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Tue Apr 10 21:46:10 BST 2007

I am sure the insurance companies would love that requirement, and while =
it has some pluses, don't think it would go over. Yes, auto insurance is =
mandatory, yet you would be shocked how many don't carry it or only =
carry it long enough to renew registrations and inspections and then let =
it lapse. I would be more in favor of regulations requiring insurance =
companies to actually pay claims dollar for dollar in a timely manner =
without huge amounts of paperwork and multiple appeals. Insurance =
premiums continue to rise, and payments continue to fall. Almost =
anything seems to be a reason to deny payment.=20

-----Original Message-----
From: trauma-list-bounces at trauma.org =
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Alex Garbino
Sent: Tuesday, April 10, 2007 3:13 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: [ccm-l] Employment and benefits manipulations

I've been wondering why the alternatives are either "free healthcare for =
all" or "if you can't pay, get out". I'm a medical student in Houston, =
and was raised in Switzerland, so I obviously have had only a fraction =
of the exposure most have had to the US indigent population. But this =
debate tends to focus on the issues of compassion and personal =
responsability; often placed against each other.

Popular today is of the idea to emulate Canadian or UK-style systems; =
although they would help reducing the access problem, my brother =
(currently living in England, and not in healthcare) despises the system =
for many reasons. Similarly, a Swedish friend points out the problem of =
people living off the state.

What I've wondered is why healthcare is debate of "entitlement/right" =
versus a "service you earn", with not much middle ground. In =
Switzerland, healthcare is a "responsability" (which I think most people =
find is the biggest problem): you MUST, by law, have health insurance; =
the government does partially subsidize poor families, and insurance =
companies can't turn down people who want the "basic minimum" that the =
law requires. People can, of course, pay more to get private rooms, =
smaller copays, etc. I know that (in Texas, at least), drivers MUST =
insure their vehicles; so I don't think there is a fundamental legal =
problem with requiring insurance. Obviously, there is a problem with =
uninsured drivers, but putting that aside does anyone care to comment on =
why a basic minimum requirement would or would not work in the US?

Regards,
Alex Garbino

On 4/10/07, Enrique Daza <edazamd at verizon.net> wrote:
>
> Yes, the trauma of having to take care of the indigent, uninsured with =

> a sense of entitlement.
>
> E Daza FACS
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of Sohail Muzammil
> Sent: Tuesday, April 10, 2007 3:29 PM
> To: Trauma &amp; Critical Care mailing list
> Subject: Re: [ccm-l] Employment and benefits manipulations
>
> here I was, thinking I was subscribed to a trauma list..
>
> S Muzammil FRCS
> ----- Original Message -----
> From: "Anthony Caruso" <Medic541 at hotmail.com>
> To: "'Trauma &amp; Critical Care mailing list'"=20
> <trauma-list at trauma.org>
> Sent: Monday, 09 April, 2007 11:26 PM
> Subject: RE: [ccm-l] Employment and benefits manipulations
>
>
> Pr=A8=BAt, I beg your pardon.  I have worked in areas that indeed do =
have=20
> such amenities at home.  How aggravating it is when they present to=20
> you the card that for them fixes everything.  And not have to worry=20
> any consequence what's so ever of there actions.  The "disabled" man=20
> or woman that has no steady job that uses his Mass health card in the=20
> EW cause of his "tummy ache".  And in the end doesn't have to worry=20
> about a copy or that his insurance for family coverage costs 150=20
> dollars a week.
> Honest, Poor working families?  Yeah I know they exist.  They know how =

> to restrain themselves from buying the latest Motorola razor phone or=20
> the play stations.  Concocting an upside to poverty is not my point. =20
> However, the next time you see an ambulance pull in to the bay.  Take=20
> the folks to the side and ask them if they have ever heard of such a=20
> story that I have presented.
> You work in a  big city hospital I assume.  How many times dose this=20
> happen?  Plane load of immigrants lands from the airport.  Give the=20
> Triage nurse something vague that there kids are experiencing like oh, =

> umm "headache" for instance.  What a coincidence, all of there=20
> children have the same signs and symptoms.  You know as well as I do=20
> that they get a warm meal and a full work up.
> My Father came here from Italy, made himself a good reputation as a=20
> landscaper.  Not once, EVER did he take a hand-out from the=20
> government.  Go figure!  Didn't speak a lick of English and today owns =

