Author Topic: 2020 POTUS Candidates  (Read 178931 times)

Gin1984

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Re: 2020 POTUS Candidates
« Reply #1700 on: December 13, 2019, 09:42:40 AM »
My guess is that most people on this board are so smart that they hardly realize how useful their calculus and physics has been.

From my understanding, a large part of being an MD is staying up to date on new research. This research is going to include different "rates of change". A doctor is going to need to understand the implications of what that means and to generally understand what those graphs or tables might indicate.

Physics is extremely important in understanding the movement of muscles and our skeleton in general. Why is it that we say that the weight on our knees is 1.5x our body weight?

However, Medical schools understand that there isn't an additional benefit to studying Cal II or beyond Physics II. They don't need to do the math; heck who does math by hand except students? But doctors do need a cursory understanding of these topics. My guess is that people here have actually used their calculus/physics knowledge a good bit more than they realize.
There is non-calc based physics, data in research needs statistics, not calc. There is literally no value in it. Frankly, I ran power analysis for PIs (both MDs and PhDs, though mostly MD) as a graduate student because my statistics background as a psychology major prepared me better for the analysis than any calc they took (and I did take calc, it was not worth it).

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DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1701 on: December 13, 2019, 09:49:22 AM »
I have to agree with FIPurpose and not most of the rest of you on the issue of physics, and probably also calculus. Physics is definitely a part of the understanding of movement and relates to the various musculoskeletal problems that many have.

Gin1984

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Re: 2020 POTUS Candidates
« Reply #1702 on: December 13, 2019, 10:13:03 AM »
I have to agree with FIPurpose and not most of the rest of you on the issue of physics, and probably also calculus. Physics is definitely a part of the understanding of movement and relates to the various musculoskeletal problems that many have.
Except that the PhDs who teach many of those classes did not take either in undergrad.  So why is it required for MDs but not PhDs? 

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1703 on: December 13, 2019, 10:19:33 AM »
Because the MD is going to be doing things like hip replacement surgery.

Gin1984

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Re: 2020 POTUS Candidates
« Reply #1704 on: December 13, 2019, 10:21:43 AM »
Because the MD is going to be doing things like hip replacement surgery.
And you really think they are using physics during that? ok

YttriumNitrate

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Re: 2020 POTUS Candidates
« Reply #1705 on: December 13, 2019, 10:24:14 AM »
I thought that those math courses might weed out folks.
That's kind of what I thought too. Organic chemistry, biology, physics, and calculus each tests a somewhat different mixture of the student's ability to understand new concepts and rote memorization.

Perhaps that's the theory, but have studies been done showing that it's effective? And more importantly, is it more effective than using coursework relevant to ones goals to achieve the same purpose?

I won't argue that using math to weed students out for unrelated degrees is suboptimal because I really don't know whether it is or not, but I also think there should be some strong evidence that it is optimal before we invest our resources in that path. From what I do know it seems we do things the way we do because that's the way they've always been done, not because we've shown them to be effective.

Another thing to consider is that what might be optimal for producing doctors might not be the best option for student body as a whole. As an example, based on some quick googling, it looks like only 1 in 5 premed freshman actually end up going to medical school. Starting premed freshman out with cadaver dissection might be optimal for the 20% that go to med school, but that might be sub-optimal for the 80% that do not.

Davnasty

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Re: 2020 POTUS Candidates
« Reply #1706 on: December 13, 2019, 10:39:49 AM »
Because the MD is going to be doing things like hip replacement surgery.

I agree with maizeman's take on this. You can make a reasonable argument that physics may be useful for a doctor but the question shouldn't be, "is it useful?" the question should be "is it more useful than another course designed specifically for someone who will end up performing hip replacement surgery?" There is an opportunity cost to everything. Resources such as time, money, and effort are finite and every course a student takes uses some of those resources.*

On the other hand If I were choosing examples of subjects that aspiring doctors shouldn't be required to take, physics isn't the worst offender. Advanced maths and organic chemistry are probably more frivolous to that career path.

*If I were going to argue against myself here, I'd mention that perhaps these more general courses are used to weed students out because they're cheaper to administer. This saves universities resources, but not the student.


Davnasty

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Re: 2020 POTUS Candidates
« Reply #1707 on: December 13, 2019, 10:50:24 AM »
I thought that those math courses might weed out folks.
That's kind of what I thought too. Organic chemistry, biology, physics, and calculus each tests a somewhat different mixture of the student's ability to understand new concepts and rote memorization.

Perhaps that's the theory, but have studies been done showing that it's effective? And more importantly, is it more effective than using coursework relevant to ones goals to achieve the same purpose?

I won't argue that using math to weed students out for unrelated degrees is suboptimal because I really don't know whether it is or not, but I also think there should be some strong evidence that it is optimal before we invest our resources in that path. From what I do know it seems we do things the way we do because that's the way they've always been done, not because we've shown them to be effective.

