What can we atheists do about our reputation?

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This topic contains 29 replies, has 5 voices, and was last updated by  Ivy 1 month ago.

Viewing 15 posts - 16 through 30 (of 30 total)
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  • #40084

    jakelafort
    Participant

    Sounds like a rough patch Enco. It is always a big relief to get shit like that behind you with clean bill of health.

    But i think the shortage in qualified professionals has as much to do with the cost of education as some collusion or other. I also am guessing that certificates of need for diagnostic equipment relates to the pandemic as opposed to a kafkaesque reg.

    #40110

    TheEncogitationer
    Participant

    Unseen and Jake,

    Here is a link that details all of the 38 States which have “Certificate Of Need” requirements:

    50 State Scan of Certificate Of Need Programs

    50-State Scan of State Certificate-of-Need Programs

    I knew that “Certificates Of Need” were at least 40 years old because I first read of them in the early Eighties writings of Free-Market Economist Walter E. Williams. Further research reveals that “Certificates Of Need” go back to 1974 and can be Federal as well as State-issued:

    Certificate Of Need–Wikipedia
    https://en.m.wikipedia.org/wiki/Certificate_of_need

    “Certificates Of Need” were proposed originally as a means of checking hospitals from overcharging patients to recoup investment in underused facilities.

    However, a simple glance at the Law of Supply and Demand shows that anything that arbitrarily limits the available Supply of facilities and equipment in the face of constant or increased Demand is what results in higher prices. Thus, “Certificates Of Need” achieve the exact opposite of their intended purpose.

    There are better ways to address the problem without giving State or Federal Government control over the opening of facilities or the purchase of new technology. For instance, hospitals and medical facilities could be built in a modular fashion, with added pods for patients attached on with an up-tick in patients and the pods removed, cleaned, sanitized, and kept in storage when not in use.

    Or, if a facility has a static number of rooms, the unused rooms, within the bounds of hygiene and safety, could be re-purposed into, say, training areas for Nurses, Interns and Residencies, or exercise rooms for recovering patients, or entertainment for patients, or storage for non-perishable supplies, etc. Things inside the rooms could be kept on wheels or jacks so that staff can make room for new patients at a moment’s notice.

    In the case of specialized equipment, if a hospital couldn’t justify the expense of buying, say, a CT Scanner or Ultrasoound, they could rent the equipment from a nearby dealer. The dealer could send one over and set it up or, barring that convenience, provide a separate facility for the device to which the hospital could transport the patient. By renting instead of flat-out buying equipment, the hospital could flexibly use as many or few machines as patient needs require while reducing sunk costs.

    Arrangements like these or others would see that patients got the care they needed faster, flexibly, and at more affordable prices and would require no “Big Brother May I?” to do.

    #40114

    Unseen
    Participant

    @TheEnco…

    What is the other side of the story. The one presented to the public to justify these restriction?

    In other words, “The public needs this regulation because _______ and benefits in these ways ________.”

    #40115

    jakelafort
    Participant

    Enco in just a cursory perusal of your links, CON law was established in the 80s as fed.law to combat the uneven distribution of health care, rising costs and access. But it wasn’t working so it was repealed. But states continue to have CON agencies and regulations. Even so 22 states have dropped the CON requirements in light of the pandemic to expedite shit. Florida is not one of the more enlightened states one might add without fear of contradiction.

    I am not going to defend government beaurocracy as a whole. You don’t need to read a Russian novel to get the gist or even have bad experiences with it. It falls in line nicely with the tired line…that gov is best that governs least.

    On the other hand part of the problem is capitalism. There is suspicion that the entrenched business interests in medicine don’t want to compete with expansion or new biz. We as a nation would be wise to copy more enlightened nations and have some form of socialized medicine.

    #40116

    Unseen
    Participant

    @The Enco…

    What happens to the charge for MRI’s, for example, if instead of several hospitals sharing one and splitting the costs, each hospital has its own and has to pay for the device on its own? Which of the states offers the lowest cost MRI’s?

    #40117

    TheEncogitationer
    Participant

    Jake,

    The Wiki said that CON first came about in 1964 in New York (yet another reason to call it Fuckin’ New Fuckin’ York,) then by 18 other States, then Federally in 1974 with the National Health Planning and Resources Development Act. (A typical douche-baggie policy one would expect from a Statist like Richard M. Nixon.)

