If Mort Divine ruled the world

[Dak]

I care much less about the statistical outliers in this scenario, and am addressing it from the viewpoint of the right to life itself. Society clearly values its prime movers, but I think that within a society everyone has an equal opportunity to life itself. Otherwise we are no better than animals.

Yes, people have an equal right to be left alone. Not a right to take from those with more than them, or take from those with different skills. A "right to health care" makes doctors, nurses, etc and medical tech companies slaves.

If you were to completely ignore the social aspects of the advancement of civilized society, then yes, you are right. But society has been driven to innovation by people with big aspirations, grand ideas, and yes ideals.

How much have social aspects improved? So much so that everyone is fucking depressed, anxious, and in pain. So much improvement. I suppose you think Zuckerberg created Facebook and keeps it free for users because of a purely altruistic position.

 

[Einherjar86]

Yes, people have an equal right to be left alone. Not a right to take from those with more than them, or take from those with different skills. A "right to health care" makes doctors, nurses, etc and medical tech companies slaves.

Your sense of "slave" is less logically accurate than it is rhetorically provocative. In a similar sense, we're all slaves to time, or money, or the gastrointestinal system.

How much have social aspects improved? So much so that everyone is fucking depressed, anxious, and in pain. So much improvement. I suppose you think Zuckerberg created Facebook and keeps it free for users because of a purely altruistic position.

Well, the world has grown less violent since last century. As far as depression, anxiety, and pain go, people have always been these things. We're simply treating them differently today, for better or worse.

 

[arg]

I care much less about the statistical outliers in this scenario, and am addressing it from the viewpoint of the right to life itself. Society clearly values its prime movers, but I think that within a society everyone has an equal opportunity to life itself. Otherwise we are no better than animals.



If you were to completely ignore the social aspects of the advancement of civilized society, then yes, you are right. But society has been driven to innovation by people with big aspirations, grand ideas, and yes ideals.



I agree mostly with your first two points, but disagree fundamentally with the third. If a doctor is morally obligated to do everything in his power to save a patient's life, then I think we could extend this logic to a healthcare system that is morally obligated to help anybody within it's scope to the same life-saving obligation. As an EMT I have met many people who are unwilling to seek treatments because they either dont have insurance and/or cannot afford care. This to me is an injustice and there should be attempts to alleviate this issue. As a society we already pool together "other people's resources" to support civilized society, and there is nothing more important to someone than their own health.

No, healthcare is a service and healthcare providers should be allowed to reject patients who can’t pay (or just give them painkillers and tell them to fuck off and not cure the expensive disease).

They can go find a compassionate doctor who will treat them for free or beg for money on gofundme, but they have no moral justification to get the government to reach into my pocket to cure them, they can fuck off and die.

 

[Dak]

Your sense of "slave" is less logically accurate than it is rhetorically provocative. In a similar sense, we're all slaves to time, or money, or the gastrointestinal system.

Sure, but why bother developing advanced aids or techniques if it just makes you the slave of some soapdope?

Well, the world has grown less violent since last century. As far as depression, anxiety, and pain go, people have always been these things. We're simply treating them differently today, for better or worse.

The lower violence has been a twin result of the increased threat of violence and the increased level of material wealth. That is a separate matter from the increased levels of depression of anxiety, even if also related.

 

[Einherjar86]

Sure, but why bother developing advanced aids or techniques if it just makes you the slave of some soapdope?

My point is that using the word "slave" implies a particular perspective on the issue that in turn implies a particular ideological stance. You're still using "slave" as though it correlates to a definitive state of being in the real world. Doctors working in a modern society that guarantees universal healthcare aren't actual slaves.

As far as your question goes, why would universal healthcare preclude the impetus for scientific development? Isn't it possible that people who go into medicine do so for the contribution it might have to a broader social good, as opposed to simply securing individual financial security?

The lower violence has been a twin result of the increased threat of violence and the increased level of material wealth. That is a separate matter from the increased levels of depression of anxiety, even if also related.

If you say so.

 

[Serjeant Grumbles]

How much have social aspects improved? So much so that everyone is fucking depressed, anxious, and in pain. So much improvement.

That's just because of all the vaccines people are taking. Sometimes they cause autism, but other times they cause depression or anxiety. I'm disappointed that you didn't already know this.

 

[Onder]

No, healthcare is a service and healthcare providers should be allowed to reject patients who can’t pay (or just give them painkillers and tell them to fuck off and not cure the expensive disease).

They can go find a compassionate doctor who will treat them for free or beg for money on gofundme, but they have no moral justification to get the government to reach into my pocket to cure them, they can fuck off and die.

