33 replies to this topic

[griz]

A good friend's son died last week. He was born with Spina Bifida; the obit says he endured 40 surgeries in his 28 year life. I met her when she was 28. Over the years we discussed my opinion of heroic medicine; it was hard on her, but I wasn't going to lie about my beliefs. Her case only strengthens my conviction:

• The son's 28 years of suffering vs a month or two
  
• The mother's alcoholism
  
• The mother's dark outlook on everything
  
• The mother's 3 divorces and God-only-knows how many bad drunken relationships
  
• The extraordinary cost to society - she didn't pay for her son's surgeries
  
• The extraordinary cost to care take the kid - they paid momma to care for her son

The difference between me and Obamacare? I would never attempt to force my beliefs on you.

[pUnK]

Heroic medicine is an interesting term for what you are trying to characterize but if you resent the fact that kids like my micro preemie son are given all medical opportunity to survive, then you need to really move yourself to Belarus. Have you forgotten the documentary on how Belarus handles the disabled? I have two cousins with spina bifida and the world is a better place for having them in it. I am a better person for knowing them.

If we elect you then perhaps we need a maternity ward executioner? Death panels for newborns? Get over it, that kid's medical care and surgeries were not about you.

[griz]

Heroic medicine is the descriptor assigned by my physician to extraordinary attempts to "save a life." His usage appears to be understood in the medical community without regard to the Wiki.

I never said this kid's death was about me PUNK; it's about the ignorance of people unable to make tough, well-grounded decisions.

There is no doubt in my mind that parents who subject their children to such medical treatments are guilty of felonious child abuse. Of course, the parents make these bad decisions with the very best intentions and the law supports their cowardly infliction of pain and suffering on these helpless children.

I am so happy that you think the opportunity to know your two cousins is worth their suffering. You are one heartless, selfish, son of a bitch.

[pUnK]

griz, on 02 May 2010 - 08:10 PM, said:

Heroic medicine is the descriptor assigned by my physician to extraordinary attempts to "save a life." His usage appears to be understood in the medical community without regard to the Wiki.

I never said this kid's death was about me PUNK; it's about the ignorance of people unable to make tough, well-grounded decisions.

There is no doubt in my mind that parents who subject their children to such medical treatments are guilty of felonious child abuse. Of course, the parents make these bad decisions with the very best intentions and the law supports their cowardly infliction of pain and suffering on these helpless children.

I am so happy that you think the opportunity to know your two cousins is worth their suffering. You are one heartless, selfish, son of a bitch.

Oh but it is about you because of your perception of people's 'ignorance' in refusing to make a decision to let their child die. You call ME heartless and selfish and a son of a bitch? Tell me about 'selfish' since you are the one that brought up the cost of this kid's surgery on society. Are your tax dollars better spent on cluster bombs? On building yet still more federal prisons? Did you see the disgusting expose' on the treatment of such children in Belarus? Did you? Of course you didn't because you don't care enough to educate yourself about how those kids can lay for years and years because their society has adopted your view of a medical hands off. Nice. That's what we want to be as a society isn't it?

You call me heartless when YOU are the one who wanted the kid to die or would have never chosen for him to have a chance to live. You don't know my cousins, sir, so don't you pretend to act like you know anything about their quality of life. My younger cousin is college educated despite his spina bifida...but I suppose you consider his being confined to a wheelchair as a result of being born with the MOST COMMON permanently disabling birth defect to make him unworthy of that chance. Do you know that 80% of children born with spina bifida have at least normal intelligence? No, of course you didn't because you assume that anyone with spina bifida leads a miserable, tortured and painful existence. And you are wrong.

Temper back your comments and meditate on your own issues. Your comments are beneath being worthy of acknowledgment and now that I have kicked your dirt off of my shoe, I am going to go check on my son who was saved by the usage of 'heroic efforts' (the correct term).

[Max Power]

griz, on 02 May 2010 - 08:10 PM, said:

Heroic medicine is the descriptor assigned by my physician to extraordinary attempts to "save a life." His usage appears to be understood in the medical community without regard to the Wiki.

I never said this kid's death was about me PUNK; it's about the ignorance of people unable to make tough, well-grounded decisions.

There is no doubt in my mind that parents who subject their children to such medical treatments are guilty of felonious child abuse. Of course, the parents make these bad decisions with the very best intentions and the law supports their cowardly infliction of pain and suffering on these helpless children.

I am so happy that you think the opportunity to know your two cousins is worth their suffering. You are one heartless, selfish, son of a bitch.

Wow, that is really fucking rich. What the fuck is wrong with you?

I agree that medical care doesn't have the checks and balances that it should when it comes to costs, and our society values life above all else, including costs, but really, where do you get off addressing someone like that?

Way to take a somewhat reasonable point and turn into into a "Griz" moment. Get the fuck over yourself.

[Prizetek]

pUnK, on 02 May 2010 - 06:20 PM, said:

Get over it, that kid's medical care and surgeries were not about you.

Wrong.

Griz and the rest of us in society absorbed those costs.

I do not agree with Griz here, and I certainly do not approve of the tone he has taken, but . . .

