Another Trip Around The Sun

Yesterday was my annual physical, so I got to experience a little bit of the American health care system. Since I don’t have any maladies, I only experience the system on these annual trips to get inspected. As is always the case, when you are familiar with something, its quirks seem normal. When you are unfamiliar with something, those quirks and contradictions jump out to you. My trip to the doctor is like visiting a strange place for the first time. All the weirdness stands out to me.

The first bit of oddness is the check-in. Last year they started this new process where you answer a survey when you arrive for the appointment. They ask questions about your personal habits that are none of their business. One question was whether you own firearms and why. There’s no reason for the doctor to know this or ask it, but that question was on the survey again this year. A new question was to list the states I had visited in the last year. It is not hard to see where this is going.

Another new item this year is a kiosk where you check-in for the appointment. One of the things they do is take your picture. My dentist started this last year. There’s no reason for them to take a picture of you, at least not one to do with health. Most likely, the pics are being sold to the tech giants. The mass surveillance system being built out by companies like Google and Facebook will use facial recognition to track us as we go about our business, so they want a database of faces.

In this regard, the health care system is a glimpse into the future our rulers have planned for us. To the people in the health care system, I am just a talking meat stick, one of many, they have to supervise. The relationship between the patient and the system is impersonal and transactional. Health care is a process. The patients enter the system, pass through the system and come out the other end repaired, broken in some new way or dead. No one really cares, just as long as the process continues.

Of course, the American health care system is really just a massive series of toll booths and processing centers. All along the way, patients are turned upside down and given a good shake to get money from their insurer. If you have a malady, you get diverted into a new series of toll booths and processing centers, so the people manning those operations can dip into the insurance pool you represent. The business of treating sick people is a good business for a lot of people.

A good example of how this works is I had patella tendinitis a few years back. I was pretty sure that was the issue, but I asked the doctor about it. He sent me to a quack called a physical therapist. My insurance covered five visits, so he said I needed five visits, then I would be sent for an MRI. To get the MRI, I would need an X-ray. The doctor, of course, needed to see me in-between stops. The point of the process was to squeeze out every dime from my insurance plan.

If the goal were to treat my injury, they would have sent me for the MRI right away, as that would tell them the best course of action. They would see that it was tendinitis and that rest and a brace were the right course. That would not line the pockets of the quack, the X-ray company or the doctor, so that’s not what happens. This is one reason American health care is absurdly expensive. We have great health care, but you have to pass through a lot of toll booths to get it.

Another new thing this year was a giant flat screen in the waiting area running ads for various drugs and treatments. It used to be that the sci-fi movies about the dystopian future would show a world bombarded by ads everywhere you went. That’s where we are headed now. I suspect that the next time I see the doctor, he will have patches on his smock like race car drivers. He will great me with, “this physical has been brought to you by the makers of” some drug being pushed on patients.

The funny thing about the problems of the American health care system is that this is the one area where libertarians could apply their arguments. They don’t, of course, as that would take time away from selling weed and porn to grade school kids, but there is a libertarian case to be made about health care. In fact, we have a libertarian health care system operating in the United States. It is world class and provides amazing results for the patients. It is called veterinary medicine.

In America, our pets get better health care than most humans on earth. The cost, compared to any system in the West, is trivial. The service is phenomenal, as there are lots of suppliers competing for customers. In my area, I have one doctor and five veterinary clinics. I don’t need permission to make an appointment and I am not required to pay a monthly fee for services I’ll never use. It is a great example of how to operate a market-based health care system that no one ever mentions.

Whenever I mention this, the immediate push-back is that you can choose to put down your animal, but you cannot put down your granny. That is nonsense, as we end care all the time for terminal people. In Europe, they are euthanizing people now, sometimes against their will, just to cut costs. All the current system does is disguise these tough choices by shifting them onto the system. For most of human history people accepted that death was the inevitable end of life. We can accept is again.

The good news is the ravages of time have not made me obsolete, so the system recommended I remain operational for another orbit around the sun. Even though I had no issues to report, I was still relieved to learn I was not on that list. Like most men, I don’t like interfacing with the health care system, so good health means less interaction with the system. Of course, it will not be long before my social credit score flags me for refurbishment or perhaps recycling, but for now I get to live another day.

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231 thoughts on “Another Trip Around The Sun

  1. This is happening everywhere. Board a United flight and watch the Star Wars tie in on the safety video. Before it was the Spiderman tie in. Was my ticket really cheaper because of this tie in? The libertarian would say, well, if that bothers you, just fly another airline instead. Sure thing. We now have SO MANY airlines to choose from. I’ll book that Braniff flight tomorrow. Maybe even Northwest, or Continental, or even PSA. Consolidation allows for rapacious activity. Shhhhh, don’t tell the “free market” libertarian. Our country is now consolidated to the extreme, same wholesalers, same retailers, same hospital groups. Death by sameness. Same Marriott, different town. It also adds a cheapness to everything. This isn’t how we were meant to live.

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  3. Great catch noting that veterinary medicine is the true free market. As a boomer I can remember us medical care before the government got involved to the extent it is today and costs skyrocket. Doctors actually made house calls

  4. I tell them now I can’t afford all those little visits back to the doctor for them to squeeze more money out of the insurance company.

    When it was $10-15, sure I’d play. Now it’s $35-50 and my time is much more valuable because everything costs 2X as much and I have to work twice as hard to pay for everyone in the cart.

    I go once, maybe twice if necessary. Call me with the results. F off.

  5. Elite presentation to the masses; why they’re a bad interface, cont’d (and on thread)….

    Z you must consider this system and indeed all the others in the context of what they are; Oligarch pyramid / rack rent scams. No one we interface with is reaping the profits, they are collecting their layer of rent. The rack rents were the system that was imposed on Ireland to keep them down. Every layer above the soil toiler serf was collecting rent for the score of layers above him, at the top was nominally the Crown but really the Great Lords in England and the bank of England. It grew to 40 layers between serf and Crown/BOE. Every layer could see the fate of the bottom and was self motivated to collect the rent so as not to fall. We may also call this Neo-Liberalism.

    This system was evident in America in the housing finance scheme. We should stop calling it socialist, it is quite neoliberal. As was of course ACA/Obamacare. ACA would have enserfed every signee, indeed every co-signee. That’s why they made one list all your assets – a lien on your household wealth.

    To be continued…

    • The system’s interface with us…cont’d

      Seen “Split”? Split is about a multiple personality disorder kidnapper who graduates to Beast level killer.
      James McAvoy presents at least a dozen personalities brilliantly.
      And nearly every last one of them is a teacher. Split could be drawn from any American school. In an average school day your average student will be presented with this same parade of freaks and losers; and lo and behold it has bought forth THE BEAST in these young white boys and men.
      This is just survival of course, these defective cackling freaks tell us of our intended doom decades before they’re actually ready to deliver. They spend most of the 12 years of education degrading, denigrating all white existence. They employ a strange mix of Quaker and Puritan methods to crush the spirit, they for a time they banish nature but he returns.

      Above all else it seems to utterly escape these loons that the kids would ever get bigger. That their balls would drop.

      That’s all Nick Fuentes, Groyper and the rest are… they’re young MEN. The rest is of minor consideration. Young Men are standing up. That is the major consideration.

      PS; do watch split- it was worth it. At first I put it down (I don’t find psychos enlightening or entertaining…but that’s not this movie). The freak show is indeed school – God help the world if our young men want payback.

      • For your consideration: Until the day when gov. schools are but a memory, it would be helpful indeed if youth and mid-life career changers of the right sort would go into teaching. We need them in the classrooms,

        Public education is not going anywhere soon, and most must partake of it at some time in their lives; for both the students and those already teaching — it would help to have reinforcements or the cavalry coming or at least a few like-minded souls with dignity to help fight of the jr-high-level gossip mongers who make up most of the average school’s staff..

  6. FWIW (from the conversation earlier this week) “The Man who shot Liberty Valance” is on TCM tonight at 8pm EST.

  7. One difference between a hospital and a veterinary hospital is that in a veterinary hospital the staff likes the patients. My dog had cataract surgery and he was treated by a highly regarded veterinary ophthalmologist (yes, such exist). He was an older gentleman with a gaggle of residents in tow. Before they got started, they all petted and gushed over the dog a bit. Naturally he loved that and was very relaxed. I thought to myself that I wished I could be sent to this hospital if I had something wrong. It looked like they used a slightly older version of the same equipment. The process was expensive but I thought the cost was reasonable.

  8. ” That is nonsense, as we end care all the time for terminal people.”

    It is euphemistically called “palliative care.” I.E. keep increasing the IV morphine until they stop breathing. This is usually done with a wink and a nod. “we really don’t want granny to suffer, ok.”

  9. “talking meat stick” made me laugh.
    Regarding physical therapy, it’s looked like a grift to me for a long time. After a hand injury (dislocated finger) years ago, a hand specialist sent me to physical therapy, which consisted of soaking my hand in warm water for 15 minutes. I figured I could do that at home for free so I stopped going.

  10. I always bring this up when people talk about health care and healthy insurance, two completely distinct and unrelated areas. Our local Amish community has all sorts of medical issues, from weird genetic diseases thanks to a tiny gene pool that overlaps too much to accidents which they are prone to thanks to the nature of their work and their almost suicidal refusal to use safety equipment. I take them to the hospital all the time and it is very weird how it works. They get the service they need and nothing else. They pay cash so they are charged a fraction of what our insurers are charged, and they negotiate the price and shop providers for the best value. They go to one hospital for most care but another one if you need a hospital stay when having a baby, because the maternity services are cheaper there. If someone has a huge bill, the community comes together to help them pay either directly or via some crazy fundraiser. In short, they shop for medical services like most of us shop for consumer goods and they seem to get much better value.

  11. I think I’m the only one who identifies as a doctor in these comments. Sorry to be late to the party today – busy clinic. The upside-down people-shaking machines are making a lot of noise as the coins hit the floor.

    A couple of years ago I had my first set of interactions with the system as a serious patient, a double-life threatening condition (both carotids 98-99% obstructed). My experience and conclusions were much the same as yours: I was a billable unit, and was treated as such.

    I could detail that incidents that delayed my surgery by about three weeks but will spare you. Bureaucracy meets scheduled break, that kind of thing. Circular finger-pointing when you try to work out the source of an error or delay.

    BTW, I don’t tell ‘providers’ I’m a doctor, but dammit, the way I talk and respond to questions gives the game away instantly. Can’t be helped: it’s the most efficient way to communicate with those folks, and I know the importance of it.

    My surgeon, whom I had not met before, is one of my heroes. Superman with a scalpel. Those types are still around, but doctors by no means run the show any more.

    Our system is predicated on supervision and second-guessing. These are expensive, and the practice has to pay for them, incentivizing the need for more jack.

    I had what is called a good outcome. The going-through was not so good.

