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2012 Sep 12, 4:50am   107,185 views  228 comments

by Patrick   ➕follow (59)   💰tip   ignore  

Who pisses off the other users the most? Let's see.

mysql> select username, dislikes / likes as trollishness from users where dislikes > 100 order by trollishness desc limit 10;

+-----------------+--------------+
| username        | trollishness |
+-----------------+--------------+
| Cloud           |       4.7667 |
| Honest Abe      |       3.3540 |
| Bap33           |       2.1308 |
| CaptainShuddup  |       1.8116 |
| KILLERJANE      |       1.6750 |
| Ruki            |       1.5085 |
| AlexS           |       1.4444 |
| thomas.wong1986 |       1.4337 |
| clambo          |       1.2775 |
| robertoaribas   |       1.2278 |
+-----------------+--------------+

mysql> select username, ignoredby from users order by ignoredby desc limit 10;

+--------------------------------+-----------+
| username                       | ignoredby |
+--------------------------------+-----------+
| APOCALYPSEFUCK is Shostakovich |        22 |
| PermaRenter                    |        18 |
| ArtimusMaxtor                  |        17 |
| Ruki                           |        14 |
| CaptainShuddup                 |        13 |
| repo4sale                      |        12 |
| Honest Abe                     |        12 |
| Dan8267                        |        11 |
| Bigsby                         |        11 |
| Cloud                          |        10 |
+--------------------------------+-----------+

The intersection of those sets is Ruki, CaptainShuddup, Honest Abe, Cloud.

« First        Comments 134 - 173 of 228       Last »     Search these comments

134   AlexS   2012 Sep 16, 12:54pm  

elliemae says

Alex - we get it - you don't like the Obamas and are trying to find a conspiracy

what a Kindergarden... he likes me he likes me not...

elliemae says

If Obama did what everyone else did, he wouldn't have become the first black president.

what? plz provide more context...

elliemae says

AlexS says

IT certifications are voluntary.

So are licenses to practice law.

try practicing law without license... just try it...

You can do IT without certifications, the latter only and arguably make you more marketable to some companies.

135   Bap33   2012 Sep 16, 12:59pm  

My bad ellie. I just lack the patients to find better vocabulary. In my little world, people that have a mind set that says it is ok to buy,sell,take illegal drugs for the express purpose of numbing the senses, and do not respect the law, are normally people I call libs. I understand you may not call them libs.

I also call an adjustable smooth jaw wrench a Cresent Wrench ... not all adjustable smooth jaw wrenches are Cresent Wrenches.

Equating the illegal buying/selling/using of a mind altering drug with segration seems a bit of a stretch.

I am against seatbelt laws. I only put my self in danger when I do not use my seatbelt. There was no seatbelt law when I started driving. My first car didn't even have seatbelts. No other person needs to break the law for me to not use my seatbelt. When I am not driving, there is no risidual effect from me not using a seatbelt. The LEFT side of the political room supported seatbelt and helmet laws, because they are NannyState piles of shit. But, I have to follow the law because it is expensive, and will cost me dearly should I be found driving without one. Now, just because a bunch of old hippys have not grown ot of the dope smoking age, and they are now in command of things, they actually have their minds set to believe that the law is what is wrong, not the mind altering behavior ... yea, nothing beats a burnout for deep ideas.

I do accept people for who I see them to be. Just like you do. I do not have to agree or like their morals or ideas, but who does? Everyone is more comfortable with people that are like themselves -- even dope heads.

136   Bap33   2012 Sep 16, 1:13pm  

Dan8267 says

But if that doesn't upset you, think about it this way. It's the state giving free housing and health care using your tax dollars. At least be upset that the prison industry is freeloading off of your taxes.

dude, I am so against jail as a form of punishment, you have NO idea! A violent crime should result in swift execution by hanging. Selling drugs is a violent crime. Raping kids is a violent crime. Murdering babies in the womb is a violent crime. Drunk driving and killing people is a violent crime. All violent crime should be met with the same swift punishment.

