Just how much is 30,000 pounds in US dollars? Basic programmers wanna know.
seasoned_geek
Simon Clubley
> http://dandyproject.co.uk/job-148219-hp-basic-for-openvms-bradford-30-000-yorkshire-s1
>
About 46000 - 48000 USD.
Two things:
1) We don't have to worry about health insurance in this country.
2) Bradford has lower living costs than, say, London.
It says the job is no longer available when I visit the site, so I cannot
read the description, but I would consider that to be a mostly ok salary
for a standard programmer in that part of Yorkshire.
Simon.
--
Simon Clubley, clubley@remove_me.eisner.decus.org-Earth.UFP
Microsoft: Bringing you 1980s technology to a 21st century world
Jan-Erik Soderholm
> http://dandyproject.co.uk/job-148219-hp-basic-for-openvms-bradford-30-000-yorkshire-s1
>
> Just how much is 30,000 pounds in US dollars?
> Basic programmers wanna know.
According to http://www.xe.com/ucc/, aprox $47.500 USD.
Richard Maher
"Simon Clubley" <clubley@remove_me.eisner.decus.org-Earth.UFP> wrote in
message news:ihnjs8$uvu$1...@news.eternal-september.org...
> On 2011-01-25, seasoned_geek <rol...@logikalsolutions.com> wrote:
>> http://dandyproject.co.uk/job-148219-hp-basic-for-openvms-bradford-30-000-yorkshire-s1
>>
>
> About 46000 - 48000 USD.
>
> Two things:
>
> 1) We don't have to worry about health insurance in this country.
As long as you're not too fussed about when or how you get treated.
(Although my experiences with Kingston hospital and teh NHS in general were
very good)
>
> 2) Bradford has lower living costs than, say, London.
That's because Yorkshire people are incredibly tight and keep the prices
down :-) Could be Yorkshire Water advertising again?
Better beer and much cheaper than London. (But as I'm currently paying twice
as much for a pint as you would in The City you should all count yourselves
lucky)
>
> It says the job is no longer available when I visit the site, so I cannot
> read the description, but I would consider that to be a mostly ok salary
> for a standard programmer in that part of Yorkshire.
>
> Simon.
Cheers Richard Maher
PS. Maybe the Bradford demographic would interest Roland :-)
Phillip Helbig---undress to reply
<mahe...@hotspamnotmail.com> writes:
> > 1) We don't have to worry about health insurance in this country.
>
> (Although my experiences with Kingston hospital and teh NHS in general
> were very good)
I know someone in the UK who has been waiting for a few years for a kidney
transplant. He said that he was happy with the NHS and that they were
doing all they could for him. (As with all transplants, it is a matter
of luck when a matching organ becomes available.)
While some other aspects of it were over the top (as with some of his
other films), Michael Moore's visit to an English hospital was quite
objective (and, to US viewers, perhaps revealing). A conservative
blogger once wrote something like "Stephen Hawking would be dead if he
lived in England". Hawking responded with a statement that he had lived
in England all his life and was happy with NHS treatment. Touché. In
such discussions, one has to agree on at least basic, verifiable facts.
Dave
undress to reply) wrote:
> In article <ihnn1a$bq...@speranza.aioe.org>, "Richard Maher"
I agree with Philip. Most people's knowledge of "Socialized"
medicine is based on what they have read, seen or been told. And
of course, that then depends on What they read, What they watch, and
Who they listen too, i.e. their political inclination. I hear
endless tales about how "terrible" things are over there, however very
few speak from experience, mostly it comes back to the above, i.e.
"What they read, What... etc."
I have lived and worked in the US for over 20 years, so I can
comfortably speak about both systems.
Frankly, it depresses me the way that the US system is constantly
referred to as "the best HC in the world", and the way this is
believed/accepted, without any supporting evidence, and contrary to
just about every metric that is measured. Being the most expensive
does not equate to being the best.
It is always possible to come up with individual cases to support
whatever point of view you wish to propose, and if the truth was
told, over all there is probably little difference in the quality of
healthcare provided. The main difference is that, although any
given ailment may lead to your death, in the socialized system your
death is usually because your body cant support life anymore. In
the US system, it is often because the Insurance companies decide that
you are too expensive to live.
In the recent debate about healthcare, a big deal was made out of the
prospect of "Death Panels", (i.e. lets scare Grandma). We already
live with death panels, they are called insurance companies.
And just for the record, I have a family member (US citizen) who has
been on the waiting list for a lung transplant for over 4 months.
She probably has a couple of months left in her life. So waiting
lists are not something reserved for "those nasty Socialists".
