Friday, June 26, 2009

File Under Topical - In the News Today

Michael Jackson died this morning. 

I was never a fan of his music--either of the tradition from which it sprang (Motown), or his particular use of it, a high-powered kinky jive routine which didn't leave much room for expressive definition. I found his voice flat and lacking in articulation. 

The personality he came to project--filled with self-loathing, a frenetic dervish emulating a child-like immaturity which became increasingly strained as he aged--left me cold. Why did people like him? As a projection of adolescent fantasy, he seemed a peculiar and odd amalgam of the teen idol: A lonely, lost soul who'd skipped growing up, and then began to mourn the loss of his own innocence. A Black man who wanted to be a white puppet, who attempted to create his own literal version of Never-Never Land, whose fixation upon little boys betrayed deep-seated psychological issues. 

His performances--of which I saw perhaps three, all on television--basically dance-numbers with voices dubbed in--showed his real talent as a dancer, though the moves and the themes of these--frankly masturbatory--seemed deliberately tasteless. If Jackson wanted to appeal to children, in the end, how was massaging his penis in those dance-numbers supposed to accomplish that?   

If Michael Jackson was the symbolic projection of our popular cultural ideal, what does this tell us about our collective unconscious?      



The growth of the medical industry over the last two centuries is one of the most dramatic phenomena of the modern world. The rapid increase in "universal treatment" in civilized societies has been facilitated by increasing mechanization of treatment, the advance of chemical applications and vaccines, and our understanding of physiology, body chemistry, and behavior.

This expansion of knowledge and treatment options has brought about the steady increases in costs of treatment, rapidly overtaking the ability of individuals, or the population at large, to pay for it. To be blunt: We can't afford to treat everyone for all the ills they suffer. 

For a long time, we've been pretending that there is no limit on treatment, that if we could only come up with the right "formula", the right combination of public and private "coverage", everyone could count on being taken care of, no matter how serious their conditions, no matter how rich or poor they were. This is a dangerous fallacy.  

There is not enough resource in even the richest societies, to provide equivalently efficient and effective medical care for everyone. The so-called "difficult choices" which we will make going forward are likely to make this graphically clear. The days of affordable group coverage are over. The days of providing state-of-the-art treatment for the poor are over. As the U.S. moves towards socialized medicine, the tiers of the medical treatment hierarchy will become more controversial, and clear-cut. 

Modern medicine is a miracle of science, but it's too expensive. We can't afford to offer it to everyone. There's not enough treasure in all the world to pay for it.

15 comments:

Iain said...

You do know that there are poorer countries that provide better and more efficient health care to everyone right? Given the technology we have access to, we actually provide pretty bad care. Compare this to countries that have lower infant mortality rates and can't even get a hold of aspirin.

Curtis Faville said...

It is possible to provide sub-standard care for everyone--that has been demonstrated across the globe. People in countries like India or South America can get out-patient clinic service manned by nurse practitioners etc. That's all very well.

But modern medicine as practiced in highly developed countries employs a lot of expensive testing equipment, and highly specialized technicians. These form the basis of most of the sophisticated (and very expensive) treatments available for serious diseases and injuries. Most hospitals aspire to provide care at this high level. But without a firm client/group insured base, most hospitals get stuck not being reimbursed for a lot of the care they provide.

The fact is, most people could never afford to pay for what these medical groups offer. For a long time, our society has been coasting along on subsidized medicine, shored up with employer and government plans, while costs have been shooting up like Roman candles. But the system is falling apart. Americans don't want to settle for the ambulatory nurse-practitioner system (as in China), but eventually that's what's going to happen. Eventually only the rich are going to be able to participate in good treatment plans. There isn't enough money in the world to pay for all the fancy treatment people think they deserve. Once upon a time, people didn't get all that expensive treatment. My guess is that we'll regress to that situation again in this century.

