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Obamacare increase the avability of healthcare in what ways?

  1. tirelesstraveler profile image86
    tirelesstravelerposted 3 years ago

    I have been listening to how the government has a billion dollars for getting people to sign up for the Affordable Healthcare Act.  Would that money have been better spent training more doctors and building new hospitals?  New Jersey has closed how many community hospitals in the last few years? Medical schools turns thousands of qualified students away each year.  What happens to those people?
    The bill is being pushed as the best thing in the world.  But how is the government increasing the supply of medical care as they make it more affordable?  Today the average doc gets out of school with $250,000 in college debt.  How will they pay those bills if they don't make much money?

    1. wilderness profile image97
      wildernessposted 3 years ago in reply to this

      As near as I can tell from the advertising and/or comments from proponents the concept is that because the nation will provide more medical care (costing more money), we will need less care and costs will go down.

      At least that's what I get from it...

      1. Shawn McIntyre profile image86
        Shawn McIntyreposted 3 years ago in reply to this

        In theory, that's how it's "supposed" to work, the problem is that the proponents of the Affordable Care Act, like so many before them, are ignoring the basic law of supply and demand.

        Since this law increases demand for Insurance (through the mandate), and does nothing to increase the supply of medical professionals, costs will go up, it's a simple economic fact.

        1. wilderness profile image97
          wildernessposted 3 years ago in reply to this

          Well, I haven't read the bill any more than those that voted for it did, but from what I see in the news and comments on the web, the price of care will be reduced by law.  Govt. will cap what can be charged at considerably less than current fees.

          This will so please potential doctors that they will enter the field in droves, providing the necessary increase in numbers of medical professionals.

          1. Shawn McIntyre profile image86
            Shawn McIntyreposted 3 years ago in reply to this

            It took two lawyers the better part of three days to explain it to me, and I still didn't understand half of it. The Schoolhouse Rock version is this: come January, the plan that I have now will go up nearly 40%. So, I've decided to cap my number of employees at around 30 and hire everyone else as an independent contractor. It was either that, or I was going to have to let people go.

            My biggest problem with the law is that they took the length and complexity of the Tax Code, and brought it to the health care system.

            1. tirelesstraveler profile image86
              tirelesstravelerposted 3 years ago in reply to this

              The IRS overseeing it will guarantee nobody gets much healthcare.
              It will be interesting to see what kind of insurance IRS workers get.

            2. Dr Billy Kidd profile image90
              Dr Billy Kiddposted 3 years ago in reply to this

              Shawn, all your employees get healthcare and that should make your business run better. You business policy will cover 30 of them at a lower cost than you're paying now--at least that's what is happening in N.Y. and N.J. The rest of your employees will get a subsidy from the government so they can afford health insurance, rather than use the ER. Sounds like a win-win for everyone. I missed the part about the tax code. It doesn't much apply to you if you have under 50 employees.

              1. tirelesstraveler profile image86
                tirelesstravelerposted 3 years ago in reply to this

                The federal government  is only subsidizing until 2017.  Then the states get to take over that burden.  Ca is so close to bankruptcy this could take it down.

        2. Quilligrapher profile image89
          Quilligrapherposted 3 years ago in reply to this

          Good evening, Mr. McIntyre. It is nice to be able to exchange views with you once again. I hope things have been going really well for you.

          Without a doubt, the greatest obstacles to understanding Obamacare are the people who make false assumptions about the law and then go around treating their erroneous claims as if they were facts. What you assert to be ”a simple economic fact” turns out to be a simple distortion of facts. The ACA has actually done a great deal since 2010 “to increase the supply of medical professionals.” Since your post states otherwise, it is clear that no effort was made to fact check the false claims.

          The Affordable Care Act of 2009 provides incentives to increase the availability of primary care doctors, nurses, and physician assistants. It also includes funding for scholarships and loan repayments for primary care doctors and nurses working in underserved areas.  The bill goes on to eliminate taxes payable by doctors and nurses on payments received under any state loan repayment or loan forgiveness program intended to increase the availability of health care services in underserved or health professional shortage areas. In addition, Mr. McIntyre, this law provides increased payments to rural health care providers to help them continue to serve their remote, low-density communities. Obamacare also includes new funding to construct and/or expand services at community health centers to serve about 20 million new patients across the country. {1}

          Providing affordable healthcare insurance coverage for 55 million Americas who were without coverage before 2014 will not, I repeat will not, increase the cost of providing medical services. Many other factors will certainly contribute to higher costs but the individual mandate certainly is not one of them. It is possible that you have not looked at the many ways the ACA will reduce, not increase, the cost of providing healthcare services, therefore, please allow me to list some of provisions that will cut the cost of providing medical services.

          … Cost-free preventive services, like mammograms and colonoscopies, by their very nature, will reduce or significantly delay the need for treatments for many serious illnesses. {2}

          … People with Medicare are eligible to receive a 50% discount on brand-name drugs when in the Medicare “donut hole." This will further reduce or significantly delay the need for treatments for many serious illnesses. {3}

          … States will be share in the new Prevention and Public Health Fund allowing them to invest in proven prevention and public health programs that can help keep Americans healthy, programs ranging from smoking cessation to combating obesity.

          … Funding will continue to fight fraud that resulted in $2.5 billion being returned to the Medicare Trust Fund in fiscal year 2009 alone.

          … The Center for Medicare & Medicaid Innovation is developing and testing new ways of delivering care to patients aimed at improving the quality of care, and reduce the rate of growth in health care costs. {4}

          … A hospital Value-Based Purchasing program (VBP) in Traditional Medicare offers financial incentives to hospitals to improve the quality of care.

          … Obamacare provides incentives for physicians to join together to form “Accountable Care Organizations” to better coordinate patient care and improve quality, help prevent disease and illness and reduce unnecessary hospital admissions.

          … The ACA of 2009 instituted a series of changes to standardize billing and to require health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. The changes are designed to reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care.

          … The Community Care Transition Program assists hospitalized, high risk Medicare beneficiaries to coordinate care and local community services thus avoiding unnecessary readmission. {5}

          … As Medicaid programs and providers prepare to cover more patients in 2014, the Act requires and reimburses states to pay primary care physicians no less than 100% of Medicare payment rates in 2013 and 2014 for primary care services.

          The list goes on, Mr. McIntyre, therefore, I suggest you visit http://www.hhs.gov/healthcare/facts/tim … -text.html for even more cost saving provisions in Obamacare. You may also wish to visit http://thehill.com/blogs/floor-action/h … he-deficit to learn that CBO is standing by their July 2012 projections that Obamacare is expected to reduce the national deficit and the national debt by more than $100 B over the next 9 years.
          http://s2.hubimg.com/u/6919429.jpg
          {1} http://www.hhs.gov/healthcare/facts/fac … 12012.html
          {2} http://www.hhs.gov/healthcare/facts/tim … -text.html
          {3} http://www.medicare.gov/Publications/Pubs/pdf/11493.pdf
          {4}  http://innovation.cms.gov/
          {5} http://innovation.cms.gov/initiatives/C … cms1239313

          1. Shawn McIntyre profile image86
            Shawn McIntyreposted 3 years ago in reply to this

            Hello again Mr. Quilligrapher,

            Indeed it has been a while. I've have been well, getting the kids back in school for a new year (always a busy and exciting time). I hope the intervening period between this, and our last conversation, has found you equally as well.

            After reading the information you were kind enough to provide, I feel that I must (as it always seems with the two of us) respectfully disagree with your assessment. As is my usual custom, I will respond on a point by point basis, if you will so indulge:



            I completely agree that those who make false assumptions about Obamacare are the ones who have been so instrumental in creating this climate of confusion; on this point we are of one mind. You will forgive me however, as I forced to point out, that I am not one of the ones making those false assumptions.

            The materials you provided, while certainly intriguing, are, at best, misguided. They tell me how the Affordable Care Act should work, and what it was designed to do; as a business owner, I can tell you first hand, the actual experience of it is much, much different.

            It seems to be that proponents of the ACA are laboring under the assumption that if they simply keep repeating "it's a good law" long enough, then they'll convince those of us who have our doubts.



            All of these are perfectly worthwhile objectives my dear Mr. Quilligrapher, yet they fall woefully short of actually accomplishing anything. According to the Association of American Medical Colleges, when speaking about the current shortage of Medical Professionals in the country:

            "The shortage could quintuple over the next decade, thanks to the aging of the American population — and the aging and consequent retirement of many physicians. Nearly half of the 800,000-plus doctors in the United States are over the age of 50."[Source]

            Indeed it's not a hard concept to grasp: we have a doctor shortage now in this country with the number of people currently insured, by adding an additional 55 Million people into that pool, it is delusional to the point of absurdity to think that the we will not face a more drastic shortage in the future.

            As I have stated on more than one occasion (I even wrote a Hub about it, if you'll forgive my shameless plug smile), the Law of Supply and Demand clearly teaches us that if Demand increases, and supply either stays the same, or decreases, then prices will go up. It is an economic certainty, that has been true since humans first began trading goods and services with one another. 



