The Poverty Of Expertise
I am considered an expert in my sub-specialty in Medicine. What does this mean? It means that I have mastered the current ideas, methodologies, procedures, etc. But remember, it wasn't very long ago that the "experts" were drilling holes in patients' skulls in order to allow evil spirits to escape.
I was chatting with a couple of folks the other day and imploring them to educate themselves vis a vis medical matters and not just be satisfied with the what experts have to contribute to the conversation. I received a great amount of push-back, even being accused of this, that, and the other thing. I wanted to further that conversation.
Even if a medical expert knows 100% of the clinical information necessary to render a decision, it does not mean that they know your situation, and this is often THE most important part of the puzzle. Each individual has a unique history and a unique succession of events that have manifest into the current medical issue. Only YOU will be able to completely understand these histories/events, so this makes the individual the most important factor (by far) in their own health care.
It is imperative that each person educate themselves (schools have been woefully inadequate) so that they can apply all the preventive measures available and avoid infirmity. Eating properly, sleeping well, getting regular exercise, and having a daily religious/spiritual practice will take care of the vast majority of potential issues (practices handed down by the sages over the millennia).
Beyond these fundamental measures, understanding basic anatomy, physiology, and nutrition (intelligible for almost anybody with a high school education) will go a long way to getting a handle on the basic principles that govern organ systems.
At the very least, armed with knowledge, you can present to your physician as an educated person so they can spend time filling in the gaps in your knowledge (remember, doctor means "teacher" in Latin). This should be your health care providers' first responsibility.
In the end, it should be YOU who is making the decisions because nobody cares about your health like you. If you are going to defer to an expert, then you are going to treated by a physician doing the best they can, but that's not nearly good enough.
Don't leave something as important as your health to the experts because you never know when they are going to take the drill out of their black bag and...
I was chatting with a couple of folks the other day and imploring them to educate themselves vis a vis medical matters and not just be satisfied with the what experts have to contribute to the conversation. I received a great amount of push-back, even being accused of this, that, and the other thing. I wanted to further that conversation.
Even if a medical expert knows 100% of the clinical information necessary to render a decision, it does not mean that they know your situation, and this is often THE most important part of the puzzle. Each individual has a unique history and a unique succession of events that have manifest into the current medical issue. Only YOU will be able to completely understand these histories/events, so this makes the individual the most important factor (by far) in their own health care.
It is imperative that each person educate themselves (schools have been woefully inadequate) so that they can apply all the preventive measures available and avoid infirmity. Eating properly, sleeping well, getting regular exercise, and having a daily religious/spiritual practice will take care of the vast majority of potential issues (practices handed down by the sages over the millennia).
Beyond these fundamental measures, understanding basic anatomy, physiology, and nutrition (intelligible for almost anybody with a high school education) will go a long way to getting a handle on the basic principles that govern organ systems.
At the very least, armed with knowledge, you can present to your physician as an educated person so they can spend time filling in the gaps in your knowledge (remember, doctor means "teacher" in Latin). This should be your health care providers' first responsibility.
In the end, it should be YOU who is making the decisions because nobody cares about your health like you. If you are going to defer to an expert, then you are going to treated by a physician doing the best they can, but that's not nearly good enough.
Don't leave something as important as your health to the experts because you never know when they are going to take the drill out of their black bag and...
Comments (101)
I have worked in mental health care and I do believe that the direction that aspect of healthcare is going towards is recovery focused models of care. Hopefully, my fears of totalitarian authority are not going to come into medicine and the direction will be one of empowering people to make their own decisions about health. In my last job, in inpatient psychological therapies, a central idea was aiding the person to become their own therapist.
I finished college and had still not acquired a very good, practical understanding of how a body worked. Over the last 50 years since I have put together what I think is a solid understanding through reading magazines like Scientific American or the New York Times science section, and picking up consistent information here and there in books, conversations with well informed people, etc.
Careful use of the Internet is also a good source of info, with the understanding that there is a lot of garbage out there.
