This is a good point. Can the mods force him to answer this if he wants to keep jew posting?
Ultimately the lack of price transparency is not something that should be relevant to patients, you functionally need insurance in the US and every having to do with payment outside of your insurance fees is a total nonsense dance between various entities. If your ultrasound costs 300 dollars or 350 dollars shouldn't be relevant if you are paying 0, 5, or 20 for the thing.
It's certainly annoying not to know stuff if you are a curious person, but I'm not really sure it is ever relevant.
I agree in general, and I do think people should be able to have opinions I find odious, but if you are going to make it your thing, some level of forced engagement instead of just drive by jew-posting might be better than just straight up banning/ongoing warnings of "chillllllll."
anti-vaxxer
I mean, you said you didn't want to get some vaccines?
And you said it was because risks whatever that means and because you don't trust experts?
What is it you think that anti-vaxxers say?
Ultimately you don't know what you don't know - see the chickenpox party bit.
Also, the COVID vaccine is uniquely politically compromised but is a. not insanity, b. has an incentive we understand for the handwringing on both sides - political bullshit.
Vaccines in general have little incentive (as many are mature at this point it's not a money thing) to over push them or hide flaws. If you do the research on say the polio vaccine you can see exactly what went wrong in the past and why and the rationale behind the U.S. (and Danish) schedules. This stuff is out in the open and risks and benefits are known and the people who decide them are extremely competent and knowledgeable.
And the risks of the vaccines are minuscule (again with little incentive to lie or minimize them) and the benefits are immense, if rarely applicable for some things like Hepatitis A in the U.S..
Not following the schedule is essentially gambling with your child's life with the justification being "eh, the risk of this bad outcome is low but I won't take very easy steps to avoid it anyway because I'm mad about COVID."
You are welcome to be obstinate about the public health response to COVID but if you are putting other people at risk, especially your own children you should really look inside yourself and think about what you are doing.
That's putting aside the whole sentencing your child to a bunch of extremely avoidable paperwork and administrative headache in the future and the risk of things like ending up with a lower quality pediatrician because you refused to follow the vaccine schedule.
Importantly, if you are going to decide not to listen to medical advice and potentially put your child's life at risk you need to actually research what you are doing. Do not just jam it into an AI which you already admitted misled you or go "well shit this can't be right because COVID." Raising a child is one of the most important things someone should do and if you decide you will not listen to the medical consensus then you must actually put in time or effort or a reasonable person may judge you a poor parent.
Generally I don't get too heated with the questionable medical content that appears here because people aren't doing anything more than promulgating misinformation (which I'm committed to allow as a free speech person) and harming themselves - and people here do come up with novel things sometimes.
Putting a kid at risk and under baking your thought process is not that however.
The initial don't wear masks this was absolutely a lie and with very good reason - lots of healthcare providers ended up dying due to lack of PPE.
But it was a lie.
The masks work bit is not a lie it's just complicated and still has a ton of debate today. That's picking and choosing which evidence base to use in public policy messaging.
Moving the goalposts on herd immunity is a political and not medical question and not really a lie no matter how well or ill advised it was.
No shit politicians lie (and Fauci is a doctor), but don't mix that up with the medical side of things.
Please supply the data if you can because nothing about that makes sense. Medicare cuts to physician reimbursements are well known, several specialties are frequently sub 200k which isn't really consistent with any form of keeping up with inflation.
I don't know this writer but I think it's pretty reasonable to conclude it's likely an anti-physician agenda post given this: if physician pay is one of the biggest factors behind healthcare costs (as they say), why is it such a small percentage of healthcare costs and they don't even mention what the percentage is or note if its increased or decreased over time?
I think it is reasonable to have significant suspicions after noticing that.
1
So you probably didn't see all the people who died, maybe because they weren't in your social group, maybe you lived away from inner city squalor for instance. It was bad, it really was.
2
COVID vaccine into culture war. I don't know a single republican, anti-woke, fuck the establishment doctor who has anything negative to say about non-COVID vaccines at all. These people do exist and one of the biggest eventually recanted but nobody takes them seriously.
