Do you support UHC?

[dali71]

Originally posted by: n yusef

Originally posted by: Pneumothorax
So where is all this extra money coming from when even Medicare/Medicaid is currently underfunded? Yes the 40 million who don't have coverage will also be now covered, but don't tell me the ones who are paying right now will continue to pay out of pocket when the gov gives out for "free" Also, when your employer isn't going to pay for it now, since the government is going to pay for it, do you think they're actually going to give you a raise instead? Fat chance. And considering that the federal government gets most of it's money from income tax and basically half of the nation's working population doesn't pay (net) income tax, the people who can already afford healthcare now are going to be the only ones truly paying for it.

Some people don't mind assisting the less fortunate in society. It's a shame that selfishness is an American virtue.

Sorry to put a damper on your America bashing, but we give far more in charitable contributions than any other country.

 

[nobodyknows]

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707
No. The UK recently decided that people with my condition (rheumatoid arthritis) get one shot at a particular class of drugs (biologics) that has three incarnations (enbrel, remicade and humira) and if their one shot does not work (say, remicade) they don't get to try using the other two (enbrel and humira) because the drugs are too highly priced ($30-50k USD/year) and the ratio of success is not sufficient from a cost-benefit perspective to be worth trying again.

If 7/10 (made up number) RA patients who do not respond to one do not respond to the other two, the experimentation process is taking cash away from some cancer patient who might survive if their treatment was paid for. It's reasonable logic, totally understandable, but it does absolutely nothing for the individual patient, those 3/10 RA patients who would have benefited from the other drugs are left with pain, deformity and incapacity, losing all chance at living a normal and full-length life, working until retirement and existing without requiring a human aide to do everyday tasks.

I will stuff envelopes, empty grease traps, pick up trash, whatever it takes to maintain health care through my employer, and I'm grateful for the opportunity. My health care decisions are in MY hands, being made by the only person to whom they are truly and literally a matter of life and death.

This isn't a conceptual discussion for me; if I lived in the UK and depended on their nation health care I would be crippled right now. I live in the US and I can walk. The difference between systems is black and white to me.

Nobody is going to hire you if they know of your condition in advance and if they did hire you, once they find out they will do everything they can to fire you.

Odd, I've worked for two Fortune 500 companies and they've done everything necessary to accommodate my disease. The keyboard I'm typing this on is a Kinesis Advantage Pro, $600 and purchased by the company under the Americans with Disabilities Act to accommodate me doing my job. Nobody has ever once asked me about my health in an interview and I have never had any issues after hire when I've disclosed my health problems. I've always been given time off to see doctors as needed, and I have been provided with everything I need and then some.

Sorry, try flamebaiting again later.

I've seem plenty of people fired for trumped up reasons when the real reasons were helath care costs. Maybe it hasn't happened to you....... yet.

Let's hear a little background on where you've worked and how you knew what you knew. I worked in HR (systems) in my last company; the HR managers would rip the retail managers (or anyone else) up one side and down the other for an ADA violation like that, and they took every complaint call that came in and investigated it very seriously. I saw my own boss get fired when she disclosed that she wouldn't hire a particular qualified candidate because he was dyslexic.

Make your claims and tell us why you make them. Lots of people perceive the workings of corporate America as arbitrary and unfair when there are good reasons behind it. "Trumped up" meaning that they were late for work, stealing from the company, etc? If you're the coworker who's not tracking their time, the friend who doesn't believe that they stole or thinks it's not a big deal, then yeah, "trumped up" can sound pretty legit. If you're the person doing the investigation without a personal bias, all you see is employees taking advantage or not being responsible or whatever.

If you seriously ever get fired for health reasons, get yourself an attorney and sue. ADA is serious business, and if you can prove that you were fired for trumped up reasons then you will more than recoup your lost income, attorney expenses and effort. If you can't prove in a fair court of law that the firing was trumped up then guess what... it probably wasn't.

Your rights are only as good to you as you exercise them. It is your legal right to not be discriminated because of a disability. Educate yourself and be prepared to defend yourself if necessary and it will rarely come to that.

I live in a "right to work" state and they can fire you for being 10 seconds late if they want to and there is not a damn thing you can do about it.

 

[AreaCode707]

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707
No. The UK recently decided that people with my condition (rheumatoid arthritis) get one shot at a particular class of drugs (biologics) that has three incarnations (enbrel, remicade and humira) and if their one shot does not work (say, remicade) they don't get to try using the other two (enbrel and humira) because the drugs are too highly priced ($30-50k USD/year) and the ratio of success is not sufficient from a cost-benefit perspective to be worth trying again.

If 7/10 (made up number) RA patients who do not respond to one do not respond to the other two, the experimentation process is taking cash away from some cancer patient who might survive if their treatment was paid for. It's reasonable logic, totally understandable, but it does absolutely nothing for the individual patient, those 3/10 RA patients who would have benefited from the other drugs are left with pain, deformity and incapacity, losing all chance at living a normal and full-length life, working until retirement and existing without requiring a human aide to do everyday tasks.

I will stuff envelopes, empty grease traps, pick up trash, whatever it takes to maintain health care through my employer, and I'm grateful for the opportunity. My health care decisions are in MY hands, being made by the only person to whom they are truly and literally a matter of life and death.

