Premeds: Do you believe access to healthcare is a right or a privilege?

[VneZonyDostupa]

VneZonyDostupa,

what are you talking about? at one point, all of the US was is support of slavery. It took a VERY long time (hundred plus years) for slavery to end in the north.

New Jersey was the last northern state to officially end slavery, in 1804. That's roughly 30 years after the nation was founded (1776). One hundered plus does not equal thirty. Come to think of it, slavery officially ended nationwide in 1865, not even 100 years after our nation was founded.

What was your point, again?

Civil war? why are you suggesting the civil war? is there no US history before then? my my, you are a silly goose.

I addressed this above.

To claim it as a right is to suggest you can demand at your will. It is not your right to demand a service from another.

I claim healthcare is a right of every citizen. Thus, every citizen should be able to go to a government hospital and receive adequate (not VA-grade) treatment for emergent or life-altering/threatening conditions. No where in this statement is it implied that you could approach a doctor and demand he treat you, unless he works in such a facility. Get it now?

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[Retsage]

You guys are playing a game of semantics, and the problem is that no two people are defining "right" in the same way.

If your house is on fire, is it a right or a privilege for the firefighters to come out? If you are raped, is it your right or a privilege for you to have the police investigate it?

I'd say that we live in a society where we have created a social contract. We pay our taxes and the government gives us these rights. Now, you can call them privileges, but, quite frankly, there is no right that you cannot call a privilege by just playing semantics with it.

 

[PreMedPrincess]

No cure is free. Everyone pitches in. Just because you cannot afford an HIV pill because you flip burgers in In-N-Out, does not mean you should not get the treatment. Believe it or not, being a physician or other well-off professional is a privilege afforded by few. To the lower-class you refer to, the idea that I can become a doctor is almost non-existent. UH would work if you deduct $ from payroll taxes (like we do for social security now) based on income. If you do not make enough (say <$30K), the government picks up this fee.

Prevention is the best form of medicine, and I agree that we should be putting more resources into it.



Medicare covers A LOT. If you are not happy with your doctor, you can just go to another one. And you can repeat this as many times as you want. In 1965, Medicare, Medicaid, and Social Security (MMS) spending averaged only 28 percent of per capita income; in 1980 it was 63; today it is 79; and in 2030, it is predicted to be 91% due to the baby-boomers. To put this in perspective, in 2030, the MMS benefit (per year) will be $50,540 in today's dollars . In other words, the government is spending $50K per year on every medicare enrollee (~77 million baby-boomers in 2035). This will total to just above 20% of our GDP! Will we be able to afford this? Absolutely not.

Ref: Kotlikoff 'Healthcare Fix'

Universal Healthcare can work. You have to remember the type of consumers we are dealing with, however. Alot of people will forego health-insurance for that new car or that east-euro vacation they've been wanting to have.

The problem with making things universal is that it is completely in the wrong direction of capitalism, and the economy will be hit harder than it already has. The competition is was drives this country. To take that away will only create another handicap.

 

[PreMedPrincess]

You guys are playing a game of semantics, and the problem is that no two people are defining "right" in the same way.

If your house is on fire, is it a right or a privilege for the firefighters to come out? If you are raped, is it your right or a privilege for you to have the police investigate it?

I'd say that we live in a society where we have created a social contract. We pay our taxes and the government gives us these rights. Now, you can call them privileges, but, quite frankly, there is no right that you cannot call a privilege by just playing semantics with it.

best post thus far.

 

[PreMedPrincess]

New Jersey was the last northern state to officially end slavery, in 1804. That's roughly 30 years after the nation was founded (1776). One hundered plus does not equal thirty. Come to think of it, slavery officially ended nationwide in 1865, not even 100 years after our nation was founded.

What was your point, again?



I addressed this above.



I claim healthcare is a right of every citizen. Thus, every citizen should be able to go to a government hospital and receive adequate (not VA-grade) treatment for emergent or life-altering/threatening conditions. No where in this statement is it implied that you could approach a doctor and demand he treat you, unless he works in such a facility. Get it now?

taken from your trusted wiki:

Northern slave states
Significant dates VT PA MA NH CT RI NY NJ
European settlement 1666 1638 1620 1623 1633 1636 1624 1620
First record of slavery c.1760? 1639 1629? 1645 1639 1652 1626 1627
Official end of slavery 1777 1780 1783 1783 1784 1784 1799 1804
Actual end of slavery 1777 c.1845 1783 c.1845? 1848 1842 1827 1865


Universal healthcare will devalue medicine and cause it to remain fairly stagnant in terms of research and advancement. The lack of competition will also cause the quality of medical service to go down.