 

[EternalMetal]

No, healthcare is a service and healthcare providers should be allowed to reject patients who can’t pay (or just give them painkillers and tell them to fuck off and not cure the expensive disease).

They can go find a compassionate doctor who will treat them for free or beg for money on gofundme, but they have no moral justification to get the government to reach into my pocket to cure them, they can fuck off and die.

Savage response. Then again, I wouldnt expect someone like you to even remotely understand basic morality. I already knew from the beginning that I was taking a controversial stance, but people who can look down on the downtrodden without any sort of empathy and say that they can "fuck off and die" are fucking assholes that deserve some crippling illness. And when you are sick, laying in bed unable to work, your funds drained attempting to sustain yourself, you will do what exactly? Fuck off and die apparently.

As far as your question goes, why would universal healthcare preclude the impetus for scientific development? Isn't it possible that people who go into medicine do so for the contribution it might have to a broader social good, as opposed to simply securing individual financial security?

Almost everyone I know in the healthcare industry legitimately sympathizes with sick patients and feels horrible about denying care to those who cannot afford it. I am part of an organization (an EMS squad with ambulances) that has many members who volunteer their time to safely transport ill and dying patients to hospitals. We are one of many thousands across the nation, and probably even more across the world. Nobody wants to kick patients to the curb, but at the moment US healthcare would cripple itself and crumble if it were to serve everyone regardless of their ability to pay. I am unwilling to accept this as an end goal. Even researchers who work feverishly on cures for diseases completely removed from direct patient care would want everyone who has it to be treated.

 

[The Ozzman]

I am part of an organization (an EMS squad with ambulances)

Are you the staff MD or something?

 

[Dak]

My point is that using the word "slave" implies a particular perspective on the issue that in turn implies a particular ideological stance. You're still using "slave" as though it correlates to a definitive state of being in the real world. Doctors working in a modern society that guarantees universal healthcare aren't actual slaves.

Maybe not at the moment, but the precedent is set and the situation becomes real as forces constrain the ability to renumerate competitively and provide adequate services to the sick multitudes.

As far as your question goes, why would universal healthcare preclude the impetus for scientific development? Isn't it possible that people who go into medicine do so for the contribution it might have to a broader social good, as opposed to simply securing individual financial security?

A dozen years in school and 80+ hour work weeks to live the same material life as someone who just plays videogames all day? While some might still take the former, it wouldn't be enough to provide the services needed in a Brave New World.

 

[Einherjar86]

Maybe not at the moment, but the precedent is set and the situation becomes real as forces constrain the ability to renumerate competitively and provide adequate services to the sick multitudes.

The precedent is not there. You're imagining a precedent based on your disposition. If doctors weren't allowed to quit their jobs, or received corporeal punishment for refusing to work, then I'd concede your point.

Very very few doctors would even dream of not treating a patient no matter how much they didn't want to. It's simply not something they even consider. It's what they do--they treat people regardless of external factors. Our current situation is not establishing a precedent for doctors to become slaves in any fashion. The case I foresee is that potentially fewer people become doctors. That would happen well before they become slaves.

A dozen years in school and 80+ hour work weeks to live the same material life as someone who just plays videogames all day? While some might still take the former, it wouldn't be enough to provide the services needed in a Brave New World.

It wouldn't be the same material life. Why do you assume that universal care would so level the economic landscape that welfare recipients enjoy the same private luxuries as doctors? This is an absurd assumption.

 

[Dak]

The precedent is not there. You're imagining a precedent based on your disposition. If doctors weren't allowed to quit their jobs, or received corporeal punishment for refusing to work, then I'd concede your point.

Very very few doctors would even dream of not treating a patient no matter how much they didn't want to. It's simply not something they even consider. It's what they do--they treat people regardless of external factors. Our current situation is not establishing a precedent for doctors to become slaves in any fashion. The case I foresee is that potentially fewer people become doctors. That would happen well before they become slaves.

The claim that "healthcare is a right" places a claim of ownership over the property and labor of others. With few enough sick persons and enough healthcare providers of various types and general societal wealth, the problems with this arrangement are papered over, if you will. But if pressure is placed through any of these three vectors, cracks will emerge. I do agree that at some point, rational self-interested calculation would see doctors quit before becoming slaves - but then what of the claims about the right to healthcare when no one wants to doctor? Either the claim is revealed to be a sham, or doctors, nurses, etc must be forced back into the line of duty. A draft, if you will.

