as far as more resistance from penacillian. the same problems are there with people who do not listen to labels and doctors that tell you to take this exact amount and do not stop taking it! Some people dont listen. So you have the same problems with resistence than if you had it over counter telling you this in the first place. So again the problem lays with too much control with the doctors and people such as yourself you can not trust the people to make decisions for themselves.
Weather are not he was offered surgery through an insurer, its clear he is not happy or willing to go through these people for what ever his reasons are they are what count. So the problem is the same as with me. Being able and allowed the chance to go through whom we feel is best qualified and usually that means other than the doctors who will work for those on medicaid. These doctors are poorly paid, and go through alot of people like a assembly line. The quality of care is not the same as say money out of your own pocket for care.Please Register or Log in to view the hidden image! So I see where you are coming from on this thread.
My attention was caught by Tiassa's subject line. My question to her is, who are you addressing in this thread? Who does that "your" refer to? And what sort of rhetorical position is being implicitly assumed from which to address them? You certainly have a passionate interest in American domestic politics. But in this thread at least, there's a note of aloofness as well, the hint that the citizens of the United States are foreign, them as opposed to us.
The difference is the only way they could call you up and tell you it was Strep is if you went in to the doctor's office and had a culture done. So with your over the counter dispensing of antibiotics you would never know. The insurance company doesn't make any money on this transaction by the way, they lose money because they are paying most of the cost for the antibiotics and the cost of the billing. Insurance companies make money when you aren't sick.
They spent 8 weeks on this guy in the hospital and repaired his hernia. There is NO indication that the quality of care he is getting is poor or that he is being treated like he is on an assembly line or that the doctors are not being well paid to treat him. And unlike your previous assertion, he is on disability. Arthur
The narrow and the broad Technically, my fellow Americans. This is what we've made. If I hold myself apart from them, that's well enough; in my America—i.e., a nation fashioned according to my understanding of what makes this nation the so-called greatest on Earth—we would have this guy fixed up as much as possible and back into productive society as soon as possible. And, for instance, in our neighbor Madanthonywayne's America, he is "disappointed that the doctors at UCLA didn't take him on as a charity case", and hopes "the publicity he will receive as a result of this article will help him raise the money he needs and/or shame UCLA into taking care of him for free or at least accepting the rate Medicaid would pay". But one need not be an American to consider the issue. What is anyone's idea of "America", as we advertise this seemingly fabulous nation with the power to completely screw up the world in addition to our own people? Everyone on the planet has a stake in the idea of "America"; we've made sure of that.
What is "what we've made"? America didn't cause this guy's unfortuate condition. There's this idea out there, often kind of implicit in a lot of political rhetoric, that life would be perfection if only it weren't for other people's evil. So if something goes wrong in somebody's life, people immediately look around for who's responsible, for who to blame. But life isn't perfect. Ultimately, we are all going to grow old and die. That's the human condition. This gentleman has a grotesque and unfortunate disease, probably through no fault of anyone's. He's receiving medical care and apparently his case is rather baffling to the physicians. They have offered to treat him, at public expense no less, but as is often the case in medicine and surgery, the treatment has its dangers. The guy has apparently turned the local doctors down, and would rather receive what looks like an unusual and perhaps experimental treatment out of state. Nevada public assistance has declined to pay for it. Private medical insurance probably wouldn't pay for it either. If you read the small print in your medical plan's disclosure booklet, it almost certainly excludes experimental treatments. It's doubtful whether the government managed British or Canadian health services would give this guy what he wants either. He can accept the treatment that he's been offered. Or he can continue to hold out in hopes of receiving treatment that he prefers and believes might be more optimal. It's the same America. Imperfect and human as all nations are. I don't really see anything wrong with that and basically agree with it. You don't really like America very much, do you? You may say that you do, but what you love is the vision of what you think that America could ideally be, after its been purified. Right? That's an old theme in American (and European) thought. It goes back to the Puritans' dream of a Biblical commonwealth, at least. It's been secularized, but the deeper thrust remains -- The imperfect actuality still has to be condemned in hopes that people's resulting dissatisfaction might somehow motivate them to bring the promised kingdom into being.
