AuthorTopic: True Health Care Reform  (Read 5921 times)

Offline impermanence

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True Health Care Reform
« on: November 05, 2013, 11:35:38 AM »
I wrote this short essay a couple of years ago and would appreciate comments.

The decades-long health care crisis we continue to experience in the United States is mufti-faceted and highly complex, touching every U.S. citizen and every American institution. Despite the complexities, getting to the root of the problem simply requires us to confront the following realities.

First and foremost, we can not, nor will we ever be able to arrest the aging process, eliminate illness, nor avoid death. Despite what the myriad of “Eternal Fountain of Youth,” industries puts forward, these very events define what it is to be part of the organic life-cycle on this planet.

Therefore, it would seem that we, as a society, need to let go of the illusion that we can circumvent the natural order of things.

Secondly, each individual needs to take primary responsibility for his/her own health [care]. No more dependence on having others bail us out of poor life choices [insufficient exercise, poor diet, unstable mental/emotional/spiritual states]. No more squandering the nation’s wealth on highly destructive lifestyles and their outrageously expensive antidotes.

Additionally, and believe it or not, the amount of social wealth that can be allocated to health care is finite. We can no longer tolerate insurance companies acting as health commissars, corporations that are a hideous synthesis of investment banker, tax collector, medical policy and decision maker, and grand financializer, indeed, the worst of all worlds.

If we well-understand that ignoring basic vehicular maintenance leads to pre-mature wear, mechanical breakdown, and expensive repair costs, why do so many of us fail to acknowledge that a similar outcome is inevitable when it comes to our bodies?

Although volumes can be produced attempting to figure out why people do what they do [regarding their health habits], social policy need not be concerned with the reasons, but only insure that individuals take personal responsibility for their actions, and not necessarily because it will result in a better [health] outcomes or a more productive citizenry, but instead, because there are simply no other fiscally sustainable alternatives.

The current health care system is geared to heal, repair and/or replace. Attempting to repair and re-fabricate body parts on every American within the context of the current explosion in technologic potentiality is absurd.

Imagine the possibilities when considering the varieties medical technologies already in place; transplantation, bio-mechanics [robotics], genetic engineering, and pharmacologic, to name a few. Soon enough, you will be able to spend nearly unlimited amounts of money keeping just one person alive!

The solution? There is only one solution and that is prevention only. And although this may seem harsh upon first consideration, it certainly seems to be closer to what Nature intended for all of Her life-forms. Regardless, it is what it is.

Whatever resources can be allocated to health care [within the context of a fiscally responsible government], should be earmarked to prevention, that is, actual health care.

If, by chance [or misfortune], you happen to contract a disease/develop a condition/be subject to an accident, then you are in the same position as people are today when there are no known treatments available.

What would probably be available are low-cost conventional, alternative, and natural remedies, provided by individuals or small businesses, and payable in cash.

In order to prevent a similar sick-care system from being resurrected, health care must be de-institutionalized. No more insurance companies, no more Big Pharma, no more corporate super hospital systems designed to turn natural events into mega-profits for the few and fiscal bankruptcy for the rest.

The results of a de-centralized system will be fiscal sanity, individual responsibility, and hopefully, a much healthier population. This is not to deny that a move toward sanity in one respect will not cause much pain and adjustment in others, but the development of just social policy must have [at its core] compassion, personal responsibility, and sustainability driving the process.

Just as the welfare state could not save everybody from the natural forces of human social interaction, or give unqualified people mortgages in order to allow them to live “a better life,” we cannot promise to save everybody from the inevitabilities of our own natural life-cycle.

Getting beyond this era of counterfeit debt-money, and the resulting fiscal insanity it has guaranteed, will require the acceptance of principles that were once very much a part of who we were as Americans.

We must accept that just as real wealth is created by producing, saving, and investment guided by the principles of transparent risk/reward assessment, our good health must also be earned through sensible eating habits, adequate exercise, and some method of maintaining mental/emotional/spiritual balance.

