If it's not a contract, then how do you propose to make me bound to it?
If it is a contract: how can the Supreme Court, as a party itself to the contract be the sole and final arbiter as to the meaning of the contract?
Here's my understanding of your interpretation of the Constitution: "We, the federal government will determine what we, the federal government may do to you, the States and the People. States and people, please sign at the dotted line."
That's not entirely the case - the Supreme Court can come down with a ruling, but then the other two branches of government can perform various actions.
For example, Congress could modify the law to be consistent, Congress could change a law such that it eviscerates the SCT ruling.
A constitutional amendment could come about - which serves to nullify the SCT decision.
The SCT could later say it was wrong without saying it was actually wrong. No, they've really done that - following SCT precedent in certain instances makes ones head explode.
It means the same thing, he's just phrasing it differently. That is exactly what the commerce clause says: commerce among the several States.
Your very language shows how your viewpoint on the commerce clause is an interpretation. If you are saying "It means the same thing," you are making an interpretation.
Once again, the Constitution says that Congress can regulate commerce among the several States. No where does it explicitly say how it can regulate that commerce. No where in that statement does it make a distinction between creating laws that affect private businesses and those that affect private citizens. If Congress needs to fine a business to regulate commerce, it can. If Congress needs to fine a citizen to regulate commerce, it can.
If it's not a contract, then how do you propose to make me bound to it?
If it is a contract: how can the Supreme Court, as a party itself to the contract be the sole and final arbiter as to the meaning of the contract?
Any contract can be interpreted by any court. There are many times when legal contracts need to be interpreted because circumstances arise that were not specifically spelled out in the contract.
This gives every court in the country the ability to interpret the Constitution. The federal Supreme Court, however, has final jurisdiction over all legal cases in the country (except cases involving only a single state's laws). This is a power granted by Article 3, Section 2 of the Constitution. This is why many cases that deal with interpretations of the Constitution end up being appealed to the federal Supreme Court.
So the federal Supreme Court has no additional powers over any other court in the country. They just have the final say.
I think it's really informative and I'll quote some interesting sections here - In all honestly, coming from the professional side myself (different field, similar motivations), I really agree with most of what's being said here.
The passage of this bill does not fundamentally change the flaws in this system. It has not changed the physician reimbursement formula. It has not changed the need for preapprovals or referrals. To the contrary, we are forced into more bean counting.
- more inefficiency means more cost for everyone.
But the real problem is shortage of providers, not a shortage of insurance. The new health care law does nothing to address this. They whiffed completely.
- already discussed earlier in this thread, but it bears repeating.
The lack of any meaningful tort reform in the bill is also very concerning. Studies in Massachusetts have shown that 25% of imaging tests performed (CT scans, MRI's etc.) are ordered as a direct result of defensive medicine. The same report calculated that such defensive practices added up to $1.4 billion per year in Massachusetts alone.
- that's a nice chunk of money if something can be done to (1) reform medical malpractice tort law within each state (2) somehow reduce defensive medicine...not to mention CT scans, etc expose you to radiation, every test has a risk.
Doctors are going to try for the most lucrative positions in the best areas, not because they are greedy but because they are just starting their careers and families, have lost nine years of earning potential, and have debt to pay off.
I would love to choose what type of medicine I practice without thinking about money - but with debt approaching a quarter of a million dollars, money will influence where I end up.
- and this is a great illustration of my argument as to why doctors avoid being a family doctor or primary care physician. Typically, its the individuals who either don't have an option or were "born" wealthy such that they don't have this debt load to consider.
General medicine is also very demanding on docs in ways that specialization isn't.
General medicine:
-You have to know more about more different things.
-You have to see a lot more patients in a day
-You get shorter visits with each patient and must make a lot of snap decisions on very limited information.
-You get a lot of walk-ins and your schedule is chaos.
-You work longer hours.
-Your fee schedule is the most closely scrutinized, as you're the gatekeeper.
-A lot of what you see will be routine and somewhat boring to you. This depends on your temperament, but some docs find this type of thing intolerable.
As a subspecialist:
-You are able to focus on a smaller area and become an expert in that area.
-You see fewer patients, and have more time with each patient. Some data indicates this leads to better care.
-You make more money per visit.
-Your schedule is more stable, with fewer walk-ins and emergencies, and more predictable hours.
-Your hours are shorter overall, unless you also have an inpatient population that you follow, or do procedures, in which case it's somewhere about the same
-Your fee schedule is regulated but not to the same extent as the general practitioner's. As a specialist, your regulatory college has a stronger bargaining position with the payer, especially if you do procedures.
-A lot of what you see will be the same type of problem, over and over again, day in and day out. Which to some, is unendurably dull, and to others, is exactly the kind of focus and use of their expertise they are looking for.
The only things that differentiate the two:
-Focus
-need to enter the workforce earlier rather than later.
