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  • Leland
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    reported

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  • Jerome Scuggs
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    Originally posted by Ephemeral View Post
    I live this shit every fucking week and have extensive experience with healthcare over the last 4 years. Perhaps the view is different from the outside looking into the US medical system, but I defy you to come experience this stuff for yourself before forming theoretical opinions.


    I do not give a shit what labels are used to define the socio-economic system. As I stated, I am looking for two things, choices and to associate with the best people I can. Whatever the system label is defined, if I am allowed choices that allows me to find and use the best care I can then I am happy. Putting everything in the hands of a single governmental entity is not going to do that at all. People that work in a governmental system are just as greedy as those who work in a corporation. There is no panacea in any of the socio-economic systems, they all suck because they are all run but humans.
    Eph


    https://www.npr.org/sections/thetwo-...ons-treatments

    A key thing you're missing here is that this is exactly why the founding fathers designed a system where if humans were being shitty, we couid engage in political action to find solutions. If I didn't see this tweet about Pfizer, if I didn't follow up and confirm it with a google search, do you think this is something you'd catch on the news? You're well aware of the problems with public institutions because they're public. Meanwhile, I read stories, every single day, about abuses committed by corporations who are getting away with it and being subsidized by your tax dollars to do it. But these stories rarely tend to make headlines, because there's not a profit motive to do so

    You clearly don't think "all systems suck" because you clearly have a preference towards one and not the other. "all X sucks" is something people say when they still defend something but can't think of any reasons to defend it :P

    But honestly? My main concern here, obviously, is that I would like to see everyone have access to healthcare that's of a quality expected of the most wealthy country on earth. How do you think we could begin to craft such a system? Where do we go from here? (This isn't some rhetorical question or a question intended to prove a point. I genuinely want to look forwards here, and start a conversation about what COULD be done.)

    edit: for what it's worth, richard nixon wasn't concerned with profit motive when he launched the "war on cancer" and signed a bill which massively funded cancer research. no corporation in his lifetime thought wasting that much money would pay off. but because of this massive jumpstart, we have been seeing the fruits of this research for at least a decade now.
    Last edited by Jerome Scuggs; 01-27-2018, 08:19 PM.

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  • Crescent Seal
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  • Ephemeral
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    I guess it is easy when I go to the infusion center, which I have a choice of 4 different ones in my area and compare it to the dialysis center with no choices. Both centers have about the same amount of chairs. Both offer services which take between 3-5 hours, both deal with people who are dying. All are owned by corporations; the difference is competition. The primary deltas between the two are the number of healthcare providers to patients, the morale of the healthcare providers, the turnover rate of healthcare providers, and the training and education level of healthcare providers. It is truly night and day. In the competitive infusion centers the service is remarkable, you feel like they care, you feel like know you and your medical history. In the dialysis center, they treat you like a cattle call, ‘treat them and street them,’ is the motto. The emphasis is on production, turning the chairs, I have literally heard them tell patients, ‘just get in here, sit down, and shut up’.


    Allow me to give you one simple example; the administration of medications. The administration of meds falls under both Federal and State laws, the define the minimum standards for how it gets done and who does it. So the infusion center and the dialysis center work under the exact same rules. The dialysis center uses the very minimum standard, the infusion centers (and in fact EVERY medical clinic, hospital and care provider I have use in the last 4 years) do not. What does this mean?


    At the dialysis center they allow healthcare providers with NO formal medical training to draw and push meds like Heparin. You have this $11 an hour person coming up to you and administrating meds directly into your IV. Twice in the last year I stopped them just as they were about ready to stick the needle in the IV to give me a med that would have killed me. Nice huh? A few weeks the guy sitting a few chairs down form was not so lucky, they injected a flu shot (which is a shot which is ONLY intramuscular) directly into his bloodstream the IV, EMS carted him out on a stretcher (he survived). These mistakes are common at the dialysis center because no one verifies shit when they give you meds. A single person walks up and administers meds without saying a word to you, without checking anything.


