What the Trump administration has done to change the health care system

[EMEDPA]

I have no issue with lower pay if 100% of my health care for reasonable things is covered, like it would have been if I had taken the job in the UK. I also wouldn't have to have a $2400/yr disability policy, because guess what? They would cover that too. Also, no malpractice policy because it's not a thing there. 

You have probably heard of the "Happiness index". Know where people are consistently objectively happier? Socialized countries. It ranks the top 20 countries. we are #18

https://www.forbes.com/sites/laurabegleybloom/2020/03/20/ranked-20-happiest-countries-2020/#4f028b5a7850

World's 20 Happiest Countries

 

1. Finland
2. Denmark
3. Switzerland
4. Iceland
5. Norway
6. Netherlands
7. Sweden
8. New Zealand
9. Austria
10. Luxembourg
11. Canada
12. Australia
13. United Kingdom
14. Israel
15. Costa Rica
16. Ireland
17. Germany
18. United States
19. Czech Republic
20. Belgium

[CAAdmission]

1 hour ago, EMEDPA said:

You have probably heard of the "Happiness index". Know where people are consistently objectively happier? Socialized countries. It ranks the top 20 countries. we are #18

I guess to each their own. A lot of the top countries are icy hells that don't see the sun rise for months in the winter. There's nothing that would make me happy there. And good for Israel keeping a stiff upper lip. Neighbors on all sides hate them and they are subject to constant terrorist threats and attacks.

Many of these happy countries are also probably not very diverse in culture. When you have a country that is as big a melting pot as the US, there are bound to be things that don't melt together well. 

[ventana]

5 hours ago, Boatswain2PA said:

I guess it would depend on how the healthcare IS funded.  If we jack up taxes on businesses to pay for increasing national healthcare expenditures, then no, I don't think wages would go up.

If government wants to raise taxes on individuals to pay for the increasing healthcare expenditures, then wages may go up, but the taxes go up as well.

Or if the government got out of healthcare and reduced restrictions on insurance companies (letting them offer wider variety of plans like catastrophic only) then wages could go up and people could shop around.

70% of health care is ALREADY paid for by Govt

health insurance creates huge expense and restricts care

we already spend more then enough to pay for health care for all, just re-allocate it so that pharma and insurance companies do not make profit

 

 

5 hours ago, CJAdmission said:

For the folks that want a national health plan, what do you see happening to the current insurance industry? Do most of them become federalized employees and the government takes over their operations? Or do they get shut down?

literally every other first world country has already figured this out... we don't have to reinvent the wheel

Your question is a good one as there would be job losses in these fields - but with a slow introduction and formal retraining programs change is possible, avoiding change is not a reason to not change...

 

 

6 hours ago, Boatswain2PA said:

It's not "extreme leftist", but it is growing socialism.

When Medicare/Medicaid first came out it was called out as a socialist program because it is.  It is society promising to pay for (at least some) of the healthcare of a person, with no real defined benefit to others.  This is the difference between socialist programs like government funded healthcare and things like roads, military defense, food inspections, etc.  A socialist program is there to benefit a person (ie: paying for Grandma's ICU bill), without a real benefit to the community (the community would not be worse off if Grandma died).  However building roads, having a police department to enforce laws, military defense, etc are all COMMUNAL goods for the entirety of the community.  Everyone can use the roads, without enforcement of laws you could not have property rights, and without a military we would quickly be subjugated.  

Since the birth of Medicare and Medicaid (again, socialist programs) there has been a push to expand them to cover more people, and have them cover more things.  

And now there is the push for a national healthcare idea. 

So it's not that those evil conservative/right-wingers are "successful in labeling centrists" as "extreme leftist", it's more that those on the left continue to push to expand the socialist programs (in this case, healthcare for all).

 

You finally touch upon the crux of the situation, but one that nobody ever really talks about - how do we ration healthcare.

You say it doesn't need to be a "high bells and whistles coverage", but just "something to protect our citizens and our healthcare delivery."

Like what? Do we cover insulin?  We all agree on that.  What about your 98 year old grandmother's 3 week ICU stay?  Where do we draw that line?

How about cosmetic surgery?  I'm ugly and want to look pretty, isn't that healthcare?  

Many people want to live an exceptionally long and healthy life despite eating a diet consisting of chocolate cake and mountain dew while enjoying frequent methamphetamine highs and smoking 3 ppd.  