But, doing drugs is just a really bad choice, like masterbating in a public area or in public view. If all social support were not accessible by anyone found to be taking narcotics, so that the listless burnouts and speed freaks will just starve to death, as will there children to help clean the gene pool a little bit, then I would support full libertain social government.

The use of alcohol is much more natural than smoking, because drinking is a natural act. Smoking anything is unnatural and disgusting. I know, I know, libs tend to be intollerant toward a person with my views, and willing to call one thing natural and another thing unnatural. Their intollerance is amazing at times.

137   Bigsby   2012 Sep 16, 1:55pm  

Bap33 says

Their intollerance is amazing at times.

Whereas yours is entirely predictable.

138   elliemae   2012 Sep 16, 2:06pm  

AlexS says

try practicing law without license... just try it...

If you have no immediate desire to practice law, you don't need a license. They're not practicing. No great conspiracy there.

AlexS says

If Obama did what everyone else did, he wouldn't have become the first black president.

what? plz provide more context...

Elementary. There was no black president before him. Had he bought into the trend, he wouldn't be president now.

AlexS says

Alex - we get it - you don't like the Obamas and are trying to find a conspiracy

what a Kindergarden... he likes me he likes me not...

Exactly. Looking for a conspiracy where there is none is childish.

139   anonymous   2012 Sep 16, 2:35pm  

Bap33 says

dude, I am so against jail as a form of punishment, you have NO idea! A violent crime should result in swift execution by hanging. Selling drugs is a violent crime. Raping kids is a violent crime. Murdering babies in the womb is a violent crime. Drunk driving and killing people is a violent crime. All violent crime should be met with the same swift punishment.

what exactly do you find violent about the act of growing/trading/consuming marijuana?

using your mind as a litter box, and the government as a weapon of mass destruction is a crime that should be met with the harshest of punishments, but i digress

you are what you hate, you just aren't cognizant the implications of your actions enough to realize it, you liberal statist

why do you hate personal freedoms?

Bap33 says

The use of alcohol is much more natural than smoking, because drinking is a natural act. Smoking anything is unnatural and disgusting

um, there is nothing more natural then a plant that grows in nature, and takes ZERO processing prior to consumption. Alcohol, on the other hand, takes a fair amount of processing

cannabanoids are lipophilic, so why not consume marijuana orally? Eating things is a natural act, no? And as far as i know, the only liquid that is 'natural' to drink, is water

The worst part of your silly so called rationalization in attempt to make some limp wristed argument, is that ALCOHOL IS TOXIC, while marijuana is non-toxic.

You'd sound less confused if you just honestly stated "the government told me dope is bad, hence dope is bad", because that seems to be the depth of your argument

140   Dan8267   2012 Sep 16, 3:25pm  

Bap33 says

Selling drugs is a violent crime.

There are about 5,264 hard drugs that are legal to sell. They are called prescription drugs. Is selling these drugs a violent crime? Should those sellers be hung? If not, why should a drug far less dangerous than any of these five thousand drugs be criminal to sell?

And by your analysis, shouldn't it be perfectly legal to grow and use your own weed if you aren't selling it? This would harm the legal drug industry and the prison industry, but why should it be illegal?

Bap33 says

All violent crime should be met with the same swift punishment.

So a barroom fight and first degree murder should result in the same punishment: execution. Can't say I agree with that.

Bap33 says

But, doing drugs is just a really bad choice

Lots of things are really bad choices including what you mentioned: not wearing seat belts and helmets. Why should the state punish people for making bad choices that do not harm other people? The state is also very inconsistent in which bad choices it punishes. When was the last time you were fined for eating at McDonald's or Chick-fil-A? As someone who is against the nanny state, you should be against the state prohibiting people from ingesting whatever they want including drugs. The only justifiable drug law is one that prohibits a drug which directly causes people to become violent. Weed does not do this.

Oh, and liberals don't believe in the state forcing people to wear seat belts and helmets. Liberals oppose all nanny states and father-knows-best states. You're confusing leftism and liberalism. Remember, the root of liberalism is liberty. Liberals are pro-freedom.

Bap33 says

like masterbating in a public area or in public view.