> his own business. I agree that the 99% may be a bit exaggerated but=20
> I'm not way off.
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of Bjorn, Pret
> Sent: Monday, April 09, 2007 8:59 AM
> To: Trauma &amp; Critical Care mailing list
> Subject: RE: [ccm-l] Employment and benefits manipulations
>
>
> For the love of Christ.  Listen to yourselves.
>
> How easy it is to concoct an upside to poverty, and to fatten the lore =

> of welfare manipulation with tales of widescreen televisions and=20
> sports cars, while something like 37 million Americans struggle to=20
> feed, clothe, and shelter themselves while for the most part cheating=20
> no one, and asking for little or nothing, often to their silent and =
invisible deaths.
>
> " ...99% of them have a huge entertainment system of some kind.  All=20
> of the fancy gadgets included.  Hi-Def surround sound, hi-def flat=20
> screen TV and hi-def whatever!... "
>
> This is more than an exaggeration; it's a reprehensibly malevolent=20
> lie, clearly penned by someone who hasn't the most remote familiarity=20
> with America's honest poor, most of whom work at least as hard as he =
does:
> families forced to choose between filling a prescription and paying=20
> the rent or buying food; who tolerate their illnesses because they=20
> can't afford insurance and going to a doctor would bankrupt them -- or =

> worse, force them into welfare.
>
> How seductively satisfying, the myth that those of us with proper=20
> education and good jobs and warm homes and weekly restaurant tabs and=20
> hyperactive Netflix accounts are somehow victims of the needy.  How=20
> utterly obscene to ignore the corporate welfare shoveled into U.S.=20
> energy and pharmaceutical and insurance interests, or our=20
> half-trillion-dollar debacle in the desert, while enthusiastically=20
> shitting on families of four making under $20k per year.
>
> Let's use the crackhead with the Playstation to quantify the creeping=20
> failure of our civilization.
>
> How can we not be sick of ourselves?
>
> Pret Bjorn, RN
> Bangor, ME USA
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of RWolfer at aol.com
> Sent: Sunday, April 08, 2007 8:55 PM
> To: trauma-list at trauma.org
> Subject: Re: [ccm-l] Employment and benefits manipulations
>
>
> In a message dated 4/8/2007 11:42:32 AM Eastern Daylight Time,=20
> medic541 at hotmail.com writes:
>
> I have  to agree with some of the posts with Dr. Mattox  For many=20
> years now I
>
> have gone into some of the sate funded housing for people that cannot=20
> pay for housing themselves.  No matter who you talk to whether it=20
> would  be a Firefighter, Paramedic or police officer the one thing=20
> that all agree  on is
>
> that upon entering the homes of such people is 99% of them have a =20
> huge entertainment system of some kind.  All of the fancy gadgets  =
included.
> Hi-Def surround sound, hi-def flat screen TV and hi-def  whatever! =20
> Upon transporting such individuals the first thing that  they present=20
> is the State funded health card.  ( I.E medicare or in  Massachusetts=20
> Medicaid.) We, the hard working tax payers, pay  for all of there=20
> leisure and time off.  If you collect all of this  free care free this =

> and free that what incentive do you really need to  have to get off of =

> public assistance?
> Public assistance has become a  way of life for some.  Not a way out=20
> as is was intended to be. You  have to admit, Dr. Mattox has some =
valid points.
> Anthony Caruso  EMT-P Natick, Massachusetts.
>
>
> >From: "Ronald Gross"  <Rgross at harthosp.org>
> >Reply-To: "Trauma &amp; Critical Care  mailing list"
> ><trauma-list at trauma.org>
> >To: "Trauma  &amp; Critical Care mailing list" =20
> ><trauma-list at trauma.org>
> >Subject: RE: [ccm-l] Employment and  benefits manipulations
> >Date: Fri, 06 Apr 2007 13:38:02  -0400
> >
> >Actually in that case hypocritical would be the term, not  cynical. =20
> >I hold those upscale hypocrites in the same light as all  the others=20
> >who want to take everything from everyone and give nothing  to =
anyone.
> >
> > >>> "Offner, Patrick"  <PatrickOffner at Centura.Org> 4/6/2007 1:33 PM
> > >>> >>>
> >But  those same upscale individuals DON'T want to pay for their=20
> >routine and  emergent medical care. In fact, many do not have=20
> >insurance because they  would rather have a BMW or a large flat=20
> >screen TV.  Yes--getting cynical.
> >
> >-----Original  Message-----
> >From:  trauma-list-bounces at trauma.org=20
> >[mailto:trauma-list-bounces at trauma.org]  On Behalf Of Ronald Gross
> >Sent: Friday, April 06, 2007 10:13  AM
> >To: Trauma &amp; Critical Care mailing list
> >Subject: RE:  [ccm-l] Employment and benefits manipulations
> >
> >Lets be real here  - how many of the indigent patients that receive=20
> >free medical care pay  for their root canals?  In fact, how many=20
> >actually have any dental  care at all?  None.  They go to the free=20
> >clinics at the  large city hospitals and get their free dental care=20
> >(that we all pay  for), while the dentists you talked about continue=20
> >to serve their  upscale suburban families 3-4 days a week and go to=20
> >their country homes  the other 3-4 days per week.  Same with the=20
> >"cosmetic surgeons" or  "sports medicine" ortho guys who do their=20
> >jobs in nice self-owned and  self-build private clinics and get paid=20
> >cash by the dentist who blew  out his knee and messed up his nose=20
> >while skiing at Vail.
> >
> >Cynical, are we???
> >
> > >>> "Offner,  Patrick" <PatrickOffner at Centura.Org> 4/6/2007 11:47 AM
> >  >>>
> >Yes, but it was easier to justify providing some indigent  care(say
> >10%) when reimbursement for non-indigent care was reasonable  and=20
> >appropriate. Now that we have to work 3-10 times as hard to  earn the =

