Vote for Mitt Romney...the opponent thinks our success is not because of hardwrk

[polar403]

Obviously, I don't have a specific answer or percent to give you, and I don't know what it's like to pay 30-40% of a paycheck towards taxes. I also don't know what it's like to be a paraplegic, but I can understand that it must be pretty unbearable. So, what do I think is fair, first off, whatever you're paying in taxes right now is fair. I feel that, for example, if we tax someone that makes $500,000 a year it should go accordingly; first $250,000 made need to be taxed at a certain rate, the next $250,000 should be taxed at a higher rate. Stop acting like you're some big bad #ss that didn't have any help from the "system" along the way. Paying it back to the system that allows you to have your Mcmansion, porsche, and trophy wife so that others don't have to struggle so hard to live doesn't seem like an unreasonable thing to ask.

I'd say that paying back the loans the government let me borrow at a 6.8% interest rate is a pretty fair return for them, considering the money they lent me was borrowed at a rate close to 0%. I think that's "paying it back" enough.

---

Members don't see this ad.

 

[periopdoc]

I get it, that's still wayyyy better than the avg person living in the "world"--dumbest argument I've heard yet.

Funny how crystal clear the stupidity of YOUR argument becomes when the tables are turned and YOUR argument is applied to you personally instead of some nebulous rich person.

- pod

 

[xf3rn4nd3sx]

It's not a sales tax - it's a VAT. Something that costs $1 today would still cost $1 under the Fair Tax, not $1.23. The idea is that 23% of the cost of every item sold is already due to taxes.

The concept, as laid out in the books by Neil Boortz and former Congressman John Linder, is fascinating as well as fair. No special interests, no deductions.

Herman Cain was actually a huge proponent of the Fair Tax, but so many people who are against it (stupid as they are) change the "rules" and make it something it's not to justify opposing it. That's why he came up with his 9-9-9 plan as an alternative. It was easier to explain.

Yeah, it is actually a VAT. I was just using essentially the first paragraph of the fairtax website in which they do label (incorrectly) it as a national sales tax. Regardless, I completely agree. No special interests, no deductions, no IRS, and tax season will be so much less of a headache (nonexistent )

Clearly more than you do.

 

[xf3rn4nd3sx]

Once again - spoken like someone who has never paid taxes, and is perfectly willing to suck off the teat of the US taxpayer.

So - the first $250k should be taxed at a certain rate. What would that rate be? How about for the next $250k? The problem is, you don't pay taxes - you have no idea how taxes affect your personal bottom line.

Here's where you're showing your true liberal colors - Paying it back to the system that allows you to have your Mcmansion, porsche, and trophy wife so that others don't have to struggle so hard to live..... Paying back what to whom? You think I got my money from the government in the first place? This is what's wrong with stupid liberals like you and your Marxist/socialist president. They think the government owns it ALL, and that the government ALLOWS us to keep SOME of IT'S money, and give the rest BACK to the government where it all came from in the first place. Why is it MY responsibility to pay so that "others don't have to struggle so hard to live". WTF?!?!?!?

You don't get it. IT'S MY MONEY, not the government's. You're so friggin clueless it just kills me.

Very true. People such as bigkahuna burger believe in the system so long as it benefits them self (until they are taxed at 30+%). None of us owe the government anything. We use public services just as much as everyone else and have paid more than our fair share for their usage. The government honestly hasn't done any favors for me or given me any "freebies". I went to a public school, which was supported via my parents' property taxes. I attended college and med school with private scholarships. You may say that I use bridges, roads, etc., but I pay hundreds of thousands a year in taxes to use those services. Seems a little unreasonable. I don't owe the government or "people who have to struggle so hard to live" anything. In fact, I was a "person who had to struggle so hard to live" and did just fine without leaching off of those with "Mcmansions, porsches, and trophy wives."

 

[MOHS_01]

Obviously, I don't have a specific answer or percent to give you, and I don't know what it's like to pay 30-40% of a paycheck towards taxes. I also don't know what it's like to be a paraplegic, but I can understand that it must be pretty unbearable. So, what do I think is fair, first off, whatever you're paying in taxes right now is fair. I feel that, for example, if we tax someone that makes $500,000 a year it should go accordingly; first $250,000 made need to be taxed at a certain rate, the next $250,000 should be taxed at a higher rate. Stop acting like you're some big bad #ss that didn't have any help from the "system" along the way. Paying it back to the system that allows you to have your Mcmansion, porsche, and trophy wife so that others don't have to struggle so hard to live doesn't seem like an unreasonable thing to ask.

That's cute -- you deciding what is "fair" to abscond with. I'd wager that you have given less critical though and devoted less time to learning the history and progression of these thoughts than you had given to your last piece of throwaway technology purchase.

 

[yappy]

Physicians should pay zero taxes. If a doctor accepts a Gov. insurance for less than market value (ex: Medicare pt pays 80 while BlueCross/Shield pays 120 = 40 dollars against tax liability) they should have that deducted from their tax liability.

It's only "fair". They're essentially paying for entitlement short comings by being forced to work for little money. This "tax" is an off the books tax on providers as no one but them is having to foot the bill. Democrats have evil views and will continue to drive this country into the worst kind of collapse if they are left in office. Work to eliminate them from any area of office then we will take care of the sympathizing D voters later. But for now elections must be won.

 

[bigkahunaburger]

Aww Mohs just called me cute, that made my day.