This isn't a conceptual discussion for me; if I lived in the UK and depended on their nation health care I would be crippled right now. I live in the US and I can walk. The difference between systems is black and white to me.

Nobody is going to hire you if they know of your condition in advance and if they did hire you, once they find out they will do everything they can to fire you.

Odd, I've worked for two Fortune 500 companies and they've done everything necessary to accommodate my disease. The keyboard I'm typing this on is a Kinesis Advantage Pro, $600 and purchased by the company under the Americans with Disabilities Act to accommodate me doing my job. Nobody has ever once asked me about my health in an interview and I have never had any issues after hire when I've disclosed my health problems. I've always been given time off to see doctors as needed, and I have been provided with everything I need and then some.

Sorry, try flamebaiting again later.

I've seem plenty of people fired for trumped up reasons when the real reasons were helath care costs. Maybe it hasn't happened to you....... yet.

Let's hear a little background on where you've worked and how you knew what you knew. I worked in HR (systems) in my last company; the HR managers would rip the retail managers (or anyone else) up one side and down the other for an ADA violation like that, and they took every complaint call that came in and investigated it very seriously. I saw my own boss get fired when she disclosed that she wouldn't hire a particular qualified candidate because he was dyslexic.

Make your claims and tell us why you make them. Lots of people perceive the workings of corporate America as arbitrary and unfair when there are good reasons behind it. "Trumped up" meaning that they were late for work, stealing from the company, etc? If you're the coworker who's not tracking their time, the friend who doesn't believe that they stole or thinks it's not a big deal, then yeah, "trumped up" can sound pretty legit. If you're the person doing the investigation without a personal bias, all you see is employees taking advantage or not being responsible or whatever.

If you seriously ever get fired for health reasons, get yourself an attorney and sue. ADA is serious business, and if you can prove that you were fired for trumped up reasons then you will more than recoup your lost income, attorney expenses and effort. If you can't prove in a fair court of law that the firing was trumped up then guess what... it probably wasn't.

Your rights are only as good to you as you exercise them. It is your legal right to not be discriminated because of a disability. Educate yourself and be prepared to defend yourself if necessary and it will rarely come to that.

I live in a "right to work" state and they can fire you for being 10 seconds late if they want to and there is not a damn thing you can do about it.

http://www.ada.gov/q%26aeng02.htm#State11481

Q. Does the ADA apply to State and local governments?

A. Title II of the ADA prohibits discrimination against qualified individuals with disabilities in all programs, activities, and services of public entities. It applies to all State and local governments, their departments and agencies, and any other instrumentalities or special purpose districts of State or local governments. It clarifies the requirements of section 504 of the Rehabilitation Act of 1973 for public transportation systems that receive Federal financial assistance, and extends coverage to all public entities that provide public transportation, whether or not they receive Federal financial assistance. It establishes detailed standards for the operation of public transit systems, including commuter and intercity rail (AMTRAK).

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

 

[StageLeft]

Something fun about UHC and public employees who work in it, at least in Canada, is the unions. Take for example Newfoundland, right now where the nurses are going to strike and operations have to be cancelled. Give an inch, they take a mile.

Realize there is no panacea.

 

[mattpegher]

I'm not so much against UHC as I see problems>

1. I don't want myself or my patients being told that they can't have or must wait for necessary treatments, Short of cosmetic proceedures it should be up to the doctor to decide what the patient needs.

2. Currently, hospitals are losing money even in areas that have good health insurance coverage. And Insurance companies are making record profits. So were is all this money going --------> insurance companys not actual health care.

3. If you decrease the financial incentive to doctors then less students will seek medical school ( which I am still paying for 15 years after graduation), So we lower the requirements and all the smart kids go to business school, and your local doctor is the kid you tutored in highschool.

4. Less financial incentive also means less money put into new drug research.

 

[nobodyknows]

Originally posted by: AreaCode707

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

 

[AreaCode707]

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

You still haven't cited on what authority you are speaking, or what research you've done to back up your claims.

 

[nobodyknows]

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

You still haven't cited on what authority you are speaking, or what research you've done to back up your claims.

Try a lifetime of living and working in a right-to-work state.

Do you think a corporation is going to be upfront and tell you that they're giving you the ax because of health cost concerns when they don't have to? That's not the reality I live in.

 

[BoomerD]

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

You still haven't cited on what authority you are speaking, or what research you've done to back up your claims.

AC, your naiveté is showing.

Yes, you're 100% correct that the laws DO protect people from being discriminated against...BUT, most managers are smart (and well trained) enough to find a myriad of other reasons to fire someone rather than a medical condition, age of the person, race, religion, etc.

In a perfect world, we wouldn't need any of these protections, and in a less-perfect world, the ones we have would actually prevent discrimination, but in our society, all they mean is that the managers have to be a bit smarter...and not fire someone over a protected issue.


Right-to-work and at will states still have to abide by the discrimination laws...but they don't have to have a REAL reason for firing you.

 

[AreaCode707]

Originally posted by: BoomerD

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

You still haven't cited on what authority you are speaking, or what research you've done to back up your claims.

AC, your naiveté is showing.

Yes, you're 100% correct that the laws DO protect people from being discriminated against...BUT, most managers are smart (and well trained) enough to find a myriad of other reasons to fire someone rather than a medical condition, age of the person, race, religion, etc.