It wouldn't be the same material life. Why do you assume that universal care would so level the economic landscape that welfare recipients enjoy the same private luxuries as doctors? This is an absurd assumption.

https://www.statnews.com/2017/02/08/cuba-doctors-meager-pay/

Cuba is proud of its government-run health care system and its skilled doctors. But even with a raise two years ago, the highest paid doctors make $67 a month, while nurses top out at $40. That leaves many feeling demoralized — and searching for ways to improve their lives.

Compare this to the national numbers:

http://www.miamiherald.com/news/nation-world/world/americas/cuba/article89133407.html

The survey, which was conducted among 1,067 Cubans in Havana, Santiago de Cuba, Holguín, Camagüey, Pinar del Río, and Cienfuegos in May and June, found that about 27 percent of Cubans earn under $50 per month; 34 percent earn the equivalent of $50 to $100 per month; and 20 percent earn $101 to $200. Twelve percent reported earning $201 to $500 a month; and almost 4 percent said their monthly earnings topped $500, including 1.5 percent who said they earned more than $1,000.

So no, it's not an absurd assumption.

 

[arg]

Savage response. Then again, I wouldnt expect someone like you to even remotely understand basic morality. I already knew from the beginning that I was taking a controversial stance, but people who can look down on the downtrodden without any sort of empathy and say that they can "fuck off and die" are fucking assholes that deserve some crippling illness. And when you are sick, laying in bed unable to work, your funds drained attempting to sustain yourself, you will do what exactly? Fuck off and die apparently.



Almost everyone I know in the healthcare industry legitimately sympathizes with sick patients and feels horrible about denying care to those who cannot afford it. I am part of an organization (an EMS squad with ambulances) that has many members who volunteer their time to safely transport ill and dying patients to hospitals. We are one of many thousands across the nation, and probably even more across the world. Nobody wants to kick patients to the curb, but at the moment US healthcare would cripple itself and crumble if it were to serve everyone regardless of their ability to pay. I am unwilling to accept this as an end goal. Even researchers who work feverishly on cures for diseases completely removed from direct patient care would want everyone who has it to be treated.

Yes I would rather accept death than ask the government to extort money from some billionaires even if the cost of my treatment would be a drop in a bucket for them.

 

[Einherjar86]

The claim that "healthcare is a right" places a claim of ownership over the property and labor of others. With few enough sick persons and enough healthcare providers of various types and general societal wealth, the problems with this arrangement are papered over, if you will. But if pressure is placed through any of these three vectors, cracks will emerge. I do agree that at some point, rational self-interested calculation would see doctors quit before becoming slaves - but then what of the claims about the right to healthcare when no one wants to doctor? Either the claim is revealed to be a sham, or doctors, nurses, etc must be forced back into the line of duty. A draft, if you will.

This isn't even an irrational vision, it's illogical.

Let's assume this scenario comes about. Doctors are being physically coerced to treat people; but let's face it, most of them end up being ferried between the residences of wealthy individuals and politicians, because those are the people that matter. With guns pointed at their heads, doctors are told they must see patients and perform operations. The enslaved physicians realize that if they all died, there would be no one to provide healthcare. They all go on strike and say "Go ahead, beat us, torture us, kill us--but without us in supreme working condition, you won't have anyone to treat your upper-middle-classes." The shoe's on the other foot now, and suddenly the "draft" doesn't look like such a good idea because--wouldn't you know--the military draft teaches soldiers the skills they need to know, whereas the "healthcare draft" requires its doctors to already be familiar with their craft (and unfortunately, they're the only ones who know how to do it... ).

https://www.statnews.com/2017/02/08/cuba-doctors-meager-pay/

Compare this to the national numbers:

http://www.miamiherald.com/news/nation-world/world/americas/cuba/article89133407.html

So no, it's not an absurd assumption.

Yes, it is. You're comparing a wealthy country's attempts to move toward wider health coverage with a third-world country that has suffered tremendously at the hands of the global economy. There's virtually no reason to assume that wider coverage here would look like Cuba's system now.

 

[Dak]

This isn't even an irrational vision, it's illogical.

Let's assume this scenario comes about. Doctors are being physically coerced to treat people; but let's face it, most of them end up being ferried between the residences of wealthy individuals and politicians, because those are the people that matter. With guns pointed at their heads, doctors are told they must see patients and perform operations. The enslaved physicians realize that if they all died, there would be no one to provide healthcare. They all go on strike and say "Go ahead, beat us, torture us, kill us--but without us in supreme working condition, you won't have anyone to treat your upper-middle-classes." The shoe's on the other foot now, and suddenly the "draft" doesn't look like such a good idea because--wouldn't you know--the military draft teaches soldiers the skills they need to know, whereas the "healthcare draft" requires its doctors to already be familiar with their craft (and unfortunately, they're the only ones who know how to do it... ).

