Health care, or more properly, the disease industry,i is the most leviathanic component of contemporary western societies. Depending on your jurisdiction, about half of your tax dollars are being funneled into a bureaucratic quagmire the likes of which haven’t been seen since the days of the USSR, if not the Ming Dynasty. It’s a beast, this, and a preventable one too.
The most fucktarded part of the health care scam, the part that has to make your blood boil, is that of this ~1/2 of every dollar you contribute to the pot, about half is spent treating patients already knocking on heaven’s door, that is, in the last 6-12 months of life ! So if you’re paying, say, 60% of your salary in taxes of one kind or another,ii 15% of every dollar you earn is being literally buried or burned, never to be seen or heard from again, within a year. Pretty shitty investment, eh ?iii
All of which is, to a large degree, a necessary pillar in the founding mythology of the whole democratic charade. Western society is obsessed with ‘longer life’iv because it can measure it and therefore publicise it on TV and shit, and so what if it has to value a life at waaay over a bitcent to get there. You gotta do what you gotta do. But ultimately, it’s this refusal to let death in the door, this rejection of the mortality of not just ourselves, but socialist democracy as a working model, that fuels this very pricey fire.
Needless to say, this anti-death braindamage, whether it shows up on CT scans or not, seeps its way into the once-liberal-and-presently-servile profession of medicine.v All of which brings us to Dr. Saurabh Jha, Assistant Professor of Radiology at the Hospital of the University of Pennsylvania and one of the more reflective and outspoken members of his profession. This being granted as a relative merit, let’s dig into his recent article entitled The vexing problem of dying for the medical profession :vi
Thomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long.
Well, it’s not just death under the Leviathan state (what free market ?) that’s nasty, brutish, and long, it’s arguably life as well. If this is too dim a perspective, you’re either hopped up on the Q or drinking the ‘because reasons’ kool-aid. Thinking that your life is better than it could ever otherwise be under any other system, even while you self-gavroche rubber chicken and wonder where all the autism suddenly came from, is meta-metastaticity at finest. In general, the state has twisted the narrative to shine the best possible light on its kludge factory of twisted incentives. As one would expect.
You’re not better off under the current regime. Not really.
Surgeon and writer, Atul Gawande, explores the medicalization of aging and death in Being Mortal. Gawande points to a glaring deficiency in medical education. Taught to save lives and fight death, doctors don’t bow out gracefully and say enough is enough. We’re not taught about dying. We’re taught about not dying.
Of course doctors aren’t taught about dying, neither is anyone else ! How else is the first, biggest, best democracy that you live in supposed to persist ?
Besides, when doctors are slaves to their industries and slaves to their patients, which they undeniably are immutably are (at least at present), who are they to say that ‘enough is enough’ ? This is like your pet dog telling you that he’d rather take a shit on the living room carpet instead of at the park. Seriously, how’d that work ?
In our lexicon, life is a constant war against the grim reaper. We say inactivity kills; screening saves lives; an intervention reduces mortality by 5 percent — an arithmetic impossibility as mortality for our species, barring select prophets, remains 100 percent. Words have precise meanings. Words also hide precise desires. It’s not that we can’t distinguish between a murderer and colorectal cancer; but by giving cancer moral agency — we wage war on cancer — we imply that death is an anomaly that must be fought.
Quite so. Jha makes an astute observation here but he doesn’t yet see the why. For the better part of a century, the USG has been waging wars against words specifically because of their emotional appeal, which stems from their inherent vagueness. This is useful for passing legislation that would otherwise be branded as totalitarian. So whether it’s the war against communism, poverty, hunger, terrorism, inequality, death, AIDS, or cancer, the war is always fought with feelings : the most accessible language to the lowest common denominator. Amirite, girls ?vii
Modernism’s paradox is that strange calculus between independence and dependence. Individualism has oddly increased dependence. Dependence, that is, with the medical profession. But doctors did not cross this line willfully, even though many crossed happily. They were invited to fill a space that was occupied traditionally by religion, family, and community.
This paradox belongs not just to modernism and its descendents, but also to the socialist barnacle attached to its ‘progressive’ hull. That the state has taken on the roles formerly occupied by religion, family, and the community is very much by design. With papa government as the planet around which the stars orbit (yes, the idea is exactly that old and that ignorant), alternatives are that much harder to imagine and the day when the bureaucrats hang by their guts is that much further away.
Your dependence is the state’s oxygen, which is why encryption and private currency are its death knell. And why the next emotion-fueled war will be against ‘cyber-terrorists.’ We’re already seeing the first Hollywood agitprop films working in this direction at the same time as we’re seeing the de-computerisation of computing.viii
For while the rise of the nuclear family has made many people more independent, it has also left them more lonely and insecure as well — and left many people feeling guilty for ignoring their parents too.
What rise of the nuclear family ? Seriously, how many western families have dinner together every night ? Divorces, TV shows, iPads, hockey games, and a million other distractions have fractured the nuclear family like an old woman’s hip after a ski accident.
Besides, people only feel guilty for ignoring their parents because a) their parents craftily maneuvered their way into the friend zone where they don’t belong, b) they live too close to their parents, and c) their parents are annoying nags. This are all resolvable. This guilt is a choice.
Paternalism is a good thing to shun and patient empowerment is a good thing to encourage. But even good things have side effects, and one side effect here is that physicians would rather intervene than risk being accused of undertreatment or paternalism.
This “bad things are good things even though they have ill effects” argument reminds me of ‘technology improvements’ that make roads more prone to potholes.ix Makes you wonder how much more progress we can take !
