Generation Y and Z Debt

Discussion in 'Off-Topic' started by Bobber, Jul 16, 2019.

  1. ArgentCy

    ArgentCy Well-Known Member
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    The FDA also made it Illegal or impossible to patent anything that is natural. So nobody can say that something like marijuana can have medical benefits. Or opium for that matter. A company has to refine it into say heroine and then they can patent the "drug".
     
  2. AuH2O

    AuH2O Well-Known Member

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    That's one aspect that I think is deceiving about health care performance studies. Many include obesity rates as an outcome of the health system rather than a condition that the health care system has to deal with. As most can imagine, the US is far and away the most obese OECD country. If you believe our health care system causes people to be fat, then yes, our performance is very poor and our health care system should be changed to about anything else. If you believe that causes outside of our health care system make people in the US obese, then that is not necessarily the case. Obesity and the lifestyles that lead to it destroy the US's performance in most metrics.

    I think there are some aspects of health care systems that may help reduce obesity rates, but if you look at how different countries around the world rank, it seems there is no correlation between style of health care system and obesity. It appears to be driven by cultural and economic factors. In other words, obesity is something that each health care system around the world have to deal with at different levels.

    How would Sweden or Denmark's health care system perform in terms of medical outcomes if they nearly doubled their obesity rate to match US levels?
     
  3. ArgentCy

    ArgentCy Well-Known Member
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    Just the freaking cost of one lawsuit these days can easily bankrupt a small businesses. The E & O insurance costs for doctors and hospitals just has to be freaking insane because a jury can award almost limitless money for someone's "pain and suffering".
     
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  4. Halincandenza

    Halincandenza Well-Known Member

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    This is just false.
     
  5. Sigmapolis

    Sigmapolis Well-Known Member
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    Malpractice insurance can vary between a few thousand to tens of thousands depending on your specialty and which state you are practicing in.

    That is not exactly a cheap addition to the cost of care. It all adds up.

    I think the "defensive medicine" mentality that a litigation-heavy environment creates is the far more damaging issue, and its costs do not show up as a line-item anywhere.

    Every physician I have met complains about it, but nobody wants to be the one to try to do something about it given the individuals' downside risks.
     
  6. madguy30

    madguy30 Well-Known Member

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    My viewpoint on this type of stuff is likely far too simplistic and unachievable but I had some morning show on this morning and they were going over some huge 'summer spread' lunch or whatever. The whole thing made it look like you need to go buy X amount of ingredients for X amount of courses in the meal, and many of the ingredients looked like things that make the meal unhealthy and overall, expensive. This goes down the rabbit hole of making it look like you need to make enough money to eat the food, and then the meal is made unhealthy anyway.

    There needs to be more campaigning for eating healthy, and providing the evidence that eating healthy doesn't have to cost a bunch. I.e. a bunch of bananas is going to cost like $1.50 or something which is cheaper or the same price as a bag of chips.

    There's several other examples but just thoughts on taking real preventative measures to avoid future issues.
     
  7. Halincandenza

    Halincandenza Well-Known Member

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    People complaining doesn’t mean much. As a percentage of cost of doing business, malpractice insurance is pretty small. In fact is that it is very difficult to win malpractice lawsuits and states have all enacted protections that cap damages awarded even if you do win.
    If you are doing something out of fear of malpractice, then you probably aren’t good at your job.
     
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  8. Sigmapolis

    Sigmapolis Well-Known Member
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    I do not disagree with you that malpractice insurance is not a huge cut of $$$ -- but again, I think the issue is fear of the same drives over-prescribing and over-testing of healthcare. Preserving your reputation as an institution and individual practitioner is valuable, too, as the accountants would call the "goodwill" of your practice, far beyond just the costs associated with insurance premiums or any payments you need to make. You need to look good to attract customers through those doors, which means avoiding lawsuits and negative publicity.

    My wife and every one of her colleagues I have talked to reports it as very real. That is anecdotal, of course, so how about we see what the literature has to say about it...

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728884/

    The kind of stuff we are discussing is absolutely rampant...