    When I have time I’ll go OT and relate some of the ways I think we went off the rails.

    Oh- we don’t have a TV in my waiting room, nor in the break room. That’s because I run the place. CMS hasn’t mandated one set to CNN on loud yet.

    • “both carotids 98-99% obstructed”
      if you don’t mind me asking,
      what are the symptoms I should be looking for?

      • That’s the scary part: I had none whatsoever. I was bicycling daily, but losing acceleration. Turns out that was an unrelated problem (I have a muscle disease), but in the evaluation of it a diligent doctor listened to my carotids (with stethoscope) and heard the characteristic whoosh-whoosh, like the sound a kinked garden hose makes just before the flow is cut off entirely.

        For those with symptoms, they are generally the same as those of a stroke: one-sided weakness, paralysis or abnormal sensations, or trouble speaking, either with finding or articulating the right word. These can be transient, but do not ignore them, no matter how little trust we’re engendering here in our health care system.

        There are still plenty of those who will go out of their way to help you, no matter how the bureaucracy gums up the works.

  12. Last time I was at the doctor he told me I talked like a fag and my shit’s all retarded. But he told me not to worry: plenty of ‘tards out there are living kick-ass lives. His first wife is ‘tarded and she’s a pilot now! So there’s hope.

    • You have Warren Zevon’s doctor or something?

      Well, I went to the doctor
      I said, “I’m feeling kind of rough”
      “Let me break it to you son
      Your shit’s fucked up.”
      I said, “My shit’s fucked up?
      Well, I don’t see how.”
      He said, “The shit that used to work-
      It won’t work now.”

      From the album “Life’ll Kill ya”

  13. Look at how long your great grandparents lived. That’s a good indication of how long you might expect to survive in the absence of modern medical care (assuming you eat healthy, etc.)

    For me, great grandparents lived into their mid 60s, on one side. The other side was riddled with cancer, wacky genetic mutations… most were lucky to hit 50. Apparently none of those ailments are hereditary, but still…

    So I estimate a lifespan of between 55 and 65. Zero faith that the medical system will hold up at all. It is what it is.

  14. What the Cartel has done is to cut off independent doctors from outside the “network” having admitting privileges to hospitals. It’s no longer about patient care – if it ever was. It’s about the shareholders and their bottom line.

  15. You’re getting screwed:

    (referring to Warren’s Medicare for All proposal) :

    ” Robert Pollin of UMass’ Political Economy Research Institute told Kaiser Health News earlier this year that most of the roughly 2 million estimated job losses would hit administrative positions — about half among insurers and half in hospitals and doctors’ offices.”

    Karl’s comment:

    ” 2,000,000 people
    X$50,000 (salary and maybe benefits per-job)

    $ 100,000,000,000 per year.

    That’s one hundred billion dollars a year you are getting screwed out of and by the way, that’s just salaries; we haven’t done a thing about monopolist pricing, which Warren’s proposal will not address. (With no competition there will be no halt to monopolist pricing.)

    Incidentally that figure is ridiculously low; the health industry has added roughly 400,000 person per year for the last 10 years to the employment rolls (that’s 4 million people) and of them 90%, approximately, never provide a single second of care to a single person. They are all administrators. Nor did this start after the crash; it was going on for a couple of decades beforehand.

    So 2 million people is a fancifully low estimate short of more bribery in the health care sector aimed at Congress; the real number should all that overhead go away is more than double that and the cost per is likely low too as most of these are middle-class jobs and thus it’s farcical that their total per-employee cost on a fully-counted basis, including their health care and other benefits, is that low.

    In other words it’s probably closer to a quarter of a trillion dollars a year you’re getting raped out of by this aspect of the current system alone.

    There’s one answer to this and it’s something that is functionally what I’ve proposed. But neither side of the political aisle will do it, given the amount of money thrown around by insurance companies, pharma and other medical lobbyists and firms, never mind the stock market implications, unless the politicians have literally no choice, and that means the entire nation must decide that this is not an option, it’s a demand with an “or else” that is worse than some political person losing their job. “

  16. I recently took our two yearling kittens in for an annual check-up at the vet. My wife, who is a health care worker at the local hospital was shocked when I told her the vet had plenty of rabies vaccines for pooches and puddies.

    That’s something else about veterinary care compared to human care. They have plenty of the stuff they need, like vaccines to protect against an incurable disease like rabies where the hospital and local doctors can’t get it at anything less than confiscatory rates.

    • One of the dirty little secrets of the black/gray market is that many veterinary medicines are perfectly suitable for humans. You can get all kinds of meds off prescription for animals, and there’s plenty of info on dosage on the internet.

  17. Interesting that you say that health care is one area that libertarianism can work. I agree with you 100% and it is specifically medical stuff why I am more of an “Ayn Rand” libertarian today than I was in my 20’s.

    The U.S. health care system is fascist. That of most other countries is communist. Fascism does work better than communism even if it is not as good as we would like. The fact that veterinary medicine is actually better and cheaper than human medicine is a key point here. Another is cosmetic (elective) stuff like Lasik eye surgery. Both are examples of medicine that has followed cost performance improvement over time.

    The bigger and more fundamental problem (this is the REAL reason why I am such a fanatical libertarian today) is that much of conventional medicine not only does not work, but actually causes more damage. Cancer treatment is one. Contrast agents used unnecessarily in MRI scans is another. The fact is that conventional treatments do not fix the underlying causes of medical problems. For example, high blood pressure meds do not decalcify your arteries, which is the root cause of high blood pressure. Most medical conditions are due to chronic inflammation which, in turn, is caused by a build-up of senescent cells that are not properly recycled (autophagy) by your body. Hence, one needs to use senolytic compounds occasional to get rid of these cells. Then one need to repair mitochondrial DNA (a fission./fusion protocol I will try early next year) as well. One then needs invivo cellular reprogramming to complete the repair of one’s body.

    Is the conventional medical system offering these therapies that address the root causes of medical conditions? No. Of course not. For one, there is less money in offering such effective treatments. Two, there seems to be an ideological bias against fixing the actual cause of chronic medical problems that people experience. in other words, we are expected to sacrifice our health and vitality for mere political ideology!

    The only way forward in all of this is DIY biohacking. Its the only option if you really are committed to the long haul. The existing system simply cannot do it.

    We often talk about left vs right, local vs global, and the like. My 30 plus years experience as an adult has taught me the ultimate battle in this world is bureaucracy vs. humanity. Right now, bureaucracy seems to be winning. Do not allow yourself and your children to be victims of bureaucracy.

    • “Bureaucracy vs. humanity.” I’ve been saying “globalism vs. sovereignty,” but they are the same, one just in more of an overall, macro sense.

  18. All the money hoovered up by the medical insurance scams goes into the banking and investment sector. Ergo, insurance is simply part of the banking biz. Is there nothing these bandits don’t control?

    • Let me think . . . Repeal of Glass-Steagall? Nope, that just laid the foundation for the (ongoing) biggest wealth transfer in history.

  19. I’m not as sure that the data is being sold; from what I gather, it’s for the same purpose as the old check cashing photos. In case of suspected fraud, they can go back to the photos, and either OK the service to the patient, or to question who had access to the card.

    Apparently, using medical cards is abused like driver’s licenses, credit cards, and EBT cards – it’s usually a friend or relative that “borrowed” the card, often with permission.

    • Thanks for that. I had known about it—-causing exasperation with this ongoing charade we’re all witnessing — but had not read the document itself. Appreciated.

  20. The medical system is a outright racket.

    Take for example a bag saline. It costs a health clinic about $1.00. Now if you get that same bag of saline during a ambulance ride, you get charged $800.00.

    Or take Scorpion antivenom. It comes from Mexico where you can buy it for $150.00 a dose. Here in the U.S. hospitals charge you $10,000.00 per dose.

    Private surgery clinics vs. hospitals. I went to a private surgery clinic for outpatient surgery. Cost was $400.00 out of pocket(I’;m a Medicare patient) Medicare was charged $2000.00. Same surgery done in a hospital and I was charged over $2000.00 and Medicare over $20,000.

    Worse, the costs of all Medical procedures are not listed and the costs change depending on the insurance you have. Now this is illegal as hell, In any other industry you go to jail for doing that.

    Now onto drugs. For example a drug that costs you $30.00 per pill can be had in India for $1.00. So where some ill American is forced to spend $1000 out of pocket per month on drugs, Pajeet in India gets a month supply for the price of a movie and popcorn.

    • Yes, there is a racket aspect (which I’ve talked about previously, specifically what is billed and what is reimbursed), but the main reason you are overcharged for everything, especially supplies, is that you’re subsidizing all those who do not pay. This is largely uninsured (and often illegal) people who have no identifiable income or assets and simply throw away their bills. “Come and get me — if you can find me. I got nothing.” But we can’t turn them away at Emergency. (Also, this group uses Emergency for minor things, and each ER visit is WAY more expensive than an outpatient [clinic] visit.)

      As to private surgical clinics. The majority of those people are in some sense skimming the system. If the surgery goes as planned, they collect their fee and you’re done. But if there is a problem, they don’t have the capabilities of dealing with it, so they send the poor victim (er patient) to the real hospital that has an ICU, and multiple specialists, advanced imaging, etc. The cost of having those tertiary/quatrenary care providers and services available is non-negligible, as you may imagine.

  21. I wrote a comment late yesterday about my poor rural community. I allude that some of the best things about it are the depth of the roots — the families that go back so many generations, the history of the place and the sense of community.

    So it was with irony that I read today that our betters think that sort of stability and rootedness is just terrible:

    Mobility in the United States has fallen to record lows. In 1985, nearly 20 percent of Americans had changed their residence within the preceding 12 months, but by 2018, fewer than ten percent had. That’s the lowest level since 1948, when the Census Bureau first started tracking mobility.

    Declining mobility contributes to a host of economic and social issues: less economic dynamism, lower rates of innovation, and lower productivity. By locking people into place, it exacerbates inequality by limiting the economic opportunities for workers.

    ATTENTION ECONOMIC UNITS: Mobile economic units are preferable for state needs! Cease all community attachments immediately!

    As Vox Day observes, “Now keep in mind that the entire purpose of free trade’s supposed economic benefits is to expand this labor mobility worldwide. The only price is the complete destruction of everything you know and love, including your relationships with your friends and family. “

    • Both parties are vested in replacing legacy communities. No, they won’t help you with moving costs when they tell you to up sticks and move. No, they won’t help link you up with a job. They’ve got tax breaks that allow them to hire foreigners for cheap. (Bonus for the resettlement agencies!)

    • “since 1948, when the Census Bureau first started tracking mobility.”

      The Census is only constitutionally authorized to do one thing..
      count the number of citizens, for the purpose of creating election districts and apportioning congressional seats.

      everything else, which is morphing into consumer survey territory,
      is Nun of their Bizniz.


