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posted by Fnord666 on Monday June 05 2017, @04:37PM   Printer-friendly
from the can't-take-it-with-you dept.

Arthur T Knackerbracket has found the following story:

SAN FRANCISCO — When John Battelle's teenage son broke his leg at a suburban soccer game, naturally the first call his parents made was to 911. The second was to Dr. Jordan Shlain, the concierge doctor here who treats Mr. Battelle and his family. "They're taking him to a local hospital," Mr. Battelle's wife, Michelle, told Dr. Shlain as the boy rode in an ambulance to a nearby emergency room in Marin County. "No, they're not," Dr. Shlain instructed them. "You don't want that leg set by an E.R. doc at a local medical center. You want it set by the head of orthopedics at a hospital in the city." Within minutes, the ambulance was on the Golden Gate Bridge, bound for California Pacific Medical Center, one of San Francisco's top hospitals. Dr. Shlain was there to meet them when they arrived, and the boy was seen almost immediately by an orthopedist with decades of experience.

For Mr. Battelle, a veteran media entrepreneur, the experience convinced him that the annual fee he pays to have Dr. Shlain on call is worth it, despite his guilt over what he admits is very special treatment. "I feel badly that I have the means to jump the line," he said. "But when you have kids, you jump the line. You just do. If you have the money, would you not spend it for that?"

Increasingly, it is a question being asked in hospitals and doctor's offices, especially in wealthier enclaves in places like Los Angeles, Seattle, San Francisco and New York. And just as a virtual velvet rope has risen between the wealthiest Americans and everyone else on airplanes, cruise ships and amusement parks, widening inequality is also transforming how health care is delivered. Money has always made a big difference in the medical world: fancier rooms at hospitals, better food and access to the latest treatments and technology. Concierge practices, where patients pay several thousand dollars a year so they can quickly reach their primary care doctor, with guaranteed same-day appointments, have been around for decades.

But these aren't the concierge doctors you've heard about — and that's intentional.

Dr. Shlain's Private Medical group does not advertise and has virtually no presence on the web, and new patients come strictly by word of mouth. But with annual fees that range from $40,000 to $80,000 (more than 10 times what conventional concierge practices charge), the suite of services goes far beyond 24-hour access or a Nespresso machine in the waiting room.

Indeed, as many Americans struggle to pay for health care — or even, with the future of the Affordable Care Act in question on Capitol Hill, face a loss of coverage — this corner of what some doctors call the medical-industrial complex is booming: boutique doctors and high-end hospital wards.

-- submitted from IRC


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  • (Score: 2) by edIII on Monday June 05 2017, @08:43PM (4 children)

    by edIII (791) on Monday June 05 2017, @08:43PM (#520972)

    I'm seriously proposing that iterative process. My problem is not income inequality, but the undue suffering of the American worker, which is largely representative of the American People. I believe we can have a society where overachievers can rise to billionaire status, without brutally exploiting those around them.

    That suffering is simple to understand. They were never paid a living wage, and the engineered inefficiencies of our society cause money to trickle up and pool at the top. That money never trickles back down to help the worker out, as the myth goes.

    If everyone is WORKING, not gold bricking, and their performance is adequate enough to continue working, they should get what they NEED to survive. All too often living wage is conflated with access to the excesses of wealth and consumerism. It's not, and instead means the ability to eat, clothe, and shelter yourself while having access to medical care.

    We all know what happens when you don't. Walmart creates "wards of the state" the moment somebody starts to work for them, unless they are in the special section of society... the MBAs and executive scum that are deluded enough to believe they are worth anywhere from several times more, to dozens of times more income than the average worker.

    This fucker is complaining about having a job that is obviously high 6 figures, possibly 7 figures, and being guilty about getting privileged access to health care personnel who sold their souls and only care for the rich. That doctor deserves to be culled too.

    I think at this point our society can only be saved by continually culling the top 1% until things get better. That is the only thing that will motivate them to give back, although I disagree with the idea they are giving back. It's more truthful to represent it as they are returning the goods that they stole from weaker people who were desperate enough to take a work offer that doesn't sustain them. The 1% engineered that environment of duress, specifically to profit from the exploitation of their leverage. That leverage being the worker starving, or watching their kids starve.

    That, is the problem in a nutshell; The average American cannot sustain themselves from their own work production on a daily basis. That's a critical problem that has been going on for decades. We all know the consumer debt bubble is coming, precisely because we must go into debt. Debt is preferred and insidious by the 1%. We don't get paid enough to live, so we pay even more to go into debt, to not get enough to pay off the debt, and then.......

    Kill the rich. Kill them now. It may already be too late, and I strongly suspect that on a planetary basis we are experiencing a cascade failure in process. An unrecoverable cascade failure. The 1% caused this cascade failure. Period. Fuck them, and whether we kill them or not, their paths are almost universally believed to be leading the 1% to hell anyways. So hell, karma, the death of our planet, at some point the 1% will suffer the consequences. It's a tragedy of epic proportions that they take the rest of us with them.

