Doctors Lying

[snuginarug]

I'm not really saying anything other than : not-for-profit hospitals can deliver good care, ergo for-profit hospitals are not the only solution. And if not-for-profit hospitals are possible, not-for-profit health care in general is possible. The world won't collapse and fall in upon itself if profit motive is removed from the health care system. That's all. I mainly point that out to allay the fears of die-hard capitalists. People can actually create things that are not profit driven that benefit all of society. It is within the realm of possibility. That fact pleases the idealist in me.

[ChicagoGranny]

People can actually create things that are not profit driven that benefit all of society. It is within the realm of possibility. That fact pleases the idealist in me.

I hope when you vote you drop your idealism and face the reality of a world with limited resources and individuals with self interest.

... wait until you get to heaven for idealism. History has proven it doesn't work in this sphere.

[MaxDarkside]

About the time I left WA in '99, the state was devising a state wide health care plan. It was interesting and responsible. They had a board that laid out what they would not be able to provide for. Example: heart transplants for terminal cancer patients. Duh. There was a nationwide uproar about death panels. The reality is people die. 95% of our population dies in hospitals with their qualiity of life in the distant past.

I saw somewhere the "funny" quotation: "Healthy is just the longest path to the inevitable".

We lived in WA for a decade, on the east side of Seattle (Redmond, Kirkland). My wife worked at Harborview ER / Trauma Center as a HUC (Health Unit Coordinator). HUCs are like the "Radar O'Reilly" of units they serve. They know all, see all, from the chopper inbound to ordering/arranging/scheduling all the tests and procedures, to the medical records, dictations, ...

As much as hospitals bitch about the uninsured using emergency room facilities, how many have you seen set up a clinic for non-emergency underinsured patients?

Actually some do. One of the hospitals where my wife worked had a 24 hr clinic next to the ER. They would triage people in the door and route them. Very smart. ER waits were short, mmm, cuz an ER is supposed to be for EMERGENCIES, not cut fingers, or more commonly, drug seekers. (sad) These days there are a LOT of drug seekers (opiates). Some take an ambulance to the ER to increase the "justification" for getting a prescription. One lady did from the apartments across the street.

I think we don't so much have an insurance problem in this country, we have other much more important issues about costs, care, drugs, prescription drug abuse, mental health (why so much ADD / ADHD? Why so much depression?), food, additives, cancer (plastics?). I think we can get much SMARTER about medicine not just "throw money" at the problem.

[chunkyfrog]

Just put the opiates in a punch bowl, let them help themselves,
but they have to use it on the premises; oh, by the way: DNR!
Drug problem solved.

[MaxDarkside]

Just put the opiates in a punch bowl, let them help themselves,
but they have to use it on the premises; oh, by the way: DNR!
Drug problem solved.

Opiates are such a challenge. We had a family member get into an opiate/alcohol addiction problem. It went on for many years, but the only way to recovery is first hitting a "wake up call" low. In our case it was an arrest for a prescription forgery charge, you see, it's the Devil. And when the Devil demands, the addict is compelled to comply. It's like it isn't even them. The person would even growl. It was scary. It took that low, and immense support from family and friends, a great treatment center, a 72 hour lock down and constant vigilance every day thereafter to not slide down that slippery slope into the evil pit of addiction again. Once a doc even prescribed opiates for the person again, for pain, and it took another family member to dive for the bottle, flush them down the toilet, call the doctor and tell them to mark the medical record to NEVER EVER do that again. It is SO hard, for everyone involved.

[snuginarug]

If no one strives for betterment of the human situation, there will be no betterment. If you don't try to fix a broken toilet, it will stay broken and keep gushing shit all over the place. There is nothing wrong with toilets or the idea that toilets might work properly. I'll keep my idealism.

(As an aside, Germany has managed to create a not-for-profit system that works quite well without bankrupting the country or diminishing the quality of care provided. If it can be done in one place, it can be done in other places.)

[chunkyfrog]

Oops. Oh, yes, there are successful detox stories.
Significant for their rarity and the supreme effort involved.
Fingers crossed for your relative, Max.
Too many addicts have already totally separated themselves from any support systems;
Nothing but loving family and constant vigilance seems to have had any lasting effect, if that.
Too many seem to be far beyond help; and a detriment to their community, family, etc.

[MaxDarkside]

Oops. Oh, yes, there are successful detox stories.

It all starts so benign in many cases; back pain, headaches/migraines, "fibromyalgia", etc. Doc's prescribe opiates too much, sometimes in large counts, the person takes them, then more, then more, discovers alcohol amplifies their effect, then become first and foremost an opiate addict, but secondarily an alcoholic, sucking down box wine, a box every day or two/three days. Then it is too late, they are down the slippery slope. Generally no escape without hitting a horrid low. A distant family member, another, just spiraled downward to organ failure. The lows hit, including jail, were not low enough for the "wake up". He's dead. So sad.