Better times lie ahead for those willing to take responsibility for their own wealth and their own health. 

Offline Eddie

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Re: True Health Care Reform
« Reply #1 on: November 05, 2013, 01:32:55 PM »
The problem with limiting medical care to "prevention only" is that it leaves a huge gap in meeting the needs of an awful lot of people.

My profession has been preaching prevention for nearly a hundred years. We are strongly into patient education, and I'm an advocate of people taking personal responsibility for their own health. Nevertheless, people still have problems. Some are preventable, some aren't.

If you bite down on a rock in your breakfast cereal and fracture a molar, preventive dental care is going to be the last thing on your mind. I pretty much guarantee you you'll find someone to fix your tooth or extract it.

If a kid breaks his arm, somebody has to set it right? Nobody is going to accept that nothing can be done, because everyone knows that a simple fracture is treatable and has a great prognosis.

I know the current level and style of care is unsustainable. But "no care" is not acceptable. Nor is it desirable. We can't replace doctors with nutritionists and fitness coaches. We could do some good if we exercised and ate right, but it wouldn't eliminate the need for care.

If we quit training doctors, we would soon have a variety of witch doctors and healers to fill the gap, because people will do anything to get help, and will turn to anyone who might offer to help them.

I do agree with much of what you've said, however.

My best alternative would be to let people age out of care at age 70 or 75. Not even eliminate care for them, but give palliative care only. And I'd have the system stop giving life support for infants born more than a month or so pre-term. And then I'd eliminate the military and put the money into healthcare. I'd nationalize healthcare completely and put the insurance companies out of business. I'd regulate the shit out of big pharma.

That would work in a pre-collapse world, I think.

 Post-collapse, I see medical care very much as Kunstler describes in his novels. A tough necessary job with lots of long days, and a lot of blood, sweat and tears. Lots of morbidity and mortality. But no plaintiffs attorneys, and a lot grateful local patients.

What makes the desert beautiful is that somewhere it hides a well.

Offline monsta666

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Re: True Health Care Reform
« Reply #2 on: November 05, 2013, 03:48:16 PM »
I think one of the biggest issues is that there is a fundamental conflict of interest when you make medical treatment a profit making business. The need to make profits often runs contrary to curing or preventing the patient from getting ill. This fundamental conflict of interest is what generates the most waste in terms of unnecessary procedures or middle-men (insurance companies) getting in the way and taking an excessively large cut in the whole process. This is why I think medicine is generally cheaper if it is socialised as you eliminate the conflict of interest and thus allow doctors and nurses to focus on what they do best and that is offer the best service for the patients needs.

Now the argument can be made that if people are not directly paying for their medical coverage money will wasted due to moral hazard whereby they go into hospital for frivolous reasons. I will not argue that this will not happen as you will get some cases of money being squandered on unnecessary treatment. I would argue however that the waste caused by this moral hazard would be less than the waste generated by a profit led medical industry as in any system that involves profit making not only must you account for the service cost but you must add on the profit margins these companies make. It should also be remembered that in many cases people don't want to go to hospitals because they dislike hospitals. This dislike and reluctance to visit hospitals is only exacerbated if people pay directly for their medical expenses because then they are more likely to go when things get really bad. The problem with that is if people wait to go to hospital when a case is at an advanced state then often the medical costs will be higher than if they went earlier. So when talking about the two systems it is good to bear this point in mind.

As for the other point about making people lead a more healthy lifestyle; I think this is a very difficult task regardless of what medical system you use. Paying higher medical costs does not seem to make people change their lifestyles and I feel attitudes towards diet, exercise are more largely governed by the prevailing culture rather than medical expenses. If you look at places like Italy or Japan the cost of medical treatment is not significantly higher there than the US (in fact the opposite is likely to be true) yet their dietary and exercise habits are better. I am not sure you can really control these attitudes easily although the government can slowly change attitudes if they are willing to invest in awareness campaigns for long enough period of time. For example the attitudes towards smoking and drink driving in the UK have changed significantly over the last 30 years so attitudes can change at least to some degree. Then again there are limits to what you can do here and at the end of the day people have got to make the decisions.

