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Should employers be allowed to opt out of offering treatments they object to?
Posted: 29 May 2013 06:35 PM   [ Ignore ]   [ # 31 ]
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Its an interesting point you bring up Mariana. Ive heard similar arguments made for other things too such as fertility treatments. Technically infertility does not affect your health and since under-population is clearly not a problem its hard to argue that this is a necessary service. Others may disagree obviously but these sorts of arguments can be made for many treatments. Whatever system we come up with we will have do decide on a set of basic services that everyone should have access to and perhaps a set of optional services for which coverage could be purchased separately if so desired.

I suspect there would be a great deal of disagreement among the population as to what services are basic and necessary and what ones should be optional and in all likelihood reason will not guide the outcome.

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Posted: 29 May 2013 08:03 PM   [ Ignore ]   [ # 32 ]
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macgyver - 29 May 2013 06:35 PM

Its an interesting point you bring up Mariana. Ive heard similar arguments made for other things too such as fertility treatments. Technically infertility does not affect your health and since under-population is clearly not a problem its hard to argue that this is a necessary service. Others may disagree obviously but these sorts of arguments can be made for many treatments. Whatever system we come up with we will have do decide on a set of basic services that everyone should have access to and perhaps a set of optional services for which coverage could be purchased separately if so desired.

I suspect there would be a great deal of disagreement among the population as to what services are basic and necessary and what ones should be optional and in all likelihood reason will not guide the outcome.

IMHO, preventive medicine should be covered and if there is a problem, such as cancer or diabetes, treatment for it covered also.  However, this leads to the question of Women’s Health Care.  Sometimes termination of a pregnancy is not optional, but necessary for the mother’s health and/or life.  Therefore, people would still argue even about preventive care and treatments, as you pointed out, so I think it boils down to individualized preventive medicine and treatment, which is the long run could be better or worse, esp economic wise.  Having a one size fits all plan won’t work, esp when we get down to women’s health v men’s health and in some cases, illnesses such as sickle cell.  Health insurance is a very tricky thing when it comes down to humans, because, let’s face it, we aren’t all alike and we all don’t take the same interests that could affect our health- such as football.  I never liked the sport, but some people do and it can cause everything from pulled muscles to broken bones to concussions, then again, so can roller skating.  The point is, even if we eliminated things like sports medicine, we can’t eliminate Women’s health or specific illnesses like Sickle Cell.  There has to be some sort of compromise though and where do we begin?

Secondly, not every black person is prone to Sickle Cell and a small percentage of white people can get it, but is it necessary for everyone to be insured for such an illnesses? Do those of us with American Indian heritage pay more because we are prone to diabetes?  Men don’t get pregnant, but are prone to male specific cancers, just as women are.  Do women pay for coverage of male conditions and do men pay for coverage of women’s conditions?  Do athletes pay for sports oriented insurance?  Should treatment for substance abuse be covered?  Should mental illness be covered, even when one doesn’t have a mental illness or could just take something like Zoloft for depression, only seeing a physician?  The list goes on and on and arguments could be made for everything.  BTW, some people would argue that mental health treatment isn’t necessary or effective too.

Granted, many things, such as questionable treatments and proven not to work treatments, aren’t necessary for anyone, but some things are necessary for some people.

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Posted: 29 May 2013 11:43 PM   [ Ignore ]   [ # 33 ]
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macgyver - 29 May 2013 06:35 PM

Its an interesting point you bring up Mariana. Ive heard similar arguments made for other things too such as fertility treatments. Technically infertility does not affect your health and since under-population is clearly not a problem its hard to argue that this is a necessary service. Others may disagree obviously but these sorts of arguments can be made for many treatments. Whatever system we come up with we will have do decide on a set of basic services that everyone should have access to and perhaps a set of optional services for which coverage could be purchased separately if so desired.

I suspect there would be a great deal of disagreement among the population as to what services are basic and necessary and what ones should be optional and in all likelihood reason will not guide the outcome.

How is it handled in the countries with the best health care systems? The ones where the most people get decent health care. France seems to be at the top of many lists while the US is way down behind a lot of much poorer countries. We could learn something by studying their systems and emulating them. Where there’s a will, there’s a way. 