We have always, and WILL always ration healthcare.  The question is how do we do it, and how much tax money are we going to spend on it.

whoa....

lets go back to the definition of socialism as people are oh so quick to call it socialism (which it is not)

DEFINITION". a political and economic theory of social organization which advocates that the means of production, distribution, and exchange should be owned or regulated by the community as a whole.

nowhere no how does this apply to a single payer system.  The hospital, dr's office, NH's, rehabs are all still privately owned, the paycheck still comes from the same employer, and not the gov't.  Throwing out the  "Socialism" label is just a fear tactic the right has come to provide a sound bite (simple and concise but wrong) about universal payer.  My stats has had universal coverage since 2006.  We also continue to have, and they continue to thrive, some of the biggest and more prestigious hospitals in the country.  Brigham and Womens, Tufts, Mass General, Lahey, Beth Israel........

4 hours ago, Boatswain2PA said:

The questions I asked were simply to make a point about the crux of the matter - how we ration healthcare.

 

your comments about letting grandma die i the ICU or not paying for insulin are meant to inflame.  that is not what anyone is saying and in fact I would suggest many many more people die needless deaths now, at home, with out care, due to no insurance and no care.  I did not get into medicine to care only for those that can afford it, and I don't think most people did.  

 

I find it amazing that MASS did this 14 years ago and no one is running around saying the sky is falling, the hospitals are broke, the practices are bankrupt and we are in trouble.  In fact out health care economy in the state is healthy and robust and we are covering something like 97% of our population.

[EMEDPA]

MASS is a great model. OR had something similar for those on medicaid a few years when the Oregon health plan was more robust under Gov Kitzhaber(An ER doc). 

We need to cover everyone for legitimate medical issues, certainly communicable diseases, prevention (tobacco cessation, vaccinations, prenatal care, etc). I think if someone wants a cosmetic procedure not indicated due to a major trauma/burn/etc they should have to pay out of pocket for it. Hair transplants, breast augmentation(except s/p cancer, etc) should be the responsibility of the individual. 

It is ridiculous that places like Cuba have better infant mortality stats than we do. 

[CAAdmission]

15 minutes ago, ventana said:

I find it amazing that MASS did this 14 years ago and no one is running around saying the sky is falling, the hospitals are broke, the practices are bankrupt and we are in trouble.  In fact out health care economy in the state is healthy and robust and we are covering something like 97% of our population.

When this was implemented, did MA start to notice a population influx? I'd think that all things being equal, droves of people with health problems from the Northeast would try to take advantage. 

 

2 minutes ago, EMEDPA said:

It is ridiculous that places like Cuba have better infant mortality stats than we do. 

The press in Cuba is under dictatorial control. I'm not sure I'd trust their stats much. 

[EMEDPA]

13 minutes ago, CJAdmission said:

The press in Cuba is under dictatorial control. I'm not sure I'd trust their stats much. 

pretty sure they are WHO stats. 

[Boatswain2PA]

38 minutes ago, EMEDPA said:

OR had something similar for those on medicaid a few years when the Oregon health plan was more robust under Gov Kitzhaber(

I think the (original) OHP should be used as a national blueprint.  Prioritize what we will pay for, have the actuarials figure out the cost, and then let the legislators figure out how much to spend.  Where those lines intersect is what the government pays for.

Of course the OHP failed when the legislators decided to mandate it pay for additional things, which broke the bank.

Someone eventually has to say no to things.

[Boatswain2PA]

43 minutes ago, EMEDPA said:

It is ridiculous that places like Cuba have better infant mortality stats than we do. 

I think the vast majority of our infant mortality comes from drug addicts.  Turns out that meth, cocaine, and heroin are toxic to babies.

I think there is also a delta in reporting. If a 22 weeker is born in my ED they get resuscitated and hopefully shipped.  If baby dies it counts as an infant mortality.

Pretty sure lots of those instances are not counted in some other countries.

[EMEDPA]

13 minutes ago, Boatswain2PA said:

I think the vast majority of our infant mortality comes from drug addicts.  Turns out that meth, cocaine, and heroin are toxic to babies.

pretty sure the drug epidemic is not a uniquely American issue. 

