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Thread: The health care debate thread.

  1. #301
    Administrator U-Ute's Avatar
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    Quote Originally Posted by NorthwestUteFan View Post
    Good teachers are worth their weight in gold. They deserve to have states make a substantial investment in the children by paying teachers enough money to attract the best candidates.

    Likewise with cops. It is almost unconscionable that cops are forced to pick up extra OT shifts after working a full shift, just to make ends meet.

    I am very lucky to live in an area with very good schools and excellent teachers. Both of the local high schools are 99th percentile schools (open enrollment, kids can choose either). I also know that our teachers make a good salary, and as I said they are worth every penny.

    It all comes down to what the local community and the state values.

    One problem is our society really doesn't value workers on the lower end on the scale. We Americans tend to hold highly-paid people in high regard, while looking down our nose somewhat at our waitress, or grocery/retail clerk, fast food cook, gas station attendant, etc. We tend not to respect the working poor, and to blame them for their situation in life.
    It reminds me of this article from Forbes: We Are All Low Skilled Workers Now

    Basically, it says that as robotics and AI get better and better, people higher up on the "skill" ladder will be replaced.

  2. #302
    Quote Originally Posted by NorthwestUteFan View Post
    Good teachers are worth their weight in gold. They deserve to have states make a substantial investment in the children by paying teachers enough money to attract the best candidates.

    Likewise with cops. It is almost unconscionable that cops are forced to pick up extra OT shifts after working a full shift, just to make ends meet.

    I am very lucky to live in an area with very good schools and excellent teachers. Both of the local high schools are 99th percentile schools (open enrollment, kids can choose either). I also know that our teachers make a good salary, and as I said they are worth every penny.

    It all comes down to what the local community and the state values.

    One problem is our society really doesn't value workers on the lower end on the scale. We Americans tend to hold highly-paid people in high regard, while looking down our nose somewhat at our waitress, or grocery/retail clerk, fast food cook, gas station attendant, etc. We tend not to respect the working poor, and to blame them for their situation in life.
    I think all this talk is great. Below are the reasons why most Canadians I know (friends and family) are either teachers or police officers ...

    Salary: As of January 1, 2015, a Constable-in-Training at the Ontario Police College (OPC) earns $55,146/ annually. Upon graduation from OPC, members will become 4th Class Constables earning $64,336/ annually. As a 1st Class Constable, you can earn $91,909 to $100,183/ annually."
    https://www.hamilton.ca/jobs-city/jo...police-service

    Annual starting salary for a new teacher at lowest and highest pay rates: $45,709, $55,404. Salary for a teacher with more than 10 years of service at the lowest and highest pay rates: $76,021, $94,707
    http://www.theglobeandmail.com/news/...rticle6015968/

    Now, for a dose of reality. Ask me how much I pay in taxes to help pay those salaries and prepare for your knees to buckle. Because we also have universal health care to pay for

    NOTE: I also paid a $1.10 per litre for gas when I filled up yesterday.
    Last edited by tooblue; 01-19-2017 at 04:11 PM.

  3. #303
    Five-O Diehard Ute's Avatar
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    Quote Originally Posted by tooblue View Post
    I think all this talk is great. Below are the reasons why most Canadians I know (friends and family) are either teachers or police officers ...



    https://www.hamilton.ca/jobs-city/jo...police-service



    http://www.theglobeandmail.com/news/...rticle6015968/

    Now, for a dose of reality. Ask me how much I pay in taxes to help pay those salaries and prepare for your knees to buckle. Because we also have universal health care to pay for

    NOTE: I also paid a $1.10 per litre for gas when I filled up yesterday.
    Yeah, we ain't in Canada haha


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  4. #304
    Quote Originally Posted by Diehard Ute View Post
    Yeah, we ain't in Canada haha


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    Yup. I doubt you bring home 100k annually, and Rocker's wife never dreamed that after 10 years, as long as she was willing to take on some admin duties in addition to teaching, she would be making between 70 and 90k a year. Also, I am pretty certain none of you paid $4.40 a gallon for gas today, yesterday or ever. Health care and salaries for government workers has to be paid for somehow.

