dixie

[Don Quixote]

from dixie (partial quote)

when you start fantasizing like DQ, about nationwide clinics open 24/7, you will have to find a way to staff them and pay for the doctors to work there.


first, i did not say open 24/7 - perhaps 7 days a week 10 am to 10 pm, but er's would do for after 10pm and before 10am


second, the use of nurses, nurse practitioners and physician assistants rather than full MDs would be more practical

two doctors, a family practice or general physician and a pediatric physician would be adequate for most localized clinics with referrals to specialized physicians at regional clinics (a certain number of local clinics would feed a regional clinic depending on population density)

as for how much a sick person pays or paid in taxes, do you want to relegate people that pay less in taxes to the status of cattle

there have been times in my life when i paid less in taxes and more - so does it depend on how much i paid on average or what i am paying now

would you set up priorities by class of who pays or owns the most?

i would have you know that paramedics and er's perform triage on incoming patients and allocate priority by how bad off a patient is, not by how good a medical plan they have or how much money they have or have paid in taxes

also, getting people out of hospitals and caring for them at an earlier stage in their disease or injury usually costs less

hospitals kill people through ineptitude and are breeding grounds for drug resistant diseases

fyi, the medical community is taught to look for 'horses' not 'zebras' when it comes to diagnosing medical problems - unfortunately, this leads to 'zebra' type problems to be overlooked

overall, we have lousy medical care for how much we pay for it

perhaps you have a way to get more bang for our buck when it comes to medical care

there are (at least) two things that the working poor need - decent medical care and child care - perhaps clinics and child care could be co-located


cities exist and fractured families exist - both situations tend to produce working poor

also, there is another word for ghettos that are mostly filled with the poor - genocide - people used to look at AIDS as the male homosexual disease and then added drug users, but guess what, it spilled over into the rest of the community and now reaches all levels of society

how long until some other disease spills out of the ghetto

how long until somebody visiting another country brings back the new plague - just a plane ride away...

 

[Dixie - In Memoriam]

from dixie (partial quote)

when you start fantasizing like DQ, about nationwide clinics open 24/7, you will have to find a way to staff them and pay for the doctors to work there.


first, i did not say open 24/7 - perhaps 7 days a week 10 am to 10 pm, but er's would do for after 10pm and before 10am

You may as well be saying "24/7" because doctors are not going to want to work evenings.

second, the use of nurses, nurse practitioners and physician assistants rather than full MDs would be more practical

Okay... so what do you do about the very real prospect of someone suing the clinic because a "less than qualified" person treated them? If you did this, you would have to staff it at all hours with full fledged doctors, to protect the clinic from liability.

two doctors, a family practice or general physician and a pediatric physician would be adequate for most localized clinics with referrals to specialized physicians at regional clinics (a certain number of local clinics would feed a regional clinic depending on population density)

Again.... Where is the money going to come from to fund this? Our country is BROKE! We have no extra pile of cash to devote to this ambitious dream! Besides, it sounds a LOT like Public Health Clinics which we already have in EVERY state and most EVERY city! WE ARE DOING THIS ALREADY ON THE STATE LEVEL!

as for how much a sick person pays or paid in taxes, do you want to relegate people that pay less in taxes to the status of cattle

there have been times in my life when i paid less in taxes and more - so does it depend on how much i paid on average or what i am paying now

would you set up priorities by class of who pays or owns the most?