That raises an interesting question: If we (American medical providers) were better at limiting narcotics like say Australia, wouldn't we have fewer opiate addicts? A doc I knew did a sabbatical there and was pulled aside after his first month and told he had written more opiate scripts in a month than the rest of the hospital's medical staff did in a year. And he was not a candy man kinda guy, just a nl American ER doc. When we write percocet for ankle sprains( you know, because of press-ganey) and folks get hooked on them and then their pcp's don't refill them some turn to heroin. That is a structural systems problem...one of the big benefits of socialized medicine: It doesn't matter if the patients like you or not. You give good care and there is no did you like us, were we fast and polite survey. 

I love this study: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108766#23426274

especially this part: During 142 565 person-years of follow-up duration from 2000 to 2006, a total of 1396 patients died (3.8% of 36 428 patients). In adjusted survival analyses, relative to the least satisfied patients at baseline, the most satisfied patients had a 26% greater mortality risk (adjusted hazard ratio [aHR], 1.26; 95% CI, 1.05-1.53; P = .02) (Table 4). The association between higher patient satisfaction and mortality remained significant in an analysis that excluded patients with poor self-rated health and 3 or more chronic diseases (aHR, 1.44; 95% CI, 1.10-1.88; P = .008).

[CAdamsPAC]

On 10/18/2020 at 2:03 PM, Boatswain2PA said:

I agree.  However if we can have a policy the reduced the number of those folks (meaning infected folks, so some of you can spare calling me a racist) coming into the country is worth something.

There was once a requirement that immigrants be free of contagious disease before entering this country.

 

[ventana]

9 hours ago, Boatswain2PA said:

I think the (original) OHP should be used as a national blueprint.  Prioritize what we will pay for, have the actuarials figure out the cost, and then let the legislators figure out how much to spend.  Where those lines intersect is what the government pays for.

Of course the OHP failed when the legislators decided to mandate it pay for additional things, which broke the bank.

Someone eventually has to say no to things.

this is a great idea, but impossible to implement.  How much care is not getting done in a population is next to impossible to tell, but we can come up with generalities and follow these - the point is that the monies are already there, and BTW the working class PA is paying MORE then their share either through their employer paying tens of thousands of dollars for insurance, or the employee portion

9 hours ago, Boatswain2PA said:

I think the vast majority of our infant mortality comes from drug addicts.  Turns out that meth, cocaine, and heroin are toxic to babies.

I think there is also a delta in reporting. If a 22 weeker is born in my ED they get resuscitated and hopefully shipped.  If baby dies it counts as an infant mortality.

 

OMG

I just about lost my coffee

How dare you throw such vitriol and hate towards a medical Dx of addiction - as well it is absolutely unbelievable  to think that  people think the USA doing well in the 20th century and this was only a problem in the last 15 years.  This is a long standing problem, please go look at WHO rankings...  News flash, we have been trailing the first world for most of recent history

 

please if you do not know the answer to something do not just pick a likely culprit and blame that.... ie addiction, that is dangerous and ill willed.  I have seen numerous articles over the past 15 years that infant mortality rate in the USA is most likely tied to lack of following standards of care, including pre-natal and at the same time the actual care delivered by medical professionals like us - ie not following the guidelines...  And I am not even in OB or GYN - just have read them as general interest

 

This is from the CDC.  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2bx2.htm

Challenges for the 21st Century

Despite the dramatic decline in infant and maternal mortality during the 20th century, challenges remain. Perhaps the greatest is the persistent difference in maternal and infant health among various racial/ethnic groups, particularly between black and white women and infants. Although overall rates have plummeted, black infants are more than twice as likely to die as white infants; this ratio has increased in recent decades. The higher risk for infant mortality among blacks compared with whites is attributed to higher LBW incidence and preterm births and to a higher risk for death among normal birthweight infants (greater than or equal to 5 lbs, 8 oz [greater than or equal to 2500 g]) (18). American Indian/ Alaska Native infants have higher death rates than white infants because of higher SIDS rates. Hispanics of Puerto Rican origin have higher death rates than white infants because of higher LBW rates (19). The gap in maternal mortality between black and white women has increased since the early 1900s. During the first decades of the 20th century, black women were twice as likely to die of pregnancy-related complications as white women. Today, black women are more than three times as likely to die as white women.

