DS: Only the best should get the best?

[DianaCox]

Rob - have you had your coffee yet this morning??

• "by definition, 50% of the population has an IQ at or below average"
• "I had no idea the number was that high"
• http://en.wikipedia.org/wiki/Normal_distribution
• http://en.wikipedia.org/wiki/Intelligence_quotient#Current_tests

 

[Munchkin]

People die here in the US every day for lack of health care. Many are more afraid of debts they can't pay than they are of death. And most of them are not slackers scamming the system. Most of them work just like you and many work harder than you do. Since I've been on both sides of this I can say for sure I worked harder for $9 per hour with no benefits than I did for $40 or 50 with full benefits. I know many people here legally and illegally who haven't had a day off in 5 or 6 years because they work more than one part time job.

There are scammers in the workplace and in the 'system'. It's quite popular to say welfare recipients should be drug tested and that would clear 'em all out. Florida and Utah tried this and determined the numbers were so small it wasn't worth the money to test. Part of the problem is the poor are invisible. We don't see lines of people at soup kitchens or waiting for the dole like there were during the Great Depression. But that doesn't mean it's not there. Now they are issued EBT cards and swipe like everyone else. They apply online too, much cleaner and neater. And most of the poor are not unemployed. Many used to make a middle class salary and became downwardly mobile when the economy changed. They are now competing for low wage jobs formerly filled by people who think an elephant is bigger than the moon. The average salary in the US is now 28K. And I'm not too worried about that guy. It's the 50% of the workers who make less than that I'm concerned about.

I don't think anyone really knows how much we pay in taxes. I remember reading there is some huge number of hidden taxes we pay on a gallon of milk. Over 100 of them. I want a way to add them all up, fed, state, local, hidden, gas. Our tax burden isn't enough less than what the rest of the world pays that we should be happy to live without universal health care.

Corporations are making record profits. The stock market is up. The banksters we bailed out are back to business as usual when they should still be in jail. They are doing well because they no longer pay taxes here and many of their employees are now in Bangalore. They have bought and paid for the government. Anyone familiar with the Omnibus Bill? Now they can come after your pension and they gave themselves 1K per month for their personal cars. Most everything we buy is made somewhere else. The truck drivers who pick up the containers at the port are from some other Central or South American country. More and more cashier type jobs are being replaced by machines.

Historically speaking, any country that can't offer meaningful employment to a majority of it's working age population is in trouble. And what's left of the middle class is no longer enough to carry the rich and the poor.

 

[robs477]

Rob - have you had your coffee yet this morning??

• "by definition, 50% of the population has an IQ at or below average"
• "I had no idea the number was that high"

Maybe I'm in that 50% category also

 

[DianaCox]

Math again - I think you're mixing mean and median. "The average salary in the US is now 28K. ... the 50% of the workers who make less than that "

I would venture to guess that if the AVERAGE salary (all salaries divided by people) is $28K, then the NUMBER OF PEOPLE who make less than that is going to be WAY more than 50% of the workers, because one person making $150K/year offsets TEN people making $15K. And someone who makes $1.5M/year offsets 100 of the $15K schmucks. See this explanation: http://wjmc.blogspot.com/2010/04/statistics-by-amateurs.html (numbers are probably from 2009 or so) - note that this applies to income, not IQ, where the MEAN is 100 (and I believe the generic bell curve is one in which the mean, median AND mode all are the same):

According to Ray Fisman of Slate, "It's a sad statistical reality: Half of us are below average." Well, I regret to inform Fisman and the editors atSlate that this claim is emphatically not "reality." Recall that "average" is also known as the "mean," which is the value derived by dividing the sum of a set of quantities by the number of quantities in the set. The "median" is the numeric value separating the higher half of a sample, population, or a probability distribution, from the lower half. The "mode" is the value that occurs the most frequently in a data set or a probability distribution. Fisman is confusing the "average" with "median" in his assertion.