    HUD still requires “Certificates Of Need” even in States which have no “Certificate Of Need” laws of their own. When State and Federal determinations do not match, then HUD reviews it and from there it is hit or miss whether a project is approved.

    While many States have suspended “Certificates Of Need” laws for the time being with COVID-19, many still have them, (notably South Carolina, where it delayed a hospital constuction for 15 years, including the last two.) Also, suspension of the laws still doesn’t make them repealed and they could come back anytime. If the Supremes still used the 14th Amendement to strike down anti-freedom economic regulation, “Certificate Of Need” laws would most likely not exist.

    Then hospitals could “expedite shit” like any other industry, i.e. if you need it and have got jack to get it, you got it, no certificate or “Big Brother May I?” required.

    Anywho, with your support of doing the government control we’re doing and getting what we’re getting, only much harder, I am just glad you don’t have a hand in any of this. Please stay in your lane.

    • This reply was modified 1 month, 2 weeks ago by  TheEncogitationer. Reason: Grammar and spacing
    #40119

    jakelafort
    Participant

    Enco, that is racist!

    Smoke smoke have a toke. Pass it down to sis or bloke.

    #40120

    TheEncogitationer
    Participant

    Unseen,

    @TheEnco…

    What is the other side of the story. The one presented to the public to justify these restriction?

    In other words, “The public needs this regulation because _______ and benefits in these ways ________.”

    As the Wiki page points out, the ostenive reason for “Certificate Of Need” laws was to keep hospitals and facilities from overcharging patients for consturction and technology that is underutilized.

    But as I pointed out, there are ways to avoid that by building hospitals modular and capable of expanding or contracting with patient demand, by repurposing facilities when not in use, and by renting equipment as needed instead of flat-out purchase. Without “Certificates Of Need” laws, hospitals and facilities could have the flexibility to do all of this.

    @The Enco…

    What happens to the charge for MRI’s, for example, if instead of several hospitals sharing one and splitting the costs, each hospital has its own and has to pay for the device on its own? Which of the states offers the lowest cost MRI’s?

    All those are very food questions. Naturally, several hospitals could save on costs by sharing technology, although the hospitals would all need to be in close proximity to keep from adding to transportation costs for patients.

    Of course, each hospital having it’s own technology and then sharing in the event of breakdowns or increased patient load would make the whole system more resilient in times of mass crisis like the present endemic or natural and human-created disasters. For my money, resilience is best, since it makes the care more reliable.

    And without “Certificate of Need” laws to inhibit purchases, more hospitals and facilities would purchase more technology, manufacturers would respond to demand and produce more and better technology, and Supply and Demand and competition would drive prices lower and quality higher.

    Now which State has the cheapest MRIs is also a great question, but a whole other kettle of fish. A big problem with the Medicine and Pharmacology professions is that too often they aren’t transparent with prices of medicines or procedures or devices, with the result that patients cannot plan in advance for what to get and how to pay for it.

    I say let Practitioners and Pharmacies offer a full menu board or phone directory ads or ads in other media specifying what they charge for what devices, procedures and medicines. Then patients could comparison shop for the best devices, procedures, and medicines for the best price, just like they do with any other product or service.

    As with many things, it is a matter of getting burdensome regulations out of the way.

    • This reply was modified 1 month, 2 weeks ago by  TheEncogitationer. Reason: Correcting clumsy fingers
    #40122

    TheEncogitationer
    Participant

    Jake,

    Enco, that is racist!

    Smoke smoke have a toke. Pass it down to sis or bloke.

    You’ve got some sad Hokey-Pokeys if “that’s what it’s all about” for you.

    #40123

    jakelafort
    Participant

    Enco, that is racist!

    Famous Amos wouldn’t have been famous if it were all the same to us.

    Competition, markets good for consumers. Except when it isn’t. Big bizzz does not want competition to drive down prices and their profits so they pay to procure favorable laws. They purposely price out mom and pop to extinguish em. And when R & D produces some lifesaver for a lethal medical condition and they lack competition those consumers who would be saved in the name of libertarianism are SOL. Businesses utilize ruthlessly whatever means to further their interests. If we really get the government out we can bring back slavery. Now that is MAGA!