 

[BLADEMDA]

 

[TheBlend]

Once again - spoken like someone who has never paid taxes, and is perfectly willing to suck off the teat of the US taxpayer.

So - the first $250k should be taxed at a certain rate. What would that rate be? How about for the next $250k? The problem is, you don't pay taxes - you have no idea how taxes affect your personal bottom line.

Here's where you're showing your true liberal colors - Paying it back to the system that allows you to have your Mcmansion, porsche, and trophy wife so that others don't have to struggle so hard to live..... Paying back what to whom? You think I got my money from the government in the first place? This is what's wrong with stupid liberals like you and your Marxist/socialist president. They think the government owns it ALL, and that the government ALLOWS us to keep SOME of IT'S money, and give the rest BACK to the government where it all came from in the first place. Why is it MY responsibility to pay so that "others don't have to struggle so hard to live". WTF?!?!?!?

You don't get it. IT'S MY MONEY, not the government's. You're so friggin clueless it just kills me.

Spoken like a true conservative republican. my money>morality and community

This is the essence of why conservatives don't understand the president's comments. No matter how successful you have been in your life, it is not due 100% to your decisions and behavior alone. Liberals are not anti-rich people, just as conservatives are not anti-poor. The difference is in whether you view government as a force for good in the world.

Liberals view 'entitlement programs' as a net good for people who cannot sufficently provide for themselves or their families, while many conservativess see them as unneccessary, corrupt, or innefficient. What is an acceptable fraud rate for unemployment or food stamps?

Liberals don't think the government "owns it all". We see vast inequality that is worsening year after year. We see the middle class being phased out by lobbyists, manipulation, and misinformation.

For being so terrified of the government being too big or having too much power, you righites have zero concern about too much power in the hands of big banks and insurance companies or colluding corporations forming monopolies.

Ya know maybe you're right, so what if a few hundred people get laid off, lose their benefits, can't pay rent or buy groceries (they should have done their homework in high school and gotten a better job)......Anyways, Bain Capitol probably just made huge ROI from the mass layoff and your stock value just increased CHA CHING!
------------------------------------------------------------------------------

WE THE PEOPLE of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

 

[jwk]

Spoken like a true conservative republican. my money>morality and community

This is the essence of why conservatives don't understand the president's comments. No matter how successful you have been in your life, it is not due 100% to your decisions and behavior alone. Liberals are not anti-rich people, just as conservatives are not anti-poor. The difference is in whether you view government as a force for good in the world.

Liberals view 'entitlement programs' as a net good for people who cannot sufficently provide for themselves or their families, while many conservativess see them as unneccessary, corrupt, or innefficient. What is an acceptable fraud rate for unemployment or food stamps?

Liberals don't think the government "owns it all". We see vast inequality that is worsening year after year. We see the middle class being phased out by lobbyists, manipulation, and misinformation.

For being so terrified of the government being too big or having too much power, you righites have zero concern about too much power in the hands of big banks and insurance companies or colluding corporations forming monopolies.

Ya know maybe you're right, so what if a few hundred people get laid off, lose their benefits, can't pay rent or buy groceries (they should have done their homework in high school and gotten a better job)......Anyways, Bain Capitol probably just made huge ROI from the mass layoff and your stock value just increased CHA CHING!
------------------------------------------------------------------------------

WE THE PEOPLE of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

The "general welfare" in the Constitution is not Welfare as we know it today. Hopefully you understand that. The founding fathers would be appalled at the welfare state in this country.

You think because I disagree with Maobama that I don't "understand the president's comments"? Are you serious? I understand him perfectly - I disagree with him vehemently and wholeheartedly. This is the CORE of the liberal argument - government is the answer - that nobody succeeds without the help of the government. And you're an absolute fool if you don't think that liberals believe "It's the government's money". They damn sure do!

The core argument for conservatives is that the government is the problem and needs to get the hell out of the way. Read the Federalist Papers - all of them. Perhaps you'll gain a better understanding of the intent of the founding fathers. They understood the dangers of an all-encompassing all-powerful federal government, hence the 10th amendment, that all powers, not specifically enumerated and authorized to the federal government in the Constitution, are otherwise reserved to the states or to the people. The idea of the United STATES of America was that the states would have more control at their level than the federal government did.

You want to deal with collusion? The mortgage crisis happened because liberal Democrats and their bed-partners colluded to lower lending standards, forcing banks to make sub-standard high-risk loans. You know, everyone is "entitled" to a house, a college education, yada, yada, yada. The fact that they can't afford it is immaterial, right, because the government is here to help. Mortgage rates are 3.5% for 30 years - and the market isn't budging because it's in such a deep hole and most owners that have a mortgage are upside down and can't sell without destroying their credit.

Liberals, such as yourself, apparently are perfectly happy spending other people's money. Remind me how much Barry and Joe contributed to charity the last several years as a percentage of their income? As I recall, the Biden's wasn't even $3000. Wow! Impresive.

 

[TheBlend]

The "general welfare" in the Constitution is not Welfare as we know it today. Hopefully you understand that. The founding fathers would be appalled at the welfare state in this country.

You think because I disagree with Maobama that I don't "understand the president's comments"? Are you serious? I understand him perfectly - I disagree with him vehemently and wholeheartedly. This is the CORE of the liberal argument - government is the answer - that nobody succeeds without the help of the government. And you're an absolute fool if you don't think that liberals believe "It's the government's money". They damn sure do!