If you are highly focused then you will do very poorly as a GP. It's not a matter of choice, it's a matter of how your brain works. General practice is far more demanding on the circuitry than specialization, because it requires you to be fluent in dozens of different kinds of medicine, fluent enough to avoid making a serious error in judgment, and yet not attached to any one of them (So your objectivity isn't clouded).
This is why many people, despite the obvious desperate need for GPs, still go into specialties. Not because specialties are more lucrative, not because they are sexier and have more bargaining power. The raw brutal truth is that a lot of medical graduates simply don't have the multitasking and computing power to do general medicine.
Say what you want about how highstakes and demanding cardiothoracic or trauma surgery is, say what you want about how demanding [insert subspecialty of choice] is, being the frontline doc for an entire community or population center is never harder than it is now.
Consider that until about 1985, three years of postdoctoral training was seen as sufficient to prepare almost all grads for general practice. Now, with the sheer explosion of scientific evidence, technology, and parallel growth in medical ethics, law, and liability, and you have a situation that is untenable. Many Gp trainees are spending an additional year to 3 years in training. The cost imperative to get these trainees out working is never heavier. But they are woefully under-prepared and somehow still make it all work, by dint of sheer computing and multitasking power. These are the true elites, not the subspecialists.
eventually I think we will reach a point where the minimal standard amount of training required to be a GP and practice according to a standard of care, will be too great for the cost required to train each GP. I think we may have already reached that point, and that the allied health professions will need to be allowed to take their place alongside GPs to help spread the workload out.
That's nurse practitioners, physicians' assistants, nurse specialists, and technologists. All have a small scope of practice, that will need to be expanded to meet the growing collective need brought by expanding health care coverage.
And also, to address the expanding scientific knowledge and moral/ethical knowledge we expect to be part of medical decision-making at the GP level.
General medicine is also very demanding on docs in ways that specialization isn't.
General medicine:
-You have to know more about more different things.
-You have to see a lot more patients in a day
-You get shorter visits with each patient and must make a lot of snap decisions on very limited information.
-You get a lot of walk-ins and your schedule is chaos.
-You work longer hours.
-Your fee schedule is the most closely scrutinized, as you're the gatekeeper.
-A lot of what you see will be routine and somewhat boring to you. This depends on your temperament, but some docs find this type of thing intolerable.
My wife has had quite a few medical problems for someone not quite 30, and has had three general practicioners in the past decade. From what I have seen when at the doctor's office with her is that general doctors primary purpose is to send you to a specialist. It seems to me that this job could be more economically accomplished with nurses using tools similar to WebMD. I would never recommend the general public using WebMD instead of doctors to diagnose, but a trained individual such as a nurse would surely be able to send you to the correct specialists. Even my wife's general doctors often send her to 2-3 specialists so that hopefully one of them can help.
Convenient, then, that the business of government is not slavery.
So, they granted the freedom. It was merely confirmed by that present charter, rather than established by it.
Notice, it is even repeated for clarity in the charter: "...we granted and confirmed by charter..."
Notice the authorial "we" in Magna Carta refers to the King. The quoted passage is in effect to say that the King, in his capacity of government, establishes that he has granted the English Church freedom. The freedom of the English church in this derives from his grant thereof, not of its innate right.
It is fundamentally unhelpful to point toward Magna Carta as a guarantee of natural rights, because the very reason for its existence is the legal doctrine under which all legal authority is vested in the person of the monarch, ie. the opposite of the idea of natural rights. In this context it's nothing more than a buzzword.
Humans must subscribe to Common Law, because it is natural. If someone attacked me, I would try to defend myself or flee.
But statutory laws are merely rules made by corporations, such as The United States Corporation or The United Kingdom Corporation. They can say anything. For example, The United Kingdom Corporation can demand that I personally pay them an annual tribute of the equivalent value of 500 Euros. Now, do I have to do that? Why not, if it is a statutory law?
Calling governments corporations is an unnecessary, unhelpful, and inaccurate abstraction.
You are obliged to pay as part of the same agreement by which you receive services from the British crown.
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Sing lustily and with good courage.
Be aware of singing as if you were half dead,
or half asleep:
but lift your voice with strength.
Be no more afraid of your voice now,
nor more ashamed of its being heard,
than when you sang the songs of Satan.
Humans must subscribe to Common Law, because it is natural. If someone attacked me, I would try to defend myself or flee.
Common law is not natural law. It's the law that is established by judicial precedent rather than legislation, nothing more. We can talk about the existence and nature of natural law if you like, but please get your terminology sorted out.
Here's a pony. Just linking things doesn't get you anywhere.
Here is an opinion of Supreme Court Chief Justice John Jay, regarding the case of Chisholm v. Georgia, individual sovereignty, and The Treaty of Peace:
That is not really coherent. The American Revolution implied a fundamental rejection of the political theory that allowed for the creation of Magna Carta in the first place. So had the last century of evolution in English jurisprudence. The Revolution was an assertion that the King never had that power in the first place; if he had, there would have been no logically coherent justification for overthrowing him and establishing a republic.
