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Lol, I said that when I started on these boards, I had more libertarian leanings....

I guess in reality, I'm more of a utilitarian, the most good for the most people.

But, the more I look at our history, as well as what's going on right now, I'm more afraid of the gak the Republicans want to get up to than I am of what Sanders is after (and at least he's more honest and up-front about his views and leanings than most Rs are)

 CptJake wrote:
I honestly do not see how anyone who has any libertarian leanings can believe a socialist is the best person for President.

You've never heard of libertarian socialism?

The US Libertarian Party is not the ultimate authority on libertarianism, despite how hard it tries to be.

 Ensis Ferrae wrote:
Granted, Sanders hasn't really touched the whole Bush thing that I know of....

My inner child is laughing his head off at the double entendre there.

 sebster wrote:

 Ensis Ferrae wrote:
Granted, Sanders hasn't really touched the whole Bush thing that I know of....

My inner child is laughing his head off at the double entendre there.

Lol... yeah, I didn't really even see it that way till you pointed it out. touche

 whembly wrote:
He ain't nothing like his brother... Jeb comes off very cerebral here and works the crowd really well.

He's not my first choice (nor my 2nd or 3rd!), but... if he's the nominee... I'll vote for him.

He’s an odd sort of candidate. As you say his campaigning skills are strong, and that should carry him quite far. But get past that and you’ve basically got the same song that every Republican is singing. Nothing wrong with that, of course, but anyone can do that, in order to stand out you need something. Jeb is relying on his time as Florida governor to try and substantiate that he really knows how to hold back government and let growth flourish… but the most cursory look past Jeb’s own story will show it’s pretty much a crock.

Nothing he did created extra growth in Florida, he basically sat on an even bigger housing bubble than we saw in other states, and when it popped the slump that followed was harder than you see in other states, so much so the state still hasn’t recovered, and is lagging the rest of the country by quite some way.

As a precautionary tale for unregulated markets and wasted booms with excessive tax cuts, Jeb has a lot to offer, as a Republican candidate he really should be DOA.


EDIT – Just thinking about this, it kind of reads as a general dig at Republicans. That isn’t my intent, at least it isn’t my intent this time My point is more that there are candidates out there that can sell the Republican message with their achievements way better than Jeb Bush. Perry, for instance, actually presided over a state that showed sustained growth above the national average, but you can actually link that growth to Texas small government principles.

 sebster wrote:

As a precautionary tale for unregulated markets and wasted booms with excessive tax cuts, Jeb has a lot to offer, as a Republican candidate he really should be DOA.

If only you could meet my neighbor... you're so much more eloquent than I in convincing people

 whembly wrote:

Here, in the states, everything is so specialized. You barely see your attending physician.

Unless you are referred to a specialist, or have a decent insurance plan.

 whembly wrote:

It's the Nurses, Respiratory Therapists, Lab tech, Radiologist, etc...

Physician are becoming more like, research analyst than actual caregiver.

Radiologists are physicians. Respiratory therapists are not, but they are vetted in a manner similar to RNs; a high standard.

When have you ever seen a lab tech?

I think he means compared to countries like mine, where your primary point of contact is your GP, and you get farmed out to specialists less. It's a common aspect that gets pointed out as a difference between our two systems that I have heard from a lot of people. Admittedly they were all Australians, so take it with salt since they haven't all been to the US, but yeah.

If only Jeb would have ran instead of his mentally challenged/recovering alcoholic brother in 2000... My life might have been different

So.... the trump is running for president. Now there's a republican candidate i could get behind. Middle east - you're fired.

 motyak wrote:
I think he means compared to countries like mine, where your primary point of contact is your GP, and you get farmed out to specialists less.

In the US the primary point of contact is a GP's office, you just may not see the GP himself. If the RN determines that your issue is serious you'll probably be passed on to an NP. If it is really serious, or your insurance is really good, the RN will say "Hey, GP, come look at this person." In that event the GP won't likely be caring for you, he'll probably write a prescription or a referral; same as an NP in that office would do.

 dogma wrote:
In the US the primary point of contact is a GP's office, you just may not see the GP himself. If the RN determines that your issue is serious you'll probably be passed on to an NP. If it is really serious, or your insurance is really good, the RN will say "Hey, GP, come look at this person." In that event the GP won't likely be caring for you, he'll probably write a prescription or a referral; same as an NP in that office would do.

There’s been various attempts to get registered nurses to take on a lot of the work that GPs do here. They’ve never really gotten anywhere but I’ve always thought they make a lot of sense. Sitting in the waiting room for 20 minutes after my appointment time just to get a repeat prescription for my gout medication just seemed like a waste of everyone’s time.


Automatically Appended Next Post:

 whembly wrote:
I should also add when I say "I want the German Model™"... I also mean: How clinics and hospitals are operated

Sorry mate, I didn’t respond to this for a while because it took me a while to put in to words what I finally realised about how we’ve debated this issue all the way through. You’ve looked at this issue from a procedural point of view, how different parts of the healthcare system are processed daily, because that’s what you do for a living. Whereas I’ve looked at it from an economic point of view, a big picture approach, because to be honest that’s really been the only area I’ve had the ability to engage on the issue, and the interest to do so.

