State of the healthcare system in America: Let's discuss why it's failing

Kate Collins67 said:Ugh, this overhyped Hippocrates guy... I honestly can't stand him.
You can't just call someone else's stance "incorrect" when we're talking about an opinion rather than hard facts.
Unless you're actually out there on the front lines—I mean, working in an ER or a high-pressure trauma center at a major hospital—you don't really have any professional experience to back up these claims. You're basically stuck in the "semi-amateur" category because, while you might be studying medicine, right now it's all just theory to you.

And then there's this latest gem from our doctor... I genuinely don't know what to make of it anymore.
I’m struggling to figure out how to trust my physician after this, though, if I'm being totally honest, I have up until now. I just really hope he doesn't harbor such a warped view of his patients and that he manages to follow that damn oath, even if only halfway.

Look, I know there are all kinds of patients and doctors out there—no point in making sweeping generalizations—but basic human decency? That costs absolutely nothing, yet it seems like people are starting to charge a premium for it lately. It’s like empathy has become some kind of rare luxury.
Honestly, seeing this kind of condescending, arrogant behavior from a doctor feels like a much more common occurrence than encountering fake patients.
My biggest struggle is during follow-ups; part of me wants to dodge them entirely, but unfortunately, since I actually enjoy being alive, I have the right to seek treatment—and the willpower to go through with it.
Doctors, seriously, you need to loosen up. Just because you think your way is the only "right" way doesn't mean it is, and heaven forbid I actually end up under your care.

Kate Collins67 said:Look, we can't just point fingers at patients and act like they’re the sole cause of all this chaos. Let’s be real—there are plenty of doctors out there who honestly don't know what they're doing, and their incompetence leads to a massive wave of unnecessary tests and redundant screenings. It’s a vicious cycle that just ends up bloating those endless waiting lists even further.

Now, I realize I shouldn't be lecturing people about physicians from a patient's perspective—I haven't exactly been a "serious" patient myself yet, so I don't deal with the system's headaches quite the way you guys do. And honestly? If I ever do run into medical trouble, I’ll probably just breeze through the red tape and get it sorted quickly—but hey, I guess that's just one of the perks of working within the system.

Hey, let's not be too harsh—some of them just don't seem to care much either..
I guess I wonder why nobody ever talks about negative selection or the hiring criteria, like how department heads are actually chosen and all that?

Unfortunately, I feel like people aren't even aware of the kind of staff that ends up filtering through the top-tier hospitals here in the US
I'm honestly in a spot where I'm worried my next supervisor might be someone who knows absolutely nothing about what I do, let alone anything about me... and to make matters worse, they don't even have to be in the medical field...

I'll just leave you with one friendly little bit of advice... it doesn't even matter if you're in medicine, because let's face it, the professionals in the American healthcare system are basically leaving in droves...
Whenever you get an opinion from one doctor, I guess you should definitely go out and get a second or even a third opinion...

I am making a formal pledge right here and now: I will do absolutely everything in my power to ensure that psychological evaluations are integrated into the medical school admissions process. Furthermore, I will fight to make Communication Studies a mandatory core subject—one where passing is an absolute prerequisite for obtaining a medical license.
May God help me, and may He watch over all future medical students.😳

Angela Wright said:I am making a formal pledge right here and now: I will do absolutely everything in my power to ensure that psychological evaluations are integrated into the medical school admissions process. Furthermore, I will fight to make Communication Studies a mandatory core subject—one where passing is an absolute prerequisite for obtaining a medical license.
May God help me, and may He watch over all future medical students.😳

🙏
If there’s ever a petition for this, let me know!
I’ll sign it with my full name, Social Security number, and everything else you need!

There are some truly wonderful people working in our hospitals, but let's be honest, there’s also some absolute bottom-of-the-barrel behavior out there.
Unfortunately, just like in any other part of life, one terrible person can completely ruin the hard work of a hundred amazing ones.

I don't read every single post in detail because some of them honestly make my skin crawl!
ruggedscout91, what they were saying to you is basically nothing short of Nazism.
It's just pathetic.
The worst part is how hypocritical people are. They love acting like judges over who deserves decent care and treatment, but the second they find themselves in pain or needing help, they're the first ones fighting for their own lives—even though they wouldn't hesitate to leave someone else suffering in the dark.

