US Birth Rate

[chainsaw 9851]

2 minutes ago, Judge Roybeanbag said:

Here y’all go doing black and white again.  How about a system that gives free preventative care, like colonoscopies and mammograms, and health credits for you know, being healthy, instead of arguing about big dollar items and the huge cost of end of life care?

These a good ideas. My thinking however is then we start having big debates about where to draw the line (like with the abortion debate). We can avoid that bullshit by offering everything as a public service. If you want concierge stuff for faster wait times, you can find a private provider for that and they'll have to compete on price under much fairer circumstances.

[Sawbonz 27527]

Just now, Judge Roybeanbag said:

Here y’all go doing black and white again.  How about a system that gives free preventative care, like colonoscopies and mammograms, and health credits for you know, being healthy, instead of arguing about big dollar items and the huge cost of end of life care?

Agreed but anytime someone is advocating for communism I think it is pretty black and white. Other than a feudal system or outright chattel slavery, communism everywhere it has been attempted has been the most oppressive system imaginable. 

[chainsaw 9851]

3 minutes ago, Sawbonz said:

no by all means start comparing 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323087/

Here's a starting point.

[VRHorn 718]

11 minutes ago, chainsaw said:

Nobody here supports fascism dude.

Not talking about you, but that statement is demonstrably false around here.

Edited July 10, 2022 by VRHorn
Troph beat me to it.

[David Dennison 18841]

2 minutes ago, troph said:

I didn’t say that. I didn’t say the only way, I didn’t say pure capitalism. I said:

1. Liberal democracy 

2. well regulated capitalism 

3. where the planet is a stakeholder, and

4. where humanity is a stakeholder.

gives us our best chance to innovate out of this climate change mess where rapid innovation and efficiency is needed most. 

does the US do this well? Some parts better than others - the very fact we have technologies that could get us out is a huge success but at the moment the soul of America has been kidnapped so probably not. That is NOT an indictment of 1-4 above, it’s an indictment of fascism, authoritarianism, and political Christianity. 
 

what’s the answer? Honestly sidelining the republicans and letting adults in the room that recognize the problems work to solve them is the answer. 

The problem in America is that the Republican Party believes "well regulated capitalism" is an oxymoron.

[troph 24781]

Comparing European health care to US healthcare is fine, most here think major healthcare reforms are needed. Welcome to the party.  

[ChiTownDoc 21139]

6 minutes ago, chainsaw said:

If we're going to be comparing preventable deaths I don't think this is a hill you want to die on.

Actually it definitely is.  I’m not talking policy or covidiots.  I’m talking about the capabilities of our health care system for even the poorest Americans.  I have over 500 doctors in a company I started from scratch.  If I deliver shitty outcomes we cut Medicare and payers 10 and 11 figure checks.  So I don’t think I’m some clown arguing with you.
 
Also, the AMA is all about better policy with bullshit ‘political’ issues like gun control, covid, the EPA…but that’s not what we are arguing here.  Political in quotes because they most definitely are healthcare issues that shouldn’t be politicized but we are morons.  Morons who are still centuries ahead of Russia. 
Also the guy who died was in an EU country, Slovakia.  For all you, omg my ER was so clean in europe people.  Lol

[chainsaw 9851]

1 minute ago, VRHorn said:

Not talking about you, but that statement is demonstrably false around here.

I meant in the immediate discussion, but I get you

[chainsaw 9851]

1 minute ago, ChiTownDoc said:

Actually it definitely is.  I’m not talking policy or covidiots.  I’m talking about the capabilities of our health care system for even the poorest Americans.  I have over 500 doctors in a company I started from scratch.  If I deliver shitty outcomes we cut Medicare and payers 10 and 11 figure checks.  So I don’t think I’m some clown arguing with you.
 
