Of course, and I've been clear. Things cost money and those with more money can choose to pay for more/better things. That's not a new proposal.
So you're saying no scientific evidence. I'm pretty sure we've all (hopefully) been trained that anecdotes don't equal scientific support, especially given our nature towards negative bias.
I certainly have a negative bias about the notion that people have a right to my wallet. That's accurate
I think we're really discussing the end reaction to the patient's behavior as opposed to why they chose their behavior. Frankly, from an economics standpoint, I don't think the "why" matters even a little bit. The "why" can matter in terms of motivational interviewing and patient counseling but none of it means their neighbor owes them health care. That last few words is the part that really is the big diversion of opinions
I think that maybe I could get behind these principles if everybody in this country were born into equal circumstances, but that is simply not true.
we do agree that everyone has a very different starting point in life, despite the same legal access to economic possibility in the US there is definitely a different starting place
That's adorable.I think if your metric is "do all people make the most coldly logical BEST decision?". Of course not, hell no. Some people are dumb, some people simply have different values, some have different life responsibilities, etc etc
cool, let's have that specific discussion then. Explain what legal accesses are different, maybe you'll win a legislative supporter to a portion of your belief system
and that's a fair point. I always though the deterrent argument was a poor one anyway. The best argument against the death penalty is an incompetent justice system being trusted to get it right. If I trusted prosecution/judges more, I'd be really ok with the death penalty because "that's what you get when you act like that".....but alas, that's not what we have
I would likely enjoy that conversation very much (maybe moreso as we got deeper into the scotch).
I think this same argument could easily be applied to your position in this thread.
It's something I do often with a good buddy here who has some fairly opposed viewpoints, though he doesn't like liquor, so I drink the scotch and he sticks to the beer.
if the govt was forcing bad health on people, I might agree.
There are lots of factors outside of genetics and decision-making that affect our health, like ses, education, random accidents, etc., many of which the government has contributed to.
at this point everyone with basic level intelligence/health has the ability to prop their kids up a rung further on the economic ladder, at some point we have to stop assuming it is govts job to fix everyone
I can't speak to the field as a whole, but in my niche area, the state Medicaid plans (about 90% of my clients) are the easiest to work with in terms of authorizations and coverage. Less runaround, and less denials than commercial plans (that are all, ultimately, overturned after extra work and lots of upset parents). Reimbursement rates are comparable.
your lateral move notion is simply not true. There is pretty good class mobility from generation to generation in the states
they only do that because emtala means they buy a ton of those braces they'll never get paid for and because certificate of need laws give them a local monopoly by restricting competition, govt caused those problems
Your Randian thinking about health systems is interesting.
We all like profit. I'd gladly charge 5 times what I do now for my time if customers would still show up. One of the ways that gets avoided is a market that provides enough competition to keep me from being able to do so.
www.brookings.edu
We went through the mobility of folks by quintile of income given their parent's quintile in another thread last year. Lowest quintile parents have a more than 50% of going up a quintile. Mobility is there if you work it"Most Americans born in 1940 ended up better off, in real terms, than their parents at the same age. Only half of those of those born in 1980 have surpassed their parent’s family income." There's also a strong relationship between income of parents and income of children, which sort of goes against the upward mobility argument. Absolute social mobility has also actually been declining, and mobility varies by ethnic group.
A good summary with graphics of some of Chetty's findings:
Raj Chetty in 14 charts: Big findings on opportunity and mobility we should all know | Brookings
[author-bio] Few scholars make as big an impact on their field as Professor Raj Chetty. As leader of the Equality of Opportunity Project, and with access to (anonymised) tax records, Chetty and his co-authors have transformed our understanding of social mobility in the U.S. Among the many...
Other data:
Americans’ occupational status reflects the status of both of their parents
Occupational status persists across generations in the United States to a degree incompatible with the popular theme of “land of opportunity.” Data from 1994–2016 show that median occupational status rose 0.5 point for every one-point increase in parents’ status (somewhat less if the father was...www.pnas.org
regression to the mean?
A rose by any other name. Still mobility
Upper quintile did tend to move down (but admittedly this was income, not assets)
"Most Americans born in 1940 ended up better off, in real terms, than their parents at the same age. Only half of those of those born in 1980 have surpassed their parent’s family income." There's also a strong relationship between income of parents and income of children, which sort of goes against the upward mobility argument. Absolute social mobility has also actually been declining, and mobility varies by ethnic group.
A good summary with graphics of some of Chetty's findings:
Raj Chetty in 14 charts: Big findings on opportunity and mobility we should all know | Brookings
[author-bio] Few scholars make as big an impact on their field as Professor Raj Chetty. As leader of the Equality of Opportunity Project, and with access to (anonymised) tax records, Chetty and his co-authors have transformed our understanding of social mobility in the U.S. Among the many...
Other data:
Americans’ occupational status reflects the status of both of their parents
Occupational status persists across generations in the United States to a degree incompatible with the popular theme of “land of opportunity.” Data from 1994–2016 show that median occupational status rose 0.5 point for every one-point increase in parents’ status (somewhat less if the father was...
you find it more beneficial to tell people they are victims of circumstance that can never change their lot in this country? Nope, I'm not doing that
Your complete and intentional misstating of my point further demonstrates your death grip on your ideals. I am sure it serves some function to you. And as psychologists, we all know the proper approach with which to challenge those kinds of beliefs.
I'm aware of the patterns. My apologies for the imprecise speech
WOrking one’s tail off for 20 yrs while making reasonable financial decisions does afford one some advantages in life, “privilege” wouldn’t be my word choice
No one owes me an mri any more than they owe my food, shelter, or a car. I don’t have a right to demand goods/services from others