Ed Baker said...

when was the last time your head went up in flames when you were breaking down racial barriers?

my mother now in hospice... takin same medications that MJ took...

they cause loss of appetite (you starve to death) and heart events...

you are ignorant of what is about Michael Jackson!


you still want my Views of Jeopardyn (Jack Gilbert) send a check for $2200 when it clears I will send you the book!

Curtis Faville said...

"when was the last time your head went up in flames when you were breaking down racial barriers?"

Ed, I don't follow this?

"you are ignorant of what is about Michael Jackson!"

I dare you to try to convince me how great he was. Maybe this involves your first statement about racial barriers???

Ed Baker said...

he was making a pepsi commercial when his head caught fire... some explosion due to the pyrotechnics used for/in the commercial..


his health mental and physical went down-hill from there.

don't take it personally, Curtis: via your blog you're "out there" in the public!

Iain said...

where do you get your information regarding health care? I mean, I do a lot of reading about world health care systems and worked as a paramedic for a short time, but still don't consider myself qualified enough to publish something that goes against what most experts would say without citing a single source.

saw this in the Denver Post, thought of you

Curtis Faville said...

I worked for a government agency for decades and dealt with coverage and claim matters. I've also read extensively about social insurance systems (America and Europe, and Canada).

The statistics regarding the rising costs of sophisticated health delivery systems are not encouraging. I've heard dozens and dozens of accounts from disappointed customers in the UK and Canada regarding their national health plans--they don't like them!

Our whole system is geared towards profits. The doctors, the private insurance corporations, the high tech testing and treatment systems manufacturers--they're all gouging and skimming like mad. We've all had experiences of non- or substandard care, with huge price-tags.

If we subtract the profit motive from quality care, can we replace it with an altruistic and responsible system which puts the patient front and center? That remains to be seen.

I doubt that efficient quality care can be delivered to a majority of the world's population. Can you point to a national system that works and has a clear road ahead?

Ed Baker said...

well...

lawyers and accounts
and
maybe The Pharmaceuticals

run Universal Health Care

duhhh! what doctor these daze says says...

"you wouldn't have a knee problem if you didn't weigh 235 pounds"

my drug-free 94 year old mother now in a hospice situation first thing done? give her pain medications that cause starvation and heart events... same stuff that killed MJ

so hospice care just a stretched out "assited suicide" program and 100 % paid for by Medicare.

nurse said it should take about 2 months or less... but, she will die "PAIN FREE"

this is not some abstract National Universal this country or that country morality health care crap.. this is specific!

this political/moral/religious/ economic stuff is a crock of shit!

so

let us now pay all attention to the poisons in our air and food supply...

let us deep fry everything to kill them viruses
and get more "healthy" via Big Mac

Kirby Olson said...

I saw the Gay Pride parade yesterday in New York. A lot of it was about wanting better medical coverage. The other part was about wiggling bodies around in wild solicitations.

I thought it was odd. They want other people to pay for the diseases.

Meanwhile, Lyme's Disease is apparently huge. Almost 2% of Americans now have it. It's incurable and requires constant drug use, and is expensive as heck.

The CDC can't afford all the diseases we've got. They focus on whichever focus group screams loudest, which right now is the adults with sex diseases.

The Lyme's people get nothing for research.

And doctors increasingly don't want to diagnose it. There's a documentary out aboiut it called Under My Skin.

Doctors are pretending that Lyme's doesn't exist.

I don't know if government health care is a bad idea or not. In Finland I had a kidney stone and they gave me an aspirin and told me to tough it out. In America, I received an expensive surgery that got the thing out, and cost roughly 18 thousand dollars.

In Finland you can't sue the government.

Here, you can, which sends allt he costs up.

The expensive surgery here didn't cost me a dime.

In Finland, it didn't cost me a dime either.

Except I cracked a tooth from the incredible pain I felt that week in finland, and grinding my teeth waiting for the thing to pass.

Curtis Faville said...

