![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 68. Go back in thread:
Posted by Phillipa on August 8, 2006, at 10:07:04
In reply to Re: cost of drugs, posted by kylenn on August 6, 2006, at 11:26:05
That's a scarey thought to me. I know some docs do abuse drugs and are working overtime. But to think they are that depressed that they are acting is truley scarey to me. Running a code? And with Aids and othe STD's why do you want to legalize it? I know there wouldn't be less crime as rapes are committed by men who they say are not doing it for sexual gratification but anger towards women in general. Phillipa
Posted by Meri-Tuuli on August 8, 2006, at 10:07:06
In reply to Re: cost of drugs, posted by kylenn on August 6, 2006, at 11:23:41
Hello again.
Yes I understand what you are saying. Although we have completely different tax systems. Wow, people here would long for income tax to be as low as 5%. I'm not too sure of the finer points of our tax system, but here in the UK we get our income taxed at around 25%. Yes the government takes this away before we even see our paychecks. In the Scando countries, its even higher. Sweden, I think, taxes its citizens closer to the 50% mark.
But you know, its made a society (in Finland anyway) whereby you are perfectly safe to walk the streets on your own as a 17 year old girl in a capital city at 11.30pm at night. I'm not sure I could say that of America, certainly not in a down town area or even here in the UK.
We also get *all* of our goods we buy taxed at 17.5%. Actually, they tax booze and cigarettes much higher (and perhaps other things too like luxuary cars), and a few essential items such as bread and milk and childrens apparel, they don't tax at all.
So we have income tax and sales tax. But, its no so bad. To be honest, they are quite strict here on who gets disability etc.
I don't know, its difficult. On the one hand you have America with its 'live free or die' menality and not much in the way of state care, and the other extreme you have the Scando counties with their 50% income tax and whatnot. But the thing is, nothing is free, as we well know, and the Scando counties have alot more free stuff (heatlhcare, childcare, tertiary education etc) but they pay alot of tax. Things in the US ain't free but you pay next to nothing in tax (well, compared to the Scando countries at least).
Its just about how much you want the state to intervene in your life, and 'take care' of you.
I see your point and bitterness about those who aren't really ill/whatever and abuse the system. Yeah we have that too here, and the bitter people. I guess its always going to happen. Personally, I would rather see them use the system, than they become homeless, drug ridden etc. I mean, think about it, a certain amount of sercurity means that they are off the streets making them safer for us folks. Sort of.
People in finland, for example, don't mind paying their high tax, because there is a level playing field. Did you know, that they don't have private schools in Finland? They have the best educational system in the world apparently (according to the Washing Post http://blog.washingtonpost.com/finlanddiary/ ) There is no unfair start to life because your parents have money. So people don't mind.
Anyway, well, yeah. I don't know what the answer is. Set up your own political party??
Yeah and it must be rather infuritating to know that the the US government is wasting billions, if not trillions, of tax money funding the war in Iraq. Certainly we're paying billions of our UK tax money for the war in the middle east, and nobody even wants a war here! Now that is something I am bitter about, not the freeloaders of the system. I bet the war in Iraq is costing much much much more to the tax payer in America than the freeloaders are.
Kind regards
Meri
Posted by Meri-Tuuli on August 8, 2006, at 10:07:07
In reply to Re: cost of drugs » kylenn, posted by Meri-Tuuli on August 6, 2006, at 13:12:01
Hello yet again!
I really urge you to read the Washington Post's full article, here is the direct link:
http://www.washingtonpost.com/wp-dyn/content/article/2005/08/05/AR2005080502015.html
I think you'll find it interesting and illumitating!!!
Posted by kylenn on August 8, 2006, at 10:07:07
In reply to Re: cost of drugs » Meri-Tuuli, posted by Meri-Tuuli on August 6, 2006, at 13:25:57
Meri-Tuuli,
Thanks for the nice article.
Finland does sound lovely.
Little bit creeped out by "groupthink" though!
kylenn
Posted by kylenn on August 8, 2006, at 10:07:08
In reply to Re: cost of drugs » kylenn, posted by Meri-Tuuli on August 6, 2006, at 13:12:01
Meri
Hi
Yes, I, too, would end the interference in Iraq if I could. We should stay out of the middle east, I think.
I am not military minded, although I did grow up as the dependant of an Air Force career enlistee.
My first husband spent 4 years in the U.S. Army.I was very scared after 911 for several weeks.
I didn't mean to mislead you about our taxes; currently we are taxed at about 30% on our income by the federal govt.
The initial income tax was 5%. It has grown a bit since then.
I am very attuned to what I see as fairness or unfairness.
I would rather have people in govt housing than foraging on the streets. It just rubs me the wrong way when I know that there are people as capable as I am of getting up and going to work every day, but they don't.
The people who don't work and get free medical care in this country under the Medicaid system are, generally speaking, the worst kind of patient.
Although they truly pay nothing for health care, not even taxes on income or sales taxes etc,
they are almost always the most demanding, the least compliant, the least grateful, and the most likely to sue.
It is tough not to get bitter.
I wish I wasn't bitter, but I am.
Please do not think, though, that I spend every waking moment thinking about and grousing about this type of thing! I don't.
But when the thoughts get triggered by whatever, and if I have a chance to start rambling on about it, well, it is an itch I cannot resist scratching!