    Now at every other facility this is how they administers meds…a licensed RN nurse arrives with med. That nurse calls another nurse over and they double check the med, the order in the system and then turns to ask the patient to give them their name and date of birth. This simple step saves lives. This simple step saves a healthcare worker from counseling after they have the guilt of killing patients hanging over their head.


    But the dialysis center says that takes too much time. Right now as I type this, I am sitting at dialysis. There are two nurse trying to handle 44 patients, a ratio of 22:1. When I go to the infusion center, the nurse to patient ratio is 4:1.


    I live this shit every fucking week and have extensive experience with healthcare over the last 4 years. Perhaps the view is different from the outside looking into the US medical system, but I defy you to come experience this stuff for yourself before forming theoretical opinions.


    I do not give a shit what labels are used to define the socio-economic system. As I stated, I am looking for two things, choices and to associate with the best people I can. Whatever the system label is defined, if I am allowed choices that allows me to find and use the best care I can then I am happy. Putting everything in the hands of a single governmental entity is not going to do that at all. People that work in a governmental system are just as greedy as those who work in a corporation. There is no panacea in any of the socio-economic systems, they all suck because they are all run but humans.
    Eph

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  • Jerome Scuggs
    replied
    oh my fucking god i just typed a huge wall of text and wasnt logged in and it disappeared

    but this is cool because now i can organize and re-attempt the post in a shorter way



    This is a passage i screenshotted a long time ago. Can't remember the page, but if you started typing the passage into google you'd find it was from adam smith's wealth of nations.

    Competition is capitalism. From Karl Marx to Adam Smith, this is one thing we can all agree on. And, naturally, competition leads to monopolization. But, and this is important here, note how Smith basically describes what you're talking about, and doesn't use the term "socialism". Why? Because not all regulation is "socialism".

    Now I'm coming from my 2008, libertarian, point of view. Companies are driven by greed, and they will absolutely use their money to, if possible, get regulation in their favor. Insurance companies spend a few million to lobby politicians - both dem and republican, mind you - and in return they get the ACA, which forces people to buy insurance. This isn't socialism... it's a damn good investment. And that's why conservatives are super invested in calling it "socialism", because if we all knew how much money these corporations were making from the systematic looting of our public infrastructure, there would be a revolt.

    Freedom of choice is nice, but let's look at the national security market. Would you argue in favor of choice there? Instead of the United Stated Military, relying on a hodgepodge of private contractors and firms? Hopefully we can both agree that, paradoxically, privatizing the state monopoly on defense would be ludicrous, inefficient, and downright unsafe.

    To me, a solution isn't good if it gives you choices, it's good if it's good :P I think that, much like national defense, the market for healthcare is alot more complex than other markets - for factors that we simply cannot quantify. You can't put a price on "freedom from invasion", and you can't put a price on a human life. Which is why this line keeps standing out at me:

    The message here to me is that my life, living in an area without any competition, is worth LESS than another dialysis patient in a metro area. Fuck that.
    Because this is so much of why I became disillusioned with libertarianism. Literally what's happened here is these corporations crunched the numbers and decided you were, in fact, worth less to them. Do you feel like you've been robbed of good healthcare? If so, you might understand better why Adam Smith, above, referred to these profits as a tax. Once again not Karl Marx, mind you... Adam Smith. Not exactly known for being a socialist. Not all government policies are socialist, and not all socialism is government policies. For example: https://en.wikipedia.org/wiki/Mondragon_Corporation

    But yeah man, i dunno. If "socialism" is the problem... then why did these corporations, and their millionaire owners, donate huge sums of money to hillary clinton, who then turned around and provably rigged a primary against bernie sanders, an actual socialist? the same corporations who lobbied and paid to secure monopolies over healthcare markets? if our market is "socialist", why is its history nothing but one of increasing profits and expansion for healthcare corporations?

    to look into the history of "failing" government programs is to also see a history of politicians who deliberately either 1) failed to maintain or update the program or 2) choked it to death via cuts and legislation. watch what happens in kentucky. they just made it harder to get medicaid, so less people will go through the effort to get it, so republicans will be able to say "look, less people are on medicaid", and they will say that "the cuts" helped while they ignore everyone who suffers or even dies because of it.