            Again my friend, you have fallen into the same old trap of simply repeating what the law is designed to do, the reality is sadly much different.

            I understand that, as a supporter of the ACA, you want to believe in it, and its ability to do what it was intended to do: provide affordable health care to the millions of Americans who are currently uninsured. As I have stated many times before, this is, and should be, one of the goals for any government.

            The difficulty that I, and others who don't share your faith in the ACA, have with this law, is that it so blatantly fails at every purpose for which it was intended; and no amount of recitation of the talking points and "party line", can disguise that fact.

            Forgetting for a moment the sheer absurdity of trying to improve health care by reforming the Insurance Industry, this law, like so many others, fails to recognize and accept even the most basic of economic truths.

            Now maybe you're right, and maybe this law will miraculously fix the appalling health care conditions in this country, and maybe it will help cut the National Debt, but it's had to have faith in the virtues of a law that keeps getting delayed.

            If Obamacare is the answer, if it really will do all of these wonderful things, then why is it constantly being delayed? Why has this law missed half (41 of 82) of the legally imposed deadlines for implementation [Source]?

            Again, hoping this reply finds you well,
            Your Friend,
            Shawn.

            1. Quilligrapher profile image89
              Quilligrapherposted 3 years ago in reply to this

              Hey there,Mr. McIntyre. Many thanks for sharing your views with us.

              I think we can agree on one point: the shortage of primary care practitioners, predicted years before Obamacare became law, has not been caused by the ACA nor by the previously uninsured. “The medical-education establishment is on a track aimed at increasing output 30 percent by 2020”, declared The Chronicle of Higher Education in a 2008 article titled M.D. Graduates: From Glut to Shortage. {1}

              The Forbes article you cite begins by saying the shortage of doctors is the result of “the aging of the American population — and the aging and consequent retirement of many physicians.” Displaying an amazing lack of rational thinking, the same article closes with the conclusion, “The first step in addressing America’s shortage of doctors is full repeal of Obamacare.” The paragraphs in between are filled with scare rhetoric and they never establish a supportable causal relationship between Obamacare and the declining number of practitioners. {2}

              Looking to Obamacare to solve the pressing shortage of doctors is ludicrous. It is within the domain of the medical establishment to ramp up the supply of practitioners but your source reaches the illogical conclusion that the ACA is to blame.

              “If Obamacare is the answer,” you asked, “if it really will do all of these wonderful things, then why is it constantly being delayed? Why has this law missed half (41 of 82) of the legally imposed deadlines for implementation?” These pointless questions are supported by another Forbes article. {3}

              Really? It is your position that the law is not good for the country because the government did not meet deadlines on time. Wow! That line of thinking does not impress me. Perhaps you missed the statement by the author “Most of these deadlines aren’t for mission-critical features of the law.” Mr. Roy also admitted, “We should make one thing clear. The law isn’t going to ‘collapse unto itself’ or any such thing that conservatives appear to pine for. For every missed deadline or White House waiver, there are nine aspects of Obamacare that are being implemented as we speak.” Never the less, you argue, like the Forbes article referenced above, against the law for totally illogical reasons.

              I should also point out that as of May 31, 2013, 49 deadlines (60%) had been completed, 24 (29%) were still to completed, and 9 (11%) were obstructed by congress. 

              I found most of your post to be rhetoric without substance. For example, you say I “have fallen into the same old trap of simply repeating what the law is designed to do, the reality is sadly much different.” You do not tell us how your reality is different from mine. You even say, “it (the ACA) so blatantly fails at every purpose for which it was intended.” You do not tell us how all of the purposes have failed. You simple declare that they have. I find this stance to be weak and unconvincing.

              Now, here lies the crux of our different positions. In my last post, I listed many facts and features in the ACA that have already or will in the future reduce the cost of delivering healthcare in this country, but in your reply, you reject them all without providing one fact or any evidence that proves these goals have not or can not be achieved. If you have facts or verifiable evidence to prove all of the goals of the ACA can not be achieved, I would love to hear about them.
              http://s2.hubimg.com/u/6919429.jpg
              {1} http://chronicle.com/blogs/brainstorm/m … rtage/5973
              {2}  http://www.forbes.com/sites/sallypipes/ … quintuple/
              {3} http://www.forbes.com/sites/theapotheca … deadlines/

              1. Ralph Deeds profile image69
                Ralph Deedsposted 3 years ago in reply to this

                +++

              2. Shawn McIntyre profile image86
                Shawn McIntyreposted 3 years ago in reply to this

                Mr. Quilligrapher,

                As always it's a pleasure to hear from you; your daily insights into the nuance of American politics are always intriguing; I know you may not believe this, given our generally opposing view points on nearly every topic we've ever discussed, but I always find your replies refreshing and enjoyable.

                Unfortunately, albeit unsurprisingly, in our present discussion, we seemed to have reached somewhat of an impasse. Never one to give up, I decided to more closely examine the nature of our disagreement; could it be that I really am a heartless corporate conservative of Dickensian proportions, one who cares nothing for the poor and downtrodden? Could it be that you're a proverbial tree-hugging, bleeding heart liberal, who seeks to enslave the population by making them dependant on the Government for nearly everything? Neither of these descriptions sound particularly accurate.

                When you boil our current disagreement down to its most basic element, you're left with one simple issue: you believe that the Affordable Care Act is the answer to the Health Care problem we have in America, and I don't.

                Obvious philosophical, and political differences aside (I suspect neither of us are as to the far left/right as the other would imagine), this tells us that, if nothing else, we can both agree that there is a serious problem with healthcare in this country, and that's something.

                Now we could, as we have done in the past, keep trading reference laden posts back and forth; each filled with sources that support our own opinions. As fun as that may be, I have decided to appeal to your sense of logic in this case. Not with the hopes of swaying you to my side (which I believe would be an exercise in futility), but to shed some light on why I believe that the ACA is so tragically flawed.

                To avoid hijacking this thread, or at the very least monopolizing the discussion, I take the rest of the day to write my response in the form of a new Hub, which I will post later this evening. To avoid the appearance of self-promotion, I'm not going to post links to it here on the forum, but you'll be able to find it from my profile.

                As always, hoping you are well,
                Your friend,
                Shawn

                1. Quilligrapher profile image89
                  Quilligrapherposted 3 years ago in reply to this

                  Good Evening, Mr. McIntyre.

                  I am looking forward to reading your hub. I hope you avoid continuing with a litany of unsupported opinions and finally provide facts and verifiable evidence that proves all of the goals of the ACA can not be achieved. Mere predictions of gloom and doom are already widely available.

                  Good luck.
                  http://s2.hubimg.com/u/6919429.jpg

                  1. Shawn McIntyre profile image86
                    Shawn McIntyreposted 3 years ago in reply to this

                    I had a much busier day at work than I was expecting, I'm still working on the Hub at the moment. It'll be up (hopefully) later on this evening.

                  2. Shawn McIntyre profile image86
                    Shawn McIntyreposted 3 years ago in reply to this

                    The Hub was just published. Again, I apologize for the delay, but the market decided to mess up my day today.

                    As always, hoping you are well,
                    Shawn.

        3. Ralph Deeds profile image69
          Ralph Deedsposted 3 years ago in reply to this

          There's nothing simple about our broken health care system or solutions to fix it.

    2. Ralph Deeds profile image69
      Ralph Deedsposted 3 years ago in reply to this

      Short answer: No. There is obviously a need to publicize and explain the terms of the Act.

    3. Dr Billy Kidd profile image90
      Dr Billy Kiddposted 3 years ago in reply to this

      Nobody seem to have read the question. Obamacare with increase the availability of healthcare in what ways.
      1. It will cut cost for business and individuals. Premiums have risen the slowest in the last 20 years because of Obamacare.
      2. There is a guarantee that you can get healthcare or keep the policy you have. Previously if you lost your job, your family lost their health care. And you could not buy an individual policy if you were over 50 or had an illness. That's all over.
      3. Medicare will be expanded to cover poor people, who will see their doctors before they need the ER. That cuts costs for these people without health insurance. Preventative treatment for everyone cuts costs--period.
      4. Small business people will be able to buy affordable policies and cannot be turned down because someone has an illness. This will take a big burden off the backs of small businesses.
      5. Medicare people will not have to pay the 4500 dollar donut hole for getting prescriptions. That stops about 1/4 of all Medicare patients from getting treatment.
      6. Children can stay on their parents policies until they are 26.
      7. With electronic charting of patient's conditions, administration costs will fall and that money can be used for treatment (We discovered that in our business in the 90s.). The new law limits administration spending and profits to 20%.. This is why premiums fell in some states already.
      8. The most important issue is that the law guarantees that you can have healthcare insurance. Doesn't matter if your job is eliminated or if you've been unemployed or if you start a new business and invest all your money in it. The cost cutting features of the Affordable Care Act will make the all work, with a few adjustments, as is the case with any new program. And yes, I have read the bill.