The core argument for conservatives is that the government is the problem and needs to get the hell out of the way. Read the Federalist Papers - all of them. Perhaps you'll gain a better understanding of the intent of the founding fathers. They understood the dangers of an all-encompassing all-powerful federal government, hence the 10th amendment, that all powers, not specifically enumerated and authorized to the federal government in the Constitution, are otherwise reserved to the states or to the people. The idea of the United STATES of America was that the states would have more control at their level than the federal government did.

You want to deal with collusion? The mortgage crisis happened because liberal Democrats and their bed-partners colluded to lower lending standards, forcing banks to make sub-standard high-risk loans. You know, everyone is "entitled" to a house, a college education, yada, yada, yada. The fact that they can't afford it is immaterial, right, because the government is here to help. Mortgage rates are 3.5% for 30 years - and the market isn't budging because it's in such a deep hole and most owners that have a mortgage are upside down and can't sell without destroying their credit.

Liberals, such as yourself, apparently are perfectly happy spending other people's money. Remind me how much Barry and Joe contributed to charity the last several years as a percentage of their income? As I recall, the Biden's wasn't even $3000. Wow! Impresive.

It's so impressive how conservatives are the lone interpreters of the founding fathers intents on every issue. Must be from all that perfect bible interpretation.
The CORE of the liberal argument is that government CAN be AN ANSWER for SOME things. Your side thinks it is evil across the board, well except for the military, but the military isn't REALLLLY government.

Nobody is talking about an " all-encompassing all-powerful federal government".
Although, the GOP of the past few years wants a government so small that it can regulate and police every pregnancy and OBGYN visit in the country.

Liberals are concerned about too much power in any form.You folks fail to understand that the government is supposed to be a representation of us. It's not some separate abstract concept. The only thing keeping us from having more direct control is the special interests which your party LOVES! They have convinced you that corporations are people, money is free speech, and things like the death tax effect your life. And then you go out and fight and argue on their behalf......

The mortgage crisis was a combination of greedy banks, uninformed borrowers, policies of both parties, and the naivety of some officials that banks wouldn't actually bet against the loans they were issuing. It was de-regulation that caused the meltdown and we all know it. No credit default swaps and no repeal of glass-steagal = No Meltdown.

The states rights argument has been done to death. We know the right wants to be able to keep blacks and browns out of thier diners in Alabama, it just aint gonna happen.

About being happy to spend OTHER people's money. Where were you when GW ran up the debt with the wars, medicare part D, and the bush tax cuts? Also keep in mind that the 2009 budget is from the year before so all the talk about how the debt has exploded since obama 'took office' is just another example of this manipulation.

 

[Perrotfish]

Very true. People such as bigkahuna burger believe in the system so long as it benefits them self (until they are taxed at 30+%). None of us owe the government anything. We use public services just as much as everyone else and have paid more than our fair share for their usage. The government honestly hasn't done any favors for me or given me any "freebies". I went to a public school, which was supported via my parents' property taxes. I attended college and med school with private scholarships. You may say that I use bridges, roads, etc., but I pay hundreds of thousands a year in taxes to use those services. Seems a little unreasonable. I don't owe the government or "people who have to struggle so hard to live" anything. In fact, I was a "person who had to struggle so hard to live" and did just fine without leaching off of those with "Mcmansions, porsches, and trophy wives."

The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government.

 

[cincincyreds]

Physicians should pay zero taxes. If a doctor accepts a Gov. insurance for less than market value (ex: Medicare pt pays 80 while BlueCross/Shield pays 120 = 40 dollars against tax liability) they should have that deducted from their tax liability.

It's only "fair". They're essentially paying for entitlement short comings by being forced to work for little money. This "tax" is an off the books tax on providers as no one but them is having to foot the bill. Democrats have evil views and will continue to drive this country into the worst kind of collapse if they are left in office. Work to eliminate them from any area of office then we will take care of the sympathizing D voters later. But for now elections must be won.

I agree. Being forced to work under market rate is what I would define as slavery. Similar to building the pyramids in my eyes.

 

[jwk]

It's so impressive how conservatives are the lone interpreters of the founding fathers intents on every issue. Must be from all that perfect bible interpretation.
The CORE of the liberal argument is that government CAN be AN ANSWER for SOME things. Your side thinks it is evil across the board, well except for the military, but the military isn't REALLLLY government.

Nobody is talking about an " all-encompassing all-powerful federal government".
Although, the GOP of the past few years wants a government so small that it can regulate and police every pregnancy and OBGYN visit in the country.

Liberals are concerned about too much power in any form.You folks fail to understand that the government is supposed to be a representation of us. It's not some separate abstract concept. The only thing keeping us from having more direct control is the special interests which your party LOVES! They have convinced you that corporations are people, money is free speech, and things like the death tax effect your life. And then you go out and fight and argue on their behalf......

The mortgage crisis was a combination of greedy banks, uninformed borrowers, policies of both parties, and the naivety of some officials that banks wouldn't actually bet against the loans they were issuing. It was de-regulation that caused the meltdown and we all know it. No credit default swaps and no repeal of glass-steagal = No Meltdown.

The states rights argument has been done to death. We know the right wants to be able to keep blacks and browns out of thier diners in Alabama, it just aint gonna happen.

About being happy to spend OTHER people's money. Where were you when GW ran up the debt with the wars, medicare part D, and the bush tax cuts? Also keep in mind that the 2009 budget is from the year before so all the talk about how the debt has exploded since obama 'took office' is just another example of this manipulation.

"Blacks and browns"??? WTF dude.

