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Should medicine be an entitlement?
- Thread starter gxb
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I guess I am just going to have to respectfully disagree. There will always be some portion of society at the bottom of the economic ladder. These people often suffer the worst of what society has to offer. They are left with the scraps, and it ends up showing through their health. They have to work in horrible working conditions, they eat toxic food, and they barely even have time to sleep between working two jobs.
I believe they are owed healthcare. I can't justify it using an economic argument and make it sound fancy. But I just believe the well-off individuals have a responsibility to care for the less fortunate. I understand why other people won't see it as proper justification though : /
Reading my first post, I guess I do come across as an organic hippie oh god...*slowly inches out of thread*
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Picking this apart a little, there are a few base assumptions that are interesting to me: your (docs' versus individuals'? Not clear exactly who.) judgement on who 'deserves' saving seems related to time elapsed from time of the treatment in question to death. It's even more interesting to me that you used the example of a junkie rather than something more concrete like an alcoholic (certainly a type of junkie, but I think that word can be used much more broadly than substance abuse). I'm reading this to mean that based on a person's lifestyle which one simply disagrees with, one can withhold treatment from one patient in favor of another patient who the treater feels is more worthwhile. I find this consistent with my experience working with docs (and everyone else, for that matter).
The reason I find this interesting is because this is also the opposing argument people are making; it's only the authority which is not equal. To be more clear, one side of this disagreement argues that everyone should be treated equally with exceptions physicians (again, not exceptionally clear who should be deciding, but I think people on that side mean physicians) decide upon, and the other side argues that individual physicians should be able to decide who to treat. They're the same argument, just with different deciders.
It seems like one side trusts themselves (and each individual physician) to make the right choice, and the other side either doesn't trust themselves or doesn't trust its colleagues to make the right choice.
To the former group (pro-individual-decision-makers), I'd ask if you have so much faith in your colleagues, then why do you care if such rules are mandated? To the latter group (pro-mandatory-standard), I'd ask you one of 2 questions, depending on who you lack trust in. If you don't trust your colleagues, how can you want them to make this rule for you? Unless, of course, that person just wants to be the one making the rules. In which case, I'd refer them to this page. If you don't trust yourself... well then I guess this makes sense, actually! You're afraid that you'd do something horrible if left to make this decision on your own.
Strangely, the only people in this discussion who argue for a system supported by their understanding are those who don't trust themselves to make good decisions. Begging the question would be to ask if these people should be doctors in the first place, but that also implies that only people who arrive at illogical conclusions 'should be' physicians!
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The real question is how many logical fallacies can you cram into one thread? According to the posters here being a provider in a universal healthcare system where your salary, benefits, and pension are paid by the taxes from the community you serve is akin slavery and that the government is as tangible as mythical dragons. Wtf?
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Picking this apart a little, there are a few base assumptions that are interesting to me: your (docs' versus individuals'? Not clear exactly who.) judgement on who 'deserves' saving seems related to time elapsed from time of the treatment in question to death. It's even more interesting to me that you used the example of a junkie rather than something more concrete like an alcoholic (certainly a type of junkie, but I think that word can be used much more broadly than substance abuse). I'm reading this to mean that based on a person's lifestyle which one simply disagrees with, one can withhold treatment from one patient in favor of another patient who the treater feels is more worthwhile. I find this consistent with my experience working with docs (and everyone else, for that matter).
The reason I find this interesting is because this is also the opposing argument people are making; it's only the authority which is not equal. To be more clear, one side of this disagreement argues that everyone should be treated equally with exceptions physicians (again, not exceptionally clear who should be deciding, but I think people on that side mean physicians) decide upon, and the other side argues that individual physicians should be able to decide who to treat. They're the same argument, just with different deciders.
It seems like one side trusts themselves (and each individual physician) to make the right choice, and the other side either doesn't trust themselves or doesn't trust its colleagues to make the right choice.
To the former group (pro-individual-decision-makers), I'd ask if you have so much faith in your colleagues, then why do you care if such rules are mandated? To the latter group (pro-mandatory-standard), I'd ask you one of 2 questions, depending on who you lack trust in. If you don't trust your colleagues, how can you want them to make this rule for you? Unless, of course, that person just wants to be the one making the rules. In which case, I'd refer them to this page. If you don't trust yourself... well then I guess this makes sense, actually! You're afraid that you'd do something horrible if left to make this decision on your own.
