Current Events > Trump trying to get rid of pre-existing condition protections

(+) Yeah! (+)

SableWolfAngel posted...

Does a weak heart from surgery count as a pre-existing condition?

If so, would someone with this problem lose their insurance after this reform?

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wah_wah_wah posted...

Whatever you're describing here, it doesn't sound like you want empirical medicine

Lol what? You're skipping a few steps in your thought process here, I'm not following.

wah_wah_wah posted...

because individual fault has nothing to do with that. Sounds like you're begging for a church

...what? I don't think you quite understand my position either.
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BlameAnesthesia posted...

wah_wah_wah posted...

Whatever you're describing here, it doesn't sound like you want empirical medicine

Lol what? You're skipping a few steps in your thought process here, I'm not following.

wah_wah_wah posted...

because individual fault has nothing to do with that. Sounds like you're begging for a church

...what? I don't think you quite understand my position either.

There is nothing to understand. You clearly have no idea what you're talking about. You don't even have a working understanding of the goal of healthcare and disease theory. You seem to think that individual choices make people sick rather than their environment, and your solution is to kill those people. There is a reason you're on GameFAQs blathering away and not at John Hopkins.

As someone who is a type 1 diabetic, this news is making me
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BlameAnesthesia posted...

P4wn4g3 posted...

BlameAnesthesia posted...

The people who don't manage their COPD, CHF, Diabetes, etc are the ones in the millions. They're the ones that we have a conversation with every single doctor's visit. This is going to kill you. You're going to lose your foot. You're going to get pneumonia and end up in the hospital. Over. And over. And over. And over.

And the poorly controlled diabetic who gets the nonhealing foot ulcer then gets gangrene and needs it amputated to prevent sepsis and death? First question in the recovery unit post-op: "WHAT'S FOR DESSERT?"

You need to remember this: you can lead a horse to water, but you can't force it to drink. It's an age old saying for good reason. The only real way to cure the problem you are describing is eugenics. Just kill them all. Education? My grandpa knew he was sick as fuck, we have many health professionals in the family but even an idiot could tell you he was sick, yet he insisted he was fine until the day he couldn't move due to pain and we sent him to the ER and he was diagnosed with necrotic pneumonia and sent to rehab. You think families can fix this? You understand nothing of individual rights. You think the government can just step in? They can't. You think denying the millions of people struggling to make a living basic Healthcare wi make everyone's lives easier? You are wrong.

It's too bad people don't give a fuck, but there is no simple solution today. If the government had more authority in these matters we might get closer to one.

You still don't understand my point and it's clear.

I'm not in favor of removing pre-existing conditions. But I'm not in favor of the current system anyway. But I know single payer would fail on the premise of what coffeebeanz is describing.

And no, it's not eugenics, and you're just as emotional in your argument as the people who disagreed with obama based off of "death panels."

The reality is poorly managed disease that is preventable should not be covered. If they die as a result of being unable to afford their care is not society's problem. They are given every resource. The system keeps telling them the consequences. At some level, short of taking over autonomy of their life, they will never reach the conclusion until it is too late, as you so aptly described with your own grandpa.

It's unfortunate, but the choice is between "prolong everyone's life, not necessarily improving their quality of life, which consists of repeat admissions until eventually the complication kills them--The consequence being no one else can afford health care." or "Draw a line, whereby patients who are too stubborn in their lifestyle choices suffer the consequences of their own decisions. They die sooner, but not a prolonged course of going to the hospital every 1-6 months until they die. And everyone else gets much more affordable and accessible health care to improve the quality of life for everyone who is willing."

There is no magical fairy tale where you get the best of both options.

So if you are asking for me to take a stance here, I like the pragmatism and am all for drawing a line. But the problem is this: who gets to decide what is a "preventable illness" ? Who oversees those people? What would it take for them to sell out? It's the razor's edge really. You can't simply give someone unfettered authority and expect it to be better than what we have now because it won't be.

On the flip side, if we implement something like single layer and people are still being a drain and dying, they will have people cut them out of the family. They will lose connections and access to things. They will die faster. People who are willing to take care of themselves will do so. That's just how life is.
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SableWolfAngel posted...

SableWolfAngel posted...

Does a weak heart from surgery count as a pre-existing condition?

If so, would someone with this problem lose their insurance after this reform?

Yes and yes.

People arguing against coffeebeanz are worried about the moral implication of that.

Coffeebeanz is categorizing that the people in that category CAN have affordable care for their congenital conditions because their overall healthcare burden is low relative to the majority of people with poorly managed common diseases like diabetes, congestive heart failure, and chronic obstructive pulmonary disease.