During the last few decades, the key reason for the decline in neonatal mortality has been the improved rates of survival among LBW babies, not the reduction in the incidence of LBW. The long-term effects of LBW include neurologic disorders, learning disabilities, and delayed development (20). During the 1990s, the increased use of assisted reproductive technology has led to an increase in multiple gestations and a concomitant increase in the preterm delivery and LBW rates (21). Therefore, in the coming decades, public health programs will need to address the two leading causes of infant mortality: deaths related to LBW and preterm births and congenital anomalies. Additional substantial decline in neonatal mortality will require effective strategies to reduce LBW and preterm births. This will be especially important in reducing racial/ethnic disparities in the health of infants.

Approximately half of all pregnancies in the United States are unintended, including approximately three quarters among women aged less than 20 years. Unintended pregnancy is associated with increased morbidity and mortality for the mother and infant. Lifestyle factors (e.g., smoking, drinking alcohol, unsafe sex practices, and poor nutrition) and inadequate intake of foods containing folic acid pose serious health hazards to the mother and fetus and are more common among women with unintended pregnancies. In addition, one fifth of all pregnant women and approximately half of women with unintended pregnancies do not start prenatal care during the first trimester. Effective strategies to reduce unintended pregnancy, to eliminate exposure to unhealthy lifestyle factors, and to ensure that all women begin prenatal care early are important challenges for the next century.

Compared with the 1970s, the 1980s and 1990s have seen a lack of decline in maternal mortality and a slower rate of decline in infant mortality. Some experts consider that the United States may be approaching an irreducible minimum in these areas. However, three factors indicate that this is unlikely. First, scientists have believed that infant and maternal mortality was as low as possible at other times during the century, when the rates were much higher than they are now. Second, the United States has higher maternal and infant mortality rates than other developed countries; it ranks 25th in infant mortality (22) and 21st in maternal mortality (23). Third, most of the U.S. population has infant and maternal mortality rates substantially lower than some racial/ethnic subgroups, and no definable biologic reason has been found to indicate that a minimum has been reached.

To develop effective strategies for the 21st century, studies of the underlying factors that contribute to morbidity and mortality should be conducted. These studies should include efforts to understand not only the biologic factors but also the social, economic, psychological, and environmental factors that contribute to maternal and infant deaths. Researchers are examining "fetal programming"--the effect of uterine environment (e.g., maternal stress, nutrition, and infection) on fetal development and its effect on health from childhood to adulthood. Because reproductive tract infections (e.g., bacterial vaginosis) are associated with preterm birth, development of effective screening and treatment strategies may reduce preterm births. Case reviews or audits are being used increasingly to investigate fetal, infant, and maternal deaths; they focus on identifying preventable deaths such as those resulting from health-care system failures and gaps in quality of care and in access to care. Another strategy is to study cases of severe morbidity in which the woman or infant did not die. More clinically focused than reviews or audits, such "near miss" studies may explain why one woman or infant with a serious problem died while another survived.

A thorough review of the quality of health care and access to care for all women and infants is needed to avoid preventable mortality and morbidity and to develop public health programs that can eliminate racial/ethnic disparities in health. Preconception health services for all women of childbearing age, including healthy women who intend to become pregnant, and quality care during pregnancy, delivery, and the postpartum period are critical elements needed to improve maternal and infant outcomes (see box, page 856).

Reported by: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

 

 

 

This graphic is particularly powerful at how bad the USA is at this

  

[MediMike]

13 hours ago, Boatswain2PA said:

Well of course it does.  Just like if everyone were a millionaire it would be beneficial to society, or if everyone read Chaucer, or...the list goes on.
 

Removed most of the quoted post to save time and space.

While we will clearly never agree on many things I appreciate the discussion!

[Boatswain2PA]

14 hours ago, ventana said:

DEFINITION". a political and economic theory of social organization which advocates that the means of production, distribution, and exchange should be owned or regulated by the community as a whole.

nowhere no how does this apply to a single payer system. 

Well, since the whole single payor system is regulated by the community as a whole, it even meets your definition of socialism. Thanks.
 

14 hours ago, ventana said:

your comments about letting grandma die i the ICU or not paying for insulin are meant to inflame.

Must be terrible to have such sensitive skin.  

 

13 hours ago, EMEDPA said:

pretty sure the drug epidemic is not a uniquely American issue. 

My point is that if you look at the data of WHERE we have most of these infant mortalities they are in the more drug plagued areas.  It has been a while since I've seen that, but I would believe it remains true.  