I’m not sure that produces any kind of insight that will help us discuss this more constructively or anything like that, but it’s interesting, I think.

As to taxing the employee insurance as income, I'd be alright with that... but, not in a vacuum. There's a feth ton of other "easy" thing to incrementially fix.

Absolutely, it couldn’t be in a vacuum. Hell, I’d only agree with it if the money raised went to sensible things (like low income health insurance subsidies, or a change to low income tax rates).

 sebster wrote:

There’s been various attempts to get registered nurses to take on a lot of the work that GPs do here.

For some reason many people don't respect nurses. Probably a combination of misogyny and the association of nursing with femininity.

 dogma wrote:

 motyak wrote:
I think he means compared to countries like mine, where your primary point of contact is your GP, and you get farmed out to specialists less.

In the US the primary point of contact is a GP's office, you just may not see the GP himself. If the RN determines that your issue is serious you'll probably be passed on to an NP. If it is really serious, or your insurance is really good, the RN will say "Hey, GP, come look at this person." In that event the GP won't likely be caring for you, he'll probably write a prescription or a referral; same as an NP in that office would do.

I've never known anyone in the US including under Medicare or Medicaid who ran under the system you just described.

 Frazzled wrote:

I've never known anyone in the US including under Medicare or Medicaid who ran under the system you just described.

You've never known a person who encountered, or engaged in, triage?

Maybe different doctors handle it differently. When I go to my doctor's office, it's the doctor I see. He does have a PA to help lighten the load for those who just need a quick referral to a specialist, though. But the only place I've experienced "triage" at is the emergency room.

 dogma wrote:

 Frazzled wrote:

I've never known anyone in the US including under Medicare or Medicaid who ran under the system you just described.

You've never known a person who encountered, or engaged in, triage?

EDIT: Frazzled typing hostilly like a jerk for no reason.
On a normal doctor visit, no. Unless you are going to an emergency room. Even then you'll still see the doctor.
Are you referring to ER visits?

I see the RN, and maybe the NP or physician; unless I am already seeing a specialist. In that case the appointment is usually a surgical followup or an in-office procedure.

 Frazzled wrote:

On a normal doctor visit, not at all. Unless you are going to an emergency room. Even then you'll still see the doctor.

Sure, and I didn't say otherwise.

 Frazzled wrote:

Wht the hell kind of medical care do you have where a nurse decides if you see the GP? You could sue the gak out of them.

Sure, if I were injured due to malpractice. Turns out nurses are competent and don't generally make injurious mistakes.

Note: I edited my comment for being harsh for no reason. I blame the lack of barbeque due to Tropical Storm Bill.

 dogma wrote:
I see the RN, and maybe the NP or physician; unless I am already seeing a specialist. In that case the appointment is usually a surgical followup or an in-office procedure.

Again, thats not how it worked for my family on Medicare, nor how I've ever heard of it working. You must have some different sort of plan.

Automatically Appended Next Post:

 Frazzled wrote:

On a normal doctor visit, not at all. Unless you are going to an emergency room. Even then you'll still see the doctor.

What is a normal doctor visit?

What? You know normal checkups. Are you still a youngin and don't have those yet? remember, when the doc puts the glove on, stop him and say "Get your jollies somewhere else doc. I know there's a blood test for that now!"

 Frazzled wrote:

Wht the hell kind of medical care do you have where a nurse decides if you see the GP? You could sue the gak out of them.

Sure, if I were injured due to malpractice. Turns out nurses are competent and don't generally make injurious mistakes.

A good lawyer would blow that right. Something about not be licensed to practice medicine...

 Frazzled wrote:
.
Are you referring to ER visits?

Visits within an HMO network.

 Frazzled wrote:

What? You know normal checkups. Are you still a youngin and don't have those yet?

My normal checkups involve knees, ankles, shoulders, hips, and my neck. I am old beyond my years.

 Frazzled wrote:

A good lawyer would blow that right. Something about not be licensed to practice medicine...

RNs and NPs are licensed to practice medicine.

Please let someone request that Trump release his original long-form birth certificate

 dogma wrote:

 Frazzled wrote:
.
Are you referring to ER visits?

Visits within an HMO network.

 Frazzled wrote:

What? You know normal checkups. Are you still a youngin and don't have those yet?

My normal checkups involve knees, ankles, shoulders, hips, and my neck. I am old beyond my years.

 Frazzled wrote:

A good lawyer would blow that right. Something about not be licensed to practice medicine...

RNs and NPs are licensed to practice medicine.

RNS are certified to a certain level only.


Automatically Appended Next Post:

 A Town Called Malus wrote:
Please let someone request that Trump release his original long-form birth certificate

I agree.

 sebster wrote:

 whembly wrote:
I should also add when I say "I want the German Model™"... I also mean: How clinics and hospitals are operated

Sorry mate, I didn’t respond to this for a while because it took me a while to put in to words what I finally realised about how we’ve debated this issue all the way through. You’ve looked at this issue from a procedural point of view, how different parts of the healthcare system are processed daily, because that’s what you do for a living. Whereas I’ve looked at it from an economic point of view, a big picture approach, because to be honest that’s really been the only area I’ve had the ability to engage on the issue, and the interest to do so.