 

[VneZonyDostupa]

taken from your trusted wiki:

Can you show me where, on the chart you posted, is shows slavery ending over 100 years past our founding? I think you just disproved your original point.

Universal healthcare will devalue medicine and cause it to remain fairly stagnant in terms of research and advancement. The lack of competition will also cause the quality of medical service to go down.

Wow, you better tell Sweden, France, and England that. Those people would be so glad to know they are getting poor quality healthcare. Just because people have to wait (the wait times have actually been found to be comparable to those in the United States, often times), doesn't mean the quality of care is less.

 

[mdmarty]

The problem with making things universal is that it is completely in the wrong direction of capitalism, and the economy will be hit harder than it already has. The competition is was drives this country. To take that away will only create another handicap.

You are incorrect. Our current system cannot even support our medical expenditures! Per my previous post, by 2050, Medicare will not be possible. Period. Our economy will drop dead if we do not make a change.

Additionally, for-profit medical organizations have shown to not be any better than, and in some cases worse than, their non-profit counterparts. In fact, for profit medical organizations tend to be more expensive for the same level of care than non-for profit ones. See Relman A.S. 'A Second Opinion' chapter 2.

You see, traditional market economics does not apply well to medicine. Think about it, are you going to shop around to find the cheapest brain surgeon to cut out that neuroglioma? I bet that you'll be pleased when you find out that your surgeon is the most expensive in town. Before WWII, medicine was a profession, not an industry, as it is now.

 

[FutureInternist]

See post above.



I wasn't aware things could only be worked on in a linear fashion, rather than in tandem. And here I thought Congress could vote on more than one bill per term



Why would we need to?



Sad but true.

Me not so good with the multiple quoting thingamajig

My point about the food/shelter was MONEY. Since there is only a limited amount of it does it not make sense to spend it on food/shelter rather than medicine. Who knows, with proper nutrition, housing, immunisations there may be a decrease in childhood diseases/obesity & would actually create healthier individuals.
You can pass all the laws you want but you do have to find the money to pay for it.

 

[VneZonyDostupa]

My point about the food/shelter was MONEY. Since there is only a limited amount of it does it not make sense to spend it on food/shelter rather than medicine. Who knows, with proper nutrition, housing, immunisations there may be a decrease in childhood diseases/obesity & would actually create healthier individuals.
You can pass all the laws you want but you do have to find the money to pay for it.

Oh, I absolutely agree something needs to be done to improve the general health of our population, which is what Sweden did through social health promotion programs in schools and employers, to cut costs.

Also, more money would be generated by raising taxes 5-7% to match the low end of European rates, which most people wouldn't notice as they spend that much for inefficient private care already (you know, those companies that hire doctors to find ways NOT to pay for your care).

 

[mdmarty]

Universal healthcare will devalue medicine and cause it to remain fairly stagnant in terms of research and advancement. The lack of competition will also cause the quality of medical service to go down.

Gee, I guess that's why grad students slave away in labs late at night. That $25,000 stipend sure is generous.

 

[greg1184]

Neither a right nor a privilege. Nobody should get healthcare. That way the fittest genes will be passed on. It's all about Darwinism!!

Healthcare problem solved!

 

[Bradstein]

About 47.8%, part of which is paid by your employer. It's 12% higher than my current taxes, but I pay more than 12% of my income in healthcare costs with similar wait times for appointments (~30days).

What's your point?

Where'd you get that number for tax? Also, how can the employer "pay" your taxes, doesn't that count as additional income, which is also taxed?

For example, I'm sure that they have a more educated populace than we do here (thus their higher per capita GDP).

Wrong. CIA World Factbook lists the US GDP per capita as $45,800, and Sweden's as $36,500.

 

[Shaptown]

Premedprincess-
You are one of the most ignorant people I have ever observed. Not only have your arguments gone completely awry from the original topic, but you are proven wrong time and time again. I pray you do not get into med school so that you can see the health-care system from the ugly end; the end where you pay hundreds of thousands of dollars to treat a loved one who was developed aggressive cancer only to see them deteriorate and pass away. You have NO clue what you are talking about, put yourself in someone else's shoes for the FIRST time in your self-centered life.

 

[8744]

It's a right. Please don't go into this profession if you think otherwise.