Strangely, the only people in this discussion who argue for a system supported by their understanding are those who don't trust themselves to make good decisions. Begging the question would be to ask if these people should be doctors in the first place, but that also implies that only people who arrive at illogical conclusions 'should be' physicians!
Who deserves *what* treatment. Not all treatments are the same. No one needs to have a set of tits put in. People who are dying from acute hypoxia respiratory failure deserve a vent unless they've explicitly said they don't want it. Just a for instance. It's not all or nothing.
Junkie was simply the way the conversation got started. That's why it was used. It wasn't pulled out arbitrarily.
I haven't at any time suggesting forcing anyone to do anything.
So. I'm not sure what you're on about.
You could try synthesizing your points here with less words and more precise language.
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Whoa, whoa, whoa. Let's not get carried away here.
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One of the biggest issues with healthcare today is lack of personal accountability. The american way of life is toxic, people eat fast food 3 times a day, resist exercising, and spend their workday on their fat ass. Serious medical complications are an obvious consequence. If people actually took care of themselves instead eating their way into a six vessel bypass, then the government would spend a significantly less amount of money taking care of people. Now when it comes to right vs. privilege, how can you anyone believe that those who fail to take responsibility for themselves can honestly expect other people to be accountable for them?
Ultimately, like all things in life, health care and treatment come down to money. If you can't pay for it, and you don't take care of yourself, I refuse to believe other people should be responsible for paying to take care of you.
It would be nice if everything were free and everyone were happy and healthy and it rained puppies. That's not the world we live in, and we need to face it.
Ultimately, like all things in life, health care and treatment come down to money. If you can't pay for it, and you don't take care of yourself, I refuse to believe other people should be responsible for paying to take care of you.
It would be nice if everything were free and everyone were happy and healthy and it rained puppies. That's not the world we live in, and we need to face it.
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Don't be thick. Being required to provide your services for free is what's being trumpeted as slavery. When medicine becomes a right wherein it must be dispensed free of payment, that qualifies as free labor aka slavery. Now this may be a bit dramatic, but voila the internet.
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This statement is all you need to evaluate the strength of your argument.
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so i just had a patient and wrote that they didn't have a surgical history, then i noticed that they actually had a breast augmentation several years ago. i didn't notice
The basis of my argument was that this toxic lifestyle, which I mentioned previously, is unavoidable for many Americans and therefore the government has a duty to provide healthcare for everyone, since the government is the main source propagating this toxic lifestyle in the first place.
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Me pointing out the absurdity of comparing a government salaried position to slavery is being thick? Are police officers and firefighters slaves? Not only does the comparison have no basis in reality, it's offensive.
You are not providing the service for free. Society foots the bill through taxes which pay the people in the infrastructure. You are presenting this as if socialized medicine is forcing doctor's to provide a service with no financial reward for their efforts. This is a textbook example of a straw man fallacy.
I don't follow the substance behind this viewpoint. In what way does considering healthcare an entitlement mean that doctors would be asked to or required to dispense medical treatment for free? Outside of charitable volunteer work, doctors do not provide care free of charge in any healthcare system of which I am aware. Single payer does not mean doctors are providing health care free of payment, it just means that someone other than the patient receiving treatment is paying for the services. Claiming that making medicine an entitlement (which is a political word in this context and therefore not a word that can be defined using a dictionary) would require doctors to provide care without compensation is quite simply a load of bull****.
D
deleted480308
Nope, our system does not require that everyone pay income tax, a solid half the country doesn't. Our system allows that half to live off the rest of us, it is theft
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Sorry, I should have been more clear. The first paragraph was meant to frame the argument on life-saving treatment (hence the timeframe bit). But yes, I acknowledge that 'junkie' was not arbitrary. That is why I found it interesting, not just in your comment, but the fact that it was chosen for this discussion in the first place.
I did not accuse you of arguing for 'forcing' anyone to do anything, though I agree that there is a rather large element of coercion proposed by the 'pro-mandating' group. It's interesting that you commented on that and I did not; usually I am the one to first point out theviolenceinherentinthesystem (Monty Python, anyone?).
I made my best effort to keep my assessment brief. I realize that walls of text are unpopular on SDN, but there were a few dots to connect. When duty calls!