I’m not sure that produces any kind of insight that will help us discuss this more constructively or anything like that, but it’s interesting, I think.

This is basically how it was explained to me, by a German when I was living there:

Everyone is required, by law, to have health insurance. Now, there are a number of "private" insurance plans (read: corporate, like Humana or BC/BS), but if you cannot afford to pay for insurance, and there are numerous forms to fill out to show this, you and your family are put onto a State plan. The reason this works is because through regulation, every health insurance company in Germany pays into a single "pool" which keeps costs down for most people. On top of that, unlike the US, these same insurance companies can only charge a certain percentage of your monthly income for your premiums each month.

By capping how much you pay, and combining the "wealth" they have a practical, and artificial means of making insurance affordable for all.

 Frazzled wrote:

RNS are certified to a certain level only.

The same is true of GPs and NPs, but they are all licensed. So long as the person was acting within their competence it would be difficult for a plaintiff to win a suit.

 sebster wrote:

Automatically Appended Next Post:

 whembly wrote:
I should also add when I say "I want the German Model™"... I also mean: How clinics and hospitals are operated

Sorry mate, I didn’t respond to this for a while because it took me a while to put in to words what I finally realised about how we’ve debated this issue all the way through. You’ve looked at this issue from a procedural point of view, how different parts of the healthcare system are processed daily, because that’s what you do for a living. Whereas I’ve looked at it from an economic point of view, a big picture approach, because to be honest that’s really been the only area I’ve had the ability to engage on the issue, and the interest to do so.

I’m not sure that produces any kind of insight that will help us discuss this more constructively or anything like that, but it’s interesting, I think.

Indeed man. We're definitely debating this from different angles.... nothing wrong with that, because maybe we can educate each other on these issues (or at least spawn of avenues of research on our own time).

From my perspective, we can do much, MUCH better with our system... which doesn't necessarily means throwing more money at the current model.

This industry is so heavily regulated... we might as well as go to a single payer system, ala NHS/Canada. Can't cost that much more than it does now.


Automatically Appended Next Post:

 Ensis Ferrae wrote:

This is basically how it was explained to me, by a German when I was living there:

Everyone is required, by law, to have health insurance. Now, there are a number of "private" insurance plans (read: corporate, like Humana or BC/BS), but if you cannot afford to pay for insurance, and there are numerous forms to fill out to show this, you and your family are put onto a State plan. The reason this works is because through regulation, every health insurance company in Germany pays into a single "pool" which keeps costs down for most people. On top of that, unlike the US, these same insurance companies can only charge a certain percentage of your monthly income for your premiums each month.

By capping how much you pay, and combining the "wealth" they have a practical, and artificial means of making insurance affordable for all.

Indeed... this is how the PPACA should've evolved into....

 whembly wrote:

Indeed... this is how the PPACA should've evolved into....

Legislation capping premiums and creating a public option will not pass in the present US environment unless a conservative Republican introduces it. This is very unlikely.

 dogma wrote:
For some reason many people don't respect nurses. Probably a combination of misogyny and the association of nursing with femininity.

That’s probably part of it. I think another part is the expectations people have when it comes to healthcare – people feel uncomfortable about seeing a less skilled person, just in case it might be something more than a regulation cold. This is compounded by healthcare systems in which the person receiving the treatment pays little of the cost of the visit – if they were paying $100 out of their own pocket for the doctor, or $50 for the nurse you might see a lot more people accept the nurse.

 dogma wrote:

 whembly wrote:

Indeed... this is how the PPACA should've evolved into....

Legislation capping premiums and creating a public option will not pass in the present US environment unless a conservative Republican introduces it. This is very unlikely.

I agree.

A start would be to somehow enforce pricing/cost visibility on every facet of healthcare.

It's so opaque, it's largely immune to *market* pressure. The public's ire towards the insurance industries themselves is largely misplaced.

'Tis why I've always advocated incremental reforms.

I have far more respect for nurses than doctors, nurses at least seem to wash their hands, doctors seem to have disease resistant physicians hands (TM)

 sebster wrote:

 dogma wrote:
For some reason many people don't respect nurses. Probably a combination of misogyny and the association of nursing with femininity.

That’s probably part of it. I think another part is the expectations people have when it comes to healthcare – people feel uncomfortable about seeing a less skilled person, just in case it might be something more than a regulation cold. This is compounded by healthcare systems in which the person receiving the treatment pays little of the cost of the visit – if they were paying $100 out of their own pocket for the doctor, or $50 for the nurse you might see a lot more people accept the nurse.

Having a sister-in-law who is a nurse, and hearing her stories, I actually have pretty much changed my views on the Doctor/nurse relationship/respect.... As she once ranted to me (well, me and my wife, her husband wasn't home yet).. she regularly has to correct doctors on medication. It is her and her coworkers that actually know the patients, it's they who take BP, medical history, connect IVs and fluids, clean up poo and pee and all manner of bodily fluids... the doctor's rarely interact with the patients, instead they interact more with the chart and the nurse.