Ah. Another convert to the Religion of Medicine.

 

[Lokhtar]

I don't think its a right. But it should be.

Absolutely, without a doubt. I've lived in a country with universal health care, and I wouldn't trade it for the US system. We'll definitely have to change some of the things, especially how much we spend on the very elderly and those with little chance of making it, but that's the price to pay to make sure those who can get better, are given the care to do so.

 

[8744]

I don't think its a right. But it should be.

Absolutely, without a doubt. I've lived in a country with universal health care, and I wouldn't trade it for the US system. We'll definitely have to change some of the things, especially how much we spend on the very elderly and those with little chance of making it, but that's the price to pay to make sure those who can get better, are given the care to do so.

So the elderly don't have the same rights as the young? Is it sort of a sliding scale of civil liberties.

 

[Lokhtar]

So the elderly don't have the same rights as the young? Is it sort of a sliding scale of civil liberties.

No, that's not what I mean. I mean that if you are 97 and your quality of life, or chance of surviving the next twelve months are almost non-existent - you shouldn't have two million dollars and ten specialists worth of medical care spent on you. On the other hand, if you are 35 and are afflicted with a condition where you have a chance of living a normal life with treatment, you should be higher on the totem pole in terms of receiving care.

It may sound harsh but there aren't an infinite amount of health dollars, and you have to ration it somehow.

 

[8744]

Read the rest of my post. Rights are paid for by taxes AND service. Even those who pay $0 in taxes serve jury duty, register for the selective service, vote (voting is a service, yes), and generally contribute to society.

Oh man. You don't get out much. I have legions of patients who contribute nothing to society at all. Absolutely nothing. Less than nothing because they are a huge drain on the public treasury and will be for their whole lives.

And if registering to vote and for selective service, both low-risk behaviors because you can do the first when you apply for food stamps and can ignore the seconds because we don't have a draft, is all that you think qualifies you as a productive citizen, you have set the bar really, really low.

Besides, any fool can vote. Many of my patients can't even find our state on a map or name their governor and their votes count the same as mine and yours.

 

[8744]

No, that's not what I mean. I mean that if you are 97 and your quality of life, or chance of surviving the next twelve months are almost non-existent - you shouldn't have two million dollars and ten specialists worth of medical care spent on you. On the other hand, if you are 35 and are afflicted with a condition where you have a chance of living a normal life with treatment, you should be higher on the totem pole in terms of receiving care.

It may sound harsh but there aren't an infinite amount of health dollars, and you have to ration it somehow.

So we're rationing rights based on economics?

 

[Lokhtar]

You don't have the right to every single test in existence....if that is what you are asking.

We, as a society, need to decide how much we want to spend, and then decide how we are going to distribute those dollars to achieve the best results. Right now, we are already spending more than any other country - the difference is that the way those dollars are spent is completely ridiculous and inefficient in terms of ensuring the best health for the most amount of people. Basically, a 35 year old is denied chemo once his insurance reaches its 'max' limit, but a 97 year old is kept on life support for years on end. To me, that's not a good system.

We decide to do the same for many other 'rights', such as police protection, or national defense.

 

[VneZonyDostupa]

And if registering to vote and for selective service, both low-risk behaviors because you can do the first when you apply for food stamps and can ignore the seconds because we don't have a draft, is all that you think qualifies you as a productive citizen, you have set the bar really, really low.

Besides, any fool can vote. Many of my patients can't even find our state on a map or name their governor and their votes count the same as mine and yours.

Not everyone has a doctorate, but you don't seem to realise that. Sure. some people may seem like a waste of space to you, but then, you're incredibly condescending. If someone is a functioning member of society, that is, they don't prevent the working of society, regardless of whether they draw welfare or note, why shouldn't they be entitled to the benefits of being a citizen?

 

[jult24er]

Receiving healthcare requires that someone else took the time and effort to learn medicine and then takes the additional effort to use that knowledge in giving care. Someone can not have a universal right to healthcare, then, unless they are allowed to force someone else's behavior. It is impossible to believe both healthcare and the freedom to make choices regarding one's own life are universal human rights. I think most people would go with the latter.

Thats not to say that, in a society as wealthy as ours, we couldnt figure out a way to provide everyone with health insurance without forcing anyone to give care ... but it is a human right? I think no.

 

[Lokhtar]

Is it a right to have police protection? I'd say yes. Someone else has to be trained and provide that too.