Are you missing the point, or dodging it? But we have made an America in which money comes first, above all else. Critics keep trying to hide behind that point, though they must rely on shaky inference declared as fact. And what treatment is that? As long as others are obliged, right? Like the doctors? And the medical center itself? Multiple surgeons for an uninsured (i.e., cash) patient who likely won't ever be able to pay off the value of the procedure? It's all about money. And whether you want to criticize the doctors, the hospital, the insurance companies, the politicians, or even the patient himself, what we are dealing with here is a society in which money is more important than anything else. Hell, if you give the guy the surgery and get him back into the workforce, at least you've gotten him off the public roll. But in the America we've built, the better option, apparently, is to leave the guy adapting sweatshirt hoods to hold his scrotum on a milk crate. Because, well, at the end of the day, it's the money that is important. Well, I adore the "America" I was taught to believe in by parents, teachers, preachers, and community in general. I just wish it was real. And the America we have falls, daily, further from that idyll, and mostly because money is just that important.
No Tiassa, the guy was offered surgery at UMC paid for under Medicaid to fix his condition and decided not to go for it. There is no "shaky inference" in this as indeed the option was clearly spelled out: There is no other way to interpret that sentence so when presented with clear evidence why you refuse to accept that you are so obviously wrong about this is what is getting pretty funny. Arthur
That the code exists doesn't mean there is a doctor available This is the reason I doubt your reading comprehension. To start with, one of the problems of approaching medicine from an accounting standpoint—as insurance schemes do—is that everything must fit into a neat category. Next time you get a statement from your doctor, look for the numerical codes next to the procedures. With insurance schemes, including Medicaid, if there is not a code to describe a condition or procedure, it effectively does not exist for the purposes of that outlook. That Nevada Medicaid might account for a diagnosis of scrotal lymphedema does not mean the service is necessarily available in the state. Perhaps it is; indeed, this is a question to be resolved in our disagreement. You have presumed that it is. Certainly, any doctor with a surgical permission at a given hospital can decide to attempt a procedure, but that does not necessarily mean it is advisable to do so. To wit, in recent years, prominent cardiologists from the United States traveled to Brazil in order to learn about a newly-developed procedure to treat heart enlargement. Essentially, the procedure cuts away as much of a third of the heart. At the time, there was only one surgeon in the world who knew how to do it, because he was crazy enough to pioneer the procedure. Once American doctors heard about the surgery, they scrambled to learn how to perform it. All the sentence you note says is that Medicaid would cover a surgical procedure for scrotal lymphedema. Nothing in the story suggests that UMC had the personnel ready to perform it. Indeed, the story implies otherwise: ... Warren said he went to doctors off and on for months, including a lymphedema specialist, without finding help. "I kind of gave up," he said .... .... Though the infectious disease generally tied to the elephantiasis was not found, Voss said multiple courses of antibiotics and anti-viral medications were given to Warren in hopes that they would take down the massive swelling. When they didn't, she said doctors told him about a surgery that could be performed through Medicaid. Urologist Kassahun informed Warren that a team of urologists and plastic surgeons would be needed to cut away the excess tissue and to perform the reconstructive surgery that would include skin grafts. Every attempt would be made to save and reconstruct Warren's penis and testicles, but it was possible that they would have to be completely excised. "I told him that if there was major bleeding we might not be able to save them," Kassahun said .... .... Even though scrotal lymphedema is exceedingly rare outside certain tropical regions of the world, Kassahun told Warren that it was possible that the UCLA Medical Center in California may have surgeons who could better deal with his situation. At UCLA, where Warren recently paid nearly $600 for an evaluation, he said doctors seemed more confident about saving his penis and testicles. They also told him that it would cost nearly seven figures for the procedure. Even if Nevada's Medicaid program would allow him to go out-of-state for surgery, Warren said UCLA doctors informed him that they doubted