How is the government take over going to work w/o doctors?

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kiryan
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How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 3:50 pm

http://www.foxnews.com/politics/2009/11 ... e-doc-fix/

Supporters of the "doctor fix" say that a long-term fix is needed to provide certainty to doctors, and thereby their patients, who fear the cuts and therefore refuse to treat Medicare patients.

--

So this article is about the Dems bringing a bill to the floor to delay the mandated cut in payments to doctors... The same one Dems/Republicans issue every year for the past 5 years yet fail to actually address permanently (like the AMT tax fix). As I was reading, the above line reminded me that doctors have been threatening for years to stop taking government insurance which makes me wonder how they hope to address the following problems.

Its a well known position that there aren't enough doctors (especially general practice or family medicine type). Its also a well known position that Medicare / Medicaid pay something like 67 cents on the dollar for healthcare which the healthcare industry claims doesn't cover the actual cost of providing care. Another one is that some doctors have stopped taking medicare and many more consider it (also giving rise to concierge practices private subscribtion based doctors).

I was listening to a PBS radio program couple months ago on concierge medicine and 1 of the doctors basically said, I worked hard in school and now and its wrong for you to advocate taking my pay away from me (with low reimbursement rates) because its in the interests of public health.... or to prevent me from running a concierge practice which exacerbates the "doctor shortage". The doc representing public health basically said concierge practices were immoral and unfair to poor people who can't afford them.

The government can't even pay a market rate for healthcare as it is and subsidizes it on our backs (its a hidden tax through our insurance premiums), can't even figure out how much they should pay doctors (passing a fix every year kickign the can down the road) and have no solution for the doctor shortage... and this is before we start discussing VA and Native American care...

and you want them running healthcare?

I don't care what tricky dick, I mean obama, says, government run healthcare can only cost more. 200 years of history proves they can't do anything cheaper or better than the private sector.
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Re: How is the government take over going to work w/o doctors?

Postby Ragorn » Thu Nov 19, 2009 7:39 pm

kiryan wrote:I don't care what tricky dick, I mean obama, says, government run healthcare can only cost more. 200 years of history proves they can't do anything cheaper or better than the private sector.

Mail service.

Stick a fork in it, done in one.

(Special bonus: Military service. Or do you prefer Blackwater over the US Marine Corps?)
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Re: How is the government take over going to work w/o doctors?

Postby Corth » Thu Nov 19, 2009 7:46 pm

Rofl - you are going to rely on the USPS as an example of government efficiency?
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 7:48 pm

Corth wrote:Rofl - you are going to rely on the USPS as an example of government efficiency?


It's only recently started having problems, due largely to computers and the internet obviating it's necessity. You know that.

Hell, we JUST had that argument a couple weeks ago.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 7:59 pm

Nice attempt

USPS - losing 3.8 billion dollars? Has been raising the price of stamps like mad and still can't cover their costs? Unionized and going broke, a common pairing these days. Also, supposedly its a private company =). I did praise them in another thread for their efficiency, out of all government its probably the most efficient with possible exception of the IRS (which just has really complicated rules, the actual processing is very efficient).

Addressing Sarvis' comment... we aren't talkign solely about efficiency, we are also talking about adjusting to the market. Good example of efficiency, and pretty much what we can expect under government run healthcare, it will go broke, we'll have to cut service (rationing) and the unions will make a fortune.

Military - you haven't seen waste until you've seen the military. PTSD? oh yea code for too mentally weak to deal with reality that bad shit happens and you signed up for it. Housing allowances for living off campus = extra pay. Stationed overseas in Korea or Japan = 20 year long vacation. Their efficiency rating is terrible if you look at the actual work being done and how many people it takes to do it. We staff an army for war and in peace time they sit around on their thumbs.

I'm not going to get into blackwater too much, but the argument probably goes that they are actually cheaper or can do things that the army can't whether because it lacks the expertise or because the burecracy can't move with the agility that a private company can. Like for instance adapting vehicles for IED defense. Even if they aren't... who hired them? Government so cheaper or more expensive Government did it.
Last edited by kiryan on Thu Nov 19, 2009 8:05 pm, edited 1 time in total.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 8:02 pm

kiryan wrote: Unionized and going broke, a common pairing these days.


Yeah, it's the unions causing the problem... not the fact that no one uses the service anymore. :roll:

Show me ONE corporation that would survive it's entire customer base turning away from it's products.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 8:07 pm

Apple computers.

