America, party of 2

Aromatic · Nov 13, 2016

Safety nets are fine, as long as they are uncomfortable. There are not many people in the country who cannot at least do some sort of work. For those that cannot, we are here to support them.

If somebody needs a safety net and works at the same time, awesome. But for the few that abuse it, it needs to be very very uncomfortable to receive government benefits. Our minds like to take the path of least resistance, so if you enable inactivity, many will stay there.

Even if we are 100% super duper ultra altruistic, we wont be able to afford the ACA at the rate it is going. Not everybody can get a free lunch.

If people dont have to pay for it, anybody with a slight bit of common sense will know they will sooner or later abuse the system. I cant tell you how many medicaide patients I have had come in the ER wanting 1000 scans for everything in the world for them, their child, their grandmother, and their 32 pets well knowing they wont have to pay a dime. This assumption may contain some base-rate-fallacy, but hey, just look around on every forum in the world and in your work place. The worst patients are medicaid patients because there are many that abuse the system.

If people are not productive members of society they should not receive the same benefits as those who are. In exception, those with mental or physical illness that prevents them from being so. Physical illness we cases we can weed out the fakers. Mental illness is a little harder, but we can still make it difficult for them to remain idle unless they really need mental healthcare by requiring them to keep up with office visits, and in severe cases, many should live in group homes. If you are not suffering from a work-preventing mental illness and get stuck with a bunch of people with true mental illness, you can bet most will get off their ass and get to work.

Aromatic · Nov 13, 2016

So, basically, you're advocating for a society in which those who can't afford expensive healthcare just die and don't hang around being a burden on the rest of us. Spoken like a true Republican.

If they cant afford it out of their own laziness then yes. Let them get ill, hungry, skinny, and weak until they get up and get a job. Hunger and illness is a good motivator.

For those who really need help then yeah, help them.

Free government benefits aint for those who sit around and smoke, drink, and suck on bottles of actavis all day while downing cheetos and banging hoes in the trailer park or ghetto.

and in order to receive government benefits all the chicks should get progesterone implants. Mandantory. If you cant support yourself you should lose your right to have children because we dont need any more actavis sucking gang bangers out there.

and before using the sexist card on me I say chicks because progesterone implants are easier to reverse than the male counterpart

PG2018 · Nov 13, 2016

I agree wholeheartedly that we, as a charitable society, have bred a population of people who choose not to contribute, exaggerate the problems they do have (mostly socioeconomic I might add), receive benefits and receive instruction on how to how to perpetuate the process. Then, what I deem as actually worse, society lynch mobs people such as myself who call foul because they're blind and afraid.

You may love thy neighbor and still recognize, point out, and require they correct their faults. It is in no way wrong to expect everyone to work. If they choose not to or cannot in some way then that's different. We shall ostracize the former and assist the latter in a manner of the majority's choosing.

One example of the stupidity of this is sex reassignment surgery. Why in the world would that be included in insurance? Why should everyone have to pay for that especially when it's a niche, personal problem in no way align with human norms? If you can't afford to have your hormones and genitals reshaped don't make me pay for it. Get a job and save maybe the pursue a quack willing to take your money.

adnrnstudent, ASN, RN · Nov 13, 2016

Because little girls will grow up with the knowledge that a man can sexually assault someone, brag about it, and people will still elect him to be the most powerful person in the whole world. How can they feel safe reporting sex crimes?
Because he's vowed to ban all Muslims from entering the United States. This has been used and will be continued to be used by ISIS as propaganda to rally their troops of their hate against the US
Because he's determined to build a wall along the border of Mexico and calls Mexicans rapists.
Because his running mate signed a bill to jail people who applied for a same-sex marriage license.
Because he allows himself to be easily angered and goaded which is dangerous in the international community.
Because even if he doesn't mean a single word he has said, he has still stoked people's hatred and intolerance of those different from them. Hate crimes are being reported all over the US right now, just do a google search. Even if he doesn't mean any of his rhetoric, he has allowed it to be socially acceptable.
A POTUS has enormous influence in this country. It's not the bills he signs but the culture that he influences. And yes, even despite all that, the POTUS is still the most powerful person in the world. He can send military troops to fight wherever he wants without anyone's approval for two months. He can sign executive orders. Yes, we have checks and balances in our system- but a president can still do a lot of damage.

Politely, my fellow nurse. You need to re-read some of the stuff he said.

On a couple of your points though, there is no other country in world that you can go and stay illegally. Why should we be that country?

On another note, he said Muslims need to be thoroughly vetted before being allowed in the USA. I don't have a problem with that, especially from radicalized countries. Many of these people want you and your children dead.

Aromatic · Nov 13, 2016

Hopefully trump will put a lot of people to work in decent paying jobs to rebuild our infrastructure, which has fallen in many areas to that of 2nd world countries.

asia is kicking our ass, we might still be ahead, but we are limping while they are running faster than Bolt in a 100 meter dash.

Sex reassignment surgery is the same thing as breast implants, optional, no insurance should cover that or be forced to unless your lady parts is about to explode and the only way to save your life is to manipulate it into the shape of a member.

And there is almost no excuse to work, there are jobs out there, just not ones that require a "liberal arts" degree. plumbers, welders, electricians, linemen, etc. Last I checked, those jobs are needed and grossly in demand and pay well, better than nursing in many cases, with less garbage to put up with.

And the degrees are FREE at community colleges, and now that we have a president vested in the economy I am sure they will be even more needed. Hell, i know people banking 100k in those fields.