    Generally, the physician's aim is to reduce chances of litigation. In some cases, it may be medically justified, but in some, it will be medically inept. In a study conducted by Studdert, et al. in Pennsylvania among 800 physicians to determine the prevalence of defensive medicine revealed that 92% of physicians were found to be ordering imaging tests and diagnostic measures for assurance and 42% were eliminating high risk procedures and avoiding patients with complications.[3] Gallup and Jackson Healthcare in 2010 found 73% and 92% of private sector physicians, respectively, admitted practicing defensive medicine, which was high compared to 48% of government physicians.[4] The above studies highlight how prevalent defensive medicine is due to fear of litigation. Another study conducted by Harvard Medical School concluded that majority of physicians across various specialties tends to adopt a defensive professional culture.[2] Rodriguez, et al., study in 2007 demonstrated that 50% of the doctors operating in emergency departments in California between 2001 and 2005 were concerned with matter of malpractice litigation.[5] Similar results emerged from a study conducted in Japan in 2006 with a group of 131 gastroenterologists.[6]

    Well, you just said basically every doctor in this country is bad at their job. Anywhere from 50% to 90% based on that broad review of the literature there.

    It is bad medicine and wastes a lot of money. I think we agree there.

    Sounds like our healthcare system in general, no?
     
  9. Halincandenza

    Halincandenza Well-Known Member

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    Well, if they are ordering testing out of fear of litigation. Then yes, they are bad at their job. And what you cited does not say that fear of litigation is the main factor for defensive medicine. There is also a built in assumption with this line of thinking that all defensive medicine is bad medicine. When in fact, doctors do miss things and misdiagnose. So getting a doctor to do an additional test or explore an alternate diagnosis is not always a bad thing for the doctor or the patient.

    The right along with right wing special interests groups have been pushing this malpractice fallacy for years. This magic pill of tort reform.

    https://cardozo.yu.edu/fallacies-medical-malpractice-tort-reform


    But the disingenuity of this claim has been exposed a decade ago. In 2003, the Government Accountability Office (GAO) found: “[T]he overall prevalence and costs of [defensive medicine] have not been reliably measured. Studies designed to measure physicians’ defensive medicine practices examined physician behavior in specific clinical situations, such as treating elderly Medicare patients with certain heart conditions. Given their limited scope, the study results cannot be generalized to estimate the extent and cost of defensive medicine practices across the health care system.”6

    The Congressional Office of Technology Assessment (OTA) found that less than 8% of all diagnostic procedures were likely to be caused primarily by liability concerns.7 The OTA found that most physicians who “order aggressive diagnostic procedures...do so primarily because they believe such procedures are medically indicated, not primarily because of concerns about liability.”

    https://www.cato.org/publications/commentary/case-against-national-medical-malpractice-reform
    A 2014 study reported in JAMA, the journal of the American Medical Association, by Michael Rothberg and others concluded, “although a large portion of hospital orders had some defensive component, our study found that few orders were completely defensive and that physicians’ attitudes about defensive medicine did not correlate with cost. Our findings suggest that only a small portion of medical costs might be reduced by tort reform.”

    Furthermore, even after tort reform in states including capping of economic damages, medical malpractice insurance has not gone down. Nor has all the tort reform resulted in lower health care costs for individuals. If anything it is hurt patients because of how difficult it is for someone who has suffered as the result of doctor error to be able to made whole.


    There are many more articles I could link to.
    https://www.montlick.com/montlick-blog/medical-malpractice/1720-debunking-common-fallacies-about-medical-malpractice
    https://michiganjustice.wordpress.com/2014/04/07/michigans-medical-malpractice-tort-reform-the-juice-isnt-worth-the-squeeze/

    Then the fact is that people have a right to be made whole if there was malpractice and all tort reform has done is increase insurance profits and make it more difficult for those that have been wronged to get compensation for the damage that was done.
     
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  10. Clonefan32

    Clonefan32 Well-Known Member

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    As someone with a law degree I can tell you I never look back to my undergraduate degree, and very rarely look back to my law school education.

    I actually think law school is a good indicator of Sigmapolis's general concept. At least where I went to law school, you did not learn anything state specific. We learned the "common law" approach to most legal issues. So we were reviewing laws and cases from jurisdictions we would never practice in that were illustrative of some larger legal issue.

