Scrapping Welfare

[CaptFun]

As a Catholic do you support scrapping welfare in America? I mean completely removing it.

psst: Headline should read Scrapping Welfare ABUSE

YES. I favor THAT. As a Catholic. An American. A Californian. Whatever.

 

[DarkLight]

psst: Headline should read Scrapping Welfare ABUSE

I mean, I think everyone agrees with that in principle. Usually the arguments are over how many people are actually abusing it and what the best way to prevent abuse without leaving those in need out is.

 

[randirhoades]

Thank you Theo520 for being concerned.

I don’t hang around those friends. I just know they are wealthy. The friends I do have are in the same boat as I am.

Like Birds of a feather, flock together. lol

May God bless you Forever.

 

[Pup7]

So if a poor person has glaucoma and needs to see an ophthalmologist, they should just be allowed to go blind instead? Or what about someone who has serious acid reflux disease and needs to see a gastroenterologist? If they’re not treated, they’re likely to get cancer in their throat.

A GP can treat acid reflux. We do it all the time. You need a proton pump inhibitor if it’s severe, and often it can be treated (if caught early) with far less sophisticated drugs, like H2 histamine blockers (Tagamet, for one). It can be diagnosed and treated by a primary provider. Glaucoma is indeed different. But there are many things GPs can manage and treat.

We also need to make being a GP more attractive, and we need the AMA to chill out on physician extenders like NPs and PAs, who do them a great service by assisting in the management of the less complex cases. I’m bored with the AMA’s disparaging of NPs.

 

[DarkLight]

A GP can treat acid reflux. We do it all the time. You need a proton pump inhibitor. It can be diagnosed and treated by a primary provider.

It can sometimes be treated by a primary provider.

And then you get people like me where the answer is “you definitely have acid problems but can’t tolerate proton pump inhibitors, so you’re going to need a GI to figure out what to do.” (This is why my medical care is so expensive - there’s apparently a certain portion of the population that genetically just doesn’t seem to react to drugs right. I’m apparently in that.)

 

[Pup7]

Most acid reflux is actually treated at the PCM level. You’re a different case, and they do exist, but most acid reflux drugs are written for by primary care managers and not specialists. Insurance companies have seen to that, which is sometimes the only thing they’re good for - restricting people from being able to go in and demand referrals they don’t need that cause costs to escalate. Because at one time people could do that.

I know there are people who need specialist care for reflux - but most actually don’t. And in many, many cases, if there was easier access to primary care, specialists could be delayed or maybe even not needed altogether (and no, I’m not saying in your case, I’m speaking quite broadly).

 

[Pup7]

I’ve always said we need basic universal primary care with some midlevel specialties included (like treatment for glaucoma - that’s the very ‘low end’ of what ophthalmologists do), and we need to make being a GP more attractive as a career. And we need to make getting that GP easier - I’d be all about subsidizing medical school costs for folks wanting to be GPs, or at least helping somewhat with loans and expenses somehow. Make it worth their time.

A good GP is worth their weight in gold. Literally.

 

[Pup7]

Treating chronic conditions is killing the cost of healthcare.

Some of that is self-determined.

A lot of times getting people off their butts and getting them to stop eating trash will lower cholesterol to amazing levels and drop their blood pressure to healthy numbers. Lifestyle changes are a big deal and not hard to implement, but we’ve got a pill for everything now, and people think it will cure everything. That’s not how it works. I think that’s changing, but it’s still there.

 

[blackforest]

Ah, bloody [expletive]!

There went my evil plot to spend a spa day undergoing an orgy of body scans and exploratory surgery . . . .

 

[Thorolfr]

A GP can treat acid reflux. We do it all the time. You need a proton pump inhibitor if it’s severe, and often it can be treated (if caught early) with far less sophisticated drugs, like H2 histamine blockers (Tagamet, for one). It can be diagnosed and treated by a primary provider.

I agree. But someone with severe acid reflux might need to have an endoscopy to check for things like Barrett’s esophagus. Only a gastroenterologist can do an endoscopy.

