The Sad Case of the Patient Protection and Affordable Care Act

[brookyone]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Trying to please everyone is unrealistic. It gets us into the mess we're in now. This is why I don't like let's-be-friends centrists or people who put their emotions ahead of their brains. You don't think it's realistic because you're too wrapped up in your feelings.

Or "too wrapped up" in common sense.

Wrong gender guess per your rep BTW. I buy my contraception devices at the drugstore.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Trying to please everyone is unrealistic. It gets us into the mess we're in now. This is why I don't like let's-be-friends centrists or people who put their emotions ahead of their brains. You don't think it's realistic because you're too wrapped up in your feelings. I think don't work don't eat is absolutely perfect. Maybe with that, people in this country will once again have some character about them.

It seems to me that you are being unrealistic here. Some people are born with genetic defects...would you perform infanticide on them? Some people suffer debilitating injuries through no fault of their own, would you just let them starve?

"The perfect is the enemy of the good."

-- someone famous, I suppose....

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

It seems to me that you are being unrealistic here. Some people are born with genetic defects...would you perform infanticide on them? Some people suffer debilitating injuries through no fault of their own, would you just let them starve?

"The perfect is the enemy of the good."

-- someone famous, I suppose....

Life throws curve balls. It happens. How you react to those curve balls is what develops character.

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Trying to please everyone is unrealistic. It gets us into the mess we're in now. This is why I don't like let's-be-friends centrists or people who put their emotions ahead of their brains. You don't think it's realistic because you're too wrapped up in your feelings. I think don't work don't eat is absolutely perfect. Maybe with that, people in this country will once again have some character about them.

Life throws curve balls. It happens. How you react to those curve balls is what develops character.

THis sort of response sounds wonderful if you were a politician, would play to the those wide of the center and be absolutely impossible to pass into law. Taking any sort of emotion out of it, no matter how much you want to play hard ball the general public does not have the stomach to follow through. At least half the population would be diametrically opposed to this and the in the rest you wouldn't find enough to get anywhere.

THanks FF and joect for the thoughtful responses. I really wish the politicians were not so focused on the reactionaries in the respective parties and could use the some of those solutions.

2cents- I would salary everyone. Too much incentive to do too much or get penalized if you care for the patient instead of the insurance company.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Life throws curve balls. It happens. How you react to those curve balls is what develops character.

"what doesn't kill us, makes us stronger"
-- naive idealist

"what doesn't kill us, maims us for life"
-- reality

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Remember how "getting coverage for people with pre-existing conditions" was supposed to be a major rationale for this unprecedented experiment in hubris?

How's that going so far?

The Affordable Care Act established a federally funded risk pool—the Pre-Existing Condition Insurance Plan—that allows individuals with such disqualifying conditions to buy a policy for the same premium a healthy person would pay. About 82,000 people have signed up as of July 31, according to the Kaiser Family Foundation's statehealthfacts.org.

That is not a misprint. Out of a population of more than 300 million, some 82,000 have the problem that was cited as the principal reason for spending $1.8 trillion over the next 10 years and in the process [author's editorial aside].

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

We want to contain medical costs.
We think it is Ok for insurance companies to pay people who do not have advanced medical degrees to make decisions regarding what will be covered.
We are offended when it is suggested that a team of medical experts make general recommendations regarding care for certain diagnoses
We declare people sshould have personal freedoms to make decisions regarding medical care.
We complain that end of life care costs too much
We do not think it is OK for the patient to have an advance directive that says they should not get care or the family can decline further treatment
We have people who go to court to forbid withdrawal of life support systems for those outside their family
We want to ban assisted suicide.

We actively work to ban assisted suicide (Mass currently has an initiative re: assisted suicide)
We are upset when the end of life care costs large sums of money
We do not want people to be paid to discuss what options people have regarding end of life
We expect people to figure out how to navigate the system and to make informed decisions regarding end of life care
We are afraid end of life discussions are a way to decrease cost to system
We do not want to hear about the studies that show people do better medically when they have those discussions
We want church and state to be separate.
We want to cut funding to Planned Parenthood/clinics that provide care to those who are economically challenged because we do not believe birth control is what God wants
We do not want to fund education programs that teach prevention of pregnancy because kids should be abstinent
We are frustrated when young women get pregnant before marriage.