It is also important to realise that regardless of what system you operate be it privatised or socialised neither system is sustainable if it is based on catering to ever growing populations that are living progressively longer and resources are limited. This means when framing these arguments we should not fall into the trap that one system is sustainable while the other is not. Modern medicine as we know cannot be sustained and it is just a question of which system can last longer than the other. In a post collapse world nature will sort this stuff out and it won't be pretty however if one wishes the system to persist as long as possible then the obvious way in reducing costs is to stop treating people above a certain age say 75 or more. This will save a hell of a lot of money but unfortunately such a stance is politically untenable.

Offline WHD

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Re: True Health Care Reform
« Reply #3 on: November 05, 2013, 05:48:08 PM »
Life strives to stay alive. Expecting humans not to take advantage of the means available to heal, whatever it is, is contrary to the nature of Life. Also, some people will take care of themselves, some will not. It just happens now, people are encouraged to treat themselves in a way that weakens them, that they might be fodder for a predatory capitalist "Health Care" industry, and so are "rewarded" for gorging on GMO, high-fructose corn syrup, corn fed meat, fast food etc. It will not always be thus, though. Soon enough in historical time, those who do not take care of themselves will not survive so long, many of those genetic anomalies that have persisted (such as my shitty eyesight) will be weeded out quite naturally.

That said, it is something like disingenuous to perform open heart surgery on 6 month olds. Such as these, kept alive, as much a joy they might be to those close to them, often are the beneficiaries of millions of dollars of medical care before they are out of their teens. Contrasted, I am healthy, hard working, knowledgeable etc, but society will not pay for me to fix my eyes, or even simple work on my teeth, even as I am expected to pay (Soc Sec) for the care for that 6 month old? What madness is this? The kind that makes us wail for that child, but shrug indifferently as our Peace Prize Prez drops drone bombs on kids in the Middle East.

Capitalism benefits the worst among us the most, and we justify that in part, by heaping wealth upon the weakest, in the form of modern health care. Capitalism as we have known it is in it's death knell, as is Health Care, so again, all that will change. It's always a good idea to take care of yourself, no matter what. Better yet, stay light of spirit, which is the greatest of tonics. Otherwise, for those who care deeply about future generations, look to plants. Most of Science will be lost, but plants will remain. As Wolf Storl likes to say, there's a plant for every ailment.

WHD

 

Offline impermanence

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Re: True Health Care Reform
« Reply #4 on: November 05, 2013, 06:03:16 PM »
@Eddie

The problem with limiting medical care to "prevention only" is that it leaves a huge gap in meeting the needs of an awful lot of people.

This is the problem with thinking.  People have come to the conclusion that people need to make the attempt to live forever.  Of course the health care establishment buys into this insanity because, among other things, you can make a great deal of money off of such lunacy.  So crazy is this idea that it brought in the clowns to counterfeit money and bring future income forward [debt] as methods to keep this Ponzi going.

"Needs" change quickly.  Seems like everybody needs a new car now, and a granite counter-top, and all the other non-sense.

The only sustainable economic paradigm is for people to live within their means.  Whatever income they might have to dedicate to health is all they should spend, period.

Offline impermanence

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Re: True Health Care Reform
« Reply #5 on: November 05, 2013, 06:09:54 PM »
@monsta666

In a post collapse world...

The collapse has already happened.  This IS the post-collapse world.

Offline Petty Tyrant

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Re: True Health Care Reform
« Reply #6 on: November 05, 2013, 06:20:54 PM »
agreement all round it seems on wa$te where the grossly overweight, drug addicted, renal dialysis, palliative and a trimester pre term are concerned.