 

[Bruised_Reed]

A GP can treat acid reflux.

Most acid reflux is actually treated at the PCM level.

Yes, but you missed the post that DarkLight was replying to which suggested that there be a cap on specialist care. That was the point; not what GPs can do.

 

[DarkLight]

The main debate here is what lifestyle changes are reasonable and what we can expect from who.

I know this is a big debate with mental illness, because there are definitely lifestyle changes that can help. But at the same time, mental illness can impair the ability to make those changes. Poverty can too - for example, the problem of food deserts in some major cities.

 

[Socrates92]

Also, I had to actually do the math for a proposal I designed (though it was hypothetical) while in a professional military education course - and I did it to justify the proposal I made, which was charging service members a percentage of pay to lower the taxpayer out of pocket cost for our healthcare program.

Well, I would oppose that too, both as a civilian now and as an ex-reservist. Mainly because it amounts to changing the terms of employment after the fact, and would therefore be very dishonest and unjust.

 

[philipl]

So that any business that will hire them will know instead of paying them what they are worth, they can offer them less as their wages are subsidized by government.

 

[Theo520]

Some of that is self-determined.

A lot of times getting people off their butts and getting them to stop eating trash will lower cholesterol to amazing levels and drop their blood pressure to healthy numbers. Lifestyle changes are a big deal and not hard to implement, but we’ve got a pill for everything now, and people think it will cure everything. That’s not how it works. I think that’s changing, but it’s still there.

I think a focus on accessible primary care but not full coverage of specialists would help people make smarter lifestyle choices. It would be the best bang for our public healthcare $

 

[Pup7]

Pup7:

A GP can treat acid reflux. We do it all the time. You need a proton pump inhibitor if it’s severe, and often it can be treated (if caught early) with far less sophisticated drugs, like H2 histamine blockers (Tagamet, for one). It can be diagnosed and treated by a primary provider.

I agree. But someone with severe acid reflux might need to have an endoscopy to check for things like Barrett’s esophagus. Only a gastroenterologist can do an endoscopy.

Yes I know that.

Yes, but you missed the post that DarkLight was replying to which suggested that there be a cap on specialist care. That was the point; not what GPs can do.

And I didn’t disagree with that. My point was many, many things can be nipped by a GP before they become severe.

Goodness, folks. No one said scrap specialists, did they?

 

[Pup7]

I think a focus on accessible primary care but not full coverage of specialists would help people make smarter lifestyle choices. It would be the best bang for our public healthcare $

I actually don’t see that as the problem.

I live in a world where pretty much all care is 100 percent covered, many specialists for those outside TRICARE Prime (read: many retirees) aren’t 100% covered, and people still don’t make wise lifestyle choices.

And these are people for whom their jobs either depend on their fitness, or once depended on their fitness. These aren’t dependents - these are the active duty members.

 

[DarkLight]

I actually don’t see that as the problem.

I live in a world where pretty much all care is 100 percent covered, many specialists for those outside TRICARE Prime (read: many retirees) aren’t 100% covered, and people still don’t make wise lifestyle choices.

And these are people for whom their jobs either depend on their fitness, or once depended on their fitness. These aren’t dependents - these are the active duty members.

You’d have to adjust it for income. For example, when I was at my worst, I definitely needed to see a psychiatrist regularly. I also did not have an income, for pretty much the same reasons I needed to see a psychiatrist regularly. If it wasn’t 100% covered I couldn’t afford it.

 

[RCIAGraduate]

Could community health centers serve as an alternative third way to the health care debate? For those in genuine and dire need, there is a clinic or health center that can address their needs?

 

[Theo520]

I live in a world where pretty much all care is 100 percent covered,

So you don’t think if they had to start paying for their specialists, it wouldn’t have an impact?
It would also take a shift in attitude by primary care doctors, who now seem quick to send you off to a specialist.

I think the public would save money even if it meant they saw the specialist less frequently because they were paying a much larger share.