Another thing to consider is that what might be optimal for producing doctors might not be the best option for student body as a whole. As an example, based on some quick googling, it looks like only 1 in 5 premed freshman actually end up going to medical school. Starting premed freshman out with cadaver dissection might be optimal for the 20% that go to med school, but that might be sub-optimal for the 80% that do not.

That's a fair point, but cadaver dissection sounds like a highly specialized course for medical school. Certainly there are subjects that fall somewhere between unrelated and highly specialized that are also difficult enough to weed out those who aren't cut out for medical school.

PathtoFIRE

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Re: 2020 POTUS Candidates
« Reply #1708 on: December 13, 2019, 11:01:57 AM »
As an MD, I can say that the prereqs do provide a foundation on which medical school education is based, but it doesn't have to be that way. Most schools are going to only 1.5 years of basic science curriculum before tossing the students into the clinical clerkships, and it helps to have learned a lot of these basic science topics earlier as an undergrad, so that you're just layering additional understanding and depth.

But just to push back a little bit, and maybe bring this discussion back to the topic of this thread a little more, I think that we need to be arguing for greater, broader, more liberalized education all around. I'm shooting from the hip here a little, but I feel very uneasy with the logic of the recent decades, arguing for a strictly utilitarian view of education as simply a tool to turn out workers for our companies. I don't think it's a coincidence that you're seeing the rise of anti-education anti-science anti-intellectual movements at the same time that we see moves to reduce education, especially secondary and undergraduate, to a lowest common denominator. So in parallel, you might say why do physicians need to understand the physical sciences, in depth genetics, or even philosophy and literature? And I'd say that as society gets wealthier and more productive, that liberalizing the education of all for just the primary benefit that that brings to society, irregardless of whether it connects directly to the tasks that someone will perform at a job, becomes easier to accommodate and even emphasize.

Also, in regards to physics, please don't forget that radiology and radiation oncology require direct understanding of many of these principles. It's covered later in their residency, but still can be argued as a necessary prereq for at least a subset of physicians.

Davnasty

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Re: 2020 POTUS Candidates
« Reply #1709 on: December 13, 2019, 11:22:36 AM »
As an MD, I can say that the prereqs do provide a foundation on which medical school education is based, but it doesn't have to be that way. Most schools are going to only 1.5 years of basic science curriculum before tossing the students into the clinical clerkships, and it helps to have learned a lot of these basic science topics earlier as an undergrad, so that you're just layering additional understanding and depth.

But just to push back a little bit, and maybe bring this discussion back to the topic of this thread a little more, I think that we need to be arguing for greater, broader, more liberalized education all around. I'm shooting from the hip here a little, but I feel very uneasy with the logic of the recent decades, arguing for a strictly utilitarian view of education as simply a tool to turn out workers for our companies. I don't think it's a coincidence that you're seeing the rise of anti-education anti-science anti-intellectual movements at the same time that we see moves to reduce education, especially secondary and undergraduate, to a lowest common denominator. So in parallel, you might say why do physicians need to understand the physical sciences, in depth genetics, or even philosophy and literature? And I'd say that as society gets wealthier and more productive, that liberalizing the education of all for just the primary benefit that that brings to society, irregardless of whether it connects directly to the tasks that someone will perform at a job, becomes easier to accommodate and even emphasize.

Also, in regards to physics, please don't forget that radiology and radiation oncology require direct understanding of many of these principles. It's covered later in their residency, but still can be argued as a necessary prereq for at least a subset of physicians.

This I can agree with. I'm not arguing for getting rid of general education, just some of the more specific advanced courses like organic chemistry being required for specific career paths.

former player

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Re: 2020 POTUS Candidates
« Reply #1710 on: December 13, 2019, 11:25:42 AM »
Because the MD is going to be doing things like hip replacement surgery.
And you really think they are using physics during that? ok
Probably why it took 100 years for doctors to realise hip replacements for women needed to be a different shape from hip replacements for men, and even longer (2018) to realise that post-op physio also needed to be different for women than it is for men. 

maizeman

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Re: 2020 POTUS Candidates
« Reply #1711 on: December 13, 2019, 11:27:41 AM »
With the question would be whether things like physics are part of the curriculum in countries where people go straight into specialized education to become an MD instead of only starting after getting a regular bachelor's degree (and the overall education takes fewer years)? If they aren't, we could compare the quality of the doctors produced by the two systems.

With regards to people being so smart they don't realize how much they're using calculus, I'm not sure I agree. I DO use algebra a surprising about, and I always notice it when I do because it brings back memories of being a bored middle school kid thinking there was no reason I'd ever need to know this stuff. Geometry/trig a little but not nearly as much as algebra. For calculus it's useful to know the names of terms, but I don't think I've actually used any of the skills I used in that class ever since. If I'd enjoyed calc more, I would have taken more statistics, which is the thing I really regret missing out on as an undergrad.