And by the way, many European nations are NOT Socialist, but they
still manage to have National Healthcare for all.
Phillip Helbig---undress to reply
<a50a23ea-a9c2-4cb6...@h17g2000pre.googlegroups.com>,
Dave <Bax...@tessco.com> writes:
> I agree with Philip. Most people's knowledge of "Socialized"
> medicine is based on what they have read, seen or been told. And
> of course, that then depends on What they read, What they watch, and
> Who they listen too, i.e. their political inclination. I hear
> endless tales about how "terrible" things are over there, however very
> few speak from experience, mostly it comes back to the above, i.e.
> "What they read, What... etc."
The idea with any insurance, of course, is that one pays a small amount
in regularly and most people end up paying more than they get out of it.
The unlucky ones, though, don't have to worry about costs. For years, I
paid in more than I used, until I got cancer. I'm going back for a
regular checkup next week; everything seems OK (the last chemotherapy
was more than 2 years ago). The treatment was good, and I wouldn't have
gotten any different treatment had I been insured otherwise or paid
everything in cash. (Farrah Fawcett came to the same hospital, the
university hospital in Frankfurt, in a last-ditch effort to avoid dying,
but it was too late.)
> I have lived and worked in the US for over 20 years, so I can
> comfortably speak about both systems.
Right. I've lived 18� years in the US and 27� in Germany (with stints
of a couple of years each in the UK and the Netherlands as well as
making use of public healthcare in Sweden when my son fell down a
mountain and in Spain when another son was born prematurely---there is a
deal within the EU that those insured in one country get coverage in
another country for up to 6 weeks a year, i.e. normal holiday time).
> Frankly, it depresses me the way that the US system is constantly
> referred to as "the best HC in the world", and the way this is
> believed/accepted, without any supporting evidence, and contrary to
> just about every metric that is measured. Being the most expensive
> does not equate to being the best.
It is definitely the most expensive. As for quality, one statistic I
saw had it placed about the same as Slovenia---not third-world quality,
by any means, but not at the top either. However, the average quality
is not the only important thing---that can be achieved by having
excellent quality for some and none at all for others.
> It is always possible to come up with individual cases to support
> whatever point of view you wish to propose, and if the truth was
> told, over all there is probably little difference in the quality of
> healthcare provided. The main difference is that, although any
> given ailment may lead to your death, in the socialized system your
> death is usually because your body cant support life anymore. In
> the US system, it is often because the Insurance companies decide that
> you are too expensive to live.
This is the main difference. Public health-care systems in Europe must
accept everyone and there is no difference in fee based on state of
health (but there might be based on income). (This was originally due,
a long time ago, to the main expense of the health insurers being paying
out substitute salaries for people too ill to work, in which case it
makes sense to have it follow the salary, like retirement or
unemployment income. These days, this aspect still exists but is
relatively less important and the main effect is to have premiums which
everyone can pay, i.e. a fixed percentage (with a cap in some
countries), although other countries go the more logical route and just
pay it out of tax.)
> In the recent debate about healthcare, a big deal was made out of the
> prospect of "Death Panels", (i.e. lets scare Grandma). We already
> live with death panels, they are called insurance companies.
Indeed.
> And just for the record, I have a family member (US citizen) who has
> been on the waiting list for a lung transplant for over 4 months.
> She probably has a couple of months left in her life. So waiting
> lists are not something reserved for "those nasty Socialists".
> And by the way, many European nations are NOT Socialist, but they
> still manage to have National Healthcare for all.
Right. Even the conservative parties here wouldn't dream of abolishing
a system far to the "left" of Obama's most optimistic plans.
Paul Sture
"Richard Maher" <mahe...@hotspamnotmail.com> wrote:
> That's because Yorkshire people are incredibly tight and keep the prices
> down :-) Could be Yorkshire Water advertising again?
>
> Better beer and much cheaper than London. (But as I'm currently paying twice
> as much for a pint as you would in The City you should all count yourselves
> lucky)
I started my career in Yorkshire and at that time was definitely
attracted by the salaries in London. When I went into the higher cost
of living in the SE, those salaries really didn't look so attractive any
more.
> PS. Maybe the Bradford demographic would interest Roland :-)
A history of bad press, Compare the statistics with Leicester. Or
London for that matter ;-)
--
Paul Sture
Paul Sture
Simon Clubley <clubley@remove_me.eisner.decus.org-Earth.UFP> wrote:
> On 2011-01-25, seasoned_geek <rol...@logikalsolutions.com> wrote:
> > http://dandyproject.co.uk/job-148219-hp-basic-for-openvms-bradford-30-000-yo
> > rkshire-s1
> >
>
> About 46000 - 48000 USD.
