If you simply mean that capitalism and the global banking system is unsustainable then yeah, no-shit Sherlock, but if you mean anything more specific it would be interesting to hear. — praxis

Capitalism is what it is.. What's mostly wrong wit it are the incredible levels of corruption that have plagued every system. So, would you rather have Capitalism that when corrupted causes what we see today or Communism/Socialism that caused over 100M murders in the 20th century?

SO how do those with disabilities fit your scheme? — Banno

That's up to each society to determine.

You want to bankrupt your society trying to keep everybody alive forever, go for it!

If you simply mean that capitalism and the global banking system is unsustainable then yeah, no-shit Sherlock, but if you mean anything more specific it would be interesting to hear.
— praxis

Capitalism is what it is.. What's mostly wrong wit it are the incredible levels of corruption that have plagued every system. — synthesis

You seemed to be concerned with sustainability initially and have now switched to corruption. I was interesting in knowing if you could back up the claim that the shits gonna hit the fan "sooner than you think" in any way. My current understanding is that the cost of energy will rise in the near future, having reached peek oil, and this will slow economic growth, but there's no immediate end in sight. Economy's will become increasingly unstable and it will be difficult to adjust to lower growth. Pandemics, war over depleting resources, and possibly technologies like GAI are more immediate existential threats.

Don't you people want to be free again? — synthesis

At the age of 84, no. I'm relatively healthy other than arthritis and a really bad back, but when I have needed medical attention Medicare has treated me very well. I have a supplementary policy that includes Healthways and free admission to expensive fitness gyms. The thought of all that vanishing and having to spend really big bucks is not pleasing. And, yes, Medicare funding is questionable, but some sort of means testing might shore it up. I have a very wealthy friend who pays only a tad more than I do for the plan.

Dare I ask, What do you think of Medicare? :scream:

It truly amazes me how dependent (intelligent) people have become. You people act as if am asking for two kidneys and a liver instead of just suggesting that you take responsibility for your own health. — synthesis

Probably all of this is just a matter of language and understanding. I assume you drive, and that when your car needs work, routine or otherwise, you pay for a mechanic - an expert - to fix it. If by taking responsibility you mean an adult's cognizance of his or her own abilities and making appropriate judgments about what he or she can do, then I'm with you. On the other hand, if you're doing your own brake work, for example, or in your home doing your own electrical work or plumbing, not having the training or "expertise," and thinking that's the better way, then I'll argue you're wrong. Or maybe you think folks should take care of their own or their family's surgical needs or other medical needs themselves?

Or maybe you think folks should take care of their own or their family's surgical needs or other medical needs themselves? — tim wood

Why would I infer such a thing? By taking responsibility for your own health means doing whatever you can to stay healthy, and if something comes up, educate yourself so you can participate in your own care.

I have had many patients self-educate to an incredibly high level where they would come in an make a pretty darn good case for going with a particular medication/procedure. It is not only possible, but I believe it is imperative because you cannot assume that your provider is making the best decision for you (perhaps they're Rx'ing a particular med because it is the cheapest or because the drug rep smiled at him/her. Who knows? It's your health. Do your homework!

I have found that there are two types of highly successful people, the ones that have everybody else doing things for them, and those who really like to understand how things work and do everything they can themselves. If you have a choice, go with the later.

Dare I ask, What do you think of Medicare? :scream: — jgill

I am on Medicare, as well. It is what it is...unsustainable. Soon you will be able to spend nearly an unlimited amount of money keeping one person alive. How's that going to work?

That's great that you are enjoying good health into your 80's. I see many patients well into their 90's who are also doing quite well these days. The problem isn't with the relatively healthy people, it's those with chronic health issues such as uncontrolled hypertension, diabetes, obesity, and the like. These people end up with all kinds of major organ issues and they are tens of millions of them. And many are young.

Things need to change...and soon.

My current understanding is that the cost of energy will rise in the near future, having reached peek oil, and this will slow economic growth, but there's no immediate end in sight. — praxis

In theory, this debt bubble has to pop sooner or later. That's the main impediment to growth. Since all matter is energy, that issue should take care of itself.

