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gariig posted:That's medical rationing. It's not necessarily evil. Sometimes it's what you have to do for society to function. My personal viewpoint is that for the millions of dollars we spend on people who will never have a chance at having any quality of life (ie, people who have no higher brain functioning), we could instead let them die and spend that money treating many more people who can have some quality of life. But I think this statement itself is pretty grotesque and unpalatable to most people. How is Vermont going to deal with these top-down medical decisions if they institute single-payer? It seems politically unfeasible with American's cultural attitudes towards healthcare and death, which is that we should be able to go to any extreme to get treatment and keep a person's heart beating.
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May 5, 2014 17:53
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Holy crazy derail, Batman. What have I come back to after being gone for the weekend? I'm going to write one response to this subthread and then drop it. For clarification: My friend did not have insurance. He was in college and had a minimum-wage job at the time. I'm not surprised at the misunderstandings, because hospital charges can vary wildly by a factor of 10 or more so comparing individual experiences/expenses is difficult. I have a friend who slipped on the sidewalk and broke his ankle walking back to work from lunch. I have a client who is a shut-in because "people get hurt outside all the time! I'm safe at home." She does nothing but surf the internet all day. She weighs over 300 pounds and has a whole host of health issues related to that. Being alive bears a nonzero risk of medical problems. Skiing is not an extreme sport. It is a remarkably safe activity, as snow tends to be very forgiving. We've already got the data thanks to Mo_Steel: The injury rate for skiing is below 2.5 per 1,000 skiers; in 2012 the injury rate on the roads was 11 per 1,000 licensed drivers. For another interesting data point, simply playing on the playground lands 3.5 per 1,000 children under 14 in the ER every year - and as the CDC notes playgrounds in low-income areas are the most dangerous. Should the poors not let their children out to play? That's ludicrous, because the benefits of physical activity are huge, both physiologically and psychologically. NOT going outside and engaging in physical activity is ultimately less healthy. The idea that car insurance/suing people covers anything significant is laughable. California's minimum insurance requirement, for example, is $15,000 for personal injury. My grandmother got hit while walking on the sidewalk when she was in her 70's. Emergency surgery, two weeks in the hospital, two months in a recovery home, and 6 months of physical therapy cost hundreds of thousands of dollars. Her own uninsured motorist insurance covered another $100,000 on top of the driver's $15,000, leaving the rest to her health insurance - which covered about 80%, leaving her tens of thousands of dollars in the hole (and this is someone who didn't have a job to miss). Of course she sued the woman and won, but you can't get blood from a stone. If my grandmother had been a poor young woman working 2 minimum-wage jobs to make ends meet, she would have been 100x as hosed. TL/DR But all of that had nothing to do with the point of my story, which was this: People from countries with UHC take that poo poo for granted, whereas most people in the US take the calculation "should I go to the doctor or take the risk and hope that this just goes away" for granted. I know which attitude I'd prefer to have.
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May 5, 2014 18:11
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forgot my pants posted:My personal viewpoint is that for the millions of dollars we spend on people who will never have a chance at having any quality of life (ie, people who have no higher brain functioning), we could instead let them die and spend that money treating many more people who can have some quality of life. But I think this statement itself is pretty grotesque and unpalatable to most people. As I said at the beginning of this tangent, the point of single payer is to distribute costs across the entire population. The result is that we don't actually have to choose between helping the severely disabled on the one hand and treating everybody else on the other, any more than the British NHS spending £2 million saving a patient with brain cancer means they're going to turn their backs on £2 million worth of people with the flu. Developed countries like the USA actually have a lot of surplus resources and spending is a matter of priorities rather than a zero-sum game. Society balances the cost:benefit ratio of the government providing services out of public funds, which could entail higher taxes. In this case, a person asks himself, "Do I want to pay for the government to care for profoundly disabled people, possibly paying higher taxes, or do I want to have marginally more money but live in a society that euthanizes the disabled?" As you say, you might answer that one way, but most people would answer it the other. The specific topic you're talking about actually has less impact than you seem to think, because the percentage of people so profoundly disabled as to require that kind of expensive lifetime care is actually rather small. You should be worried about things like obesity, lack of exercise, unhealthy eating habits, tobacco use, alcoholism, end-of-life costs for dying elderly people, and generalized stress, all of which have dollar-value impact on healthcare costs and don't pound on the  to nearly the same extent as what you're expressing.