Pretty much every company that exists, becuase if you don't adapt to the changes, you go out of business unless Obama bails you out to save the union.

Government is a shitty adapter and its adaptions are more often for political gain than to make anything better.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 8:12 pm

kiryan wrote:Apple computers.

Pretty much every company that exists, becuase if you don't adapt to the changes, you go out of business unless Obama bails you out to save the union.

Government is a shitty adapter and its adaptions are more often for political gain than to make anything better.


Really? When has Apple ever been in the position of people NO LONGER USING computers, cell phones and mp3 players?
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 8:23 pm

your words: Show me ONE corporation that would survive it's entire customer base turning away from it's products.

the reality: people en masse turned away from Apple products of every kind until it remade itself as a powerhouse of MP3 players and music / app distribution. it was down to I believe 2% of the PC market share earlier this decade and is now hitting 10%.

Banana Republic: used to be a company that sold blue collar clothing, it remade itself into a high end fashionable safari style clothing store when its customers turned towards other companies.
Last edited by kiryan on Thu Nov 19, 2009 8:30 pm, edited 1 time in total.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 8:30 pm

kiryan wrote:your words: Show me ONE corporation that would survive it's entire customer base turning away from it's products.

the reality: people en masse turned away from Apple products of every kind until it remade itself as a powerhouse of MP3 players and music / app distribution.

Banana Republic: used to be a company that sold blue collar clothing, it remade itself into a high end fashionable safari style clothing store when its customers turned towards other companies.


You're deliberately focusing on a lack of clarity in my writing.

People no longer need to send letters AT ALL. There is no need or use for it.

While people "turned away from Apple computers" they still used computers, both Apple and otherwise.

That is not the same thing.

People still wear clothes, as well. There may be less demand for certain types of clothing... but that is not the same as everyone deciding to walk around nude.

You are somewhat right about the USPS being inflexible, because they were created and MUST do one thing.

Fundamentally though, Apple really only does one thing. They pair hardware with an easy to use OS and market it.

If people ever stop needing hardware, Apple is as screwed as the USPS.

Well, maybe they could become a marketing company. It's their true specialty after all!

Yes, the USPS can't switch businesses. What does that have to do with how well it has been run up until it's product was no longer needed, anyway? Nothing? Oh, right. Thanks for once again derailing us into some stupid straw man argument of yours.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 8:35 pm

ok... I'll still point out that Apple when faced with losing all its PC customers essentially reinvented itself as a MP3 and music marketplace power house. It managed this over the course of 1-2 years in the market (and probably a good couple years in R&D before that).

USPS is losing its customers and the best answer that congress can come up with is start charging postage on email messages... meanwhile USPS does not adapt and loses billions of dollars every year despite postage rate hikes and now talking about cutting a day of delivery (rationing). USPS can't go bankrupt (its got too many union employees) so how is this trend going to change?

SSI has been insolvent for how long? they were talking about how its going to go bankrupt at least 15 years ago... what has the government done to address it?

And you want them running healthcare?
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 8:44 pm

Ok, genius. How does the USPS "adapt."

What would YOU have the USPS do, exactly, to remain solvent?

Remember that it's a government institution so it SHOULD NOT do anything else. Otherwise you, Teffie, Corth and others would be gathering torches and pitchforks to rally against government abuse of power.

And again, Apple was not DEAD in the computer market. They were still releasing PCs and in fact had just released their latest and greatest OS.

People were STILL USING the product Apple provided. Still using it enough to fund, as you put it, "a good couple years in R&D."

Enough with the straw man. Companies will not survive their entire product line becoming useless. That's why you don't see a lot of donkey cart makers around these days.

USPS was perfectly solvent, cheap and efficient up until people stopped needing to send mail. You know this and have admitted it. Yes, I do want healthcare run like that. Universal Healthcare may also run into problems when people stop getting sick, but you know what? I'm ok with dealing with that problem when it arises.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 8:54 pm

Apple was a computer company that turned itself into a MP3 and music company to survive. I dont know what the USPS could do... but I know its insolvent the way it is and I know the only way to fix its budget problems is to pump more tax payer money into keeping it's union members afloat. Private business would go bankrupt, but we'll just keep shoveling money into it.