In a perfect world, we wouldn't need any of these protections, and in a less-perfect world, the ones we have would actually prevent discrimination, but in our society, all they mean is that the managers have to be a bit smarter...and not fire someone over a protected issue.


Right-to-work and at will states still have to abide by the discrimination laws...but they don't have to have a REAL reason for firing you.

I'm not as naive about this as it might seem. I'm arguing against his original statement:

Nobody is going to hire you if they know of your condition in advance and if they did hire you, once they find out they will do everything they can to fire you.

which is a gross overgeneralization and, put into widespread use, is exactly where the laws become effective.

I'm not saying that wrongful termination that cannot be proven never exists, I'm just rebutting the fact that "nobody" will hire a disabled person, and that companies will "do everything they can" to fire a disabled person. Neither of those statements is true when applied so widely, and in the cases where they are applied widely across a given company then the ADA laws are actually fairly effective (companies that show a trend for discrimination are smacked down much more easily than companies that discriminate a little here and there).

 

[Phokus]

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707

Originally posted by: nobodyknows

Originally posted by: AreaCode707
No. The UK recently decided that people with my condition (rheumatoid arthritis) get one shot at a particular class of drugs (biologics) that has three incarnations (enbrel, remicade and humira) and if their one shot does not work (say, remicade) they don't get to try using the other two (enbrel and humira) because the drugs are too highly priced ($30-50k USD/year) and the ratio of success is not sufficient from a cost-benefit perspective to be worth trying again.

If 7/10 (made up number) RA patients who do not respond to one do not respond to the other two, the experimentation process is taking cash away from some cancer patient who might survive if their treatment was paid for. It's reasonable logic, totally understandable, but it does absolutely nothing for the individual patient, those 3/10 RA patients who would have benefited from the other drugs are left with pain, deformity and incapacity, losing all chance at living a normal and full-length life, working until retirement and existing without requiring a human aide to do everyday tasks.

I will stuff envelopes, empty grease traps, pick up trash, whatever it takes to maintain health care through my employer, and I'm grateful for the opportunity. My health care decisions are in MY hands, being made by the only person to whom they are truly and literally a matter of life and death.

This isn't a conceptual discussion for me; if I lived in the UK and depended on their nation health care I would be crippled right now. I live in the US and I can walk. The difference between systems is black and white to me.

Nobody is going to hire you if they know of your condition in advance and if they did hire you, once they find out they will do everything they can to fire you.

Odd, I've worked for two Fortune 500 companies and they've done everything necessary to accommodate my disease. The keyboard I'm typing this on is a Kinesis Advantage Pro, $600 and purchased by the company under the Americans with Disabilities Act to accommodate me doing my job. Nobody has ever once asked me about my health in an interview and I have never had any issues after hire when I've disclosed my health problems. I've always been given time off to see doctors as needed, and I have been provided with everything I need and then some.

Sorry, try flamebaiting again later.

I've seem plenty of people fired for trumped up reasons when the real reasons were helath care costs. Maybe it hasn't happened to you....... yet.

Let's hear a little background on where you've worked and how you knew what you knew. I worked in HR (systems) in my last company; the HR managers would rip the retail managers (or anyone else) up one side and down the other for an ADA violation like that, and they took every complaint call that came in and investigated it very seriously. I saw my own boss get fired when she disclosed that she wouldn't hire a particular qualified candidate because he was dyslexic.

Make your claims and tell us why you make them. Lots of people perceive the workings of corporate America as arbitrary and unfair when there are good reasons behind it. "Trumped up" meaning that they were late for work, stealing from the company, etc? If you're the coworker who's not tracking their time, the friend who doesn't believe that they stole or thinks it's not a big deal, then yeah, "trumped up" can sound pretty legit. If you're the person doing the investigation without a personal bias, all you see is employees taking advantage or not being responsible or whatever.

If you seriously ever get fired for health reasons, get yourself an attorney and sue. ADA is serious business, and if you can prove that you were fired for trumped up reasons then you will more than recoup your lost income, attorney expenses and effort. If you can't prove in a fair court of law that the firing was trumped up then guess what... it probably wasn't.

Your rights are only as good to you as you exercise them. It is your legal right to not be discriminated because of a disability. Educate yourself and be prepared to defend yourself if necessary and it will rarely come to that.

I live in a "right to work" state and they can fire you for being 10 seconds late if they want to and there is not a damn thing you can do about it.

http://www.ada.gov/q%26aeng02.htm#State11481

Q. Does the ADA apply to State and local governments?

A. Title II of the ADA prohibits discrimination against qualified individuals with disabilities in all programs, activities, and services of public entities. It applies to all State and local governments, their departments and agencies, and any other instrumentalities or special purpose districts of State or local governments. It clarifies the requirements of section 504 of the Rehabilitation Act of 1973 for public transportation systems that receive Federal financial assistance, and extends coverage to all public entities that provide public transportation, whether or not they receive Federal financial assistance. It establishes detailed standards for the operation of public transit systems, including commuter and intercity rail (AMTRAK).

Right to work state or not, if you can show discrimination based on disability then the company is in violation of the Americans with Disabilities Act and....
http://www.ada.gov/enforce.htm

The Department of Justice may file lawsuits in federal court to enforce the ADA, and courts may order compensatory damages and back pay to remedy discrimination if the Department prevails. Under title III, the Department of Justice may also obtain civil penalties of up to $55,000 for the first violation and $110,000 for any subsequent violation.

