A billion in perspective......

[Skippman]

So which is it? Smaller government and lower taxes for the wealthy? Or some regulation and taxes that will keep our economy moving?

There's part of the problem, the illusion of an American economy. Back in the 50's this was true. Today we are in a global economy. When you buy something, even something "Made in America", it's almost asured that a part of it was made in a foreighn country. Consider a box of cereal. The plastic for the bag was likely made from oil from the Mid-East, which was likely refined there, and then shipped to China where it was made into plastic bags. Those plastic bags were likely shipped to the US where our grain was processed and placed into the bags. Those bags where then placed in boxes likely made from cardboard from Canada. So in the entire chain, only one part is American.

I'd love to believe in the American economy but the fact of the matter is we're no longer an insular nation an nor can we afford to be. Those lower income people you speak of likely buy thier product at Wal-Mart. Those products are likely made in China or another foreighn country.

If America wants to climb out of this economic slump we need to return to what we do best, developing technologies. America has a tradition of being the technological leader of the world for the last 70 years. The DC circuit, AC electricity, space travel, atomic energy, the telephone, the internet... all are American inventions, whether invented by a native born or an immigrant. Our education system is falling appart. We need to turn that trend arround. Our future lies not in car production but in medical sciences, computers, and newer energy producing technologies.

Manufacturing will always be done by the cheapest labor pool. A jobs pay is directly proportinate to it's difficulty level (with rare exception). Which is why fast food and custodial servies do not demand the same wage as say a mechanic or a doctor. There will always be a need for labor unions (I'm in one, CWA 6310) for skilled labor jobs like mechanics, technicians, and carpenters. But the belief that we'll return to being a manufacturing power house like we were in the 50's is not something I see becoming a reality.

[Nobahar]

The problem is we go through the expense of developing the technology, but once we have it- it's pretty easy for another country to just copy it. They benefit at our expense of the billions of research (particularly medicine).

Also wanted to add that flat tax wouldn't be fair either. 5K to someone who makes 50K may be the same percent as 50K to someone who makes 500K, but what about fixed taxes? If we spend $5000 groceries in a year with 5% sales tax, that's 250 dollars of tax. 250/50K is a larger percent than 250/500K so they pay more of a percent of their income in sales tax, and that's just one of all the fixed taxes we have and other standard expenses like health insurance, car insurance, etc. Even with graded income tax brackets, the rich are still better off than the poor AND THEY SHOULD BE. However, the reason there isn't a flat tax is so the income discrepancy doesn't perpetuate itself. When you have money you develop assets, when you can't afford paying more to buy your home and are renting- that's money being redistributed from the poor/middle classes to the upper-middle/upper classes.

The mistake poor/middle-class people do is Wal-mart. They should be using it to develop assets and better their financial situation, hopefully in America but not always.

A fun example I give for income taxes is when you have more money, the government has more meaning to you because it is the infrastructure that protects your assets and wealth. Someone who makes 500K is getting equal protection under the defense budget as someone who makes 50K, but who has more to lose if we go to war. Well, actually the poor if they are producing the soldiers that fight it, but you get my point.

[Skippman]

Your implication is that once money is made, it can never be lost and that is a falicy. It takes skill to manage ones assets and to ensure that they will be there not just for yourself, but for your future generations. One of the things I consider when planning for my future is the possiblity of children and how to transfer that wealth that I will have built for myself to them so they will not have to work as hard as I did. That's part of the American Dream, the chance to make things better/easier for your children than you had it.

Once again we're getting into the argument over how I'm suddenly any more responsible for my neighbor than he is for himself. There are programs for people who wish to purchase a house but find themselves in an economic hardship, it's called HUD. Now what HUD can help them get and what they feel they deserve are two entirely diffrent things. I've come from very humble beginnings to what would be considered a "comfortable" lifestyle. I'm not wealthy by any streach of the imagination but I've done well for myself. I worked my way through school, payed my own tuition, and made the downpayment on my home all without the aid of Uncle Sam or anyone else for that matter. Now, I'm being told that if I continue to struggle to improve my lot in life I'm morally or legally obligated to pull someone along with me and I resent the implication. Nothing freely given is worth anything. That's the problem. You need look no further than the abandoned housing projects in any major city to see that.