Angela Wright said:I am making a formal pledge right here and now: I will do absolutely everything in my power to ensure that psychological evaluations are integrated into the medical school admissions process. Furthermore, I will fight to make Communication Studies a mandatory core subject—one where passing is an absolute prerequisite for obtaining a medical license.
May God help me, and may He watch over all future medical students.😳

I couldn't agree more. Consider me signed on.

Jacob Fox6 said:I couldn't agree more with everything said here.

It’s pretty obvious that our healthcare system is struggling partly because some people decide to play judge and jury instead of just doing their jobs...

An alcoholic is essentially someone suffering from a mental health condition who ended up destroying their liver as a result. To deny them help just because they damaged their own health through an untreated primary illness is just wrong. Any doctor who views an alcoholic as anything other than a mental health patient isn't really practicing medicine properly. You can excuse a random person on the street for not knowing the first thing about medicine, but you can't excuse a physician for labeling and stereotyping. The second they start doing that, they stop being a healer. Why should we accept physical ailments but marginalize, belittle, and label mental ones, effectively deciding someone doesn't have the right to live? That's why not everyone is cut out for this; medicine isn't just a career, it's a calling, and clearly, for some people, it's become just another paycheck...

The state of modern medicine is pretty grim, and nobody is disputing that... from the decent paychecks to the endless bureaucratic red tape, the constant arguing over everything, and the fact that some people work themselves to death while others just coast through their shifts... I get the frustration, I really do. But that’s no excuse to let your moral compass slide, because that's just a weakness of character, and that’s the last thing you want in a doctor...

A lot of doctors will tell you, "Man, I just take the path of least resistance to survive," but I don't buy that for a second... because there are plenty of doctors who stayed true to themselves despite impossible working conditions. I know a doctor who spends an hour and a half on the treadmill after her shift just to process all the stress... It's not some wild fantasy, either; doctors should be the first to know that physical exercise is one of the best ways to handle mental burnout, which science has been proving for years now...

Crystal clear, and I agree—at the end of the day, we are all just human beings.

jadesailor14 said:🙏
If there’s ever a petition for this, let me know!
I’ll sign it with my full name, Social Security number, and everything else you need!

There are some truly wonderful people working in our hospitals, but let's be honest, there’s also some absolute bottom-of-the-barrel behavior out there.
Unfortunately, just like in any other part of life, one terrible person can completely ruin the hard work of a hundred amazing ones.

I don't read every single post in detail because some of them honestly make my skin crawl!
ruggedscout91, what they were saying to you is basically nothing short of Nazism.
It's just pathetic.
The worst part is how hypocritical people are. They love acting like judges over who deserves decent care and treatment, but the second they find themselves in pain or needing help, they're the first ones fighting for their own lives—even though they wouldn't hesitate to leave someone else suffering in the dark.

Any sane person would be repulsed by certain statements here, especially since they're usually written by people who feel forced to take a stance diametrically opposed to reality.
Absolutely terrifying!!!!
And ruggedscout91 has such a warped perspective that I honestly doubt he'd even claim not to be a doctor. It’s not just pathetic; it’s something much worse. When it comes to their own people, their stance flips instantly to the exact opposite of whatever they just shouted.
It's sad. Honestly, sometimes it's better not to read or type anything at all, because realizing the truth is just too painful.

Sigh...
All I can say is you get exactly the system you deserve.

If you step away from all this fake moralizing for a second, you’ll realize that nobody here is actually talking about how things *should* be—we’re talking about how life actually works, what our actual options are in this messed-up existence, and the choices being forced upon us every single day.

This isn't some matter of personal preference; it's being imposed on us by the entire system.
And honestly, if your hair is standing on end because of a comment like that, you clearly aren't ready for a real debate. Opinions exist to be argued and dismantled with logic, not feelings.

Out of everyone here holding an opinion contrary to mine, it's funny how not one single person seems to be a professional—and let’s be clear, having a job at Vixen versus whatever else is going on, those ideals die pretty fast when reality hits.
Unlike some people around here, I don't need some Hippocratic oath or a local priest to lecture me on morality; when it comes to making decisions, I use my own damn head.