that would work. "They said Nevada Medicaid doesn't pay enough so I would be a cash patient," he said. Still, even if he comes up with the cash, Warren admits that there is no guarantee the surgery would work. "But I do feel I would have a better chance," Warren said. In a situation as extraordinary as Warren's, Kassahun said, there can never be a guarantee of success. "That would be irresponsible," he said. (Harasim) It would seem that while doctors could be brought to UMC to perform the surgery, Kassahun's recommendation was to go to UCLA, where there are surgeons qualified to perform the procedure. Any doctor willing to give it a go can probably slice away at your scrotum, but there are certain faculties at certain hospitals that are actually familiar with, practiced in, and qualified for certain surgeries. Bringing UCLA's doctors to Nevada would require certifying them for practice and surgery in the new state and at the hospital, and obtaining a specific insurance policy to cover them on this one procedure. Perhaps one might suggest shaming UMC into undertaking that risk, but in the end, it's all about money no matter what solution they follow. And that is the problem. Money. It all comes back to money. Medicine in America isn't really about health. It's about money. And you're perfectly welcome to doubt my reading of the story, but it is ludicrous for you, or anyone else, to suggest, "There is no 'shaky inference'," or, "There is no other way to interpret that sentence." You have simply chosen the interpretation that best suits your political desires and declared it as unquestionable fact. Or else, I suppose, you can demonstrate without question that the fact that a Medicaid code exists for the procedure means that UMC is staffed with the requisite, qualified urologists, plastic surgeons, and others needed to make the surgery a responsible endeavor. If Kassahun felt there was a facility in Nevada that could pull it off, he would not have recommended the patient go to California. Or else, maybe, he's just a terrible doctor who doesn't know what he's talking about. I suppose there's always that. This isn't cataract surgery, or even heart bypass surgery. I'm pretty sure you can find a qualified surgeon in any of the states for those sorts of things. But this is a rare specialty even among urologists. That a surgery can be performed through Medicaid simply means that the program accounts for it in its accounting codes. ____________________ Notes: Harasim, Paul. "Las Vegas man with 100-pound scrotum seeks money for surgery". Las Vegas Review-Journal. October 16, 2011. LVRJ.com. October 21, 2011. http://www.lvrj.com/health/las-vega...um-needs-1-million-for-surgery-131962533.html
No Tiassa, it is you who have this problem. Clearly that last sentence, with the use of WE, means that the team which included Kassahun was going to do the surgery there and Kassahun was simply explaining to Warren the risks of the procedure. Well what news shook Warren? It was the news that the team of doctors at UCM could cut down his massive testicles but in doing so, might not be able to save his manhood, and so he refused. Based on his refusal Kassahun said if he didn't trust the surgeons at UCM he could try the surgeons at UCLA. Note the BETTER DEAL, Better than what Tiassa? This again only makes sense if the UCM were going to try to deal with it surgically. Indeed, that is echoed in Warren's statement: What's the "better chance" Tiassa if it isn't a better chance than the surgery offered at UMC. I'm done Tiassa. You can't wake a person who is pretending to be asleep as you are. Arthur
I am detecting a pattern here Arthur. When you cannot defend your positions you runaway after doing some good old ad hominem.
The eternal question of human strife He cannot even acknowledge that there is a question. This is because his human compassion is subordinate to his conservative politic. It's one of the fundamental differences between the main sequences of the broad identity labels. It's like the old idea that one must earn respect. Certes, one can forfeit or refuse respect, but waiting for one to cajole and satisfy the other into benevolently bestowing the privilege of respect is among the most powerful motivators of human strife. The great sages of the millennia—Buddha, Christ, Muhammad, and others—saw the contrast quite clearly. And then you have folks like Nietzsche, Crowley, and even Leo Strauss, who tried to rationalize the other side of that juxtaposition. Fundamentally, beyond party names, the argument is still what it has always been. One side demands the other fight, and thus fears the compassionate because there does, in fact, come a point when they will fight. Remember Clausewitz: All wars are started by the defenders; if the defenders simply let the aggressors have whatever they want, there would be no war.
