Why would anyone go into primary care nowadays?

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tdram said:
I'm talking about reality. In America of all places, there's no excuse for being in a minimum wage job your whole life. Look at Asian immigrants. They came here from halfway around the globe, not even knowing the language, not knowing the culture, having no connections, having no idea how the system works, being discriminated against heavily throughout history, and they have risen up to become among the most successful people in this country. That itself proves that if you work hard enough, you can succeed here.
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Well I was with you until you started talking about Asians as having "proven" anything.

But this isn't about what any individual can achieve. Not by a long shot. And I sure as heck never said that effort is worthless.

I too am talking about reality, and the reality is that millions of Americans - actual human beings who are citizens of the same states and country as us - don't have access to medical care for various reasons. You're fine with letting them not have care. I think it's shameful that America, the greatest and most prosperous country in the world, is so willing to let that situation continue indefinitely.
 
@jonnythan if you find this system shameful and want to provide care for everyone, feel free to do it. but why are you insisting that those of us who don't share your views be forced to pay for this by increasing our taxes? This is the real problem that I have.
 
tdram said:
@jonnythan if you find this system shameful and want to provide care for everyone, feel free to do it. but why are you insisting that those of us who don't share your views be forced to pay for this by increasing our taxes? This is the real problem that I have.
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Bc everyone must fund his pet project.
 
tdram said:
@jonnythan if you find this system shameful and want to provide care for everyone, feel free to do it. but why are you insisting that those of us who don't share your views be forced to pay for this by increasing our taxes? This is the real problem that I have.
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Same reason everyone is forced to fund DHS, corn subsidies, military intervention in Iraq, the Ed, subsidized undergraduate loans, etc.
 
jonnythan said:
Same reason everyone is forced to fund DHS, corn subsidies, military intervention in Iraq, the Ed, subsidized undergraduate loans, etc.
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What makes you think I want to fund those things? I'm only doing so because if I don't, I'll end up in jail. That's not a good reason to force me to fund more things I don't want to.
 
tdram said:
What makes you think I want to fund those things? I'm only doing so because if I don't, I'll end up in jail. That's not a good reason to force me to fund more things I don't want to.
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Never said you did. I don't want to fund most of those things either. But we do.
 
jonnythan said:
Never said you did. I don't want to fund most of those things either. But we do.
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Just because we do, doesn't make it right. Forcing people to pay for something they don't want to just isn't right. There are very few cases that you might make an argument for that, like military or police protection, but in the vast majority of examples including the ones you pointed out, there is no reason that we all have to be responsible for paying for those things. I'm all for smaller government and less taxation.

You're making it worse by proposing that we fund even more things we don't want to.
 
tdram said:
Just because we do, doesn't make it right. Forcing people to pay for something they don't want to just isn't right. There are very few cases that you might make an argument for that, like military or police protection, but in the vast majority of examples including the ones you pointed out, there is no reason that we all have to be responsible for paying for those things. I'm all for smaller government and less taxation.

You're making it worse by proposing that we fund even more things we don't want to.
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The reason is that if we aren't forced to fund those things through taxation, then they simply don't happen. I think that basic medical care is one of those things that we need to make sure happens.
 
DermViser said:
So it makes sense then to add onto that list?
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There are some things that we should take off the list, and there are some things that we should add to the list.

Surely it's not earth-shattering that someone has the opinion that the list of things funded by taxes should be changed.
 
jonnythan said:
The reason is that if we aren't forced to fund those things through taxation, then they simply don't happen. I think that basic medical care is one of those things that we need to make sure happens.
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No, if you can't find enough people to pitch in voluntarily to make that happen, it means it's not meant to happen. The answer isn't to force people into paying for things they don't want because you happen to think it's right.
 
tdram said:
No, if you can't find enough people to pitch in voluntarily to make that happen, it means it's not meant to happen. The answer isn't to force people into paying for things they don't want because you happen to think it's right.
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It's happened in other countries. I don't think it's going to happen here any time soon. The idea that it's "meant to happen" or "not meant to happen" is silly.