For instance, Wikipedia affirms your evil spirit treatment by trepanation, but also says:
Is trepanation an effective treatment for evil obstructionist conservative politicians? Let's find out! I have a wood chisel and a hammer; line them up and send them in. We could also try icepick frontal lobotomies, while we are at it.
The words, "expert" and "experience" share the same word root which is "experiri" whose meaning is "TRY". By that token, anyone who tries even for the very first time is an experienced expert :lol:
Jokes aside, experts must have 1) knowledge at the level of principles governing the objects and phenomena that make up their domain and 2) hands-on experience, a good track record insofar as handling real-life situations that involve their area of expertise.
In short, an expert is a knowledgeable and experienced person. The problem is that our youth is spent absorbing knowledge and our dotage is spent gaining experience and so, quite naturally, we're all dead by the time the word "expert" is applicable to us.
Looking for an expert? Ask for directions to the nearest (to save time) mortuary.
And yet doctors and other medical professionals routinely expect their patients to blindly trust them and obey them. They hate an informed patient.
In most cases this is true. The key is in understanding why this is the case.
Let's eliminate the ego-factor that many high achieving individuals seem to possess. This accounts for much of the, "I am better than you because I went to school X years, so on and so forth," attitude.
I will speak only for the U.S. as this is where I have always practiced. Doctors of all stripes are really good people. I have known very few who are incompetent or uncaring. That's the good news. The bad news is that doctors (as everybody should understand at this juncture), have been massively dis-empowered by the corporate-government cabal that runs the U.S. health care system.
Be in price fixing by the government in Medicare/Medicaid or the incredible control that health insurance companies have over every aspect of modern practice, almost all doctors are no more than glorified employees (if not actual employees) of a system that has long prioritized efficiency and profits over patients.
The way they have done this is through all the same processes that have metastasized the U.S. economy since the seventies, i.e., changing the laws, rules, regulations, financialization (student loans and insurance schemes), and outright fraud (e.g., price fixing with BIG Pharma).
Doctors are caught between a rock and a hard place and most have absolutely no choice but to act in the interests of those who control them. This is why I have told my patients to never assume their doctor is acting in their best interests, and their best defense is to educate themselves.
Doctors do not want you to be informed because the system pays them for seeing as many patients as is possible, so an informed patient requires time...to further educate, to lay out options, to discuss options, to develop a plan, etc. It's THAT simple. The government and the corporations decided that you will remain ignorant and without choices because your doctor is not being paid to educate you, instead, they are being paid to make money for corporate interests (while at the same time keeping the government bureaucracy sufficiently bloated).
Of course, it's not that black and white and there are highly skilled and very compassionate doctors out there who do everything they can to circumvent the system, but the pressure to see patients "as efficiently as is possible" is ENORMOUS and has been for a long time now.
All systems work by creating dependency. There is no better example of this process than is modern health care in the U.S.. You have little choice other than educating yourself and then acting intelligently by taking good care of your body and then, if the needs arises, confronting the health care system armed with knowledge that will help you get the best care possible.
Very Socrates of you..ha
"If you listen carefully enough, the patient will tell you EXACTLY what is wrong with them."
Never discount the value of your knowledge when you go to the see your doctor. Tell him/her everything you can remember about your issue. You have no idea how much this helps!
And the patient is, of course, by default "the fool who thinks he knows".
No, the problem is that people are too damn lazy.
Have these schools poisoned your minds to the extent where you simply believe there is no purpose to educating yourselves?
If this is the case, then you folks have zero chance.
I have said to my friends and family many times, "I don't see how anyone survives the American medical system without a nurse in the family." My wife is a nurse. My sister-in-law and many of my neighbors are nurses, with one doctor in the bunch. One neighbor, a maternity nurse, was at the birth of all three of my children. So, my solution to the problem, only partly in jest - marry a nurse.