Posted by kylenn on August 8, 2006, at 10:07:09
In reply to ReScarey Thought, posted by Phillipa on August 6, 2006, at 11:45:58
Ok, Phillipa,
I am going to let this be my last response to you.
Obviously, you are taking everything I say the wrong way; perhaps my communication skills are not as stellar as I thought they were.
Acting happy when one is not does not make one incompetent. I am not sure why you are so confused over this.
And, sweetie, if you want your docs to NOT be acting, I surely do not know what to tell you.
Presenting yourself as a caring professional is something that is drilled into us in the long years of med school and residency.
We have to learn, no matter what our mental/emotional state is, that we can not reveal that to patients, especially those that do not know us and are acutely ill.
Patients generally do not want to know that their doctor is angry at women in general because he just found out his wife is cheating on him. A good doc will manage to veil his feelings while dealing with his female patients.
A mother with her newborn does not want to know how sad the nurse that is caring for her is because she just had her third miscarriage.
A person just diagnosed with cancer does not want to know how tired doc is after 36 hours straight in the hospital.
Hon, I can't think of many jobs in life that don't require some amount of "acting".Not only that, but one of the things I have learned in therapy is that sometimes ACTING happy can actually foster true happiness. Hard to believe, but it is true.
I am sometimes honest with my patients about my feelings, but only, and I mean ONLY when I think self-disclosure may help the patient, and guess what, this usually happens when I am dealing with a desperately depressed patient, usually a female.
They have been "acting" for their family, for their job, for their spouse for so long, and just scratching the surface of the facade is all it takes to reveal their utter sadness and hopelessness. I am in a position to help, and at times, when they seem so alone in their misery, I reach out and let them know, they are not alone. I have been where they are now,and I can help them find their way out. I know the way; I am there for them. They can continue the act that they need to do to keep things running at the house or on the job. They can turn into a puddle with me.
I have a valuable role in my community.
I care VERY much about my patients, yes, even the ones that I have decided just might not be for real or might be taking advantage of the system in some way. I am, by nature, a very caring and concerned person. I feel deeply the hurt that others feel. I can not keep myself emotionally aloof from the desperately ill and sad patients and their families that I care for. I have been this way since I was 4 years old.If I have to "act" calm in the midst of chaos, no matter how nervous I am at my core, this is my job. By acting calm, calmness ensues, thinking clears, decisions get made.
Coding is one of the scariest things a health professional can do. The situation is, by nature, chaotic and scary. I have heard many a colleague say that the day codes don't make their heart beat a little faster is the day they need to quit.
I have been able over the course of my career to hone my acting skills to the point where, when I enter the room to begin a patient encounter, no matter how I felt in the hall, I immediately and without conscious effort go into the role of the "doctor" and whatever that patient needs from me at that moment, he will get, no matter what is in my heart. I am not in that room to indulge my own feelings and emotions, opinions or biases. I am in that room to be the one person that that patient can count on, confide in and trust. I will listen to him/her and I will do everything I can to make his or her life just a little easier.
And it does not matter how hard my life is and how I wish my life was easier. My job is to do what I can for that patient, and if that means putting on a brave face when I am scared, a serious face when I feel silly, a delighted face when I feel disappointed or a gentle face when I feel angry, that is what I will do.
If I do not need to "put on a face" for the patient, then I won't! Those encounters are, admittedly, the easiest! But, I know my job.
And I am good at it. Really good.
I consider myself an Oscar quality actress.
Posted by Phillipa on August 8, 2006, at 10:07:09
In reply to welfare state, posted by kylenn on August 6, 2006, at 19:52:14
I tend to agree with that. Of course there are exceptions. I don't like to generalize. Phillipa
Posted by Phillipa on August 8, 2006, at 10:07:09
In reply to Reality check, posted by kylenn on August 6, 2006, at 20:18:39
No reason to reply. You're so right I'm not stupid or dumb. I just recognize when I might not pick up on a mistake a doc made in writing orders for a patient. As RN's carry Malpractice insurance also because the Hospital may not defend them. And RN's know meds better than docs sometimes it's our job. I can't count how many times docs are called back on the phone cause their order is not or may not be correct. We are responsible for knowing what doses are recommended. And I wish docs would learn to write so they don't have to be called and awakened in the middle of the night. But safety first. And I was Nationally Certified in Psych Nursing which I lost when I became ill so ill that my pdoc said no you may not work. And this breaks my heart as I love nursing and helping others. And sometimes a patient does want to hear about that nurses miscarriage. Sometimes it helps to know the person truly understands as she has just gone through the same thing. And Nurses where I have worked have done all the med teaching to the patients and on Psych did all the patient Groups. I know a Resident who posts on this board that said he couldn't do his job without Nurses. And we have about 8 patients each. And when one dies we put on a happy face because our other patients must be cared for. Everything gets stuffed inside. No crying allowed. And this leads to the same burn out that many docs have. And in turn leads to Depression or other illnesses. So forgive me for not working if I know and only I can positively know that I am incapable of working at this time. Hopefully I will be able to return to work. If not I'll end up volunteering. I'm just sorry that I'm not one of the people who meds work for. I'm still trying and won't give up. I'm 60 years old now. I don't have that much time. So I am doing everything in my power to become well again. A lot of my neighbors in their 50's are already retired. I have no idea your age and it doesn't matter. What matters to me is that there are too many errors made in Hospitals, Doc's offices, Pharmacies. Needless mistakes. One of the reasons Malpractice is so high. Maybe one day the system will not work their Interns so hard. At least RN's must have 8 hours before they can work after sometimes doing double shifts which are l6 hours long. And Doc's do have on call Doc's they share it. That's long enough. Phillipa
Posted by Jost on August 8, 2006, at 10:07:10
In reply to Re: welfare state » kylenn, posted by Phillipa on August 6, 2006, at 20:44:18
Phillipa, thanks for taking time to talk more about your life. Your posts are so short and pithy usually, and I've often wondered were you are in life.