But where do you all stand on disability services for the profoundly disabled. "coordinated care" monthly meetings where 6 or 8 service providers sit around a table devoting also travel time to and from, etc. Its hugely expensive.   

Also where do you all stand on affordable accessible mental health care for everyone?
ELEVATE YOUR GAME

Offline impermanence

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Re: True Health Care Reform
« Reply #7 on: November 05, 2013, 08:09:41 PM »
@WHD

Expecting humans not to take advantage of the means available to heal, whatever it is, is contrary to the nature of Life.

Understood. 

This is the problem and one of the methods by which those who organize, exploit the rest.   Be it Religion, Government, Education, Health Care, or other powerful institution, it is the creation of dependency through the exploitation of natural tendencies that garner the greatest rewards.



Offline impermanence

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Re: True Health Care Reform
« Reply #8 on: November 05, 2013, 08:18:52 PM »
UB

But where do you all stand on disability services for the profoundly disabled. "coordinated care" monthly meetings where 6 or 8 service providers sit around a table devoting also travel time to and from, etc. Its hugely expensive.   

Also where do you all stand on affordable accessible mental health care for everyone?


It doesn't matter where I stand, all that matters is that people spend that amount of resources they can afford.  Let the market determine what will be.  Who knows what interesting things will crop up once you give the system back to individuals.  Seems to me that a lot of great things can happen in health care within the context of simplicity. 

Just think about how people might approach there health if they didn't feel as if they were going to be bailed out by medical/surgical intervention.  And, if they choose to ignore such, so be it.  The key is in re-instituting personal responsibility.

Offline WHD

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Re: True Health Care Reform
« Reply #9 on: November 05, 2013, 08:52:00 PM »
I was thinking about the course of the health care dialogue going on here lately, as I was @ work today. Consider a young woman, open heart surgery @ 6 months, somewhat physically disabled, present and verbal but autistic, among a myriad of other mental and physical issues. She has a high quality of life considering she is on death watch, on a no-resuscitate order of her own and her family's design. I estimate she has "consumed" maybe $2-5 million in health services in her life, maybe more, maybe much more, as she has never been without extensive care in 21 years.

I know her. I like her. She loves her mom. Her mom loves her. She has friends. She misses her grandmother very much, and anticipates seeing her in heaven.

Who is to say she should not have had that care? 

Then again, would any involved have lost less if she had been allowed to pass 21 years ago? And where would health care be if we were as a culture not so sure that it is right to keep them alive when nature alone would take them?

Then again, there are some who can not take care of themselves, but who are joyous, good people, often a joy to be around? In a less care oriented culture, would these have been allowed to grow, and if not, what would be lost?

It is not so easy as making broad statements about what should, or must be done. It will NEVER be an easy question, no matter the state of the culture.

WHD     

Offline Petty Tyrant

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Re: True Health Care Reform
« Reply #10 on: November 06, 2013, 03:33:01 AM »
UB

But where do you all stand on disability services for the profoundly disabled. "coordinated care" monthly meetings where 6 or 8 service providers sit around a table devoting also travel time to and from, etc. Its hugely expensive.   

Also where do you all stand on affordable accessible mental health care for everyone?


It doesn't matter where I stand, all that matters is that people spend that amount of resources they can afford.  Let the market determine what will be.  Who knows what interesting things will crop up once you give the system back to individuals.  Seems to me that a lot of great things can happen in health care within the context of simplicity. 

Just think about how people might approach there health if they didn't feel as if they were going to be bailed out by medical/surgical intervention.  And, if they choose to ignore such, so be it.  The key is in re-instituting personal responsibility.

Nobody smokes and drinks and takes drugs to excess, eats to excess or has retarded children thinking it will be fine because of the medical system. They simply think either it will not happen to them or they will stop before they get terminally ill. Other than that it seems to be stating the obvious. The only question then flowing from this is: In the future/present collapsed system, will/do you give free advice or tx?

