If you fall on the slippery slope, will Medicaid pay for your broken bone?
August 25, 2006 8:41 AM Subscribe
I promise to try not to smoke, or drink too much, or eat too much, or be lazy. If I fail, you can cut my benefits. Sign here please. West Virginia recently approved a controversial change to its Medicaid program: a Member Agreement [NB: links to .pdf] that adds several "personal responsibilities" including attempting to avoid smoking, (illegal) drugs, heavy drinking and sloth (not sloths). It also includes clauses on compliance with doctors recommendations, keeping appointments, reading the written materials that doctors provide, and minimizing emergency department visits. Patients who don't uphold their end of the bargain will have some benefits reduced or eliminated (that'll learn them). Lube up the slippery slope arguments. Will it work? Is it fair? Want to hear more? And more (from NPR)?.
(Article .pdfs archived here and here. Interview .mp3 archived here if you can't access them through above links).
(Article .pdfs archived here and here. Interview .mp3 archived here if you can't access them through above links).
Should indulging in booze, cigarettes, etc, be only a privilige of the wealthy?
When has it ever not been so?
posted by Blazecock Pileon at 8:49 AM on August 25, 2006
When has it ever not been so?
posted by Blazecock Pileon at 8:49 AM on August 25, 2006
Since forever. Regardless of income, people usually find a way to drink and smoke.
posted by jonmc at 8:51 AM on August 25, 2006
posted by jonmc at 8:51 AM on August 25, 2006
When has it ever not been so?
I'll tell that to the thousands of patients I've seen come though our detox center. They'll feel like millionaires.
posted by KevinSkomsvold at 8:55 AM on August 25, 2006
I'll tell that to the thousands of patients I've seen come though our detox center. They'll feel like millionaires.
posted by KevinSkomsvold at 8:55 AM on August 25, 2006
I think all the regulations in the world won't tear SOME people from SOME of their vices. I have to say that the side of me that believes in taking full responsibility for one's choices says you should be penalized for abusing your health voluntarily, of course that is easy in an ethical vacuum where these clear budget cutting moves won't be used in an unfair and unbalanced way by people tasked with kicking the poor off the medicaid rolls. Fucking believing in the total autonomy of the individual isn't all the glorious death of tyranny and booze and humping in the streets, I am finding.
posted by Divine_Wino at 9:00 AM on August 25, 2006
posted by Divine_Wino at 9:00 AM on August 25, 2006
I don't know. I stand by my observation that overindulgence of luxuries on a massive scale is a recent phenomenon. The pendulum is just swinging back from fat times to thin, is all.
posted by Blazecock Pileon at 9:04 AM on August 25, 2006
posted by Blazecock Pileon at 9:04 AM on August 25, 2006
It is reasonable to try to get people to behave in ways that will increase their health and reduce healthcare costs. Violating this agreement won't leave people completely without coverage; they'll still have much better coverage than many uninsured people. Hopefully this would be enough to keep people who don't have a pre-existing drinking, smoking, drug, or weight problem from developing one. As for people who already have these problems, though, the requirements that they attend classes and programs ordered by their health care provider might be really difficult. They could be working several jobs to try to make ends meet, they may lack transportation, they may have any number of barriers preventing them from investing the large amounts of time that may be required here. The same goes for all the requirements listed about how many checkups and tests each person has to have to be a "healthy man" or a "healthy woman." There are significantly more requirements listed for women than men, placing a much larger burden on them to spend time and find means of transportation than are placed on men. I wonder if this could be considered a violation of federal civil rights law for that reason.
posted by leapingsheep at 9:11 AM on August 25, 2006
posted by leapingsheep at 9:11 AM on August 25, 2006
No one wants to have their freedoms taken away, even the freedoms to be irresponsible, lazy, fat, drunk, stoned-out and/or ignorant.
posted by chudmonkey at 9:11 AM on August 25, 2006
posted by chudmonkey at 9:11 AM on August 25, 2006
For children, the basic benefit package will limit them to four prescription drugs a month and impose new limits on dental, hearing, and vision services. In addition, it will eliminate coverage for skilled nursing care, orthotics, prosthetics, tobacco cessation programs, nutrition education, diabetes care, and chemical dependency and mental health services.
Are you kidding me? Does this mean if some unlucky child loses a foot, the state won't pay for a prosthetic?
And no mental health services or diabetes care for children? This cannot possibly be right. Surely the state cannot be saying "Fuck you for having diabetes, you are shit out of luck."
posted by Secret Life of Gravy at 9:12 AM on August 25, 2006
Are you kidding me? Does this mean if some unlucky child loses a foot, the state won't pay for a prosthetic?
And no mental health services or diabetes care for children? This cannot possibly be right. Surely the state cannot be saying "Fuck you for having diabetes, you are shit out of luck."
posted by Secret Life of Gravy at 9:12 AM on August 25, 2006
DW. You had me at "humping in the streets."
Blazecock. This is not a troll; junt wondering what you mean by: "overindulgence of luxuries on a massive scale is a recent phenomenon." To me, it seems that overindulgence has been a national pastime for ages.
posted by KevinSkomsvold at 9:14 AM on August 25, 2006
Blazecock. This is not a troll; junt wondering what you mean by: "overindulgence of luxuries on a massive scale is a recent phenomenon." To me, it seems that overindulgence has been a national pastime for ages.
posted by KevinSkomsvold at 9:14 AM on August 25, 2006
My dilemma has to do with the fact that state Medicaid budgets are tight (and getting tighter), with more physicians opting out of Medicaid because the reimbursement is so low (lower than the cost of delivering care). Should patients with self-induced disease (e.g., the majority of cases of lung cancers, the majority of cases of cirrhosis) be allowed to consume the resources in a pool that is also intended to cover those who do not indulge in higher-risk behaviors (e.g., children). Perhaps Medicaid should cover children's health first and then the remainder can be used to fund adult medical care.
posted by scblackman at 9:16 AM on August 25, 2006
posted by scblackman at 9:16 AM on August 25, 2006
Gravy, keep reading. That is the basic plan once they sign the agreement they get all the stuff instituted.
posted by stormygrey at 9:17 AM on August 25, 2006
posted by stormygrey at 9:17 AM on August 25, 2006
Friends, the Revolution has arrived! Lower your expectations! Forget your fantasies of success and happiness! Drop your dreams of accomplishment! You have nothing to lose but your benefits! I had a dream, it's true, but now I only hope... that tomorrow will be worse than today, and that we can quickly be rid of the soft, egalitarian values that have driven America to its desperate, world-dominating straits! Don't you see? When you're at the top, there's nowhere to go but down!
posted by anotherpanacea at 9:20 AM on August 25, 2006
posted by anotherpanacea at 9:20 AM on August 25, 2006
Should indulging in booze, cigarettes, etc, be only a privilige of the wealthy?
Should the state be responsible for keeping someone in their vices?
---
I was once a lazy welfare bum. I drew from the system without real need because I didn't have the skills or the desire to get work (and keep it). I don't suggest cutting off the mentally ill or physically ill or drug addicted, but barring an economic collapse where there are no jobs to be found, a lot of people should not receive benefits. It was wrong when I did it, and it's wrong now.
That being said, when I finally decided to change my ways of doing things, the system was designed to not help me. The amount of money I received each month covered food and shelter but not clothing or simple things like photocopying resumes to give to employers. So I drew benefits longer than I had to as I struggled to find a way past that (which ended up being used clothes from the Salvation Army, a belt to hold up my loose pants made from a bicycle tire, and a making a friend who had a printer for his Mac IIe.
posted by Kickstart70 at 9:23 AM on August 25, 2006 [1 favorite]
Should the state be responsible for keeping someone in their vices?
---
I was once a lazy welfare bum. I drew from the system without real need because I didn't have the skills or the desire to get work (and keep it). I don't suggest cutting off the mentally ill or physically ill or drug addicted, but barring an economic collapse where there are no jobs to be found, a lot of people should not receive benefits. It was wrong when I did it, and it's wrong now.
That being said, when I finally decided to change my ways of doing things, the system was designed to not help me. The amount of money I received each month covered food and shelter but not clothing or simple things like photocopying resumes to give to employers. So I drew benefits longer than I had to as I struggled to find a way past that (which ended up being used clothes from the Salvation Army, a belt to hold up my loose pants made from a bicycle tire, and a making a friend who had a printer for his Mac IIe.
posted by Kickstart70 at 9:23 AM on August 25, 2006 [1 favorite]
I don't know. I stand by my observation that overindulgence of luxuries on a massive scale is a recent phenomenon. The pendulum is just swinging back from fat times to thin, is all.
Truly, excess on this kind of scale is a recent phenomenon.
posted by god hates math at 9:26 AM on August 25, 2006
Truly, excess on this kind of scale is a recent phenomenon.
posted by god hates math at 9:26 AM on August 25, 2006
i see puritanism is alive and well in america
posted by pyramid termite at 9:26 AM on August 25, 2006
posted by pyramid termite at 9:26 AM on August 25, 2006
You wouldn't think that construction companies would have to FORCE workers to follow safety rules. But they do. And if they let up for a minute, if they trust that highly skilled workers with years of experience will wear helmets and follow basic, obviously worthwhile, low or no hassle safely guidelines without vigorous enforcement by management - they wind up with an epidemic of accidents.
This doesn't look to be a whole lot different.
posted by Jos Bleau at 9:29 AM on August 25, 2006 [1 favorite]
This doesn't look to be a whole lot different.
posted by Jos Bleau at 9:29 AM on August 25, 2006 [1 favorite]
This type of institutionalizing values is based on the government's knowledge and prevention of moral hazard. For those who don't feel like clicking:
In insurance theory, moral hazard is the name given to the increased risk of problematical (immoral) behavior, and thus a negative outcome ("hazard"), because the person who caused the problem doesn't suffer the full (or any) consequences, or may actually benefit. Such a concern typically arises in the context of a contract (for example, an insurance policy).