Our ancestors fought a Revolutionary War in order to make it clear that the natural rights of humans were not to be held jealously by a single individual or oligarchy, but rather by all humans.
No.
The basic intellectual justification for the idea of collective natural rights is in works like Locke's Second Treatise and Rousseau's Social Contract. Fundamental to these works is the assertion that political power cannot, by its very nature be the privilege of one man; ie, that the idea of a king controlling the rights of the people is a tyranny, that it is invalid, and that he has no especial right to grant anything except insofar as that right is granted by the people who hold the rights.
Otherwise, by definition, any revolution would be an unjustifiable and illicit act. Certainly, no king has ever granted his subjects any right to revolt - where, then, do they derive this right which the possessor of all rights never vested in them?
The rights of Magna Carta remain in effect; it is only their enforcer that has changed.
I would challenge you to find a judge in the country who would argue that Magna Carta is legally binding.
It was nice of that man to elucidate these natural rights in Magna Carta, though.
A right that is granted cannot be natural. By definition.
I'd like you to prove how it is inaccurate. Nation-states are corporations, except that they possess sovereignty via the people who constitute them, unlike other corporations.
A corporation must be subject to external laws. This does not include natural laws, because by that definition, nearly any group is.
Nation-states cannot be subject to suit made by an individual in the courts, because they do possess this sovereignty. However, by that very same rule, since nation-state sovereignty is derived solely from the people which constitute it, anyone may choose to stop participating in a nation-state, and thereby exempt himself or herself from any claim made by that nation-state corporation or any of its constituents, in regard to its statutory law.
Sing lustily and with good courage.
Be aware of singing as if you were half dead,
or half asleep:
but lift your voice with strength.
Be no more afraid of your voice now,
nor more ashamed of its being heard,
than when you sang the songs of Satan.
Is rape commerce? Sensory pleasure, as something of value, is exchanged, albeit through force.
Yes? I don't see the relevance. So is theft.
What other people think is necessary to survive, or what they believe in general, should not be forced on me by government, as long as I behave peacefully.
No.
At the time of this writing, it is safe to say that you live in a developed western democracy – apparently one that has English as its majority language, since you seem to have a good grasp of it. It doesn't really matter whether you live in the United States, Canada, the UK, or the Bahamas; you exist within a certain recognizable legal framework that I'll call, for convenience's sake, "Western-style government."
As a freely participating member of such a state, you necessarily take advantage of certain privileges, whether by active involvement or passive participation. For example, you take advantage of the protection of the fire department, inasmuch as, if you were to find yourself in a burning building, you would not hesitate to be assisted out by a daring rescuer from that noble government agency. Likewise, you use the police department; if you were being held at gunpoint by a burglar, I think there to be little chance that you would reject a policeman's offer for help.
There are a constellation of such services provided to you by a Western-style government. Some of them are so omnipresent that you hardly even think of them as such, like a police force; others, being less established, like health care, are decidedly visible. But they do not differ either in character or in implementation. Universal health care involves everyone being taxed for the benefit of everyone else as surely as does police protection; you receive health care paid for by others and partly by yourself, and likewise, you receive police protection paid for by others and yourself. When others receive either type of care, it is with your money, and yet it is undeniably not solely for their benefit.
In both cases, they receive this because the government has elected to provide it, and the government elects to provide it because a group of representatives were voted into office the majority of whom pledged to implement it, and (as yet) no majority has been elected into office pledging to reverse it. This is the character of democracy. Democracy itself is viable because there exists a social contract between the people to invest their collective sovereignty in the government, and agree to abide by its non-arbitrary decisions (non-arbitrary being defined as decisions that are both reflective of the majority and not unduly harmful to the minority).
Now, there may be a valid argument to be made that both of these services - health care and police protection - should not be provided by the government. I think they're fundamentally wrong-headed, but they are at least arguments. This is why, fundamentally, no-one forces you to engage in this state; there is no Sword of Damocles hanging over your head which threatens to kill you at the suggestion of dissent. You have the option to vote against such proposals at elections, or to leave the country and try to cause a government on your terms somewhere else. The first is an exercise of your right within the social contract to dissent and try to change the narrative; the latter is your option to leave the social contract. They might not be entirely desirable outcomes either way, but the fact is that people in democracies must (inherently) occasionally accept decisions not going their way.
The alternative is a tyranny of the minority, and I doubt anyone believes in that.
If I behave maliciously and someone gets hurt, that's a breach of Common Law, a breach of that human's natural rights, and it is within the government's capacity to take appropriate measures to respond to that.