Do you have access to  chest xray? No

Do you have acess to a stethoscope then? No

Do you have access to a good ear for a chest tap? Yes

Do you have acess to antibiotics for your dx? No

How many eggs are you asking for now for your help in this brave new world of possibility when the money to run the system is gone?

So you can no longer prescribe anything, radiologists etc are all obsolete, you cant get a blood path test done even.

You can advise people to eat less and exercise more at least. But they probably already are.

Non paharmacological psychological intervention is still possible. Its about the last thing left so has to be central to your central thesis.

Herbalists with herb gardens should do real well, as well as anyone familiar with emergency surgical procedures who can improvise what they need. Boxers can even moomlight as anaethestists.

ELEVATE YOUR GAME

Offline g

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Re: True Health Care Reform: No Folks, It's not Going to Work
« Reply #11 on: November 06, 2013, 04:43:17 AM »
From the pen of Karl Denninger,



No, Folks, It's Not Going To Work
 


President Obama has now changed his tune, trying to defend the lie he sold young adults (most of whom voted for him twice), now saying that his line about "if you like your health insurance (or doctor!) you can keep it" wasn't really a lie -- he's claiming that what you were buying was a substandard ("defective") policy and that he knows better than you.

Really?  Does that apply to who your doctor is as well?  Or to which hospital you can use without getting a $500,000 bill (which you don't have, of course.)

    Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.

Isn't that special?

It's even better -- in many counties, including mine, there is exactly one company offering Brosurance, otherwise known as Obamacare, and Obamacare prohibits shopping across county lines.  In other words it's now a "take it or leave it and get taxed" situation.

What if your hospital of choice -- or doctor of choice -- won't accept that single "choice"?  Then you get the $50,000, $100,000 or $500,000 bill, that's what.

Let me point out my view on this -- I'm 50, in good health, and I've had a decent life on-balance.  If I contract some horrible disease or condition and have to choose between spending the rest of my material wealth on "treatment" (which may or may not be successful) or choosing to take the walk out on the ice, while it will involve a lot of contemplation the odds are very high that I will choose the ice and leave what I have of material wealth to those who I love and care about.

And before you scream "bull****!" I strongly suggest that you do more than a bit of research as to exactly how personally and topically-informed I might be on what is involved in that decision and its outcomes.  If you don't you're likely to find out how exactly nasty my language can be when provoked in public on a subject I'm rather motivated about.

But what if I was 18 -- or 27?  Or in my early 30s, with a very young child?  Maybe instead, faced with death or indentured servitude and a yound kid who is going to get rat****ed either way, entirely constructed by intentional acts of politicians who have sold knowing lies to the electorate, I might decide to take the path that was laid forward by Genesis in their 1974 song "Back In N.Y.C.":

    I don't care who I hurt, I don't care who I do wrong.
    This is your mess I'm stuck in, I really don't belong.
    When I take out my bottle, filled up high with gasoline,
    You can tell by the night fires where Rael has been, has been.

    ....

    Your sitting in your comfort you don't believe I'm real,
    You cannot buy protection from the way that I feel.
    Your progressive hypocrites hand out their trash,
    But it was mine in the first place, so I'll burn it to ash.

A band before it's time, I suspect.

Have we learned nothing from history, even recent history?  Our monetary policies and "rescues" of those who took actions that under any rational view would be called fraud were responsible for a rough doubling of the cost of living in places like Egypt.

Gee, you don't think Arab Spring might have sprung from the spirit of Rael, do you?

Does it stop here?  Oh hell no.  Now government is going to be making decisions on whether to spend $1.2 million on cancer treatment for one person?  Do you really think they will make that decision in your favor when the time comes? 

I'm reasonably sure they will when it's Pelosi, Reid, or Obama -- but how about when it's you?  :'( :exp-angry: :exp-angry:

You know the answer to that in both your head and heart, don't you?  You have to, both intellectually and emotionally, because it simply can't be paid for were everyone to get those "options."

