Immigration is Destroying America.

[TemplarKormac]

My only delerium might be in why do I even respond to stuff like this ?

"delirium"

Try using words you actually know the meaning of.

I'm the POET in this thread. I use words as I see fit.

http://www.usmessageboard.com/writing/64331-poet-s-corner-78.html

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

 

[Unkotare]

"delirium"

Try using words you actually know the meaning of.

I'm the POET in this thread. I use words as I see fit.

http://www.usmessageboard.com/writing/64331-poet-s-corner-78.html

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

I know he deserves it, but don't abuse the mentally infirm too badly.

 

[RKMBrown]

I'm the POET in this thread. I use words as I see fit.

http://www.usmessageboard.com/writing/64331-poet-s-corner-78.html

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

I know he deserves it, but don't abuse the mentally infirm too badly.

Yeah, save something for the rest of us to take a swing at

 

[protectionist]

"delirium"

Try using words you actually know the meaning of.

I'm the POET in this thread. I use words as I see fit.

http://www.usmessageboard.com/writing/64331-poet-s-corner-78.html

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

As a poet, I exercise artistic license. Your teacher at school could explain it to you.

 

[protectionist]

1. Some people have be told twice.

Indeed they do.

NO, I did NOT make an "assertion". You are belittling it [what protectionist claimed] to that [an assertion], to fit your own biased agenda.

Belittle? You find logic belittling?

How about vocabulary? Do you find English Vocabulary belittling?

as·ser·tion (ə-sûr′shən)
n.
1. The act of asserting.
2. Something declared or stated positively, often with no support or attempt at proof.



Then you should have no probably finding one shred of evidence that corroborates your claim, if it is so obvious and well known.

Here is a link that can help:
Google


Disingenuousness? I think there is some disingenuousness in this thread, but it is coming from you. You spend a lot of time on these posts, so I am inclined to think you are not just trolling for lulz, but other than the amount of time that is required to type out your long numbered lists you do follow that old billygoat-eating pattern.


Legal immigrants are Americans. Immigration is how we all got here. How do you differentiate between "Americans" and "Legal Immigrants to America"? Is there some criteria you are not specifying? Are you including foreign workers on visas or are you just angry at brown people?

But that was not your original contention.


Let's not lose sight of the edge of the rabbit hole.


Oh my, so you really think Americans are all white. What does that make darker skinned people living here... Canadians?


Wow. How could they? I mean, how could they? I'm asking you, how could millions of white males not be losing jobs as a result of that AA given that they are not?


I want to quote South Park now
"They took our jobs!"



I'm sure they look forward to your calls.... your many many many many many calls.


Did you just accuse the EEOC of protecting "muslim terrorists"? I'm not outraged... I mean... really?
Do you live under a bridge? Do you enjoy fresh goat? Perhaps a little one, then a medium sized one, then a larger one, that sort of thing?


I don't like picking on someone's spelling but "affirimative action" is kind of funny. You said AA is "pure racism" but you have not reconciled that with the existence of the authority of the Supreme Court.


Was that last statement a question?
You specifically said that AA was "pure racism", and made quite a fuss about AA being "pure racism" but then you say de jure racial segregation is not like AA, which means you don't think de jure racial segregation is "pure racism".
I'm afraid to ask what you think de jure racial segregation is.



No, that's the legislature that makes laws, not the judiciary.


The antecedent is ambiguous. But it is evident that you think laws and courts are "optional".



There's no such thing as "unconstitutionality laws".

Oh, I get it now! You have confused this section of the forum for the FICTION section!
Oh, wow, this all makes sense now. Okay... Let's do that!


I happen to know someone who never filled that crap out, but then they turned into a zombie...
Oh wait, that person was me!
Or did I get bit? I don't know, fail to fill out an optional AA questionnaire or get bit, either way one turns into a zombie.



Such that I might fill out a menu complete with different flavors of human flesh... I mean so you can fight for liberty, of course!
yeah, that's the ticket!



Does Affirmative Action, in any way, help societal cohesion and integration? Because if so, as a member of the vanguard of a horde of the undead, I would be against anything that would help organize resistance against our slow moving horde.



Evidence please.



Just because you decide to start calling racism AA does not mean the rest of us have to follow suit. You can start calling apples oranges and bananas pears (and I'm certain you'll try it and frustrate the heck out of the checkout clerk) but the rest of us like the language as is.
Oh, wait we're still in fiction mode...