This is about saving tax dollars for those who actually need the money, as opposed to those who purposefully living dangerous lives because they know the state will foot the bill. It's a well known phenomena that people who drive automobiles without auto insurance are far more cautious than those with it, because those with it know that they're covered (and are paying premiums).
This isn't about being "uncaring" or "cheap", it's the fact that medical coverage is bloated because people don't take care of themselves and those who are genuinely healthy and careful end up paying for the irresponsible lifestyle of others.
posted by SeizeTheDay at 9:29 AM on August 25, 2006
In insurance theory, moral hazard is the name given to the increased risk of problematical (immoral) behavior, and thus a negative outcome ("hazard"), because the person who caused the problem doesn't suffer the full (or any) consequences, or may actually benefit. Such a concern typically arises in the context of a contract (for example, an insurance policy).
This is about saving tax dollars for those who actually need the money, as opposed to those who purposefully living dangerous lives because they know the state will foot the bill. It's a well known phenomena that people who drive automobiles without auto insurance are far more cautious than those with it, because those with it know that they're covered (and are paying premiums).
This isn't about being "uncaring" or "cheap", it's the fact that medical coverage is bloated because people don't take care of themselves and those who are genuinely healthy and careful end up paying for the irresponsible lifestyle of others.
posted by SeizeTheDay at 9:29 AM on August 25, 2006
The problem here is that there is no fair way to mandate this. Sure, on the outset it may seem fair that those getting state-paid medical benefits have a responsibility to take care of their health and it sure seems like the right thing to do is to not drink, smoke, and eat excessively.
But how does one mandate this? We all know people who eat total crap but are not overweight, people who smoke for years and never get lung cancer and people who drink heavily and never get liver disease. And vice versa.
So the question is, can you regulate this and not completely screw a segment of the population who is doing the right thing, but does not appear to be? Who decides who smokes too much and who only drinks in moderation? And the cost of beaurocratizing all that babysitting? Are you really saving that much?
It is one of those things, like a lot of regulating programs of this sort, where the question has to be asked: Do you want to punish the few innocents to get to the guilty? Or is it better to let a few of the guilty go to be fair to the innocents?
posted by Bueller at 9:30 AM on August 25, 2006
But how does one mandate this? We all know people who eat total crap but are not overweight, people who smoke for years and never get lung cancer and people who drink heavily and never get liver disease. And vice versa.
So the question is, can you regulate this and not completely screw a segment of the population who is doing the right thing, but does not appear to be? Who decides who smokes too much and who only drinks in moderation? And the cost of beaurocratizing all that babysitting? Are you really saving that much?
It is one of those things, like a lot of regulating programs of this sort, where the question has to be asked: Do you want to punish the few innocents to get to the guilty? Or is it better to let a few of the guilty go to be fair to the innocents?
posted by Bueller at 9:30 AM on August 25, 2006
To me, it seems that overindulgence has been a national pastime for ages.
Oddly enough, my partner and I were looking at childhood snapshots last night and noticed how thin everyone was, and noticed how much more chubby, on average, children are today than twenty years ago.
We're both literate fellas and don't believe this view is confirmation bias. Epidemiologist studies agree that this culture encourages indulgence on a scale never seen before in human history — even China's burgeoning middle class is getting into the spirit! As one example, WalMart is targeting its product lines to both change the average Chinese diet and meet estimated raised consumption targets, including bringing in diet and exercise products in 2-5 years. I'll look for the citation if you're curious about it.
At some point the piper must be paid. As members of Western societies we cannot abuse our health as much as we do — by choice — without some cost down the line.
The democratic process will, hopefully, decide if we elect leaders who sponsor indulging ourselves to bankrupcy, or allowing some partial measure of legal controls in exchange for public services.
My point to jonmc is that the rich or politically privileged have always been able to indulge, through good times and bad, so I don't know that that necessarily qualifies as a reason for or against legal controls over behavior in exchange for free healthcare.
Let's be realistic: Whatever government we have, you can be sure there will always be a wealthy class, Inner Circle, Politburo, or whatever mix thereof that will be able to eat, drink and smoke whatever it damn well pleases. So we might as well ignore them as far as deciding what the rest of us get to do.
We raise barriers over accessing other public services, such as unemployment insurance, so I don't see why this reasoning is necessarily different in the overall respect of deciding where and how public services are made available.
The real unspoken problem is the enforcement of said rules. How will they know you quit smoking, for example, or not scarfing down a bag of greasy cheeseburgers while watching Hogan's Heroes reruns, without the infrastructure to watch every aspect of your public and private life?
To me, that's a much more interesting problem because it deals with the full gamut of civil rights and liberties abuses committed by governments since time immemorial. As always, I suspect a balance will be made acceptable to the public as a whole, insofar as it is willing to bear some, but probably not all, of the cost of indulgence in luxuries.
posted by Blazecock Pileon at 9:32 AM on August 25, 2006
Oddly enough, my partner and I were looking at childhood snapshots last night and noticed how thin everyone was, and noticed how much more chubby, on average, children are today than twenty years ago.
We're both literate fellas and don't believe this view is confirmation bias. Epidemiologist studies agree that this culture encourages indulgence on a scale never seen before in human history — even China's burgeoning middle class is getting into the spirit! As one example, WalMart is targeting its product lines to both change the average Chinese diet and meet estimated raised consumption targets, including bringing in diet and exercise products in 2-5 years. I'll look for the citation if you're curious about it.
At some point the piper must be paid. As members of Western societies we cannot abuse our health as much as we do — by choice — without some cost down the line.
The democratic process will, hopefully, decide if we elect leaders who sponsor indulging ourselves to bankrupcy, or allowing some partial measure of legal controls in exchange for public services.
My point to jonmc is that the rich or politically privileged have always been able to indulge, through good times and bad, so I don't know that that necessarily qualifies as a reason for or against legal controls over behavior in exchange for free healthcare.
Let's be realistic: Whatever government we have, you can be sure there will always be a wealthy class, Inner Circle, Politburo, or whatever mix thereof that will be able to eat, drink and smoke whatever it damn well pleases. So we might as well ignore them as far as deciding what the rest of us get to do.
We raise barriers over accessing other public services, such as unemployment insurance, so I don't see why this reasoning is necessarily different in the overall respect of deciding where and how public services are made available.
The real unspoken problem is the enforcement of said rules. How will they know you quit smoking, for example, or not scarfing down a bag of greasy cheeseburgers while watching Hogan's Heroes reruns, without the infrastructure to watch every aspect of your public and private life?
To me, that's a much more interesting problem because it deals with the full gamut of civil rights and liberties abuses committed by governments since time immemorial. As always, I suspect a balance will be made acceptable to the public as a whole, insofar as it is willing to bear some, but probably not all, of the cost of indulgence in luxuries.
posted by Blazecock Pileon at 9:32 AM on August 25, 2006
I stand by my observation that overindulgence of luxuries on a massive scale is a recent phenomenon.
I don't think so. Overindulgence of luxuries is what we do best. What is a recent phenomenon though is the amount of good, free welfare available on such a massive scale. As much as people might bitch about the NHS in the UK it's a pretty good system for helping those who need it. Problem is, how do you scale a system like this when more and more people survive longer?
A member agreement is certainly one way, I don't agree with it but something is going to have to give.
posted by twistedonion at 9:34 AM on August 25, 2006
I don't think so. Overindulgence of luxuries is what we do best. What is a recent phenomenon though is the amount of good, free welfare available on such a massive scale. As much as people might bitch about the NHS in the UK it's a pretty good system for helping those who need it. Problem is, how do you scale a system like this when more and more people survive longer?
A member agreement is certainly one way, I don't agree with it but something is going to have to give.
posted by twistedonion at 9:34 AM on August 25, 2006
This really falls right in line with the drug war's message that the best way to get people to not do drugs is to punish them. And that's worked out pretty well, hasn't it?
The longer I live, the stupider this country looks. I'm only 43, I'm not sure I want to be around to see what 30 year stupider looks like.
posted by doctor_negative at 9:34 AM on August 25, 2006 [1 favorite]
The longer I live, the stupider this country looks. I'm only 43, I'm not sure I want to be around to see what 30 year stupider looks like.
posted by doctor_negative at 9:34 AM on August 25, 2006 [1 favorite]
Blazecock, the problem with your argument is that it fails to acknowledge changes in diets, food ingredients, and lifestyles of America. Some examples include the overindulgence of carbs (as dictated by the old food pyramid), the introduction of high fructose corn syrup (I don't want to get into the details, but damn is that shit bad), and the necessity of two incomes to maintain a decent life (which forces less home-cooked meals and replaces them with fatty fast-food).
posted by SeizeTheDay at 9:36 AM on August 25, 2006
posted by SeizeTheDay at 9:36 AM on August 25, 2006
Truly, excess on this kind of scale is a recent phenomenon.
You know that Dionysus ain't real, right?
Anyway, voting Greeks were wealthy slave-owners, so they weren't really living off the sweat of their brows.
posted by Blazecock Pileon at 9:37 AM on August 25, 2006
You know that Dionysus ain't real, right?
Anyway, voting Greeks were wealthy slave-owners, so they weren't really living off the sweat of their brows.
posted by Blazecock Pileon at 9:37 AM on August 25, 2006
Blazecock Pileon writes "I stand by my observation that overindulgence of luxuries on a massive scale is a recent phenomenon."
The luxuries of tobacco, drugs, and alcohol?
Well, I will give you that not many people were taking opium or morphine in the 1700s. And not a lot of (white) people were smoking tobacco before 1492. And drinking? Well, I'm sure some time back in 5000 BC, people may not have overindulged in alcohol. So, yeah, sure, if you consider a range from the last 6-odd thousand years ago until maybe 200 years ago to be "recent", then, yes, the overindulgences of the luxuries we're discussing: tobacco, drugs, and alcohol, is a recent phenomenon.
posted by Bugbread at 9:37 AM on August 25, 2006
The luxuries of tobacco, drugs, and alcohol?