Thanks for the feedback, though! As I feel that it's unclear based on your reply, I don't disagree with your point of view. My whole point was that the actual discussion being had isn't about if life-saving healthcare was a right/entitlement (clearly it's not if we're not going to save [less-worthwhile people] in favor of [better people]). The debate is about who we think should make the decisions on the matter.
“The beginning of wisdom is to call things by their proper name.” - Confucius (In this context: What are we really arguing about?)
... and are you making a joke by telling me that I should choose my words with more precision? I'm a big enough nerd that I get it and I think it's pretty clever.
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deleted480308
stealing from your neighbor to pay your bill isn't any more moral than enslaving the doctor by forcing them to work for free...it's just semantics for an immoral expectation
So are we going to create a biological test that can determine whether somebodies health care needs are caused by a lack of personal accountability or uncontrollable event like genetics? If the individual is deemed to have lived a responsible life, even if they are poor, they receive treatment, otherwise they are turned away to suffer the treatable complications? I think this would be too conservative for even Sarah Palin's death panels.
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This was a good read. Thanks for the Step 1 study break everybody.
Is it moral to steal from a neighbor to pay for for public education, police, firemen, roads, bridges, or the military? To quote former Supreme Court Justice Oliver Wendell Holmes, "Taxes are the price we pay for a for a civilized society". Essentially, adding healthcare (which is already largely paid for by the government) to the public rap sheet is just an extension of the same taxation system that has been implemented in every advanced society in the history of civilization. Even Aristotle, often considered the father of conservatism, was an advocate for the necessity of the welfare state due to the certainty that a small proportion of any society will not be able to provide for themselves. A liberal might want to provide for these people out of compassion. A conservative might want to provide for these people so they don't steal from their own family. This is of course a broad generalization, but the idea that providing any services for those in need is stealing is far far on the extreme side of the bell curve, and I believe would make for a chaotic and dangerous society.
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deleted480308
your belief that the theft is beneficial doesn't make it any better.
Ha! We are never going to see eye to eye on this one.
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Is it really necessary to broadly paint liberal = compassionate, conservative = selfish to make your argument? Pretty sure there are both kinds on both sides.
There are plenty of people in the 1% who are not against taxation.
This is why I said I was making broad generalization and "might". However, You are right, I could have made the same point without using those words. My bad.
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deleted480308
robin hood didn't steal from those who were wealthy due to honest success, he stole from the government which taxing the people
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My apologies for the delayed response. I was previously mobile and didn't feel like I could respond adequately until in front of a real keyboard.
As you sort of start to indicate, your argument is changing. If people deserve healthcare because they're being poisoned by unhealthy food, then they deserve that healthcare irrespective of their socioeconomic status. A middle-class soccer mom can be lied to by the USDA just as easily as the impoverished. As I stated earlier, I contend that even people who are free of supposed food-choice delusions will still get sick, so I find that an insufficient justifcation for providing healthcare. Stated simply, the decision to provide healthcare should be divorced from the quality of our food. If there is a problem with the latter, then it should be addressed accordingly, but separately.
Later on, you indicate that the less fortunate among us deserve healthcare because they endure a disproportionate amount of suffering. That the less fortunate endure more suffering is virtually existential. Otherwise, they wouldn't be less fortunate, but it doesn't follow that this is an adequate reasoning for providing healthcare. If people deserve healthcare, then they deserve it regardless of their specific circumstances.
Ultimately, what I think you're saying is what is similarly said by many others on this thread. To wit, that healthcare is not a right, but it is a worthwhile service that should be provided, even if the costs are substantial. That the government should provide it reflects the inadequacy of the private sector's ability to do so, rather than an unalienable right afforded to all at birth. We shouldn't confuse the two, and, in these circumstances, semantics is important. Accordingly, no one has a right to a coronary stent, but we ought to provide said stent because it is worthwhile to do so.
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In fact, I think I saw somewhere that the 1% account for a 26% of total salary yet are responsible for paying 40% of total taxes. Clearly anti-taxation...
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I hope you complemented the surgeon.
For the practical purpose of implementation I think the difference between calling something a right or a worthwhile service that should be provided is political theory semantics without relevance to whether the action is the right course of action. We could go down the list for nearly every service provided by the government and argue about whether the service is provided because it is something people are entitled to or because it makes worthwhile sense to provide the service. At then end of the day, the only purpose of such an exercise is convince more people that the service should or should not be provided. After all, a service can only be provided if there are resources available to provide it. If the resources do not exist then it does not make any difference whether you call it an entitlement or a "worthwhile service", not everybody is going to get it.