Lois

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Posted: 30 May 2013 04:03 AM   [ Ignore ]   [ # 34 ]
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Mriana - 29 May 2013 07:01 AM
mid atlantic - 29 May 2013 12:49 AM

I think they should be able to opt out of some things. Alternative treatments that don’t have any scientific evidence, for one.

Even then, I think people should have freedom of choice.  A holistic dr who uses both is better than one who is completely alternative, in part because a holistic dr uses both scientifically proven methods and methods still needing tests to prove their efficacy and usefulness.  However, if s/he used both at the same time, it would be difficult to prove the alternative was effective.

For example:  My older son is studying to be a massage therapist and according to him massage is an effective treatment for premie babies.  I did some research and it’s not so much the massage, but rather the human touch, which humans thrive on and even need, because we are born social animals.  That in conjunction with scientifically proven treatments could be a boost for babies born premature.  It won’t trigger lung development or alike, but it does give that social aspect that humans need from birth.

In sports injuries, massage allegedly stimulates blood flow to the injured area, thereby assisting in helping it heal and currently used for some people, with certain injuries, in conjunction with physical and rehabilitation/occupational therapy, as well as any medications the doctor Rx.

In his chosen field of study, massage therapy isn’t the only treatment patients are given, but it is combined with other treatments.  Before any massage is given, he inquires about the person’s medical history and any meds they maybe on.  If there is a potential for a clot, then massage therapy isn’t an option, from what I understood.  Certain or recent neck injuries could also exclude them from massage therapy too.

I was skeptical at first, concerning his chosen field, but then I did some research, beyond the information the school gave out to students and their parents.  Of course, when he started at age 20 (now 24) my hands were a bit tied to stop him, if I didn’t agree, but instead of arguing with him, I did research on massage therapy, even on massage therapy v a spa massage, which apparently are two different categories of massage.

My point is, some [alternative] treatments are therapeutic and in conjunction with proven methods, could lead to new viable treatments.  I don’t think we should exclude all things that are considered “alternative”.  Even allegedly proven physical and rehabilitation therapies aren’t necessarily good and medical professionals have been known to change their minds about certain OT and PT methods.  Apparently, massage therapy is becoming a more acceptable course in conjunction with PT and OT and not just something for spas (which is a different kind of massage with a different course of study).  Spa doesn’t have much by way of study of muscles and bones.  Therapeutic massage studies muscles and bones.

Whatever the case, my son does give good massages, providing temporary relief, at least with muscles full of stress.  I still have some skepticism, but I’m still researching it too.  However, the field he is going into is not the end all and be all treatment for sports injury or any other injury patients or even for premature babies.  There’s more to their treatment than that, but it seems to be receiving attention and is becoming part of the Tx within some patients OT and/or PT.

AFAIK, massage has long been used as part of physical therapy in injury recovery, so is not really considered alternative treatment.

Regarding it’s use with premature babies, I have no idea. There is definitely validity to massage in physical therapy, though.

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Posted: 30 May 2013 01:58 PM   [ Ignore ]   [ # 35 ]
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asanta - 29 May 2013 03:20 PM

We don’t use massage therapy on our preemies where we work. No proof of efficacy, and personally, I can see it as being harmful.

Wejj, there is this:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844909/

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Posted: 30 May 2013 02:24 PM   [ Ignore ]   [ # 36 ]
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Also, a small number of studies “on the benefits of massage therapy for infants less than 6 months of age (and were not pre-term or underweight) found tentative evidence of benefit for mother-infant interaction, sleeping and crying, and on stress hormone levels.”

I guess my point is that it is clear to anyone who has undergone regular massage treatments that it has positive health benefits, even for people who are already healthy.  As McGyver points out we can’t expect medical coverage of massage treatments, even applied by or under the direction of medical practitioners since the mechanisms by which it works or which specific maladies might be positively effected is not well known and documented. 

But I think that this points to another problem with our medical care system.  Massage therapy is an example of a potentially viable and efficacious treatment for various disorders, but there is a dearth of research to examine and verify this.  Meanwhile there is extraordinary amounts of research going on constantly in regards to pharmaceuticals.