Also, never leave anyone you care about in a hospital alone. See them every day. Make sure you understand what is going on and who is responsible. They probably won't be able to do that. Even without whatever problem they came there with, hospitals are disorienting and discouraging for patients. Someone needs to be paying attention to the patient's well being above all else. That's probably you.
Good observation! I honestly never noticed that parallel.
I always come to doctors (and most any kind of expert) with all the information I can and what analysis I’ve done of it myself and where I got stuck trying to figure it all out myself (which is why I’m now seeking expert help)... and more often than not come away with an off-the-shelf non-solution that doesn’t account for most of the details of my particular case.
You might be confusing efficiency with laziness. If a person can do more than another person in the same time, you might mistake the more efficient one as a lazy bum.
This is exactly how broken the health care system is (as are all institutions). Keep in mind that there still are some good doctors out there. You just have to search for them (word of mouth) if you are able to access providers outside of your insurance.
Just the same (and keeping in mind what the situation is) keep educating yourself. It's your best defense (other than doing everything possible to stay healthy) that may alert you to a provider who really isn't paying enough attention.
This health care system could care less about individuals. It's all about group statistics.
Based on my experience of working in England, it is hard to balance the emphasis on quality of patient care and statistics. I think that it fluctuates, but both are seen as important. At the moment, we have government funded healthcare, and I just hope it continues. Certainly, managers have an emphasis on high quality care, but this is also bound up with a concern to meet standards and targets in order for funding. But, generally, staff members in mental health care usually strive to give quality care in the settings which I have worked in.
Statistics are how large organisations decide if goals have been reached (and they are never about individuals). They always allow for the failures because they are only interested in how the majority fare, i.e., if the most people get mediocre care, than its a "win" for them (despite the fact that the minority received nothing that addressed their issues). Only individual providers are capable of dispensing human compassion.
Quoting Jack CumminsThat's like hoping that the guy who rapes your sister is (at least) good looking. The answer is to get rid of the government and the corporations and give health care back to individuals and very small companies.
Mixing large groups and health care turned out to be the complete disaster as was predicted decades ago. It did not take an Einsteinian mental acuity to have predicted this outcome..
I think that if England lost the NHS it would be the biggest misfortune for England. If people had to pay for healthcare, most would probably simply go without it because they wouldn't have the money. I think it is already getting to the point where people are trying to do their own dental extraction. We would probably be in the situation of people becoming seriously unwell and not getting treatment, and I am talking about physical illness, not just mental illness. The rich would thrive and the poor would not.
In mental health care, many facilities, especially rehab services have been privatised but funding packages are usually available.The reason why the services were privatised was because what they were offering was social care mainly.
I don't know which area you worked in but I saw high standards of care in mental health care, because I know that most patients felt that way. I think that statistics is less a focus rather than quality care inspections, and patients views are central in England. The problem which I saw was that so much demand was put on staff members, especially in acute psychiatric care . Also, there is so much anxiety about inspections amongst managers and the staff who look after patients directly. I am thinking that I would like to go in a slightly different direction lon the future , like working with the homeless or in addiction services.
However, I do believe that there is a certain authoritarian aspect to the medical model of psychiatry, when patients are medicated against their wishes. However, it is complicated because the consequences of untreated mental health can be serious for the individual and for risks posed to others. I do see recovery focused care as a positive move, and I do favour holistic ways of helping people. However, I do think that some of the thinking in mental health care is a bit rigid and after being out of the system for a while, and writing on this site, I would find it hard to fit in again. Going back, I used to sometimes say things and other staff looked at me in a puzzled way. Certainly, most of the nursing staff I worked with didn't embrace philosophy, and I am not really sure about the psychiatrists. One funny comment I received from a patient when I was working in an acute psychiatric admissions ward was, 'You're madder than any patient on this ward.'
Consequently if you get a family practitioner, you stick with him or her, because there is no way you can shop around. A lot of people rely on walk-in-clinics to get family medical help.
My doctor is good. He listens to me, and he does consider my input. However, he gets angry and he gets verbally hurtful. He does not trust that I say my symptoms right, or accurately, he's convinced that I exaggerate.