Source: Shor (2010)
Consider the average per capita incomes in the US and The Netherlands as depicted above. The distributions show that the average income in the US is $36,092, while the average income in The Netherlands is $32,972. In other words, the average income in the US is higher than in The Netherlands. However, the median income in the US is $22,960, while the median in The Netherlands is $28,032. In other words, workers in The Netherlands generally earn more than workers in the US. Finally, the mode or most common annual income in the US appears to be around $20,000, while the mode in The Netherlands is clearly higher at an amount above that of the US.
The error that Fisman makes in his assertion that "half of us are below average" is a banal misconception, and demonstrates why analytical "amateurs" (in every field of endeavor) should take greater care with their use and interpretation of statistics.​

 

[Sheanie]

I'm pretty sure if they drug tested the Medicaid recipients in MY home town, they'd weed out more than half due to illegal drug use. And I'm not talking about Medical Marijuana, either. They already have their MMC and use their cash assistance to purchase weed. I know both my nieces would test positive.

 

[Larra]

@robs477 there is a comedian who builds his routine around his line that you can't fix stupid. I forget his name - last name White, maybe? someone will know.

IQ, like so many other things, is plotted out on a bell curve, with an IQ of 100 being "average", and anything above that is above average, anything below is below average. So technically 50% or thereabouts of the population is below average. In reality, however, anyone within 1 standard deviation of 100 would be considered "normal" IQ, and one standard deviation, if I remember from my long ago days working with what was then called the mentally retarded (now developmentally disabled) was 15, or maybe 20. That was a long time ago. So if someone tests out at an IQ of, say, 89, they would be considered normal.
In addition, the unfortunate souls at the very bottom of the IQ scale, i.e. the profoundly retarded, are not people you are going to meet in the every day course of events.
So really, more than 50% of the people you meet have at least average intelligence.
HOWEVER,, this does NOT mean that people use the brains G-d gave them. I've met lots of smart people who act stupid. I'm sure you have too. And you can't fix that either.

 

[southernlady]

@robs477 there is a comedian who builds his routine around his line that you can't fix stupid. I forget his name - last name White, maybe? someone will know.

Ron White...Blue Collar Comedy

Same group with Jeff Foxworthy "You might be a redneck" and Bill Engvall of "here's your sign" and Larry the Cable Guy.

 

[Larra]

Thank you @southernlady! Yes, he's the one. Very funny guy.

 

[star0210]

"While there are some people who [sic: for whom] WLS is medically necessary, I think more people ha e [sic: have] it for cosmetic elective reasons."

Wow, just wow. Are you KIDDING me?? SB said it nicely - I'm not feeling so nice after reading this. You, with your "VSG should be good enough" - but it wasn't - and "my revision wasn't medically necessary, I just preferred it to taking statins" - TWO surgeries presume to judge others, pre-ops who don't have your advantages? Really?

That may not be your observation or experience and it may not be true overall, but it IS what I've observed over and over on the different forums (mostly OH) and the various fb pages (not so much on the DS pages, but the general wls pages). While most of these people do have some co-morbidities, their predominant reason for wanting WLS isn't to resolve those. They get advice such as "put ankle weights on under your pants to make you weigh more". They try to come up with co-morbidities because their BMI isn't high enough to qualify. Their motive isn't to resolve health issues. I don't think you see this so much with DS'ers.

So to your other points...I never said the VSG SHOULD be good enough...I said I HOPED it would be enough. And no, I do not think my revision was medically necessary AT THIS TIME. If I had continued to gain weight, I'm sure more of my previous health issues would have returned, making it more medically necessary. My original surgeon and my PCP both didn't think it was. My PCP however was supportive of my decision to do it.

You know, there may well be VSGers and CrapBandsters who trifle with WLS, and think (or are misled to believe) that bariatric surgery is a safe way to get thin and avoid the pain of dieting (and of course they're wrong on both counts), but there are very few DSers who have that attitude.

Hence why I used WLS and not DS in all of my posts. I wasn't speaking of DS'ers...I was speaking of WLS in general. I think that those people who consider and want/get DS are more serious and have more health issues and that is their primary motivator.

I think you are projecting your own misguided, elitist and selfish rationale on others. Worse, you claim you were in a position to see to it that your fellow employees and their families had the right to proper medical treatment for their DISEASE of morbid obesity, but - you already had YOURS, and YOU had to pay for it yourself, so why should anyone else get one covered by insurance on your watch??

I'm sorry, this REALLY pissed me off.