Good luck proving discrimination. Unless you're stupid enough to tell people you won't hire someone or you'll fire someone because of a disability, it's damn near impossible to prove, just like racial discrimination cases.

 

[sactoking]

Originally posted by: nobodyknows
You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

Originally posted by: nobodyknows
Try a lifetime of living and working in a right-to-work state.

Originally posted by: BoomerD
Right-to-work and at will states still have to abide by the discrimination laws...but they don't have to have a REAL reason for firing you.

Inigo Montoya: You keep using that word. I do not think it means what you think it means.

'Right-to-work' states are those that have laws/statues making it illegal for unions to force people to join if a union is already present, otherwise known as a 'closed-shop'. 'Right-to-work' has absolutely no bearing on on discussion y'all are having.

 

[Gooberlx2]

Originally posted by: evident

Originally posted by: Fern

Originally posted by: evident
the fact today is, a person without health insurance who has a catastrophic health problem will be financially ruined for the rest of their lives to pay for the care they received. that is absolutely the most fucked up thing i've heard and it's NOT the american way.

people who don't have health insurance don't have it for a myriad of reasons, and yes, one is being a lazy fuck. but what about honest people who've had bad luck with a job and no family, or a job w/ no benefits? is it ok to lump them in with the lazy fuck crowd as well?

Re: Bolded sentence above - So will many people WITH health insurance.

Go look it up, some well known (female) journalist whose name I can't remember ATM recently did a big story on it in Time magazine (IIRC). It's what happened to her brother, he had HI and went bankrupt anyway etc.

How does a lack of HI translate into being a "lazy fuck"? If you're talking about unemplyed/poor, they have great HI. It's called Medicaid. In other words, in this country the easiest way to get the best coverage possible is become a "lazy fuck".

Fern

I've heard about people who've exceeded their HI premiums and had to pay out the ass too. that makes it even worse.

my "lazy fuck" sentence is a reference to the majority of R thinking, that bottom feeders will never find a job and just live off of welfare and UHC.

Easy to do. For example, one of my old bosses was bitten by a rattlesnake on the job. $2,000,000 in medical bills after everything was finished (really, he got FUCKED up)...and that's NOT an exaggeration. Good for him it happened on the job and was covered by worker's comp, because the company's group plan had a $1,000,000 lifetime maximum payout.

 

[TruePaige]

Originally posted by: sactoking

Originally posted by: nobodyknows
You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

Originally posted by: nobodyknows
Try a lifetime of living and working in a right-to-work state.

Originally posted by: BoomerD
Right-to-work and at will states still have to abide by the discrimination laws...but they don't have to have a REAL reason for firing you.

Inigo Montoya: You keep using that word. I do not think it means what you think it means.

'Right-to-work' states are those that have laws/statues making it illegal for unions to force people to join if a union is already present, otherwise known as a 'closed-shop'. 'Right-to-work' has absolutely no bearing on on discussion y'all are having.

Just to add the proper term: They mean employment-at-will I believe.

 

[BoomerD]

Originally posted by: sactoking

Originally posted by: nobodyknows
You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

Originally posted by: nobodyknows
Try a lifetime of living and working in a right-to-work state.

Originally posted by: BoomerD
Right-to-work and at will states still have to abide by the discrimination laws...but they don't have to have a REAL reason for firing you.

Inigo Montoya: You keep using that word. I do not think it means what you think it means.

'Right-to-work' states are those that have laws/statues making it illegal for unions to force people to join if a union is already present, otherwise known as a 'closed-shop'. 'Right-to-work' has absolutely no bearing on on discussion y'all are having.

I have a VERY good understanding of what "Right-to-Work (for less) is all about.

I used to be a union business agent in a union that represented workers in a couple of RTWFL states...

Yes, it PRIMARILY deals with union membership, but invariably, those states also have less worker protection and fewer cases of enforcement of the various laws.

Yes, "at-will" means that unless you have a written contract, you can be fired for any reason...and you can quit at anytime.

Oddly enough, I think ALL Right-to-Work (for less) states are also at-will states...but of course, not all at-will states are RTWFL states...yet. The Republicans keep trying though.

 

[Rustler]

Missouri: Rep. Jo Anne Emerson (R) said that her district has 28 rural counties, where many cannot get medical treatment, because it isn't there to be had. This is typical of rural counties cross country, where there is a "workforce shortage," and "decaying rural health-care infrastructure." There aren't enough doctors, nurses, and other staff. We "need to fix and build rural health-care infrastructure." Furthermore, people can't travel the distances to seek care. "We don't have public transportation at all.... Unless you are a senior [potentially eligible for van service] you have no public transportation."

Pennsylvania: Rep. Allyson Schwartz (D) said the situation is now the same in many urban and suburban areas. In half of her own 13th C.D., "you can't have a baby!" In northeast Philadelphia, they no longer have obstetrical services at the hospitals. Sure, she said, "You can go somewhere else to have your baby?if you can get there!"