@ Sarah Johnson11 — your story comes from personal experience, and the way you're writing this just reflects your disgust and the fear that what I’m saying might somehow rub off on you. But believe me, I'm neither a monster nor insane; it's just incredibly difficult to unpack complex issues on a forum. To really get into it, you need a continuous dialogue lasting hours or even days—a forum post is always just a fragment of a thought.

Angela Wright said:I am making a formal pledge right here and now: I will do absolutely everything in my power to ensure that psychological evaluations are integrated into the medical school admissions process. Furthermore, I will fight to make Communication Studies a mandatory core subject—one where passing is an absolute prerequisite for obtaining a medical license.
May God help me, and may He watch over all future medical students.😳

You aren't going to achieve a single thing with that attitude; I went through all the psych testing myself and look where I am...

It is simply impossible to explain the nuances of what a poet is trying to convey to someone who isn't actually deep inside the system. Look, nobody is asking you to agree with my perspective—I’m just reporting exactly what I see and how things are actually being handled on the ground.

Let me give you a real-world example from my own practice: A patient was referred from a local community hospital to the Mayo Clinic hematology clinic because they needed urgent intervention due to a platelet count of 3 and obvious subcutaneous bleeding. This patient wasn't responding to the standard therapy available at the general hospital.
And according to you people, I’m some kind of monster just because I sent this individual to the Mayo Clinic—only to have them sent right back with some idiotic excuse? It’s either because the doctor who saw them was too overwhelmed to care, or they are one of those pseudo-moralists who loves to lecture everyone about the Hippocratic Oath while doing nothing...
Two days later, that same patient was admitted to the Cleveland Clinic and the procedure was successfully completed.

If you can't see why these systemic failures happen, then there is absolutely nothing I can do to help you understand.

Kate Collins67 said:Sigh...
All I can say is you get exactly the system you deserve.

If you step away from all this fake moralizing for a second, you’ll realize that nobody here is actually talking about how things *should* be—we’re talking about how life actually works, what our actual options are in this messed-up existence, and the choices being forced upon us every single day.

This isn't some matter of personal preference; it's being imposed on us by the entire system.
And honestly, if your hair is standing on end because of a comment like that, you clearly aren't ready for a real debate. Opinions exist to be argued and dismantled with logic, not feelings.

Out of everyone here holding an opinion contrary to mine, it's funny how not one single person seems to be a professional—and let’s be clear, having a job at Vixen versus whatever else is going on, those ideals die pretty fast when reality hits.
Unlike some people around here, I don't need some Hippocratic oath or a local priest to lecture me on morality; when it comes to making decisions, I use my own damn head.

@ Sarah Johnson11 — your story comes from personal experience, and the way you're writing this just reflects your disgust and the fear that what I’m saying might somehow rub off on you. But believe me, I'm neither a monster nor insane; it's just incredibly difficult to unpack complex issues on a forum. To really get into it, you need a continuous dialogue lasting hours or even days—a forum post is always just a fragment of a thought.

Is lacking basic humanity considered "immature"?
Because cutting off medical care and dignified support for our seniors and the critically ill—what exactly does that say about us?
Who gets to play judge and decide who deserves care and treatment?
Are some people just trying to play God to satisfy their own egos and interests?

And as for ideals dying out too fast... I don't think anyone qualified to judge that has ever actually lived by them.
Sure, some die out, but there are plenty of people out there who carry those values with them for their entire lives!

jadesailor14 said:🙏
If there’s ever a petition for this, let me know!
I’ll sign it with my full name, Social Security number, and everything else you need!

There are some truly wonderful people working in our hospitals, but let's be honest, there’s also some absolute bottom-of-the-barrel behavior out there.
Unfortunately, just like in any other part of life, one terrible person can completely ruin the hard work of a hundred amazing ones.

I don't read every single post in detail because some of them honestly make my skin crawl!
ruggedscout91, what they were saying to you is basically nothing short of Nazism.
It's just pathetic.
The worst part is how hypocritical people are. They love acting like judges over who deserves decent care and treatment, but the second they find themselves in pain or needing help, they're the first ones fighting for their own lives—even though they wouldn't hesitate to leave someone else suffering in the dark.