Well, I will give you that not many people were taking opium or morphine in the 1700s. And not a lot of (white) people were smoking tobacco before 1492. And drinking? Well, I'm sure some time back in 5000 BC, people may not have overindulged in alcohol. So, yeah, sure, if you consider a range from the last 6-odd thousand years ago until maybe 200 years ago to be "recent", then, yes, the overindulgences of the luxuries we're discussing: tobacco, drugs, and alcohol, is a recent phenomenon.
posted by Bugbread at 9:37 AM on August 25, 2006
Oddly enough, my partner and I were looking at childhood snapshots last night and noticed how thin everyone was, and noticed how much more chubby, on average, children are today than twenty years ago.
imho that is due to the quality of shit everyone pours down their kids throats these days combined with lack of wxercise. Nothing to do with overindulgence. Not find it funny that the rise of the fast food industry in the past 20 years fits nicely with your observation?
I'm telling you, we are poisoning ourselves... nothing to do with quantity and all to do with the quality!
posted by twistedonion at 9:38 AM on August 25, 2006
imho that is due to the quality of shit everyone pours down their kids throats these days combined with lack of wxercise. Nothing to do with overindulgence. Not find it funny that the rise of the fast food industry in the past 20 years fits nicely with your observation?
I'm telling you, we are poisoning ourselves... nothing to do with quantity and all to do with the quality!
posted by twistedonion at 9:38 AM on August 25, 2006
If I'm going to be forced to pay for others' health care, shouldn't said others be forced to take better care of themselves to make the most of my "investment?"
Seems only fair.
posted by ZenMasterThis at 9:38 AM on August 25, 2006 [1 favorite]
Seems only fair.
posted by ZenMasterThis at 9:38 AM on August 25, 2006 [1 favorite]
wxercise, it's that lazy kind of exercise!
posted by twistedonion at 9:40 AM on August 25, 2006
posted by twistedonion at 9:40 AM on August 25, 2006
This is not too surprising, once the government starts funding things it will always use that power to regulate them. There's no way around it, it would be irresponsible of the state to subsidize unhealthy behavior, and they're trying not to do so. It might be terrible, but it's how these things work. I doubt it will, but I hope this serves as a warning to some of the supporters of universal health care.
posted by Bulgaroktonos at 9:40 AM on August 25, 2006
posted by Bulgaroktonos at 9:40 AM on August 25, 2006
Blazecock Pileon writes "Oddly enough, my partner and I were looking at childhood snapshots last night and noticed how thin everyone was, and noticed how much more chubby, on average, children are today than twenty years ago. "
Food, I will grant you straight up. Food is the indulgence that has recently spread from the rich to the everyone.
Blazecock Pileon writes "My point to jonmc is that the rich or politically privileged have always been able to indulge, through good times and bad"
You probably should have said that, then, instead of saying that alcohol and cigarettes have always been a privilege of the wealthy.
That's like saying "Hitler invaded Kansas", and then when someone says "No, he didn't", saying "I stand by my point that Hitler was a bad guy and invaded other nations".
posted by Bugbread at 9:43 AM on August 25, 2006
Food, I will grant you straight up. Food is the indulgence that has recently spread from the rich to the everyone.
Blazecock Pileon writes "My point to jonmc is that the rich or politically privileged have always been able to indulge, through good times and bad"
You probably should have said that, then, instead of saying that alcohol and cigarettes have always been a privilege of the wealthy.
That's like saying "Hitler invaded Kansas", and then when someone says "No, he didn't", saying "I stand by my point that Hitler was a bad guy and invaded other nations".
posted by Bugbread at 9:43 AM on August 25, 2006
the introduction of high fructose corn syrup
I've heard that this is a myth, though there are other issues with maintaining such large corn-based agricultural subsidies, in that corn becomes such a central — biologically vulnerable and foreign oil-consuming — part of your economy. I agree that imposing a high-sugar, high-fat diet on the economically vulnerable part of your population is not helping the problem.
necessity of two incomes to maintain a decent life
"Decent lifestyle" means something on an entirely different scale today than a generation or two ago.
posted by Blazecock Pileon at 9:44 AM on August 25, 2006
I've heard that this is a myth, though there are other issues with maintaining such large corn-based agricultural subsidies, in that corn becomes such a central — biologically vulnerable and foreign oil-consuming — part of your economy. I agree that imposing a high-sugar, high-fat diet on the economically vulnerable part of your population is not helping the problem.
necessity of two incomes to maintain a decent life
"Decent lifestyle" means something on an entirely different scale today than a generation or two ago.
posted by Blazecock Pileon at 9:44 AM on August 25, 2006
my expectation is that--just like with regular health insurance, HMOs, and workers' comp--the money spent enforcing a policy like this will outweigh the potential savings to the company or its customers--not to mention that such administrators these days are all about setting up roadblocks for authorizing treatment, and this is just one more they will call upon, unfairly as often as fairly...
...what is disappointing is that insurance companies profit by and succeed so well in turning us against ourselves--they tell us that high costs and benefit reductions are due to fraud in the system, and we'll easily jump right in and blame either hospitals or doctors (except the ones who treat me, of course) or patients (except me and my family, of course)
...it's especially true if you get hurt on the job...many assume that anyone with back pain is scamming the system, until they get hurt themselves...health plans take their cues from what workers' compensation systems are able to establish as legal precedent, and if you've seen what the insurance-established standard of care for injured workers is like these days (in california, particularly), you know we've got something to fear
posted by troybob at 9:45 AM on August 25, 2006
...what is disappointing is that insurance companies profit by and succeed so well in turning us against ourselves--they tell us that high costs and benefit reductions are due to fraud in the system, and we'll easily jump right in and blame either hospitals or doctors (except the ones who treat me, of course) or patients (except me and my family, of course)
...it's especially true if you get hurt on the job...many assume that anyone with back pain is scamming the system, until they get hurt themselves...health plans take their cues from what workers' compensation systems are able to establish as legal precedent, and if you've seen what the insurance-established standard of care for injured workers is like these days (in california, particularly), you know we've got something to fear
posted by troybob at 9:45 AM on August 25, 2006
When I made reference to "decent lifestyle", I assumed you read the recent AskMeFi thread concerning the issue of two incomes. And to claim that HFCS problems are a myth are the equivalent of claiming the moon landing as fake. No offense, but that's just crazy.
posted by SeizeTheDay at 9:47 AM on August 25, 2006
posted by SeizeTheDay at 9:47 AM on August 25, 2006
You probably should have said that, then, instead of saying that alcohol and cigarettes have always been a privilege of the wealthy.
That's like saying "Hitler invaded Kansas", and then when someone says "No, he didn't", saying "I stand by my point that Hitler was a bad guy and invaded other nations".
I didn't say Hitler invaded Kansas, nor anything like it. What is your problem?
posted by Blazecock Pileon at 9:47 AM on August 25, 2006
That's like saying "Hitler invaded Kansas", and then when someone says "No, he didn't", saying "I stand by my point that Hitler was a bad guy and invaded other nations".
I didn't say Hitler invaded Kansas, nor anything like it. What is your problem?
posted by Blazecock Pileon at 9:47 AM on August 25, 2006
And to claim that HFCS problems are a myth are the equivalent of claiming the moon landing as fake
Before we get started with the hyperbole:
A Sweetner With a Bad Rap: Many emotions, less science, in a debate over high-fructose corn syrup (PDF), NYT, July 2, 2006.
posted by Blazecock Pileon at 9:50 AM on August 25, 2006 [1 favorite]
Before we get started with the hyperbole:
A Sweetner With a Bad Rap: Many emotions, less science, in a debate over high-fructose corn syrup (PDF), NYT, July 2, 2006.
posted by Blazecock Pileon at 9:50 AM on August 25, 2006 [1 favorite]
For children, the basic benefit package will limit them to four prescription drugs a month and impose new limits on dental, hearing, and vision services. In addition, it will eliminate coverage for skilled nursing care, orthotics, prosthetics, tobacco cessation programs, nutrition education, diabetes care, and chemical dependency and mental health services.
Oh, brilliant. For the poorest folks, let's restrict access to the very health services that address impediments to moving up on the socioeconomic scale, like having bad teeth, or getting a substandard education because you can't see the blackboard. Let's chop out services that work to prevent chronic health problems, like those that arise from untreated diabetes or ill-informed nutrition.
posted by desuetude at 9:50 AM on August 25, 2006
Oh, brilliant. For the poorest folks, let's restrict access to the very health services that address impediments to moving up on the socioeconomic scale, like having bad teeth, or getting a substandard education because you can't see the blackboard. Let's chop out services that work to prevent chronic health problems, like those that arise from untreated diabetes or ill-informed nutrition.
posted by desuetude at 9:50 AM on August 25, 2006
Positive reinforcement is always better for behavior modification than negative punishment. Stupid humans. *smack*
posted by effwerd at 9:56 AM on August 25, 2006
posted by effwerd at 9:56 AM on August 25, 2006
Blazecock Pileon writes "I didn't say Hitler invaded Kansas, nor anything like it. What is your problem?"
I know you didn't say Hitler invaded Kansas. That's the point of the word "like" in the sentence.
You just said something untrue, got called on it, and said "I don't know. I stand by my observation that (different, possibly true observation)." It's not the end of the world, it just seems goofy that you're playing the issue of what you said being true because something else which is tangentially related is true. I used a metaphor (or is it simile? regardless, a hypothetical example) to explain that, because otherwise it's a bit hard to understand. And I used Hitler because, well, because I usually use Hitler for examples. I'm not comparing you to Hitler.