I'm misguided, elitest, and selfish because I dislike people who abuse the system? Mmmk.
I didn't always have the means I have now and I may not always have them in the future. I well remember the days crying because my baby was sick and I didn't have the money to pay the doctor and begging them to let me write a post dated check. I remember the helpless and terrified feeling of having no money and wondering how I was going to buy groceries or pay rent. I remember the days when my water would get turned off because I couldn't pay the bill....thank GOD I have such wonderful parents who bailed us out time and again. I paid them back every single time and now that they're older in their senior years and living on a fixed income, I go above and beyond for them because I OWE them. They took care of me way longer than they should have had to and now it's my turn to take care of them. My parents are the single most best people I know. They have devoted their retirement years to giving back. Special Olympics is their number one thing. They've always been very civic minded and they taught that to me as well.
My point is...I've been there. I've been on that side.
You know what? I'll give you misguided. That might be true in some cases...but elitest and selfish do not describe me.

As for your last sentence, I think you should go and re-read my post again. I never said anything about denying my employees anything.
Let me try this again. I have 17 employees...all of them are like family to me. I said that none of the plans I had to choose from included bariatric services. I said that I supposed I could have told my broker to go find me a plan that covers WLS...but I would have been doing that for selfish purposes...because it would have benefited me and probably hurt them. I look at the needs and wants of my employees. I poll them to see what's important to them when it comes to health insurance. None of them said WLS. Yes, there are a few of them that would benefit from it, but not something they're all that interested in or concerned about. They care mostly about how much the plan is going to cost and what kind of OOP expenses they are looking at to use it. I chose our company's plan based on THAT criteria. What THEY wanted.

 

[star0210]

The medical community has determined that a bmi of 40 or more, or 35 or more with specific comorbidities, are the medical criteria that qualify someone for bariatric surgery. The medical community has accepted, more recently, that morbid obesity is a disease. While there are a small number of people who don't meet these criteria having bariatric surgery for cosmetic reasons (and they are all self-pay), this means that the people you disparage and would like to just live with their morbid obesity have a disease and need medical treatment.
Morbid obesity is about far more than what people weigh or how they look. Even for people who are young and don't yet have severe comorbidities, the damage is being done. Internal organs like the liver and pancreas are being damaged, the damage just hasn't shown up...yet. But eventually, it will. Even without a diagnosis of arthritis - yet - weight bearing joints are gradually being damaged by carrying all that excess weight. Eventually, there will be enough damage and loss of cartilage that a diagnosis will be made and disability will begin. Morbidly obese, or even "just" obese people are at higher risk for many kinds of cancer. Heart disease develops gradually, even if it shows up as someone dropping dead. The list goes on.
In other words, those "healthy" morbidly obese Medicaid deadbeats that you think shouldn't have their surgery paid for are not healthy. They are sick in ways that are not visible to you but that will become very apparent, very debilitating, and very expensive at some point. If anything, I wish MORE people would volunteer for bariatric surgery, but in reality only a small minority of the people who meet the medical criteria for this life-saving care ever choose to have it.

I am glad you had the resources to pay for your TWO bariatric surgeries. I am saddened that you, in your infinite wisdom, would deny insurance coverage for others based on what you have now shown to be a very limited understanding of the disease of morbid obesity. And please note that both here and elsewhere, I no longer refer to bariatric surgery as "weight loss surgery" or "wls" even though that would be a lot quicker to type, because this life-saving surgery is about so much more than the number on the scale.

I totally agree with everything you said.
My point was from the beginning of this conversation is that if people cannot afford to pay for health insurance, how can they afford the additional protein, vitamin, and nutrient supplements that will be required? I never said poor people don't deserve WLS or that it's their fault they are fat as someone way up above perceived my comments to mean. What I DID say is that maybe it's not the right TIME for them to have it. Maybe they need to work towards getting to a more stable place so they can properly take care of themselves after.
My other point is that while everything you said about obesity being a disease and the damage it causes is all an incontrovertible truth, in a LOT of cases, that is not the motivation of the people wanting the surgery. Please note I didn't say all.....I have no idea what the percentage is. As I said in my above post, I think that number in the DS community is very tiny...I think the numbers in the other communities are much higher.

Sigh...I knew I should have stayed out of this thread to begin with.