As for shipping our poor off to war as you put it, the last time I checked we're an entirely volunteer army and have been for quite some time. I considered enlisting but was disqualifed due to a medical condition. The phrasing of your argument is that we force our poor to fight for us which is non-sense. Patriotism should be the primary motivation for anyone who wants to serve. If you've joined the armed forces under the delisuion that you're doing community service in exchange for college tuition you've not done your homework. ANYONE who enlists in the armed forces should do so with the expectation that they will be put in harms way.

[Nobahar]

On your last statement, it's not patriotism necessarily. It's financial incentive. Look at the HPSP scholarship, they pay for every medical school expense and give you a stipend (estimated value ~60K for this year at my school) in return for a year of service per year of scholarship.

Now while you say that doctors make a lot of money, it's not always true. Consider primary care, where doctors have to see almost a hundred patients per day to make as much as a surgeon makes doing one surgery every three days. 60K a year for 4 years is 240K, add any student loans from undergrad and the fact that you don't really make much money during your years of residency (4 on average). It comes out to paying nearly 800K in interest and principle over a 25 year period, sure you can try a 10-year but think about what the monthly payments of that magnitude would be. At the same time, maybe you are starting a family or want to buy a house, car, etc. That's why you see large shortages in primary care doctors, primarily in rural communities. And doctors are on the high-end of education, yet at the same time we're talking 2 lawsuits average per doctor and other ways of draining expenses. It's really easy for me to say, sure- give me the scholarship, I'll be better off after the years served in the military.

I didn't take the scholarship for a variety of reasons, but there are a lot of people that do. It has nothing to do with patriotism.

[Skippman]

On your last statement, it's not patriotism necessarily. It's financial incentive. Look at the HPSP scholarship, they pay for every medical school expense and give you a stipend (estimated value ~60K for this year at my school) in return for a year of service per year of scholarship.

I didn't take the scholarship for a variety of reasons, but there are a lot of people that do. It has nothing to do with patriotism.

I prefeced my statement by saying it SHOULD be, not that it always is. I do understand there is a financial consideration there. But those financial incentives are there for a reason, because the job is inherrently dangerous. No one should ever enlist in the armed forces without any expectency of danger. It's not the Peace Corps, it's the military. To do anything else is either falling into denial or being outright foolish.

Now, on the matter of physicians, I agree with you to a point. One of my best friends is a Chiropractor. Not exactly a surgeon either. I saw what it took to try and make a practice successful and it was a lot of hard work. One of the major things working against him was his malpractice insurance. This is a major consideration for a lot of medical practices, particular anything relating to prenatal care or young children. We need serious tort reform in this country.

I was talking to an Aussie who was studying medial law while on a ski trip last year. He advised me that in Australia they actually have a book that lists the payout for any workmans comp injury or other malpractice issue. You loose an arm it's X amount of dollars, you loose a finger it's Y ammount. No payout for pain and suffering. This keeps thier legal system free of frivilous lawsuits for "emotional anguish". While I'm not debating that people who've lost a limb certainly have mental duress, that is part of the payout. They're system is fair in that every injury receives an ammount that doctors and lawyers decided was resonable. They review the list every so often and update it as nessicary. This helps keep insurance costs down as the malpractice insurance agencies know what to expect to pay out on a failed proceedure. I don't know that it's right, but they have a system that works and seems to make more sense than ours here where if a plaintif doesn't get the award he wants he simply appeals and starts the process over again.

Nobahar this has to be one of the best discussions I've had on a forum ever. I appreciate you keeping the tone civil and keeping it an intellectual discussion as opposed to a rant! :D

[Nobahar]

With military on one hand you have the patriots, families that have a history of military service, etc. On the other hand you have the poorer families where military is a way out, it's tough to get from an inner city school through the system to get a decent education against odds. Affirmative action somewhat helps, but not really as it doesn't target income bracket as much as it targets race. I'm not saying it is entirely bad, I just met a guy here last month who was drug dealing for money on the side as a kid, decided that there was no future in it and enlisted in the army. He turned out to be a software engineer, and lives pretty comfortably now. He knew about the risks involved, and actually does get some kind of disability compensation as he was injured in the line of duty. It seems like a very risky thing for me, but I can totally understand why he would do it and he has actually changed the course of his life as he could have easily ended up in jail if he kept going on that early path.

Doctors don't tend to be in danger areas as much as in hospitals working with injured American soldiers, it's part of providing the best healthcare for them- which I agree with. I wouldn't mind it if it was easier to negotiate with the military, once you get that scholarship they own you. I figure if I really want to, I can always get them to propose my own contract with them, whereby they erase my debt and I work for them as a contractor. Then again, I'm sure there are also federal programs for working in an inner city hospital or other under served area with similar debt forgiveness.