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Posted: 30 May 2013 02:28 PM   [ Ignore ]   [ # 37 ]
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TimB - 30 May 2013 01:58 PM
asanta - 29 May 2013 03:20 PM

We don’t use massage therapy on our preemies where we work. No proof of efficacy, and personally, I can see it as being harmful.

Wejj, there is this:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844909/

Thanks for the link Tim. The study is interesting. I can certainly think of a number of non-magical ways in which massage may benefit babies since its possible it might stimulate respiration and other biological processes which could lead cause a baby to eat more. I’m not familiar with the journal that was cited so its not clear to me how rigorously these studies were examined. It might be interesting to know whether babies that were massaged do any better than a cohort that was simply held and cuddled by mom for an equivalent period of additional time. I have a suspicion that the outcome might be the same. Acupuncture studies have often shown similar results when sham acupuncture is compared to treatments given by “trained ” acupuncturists. Its often just the touch that is important rather than the actual specifics of how it is done.

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Posted: 02 June 2013 03:54 PM   [ Ignore ]   [ # 38 ]
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TromboneAndrew - 29 May 2013 08:35 AM
TimB - 28 May 2013 03:29 PM

I’m assuming that our middle class is largely composed of persons who would be classified as employees rather than employers.  But with that assumption, is it just a coincidence that our middle class (which is in severe decline http://www.infowars.com/84-statistics-that-prove-the-decline-of-the-middle-class-is-real-and-that-it-is-getting-worse/ ) was so much better off when there existed a countervailing Communistic world power?

The American middle class became affluent primarily because of the rise of the assembly line. Industrial revolution and stuff.

Ok, but didn’t Unions come out of that, and was the middle class not better off when Unions were strong?

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Posted: 03 June 2013 02:47 PM   [ Ignore ]   [ # 39 ]
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TimB - 02 June 2013 03:54 PM
TromboneAndrew - 29 May 2013 08:35 AM
TimB - 28 May 2013 03:29 PM

I’m assuming that our middle class is largely composed of persons who would be classified as employees rather than employers.  But with that assumption, is it just a coincidence that our middle class (which is in severe decline http://www.infowars.com/84-statistics-that-prove-the-decline-of-the-middle-class-is-real-and-that-it-is-getting-worse/ ) was so much better off when there existed a countervailing Communistic world power?

The American middle class became affluent primarily because of the rise of the assembly line. Industrial revolution and stuff.

Ok, but didn’t Unions come out of that, and was the middle class not better off when Unions were strong?

Yes everything in all of this is true. the assembly line, the countervailing force of Communism, the Unions.
The other strong force in my opinion is when our country was more Nationalistic, economically and socially.
All of this here is encapsulated in a stronger sense of nationalism.
We are losing this identity…and with it we are losing much more than we know.  Although we are feeling the effects as noted above.
We identify the symptoms, we can’t and/or won’t identify the problem.

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Posted: 03 June 2013 04:41 PM   [ Ignore ]   [ # 40 ]
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macgyver - 30 May 2013 02:28 PM
TimB - 30 May 2013 01:58 PM
asanta - 29 May 2013 03:20 PM

We don’t use massage therapy on our preemies where we work. No proof of efficacy, and personally, I can see it as being harmful.

Wejj, there is this:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844909/

Thanks for the link Tim. The study is interesting. I can certainly think of a number of non-magical ways in which massage may benefit babies since its possible it might stimulate respiration and other biological processes which could lead cause a baby to eat more. I’m not familiar with the journal that was cited so its not clear to me how rigorously these studies were examined. It might be interesting to know whether babies that were massaged do any better than a cohort that was simply held and cuddled by mom for an equivalent period of additional time. I have a suspicion that the outcome might be the same. Acupuncture studies have often shown similar results when sham acupuncture is compared to treatments given by “trained ” acupuncturists. Its often just the touch that is important rather than the actual specifics of how it is done.

We encourage frequent skin to skin ‘kangaroo’ contact with the parent and containment to calm them. It works better than magical massage….