I see where you're coming from. It's pointless to talk to people like you.

 

[ssmallz]

The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government.

The difference is that when a computer programmer screws up the code no one dies. We deal with life and death on a daily basis, there should probably be a minimum standard in which all practitioners need to meet in order to be allowed this privilege. That way when your mom or dad goes in to see a physician they have the full confidence that this person can practice safely and effectively, their diganosis is reasonably accurate, and the medicine they are prescribing is safe and won't kill them. But if you'd rather play russian roullete, let's let anyone with a 6 month training course whose read through first aid a few times practice and then let the general public do the detective work on who's a doc and who's a quack.

I know your status says resident but you can't be think this is truely a good idea after all the stuff you've seen so far in medicine.

 

[Gern Blansten]

The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government.

Just for clarity, you are advocating for a state of medical practice where no medical licensing is needed so that half trained technicians, as you describe, can do what our current licensed physicians do? Just want to make sure I am not misreading your thoughts. So we are equivalent to gas pumpers in what we do, right?

 

[powermd]

The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government.

Everyone who is a physician needs to acknowledge our above average incomes are a direct result of government regulation of the free market. Open the floodgates to FMGs, and give PA/NP equal independent practice and watch what happens. Walmart medicine for the masses, Madison Avenue for a few. Medicine (as a lucrative line of work) is a racket, like any other in the good ole' USA. It's dying because we lack the funds (maybe) and the will (definitely) to actively corrupt politicians into favoring our interests. It's really that simple.

 

[VA Hopeful Dr]

"The test of our progress in not whether we add more to the abundance of those who have much: it is whether we provide enough for those who have too little."
-Franklin D. Roosevelt-

I'm quite sure we're providing enough. There is food/water/shelter aplenty for those that can't afford it.

 

[DoctwoB]

People are waaaay over-reacting to obama's comments. All he said was that individual accomplishments can occur more readily thanks to a government that provides for infrastructure, safety, and the common defense. Granted he could have said it more eloquently, but I fail to see what the big deal is.

There's not a huge difference between the two. One wants a higher percentage of the tax burden on the upper class and favors increased government regulation of markets and healthcare. The other wants a higher portion of the tax burden on the low/middle class and reduced government involvement in markets and healthcare. Everything else is just blustering and rhetoric. Make your decision based on which of those you prefer, not this OMG SOCIALIZM!! garbage many here are spewing.

 

[jwk]

People are waaaay over-reacting to obama's comments. All he said was that individual accomplishments can occur more readily thanks to a government that provides for infrastructure, safety, and the common defense. Granted he could have said it more eloquently, but I fail to see what the big deal is.

There's not a huge difference between the two. One wants a higher percentage of the tax burden on the upper class and favors increased government regulation of markets and healthcare. The other wants a higher portion of the tax burden on the low/middle class and reduced government involvement in markets and healthcare. Everything else is just blustering and rhetoric. Make your decision based on which of those you prefer, not this OMG SOCIALIZM!! garbage many here are spewing.

Clearly you just don't get it. Have you listened to his full speech?

And if you think there is not a HUGE difference between the two, you are incredibly and woefully uninformed.

 

[polar403]

The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government.

I may be mistaken, but don't you need a law degree to be able to sit for the bar? Or is that state dependent?

 

[Perrotfish]

Just for clarity, you are advocating for a state of medical practice where no medical licensing is needed so that half trained technicians, as you describe, can do what our current licensed physicians do? Just want to make sure I am not misreading your thoughts. So we are equivalent to gas pumpers in what we do, right?

Yes and no. I think what would be best for medicine is for it to be governed like most forms of engineering; that is to say by the demands of consumers (paying cash) and the limitations imposed by liability. That kind of system isn't unregulated, its regulated by the free market. I don't think (in most cases) that consumers would go to technicians with 6 month degrees to mange their transplant surgery, but rather than the market would strive, as it generally does, to find a balance between risk and cost that the consumer is comfortable with. For most people I think that would look a lot like an engineer: a bright but not generally spectacular student who worked hard in undergrad to get a technical degree, and then went to work for older people in his field who showed him the ropes. Few Masters and fewer doctorates. I also think that without the tyranny of the perscription pad a lot of simpler conditions wouldn't need physicians at all: someone managed by a few medical algorithems could follow them themselves without the need to constantl be checked up on by traned personel. Finally on general principle I'm advocating for the patiens' right to decide who they want to see and who they don't. If they think a 6 month course is enough, then its enough for them.

The difference is that when a computer programmer screws up the code no
one dies. We deal with life and death on a daily basis, there should
probably be a minimum standard in which all practitioners need to meet in order
to be allowed this privilege. That way when your mom or dad goes in to see a
physician they have the full confidence that this person can practice safely and
effectively, their diganosis is reasonably accurate, and the medicine they are
prescribing is safe and won't kill them. But if you'd rather play russian
roullete, let's let anyone with a 6 month training course whose read through
first aid a few times practice and then let the general public do the detective
work on who's a doc and who's a quack.

I know your status says resident
but you can't be think this is truely a good idea after all the stuff you've
seen so far in medicine.