 

[Spiky Bugger]

I totally agree with everything you said.
My point was from the beginning of this conversation is that if people cannot afford to pay for health insurance, how can they afford the additional protein, vitamin, and nutrient supplements that will be required? I never said poor people don't deserve WLS or that it's their fault they are fat as someone way up above perceived my comments to mean. What I DID say is that maybe it's not the right TIME for them to have it. Maybe they need to work towards getting to a more stable place so they can properly take care of themselves after.
My other point is that while everything you said about obesity being a disease and the damage it causes is all an incontrovertible truth, in a LOT of cases, that is not the motivation of the people wanting the surgery. Please note I didn't say all.....I have no idea what the percentage is. As I said in my above post, I think that number in the DS community is very tiny...I think the numbers in the other communities are much higher.

Sigh...I knew I should have stayed out of this thread to begin with.

But, Star, there is more going on here than you are acknowledging.


•You have a very small employee pool. But if everyone paid in a few bucks more, for a better policy, isn't it possible...or even likely...that they would ALL be eligible for insurance that might save the life of one of them or one of their family members? Your decision that a cheaper policy is in the best interest of everyone is probably related to what position in life YOU currently occupy. You may not know whose spouse just got a change to a policy, or lost a job, and now the ONLY insurance they have is what you decided on...even if they answered one way today, doesn't mean they won't need something more tomorrow. Will this policy cover ANYTHING that might be related to your bariatric surgery...or will you have to pay again?

•How other people spend their money is a recurrent theme in your posts. When someone on Medicaid wants to know a cash price....how do you know that they are not so desperate that they are about to ask their parents or grandparents to pay for surgery or loan them the money? Do you know for sure that the "deadbeat" posting is not in reality the SAHM of a severely disabled child and--because that kid needs around-the-clock care and because her husband couldn't handle the child's disabilities and split (as they often do)--who is at home being low-income and qualifies for Medicaid because of that?

•Do you really feel that people post "the truth, the whole truth, and nothing but the truth" online...or even that they are not in denial about how sick they are? My 5'2" 300 pound + sister was APPALLED when she sneaked a peek at her file at the doctor's office and it said "morbidly obese." Her BMI was pushing 60 and all she knew (or chose to be aware of) was that she needed the "extended sizes" at Avenue or Lane Bryant, but mostly had to use Roaman's catalog. THAT bothered her. But her lack of awareness of what her 76" hips. (I kid you not) were doing inside her body did not negate what was happening inside her body. She was sick and getting sicker, from a disease that needed treatment...but she would NEVER have mentioned that part.

•I agree that people who do not have the resources to maintain supplementation should find a source or wait. But some people have caring parents. If my kid were broke and on Medicaid, I would volunteer to cover the cost of supplements to improve her health. I (at least for the moment) have the resources to pop for a loved one's bariatric surgery...even in this country...but almost nobody has the resources to say, "Oh, Honey...don't apply for that nasty old Medicaid, I'll cover your medical bills, whatever they are."

•Yes, the world is full of scammers. When I made a contribution to the (adult) children of a man killed in a newsworthy event, I had to make sure it was going STRAIGHT to them and not to the dead guy's sociopathic mother, who made sure that she was included in some of the "contributions to family." That woman has been on Social Security Disability for over 30 years because she is too emotionally fragile to leave her home...unless there's a free trip to another continent or to be on a TV show taped in NY ...then she has magic recoveries and relapses, just like clockwork. She HAS BEEN turned in, by many people over many years, but sociopaths are VERY good at what they do.

But I'm old enough and I've seen enough suffering to know that some people who look like they need help are just fine and many who look fine are hanging on by a thread. (In fact, I took my K-mart-wardrobe-clad cousin to my car dealership to look around. She wrote a check for her brand new Lexus. You just can't tell by looking. And...and this just irritates the hell out of me...she just let her very depressed adult Down Syndrome son go without his meds for two months while she worked on straightening out his Medicare/Medicaid. She adores him, but it would never occur to her to pay for the meds, even though she would have received 80% reimbursement from an out-of-ountry source. So I get that some parents won't pay. But, really.)


•I don't think you sound elitist. To me, you sound like a working class person who had to struggle to get what she needed and does not believe that others cannot do the same. Thing is, though, we don't all come into this game similarly equipped. Maybe you are set for life...maybe you just think/hope you are. Maybe, like my MO sister, you think you have one problem (people gaming the system) when you really have another that you don't even see (whatever.)

BTW...that ankle weight crap...no one should do that. But I can see why someone with a BMI of 47 who wants the DS and has to fight an insurance company which, for NO LEGITIMATE REASON, insists that person have a BMI of 50 might be tempted to fight immoral BS with immoral BS. Doesn't make it right, but I understand it better.