As long as "the rest of us" are being forced to work and pay for these "heroic efforts" then we most certainly are involved and most certainly are entitled to state our opinions on these surgeries and lobby our elected officials accordingly.

Meanwhile . . .

I am very happy that your son survived and is thriving. To the extent that my insurance premiums or tax dollars went to help pay for any of that, then I am very glad for that, too. However, if some of those costs were born by insurance premiums paid by others and/or the government, then IMO you can and should be thankful to the rest of society for making that possible.

[Breedy]

How much exactly do you think that YOU were out of pocket? Did this boy's or one else surgeries place such a financial or emotional strain on you that it wasn't worth the price of your humanity?

Where do you draw the cut off... Kids have asthma, but fuck their inhalers. Worthless, mopes should go get jobs and support themselves. Kids need glasses, lazy bastards should collect cans if they want to see. Seizure medication is a waste, because kids shaking and frying their brains cells is hilarious.

Better yet, next time you see a kid dying of cancer or laying in the burn unit have the courage in your convictions to go up to them and their families and let them know how much of a burden they are on you. Cause unitl you are ready to do that, this whole keyboard commando shit isn't flying with me.

Edited by Breedy, 04 May 2010 - 02:32 PM.

[Prizetek]

Breedy, on 04 May 2010 - 02:31 PM, said:

How much exactly do you think that YOU were out of pocket? Did this boy's or one else surgeries place such a financial or emotional strain on you that it wasn't worth the price of your humanity?

Where do you draw the cut off... Kids have asthma, but fuck their inhalers. Worthless, mopes should go get jobs and support themselves. Kids need glasses, lazy bastards should collect cans if they want to see. Seizure medication is a waste, because kids shaking and frying their brains cells is hilarious.

Better yet, next time you see a kid dying of cancer or laying in the burn unit have the courage in your convictions to go up to them and their families and let them know how much of a burden they are on you. Cause unitl you are ready to do that, this whole keyboard commando shit isn't flying with me.

1) The thread is about extraordinary (and extraordinarily expensive) measures. Not asthma inhalers or glasses.



2) Please send me a dime. And help me pass a law requiring that everyone else in America send me a dime. It would make me very happy, and it would not "place such a financial or emotional strain on you that it wasn't worth the price of" my happiness.

3) I can't remember the last time I was in a cancer ward or burn unit. Oh, wait, yes I can. Never. But I do know that there is a time and place for everything - something you apparently have not yet learned.

4) How about the flip side?

Instead of paying for expensive medical procedures of questionable social value through income tax confiscation of folks' money that they never even get to see or hold, instead why don't we require folks who want these extraordinary (and extraordinarily expensive) measures taken for their family to go around and personally collect this money from their neighbors? It might make them appreciate a bit more that their decisions do impose burdens on others, and that they should be a bit more appreciative of the sacrifices that others make for them instead of acting like they are entitled to this by some God-given right. Unless of course you think that if folks are given the freedom of choice, they would refuse to cough up the coinage.

[pUnK]

Prizetek, on 04 May 2010 - 02:48 PM, said:

2) Please send me a dime. And help me pass a law requiring that everyone else in America send me a dime. It would make me very happy, and it would not "place such a financial or emotional strain on you that it wasn't worth the price of" my happiness.

3) I can't remember the last time I was in a cancer ward or burn unit. Oh, wait, yes I can. Never. But I do know that there is a time and place for everything - something you apparently have not yet learned.

4) How about the flip side?

Instead of paying for expensive medical procedures of questionable social value through income tax confiscation of folks' money that they never even get to see or hold, instead why don't we require folks who want these extraordinary (and extraordinarily expensive) measures taken for their family to go around and personally collect this money from their neighbors? It might make them appreciate a bit more that their decisions do impose burdens on others, and that they should be a bit more appreciative of the sacrifices that others make for them instead of acting like they are entitled to this by some God-given right. Unless of course you think that if folks are given the freedom of choice, they would refuse to cough up the coinage.

Yes, how about the flip side? Let's assume that those 40 surgeries cost a total of $2,000,000. That, I am sure, is on the high side but let's take it to that limit. As of today, the population of the United States is 309,201,723 . So, if all of us except for the kid and his mother were to have paid the full $2,000,000 then that amounts to a little over 6/10ths of one cent for the payment of the medical care.

Sure, we can debate about the elements of social contract theory and all of the Hobbes, Locke, Rousseau, Abraham, Moses and other notable contributors to the topic. Obviously that same argument has been going on since the days of early Greek philosophy (oi, Greece needs to re-think its policies a bit). But we have chosen that our United States of America is better than this or this . We have, as a society made that judgment call, as part of our social contract to one another, and while some may freeload on the system, my .006 of one dollar is worth avoiding what you have seen in those videos.

And, if you couldn't tell from the original Griz post, YES, there would be quite a few people who would not on their own cough up the cash to help those in need. No doubt about it.

[griz]

I wondered what it would take to put a little life in this board. I meant exactly what I said in my response to PUNK, although the tone was intended to provoke. People who have known me through CF know that this has always been my belief.