>
> Two things:
>
> 1) We don't have to worry about health insurance in this country.
>
> 2) Bradford has lower living costs than, say, London.
>
> It says the job is no longer available when I visit the site, so I cannot
> read the description, but I would consider that to be a mostly ok salary
> for a standard programmer in that part of Yorkshire.
>
I found several references to it at:
http://www.jobisjob.co.uk/openvms/jobs
They all say exactly the same:
----
I have an urgent new requirement for a Programmer with HP Basic for
OpenVMS. You will be primarily responsible for writing and modifying HP
Basic programs. This is an excellent opportunity to work for a
nationally recognised brand.
Salary: £25,000 - £30,000
Location: Bradford.
Type: Permanent
----
"nationally recognised brand" doesn't sound like Yorkshire Water.
--
Paul Sture
seasoned_geek
undress to reply) wrote:
>
> The idea with any insurance, of course, is that one pays a small amount
> in regularly and most people end up paying more than they get out of it.
> The unlucky ones, though, don't have to worry about costs. For years, I
> paid in more than I used, until I got cancer. I'm going back for a
Well, as one who has worked in the healthcare world multiple times, I
would say you are quoting the propaganda, not the reality. The
healthcare business is entirely about killing patients for profit.
I've never worked for a single provider that didn't actively engage in
it.
As a general rule, the only reason U.S. citizens aren't killed off the
instant a long term or costly diagnosis hits their file is that the
health care workers know how to work the system to override automatic
denials.
If you happen to live long enough to get on Medicaid/Medicare, the
number of things which can be denied drops dramatically and your life
expectancy improves greatly.
I have watched, time and time again, kids under the age of 25 with
nothing more than a High School Health class deny treatment to people
who could otherwise be saved and lead productive lives because it was
more cost effective to kill them. Murder for profit was legalized
when they created the HMO.
Doug Phillips
> On Jan 26, 12:43 pm, hel...@astro.multiCLOTHESvax.de (Phillip Helbig---
>
> undress to reply) wrote:
>
> > The idea with any insurance, of course, is that one pays a small amount
> > in regularly and most people end up paying more than they get out of it.
> > The unlucky ones, though, don't have to worry about costs. For years, I
> > paid in more than I used, until I got cancer. I'm going back for a
>
> Well, as one who has worked in the healthcare world multiple times, I
> would say you are quoting the propaganda, not the reality. The
> healthcare business is entirely about killing patients for profit.
> I've never worked for a single provider that didn't actively engage in
> it.
>
> As a general rule, the only reason U.S. citizens aren't killed off the
> instant a long term or costly diagnosis hits their file is that the
> health care workers know how to work the system to override automatic
> denials.
>
I've always wondered, if a person has both health insurance and life
insurance with the same company, does the company check to see which
policy would cost them less to pay out on?
> If you happen to live long enough to get on Medicaid/Medicare, the
> number of things which can be denied drops dramatically and your life
> expectancy improves greatly.
>
Of course, with the government's current financial problems causing
slow payment to providers, fewer and fewer doctors are accepting
Medicare/Medicaid patients.
> I have watched, time and time again, kids under the age of 25 with
> nothing more than a High School Health class deny treatment to people
> who could otherwise be saved and lead productive lives because it was
> more cost effective to kill them. Murder for profit was legalized
> when they created the HMO.
The heath care problem in the U.S. is a many headed beast. The health
insurance industry is a middle man that contributes nothing to the
quality of health care and a great deal to its cost. The health care
providers, with some outstanding exceptions, spend as much time
worrying about paperwork and competition as they do treating patients.
The insurance industry adds nothing to the quality of health care but
adds significantly to its cost.
Doctors are practicing medicine defensively. The legal system needs
reform. High tech equipment is expensive and it must be used in order
to pay for it. Too often it is used needlessly. Health providers must
be allowed to cooperate instead of being forced to compete. Competing
hospitals in my metro area were not allowed to merge because of anti-
trust laws. So, the "they have one so we need one too" game continues.
The "normal" hospital/clinic that I've had contact with use billing
patient billing procedures that are insane.
I wonder if this sounds familiar to anyone:
You feel like something is wrong so you go to your primary doctor, who
examines you and refers you to a specialist. S/he orders some tests
and says you need inpatient surgery, which s/he schedules after
talking to the hospital and your primary.
You call your insurance company and give them the information about
the procedure, the date, hospital and the names of your primary &
specialist. They look it all up, it's "in network" and they approve
it.