    • ” I read today that our betters think that sort of stability and rootedness is just terrible.
      Mobile economic units are preferable for state needs! Cease all community attachments immediately!”

      Such cynicism. I am so very very sorry that you misunderstand such things. Clearly our betters are always wanting the best for us. Being rootless cosmopolitans has worked incredibly well for them, so is it any surprise that they want us to share this status? So generous and wise. It’s all part of repairing the world!

      • It’s a generational thing. Young people want to — and do — move from the quiet, rural places looking for “more” —- and with maturity, very often return to the quiet, rural places, again looking for “more — this time, for more calm, more privacy, more independence, and more space between you and your loved ones…..and the rest of the world.

    • Stuff like that is why I see Vox as a net positive. He makes strong criticisms of capitalism on that basis, liked that about him since at least “Cuckservative” (despite Milo’s degenerate presence in the book’s forward).

    • But if I don’t sign on for permanent “mobility,” how can I be like Jack Reacher drifting through America; having my nose stuck into problems that can only be solved by my unique skill set? They can’t find you if you don’t settle down.

  22. Good grief! Z Dear….why are you putting up with this? Move from the East Coast. So far this has not infiltrated Southern Utah. I went to the dermatologist recently, was handed a status form to fill in, wanted to know about my mental health and I kinda ignored it…Ha! Wrote “None”, no question about guns, then a question about my sex life….I wrote on the form None Of Your Damn Business. The worker bees never said a word. My skin doc really thinks I’m amusing. Plus he always asks what I’m reading.

    “The patients enter the system, pass through the system and come out the other end repaired, broken in some new way or dead.” Yep! Glad you’ve got another year to orbit the sun.

    “It is world class and provides amazing results for the patients. It is called veterinary medicine.” You bet…..the cats have a great vet, the vet likes me and he really talks with me. I make a suggestion and he listens. I diagnosed the cat for hyper thyroid and he appreciated that. He has life experience wisdom. When everything turns to shit in my body, I’m going to ask him to put me down.

  23. Entrapment is how these surveys will eventually be used…if that wasn’t what they were intended for to begin with.

    Tell the doc one thing but have a paper trail that says the opposite? Oopps, that’s Homeland knocking on your door.

    Every thing you do or have done is tracked in one fashion or another. Your entire life is divided piecemeal between various databases. Belong to the wrong group? Said the wrong thing? Travelled to the wrong locale? Get noticed and they search for A not corresponding to B. Then the screws get tightened.

    A lot of this is just to make you a more efficient tax cow…but stop being passively herded and it will be used as a bludgeon.

    • Yup, the population will be divided into two groups, those who go with the program, and, well, people like us. What those who go with the program don’t understand is that the noose will draw ever tighter, and the smallest infractions, even done inadvertently, will get one put down. Beyond that, the youthful George Soroses of the world will have a field day accusing people of things, and the authorities will choose the easier choice of snuffing out versus working at finding the truth. We are expedient irritants to the powers that be, and we must never forget it.

  24. Like many men of a certain age I rarely see a doctor, and only when I have a particular ailment. The key to dealing with the medical system is to make it painfully clear from the first moment that you, the patient, are in charge of the doctor/patient relationship. I am brutally blunt with any doctor who won’t treat the malady for which I am seeking treatment, or who attempts to go off on tangents about guns, depression, drinking, etc. Look the doctor square in the eye and tell him/her that you are seeking treatment for X, and if they can’t or won’t provide it then you will leave now and go find a doctor who will.

    A couple months ago I had all the classic symptoms of strep throat while traveling. I emailed my doctor and request a script for a Z-pack. She refused to provide it without a positive culture test. I got onto one of the online service providers and had a Z-pack waiting for me in 2 hours. Cost was $66, which is probably less than my copay.

    Doctors really have to get past the insane notion that they have some sort of higher calling.

    • This is a definite issue, and more generational I would hazard. Older people did/do seem to regard doctors as Gods and never question them. I, too, start out making it clear I’m very much in charge of my own health and am paying them for a specific service. Another part of the problem is the overuse of antibiotics, particularly overseas, so doctors here hesitate to prescribe them. I know when a cold has turned into a secondary infection, damn it, and shouldn’t have to routinely lie about what specific day symptoms began to get more than an OTC medication. I definitely consider healthcare as a simple transactional business, and most doctors aren’t nearly as bright as they think they are.

    • Before I was diagnosed with a chronic disease, I never sought a doctor’s help unless I had a broken bone, a spurting blood vessel or a pain which was so intolerable that it could not be borne. On those occasions, the doctor mended the acute problem and I returned to the blissfully ignorant state of rude health. All that changed when a routine exam that I sought, perhaps with hindsight against my better judgment, led me down the rabbit hole. I endured years of blood testing and pharmaceutical intervention to “control” indicators of metabolic processes that are claimed to be a leading cause of death; yet no one can explain to my satisfaction exactly how “bad” numbers are going to kill me. As far as I could tell, the only impact on my daily life was entirely consistent with what aging, inactivity and a less-than-ideal diet would produce. When my former doctor retired two years ago, I took the opportunity to reorient my relationship with the new one. Now, I take half the drug and plan to taper to zero within two years. I only do labs once a year instead of four; and I refuse to allow numbers alone to drive the treatment process. I am a firm advocate for the patient educating him or herself and driving the interactions with the medical establishment. The good news is that unless you require an acute/emergency treatment or a truly therapeutic prescription drug, a doctor’s involvement is rarely necessary.

      • Good for you. One of the teachings of the advance in genetic science is that 90 percent of your health outcomes are determined at conception by your genes.The genetic lottery will determine when your number is up, and there’s not much you can do about it. Make the most of the time you have here and go out with grace.

  25. Most of the doctors young and old that I speak with in the course of day-jobbery dream of opening a practice that takes only payment up front directly from the patient, something that’s becoming more common among the well-heeled.

    A very successful Beantown cardiologist in his 60’s told me a couple years back that if he had it all to do over again, he would have traded most of his lucrative high-status positions and honors for this kind of practice.

    He lamented that he was essentially retiring early because he was just burned out by the constant interference with his decisions by third-party-payors, the assembly-line level of care provided by the support staff for many of his patients and spending more hours doing charting and paperwork than treating patients. He was just too played out to start over in a more fulfilling small cash-practice. His job had been drained or much of its joy and meaning, and this was a guy who literally saved lives and made big money doing so.

    I’ve said often that the J-pill is the hardest to swallow, but the C(apitialism)-pill is right up there. Thinking about that guy makes the bitter medicine go down a little easier.

    • The C-pill is labeled “capitalism” but it is actually corporatism, which is what we live under these days.

    • A practice that takes payment up front, is just a voluntary exchange between doctor and patient, and cuts out all the administrative bullshit and bureaucratic meddling *is* capitalism.

      • In a technical sense, yes, but the point is that without strong political and cultural constraints, capitalism inevitably morphs into the crony, corporatist, cancerous form we have today. Third positionism sees the government, trade unions and the like as those external forces pushing the capitalists into “reset” mode when they overreach.

        • Well, we’ve got all those external forces and they’ve betrayed us at every turn. So, now what?

          I don’t like the answer that “it just hasn’t been done right yet.” I’ve had that leg pulled too many times.

          • Once again, we only have the barest technical semblance of those forces. We have a government, but it serves capital rather than the people. We have unions, same problem. And on and on.

            There is no wholly systemic solution. A bad system run by good people is better than a good system run by bad people.

            It has been done right before but it can’t be done right when you fail to get the biology and culture right first.

            A “nation” full of strangers on the grift looking to grab what they can before the eternal night falls, game over, can’t make any system produce a life worth living.

          • There is no wholly systemic solution. A bad system run by good people is better than a good system run by bad people.

            Well, sure, but wasn’t the US of 1787 run by good people? Yet here we are. Wasn’t Sweden run by good people?

            I see no evidence that good people continue to stay good people or continue to rationally look out for their own interests in the long term.

            If history is any indicator, about all we can expect is temporary oases of good societies before inevitable ruin sets in.

            Your own statement that biology and culture are more important and the clear historical record of failure of *all* types of societies gives the lie to the idea that government and unions work to reset capitalist overreach.

            If we look at long-lived societies in history, we see republics, authoritarian empires, bureaucracies, monarchies and more. There is no clear winner. Some peoples and races simply *like* to live under very different systems. What suits the Chinese doesn’t suit the Swedes, and vice versa.

            I see no evidence that your “third positionism” is any better or worse than any other.

            No Western society has ever resisted the pull toward entropy. Chinese societies in the past seemed to move slower, but even they have aphorisms about the inevitable cycle of ruin.

            So, if we get the biology right, it will be better for a while, but not permanently, regardless of the structure we choose, so why should I care about “third positionism?”

            I’m reminded of a column John Derbyshire wrote a long time ago about school reform. He noted that all the big schemes for improving student outcomes involved ensuring “excellence” among all teachers. He observed, correctly, that this was plainly logically and statistically impossible and that unless a system was designed to work well with mostly mediocre teachers, it wasn’t worth considering.

            The same goes for governments. Unless you design a system that will function well under the control of a small number of smart, good people and a majority of mostly undistinguished mediocrities in conflict with a small cadre of smart, evil sociopaths and their similarly mediocre minions actively working to undermine it, then I am not interested. History suggests there is no such system.

            Given that, I’ll just advocate getting the biology right, then implementing the system I personally like, because I like it, and it is no worse than any other.

        • Since it’s exactly the same in education (esp sped) with the paperwork, cronyism, and all the rest described here, perhaps it is not just “capitalism” but “bureaucratism” — gov. works the same, as we esp see right now with all the cronies working together in the “it’s-only–a-conspiracy-theory-ha-ha” Deep State.

    • Another M*hole heard from? Once again this traces back to the lobbies. Why did all those family doctors with offices in their homes disappear? They were a staple. Even in the 90s. Until the financialization takeover of the health care industry. No discussion of whether this was a societal good or not. Just whether it profited the share/bond holders.

    • Yes, concierge practices are the way out of the morass for doctors who want to care for patients. Medical insurance is the scam. Those who benefit most have the least skin in the health outcome (word chosen intentionally). But what supports the scam’s perpetuation is people’s fear that life is cheap and meaningless unless death is forestalled for as long as possible. Insurance exists on the razor’s edge between maximizing premium revenue and minimizing claim payments. They want us to live long enough to extract the optimal number of monthly premium payments, but to die before the really expensive end-of-life interventions kick in. We all die. Suck it up buttercup; and stop demanding that doctors extend your life with stage 4 pancreatic cancer by administering six-figure chemo. Accept that your life will end sooner as a consequence of those four coronary artery blockages, rather than demand six-figure bypass surgery. You don’t need more life; you need to make friends with death and cultivate gratitude rather than resentment. Be stoic.

