Student mental illness (Part 2)

Posted by on

Statistic of the week:  75%  of diagnosable mental illnesses crop up by the age of 24, driven by fear of failure and the eternal chatter about how essential it is to get a job straight out of college.

American psychologists are increasingly seeing children with ADD  and some kind of executive functioning problem among college students who haven’t learned to manage their time or structure their days, because their parents have always organized everything for them.  

American parents are often so focused on their children’s cognitive development – in part , because that’s what colleges reward – that they neglect to encourage self-management.  They are let off chores, even making beds or learning how to operate a washing machine. They need responsibility- building tasks so that they can be self-reliant.  If they are mothered to death, when they get to college they cannot cope.

There has been a cultural shift, starting with the Columbine massacre, the twin towers and the 2007 financial crash, from parental encouragement of autonomy in childhood to parental control. Parents are now super-anxious, and this communicates itself to children.  They, the parents think every little mistake is something to be fixed, rather than a learning experience which helps the child grow into an adult.  If the parents catch every fall then the child ends up afraid to fall.

There is the huge pressure to get A grades (of course, once in college everyone gets A grades! – equally ridiculous( Ed.). The message is that the child will not have a good, productive life unless they go to the best colleges for four years and do stellar work.  But there is no single perfect way of preparing for life, and the sub-text is the importance of earning power.  

Then there is the pressure kids feel as they try to make new friends at college in an atmosphere where social media is pervasive and virtual friends are not the same as real, flesh and blood friends.  It has also become more difficult to make these real friends because kids are sitting, isolated, with earphones on, staring at a computer. (These comments were extracted from a Bryn Mawr College newsletter).

Parents need to understand that their job is to prepare their children for the world of personal responsibility, starting with doing chores around the house and submitting to discipline (starting with time limits on-line).  Secondly, going to college at 17 or 18 might be satisfactory for girls ( who grow up quicker than boys), but at that age the boys, in particular, are generally still children, and need help taking responsibility for their lives and their actions.  They will get more out of college by having a gap year before college, when they either travel (yes, to Thailand possibly) or get jobs for a year where they learn some self- discipline and experience adulthood.

I believe that this whole thing is enabled by the corporations , whose interest is in hustling kids through puberty and college so that they can bolster the ( cheap) workforce.  We should be resisting.  We are, all of us, only young once.

 

Student mental illness ( Part 1)

Posted by on

A surge in anxiety, mental breakdowns, depression and stress is sweeping British university campuses. Above all, a growing proportion just seem terrified of failure, and experience the whole process of learning and assessment as an unforgiving ordeal that offers no room for creativity or mistakes,” says William Davies, lecturer at Goldsmiths and author of The Happiness Industry, a book about the commercialisation of wellbeing. One study found that six times more young people in England (aged four to 24) have psychological problems today than a generation ago, in 1995.  (The Guardian 27/09)

This is obviously a difficult and fraught subject that touches on a host of issues, including parenting, social media, the perceived job market and other factors.

My personal take will be ferociously unpopular, but it has an Epicurean aspect.  I was one of the last people to do British National Service, in the Army. I was 18 when I joined up and nearly 21 when I went up to university.  It was the first time I had encountered unforgiving discipline and encountered at close quarters young men of very different backgrounds who had been working for two or three years, were street- smart and, compared with me, were grown-up young adults.  Great guys!

I ended up commanding , as a second lieutenant, 45 men under active service in a shooting/ bombing/damn dangerous environment, making life and death decisions sometimes.  In short, postponing university grew me up rather quickly, taught me respect and consideration for people of all backgrounds, how to manage men and inspire (hopefully) respect in them, to darn socks and sew on buttons (literal and figurative).

You can spot where I am going with this.  Cosseted youngsters are leaving home, often for the first time, far too young, having had little experience of standing on their own feet and making their own decisions.  Most are not even taking a year off to travel the world ( called a “gap year” in the UK), even if all that means is sitting on a beach in Thailand and drinking too much beer.  If nothing else, this gets kids away from home, taking responsibility for themselves, without messing up their future careers.

Tomorrow, I will report and comment on the views on this subject of two Americans who have studied the epidemic that has hit college students: psychologist B. Janet Hibbs  and Dr. Anthony Rostain.