    --
    Technically, lunchtime is at any moment. It's just a wave function.
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  • (Score: 2) by bob_super on Monday June 05 2017, @09:28PM (3 children)

    by bob_super (1357) on Monday June 05 2017, @09:28PM (#520995)

    > although I disagree with the idea they are giving back. It's more truthful to represent it as they are returning the goods that they stole

    "Give his toy back to your brother, now!"

    The confusion might stem, and we see it with some of the regulars here, that getting money doesn't intrinsically make it "my money", in the sense that every dime taken from it is stolen from me. My boss knows that I pay taxes, and pays me based also on how much of that raw paycheck will then go to various civilization-supporting organizations. Similarly, any ROI is (should be) subject to some kind of contribution back to the networks that made it possible. Yet, the US has extremely low levels of taxation, high deficits, and people with the most are always eager to scream bloody murder at the idea that one can live without billions.

    • (Score: 2) by edIII on Monday June 05 2017, @11:36PM (2 children)

      by edIII (791) on Monday June 05 2017, @11:36PM (#521044)

      The confusion might stem, and we see it with some of the regulars here, that getting money doesn't intrinsically make it "my money", in the sense that every dime taken from it is stolen from me. My boss knows that I pay taxes, and pays me based also on how much of that raw paycheck will then go to various civilization-supporting organizations.

      I believe what you are trying to say is that the deductions on pay are now always theft. Meaning, the government taking taxes from you isn't theft. OK. I can see that, but that is not what I'm saying.

      All of the money given to my for my work production is in fact, in totality, MY FUCKING MONEY. Immediately, more often than not, the government satisfies the taxation portion. That's not the employer or company paying them, that's ME paying them from MY money. Likewise, anybody that is receiving money from it, is in fact, being paid by ME. So it is all of money, intrinsically, explicitly, implicitly, diagonally, whatever fucking way you want. Not to be confused with matching employer contributions to the government. The employer paid, and I paid. The employer with capital from the corporation, and myself from my own money that I made from the corporation in exchange for my work production.

      The Boss does very well fucking know how much of that raw paycheck will go to places, because he controls the accountants that make it possible. The Boss also lives in the same fucking community I do (most of the time I suspect that is true) and is FULLY aware of how much food costs, how much water costs, how much gas costs, etc.

      When the Boss decides to pay me less than what I need, then the Boss is STEALING from me, the government, and our community. That "raw" paycheck was too light to begin with, the government should've had more in taxes, and I should've ended up with MORE of MY FUCKING MONEY. Where does that money go? Into the BOSS's pockets. For what? MY WORK PRODUCTION, NOT HIS! Then it is compounded by the Boss STEALING from EVERYONE. When we need to collect our taxes to put them into social programs that really only exist at the scale they do because the Boss couldn't be bothered to pay a living wage. So when he doesn't, he is fully aware of the burden he places upon the social security nets. The BOSS steals the money from all of us, because now I'm just a dirty fucking poor person, with obviously bad character and habits, that can't make it, needs help, and the government now has to take care of me. Yet, I put in a full day's worth of work. The average American worker, does in fact, work much harder than the soft handed executives that never knew what work actually was.

      They're fucking parasites, and they do steal from us. Every day. Billions upon billions per year, stolen from the American worker in shitty work offers in failing communities full of duress and an ever increasing homeless population. Those affordable places to live within the wages being currently proffered? GONE. Other rich hell bound avaricious fuckers swooped in and raised the prices. All of those fucks on AirBnb offering their places as 100% rentals should be flayed alive and dipped in salt.

      It's from all sides dude. They raise the prices of commodities, they raise the prices of energy, they raise the prices of housing, but they NEVER raise the wages. They raise THEIR OWN wages, but they never raise OURS.

      I'm not confused about anything. When I make less than a living wage and suffer material deprivation, while some MBA Ivy-league fucktard takes long lunches and does practically no fucking work, then yes, very much so, he has stolen from money that is rightfully mine. I don't give a fuck how much he makes, as long the company stays solvent, stays active, and continues to pay me a living wage.

      The problem is not billionaires, but the billionaires stealing from the little guys to become billionaires.

      --
      Technically, lunchtime is at any moment. It's just a wave function.
      • (Score: 2) by bob_super on Tuesday June 06 2017, @01:06AM (1 child)

        by bob_super (1357) on Tuesday June 06 2017, @01:06AM (#521090)

        I agree with your points starting at paragraph 3...

