I spend a large portion of my time outside the USA, but I know of 2 hospitals in the US that moved things like their OB departments outside of city limits into very wealthy neighborhoods in order to be able to transfer charity OB out instead of rendering mandated care because "they don't ofer the service."
Throwing down the gauntlet
- Thread starter Veneficus
- Start date
I spend a large portion of my time outside the USA, but I know of 2 hospitals in the US that moved things like their OB departments outside of city limits into very wealthy neighborhoods in order to be able to transfer charity OB out instead of rendering mandated care because "they don't ofer the service."
emt seeking first job
Forum Asst. Chief
- 921
- 0
- 0
I noticed a lot of "urgent care" with signs that read THIS IS NOT AN EMERGENCY ROOM, CALL 911 FOR EMERGENCY clinics opening up and ER's closing. In fact I know of one hospital, shut down, ER closed, another insititution bought it, and now it is an "Urgent Care Center"
Get the chance and see what it's like? Are you going to tell us at some point that you, or someone in your family (God forbid) is being denied a treatment or surgery?
The good thing about urgent care centers is that it cut down on the ED crowds, and also our call volume. I didn't see many at all back in NY , although I last worked in the system in 2007. We get emergent calls out of these centers from time to time, but they're typically insured, so we're at least getting reimbursed.
I've seen that as well. In my own county, INOVA Mt. Vernon cut their OB dept. The Richmond Highway (Rt. 1) area is the poorest region in the county. I think that we're eventually going to see just a handful of huge hospiatlas that provide many specialty services, like NYU, Cornell, NSUH Manhasset in NY, for example. Those surgeries and services can overcome the burden of the numerous uncompensated cases. The smaller hospitals will keep falling like dominoes, like NYC's St. Vincent's CMC. They just can't cut a profit with so many of the uninsured and underinsured using them. I understand they may have nowhere else to go, and there's nothing wrong with that, but it still results in the hospital going belly up at some point.
No, that is not the case.
I am experiencing what it is like when people are turned down for treatment because they cannot afford it due to under or uninsured.
Where when a medicine is prescribed the patient tells you they simply cannot afford it.
I find it is very difficult to see people go through it and see it as the direction the US is heading unless some type of meaningful and workable reform is enacted.
Taking the example of the numerous hospital closings in NYC over the past several years, if the hospital denies no one, and provides treatment and surgeries to anyone who needs it, they'll eventually run deep in the red and shut down.
My understanding in Canada is that the physician or specialist is capped at a certain dollar amount of profit each year. Specialists can make more than a general practicioner, but they're still capped. What they do is pace themselves throughout the year, to reach that cap at or just before the end of the year. This applied to treatment and surgeries as well as office visits. This is why there are waiting lists, why elective surgeries have to wait months and months. There's no incentive to get pts what they need as quickly as possible; they'll be working for free for the last few months of every year, or be taking under the table bribes to place the more affluent ahead of all others in line. This keeps costs down, I would think, since there are less surgeries and treatments being provided. Actually, this keeps the govt's costs down, not mine, since we're all carrying those who refuse to pay (welfare abusers and career entitlement scam artists, not those that have legitimate need). This is what we're headed for.
So what do you suggest?
My understanding in Canada is that the physician or specialist is capped at a certain dollar amount of profit each year. Specialists can make more than a general practicioner, but they're still capped. What they do is pace themselves throughout the year, to reach that cap at or just before the end of the year. This applied to treatment and surgeries as well as office visits. This is why there are waiting lists, why elective surgeries have to wait months and months. There's no incentive to get pts what they need as quickly as possible; they'll be working for free for the last few months of every year, or be taking under the table bribes to place the more affluent ahead of all others in line. This keeps costs down, I would think, since there are less surgeries and treatments being provided. Actually, this keeps the govt's costs down, not mine, since we're all carrying those who refuse to pay (welfare abusers and career entitlement scam artists, not those that have legitimate need). This is what we're headed for.
So what do you suggest?
That's where I teach.
I have lots of stories of students (or student's immediate family members) being denied care because they can't pay, but I feel like I'd cross a professionalism line if I shared.
I understand that everything costs money, and health care has to be paid for some how, but it's wrong to let people suffer because we can't figure out how to fix health insurance.
There is no simple answer, there are many issues that have to be addressed, and too many hands in the pot that have too much to lose to let anything meaningful happen.
Ultimately I think everyone who has an interest will have to sacrifice something.
The only real question is whether it is done before the economic realities force a cash and carry only system.
Smash
Forum Asst. Chief
- 997
- 3
- 18
The rest of the world looks on with dismay at this sort of attitude amongst those who are supposedly in caring professions. We also find it perplexing when we happily provide the Great Satan of socialized health care, and yet strangely enough our economies haven't collapsed, society hasn't broken down, and everyone gets the care they need.