  5. #305
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    Quote Originally Posted by tooblue View Post
    Yup. I doubt you bring home 100k annually, and Rocker's wife never dreamed that after 10 years, as long as she was willing to take on some admin duties in addition to teaching, she would be making between 70 and 90k a year. Also, I am pretty certain none of you paid $4.40 a gallon for gas today, yesterday or ever. Health care and salaries for government workers has to be paid for somehow.
    We've had $4 gas here, but it's about half that now.

    I just checked the state occupational employment wage estimates. For Salt Lake area the mean salary for police in 2015 was about $52,000. Teachers was $57,000. A police supervisor was $76,000


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  6. #306
    I just searched:

    http://www.utahsright.com/h_salaries.php

    I searched SLC school district for last name "Brown" and found a handful of elementary school teachers earning over $100,000.

  7. #307
    Quote Originally Posted by sancho View Post
    I just searched:

    http://www.utahsright.com/h_salaries.php

    I searched SLC school district for last name "Brown" and found a handful of elementary school teachers earning over $100,000.
    That is more than salary--it includes benefits such as health care, retirement, vacation days, etc. Salary probably substantially lower.

  8. #308
    Quote Originally Posted by Diehard Ute View Post
    We've had $4 gas here, but it's about half that now.

    I just checked the state occupational employment wage estimates. For Salt Lake area the mean salary for police in 2015 was about $52,000. Teachers was $57,000. A police supervisor was $76,000


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    So, if we account for the fact a Canadian dollar is only worth US 75 cents the pay disparity isn't all that great. But, I don't live in the US, so that's immaterial. Because I pay Canadian prices earning a Canadian wage. However, I do benefit from universal health care (no, it's not as terrible as FOX news say it is—there are no death panels). So, why is US heath care so much more expensive, especially prescription drugs? There is the issue of population: 35 million as compared to 318 million, but still. And why can't teachers and police officers be paid more?
    Last edited by tooblue; 01-19-2017 at 04:50 PM.

  9. #309
    Quote Originally Posted by concerned View Post
    That is more than salary--it includes benefits such as health care, retirement, vacation days, etc. Salary probably substantially lower.
    Oh, makes sense. I guess I should try reading stuff more often.

  10. #310
    Quote Originally Posted by Diehard Ute View Post
    We've had $4 gas here, but it's about half that now.

    I just checked the state occupational employment wage estimates. For Salt Lake area the mean salary for police in 2015 was about $52,000. Teachers was $57,000. A police supervisor was $76,000


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    Sometimes I feel like you learned nothing from Kindergarten Cop.

  11. #311
    Quote Originally Posted by tooblue View Post
    I think all this talk is great. Below are the reasons why most Canadians I know (friends and family) are either teachers or police officers ...



    https://www.hamilton.ca/jobs-city/jo...police-service



    http://www.theglobeandmail.com/news/...rticle6015968/

    Now, for a dose of reality. Ask me how much I pay in taxes to help pay those salaries and prepare for your knees to buckle. Because we also have universal health care to pay for

    NOTE: I also paid a $1.10 per litre for gas when I filled up yesterday.
    Yeah, but that is like US$20k, so yeah. (Kidding)
    When we include all taxes, plus the cost of health and other insurance premiums and retirement investments, all of which we buy on the private market but are included in your Canadian taxes, the actual difference of totals paid is marginal. Canada (and Europe) has a far greater degree of upward mobility than in the US, particularly for lower earners. The American Dream is alive and well in Canada in many respects.
    Quote Originally Posted by Rocker Ute View Post
    Sometimes I feel like you learned nothing from Kindergarten Cop.
    "Boys have a penis, and girls..."
    Last edited by NorthwestUteFan; 01-19-2017 at 08:33 PM.

  12. #312
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Two Utes View Post
    We already made this decision. No one gets turned away. No one. They just go to the emergency centers.

    I'm just going to go ahead and assume this is sarcasm. At least on the principle that this is a sound alternative.

  13. #313
    Quote Originally Posted by U-Ute View Post
    I'm just going to go ahead and assume this is sarcasm. At least on the principle that this is a sound alternative.

    It's not a sound alternative. But if there is anybody out there who doesn't accept the fact that we have already decided to insure everybody, then they need to realize they are wrong. Because we've already made this decision, we need to do it the most effective way possible. My solution is make each state have a health care plan. Screw California and New York. You guys build and pay your own and we will do the same.