If it helps, let's rephrase it to "That's like saying 'Jimi Hendrix played guitar on 'Paranoid Android', being told 'No, Hendrix died years before Radiohead was even formed', and responding 'I don't know. I stand by my observation that Hendrix was an excellent guitar player.'".
posted by Bugbread at 10:02 AM on August 25, 2006
I know you didn't say Hitler invaded Kansas. That's the point of the word "like" in the sentence.
You just said something untrue, got called on it, and said "I don't know. I stand by my observation that (different, possibly true observation)." It's not the end of the world, it just seems goofy that you're playing the issue of what you said being true because something else which is tangentially related is true. I used a metaphor (or is it simile? regardless, a hypothetical example) to explain that, because otherwise it's a bit hard to understand. And I used Hitler because, well, because I usually use Hitler for examples. I'm not comparing you to Hitler.
If it helps, let's rephrase it to "That's like saying 'Jimi Hendrix played guitar on 'Paranoid Android', being told 'No, Hendrix died years before Radiohead was even formed', and responding 'I don't know. I stand by my observation that Hendrix was an excellent guitar player.'".
posted by Bugbread at 10:02 AM on August 25, 2006
Blazecock Pileon - I stand by my observation that overindulgence of luxuries on a massive scale is a recent phenomenon.
In 1996, Scientific American published an article on the history of alcohol control policies in the US.
Some choice quotes:
In 1996, Scientific American published an article on the history of alcohol control policies in the US.
Some choice quotes:
By the early decades of the 19th century, Americans drank roughly three times as much alcohol as they do in the 1990s.posted by daksya at 10:23 AM on August 25, 2006
At its peak in 1855, 13 of 40 states and territories had adopted legal prohibition. By the 1870s, public opinion had turned back, and liquor was flowing freely again; then, around the turn of the century, a movement for abstinence gained steam, culminating in the 13-year experiment of Prohibition that began in 1920.
Over the history of the U.S., popular attitudes and legal responses to the consumption of alcohol and other moodaltering substances have oscillated from toleration to a peak of disapproval and back again in cycles roughly 70 years long. Although other nations appear to have embraced the virtues of moderation, the U.S. continues to swing slowly back and forth between extremes. The length of these trends may explain why most people are unaware of our repetitive history.
It now appears that a third era of temperance is under way in the U.S. Alcohol consumption peaked around 1980 and has since fallen by about 15 percent. The biggest drop has been in distilled spirits, but wine use has also waned. Beer sales have fallen less, but nonalcoholic brews—replicas of Prohibition’s “near beer”—have been rising in popularity.
In 1988 Congress set up the Office of Substance Abuse Prevention (osap) under the auspices of the Department of Health and Human Services. The osap provided what it called “editorial guidelines” to encourage media to adopt new ways of describing drug and alcohol use. Instead of referring to “responsible use” of alcohol, for example, the office suggested that newspapers and magazines should speak simply of “use, since there is a risk associated with all use.” This language suggests that there is no safe threshold of consumption—a view also espoused by the American Temperance Society in the 1840s and the Anti-Saloon League early in this century. The osap also evaluated information on alcohol and drugs intended for distribution to schools and communities. It asserted that “materials recommending a designated driver should be rated unacceptable. They encourage heavy alcohol use by implying it is okay to drink to intoxication as long as you don’t drive.”
Annual consumption peaked around 1830 at an estimated 7.1 gallons of alcohol per adult.
In each era of reform, people have tried to influence the education of children and to portray alcohol in a new, presumably more correct light. Today the federal Center for Substance Abuse Prevention (csap, the successor to the osap) works through prevention materials distributed to schools, but the champion of early efforts was the WCTU’s Department of Scientific Temperance Instruction. It successfully fought for mandatory temperance lessons in the public schools and oversaw the writing of approved texts. Pupils would learn, among other things, that “the majority of beer drinkers die of dropsy”; “when alcohol passes down the throat it burns off the skin, leaving it bare and burning”; and “alcohol clogs the brain and turns the liver quickly from yellow to green to black.”
Is our Puritan tradition of uncompromising moral stances still supplying righteous energy to the battle against alcohol? During the 1920s, when many nations of the Western world turned against alcohol, a sustained campaign in the Netherlands led by the workers’ movement and religious groups reduced alcohol consumption by 1930 to a very low level, but without legal prohibition. Likewise in Britain: the antialcohol movement reduced consumption even though it did not result in legal bans. Apparently, each nation has its own style of control.
You just said something untrue
If it is untrue, you agreed with it here. Whatever.
posted by Blazecock Pileon at 10:29 AM on August 25, 2006
If it is untrue, you agreed with it here. Whatever.
posted by Blazecock Pileon at 10:29 AM on August 25, 2006
BP, he agreed with one singular point, of the broad generalization you made. Don't move the goalposts.
FWIW: Venus of Willendorf (some images NSFW) is an example that refutes even this one point.
posted by Kickstart70 at 10:41 AM on August 25, 2006
FWIW: Venus of Willendorf (some images NSFW) is an example that refutes even this one point.
posted by Kickstart70 at 10:41 AM on August 25, 2006
Where are the enforcement concerns coming from? My reading was that it wasn't there to be enforced, but would rather be based on the honor system (remember that?).
I really have to admit I don't see the problem.
My perception is that this negatively affects people that publically refuse to TRY to give up their habits that negatively impact their health. Cry me a river. Maybe I'm reading the plan wrong or I'm not understanding the issue others are seeing, but I'm definitely not seeing the problem.
posted by forforf at 10:45 AM on August 25, 2006
I really have to admit I don't see the problem.
My perception is that this negatively affects people that publically refuse to TRY to give up their habits that negatively impact their health. Cry me a river. Maybe I'm reading the plan wrong or I'm not understanding the issue others are seeing, but I'm definitely not seeing the problem.
posted by forforf at 10:45 AM on August 25, 2006
Adverse effects of dietary fructose.
Fructose, insulin resistance, and metabolic dyslipidemia.
The obesity epidemic in the United States.
High-fructose corn syrup and the obesity epidemic.
Beverage consumption and risk of obesity among Native Americans in Arizona.
Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity.
Fructose, weight gain, and the insulin resistance syndrome.
posted by porpoise at 10:47 AM on August 25, 2006
Fructose, insulin resistance, and metabolic dyslipidemia.
The obesity epidemic in the United States.
High-fructose corn syrup and the obesity epidemic.
Beverage consumption and risk of obesity among Native Americans in Arizona.
Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity.
Fructose, weight gain, and the insulin resistance syndrome.
posted by porpoise at 10:47 AM on August 25, 2006
FWIW: Venus of Willendorf (some images NSFW) is an example that refutes even this one point.
You're using a fertility idol as representative of how people lived? That's as bad as citing Dionysus.
posted by Blazecock Pileon at 10:55 AM on August 25, 2006
You're using a fertility idol as representative of how people lived? That's as bad as citing Dionysus.
posted by Blazecock Pileon at 10:55 AM on August 25, 2006
Oh, the amount of high-handed moral prissy-ass sniffing at the ways of those irresponsible poor is getting a wee bit much. I don't even smoke, but having to sign something so degrading as these agreements would make me want to start. While eating an economy-sized bag of Cheetos. Who among us could live up to such an agreement every day? How many of you could abstain from all unhealthy indulgences in this way...and yet we expect people living in the stress of poverty, working their crappy jobs and living in roach-infested apartments because that's all they can afford, to give up the small pleasure of indulging in something sweet/salty/fatty/alcholic or nicotine-laced at the end of the day?
And yes, ADDICTION is a problem. Which requires...long term treatment. And helping the addict find a better way to cope with life, if they're willing. When has shaming addicts into not being addicts ever worked? Oddly enough, it often makes their addiction worse to deal with all the sh*t they get from everyone else! Who would have thought?
Yes, people should be encouraged (whether on public assistance or not) to behave responsibly. Perhaps, though, it would behoove those of us who have health insurance, money for healthy food, and do not live in neighborhoods and families where drug addiction is a normal way of coping with truly horrendous realities, to step off and treat the poor with a little dignity. If only because we could all be there one day.
Short version: if we want the poor to stop being so damned poor, maybe we should stop treating them like lepers and start removing the obstacles to leaving poverty.
But then we couldn't feel superior about how much better we are than them.
posted by emjaybee at 10:58 AM on August 25, 2006 [2 favorites]
And yes, ADDICTION is a problem. Which requires...long term treatment. And helping the addict find a better way to cope with life, if they're willing. When has shaming addicts into not being addicts ever worked? Oddly enough, it often makes their addiction worse to deal with all the sh*t they get from everyone else! Who would have thought?
Yes, people should be encouraged (whether on public assistance or not) to behave responsibly. Perhaps, though, it would behoove those of us who have health insurance, money for healthy food, and do not live in neighborhoods and families where drug addiction is a normal way of coping with truly horrendous realities, to step off and treat the poor with a little dignity. If only because we could all be there one day.
Short version: if we want the poor to stop being so damned poor, maybe we should stop treating them like lepers and start removing the obstacles to leaving poverty.
But then we couldn't feel superior about how much better we are than them.
posted by emjaybee at 10:58 AM on August 25, 2006 [2 favorites]
This isn't about being "uncaring" or "cheap", it's the fact that medical coverage is bloated because people don't take care of themselves and those who are genuinely healthy and careful end up paying for the irresponsible lifestyle of others.
there are a whole lotta ways that we pay for the irresponsibility of others...maybe using this logic i don't think the police should investigate cases of theft in which the owner did not secure the property appropriately, because it's my tax money paying for that...and if your child has to repeat a grade, i don't think my taxes should pay for that because he/she should have studied more...or i don't think emergency service should be provided to people injured in recreational activities...
