While driving my daughter to preschool today I passed a gas station that, just yesterday, was selling gas for $3.55 a gallon. Today? $3.70. Where did the 15 cents come from?
I'm actually in an area that's not been hit as bad as others - we've yet to reach over $4 for 87 octane, but I'm not holding my breath that it won't happen in the next couple weeks. I wonder, when's it going to end and why is this happening in the first place?
I mean, as I'm sure all Americans are wondering right now, what the fuck is going on here? Are there no more controls? Are we at the mercy of every CEO who controls energy in this country since the Bush-era arrived to pillage the country into extremis?
Before gas would rise based on "situations" that would invarably be used as excuses. Now I don't even hear anything - just expect it to keep going up. Bend over and take it, America, you're fucked and we're getting rich as hell doing it.
A sign I read the other day stated that gas was about $1.50 a gallon in 2000. While looking over some of my daughter's baby book I noted that we had placed gas at $1.75 a gallon. She is 4 years old. More than a 100% increase in over 4 years.
I wonder where it's going to eventually end. If we had better public transportation here (meaning it would leave early enough so that I wouldn't be late getting to the hospital for rounds) I would have ditched driving a long time ago. As it stands I have to budget a certain amount, fill up to that, and hope I don't have to get gas again for another 7 days. Anymore than $4 a gallon and I don't know what's going to happen to a lot of people commuting. Unemployment will surely rise, the economy will continue to falter and fail, investors will be ruined while the companies they invested in will be "saved" by the gob'mint, and the Bushies will thump their chests, smoke their cigars, watch their children get married in lavish ceremonies, and laugh all the way to the bank.
Showing posts with label poor. Show all posts
Showing posts with label poor. Show all posts
Monday, May 12, 2008
Friday, November 23, 2007
Makes You Think
I've been known to complain a bit about trivial stuff. However, seeing this poor guy the other day, walking in a good drenching rain with a walker, made me realize that life is often pretty good and there are lots of people worse off then me.
Monday, July 2, 2007
Mining for Gold
“How’s your pain today, Ms. Drugseeker?”
“It still hurts like hell!”
“How’d you rate it?”
“Same as yesterday, a fucking 10! God, why don’t you give me anything?” Her eyes demonstrate a clear desire for pain meds; desperate and conniving as is often seen in connoisseurs of opiates.
“We are giving you pain medications. We aren’t going to increase the dose at this point as you've yet to gain any relief over several days.” I lie to the patient. Really we know she’s full of it and we’re planning on taking her down, giving something for her iatrogenic constipation, and giving her the boot.
I proceed to complete the requisite physical check which includes the patient jumping with “pain” each and every time I touch around her left chest. Oddly enough every test performed to this date has come back negative. Wonder of wonders. She doesn’t have ACS, an MI, or any other problems - except drug addiction and vagrancy. I’ll be glad when she’s outta my hair.
I learned quite early in my 3rd year of training that some patients need a place to stay, some need a bed and a meal for the night, and others just want drugs and use the hospital for these purposes. Things that I knew already, but never quite understood how it was that they were able to manipulate the system so well. I've seen the scams and read about others. Oddly many are very similar, but unique with the person involved.
Ms. Drugseeker will receive a bed because she is middle aged, has abused her physical and psychological health for years, ingests varied amounts of drugs which she obtains by doing unmentionable acts, and has not seen a regular physician since Nixon was in office. An abnormal EKG results and labs will most likely surface, relegating the on-call team to take on this freeloader in a useless search for the etiology.
The patient stays, getting a bed, free food, free healthcare, free drugs, and a place for her hubby to sleep as well while the doctors, nurses, and medical students try to not think about the waste of money this person has become. Hubby remains sedated throughout the process until he hears they're being "evicted". Then he suddenly is concerned about his wife's condition.
Unfortunately for our society this is an all too common occurrence. Many private hospitals won’t take them and will either give a quick drug cocktail and/ or street the druggie. Then the charade plays out all over again, at another ER, another clinic, wasting the same taxpayer dollars; but nothing can be done because god forbid if the constant abuse of heath resources by a parasite might actually lead to the discovery of some illness. Then the lottery is in town.
Hell, we might find gold in them thar hills…so wouldn’t it be a shame to not go looking at the same or slightly varied complaint for the upteenth time while knowing full well that you‘re most likely not going to find anything other than someone who can only tolerate a “D“ drug? That’s what a litigious society has constructed for our kids.
Personally this abuse pisses me off. If we’re going to ever have a healthcare system that has any potential to become universal this exploitation has got to stop. Personally I like the idea that people have a certain amount of points that they can use. Use it up and your done for the month, year, etc. If you’ve been diagnosed with a legitimate disease that will increase your healthcare use then you receive additional points.
This would reduce the overuse of ER’s for minor ailments, reduce the ICU stays with ridiculous attempts to prolong lives already long lost, and might just curtail drug seeking abuse. Of course there's a lot to be desired from this plan; it won't define what an actual "emergency" is, it won't create jobs and decrease poverty/ addiction in many abusers, and it won't take care of the illegal immigrant crisis. But I like it in it's infancy.