Once down the slope, I feel for them. There's not much they can do, the Devil takes over, demanding regardless of the cost.

The best cure is not approach that swirling evil pit of addiction, to reject opiates at all cost, or at least recognize them for the evil swirling pit they are, and if one MUST take them, only for a short while and stop before going too far over the edge, but that is very dangerous. When I have severe pain, I alternate large doses of Naproxin and Tylenol and Ibuprofen. One doc pointed out that there's a combination of those proven to be as or more effective in pain killing than opiates.

[ChicagoGranny]

If no one strives for betterment of the human situation, there will be no betterment. If you don't try to fix a broken toilet, it will stay broken and keep gushing shit all over the place. There is nothing wrong with toilets or the idea that toilets might work properly. I'll keep my idealism.

Think of a better analogy.

I surely will call my for-profit plumber when the toilet is broke. I do volunteer work for non-profits and know better than to let them touch the plumbing in my house.

You introduce a vulgar word and here it comes again. I have literally cleaned s*** off the walls of a restroom in a non-profit because the staff and their clients did not have the initiative to do it themselves.

Non-profits do sometimes fill in some gaps that capitalists do not. But generally non-profits operate inefficiently and often their mission evolves from client-centered to non-profit management centered - meaning they begin to exist to perpetuate the salaries and careers of the staff.

Of course this also happens in for-profit business but the market (competition and discriminating customers) eventually, and often quickly, dispenses with the sluggards.

As far as striving for betterment of the human condition, capitalism has a stellar record of achievement. I can remember how the middle class lived in 1960 and I can tell you the middle class lives much better in 2012 than very wealthy people did in 1960. As only one example, the amount of travel the middle class enjoys today is more than the wealthy enjoyed in 1960.

Now that is betterment of the human condition - thanks to capitalism!

[MaxDarkside]

But generally non-profits operate inefficiently and often their mission evolves from client-centered to non-profit management centered - meaning they begin to exist to perpetuate the salaries and careers of the staff

When a friend says, "They are a non-profit organization!!!" in a justification of their nobility and righteousness I scoff and think "OK, so there's no money left after the management team draws their salaries". Truth be known that many S-Corporations, which by definition are "for profit", are actually in all practical purposes are operating as non-profits, every $ in is nearly spent by year end else the stock holders get smacked with big taxes. It's not so much the "corporation", but how it's managed.

[snuginarug]

I surely will call my for-profit plumber when the toilet is broke. I do volunteer work for non-profits and know better than to let them touch the plumbing in my house.

You introduce a vulgar word and here it comes again. I have literally cleaned s*** off the walls of a restroom in a non-profit because the staff and their clients did not have the initiative to do it themselves.

Non-profits do sometimes fill in some gaps that capitalists do not. But generally non-profits operate inefficiently and often their mission evolves from client-centered to non-profit management centered - meaning they begin to exist to perpetuate the salaries and careers of the staff.

First off, I have worked as a volunteer at a non-profit where the walls have been clean of excrement for seven years. The director and the paid staff are compensated for their work with a living wage, not extravagant over-the-top salaries. They provide a necessary service. They receive a lot of government funding contingent upon fulfilling certain stringent requirements. The paid employees work hard to make sure that the requirements are met or exceeded. We usually exceed the requirements.

I received clean water from the Red Cross when the city water became contaminated with human waste due to a flood. I also received two units of blood my last trip to the hospital, thanks to the Red Cross.

I could sit here and cite subjective example after subjective example of good non-profits until the cows come home. I expect if you dug around you could do the same with bad non-profits. Now I will point to a real, hard, objective example of a non-profit system enacted by the government. Germany's health care system is run on a non-profit basis and folks there receive excellent care. That is not an anecdotal and and isolated example... that is an entire country full of objective examples.

Think of a better analogy.

I stick with my analogy. If the basis for society is broken (corporations and politicians hand-in-hand running the country without reference to those who elected them... this is a fundamental problem with both democrats and republicans) we need to fix it. It is possible to have reasonable social programs that provide a safety net for those who need it without bankrupting the country or ruining the economy or doing any of the drastic things suggested by ultra conservatives of the extreme far right. Again, I point to Germany. They have social programs, they have a non-profit based health system, they have unions--- they have all the things being demonized by the right, yet they have a good economy even in these hard times.

Strict market economy without any checks or regulations (regulations being a dirty word in some circles) brought about the conditions during the late 1800s and early 1900s, which involved adulterated food (food purity and sanitary regulations), murderously dangerous working conditions (unions), people dying of hunger(government programs), wholesale destruction of natural features such as denuded forests or contamination of rivers and lakes (environmental standards).

I could go on with other points to make, but due to my idealistic nature I've got to go work hard at a good non-profit to better society. I'm running late already.