Proof of residence for EU citizens in the UK

Posted by on

To The Guardian

I have just read Brandon Lewis’s article (“The Home Office’s message to EU citizens living here: we want you to stay”) in respect of the need for us EU citizens living in the UK to apply for settled status, mainly to prove to the authorities that we have lived permanently in the UK for more than five years and are permitted to stay after Brexit.

I would dearly like to know what proof the authorities need from me, as someone who has lived in the UK since 1964, married a British citizen in 1968, and produced two quite intelligent and useful British citizens who in turn are contributing to society and are taxpayers?

The Home Office should really know me by now. I have a national insurance number, an NHS number and a British driving licence. I have a tax reference number because, believe me, I pay large sums to HMRC. I draw a UK state pension.

The information that I am still a German citizen (in my head, always an EU citizen) can be found in the electoral roll. Why, after all this, do I need to comply with a requirement to prove that I have existed in this country not merely for five, but for more than 55 years? Does this speak of incompetence by the Home Office, or rather a desire to belittle and humiliate EU citizens? That is certainly what it feels like.

Marlies Branston, Bedford. Sep 2019

Mr. Branston is one of thousands who, hopefully, will remain in the UK after Brexit, contributing to the country.  Unfortunately, what the uninformed and emotional supporters of Brexit expect is that most “foreigners” will be despatched “ home”.  Not only would this be cruel and crude but self-defeating.  Britain heavily relies on smart, clever and hardworking people of foreign origin to do everything from scientific research, to fixing holes in roofs, to planning a better transport system for London.  The Tory party have done such a lousy job with both education and health that there are insufficient trained people to do almost everything technical,  from nursing to plumbing.  One of the huge benefits of EU membership was the ability to attract ability.  When and if the obscurantists (who want the country to be a mean little offshore home of the semi-ignorant) have their way there will be no one to repair the electrics in their houses or to teach mathematics.  Just don’t later start bleating about it to the rest of us!

My declared intention to avoid politics never meant that I would stop protesting crass stupidity.

Dealing with people

Posted by on

“People like it when you tell them things, in suitable portions, in a modest, intimate tone, and they think they know you, but they do not, they know about you, for what they are let in on are facts, not feelings, not what your opinion is about anything at all, not how what has happened to you and how all the decisions you have made have turned you into who you are.  What they do is they fill in with their own feelings  and opinions and assumptions, and they compose a new life which has precious little to do with yours, and that lets you off the hook.  No one can touch you unless you yourself want them to.  You only have to be polite and smile and keep paranoid thoughts bay, because they will talk about you no matter how much you squirm, it is inevitable, and you would do the same thing yourself.”

From “Out Stealing Horses”, by Per Petterson, published in 2003, in the US by Graywolf Press.  The book was originally in Norwegian. The book is about the thought and random life events of a man living in the Norwegian forest.

A somewhat long, but hopefully useful, philosophy crib list

Posted by on

Pre-Socratics (6th-5th cent BC)  Interested in the natural world

          –Thales: 1st philosopher; “everything comes from water”

            –Anaximander:  “Our world is one of many and what comes before and after all created things is boundless.” 

            –Parmenides:  “Everything that exists has always existed and nothing changes.”  He was the first rationalist.

            –Heraclitus:  “The basic characteristic of nature is constant change, or flow.  The world is characterized by opposites.  He is the first empiricist.  He says God is logosor “universal reason”.

            –Empedocles:  “All things are made of air, water, earth and fire–which don’t change but are recombined.  He distinguishes between substance (the 4 elements) and force (love and strife).

            -Anaxagoras:  “Nature is built up of an infinite number of minute particles invisible to the eye, e.g. skin and bone are made of minute skin and bone seeds”.

            –Democritus:  The building blocks of nature are different eternal and immutable atoms.  He was the first materialist.  Things happen due to natural causes, not due to an external force or soul.

            –Hippocrates:  Founder of Greek medicine, influenced later philosophers..  “The road to health is through moderation, harmony, and sound mind and sound body..

 Athenians:  Interested in man and his place in society

            Sophists (e.g. Protagoras):  Taught for money and pretended to know a lot.  “Man is the measure of all things.”  About the gods, “The question is complex and life is short.”  (He was the first agnostic.)  He distinguished between what is natural and what is socially induced.  He believed there were no absolute norms for right and wrong.