Till then the exploitations will continue, the drug seekers shall refine and perfect their lies, the viral URI's will get treated with antibiotics at 3am, illegal immigrants shall continue to invade ED’s for each and every complaint to avoid INS troubles, and my taxes and health insurance premiums will continue to increase.
“It still hurts like hell!”
“How’d you rate it?”
“Same as yesterday, a fucking 10! God, why don’t you give me anything?” Her eyes demonstrate a clear desire for pain meds; desperate and conniving as is often seen in connoisseurs of opiates.
“We are giving you pain medications. We aren’t going to increase the dose at this point as you've yet to gain any relief over several days.” I lie to the patient. Really we know she’s full of it and we’re planning on taking her down, giving something for her iatrogenic constipation, and giving her the boot.
I proceed to complete the requisite physical check which includes the patient jumping with “pain” each and every time I touch around her left chest. Oddly enough every test performed to this date has come back negative. Wonder of wonders. She doesn’t have ACS, an MI, or any other problems - except drug addiction and vagrancy. I’ll be glad when she’s outta my hair.
I learned quite early in my 3rd year of training that some patients need a place to stay, some need a bed and a meal for the night, and others just want drugs and use the hospital for these purposes. Things that I knew already, but never quite understood how it was that they were able to manipulate the system so well. I've seen the scams and read about others. Oddly many are very similar, but unique with the person involved.
Ms. Drugseeker will receive a bed because she is middle aged, has abused her physical and psychological health for years, ingests varied amounts of drugs which she obtains by doing unmentionable acts, and has not seen a regular physician since Nixon was in office. An abnormal EKG results and labs will most likely surface, relegating the on-call team to take on this freeloader in a useless search for the etiology.
The patient stays, getting a bed, free food, free healthcare, free drugs, and a place for her hubby to sleep as well while the doctors, nurses, and medical students try to not think about the waste of money this person has become. Hubby remains sedated throughout the process until he hears they're being "evicted". Then he suddenly is concerned about his wife's condition.
Unfortunately for our society this is an all too common occurrence. Many private hospitals won’t take them and will either give a quick drug cocktail and/ or street the druggie. Then the charade plays out all over again, at another ER, another clinic, wasting the same taxpayer dollars; but nothing can be done because god forbid if the constant abuse of heath resources by a parasite might actually lead to the discovery of some illness. Then the lottery is in town.
Hell, we might find gold in them thar hills…so wouldn’t it be a shame to not go looking at the same or slightly varied complaint for the upteenth time while knowing full well that you‘re most likely not going to find anything other than someone who can only tolerate a “D“ drug? That’s what a litigious society has constructed for our kids.
Personally this abuse pisses me off. If we’re going to ever have a healthcare system that has any potential to become universal this exploitation has got to stop. Personally I like the idea that people have a certain amount of points that they can use. Use it up and your done for the month, year, etc. If you’ve been diagnosed with a legitimate disease that will increase your healthcare use then you receive additional points.
This would reduce the overuse of ER’s for minor ailments, reduce the ICU stays with ridiculous attempts to prolong lives already long lost, and might just curtail drug seeking abuse. Of course there's a lot to be desired from this plan; it won't define what an actual "emergency" is, it won't create jobs and decrease poverty/ addiction in many abusers, and it won't take care of the illegal immigrant crisis. But I like it in it's infancy.
Till then the exploitations will continue, the drug seekers shall refine and perfect their lies, the viral URI's will get treated with antibiotics at 3am, illegal immigrants shall continue to invade ED’s for each and every complaint to avoid INS troubles, and my taxes and health insurance premiums will continue to increase.
Sunday, May 27, 2007
Not For Me
When did I discover it wasn’t for me? Basically a question often asked of me by underclassmen regarding my deviation from Emergency Medicine (of which I’m still VP of the interest group – when are the elections already?). Essentially I can honestly and without delay state that the time was during my Internal Medicine rotation.
I liked IM enough. I figure I could be a rather great internist because of the knowledge aspect and the detective work that goes into managing patients. I really enjoyed that part of Medicine. The problem that I had, however, was that I didn’t like the patients.
And not just the patients, I didn’t like the type of patients we mostly catered to: poor, underserved, homeless, etc. The “scum of the earth” as some might put it. I thought about these patients and how most of them came to us from the ER. I evaluated the prospect that I would have to deal with these kinds of patients on daily basis many times over for year and years. And I knew I couldn’t do it.
It just wasn’t in me. I would have burned out incredibly fast had I decided to enter this field of medicine. Partly because I think many of these social parasites shirk their responsibilities and trust in others to do everything for them while continiuing their immoral behaviors. I can’t remain humble and self-less to people that I can’t even stand to talk to or interact with in some semblance of humanity. For that reason I knew EM was not for me and I believe that these patients would be better off without me as their “primary care giver”.
I liked IM enough. I figure I could be a rather great internist because of the knowledge aspect and the detective work that goes into managing patients. I really enjoyed that part of Medicine. The problem that I had, however, was that I didn’t like the patients.