        Yet I can't agree with:

        All of the money given to my for my work production is in fact, in totality, MY FUCKING MONEY. Immediately, more often than not, the government satisfies the taxation portion. That's not the employer or company paying them, that's ME paying them from MY money. Likewise, anybody that is receiving money from it, is in fact, being paid by ME. So it is all of money, intrinsically, explicitly, implicitly, diagonally, whatever fucking way you want. Not to be confused with matching employer contributions to the government. The employer paid, and I paid. The employer with capital from the corporation, and myself from my own money that I made from the corporation in exchange for my work production.

        It's like the stupid US habit of adding taxes at the register: You're seeing a number that doe not correspond to the reality, whether it's the paycheck's top line or the burger's cost...

        What your employer pays vs what you pay isn't fucking relevant, because they are both numbers taken off the total cost to your employer (the one they care about), and the number that you care about is the one at the bottom. Someone artificially draws a line and says "that's the employer taxes for that employer cost, and this is the employee's taxes for that employer cost". It's gotta get paid, and if you got to chose between paying 0% (employer pays all charges and taxes, still pays you the same bottom line), or 100% (scumbag employer pays nothing, but pays you more, and you get tax-raped yet still arrive at the same bottom line), you'd choose 0% because evil.gov wouldn't steal from you, and your neighbor would choose 100% because he prefers the higher top line.

        The bottom line is indeed your fucking money (or drug money, or booze money, let's not be vice-ist). You can't change the bottom line anymore than you can change the fact that you ain't paying the stupid pretax number for that burger.
        It's a question of perception, but the result is the same. Feel free to chose to interpret it in the way which makes you angry.

        • (Score: 3, Interesting) by edIII on Tuesday June 06 2017, @03:19AM

          by edIII (791) on Tuesday June 06 2017, @03:19AM (#521136)

          It's like the stupid US habit of adding taxes at the register: You're seeing a number that doe not correspond to the reality, whether it's the paycheck's top line or the burger's cost...

          Maybe, maybe not. This is really an accounting question. My view is that the total raw amount, is very very much, and indeed, MINE. If it wasn't, then it could never be counted as income towards me. Yet, I think if we both looked, the government would consider whatever garnished as part of MY income, and not a direct expense of the employer. With matching contributions, whatever I have matched, is still income towards me at the end of the year. Heck, you can discharge debt in such a way that it switches to income for the person that borrowed it. USAA was giving the big fuck you to people who defaulted on them by not even selling the debt. They FORGAVE it. Which is basically USAA reporting to the government that they gave you all of that money, inclusive of any interest or penalties. That's a real vindictive fucker for you :)

          Plus, I think you've misconstrued tax withholdings with matched contributions. Whatever the employer garnishes from me (which is kind of the correct word here), is consensual, and 100% goes towards my tax bill at the end of the year. That is simply an accounting preference we all get to make, whether we want no withholding or max. There is no theft of any kind here, but the employer acting on my behalf in accordance with law.

          Feel free to chose to interpret it in the way which makes you angry.

          Not angry, but I wholly disagree with you. Still, we're talking about accounting semantics at the moment and missing the overall point. Which is that the bosses (MBAs, board, and shareholders) are stealing from all of us, with the amount stolen being the difference between a living wage and the raw amount of one's check. All of the taxes and whatnot, are being paid by me direct with money given to me for work production. The employer does not pay my taxes for me, I do. So whatever taxes do exist, are they for me to satisfy, and are hence included in the living wage, and are treated as an expense by me. You can't treat something as an expense without the corresponding (double entry accounting) credit.

          The original overall point again being, if the 1% were killed off, and the corresponding avarice removed from our society, you would see the cost of medical fall, while at the same time wages would raise to cover them. Eventually, we would look at each other, realize we live in wealth and abundance, and it's not even a thang to get your kids broken bone set at the hospital. No Soviet style bread lines to get seen, and no drama. Just an advanced society at work with sustainable practices and behavior. Nothing is more sustainable than paying people living wages, as that is a sustainable wage by definition.

          Likewise, any wage that is not a living wage, is unsustainable. Until, and unless, we truly become comfortable with watching people die in the streets while existing in abject poverty (like India) we will continue to argue bitterly about our social programs.

          We bring it all on ourselves by being so fucking weak and not engaging in extremely strong and persuasive group representation. By strong, I mean pre-American Revolution strength where we burned down the tax collectors house and ran them and their family out of town on a log so to speak.

          That's why I'm so disappointed in the American coal miner. What fucking pussies they've become. They used to unionize and fight the hell out of the coal barons. Instead of taking the coal baron out back and beating the living fuck out him till he pays them well enough, they listen to the avarice and entitled whining of the dude.... and then vote for Trump. At the end, we share responsibility for accepting the unsustainable work offers, and then not fighting for something better. The time to start fighting again was over 20 years ago, and now we have no fight left. Too weak.

          --
          Technically, lunchtime is at any moment. It's just a wave function.