I state my problems as precisely as possible. My doctor listens, and I don't know what goes on in his mind. He gives me proper treatment, with a hurtful tone of voice and with hurtful remarks.
dr. Synthesis, what should I do? "Take two aspirins and I'll not see you in the morning."
We have a similar system here in Canada. And all, or most Canadians think that if we lost the NHL, we'd be much poorer for it.
If England lost the NHS I think it would the complete end of the country. Significant proportions of the population would die literally. It would be on such a scale that it would make the deaths from Covid_19 seems a minute fraction. I think that is why England has imposed such extreme restrictions on people, because the NHS and the welfare state are central to life. So many people are dependent on it and would not be able to survive at all if it collapsed. It would be a catastrophe beyond all proportions if the NHS crumbled.
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?
There are many issues here but the bottom-line is that each individual needs to be personally responsibility for their own heath (just like the solution to education is to make each parent responsible for their children's education) . The days of treating your body like an hated enemy is over. Society can not afford to repair everybody due to the fact that people have refused to take proper care of themselves.
Imagine if tomorrow your government decided that they would fix everybody's automobile regardless of the maintenance you preformed on it. How would that work? This is what's going on in health care.
Health care needs to be about health care, not sick care. The majority of the money invested in the system needs to be about education and promoting beneficial health practices. Of course, there's no money in maintaining good health which is why the corporations must go. They are only concerned with profits (as they should be). There is no niche for this type of organisation in health care.
On the way out the door (and right behind the corporate CEOs) should be the government bureaucrats as the only purpose they serve is to make things worse (more complicated and more expensive). The system needs to be given back to individuals and small non-profits
You will ask, "What happens to the people who become ill or are born with various issues that are no fault of their own?" I suppose each society will have to answer this question after taking off the rose colored glasses that have been allowing them to go into massive debt and/or counterfeit their currencies. The funny money is going to go away sooner than you think.
Much of the previous fifty years of completely irresponsible social policy has been financed fraudulently, something that the majority of folks should be aware of at this point. New leadership needs to tell the truth (adopt sustainable policies via using real money) and then societies can decide on what they are willing to spend on sick care.
These are complex issues but ones that need to be confronted before the corporations decide that serfdom is truly the new black.
Cool.
SO how do those with disabilities fit your scheme?
I am not sure how health care is different in America but in England there I am more worried that we are on the verge of losing what we have rather than wanting it all to go. Personally, I am able to read up on health matters but that is because I have worked in health care. I usually only go to the doctor if feel that I need some specific medicine or some interventions which I cannot get without a prescription. However, when I interact with so many people, who are intelligent, they really don't seem to have much knowledge of health. It may be a problem of the education system, and it may be at this level that improvement can take place rather than by trying to dismantle the health care system itself.
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.
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.
These systems are horrendous but you'd rather have them then take the chance on having a much better system that actually addresses core issues. The deal is to stay healthy, not wait until you body refuses to take any more abuse. This should not be this hard to understand.
And desiring to hang on to broken-down institutions? What's with that?
It's time to move on, folks. It's long past time to say good-bye to mommy and daddy (corporations and governments) and take control of your own lives. Don't you people want to be free again?
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?
That's up to each society to determine.
You want to bankrupt your society trying to keep everybody alive forever, go for it!
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.
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:
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.
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.
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.
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 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.
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.
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 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.
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.
And you base this on what information?
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!
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.
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.
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.
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.
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.
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.
Corporate power.
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.
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.
- 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
How can you have a tea party without sugar? It's time the Britons threw their own selves over.
Corporate power is derived from governments. Look at what governments did over something like COVID. Just about shut-down the world.
Go tell that to the 100M people murdered by the Communist/Socialist governments in the 20th century.
How do you reconcile the fact that the US is about the only developed nation without socialized healthcare and yet the US government pays far more than any other nation, and with no better healthcare outcomes.