Or perhaps the better way to put it is, like policework, healthcare is one of the services that is expected to be provided by the state.

 

[Chocolate Bear]

You don't have the right to every single test in existence....if that is what you are asking.

We, as a society, need to decide how much we want to spend, and then decide how we are going to distribute those dollars to achieve the best results. Right now, we are already spending more than any other country - the difference is that the way those dollars are spent is completely ridiculous and inefficient in terms of ensuring the best health for the most amount of people. Basically, a 35 year old is denied chemo once his insurance reaches its 'max' limit, but a 97 year old is kept on life support for years on end. To me, that's not a good system.

We decide to do the same for many other 'rights', such as police protection, or national defense.

 

[jult24er]

Is it a right to have police protection? I'd say yes. Someone else has to be trained and provide that too.

Or perhaps the better way to put it is, like policework, healthcare is one of the services that is expected to be provided by the state.

Hmm, tough one, it's a human right not to be coerced, but does that mean i have to spend my life providing police protection? i guess if you want your human rights protected, you have to be willing to protect others', so people choose to provide protection, they dont have to be forced.

If you believed there was some natural state where people did not coerce each other, so only because of society was there crime, then maybe the people who contol and benifit from society should be expected to provide police in exchange for the coercion exerted to run society, land rights, etc. I cant see a similar argument for healthcare, except maybe for certain cases, say cancer from pollution.

 

[Greonis]

No, that's not what I mean. I mean that if you are 97 and your quality of life, or chance of surviving the next twelve months are almost non-existent - you shouldn't have two million dollars and ten specialists worth of medical care spent on you. On the other hand, if you are 35 and are afflicted with a condition where you have a chance of living a normal life with treatment, you should be higher on the totem pole in terms of receiving care.

It may sound harsh but there aren't an infinite amount of health dollars, and you have to ration it somehow.

I completely agree. A major problem with modern healthcare is that as a country, we can't seem to come to terms with the notion that there comes a time when medicine can do no more and it is better to let someone pass on naturally. Someone is not "alive" if their mind is gone and they have no hope beyond being a shell that eats and breathes. BILLIONS of healthcare dollars are spent on sustaining these people. Why? Many reasons, but the two primary ones are the "climate of fear" and our ignorance-driven political correctness.

Solution? I believe that we as a nation need to be educated about end-of-life care. Family members of individuals whose quality of life is zero should be taught that it is normal for people to pass on and that keeping such people alive only wastes money and prolongs familial agony/stress. Doctors should be able to make decisions for these patients not based on maximizing their profits or avoiding a lawsuit, but rather determining if the patient can still live a good life and if a treatment will benefit the patient at all. Because (to cite an example) there's generally not a whole lot that a doctor can do when a 90-year-old with no quality of life comes in to the ER with "dizziness." But, because of our climate, they'll get thousands of dollars in tests anyway and then discharged, only to come back a week later with the same problem (and thus receive the same costly tests).

It's not easy to face, and many people have chided me for "telling other people how to live their lives" after I share my beliefs. For that reason, I stress improved education. If people understood the system better and were more aware of how their loved ones were truly "living" in those nursing homes, then they could make better decisions for both themselves and their family members and it wouldn't be necessary to give them a dose of reality. If that were to happen, then healthcare costs would naturally be reduced and care would be more readily available for those that still have a quality of life at their disposal. Is this fair? No, of course not. But the fact is that our healthcare system needs a change, and changing our understanding of it is an essential way to get started.

 

[8744]

You don't have the right to every single test in existence....if that is what you are asking.

We, as a society, need to decide how much we want to spend, and then decide how we are going to distribute those dollars to achieve the best results. Right now, we are already spending more than any other country - the difference is that the way those dollars are spent is completely ridiculous and inefficient in terms of ensuring the best health for the most amount of people. Basically, a 35 year old is denied chemo once his insurance reaches its 'max' limit, but a 97 year old is kept on life support for years on end. To me, that's not a good system.

We decide to do the same for many other 'rights', such as police protection, or national defense.

Like someone said, it must be just semantics but in the United States, rights are those inalienable things that governments are instituted to secure. We're really slumming it when we work down from Life, Liberty, and the Pursuit of Happiness to the Right to Free Government Cheese and Public Housing.

Additionally, there is no need to "danger quote" the word "rights." Rights are ethereal things which exist independent of government and define what government is not allowed to do. "Free Medical Care" is a public service, like cheap buses and sewers.