 

[star0210]

But, Star, there is more going on here than you are acknowledging.


•You have a very small employee pool. But if everyone paid in a few bucks more, for a better policy, isn't it possible...or even likely...that they would ALL be eligible for insurance that might save the life of one of them or one of their family members? Your decision that a cheaper policy is in the best interest of everyone is probably related to what position in life YOU currently occupy. You may not know whose spouse just got a change to a policy, or lost a job, and now the ONLY insurance they have is what you decided on...even if they answered one way today, doesn't mean they won't need something more tomorrow. Will this policy cover ANYTHING that might be related to your bariatric surgery...or will you have to pay again?

We have an excellent policy. The best we could get for an ACA plan. It's a BCBS platinum plan. For this year, it was a bit cheaper than the grandfathered plan we had for years prior. Next year, it will likely be as much as our old policy was going to be according to my broker. Everybody was happy with our old plan and at first nobody wanted to change until I showed them the rates. Then every last one of them said ok, we have to change plans. Everybody cannot AFFORD to pay a few bucks more...they're already paying WAY more now than they were a few years ago...even with the company's contribution. While I'm not required to offer insurance at all because i have less than 50 employees, because I do, I have to meet the rules. I have to pay at least 50% of a employee only's premium, and their portion of their premium cannot exceed more than 9.5% of their gross salary. For a few of my older employees, I'm having to kick in more than 50% for them to meet the 9.5% rule...because their premiums are THAT high. Not that they don't make very good money. For some of my younger employees, they don't have to pay anything out of pocket because their premiums are much lower and the company contribution covers all of it.
I even offered to them to stop offering health insurance and just give them raises to make up for it and let them go get their own policies on the exchange. Not a single one of them wanted me to do that.
On ALL the plans we looked at, bariatric services were excluded.

As for whether my policy will cover anything that might be related to my surgery, I honestly have no idea. I had already chosen the plan and been through open enrollment before I decided to have my revision and secondly, it wouldn't have changed the plan I chose...because what I chose was the best there was for my employees. There's 17 of them, and one of me.

 

[Sheanie]

@star0210 , I do wonder if you and I are the only people in this conversation or thread who own our own businesses. Because I think your view changes when you are in that position. We also had to choose a health plan that really is inferior, due to the ACA. Our employees will now suffer because of it, and there's nothing we can do. It is the best plan available, and it doesn't cover even half of what our previous plan did.

When people have to write out a check (or give the IRS access to suck payments out of their personal bank account), for their taxes instead of having them deducted by their employer, they lose all connection to how much they actually pay. That's why you feel so alone in this discussion. But you are not, because I share your views and have for almost 35 years now.

The ACA is a bad, slippery slope. Time will prove me right. The intent was good, the result will be catastrophic. We will lose good doctors because they cannot earn enough to pay for medical school. We are sliding into Socialism, and that's never good.

 

[Sheanie]

One thing that this thread brings up that really bothers me is calling Medicaid "insurance". Medicaid is NOT insurance, was never meant to be insurance. It is not meant to cover health care. It's meant to pay for EMERGENCY care for people who are temporarily unable to obtain it otherwise. It's not meant to pay for routine physicals, dental cleanings, or adult immunizations. It was never intended to become a way of life, with 7 and 8 generations collecting support and depending on Medicaid for healthcare. This is what is happening in my town right now. Saginaw, Michigan. One of the very worst examples in the United States.

 

[star0210]

@star0210 , I do wonder if you and I are the only people in this conversation or thread who own our own businesses. Because I think your view changes when you are in that position. We also had to choose a health plan that really is inferior, due to the ACA. Our employees will now suffer because of it, and there's nothing we can do. It is the best plan available, and it doesn't cover even half of what our previous plan did.

When people have to write out a check (or give the IRS access to suck payments out of their personal bank account), for their taxes instead of having them deducted by their employer, they lose all connection to how much they actually pay. That's why you feel so alone in this discussion. But you are not, because I share your views and have for almost 35 years now.

The ACA is a bad, slippery slope. Time will prove me right. The intent was good, the result will be catastrophic. We will lose good doctors because they cannot earn enough to pay for medical school. We are sliding into Socialism, and that's never good.

Thanks...I really appreciate it. And I totally agree.