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Why doctors are sick of their profession

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Re: Why doctors are sick of their profession

#241
post #92

Earlier quoted context omitted.

Um, you may have missed the point. 1. The thing that distinguishes the values of the Civil Rights era reactionaries is that they're generally failing to transmit themselves from one generation to a next. So unlike the more egalitarian values of the left - which are actually growing stronger with each subsequent generation - the bigotry of the right is uniquely tied to the lifespans of specific people. When they die,…

I'm not sure how racism worked its way into an article on health care. But, your assertions that the TEA Party and Republicans are inherently racist are misplaced. Let's start with a little history. Lincoln who freed the slaves, Republican. Jim Crow laws, Southern Democrats. Most votes against the 1964 Civil Rights act, Democrat. Inner cities where blacks are oppressed, run by Democrats. In fact, you would be hard pr…

"In fact, you would be hard pressed to find any racism in the TEA Party or Republican party."

Lol.

Re: Why doctors are sick of their profession

#242
post #237

Earlier quoted context omitted.

Well, actually, they would, for the same reasons that the postal service will make money in populated areas and lose money in less populated areas. Say you need a trauma center within 1 hour of anywhere in the country. A trauma center in Manhattan is going to see a lot of traffic, while one in Clayton, NM, isn't. But the centers have the same basic cost in staff and gizmos.

> But the centers have the same basic cost in staff and gizmos. Hang on: A busier unit is going to have more staff. Staff is not a trivial cost.

In my simple model here, staff is per-capita; fixed costs like property, plant, and equipment are per-unit-area. Which wins in this case? I don't actually know, but I don't believe it is a trivial calculation. (Further, the medical events are not necessarily comparable in the two cases---rural means farming and resource extraction, etc., and that shit's dangerous, compared to white-collar work. And then there's transportation costs.)

I do know that in other similar situations, wealthier, more populated areas end up subsidizing poorer, less populated areas.

Re: Why doctors are sick of their profession

#243
post #92

Earlier quoted context omitted.

Um, you may have missed the point. 1. The thing that distinguishes the values of the Civil Rights era reactionaries is that they're generally failing to transmit themselves from one generation to a next. So unlike the more egalitarian values of the left - which are actually growing stronger with each subsequent generation - the bigotry of the right is uniquely tied to the lifespans of specific people. When they die,…

I'm not sure how racism worked its way into an article on health care. But, your assertions that the TEA Party and Republicans are inherently racist are misplaced. Let's start with a little history. Lincoln who freed the slaves, Republican. Jim Crow laws, Southern Democrats. Most votes against the 1964 Civil Rights act, Democrat. Inner cities where blacks are oppressed, run by Democrats. In fact, you would be hard pr…

"I'm not sure how racism worked its way into an article on health care."

That confusion may be a product of poor reading comprehension. Notice that my comment was not a direct reply to the article, but one directed to a secondary question raised by the article. (Specifically, "Why, if we know what works, are these known solutions not being implemented in America?")

The answer, again, is that these systems depend on a social contract which is flatly incompatible with the white supremacist ideology that, for a variety of structural reasons, still holds a remarkable and disproportionate amount of power within our political system.

"But, your assertions that the TEA Party and Republicans are inherently racist are misplaced."

Um, no dude. Those are your assertions, not mine. Since I never mentioned Republicans or Tea Partiers at all, I could not have said anything specific about either. Indeed, I can think of many Republicans - some I know personally - who are deeply embarrassed by this concentration of racist, jingoist, revanchism that has not only found its way into their party, but has taken to calling those who try tempering their most toxic characteristics as "RINOs" (that's "Republicans In Name Only", in case you were unfamiliar with the term).

But since you mention history, let's discuss that. This toxic group, as you seem to know, is not new to American life. They were a principle target of Abraham Lincoln and the Republican party of the 19th century. What is (relatively) new is their occupation and transformation of the Republican party, and the way they turned what had been bastion of opposition into their home.

The switch started in the wake of LBJ's "betrayal" in signing Civil Rights legislation. LBJ was, of course, a Democrat. And he was faced with choosing between the people he saw as the future of the party and the Dixiecrats (as they were known), who represented its racist, soiled, and discredited past. He made the right choice, and in doing so, rendered a large block of Southern white supremacists politically homeless.

They didn't stay that way for long. By the 1970s they were staging an aggressive takeover of the once-hated Republican party, employing a heady mixture of religious fundamentalism, supply side economics, and "tough on crime" rhetoric, bringing a messianic zeal to re-establishing the dominance they'd lost with the scrapping of Jim Crow laws.

The GOP managed to temper and accommodate their presence through the presidency of George Bush senior. But his defeat after one term in office signaled the end of the moderation. By the time Bill Clinton was in the White House, Newt Gingrich attained the Speakership, and the extremist elements began calling the shots within the GOP. This marked the completion of an fundamental transformation. Within period of two decades they’d converted the Republican party from the traditional opponent of the Confederacy to the vehicle of its contemporary resurgence.