A hospital billing person calls you (or you have to call them) and you
verify your insurance information. You have the procedure done and
after a couple of days you go home and maybe have to start some
therapy.
A month or more later, you get a bill from the hospital that's
slightly shorter but a bit scarier than a Steven King short story. It
says it's been submitted to your insurance company. Your primary
doctor sends a bill and so does the specialist. A few weeks later,
another bill comes from some doctor you've never heard of who says he
was your anesthesiologist. A few weeks later, another bill comes from
some lab you've never heard of. A few more bills trickle in, all from
people and places you don't know.
Eventually, your insurance company sends you a statement showing what
was covered and what wasn't, your deductible and co-pay, and some
adjustments because of provider agreement (or some such) .
The hospital sends a statement showing how much the insurance company
paid, and what you owe. The numbers don't match.
Insurance company statements arrive over the next few week. Some are
denied and marked "out of network." Some are marked "not covered."
You call the insurance company and they tell you that the radiology
lab isn't one of their providers, and some of the other items billed
don't match what they allow for that type of procedure. So, you call
the doctor, the hospital, the insurance company, the doctor again...
who finally says he'll call the insurance company himself... and the
maybe that helps or maybe not. In any case, he and his staff have
wasted a lot of care-giving time.
In the mean time, therapy bills and statements are flowing in and the
paperwork is piling up and even though you're supposed to be getting
better, your stress level is rising faster than your body is healing.
After maybe a year, if you're lucky, you start to live almost normally
again and you're almost ready for the next round of the "stress that
sick person" game we call a health care system.
That's one "healthy" person's experience. We've all heard and read the
stories of people with chronic illnesses, and I know some of you have
some amazing tales to tell, but do we really understand the stress
they and their families must go through in dealing with this madness?
A friend's mother died last year after suffering from cancer for
months. Eight months after she died, she was still getting bills from
the hospital and clinic for visits during the months before she died.
Really? They can't do better than that?
The health care provider system does have a few outstanding examples
of how efficient and affordable care can work. I'm most familiar with
the Mayo Clinic. Outstanding in every way.
A typical procedure at Mayo can cost half of much as at one of the
local hospitals, and it will be done with less wasted time and will
have better results. And you get one bill, and it's ready when you
check out. Oddly enough, this more efficient and affordable health
care is often considered "out of network" in many insurance policies.
There are other hospitals/clinics in the U.S. that work just as well,
so I am told, so with good models available there's no excuse for the
system to be as inefficient as it is. Other nations have health care
systems that work. The U.S. system is generally broken, and my
comments have only touched a few of the cracks.
Sorry for the novella. Must have hit a raw nerve there ;-)
Phillip Helbig---undress to reply
<ba221e70-4613-4979...@n18g2000vbq.googlegroups.com>,
Doug Phillips <dphi...@netscape.net> writes:
> I've always wondered, if a person has both health insurance and life
> insurance with the same company, does the company check to see which
> policy would cost them less to pay out on?
When I was a child in Texas, I remember that some funeral homes also had
ambulances. If the person died, and there were no other arrangements,
then the owner of the ambulance got to handle the burial (and get paid
for it). Talk about a conflict of interest.
> Of course, with the government's current financial problems causing
> slow payment to providers, fewer and fewer doctors are accepting
> Medicare/Medicaid patients.
Any country where a physician can refuse to accept a patient is not
civilised.
Doug Phillips
undress to reply) wrote:
> In article
> <ba221e70-4613-4979-ad1d-fc62fbc7e...@n18g2000vbq.googlegroups.com>,
>
> Doug Phillips <dphil...@netscape.net> writes:
> > I've always wondered, if a person has both health insurance and life
> > insurance with the same company, does the company check to see which
> > policy would cost them less to pay out on?
>
> When I was a child in Texas, I remember that some funeral homes also had
> ambulances. If the person died, and there were no other arrangements,
> then the owner of the ambulance got to handle the burial (and get paid
> for it). Talk about a conflict of interest.
>
Sorry mam, yer hubby died from complications in transit. Now, this
particular model of casket has been very popular and we're running a
special on our genuine imitation marble headstones today.
> > Of course, with the government's current financial problems causing
> > slow payment to providers, fewer and fewer doctors are accepting
> > Medicare/Medicaid patients.
>
> Any country where a physician can refuse to accept a patient is not
> civilised.
Maybe it's our use of the letter Z in words like "civilized" that has
caused some to question our civility ;-)
A physician might see a person who comes to them in need, but might
not accept that person as a regular patient. A doctor can only have so
many patients, and often it isn't the doctor's decision but the
organization for whom the doctor works that decides. Physicians with a
full practice will usually refer a new patient to someone more able to
take them on.