The entire situation is tragic. The difference is that right thinking people know suffering and death defines life. The ignorant masses fail to understand that the prolonged suffering initiated by misguided, cowardly decisions come from the straight from the heart of Josef Mengele.

The path my friend led her son down was inhumane, child abuse. Were I king, I'd judge it to be criminal. I feel that way about every family making such decisions for minors.

Belarus is not relevant to this conversation. I would never impose my beliefs on anyone other than my own family and I would assist my own to find a peaceful end; I would not allow them to linger unless that were their choice.

HOWEVER, Belarus may become relevant as the effects of Obamacare shape the American medical system.

[pUnK]

griz, on 04 May 2010 - 10:42 PM, said:

I meant exactly what I said in my response to PUNK, although the tone was intended to provoke.

In other words, you meant to call me "one heartless, selfish, son of a bitch." Go provoke someone with real thought provoking commentary rather than incendiary gutter insults. That may require a bit more thought but you will find the results far more fulfilling.

First and foremost is the issue that I have with your calling my mother a 'bitch'. If I am a 'son of a bitch' then my mother would have to be the bitch that gave birth to me. My mother passed away on August 31, 2009 and this coming weekend will be my first Mother's Day without her. Pretty cool of you to call her a bitch though...I will tell her that you said 'hello' when I visit the cemetery this week.

As for the heartless part, your reference as such is misguided in this instance. You projected the suffering of someone you know on to the lack of suffering of someone that I know. While I may be heartless in business, I am hardly heartless in family and personal matters.

Lastly, if you would like to join me in raising funds for the next marathon that I will run as a fundraiser for the March of Dimes then feel free to do so. After the race we can talk about who is selfish.

[Breedy]

griz, on 04 May 2010 - 10:42 PM, said:

Were I king, I'd judge it to be criminal. I feel that way about every family making such decisions for minors.

Well you are not king. If you were I think you soon find subjects holding you at daggers point over the 6/10th of a cent you were to crass to give up. What gives you the right to be king and not others? What makes your judgment so much more sound...the fact that you are willing to look past a infants pain and suffering for less than one cent?

You talk about not imposing your beliefs on others, but by soliciting opinions in a public forum that was your ultimate goal, was it not?

1) The thread is about extraordinary (and extraordinarily expensive) measures. Not asthma inhalers or glasses.

Yet extraordinary measures are being cited as the norm not the exception. Far more money is spent on "common" conditions such as the ones I mentioned when compared to the extraordinary measures that are brought up.

The simple fact is you came to a public forum stating that you are not willing to improve some quality of life, or their conceived quality of life, for the less than the amount of money that I could find in my couch cushions. Good on you for never taking the time to go visit those cold miserable souls in the childrens' cancer ward or the burn unit. Lord forbid you might discover life is more than just a spread sheet.

I won't pretend to know you or what you do for a profession, but I have been those places and am willing to bet that I, on a day to day basis have more contact and have seen more humanity from the people you seem to despise as "inhumane and cowardly" than you show anyone in your own household.

My challenge still stands, go to a cancer ward or burn unit and look a kid in the face and tell them and their families that they aren't worth a spare dime, post some pics for proof and I will send you a BBMF and a VSG ER.

Edited by Breedy, 04 May 2010 - 11:51 PM.

[Prizetek]

pUnK, on 04 May 2010 - 08:42 PM, said:

Yes, how about the flip side? Let's assume that those 40 surgeries cost a total of $2,000,000. That, I am sure, is on the high side but let's take it to that limit. As of today, the population of the United States is 309,201,723 . So, if all of us except for the kid and his mother were to have paid the full $2,000,000 then that amounts to a little over 6/10ths of one cent for the payment of the medical care.

Yes, and I am SURE this is the only case where a huge amount of money has been spent on extraordinary measures.



If only $50 billion is spent on such extraordinary measures each year across the whole country (probably a very low number) then suddenly that cost my family $500. Since you are the one advocating for this, you can e-mail me for an address where you can send me a check to reimburse me.

pUnK, on 04 May 2010 - 08:42 PM, said:

We have, as a society made that judgment call, as part of our social contract to one another, and while some may freeload on the system, my .006 of one dollar is worth avoiding what you have seen in those videos.

And as a society we may reevaluate that judgment call if enough people disagree with it. THAT is what this thread is about. Sounds like you aren't too happy that some folks may want to reevaluate that. I seriously doubt that every time society has made a "judgment call" that you don't like or agree with that you just accept it as a settled matter, like you are trying to argue that griz should do here. 250 years ago society had made a "judgment call" that it was Ok to enslave black folks. Fifty years ago, society had made a "judgment call" that homosexuality was unacceptrable and criminalized it. We change our "judgment calls" all the damn time. Maybe it is a good time to reevaluate this one. Deal with it.

BTW, the phrase "social contract" is mere propaganda. A contract is a voluntary agreement between people. I never agreed to any such "social contract." Your so-called social contract is more accurately called a "social dictate."

pUnK, on 04 May 2010 - 08:42 PM, said:

And, if you couldn't tell from the original Griz post, YES, there would be quite a few people who would not on their own cough up the cash to help those in need. No doubt about it.