Getting back to health care, if you didn't see these people coming out in full force to oppose the ACA it's because you simply weren't paying attention. Like, not at all. In reality, the continued political presence and power of these people has an enormous amount to do with the irrationality of our medical system. (The same could also be said of our criminal justice and immigration systems.)

And the existence of these people is hardly a matter of speculation. We've had a number of racially charged incidents that become flash points for the racists to express their views and indicate their numbers. Consider the recent mayhem in Ferguson, where a white K-9 officer allowed his dog to urinate on the memorial set up by the mother of a young man killed by the same police force. It's impossible to chalk up contempt this raw as a rare an isolated thing when a staggering volume of social media posts indicates broad and deep support for this treatment - and worse - among certain quarters. Lynchings, may I remind you, are still a matter of living memory. And as open comment sections reveal, there are still plenty of Americans who would bring them back if they could. Thanks to the distorting effects of Senatorial overrepresentation in predominately rural states and pro-GOP gerrymandering of the House, their electoral power vastly exceeds their numbers. They do not represent America, but they do represent a major problem for America, and have done so since before the Civil War.

But the good news, is that their attitudes are not replicating themselves across generations as reliably as they once did. Given time, this problem will solve itself. For those who can't wait, I recommend a focus on the structural reforms that will accelerate their demise. Specifically, that means an end to closed primaries and partisan redistricting (i.e. gerrymandering) and much greater access to the ballot box.

In any case, if you are going to attempt lecturing people on the history of political alignments, make sure the version you’re trying to push doesn’t conveniently stop in the mid 60s, just before one of the most momentous realignments in American history took place. Being that economical with the facts makes you look stupid, dishonest, or both and HN is not the place to pull that shit.

Re: Why doctors are sick of their profession

#244
post #129
post #109

Earlier quoted context omitted.

The doctors lost the argument decades ago when they agreed that people had a right to medical services. A bold claim without any backup.

From the AMA; (6) The patient has a basic right to have available adequate health care. Physicians, along with the rest of society, should continue to work toward this goal. Fulfillment of this right is dependent on society providing resources so that no patient is deprived of necessary care because of an inability to pay for the care. Physicians should continue their traditional assumption of a part of the responsib…

I'm sorry, but that doesn't make it any clearer.

Re: Why doctors are sick of their profession

#245

Earlier quoted context omitted.

I read this years ago. Google is a wonderful thing: "Gilded Paychecks: Lure of Great Wealth Affects Career Choices." NY Times. November 27, 2006. http://www.nytimes.com/2006/11/27/business/27richer.html

The first step of that career path is still "Become a doctor"

Yes.

  * Get your M.D. 
  * Do anything afterward, except practice medicine 
  * Profit
That's what that article is saying.

I think being a doctor is about more than making money. But it isn't simply about helping people and making a good living. Smart people want to be able to exercise their own judgment and initiative. We need to be careful as a society, or the people we want as doctors are going to be the people we chase away.

Re: Why doctors are sick of their profession

#246

Earlier quoted context omitted.

I'm not sure how racism worked its way into an article on health care. But, your assertions that the TEA Party and Republicans are inherently racist are misplaced. Let's start with a little history. Lincoln who freed the slaves, Republican. Jim Crow laws, Southern Democrats. Most votes against the 1964 Civil Rights act, Democrat. Inner cities where blacks are oppressed, run by Democrats. In fact, you would be hard pr…

"I'm not sure how racism worked its way into an article on health care." That confusion may be a product of poor reading comprehension. Notice that my comment was not a direct reply to the article, but one directed to a secondary question raised by the article. (Specifically, "Why, if we know what works, are these known solutions not being implemented in America?") The answer, again, is that these systems depend on a…

You would think then that the Republican party would be full of KKK members. But the only KKK member to be elected to the Senate, Robert Byrd, was Democrat, and he retired in 2010, not 1960. I don't know why you call them "Dixiecrats". Why don't you call them by their real name: racist southern Democrats. There is simply no evidence there was a mass conversion from Democrats to Republicans in the South. A small amount converted due to the civil rights act and Nixon's Southern strategy, but the largest shift occurred in the 1990s with the rise of evangelical Christians. I think the debate would be better served if you kept to policy arguments instead of attacking your opponents.

Re: Why doctors are sick of their profession

#247

Earlier quoted context omitted.

"Anyone bright enough to do medicine would do far better in another profession." Just as a point of reference, I'm in the U.S. and not a doctor. But I've always seen careers in medicine as a kind of social scam. Not necessarily a bad one, but there is or was something funny going on. A person smart enough to be a doctor could be many things and earn a lot more money doing one of those things. The only thing society c…

> A person smart enough to be a doctor could be many things and earn a lot more money doing one of those things. Is that really true? Doctors are most of the best-paying jobs in the US [0] It seems to me that if you're bright, and care about making a lot of money, medicine is absolutely the way to go. Yes, there are some people who strike it rich with startups or high finance, but that's essentially buying a lotto ti…

If you are really smart enough to be a doctor and still think that money matters, then the best route is -> Ivy -> IB -> PE/HF.

The thirty somethings in my son's firm take home over 3M a year. One of the owners took home over 800M a couple of years ago.

