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And yet, many other countries don't do super-long shifts, while also having a record of better medical outcomes, right?
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Jul 13, 2017 18:38
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The Wiggly Wizard posted:Maybe it will improve transportation infrastructure down there? That was the major reason we were going for it. Though pushing it back to 2028 doesn't accelerate stuff by that much.
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Jul 13, 2017 18:45
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Leperflesh posted:And yet, many other countries don't do super-long shifts, while also having a record of better medical outcomes, right? Where did you get that idea, exactly? Right now in the UK they are debating getting the maximum number of hours worked in a week down to 72.
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Jul 13, 2017 18:50
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LanceHunter posted:Where did you get that idea, exactly? Right now in the UK they are debating getting the maximum number of hours worked in a week down to 72. That's a misrepresentation. You are looking at junior physicians which is the UK equivalent of America's medical interns. From the AMA's own website, 77% of physicians work 60 hours a week or less - unlike interns who are expected to put in 80. (https://wire.ama-assn.org/life-career/how-many-hours-are-average-physician-workweek) Also as the article you just posted shows, hours averaged per week vs. hours per shift are not the same.
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Jul 13, 2017 19:06
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In my line of work I begin flagging after ~10 hours, at ~12 I am tempted to take inappropriate shortcuts, and at 16 I feel like I have had too much alcohol and I start feeling as if I am getting a head cold. Medical professionals must be super humans who don't feel the same effects as me.
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Jul 13, 2017 19:09
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Jaxyon posted:That was the major reason we were going for it. The effect on housing will be interesting to measure for sure.
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Jul 13, 2017 19:10
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LanceHunter posted:Where did you get that idea, exactly? Right now in the UK they are debating getting the maximum number of hours worked in a week down to 72. https://bmcmededuc.biomedcentral.com/articles/10.1186/1472-6920-14-S1-S8 quote:The current situation of the 48-hour EWTD is as follows. Pan-european compliance remains low. But we can look at the countries that are complying and see how terribly compliance has affected outcomes: quote:A small number of administrations, predominantly in northern Europe, have achieved enviable success in reducing duty hours. Restrictions to 48 hours or less have been confirmed to provide safe care for patients while still achieving satisfactory education and training for staff within an acceptable time frame. These goals seem a long way from fulfilment in the rest of the “developed” world at present. So what is required to get better outcomes? quote:Those disciplines responsible for 24/7 service for emergency and urgent conditions, and the support services assisting this clinical care delivery, are most stressed by the hours reductions, but these are often the very specialties most resistant to change in the mode of service delivery. Such resistance frequently arises either from a fear of more senior doctors being made to be resident when on call or from a conviction that “what was good for us is good for those following behind.” The number of consultants in the United Kingdom increased by more than 60% from 2000 to 2010. The number of more junior doctors employed was also increased in the same proportion by stepping up the output and number of medical schools and through very active recruiting of foreign medical graduates. The result has been that methods of training and service delivery did not change. Hence the main conclusion of Time for Training, highlighted earlier. This isn't just goons handwringing. Research such as this paper shows that countries that make the transition to reduced resident hours - and make the structural changes necessary to support that - do not see worse outcomes (and in general european healthcare outcomes are better than those in the US to begin with). quote:Although Europe aims to maintain a maximum 48-hour work week for all health care workers, in North America the standard the authorities state they are trying to reduce to is 80 hours per week – the so called “safe hours.” Yet, because of the lack of any enforceable consensus, it is still not uncommon in many places for residents to work in excess of 100 hours per week. Leperflesh fucked around with this message at 19:13 on Jul 13, 2017 |
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Jul 13, 2017 19:11
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FilthyImp posted:It's likely that whatever gains in transportation are made will be irrelevant after a ginormous gentrification wave overtakes the city and makes the $6500 3b/2ba luxury new construction in Little Manila look restrained. I am renting the gently caress out of my house for the Olympics.
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Jul 13, 2017 19:16
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SKULL.GIF posted:apparently thanks to legal interactions between state and federal law, under BRCA Californians get zero subsidies a pity it's apparently impossible to start creating an alternative system for Californians
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Jul 13, 2017 19:18
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Raskolnikov38 posted:a pity it's apparently impossible to start creating an alternative system for Californians Lol this is going to force a SCOTUS decision on abortion that will supersede Roe. In a 5-4 decision Abortion is illegal on a federal level / prohibits any government funds to be used to support abortion.
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Jul 13, 2017 19:45
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Raskolnikov38 posted:a pity it's apparently impossible to start creating an alternative system for Californians But why is this man worried, this shouldn't be a problem, right? California is big and special and can make up any increased costs on its own with no decrease in care, right? Seems like subsidizing insurance within the state would be a great small scale test.
