Why the U.S. Needs Universal Health Care...Now! - Intelligent debate wanted here...

Cobra Commander · 2003-10-15 15:22:41

Wow, I find myself agreeing with Clark more every day...

clark · 2003-10-15 15:24:20

LOL.

One down, six billion more to go.

Shaun Barrett · 2003-10-15 19:56:56

Clark, I believe your reply to Cindy's post about the complexities of medical practice stems either from a certain sense of mischief on your part towards her or a serious underestimation of how difficult it is to be a competent doctor.
You ask a plethora of ironic questions which are ostensibly designed to pull the rug out from under Cindy's argument but which, to my mind, betray the simplicity of your own position:-

1) "But do I need this information to set a bone? ... "
2) "When is it necessary to be aware of all the
chemicals in the human body? ... "
3) "When, and in what instances, is this information
necessary and relevant? .... Is there some reason we
can't learn why this is important? ... "
4) "No, but when are lab tests necessary? ... "
5) "Are we unable to learn? And again, when is this information
relevant and necessary? ... "
6) "No, diagnosing is easy. Being sure is hard. ..."

The fact that you don't know when any of the information Cindy alluded to about the human body is 'necessary and relevant' is fundamentally important here. Knowing what's relevant and what isn't, is crucially important in any health-care diagnosis.
Your almost plaintive 'Are we unable to learn?' is, in this context, amusingly theatrical and rather disingenuous. Of course, the answer is yes ... we can go to medical school!

And as for diagnosis being easy, that comment betrays a profound lack of understanding of how difficult diagnosis can be. Being a good diagnostician is the greater part of being a good practitioner because it relies on the successful synthesis of everything the practitioner has ever been taught - it requires knowledge, logic, experience, and judgment.
Your proviso that 'being sure is hard' is just a case of semantics. When your life is on the line and you're relying on a practitioner to make the right call, you want a good diagnosis ... simple as that!

If you believe in Josh's suggestion that more primary health care practitioners, with perhaps a lesser academic standard, is a good idea, then I think you should be talking about expanding the schools of nursing. Rather than dumbing down the doctors, how about supplementing the nursing training to create many more "District Nurses" with appropriate skills?
Would the public trust them and make use of them? Would their fee structure make them more accessible to the less well off? Would they also fall prey to the litigious scavengers in society, and their leech-like lawyers, thus creating further indemnity insurance stumbling blocks? I don't know.

But Clark, I feel you should stick with channelling your obvious intelligence into creative and constructive solutions to these problems, rather than revving up Cindy with rhetorical nit-picking.
:;):

Just a thought.

Josh Cryer · 2003-10-16 00:43:23

Do you honestly think Cuba does an "in depth" analysis of every person? If "in depth" study of a given persons physiology is 'necessary' to have healthy people, then why, pray tell, does Cuba rank as a first world in health care (let me clue you in that Cuba couldn't afford to do an "in depth" analysis every time someone sneezes, much less anually for the whole population; this isn't to praise Cuba, merely to use a bit of common sense)?

As long as people are well fed, and have good hygine (clean water, and bathing, etc), major sickness is almost automatically eradicated. And most bad sicknesses are self diagnosed anyway.

"In depth" analysises are good for catching certain things before your body tells you that you're getting sick (and thus, give doctors a chance to preemptively act), but by the same token, a visit once a year isn't guaranteed to catch something before it hits (ie, you could get sick with a slow cancer or whatever the day after you leave the doctor, and it could affect you for a whole year without you complaining).

The US has lots of poverty, but when it comes down to it, our longevity and birth rate is stunning; this has nothing with our health care, I don't think, it's all about our hygine (ie, mandatory vaccines, most people have running water; even the poor, food is avaliable very cheap and in quantity, etc).

So Shaun, do you think an in depth analysis of someone is necessary every time they visit a doctor? Or are you a hypochondriac? Heh, just kidding...

When I was a kid, we had welfare for a period when my dads back went out. I would get my blood pressure checked, someone would listen to my breathing, check my pulse, and check my blood count.

Tell me you don't think any more than that is necessary for the average person?

