On 10/11/2013 4:30 PM, Jim Henderson wrote:
> On Fri, 11 Oct 2013 17:42:01 -0500, Shay wrote:
>
>> The only sane answer is that I would not force a hospital to do any of
>> these. I would let the hospital decide.
>
> So, how would you fix the healthcare problems in the US?
>
> Jim
>
He wouldn't. You can't "not" force someone help others, and not have 
people die as a result. What pisses me off a whole lot, are the ones 
that will assert all the things no one should be "forced" to do, then, 
when its them in the situation, praise the same rules they think 
shouldn't exist, which resulting in them being saved.

Its also a false equivalence. Preventative care means "less" emergency 
care, since a great many cases never reach the state in which they "are" 
an emergency. Since such emergency care costs more, and has higher 
risks, liabilities, and thus... again, costs more, reducing the number 
of cases that reach that stage actually "increases" the available 
resources to deal with emergencies. If you ignore this, you get idiot 
shit like in my city, where the hospital can't handle some emergencies 
at all, so has to, as extreme expense, ship people hundreds of miles, by 
chopper, to some place that can. Basically - don't make the mistake of 
having a major heart attack, or anything else untreatable here, in the 
same 3-4 hours it takes for them to ship the last patient off, refuel, 
and come back. If you do... you're dead. Which is just insane, except.. 
they also fail, miserably, at "preventative care" as well, so... odds 
are, if you have a problem, it "will" progress to the point, eventually, 
where you need that airlift.

All of the other arguments about "forcing" people are similar idiocies. 
Its not the damn hospitals forcing people to not do care, or forcing 
them to pick between expensive, one shot, high death, "emergency care", 
instead of preventative care. Its insurance companies telling people, 
"We will pay to replace your kidney, assuming we can bloody find one in 
time, but we **won't** pay for the care needed to prevent kidney failure 
in the first place." But, I suppose, Shay thinks its "inappropriate" to 
"force" insurance companies to actually pay for procedures, which the 
doctors **would provide**, if the insurance didn't deny them?

Because, I know for a damn fact that you won't find a single competent 
doctor, unless they are some high paid idiot for the stars/certain 
politicians, or a specialist, who knows that preventative care would cut 
into the number of open heart surgeries, or the like they could charge 
people for, who thinks "preventative care" is a bad if idea, and they 
would be "forced" to give up emergency care to get it. First off, the 
people providing the emergency care are often experts "at" that kind of 
care, not the family doctors you go to, in order to get preventative 
care. Second, most emergency wards are overworked, dealing with crap 
that "should be" preventative. If you go in with a damn cold, odds are, 
instead of going to a regular doctor, or a care center that deal with 
basic prevention, you may find yourself waiting in line with someone who 
needs their arm reattached, do to some serious accident.

But, this was **never** the way it was supposed to work. It wasn't the 
way it worked before, and it only reached this point precisely because 
less and less "preventative" medicine has been practiced, leaving anyone 
from someone in needs of a damn bandaid, to people in need of major 
surgery, from a car accident, all shoved into the "emergency room". The 
one damn place that the former ***doesn't belong in the first place, 
except, they can't afford a family doctor, or find anyone working, on 
the day they need "basic care". And, given how many don't have doctors 
at all, most of these people would have never ***had to*** go to the 
emergency room, to look for even "basic care", if they had been able to 
go to/find a regular doctor, to get "preventative care", to keep their 
chest cold, for example, from progressing from something a few pills 
would have cured, to full blown pneumonia.

"Preventative care" saves costs on unneeded "basic care".
Having "basic care" handled properly by places that **just** deal with 
such non-emergencies saves money that would be better spent on 
"emergency care".
And, if you are not messing with "basic care" right along side of bloody 
"emergency care", in the same damn place, fewer people die, because 
doctors, nurses, etc. who work in the emergency rooms, are over worked, 
over stressed, and trying to deal with 500 problems an hour, instead of 50.

All of which hinges not on "doctors" being "forced" to provide such 
things, but on an unwillingness of insurance companies to pay for proper 
"preventative care", agree on the best "basic care", or, sometimes, even 
pay for "emergency care", if it falls into some category of, "Well, 
there is a cheaper, inferior, solution, which you will probably die from 
sooner, saving us, the insurance company, money." Except, because the 
insurance companies are the ones making these decisions, on what is, or 
isn't, paid for, and the "preventative care" is the one they are 
***least likely*** to pay for.. it was decided to, instead of fixing the 
fucking problem, to instead "require" any and all problems, no matter 
how trivial, which come into an emergency ward, to be "treated", for 
free. The only "forcing" being done, sadly, being done "purely" to treat 
as many people as possible, including the ones that are there 
**because** they never got preventative, or basic, care, until a minor, 
cheaply fixed, trivial, infection, or other problem, has **escalated** 
into a full blown emergency (assuming, of course, that they don't come 
in before it gets to that point, get handed a few pills, told to go to a 
regular doctor, which they don't have, to continue treatment, and thus, 
never do, leading, again, to them "eventually" actually ending up in the 
emergency room because they are not not just sick, but possibly dying.)

Yeah, I have absolutely no bloody patience with people that think fixing 
this idiot mess is a bad idea, or that someone more people will die, by 
making sure more people don't get to the point they are dying in the 
damn first place.. It shows a complete, and total, oblivious ignorance 
of what is going, on, what doctors themselves say on the subject, what 
the actual problems are, or why the fuck they got that way, in the first 
place.

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