This one says:
MEDICAID CUTS ARE WRONG!!!!!!!!
John Faso and Tom Suozzi are running for Governor of New York State and they both say Medicaid is an expensive program that NY can not afford. They feel we need "health care savings accounts". Health care savings accounts are money we are supposed to save out of our money. Are these two idiots? Most of us can not afford the co pays for our prescriptions. Most of us are scrimping by and they want us to get blood out of a rock. health care is a necessity not a luxury. After all politicians have the best healthcare and we pay for it. We must be heard, Medicaid should be preserved not cut. Thel imits should be raised so more people can qualify. We should have universal healthcare. Every man, women [sic] and child would have health insurance coverage. Make sure you are registered to vote. Write letters to the Buffalo News and politicians. Let them know no more cuts. Tell them Medicaid preservation must be at the top of their list.
Call: [list of reps]
Tell them no cuts to Medicaid. Once MEDCAID [sic] is gone it will be gone. Can you afford to pay for your own healthcare? Most of us can not. Please make the calls and write the letters and vote.
The election is right around the corner and they want your vote. They work for us and they need to start acting like it. Let them know we count. Also remember to let them know we can not afford so called health care savings accounts. MEDICAID MATTERS. We matter and we need to stay healthy!
I don't even know where to start. First of all, I applaud whoever wrote this for being an involved citizen and taking action. It's better than being apathetic (like I am). So that's good.
But... I just hate the fact that no one seems to want to take responsibility for anything.
Yes, health care is expensive. It's a crisis in this country. I understand it's hard to pay for meds. And medicaid IS an expensive program. But there's also something called personal responsibility and accountability. No such thing as a free lunch. Work for what you want. etc etc etc. I just don't get this attitude- "what?! PAY (part of) the cost of my meds?! Outrageous! how dare anyone suggest that!" I disagree that "health care is a right not a luxury". Don't get me wrong- I don't think you should be turned away from the ER b/c of insurance/money/lack thereof. BUT I also don't think it's unreasonable to be asked to pay a little something. Especially when it's a totally frivolous ER visit, as many of them are. Like calling the ambulance because you're drunk and hungry, then saying 'um... my leg hurts I think it's broken' (so the docs are obligated to check you out and get xrays) 'ok can I have a sandwich now?' (No, I am not exaggerating). Racking up a $1000 (at least, probably 10,000) ER bill, in order to get a "free" sandwich. Yeah, that's an efficient use of health care dollars.
People act like medical bills are just garbage and they can ignore them. Why is that?? You get yourself shot and are in the ICU for 2 months and have a 2 million dollar bill... obviously you can't pay it, I understand that, but who is supposed to? I just wish people would make a good faith effort. "Ok, I obviously can't afford 2 million, but here's the $10 I can afford."
I just don't understand why everyone thinks all their meds/surgery/etc should be free. Who do they think SHOULD pay for all this?
sorry for ranting, but this has always pissed me off.
In med school I spent some time working at Charity Hospital in New Orleans (RIP!). It was, as you might guess, a county hospital that served mostly the indigent population. Yet they still had a plastic surgery clinic. I never understood that. So we'd see all these people... and one of the most requested procedures was breast reduction. Now, breast reduction is considered a cosmetic procedure, and this is NOT covered by insurance, most of the time. BUT, if you meet certain weight/height/breast size criteria, sometimes it is considered "medically necessary". So when these giant obese women came in asking for their free breast reduction, the first thing we would do is check their height/weight on a chart and see if they qualify. So one day I had to tell this woman that she had to lose 50lb to qualify. (and these are NOT very strict weight guidlines- you do not have to be a stick. But 5'1 300lb doesn't cut it.) So she got ALL pissed. And yelled at me "so what are you saying? there's no way i can have this surgery?" And I said "well, like I said if you lose some weight we'll re-evaluate you. or of course if you are willing to pay for it." My god I thought she was going to slap me. How DARE I suggest that my tax dollars not pay for her cosmetic surgery.
Or a few months ago I was looking at the OR schedule at ECMC... and I saw I was assigned to a little case in the procedure room. "excision of skin lesion". That often means skin cancers. So I go to meet the patient... he's a prisoner. Ok, fine, ECMC is where the prisoners go. So I go to check out his 'lesion'- it's a very NON-suspicious looking mole on his nose. NOT worrisome for cancer. But on his face. And he didn't like the way it looked. so we removed it.