  26. If the goal were to treat my injury, they would have sent me for the MRI right away, as that would tell them the best course of action. They would see that it was tendinitis and that rest and a brace were the right course.

    Or you could buy yourself a knee brace without ever going to see the doctor, take a couple aspirin, give your knee some rest and see if that helps before subjecting yourself to the system.

    I’ve also made the same observation about the veterinary medicine system. If only our healthcare were modeled on that system.

    The only way you get that kind of system is if the patient is the one responsible for and paying the bills.

    As for putting down people. They do indeed do it all the time. Sometimes they do it in ways that would get you brought up on animal cruelty charges if you did it to an animal — depriving them of food and water.

    • Vizzini, we are probably the last generation that remembers when things were not just “different,” but Bizarro different. I frequently visit the old ‘hood, and my friend’s parents were showing me the bill from when she was born vs. when friend’s kids were born. Even in “real” (HAHAHAHAHA) dollars it’s absurd.

      • All my kids were born at home, so I never experienced absurd childbirth costs.

        But I’ve seen the absurdity in other healthcare costs.

        I have had some pretty expensive medical interventions for my horses. Cancer surgery, eye removal and radiation treatment on one went for about $2,200 at one of the top equine medical facilities in the country. Probably over $100k for the same treatment for a human.

        • Vizzini – Homebirth. You just confirmed for me that we’re manifestly on the same page. I delivered our last child … midwife couldn’t make it through the snow storm. My grandson was just born at home. At-home birthing isn’t for weak women, but it does demonstrate that we’re created (or evolved if you prefer) to endure a lot more than the medical industry would have you believe.

        • That’s not good. I’d like for the brightest, most motivated, disciplined kids who wanted to go into medicine not become serfs for their degrees.

  27. I was born in 1954. Our family doctor, in Boston, came to the house with his black leather bag when one of us was sick, or met my mother at the hospital when she gave birth to me and to my sisters. Health care was for the most part a free market business in those days. That was before Medicare and Medicaid. Since the mid 1960s, health care costs have skyrocketed, as does the cost of everything the government regulates. Which makes sense as that is the entire point of the regulation; more money for those in the regulated business, and less money in your pocket.

    • I can remember going to the pediatrician as a child – which if I remember correctly , was the same woman my mother had seen when she was a child. She had her office in the first floor of her home – no visits to a “medical center” or anything like that. You came in and sat and waited and she came out to meet you – no receptionist.

      I can’t believe I survived that primitive healthcare model

  28. Z Man, another narrative for the treatment of the knee issue you had is that your insurance company set up all those gates to keep you away from the MRI exam, which, as I understand it is (or used to be) VERY expensive. I’m not excusing all the grifters in between. I’m just saying that the insurance company would rather pay some low paid physical therapist (I had a similar experience several years ago) than paid a HUGE bill for an MRI exam. I don’t think the insurance companies are helpless in this.

  29. Another racket is the keep ’em alive and keep ’em paying nursing home. My 93 year old father resisted going to a “home” so he stayed in his own home with a modest amount of help as he was declining in health and incontinent with no prospects of being fit and fifty again. One morning, as they say around here, he woke up dead. He went in his own bed with some dignity left. He had good insurance. If he had been in a nursing home bells would have chimed and he would have been revived to continue his decline to keep the meter running.

    • Those’re murky waters, though. Sometimes the body can go on longer than the mind; sometimes the mind much longer than the body. My mother was confined to a wheelchair. She could walk a few steps, but not much more. Like many people with the same affliction she suffered from (UTI) infections. I’ll never forget when the Pajeet hospitalist called us after an infection went septic and said “Why do you want to do anything?” Mum lived well more than a decade after that. In her own home. Continued to read a book every couple of days.

  30. We used to have family doctors who knew us and could treat us for just about anything. Now you have to navigate an endless series of specialized clinics for this or that, each one requiring the same forms to be filled out while you wait longer than you should; no one knows you, and you’re basically treated like a piece of meat the whole way. It sucks, and as I’m in my late 50s, I’m afraid I’ll be interfacing with this system more often in the not-to-distant future.

  31. You forgot to mention that the best place to acquire a novel disease is while in the hospital, but thankfully they don’t charge extra for that service. OT, but to combine two elements from your post. Nurse porn is becoming a growth enterprise, much of it videoed onsite. Talk about multitasking.

    • An elderly man I knew died of a staph infection picked up at a hospital.

      I spent two days at a hospital for mild double pneumonia. Shortness of breath and water in my lungs persisted after discharge, so for six months I underwent further tests and finally discovered that not only did I still have the klebsiella bacterial infection, but a staph infection on top of that. I was given medication and was fine in three days. I remarked to someone that I went into the hospital with one problem and left with two.

  32. Here out West Urgentcare offices have largely replaced emergency rooms and even ordinary doctor visits…You get a firm appointment time and no nonsense treatment…..very Libertarian.

    • And terrible, from anecdotal experience. They told my MIL she was having a heart attack so they refused to treat her, made her go to the ER. She then sat in the ER waiting room for 8 hours before giving up. Apparently she wasn’t having a heart attack. Nobody wanted to deal with an old ornery white woman.

  33. By now, everyone realizes that you aren’t Facebook’s customer…
    you’re the product that they sell to their real customers, the advertisers.
    “if the service is Free, you’re not the customer, you’re the product”

    Healthcare has become the same.
    You’re just the product, a series of diagnostic codes and treatment codes that they’re selling to the insurance companies, Medicare & Medicaid.

    • How dare Politico call it that, when Nancy has pointed out over and over and over that this is NOT “impeachment,” but an impeachment “inquiry” and that’s why Adam Schiff is God and no one else has rights except through his (and her) whims.

  34. The “do you own firearms” question is there because a lot of doctors and the AMA consider guns to be some sort of “health issue”. Strangely enough – here in MA , I don’t ever recall being asked that question – even from the pediatrician we see for our infant.

    Perhaps that’s a side benefit of living inside the walls of the liberal utopia, they just assume that nobody owns guns so they don’t bother to ask the question.

    If you want to do a deep dive on the ins and outs of the US healthcare and dollar extraction system – start reading Karl Denninger, he’s been covering the corruption and insane costs for years.

    You’re right about the comparison between human healthcare and veterinarian services – but you’re not the first one to notice it. I’ve seen that comparison being made for years.

    • It must be your provider. I remember getting that question as far back as “RomneyCare” in the 90s.

    • because a lot of doctors and the AMA consider guns to be some sort of “health issue”

      Yes, the AMA and the Mass Medical Society are fully pozzed. I refuse to belong to either, but I did sit in on an MMS webinar on “How to talk to your patients about guns” a couple of years ago. My intent was to see if their presenters had any idea what they were talking about, but it was over an hour of anti-gun indoctrination, including a talk by a cop, I think it was a Mass State Trooper, whose message was “You civilians (sic) shouldn’t have guns”. That was it. No “Eddie Eagle” type stuff, lots of ginned up “statistics” and sob stories about poor children of color being killed by guns (nothing about the [mostly] other POCs who killed them).

      • “As a medical professional I’m curious what the predominant factors are in determining why it’s so often children of color that are victims of gun violence. My understanding is that the rate of gun ownership is far higher among other cultural and socio-economic groups – with no apparent correspondence to children being victims of gun violence. Surely the medical profession should be able to look at this problem scientifically and identify the root of the problem – I’m curious as why nobody has ever bothered to do this before?”.

        Try asking that one the next time you attend one of these seminars……. 🙂

  35. We ought to discover some sort of ‘inalienable right’ to be treated by someone of your own race. Or, take the Japanese approach and develop health care robots.

  36. Find a Scandinavian doctor if at all possible. I was assigned to one after my punjabi doc (he wasn’t bad) left the practice and I feel like I hit the lotto. Super competent, no b.s. “alright you’ve gotten too fat, lose 10 lbs. in the next month” honesty, and part of his health recommendations is the consumption of two good quality beers or lagers per week. Direct, efficient and doesn’t have a mild aroma of cologne and curry.

    • Can confirm. Saw a Scandi eye doc in SoCal last year – showed a level of give-a-sh*t and thoroughness that I hadn’t seen in years.

  37. Even in health care it’s another example where we’re increasingly seen by them as interchangeable economic units. It’s happening everywhere. My sister, who’s a teacher and unfortunately leans to the left, is retiring after this year. The last few years she’s become frustrated with teaching, recently complaining that “the administration is treating kids like interchangeable widgets.” Her comment gives me an opening to try and convert her to our side.

    • The fundamental problem is that it is being driven by people who care not a whit for the well-being of the widgets/meat sticks/patients. We are simply a population of revenue sources, categorized and arranged for maximum efficiency in revenue extraction. It is like this in every big business.

      • Globalism marches on, flattening everything in its path in the ultimate quest for efficiency, profits and standardization. I suppose what our overlords see as an eventual result is a society where there’s a uniformity of students’ test scores, workers’ income, people with the same thoughts and opinions, consuming the same entertainment, and being all around obedient global citizens living in places that look the same, with the same strip malls as any other place.

        • At one time, companies had a “Personnel Department.” Now it’s the “Human Resources Department.” We’re not people, just resources to be used and discarded when no longer needed.

          • Bravo. I’ve been saying the same for years. I am an employee (or consultant at times) an adult who knowingly entered into a contractural relationship, not an iron ore deposit, to be strip mined, not a forest to be clear cut.

      • I’m not sure if this makes it better or worse, but in my experience with the corporate world, the typical Globohomo big business isn’t even doing a very good job at maximum revenue/profit extraction.

        A big business is a collection of people, half of whom are completely incompetent, and almost none of whom actually care about the company’s bottom line in any real manner. Probably the top execs care. Down at the bottom, the goal is simply “make it to the end of the day/week without committing any fireable offenses” and “do as little work as possible” and “gossip about who’s sleeping with whom/who wants to sleep with whom.” Creation of profits is secondary.

        In fact, even for the top execs, creation of profits is secondary; that’s a sucker’s game. Resource extraction is where it’s at! Issue debt + stock options. Manipulate stock price + pay yourself in share buybacks. Make meaningless statements about how you increased “non-GAAP earnings excluding one-time charges” by 73% year-over-year. Schmooze with other execs at expensive company-paid dinners and get on each others’ boards of directors so you can all approve each others’ compensation packages. Then get out before the house of cards collapses on the next guy’s watch.

        • ” Resource extraction is where it’s at!”

          Exactly. I’ve always maintained that if I ran a medical practice like corporate America runs things, here’s how it would go.

          Example: Dan Smith, 50-yo man, comes to my clinic for his annual check up. Dan is 40 pounds overweight, smokes 1ppd, and has blood pressure of 144/78. His modifiable risk factors (we will ignore lab tests such as cholesterol here) are: overweight (needs to lose 40 lbs), smoking (needs to stop), high blood pressure (goal 120/80 or less).