Broad science requirements for pre-meds help to subsidize science departments that don't attract as many majors (physics to a larger extent and more recently chemistry as well). I think one of the hopes at the university level is also that students will discover other passions by taking those classes and go off to major in one of the other sciences. But I think there is a less recognized cost in the quality of intro level courses that actually reduces the number of students who choose to major in those disciplines. If your first two years of chemistry are classes mostly full of pre-meds who are grumpy and stressed and don't see the point of learning the material, it makes it noticeably harder to develop a passion for the topic yourself. At the same time, because the expectation is that many of the students taking those classes are going to be disengaged pre-meds who won't like the material instructors regardless of teaching quality, it makes it harder to identify the most and least effective professors and TAs or to improve the quality of the teaching.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1712 on: December 13, 2019, 11:54:50 AM »
At the same time, because the expectation is that many of the students taking those classes are going to be disengaged pre-meds who won't like the material instructors regardless of teaching quality, it makes it harder to identify the most and least effective professors and TAs or to improve the quality of the teaching.

Most pre-meds have a passion for science and learning which is partly what attracted them to medicine in the first place.

maizeman

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Re: 2020 POTUS Candidates
« Reply #1713 on: December 13, 2019, 12:27:38 PM »
At the same time, because the expectation is that many of the students taking those classes are going to be disengaged pre-meds who won't like the material instructors regardless of teaching quality, it makes it harder to identify the most and least effective professors and TAs or to improve the quality of the teaching.

Most pre-meds have a passion for science and learning which is partly what attracted them to medicine in the first place.

This may well be true, but it is not the reputation that this group has developed on a number of college campuses where I have been a part of the culture.

And rightly or wrongly I have seen that stereotype used to dismiss negative feedback/evaluations on intro level science courses.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1714 on: December 13, 2019, 01:04:07 PM »
In fact pre-med undergraduates were often recruited by professors in the biological sciences for helping with research in labs.

Poundwise

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Re: 2020 POTUS Candidates
« Reply #1715 on: December 14, 2019, 08:42:00 AM »
Under M4A, doctors and their staff would spend more time actually caring for patients, and less time doing paperwork.  According to the following comparison study of doctors in the US and Ontario, nursing staff in the US spends an additional 21 hours per week per doctor on insurance, and clerical staff spends an additional 53 hours interacting with insurers (including 45.5 hours on claims and billing tasks).
https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0893

Hopefully these savings will translate into more money spent on hiring physician's aides, nurses, and medical technicians.  There will be a greater demand for healthcare, since 12.4% of Americans are still uninsured and "the number of underinsured Americans insured by their employers jumped from 17% in 2010 to 28% last year, while it has increased from 37% to 42% in the individual insurance market."
https://fortune.com/2019/02/07/americans-health-care-underinsured-rate/

pecunia

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Re: 2020 POTUS Candidates
« Reply #1716 on: December 14, 2019, 10:18:03 AM »

- SNIP -

 And I'd say that as society gets wealthier and more productive, that liberalizing the education of all for just the primary benefit that that brings to society, irregardless of whether it connects directly to the tasks that someone will perform at a job, becomes easier to accommodate and even emphasize.

Also, in regards to physics, please don't forget that radiology and radiation oncology require direct understanding of many of these principles. It's covered later in their residency, but still can be argued as a necessary prereq for at least a subset of physicians.

Some of us look around and ponder whether society is actually getting wealthier.  Some groups are getting more wealthy and I think it is fair to include MDs with this group.  How about the rest of us?  The rest of us are paying for your increasing wealth and we are questioning whether we are getting the "bang for the buck" that we expect.  In regards to the additional training including Calculus and Physics, I would think that the physical principles needed for MD training could be incorporated into the specialized courses for the MD.  This would take a more focused approach where the future doctor would immediately see where the principles apply.  The connection between Newton's laws and the movement of the skeleton could be made directly.  The fluid mechanics of the circulatory system could be directly applied in the specialized class.  Time in training could be saved.

As for the use of the additional math and physics classes being weed-out classes, the weed-out could be done in medical courses.  Perhaps, there would be less of a weed-out and the artificially controlled supply of doctors would be lessened.  Perhaps the dream of being a doctor would be given to more of our bright young people.  Perhaps better access would be made for the rest of us.

The world can be a better place than it is today.

FIPurpose

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Re: 2020 POTUS Candidates
« Reply #1717 on: December 14, 2019, 11:26:09 AM »
In regards to the additional training including Calculus and Physics, I would think that the physical principles needed for MD training could be incorporated into the specialized courses for the MD.  This would take a more focused approach where the future doctor would immediately see where the principles apply.  The connection between Newton's laws and the movement of the skeleton could be made directly.  The fluid mechanics of the circulatory system could be directly applied in the specialized class.  Time in training could be saved.

As for the use of the additional math and physics classes being weed-out classes, the weed-out could be done in medical courses.  Perhaps, there would be less of a weed-out and the artificially controlled supply of doctors would be lessened.  Perhaps the dream of being a doctor would be given to more of our bright young people.  Perhaps better access would be made for the rest of us.

The world can be a better place than it is today.

Why are some people hanging their hat on like 7 hours worth of classes? And you're suggestion is to reduce those hours by a specialized class that might take off 1-2 of those hours of an 8 year education program? But if anyone decides to change majors to engineering? Well too bad, you'll have to start over.