What right does the state have to prevent or punish anyone from masturbating in public? What right does the state have to punish anyone for activating nerve cells that send signals to the brain which then interpret these signals as pleasure? It is utterly ridiculous to think the state has any right to interfere with such personal liberty. Where does the state get such a right? Not from the people. If I don't have the right to control your body, then I can't give that right to the state. I can't give what I don't have. Since no one has the right to control another person's sexuality, the people cannot give the state that right.

http://www.youtube.com/embed/muHg86Mys7I

And why should the state be allowed to prevent people from doing anything that causes no harm to others? Just because you find something disgusting or offensive does not give you the right to prevent others from engaging in it even in public places. You know how disgusting and offensive I find religion. I find it at least as offensive as you find a guy jacking off. Does that mean I get to use the state's monopoly on violence to arrest anyone who tries to say a prayer in public?

Oh, that's a religious matter and it's protected by the First Amendment. Well, orgies are also religious matters going all the way back to ancient Greece (and actually even further). So public orgies should be protected by the First Amendment as well. And yes, even weed can be as rightfully called a religious sacrament as anything Christians do. After all, weed and other now illegal drugs were the inspiration for almost all of religion including Christianity. All those ancient religious experiences? Drug hallucinations.

So you see, what you really are advocating is that the state uses violence to enforce arbitrary cultural preferences. Such use of violence for completely arbitrary preferences held by only some of the members of a society is hardly the hallmark of freedom. And if the state can violently enforce arbitrary cultural preferences, then some day it will enforce cultural preferences that you appall, perhaps coming from Islamic culture. All it would take is a sufficient number of people with those cultural preferences, and Islam is the fastest growing religion.

Bap33 says

The use of alcohol is much more natural than smoking, because drinking is a natural act. Smoking anything is unnatural and disgusting.

So then you would have no problem with marijuana if the active ingredient THC were dissolved in water and drank like alcohol? Then it should be legal by your reasoning, right?

How about ecstasy? That is already dissolved in water and drank. Are you for legalizing that?

How about tobacco? Shouldn't that be illegal since it is smoked?

The fact is that the law does not reflect any consistent philosophy, and your proposals don't make it any more consistent.

141   Dan8267   2012 Sep 16, 3:35pm  

errc says

And as far as i know, the only liquid that is 'natural' to drink, is water

Then again, natural does not mean good, so it's a mute issue.

I'm very much in favor of drinking decaffeinated ice tea without any sweeteners. It's calorie free and even healthier than water as it provides antioxidants, and you're less likely to get bored with it and crave a soda.

errc says

The worst part of your silly so called rationalization in attempt to make some limp wristed argument, is that ALCOHOL IS TOXIC, while marijuana is non-toxic.

Very true. The only motivation consistent with the behavior of our government, is that it does not want marijuana to compete with prescription drugs because, if marijuana were legal, there would be no profits in it or the prescription drugs as anyone can easily grow hemp. Why pay for something you can freely grow yourself?

Profit seems to be the only motivation for anti-marijuana laws. The thing is, it's not profitable to society to
1. Lock up enormous number of people.
2. Pay prison guards for this.
3. Keep the prisoners from being productive members of society.
4. Prevent those people from being able to get jobs and become productive members of society when they leave prison because they have a record.

It's actually utterly ludicrous from an economic perspective. It's only profitable to a few corporations and the prison industry. For the rest of society, the war on drugs is a major economic disaster. And that's ignoring the vileness of violating people's rights and freedom.

142   curious2   2012 Sep 16, 5:12pm  

Dan8267 says

it's a mute issue.

Like a cow's opinion, it's moo!

143   anonymous   2012 Sep 16, 10:44pm  

Do you ever wonder why people that consume sugar (a mind altering, highly addictive stimulant) en masse, never utter a peep about how sugar should be illegal, yet these same addicts and drug users wave their finger at people that consume a non toxic plant with health benefits?

