Health Care Debate: Cutting Unnessicary Procedures - DFWstangs Forums
Reply
 
LinkBack Thread Tools Display Modes
post #1 of 92 (permalink) Old 03-09-2010, 08:05 AM Thread Starter
WE ARE THE CHAMPIONS!
 
Sgt Beavis's Avatar
 
Join Date: Jul 2002
Location: Lake Dallas, TX
Posts: 10,859
Health Care Debate: Cutting Unnessicary Procedures

An interesting read. I'm all for health care reform that actually cuts costs in a reasonable manner. Of course the "reasonable" part is the real debate..

http://www.newsweek.com/id/234514

Quote:
This Won’t Hurt a Bit

How we can save billions by cutting out unnecessary procedures that kill tens of thousands a year.

When the White House and Congress were struggling last year to keep the cost of health-care reform from exploding, they got most of the industry to ante up. Pharma agreed to give up $80 billion in revenue over the next decade, hospitals kicked in $155 billion in foregone Medicare and Medicaid payments, and medical-device makers grudgingly agreed to a $20 billion tax. But one big player refused to put any money on the table: doctors. The American Medical Association pledged to support health-care reform only if its members' incomes didn't take a hit.

That doctors demanded protection for their wallets strikes Howard Brody, a family physician at the University of Texas Medical Branch, as "ethically questionable," and not only because he thinks doctors have a moral obligation to help get the nation's health-care bill under control. The bigger problem is that "doctors rip off the system with inappropriate care," says Brody. An estimated one fifth to one third of U.S. health-care costs, at least $500 billion a year, goes toward tests and treatments that do not benefit patients—routine CT scans in the ER, antibiotics for colds, Pap tests for women who do not have a cervix, and …

What comes after the ellipsis is the question of the hour. Brody recently proposed, in The New England Journal of Medicine, that every medical specialty identify five procedures—diagnostic or therapeutic—that are done a lot and cost a lot but provide no benefits to some or all of the patients who receive them. Five is just a suggestion, high enough to be meaningful but low enough to exclude procedures in which the science is still open to debate, such as annual mammograms for women under 50. "I'm pretty convinced that each specialty could come up with 15 or 20, but in calling for five I think we can find uncontroversial ones," says Brody. It's not just about saving money, either. Any time a doctor performs a procedure, there is the risk of medical error and side effects, such as an elevated risk of cancer from CT scans. Unnecessary care kills 30,000 Americans every year, estimates Dr. Elliott Fisher of Dartmouth Medical School—and that figure includes only Medicare patients.

Medical groups have not exactly beaten a path to Brody's door, so NEWSWEEK contacted several to see if they would play along. Reactions ranged from "we do no unnecessary care" (dermatology) to "only five?!" (emergency medicine). Allen Lichter, CEO of the American Society of Clinical Oncology, nominates what he calls "nth-line therapy"—the third or fourth or fifth chemotherapy drug for a patient whose cancer has not been felled by the first or second. "I don't know what n should be," he says. "But at some point chemotherapy has an extremely low chance of extending life and a high chance of shortening life due to toxicity."

Experts in internal medicine are already well along in identifying items for Brody's list. "I hate to say it, but it's true: doctors sometimes do things that do not benefit patients and can even be harmful," says Stephen Smith of Brown University medical school, who is spearheading the effort. Nominations, all from physicians, include antibiotics for upper-respiratory infections (the drugs kill bacteria, not the viruses that cause colds), Pap tests for women under 21 ("solid research shows that they find things that lead to unnecessary interventions but would clear up on their own," says Smith), and me-too drugs that are no more effective than older versions (anything other than diuretics for first-line treatment of high blood pressure).

High-tech tests are also in Smith's crosshairs. For coronary calcium scans, he says, "there is no evidence they lead to better outcomes. In low-risk patients, high coronary-artery calcification still means the patient is at low risk for heart disease and nothing needs to be done other than the usual 'heart healthy' behaviors. In a high-risk patient, aggressive efforts at reducing risk factors need to be undertaken regardless of the coronary-artery calcification." Similarly, thyroid testing in a patient with no symptoms "rarely yields an abnormal result," Smith says, and so "is not worth doing" on a symptom-free patient. Smith's team will "field test" these and other nominees this spring by asking hundreds of doctors if they agree. Eventually, docs who pledge to avoid unhelpful procedures might display some sort of emblem.

Smith's group is also considering nixing X-rays and MRIs for lower-back pain: the scans often spot something that is unrelated to the pain. About 80 percent of adults over 40 have a bulge or other deformation in their lower back that makes surgeons think "operate"—but no pain. So when such an "abnormality" shows up on a CT or MRI, attributing a patient's pain to it is probably nonsense. In fact, the vast majority of lower-back pain is caused by muscle sprains and strains that don't show up on scans, and for which surgery is no more effective (and is more dangerous) than over-the-counter pain meds, time, rest, and exercise. Although lower-back pain typically resolves within six weeks, many patients refuse to wait, and surgeons and radiologists have financial incentives to see that they don't. A 2009 study found that Americans spent $85.9 billion for imaging, surgery, drugs, and doctors' visits for lower-back pain—most of it for no benefit. "The use of MRI within six weeks of the start of lower-back pain is not only not useful, but it increases the number of surgeries, treatments, and costs," says anesthesiologist Ray Baker, president of the North American Spine Society, whose members do those very things.