If you insist that it violates natural rights, so be it (though I wager most legal scholars would respectfully disagree). It is not, however, in any way a breach of common law, which you repeatedly use incorrectly. Common law refers specifically and solely to the concept of judicial primacy in law. Please learn the term and use it correctly. Thanks.
If I behave peacefully and someone gets hurt by their own actions or by an accident, then there is no breach of Common Law on my part, I have breached no natural right, and it is not within the capacity of the government, nor anyone, to try to punish me.
Why the restriction on "by their own actions or an accident"? If your justification is that you ought to be left alone with your earnings, that outlaws any taxation whatsoever, which takes away the financial soundness of any modern government; if your justification is that you ought not pay for others' stupidity, then you really have no logical basis other than pettiness. Now, I know you say this because you believe that a state-run police force is a necessary thing, yet how does that take your money for someone else's good any less than health care does? To be certain, it provides you good on the rare occasion where your tax money goes toward your personal defense, yet the same is true of health care.
Please be logically consistent here.
This is exactly what humans have advocated for the duration of our existence on Earth, and it has even been written down on paper before and made very well-known.
The thrust of human history has been in fact toward more collective action, not less. This is self-evident.
How fundamental a rejection was it? Rights remained. Sovereignty, as a concept, remained, and was reinforced. The concept of justice remained, along with those of victory, ownership, authority, functionality, order, similarity, and permanence. They were all reinforced, used as justification for the revolution.
Law remained, and the necessity of legal precedent remains.
In practical terms, nothing, because both systems provided for what is essentially necessary in a relatively liberal capitalist state. In intellectual terms, the revolution is a total repudiation of the previous system. The intellectual repudiation is in fact far more important, because it changes the parameters in which action can be then taken in the future.
The Bolshevik revolution in Russia in many ways did not create immediate practical change. People still had rights. The state was still sovereign. Justice was still a concept, along with all of those others. The thing is that with a completely different intellectual basis, none of those things needed necessarily to be enforced (though they hardly were before the revolution anyway). The initial form is the same precisely because a massive political change with simultaneous societal changes most often leads to the stars falling down. Massive political change, on the other hand, inevitably produces social change.
I agree with this... but just because the premise of Magna Carta became invalid, does not mean the rest of the document became meaningless. Magna Carta remains in service as the original written description of the essence of Common Law, even if the justification it described for Common Law was not completely proper.
I don't know what you're talking about, because I have no idea which common law you're speaking from, but in either case your argument makes very little sense. Yes, Magna Carta is a historical document that serves as the original description of the idea that the king can't do everything arbitrarily. And Hammurabi's code is a historical document that shows that the states can create laws. So what? They're historical documents, nothing more.
People today trump up the importance of Magna Carta because it sounds important and because, when such rhetoric was formulated back in the 17th century, there were very few such documents to point to. That doesn't mean that it's actually that important.
Defendants argue, not judges. What a judge would or would not do in the abstract hasn't relevance that I can find. It is the defendant or his lawyer who cites legal precedents and makes arguments in Court.
If judges err, their errors do not gain authority.
And it is the judge who decides whether a particular precedent is relevant or binding. That's common law. Their judgment is ultimately more important than a lawyer or defendant. Ergo, if no judge would rule that Magna Carta is relevant, it ipso facto is not.
Ok, so it was invalid of Magna Carta to grant rights. It was even invalid of Magna Carta to elucidate that such rights existed; for there are no such rights, and Magna Carta is a record of a fallacy.
But that's not the thing. Magna Carta isn't a fallacy, because Magna Carta wasn't a grant of rights. It was a declaration by the King that he would grant certain privileges to his subjects, and his successors would honor them.
The more important question, really, is why you think "rights" can be granted in the first place. A right by definition is inherent; you have a right to it regardless of what people say. If such things have to be granted, in what sense are they rights?
However, for those who believe such rights do exist, it ought to be important to understand the history of lawful limitations on them, especially to prevent corporatist-bought-and-sold judges from manipulating law into instituting a permanent consumerist underclass here in the USA.
How does that follow? How can judges institute "a permanent consumerist underclass" (whatever that means)? And since rights in your system are granted anyway, who's to say which restrictions are lawful or not?
Look, I'm not arguing to be obstinate. This whole permanent consumerist underclass goal of the corporatists is simply going to fail. The question is how shall it fail? I want it to fail peaceably, but after a certain threshold of decadence is reached, not even my inspirational, calm, deliberate, concise messages will suffice to quell the anger in the youth's heartbroken lives.
I think you overestimate the extent to which people are actually angry about a large government.
It is in the state's interest to preserve its population by accommodating their liberties to some degree, as long as these liberties do not infringe on the liberties of others or the environment. Negative rights serve this end pretty effectively.
Yes. This, however, does not follow from what I was responding to.
The state partially depends on me for its survival. I do not depend on the state or its resources for my own survival like Jean-Jacques Rousseau supposed.