      1. wilderness profile image97
        wildernessposted 3 years ago in reply to this

        Whether right or wrong, everything you have said here concerns healthcare insurance, not healthcare itself.

        The question is where the huge numbers of healthcare providers will come from, not how to get insurance.  Shuffle all the paperwork in the world, but if there is no doctor available to look at you, you won't get any care.

        1. Dr Billy Kidd profile image90
          Dr Billy Kiddposted 3 years ago in reply to this

          When the money is there, the providers will come. The U.S. government cut back the number of residencies for med school graduates in the 1990s by 1/5. The idea was that having fewer doctors would increase pay. Those residencies cost $100,000 a year because hospitals aren't going to fork out their own money to train new people. They can always hire them from India.. And like I said, if the money was there, hospitals would be training more doctors.

          1. Shawn McIntyre profile image86
            Shawn McIntyreposted 3 years ago in reply to this

            So the answer to Health Care is "If you build it, they will come"?

            1. 84
              Education Answerposted 3 years ago in reply to this

              Oh, the money will be there.  All we have to do is print it, borrow it, or coin a trillion dollar coin.  Then, once we've kicked the can further down the road, we can all look forward to potential bankruptcy.  Please excuse my skepticism.  The same government that wastes trillions of dollars feels it can do a better job managing a massive healthcare program.  This is the same government that has already been involved in regulating the healthcare industry, the same government that can't run itself without borrowing trillions of dollars.  Let's trust it with trillions more!  What could go wrong?

      2. Kathleen Cochran profile image86
        Kathleen Cochranposted 3 years ago in reply to this

        Your list sounds only too reasonable.  Who wouldn't want all this? 

        And that's exactly the question we should be asking ourselves.  Who doesn't want this and why?

        1. 84
          Education Answerposted 3 years ago in reply to this

          I would also like:

          50 exotic cars
          50,000 more square feet of living space
          10 houses in exotic locations
          5 private jets

          Everything has a cost.  Promising is one thing.  Delivering is another.  Giving is one thing.  Paying for it is another.

          1. Zelkiiro profile image83
            Zelkiiroposted 3 years ago in reply to this

            Countries with lesser economies (e.g. Norway) can afford universal healthcare just fine, all while providing their average worker with the equivalent of upper middle-class pay.

            Maybe if we weren't wasting trillions of dollars on useless, idiotic wars...

            1. Shawn McIntyre profile image86
              Shawn McIntyreposted 3 years ago in reply to this

              In honor of all of the High School kids who are beginning their senior year, and who will be taking the S.A.T.'s soon:

              Q. Norway (population 5,063,709 with a GDP of $266 Billion) is to the United States (population 316,530,000 with a GDP of $15.7 Trillion) as _____________ is to Walmart.

              A. A little kid's Lemonade Stand

              I understand you want to make a point, but the two countries are nowhere near comparable.

              1. Zelkiiro profile image83
                Zelkiiroposted 3 years ago in reply to this

                Ironically, a little kid's lemonade stand has more integrity and does more honest business than Walmart does.

                Hmmm...

                1. Shawn McIntyre profile image86
                  Shawn McIntyreposted 3 years ago in reply to this

                  And you're basing that statement on...

              2. psycheskinner profile image81
                psycheskinnerposted 3 years ago in reply to this

                How does scale fundamentally change the relation between the variables in this case?

                1. wilderness profile image97
                  wildernessposted 3 years ago in reply to this

                  Norway's per capita spending on the military isn't far below ours - they are tops in Europe for that.

                  Given that we're in at least one war right now and have somehow become the world's policeman to boot it doesn't seem that we're that far above Norway in military spending.

                2. Shawn McIntyre profile image86
                  Shawn McIntyreposted 3 years ago in reply to this

                  Because the difference in the scope and scale of the dollars involved is massive. Tax participation and rates as a percentage of GDP are different. Norway's nominal GDP is about twice that of its PPP GDP. The quality and structure of the health care provided is immensely more complicated.

                  There are a thousand reasons the two don't make a very good comparison.

                  1. psycheskinner profile image81
                    psycheskinnerposted 3 years ago in reply to this

                    That doesn't answer the question of why you don't think the issue is scalable.  IMHO is anything economy of scale should make it work even better.

            2. 84
              Education Answerposted 3 years ago in reply to this

              That's a fair point. May I add that we are wasting mass quantitites of money in other areas too? 

              Here are some examples of wasted money:

              "Health care fraud is estimated to cost taxpayers more than $60 billion annually."

              "Medicare officials recently mailed $50 million in erroneous refunds to 230,000 Medicare recipients."

              "The Federal Communications Commission spent $350,000 to sponsor NASCAR driver David Gilliland."

              "Congress recently gave Alaska Airlines $500,000 to paint a Chinook salmon on a Boeing 737."

              "Washington spends $60,000 per hour shooting Air Force One photo-ops in front of national landmarks."


              Here's the source:

              http://www.heritage.org/research/report … ment-waste

            3. Kathleen Cochran profile image86
              Kathleen Cochranposted 3 years ago in reply to this

              Well said.

          2. tirelesstraveler profile image86
            tirelesstravelerposted 3 years ago in reply to this

            I would like a Mercedes Benz, my friends all have Porses I must make amends. O Lord won't you buy me a Mercedes Benz.

            1. Shawn McIntyre profile image86
              Shawn McIntyreposted 3 years ago in reply to this

              lol, I love that song. smile

        2. 84
          Education Answerposted 3 years ago in reply to this

          My doctor is adamantly opposed to "electronic charting" of her patients, but I guess the bureaucrats know better than she does.  She has grave reservations about confidentiality issues and "electronic charting" FOR the government.   She talks about all of the confidentiality laws she is bound by, both legally and ethically. Then, she explains, that we are going to be posting these same confidential files on the Internet and for the government to know?  This is not going to be as confidential.  Big Brother, here we come!

          By the way, she had to hire another person to begin doing this "charting."  The positive is that Obamacare appears to be employing people, even if it is temporary.  The negative is that she isn't going to eat that cost.  She merely passes it on to the patient or the government.

  2. psycheskinner profile image81
    psycheskinnerposted 3 years ago

    It doesn't matter how many hospitals you have if a big proportion of the nation can't afford to use them, or use them but never pay into them thus driving them bankrupt. Obamacare is about getting more people insured and involved in preventative healthcare.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      Insurance does not automatically equate to better Health Care. I don't care how great your insurance is, or how cheap is costs, it's the doctors that "do the fixin", so to speak. If we don't increase the number of health care professionals available, then nothing else is going to matter.

      1. tirelesstraveler profile image86
        tirelesstravelerposted 3 years ago in reply to this

        Shawn, so true.
        California acutely aware of the doctor shortage. Legislation  has passed allowing nurse practitioners to do abortions  All the while other states have mandated clinics doing abortions be hospital grade with qualified doctors.
        CA also made it possible for non medical staff to give insulin injections to children in elementary school.  Many of my father-laws health problems in his last year came from mismanagement of his insulin.

        Many nursing school grads can't get jobs. Hospitals can't afford to pay them the high cost of nurses, because there is a six month internship that all new grads must go through.  (I HIGHLY AGREE WITH THIS) The catch, hospitals have to pay these grads almost as much as an experienced nurse. Its cheaper to hire traveling nurses from out of state than in-state new grads.   
        Who doesn't want to come to the San Francisco bay area, make per diem, work for a couple of months d and go home.

      2. gmwilliams profile image86
        gmwilliamsposted 3 years ago in reply to this

        +1,000,000,000,000,000,000,000,000!

    2. tirelesstraveler profile image86
      tirelesstravelerposted 3 years ago in reply to this

      I disagree.  The more scarce a quantity the more you pay for it.  You flood the market with doctors the way our nation has flooded the market with lawyers and see what happens.  Several Universities cut the number of applicants it accepted for law school this year. I know a lawyer, just out of law school who have volunteered for the LA District attorney for almost a year to get enough experience to get hired by a law firm.  Several of our friends went to law school ,after their kids graduated, and they are finding the same thing.

    3. tirelesstraveler profile image86
      tirelesstravelerposted 3 years ago in reply to this

      I heard Thursday, 17 community hospitals, inNew Jersey have closed in the last 3 years. That sound like scarce commodity preparing to happen.

  3. tirelesstraveler profile image86
    tirelesstravelerposted 3 years ago

    Costs are going up and people are losing health care so fast it makes your head spin.
    Ask the folks at UPS.  People have had their hours cut so, the small businesses they work for don't get taxed for not providing health care, not because they don't want to, but the cost is too high.  United Healthcare no longer offers policies for individuals in CA.
    Why is the government spending billions on advertising this plan when they could be putting that to training more doctors and nurses? 
    Why haven't you read the bill?.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      Because that damn thing is nearly 10,000 pages on its own, without all of the accompanying documents that go with it.

