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PoliGAF 2017 |OT1| From Russia with Love

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K

kirblar

Member
Bonen no Max'd said:
This doesn't change the point that private health insurance is much less efficient than public coverage?
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Switching from private->public is even less efficient due to the massive infrastructure costs required to transition.

It's fine enough, you just need to actually get everyone covered.
 
J

JesseEwiak

Member
kirblar said:
Switching from private->public is even less efficient due to the massive infrastructure costs required to transition.

It's fine enough, you just need to actually get everyone covered.
Click to expand...

My only thing is, if American Health Insurance companies were being regulated by Swiss & German regulators, I'd have no worries. Instead, they're being regulated by state insurance commissioners that voted overwhelmingly for Trump.
 
K

kirblar

Member
JesseEwiak said:
My only thing is, if American Health Insurance companies were being regulated by Swiss & German regulators, I'd have no worries. Instead, they're being regulated by state insurance commissioners that voted overwhelmingly for Trump.
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I'd like to be at the point where we have everyone covered first.
TestOfTide said:
I'm not disagreeing with that, but the biggest reason for not just the US's healthcare issues, but most countries' healthcare issues, is a lack of doctors.
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The US gets a huge influx of foreign ones because we actually pay ours well.
 
D

daedalius

Member
mackaveli said:
But maybe Trump will just be distracted everyday and go off the rails but congress will still pass bills while Priebus just tells him where to sign and the media just goes to the next speech Trump gives and never discusses policy / law. Like they did during the election.
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Trump is a rubber stamp to the Republican Party, they don't give a shit if the executive branch wants to legislate anything as long as he passes their bills. Rob Reich posted a while back that he had a republican friend on Capitol Hill who said they are basically just going to use him till he steps out of line then impeach him.

rokkerkory said:
So while we close up our borders and build walls, China is investing in Latin America. Great job Trump you're handing your biggest economic enemy over to China.
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America is going to voluntarily get out of the way and let China become the next economic/tech leader, they are investing what 10trillion into renewables this year or something? They will corner that market and we will still be worrying about the 6000 coal miners left in America
 
B

Bonen no Max'd

Banned
kirblar said:
I'd like to be at the point where we have everyone covered first.

The US gets a huge influx of foreign ones because we actually pay ours well.
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This is actually the opposite, domestic doctors are paid really well because we engage in protectionist policies to keep out foreign doctors.

http://www.theatlantic.com/health/a...w-the-us-shuts-out-foreign-physicians/382723/

Of course, it's bad to engage in protectionist behavior to protect domestic worker wages at the cost of consumers so I'm sure we'll get some progress made here soon.
 
I

ItWasMeantToBe19

Banned
Nate Silver, after a strong end to 2016, comes out with the dumbest take of 2017.

Maybe the presidency will be different, but the campaign taught me to be skeptical when the CW was that the wheels were coming off Trump.
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North Korea is about to launch an ICBM and Trump's actions could affect millions of lives... this is slightly different than campaigns that have no consequences until the results are in.

Nate without a model continues to be the dumbest pundit alive.

https://twitter.com/NateSilver538/status/823744596396097536
 
davepoobond

davepoobond

you can't put a price on sparks
Bonen no Max'd said:
Well I mean of course California Democrats are doing well, it's pretty hard to screw up when you have four million more voters than the other party.
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interstate politics are a lot different than that, though. we have a propensity to have republican governors just as easily as democratic ones
 
B

BadenBadenLily

Banned
TestOfTide said:
I'm not disagreeing with that, but the biggest reason for not just the US's healthcare issues, but most countries' healthcare issues, is a lack of doctors.
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The shortage of doctors is entirely artificial.

Increase the number of med schools and residency programs. There is no shortage of talented individuals who want to be doctors, just a hard cap preventing them from doing so.

AMA would never allow that though, as it would drive downward pressure on their wages.
 
I

ItWasMeantToBe19

Banned
I don't understand that Nate Silver tweet at all, what is he even saying? Voters got bored with Trump's scandals during the campaign so this means that Trump will be fine on deciding whether or not to bomb Iran? How stupid can one man be?

Does Nate actually get that this isn't some sports game and people live and die based on the decisions of the president?
 