...medical coverage is bloated for a lot of reasons that make one's lifestyle choices--to the degree that we can control or monitor them--rather small in comparison...the problem is that the real issues aren't convenient targets for your moral superiority...the fact is that for most of us, the threshold for 'irresponsible' behavior falls just outside the point at which we ourselves would be included in the definition; you'll define too much alcohol is that amount beyond what you drink, too much food as that beyond what you eat...
...as for the coverage itself, the cost is inevitable anyway...medicaid can surely deny services to those who make irresponsible choices...but consider who medicaid is for in the first place...denial of medical services does not mean that the patient will fund it by other means; it means the patient probably won't get it at all...and when that person shows up at an emergency room or develops some chronic illness that's going to be far more expensive, who do you think is going to pay for that in the end?
posted by troybob at 10:58 AM on August 25, 2006
there are a whole lotta ways that we pay for the irresponsibility of others...maybe using this logic i don't think the police should investigate cases of theft in which the owner did not secure the property appropriately, because it's my tax money paying for that...and if your child has to repeat a grade, i don't think my taxes should pay for that because he/she should have studied more...or i don't think emergency service should be provided to people injured in recreational activities...
...medical coverage is bloated for a lot of reasons that make one's lifestyle choices--to the degree that we can control or monitor them--rather small in comparison...the problem is that the real issues aren't convenient targets for your moral superiority...the fact is that for most of us, the threshold for 'irresponsible' behavior falls just outside the point at which we ourselves would be included in the definition; you'll define too much alcohol is that amount beyond what you drink, too much food as that beyond what you eat...
...as for the coverage itself, the cost is inevitable anyway...medicaid can surely deny services to those who make irresponsible choices...but consider who medicaid is for in the first place...denial of medical services does not mean that the patient will fund it by other means; it means the patient probably won't get it at all...and when that person shows up at an emergency room or develops some chronic illness that's going to be far more expensive, who do you think is going to pay for that in the end?
posted by troybob at 10:58 AM on August 25, 2006
bruce sterling's novel Holy Fire describes a future where your every action affects your health insurance rating. then, as health science progresses, the safest people begin living longer and longer while the poor/"dangerous" all die out young...
posted by cgs at 10:58 AM on August 25, 2006
posted by cgs at 10:58 AM on August 25, 2006
> No one wants to have their freedoms taken away, even the freedoms to be irresponsible,
> lazy, fat, drunk, stoned-out and/or ignorant.
They're welcome to keep those freedoms, as long as they don't expect to be rescued when their folly gets them into health trouble. But if someone expects to be taken care of by some outside entity (society, the government, Mom, whoever), that outside entity suddenly has the right to do all kinds of officious, intrusive snooping and regulating in what he previously thought of as his private life and personal business. Count on it, it's a sure bet.
posted by jfuller at 11:10 AM on August 25, 2006 [1 favorite]
> lazy, fat, drunk, stoned-out and/or ignorant.
They're welcome to keep those freedoms, as long as they don't expect to be rescued when their folly gets them into health trouble. But if someone expects to be taken care of by some outside entity (society, the government, Mom, whoever), that outside entity suddenly has the right to do all kinds of officious, intrusive snooping and regulating in what he previously thought of as his private life and personal business. Count on it, it's a sure bet.
posted by jfuller at 11:10 AM on August 25, 2006 [1 favorite]
troybob, I'm not arguing that this is a fool-proof way of trying to keep people "clean", but that budgets are tight and the issue of moral hazard is real. Obviously this problem is more complex than, "Hey, you get your act together or we'll cut your benefits!", but there is some truth to medicaid patients milking the system (living more dangerously than they should) because they know the state has got their back.
posted by SeizeTheDay at 11:21 AM on August 25, 2006
posted by SeizeTheDay at 11:21 AM on August 25, 2006
My perception is that this negatively affects people that publically refuse to TRY to give up their habits that negatively impact their health. Cry me a river. Maybe I'm reading the plan wrong or I'm not understanding the issue others are seeing, but I'm definitely not seeing the problem.
Stupid diabetics. If they just had a little more self-control, they'd be able to naturally produce insulin like respectable people.
posted by desuetude at 11:29 AM on August 25, 2006
Stupid diabetics. If they just had a little more self-control, they'd be able to naturally produce insulin like respectable people.
posted by desuetude at 11:29 AM on August 25, 2006
there is some truth to medicaid patients milking the system (living more dangerously than they should) because they know the state has got their back.
Citation, please?
posted by desuetude at 11:30 AM on August 25, 2006
Citation, please?
posted by desuetude at 11:30 AM on August 25, 2006
... in my view, people who ski or skateboard or play violent sports are living more dangerously than they should...and in general, in considering who deserves services, if we successfully exclude, for instance, someone who drinks too much, then the next step within the remaining population will be to get rid of people who drink at all, because they'll be ruining it for the non-drinkers...
i know there are people who live down to a certain level and count on the system to take care of them--though i think arguments like this tend to overestimate the number of people who adopt this as a lifestyle choice--but i don't think it is their state-provided benefits that give them some comfort in making unhealthy choices, any more than i (with good private insurance) would ignore my health because i know the consequences are covered...
...and i think it's easy to say that we should make 'those people' follow a certain set of guidelines in exchange for being 'taken care of'...but programs like medicaid are also safety nets that any of us might fall into someday given an unfortunate sequence of events...i would not then appreciate the additional indignity of having my lifestyle choices reviewed or questioned in exchange for using services covered under taxes that i have paid up to that point...and frankly, i think a lot of the standards of behavior people are throwing around here are a lot more stringent than even those who state them are willing or able to follow...
...i've got nothing against encouraging healthy lifestyle choices, and the system should promote them as much as they are able...better so if they provide programs for overcoming such behavior (and many systems do these days)...the problem is that what has been mentioned here as more like an 'honor system' is inevitably going to hit the piont where someone's coverage is denied because a neighbor reported seeing her smoke a cigarette, and in the ever-growing pressure to cut costs, administrators are going to start actively seeking reasons not to pay for something...and by saying now that it's okay to do it for this particular group, we're putting ourselve on a path where the rest of us will be subject to it as well...and we're not going to be so hard-assed about it when we're the ones being checked out...
posted by troybob at 12:07 PM on August 25, 2006
i know there are people who live down to a certain level and count on the system to take care of them--though i think arguments like this tend to overestimate the number of people who adopt this as a lifestyle choice--but i don't think it is their state-provided benefits that give them some comfort in making unhealthy choices, any more than i (with good private insurance) would ignore my health because i know the consequences are covered...
...and i think it's easy to say that we should make 'those people' follow a certain set of guidelines in exchange for being 'taken care of'...but programs like medicaid are also safety nets that any of us might fall into someday given an unfortunate sequence of events...i would not then appreciate the additional indignity of having my lifestyle choices reviewed or questioned in exchange for using services covered under taxes that i have paid up to that point...and frankly, i think a lot of the standards of behavior people are throwing around here are a lot more stringent than even those who state them are willing or able to follow...
...i've got nothing against encouraging healthy lifestyle choices, and the system should promote them as much as they are able...better so if they provide programs for overcoming such behavior (and many systems do these days)...the problem is that what has been mentioned here as more like an 'honor system' is inevitably going to hit the piont where someone's coverage is denied because a neighbor reported seeing her smoke a cigarette, and in the ever-growing pressure to cut costs, administrators are going to start actively seeking reasons not to pay for something...and by saying now that it's okay to do it for this particular group, we're putting ourselve on a path where the rest of us will be subject to it as well...and we're not going to be so hard-assed about it when we're the ones being checked out...
posted by troybob at 12:07 PM on August 25, 2006
this is similar to what North Carolina did for public housing and Welfare reform. These systems have both worked rather well in other sectors, but it is interesting that this comes in a field like medecine where Doctors are more concerned with ethics than economics (yes I know giant big pharm yada yada yada but medical schools do still teach ethics etc.) It's also notable that this program is beginning in 3 rural counties and then being phased in over 4 years hence giving the program time to find out if it's going to work or not. maybe medicare should just buy on price caps like other countries' healthcare programs or just buy everything from Canada.
posted by aljones15 at 12:18 PM on August 25, 2006
posted by aljones15 at 12:18 PM on August 25, 2006
The profound stupidity of this is that it begins with the idea that people are equally vulnerable to addictions-- whether they be to overeating, cigarettes or heroin.
This is simply not true: there is a linear relationship between the number of traumatic events in one's life and one's risk for various addictions. There are also strong genetic influences, which, almost certainly, intersect such that, for example, if you have one set of genes, you need 3 traumas to make you into an addict, but if you have a different set, it takes 6.
So, what they are asking is for a woman who has been raped repeatedly from age 2 to 7, saw her mother stabbed to death in front of her, lost her sister to AIDS, has bipolar disorder and PTSD and has five children by four different men to "just say no" in order to get health care.
That may sound like an extreme example, but if you take the life histories of the worst addicts, you will tend to find similarly unbelievable (but verifiable if you look prospectively) catalogs of misfortune.
Half of all addicts have a co-existing mental illness.
And the brilliance of this plan is that by denying mental health and substance abuse services to children, it means there will be more likely to be more adults who are addicts later and therefore more costs to be cut later by denying them services.
Even more brilliant is that if you are already an addict or overweight person whose very condition is likely to produce "noncompliance" in the eyes of the state, your punishment will be to receive no more help-- so therefore you are likely to wind up costing everyone more through the emergency room and police and prison systems. This is so smart!
posted by Maias at 12:27 PM on August 25, 2006
I don't know. I stand by my observation that overindulgence of luxuries on a massive scale is a recent phenomenon. The pendulum is just swinging back from fat times to thin, is all.
Drugs and lazyness are certanly not Luxuries..
posted by delmoi at 12:31 PM on August 25, 2006
Drugs and lazyness are certanly not Luxuries..
posted by delmoi at 12:31 PM on August 25, 2006
some qoutes from the proposal:
"The current categorical eligibility system does not allow appropriate populations to receive benefits, i.e., low-income childless adults, "
Hence single people on welfare will now qualify for medicaire. That should increase the number of people in the program.
