Lurker > wah_wah_wah

Some of the choices in this topic are baffling.

I have been binge watching movies this year. The saddest were Shoah and 12 Years a Slave.

wet

It is a dire, dire docks of a problem

Coffeebeanz posted...

wah_wah_wah posted...

Coffeebeanz posted...

wah_wah_wah posted...

P4wn4g3 posted...

Yeah, nobody said malpractice doesn't happen. Nobody said doctors have well measured authority. Those points were discussed earlier. You do need to be your own advocate when going to a doctor as well, that much is true. If they don't work with you then go get a second opinion. These aren't things that will change with anything discussed in this topic.

How can you even get a second opinion if you're labeled a "frequent flyer" and banned from care?

We don't "ban" frequent flyers and we always give them a full medical workup. Every time.

Stop making shit up.

But isn't that what was talked about earlier? Starting to deny care to these people?

No.

We don't deny care to people who need it, regardless of the reason.

We're talking about the problem of overutilization from diseases that could be more effectively managed by primary care.

OK that's fine. I apologize for my frustration. I hope though as part of this doctors themselves have more accountability for the resources they waste too by simply being incompetent. I found in my experience it is very hard for a doctor ever to get let go even if they fuck up badly, and sometimes the hospital enables that.

I can understand even the logic of, well if he is only 50% effective at his job, hes still helping 50% whereas if hes fired, hes helping 0%. But then I think you have to understand that none of this is disclosed to the patient. So theyll understandably be like, am I getting the guy that knows what hes doing or the fuck up? And that anxiety isnt going to drop visits either.

Coffeebeanz posted...

wah_wah_wah posted...

P4wn4g3 posted...

Yeah, nobody said malpractice doesn't happen. Nobody said doctors have well measured authority. Those points were discussed earlier. You do need to be your own advocate when going to a doctor as well, that much is true. If they don't work with you then go get a second opinion. These aren't things that will change with anything discussed in this topic.

How can you even get a second opinion if you're labeled a "frequent flyer" and banned from care?

We don't "ban" frequent flyers and we always give them a full medical workup. Every time.

Stop making shit up.

But isn't that what was talked about earlier? Starting to deny care to these people?

P4wn4g3 posted...

Yeah, nobody said malpractice doesn't happen. Nobody said doctors have well measured authority. Those points were discussed earlier. You do need to be your own advocate when going to a doctor as well, that much is true. If they don't work with you then go get a second opinion. These aren't things that will change with anything discussed in this topic.

How can you even get a second opinion if you're labeled a "frequent flyer" and banned from care?

I'm not generalizing as much as bringing up a counter-example to your generalizations. I have seen it when hospitals get frustrated with frequent patients and ignore the asshole doctor's crappy work, and it wasn't pretty. You've already made the argument yourself "hey doctors can be assholes" as if you're unwilling to get rid of asshole doctors that can't perform. I guess I can empathize with you a bit. I only lost my dad because of this protectiveness. You might lose a bridge partner on the weekends.

My story shows that people can repeatedly go to seek care and not have their problems solved not because they are frequent flyers but because doctors are incompetent. Im not comforted by the whatever response of doctors can be assholes... if they are assholes, they shouldnt be doctors. Thats the waste. And it is indicative of his mindset that seeks to protect the hospital and its resources over getting rid of people who cant perform their jobs. It becomes a clubhouse, Ive seen it.

It is all good and easy to say dont go to the doctor so often but in my experience I have found that if you dont press your problems and raise hell, and you have too much trust in doctors, theyll say youre OK right up until the time youre dead. You roll your eyes all you want , but it's only because you know it's not your life on the line.

Knowledge_King posted...

wah_wah_wah posted...

He asked "Is it my heart" and you guys didn't do the tests. He came back and you guys kept not doing the tests until he died.

Are...are you just assuming that all doctors are a hivemind and dude/girl in this topic is the one that killed your dad? That's kinda...insane.

Here's his response to my story

Coffeebeanz posted...

Doctors are human
Humans can be a******s

Total indifference. Doesn't care. Might as well be one of them. He "bad apples" shit like this and then continues on supporting the same shit.

There's nothing complicated about it. He asked "Is it my heart" and you guys didn't do the tests. He came back and you guys kept not doing the tests until he died. Like what else was going on? On the surface he's a person who is sick and has to keep coming back. You'd probably call him a frequent flyer bullshitting his heart symptoms. Instead of a doctor that needed to be canned. I'm sure it is complicated for you and your buddies at the hospital. You're all friends and don't want to admit that one of you is a negligent bastard. Much easier to pretend like it's the patient's fault.