It's like trying to get Toyota's banned because a BMW ran over your dog. Nothing about them is similar.
3
Medical research certainly has its problems but their is an immense world of difference in consideration between things like "get your fucking MMR shot" "here's a complicated discussion about the value of the Rotavirus vaccine" and "here's a retrospective study of complication rates using an N of 600,000.
As a sidebar their weren't a lot of lies during the pandemic, their was a lot of bad messaging. Things like "the fatality rate will go down overtime as the virus burns through the available tinder and mutates to be less deadly" were stated loudly and often but people didn't listen.
Stuff like the initial mask messaging was a lie and I was annoyed by it but it was well meaning.
Unforced errors sure but most of it wasn't lies and a lot of things are still true (yes it is dangerous), were found to be true (no Ivermectin didn't actually work the research that said it did had big flaws), or involve ongoing complicated debates (lab leak).
These are not in fact the options. Another option is to not deprive those who have been involuntary committed of their right to keep and bear arms once they are released.
Guy threatens to kill you for raping him. He gets admitted to the hospital. He gets discharged and still wants to kill you after he stops his meds, so he goes to a gun store, buys a gun, and shoots you.
How do you prevent this?
I don't disagree that the approach was mangled but I think the science is settled now and for adults its something like benefits outweigh the risks for everyone except for very young men (I don't know kids though).
This was a unique situation though where people very publicly turned off their brains because of politics. That doesn't happen very often, and it's always pretty obvious when it's happening (still the case with any medical content that is significantly woke adjacent).
Most of public health this caveat does not apply.
Yes and I'm aware of that risk and I think about it and I take steps to mitigate it when appropriate.
You are choosing risk for no reason. That's the issue.
Furthermore you need to be responsible. Engage with the rest of the comment. The ask is to actually do your homework instead of being mad about COVID.
That should be easy.
Yeah sorry lemme rephrase as "please please please follow the *U.S. vaccination schedule."
Not accusing you of not going for MMR but just using it as an example of downstream effects.
Something to keep in mind is that the U.S. schedule is optimized for "we are the wealthiest country in the in world" others may have more resource limitation focused choices.
COVID you can skip.
Using your other post as a reference point (and please forgive me Peds is not my area so I my professional level knowledge of this is distant).
Also several of these can impact getting jobs or housing at university (ex: the Heps, Meningitis), and skipping them will put you in the naughty bucket in your pediatrician's mind which isn't necessarily appropriate but is the reality.
Hep A - prob rare in Denmark? Hep B - prob rare in Denmark? Chicken Pox - no idea why they aren't doing this. Per PLOS Glob Public Health. 2023 Apr 5;3(4):e0001743. doi: 10.1371/journal.pgph.0001743 eople are advocating it? Rotavirus - this one is super complex and can't really be summarized here. Covid - skip if you want. Flu - don't skip please. Tetanus (from age 12) again probably low yield. Meningitis (from age 12) - don't skip please, looks like they have it but don't give to kids? Maybe it's pre college matriculation? IDK seems strange.
Keep in mind that incidence of disease varies country to country and the sheer variety and amount of immigrants in the U.S. (as well as poor health) put people at higher risks of somethings. This impacts the schedule.
Hold up, are you saying doctors want patients to spend more money on meds?
The supply of doctors in the US is artificially constrained which means you can increase the supply of doctors while lowering salaries.
Putting aside whether this is true or not the whole point of my post is that it doesn't matter since doctor salaries aren't the problem.
Why can't you change jobs? Every doctor in my family has done so at least once. Don't many doctors work for themselves at their own clinics?
You can't change your job or choose where you live during residency (and to a less extent medical school). 7-11+ years.
Keep on snarkily dismissing it rather than refuting it.
There is a surplus of medical students and residency slots every year. AMA lobbies for increased supply of providers.
You can verify these for yourself if you'd like.
So you don't think doctors are spending a ton of time and energy trying to improve patient care?