Yes, you do. Every day you leave your house (if you have one), you leave it having had the loan insured by the government. You walk along government-built sidewalks or drive on government-built streets on streets with traffic that is regulated by the government in a car whose safety and fuel standards are regulated by the government. When you leave your car, you aren't stopped and shot because there is a government crime-enforcement apparatus to disincentivize such things. Whatever your employer is probably to some extent patronized by the government, and if you make a minimum wage, it's because the government requires you to.
At night, as you sleep in your home, you know that if your house catches on fire, there's a chance you'll be alright because of the government-run fire department. You know that the neighboring country won't invade because of the government. You know that a plane won't crash into you because of government regulation, that your toothpaste doesn't have a chance of poisoning you because of government (or because the manufacturer can be sued in a government-run process).
Later, your parents call on your cellphone, funded with government money. You're able to not have your call drop immediately because the frequencies are regulated by the government, and therefore don't compete with one another in predatory or accidental ways. You look through your mail, delivered by a government service and protected by government officials.
Then you get on a plane, and you go through government security (to ensure that your flight isn't brought down by a terrorist) and then fly along a flight path regulated by the government to your final destination, another airport, which are all heavily funded by the government.
Many of these things would be possible in complete anarchy, but many wouldn't, and certainly not for free. You don't notice all of the little things you depend on the government for, but it does them.
But it's not even a question of survival, for I am not going to survive indefinitely, and I am therefore going to refrain from judging things from a perspective that holds myself as permanent.
The question is, how will children and future generations be treated? Will humanity overall be respected, or abused? How much reverence does the institution of the state show for humanity and individual sovereignty? Because that is what really affects fiscal policy, foreign policy, and everything else the state does "for me."
A lot.
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Sing lustily and with good courage.
Be aware of singing as if you were half dead,
or half asleep:
but lift your voice with strength.
Be no more afraid of your voice now,
nor more ashamed of its being heard,
than when you sang the songs of Satan.
Health care most certainly isn't dead. The U.S. is just going through what I like to call a "Roosevelt" period, since Teddy Roosevelt actually implemented a number of services into society today that still exist to help people during the depression. During that time, banks were reformed, there were restrictions on stocks and free-enterprise, social security arose along with a number of other programs that provided public services such and publicly owned electrical companies. Just about every group, the left wing, the right wing, socialists, moderates, even the supreme court all had something against it, but in the end, it turned out not to be such a bad thing. Obama is basically doing what Roosevelt did, but to a lesser extent, and not as effective because he doesn't have as many groups mad at him. And there are other people who agree with the Roosevelt tactic today when you look at all the public services we have now. Progressives also helped with this two, they made people elected into congress more fair so that people could actually vote who they wanted into the senate and congress, and gave a number of public services such as firefighters. Before that, if you had a fire, the firefighters would come to your house and probably say something like "So you going to pay us?" and chances are you'd pay then if your house was on fire and it wasn't cheap either.
Everyone got mad at these ideas, but it turned out to help everyone and as long as Obama can hold his grounds with things like that, he and the people who agree with him will have a pretty decent chance of getting health care passed eventually.
Also this:
You have people like Zinn who say that the New Deal from Roosevelt didn't help anyone, but at the same time, he also said that the U.S. is such a rich and prosperous nation that it doesn't make sense how poorer countries could have public healthcare while we don't.
That's not entirely the case - the Supreme Court can come down with a ruling, but then the other two branches of government can perform various actions.
For example, Congress could modify the law to be consistent, Congress could change a law such that it eviscerates the SCT ruling.
A constitutional amendment could come about - which serves to nullify the SCT decision.
The SCT could later say it was wrong without saying it was actually wrong. No, they've really done that - following SCT precedent in certain instances makes ones head explode.
Trade/Sell me your Demonic Attorney!
Your very language shows how your viewpoint on the commerce clause is an interpretation. If you are saying "It means the same thing," you are making an interpretation.
Once again, the Constitution says that Congress can regulate commerce among the several States. No where does it explicitly say how it can regulate that commerce. No where in that statement does it make a distinction between creating laws that affect private businesses and those that affect private citizens. If Congress needs to fine a business to regulate commerce, it can. If Congress needs to fine a citizen to regulate commerce, it can.
Any contract can be interpreted by any court. There are many times when legal contracts need to be interpreted because circumstances arise that were not specifically spelled out in the contract.
This gives every court in the country the ability to interpret the Constitution. The federal Supreme Court, however, has final jurisdiction over all legal cases in the country (except cases involving only a single state's laws). This is a power granted by Article 3, Section 2 of the Constitution. This is why many cases that deal with interpretations of the Constitution end up being appealed to the federal Supreme Court.
So the federal Supreme Court has no additional powers over any other court in the country. They just have the final say.
http://money.cnn.com/galleries/2010/news/1004/gallery.doctors_react_to_health_care_legislation/index.html
I think it's really informative and I'll quote some interesting sections here - In all honestly, coming from the professional side myself (different field, similar motivations), I really agree with most of what's being said here.