Baker, who "applauds" Brody's call to arms, believes there are enough data to "draw a circle around" other procedures that are his members' bread and butter. For instance, at least 351,000 spinal fusions were performed in 2007, reports the Agency for Healthcare Research and Quality, at a cost of $26.2 billion. Yet except in the tiny fraction of cases in which the pain is caused by fracture or tumor, they're useless—but financially irresistible, points out Shannon Brownlee in her 2007 book Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer. At $75,000 per spinal-fusion procedure, medical-device makers, hospitals, and surgeons have every reason to keep the gravy train rolling. "We doctors are extremely good at rationalizing," says Brody. "Somehow we manage to figure out how the very best care just happens to be the care that brings us the most money."

Doctors who want to eliminate unhelpful procedures have their scalpels aimed at several other surgeries. Brody nominates arthroscopic surgery for osteoarthritis of the knee. A 2004 study showed that it is no more effective at restoring mobility and reducing pain than sham surgery. In other words, all the benefits reflect a placebo response on the part of patients, who think, "Docs in surgical scrubs, high-tech surgery, gleaming OR—this will certainly help me." But orthopedic surgeons still do the surgeries, which cost about $6,000.

They are not the only physicians who ignore the findings of clinical trials. Two studies last year in the NEJM showed that vertebroplasty, in which cement is inserted through a needle into the spine to stabilize vertebrae, is no more effective at reducing pain and disability than fake surgery (anesthesia, small incision for the needle, no cement). That suggests it is the hope and expectations of patients, not the procedure, that help. Yet about 170,000 vertebroplasties are done every year, at a typical cost of $5,000. Surgeons protest that their vertebroplasty patients hug them in relief that their pain has vanished. But "we saw 'miracle cures' in the sham-surgery group, too," says David Kallmes of the Mayo Clinic, who led one of the studies.

Every year cardiac surgeons perform bypasses on thousands of patients who have one or two blocked arteries, and cardiologists do angioplasty (with and without stenting) on thousands more. But five large clinical trials have shown that, except in an emergency, inserting a stent (to prop open a clogged artery) does not reduce the risk of heart attack or death any better than treating with drugs first (and stenting only if the pain persists). Interventional cardiology nevertheless carries on to the tune of about 500,000 elective angioplasties a year, at $51,000 each, including in patients who should get drugs instead. Hospitals can get $20,000 from private insurers for angioplasty, Brownlee found, almost half of which is pure profit. "Advocates say, 'We do it differently' or 'The clinical trials focused only on particular populations of patients, and we do these surgeries only where appropriate,'?" says Nortin Hadler, professor of medicine at the University of North Carolina and author of the 2009 book Stabbed in the Back: Confronting Back Pain in an Overtreated Society. "These arguments walk a fine line between hubris and quackery."

No one is saying cutting back on unnecessary medicine will be easy. There is a reason for every procedure doctors perform. The fact that the reasons are sometimes financial or legal (protecting against malpractice claims) makes them no less powerful. Few doctors have the training in statistics and trial design to understand what the science says about various therapies. And many honestly believe their patients are different from those in a study that found no benefit from some procedure. But if they're right about that, points out Baker of the spine society, it means there are no data that the procedure benefits those patients.

Consumers, too, are a powerful force for unnecessary medical care. Parents insist the ER do a CT scan on a child who bumped her head; runny-nose patients won't leave their internist without a prescription for antibiotics. "In a busy practice, it's sometimes easier to write the prescription than to talk the mom out of it," says pediatrician Beth Pletcher of the University of Medicine and Dentistry of New Jersey. And the heart patient who doesn't believe that pills could possibly be as effective as surgery? "Angioplasties, stents, and bypass have attained 'entitlement' status," notes Hadler.

Why do insurers pay for unnecessary care? Partly because they're battle-weary, having been successfully sued for refusing to cover, for instance, high-dose chemo plus bone-marrow transplants for breast cancer—which turned out to be not just useless but, for thousands of patients, deadly. "The abrasion that would result from even more intervention by health-care plans becomes problematic," says Joe Singer, vice president for medical affairs at HealthCore, a subsidiary of the insurance giant WellPoint. Translation: insurers have had it with trying to refuse coverage for useless procedures, since they can simply raise premiums—yours and mine—to cover the cost.

Perhaps, since so much useless care reflects financial incentives, financial disincentives might reduce it. In a paper last month in PLoS Medicine, R. Scott Braithwaite of the New York University School of Medicine and colleagues suggested that insurance cover 100 percent of effective diagnostic tests and treatments, but little to nothing for less effective ones. You really think you need an MRI for the back pain that started last week? It's on your nickel.



We're Adopting. Contact us through our website.

http://www.theboyetts.com

You can also LIKE us on Facebook
Sgt Beavis is offline  
Sponsored Links
Advertisement
 
post #2 of 92 (permalink) Old 03-09-2010, 08:07 AM
Out
 
Join Date: Apr 2000
Posts: 41,952
unnecessary


Sorry. Dave just got me on a typo, so I had to make myself feel better.
Denny is offline  
post #3 of 92 (permalink) Old 03-09-2010, 08:19 AM Thread Starter
WE ARE THE CHAMPIONS!
 