And not just the patients, I didn’t like the type of patients we mostly catered to: poor, underserved, homeless, etc. The “scum of the earth” as some might put it. I thought about these patients and how most of them came to us from the ER. I evaluated the prospect that I would have to deal with these kinds of patients on daily basis many times over for year and years. And I knew I couldn’t do it.
It just wasn’t in me. I would have burned out incredibly fast had I decided to enter this field of medicine. Partly because I think many of these social parasites shirk their responsibilities and trust in others to do everything for them while continiuing their immoral behaviors. I can’t remain humble and self-less to people that I can’t even stand to talk to or interact with in some semblance of humanity. For that reason I knew EM was not for me and I believe that these patients would be better off without me as their “primary care giver”.
Friday, May 18, 2007
Parasites
The way some people carry-on you think they were royalty. In a hospital that caters towards the indigent and uninsured I see a great deal of unwillingness in patients to help themselves out of their dire situation who will, at the drop of a hat, threaten to leave for a better hospital. They don’t like what’s happening here and they want better care. In short they feel entitled.
But here’s the thing: these other hospitals that these tragic patients want to have their care transferred to won’t see them. They’ll kick their asses straight out the door should they try and walk-in and they sure as shit won’t receive them as a transfer. Why? No ability to pay for services rendered.
So instead this hospital accepts these patients, hemorrhaging money by the millions each year in order to give the extremely poor a place to receive equal and fair treatment. Because of the huge financial pitfalls there are areas where we suffer. We don’t have the newest, most expensive, and most advertised machinery or treatment options. Instead patients receive quality care with methods proven to work. And all at almost no expense to themselves (since we all know they’re not paying for anything anyway).
Despite these efforts and the obvious level of gratitude that should be inherent in these people I often see them ungrateful. Upset at the conditions they “perceive” in a place that’s never out of the red.
“I’m going somewhere else. They’ll take better care of me.”
“You don’t know what you’re doing. Over at (huge research hospital with lots of fancy and expensive new equipment) I’d get this test done. I’m outta here.”
“I’m leaving AMA. I don’t care what you say. Some doctor out there will take me and care for me without insurance and a stable income.”
I hear these lines or variations everyday. Trying to explain to a patient who has not had a job in over 5 years, drinks 12 or more beers a day, smokes like a chimney, and has absolutely no means of paying for services for his congestive heart failure, kidney failure, and rectal cancer that no doctor in town will touch him other than those currently seeing him is just futile. They don’t get it. They don’t want to get it. All they want is a handout and feel entitled to the services and care received by the best insured and wealthiest in society.
I guess it’s the delusional aspect of many of these patients that got them where they are in the first place. Believing that someone will always take care of them, trusting in the fact that Uncle Sam will never stop giving them money or food or clothing. Ensuring that they’re not responsible for their own damn care – ever and behaving like spoiled children with surrogate parents. Why else wouldn’t they think they can get that new drug, fancy treatment, or costly surgery with little to no cost to themselves? It’s how they’ve been living their entire life.
But here’s the thing: these other hospitals that these tragic patients want to have their care transferred to won’t see them. They’ll kick their asses straight out the door should they try and walk-in and they sure as shit won’t receive them as a transfer. Why? No ability to pay for services rendered.
So instead this hospital accepts these patients, hemorrhaging money by the millions each year in order to give the extremely poor a place to receive equal and fair treatment. Because of the huge financial pitfalls there are areas where we suffer. We don’t have the newest, most expensive, and most advertised machinery or treatment options. Instead patients receive quality care with methods proven to work. And all at almost no expense to themselves (since we all know they’re not paying for anything anyway).
Despite these efforts and the obvious level of gratitude that should be inherent in these people I often see them ungrateful. Upset at the conditions they “perceive” in a place that’s never out of the red.
“I’m going somewhere else. They’ll take better care of me.”
“You don’t know what you’re doing. Over at (huge research hospital with lots of fancy and expensive new equipment) I’d get this test done. I’m outta here.”
“I’m leaving AMA. I don’t care what you say. Some doctor out there will take me and care for me without insurance and a stable income.”
I hear these lines or variations everyday. Trying to explain to a patient who has not had a job in over 5 years, drinks 12 or more beers a day, smokes like a chimney, and has absolutely no means of paying for services for his congestive heart failure, kidney failure, and rectal cancer that no doctor in town will touch him other than those currently seeing him is just futile. They don’t get it. They don’t want to get it. All they want is a handout and feel entitled to the services and care received by the best insured and wealthiest in society.
I guess it’s the delusional aspect of many of these patients that got them where they are in the first place. Believing that someone will always take care of them, trusting in the fact that Uncle Sam will never stop giving them money or food or clothing. Ensuring that they’re not responsible for their own damn care – ever and behaving like spoiled children with surrogate parents. Why else wouldn’t they think they can get that new drug, fancy treatment, or costly surgery with little to no cost to themselves? It’s how they’ve been living their entire life.
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