It sounds like you were a great nurse. The kind of nursing in hospitals makes so much difference, since hospital phyisicians get more detached and often less knowledgeable about each patient in this new era. I hope you'll get back to a place where you can practice nursing again.
Maybe emsam will be part of the answer. When do you start?
Jost
Posted by Phillipa on August 8, 2006, at 10:07:10
In reply to Re: welfare state » Phillipa, posted by Jost on August 7, 2006, at 11:21:22
Hi Jost. Certain subjects I get passionate about. And sometimes I'll join a thread to learn hence the short notes. Right now I'm in the process of changing from valium to klonopin as a lot think it's a better benzo, and weaning down on luvox which is taking longer than I'd hoped due to dizzyness. And I just stopped the lamictal. So as soon as I get my anxiety, fear of going out alone , and fear of being home alone, I'll concentrate more on the EMSAM how much, etc. Love Phillipa
Posted by Estella on August 8, 2006, at 10:07:11
In reply to Re: cost of drugs, posted by kylenn on August 5, 2006, at 16:54:05
> And so, if something is a "basic human right" because it is necessary for survival, then I certainly feel that food, water, shelter and clothing would come BEFORE health care. Sanitation would come before health care as well. These items are MUCH MUCH more important for survival on a DAY to DAY basis (and it would follow, therefore, that they would qualify over and above health care as "basic human rights") It should, therefore, by the same reasoning, all be paid for by the government (out of taxes, which the people pay to the government).
> So, we should all just turn over our whole paychecks to the government so that they could take care of the costs of things that are necessary for survival, these "basic human rights".
Ah, but you see that doesn't follow. When 10% of the country have over half the wealth in the country... When you look at the money spent on war and military research... When you consider that the amount of money people spend on bottled water (when non-bottled water is safe to drink) could provide drinkable water for third world countries...
The last bit doesn't follow.
I think that it is a human right to have your basic needs met. And rights... Entail duties, yes.
But I've been told I'm an idealist.
Comes of being on welfare most of my life you see.
If welfare hadn't supported my mother and me...
If welfare hadn't supported me living in a girls home...
If welfare hadn't brought me food...
If welfare hadn't brought me clothing...
If welfare hadn't brought me school books...
If welfare hadn't paid for the bus...Where would I be now?
I'm studying towards a grad degree.
But I have a lot of sympathy for those who don't do anything because... They don't think they can do anything meaningful. IMO they need more help (in the form of psychological / social work intervention) - not judgement.
I sympathise with long hours and numerous patients etc.
But I'm sorry I can't bring myself to judge these people harshly...
Posted by Dr. Bob on August 8, 2006, at 10:18:08
In reply to Re: cost of drugs » kylenn, posted by Tomatheus on August 5, 2006, at 23:11:17
> in today's world, the HARDER you work, the MORE you support the lazy.
>
> kylenn> in all likelihood, you'll never see any of the harm that will probably result from your "lecture," much less do anything to help those who might be harmed.
>
> TomatheusPlease post anything that could lead others to feel accused or put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're bad people.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Thanks,
Bob
Posted by Jost on August 8, 2006, at 13:15:20
In reply to Re: welfare state » Jost, posted by Phillipa on August 7, 2006, at 20:18:58
Phillipa, I'm glad you're passionate about nursing. I'm sure you were (are) a great nurse. I'm extremely grateful to the nurses who helped my brother-in-law, and us--they made all the difference for him and us.
But I hope you don't put off the emsam too long. It could help a lot with having energy and wanting to go out.
I always enjoy seeing your posts, long or short.
Jost
Posted by AuntieMel on August 8, 2006, at 14:24:31
In reply to Re: please be civil » kylenn » Tomatheus, posted by Dr. Bob on August 8, 2006, at 10:18:08
Freudian slip??
"Please post anything that could lead others..."
Posted by AuntieMel on August 8, 2006, at 14:48:24
In reply to Re: cost of drugs, posted by Estella on August 8, 2006, at 9:44:49
well, sort of...
I quite often disagree with E. because I don't think it's a right to get these things just because you don't want to work.
But I also agree that in many cases welfare can get folks to a point where they are productive and can give back to the system.
And health care? How much better would it be if we *did* take care of those who couldn't pay.
They wouldn't bring their kids into the ER because they didn't have a clinic. There would be preventive care so that they wouldn't end up with more debiliting diseases.
It would actually end up costing society less in the long run.
And (to be selfish) the next time I really needed an ER maybe I wouldn't have to wait so long.
This coming from what you would call a non-slacker. I worked 3 jobs at a time to get through school. But I also qualified for government grants (handouts.) And now that I make a pretty good living I've paid it back in spades.