Sgt Beavis's Avatar
 
Join Date: Jul 2002
Location: Lake Dallas, TX
Posts: 10,859
Quote:
Originally Posted by Denny View Post
unnecessary


Sorry. Dave just got me on a typo, so I had to make myself feel better.
I was edjumacated in Louisiana, what was your excuse

We're Adopting. Contact us through our website.

http://www.theboyetts.com

You can also LIKE us on Facebook
Sgt Beavis is offline  
 
post #4 of 92 (permalink) Old 03-09-2010, 08:24 AM
Out
 
Join Date: Apr 2000
Posts: 41,952
Since I just put one S instead of two, I'll blame mine on this crappy laptop keyboard, but I just took the correction like a man.
Denny is offline  
post #5 of 92 (permalink) Old 03-09-2010, 08:30 AM
Lifer
 
davbrucas's Avatar
 
Join Date: Jan 2001
Location: Houston
Posts: 8,841
Nice Denny...you beat me to it!

As far as the article, I agree with some of it, but a test is only unnecessary after it comes back negative. In the ER I get a small glimpse at a patient and their complaints and have to make decisions based on that glimpse. So if a patient tells me that they hit their head and had LOC and nausea but no neurological findings I am going to CT their head. Do I think that they have something bad going on it their head? Nope...but I am not willing to gamble a large malpractice suit to forego the scan. Mandating that we refrain from ordering these studies and not protecting us from litigation is absurd.
davbrucas is offline  
post #6 of 92 (permalink) Old 03-09-2010, 08:31 AM
Lifer
 
davbrucas's Avatar
 
Join Date: Jan 2001
Location: Houston
Posts: 8,841
Quote:
Originally Posted by Sgt Beavis View Post
I was edjumacated in Louisiana, what was your excuse
So was I...try again. But I did attend Texas schools K-12.
davbrucas is offline  
post #7 of 92 (permalink) Old 03-09-2010, 08:32 AM
Lifer
 
davbrucas's Avatar
 
Join Date: Jan 2001
Location: Houston
Posts: 8,841
Quote:
Originally Posted by Denny View Post
Since I just put one S instead of two, I'll blame mine on this crappy laptop keyboard, but I just took the correction like a man.
I fully expect the favor to be returned soon enough!
davbrucas is offline  
post #8 of 92 (permalink) Old 03-09-2010, 08:33 AM
Out
 
Join Date: Apr 2000
Posts: 41,952
Quote:
Originally Posted by davbrucas View Post
Nice Denny...you beat me to it!

As far as the article, I agree with some of it, but a test is only unnecessary after it comes back negative. In the ER I get a small glimpse at a patient and their complaints and have to make decisions based on that glimpse. So if a patient tells me that they hit their head and had LOC and nausea but no neurological findings I am going to CT their head. Do I think that they have something bad going on it their head? Nope...but I am not willing to gamble a large malpractice suit to forego the scan. Mandating that we refrain from ordering these studies and not protecting us from litigation is absurd.
THey're trying to take away your discretion, Doc.
Denny is offline  
post #9 of 92 (permalink) Old 03-09-2010, 08:36 AM
Lifer
 
davbrucas's Avatar
 
Join Date: Jan 2001
Location: Houston
Posts: 8,841
Quote:
Originally Posted by Denny View Post
THey're trying to take away your discretion, Doc.
Yup...pretty soon, we will be obsolete. The politicians and insurance companies will decide your diagnosis and fate.
davbrucas is offline  
post #10 of 92 (permalink) Old 03-09-2010, 08:50 AM
Lifer
 
slow06's Avatar
 
Join Date: Jul 2006
Location: Arlington
Posts: 2,075
Quote:
Originally Posted by davbrucas View Post
Nice Denny...you beat me to it!

As far as the article, I agree with some of it, but a test is only unnecessary after it comes back negative. In the ER I get a small glimpse at a patient and their complaints and have to make decisions based on that glimpse. So if a patient tells me that they hit their head and had LOC and nausea but no neurological findings I am going to CT their head. Do I think that they have something bad going on it their head? Nope...but I am not willing to gamble a large malpractice suit to forego the scan. Mandating that we refrain from ordering these studies and not protecting us from litigation is absurd.
That is the problem right there, or at the least a very large chunk of it. BS lawsuits have doctors having to cover their asses instead of just taking care of people.

"A government big enough to give you everything you want, is strong enough to take everything you have."
-Gerald Ford/Thomas Jefferson

"A Republic, if you can keep it"
- Benjamin Franklin

The way to peaceably remove elected officials who deviate from the constitution of the United States of America...
www.blowoutcongress.com
slow06 is offline  
post #11 of 92 (permalink) Old 03-09-2010, 08:59 AM Thread Starter
WE ARE THE CHAMPIONS!
 