          REAL WORLD: I refer Dan to a diet and exercise program for weight and BP, smoking cessation, and while we’re waiting for the weight loss and exercise to reduce his BP, I’ll put him on an antihypertensive medication. Apart from the BP drugs, everything will take months to years to get to where we want to be. Not very exciting, is it? And note well that *my* job performance is evaluated in part by how well I get Dan (and other patients) to targets. Now, if all goes well, Dan works another 20 years, lives another 10 after retirement, modestly but comfortably with his wife in their paid-off house. And in the meantime Dan continues to go to work, support his family (wife and two kids, one in college, one a HS junior), and pay his taxes and his mortgage.

          MEDICINE-as-Corporate-America: My three performance metrics are 1) weight loss, 2) smoking cessation, 3) BP control. Note that Dan’s diastolic BP (78) is already at target levels, so I just need to get his 144mmHg down to 120. Here’s what I would do. Admit Dan to hospital and put in an arterial line (for continuous blood pressure monitoring – no cuff required). Then, I cut Dan’s leg off with a power saw. Instant 40-lb weight loss. Target #1 achieved!

          As Dan exsanguinates from having his leg cut off, his BP drops like a rock. At the exact instant his systolic BP is 118 mmHg, I take a photograph of the monitor and present this as proof that I met my BP metric. Goal #3 unlocked. Now a minute later Dan’s is BP is ZERO, but that’s not my problem.

          So I failed on #2 (smoking) but in a few hours I achieved performance metrics #1 and #3. Compare that to the months/years it would normally have taken. So I collect a fat performance bonus. And I bill Dan’s insurance for my “services” as well. Then I sell Dan’s corneas, lungs, kidneys, and whatever other organs are transplantable. What’s left of the corpse is the responsibility of Dan’s family to pay to cremate or bury. Further downstream, Dan’s family can’t pay the mortgage and are evicted, and the older kid has to drop out of college. Sucks to be them, eh? But I met my performance goals in exemplary fashion, and got my bonus, and that’s all that matters.

          At least that’s my ignorant, knuckle-dragging outsider’s view of how at least half of corporate America seems to run things.

          • “So I failed on #2 (smoking)” — nonsense, Dan will never smoke again! You get a perfect score. VP material for sure. Promote this guy and give him stock options!

          • How about this? Since no one actually dies from being fat, smoking or having an elevated systolic BP (meaning these are not diseases like cancer or mechanisms of death like stroke or m.i.), why not let Dan be Dan. He’ll die when he dies; fat, buzzed on nicotine and happy. It is the hubris of trying to cheat death that has destroyed the health care system. Let’s return to setting broken bones, stitching bleeding wounds, dispensing some antibiotics, antivirals and pain killers — dealing with the acute stuff — and letting people die of the chronic stuff on whatever schedule nature unfolds. Dan’s wife and kids are his responsibility, maybe his kin’s; but not mine. Though I have no objection if those left behind want to take a stab at a GoFundMe campaign.

          • Actually, I’m more aboard with some of what you said than you might think. One of the reasons I moved into what I do now (which is not direct patient care).

            That said, the “chronic stuff” is what leads to the acute stuff (e.g. heart attack, stroke) that ultimately kills you. And importantly, people with lots of the chronic stuff don’t usually just be fat and happy one day, and dead the next. Rather the pathway is years of ever-increasing debility for the patient, and increasing cost to society. Get diabetic, don’t fix (okay, try to control) it, and eventually the surgeons are cutting off your feet because of shit circulation (especially if you also smoke), or you have terrible diabetic neuropathy and stepped on a nail and didn’t know it for weeks until you had this horrible infected wound with pus dripping and I can see the damn bones in the bottom of the hole (this is a real thing); or you’re going on dialysis — because the end-organ damage is ever progressing.

            Not to turn this into a medical lecture, so I’ll keep it brief in “footnotes” [1, 2, 3]

            As to Dan’s family, that was for analogy purposes. I was saying that IMO too much of corporate America is about short term metrics, and complete disregard of societal effects. E.g. closing a profitable (but not very) plant in Indiana to move it to a maquiladora, or to China. Fictional “me” offing Dan to sell his organs while saying “screw his family” is the analogy. I wasn’t saying that you should be responsible for Dan’s family. However, the reality is that we do end up paying for other people’s care and feeding all the time, upon threat of prison, in fact. Personally I’d prefer that it was more voluntary and put “ours” in line before “rest of world”, but I also prefer a society where we do try to look out for those who are genuinely unfortunate, particularly through no fault of their own.

            [1] Weight: Obesity leads to type 2 diabetes (DM2). DM2 isn’t “just a sugar disease”. It markedly degrades endothelial function (the lining of arteries is actually highly bioactive – it ain’t just a tube or pipe) which in turn promotes plaque deposition which leads to heart attack, kidney dysfunction, stroke, etc.

            [2] Smoking: Smoking increases both cancer risk as well heart disease and stroke. It greatly increases risk of venous disease as well. It also weakens the structure of major arteries.

            [3] Hypertension: results in adverse remodeling of heart (left ventricular hypertrophy, LVH) and arteries, leads to greater shear stress on wall of major arteries. LVH is a very very strong predictor of increased predictor of excess mortality, kidney failure, and cardiovascular morbidity.

          • I too don’t want to live in a society that says “tough beans, Dan.”

            All of the chronic health issues you cite are catalyzed if not wholly caused by consumer culture.

            I smoked for 20 years – never needed to, never gained from it, contra Ayn Rand’s creepy romanticism about smoking. At least her cause of death was poetic justice.
            Thanks-no thanks to the tobacco companies as well. I’m so glad they helped me shorten my life by years and pay six figures for the privilege.

            As for obesity, I can’t believe that our genetics have changed so radically in 100 years that 40% of the US is now obese because “can’t help it.” We all see these people in the shoping aisle and think “no wonder” as they ring up their awful dietary choices.

            Hypertension – see smoking & obesity, above.

            Lack of quality sleep is also a huge driver of chronic health issues, physical and mental. Once again, lifestyle driven – having to outwork Pajeet or lose our underpaid job with crappy benefits, among other laissez-faire perverse incentives to rush toward the grave sick and in pain.

            As I said immediately above, making peace with death is fundamental, but you are right about chronic health issues having a social cost as well as personal. To the extent it’s an unnecesary self-inflicted problem, we need to change the cultural incentives that drive this stuff.

          • That’s the heart of it. All of the medical interventionism, big pharma and resulting mountains of debt stem from our culture’s inability to face the inevitable end, NuChristians as well as atheists, it seems.

            Our pagan and Old Christian ancestors with their danse macabre sensibilities had a deeper more mature understanding and acceptance of death than our modern masters of the universe.

            Many of us who’ve died & been revived can attest there is something beyond all of this, but instead of serving as an inspiration for society to transform its understanding of death, we’re relegated to the flat earth fringe or damned as charlatans one and all.

            Moderns would rather deny death at all costs until the day they’re dragged in terror into an unknown darkness than accept all that’s implied by the reality that this life is just part of a greater whole.

    • It’s a worldview thing: man is either a being with inherent dignity and worth OR a cellular cosmic accident. The latter drives a mechanistic, economic approach to health care. The things we’re discussing are valid, but also a natural consequence of postmodern philosophy. Nihilism isn’t just a philosophy … there are real-life ramifications.

      • It has consequences too. We’ve been freeloading off moral capital for a long time. As things get worse, people have less to lose and need something to believe in , there is a plenty of room for mischief makers to put people to work. Including our side FWIW

        Also the “grid” that our leaders are counting on to keep them safe isn’t looking so hot when the power is out and excrement is on the street.

        A buddy of mine just finished a business meeting at what is usually an $800 a night hotel in L.A. They had signs up wandering about human feces and his coworker freaked out (Was from the middle east somewhere but her society is clean) when she nearly stepped in it.

    • In education, admin’s always pushing “best practices” according to the latest leftist academic “research” — as if your “practices” don’t change class-by-class and hour-by-hour depending on the kids, the topic, your mood, the weather….Education admin is pretty much a joke.

  38. I am fairly certain the reason for taking your picture is so the high quality health care professionals can look at it and confirm they are treating the right person. They could try to sell it to Big Tech, but so many people are already on social media, I doubt it would be worth much to them.

    Since having a child, my wife and I noticed those questionnaires are filled with questions the doctor has no reason to know. It is pretty obvious this is being driven from the administrative level. Much like with education, if meaningful reform is going to happen the administrative level will need a good purge.

    • Barnard, I also think there is a lot of scamming going on.

      If everyones last name is Rodriguez or Mohammed el Mohammed, things get confusing.

      I am asked my name and DOB by every dipshit from the front door to the OR.

      There are even signs up: “if you are not asked to confirm your identity, please report this immediately” or somesuch.

      Maybe this is part of the ‘don’t cut off the wrong leg’ process oversight, but I suspect it has more to do with the growing vibrancy and their penchant for gaming any system ripe for gibs.

      In general, my provider (not ‘Doctor’) seems most concerned with customer service.

      I have a potentially life threatening issue (more statistical than physical) that took over a year to get diagnosed.

      My neurologist has never checked in with me and I’m due for follow-up imaging. But I get an email a week – and one after every visit, asking for feedback about ‘my experience’.

      My experience? Its like walking into the space port of entry from Men in Black.

      I gashed open my hand recently and the thought of going in there with an open wound gave me chills.

      I paid the $185 to have a young white doctor stitch me up at a new doc-in-a-box down the street. 30 min. In/out. Cup of coffee while I waited. Fireplace in the corner.

      I need to make more money.

      • This is the case in California. We have titanic mounts of fraud , mostly to get pain pills but other things as well.

        Some providers have explicit no sell policies BTW , other do not and no doubt they are selling them.

      • Good point. I can see diverse members of our society trying to “share” health insurance with those who don’t have it. Having a photo attached to the patient file would help prevent that.

      • Screwtape –
        I’m a RN. I’m white. I can assure you that the reason you are asked your name and DOB all the time is for patient safety. I work in a large trauma center. Every week, sometimes every day, we have two patients show up with identical or almost identical names. If you are one of those people and you are having your appendix removed and the other guy is having a rectal exam under anesthesia, I bet you want us to make sure we have the right guy lined up for the right procedure.

        There are plenty of good reasons everyone here is complaining about the health care system. I get it. I’m a patient too sometimes. But our hospital alone has over 2 million visits a year. It’s a system. We have to be careful.

        I wish we could do it differently.

    • Indeed, selling your photo as sourced at a specific medical facility would probably expose that facility to liability for a HIPAA violation. I know many lawyers who would be only too happy to drive up the aggregate cost of healthcare in exchange for an easy invasion of privacy tort settlement. The Almighty Fed giveth and it taketh away because it is such an unwieldy behemoth that the right hand doesn’t know what the left hand is doing and vice versa.