U

ugaboga232

Member
Yea the lack of residency spots keeps doctor salaries high (with some important caveats and because of the shortage doctors have to do more and more each day so I wouldn't mind taking a small pay cut for more time per patient but I'm already taking a paycut to do research so what do I know). Doctor pay last I checked was not a major component of healthcare spending (neither is prescription drugs though that seems a big problem due to its financial proximity to the patient as opposed to some of the costlier components).

Private vs Public doesn't matter that much, the real cost setter is regulations. You can have amazing, efficient private healthcare if regulated to basically be public in all but name like in Germany or you can have well regulated public like in Canada. As they say, the devil is in the details (and how estimates peg up to 50% of all inpatient healthcare spending as wasteful but that's a topic for another time).

You probably don't even need to really tinker too much with doctor salaries and still get a much more efficient system (a big problem is that people who could be good doctors go to other fields for various reasons especially quality of life concerns because residency is basically an 80 hour minimum work week at below minimum wage pay for most specialties).
 
K

kirblar

Member
Bonen no Max'd said:
This is actually the opposite, domestic doctors are paid really well because we engage in protectionist policies to keep out foreign doctors.

http://www.theatlantic.com/health/a...w-the-us-shuts-out-foreign-physicians/382723/

Of course, it's bad to engage in protectionist behavior to protect domestic worker wages at the cost of consumers so I'm sure we'll get some progress made here soon.
Click to expand...
High barriers have nothing to do with high salaries. The effect from missing foreign docs is marginal.
American Medical Association President Robert Wah recognizes this residency bottleneck. ”U.S. residency program positions have not increased at an adequate rate to accommodate the expanding number of U.S. medical graduates and the current IMG [International Medical Group] applicant pool," he said in an email.

Even if the AMA were to magically produce a few thousand more residency slots, it would barely make a dent in 91,500 projected doctor shortage.
Click to expand...
 
T

Tall4Life

Member
ItWasMeantToBe19 said:
I don't understand that Nate Silver tweet at all, what is he even saying? Voters got bored with Trump's scandals during the campaign so this means that Trump will be fine on deciding whether or not to bomb Iran? How stupid can one man be?

Does Nate actually get that this isn't some sports game and people live and die based on the decisions of the president?
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Nate Gold was redeemed this election therefore he is infallible
 
I

ItWasMeantToBe19

Banned
VendettaRed07 said:
This isn't stupid at all actually. And probably true.
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What does the fact that voters got bored with Trump being a sexual predator have to do with Trump's decision making on whether or not to bomb Iran?

"Media predicts things and didn't happen so obviously opposite of what media predicts will happen now!" is fucking stupid. The media predicted the Cavs would lose in the Finals when they were down 3-1 to the Warriors so should I pick the Brooklyn Nets to win the Finals because the media says they won't win the Finals?

Trump has been having a meltdown for the last two months and has been trying to start a war with China before talking about all the imaginary people who are both for him and against him, when is this supposed to stop or something?
 
I

ItWasMeantToBe19

Banned
The idea that America is okay moving forward because *waves hands in the air* is just so dumb. Every American institution failed in the last 6-9 years and we proved that all of our norms and institutions and everything else are meaningless. We now have someone who campaigned on mass murder ("You have to go after their families") having control of the greatest weapons stockpile in the history of man with no checks or balances.

Wall Street traders are obviously much dumber than Nate Silver, but people as a whole are pretttty stupid right now.

This tweet literally comes on the day when McCain, Graham, and Rubio shit on their own ideals to give Trump more power while Trump was ranting about imaginary voters and supporters, come the fuck on.
 
O

Oblivion

Fetishing muscular manly men in skintight hosery
So once again, is 2018 our last shot to fix this gerrymandering mess before the next round?
 
B

Bonen no Max'd

Banned
kirblar said:
High barriers have nothing to do with high salaries. The effect from missing foreign docs is marginal.
Click to expand...
The article details that it's more than just the residency programs preventing the high barrier of entry to get doctors into the US, particularly the number of years it takes to get licensed even if you're already a qualified and trained doctor.