EXCUSE ME? Now prisoners get free cosmetic surgery?
My other favorite is when you see a patient in follow up and ask them if they took the medication you prescribed... say, an antibiotic to try to keep their infected toe (due to diabetes/obesity/smoking) from falling off- and they say no, they didn't, because they couldn't afford it. Yet somehow they could afford 2 6-packs a week and 2 packs a day. oh, and could we give them some "free samples" of that, what's it called, lortab? Because they're "allergic" to tylenol and ibuprofen.
Ok, and while I'm ranting...
I saw something on CNN tonight- Bush has proposed a "north american union"- combining the US/Canada/Mexico??? Huh???
And then this one- the ACLU is asking Rhode Island to just "not enforce" immigration laws. Saying it's not fair to send illegal immigrants home. Umm, aren't they called ILLEGAL immigrants for a reason?
haha, see, that is why I don't talk politics much. my views are often too far to the right and I get labelled a rich bitch who doesn't care about the poor.
Which is not true.
But I just hate when people think they are entitled to everything.
So go ahead... flame away...
-J
Josh- I agree.
Peter- You're dead on. Sure, I think I deserve to be paid and I want to make a living- but at the same time I think the point of medicine is to take care of people- not to line pockets. Seeing hospitals ADVERTISE on billboards makes me ill. And yes, the drug companies piss me off. Yes, it's expensive to make a drug, and like josh said most of the expense is the R&D etc. But at the same time- maybe if the drug reps didn't take us for dinner at the chop house all the time, they could charge a little less for the drugs. However a lot of the big companies have low-income assistance programs, where people can get drugs for free- which is great- but it's a lot of paperwork and a hassle, which keeps people from using it as often as they probably should.
And don't get me started on insurance companies. The fact that some guy in an office decides what care is appropriate and will be covered, and what won't be covered, is ludicrous. I'm not an idiot. There is a lot of money in medicine, and I'm not going to pretend that I don't know doctors are paid well. (my only counter to that is that we work our asses off, "sacrifice" the "prime years of our lives" to miserable residency, and generally have >150K in loans to pay off.) But my point is- I think that if anyone in medicine deserves to make a little money- it's the people that provide the care. The doctors, nurses, lab/xray people, etc. NOT the fucking CEO of blue cross.
Yes, medicare/medicaid are all fucked up. Not denying that. I guess the point of the original post is just that it bugs me when people seem to think that health care should just be free. Right or wrong, it's expensive. and SOMEONE has to pay for it. I don't think it's unreasonable for the recipient of said care to be responsible for at least part of the cost. That's all I'm saying. Yes we need ways to help people who can't pay, etc etc. We need massive insurance reform.
and one last thing- after doing this for a few years, and seeing how smoking/obesity (and thus diabetes) are pretty much directly responsible for the VAST majority of illness in this country- I am vehemently anti-smoking. If people, knowing full well how dangerous it is, still choose to smoke- I have no problem with them paying more for insurance. A lot of plastic surgeons I know won't operate on smokers, because it impairs wound healing so much.
ok, enough talking shop!
See you all tonight!
First of all it is nice to see you go On a political rant. I do agree with you that there is a lot of abuse and that people do need to be more self responable.
That being said I do think that the current Medicade system is verry flawed and does need some fixing but how to do that I really don't know. (what I'm about to say isn't dirrected at you personaly or at other doctors so don't take it personaly). I think the real problem is pharmasudical companies and Hospitals are big business. There goal one is money and share holders. Yes they are in the people helping buisiness but profits should be secondary to helping people. If you belive the old myths in the old days doctors would find out what was wrong then send you to a drugest with a prescript that they knew. There is nothing wrong with that (assuming you really need care). I not just picking on the medical business I'm picking on all big business. You know companies that fire people and lay them off but then the bosses get bonuses. Health insurance is getting the same way. You know there are some insurances that won't cover if you are a smoker or if you are the prices per month go up, because you are a greater risk. Sometimes if you have a condition that predates your insurance they won't cover it. Sometimes that is true of a job injury. Say I destroy my shoulder sking and have some laging problems but I'm able to work. I re injur that shoulder at work. "Sorry you get no workers comp cause it was pre what ever condition it is called". Why because they only care about the money and not people.