  39. sounds like heaven to me. When you live in Canada, just having a family doctor puts one in a very elite group, one that I used to belong to until yesterday. I have friends that have been on a waiting list for years and still have no family doctor. Now, I no longer have a family physician as he has decided to (at the demands of his wifey) relocate to a larger population center, my name will go on the waiting list, behind my friends but as we know, “waiting in line is a good thing”.. My health care is of course “free”, I now have the luxury of spending MY free time in the emergency room where I can wait to speak to a physician that knows nothing about me except that I stand between them and an overflowing emergency room full of self induced health problems.

    • Youch. I live in Canada too, and I guess I am a member of the elite group — our GP is fantastic and thus far we have always had great care. That said, I dread the day our GP retires. Seeking treatment in the ER is a nightmare, not to mention incredibly inefficient from a financial POV. As usual, our Dear Leaders are in the process of breaking what used to be a very good system.

  40. Having visited doctors in both Europe and the U.S., my observation is how overstaffed the U.S. system is. In Europe, you almost always see the doctor first–i’ve been to offices where the doctor literally opened the door and answered the telephone. The doctor takes blood pressure and other vital signs. There are a minimum of technicians, except in areas like radiology. Even there, in one case in Russia, the radiologist herself came out and explained the results to my wife and I personally–there was no need to relay the information back to the original doctor for explanation, in a week or so. In the U.S., it’s just like the Zman observed–there’s a series of toll booths and a gauntlet of technicians before you finally see the doctor.

    I am looking forward to the fight that’s coming when President Warren decides to impose some form of Medicare/Medicaid for all. Pass the popcorn (I’m going to Europe in January) while the Dems battle Big Insurance, Big Pharma, and Big Medicine!

    • “while the Dems battle Big Insurance, Big Pharma, and Big Medicine!”

      “BATTLE” ??
      There all on the same team!
      It’s all for show.

      • The Dems are in for a nasty surprise as there is no way they can raise a fraction of the revenue national health care requires and they won’t be allowed to do cost control ala Europe or gobble up Medicare.

        The US cannot and will not collect more than 20% of GDP in federal taxes, every attempt has failed and even a VAT tax would simply result in reduced sales of everything.

        This means duplicating the NHS for example would require half the federal budget , complete elimination of a huge part of the insurance sector , massive costs and profit control and the last time they tried reform, we got the misnamed Affordable Care Act.

        There is simply too much money in the system to allow this and unless we as a society are willing to amend the Constitution or stack the court and eliminate Citizens United , we’ll have the best Congress corporate money can buy.

  41. We’ve got to keep Z going to see out his revolution.

    But don’t worry; even if you don’t make it, there will be a meat-stick statue in your honor in every city, town, and village.

  42. You should try the VA for a taste of what our leftist overlords want for everyone’s healthcare. Every single one of us veterans have stories to tell about the dystopian nightmare that is. In fact, we used to joke that dogs got better treatment than us…

    • Part of the problem (just part, but still) with the VA is the large number of veterans that could get perfectly good healthcare somewhere else. Obviously, I’m not referring to those who need the VA system, but to those many, many vets (vast majority) who did a few years, had no real issues, then use the VA for the rest of their lives, instead of being responsible and getting health coverage like the rest of us.

      I served and have full rights to use VA healthcare, and maybe someday I’ll need it, but right now, I don’t need it and have never used it. I figure it makes more room for those that do need it. I get really tired of all those vets out there that think that just because they did one enlistment 20 years ago that that makes them entitled for the rest of their lives.

      • I’m not going to disagree with you there. There should be a distinction made between the real veterans of combat units who get VIP treatment and everyone else who kicked boxes or flipped burgers in the chow hall.

        It’s exactly that distinction that infuriates me about Tulsi Gabbard, Buttigieg and that fat sack of shit Vindmann. All of them claim to be veterans too, but they sure as hell ain’t veterans like me.

        I earned mine the hard way.

  43. I’m just going to identify as a dog and go to the vet.

    (Oh, you laugh today, but just wait until tomorrow…)

    • I tell my family “If anything happens, just bring me to Muddy Creek.” (Muddy Creek is where our four-legged pals get treatment.)

      • And then the family can’t have the patient back if he is allowed to run around in the yard without a leash.

      • “mandatory neutering”

        Huh. So that’s the counter for the old “I’ll identify as a dog and then they can’t do anything to me if I run up to attractive women on the street and hump their leg” scam.

  44. Many apologies for the ‘but ackstually’ sperg out:

    In the before time, a well trained, confident, white male MD would examine your knee, pat you on the head with a ‘don’t do that’ and some aspirin and call me in two weeks.

    The PT is meant to be a holding pattern, to purposely keep you out of the price escalation vortex with the knowledge that most aches and pains will go away in a few weeks on their own, and they’ll never hear from you again about it. The MRI will probably cost your insurance as much as 3 grand, depending on the locale, so they want to delay that. If they see something on it, and they always do, that means a trip to the orthopedic $urgeon, who is going to want to $cope it.

    Why the Xray first? because if the joint is completely toast, they will just replace it, and a 300 dollar xray will show that. It’s unlikely at your age, but not unheard of if you blew out your knee playing football in HS or something similar.

    Commercial health insurance, by design, is programmed to put barriers in place between patients and care, and to delay and deny payment to those that give it, very often after the fact. Feature, not bug.

    • Absolutely! In today’s world of internet medical sites, constant TV advertisement and fake doctors, people come into the doctor with their own self-diagnosis and lists of tests and procedures that will need to be done, before ever seeing a provider. Hell, most test for testosterone are requested by the patients.

      In the clinical laboratory, we are faced with huge costs and high volumes. Multiple studies have shown that around 70% of laboratory tests are completely unnecessary-not just negative values, but shouldn’t have been ordered in the first place. There are many reasons, but CYA is a big one.

      It’s even worse for patients on Medicaid. They don’t pay for anything, so they demand everything. If you can add in some inconvenience, it sometimes slows down their demands and makes room for those who actually need it. Unfortunately, it sucks for the rest of us.

      • Are you saying that the evidence of a major reduction in T should be ignored by the public just as it is ignored by the medical establishment?

        • I’m saying that as soon as a new ad campaign begins for whatever new drug they are trying to sell, people will immediately start asking their providers about it. Don’t ever tell me that marketing doesn’t work.

          Also, reductions in testosterone levels are normal as men age. As far as the various ‘soy’ effects on T at earlier ages, well…the last thing this world needs is a bunch of soy-boy Antifa-types with high-T.

        • No. However medicine and science typically only advances as the older scientists die off. Both of this skill sets have status attached to them and have pretty high time and money costs, four to eight years or more sometimes and no one is going to change a damned thing is they can help it.

          Basically most doctors won’t do anything or know anything or care. old dogs, no new tricks

          As to Outdoorspro point, there are excellent reasons medical ads are banned basically everywhere. They are actually harmful.

          To my way of thinking if we can ban tobacco ads and ban gun ads by policy we ought to ban medicine ads. We won’t as they , along with cars are keeping TV alive but as policy goes it’s the right choice.

    • Following up. The dumb questions were mandated by the government. They forced computer records on medicine then needed to show that it was “doing” something. Recording things was the answer. Are you depressed, did the “Doc” check for depression? Answer these questions, charge for the screen, and voila! We did something. Ask about guns. Why? Because the SJWs at CDC want you to. This way they have a record of homes to raid. Picture-probably so the “Doc” can pretend to recognize you when they walk into the room. PT was a check the box algorithm. This way the non-MD or FMG gets to bill more for the employer/clinic. MRI- so you don’t think they are blowing you off/you do not sue them for not getting MRI. It takes longer to explain that you do not need an MRI than to say “sure”. If you want good medicine go to the small, interdependent group of middle aged and up white guys.

    • Taleb for all his recent halo-effect scrapes with IQ scientists and the like did seem to have some good concepts to offer for medicine in “Antifragile,” largely along those lines. Iatrogenic meddling is often more dangerous for patients than simply braving the Fates.

    • Don’t leave out the lawyers. If you don’t run these tests and something is wrong then all the sudden you’re being sued for negligence

      • My big brother firm has all sorts of CYA documentation going on; I write various reports all day, as part of my work. I like to joke that the CYA work is not for “me”, as they tell us, it is for “them”, so they can institutionally say everything was done by the book, and any anomalies must be “my” fault.

  45. Quote of the week: “To the people in the health care system, I am just a talking meat stick, one of many, they have to supervise. ”

    Z-man nails it again. I have to say, however, even with all its faults and ticks, the Canadian system sounds far better than what Z-man describes. At least the health guys in the Frozen North know they’re not going to get a lot of extra bucks by running you through the toll booths, so they just get on with it., Sometimes very slowly, admittedly, but usually the job gets done, at least in my experience.

      • True. Don’t get me wrong, our politics are nothing at all to brag about. We are slowly, quietly going down the tubes here. We have a high school drama teacher, besotted with political correctness, “leading” the country. His cabinet is an exercise in diversity, incompetence and virtue signalling, We are a mess economically, again largely thanks to said drama teacher and his govt. . Just saying that so far, the healthcare system sort of works, and there are fewer “toll booths” along the road.

        • One big advantage of the Canadian system is the lack of competing billing sources. In the US, if you need to have a significant procedure done (say, surgery) you will get bills and EOBs from many different sources. It is nearly impossible to answer the simple question: what do I owe?

          The only responsible thing to do, other than paying cash up front, is to wait months for all the providers, institutions and insurance companies to finish their routines. Then, just wait for the final bills and pay right before they go to collection.

          At least in Canada, we never had that problem.

    • How about the experience of a family (Canadian) friend, who was on a very, very long waiting list for an essential heart surgery procedure?
      No, Canada is NOT a good example of socialized medicine. It too, is where we are headed.

      • But other than that, Mrs Lincoln…

        Yes, we do have serious problems, and wait time is a major one. I worked in the system, so I can tell you the biggest problems (a) Just not nearly enough money going into the system, Dollars are being diverted to pay for things like “refugee shelters,” “diversity training” etc. etc (B) training foreign docs at the expense of Canadian docs because it brings in more cash to med schools. Result — a long term shortage of docs. As always, the “leaders” don’t have to suffer, they just jump the queue or go to the US for treatment. The rest of us dirt people stand in line until we drop. (DO you get the idea I am irritated?)

      • It’s pretty much built into the system that you will go south if you absolutely need to. And when you shop cash the retail price disappears.

    • Hmmmmmm.

      That has not been my experience at all. I would have said that anyone that thinks that Canadian health care is superior – has not done his homework. Look at our tax rate. We are taxed at a base rate of around 43%. Add in the hidden taxes and graft and we go up to around 55%, depending on which province you live in. Most of that is health care.