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May 5, 2014 19:03
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Choadmaster posted:But all of that had nothing to do with the point of my story, which was this: People from countries with UHC take that poo poo for granted, whereas most people in the US take the calculation "should I go to the doctor or take the risk and hope that this just goes away" for granted. I know which attitude I'd prefer to have. You might look at it that way; you might also say that his friend successfully convinced him to get medical care he didn't need. They found nothing, and if they had found something he probably wouldn't have been able to do much for it at the hospital that he couldnt do at home except stay under observation (since it was a head injury).
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May 5, 2014 19:11
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StarMagician posted:You might look at it that way; you might also say that his friend successfully convinced him to get medical care he didn't need. They found nothing, and if they had found something he probably wouldn't have been able to do much for it at the hospital that he couldnt do at home except stay under observation (since it was a head injury). Hospitals tend to hold people for observation because head injuries can result in complications that are difficult to immediately detect, but can rapidly worsen and cause permanent brain damage and/or death unless timely intervention is forthcoming. The death of Natasha Richardson was a famous recent example of this, and I'd actually guess that the Canadian friend was thinking of that exact case, because there was a lot of discussion of it among skiers.
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May 5, 2014 19:46
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EvanSchenck posted:Hospitals tend to hold people for observation because head injuries can result in complications that are difficult to immediately detect, but can rapidly worsen and cause permanent brain damage and/or death unless timely intervention is forthcoming. The death of Natasha Richardson was a famous recent example of this, and I'd actually guess that the Canadian friend was thinking of that exact case, because there was a lot of discussion of it among skiers.
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May 5, 2014 19:49
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EvanSchenck posted:As I said at the beginning of this tangent, the point of single payer is to distribute costs across the entire population. The result is that we don't actually have to choose between helping the severely disabled on the one hand and treating everybody else on the other, any more than the British NHS spending £2 million saving a patient with brain cancer means they're going to turn their backs on £2 million worth of people with the flu. Developed countries like the USA actually have a lot of surplus resources and spending is a matter of priorities rather than a zero-sum game. Society balances the cost:benefit ratio of the government providing services out of public funds, which could entail higher taxes. In this case, a person asks himself, "Do I want to pay for the government to care for profoundly disabled people, possibly paying higher taxes, or do I want to have marginally more money but live in a society that euthanizes the disabled?" As you say, you might answer that one way, but most people would answer it the other. I didn't say anything about euthanizing the disabled, so please be more precise with your wording. Anyway, I may be misreading what you're saying, but it seems like you believe there is an infinite amount of healthcare to go around, if we just prioritize it. This just isn't true, as evidenced by previous posts about rationing of care in single-payer systems, which you admitted occurs. A good example of this is radioisotopes used in PET scans. There are a number of different molecules used, but they are all produced by just a handful of nuclear reactors in the world. In the past, when these reactors have had to shut down unexpectedly, it's resulted in shortages of these radioisotopes worldwide. There's lots of drugs that we have periodic shortages of as well, but radioisotopes are illustrative of the supply problem. Right now we can only effectively produce them in nuclear reactors, so increasing the supply would be a difficult undertaking that would require a decade or more of work. While the specific circumstances I laid out in my original post have a small (but disproportionate) effect on the cost of healthcare, there are many similar questions, which cumulatively have a large effect. For instance, do single-payer systems pay for surgeries on terminal cancer patients when those surgeries will not statistically benefit a patient? Will they pay for double mastectomies in unilateral breast cancer patients who are unlikely to develop cancer in the healthy breast, yet want to prevent that possibility altogether (while risking additional complications from the more invasive surgery)? I know the UK uses quality adjusted years of life scores to account for these questions, which seems fair. But the average American seems to believe they should be able to get any treatment they demand, in the vanishing hope that it might prolong their life. Places like Cancer Treatment Centers of America exploit this mentality quite effectively. I think that mentality needs to be changed before it will be palatable for the federal government to create a standard like QALY that dictates what care you can receive.
