Follow The Money: Your Money Or Your Life-The American Health Care Dilemma.

Civilization is still reeling from the murderous assault of radical Islam on Paris two days ago.It is becoming clear that compromise may be impossible with forces and minds that wish to restore the 16th century.The integrity of the civilized world including its health is of fundamental import and as D.S. has suggested very possibly one of the reasons that a federal government might not unreasonably wish to preempt health care, but the rest of the admonition using examples of Obama Care and the V.A. system as failures is not valid. Having trained in V.A. systems at a time when it was an outstanding clinical and research entity(a twenty year period roughly from 1950 to 1970)and having watched its deterioration from congressional neglect,(both funding wise and oversight wise)We must understand the bureaucratic cover up that took the place of oversight. Obamacare has added 16 million Americans to the roster of those covered by insurance and the Republican mantra of” It must be repealed” is abject nonsense.(Look at their alternatives…the best is “let’s think about it”)What is true is that Americans for the most part do not understand that Dr. Kildare never existed and that health care is a commodity.Death panels don’t exist but differential mortality according to race,and social class does exist.S.B. points us to a recent N.Y.Times article referencing research that shows increased mortality for white males linked to alcohol and drugs(particularly opioids),while s recent L.A. Times article references research that shows blacks(males in particular)narrowing the life expectancy gap between themselves and white males.This indicates that newer definitions of the likes of hypertension and diabetes are drifting down to the facilities that serve blacks and that greater access is being provided.White males(over 50) on the other hand are committing suicide and dying earlier due to alcohol and drug exposure.Hispanics are not being affected positively to the same degree but are gaining slowly.
The model of care is important, it affects access in critical ways. No self respecting physician with a public health sensitivity will deny that the single payer system provides the best overall coverage. It is not only true for small socialist countries.What it will affect is the flow of money.The intermediation which allows health administrative structures to siphon off huge sums will virtually disappear.The argument is is it “for better or for worse” economically?Choice of physician is not likely to be affected anymore than it is now by the HMO system.Negotiation for price of drugs and procedures will be affected but probably not much differently from the kind of impact that medicare is now having.The possibility of controlling epidemic illness(imported or otherwise) will be magnified hugely…think Isis.
S.B’s referenced article blames the doctors and greed for the opioid craze, I agree with the greed hypothesis but I would lay it more at the door of the drug companies who double,treble and more the cost of drugs and charge outrageously for life protracting drugs which may or may not be needed.D.S. thinks that “trickle down” works.I don’t. If it did then there would be many fewer Saudis manning the ranks of radical Islam and places like George Baker’s kingdoms and Jonestown would not have existed.
The health (mental as well) of Americans is a critical factor in the war on Isis ; the control of addiction to heroin and cocaine on both coasts and the addiction to metamphetamine in middle America are vital to the ability of civilization to fight a protracted war against evil.There is no quick strike solution possible, particularly when disaffection and non representation are feeding those forces with our own people.Even though many are willing to turn large areas of the middle east into S.B.’s “sea of glass”,it can’t be done with your own territory. We have to think and work strategically through a powerful,supported(not undermined )executive to ensure that Humphrey Bogart can keep saying to Ingrid Bergman “We’ll always have Paris”.



  1. Professor Thomas … how do we define and, more importantly, convince on a sense of purpose? It seems that the human experience … aside from the basic needs of food, shelter and security … is the never-ending quest of self-identity. To answer “why?” Why are we here? Thus, religions. They have the promise of answers … but, scratch the surface and, do they? It’s difficult to keep our survival instinct straight … it’s constantly warping. The lack of trust is now so pervasive that to not look for the ulterior motives qualifies one to the role of the ultimate naïveté. Or, worse yet, accused of arrogant claims of certainty where success is defined by only one’s opinion.
    CST: “Civilization is still reeling from the murderous assault of radical Islam on Paris two days ago.”
    All in the name of identity. Reeling? Stop the world … I want to get off! Is it age or a propensity to depression?
    CST: “The health (mental as well) of Americans is a critical factor in the war on Isis …”
    Yes. How can we attempt to “cure” the ills of the world without recognizing our own? The nihilistic acceptance that is reflected in ISIS/ISIL and its followers is surely a collective mental health issue. Anosognosia. Just learned the term from the below article by … of all people … Norman Ornstein. Another tragic experience.

    Like diabetes identified as an epidemic, is mental illness on an epidemic track? If we’re not aware of it … or, as suggested in the past, we’re ashamed of its existence … how to effectively treat it?