Compared to remunerations like that, doctors get a miserable pittance.

Re: Why doctors are sick of their profession

#248

Earlier quoted context omitted.

"I'm not sure how racism worked its way into an article on health care." That confusion may be a product of poor reading comprehension. Notice that my comment was not a direct reply to the article, but one directed to a secondary question raised by the article. (Specifically, "Why, if we know what works, are these known solutions not being implemented in America?") The answer, again, is that these systems depend on a…

You would think then that the Republican party would be full of KKK members. But the only KKK member to be elected to the Senate, Robert Byrd, was Democrat, and he retired in 2010, not 1960. I don't know why you call them "Dixiecrats". Why don't you call them by their real name: racist southern Democrats. There is simply no evidence there was a mass conversion from Democrats to Republicans in the South. A small amoun…

>> "You would think then that the Republican party would be full of KKK members."

No, because the Republicans are a national party and the KKK barely has enough members to populate a state fair. In other words, I would not think this because I can do basic math.

>> "But the only KKK member to be elected to the Senate, Robert Byrd, was Democrat, and he retired in 2010, not 1960."

Not exactly true. Byrd dropped his membership in 1952, as he was running for the House, where he served from 1953 until 1959, when he ran for the Senate. But this is hardly relevant, since it all took place a decade or two before the great political realignment triggered by LBJ.

>> "I don't know why you call them "Dixiecrats".

Because that's what pro-segregation southern Democrats are called. And because that's exactly who we're talking about. So you know, "Dixiecrat" was the informal name used by a short-lived, pro- segregationist breakaway faction from the Democratic party. The group flamed out in 1948, but the name hung around, finally sticking to the southern, white, and openly racist Democrats who were vehemently opposed to the Civil Rights Act and who subsequently formed the core of today's predominantly Southern GOP - which is precisely who we're talking about here.

>> “There is simply no evidence there was a mass conversion from Democrats to Republicans in the South."

Um, wow. Where do I even begin? I mean, saying something this demonstrably wrong is a bit like saying "There's no evidence that the Earth is round," or "There's no evidence that the Titanic really sunk," or "There's no evidence that Boston is north of New York City."

I could go on, but you get the point. And yes, there's is lots (and lots and lots and lots) of evidence there was a mass conversion from Democrats to Republicans in the South. Chiefly, the public record of election results for the United States of America.

Here's but one summary of the shift. Scroll down for the helpful charts that document the shift on a year by year basis. The section you want to pay especially close attention to is marked "1964 Election – Regional Realignment".

http://mattsmaps.wordpress.com/2011/07/14/southern-realignme...

Again, this shift started in the Civil Rights era. It grew under Reagan, and it went ballistic in the 1990s, as you correctly note. Like I said originally, this didn't happen overnight. It took about three decades to unfold, by which time the home of southern, white voters who are generally opposed to strong civil rights legislation has completed its swing from the Democratic party to the GOP.

Today, the South is solidly Republican. In general, Democrats don’t have a snowball’s chance in hell of representing these states. Indeed, this is where they face their very toughest odds. And that’s not because there’s been some sea change in the population, culture, attitudes, or beliefs commonly held by white people in the American southeast. It’s because the party that was once aligned with their interests abandoned them, and because the party that once opposed those interests was captured and radically changed by them.

I accept this change, by the way. These shifts are par for the course in American politics. What I don’t accept is present day Republicans who try to deflect well-grounded charges of racism by claiming that they’re members of “the party of Lincoln” while ignoring the near-perfect realignment in the major party’s respective bases that happened between now and then. It's like somebody who has had a sex change trying to insist that they were born in their current state. I don't object to the operation. I do object to the lying.

Seriously, if the point your making only sounds convincing to people with zero grasp of history, then what you're asserting is just straigh-up bullshit, which is like lying, except worse.

http://en.wikipedia.org/wiki/On_Bullshit

So you know, honest, intelligent, decent people who respect the truth don't behave like that. You - apparently - are none of the above.

>> "I think the debate would be better served if you kept to policy arguments instead of attacking your opponents."

Except this isn't a debate. This you not knowing your ass from your elbow, behaving in an intellectually dishonest fashion, and getting schooled accordingly. So you know, debates revolve around opinions, ideas, and perspectives. What we're talking about here are matters of well-established (i.e. non-debatable) fact.

Re: Why doctors are sick of their profession

#249

Earlier quoted context omitted.

I'm not sure how racism worked its way into an article on health care. But, your assertions that the TEA Party and Republicans are inherently racist are misplaced. Let's start with a little history. Lincoln who freed the slaves, Republican. Jim Crow laws, Southern Democrats. Most votes against the 1964 Civil Rights act, Democrat. Inner cities where blacks are oppressed, run by Democrats. In fact, you would be hard pr…

"In fact, you would be hard pressed to find any racism in the TEA Party or Republican party." Lol.

Here's an elected representative (i.e. not an unrepresentative outlier) who wants to make it harder for black people to vote specifically and explicitly because they're black.

http://fortressamerica.gawker.com/georgia-lawmaker-vows-to-e...

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