> >same income--in the face of inflation and rising malpractice =20
> >fees--it seems harder to swallow the "forced" indigent care we have =
to  provide.
> >It seems that at least 50% of the trauma and emergency general =20
> >surgery I see in the ED is uninsured. We still give them excellent=20
> >care  but it is getting harder to swallow.
> >The dentists somehow seem  to have gotten it right. They get 50-80%=20
> >reimbursement on the billings  and charge the patient for the rest.=20
> >And the patients are willing to  pay for the rest. Most dentists that =

> >I know only work 3-4 days per  week, rarely take call and make a lot=20
> >more money than I do. We on the  other hand get about 30-40% of what=20
> >we bill and are contractually  prevented from balance billing the=20
> >patient. Moreover, the patients now  EXPECT to get their care for=20
> >free. Why are they willing to pay for  their root canal but not for=20
> >their emergency appendectomy or their  elective colon cancer =
resection?
> >
> >-----Original  Message-----
> >From:  trauma-list-bounces at trauma.org=20
> >[mailto:trauma-list-bounces at trauma.org]  On Behalf Of Ronald Gross
> >Sent: Friday, April 06, 2007 8:54  AM
> >To: Trauma &amp; Critical Care mailing list
> >Subject: RE:  [ccm-l] Employment and benefits manipulations
> >
> >Tort reform,  insurance company executive salaries, drug company =
"R&D"
> >costs, etc  - all part of the solution. Not part of the solution - a=20
> >free lunch and  an excuse for all of the "disenfranchised" whether=20
> >their condition is  self-imposed or "imposed by others" whoever those =

> >"others" might  be......
> >
> > >>> "Offner, Patrick"  <PatrickOffner at Centura.Org> 4/5/2007 6:46 PM
> > >>> >>>
> >Dr.  Mattox,
> >
> >While I agree with you almost 100%--don't you believe  that insurance =

> >costs are also out of control--to the point that a lot  of people=20
> >just cannot afford them. Your "fix" is just the tip of the =20
> >iceberg--we also need insurance reform as well as tort reform--it is  =
all intertwined.
> >
> >-----Original Message-----
> >From:  trauma-list-bounces at trauma.org=20
> >[mailto:trauma-list-bounces at trauma.org]  On Behalf Of KMATTOX at aol.com
> >
> >Sent: Thursday, April 05, 2007  3:01 PM
> >To: trauma-list at trauma.org
> >Subject: Re: [ccm-l]  Employment and benefits manipulations
> >
> >
> >In a message  dated 4/5/2007 3:48:23 P.M. Central Daylight  Time,=20
> >thoran at sarah. br writes:
> >
> >Of the  30  -40 million US uninsured how many are the fast driving=20
> >drug addicts,  or  lazy, obese cigarette smokers whom you abhor and=20
> >how many of  them are ordinary  folks, the people who are apparently=20
> >easy for you to dismiss , the working poor, in jobs that need =20
> >filling but just don=A5=D5=A1=B7 get paid very well , certainly not =
enough to =20
> >part with 1,200 a month...  maybe the receptionist or the cleaner  or =

