healthcare as a right: heresy or gospel?

[jenfly00 0]

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Dude, read your own posts. They ain't exactly dripping with the milk of human kindness.

I suppose looking at it one way, I am a cold peckerwood. On the other hand, I could accuse you of being of the opinion that anything less than outright coddling of others is by its nature uncaring and unkind.

I suppose you don't see the kindness in cruelty, do you? The two cruelest and kindest people I ever knew were the same two people: My physical therapist, who tortured me for about a month to get back full range of motion in my knee; and my drill sergeant, who wouldn't let me believe I couldn't.

Both of them told me and showed me that the pain of moving forward is, in the long run, less than the pain of not moving forward. Drill sergeant Nichols, especially, showed me that I had capabilities I had never known because I hadn't pushed myself. So HE pushed me and wouldn't let me quit. It soon became me pushing myself, because I wouldn't let him push me. The cruelest person I ever knew. He was also the kindest.


So, jen, I'll ask you these questions:
1) Which is nicer? Convincing someone to go through the hell of rehab, or just letting them live the more easily tolerated hell of addiction?
2) Which is nicer? Putting someone through the hell of chemotherapy, or convincing the person try living with cancer untreated?
3) Which is nicer? Getting my child to go out and play, or letting him watch TV and eat chips nd drink soda, which is what he may realy want to do?
4) Which is nicer? Coddling a person, or having expectations of a person?

Human kindness comes from different things. Letting people feel sorry for themselves is NEVER a good thing, in my book. Helping people move forward IS a nice thing, even though it doesn't seem like it at the time.

"The milk of human kindness?" Even babies get weaned. They hate it, but it happens because we all must move forward. It so happens, it's a kind thing to do to growing children.

"The milk of human kindness?" Is your suggestion that everyone stay on the teat of someone else through perpetuity? That's mean to all involved.

I'd willingly support giving the college student with the UTI a few dollars in antibiotics. Back to the point of the thread. It's basic health care and I believe should be supplied to every citizen.

I appreciated the candor in you response in the compassion thread, BTW.

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"O brave new world that has such people in it".

[wmw999 2,147]

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It's basic health care and I believe should be supplied to every citizen.

How do you define basic health care, and who do you think should get to define it in each case?

Because the answer will be vastly different if it's the patients rather than the doctors. Or an HMO. And the answer to that question is the key to any meaningful work ever happening on this issue.

Edit to add: does you mean that taxpaying non-citizens are ineligible for that same sort of basic healt care?

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[jenfly00 0]

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It's basic health care and I believe should be supplied to every citizen.

How do you define basic health care, and who do you think should get to define it in each case?

Because the answer will be vastly different if it's the patients rather than the doctors. Or an HMO. And the answer to that question is the key to any meaningful work ever happening on this issue.

Edit to add: does you mean that taxpaying non-citizens are ineligible for that same sort of basic healt care?

Wendy W.

I agree it is a complex issue (your edit is just plain silly, however). We need to do it, however, because it is the right thing to do. It is the human thing to do. It is the American thing to do.

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"O brave new world that has such people in it".

[wmw999 2,147]

My edit is based on the content of your post.

That said, you still haven't defined what constitutes basic health care. If you want to assert that everyone should get basic healthcare, you should be prepared to define it. Because otherwise you're just setting up for a competitive debate, and not discussion.

Right now if someone is hit by a car, the vast majority of the time they will be taken to a hospital, stabilized, and given some sort of reasonably appropriate treatment. So obviously it's unreasonable to say that no healthcare is provided.

On the other hand, few people are going to get boob jobs on public dollars. There's a lot of room between them.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[wmw999 2,147]

Just to get things started, I haven't been in this thread much because I'm not at all sure where the line is.
- Preventive care:
- Free immunizations
- Free flu vaccines (Reactions to these two are treated like illnesses; you pay for them. Yes, some people are luckier than others)
- Free vision screening for children in school, and free eyeglasses (1 pair every 2 years, or on a pre-established prescription change level) for children.
- Free condoms at every drugstore
- Mandatory health education in school, with emphasis on fitness and nutrition, as well as informing children starting at the age of 13 that condoms are available at every drug store.