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Posted: 03 June 2013 04:42 PM   [ Ignore ]   [ # 41 ]
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TimB - 30 May 2013 02:24 PM

Also, a small number of studies “on the benefits of massage therapy for infants less than 6 months of age (and were not pre-term or underweight) found tentative evidence of benefit for mother-infant interaction, sleeping and crying, and on stress hormone levels.”

I guess my point is that it is clear to anyone who has undergone regular massage treatments that it has positive health benefits, even for people who are already healthy.  As McGyver points out we can’t expect medical coverage of massage treatments, even applied by or under the direction of medical practitioners since the mechanisms by which it works or which specific maladies might be positively effected is not well known and documented. 

But I think that this points to another problem with our medical care system.  Massage therapy is an example of a potentially viable and efficacious treatment for various disorders, but there is a dearth of research to examine and verify this.  Meanwhile there is extraordinary amounts of research going on constantly in regards to pharmaceuticals.

How do they know it is the massage, and not just the human touch, which it has been demonstrated that infants MUST have to survive and grow?

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Posted: 03 June 2013 05:27 PM   [ Ignore ]   [ # 42 ]
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asanta - 03 June 2013 04:42 PM
TimB - 30 May 2013 02:24 PM

Also, a small number of studies “on the benefits of massage therapy for infants less than 6 months of age (and were not pre-term or underweight) found tentative evidence of benefit for mother-infant interaction, sleeping and crying, and on stress hormone levels.”

I guess my point is that it is clear to anyone who has undergone regular massage treatments that it has positive health benefits, even for people who are already healthy.  As McGyver points out we can’t expect medical coverage of massage treatments, even applied by or under the direction of medical practitioners since the mechanisms by which it works or which specific maladies might be positively effected is not well known and documented. 

But I think that this points to another problem with our medical care system.  Massage therapy is an example of a potentially viable and efficacious treatment for various disorders, but there is a dearth of research to examine and verify this.  Meanwhile there is extraordinary amounts of research going on constantly in regards to pharmaceuticals.

How do they know it is the massage, and not just the human touch, which it has been demonstrated that infants MUST have to survive and grow?

Yes natural human contact is critically important in early development.  So unbiased research that is designed to control for that would be important in determining if massage is doing anything else.  (Of course, however, there must never be a control group of very young humans that has no natural human contact, as that would be grossly unethical, even criminal, I would say.)

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Posted: 03 June 2013 08:52 PM   [ Ignore ]   [ # 43 ]
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macgyver - 23 May 2013 01:47 PM

There is a challenge in the courts right now from several companies that want protection from a part of the ACA that requires employers to cover the morning after pill. I could go into the ignorance behind this complaint ( ie: that the pill induces an abortion - it does not) but the real question is whether we should allow exemptions at all. What if a company were owned by the Jahova’s Witnesses. Should they be allowed to deny coverage for blood transfusions to their employees?

Just one more reason why we need universal coverage. Its just another example of insanity in the existing system. You may have serious gaps in your coverage depending on who you work for and you may not even know it.

I think it is wrong and there should be NO exemptions. Lets say there is a “god,” wouldn’t he judge the person who actually decided on “sinful” medical therapies and not the unknowing company? However, there is another side to this: we decide where we work; if I was a female and wanted to make my own reproductive and birth control decisions, I wouldn’t go seek work for a Catholic company, knowing they hold a strong stance against my rights and reproduction.

Also, if med insurance is part of your benefits package, isn’t it “yours” kind of like your pay check? If employers can tell you how to spend your insurance money, what would stop them from telling a someone how to spend their paycheck? When you think about it, your paycheck is yours to do as you wish, whether that be donate large portions to a charity of choice, gamble it all away or whatever. Basically, if you’re offering med insurance, it’s part and parcel to the employees pay/package and thus no business of the employer how it is spent, just because they are contributing to it, the employee earned that benefits package and it is in the hands of the employee (just like a paycheck).

[ Edited: 03 June 2013 09:17 PM by FinallyDecided ]
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Posted: 03 June 2013 09:12 PM   [ Ignore ]   [ # 44 ]
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TimB - 02 June 2013 03:54 PM
TromboneAndrew - 29 May 2013 08:35 AM
TimB - 28 May 2013 03:29 PM

I’m assuming that our middle class is largely composed of persons who would be classified as employees rather than employers.  But with that assumption, is it just a coincidence that our middle class (which is in severe decline http://www.infowars.com/84-statistics-that-prove-the-decline-of-the-middle-class-is-real-and-that-it-is-getting-worse/ ) was so much better off when there existed a countervailing Communistic world power?