Posted by Estella on August 8, 2006, at 20:13:18
In reply to Re: Yikes! I agree with Estella, posted by AuntieMel on August 8, 2006, at 14:48:24
> I don't think it's a right to get these things just because you don't want to work.
i don't think that either.
i think it is a right to get those things because... we are human beings. and because... we have this complex forebrain that allows us to empathise with others plights, see that they have needs as we have needs, and see that people who don't get their basic needs met... suffer. as we would if we were precisely where they are in life.i agree with what you just said, but i see it a little differently in the sense that:
> I don't think it's a right to get these things just because you don't want to work.
I don't know how many times I've heard that in my life 'I don't want to work I think I'll just go on the dole or try and get onto the sickness benefit'. Countless times. I've heard it countless times.
But now I jump up and down and get a bit excited... IMHO the million dollar question is:
Why?
Why on earth would you prefer to sit at home in front of the tv all day (which does indeed seem to be what a fair few of them do) getting a pittance that is barely enough to meet your basic needs...
Compared to doing something so that you can go on holiday and travel and buy a car and go to the movies and eat out and live in a nicer house etc etc. Why on earth would they prefer to do that?IMHO usually because... They don't believe they can do anything meaningful.
So... That is why I conclude that they need assistance to find something rather than being left to... die... or whatever. rather than relying on handouts (which can feel really very humiliating compared to a sum just being deposited weekly).
I don't think the humiliation helps them feel better about themselves and motivate them to get into a course or do charity work to build up some skills or anything. At least... I've never found humiliation to help me.
> It would actually end up costing society less in the long run.
It could do if it was well run, yeah i believe that.
But even more so... I believe in altruism and empathy... I think it would be nice to do it out of empathy rather than out of... Egoism.
I mean... Thinking we would be better off is a better reason than no reason at all... But still I want to say... They are people too. It isn't much fun living on welfare. Fairly demoralising. Really. People who plan to do that... Well I have sympathy for them because typically they are doing it because... They don't believe they are capable / worthy / able to live a more prosperous life. They don't think they CAN do anything.
Posted by Phillipa on August 8, 2006, at 20:28:58
In reply to Re: Yikes! I agree with Auntiemel, posted by Estella on August 8, 2006, at 20:13:18
Tough one I agree and disagree. Yes to those being able to take courses and get a job to be proud of. No to those who are unable due to lets say ALS or something similar.They can learn to deal with their illness for as long as they can. But inevitably are on a respirator. No ability to speak or move. Need constant Nursing care. Can't even have a bowel movement on their own. Society has to take care of them . Or should I say I feel it should? Love Phillipa
Posted by Estella on August 8, 2006, at 20:44:16
In reply to Re: Yikes! I agree with Auntiemel » Estella, posted by Phillipa on August 8, 2006, at 20:28:58
> Tough one I agree and disagree. Yes to those being able to take courses and get a job to be proud of. No to those who are unable due to lets say ALS or something similar.
Yes I agree. I wasn't talking about people who are physically unable to work. But then there are different things that people who are physically disabled / sick are and are not able to do. Though sometimes... They don't believe they can do anything meaningful when their sickness / disability means they can't do what they used to do.
I was trying to comment on the 'lazy' notion. IMHO 'laziness' has another name: depression.
It is a social problem. Medical model locates the cause of blame and responsibility within the individual...
We evolved to live in close kin groups and I don't think we have evolved out of the need for social support just yet ;-)
Oftentimes I think that what is typically considered to be a problem within the individual e.g. they are *just* lazy is more a problem with society - what is it that society has done to show them that they *can* have a productive place in it?
social problems... need a social solution imho...
and it can be really really really really really very hard imho.
i don't really understand the volountary work structure in the US... i've heard someone say that they couldn't get volountary work. i don't really understand that one... i guess not as many people do volountary work where i'm from. it isn't a factor on applications or anything like that (though kudos to you if you do it off your own bat of course).
i don't know...
but if you are thinking of you...
what would you like to do?
i mean... you don't have money troubles - do you?
you are fairly close to retirement (so retraining can be much harder)
you were in a very high anxiety job...people should be able to retire at some point, shouldn't they?
and of course solo parents trying to raise kids... imho that jolly well *should* be paid work.
Posted by kylenn on August 8, 2006, at 20:56:08
In reply to Re: cost of drugs, posted by Estella on August 8, 2006, at 9:44:49
Again, you took me out of context.
I realize you put my "exact words" above your response, but you left some other paragraphs/ideas out.
I am not talking about the super-rich, anyway, but I DID say (look again) that LUXURIES should be SUPER-TAXED!!! That is the closest we can get to fairness in my world view as far as taxes go.
I am still thinking about the fining process in Finland, and I think I agree with it.
If it is money (and not time in jail) they are talking about, then the punishment should hurt everyone equally, (in order to be fair), so I agree that if an 18 year old minimum wage student has to chunk out 1/2 a paycheck for a fine for speeding, then so should the 22 year old heir of a billion dollar fortune.
If the 18 year old makes $500 every two weeks, and has to pay $250 for a fine then if the heir makes (or gets, because he may not work for it)
$50,000 every two weeks, then he should have to pay $25,000 for the same crime in my view.
And when they buy that 10,000 square foot home with a tennis court and a pool.
I said luxuries, excesses--should be taxed at what did I say? 20-25%? And sins even higher.
That would effectivley tax ONLY the super rich.