Sgt Beavis's Avatar
 
Join Date: Jul 2002
Location: Lake Dallas, TX
Posts: 10,859
Quote:
Originally Posted by slow06 View Post
That is the problem right there, or at the least a very large chunk of it. BS lawsuits have doctors having to cover their asses instead of just taking care of people.
I agree with you for the mot part, but there is one thing that bugs me here. We had a substantial tort reform bill in Texas to cut back on that kind of thing but Doctors haven't seen any real cut in their malpractice insurance premiums.

We're Adopting. Contact us through our website.

http://www.theboyetts.com

You can also LIKE us on Facebook
Sgt Beavis is offline  
post #12 of 92 (permalink) Old 03-15-2010, 12:57 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by Sgt Beavis View Post
An interesting read. I'm all for health care reform that actually cuts costs in a reasonable manner. Of course the "reasonable" part is the real debate..

http://www.newsweek.com/id/234514
There are multiple countries with great "universal" health care that pay less than half what Americans do for costs. The extra taxes you'd have to pay would in most cases be less than what you pay for your current health insurer/employer for your benefits.

Just sayin.

Taylor is offline  
post #13 of 92 (permalink) Old 03-15-2010, 01:13 PM
Wolverines!!!
 
SlowLX's Avatar
 
Join Date: May 2002
Location: 1st Civ Div
Posts: 9,261
Quote:
Originally Posted by Taylor View Post
There are multiple countries with great "universal" health care that pay less than half what Americans do for costs. The extra taxes you'd have to pay would in most cases be less than what you pay for your current health insurer/employer for your benefits.

Just sayin.
They also have a smaller population than some of our states. They're infrastructure required for universal healthcare is tiny.
SlowLX is offline  
post #14 of 92 (permalink) Old 03-15-2010, 01:27 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by SlowLX View Post
They also have a smaller population than some of our states. They're infrastructure required for universal healthcare is tiny.
Japan only spends 8% of its GDP on health care.

Edit: And they have 130 million citizens.

Edit #2: The least they could do is what the Taiwanese did - look at every health care system in the world, pick and choose the best options, and use it to design their own plan. It couldn't possible cost us anymore than we're getting raped for right now.

Taylor is offline  
post #15 of 92 (permalink) Old 03-15-2010, 01:37 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
There are multiple countries with great "universal" health care that pay less than half what Americans do for costs. The extra taxes you'd have to pay would in most cases be less than what you pay for your current health insurer/employer for your benefits.

Just sayin.
No it wouldn't.

One of those countries is New Zealand, the top tax bracket there is 50% last time I checked, same for England. Each of their income tax brackets is roughly 5% higher than ours at a given income level.

You really should do some research and basic analysis before you make stupid claims.

EDIT: Oops I am sorry, I was wrong New Zealand only wants 38% of every dollar you make over $70K. It was England only that had the 50% top bracket.
AL P is offline  
post #16 of 92 (permalink) Old 03-15-2010, 01:45 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Uhh you're using their entire tax bracket as an example? lol?

Do some research on what % of that tax bracket goes to health care. It's probably cheaper than what we pay or our employers pay. Tack that onto what we pay now and it's definitely not 50% or even 38%.

Edit: A 5% increase in taxes for most Americans would still net them in the 20s.

Taylor is offline  
post #17 of 92 (permalink) Old 03-15-2010, 01:52 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
Uhh you're using their entire tax bracket as an example? lol?

Do some research on what % of that tax bracket goes to health care. It's probably cheaper than what we pay or our employers pay. Tack that onto what we pay now and it's definitely not 50% or even 38%.

Edit: A 5% increase in taxes for most Americans would still net them in the 20s.
You said the increase in taxes would be "worth it".

England wants 40% of every dollar you make over $54,000. I would pay another $25K a year in taxes in England. My health insurance that my employer pays for through Blue Cross and Blue Shield is ~$600 a month. Even if you attribute 1/3 of the tax increase in England to medical care, your statement is pure horseshit.

It isn't my fault that you spout dumb shit off without doing any numbers.
AL P is offline  
post #18 of 92 (permalink) Old 03-15-2010, 01:56 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Well you're not paying 40% here are you, you dumb twat?

Taylor is offline  
post #19 of 92 (permalink) Old 03-15-2010, 02:00 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
Well you're not paying 40% here are you, you dumb twat?
I never said the 40% applies to every dollar I make, did I moron?
AL P is offline  
post #20 of 92 (permalink) Old 03-15-2010, 02:04 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by AL P View Post
I never said the 40% applies to every dollar I make, did I moron?
Neither did I, moron. But you're comparing apples to oranges. You're taking the most extreme example you can find and using it as a basis for your argument. Maybe I should pick a country where less than 5% of its population has health insurance and use it as my basis of argument for universal health care.

Taylor is offline  
post #21 of 92 (permalink) Old 03-15-2010, 02:06 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
Neither did I. But you're comparing apples to oranges.
Oh I am? Go ahead and tell me why that is.
AL P is offline  
post #22 of 92 (permalink) Old 03-15-2010, 02:17 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
I already edited my post explaining why.

Take a look at the Swiss system. They're required to buy health care by law but the government controls pricing through private providers. They pay more than other countries (but still considerably less than the USA) but their quality of care is on par with the USA. Seems like a pretty good system for the US to adopt. Oh, and they don't pay 40% of their income in taxes.