Sure people talking about increasing the supply of physicians and therefore driving costs down, but that only matters if reducing physician salaries does anything useful. It's not a large enough slice of the pie.
Profit as in profit margins is not egregiously high, but 4-6 percent of hundred of billions of dollars is a lot of money that could be spent elsewhere.
Moreover financial success can be spent on the company - inflating salaries for executives, finding no need to trim administrative fat, more general reinvestment.
I'm usually pro-CEO pay. Let people like Elon make a fuckton of money if they are bringing value, but the insurance companies are only bringing value by fucking over American citizens are further destabilizing an already fragile healthcare system.
So they are profitable in the sense that they help some people get rich at the expense of Americans, not profitable in the sense that they have excess profit margins.
My right to be alive supersedes your right to have a gun.
People who dislike me because of X attribute (for instance jihadis) can have a gun. People who have said threatening things towards people like me can have a gun. People who have gone out and attacked people like me can't have a gun. People who have murdered people like me definitely can't have a gun.
That's what felons have done, committed a crime and so you lost the right. Involuntarily committed people have usually committed a crime (that does not go charged because we don't usually charge people for suicide attempts or attacking an ER nurse while psychotic), or have expressed a desire, willingness, and ability to commit a crime.
It is not assessed through a jury of peers, but this is why I'm asking what you want instead, because if you want that shit gets worse - do you want to be held until the legal system gets its shit together instead of just discharged from the hospital? Do you want your taxes to balloon?
Accept the current system, propose something else, or let your psychotic neighbor shoot you in the face.
You've also declined to say whether limitations should exist, which is clearly important.
There are always limitations. If I state that I have the right to murder people I disagree with because murder is expression of my speech. I will get laughed out of court for making this argument.
For 2A there are limitations..... well first of all what is a gun? I say a tank, a Warthog, and a fissile device are all guns. The court may say they are not guns and therefore I have no constitutional right to them. Some fictional guns are gun shaped and launch projectiles but are sufficient to destroy the planet. The government better ban them, I live on the planet.
Limitations must exist, else you live in a society where I can murder you legally for no reason because I assert it is my constitutional right to do so.
I don't think you believe that no limits should be placed on constitutional rights though, I think you are mad at the current limits, which are more expansive than what I'm asking for.
American citizen Jihadis absolutely have the right to guns if they haven't been convicted of crimes. We can't just have a member of the priesthood point to them and say "Man, those are some BAD muzzies" and no guns for them.
This is in bad faith. I didn't say Jihadis couldn't have guns. I said they couldn't have nukes. That is an example of a common sense limitation.
Certain people can't be trusted with certain powers. Determining this adequately is hard and frustrating. Nearly nobody should be trusted with nukes. Nearly everybody should be trusted with a fork and knife.
If you want to criticize an aspect of the current plan you need to either assert that no rights limitations are appropriate (which you have alluded to but not actually done) or come up with an alternative solution to the problem.
Okay let me actually think about this deeply and come up with what I'd consider acceptable policy.
I figure felony and involuntary commitment should be considered around the same in terms of severity (we'll come back to this).
This means default to no for gun acquisition for people in those categories. People deserve rights including the right not to be limited in their behavior when possible, however other individuals deserve the right to be free of molestation and incidents of bad behavior skyrocket once you look at the pot of the population that are felons or involuntarily committed. Schizophrenics crime rates are lower than many might anticipate but this is in part driven by underreporting and the most heinous crimes in society are committed by violent psychotics, both of those facts should be kept in mind.
Both involuntary commitment and felony charges get misused. Trump is now a felon. A patient who was diagnosed with cancer at age 19, made a credible attempt to end their own life in the setting of that stressor but then survives and has no further interaction with mental health care? Yeah seems like both of those shouldn't be limited.
Therefore there should be an adversarial process to get permission to own a gun again (like an expungement hearing). Yes this puts a time and financial burden on people to regain their rights but they lost them for good reason and the majority of people who go through either of those are appropriately labeled.