Hospital Systems Decline

The number of community hospitals in the U.S. fell from nearly 7,000 in the mid-1970s, down to barely 5,000 in 1999, and today, stands at 4,897. The ratio of licensed hospital beds per 1,000 citizens has dropped from 4.5 in the 1970s, down to 3 today.


As of 2000, the total U.S. public health-care workforce numbered 448,000, which was 50,000 fewer than in 1980. Looked at per capita; in 1980, there were 220 public-health workers per 100,000 U.S. residents; but in 2000, this had fallen to 158 per 100,000.

http://www.larouchepac.com/node/10238

 

[sactoking]

Originally posted by: BoomerD
I have a VERY good understanding of what "Right-to-Work (for less) is all about.

I used to be a union business agent in a union that represented workers in a couple of RTWFL states...

Yes, it PRIMARILY deals with union membership, but invariably, those states also have less worker protection and fewer cases of enforcement of the various laws.

Yes, "at-will" means that unless you have a written contract, you can be fired for any reason...and you can quit at anytime.

Oddly enough, I think ALL Right-to-Work (for less) states are also at-will states...but of course, not all at-will states are RTWFL states...yet. The Republicans keep trying though.

Leaving your opinions about unions out of this, correlation does not equal causation. Interestingly enough, your statement is more right than you think. ALL 50 States are "at-will" states. Some have differing degrees to which the standard applies. But all 50 states have their employment law based in an at-will background.

So yes, it would seem like all RTW are also at-will. All forced union states are also at-will.

 

[nobodyknows]

Originally posted by: sactoking

Originally posted by: nobodyknows
You don't have a clue of how easy it is to terminate an employee you don't want in a right to work state.

Originally posted by: nobodyknows
Try a lifetime of living and working in a right-to-work state.

Originally posted by: BoomerD
Right-to-work and at will states still have to abide by the discrimination laws...but they don't have to have a REAL reason for firing you.

Inigo Montoya: You keep using that word. I do not think it means what you think it means.

'Right-to-work' states are those that have laws/statues making it illegal for unions to force people to join if a union is already present, otherwise known as a 'closed-shop'. 'Right-to-work' has absolutely no bearing on on discussion y'all are having.

In other words it's just you against a whole corporation because there are no unions sticking up for employee's rights.

 

[dennilfloss]

Originally posted by: GodlessAstronomer
I live in a country where we have universal health care. It's a wonderful system and I certainly wouldn't trade it for any privatised system that I know of.

 

[gingermeggs]

Originally posted by: mattpegher
I'm not so much against UHC as I see problems>

1. I don't want myself or my patients being told that they can't have or must wait for necessary treatments, Short of cosmetic proceedures it should be up to the doctor to decide what the patient needs.

2. Currently, hospitals are losing money even in areas that have good health insurance coverage. And Insurance companies are making record profits. So were is all this money going --------> insurance companys not actual health care.

3. If you decrease the financial incentive to doctors then less students will seek medical school ( which I am still paying for 15 years after graduation), So we lower the requirements and all the smart kids go to business school, and your local doctor is the kid you tutored in highschool.

4. Less financial incentive also means less money put into new drug research.

yes, so a business, economics or law degree is more attractive currently to "intelligent" people. But based on supply and demand, this should turn around?
My mother was a RN all her working life and she made a comment about administration staff ratios changing from 1 admin to 5 nursing to now 3 admin to 2 nurses, much of it caused by law, business managers and economists making room for their own financial existences in many fundamental human services. So if you were to change anything it would be to get "the pigs out of the trough".
Once upon a time, public hospitals(in australia) had voluntary(unpaid) boards of directors made up of altruistic people the like's of elder doctors, scientists and engineers, who's only reason for being in such positions were to give to their society- my father was a director of mona vale hospital after being a council civil engineer all his life (maybe because his wife worked so hard in public health in the op theatres). They have first hand experience in service delivery, so didn't need so much advising to come up with good workable solutions- you can't buy a kilo of experience!

Now, the hospitals here, have paid boards full of business bureaucrats from law, banking and insurance, services here have slipped away from a very cost effective public service(free health care) to a private Insurance racket.
If anything needs changing; it is to restrict access of those parasite professions from sucking the money out of such honorable institutions like hospitals.

Japanese and Swiss government systems look like a good model to follow, maybe real Fascist is better then aka "capitalista"?

 

[fskimospy]

Originally posted by: mattpegher
I'm not so much against UHC as I see problems>

1. I don't want myself or my patients being told that they can't have or must wait for necessary treatments, Short of cosmetic proceedures it should be up to the doctor to decide what the patient needs.

2. Currently, hospitals are losing money even in areas that have good health insurance coverage. And Insurance companies are making record profits. So were is all this money going --------> insurance companys not actual health care.

3. If you decrease the financial incentive to doctors then less students will seek medical school ( which I am still paying for 15 years after graduation), So we lower the requirements and all the smart kids go to business school, and your local doctor is the kid you tutored in highschool.

4. Less financial incentive also means less money put into new drug research.

1.) Waiting times on average are already atrocious in the US, comparable to waiting times in UHC systems.

2.) Right, I don't see how this is a knock against UHC.

3.) And if we paid every doctor $20,000,000 we'd most certainly have only the best and brightest, right? The question is not how to get the absolute top people into a field, it is to get the maximum number of people who can be effective to be doctors. It's all a cost/benefit analysis.