Oh come on, Doctors don't have a monopoly on death. Anyone who has ever read about a plane crash, or another Firestone recall, knows that incompetent engineers can kill thousands. Anyone who has been through a divorce or a custody battle knows the kind of shape an incompetent lawyer can leave you in. And if you think that computer programs don't have lives in their hands you clearly don't know how much of your life (not to mention those nice anesthesia machines you use) have minds of their own these day. Doctors feel like we know more about death because its more visceral for us: when we screw up we get to see the patient asphyxiate and/or bleed out in front of our eyes. In reality, though, the only thing that distinguishes doctors from most other professionals is that, when we make a mistake, its likely to only kill one person at a time. So why does the public need this kind of legally mandated handholding when finding a physician but not when, say, buying a used car?

I may be mistaken, but don't you need a law degree to be able to sit for the
bar? Or is that state dependent

Its state dependent. Also there seems to be no practical limit to who can open a law school, or how many seats they can offer, so even in states that do require a degree there is no practical barrier to an infinate number of people practicing.

 

[yappy]

Engineering is different. It's essentially 2 years of math with a few core classes + electives. I don't think that is the case with medicine. Greater volume of information and technical skills and the need for real on the job learning. The patient : doctor ratio is also a lot different from engineer : project ratio. The only thing that would drive down physician salaries would be corporatism which is the natural result of a libertarian societies.

Those with capital would use it to "employ" everyone and take over the markets - monopolies. I've always thought this would be fine as long as physical force could be utilized by those who lack economic power for balance but my understanding is that libertarians don't accept that. I actually think we need more people who are their own agents and in command of their own labor. Look across the labor sector and you will see that those who hold the most control over their skillset/employment situation are paid the most. This is why some trades (plumbers/electricians) earn more than many engineers. It isn't that their job is more difficult it's because they have a employment situation where the revenue they create isn't used to prop up a corporate structure.

EDIT: In today's dollars - physicians in the 1920's averaged ~300k/yr. Not too bad.

 

[ssmallz]

Oh come on, Doctors don't have a monopoly on death. Anyone who has ever read about a plane crash, or another Firestone recall, knows that incompetent engineers can kill thousands. Anyone who has been through a divorce or a custody battle knows the kind of shape an incompetent lawyer can leave you in. And if you think that computer programs don't have lives in their hands you clearly don't know how much of your life (not to mention those nice anesthesia machines you use) have minds of their own these day. Doctors feel like we know more about death because its more visceral for us: when we screw up we get to see the patient asphyxiate and/or bleed out in front of our eyes. In reality, though, the only thing that distinguishes doctors from most other professionals is that, when we make a mistake, its likely to only kill one person at a time. So why does the public need this kind of legally mandated handholding when finding a physician but not when, say, buying a used car?

The real funny part about some of the examples you use to state how licences limit the amount of doctors and therefore increase their salary is that pilots and lawyers are both licensed professionals. As you've stated both jobs that are directly responsible for the lives of their clients and I know I feel a lot safer knowing that the commercial airline pilot taking me from LAX to JFK has a valid licence and isn't the lowest bidder.

As for engineers, when an engineer makes a product, like a tire, car, or anesthesia machine, it can be rigorously tested on crash dummies and simulators to prove it works or it doesn't. Yea, sometimes bad products get out and recalls happen but an engineer, designs a product, has a bunch of supervisors approving, then there is testing, and finally that product gets sold to the general public. The engineer isn't directly responsible for the death of people if the tire fails, more indirectly responsible, like a cog in the wheel. That's why in class action law suits it's "The firestone company" that gets named as the defendent, not Joe Engineer. Yea I know money plays a part in that decision but the Joe has an entire team behind him, double and triple checking his work. Engineers can be unlicensed because if they suck, it's real easy to figure out because the products don't work and if they make bad designs, they are usually picked up prior to public trials.

Contrast that to an attending anesthesiologist, you are the expert. If your plan doesn't work, pt dies. No R&D team, no crash test dummy. You base your decision on years of experience gained as a medical student and resident. There's no one looking over your shoulder until something goes bad, then your decisions will be picked apart one by one using hindsight. Human being are also vastly different than tires in that no 2 are alike. Tires can be mass produced and are essentially the all same where as in medicine you can see something completely new tomorrow. As a resident, I really hope you have an appreciation for this.

Frankly I'm shocked that as fellow physician you think it would be a good idea to have pts decide which drugs they should or shouldn't take or how long they should take them for. You believe we control them through the "tyranny of the prescription pad"? Pts don't understand the subtle differences between drugs like ACEIs, ARBs, and diuretics taken for a simple condition like HTN. A good portion can't even remember which meds they take or what they take them for only that "their doctor told them to take a purple pill, its round, you know the one right?". When it comes to understanding medicine, the average person is an idiot, and guess what, that's ok. I don't know the first thing about how to fly a plane but I still get use the airplane. Know why this system works? Because the pilot in change of getting me to my destination safely has gone through years of rigorous training and meets the minimum standard that the governing body says is safe for them to operate that airplane? Sound familar? This is NOT a government artificially inflating their salary, it's the government saying they deserve that premium salary based on their years of experience and specific skill set

A few medical algorithms? Are you kidding? How many times has a patient come up to you in clinic and said "I think have XYZ zebra disease cause I that's what emedicine said" and then you diagnose them with something else entirely. I'm not even going to get into schedule 2s because I truly hope you can see the value in limiting access to those drugs.

You've been through 4 years of rigorous medical education and I'm just floored that you don't think you've learned enough in those 4 years to say to yourself "maybe we should leave the doctoring to others who have been through that type of training and maybe a licencing system would be a good way to ensure that the average patients get a minimum level of competence from someone who has the ability to accidentally kill them."