We do actually occasionally cut the budget for police departments, the military, and many other public services. These things are not "rights" at all but, I repeat, public services upon which the taxpayers agree to expend money.

 

[Lokhtar]

We do actually occasionally cut the budget for police departments, the military, and many other public services. These things are not "rights" at all but, I repeat, public services upon which the taxpayers agree to expend money.

That is fair enough. I would put health care in this category, rather than the inalienable rights that the constitution protects the government from infringing on.

It is an essential service which should be provided by the government, rather than an inalienable right to a PET scan.

 

[8744]

Not everyone has a doctorate, but you don't seem to realise that. Sure. some people may seem like a waste of space to you, but then, you're incredibly condescending. If someone is a functioning member of society, that is, they don't prevent the working of society, regardless of whether they draw welfare or note, why shouldn't they be entitled to the benefits of being a citizen?

They should have the benefits of citizenship. But to call my typical 3AM chronic narcotic seeker a productive member of society is a stretch unless by productive you mean just breathing air and hanging around doing nothing. "Not preventing the working of society" is not the same thing as being a productive member of society.

Some of my patients also have criminal records and are, consequently, not eligible for Jury Duty.

 

[8744]

Is it a right to have police protection? I'd say yes. Someone else has to be trained and provide that too.

Or perhaps the better way to put it is, like policework, healthcare is one of the services that is expected to be provided by the state.

Well, that's different. If we agree to provide health care just provide it without getting all sanctimonious about it and calling it a right. Suppose ten years from now we come to our senses, slap ourselves in the head sheepishly and say, "Yikes, this 'right' is bankrupting the nation and most of what we are spending is bull**** anyways." How we gonna' curtail yer' stinking rights?

My friends, I see you all worship at the Church of Medicine which is more of a cult and from whose Koolaid vat you have imbibed deeply.

 

[VneZonyDostupa]

They should have the benefits of citizenship. But to call my typical 3AM chronic narcotic seeker a productive member of society is a stretch unless by productive you mean just breathing air and hanging around doing nothing. "Not preventing the working of society" is not the same thing as being a productive member of society.

Some of my patients also have criminal records and are, consequently, not eligible for Jury Duty.

Do they have a child? That's a public service, as that child may go on to be a tax-payer or public servant.

Do they perform community service, whether voluntarily or compulsary? That's a public service.

Do they ride public transit? Their dollar in the fare box helps pay the upkeep so that others can continue to ride, too.

Do they buy anything, legally or illegally? That cash flow contributes to the economy of a community.

My problem with you, Panda, is that you take the small fraction of someone's life that you observe and extrapolate that into some caricature of that person's entire existence. It's not that simple.

 

[Lokhtar]

Well, that's different. If we agree to provide health care just provide it without getting all sanctimonious about it and calling it a right. Suppose ten years from now we come to our senses, slap ourselves in the head sheepishly and say, "Yikes, this 'right' is bankrupting the nation and most of what we are spending is bull**** anyways." How we gonna' curtail yer' stinking rights?.

Then the solution would be to curtail the so called bull**** spending, especially things like end-of-life futile care, rather than withdrawing the service.

Yes, we are much more unhealthy than other countries, but, I'm sure you can estimate how much money would be saved if all we did was:

1. End futile overspending on end-of-life care for those with little chance of a good quality of life or prospects
2. Give FM/IM doctors the type of responsibilities that GPs in UK have (e.g, the ability to treat most conditions without using mostly cover-your-ass consults, except when they actually need them)
3. In case of frivolous law suits, the accuser must pay the court costs as well as the doctor's lawyer fees
4. Remove the bureaucracies associated with dealing insurance and all the paper work just to make sure you don't get sued

Can we completely get rid of all of the above? Probably not, but is it wrong to have a national conversation about the above and trying to do something about it while providing care to those who can benefit the most from the treatment (instead of CAT scan for every headache, and $2 million treatment X for 97 year old who is pretty much bed ridden and has no chance of ever standing up again)?

My friends, I see you all worship at the Church of Medicine which is more of a cult and from whose Koolaid vat you have imbibed deeply.

I think this is an unfair characterization, at least of my positions.

 

[8744]

Do they have a child? That's a public service, as that child may go on to be a tax-payer or public servant.

Do they perform community service, whether voluntarily or compulsary? That's a public service.

Do they ride public transit? Their dollar in the fare box helps pay the upkeep so that others can continue to ride, too.

Do they buy anything, legally or illegally? That cash flow contributes to the economy of a community.