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May 5, 2014 20:17
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forgot my pants posted:I didn't say anything about euthanizing the disabled, so please be more precise with your wording. The cost of healthcare does not have anything to do with the actual cost of healthcare. We pay more for every single procedure, device, medication, and service. Let me rephrase: we (the US) spend more on private healthcare than other countries pay on UHC. Even still, fewer people can get care, pay for that care, and remain in care long enough to recover than in other countries. If anyone wants to talk about the price of American healthcare compared to UHC, they're welcome to explain why other countries are healthier, recover from injury and illness faster, and have other better outcomes despite "death panels", "rationing", and "high taxes".
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May 5, 2014 20:34
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forgot my pants posted:I didn't say anything about euthanizing the disabled, so please be more precise with your wording. Have you ever dealt with an American health insurance company? They love, love, LOVE denying procedures like that. People have died in the US waiting for their insurance company to approve procedures that would literally save their lives. You might be okay if you can pay for it yourself, but it sure as hell is not a guarantee that you'll get healthcare no matter how medically necessary or how many physicians approve of it if the insurance company has excluded it.
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May 5, 2014 20:45
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Choadmaster posted:TL/DR My dad's a doctor, so I'm used to being able to talk to a medical professional if something bugs me. Being able to come home and have my dad check out an injury, or talk to him about how I'm feeling, is something I just take for granted. If I feel sick or if I get hurt, I can have someone to see if things are serious or not. Growing up, I really didn't realize how serious it was to have something looked at by a doctor. "You should have that looked at" was an idle statement of concern, and I didn't realize that could be hundreds of dollars for people unconnected. If you take a nasty fall on the slope and feel kinda weird, it shouldn't be months of wages to have someone look at it and tell you if things are OK.
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May 5, 2014 21:15
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anonumos posted:The cost of healthcare does not have anything to do with the actual cost of healthcare. We pay more for every single procedure, device, medication, and service. Let me rephrase: we (the US) spend more on private healthcare than other countries pay on UHC. Even still, fewer people can get care, pay for that care, and remain in care long enough to recover than in other countries. If anyone wants to talk about the price of American healthcare compared to UHC, they're welcome to explain why other countries are healthier, recover from injury and illness faster, and have other better outcomes despite "death panels", "rationing", and "high taxes". Certainly the US system is far less efficient than first-world countries with UHC. That does not mean those countries have infinite resources to spend on healthcare. While the US could become more efficient by adopting a true UHC system (ideally single-payer), it would still not have infinite resources. I personally think that proper rationing of healthcare is a way to improve the healthcare outcomes for the greatest amount of people. A good example of this is the previous post about the child who was deaf in both ears, where her home country would only pay for surgery to fix one ear. This seems like a reasonable compromise to free up resources that can be spent to improve someone else's quality of life. In the US we ration care based on more random factors, like "how much money do you have?" or "how well did you research your insurance plan?" I do not believe this optimally increases efficiency. However, in the US there is a lot of resistance to rationing decisions that are decided from top-down. For some reason, people here are not as concerned about being denied healthcare by their insurance agency as they are about being denied it by their government. Do we need to overcome that mindset to institute single-payer? If so, how do we overcome it? Lyesh posted:Have you ever dealt with an American health insurance company? They love, love, LOVE denying procedures like that. People have died in the US waiting for their insurance company to approve procedures that would literally save their lives. You might be okay if you can pay for it yourself, but it sure as hell is not a guarantee that you'll get healthcare no matter how medically necessary or how many physicians approve of it if the insurance company has excluded it. I'm talking about unnecessary medical procedures (ie, ones with neutral or negative QALY scores).