It's also pretty clear that we disagree on whether it's right to use tax dollars to fund medical care for people who can't afford it themselves. The funny part is that things are going more in that direction than not, with the recent Medicaid expansion happening in many states.
 
jonnythan said:
It's happened in other countries. I don't think it's going to happen here any time soon. The idea that it's "meant to happen" or "not meant to happen" is silly.

It's also pretty clear that we disagree on whether it's right to use tax dollars to fund medical care for people who can't afford it themselves. The funny part is that things are going more in that direction than not, with the recent Medicaid expansion happening in many states.
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All I'm saying is, don't force people who don't want it, to pay for it. It's that simple. I really don't care that you or however many other people want it and think it's right. I also really don't care however many other countries managed to force their citizens to pay for it. We shouldn't be doing that. If that means it can't happen, tough luck.

I'd much rather provide free medical care on my own to people who can't afford it (and I fully intend to do so as much as I can afford to), than hand it over to a government bureaucrat who will inevitably use the vast majority of it to feed the salaries of overpaid, inefficient government employees. Very little of our money actually ends up helping poor people. Have you ever rotated at the VA? If not, I'd like to tell you a few stories about how they spend tax dollars.
 
tdram said:
All I'm saying is, don't force people who don't want it, to pay for it. It's that simple. I really don't care that you or however many other people want it and think it's right. I also really don't care however many other countries managed to force their citizens to pay for it. We shouldn't be doing that. If that means it can't happen, tough luck.

I'd much rather provide free medical care on my own to people who can't afford it (and I fully intend to do so as much as I can afford to), than hand it over to a government bureaucrat who will inevitably use the vast majority of it to feed the salaries of overpaid, inefficient government employees. Very little of our money actually ends up helping poor people. Have you ever rotated at the VA? If not, I'd like to tell you a few stories about how they spend tax dollars.
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The VA is single payer medicine to the letter. Want to know how single payer will look like? See the VA.
 
tdram said:
All I'm saying is, don't force people who don't want it, to pay for it. It's that simple.
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I know that's what you're saying. You've made that very clear.

All I'm saying is that I disagree with that. There are things worth forcing people to pay for; we all agree on that. Where we disagree is whether basic medical care is one of those things.
 
jonnythan said:
I know that's what you're saying. You've made that very clear.

All I'm saying is that I disagree with that. There are things worth forcing people to pay for; we all agree on that. Where we disagree is whether basic medical care is one of those things.
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Let's also not forget that the government is not run by selfless individuals who only exist to ensure that everyone gets equal access to care. They pay lip service to that stuff, but in the end their motivation is no different than any corporate person. Take a look at how much waste there is in government. How many people are given jobs who don't really do anything of importance, just because someone had to do a favor to somebody who contributed or supported their campaign. Politics is full of that stuff. Not to mention how much we actually spend on politicians themselves. If they really are selfless people, why do they live like Kings when they're in office?

They also don't think too long-term, because politicians have a set end-date to their terms. Why would the politician care if the decisions he makes today causes trouble 20 years from now when he's no longer eligible for election.

The problem with taxes is that we can't just decide to stop paying them if we're unhappy with how they're being used, because the government has the authority to use violence on us if we don't comply. For this reason we should keep them as minimal as possible.
 
tdram said:
Let's also not forget that the government is not run by selfless individuals who only exist to ensure that everyone gets equal access to care. They pay lip service to that stuff, but in the end their motivation is no different than any corporate person. Take a look at how much waste there is in government. How many people are given jobs who don't really do anything of importance, just because someone had to do a favor to somebody who contributed or supported their campaign.

They also don't think too long-term, because politicians have a set end-date to their terms. Why would the politician care if the decisions he makes today causes trouble 20 years from now when he's no longer eligible for election.
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I work in government, and I know how true all of that is.
 
jonnythan said:
I work in government, and I know how true all of that is.
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So you should know how dangerous it is to keep giving the government more and more of our money, then? And that the government isn't the best solution to ensure everyone has equal access to anything?
 
jonnythan said:
I work in government, and I know how true all of that is.
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And yet you wish for the number one thing: Healthcare to be in its control, with care rationed, influenced by political considerations. Fantastic.
 
tdram said:
So you should know how dangerous it is to keep giving the government more and more of our money, then? And that the government isn't the best solution to ensure everyone has equal access to anything?
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DermViser said:
And yet you wish for the number one thing: Healthcare to be in its control, with care rationed, influenced by political considerations. Fantastic.
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Yeah. Crazy, right? Government doesn't do anything well, that's for sure. That's why the only things I think government should do are the ones that absolutely can't be done any other way, and are worth doing.