The American middle class became affluent primarily because of the rise of the assembly line. Industrial revolution and stuff.

Ok, but didn’t Unions come out of that, and was the middle class not better off when Unions were strong?

No, Unions arose because the middle class was being horribly abused. The whole point of unions, in the long term, is to make themselves unnecessary, however unfeasible that is in practice.

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Posted: 03 June 2013 09:47 PM   [ Ignore ]   [ # 45 ]
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asanta - 03 June 2013 04:42 PM
TimB - 30 May 2013 02:24 PM

Also, a small number of studies “on the benefits of massage therapy for infants less than 6 months of age (and were not pre-term or underweight) found tentative evidence of benefit for mother-infant interaction, sleeping and crying, and on stress hormone levels.”

I guess my point is that it is clear to anyone who has undergone regular massage treatments that it has positive health benefits, even for people who are already healthy.  As McGyver points out we can’t expect medical coverage of massage treatments, even applied by or under the direction of medical practitioners since the mechanisms by which it works or which specific maladies might be positively effected is not well known and documented. 

But I think that this points to another problem with our medical care system.  Massage therapy is an example of a potentially viable and efficacious treatment for various disorders, but there is a dearth of research to examine and verify this.  Meanwhile there is extraordinary amounts of research going on constantly in regards to pharmaceuticals.

How do they know it is the massage, and not just the human touch, which it has been demonstrated that infants MUST have to survive and grow?

The human touch is a big part of massage therapy with premature babies.  However, for others, it can be helpful in other ways by stimulating blood flow to area.  Be that as it may, as one with shoulder, neck, and back problems, I must say, it is rather nice to be the one who often gets practiced on during my son’s time in training.  When my neck, shoulders, and/or back are hurting (due to previous injuries), I must say it does feel nice for him to give me a therapeutic massage.  It’s kind of difficult to knock it when one feels better from it, esp when one doesn’t want to take potentially addictive pain medicine and muscle relaxants.  Massage or pain pills?  The choice is easy, esp when massage works better than the pain pills and muscle relaxants and I find the massage does work better than the pain pills and muscle relaxants.  1. It relaxes me 2. it some how eases the pain in less time and less rounds then the pills. 3. I can easily become awake and alert again with massage than with pills, when I have to.  4. between heat and massage, the muscle tightness lessen faster than with pills.  I find it the lesser of two evils, with better effects.  Since I have no insurance currently, it’s also cheaper for my son to massage my painful muscle tight neck, shoulders, and back.  If I must pick my druthers in this case, I rather go with massage therapy from my son than take costly and addictive pain pills and muscle relaxants.  Then again, I really don’t care much for taking pills, esp since most cause me to feel funny, sick, or (due to my size) to much for my system.  Many drs, except for my long time doctor, often Rx too much medicine for my size, causing me to prefer to go without it or avoid it as much as possible, if I can.  That and a lot of meds don’t set right with me.  For example, I went to the ER not long ago, with a painfully swollen and inflamed eye.  It was conjunctivitis, but the dr not only gave me an antibiotic to put in my eye (can’t massage the eye, but this is an example of my med intolerance) and Hydrocodacet with Acetominophine 5/325.  I ended up with an explosive headache and threw up not long after I took it (Maybe 2 hours later at most).  After I threw up I was OK after a while.  This happens with a lot of meds.  If not that, an allergic reaction- I lost 3 days from Penicillian, waking up in a white room (as a child) and my mother telling me, if I ever took it again, I’d die.

I’m not anti-medication.  It’s just a lot do not set right with me.  Some, I even have to cut the dose in 1/2 (if possible) to get better results.  Antibiotics not so much, unless they are in the Penicillian family.  Like many people, I won’t take anything that makes me feel bad or worse.  If the alleged cure is worse than the disease, forget it.

[ Edited: 03 June 2013 09:50 PM by Mriana ]
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