Well then it sounds like AA is a terribly divisive policy that I'll be sure to support to foment dissent among the ranks of the living.




Bullies are bad! Let's eat them!


Must be so hard to be a white male. I wouldn't know. I'm actually reanimated flesh, and the blue green discoloration really overpowers any former pigmentation.



You are claiming SCOTUS has no de facto authority? Because that would be really useful when my horde arrives. I mean, usually a civilization collapses a few weeks into a zombie apocalypse; but if the judiciary is already powerless that really makes the march of the undead so much easier.

And when millions of foreigner pour into the country, hungry for jobs,

Hey, hey now! I represent an interest group of reanimated corpses who desire to pour into this country hungry for living flesh... I mean jobs... we zombies are hungry jobs... yeah, that's the ticket!

and they are in the AA preference groups (ex. Hispanic), those racist AA employers will hire THEM, rather than white Americans (but they'll probably hire the immigrant anyway, for the low wages and working conditions he'll accept).

We zombies seek ... jobs... but not your jobs... oh no, that's the Mexicans! We zombies seek other... jobs. That's right, it's the Mexicans you need to fear. We zombies only want to help you build a tall wall so you can't get away... I mean keep out anyone who could help you... I mean live free! That's right, live free! Yes, yes, yes, free range... Yes! Free range is so much tastier... I mean, more American! yeah, that's the ticket!

Go apply for a job (especially a govt one) When they hand you an application with an AA questionnaire, you've got your evidence (in your hand). Hey. Didn't we already go over this ? Sure we did. And if I bother to address the rest of your tape measure rant here, we'll be trodding over old ground, in which I handed you your ass in Posts #s 1406 and 1415. So, no need to do that, just to accomodate your make-believe posture, that you still have something substantial to say.

PS - you need to quit using the term "which means". You're already looking bad enough in this thread with the other statements you're making. As for your zombie talk, Pheeeeeeeeeww!! (high-pitched whistle, eyes rolling around in head, .....NO, not hardly.)

 

[protectionist]

I'm broke man. I'd bet rep, but it's non transferable.

No, protectionist will summon up the trollish energies of Stormfront, and go on another 100 pages of nonsense.

If you're referring to that pitiful post of Zombie Pundit, no Stormfront or any web site is needed to refute stuff that refutes itself.

No. You just have no ways of refuting it.

Other than the ways I used to refute it. Every bit of it. When somebody comes along who has a substantial argument to present, then we could discuss if I refuted it or not. This guy had nothing to say. ZERO.

 

[protectionist]

LOL.

Protectionist got whooped again.

Protectionist has NEVER been whooped in this forum. Least of all by you, Puppy.

 

[protectionist]

I'm the POET in this thread. I use words as I see fit.

http://www.usmessageboard.com/writing/64331-poet-s-corner-78.html

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

I know he deserves it, but don't abuse the mentally infirm too badly.

Punkotard emerges from his slumber. Pssssht. Pssssht. (sound of disinfectant being sprayed in the room).

 

[Unkotare]

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

I know he deserves it, but don't abuse the mentally infirm too badly.

Yeah, save something for the rest of us to take a swing at

I think reality has already beaten any sense he might once have had right out of him. Can't say he didn't have it coming...

 

[protectionist]

No, you're the idiot in this thread.

And you will spell words correctly while being pummeled in this debate!

I know he deserves it, but don't abuse the mentally infirm too badly.

Yeah, save something for the rest of us to take a swing at

Yes, keep having fun on that swing. And the monkey bars. And the see-saw. And the sliding pond.

 

[protectionist]

I know he deserves it, but don't abuse the mentally infirm too badly.

Yeah, save something for the rest of us to take a swing at

I think reality has already beaten any sense he might once have had right out of him. Can't say he didn't have it coming...

Is there a doctor in the house ?

 

[Unkotare]

Foreign-Born Health Care Workers in the United States | migrationpolicy.org


Doctor, Doctor, Why Won't America Let In More Doctors? - Forbes

 

[Unkotare]

Searching For Asian America . Foreign Born Doctors | PBS

Foreign-Born to Help Fill Gap in U.S. Doctors : Immigration Impact

 

[protectionist]

Doctor, Doctor, Why Won't America Let In More Doctors? - Forbes

Maybe because the American people aren't quite comfortable with the sight of an untrustable foreigner with a knife in his hands ?