            Socrates:  A rationalist,he believed in the art of discourse.  He believed in absolute and universally valid norms and that right insight leads to right action and happiness.

            –Plato:  Established an Academy and wrote down much of Socrates and his own thoughts.  Was a rationalistbut also a dualist, since “everything in the material world flows but the soul is immortal.”  Myth of the cave:  what we see is just a reflection of the true eternal set of ideas.  He distinguishes between the natural world and the world of ideas which only a few men and women see.  These are the philosophers, who should govern the state.  Like the Hindu caste system, everything has its place.

            –Aristotle:  Spent 20 years at Plato’s Academy.  Believed in using our senses as well as our reason, and unlike Plato, that the chicken comes before the idea of the chicken.  Distinguishes between “substance”, or what things are made of, and “form”, their particular characteristics and what they do.  When a chicken dies, only the substance remains. Form governs a thing’s potential and limitation.  He classified everything in to animal, vegetable, and mineral.  He distinguished 4 different causes, including the “first” or “final” cause, which was God.  Ethics:  There are 3 forms of happiness: pleasure; as a free, responsible citizen; and as a thinker/philosopher.  He believed in balance and moderation in all things, echoing the Golden Mean and Greek medicine.  He believed women are incomplete, and all of a child’s characteristics come from the sperm.

            –Stoics:  Believed in a universal natural law, like Socrates.  Believed in one nature (monism), and the importance of politics.  Believed in enduring pain and accepting destiny.

            –Epicurus:  He believed in creating one’s own “garden” and avoiding politics.

His basic guide to living:

1) Don’t fear God.

2) Don’t worry about death.

3) Don’t fear pain.

4) Live simply.

5) Pursue pleasure wisely.

6) Make friends and be a good friend.

7) Be honest in your business and private life.

8) Avoid fame and political ambition.

I would add: think of others; be polite and considerate; try to see the other point of view; meet others half way, if possible. Take the smooth and pleasant road, as free from stress and conflict as possible. But don’t be put upon!

            –Mysticism:  Western mysticism involves communication with a personal god; eastern mysticism involves merging with the cosmos.

            –Neo-platonism:  Plotinusbelieved that the world is a span between 2 poles: the devine light (the “one”) and absolute darkness

Middle Ages  Were interested in God and mind and body relationships

            -St. Augustine:  4th/5th cent.  Saw no conflict between Christianity and the philosopy of Plato.  Believed God created the world, which was in his mind as a devine idea.  Within each person is a struggle between Kingdom of the World and the Kingdom of God (or City of God) and the way to God is thru faith.

            –St. Thomas Acquinas:  13th cent.  Like Aristotle, believed that God was the first cause, or prime mover.  There are two paths to God, one through reason, one through faith.

The Enlightenment  Were interested in rationality, etc.

            -Descartes:  A rationalist, like Plato, believes the proof of God is that humans have an idea of a “supreme being”.

            Spinoza:  A materialist, like Democritus, believes that everything happens through natural causes and questions man’s freedom.

            Locke:  17th cent. empiricist–believed everything we know comes from our senses and distinguishes between primary and secondary qualities.  But also a rationalistwho believed in the idea of a natural right and the ability of man to “know” God exists.  A forerunner of liberal ideas including equality of sexes (influenced Mill) and division of powers of state.

            Hume:  18th cent.  qualified empiricistand agnostic, distinguished between impressions (immediate sensations) and ideas (reflection on experience), which can be simple or complex (like our idea of Heaven).  He said complex ideas are not trustworthy.  The sense of self is just a collection of “simple” impressions; we don’t really have an unalterable ego, or immortal soul.  Buddha said the same thing 2,500 years ago.  What we see as “laws of nature” are only things we are in the habit of seeing.  They don’t prove anything.  He thinks right and wrong are based on sentiment, not reason.  Distinguishes between descriptive and normative statements.

            Berkeley:  18th cent. Irish bishop.  Did not believe in the reality of the material world.  The cause of our perceptions is spiritual, the effect of God’s power.