Taylor is offline  
post #23 of 92 (permalink) Old 03-15-2010, 02:18 PM
Resident Curmudgeon
 
mardyn's Avatar
 
Join Date: Mar 2004
Location: Beautiful East Texas
Posts: 3,232
The last people I want dictating my health care are those idiots in Washington.

Give the Doctors and Hospitals some real protection from the frivolous and B/S lawsuits and costs will eventually come down.

mardyn

R.I.P. James E. Berry 01/03/57-- 01/14/05

mardyn is offline  
post #24 of 92 (permalink) Old 03-15-2010, 02:24 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
Neither did I, moron. But you're comparing apples to oranges. You're taking the most extreme example you can find and using it as a basis for your argument. Maybe I should pick a country where less than 5% of its population has health insurance and use it as my basis of argument for universal health care.
The most extreme example I can find? Neither of those countries I mentioned are even close to having the highest personal tax rates.
AL P is offline  
post #25 of 92 (permalink) Old 03-15-2010, 02:30 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
I already edited my post explaining why.

Take a look at the Swiss system. They're required to buy health care by law but the government controls pricing through private providers. They pay more than other countries (but still considerably less than the USA) but their quality of care is on par with the USA. Seems like a pretty good system for the US to adopt. Oh, and they don't pay 40% of their income in taxes.
They pay higher personal tax rates than we do.

If you believe this then why are you on here talking about a tax increase being "worth it"? Sounds like you are just pulling things out of your ass to me.
AL P is offline  
post #26 of 92 (permalink) Old 03-15-2010, 03:04 PM
makin' bacon
 
Stevo's Avatar
 
Join Date: Dec 2004
Location: Longview,TX
Posts: 5,752
Quote:
Originally Posted by Taylor View Post
There are multiple countries with great "universal" health care that pay less than half what Americans do for costs. The extra taxes you'd have to pay would in most cases be less than what you pay for your current health insurer/employer for your benefits.

Just sayin.
How many of those countries are laden with a large percentage of the health care services being given as welfare to people that pay very little to no taxes?

Stevo

Animal whisperings

Intoxicate the night

Hypnotize the desperate

Slow motion light

Wash away into the rain

Blood, milk and sky


Stevo is offline  
post #27 of 92 (permalink) Old 03-15-2010, 11:03 PM
The Janitor
 
32VfromHell's Avatar
 
Join Date: Jan 2001
Location: Sacred Heart Hospital
Posts: 16,424
Quote:
Originally Posted by Taylor View Post
Japan only spends 8% of its GDP on health care.

Edit: And they have 130 million citizens.

Edit #2: The least they could do is what the Taiwanese did - look at every health care system in the world, pick and choose the best options, and use it to design their own plan. It couldn't possible cost us anymore than we're getting raped for right now.
Japan has one of the most rapidly aging populations in the world. They are going to have more retirees per working age citizens and the burden on them is only going to get worse and worse. Japan's incredibly strict immigration policy and low birth rate is going to strangle them.
32VfromHell is offline  
post #28 of 92 (permalink) Old 03-16-2010, 08:39 AM
PAN
 
Join Date: Mar 2002
Location: Under a rock
Posts: 20,154
Post 28 and no comments on what the article seemed to discuss, which is medical procedures that are being performed with regularity that provide little to none in terms of benefit to the patient, but do provide benefit to the doctor performing.

Interesting that a dumb shit like taylor has managed to completely sidetrack the discussion...
Fox466 is offline  
post #29 of 92 (permalink) Old 03-16-2010, 12:12 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by mardyn View Post
The last people I want dictating my health care are those idiots in Washington.

Give the Doctors and Hospitals some real protection from the frivolous and B/S lawsuits and costs will eventually come down.

mardyn
A couple of the best health insurance policies you can get in the US are through the military and federal employment. The bill being pushed is pretty much a carbon copy of the federal employment policy and it's fantastic.

Quote:
Originally Posted by Fox466 View Post
Post 28 and no comments on what the article seemed to discuss, which is medical procedures that are being performed with regularity that provide little to none in terms of benefit to the patient, but do provide benefit to the doctor performing.

Interesting that a dumb shit like taylor has managed to completely sidetrack the discussion...
And even more interesting that you dumbshits would rather argue with me than debate the topic at hand.

Taylor is offline  
post #30 of 92 (permalink) Old 03-16-2010, 12:15 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by Stevo View Post
How many of those countries are laden with a large percentage of the health care services being given as welfare to people that pay very little to no taxes?

Stevo
How many of those countries have as many super wealthy citizens (or have a tax system where the top 3% pay 66% of the taxes) like the US does?

Taylor is offline  
post #31 of 92 (permalink) Old 03-16-2010, 12:28 PM
makin' bacon
 
Stevo's Avatar
 
Join Date: Dec 2004
Location: Longview,TX
Posts: 5,752
Quote:
Originally Posted by Taylor View Post
How many of those countries have as many super wealthy citizens (or have a tax system where the top 3% pay 66% of the taxes) like the US does?
So, I guess your response means you refuse to answer the question given to you? Typical.