What I am saying isn't meant to be entertaining; you have to understand why it was said.
When it was my turn, I barely survived. I became a victim of a negligent gynecologist who neglected a regularly monitored fibroid—one that was obviously well-paid for—until it ravaged everything in my pelvic region.
Aside from a CT scan, I didn't fight at all; I just wanted everyone to leave me alone. I saw how much the doctors and nurses actually do. My child will never study medicine, especially not to do things like this here.
What I write is rooted in pure reality. First, a person gets angry, but once they wake up and regain their senses, they realize the essence of the problem within the healthcare system. It is our everything. Personnel isn't the issue. They don't even have a voice within their own profession. Even Walmart would have more say in medical matters than they do.
Read carefully and state specifically what anyone finds objectionable.
They attacked Kate Collins67 upstairs, but they haven't actually written anything except rebukes about things they know are happening.

Psychiatric evaluations would be extremely necessary for the President of the United States, as well as for all the members of Congress and mayors who love to hear themselves talk. Some of them act in such a way that when outsiders look at them, they think they're looking at scenes from an asylum.
And almost every human being has one life interest where they demand something they feel is "right"—whether it's household order, religious moralizing ("we are righteous and others are not"—which isn't labeled Nazism but could be), landscaping, or various political doctrines. These are all different forms of Nazism.
If some sense of order and morality is used to ensure a person receives the right service at the right time—respecting at least the kind of order seen during wartime—then yes, I am a Nazi. I refuse to finance a system that effectively offers "reserve organs" on a silver platter to those who aren't conscious of their actions, like alcoholics, addicts, or promiscuous individuals, while that very organ could save the life of someone living responsibly and humanely.
At some point, the American healthcare system needs to establish exactly what is done where, and who issues which referrals and for what. There must be definitive waiting lists. Once there is order and transparency, the various forms of corruption and the unreasonable expectations of certain patient groups will have to face reality: that we are lagging behind the rest of the world because no government institution possesses the necessary authority to function properly.
It's as if we were in India.

jadesailor14 said:Is lacking basic humanity considered "immature"?
Because cutting off medical care and dignified support for our seniors and the critically ill—what exactly does that say about us?
Who gets to play judge and decide who deserves care and treatment?
Are some people just trying to play God to satisfy their own egos and interests?

And as for ideals dying out too fast... I don't think anyone qualified to judge that has ever actually lived by them.
Sure, some die out, but there are plenty of people out there who carry those values with them for their entire lives!

Oh, please—demagoguery is usually the strongest weapon for those who are terrified of actual change...
Look, let's not go in circles here; if we follow your logic, everyone should have access to everything from start to finish in equal measure. Happy now?
The reality is that people will continue to get sick and pass away even when, from a purely medical standpoint, they shouldn't—but hey, at least it’ll make things a little easier for those who actually have all their rights intact, right?

It's incredibly easy to act like a genius when you aren't the one making the hard calls...
And regarding this whole debate about who decides who gets treatment and who doesn't—from where I'm standing, it's Medicare, the Government, the Secretary of Health, and the doctors themselves. They are constantly deciding this through their policies, whether directly or indirectly.

So, in your opinion, who is supposed to organize the system and make these calls? You seem to think decisions should just spontaneously manifest out of thin air...

If we all agree that the current system is broken, then instead of just sitting there moralizing about how "everyone has a right to everything," why don't you actually propose a system where that's possible? Then maybe we wouldn't have to deal with these endless, exhausting arguments.

jadesailor14 said:Is lacking basic humanity considered "immature"?
Because cutting off medical care and dignified support for our seniors and the critically ill—what exactly does that say about us?
Who gets to play judge and decide who deserves care and treatment?
Are some people just trying to play God to satisfy their own egos and interests?

And as for ideals dying out too fast... I don't think anyone qualified to judge that has ever actually lived by them.
Sure, some die out, but there are plenty of people out there who carry those values with them for their entire lives!