If you need any more proof of what can happen if someone doesn't know what they are doing see "Jackson, Michael 2009"

 

[TheBlend]

"Blacks and browns"??? WTF dude.

I see where you're coming from. It's pointless to talk to people like you.

I did say a lot more than that little excerpt.

 

[PinchandBurn]

Just vote for Mitt Romney, he is the RIGHT decision.

If you are in medicine/healthcare and you do not realize this yet after 4 years, you have real issues to contend with.

 

[yappy]

We need Romney in order to get rid of Obama Care.

What we need is something like the Tea Party's OPINION act to reform health care into a workable system that optimizes freedom and respects physicians as people in our society who have dignity and autonomy of their professional skills and time.

Broun's bill is divided into five parts: (1) repealing Obamacare; (2) changing the tax treatment of health expenditures [tax deductible]; (3) Medicare premium support; (4) reforms of EMTALA, the federal mandate that forces emergency rooms to care for people regardless of their ability to pay; and (5) allowing people to purchase insurance across state lines, and small businesses to band together to purchase lower-cost association health plans (AHPs).

http://www.forbes.com/sites/aroy/2012/04/07/the-tea-partys-plan-for-replacing-obamacare/

The OPINION plan is a worlds different from the entitlement plan that Obama and the democrats have passed. The contrast is staggering. Where do you stand on the issue? Will you vote for freedom? Will you vote right?

Vote Romney.

 

[GoodmanBrown]

Just vote for Mitt Romney, he is the RIGHT decision.

If you are in medicine/healthcare and you do not realize this yet after 4 years, you have real issues to contend with.

For almost all doctors, you realize that Mitt Romney is planning to raise their taxes, right?

 

[BLADEMDA]

For almost all doctors, you realize that Mitt Romney is planning to raise their taxes, right?

False.



Under a future President Romney, millionaires would get an $87,000 tax cut, while just about everyone else would see their tax bills go up by around $500 a year.
That’s one conclusion of a new study published by two Washington think tanks, the Brookings Institution and the Tax Policy Center.
Romney promises voters a host of tax cuts but doesn’t answer the looming question of how all these cuts will pay for themselves without increasing the deficit or cutting deeply into tax credits that are cherished by the middle class.
Romney says he would permanently extend the Bush tax cuts. He’d get rid of taxes on long-term capital gains, dividends, and interest income for married couples filing jointly with income under $200,000. And he’d repeal the federal estate tax. Those cuts skew toward helping the wealthy. For the middle class, Romney says he’d reduce most individual income tax rates by 20 percent.

 

[jwk]

I did say a lot more than that little excerpt.

That little excerpt tells me plenty.

 

[GoodmanBrown]

False.

Under a future President Romney, millionaires would get an $87,000 tax cut, while just about everyone else would see their tax bills go up by around $500 a year.

A little confused here, unless you're assuming most doctors are millionaires, which I suspect is not entirely the case. I know you're a a bit older and have worked in a lucrative specialty over the years, but you have to realize most doctors don't have several million in the bank when you consider all attending doctors.

Besides, the true tax breaks are going to those who earn $1+ million per year as income. I know of only a handful of docs for whom that is true. So, I stand by my statement that most docs will see their taxes rise under Romney's current plan.

 

[yappy]

Lets assume this is true.

Romney = 500 dollars in tax increase.

Obama = >>>>>>>>>>500 dollar tax increase, Gut the medical system, expand medicaid with out increasing funding, mandate all physicians take entitlements, implement SGR cuts, and expand mid level programs and scope of practice.

Yeah... I'll take Romney.

A little confused here, unless you're assuming most doctors are millionaires, which I suspect is not entirely the case. I know you're a a bit older and have worked in a lucrative specialty over the years, but you have to realize most doctors don't have several million in the bank when you consider all attending doctors.

Besides, the true tax breaks are going to those who earn $1+ million per year as income. I know of only a handful of docs for whom that is true. So, I stand by my statement that most docs will see their taxes rise under Romney's current plan.

 

[GoodmanBrown]

Lets assume this is true.

Romney = 500 dollars in tax increase.

Obama = >>>>>>>>>>500 dollar tax increase, Gut the medical system, expand medicaid with out increasing funding, mandate all physicians take entitlements, implement SGR cuts, and expand mid level programs and scope of practice.

Yeah... I'll take Romney.

Romney = All bunnies will be killed, farting made illegal, it will rain frogs, and we all have to wear magical undergarments.

See, I can make up terrible hypothetical scenarios for one of the presidential candidates, too!

 

[yappy]

Everything I said was straight out of the liberal play book.

I've read on several "progress" type web sites about how their aim is to go for French style health care where providers are paid less than 80k/yr and subject to the state. Many outlined those methods as a way to get there. Pull off your blinders and look at the trends.

Romney = All bunnies will be killed, farting made illegal, it will rain frogs, and we all have to wear magical undergarments.

See, I can make up terrible hypothetical scenarios for one of the presidential candidates, too!

 

[jwk]

Romney = All bunnies will be killed, farting made illegal, it will rain frogs, and we all have to wear magical undergarments.

See, I can make up terrible hypothetical scenarios for one of the presidential candidates, too!

Your Romney scenario is hypothetical. The Maobama scenario is not.

 

[yappy]

Article: Doctors Say We Need To Pay Doctors More on the Think Progress web site. A left leaning Obama supporting website.

I have to believe that it's possible to reduce payments to health care providers (as will be done if the super committee "trigger" is pulled) without harming patients in a proportionate way...

