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Enlil
OTD God-King




Registered: 08/16/03
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Compete? Like public schools compete with private schools? When funding is determined by statute, there is no competition. Like all government employees, they'll do the minimum they can to keep their jobs and that's it.
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Falcon91Wolvrn03
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A public option is fine, provided the Government subsidizes the costs of whichever plan people choose (otherwise it's too expensive for the poor).
-------------------- I am in a minority on the shroomery, as I frequently defend the opposing side when they have a point about something or when my side make believes something about them. I also attack my side if I think they're wrong. People here get very confused by that and think it means I prefer the other side.
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ballsalsa
Universally Loathed and Reviled



Registered: 03/11/15
Posts: 22,490
Loc: Foreign Lands
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Re: Dumpcare [Re: Enlil]
#24188681 - 03/24/17 12:09 PM (7 years, 1 month ago) |
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L.A. DWP is owned by the city, and provides excellent service at a very competetive price when compared to other energy providers in the region. Their employees enjoy good pay and benefits, and It contributes to the city's funding. I don't know anyone who has Edison, for instance, that doesn't wish they had DWP service.
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ballsalsa
Universally Loathed and Reviled



Registered: 03/11/15
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Quote:
Falcon91Wolvrn03 said: A public option is fine, provided the Government subsidizes the costs of whichever plan people choose (otherwise it's too expensive for the poor).
To be clear, i am in favor of single payer, but i was trying to feel out Enlil's position.
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Enlil
OTD God-King




Registered: 08/16/03
Posts: 67,515
Loc: Uncanny Valley
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From a philosophical/public policy point of view, I'd like to see a system that allows every man, woman, and child in the U.S. to have access to a doctor when he/she/it needs one. This would obviously include life-threatening situations, but it would cover more than that. Having said that, it should not cover enough for this to be the first choice for people. It should be the baseline or backup plan. It should be designed such that we're not leaving people so fucked that they can't function, but we're also not making them comfortable so that they have no incentive to work to get a better plan.
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Falcon91Wolvrn03
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Re: Dumpcare [Re: Enlil]
#24188696 - 03/24/17 12:13 PM (7 years, 1 month ago) |
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I can agree with that.
-------------------- I am in a minority on the shroomery, as I frequently defend the opposing side when they have a point about something or when my side make believes something about them. I also attack my side if I think they're wrong. People here get very confused by that and think it means I prefer the other side.
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Enlil
OTD God-King




Registered: 08/16/03
Posts: 67,515
Loc: Uncanny Valley
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Quote:
ballsalsa said: L.A. DWP is owned by the city, and provides excellent service at a very competetive price when compared to other energy providers in the region. Their employees enjoy good pay and benefits, and It contributes to the city's funding. I don't know anyone who has Edison, for instance, that doesn't wish they had DWP service.
You do now.
I've had Edison for about 15 years, and I had DWP for about 8. DWP is twice the cost, half the service, and unbelievably rude when I did actually have to deal with their employees.
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Enlil
OTD God-King




Registered: 08/16/03
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Quote:
Falcon91Wolvrn03 said: I can agree with that.
So, really, we only disagree on what it takes to make that happen.
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Falcon91Wolvrn03
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Re: Dumpcare [Re: Enlil]
#24188733 - 03/24/17 12:26 PM (7 years, 1 month ago) |
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Correct. You seem to think (correct me if I'm wrong) private insurers would better look out for our interests than Government.
Granted, Government's record hasn't been stellar since the 80's, but neither has private insurance.
-------------------- I am in a minority on the shroomery, as I frequently defend the opposing side when they have a point about something or when my side make believes something about them. I also attack my side if I think they're wrong. People here get very confused by that and think it means I prefer the other side.
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sweeper54



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Ok this is the new try to get Dumpcare passed, 12 new amendments.
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Enlil
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It's not so much that they'd look out for our interests. It's that they'd look out for their interests, one of which is retaining customers. Another of those interests is to avoid liability for failure to provide care.
Government, on the other hand, won't care about retaining customers or looking out for our interests. They also won't have any fear of lawsuits for failure to provide coverage, etc.
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sweeper54