That doesn't sound like an organic, nor a rational, line of thought. It sounds much more like somebody else planted that idea inside your head (propaganda)

Sugar is toxic
Sugar is the gateway drug
Sugar has no nutritional benefits
Sugar has had much greater, negative affects on society

Relative to marijuana, which has industrial uses, medicinal uses, recreational uses, is non-toxic, not a gateway drug, has nutritional value, and does not negatively impact society

Enjoy your sugar in your caffeinated coffee, as it rots your teeth, brain, body and soul!!

144   freak80   2012 Sep 17, 1:03am  

I never realized how addictive sugar was (at least for my brain) until I stopped eating it "cold turkey." There was a week of mild "withdrawal" and then I had no desire for it. Then I started eating it again and was "hooked." Maybe it's not as bad as tobacco (never used it) but I still think sugar is addictive.

Sounds like marijuana has different effects for different people. Sort of like "legal" prescription drugs for anxiety/depression. When I was having anxiety "issues" the doctor told me I had to "experiment" with different drugs in order to find the "right" one. I ended up in the ER with a panic attack after starting out with Prozac. Gotta love experimenting with mind-altering drugs. Timothy Leary would be proud.

145   freak80   2012 Sep 17, 1:05am  

errc says

Sugar is the gateway drug

Sugar is a gateway drug? To what? ;-)

146   Bigsby   2012 Sep 17, 1:10am  

freak80 says

errc says

Sugar is the gateway drug

Sugar is a gateway drug? To what? ;-)

A shit diet?

147   rooemoore   2012 Sep 17, 1:13am  

Bigsby says

freak80 says

errc says

Sugar is the gateway drug

Sugar is a gateway drug? To what? ;-)

A shit diet?

Marijuana is a gateway drug to sugar.

148   Y   2012 Sep 17, 1:43am  

turning into a fat fuck for the rest of your life....

freak80 says

errc says

Sugar is the gateway drug

Sugar is a gateway drug? To what? ;-)

149   elliemae   2012 Sep 17, 2:54am  

errc says

Sugar is toxic
Sugar is the gateway drug
Sugar has no nutritional benefits
Sugar has had much greater, negative affects on society

You're narrowing down the list of things that I can do... But you're wrong about sugar having a negative effect on society...

I used to give my nieces & nephews sugar about 20 minutes before I left my sister's house. It paid her back for the time she cut my doll's hair (when I was 8) and she told me it would grow back...

THAT sugar had a positive effect on me!!!

150   freak80   2012 Sep 17, 5:25am  

Isn't marijuana a gateway drug to sugar (twinkies, Haagen Dasz, etc)?

151   bob2356   2012 Sep 17, 5:28am  

curious2 says

No it isn't fair to people who are in pain that they are used as hostages with ransom paid to the medical industrial complex. You've been away lately but a big deal in the US now is the mandatory coverage for "preventive care" with no copay which means PhRMA is rolling out new patented contraceptives with hardly any testing, because it's more profitable than the old familiar Pill that went generic years ago; everyone is forced to pay PhRMA for the new patented ones, and the prescribers are coerced into prescribing them, and the patients who take them will discover the currently unknown side effects as they arise. No one ever said the law is fair, except you did just now and really I think it's because of the cognitive dissonance that would result from admitting you profit personally from an unfair law. It's profitable, not fair.

So where exactly in all this ramble is the part where people are "forced" to use on patent meds. Anyone can ask either their doctor or their pharmacist for generics. I do it.

152   curious2   2012 Sep 17, 5:59am  

bob2356 says

So where exactly in all this ramble is the part where people are "forced" to use on patent meds. Anyone can ask either their doctor or their pharmacist for generics.

Please read more carefully. Everyone is forced to PAY FOR patent meds. If you don't see how, read it again.

Yes, people who are knowledgeable can ask permission to buy something cheaper, and some doctors will grant that permission when requested. But, doctors are on a treadmill, caught between PhRMA, CME, and insurance; they need to prescribe profitably. They can easily think of reasons why a particular patient should have the patent drug, reciting claims presented in CME or touted by drug industry reps that visit the doctor's office, and it takes a rather confident patient to argue in that situation. In particular, the less educated patients are in a much weaker position. This may be one reason why education is the best predictor of longevity, not money and certainly not medical insurance.