Most of that can be done by anyone with a microscope, stethoscope, and blood pressure gauge, though general blood analysis can quite happily be aided by higher technology which is isn't that costly to a first world (5 grand for an analyzer) and if created enmasse could be quite cheap; yes, these hematology analyzers don't need any more training than a VCR; and since unhealthy people have obvious deviations from the norm, they would be detected even by the most untrained 'nurse.' Then you get the highly trained professional.

In the future, I do expect hematology analyzers to be available in the palm of my hand (ie, like a diabetes machine), for cheap, and that was the point of my "diagnosis device" comment. Then 'checkups' could be done every night after I took a shower, but the honest truth of the matter, is that I know that when I'm sick... I'll know it. I don't need a little machine to tell me that.

Bah, I didn't even want to get into this discussion.

clark · 2003-10-16 04:14:08

Clark, I believe your reply to Cindy's post about the complexities of medical practice stems either from a certain sense of mischief on your part towards her or a serious underestimation of how difficult it is to be a competent doctor.

Everyone has an opinion about motives. :laugh: So far, you make number three in this thread.

The fact that you don't know when any of the information Cindy alluded to about the human body is 'necessary and relevant' is fundamentally important here.

Actually, I do have some idea of when that information is neccessary, and when it is relevant. That's why I pointed it out. All of those questions, all of Cindy's points regarding "doctor kit's" and how they are a bad idea were based on a premise of hospitalization. That's why I asked those questions. Precisely becuase they demonstrate the vast difference between a general check-up office visit versus that of a visit to intensive care.

No one is suggesting that you or I or anyone ellse should do many of the myriad of complicated things physicans do. Yet, to suggest that there are some things we cannot do that doctors do stretchs crediability.

Your almost plaintive 'Are we unable to learn?' is, in this context, amusingly theatrical and rather disingenuous. Of course, the answer is yes ... we can go to medical school!

If yes, then there is no barrier to enabling people to do for themselves. Now it simply a matter of deciding on what level of knowledge is neccessary.

And as for diagnosis being easy, that comment betrays a profound lack of understanding of how difficult diagnosis can be. Being a good diagnostician is the greater part of being a good practitioner because it relies on the successful synthesis of everything the practitioner has ever been taught - it requires knowledge, logic, experience, and judgment.

Yeah, if we want to identify the root cause of a neurological tick. Diagnosis is difficult, and it is easy. It depends on the situation, as with all things. But, by and large, in a general practioner setting, it's not overly complex. It becomes more of an issue when you start dealing with the various sub-speacialties. When you start drilling down.

However, I for one fail to see how any of this is affected by enabling people to care more for themselves. Maybe you could explain that to me.

When your life is on the line and you're relying on a practitioner to make the right call, you want a good diagnosis ... simple as that!

And here is where you prove my point. When your life is on the line, you do research to understand what it is that is going on, and you look for answers and solutions to your problem. This is the trend in health care. This is the result of information being freely available. People no longer HAVE to rely on a physician to make a determination (they had to because the doctors held all the info) becuase they figure it out themselves.

Josh's idea merely extends this trend and philosphy one more step. Why is that so bad?

If you believe in Josh's suggestion that more primary health care practitioners, with perhaps a lesser academic standard, is a good idea, then I think you should be talking about expanding the schools of nursing.

Did I say that? I commented on one idea, not all of them. I think it's an incredibly bad idea. So there. :laugh:

But Clark, I feel you should stick with channelling your obvious intelligence into creative and constructive solutions to these problems, rather than revving up Cindy with rhetorical nit-picking.

I saw an idea get unfairly treated, an idea I believe has value.

Palomar · 2003-10-16 05:19:11

*Hi Shaun.

Thanks for your input. You are reasonable, fair, and "get it"...like usual.

A reference keeps being made by some folks in this thread to the effect that my original comments were somehow related to "the premise of hospitalization."

That's either an unfortunate assumption or a mischaracterization/misconstrual of my statements on their part. ::Sigh:: And because of that, I suppose I should make one more (hopefully -clarifying-) post, as I don't care for misrepresentation (deliberate or otherwise) of my comments.