And of course it's not just the drug use, but the socio-economic factors that are associated with heavy drug use are also associated with poor health in general, which leads to increased infant mortality.

And this isn't a problem we can solve by throwing money at it.  As is frequently pointed out, we spend more than anyone, yet are failing in these metrics.  

13 hours ago, EMEDPA said:

If we (American medical providers) were better at limiting narcotics like say Australia, wouldn't we have fewer opiate addicts? A doc I knew did a sabbatical there and was pulled aside after his first month and told he had written more opiate scripts in a month than the rest of the hospital's medical staff did in a year. And he was not a candy man kinda guy, just a nl American ER doc. When we write percocet for ankle sprains( you know, because of press-ganey) and folks get hooked on them and then their pcp's don't refill them some turn to heroin. That is a structural systems problem...one of the big benefits of socialized medicine: It doesn't matter if the patients like you or not. You give good care and there is no did you like us, were we fast and polite survey. 

You think that increasing government control over healthcare will improve things like this?  The government had a big role in CAUSING the opioid crisis with CMS tying reimbursement to "pain is the 5th vital sign" BS.  This wasn't Press Ganey, this was pressure from CMS to ensue "no patient is in pain".  

I also don't think we would get rid of the Press-Ganey stupidity when we shift to single payor.  I think the gubment bureaucrats will just roll that into their metrics.

 

3 hours ago, ventana said:

this is a great idea, but impossible to implement. 

It is actually VERY possible to implement, and Oregon DID it 25 years ago (?) with Kitzhaber's Oregon Health Plan.  

However as we move more toward democracy (and away from republicanism), it becomes more impossible to maintain such a system.  Again, the failure of the OHP was because the legislature started skipping down the list to cover things that were not funded.  

In other words, they were unable to say "no".  Which ties back to my point that the crux of the issue is how we ration healthcare.

 

3 hours ago, ventana said:

How much care is not getting done in a population is next to impossible to tell,

Well, first you would have to define health care.  What IS healthcare, and what is NOT healthcare.  

We can't even do that.

 

3 hours ago, ventana said:

How dare you throw such vitriol and hate towards a medical Dx of addiction

Since you seem to lack the ability to understand anything I write, how about you just hit that ignore button so you don't have to read anything I post anymore, okay?  That way your highly-emotional state won't force you to get "enflamed" or "spit coffee".

 

3 hours ago, ventana said:

I have seen numerous articles over the past 15 years that infant mortality rate in the USA is most likely tied to lack of following standards of care, including pre-natal

And which patient population is most likely to not follow standards of care?  The same populations that are most likely to resort to heavy drug use.

Again, we throw more money at healthcare than anyone, yet we don't do so well on many metrics.  It's not a money problem, it's a cultural problem.  And if you look at infant mortality specifically, it is highest in distinct geographical areas that are associated with poverty and drug use.

[MediMike]

9 hours ago, Boatswain2PA said:

My point is that if you look at the data of WHERE we have most of these infant mortalities they are in the more drug plagued areas.  It has been a while since I've seen that, but I would believe it remains true.  

And of course it's not just the drug use, but the socio-economic factors that are associated with heavy drug use are also associated with poor health in general, which leads to increased infant mortality.

And which patient population is most likely to not follow standards of care?  The same populations that are most likely to resort to heavy drug use.

Again, we throw more money at healthcare than anyone, yet we don't do so well on many metrics.  It's not a money problem, it's a cultural problem.  And if you look at infant mortality specifically, it is highest in distinct geographical areas that are associated with poverty and drug use.

Duuuuuude. Come on. You are making some leaps here that just don't play out.

Your logic is: People who use drugs are from a lower socioeconomic status and therefore all people from a lower socioeconomic status use drugs.

Believe it or not, there are a vast number of people in the lower socioeconomic strata who simply lack access to care and education surrounding healthcare without being addicted to drugs or even recreational users. 

I'm curious where you think these dens of sin are? When you track out infant mortality per the CDC the highest rated correspond with the lowest access to healthcare.

[Boatswain2PA]

12 hours ago, MediMike said:

Duuuuuude. Come on. You are making some leaps here that just don't play out.

Your logic is: People who use drugs are from a lower socioeconomic status and therefore all people from a lower socioeconomic status use drugs.

