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Originally Posted by Gibonius View Post
So, are you going to be finding a new profession? I hear that all our doctors are now going to be unable to make a living and are going to become taxi drivers or something.


/conservative rant radio mode

This isn't just a rant, it's real. I've worked for the same medical practice for the past 10 years, this place has been around for 33 years and now it's doubtful we'll even make it to 2014 when all of the changes really start happening. These are scary times for doctors.
Old 03-25-2010, 12:46 PM Sarah Palin is offline  
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Originally Posted by Gibonius View Post
The best at the top end, sure. If you had the money, you could get really really good care. But we spend the most money to cover the fewest people, and we're spending more money every year, putting care out of the reach of more people every year. Even today, people in the middle class are feeling significant pressure from the costs. Additionally, with our employer based system, it was putting an incredible strain on our businesses. It was an unsustainable system, we simply couldn't allow health care to become 25-30% of our entire economy as it was trending towards.

If you try to buy a house in New York or California it's the same thing, most average homes outprice average families. So what's the answer there?

Unfortunately the sad sad truth is healthcare is no different from housing, education or the car you drive. Money talks, if you can afford better you get better. Once you start saying HEY THATS NOT FAIR I WANT WHAT HE HAS and expect everyone to get the same, then you aren't the USA anymore.
Old 03-25-2010, 12:51 PM Sarah Palin is offline  
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It would be unconstitutional for the feds to pass tort reform as most malpractice cases are handled at the state level, it's pretty much up to each individual state to impose these reforms, not the feds... some have started
I'm not so sure about that, Federal law can supersede state laws. I don't know about this specific case, but in general it's possible.

Like I said, this is a Republican talking point. They're hypothetically the state's rights party, so maybe they're talking out of both sides of their mouths and the whole thing is even more ridiculous. I don't care to defend it, because I think it's kind of a stupid idea anyway.
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We have to be careful about how big we want the federal gov't to be. The country was set up with sovereign states, and as it stands now if you don't like the policy of one, you can move to another. If we remove this and make everything "the same" under one big federal government then we really screw ourselves because our votes will then matter less than they already do.
We have to be careful about letting rabid adherence to dogma cripple our country too. The problems with health care were not going to go away, nor were they going to be addressed seriously at the state level any time soon. There are also serious interstate issues like people that work in a different state from where they live, or people who travel, that cannot be dealt with on the individual state level. It's a nice idea that every state can run their own little experiment on policy and people can move to wherever is working, but no state has figured this out yet.

Quote:
This isn't just a rant, it's real. I've worked for the same medical practice for the past 10 years, this place has been around for 33 years and now it's doubtful we'll even make it to 2014 when all of the changes really start happening. These are scary times for doctors.
If the practice isn't going to make it to 2014, you should really be in favor of some kind of reform, since the old system was only going to get worse every year.

I don't have any particular sympathy for the medical profession. They're dealing with what the entire country has dealt with over the last couple decades: it's harder to make a living. Being a doctor no longer automatically means you're going to be rich. Being a nurse no longer automatically means you can support yourself on middle class lifestyle. But the same thing has happened to many, many professions. It's just something we all have to live with, medical practitioners are not exempt. Used to be that getting a college degree was a meal ticket to the middle class and a professional degree meant $$$. No longer. People need to accept that, or we need to start radically changing our economic policy.

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If you try to buy a house in New York or California it's the same thing, most average homes outprice average families. So what's the answer there?
Rent. Move. Have a roommate. No one needs to own a house to live, nor live in California or New York. On the other hand, everyone needs health care and there are no tolerable alternatives. You either get what you need, or you suffer and/or die.

Also real estate bubble ftw on this one. I love this shit, saving me hundreds of thousands of dollars when I go to buy a house soon.
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Unfortunately the sad sad truth is healthcare is no different from housing, education or the car you drive. Money talks, if you can afford better you get better. Once you start saying HEY THATS NOT FAIR I WANT WHAT HE HAS and expect everyone to get the same, then you aren't the USA anymore.
No one is talking about equal health care for everyone. The idea is access to BASIC health care for all. Health care, unlike owning a house, is a basic human necessity. We have public schooling, for everyone. We have assisted living, public housing, etc for people who can't afford it. But until recently, we had huge numbers of people who couldn't afford even basic health care. The rich are still going to have access to better insurance and better care, that's perfectly fine, but at least now most everyone can get SOME care when they need it.
Old 03-25-2010, 02:23 PM Gibonius is offline  
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This isn't just a rant, it's real. I've worked for the same medical practice for the past 10 years, this place has been around for 33 years and now it's doubtful we'll even make it to 2014 when all of the changes really start happening. These are scary times for doctors.



please feel free to elaborate how your medical practice with a 33year history is doubtful to make it 4 more years.
No more patients?
Free treatments?

