Challenging assumptions


Why is it, when you reply to a misleading post on line, with information that challenges the poster’s assumptions and points out misleading information, they get so incredibly butt hurt??  Why is it that they get snide and disrespectful but that’s what they end up accusing you of?  Why is it they are allowed to swear but you’re not?  Why when you point out that you have personal, familial experience with something, not to mention professional experience, that is a disrespectful response?

You know, part of discussion is disagreement.  If anyone is to learn anything new, then ideas have to be challenged.  John Michael Greer coined a term:  dissensus.  It means, essentially, the opposite of consensus – which in my opinion is basically imposition of the strongest personality’s ideas by holding everyone else hostage until they agree.  Dissensus means holding an opinion which goes contrary to the established consensus.  It’s usually better if one has research backing up their dissensus, but sometimes it’s just logical deduction that creates it.

The post that caused me to be sworn at, and to be labelled disrespectful, regarded debunking the myth that hordes of Canadians are coming across the border to the US for needed care because the lines are so long in Canada that people are in danger of dying if they don’t do so.  This person brought up one example “friends” (who in fact turned out to be a married couple, only one of whom required medical care) who “had” to come to the US because they had to wait so long for a procedure.  The procedure turned out to be an MRI, for ‘chest pains’ which isn’t exactly first line diagnostic for that.  Lab work and a chest xray would have been done first.  And the wait for this procedure?  4 weeks.  Not exactly a lifetime, and not a time period that would be considered unreasonable even here if you are waiting for insurance pre-authorization.  Not to mention that this person had a stage 3 cancer diagnosis and was given 6 months to live; the MRI in my opinion, though I wasn’t there, was most likely to determine the extent of the cancer not to diagnose it.  And the fact that I know Canadians, and have in-law family in Edmonton and therefore have personal knowledge of how the Canadian system works, only served to make this person even more upset.

I detest how people get so irate and hateful when you challenge their stories.  Especially conservatives because they have such a religious conviction that ‘socialized’ care is evil.  Even when given facts to the contrary.  I especially detest how they are so dedicated to believing the ‘one’ story and they don’t bother to do ANY research whatsoever, instead getting their ‘research’ and ‘facts’ from sites that are paid for by corporations with a vested interest in making sure people don’t have any option but for profit ones.

Now I will be honest.  The Canadian system holds people accountable.  When I worked a contract job for a flight company, we flew a Canadian snowbird from a rural facility to a trauma facility for a head injury.  How did he suffer this head injury?  He was drunk and he fell off the bar stool.  I can tell you his wife was absolutely furious, because their Canadian insurance specifically did NOT cover accidents suffered as a result of alcohol intoxication.  They were going to end up footing the bill.

But so does the AHCCCS system hold people accountable.  They don’t cover accidents resulting from drug or alcohol intoxication either, though most people don’t know that and those that are on the state’s Medicaid system really don’t have any intention of paying the bill that results anyway.

The idea of entitlement seems to be seriously misunderstood.  According to Mirriam Webster Online, entitlement has three meanings:

  1. the condition of having a right to have, do, or get something
  2. the feeling or belief that you deserve to be given something (such as special privileges) (parentheses theirs)
  3. a type of financial help provided by the government for members of a particular group

Now, I told this person in my post that most Americans have a misplaced sense of entitlement, and I meant it in the second way — that people think they’re entitled to have the government foot the bill for their health care, and they don’t have any personal responsibility to manage their own health.  I also meant it in the sense that people want what they want when they want it and damned be the consequences if they have to wait.  I pointed out to said poster that his ‘friend’ exhibited that same sense of entitlement by being unwilling to wait for an MRI and coming to the US to get it.  Lucky him, he had money to be able to cut to the head of the line, because that’s how the triage system works in America — unlike in Canada where for the most part the sickest go to the head of the line and the rest wait their turn.

Health care is a basic human right.  Having someone else foot the bill is not.  Does that mean I think the poor should just do without?  Absolutely not!!!!  It does mean though, that EVERYONE needs to have skin in the game — they need to be required to pay according to their means, and they need to take responsibility for their own health, and they need to be held to a standard of accountability the same as the rest of us — including the very wealthy.

Health care is not an entitlement in the sense of the common usage definition.  Nor is food stamps, or welfare.  Unemployment insurance IS, and so is Medicare, and so is Social Security.  Why?  Because we all pay into that with our taxes for our entire working lives.  Even if you file exempt you do not avoid paying these taxes.  These are programs that are promised to us as long as we pay these taxes via our payroll deductions.  Therefore you should have the right to pull out at least as much as you put in to the system.  And the government has a responsibility to shepherd that money carefully, because it doesn’t belong to them, it belongs to us.  The pissing away of the Social Security trust fund is reason enough to put government officials in prison, in my opinion.  That money was never meant for anything EXCEPT retirement — not funding wars, or paying for NSA spying apparatus.