There are free clinics where doctors donate their services, and many
doctors allocate a limited number of "slots" to Medicare/Medicaid or
indigent patients, knowing that payment will not be quick or full or
at all. Some doctors would provide all of their services for free if
they could, but without sufficient income their practice wouldn't
survive. Some drive Rolls Royces and live in mansions. Such is life in
the U.S.A.
seasoned_geek
>
> I've always wondered, if a person has both health insurance and life
> insurance with the same company, does the company check to see which
> policy would cost them less to pay out on?
>
The short answer is yes, but not the company you think. As a general
rule, IF your company provides both life insurance and health
insurance they are provided by the same umbrella company, even if each
"provider" has a different name. Most large employers take out life
insurance on their "expensive" employees and list the corporation as
the beneficiary. The employee is never told. As a general rule, and
as was confessed by that doctor before Congress on video even, if you
are diagnosed with some expensive long term illness and a 70% or less
survival rate, but have only a 100K life insurance policy, HMO cost
cutting dictates they pay out on the cheaper of the two. All
treatment, other than pain killers, is denied.
HMOs have an answer for everything.
Now take your package of Soylent Green and move along.
seasoned_geek
undress to reply) wrote:
> Any country where a physician can refuse to accept a patient is not
> civilised.
A physician is not allowed. They are required to treat the patient in
front of them or lose their license. This is why there is such a mine
field of administrators and LPNs between the patient and the
physician, re-directing them to county.
George Cook
> On Feb 1, 4:02=A0pm, hel...@astro.multiCLOTHESvax.de (Phillip Helbig---
> undress to reply) wrote:
>> Any country where a physician can refuse to accept a patient is not
>
> A physician is not allowed. They are required to treat the patient in
> front of them or lose their license. This is why there is such a mine
> field of administrators and LPNs between the patient and the
> physician, re-directing them to county.
What country are you referring to? In general, in the US,
hospitals and individual docters can turn away anyone unless
it is an emergency, although public hospitals usually treat
anyone regardless of ability to pay. The main reason why some
emergency rooms are so crowded is that people who can only afford
"free" care go there. In general, emergency departments (at
least non-private ones) treat anyone seeking care whether or not
it is an emergency, however, even public Level 1 trauma centers
(due to being over capacity) sometime turn away ambulances unless
it is a true Level 1 emergency (i.e., the patient will most likely
die before reaching the next available ER).
George Cook
seasoned_geek
In the U.S., a DOCTOR is not allowed to refuse treatment and maintain
their license. The nurse and admin people in the doctor's office are
the ones turning patients away. Again, at a Level 1 trauma center,
the admin staff are the ones turning patients away, not a DOCTOR.
It's part of the licensing and part of the modern hippocratic oath
http://en.wikipedia.org/wiki/Hippocratic_Oath
"I will remember that I remain a member of society, with special
obligations to all my fellow human beings, those sound of mind and
body as well as the infirm."
There was even a West Wing episode devoted mostly to this topic.
http://communicationsoffice.tripod.com/4-09.txt
BARTLET
The only doctor available won't do it.
ABBEY
He's Jewish?
BARTLET
Persian.
ABBEY
He doesn't have a choice.
BARTLET
Abbey...
ABBEY
He doesn't. Doctors aren't instruments of the state, and they're not
allowed to choose
patients on spec.
BARTLET
I can't order him to do it.
ABBEY
Yes, you can.
BARTLET
Through the power vested in me by you?
ABBEY
Samuel Mudd set Booth's leg after he shot Lincoln. Doctors are liable
in this country
if they don't treat the patient right in front of them.
BARTLET
Just for the record, this is why we don't talk about foreign policy.
Which we do, and
you don't think we do it enough.
ABBEY
Why?
BARTLET
Because Samuel Mudd was tried and convicted of treason for setting
that leg.
ABBEY
So?
BARTLET
What 'so'?
ABBEY
So that's the way it goes. You set the leg.
http://www.bigtattooplanet.com/forums/chit-chat/18403-when-ink-ideology-clash
George Cook
> On Feb 6, 7:51=A0pm, c...@wvnvms.wvnet.edu (George Cook) wrote:
>> In article <3f270075-45cc-4f2d-9e38-a77f1e8ac...@z20g2000yqe.googlegroups=>> > On Feb 1, 4:02=3DA0pm, hel...@astro.multiCLOTHESvax.de (Phillip Helbig-=
> --
>> > undress to reply) wrote:
>> >> Any country where a physician can refuse to accept a patient is not
>>
>> > A physician is not allowed. =A0They are required to treat the patient i=
> n
>> > front of them or lose their license. =A0This is why there is such a min=
> e
>> > field of administrators and LPNs between the patient and the
>> > physician, re-directing them to county.