I guess those folks didn't agree to your "social contract" either.

Doesn't sound much like freedom to me.

Edited by Prizetek, 05 May 2010 - 06:59 AM.

[Prizetek]

Breedy, on 04 May 2010 - 11:41 PM, said:

What gives you the right to be king and not others?

Where did he said that he had the RIGHT to be king?

He said "if."

It's called a "premise." Look it up.

Breedy, on 04 May 2010 - 11:41 PM, said:

You talk about not imposing your beliefs on others, but by soliciting opinions in a public forum that was your ultimate goal, was it not?

No.

It is sad that you cannot understand that.

Breedy, on 04 May 2010 - 11:41 PM, said:

Yet extraordinary measures are being cited as the norm not the exception.

Where did anyone do that?

I think it is implicit in the phase "EXTRAORDINARY measures" that it is exceptional, not normal.

Breedy, on 04 May 2010 - 11:41 PM, said:

The simple fact is you came to a public forum stating that you are not willing to improve some quality of life, or their conceived quality of life, for the less than the amount of money that I could find in my couch cushions.

There are six billion folks on this planet, including so many impoverished and sick children.

Surely the kid in griz' story is not more deserving than each and every one of these poor and sick children in Haiti, in Sudan, in Bangladesh . . .

Don't they all also each deserve the same six-tenths of a cent???

For each of those kids we could "improve some quality of life, or their conceived (sic) quality of life" if everyone would only chip in six-tenths of a cent each.

How could anyone be so heartless as to not surrender six-tenths of a cent for each and every one of these needy and deserving children??

And if there were only a hundred million of them, then six-tenths of a cent per kid will only cost each of us $600,000.

What - you don't want to spend $600,000.00???

How can you deny food, shelter, and quality care tyo any of these kids when it only costs you six-tenths of a cent???

Cold-hearted bastard!!!

Breedy, on 04 May 2010 - 11:41 PM, said:

My challenge still stands, go to a cancer ward or burn unit and look a kid in the face and tell them and their families that they aren't worth a spare dime, post some pics for proof and I will send you a BBMF and a VSG ER.

And I challenge YOU to go to each and every cancer ward and burn unit on the planet and give a dime to each and every patient you find there.

Better bring a really big coin purse.

[Breedy]

Must be really nice dealing in a world of absolutes. It is a given fact that you can not help everyone, I don't think anyone is arguing that.

So by your logic you shouldn't help anyone if you can't help everyone? You fix the problems you can. If you can't see that then no point in continuing the debate.

I don't know how "Obama-care" is even an issue here by the by...I would think that his roving band of death squads would have eliminate some of the older more burdensome members of society now...

Edited by Breedy, 05 May 2010 - 08:43 AM.

[pUnK]

Prizetek, on 05 May 2010 - 06:57 AM, said:

If only $50 billion is spent on such extraordinary measures each year across the whole country (probably a very low number) then suddenly that cost my family $500. Since you are the one advocating for this, you can e-mail me for an address where you can send me a check to reimburse me.

Your unrepentent greed is impressive. I am going to send you jack shit since I owe you nothing. I pay my taxes too. That $500 that is taken from your family, according to your math, was your contribution to eliminate the United States from having conditions such as those shown in the two videos that I linked. Of course, my math should reflect that the .6 cents you paid for the medical care of that one kid was spread over 28 years for an actual yearly contribution to him of .0002142 per year coming from you toward his care.

Do you think the kids in those videos are treated fairly? Do you want that kind of treatment to be the norm for disabled children in our society? Do you realize that conditions such as those would happen here in our backyard if it were not for governmental assistance? You have not addressed those questions and appear to be very willing to allow for those kids to suffer endlessly through the pain of no medical relief. Am I wrong in that assessment? Charity does not rise to the level of government programming and while that is a sad truth, it is none the less a truth. We are not talking about all of the kids in Haiti, Bangladesh or elsewhere, we are talking about kids here. Frankly, if you were to challenge foreign aid then I would be right there with you. We have problems of our own and we need to address those rather than the problems of someone else. To the extent your $500 goes overseas, you may have a point but we are talking about that money staying home. There are not 100,000,000 kids that we are talking about.

Your speaking of hating taxes is admirable. I think we all hate taxes. That being said, you cannot ignore the fact that you do derive benefit from the taxes that you pay. Social Contract theory is an entire segment of Political Science study which I neither invented nor gave a name. That being said, you would be hard pressed to find any nation in the world that does not have a social contract among citizens or, if you were to find one, you would likely not want to live there. Perhaps part of the issue is that none of us like the entire contract that we have with our nation but I do not see many of us heading to other countries to get away from here. My guess is that few leave because this is among the very best places in the world to live and I submit to you that the reason this is among the best places to live is that we do not treat our citizens the way that those kids in the videos are treated.