The United States also has strict policies regarding medical licensing—a doctor is only allowed to practice in the U.S. once he has obtained a license in the state in which he intends to work. The person must acquire a visa, pass the first two steps of the United States Medical-Licensing Exam (USMLE), then become certified by the Education Commission for Foreign Medical Graduates (ECFMG), get into an accredited U.S. or Canadian residency program, and finally, go back and pass step three of the USMLE. Each of these steps could take multiple years, repelling doctors who are already able to practice in the country in which they were trained.
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But he didn’t end up crossing the Atlantic. “In the U.S. I would have had to do five years of general surgery and a two-year fellowship in vascular surgery to be a vascular surgeon. Seven years total. I got an offer in Paris to do a five-year vascular surgery program. They also reduced my training by one year since I had done two years in the U.K.”
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This article from The New York Times also covers the same problems

Consider Sajith Abeyawickrama, 37, who was a celebrated anesthesiologist in his native Sri Lanka. But here in the United States, where he came in 2010 to marry, he cannot practice medicine.

Instead of working as a doctor himself, he has held a series of jobs in the medical industry, including an unpaid position where he entered patient data into a hospital’s electronic medical records system, and, more recently, a paid position teaching a test prep course for students trying to become licensed doctors themselves.
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That residency, which typically involves grueling 80-hour workweeks, is required even if a doctor previously did a residency in a country with an advanced medical system, like Britain or Japan. The only exception is for doctors who did their residencies in Canada.

The whole process can consume upward of a decade — for those lucky few who make it through.

“It took me double the time I thought, since I was still having to work while I was studying to pay for the visa, which was very expensive,” said Alisson Sombredero, 33, an H.I.V. specialist who came to the United States from Colombia in 2005.
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The Atlantic article also explicitly links these protectionist policies to the higher wages for doctors in the US.

Further, an influx of doctors could impact a more sensitive matter—with an increased doctor supply, salaries among America’s white-coats would almost certainly go down.

“Nobody wants to share their pie,” Alomran says. “This is the same everywhere and is not unique to medicine, in my opinion.”
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Even if that's wrong, I do believe your comment was

kirblar said:
The US gets a huge influx of foreign ones because we actually pay ours well.
Click to expand...
Which isn't true at all and the inverse is the actual relationship. It's almost like exposing local workers to cheaper foreign competition drives down wages, huh.

But sorry, I'll let you do the Pure Factual Analysis With No Ideological Bent.
 
P

Pixieking

Banned
whyamihere said:
jesus FUCKING christ

http://www.politico.com/story/2017/01/donald-trump-fraud-claims-234083
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I mean, this is...

Americans (as an "ethnic group") have a stereotype of being a bit stupid, y'know? Yes, it's a stereotype, and it's not really got a lot of basis in reality, but... They don't get irony, they're uneducated, loud, somewhat obnoxious - these are all basic stereotypes of the "American". Well, Trump being elected is going to do three things for that stereotype:

1) It's going to reinforce it abroad. Only in America would the electorate choose Trump over Clinton. Along with sympathy for those who didn't vote for him (and are going to be hurt by him), there's going to be a fair amount of "Well, Americans are stupid, so we didn't expect anything else."

2) It's going to push the American people into realising how stupid some of their countrymen really are, because Trump really is the dumbest of the dumb. I think there may have been the assumption that just holding the office of POTUS would make someone smart, and Trump is going to show that to be the fallacy it is. I think he already has, to be honest.

3) It's going to severely embarrass people who think that America is great because of its leaders. I can't see anyone but the most ignorant of people thinking that Trump complaining about losing the popular vote on his third day makes a good impression to anyone. To the outside world, to their wife/mother/sister, to their children.

Outside of that, Trump is also well on his way to proving his word matters little. He's signed the US out of TPP, yes, but he's evasive on renegotiating NAFTA (is that even possible?), and he loses on the Federal hiring freeze no matter what. Either he doesn't create jobs because its so effective, or he barely makes any difference because his "Except the military" waiver means most hiring will still occur.

I mean, it sucks for the people of the US, no doubt. But for the Dems and the left generally, I don't think he could've made a better start.
 
U

ugaboga232

Member
Bonen no Max'd said:
The article details that it's more than just the residency programs preventing the high barrier of entry to get doctors into the US, particularly the number of years it takes to get licensed even if you're already a qualified and trained doctor.