No Tiassa, the question was only one of your making. I showed line by line where you read it wrong, and you've simply ignored the explanation of how the surgery being performed at UMC was clearly covered in the article. You misread it, posted a long winded post about it and so now can't admit that you made a mistake. Arthur
A Note for Joe A Note for Joe As I was saying: Remember this aspect of conservative conduct the next time they lament something about how the evil liberals are unwilling to have a civilized, rational discussion. Quite clearly, there are many conservatives who don't want to have a civilized, rational discussion, and it is futile to even bother with them. Our neighbor Arthur, unfortunately, is case in point.
Totally Predicatable No Tiassa, you simply picked a bad example to make your point because you misread the article and then won't admit that you are wrong even when it has been clearly pointed out to you where and why you were wrong. Now, since you can't defend your point, all you are left with is attacking me. Pretty pathetic actually. Arthur
Agreed. Tiassa is completely off the rails on this one. He thought he'd found an example of the evil American health care system denying care to a man suffering from a horrific and tragic medical condition; when he'd actually simply found an example of someone understandably dissatisfied with the limitations of his health plan. No health coverage is perfect. There are always trade offs and limitations. The gentleman in the OP is suffering from a condition so rare and severe that no doctor or team of doctors in his state is confident that they can treat him successfully. They were willing to try, but offered him no guarantees. His doctor told him "that it was possible that the UCLA Medical Center in California may have surgeons who could better deal with his situation." It was possible that UCLA had surgeons who could better deal with the situation. I'm sure even there he'd get no guarantees. But with his balls literally on the line, he understandably wanted to go where he'd have the best chance of a successful outcome. Unfortunately, his state based government insurance wouldn't allow him to go out of state for treatment. Worse yet, even if it did, the amount Medicaid is willing to pay won't cover the fee at UCLA. Now is any of this sad tale indicative of problems unique to the American healthcare system or of private healthcare systems in general? I don't think so. First of all, the gentleman in question actually had a government funded plan. Sure, it's not Tiassa's ideal plan. But we are dealing with reality here, not some parallel dimension where Tiassa is dictator. Furthermore, it is actually Mr. Warren's government health plan that refuses to pay for surgery at the place he wants to go. The place he believes will give him the best chance of keeping his balls. Now is it possible that we could enact a single payer plan that would allow anyone to see any doctor or team of doctors they wanted to see anywhere in the nation with no limitations (be they geographic or financial) whatsoever? I suppose so. But it's also possible that s single payer plan might further limit our choices. It's possible that Mr Warren might not even have the option of trying to raise the money to pay for his surgery under a government run plan. All this story illustrates is that our system isn't perfect. But no system is. And even a perfect system won't always guarantee a positive outcome, especially in extreme cases such as that of Mr. Warren.
And those 22 words weren't totally ad-hominem? I think that Arthur has already stated his position and he's argued for it very well. I agree with him. People don't win debates by simply refusing to consider what their opponent has said, by waiting for him to eventually tire of repeating himself and walk off the podium, and then by crowing about how he's a beaten craven coward. Maybe stubbornness contests are conducted that way, but not debates. Both sides need to make their points as well and as persuasively as they are able, and then that's it. It's over. The audience can make up their own minds who won. In this particular instance, my estimation is that Arthur won.
This, That, and the Other I would challenge any of you three to point out where you explicitly see that Warren refused surgery under Medicaid. After all— —it would seem Yazata thinks Arthur won by behaving exactly as one apparently doesn't win a debate by behaving: That's the whole of the argument. Of course, expecting objectivity, consistency, or integrity of conservatives is always a risky venture. Stick together, thou birds of a feather. • • • Actually, what we have here is an example of how we've made the so-called best country on Earth: Money is the most important thing. I can understand why a capitalist like yourself would want to avoid admitting that, but, really, it's kind of desperate. This is why people say conservatives want things to get worse, and want other people to suffer. Take a look at the CCC—the Conservative Cheerleaders Corps. It's good to see some solidarity; it suggests there really is a sense of honor among thieves. All you can do is insist that your inference is fact (Madanthonywayne, Adoucette), and then decry that very behavior (Yazata) while proclaiming victory for that behavior (Yazata). It's actually quite hilarious, but it doesn't do much for your reputations.