  14. #314
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    Quote Originally Posted by Two Utes View Post
    It's not a sound alternative. But if there is anybody out there who doesn't accept the fact that we have already decided to insure everybody, then they need to realize they are wrong. Because we've already made this decision, we need to do it the most effective way possible. My solution is make each state have a health care plan. Screw California and New York. You guys build and pay your own and we will do the same.
    And you're right.

    The last year I worked for University Healthcare they wrote off $250,000,000 in charges (2006).

    I can't tell you how many people I see taken to the ER by ambulance each week who we all know will never be able to pay.




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  15. #315
    Quote Originally Posted by Diehard Ute View Post
    And you're right.

    The last year I worked for University Healthcare they wrote off $250,000,000 in charges (2006).

    I can't tell you how many people I see taken to the ER by ambulance each week who we all know will never be able to pay.




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    When I worked there (left in '99) we only received ~2-4% of our budget from the state, but were forced to take most of the indigent. LDS hospital would re-route ambulances to us, etc. We got all of the prisoners (obviously), but also nearly all of the homeless people, etc.

  16. #316
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    Quote Originally Posted by NorthwestUteFan View Post
    When I worked there (left in '99) we only received ~2-4% of our budget from the state, but were forced to take most of the indigent. LDS hospital would re-route ambulances to us, etc. We got all of the prisoners (obviously), but also nearly all of the homeless people, etc.
    The prisoners are actually great. The prison and SL County jail pay more than Medicare pays. Most of the routine prison visits now are done via video. (Many people may not know Medicare pays roughly 60% of what the charge is, and they don't negotiate. They tell the hospital what they'll pay)

    The homeless aren't routed anywhere specific these days. Although I would guess SL Regional gets more

    The hospitals outside SLC (IMC, St Marks, Jordan and Pioneer Valley etc) take on far less of that burden.


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  17. #317
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by NorthwestUteFan View Post
    When I worked there (left in '99) we only received ~2-4% of our budget from the state, but were forced to take most of the indigent. LDS hospital would re-route ambulances to us, etc. We got all of the prisoners (obviously), but also nearly all of the homeless people, etc.
    In a normal environment, EMS personnel are supposed to take people to the nearest hospital with capability to provide the care needed. Maybe IHC just has the clout necessary to re-route ambulances?

    That said, once an ambulance is actually on the hospital property with a sick person aboard it's a serious violation of federal law to send the ambulance away without at least screening the individual and stabilizing any emergency condition the examination discloses. So I hope IHC isn't getting away with that.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  18. #318
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    Quote Originally Posted by LA Ute View Post
    In a normal environment, EMS personnel are supposed to take people to the nearest hospital with capability to provide the care needed. Maybe IHC just has the clout necessary to re-route ambulances?

    That said, once an ambulance is actually on the hospital property with a sick person aboard it's a serious violation of federal law to send the ambulance away without at least screening the individual and stabilizing any emergency condition the examination discloses. So I hope IHC isn't getting away with that.
    That only applies if it's a life or death situation correct?

    Most times the ambulance crews ask the patient where they want to go.

    Ambulances don't change once they're at a hospital. They are sometimes changed en route due to hospitals being on critical census or emergency divert.

    (One thing has changed since NWU worked at the U, IHC opened IMC, thus removing LDS as a trauma center. Now days I'd say on the trauma cases it's entirely distance. If you're south and west in SLC they're likely headed to IMC, north and east the U. In between it's a crap shoot.


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  19. #319
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Diehard Ute View Post
    That only applies if it's a life or death situation correct?
    If you're talking about what hospitals must do when an ambulance shows up, they have to do a screening exam to see what's going on with the patient, even if it's just a cold.