"The State intends to restrict access to some services currently mandated by federal
law. For example, healthy adults may not have access to podiatry, this service would be
limited to diabetics and others demonstrating medical necessity."
" The addition of non-traditional services to certain segments of our client group would
be phased in over the first three years of the demonstration. These may include medical
screenings, weight loss assistance, nutrition counseling, addiction counseling and the
continuation of smoking cessation programs.
"
so they will start programs to help people with weight problems or drug habits to quit.
" Program success will be
measured in decreases in diabetes diagnosis rates, diabetic complications, high cholesterol
rates, high blood pressure rates, along with other disease-based health improvement
measures. Increases in immunization rates will also be measured as evidence of program
success.
"
if these things don't happen the program is ditched at 3 counties.
posted by aljones15 at 12:42 PM on August 25, 2006
"The current categorical eligibility system does not allow appropriate populations to receive benefits, i.e., low-income childless adults, "
Hence single people on welfare will now qualify for medicaire. That should increase the number of people in the program.
"The State intends to restrict access to some services currently mandated by federal
law. For example, healthy adults may not have access to podiatry, this service would be
limited to diabetics and others demonstrating medical necessity."
" The addition of non-traditional services to certain segments of our client group would
be phased in over the first three years of the demonstration. These may include medical
screenings, weight loss assistance, nutrition counseling, addiction counseling and the
continuation of smoking cessation programs.
"
so they will start programs to help people with weight problems or drug habits to quit.
" Program success will be
measured in decreases in diabetes diagnosis rates, diabetic complications, high cholesterol
rates, high blood pressure rates, along with other disease-based health improvement
measures. Increases in immunization rates will also be measured as evidence of program
success.
"
if these things don't happen the program is ditched at 3 counties.
posted by aljones15 at 12:42 PM on August 25, 2006
this sounds like a great idea. let's apply it to every employee that works for a company that benefits from government contracts. halliburton wants that new no bid? only as long as employees acquiesce to regular adult nanny visits. if you're gonna obtain any of your income from the government then you have to learn to be double plus good with living habits.
i work on an ambulance and at 4 a.m. last night i picked up someone threatening to kill themselves after 5 days on meth. he was in the parking lot of a e.r. in the very wealthy parts of the city. the police and that hospital refused to help the guy (violating state and federal law) demanding we take him to the county hospital 40 minutes away. so what are we gonna be doing 10 years from now? literally find an island to throw people onto? some kind of income to booze/cigarette ratio?
posted by andywolf at 12:51 PM on August 25, 2006
i work on an ambulance and at 4 a.m. last night i picked up someone threatening to kill themselves after 5 days on meth. he was in the parking lot of a e.r. in the very wealthy parts of the city. the police and that hospital refused to help the guy (violating state and federal law) demanding we take him to the county hospital 40 minutes away. so what are we gonna be doing 10 years from now? literally find an island to throw people onto? some kind of income to booze/cigarette ratio?
posted by andywolf at 12:51 PM on August 25, 2006
the police and that hospital refused to help the guy (violating state and federal law) demanding we take him to the county hospital 40 minutes away.
Can you get them in trouble for this? I don't even know who to tell if the police refuse.
posted by agregoli at 12:53 PM on August 25, 2006
Can you get them in trouble for this? I don't even know who to tell if the police refuse.
posted by agregoli at 12:53 PM on August 25, 2006
i gave the badge number to the receiving hospital. the cop will most likely get a slap on the wrist and do the same again. it's interesting when you site state law to a cop and they basically tell you to fuck off. the receiving hospital would need to pursue getting the hospital that refused a fine (50,000$). unlikely because of politics between the two.
posted by andywolf at 12:57 PM on August 25, 2006
posted by andywolf at 12:57 PM on August 25, 2006
I am kind of amazed the American government is engaging in hard paternalism rather than pimping the benefits of capitalism.
Recently there has been some stir on the fact welfare reform in the USA during the 1990's has been a success, however things like this are pushing it. It reflects a newfound corporate attitude that one is responsible to uphold certain morals/attitudes even outside the workplace.
As a Norwegian, I find these kinds of stipulations on helping our fellow man downright degrading, if not a violation of human rights. Sure, there should be some guidelines as to what you can and cannot do with government cash, but somehow, to me at least, better education and healthcare inevitably lead to more productive members of society.
This is all smoke and mirrors avoiding the real issues behind poverty.
posted by Funmonkey1 at 1:16 PM on August 25, 2006
Recently there has been some stir on the fact welfare reform in the USA during the 1990's has been a success, however things like this are pushing it. It reflects a newfound corporate attitude that one is responsible to uphold certain morals/attitudes even outside the workplace.
As a Norwegian, I find these kinds of stipulations on helping our fellow man downright degrading, if not a violation of human rights. Sure, there should be some guidelines as to what you can and cannot do with government cash, but somehow, to me at least, better education and healthcare inevitably lead to more productive members of society.
This is all smoke and mirrors avoiding the real issues behind poverty.
posted by Funmonkey1 at 1:16 PM on August 25, 2006
Caught in drug plan's 'hole': Many are surprised by gap in Medicare that can require them to pay thousands.
posted by homunculus at 1:25 PM on August 25, 2006
posted by homunculus at 1:25 PM on August 25, 2006
Drugs and lazyness are certanly not Luxuries..
Drugs and laziness are certainly not "Luxuries" but indulging in them certainly is a luxury.
posted by Blazecock Pileon at 1:25 PM on August 25, 2006
Drugs and laziness are certainly not "Luxuries" but indulging in them certainly is a luxury.
posted by Blazecock Pileon at 1:25 PM on August 25, 2006
"As a Norwegian, I find these kinds of stipulations on helping our fellow man downright degrading ..."
Actually, as a a Norwegian, you get huge benefits from oil revenues that your better education and healthcare had nothing to do with creating. If those revenues went away tomorrow, your per capita GNP would be about 2/3rds that of West Virginia - or less.
If that were to actually happen, how would you deal with the real issues behind your new-found poverty? More healthcare and education expeinditures?
Or mass emigration, as your great-grandparent were forced to do?
posted by Jos Bleau at 1:28 PM on August 25, 2006
Actually, as a a Norwegian, you get huge benefits from oil revenues that your better education and healthcare had nothing to do with creating. If those revenues went away tomorrow, your per capita GNP would be about 2/3rds that of West Virginia - or less.
If that were to actually happen, how would you deal with the real issues behind your new-found poverty? More healthcare and education expeinditures?
Or mass emigration, as your great-grandparent were forced to do?
posted by Jos Bleau at 1:28 PM on August 25, 2006
Jos, funny enough you mention oil revenues. Yes, we do have a substantial bank roll due to the crude and natural gas reserves, however you will find is most of it squirrelled away for when we don't. At the same time Norway has used taxes and an ever expanding economy originally driven by oil wealth to branch out. Funny enough, there are some paradoxes to an American economy.
America generates a vast amount of wealth. Spending a trillion dollars on the military industrial complex to achieve incredibly poor results versus investing in education and health care is a no brainer. Just take a look at that massive surplus the US treasury had coming into 2000....Poof!!! It's gone! We can argue back on forth on where the wealth came from, but it is what you do with it that counts. Regulating welfare through social behavior contracts? Spend a buck and buy a clue, it doesn't work and is offensive to any taxpayer. Especially to people that require help.
posted by Funmonkey1 at 1:43 PM on August 25, 2006
America generates a vast amount of wealth. Spending a trillion dollars on the military industrial complex to achieve incredibly poor results versus investing in education and health care is a no brainer. Just take a look at that massive surplus the US treasury had coming into 2000....Poof!!! It's gone! We can argue back on forth on where the wealth came from, but it is what you do with it that counts. Regulating welfare through social behavior contracts? Spend a buck and buy a clue, it doesn't work and is offensive to any taxpayer. Especially to people that require help.
posted by Funmonkey1 at 1:43 PM on August 25, 2006
"Time to wake up, citizen! Wake up, the Physical Jerks will begin in three minutes!"posted by ceribus peribus at 1:48 PM on August 25, 2006
Winston sprang to attention in front of the telescreen, upon which the image of a youngish woman, scrawny but muscular, dressed in tunic and gym-shoes, had already appeared.
'Arms bending and stretching!' she rapped out. 'Take your time by me. One, two, three, four! One, two, three, four! Come on, comrades, put a bit of life into it! One, two, three, four! One, two, three, four! ...'
"Time to wake up, citizen! Wake up, the Physical Jerks will begin in three minutes!"
Hehe, far too close to the truth.
posted by Funmonkey1 at 1:52 PM on August 25, 2006
Hehe, far too close to the truth.
posted by Funmonkey1 at 1:52 PM on August 25, 2006
From the plan document:
* I will do my best to stay healthy. I will go to health improvement programs as directed by my medical home.
* I will read the booklets and papers my medical home gives me. If I have questions about them, I will ask for help.
* I will go to my medical home when I am sick.
* I will take my children to their medical home when they are sick.
* I will go to my medical home for check-ups.
* I will take my children to their medical home for check-ups.
* I will take the medicines my health care provider prescribes for me.
* I will show up on time when I have my appointments.
* I will bring my children to their appointments on time.
* I will call the medical home to let them know if I cannot keep my appointments or those for my children.
* I will let my medical home know when there has been a change in my address or phone number for myself or my children.
* I will use the hospital emergency room only for emergencies.
What is unreasonable in those requests? They are getting a benefit, what is being enumerated is their responsibilities under that benefit. I still fail to see what is bad about this particular plan.
posted by forforf at 2:53 PM on August 25, 2006
* I will do my best to stay healthy. I will go to health improvement programs as directed by my medical home.
