The Alt-Right, Opioids, and Pain Patients?

[drusso]

I've been trying to wrap my head around what this ideology means for patients with chronic pain:

I predict that the rise of Alt-right ideology will promote the stigmatization of people with chronic pain (damaged goods, miscreants, genetically inferior, etc). In turn, there will be an organized effort to "de-medicalize" and reduce access to care for these conditions driven by "cost containment." Essentially, chronic pain patients will be labeled sociopaths. They will seek to dismantle academic programs and marginalize researchers who don't promote their views. Immigrants (drug dealters and rapists) will be blamed for the opioid epidemic. I'm certain that there's room to speculate on ties between greedy "Jewish" doctors and Big Pharma...

On the other side is the Nanny/welfare state: They will seek to normalize chronic pain and frame access issues in terms of "equity," and "disparities." They will promote "systems of care" for those with sensory differences and alterations in comfort. Opioids and other treatments will need to be rationed. They will want to increase funding for research into pain. Big Pharma and medical device companies will "have to pay their fair share" for addiction treatment and expanded mental health.

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[lonelobo]

My vote is for neither

 

[Disciple]

I've been trying to wrap my head around what this ideology means for patients with chronic pain:

I predict that the rise of Alt-right ideology will promote the stigmatization of people with chronic pain (damaged goods, miscreants, genetically inferior, etc). In turn, there will be an organized effort to "de-medicalize" and reduce access to care for these conditions driven by "cost containment." Essentially, chronic pain patients will be labeled sociopaths. They will seek to dismantle academic programs and marginalize researchers who don't promote their views. Immigrants (drug dealters and rapists) will be blamed for the opioid epidemic. I'm certain that there's room to speculate on ties between greedy "Jewish" doctors and Big Pharma...

On the other side is the Nanny/welfare state: They will seek to normalize chronic pain and frame access issues in terms of "equity," and "disparities." They will promote "systems of care" for those with sensory differences and alterations in comfort. Opioids and other treatments will need to be rationed. They will want to increase funding for research into pain. Big Pharma and medical device companies will "have to pay their fair share" for addiction treatment and expanded mental health.

Scenario B is already here to an extent (Medicaid programs on the left coast).

Scenario A is sounding a little too Nazi Germany for me to really worry that it might actually happen. It's been pointed out in other threads that a lot of Trump supporters are part of the chronic pain/opioid/disability population. They just happen to be from rural white areas instead of Urban.

 

[bedrock]

Scenario B is already here to an extent (Medicaid programs on the left coast).

Scenario A is sounding a little too Nazi Germany for me to really worry that it might actually happen. It's been pointed out in other threads that a lot of Trump supporters are part of the chronic pain/opioid/disability population. They just happen to be from rural white areas instead of Urban.

Agree with disciple. Lots of Trump supporters are in the chronic pain, opioids, disability population.

You guys worry too much about Trump. He will do a few crazy things for sure, but the USA is not going to become Nazi germany. Checks and balances of the constitution.

 

[SeniorWrangler]

Sally Satel is a conservative psychiatrist who writes for the WSJ sometimes and she works for a methadone clinic, maybe she will have some influence. S

 

[Disciple]

With the likely cuts in Medicaid/other social safety net programs and decreased access, I see the opioid refill clinics 101N has described becoming commonplace, minus social justice components from Scenario B above.

 

[clubdeac]

I've read that we are nearing 1 trillion in spending on our welfare programs in the US with 1/3 of Americans receiving benefits. This number increases to 1/2 when Medicare and SS are included!!! Astonishing

 

[bedrock]

I've read that we are nearing 1 trillion in spending on our welfare programs in the US with 1/3 of Americans receiving benefits. This number increases to 1/2 when Medicare and SS are included!!! Astonishing

The welfare state is ridiculous. This is something I hope trump and the republicans recognize. It's bankrupting our country.

I'd love to be put in charge of federal SSI disability standards. I'd kick out 90% of those on disability. That would go a long way toward balancing the budget.

 

[Ducttape]

The welfare state is ridiculous. This is something I hope trump and the republicans recognize. It's bankrupting our country.

I'd love to be put in charge of federal SSI disability standards. I'd kick out 90% of those on disability. That would go a long way toward balancing the budget.

Here's a little food for thought - what will these marginally existing people do when their safety net is gone?

Balance the budget at the cost of losing a significant portion of the population? I'm not saying what they are doing is "raight", or good for the country, but "trickle down economics" will not affect them.

If one is going to be radical, you should conceive of a jobs program that allows most of these individuals access to minimal standard of living.


Sent from my iPhone using SDN mobile

 

[bedrock]

Here's a little food for thought - what will these marginally existing people do when their safety net is gone?

Balance the budget at the cost of losing a significant portion of the population? I'm not saying what they are doing is "raight", or good for the country, but "trickle down economics" will not affect them.

If one is going to be radical, you should conceive of a jobs program that allows most of these individuals access to minimal standard of living.