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May 5, 2014 22:31
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Fat Ogre posted:
Then you're laughably out of touch. Chemistry graduate students, for example, are expected to work in the lab anywhere from full time to 80 hours/week and a typical stipend is between 20 and 30k/year, typically on the lower end. Insurance is frequently done through the school, and at private universities at least is 1. bad coverage 2. expensive as gently caress. Try telling someone who's working monday-saturday 8-8 to get a full time job. There aren't enough hours in the week for fucks sake.
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May 5, 2014 22:37
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Axe Master posted:Then you're laughably out of touch. Chemistry graduate students, for example, are expected to work in the lab anywhere from full time to 80 hours/week and a typical stipend is between 20 and 30k/year, typically on the lower end. Insurance is frequently done through the school, and at private universities at least is 1. bad coverage 2. expensive as gently caress. Or maybe force them to pay grad students a livable wage and offer better insurance?  It isn't like the university isn't going to profit off your work.Or if that is too extreme, maybe choose a different career? I had a bunch of friends graduate with history, art and poli-sci degrees and then were annoyed they couldn't find work and were up to their eyeballs in debt. It isn't like everyone told them, those degrees don't pay for poo poo, maybe you should rethink it. I made a conscious decision to get a job to pay for school (no loans), and get a job that had insurance. The only reason I stuck with it and got my degree was that I felt like it might be useful to have it one day. Still hasn't really been needed but oh well. Meanwhile my friends that bragged about getting done in 4 years are saddled with debt, work at a lovely job not using their degree or skill set and are bitter as gently caress. I on the other hand took 7 years to earn a 4 year degree by only going to school part-time, I graduated with no debt, and had health insurance and a full time job the entire time I was in school. So that once I graduated I could immediately say I already had 5 years of real work experience and got paid even more. (the first 2 years weren't career related) I don't see why that is so crazy. Oh and that was basically 7 years of 80 hour work weeks (40 at work and 40 for school) so cry me a river. Also I saved my work money in high school instead of wasting it on cars, or cloths or other stupid poo poo. Fat Ogre fucked around with this message at 23:02 on May 5, 2014 |
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May 5, 2014 22:51
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Fat Ogre posted:I don't see why that is so crazy. Oh and that was basically 7 years of 80 hour work weeks (40 at work and 40 for school) so cry me a river. Also I saved my work money in high school instead of wasting it on cars, or cloths or other stupid poo poo. You spent 40 hours a week on school while going part time? Either you're exaggerating or you are a really slow learner.
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May 5, 2014 23:43
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forgot my pants posted:You spent 40 hours a week on school while going part time? Either you're exaggerating or you are a really slow learner. 9-12 hours of school actual school depending on the semester. Usually 3-6 in the summers 5-6 hours of labs. Studying and Homework for the rest of the time. On top of having to work over time etc with work.
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May 5, 2014 23:56
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Fat Ogre posted:9-12 hours of school actual school depending on the semester. Usually 3-6 in the summers Oh, ok, if you're taking 3-4 classes plus 2 labs you can call yourself fulltime by my personal standard, anyway!