Are you going to ask that same question when you leave your own mother or father stuck in a hospital bed, relying on strangers just to wash them and feed them because you couldn't be bothered to handle it yourself at home? (That’s just standard behavior for an American patient's family.)

jadesailor14 said:Is lacking basic humanity considered "immature"?
Because cutting off medical care and dignified support for our seniors and the critically ill—what exactly does that say about us?
Who gets to play judge and decide who deserves care and treatment?
Are some people just trying to play God to satisfy their own egos and interests?

And as for ideals dying out too fast... I don't think anyone qualified to judge that has ever actually lived by them.
Sure, some die out, but there are plenty of people out there who carry those values with them for their entire lives!

And who is actually talking about cutting off treatment and dignified care for the elderly and the critically ill?
The discussion is about acting responsibly toward these individuals, not shuttling them from one medical facility to another just to maintain the illusion that someone is being treated.
Would anyone who doesn't require emergency services allow themselves to occupy precious time that could be better used by their grandchild?
My grandmother passed away in my arms right after she was discharged because there was simply nothing more that could be done. Is it not better that she drew her last breath in my and my husband's arms, in her own home and her own bed, rather than somewhere surrounded by tubes and catheters with no family nearby?
We need to understand what the elderly and the sick actually want. They want to be recognized first and foremost as human beings with a right to their own opinions.
Exactly. And now, healthcare workers are supposed to be blamed because someone has to die. Well, we are all going to die eventually.
I would love to be lucky enough to die with dignity, without being drained by useless therapeutic procedures, and to have someone there who can sign the papers to let me go when the time comes.
I cannot stand fake altruism. We live in a society where even time itself can be bought with money, yet no one dares to point a finger where it truly belongs.
Instead, we point fingers at those who won't fight back.

Regarding my profession—God forbid—I am neither a doctor nor a nurse, and I doubt anyone close to me will be either. I chose something rooted in physics. In my field, "equals" always means "is."

@ ruggedscout91

Man, you should just start writing stuff for me—like, I’ll draft something up, and then you can take over the actual writing. It would save me a massive amount of grief from critics, because let's be honest, things always hit differently when they're coming from a patient rather than some doctor's mouth.

ruggedscout91 said:If we don't implement proper triage and prioritize emergencies correctly, the inefficiency of the medical system will result in even the most easily treatable diseases deciding who lives and who dies.
Regarding psychiatric illnesses, what is the actual ratio between existing alcoholics and those receiving treatment, or between those seeking help and those left out? Doesn't an alcoholic who actually seeks treatment demonstrate a desire to improve, deserving a higher degree of care? Of course they do. That is what Jacob Fox6 is talking about.
Organs and health aren't items in a grocery store; you can't just go buy new ones when you run through your supply too quickly. That is a utopia.
Personally, I am glad you still have enthusiasm. I appreciate it, though that enthusiasm needs to be tempered with the reality that awaits you after medical school. Neither you nor I are to blame for this.
I am simply trying, in the absence of other options, to debunk certain misconceptions on this forum regarding the use of the system. People are unreasonably disappointed, yet when it comes to the ACTUAL SYSTEMIC FAILURES, no one wants to point a finger.
It is an expensive, inefficient system, paralyzed by the inertia of a political establishment that most doctors have integrated themselves into. The results are catastrophic. Because of politics, no one dares to wake the sleeping lion. Issues aren't resolved even at the primary care level, creating a domino effect that hits secondary and tertiary care, effectively turning specialized care into basic services and blurring the lines between all levels of medicine.
Courting a woman with flowers and chocolates while telling her she's beautiful, yet choosing to sleep with the neighbor instead—that is the essence of our healthcare system today. It is pure hypocrisy, and frankly, it suits certain people just fine. They enjoy the weekly hygiene maintenance, the ability to ease the guilty consciences of the patient's relatives, and the luxury of feeding the terminally ill false hope instead of offering honest hospice care and a dignified death. They prefer sending children from wealthy families to the front of transplant lists while leaving the kids of average citizens stuck on waiting lists twenty people deep. It’s a rigged game, and some people thrive in it.
The detergent label exists to show the difference between being responsible with your household groceries and being negligent with your health—like when there aren't enough spare parts for a defibrillator. Regarding the former, people claim, "We can influence this" (just tell the boss). Regarding the latter, they say, "There's nothing we can do."
WE COULD, if that doctor mentioned the chaos he caused, called the news, and announced that he's missing a defibrillator and someone might die tonight. Only then would something actually happen.
BUT IT WOULD ALSO MEAN he gets fired on the spot and blacklisted from ever working in the medical field in the USA again.
We have stumbled into the territory of a physician's constitutional rights versus their Hippocratic Oath, and whether they should face termination for simply following their conscience and their oath.
I hope you never find yourself in such a position.