DeNile (sic) is not a river in Egypt.

There are those who claim we should "listen for the voices of reason" in the health care debate.  Really?

The voices of reason, of which there are damned few, point to the Sherman and Clayton Acts, 15 USC, law passed because Standard Oil had a massive monopoly over the price of everything crude.  I simply say apply that law to every element of health care, whether it be pharma, hospitals, doctors or whatever and watch the price of health care crash by 90%, enabling virtually everyone to pay cash and obviating the need for "Brosurance" -- or anything else. 

And if we did that the above example -- the $1.2 million cancer treatment -- would be affordable.  It would cost $50,000 or $100,000.  And while that's still damned expensive, it now is within the realm where you could buy a catastrophic policy for about the cost of fire insurance on a modest home -- maybe $500 a year.  But for the routine doctor visit you'd stroke the $50 or $100 check yourself, for the medication you want you'd buy it for cash, and all of it would be dramatically cheaper than it is today.

This is not the work of fancy, because it was not long ago -- indeed, just 30 or 40 years ago -- that health care was exactly like that.  You took out your checkbook and paid.  You knew the price and it was both reasonable and affordable, even to a working-class family.  I know this to be true because I lived it and still remember it from my time as a boy. 

Remember folks, if you take the cost of a routine birth from 1963, in a hospital, complete with the epidural, doctor, anesthesiologist and three nights in the hospital, inflating that bill by the consumer price index from 1963 to today.  That birth today should cost less than $1,000 -- complete.

Go ahead -- try to buy that service for less than five times that amount today -- and you'll be kicked out of the hospital in 12-24 hours on top of it.

This is what "financializing" everything does.  It's what Wall Street and Washington DC have done to the price of anything where they can manage to build a monopoly wall around it, and all such walls are aided in some or fashion by government force.

They have to be, when you get down to it -- because without force all such monopolies eventually collapse.  If you put 20 carpet manufacturers in a room and let them negotiate among themselves where they will sell and at what price, the 21st guy, who is excluded from the room, will eventually figure out how to break the monopoly by underselling them. 

To prevent this the 20 need to use force -- either directly, by killing or threatening to kill the 21st or by getting the government to do it for them.

Thus you have laws forbidding you to go into Canada and buy Viagra by the truckload for 20 cents a pill, undercutting the $20 it costs here.  You have the "prescription" system for drugs that have no potential for abuse but for which monopoly profits would be instantly destroyed were they able to be bought and sold freely over the counter, especially across national lines.  You have the outrages such as the woman in Arizona who got billed $60,000 for a short hospital stay and two $100 vials of scorpion anti-venom made in Mexico -- that the hospital charged roughly $30,000 each to supply to her.  With no legal option to have someone get them in Mexico and bring them to her she was legally extorted at a rate three hundred times the going price. 

How else does a hospital charge you $5 or even more for a ten cent Tylenol capsule?  Why can't you provide your own, sending your best friend, husband or kid out for a bottle?  Simple: legalized extortion.

Why are not hospitals forced to post prices in public and not discriminate against or for any particular person?  How many liberals scream about discrimination on the basis of whether you like to sleep with men or women while at the same time they support and do not politically burn to ash every single medical provider that discriminates to the tune of 10, 100 or even 1,000% daily for some people and against others within the very walls of that facility?

The same applies to "higher education."  Why is it legal to discriminate against one person and for another?  Why can Harvard discriminate against the wealthy kid's parents, effectively forcing them to pay 2, 3, 5 or 10x as much for their son or daughter's education when the kid sitting next to him gets that same education for little or nothing out-of-pocket and both are equally intelligent on an objective basis?

No, folks, this is not just, it is not right, and it won't work.  The political calculus is that if the government can get you to believe you're the "winner" of such discrimination you'll vote for and support it.  But you're never in fact the winner -- you're the loser, and their cronies in industry are the only winners.