Several doctor's memoirs I've read have all mentioned their philosophy courses as some of their most important and relevant to actually being a doctor.

Honestly, how different would Facebook be if Zuckerberg were forced to take a course on Marx or Orwellian philosophy? How many rich people seem to have little to no understanding of poverty or economics in general?

Doctors are not utilities. They have to interact with all kinds of people in society, many encounter unique situations where there is no precedent. Even in my own education as an engineer, the "specific knowledge" courses were least memorable and least applicable to my current job. Simply put, your brain encodes the knowledge differently. Generic courses teach you to recognize a pattern at a very foundational level. Specific knowledge courses teach you to recognize specific cases.

maizeman

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Re: 2020 POTUS Candidates
« Reply #1718 on: December 14, 2019, 12:22:27 PM »
Why are some people hanging their hat on like 7 hours worth of classes? And you're suggestion is to reduce those hours by a specialized class that might take off 1-2 of those hours of an 8 year education program?

I think the issue is that hours add up and rapidly become years.

Going from a kid fresh out of high school at 18 to someone licensed to practice medicine in the US takes 10-14 years: 4 years of undergrad, 4 years of med schools 2-6 years of residency (basically an apprenticeship). Many other developed countries produce equally good physicians in six years training people for a single combined degree instead of two sequential ones taking eight years. Those two years make a big difference.

Because the training to become an independently licensed physician takes so long, the average physician (who isn't pursing FIRE) might have a 30 year working career before retirement. Reducing training time by two years and giving people longer to actually practice would grow the total supply of physicians by 6-7% without having to expand the number of med school seats.* It would also significantly reduce the cost of going to med school.

The average newly minted MD has something like 200k of debt at 6.25% interest. Let's say it takes them an average of 10 years to pay off that debt. (70k in interest over the lifetime of the loan). Cutting total training time by 1/4 reduces the debt owed by my than 1/4th since the early years loans have less time to start accumulating interest, but even without calculating that, our hypothetical new MD can pay their loans off in about 8 years (rather than 10), pay 30k less in interest over the lifetime of the loan, and repay 50k less principle.

Combining a longer working career to earn money and less debt to pay off with that money, physician salaries could come down (somewhat), reducing costs for our healthcare system, and new medical graduates would still be better off financially than they are now.

As a bonus, reducing both debt and number of years required to become an MD -- bringing us in line with most of the rest of the developed world -- would make the profession more accessible to those coming from economically disadvantaged backgrounds who are going to have the largest loans and the most pressure to start earning significant money earlier in their lifetime.**

*Although to be up front with you, I think we should expand the number of seats anyway

**Another way to make the profession more accessible to those coming from nonprivileged backgrounds would be to expand the number of residency slots to reduce the number of student who graduate, pass the USMLE, but aren't offered a residency anywhere, leaving them with six figures of debt and no ability to practice medicine. The odds of this happening are low (perhaps 5%) but high enough for me to lose sleep over if I were in that position.

pecunia

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Re: 2020 POTUS Candidates
« Reply #1719 on: December 14, 2019, 04:55:43 PM »

- SNIP -

 But if anyone decides to change majors to engineering? Well too bad, you'll have to start over.

- SNIP -


Don't get me started on that one.  Employers in the USA treat engineers as a commodity.  Hire the young ones and lay them off after a few years.  Buy a congressman or two and make use of the H-1B visa program to ensure their cost is low.  There are reasons why so many posting herein are engineers looking to get out by early retirement.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1720 on: December 18, 2019, 07:59:55 PM »
Wow Tulsi Gabbard didn't vote to impeach Trump.
There's no good reason to do that given all the evidence provided.

secondcor521

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Re: 2020 POTUS Candidates
« Reply #1721 on: December 18, 2019, 08:05:18 PM »
Wow Tulsi Gabbard didn't vote to impeach Trump.
There's no good reason to do that given all the evidence provided.

Yeah, voting "present" on both articles is probably the most unpopular thing she could have done.  I'm surprised too.

GuitarStv

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Re: 2020 POTUS Candidates
« Reply #1722 on: December 19, 2019, 07:00:51 AM »
She's hoping to appeal to moderate Republicans I guess. Assuming such a thing exists.

ketchup

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Re: 2020 POTUS Candidates
« Reply #1723 on: December 19, 2019, 07:44:19 AM »
She's hoping to appeal to moderate Republicans I guess. Assuming such a thing exists.
Moderates in general are pretty quiet.  They're still around.  I'm not sure exactly what Tulsi's play is there though, honestly.  She needs more dem support right now if she wants to get anywhere.