Other care is harder; there are so many things that can go wrong, and so many of them get worse with neglect. Right now, we reward people too much for putting things off; they're more dramatic, and more of an emergency.

Some folks just want to talk to a doctor/nurse practitioner; preferably for a really long time. They take the time that others could be using. But they don't pay more. And some people will totally abuse any system.

Do people have the "right" to use a system they regularly abuse, because of their humanity? I'm not sure they should. People don't deserve not to be miserable. And yes, some people are luckier than others.

Of course, I also think that drug advertising should, by and large, be banned. The amount of money spent on advertising eclipses sometimes the amount spent on research. Which means that advances are made in profitable conditions, where new drugs in new-colored pills can come out every couple of years. And people are arrested for buying a less expensive one from the next country over.

Just a few thoughts. I'm sure there are lots of holes in them.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[skydiver30960 0]

Awright everybody: it's a great thread so far, don't let it degrade to PA's... keep up the good work!

Now:

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Every time you have a headache....every time you have nausea/vomiting....do you go for a CT scan?

Interestingly enough, a lot of my ER docs do just this very thing. It's quick, it's easy, and it covers their ass against the fabled one-in-a-million "hidden nightmare."

Notice I didn't say it's cheap.

I think a lot of the discussion between you two (jen and linz) boils down to "what we do" vs. "what we should do." But here's the real question we need to tackle: what changes need to be made to bring these two things together?

For me, tort reform and liability reform are tops on the list. I've heard that the OB/GYNs in my area are leaving the field in DROVES because as one put it "I'm working seven months out of every year just to pay my insurance." Leave it to a skydiver to say this, but society needs to be ready to accept the results of our decisions, including who we choose for our healthcare. Lawrocket, waddaya think?

What other changes do we as a group think need to be made to make what we do, what we should do?

Elvisio "zebra" Rodriguez

[lawrocket 3]

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For me, tort reform and liability reform are tops on the list.

I agree wholeheartedly. Physicians - especially OB's and ER docs, are like walking lawsuits. Especially OB's - every time a baby is born with a zit, sue the doctor. Chromosomal defect? Sue the doctor. Unexpected shoulder dystocia? Sue the doctor.

I personally would like to see tort reform based on a contributory negligence theory. That is, if any patient is shown to have been negligent in following medical advice, then their recovery is substantially limited, if not barred outright. ANy patient shown to be noncompliant with care instructions (i.e., a high risk OB who refuses to take off from work against medical advice) should be held responsible for the consequences.

I'm arguing for different treatment for doctors, but I think in temrs of societal need, we NEED to cut them some slack.

My wife is hotter than your wife.

[mnealtx 0]

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They weren't hurt feelings. However, if I were to say something patently false about you, I'd expect you to not be some spineless milquetoast and say something about it.

I personally would love it if linds treated me. She coul dcut my belly open and show me all the black stuff I have in there.

Is that a lawyer technique? Draw others into your disagreement for support? Damn, I see why you make the big bucks.

Dude, read your own posts. They ain't exactly dripping with the milk of human kindness.

Poor baby. Want me to get you a tissue?

Quite welcome!

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[jenfly00 0]

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My edit is based on the content of your post.

That said, you still haven't defined what constitutes basic health care. If you want to assert that everyone should get basic healthcare, you should be prepared to define it. Because otherwise you're just setting up for a competitive debate, and not discussion.

Right now if someone is hit by a car, the vast majority of the time they will be taken to a hospital, stabilized, and given some sort of reasonably appropriate treatment. So obviously it's unreasonable to say that no healthcare is provided.