Also, the AMA is all about better policy with bullshit ‘political’ issues like gun control, covid, the EPA…but that’s not what we are arguing here.  Political in quotes because they most definitely are healthcare issues that shouldn’t be politicized but we are morons.  Morons who are still centuries ahead of Russia. 
Also the guy who died was in an EU country, Slovakia.  For all you, omg my ER was so clean in europe people.  Lol

Is it you or a malpractice carrier?

[Sawbonz 27527]

2 minutes ago, chainsaw said:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323087/

Here's a starting point.

If you want to be taken seriously don’t post something you just googled esp if it’s regarding data from 2006

 

[David Dennison 18841]

1 minute ago, ChiTownDoc said:

Actually it definitely is.  I’m not talking policy or covidiots.  I’m talking about the capabilities of our health care system for even the poorest Americans.  I have over 500 doctors in a company I started from scratch.  If I deliver shitty outcomes we cut Medicare and payers 10 and 11 figure checks.  So I don’t think I’m some clown arguing with you.
 
Also, the AMA is all about better policy with bullshit ‘political’ issues like gun control, covid, the EPA…but that’s not what we are arguing here.  Political in quotes because they most definitely are healthcare issues that shouldn’t be politicized but we are morons.  Morons who are still centuries ahead of Russia. 
Also the guy who died was in an EU country, Slovakia.  For all you, omg my ER was so clean in europe people.  Lol

Our healthcare system for the poorest Americans sucks. Period.

[Judge Roybeanbag 11819]

1 minute ago, Sawbonz said:

Agreed but anytime someone is advocating for communism I think it is pretty black and white. Other than a feudal system or outright chattel slavery, communism everywhere it has been attempted has been the most oppressive system imaginable. 

I don’t disagree, but go back to my comment about being dumb, there is a HUGE swatch of people who equate socialism with communism.  Socialism confined isn’t bad.  Without it we would not have much of anything as a nation.  

[chainsaw 9851]

1 minute ago, Sawbonz said:

If you want to be taken seriously don’t post something you just googled esp if it’s regarding data from 2006

 

If you want to be taken seriously don't change the subject when you can't back up your points

[Sawbonz 27527]

Just now, chainsaw said:

Is it you or a malpractice carrier?

Dude just stop. He’s talking about outcomes measurement and pay for performance on a large scale. 

[ChiTownDoc 21139]

Just now, David Dennison said:

Our healthcare system for the poorest Americans sucks. Period.

Again - still better than for the poorest in other countries.  Btw we should do this by state.  In IL you can go to cook county and are taken care of by some brilliant residents.  Texas is much worse.  I’ll give you that.  But the example stated couldn’t simply fly somewhere else within his country for surgery and he actually had the means to do so…

[chainsaw 9851]

1 minute ago, Sawbonz said:

Dude just stop. He’s talking about outcomes measurement and pay for performance on a large scale. 

How do you know that's what he's talking about? Did he say anything about a performance contract?

[Sawbonz 27527]

1 minute ago, David Dennison said:

Our healthcare system for the poorest Americans sucks. Period.

Actually for the poorest Americans care is really good. It sucks for those who make too much to qualify for subsidies for an exchange plan and don’t have employer provided insurance. Poor Texans otoh are fucked because we didn’t accept the federal $$ for Medicaid expansion. 

[ChiTownDoc 21139]

2 minutes ago, chainsaw said:

Is it you or a malpractice carrier?

lol.  No dumbfuck.  You’re clueless.  It’s at risk payment plans with payers.  Literally has ZERO to do with medmal.  You’re a clown arguing points about which you have no clue.  

[ChiTownDoc 21139]

1 minute ago, chainsaw said:

How do you know that's what he's talking about? Did he say anything about a performance contract?

Because he’s a doctor and any doctor reading my post would figure it out.  Lulz

[Sawbonz 27527]

2 minutes ago, chainsaw said:

If you want to be taken seriously don't change the subject when you can't back up your points

Lol you quoted pre ACA data. Gtfo with that shit

[royiv 9244]

1 minute ago, chainsaw said:

How do you know that's what he's talking about? Did he say anything about a performance contract?