    Fast-forward to actually practicing, the "common law" approach means nothing. Everything is specific to your jurisdiction's Code, cases, etc. So you learn a general approach to several different legal issues, but then you have to go back through the process of seeing if your state applies the general approach. It's all very inefficient. The vast majority of what I use in my day-to-day practice was picked up through independent research and mentoring from other attorneys.
     
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  11. Sigmapolis

    Sigmapolis Well-Known Member
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    Tying to synthesize this for both of us...

    There is ample literature to document that there is *some* effect here from defensive medicine and defensive medicine undertaken with liability exposure in mind. The same is true of doctors avoiding certain patients because they are risky.

    That number is not zero. That number is not "all of it" like some of the right-wing tort reformers would want to believe. I think it is a relatively small fish in the huge pond of the U.S. healthcare system. We can talk about if it is a minnow or a chub, but there are some Great Whites swimming around in the same water, so does it matter much really?

    I am not one to blame trial lawyers or think tort reform is some sort of silver bullet. I do not think there is a "bad guy" here -- plenty of patients are seriously harmed by errors and malpractice, and they deserve good representation from well-meaning attorneys and fair compensation. Indeed, medical errors plague our system right now, and very few of them go detected or litigated. There are bad doctors out there who need punished or even run out of the field, but most of them are trying to do their best, doing good, and reasonably responding to the incentives that a lawsuit could create and expose them to some serious financial and reputational risks. It is one of the reasons our system is expensive, but far from the only one.

    I just see it as one of many contributing factors.

    @Halincandenza is going to want to beat you with a hammer for posting this.
     
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  12. SpokaneCY

    SpokaneCY Well-Known Member
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    Maturity, experience, perspective, discipline, world-view, ability to complete a course of anything....

    Hi - I'm Doogie Howser and I'll be your corporate attorney after I get home from prom.
     
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  13. Halincandenza

    Halincandenza Well-Known Member

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    Hey! I don't want to beat anyone with a hammer, at least not literally.
     
  14. Cyched

    Cyched Well-Known Member

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    Speak for yourself
     
  15. Sigmapolis

    Sigmapolis Well-Known Member
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    17 year olds used to fly Hellcats against the Japanese over the Pacific

    The increasing length of adolescence and delaying of adulthood is a modern phenomenon and a particular culture one, not something inherent about teenagers.

    Plus, knowing what I know about most undergraduate educations, I am not sure they are particularly good at installing any of those things in a young adult, especially if they did not already have a good head on their shoulders to start.

    I think you are dodging the point, though. I am not exactly advocating an 18 year old be the lead attorney in some multi-billion dollar litigation or capital crime. But would they be served worse by working as a clerk in a law office to start (and making some money) before moving up than they would paying tends of thousands to go to a law school?

    Or doing that instead of earning a BA in flute performance or whatever before going to law school? Going to be a long time until they have some real authority either way.

    We complain about inequality and poverty, but then we put a college degree -- an incredibly expensive item -- up as the ticket to the middle-class. Why not try to have more ways up instead of just that one, singular, expensive, and nerdy way to do it?
     
  16. SimpsonClone

    SimpsonClone Active Member

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    I have worked with kids for five years and my wife has for four. It has bought me a good amount of time, but it appears that this form of contraception loses its effectiveness over time. My mom does daycare and my brothers both have two kids. Maybe a week long trip before school starts is in order. I might even volunteer to babysit so my brothers and their wives can go out for the evening.
     
  17. cowgirl836

    cowgirl836 Well-Known Member

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    Set an alarm on her phone to go off in intervals overnight ranging from 45 minutes to 2 hours.
     
  18. SimpsonClone

    SimpsonClone Active Member

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    That's too risky. She already punches/kicks me when I get into bed and startle her.
     
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  19. yowza

    yowza Active Member

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    I hope this is sarcasm. You get what you work for. educate yourself. make educated decisions. use available resources. Take some risks and don't do stupid ****. And if someone lives their life based on what they see on Facebook or message forums, they need to reevaluate.
     
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  20. BCClone

    BCClone Well-Known Member

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    I definitely say my generation has it easier than my predecessors. I wasn’t shot at by people in a different country like them.
     
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