Stevo

Animal whisperings

Intoxicate the night

Hypnotize the desperate

Slow motion light

Wash away into the rain

Blood, milk and sky


Stevo is offline  
post #32 of 92 (permalink) Old 03-16-2010, 12:35 PM
DFWMUSTANGS.NET
 
Join Date: Jun 2007
Posts: 3,635
Quote:
Originally Posted by Stevo View Post
So, I guess your response means you refuse to answer the question given to you? Typical.

Stevo

We already know his motives. He wants govt. subsidized health insurance for himself, because he doesn't have the good sense to cut his school hours back and get a job so he can afford to PAY for it like someone who knows the meaning of personal responsibility.

I've just added him to my ignore list because whatever he says is just an attempt to convince the producers in this country to pay for his idiocy, and I want to hear no more of it.
sc281_99-0135 is offline  
post #33 of 92 (permalink) Old 03-16-2010, 12:52 PM
tex
Lifer
 
Join Date: Apr 2001
Location: ATL
Posts: 12,790
Quote:
Originally Posted by Taylor View Post
How many of those countries have as many super wealthy citizens (or have a tax system where the top 3% pay 66% of the taxes) like the US does?
How on earth are you trying to construe this into support for your argument?

“…what a disgrace it would be for a man to grow old without ever seeing the beauty and strength of which his body is capable.” - Socrates
tex is offline  
post #34 of 92 (permalink) Old 03-16-2010, 02:47 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by Taylor View Post
How many of those countries have as many super wealthy citizens (or have a tax system where the top 3% pay 66% of the taxes) like the US does?
uhhh...all of them?

I do love the fact that you don't bother to research or analyze anything you read but come here to repeat it.

"I find that the harder I work, the more luck I seem to have." - Thomas Jefferson (1743-1826)

"There are four boxes to be used in defense of liberty: soap, ballot, jury, and ammo. Please use in that order." - Ed Howdershelt
AL P is offline  
post #35 of 92 (permalink) Old 03-16-2010, 03:34 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by sc281_99-0135 View Post
We already know his motives. He wants govt. subsidized health insurance for himself, because he doesn't have the good sense to cut his school hours back and get a job so he can afford to PAY for it like someone who knows the meaning of personal responsibility.

I've just added him to my ignore list because whatever he says is just an attempt to convince the producers in this country to pay for his idiocy, and I want to hear no more of it.
Sorry bud but it doesn't work like that. Who the hell gets a job first then goes to college? That's pretty ass backwards.

Unless you're going to those shitty community colleges like you and your brother. That's not "real" college.

Edit: And you're right. I do want affordable health care. Everyone does. The only reason you tards oppose it because its da gubment doing it and it's not the status quo.

Taylor is offline  
post #36 of 92 (permalink) Old 03-16-2010, 03:36 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by tex View Post
How on earth are you trying to construe this into support for your argument?
They're already picking up the bill for the poor.

Taylor is offline  
post #37 of 92 (permalink) Old 03-16-2010, 04:15 PM
tex
Lifer
 
Join Date: Apr 2001
Location: ATL
Posts: 12,790
Quote:
Originally Posted by Taylor View Post
They're already picking up the bill for the poor.
So how the fuck can you justify a bill that RAISES taxes higher?!

“…what a disgrace it would be for a man to grow old without ever seeing the beauty and strength of which his body is capable.” - Socrates
tex is offline  
post #38 of 92 (permalink) Old 03-16-2010, 04:22 PM
Resident Epicurean
 
Join Date: Mar 2003
Location: Irving
Posts: 23,270
Quote:
Originally Posted by Taylor View Post
Sorry bud but it doesn't work like that. Who the hell gets a job first then goes to college?
Millions of kids who aren't living off of mommy's tit.

QUOTE=Taylor;6132903] That's pretty ass backwards.[/QUOTE]

Not really.

Quote:
Originally Posted by Taylor View Post
Unless you're going to those shitty community colleges like you and your brother. That's not "real" college.

So what prestigious University are you attending, smart guy?

Quote:
Originally Posted by Taylor View Post
Edit: And you're right. I do want affordable health care. Everyone does.
I don't have a problem with my healthcare. It's affordable, and great coverage. Sorry you leaches of society can't get a good enough job to have good benefits. If I did it, anyone can do it. Oh, wait, that's where personal responsibility comes in. Something 90% of people your/my age don't know anything about....


Quote:
Originally Posted by Taylor View Post
The only reason you tards oppose it because its da gubment doing it and it's not the status quo.

Have you read ANY of the healthcare bill? It might help you to know the argument you are up against, because that isn't it. Sure, a lot of people are gunshy about it because the govt would run it. Rightfully so. Have you ever been to the post office? Just look at the awesome job the govt has done with social security. Oh, and Homeland Security. And the IRS, and do I really need to keep going?!?!?!? Do you want some panel board that's never met you and doesn't know dick about you deciding your fate when it comes to medical care? I know I don't. There isn't a fucking thing wrong with the coverage I have, the amount I pay, and the care I receive. NOTHING. NOT A DAMN THING.
bcoop is offline  
post #39 of 92 (permalink) Old 03-16-2010, 04:26 PM
AHMO!
 
