prescribe, but we can't have a say in how healthcare policy is managed? Sounds like an abusive relationship to me.
"During my term as associate dean of curriculum at the University of Pennsylvania's medical school, I was chastised by a faculty member for not including a program on climate change in the course of study. "
--> And there is the Freudian slip: it's about you. You're threatened. You don't feel powerful anymore. And now you're acting out attempting to justify your views.
"Why have medical schools become a target for inculcating social policy when the stated purpose of medical education since Hippocrates has been to develop individuals who know how to cure patients?"
--> Nevermind the fact that many medical schools in the US don't employ the Hippocratic oath at their white coat ceremonies, there is that tiny part about "therapeutic nihilism", and your views seem to be an extention of that philosophy. "We simply cannot cure gun violence through better gun control" (despite the overwhelming evidence to the contrary).
"A new wave of educational specialists is increasingly influencing medical education."
--> And they aren't you.
"They emphasize "social justice" that relates to health care only tangentially."
--> And that's a problem because?
"These educators focus on eliminating health disparities and ensuring that the next generation of physicians is well-equipped to deal with cultural diversity, which are worthwhile goals. But teaching these issues is coming at the expense of rigorous training in medical science."
--> You spend the whole article complaining, but don't seem to explain HOW this is detrimental to our "rigorous training".
"The traditional American model of medical training, which has been emulated around the world, emphasizes a scientific approach to treatment and subjects students to rigorous classroom instruction."
--> No, it's not. We fare poorly in outcomes on a variety of illness compared to our developed western counterparts. They don't emulate our style: they spend less time in undergrad and more time in medical school, have more rigorous, evidence-based treatment standards that aren't influenced by pharmaceutical companies, have more accessible healthcare systems and don't require students to take a half-million in debt to become a physician.
"Students didn't encounter patients until they had some fundamental knowledge of disease processes and knew how to interpret symptoms. They were expected to appreciate medical advances and be able to incorporate them into their eventual fields of practice. Medical education was demanding and occasionally led to student failure, but it produced a technically proficient and responsible physician corps for the U.S."
--> Again, no, it's not. Schools are charging more and providing less by the year. Medical education has become formulaic and almost entirely dependent on resources like uWorld, USMLE First Aid, and Kaplan. Our first two years are geared entirely for Step I and nothing else. Schools are also increasingly becoming reliant on for-profit hospitals and groups for clinical rotations while continuing to charge an arm and leg for tuition.
"The traditional American model first came under attack by progressive sociologists of the 1960s and '70s, who condemned medicine as a failing enterprise because increased spending hadn't led to breakthroughs in cancer treatment and other fields. The influential critic Ivan Illich called the medical industry an instrument of "pain, sickness, and death," and sought to reorder the field toward an egalitarian social purpose. These ideas were long kept out of the mainstream of medical education, but the tide of recent political culture has brought them in."
--> No, friend. There were American physicians long before and long after your boogeyman that advocated for greater accessibility, flexibility, and efficiency in healthcare. Doctors aren't stupid, they're also capable of altering and influencing their surroundings. And since when did treating patients equally every been outside of the "mainstream".
"As concerns about social justice have taken over undergraduate education, graduate schools have raced to develop curricula that will steep future educators in the same ideology. Today a master's degree in education is often what it takes to qualify for key administrative roles on medical-school faculties. The zeitgeist of sociology and social work have become the driving force in medical education."
--> What does this even mean? Having a masters in education will help you administer education more effectively? You don't say.
"This fits perfectly with the current administrator-rich, policy-heavy, form-over-function approach at every level of American education. Theories of learning with virtually no experimental basis for their impact on society and professions now prevail. Students are taught in the tradition of educational theorist Etienne Wenger, who emphasized "communal learning" rather than individual mastery of crucial information."
--> Yes, let's have an unregulated, unregimented, highly functional approach to American education. Who the hell cares about standards? It's not like we use those in everyday practice. What theories exactly?