    Also this study was just released: http://www.ajmc.com/newsroom/america...ed-report-says

    Last year costs and overall spending INCREASED for healthcare even though actual use DECREASED. Of course it's interesting to look at WHY the costs rose, and the study, linked above, shows that a vast majority/share of the increase was driven by costs tied to market actors - pharma companies who set the price of drugs, for example.

    I don't think we as a society are fully aware of just how bad our runaway capitalism is, and the extent to which monopolization has all but ended competition in so many markets. And for some reason we keep thinking the government is "letting" it happen, like these corporations aren't pouring billions into our politicians to secure laws to benefit themselves. companies are actively lobbying the government because it's a good investment for them, and as long as we focus on "runaway government" without realizing the capitalist class has amassed an equally terrifying amount of power, we're just gonna keep spinning wheels.

    Like I read this recently in the new york times:


    and it's crazy because apple could have brought back these jobs or a factory at any time, but instead literally held out until the government wrote a policy they considered profitable. and we're convinced this tax break was for us, haha. this is a form of economic warfare called a "capital strike", which is ironic of course because these corporations also dump alot of money into preventing their employees from being able to strike.

    i dunno man. i dont think im crazy when i say i just dont see how you can pin this healthcare shit on "socialism".
    Last edited by Jerome Scuggs; 01-26-2018, 05:15 AM.

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  • Ephemeral
    replied
    I do not think that this is an issue of capitalism. It is an issue of a lack of competition. DaVita and Fresenius have carved up the marketplace and monopolize most market areas. In other words, in very few areas do they actually compete with one another. In the places they do compete (a handful of metropolitan areas) the techs earn an average of $2 an hour more and the patient to healthcare provider ratio is higher. WTF?

    The message here to me is that my life, living in an area without any competition, is worth LESS than another dialysis patient in a metro area. Fuck that. The reason is simple, when two or more companies compete, they are forced to offer choices. Choices which include choices for the patients AND choices for employees. Patients can evaluate the competing systems and decide support the one they feel is better. Employees also evaluate the job, and then decide if they want to stay or leave to go to a better job on the other side of town.

    By allowing these two companies to split up the market between them, the Feds have let this situation evolve into localized monopolies. I think we can all agree that without competition things get bad. So the solution is either for the Feds to regulate this situation and force competition or step in and take over the entire thing.

    So let’s say the Feds take it completely over. The Fed have proven over and over that they cannot run anything well; I have no confidence that socializing healthcare in the US would result in a good system. The VA is a good example. Recall the roll out of the Obamacare website? I do. I spent over 30 hour struggling with it trying to get signed up. And once I did finally get signed up in the ‘affordable’ care system my first year insurance cost was $20k per year but in the second year when the NC insurance choices were reduced to one company, they jacked my annual insurance cost up to over $35k.

    I am not convinced that the Feds are going to be able to offer a better situation unless they too have competition. To me, a monopoly is a monopoly and the Fed are the biggest monopoly in the country. I think that supporting socialize healthcare is the same supporting giving all the business to one giant company. The US federal government is one giant corporation; one that is run worse than any other giant corporation.

    I grew up in the 1960s, back when being a radical actually meant fighting against The Man. We fought against crazy stupid things like racism and fighting a meaningless war that we were being FORCED to go die for. At that time if you were 18 years old you could not buy a beer, but you could be drafted to go die for a stupid war. We fought against bad corporations which were literally poisoning us as they put profits ahead of lives. We formed and joined communes thinking that they were the solution. But what we found out is the problem was not companies, the problem was not the Feds, the problem was that humans suck.

    The grand fantasy of a bunch of likeminded people a working towards a common goal failed over and over in every commune that was established. Why? Because the bit of everyone throwing down the same amount of contributions never occurred. Some people are lazy, some are greedy, some are good. The issue was not the system being utilized, the issue was the humans.

