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Sun Jul 26 19:23:07 BST 2009

Ken you left out the other 'wonderful' social system...US postal service. Many horror stories in New Orleans after Katrina but I truly think that some are national. Like hiring postal deliver personal for only 89 days so that they will not have to pay retirement, and other fringe benefits. I do not know about the health insurance part one way or the other.

Norman

Norman McSwain MD
Trauma Director, Charity Hospital
Professor of Surgery, Tulane University
New Orleans LA
504 988 5111
norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu> 

________________________________

From: trauma-list-bounces at trauma.org on behalf of KMATTOX at aol.com
Sent: Sun 7/26/2009 1:12 PM
To: trauma-list at trauma.org
Subject: Centrist vs Local Social Systems

What I do think will happen, and it is a variation of what drydok has 
suggested, is a LOCAL OPTION.  That is federal dollars will be funneled to 
local programs to be administered locally.    Many successful  examples exist.  
 What has not worked is for a federalized  system of disaster care, social
care, medical care, distribution of food, etc.  etc.     ALL politics is
local.   ALL medical  disaster management is local, and all physican-patient
interactions are  local.    

k

In a message dated 7/26/2009 1:03:46 P.M. Central Standard Time, 
drydok at hotmail.com writes:

From: KMATTOX at aol.com
> Don't bet on  it

--> Well, as I did mention, I have NOT bet on it. I have  "bet" against it.
Although while making investments at the time I made them, I  did not
consider the dawn of universal health care as a factor, it will likely  cause me
losses if a more socialised system came through. And, regardless of  whether
I think it will be good for the USA or not (and I am not American, so  I
will not vote) I honestly really BELIEVE such a system will come and that 
it's only a matter of time.

This is what I believe. Please  no-one shout at me - I am NOT CAUSING it to
happen!

And I'd  save people the time of trying to convince me that it's the wrong
thing for  the USA, 'cause y'all have better things to do - I will NOT be
voting!  Additionally, I tend to look at evidence in these issues, so it would
be  tough...

> ...have patients who look up to their   doctor much more than they look
up to their politicians

-->  Agreed! This is universal and is very much related to how we use
evidence in  making arguments (not politics), how we appear to care for the
patient more  than for our pocket, etc. (but see below)

> list servers...  have had a tremendous influence on the Democratic Blue
Dogs  in Congress,  just the past 10 days

--> Welcome to politics, I  guess...

> 1:1 audience with important  persons...

--> But, to use our previous terminology, what is  the OBJECTIVE of these
important persons, be they blue dogs or indigo hyenas,  what is the OBJECTIVE
of each of these important people? Will their own  PERSONAL OBJECTIVE
actually be served by succeeding in defeating a democratic  president so early in
his tenure and "opening the door"? Or are they merely  being polite?

No, I DON'T know better than you. I am 1000%  certain I know less in these
matters. Perhaps I'm merely playing a poor  devil's advocate... If you're
right then at least ONE cheerful thing will be  proven and that is that there
ARE ENOUGH politicians who put their true  conscience ahead of their
career's and their party's success. Still, if that  costs the USA this chance at
universal coverage, it will only be  delayed...

BTW, I am not casting stones in complete ignorance  of the glass around me.
I also think that it is inevitable that the UK's  nationalised system will
be made MORE "capitalist" by successive governments  for the same reason -
perceived success in making change gets  votes.

> a comment was made about doctors doing  tonsillectomies just to make
money...  insult...

-->  Did not hear this myself. But I must say I am surprised. Can you send
me the  actual text?
Did he say this about DOCTORS? Or was it about "some doctors"  or "a
doctor"? Was it stated as a FACT or as a potential possibility? That it  DOES
happen or that it MAY?

In each of these examples, the  latter version is how a politician would
put it. I am sure you all know that  you could run as many circles as you
wish, but you still could not eliminate  the fact that SOME doctors SOMETIMES do
things for money (or fear of  litigation, I.E. FOR MONEY) in advance of 
ethics/principles...

> Do not underestimate the power and  influence of even one committed
tenacious person

--> You  misunderstood my meaning. I do not underestimate it, I am RELYING
on it - I  think Mr. Obama, if nothing else, is a man of immense power,
influence,  commitment & tenacity. Additionally, he is motivated by his career
riding  on this, while the majority of doctors (the majority which will
remain 100%  silent in this debate) do still know that even if they object to the
change  and lose, they new system will depend on their careers even more
than the  current one. Although some of them may well think they will make
less money,  they know that they will be able to continue in their chosen 
profession.

From: Gross, Ronald  (Ronald.Gross at baystatehealth.org) 
> President Obama has focused  the 'numbers' debate for the medical field
on making money, not providing  universal quality of care when he said (as
best as I can remember and  paraphrase) that a doctor would, for example, do a
tonsillectomy rather then  treat the tonsillitis because it pays more. That
was as poor a choice of  words

--> ... In the eyes of an intelligent medical  professional it might be a
poor choice. But in the eyes of a recently  unemployed secretary?...

> the key here will now be for the  AMA, the ACS and ALL OF US to become
very politically  active

--> Well, as I said above, welcome to  politics!
Still, we must remember that the trust the public put in us may  well be
eroded towards the politician level if that is what we  become...

> Just my 2 cents (a far cry from the trillion  thing!)

--> In a funny way, I believe the way you signed  your message is EXACTLY
my point!!!

If levers may move the  earth, it is still more likely to move in the
direction of a lever that is a  trillion-long, not a .02-long... In a capitalist
system, that  is...

> ...we need to adopt the "union  mentality"

--> How socialist of you!

>  QUALITY universal health care in an American capitalistic  way...

--> Yes! Mold it - don't fight it!

No need  to emulate a communist system. There are capitalist societies with
universal  healthcare alongside capitalist care - why is that beyond the
capability of  the American  Nation?

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Centrist vs Local Social Systems