      This is what the law looks like all packaged up...
      http://michaeljdaugherty.com/wp-content/uploads/2013/03/obamacare-law.jpg

      1. tirelesstraveler profile image86
        tirelesstravelerposted 3 years ago in reply to this

        That wasn't intended for you Shawn, your reply was priceless though.

        1. Shawn McIntyre profile image86
          Shawn McIntyreposted 3 years ago in reply to this

          smile

  4. peanutroaster profile image80
    peanutroasterposted 3 years ago

    The objective is to spread the risk.  Young people pay into the system they will eventually use.  Just like when you buy car insurance even if you are a careful driver - you never know when you will need it.

    Right now hospitals eat the costs of uninsured people showing up at the emergency rooms which is the most expensive way to provide care.  Hospitals have to write off billions of dollars for these - well, deadbeats.  Who do you think pays for them?  That's right you do.

    The uninsured are like shoplifters who cause everyone else to pay more.

    1. 84
      Education Answerposted 3 years ago in reply to this

      Why don't the hospitals go after the deadbeats?  In my experience, hospitals are all too willing to write off deadbeats without pushing for payment.  They certainly push for payment from people who can pay.

    2. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      This would only work if everyone was going to be required to pay for the insurance. Taxpayers are still going to be paying for everyone who makes less than 400% of the poverty level.

  5. peanutroaster profile image80
    peanutroasterposted 3 years ago

    BTW - Obamacare Outreach Campaign To Cost At Least $684 Million

    This is a drop in the bucket compared to the billions it costs us to pay for uninsured people showing up in the emergency room and not paying.

    1. 84
      Education Answerposted 3 years ago in reply to this

      I know people who pay nothing.  They pay nothing, because the hospital tells them they qualify for government assistance.  There lies the problem.  Why don't hospitals put people on payment plans and DEMAND payment?  The hospitals have no problem pushing for money from those of us who have insurance.  Why do they push for government payment for people who are not insured?

      1. Ralph Deeds profile image69
        Ralph Deedsposted 3 years ago in reply to this

        Medical bills are the single largest cause of bankruptcy in the United States.

        1. 84
          Education Answerposted 3 years ago in reply to this

          I have no problem with addressing healthcare issues in America, and there are plenty to address.  Yes, many of us have been nailed with the high cost of healthcare.  Believe me, I understand that.  Others pay nothing, because the government pays for them.

          One of the problems is the fact that some people pay NOTHING.  In Arizona, some people are actually paid to go the doctor at times!  Why aren't hospitals requiring something from those people who go to the emergency room but claim they can't pay? Why don't they pay a portion of the cost or go on payments?  The government pays their bills, so why should hospitals try to get payment from those uninsured patients who claim to be destitute?  The government should be requiring partial payment or a payment plan from the deadbeats, something or anything.  Instead, the government just pays the entire cost, and the deadbeats keep coming. 

          I believe our country can be compassionate about taking care of our poor and financially responsible at the same time.  Requiring some form of payment, even if it is minimal, will reduce costs and reduce needless visits to the emergency room.  Instead, we just keep paying.  I know somebody on the board of directors from a nearby hospital.  He tells me that the government is the single biggest billing source for the hospital, and that's not because of the elderly.  It's because of the people who just expect the government to pay the bill.

  6. peanutroaster profile image80
    peanutroasterposted 3 years ago

    There are the truly poor who really can't pay.  And then there are the those who choose not to pay for insurance because they'd rather have a new flat screen, cell phone and truck.

    I knew a young guy in Maine who was a lobsterman.  He ran his own business.  Owned the boat, a truck, a house, video games, cell phone etc.  Didn't have any insurance. 

    Had severe pain.  Went to the emergency room where the diagnosed kidney stones.  Bill him.  Didn't pay.  Hospital ate the cost.  Probably had to hold more fundraisers to cover the cost.

    And on the flip side the guy decided to pass the painful kidney stones out on the water on his boat.

    Everyone loses here.  Guy suffers unneeded pain.  Hospital loses money.  If he was insured everyone would win. 

    Why wasn't he insured?  Because the decision was left to him and he gambled that he wouldn't need medical treatment and that new TV was much more fun to buy than insurance.

    1. 84
      Education Answerposted 3 years ago in reply to this

      Absolutely!

      I personally know of families that live better than I do, yet they receive free healthcare.  I am a teacher, so I am not rich.  On the other hand, I'm not poor either.  Something is truly wrong with this scenerio.  People are bilking the system.  As a teacher, I see it happen all the time, from free lunches all the way to free healthcare.  For some people, it's all about what the government can do for them.

      Should a person whose children receives free lunches be driving a new Lincoln Navigator, wearing fairly expensive clothing, living in a 2,500 square foot home, and taking multiple, expensive vacations a year?  It seems a bit wrong.  I see the same abuse in the healthcare industry. 

      The government is the enabler, so we decide to add more government regulation?  Great.

      1. psycheskinner profile image81
        psycheskinnerposted 3 years ago in reply to this

        The point of Obamacare is that people who have money have to pay for it -- they can't just use the ER as a GP and help drive hospitals bankrupt.

        1. 84
          Education Answerposted 3 years ago in reply to this

          The point should be that some people who have the ability to pay part of their bill don't pay anything.  They should pay part of their bill, and that would reduce needless visits and costs.  We never addressed so many issues in healthcare and then over regulated with a massive bill.

          If some government regulation isn't working, we must need far more?

          1. Kathryn L Hill profile image85
            Kathryn L Hillposted 3 years ago in reply to this

            Those who can't afford health care will get healthcare... paid by all who have to pay fines...and those who pay the fines are those who can't afford to pay for health care.

            1. 84
              Education Answerposted 3 years ago in reply to this

              Yes.  +1

              I don't know if it is a total lie or not, but my insurance company claims that my insurance premium increases are due to Obamacare.  My insurance has increased in cost four years out of the last five, with another eighty dollar increase, per month, on my last paycheck.  It very well could be a total lie intended to result in greater profit, or it could be true.  I do know that this middle-class teacher is being priced out of being able to afford insurance for my family.  Six years ago, my insurance was relatively cheap and good.  Now, it's expensive and fair.

              1. Kathryn L Hill profile image85
                Kathryn L Hillposted 3 years ago in reply to this

                My very expensive health care won't provide coverage for physical therapy or even MRIs. My radiology bill recently for an MRI, was over $1800. I have to quit paying for my health care if they won't help me with this bill.
                (www.dontfundit.com. to sign a petition.)

  7. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    So, I'm going to challenge everyone in this thread - both supporters and opponents of the ACA.

    If you were in a position to propose a law to Congress to fix the healthcare system what, Cliff Notes version, would it contain?

    I'm ambivalent about the ACA - I feel that at least Obama tried, but it's not a solution. Here's what needs to be addressed:

    1. Uninsured and poor people going to the ER for basic, routine health care. Part of the solution is walk-in clinics which can offer treatment for minor injuries and the like for a fraction of the costs of a fully-equipped ER.

    2. Uninsured and poor people not getting cheap preventive care or good nutrition, resulting in the government having to pay for expensive care later. This is being partially addressed by schools providing higher quality food to children, but that doesn't help their parents.

    3. The United States has the highest per unit costs for health care in the world. How do we bring those costs down?

    4. A shortage of practitioners, especially GPs, nurses and, in some parts of the country at least, midwives. This is exacerbated by the massive amounts of debts doctors graduate with and the relatively low pay received by GPs - as a result most med school graduates want to work at hospitals.

    Also, the idea that "everyone should pay something" could only be proposed by somebody who has never tried to live off of an income that's barely more than the rent of the cheapest accommodation they can find... Let's put even more people in the "Do I pay my medical bills or my heating bill this month" position. Why not? tongue

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      That's the problem, you can't fix it in one law; that's one of the reasons why the ACA is so terrible.

      The first step, before we get anywhere near insurance, is to fix the doctor shortage. I don't care how affordable you make health insurance, if there's no doctor to actually treat you, then your insurance is worthless. You really can't solve anything else until this is fixed.

    2. 84
      Education Answerposted 3 years ago in reply to this

      I disagree with part of your statement.  You said, "Also, the idea that 'everyone should pay something' could only be proposed by somebody who has never tried to live off of an income that's barely more than the rent of the cheapest accommodation they can find... Let's put even more people in the 'Do I pay my medical bills or my heating bill this month' position. Why not?"

      I have lived off of an income that was exactly what you described.  I am a teacher in one of the lowest paying districts in America, quite literally.  For years, I struggled, working more than one job, just to make rent, pay student loans, and eat Ramen noodles.  I believe ALL people can pay SOMETHING for healthcare.  I paid my healthcare bills even when it was extremely difficult to do so.  I got a second, and sometimes even a third job, to do so.  I tutored in my spare time, and I made it happen.   

      Now, I have no problem with reducing the bill for people who truly struggle, but everybody needs to pay something.  Without that kind of financial accountability, people just go to the ER for every little issue, and taxpayers have to pay the bill.  That's not right, and it's part of the reason we're in this mess right now.  Holding all people, including poor people, accountable, to a reasonable level, is responsible, fair, and right.