> >the guy in the parking garage, people who just  do NOT appear  on=20
> >your radar because they do NOT read a novel a
> >week, do NOT   know the right people, do NOT belong to the right
> >organizations, did  NOT go to  the best schools. Never mind Dr.=20
> >Crippens friend but  what about the disabled,  the folks in the other =

> >car,  the unemployed, the unemployable, good cannon  fo dder but No =
FREE  LUNCH.
> >Never mind that the free lunches are served up in   corporate board
> >rooms every where, provided by the moms and pops  investing in  the=20
> >great enterprises that won't provide  health  insurance.
> >
> >
> >
> >In every society, and  especially at the local level, provisions are=20
> >made  for
> >the  kind of persons you cite above.   Many local good examples   =
exist.
> >
> >
> >These same individuals do not have state  sponsored lawyer  aid,=20
> >housing aid,
> >church aid, food aid,  family counseling, cell phones,  etc.   Why =
must
> >or  should
> >health care be any different.    MANY MANY of the  persons you cite
> >above CHOOSE
> >to not have health dollars   available in order to pay for cell =
phones,
> >send money back to family in  another  country, have a late model=20
> >car, drink alcohol every day,  go to cock fights, and  have somewhat=20
> >expensive watches and  designer
> >glasses.   I see them  every day, and then they  expect FREE medical
> >care.
> >WRONG.  One  cannot have it  both ways.    If they go to church, the
> >priest
> >EXPECTS  them to put something in the collection plate and even pay=20
> >for some of  their absolution by giving to the church (up to and=20
> >greater than 10% of  their
> >income).   If they need to go to court, they must pay  for an
> >attorney.
> >
> >
> >I have NO problem for fairness  with a prorated calculation of a=20
> >discounted bill based on disability,  inability to work (real, and=20
> >not just a matter of a created social  welfare state to pay someone=20
> >NOT to work), and a feeling of  responsibility for ones own services, =

> >whatever they might be.  It  is not  the state or the employers=20
> >responsibility to assure that  everyone is provided  all creature=20
> >comforts from the
> cradle
> >to the  grave.  That is a family and  an individual responsibility.   =
The
> >governmental responsibility is to  protect,  NOT PROVIDE.
> >
> >We in every society MUST also address the  HUGE profits from=20
> >insurance companies, HMOs, and hospitals whose  overhead and payments =

> >to upper level
> >management and stockholders  are obscene.    The persons who have   =
been
> >unfairly
> >burdened with the financing of individual health  care has become =20
> >the employer, and that is the most unfair  of all  systems.
> >
> >Kenneth
> >L. Mattox,  MD
> >Houston
> >
> >
> >
> >**************************************  See what's free at=20
> >http://www.aol.com.
> >--
> >trauma-list :  TRAUMA.ORG
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>
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> >may contain information that is privileged and confidential.   If you =
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> _________________________________________________________________
> The  average US Credit Score is 675. The cost to see yours: $0 by=20
> Experian.
>
>
> =
http://www.freecreditreport.com/pm/default.aspx?sc=3D660600&bcd=3DEMAILFO=
O
> TERAVE
> RA
> GE
>
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>
>
> Ithink that this was intended to be a way of "getting folks thru" but=20
> is now a way of life.  We have become a society of entitlement and  "I =
=20
> deserve and
>
> I need" instead of I worked for this. there are now generations upon=20
> generations of this.  Some of us were raised to work for what we got=20
> and pay our own way.  I think the only way to change this is to stop=20
> it and  make people work for what they get.  there is plenty of work=20
> out there,  cleaning roadsides, taking the elderly to appointments=20
> ect.  We see traumas  hurt on ATVs or drunk driving all the time who=20
> are on disabiltiy for whatever  reason.  I think that if you can drive =

> a car or ride an ATV you can  work.  there is a job for everyone.=20
> Heck, McDonalds hires folks with Downs  all the time.  They are often=20
> the hardest workers and very proud of the  fact that they have a job=20
> and can contribute.  I think if you get welfare  or medicare you need=20
> to do something for it. You dont get something for  nothing. =20
> Unfortunately we need to change generations of thinking.  We  are , as =

> a country and as individuals, going broke working so that others can =20
> sit around and do nothing.  Some of them drive better cars and have=20
> better  TVs ect than those of us that work our tails off.
>
> RW
>
>
>
> ************************************** See what's free at=20
> http://www.aol.com.
> --
> trauma-list : TRAUMA.ORG
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[ccm-l] Employment and benefits manipulations