Here's to hoping the debate tonight isn't dominated by questions like "What do you impeach about impeaching the impeachment?"  Let's have some real talk about The Issues, please.

talltexan

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Re: 2020 POTUS Candidates
« Reply #1724 on: December 19, 2019, 08:56:20 AM »
Under M4A, doctors and their staff would spend more time actually caring for patients, and less time doing paperwork.  According to the following comparison study of doctors in the US and Ontario, nursing staff in the US spends an additional 21 hours per week per doctor on insurance, and clerical staff spends an additional 53 hours interacting with insurers (including 45.5 hours on claims and billing tasks).
https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0893

Hopefully these savings will translate into more money spent on hiring physician's aides, nurses, and medical technicians.  There will be a greater demand for healthcare, since 12.4% of Americans are still uninsured and "the number of underinsured Americans insured by their employers jumped from 17% in 2010 to 28% last year, while it has increased from 37% to 42% in the individual insurance market."
https://fortune.com/2019/02/07/americans-health-care-underinsured-rate/

I have to admit, when I hear physicians call into Dave Ramsey and report incomes in the $400,000-$750,000 annual range, I do start to wonder if health care reform has truly damaged them the way they all claimed it would when they voted for Tea Partiers in 2010.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1725 on: December 19, 2019, 10:06:49 AM »
Under M4A, doctors and their staff would spend more time actually caring for patients, and less time doing paperwork.  According to the following comparison study of doctors in the US and Ontario, nursing staff in the US spends an additional 21 hours per week per doctor on insurance, and clerical staff spends an additional 53 hours interacting with insurers (including 45.5 hours on claims and billing tasks).
https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0893

Hopefully these savings will translate into more money spent on hiring physician's aides, nurses, and medical technicians.  There will be a greater demand for healthcare, since 12.4% of Americans are still uninsured and "the number of underinsured Americans insured by their employers jumped from 17% in 2010 to 28% last year, while it has increased from 37% to 42% in the individual insurance market."
https://fortune.com/2019/02/07/americans-health-care-underinsured-rate/

I have to admit, when I hear physicians call into Dave Ramsey and report incomes in the $400,000-$750,000 annual range, I do start to wonder if health care reform has truly damaged them the way they all claimed it would when they voted for Tea Partiers in 2010.

You don't need medicare for all in order to reform the medical billing system, to make it more streamlined and less costly. In fact, streamlining this is considered a regulation that could help reduce overall health care costs.

talltexan

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Re: 2020 POTUS Candidates
« Reply #1726 on: December 19, 2019, 01:55:40 PM »
I have to say that--initially--I was jaded on the whole "Old White Billionaires running for President" thing when Bloomberg's ads started appearing everywhere.

But Mike Pesca gave a pretty serious defense of his achievements as Mayor of NYC (I listen to Mike Pesca's daily podcast The Gist): national headlines focus a lot on stop/frisk and the soda size thing, but he has a record of education reform and lead pollution remediation that holds up. If you like Mayor Pete, give some consideration to a main who was mayor of a larger city for longer.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1727 on: December 19, 2019, 02:56:38 PM »
The Democratic primary debate is tonight at 8pm EST.

Kris

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Re: 2020 POTUS Candidates
« Reply #1728 on: December 19, 2019, 03:20:54 PM »
The Democratic primary debate is tonight at 8pm EST.

Holy crap, is that right?! With everything else going on, I had no idea! :D

KBecks

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Re: 2020 POTUS Candidates
« Reply #1729 on: December 19, 2019, 03:32:16 PM »
Under M4A, doctors and their staff would spend more time actually caring for patients, and less time doing paperwork.  According to the following comparison study of doctors in the US and Ontario, nursing staff in the US spends an additional 21 hours per week per doctor on insurance, and clerical staff spends an additional 53 hours interacting with insurers (including 45.5 hours on claims and billing tasks).
https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0893

Hopefully these savings will translate into more money spent on hiring physician's aides, nurses, and medical technicians.  There will be a greater demand for healthcare, since 12.4% of Americans are still uninsured and "the number of underinsured Americans insured by their employers jumped from 17% in 2010 to 28% last year, while it has increased from 37% to 42% in the individual insurance market."
https://fortune.com/2019/02/07/americans-health-care-underinsured-rate/

I have to admit, when I hear physicians call into Dave Ramsey and report incomes in the $400,000-$750,000 annual range, I do start to wonder if health care reform has truly damaged them the way they all claimed it would when they voted for Tea Partiers in 2010.

All the MDs I hear calling Dave Ramsey have $200k - $400k in student loan debt! 

maizeman

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Re: 2020 POTUS Candidates
« Reply #1730 on: December 19, 2019, 05:11:00 PM »
Yup, excited to watch!

Field is starting to narrow, hopefully we'll get something closer to either equal time per candidate or time proportional to candidate ranking in the polls (I'd be happy with either), and at least a little more substantive discussion than some of the past ones.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1731 on: December 19, 2019, 05:57:17 PM »
Under M4A, doctors and their staff would spend more time actually caring for patients, and less time doing paperwork.  According to the following comparison study of doctors in the US and Ontario, nursing staff in the US spends an additional 21 hours per week per doctor on insurance, and clerical staff spends an additional 53 hours interacting with insurers (including 45.5 hours on claims and billing tasks).
https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0893

Hopefully these savings will translate into more money spent on hiring physician's aides, nurses, and medical technicians.  There will be a greater demand for healthcare, since 12.4% of Americans are still uninsured and "the number of underinsured Americans insured by their employers jumped from 17% in 2010 to 28% last year, while it has increased from 37% to 42% in the individual insurance market."
https://fortune.com/2019/02/07/americans-health-care-underinsured-rate/

I have to admit, when I hear physicians call into Dave Ramsey and report incomes in the $400,000-$750,000 annual range, I do start to wonder if health care reform has truly damaged them the way they all claimed it would when they voted for Tea Partiers in 2010.