PS - I feel badly for whoever wrote that, and for particular individuals who can't (or won't) pay for their own healthcare, but this goes back to the free lunch argument. Also NYS has programs that assist the elderly and kids with prescription drugs and healthcare that are not related to Medicaid.
The problem with Medicaid right now is that the state is mandating certain medical benefits then asking localities to pay for it. Its bankrupting our region.
Another thing that people fail to understand when they are talking about the big, bad drug companies is a) the sheer amount of money that is required to develop a new drug, and b) drug companies aren't soup kitchens... this isn't meant to be a not-for-profit business. The bottom line is, if the drug companies can't at least recoup the money they spend developing the drugs then the alternative is that the drugs will not be developed at all. So which would you like?
I can't imagine what kind of throwaway studies that are out there that rank our quality of health care dead last. That is complete and utter nonsense. The quality of healthcare that we have is by far the most superior on the planet - the question is NOT about whether or not our healthcare is the best, but who has access to it... which has been a source of bitterness and the inspiration for these throwaway studies.
Our neighbors to the north have broader access to health care, but often times they cross the border and use our health care because they cannot wait 6 weeks for a pregnant lady to get a checkup, for example. For that, they get double dip taxation aka the VAT, 45% income taxation, etc. - the things that Americans would never tolerate. We will not have socialized medicine anytime soon.
One of my favorite health care moments was when I went to BGH for alcohol counseling.
Someone there wanted to know how they could get their medications if they don't have a car, or don't have money to get a cab or a bus. There were some people with real issues there, making mine look hella minor.
The lead counselor in our group meeting actually suggested outright fraud and abuse of the system by suggesting they call for an ambulance, who would most certainly come and get them. This, rather than simply offering bus tokens?
re:sweden- I can't remember where I heard that. It was stated as very matter-of-fact at work one day. And maybe it wasn't sweden, but it was a country that surprised me. Maybe even england? And I mis-spoke. It's not that you can't see a doc after 80 (maybe it's 85)- but it's that you're not eligible for some extreme measures. It's their way of conserving resources. Vs here, where we have some 105 year old guy with 20 tumors who is moribund- but the family says "do everything" so we do- millions of dollars worth of care- and the guy still dies in a few days. In sweden (or whatever country I'm thinking of) apparently they just say "no. he's 105. he can have medicine and antibiotics etc- but he can not have a heart transplant. we save those for people with a chance of survival". That's a little frustrating for me. We're not "allowed" to say no. All we can do is present options to the patient/family. We can say "this costs a bazillion dollars and there is only a 0.00001% chance it will work. We don't recommend it." And the family says "but it's grandpa! do it!" And our hands are tied, and we pretty much have to. It's all medico-legal, cover-your-ass medicine. Docs aren't willing to take a stand b/c the chance of getting (frivolously) sued is too high. Talk about waste of resources... not that a life isn't valuable, but unfortunately "money doesn't grow on trees" and we are already in crisis, and need to be making it better, not worse.
and as far as supply/demand for docs- is there really a physician shortage, first of all? Or is it geographic? e.g. too many in NYC, but not enough in rural wyoming? I think the bottom line is that medical education/training is not cheap. It costs a lot to make a doc.
(e:Jenks), I _really_ doubt that Sweden would cut off access to doctors at 80. I've looked around and couldn't find any reference to that.
You can find numerous studies which show that the US ranks just about dead last in the list of OECD countries in terms of quality of healthcare (OECD being the "developed" countries). By all measures (life expectancy, infant mortality, etc.) US is near the bottom.
And this is despite the fact that per-capita spending on healthcare is TWICE that of most other countries.
Regarding AMA/ACGME: what I had read was that the ACGME (and not AMA, as you rightly pointed out) restricts the admissions, for various reasons. It's a shame that a severe physician shortage exists. One would think that the law of supply and demand would have evened things out?
I think that some health care should be state sponsored and I am more than willing to pay a lot of taxes for those services if it helps people that otherwise cannot afford it. However, I do recognize the the abuse and that some people will never learn to become independent citizens unless they have to take care of themselves.