The category you refer to is a minority. The category she is referring to is in the millions. They see a doctor and ignore the advice/treatments. They wait until they suffer a complication of their disease, which leads to expensive hospitalizations. These diseases aren't "curable", but you can prevent hospitalizations by preventing the disease from progressing with lifestyle change and compliance with their medications.

For whatever reason, patients refuse and simply bounce back and forth in the hospital. This is predominantly most of our health care costs. Sure, SOME of these admissions are not due to the fault of the patient. But a surprising amount that someone who has never spent time on a medical ward will fail to acknowledge is simply due to lack of motivation/willpower/desire.

And anyone who has spent time in a medical ward also knows there is this American mentality of "wanting the best, always." This leads to vegetables on ventilators for months and years, costing millions, which cannot be afforded by the average family, and the bill is being tossed back and forth between government and industry, snowballing to what we have today.

If America wants affordable healthcare, they need to accept a subset of the population is not willing to do what it takes to not be a massively disproportionate burden.
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P4wn4g3 posted...

So if you are asking for me to take a stance here, I like the pragmatism and am all for drawing a line. But the problem is this: who gets to decide what is a "preventable illness" ? Who oversees those people? What would it take for them to sell out? It's the razor's edge really

Actually for anyone who studied pathophysiology, the distinction is a lot clearer than you think.

Again, talking in abstracts about problems that are predominantly an issue of implementation.
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BlameAnesthesia posted...

SableWolfAngel posted...

SableWolfAngel posted...

Does a weak heart from surgery count as a pre-existing condition?

If so, would someone with this problem lose their insurance after this reform?

Yes and yes.

People arguing against coffeebeanz are worried about the moral implication of that.

Coffeebeanz is categorizing that the people in that category CAN have affordable care for their congenital conditions because their overall healthcare burden is low relative to the majority of people with poorly managed common diseases like diabetes, congestive heart failure, and chronic obstructive pulmonary disease.

The category you refer to is a minority. The category she is referring to is in the millions. They see a doctor and ignore the advice/treatments. They wait until they suffer a complication of their disease, which leads to expensive hospitalizations. These diseases aren't "curable", but you can prevent hospitalizations by preventing the disease from progressing with lifestyle change and compliance with their medications.

For whatever reason, patients refuse and simply bounce back and forth in the hospital. This is predominantly most of our health care costs. Sure, SOME of these admissions are not due to the fault of the patient. But a surprising amount that someone who has never spent time on a medical ward will fail to acknowledge is simply due to lack of motivation/willpower/desire.

And anyone who has spent time in a medical ward also knows there is this American mentality of "wanting the best, always." This leads to vegetables on ventilators for months and years, costing millions, which cannot be afforded by the average family, and the bill is being tossed back and forth between government and industry, snowballing to what we have today.

If America wants affordable healthcare, they need to accept a subset of the population is not willing to do what it takes to not be a massively disproportionate burden.

It's a stupid argument either way, which assumes that people are horrible by nature and want to die anyway. It isn't something anyone who is serious about healthcare and works in medicine would even consider for longer than half a second. He would be laughed out of any hospital with such theories.

P4wn4g3 posted...

On the flip side, if we implement something like single layer and people are still being a drain and dying, they will have people cut them out of the family. They will lose connections and access to things. They will die faster. People who are willing to take care of themselves will do so. That's just how life is.

You do realize that's what I'm arguing for right?

The people who recognize the importance of managing their COPD, DM, CHF, etc will still be able to be hospitalized for issues outside of their control if it came to that.

The only people that will die "prematurely" here are the people absolutely refusing to listen to the consequences of their current course. Multiple times. Multiple, multiple times.

The arguments here are for those people who are behaving in a manner that demonstrates they don't care about their health. And the consequence is the current system we have that's unaffordable. I'm really surprised people are that sympathetic to people who don't care.

Let the ones who do care prosper. Our country is too fat and unhealthy these days because we're too permissive with people's choices. Period.
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Like I said, this is a different discussion than simply allowing anyone coverage. If you want to talk about idiots taking advantage of the system, introduce harsh legislation on patient compliance. This of course would swing the ball back into the doctor's court and we would have doctors giving unrealistic orders to make money or be shitty, but again, take out the middle man that is insurance.
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BlameAnesthesia posted...

The only people that will die "prematurely" here are the people absolutely refusing to listen to the consequences of their current course. Multiple times. Multiple, multiple times.

The arguments here are for those people who are behaving in a manner that demonstrates they don't care about their health.

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

wah_wah_wah posted...

BlameAnesthesia posted...

The only people that will die "prematurely" here are the people absolutely refusing to listen to the consequences of their current course. Multiple times. Multiple, multiple times.

The arguments here are for those people who are behaving in a manner that demonstrates they don't care about their health.

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

Because their body and basic instincts have overridden their pride or stupidity. This is actually a thing that happens.
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wah_wah_wah posted...