>>
>> hospitals and individual docters can turn away anyone unless
>> it is an emergency, although public hospitals usually treat
>> emergency rooms are so crowded is that people who can only afford
>> least non-private ones) treat anyone seeking care whether or not
>> it is an emergency, however, even public Level 1 trauma centers
>> (due to being over capacity) sometime turn away ambulances unless
>> it is a true Level 1 emergency (i.e., the patient will most likely
>> die before reaching the next available ER).
>>
>> George Cook
>
> their license. The nurse and admin people in the doctor's office are
> the ones turning patients away. Again, at a Level 1 trauma center,
> the admin staff are the ones turning patients away, not a DOCTOR.
> It's part of the licensing and part of the modern hippocratic oath
I'm sorry, but you are wrong. The North won the war and ended
slavery. Unless it is an emergency, a doctor doesn't have to do
anything. It is the head of the ER (a doctor) who declares closure
to new patients. In triage situations, doctors (in person) often
refuse to treat patients who are less likely to survive even if
there is a chance they might survive. Ethical (as opposed to
ones who will do anything for the right price) cosmetic surgeons
regularly turn patients away if they believe the patients want it
for the wrong reasons or that they have unreasonable expectations.
IMO, the surgeon who did Joan Rivers should lose his license for
malpractice; just because someone wants to become hideously
disfigured doesn't mean a doctor is required to do it. The
unethical fertility doctor who treated the Octomom should have
lost his license (a prison sentence would not have been too
harsh IMO).
You seem to think that by simply walking up to the first doctor
you meet on the street, that he is required to treat whatever
ills you (e.g. bad cold, ingrown toenail, cataracts, hangover,
baldness, hay fever, high blood presssure, ...). I suppose you
think if you ambush a doctor as he is entering/leaving his office
(thereby getting the nurses and admins out of the way), that he
is therefore forced to accept you as a patient? You couldn't
be more wrong.
A personal example: if I had asked the doctor who was giving me
a second opinion on my back to take over my care, he would have
had every right to tell me he was not accepting new patients.
You actually think otherwise?
Please don't tell me you believe anything shown on fictional TV
dramas? Unless you have something intelligent to say, this will
be my last reply. I apologize to the group if I have fallen
victim to a troll.
George Cook
Doug Phillips
disagreement, I feel compelled to respond:
On Feb 10, 9:32 pm, c...@wvnvms.wvnet.edu (George Cook) wrote:
> In article <e1e00b54-1e9b-4224-8d2f-1fb1cc9a9...@o10g2000vbg.googlegroups.com>, seasoned_geek <rol...@logikalsolutions.com> writes:
> > On Feb 6, 7:51=A0pm, c...@wvnvms.wvnet.edu (George Cook) wrote:
> >> In article <3f270075-45cc-4f2d-9e38-a77f1e8ac...@z20g2000yqe.googlegroups=
> > .com>, seasoned_geek <rol...@logikalsolutions.com> writes:
>
My original statement, the one that seems to have started this, was
omitted from the last few quotes:
I said:
Of course, with the government's current financial problems
causing
slow payment to providers, fewer and fewer doctors are accepting
Medicare/Medicaid patients.
After that, the discussion went to hell:
> >> > On Feb 1, 4:02=3DA0pm, hel...@astro.multiCLOTHESvax.de (Phillip Helbig undress to reply) wrote:
> >> >> Any country where a physician can refuse to accept a patient is not
> >> >> civilised. =3DA0
>
> >> > A physician is not allowed. =A0They are required to treat the patient i=
> > n
> >> > front of them or lose their license. =A0This is why there is such a min=
> > e
> >> > field of administrators and LPNs between the patient and the
> >> > physician, re-directing them to county.
>
> >> What country are you referring to? =A0In general, in the US,
> >> hospitals and individual docters can turn away anyone unless
> >> it is an emergency, although public hospitals usually treat
> >> anyone regardless of ability to pay. =A0The main reason why some
> >> emergency rooms are so crowded is that people who can only afford
> >> "free" care go there. =A0In general, emergency departments (at
> >> least non-private ones) treat anyone seeking care whether or not
> >> it is an emergency, however, even public Level 1 trauma centers
> >> (due to being over capacity) sometime turn away ambulances unless
> >> it is a true Level 1 emergency (i.e., the patient will most likely
> >> die before reaching the next available ER).