Where did I say "all"?  You are conflating what I said ("socio-economic factors that are associated with heavy drug use are also associated with poor health in general, which leads to increased infant mortality") into "all poor people do drugs" when I never said that, and I certainly don't mean that.

There is a clear association between heavy drug use and low socio-economic status.  I would suggest it's not just associative, but causative (at least in one direction, with heavy drug use ensuring you end up in the low socio-economic strata).
 

12 hours ago, MediMike said:

Believe it or not, there are a vast number of people in the lower socioeconomic strata who simply lack access to care and education surrounding healthcare without being addicted to drugs or even recreational users. 

Of course there are, never insinuated there aren't.  Much of this is cultural with a mistrust of healthcare providers, systems, and "the man" in general.  Another prime driver is the localization of specialty care into urban centers, and there are many others.  

Regarding your CDC map.  I saw a similar map 15+ years ago that was probably broken down to county level, appalachicola was highlighted like yours, but also had some counties with large cities in it.  One of the few things that the major urban centers have with appalachicola is extreme poverty and heavy drug use.

[ventana]

Boats

you are simply beyond logic

you seem only interested in stirring the pot for the mere reason to create conflict

 

many different posters are calling you out on your mis information and statements and all you do is pivot to a different topic

 

To state that the opioid crisis is part of infant mortality and then defend it shows a startling lack of understand of the timeline of both problems, a total lack of looking at data and history and in general a very mean streak to try to through more blame at a population of people (those suffering with OUD) for something they clearly do not control.  

 

I just do not understand how you can continue to have such beliefs and statements that are so far from the proven mainstream......

[Cideous]

3 hours ago, ventana said:

Boats

you are simply beyond logic

you seem only interested in stirring the pot for the mere reason to create conflict

 

many different posters are calling you out on your mis information and statements and all you do is pivot to a different topic

 

To state that the opioid crisis is part of infant mortality and then defend it shows a startling lack of understand of the timeline of both problems, a total lack of looking at data and history and in general a very mean streak to try to through more blame at a population of people (those suffering with OUD) for something they clearly do not control.  

 

I just do not understand how you can continue to have such beliefs and statements that are so far from the proven mainstream......

I have a few family members like him, you can look up and see a perfectly blue sky...and they will swear it to be red.  I've learned not to engage, but to focus getting information to people on the fence or who are intellectually curious. Something most Trump cool aid drinkers are not.  They believe in what they want to regardless of facts and everything else is "fake news".  The good news is that Millennials and Gen Z's have cast aside those ideals and have for the most part sought out their own answers in politics, and that is why Republicans are doing everything in their power to suppress the vote.  They are scared crapless because they know they are a few years away from AZ becoming blue and Texas becoming purple, not to mention Georgia and North Carolina.  All they can do is try and install fear and loathing among their followers for those that may look different then them, worship different then them or vote different then them.

 

They are a dieing breed and in the end, they will become a loud, screaming super-minority, but a minority they are becoming.

Edited October 22, 2020 by Cideous

[CAAdmission]

3 hours ago, Cideous said:

why Republicans are doing everything in their power to suppress the vote.

You are of course entitled to this belief, but it's nothing more than an asinine lefty talking point. I need to show ID to buy booze (and now cough medicine) but not to vote? Do you also think mail in ballots don't present a risk for voter fraud?

Edited October 22, 2020 by CJAdmission

[CAAdmission]

On 10/18/2020 at 2:01 PM, CJAdmission said:

How about the economics of non-contagious problems? I have a buddy that does neurosurgery at a big urban tertiary center. A few times a year a Central American shows up with a tumor that is treated and then they skate back home leaving us on the hook for the bill. Granted there is a payback in that it allows residents and fellows a means to practice their technique, but this does get expensive. 

@mcclane - 

You downvoted this without comment. I'm not sure how to interpret this. You are thinking that we are obligated to provide free care to anyone who presents for care? 

[Cideous]

21 minutes ago, CJAdmission said:

You are of course entitled to this belief, but it's nothing more than an asinine lefty talking point. I need to show ID to buy booze (and now cough medicine) but not to vote? Do you also think mail in ballots don't present a risk for voter fraud?

3 out of 4 voters in Arizona vote by mail and have for years and years...Fraud is virtually non-exsistant.  Voting by mail is safe, fair and in a pandemic...smart.

