This is an old story about the school that sent laptops home with kids with the webcams turned on, but one that recently came back to my attention. I am not easily surprised, but it surprises me that this was actually considered a good idea.
I find it utterly bizarre how dressing a guy in a penguin suit can actually make me want to try your beer.
We need to be moving in the opposite direction of this, liberalizing the sale of cars across state lines. Not applying the stupid car model to wines.
Doctors pursuing politics in record numbers. No big surprise, but most are Republicans. The political distribution of the docs that I know through Clancy is actually a relatively even alignment and may even veer slightly leftward. I suspect that the higher up the specialist chain you get, the more Republican you get.
We’ve talked off and on about Pre-existing Conditions here at Hit Coffee, so I thought I would pass along an editorial by the (rock-ribbed conservative, it should be noted) Investor’s Business Daily that contains some pretty uncomfortable tidbits about what happens when you force PEC coverage.
I am an anti-fan of the Nebraska Cornhuskers, but a couple of interesting and positive stories coming out of Lincoln. First, defensive superstar Ndamukong Suh pledged a boatload of money from his first contract back to the University. Former Husker Cal Nicks, known throughout his collegiate career as a troublemaker, actually went back to the university to apologize for being an arse.
A look at the shortage in rural health care providers. It really almost doesn’t matter what system we operate under. This is not a problem that’s going to go away. Even if we flood the market with new docs, rural America will be among the last places that they’ll go.
The anatomy of a bogus degree mill (mills, actually) and how an irate professor put a stop to it.
I find various mentions of how insolvent the suburbs are and how all the suburbanites are going to have to move into cities perplexing. Not because I am confident that the suburban model will work out in the long run (well, I guess I am a little bit, but I recognize that I could be wrong), but that the same government that wouldn’t let General Motors fail will let the entirety of suburbia fail.
The latest Toyota malfunction. The part in question is much more prominent on some badges such as Scion and Lexus than others, though. I don’t know. I think this is something else we might be able to pin on the drivers.
Five myths about green energy. Least surprising? The jobs part. Most surprising? Our relative progress in “going green.”
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Doctors going into politics is decent evidence that being a physician isn’t as great a career as it used to be.
I can think of a couple of reasons why they tend towards Republicans. People say that except for research, most medicine doesn’t require creativity or innovation. A huge chunk of medicine is skilled labor. Surgery tends to draw people, who if they weren’t as bright, would be carpenters. People in, for lack of a better term, practical fields, tend to be more Repubican.
Doctors seem to feel especially screwed by the tax system. After a decade of school and residency, they pay in top brackets, and the tax code doesn’t take consideration of the ten years of not making much money.
In the Q&A about physician compensation, I linked to an article about how doctors report extremely low levels of job satisfaction. When you consider how much they make, it’s really pretty remarkable.
I am personally rather surprised at how much the tax issue stings. In the vague sense, I don’t think that we’re paying too much in taxes as a percentage of our income, but watching it come out of the paycheck just hurts and it does provide a disincentive for me to work knowing that a huge chunk of what I make is going to be taken out in taxes (since it all comes out of our highest rate). It’s not rational since the alternative to working is not making any money at all and I have been considering working on open-source software for free, but it’s there.
There are a couple of other issues I can think of as to why docs veer to the right.
Medicine is a rather meritocratic place. Once you get into medical school, if you are good and hardworking you will do just fine. Contrast this with the arts, where even if you make it big you know a whole lot of really talented and hardworking people that are struggling to make ends meet. It’s not surprising that the Republican talking points about self-reliance and hard work getting you ahead would resonate.
Second, when in residency they spend 80 hours a week making $10 an hour at charity hospitals taking care of people that often stubbornly refuse to take care of themselves. I’ve heard even liberal docs express a degree of frustration over the self-destructive habits of a portion of the underclass. For docs that are not already avowedly liberal, it’s again not hard to see how Republican talking points would resonate.
As far as PEC, there are always two sides to the coin.
On the one side, as you point out, there are the “relatively healthy” who game the system till they need something.