It's a stupid argument either way, which assumes that people are horrible by nature and want to die anyway. It isn't something anyone who is serious about healthcare and works in medicine would even consider for longer than half a second. He would be laughed out of any hospital with such theories.

That's not at all what I am saying either.

And also the problem with these discussions. It's so generalized, so people extrapolate what I say to these extremes.

No, people in general aren't horrible and want to die.

I'm saying a subset of the population is like this, and they are disproportionately what is costing us so much. Cut them, and suddenly everyone who does care gets better, affordable care. The "fire" under their ass might motivate some of them to fix it before it's too late. The ones who die as a result of their failure, well, it's not necessarily a worse fate compared to being in an out of a hospital every month. That is its own hell.

Ask how many doctors and nurses want to extend life and have the most aggressive care during end-of-life. You'll find drastically almost zero.

This is an American cultural issue and ethically does a lot of harm. Read Being Mortal. Please.
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wah_wah_wah posted...

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

Oh. My. God.

Please, go shadow in an ER or a medicine ward for a few days. Please. Just please. You don't know how ignorant you sound right now.
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P4wn4g3 posted...

wah_wah_wah posted...

BlameAnesthesia posted...

The only people that will die "prematurely" here are the people absolutely refusing to listen to the consequences of their current course. Multiple times. Multiple, multiple times.

The arguments here are for those people who are behaving in a manner that demonstrates they don't care about their health.

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

Because their body and basic instincts have overridden their pride or stupidity. This is actually a thing that happens.

Someone who is alive, regardless of the mistakes they may have made, can still change and learn. Someone youve killed out of neglect isnt going to change or contributed or learn anything. They are dead, and your neglect killed them. Not theirs. They might not have followed your orders exactly as you prescribed, but youre responsible for not giving them care and allowing them to die. And that isn't going to do anything to teach anyone anything. You killed a person and are now are insisting on the absurdity that it was necessary to kill them so that person would learn.

BlameAnesthesia posted...

wah_wah_wah posted...

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

Oh. My. God.

Please, go shadow in an ER or a medicine ward for a few days. Please. Just please. You don't know how ignorant you sound right now.

I'm not the one suggesting that we kill people out of neglect. You're out of your fucking mind if you think anyone would believe that someone like you would be allowed even two feet inside of a hospital with that depraved ideology.

wah_wah_wah posted...

Someone who is alive, regardless of the mistakes they may have made, can still change and learn.

This is false though. It would be wonderful if true, but people are hard set in their ways by time they are mid 20s at the latest. If their personality includes bettering themselves then sure, some changes can be made. If not, then they can't be. Even those who can change are very limited in what they can change. The system can't help people who can't do the work for themselves. That's they basic argument here and as far as today's medicine goes it's correct.
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P4wn4g3 posted...

Like I said, this is a different discussion than simply allowing anyone coverage. If you want to talk about idiots taking advantage of the system, introduce harsh legislation on patient compliance. This of course would swing the ball back into the doctor's court and we would have doctors giving unrealistic orders to make money or be shitty, but again, take out the middle man that is insurance.

I see what you mean, but if it's centered around outcome, it's not as bad as you think.

Before Obamacare, hospitals loved repeat admissions. They loved the surgical outcome that required extensive ICU stays. Doctors had their hands tied--it was a shitty practice.

ACA introduced penalties in reimbursement for these repeat offenders. Suddenly hospitals can't strike a profit on the repeat admissions, but now doctors were tasked with an impossible feat--I don't care how idealistic someone is. They will fail at convincing a poorly controlled diabetic to make changes in their diet and to take their medicine.

This is not saying EVERY diabetic is like this. Just the ones that are poorly controlled is a more deeply seated psychological reason than we have the tools to actually address.

Doctors got penalized for outcomes they couldn't control. It's a shitty system.

Under single payer, hospitals will require doctors' expertise in knowing what plan of care is most efficient. The cheaper it is, the more leftover there is for everyone involved.

No more incentives based on volume, treating health care like a commodity. The buck is stopped at a limited reimbursement and the only people who make money are the ones most efficient at providing good care.

The unfortunate nature is that the repeat offenders will not be offered that care. They will be given chances in the beginning, when they're diagnosed. They'll have years of follow up before it becomes serious enough.

If a decade of bad decisions isn't enough, they'll find the disease kills them, rather than simply being a system that stabilizes an acute decompensation just enough to send them home, only for it to get bad enough in a month.
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now I understand what people mean when they call America a shithole
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wah_wah_wah posted...

I'm not the one suggesting that we kill people out of neglect. You're out of your fucking mind if you think anyone would believe that someone like you would be allowed even two feet inside of a hospital with that depraved ideology.

Oh my sweet summer child...
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P4wn4g3 posted...

wah_wah_wah posted...