Where did this tax thing come from? My position is, whatever we have in the way of health care facilities, shouldn't discriminate based on taxes paid. I'm not sure where you came up with this from what I have said, but I think we agree on that.

i would have you know that paramedics and er's perform triage on incoming patients and allocate priority by how bad off a patient is, not by how good a medical plan they have or how much money they have or have paid in taxes

also, getting people out of hospitals and caring for them at an earlier stage in their disease or injury usually costs less

hospitals kill people through ineptitude and are breeding grounds for drug resistant diseases

fyi, the medical community is taught to look for 'horses' not 'zebras' when it comes to diagnosing medical problems - unfortunately, this leads to 'zebra' type problems to be overlooked

overall, we have lousy medical care for how much we pay for it

Well, Don.... I don't know what to say to this, you are getting way out in left field with this, and I don't honestly know what the hell you're talking about here. If you want BETTER quality health care, it would seem you could understand why we DON'T need to turn it over to the GOVERNMENT! I mean... Have you ever BEEN to the Post Office, or the Department of Motor Vehicles?

perhaps you have a way to get more bang for our buck when it comes to medical care

I do! It's called the PRIVATE SECTOR! Let free enterprise give us the best doctors and medical care money can buy, and it will!

there are (at least) two things that the working poor need - decent medical care and child care - perhaps clinics and child care could be co-located

No, there are hundreds and hundreds of things the "working poor" need, if you think really hard! With Liberals, it fucking never ends! As soon as they get government run health care and child care, it will be something else, and then something else after that, and then....

cities exist and fractured families exist - both situations tend to produce working poor

also, there is another word for ghettos that are mostly filled with the poor - genocide - people used to look at AIDS as the male homosexual disease and then added drug users, but guess what, it spilled over into the rest of the community and now reaches all levels of society

how long until some other disease spills out of the ghetto

how long until somebody visiting another country brings back the new plague - just a plane ride away...

Again, you seem to be rambling incoherently here, but I will close by saying, if and when that next deadly disease comes along, you better hope we don't have the incompetent and inefficient federal government running the health care industry! You better hope we don't have to depend on the politicians on Capitol Hill to figure out how to save us! If so, we're all dead!

 

[uscitizen]

Banks and courthouses and such should work til 9 pm so that wworking people can do business with them

 

[Dixie - In Memoriam]

Banks and courthouses and such should work til 9 pm so that wworking people can do business with them

Well why don't we demand the Government pass a law to make them work until 9pm? We can just add the extra expense to the tax burden on the upper 1%, they can afford it, right? But wait... those people who work in the Banks and courthouses... when are they supposed to go grocery shopping? We need to pass a law to make groceries stay open until midnight! But wait... what about the people who work at grocery stores???? Okay, I've got it! We pass a law that says everyone has to work 24 hrs a day, and they have to pay all of their income into taxes to fund all the shit you can dream up! Will that make you happy? IDIOT!

 

[Cancel3]

Well why don't we demand the Government pass a law to make them work until 9pm? We can just add the extra expense to the tax burden on the upper 1%, they can afford it, right? But wait... those people who work in the Banks and courthouses... when are they supposed to go grocery shopping? We need to pass a law to make groceries stay open until midnight! But wait... what about the people who work at grocery stores???? Okay, I've got it! We pass a law that says everyone has to work 24 hrs a day, and they have to pay all of their income into taxes to fund all the shit you can dream up! Will that make you happy? IDIOT!

Kinda going off the deepend here, aren't you?

Did a law get passed that keeps retail stores open until 9pm? Did a law get passed to have walmarts stay open all night?

How about we open clinics until 9 or 10, and then HIRE doctors to work the shifts? Are they so holy and mighty that they only have to work hours that they choose? Or will they work the hours their employer tells them?

These arguments that it will be astronomically expensive are just nonsense. We are already spending the bulk of the money. The clinics already exist. The just need to be augmented and updated to provide basic care for the poor.

 

[Socrtease]

Nurse Practioners and PA's are NOT less than qualified to work in clinic.

 

[Dixie - In Memoriam]

Kinda going off the deepend here, aren't you?

Did a law get passed that keeps retail stores open until 9pm? Did a law get passed to have walmarts stay open all night?

How about we open clinics until 9 or 10, and then HIRE doctors to work the shifts? Are they so holy and mighty that they only have to work hours that they choose? Or will they work the hours their employer tells them?

These arguments that it will be astronomically expensive are just nonsense. We are already spending the bulk of the money. The clinics already exist. The just need to be augmented and updated to provide basic care for the poor.

