we’re going to hold you to that.

Once again, your ignorance radiates from all around you and your words. Again, you have not answered any of the questions and instead made childish comments. You and Matt have comment equivalent to “You are stupid. You are fat.” Honestly, I thought you all were at least in college in that you would have the intelligence to talk about current events. Apparently, I assumed too much. Thats ok though. You must have had a hard day today. Let me guess how this went:
Woke up at 1130 AM (late night at the bar and mom and dad’s credit card is without limit so you got hammered). Then, you went to your political science class where, in your hung over state, you thought you had a moment of enlightenment and decided to sound off to the world about the latest injustice. You came home, ate some organic something or other that you paid triple for because you, the ignorant hippy consumer believe that organic means better, when really organic simply means that it contains carbon atoms. You did not care though because Mommy and Daddy gave you their credit card to pay for it. Next you went to your blog and typed you garbage of the day. You found my post and upset by my logic, you decided to attack me with “And only a flaming idiot wouldn’t understand the meaning of the term “flaming idiot.” Bravo, lets begin:

1. “Stick to dissecting frogs, buddy.” Wow smarty pants – clearly no science classes for you since 7th grade biology. Way to go! Yes, in medical school, we learn about human anatomy by studying frogs.

2. “(I don’t think anyone is listening to you here. so you’re just talking to yourself.)” Well, clearly as you and Matt have responded now a number of times.

3. “By the way, you are pretty deluded if you think anything you wrote has made Matt or me look bad or feel bad.” No, I do not think I made you both look bad – you both do that pretty well on your own. However, your lack of saying anything about the content about this debate and my making logical points makes you look pretty bad. I mean imagine this in a presidential debate. Obama answers the question in a well thought out speech, then it is McCain’s turn and he responds to the question of what to do about the problems in Iraq by saying to Obama “You are a flaming idiot.” Yeah, that is what you and Matt are like, so I guess in this case we both (you and I) have made you look foolish this time. In fact, I would liken your responses (and Matt’s) to comments by Sarah Palin. I think you three should have your own news show or blog and then let the whole world laugh a little. Afterall, laughter is good for your health and this way you two could actually contribute to society in a meaningful way.

3. “And only a flaming idiot wouldn’t understand the meaning of the term “flaming idiot.” Way to dodge this one! I did not see this strategy coming – dont answer the question and instead insult him? Wow – brilliant. Reminds me of a 4 year old child at kindergarten.

Now, back to the main point – read my previous points…but just in case….

Cliff Notes for Sarabeth and Matt:
American dream = work hard, get rewarded for hard work. No one is a slave to another person. If unable to work because of things out of your control, then society can help you.

In conclusion, thank you Matt and Sarabeth for your lovely discussion and your incredible blog showing such a great point of view (this is sarcasm). I am done with this debate as no debate is to be had with you.

Let me dissect out what you have said

Stick to dissecting frogs, buddy. (I don’t think anyone is listening to you here. so you’re just talking to yourself.)

By the way, you are pretty deluded if you think anything you wrote has made Matt or me look bad or feel bad.

And only a flaming idiot wouldn’t understand the meaning of the term “flaming idiot”.

Let me dissect out what you have said as it has just as much meaning as what Matt had to say.

1. Anon, you are a narcissist.
- Is that because I believe I am better trained than you to understand medicine? Or is it because I have had to work longer hours than you? Is it because while you are at home sleeping in your bed or spending you weekend out by the pool, my colleagues and I spend out nights sleeping in this hospital ensure availability to all of our patients? No, it is because I am stating the truth and this bothers you. Lets say you or Matt work at a local bar, restaurant, interning at a law firm or whatever – are you willing to pay to do this and do it 6-7 days a week for years and making sure you are always available? No. There is nothing narcissistic about it – we work harder than most people and sacrifice more. Short of you being a marine, dont try to tell me you sacrifice and work harder because you are a liar if you say such a thing.

2. I am flaming? Do you mean that I am literally on fire? Are you making a derogatory comment about sexual orientation? Do you mean that you are just flaming the fire arguing with me? I will assume it is the third option as the other two make you out to be an idiot and I do not want to assume you are one. Yes, you and people like you flame the fire. You are looking for something for free. That is ok – that is human nature. We all would like things for free, but if everyone working for free means that some work really hard and some do nothing all day and act as parasites – which is unfair and is the reason why a pure, true communistic society never works. The last time people worked for free with no personal gain at all was slavery and the people who go into medicine are generally too intelligent to allow themselves to become slaves. Now, does that comment where I assume the average physician to too intelligent to be a slave point out my narcissism? I think not – it is a fact that most if not all physicians are relatively intelligent people.