Aww shiit
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Old 03-25-2010, 02:27 PM Bukkakeboy is offline  
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Unfortunately the sad sad truth is healthcare is no different from housing, education or the car you drive. Money talks, if you can afford better you get better. Once you start saying HEY THATS NOT FAIR I WANT WHAT HE HAS and expect everyone to get the same, then you aren't the USA anymore.



Bout time you came here and said something _really_ retarded. Been a while since you shat out a tardnugget in the pit and then vanished.


also, thanks to gib for replying to this in a coherent matter.
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Old 03-25-2010, 02:31 PM Bukkakeboy is offline  
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and how is this best?

When a significant portion of your citizens don't have access to said service, your country does not have the best service in the world

You may have the best service for the privileged, but that is not a good measure for an entire country's healthcare system.

Zangmonkey: please reply
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Old 03-25-2010, 02:33 PM Bukkakeboy is offline  
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please feel free to elaborate how your medical practice with a 33year history is doubtful to make it 4 more years.
No more patients?
Free treatments?

Aww shiit

Medicare has already cut physician compensation drastically, with another 21% cut postponed until the end of this month, all other insurance companies base their compensation upon medicare, so when medicare goes down, so does everyone else.

At least in our area, private practices have been struggling for some time, we have to pay healthcare premiums too, as well as malpractice premiums, these are all very very high, our costs continue to rise and our compensations continue to fall.

We are also under a EMR deadline that takes effect around 2014ish as well, and this comes at a considerable cost, tens of thousands up to a hundred thousand dollars or more in investment with a $40k incentive coming from the gov't by way of tax breaks stepped out over 5 years (for practices implementing EMR by 2012 only)

It's a growing concern that the money it costs to run a medical practice outweighs any compensation to be received without some sort of hospital or government affiliation.

At this point, our practice is struggling to make it through the end of the year, and at that time it's going to be iffy if the docs will just take early retirement and fold or if they'll continue to practice at all.
Old 03-25-2010, 04:18 PM Sarah Palin is offline  
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Originally Posted by Gibonius View Post

No one is talking about equal health care for everyone. The idea is access to BASIC health care for all. Health care, unlike owning a house, is a basic human necessity. We have public schooling, for everyone. We have assisted living, public housing, etc for people who can't afford it. But until recently, we had huge numbers of people who couldn't afford even basic health care. The rich are still going to have access to better insurance and better care, that's perfectly fine, but at least now most everyone can get SOME care when they need it.

people have always had access to free healh care, you go to the ER you get treated you don't pay the bill... sometimes you can even get a free clinic and not have a bill at all.. free health care has always been available, maybe it's not top notch, but neither is my 11 year old car, but it's what I can afford... Health CARE is not the issue, tha'ts available, it's health care COVERAGE we're talking about here.
Old 03-25-2010, 04:22 PM Sarah Palin is offline  
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Bout time you came here and said something _really_ retarded. Been a while since you shat out a tardnugget in the pit and then vanished.


also, thanks to gib for replying to this in a coherent matter.

Yeah well you're ugly

There now we both made useless trollish replies

Is this how it goes in The Pit now? You disagree with something someone says and all you have to do is say "RETARD" and that's a fair argument?

Interesting.
Old 03-25-2010, 04:35 PM Sarah Palin is offline  
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people have always had access to free healh care, you go to the ER you get treated you don't pay the bill... sometimes you can even get a free clinic and not have a bill at all.. free health care has always been available, maybe it's not top notch, but neither is my 11 year old car, but it's what I can afford... Health CARE is not the issue, tha'ts available, it's health care COVERAGE we're talking about here.

It's only for emergencies. There's a huge difference between "the hospital won't let you die, right now" and "access to free health care."

I'll use myself as an example, with some slight modifications. As of last year I had a marginal salary ($22k) and decent insurance. But, even a slight twist could have left me without insurance, or without a salary period. Let's assume that was actually what happened, since there are plenty of people like that in the US. I'm also a diabetic. It costs $5000 or so a year to adequately treat my condition. This is a daily, hourly really, thing. I cannot wait until it's an emergency to go to the hospital. Medicaid wasn't an option (no dependents). I would have had to rely on fickle charity to stay alive and vaguely healthy. Additionally, I herniated a disc last year. The surgery was $40k (before the insurance adjustment, so like $20k in reality), but it took me from being in debilitating pain to perfectly fine. Now I've got a good job and am paying taxes. Without insurance, I wouldn't have been able to get the surgery, would have been in pain perpetually, and would have been sitting on my ass at home collecting disability.