I wouldn't mind if they taxed luxuries like 40% and sins 50 or 60%!
whatever! and that would, as I said, tax ONLY the super-rich.
As I said (I am repeating here)
essentials like food, water, electricity, health care, shelter should not be taxed at all; houses over say 1500 square feet per person should be considered luxury houses and the square footage over what would be essential could be taxed as non-essentials.
Cars over say $25,000 should be taxed as luxury cars the same way.
I am a fair minded person.
As I have said.
But I will stand my ground when I say that hard work and ambition should NOT be taxed; at least the tax should not be HIGHER for a bigger paycheck.
If a person works for the money, it should be his money.
It is when he spends it on non-essentials that the government could step in and take a chunk of it.
As I said.
And criminals, who make a lot more money than you or I, all income tax free, well, they REALLY like to spend that money, don't they? The big, fancy cars with all the non-essential silly rims and lights and stereos, the hotel suites, the pretentious jewelry, the fancy high dollar restaurants (yes, eating out is a non-essential)
Then, it would be fair. The super-rich, the criminal element, all would pay for their excesses with high taxes, and it would be so much more fair.
I really, really, really do not understand why anyone disagrees with this.
Especially a grad student that has worked so hard to get where she is. When you are finally out there getting a paycheck of say, $65,000/yr, you'll know what I am talking about when you see what Uncle Sam has in store for you.
And when he takes $22,000, and then you have your $750/month student loan payment (mine is over $1500 and from what I understand, that is just the interest--I owe about $165K which is about average for med school grads) and you have your $500-$1000/month rent (depending on where you live, could be more, might be less) and your$200/month gas bill, $200/month light bill, $350/month car note, $125/month car insurance, $100/mo phone bill, $65/month cable, (an non-essential, I shall admit, but I bet you have it),
$50/month cell phone bill, and $400/month food bill, you might start to realize that if you had an extra $22,000, you might be able to save for retirement. As it is, you won't. And do you think the government is REALLY going to keep up the welfare state that we already have? The Elderly SHOULD NOT have to worry about food, shelter, water, lights, transportation, and health care ESPECIALLY when they have spent their life working and EVEN if they haven't. I sincerely believe that after the age of 65-70, these worries should be behind you.
But, I would bet you money that Social Security, (which doesn't take away these worries by a long shot now) will NOT be there when I retire (I'm 44) and it WON'T be there when my daughter retires (she's 23) or my son (he's 21) or my youngest (he's 11). And I am not able to save ANY money for retirement at this point in my life; alot of that has to do with having had this depression to deal with.
When income tax was first put into action, there were approximately 15 workers paying into the system for every 1 person unable to work.
The same with social security.
Now, the ratio is about 3:1, and that was as of 5 years ago, I believe.
We are NOT making 5X more than our predecessors (inflation adjusted income) were making, check it out. Can people not see this is a disaster waiting to happen? The baby boomer generation is retiring. That is going to mean EVEN LESS workers to contribute. The ratio may go to 2:1.
It WILL NOT be possible to put enough income tax on the people to support the welfare state we have now.
I am certainly CERTAINLY not suggesting FOR A SECOND that the elderly and the disabled should all go to work!
I am saying INCOME TAX is not going to sustain it, and it is unfair, anyway.
People with more disposable income SPEND MORE, don't they???? And how much do you think they SPEND ON NECESSITIES? Not much more than you or I.
The rest is all cream, baby.
And THAT should be where we get the money for the disabled. THAT IS WHERE we should get the money for the elderly.
SIN TAXES like a 50% or higher tax on cigarettes and alcohol and gambling wins should be AUTOMATICALLY put towards HEALTH CARE.
LUXURY TAXES should be towards paying for the necessities of those who cannot afford them and are elderly or disabled.
Maybe LUXURY TAXES on things like VACATIONS IN ST TROPEZ (is there such a place?) should be earmarked for MENTAL HEALTH CARE for those of us who cannot afford to unwind on the white sands of the Caribbean!!
Taxes on luxury automobiles and first class plane tickets and cruises could pay for transportation for the elderly and disabled (notice I do not like to use the word needy, because to me there is a BIG difference between someone who is "needy" and someone who is elderly or disabled OR DIAGNOSED WITH SOME KIND OF HORRIBLE DISEASE THAT IS EITHER INCURABLE OR IS GOING TO BE PROHIBITIVLEY EXPENSIVE TO TREAT.
And you know what? I would even GO FOR a nationalized health care system if AND ONLY IF, they would do away with the income tax.
And, while I am spelling out my wish list, do away with all these stupid and pointless laws like HIPPA and these stupid DRGs that MEDICARE and other insurance companies use to pay for certain things like hospital stays (like if you get diagnosed with chest pain, the DRG says you can only stay for 24 hours max and then you have to be discharged, or medicare won't pay.) and HIPPA is a law that added OMIGOD so much paperwork to medical care for SUCH a stupid reason (THE ONLY PEOPLE THAT BENEFIT FROM THE HIPPA LAW AREN'T PEOPLE AT ALL: THEY ARE INSURANCE COMPANIES!!!)
All that paperwork they make you sign now at the doctor's office and at the hospital saying you have recieved the HIPPA paperwork which basically spells out your "RIGHTS" as a patient when it comes to your health care information.