Join Date: Apr 2004
Location: the original let me google that for ya guy
Posts: 16,810
Quote:
Originally Posted by Taylor View Post
Sorry bud but it doesn't work like that. Who the hell gets a job first then goes to college? That's pretty ass backwards.
I did...and maintained the job while in college. It was pretty not ass backwards as I didn't come out with a ton of student loans and I didn't have my schooling paid for either by mommy/daddy.
Nate is offline  
post #40 of 92 (permalink) Old 03-16-2010, 04:28 PM
Resident Epicurean
 
Join Date: Mar 2003
Location: Irving
Posts: 23,270
Quote:
Originally Posted by Taylor View Post
They're already picking up the bill for the poor.
Oh, I get it. Fuck it, right? I mean, it's not your money, so who gives a shit, right?
bcoop is offline  
post #41 of 92 (permalink) Old 03-16-2010, 05:29 PM
Lifer
 
davbrucas's Avatar
 
Join Date: Jan 2001
Location: Houston
Posts: 8,841
Quote:
Originally Posted by Taylor View Post
A couple of the best health insurance policies you can get in the US are through the military and federal employment.
Are you insane? Have you been in the military or have you been treated at...or worked at...any VA Hospital? If you have, then you wouldnt make this ridiculous statement.
davbrucas is offline  
post #42 of 92 (permalink) Old 03-16-2010, 05:51 PM
Worship me
 
AL P's Avatar
 
Join Date: Mar 2000
Posts: 34,345
Quote:
Originally Posted by davbrucas View Post
Are you insane? Have you been in the military or have you been treated at...or worked at...any VA Hospital? If you have, then you wouldnt make this ridiculous statement.
I am glad that I am not the only one who picked up on the fact that this kid doesn't know shit.
AL P is offline  
post #43 of 92 (permalink) Old 03-16-2010, 11:37 PM
PAN
 
Join Date: Mar 2002
Location: Under a rock
Posts: 20,154
43 posts now and it's STILL about this dumbshit taylor.


Kid definitely has a gift...
Fox466 is offline  
post #44 of 92 (permalink) Old 03-17-2010, 09:07 AM
Canada is welcome here.
 
justinsn95's Avatar
 
Join Date: Mar 2005
Location: ft worth
Posts: 4,039
Quote:
Originally Posted by Taylor View Post
The least they could do is what the Taiwanese did - look at every health care system in the world, pick and choose the best options, and use it to design their own plan. It couldn't possible cost us anymore than we're getting raped for right now.
You really think our drooling retard of a government will make anything close to a decision that smart? HA!

Quote:
Originally Posted by Taylor View Post
you're comparing apples to oranges. You're taking the most extreme example you can find and using it as a basis for your argument.
Doesn't matter. We'll be just like 'em. Again, I know you haven't noticed, but our government is akin to a drooling retard. We will likely end up as the most extreme example, if this passes.


Quote:
Originally Posted by Taylor View Post
Unless you're going to those shitty community colleges like you and your brother. That's not "real" college.

Edit: And you're right. I do want affordable health care. Everyone does. The only reason you tards oppose it because its da gubment doing it and it's not the status quo.
And with that, I now know that you are a 16 year old boy. You're fucking stupid if you think you can't get a $150k-$200k (or more) job going to a community college, as long as you pick a field that's in high demand. Of which there are many. I know your little 16 year old boy ass doesn't make anything that would remotely resemble those figures lol. And, you never will.

Quote:
Originally Posted by aksthem1 View Post
i think thedark1337 is a pretty cool guy. eh plays the game and doesnt afraid of anything


Quote:
Originally Posted by Chillaxed View Post
- later on when i was about 16 i suddenly came to the realization that i had zero appeal to women and i said "i'm going to say i'm gay from now on"
justinsn95 is offline  
post #45 of 92 (permalink) Old 03-17-2010, 03:37 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by davbrucas View Post
Are you insane? Have you been in the military or have you been treated at...or worked at...any VA Hospital? If you have, then you wouldnt make this ridiculous statement.
I'm not talking about the VA. The military offers Tricare and the coverage is incredible. I paid $25 for a $10k+ surgery a couple of years ago and then $8 apiece for the 2 pain prescriptions.

Everyone knows the VA sucks.

Quote:
Originally Posted by justinsn95 View Post
You really think our drooling retard of a government will make anything close to a decision that smart? HA!

Doesn't matter. We'll be just like 'em. Again, I know you haven't noticed, but our government is akin to a drooling retard. We will likely end up as the most extreme example, if this passes.
The most extreme example has already been turned down. That's why this thing hasn't passed yet, so I do have faith they can come up with a better system.

Quote:
And with that, I now know that you are a 16 year old boy. You're fucking stupid if you think you can't get a $150k-$200k (or more) job going to a community college, as long as you pick a field that's in high demand. Of which there are many. I know your little 16 year old boy ass doesn't make anything that would remotely resemble those figures lol. And, you never will.
I never said you couldn't get a well-paying job with a community college degree. My point was he bragged all day about going to college and working full-time at the same time to pay for his college. That's not even a remote possibility at a university. And no, employers in most cases will hire a university grad over a CC grad (I've talked to several employers that said so). But that was mostly just a knock at whatever that dude's name is.