            Enlightenment philosophers (Montesquieu, Voltaire, Rousseau):   Were interested in the following ideas (which moved from England (early 18th cent) to France (mid-18th cent) to Germany (late 18th cent.):

            -Opposition to authority (Locke)

            -Rationalism (Montesquieu, Voltaire)

            -the Enlightenment movement (writing of the 1st encyclopedia)

            -Cultural optimism

            -the Return to Nature (Rousseau)

            -Natural religion (Deism:  God is the prime mover but has not revealed himself since except thru nature and natural laws)

            -Human rights (Locke, later Mill)

            –Kant:  18th cent.  Said time and space are our 2 forms of intuition and things adapt themselves to this perception, distorting reality.  Believes we use both senses and reason to know.  The law of causality is in our minds: he distinguishes between “the thing for me” or the formof knowledge and “the thing in itself”, or the materialof knowledge.  The Existence of God, the Immortality of the Sourl, and Free Will are practical postulates; they can be known only by faith, not reason (he’s a Protestant).  The ability to tell right from wrong is part of our practical reason.  He tried to reconcile the rationalists and empiricists.

            –Hegel;  He united and developed many of the ideas developed by the Romantic movement but confined the definition of “world spirit” or “world reason”  to humans.  He said that all knowledge is human knowledge and truth is subjective.  He believed there are no eternal truths; knowledge evolves over time.  The history of thought follows a dialectic process; thesis, antithesis, and symthesis.  The synthesis then becomes the point of departure for the next thesis.  In contrast to the romantic thesis of individualism (subjective spirit) , Hegel emphasized the importance of the family, civil society and the state (objective spririt).  Beyond this, there is the “absolute spirit” represented by art, religion, and philosophy.

            –Kierkegard:  A Dane, who reacted against Hegel by emphasizing the individual’s responsibility for his own life.  e,g, deciding whether Christianity is true for you (not in general).  The 3 stages of life are:  aesthetic (enjoyment of life, may also lead to angst); ethical (characterized by seriousness and consistency of moral choices) and religious (characterized by the leap of faith that dominates both the search for pleasure and reasoned behaviour).  He became significant to existentialists as well as Christians.

            –Marx:  Known as an historical materialist (i.e. it is the material factors in society that have been decisive for historical development, not “world reason”), Marx also rejected Hegel’s idealism, or system. He believed that the purpose of philosophy was not to interpret the world but to change it.  His thinking therefore had a practical, political objective.  In particular, he claimed that it is the economic forces in society that create change, i.e. the basis of society creates the superstructure (political ideas and institutions, etc.)  The interaction between these two is known as dialectical materialism; the superstructure does not have any life of its own.

            –Nietsche:  Said “God is dead” and don’t listen to those who offer you supernatural expectations.  Believed the life force of the strongest should not be hampered by the weakest.

            –Existentialism:  Sartre said “existentialism is humanism”, and we must create our own essence because it is not fixed in advance.   Man feels alien in a world without meaning, hence feelings of the absurd, of despair, boredom.  Man’s freedom is a curse.

(I would like to thank Jostein Gaarder, the author of “Sophie’s World” (1991) for both the idea and for the foreshortened summing ups)

Thought for the day

Posted by on

Crises

Eruptions

Anxieties

Stressful encounters

Document losses

House keys mislaid

Dents in the bumper

Disappointments

Rain on your parade

Promised phone calls never happening

No less than five political fundraising calls in a day

Netflix buffering for twenty minutes

The local food store is out of milk, tea and cereal

The boiling coffee pot has fallen on the kitchen floor

The only place you are safe is under the bedclothes.

 

 

Alzheimer’s test is promising

Posted by on

 A blood test that can detect signs of Alzheimers as much as 20 years before its onset has been developed. Scientists at the Washington University School of Medicine in St Louis in Missouri believe it is 94% accurate while being much cheaper and simpler than a brain scan.

The test measures levels of amyloid beta protein, a key indicator of Alzheimer’s, and combines it with analysis of age and genetic risk factors. Researchers say clumps of the protein begin to form in the brain up to two decades before the onset of the characteristic memory loss. 

I have more than enough experience of memory loss, whether you technically call it Alzheimer’s, or the effect of early brain trauma owing to an accident.  Whatever the technical term used, it is a horrible disease, both for the sufferer and for the family of the sick person.  How does one maintain one’s calmness when, for instance, you are physically assaulted by your own mother (who has no idea what she was doing)?   How do you remain calm, understanding and patient when your companion gets lost going to the local store, or even forgets who you are?