Kirb:

I had a kidney stone too. They gave me some morphine, then took x-rays to verify it was that, then sent me home. "Drink lots of water and jump up and down."

Right.

They say it's the worst pain a man can feel--sort of the equivalent to having a baby. I can believe it.

My two hour visit cost us and the insurance company, I think, about $6000. Utter nonsense!

I passed the stone the next day. Nasty thing, looked like reddish-black volcanic glass--no wonder the 5ucker hurt so much!

Kirby Olson said...

Yes, they look like WWI mines with spikes. I had mine for two or three months. It didn't pass in Finland.

I had to wait until I got back here. I was in Oregon, teaching at Portland Community College, and I hadn't yet worked the requisite 30 days until my insurance kicked in.

So this thing was killing me. The woman in the ambulance told me she had had four babies and three stones. I said which hurt more. She said the stones are about ten times worse.

Mine was stuck at the end of my ureter. They said we can't treat you, you have no insurance. But I was in Oregon, which has the right to die. I said, just kill me.

I meant it.

Instead, they gave me morphine, and ultimately put in something called a stent.

I pled poverty, and said I had preferred death. So the state ate it.

I think a lot of people without insurance end up getting their medical costs eaten by the state. Because hospitals by law have to treat the indigent. They try to turn you away, but by law they actually can't do that.

I don't know which way is ultimately more expensive. No one really talks about anything specific. Our politicians are too stupid to really think.

They just launch a bit of rhetoric now and then between visits to hookers or airport bathroom stalls, where they get on with their real interests.

Iain said...

Kirby brings up an excellent reason why we can afford to give everyone health care. Namely, that we already do pay everyone's health care one way or the other.

The vast majority of people in ambulances and ERs do not have insurance. Also, most of these people go to the ER for minor injuries and ailments because they cannot be turned away by law. Since they can't pay, the state ends up "eating the cost".

If we paid for preventative care for everyone, the state would be shelling out fractions of what it does now. It's not as if people without health care just die quietly at home at no expense to the state. Minor, cheaply treated ailments quickly become major expensive ones which will end up being paid for by the state one way or the other.

Kirby Olson said...

I wonder if the truly indigent know their rights with regard to the fact that hospitals must take them. This hospital attempted to turn me away, but I insisted on treatment and got it, and knew how to work the system so that I didn't have to pay.

I'm not sure this is always the case, or what happens.

Certainly I wouldn't have gotten a room. They treated me and released me. Later, when I had insurance, and the same thing happened, I got a room, and far better treatment.

The nurses were actually nice to me.

when I didn't have insurance I was treated as a menace to their system. Which I suppose I was.

I was also given the minimum care, which was still outrageously expensive to the system.

If we got universal health, kicked out the illegal immigrants, AND made some cap on malpractice lawsuits, medical care would still be outrageous, but it might be that the country could actually afford it.

Obama won't talk about the immigrant situation. He needs the Hispanic vote as part of his coalition.

He won't deal with malpractice lawsuits. There's no clear voting pattenr there and he doesn't want to risk anything when he doesn't have to, and he has no strong leadership ideas. He does want universal health care because he wants those votes.

Plus he wants the government to own as much of the private sector as possible so that he can control it better.

He wants a total nanny state, with only one party ever in office.

But he also wants it manageable, or else he will lose votes.

Conrad DiDiodato said...

Curtis,

just thought I'd let you know that they lowered our flag at half-mast on Capitol Hill, in Ottawa, at Canada Day celebrations, for Michael Jackson!

But the body-bag count from Afghanistan grows almost weekly for our Canadian forces.

Nuff said!

Curtis Faville said...

Not sure what the significance of these two events is, but death is never anyone's cup of tea.

To criticize the general taste is not to wish upon the object of their attachment any ill. Michael Jackson seemed like a very unhappy man; all his wealth and talent couldn't compensate. His death is undoubtedly a tragedy, but a tragedy of smaller dimension to me than to his many fans.