Wal-Mart Wins.

Woah:

Mr. Berman...Wal-Mart as our cultural embassador? Surely someone with your intelligence wouldn't take such a stance? Are their other mass marketers which you feel embody the values and beliefs we, as Americans, hold dear? Hooters, perhaps...?

As far as your belief in the private sector:

God bless Rockefeller
God bless Henry Ford
God bless J.P. Morgan too, and his great treasure horde
God bless sex appeal
When wealthy men get bored
God keep their faith and profits high
And though the poor may starve and die
Make sure there is no Earthly court
To try
The Rich
Oh, Lord

I don't think anyone is belittling your sacrifices; my concern is that they may have been made some time ago, and you've since become insulated from some of the emotions you may have experienced back then. I'm sure you give a lot; lots of us do.

I can only hope that your rapport with your patients is far different from your manner here on PC. Here, you practice selective concentration and focus, and come across as very fixed and defensive, and unable to admit error.

 

<div class='quotetop'>QUOTE(Mystery Squid @ Jan 22 2007, 03:39 PM) [snapback]379133[/snapback]</div>

Oh geez...I can't believe I'm actually agreeing with Squid on something! Surely it is a sign of the apocalypse? Wait, is that the sound of hooves?

 

<div class='quotetop'>QUOTE(livelychick @ Jan 23 2007, 01:36 PM) [snapback]379609[/snapback]</div>

It's a nasty shock when that happens, isn't it?

 

<div class='quotetop'>QUOTE(dbermanmd @ Jan 23 2007, 10:47 AM) [snapback]379489[/snapback]</div>

thanks. and i know i'm not alone, which is why my temper flared when the discussion turned to canadian healthcare and why it's so cheap. it's expensive as all hell here and we see the same crap.

i get my insurance through the graduate school, it's bcbs. i can't afford anything else, i've checked into self-insurance and without making major sacrifices in coverage we couldn't pay for it. it would be even more expensive than it is now to add me to DH's plan for a number of reasons, we've calculated it all out, and besides, his policy has its own major downside. (and caused the majority of our 6-month spending)

when you get insurance through the grad school you have no primary care insurance, it's all through the student death *cough* health center and they send you around. if i've got legal recourse i'd love to hear about it. but as far as i can tell, they've followed all the procedures of my policy, with the exception of violating my patient's rights by not telling me what was being done to me at each appointment till i got there.

 

Information for Boggy Creek can be found at:
http://www.boggycreek.org
and donation information is available at:
http://www.boggycreek.org/2006/contribute/donations.asp

Now, a let me pose to you a situation. Someone walks into the clinic with chest pain - he's having a heart attack. He gets taken care of (i have no doubt that a clinic will at least keep him alive and get his heart beating again, regardless of his standing in life). Now, if he's well off, has medical insurance and all that, he might get a pacemaker or ICD. What happens to the homeless guy? Does he get one too, even though he has no insurance or money to pay for it? Does the hospital foot the bill for the device and all of the follow ups that come with it?

Now expand that situation to something even more costly. a hospital stay that may cost in the hundreds of thousands after you account for operations, equipment, and such. The guy with 10 figures is fine, he can afford it. What happens to the homeless guy? does he get some morphine so his last few days are relatively pain free instead of going through the procedure? what about the middle American, who makes less than 50k a year and has a savings large enough to pay for their children's schooling, if they're lucky? Sure, they have medical coverage... but most medical coverage isn't 100%... it might only be 80%, so instead of hundreds of thousands, we're only taking tens of thousands... a prolonged stay at the hospital and expensive life saving procedures can very quickly add up to a lot of money, easily enough to wipe out the 50k someone stuck away for their children's education.

 

OK, and now what about that middle American who doesn't have any health insurance, or in some cases the health insurance is minimal at best? They can afford the treatment, if the hock everything they own. but they don't qualify for medicaid - they aren't frail or infirm, or a child, or a poor adult... they're strictly middle of the road, middle income family.

IMO, the whole health care industry needs an overhaul. treatment in this country (especially medication) is way too expensive - it's usually much cheaper elsewhere like in Canada. Additionally, it's been hacked together over the years taking bits and pieces from various other sources - you get your health insurance, but it's not required. The government will pay for some stuff, but only if you're poor, elderly, or in a real shitty situation to begin with (like being a single mother of three or something). Your average middle class individual in his or her 20's or 30's is pretty much shucks out of luck.

Now, i don't pretend to know the solution to the problem. the current system really only lends itself to going two ways: either take the government out completely, or let the government take control completely. Neither of these solutions really appeal to me.

One of the biggest problems, IMO, is that those who present a drain on society (people who have pretty much never been employed, etc) are getting medical bills paid for by the government while those who are paying taxes to support those programs get basically nothing.

A new thought i haven't really figured out yet for the issue: Maybe we don't need to fix the current system of medicare, medicade, and health insurance... maybe, instead, we should fix the rising costs behind health care... Have the government absorb the costs associated with finding new drugs instead of the drug companies. then drugs would be available cheaply here at home, and we could sell them abroad to help pay for the program... of course, that smacks of socialism, which isn't necessarily a good thing either... gonna have to think on it a bit more.