Sent from my iPhone using SDN mobile

Agree that a jobs program is a good idea to help them get started.

But seriously, don't you think think that all the people on permanent disability for low back pain from DDD, from fibromyalgia, from anxiety, or depression, would get jobs if it was either work or they starve?

They would get off their couches, put away their bongs and get to work, and the economy, deficit, and society would be better for it.

I'm not talking about people on disability for real reasons like quadriplegics, severe stroke, severe MS, etc. They need and deserve our help.

 

[hyperalgesia]

Here's a little food for thought - what will these marginally existing people do when their safety net is gone?

Balance the budget at the cost of losing a significant portion of the population? I'm not saying what they are doing is "raight", or good for the country, but "trickle down economics" will not affect them.

If one is going to be radical, you should conceive of a jobs program that allows most of these individuals access to minimal standard of living.

I keep hearing the stats for unemployment don't include people who "choose to not participate in the labor force". WTH is up with that? Able-bodied people shouldn't have a "choice" of whether to work for money, food, and shelter vs just get it all for nothing.

 

[Disciple]

Here's a little food for thought - what will these marginally existing people do when their safety net is gone?

Balance the budget at the cost of losing a significant portion of the population? I'm not saying what they are doing is "raight", or good for the country, but "trickle down economics" will not affect them.

If one is going to be radical, you should conceive of a jobs program that allows most of these individuals access to minimal standard of living.


Sent from my iPhone using SDN mobile

Are there many states that have not re-instituted the work for food stamps requirement?

 

[SeniorWrangler]

I never thought of social security and medicare as part of "welfare", since pretty much everyone in the USA uses them when they get to be that age, and your social security benefits are partially based on what you pay into the system during your working life.

 

[bedrock]

I never thought of social security and medicare as part of "welfare", since pretty much everyone in the USA uses them when they get to be that age, and your social security benefits are partially based on what you pay into the system during your working life.

SSI is welfare by another name for 90% of recipients.

all the millions of young people on SSI disability, (which also gets them Medicare), cost the system billions without them putting anything into it. Another reason the government doesn't have money for meaningful programs like infrastructure spending...........because we waste billions each year, supporting lazy people who should be working and paying taxes.

 

[Ducttape]

Agree that a jobs program is a good idea to help them get started.

But seriously, don't you think think that all the people on permanent disability for low back pain from DDD, from fibromyalgia, from anxiety, or depression, would get jobs if it was either work or they starve?

They would get off their couches, put away their bongs and get to work, and the economy, deficit, and society would be better for it.

I'm not talking about people on disability for real reasons like quadriplegics, severe stroke, severe MS, etc. They need and deserve our help.

that wont happen. you have an unrealistic impression of humanity.

statistically speaking, 8.8 million disabled workers. $10.3 billion per month (14.6%). the vast majority of those getting SSI or social security are aged and survivors (82%), however.

i am not against getting rid of the vast majority of disability, dont get me wrong. it is the modern day welfare state. but if already we have an 40 million Americans age 21 to 65 who are unemployed (using Trump's numbers but minus those below age 21 and above age 65, retirement age), and at least 8 million who cannot find a job and are listed as unemployed, how does these 9 million (who are part of the 40 million but not the 8 million) get a job? ergo, jobs program - but it is big government again...

 

[neutro]

I hear a lot of this "manufacturing jobs need to come from america" and that is the basis of trump's victory. what i dont understand is why these "rural americans" find jobs in different industries and adapt instead?
why are we stuck in 70's and 80's job mindset? that in essence is the problem. these people dont WANT to work or learn new skill and trade.

There are plenty of jobs out there in service, food, labor.

I mean, I am a first generation immigrant from a third world country (dont worry - we are legally here ). We left our country in 1998 with a total of $10, 000 in our pockets and an uncertain future. My father's qualifications were not accepted even though he had a very good job back home, and has a degree in engineering and business. For two years, he did labor work, was a car salesman, did odd jobs, sold Amway products while obtaining certifications through community colleges in his late 40s. Now he is doing well and works for a top pharma company in their logistics dept.
And he raised 4 kids - all went to college.
He's still working. Has never skimped on taxes, has always donated to charity like on schedule, and always paid his bills two days before they are due.

What I don't understand is that when these so-called "immigrants" who supposedly "hate" the country can turn their lives around and contribute to the society, despite not having ANY of the advantages that Americans have (language, knowledge of culture and awareness of the system are a few big ones) - why can they succeed, and not those who are born and raised here?

The answer is laziness. The answer is not appreciating what they have. The answer is not really caring for themselves and their country - yet these people are the loudest of them all.

One of my fellow anesthesiologists is moving to New Zealand after Trump victory. He said he can't take it anymore lol.

 

[DrCommonSense]

I hear a lot of this "manufacturing jobs need to come from america" and that is the basis of trump's victory. what i dont understand is why these "rural americans" find jobs in different industries and adapt instead?
why are we stuck in 70's and 80's job mindset? that in essence is the problem. these people dont WANT to work or learn new skill and trade.