- more inefficiency means more cost for everyone.
- already discussed earlier in this thread, but it bears repeating.
- that's a nice chunk of money if something can be done to (1) reform medical malpractice tort law within each state (2) somehow reduce defensive medicine...not to mention CT scans, etc expose you to radiation, every test has a risk.
- and this is a great illustration of my argument as to why doctors avoid being a family doctor or primary care physician. Typically, its the individuals who either don't have an option or were "born" wealthy such that they don't have this debt load to consider.
Any thoughts on the collection of doctor opinion?
Trade/Sell me your Demonic Attorney!
General medicine:
-You have to know more about more different things.
-You have to see a lot more patients in a day
-You get shorter visits with each patient and must make a lot of snap decisions on very limited information.
-You get a lot of walk-ins and your schedule is chaos.
-You work longer hours.
-Your fee schedule is the most closely scrutinized, as you're the gatekeeper.
-A lot of what you see will be routine and somewhat boring to you. This depends on your temperament, but some docs find this type of thing intolerable.
As a subspecialist:
-You are able to focus on a smaller area and become an expert in that area.
-You see fewer patients, and have more time with each patient. Some data indicates this leads to better care.
-You make more money per visit.
-Your schedule is more stable, with fewer walk-ins and emergencies, and more predictable hours.
-Your hours are shorter overall, unless you also have an inpatient population that you follow, or do procedures, in which case it's somewhere about the same
-Your fee schedule is regulated but not to the same extent as the general practitioner's. As a specialist, your regulatory college has a stronger bargaining position with the payer, especially if you do procedures.
-A lot of what you see will be the same type of problem, over and over again, day in and day out. Which to some, is unendurably dull, and to others, is exactly the kind of focus and use of their expertise they are looking for.
The only things that differentiate the two:
-Focus
-need to enter the workforce earlier rather than later.
If you are highly focused then you will do very poorly as a GP. It's not a matter of choice, it's a matter of how your brain works. General practice is far more demanding on the circuitry than specialization, because it requires you to be fluent in dozens of different kinds of medicine, fluent enough to avoid making a serious error in judgment, and yet not attached to any one of them (So your objectivity isn't clouded).
This is why many people, despite the obvious desperate need for GPs, still go into specialties. Not because specialties are more lucrative, not because they are sexier and have more bargaining power. The raw brutal truth is that a lot of medical graduates simply don't have the multitasking and computing power to do general medicine.
Say what you want about how highstakes and demanding cardiothoracic or trauma surgery is, say what you want about how demanding [insert subspecialty of choice] is, being the frontline doc for an entire community or population center is never harder than it is now.
Consider that until about 1985, three years of postdoctoral training was seen as sufficient to prepare almost all grads for general practice. Now, with the sheer explosion of scientific evidence, technology, and parallel growth in medical ethics, law, and liability, and you have a situation that is untenable. Many Gp trainees are spending an additional year to 3 years in training. The cost imperative to get these trainees out working is never heavier. But they are woefully under-prepared and somehow still make it all work, by dint of sheer computing and multitasking power. These are the true elites, not the subspecialists.
eventually I think we will reach a point where the minimal standard amount of training required to be a GP and practice according to a standard of care, will be too great for the cost required to train each GP. I think we may have already reached that point, and that the allied health professions will need to be allowed to take their place alongside GPs to help spread the workload out.
That's nurse practitioners, physicians' assistants, nurse specialists, and technologists. All have a small scope of practice, that will need to be expanded to meet the growing collective need brought by expanding health care coverage.
And also, to address the expanding scientific knowledge and moral/ethical knowledge we expect to be part of medical decision-making at the GP level.
My wife has had quite a few medical problems for someone not quite 30, and has had three general practicioners in the past decade. From what I have seen when at the doctor's office with her is that general doctors primary purpose is to send you to a specialist. It seems to me that this job could be more economically accomplished with nurses using tools similar to WebMD. I would never recommend the general public using WebMD instead of doctors to diagnose, but a trained individual such as a nurse would surely be able to send you to the correct specialists. Even my wife's general doctors often send her to 2-3 specialists so that hopefully one of them can help.
Convenient, then, that the business of government is not slavery.
Notice the authorial "we" in Magna Carta refers to the King. The quoted passage is in effect to say that the King, in his capacity of government, establishes that he has granted the English Church freedom. The freedom of the English church in this derives from his grant thereof, not of its innate right.
It is fundamentally unhelpful to point toward Magna Carta as a guarantee of natural rights, because the very reason for its existence is the legal doctrine under which all legal authority is vested in the person of the monarch, ie. the opposite of the idea of natural rights. In this context it's nothing more than a buzzword.
Calling governments corporations is an unnecessary, unhelpful, and inaccurate abstraction.