My current understanding is that the cost of energy will rise in the near future, having reached peek oil, and this will slow economic growth, but there's no immediate end in sight.
— praxis

In theory, this debt bubble has to pop sooner or later. That's the main impediment to growth. Since all matter is energy, that issue should take care of itself. — synthesis

In theory it's possible to generate energy as cheaply and efficiently as oil, but I don't think anyone has developed it in reality yet. Cheap energy is the impediment to growth, in our current economic/financial system, and we see the global Ponzi scheme falter all the time. Many things can collapse it, like a pandemic, most recently.

So we can all agree that present system, be it private insurance or a national health model, is clearly not working (as is the case for all Western institutions). Is the answer to do more of the same? — synthesis

So I don't agree to this.

The healthcare system works in almost all countries. There is no system -- healthcare or other -- that is completely void of glitches. Just because a system has glitches, it does not mean it is not working. It is working just fine.

I reject your initial premis that the healthcare system, whether it be privately or collectively (nationally) funded, does not work.

You people act as if am asking for two kidneys and a liver instead of just suggesting that you take responsibility for your own health. — synthesis

That's a wee bit disingenuous. Sure, take responsibility for your own health care. That's not all you have said, though. You've blown a simple suggestion with which few would disagree into a growing ballon of health ethics and economics.

And what you said is trite. It's the self-made American myth applied to healthcare - each for themselves. Sure, the U.S. heath system is fucked. Other western nations, and some outside that group, are doing far better. But you have mistaken the cause for the solution.

Hence my question, where do those with disabilities fit in your scheme? Those who cannot negotiate with and between doctors? You, a middle-class educated male, have unsurprisingly invented a medical scheme best suited to middle class educated males. You are obliged to say "That's up to each society to determine" because your system would be inadequate to the needs of most people.

I don't see that you have given the issues here much thought at all.

Don't you people want to be free again? — synthesis

No. They don't want to be free, not ever. The vast, vast majority of my patients want someone to blame (just never them) for whatever predicament they find themselves in. Live healthy and personal responsibility? Terrifying idea to them. More nachos, gravy and book me in for a triple bypass? Much more support than eat healthy, exercise regularly, and sleep well. Diet pills, anti-depressants, and sleep aides are much more appreciated; because none of it is the patient's fault, ever.

I tell my patients to eat real food, organic if they can afford it, but real food nonetheless. Learn to cook, be active (walk, run, jog, yoga, whatever, just move around more), and get a good nights sleep. Have a mid afternoon nap when you can. Take the T.V (laptop, cellphone, etc) out of the bedroom, bedrooms are for bed activities, none of which involve a screen. Most of the time I get nods and that's about it. Next time they come in, have they changed anything? No, and not so shockingly, all their problems are also unchanged. The excuses are thick and personal responsibility is non-existent.

Years ago I had a chronic pain patient, claiming to be so desperate for pain relief that he was feeling suicidal "to make the pain go away". He kept telling me how great he felt at 45 and how wonderful it would be if he could be that way again. I asked him what his weight was at 45. "154lbs" he proudly answered. He weighed 215 lbs in my office. I then asked him, at 45, how he would have felt at the end of the day if he had carried a 60 lb pack everywhere he went, all day long. "Sore as hell" he responded, "that's a lot of weight to always carry around". I agreed and made an appointment to see him the following week, after he decided to try my recommendations, which I would tell him next week. I designed a weight loss plan (low-impact in the pool), arranged for a yoga program and instructor, nutritionist consultation and follow up, complete with cooking classes, and an alternative medication regime which accounted for the anticipated pain associated with the increase in activity as well as a tapering dosage over time to avoid any addiction concerns. The next week when I saw him he declined every aspect of the treatment plan. The only thing he wanted was medication. I told him that for any future visits he was not to bring up his chronic pain as I refused to treat it further. He accurately portrays my average patient.