You are literally being robbled blind and not only are consenting to it in your own delusional state you're demanding it continue and accelerate!

Consider the medical situation again.  Your "win" is pyrrhic, because while you pay "just 20%" of the bill the bill itself was inflated by 500% and thus you paid the entire bill anyway and then on top of it you spent thousands on what is on any dispassionate analysis worthless "insurance."

Why worthless?  Because but for the scam that you voted for and supported the price would be 1/5th or even 1/10th of what it is today, your cost out-of-pocket would be the same or less than it is today, and you'd still have all the money you paid for the so-called "insurance" to spend on something else!

Wake up folks and burn this crap to the ground in all areas of our economy.  Do it peacefully and politically, but do it and do it today, because if you don't you, and your children, will be the ones who are destroyed.

http://market-ticker.org/akcs-www?post=225723 :icon_study:

Offline monsta666

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Re: True Health Care Reform
« Reply #12 on: November 06, 2013, 06:39:01 AM »
I don't think collapse has happened yet. True there has been a definite decline in living standards for many people but at this moment of time what we see is a slow decline and not something I would describe as collapse. At least this is my impression for places like the United States (the picture would be different if you are talking about Greece, Spain, Egypt etc.). In the bigger "core" economies such as the US people can still pretend BAU exists. At some point however you will see another crash reminiscent of 2008 but worse and at that point it will be undeniable that BAU no longer exists. What does this mean and what signs to look for? I would say a severe reduction in global trade, almost universal reductions in pension payouts and people losing access to their bank accounts either completely or partially. Imagine Cyprus but see that occurring in the US, UK, Japan, Germany etc. in the core economies that can't go bust. When things of that nature start happening that is when I see collapse happening and then there will be major changes in the health sector. At this moment of time though I feel we are in a bubble but this is the bull run phase of the bubble and it is only a question of when this things blows. My general hedge on this is 4-9 years when we see things really imploding.

Offline g

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Re: True Health Care Reform
« Reply #13 on: November 06, 2013, 06:59:01 AM »
I don't think collapse has happened yet. True there has been a definite decline in living standards for many people but at this moment of time what we see is a slow decline and not something I would describe as collapse. At least this is my impression for places like the United States (the picture would be different if you are talking about Greece, Spain, Egypt etc.). In the bigger "core" economies such as the US people can still pretend BAU exists. At some point however you will see another crash reminiscent of 2008 but worse and at that point it will be undeniable that BAU no longer exists. What does this mean and what signs to look for? I would say a severe reduction in global trade, almost universal reductions in pension payouts and people losing access to their bank accounts either completely or partially. Imagine Cyprus but see that occurring in the US, UK, Japan, Germany etc. in the core economies that can't go bust. When things of that nature start happening that is when I see collapse happening and then there will be major changes in the health sector. At this moment of time though I feel we are in a bubble but this is the bull run phase of the bubble and it is only a question of when this things blows. My general hedge on this is 4-9 years when we see things really imploding.

Hi Monsta, Hope you are feeling better.

I tend to agree generally with your posting, but can assure you that it depends on your individual perch in the US. There are large numbers of the population that have recently suffered a drastic drop in their living standards since the financial crises.

While my time frame for big trouble is much the same as yours; I think we both know that the fragility of the system could cause us to be way off the mark. The Japan situation is one quickly getting out of control, and it worries me an awful lot of late. Of course there are many other events, such as the European disarray to worry about as well.  The "Chinese Miracle" is a phrase notably absent as well of late. Much to be concerned and wary of.

Offline impermanence

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Re: True Health Care Reform
« Reply #14 on: November 06, 2013, 09:37:33 AM »
It is not so easy as making broad statements about what should, or must be done. It will NEVER be an easy question, no matter the state of the culture.

WHD 
   

In a sane system, the answers become self-evident.  It would be like buying everybody a Ferrari and then trying to figure out how the majority is going to afford the maintenance.

A system has been created that nobody can afford.   

 

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