Ordering drop off ballet boxes in places like Harris county to go from 12 to 1 is voter suppression.  Plain and simple.

[CAAdmission]

27 minutes ago, Cideous said:

3 out of 4 voters in Arizona vote by mail and have for years and years...Fraud is virtually non-exsistant.  Voting by mail is safe, fair and in a pandemic...smart.

Except in those places where US Postal employees have been dumping ballots in the trash, by the side of the road, etc. I'd be perfectly happy to vote in person, yet I'm being forced not to. If people can go to bars, they can go to vote. 

[ANESMCR]

19 minutes ago, CJAdmission said:

Except in those places where US Postal employees have been dumping ballots in the trash, by the side of the road, etc. I'd be perfectly happy to vote in person, yet I'm being forced not to. If people can go to bars, they can go to vote. 

This has been completely debunked.

[ANESMCR]

7 hours ago, ventana said:

you seem only interested in stirring the pot for the mere reason to create conflict.

This. 

[Boatswain2PA]

11 hours ago, ventana said:

you seem only interested in stirring the pot for the mere reason to create conflict

You seem to view everything posted through an overly emotional lens.  

Please directly quote (not paraphrasing through your overly emotional lens) what I have said that you feel is just stirring the pot.

 

11 hours ago, ventana said:

To state that the opioid crisis is part of infant mortality and then defend it shows a startling lack of understand of the timeline of both problems,

Great example of you viewing my posts through your overly emotional lens.  

I never said the opiod crisis (particularly the medical-system created opioid crisis) was a "part" of infant mortality.  If I have said that, then please refresh my memory of where I said that.  If I did, then

I said drug use is a part of it, and I specifically mentioned methamphetamines and cocaine which, apparently by all medical literature, is bad for an unborn baby (along with the mother).  

Now, I think we all would agree that there is an association between poverty and poor health outcomes, including infant mortality.  Right? 

And I think we would agree that there is an association between poverty and heavy drug use (well, except for those heavy drug users who have vice presidents as daddy's, they somehow seem to be able to maintain great health despite their heavy drug use! lol)

(And, just to ensure we don't have anyone putting words in my mouth like MedMike did, by "association" I mean the scientific/statistical term "association".  I am not saying "all poor people do drugs" like MedMike somehow inferred I said, nor am I saying "all poor people have poor health outcomes".)

So, using logic that was idealized almost three thousand years ago by the Greeks, if there is an association between poverty and poor health, and an association between poverty and heavy drug use, we can use "if A = B, and B = C, then A = C" and infer that there is AN ASSOCIATION BETWEEN HEAVY DRUG USE AND POOR HEALTH OUTCOMES INCLUDING INFANT MORTALITY.

This isn't rocket science, and is in every damn public health textbook out there.  
 

11 hours ago, ventana said:

general a very mean streak to try to through more blame at a population of people (those suffering with OUD) for something they clearly do not control.  

Where am I BLAMING people for things they clearly don't control.  If diabetes comes from sugar over-consumption burning out the pancreas, then it is the sugar over-consumption by the owner of the pancreas.  That doesn't mean they are bad people, and I don't propose we castigate them from society.  Same thing with health sequalea of heavy drug use.  It doesn't mean they are bad people.

So maybe I'm blaming people for things they should be blamed for.  I blame myself for wasting my time trying to explain to you that I'm neither trolling, being inflammatory, or any of the myriad of other things you incessantly blame me of doing.  It's called laying responsibility where it belongs, but that people who make bad decisions (like me, you, and everyone else) still deserve to be treated with respect.  

Except, it seems, those damn deplorables.  Those guys just need to hurry up and die, right Cideous?

 

11 hours ago, ventana said:

I just do not understand how you can continue to have such beliefs and statements that are so far from the proven mainstream......

Please, cut and past one belief/statement that are so far from the proven mainstream.  

 

8 hours ago, Cideous said:

They are a dieing breed and in the end, they will become a loud, screaming super-minority, but a minority they are becoming.

And those minorities have no rights in democracies.

 

[ANESMCR]

18 minutes ago, Boatswain2PA said:

And I think we would agree that there is an association between poverty and heavy drug use (well, except for those heavy drug users who have vice presidents as daddy's, they somehow seem to be able to maintain great health despite their heavy drug use! lol)

Insults addiction. Says he didn’t insult addiction. Insults addiction again.