Sure, the system isn't perfect, there are many things that could be changed for the better, but the fact of the matter is, if I pick up a homeless, jobless and uninsured patient off the street who is having a STEMI, he will get stented, he will get the medications he needs (not plavix or heparin hopefully!) and he will get follow up and cardiac rehab afterwards. This doesn't break the economy, doesn't cost jobs and doesn't cripple us with taxation, hence our trouble understanding the vicious, cold hearted and frankly disturbing attitude displayed here.
The mark of true civilization is how we treat those less fortunate than ourselves.
So, either we deepen the rift between the haves and the have nots, and tell the have nots that they're SOL, or we all carry those that can't provide for themselves (a relatively small number) and the career entitlement abusers (their numbers are legion, and their votes are highly valued). I'm okay with universal healthcare, provided that all able bodied adults are productive in some way, shape, or form, and there needs to be massive entitlemnt reform (pipe dream, that would constitute political suicide). There's absolutely no reason why a welfare recipient can't perform labor for the government. How about litter removal, parks beautification, landscaping such as cutting grass, stuffing envelopes, janitorial work such as cleaning bathrooms and mopping, something. If the career entitlement abusers were forced to leave their homes and surrender their free time to perform labor for 40 hours a week, you would see a lot less people on the gov't dole. It's hard to work your under the table job while receiving a gov't check when you're mandated to be somewhere else.
I'd also like to see our retirement system replaced with a plan similar to the one in Chile:
http://www.cato.org/pub_display.php?pub_id=5981
Why is a proposal similar to this not on the table, as we're discussing entitlement reform?
emt seeking first job
Forum Asst. Chief
- 921
- 0
- 0
IMHO, just like everyone is entitled to a basic level of police, fire, and education for free, there should be free health care.
Just like the above can be augemented with private security and private schools/tutors; private health care could be made available for those willing and able to pay.
There was a time when there was no public education and some places have subscriber paid police and fire...
It could be done, it just has to be fitted into the baseline status quo.
Think of all the taxes saved if there were no free schools. But nobody ever says to do away with that.
emt seeking first job
Forum Asst. Chief
- 921
- 0
- 0
I agree with 46Y, there has to be other reforms implemented in. Also as I wrote end the prohibition on recreational drug use. Also better mass transit in population dense areas.
So long as no one is in a position of trust, or operating a vehicle or vessel, why cant someone toke/shoot/snort away...?
I agree. People are always going to get their drugs. We might as well regulate it, and get revenue from taxes, permits, etc. Starve out these gangs by taking their income. At least start with weed and ecstasy and see how this goes. Do it with prostitution as well. Regulate these things, and you won't see hookers on the street corner, and much less junkies mugging people, carjacking, etc. Gang numbers and prison populations will dwindle. Gang recruitment will suffer, as there won't be enough money to attract many kids without the drug money. There's not enough money in stickups, home break ins, and car jackings to be able to live the glorified lifestyle they see on MTV. Without drug money, you'll actually make more by going to school and getting a job.
the_negro_puppy
Forum Asst. Chief
- 897
- 0
- 0
Not an issue down under. Public hospitals are free and ambulances are free ($100) levy per year added to electricity bill. Obviously this opens the system for abuse. We also have private hospitals with private health insurance available. Obviously there can be long waits for less acute patients but the option exists to go private for instant treatment if you want to pay. This system works well though is inevitably always under resourced. I take great comfort in the fact that even if I was homeless I could still access and not worry about getting a $25k bill for the basic human right of healthcare. Why is america the only developed nation without socialized health?
thegreypilgrim
Forum Asst. Chief
- 521
- 0
- 16
Some (and by some I mean "a lot") of the people on this thread need to read some John Rawls...and some Keynes.
emt seeking first job
Forum Asst. Chief
- 921
- 0
- 0
Those are crimes with victims.
If there were organized gangs doing that there would be public outcry, selling drugs, gambling or sex, people just avert their eyes....
emt seeking first job
Forum Asst. Chief
- 921
- 0
- 0
"Priming the pump" by increasing spending, increasing the money supply, or the gov't buying things on the market itself...... that obviously isn't working. Keynesian economics warns against the practice of too much saving, or underconsumption, and not enough consumption, or spending, in the economy. It also supports considerable redistribution of wealth, when needed. Keynesian economics further concludes that there is a pragmatic reason for the massive redistribution of wealth: if the poorer segments of society are given sums of money, they will likely spend it, rather than save it, thus promoting economic growth. Explain to me why that will work in the U.S. It obviously hasn't worked elsewhere.
The role of the federal government is to provide national protective and infrastructure services. At the point they started giving my money to someone who did not earn it is the point where they legalized theft, created a nanny state, started legalized bribes for political votes, and started us on a spiral that only those with real intestinal fortitude on the Hill (like Ron Paul who has been saying this for 30+ years) can stop and reverse and eventually abolish these practices Constitutionally (which will be great when congress starts adhering to it).