On the other side, as long as the system is reliant on employers as the primary method by which people get insurance (and no, governmental “high risk pools” don’t count as an adequate alternative), you have a major problem. Trying to get personal, private insurance when you have a PEC right now is, in no uncertain terms, a joke. Your only other option is to game the existing system by permanently being a student and buying into student plans over and over, or else by somehow ensuring that you never leave a job unless you are 100% damn sure that you have insurance waiting in another job already lined up.
Yes there is COBRA, but depending on how long you could be unemployed, that may not be the greatest of comforts, especially trying to maintain it when other things are already squeezed.
Web, that’s why I support a middle ground. The problems mentioned in the IBD article could be avoided with a waiting period for PEC’s (my idea was a waiting period variable depending on how long you have been uninsured). Another option would be open enrollment periods where you have to sign up on a particular month or you have to demonstrate a change in coverage status (ie you lost your job and your health insurance).
On the other side of the ledger, if you have maintained coverage, then they have to cover PECs for individual policies the same way that they have to cover them for group policies. If there is a discrepancy in coverage levels, they are only obligated to meet the terms of the previous insurance contract (to prevent someone from getting Assurant until they need real insurance for a period of time.
I’m flexible on the details, but the (pre-PPACA) status quo and the Massachusetts/PPACA arrangements leave us going from one problematic extreme to another.
Maybe I’m just a liberal, but how about just giving Medicare to everyone and raising taxes to cover it? Plenty of European countries do it and they spend less money on healthcare than us.
SFG, kinda avoiding general policy prescriptions for health care on Hit Coffee. They almost always fall down into name-callings of SOCIALIST! and HEARTLESS BASTARD! and so on. That’s why I tend to stick to specific micro-issues.
The meritocratic aspect of medicine has another effect. Doctors do well financially, but not spectacularly well. They socialize with the higher end of the professional-managerial class Their peer group often have similar or higher income, and didn’t have to be both poor and working 80-100 hour weeks in their 20’s. Some of them must think “If I had gone into business/banking, I’d be making X much with less stress. The fact that tons of people go into those fields and never rise to 150K/year is sort of invisible.
I linked to an article about how doctors report extremely low levels of job satisfaction.
I’ll have to read that. Ever since I got didn’t even get into osteopathy school, I’ve been trying to make the grapes as sour as possible.
Of hand, I can see a bunch of reasons why doctors aren’t happy. They mostly deal with things they can’t fix. To a huge extent, it’s good thing. If I have, say syphilis, I go to the doctor, get the antibiotics. If the doc prescribed the right drug, and I take it correctly, I get well. I don’t go back. If he prescribes badly, or I can’t get by sh*t together to take the whole script, I go back, maybe more than once. Even worse with chronic diseases that at best are manageable. Doctors spend so much of their time on sick people that they can’t make well either because the people are irresponsible or (probably more often) there’s just no way to fix the problem. It has to be frustrating.
Plus, sick people tend to be unhappy. Being around miserable people all day is really hard on anyone with enough empathy to be a decent doctor. I’ve heard that lots of docs have depersonalize patients. It’s hard to turn that on and off. It’s said that people become obstetricians because it’s the only happy place of the hospital.
Doctors also see bad things more often than average. My dad’s a pathologist, and growing up he was the most neurotic father about safety in the neighborhood. Climbing trees is dangerous! Wear a bike helmet! This was before kids actually wore bike helmets. He was probably like that cuz every time he saw a kid who climbed a tree, that kid fell and died. We all know all car crashes happen. If I saw mangled people from it every day, I’d probably be pretty frightened and dour.
The charity hospital thing fits into making doctors unsatisfied and Republican both. In Bonfire of the Vanities, Wolf has a character think about how the key to living in New York (for people like Sherman) is isolating themselves from poor people. Most people with brains and personalities similar to physicians don’t deal with the underclass much at all. Being around them is depressing.
Our total tax bite this year including state, local, and federal, plus SS and Medicare payments and property taxes, was 65K. This was with me only getting a paycheck five months last year, plus some unemployment compensation.
It does come to a point where you realize that combining two higher incomes often doesn’t add up. It’s probably cheaper for me to work part-time or not at all.