How about WE don't do anything, except allow the free market to work? How about WE let doctors and medical professionals decide where it is profitable to open clinics and how long to stay open, like we do with Walmart? And how about YOU stop speaking for ME and spending MY money?

The "poor" have a place to get free health care, it's called a Public Health Clinic, and it is already funded by State taxes. They operate in almost every city in America! Emergency treatment is mandatory at ANY hospital in the country, it is against the law to deny ANYONE emergency services! Why don't WE stop being over dramatic about this situation, and how about WE stop dreaming and imagining a crisis that doesn't exist?

WE are 10 fucking trillion dollars in debt! OUR checkbook is overdrawn by $10,000,000,000,000.00... and YOU keep concocting liberal ideas for how government can waste even MORE money on things WE don't need! It might be different if WE were $10 trillion in the green, if WE had some huge windfall surplus of money to blow, then maybe what YOU idiots are proposing would make sense! As it stands, it doesn't make a lick of sense! It's just more of what we have come to know and expect from Liberal IDIOTS!

 

[Cancel7]

Iran said "Boo!" to israel!

Let's invade!

The cost? Huh? Where am I?

 

[Dixie - In Memoriam]

Nurse Practioners and PA's are NOT less than qualified to work in clinic.

Yes, I am more than certain a court case could be made, that a nurse practitioner or PA is far less qualified to treat patients than a MD. The first time a NP or PA misdiagnosed something or prescribed the wrong treatment for something, there would be a lawsuit for damages. And rest assured, damages would be awarded! So... who will pay for those? Well, the American taxpayer, of course!

 

[Jarod]

Often I would perfer a Nurse Practitioner or a PA to an MD. You get more time, more bedside maner and I belive often just as much knoledge.

 

[Dixie - In Memoriam]

You are certainly in desperate need of knoledge!

 

[Cancel3]

Unless the diagnosis is uncertain or the injury a serious one, a nurse practioner is perfectly acceptable.

Yes, lets let the free market decide it all. Lets let the profit margins determine the quality of healthcare. I am sure that will cure all the problems in the system.


The public clinics are understaffed and under funded. They are barely able to take care of the illnesses and injuries that come in. No preventive medicine is practiced in these clinics. Which is what has constantly been pressed for, but people like you argue against it.

Darla, good point. Fund all the wars you want but don't sweat the working poor or the poor. Let'em get sick.

 

[Dixie - In Memoriam]

Unless the diagnosis is uncertain or the injury a serious one, a nurse practioner is perfectly acceptable.

Yes, lets let the free market decide it all. Lets let the profit margins determine the quality of healthcare. I am sure that will cure all the problems in the system.


The public clinics are understaffed and under funded. They are barely able to take care of the illnesses and injuries that come in. No preventive medicine is practiced in these clinics. Which is what has constantly been pressed for, but people like you argue against it.

Darla, good point. Fund all the wars you want but don't sweat the working poor or the poor. Let'em get sick.

Regardless of any diagnosis, you let a nurse practitioner treat a patient, and something happen to that patient, and the clinic will promptly be sued. That is what is happening in the real world now! There is no room for common sense or reasonableness, the sheister lawyer won't give a shit that this was a federal clinic staffed with nurse practitioners to save money, they will make the claim of negligence and an award will be granted by a liberal judge who will pay no attention to your opinion a nurse practitioner is just as good as a real doctor. Those are the facts of life.

If state operated and funded public health clinics are understaffed or underfunded, that is a problem for the state to deal with, not the federal government. Preventative medicine is most certainly practiced there, who do you think gives out the flu shots every year? "People like me" have never argued AGAINST preventative medicine! Show me ONE post I have EVER made that argues against preventative medicine, and I will apologize for calling you a lying sack of dog shit.

Duhla has never made a good point in her life. Like the insufferable and miserable cunt she is, she's awful good at throwing up red herrings!