Keynesian Economics was never meant to be use for long periods of time, but rather it was only supposed to "jump start" the economic system. I believe it did just that, albeit because of a war, though it continued to be used in the sense that government grew exponentially over the next few decades.
There should be a healthy balance with everything.
Edit: Some suggested reading for you:
"This Time Is Different - Eight Centuries of Financial Folly" by Reinhart and Rogoff.
I'd like to get away from the Cloward Piven strategy that is in effect at the present.
Last edited by a moderator:
Says who? Where is the data? Where are the numbers?
I spent many years working in "underpriviledged" US neighborhoods, most of those people weren't even registered to vote. (or even had a permanant address) Thinking they would actually be bothered to take the time to vote, or protest, is beyond fantasy.
I doubt many would even wake up in time.
For many years and in many examples both past and present, those in power defend the status quo by villifying minority groups or creating ficticious threats.
When you look at US voter turnout for elections, in the 20%s where is this massive block of entitlement voters?
It sure does create a lot of mental security thinking there is some external force responsible for the problems of the US, but I often ask myself, who stands to gin the most by maintaining things how they are? I didn't see a whole lot of working people benefit from economic bailouts. Infact I didn't see any.
Have you ever got the feeling that one group of people was feeding BS stories in order to deflect attention off themselves by focusing attention on another group that nobody seems to be able to account for except by hearsay?
If say a florida company rips off medicare/medicaid with fraudulent billing to the tune of 1.7 billion, how many of these entitlement people would be payed for by that money. Would you vote for him for governor?
http://en.wikipedia.org/wiki/Rick_Scott
"Columbia/HCA fraud case detailsOn March 19, 1997, investigators from the FBI, the Internal Revenue Service and the Department of Health and Human Services served search warrants at Columbia/HCA facilities in El Paso and on dozens of doctors with suspected ties to the company.[19]
Following the raids, the Columbia/HCA board of directors forced Scott to resign as Chairman and CEO.[20] He was paid $9.88 million in a settlement. He also left owning 10 million shares of stock worth over $350 million.[21][22][23]
In 1999, Columbia/HCA changed its name back to HCA, Inc.
In settlements reached in 2000 and 2002, Columbia/HCA plead guilty to 14 felonies and agreed to a $600+ million fine in the largest fraud settlement in US history. Columbia/HCA admitted systematically overcharging the government by claiming marketing costs as reimbursable, by striking illegal deals with home care agencies, and by filing false data about use of hospital space. They also admitted fraudulently billing Medicare and other health programs by inflating the seriousness of diagnoses and to giving doctors partnerships in company hospitals as a kickback for the doctors referring patients to HCA. They filed false cost reports, fraudulently billing Medicare for home health care workers, and paid kickbacks in the sale of home health agencies and to doctors to refer patients. In addition, they gave doctors "loans" never intending to be repaid, free rent, free office furniture, and free drugs from hospital pharmacies.[3][4][5][6][7]
In late 2002, HCA agreed to pay the U.S. government $631 million, plus interest, and pay $17.5 million to state Medicaid agencies, in addition to $250 million paid up to that point to resolve outstanding Medicare expense claims.[24] In all, civil law suits cost HCA more than $2 billion to settle, by far the largest fraud settlement in US history.[25]"
I am sure he is completely innocent. In an OJ sort of way.
Is it possible, that the reason there is so much negative propaganda about universal healthcare is because some groups might lose a lot of money?
I wonder who those groups could be?
Pharm companies? Doctors? Insurance companies? Politicians getting paid by them? Politicians invested in them? Private individuals invested in those companies? Healthcare equipment suppliers and manufacturers?
Any chance at all?
Ever see a comparison on how much of the 26% of the GDP of the US these people get compared to the entitlement crowd? Because I can't find those numbers anywhere.
There most certainly is a reason.
Unions.
Many of those things you listed are performed by government employees. Who make up the largest group of laborers belonging to unions in the US. If we had workfare people who were doing that for their meager benefits, who in their right mind would hire a union government worker at the average salary of a government worker? That might create more of the have nots wouldn't it?
I seem to remember reading something about early in the 20th century chaingangs being abolished for road repairs because contractors couldn't underbid prison systems.
How many public works employees would lose their jobs do you think?
I really think the amount of these people is insignificant compared to the amount of government workers paid wages and benefits far beyond their value in actual positions. Those people have not only the incentive to vote, but the organization as well.
Tell me, what organization mobilizes entitlement people to vote? What do those people paying for that organization and mobiliation have to gain?
I have belonged to 2 unions in my time, and they were always sending me information on who to vote for and why in every election.
But unions aren't all bad, here are some of the things in the current healthcare reform they are proud of:
http://www.aflcio.org/issues/healthcare/
Are those things bad?
You are a smart guy, I think if you really start looking into some of the stuff you are hearing, you may figure out it doesn't really add up.