[griz]

Prizetek, on 05 May 2010 - 06:57 AM, said:

And as a society we may reevaluate that judgment call if enough people disagree with it. THAT is what this thread is about. Sounds like you aren't too happy that some folks may want to reevaluate that. I seriously doubt that every time society has made a "judgment call" that you don't like or agree with that you just accept it as a settled matter, like you are trying to argue that griz should do here. 250 years ago society had made a "judgment call" that it was Ok to enslave black folks. Fifty years ago, society had made a "judgment call" that homosexuality was unacceptrable and criminalized it. We change our "judgment calls" all the damn time. Maybe it is a good time to reevaluate this one. Deal with it.

BTW, the phrase "social contract" is mere propaganda. A contract is a voluntary agreement between people. I never agreed to any such "social contract." Your so-called social contract is more accurately called a "social dictate."

I am amazed. Thank you Prizetek, it is good to know that at least one person has the gray matter to understand my point.

I have tremendous sorrow for my friend because she knows the price her son paid for her decision to listen to the doctors, the preachers, the family, society and the we can save the baby monsters; it will haunt her for the rest of her days.

This issue is not just about debilitating juvenile diseases & defects, it bears on all of us; it might be a terrible traffic accident where they save us for a life of twitching, drooling and shitting ourselves; or maybe it's a terribly slow cancer that tortures us with continuous pain while our family watches us rot before their very eyes.

My wishes are well documented for my doctors; a like-minded friend is authorized to make the call over the wishes of my family when the day comes for me.

This is not really about money, but rather about facing your responsibility as a man.

Considerable outrage was fostered by the political discussion of death panels, but doctors are well-trained to manage "death panels;" it is better known in the medical profession as triage. There may be a few guys on this board who are alive today because of "death panels" in the military hospitals during Vietnam. These sorts of tough decisions are not just for the battlefield, although the feeble-minded do all sorts of mental gymnastics to make such decisions palatable...and honorable under those circumstances.

Ultimately it becomes a matter of resources and promises to make Obamacare very interesting when the money runs out...and it will.

[Breedy]

griz, on 06 May 2010 - 12:18 AM, said:

Ultimately it becomes a matter of resources and promises to make Obamacare very interesting when the money runs out...and it will.

Weren't the likes of Glenn Beck telling seniors that Obamacare death panels would be making the rounds and killing them if health care passed? By either out right killing (which was some what implied) or by not covering certain procedures and medicines the older population would die at a younger age, thus decreasing the total drain on the system.

So according to you, Obamacare will only kill the elderly, yet provide continued and improved benefits for "baby monster" as you put it?

Of course since you have grey matter, you might realize that your friend is going thru various stages of grief. Right now she may regret the decisions that she and her son made, but only time will tell her true feelings.

Edited to add

I am not sure how or why you think referencing trauma triage has any bearing on the discussion at hand. Triage is about the expedience of care given a fix amount of assets in difficult situations. Not about withholding care when it could be provided.

Edited by Breedy, 07 May 2010 - 09:07 AM.

[griz]

Breedy, on 07 May 2010 - 08:56 AM, said:

So according to you, Obamacare will only kill the elderly, yet provide continued and improved benefits for "baby monster" as you put it?

I certainly didn't say or imply that in this post; you must have a reading deficiency.

Breedy, on 07 May 2010 - 08:56 AM, said:

I am not sure how or why you think referencing trauma triage has any bearing on the discussion at hand. Triage is about the expedience of care given a fix amount of assets in difficult situations. Not about withholding care when it could be provided.

I'm afraid your understanding of triage is flawed. Triage is used every day in big cities to provide treatment to those who need it first and have a reasonable prospect of survival compared to another person in dire straits. Care is often denied or significantly delayed in over-burdened facilities based on need for care and likelihood of survival. It is a delicate balancing act. Doctors and support staff do a tremendous job 99% of the time. ...but make no mistake, they are denying care and in some cases they deny care to people whose life is in jeopardy because there are others in need of care with a better chance of survival. Big city medical facilities can have battlefield like conditions frequently.

Your correct that triage is not about withholding care. However, if you take available resources to treat a person with a high prospect of survival rather than treat a person in more urgent need of care with a small prospect of survival, you have withheld needed medical treatment.



Would you like me to recommend someone for remedial reading instruction?

[Pete]

pUnK, on 04 May 2010 - 08:42 PM, said:

Yes, how about the flip side? Let's assume that those 40 surgeries cost a total of $2,000,000. That, I am sure, is on the high side but let's take it to that limit. As of today, the population of the United States is 309,201,723 . So, if all of us except for the kid and his mother were to have paid the full $2,000,000 then that amounts to a little over 6/10ths of one cent for the payment of the medical care.

Valid point albeit simplified. It also speaks directly to the problem. My guess is most of the citizenship of the US would agree to fund a case like this without much forethought. However in fairness to the issue you have to continue the thought process. Out of the rest of the 309+ million people you have many, many more that use/abuse the system. I work in the ER at a local trauma center and on a fire department. Every shift, in either setting, we haul/treat numerous people who use the ambulance as a cab and the ER as a clinic. No insurance and no way (or intention at least) to pay. Many of these people use both systems, EMS and hospital ER, on a regular basis and when you start adding up the costs of them, as well as your above theory, the out of pocket cost begins to multiply. Conversely I pay my co-pay at my clinic when I go.