You are obliged to pay as part of the same agreement by which you receive services from the British crown.
Be aware of singing as if you were half dead,
or half asleep:
but lift your voice with strength.
Be no more afraid of your voice now,
nor more ashamed of its being heard,
than when you sang the songs of Satan.
Ambition must be made to counteract ambition.
Individualities may form communities, but it is institutions alone that can create a nation.
Nothing succeeds like the appearance of success.
Here is my principle: Taxes shall be levied according to ability to pay. That is the only American principle.
Common law is not natural law. It's the law that is established by judicial precedent rather than legislation, nothing more. We can talk about the existence and nature of natural law if you like, but please get your terminology sorted out.
Indeed, the business of the government is stomping slavery. Which is exactly what happened.
candidus inperti; si nil, his utere mecum.
Please reread this statement and consider what my possible response might be.
candidus inperti; si nil, his utere mecum.
"Social contract."
The King was considered to be the sovereign. His subjects had no rights - natural or otherwise - except as granted by him.
Here's a pony. Just linking things doesn't get you anywhere.
That is not really coherent. The American Revolution implied a fundamental rejection of the political theory that allowed for the creation of Magna Carta in the first place. So had the last century of evolution in English jurisprudence. The Revolution was an assertion that the King never had that power in the first place; if he had, there would have been no logically coherent justification for overthrowing him and establishing a republic.
No.
The basic intellectual justification for the idea of collective natural rights is in works like Locke's Second Treatise and Rousseau's Social Contract. Fundamental to these works is the assertion that political power cannot, by its very nature be the privilege of one man; ie, that the idea of a king controlling the rights of the people is a tyranny, that it is invalid, and that he has no especial right to grant anything except insofar as that right is granted by the people who hold the rights.
Otherwise, by definition, any revolution would be an unjustifiable and illicit act. Certainly, no king has ever granted his subjects any right to revolt - where, then, do they derive this right which the possessor of all rights never vested in them?
I would challenge you to find a judge in the country who would argue that Magna Carta is legally binding.
A right that is granted cannot be natural. By definition.
A corporation must be subject to external laws. This does not include natural laws, because by that definition, nearly any group is.
Yes. So what?
It's implied by your participation in the state and by your taking advantage of the state's resources.
David Icke? Really?
Be aware of singing as if you were half dead,
or half asleep:
but lift your voice with strength.
Be no more afraid of your voice now,
nor more ashamed of its being heard,
than when you sang the songs of Satan.
Yes? I don't see the relevance. So is theft.
No.
At the time of this writing, it is safe to say that you live in a developed western democracy – apparently one that has English as its majority language, since you seem to have a good grasp of it. It doesn't really matter whether you live in the United States, Canada, the UK, or the Bahamas; you exist within a certain recognizable legal framework that I'll call, for convenience's sake, "Western-style government."
As a freely participating member of such a state, you necessarily take advantage of certain privileges, whether by active involvement or passive participation. For example, you take advantage of the protection of the fire department, inasmuch as, if you were to find yourself in a burning building, you would not hesitate to be assisted out by a daring rescuer from that noble government agency. Likewise, you use the police department; if you were being held at gunpoint by a burglar, I think there to be little chance that you would reject a policeman's offer for help.
There are a constellation of such services provided to you by a Western-style government. Some of them are so omnipresent that you hardly even think of them as such, like a police force; others, being less established, like health care, are decidedly visible. But they do not differ either in character or in implementation. Universal health care involves everyone being taxed for the benefit of everyone else as surely as does police protection; you receive health care paid for by others and partly by yourself, and likewise, you receive police protection paid for by others and yourself. When others receive either type of care, it is with your money, and yet it is undeniably not solely for their benefit.
In both cases, they receive this because the government has elected to provide it, and the government elects to provide it because a group of representatives were voted into office the majority of whom pledged to implement it, and (as yet) no majority has been elected into office pledging to reverse it. This is the character of democracy. Democracy itself is viable because there exists a social contract between the people to invest their collective sovereignty in the government, and agree to abide by its non-arbitrary decisions (non-arbitrary being defined as decisions that are both reflective of the majority and not unduly harmful to the minority).
Now, there may be a valid argument to be made that both of these services - health care and police protection - should not be provided by the government. I think they're fundamentally wrong-headed, but they are at least arguments. This is why, fundamentally, no-one forces you to engage in this state; there is no Sword of Damocles hanging over your head which threatens to kill you at the suggestion of dissent. You have the option to vote against such proposals at elections, or to leave the country and try to cause a government on your terms somewhere else. The first is an exercise of your right within the social contract to dissent and try to change the narrative; the latter is your option to leave the social contract. They might not be entirely desirable outcomes either way, but the fact is that people in democracies must (inherently) occasionally accept decisions not going their way.
The alternative is a tyranny of the minority, and I doubt anyone believes in that.