My problem with you, Panda, is that you take the small fraction of someone's life that you observe and extrapolate that into some caricature of that person's entire existence. It's not that simple.

1. No, not generally, but one generation of freeloaders begets another and many of my patients churn out kids who in turn grow to contribute nothing to society.

2. No. they are totally selfish and perform no public service or any act for the public good whatsoever.

3. Yes, but we generally give them bus tokens so that dollar or two in the bus cash box comes out of your pocket. And they often call the ambulance for a free ride to the Emergency Department so one trip as it costs Medicare (the payer for their disability) five-hundred bucks essentially wipes out their contribution to public transit. Multiply this by twenty ambulance calls a year and you see the problem. If they have no public insurance the ambulance company of course just eats it.

4. Everything they buy comes from public money transferred to them in exchange for which they do nothing. May as well just take the money to the liquor store and hand it to the clerk...you know, to eliminate the middleman.

I would say that two or three of the twenty patients I see every shift fit this description. It is not a trivial problem and the cost of enabling this kind of behavior is immense.

 

[8744]

...I think this is an unfair characterization, at least of my positions...

No. No it's not. You, and almost everybody on the pre-med side of SDN, believe in medical care like foxes believe in chickens. That is, you think it's the central good of life without which existence is impossible. But medical care is mostly a waste of money for most people most of the time. I throw out arbitrary percentages every now and then but, while I am unsure as to the exact amount, I am perfectly sure that anywhere from fifty to eighty percent of all the money we spend in the United States on medical care is totally and utterly wasted. In other words, for every diabetic who we keep alive or every inflamed gallbladder that we remove, we have ten self-limiting complaints or chronic conditions being treated with expensive therapies and procedures the benefits of which may be only marginal or none at all.

And it's not just futile care although this surely contributes mightily to the problem. Programs like SCHIPs are also mostly a waste of money and a tremendous scam whereby hospitals all over the country have built "Childrens Hospitals" and Pediatric Emergency Departments (nothing more really than Urgent Care) to reap the rich federal bounty.

 

[Lokhtar]

No. No it's not. You, and almost everybody on the pre-med side of SDN, believe in medical care like foxes believe in chickens. That is, you think it's the central good of life without which existence is impossible. But medical care is mostly a waste of money for most people most of the time. I throw out arbitrary percentages every now and then but, while I am unsure as to the exact amount, I am perfectly sure that anywhere from fifty to eighty percent of all the money we spend in the United States on medical care is totally and utterly wasted. In other words, for every diabetic who we keep alive or every inflamed gallbladder that we remove, we have ten self-limiting complaints or chronic conditions being treated with expensive therapies and procedures the benefits of which may be only marginal or none at all.

And yet, I don't really disagree with you on this....

Curtailing wasteful spending should definitely be a major goal.

 

[45408]

It's a privilege. If it were a right, IMO, we'd need to provide hospitals all across the country, transportation for anyone/everyone to and from these hospitals, and pay to staff them at all times.

 

[45408]

They should have the benefits of citizenship. But to call my typical 3AM chronic narcotic seeker a productive member of society is a stretch unless by productive you mean just breathing air and hanging around doing nothing. "Not preventing the working of society" is not the same thing as being a productive member of society.

Some of my patients also have criminal records and are, consequently, not eligible for Jury Duty.

Or voting, for that matter.

Do they have a child? That's a public service, as that child may go on to be a tax-payer or public servant.

Wow. That child MAY also go on to become a criminal that will be in prison to the tune of thousands of dollars a month, possibly for the rest of their life.

 

[amph119]

Do they have a child? That's a public service, as that child may go on to be a tax-payer or public servant.

Do they perform community service, whether voluntarily or compulsary? That's a public service.

Do they ride public transit? Their dollar in the fare box helps pay the upkeep so that others can continue to ride, too.

Do they buy anything, legally or illegally? That cash flow contributes to the economy of a community.

My problem with you, Panda, is that you take the small fraction of someone's life that you observe and extrapolate that into some caricature of that person's entire existence. It's not that simple.

C'mon... are you serious?

 

[VneZonyDostupa]

1. No, not generally, but one generation of freeloaders begets another and many of my patients churn out kids who in turn grow to contribute nothing to society.