“I find various mentions of how insolvent the suburbs are and how all the suburbanites are going to have to move into cities perplexing.”
It makes a great deal more sense if you think of it as premature schadenfreude from people who dislike surburbia anyway for esthetic or ideological reasons.
I get that part, why people dislike the suburbs and why they assume that which they dislike must therefore be bad, bad, bad. But can they seriously envision the government failing to subsidize suburbanites who make up the most crucial block of swing voters in the country? That’s the part I don’t get.
But can they seriously envision the government failing to subsidize suburbanites who make up the most crucial block of swing voters in the country?
It depends on the form of the subsidy. If we subsidize coal liquefaction, natural gas production, biofuels, electric cars, and public transport, then yes, we will probably subsidize suburbanites even more. If you mean in terms subsidies for the purchase of gasoline when there are severe price shocks (i.e $20/gallon gas), then I think that’s far less likely, and the government would probably want the scarce fuels for the aviation industry and military.
That’s the part I don’t get.
The presumption is that petrol will become so expensive, even the government would be unable to subsidize its purchase thus forcing people to move into a more urban environment.
They will go with whatever subsidies they can manage. Once subsidizing gas no longer becomes possible, they’ll shift to other things. However, contrary to the opinions of a lot of smug urbanites, suburbia is not incompatible with reasonable gasoline usage. Comparatively few suburbanites actually go into the city on a regular basis. A lot more commute from one suburb to another. Hike up gas prices and they’ll just swap suburbs. Those that do need to go into the city can take the bus or whatever other option the government gives them.
In the comment section of the Unfogged post, they actually spend more time talking about water than gasoline. That strikes me as a more significant threat. It also strikes me as something that the government will subsidize.
From the diploma mill article:
To go after the Randocks, the Secret Service used online aliases to purchase degrees and then followed up as fictitious employers ostensibly verifying credentials. The most valuable evidence for investigators came in response to inquiries from an invented character named Mohammed Syed, who sounded like a terrorist plucked from a Hollywood script.
Really? Which script would that be?
Could they be thinking of, you know, the real world?
“Wolf has a character think about how the key to living in New York (for people like Sherman) is isolating themselves from poor people.”
As I remember, the word Sherman used was “insulate.”
I think about that every so often. I like that at least he admitted his need and desire to do that. Most people don’t seem to. They pay lip service to diversity, while living privileged lifestyles that screen out the poor and uneducated.
“It does come to a point where you realize that combining two higher incomes often doesn’t add up. It’s probably cheaper for me to work part-time or not at all. ”
Yes, our tax bill this year came to roughly the same amount as my take-home income. But 1) that level of income is not guaranteed us (I’m on salary, my husband isn’t) and 2) it would suck to be a housewife. At least that’s my opinion after having tried it out for a few weeks on maternity leave.
Out tax bill will exceed far more than I have ever made. Objectively, it’s not like I’m working for nothing since most of those taxes would be there anyway. It just gives that sort of running-in-water feeling that is really quite disincentivizing. Despite the fact that I’m not excited about our tax rates generally and do not favor lowering rates. I’m still trying to make sense of these contradictory feelings and thoughts.
Rob, don’t feel bad for not getting into DO school. It’s all really, really competitive. We need more slots.
One of my favorite songs is “The Last Thing On My Mind” by Bare Naked Ladies. It’s a very graphic description of a car accident. Clancy cannot stand the song and it’s one of the few that I would never consider not skipping if she is in the car. She has had to deal with the consequences. It means something very different for her than it does for me.
You’re right that the patients that doctors see most are the ones that can’t take care of their problems (either because their problems are that bad or they can’t take care of themselves). Or at least this was particularly true when Clancy was working at the charity hospital. Callie has stronger demographics, so I think a lower proportion of her parient-base are broken people. But all of them go through residency and all of them go through periods of dealing with broken people, regardless of their specialty. Obstetrics may be a mild exception since it requires regular visits more evenly along SES lines.
(I have to add that my contributions here are speculative and second-hand. Don’t assume I am quoting Clancy on this.)