This is -not- about the "premise of hospitalization."

Any and all doctor's clinics/offices (multispeciality or singular) also consistently draw blood work, to check blood glucose levels, hemoglobins and hematocrits (each of which has a long battery of tests run within the group name), comprehensive metabolic panels, CBCs, platelets with differentials, and -many- other diagnostic serum and urine tests. Some clinics have their own laboratory services in a building (not hospital) in close proximity to their offices.

Many diagnoses are made in clinics/doctor's offices.

Persons ignorant of the general sphere of medical healthcare and how it is carried out wouldn't know this, of course. That "general office checkup" often can and does include blood draws, urine screenings, and the like...all of which involve centrifuges, diagnostic read-out machinery, and phlebotomy techniques. Not to mention a working knowledge of chemistry.

Most testing procedures are also -not- done on a "hospitalization" basis. X-rays, CAT scans, MRIs, and even biopsies/cold biopsies can be done in outpatient facilities.

I stated previously that *if* people can someday learn to do all this on their own, that'd be great. I simply don't foresee it, however, based on the sheer complexity of it all.

Josh raised some good points. For instance, I think of the home glucose-testing monitors diabetics can now purchase for home use, to screen their blood sugars throughout the day. This technology wasn't possible 10 years ago. However, -a lot- of endocrinological know-how from specialists (M.D.s) went into the creation of this home-at-hand marvel.

Sorry if what knowledge and familiarity I have with the medical/surgical arena (16+ years) offends anyone's wishful thinking. I think I've been fair and honest in my statements.

--Cindy

George H · 2003-10-16 05:50:19

There are people here who profess and proclaim God, Jesus, Christianity and religious beliefs...but I have yet to see you bring up their religious beliefs/practices/studies in an unrelated context, as if using it in a slying insulting way -- as you have done to me repeatedly.
I have, and I do. But then, many people who believe in their version of God are a lot less vocal about it than you are about Voltaire. You're not a bible thumper, you're a Voltaire thumper. Nothing wrong with that per se, but it's still pretty much the same thing.
Why do you do this?
I never cared for proselytizing.

ROFLMAO!!! Now read Cindy's sig line!! Hey Clark, looks kinda unfair of you to say she's a thumper & proslytizer when YOUR a member of her Voltaire group. LOLLOLOL. Seems your a hypacrite.

clark · 2003-10-16 08:39:59

Cindy can feel free to inform you all of the lenghty posts I leave there too. Go ahead.

This is all so weird now. Somehow I'm being faulted for looking into what she talks about. Some people consider that a sign of respect. But what the hell do I know.

As always, people make mistakes. I obviously made some by trying to meet half way. I see what that gets me.

Simply incredible.

Shaun Barrett · 2003-10-16 19:14:15

I always think it's interesting to see how people's feelings, experiences, or prejudices colour their arguments. If we do that, it helps us understand where someone might be coming from and helps us see why they say the things they say.

Josh is a self-declared anarchist (unless I've really got my wires crossed) and, presumably, dislikes or mistrusts large organisations, preferring us all to be individuals unbound by rules and regulations. Perhaps this is why he espouses individuality and freedom in all things(?), even to the point of opening up the practice of medicine to the masses.

Cindy sees the detailed side of medicine every day and has a deep understanding of just how complicated it really is and, therefore, how easily things can go wrong.
I've seen something of what she's seen and I have to say I agree with her.

Clark is a dark horse, as always, in all this. We don't know much about him (assuming the male gender! ); we don't even know his age and he declares no personal interests in the profile section. Clearly privacy is very important.
But we do know he's hurt by the way he's treated ("Somehow I'm being faulted for looking into what she talks about.").
We can almost see the look of puzzlement and pain on his face as his innocent well-meaning comments and questions are twisted around by others and turned against him. ("But what the hell do I know.")
But the look of pathos and incomprehension changes to one of grit and determination as his strength of character comes shining through ("As always, people make mistakes. I obviously made some by trying to meet half way. I see what that gets me. Simply incredible.")
With that, the stricken hero turns and strides purposefully into the sunset, wearing his wounded pride like a newfound badge of honour.