 

[FUCK THE POLICE]

Regardless of any diagnosis, you let a nurse practitioner treat a patient, and something happen to that patient, and the clinic will promptly be sued. That is what is happening in the real world now! There is no room for common sense or reasonableness, the sheister lawyer won't give a shit that this was a federal clinic staffed with nurse practitioners to save money, they will make the claim of negligence and an award will be granted by a liberal judge who will pay no attention to your opinion a nurse practitioner is just as good as a real doctor. Those are the facts of life.

If state operated and funded public health clinics are understaffed or underfunded, that is a problem for the state to deal with, not the federal government. Preventative medicine is most certainly practiced there, who do you think gives out the flu shots every year? "People like me" have never argued AGAINST preventative medicine! Show me ONE post I have EVER made that argues against preventative medicine, and I will apologize for calling you a lying sack of dog shit.

Duhla has never made a good point in her life. Like the insufferable and miserable cunt she is, she's awful good at throwing up red herrings!

STUPID


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[Cancel3]

Regardless of any diagnosis, you let a nurse practitioner treat a patient, and something happen to that patient, and the clinic will promptly be sued. That is what is happening in the real world now! There is no room for common sense or reasonableness, the sheister lawyer won't give a shit that this was a federal clinic staffed with nurse practitioners to save money, they will make the claim of negligence and an award will be granted by a liberal judge who will pay no attention to your opinion a nurse practitioner is just as good as a real doctor. Those are the facts of life.

If state operated and funded public health clinics are understaffed or underfunded, that is a problem for the state to deal with, not the federal government. Preventative medicine is most certainly practiced there, who do you think gives out the flu shots every year? "People like me" have never argued AGAINST preventative medicine! Show me ONE post I have EVER made that argues against preventative medicine, and I will apologize for calling you a lying sack of dog shit.

Duhla has never made a good point in her life. Like the insufferable and miserable cunt she is, she's awful good at throwing up red herrings!

Patients are seen every day by nurse practioners. It happens all the time. If a patient needs to see a Dr they will see one, but those that do not need to see a Dr won't. There are pregnant women seeing nurse practioners for most of their prenatal visits, and many claim to prefer them to Drs.

You don't argue against preventive medicine. You just argue against federal funding to provide it for people who cannot afford it. You can be all for it, but argue against the funding for it, and you have effectively argued against it and often won. Whether you apologize for calling me names is pretty far down on the list of "Things That Matter to Solitary", trust me on that one.

Flu shots are great. I think the old, the infirm and people with health problems probably should have one. But that if that is what you term "preventive medicine", you really should look into what can be done with preventive medicine. Many cancers, most heart attacks, much early high blood pressure, many birth defects, many cases of diabetes, and many many more expensive ailments can be prevented with low cost or even educational medical care.

 

[Don Quixote]

Patients are seen every day by nurse practioners. It happens all the time. If a patient needs to see a Dr they will see one, but those that do not need to see a Dr won't. There are pregnant women seeing nurse practioners for most of their prenatal visits, and many claim to prefer them to Drs.

You don't argue against preventive medicine. You just argue against federal funding to provide it for people who cannot afford it. You can be all for it, but argue against the funding for it, and you have effectively argued against it and often won. Whether you apologize for calling me names is pretty far down on the list of "Things That Matter to Solitary", trust me on that one.

Flu shots are great. I think the old, the infirm and people with health problems probably should have one. But that if that is what you term "preventive medicine", you really should look into what can be done with preventive medicine. Many cancers, most heart attacks, much early high blood pressure, many birth defects, many cases of diabetes, and many many more expensive ailments can be prevented with low cost or even educational medical care.

np's and pa's have to check with their supervising doctor with regard to their diagnosis, prescriptions and other recommendations
for routine matters, i see a np, but for more esoteric problems like heart disease, kidney disease and mental disease i see a doctor

 

[Dixie - In Memoriam]

Patients are seen every day by nurse practioners. It happens all the time. If a patient needs to see a Dr they will see one, but those that do not need to see a Dr won't. There are pregnant women seeing nurse practioners for most of their prenatal visits, and many claim to prefer them to Drs.