2. No. they are totally selfish and perform no public service or any act for the public good whatsoever.

3. Yes, but we generally give them bus tokens so that dollar or two in the bus cash box comes out of your pocket. And they often call the ambulance for a free ride to the Emergency Department so one trip as it costs Medicare (the payer for their disability) five-hundred bucks essentially wipes out their contribution to public transit. Multiply this by twenty ambulance calls a year and you see the problem. If they have no public insurance the ambulance company of course just eats it.

4. Everything they buy comes from public money transferred to them in exchange for which they do nothing. May as well just take the money to the liquor store and hand it to the clerk...you know, to eliminate the middleman.

I would say that two or three of the twenty patients I see every shift fit this description. It is not a trivial problem and the cost of enabling this kind of behavior is immense.

I'm not sure why I even argue with you anymore. Every thread you post in turns into the same thing: you swoop in, drop a few anecdotes about how much you hate the poor, and then call everyone who disagrees with you a "kool-aid" drinker. Sort of hard to defend against ad hominems and anecdotes.

 

[VneZonyDostupa]

Or voting, for that matter.


Wow. That child MAY also go on to become a criminal that will be in prison to the tune of thousands of dollars a month, possibly for the rest of their life.

You're right, they may. Good to see you condemn children in utero. Awesome.

 

[Chemist0157]

I genuinely wish that everyone had solid health care coverage, and maybe a federal health care system can be implemented someday. But there had better be some stipulations/requirements for everyone to follow. People had better learn to just take care of themselves. I don't want my tax dollars going to someone who has lung cancer simply because they wasted their own money smoking themselves to death. That is idiotic. The primary reason I do not want to see a universal health care system is because, since Americans are so great at being healthy *sarcasm*, much of the money is going to be used on fixing people's lifetime mistakes, and not diseases or accidents that could not be avoided.

 

[Greonis]

I genuinely wish that everyone had solid health care coverage, and maybe a federal health care system can be implemented someday. But there had better be some stipulations/requirements for everyone to follow. People had better learn to just take care of themselves. I don't want my tax dollars going to someone who has lung cancer simply because they wasted their own money smoking themselves to death. That is idiotic. The primary reason I do not want to see a universal health care system is because, since Americans are so great at being healthy *sarcasm*, much of the money is going to be used on fixing people's lifetime mistakes, and not diseases or accidents that could not be avoided.

That is why I believe education should be a top priority in fixing our healthcare system. An improved understanding of how the system works and when it is appropriate/justified to use the system would help people make better choices and ultimately save money. One area that is in dire need of elucidation is how people view the emergency room (that is, getting them to realize that the word "emergency" is there for a reason).

Of course, how to implement such curricula (not to mention teaching the throngs of people already beyond the educational system) is a whole other problem.

 

[jr doctor in sd]

I genuinely wish that everyone had solid health care coverage, and maybe a federal health care system can be implemented someday. But there had better be some stipulations/requirements for everyone to follow. People had better learn to just take care of themselves. I don't want my tax dollars going to someone who has lung cancer simply because they wasted their own money smoking themselves to death. That is idiotic. The primary reason I do not want to see a universal health care system is because, since Americans are so great at being healthy *sarcasm*, much of the money is going to be used on fixing people's lifetime mistakes, and not diseases or accidents that could not be avoided.

I agree that people need to become more educated about health and take some responsibility, rather than run to the doctor and whine about health-care prices, long waits, etc. If we got rid of the non-serious "waste-of-time' visits then I think the system would be far more efficient and less costly.

For your second point (underlined), I agree that it is kind of annoying to pay tax dollars to help someone smoking themselves to death (and it fully shocks me to see nurses working on patients with lung cancer as a result of smoking and then I get off shift to skate home and I see them all in a circle having some stogies can they be more idiotic?? [some of them...the rest are amazing and extremely gifted!]) But I don't think it's right to say we shouldn't pay for people's mistakes. Is that what you'd tell a kid who is hemorrhaging in his brain from falling off a bike because he wasn't wearing a helmet? "sorry son, should've worn protective equipment - we're gonna only spend money on the non-preventable accidents"

Or even the same deal with a smoker - I think it is idiotic to even start cigarettes knowing their addictive/harmful properties but I could not tell someone who is smoking I will not pay to see them get better and quit that horrible habit (I just have that optimistic and usually wrong view thinking maybe after some long medication/hospital stays they will learn and quit). If i was in that situation, I know I'd need help of others

 

[linguini]

I genuinely wish that everyone had solid health care coverage, and maybe a federal health care system can be implemented someday. But there had better be some stipulations/requirements for everyone to follow. People had better learn to just take care of themselves. I don't want my tax dollars going to someone who has lung cancer simply because they wasted their own money smoking themselves to death. That is idiotic. The primary reason I do not want to see a universal health care system is because, since Americans are so great at being healthy *sarcasm*, much of the money is going to be used on fixing people's lifetime mistakes, and not diseases or accidents that could not be avoided.