We can neglect the ethical components of refusing access to care until it's an emergency, but on a strictly practical sense, it's a bad financial decision. Emergency care is incredibly expensive. A single emergency room visit would pay for a year's worth of insulin. Two year's worth of disability payments would pay for a herniated disc surgery, and then that person would be paying taxes again instead of sucking down disability. We can go on.
Old 03-25-2010, 08:44 PM Gibonius is offline  
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Quote:
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Medicare has already cut physician compensation drastically, with another 21% cut postponed until the end of this month, all other insurance companies base their compensation upon medicare, so when medicare goes down, so does everyone else.

At least in our area, private practices have been struggling for some time, we have to pay healthcare premiums too, as well as malpractice premiums, these are all very very high, our costs continue to rise and our compensations continue to fall.

We are also under a EMR deadline that takes effect around 2014ish as well, and this comes at a considerable cost, tens of thousands up to a hundred thousand dollars or more in investment with a $40k incentive coming from the gov't by way of tax breaks stepped out over 5 years (for practices implementing EMR by 2012 only)

It's a growing concern that the money it costs to run a medical practice outweighs any compensation to be received without some sort of hospital or government affiliation.

At this point, our practice is struggling to make it through the end of the year, and at that time it's going to be iffy if the docs will just take early retirement and fold or if they'll continue to practice at all.

This sounds more like a problem linked to trying to run a business in Michigan, not the general economic climate for the health care industry. I live in a different region of the country and all my doctor friends are rolling in dough (most tell me they don't turn down medicare rates because they make enough money otherwise that there's just no use in being dicks).
Old 03-25-2010, 08:57 PM bingstudent is offline  
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"House gives final approval to 'fixes' for health care law"

So they deliberately pushed something through that they knew was flawed?
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Old 03-25-2010, 11:28 PM mofugger is offline  
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"House gives final approval to 'fixes' for health care law"

So they deliberately pushed something through that they knew was flawed?

that is what I don't like about the new bill.

They couldn't get enough support in their own party to do a proper reform (something more norway'y or germany'y), prolly due to corruption/clashing loyalties (ie. not the people). From the republicans all you'd get was a stone wall no matter what they brought up (unless it was the same 0 changes the repubs have been "fighting" for the last 10yrs).

Partisanism and not having the best for the country/people in mind is what fucked it up.

It is still good that it passed, because if it hadn't, nothing meaningful would have changed and you'd still keep fucking over the american people (like in Gib's example).

SPalin: Gib again explained why your statement is retarded. Though in a very demonstrative way.
I just called you out on your retardocity, because god DAMN that statement was fucking out there.

People weren't "looking to the next guy" thinking they were entitled to "the best healthcare in the world(tm)", they were getting ill and/or fired and getting FUCKED in the ass, no lube by an 18-wheeler 100% legally!. Fuck insurance companies were giving bonuses to their employees who managed to drop people who actually needed care! (Imo, if that could be proven in a court of law I'd dismantle the whole fucking company and put the execs in charge in jail for 20+yrs)

Like gib said, (and I don't even know how long the healthcare system has been like it was up until now) you have been grinding people into disability/being a burden on society despite their best efforts/wishes/wants. Is this in line with your republican talking point mentality?

All it took was one or two strokes of bad luck and hello to a life of being a burden on the ass of society.
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Last edited by Bukkakeboy; 03-26-2010 at 01:34 AM..
Old 03-26-2010, 01:28 AM Bukkakeboy is offline  
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people have always had access to free healh care, you go to the ER you get treated you don't pay the bill... sometimes you can even get a free clinic and not have a bill at all.. free health care has always been available, maybe it's not top notch, but neither is my 11 year old car, but it's what I can afford... Health CARE is not the issue, tha'ts available, it's health care COVERAGE we're talking about here.

I just facepalmed. I am glad Gib has the patience to give thoughtful and reasoned rebuttal, though I'm not sure this comment deserves either.

I'll just say this: we live in an age and society of chronic disease. Hypertension, diabetes, obesity, COPD, chronic pain, substance abuse, congestive heart failure, etc etc etc - these are the things that fill our hospitals and ERs. Managing any of these in a cross section of time during an acute care visit doesn't do much to change the trajectory of these conditions over time. Complications accumulate, requiring more and more acute care visits, more and more testing, more and more procedures and more and more expense to the individual and the system. A horrible solution for chronic disease, considering many of these complications could be avoided by very simple maintenance primary care.

Going to restrain myself with that said.
Old 03-26-2010, 04:05 PM Arjuna is offline  
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TheMorlock
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Arjuna, until we solve the aging process all the problems you list will come to pass no matter what. It just depends on when.

With the level of medical care that this laws supporters claim to want for everyone it just stretches that level of care for 20 years beyond the point where the person has a semblance of a mind left. And instead of the few who get it the entire population gets it.

Costing even more.
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Old 03-26-2010, 05:27 PM TheMorlock is offline  
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