Someone who is alive, regardless of the mistakes they may have made, can still change and learn.

This is false though. It would be wonderful if true, but people are hard set in their ways by time they are mid 20s at the latest. If their personality includes bettering themselves then sure, some changes can be made. If not, then they can't be. Even those who can change are very limited in what they can change. The system can't help people who can't do the work for themselves. That's they basic argument here and as far as today's medicine goes it's correct.

I guess they don't change if you just straight up kill them. But this is assumption, not fact. Plenty of people change their minds about things all the time. I can't believe I am actually in an argument where someone is literally saying that people always never change their minds about anything. Like are you for real or are you just that stupid?

BlameAnesthesia posted...

wah_wah_wah posted...

I'm not the one suggesting that we kill people out of neglect. You're out of your fucking mind if you think anyone would believe that someone like you would be allowed even two feet inside of a hospital with that depraved ideology.

Oh my sweet summer child...

Seriously, tell me what hospital you work for. Give me your credentials and name.

wah_wah_wah posted...

I guess they don't change if you just straight up kill them.

No one is killing anyone here. Stop using emotionally charged language.

No one is saying absolutes. Of course patients change. You still are horribly naive at the number of patients who don't change, right up until the die, after amassing millions in medical expenses, when these medical treatments aren't necessarily doing them much good, just delaying their death.

It's not improving their quality of life. They spend most of it in a hospital. Going through unnecessary procedures. Suffering hospital acquired infections. Their families can't let go that they really died 6 months ago, but emotionally they prolong it, and often times it hurts the patient.

But it gets done anyway.

The people who provide this care are in a system they can't fix. Doctors, nurses, I don't care. Cogs in an inhumane system. We can do a lot of good, but a lot of harm is done.

What we're talking about is trying to end the harm, but people who don't know a fucking thing about this issue take a misguided moral approach and think we're heartless.

Go shadow a fucking hospital. You have to see it for yourself. Or remain willfully ignorant and pretend the reality is what ever image you've conjured in your head. I'm too busy trying to do what good I can do in a broken system.
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BlameAnesthesia posted...

P4wn4g3 posted...

Like I said, this is a different discussion than simply allowing anyone coverage. If you want to talk about idiots taking advantage of the system, introduce harsh legislation on patient compliance. This of course would swing the ball back into the doctor's court and we would have doctors giving unrealistic orders to make money or be shitty, but again, take out the middle man that is insurance.

I see what you mean, but if it's centered around outcome, it's not as bad as you think.

Before Obamacare, hospitals loved repeat admissions. They loved the surgical outcome that required extensive ICU stays. Doctors had their hands tied--it was a shitty practice.

ACA introduced penalties in reimbursement for these repeat offenders. Suddenly hospitals can't strike a profit on the repeat admissions, but now doctors were tasked with an impossible feat--I don't care how idealistic someone is. They will fail at convincing a poorly controlled diabetic to make changes in their diet and to take their medicine.

This is not saying EVERY diabetic is like this. Just the ones that are poorly controlled is a more deeply seated psychological reason than we have the tools to actually address.

Doctors got penalized for outcomes they couldn't control. It's a shitty system.

Under single payer, hospitals will require doctors' expertise in knowing what plan of care is most efficient. The cheaper it is, the more leftover there is for everyone involved.

No more incentives based on volume, treating health care like a commodity. The buck is stopped at a limited reimbursement and the only people who make money are the ones most efficient at providing good care.

The unfortunate nature is that the repeat offenders will not be offered that care. They will be given chances in the beginning, when they're diagnosed. They'll have years of follow up before it becomes serious enough.

If a decade of bad decisions isn't enough, they'll find the disease kills them, rather than simply being a system that stabilizes an acute decompensation just enough to send them home, only for it to get bad enough in a month.

Honestly that sounds fine to me. Again we would need to be sure not to allow for severe abuse of authority, but that's a bit more granular in the administration of how the policy would be implemented.
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P4wn4g3 posted...

Honestly that sounds fine to me. Again we would need to be sure not to allow for severe abuse of authority, but that's a bit more granular in the administration of how the policy would be implemented.

Absolutely. Doubt it would be without it's problems, but no system is perfect =/
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Oh no!! I can't lose my insurance!! It's not my fault my heart is weak!! I'll die without proper care!!
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SableWolfAngel posted...

Oh no!! I can't lose my insurance!! It's not my fault my heart is weak!! I'll die without proper care!!

Not what the last 100 posts have been talking about, but okay.
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BlameAnesthesia posted...

wah_wah_wah posted...

I guess they don't change if you just straight up kill them.

No one is killing anyone here. Stop using emotionally charged language.

No one is saying absolutes. Of course patients change. You still are horribly naive at the number of patients who don't change, right up until the die, after amassing millions in medical expenses, when these medical treatments aren't necessarily doing them much good, just delaying their death.

