People who answer “single payer healthcare” every time a problem with the U.S. healthcare system is brought up are part of the problem.
Mashing the SPH button every time the grownups are talking simplifies the conversation about US healthcare to a useless degree. SPH is the goal, but just injecting those three magic words into every conversation does nothing to address the complexity and nuance, and only allows the person saying it to feel good. Most of them are just as uneducated as people who want it to remain a for-profit system.
If you are in favor of SHP, as every sane person should be, then you need to get your hands dirty and educate yourself on some things. Here, I’ll start you off:
1. Torte reform. Want to curb over testing and over prescribing? Torte reform. Doctors need to be able to not worry about being sued because they missed your zebra or something unrelated to what you saw them for, and they need to feel comfortable saying, “No, Barbara, you can’t have a zpak for your virus”. TORTE. REFORM.
2. The cost of med school. As it stands, most students leave med school with 300-400k in debt. As single payer statistically speaking involves a drop in pay, this becomes untenable. They should not be paying a mortgage when they get out of school.
3. Residencies are underfunded. Doctors can sometimes come out of school, with the debt mentioned above, and not be able to match into a residency and finish their training.
4. Doctor shortage. 2 & 3 would help address this, but if we want to switch to SPH we need more doctors to handle the load, otherwise you’ll be waiting weeks to see one. Plenty of smart, potentially qualified people go to a different field because they don’t want to take on the crushing debt.
5. Preventative care. The whole conversation around this needs to change, to emphasize it over emergency care. Treating stage 1 cancer is cheaper than treating stage 4. 2, 3, and 4 are related to this. A heavier primary care load means we need more primary care doctors.
6. Transparency of pricing. Everyone involved in the process, especially doctors, need to know what things cost. This also goes towards over testing (Noticing a pattern? It’s all connected.). Right now that’s not the case, and to avoid being sued, expensive tests are probably being ordered in excess of what is necessary if there’s an efficient cheap one.
7. Profit limits. Now, I tend to lean more capitalist than most of Tumblr does, so I don’t have a problem with some profit being made. BUT. There needs to be a limit to how much drug companies, hospitals, and insurance companies can over charge. That could be a flat %, I don’t know. But it would definitely help limit the expenses and how much is paid in general (which makes it easier to switch to SPH.). Drug companies especially.
8. Doctors need to be educated about how the admin side works (thanks @md-admissions for that one.) so they can be better prescribers and be more aware of what it’s like on the other side of the fence. Here’s the quick and dirty: Dr. dxs and codes for that. –> treatments are added in the form of HCPCs –> After the appt, stay, etc. is over the billers charge the insurance company, after going through a whole host of corrections. Mostly because of the next step, and because you can only use certain ICD codes with certain HCPC codes –> bill goes to a clearinghouse, whose only purpose is to check it for errors. It’s an automated system that will reject for completely minor things. Bill is either accepted and sent to the payer, or rejected and sent back to the provider for corrections –> Biller performs corrections and resubmits. This part can literally go on for months, but it’s eventually sent to the payer, or the exasperated provider gives up –> once at the payer (insurance demon I mean company), they look it and either pay it or reject it. Often they refuse to give you more reason for the rejection than an arcane code. If it’s medicare you may or may not get a human-readable report. It’s a crapshoot if you get a 277 or 999, as far as I can tell. If the payer rejects it sometimes they won’t even discuss it with the provider, and insist you use the clearing house as a go-between. They look for any reason to reject and providers lose *millions* to this BS. –> After all of this, the balance is either written off or forwarded on to the pt.
9. Eliminate clearing houses and insurance companies. This would happen as a by-product of switching to single payer, but none-the-less, it still addresses the problem of administrative waste that would still need to be watched out for under a SPH system. Clearinghouses are useless. People who do the job of checking the coding and whatnot tho (coding is important and necessary, because it allows for tracking of illness for stat reasons but also because that’s how they know what to pay.) could be transitioned to the same job in a SPH system.
Ok this isn’t exhaustive, but I think it’s a good start.
So please, SHP people, before you go beating that drum make sure you’re ready to address the complex mess that is American healthcare because I’m tired of listening to your smug assertion of “single payer would fix this” and I agree with you. It’s lazy and uninformed.
Hey! I did a lot of these last year so I decided to make a new post for them and open them again, if anyone is interested. They’re basically pokemon customized to represent you or anyone you choose. (the ones pictured are @stoatpartyand me)
Just give me a pokemon and 1-3 accessories and you’ll get a full-size transparent portrait. The base price is $15 but particularly large or complicated pokemon cost and extra $5 (paypal only).
If you’re interested, send me an IM and I’ll get back to you asap. Art is my only income and commissions help me tremendously! Thank you :)
Won’t lie, my family’s in a huge financial dump right now and I need any sort of money I can get my hands on. There’s a huge chance we won’t get any benefit money from the council for the next few weeks; my mother is already overworking herself and I dug up what I had stashed away but it’s not enough. They don’t let her work more than 3 days a week (on record) for shit money otherwise they’ll cut off the benefits she has left.
We have to pay for the bills, if we do we won’t have money for food. The fridge is more empty than usual and I’m refusing to eat so that my two younger brothers will have something. My older bastard of a brother who leeches off of us and refuses to move out is coming back on the 17th, things will get much worse then.
I’m trying to get a job on the side while this is happening but for now I’m literally willing to draw pretty much anything to just get enough money to get through the next few weeks.
I’ll be grateful for any sort of commission or money or anything. Anything is good. Thank you in advance
I’ve never had much success with my art on Tumblr, but.. in my current situation anything’s worth a shot. Let’s try this..
To make a long story short, I just found out today that I need to come up with $1000 in one week, which is July 10th. My step-mother is demanding I pay half of our mortgage for this month. Thankfully, I’m not too irresponsible with my money and have most of it ready, but.. I really don’t just make that kind of money with my current day job, and I still require some emergency commissions to make sure I can pay it in full, on time. After some math, it seems I’ll need to make about $230. My current commission sheet contains some outdated art but the prices are the same, so I’m going to put all my prices and examples below.
CHARACTER ON SIMPLE OR TRANSPARENT BACKGROUND
BASE PRICE: $15 USD, + $8 PER ADDED CHARACTER
CHARACTER ON COMPLEX BACKGROUND/SCENE
BASE PRICE: $35 USD, + $10 PER ADDED CHARACTER
BASE PRICE: $8 USD, OR $14 FOR CONNECTED PARTNER ICONS
WHAT I WILL DRAW:
-Any character type. Anthros, humans, aliens, robots, ferals/animals, weird entities of an unspecified nature, you name it. -Pairings of any orientation. -Blood, violence, and some gore. -Stuff can be cute and cuddly or terrifying and horrific. I’m pretty versatile when it comes to themes~
WHAT I WON’T DRAW
-Fetishes -Pornography -Suggestive material -Nudity -Any pairings involving minors, incest, bestiality, or abuse of any sort -Anything with hateful messages directed at any specific person or group. Especially if it’s political. -Reference sheets -Unfinished work- sorry, no sketches or plain lineart!
Shoot me a message here on Tumblr, or on DeviantART (Username: Timbernator), or just.. honestly on any of my social media. I’m pretty active on them all. Please tell me what you want in the message, and give me your email address so I can send you an invoice by PayPal, which is my ONLY payment method allowed, especially in my current situation, because I need real money for this stuff.
They talk about how the margins for housing are razor-thin, but one of the classic cliches about house-building is that You Will Get Ripped Off, price transparency is total shit. It’s possible one of those is incorrect, but it’s possible that both are true and that feels sort of weird.