Add to that the cost of living outside the realm of medical care. Stadium taxes, escalating fuel and grocery costs, propery taxes that hinge on so many local community programs that your dollar is even smaller. Don't get me wrong here. Philanthropy is/can be an admirable thing. But personally I'd prefer to choose my own charitable giving rather than have more people pick away at it.

Triage, by the way, is about rating severity. Lumping triage in with withholding medical care is a slippery slope. The average wait time in an ER is around 3 1/2 hours. While that is a long time in and of itself it is largely because of the people mentioned above. If you have a sore back you can probably expect to wait even longer but eventually you will be treated in the hospital in which I work. Things may be handled differently in Cook County or Bellvue, I don't know. But I do know that our Governor Tim Pawlenty, and you will meet him too when he makes his bid for POTUS, addressed the state and made it clear that if you feel you need medical care, get it. Try a clinic or go the a hospital. If you need a ride call an ambulance. If you can't pay the bill don't worry about it. Thanks Tim. Just another perspective on why this is the issue that it is.

[griz]

Your point about the breadth of resource consumption is well-made, Pete. As you consider that and all of the other ways resources are consumed in less than optimum fashion, it makes the matter of triage more significant.

Pete, on 13 May 2010 - 07:47 PM, said:

Triage, by the way, is about rating severity. Lumping triage in with withholding medical care is a slippery slope.

I understand that you work in the medical profession, but it is a bit disingenuous to describe triage as simply a rating system. There's a further evaluation that is an integral part of it. You tell me:

Patient A is in terrible shape with a 10% chance of survival;
Patient B is in terrible shape with a 60% chance of survival...

Which one gets treated first?

In fact, it goes beyond that; Patient C who is in very bad, but not terrible shape and has an excellent chance of survival may even get treatment before Patient A based on the available resources of the medical facility at a given moment.

The intention is not to withhold care from a person in need, but the bottom line is that care is withheld from one patient with a small chance of survival in order to be able to treat another with a much better prospect of survival.

In ideal circumstances the "withholding care" part is not life threatening; but as circumstances worsen (in terms of available resources - docs, nurses, facilities, meds, time) the prospect of treating one before another based on the triage evaluation may have dire consequences.

Don't paint a rosy picture of it; the job is a terrible responsibility for mere mortals. The medical staff responsible for triage makes life & death decisions in split seconds and often with only the most elementary data to support their decisions; I would not want that responsibility. Fortunately, our medical infrastructure is usually sound enough to navigate past extreme triage conditions more often than not. ...but fiddle with a basically sound health care system and the chances are you are going to break it not improve it.

[Pete]

griz, on 14 May 2010 - 12:07 AM, said:

Your point about the breadth of resource consumption is well-made, Pete. As you consider that and all of the other ways resources are consumed in less than optimum fashion, it makes the matter of triage more significant.



I understand that you work in the medical profession, but it is a bit disingenuous to describe triage as simply a rating system. There's a further evaluation that is an integral part of it. You tell me:

Patient A is in terrible shape with a 10% chance of survival;
Patient B is in terrible shape with a 60% chance of survival...

Which one gets treated first?

In fact, it goes beyond that; Patient C who is in very bad, but not terrible shape and has an excellent chance of survival may even get treatment before Patient A based on the available resources of the medical facility at a given moment.

The intention is not to withhold care from a person in need, but the bottom line is that care is withheld from one patient with a small chance of survival in order to be able to treat another with a much better prospect of survival.

In ideal circumstances the "withholding care" part is not life threatening; but as circumstances worsen (in terms of available resources - docs, nurses, facilities, meds, time) the prospect of treating one before another based on the triage evaluation may have dire consequences.

Don't paint a rosy picture of it; the job is a terrible responsibility for mere mortals. The medical staff responsible for triage makes life & death decisions in split seconds and often with only the most elementary data to support their decisions; I would not want that responsibility. Fortunately, our medical infrastructure is usually sound enough to navigate past extreme triage conditions more often than not. ...but fiddle with a basically sound health care system and the chances are you are going to break it not improve it.

Griz I think we're probably just talking semantic's here. I didn't mean to infer that triage is simply rating. In fact you are absolutely correct to say that it is the foundation for the continuing care that you described. As an oversimplified example we train for mass casualty incidents using START. In this process the injured are triaged from least to worst.. In any given scenario someone can still be alive but meet the criteria for 'unsalvageable' and passed by. Or left to die as it were. While that is just a microcosm of your post, it is still a glimpse of how it works. It is not a rosy picture at all.

And to address your question more directly, Pt A would be treated first if he came in first. This is assuming both patients have incredibly similar circumstances. The water gets muddy when you factor the human component of past history, family history, past court rulings, ethics and morals, pt insurance and the fact that pt outcomes cannot be that clearly defined. (However I understand your point in the purpose of this thread.) That also speaks to withholding care which is where we are probably just talking semantics. To that end when you say 'withholding care' it means 'not providing care when you can' to me. That is very different than delaying care since in your scenario it would be Pt B or C, then C or B with A left to hospice which is still a form of care. Believe me I wish things were that simple. And trust me, I'm not disingenuous on this issue at all. One of my jobs in the ER is triage. Specifically, I am the first person to initially assess all non-ambulance pt's coming into the ER for treatment.