Medicare is able to get away with low payment rates because it has such a giant customer base. There are a lot of old people out there, and they consume a lot of health care services. It's hard to make a living as a doctor without serving those clients. If the rates get cut further, surely some doctors will try to get along without them, but how many will really be able to do so?...

...health care solutions ought to be systematic. If you cut Medicaid payment rates, providers will try to get by only seeing Medicare patients and patients with "private" health insurance. If you then try to cut Medicare rates too far, providers will try to get by only seeing patients with "private" health insurance. But even the "private" health insurance benefits from hefty government subsidies through the tax code and, in the future, through the health insurance exchanges. By moving toward all-payer rate setting we can cut excess expense while leaving providers with nowhere to run.

http://thinkprogress.org/yglesias/2011/08/03/286897/doctors-say-we-need-to-pay-doctors-more/?mobile=nc

Only in a liberals mind would taking over an entire industry to drive down prices make sense, ethically. I do not share those values and therefore feel alienated as a former D. As I said - I will never vote democrat again and I will work towards informing everyone in my pre-health club and on campus that come this election the R is the lesser of the two evils.

The viewpoints represented in that article are pathetic and exert mob rule on hard working people.

 

[Perrotfish]

Lets assume this is true.

Romney = 500 dollars in tax increase.

Obama = >>>>>>>>>>500 dollar tax increase, Gut the medical system, expand medicaid with out increasing funding, mandate all physicians take entitlements, implement SGR cuts, and expand mid level programs and scope of practice.

Yeah... I'll take Romney.

The bill that Obama proposed and passed is basically just a massive expansion of Medicaid. It increases how many people it covers (doubles that) and drastically increases how much it pays (reimbursements must match Medicare). Shoveling yet more government dollars into the healthcare system is not 'gutting' healthcare, its expanding he market for your services. No one in the executive branch wants to make you take entitlements, and mid levels remain a state to state issue.

The Ryan plan, on her other hand, which Romney endorses, would truly gut healthcare. Do you have any idea what percentage of our industry relies on the elderly having a.limitless healthcare budget? So you know what would happen to adult medicine if we were forced to care for them for a small, finite amount if money?

 

[Surfer]

The bill that Obama proposed and passed is basically just a massive expansion of Medicaid. It increases how many people it covers (doubles that) and drastically increases how much it pays (reimbursements must match Medicare). Shoveling yet more government dollars into the healthcare system is not 'gutting' healthcare, its expanding he market for your services. No one in the executive branch wants to make you take entitlements, and mid levels remain a state to state issue.

The Ryan plan, on her other hand, which Romney endorses, would truly gut healthcare. Do you have any idea what percentage of our industry relies on the elderly having a.limitless healthcare budget? So you know what would happen to adult medicine if we were forced to care for them for a small, finite amount if money?

you are so incredibly misinformed its scary. obamacare guts medicare to the tune of 500 BILLION dollars. Thats billion with a B. Most of that reduction comes in the form of reduced reimbursement to physicians. As it is, Medicare pays me about $17/unit, or less than a plumber makes coming to your house for a clogged toilet. Blue cross pays me about $65/unit. Do the math dumb*****.

Seriously, liberals are just ******ed.

 

[Perrotfish]

you are so incredibly misinformed its scary. obamacare guts medicare to the tune of 500 BILLION dollars. Thats billion with a B. Most of that reduction comes in the form of reduced reimbursement to physicians. As it is, Medicare pays me about $17/unit, or less than a plumber makes coming to your house for a clogged toilet. Blue cross pays me about $65/unit. Do the math dumb*****.

Seriously, liberals are just ******ed.

I think if you look at the policy as it was actually passed, you'll see that most of those supposed 'cuts' in the Medicare program (that 500 billion was over 10 years, BTW) were savings from basically getting rid of Medicare advantage, a program that passed a notoriously low percentage of government dollars along from the private insurers (which it paid directly) to the real providers who actually delivered the care. I suppose that you might lose a few customers with moderately higher reimbursement rates, but ultimately that's not an attack on your income so much as on the inefficency of paying the insurers to pay the customers for Medicare when the government can supply the insurance directly.


The supposed cuts to provider reimburesment are 100% theoretical and still in the offing. There is no passed legislation that actually cuts your pay. More importantly it goes back to a basic principle of supply and demand: when you dump more money into healthcare it means more money for the people in healthcare. In this case the legislation shuffles the deck a little, switching money from medicare to Medicaid, but it also infuses the healthcare industry with fresh cash: taxing top income earners and capital gains and dumping that money directly onto the underfunded medicaid market that the government already forces our hospitals to care for at an enourmous loss. However its arranged, ultimately more money is more money and less money is less money. ER doctors are a great example of the fungibility of hospital funds: they're some of the highest paid physicians in the hospital (relative to their hours worked) and yet they often work rooms that are operating at an enormous loss. When the money gets to the hospital it trickles back down to the practicioners

Now again, I'm not saying that the Obama administration isn't a risk for our profession. As many have pointed out, he's made no secret that he wants the upper income brackets to pay 'their fair share'. However Romney doesn't exactly want to shower top earners with riches either: he's said very little about the high tax rates on earned income, instead focusing on his lifelong mission to lower taxes on unearned income like investments and inherited estates, which is a modest benifit at best for physicians that start working late in life with high loads of debt. Tax cuts for those who actually work for a living seem a second priority at best for Romeny. Now that might still be a better deal vs Obama for a plastic surgeon working in a cash market, but for those of us working either directly for the government, accepting insurance from the government, or just working in a market with prices propped up by the government, it seem like the programs Romney wants to cut to get rid of the estate tax are worth much more to us than whatever nominal tax cut he might give us. The Rand plan, where medicare becomes a capped benifit, really would mean cutting healthcare spending to a fraction of what it is today. And I'm not sure Romney would have the political courage to keep congress from making you see the now unfunded hordes of perpetually emergent Medicare patients that his policy would create.