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Jul 13, 2017 19:50
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We should just try nothing ever.
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Jul 13, 2017 19:57
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Leperflesh posted:So what is required to get better outcomes? Hey, that's what I was saying two pages ago... LanceHunter posted:A good single-payer bill is going to need to include a lot of extra funding for med schools, teaching hospitals, and probably scholarships, too. I don't see this in the current CA plan, which is why the whole thing needs serious overhaul.
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Jul 13, 2017 20:17
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CopperHound posted:In my line of work I begin flagging after ~10 hours, at ~12 I am tempted to take inappropriate shortcuts, and at 16 I feel like I have had too much alcohol and I start feeling as if I am getting a head cold. Those numbers are already super-human. You should be very proud.
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Jul 13, 2017 20:24
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Dead Reckoning posted:But why is this man worried, this shouldn't be a problem, right? California is big and special and can make up any increased costs on its own with no decrease in care, right? Seems like subsidizing insurance within the state would be a great small scale test. oh i forgot we already had a single payer system where the state could actually address these issues
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Jul 13, 2017 21:18
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Raskolnikov38 posted:a pity it's apparently impossible to start creating an alternative system for Californians dont be mean to me posted:Or [Trump] tells us to lay down and die and we get the second civil war. At some point Trump's probably going to get pissed that we don't lay down and die.
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Jul 13, 2017 21:28
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I am being serious when I say that 10% of America would have absolutely no problem with droning us all to death, sight unseen. Some of the poo poo about our state that comes out of right-wingers' mouths in the rest of the country is both horrible and chilling. Basically don't wish for a civil war, is what I'm saying.
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Jul 13, 2017 22:46
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Raskolnikov38 posted:oh i forgot we already had a single payer system where the state could actually address these issues Megaman's Jockstrap posted:I am being serious when I say that 10% of America would have absolutely no problem with droning us all to death, sight unseen.
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Jul 13, 2017 22:51
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Megaman's Jockstrap posted:I am being serious when I say that 10% of America would have absolutely no problem with droning us all to death, sight unseen. Then there is no hope. If anything we could possibly do to make this a place worth living will just invite them to kill us all, then we can never make this a place worth living. So what's the point? dont be mean to me fucked around with this message at 23:02 on Jul 13, 2017 |
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Jul 13, 2017 22:53
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Megaman's Jockstrap posted:I am being serious when I say that 10% of America would have absolutely no problem with droning us all to death, sight unseen. Before I moved to California, I didn't really understand what people were talking about when they complained about the coastal elite. After I moved to California, I saw that there was a surprising amount of truth to the complaints. Coastal liberals can be incredibly classist and closed-minded in their own ways, two things which they rail against Republicans for. silence_kit fucked around with this message at 23:14 on Jul 13, 2017 |
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Jul 13, 2017 23:09
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dont be mean to me posted:Then there is no hope. I think you are seriously overestimating the Midwest's lust for golden state blood.
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Jul 13, 2017 23:12
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silence_kit posted:Before I moved to California, I didn't really understand what people were talking about when they complained about the coastal elite. After I moved to California, I saw that there was a surprising of truth to the complaints. Coastal liberals can be incredibly classist and closed-minded in their own ways, two things which they rail against Republicans for. So much for the tolerant left coast am i roite.
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Jul 13, 2017 23:13
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silence_kit posted:Before I moved to California, I didn't really understand what people were talking about when they complained about the coastal elite. After I moved to California, I saw that there was a surprising amount of truth to the complaints. Coastal liberals can be incredibly classist and closed-minded in their own ways, two things which they rail against Republicans for. Then you have everything you need to strap up and go for the high score, don't you.
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Jul 13, 2017 23:18
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silence_kit posted:Before I moved to California, I didn't really understand what people were talking about when they complained about the coastal elite. After I moved to California, I saw that there was a surprising amount of truth to the complaints. Coastal liberals can be incredibly classist and closed-minded in their own ways, two things which they rail against Republicans for. Yeah it was shocking for me as well, to find out that living near water didn't prevent people from being bad.
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Jul 13, 2017 23:25
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OTOH, I lived in Kansas for five years, and the only people who mentioned California were the people who couldn't wait to move the promised land, where the streets were paved with bales of weed wrapped in pride flags.
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Jul 14, 2017 00:47
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silence_kit posted:Before I moved to California, I didn't really understand what people were talking about when they complained about the coastal elite. After I moved to California, I saw that there was a surprising amount of truth to the complaints. Coastal liberals can be incredibly classist and closed-minded in their own ways, two things which they rail against Republicans for. lmao
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Jul 14, 2017 00:49
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Dead Reckoning posted:OTOH, I lived in Kansas for five years, and the only people who mentioned California were the people who couldn't wait to move the promised land, where the streets were paved with bales of weed wrapped in pride flags. OTOOH, I live in Texas right this very moment and everyone in state government is constantly talking about how we have to stop gays from getting married and let people pollute the water or else we will be come the next California!!!