Because it's exactly what he said. Some people on here actually work in the medical industry and know how these things work.

[David Dennison 18841]

Just now, ChiTownDoc said:

Again - still better than for the poorest in other countries.  Btw we should do this by state.  In IL you can go to cook county and are taken care of by some brilliant residents.  Texas is much worse.  I’ll give you that.  But the example stated couldn’t simply fly somewhere else within his country for surgery and he actually had the means to do so…

Are you saying there are no countries in which poor people have access to better healthcare than the United States?

[royiv 9244]

1 minute ago, Sawbonz said:

 Poor Texans otoh are fucked because we didn’t accept the federal $$ for Medicaid expansion. 

This right here. Abbott and his cronies have refused to accept federal dollars for Medicaid expansion. Republicans hate poor people. If you think the healthcare for poor people sucks in TX, don't vote for the Republicans who have been purposefully making it harder on poor people.

[David Dennison 18841]

3 minutes ago, Sawbonz said:

Actually for the poorest Americans care is really good. It sucks for those who make too much to qualify for subsidies for an exchange plan and don’t have employer provided insurance. Poor Texans otoh are fucked because we didn’t accept the federal $$ for Medicaid expansion. 

What good is quality care if you can't access it?

[ChiTownDoc 21139]

3 minutes ago, David Dennison said:

Are you saying there are no countries in which poor people have access to better healthcare than the United States?

Oh yes.  Actual access?  It’s there.  I know.  Because in my county/state you fly in and no matter who you are you get the best care. 
 

If you’re arguing wellness check ups and the like I agree but that’s what politicians have fucked up.  
 

You have no money and an operable malignant tumor?  This is the best place in the world.  

[Sawbonz 27527]

1 minute ago, David Dennison said:

What good is quality care if you can't access it?

You’re talking about the NHS right?

[ChiTownDoc 21139]

3 minutes ago, royiv said:

This right here. Abbott and his cronies have refused to accept federal dollars for Medicaid expansion. Republicans hate poor people. If you think the healthcare for poor people sucks in TX, don't vote for the Republicans who have been purposefully making it harder on poor people.

Yep.  

[Snake Diggity 4619]

I think most concern over population growth/decline is overblown.  I would rather earth’s population stabilize around 10B but as long as it stays >2B and <20B then I think humanity will be ok.  Obviously any major changes need to be gradual.  It’s when it explodes/implodes that trouble starts.

 

Wrt to the semi-related discussion on capitalism, we need to keep the system we have but make it much much more difficult to accumulate wealth beyond ~$100M and make it virtually impossible to pass on more than ~$10M to your kids.

[ChiTownDoc 21139]

8 minutes ago, Sawbonz said:

Lol you quoted pre ACA data. Gtfo with that shit

You’ll have to tell him what ACA is…

[David Dennison 18841]

3 minutes ago, Sawbonz said:

You’re talking about the NHS right?

I'm talking about poor people in states in which they do not qualify for Medicaid. 

[David Dennison 18841]

6 minutes ago, ChiTownDoc said:

Oh yes.  Actual access?  It’s there.  I know.  Because in my county/state you fly in and no matter who you are you get the best care. 
 

If you’re arguing wellness check ups and the like I agree but that’s what politicians have fucked up.  
 

You have no money and an operable malignant tumor?  This is the best place in the world.  

Who picks up the tab for the operation and post-op treatments?

Edited July 10, 2022 by David Dennison

[Sawbonz 27527]

1 minute ago, David Dennison said:

I'm talking about poor people in states in which they do not qualify for Medicaid. 

Yeah that sucks. They should vote for Democrats

[royiv 9244]

Just now, Sawbonz said:

Yeah that sucks. They should vote for Democrats

That's the insane thing about poorly educated white people. They vote against their own best interests. The people they vote for hate people like themselves.

[ChiTownDoc 21139]

Just now, David Dennison said:

Who picks up that the tab for the operation and post-op treatments?