Coffeebeanz posted...

I don't know how many times I've directly refuted your ridiculous straw man argument, but you keep reiterating it as if saying it enough times makes it true.

Yeah something that happened in my real life is a straw man. Fuck you.

Coffeebeanz posted...

wah_wah_wah posted...

Coffeebeanz posted...

But that's the problem, you shouldn't have any pre-conceived notion of what is going on before you investigate. That's not evidence-based medicine.

It's called a differential diagnosis, jfc what the hell is wrong with you

I dunno, ask my dad. Oh nevermind, your differential diagnosis (or whatever you call dismissing patients with problems) killed him. Have fun with all the resources you saved. That'll do me a lot of good. We'll call him a frequent flyer when he's alive. When he's dead, we'll call him a legitimate patient that needed care.

Dude, you need help.

My dad needed help. You guys killed him instead.

Coffeebeanz posted...

But that's the problem, you shouldn't have any pre-conceived notion of what is going on before you investigate. That's not evidence-based medicine.

It's called a differential diagnosis, jfc what the hell is wrong with you

I dunno, ask my dad. Oh nevermind, your differential diagnosis (or whatever you call dismissing patients with problems) killed him. Have fun with all the resources you saved. That'll do me a lot of good. We'll call him a frequent flyer when he's alive. When he's dead, we'll call him a legitimate patient that needed care.

Coffeebeanz posted...

By the way, you need to quit being a dick to us just because you have a chip on your shoulder about doctors

What, are you going to "save resources" with me?

Coffeebeanz posted...

You always give the patient a full work up, regardless if you suspect it's nothing. That's basic standard of care. Even if I think chest pain is bogus, I'm going to get troponins and ekgs, and give them the associated meds.

But that's the problem, you shouldn't have any pre-conceived notion of what is going on before you investigate. That's not evidence-based medicine. How is anyone supposed to trust you if you have the attitude that looking is a waste of time?

You hire doctors that have no idea what the fuck they are doing, nurses that dont know what the fuck they are doing, wasting visits and not pursuing obvious causes, and theyre all protected by the big union scam. They can never get fired and you all go around and say nothing can be done when a patient goes to you so many times, deliberately asks pointed questions on the very thing that killed him, and you guys dont do a fucking thing, and they are even made to feel guilty for even coming in. Its easy for you to make these rules and say trust us but you dont know what its like when you doctors fuck up the trust. If people outside the club die, for people like you its like whatever I guess, I was just saving resources. And its so convenient too that you go and then deny care to kill the very people that would know the most about the rot and indifference in your institutions. Another critic silenced. Nothing ever changes. Everyone is everyone's buddy at the hospital.

Coffeebeanz posted...

wah_wah_wah posted...

Coffeebeanz posted...

Darkman124 posted...

Coffeebeanz posted...

What really grinds my gears is that the hospital I work at is always full, and a large percentage of the patients are frequent flyers with no actual medical problems. They take up a bed that could've been used for someone who needs legitimate medical attention.

We have to admit then and order expensive tests that we know will negative, because they were negative the last 20 times they were admitted. Then they never actually pay their bills, because of course they don't, so the cost is distributed to everyone else.

Is there an inpatient version of GOMER?

Absolutely.

Just say you have crushing substernal chest pain radiating to your left arm and you've bought yourself at least one day.

Or my favorite: "intractable nausea"

Its easy for you guys to whine about how people are going to the doctor so much, but sometimes they do because a few of you have no idea what the fuck youre doing and shouldnt be practicing medicine. My dad had serious symptoms and they were mostly ignored. He even pressed, Do you think this has to do with my heart? and he was brushed off and told to ignore his symptoms. He would until they got so bad he had to go in again, and theyd say the same thing. It sucks (to put it mildly) to have someone in your family who is basically dying and a few of guys just play with your dicks all day and dont do anything about it when you can. He was a vet who fought for this country and with the trust they place in you, you guys just let him die. And ate some of the remaining time of his life he had with pointless visits where you did nothing.

I feel like all youre going to do by denying care is enable these doctors who dont get it right, and pass that blame and the fallout onto patients (who shouldnt be expected to know medicine). Im not a hater of medicine, but some of you hospitals operate a lot like the police where you coddle your worst members because theyre part of the club... I can already see that sort of us vs. them mentality in a lot of the posters here.

Doctors are human
Humans can be assholes

I'm not talking about normal patients. I'm talking about frequent flyers.

Also you seriously need to stop making up shitty straw man arguments. It's insulting to the people who actually are trying to make things better.