[griz]

Pete, on 14 May 2010 - 09:40 AM, said:

I am the first person to initially assess all non-ambulance pt's coming into the ER for treatment.

You couldn't give me your job at double your pay!


We are aligned other than terminology it seems.

[AmbassadorMark]

pUnK, on 04 May 2010 - 08:42 PM, said:

Yes, how about the flip side? Let's assume that those 40 surgeries cost a total of $2,000,000. That, I am sure, is on the high side but let's take it to that limit. As of today, the population of the United States is 309,201,723 . So, if all of us except for the kid and his mother were to have paid the full $2,000,000 then that amounts to a little over 6/10ths of one cent for the payment of the medical care.

Sure, we can debate about the elements of social contract theory and all of the Hobbes, Locke, Rousseau, Abraham, Moses and other notable contributors to the topic. Obviously that same argument has been going on since the days of early Greek philosophy (oi, Greece needs to re-think its policies a bit). But we have chosen that our United States of America is better than this or this . We have, as a society made that judgment call, as part of our social contract to one another, and while some may freeload on the system, my .006 of one dollar is worth avoiding what you have seen in those videos.

And, if you couldn't tell from the original Griz post, YES, there would be quite a few people who would not on their own cough up the cash to help those in need. No doubt about it.

Sadly, you're missing the point. If it were only that one child, spreading that $2M medical bill over 300 Million people would be irrelevant. But when you take 100,000 children like that, at $2M each, different story. If you need, I can do that math for you. I'm not stating this to say I disagree with having invested that money to save a life but frankly, you're attempt at creating an analogy to minimize the cost was lame at best. If you're going to try a debate something, at least make some reasonable attempt at doing so in an intelligent fashion.

[pUnK]

AmbassadorMark, on 14 May 2010 - 05:36 PM, said:

Sadly, you're missing the point. If it were only that one child, spreading that $2M medical bill over 300 Million people would be irrelevant. But when you take 100,000 children like that, at $2M each, different story. If you need, I can do that math for you. I'm not stating this to say I disagree with having invested that money to save a life but frankly, you're attempt at creating an analogy to minimize the cost was lame at best. If you're going to try a debate something, at least make some reasonable attempt at doing so in an intelligent fashion.

Settle down, Mark. Before you go criticizing the intelligence of anything, you need to review the scope of the issue presented. Your expansion of the issue presented is an amazing stretch that requires far far more analysis and development than can be had within this medium of communication.

Recall that this thread was in discussion of one kid's surgeries estimated at a grossly high amount per surgery over a 28 year time frame. The OP essentially set forward that kids born with spina bifida are not worth ANY kind of medical assistance. Given that you also have not seen fit to tell us what you would do in order to address the kids in the videos that I posted, I can at least enlighten you as to the scope of the issue. Currently 1 of every 2,000 kids born in the United States is born with spina bifida. Recent births in the United States have run at about 4.2 milllion kids per year. I will do some math for you: 4,200,000 divided by 2,000 is 2100 per year. So, your exaggeration of my numbers related to spina bifida kids by using a figure like "100,000 children" is an exaggeration by a huge multiple. Now we can get into things like mortality rates for spina bifida kids, average medical costs for those kids and determination of those that are on private insurance versus Medicaid but that is really more of a doctoral level study than cigar forum discussion.

Also, I hope you do realize how overstated the $2,000,000 figure for the medical care is. If you need some math on that then just feel free to let me do math for you based on average costs for kids on Medicaid. This thread is NOT about a break down of the federal Medicaid budget to a per person figure and my comments here have never been directed to that point. Do not make things what they are not.

[Pete]

griz, on 14 May 2010 - 03:01 PM, said:

You couldn't give me your job at double your pay!


We are aligned other than terminology it seems.

Absolutely we are, thank you. I would also like to point out I added my job description as a point of information and nothing more. I wish you were in charge of my pay. And it's not as impressive, for lack of a better term, as it may sound. Certainly it has its moments, but considering I have been doing both for quite some time those moments are less frequent.

[Tech]

Pete, on 15 May 2010 - 05:49 AM, said:

Absolutely we are, thank you. I would also like to point out I added my job description as a point of information and nothing more. I wish you were in charge of my pay. And it's not as impressive, for lack of a better term, as it may sound. Certainly it has its moments, but considering I have been doing both for quite some time those moments are less frequent.

Can I slip you a twenty to move to the front of the line like a matrade?

[Pete]

Tech, on 15 May 2010 - 08:29 AM, said:

Can I slip you a twenty to move to the front of the line like a matrade?

Money talks, bullshit walks.

[Breedy]

Griz, what sort of medical qualifications do you hold for you make your claims? Do you work in an ER, have you ever worked in the medical field, have you ever done triage?