All the MDs I hear calling Dave Ramsey have $200k - $400k in student loan debt!

Well if they listen to Mr. MoneyMustache they can pay off that debt in 1 year.

DavidAnnArbor

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Re: 2020 POTUS Candidates
« Reply #1732 on: December 19, 2019, 06:22:40 PM »
I like Warren's anti-corruption message.

Roland of Gilead

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Re: 2020 POTUS Candidates
« Reply #1733 on: December 19, 2019, 08:01:09 PM »
Watched the debate tonight.   I rather like Yang now.  It is still going to be really hard to beat Trump.

Didn't like Warren and her 2 cents.   Just own it and say 2%.   $2 billion a year in wealth tax on Bezos every year above any other tax.  If you are going to tax them, then at least be honest about it and don't try to hide it under some "it is just 2 cents" to make people think it is insignificant.

Yang giving everyone $1000 sounds like it would solve a lot of issues, including student loans, reparations, living wage, etc.

maizeman

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Re: 2020 POTUS Candidates
« Reply #1734 on: December 19, 2019, 09:50:43 PM »
I thought this was by far the best debate to date.

Lots of substantive questions about issues, and even the debates and attacks between candidates were about real issues and disagreements about values and priorities that reflect real differences among voters.

Yang was relentlessly upbeat even when talking about dark and depressing subjects (declining life expectancy, drug overdoses, losing towns to rising sea levels etc) and I think laid out a really positive vision he could run on in the general.

I wish he'd gotten as much speaking time as Klobuchar, as he's polling slightly ahead of her, but overall hats off to the PBS/Politico team on a fair and issue heavy debate. Can we just have PBS moderate all the rest of the debates?
« Last Edit: December 19, 2019, 09:55:11 PM by maizeman »

ketchup

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Re: 2020 POTUS Candidates
« Reply #1735 on: December 21, 2019, 05:07:37 PM »
Yang giving everyone $1000 sounds like it would solve a lot of issues, including student loans, reparations, living wage, etc.
The great thing is that is that it addresses all those issues without stigmatizing it. ("I don't want my tax dollars going to pay for other people's college when I had to pay, etc.")  It's universal.  And it addresses things like reparations which might be a reasonable and prudent idea in theory, but would be a nightmare to administer as a standalone entity.

Poundwise

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Re: 2020 POTUS Candidates
« Reply #1736 on: December 21, 2019, 07:31:58 PM »
I have to say that--initially--I was jaded on the whole "Old White Billionaires running for President" thing when Bloomberg's ads started appearing everywhere.

But Mike Pesca gave a pretty serious defense of his achievements as Mayor of NYC (I listen to Mike Pesca's daily podcast The Gist): national headlines focus a lot on stop/frisk and the soda size thing, but he has a record of education reform and lead pollution remediation that holds up. If you like Mayor Pete, give some consideration to a main who was mayor of a larger city for longer.
I may have mentioned earlier in this long long thread but Bloomberg's "education reform" was unimpressive. My kids were in the NYC public school system in the Bronx, so I saw.  Every day, teaching to the test, kids bored and forced to do endless worksheets at too early an age.  Teachers stressed by ever-changing standards and metrics. Tons of money going to top-heavy administration, not so much to hiring more teachers. Tons of money spent on technology that often was not used in the classroom and quickly went obsolete.  I visited middle schools and high schools that had been closed for failing, then chopped up into smaller schools with little success... had friends who taught in charter schools that had few standards and little direction, and burned out their inexperienced teachers so they quit in the middle of the semester...

Meh.

https://www.nydailynews.com/news/politics/bloomberg-doubled-education-budget-reform-efforts-yielded-article-1.1552573

maizeman

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Re: 2020 POTUS Candidates
« Reply #1737 on: December 21, 2019, 07:45:24 PM »
FiveThirtyEight/Morning Consult showed Yang received the greatest increase in net favorability from the debate with Klobuchar a close second and everyone else way back. The question will be whether enough people watched the debate to move the needle for either of them (and/or if they benefit from additional earned media coverage over the next couple of weeks based on their debate performance).

The video from a local Iowa television station's focus group after the debate was also quite positive about Yang (and entertaining to watch). It's really interesting because those folks clearly have a quite different perspective, having been blanketed with paid ads and personal events/interactions with candidates for most of the last year than folks like me who just get to read about it on the internet, and tune in to the occasional debate.