Nobody's denying care to anyone. Nobody's saying anyone deserves to die. We're highlighting a major problem with the distribution of healthcare resources. Sticking your head in the ground and uttering white knight mantras won't change that fact.

No matter how badly you want to believe otherwise, healthcare is a very limited resource. There's only so many doctors, nurses, hospital beds and dollars. If you want to actually make a difference, become a doctor or a nurse. We have a ridiculously dangerous shortage of both. Or find ways to reduce healthcare costs and improve access. Sitting in your armchair uttering shit about "nobody has a right to judge who deserves healthcare" just makes you an armchair quarterback.

How can you tell the difference? How do you know if the doctor they keep seeing isn't messing up his job? If a patient keeps going to the doctor and the problem doesn't get resolve, how do you determine whether to label with the prerogative "frequent flyer" instead of a doctor that should be fired? I've seen doctors like you dismissing shit. It killed my dad. To glibly dismiss it with "well I guess people are assholes" shows complicit in shit like that. And one of the assholes.

Coffeebeanz posted...

Darkman124 posted...

Coffeebeanz posted...

What really grinds my gears is that the hospital I work at is always full, and a large percentage of the patients are frequent flyers with no actual medical problems. They take up a bed that could've been used for someone who needs legitimate medical attention.

We have to admit then and order expensive tests that we know will negative, because they were negative the last 20 times they were admitted. Then they never actually pay their bills, because of course they don't, so the cost is distributed to everyone else.

Is there an inpatient version of GOMER?

Absolutely.

Just say you have crushing substernal chest pain radiating to your left arm and you've bought yourself at least one day.

Or my favorite: "intractable nausea"

Its easy for you guys to whine about how people are going to the doctor so much, but sometimes they do because a few of you have no idea what the fuck youre doing and shouldnt be practicing medicine. My dad had serious symptoms and they were mostly ignored. He even pressed, Do you think this has to do with my heart? and he was brushed off and told to ignore his symptoms. He would until they got so bad he had to go in again, and theyd say the same thing. It sucks (to put it mildly) to have someone in your family who is basically dying and a few of guys just play with your dicks all day and dont do anything about it when you can. He was a vet who fought for this country and with the trust they place in you, you guys just let him die. And ate some of the remaining time of his life he had with pointless visits where you did nothing.

I feel like all youre going to do by denying care is enable these doctors who dont get it right, and pass that blame and the fallout onto patients (who shouldnt be expected to know medicine). Im not a hater of medicine, but some of you hospitals operate a lot like the police where you coddle your worst members because theyre part of the club... I can already see that sort of us vs. them mentality in a lot of the posters here.

Coffeebeanz posted...

What really grinds my gears is that the hospital I work at is always full, and a large percentage of the patients are frequent flyers with no actual medical problems. They take up a bed that could've been used for someone who needs legitimate medical attention.

We have to admit then and order expensive tests that we know will negative, because they were negative the last 20 times they were admitted. Then they never actually pay their bills, because of course they don't, so the cost is distributed to everyone else.

I would think the opposite would be just as much of a problem (If not worse) - where people don't come in until its too late because they are afraid of the bill.

Nearly all of your patients are not trained in medicine so how are they supposed to know exactly when to come in?

I'll apologize for getting to angry to most people in this topic, but I find most of the ways of "controlling costs" to be mostly arbitrary and prone to corruption, and driven especially by a market delivery system that only makes money through scarcity. I understand that's just how it mostly is in general, with the resources being limited. But I think when you start that conversation at "we have to kill people"... I mean there's a million other places of savings to go before your mind goes immediately to that.

P4wn4g3 posted...

wah_wah_wah posted...

The problem with selecting for the "worthy patients" is that it can so easily be abused. If we can't do anything to increase the supply, then it has to be first come first serve. Because it's randomized. We don't have to have human beings deciding who lives and who dies.

You are incredibly naive about how ERs, treatment clinics, and doctors decide who gets in. There are a large number of protocols and such that decide the priority of a patient. For example, stroke protocol will give a patient immediate priority and they will have them admitted and undergoing tests immediately. This is basically how it's always been done. Medical professionals can't operate on the dead, they can't let urgent patients die, they can't prioritize wounded people just because they are in pain.

The issue is really what we were discussing before, who decides what "disability" is accepted at this hospital. Or this insurance company.

I never denied any of that, but you're all trying to argue that someone who is dying has no priority because of things like not following through on homecare and should be turned away. That's negligent, and a completely different type of prioritization that goes on, which is by medical danger

kayoticdreamz posted...

its a thought experiment that you failed at.