I'm actually learning from discussing, and it's a pleasant break from studying . I had no idea about AT&T concept but what you said makes sense, I did have a microeconomics course once so I am remembering some things. Furthermore, I had no idea about Australia's system. Tort reform is definitely something that should be looked at, but in ethics class I heard all kinds of horror stories and I do believe there needs to be a standardized way of protocol. You might work day and night to help a patient, but if you can't communicate effectively to them they might sue you for emotional reasons- and obviously it's about money and they pick a jury of your "peers" consisting of uneducated, doctor-loathing people. It's definitely not justice, and ultimately it is hurting healthcare in America when doctors have to weigh making the right decision and risk law suit against a more conventional but maybe not the most immediately effective approach. Furthermore, insurance pay-outs are the big factor that is destroying primary care medicine and pharmaceutical companies have way too much influence on doctors. I read in a book that they can access data of what drugs you prescribe at what frequency to patients (anonymous patients for HIPAA reasons, but it's absurd). The capitalist model doesn't work perfectly with medicine, and neither candidate really has a clear approach to solve this crisis.

Both candidates believe in the free market, Republicans have more of a history with it but it's more important to factor what is feasible with congress and what is just political fluff (like Bush talking about going back to the moon four years ago, lol). What really irks me about McCain are the tactics he stoops to to demean his opponent, if his policies were sound he wouldn't have to try and play a popularity card by choosing a dumb, but hot woman as VP. McCain is very comfortable talking with his base, but had a hard time addressing America- particularly the first two debates, he got better at it by the third debate. While I dislike Biden, it's clear he has a lot more knowledge than Palin and I think that combination will work to make a more dynamic white house. Obama's foreign policy and global popularity are a clear advantage to improving the U.S. image.

I don't think Obama is any more of an enemy of small business than Clinton, and I wouldn't really say the 90's were a bad time for our economy. I disagree with his proposal to tax Exxon, but I'm pretty sure that will get stalled in congress. If we can't pass an emergency bill to save our short-term economy quickly enough to prevent the stock market from bouncing from heaven to hell and back, and with the huge oil lobby it's just not going to happen. So, the good things about Obama are within his presidential powers, the bad things about him will hopefully get blocked by the Republicans . And we get more tax cuts on top of him not undoing Bush tax cuts, whatever happens next week we are better off I think.

[Skippman]

I have nothing againt Obama personally. It's Biden that scares the crap out of me. He's been involved with more anti privacy legislature than any other candidate. He's pretty much the reason that PGP was created. At least according to the author of the program. Poltically speaking, I'm a Liberterian. I believe what I do in my house is my business so long as it does not impact anyone else.

The drug thing I new about as the FDA and CDC both track those statistics as well in case a defect is found in a medication. What I don't agree with is all the pharmaceutical comercials on TV. What business do I have telling my doctor what to proscribe to me. I'm a network technician, not a physician. I trust that my doctor knows what he's doing. I checked his credentials before choosing him as my primary care physician. If for some reason he were to give me an unusual diagnosis I would certianlly get a second opinion before I took action if it was not immediatly life threatening. People forget that it's called "practicing" medicine because no one will ever be 100% accurate or infaliable.

As for the military, I do understand what you're saying in that it's a spring board for people of low economic means. But those same people can also earn a scholarship, tuition aid, and PEL grants. Once you become over a certian economic level your no longer able to apply for many of those programs. Personally, I think apprenticeships should make a come back. My cousin back in Germany just finished his. Now, at 17, he has the beginnings of a career in HVAC thanks to that. Skilled trades like mechanic, plumber, etc need programs like that. You can't learn everything from a text book.

[Nobahar]

Yeah, Biden is a peculiar individual. I also mostly side with libertarians. Actually, surprisingly I'm not against commercials, even though they don't give all the information necessary to make a truly informative decision, I think people getting more involved in educating themselves about drugs is a great thing. Now a tv commercial is far from being a good source, but maybe people will want to learn more, even something as basic as a wikipedia search helps. The doctor will know all these things, but the patient can also express his/her own concern over complications or whether this new drug can help them, sometimes a doctor who has been practicing a long time is resistant to try something new that works similarly to an older drug. If a patient expresses interest in trying a newer drug, dissatisfied with the current one- it might be worth a closer look.