      Even though the industry is subsidized out the wazzoo, and propped up with cheap labour pajeets, kebabs, and nine irons – the lines are growing. The big trick now is that if you’re waiting for a kidney transplant, for example – your paperwork gets misplaced, misfiled, or “File 13ed” and you die standing in line. The rich dodge all that by jetting off to posh private care clinics in other countries. Even the commies in Canada are doing it – Gassy Jack Layton (the former leader of the NDP and notorious pedo) and Jean Poutine Cretin (former liberal party leader and notorious fwench grifter) – went out of country while pushing public healthcare on the rest of us.

      Another issue is that the baby boomer demographic is now hitting the healthcare system for all the freebies that they voted for themselves back in the 70’s. They are hitting the system en masse in a demographic wave, and the system is already starting to buckle. If you want to see a Boomer chit himself in fear – start talking about two tier health systems.

      The system is running on debt now, and even so… every year more vibrants flood in to the country to take full advantage of a plan they never paid into. Math is a harsh mistress and eventually that can only end one way. Most of us will live to see the implosion… but I DO wish my shitlib parents and inlaws would too. It would make me happy to see them suffer for their idiocy the same way I and the younger ones will.

      There are times when this Christianity stuff is incredibly difficult to do.

      • Wrong. Canada was 72% white in the 2016 census. Ontario, BC, Alberta were in the 60s.

        When I go to the clinic, it’s mostly foreigners or paperwork canadians. They go for a papercut to the walkin clinic.

        The system only still functions, because behind the scenes the majority of important people are old, white (Anglo) men. In the next 10 years a mass of these people will retire, and diversity will be pushed into the leadership ranks. After this, all bets are off.

        Stay healthy, friends.

    • For what it’s worth (i.e. the plural of anecdotes is not data), I have taken care of several Canadian MDs who came to the US to pay for cardiac procedures out of pocket rather than wait through their own system to get care.

      Specifically, these were people getting cardiac catheterization and PCI (percutaneous coronary intervention, i.e. getting a stent – or several – in your coronary arteries). (And full disclosure, I’m not an interventionalist; I don’t do stents, I was part of the care team. Not doing the “stolen valor” thing by deliberately misleading omission here….)

  46. In addition to veterinary medicine, we also have a free market for laser vision correction. It has all the same features Z mentioned and has improved the lives of millions.

    Doing this for basic medical treatment shouldn’t be hard.

    • Dental care is another pretty efficient market. Dental insurance doesn’t make much sense to buy because there are no low-probability/high-cost scenarios. So the pricing for various procedures is very upfront and transparent.

      • I save even more money by going to the University of Medicine and Dentistry in Newark to be treated by the student dentists. Great up-to-date care provided by young dentists who will graduate in a year or two. They are not looking to make money, but earn credit, all under the supervision of professors. The downside is that care sometimes takes longer than going to a private dentist.

        • It can easily be in the thousands. One problem is, you go in for one thing, and they’ll say Have take x-rays first, so you’re up into the hundreds and then they’ll say, “Yeah, we can do a bridge, but first we have to fill these two and pull that one and…”

          Maybe it’s different elsewhere, but everywhere I’ve lived, I’ve never had a dentist just do the one thing bothering me. It’s as if there’s a special morality, and they’re appalled at the suggestion or the treatment you want, always with “No, we have to take care of this before we can do that….We’ll write up a treatment plan.”

          “I’d like to just do this right now.”

          “Can’t do that. Have to do these things first….”

          Nobody else runs into that? Maybe it’s ‘cos I stay away from both doctors and dentists unless it’s an absolute necessity…And as long as I stay in town, it’s good, ol’-fashioned Baptists, but if it’s a specialty referral to the college town nearby….always vibrant (Indian. specifically). Always.

  47. Glad to hear you will be around for a while at least. Who knows how much time any of us have left. There are no guarantees. We all have to make the best of what time we have left.

  48. Great synopsis of a corrupt system. Once again, you’re articulating the plethora of “taxes” that we’re forced to accept as a part of everyday life. Whether a trip to the DMV or WalMart or the doc office, there’s a tax on our patience and dignity.

    I would add, though, that health care is yet another area of life where secession is worth the effort. No question I want an American hospital if I’m in an accident, but otherwise there’s a lot of self-care that can be done with the acquisition of minimal supplies and a few skills. Stitches come to mind: we live on a farm and have had multiple injuries that “required” stitches … some antibiotic ointments and butterfly bandages did the trick (and then there’s always CA glue.) Every family should have a bottle of Vetericyn on hand (great advice from my livestock vet). Blood pressure is controlled with exercise, magnesium supplements, and avoidance of DMV, Walmart, and doctors offices.

    • Had the weirdest experience at the DMV the other day. Took one of my horde for a permit exam and received outstanding and friendly service from multiple employees. Was approached twice by wandering employees and asked if I had everything I needed. Was courteously escorted to two different lines. Escorted, I say. The place was packed with the usual customer melange of non-English speakers and ghetto denizens… but everyone was friendly and helpful.

      I’m still freaked the hell out. Anyone have any ideas of what the heck I just experienced?

      If not, I’m going with it’s The End of Days.

      • Heh! Had the same recent DMV experience recently, and I live just up the hill from you. They did carefully take my photo for my new, special driver’s license that lets me go through airports. Multiple takes. Made me take my glasses off, for maximum retinal scan purposes, most likely. I figure the DMV is now the primary source of government created identity data, so they may as well make it as user-friendly as possible.

        • You poor guys! In southern Utah, I can get in and out of my DMV in 5-10 minutes, polite white people, plus no nasty body odor or stink bug breath. Mormons are good for something.

          • Range,

            I’ve worked with a number of Mormon men. They aren’t a bad sort. Efficient and hardworking. Of course it is also fun to push the limit with them… all that “gosh” and “golly” stuff makes me become uncharacteristically course and crass… just to see if they’ll break. Nope, they just chuckle along no matter how far I push it.

            Of course, I figured out that they will probably inherit the earth through sheer numbers and clean living. They aren’t chuckling along with my blue humor… they are chuckling at the fact that after it hits the fan and their year supply of food runs out… the mouthy gentiles like me make the perfect meal on the hoof. Yup. Pretty sure that’s the plan.

          • Agreed, my city is actually run by the Mormons, quietly and behind the scenes. They do have a funny little “I know something you don’t know” thing going, in their relationships with the rest of us. IMO, it is their sense of Community backing them up that we largely lack, and need to work on.

          • A while back I chatted up one of the owners of Smith & Edwards in North Ogden. A massive store, great gun selection, you can just about buy anything country you could ever want, a bit like Lehmans. Mr. S&E definitely lead me to believe they have a plan when the world turns to crap. Nice to have them around. And when it isn’t, I just remind myself that life is messy.

          • Yep….we too have the full pantry. A lot of the younger Mormons are in debt, not getting prepped up and going all rainbow. Maybe we should eat them!

            Hmm….when the sky falls, wonder how long those little prairie dogs in the back field will last before depleted. My trusty .22.

          • After their year long supply of food runs out you’ll be eleven months dead,
            You’ll be “on the claw” of whatever vulture ate you, not “on the hoof”

          • Normally you’d be right Bile. But you got the wrong fellah. We’re a bit more prepared than that. They have the numbers and I’m sure will get what they want eventually. But the butcher’s bill will be dear, Son… quite dear.

          • I think the key phrase is “white (NW Euro) people” – the fact that they are Mormons is not necessarily important. However, due to the fact that they are Mormons, they aren’t totally pozzed and supportive of degeneracy.

            It’s just the outcome that occurs when NW Euros have a good value system and are comfortable in their own skin. Neither race nor value system alone is enough. When they work together, there can be a strong effect, be it positive (Mormons, Evangelicals) or negative (Globohomo, cat ladies).

            Mormonism is probably one of the most compatible systems with NW Euros, given its founder was Joseph Smith an Englishman. Not saying we should all be Mormons… but it works well with the white race.

          • Yes it does, individually. The 12 are supplicating to the Imperial Empire to gain as much time to fly under the radar. When they point in a direction, the sheepies by command turn to that direction.

          • There’s a lot to be said for LDS. I just personally like coffee, dip and booze too much. Oh yeah, and not being a heretic. That’s up there too.

          • How can anyone think Mormons and Evangelicals are “positive”? They’re mostly stupid weirdos who act as a ball and chain on traditionalism.

      • I’ve found my local DMV to be staffed by very pleasant imbeciles. They know their statutory checklists cold and have been trained to put their brain on a shelf before commencing work. Their motto is “Do NOT exercise reasonable judgment.” I put DMV employees on the same level as TSA rabble … behind their “May I help you please” persona is a relish for power and cuffing/stuffing sheeple.

        • Capt,

          Nope. The system crashed and the employee actually jiggered a way around to get my offspring his confirmation and test. Of course, then my kid choked and missed passing the exam by one question. The employee was very conciliatory to the boy and said, “Hey, no problem, you only missed it by one, brush up and come back in eight days… you got this kid!”

          I swear, if Rod Serling had suddenly sauntered out into the lobby with a lit cigarette and began, “Picture of a father and son, mouth agape in the DMV…”

      • DMVs in my area are franchised out to private entities, so the government mentality is much lower than when the state ran the place. That could be what you are seeing.

      • … everyone was friendly and helpful.

        I’m still freaked the hell out. Anyone have any ideas of what the heck I just experienced?

        “And then I woke up. It had all been a dream.”

        • Hahaha! ICE cap is also the way to instantaneously go from #122 on the Emergency Department waiting list to #9 with That One Weird Trick.

    • Thats a big part of the problem Capt.: self sufficiency, but also lifestyle choices.

      I definitely want the full monty if I wrap my Camry around a tree. But alternatives for cheap and easy care and self-sufficiency are important for sure.

      The problem is that the system is not about providing care for random health issues, but rather about confronting a population that is intent on suicide by lifestyle. Its about taking the fat man through the eye of the needle.

      People want ‘insurance’ aka a guaranty of ‘good health’, whatever that means to them, in spite of them being determined to undermine good health through their choices.

      To make matters worse, the invaders love the American hummingbird diet and sedentary life of amusement. Mexicans are already challenging the US for global fatness crown. And they are all coming here because statue of liberty.

      My medical provider is staffed by all women and fat mexican clerks. The clinic is like a refugee camp. POC babies everywhere.

      Based on what I see in there, it is totally worthless for anything but stitches, STDs, and cranking out baby invaders.

      This is the future. Like everything else coming in our brave new world, if you are rich you will have to pay your way into better care.

      If you are not, prepare to step into a dehumanizing system that is solving for an actuarial solution run by the very people who hate you and want your stuff.

      Yes, every family should practice first aid, wound care, and many other basic healthcare skills and have a small stock of supplies.

      A basic understanding of natural remedies is also valuable, especially if you can grow or forage. A lot of herbs out there with actual benefits.