4.) The 'drug research' approach is a total red herring. Currently pharma companies spend far far more on marketing than they do on R+D. Even if you're worried about R+D funding, irrationally paying way more than anyone else in the world for drugs is about the worst possible way to promote new R+D. Instead of just driving a truck filled with money up to their headquarters and hope they spend it wisely, why don't we use that same amount of cash to subsidize drug R+D, but on things that we as a society want. I'm not against subsidizing drug research, but to just blindly shovel them cash and hope they do it is a terrible way to go.

 

[gingermeggs]

You do what you do, because it is forefilling and it makes you feel worthwhile-mature- professional, justified!
a bunch of kids of high IQ are not as capable as a passionate person whom is dedicated, just because they crunch fastest doesn't make em' accurate. The British system in it's heyday proved that.
Everyone has a reason and a true station in life, even if it isn't fashionable.
Pardon my satire at time fellas, I get down to.

 

[colossus]

Originally posted by: eskimospy

Originally posted by: mattpegher
I'm not so much against UHC as I see problems>

1. I don't want myself or my patients being told that they can't have or must wait for necessary treatments, Short of cosmetic proceedures it should be up to the doctor to decide what the patient needs.

2. Currently, hospitals are losing money even in areas that have good health insurance coverage. And Insurance companies are making record profits. So were is all this money going --------> insurance companys not actual health care.

3. If you decrease the financial incentive to doctors then less students will seek medical school ( which I am still paying for 15 years after graduation), So we lower the requirements and all the smart kids go to business school, and your local doctor is the kid you tutored in highschool.

4. Less financial incentive also means less money put into new drug research.

1.) Waiting times on average are already atrocious in the US, comparable to waiting times in UHC systems.

2.) Right, I don't see how this is a knock against UHC.

3.) And if we paid every doctor $20,000,000 we'd most certainly have only the best and brightest, right? The question is not how to get the absolute top people into a field, it is to get the maximum number of people who can be effective to be doctors. It's all a cost/benefit analysis.

4.) The 'drug research' approach is a total red herring. Currently pharma companies spend far far more on marketing than they do on R+D. Even if you're worried about R+D funding, irrationally paying way more than anyone else in the world for drugs is about the worst possible way to promote new R+D. Instead of just driving a truck filled with money up to their headquarters and hope they spend it wisely, why don't we use that same amount of cash to subsidize drug R+D, but on things that we as a society want. I'm not against subsidizing drug research, but to just blindly shovel them cash and hope they do it is a terrible way to go.

1) Wait time in the US are not atrocious. They're actually probably the best in the world when counting the population at large and based on statistical need/severity. If you're going to the ER for a bad sore throat and a 103 fever yes you may wait up to 8 hours in a moderately impacted hospital. If you're having an acute myocardial infarction and need to go to the cath lab within 1 hour (time is heart muscle) I think I would rather be in the US than anywhere else on earth. Major comparative morbitiy and mortality statisical comparisons show this. The main cost of medical care is primarily born in procedures (why specialist make more than primary care) and a heart cath/stenting can run upwards of 30k for 1.5 hours of "work". That sore throat may only take the ER doc 10 minutes (paper/face time) and so is miniscule in comparison. No need to bother with a heart cath 2 days after the patient had the heart attack since the damage is done. The good news is you get to go home w/ free meds for life and now have to live w/ Class III or IV heart failure.

Wait times for primary/urgent care (the field I work in) are bad in the US primarily because of the lack of sufficient primary care physicians. Sure a lot of specialist look down in the FP/Internist as not being smart - in reality if I was a lay person and had a choice of a specialist or a primary to heal a random problem I would pick primary care. When a nephrologist can get $70 a day from Medicare for a 2 min visit and 2 min note why go into primary care/internal medicine who has to spend anywhere between 5min-2 hours face time and 5 minute note? I was matched for anesthesia (one of the better paying and cushier specialties) and I often regret my altruistic decision of going to primary care (watch Scrubs not Grey's to see the grief). If you want to fix "wait time" either fund more primary care training.

2) Not sure what the point of the original statement was - perhaps to indicate that there is some inherent waste in the medical system. I read the majority of the posts here. It seems those advocating UHC believe it to be a more efficient system. It probably is. It is efficient in that there is no need to have a medical biller with years of training under his/her belt to know how to actually get around those repeated denials for claims. It is efficient in that there would be a single purchaser/distributor of goods (the government). Typically with consolidation you do see removal of excessive administration and overhead. Hell if you take the majority of insurance companies out the equation there is a lot more $ to go towards true medical care. Don't think anybody can argue against that. This would, however, result in the immediate loss of millions of jobs - i would guess about 5-10 million directly and the so-called ripple effect. I don't want to comment on that - the same can be said for straightening out the tax code would would unemploy so many CPAs it's not even funny