Poundwise

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Re: 2020 POTUS Candidates
« Reply #1738 on: December 21, 2019, 07:54:06 PM »
Under M4A, doctors and their staff would spend more time actually caring for patients, and less time doing paperwork.  According to the following comparison study of doctors in the US and Ontario, nursing staff in the US spends an additional 21 hours per week per doctor on insurance, and clerical staff spends an additional 53 hours interacting with insurers (including 45.5 hours on claims and billing tasks).
https://www.healthaffairs.org/doi/10.1377/hlthaff.2010.0893

Hopefully these savings will translate into more money spent on hiring physician's aides, nurses, and medical technicians.  There will be a greater demand for healthcare, since 12.4% of Americans are still uninsured and "the number of underinsured Americans insured by their employers jumped from 17% in 2010 to 28% last year, while it has increased from 37% to 42% in the individual insurance market."
https://fortune.com/2019/02/07/americans-health-care-underinsured-rate/

I have to admit, when I hear physicians call into Dave Ramsey and report incomes in the $400,000-$750,000 annual range, I do start to wonder if health care reform has truly damaged them the way they all claimed it would when they voted for Tea Partiers in 2010.

You don't need medicare for all in order to reform the medical billing system, to make it more streamlined and less costly. In fact, streamlining this is considered a regulation that could help reduce overall health care costs.

True, it should be possible to cut some costs by streamlining.  But even if the interface were all the same, administrators still would have to deal with different coverages, tiers, etc.  Also every corporate insurance company will still have its own administration to support, and profits to make, which necessarily means less money spent on actual healthcare. 

Another issue with allowing corporate insurers to duplicate government coverage is that in order to attract clients, the private insurance would have to undercut government coverage (by cherry picking or lemon dropping, not sure if I'm repeating myself) or give select access to healthcare providers (which means that there would be little incentive for providers to lower prices or to take M4A. Upbilling is the biggest reason for high healthcare costs in this country anyway.) 

I mean, it's possible that we will miss out on some fantastic, radically innovative way of paying bills by not letting private insurers enter the market. But frankly I'd rather that the money went actually to providing healthcare, so an employee feels secure enough to leave his/her job to become the fantastic, radically innovative owner of a new business in something else.
« Last Edit: December 21, 2019, 07:57:51 PM by Poundwise »

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Re: 2020 POTUS Candidates
« Reply #1739 on: December 22, 2019, 09:41:50 AM »
I thought Biden imitating a stutter was so awkward.  I read later that he had a speech impediment as a biy that he had to overcome,  but so unnecessary to do a pretend stutter when most casual observers dont know that backstory.  I thought Mayor Pete did a great job and had a great rebuttal to Warreb calling him out for his wine cellar event.

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Re: 2020 POTUS Candidates
« Reply #1740 on: December 22, 2019, 05:31:14 PM »
I have to say that--initially--I was jaded on the whole "Old White Billionaires running for President" thing when Bloomberg's ads started appearing everywhere.

But Mike Pesca gave a pretty serious defense of his achievements as Mayor of NYC (I listen to Mike Pesca's daily podcast The Gist): national headlines focus a lot on stop/frisk and the soda size thing, but he has a record of education reform and lead pollution remediation that holds up. If you like Mayor Pete, give some consideration to a main who was mayor of a larger city for longer.

Bloomberg is   inimical to constitutional protections.

Bloomberg supported a stop-and-frisk policy that violated the Fourth Amendment's protection against unreasonable searches and seizures.  Judge Scheindlin found that it was a “policy of indirect racial profiling.”

An irate Bloomberg said the judge denied the city "a fair trial" and defiantly declared “You’re not going to see any change in tactics overnight.”

Bloomberg's brazen, anticonstitutionalist  temperament is utterly disqualifying of a candidate for the presidency.


HAPPY NEW YEAR!
« Last Edit: December 22, 2019, 05:46:37 PM by John Galt incarnate! »

Daisy

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Re: 2020 POTUS Candidates
« Reply #1741 on: December 22, 2019, 07:41:18 PM »
Yes Bloomberg's stop and frisk policy is troubling. As troubling as his nanny state politics in banning large sodas.  I am not a fan of sodas  actually  but I don't believe in banning them especially based on size . And thirdly he got New York City to abandon its term limits rules so he could run for another term.

He's a little too  authoritarian for me  He's definitely not my choice.
« Last Edit: December 22, 2019, 07:57:07 PM by Daisy »

DaMa

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Re: 2020 POTUS Candidates
« Reply #1742 on: December 22, 2019, 08:02:55 PM »

*snip
 
Upbilling is the biggest reason for high healthcare costs in this country anyway.
[/quote]

My grandson was showing as not eligible on my son's insurance.  His pediatrician billed $60 for 1yr old well baby visit for "cash pay" customer.  Insurance issue was fixed.  Pediatrician billed insurance $1095 and got paid $746.22.




Roland of Gilead

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Re: 2020 POTUS Candidates
« Reply #1743 on: December 22, 2019, 08:27:19 PM »
Oh that does remind me of something that slightly pissed me off about the debate.

Several candidates (Warren and Sanders?) pretty much blamed drug and insurance companies entirely for the healthcare cost problem in the USA.