Ha ha !! :laugh:

An absolutely brilliant display of B-grade movie material, Clark! If you tried that on here in Australia you'd never live it down; you'd be ragged and bagged forever more!!

Since you're obviously not unintelligent, I have to deduce you jest with us, my friend. At least ... I sincerely hope that's the case!

clark · 2003-10-16 19:42:21

I always think it's interesting to see how people's feelings, experiences, or prejudices colour their arguments. If we do that, it helps us understand where someone might be coming from and helps us see why they say the things they say.

Wise words, peacemaker.

Some wear their hearts on their sleeve, but don't worry too much about my feelings though, I have few enough to begin with.

As for the grade you give my movie material, well, everyone is a critic.

This has all devolved into some petty bickering emotional tantrum. I like to think of it like a waltz.

Dum-de-dum-de-dum-de-do-de-dum
Da-de-da-de-da-de-da-dum.

Come-dance-with-me-de-dum-de-dum
Come-laugh-with-me-da-de-da-dum
Come-see-the-cries-de-dum-de-dum
And-join-the-merry-fun-de-dum!

Perhaps one day, I'll buy you a pint (not Foster though, that tastes like piss!) and we can have a merry ol' laugh with your chums in Australia.

Now, I reckon I better find me my horse and ride off into that western sunset, pardner. :laugh:

In the mean time, I have rainbows to catch in the valley of the blind!

Josh Cryer · 2003-10-16 20:28:06

Josh is a self-declared anarchist (unless I've really got my wires crossed) and, presumably, dislikes or mistrusts large organisations, preferring us all to be individuals unbound by rules and regulations. Perhaps this is why he espouses individuality and freedom in all things(?), even to the point of opening up the practice of medicine to the masses.

Hehehe, well put.

Spider-Man · 2003-10-16 22:29:57

[color=#000F22:post_uid0]I urge that everyone who reads this rent [b:post_uid0][i:post_uid0]Bowling for Columbine[/b:post_uid0][/i:post_uid0], as it directly pertains to everything relevant to this discussion, and so many others. I thought it was absolutely wonderful and poignant and frighteningly powerful, not to mention delightfully hilarious.

http://www.bowlingforcolumbine.com/about/index.php[/color:post_uid0]

clark · 2003-10-17 13:26:46

When the fury of gale and storm cause sail to billow far off course, the wise navigator tries a different tack.

Let me begin in agreement, instead of ending in disagreement, and then perhaps we might all meet somewhere else.

Cindy, Shaun, you are both correct. I agree with your point of view. I, and others, succumbed to a simplistic na?vet?. Idealism and optimistic beliefs led us astray. I cannot of course speak for the others, but perhaps I might frame this in such a way that we all can understand, and perhaps even say, yes, I agree now too!

Ordinary people have no place in doing what medically certified physicians do. Ordinary people are incapable of learning the vast amount of medical knowledge necessary to identify properly any probable illness they might, or might not have. Ordinary people lack the sophistication, or even the ability, to comprehend what might be causing, or might not be causing, their illness. Even if ordinary people could, by and large, these ordinary people cannot be trusted to come to the correct conclusions regarding their personal health, or the personal health of their family. After all, ordinary people have enough problems programming their VCR, or even doing their taxes. Cindy rightly points this out, and I was remiss not to see the truth in her words.

Ordinary people simply can?t do what medically trained physicians do. In order for ordinary people to do what medically trained physicians do, they would need more education. They would need more information, and we would have to trust that these ordinary people could learn and understand this necessary and vital information. My own questions previously in this thread, as Shaun pointed out, demonstrate how much ignorance related to this issue there is. I don?t know when much of this medical information would be necessary, obviously because I?m not a medically trained physician. So in all actuality, by enabling me to do some of the things that a medically trained physician does, we actually create a potential for more harm being done to my personal health than not.