If you insist that it violates natural rights, so be it (though I wager most legal scholars would respectfully disagree). It is not, however, in any way a breach of common law, which you repeatedly use incorrectly. Common law refers specifically and solely to the concept of judicial primacy in law. Please learn the term and use it correctly. Thanks.
Why the restriction on "by their own actions or an accident"? If your justification is that you ought to be left alone with your earnings, that outlaws any taxation whatsoever, which takes away the financial soundness of any modern government; if your justification is that you ought not pay for others' stupidity, then you really have no logical basis other than pettiness. Now, I know you say this because you believe that a state-run police force is a necessary thing, yet how does that take your money for someone else's good any less than health care does? To be certain, it provides you good on the rare occasion where your tax money goes toward your personal defense, yet the same is true of health care.
Please be logically consistent here.
The thrust of human history has been in fact toward more collective action, not less. This is self-evident.
In practical terms, nothing, because both systems provided for what is essentially necessary in a relatively liberal capitalist state. In intellectual terms, the revolution is a total repudiation of the previous system. The intellectual repudiation is in fact far more important, because it changes the parameters in which action can be then taken in the future.
The Bolshevik revolution in Russia in many ways did not create immediate practical change. People still had rights. The state was still sovereign. Justice was still a concept, along with all of those others. The thing is that with a completely different intellectual basis, none of those things needed necessarily to be enforced (though they hardly were before the revolution anyway). The initial form is the same precisely because a massive political change with simultaneous societal changes most often leads to the stars falling down. Massive political change, on the other hand, inevitably produces social change.
I don't know what you're talking about, because I have no idea which common law you're speaking from, but in either case your argument makes very little sense. Yes, Magna Carta is a historical document that serves as the original description of the idea that the king can't do everything arbitrarily. And Hammurabi's code is a historical document that shows that the states can create laws. So what? They're historical documents, nothing more.
People today trump up the importance of Magna Carta because it sounds important and because, when such rhetoric was formulated back in the 17th century, there were very few such documents to point to. That doesn't mean that it's actually that important.
And it is the judge who decides whether a particular precedent is relevant or binding. That's common law. Their judgment is ultimately more important than a lawyer or defendant. Ergo, if no judge would rule that Magna Carta is relevant, it ipso facto is not.
But that's not the thing. Magna Carta isn't a fallacy, because Magna Carta wasn't a grant of rights. It was a declaration by the King that he would grant certain privileges to his subjects, and his successors would honor them.
The more important question, really, is why you think "rights" can be granted in the first place. A right by definition is inherent; you have a right to it regardless of what people say. If such things have to be granted, in what sense are they rights?
How does that follow? How can judges institute "a permanent consumerist underclass" (whatever that means)? And since rights in your system are granted anyway, who's to say which restrictions are lawful or not?
I think you overestimate the extent to which people are actually angry about a large government.
Yes. This, however, does not follow from what I was responding to.
Yes, you do. Every day you leave your house (if you have one), you leave it having had the loan insured by the government. You walk along government-built sidewalks or drive on government-built streets on streets with traffic that is regulated by the government in a car whose safety and fuel standards are regulated by the government. When you leave your car, you aren't stopped and shot because there is a government crime-enforcement apparatus to disincentivize such things. Whatever your employer is probably to some extent patronized by the government, and if you make a minimum wage, it's because the government requires you to.
At night, as you sleep in your home, you know that if your house catches on fire, there's a chance you'll be alright because of the government-run fire department. You know that the neighboring country won't invade because of the government. You know that a plane won't crash into you because of government regulation, that your toothpaste doesn't have a chance of poisoning you because of government (or because the manufacturer can be sued in a government-run process).
Later, your parents call on your cellphone, funded with government money. You're able to not have your call drop immediately because the frequencies are regulated by the government, and therefore don't compete with one another in predatory or accidental ways. You look through your mail, delivered by a government service and protected by government officials.
Then you get on a plane, and you go through government security (to ensure that your flight isn't brought down by a terrorist) and then fly along a flight path regulated by the government to your final destination, another airport, which are all heavily funded by the government.
Many of these things would be possible in complete anarchy, but many wouldn't, and certainly not for free. You don't notice all of the little things you depend on the government for, but it does them.
A lot.
Be aware of singing as if you were half dead,
or half asleep:
but lift your voice with strength.
Be no more afraid of your voice now,
nor more ashamed of its being heard,
than when you sang the songs of Satan.
Everyone got mad at these ideas, but it turned out to help everyone and as long as Obama can hold his grounds with things like that, he and the people who agree with him will have a pretty decent chance of getting health care passed eventually.
Also this:
You have people like Zinn who say that the New Deal from Roosevelt didn't help anyone, but at the same time, he also said that the U.S. is such a rich and prosperous nation that it doesn't make sense how poorer countries could have public healthcare while we don't.