Health reform from my side of the surgery table
Forty years as a surgeon in university and community hospitals gives some authenticity for the following reflections regarding the failings of our health care delivery. Partisan rhetoric has led to shouting matches rather than reasoned choices, while the most fundamental issue in health care reform has yet to be stated: should health care be continued as a profit-driven enterprise? If a problem well-stated is a problem half solved, a clear answer will allow for progress. Here are the some of the problems I have observed:
Dr. John Gary Maxwell raises some interesting points, and his British patient anecdote was spot on. This type of individual mob mentality has to stop, but I don’t see it happening in the near future.
the only advanced democracy on Earth
Wish it all you want, we are not a democracy.
We are a Republic.
Change the Constitution if you want the federal government to care for the people.
However, it won’t make one bit of difference. The federal government has already screwed up HC so bad I am not sure it can be fixed, what with all the special interests involved writing the regulations for us.
From an input-output point of view, would all the premiums paid to health insurance companies today be enough to pay for all the health care dispensed today?
Logic says it should be, but what does reality say?
Isn’t “provide for the common defense” suggesting something like “against disease and injury” as well?
Aways find it interesting that people growing up in a country that allows one to determine their own self-direction are so very quick to give away that same freedom.
Using a …community of peers… to determine the cost efficencies of prolonged medical care or even the payroll of doctors is an error in judgement that most children learn to avoid in grade school.
Aways find it interesting that people growing up in a country that allows one to determine their own self-direction are so very quick to misapply the concept so readilyAways find it interesting that people growing up in a country that allows one to determine their own self-direction are so very quick to give away that same freedom.
Using a …community of peers… to determine the cost efficencies of prolonged medical care or even the payroll of doctors is a lesson in judgment that most children fail to learn in grade school.
And yet these LIEBERTARIANS still have a brain stem evidencing it takes very little to breath and breed.
Using a …community of peers… to determine the cost efficencies of prolonged medical care or even the payroll of doctors is an error in judgement that most children learn to avoid in grade school.
# 2 LibertyLover
“Wish it all you want, we are not a democracy. We are a Republic.”
Here’s a shocker for you: you’re both, because the two are not mutually exclusive.
The “democracy” part describes how your officials are selected; the “republic” part describes who the head of state is. The two sit of completely different axes describing the method of election (democracy and dictatorship being the opposites) and the claim to sovereignty (republic and monarchy being the opposites), respectively.
You can’t just be “a democracy” or “a republic” because then you either have no representative(s) or lack a nation.
6 Tippis,
Well done sir.
Never understood why Americans think that it was anything else.
The big difference was the change of the electoral voters: that from land owners to general citizenry.
Rich white people hate that.
That article was so well thought out that and logical that the author should be declared a CommiNazi and sent to guantanamo.
The good doctor forgot to mention that you can socialize medicine, but medical innovations will come to a screeching halt. Or you can have profit-driven medicine with lots of medical innovation. You cannot get the best of both…. unless you want astronomical tax rates.
The moment you remove the “greed” factor, companies will cease to try and come up with the next big innovation because the risks vs. rewards are not worth it.
Regardless, health care is not a Constitutional right to be provided to people by the Federal Government. As cold and heartless as that may sound, that’s the reality of it.
This all being said, I think of Congress wants to shove this down our throats, they need to forfeit all current health care they get and be on the health care plan they’re creating…. but we all know that will never happen.
#6–tippis==after the point that democracy and republican forms of government are not mutually exclusive, you are mostly wrong. Because they are not mutually exclusive, “basically” either form/approach can do about everything the other one does.
Again, simply, straight democracy is used to elect Senators and Representatives while a form of Republicanism, the Electorial College, is used to elect the President. After that confusion, a combination of democracy and republicanism is again used in the three branches of government to govern the governed==again more republican at the federal level with more direct democracy at the State level.
All academic. Use your favorite google to delve further.
#6, Not really.
It is heading toward a full-fledged democracy, but it is not there yet.
The Senate is supposed to represent the interests of the States. It is there to ensure the States keep their Rights in the face of a burgeoning federal government. That is why the Senators were selected by the States.
The House is supposed to represent the interests of the People. It is there to let the government know what the People want. Hence a two-year term — fresh faces, fresh ideas. That’s why the House reps are selected by the People.
Thus, you had a check against near-total democracy and tyranny by the People — a Republic.
However, since Senators are now elected by the People as well, you no longer have that check. You have two bodies that more or less operate the same way, bowing to the whims of the mob to get re-elected. And there are calls to totally eliminate the electoral college as well (though I admit, it has become a shadow of what it was supposed to be).
A democracy is where the majority always rules against the minority. There are democratic elements to our republic such as the election of representatives.