3) I have often told my patients and even friends that 95% of the general populace could become a physician. Having seen some people graduate medical school who have just enough neurons to memorize for the test but not enough common sense to even introduce themselves to patients they see for the first time. I'm not the smartest sheep in the flock. I will say I did have to work to make it through med school (there were a couple of guys who partied all the time and still learned everything and ended up wasting their brains doing derm lol). I worked my ass off. I'm sure if we used threats of violence and enough carrots we could get 95% of the populace to pass the required tests. About 15% of them would make good physicians - and given the current state of medicine sadly only 1% of them would want to practice medicine for a lifetime. I'm not one of those 1%. I regret choosing medicine primarily because of the $/grief ratio is just not worth it. Maybe I go overboard (I was rated top doc by the RNs/Staff last year at my little 200 bed hospital) but I do feel I'm getting shafted. I don't think I know of any profession that has seen income drop each year since 1980 except maybe 8-track repair guy (and even that dude probably charges $500/hr). Yeah I'm a little bitter I missed the crazy 80's when every doc could afford a Ferrarri but it's sad when I see reports about how abused these regional pilots are and think back to 6 years ago when I had to put my finger up at least 10 rectums per night for what amounted to $3.81 cents/hr (before 80 hr/week law was enforced). If I got $20 million/yr I would probably give $18 million to charity just to spite the goverment on taxes. I would be happy just making as much a plumber makes per hour. Roto Rooter charged $180 to snake out to the main in 4 minutes and $45 for weekend visit - I work 365 days a year and have yet to see Medicare/MediCal/BX/BS/PPO/HMO pay extra for "holiday rates". I spend about 10-20 minutes per day w/ each of my inpatients (actual face time) which is an unheard amount of time. Back when I did ER call I spent even more time on the uninsured patients just making sure they knew what was up so I wouldn't get sued. The future of medicine really needs to modify payment based on quality of care (pisses me off to see dumbass crooked docs who write notes on patients without even setting foot in the room - which is illegal BTW). In all the rambling, my point is this - I want to feel that I as a physician am getting paid adequately for my time/training and seeing $110/hr for ACE mechanics or $180/3 minute snake doesn't make me feel all warm and fuzzy. Care to guess how much the cardiologist makes for that 1.5 hour heart cath/stenting I mentioned above - you'll crap your pants and any plumber will laugh with a big grin.

4) I did drug research (no not that kind - the real kind with clinical trials and consent forms) and I also own drug stocks (PFE,LLY). When I was growing up I never saw a commercial for a drug - now watch the evening news and try to get by 1 break w/o seeing 3 adds in 2 minutes. I do believe the pharm groups are stupidly advertising to the patient and the only ones benefitting from it are the media outlets. The drugs companies do have a bit more humanity in them than most companies, but again they are large corporations with shareholders and employees to protect. Make of that what you will. I think the only way to kill the R&D arguement would be to have a straight tax on the pharma net revenue and channel that through FDA/CDC/NIH government run clinical trials. That would be the only way you could direct more research towards disease of chronicity instead of researching the next Cialis (not Viagra since that was supposed to be a vasodilator BP med).

If you look for my previous rant about the stupid patient I had who was so concerned about her trip to Vegas instead of getting medical insurance you'll see what I think is the inherent problem with UHC - the concept of who is going to pay. Since it is Universal - everybody in the US would have to pay. We all know that end up just becoming another tax - there's no debate on this so far. This tax will most likely draw more revenue from more affluent individuals. Now to somebody who is homeless, making no $, or making so little that their contribution would me miniscule this would not be seen as a problem (at least not a financial one). To somebody who's making 300 million/yr a 10% chunk of your gross income would feel like a kick in the pants (I'm not debating on whether a million could survive happily on a $80k salary - just saying the tax is a big number). To those rich people out there who can afford to go to $1000/plate dinners, who can take private planes at their whim, or don't look at the price tag when they buy things - this tax would have significant effect on their wealth (albeit maybe not on their lifestyle lol). Some rich people say they'de be happy to pay that tax Oprah and Soros for the betterment of everybody. Some rich people will foam at the mouht - Limbaugh. Some poor people may say it's not fair to punish the rich (probably the ones with dreams of one day becoming rich).

I for one stand to increase my income if UHC passes (assuming the goverment actually pays me to see patients unlike my lying whore of a goverment - CA Medical). But I just can't see the middle class liking the outcome. The end result for people making 30-300k (30K in some states buys 1/2 a home, 300k in Cerritos, CA buys 1/2 my crappy 1200 sq ft 1964 house) is that they'll have to pay a certain amount of their income to a federally funded system (they're already doing that w/ Medicare) and hope that the care given to them is better than the HMO/PPO/IPA/Private care they currently get. If any of the rest of the world's models are an indication - Americans would be worse off. Worse in the sense that the availability of private choice would be decreased the the motivation for physicians to go a step above would not be there - so you would get even more attitude from your doc. This is assuming that those 40-60 million people are added to the coverage.

Then comes in the US citizen vs illegal arguement. Currently we do have UHC as people have said above. If you have nothing to your name you can get anything from the best care in the country to the worst treatment there is - depends on location/time of day/luck of the draw on your doc/nurse. I can only assume Obama will grant amnesty and another 15-20 million will be added to the insured list in the next 10-15 yrs. There is no point of talking short term afterall - all gov programs look good the first year right? The uninsured masses will be competing w/ the previously insured PPO/HMO/IPA/Private patients for face time w/ the docs. Again, unless we massively extend out the primary care network (RNP/PA/FP) then your doc's office will become a zoo in the short run. This will force a certain group of more affluent middle class to go looking for offices w/ private docs who keep volume down in exchange for more facetime. Considering the UHC primary docs in other countries make way more than primaries here, the private docs will most likely double their fees. Of course private people no longer have to subsidize the 60-80 million uninsured who just got UHC - so I'm not sure what the true cost would be (may go up or down). The rich peeps will still have their Cedar Sanai's. The upper middle class will have private docs for outpatient visits and maybe inpatient if they can afford them. The rest will have UHC. With the way medicine & legal system currently are run - I can see UHC being able to provide more care.