  8. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    That's a good answer, Shawn. So, let's expand the challenge to allow step by step approaches.

    So. How do we fix the doctor shortage?

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      The same way you fix any shortage: either increase production, or purchase from someone else.

      As for production: Right now there are around 150 medical schools in the country, I'd look to get that number up closer to 200. We also need to create a panel of medical professionals to go through and reevaluate the scope of practice for everyone from doctors on down.

      They need to come up with one national standard, and evaluate if patients really need to wait 4 hours to see a 2nd year resident to confirm what the nurse with 25 years of experience told them to start with (as in the case of my last trip to the hospital).

      As for purchasing from someone else: We also need to encouraging more foreign doctors to relocate to the US. I know this has been a popular (and successful) policy for the last few years, so let's ramp it up.

  9. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Did you do so by taking food off of your own table? Your children's? (I'm figuring you didn't have any from the timeline).

    Now, your story would open entire other can of worms if we let it (teacher pay).

    Accountable? So, you get hit by a cyclist who comes around a tight corner and bowled over. You end up with concussion. You are already struggling to rent a tiny room in a private home. Most of your food is coming out of dumpsters because you *can't afford to buy food*. You're still in college. You don't have health insurance, but aren't eligible for government assistance because you're "already getting financial aid." You can't get a job because every single employer expects "availability for all shifts" and you need to get to class. You're trying to get a job. You just can't find one that allows for your schedule. You have chronic fatigue that's likely an after effect of the concussion.

    So, by your standards, this person should what? Move into her car? Kinda hard to study then and if she drops out, the student loans come due...

    Accountability? None of us know when we're going to need healthcare and no matter *what you do* you can't prevent accidents...or other people's stupidity.

    People go to the ER for every little issue because they would have to skip meals to pay a doctor. Do we need to fix that? Yes. But people who get insufficient nutrition because, you know, *they can't afford food* are more likely to end up needing medical care...and going to the ER because it's the only place they can be treated without paying up front, and if they pay, well, they're going to be moving to the homeless shelter at the end of the month. Which the rest of us have to pay for.

    I'm not dismissing your struggle, but...

    1. 84
      Education Answerposted 3 years ago in reply to this

      To answer your question, I paid my bills, fed my family, and showed responsibility, something my children understand and respect.  My family is happy and healthy.  I am blessed, but I have worked very hard to get where I am.  It didn't come easily.  I worked long, hard hours, and I do not regret doing what was right.  Relying on the government isn't my way.  I pay my own bills, and I provide for my own family.  I'm not saying that the government shouldn't assist people; I am saying that many people are all too willing to accept assistance instead of working harder or longer hours.  What happened to personal responsibility?  What happened to self reliance?  Government assistance should be the last option, an option that is available to people who have really put forth the effort to not be on assistance in the first place.  I have MAJOR respect for these people and disdain for those who just feel that the government owes them a living because of poor career choices or a lack of effort.

      I'm not going to dismiss another person's struggles either; I have the utmost respect for those who work hard every day.  The problem is that many people who get free healthcare don't struggle to pay their bills.  They just expect the government to step in and pay.  I'm not saying that hospitals should go after patients like you suggest or that people should have to make the choices you mention.  I am saying that virtually everybody can pay SOMETHING.  I believe that the vast majority of patients need to have a little skin in the game to ensure patient accountability, something we seldom hear about.

  10. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Another idea might be to hold a survey of teenagers and ask them why they aren't interested in becoming doctors or nurses.

    That might give us some areas to address.

    Increasing the value of nurses would help more if there wasn't a shortage of nurses too.

    1. Kathryn L Hill profile image85
      Kathryn L Hillposted 3 years ago in reply to this

      Maybe 'cause they can't read or write very well.

    2. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      I can answer that one for you right now: because it's ridiculously hard and the pay sucks; at least that's the perception.

      I wanted to be a doctor when I was in High School, it's one of the reasons I chose to go to UF (GO GATORS!), but once I looked into the classes, and the amount of education needed, and the cost of said education, and then compared that to the time it would take before I'd actually start making money, I switched to business instead. I got two degrees in 5 and a half years (Marketing and Economics), and for around a 20% of the cost of a Medical Degree.

      I don't think it's as much about convincing more people to become doctors, as it is about finding space for all of the qualified applicants there are now.

  11. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Bringing down the cost of medical school is certainly part of the answer. Which would, yes, start with more medical school.

    Kathryn, you're saying we need to improve the quality of education overall? And I was kinda avoiding hijacking this into teacher pay... tongue

    1. Kathryn L Hill profile image85
      Kathryn L Hillposted 3 years ago in reply to this

      -can of worms, I'll say.

  12. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Exactly. But overall improvements in the quality of education would give us more doctors and nurses...and more other things too. Paying teachers well enough they don't have to get second jobs to survive would help with that.

    Except that means spending taxpayer money, something too many people are allergic to right now. They don't understand things like "ROI"

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      Some people (myself included) can spot a bad investment when we see it however. In 2009, education spending was 5.4% of GDP ($778,572,000), and yet that same year, we ranked 25th out of 34 countries in Math and Science.

      Money is not the problem.

  13. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    So, then, why are teachers having to get second jobs when we're spending that much on education?

    Money IS the problem. Either there isn't enough of it or it's being spent in the wrong places.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      Let me rephrase that, the amount of money being spent is not the problem. 

      You want teachers to make more money? Get rid of tenure and switch to merit based pay- boom, teachers will make more; the ones who don't, probably shouldn't be teachers in the first place.

      We need to raise the standards for students, not lower them, and if a teacher can't get the job done, then they need to go. If teachers want to get paid more and more money every year while failing to produce and substantive results, let them run for Congress.

      1. 84
        Education Answerposted 3 years ago in reply to this

        I am a teacher, and I welcome merit pay, the minute you can find a way to truly assess how effective a teacher has been.  In what business can a lousy employee get paid the same salary as a great employee merely because they both have the same years of experience?  We desperately need a financial incentive for doing a better job.

        We need to have a curriculum that makes sense.  Then, we need to raise standards.

        1. Kathryn L Hill profile image85
          Kathryn L Hillposted 3 years ago in reply to this

          How about teachers being encouraged to think for themselves and determine for themselves the best way to teach their students. If teachers jump through the seemingly endless multitude of university hoops and finally actually receive their teaching credentials, they should be trusted to be able to TEACH!!

        2. Shawn McIntyre profile image86
          Shawn McIntyreposted 3 years ago in reply to this

          Annual double-blind Independent third-party testing. Outside firms, one administers the test, the other grades it. Teachers are assessed based on student performance.

          1. 84
            Education Answerposted 3 years ago in reply to this

            I get that, and it has its merits.  Still, kids are kids, and their performance can be erratic.  So many factors contribute to whether or not a student does well on a single test.  Many of these home-life  factors have absolutely nothing to do with the teacher.  Tying a person's salary to that potentially erratic, ever-changing variable, children, is scary for teachers.

            1. Kathryn L Hill profile image85
              Kathryn L Hillposted 3 years ago in reply to this

              Especially now. Children have been raised with technology and are extremely used to rapid fire stimulation. It is hard to keep their attention. They want rapid fire stimulation. rapid fire.
              If the teacher can't provide it, they start to wander around the room and worse.
              They have diminished respect for authority too, I notice.
              why?

            2. Shawn McIntyre profile image86
              Shawn McIntyreposted 3 years ago in reply to this

              That argument sounds like a bit of a cop-out to me. There are tests and quizzes all year long, as well as general in class performance, so teachers have an entire school year to identify students who are having issues. Either take measures to try and correct it, or if that's not possible for some reason, refer them to someone who can.

              If teachers can't, during an entire school year, identify those kids who may be having a problem and take the appropriate steps to fix it, then they absolutely should be held accountable for that students performance on the test.

              1. 84
                Education Answerposted 3 years ago in reply to this

                Shawn,

                We can identify these students, but getting help can take months or even years.  Why?  It's all about the federal laws that regulate special education.  Teachers have far less control over these issues than you might think.  Bureaucrats in Washington tell us what we can and can't do when it comes to getting help for students who are struggling.  Most of the students who are referred for special help don't qualify for it, based on federal laws.  Here's an example:

                Student A is struggling in class.  She works hard but doesn't learn the concepts.  She is years behind where she needs to be.  The teacher fills out an se-1 form and refers the child to the learning support team, per federal requirements.  The team meets and decides to recommend several different ideas for the teacher to try, per federal requirements.  After 30-60 days, the teacher returns to inform the team that nothing worked; the student continues to struggle.  The team makes further recommendations.  Again, 30-60 days later, the teacher returns.  The team decides to recommend testing for special education at this time, if the year hasn't already ended by now.  After a week or two, the test results come back as low IQ.  Student A has a low IQ, and she is working to her potential.  N O services are available, per federal law.  A child with a low IQ does not qualify for special education if he/she is performing at his/her ability, even if the student is failing and falling further and further behind.  How do you get help for this kid, when the law is written to exclude her from this help, when the law forces schools to slow down to this extent?  The federal government is getting in our way.  By the way, this is not an uncommon problem.  This same problem occurs in most schools across the nation, and sadly, it's only one example of how the government is an obstacle to learning. 