You don't argue against preventive medicine. You just argue against federal funding to provide it for people who cannot afford it. You can be all for it, but argue against the funding for it, and you have effectively argued against it and often won. Whether you apologize for calling me names is pretty far down on the list of "Things That Matter to Solitary", trust me on that one.

Flu shots are great. I think the old, the infirm and people with health problems probably should have one. But that if that is what you term "preventive medicine", you really should look into what can be done with preventive medicine. Many cancers, most heart attacks, much early high blood pressure, many birth defects, many cases of diabetes, and many many more expensive ailments can be prevented with low cost or even educational medical care.

Solitary, let's say you staff a clinic with no doctors, just a nurse practitioner to see patients. A man comes in one day complaining of stomach pain. The NP diagnosis a stomach virus, prescribes the appropriate medicine for it, and sends the man home. Later that evening, he dies in his sleep, and an autopsy reveals he had acute appendicitis and his appendix ruptured. His widow goes and hires Flotz and Jetson, Attorneys at Law, and they file suit against the clinic. In the trial, they argue the clinic should have had a physician on staff and the man should have been properly examined by a real doctor. Judge bangs the gavel, case closed, the widow is awarded $15 million in punitive damages for the loss of her beloved hubby. That is what happens in the real world.

Yes, I understand, some hospitals and clinics use NP's to make initial examinations of patients and then refer them to the appropriate physicians for treatment and final diagnosis. They do not treat patients as doctors, they are not allowed to do so by law, because they are not doctors, they are nurse practitioners. My sister is a NP, so I know a little about this subject, and you don't know what the fuck you're talking about.

As for preventative care, flu shots are indeed "preventative" and "care" so I don't know why you refuse to admit the truth as I stated it. Health clinics also give vaccinations, which is also "preventative care", and millions of poor people get these for free annually. What you and Don are wanting to spend another trillion tax payer dollars on, is already being done on the state level. If it were something we had a need for, something that wasn't currently being provided, I might see a point in spending the money we will have to borrow from China to do it, but that is simply not the case here.

Look... You want to drop a trillion on research and development of alternative energy? Fine, I can go along with it, even though we can't afford that either, at least it's something we NEED! But please, for God's sake, stop this liberal bleeding heart whining and moaning for something that is absolutely ridiculous and redundant! Is this what the next 4 years are going to be like? Every week, having to hear a bunch of bird-brain liberals whine and moan about what we "need" that we really don't need at all?

 

[Cancel3]

Solitary, let's say you staff a clinic with no doctors, just a nurse practitioner to see patients. A man comes in one day complaining of stomach pain. The NP diagnosis a stomach virus, prescribes the appropriate medicine for it, and sends the man home. Later that evening, he dies in his sleep, and an autopsy reveals he had acute appendicitis and his appendix ruptured. His widow goes and hires Flotz and Jetson, Attorneys at Law, and they file suit against the clinic. In the trial, they argue the clinic should have had a physician on staff and the man should have been properly examined by a real doctor. Judge bangs the gavel, case closed, the widow is awarded $15 million in punitive damages for the loss of her beloved hubby. That is what happens in the real world.

Yes, I understand, some hospitals and clinics use NP's to make initial examinations of patients and then refer them to the appropriate physicians for treatment and final diagnosis. They do not treat patients as doctors, they are not allowed to do so by law, because they are not doctors, they are nurse practitioners. My sister is a NP, so I know a little about this subject, and you don't know what the fuck you're talking about.

As for preventative care, flu shots are indeed "preventative" and "care" so I don't know why you refuse to admit the truth as I stated it. Health clinics also give vaccinations, which is also "preventative care", and millions of poor people get these for free annually. What you and Don are wanting to spend another trillion tax payer dollars on, is already being done on the state level. If it were something we had a need for, something that wasn't currently being provided, I might see a point in spending the money we will have to borrow from China to do it, but that is simply not the case here.