As for asking the pharmacist, that usually doesn't work. In some states, if the doctor has allowed generic substitution, you can get a generic "equivalent" with the same active ingredient, if the pharmacy has one. (These may not actually be equivalent, and you are not allowed to compare generic manufacturers the way you can with OTC drugs.) You are never allowed to substitute a similar Rx drug with a different active ingredient the way you can with OTC drugs. For example, if you're shopping for OTC analgesics, you can choose freely among different active ingredients and multiple brands of each. You definitely can't do that with Rx analgesics. The discrepancy is part of why Americans, who pay the lowest prices in the world for OTC drugs, pay the highest prices in the world for Rx drugs. Again, the key to understanding the persistence of the system is to recognize that it's profitable, not fair.

153   curious2   2012 Sep 17, 6:10am  

freak80 says

sugar is addictive.

Definitely. Interestingly, even artificial sweeteners can set off a similar chain of events, with the consequence that people who switch to "diet" soda don't lose weight.

freak80 says

I ended up in the ER with a panic attack after starting out with Prozac.

Prescription drugs are a leading cause of emergency hospitalizations, in some age groups #1. That's part of why RomneyCare led to a 30% increase in emergency hospitalizations, after supporters promised that "preventive care" would lead to fewer. ("Preventive" CT scans in asymptomatic patients will lead to more hospitalizations, for cancer, but those will take longer to show up.) Funny how boosters of ObamneyCare recycled the same claim to advocate the same plan nationally, and the semi-"smart" people who trust commercial news (where literally a majority of the ads come from PhRMA) fell for it again. One might think the industry would need to come up with new lies at least to sell the same policy, but no, with enough lobbying $ they can get politicians to echo the same lies over and over again. The main difference between Rx drugs and illegal drugs is, Rx drugs are backed by a powerful "legitimate" industry that shares the "legitimate" $ with lobbyists and politicians, while illegal drugs are backed by a powerful illegal industry that launders its $ through money-center banks that share their "legitimate" $ with lobbyists and politicians. They are different categories, with the markups finding their way back to the politicians via different routes, but safety and efficacy are not really related to the political and financial categorization.

154   elliemae   2012 Sep 17, 12:18pm  

Wow! They like me! Right now, they really like me!!!

155   Patrick   2012 Sep 17, 12:35pm  

It's just division: dislikes / likes

That's all there is to it. Not very useful really, except as a kind of measure of how much people like your comments.

156   bob2356   2012 Sep 17, 10:01pm  

curious2 says

Please read more carefully. Everyone is forced to PAY FOR patent meds. If you don't see how, read it again.

I read it again, I don't see it the first time, I still don't see it. Most people are already covered for contraceptives. Look it up, almost all employer insurance plans already cover contraception. Why would everyone suddenly change their contraception? Doesn't make sense. Trust me, doctors truly don't give a shit whether someone uses the pill or norplant or burning incense with chanting for contraception. The other seven items of affordable health care act womens preventative care don't involve drugs at all so they have no relevance.

curious2 says

Yes, people who are knowledgeable can ask permission to buy something cheaper, and some doctors will grant that permission when requested. But, doctors are on a treadmill, caught between PhRMA, CME, and insurance; they need to prescribe profitably.

Not any doctors I know. My wife the doctor is very curious how all this works. . So please give us the benefit of your extensive inside knowledge of how medical practices work. A couple free drug samples (that she and most doctors give to patients that they know have a hard time paying for meds) and the every other month rubber chicken dinner with power point presentation isn't exactly being in bondage to big pharma. She has never seen on patent drugs discussed at a CME course. She has never had an insurance company ask about prescriptions. Never, not once. She's spent years in practice and running her practice. I have spent years doing medical billing and medical practice management software for doctors offices, Neither of us has a clue what you are talking about when you say prescribe profitably. Enlighten us, starting with some type of description of your vast experience working day to day in the medical field.

No matter what she prescribes, on or off patent, there is zero affect on my wife's income from prescription drugs. So cognitive dissonance is not in play here. Nice try, but it ain't so joe.