Because it is so far abstracted from the specifics that I don't care to play. I might as well come up with this thought experiment where there are 100000 cheese pizzas and 3 people, and you're going to let people starve? It has just as much reality to the real numbers as your experiment.

kayoticdreamz posted...

your response is easily solved in said thought experiment, you say first come first serve.....well okay then, the first guy to come in, is a drunk that hit their head and was bleeding but isnt anymore, and the second guy to come in is having a heart attack. you have one doctor on duty. who does the doctor help? they come in 3 seconds apart but the drunk comes in first.

As much as you are convinced you are an intelligent person, responses like this prove that you are not. Who's to say the heart attack guy isn't having it because of a coke problem? Or maybe he is having a heart attack because he is arguing poorly on GameFAQs (not wishing anything on you).

kayoticdreamz posted...

like wise with the pies.....someone might not have eaten in 2 days.is it still first come first serve?

If you were fair (or smart) you would have had both guys at danger of starving. This is what happens when you play with idiotic thought experiments. You contrive positions I never made.

And in such a case, I'm not morally responsible because I didn't select the other person to die. I fed the first person and ran out afterwords. I didn't first see if he is starving because he threw up earlier. All of this criminal investigation you want to add to the medical profession doesn't sound like it's going to do a damn thing to ration resources. You're just going to be dick-diddling around for the first hour of a hospital visit trying to determine if the human life is worthy, rather than administering treatment and moving on.

kayoticdreamz posted...

wah_wah_wah posted...

kayoticdreamz posted...

thats what you're doing though. you're killing people by saying everyone can abuse the whole system until it breaks and then it breaks, instead of only a few people getting f***ed, we're all f***ed. but hey at least you're a moral straw man right?

None of you have made a convincing case that killing demanding patients is going to solve this problem. You've only instead abandoned medical ethics in the quest of making better medicine. Which is always a shitty thing to do.

and all you've said is we can magically save everyone somehow without explaining the "somehow" part.

here think of this way.

we have 100 people.

and there are 3 average sized pies cut into 8 pieces this means there are 24 pieces.

decide who gets them and explain your reasoning.

we're saying not everyone gets a piece, you're saying everyone does. which is our dilemma.

EDIT:

if you make the pieces smaller, then that won't satisfy the people, as who knows, maybe some wants 2 pieces?

That's an abstract thought experiment that has nothing to do with the specifics of healthcare. The problem with selecting for the "worthy patients" is that it can so easily be abused. If we can't do anything to increase the supply, then it has to be first come first serve. Because it's randomized. We don't have to have human beings deciding who lives and who dies. It also allows patients to be forthcoming about how they may have contributed to their own health problems. If everyone knew you'd get thrown out of a hospital for possibly being irresponsible, they'd just lie and make up a story instead where they look good. You'd only be punishing the people who are honest and tell you, hey I fucked up on my homecare.

kayoticdreamz posted...

thats what you're doing though. you're killing people by saying everyone can abuse the whole system until it breaks and then it breaks, instead of only a few people getting f***ed, we're all f***ed. but hey at least you're a moral straw man right?

None of you have made a convincing case that killing demanding patients is going to solve this problem. You've only instead abandoned medical ethics in the quest of making better medicine. Which is always a shitty thing to do.

mustachedmystic posted...

I can understand an alcoholic or a smoker who can't seem to quit, but a person not taking lifesaving medicine they have easy access to? I'm not calling any of y'all lairs, but this really blows my mind.

I'll admit they are right that it happens a lot. But not to the point where it becomes as catastrophic to the entire system as they are saying (though it is a problem), and selecting worthy sick people as a solution is where the ethics get really shitty. It also does a lot to place mistrust between doctor and patient, who might as well lie and say he/she IS taking the medication, if he knows admitting he isn't is going to get him kicked out and not treated. In a way that might end up wasting even more resources (including potential lives loss, which then become the responsibility of the hospital, who will more than likely get a lawsuit).

If you have a situation where you can't admit anyone else for lack of supplies, then yes you have to turn people away. You can't really prioritize it by personal responsibility for the illness, nor lessen demand by letting certain individuals die, because then you're about as ethical as Mengele. At least when they come first come first serve, it is randomized. There is no way to be an ethical angel of death.

Coffeebeanz posted...

Is any of that shit in danger of immediately running out?

Yes, actually.

Blame Patch Adams. He steals from hospitals.

BlameAnesthesia posted...

wah_wah_wah posted...

So are you saying that people are taking parts of the hospital home with them? Trying to make a hospital comparable to a commodity like corn seems pretty idiotic.