* I will read the booklets and papers my medical home gives me. If I have questions about them, I will ask for help.
* I will go to my medical home when I am sick.
* I will take my children to their medical home when they are sick.
* I will go to my medical home for check-ups.
* I will take my children to their medical home for check-ups.
* I will take the medicines my health care provider prescribes for me.
* I will show up on time when I have my appointments.
* I will bring my children to their appointments on time.
* I will call the medical home to let them know if I cannot keep my appointments or those for my children.
* I will let my medical home know when there has been a change in my address or phone number for myself or my children.
* I will use the hospital emergency room only for emergencies.
What is unreasonable in those requests? They are getting a benefit, what is being enumerated is their responsibilities under that benefit. I still fail to see what is bad about this particular plan.
posted by forforf at 2:53 PM on August 25, 2006
What is unreasonable in those requests?
Right, coercion can be good for you. In this new enlightened century, the ends always justify the means.
posted by effwerd at 3:27 PM on August 25, 2006
Right, coercion can be good for you. In this new enlightened century, the ends always justify the means.
posted by effwerd at 3:27 PM on August 25, 2006
forforf, is not the ambiguity in each of these statements enough to say something is wrong?
For example - I will do my best to stay healthy. I will go to health improvement programs as directed by my medical home.
What is the definition of healthy? Does that mean purchasing a packet of crisps which contain 30mg of fat per 100 grams is tantamount to losing $x.xx benefit?
Or maybe - I will take the medicines my health care provider prescribes for me.
So that means if a certain medication doesn't work and the benefit recipient seeks a second medical opinion and subsequent new prescription they will lose $x.xx benefit?
It's a Pandora box that isn't reasonable and gives complete life control over to what at best could be described as an outside authority that has no interest in public health/welfare.
I wonder what you would say if your HMO decided not to cover your choices.......
posted by Funmonkey1 at 3:33 PM on August 25, 2006
For example - I will do my best to stay healthy. I will go to health improvement programs as directed by my medical home.
What is the definition of healthy? Does that mean purchasing a packet of crisps which contain 30mg of fat per 100 grams is tantamount to losing $x.xx benefit?
Or maybe - I will take the medicines my health care provider prescribes for me.
So that means if a certain medication doesn't work and the benefit recipient seeks a second medical opinion and subsequent new prescription they will lose $x.xx benefit?
It's a Pandora box that isn't reasonable and gives complete life control over to what at best could be described as an outside authority that has no interest in public health/welfare.
I wonder what you would say if your HMO decided not to cover your choices.......
posted by Funmonkey1 at 3:33 PM on August 25, 2006
The point of health insurance is that the lucky subsidize the unlucky.
Trying to determine how much "luck" in health is actually down to personal choice is a fool's game that completely undermines the whole idea.
Here's what happens when you give bureaucrats the right to determine whether people's behavior is "healthy":
DAILY GAZETTE, Schenectady, New York
August 22, 2006
Carl Strock
THE VIEW FROM HERE
Mother still can’t get her daughter
A couple of months ago I wrote that Angel Bishop would get her children back if she danced to the music of the child-protection bureaucracy a little bit.
Well, she danced a little bit but not enough. She got her son back at the end of June, as scheduled, but yesterday she found out she will not get her daughter back until December at the earliest, not now, as was scheduled at her June court appearance.
In case you have forgotten, the children — a 10-year-old boy and a 6-year-old girl — were taken away from her even though she had not been accused of abusing them. Rather, she had stopped giving her son the amphetamines that he was prescribed for his unruly behavior, because she said they made him worse, and she had blown off appointments for her daughter at a sex-abuse counseling program, having in mind that the daughter had merely "acted out" some things with another little girl and had not actually been sexually abused.
Plus, she lived a marginal kind of life as a high-school dropout with little employment to her credit, inhabiting an apartment in a lousy neighborhood, and so forth.
She was a "client," someone perpetually under the watch of the Schenectady County Department of Social Services and its subdivision, Child Protective Services. When they got pushed, by Angel’s refusing to let them into her apartment, they reacted.
They went to Family Court and got the children removed, the boy to a foster home, the girl to the home of her otherwise absent father and his new wife, though the father may not have been present in that other home.
She could get her children back if she met their conditions: Keep all the appointments, go to all the counseling, find an apartment in a better neighborhood, don’t have friends in and out of her home, and so forth.
But after two months, her level of compliance was not up to their standards, so they "violated" her, as they say.
Specifically, her caseworker, Betsy Martineau, found that Angel "has allowed other people to be in her home that are not family members" during her daughter’s permitted 8-hour visits, which is accusation No. 1.
Angel says that’s not true, that she did hang out with one old friend, whom she regards as a sister because they grew up under the same mother, but only at a park, not inside her home.
But right away ask yourself, what could possibly be wrong with having a childhood friend inside her home even if she did allow it? What kind of craziness is it for a government agency to punish a mother and deprive her of her own child for such a normal thing as having a friend in her home while her child is there? Have you ever heard of anything like that?
Furthermore, this was alleged to be a violation of the court order that set the conditions for her to get her kids back, but she was not even given a copy of that order, so she doesn’t know exactly what it says. She was given instead an improvised contract to sign, between her and the caseworker, which stipulates among other things, "Angel Bishop agrees not to allow any inappropriate people in her home," without defining "inappropriate."
On that basis she got cited for going to a park with a childhood friend! Accusation No. 2 against her: She made only one appointment for her daughter at a sexabuse treatment program, from her June 8 court appearance till now, which she concedes is true, but she points out, her daughter doesn’t live with her. She lives with her father’s new wife, and is only an occasional visitor. Why don’t the people who have custody of her take her to this treatment program?
She did make one appointment, and she kept it, but that’s not good enough. (Even though, remember, there is no accusation that the girl was ever sexually abused.)
No. 3: The accusation is that visitation between her and her daughter "has not progressed as outlined in the court order because Angel took a job and has no days off," which is perhaps my favorite. A welfare recipient is punished for getting a job!
Of course, again, Angel doesn’t know what might be outlined in the court order because no one ever gave it to her, including her own lawyer, but it’s true, she took a job as a cleaner at Saratoga Race Course.
She says it’s not true that she had no days off. She had Tuesdays off, and on every Tuesday of the six weeks she worked she had the permitted 8-hour visit with her daughter except for one Tuesday when the caseworker, not she, couldn’t make it.
The point is, she was allowed two visits a week but availed herself of only one, because she was working six days a week. So that’s another strike. And never mind that she needs to have visits in the first place only because DSS took the kid away from her for no good reason.
Accusation No. 4: "Angel failed to abide by the court’s order of introducing the children to her significant other by doing so on the very night that [her son] was returned to her care." In other words, Family Court allegedly ordered her not to introduce her children to any boyfriend she might have — imagine the gall — but she did it anyway, and that’s another strike.
But again, she has seen no court order, and neither have I. I was in court when it was given orally, and I didn’t hear anything like that. And the bogus contract she was required to sign says nothing about introducing or not introducing her children to a boyfriend. It says she is not to have "inappropriate people" in her home or anyone living with her. (Imagine the gall of that one, too.)
What happened, Angel says, is the day her son returned to her, at the end of June, she went to visit her mother, and her boyfriend was there at her mother’s house, and her son met him.
So this has nothing to do with the little girl, who was away then and still away now. Nevertheless it is used as grounds for keeping her from her mother. (Angel has since dropped the boyfriend because of these difficulties.)
Can you imagine anything as crazy as this? Can you imagine a government agency making charges like this against a United States citizen, and can you imagine a court, specifically Schenectady County Family Court, upholding them and using them to keep a child away from her mother?
I swear, if I didn’t see it with my own eyes, I wouldn’t believe it either.
Yesterday, out in front of their new home in a safer neighborhood, next door to Angel’s mother, the boy, now 11, cried as he told me, "I want my sister to come home."
Accusation No. 5: At Parsons Child and Family Center, on Franklin Street, Angel was "very abrupt and informed Parsons that she did not need services or want anyone coming into her home," the complaint against her reads, which Angel admits is basically true.
She says a psychiatrist there told her she was a bad mother, "and I called him out on it, I told him, You’re not professional.’ " And she also told him, "I don’t need nobody to come in and tell me how to raise my kids."
I told her this was not a politic thing to do, and she agreed but said, "I’m not the kind of person that keeps my mouth shut. I guess that’s what they’re using against me."
Also, she admits she unloaded on the caseworker, Ms. Martineau, during a home visit the other day, and really "gave it to her good," which also was not politic and probably informs Ms. Martineau’s complaint, registered in a written report, "Angel Bishop’s efforts to engage in services has been minimal."
Yes, minimal efforts to dance to the music. Punishment: the daughter to be kept away from both her mother and her brother for at least a few more months to see if the mother will finally dance, and if she won’t, she’ll lose the kid for good.
Ask yourself, what country is this happening in?
Do we really want to have such people determining who gets health care? Because that's what we're talking about here.
posted by Maias at 4:21 PM on August 25, 2006
I'll agree that there should be safeguards, but in my mind the general intent of the program is sound. It is trying to say to people that you have to take on added responsibilities to get added benefits. Call it what you like, but that's how the world works. They are getting a benefit, a hand out. And I'm happy to give them one, but I'm not happy to enable people to abuse a system meant to help them.
They are not cut off from the system if they elect not to sign on to this program. They just get the minimal care. I guess one could just give everybody the minimal care and forget the whole additional benefits.
Here's where I do sorta agree with some of the points. I think there should be no enforcement of this, and that in order for a patient to be forcibly removed for not following the rules would require a caregiver (not a social worker!) to report the patient (maybe require multiple chances). To get back on again, the patient would have to resubmit the paperwork and re-sign the statement.