This is one of those things. There really are no alternative ways to accomplish it.
 
jonnythan said:
Yeah. Crazy, right? Government doesn't do anything well, that's for sure. That's why the only things I think government should do are the ones that absolutely can't be done any other way, and are worth doing.

This is one of those things. There really are no alternative ways to accomplish it.
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Yes, there actually is another way and there are alternatives. Leaving the govt. out of it. You acknowledge it doesn't do anything well and yet you're more than happy to turn all of healthcare over to it.
 
jonnythan said:
Yeah. Crazy, right? Government doesn't do anything well, that's for sure. That's why the only things I think government should do are the ones that absolutely can't be done any other way, and are worth doing.

This is one of those things. There really are no alternative ways to accomplish it.
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I don't believe that's true. Defaulting on the government to solve the problem is probably the worst possible thing you can do. Our culture just is not going to tolerate the kinds of sacrifices you have to make to have a single-payer system. You'll have riots the first time care rationing is implemented. Americans just don't sit back and take these things. Americans are loud, angry, and complain about virtually everything, even the tiniest of annoyances. People in other countries just aren't like that.
 
DermViser said:
Yes, there actually is another way and there are alternatives. Leaving the govt. out of it. You acknowledge it doesn't do anything well and yet you're more than happy to turn all of healthcare over to it.
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What alternative way is there to ensure that everyone has access to basic medical care? Or did you mean that the alternative is not doing so?
 
jonnythan said:
What alternative way is there to ensure that everyone has access to basic medical care? Or did you mean that the alternative is not doing so?
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I think you can get much closer by 1) reducing government regulatory burden in healthcare leading to costs lowering and more people being able to afford care 2) reforming the legal system to decrease liability, also greatly lowering costs 3) incentivizing the private sector to provide care to those who can't afford it 4) helping non-profit organizations to provide more care to the poor.

Don't throw more money into the pots of the government bureaucrats.
 
DermViser said:
Yup. Money is overflowing in the U.S. Just look at our budget. But who needs that when you have a pet project to fund?
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Name something the US is currently #1 at besides military spending and our deficit.

(Seriously I'd like to know)




MD Class of 2017
 
tdram said:
I think you can get much closer by 1) reducing government regulatory burden in healthcare leading to costs lowering 2) reforming the legal system to decrease liability 3) incentivizing the private sector to provide care to those who can't afford it 4) helping non-profit organizations to provide more care to the poor.
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1) Sounds like a good idea to me.
2) Sounds like a good idea to me.
3) Sounds vague. How would you do this, and what evidence is there that this would ensure everyone would actually receive basic health care?
4) Helping in what way? With tax dollars?
 
jonnythan said:
1) Sounds like a good idea to me.
2) Sounds like a good idea to me.
3) Sounds vague. How would you do this, and what evidence is there that this would ensure everyone would actually receive basic health care?
4) Helping in what way? With tax dollars?
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You and all the people who believe everyone should get care should make a point to only patronize companies that give out free care. Keeping customers happy is what companies exist to do. You can also encourage everyone to donate to non-profits, and donate generously yourself.

We need a cultural shift whereby enough people agree with you to put their money where their mouth is. On the other hand, if it turns out the vast majority of Americans don't agree with you, then should we even be doing this? This is a democracy isn't it?

Of course it won't ensure everyone will recieve care, but it will go farther than the government's plan of expanding Medicaid, which most providers will not even accept, thus making it futile.
 
jonnythan said:
Just going to ignore the actual questions?
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I think the first problem we have is you still haven't clearly defined what you mean by "basic medical care". A free first aid kit could qualify as "basic care" for all I know.
 
jonnythan said:
I guess the answer is "yes."