I basically agree with that, though I feel like when it comes to the two of us, things might play out a little differently...

We’re out here talking about taking care of our health, but let's be real—more and more people are losing their jobs every single day and that trend isn't slowing down anytime soon... We talk all about how the American insurance system is supposed to work, only to face the reality where you're stuck waiting an entire year just for a basic scan or some routine testing. Everyone loves to chime in with "it should be this way" or "they don't have the right equipment in the hospitals," but honestly, nobody seems to grasp that all of this is just the byproduct of money, corporate greed, and political maneuvering... To me, listening to the endless complaining about what a hospital lacks is pretty pointless when everyone from the patients to the doctors and the medical center directors already knows the deal. That same director who turns down a specific medication isn't being difficult for fun; they're just working within a tight budget at a hospital that's already drowning in debt. And look, I’m just a regular guy doing my job, so there's no point in overanalyzing it... If you can handle the grind, then handle it, but if you can't, go find some help to make things a little easier on yourself...

What you’re calling some kind of utopia is honestly just a total misunderstanding on your part... expecting the healthcare system to actually work properly anytime soon isn't a dream, it's just reality, and whining about it is pretty much just exhausting and unnecessary... but it definitely isn't a utopia to say that even within the current system, no matter how flawed, a person shouldn't throw their morals out the window and try to play judge and jury themselves... like, here's a simple example—if someone is at the top of the list for a kidney transplant, they get that kidney, period, regardless of age, medical history, or what anyone personally thinks about them being "worthy"... a doctor is in the hospital to focus on the illness and the patient, not to let their own personal moral compass dictate how they act... my own moral leanings happen to align perfectly with the Hippocratic Oath, thank God, and I don't recognize any other way of doing things...

There's really no such thing as absolute correctness because humans aren't perfect beings, and since everything involving people is subjective, I honestly have zero interest in arguing over who "deserves" what or anything like that... I'm not there to pass judgment, I'm there to follow the laws as they stand... if someone has an issue with the law itself, they should take it up with the right authorities... it’s like being a lawyer who has to defend a guilty client; even if it clashes with your personal code, you don't just turn around and blame them in court instead of doing your job, because that would just be hypocritical... the institution makes the calls, not the individual, and there's a reason it works that way... everything I've heard so far feels like nothing more than isolated, deviant takes on what morality actually means...

I still firmly believe that being a doctor isn't for everyone, because it requires this massive amount of humanity that, unfortunately, not everyone possesses... I didn't go into medicine just to pick and choose who gets help, I went into it to help everyone I possibly can... and when you hit those situations where helping everyone is impossible, the rules are crystal clear... anything else is just chaos... if someone can't handle following professional standards, then they probably shouldn't be practicing this profession in the first place...

Jacob Fox6 said:I basically agree with that, though I feel like when it comes to the two of us, things might play out a little differently...

We’re out here talking about taking care of our health, but let's be real—more and more people are losing their jobs every single day and that trend isn't slowing down anytime soon... We talk all about how the American insurance system is supposed to work, only to face the reality where you're stuck waiting an entire year just for a basic scan or some routine testing. Everyone loves to chime in with "it should be this way" or "they don't have the right equipment in the hospitals," but honestly, nobody seems to grasp that all of this is just the byproduct of money, corporate greed, and political maneuvering... To me, listening to the endless complaining about what a hospital lacks is pretty pointless when everyone from the patients to the doctors and the medical center directors already knows the deal. That same director who turns down a specific medication isn't being difficult for fun; they're just working within a tight budget at a hospital that's already drowning in debt. And look, I’m just a regular guy doing my job, so there's no point in overanalyzing it... If you can handle the grind, then handle it, but if you can't, go find some help to make things a little easier on yourself...