    One of my clients had a patient come to the ER (he was a "frequent flier" who showed up in the ER often) and start threatening to kill people. He had a knife and was clearly delusional. The ER was evacuated and the police were called. When the police got there they handcuffed the guy and put him in a car out in the parking lot while the hospital arranged to get him admitted to a hospital with a psychiatric service (my client was just a community hospital -- no psych service). CMS (the Medicare agency) commenced a termination action (the process for kicking the hospital out of the Medicare program) because the ER provided the guy no screening exam. CMS wanted the hospital to send someone out to the police car, where the handcuffed man sat, and check his vitals etc. to make sure he was not suffering from an emergency condition that needed immediate attention. A crazy situation, but that's what the law requires. If you show up anywhere on a hospital's property and request evaluation or treatment for a medical condition, they can't send you away without checking you out and providing any emergency care you need. Oh, by the way, in that situation it's also prohibited to ask the patient any questions about his/her insurance status or ability to pay until you've screened and stabilized.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  20. #320
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    Quote Originally Posted by LA Ute View Post
    If you're talking about what hospitals must do when an ambulance shows up, they have to do a screening exam to see what's going on with the patient, even if it's just a cold.

    One of my clients had a patient come to the ER (he was a "frequent flier" who showed up in the ER often) and start threatening to kill people. He had a knife and was clearly delusional. The ER was evacuated and the police were called. When the police got there they handcuffed the guy and put him in a car out in the parking lot while the hospital arranged to get him admitted to a hospital with a psychiatric service (my client was just a community hospital -- no psych service). CMS (the Medicare agency) commenced a termination action (the process for kicking the hospital out of the Medicare program) because the ER provided the guy no screening exam. CMS wanted the hospital to send someone out to the police car, where the handcuffed man sat, and check his vitals etc. to make sure he was not suffering from an emergency condition that needed immediate attention. A crazy situation, but that's what the law requires. If you show up anywhere on a hospital's property and request evaluation or treatment for a medical condition, they can't send you away without checking you out and providing any emergency care you need. Oh, by the way, in that situation it's also prohibited to ask the patient any questions about his/her insurance status or ability to pay until you've screened and stabilized.
    No no

    The nearest hospital thing.

    That's only in life or death situations, not a rolled ankle or hearing voices.

    (Of course nearest hospital isn't always nearest hospital, as a trauma center is better than a hospital that will just have to transfer them to
    A trauma center)

    Obviously though things are a bit different where you are, all hospitals here take psych patients. The county is responsible for them not the hospital. The emergent assessment is done at any ER and then long term arrangements are made.


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  21. #321
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Diehard Ute View Post
    No no

    The nearest hospital thing.

    That's only in life or death situations, not a rolled ankle or hearing voices.

    (Of course nearest hospital isn't always nearest hospital, as a trauma center is better than a hospital that will just have to transfer them to
    A trauma center)

    Obviously though things are a bit different where you are, all hospitals here take psych patients. The county is responsible for them not the hospital. The emergent assessment is done at any ER and then long term arrangements are made.


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    Here we have EMS (Emergency Medical Services) protocols set up by the counties. The ambulances have to take the patient to the nearest hospital ER with capability (e.g., trauma, psych) unless that ER is on "diversion," meaning it is too swamped to take any new patients. Even that is subject to oversight because it can be easily abused. I imagine SL County has something similar. Here every hospital ER can hold a psych patient for 8 hours while a transfer is arranged to a hospital with a locked unit (talking about patients who are a danger to self or others). I think this is pretty standard around the country although the details differ. In the case of my community hospital client (in the State of Washington) they had no capacity to care for a raving psychotic patient, which is why they called the police. Fun times! I'm sure you end up dealing with such people pretty often.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  22. #322
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    Quote Originally Posted by LA Ute View Post
    Here we have EMS (Emergency Medical Services) protocols set up by the counties. The ambulances have to take the patient to the nearest hospital ER with capability (e.g., trauma, psych) unless that ER is on "diversion," meaning it is too swamped to take any new patients. Even that is subject to oversight because it can be easily abused. I imagine SL County has something similar. Here every hospital ER can hold a psych patient for 8 hours while a transfer is arranged to a hospital with a locked unit (talking about patients who are a danger to self or others). I think this is pretty standard around the country although the details differ. In the case of my community hospital client (in the State of Washington) they had no capacity to care for a raving psychotic patient, which is why they called the police. Fun times! I'm sure you end up dealing with such people pretty often.
    Yeah, in Utah people can only be involuntarily taken to a hospital for a psych issue if a law enforcement officer has probable cause they are a danger to themselves or another. Then we force them to go, they remain until a crisis worker and doctor release them (sometimes that's 2 hours later)

    Doctors can put someone on a hold but it's more difficult for them to do outside of a hospital.