    What are corporations? People. They are not some automated system, the system is made up of people. What is a government? People. The government is not some faceless system, it is made up of, and run by, humans. So we can debate shit all day long but at the end of it the problem is still humans. No one can fix greed, no one can fix human nature. At best you try to find and associate with the best people you can…which means we need choices. Any solution that brings choices to the table is a good one. Any solution which limits choices is a bad one.
    Eph

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  • Jerome Scuggs
    replied
    also ive never seen this clip and holy shit

    also what's your opinion on what kentucky just did with medicaid

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  • Jerome Scuggs
    replied
    yo eph, your assessment of the situation is 100% spot-on, but i guess where we disagree is i don't see a system where private companies used their wealth to lobby for political favors in the form of legislation securing their monopoly as "socialism". it's actually, in my eyes, exactly what's wrong with free markets: if you allow the "winners" to "win" unchecked, they attain so much wealth that they can begin "investing" some of it in the form of lobbying. with lobbying, they can literally buy legislation securing their market status, like these companies did, like insurance companies did with obamacare. when you think this through the only (libertarian) solution is ultimately: get rid of the government entirely and then it won't be there for people to abuse. i don't think that's realistic. i think we need to look at limits on the 1% in the same way we look at limits on politicians and political power, because both inevitably reduce liberty for the masses.

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  • kthx
    replied
    I would watch it if it wasn't that faggot John Oliver, but I will take your word for it.

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  • Ephemeral
    replied
    In the US, anyone who is diagnosed with ESRD (kidney failure) is fully covered under Medicare (this was passed in the 1970s under Nixon). So 98% of all the dialysis is done by a few companies, DaVita and Fresenius own the vast majority of the business. (These are companies which get around $12 BILLION each.) Since all US taxpayers foot the bill for all the dialysis patients like myself (450,000 of us) and there is no competition between the companies, it is perfect examples of what happens to healthcare in a socialized system. Without competition, with rates dictated by the Feds, the only way to be profitable is to lower the quality of the health care.


    We have roaches running across us during treatments, they allow techs with no formal medical education draw and push IV drugs, the people who I put my life in their hands every day are started at $11 an hour (less than Walmart). They have the employee turnover rate (25%) of a McDonalds.


    A bit long to watch but this nighttime commentary sums it up pretty well





    Eph
    Last edited by Ephemeral; 01-23-2018, 01:21 PM.

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  • kthx
    replied
    I mean.. thats like saying that blockbuster management is going to tell you how good redbox is. I have heard some horror stories from both to be honest though, mostly good though with my family and friends who had to do it. Also Houston's is the largest. Methodist is a nice place though, grats on getting that cake gig and not getting sent to Ben Taub

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  • paradise!
    replied
    Originally posted by kthx View Post
    It works very well, I live near the Medical Center, and we have several colleges nearby that train medical students and nurses, so that isn't really ever a problem. Because you know I live in the third largest city in the world, with the worlds largest medical center. Where did you live again paradise? Probably not very many people go there to work you know. Yawn.
    relax buddy, i spent a month working at methodist. i got stories for days bruh. and also largest med center? thought that was pitt....

    im just saying davita, etc don't have great reputations in the medical community

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  • kthx
    replied
    It works very well, I live near the Medical Center, and we have several colleges nearby that train medical students and nurses, so that isn't really ever a problem. Because you know I live in the third largest city in the world, with the worlds largest medical center. Where did you live again paradise? Probably not very many people go there to work you know. Yawn.

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  • paradise!
    replied
    Originally posted by kthx View Post
    You guys don't have private dialysis centers where you live? We do here in Houston. Really nice ones with personal rooms, tv's wifi, and lazy boys.
    how would a public dialysis center work

    all about 'competition in the marketplace' until your only local dialysis center is ran by untrained staff
    Last edited by paradise!; 01-23-2018, 01:03 AM.

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  • kthx
    replied
    You guys don't have private dialysis centers where you live? We do here in Houston. Really nice ones with personal rooms, tv's wifi, and lazy boys.

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