                Then, people want to base a teacher's salary on testing.  Sadly, this child won't do well on that test.  She doesn't qualify for any help.  Should the teacher be punished with a diminished salary even though the teacher is trying her hardest and has tried to get help for this child?  Should the teacher take a financial hit, because special education laws work against children who need help?  Remember, I am for merit pay.  I mention this, because judging a teacher's effectiveness is difficult when you are dealing with a mercurial product, children.  Judging a teacher's effectiveness is difficult when laws work against us.

                1. Shawn McIntyre profile image86
                  Shawn McIntyreposted 3 years ago in reply to this

                  It's a fair point, but I think you missed the first part of my response. What I said was teachers who fail to identify students who need help should absolutely have to take responsibility for that child's grades. In your scenario, the teacher identified and recommended the student for assistance. This teacher did his/her job, and this student's score on the end of year test would be scaled to reflect that.

                  My issue is not with teachers like the one in your example, it's with the ones who simply show up every day and rubber stamp kids along, regardless if they're learning anything or not. Those are the teachers that need to be weeded out and gotten rid of, not the teachers who are making an honest effort and are just getting screwed by the system.

                  1. 84
                    Education Answerposted 3 years ago in reply to this

                    In my experience, I have seldom seen a teacher who does not recognize when a student is failing.  I, however, happen to work at one of the best schools in Arizona, per the state's evaluation of schools.  We don't have a shortage of students being referred for testing.  We have a shortage of government-generated common sense when it comes to getting that help for those students.  You should see how many children are denied services, because the government says they don't need them.  Still, I understand your point.  IF a teacher fails to recognize that a student needs help, then yes, he/she should be penalized.  There's a problem with that scenario though.  Who decides whether or not the child should have been referred for services?  Is it by some arbitrary measure, opinion?  Is it by some government standard?  If it's by opinion, then that seems unfair.  If it's by some government standard, then it's ludicrous, at least with existing laws and definitions.

    2. 84
      Education Answerposted 3 years ago in reply to this

      Many teachers have second jobs.  You get what you pay for.  The starting salary for teachers in my district is $29,000.  Do you know how hard it is to make a living on that salary right out of college, with college loans to pay?  I just got a 3% raise, my first raise in seven years.  My net salary is less than it was ten years ago, because Arizona retirement has increased, taxes have increased, and insurance has increased.  Again, you get what you pay for. Would you go to a bargain surgeon and expect great results?

      1. Kathryn L Hill profile image85
        Kathryn L Hillposted 3 years ago in reply to this

        No, teachers teach because they enjoy teaching. Most teachers don't go into it for the money. They shouldn't anyway. This was understood in the past. Now it is seen as a job/career for adults. Just another way to earn a living. It isn't just another job.
        It is a most important job,
        bordering on spiritual.
        Therefore, the quality of the person is the most important consideration.
        Old school.
        I know.

        1. 84
          Education Answerposted 3 years ago in reply to this

          That's true, but my love of teaching doesn't work if I can't put food on the table.  Necessities outweigh my passion, sadly.  Many of my colleagues, good teachers, have left the profession out of financial necessity.

          1. Kathryn L Hill profile image85
            Kathryn L Hillposted 3 years ago in reply to this

            Never marry a teacher.

  14. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Raise standards? Our educational results are lower than countries without standardized testing - all the evidence indicates that standardized tests and "consistent standards" don't work and, if anything, lower the quality of education. There are plenty of stories about teachers helping students cheat the tests.

    Rather than "raising" standards, we need to look at how we assess standards and how we decide what is a "good school," because the current system doesn't work.

    Zing on the Congress comment *grin*

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      This is exactly what I'm talking about. We don't need to "assess standards", we need to set them. If kids are not learning the things they're required to learn, then the teachers need to be held accountable, it's that simple.


      smile

      1. 84
        Education Answerposted 3 years ago in reply to this

        What if the problem is that the kids ARE learning what the bureaucrats want them to learn? 

        Should a second grade teacher really have to spend time teaching about Euler circuits?  In Arizona, the bureaucrats believe that they should, even though most adults don't even know or care about what an Euler circuit is.  Teachers are spinning their wheels teaching concepts that that are a waste of time, merely because bureaucrats tell teachers what we have to teach.  Then, we teachers are held accountable for concepts that should never be taught in the first place.  When students are not prepared for the real world, teachers get blamed.  Blame the bureaucrats too.  They tell us what we have to teach and tie our salaries to their curricular objectives, objectives that often make no sense or run contrary to what really needs to be taught.  Instead of adding, subtracting, and multiplication, second grade teachers need to spend more time teaching Euler circuits?  Give me a break.

        1. Kathryn L Hill profile image85
          Kathryn L Hillposted 3 years ago in reply to this

          Right,
          ...meanwhile they can't even write sentences with properly spelled words and careful writing.
          Do you know they are actually encouraged to sound out what they do not know how to spell in first grade...where I substitute teach?  I was told not to comment or correct anyone in a classroom of first graders as they wrote in their journals. One boy came up to me and asked me how to spell a word. I looked to make sure the aide wasn't looking and gave him the correct spelling. He was so happy.

          1. 84
            Education Answerposted 3 years ago in reply to this

            Because we don't want to stifle creativity, we allow creative spelling.  Our idea of spelling is having students memorize twenty words each week.  Then, the kids misspell right and left on their assignments, and we give them an "A"  for memorized twenty words, the same words they will misspell on tomorrow's writing assignment.

            1. Kathryn L Hill profile image85
              Kathryn L Hillposted 3 years ago in reply to this

              huh? I mean, oh! Thanks for clarifying that for me. We subs are so out of the loop. (And we really are! It's pathetic.)

              1. 84
                Education Answerposted 3 years ago in reply to this

                When it comes to teaching spelling, it seems most people in the field of education are "out of the loop." 

                I have the utmost respect for what you do.  Thank you.

                Best wishes.

            2. wilderness profile image97
              wildernessposted 3 years ago in reply to this

              "Creative" spelling, yet!  Is that like eubonics?

              1. 84
                Education Answerposted 3 years ago in reply to this

                It's the liberal establishment in education.

            3. Shawn McIntyre profile image86
              Shawn McIntyreposted 3 years ago in reply to this

              If you want kids to be creative, let them draw a picture. As a business owner, I can promise you that "creative spelling" will get your résumé a one-way-trip to the shredder.

              1. wilderness profile image97
                wildernessposted 3 years ago in reply to this

                But that's all right.  It's more important to feel like a winner than to be able to survive outside the school environment.  We must never ever let our children feel like they failed at anything.  Failure is not an option - at least not until they're out of school and fail at landing a job.  That's OK.

                1. Shawn McIntyre profile image86
                  Shawn McIntyreposted 3 years ago in reply to this

                  Yeah, I have no idea what people were thinking when they started this whole "Everyone Is A Winner", "Everyone Is Special" movement, but it's been a disaster.

        2. Shawn McIntyre profile image86
          Shawn McIntyreposted 3 years ago in reply to this

          That's why we need nationalized standards not the crap we have now. Here in Florida (which I'm sure is the same as the rest of the country), the Every district has its own standards. My kids go to the same schools I went to when I was their age, and they take roughly the same classes I did. My niece in Tampa however, is in 6th grade and she's just learning multiplication this year. My kids started that in third grade here; it's insane.

  15. Kathryn L Hill profile image85
    Kathryn L Hillposted 3 years ago

    ... But Back to the health care issue: We need to be able be more proactive in staying safe and healthy.  We need to stop doing all things dangerous: riding bikes, jumping on trampolines, driving cars, rock climbing, surfing, mountain biking, swimming, camping, and hiking. We need to stop eating white sugar, white flour and all junk food. We need to be more willing to die. This is the future I see in my crystal ball: People sitting in front of every sort of electronic media playing X Box, computer games, Wii, using iPads and smart phones, digital TV streaming movies, etc...
    they will be fine...safe in cozy homes, eating carrots.
    Just fine.
    No need for health care...
    or the ability to read, write or do arithmetic.

    1. 84
      Education Answerposted 3 years ago in reply to this

      We wouldn't have so many of these health issues in New York if the 16-ounce soda ban had stuck!  That's my attempt at humor.

      1. Kathryn L Hill profile image85
        Kathryn L Hillposted 3 years ago in reply to this

        That is not funny. It is exactly right. (mine too)

  16. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    And then it's okay to blame them and call them lazy...