    CST: “We have to think and work strategically through a powerful, supported (not undermined) executive …”
    How very true! Unsupported criticism for the sake of power grabbing only assists the negative forces we’re trying to defeat. In the meantime, no viable solutions are ever forthcoming … short of the “sea of glass” option. We continue to dream of 18th and 19th centuries conditions, akin to thinking like children … not wanting to grow up. By denying support and funding, we create favorite punching bags. The V.A. My intelligent, educated daughter-in-law works for the V.A. in Washington. Long hours. How demoralizing it must be to be the brunt of so much misunderstanding. Yes, single payer is what our country deserves. Healthcare a commodity? It’s a human right … not a luxury item to take or leave. And, just in case anyone is as confused as I confess I am regarding the situation in the Middle East, I’m sharing the below (which was sent to me highly recommended) and which I have printed in order to be able to keep in mind the interests of the different participants.

    Identity. Oh, yes … we have not come far from the days of the Roman Empire where the gladiators were the rock stars of the day. Now we call them … the NFL. They can drive around in their Lamborghinis … if their beat-up brains still know how. Now, mental health … health … a work in progress. As always, thank you, Professor Thomas.

    1. Thanks Susanna,the Roy(N.Y.Times) analysis is on the mark.the three dimensional game of chess is extraordinarily difficult and knowing the limits of power and the risks of its exercise are crucial to staying in the game.Anosognosia is a word that I haven’t seen for a long time and oddly,in my mind, it is tied to the lack of culpability in the committing of a crime.(though not enough for most legal systems!)Sullivanian selective inattention is more comfortable for me because while it can be tied to schizophrenia, the tie is looser and there is also the implication of purposiveness.Harry Stack Sullivan was also(mostly) an American and that’s probably operating somewhere and somehow.My thought (yes there is one)is that those who refuse to see and understand are,in their own minds, relieved of the responsibility of weighed judgment and action.They are thus free to sloganeer and knee jerk respond.While the gladiators distract us, the bulls are vying to get into the china shop wherein lie the tools for the three dimensional, protracted struggle against the end of days.I can’t help seeing evil as a palpable dimension in all this. Simplicity, whether due to anosognosia or selective inattention or stupidity, will take us down.Obama is right in resisting “decisive” action when it can’t be defined.

      1. Professor Thomas … as a follow-up to my opening question … “how do we define and, more importantly, convince on a sense of purpose?” … may I submit the following article (the authors, Scott Atran and Nafees Hamid were interviewed this evening)? Atran and Hamid are by no means condoning the ISIS/ISIL movement, rather supporting the short term solution of attempting to destroy it. But, then, comes the long term repercussion or aftermath … and that’s what they’re attempting to explain and inform. From the closing paragraph:

        “France, the United States, and our allies may opt for force of arms, with all of the unforeseen and unintended consequences that are likely to result from all-out war. But even if ISIS is destroyed, its message could still captivate many in coming generations. Until we recognize the passions this message is capable of stirring up among disaffected youth around the world, we risk strengthening them and contributing to the chaos that ISIS cherishes.”

        Quoting Atran from the interview:

        “… fighting a more materialistic society … a corruptible democratic system, one that is deprived of spirituality … young people attracted to ISIS … 20% are converts from Christian families … strongest counterculture movement in the world today … speaks to the notion of glory, and adventure, and self-sacrifice, and human beings intermittently need that … and what we are offering on the other side is ease, security, avoidance of risk … it can’t compete.”

        There seems to be a perception at this particular juncture that something is not being honestly addressed … reminiscent of the 1960s. And the young people, in their nature, are rebelling. It’s even being addressed by/through other quarters:

        “Lighting the walls of Jerusalem in the colors of the French Republic is not a sign of solidarity; it is a sign of ignorance and escapism.”

        CST: “… those who refuse to see and understand are, in their own minds, relieved of the responsibility of weighed judgment and action.”

        Ah, responsibility. Easily demanded of others while avoiding it in one’s self … as in self-sacrifice as Atran identifies, which gives meaning to our existence.

        CST: “They are thus free to sloganeer and knee jerk respond.”

        Yes … as done through social media … faux engagement … just mere trolling, lacking depth.

        CST: “I can’t help seeing evil as a palpable dimension in all this. Simplicity whether due to anosognosia or selective inattention or stupidity, will take us down.”

        Sadly, I couldn’t agree with you more … especially because I don’t think we have reached rock bottom yet.

        CST: “Obama is right in resisting ‘decisive’ action while it can’t be defined.”

        To be sure. I apologize from having digressed from the subject of mental illness. As always, thank you, Professor Thomas.

  2. Reblogged this on daedal2207's Blog and commented:

    Our own dissenters will always push the pendulum further than is entirely reasonable but it is far better to let it swing back than to crush them and force them into the 3 dimensional chess game as someone else’s pawns.The alliance of the civilized must be preserved and so the three dimensional game must go on and all allies, friends as well as frenemies, must be in it.We cannot see it as we did the proxy wars that preceded WWII.

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