But consider someone who has cancer but not health care insurance yet works 40 hours a week to make less than $300 /week. So then you subtract food, and housing and you are left with just about no money. How does that person go ahead and pay the 100,000 they owe for chemo and treatment and also still live life a bit.
I realize there are plenty of people that abuse this system but if we privatize it all the smart people with jobs and everything are going to be the only people left health insurance. I am not sure most of the underpriveleged people are at fault with their circumstances. We still have to consider all of the advantages that we were given as children, which helped us to develop into the self-sufficient people that we are.
My biggest problem with it is how much everything costs. Like my lame ass physical that cost a whole bunch of money for the doctor to barely look me over.
Or when (e:matthew) cut his finger and got stitches they were $900 in cost but about $9 in quality. We had a retard blond bimbo intern who had to sew it multiple times. Now his finger is so fucked up. We just didn't pay for it and not because I couldn't afford it but because it was done so poorly. I could have done a better job with thread at home and next time if something like happens maybe we will just do it ourselves.
uhoh, a comment-debate with Ajay?! I feel like a Larson! ;)
But briefly:
I am not at all arguing that health care is not fucked up in this country. And no, i don't have an easy solution. If there was one, I'm not sure we'd be in the mess we are. And the idea of a 'universal' health care system is nice- but the ones everyone cites as example (canada) are not all so great either- waiting 2 months for a CT scan, etc. Or in I think it's sweden (but I could be wrong) where once you hit 80 or so you just don't get to see a doc anymore...
So yes, meds are too expensive and I don't argue that, but it's not so much my point.
I am not going indulgle in conspiracy theorism about the pharm industry vs. gov't witholding "the cure for diabetes" to make a buck etc.
And as fas as the AMA restricting the # of docs- where does that come from?! I've never heard that before, and certainly hope it's not true. I've never seen that claim before so I have no way to support/refute it.
As far as I know, the # of docs has to do with the number of people in the med school classes each year, and the number of residency positions available to train them- which (I believe) is regulated by the ACGME (american council on graduate medical education)- which i believe is a gov't org- and has nothing to do with the AMA- which is (it is my understanding) largely an "activist" group- albeit powerful.
Yes, simple primary care needs to be accessible and affordable. But people also need to not expect the gov't to just give them everything for free since it's a "right".
Ok, so much for briefly.
I dunno. I get frustrated with a system that denotes the other side must immediately be wrong simply because they are the other side. As a left leaning Democrat, I'm fully aware that there are smart conservative republicans. Trouble is we're all get drowned out by the yahoos like Hannity and Colmes.
I agree with you on a number of levels and I agree with some of what Ajay is saying.
That is already starting to make my head hurt, so I'm getting a drink
My definition of die-hard liberal is "one who believes that any suffering anywhere is entirely due to some evil system that serves the rich and powerful, and is never due to personal choices or failure to take responsibility for one's actions."
My definition of die-hard conservative is "one who believes that any suffering anywhere is entirely due to personal choices and failure to take responsibility for one's actions, and is never due to any established bureaucratic system favoring the rich and powerful and politically well-connected."
The problem with being a centrist such as yourself is that you are always "way to the left" or "way to the right" of someone, so you're always on somebody's shit list.
You do have some valid points. Maybe this calls for a more extensive discussion.
But keep in mind that the US is the only(?) industrialized country without some notion of "medical care for all" (I hate the term "socialized medicine", because it draws out foaming-at-the-mouth right wingnuts).
The fact is that people in the US pay more for prescription medicines than people 5 miles north of Buffalo.
The fact is that the pharmaceutical industry spends oodles of money tying the government's hands, so that government departments can't even use the free market forces to lower the cost of health insurance.
The fact is that the AMA artificially restricts the number of doctors who will be produced, thereby assuring a shortage (correct me if this is not the case).
If affordable primary care was available to people, they wouldn't have to resort to the ER every time they got a headache. We need a system where working families can get access to affordable healthcare.
Anyways: too much to argue without a beer or two. :-D
doh. I [sic]d the flyer's typos, yet somehow missed about 10 of my own. Sorry for being a hypocrite. (but the post-edit button doesn't work on this computer for some reason so I can't fix it.)