I can't even....

what happens to all the needles, catheters, cannulas, medications, IV bags, EKG leads? The cost of electricity for all the ventilators and equipment? Cost of transporting all the goods and keeping everything stocked 24/7? Having the most educated work-force from doctors to nurses to occupational and physical therapists to pharmacists, to technicians in all realms of medicine, each with their own individualized training and education all staffed 24/7?

There are a billion disposable expenses in medicine. I can't even begin to describe how large that list is. You think it's all free and we all use magic to heal our patients and it's just a matter of us being too lazy or too morally corrupt in character to care?

What the fuck. It's like I'm talking to a toddler.

Is any of that shit in danger of immediately running out? Then why are you so quick to deny care and kill people? That's where you become a frightening person. Your doomsday event where this small number of people consumes all these resources including the ability to produce more and leaves the rest for nothing... god damn, it's like I'm talking to someone that should not be in medicine, and probably won't be for long.

BlameAnesthesia posted...

wah_wah_wah posted...

That's also a fallacy

When we use numbers and figures to describe real problems, you go off about the "potential" a life can bring to the extreme that any cost is justifiable. Ignoring the fact that eventually the entire resource can run out and not only do those people die, but everyone else who needed the healthcare.

If everyone ran their sink 24/7, we'd run out of water and we'd all die. We're arguing to not allow the 5-15% to stop running their water 24/7 and use it only when necessary. This includes taking responsibility for knowing when it is appropriate to use that water.

You're advocating we ought to let them keep running that water. Consequences be damned because they don't exist in your world.

Like what you said was a straight up fallacy. It doesn't cost more money to buy something just because you bought something earlier in the day. You won't even admit it is a fallacy because you're a lying wreck that can't keep to his story. Your not even talking about a concrete situation anymore, either, is what the frightening aspect of this is. You're just saying these people need to be denied care because of some vague doomsday event where we're all going to run out of hospital. You sound like you need to be a patient of a hospital.

BlameAnesthesia posted...

Should everyone with access to running water be allowed to run their shower 24/7, 365 days a year? Why not?

Turning off the water isn't going to kill them. No way a comparable situation.

BlameAnesthesia posted...

Let me ask you this. Are you responsible for everyone's death when we run out?

So are you saying that people are taking parts of the hospital home with them? Trying to make a hospital comparable to a commodity like corn seems pretty idiotic.

BlameAnesthesia posted...

wah_wah_wah posted...

So again, you're either lying again or you can't make up your mind what you're even talking about. The latter statement definitely proves that you're doing more than describing the effects of the current system.

There is a difference between covering someone's hospital visit for a CHF exacerbation and covering someone's 9th visit for the year to the tune of a million dollars that they aren't paying, and even though their medication costs like $20/month, they still don't take it for x, y, z, reason. So we spend another 250k to get them better next month. For a few more months...

And like what coffeebeanz said, that bill necessarily makes little Timmy's chemo more expensive. Eventually the bill will make it prohibitively expensive for Timmy, because at the end of the day Mr. COPD didn't want to change his 100 pack year smoking habit.

That's also a fallacy. That's like saying my dinner costs more because I bought lunch earlier in the day. There is no justification for tying the two together like that.

kayoticdreamz posted...

this has nothing to do with the jews so why are you dragging the holocaust in this?

Of course it doesn't. But you know it doesn't. You're either being deliberately obtuse of my larger meaning which was to illustrate fallacious reasoning or you're stupid. Let's keep reading to find out...

kayoticdreamz posted...

his point is valid, at what point do we as society just let people do stupid stuff, put our hands up and say live with the damn consequences?

Because any decision where you decide that someone dies is an irreversible decision, and you are also responsible for killing them.

kayoticdreamz posted...

they have smoked for 40 years and get lung cancer. they knew it was killing them, they made 0 effort to change their habits, and now not only want cancer treatment but want it to be free because they cannot afford it.

Who's to say that they won't be able to make up for it later if they live? Who can really say what people are capable of if they live? There's people that are cured of disease and go on to do wonderful things. So we don't know what they'll do if they live. We only know what they are capable of if they die, which is absolutely nothing. Not saving a life is the waste, regardless of the environmental factors that lead to it (which of course you don't blame the tobacco company either).

kayoticdreamz posted...

why should society bear that cost? because it's moral? what about the smoker? his actions were immoral. should he got off free of charge?

I'm not even saying that, exactly. I think it's dumb to say saving a person's life costs too much money when we have no idea how much that person may contribute back to society. And regardless of it being immoral to smoke, it is immoral to sell cigarettes too (yet legal). It is also immoral to just say "fuck you, die" when you can save them.