I really think alzheimers ( memory loss, call it what you will) is one of the great challenges to those who follow and support the ideas of Epicurus.  In his day life expectancy was short compared with today.  The problem surely existed, but must have been fairly rare.  Now it is an epidemic, testing  the ataraxia of the most loving of us all.

On the other hand, do you really want to know that you are going to lose your memory twenty years from now?   I suggest: only if a cure is on the horizon!

Getting your priorities wrong

Posted by on

Some US state motor vehicle bureaus have found an unacceptable new way of raising revenue.  They are selling the information given to the government to get a driver’s license —  your birthdate to your address etc — to third parties, including bail bond companies and private investigators.

We have a better idea for states looking to enhance the public purse: raise taxes on the wealthy! Higher tax levies on the wealthy don’t require any invasions of privacy and have an extra added benefit. They reduce the inequality that’s poisoning our future.   (Chuck Collins, Institute for Policy Studies Inequality. org) 

The loss of personal privacy that has accompanied the wired society is dismaying.  When the internet, and everything that goes with it, were introduced we all thought them exciting modern developments, full of promise.  And they were and are.  But why is is that a minority of people look at every innovation as an invitation to either enrich themselves or to use them for twisted, nefarious purposes?   And why, when we desperately need to trust those who govern us, and for whom we vote, are we betrayed by people with no common sense?

My never-to-be Epicurean government would make personal privacy second only to doing something quick, decisive and effective about the climate crisis.

 

 

 

Evangelical support wanes among young people

Posted by on

From the  Washington Post

Much white evangelical support for President Trump is based on a bargain or transaction: political loyalty (and political cover for the president’s moral flaws) in return for protection from a hostile culture. Many evangelicals are fearful that courts and government regulators will increasingly treat their moral and religious convictions as varieties of bigotry. And that this will undermine the ability of religious institutions to maintain their identities and do their work. Such alarm is embedded within a larger anxiety about lost social standing that makes Trump’s promise of a return to “greatness” appealing.

Evangelical concerns may be exaggerated, but they are not imaginary. There are some political progressive who would grant institutional religious liberty only to churches, synagogues and mosques, not to religious schools, religious hospitals and religious charities. Such a cramped view of pluralism amounts to the establishment of secularism, which would undermine the long-standing cooperation of government and religious institutions in tasks such as treating addiction, placing children in adoptive homes, caring for the sick and educating the young.

But this is not, by any reasonable measure, the largest problem evangelicals face. It is, instead, the massive exit from evangelicalism among the young. About 26 percent of Americans 65 and older identify as white evangelical Protestants. Among those ages 18 to 29, the figure is 8 percent. Why this demographic abyss does not cause greater panic — panic concerning the existence of evangelicalism as a major force in the United States — is a mystery and a scandal. With their focus on repeal of the Johnson Amendment and the right to say “Merry Christmas,” some evangelical leaders are tidying up the kitchen while the house burns down around them.  (Michael Gerson, Washington Post, 2019).

I think the answer is, maybe, that young people, regardless of religious outlook, tend to be less racist than the older generation, more tolerant of diversity, deeply concerned about the climate crisis, and also very concerned about their futures in the workplace, the short-term contracts and lack of pay increases over so many years, and so on. This doesn’t make all of them want to vote for Democrats, or to vote at all,  but maybe they no longer share the attitude of their parents towards abortion, women’s rights, minority rights and the environment.   It is also true that religiosity is declining, in the towns and cities at any rate.  America cannot any longer be called a christian nation in any meaningful sense of the word; it started stopping being so a while ago, but its moral corruption gathers at a massive rate, unremarked by old evangelicals.

Lawlessness in Mexico

Posted by on

 From The Guardian

Last year Mexico registered 35,964 murders, an increase of three times the previous year. Only a tiny fraction of crimes committed are solved, and increasingly ordinary people are taking the law into their own hands, specifically, 174 times last year, lynching suspects wherever they can find them.  Citizens are frustrated by incompetent policing, a failing justice system, and increasing organised crime.  It’s called “institutional abandonment” when the citizens feel they cannot rely on the authorities.  How much the detection rate is influenced by corruption isn’t clear, but what is clear is the ordinary folk are totally fed up. (The Guardian, 30 Aug 2019)

Nearly 36,000 murders in a single year!  It sounds like outright civil war, and yet we hear little about it, and no reasons are suggested for the massacre of so many people. One assumes it is an extension of what it is happening to the ofher countries in Central America:  drug cartel violence,  and the effects of climate change and the desperation this is starting to cause. If these are the main reasons then we have to look ahead to more bad news, year by year, and building walls is not going to insulate the US from the influx of desperate people – that’s just a cruel political gimmick.