The founders did not want a democracy. They wanted a republic. No where in the Declaration of Independence or the U.S. Constitution is the word democracy (or any derivations of it) used.
All democracies in history have turned into some form of oligarchy because they could never get anything done. Once the People realize there is money to be doled out, they want it, regardless of what it does to their nation.
Another doctor’s perspective
#11–Liberty==a fair stumble towards a more accurate summary. The protection against mob rule is the Bill of Rights and the Court system, not Republicanism.
I defy you to demonstrate any different role the Electoral College plays today compared to any other time. Pure mindless fluff.
You say: “Once the People realize there is money to be doled out, they want it, regardless of what it does to their nation.” If by people you mean international capitalist corporatists who have no national ties, you must explain how this happened under “the Republic.”
Quick Summaries are always rough, leaving out more than they capture. Let the dialectic continue.
#11, Loser,
You’ve been taken to task (again I might add) for your error about the USA NOT being a democracy.
The Senate is supposed to represent the interests of the States.
More of the same bullshit you learned in your mother’s basement reading Lyndon LaRouche pamphlets. No where in the Constitution is the Senate tasked with representing the States. In case you missed it, the Constitutional Amendment that gave the Senate direct elections, was approved by 3/4 of the States AND the Senate.
Having said that, however, my two Senators represent ALL the citizens in my State. They also represent my State’s interests the same as our Congressmen do.
Unless, you wanted the Senators to represent and owe allegiance to the Governor instead of the people. That was the problem that led to direct elections for Senators.
Hrrm, my image didn’t work
http://i.somethingawful.com/u/garbageday/photoshop_phriday/2009_11_27/Fl0yd_01.gif
#11, Loser,
A democracy is where the majority always rules against the minority.
Except in a Constitutional Democracy. Congress is restricted on what the majority may do as the rights of the minority are protected and the limits of government are laid out.
The founders did not want a democracy. They wanted a republic. No where in the Declaration of Independence or the U.S. Constitution is the word democracy (or any derivations of it) used.
It is laid out in other words as the word “democracy” was not well established in the English language, nor was the concept in the governing establishment mindset. Here, something interesting you might want to read. it explains a lot of what you whine about.
Aahhh, “We the People”. Did you notice, the Constitution capitalized “People”?
#14, lol Fusion, so quick to call others names, when you yourself have such a limited understanding of what you are talking about.
“More of the same bullshit you learned in your mother’s basement reading Lyndon LaRouche pamphlets.”
Perhaps James Madison is a more authoritative source?
From Federalist #62:
The House of Representatives was designed to represent the people directly, the Senate was designed to represent and retain the sovereignty of the States.
While the practical effects of the change to how they are chosen is certainly debatable, please know what you are talking about before “taking people to task” for their positions of the intended purpose of a particular house of Congress.
#14, If you wish to take someone to task, perhaps you should step up to the plate yourself. Until then, your words are feeble.
Why would you sacrifice others to save your wife.
#10, 13 Bobo:
The problem is that you’re using an antiquated definition of both democracy and republic – the ones used in 1776, which are no longer relevant.
It doesn’t matter what kind of representative structures are used – if the popular vote is the foundation for the formation of a government, it’s a democracy. What slides the scale away from democracy is how impeded the people is in expressing that power. Who can vote and who cannot and for what arbitrary reason? Whom can they vote for, and what restrictions are there in that regard? The structures you’re talking about do not appear on this scale, but are rather governance factors – which can end up in a number of funny combinations of parliamentarism, (con)federalism, etc etc. The main argument against the US being a democracy has nothing to do with the multi-tiered system or the electoral college, and more to do with it essentially being a one-and-a-half-party system that offers little to no choice for the voters.
Same goes for the word republic – it only denotes that the government offices are publicly held positions, rather than hereditary ones, and even then, the only position that really matters is the head of state. Ruling the state is a *job*, not a divine duty (although it certainly could be argued that some would treat it as such).
Both words meant something completely different when the constitution was written, but that doesn’t make any difference in how the country is defined today.
I will mention a few things..
the SAME has happened all thru the CORP/COMPANY mentality.
“IF’ I cant get my money from the POOR, I will inflate it for the RICH.”
Those persons that ‘GOTTA HAVE IT NOW’ will spend the most, and wont wait for a GOOD item to drop in price in 6 months to 1 year.
Those with the money, will JUMP into the hospital to get it FIXED, while the rest of us SUFFER, because we know how much it will cost.
IF you are going to regulate the medical profession, then you MIGHT as well do ALL the corps and companies..
#21–gee Tippis==I’d like to agree with you or at least understand what target you are trying to hit, but I can’t.