GUESS WHAT? the HIPPA law made it ILLEGAL for a doctor to tell ANYONE IN YOUR FAMILY ANYTHING TO DO WITH YOUR HEALTH CARE INFORMATION AND THAT INCLUDES HUSBANDS/WIVES, ADULT CHILDREN/PARENTS, PARENTS/ADULT CHILDREN, SIGNIFICANT OTHERS, SISTERS/BROTHERS BUT GUESS WHO HAS TOTAL AND COMPLETE ACCESS TO YOUR HEALTH INFORMATION (AND SOMETIMES MISINFORMATION?) THAT'S RIGHT, YOUR FRIEND AND MINE, THE INSURANCE COMPANIES HAVE THE RIGHT TO YOUR HEALTH CARE INFORMATION IF YOU APPLY FOR INSURANCE.!!!!!! That's what the big money insurance companies spent most of their lobby funds in Washington on during the Clinton years. Think about it. UNLESS you give your doc specific WRITTEN permission to tell your wife, your daughter, your mother, your brother, your partner about your health (even if you are in a coma as a result of an accident, they can NOT, BY LAW, tell you what is wrong with your loved one if written permission was not obtained prior.
BUt, you can be if your son gets DDAVP for bedwetting at age 8 and then applies for insurance (not group insurance, right now that is a loophole. if you have group insurance HANG ONTO IT) applies for insurance on his own at age 24 after he opens his own auto-body shop, guess what? The insurance companies will jack up his premiums and AND refuse to cover ANYTHING THAT HAS ANYTHING TO DO WITH THE URINARY SYSTEM. And so that means, just because your son had a little bedwetting at age 8, if he develops, say diabetes at age 28 and then develops kidney problems from it at say, 38, he is SOL! The insurance companies knew what they were doing. So did congress. (I am really putting a BIG ASSUMPTION) on that one. BUT guess who did not have a clue??
That's right, you and me, bub.
I didn't just wake up one morning with all these opinions. I used to be a liberal democrat. then I was a repulblican. NOW, I am neither, because they are all FOS.
I thought about fairness long and hard.
It IS right and fair that the one of the big functions of govt (since we cannot do without it)
should be to look out for those unable to look out for themselves (UNABLE)
BUT, it SHOULD NOT PUNISH people who believed in the "AMERICAN DREAM" and worked their A##es off to attain their goals of breaking out of poverty (which, y'all, that is how I grew up).
Income tax should be done away with. ANd if it cannot be (and I truly do not know why it couldn't be) then it should be a FLAT TAX.
BUt I think that the Federal Sales Tax would be even better, bring even more money to the federal coffers, and truly be a fair tax, that the disadvantaged would be totally unaffected by.
Even if they work their a99 off for a few weeks of overtime, all the money they make, they keep.
And maybe Christmas won't be so sad this year!
Maybe people really can start saving for a "rainy day".
And the SUPER RICH and the CRIMINALS would finally do their part.
See, the thing about the Finnish system of paying a fine is fair.
Yes, the rich pay more because it is a punishment and the way it makes a person feel about their crime should be equal for the crime committed.
If a rich man pays a $200 fine, it is pocket change, I can see that.
Make it a percentage of a months pay or something, that is fair.
But DON"T make the same assumption about GOOD DEEDs and HARD WORK!!! THESE things should be REWARDED!! and they usually are, with higher wages. BUt, when the gov't nullifies that reward by just taking that much more in taxes, percentage wise, it FEELS like and is the EQUIVALENT of, a PUNISHMENT.
My employees all worked about 10 hours of overtime a few weeks ago. I was excited for them and they were excited. Guess how much more their average paycheck was? Less than $30 more than if they had worked NO OVERTIME. They were essentially paid LESS THAN MINIMUM WAGE for their overtime hours. WHY? BECAUSE THE STUPID INCOME TAXES TOOK SO MUCH MORE OF A PERCENTAGE SINCE FOR THAT TWO WEEKS THEIR INCOME GOT BUMPED UP A BIT.
noW, who thinks that is fair???????
I know they did NOT.
Posted by kylenn on August 8, 2006, at 21:27:29
In reply to Re: Yikes! I agree with Estella, posted by AuntieMel on August 8, 2006, at 14:48:24
You are right about the ERs being used as clinics. but as a person who has worked in ERs MANY times as a student, resident, and now as an attending, I have to point out that the ones who truly abuse the ERs generally (sorry, I have to generalize because I am aware that there are exceptions but public welfare systems run on statistics and statistics are, by definition, a way to find out, GENERALLY, what things are or how things are used, etc)
but generally, the biggest abusers of the ER for things like an earache for 3 days brought to the ER at 10p.m on Thursday night ARE folks that are taken care of by the system, and they DO have clinics they can go to during the day and they GENERALLY get better care, wait less, and have better follow up, if they go to their clinics.
But, they don't they go to the ER. At 10pm or 1a.m or 4a.m with their 6 year old who has had a sore throat for 5 days. I kid you not. Now, what was that kid doing on Monday, Tuesday? Wednesday, all day Thursday? I have EVEN seen them come in like that and actually say THAT THE KID IS FEELING BETTER TO DAY BUT THEY THOUGHT THEY SHOULD JUST GET IT CHECKED OUT!!! Guess what, I agree, but why the ER? why in the middle of the night? why not when they were feeling really bad? why not this morning? why not in a couple of hours? Why is your 6 year old up at 4 am on a school night?