There are plenty of jobs out there in service, food, labor.

I mean, I am a first generation immigrant from a third world country (dont worry - we are legally here ). We left our country in 1998 with a total of $10, 000 in our pockets and an uncertain future. My father's qualifications were not accepted even though he had a very good job back home, and has a degree in engineering and business. For two years, he did labor work, was a car salesman, did odd jobs, sold Amway products while obtaining certifications through community colleges in his late 40s. Now he is doing well and works for a top pharma company in their logistics dept.
And he raised 4 kids - all went to college.
He's still working. Has never skimped on taxes, has always donated to charity like on schedule, and always paid his bills two days before they are due.

What I don't understand is that when these so-called "immigrants" who supposedly "hate" the country can turn their lives around and contribute to the society, despite not having ANY of the advantages that Americans have (language, knowledge of culture and awareness of the system are a few big ones) - why can they succeed, and not those who are born and raised here?

The answer is laziness. The answer is not appreciating what they have. The answer is not really caring for themselves and their country - yet these people are the loudest of them all.

One of my fellow anesthesiologists is moving to New Zealand after Trump victory. He said he can't take it anymore lol.

Actually, these "hard working immigrants" cost far more to the govt than they produce.

Here is how those "hard working immigrants" stack up against "natives" in welfare comparisons.

http://cis.org/Cost-Welfare-Immigrant-Native-Households

So your anecdotal information doesn't hold any weight.

 

[neutro]

Neither does your non-sensical post I am afraid.
What about immigrants who are "professionals", not "hard working immigrants" and those who contribute to the economy?
20-25% of physicians in america are immigrants also, serving the "rural americans" and paying taxes.
http://www.forbes.com/sites/nicolef...n-reform-solve-our-doc-shortage/#74d65137702b

also - unless you're native American, you are an immigrant also. the difference is the # of generations.

 

[DrCommonSense]

Neither does your non-sensical post I am afraid.
What about immigrants who are "professionals", not "hard working immigrants" and those who contribute to the economy?
20-25% of physicians in america are immigrants also, serving the "rural americans" and paying taxes.
http://www.forbes.com/sites/nicolef...n-reform-solve-our-doc-shortage/#74d65137702b

also - unless you're native American, you are an immigrant also. the difference is the # of generations.

You are now switching your criteria.

Initially, you pretended inaccurately that "immigrants are adding more to the economy than natives" and "why can't natives work as hard as immigrants to contribute as much". This was clearly inaccurate due to the welfare rates being given earlier as to the average per capita immigrant costing the govt far more than the average native population.

Now you are switching this to a caveat that "professional immigrants" add more value.

What percentage of the total immigrant population are "professionals" though?

Ergo, your analysis is flawed that immigrants on average add more value to the society when looking at cost/benefits in terms of taxes/govt services.

 

[DrCommonSense]

Neither does your non-sensical post I am afraid.
What about immigrants who are "professionals", not "hard working immigrants" and those who contribute to the economy?
20-25% of physicians in america are immigrants also, serving the "rural americans" and paying taxes.
http://www.forbes.com/sites/nicolef...n-reform-solve-our-doc-shortage/#74d65137702b

also - unless you're native American, you are an immigrant also. the difference is the # of generations.

Also, im not convinced of that propaganda about "foreign physicians" being willing to be PCPs.

I have seen MANY/MAJORITY of foreign physicians gravitate to lucrative specialties including cardiology, GI medicine, etc which are definitely NOT in need of more physicians to "go into it for need" reasons.

Im not particularly convinced that foreign docs are much harder working or altruistic either since I've seen most of them gunning for the higher paying speciality jobs as well despite the fact that there is actually ZERO need for those jobs being taken up by foreign labor due to plenty of indigenous supply.

 

[bronchospasm]

So who can piss further ??
natives or immigrants or foreign physicians vs American grads; Anesthesia Pain docs or PMR Pain docs

Cmon people

 

[SeniorWrangler]

Some of the people on this forum are foreign medical graduates or have foreign medical graduates in their family.
I think it's fine to talk about the role of FMG's in the medical system, but please don't resort to name calling.

 

[mid|ine]

Agree that a jobs program is a good idea to help them get started.

But seriously, don't you think think that all the people on permanent disability for low back pain from DDD, from fibromyalgia, from anxiety, or depression, would get jobs if it was either work or they starve?

They would get off their couches, put away their bongs and get to work, and the economy, deficit, and society would be better for it.

I'm not talking about people on disability for real reasons like quadriplegics, severe stroke, severe MS, etc. They need and deserve our help.

Just saw a quadriplegic patient yesterday, fully employed. Cspine injury in teen years. My dad's good friend was quadriplegic from MVA as a teen and fully employed.

I keep hearing the stats for unemployment don't include people who "choose to not participate in the labor force". WTH is up with that? Able-bodied people shouldn't have a "choice" of whether to work for money, food, and shelter vs just get it all for nothing.

Its simply the definition. Labor force participation rate takes into account those that could work.