3. I am long winded because I type such long responses. You are right about this one. I am long winded because I am so irritated by people like you. You work hard and you hard work will pay off. That is the American dream. Families of immigrants know this as they fled from true hardship to come to the land of opportunity. They work their butts off when they come here. People like you, on the other hand, feel that you are entitled to everything because you grew up here and never knew hardship. I grew up here too, but I recognize you must work hard to succeed in life. However, plenty of kids I went to high school with who had everything handed to them ended up doing nothing with their lives. In fact, many of them went on to get hooked on drugs and some even ODed and died.

** NOTE ** I am not anti-drug and that last comment was not meant to sound like I am some unrealistic super conservative person. This is another story all together though.

4. Your comment had no point to it. You simply said anon student, you are (insert negative word here). You see? You and Matt do not make actual points. This may be because you do not understand and that is OK. Some day you may.

5. My plan for a good healthcare system that people can afford:

I know health care is outrageous in terms of cost. I am not denying that. However there are a few key points that must be understood.

PROBLEM: Healthcare is a commodity, not a right. It costs money to provide healthcare. These costs include the cost of having a highly trained person work on you (physician). Additionally, you may work with many other allied health care providers, many of whom went through long training as well. Then you have to pay for rental of the health care facilities, such as the hospital, ER or whatever. You also pay for imaging that you need done (and machines cost in the millions often). You have to pay for the medicine you use and the research and development that drug companies put into making this medicine. You pay for the administrators who make sure that everything runs smoothly. You pay for the materials used in you health care. More importantly, you often pay (especially at the hospital) to offset the cost of money lost on the uninsured, the poor and those who will not pay their hospital bills for whatever reason. Unfortunately, health care facilities and workers have bills to pay as well and so they cannot take more losses than income and they therefore have to raise prices to compensate for those who do not pay.

SOLUTIONS
1. Tort reform: If you bring a lawsuit against a physician just to try to make a quick buck and it is found to be a frivolous lawsuit, the plaintiff, in all cases, should be solely responsible for paying for the court costs and the lost work time of the physician. In turn, physicians would stop having to order unnecessary tests to protect themselves from lawsuits. This would also drive the malpractice insurance costs down so that doctors did not require as high of salaries. In some states, certain specialties are required to pay tens of thousands of dollars annually just for insurance – which must come out of their salary.
Additionally, malpractice suit payouts must be capped at a reasonable size.

2. Physicians should have income lowered somewhat. However, this means physicians should not be required to incur as much debt as they do. In turn, this means the cost of healthcare should come down. First, taxes need to be raised to subsidize the costs of medical schools. Second, see number 1. Third, doctors should not be required to work more than the general population. What this means is that the supply of doctors must increase exponentially to allow them to have enough doctors so people can work 40-50 hour weeks like the rest of Americans. When you work more hours, you deserve to be paid for them.

3. Patients MUST assume responsibility as well. This means you MatT and you Sarabeth must:
a. Not smoke
b. Not drink
c. Not do drugs
d. Wear seat belts always and never speed
e. Only be permitted a certain blood glucose and cholesterol level. To do this, you must exercise and eat as prescribed by your doctor or a nutritionalist.
f. You must take medications as prescribed
g. You must undergo all recommended screens. There is a list of screens recommended, but they include mammograms and pap smears (at the right age) for you Sarabeth and colonoscopies for you both. There may be a digital rectal exam recommendation for you as well Matt, so if your doctor wants you to do it, you will have to do so.

Now, if you and all Americans comply with this aggressive preventative care, you will save billions and billions of dollars annually. However, if you choose to say, smoke cigarettes, despite warnings of the risk of cancer, COPD, atherosclerosis and more, you cannot be eligible for the costs to treat such conditions which you selfishly decided was worth the risk. Again, there is a limited amount of money in the pot and quite frankly, if you decide to be a smoker Sarabeth, but someone’s little 4 year old boy has leukemia, this child deserves that money and you do not. We are all in this together.

4. Medications and Innovation: none of this comes free. If you want the smartest researchers continuing to bring you meds and medical tools to help better your life, they have to be paid. If they are paid by private companies, it will be profit driven. However, if the government paid, then it would not be so profit driven and would be more affordable to the population. This means taxes must be raised to pay for such research and development because right now, the only one paying for drugs to go through FDA trials for approval to be used on humans are the drug companies.

5. Catastrophic medical conditions: Everyone must be ensured for this (unless you are self inducing the catastrophe or you life expectancy is so short that the costs outweigh benefits – as some countries with socialized medicine already do). This means that there must be a universal plan of some kind.