Here's the future of government healthcare USPS style. Healthcare costs keep rising, we keep providing service at a rate everyone can afford taking bigger and bigger losses. Eventually we go from 6 days of delivery down to 5 down to 3 down to 1 because it costs too much. Private business finds a model of providing next day service where they can make a profit providing care at a premium that you can't get under the government plan due to rationing. Now we pay for healthcare we can't use + the healthcare we actually use, meanwhile every year there are trillion dollar deficits until China gets fed up with the decreasing dollar and floods the market with its holdings which makes the dollar worthless and us a 3rd world country. Hugo Chavez nationalizes the medical device manufacturers and forces them to sell their product below cost to the government then threatens doctors with jail time if they charge more than he declares is the right price or refuse to work.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 9:02 pm

kiryan wrote:Apple was a computer company that turned itself into a MP3 and music company to survive.


Considering they are gaining ever greater share of the computer market, you're doing a SPECTACULAR job of demonstrating what happens when you ignore facts and listen to pundits about what you should think.

I dont know what the USPS could do... but I know its insolvent the way it is and I know the only way to fix its budget problems is to pump more tax payer money into keeping it's union members afloat. Private business would go bankrupt, but we'll just keep shoveling money into it.


There's still a need for it. When everyone in America has internet access, we can probably retire it. But thanks for bitching about how "crappy" the USPS because you NEED them to look crappy as an example, even though you admit there's no way to make their service relevant in the modern age.

Unlike mail, the need for healthcare is never going to go away. Making your entire argument completely and utterly invalid.

The USPS was a model of efficiency and service. Every bit as much as the DMV was once a model of inefficiency and pain. Our healthcare system could only HOPE to be as efficient as the USPS, and won't ever have the problem of people NOT NEEDING IT. The one thing that is breaking the USPS will never be a factor for Universal Healthcare.

Once again: The one thing that is breaking the USPS will never be a factor for Universal Healthcare.


Here's the future of government healthcare USPS style. Healthcare costs keep rising, we keep providing service at a rate everyone can afford taking bigger and bigger losses. Eventually we go from 6 days of delivery down to 5 down to 3 down to 1 because it costs too much.


Really? Because, you know, that didn't happen until people stopped needing "healthcare."

Actually, the USPS hasn't even dropped service days yet that I know of. But thanks for trying.

Private business finds a model of providing next day service where they can make a profit providing care at a premium that you can't get under the government plan due to rationing. Now we pay for healthcare we can't use + the healthcare we actually use, meanwhile every year there are trillion dollar deficits until China gets fed up with the decreasing dollar and floods the market with its holdings which makes the dollar worthless and us a 3rd world country. Hugo Chavez nationalizes the medical device manufacturers and forces them to sell their product below cost to the government then threatens doctors with jail time if they charge more than he declares is the right price or refuse to work.


I'm really way too tired to deal with THAT nonsensical rant. But if you can predict the future so well, can you get into the stock trading thread and tell us what to buy at least? Oh, and when to transfer our funds to Chinese currency so we stay rich when your prophecy of DOOOOOOOOOOOOOOMMMMMMMM! comes true.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 9:11 pm

They are gaining market share why? Because their brand got a shot in the arm on how well they did the IPOD. They were dead before the Ipod and with some reinvention diversified their business and brought back a declinign business.

Why can't the USPS change? Because its run by the government and funded by a limitless source of money, the tax payers. Why did Apple change, cuz if it didn't it wouldn't exist anymore.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 9:15 pm

Anyhow why don't you answer my other point. How is government going to provide healthcare without any doctors? They keep pushing off "cost saving" measures every year because they know damn well as soon as those rate reductions happen, a large # of doctors will stop taking government insurance.
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Re: How is the government take over going to work w/o doctors?

Postby teflor the ranger » Thu Nov 19, 2009 9:25 pm

Sarvis wrote:Show me ONE corporation that would survive it's entire customer base turning away from it's products.


Sarvis wrote:
kiryan wrote:Apple computers.


Really? When has Apple ever been in the position of people NO LONGER USING computers, cell phones and mp3 players?


Apple Computer Company was in the position of people no longer using it's products from 1996-1998. Sarvis, Apple is the textbook case that makes Kiryan's point.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 9:34 pm

kiryan wrote:They are gaining market share why? Because their brand got a shot in the arm on how well they did the IPOD. They were dead before the Ipod and with some reinvention diversified their business and brought back a declinign business.

Why can't the USPS change? Because its run by the government and funded by a limitless source of money, the tax payers. Why did Apple change, cuz if it didn't it wouldn't exist anymore.


Apple's fundamental change, according to you, was to go from selling computers to selling smaller computers.

Right. Got it.

I think we're done here.