Main Entry: re·pub·lic
Pronunciation: \ri-ˈpə-blik\
Function: noun
Etymology: French république, from Middle French republique, from Latin respublica, from res thing, wealth + publica, feminine of publicus public — more at real, public
Date: 1604
1 —-(1) : a government in which supreme power resides in a body of citizens entitled to vote and is exercised by elected officers and representatives responsible to them and governing according to law (2) : a political unit (as a nation) having such a form of government
Who can vote is “always” arbitrary depending on how you define it. Age limits? Why 21 or 18? Your complaint is meaningless because of its universality.
You say: “The main argument against the US being a democracy has nothing to do with the multi-tiered system or the electoral college, and more to do with it essentially being a one-and-a-half-party system that offers little to no choice for the voters.” /// While I heartily agree the two party system has great limitations and needs to be changed, THAT has nothing to do with the definition of democracy. THE BEST argument that the USA is not a democracy is the Constitution that formally and expressly set up a Republican form of government split between three branches to act as check and balance against excesses along with the Bill of Rights to mitigate against mob rule.
Its not complicated. In fact, pretty narrowly defined and resolved.
#12 Wow, that was a cool article. Thx
I don’t live under your system so I don’t care about the debate, But I love the picture. Very Norman Rockwell with the colours.
Libertylover,
“Change the Constitution if you want the federal government to care for the people.”
Social Security settled the fact that the status quo is to ignore the constitution and pretend it says whatever you feel like. The facts are completely irrelevant and so is the constitution.
Of course unless that particular party feeeeels.. like enforcing say the part of an amendment sub section A and then ignore sub section B. Both sides do it are liars.
14, Fusion, Under Article 1 Section 3 of the Constitution, Senators used to be selected by the state legislators / governor of the states they came from. This is why Senators today serve a six-year term instead of a two-year term. What LibertyLover is talking about was essentially true up until 1913. In 1913, Senators were no longer appointed by their state legislatures / Governor due to the 17th Amendment.
http://tinyurl.com/67wzpv
17, Fusion, The fore-fathers knew that a true democracy was not a good idea for the very reasons LibertyLover has stated in that the majority would outvote the minority in every case of a true democracy.
The fore fathers decided to have a Democratic Republic instead due to the very shortcomings of a true democracy. This is what you’re referring to as a “Constitutional Democracy”.
The problem is you want to take a literal and modern reinterpretation of the words you’re quoting and then spinning it with polemics.
That’s being just as intellectually dishonest as trying to use the general welfare clause to somehow “prove” the Federal Government is required to provide everyone health care.
Would it be nice if the Federal Government provides everyone “free” health care? Maybe, maybe not. Regardless, the Federal Government is expanding its powers in this particular case by not operating within its enumerated powers. Anything not explicitly granted to the Federal Government by the Constitution is a State Government right.
The problem lies in that Liberals believe the Constitution is a living and breathing document which ultimately means someone can argue that the Constitution is somehow “unconstitutional”.
18, Chris, okay “screeching halt” is a bit of an exaggeration. Crawl would be more appropriate.
What’s the last greatest U.S. Government-funded medical innovation? Better yet, what’s the last greatest non-U.S. Government funded medical innovation?
Watch from 4:25 to 5:40 – http://tinyurl.com/mdax62
#23, Bobo:
You’ll note that the definition you gave *exactly* matches what I said: power is executed by elected officials, not by inherited peers. I’m not complaining about the arbitrariness – I have no idea where you got that. I’m saying that democracy is often limited by arbitrary restrictions, and those are the ones that determine how far away from an ideal democracy a state is. So you *are* agreeing with me – or at least repeating my points as arguments for why you’re right — even if you don’t want to.
The argument that the constitution calls the country a republic is pointless because the wording is archaic and not relevant for how “republic” and “democracy” are defined *today* and how they are used to describe a country. The US is still a republic (but not in the sense used two centuries ago), but is is *also* a democracy (but not in the sense of the 18th century), because there is no conflict – none, zip, zero – between the two terms.
I wonder if and when we go to government-run health care if we’ll ever take the Chinese approach: http://tinyurl.com/ya4oqje
The Liberals here could sell it as an approach to keeping health care costs “affordable” for tax payers as well as reducing our country’s CO2 output.
The Liberals only need a little Hope & Change. 🙂
#30 China has too many people; is it any wonder their health system is non-existent at best? Their demographics are a crucial stumbling block to steady development. I like Brazil or India better long term.
China does illustrate the, uh, clarifying force government can bring to massive investments. Could the private sector allocate investment to Chinese infrastructure neatly enough to prevent the country from imploding? I think not.