Yes the current system is broken, well past broken. Letting it die and rebuilding means accepting responsibility for our own health and seeking out skilled practitioners to supplement our own knowledge. Damned few of us would be willing to accept that. I would, my wife would. Sounds like you would too. But we know the system, we lived it, we see the monumental flaws within it.

Everyone else reads the news, and believes what they read while reaching for another beer and bag of chips.

I reject your initial premis that the healthcare system, whether it be privately or collectively (nationally) funded, does not work. — god must be atheist

I don't know about all healthcare systems not working, or working. I haven't experience with many, just the one I work in, which is not the same as Synthesis's. I can state that the system I work in is fatally flawed. There have been few steps forward during my career here (MAID being one of them). The system I work in allows the patient to never have to assume responsibility for their actions or decisions, thereby creating increasingly entitled patients with ever increasing medical costs. Eventually the system will crash. No worries, until then I make good money babysitting people with mostly self created problems.

I don't see that you have given the issues here much thought at all. — Banno

What amazing insight. After being in practice for four decades and giving 100% to each and every patient while fighting tooth and nail with insurance companies and the like, I just decided to sit down the other day and think about this.

The healthcare system works in almost all countries. — god must be atheist

And you base this on what information?

Yes the current system is broken, well past broken. Letting it die and rebuilding means accepting responsibility for our own health and seeking out skilled practitioners to supplement our own knowledge. Damned few of us would be willing to accept that. I would, my wife would. Sounds like you would too. But we know the system, we lived it, we see the monumental flaws within it. — Book273

Unfortunately, so few health care providers have been willing to tell it like it is (for all kinds of reasons) but it is as you say it is...horribly flawed. This is not to take anything away from the countless individuals who provide compassionate care to millions of people, but the combination of government regulation/bureaucracy and corporate monopoly-like control over every damn thing has created an environment that is extremely difficult to practice within (especially if you really care about your patients).

Keep up the good fight!

I go to the doctor for a bad cold with flu-like symptoms and difficulty breathing (some years ago). I'm old and know myself to some extent, so I've gone to the doctor because to me the symptoms are worrisome. My appointment lasts twenty-two minutes, eight of which he is out of the room. He performs an EKG, tells me I have had two heart attacks and that I have COPD, and by the way I should see a specialist about these matters. He bills at an annualized rate of around 3+ million dollars per year. In my case about $750. The specialists see me, and no I have not had any heart attacks, and no I do not have COPD. These visits billed at, as I recall, about $150 each, taking mere minutes.

And this same scenario has played out multiple times in my experiences over years, with doctors.

Or, the hospital that refused to tell me what a routine required chest x-ray would cost, and then billed my $1200 dollars for it.

In the first case, I was insured and stuck only with copays. In the second, I paid the local "health-stop" rate for an xray, $89(!), and the hospital never sent me another letter.

Do you see any problems with this? I am satisfied that even Bill Gates has health insurance because even he cannot afford to pay out of pocket (as financially reasonable: likely he could afford it; but the rest of us simply cannot).

Do you see any problems with this? — tim wood

There are problems in this health care system from A-Z. It is a system designed by bureaucrats and corporations for the benefit of bureaucrats and corporations. I have heard stories like yours for years and years and years...

Again, this is not to say that individuals are not doing amazing things within this system, but the waste and fraud, the over-billing and over-testing and over-prescribing and all the rest need to be dealt with one way or another.

The best way to do this is make people responsible for their own health care (surgically remove the government and corporations) and then people might just pay attention. And for those who don't care about their own health, well, that 's the way it goes. It's just like the homeless...they're out there to scare the shit out of the middle class so they keep going to those jobs (credit to George Carlin).

One problem which I see in England, and I am sorry if I seem to be not addressing America, is some ideas which I have seen such as specific plans to introduce sugar tax. The idea seems to be of plans to introduce specific measures to enforce healthy lifestyles. While I am believe that healthy diet is important, I am not sure that I would wish to see that enforced by the government. That would seem to be a form of totalitarianism.

The main reason why I am opposed to the eradication of the health care system which we have is that I think that it may end up being replaced by a far more oppressive one. I think that any new system which could be implemented may give less empowerment to individuals and be more coercive, and restricting of civil liberties and less favourable towards vulnerable minority groups.