It's not improving their quality of life. They spend most of it in a hospital. Going through unnecessary procedures. Suffering hospital acquired infections. Their families can't let go that they really died 6 months ago, but emotionally they prolong it, and often times it hurts the patient.

But it gets done anyway.

The people who provide this care are in a system they can't fix. Doctors, nurses, I don't care. Cogs in an inhumane system. We can do a lot of good, but a lot of harm is done.

What we're talking about is trying to end the harm, but people who don't know a fucking thing about this issue take a misguided moral approach and think we're heartless.

Go shadow a fucking hospital. You have to see it for yourself. Or remain willfully ignorant and pretend the reality is what ever image you've conjured in your head. I'm too busy trying to do what good I can do in a broken system.

So tell me what's your solution? Because what I'm getting is, you want to deny care to people because they aren't following the treatment plans exactly. Is that correct? Because you do realize that for some, that means certain death right? And you would be responsible for that? Because you could have given care and you didn't. That is a straight-line responsibility on your part. I'm sorry you have trouble processing emotions (which again tips off that you probably work in a spank booth and not a medical setting) but you're making nightmarish pronouncements with no actual knowledge of medical ethics.

wah_wah_wah posted...

BlameAnesthesia posted...

wah_wah_wah posted...

I'm not the one suggesting that we kill people out of neglect. You're out of your fucking mind if you think anyone would believe that someone like you would be allowed even two feet inside of a hospital with that depraved ideology.

Oh my sweet summer child...

Seriously, tell me what hospital you work for. Give me your credentials and name.

There isn't a single part of this that is a happy subject you know.
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wah_wah_wah posted...

So tell me what's your solution? Because what I'm getting is, you want to deny care to people because they aren't following the treatment plans exactly. Is that correct?

No, that's not correct.

wah_wah_wah posted...

Because you do realize that for some, that means certain death right?

Not talking about denying acute care. That's against the law (EMTALA).

wah_wah_wah posted...

And you would be responsible for that? Because you could have given care and you didn't.

No one is talking about denying people care for not following a treatment plan perfectly. Stop with the exaggerations.

wah_wah_wah posted...

That is a straight-line responsibility on your part. I'm sorry you have trouble processing emotions (which again tips off that you probably work in a spank booth and not a medical setting) but you're making nightmarish pronouncements with no actual knowledge of medical ethics.

You are being extremely aggressive whilst accusing me of things I do not endorse.
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BlameAnesthesia posted...

wah_wah_wah posted...

So tell me what's your solution? Because what I'm getting is, you want to deny care to people because they aren't following the treatment plans exactly. Is that correct?

No, that's not correct.

wah_wah_wah posted...

Because you do realize that for some, that means certain death right?

Not talking about denying acute care. That's against the law (EMTALA).

wah_wah_wah posted...

And you would be responsible for that? Because you could have given care and you didn't.

No one is talking about denying people care for not following a treatment plan perfectly. Stop with the exaggerations.

wah_wah_wah posted...

That is a straight-line responsibility on your part. I'm sorry you have trouble processing emotions (which again tips off that you probably work in a spank booth and not a medical setting) but you're making nightmarish pronouncements with no actual knowledge of medical ethics.

You are being extremely aggressive whilst accusing me of things I do not endorse.

See I know you're a bullshit artist because you're quick to tell me what you're not saying then don't offer anything about what you are saying. On some level you're trying to rationalize denial of care as a solution and I'm sorry, but if you are in the medical field with that attitude, you're a straight up fucking quack. Set you in the pond to eat bread.

BlameAnesthesia posted...

SableWolfAngel posted...

Oh no!! I can't lose my insurance!! It's not my fault my heart is weak!! I'll die without proper care!!

Not what the last 100 posts have been talking about, but okay.

It's going so fast that it's hard to keep up. Besides, am I not allowed to be concerned about the base issue this topic is about? I really am afraid of losing my insurance because of my heart condition.
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Wah wah, I cannot explain to you the nuances of everything because you haven't been to medical school. You don't understand the physiology of congestive heart failure. You don't understand the rationale in medical treatment for it. You don't understand the complications of the disease as it progresses. You don't understand the inpatient management of those complications.

You need to understand these to really get at my point here.

To reach the point of coming in and out of the hospital every month is preceeded by a decade of patients continually refusing to listen to ANY treatment plans whatsoever. Yes, systemic issues like people not affording meds. Cultural reasons that might prevent someone from seeking western care. Lack of education or understanding.

But health care already has means of addressing these. And they regularly do. And a lot get better. A lot listen to the advice. They still suffer the complications occasionally. They absolutely deserve treatment. A person not being perfectly compliant? Still deserves treatment.