The problem here is that drugs make up only 14% of the cost of healthcare in the USA.   Hospitals are 30%.

Not one word about some form of hospital reform, just the easy to attack, quick soundbite, plays well with the general population, drug and insurance companies are the problem.

If we reduce the cost of all drugs made down to 0% of the cost of healthcare in the USA, we will still be much much higher than any other country.

Someone with a $200,000 medical bill is still going to have a $172,000 medical bill and is still going to go bankrupt.

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Re: 2020 POTUS Candidates
« Reply #1744 on: December 22, 2019, 10:31:47 PM »
Oh that does remind me of something that slightly pissed me off about the debate.

Several candidates (Warren and Sanders?) pretty much blamed drug and insurance companies entirely for the healthcare cost problem in the USA.

The problem here is that drugs make up only 14% of the cost of healthcare in the USA.   Hospitals are 30%.

Not one word about some form of hospital reform, just the easy to attack, quick soundbite, plays well with the general population, drug and insurance companies are the problem.

If we reduce the cost of all drugs made down to 0% of the cost of healthcare in the USA, we will still be much much higher than any other country.

Someone with a $200,000 medical bill is still going to have a $172,000 medical bill and is still going to go bankrupt.

Warren and Sanders (especially him) never met a publicly traded company they didn't hate.

pecunia

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Re: 2020 POTUS Candidates
« Reply #1745 on: December 23, 2019, 02:29:46 PM »
I think he likes Ben and Jerry's.  Is that publicly traded?

geekette

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Re: 2020 POTUS Candidates
« Reply #1746 on: December 23, 2019, 03:06:23 PM »
Ben & Jerrys sold out to Unilever.

pecunia

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Re: 2020 POTUS Candidates
« Reply #1747 on: December 23, 2019, 05:03:41 PM »
Corporate Ice Cream. 

DarkandStormy

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Re: 2020 POTUS Candidates
« Reply #1748 on: December 24, 2019, 10:34:14 AM »
I thought Mayor Pete did a great job and had a great rebuttal to Warreb calling him out for his wine cellar event.

He didn't, though.  Claiming everyone on the stage is a millionaire or billionaire and he's not (he's 37) is bad faith - or he doesn't understand the power of compound interest, earnings potential, etc. etc.  It's also not about being a millionaire - it's the elite class has an *overwhelming advantage* when it comes to access and power.  The government currently recognizes money as "free speech" in politics vis a vis Citizens United.  If you truly believe in "one person = one vote" and are vowing to get money out of politics as part of your campaign, you shouldn't be turning around holding closed door fundraisers where only a certain class of people can afford to get in and you shouldn't be taking money from wealthy "bundlers" who are emailing "pay to play" opportunities to other wealthy donors.

Mayor Pete's entire campaign is built on bad faith.  He's a genuinely awful candidate with no convictions except furthering his own political career.  He doesn't care how he does it and we see that with his flip-flopping once the wealthy donors got involved.

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Re: 2020 POTUS Candidates
« Reply #1749 on: December 24, 2019, 12:03:49 PM »
I thought Mayor Pete did a great job and had a great rebuttal to Warreb calling him out for his wine cellar event.

He didn't, though.  Claiming everyone on the stage is a millionaire or billionaire and he's not (he's 37) is bad faith - or he doesn't understand the power of compound interest, earnings potential, etc. etc.  It's also not about being a millionaire - it's the elite class has an *overwhelming advantage* when it comes to access and power.  The government currently recognizes money as "free speech" in politics vis a vis Citizens United.  If you truly believe in "one person = one vote" and are vowing to get money out of politics as part of your campaign, you shouldn't be turning around holding closed door fundraisers where only a certain class of people can afford to get in and you shouldn't be taking money from wealthy "bundlers" who are emailing "pay to play" opportunities to other wealthy donors.

Mayor Pete's entire campaign is built on bad faith.  He's a genuinely awful candidate with no convictions except furthering his own political career.  He doesn't care how he does it and we see that with his flip-flopping once the wealthy donors got involved.

 Claiming he is not a millionaire was a great rebuttal bc it played out well and is factually correct. One could argue that Warren’s initial accusation was in bad faith since she transferred money from her senate run (that alone put her at an advantage over Buttigieg), let alone that some of the money was raised in very much the same manner.

What did he flip on? He has been for Medicare for all who want it since before he ran.

He’s against CU.

The emails were bad and looked bad. I agree that it is an indication that pay to play has infiltrated his campaign, whether he was aware of this instance or not, and was not impressed with his campaign’s response. But I think he’s the only one that got caught bc the person who sent that email is not a politician I believe, who has worked on campaigns to my knowledge, so lacked the finesse and cya skills that other career campaigners have.

I like both Buttigieg and Warren btw. She is a bit far left for me, but she is smart as a whip and I trust her to fall back on her loftier plans if/when it doesn’t appear it will be the right path forward for the moment. So while others jumped on her for her healthcare walk-back, I applauded her for being brave and willing to adjust rather than forge ahead for the sake of political continuity.