BlameAnesthesia posted...

I'm simply stating the effect of the current system we have now.

Meanwhile a few posts earlier

BlameAnesthesia posted...

The reality is poorly managed disease that is preventable should not be covered. If they die as a result of being unable to afford their care is not society's problem. They are given every resource. The system keeps telling them the consequences. At some level, short of taking over autonomy of their life, they will never reach the conclusion until it is too late,

So again, you're either lying again or you can't make up your mind what you're even talking about. The latter statement definitely proves that you're doing more than describing the effects of the current system.

You also keep pressing me for the ultimate solution, but that's a fallacy too. That's like saying I need to come up for another plan for the Jews in order to say that a plan to kill them all is wrong.

P4wn4g3 posted...

wah_wah_wah posted...

The problem is the cost of letting them die is not valued at all, so you assume (naively) that the cost is nothing.

This is wrong, nobody likes it when someone let's themselves die but nobody can do anything about it either since it's neglect of self care.

But you denied them care that allowed them to die. It's also your responsibility that they died.

BlameAnesthesia posted...

wah_wah_wah posted...

I'm not required to offer a solution in order to illustrate why a solution that kills people is wrong.

"If healthcare eventually becomes unaffordable to all, leading to more total deaths, at least I know my hands are clean of a moral straw man."

This is your problem. You totally lack self-awareness and yet you think you might not be part of the problem. This is itself a straw man, in quotes that I never said. Continuing your general pattern of dishonesty.

BlameAnesthesia posted...

I still don't believe what you think I believe and you'll find my "beliefs" are pretty common in my profession. Calling futile care what it is or otherwise admitting a subset of patients disproportionately costing everyone more due to lifestyle choices is not me "wanting to kill them all."

The problem is the cost of letting them die is not valued at all, so you assume (naively) that the cost is nothing. That's where you get fringey and quacky.

Also your badge says student. It is presumptuous for you to say it is "your" profession (also more dishonesty).

BlameAnesthesia posted...

wah_wah_wah posted...

Great way to start things out by straight up lying about knowledge you don't have.

https://imgur.com/TPrQhMA

This isn't verifiable info. You've crossed out everything that proves anything. But I'll take your word for it, since I'd actually avoid giving your real name and info, too. If it gets attached to your views as expressed here, to put it mildly, you're going to be in trouble finding employment once you graduate. I'm holding out hope you'll learn that your perspectives on this are pretty messed up and assume a lot of knowledge you don't have.

I was mostly calling you a liar because you assumed I hadn't went to medical school. I'm not going to say whether I have or haven't, either. Because I'm not prepared to verify it either way.

P4wn4g3 posted...

wah_wah_wah posted...

See this is yet another poor assumption on your part. You have no idea what this person will go on to do, if they get treatment. You are making a cost-benefit analysis without knowing the cost of losing a human life. And the reason why you're making this statement is because you can't possibly know that, just like you can't know that I went to medical school yet you declare it as fact at the very beginning. You also can't automatically know the reasons why someone might not be following your treatment plan for sure. It could be because they are not listening. But it could very well an institutional problem on your part that you're not thinking of. If you deny someone care and they die and you find out later that there may have been a way to approach it that could have got more compliance. But if you deny the care, you can't bring them back to life. They're dead. There is no hope for treatment or a turnaround with a corpse. That's why you have to do everything possible to keep someone alive, even if you believe that it's the person's fault. Because what if you find out later it isn't? You can't resurrect the dead.

So what's your solution

I'm not required to offer a solution in order to illustrate why a solution that kills people is wrong.

BlameAnesthesia posted...

Wah wah, I cannot explain to you the nuances of everything because you haven't been to medical school. You don't understand the physiology of congestive heart failure. You don't understand the rationale in medical treatment for it. You don't understand the complications of the disease as it progressives. You don't understand the inpatient management of those complications.

You have absolutely no idea who I am other than a GameFAQs user. But I guess that's in line with all your other quackery you've revealed so far this thread. Great way to start things out by straight up lying about knowledge you don't have.

BlameAnesthesia posted...

Except each of those hospital admissions was 250k and over the course of their illness their simple diabetes which is VERY EASILY TREATABLE cost millions and millions.