>
> >> George Cook
>
All true, but nothing to do with a doctor accepting a new patient, or
the Medicare/Medicaid situation, but you have highlighted a few
problems in our current health care system.
Doctors are required to *treat* a person in immediate need. They are
not required to *accept* that person as a patient.
It looks like there is a misunderstanding between treating a patient
and accepting a patient. Treatment implies an immediate action.
Acceptance implies an on-going relationship.
When a person seeking medical aid is, as seasoned_geek said, "in front
of" a doctor, the doctor is obligated to assess whether or not the
person is in danger of dying if immediate treatment is not given, and
to at least stabilize the person if possible. What happens after that
depends on a large number of variables.
If you walk into a doctors office complaining of a sore arm, and you
are not already that doctor's patient, many things could happen.
Whether or not you are a Medicare/Medicaid patient might be one of the
determining factors.
If you walk in with blood gushing from your arm, you must be treated.
The doctor, while compelled to provide treatment, is not compelled to
accept you as a patient.
> > In the U.S., a DOCTOR is not allowed to refuse treatment and maintain
> > their license. The nurse and admin people in the doctor's office are
> > the ones turning patients away. Again, at a Level 1 trauma center,
> > the admin staff are the ones turning patients away, not a DOCTOR.
> > It's part of the licensing and part of the modern hippocratic oath
>
> I'm sorry, but you are wrong. The North won the war and ended
> slavery.
There is a difference between slavery and being licensed to practice
medicine. Many things that a person wants to do require a license, and
failure to comply with its terms can cause it to be revoked.
> Unless it is an emergency, a doctor doesn't have to do
> anything.
No one said otherwise. You are confusing the terms "provide treatment"
and "accepting a patient."
> It is the head of the ER (a doctor) who declares closure
> to new patients. In triage situations, doctors (in person) often
> refuse to treat patients who are less likely to survive even if
> there is a chance they might survive. Ethical (as opposed to
> ones who will do anything for the right price) cosmetic surgeons
> regularly turn patients away if they believe the patients want it
> for the wrong reasons or that they have unreasonable expectations.
> IMO, the surgeon who did Joan Rivers should lose his license for
> malpractice; just because someone wants to become hideously
> disfigured doesn't mean a doctor is required to do it. The
> unethical fertility doctor who treated the Octomom should have
> lost his license (a prison sentence would not have been too
> harsh IMO).
>
Your points are valid, but have nothing to do with a physician
accepting or not accepting medicare/medicaid recipients as new
patients.
> You seem to think that by simply walking up to the first doctor
> you meet on the street, that he is required to treat whatever
> ills you (e.g. bad cold, ingrown toenail, cataracts, hangover,
> baldness, hay fever, high blood presssure, ...). I suppose you
> think if you ambush a doctor as he is entering/leaving his office
> (thereby getting the nurses and admins out of the way), that he
> is therefore forced to accept you as a patient? You couldn't
> be more wrong.
>
I didn't read anyone in this thread claiming any of those things.
> A personal example: if I had asked the doctor who was giving me
> a second opinion on my back to take over my care, he would have
> had every right to tell me he was not accepting new patients.
> You actually think otherwise?
>
Who has said they think otherwise? S_g was stating a licensed doctor's
obligation to *treat* a person *in front of him* who presents
immediate need. No one has said that a doctor must accept anyone who
comes to him as a patient. You have read more into what has been
written than what was there.
> Please don't tell me you believe anything shown on fictional TV
> dramas? Unless you have something intelligent to say, this will
> be my last reply. I apologize to the group if I have fallen
> victim to a troll.
>
> George Cook
I see no trolling here. No disrespect intended.
George Cook
> Since it seems my post and Phillip's reply was what started this
> disagreement, I feel compelled to respond:
I believe we are in complete agreement as far as what doctors are
required and are not required to do. Yes, the thread got off track,
but I disagree that I misunderstood what seasoned_geek was saying.
My response was based entirely on his statements that a doctor must
treat anyone who presents themselves in front of him. I suppose
if he means "treat" = "assess if it is an emergency", then we simply
will have to agree to disagree about the meaning of the word "treat".
As to his point about nurses and admins, it doesn't matter how many
nurses and admins are in the way; a doctor is still required to
provide treatment to someone who runs into their office with blood
gushing out of a serious neck wound. Any nurse who tried to prevent
treatment would be in serious violation of their ethical code,
whereas an admin would probably be quilty of a civil, if not an
actual criminal, offense. Of course everthing changes if the
doctor is already treating a previous person who ran into their
office with a gushing neck wound.