Okay so why does this guy not deserve his gun? Well: involuntarily committed. Reading between the lines looks like for good reason at the time despite his protestations to the contrary. Now he also appears somewhat disorganized, likely has mild cognitive impairment and has poor judgement (why was he not organized in his defense? Where's the lawyer? He admits he is lying to healthcare professionals...). It's not unreasonable to assume the guy is full of shit. Navigating expert witness testimony, dealing with HIPAA and subpoenas and all the good stuff is time consuming and expensive, likely it would establish that the guy was lying about ongoing psychiatric care and the reason for his admission, the judge skipped ahead and tried to look for a justification and found one. If the guy hired a lawyer he'd be fine.
For basic rights the idea is probably that both the responsible and irresponsible are supposed to have them (and that includes 2A even though the latter part of that scares people). But once you've gone through the first "hit" it seems reasonable to make the standard now be that you have to be responsible. This guy clearly fails to establish that he is now responsible.
Okay back to why Invol and Felony should be labeled as similar faults.
Maybe the best way to make this case is to look back at one of your other points: "Sure, who are the courts going to believe?"
Most medical schools give students a chance to witness (continued) commitment hearings during the psychiatric clerkship.
Here's how it goes:
Public defender: Don't talk. If you don't talk the judge will let you go.
Patient: Okay.
Judge: Let's begin, on the matter of...
Patient: I DO NOT RESPECT THE COURT'S AUTHORITY THE JUDGE WORKS FOR THE NORTH KOREAN GOVERNMENT AND HE RAPED ME LAST NIGHT.
Public defender: "..."
Their are absolutely doctors and facilities that are soft in their commitments but especially in large urban areas you'll see patients get discharged with situations like:
-"I'm going to go home and kill myself" (16 year old and parents say they can go home safely)
-"I'm going to shoot up the school" (criminal/police matter not a psychiatric one if no pathology is present)
-Patient who won't speak to anyone in the facility because they think everyone works for the CIA but takes steps to shower, eat, and sleep.
Involuntary stays are usually appropriate.
What complicates matters in the public imagination is that most conditions that lead to commitment involve some impairment of insight so when they complain on the internet they withhold details and context and make it seem like they were abused by the system.
Commitment hearings are tricky, often there is some type of collusion between the judge and both lawyers. This is because 99/100 the situation is super obvious.
I imagine (as RovScam points out) that the everyone involved quickly identified this guy as a full of shit asshole and they went this way to avoid wasting everyone's time.
It isn't great - and I'm a very strong 2A advocate, but when you see the circumstances that result in admission you realize almost nobody who has been involuntarily should be allowed near a fire arm.
It's like prison. Are some people in prison under false pretenses? Sure. Do they almost all clearly deserve to be in prison. Yup, and it's obvious after five minutes working in a forensic setting.
Compassion and empathy do not require acceptance or being a door mat.
While saying "nope no free will" is probably excessive, we do have a lot of evidence that things like bad childhood experiences are incredibly difficult to overcome and likely only in the most optimum of circumstances.
You can say "just get over that shit" but they rarely do, particularly with very bad or multiple bad experiences.
I can tell you ivermectin literally works by making the cells inner PH less conductive to fully forming the viral capsid.
How often have we cured cancer in a lab but when you apply the thing to real life clinical practice it isn't helpful?
It's nearly all the time, in fact it's the majority of medical research.
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It....kinda should though?
We have good evidence to believe that free will is mostly BS at this point but even if you aren't about that line of thinking it is still true that childhood abuse ruins your life outcomes. We have some knowledge of things like the impact on your brain chemistry and psychological development, we can point to incredibly poor outcomes and paucity of truly effective treatment.
People just don't get better without a lot of good genetics, supportive nursing and lucky life events the majority of the time.
Doesn't mean you have to accept or interpersonally tolerate them, but you should have empathy and compassion.
It is in all likelihood not her fault and her brain is fundamentally broken and society does not have the tools to force her to do what is required to get better.
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