Let's define "basic care" as "whatever the NHS provides."
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Our population does not want what the NHS provides, trust me. If you've actually lived in the UK you'll know why.
 
LOL you guys are arguing with some DO who instantly labels any rational or thoughtful ideas as "pandering" to someone. I'm far from a staunch conservative, but one could easily argue that this guy is pandering to the far left.
First, nobody leaves people "without care." If you've ever stepped foot inside an academic institution, you would realize that charity care and discounts are rampant and that the vast majority of hospitals knowingly/willingly lose money by serving indigent populations (whether it's Columbia/Mt. Sinai in East Harlem, or a community hospital in the middle of nowhere). Just recently I was shadowing a physician who got charity care for a spinal decompression for a guy without insurance who is constantly in pain. This is not a rare occurrence. No one is just kicking people aside in a ruthless and thoughtless manner that you're describing.

Second, Asian American applicants provide powerful evidence that you can achieve anything you want via hard work. All this talk about the SAT/MCAT disadvantaging non white American WASPs is complete BS because many of these Asian applicants who decimate those exams are very culturally removed from white America (even more so than minority Americans). Obviously, not everyone is poor because they are lazy/careless but a bit of hard work and determination can go a long way.
 
Greenberg702 said:
LOL you guys are arguing with some DO who instantly labels any rational or thoughtful ideas as "pandering" to someone. I'm far from a staunch conservative, but one could easily argue that this guy is pandering to the far left.
First, nobody leaves people "without care." If you've ever stepped foot inside an academic institution, you would realize that charity care and discounts are rampant and that the vast majority of hospitals knowingly/willingly lose money by serving indigent populations (whether it's Columbia/Mt. Sinai in East Harlem, or a community hospital in the middle of nowhere). Just recently I was shadowing a physician who got charity care for a spinal decompression for a guy without insurance who is constantly in pain. This is not a rare occurrence. No one is just kicking people aside in a ruthless and thoughtless manner that you're describing.

Second, Asian American applicants provide powerful evidence that you can achieve anything you want via hard work. All this talk about the SAT/MCAT disadvantaging non white American WASPs is complete BS because many of these Asian applicants who decimate those exams are very culturally removed from white America (even more so than minority Americans). Obviously, not everyone is poor because they are lazy/careless but a bit of hard work and determination can go a long way.
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This is unbelievably well said. I rest my case. Thanks for a spirited debate!
 
jonnythan said:
I *knew* you would come up with something the NHS misspent money on.
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Misspent? Who decided that it was "misspent"? You?

You just said: Let's define "basic care" as "whatever the NHS provides." This is something that the NHS provides. Period. And there are other examples.
 
sb247 said:
in fairness, you used them as the barometer of "basic medical care"
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That's what happens when you allow the govt. to decide what is basic medical care. It's affected by politics and lobbying.
 
Americans exhaustively research what sorts of things their private insurance companies pay out on, and choose only companies that do not pay for procedures such as the one mentioned.

Oh, wait. No one does that, because even if they wanted to they can't.
 
jonnythan said:
Americans exhaustively research what sorts of things their private insurance companies pay out on, and choose only companies that do not pay for procedures such as the one mentioned.

Oh, wait. No one does that, because even if they wanted to they can't.
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There is this thing called "Explanation of Benefits" that every plan has before you start paying premiums on a health insurance plan. At least if you're going to lie, try harder to conceal it better.
 
DermViser said:
There is this thing called "Explanation of Benefits" that every plan has before you start paying premiums on a health insurance plan. At least if you're going to lie, try harder to conceal it better.
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Yes, that's the contract you have with the insurance company. Who knows what they're actually paying out for other people such as their friends? Who knows what claims they're actually approving?

The benefit of that sort of thing getting publicity is that some Congresscritters could campaign on a platform of cutting frivolous payouts such as this, and actually do it. Not much you can do about your insurance company when you don't know what sort of frivolous claims they're paying out.

But that's besides the point. Government intervention to ensure universal care would suck, but IMO it would suck less than the alternatives.
 
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