"Where will all this lead? Medical school bureaucracies have become bloated, as they have in every other sphere of education. Curricula will increasingly focus on climate change, social inequities, gun violence, bias and other progressive causes only tangentially related to treating illness. And so will many of your doctors in coming years."
--> How? How is having a 20-minute lecture on how global warming-related droughts are causing an influx of Subsaharan African refugees in my city a detriment to my education? How is knowing their cultural practices so I can best understand how to approach their treatment a detriment to my education? How is working to reduce gun violence in my city more of a burden on the hospital i work at? How, Sway?
"Meanwhile, oncologists, cardiologists, surgeons and other medical specialists are in short supply. The specialists who are produced must master more crucial material even though less and less of their medical-school education is devoted to basic scientific knowledge. If this country needs more gun control and climate change activists, medical schools are not the right place to produce them."
--> No, it's not. For all your bit*ing and complaining about a lack of evidence, you haven't sufficiently provided evidence to the contrary or anything to support the above statement.
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Just to clarify, the article is from the WSJ.
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deleted480308
If I want whay someone else has, it’s my responsibility to earn it
If I want gary to have what susan has, it’s my responsibility to either teach him how to earn it or buy it for him. Equal possessions/finances for all citizens is not an appropriate role of govt
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I can’t think of any new good measure from the government that isn’t a blunt force instrument and actually quite illiberal with respect to “ending inequality”. Really all that can be done has mostly been done. You “punish” those who discriminate specifically in certain settings: employment, housing, most business transactions. And if the government can only offer illiberal “solutions” are they even solutions and if not solutions then they don’t have much of a role.
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A wise man once predicted that the poor will always be with us.
Utopia, literally-translated, means "no place." You can't turn our world into a paradise, and, indeed, the closer we get in some ways (material comfort), the further away we get in others (eroding sense of community and belonging, social atomization). Attempts at large-scale radical equality have historically been blood-soaked failures, e.g. the French Revolution, while smaller-scale attempts, e.g. the Oneida Commune, succeeded for a while and then fizzled out. What makes you think your attempt to solve the problem of human inequality will be any different?
The problem with a universal approach to health coverage in the United States is that people are not willing to make the compromises that would make such a system fiscally feasible. Covering expensive treatments and those with a high number-needed-to-treat is already bankrupting Medicare and Medicaid; expanding those programs to all Americans would balloon the scale of the problem without doing anything to address the root cause of our disproportionate healthcare expenditures. We'd also likely have to change how we cover end-of-life care; you probably remember how well the "death panels" went over when the ACA passed.
As far as the social determinants of health go, physicians are limited in how much we can get our patients' behavior to change. How many people have you, personally, convinced to stop smoking? To stop drinking regular soda? To exercise regularly?
VA Doc pointed out upthread that a lot of our increased healthcare expenditure in this country is because we're fat and unhealthy - we'd probably get a lot more bang for our buck by putting a Pigovian tax on sugar, high-fructose corn syrup, and soybean/canola oils than we would from Medicare-for-All.
This is an unrealistic and irresponsible take. Laissez-Faire economic policies have led to a society where the playing field isn't equal; there are structural factors as to why impoverished people are and remain impoverished. You can't say with a straight face that everyone in this country who lives in poverty is there because they haven't "earned" a higher quality of life while everyone who is economically stable has "earned it". It has to do with where and who you're born to. There is a ceiling for social mobility, and while there are a few exceptions, they're just that: exceptions. I'm not advocating for absolutely equal possessions/finances, but the level of inequity that exists today is unacceptable, higher than ever, and rising. There need to be social safety nets in place to help those that are affected by structural inequality.
Again, no one, including me, suffers from the illusion that we're going to "end inequality" -- the problem is the degree of inequality (where the top 1% of earners in the USA have a higher combined net worth than the bottom 90% of earners) and the fact that the gap is growing rather than remaining stable or decreasing.