    There's nothing here forcing where ambulances go, and 70-80% of the time that choice is left up to the patient.


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  23. #323
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Diehard Ute View Post
    There's nothing here forcing where ambulances go, and 70-80% of the time that choice is left up to the patient.
    I like that. There are more than a few hospitals I know about here in CA that I'd demand not to be taken to! I'd sign whatever waiver is necessary to avoid being sick or injured inside on of those...places.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  24. #324
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    Quote Originally Posted by LA Ute View Post
    I like that. There are more than a few hospitals I know about here in CA that I'd demand not to be taken to! I'd sign whatever waiver is necessary to avoid being sick or injured inside on of those...places.
    Kaiser?


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  25. #325
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by Diehard Ute View Post
    Kaiser?


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    No, that has changed a lot. Kaiser provides very good care now. The smaller community hospitals and many of the rural ones are death traps.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  26. #326
    Quote Originally Posted by LA Ute View Post
    No, that has changed a lot. Kaiser provides very good care now. The smaller community hospitals and many of the rural ones are death traps.
    Reminds me of my grandpa going to his small town hospital here in Utah with his face slumping, loss of use of his left side of his body and slurred speech and the hospital sending him home saying he was fine. I'm glad I live where I do.


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  27. #327
    Quote Originally Posted by Rocker Ute View Post
    Reminds me of my grandpa going to his small town hospital here in Utah with his face slumping, loss of use of his left side of his body and slurred speech and the hospital sending him home saying he was fine. I'm glad I live where I do.


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    Something similar happened to my daughter-in-law in Layton a few years ago. The next morning, she was in ICU and I was driving her daughters to possibly say good bye to her for the last time.

    Another kind-of daughter-in-law (it's complicated) was an ER nurse at IMC for a few years. She said the other night that if she told us that if she were in an accident, she would only go to IMC or the U, even if other hospitals were closer.

    Don't get too comfortable just because you live in the big city.
    Last edited by chrisrenrut; 01-20-2017 at 09:29 PM.
    “To me there is no dishonor in being wrong and learning. There is dishonor in willful ignorance and there is dishonor in disrespect.” James Hatch, former Navy Seal and current Yale student.

  28. #328
    Five-O Diehard Ute's Avatar
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    Quote Originally Posted by chrisrenrut View Post
    Something similar happened to my daughter-in-law in Layton a few years ago. The next morning, she was in ICU and I was driving her daughters to possibly say good bye to her for the last time.

    Another kind-of daughter-in-law (it's complicated) was an ER nurse at IMC for a few years. She said the other night that if she told us that if she were in an accident, she would only go to IMC or the U, even if other hospitals were closer.

    Don't get too comfortable just because you live in the big city.
    Those of us in law enforcement pretty much only go to the U or IMC.

    And some depends on why you're going. If you have a burn, the U is the only choice. Anything where you've been exposed to a disease of some sort the U is the better choice.


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  29. #329
    Yes, the prisoners were great for the most part. I heard a number of great stories out of them, and frankly realized how narrow the line is between being in prison and out. It only takes a marginal shift in circumstances some times.

    The only patient who truly scared me was the Alta View Hospital shooter. He was strapped and handcuffed to the bed, wore a face shield because he spit on everybody, had two unarmed security guards in his room and two armed guards (campus police) outside.

  30. #330
    Quote Originally Posted by concerned View Post
    That is more than salary--it includes benefits such as health care, retirement, vacation days, etc. Salary probably substantially lower.
    You are correct. I looked up my data on Utah's Right, and it's waaaay beyond what gets reported on my W2.

    Actually, with such huge premiums to be paid on healthcare, I wonder if people like me could have our healthcare contributions put into preferred risk pools, just like the choices we get in retirement investments, where lifestyle, health measurables and genetic risks can be considered, and then I could get a whole lot more of what Utah's Right says I'm making.

    If you think about it, your ZIP code, your credit score and your driving record are valuable data sets to assess healthcare cost risk.

    (I'm completely against this idea, but it's a market based approach.)

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