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You don't believe that a population that feels entitled to something will feel it should be provided for them free of charge? That it's their right, and therefore you're obligated to provide it regardless of whether they think they should pay for it? That's the issue a lot of clinics are facing these days, people with flashy cell phones and new shoes scoff at the notion of a copay because they don't think they should be paying for a physician's service. Why? Because they think it should be free, because it's their right. Presently we're not in a situation where physicians are required to provide their service free of charge. IF that were the case though, I think slavery (while a dramatic term) is an accurate qualification.
At present, a single payer system doesn't mean docs will be providing services free of charge and that's why this situation isn't a reality. It doesn't hurt to consider it though considering the significantly decreased reimbursements that would inevitably follow a single payer system. The lower those reimbursements go, the closer we get to providing services free of charge. This is all besides the point though.
I don't thin this is a particularly good argument for saying the 1% are not anti-taxation. People who break the law account for a large portion of the prison population. This does not make people who break the law pro-prison.
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In my mind, rights exist irrespective of resources. If the government doesn't have the money to provide a polling station, I still have a the right to vote.
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No no no. That's obviously way too extreme. I'm just simply pointing out that until the American population starts changes it's cultural identity (which may never happen), the bigger issues are simply being ignored. We're treating symptoms, not the disease. We would save so much money (which incidentally we don't have) if we took initiative to prevent medical issues. And yes, I'm ignoring issues like genetics because I think the majority of health problems related to heart disease etc. are more to do with our lifestyle choices and less to do with our genetic draw.
No, I do not think this statement makes any sense.
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No but then I could make the argument that your view on an issue (pro-taxation/pro-jail/ etc.) is irrelevant. Only the facts matter. Perspective can ultimately be useless. You may not be pro-jail or pro-taxation but you're still a large contributor to that statistic, which is all that is really analyzed.
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Which part?
If the government doesn't have the resources to provide a way for eligible voters to vote then it is no longer a democratic republic.
When it comes to entitlements in this country, however, the programs being referred to are things like social security and medicare. If the resources for these programs did not exist then the programs would not exist. It doesn't matter if they are considered a "right".
Well the purpose of my original comment was to dissuade somebody that said it is a fact that the 1% do not want to provide for those who are less fortunate. I considered the key to this point to be the word "want" not actual practice of the 1% paying taxes because it is the law. Facts are not the only things that matter. This isn't Hard Times.
The entire comment. None of what you said actually adds up to any remote likelihood that doctors will be working for free. There is no precedent for an entitlement resulting in the person providing the entitlement not being paid for their services; teachers, police, firemen, and the military all get paid.
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Okay fair enough, I agree that though they may contribute a significant amount of the taxes they don't necessarily want to. You think the beneficiaries of those taxes care that the 1% were bitter about it? Nah they'll just get on with their day.
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We're not talking about any of those. We were discussing the hypothetical situation wherein physician's would (hypothetically) be providing free care.
I thought we were talking about what would happen is medicine was considered an entitlement?
Yes the beneficiaries do care because they want to raise taxes.
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I'm not sure how that's a refutation to my claims.
Of course it does. Let's imagine a hypothetical construct: the government has the resources to pay for one program. Its choices are between a program that would ensure free speech (let's assume it would otherwise be trampled) and a program that would fund social security. Which should it choose?
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In what fantasy land is this even remotely possible? Why not have a political debate within a realm of feasibility and not implausible extremes?
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deleted480308
our tax code already has physicians doing 30% of their work for free
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Okay let's bring it back to reality. I do think access to medical care should be a right. Actual medical care is available for those who can afford it. It would be amazing to be able to provide amazing care to everyone, but finances dictate that in the end someone will have to pay for it and as has been oft repeated, there are only so many resources. The problem we have now is that the US is paying for more than it can handle. This is a problem that needs to be fixed, and like you said, it needs to be a feasible solution.
It shouldn't (hopefully) surprise you that docs do a ton of work without being reimbursed. Not all of it, but a sizeable portion.
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And yet they still make six figure incomes. Do you not see how that's not the same as being held hostage and forced to work for free?