There are worse things than death to some people, and why would people rather die than do the thing they know how to do, just for poor compensation. That's also the transition phase. A switch to a draft process or "slotting" would later involve such training, albeit potentially poor/increasingly poor

Yes, it is. You're comparing a wealthy country's attempts to move toward wider health coverage with a third-world country that has suffered tremendously at the hands of the global economy. There's virtually no reason to assume that wider coverage here would look like Cuba's system now.

Always the excuse for failed socialism/communism. There is reason to assume things would be similar when similar systems are implemented. How about Venezuela? The global economy had rewarded them for a while, and venezuela was held up as a shining example by people like Bernie in 2011 - before it became necessary to forget them:

http://www.newsweek.com/venezuelas-economic-crisis-has-forced-doctors-become-prostitutes-672035

http://money.cnn.com/2017/07/02/news/economy/venezuela-minimum-wage-hike/index.html

Based on these two sources, even the old structure - from when oil revenues were booming - only showed doctors being paid roughly double what the total welfare package paid (a paltry sum in dollars on both accounts). This hasn't changed now, simply shifted up, but not as fast as inflation. When you have a system oriented towards "equality", it makes sense that pay structures are flat, even including those who do nothing.

 

[Einherjar86]

I'm not going to get into an argument about communism/socialism. Every single communist/socialist economy have vastly different origin stories than the rise of liberal democratic capitalism in the West. We're not having that discussion here.

As far as your first comment, why would people do what they know how to do for poor compensation when they're the only ones who know how to do it? That's supply and demand, isn't it? Extending healthcare doesn't mean abandoning market principles. You seem to think it can only be either/or.

The entire scenario is ridiculous, not to mention a strawman. It's a fantastical extrapolation based not on plausibility but on ideologically driven fears.

 

[Dak]

I like how you refer to my real world examples and brief logical examples of the problems caused when demand outstrips supply as strawmen and "fantastical ideologically driven extrapolation". Good thing no Venezualan was engaged in such fantastical extrapolations about the problems of socialism. Even Sweden has had to swing back towards privatization because why? Demand outstripping supply as can be delivered by the state. That's exactly the scenario the US is headed for, yet even moreso because at least the Swedish exercise and eat reasonably well. Americans are fat and sick, as well as increasingly old (like the rest of the developed world). Extending coverage further would just cause the trainwreck faster.

Physician burnout is real and a growing problem, and imagine what these numbers would look like if the pay wasn't even good:

https://wire.ama-assn.org/life-career/report-reveals-severity-burnout-specialty

https://www.centerforhealthjournali...etire-or-flee-doctors-are-leaving-health-care

Apparently not. Deloitte’s 2013 survey of over 20,000 physicians notes 62% say that “it is likely that many physicians will retire earlier than planned in the next one to three years. This perception is fairly uniform among all physicians, irrespective of age, gender, or medical specialty.”

And if they’re not retiring outright, doctors say they believe physicians will “scale back practice hours (55 percent) based on how the future of medicine is changing.” None of this is surprising when Deloitte reports that “six in 10 physicians (57 percent) say that the practice of medicine is in jeopardy.”

 

[Einherjar86]

None of that disproves anything I've said. As I mentioned, we would likely see a decrease in people entering the medical profession well before we see anything remotely like "slavery," which is the scenario you suggested--at which point it would be much harder to institute something like a "healthcare draft," since there would be so few people to whom it could be applied.

The strawman and fantastical scenario you're imagining is that the right to healthcare would lead to an authoritarian dytopia in which healthcare professionals are somehow forced to work. The far more likely and plausible scenario is that medical professionals leave their field and we stop talking about any "right to healthcare" altogether. The right comes with the opportunity and the applicability. No one talks about a right to healthcare in a society with no doctors.

I can't believe I'm discussing the scenario of doctors being slaves, to be honest.

 

[arg]

It can’t be done in the US without increasing taxes to 50% give or take, so fuck that

 

[Dak]

The strawman and fantastical scenario you're imagining is that the right to healthcare would lead to an authoritarian dytopia in which healthcare professionals are somehow forced to work. The far more likely and plausible scenario is that medical professionals leave their field and we stop talking about any "right to healthcare" altogether. The right comes with the opportunity and the applicability. No one talks about a right to healthcare in a society with no doctors.

I can't believe I'm discussing the scenario of doctors being slaves, to be honest.

The emboldened scenario is the more likely scenario. I'm not disagreeing there. Which means the entire "right to health-care" idea is a farce from the beginning.