The “can do” spirit of Americans, that admirable and infectious optimism and hope, means they throw the kitchen sink to extend life. Hope drives medical care: it is a state of mind and can’t be switched off by pressing a button.
You call it “hope,” I call it “a complete divorce from reality.” But hey, to-may-to, to-mah-to.
Physicians can make aging and dying less medical. Doctors are known to die differently, tending to use less medical care. What’s good for the gander is not good for the goose. Why don’t doctors prescribe thrift to others?
This raises an interesting point. Even when doctors, and other professionals, are trained to do “what’s best for the patient-client,” said patient-client can still make their own decision. Personally, when faced with a dilemma, or any kind of choice where a professional is guiding me one way or another, I ask them what they’d do. This is the “skin in the game” test. The rest is just textbooks.
This paranoia over nullifying the sanctity of an unproductive life reaches even the courts, as in the famous case of Terri Schiavo, who was enterally fed in a persistent vegetative state for years despite her husband’s objections. Even President Bush thought it important for her to be fed.
President Bush also thought it important to hang Saddam Hussein. He’s hardly the arbiter of taste, y’know ? Though he’s definitely not the only one too timid to smite the weak, even if just off the books; it’s definitely a western cultural thing. Strange, particularly for the coercive redistribution involved, isn’t it ?
Dying is a vexing problem for the medical profession. The “can do” blends with the “won’t give up,” which is difficult to give up. As long as we give health an infinite value we will demonize death. In the age of plenty it is not easy to lighten up about life. But to live a little we must risk dying a little. If we die to live, we will live solely to not die. Which would be an overmedicalized life, and a dull one.
That’s it, really. The ‘age of plenty,’ like the disease industry propping it up, is little more than a state-centred, death-defying, money-burning scam. So of course we should all lighten the fuck up !
It’s not like laughter isn’t the best medicine anyways. And affordable too!
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- Yes, it’s a fucking industry !
EvenEspecially if you live in one of those hyper-socialistoid democracies with “free health care,” as I do, there’s nothing free about it. It’s a business. Just like everything else in government is a business. It’s also a very profitable one and one therefore subject to unfathomable levels of regulatory capture.
Oh, you want to hire a midwife or a surgeon ? Too bad. The govatron owns those professions. It’s no wonder more and more people are taking up ‘medical tourism,’ this socialist shit doesn’t work for real people no matter how many bezzle bucks get thrown at it.↩
- Go ahead and add up income taxes, alcohol taxes, property taxes, gas taxes, automated traffic tickets, health care premiums, education taxes, recycling fees, disposal fees, and sales taxes, not to mention INFLATION, and then tell me that’s not 60% of everything you earn. Right, that’s what I thought.↩
- The other ~half, depending again on your jurisdiction, is spent on everything from birthing to knee replacement to emergency room care to cancer treatment to heart surgery and on and on and on.
The variety of ailments available to man is no match for the variety of ready-made and branded ‘solutions’ that the over-diagnosing, over-medicating industry has at its disposal. Oh, you thought halitosis was a real medical condition ? No, you knew that was just a marketing ploy, didn’t you. Then what exactly do you suppose ‘ADHD’ and ‘bi-polar disorder’ are ?↩
- You can keep your longer life, I’ll take the path of dignity :
Life has far more to do with quality than quantity. It has more to do with those conversations relished, books devoured, wine drunk, food feasted upon, lands explored, respect earned, power seized, and the people to share it all with.
That’s a life well lived.
- It’s not the doctors, it’s the patients who’re in the driver’s seat :
The reality of the matter (as pointed out by “me”) is that… well… the doctors have absolutely no rights. None whatsoever. All the rights belong to the patient, and they are unlimited. Does the patient have or have not the right to present himself with a subdural hematoma ? Metatarsal fracture ? It doesn’t matter, right ? The patient may present himself with anything in the book. If he so damned well pleases he can even present himself with something not in the book at all! Or maybe sort-of in the book, kinda ?
The patient has the sovereign and undisputed right to invent new diseases, and if he does the doctors will crowd around him in awed admiration, like so many teenage ditzes around the one guy that invents motorbikes every year in every highschool. The patient has the right to take his medication, all of it, some of it, none of it, when told to do so or at any other time. There’s some effort to limit how much he takes to whatever the doctor says, but this is done from a prone position : the doctor’s on his knees begging, essentially, and the patient does as he well damned pleases. And it’s his right.
Meanwhile, the doctors have obligations, and – importantly – these are not transactional but factual. They have an obligation to treat, general and universal, from which they can’t be discharged by any authority, except retrospectively.
- Also, will someone please get this man his own blog ? I bugged him about this maybe 6 months ago, back when I was still on Twitter, and he said told me he’d have one by New Years 2015. Well Jha, it’s the end of March already and you’re still using other peoples’ platforms. Let’s get with the program !↩
- Fun fact : In the face of larger smartphones, laptops, to say nothing of desktops, are dying a slow death in the 18-35 year-old demographic in these parts. Hey, more for me !↩
Past cost-cutting on road repair was one issue. Climate change with its increase in the damaging freeze-thaw cycles is another, said construction services engineer Hugh Donovan. Now, transportation officials realize a change in the asphalt mix 20 years ago is also to blame.
For decades, contractors in Edmonton added fly ash, the dust from coal-fired power plants, to the asphalt mix to get the right consistency. They didn’t realize it was also providing protection against water damage.
In 1992, technology improvements let contractors leave the fly ash out. But now when water soaks into the asphalt and freezes, it destroys the oil-based bond between the black bonding agent and the gravel aggregate, weakening the road and increasing the risk of potholes.
Researchers only discovered the protective role fly ash had been playing in 2009.