That and the drug development process is so expensive, it's a high-risk business and if they don't make profit off the new drugs they develop they can't spend the money finding new ones. Some of their business tactics do clash with ethical considerations, like a pharm. rep taking me out to dinner should not be a reason for me to prescribe their drug. I should prescribe it if I think it will be an effective drug for the patient with minimal adverse effects.

Most doctors know that, however, just like business doctors aren't always ethical. Those are the doctors that should get sued, not the doctors that are out there busting their ass for people. Like hormone replacement therapy to reverse aging? It's quackery. Not saying hormone replacement doesn't have other viable medical applications, just some things that actually are hurting people for profit. Most of the time people realize this doesn't work though and either that guy goes out of business, or gets sued in the process for actually harming his patient. Though I'm sure most of them have some subtle contracts and "informed consent" forms you have to sign that most people don't read but say that the physician isn't liable for adverse reactions to the drug. Con men know how to protect themselves from the legal system most of the time, it's the regular doctors that get destroyed by it.

Hormone replacement therapy for aging is just an example of them creating a disease out of something that isn't, aging is not a disease. That's the only time I am against commercials, it'd be like them marketing Viagra to increase your sexual virility. Sure that might happen, but the drug treats erectile dysfunction, it's not meant to be used by someone without that disorder. While it can be beneficial in that regard, all drugs have adverse effects.

[Skippman]

I completely agree. We have a tendency to be a drug oriented society that believes all issues can be solved through the proper application of pharmicuticals. Look at the number of people on mood altering drugs because they are "depressed". I know that medically there is such a thing as depression but there's also such a thing as failure to deal with reality.

I'm the kind of person who researches ANYTHING before I do it. You need look no further than the threads I've posted on this forum alone to see that. Knowledge is power and the only cure for ignorance is information. I may not always get correct information or the best advice, but I'm never afraid to ask for it to ensure I make an informed decision. I'm not much on the whole "trial and error" method, I prefer "collective ignorance" where we each know a bit of something and can contribute to the whole. That's one of the reasons I started coming back to this forum to begin with.

And that gets to the crux of our discussion here. America is riffe with what I term "willful ignorance". People are more interested in watching Dancing With The Stars and memorizing sports statistics than they are understanding the basics of science, how the investment market works, and our own government. I'm not disparaging entertainment as I watch my fair share of TV. But I do try to maintain a diverity of interests and stay informed about things that impact me. I read an article in Playboy recently about how Bradbury got it wrong. We don't have to burn the book, people have just been taught not to read them. The average American gets thier news from 1 to 2 sources. That hardly provides unbiased coverage. I love to watch BBC America's news just to get a perspective from a foreighn power of how the US really is. It's amazing how biased all our media is, Fox, CNN, MSNBC, and local. Everything has become sensationalized and agendized.

[Nobahar]

That's really the only way to go, knowledge is power but that's why we end up being better off than people who are what you call willfully ignorant. The thing that frustrates me is how much ignorance impacts everyone, not just in terms of issues people consider important for the presidential election. Even something like doctors getting sued is partially due to ignorance, people need to take responsibility for themselves and stop blaming others.

Say you have had chronic lower back pain, have foot surgery and your back pain gets worse. Believe me when I say that anesthesiologists are getting sued because of claims the lumbar anesthetic puncture damaged a nerve and aggravated back pain. It can happen, but this is a very low risk that the anesthesiologist takes every precaution to avoid. People are so keen to blame the doctor, and they overlook simple explanations. Maybe the fact that you can't walk for awhile after you have foot surgery has an effect on your lower back pain, or maybe your post-operative posture aggravated back pains. Maybe it was completely unrelated to the surgery, something else happened in your life (the window a patient can sue a doctor is 2 years post-operative, at least in this state). The ideal way to deal with it is to communicate with your doctor about the situation, how you feel worse and what can be done to identify and alleviate the problem. There is a small chance that it was the anesthesiologist's fault, but it is far more likely that it was one of the millions of other factors.

People should be trying to educate themselves and also take some responsibility for themselves and for others. The parents of those Columbine kids were responsible for not recognizing a problem and trying to help their kids, not violent video games and Slipknot. EDIT: Not just the parents obviously, everyone involved is responsible to an extent.

That's why I liked this post, it draws you to the fact that we are ignorant of the real value of a billion dollars. It's easier to understand that number through the examples:

A. A billion seconds ago it was 1959. So, if you were getting paid a dollar a second- 60 a minute- 3600 dollars an hour if you work every hour of the day, it'll take you almost 50 years to make a billion dollars? Is the math right? That's just.... wow. I mean say you work 40 hours a week instead- 144K each week- nearly 7.5 million a year, a bit over 133 years will make you a billion dollars, BEFORE TAX.