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May 6, 2014 00:09
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forgot my pants posted:I didn't say anything about euthanizing the disabled, so please be more precise with your wording. It's possible that the distinction between euthanizing the disabled and merely "allowing them to die" is important to you, but it doesn't seem like a huge difference to me. In fact euthanizing would probably be more humane if they were going to be killed anyway, because death by neglect even in a controlled medical setting is unpleasant. quote:Anyway, I may be misreading what you're saying, but it seems like you believe there is an infinite amount of healthcare to go around, if we just prioritize it. This just isn't true, as evidenced by previous posts about rationing of care in single-payer systems, which you admitted occurs. Infinite, no; sufficient, yes. Rationing in single-payer systems works by putting patients in a queue for care according to need, so that people with urgent problems are served quickly while non-critical cases wait. Remember that these systems actually exist in other countries, and by-and-large people get the care that they need and are satisfied with the system they have. Or at minimum, they would prefer it tremendously to the American-style system. I mean, it's not like there are mass numbers of Canadian women dying of breast cancer because of rationing. quote:A good example of this is radioisotopes used in PET scans. There are a number of different molecules used, but they are all produced by just a handful of nuclear reactors in the world. In the past, when these reactors have had to shut down unexpectedly, it's resulted in shortages of these radioisotopes worldwide. There's lots of drugs that we have periodic shortages of as well, but radioisotopes are illustrative of the supply problem. Right now we can only effectively produce them in nuclear reactors, so increasing the supply would be a difficult undertaking that would require a decade or more of work. You were talking about the cost of care for people with total permanent disabilities, which is almost entirely unrelated to the availability of radioactive isotopes or rare pharmaceuticals. If you want to take up an altogether different issue then yes, different factors do come into play. quote:But the average American seems to believe they should be able to get any treatment they demand, in the vanishing hope that it might prolong their life. Places like Cancer Treatment Centers of America exploit this mentality quite effectively. To a certain extent this is true, but remember that the majority of Americans either had minimal access to healthcare or it was already mediated by onerous HMO plans. The "average American" is already used to struggling with an impersonal bureaucracy and paying through the nose for healthcare, and the people who could get all they needed on demand as if they were turning on a tap are actually a minority.
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May 6, 2014 00:10
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forgot my pants posted:I'm talking about unnecessary medical procedures (ie, ones with neutral or negative QALY scores). Even NECESSARY medical procedures get turned down by insurance companies all the time. Unnecessary ones are even more likely to be turned down. Of course, there's always the private insurance market and private healthcare if you really want to spend a bunch of money to get unnecessary care. Most single-payer systems do allow these, though I personally dislike them because they stratify care by income. Edit: The point that healthcare is already rationed by bureaucracy need to be put out there a lot more. There's also plenty of related anecdotes and such, but there's also a point that a lot of Americans think health insurance works fine for them and they don't want change because they might lose the thing paying for their (relatively) cheap conditions. Which is valid but also horrifically selfish and something that really should attract more shame than it does. Lyesh fucked around with this message at 00:33 on May 6, 2014 |
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May 6, 2014 00:27
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EvanSchenck posted:It's possible that the distinction between euthanizing the disabled and merely "allowing them to die" is important to you, but it doesn't seem like a huge difference to me. I wasn't talking about the disabled. I was talking about people who are brain-dead. And euthanasia is not the same as withholding care. Our legal system and cultural traditions agree on that (though I'm pro-euthanasia). Anyway, you're trying to make my statement seem more outlandish by conflating "brain-dead" with "disabled." Brain-dead people can only experience pain, but they experience it like starfish would; they have no emotional connection to the stimuli. Disabled people can experience full quality of life depending on the severity of their disability. You're also conflating euthanasia with withholding treatment, which ignores the differences between the two. Those differences are very important to some medical professionals and religious folks, as well as the justice system. EvanSchenck posted:You were talking about the cost of care for people with total permanent disabilities, which is almost entirely unrelated to the availability of radioactive isotopes or rare pharmaceuticals. If you want to take up an altogether different issue then yes, different factors do come into play. The cost is not just the monetary cost but the resources as well. How many people do we have that can and want to perform skilled nursing care on a person that will never be conscious? This is a limited resource, of course. The example of radioisotopes is just another example of how the resources in medicine are limited. I believe your position is that there are sufficient resources to cover all medical care society needs. I'm not convinced this is true, and I think the radioisotopes example displays that it often isn't. EvanSchenck posted:To a certain extent this is true, but remember that the majority of Americans either had minimal access to healthcare or it was already mediated by onerous HMO plans. The "average American" is already used to struggling with an impersonal bureaucracy and paying through the nose for healthcare, and the people who could get all they needed on demand as if they were turning on a tap are actually a minority. Good point, and I probably should not have used the phrase "average American," but instead used something clunkier like, "the Americans who benefited under the status quo pre-PPACA." I'm not sure if that's the average American or not. But a lot of Americans benefited by denying other Americans the option of receiving healthcare. When people talk about how the wait times are longer in Canada, I like to point out that that's because in America we wouldn't let around a quarter of our population even see a doctor.