I agree that it'd be ducky if everyone just did what was best for their health. However, lets face it, this isn't going to happen to a great extent anytime soon. I believe that physicians need to be aware and accepting of this fact. Instead of juding a patient for not doing what he/she is supposed to do, you'd spend your time better by treating that patient completely objectively.

 

[Chemist0157]

One area that is in dire need of elucidation is how people view the emergency room (that is, getting them to realize that the word "emergency" is there for a reason).

Definitely. Anyone who has volunteered in the ER knows that there are few actual emergencies. Most of the visits are because their own doctor is gone, they have no doctor, or they are in a program that pays for the ER visit.

And jr., the mistakes of a child and those of an adult aren't the same thing. But, I see what you're saying, and I felt that way too even when I typed my previous post. Maybe tax funding could go to helping smokers/alcoholics/drugs addicts quit before they actually develop more expensive problems.

Everyone needs to realize this. Any program we implement will not be perfect. We are human. There are those who WILL take advantage of the system, and there WILL be people who do not get enough help (both of those could be linked). I just wanted to throw my opinions out there because I know alot of people who think a government-controlled health care system will fix everything, and the angels will sing, and no one will suffer every again. There will be real problems with any system.

 

[NoMoreAMCAS]

Privilege. The people who provide the care, and the materials needed to provide that care, are simply offering a service. You either pay for the privilege of that service or you don't. The people who provide it can not afford to provide it for free and nobody else should be forced to cough up their hard earned money to give someone the "right" to have healthcare.

Except kids. It should be a right for kids to be covered. In which case the government should provide the health care.

 

[NoMoreAMCAS]

Gee, I guess that's why grad students slave away in labs late at night. That $25,000 stipend sure is generous.

Its so they can get their degree and get paid.

Take the "paid" out of that and they aren't gonna be nearly as willing to put in all that work.

 

[VneZonyDostupa]

Privilege. The people who provide the care, and the materials needed to provide that care, are simply offering a service. You either pay for the privilege of that service or you don't. The people who provide it can not afford to provide it for free and nobody else should be forced to cough up their hard earned money to give someone the "right" to have healthcare.

Except kids. It should be a right for kids to be covered. In which case the government should provide the health care.

Who said anything about free healthcare? No country has free healthcare, it's paid for by corporate and income taxes. Also, I didn't realise altruism was a dirty word, now.

 

[NoMoreAMCAS]

Who said anything about free healthcare? No country has free healthcare, it's paid for by corporate and income taxes. Also, I didn't realise altruism was a dirty word, now.

Income taxes = not free, agreed. Someone else is paying for your health care. I said YOU either pay for YOUR healthcare or you don't get any. Money doesn't grow on trees, and i'm not trying to pay 50% of my income in taxes. We can't afford to provide universal health care without raping the country on taxes. Luckily, me and most sane americans will never allow that to happen.

 

[VneZonyDostupa]

Income taxes = not free, agreed. Someone else is paying for your health care. I said YOU either pay for YOUR healthcare or you don't get any.

What about children?

What about someone whose company goes bankrupt/lays them off?

What about college students who cannot afford healthcare AND tuition?

What about people with chronic, non-preventable conditions who onl qualify for high premium "pre-existing condition" policies?

What about people who are injured and are no longer able to work, but need physical therapy and/or home assitance, which many lower-end insurers will not cover?

Money doesn't grow on trees, and i'm not trying to pay 50% of my income in taxes. We can't afford to provide universal health care without raping the country on taxes.

No one is asking you to pay 50% income tax. The highest rate I've heard of was in Denmark, and they pay between 38 and 45%, depending on your income level. That tax rate is for healthcare and tons of other social programs. Many other Western European nations pay similar, though slightly lower, rates. Maybe you should go tell those people they are being "raped", to use your crass term. Apparently they are pretty happy in their current system.

Luckily, me and most sane americans will never allow that to happen.

Actually, 62% (given, polls are not accurate, but it's still within the margin of error) of Americans DO support a shift to some sort of universal healthcare.

I posted the link a few posts back in response to PremedPrincess's post. It was an ABCNews poll.