You’re joking right?  You know how many billions in care is just written off.  90% of groups are like mine.  When someone can’t pay you send the one notice you’re legally required to send, then let it go.  Cook county hospital, bro.  It’s all free.  Maybe some amateur like you needs to hear, it’s where ER was based!

Nobody is picking up the bill.  You sound like the loons on the right who watch Fox all day except on the other end of the retard spectrum. 

[CooterBrown 18002]

Unless they need an actual surgery for a non impending life threatening condition

Is it truly better here? It’s impossible to get an appointment with your PCP within the next six weeks. Your options are always to get on a waiting list or head to after hours care to see whoever is working that shift.

[Sawbonz 27527]

5 minutes ago, David Dennison said:

Who picks up that the tab for the operation and post-op treatments?

The county (and state) taxpayers as well as Medicaid and Medicare dollars that go to teaching institutions. We do it in Texas as well in every county that has teaching hospitals. Better to live in Dallas, Harris, Bexar, or Tarrant counties if you are poor

 

eta im talking about the institutions. The providers usually just eat it

Edited July 10, 2022 by Sawbonz

[royiv 9244]

2 minutes ago, David Dennison said:

Who picks up the tab for the operation and post-op treatments?

Taxpayers. Specifically in TX, healthcare districts can levy property taxes so it's on your yearly property tax bill.

[RomaVicta 29898]

23 hours ago, jimmyjazz said:

Our youngest is 18.  I can't imagine the world without him or his siblings.  This isn't to criticize your choice, but kids can be a blessing.  Maybe that's selfish.

We're growing like mold on this planet. The most celebrated moments in most people's lives is pledging their troph then producing children. The most ordinary things that occur in nature are celebrated like miracles by our species. 

We're slaves to the DNA. And the DNA knows only that it wants to keep going.

If I could persuade people to not make such a big fucking deal of "When are you getting married?" followed by, "When will you start the family" I would do so. But it's useless. People's brains are not in control. People are also basically herd animals very content to be doing what the herd does and has always done.

Of course, you can't imagine the world without your children. Loving that little thing is also built into the DNA.

I can imagine not having children. I have none. It's just as great. I didn't decide not to marry and have kids, it just didn't happen. As I got older, my main concern was that I might go through life without a great love reinforced by intimacy.

I got very lucky. I don't feel my relationship needs children to make it more fulfilling. 

But nobody but the childless late in life will get it. The herd, involuntarily so there's no blaming them, happily plunges ahead doing what the double helix blindly demands.

I've gotten to a place where I find weddings profoundly garish. The reaction to birth in other families is similarly so. You must have the wedding because it's the biggest day in your life. You must produce offspring because it's nature reinforced by social disapproval if you don't.

I write without rancor. It's just my observation from outside of the whole conveyor belt. Mold does not reflect on its expansion either.

[David Dennison 18841]

1 minute ago, ChiTownDoc said:

You’re joking right?  You know how many billions in care is just written off.  90% of groups are like mine.  When someone can’t pay you send the one notice you’re legally required to send, then let it go.  Cook county hospital, bro.  It’s all free.  Maybe some amateur like you needs to hear, it’s where ER was based!

Nobody is picking up the bill.  You sound like the loons on the right who watch Fox all day except on the other end of the retard spectrum. 

That's not what happens in real life, though. Hospitals don't send one notice and let it go. 

[ChiTownDoc 21139]

2 minutes ago, CooterBrown said:

Is it truly better here? It’s impossible to get an appointment with your PCP within the next six weeks. Your options are always to get on a waiting list or head to after hours care to see whoever is working that shift.

There’s definitely healthcare deserts but, again, that’s policy fuck ups by politicians.  You’ll see where the AMA and most medical academies stand.  Republican policy sucks.  Can repeat that over and over and still agree the care here is better than just about anywhere.  Also you know what else factors into shitty outcomes?  We are fat as fuck as a country and you can’t blame all of that on the healthcare system.   

