Notice bibliographique
Résumé
Editor: In his editorial (EMN 2008;30[4]:4), Dr. Lewis Goldfrank suggests that the following theoretical question should be included in the emergency medicine board examination: Universal health care is (A.) a good thing or (B.) a bad thing. Dr. Goldfrank's answer to that question would have been A. He would have gotten that answer wrong. Dr. Goldfrank and I have vastly different perspectives on the concept and reality of universal health care. I did my emergency medicine training in Canada in the mid-1970s. I saw firsthand the disaster called universal health care. Tax dollars were paid into a general fund from which health care dollars were dispensed. When money became tight, bureaucrats rationed care. At that time, little could be done for stroke patients when bureaucrats decided that no beds would be allotted for those patients. As an emergency resident at that time, I was forced to send newly hemiplegic patients home with only family members to care for them. Women waited months for a biopsy of suspicious breast lesions. Physicians fled from this system into the U.S. This system cost a lot of money, and hurt a lot of patients and their families. The 47 million so-called uninsured people in the U.S. include a large number of young healthy folks who, understandably, choose to spend their money on things other than health insurance. Because we have hospitals that turn a blind eye to theft of service, they get away with paying little or nothing for emergency care when they finally do become sick or injured. If someone walked out of a store with a TV set and didn't pay for it, he would end up in jail. The truly needy should continue to be cared for at society's expense, but a man with $2000 worth of tattoos and piercings on his body who smokes $3000 worth of tobacco and drinks $1000 worth of alcohol yearly will have a very hard time convincing me that someone else should pay for his health care. He has chosen to spend $4000 a year on tobacco and alcohol rather than on health care. Every day a patient with rotten teeth tells me that he “can't” go to a dentist because he has no insurance. If a tire blows out on his car, though, he doesn't delay replacing it because he doesn't have insurance. He opens his wallet and pays for the tire. If he saved the $10 a day he spends on tobacco, soon he would be able to pay cash for dental service just like he paid for the tire. The last two things we need in this country are another group of dependent, entitled people and the government running a universal health care system. The answer to the board question is B. Government-sponsored universal health care is a bad thing. Kenneth J. Wright, MD Redding, CT
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,052 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,005 | 0,006 |
| Communication savante | 0,014 | 0,010 |
| Science ouverte | 0,005 | 0,003 |
| Intégrité de la recherche | 0,025 | 0,046 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,021 | 0,013 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».