True. You really need to be your own advocate. But if your doctor isn't able to help you, you should keep looking. Somebody out there might know how to help.
It's hard to stay optimistic, but the people who do are more likely to find the right expert.
Corporatism and massive corruption on every level.
Let's say you go the THE best doctor in the world. Is that enough? I say no (and I should know).
What I am saying is that the patient can (and should) play a critical part in their care. The more you know and the better you can inform your caregivers, the better care you are going to get.
It's like everything else in life, you do the minimum, you get the minimum in return.
The whole point of socialism is to protect the working class from corporations and the like.
The guy who knows the Epley maneuver probably doesn't know how to weild a gamma knife. The guy who can fix your kid's heart probably doesn't know the signs of excessive copper. Sometimes you need an expert.
But yes, as I said, you need to be your own advocate. That means learning.
I am not denying that those states had oppressive regimes. But you discount the systems that they had grown out of. In the great depression most western countries in Europe had a horrible life for the common man. In the industrial upheaval in around the late nineteenth century, and early twentieth century, people literally worked themselves to death due to starvation, sickness (c.f. present day health care systems!!!), and bloody-handed treatment by police if organized resistance was suspected.
Those systems made people really look to communism, and in Russia the socialist revolution wouldn't have won, but it had the support of the people, because in those years their only hope of a decent life was via communist rule.
So... Stalin killed 30 million, Lenin... well, Lenin had to contend with the invading armies of foreign powers so his "killing" is not really directly oppression-related. In my country maybe 1000-5000 people died due to political reasons in the communist times. I don't have exact figures, because I went to school there in the sixties, and the curriculum did not cover that. Whether Stalin killed those thirty million was due to design, or due to a huge crop failure in consecutive years, is debatable. Mostly Ukranians died, and they did because the food that was very scarce was given to ethnic Russians. I admit, there were politically induced murders, everyone read the Gulag Archipelago by Solzhenyitsin. Most of those oppressed, be they eventually murdered or not, were not punished due to the regime, but due to the paranoia and madness of Stalin. He was worse than Hitler; he killed due to his paranoia, much like Nero and Caligula, not due to some evil political idealism, like Hitler.
But the oppression by governments in Eastern Europe was still a system that provided a heavenly existence to the largest segment of the population IN COMPARISON with the pre-war and turn-of the century conditions. They did not drive cars like people in America in the sixties, they did not have colour tvs like Germans in the seventies, they did not own property like anyone could in the west in the eighties, but they had food, clothing, transportation, all affordable, and free schooling and free HEALTHCARE. None of that was enjoyed by the great majority of the peoples of those countries before the communist takeover.
Sometimes the answer or the treatment or cure is not found, by a practitioner, and also by the patient, because it does not exist in present day knowledge.
I often wondered why doctors don't address some of the issues I raise to them, and I learnt over time that they don't because either the issue is not a matter of their scrutiny, or else because the scrutiny has not found a treatment.
Doctors are not gods. Patients are not doctors.
In fact, my cardiologist friend tells me what everyone knows: most people are not getting better, due entirely to their not taking their doctors' instructions. This is is beyond "educate yourself" or "be your own advocate". it is a matter of laziness, conspiracy tales trickle down effect, religious intolerance against treatment, or which is the majority, a lack of insight to know the patient needs to adhere to treatment.
No really it will work this time....HA HA HA HA!!!!
Justify mass slaughter any way you like. People have been doing it forever.
Next time you go to your doctor, preface your observations/comments by telling him/her that you know everything. That should resolve your issues with your care providers once and for all.
Here's the take-home message. Once people form poor life habits, it is difficult if not impossible to change their ways, so the emphasis should be on education when people are young and throughout their schooling. The importance of eating well, exercise, and other positive life practices should be a priority, as well.
Once people develop chronic conditions, it's late in the game.
I hope you are not talking about me, as this does not apply to me.