Ordinary people must rely on medically trained physicians to understand their health, and their illness. These trained professionals, with access to medical resources, all of which require years of training and education, are better suited, and better qualified to determine the health status of ordinary people. Ordinary people, even if given access to the same medical resources, would still represent a danger to themselves, because they lack the necessary training and education to make proper use of these medical resources. Any expectation that ordinary people could learn to properly use these resources, or that they might educate themselves regarding their personal health are the result of naive and wishful thinking. How could we expect ordinary people to be concerned about their personal health?

Ordinary people have too much else to contend with, what with jobs, family strife, crime, politics, and a whole list of other more pressing personal issues. Expecting ordinary people to be more concerned with their personal health is unfair, and dangerous. Ordinary people are better off relying on these other medically trained people to understand their personal health, and explain it to them in a way they will understand.

Obviously, when it comes to our personal health, we are all better off by not enabling ordinary people to do more for themselves. Yes, ordinary people can learn rudimentary first aid. Indeed, ordinary people should have first aid kits. But a line must be drawn somewhere, and obviously, a ?doctor?s kit? of some kind would be more of a danger than not. Ordinary people should not do more than rudimentary first-aid, precisely because they are not medically trained physicians, and lack the necessary medical background to be effective. It is doubtful that ordinary people could even learn to be effective, even assuming they could, or would want to.

When your car breaks down, you take it to the mechanic; you don?t try to fix it yourself.
When there is a fire, you call the firemen; you don?t try to put the fire out yourself.
When you have a question, you find a teacher; you don?t try to learn the answer yourself.

So too when you are sick, you see a doctor; you don?t try to heal yourself.

Cobra Commander · 2003-10-17 19:08:05

Truly masterful, Clark.

Of course this coming from one who does fix his own car and put out fires, the one usually resulting from the other.

Spider-Man · 2003-10-18 18:07:28

I think, Cindy, that you're entirely correct, without a shadow of any doubt; you couldn't be closer to the truth, and you certainly spelled it out beautifully for us. I can't believe this whole argument went on for days about performing surgery on yourself... jeez.

And I'm not seeking any debates or extensive conversation; I'm a bit under the weather right now (ironic, huh?) -- I've got a cold coming on.

Aww, poor sweet Cynthia... *Hugs compassionately.*

If anyone doubts the veracity of what I'm trying to say here...

...they're crazy, and not in the good, Quixotic kinda crazy that I admire. You're always exactly right, milady, especially on matters of your ken.

Oh, and you're right too, Clark. *Smiles.*

Josh Cryer · 2003-10-18 21:03:51

Clark rocks, Cindy rocks, everyone here rocks. Great posts all around. I love you guys.

Palomar · 2003-10-24 07:59:19

*Bryon, I saw a news story last evening on ABC which will probably (like me) make your blood boil: A man in his 60s, worked all his life, many years as a high school principal (and who, in that capacity, brought in healthcare coverage for that school's employees decades ago), diagnosed with cancer for a few months now. He lives in Kansas.

The insurance company is refusing to pay for his chemotherapy treatments.

His doctor is bombarding the insurance company with letters, pleading with them to change their mind. The man and his wife are having to work their way through mounds and mounds of paperwork -- all kinds of rigamarole. It's being speculated that the insurance company is hedging and making things extra difficult, on the basis of "rationed care," i.e., if you want it, you have to jump through all sorts of hoops to get it. This is outrageous. As if a person suffering from cancer doesn't have enough problems already.

ABC contacted the insurance company (I wish they would have outed the names of those a$$holes), and "now" they are "reconsidering" their decision. I hope they do buckle under the pressure and provide this man with the benefits he needs!

As long as I've worked in healthcare, I've -never- heard, until now, of an insurance company refusing to pay for chemotherapy treatment of a policy holder. This man has been with this insurance company for many, many years, his cancer diagnosis is recent: This is no "pre-existing condition."

It's a pity he can't take out a lawsuit against them. If a doctor were to withhold treatment, s/he could be sued. If the insurance company refuses to provide benefits for this man (which he has paid against down the years), I think that's tantamount to murder. Screw these greedy jerks.

--Cindy

SpaceNut · 2019-07-08 19:17:36

bumping topic so that I can find it later as its filled with artifacts.

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