Health Care

[Shoopy]

My mom's a die-hard conservative and brought up the issue of doctor workloads/hours.

How bad are they going to get?

The government has our education system fucked up so badly right now. That's the only reason I'm hesitant to support this thing. Anyone see that Texas Board of Curriculum segment on the Daily Show? Major lolage.

I think our schools should work like European schools. If you show an affinity for something, you get put in a specialized school that fast-tracks your ass into an applicable job-field.

Also, Uncle Mox knows his shit.

[geerussell]

I think our schools should work like European schools. If you show an affinity for something, you get put in a specialized school that fast-tracks your ass into an applicable job-field.

I need look no further than the housing market to know how much staying power a cultural ideal has here. Home ownership is central to the american dream, renting means you failed at life. Shoving every american with a pulse into a mortgage left us with the economic equivalent of nuclear winter and our solution is to provide even more subsidies to convert renters into owners.

We're just a few years away from Denzel Washington making his way across the country with a book of real estate listings.

Substitute education for housing market. Plug in you-can-be-anything college degree and trade/vocational for home ownership and renting and you have an idea of the resistance European style fast-tracks would meet. Volcano.

[WTFchris]

My mom's a die-hard conservative and brought up the issue of doctor workloads/hours.

How bad are they going to get?

I'm sure there are lots of doctors that are way overworked (probably surgeons), but a lot of them just pass on their responsibilities to other people anyway. My wife basically has to hold the hand of some of those doctors. I'll give you an example...

There is a very good doctor where she works (specializes in lung diseases) and she forgot to tell her patients she cannot make her clinic next Tuesday because she'll be at a conference out of state. My wife caught the mistake or she never would have even told her patients.

This type of thing happens with a lot of the doctors she has worked with. Perhaps it is a result of overworking, I don't know. But I do know the ones that suffer are the support staff (nurses and sometimes MA's). They get extra work pushed onto them but they have nowhere to push it themselves so they just do more.

Doctors can delegate Nurse Practitioners, Nurses, MA's, etc to do all the follow up anyway. And when clinics are overbooked and doctors can't see patients in a timely manner then the nurses get chewed out for making people wait because administrators don't dare piss off the doctors.

Sure, I'm sure I'm a little biased, but she's worked at 3 hospitals and 2 clinics (and she's the farthest thing from a complainer I know) so I'm sure she's got a good handle on the situation.

[Uncle Mxy]

My mom's a die-hard conservative and brought up the issue of doctor workloads/hours.

How bad are they going to get?

Shortages are worse for clueful medical support staff like RNs. Moreover, doctor shortages are most severe among the GPs and pediatricians most needed for the care initiatives that healthcare reform pushes. Would-be doctors discover that the best way to deal with their severe debt from med school is to specialize. Our solution thus far has been to import the talent, but with currency exchange rates as they are, it isn't as lucrative to work in the U.S. as it was. I suspect the weak dollar will lead to more shortages than the healthcare reform act over the next few years, but of course every healthcare problem from now to eternity will be blamed on the new laws by people who ignore how things were beforehand.

There's a lot of employment opportunity for GPs and nurses in the bill, of course. There's some initiatives for doing rural work. There's some funding as part of healthcare reform for bonuses to current GPs, but not really for the medical students to get them on the path. However, healthcare reform is only one part of the equation here. The student loan reforms also passed as part of reconciliation are a big fucking deal, too. Once the student loan program gets distanced from the private banks, "fertilizing" medical students further wouldn't require acts of Congress. It's not European-style vocational training (which I think we need more of, and which our academentia rails against to their detriment), but it's a start.

[Glenn]

^Lol @ "big fucking deal".

[Tahoe]

My mom's a die-hard conservative and brought up the issue of doctor workloads/hours.

How bad are they going to get?

The government has our education system fucked up so badly right now. That's the only reason I'm hesitant to support this thing. Anyone see that Texas Board of Curriculum segment on the Daily Show? Major lolage.

I think our schools should work like European schools. If you show an affinity for something, you get put in a specialized school that fast-tracks your ass into an applicable job-field.

Also, Uncle Mox knows his shit.

Mxy is obviously one of those guys you'd want to cheat off of if you were taking a test.

He researches and finds links and understands them. But if he were a conservative, he could do the same thing for the conservative side.

[Uncle Mxy]

The biggest things missing are ubiquity and cost controls.

Some aspects of what still needs fixing are pretty simple, and require political will -- undoing Medicare Part D's drug buying restrictions, allowing adults to _buy_ Medicare coverage if nothing else, etc.

One aspect that bugs me involves illegal aliens.

I suspect if you poll the population and ask "should illegal aliens get any free healthcare", most would say "no". But what a hospital may have to deal with is someone unconscious or in trauma at the ER. They don't want legal liability for denying treatment to a legal alien. Many staffers don't want the moral liability of denying care to the sick. So, we still have to deal with illegals' catastrophic costs, which is considerable.

Can we actually _bill_ the countries where the illegal aliens come from for the healthcare we're providing to their people? Can we seize their assets in our country if they don't pay? If the countries tell us to drop dead, can we tell the illegals from that country to drop dead? How much blowback would occur? This can't possibly be a new idea, but it isn't one I recall hearing from the pundits. Am I just daft?

[geerussell]

If the countries tell us to drop dead, can we tell the illegals from that country to drop dead?

We could but we wouldn't. Of course I'd have said the same thing about torture at one point so who knows, anything is possible. Maybe one day we'll just shoot them at the border and save all the fuss.

[Uncle Mxy]

He researches and finds links and understands them. But if he were a conservative, he could do the same thing for the conservative side.

It depends on what you mean by "conservative", I suppose.

Let's apply to healthcare, since that's the thread at hand. I don't subscribe to the "every sperm is sacred" camp. I don't subscribe to keeping incurably brain-dead people alive at all costs. Is that a "conservative" or "liberal" definition of human life worth saving? So-called "conservatives" in this country seem to have a very liberal view of what life is and isn't, as far as I can see. But you start talking death penalty, and suddenly many conservatives who call themselves "pro-life" are gung-ho for it... "kill 'em and let God sort it out". WTF?!

Financially, I'm a fan of socialized healthcare because the rest of the modern world (including a few governments we established) pays less than us per-person for similar results. We've lost employers and jobs over the costs our private system. Meanwhile, healthcare companies enjoy record profits during the worst recession since the Great Depression. They have plenty to spend on Lipitor ads to get Joe Q. Public to strongarm their doctors. Healthcare has antitrust exceptions and anti-competitive laws like Medicare Part D prohibiting bulk drug buys so they can be this 800 lb gorilla. But we have so-called "fiscal conservatives" spewing one bullshit argument after another in favor of this? WTF?!

Then, you have the so-called "limited government conservatives", who have sucked at the public tit in gazillions of healthcare-related ways (food and water quality, a functional sewer system, etc.) but this socialized medicine thing is "just too much". Puh-leeze. They can't generally articulate what government is doing for them, let alone what it should be doing for them in any absolute sense, and often go the route of willful ignorance in the face of basic facts. Most elected "limited government conservatives" are nothing of the kind, and just want to limit one area and overspend on another. WTF?!

Is defensive medicine, where you overmedicate just to be on the safe side, a "conservative" or a "liberal" medical philosophy?

Back on track... here's some good "plain language" writeups of the healthcare reform that from that most-liberal of publications, the Christian Science Monitor:

http://www.csmonitor.com/USA/Politic...l-means-to-you

[Uncle Mxy]

http://www.orlandosentinel.com/news/...,5593120.story