What you’re calling some kind of utopia is honestly just a total misunderstanding on your part... expecting the healthcare system to actually work properly anytime soon isn't a dream, it's just reality, and whining about it is pretty much just exhausting and unnecessary... but it definitely isn't a utopia to say that even within the current system, no matter how flawed, a person shouldn't throw their morals out the window and try to play judge and jury themselves... like, here's a simple example—if someone is at the top of the list for a kidney transplant, they get that kidney, period, regardless of age, medical history, or what anyone personally thinks about them being "worthy"... a doctor is in the hospital to focus on the illness and the patient, not to let their own personal moral compass dictate how they act... my own moral leanings happen to align perfectly with the Hippocratic Oath, thank God, and I don't recognize any other way of doing things...

There's really no such thing as absolute correctness because humans aren't perfect beings, and since everything involving people is subjective, I honestly have zero interest in arguing over who "deserves" what or anything like that... I'm not there to pass judgment, I'm there to follow the laws as they stand... if someone has an issue with the law itself, they should take it up with the right authorities... it’s like being a lawyer who has to defend a guilty client; even if it clashes with your personal code, you don't just turn around and blame them in court instead of doing your job, because that would just be hypocritical... the institution makes the calls, not the individual, and there's a reason it works that way... everything I've heard so far feels like nothing more than isolated, deviant takes on what morality actually means...

I still firmly believe that being a doctor isn't for everyone, because it requires this massive amount of humanity that, unfortunately, not everyone possesses... I didn't go into medicine just to pick and choose who gets help, I went into it to help everyone I possibly can... and when you hit those situations where helping everyone is impossible, the rules are crystal clear... anything else is just chaos... if someone can't handle following professional standards, then they probably shouldn't be practicing this profession in the first place...

But that’s exactly where the issue lies—the rules aren't actually "clear" when you leave the final call up to the individual. That’s precisely where these moral dilemmas start brewing. You seem to think we should just shift all that responsibility onto the lawmakers, and sure, I get it—that would certainly be the easiest way out—but it wouldn't solve the underlying moral conflicts. Just because a law says one thing doesn't mean it's the right thing to do in a specific moment, because let's face it, the law can't possibly be written to account for every single messy life situation we encounter.

Let’s look at a hypothetical scenario here: imagine you have, say, 100 units of thyroid hormone reagents left for the month of May 2010. After those are gone, the hospital is physically incapable of running any more tests—it's literally impossible because you lack the supplies. So now, you find yourself in this position where you have to reach out to everyone who might need them, or you try to hand-pick a specific group based on your own judgment—your experience, your knowledge, whatever—to decide who will actually benefit the most from what little you have left.

You’re staring down exactly two choices: either you message everyone in order, regardless of how slim their chances are, which means by the 15th you've burned through everything, leaving nobody else able to get tested for the rest of the month and creating a massive waiting list.
The other option is to be selective—to make the hard calls and play judge, knowing full well that in the process, you are inevitably going to screw someone over. But at least then, you're aiming to minimize the overall damage.

That is exactly how the system works in the real world. You are forced into a position where you have to choose, and you can't pretend you aren't making a choice just by acting like it doesn't concern you—because no matter what you do, you've already picked a side.

Kate Collins67 said:Let’s look at a hypothetical scenario here: imagine you have, say, 100 units of thyroid hormone reagents left for the month of May 2010. After those are gone, the hospital is physically incapable of running any more tests—it's literally impossible because you lack the supplies. So now, you find yourself in this position where you have to reach out to everyone who might need them, or you try to hand-pick a specific group based on your own judgment—your experience, your knowledge, whatever—to decide who will actually benefit the most from what little you have left.

You’re staring down exactly two choices: either you message everyone in order, regardless of how slim their chances are, which means by the 15th you've burned through everything, leaving nobody else able to get tested for the rest of the month and creating a massive waiting list.
The other option is to be selective—to make the hard calls and play judge, knowing full well that in the process, you are inevitably going to screw someone over. But at least then, you're aiming to minimize the overall damage.

That is exactly how the system works in the real world. You are forced into a position where you have to choose, and you can't pretend you aren't making a choice just by acting like it doesn't concern you—because no matter what you do, you've already picked a side.