I'm not opposed to making it easy to get the additional benefits ... I am opposed to giving those additional benefits the appearance of being "free". However, I think that the cost of these services should not involve a monetary payment, just a promise to fulfill normal patient responsibilities and a paperwork hassle if they are reported as abusing the system.
So I still think there is merit in giving this plan a try.
posted by forforf at 5:41 PM on August 25, 2006
They are not cut off from the system if they elect not to sign on to this program. They just get the minimal care. I guess one could just give everybody the minimal care and forget the whole additional benefits.
Here's where I do sorta agree with some of the points. I think there should be no enforcement of this, and that in order for a patient to be forcibly removed for not following the rules would require a caregiver (not a social worker!) to report the patient (maybe require multiple chances). To get back on again, the patient would have to resubmit the paperwork and re-sign the statement.
I'm not opposed to making it easy to get the additional benefits ... I am opposed to giving those additional benefits the appearance of being "free". However, I think that the cost of these services should not involve a monetary payment, just a promise to fulfill normal patient responsibilities and a paperwork hassle if they are reported as abusing the system.
So I still think there is merit in giving this plan a try.
posted by forforf at 5:41 PM on August 25, 2006
bugbread writes "You just said something untrue"
Blazecock Pileon writes "If it is untrue, you agreed with it here. Whatever."
The thing which you said was untrue was "When has it ever not been so?" in regards to indulging in booze, cigarettes, etc. I never agree with that. What I agreed with here was a different statement, about food indulgence.
To put this in Jimi terms:
A: "Jimi Hendrix played excellent guitar on the new N'Sync album"
B: "Jimi Hendrix didn't play guitar on the new N'Sync album"
A: "I dunno. I stand by my observation that he's a good guitar player. 'Are you Experienced?' is a great album."
B: "Your initial observation was that Jimi played on the new N'Sync album. That's untrue. 'Are you Experienced?" is a great album, though."
A: "If it's untrue, you just agreed with it. Whatever."
posted by Bugbread at 5:45 PM on August 25, 2006
Blazecock Pileon writes "If it is untrue, you agreed with it here. Whatever."
The thing which you said was untrue was "When has it ever not been so?" in regards to indulging in booze, cigarettes, etc. I never agree with that. What I agreed with here was a different statement, about food indulgence.
To put this in Jimi terms:
A: "Jimi Hendrix played excellent guitar on the new N'Sync album"
B: "Jimi Hendrix didn't play guitar on the new N'Sync album"
A: "I dunno. I stand by my observation that he's a good guitar player. 'Are you Experienced?' is a great album."
B: "Your initial observation was that Jimi played on the new N'Sync album. That's untrue. 'Are you Experienced?" is a great album, though."
A: "If it's untrue, you just agreed with it. Whatever."
posted by Bugbread at 5:45 PM on August 25, 2006
keee-rist, that's a story that needs media exposure in a big way, Malas. Toss in some email, fax, and telephone numbers for the public representative that's responsible for the administration of child/family services, etc. Get the net riled up, maybe it'd help.
posted by five fresh fish at 5:48 PM on August 25, 2006
posted by five fresh fish at 5:48 PM on August 25, 2006
Gravy, keep reading. That is the basic plan once they sign the agreement they get all the stuff instituted.
posted by stormygrey at 12:17 PM EST on August 25
Oh I read the entire link before posting. I just wonder why they are talking about a "minimal" plan for children.
Think about this. Who exactly is signing this agreement? Not the 5 year olds, presumably. Who is responsible for meeting the state's expectations? Not the 2 year olds. What happens if the agreement is voided? What if a 6 year old fails to get exercise because his mother makes him stay in the house all day and he fails to eat healthily because his mother feeds him fast food, does he lose his extended benefits? Does the state simply give up on him? Once the benefits are reduced because of noncompliance can they ever be restored?
The more I think about this, the sicker I get. There is so much money in this country. We can throw billions at New Orleans. We can squander billions on the war. We can waste billions on subsidies and bailouts for corporations. But we apparently can't find enough money to give every child in America good basic health care. The poor. Fuck 'em.
posted by Secret Life of Gravy at 8:48 PM on August 25, 2006
posted by stormygrey at 12:17 PM EST on August 25
Oh I read the entire link before posting. I just wonder why they are talking about a "minimal" plan for children.
Think about this. Who exactly is signing this agreement? Not the 5 year olds, presumably. Who is responsible for meeting the state's expectations? Not the 2 year olds. What happens if the agreement is voided? What if a 6 year old fails to get exercise because his mother makes him stay in the house all day and he fails to eat healthily because his mother feeds him fast food, does he lose his extended benefits? Does the state simply give up on him? Once the benefits are reduced because of noncompliance can they ever be restored?
The more I think about this, the sicker I get. There is so much money in this country. We can throw billions at New Orleans. We can squander billions on the war. We can waste billions on subsidies and bailouts for corporations. But we apparently can't find enough money to give every child in America good basic health care. The poor. Fuck 'em.
posted by Secret Life of Gravy at 8:48 PM on August 25, 2006
This is fucking horseshit.
Not because those proclamations don't make sense on an individual level, but because the argument over personal responsibility completely ignores the primary reason for this: to reduce their own risk, and thus save a few extra bucks. Don't think for a minute that you're going to ever see any of that cash, though.
This reminds me of the games insurance companies play. "Before we let you pay us the ludicrously cheap sum of, let's say... $400 each month for sub-standard coverage, we require that you visit a doctor and dentist beforehand so they can do a full physical evaluation. Should they find anything wrong with you--anything at all--you're coverage is subject to immediate cancellation. Haveaniceday."
Basically, they want you to keep paying, but don't want to ever pony up the dough themselves. A giant, bottomless hole in the ground where we'll let you through away your money, never to be seen again. Not only will we let you do this, we'll force you to do this and you'll be thankful for it (mandatory auto insurance, for example).
In this particular case, since they're lowering their own exposure to risk, shouldn't taxes go down?
posted by Civil_Disobedient at 9:24 PM on August 25, 2006
Not because those proclamations don't make sense on an individual level, but because the argument over personal responsibility completely ignores the primary reason for this: to reduce their own risk, and thus save a few extra bucks. Don't think for a minute that you're going to ever see any of that cash, though.
This reminds me of the games insurance companies play. "Before we let you pay us the ludicrously cheap sum of, let's say... $400 each month for sub-standard coverage, we require that you visit a doctor and dentist beforehand so they can do a full physical evaluation. Should they find anything wrong with you--anything at all--you're coverage is subject to immediate cancellation. Haveaniceday."
Basically, they want you to keep paying, but don't want to ever pony up the dough themselves. A giant, bottomless hole in the ground where we'll let you through away your money, never to be seen again. Not only will we let you do this, we'll force you to do this and you'll be thankful for it (mandatory auto insurance, for example).
In this particular case, since they're lowering their own exposure to risk, shouldn't taxes go down?
posted by Civil_Disobedient at 9:24 PM on August 25, 2006
To put this in Jimi terms:
You did better with your Hitler nonsense.
posted by Blazecock Pileon at 10:08 AM on August 26, 2006
You did better with your Hitler nonsense.
posted by Blazecock Pileon at 10:08 AM on August 26, 2006
Very well. Returning to Hitler, then. You said "Hitler invaded Kansas." jonmc and KevinSkomsvold said he didn't. You replied, "I dunno, I still stand by my observation that Hitler invaded other countries." You followed up with "My point to jonmc is that Hitler invaded other countries. Poland, for example." I replied, "I agree, he did invade Poland. If the point you wanted to make was that Hitler invaded other countries, you probably should have started with Poland, and avoided Kansas as an example."
posted by Bugbread at 10:25 AM on August 26, 2006
posted by Bugbread at 10:25 AM on August 26, 2006
Good luck with your cause.
posted by Blazecock Pileon at 1:00 PM on August 26, 2006
posted by Blazecock Pileon at 1:00 PM on August 26, 2006
For fucks' sake, guys, go get a room.
posted by five fresh fish at 8:02 PM on August 26, 2006
posted by five fresh fish at 8:02 PM on August 26, 2006
My cause is just having you understand what I'm saying. It's not to convince you of anything, to change the world, to make people eat more, make people eat less, have you admit victory, have you admit defeat, or anything else. Either you get what I'm saying, and are pretending not to, or you don't get what I'm saying. Either way, I can't explain any more clearly than I have, so I'm going to give up on "my cause". No room necessary.
posted by Bugbread at 12:07 AM on August 27, 2006
posted by Bugbread at 12:07 AM on August 27, 2006
My cause is just having you understand what I'm saying.
If I had a cause, it would be to get people on the Internet to cease invoking Hitler, fertility idols, or even emblems of drunken debauchery in Greek mythology to make dumb analogies, when they could simply say they disagree, even when they — bizarrely enough — turn around and agree a little later on, even a little bit. I don't think a room would be big enough to hold a cause this big.
posted by Blazecock Pileon at 2:08 PM on August 27, 2006
If I had a cause, it would be to get people on the Internet to cease invoking Hitler, fertility idols, or even emblems of drunken debauchery in Greek mythology to make dumb analogies, when they could simply say they disagree, even when they — bizarrely enough — turn around and agree a little later on, even a little bit. I don't think a room would be big enough to hold a cause this big.
posted by Blazecock Pileon at 2:08 PM on August 27, 2006
Your cause is good. I jumped to analogies too fast. So, straightforward: I agree with some of the things you have said, and I disagree with others. I agree with your overall points, and disagree with some of the examples you have provided for them.
posted by Bugbread at 2:48 PM on August 27, 2006
posted by Bugbread at 2:48 PM on August 27, 2006
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This thread has been archived and is closed to new comments
No. All the regulations in the world won't tear someone from their vices. Should indulging in booze, cigarettes, etc, be only a privilige of the wealthy?
posted by jonmc at 8:45 AM on August 25, 2006