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May 6, 2014 01:12
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EvanSchenck posted:It's possible that the distinction between euthanizing the disabled and merely "allowing them to die" is important to you, but it doesn't seem like a huge difference to me. In fact euthanizing would probably be more humane if they were going to be killed anyway, because death by neglect even in a controlled medical setting is unpleasant. You're presenting this is a more black and white fashion than it really is. There isn't some hard standard for "care they need". Basically what's considered good practice is determined to a large extent by what the system is willing to pay for and one major component of costs in the U.S. is that we do lots more "stuff" to people than other places. There are basically always more drugs/tests/procedures that can be done. My fiance is an NP in critical childrens care and works with ECMO systems which are capable of entirely replacing the heart and lungs and oxygenating blood external to the body. This is some cutting edge and exceedingly expensive equipment. This doesn't fall under the simple qualifier of "care they need", most places would (reasonably) let people who need this type of intervention die. This isn't at all to rail against the idea of rationing. I think we need to become comfortable with that word and it's implications and I think currently, culturally, the U.S. has a huge problem in this regard. We need to give up and let things go sometimes. But my point is that these types of choices and tradeoffs are anything but simple, it's never going to come down to just giving out "care they need", it's always going to be about making really difficult cost tradeoffs.
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May 6, 2014 01:27
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forgot my pants posted:I wasn't talking about the disabled. I was talking about people who are brain-dead. Oh, I see. I thought you might be talking about that but it didn't seem to follow because the number of brain-dead patients being kept alive at any given time is actually very small. If you're including people in persistent vegetative states the number is a bit higher but still not significant compared to the systemic costs of something like obesity. In either case I don't think it presents a big problem for transitioning to a putative single-payer system because I don't think there's a lot of health plans that will pay for continued care after a diagnosis of brain death or persistent vegetative state. The only thing that changes is who tells you it isn't covered. asdf32 posted:You're presenting this is a more black and white fashion than it really is. It's why I said "by-and-large." An artificial circulatory system is only one example, and there's any number of other exceptions you could name. For example, the availability of medical imaging systems in the USA is beyond excessive by the standards of every other country in the world, and if your insurance will pay for it you can get scanned however you want pretty much the same day you want it. I'm sure there are some people people in Canada or the UK who had a bad outcome because they had to wait in line before they got an MRI. It comes down to a numbers game.
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May 6, 2014 01:55
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I think we can also talk about self-rationing at least a little bit. There are people in the US now who are having their care rationed by their wallets because they can't pay for what they need.
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May 6, 2014 08:02
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asdf32 posted:This has taken a stupid turn. Whether it's smart for an individual to ski with no insurence is utterly unrelated to whether the nation should have nationized healthcare or not. At this moment it doesn't, so people making choices have to make them based on that reality. Right but this is a thread about a proposed UHC policy, not Helpful Advice for the Adventurous Uninsured. Unless a statewide "Don't Go Skiing" ad campaign is being proposed as an alternative policy to UHC, then musings on whether the poor are worthy of adventure sports are at best irrelevant and at worst victim-blaming.
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May 6, 2014 08:08
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How are extreme sports handled in countries with UHC? Are they covered or have reactionary laws been passed saying they don't cover voluntarily dangerous activities?
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May 6, 2014 12:58
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Why is skiing even still being discussed as if it's a high injury sport after the earlier post showing that it has a lower injury rate than childrens' playgrounds.
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May 6, 2014 13:07
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Lower injury rate then driving a loving car, something which I'm pretty sure the vast majority of americans do.
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May 6, 2014 14:31
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Fat Ogre posted:
This is impractical thinking. Never mind the generic "the humanities is a waste of a degree  " thinking, if someone is skilled in chemistry and is one year away from getting their Ph.D (at which point they stand a good chance of more than making up for the 5 years of difficult wages), but they suddenly find themselves unable to work because, say, the Remicade treatments for UC aren't covered by their insurance and the illness is taking them out of the lab too often, it's not that they're acting impractical. It's that the laws of their state related to healthcare companies and employment are not doing their job. We're not even talking about somebody unemployed or someone who made "unwise choices" here, this is a person at the entry level part of their careers who is therefore not flush with a savings account that can weather emergencies. It's a hallmark for what private insurance should be doing, even from a conservative mindset.You're essentially saying that anyone working in the sciences chose an impractical life.