But at some level, you tell a diabetic 10 years ago that if they don't change their diet or take the medications, their kidneys will die. They'll suffer peripheral nerve damage. They'll be susceptible to infections. Their wounds won't heal and it can lead to serious infections. They might need amputations if it comes to that. They'll get strokes and heart attacks. Six months later, they don't change their diet. They gained 20 lbs. Their A1C went up 2% and is now at 10%. You tell them the same story. Six months later, it's worse. 5 years later, they suffer their first complication--a stroke. They go in the hospital. You treat them and send them on their way. A warning. "If you follow this path it'll get worse." They continue to not change. Now the hospitalizations are more frequent. Once a year. Twice a year. Once every 2 months. Once every month. Now they suffered a heart attack. Now they're in heart failure. They don't treat that either. They're in once a month still.

The way you treat the complications is "simple" in the sense that all you can do is get them to a position to go home, but they aren't addressing the root cause.

Eventually they die. In spite of every attempt of the system trying to fix it. It happens. No matter how much you cry. No matter how much your heart bleeds. You cannot change that.

Except each of those hospital admissions was 250k and over the course of their illness their simple diabetes which is VERY EASILY TREATABLE cost millions and millions.

Extrapolate this to a few million people in the country and no one can afford care because society hasn't decided who pays the bill yet.

Everyone has tried every bleeding heart solution to not "abandon and kill them."

What's YOUR solution?
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wah_wah_wah posted...

See I know you're a bullshit artist because you're quick to tell me what you're not saying then don't offer anything about what you are saying. On some level you're trying to rationalize denial of care as a solution and I'm sorry, but if you are in the medical field with that attitude, you're a straight up fucking quack. Set you in the pond to eat bread.

I'm not the villian you're painting me out to be, and despite your viscous mind's premature conclusion, I still care about the patient more than anything else. Fuck the insurance company. Fuck the hospital. I care about the patient.

And I'm interested in solutions that actually brings care to the most people, not tanks the ship for the entire country because of an extremely naive moral argument that stems from not even understanding how health care is organized in this country at this present time.

Educate yourself.
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SableWolfAngel posted...

BlameAnesthesia posted...

SableWolfAngel posted...

Oh no!! I can't lose my insurance!! It's not my fault my heart is weak!! I'll die without proper care!!

Not what the last 100 posts have been talking about, but okay.

It's going so fast that it's hard to keep up. Besides, am I not allowed to be concerned about the base issue this topic is about? I really am afraid of losing my insurance because of my heart condition.

Under the classic model insurance companies had yes you'd lose coverage.
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BlameAnesthesia posted...

Wah wah, I cannot explain to you the nuances of everything because you haven't been to medical school. You don't understand the physiology of congestive heart failure. You don't understand the rationale in medical treatment for it. You don't understand the complications of the disease as it progressives. You don't understand the inpatient management of those complications.

You have absolutely no idea who I am other than a GameFAQs user. But I guess that's in line with all your other quackery you've revealed so far this thread. Great way to start things out by straight up lying about knowledge you don't have.

BlameAnesthesia posted...

Except each of those hospital admissions was 250k and over the course of their illness their simple diabetes which is VERY EASILY TREATABLE cost millions and millions.

See this is yet another poor assumption on your part. You have no idea what this person will go on to do, if they get treatment. You are making a cost-benefit analysis without knowing the cost of losing a human life. And the reason why you're making this statement is because you can't possibly know that, just like you can't know that I went to medical school yet you declare it as fact at the very beginning. You also can't automatically know the reasons why someone might not be following your treatment plan for sure. It could be because they are not listening. But it could very well an institutional problem on your part that you're not thinking of. If you deny someone care and they die and you find out later that there may have been a way to approach it that could have got more compliance. But if you deny the care, you can't bring them back to life. They're dead. There is no hope for treatment or a turnaround with a corpse. That's why you have to do everything possible to keep someone alive, even if you believe that it's the person's fault. Because what if you find out later it isn't? You can't resurrect the dead.

SableWolfAngel posted...

Besides, am I not allowed to be concerned about the base issue this topic is about? I really am afraid of losing my insurance because of my heart condition.

Of course you're allowed to be concerned. I guess let me clarify--I don't think you're the "burden" some of the bleeding hearts think I'm "against." The base issue you're talking about is certainly the Republican platform's proposal, which is not something I'm for.

Their current proposal would most certainly screw you. It "might" solve the issue coffeebeanz initially brought up, but I'm interested in a solution that doesn't affect someone like you.
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wah_wah_wah posted...