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Jul 14, 2017 00:53
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As long as every Californian keeps fleeing the state to live in Texas, it IS going to be the next California. It's like they didn't even think it through.
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Jul 14, 2017 01:24
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Dead Reckoning posted:I don't see why the state needs single payer to make up the hypothetical shortfall in subsidies out of the state budget. Are you being intentionally disingenuous? We wouldn't be funding single payer out of the current budget. You're proposing we hold a "small scale test" where we subsidize everyone's insurance with no additional revenue. It's almost like you want it to fail!
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Jul 14, 2017 01:31
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Raising the revenue to maintain the current insurance market despite the D.C. money tap being turned off would go a long way to convincing me that the state is capable of raising the massive new revenues needed for a single payer system.
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Jul 14, 2017 02:42
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CopperHound posted:In my line of work I begin flagging after ~10 hours, at ~12 I am tempted to take inappropriate shortcuts, and at 16 I feel like I have had too much alcohol and I start feeling as if I am getting a head cold. Agreed. I've worked 12-20 hour shifts pretty often, and there's not a single drat time you're working as efficiently at hour 15 as you are at hour 1. 12-hour shifts with handoffs are way loving better than some insane 20+ hour bullshit. Even with 12 hour shifts you're thinking slower and making unforced mistakes by the end, especially if it's a night shift.
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Jul 14, 2017 02:56
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American healthcare culture is hosed six ways to sunday and actively hurting the country and everyone involved fails to recognize it. The vast majority of European healthcare systems do not have 12 hour shifts. Nevertheless we persist in using them despite evidence to the contrary that it makes things worse for everyone: the workers, the sick, and the hospital overall. The vast majority of European Doctors and Healthcare professionals train for a significantly lower amount of time and much lower cost. But we continue to have insanely long study periods for nearly all medical and even dental professions despite little evidence that it improves things significantly enough to be worth it. These two amongst many other factors will bankrupt our nation and lead to a explosion of prices as more and more boomers retire. None of it is sustainable.
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Jul 14, 2017 03:25
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Dead Reckoning posted:Raising the revenue to maintain the current insurance market despite the D.C. money tap being turned off would go a long way to convincing me that the state is capable of raising the massive new revenues needed for a single payer system. Except that the single payer system completely replaces the existing system, negotiating prices for care directly with insurance companies. The fact that it would be considerably cheaper than subsidizing the absurdly overpriced insurance plans currently available is one of the biggest selling points. You're not convincing me that you're not being disingenuous.
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Jul 14, 2017 03:39
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Cup Runneth Over posted:Except that the single payer system completely replaces the existing system, negotiating prices for care directly with insurance companies. The fact that it would be considerably cheaper than subsidizing the absurdly overpriced insurance plans currently available is one of the biggest selling points. You're not convincing me that you're not being disingenuous. Just  at "You're being disingenuous! Subsidizing the insurance market will obviously be more expensive than straight up paying for everyone's health care out of the state budget as the sole insurer. This is due to incredible savings achieved by <scene missing>!"
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Jul 14, 2017 04:00
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Dead Reckoning posted:Just You literally quoted me when I linked you research showing some of the sources of cost reduction in a single payer system. Go gently caress yourself you disingenuous piece of poo poo.
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Jul 14, 2017 04:04
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Dead Reckoning posted:Just does GIP even like you?
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Jul 14, 2017 04:05
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It's not something I've ever worried or cared about. I was a noble, after all. Lemming posted:You literally quoted me when I linked you research showing some of the sources of cost reduction in a single payer system. Go gently caress yourself you disingenuous piece of poo poo. E: Oh, and single payer proponents want to expand coverage at the same time. But it won't cost more! Dead Reckoning fucked around with this message at 04:26 on Jul 14, 2017 |
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Jul 14, 2017 04:22
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Dead Reckoning posted:It's not something I've ever worried or cared about. I was a noble, after all. You're right. It won't! According to research done by people who actually know what they're talking about. You don't have a single number or figure to back up a single piece of your bullshit.
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Jul 14, 2017 05:06
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Dead Reckoning posted:E: Oh, and single payer proponents want to expand coverage at the same time. But it won't cost more! 
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Jul 14, 2017 05:18
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Yeah, I'm still going with "disingenuous" here. Sorry. It's that or "intellectually dishonest."
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Jul 14, 2017 05:29
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