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May 6, 2014 14:35
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Bicyclops posted:
I think what he's saying is that anyone who works chose an impractical life.
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May 6, 2014 14:38
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anonumos posted:I think what he's saying is that anyone who works chose an impractical life. More accurately, that anyone who doesn't begin their careers having already somehow acquired a mortgage worth of assets to cover them in the event of getting sick is leading an impractical life.
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May 6, 2014 14:46
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forgot my pants posted:My personal viewpoint is that for the millions of dollars we spend on people who will never have a chance at having any quality of life (ie, people who have no higher brain functioning), we could instead let them die and spend that money treating many more people who can have some quality of life. But I think this statement itself is pretty grotesque and unpalatable to most people. Slippery Slope.txt  Yes it's not only grotesque but also dangerous. And no I am NOT calling YOU a Nazi. Fat Ogre posted:How are extreme sports handled in countries with UHC? Are they covered or have reactionary laws been passed saying they don't cover voluntarily dangerous activities? People who are hurt get help for free, atleast in Scandinavia. Even if they got wounded in a gunfight with the police. Dilemmas like those which are discussed in this thread are utterly baffling to me. Profit motives in welfare drive up costs and lower overall quality more than any number of individuals cheating the system you can conciveably find in a decently managed UHC system. This is a Fact. Postorder Trollet89 fucked around with this message at 15:01 on May 6, 2014 |
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May 6, 2014 14:57
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 Look at you guys getting angry at actually weighing your options and taking the jobs that have healthcare and pay enough to get your way through college. poo poo isn't fair. I'm not saying it is. I'm also not saying that we shouldn't fix it. What I am saying is there are ways around it if you put thought and effort into it instead of rolling the dice and gambling on not getting sick so you can get your grad degree and then hopefully get that job related to your science degree once you get your PHD and hopefully you'll get tenure and that you'll never have a serious accident or illness that entire time. Also hopefully your spouse will have decent healthcare in the meantime if you want kids etc. It is about priorities in life and working in a given system. Sure it doesn't encourage people to take science degrees unless they have money or insurance from mom and dad. If you don't have that support network to help you out, DON'T loving risk it and instead take the practical jobs that will get you paid and get your healthcare taken care of. How many of you saw people that were the first in their family to ever go to college and they went for an arts degree thinking, "I'll study what my passion is!" Hell I've even seen it with some of the science degrees. How many Anthropologists, Archaeologists, Paleontologists, Sociologists, Psychologists etc are really needed? Yet why do people keep getting these degrees? Surefire way to end up with a poo poo job, in debt up to your eyeballs. Until we fix our healthcare system and fix the issues with student loans people need to wake the gently caress up and stop loving themselves over.
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May 6, 2014 14:58
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Really, if an 18-year-old can't predict the job market and economic condictions 4-6 years out with better accuracy than any professional economist, then he's got no business getting a degree. It's not asking much really. If teenagers in 2004 had been just this practical, then there wouldn't have been all these unemployable lawyers graduating in 2009 with no income or health insurance.
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May 6, 2014 15:00
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VitalSigns posted:Really, if an 18-year-old can't predict the job market and economic condictions 4-6 years out with better accuracy than any professional economist, then he's got no business getting a degree. Yeah because lawyers have always made lots of money Meanwhile people everywhere still need nurses, plumbers, electricians, machinists, computer drafting, computer science graduates, engineers etc. Better get that degree in Romantic Literature of the 1800s instead.
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May 6, 2014 15:03
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Fat Ogre posted:
Wow. So much for entrepreneurship, scholarship, and utilizing one's potential. gently caress all that. Do something "safe". You sound like a Republitarian shill, talking down to people and telling them their place in the world.