[royiv 9244]

4 minutes ago, CooterBrown said:

Is it truly better here? It’s impossible to get an appointment with your PCP within the next six weeks. Your options are always to get on a waiting list or head to after hours care to see whoever is working that shift.

Find a better primary care doc. If I want to see mine, I can typically get in within 10 days. If I have something urgent I can schedule a in person or telemedicine visit with her NP same day.

[ChiTownDoc 21139]

2 minutes ago, David Dennison said:

That's not what happens in real life, though. Hospitals don't send one notice and let it go. 

Again, many do.  Not where you’re from.  NW let’s a fuckload just go, if we are talking the other end of the spectrum from Cook County.  Also as stated many times, the taxpayer ends up paying.  My property taxes in Cook this year - 180k.  Nobody is locking you up after you get some junk mail.  Quit obfuscating. 

Edited July 10, 2022 by ChiTownDoc

[Judge Roybeanbag 11819]

4 minutes ago, royiv said:

Taxpayers. Specifically in TX, healthcare districts can levy property taxes so it's on your yearly property tax bill.

Yep, check out Travis County.  That cost of living here is partly paying for healthcare.  We could nationalize part of that, but it would be socialism.  

[troph 24781]

20 minutes ago, royiv said:

This right here. Abbott and his cronies have refused to accept federal dollars for Medicaid expansion. Republicans hate poor people. If you think the healthcare for poor people sucks in TX, don't vote for the Republicans who have been purposefully making it harder on poor people.

Impediments to progress, they hate humanity and the planet, they want to rule not govern.

[royiv 9244]

2 minutes ago, David Dennison said:

That's not what happens in real life, though. Hospitals don't send one notice and let it go. 

It actually happens a lot. I spent many years at a multi billion dollar healthcare organization and our practice was to send three notices and then let it go. There's not a lot you can do to go after someone that can't pay so we didn't bother.

[Sawbonz 27527]

11 minutes ago, CooterBrown said:

Is it truly better here? It’s impossible to get an appointment with your PCP within the next six weeks. Your options are always to get on a waiting list or head to after hours care to see whoever is working that shift.

Sounds like you need a new pcp. I can find multiple choices on zocdoc for a visit with IM or FP for tomorrow. 

[Bullneck 19070]

13 hours ago, troph said:

however the answer isn’t what your selling.  The answer is a more well regulated market one where humans realize the planet is a stakeholder and human basic needs are stakeholders. That’s achievable once we obtain the will to include all stakeholders at the table, but if we eradicate the profit motive the hard work of innovation will cease. 

Just curious: which places fall into this category?

Edited July 10, 2022 by Bullneck

[David Dennison 18841]

1 minute ago, royiv said:

It actually happens a lot. I spent many years at a multi billion dollar healthcare organization and our practice was to send three notices and then let it go. There's not a lot you can do to go after someone that can't pay so we didn't bother.

What was your organization's policy with regard to reporting uncollected payments to the credit bureaus?

[chainsaw 9851]

7 minutes ago, ChiTownDoc said:

There’s definitely healthcare deserts but, again, that’s policy fuck ups by politicians.  You’ll see where the AMA and most medical academies stand.  Republican policy sucks.  Can repeat that over and over and still agree the care here is better than just about anywhere.  Also you know what else factors into shitty outcomes?  We are fat as fuck as a country and you can’t blame all of that on the healthcare system.   

No, it is the profit (greed) motive inefficiently allocating a vital resource because the population served is too rich for government assistance but too poor to be a profit center. If the government were unshackled and allowed to directly participate in the market for providing healthcare services there would be fewer healthcare deserts.

Greed gets us to a point where the California has to step in and start producing its own affordable insulin.

[royiv 9244]

1 minute ago, David Dennison said:

What was your organization's policy with regard to reporting uncollected payments to the credit bureaus?

Didn’t do it.