Dont get started on Oh my God how can you say that?
Maybe the kid couldn't sleep! Maybe they thought it would get better!
and maybe monkees will fly out of my $%@!
Ok, for all of you who just can't take it,
THERE ARE exceptions. OF course I realize that.
BUT the majority just do not care.
They are awake, they have a ride, whatever, I just fail to believe that that many people really think that waiting until some ungodly hour (or during the day) and GO TO THE ER for something that IS NOT AN EMERGENCY are abusing the system, they know it, and they simply couldn't care less. They aren't paying for it.
(and I am not saying that they should)
but they might think twice if they were.
SELF PAY patients ( usually hard working lower middle class to middle class people) RARELY abuse the ER. BECAUSE THEY KNOW THEY ARE GOING TO GET A BILL AND THEY REALIZE THAT PAYING $2000 FOR A SORE THROAT AT 4 AM IS JUST PLAIN STUPID.
But, the folks on medicaid never have to pay. they never see a bill. AND I AM NOT SAYING THAT THEY SHOULD
But, they should be educated what constitutes an emergency (and my patients are, by me) and what an emergency room is meant to do (and I think most people are aware) and I think there should be a review of a situation when a person is repeatedly abusing the free healthcare in such a fashion and after education and understanding is performed and documented, repeated infractions should be fined. I am not saying make them pay the bill, I realize they could never afford it.
But, I am telling you, if they knew they were going to get docked $25 for every documented unneccessary er visit out of their SSI check, they would think twice. It would STOP. I virtually guarantee it. And, almost every health care worker I have ever heard discuss this very issue agrees. A few bucks at 4 a.m. for a sore throat vs free at 8 a.m. and they WILL wait.
(generally) :)
When I work the ER, I am very lenient on what I consider an "emergency" because I try to look at it through the eyes of the patient. But when I can see that it is just blatant abuse of the system. I realize new parents are frightened and nervous of every little sniffle! I know that a child that you thought would get better, but didn't and now it is three a.m. and you are REALLY getting worried that something is terribly wrong is an emergency. (Maybe not to a doctor or a nurse, because we might be more objective and realize the kid is ok, but you may not know that and it is our job to reassure--even at 4 a.m.--and be gentle about it.
But the abuse is usually so obvious, let me tell you.
Like a kid with "ringworm" in the ER.
When was the last time ringworm killed anyone?
or the rash for 3 days (like poison ivy)
or , the 4 a.m. sore throat that is a little better today and the kid is running down the hall chasing his big brother at 4 a.m.
That is wrong, and they know it, and if it is repeated after it is brought to their attention there should be some repercussions, and THAT is what will increase the efficiency of the ER and THAT is what will bring health care costs down in this one small slice of the pie, and THAT is putting personal responsibility back where it belongs. On the person; not the public.
ALL medicaid and medicare pts have clinics. They are assigned to doctors, and if they do not like the doctor for some reason, they can switch to another clinic, and it is all free.
And, that is fine, I am ok with medicaid for the poor kids and the truly disabled.
But the ones that don't have clinics are the ones that fall through the cracks. And, like I said, they rarely, if ever, abuse the ER.
It happens, I can think of a couple cases, and they get sent a big bill, and they can't pay, and they get mad, and they ignore the bill, and it goes to collections, and whatever, but I promise you, this is the exception to the rule of the patients that abuse the ER.
Posted by kylenn on August 8, 2006, at 21:50:29
In reply to Re: Yikes! I agree with Auntiemel, posted by Estella on August 8, 2006, at 20:13:18
I must with kindness disagree with Estella.
I do not think the reason why most people choose a life in front of the t.v. is because they do not think they can do anything meaningful.
That is not logical, because I cannot think of anything less meaningful (short of criminal activity, but we are talking about something good or useful) I cannot think of anything LESS meaningful than sitting in front of t.v. for the major part of every day of every week for the rest of your life.
Now, I think that they may actually think that whatever job they get is stupid and doesn't pay enough and they can make just as much sitting at home. THAT I believe.
But that is because they CAN make just as much, and have a much more lesiurely life, by just staying at home.
Any person, with all else being equal, would rather relax than perform menial tasks.
I know I would!
But that is the crux of the problem.
A person that sweeps the streets for a living should DEFINITELY be better off financially than the person who sits in front of the t.v.
and the person who sits in front of the t.v. should ONLY be doing so if he CAN'T work, not just because he has chosen not to.
And sifting through those who choose to and those who have no choice would be easier if the definition of disabled was better delineated and structured and that if the difference between a life in front of the t.v. and the life sweeping streets was enough to where a person may actually choose to sweep and only watch t.v. after work!
Less people unfairly getting disability would automatically mean more money in the pot for workers! And if we do away with income tax and put in a federal sales tax and tax the blankety blank out of luxury spending then the person sweeping the streets would have more money for the necesseties and maybe even some for the un-essentials, like going to the movies or out to eat which would be taxed, but not as much as luxuries and sins. (and these would be in black and white with no fuzzy definitions or loopholes)
A yacht is a yacht is a yacht.
No loophole. I don't care if it is your house.
No body NEEDS to live in a yacht.
Anything over 1500 square feet per person on the ground would be considered excessive and taxed accordingly.
These are just a couple of examples; but to be merciful, I'll stop there.