The main reason why I am opposed to the eradication of the health care system which we have is that I think that it may end up being replaced by a far more oppressive one. I think that any new system which could be implemented may give less empowerment to individuals and be more coercive, and restricting of civil liberties and less favourable towards vulnerable minority groups. — Jack Cummins

What could be more oppressive than a government system?

If you've gotten to the point where you fear change (because things could get worse), you know you are heading down the wrong path.

The best way to do this is make people responsible for their own health care (surgically remove the government and corporations) and then people might just pay attention. — synthesis

Your thinking is that if healthcare providers were somehow (magically?) untouchable by government and corporations that people would for some inexplicable reason start to eat right, exercise, get enough sleep, and pray or meditate daily?

I am not completely sure that fearing change is an actual sign that things are so bad. Perhaps it is the opposite. Currently, many of us have the economic stability and resources to look after ourselves. There are inequalities and some have far less educational opportunities. However, for many in our current time it does appear that we have health care to enable us to live as long as possible. I would not say longetivity is all that matters, of course, because quality of life is essential. However, I think that while there are flaws in health care, we are in one of the most privileged times of history. All that could be lost.

What amazing insight. After being in practice for four decades and giving 100% to each and every patient while fighting tooth and nail with insurance companies and the like, I just decided to sit down the other day and think about this. — synthesis

How amusingly ironic that in your thread titled "the poverty of expertise" you are reduced to appealing to your profession.

I asked how disabilities fit into your scheme. Your answer was flippant.

Perhaps your training did not prepare you sufficiently to defend your ethics.

Again, all you have done is design a health care system for people such as you.

Well, Jack, life is change and you have to keep moving forward. Unless you work within this (U.S.) system, it's difficult to understand the subtleties, but that aside, there are so many glaring problems that it doesn't really matter.

With the amount of money and resources dedicated to health care, each Western country should have a superb system of health care, not one that is just limping along. Major changes are going down one way or another.

I asked how disabilities fit into your scheme. Your answer was flippant. — Banno

What would you like me to tell you? Do you believe that I should decide for all 335M Americans?

You have X amount of money, so people need to decide how they are going to spend it. It's what responsible adults do.

I do think that we are at a crossroads and probably there will be changes, some bad and some good. It is hard to know who will be affected and in what way. It may be that the people who are complacent and least expecting change who may be the most affected. The question is how much influence do each of us have? I had a certain amount of influence while working in health care, but I am not sure how much exactly.

What could be more oppressive than a government system? — synthesis

Corporate power.

Do you believe that I should decide for all 335M Americans? — synthesis

You took that roll upon yourself when you posited the OP and your second post.

All I'm doing is attempting to get to to follow through on the consequences of your proposal. But you seem reticent.

The healthcare system works in almost all countries.
— god must be atheist

And you base this on what information? — synthesis

My bases for my opinion are that:

1. Your idea of a working medical system is different from mine and vice versa; and

2. I can't but help feeling that you have a preconceived strong and unchangeable opinion which basically says that healthcare systems are doomed, that people are not responsible for themselves, and that doom, defeat and destruction is the impending future of all healthcare systems. This is an opinion of mine, not stating this as facts or as a charge; this is my impression only.

What could be more oppressive than a government system? — synthesis

- religious systems
- evangelistic religions
- your father
- your Father
- your torturer at Quantanimo bay
- jails and prisons
- sadistic nurses and orderlies
- your big brother
- your big sister
- your husband
- your wife
- your aunt who controls the family wealth
- your five-year old angel of a grandson
- neighbourhood dogs
- coyotes and wolves
- lions and tigers
- Hepatitis C
- Sex maniac wife
- oxidization
- the call of the devil
- temptation
- extreme hunger
- extreme thirst
- mad Kohn, the sohn of that ganef Shlomo
- KKK
- Parish priests over altar boys
- coaches of all kinds
- life
- the third law of thermodynamics
- the music of Richard Wagner
- yourself