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Friday, February 28, 2014

The Pros and Cons of Increasing the Federal Minimum Wage.

The Pros and Cons of Increasing the Federal Minimum wage.


Increasing the federal minimum wage could result in a net job loss of

approximately 500,000 workers (0.3%) (as the CBO states 0 percent impact on

employment is a reasonable trade off), although it would mean increasing

wages for 16.5 million others.


According to the Congressional Budget Office,  2 positive effects would occur

by increasing the minimum wage which would be: It would increase the family

income for 16.5 million,  and for approximately 900,000 of these workers they

would be lifted out of the federal poverty bracket.

The negative effects would be for the same said workers would be the

elimination of some jobs.

This is a "for the greater good" argument - are there more that would benefit

or more that would lose from this minimum wage increase? If you look at it in

those terms of black and white it appears it will be more of a positive than a

negative.

The proposal is to raise minimum wage from the current $7.25 an hour to

$10.10.

As a group, workers with earnings being increased would be paying more in

taxes and receive a reduction in federal benefits, however the trade off is

those few (in relation to those receiving a wage increase) who do lose their

jobs would pay less in taxes and have their federal benefits increased -

nullifying the positive and negative effect either way, in that respect.

Therefore, since it is estimated more people would be being positively

effected (16.5 million) versus those who would lose their jobs (500,000), the

wage increase appears to be something to be supported.

Republicans that are against this seem to have an insecurity issue. Does

supporting the lower income workers somehow threaten their elite salary

status? Does oppressing those who are already repressed somehow make

them feel more powerful?

This is an issue of wealth redistribution that seems fair, but the wealthy are

constantly wanting lower taxes - so they want to obtain their wealth and

continue increasing their income - it sounds like greed to me!

The world is a better place when everyone is happy - when equality is a goal

to be achieved, not something to avoid. We should not be striving to make the

gaps between income levels larger - but working to bring everyone closer

together.

What the wealthy seem to forget (often conveniently) is that where they came

from often supports where they end up. The wealthy will say that they have

worked hard for what they have and for what status they have achieved in life,

however, they fail to recognize to themselves and others that they were

brought up in a very conducive environment to allow their success to be

realized.

Often those that have come "from nothing" and have made something of

themselves - who have achieved a high status in the world - do not embody

the attitude that those who have come from nothing and have not achieved

great things should be further oppressed - but generally support the very

programs and services that allowed them to achieve the income and social

standing they are currently enjoying. Generally these people that have

achieved great things despite their background are very grateful and wish to

encourage and support those that came from the very beginnings they did.

It is very easy to live in a bubble when you are wealthy and forget about those

who are less fortunate than you are, but that is not a very "American" stance

is it? Aren't we "the land of opportunity"?

Republicans seem intent on highlighting that the focus should be on creating

not destoying job opportunities - but this seems just a convenient argument. If

they really cared about those less fortunate - why would their platform

generally always be about decreasing funding to social programs that

support the less fortunate? About increasing taxes for the poor and

decreasing taxes for the rich?

Personally, as our household income has increased throughout the years our

party idenitifcation could much more lean to the right, but morally and

ethically I cannot allign myself with a party that seems to want to keep those

that are at the lower end of the income bracket continually oppressed.

Equality is very important to me in all forms - racial, gender, sexuality, and

income. I enjoy seeing those less fortunate and who have come from meager

beginnings rise up and thrive - and if I can assist them through direct contact,

or taxes, or by being on the supporting end of passing laws that make it

easier for them to make something of themselves despite their humble

background then I'm all for it.

As House Minsority Lader Nancy Pelosi, D-California has stated, "It's time to

give America a raise" and I have to agree with her.

Wednesday, February 12, 2014

http://www.washingtonpost.com/opinions/charles-krauthammer-the-health-care-myths-we-live-by/2014/02/06/8a74d7b2-8f66-11e3-84e1-27626c5ef5fb_story.html?tid=pm_pop


Being a nurse I found this article from 'The Washington Post' interesting.  Alot of the information provided are issues that we observe in the hospital setting. We are often frustrated by the same circumstances that are mentioned in this article. The commentary touches on, but does not explain in depth, why these discrepancies between fact and fiction may exist.

The author, Charles Krauthammer, does have medical background. Mr. Krauthammer practiced medicine for three years as a resident and progressed as a chief resident in psychiatry at Massachusetts General Hospital in the 1980s. It is interesting how his background in medicine and current status as a political commentator (on Fox news) mesh and co-exist. He was also a speechwriter for Vice President Walter Mondate and helped direct planning in psychiatric research for the Carter administration.

I found this article to raise some interesting questions, but it left me with many more questions and not alot of answers.