    1. Kathryn L Hill profile image85
      Kathryn L Hillposted 3 years ago in reply to this

      Whoever is forced for too long becomes lazy.
      Freedom within boundaries is what we all need.
      We must be able to freely guide our wills within boundaries of common sense morality. This applies to teachers and children and all mankind.

      PS
      To force anyone to pay a fine for not having health insurance is unconstitutional in this land of the (still sorta) free.
      IMO

      1. Ralph Deeds profile image69
        Ralph Deedsposted 3 years ago in reply to this

        Not according to the U.S. Supreme Court which got one right for a change.

  17. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    I was referring to those conservatives who want to end welfare because the only reason somebody would need it is if they were lazy or "refusing to get a job."

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      I don't think the only reason a person would need welfare is if they are lazy, but there are a lot of lazy people on welfare; people who could work, but who chose to live off of the Government.

  18. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    There are also a lot of women on welfare who could work, but would be worse off because of high child care costs. DC, for example, has an average child care cost of $20,000 per child - most middle class people can't afford that, let alone low skilled/unskilled single mothers.

    It's a complex and somewhat messed up situation. There are people on disability who don't deserve it and others who can't get it who really need it. And, frankly, I don't have a good answer except that every case is different and needs to be properly judged on its own merits.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      It certainly needs a top-down overhaul, that's for sure.

  19. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    We could use more child care subsidies. Somebody should run the math - which is costing the tax payers more, paying for some single mother's rent + food + food for the kid or paying for all or part of her child care so she can work?

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      I think the more important point would be to get people to stop having kids they can't afford, that's the first issue.

      All 50 States already offer some form of child care subsidy, and the problem isn't getting any better.

  20. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    The waiting list for child care subsidy in DC is two to four...

    YEARS.

    So, yeah, they offer one, but it's not enough.

    As for not having kids you can't afford...we'd have to start by having the conservative right leave access to contraceptives alone. Planned Parenthood, for example, prevents FAR more abortions than they perform and are the ONLY source of birth control for low income women in some rural areas, but nope, got to do our best to shut the horrible abortion-mills down.

    Proper sex education would help too. Teen pregnancy rates are higher in rural states where abstinence-only sex education is the norm - whether the two things have a common cause or whether this demonstrates that abstinence-only doesn't work is unclear (My personal opinion is the latter).

    People aren't going to just stop having sex, especially WITHIN relationships. It's not how humans are wired.

    1. Ralph Deeds profile image69
      Ralph Deedsposted 3 years ago in reply to this

      +++

    2. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      This is a prime example of the problem in America today. Let me say this as plainly as I can: Personal Responsibility is not a dirty phrase; if you can't afford birth control how in the bright blue hell do you think you can afford a child, which is the natural (and inevitable) result of unprotected sex. Relationship or not: If you can't afford a condom, you can't afford a kid.

      The Internet has been losing its collective mind for the last few months because of the NSA scandal; people are pissing and moaning about the "intrusive Federal Government", and how the government needs to get out of people's lives... yet they have no problem with running to Washington every time they want money for something.

      Look, no one ever said life was fair, and there are people out there who are legitimately in need of assistance, but there are many, many more, who simply expect others to finance their personal life choices; that needs to end, and end now.

      Now you can blame Republicans for going after Welfare, and you can blame the Religious right for going after birth control and abortions, but it's all just smoke and mirrors; people need to be held accountable for their own actions and stop playing the role of the "innocent victim of circumstance".

  21. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    I agree with personal responsibility.

    What I don't agree with is trying to go so far against human nature that people are miserable. The answer is to make sure everyone CAN get birth control who needs it. The pill costs $30 a month, plus a doctor's visit to get it prescribed. That's easy for women who live in a big city or have money.

    It's much more of a challenge in rural areas, made more of one by doctors who refuse to prescribe contraceptives and pharmacists who refuse to fill those prescriptions, trying to force their ethics on others.

    Condoms are a better answer, but if you absolutely can't afford a child, period, you need to be using two methods of birth control to be on the safe side - and right now, that means the pill or implants. Except - not all women CAN use hormonal contraceptives.

    One thing that would go a long way towards helping the overall situation is to get temporary vasectomies approved - they're cheap, HIGHLY effective, and more or less side-effect free. In fact, studies in India show that this may be the ONLY birth control method yet invented that is 100% effective...so, why can't men here get it? (They're temporary AND easily reversible). There's also some interesting research going on into non-hormonal female contraceptive methods that might have fewer side effects than the pill.

    On top of that, Shawn, we have generations of young people being told by those same abstinence-only "educators" that birth control methods don't actually work. That means when they DO have sex they don't see the point in using them...

    Access, thus, is not just a matter of "can you afford condoms" but a much more complex situation.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      First of all, Vasectomies are not 100% effective (my 9 year-old is proof of that roll) lol.

      Second: You're absolutely right, teaching abstinence only to a group of horny, hormone-fueled teenagers is probably the dumbest idea since Greedo shooting first.

      Third: No, it really is that simple, people just like to complicate the issue to, again, diffuse responsibility. It's no different than any other causal relationship: If you don't want to get a DUI, don't drink. If you don't want to get fat, don't eat junk food. If you don't want to have a kid, don't have unprotected sex.

      People make all of these excuses to justify risky behavior, and then blame someone/something else when it all blows up in their face.

  22. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    This is a different thing from the standard surgical vasectomy. Hold on while I find a reference. Surgical vasectomies sometimes fail - the vas defererns grows back.

    Temporary vasectomies are a completely different thing.

    Here: http://www.wired.com/magazine/2011/04/ff_vasectomy/

    It's the sort of thing a guy could have done when he goes to college and then reversed when he graduates and finds a job.

    I apologize for not citing properly in my first post.

    And yeah. We shouldn't be teaching abstinence only to teenagers - we should be handing them condoms. Contrary to popular belief it won't make them MORE likely to do the deed.

    But I don't think I'm complicating the issue beyond where it is. Over the last few years, there has been a strong trend in pharmacists refusing to fill prescriptions for birth control or emergency contraception. Some pharmacists will go as far as to confiscate the prescription, especially for EC (which, you know, you might need if that condom breaks), so the woman *can't* go anywhere else to fill it. Larger pharmacists have policies preventing employees for pulling this crap but in some rural areas there's ONE independent pharmacy women can get to. And guess what many of these objecting pharmacies also refuse to carry...

    The problem may be limited to lower income people in rural areas, but it does exist. Which is why we need to leave Planned Parenthood alone as they often fill this particular access gap.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      Yeah, with mine, the doctor just screwed up.



      You give a teenager anything and it will make them more likely to "do the deed", they're teenagers.



      Yeah, and why are we still having this fight? Republicans were willing to pass this law a few years ago, making it illegal for pharmacists to refuse to fill legally obtained prescriptions for birth control, based on religious beliefs; so why is this still a debate? Because idiotic extreme-left women's groups opposed the "age limit" included in the bill. The law would require parental notification for anyone under 16, and these "women's rights advocates" fought it.

      The extreme liberal-left is just as ass-backwards and dangerous as the far religious-right.

  23. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Shawn, I agree with you about some liberals - they make me roll my eyes JUST as much as the theocrazies. It seems unfashionable to be nicely in the middle these days, too.

    And even MORE unfashionable to actually have your own thought out stances on the issues without following a party line. Sigh.

    1. Shawn McIntyre profile image86
      Shawn McIntyreposted 3 years ago in reply to this

      You can thank Cable News and the 24-Hour News Cycle for that one.

  24. Kathryn L Hill profile image85
    Kathryn L Hillposted 3 years ago

    Parents need to be held accountable in the final analysis. And all they have to do is have their teens watch U tube videos of actual abortions. Maybe what we should do is require abortions for any female who gets pregnant without being happily married with a home, washer and dryer in-place.  A more tough love love approach, if you will.  I wonder if Fear of the Lord and the consequence of Hell after death for wrong-doing, (we used to call it a sin,)  helped women abstain from having premarital sex in the past. People do not regard premarital sex as a sin to go to hell for.
    They should.
    They should know that Hell is real... but it comes much quicker than after death. It comes as soon as the baby is born, (in the case of no nest.)
    Believe me I know:
    My neighbor's daughter got pregnant and she is 33 living in her own room in the home she grew up in. The family is trying to raise the baby and it is really hard(understatement)
    on so many levels.

  25. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    Except that back when people believed that, unmarried women were treated very badly - shamefully, even. Forced adoption was commonplace as a way of avoiding the "stigma."

    1. Kathryn L Hill profile image85
      Kathryn L Hillposted 3 years ago in reply to this

      On the other hand, maybe mothers who choose to abort should be considered murderers. Recently in the news: A 26 year old woman killed her baby right after it was born. She is being tried for murder.

      Perhaps mandatory adoption would be a better solution: It could be illegal for a woman to keep her baby if she must depend on  t a x p a y e r s  to be able to support it. Mandatory adoption by non-taxpayer-dependent couples, (or singles,) would be a truly fair and just solution for all concerned.