PS Sorry about the vulgarity, we were talking about toilets so it slipped out.

[ChicagoGranny]

If the basis for society is broken (corporations and politicians hand-in-hand running the country without reference to those who elected them... this is a fundamental problem with both democrats and republicans) we need to fix it. It is possible to have reasonable social programs that provide a safety net for those who need it without bankrupting the country or ruining the economy or doing any of the drastic things suggested by ultra conservatives of the extreme far right.

I agree wholeheartedly with that and would like to point out that you are describing crony capitalism and markets encumbered by unenlightened self-serving politicians. That is something I am very much opposed to.

PS Sorry about the vulgarity, we were talking about toilets so it slipped out.

I have to be careful myself as I can swear with the best of them.

[AHI15]

An unregulated, unfettered, free market will bring Americans the best health care possible, right? Gov't involvement guarantees waste and inefficiency, right? Give me a break!

Totally out of context as hospitals and surgeons are already a very highly regulated market and all the doctors and nurses are licensed by government regulated boards.

Yes they are. And if this kind of mistreatment of patients can occur inside a regulated system what do you think doctors and administrators could get by with if the system was unregulated like the free marketers and Repubs are screaming for? It would make the above look like childish candy stealing.

I don't think so. A large part of our problem is the disconnect between the decision making and the payment making. Ie., if I am paying out of pocket I will have a great incentive to check carefully that I need the procedure. So I will be motivated to get educated about my health decisions, and make them more carefully.

But if I don't have to pay, and the PRICE is not a factor in my decision to have the procedure--as it is not involved now since this corrupt mess of a non-market system doesn't let me negotiate the price beforehand--then the incentives are skewed toward relying on experts and just going along with what Drs. order.

Even if I have insurance, but I pay for it directly and I must gather the test results and Drs. recommendations myself--then feed them to the insurer for pre-authorization if needed, then I will have a strong incentive and the ability to think about whether this is necessary.

Free markets are always blamed when regulated, mandated, and centrally-planned markets fail. Guess which one we really have? And the Repubs. have no intention of creating free markets. They despise them--and their authentic competition--as much as leftists.

[ChicagoGranny]

Free markets are always blamed when regulated, mandated, and centrally-planned markets fail. Guess which one we really have? And the Repubs. have no intention of creating free markets. They despise them--and their authentic competition--as much as leftists.

Well said! My household is voting Gary Johnson for President 2012!

[AHI15]

Oops. Oh, yes, there are successful detox stories.

It all starts so benign in many cases; back pain, headaches/migraines, "fibromyalgia", etc. Doc's prescribe opiates too much, sometimes in large counts, the person takes them, then more, then more, discovers alcohol amplifies their effect, then become first and foremost an opiate addict, but secondarily an alcoholic, sucking down box wine, a box every day or two/three days. Then it is too late, they are down the slippery slope. Generally no escape without hitting a horrid low. A distant family member, another, just spiraled downward to organ failure. The lows hit, including jail, were not low enough for the "wake up". He's dead. So sad.

Once down the slope, I feel for them. There's not much they can do, the Devil takes over, demanding regardless of the cost.

The best cure is not approach that swirling evil pit of addiction, to reject opiates at all cost, or at least recognize them for the evil swirling pit they are, and if one MUST take them, only for a short while and stop before going too far over the edge, but that is very dangerous. When I have severe pain, I alternate large doses of Naproxin and Tylenol and Ibuprofen. One doc pointed out that there's a combination of those proven to be as or more effective in pain killing than opiates.

Why the heck to Drs. prescribe too many? That's what I can't figure out. I'm torn though, since philosophically I think people should be able to buy any drug legally. But Drs. of all people shouldn't be dispensing amounts of opiates that lead people from a medical problem into addiction. Drs. aren't stupid, they should know how long someone can take a given opiate before risking withdrawal symptoms and simply not prescribe any more, or require a "cooling off" period after which it would be safe to administer another course. Then again, perhaps because of drug prohibition, it is very difficult to collect data or conduct studies to determine the length of time someone can take the stuff without trouble.

I think opiates are actually critically valuable medicines, but just like the most powerful option of anything, they should be the last resort.

Oddly, I was prescribed a mild narcotic as well as the NSAID Toradol when I had all of my wisdom teeth yanked.

I tried the narcotic. It didn't work much at all! I DID NOT try taking more.

Then I tried the Toradol. It whipped the pain's butt! Better than 75% relief!

Unfortunately Toradol is one of the NSAIDs that is most likely to cause adverse side effects. I think it may be THE most powerful of the NSAIDs. I was prescribed it for months thereafter because I asked my Dr. for it to help with neck pain from a bone spur. One day he cut me off--probably because the science base discovered that it should be reserved for 7 days at a time in severe pain situations only.