BTW, when you need obscenities to get your point across it generally doesn't make you like the well informed one.

 

[jwk]

you are so incredibly misinformed its scary. obamacare guts medicare to the tune of 500 BILLION dollars. Thats billion with a B. Most of that reduction comes in the form of reduced reimbursement to physicians. As it is, Medicare pays me about $17/unit, or less than a plumber makes coming to your house for a clogged toilet. Blue cross pays me about $65/unit. Do the math dumb*****.

Seriously, liberals are just ******ed.

I'm not sure where some of these students and residents are getting their info.

Surfer, you're correct of course. $17/unit means losing money in our group. That does not cover the cost of an anesthetist, much less an anesthesiologist, much less overhead.

 

[xf3rn4nd3sx]

The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government.

If my profession were subject to true free market forces, I would be making at least double what I make now. Neurosurgeons were guaranteed at least $2m in the 1980s and could literally pick any city they wanted. During this time, the number of neurosurgeons relative to population was greater than it is now. The number of residents may be manipulated, but it sure as hell hasn't benefited me or my salary. The shortage just means I work more hours. Government regulation just means my reimbursement is lower.

And please, if you would rather have some foreign doc remove your brain tumor or clip your aneurysm for pennies on the dollar, by all means go overseas to have your procedure done. The volume of other patients who would prefer to have a competently trained physician is more than enough for us to survive. Sure, if you completely open the markets we may get some good docs, but quality on average will go down.

Don't pretend the government isn't getting anything from me or that the government is currently doing me any favors.

 

[alpha2agonist]

Let us be perfectly clear, medicine has not worked under free market forces since.....well I do not know when did licensing start? We work in a govt sanctioned guild as do ALL medical fields. If I hear one more screed about market forces and medicine I will
1. Vomit
2. Shoot the ayn Rand brainwashed idiot that spouts this...or myself whichever is closer.

 

[xf3rn4nd3sx]

It increases how many people it covers (doubles that) and drastically increases how much it pays (reimbursements must match Medicare).

Wow, setting the bar so high there. There is a reason many physicians are no longer willing to accept new medicare patients. There is actually a net loss on many procedure (aneurysm coiling for example) due to medicare's poor reimbursement.

Let us be perfectly clear, medicine has not worked under free market forces since.....well I do not know when did licensing start? We work in a govt sanctioned guild as do ALL medical fields. If I hear one more screed about market forces and medicine I will
1. Vomit
2. Shoot the ayn Rand brainwashed idiot that spouts this...or myself whichever is closer.

I'm assuming that you're referring to me in which case I was responding to Perrotfish's claim that free market forces would reduce physician compensation.

 

[yappy]

I think we can all look to many fields that are much less technical or require as much training/expertise that do very well without "government protections". In many other fields the demand is also alot more elastic than medical services. This to me suggests that on a free market physicians could clean up.

"Here liberal, liberal, liberals. Here liberal, liberal, liberal." They're like conditioned dogs praising their government master.

 

[Gern Blansten]

If I hear one more screed about market forces and medicine I will
1. Vomit
2. Shoot the ayn Rand brainwashed idiot that spouts this...or myself whichever is closer.

 

[Gern Blansten]

2. Shoot the ayn Rand brainwashed idiot that spouts this...or myself whichever is closer.

I will assume that you are closer to yourself than I am, so...it would be nice if just let market forces determine things in medicine. Go Ayn Rand!!

Make sure you keep your promise...

 

[powermd]

you are so incredibly misinformed its scary. obamacare guts medicare to the tune of 500 BILLION dollars. Thats billion with a B. Most of that reduction comes in the form of reduced reimbursement to physicians.

Misleading. The law cuts further increases over 10 years, it doesn't "gut" Medicare as it currently exists.

http://www.politifact.com/new-jerse...garrett-claims-affordable-care-act-raidts-me/

"Because of changes in the law, growth in Medicare spending over 10 years will be more than $500 billion less than had been projected, according to estimates from the nonpartisan Congressional Budget Office and the Centers for Medicare and Medicaid Services.

That reduction -- the biggest portion of which comes from cutting annual increases in Medicare payments to medical providers -- will help offset other costs in the law.

Still, over the same decade, Medicare spending will increase."

 

[powermd]

If my profession were subject to true free market forces, I would be making at least double what I make now.

Dream on.

 

[yappy]

Hi doctor. what's going on with me?

You have a brain tumor that I can surgically remove.

How much does it cost?

What is your credit like & do you own a home or any other assets?

.....


I think a neurosurgeon would do well on a the free market. I would give all my material assets to go from terminal to healthy again. Or at least have a shot. You cannot take anything to the grave.

 

[pgg]

I think a neurosurgeon would do well on a the free market. I would give all my material assets to go from terminal to healthy again. Or at least have a shot. You cannot take anything to the grave.

That's a pretty f'd up way to run a country's healthcare system. Getting sick shouldn't be a bankrupting event. And getting sick shouldn't be a profit opportunity for the healthcare machine.