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

We actively work to ban assisted suicide (Mass currently has an initiative re: assisted suicide)
We are upset when the end of life care costs large sums of money
We do not want people to be paid to discuss what options people have regarding end of life
We expect people to figure out how to navigate the system and to make informed decisions regarding end of life care
We are afraid end of life discussions are a way to decrease cost to system
We do not want to hear about the studies that show people do better medically when they have those discussions
We want church and state to be separate.
We want to cut funding to Planned Parenthood/clinics that provide care to those who are economically challenged because we do not believe birth control is what God wants
We do not want to fund education programs that teach prevention of pregnancy because kids should be abstinent
We are frustrated when young women get pregnant before marriage.

Les

My thoughts
1. Even the Globe seems to be against the proposed Mass. law on assisted suicide. IIRC, they think its poorly written (at least somebody read it)
2,3 & 4 -- No problem with discussions on end of life care. Some may say, keep me fed and watered and comfortable and let nature take its course. Others want to prolong their life as long as possible. That's their decision, and as long as they can afford it, no problem. When they can't, back to fed, watered, and comfortable and let nature take its course.
5. -- It can be - who is doing the counseling and do they have an agenda?
6. -- No problem. Don't hide the truth. Doc #1 did that to my Dad. Doc #2 told him he had 2 weeks to live (that's about what he lasted).
7. -- they are, but religion cannot be removed from the public square, otherwise we may end up with Germany in the 30's.
8. -- If all PP did was birth control, I'd hold my nose and look the other way. But I will not fund their abortion activities.
9. -- Kids are jumping into bed with each other waaayyyyy too early and for all the wrong reasons. Why? Is the culture to blame where the sex act is being treated as just another biological function and not something more?
10. Yes. Aren't we all???

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Les

My thoughts
1. Even the Globe seems to be against the proposed Mass. law on assisted suicide. IIRC, they think its poorly written (at least somebody read it)
2,3 & 4 -- No problem with discussions on end of life care. Some may say, keep me fed and watered and comfortable and let nature take its course. Others want to prolong their life as long as possible. That's their decision, and as long as they can afford it, no problem. When they can't, back to fed, watered, and comfortable and let nature take its course.
5. -- It can be - who is doing the counseling and do they have an agenda?
6. -- No problem. Don't hide the truth. Doc #1 did that to my Dad. Doc #2 told him he had 2 weeks to live (that's about what he lasted).
7. -- they are, but religion cannot be removed from the public square, otherwise we may end up with Germany in the 30's.
8. -- If all PP did was birth control, I'd hold my nose and look the other way. But I will not fund their abortion activities.
9. -- Kids are jumping into bed with each other waaayyyyy too early and for all the wrong reasons. Why? Is the culture to blame where the sex act is being treated as just another biological function and not something more?
10. Yes. Aren't we all???

My point is we are very conflicted in our views not that I am sure what is right. People hold views but do not think about what the fallout of those views can be. Example- Clinic in local HS dispensed BC and did education regarding prevention of pregnancy. Rates of pregnancy went way down. The numbers were astounding in a fairly short period of time. Funding was cut to these programs to 'balance the budget' and because there were those who weren't in agreement that govt should fund this type of venture. Rates went up significantly. This had the unintended affect of costing a lot of cash because a) the pregnancy medical costs b)the baby has medical costs c) mother can't afford daycare so can't work. This funding was eventually restored but not at the previous level and the numbers decreased again. We can argue all we want about the principle of the thing but the reality is that there are young people who have sex no matter what we think about the morality. That costs MONEY. We don't want to provide educationbecause of cost and morality but that is proven to decrease early sex .

THe PP thing leaves me conflicted- I would prefer no abortions were ever needed. I have a hard time with people who feel it is OK in certain circumstances and not in others- if you think it is murder it is no matter whether rape is involved or not. (the guy being lambasted in the press right now is probably the least hypocritical of us all). As a society we do nothing to make sure these babies or their mothers have a chance at success- that is all left up to serendipity and usually that means the young mother is doomed a poor economic situation and her kid is at a disadvantage.