6. Patience: As a patient, you will have to be ready to wait more. Things will not get done as fast as there will be a great abundance of people with access, but not enough providers. This will mean that more emergent situations get treated first while less serious conditions wait. Unfortunately, this is a team effort and you will have to be ready to sacrifice, too (and wait more than you do already).

7. Fairness: If you are going to cap doctors’ salaries, the same should go for other professions including athletes, actors, politicians, President Obama, lawyers, CEOs and anyone else who makes more than a set amount. You have to make this a fair situation to everyone.

Sarabeth and Matt – I am sorry to have to be so mean, I do not mean to make you feel bad. I am just explaining this to you from a perspective you dont understand. Healthcare is a national issue and we are all a part of this. In order to make it work, we need to work together.

Especially a narcissistic flaming idiot.

And arguing with a longwinded narcissistic flaming idiot has to be the classic triple whammy.

I think this guy telegraphed all three personality traits in his very first comment.

You are very clever. Did you come up with that on your own. OK then, I am going to lump you in with the religious right or stupid people. You make claims without backing up any of them and you refuse to answer any of the questions posed to you. I assume that I am correct that you are a student and your contribution to society is your blogging and so you feel empowered. That is great – I remember being in college and being irrationally liberal. I will leave you then with what my grandfather said to me when I argued with him about matter such as this. I thought I was so clever because I went to college and I knew things. Turns out, his 70 something years of experience amount to a heck of a lot more than my 4 years in college. Anyway, he said some rendition of the age old expression which I will paraphrase:

You are heartless if you are young and excessively conservative. You are brainless if you are older and excessively liberal.

When you leave school, get a job, pay your own bills and try to support your family, we will see what you have to say then. Enjoy your fantasy world while it lasts because reality is coming for you soon enough!

Ok Matt, I am going to ask because debating with you is like debating the religious right – you do not back up anything you say and you are always right in your mind regardless of the fact that you never make a point. This clearly means that you are brainwashed by someone else who has told you what you think you know about the economy, about socialism and about how the world works.

projection is not just for movie theaters.

There are no conflicts in what I say – I stand on one side of the line and repeat the same thing because people like you seem to not understand anything about hard word, about the economy and about health care in general. Once more, here is where I stand – you get what you put in. If you are a college student who puts in nothing and your parents are paying your way right now, you simply do not understand that. If put in something and someone else gets the rewards of your work because they do not work or do a job that pays less for whatever reason, that is distribution of wealth and hence socialism which eventually can lead to a complete and equal distribution of wealth (controlled by the government), which by definition is communism. Moreover, if I make my money from work and do not willingly give it away, it is a form of stealing. This is different then paying taxes because I benefit from my paying of taxes, just as the rest of the country does from my taxes and from them paying taxes. However, by saying that we need to fix healthcare and I will do this by taxing 50% of the top earner’s salaries while not increasing the percentage of tax for all else because they can afford to pay this tax – that is no longer just taxing, but this is stealing. This brings me back full circle – I and many of my colleagues will probably not put in such intense hours, work overnight, work on the weekends and work through holidays to make very little money and to be taxed so much that we have no hope of paying off our debt or of living a lifestyle that all Americans aspire to live. I do not mean having a huge house or a nice car or something like that. What I mean is the ability to have and support a family, to send our children to college so that they can get the education they need to contribute to society and support themselves (without need of government financial support), to hopefully have some security in retirement and to live the normal life that most Americans aspire to do (food, shelter, live in a nice community, clothes, occasional vacation etc).

Will this affect my doctoring ability? No. Doctoring ability comes from some natural talent, but more from dedication to your studies and to your patients. My distaste with people who take our physicians for granted and expect them to be their personal slaves does not affect how I perceive patients. I went into medicine because I want to help alleviate patient suffering and because of my desire to understand how the human body works. That is what drives me.

Again, I challenge people like you to go the medical school route to see what it is like to get there. You say you do not need to do that to understand, but let me tell you – YES YOU DO. If you do not go through it yourself, you will never understand.

like i said, you’re just repeating yourself. you don’t understand the inherent conflicts in your own argument, and i hope that doesn’t say anything about your doctoring ability.

best of luck.

I harp on this because you do not get it. We work harder than ANY of those other professions. I am tired of having to tip toe around it – it is a fact. Compared to med school, law school, business school and most graduate programs are absolute jokes. Some of the material may be difficult in other schools, but they in now way require that amount of dedication or time (not to mention debt investment). I harp because you seem to not understand this. If you went through it, maybe you would.