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Re: Dumpcare [Re: Enlil]
#24188795 - 03/24/17 12:48 PM (7 years, 1 month ago) |
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Kryptos
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Re: Dumpcare [Re: Enlil] 1
#24188947 - 03/24/17 01:39 PM (7 years, 1 month ago) |
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Quote:
Enlil said: I'd rather you tax the shit out of me to pay for education of future doctors. Lets flood the market with them and drive costs down.
I think this might have some unintended side effects.
First, currently, there are legal limits to the number of residents per hospital, under the somewhat reasonable assumption that residents should be supervised in small groups by doctors, as opposed to a lecture-like scenario. Considering that many hospitals are consolidating into mega-hospitals so that they can still negotiate with insurance company conglomerates instead of just being strongarmed out of the markets, I am not optimistic that we can even maintain the number of doctors we have without dropping standards significantly. (Do *you* wanna visit the doctor that just barely passed because there weren't enough doctors in the graduating class and they grabbed from the fail pile?)
Second, and this is the one that worries me the most, where are all these new doctors gonna come from? I currently teach an Organic Chemistry lab, required for all pre-meds, and I gotta say, the pre-meds scare me the most. The Chem majors all do their best and get As and Bs. The biologists try and get Bs and Cs. The pre-meds? They don't try, and when they get a C, I get an email from the lab supervisor asking me if I'm grading unfairly, and have to sit down and defend every instance where I took off points. This is usually easy, and in more than half of all of these cases, the students walked out of that meeting with a lower grade than they walked in with.
Since medical school standards are effectively perfect grades, it seems that becoming a doctor and becoming a politician are surprisingly similar. Never accept that you are not good enough, just call the other person an idiot and complain until they give you an A to make you leave.
This also reminds me a bit of this "action plan" committee I was on at my school. Their "action plan" included expanding enrollment and graduation rates at an alarming rate, something like ~15% over the next half decade. This sounds great on paper, huge growth, etc. The problem is, how do you maintain standards? There's a fairly set number of students that will be reaching college age every year, determined by the birthrate two decades back. If you want to see huge short term growth, then the easiest way to do it is to drop standards and devalue the degree.
Anyway, back on Dumpcare topic: I'm looking at this death spiral terminology for the first time, and I'm looking at some of the specifics, and I'm looking damn close at that 30% premium hike for dropping insurance, and the fact that there's a chance that it will be repealed if the more conservative fringe elements continue to get their way like the other concessions in the bill.
If they get rid of that 30% tax hike, I sure as shit am gonna lapse my insurance. I'm young and healthy, I won't *need* insurance for at least a decade barring random chance, and that right there is the very definition of the cause of the death spiral. And if the "random chance" scenario plays out, I'll just declare bankruptcy and take the free meds. Our society has yet to develop to the point where we allow people to die in the street without calling an ambulance since they don't have insurance.
And declaring bankruptcy is an important stepping stone to the presidency.
Edited by Kryptos (03/24/17 01:42 PM)
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koods
Ribbit



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Re: Dumpcare [Re: Kryptos] 2
#24188955 - 03/24/17 01:41 PM (7 years, 1 month ago) |
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Yay, it's dead. The bill has been scuttled.
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Enlil
OTD God-King




Registered: 08/16/03
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Loc: Uncanny Valley
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I have no problem lowering standards for doctors. Not every doctor needs to be brilliant. There can certainly be multiple tiers of medical licenses to manage the different standards. Realistically, a psychiatrist doesn't need the same skill set as an orthopedic surgeon.
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koods
Ribbit



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Re: Dumpcare [Re: Enlil] 1
#24188982 - 03/24/17 01:48 PM (7 years, 1 month ago) |
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It's already like that. A surgeon spends many years more in residency than a psychiatrist.
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Enlil
OTD God-King




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Loc: Uncanny Valley
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Re: Dumpcare [Re: koods]
#24188990 - 03/24/17 01:50 PM (7 years, 1 month ago) |
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So, admission standards for medical schools can reflect that.
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koods
Ribbit



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Re: Dumpcare [Re: Enlil] 1
#24189000 - 03/24/17 01:53 PM (7 years, 1 month ago) |
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Medical schools are like basic training. The education in specialties comes during the residency period of training.
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Kryptos
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Re: Dumpcare [Re: Enlil]
#24189042 - 03/24/17 02:12 PM (7 years, 1 month ago) |
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Quote:
koods said: Medical schools are like basic training. The education in specialties comes during the residency period of training.
Which is why I bring up the first point of residency limits. Yes, they need to be addressed to reflect the mega-hospitals, but at the same time, this is also something that needs to be considered. Residents need to be up to par.
Quote:
Enlil said: I have no problem lowering standards for doctors. Not every doctor needs to be brilliant. There can certainly be multiple tiers of medical licenses to manage the different standards. Realistically, a psychiatrist doesn't need the same skill set as an orthopedic surgeon.
I agree with this. My GP/family practice doctor can be half-retarded for all I care, because all they do is give me a referral to a specialist. Heck, I would prefer to skip the GP all together and just talk to the receptionist for a few minutes, but I gotta do the dance.
On the other hand, imagine the news headlines: "family doctors across country incapable of passing basic surgical standards! Run for your lives!"
It's a bit like how I, a chem grad who teaches organic (and does pure organic chemistry), would probably have trouble passing a gen chem test because I've literally never used half the stuff I learned. I don't need to know how to calculate galvanic cell potentials off the top of my head, because I'm no electrochemist, but if I admit that to my students, well, see "meeting with lab director" above.
It's one of those things that is very obvious when you think about it for two seconds, but if you don't spend those two seconds of thought, I just admitted that I'm horribly underqualified to teach my students.
People are generally dumb.
Edited by Kryptos (03/24/17 02:15 PM)
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koods
Ribbit



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You don't need to know how to perform surgery to graduate from medical school.
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NotSheekle said “if I believed she was 16 I would become unattracted to her”
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