157   elliemae   2012 Sep 17, 11:50pm  

bob2356 says

No matter what she prescribes, on or off patent, there is zero affect on my wife's income from prescription drugs.

People are under the impression that MD's make $$$$ from prescribing, which would be wonderful if it could happen. Then every MD would be outrageously wealthy and wouldn't have to worry about dumb stuff like ethics & sick people...

There are some MD's who participate in research and receive grants from big pharma, but imho most don't. So far as Bob's comment that samples are normally given out to people who can't afford, big pharma is giving out smaller amounts of samples for the normal stuff any more. They try to push the more expensive meds, so MD's don't have as much in their drug closet as they used to . It sucks.

The issue with the healthcare law is morals. Women are supposed to be demure little creatures who don't outwardly display their desire for sex (but are tigers in bed with the man that owns them), and should pop out babies like a pez dispenser.

Of course, if the man is gone or can't afford to pay for all of them thar babies, that's not our problem either. We need to cut back on welfare programs so that these "victims who are reliant on government handouts" can go out and get a fucking job. Leave the kids at home to watch each other, I guess.

158   Rightswingtrader   2012 Sep 18, 1:15am  

I like that this conversation all started when I said I like to smoke weed.#120
Notice the tone here overall has become a bit more "mellow" than usual with out the usual "harsh" back and forth.

159   freak80   2012 Sep 18, 1:30am  

elliemae says

Women are supposed to be demure little creatures who don't outwardly display their desire for sex (but are tigers in bed with the man that owns them), and should pop out babies like a pez dispenser.

Ellie, I do not look at women that way.

160   Y   2012 Sep 18, 2:00am  

thats cause your a 'freak'....

freak80 says

elliemae says

Women are supposed to be demure little creatures who don't outwardly display their desire for sex (but are tigers in bed with the man that owns them), and should pop out babies like a pez dispenser.

Ellie, I do not look at women that way.

161   freak80   2012 Sep 18, 3:55am  

SoftShell says

thats cause your a 'freak'....

I'm a Super Freak, Super Freak, I'm Super Freaky, YEAH!

162   curious2   2012 Sep 18, 4:09am  

bob2356 says

Not any doctors I know.

You can read more on ProPublica and even check some names if you like:

Dollars for Docs

Promotion of Prescription Drugs Through Payments and Gifts [including valuable trips and prizes, according to the Office of the Inspector General at HHS]

Lawsuits Say Pharma Illegally Paid Doctors to Push Their Drugs

drug companies pay $7 billion fines over illegal marketing [a fraction of what they made from it btw]

"Drug makers spent about $6.3 billion on marketing visits to doctors in 2009, the last year that such figures were available, according to IMS Health... [S]ome federal regulators and medical societies argue that drug makers are simply mining the data to identify and go after the doctors who would be most likely to prescribe the latest, most expensive brand-name medicines — driving up health care costs and exposing patients to newer drugs whose side effects may not yet be fully known."

After Sanctions, Doctors Get Drug Company Pay

This pattern has been so widely reported for so long that I wonder how long it's been since you've been in this country.

bob2356 says

Why would everyone suddenly change their contraception?

Why do you think PhRMA spends so much on DTC advertising? The #1 complaint of general practitioners is patients lying to get prescriptions for drugs they saw on TV but that would be bad for them. If they are "preventive" (i.e. mandatory with no copay) then everybody has to pay for the "free" drugs. Even if established patients stick to the old products, every year millions of new patients enter a market where everything is "new and improved."

And then you have the "preventive care" full body CT scans for asymptomatic patients:

"What's new is that CT is being marketed as a preventive or proactive health care measure to healthy individuals who have no symptoms of disease. [There are] No Proven Benefits for Healthy People."

As a friend put it, it's an investment in future patients. Cancer patients.

163   Patrick   2012 Sep 18, 6:07am  

Call it Crazy says

What if you did it comparing "likes" versus total posts... wouldn't that give you a ratio on how much the poster's overall comments are "liked"?