On the other hand, few people are going to get boob jobs on public dollars. There's a lot of room between them.

Wendy W.

My bad, I read it as 'tax-paying citizens'. I apologize for calling it silly.

What is covered is beyond what any of us can come up with here. Aside from my suggestion to providing compassionate end of life care for the irrecoverably ill and diverting those mega billions to medical care for those who have a chance to actually recover and live a life, I don't have specifics other than to refuse to cover 'elective' surgeries. I certainly don't have the answer to the tangled nest of illegal immigration problems.

I certainly would be most generous with preventative care, medical care for children and peri-natal care. Other than that, the decision to move in that direction needs to be made first ...the most complex details to be worked out in the process. I doubt it would be easy. I also doubt it will happen. Too many powerful people and corporations have the present system locked.

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"O brave new world that has such people in it".

[nathaniel 0]

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That is, if any patient is shown to have been negligent in following medical advice

That's not far enough. We've lost sight that medicine and health is inherently a risky business. The only guarantee is that you will get sick and die, eventually.

IMO it should be strictly the patient's liability for accepting their doctor's advice and consenting to a procedure. It should be a doctor's responsibility only to inform of the risks. Like stocks & bonds, you can't sue your financial advisor just because your investment lost money on their reasonable advice. Well you could try, but you'd lose.

Which is not to say there isn't real fraud in stocks & bonds, or that there aren't lawsuits between investors and advisors. But the financial industry is overall relatively well managed and regulated. They face much greater risks ($billions worth) on a regular basis and aren't facing collapse due to gov't subsidies.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[Lindsey 0]

CT scans??? I'd be happy if you simply allow them through the door of the ER.

Ummm....they have to get through the door to be seen. I don't think people should not even be seen. I just think that a whole lot of people can be medically screened (seen/examined by a physician) and sent away without treatment and/or further workup if they don't require emergent care

linz

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A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[kallend 1,647]

The wonderful healthcare system in action:

today.reuters.com/news/articlenews.aspx?type=domesticNews&storyID=2006-10-24T212500Z_01_N24217971_RTRUKOC_0_US-LIFE-HOMELESS.xml&WTmodLoc=USNewsHome_C2_domesticNews-2

...

The only sure way to survive a canopy collision is not to have one.

[Lindsey 0]

As scary as it is to not just let this thread die....

Our noon conference today was given by the business office. What I learned is easy to sum up. We lose hundreds of thousands of dollars in our ER because of the way we handle non-emergent cases that come to us.

Apparently, if a patient has Medicaid we can evaluate that person's condition and be paid for our what we reasonably need to do for assessment purposes. However, if we treat a person with a non-emergent problem, we are reimbursed $18. If we do the same assessment and DON'T treat with any prescription medications, we're reimbursed for most of the assessment...hundreds of dollars as opposed to $18. If we assess them and find that the condition is non-emergent, the ER is paid if we send them back to their primary care docs for treatment. For the most part, this is what I try to do anyway.

It bothers me that Medicaid encourages physicians not to treat, though, by paying us not to treat what they deem non-emergent. This even goes for things like STD's. How many people do I diagnose with Chlamydia every week???? Too many. According to their guidelines, chlamydia is a non-emergent condition and should not be treated in the ER. I usually treat Chlamydia with a one-time dose of doxy. I give it in the ER, and that way I know they're treated. When I do this, I cut the ER's reimbursement down to $18. AMAZING! And here I've been thinking that I was being kinda bold not giving someone cough medicine who's been couging for the past week. Silly me.

linz

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A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[nathaniel 0]

http://www.eurekalert.org/pub_releases/2006-10/bpl-icc103106.php

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Oakland, Calif. – October 31, 2006 – The largest-ever study on the effects of health care co-payment costs on emergency department visits has revealed that requiring patients to pay for a portion of the cost can reduce the number of visits. The study also finds that this decrease does not negatively affect health.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?