Maybe the USPS can rebrand and sell smaller mail or something. :roll:

Or maybe, just maybe, I should have gone back to this:

"I did praise them in another thread for their efficiency, out of all government its probably the most efficient" - Kiryan

Yep, sounds horrible.
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Re: How is the government take over going to work w/o doctors?

Postby teflor the ranger » Thu Nov 19, 2009 9:37 pm

Sarvis wrote:Apple's fundamental change, according to you, was to go from selling computers to selling smaller computers.

Right. Got it.

I think we're done here.


Are you really trying to say that there's nothing fundamental and earth-shakingly different between a general computer and the iPod+iTunes?

I think Steve Jobs, the business community, and MBAs worldwide would beg to differ.

You really are done here.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Thu Nov 19, 2009 9:54 pm

1 USPS employee on route or in the mail working is a beautiful thing to behold; its a marvel of efficiency. They tend to be very task oriented and don't take as many smoke breaks as your average government employee. That doesn't mean its a cost effective organization, it doesn't mean 2 employees could be hired at less cost, it doesn't mean the USPS is a well run business or program. It just means that their workers are efficient and focused and execute their duties well despite their duties being wasteful, unnecessary and not in tune with the actual needs.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Thu Nov 19, 2009 9:57 pm

For over 200 years the USPS has delivered mail across the country at a price even the poorest people could afford, without needing any taxpayer money or help of any kind.

They become insolvent because technology replaces the need for mail, and suddenly they are not a well run service.

Right.
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Re: How is the government take over going to work w/o doctors?

Postby Corth » Fri Nov 20, 2009 2:45 am

They didn't need tax money because they had a MONOPOLY granted to them by Congress. They could charge whatever was necessary to allow their business to continue. I might have had a way to deliver mail at half the cost to consumers, but I would be PROHIBITED from competing with the USPS. They will never need tax dollars from Congress because they essentially collect their own tax. Whenever their operating expenses exceed their revenue they just ask for permission to raise the price of stamps. Problem solved.

Oh and btw, I don't know about the rest of you, but some of the worst lines I have ever waited on have been at the USPS. The only things that come to mind that were as bad are Disney World and some ski lifts I have waited on at large resorts. And those last two we're talking special vacation like stuff. For everyday stuff like sending the mail, my closest analogy is going to the bank. If my bank made me wait in line the way the USPS did I would be opening accounts up elsewhere the next day. USPS - I really don't have much of a choice do I? Thanks Congress.
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Re: How is the government take over going to work w/o doctors?

Postby teflor the ranger » Sat Nov 21, 2009 4:37 am

Sarvis wrote:For over 200 years the USPS has delivered mail across the country at a price even the poorest people could afford, without needing any taxpayer money or help of any kind.

Check your facts, check them hard.
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Re: How is the government take over going to work w/o doctors?

Postby Todrael » Sat Nov 21, 2009 3:40 pm

Tyler Cowen, a respected conservative economist whom I follow, thinks this is what we should do instead to improve health care.

My favorite from the list:
3. Boost subsidies to medical R&D by more than the Obama plan will do. Establish lucrative prizes for major breakthroughs and if need be consider patent auctions to liberate beneficial ideas from P > MC.
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Re: How is the government take over going to work w/o doctors?

Postby Ambar » Sun Nov 22, 2009 1:52 am

kiryan wrote:Military - you haven't seen waste until you've seen the military. PTSD? oh yea code for too mentally weak to deal with reality that bad shit happens and you signed up for it. Housing allowances for living off campus = extra pay. Stationed overseas in Korea or Japan = 20 year long vacation. Their efficiency rating is terrible if you look at the actual work being done and how many people it takes to do it. We staff an army for war and in peace time they sit around on their thumbs.


How much time have you spent in the military, Mike? Have any idea what sailors do on cruise away from their families while working 12 on 12 off 7 days a week plus 4-6 hrs watches on off duty hrs for 6-9 months? Based on the 2009 paychart, your average E-5's base pay when he has been in the military 10 years .. 2811.00 a month. Take away state and federal taxes, I hope you don't expect them to raise a family on that. BAS is a basic allowance for sustinance .. IE: help with food and housing. You get different amounts if single or married but it never changes, if you have 6 kids, the amount stays the same. I know the average 2 bedroom apartment around here in military town is 1100-1300 a month (probably cheaper in some areas, most likey more if you want a safe area.) Base housing lists are sometimes 24 months til you can move in so you have to live on the economoy. When you go out to sea, some of the BAS is taken away since you arent there, so the paycheck goes down. BAS is also taken away completely or set on a sliding scale when they move into base housing, as generally speaking, the lower level sailors and soldiers housing is sub standard. Military folks don't usually qualify for food stamps and other govenment assisted program. Yes it is a choice, but they do it so you don't have to if you don't want to. They deserve something for their service and I thank them.