If you think it costs too much here and people should go elsewhere, then come back, you do not understand a thing about our medical system. People come here from other countries to get educated and then they go back to apply what they have learned. It does not work the other way. If you train outside of the US, you are selected against systematically. That is a fact. Before you lecture me about the health care system, get your facts straight.

I will harp again on what I said – I am not for outsourcing in ANY fields. Work should be done in the US to keep people employed. Outsourcing for anything – from making shoes, to food, to reading CT scans is a short sighted, fiscally irresponsible thing to do and those who do it should be penalized financially for doing so – either by government regulation or by the American people refusing to use their goods and services. In the end, outsourcing of any kind hurts us all.

In terms of you saying that no one is arguing about redistribution of wealth, which in its essence is not capitalism and is more like socialism or communism (the concept of redistributing wealth), you need only to look around you. It is everywhere. Have we gotten to a point where it is necessary? Maybe so. However, I am going to call it what it is. If a doctor trains harder than any other people and works harder than other people, he or she is more valuable to society and does a job that few people could do and by the law of supply and demand, they get paid more. It is simple economics. To ask them to train as hard and work as hard and not compensate them is asking to redistribute their earned wealth. Now, you go a step further and argue that docs enjoy government protectionism and demand lower taxes. Here is the truth:

The government does NOT protect doctors – not from pay cuts nor from lawyers. Tort reform is a joke in many places and we are told in medical school that most physicians will be sued. For example, I worked in a derm office where a patient had a melanoma removed and was told he was at a higher risk for a second melanoma and needed annual checkups – this was documented in the chart. However, the patient ignored the warning. 5 years later, he had another melanoma that had spread to his brain (he is going to die from this). He sued the dermatologist for this saying that it was his fault. He was not going to win this suit, but the point was that the dermatologist then had to pay me a salary to go through all of his charts and call any patient who was diagnosed with a treated for melanoma or a squamous cell carcinoma that did not come for followup and ask them to make an appointment. Most people told me they were fine and asked if business was so bad that we had to plead for people to come to in. He had to pay me to do this because of choices patients make. Ah, but I digress. The main point is the government does not protect us from a law suit crazy society. In terms of our salary, they are indirectly set by the government. The government sets medicare reimbursements for services and the private insurance sets their reimbursements around what medicare does. So, when the government says we no longer will pay you X for this procedure, but will pay you 1/8th of X, the government decreases the physician’s income and private insurance follows suit. So, to answer your question – no – the government does not protect doctors. Now the fact that they set reimbursements so that the average salary of a doctor is above 100,000 may be what you are referring to as “protection.” Again, not to beat a dead horse, but value of work is set at how trained one is, how many other people can do that same job and how much people are willing to pay for having that job done and done well. The government and society value the physician’s salary at above 100,000 because he or she meets that criteria.

Healthcare is a human right that is undeniable. That is a politician’s phrase. No where in the constitution does it say health care is a right. Again, no one is entitled to anything – this you said yourself. Here is another fact of life that I have said before – medical treatment costs money. Lets say you have some illness and want treatment. Aside from the doctor’s bills, you will also have to pay for medicine. There are different tiers of medicine. In an effort to cut costs, people without insurance are often given lesser and cheaper meds. Is that fair? Do people not have the right to the best care here in the US? Politicians would lead you to think so. In an ideal world, this would be how it would work. Medicine would cost nothing, doctors would work for free, hospitals would not have bills to pay and when you get a cold, you come in and demand a 4 day stay at the hospital. That is not reality however. No system could ever sustain something like that because there is a limit of resources – and their lies the problem with spending what you do not have.

Lastly, your point about doctors should know best about what happens when people are not treated:

Newsflash – and I have harped on this before – this is a two way street. Doctors are not miracle workers. People must practice preventative medicine including the ban of smoking, drinking or drugs. People must ban the consumption of red meat, desserts, dairy with fat, cholesterol, etc. People must exercise as recommended. Diabetics must take their meds. People with high cholesterol or hypertension must take meds. At age 50, people must get a colonoscopy. Are you going to do all of these things? Most people will not. This would save enormous costs and in a fair world, people would do this. However, as we know, this is not a fair world.

I dont know if you are on your own financially or not, but you sound a lot like I did in the beginning of college. It is easy to be super liberal and not think about the consequences to the ideas you propose when other people pay your way. I am not saying it is best to be far off to the right, cram your religious and moral views down other peoples’ throats and let the poor and the children die on the side of the street. What I am saying is that everyone must work, everyone must try their best and those who work hard should reap the benefits of their work. A society should help those who cannot help themselves, but should not promote a society of apathy.