But I did notice that those who don't follow doctors' advice are not prone to going to doctors. They have their own theories: "You only get sick in the hospital. I'll never go to a hospital. Remember uncle Fred? He went to the hospital just once, and he died there. Stay out of the place." Some people don't even take a pain pill, because they don't want to mess up their own body chemistry. Some people reduce their life-saving medication for a chronic ailment, weaning themselves off, as if it were an addictive therapy.
However, I will not say those people should be barred from visiting doctors for advice. Yes, they can stay away on their own volition, but society ought not to punish them for being blockheads.
I agree with this. However, education can only be carried so far. In my old country the emphasis is on scientific education, right in grade school, and every student needs and must take all the subjects. So they all take math, biology, chemistry, etc. as well as literature, history and phys. ed. Heck, they even must take art and drawing.
And guess what: people in my old country have vocal advocates of no mask, of public gatherings, of antivaxxing, etc. The percentage change is not different.
One more example. On a public tv show a famous (in that country) humorist celebrity pretended to be a stranger to the city. A film crew was recording this, I guess hidden from the passers-by. Everyone tried to help him with directions. Then he said, "hold on, I've got a map," and he pulled out a SEWING PATTERN. obviously it was full of random-looking lines, and dotted curves, etc, and people showed him, "You see, you are here," and they put their finger at a point, "and you go this way, then turn left," etc.
These were people with public education.
People can't all be taught. No matter what you try, and it's not only the insane or the intellectually challenged that can't be made to know. In my estimate anyone with high school education in North America and an IQ less than 120 retains less than one percent of their once-known subject material. They know how to add or subtract, but they can't divide a polynomial into another one, and they can't find the lowest common multiplier of 6 and 12. They know of the capital of Holland that it's H, and that French eat frogs. Everyone knows who Hitler was, but not many know the major achievement of pres. Jefferson. (I don't either.) Nobody knows who Adenauer was, and nobody can name the first woman in space.
Therefore my only addition to your opinion would be to have ONGOING mandatory education (academic) for adults. We know how to add and subtract because we practice it every day. We don't know why abiogenesis is possible, because the chemistry is long forgotten.
Then we'll be spending public money what we save on an educated patient clientele, on the education of the clientele.
In my opinion you can't win.
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The Czechs didn't have it so bad. And the Austro-Hungarian Empire wasn't so backward as let's say Russia. What I remember is that the country (Czechoslovakia) was a democracy and a prosperous industrialized country after it's independence. And they did have cars, they even made them back then. Tanks too! And my country's southern neighbor Estonia would likely be far more wealthier than my country today if they wouldn't have "joined" the Workers Paradise. It's catching up very quickly.
You are angry for no reason. I stated that doctors don't know everything, and I stated how they handle situations when they don't know the answer to a concern. IT DOES NOT MEAN I DO KNOW. Furthermore, there is no disrespect intended, because I DON'T EXPECT DOCTORS TO KNOW EVERYTHING.
Your advice is insulting, which is accepted on these forums, but please think back and try to see that I was not insulting the profession, I was just illuminating the standard. I have no bitterness for that, and if you got that out of my post, that I was bitter and disparaging, maybe it's your expectation that people are disrespectful in this aspect. Well, I am not, and I hope I did not write anything that would have insinuated that I am disrespectful.
The Czechs, and to a lesser degree, the Slovaks, prospered during communist times, but there was strong oppression... why else the "communism with a friendly face" movement in 1968 that brought in the Russian occupation.
Czechoslovakia was as much a democratic country as all other satellite countries of the USSR. They had a one-party system.
I think nearly all, if not all, of those car manufacturers above listed manufactured cars prior to WW2 with Skoda being the most famous...a rare car in that it was exported to the West during the Cold War. But anyway.
Many times people do bring up Czechoslovakia or East-Germany as "the better" examples, yet it is quite obvious how much better things would have been if it hadn't been for the Soviet system of marxism-leninism. The fact that we had West- and East-Germany and today still have North- and South Korea and China and Taiwan make the obvious comparison that shows what works and what doesn't.