      But we should all be taking responsibility for the 90% of healthcare that starts with our own daily choices.

      There is no system – at least one that we can or will want to pay for, that can handle a majority population of people who have abandoned their own health and wellness. Nobody cares more about you and your family than you, no matter what you pay.

      The idea that good health is dolled out by the state, that we are entitled to it, and that our own choices are unrelated, is toxic.

      When real communities take form again, incorporating a shared sense of wellness based on lifestyle will be essential.

      It is our moral duty to care for our bodies. This was lost with the rest of morality some time ago.

      • Screwtape: “The idea that good health is doled out by the state, that we are entitled to it, and that our own choices are unrelated, is toxic.” Brilliantly put. I have no wish to control who rides motorcycles or wears which helmet, or who buys cheetos with their gibs. But I refuse to subsidize others’ choices. That’s the entire premise behind American medical insurance, and it makes the state responsible for your choices and you responsible for everyone else’s consequences. Perhaps, in a semi-authoritarian ethnostate, it might be workable. Not here, not now.

      • I am in pretty good health for my age (nobody can believe I’m in my 70s) and am convinced some of that is down to nutritional supplements. Now before you account me a fool or naive, it’s true that there are exaggerated and unsupported claims for some supplements. But there is plenty of research you can check out for your own diligence, and it’s not too expensive to experiment if you hang onto common sense. Any benefit you derive will probably save far more in medical expenses than it costs.

        At the very least, I recommend supplementing with vitamins B complex, C, gamma E, and D3. Various trace minerals and amino acids target particular health needs.

        Supplements are a big business in the aggregate, although a surprisingly large number of companies consist of independent producers and retailers — among the few thriving small businesses left. Supplements are available at good discounts online from companies like Vitacost and, if you must, Amazon.

  49. Another observation is that in the near future, going to a competent white doctor will be a luxury item. As with tech support, many doctor positions are filling up with pajeets and other swarthy foreigners. There are tech support plans that are essentially “talk with a white guy in the usa” for your support. Soon a similar regime will rule health care.

    Our med schools prefer alien swarthies to domestic whites for the Ususal Reasons. And the health corporations similarly prefer imported swarthies.

    A relative who works in the system does not trust any of the swarthy doctors and few of the swarthy nurses and techs. Very little sense of mission when the doc or rn certificate is the means to get to the usa. They mesh perfectly with the corporate desire to shake max value from a customer’s insurance–private or medicare/caid–and then toss the empty sack aside.

    • Should have a survey here of how often you get even a native born doctor. I should never feel smarter than the physician attending me but I often due, and it is not because of arrogance.

      • I have one that I can call up and say I need an appointment today and I will get right in… Being in a Small Community helps because I know them on a first name basis…

    • I got into a car accident in 01 and was taken to a small hospital I never even knew existed in an area of Logos on the Delaware, in a neighborhood that turned Puerto Rican a long time ago. Apparently, it was a glimpse into what is in store for all of us. ALL of the doctors and nurses were pajeets. None could speak English properly, which didn’t really matter because the patients were speaking Spanish anyway. The place was filthy too. We’re talking blood on the walls dirty. Being in Kensington, you could step right outside the hospital and buy all the illegal pharmaceuticals you like. It was only a few blocks away from a major hospital several city blocks long. Nobody I knew ever been to that hospital, most, life long residents, didn’t even know it existed. There were no blacks and no whites. Just a sea of Puerto Ricans and Indians. The Indian staff were rude as all hell. The nurse assigned to me just started ejaculating my last name. I asked her politely to call me by my first name or Mr last name, but that was too much to ask.
      I think it exists to keep the Puerto Ricans out of the regular hospitals. It is a glimpse into our future.

    • The other side is that we add ~ 2M new people a year (more than 100M since 1980.) The medical cartel hasn’t added capacity to train more personnel, so the alternative is to bring in foreigners. Also, here in MA I know of two nursing programs that lost their accreditation because not enough of their grads could pass the boards (and yes, they were programs that had deliberately recruited to increase diversity.)

      • That nursing program thing was on the news here a few months ago. I remember seeing that segment with the wife and asking:

        “so – what’s the common thread running thru that program?”

        • Friend, we all know. The sad part is that the top-performers are tainted with the same brush. 50% passed with flying colors? “Sorry, no, they weren’t diverse enough. Kill the program.”

    • Yep. Factory-farm healthcare is perfectly suited for cut-rate Pajeets who look at patients like their fellow Bindi techies look at help-desk tickets.

      • Well Judge, there are a lot of people that really just need to hear “it says on your chart you talk like a fag and your shits all retarded” more often. Prolly as effective as anything at this point.

  50. I saw Soylent Green the other day again, and while it’s a far from perfect dystopian SF movie, that chamber where they euthanize the aged showing them music and images of their choice always got to me. Maybe the Cortez New Green Deal will have a similar clause for Caucasian Disposal. Each cauc will be allowed to select a panorama of images from Turner Classic Movies library while listening to something besides auto-tune rap, as we’re turned into a protein source for the non-whites. Method of euthanasia will obviously be a bundle of opioids courtesy of the Sacklers. I choose Tchaikovsky and “The Day the Earth Stood Still.” Yes, I’m feeling a little black-pilled this morning.

  51. At my toll booth, the attendant handed me a new form with ten questions about depression. She and the nurse/keyboardist watched me intently. I scanned the questions briefly, drew a big circle around the NO checkboxes, and handed the attendant my form. They laughed.

    If I’d circled YES the doc would have probably prescribed Xanax.

      • I’m sick and tired of useless surveys in general. Pretty much every business interaction now seems to result in a long list of nag emails/texts asking me to fill out a customer satisfaction survey, leave a review for the product, etc. I’m sure there’s a whole army of MBAs and consultants out there telling businesses to put more and more of this crap in place. From the business’s point of view, sending an email costs them nothing; but it costs me my time, even if I delete it immediately…

        • I think it’s data-harvesting. Selling your data is big business. If I have a particularly good customer-service experience (as I did with Asus, recently) I’m happy to do the survey and give the person that genuinely helped me a boost.

          • I was in Lowe’s the other day, they asked me if I wanted a printed or Email receipt for a $5 box of screws.
            I asked the woman if they ever got any email addresses. She said they do,,,,,,,

        • And they do it for 2 purposes: To have more data to sift through (which justifies the jobs of the analysts), and to potentially sell the data to someone else, so that the buyer can sift through it with their analysts too.

          Bureaucracy was bad enough before it developed a private-sector strain.

    • Absolutely – and it is a racket that is going to implode in the next couple of years. We should actually THANK Obutthole and the Donks for putting the final nails into its coffin too!

      Health care is a commodity like any other. There’s supply, demand, unions, upselling, corruption – all the stuff you would expect from any other national sized company. Most of these inappropriate questions have, as their first priority – to get the state deeper into your wallet. Understand that they are a part of an emerging business plan to cut losses and expenses. Are you a gunnie? Do you smoke? Obese? Do you think the wrong way or hang out with racists and crime thinkers?

      No healthcare for you!!!

      Interesting times are in the offing. When rich baby boomer whites find themselves stuck in line by an endlessly growing line of vibrants and welfare slobs in front of them – they will seek options and they will find them – or make their own. A viable market will rise that will cater to the demographic without the bullchit of the public one, legally or illegally.

      Another threat arises: Hmmmmm… “I have terminal cancer. I am going to die, probably in great pain, forsaken by the health programs I have paid for all my life. Maybe going out in a blaze of glory might be in order?” Why not spend what’s left of my life by taking a pot shot at one of the arsehole politicians responsible for it? Or maybe a car bomb, or maybe an ‘accident’ at the crosswalk, or maybe…? I am not encouraging anyone to do something like that… but misery loves company, and if our leaders are going to maliciously impose it on their subjects… doing such has a nasty historical boomerang effect.

      We live in very interesting times. Good stuff on the exam, Z. Stay in shape and stay healthy.

      • There may be some “Boomer Bickles” in the offing, but considering how scarce VA shootings are (they happen, but not all that frequently) I’m not sure a lot of non-combat arms older civilians will go out shooting. Some people can’t be saved or woken up, or even screwed into realizing they’ve been living a lie. They’ll probably look to Rush and Ben Shapiro for solutions and be listening to talk radio when they get hacked to death by machete-wielding vibrants breaking down their doors.

      • It began with Mitt Romney, a “Republican.” I had a moment of bitter amusement when Obamacare hit. Folks were complaining about their *family* plan premiums and deductibles that were less than I paid as a healthy, single person under RomneyCare. If we can’t get people to recognize cost-shifting when they see it, what hope is there?

        • Its the rack rents scheme. Every one of the many layers between patient Z and Davos is motivated not to fall.

          Same with mortgages. Student loans. None of this is Jewish, its Anglo. Or rather Anglo-Norman-Saxon. ACA HHS data hub of course is just a recurrence of the Domesday book tabulating every American Hide. Yes of course the Jews ran after the rentier administration pennies but this is all very, very English.

          This is for want of a better term “us.”
          This is our system of control.
          Like the Irish serf we are loathed by all the rack rent collectors above us – we are the fate that keeps them at the grinding wheel for which we are the grist. We’re all taught to love money and consumerism to stay in debt and on the wheel, persuading ourselves that spoke is a promotion above rim.

          It works. Until it doesn’t.

      • Im always amazed that hasn’t happened already. Diagnose me with stage 4 pancreatic cancer, watch what happens.

        • You’re not a Boomer. GenX and Zoomers might be a different story… but that’s a ways off

          Boomers are unable to check out of this society. They still think it’s the USA of 1980 and that law and order is what’s most important. It’s a paradigm they will not break out of.

      • Boomers won’t do shit lol.

        They will simply suffer in silence. Theyare too cucked to ever stand up for themselves, and aren’t going to change now.

        • Wrong UFO!

          Boomers will call their genx kids and bitch about how rude the nurse was during her latest appointment to treat her fatty liver, type 2, high BP, and anxiety.

          And how her doctor, who ‘is younger than my grandkids’ is always lecturing her about her weight and her diet.

          And how she has to drive to the next town over because her regular Walgreens pharmacist is from india or one of those dirty places and she can’t understand him.

          And she hates driving over there because it is full of hispanics that don’t know how to drive here.

          And she really just needs to ‘lose a few pounds’ or ’win the lottery lololz’

          • Well bitching about the pakies seems to be an improvement over Canadian boomers and white women who seem to beg them to rape them a little harder. I see it all the time, the average nice white lady is immediately defensive around them – nervous laughing, haha, looking down at the floor, not completing sentences – please, just don’t call me a racist!

            Being a whiny racist doesn’t achieve shit, except raise your blood pressure. It’s just blowing off steam. A deep, full blooded racist doesn’t need to be rude. The difference between Southern racism and the sperg racism, which I’m glad I figured out. Hint: the sperg racists aren’t often that deep.

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