 

[protectionist]

Foreign-Born to Help Fill Gap in U.S. Doctors : Immigration Impact

There is no "gap".

 

[Unkotare]

It seems that many Americans rightly trust dedicated physicians like Dr. Gascon. Of course, any xenophobic bigmouth squawking on the internet would likely cry like a baby and beg him for help if said bigmouth's life depended on the good doctor's experience and expertise. Funny how that works...

Searching For Asian America . Foreign Born Doctors | PBS

 

[TemplarKormac]

Foreign-Born to Help Fill Gap in U.S. Doctors : Immigration Impact

There is no "gap".

Yeah there is. Between the left and right hemispheres of your brain.

 

[protectionist]

Foreign-Born to Help Fill Gap in U.S. Doctors : Immigration Impact

There is no "gap".

Yeah there is. Between the left and right hemispheres of your brain.

You really must stop talking to your mirror like that. There is no shortage of doctors in the US, because immigrant doctors fill the void wherever it occurs. And we fulfill the doctor demand that way. You don't have any objection to that, do you ? If so, let's hear it.

 

[Unkotare]

https://www.aamc.org/advocacy/campaigns_and_coalitions/fixdocshortage/

 

[protectionist]

https://www.aamc.org/advocacy/campaigns_and_coalitions/fixdocshortage/

After reading this post, it will be known by all that there really isn't a doctor shortage in the US, and all who proclaim there is, are only talking about a very limited scenario of how health care is currently (inefficiently) managed, and are not aware of the WHOLE PICTURE, as described in this post, which completely REFUTES THE NOTION of a DOCTOR SHORTAGE.

Whether there is or isn't a doctor shortage is the US, is an issue that is highly debateable. On one side are the doctors (and immigrationists). On the other side are the nurse practitioners, "medical-home model" proponents, and others who back cost-effective delivery systems, and deploy different types of professionals to provide healthcare, as well as non-health care duties that doctors spend a lot of time on (ex. clerical work).

Health systems and businesses are finding ways around the physician shortage by deploying doctors and professionals who aren't physicians in more cost-effective models.
These innovative organizations are figuring what work needs to be done by a doctor and what work can better be done by different types of providers. They are optimizing the use of different professionals in patient-centered medical homes, accountable care organizations and retail clinics, which may well reduce the number of physicians needed. Some of these changes have been tenaciously opposed by organized medicine, but many physician leaders are embracing the new models.

The physician-shortage crisis is based on assumptions that “could be far from the mark … if the production function for primary care can, indeed, be changed,” wrote David Auerbach and other Rand Corp. researchers, in the November issue of Health Affairs, which focused on physician workforce issues. They said the shortage issue could be solved through technology and reallocation of responsibilities.

Dr. Scott Shipman, AAMC director of primary-care affairs, wrote in the same issue of Health Affairs that if physicians reassigned 30 minutes of their daily clerical tasks to a nonphysician in their office and spent that time with one patient, it would generate between 30 million and 40 million more physician visits a year. That's exactly what patient-centered medical-home practices are trying to do.

The new delivery models offer hope in the face of the AAMC's bleak outlook. According to the association, the biggest obstacle to increasing the physician workforce is that Medicare funding of physician training has been essentially frozen since 1997.

While medical and osteopathic school enrollment continues to climb, the number of available residency slots remains stagnant. One result was that 528 graduating medical school seniors did not match with a residency program this year, as many as twice the number of seniors who went unmatched in 2012, the AAMC reported.

This year, medical school enrollment broke the 20,000 mark for the first time ever, while enrollment in osteopathic medical colleges grew by 4.9% to 23,144.

Growth in physicians in residency training has been much slower. According to the Accreditation Council for Graduate Medical Education, the 2012-13 resident workforce totaled 117,717, a 1.8% increase from the previous year.

Each year, a bill is introduced in Congress to expand residency slots. And each year, the legislation goes nowhere. Both the Obama administration and Congress have proposed spending less on GME programs.

Colorado Association of Nurse Anesthetists >>
Reagan Myers is a nurse anesthesia resident who is training in Colorado, where a scope-of-practice fight will be reviewed by the state's Supreme Court.