Don't get me wrong, I know there is waste .. Every job has it, but just like the bank teller not being at her window, or there only being one cashier in a busy store .. you don't know the whole story until you have been there, foxnews or not.
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Mon Nov 23, 2009 3:03 pm

Sok's brother is active service for around 10 years now. Been in Japan for most of that time. I have a two other friends, one of which was a ranger for about 8 years before he claimed mental to get out of being deployed. Another highschool friend has been in the Army for 13 years. My brother in law's wife is in the national guard and 30% disabled from PTSD. My wife's step-dad is retired military. My father in law was in vietnam. My dad was in the service and is a disabled veteran and has been filing his paperwork for 25 years now and is I think 85% disabled (started at like 30%, how that works I have no idea, but my brother in law's wife is doing the same thing). My dad has milked the benefits he is entitled too which are substantial (if you perservere enough to get them and don't have the pride to feel bad about asking for them).

I get lots of opportunity to see the waste in the military system. There are so many games you can play to up your pay or to get out of shit its unreal. I've encountered a women in the national guard who gets pregnant in time to not deploy 2x so far. Most of what most military people consider "work" is about 50% of what most of us do in a normal days work. I don't know whether these are the large execption or the rule, but either way its too much waste.
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Re: How is the government take over going to work w/o doctors?

Postby Sarvis » Mon Nov 23, 2009 3:10 pm

kiryan wrote:Most of what most military people consider "work" is about 50% of what most of us do in a normal days work.


You must have some interesting co-workers if they don't waste 75% of their day on Facebook or arguing on the Toril forums.
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Re: How is the government take over going to work w/o doctors?

Postby Ambar » Mon Nov 23, 2009 3:32 pm

So all you know is slackers and and people that know how to play the system so that means all the military are slackers .. For every slacker you mentioned I know tenfold who bust their asses.

You work for foxnews don't you?

I heard of a single mom that gets welfare and food stamps even tho she had a full time job .. I guess that means ALL single moms use the system that way .. I heard of a guy who can afford a cruise but still gets his kids free lunch .. must mean all Americans are slackers and system players.

*eyeroll*

I can't help but like you Mike, I think you are funny because you are so vehement on your views .. but man you have some screwed up thought processes :)
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Re: How is the government take over going to work w/o doctors?

Postby kiryan » Mon Nov 23, 2009 3:53 pm

I know several slackers in the military, different branches, bases, domestic international, spanning at least 2 generations, but the overwhelming majority are fine upstanding citizens who are there to work hard and serve their country (and not because they screwed up in school and had no prospects in general).

Next be the union argument, oh we're not slackers milking the company, its management's fault.

Sure.

--

You must have some interesting co-workers if they don't waste 75% of their day on Facebook or arguing on the Toril forums.
kiryan wrote:Most of what most military people consider "work" is about 50% of what most of us do in a normal days work.


You must have some interesting co-workers if they don't waste 75% of their day on Facebook or arguing on the Toril forums.

I don't disagree that wasting 75% of your day on facebook is normal.... which is what makes it really sad.
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Re: How is the government take over going to work w/o doctors?

Postby Kifle » Wed Nov 25, 2009 2:57 am

kiryan wrote:I don't disagree that wasting 75% of your day on facebook is normal.... which is what makes it really sad.


If that's the status quo, I need to stop working so hard and start fucking around on facebook. Aside from watching bank accounts and e-mail, I generally browse the web for around 10 minutes a day...
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Re: How is the government take over going to work w/o doctors?

Postby teflor the ranger » Wed Nov 25, 2009 6:04 am

Ambar wrote:So all you know is slackers and and people that know how to play the system so that means all the military are slackers .. For every slacker you mentioned I know tenfold who bust their asses.

You work for foxnews don't you?

I heard of a single mom that gets welfare and food stamps even tho she had a full time job .. I guess that means ALL single moms use the system that way .. I heard of a guy who can afford a cruise but still gets his kids free lunch .. must mean all Americans are slackers and system players.

*eyeroll*

I can't help but like you Mike, I think you are funny because you are so vehement on your views .. but man you have some screwed up thought processes :)

And I can't help but to think about how many people out there don't have health insurance but buy a new xbox game every month.

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