And that's where the word care takes on a new meaning. Am I really caring for a 23 year old who complains of worsening headaches for 2 months and I feel I need to do a STAT head CT to rule out an anuerysm which would cost me a pretty penny if I get sued? No I am not. I am performing an ill timed procedure under stressed circumstances. Can't keep pt there for monitoring or wait times go up and nurses juggle too many pts. Can't send home to follow up w/ primary or neurologist since patient is unreliable or may not be aware of symptoms to loookout for w/o me spending 5 minutes to lecture on aneurysms. Why don't I do a head CT to cover my ass. And then we come to the cover-your-ass medicine. Every doc plays it. Some docs are so paranoid by it they admit every patient w/ nausea and other docs are so confident they rarely play the game - but at some point we all worry about that lawsuit. That's a whole topic in and of itself. I would happily sue another doc if I found he didn't take a proper history or didn't perform standard of care. If he missed some weird diagnoses and my mom died I would OK w/ that since shit happens - can't save everybody. The American public at large doesn't understand this. It doesn't help when people like Larry H Parker put commercials on TV saying he's 98% successful and then you see some goon saying "Larry H Parker got me 3.1 Million" or "Get All You Can!". WTF! When did a sad or tragic event become a payday!?! I wonder who will insure physicians with UHC. If their protected by the gov the way teachers in CA are - your doc would probably have to stab you in your room multiple times before even going to court lol.

I would rather see Obama focus on a national electronic medical system, a patient bill of rights, and national policy on requirement for power of attorney and Advanced directive before even talking about UHC. If you can't do simple 30-100 billion dollar overhauls, I don't want you touching a 2 trillion dollar system.

You know how much time and energy docs/nurses/PAs/clerks/orderlys waste every day w/ paper? Where's the chart? Where's the patient? Nurse Linda, what's the last BP? Did this guy have a CT scan of his chest/abd/pelvis at City of Hope? Does the doc know Coumadin interacts with Omeprazole metabolism? Every hospital in the US has 1 computer (I'm hoping). Some have thousands. Problem is they don't talk to each other. What a waste. Companies are trying to get hospitalss to throw $ at Electronic Medical Records w/o having any standard for forms or info. The only standards are still the goverment forms for Medicare/Medicaid billing. The rest is just a random form at every hospital. I don't like the goverment taking on most projects, but standardizations of weights/measures/forms/communication is something basic that the gov can and should do. It can prevent so many deaths, pay for itself just in the initial year of implementation (I can't even tell you how nuts the hospital UR went when they found out we did a head CT on a woman who had 13 of them in the last month!!!), and save so much time. One of my biggest peeves as a medical student/resident was having to write so much crap even though it was already available in the medical record. I typed an History and Physical my first month as a medical student since I typer faster than I write and I was scolded by the attending since my note stuck out like a sore thumb in the chart (illegible writing was the theme at that time - now it pretty much guarantees you lose your suit).

95% of health care dollars are spent in the last 5% of life - something medical student hears during training. It's true. All those 30-110 year olds I've had to pull the vent on or pronounce in the SICU/CCU we sucking down thousands of dollards per day. I'm not an ageist. Actually having volunteered at the VA in Long Beach, CA I love my vets and old peeps. But I do know that most often people are not prepared for death. This leads to pursuing care at the end of life that often has no tangible benefit. I'm not talking about the 30k spent on chem to give a cancer patient a extra year. I'm talking about the the 25k/day spent on the last days of a 97 year old man who didn't want to be on a vent but the family is too selfish/guilty to let the man go. I am on the Bioethics Committee at my hospital and it disgusts me to see so much $ wasted on people who did not want to live that way and at the same time the hospital can't afford to give a homeless guy a taxi ride to a shelter. Seems kind of stupid. Well, I guess only those who live can attest to it. This again is a touchy area that only the federal government can legislate. But why not make people declare their Code Status when they get their Medicare Card and just update it as necessary or with each annual reenrollment. Gee, sounds kinda hard to me. Having seen all the crap people go through at the end of life, many docs (esp ER docs) joke they're going to tattoo DNR (Do Not Resuscitate) on their chest!

 

[fskimospy]

Hey, thanks for an interesting and informative post colossus. I agree with most of what you said.

The only thing I don't agree with is your assessment of 'who is going to pay'. As I've said many times before we're all already paying for universal health care for everyone. We just pay for their care in the emergency room instead of (hopefully) their care before it gets to the critical point. It's a tax built into every product we buy and everything we do. Since we're just nickel and dimed to death by it, we don't notice.

 

[Atheus]

Originally posted by: colossus
If you're having an acute myocardial infarction and need to go to the cath lab within 1 hour (time is heart muscle) I think I would rather be in the US than anywhere else on earth. Major comparative morbitiy and mortality statisical comparisons show this.

Those statistics only count people who are in the system. Many Americans die outside the system becasue they can't afford treatment.