I am totally on board with what you're saying here...

But I can't get behind the way ruggedscout91 is looking at things, because honestly, she’d probably try to hand off someone’s organ for transplant to whoever she thinks "deserves" it more, even though the rules are super clear on that... And those comments about third-party coverage are just totally out of line, and complaining about the number of prescriptions seems pretty silly to me. Sure, there are a lot of them, but most of those people genuinely need them just to live a normal life...

What you pointed out is exactly what I was thinking about when I brought up the budget... To me, what ruggedscout91 is advocating for isn't quite the same thing as your example, because yours is pure reality while her take is pretty questionable from a moral standpoint. Of course someone is going to miss out, I never said otherwise, which is why I emphasized that absolute truth, but as long as you aren't denying someone care based on prejudices like age or lifestyle, then I'm right there with you... because it stays within the realm of reality and isn't about discriminating based on some personal worldview, but rather just judging how urgent a specific test is. Even at my local clinic where I always go for bloodwork, they handle thyroid tests right there, so I don't see why every single patient needs to be sent to a major Medical Center unless they're actually hospitalized, since local clinics usually have decent labs... But hey, that was just a simple example for thyroid stuff, and there are a million other tests that can only be done at a big hospital. I know that's why waiting lists exist and all that... But we end up back at what I said—it all comes down to the money... Even with an organized system like ours in the States, it would be so much better if hospitals just had a proper budget...

Jacob Fox6 said:I am totally on board with what you're saying here...

But I can't get behind the way ruggedscout91 is looking at things, because honestly, she’d probably try to hand off someone’s organ for transplant to whoever she thinks "deserves" it more, even though the rules are super clear on that... And those comments about third-party coverage are just totally out of line, and complaining about the number of prescriptions seems pretty silly to me. Sure, there are a lot of them, but most of those people genuinely need them just to live a normal life...

What you pointed out is exactly what I was thinking about when I brought up the budget... To me, what ruggedscout91 is advocating for isn't quite the same thing as your example, because yours is pure reality while her take is pretty questionable from a moral standpoint. Of course someone is going to miss out, I never said otherwise, which is why I emphasized that absolute truth, but as long as you aren't denying someone care based on prejudices like age or lifestyle, then I'm right there with you... because it stays within the realm of reality and isn't about discriminating based on some personal worldview, but rather just judging how urgent a specific test is. Even at my local clinic where I always go for bloodwork, they handle thyroid tests right there, so I don't see why every single patient needs to be sent to a major Medical Center unless they're actually hospitalized, since local clinics usually have decent labs... But hey, that was just a simple example for thyroid stuff, and there are a million other tests that can only be done at a big hospital. I know that's why waiting lists exist and all that... But we end up back at what I said—it all comes down to the money... Even with an organized system like ours in the States, it would be so much better if hospitals just had a proper budget...

Well, money has always been the issue. Always. But we can't sit around daydreaming about "what if" scenarios; we have to deal with the reality of surviving within the system as it exists right now.

But look, that reagent example you gave is a bit too simple because, usually, nobody gets fired over something like that. You have much more serious examples out there—far more serious potential diagnoses—where you're still prevented from acting, and suddenly you're stuck in this impossible dilemma: you know exactly what resources you have available, and you realize you can only help, say, one more person before the end of the month or the year. You're forced to choose between two people. And medically speaking? The only thing distinguishing them might be age—one is 40 and the other is 70—or maybe one struggles with alcoholism and the other doesn't. In certain situations, you might manage to game the system and help both, but in many others, you won't. And as time goes on, you'll probably start to falter because fighting against the system is exhausting and, most of the time, completely futile.

Since the law, with its restrictive budgeting, basically gives you a way to shift the blame onto the government, you’d think it would be easier to stomach—but it doesn't change the fact that you are constantly being forced to choose one person at the expense of another.
In a system set up this way, avoidance is impossible. And when you are finally making that choice, it becomes incredibly significant whether you're looking at a person with cancer or not, an alcoholic or a teetotaler, the young or the old. Because at the end of the day, you are the one making the decision that helps one person while depriving another... it's tragic, but that's just how it works. I'll say it again: sometimes there's a way to screw the system, but sometimes your hands are tied.