See this is yet another poor assumption on your part. You have no idea what this person will go on to do, if they get treatment. You are making a cost-benefit analysis without knowing the cost of losing a human life. And the reason why you're making this statement is because you can't possibly know that, just like you can't know that I went to medical school yet you declare it as fact at the very beginning. You also can't automatically know the reasons why someone might not be following your treatment plan for sure. It could be because they are not listening. But it could very well an institutional problem on your part that you're not thinking of. If you deny someone care and they die and you find out later that there may have been a way to approach it that could have got more compliance. But if you deny the care, you can't bring them back to life. They're dead. There is no hope for treatment or a turnaround with a corpse. That's why you have to do everything possible to keep someone alive, even if you believe that it's the person's fault. Because what if you find out later it isn't? You can't resurrect the dead.

BlameAnesthesia posted...

wah_wah_wah posted...

So tell me what's your solution? Because what I'm getting is, you want to deny care to people because they aren't following the treatment plans exactly. Is that correct?

No, that's not correct.

wah_wah_wah posted...

Because you do realize that for some, that means certain death right?

Not talking about denying acute care. That's against the law (EMTALA).

wah_wah_wah posted...

And you would be responsible for that? Because you could have given care and you didn't.

No one is talking about denying people care for not following a treatment plan perfectly. Stop with the exaggerations.

wah_wah_wah posted...

That is a straight-line responsibility on your part. I'm sorry you have trouble processing emotions (which again tips off that you probably work in a spank booth and not a medical setting) but you're making nightmarish pronouncements with no actual knowledge of medical ethics.

You are being extremely aggressive whilst accusing me of things I do not endorse.

See I know you're a bullshit artist because you're quick to tell me what you're not saying then don't offer anything about what you are saying. On some level you're trying to rationalize denial of care as a solution and I'm sorry, but if you are in the medical field with that attitude, you're a straight up fucking quack. Set you in the pond to eat bread.

BlameAnesthesia posted...

wah_wah_wah posted...

I guess they don't change if you just straight up kill them.

No one is killing anyone here. Stop using emotionally charged language.

No one is saying absolutes. Of course patients change. You still are horribly naive at the number of patients who don't change, right up until the die, after amassing millions in medical expenses, when these medical treatments aren't necessarily doing them much good, just delaying their death.

It's not improving their quality of life. They spend most of it in a hospital. Going through unnecessary procedures. Suffering hospital acquired infections. Their families can't let go that they really died 6 months ago, but emotionally they prolong it, and often times it hurts the patient.

But it gets done anyway.

The people who provide this care are in a system they can't fix. Doctors, nurses, I don't care. Cogs in an inhumane system. We can do a lot of good, but a lot of harm is done.

What we're talking about is trying to end the harm, but people who don't know a fucking thing about this issue take a misguided moral approach and think we're heartless.

Go shadow a fucking hospital. You have to see it for yourself. Or remain willfully ignorant and pretend the reality is what ever image you've conjured in your head. I'm too busy trying to do what good I can do in a broken system.

So tell me what's your solution? Because what I'm getting is, you want to deny care to people because they aren't following the treatment plans exactly. Is that correct? Because you do realize that for some, that means certain death right? And you would be responsible for that? Because you could have given care and you didn't. That is a straight-line responsibility on your part. I'm sorry you have trouble processing emotions (which again tips off that you probably work in a spank booth and not a medical setting) but you're making nightmarish pronouncements with no actual knowledge of medical ethics.

BlameAnesthesia posted...

wah_wah_wah posted...

I'm not the one suggesting that we kill people out of neglect. You're out of your fucking mind if you think anyone would believe that someone like you would be allowed even two feet inside of a hospital with that depraved ideology.

Oh my sweet summer child...

Seriously, tell me what hospital you work for. Give me your credentials and name.

P4wn4g3 posted...

wah_wah_wah posted...

Someone who is alive, regardless of the mistakes they may have made, can still change and learn.

This is false though. It would be wonderful if true, but people are hard set in their ways by time they are mid 20s at the latest. If their personality includes bettering themselves then sure, some changes can be made. If not, then they can't be. Even those who can change are very limited in what they can change. The system can't help people who can't do the work for themselves. That's they basic argument here and as far as today's medicine goes it's correct.

I guess they don't change if you just straight up kill them. But this is assumption, not fact. Plenty of people change their minds about things all the time. I can't believe I am actually in an argument where someone is literally saying that people always never change their minds about anything. Like are you for real or are you just that stupid?

BlameAnesthesia posted...

wah_wah_wah posted...

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

Oh. My. God.

Please, go shadow in an ER or a medicine ward for a few days. Please. Just please. You don't know how ignorant you sound right now.

I'm not the one suggesting that we kill people out of neglect. You're out of your fucking mind if you think anyone would believe that someone like you would be allowed even two feet inside of a hospital with that depraved ideology.