[Skippman]

Ah, now we get to the crux of the debate. Personal responsiblity.

We've created a society where no one is to blame for thier circumstances. Nothing is your fault. Apparently we've become a nation of playdough people where we lack the ability to be firm and stand up for ourselves. Everythings always someone elses fault. It's the doctors fault, it's the governments fault, it's gods fault, etc. While it's true that those things may have an impact on the situation it's far more likely your circumstances are the result of either your action, or inaction on a situation. You are just as responsible for your inaction as you are for the actions you take.

That's part of the core of the Liberterian persepctive, and by extention the rational anarchist view. We are each a nation unto ourselves and as such are responsible for our actions, both deliberate and indirect. I consider myself a Heinleinist to the core. His books "Stranger in a Strange Land" and "The Moon is a Harsh Mistress" are probably most responsible for my views of the world to this day. Acceptance of personal responsiblity is part of the "rugged individualism" that makes this country great. But the second you sceed your responsiblity to someone else, you give up your freedom.

Take for instance my religious views. I'm an agnostic. Neither a theist nor an atheist as I feel I lack the perspective to truely say whether a god exists or not. The second I mention that perspective to a theist I'm immediatly placed into an unethicial catagory in thier mind despite how my actions may prove contrary to that. Ethics and Morality are fundementially diffrent things even though the words are synonyms. Morality is argued from a religious perspective (My doctrine allows this, but condems that) where as ethics take on issues from an intellectual perspective (this is wrong because it would cause this, and that is ok because it prevents that). I'm an extremely ethical person, or at least I like to think so. But, by many moral standards I'd be considered barberic (I support a womans right to choose, gay marriage, etc). My ethics are derived from a sense of personal responsiblity. They demand others also maintain that same sense of personal responsiblity. I'm often disappointed but never supprised when others fail that simple test.

[Nobahar]

I'd say my ethical codes follows more of a Kantian evaluation, but they lead me to similar outcomes usually. Being ethical just reflects upon your character, which for me as a person interested in practicing medicine my image does become important for people's trust in me and the business aspects of my practice.

[Skippman]

I could definatly see that. I've considered joining the Ethical Society. It's kinda a group for athiests and agnostics where they can discuss ethical delemias and go to for support in much the same way a thiest might go to thier church or temple.

[Nobahar]

Alcohol is another way lol

[Skippman]

Alcohol is another way lol

Oh yeah! That's exactly what I want. A surgeon with the DT's.

[Nobahar]

A little more about Kant, we determine ethical conduct by ACTION not by what I say Honestly though, so long as the surgeon is not on drugs other than a mild stimulant when he is doing the procedure (including not the night before, as he is not hungover) you're pretty safe. It'd be unusual for a doctor to talk about his recreational drug-usage prior to a procedure though.

Interesting tidbit, anesthesiologists have 3X the risk of developing a drug addiction than the general populace, particularly to opiates. They don't just revoke a doctor's license if they find out, which they eventually will, they put him through an extensive rehabilitation program. Doctors are a major investment by society, better to rehabilitate than lose them.

[Skippman]

A little more about Kant, we determine ethical conduct by ACTION not by what I say Honestly though, so long as the surgeon is not on drugs other than a mild stimulant when he is doing the procedure (including not the night before, as he is not hungover) you're pretty safe. It'd be unusual for a doctor to talk about his recreational drug-usage prior to a procedure though.

Interesting tidbit, anesthesiologists have 3X the risk of developing a drug addiction than the general populace, particularly to opiates. They don't just revoke a doctor's license if they find out, which they eventually will, they put him through an extensive rehabilitation program. Doctors are a major investment by society, better to rehabilitate than lose them.

Make ONE little joke....

[Nobahar]

I take too many things seriously, that's probably what got me into med school. It's good though, has occasional caveats with gullibility- but you know, someone comes to see me for a headache I will take it seriously until I determine it is nothing.

[Skippman]

Where are you anyway? Your account doesn't say. You're the kinda guy I could have a beer with!

[jakegub]

Skippman,

you mentioned above you were an agnostic, doesn't that basically just mean you don't care. Even if you lack the perspective to KNOW, you have to know that either there is a god, or there is not. So then you either have to choose to believe one way or another, or as an agnostic you can just not care. Am I simplifying that correctly?

Sort of P(q or ~q) = 1 sort of deal....