Yes, if I did it starting from the time I instituted the "like" thing. The forum existed for years before that, so those earlier comments shouldn't count I guess.

164   Dan8267   2012 Sep 18, 6:35am  


APOCALYPSEFUCK is Shostakovich | 23.5593

Ergo, Apocalypsefuck is both troll and anti-troll. If he ever encounters himself, he will annihilate himself liberating vast quantities of gamma radiation.

Just goes to show that you can't say anything important without offending someone.

165   elliemae   2012 Sep 19, 1:27am  

Dan8267 says

Ergo, Apocalypsefuck is both troll and anti-troll. If he ever encounters himself, he will annihilate himself liberating vast quantities of gamma radiation.

So - if AF attacks himself, he would beat himself off?

(ellie never, ever misses an opportunity for a good masturbation joke)

166   bob2356   2012 Sep 26, 10:52am  

curious2 says

This pattern has been so widely reported for so long that I wonder how long it's been since you've been in this country.

What pattern do you see here exactly? There are 3 reports that there are doctors are paid to speak for drug companies. So what, shilling for the drug companies isn't prescribing to patients. I notice any mention of the number of doctors involved is very lacking. There aren't a lot and I've never met one. The hhs report is from 1991 for christ sakes. Almost everything mentioned in it hasn't been allowed for 10 years or more. Try to focus on what is actually happening in today's world, not what happened 2 decades ago. The other 2 are about how drug companies data mine to make more focused pitches to doctors. That's news? Drug companies are marketing, shocking to hear that I tell you, just shocking. So how does any of this relate to your concept of profitable prescribing? Where in any of this does it show what doctors prescribe has any affect what they earn?

curious2 says

The #1 complaint of general practitioners is patients lying to get prescriptions for drugs they saw on TV but that would be bad for them.

Ding, ding, ding. Wow, you finally got a winner after all that. Yes THE BIGGEST PROBLEM is drug companies advertising to consumers. It should have never been allowed. Patients demand what they have seen advertised. Doctors go along if it isn't counterproductive. Why not, patients are the customer. If they want to spend a lot on drugs that won't do any better job than cheaper drugs then that's their right. This goes directly against your assertion that doctors are forcing expensive pharma on poor unwilling uninformed patients to line their pockets. What you are saying is patients are sophisticated enough to mis describe their symptoms to get expensive drugs they want because they saw them advertised, but are so unsophisticated they can't say hey doc could you to prescribe a generic if they want to pay less. Which is it, you can't have it both ways.

So again how does this amount to profitable prescribing? Where is the profit for the doctor in any of this short of owning pharma stock or working for a drug company? I used to do a lot of practice management/accounting work and I don't understand how it's done. Explain the accounting ins and outs of "profitable prescribing" in an average practice to me instead of throwing up a lot of basically irrelevant articles. Debits and credits I understand.

Sorry I missed the part where you talked about how you acquired all your extensive day to day experience in the operation of physicians practices. Could you post it again perhaps.

Since you are so curious, I've been overseas 5 years. As hard as it is for the average American to understand even in the wilds of uncivilized countries like NZ there is mail service, phones, emails, even "gasp" internet. Even harder to believe, you can get on a jet plane and go back sometimes. I do keep up with what people are doing in the states. My wife spends 2-3 weeks a year at conferences in the states and spends a lot of time asking about what is going on. Keeping up on what is happening in medicine and practice management is of great interest for when we return.

Maybe you should give up on this whole profitable prescribing collusion idea and look at real problems. Start with doctors that refer to labs and diagnostic centers they have ownership in. Now that's a conflict of interest and pretty unethical in my opinion but it's legal in most states. Or why the area's that have the most doctors per capita have the highest medical cost per capita. Didn't you say licensing more doctors would make costs go down? Doesn't look like that works out in real life. So many real problems yet you are fixated on one that isn't.

167   curious2   2012 Sep 26, 11:48am  

This exchange does not relate directly to the OT but I do appreciate learning more about the subject so I will reply.

bob2356 says

why the area's that have the most doctors per capita have the highest medical cost per capita. Didn't you say licensing more doctors would make costs go down?