See this is yet another poor assumption on your part. You have no idea what this person will go on to do, if they get treatment. You are making a cost-benefit analysis without knowing the cost of losing a human life. And the reason why you're making this statement is because you can't possibly know that, just like you can't know that I went to medical school yet you declare it as fact at the very beginning. You also can't automatically know the reasons why someone might not be following your treatment plan for sure. It could be because they are not listening. But it could very well an institutional problem on your part that you're not thinking of. If you deny someone care and they die and you find out later that there may have been a way to approach it that could have got more compliance. But if you deny the care, you can't bring them back to life. They're dead. There is no hope for treatment or a turnaround with a corpse. That's why you have to do everything possible to keep someone alive, even if you believe that it's the person's fault. Because what if you find out later it isn't? You can't resurrect the dead.

So what's your solution
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P4wn4g3 posted...

wah_wah_wah posted...

See this is yet another poor assumption on your part. You have no idea what this person will go on to do, if they get treatment. You are making a cost-benefit analysis without knowing the cost of losing a human life. And the reason why you're making this statement is because you can't possibly know that, just like you can't know that I went to medical school yet you declare it as fact at the very beginning. You also can't automatically know the reasons why someone might not be following your treatment plan for sure. It could be because they are not listening. But it could very well an institutional problem on your part that you're not thinking of. If you deny someone care and they die and you find out later that there may have been a way to approach it that could have got more compliance. But if you deny the care, you can't bring them back to life. They're dead. There is no hope for treatment or a turnaround with a corpse. That's why you have to do everything possible to keep someone alive, even if you believe that it's the person's fault. Because what if you find out later it isn't? You can't resurrect the dead.

So what's your solution

I'm not required to offer a solution in order to illustrate why a solution that kills people is wrong.

BlameAnesthesia posted...

wah_wah_wah posted...

Great way to start things out by straight up lying about knowledge you don't have.

https://imgur.com/TPrQhMA

You can easily get a Barcode reader to decode that. You didn't censor it well.
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wah_wah_wah posted...

I'm not required to offer a solution in order to illustrate why a solution that kills people is wrong.

"If healthcare eventually becomes unaffordable to all, leading to more total deaths, at least I know my hands are clean of a moral straw man."
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BlameAnesthesia posted...

wah_wah_wah posted...

Great way to start things out by straight up lying about knowledge you don't have.

https://imgur.com/TPrQhMA

This isn't verifiable info. You've crossed out everything that proves anything. But I'll take your word for it, since I'd actually avoid giving your real name and info, too. If it gets attached to your views as expressed here, to put it mildly, you're going to be in trouble finding employment once you graduate. I'm holding out hope you'll learn that your perspectives on this are pretty messed up and assume a lot of knowledge you don't have.

I was mostly calling you a liar because you assumed I hadn't went to medical school. I'm not going to say whether I have or haven't, either. Because I'm not prepared to verify it either way.

wah_wah_wah posted...

This isn't verifiable info. You've crossed out everything that proves anything. But I'll take your word for it, since I'd actually avoid giving your real name and info, too. If it gets attached to your views as expressed here, to put it mildly, you're going to be in trouble finding employment once you graduate. I'm holding out hope you'll learn that your perspectives on this are pretty messed up and assume a lot of knowledge you don't have.

I was mostly calling you a liar because you assumed I hadn't went to medical school. I'm not going to say whether I have or haven't, either. Because I'm not prepared to verify it either way.

I still don't believe what you think I believe and you'll find my "beliefs" are pretty common in my profession. Calling futile care what it is or otherwise admitting a subset of patients disproportionately costing everyone more due to lifestyle choices is not me "wanting to kill them all."

Even limiting how much insurance covers inefficient care isn't even a radical opinion in my profession. It's what everyone is trying to solve right now. I'm really sorry you feel this way. Like I said, I'm not the villian you're painting me to be and you think I'm waaaay more extreme than I am. I am not at all advocating denial of care like you are proposing.
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This parody song kind of touches on it:

https://www.youtube.com/watch?v=aS3xaXsh6vo" data-time="

2.5 million views must mean it strikes a chord with clinicians.

It's simply too expensive to keep retreating admissions of acute exacerbations. The solution is addressing it before it gets to this point, but my entire point is compliance is hard. (Doesn't mean don't try. Doesn't mean kill them. Jesus...how naive).

It's specifically because of people like wah_wah who refuse to admit some patients just don't want to. We can always improve that number by improving our methods, more outreach, better chronic long term care. But that's already happening.

But what to do about the bill in the mean time. Status quo means rising premiums and ever increasing cost of our health care. What's the solution wah wah?
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BlameAnesthesia posted...

wah_wah_wah posted...

I'm not required to offer a solution in order to illustrate why a solution that kills people is wrong.

"If healthcare eventually becomes unaffordable to all, leading to more total deaths, at least I know my hands are clean of a moral straw man."