Look... You want to drop a trillion on research and development of alternative energy? Fine, I can go along with it, even though we can't afford that either, at least it's something we NEED! But please, for God's sake, stop this liberal bleeding heart whining and moaning for something that is absolutely ridiculous and redundant! Is this what the next 4 years are going to be like? Every week, having to hear a bunch of bird-brain liberals whine and moan about what we "need" that we really don't need at all?

Dixie, you always whine about someone else putting words into your mouth, and then turn around and do the very same thing.

Please show me where ANYONE said that clinics could be staffed with ONLY NPs? They didn't. You are trying to make a point by creating a moronic case. The NPs mean FEWER doctors are needed. They take the patient load off the Drs so the Drs can focus on the medical cases that NEED a Dr.

And I did not say flu shots are not preventive medicine. I said they are not nearly enough and more would save the tax payers huge amounts of money.

Checking the tire pressure and wiper fluid levels are part of your vehicle maintenance too. But if that is all the vehicle maintenance you do, the repairs later are going to be VERY expensive.


What we NEED is to stop major illnesses while they are minor illnesses. What we NEED is to take care of the poor and those who do not have medical insurance. What we NEED is to quit thinking that ignoring a problem is a viable solution. I am not advocating a total national healthcare system. But I AM advocating a system that provides basic healthcare and preventive medicine to our poor. And by preventive medicine, I mean more than vaccinations. We could cut what we spend on emergency medical treatments for people no insurance down by huge amounts if we spend a TINY portion of that amount in preventive care.

 

[Cancel3]

"Yes, I understand, some hospitals and clinics use NP's to make initial examinations of patients and then refer them to the appropriate physicians for treatment and final diagnosis. They do not treat patients as doctors, they are not allowed to do so by law, because they are not doctors, they are nurse practitioners. My sister is a NP, so I know a little about this subject, and you don't know what the fuck you're talking about."


Despite your claims of knowledge about NPs, here is some info you can use.

"Nurse practitioners (NPs) have provided health-care services to patients for more than 40 years. The nurse practitioner role had its inception in the mid-1960s in response to a nationwide shortage of physicians. NPs provide primary and some acute care, and are qualified to meet the majority of patients’ health-care needs. They promote a comprehensive approach to health care and emphasize the overall health and wellness of their patients.

NPs are registered nurses (RNs) who are prepared, through advanced education and clinical training, to provide preventive and acute health-care services to individuals of all ages. Today, most NPs complete graduate-level education that leads to a master’s degree. They work independently and collaboratively on the health-care team."

"NPs take health histories and provide complete physical examinations, diagnose and treat many common acute and chronic problems, interpret laboratory results and X-rays, prescribe and manage medications and other therapies, provide health teaching and counseling to support healthy lifestyle behaviors and prevent illness, and refer patients to other health professionals as needed.

An NP provides high-quality, cost-effective and individualized care for patients, families and communities. NPs are authorized to practice across the nation and have privileges to prescribe medications, in varying degrees in all 50 states."



That is from the "liberal media outlet" known as the Mayo Clinic.

http://www.mayo.edu/mshs/np-career.html

 

[Dixie - In Memoriam]

Solitary, I am not disputing what NP's do, as I said, my sister is a NP. She is currently doing her clinicals. They are indeed a great asset to the medical community, and do indeed perform a lot of routine "doctor-like" services. However, they are NOT doctors! In most cases, they either consult directly with the patient's physician, or direct the patient to a physician if they don't have one. There is no instance that I am aware of, where clinics use NP's instead of doctors. The reason is, liability.

The second point I would like to make is, even IF we assumed your idea had merit, and we could build all these federal clinics nationwide, to mirror the state clinics already in existence, where do you suppose we will find all of these NP's to staff them? It is one of the most highly demanded professions, and we already have a tremendous shortage of NP's. My sister is currently making over $100k per year, because she is in such high demand. We simply don't have enough NP's to do what you want to dream up, even IF we could do it!