But the street sweeper and the t.v. watcher should not share the same amenities. I am NOT saying punish the t.v. watcher; just REWARD the street sweeper so he is not tempted to do what anyone would do if there was no difference in the amount of change in his pocket.
And don't tax his income.
That will help solve a lot of this.
I am sorry, I just do not think that they choose to "become disabled" or "get on disability" for some illness, real or imagined or faked, because they cannot do anything meaningful.
It is because they get the same amount of money and better health care if they don't work than if they do work.
That is the problem.
The able should work, and they should be rewarded.
The disabled should not have to work, and they should not be punished, their needs should be taken care of; they should not suffer.
The rewarding of the worker is essential
Like I have said.
National health care is OK as long is the money comes from some sort of federal sales tax, especially a sin tax, and not out of my medical assistant's 10 hours of over time that she didn't get paid more than $30 for because it was all taken out in taxes.
And not out of the money I COULD be putting towards an eventual retirement (right now, zero is how much I can afford to put back, but w/o income tax, I could to put back a tad more.)
The disabled should have their needs met; the street sweeper should have a little bit more.
Period.
Besides, I like a nice clean street, and to me, that is a very important, and meaningful job.
And so is working at McDonald's (I did) and so is a security guard. (I don't think telephone marketing is so meaningful, but I am sure they are meaningful to the companies who hire them!!
I admire them just for taking that job!)
Posted by Jost on August 8, 2006, at 21:51:45
In reply to Re: cost of drugs, posted by kylenn on August 8, 2006, at 20:56:08
Kylenn,
I disagree with most of your economic and moral philosophy, as well as your theory of government.
One thing I noticed particularly is that you have certain ideas about what are and are not luxuries, which you think the government should enforce.
If nothing else, that sort of governmental intrusion into personal decision-making at the level of specificity that you suggest, and along the lines that you suggest, would involve a very coercive society.
Much more coercive than just having a tax system with certain percentages for certain income levels.
Also, it's not possible to theorize about how to organize a tax system without a well-developed sense of the budgetary demands that you have, the promises you've made that people have relied on in making all sorts of decisions, and many other factors that I'm not sure you've considered.
Jost
Posted by kylenn on August 8, 2006, at 21:52:37
In reply to Re: Yikes! I agree with Auntiemel » Estella, posted by Phillipa on August 8, 2006, at 20:28:58
Of course someone with ALS should qualify (automatically) for disability.
That is what I am talking about.
THAT is a REAL disease with OBJECTIVE findings.
YOU CANNOT FAKE ALS!
Posted by Estella on August 8, 2006, at 22:04:50
In reply to Re: Yikes! I agree with Estella, posted by kylenn on August 8, 2006, at 21:27:29
> but why the ER? why in the middle of the night? why not when they were feeling really bad? why not this morning? why not in a couple of hours? Why is your 6 year old up at 4 am on a school night?
have you asked them?
> I just fail to believe that that many people really think that waiting until some ungodly hour (or during the day) and GO TO THE ER for something that IS NOT AN EMERGENCY are abusing the system, they know it, and they simply couldn't care less. They aren't paying for it.
have you asked them why they do this?
maybe they haven't really thought about it...> When I work the ER, I am very lenient on what I consider an "emergency" because I try to look at it through the eyes of the patient. But when I can see that it is just blatant abuse of the system. I realize new parents are frightened and nervous of every little sniffle! I know that a child that you thought would get better, but didn't and now it is three a.m. and you are REALLY getting worried that something is terribly wrong is an emergency.
Right.
> Like a kid with "ringworm" in the ER.
> When was the last time ringworm killed anyone?Do you think the people who come in to the ER know that their kid has ringworm and know that it won't kill them? You are the doctor, remember.
> That is wrong, and they know it, and if it is repeated after it is brought to their attention there should be some repercussions, and THAT is what will increase the efficiency of the ER and THAT is what will bring health care costs down in this one small slice of the pie, and THAT is putting personal responsibility back where it belongs. On the person; not the public.
I see. You good patient doctor... They bad poor and abusing the system.
Sorry you are overworked... Sounds to me like... You are overworked.
What concerns me about this is the knowing that the person is poor -> thinking they are likely to be abusing the system inference.
I mean... Suppose some wealthy and dignified businessman comes in at 4am with the sore throat thing. If he was paying... Would you consider him to be abusing the system. Is it that these people aren't paying?
I'm sorry you feel so strongly about this.
But this reminds me of how people have made assumptions about me all my life. Poor therefore... And you wouldn't believe what people come up with. If you want people to 'abuse' the system then the fastest way to get them to do that is to... Begin with the assumption that they will.
I don't think people tend to think they are abusing. I mean... Doctors are on duty whether people go or not - right? Maybe they can't get time off work during the day. Maybe they think that there will be less wait at night. Maybe their kid couldn't sleep and they did feel worried.
If you think they are abusing the system... Well then I guess you aren't going to be feeling so sympathetic to them.
I'm sorry you are stressed.
But I still don't condone judging a group of people based on their income or lack thereof.
Posted by Phillipa on August 8, 2006, at 22:14:49
In reply to Re: Yikes! I agree with Auntiemel, posted by kylenn on August 8, 2006, at 21:52:37
Kylenn go back and read your original post . I don't believe you said heath care was a basic right but you are now. Love Phillipa
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