This article from The New York Times also covers the same problems





The Atlantic article also explicitly links these protectionist policies to the higher wages for doctors in the US.



Even if that's wrong, I do believe your comment was

Which isn't true at all and the inverse is the actual relationship. It's almost like exposing local workers to cheaper foreign competition drives down wages, huh.

But sorry, I'll let you do the Pure Factual Analysis With No Ideological Bent.
Click to expand...

As someone in med school, it is certainly a combo of not enough residency slots and making it pretty tough for foreign doctors to get certified (a big bottleneck though is that it is hard for non-standout IMG's to get residency spots recently). Increasing residency spots and encouraging new medical schools would probably make the largest difference though making it easier for IMG's to come in would have a significant effect as well. Still given the amount of training and cost for medical students to become doctors here (and the growing amount of work) medicine is not that lucrative anymore compared to what you could be doing (and research even more so).
 
B

Bonen no Max'd

Banned
ugaboga232 said:
As someone in med school, it is certainly a combo of not enough residency slots and making it pretty tough for foreign doctors to get certified (a big bottleneck though is that it is hard for non-standout IMG's to get residency spots recently). Increasing residency spots and encouraging new medical schools would probably make the largest difference though making it easier for IMG's to come in would have a significant effect as well. Still given the amount of training and cost for medical students to become doctors here (and the growing amount of work) medicine is not that lucrative anymore compared to what you could be doing (and research even more so).
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Yeah I'm not saying that doctor wages are absurd or anything, just annoyed that the liberals selectively apply the protectionist logic to manufacturing but then are fine with protectionism in other instances.

I did know this one gigantic douche at the church I used to go to who would complain about how underpaid doctors are when his parents were pretty fucking rich and he was going to school for free because his dad worked at the university. He was also the asshole who would complain about handouts to poor people or whatever lol
 
U

ugaboga232

Member
Bonen no Max'd said:
Yeah I'm not saying that doctor wages are absurd or anything, just annoyed that the liberals selectively apply the protectionist logic to manufacturing but then are fine with protectionism in other instances.

I did know this one gigantic douche at the church I used to go to who would complain about how underpaid doctors are when his parents were pretty fucking rich and he was going to school for free because his dad worked at the university. He was also the asshole who would complain about handouts to poor people or whatever lol
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Yea I think the protectionism is pretty dumb (we could use all the doctors we can get until Watson leads us into the glorious doctor free future) and doctors are probably not underpaid in most cases. As in all fields, doctors comprise an enormous and diverse set of personal philosophies. There is a reason orthopedics (cough Tom Price cough) is very conservative and well known to be a boy's club and psychiatry and infectious disease happen to be very liberal.
 
D

Debirudog

Member
ItWasMeantToBe19 said:
I don't understand that Nate Silver tweet at all, what is he even saying? Voters got bored with Trump's scandals during the campaign so this means that Trump will be fine on deciding whether or not to bomb Iran? How stupid can one man be?

Does Nate actually get that this isn't some sports game and people live and die based on the decisions of the president?
Click to expand...

He might be smart in some ways but he's a major asshole.
 
I

ItWasMeantToBe19

Banned
I will say that if Trump just straight up nuked Seoul or Tokyo, I don't think he would lose much support from voters.

But the popularity of that move would not matter very much compared to the human lives affected.
 
B

Bonen no Max'd

Banned
Holmes said:
Nevada Democrats really suck.
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They flipped two House seats, held Reid's seat, took both state houses, and held the state down for Clinton, so I assumed they're good. It looks like they got crushed in midterms though so maybe you're right and they just rode a wave of good feelings.
 
C

Crocodile

Member
B-Dubs said:
So long as no one breaks ranks in the Senate and the current filibuster rules remain we should be OK.
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Ok. I'll keep my eyes open though. People on my twitter feed were kind of freaking out about it so I asked.

ItWasMeantToBe19 said:
I will say that if Trump just straight up nuked Seoul or Tokyo, I don't think he would lose much support from voters.

But the popularity of that move would not matter very much compared to the human lives affected.
Click to expand...

I mean if those cities go, we can say goodby to like 80% of all future anime so I think Trump voters might care :p

I'm allowed to say this as an anime fan, shut up
 
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