Other experts are much more skeptical of the claimed physician-shortage crisis. RAND Corp. researchers argued in Health Affairs that properly staffed, nurse-managed health centers and doctors' offices that have adopted the patient-centered medical-home model have shown that provider organizations can serve more patients better with fewer physicians as long as they have the right team and right processes in place.

Dr. Xavier Sevilla, vice president of clinical quality at Catholic Health Initiatives, an Englewood, Colo.-based health system, said shifting to the medical-home model requires a major reallocation of staff duties. And that requires cultural changes among physicians and other clinicians. Physicians currently do lots of tasks that do not require their level of training and they must learn to delegate to other types of professionals, Sevilla said. The medical-home and “medical neighborhood” models are key parts of CHI's goal of delivering coordinated care by physicians and other providers who work to the top of their licenses.

Dr. Thomas Graf, chief medical officer for population health at Danville, Pa.-based Geisinger Health System, said the same changes have taken place at his organization. “We pushed processes from docs to nurses, and pushed administration from nurses to the front desk and to the computer,” Graf said. Geisinger has implemented the medical-home model at 45 practices it owns and 45 independent practices.

Clinicians who aren't physicians, such as nurse practitioners, have seized on the doctor shortage issue as an argument for expanding the clinical activities they are allowed to perform, such as writing prescriptions. Organized medicine counters by arguing that nurse practitioners are no more likely to practice in underserved areas than physicians are.

These scope-of-practice fights have been fierce in many states.

Even so, 17 states, including California and Colorado, have allowed certified registered nurse anesthetists to practice without being under the supervision of a doctor. The issue will be considered by the Colorado Supreme Court. The Colorado Hospital Association supports letting the nurse anesthetists practice independently, while physician groups oppose it.

But these scope-of-practice battles may be increasingly moot. All the leading organizations that offer accreditation or recognition of patient-centered medical-home practices, including the National Committee for Quality Assurance, offer medical-home recognition to practices led by clinicians other than physicians, such as nurse practitioners and physician assistants.

Market drives change >>
And the market is driving change as well. Retail clinics are growing rapidly around the country and now total around 1,400. These clinics generally are staffed by nurse practitioners who operate without onsite physician supervision. In 2010, an estimated 4.1 million families used a retail clinic, according to a study by the Center for Studying Health System Change.

Getting care in retail clinics tends to be cheaper than care in physician's office or hospital-based care, and that's attractive to patients who face increasing cost-sharing burdens under their health plans. The average cost of a 14-day episode for the 10 most common diagnoses treated in a retail clinic was $484 to $543, depending on the state, according to a report in the November Health Affairs. The comparable cost of treatment for those diagnoses in doctors' offices, hospital outpatient departments and hospital emergency departments was $704.

There are more than 750 MinuteClinic locations owned by CVS Caremark Corp. in 25 states and the District of Columbia, and they have expanded from dealing with minor illnesses and injuries to monitoring chronic conditions such as diabetes and hypertension, and administering children's physicals. CVS plans to have 1,500 MinuteClinics by 2017.

Deerfield, Ill.-based Walgreen Co. has opened more than 400 Healthcare Clinic locations staffed mostly by nurse practitioners. The clinics administer vaccines; do physical exams; conduct screenings for common conditions; and monitor and manage some chronic conditions.

In late October, Walgreen's clinics were accredited by the Accreditation Association for Ambulatory Health Care, based on providing patient-centered, accessible, comprehensive care in coordination with a patient's primary- and specialty-care providers.

Pharmacists are also playing a bigger role. Last year, Walgreen launched its WellTransitions program in which its pharmacists work with local hospitals to prevent hospital readmissions by helping make sure patients receive and take their medications.

Along the same lines, in April the University of Nebraska Medical Center's College of Pharmacy, Omaha, was awarded a $369,000 grant from the National Association of Chain Drug Stores Foundation to test how pharmacy-provided medication management could help patients in ACOs and medical-home practices control their diabetes and high blood pressure. Walgreen, the Kearney (Neb.) Clinic multispecialty practice, Blue Cross and Blue Shield of Nebraska and the Nebraska Health Information Initiative are participating in the initiative.

http://www.modernhealthcare.com/article/20131109/MAGAZINE/311099992