You seem to be confusing correlation and causation. In a free market, increasing the supply will reduce the price, all else being equal. But, in a distorted market with restricted supply (AMA cartel etc.) and artificially inflated demand (PhRMA ads on TV, mandatory insurance), many distortions can happen. A market that has a large population of sick people who watch TV all day may attract more doctors who prescribe the pills advertised on TV, resulting in higher costs. You didn't mention specific areas, but it's easy to guess that retirement destinations in Florida would have high concentrations of doctors and high costs. That doesn't change the fact that making it easier for doctors to get licensed (e.g. foreign doctors immigrating) or stay licensed (e.g. doctors retiring because they're tired of CME and other regulatory overhead) would reduce prices.

You react negatively to articles; I enjoyed these two dueling blog posts so you might prefer their candor and wit:

http://www.sciencebasedmedicine.org/index.php/bought-and-sold/

http://pharmamkting.blogspot.com/2011/05/physicians-are-concerned-about-pharma.html

Also this academic paper reports on the same issue:

http://www.scu.edu/ethics/publications/submitted/morreim/prescribing.html

Nevertheless, professionally edited newspapers continue to report the same pattern connecting prescriptions and PhRMA payments:

http://articles.courant.com/2012-07-30/health/hc-doctor-prescribers-20120730_1_second-highest-prescriber-top-medicaid-prescribers-pharmaceutical-companies

Sometimes the physicians sell the drugs directly, eliminating the added step of kickbacks:

http://www.nytimes.com/2012/07/12/business/some-physicians-making-millions-selling-drugs.html?pagewanted=all&_moc.semityn.www

Other times, it's kickbacks:

http://www.usatoday.com/money/industries/health/drugs/story/2012-07-02/glaxosmithkline-pleads-guilty-3B-fine-illicit-promotion-prescription-drugs/55979616/1

I certainly agree there are other problems, and I do not fixate on this one. It's just that you keep asking about this one, so the exchange gets more words on the page. I'm also concerned about doctors losing their independence because most of them are working directly or indirectly for insurance companies, e.g. 70% work for hospitals or large practice groups, which the largest insurers are buying. And we have exchanged comments before about C-T scans being marketed to healthy people as "preventive care" despite there being no benefits to anyone other than the revenue recipients.

168   thenuttyneutron   2012 Sep 27, 6:06am  

I am surprised that APOCALYPSEFUCK is Shostakovich is ignored so much. Half of the fun of reading this blog are his posts about the coming cannibal anarchy. Hell I enjoy reading his posts.

169   curious2   2012 Sep 27, 6:11am  

thenuttyneutron says

Half of the fun of reading this blog are [AF's] posts about the coming cannibal anarchy.

I agree, and in fact there may be a real estate opportunity: AF fans should look into real estate in AF's neighborhood, so we can all band together to defend against the zombies.

170   rooemoore   2012 Sep 27, 7:12am  

Cloud has gone. Soon to return as drizzle, no doubt.

171   Politicofact   2012 Oct 1, 3:30am  

The Trolls are coming. The Trolls are coming.

172   Bubbabeefcake   2014 Apr 18, 7:33am  

Politicofact says

The Trolls are coming. The Trolls are coming.

173   CDon   2014 Dec 17, 7:57am  


Call it Crazy says

I would be careful... when you point out these negative FACTS about Obama's record, they don't like that here..... your posts will get deleted by the forum Nazi....

Fuck you.

I don't delete anyone for posting facts, just for relentless racist infantile propoganda.

Please post a picture of Obama in a grass skirt or as an evil clown so I can blow your account away in clean conscience.

Bumped for posterity. Imagine how wonderfully ordinary and sanguine this place would be had Patrick followed through on his threats. The housing bubble was a real and legitimate issue that deserved all the attention it got.

As the bubble resolved, most other sites went out with a bang as formerly priced out people bought and moved on with their lives. This site, unable to recognize that it was over changed focus and went out with a (cockeyed arm, obamas the devil, murica is doomed) whimper.

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