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May 6, 2014 15:04
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anonumos posted:Wow. So much for entrepreneurship, scholarship, and utilizing one's potential. gently caress all that. Do something "safe". That you think you can't utilize your potential and play it safe is amusing. Get a decent 'safe' job to save money so you can start that business you always wanted to start...oh well gave up on dreams by playing it safe and now you have that nest egg to fall back on and live off of. I'm done with the education derail as it isn't all related to the initial issue of the thread.
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May 6, 2014 15:07
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Fat Ogre posted:
Tell us more about the white working class chip on your shoulder
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May 6, 2014 15:11
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Fat Ogre posted:
You don't tenure to make a decent living from having a Ph.D., but then, that isn't the point. Someone who is flat-out working retail to pay their way through a finance degree en route to an MBA is still "rolling the dice" and "gambling on not getting sick." Unless you are already very flush with assets, you are doing this in any career.
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May 6, 2014 15:15
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Fat Ogre posted:That you think you can't utilize your potential and play it safe is amusing. Get a decent 'safe' job to save money so you can start that business you always wanted to start...oh well gave up on dreams by playing it safe and now you have that nest egg to fall back on and live off of. But the skiing derail was? To actually answer your question way back: The notion of discriminating in a UHC system is frankly absurd. UHC doesn't work if the vast majority of people in a country believe that people literally deserve to die for their mistakes. Being willing to forgive your fellow man for their mistakes and offer a helping hand is core to the system. The occasional "lol, fat people should pay for their own overeating" and the like turn up occasionally in newspapers and on the net but it never actually translates into politics because it turns out that the vast majority of us aren't heartless monsters.
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May 6, 2014 15:16
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Peven Stan posted:Tell us more about the white working class chip on your shoulder The best thing about the IT/Engineering "ha ha on you for not taking the One True Degree" jag-offs is they're always so insulated they think their opinion is some kind of fresh new wisdom.
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May 6, 2014 15:28
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Postorder Trollet89 posted:Slippery Slope.txt Keep in mind I was talking about people with no higher brain functioning. To me, it is immoral to keep these people alive. The only sensation they can experience is pain. So by keeping them alive you extend their pain. Families do this because they want to stave off death at all costs. The result is their loved one contracts infection after infection until something finally kills them, but often this process takes decades and millions of dollars. Meanwhile there is no pleasure or joy in the life of their loved one, only pain. What these families don't realize is that their loved one is already dead. We can keep the heart beating indefinitely, but the mind is gone. I feel like many people without exposure to this kind of thing don't really understand it, hence why they think this position is equivalent to saying "let's kill disabled/mentally retarded people!" You can argue it's a slippery slope, but medical professionals make all sorts of decisions that put them on a slippery slope. That's part of why ethics is so important to that field. For instance, if you need a particular surgery, but you're really high risk, it may be that no surgeon will perform the surgery on you. Your treatment is being withheld because the surgeon is afraid of being sued if something goes wrong. That's a slippery slope, which results in some surgeons only taking on the easiest patients. Anyway, I'm conflicted on this whole issue. I think it's good that we let families make their own decisions in their own time. But I think there is a level of medical illiteracy in this country that results in bad decisions. Usually it involves children (it's much easier for a family to let a husband or mother or grandparent go than a child). Also I can't help but think that if we could improve the medical understanding that brain-dead is equivalent to dead, and if we could develop healthier attitudes towards death, there would be a lot less suffering by brain-dead patients and their families, while freeing up a lot of resources for patients that have a shot at getting better. I realize this is a small issue in terms of the total cost of healthcare, but it overlaps with issues like treatment of terminal cancer patients. Many of these people also want to stave off death for as long as possible, so they end up pursuing all possible treatments. The result is that for a lot of them they spend their last few months horribly sick from chemo without getting much extra time. If they had made peace with the process of dying they could have had better quality of life in those months. This issue is probably a much bigger burden on the healthcare system and families, because so many people die of cancer.
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May 6, 2014 15:37
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