Socialism in itself is not evil.  We have many, many socialized systems in America, ones that very few people seem to have a problem with:

  1. Postal service – getting mail seems to be pretty well expected by most;
  2. Fire service – what if the fire department would only come if you paid their subscription??  If you don’t think that could have negative consequences, ask anyone who’s ever had Rural Metro stand on the opposite side of the street while their house burned to the ground;
  3. Police service – aside from the increasingly militarized and abusive trend of our police agencies, I really don’t hear anyone complaining about taxes paying for police;
  4. Public roads – everyone assumes they have a right to drive on the roads, and that the roads will be maintained in decent driving condition.  What if ALL the roads were toll roads?  What if you had to pay $5 every time you went to the grocery store just to be on the road?
  5. Social Security, Medicaid, Unemployment insurance – there are those who complain about these, but they’re also the ones who are wealthy enough to not have to live on these…

See?  It’s only evil when it comes to health care.  Or rather, medical care, because our system is built around medical models of illness care, not actual health care.  Instead of railing against the evils of socialism, people would be much better served railing against the rampant corporatization of our government and the selling off of formerly public assets into private for-profit hands.  Or perhaps, instead of railing against the evils of socialism, people could rail against the prevailing medical model and demand actual public HEALTH services – you know, basic preventative health care, health education, dental and vision care, healthy food.  Not meds and expensive hospitalizations, but stuff that actually contributes to a healthy populace.

Ok, off the soap box as I’ve digressed greatly from the original thread of my post.

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5 responses

  1. I’ve been working as a family physician in Ontario, Canada since 2007 and I can confirm that Canadians rarely go to the US for medical care. Having said that, I have had a few who have done so.

    Most common reason: falling ill while on vacation in the US (snowbirds etc).

    Other reasons

    I had one patient who was very hypochondriacal and produced dozens of symptoms and requested dozens of tests, none of which revealed any significant abnormality. Dissatisfied with my care, she decided to go on a private visit to the Mayo Clinic in Minnesota, so they could find out what was wrong with her, because obviously I wasn’t up to the job. She spent about three days there being worked up by every specialist imaginable, and probably ended up with an unimaginable medical bill. They couldn’t find anything wrong with her either. However, since she came back she has been much better and hardly ever comes to see me, and when she does, she is usually much happier and it is usually just for the “normal” things like blood pressure checks and prescription refills. So hats off to the Mayo Clinic, I don’t know what they did there but whatever it was, it was money well spent from my perspective.

    I had another patient with terminal malignant melanoma with metastases who went to a clinic in Washington for a last ditch attempt to treat his melanoma with the latest chemotherapy. He suffered a lot of side effects, and died soon after.

    Before Ontario expanded its bariatric surgery program, I had a few morbidly obese patients who went to the US for their gastric bypasses and gastric banding.

    That’s about it really.

    Good luck, and don’t forget to visit Post Peak Medicine sometime (www.postpeakmedicine.com).

    • I downloaded your book a while ago, and I’m a little ashamed to say that I haven’t actually read it yet. I’ve been spending most of my reading time with my nose buried in one volume or the other of Harrison’s 🙂 and realizing that however much I know, I will never become close to an expert on any of it.

  2. You were either dealing with a shill or a programmed person. The programmed react badly to logic and facts in part because you’re essentially suggesting that all their closely-held beliefs (that they got from the teevee) are worth as much as the work they put into obtaining them, which is nothing.

    The shills, on the other hand, all apparently work from a very limited set of rules written by Saul Alinsky a long time ago. It seems far-fetched, but some parts of the internet are rotten with shills. It’s these people that pop up anywhere in discussions against gmo (to take a good example) to say that anyone opposing it hates progress. They get a list of talking points, and once you start pointing out the fallacies they have to fall back on alinsky tactics, usually ad hominem.

    I am mercifully relatively uninformed on US healthcare, but I suspect that a lot of money depends on making any other way (like Canada’s) seem inferior. They can’t rely on logic or facts to accomplish this, and so they rely on propaganda.

    A notable example of how far this goes–that no one would believe if it wasn’t on wikipedia–is Megaphone, israel’s shilling killer app.

    http://en.wikipedia.org/wiki/Megaphone_desktop_tool

    http://dprogram.net/2010/02/08/disinformation-tactics-the-methods-used-to-keep-you-in-the-dark/

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