I'm not sure where you get the idea that "all that can be done has mostly been done". Healthcare reform, housing reform, criminal justice reform, tax reform...these are all things that can help turn the tide on income inequality that haven't been done.
Again, no one is trying to "solve the problem of inequality", because that's a fool's errand. We do, however, have a moral imperative to reduce inequality towards the goal of reducing the suffering of our fellow man. And the part that is truly shameful is that we have the means to do so. No one is calling for bloodshed; there are ways to reduce the inequality gap through social policy.
One of the main reasons our healthcare expenditures are so high is that as a country, we focus on treating the sick rather than preventing illness in the first place. This is because our reimbursement system is based on productivity; the more procedures a surgeon does, the more patients a hospitalist sees, the more a hospital can bill for and squeeze from insurance providers. Switching to a single-payer system with value-based incentives will incentivize healthcare systems and providers to maximize illness prevention and reduce unnecessary procedures and tests.
Yes, behavioral change science is another topic in itself, but negative health indicators such as smoking and obesity are more highly-linked to people of low SES to begin with. It's well-established that lack of access to cheap, healthy food options in food deserts are one structural contributor to higher obesity rates among people of low SES. And tell me, who's going to have an easier time getting regular exercise; the patient who lives in the inner city, may have housing and food insecurity, and can't afford a gym membership, or the middle/upper class patient? A better way to reduce these negative health behaviors, other than trying to convince everyone to stop smoking or exercise more, is to work towards reducing these structural inequalities through implementation of better social policy.
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deleted480308
Capitalism led to the economy that the most people in the world want to escape to, there is a reason for that
Economic mobility exists just fine in this country and if you want your kids have a much better life than you do (if you are poor here) it is actually pretty likely that you boost them up the economic ladder. We’ve went through the actual stats in the spf forum here and more than 50% of those born into the lowest quintile move into the higher quintiles
Your plan of a more socialized economy is the immoral one because you ignore property rights. Your economics have literally killed millions throughout history.
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deleted480308
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You are moving the goal posts now. Income equality is a different topic than what you seemed to be going on about. With that said why should we all have equal income? I work harder, longer, am more educated, take many inherent personal liability risks, and deal with literal life and death decisions daily at work than probably any other job out there. There is no inequality just go through the education and training and then work the job.
The market and economics of the situations people find themselves in within the context of current laws and regulations are what determine pay for people. Artificially paying people too much or too little will lead to scarcity of people willing to do those jobs or scarcity of those jobs available all the time every time - scarcity either way. Economics isn’t a curse word. It’s just an inconvenient study of usual human behavior that interferes with the brave new world of well meaning but idiot leftists.
You can tax unearned gains more. Estates more. You can create a Medicare option for everyone who wants to buy in on a sliding income/age scale (not Medicare for all which is a nonstarter). You can lower mandatory minimum sentences or even stop putting people into prison for lots of things. End private for profit prison operations.
I’m not sure what needs to be done on housing “reform” but I suspect it’s stupid. Giving loans to too many people with less restrictions lead to the crisis in 07/08.
The bottom line is that the “poor” in this country live drastically better than the poor in most of the rest of the world. It can be easy to lose sight of that. It’s not perfect here but it doesn’t deserve the radical agitations.
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Weather Service, National Park Service, Army Core of Engineers, Pell Grants through the Department of Education, NIH grants, subsidized HUD loans, CHIP health insurance, Medicaid...I mean, I can go on and on. There are ways in which communities, municipalities, counties, states and yes, the federal government, can help remedy deficiencies that the market simply cannot correct. It's quite rigid and illiberal to think inequalities are entirely market driven.