P4wn4g3 posted...

wah_wah_wah posted...

BlameAnesthesia posted...

The only people that will die "prematurely" here are the people absolutely refusing to listen to the consequences of their current course. Multiple times. Multiple, multiple times.

The arguments here are for those people who are behaving in a manner that demonstrates they don't care about their health.

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

Because their body and basic instincts have overridden their pride or stupidity. This is actually a thing that happens.

Someone who is alive, regardless of the mistakes they may have made, can still change and learn. Someone youve killed out of neglect isnt going to change or contributed or learn anything. They are dead, and your neglect killed them. Not theirs. They might not have followed your orders exactly as you prescribed, but youre responsible for not giving them care and allowing them to die. And that isn't going to do anything to teach anyone anything. You killed a person and are now are insisting on the absurdity that it was necessary to kill them so that person would learn.

BlameAnesthesia posted...

The only people that will die "prematurely" here are the people absolutely refusing to listen to the consequences of their current course. Multiple times. Multiple, multiple times.

The arguments here are for those people who are behaving in a manner that demonstrates they don't care about their health.

OK so why are they showing up at the hospital for treatment? Oh yeah I forgot, you can't follow your own train of thought for more than five seconds.

BlameAnesthesia posted...

SableWolfAngel posted...

SableWolfAngel posted...

Does a weak heart from surgery count as a pre-existing condition?

If so, would someone with this problem lose their insurance after this reform?

Yes and yes.

People arguing against coffeebeanz are worried about the moral implication of that.

Coffeebeanz is categorizing that the people in that category CAN have affordable care for their congenital conditions because their overall healthcare burden is low relative to the majority of people with poorly managed common diseases like diabetes, congestive heart failure, and chronic obstructive pulmonary disease.

The category you refer to is a minority. The category she is referring to is in the millions. They see a doctor and ignore the advice/treatments. They wait until they suffer a complication of their disease, which leads to expensive hospitalizations. These diseases aren't "curable", but you can prevent hospitalizations by preventing the disease from progressing with lifestyle change and compliance with their medications.

For whatever reason, patients refuse and simply bounce back and forth in the hospital. This is predominantly most of our health care costs. Sure, SOME of these admissions are not due to the fault of the patient. But a surprising amount that someone who has never spent time on a medical ward will fail to acknowledge is simply due to lack of motivation/willpower/desire.

And anyone who has spent time in a medical ward also knows there is this American mentality of "wanting the best, always." This leads to vegetables on ventilators for months and years, costing millions, which cannot be afforded by the average family, and the bill is being tossed back and forth between government and industry, snowballing to what we have today.

If America wants affordable healthcare, they need to accept a subset of the population is not willing to do what it takes to not be a massively disproportionate burden.

It's a stupid argument either way, which assumes that people are horrible by nature and want to die anyway. It isn't something anyone who is serious about healthcare and works in medicine would even consider for longer than half a second. He would be laughed out of any hospital with such theories.

BlameAnesthesia posted...

wah_wah_wah posted...

Whatever you're describing here, it doesn't sound like you want empirical medicine

Lol what? You're skipping a few steps in your thought process here, I'm not following.

wah_wah_wah posted...

because individual fault has nothing to do with that. Sounds like you're begging for a church

...what? I don't think you quite understand my position either.

There is nothing to understand. You clearly have no idea what you're talking about. You don't even have a working understanding of the goal of healthcare and disease theory. You seem to think that individual choices make people sick rather than their environment, and your solution is to kill those people. There is a reason you're on GameFAQs blathering away and not at John Hopkins.

BlameAnesthesia posted...

And don't fool yourself into thinking the common lip service hasn't been tried. Every single medical student in this county is taught about compliance issues and lifestyle related disease. We come in bushy-tailed and wide eyed, ready to teach all of our patients and solve the issue once and for all.

Real life hits you with a ton of bricks when you realize patients are either unable to understand or unwilling to understand. You can lead a horse to water but you can't fucking force them to stop smoking, fix their dietary habits, and actually take their meds.

There is a reason doctors are so burned out. The futility wears on you. And all the idealists in this thread would be the first to burn out, FYI.

Whatever you're describing here, it doesn't sound like you want empirical medicine, because individual fault has nothing to do with that. Sounds like you're begging for a church.

The privatized healthcare model is not a model that aligns with scientifically backed medicine. Diseases come from the environment and biological factors, not from people's choices. There is no "choice" that makes people sick.

Might as well not even buy health insurance. It is completely useless.