Btw, I have a better work ethic than anyone I know. So fuck your theory.

Taylor is offline  
post #46 of 92 (permalink) Old 03-17-2010, 03:46 PM
AHMO!
 
Join Date: Apr 2004
Location: the original let me google that for ya guy
Posts: 16,810
Quote:
Originally Posted by Taylor View Post
I never said you couldn't get a well-paying job with a community college degree. My point was he bragged all day about going to college and working full-time at the same time to pay for his college. That's not even a remote possibility at a university. And no, employers in most cases will hire a university grad over a CC grad (I've talked to several employers that said so). But that was mostly just a knock at whatever that dude's name is.

Btw, I have a better work ethic than anyone I know. So fuck your theory.
<----worked full time while in college, paid for my college, and graduated at a University and I am far from "brilliant" but also far from "being Taylor" as well.

And you must not know a ton of people then.
Nate is offline  
post #47 of 92 (permalink) Old 03-17-2010, 03:46 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by bcoop View Post
Millions of kids who aren't living off of mommy's tit.

QUOTE=Taylor;6132903] That's pretty ass backwards.
There isn't a fucking thing wrong with the coverage I have, the amount I pay, and the care I receive. NOTHING. NOT A DAMN THING.[/QUOTE]

Uh well, you're not the only living in the US. For everyone of you there are 5 that can't afford it.

Quote:
Originally Posted by bcoop View Post
Oh, I get it. Fuck it, right? I mean, it's not your money, so who gives a shit, right?
I don't give two shits how much it cost honestly. At this point I think health care is just as much a right as education. We're the only industrialized country in the world without it.

And yeah, it is my money. I pay taxes too (or well, I did until this semester lol). I made $20k last year and got about $25 back in my tax return.

And no, I don't suck on mommy's teet. Everything I have I paid my own money for, and what I live on now is money I saved up + student loans. I've never leached dick from the government my entire life.

Taylor is offline  
post #48 of 92 (permalink) Old 03-17-2010, 03:49 PM
Lifer
 
Join Date: Feb 2006
Posts: 1,163
Quote:
Originally Posted by Nate View Post
<----worked full time while in college, paid for my college, and graduated at a University and I am far from "brilliant" but also far from "being Taylor" as well.

And you must not know a ton of people then.
You paid for 100% of your college while in college full-time? Average cost in Texas is $17-18k if you stay on campus. I find it hard to believe you were making probably $45-50k+ at age 18 coming out of high school, living on your own, paying your own bills, and paying for school.

But I'm sure you're leaving out parts of the equation in order to prove me wrong.

Taylor is offline  
post #49 of 92 (permalink) Old 03-17-2010, 03:50 PM
Resident Epicurean
 
Join Date: Mar 2003
Location: Irving
Posts: 23,270
Quote:
Originally Posted by Taylor View Post

Uh well, you're not the only living in the US. For everyone of you there are 5 that can't afford it.


And? How is that my problem again? And why do I need to pay for it?

It's not my fault these people can't/don't want to better themselves. Guess what? I used to have shitty medical coverage. And before that, had a few jobs with no coverage. You know what I did? I got a new job, I made improvements in my life, that transferred to a new career. These people can do the same. This IS America after all.


Oh, wait, there goes that whole "taking responsibility for yourself" thing that nobody wants to face these days.
bcoop is offline  
post #50 of 92 (permalink) Old 03-17-2010, 03:56 PM
AHMO!
 
Join Date: Apr 2004
Location: the original let me google that for ya guy
Posts: 16,810
Quote:
Originally Posted by Taylor View Post
You paid for 100% of your college while in college full-time? Average cost in Texas is $17-18k if you stay on campus. I find it hard to believe you were making probably $45-50k+ at age 18 coming out of high school, living on your own, paying your own bills, and paying for school.

But I'm sure you're leaving out parts of the equation in order to prove me wrong.
Average cost NOW is 17k to 18k.

First YEAR of UTD cost me 3k in tuition, 1k in books. Apt split with 3 others was $400 a month.

Community college drove down the overall cost of my overall college as well as I did 2/3s of my basics there.

Lived at home some of college, lived on campus/off campus some college. Paid my own bills/car note/insurance/gas.

I saved money/worked hard, got a few grants and accrued SOME debt while in college. Had 2 loans (less than 6k) after I graduated.

I didn't take full course loads EVERY semester but did graduate in 5 years.

Is there anything else you would like to try to dispute? Just because you can't do it, doesn't mean others with hard work and a little sacrifice can't do it.
Nate is offline  
Sponsored Links
Advertisement
 
Reply

Bookmarks

Quick Reply
Message:
Options

Register Now



In order to be able to post messages on the DFWstangs Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.

User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.

Password:


Confirm Password:
Email Address
Please enter a valid email address for yourself.

Email Address:
OR

Log-in










Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page
Display Modes
Linear Mode Linear Mode



Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On
Trackbacks are On
Pingbacks are On
Refbacks are On

 
For the best viewing experience please update your browser to Google Chrome