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You can have a market-based economy that invests in social welfare. In fact, investing in the health of your workers improves productivity. This can be done on a private or public level. It's glaringly inaccurate to think that investing in social programs is somehow analogous to consolidating the means of production. I don't think anyone is arguing that market-based exchange enhances social mobility, but you have institutions in this country that impede that mobility: you can't import medication from other countries, you pay a higher price for medications that cost a fraction of the price they do in other developed nations, our government can't negotiate prescription prices, our CDC isn't allowed to do research on gun violence, there are only a handful of companies that provide health insurance (and health services in general), etc. This is not "market-based", this is, in fact, corporate welfare. There are certain "products" that have inelastic demands, meaning people will need them regardless of the price - kind of like insulin. Some people simply cannot afford it because a few companies control it, and so they die as a result. That's not "market-based", that's a monopoly. If you think that's ok, you should not be a doctor.
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The weather service ends inequality?
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Make Tornadoes Great Again?
D
deleted480308
Oh dear, so much wrong here.
1. Taxation and govt isn't the method to invest in social welfare, if you have a per cause you should earn some money and give it.
2. I am arguing that a market based economy increases social mobility opportunities
3. I'm all for being able to ship in meds from overseas, that's your beloved govt stopping it. The answer to that isn't more govt.
4. Govt shouldn't be negotiating meds because they shouldn't be buying meds
5. CDC doesn't need to research gun violence, it's a crime issue not a health issue
6. There are only a few health insurance companies because of the hurdles put in place by govt. This is only "Welfare" because the govt also requires people to buy insurance. Both are bad ideas
7. Inelastic demands doesn't mean you upend the market economy and you don't know how insulin works in the marketplace. You can go to walmart right now and buy a enough insulin to keep most diabetics (particularly if even kind of eat right) alive for <$50 a month.
Save me the pearl clutching about not being a doctor.
D
deleted480308
wait.....you think federal govt involvement in college education financing has been good?
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They have been weakened lately by horrible leftist policies.
I immigrated to America as a child, my parents income never exceeded 30k as a household until I entered college. I grew up poor. Yet today I earn in the top 1% income of this country and carry a coveted MD degree. Did my family wallow around crying victim and beg for the government to give me free food, housing, money to accomplish this? Did I wail incessantly about the 200k plus loans I voluntarily took on and beg for free college from the taxpayer, instead of pay them off in a year by working 70+ hr a week moonlighting?
No. My parents knew why we came here. Because social and economic mobility in the USA is tremendous. They instilled in us the importance of education, a sense of work ethic, and look where they and I have gotten. Social safety nets will not fix the primary root cause of much of poverty, it will only perpetuate it
If investing in social programs boosts worker productivity so much...why is unemployment several times higher and economic growth stagnant or negative in Spain, France, Italy, Greece etc? These countries have really lavish welfare programs and labor laws!
Meanwhile in the US...unemployment at historic lows, real wages still rising, labor force participation has been rising again...
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Medical school professors and administrators really like to push public health concerns that neatly align with their preferred narrative—how we don’t offer enough free healthcare to illegal aliens, how healthcare is a “human right” that profiteers have destroyed, how every minority group in the US is mistreated and neglected by white male physicians, etc.
When am I going to hear about the broken culture that causes three-quarters of American black babies to be born to out-of-wedlock parents? When am I going to hear about the mainstream “gangsta” scene that encourages young people from all walks of life to engage in reckless sex, violence, and drug use? When am I going to hear about physicians who feel like they have their hands tied because of regulations imposed by our intrusive, bloated federal government?
I guess public health concerns only matter if they’re politically correct and neatly line up with leftist talking points.
When am I going to hear about the broken culture that causes three-quarters of American black babies to be born to out-of-wedlock parents? When am I going to hear about the mainstream “gangsta” scene that encourages young people from all walks of life to engage in reckless sex, violence, and drug use? When am I going to hear about physicians who feel like they have their hands tied because of regulations imposed by our intrusive, bloated federal government?
I guess public health concerns only matter if they’re politically correct and neatly line up with leftist talking points.
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