 

<div class='quotetop'>QUOTE(livelychick @ Jan 23 2007, 03:36 PM) [snapback]379609[/snapback]</div>

If you took the time to actually follow through on most issues, you would likely agree with me 99% of the time... Likwise with anyone else, the only thing impeding your/their progress is your/their egos...



<div class='quotetop'>QUOTE(Pinto Girl @ Jan 23 2007, 03:10 PM) [snapback]379597[/snapback]</div>

Your intentional, pre-meditated, attempt to be balanced, caring, thoughtful, and worst of all, APPEASING, structured approach is utterly disgusting and offensive.

 

<div class='quotetop'>QUOTE(Mystery Squid @ Jan 23 2007, 03:19 PM) [snapback]379702[/snapback]</div>

So let me get this straight... you believe everyone would agree with you if it wasn't for THEIR egos? Try checking your own... it's human nature to have your own opinion of something, and i'd say it's also human nature that often those opinions will clash with others... the people on this board are very well educated and haven't just formed their opinions on a whim... often, the arguments for both sides of an issue are well thought out and take into account all information available. Maybe you should check your ego, and think about what it means when you say everyone should agree with you...

And as for your response to Pinto's post... i think you're the one whose post is utterly disgusting and offensive, not hers...

 

I do not have all the answers either, particularly the nuts and bolts ones. I do have a concept answer though. American citizens need to have responsibility for their own health and health care. If a smoker comes in and is treated for a smoking related disease, then refuses to stop smoking, no more paid for care.

STD's? severe restrictions on care unless lifestyle changes are forth coming. Over a certain age and need a heart transplant?, sorry, not financially wise.

IOW, UGLY choices. The WORLD itself cannot afford total health care ALL of the time. As rich as we are here, we cannot afford ALL the care needed for ALL of the people to do whatever they want.

So, it is just a matter of WHAT we are willing to pay for. I believe in universal health insurance, paid on a sliding scale by everyone. Even if you are working minimum wage, health care and retirement insurance should be something you HAVE to pay for BEFORE you are allowed to 1) own a car, 2) have cable TV, 3) have a cell phone, 4)smoke or drink alcohol, 5)on and on of a list of things not needed. Neccessities before conveniences before luxuries.

Now, the federal gov't would be lousy at this. These are ALL local issues and, personally, best handled as they were in the distant past, by faith based organizations who know what compassion means.

JMHO

 

I partially agree with you... but only partially. Individuals who suffer from personal choices shouldn't get any "free" health care paid for by the public. If you have a smoking related illness because you've been smoking 2 packs a day for the past 20 years, you're SOL. If you have a smoking related illness because you worked as a waitress for the past 20 years, you get taken care of. STD? SOL. problems related to being overweight (and i don't mean genetic obesity, i'm talking about people who could be fine if they stopped eating 3 meals a day at McDonalds)? SOL.

The problem with implementing anything of that nature is the level of oversight required. Some organization would pretty much have to be looking into every aspect of your life - not something i want. I definitely don't want it to be handled by faith based organizations like you do... That would require every such organization to get involved with health care, and it would require someone to be active in such an organization. I for one don't believe in organized religion (religion, yes. organized, no), so such a solution wouldn't work for me.

IMO, it should be handled the same way as your car warranty - you go in, they do the check up, look at the symptoms, and find the problem. if they can reliably show that the cause was based on personal choice, then you foot the bill. Otherwise, your insurance covers it. Obviously, this has some problems with it too, but it would take pages and pages to come up with a solution without problems...

 

<div class='quotetop'>QUOTE(eagle33199 @ Jan 24 2007, 11:43 AM) [snapback]380093[/snapback]</div>

The problem with any "personal choice" plan is the old slippery slope. So if you jump out of a plane and break an ankle on landing, SOL, too? Be careful all you 10,000 foot and counting guys... Or you decided on a Prius and get hit by an H2 and have a ruptured spleen. Personal choice, obviously, you should have went for the H1. SOL. And once we get to the Gattaca-level of genetic screening, then insurance will be even harder to get if you have the wrong family medical history, SOL, you should have had healthier parents.

Somebody explain to me again why the Canadian plan is so horrible and why Canadians have a longer life expectancy than us here in the allegedly greatest country on earth?

 

<div class='quotetop'>QUOTE(Beryl Octet @ Jan 24 2007, 11:24 AM) [snapback]380118[/snapback]</div>

Completely agreed... which is why i said it had some very clear problems with it.

I would say Canadians have a longer life expectancy because people here are just plain stupid. It's not a lack of good medical care in this country that keeps life expectancy lower, it's the fact that we're fat, chain smoking alcoholics who don't think about the consequences of our actions.

 

<div class='quotetop'>QUOTE(Schmika @ Jan 24 2007, 12:21 PM) [snapback]380064[/snapback]</div>

Um, wait. Are you suggesting faith based organisations control everyone's choices of transportation, communication, and entertainment? Please tell me I've read this wrong.

 

<div class='quotetop'>QUOTE(eagle33199 @ Jan 24 2007, 11:43 AM) [snapback]380093[/snapback]</div>

I agree with you to a point, as long as there were therapies available to help people who may have fallen into those bad habits at an early age before they knew better. It takes more than willpower, especially in the food area (as I know from personal experience...).