The asst suicide ads right now are beyond irritating. I could understand argument on moral cause but these ads are very misleading. It makes it sound like the person can walk into the pharm and score seconol on a whim. It also says families dwon't be involved at all. Well- from what I understand it isn't a quick process to get OK'd for the drug. The person should have the personal liberty to make the decision regardless of whether we would make the decision differently. In a perfect situation the family should be involved but they shouldn't have any say in the final decision. I find it the implication that those counseling regarding end of life would have ulterior motives disturbing. In my experience the problem is the inability to discuss things realistically/folks not having the gonads to tell patients they are in a bad way rather thn them trying to get people to forgo care. All the studies show people who chose the palliative care after a good discussion end up with a better outcome as far as outlasting expectations and having better quality of life.

In both abortion and the asst suicide thing I have strong personal opinions but those are my opinions. I don't want someone else having the right to tell me what I can do with my body when the decision is life changing. I don't think anyone should have the right to make my decisions.

[DrDemento]

Re: The Sad Case of the Patient Protection and Affordable Care Act

In both abortion and the asst suicide thing I have strong personal opinions but those are my opinions. I don't want someone else having the right to tell me what I can do with my body when the decision is life changing. I don't think anyone should have the right to make my decisions.

You pretty much have summed up my feelings very well also. I never have tolerated decisions being made for me-and especially resisted when it involved my medical decisions for anyone (my patients, my family, myself). I also particulary dislike when these items become political footballs and the popular press reporting one stupid poll after another about how this group or that group feels. The most disturbing of all however, is when they try to justify making these decisions for us based on some sort of statistical or scientific basis-when we all know that it is simply about the bottom line and the dollar.

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

You pretty much have summed up my feelings very well also. I never have tolerated decisions being made for me-and especially resisted when it involved my medical decisions for anyone (my patients, my family, myself). I also particulary dislike when these items become political footballs and the popular press reporting one stupid poll after another about how this group or that group feels. The most disturbing of all however, is when they try to justify making these decisions for us based on some sort of statistical or scientific basis-when we all know that it is simply about the bottom line and the dollar.

There needs to be a like button on here

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

9. -- Kids are jumping into bed with each other waaayyyyy too early and for all the wrong reasons. Why? Is the culture to blame where the sex act is being treated as just another biological function and not something more?

I think it's more that kids are treating sex like a rite of passage to becoming an adult. I know I've been chastised a few times because I've never had intercourse, and have seen shocked looks that I "could control myself". Sex doesn't make you a man/woman. What makes you a man/woman is the ability to create the consequences of having sex (and I'm talking the kids, not the diseases). Perhaps it's the artificial barriers to manhood/womanhood that are created by society (i.e. 18 years of age), and teenagers need a way to show they truly are biological adults.

[Foxton]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I think it's more that kids are treating sex like a rite of passage to becoming an adult. I know I've been chastised a few times because I've never had intercourse, and have seen shocked looks that I "could control myself". Sex doesn't make you a man/woman. What makes you a man/woman is the ability to create the consequences of having sex (and I'm talking the kids, not the diseases). Perhaps it's the artificial barriers to manhood/womanhood that are created by society (i.e. 18 years of age), and teenagers need a way to show they truly are biological adults.

Young people have sex?!!!! This has never happened in the history of the species! Surely this is some greater sign of moral decay! If only we could go back to the old days where kids in today's middleschool would be starting families this would fix itself!

[sagard]

Les

My thoughts
.....
8. -- If all PP did was birth control, I'd hold my nose and look the other way. But I will not fund their abortion activities.

Why should you be excluded from paying for something you consider immoral?

Using google numbers from 2008 if the gov paid the entire cost of every abortion, it would have been roughly $700M. Meanwhile I find our war machine to be immoral, but I still must contribute to what Politico says might end up being $4.4T over the last ten years.

I'll listen to people who want to make abortion illegal, it is their right and they can make reasoned arguments. But saying you shouldn't have to pay is BS.

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Why should you be excluded from paying for something you consider immoral?

Using google numbers from 2008 if the gov paid the entire cost of every abortion, it would have been roughly $700M. Meanwhile I find our war machine to be immoral, but I still must contribute to what Politico says might end up being $4.4T over the last ten years.

I'll listen to people who want to make abortion illegal, it is their right and they can make reasoned arguments. But saying you shouldn't have to pay is BS.

This.