Below I have addressed several of the topics mentioned in Mr. Krauthammer's  editorial entitled, "The health-care myths we live by".

On the issue of vitamin supplements and the ongoing debate on whether they are useful, useless or harmful continues, as stated in the article. Why might this issue continue to baffle? The issue exists because the studies and experiments used to determine situations such as these (supplement effects) are reported in lag time. A delayed reaction if you will. Many of the studies and research that are conducted take an extremely long period of time to complete and are done in a variety of different environments, with different populations, and under varying circumstances. Thus, since the outcomes of the research become available at different times (depending on the technology available at the specific time the studies were conducted) and invariably are different. The outcomes of the research , since many of the studies conducted are not the same - but are testing essentially the same or nearly the same hypothesis - are going to be in conflict. It is similar to attempting to do research on the internet - you are going to find claims against and for an argument - but this gets an indivdual no closer to the truth, unfortunately. This is why some studies for supplements (and depending on who is conducting the research and whether they are wanting a positive or negative outcome) are going to be in favor of them and others against them. You also have outdated information that some portion of the population has latched on to, while updated information is being circulated as well. As the article mentions, antioxidants have long been touted to be beneficial, while new research may be suggesting that to be untrue or that they may even be harmful - it will take a certain amount of time for that information to circulate and become common knowledge.

In the medical community, generally, procedures are continued to be viewed as a staple and actively practiced until concrete evidence is available to challenge it.  As in the case of tonsillectomies, this was a widely practiced procedure - then when the research came back that it was unnecessary, for the most part, the routine procedure was, in most cases, abruptly stopped. In the medical community, issues are often based on scientific fact. The medical community is unable to waver back and forth on an issue, it must come together, examine the evidence, and make a concrete decision and stick by it. The medical community actually has to ACT ON the said research - not just decide to be for or against it - and to actually believe in it and take an active stance on it.

The author's suggestion that, "This is not to indict, but simply to advocate for caution grounded in humility" is fine for the average person, but what if you are a nurse or doctor having to assimilate fact from, literally, "fact", and actively practice and incorporate the information into your profession? Humility is not really the issue - it's an issue of attempting to provide the most accurate data available for the medical community to make the best decisions possible for it's patients. Often if a medical provider is not confident in the information that is being provided to patients, the patients become frustrated and are incapable of making individual health decisions - in some cases waiting to make a decision can be lethal and no action is the same as making a decision and sometimes it can be the wrong one.

The issue the article brings up a widely heated debate surrounding ER visits for the uninsured. We see this very frequently at the particular facility I am employed by.  What the author fails to mention are possible reasons for this other than "perhaps they still preferred the immediacy of the ER to waiting for an office appointment with a physician." I believe the problem is more indepth. Attempts to insure and place the patients on medicaid may work for a fraction of the population - but let us analyze the population. The particular assemblage in question is made up of those at the lower end of the income bracket. Generally these people are made up of people who are uneducated or under-educated, when the government wants to suddenly insure and place people on medicaid there is education that needs to go along with this change? Education needs to be provided at a level that ensures understanding for this population - otherwise the said population is more confused than ever.  When statistics are reflecting that ER visits have actually gone up since insuring a percentage of this population, is it being taken into account the rise and fall of unemployment? A habit is often created after a certain period of time and continued practice of a new behavior - has there been time allowed for it to become a habit to no longer frequent the ER and instead utilize insurance and making physician appointments? There would be people continually on either end of the spectrum utilizing insurance - those newly placed and those who obtained insured status months or even years from the time the study was conducted that states "...in a randomized study, Oregon recently found that when the uninsured were put on Medicaid, they increased their ER usage by 40 percent." Oregon does not constitute the entire nation. It seems apparent the author is attempting to sway his target audience (those against insuring the unisured and those who are undecided) that medicaid and insuring those previously uninsured is not a solution and has not been effective in reducing ER usage for this portion of the population.

On the issue of the federal government forcing doctors to convert to electronic health records and that this will "..save zillions" - this is true and false - and in writing this article I'm not sure where the author came up with "zillions" as a quotable, factual or believable figure. Employing "scribes", as they are called, and as one can imagine (at a mediocre salary at best) is far less expensive, in the long run, than having a highly-educated and well paid MD performing the mindless task of data-entry. Are "scribes" having to be employed due to EHS mandates? Yes, and at a cost, but far less than the alternative.

Over-all I would state that the view points of the author leave much to be desired. I would have appreciated a more indepth article, especially given the author's background in medicine. I believe this article was to reinforce right-wing perceptions that insuring the uninsured, preventative health-care, and mandated reforms are all unnecessary and to persuade those undecided to the right.