The fact is that now we have a young generation for whom the Soviet era and it's authoritarian system is forgotten history, hence the same rhetoric used during the Cold War can be recycled from the past. With ignorance of the reality a romantic picture can be painted, which doesn't make it look so bad, but rather interesting. As of course, not all socialist regimes were like the Red Khmer in Cambodia. And history in the West doesn't bother to look critically at the system during the Soviet era. It's not a trendy subject.
It's not about winning. Instead, it's about giving people the freedom and responsibility to make the best life possible for themselves and their families.
You can't say that we have this group over here that is lazy and just wants to get by doing the minimum (or less) and have them penalize the rest. This is what socialism does, plays to the least motivated. You want you society to be just the opposite, strive to the highest levels, but at the same time putting in place better functioning checks and balances.
Of course, those will eventually corrupt (as do all social institutions), so you put all the pieces back in the box-top and play a new game. That's what we're in the process of doing now.
Why would I be angry? Do you believe you have that type of influence on people here?
You just come-off as if you are quite knowledgeable. If I was speaking to someone who just spent the past 50 years in one field, I might listen to what they have to say (especially if I most likely have little to no experience).
Anger is 99.9% about self, not other.
Unless of course you are born with chronic conditions. Hence my unanswered question about disability.
Again, the presumption in synthesis' position is that the best system is the one set up for middle-class educated folk - presumably also male and white.
This is true. Socialism tends to obstruct the plans of the most motivated, who can morph into exploiters in the right circumstances. Socialism creates an environment where error and inefficiency are tolerated.
If you value the freedom of potential exploiters over this, why?
Social man is corrupt. I believe we can all agree on this. So what's a society to do?
You can attempt to attenuate the corruption at the top through socialism (which also cuts out most of the innovation/discovery as well as destroying incentive), or you can allow people to be as creative as possible and keep incentives in place (with REAL checks and balances) and then the entire society can benefit from the people who dedicate their entire lives to this sort of thing.
Look to the 19th century for what can happen when people are set free! THE key is always in attempting to control the corruption. Capitalism is an incredibly productive system if it is allowed to function properly and somebody is watching that the wealthy are not buying too much political influence. The other ingredient is using REAL money. This (funny money) is the cause of most of the difficulties we face today.
They made cultural wastelands of every place they touched. I don't think that's what you want.
Would the world really be lesser without all the wonderful efficiency, innovation, and incentive (money)? Granted there's a lot of money to be made in inventing, financing, producing, marketing, etc etc, all the junk (mostly unhealthy junk) in the world, but money isn't everything, is it? Beyond basic needs it doesn't offer well-being.
Capitalists. Oscar Mayer, for instance. Or the british and french bankers who laughed at the stupid Russian workers, until 1917.
They need motivation to achieve Bed Bath and Beyond, but even those are going out of business now. Amazon and slave labor proved to be more innovative and cheap, I guess. Yay capitalism!
Quoting synthesis
Funny how when the rich are taxed at a higher rate they call it redistribution but not when their taxes are reduced.
I'm not fighting anything, man. Just philosophizing. So you don't pick freedom, you have no choice. Um.
But weren't you pointing out the folly of socialism?
If you choose to take this post as pro middle class white boy rhetoric, that's what you bring to the game. Look back at my posts: No race, no gender. A patient is a patient is a patient.
The push-back against the idea of people taking responsibility for themselves is truly incredible. This political climate has fostered a mentality where many wish to blame every damn thing on somebody else. Talk about the short road to hell.
Until people start taking responsibility for themselves, nothing is going to change (except the fact the truly caring providers are going to keep burning-out). Bring in the corporate docs who could care less about anything other than meeting the fiscal metrics (so they can earn a little extra cash to pay back their usurious student loans).
The problem is corruption. Redistribution works both ways (except the elite are rich enough to pay-off the politicians to create their loopholes (again, corruption).
You never want to discourage productive behavior. That kills your economy.