As far as the reference to START Triage (Simple Triage And Rapid Treatment), the statement was erroneous. Only one thing makes some one "expectant" or "black tagged", which means they are passed by, that is NOT BREATHING. Aside from that, any other major injury regardless of severity or probable outcome is tagged as immediate.

Let me run a scenario by you to make sure I am understanding you correctly, what with my reading deficiency and all.

" A drunk driver strikes the car that your Wife/Son/Daughter is in, critically injuring your family member and themselves. Your Wife/Son/Daughter arrives at the ER first, owing to the fact the were ejected from the car. The ER Doctors begin to treat your family member but realize they only have a 5% chance of survival. In the meantime the local Fire Department extricates the drunk driver from his vehicle and bring him to the same facility that is treating your Wife/Son/Daughter. During his assessment it is found that although critically injured as well, he has a 60% chance of survival."

So in that situation, would you be alright with the Hospital Staff devoting more time and effort to save the man who has all but killed your loved one?

Edited by Breedy, 16 May 2010 - 04:41 PM.

[griz]

Breedy, on 16 May 2010 - 04:13 PM, said:

Do you work in an ER, have you ever worked in the medical field, have you ever done triage?

I've worked in an ER quite a bit in a number of roles, never medical roles. I've worked in the medical field in a number of capacities, usually providing technical training for blood gas analyzers, spec cameras, centrifuges, misc biotech equipment/agents and such. I have never done triage.

Breedy, on 16 May 2010 - 04:13 PM, said:

As far as the reference to START Triage (Simple Triage And Rapid Treatment), the statement was erroneous.

There have been absolutely no references made by me to the START protocol which is designed for the people responding to the scene of an accident with multiple, severe injuries.

I was involved in the development of one of the early trauma databases (1986) used by EMS services in the US, so this subject matter was constantly in play during the development of the db and the UI.

You really should look into remedial reading classes.

Breedy, on 16 May 2010 - 04:13 PM, said:

So in that situation, would you be alright with the Hospital Staff devoting more time and effort to save the man who has all but killed your loved one?

A bullet in the drunk's head would "black tag" him so your point is irrelevant. However, to answer your question, I would not be "alright with it" but I would understand and accept it as best I could while under such extreme stress. You don't have to like what has to be done; if it has to be done, you have to accept it and not obstruct it. ...anything less is cowardice.

You clearly haven't come to terms with the facts of life, have you.

[Stormin']

griz, on 16 May 2010 - 10:03 PM, said:

I've worked in an ER quite a bit in a number of roles, never medical roles. I've worked in the medical field in a number of capacities, usually providing technical training for blood gas analyzers, spec cameras, centrifuges, misc biotech equipment/agents and such. I have never done triage.

In other words a sales rep. Walking by the ER on the way to the lab isn't the same as working in an ER.

griz, on 16 May 2010 - 10:03 PM, said:

A bullet in the drunk's head would "black tag" him so your point is irrelevant.

Are there any of your threads that don't eventually come down to you stating the answer is a bullet in someone's head?


I have to ask: How many jobs have you had?! Reporter, database developer, sales rep... I have a feeling it takes about a year before your employers realize you are a narcissistic sociopath and let you go.

[Max Power]

Stormin', on 17 May 2010 - 08:30 AM, said:

In other words a sales rep. Walking by the ER on the way to the lab isn't the same as working in an ER.


Are there any of your threads that don't eventually come down to you stating the answer is a bullet in someone's head?


I have to ask: How many jobs have you had?! Reporter, database developer, sales rep... I have a feeling it takes about a year before your employers realize you are a narcissistic sociopath and let you go.

Careful Norm, he will accuse you of having a huge ego and a small penis!

[griz]

Stormin', on 17 May 2010 - 08:30 AM, said:

In other words a sales rep. Walking by the ER on the way to the lab isn't the same as working in an ER.

Never been a sales rep. You should stick to comments you know something about...like sucking cock clean after a trip down the chocolate express.

Stormin', on 17 May 2010 - 08:30 AM, said:

Are there any of your threads that don't eventually come down to you stating the answer is a bullet in someone's head?

The comment suited the ignorant scenario created by the reading impaired previous poster.

Stormin', on 17 May 2010 - 08:30 AM, said:

I have a feeling it takes about a year before your employers realize you are a narcissistic sociopath and let you go.

Never been fired from a non-broadcast job; never been a sales rep; never said I was a database developer. I said I was involved in developing the one of the first trauma databases, I developed the medical content.

You need an emergency brain transplant, you are beyond the reach of a remedial reading class.

[GTU]

One of first sane things I've heard from griz in a long time. We often think medicine can fix everything, even when there are times it both can't and shouldn't. Now, I don't think such decisions should exclude family wishes, but I don't think the family gets ALL the say in the decision. After all, it is rarely just their money paying for it, and often those resources would be better used with other patients. I think one of the big problems is most physicians are such utter wimps that they won't even discuss the issue with the family, but choose to fall back to the "do nothing, it is easier, and I still get paid" mentality. We wast hundreds of billions EVERY year on this problem.