This is your problem. You totally lack self-awareness and yet you think you might not be part of the problem. This is itself a straw man, in quotes that I never said. Continuing your general pattern of dishonesty.

BlameAnesthesia posted...

I still don't believe what you think I believe and you'll find my "beliefs" are pretty common in my profession. Calling futile care what it is or otherwise admitting a subset of patients disproportionately costing everyone more due to lifestyle choices is not me "wanting to kill them all."

The problem is the cost of letting them die is not valued at all, so you assume (naively) that the cost is nothing. That's where you get fringey and quacky.

Also your badge says student. It is presumptuous for you to say it is "your" profession (also more dishonesty).

P4wn4g3 posted...

Under the classic model insurance companies had yes you'd lose coverage.

Well, I'm fucked. I'll die of heart failure at a young age. At least I won't have to deal with being old. Gonna miss playing video games, though.

BlameAnesthesia posted...

SableWolfAngel posted...

Besides, am I not allowed to be concerned about the base issue this topic is about? I really am afraid of losing my insurance because of my heart condition.

Of course you're allowed to be concerned. I guess let me clarify--I don't think you're the "burden" some of the bleeding hearts think I'm "against." The base issue you're talking about is certainly the Republican platform's proposal, which is not something I'm for.

Their current proposal would most certainly screw you. It "might" solve the issue coffeebeanz initially brought up, but I'm interested in a solution that doesn't affect someone like you.

If the system is so bad, why do we continue to use it? The working poor toil without help while the rich do nothing with all the help? It sounds like the plot of a post apocalyptic movie...
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wah_wah_wah posted...

The problem is the cost of letting them die is not valued at all, so you assume (naively) that the cost is nothing.

This is wrong, nobody likes it when someone let's themselves die but nobody can do anything about it either since it's neglect of self care.
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P4wn4g3 posted...

wah_wah_wah posted...

The problem is the cost of letting them die is not valued at all, so you assume (naively) that the cost is nothing.

This is wrong, nobody likes it when someone let's themselves die but nobody can do anything about it either since it's neglect of self care.

But you denied them care that allowed them to die. It's also your responsibility that they died.

wah_wah_wah posted...

Also your badge says student. It is presumptuous for you to say it is "your" profession (also more dishonesty).

Being in my clinical years I've already had exposure "to the system" in so far as I've worked on teams which have had exactly the types of patients coffeebeanz has mentioned. I don't expect you to know the nuances of how a doctor's training and education is, but I've already started the process and surpassed the major barriers. It very much is "my" profession by now, albeit you're right in that a very small subset don't match into residency.

wah_wah_wah posted...

This is your problem. You totally lack self-awareness and yet you think you might not be part of the problem. This is itself a straw man, in quotes that I never said. Continuing your general pattern of dishonesty.

You still don't have any tangible examples or solutions other than assuming I'm advocating killing patients. Meanwhile I'm simply stating the effect of the current system we have now.

My ultimate desire is a healthcare system that's affordable to as many people as possible. Yes, that can be single payer if done right. No, that's not what will happen if we stay the course or just take the current republican's platform of removing pre-existing conditions (as this will just screw over more than just the patients we are talking about and simply put more in the pockets of the middle men in medicine like insurance).

Somehow you've warped this to mean I want to kill everyone.
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iPhone_7 posted...

Poor insurance companies struggling to make ends meet. If theyre forced to cover people with pre-existing conditions then of course they have to charge everyone else more.

you're probably being snarky, but this is actually correct.

on one hand, the whole point of insurance is to pay for medical bills but this is based on the persons health upon signing up. as such if someone with say cancer that is going to need several 100s of thousands of dollars of treatment, insurance can't just charge the same prices as if you were a healthy 20 year old or they would go out of business.....so on that hand it might seem unfair and cruel.

but then on the other hand, if you don't charge those people ridiculous prices, you are forced to charge the healthy people who can work and afford insurance, ridiculous rates and they are likely to say fuck you in return.

medicine isn't free, and this crazy song and dance of how do we make it free needs to end. it needs to be about how we can make it the most cost effective, not free, just cost effective.

also and people don't like talking about this, if you are for instance a fatass, and or a heavy drinker or smoker, you develop major health problems, you should be expected to and forced to pay for that, don't just pass the bill off to others.

and while we're at it, let's have a conversation about the ER, you know people who abuse ER since they have to treat you regardless of whether you can pay or not, that is a big burden to the entire system that is getting offset and passed on to the people who actually pay their bills resulting in higher bills or really people who stiff doctor bills in general who are probably people who don't pay their bills in general as well.

bottom line is this is all going to lead to a very uncomfortable situation for everyone and neither the liberals nor the conservatives are having honest conversations about this. conservatives act like private insurance is the magic answer to the problem and liberals act like government subsidies are the magic answer when in reality both answers have been failing for many many years now.