      I'm simply revealing the essence of what we are dealing with.
      The issue is so tricky because of accidents (oopsies) and emotions (in the extreme).
      oh, women!
      Women, it is your very own Hell which you have the power to avoid.
      Mothers TALK to your daughters truthfully!
      As though it was your patriotic duty!
      Because truthfully?
      IT IS.

      1. Shawn McIntyre profile image86
        Shawn McIntyreposted 3 years ago in reply to this

        I really, really hope you're just trolling now...

        1. Kathryn L Hill profile image85
          Kathryn L Hillposted 3 years ago in reply to this

          I am thinking with logic and common sense.
          ...what, revealing what is logical is considered "trolling" now?
          I don't doubt it.
          Not sorry.
          My point is that daughters must be informed by their mothers with a true sense of urgency, regarding the matter of unplanned pregnancies. Their daughters will listen. They really will.
          I believe a lack of communication is the problem today:  We need to be able to talk realistically to our children about the realities of life... and the truth that is their choice to have a good life
          OR NOT.
          (It is not a good life to be taxpayer-dependent.)

          1. Shawn McIntyre profile image86
            Shawn McIntyreposted 3 years ago in reply to this

            The fact that you would say that something like this:



            Is "logic and common sense" is telling, and more than a little bit disturbing. Yes, we need more education about safe sex, and yes, people need to take more responsibility for their actions, but removing kids from their parents is not the answer.

            1. Kathryn L Hill profile image85
              Kathryn L Hillposted 3 years ago in reply to this

              I know... it was just an absurdity. I was demonstrating the emotional consequences that could occur in such a heartless scenario. I'm not a monster.  But, I am not a taxpayer-dependent person either. Thank God for my child's father who did the right thing. He married me and we created a happy prosperous family.

  26. jenniferrpovey profile image94
    jenniferrpoveyposted 3 years ago

    I'm not saying adoption isn't a better solution, but what went on with those "maternity homes" was not the kind of solution a civilized country should be seeking.

    Maternity homes started over 100 years ago, but when they were first visualized by Dr. Barrett and Mr. Crittenton their mission was to help unwed mothers learn what they needed to learn to keep and raise their babies (Maybe we need a bit more of THAT today). These mothers would learn job and household skills.

    But during the era between about 1940-1945 and the early 1970s, maternity homes became about relinquishing the child and "rehabilitating" the mother. Some of these women, of course, were victims of rape. Adoption coercion still happens today, although it's less common and generally takes the form of emotional blackmail rather than force and/or slut shaming. "We only want what's best for you."

    Both birth mothers and adopted children can suffer psychological problems that last for years - open adoptions help, but are not properly legally supported in most jurisdictions. It IS better than having an abortion, but it's not the ideal solution many pro lifers feel it is.

  27. psycheskinner profile image81
    psycheskinnerposted 3 years ago

    Bring back the Magdalena Laundries, I mean what could be wrong with that? [/sarcasm]

  28. Shawn McIntyre profile image86
    Shawn McIntyreposted 3 years ago
  29. Ralph Deeds profile image69
    Ralph Deedsposted 3 years ago

    Editorial
    Doctors and Their Medicare Patients
    By THE EDITORIAL BOARD
    Published: August 31, 2013

    Critics who want radical changes in Medicare, the public insurance program for the elderly and disabled, often allege that the program is heading for disaster because stingy payments from the government are causing a rising number of doctors to refuse to serve Medicare patients.
    Today's Editorials

      In the critics’ most dire scenarios, baby boomers nearing retirement age could find that their current doctors are no longer willing to treat them under Medicare and that other doctors are turning them down as well. Those concerns have always been greatly exaggerated. Now a new analysis by experts at the Department of Health and Human Services should demolish that mythology for good.

    The analysts looked at seven years of federal survey data and found that doctors are not fleeing Medicare in droves; in fact, the percentage of doctors accepting new Medicare patients actually rose to 90.7 percent in 2012 from 87.9 percent in 2005. They are not shunning Medicare patients for better-paying private patients, either; the percentage of doctors accepting new Medicare patients in recent years was slightly higher than the percentage accepting new privately insured patients.

    Medicare patients had comparable or better access to medical services than the access reported by privately insured individuals ages 50 to 64, who are just below the age for Medicare eligibility. Surveys sponsored by the Medicare Payment Advisory Commission, an independent agency that advises Congress, found that 77 percent of the Medicare patients — compared with only 72 percent of privately insured patients — said they never had an unreasonably long wait for a routine doctor’s appointment last year.

    The findings from this survey and others can be sliced and diced in many ways. But the overall picture is clear: nationwide there is no shortage of doctors for Medicare patients. It is likely to stay that way, because Medicare is a big insurer that few medical practices can afford to ignore.

    Still, a small number of doctors have dropped out of the Medicare program. Roughly 9,500 practicing doctors have currently opted out of Medicare, according to the Centers for Medicare and Medicaid Services. If patients want to stay with these doctors, they have to pay the bills themselves; neither the doctor nor the patient can receive any payment from Medicare.

    The number of doctors opting out is tiny compared with the number of doctors, 735,000, who remain in Medicare. In addition, they are augmented by hundreds of thousands of nurse practitioners and other non-doctor providers.

    Some experts worry that, when health care reform kicks in next year and provides insurance for millions of uninsured people, the increased demand for medical services could make it harder for all patients, including Medicare beneficiaries, to schedule doctors’ appointments. If that were to happen — by no means a certainty — federal and state officials and leaders of the medical profession would need to find ways to increase the supply of health care providers.

    Meet The New York Times’s Editorial Board »



    http://www.nytimes.com/2013/09/01/opini … mp;emc=rss

    1. Quilligrapher profile image89
      Quilligrapherposted 3 years ago in reply to this

      Thank you for this post, Ralph.
      Q.

      1. tirelesstraveler profile image86
        tirelesstravelerposted 3 years ago in reply to this

        Would that be because HMO's, that pay 87k to a starting doctor, are taking up the slack?

        1. Quilligrapher profile image89
          Quilligrapherposted 3 years ago in reply to this

          I am sure that it is my lack of understanding. I just do not get your point. Please expand on your question and I will attempt to answer it if I can.
          Q.

        2. Ralph Deeds profile image69
          Ralph Deedsposted 3 years ago in reply to this

          Interesting question.  I don't know the answer. Overall, I assume that the increase in participation by doctors in an indication that the program is serving their needs and those of their patients who are eligible for Medicare (of which I am one who is quite satisfied with the program). Several doctor friends have expressed opinions on needed improvements and changes to Medicare. However, they have expressed many more complaints about the complications and costs to they experience in their dealings with private health care insurance companies.

          1. tirelesstraveler profile image86
            tirelesstravelerposted 3 years ago in reply to this

            I wasn't surprised to heard new doctors only made 87k a year, at Kaiser.  They pay mal practice insurance for them.  which can cost nearly 100k a year. But how are young doctors going to pay med school bills on 87k.   I can also see the benefits of working at Kaiser HMO. Routine hours and holiday's off.

  30. Dr Billy Kidd profile image90
    Dr Billy Kiddposted 3 years ago

    Actually, student loan payments can be set up as a percentage of a medical practitioners income. Mine was set up at 5% while I was going thought the hard times (for a psychologist). The bigger issue with medical students is marriage. When the divorce and support payments come due for the 2 and 4 year old, it takes all your remaining incoming. That's why the joke is: marry someone who makes more money than you. Forget this macho I-can-handle-it-myself stiff.

    1. tirelesstraveler profile image86
      tirelesstravelerposted 3 years ago in reply to this

      Don't know whether to laugh or cry at your predicament. 5%  for how long? Eternity.  The kid next door works as a dock hand at the lake, his ex wife make 3x more than he does, and he still pays child support.

      1. Dr Billy Kidd profile image90
        Dr Billy Kiddposted 3 years ago in reply to this

        Yes, there doesn't seem to be any fairness in capitalism's winner take all. But it's the best we got. The real issue is, of course, that humans have no biological mechanism to put greed in check. So when ya get a good break, all they want is more, more, more.

  31. 82
    LouiseTeachposted 6 months ago

    It doesn't.

    1. colorfulone profile image87
      colorfuloneposted 6 months ago in reply to this

      We will see the November 2016 price hikes just before the election.  It will help Trump, who will repeal ObamaCare.   NoObamaCare!

      1. Ralph Deeds profile image69
        Ralph Deedsposted 6 months ago in reply to this

        Not likely.

  32. 82
    LouiseTeachposted 6 months ago

    Let's hope, but unfortunately, many US citizens are stuck paying unaffordable rates to obtain health insurance until then, as unemployment rates are high, part-time jobs don't usually offer health insurance, and there is a heavy fine at tax time, if you haven't had health insurance.  It is truly an UNAffirdable Care Act!

    1. Ralph Deeds profile image69
      Ralph Deedsposted 6 months ago in reply to this
    2. 82
      LouiseTeachposted 6 months ago in reply to this

      Sorry for my typo: UNAffordable.

 
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