If seasoned_geek would clarify his statements, instead of just
repeating the same blanket statements and quoting from fictional
TV shows, then I'd be willing to have a rational discussion.
However, this is all way off topic for this group, so I think
I'm going to try to not add any more off topic noise.
George Cook
> On Feb 10, 9:32 pm, c...@wvnvms.wvnet.edu (George Cook) wrote:
>> In article <e1e00b54-1e9b-4224-8d2f-1fb1cc9a9...@o10g2000vbg.googlegroups.com>, seasoned_geek <rol...@logikalsolutions.com> writes:
>> > On Feb 6, 7:51=A0pm, c...@wvnvms.wvnet.edu (George Cook) wrote:
>> >> In article <3f270075-45cc-4f2d-9e38-a77f1e8ac...@z20g2000yqe.googlegroups=
>> > .com>, seasoned_geek <rol...@logikalsolutions.com> writes:
>>
>
> My original statement, the one that seems to have started this, was
> omitted from the last few quotes:
>
> I said:
> Of course, with the government's current financial problems
> causing
> slow payment to providers, fewer and fewer doctors are accepting
> Medicare/Medicaid patients.
>
> After that, the discussion went to hell:
>
>> >> > On Feb 1, 4:02=3DA0pm, hel...@astro.multiCLOTHESvax.de (Phillip Helbig undress to reply) wrote:
>> >> >> Any country where a physician can refuse to accept a patient is not
>> >> >> civilised. =3DA0
>>
>> >> > A physician is not allowed. =A0They are required to treat the patient i=
>> > n
>> >> > front of them or lose their license. =A0This is why there is such a min=
>> > e
>> >> > field of administrators and LPNs between the patient and the
>> >> > physician, re-directing them to county.
>>
>> >> What country are you referring to? =A0In general, in the US,
>> >> hospitals and individual docters can turn away anyone unless
>> >> it is an emergency, although public hospitals usually treat
>> >> anyone regardless of ability to pay. =A0The main reason why some
>> >> emergency rooms are so crowded is that people who can only afford
>> >> "free" care go there. =A0In general, emergency departments (at
>> >> least non-private ones) treat anyone seeking care whether or not
>> >> it is an emergency, however, even public Level 1 trauma centers
>> >> (due to being over capacity) sometime turn away ambulances unless
>> >> it is a true Level 1 emergency (i.e., the patient will most likely
>> >> die before reaching the next available ER).
>>
>> >> George Cook
>>
>
seasoned_geek
>
> If seasoned_geek would clarify his statements, instead of just
> repeating the same blanket statements and quoting from fictional
> TV shows, then I'd be willing to have a rational discussion.
> However, this is all way off topic for this group, so I think
> I'm going to try to not add any more off topic noise.
>
Why do I need to clarify my statements? Right now, you are the only
one that is bluring the two distinctly different things. Treat vs.
accept as regular patient.
> It is the head of the ER (a doctor) who declares closure
> to new patients. In triage situations, doctors (in person) often
> refuse to treat patients who are less likely to survive even if
> there is a chance they might survive.
The head of ER refuses additional patients based upon two things,
quarantine and volume. If they have empty beds in ER and aren't under
quarantine they have to be under some kind of emergency evacuation
plan to refuse entry.
triage is the orderly (although chaotic) sorting of emergency patients
by both medical need and survival probability. triage is invoked once
the onslaught of critically injured patients exceed the available
number of physicians/surgeons. While cold and calculating it is a
required rationing.
A licensed doctor is required by nature of the license to treat anyone
in front of them with immediate medical need, even if that need is not
life threatening as long as the need is medically classified as
immediate. This need does not need to be life threatening. It can be
as simple as appearing before them with a freshly broken leg or arm
because there is a time window for setting the bone. In a city with a
hospital 20 minutes away via 911, yes, they can step aside, on a ski
slope, no, they have to treat.
treat != accept as a patient
Doctors working in ER treat hundreds of patients each week that they
never accept as patients in their practice, but many hospitals require
them to work some shifts in ER to maintain/obtain "privileges" at the
hospital. A growing number of doctors don't have private practices
but are hospital employees.
FWIW, I used to be the quality of care programmer for a peer review
group which was in charge of handing out CAPs and recommending
sanction of license to OIG. (CAPs = corrective action plans think
of them as moving ticket violation traffic classes for doctors)
It appears that both the fictional TV show and the messages here have
failed to hit their mark of educating at least one member of the
general public about the licensing requirements for doctors.