    Praise the lord and pass the ammunition and we’ll all be free…

    #40127

    TheEncogitationer
    Participant

    Jake,

    You keep using the term “racist.” I do not thing that means what you think it means.

    The only people mentioned in my previous posting were New York and Richard M. Nixon.

    New York is not a “race,” but a place, and more than a place it is a State of Mind.” (Albeit this is a mentally deficient “State of Mind, ” given it’s many ridiculous laws, taxes, crime, and overall ways of doing things. Companies hiring Over-The-Road truckers attract them by offering “No New York City Routes” as a perk and truckers love that! There are too many things that can go wrong driving through NYC.)

    As for Richard M. Nixon, if he is a “race” or a “protected class,” then it’s not only by a trick law, but a Tricky Dickie law. ‘S not good.

    And now for your dining, dancing and Big Apple/Tricky Dickie dissing pleasure, here are these goodies with a commercial interlude:

    • This reply was modified 1 month, 2 weeks ago by  TheEncogitationer. Reason: Spelling
    #40131

    jakelafort
    Participant

    Yeah Enco, cogito ergo Enco, racism used to be the titular horror for the most egregious shit. Now just say racism and see the targets take cover. We’ve made a lot of progress in the good ole USA. The kickback is a little awful though, in’it?

    As to that NY state of mind love them thar Adirondacks. Don’t love the mind-bending laws and regs and a whole history of corruption. I got a speeding ticket there. Sunday afternoon. Light traffic. Was without being aware passing through a construction zone. Tiny inconspicuous sign. No workers or work being done. Cop waiting for the out of stater. 1200 bucks for that hoseyaverymuch. There is a law firm devoted to helping victims of speeding tickets. That is what they do. That is all they do. There were some 6 attorneys last i knew. Any other state such a niche would be unavailable.

    #40143

    TheEncogitationer
    Participant

    Jake,

    Yeah Enco, cogito ergo Enco, racism used to be the titular horror for the most egregious shit. Now just say racism and see the targets take cover. We’ve made a lot of progress in the good ole USA. The kickback is a little awful though, in’it?

    Making accusations of “racism” where none exists is not a kickback, just a kick…and it is just as unjust as racism itself and does nothing to solve actual racism.

    The Governor of Virginia had to find that out the hard way. He also learned that you don’t tell voters and parents “You’re not the boss of me” and expect endearment and continued employment in public office.

    All that said, my kindest sympathies on the awful price you paid for driving in NYC. I thought I had it bad getting jerked out of $80 by a one-horse, hick-burgh, broken-down, speed-trap town called Chesnee, South Carolina.

    You case takes the cake and is yet another example of injustice. Fortunately, instantaneous, uncensored global communication spreading the word can help end a continuous stream of new victims. Now we all know that NYC and Chesnee, South Carolina are “no-go” zones for convenient, timely travel. I’m sure there is also an app for finding speed traps available to an even larger audience than our humble Atheist Zone.

    (I’ll add the whole State of South Carolina to the list too. It’s only attraction to neighboring States was lower gas taxes, but SC raised the taxes until they were on a par with neighbors. Yet six years or so later, South Carolina still doesn’t believe in smooth roads and road signs to direct the way for travellers. Now there’s no reason to go to South Carolina at all. People in the European Union trying to equalize tax rates among members, please take note and equalize them down!)

    • This reply was modified 1 month, 1 week ago by  TheEncogitationer. Reason: Addendum, spelling, and punctuation
    #40145

    jakelafort
    Participant

    Enco that was a anti-woke joke. I am in agreement that baseless accusations of racism are bad.

    However i would not equate it with racism. Actual racism is one of the most egregious violations. The laws that
    protect against crimes inspired by racism are a good thing, not trick laws.

    The speeding ticket law firms give email alerts when NY cops are on the prowl. I also know of a tiny town in Vermont where a cop waits for passersby and gives tickets if you are going 28 mph in the 25 mph zone.

    #40209

    Ivy
    Participant

    You bring up an interesting point Unseen. Definitely a lot of missed potential…for SURE!

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