Advanced Practice Columnist / Guide · Nov 13, 2016

What would be wrong with privatizing it? Less government intervention results in cheaper, more efficient organizations. We have got to save money here. We're bleeding entitlement funds.

I'd have to look at how his (Rep. Ryan's) plan is laid out. As you know, Medicare is funded by our taxes and it is the largest source of health insurance for America's seniors (age 65 and above). The way I see it, we all worked hard during our productive years of being in the labor force and to me, our country ought to care for us in our twilight years by ensuring that we get medical care at a time when the need for medical care will surely rise.

I agree that Medicare is bleeding funds right now. We can't blame that on immigrants because they are not entitled to Medicare (when in fact, many are contributing to its funds by paying payroll taxes as I did before I got my citizenship). I think the biggest source of Medicare's woes is Medicare fraud and the high cost of care in the US. How many times have you seen us providers order unnecessary tests and procedures on Medicare recipients?

How many surgeries are we going to perform in hospitals on seniors that won't extend any quality of life but prolong suffering and charge Medicare for them? I think we ought to have a culture change on how we view healthcare and to me, privatization is not the answer. I'm afraid that if Medicare gets privatized, private insurers who typically put profit over service will shortchange our seniors. I'm afraid, premiums are going to rise and many seniors won't be able to afford it. It makes me afraid of the future - of my future.

Medicaid is an option of course. But do you know that you have to lose everything you have before you can even qualify for Medicaid? That's such a sad situation isn't it?

Advanced Practice Columnist / Guide · Nov 13, 2016

And why do I have to support gay marriage to effectively ameliorate psyhopathology?

Not related to your statement above but this is just a question out of curiosity as I do agree that individuals are entitled to their own beliefs. How would you approach a homosexual patient who has major depression with suicidal ideation triggered by years of bullying, lack of family acceptance, etc? Would you say outright that you won't be objective enough to provide care?

PG2018 · Nov 13, 2016

On another note, he said Muslims need to be thoroughly vetted before being allowed in the USA. I don't have a problem with that, especially from radicalized countries. Many of these people want you and your children dead.

Which by the koran is "striking at the neck."

Beheading.

PG2018 · Nov 13, 2016

Not related to your statement above but this is just a question out of curiosity as I do agree that individuals are entitled to their own beliefs. How would you approach a homosexual patient who has major depression with suicidal ideation triggered by years of bullying, lack of family acceptance, etc? Would you say outright that you won't be objective enough to provide care?

I don't do therapy by choice or spend any length of time determining the psychosocial causes of symptoms. Lithium has proven to be suicide protective in some cases. Refer to the therapist on call and have my nurse call a mobile assessor from the one of the local psych hospitals.

I provide a very circumscribed service. Evaluation, which is a 15 minute appointment, diagnosis, and medication management, referral to therapy, or both. My goal is to make people more functional through the suppression of symptoms by diagnosis, currently per DSM 5, and judicious prescription of medication targeting the neurobiological circuits posited to cause the symptoms (or signs).

Advanced Practice Columnist / Guide · Nov 13, 2016

One example of the stupidity of this is sex reassignment surgery. Why in the world would that be included in insurance? Why should everyone have to pay for that especially when it's a niche, personal problem in no way align with human norms? If you can't afford to have your hormones and genitals reshaped don't make me pay for it. Get a job and save maybe the pursue a quack willing to take your money.

I don't know man, you're the one working in Psychiatry, don't you guys have to do some kind of assessment that it's not a choice they will regret later? Lol. I don't know the answer to that other than I'm a man perfectly satisfied with being a man, on the other hand, I will never claim to understand what internal struggles these people face day to day. Should we have to shoulder the cost of that surgery? I think the answer lies in whether we accept that this is a disorder that is treatable by the surgery.

But I have to agree that we may have gone too far. Does a person with a burning desire to alter their appearance by seeking plastic surgery have a disorder? maybe, but yet insurance will not cover these types of surgery. In the end, I agree with you that sex reassignment should not be covered. I work at a facility that successfully performs these surgeries. I think we should continue to have these surgeries as an option lest these people go overseas and end up with substandard care.

RunNP · Nov 13, 2016

I try to see the other side of an issue and form some type of understanding of another's point of view, but there are just some ideas in this topic that make me sad.

Some areas I do not understand such as gender reassignment and I cannot walk a mile in their shoes or relate to the pain these individuals endure nor do I feel qualified to dismiss their pain as unreasonable. This a gray area where I admit I do not have enough information nor should I expose my ignorance on the topic to belittle others.

The same respect I apply to those who believe in a deity. I do not share their beliefs nor do I every want to dissuade those people from their beliefs, but in the same respect I do not want those beliefs forced on me in the form of laws or missionaries showing up on my door step.

What worries me about the Trump and his followers is that there seems to be a lack of respect for the dignity of others. Our country is the great melting pot and it is the diversity that makes us strong. muslims love their children enjoy their families and worship as they see fit - just like Mexicans, people from India and Americans of color and all deserve to be treated with respect and hopefully a bit of compassion. not as NP but as human beings and the lack of respect and compassion shown is sickening.

Advanced Practice Columnist / Guide · Nov 13, 2016

Which by the koran is "striking at the neck."
Beheading.

This is precisely why I have personally decided that religion is poison and that my belief in a supreme being doesn't have to conform to a set of beliefs imposed by others. Wars have been waged in the name of religion for centuries, people have been oppressed in the name of religion throughout history. The pilgrims who came to this country escaped religious persecution and in the end they also became the persecutors of others who came later. Christians are just as responsible for the ills of the world.