Time to say farewell to steak and chips (fries)

Posted by on

Soon, most of us will stop eating beef,  and it won’t be because we’ll all agree with vegans that meat is murder. It’ll be due to the logic of advanced capitalism. The alternatives to meat now being developed – plant-based substitutes and vat-grown meat produced from cultured animal cells – will taste the same as beef but, unlike cow meat, they’ll be subject to the “transformative power of the modern production line”.

It’s not just a matter of the sheer volume of goods produced; it’s the speed of manufacture from raw material to finished article, and the ability to vary supply with fluctuating demand, to dispense with low-value by-products like offal and excrement, and to develop variations in flavour. “Factory farming”, despite its name, has no such advantages. As for those who think a global industry that rears billions of animals can’t vanish overnight, I give you one word: “horses”. In the early 20th century, our cities and country lanes teemed with them. Then along came the internal combustion engine, and they were gone. As the horse went, so shall the cow. (Peter Franklin, The Week, 7 September 2019)

I must declare my position on this – I haven’t eaten beef for…..I’ve forgotten.  This was because it didn’t agree with me, not for environmental reasons.  But now, as the public view on the global climate is changing, and, as everyone must know by now, cattle rearing puts mega-tonnes of methane into the atmosphere worldwide. It is also rather a poor use of land.  It would be better, and more Epicurean, to plant (or restore) forests and slowly phase out beef production.  So, if plant-based substitutes, are edible and nutritious, and can be marketed cleverly, what objection can there be?  Just a simple request – you try them first and report back!

Is Oxbridge entrenching privilege? Or is inverse snobbery as big a problem?

Posted by on

From The Times, London

“How can we improve Britain’s “stagnant” levels of social mobility? Labour activists would like to abolish private schools, and that would surely help. But a better way to disrupt “elite self-perpetuation” would be to target Oxford and Cambridge. If we stopped those bastions of “inherited prestige and wealth” from teaching undergraduates, they would no longer be seen as incubators of the next ruling class. Canada, Australia and Sweden all have private schools, yet also have above-average social mobility. That’s partly because they don’t have highly prestigious universities that confer “a life-changing advantage” on the lucky few; just lots of good universities where students can get a decent education before proving themselves in the job market. Binning undergraduates might benefit Oxford and Cambridge, too, as they currently lose money on these students. The universities could concentrate on research and teaching postgrads, and expand their summer schools for disadvantaged students. It would retain what’s best about Oxbridge, but reduce the status-symbol aspect of these institutions that so distorts British life”.  (Simon Kuper, Financial Times, 10 August 2019)

I must declare a sinister fact – I am a product of this much-attacked educational duo.  I happen to have graduated with a a respectable degree, and wanted to get a marketing job with a manufacturer of consumer products, starting as a trainee, obviously, at the bottom.  Dozens of fruitless job applications later I at last got an interview.  “You are over-qualified”, I was told.  I thought I had no qualifications whatsoever, except a desire to learn, a frantic work ethic, and two years in the army.

Commentators such as Mr. Kuper don’t attend to inverse snobbery.  Maybe the interviewer thought I would be trying to run his international business by the end of the first year.  The reality is that you are almost forced into the professions, government or similar by what looked like prejudice.  The author talks about “proving yourself in the job market”.  Tell me about it!

I am all in favour of democratising intake at Oxbridge (from being all male, my old college is now 60% female), but we have to deal with the prejudice of hirers who employ people exactly like themselves.  The dire British class system was alive and well in my young day, and class resentment is hard to deal with for a young fellow with democratic leanings but the wrong education for a commercial job.  The other side of the coin!

Don’t find yourself in an American emergency health facility!

Posted by on

Two days before his wedding this past April, a man called Cameron Fischer got very drunk at his bachelor party, felt very ill, and had to go to an emergency room. His medical bill that was initially $12,460, all told, just to be re-hydrated .That was more than twice the cost of his wedding.

There are few constraints on how emergency rooms set prices. Hospitals have jacked up rates and are coding patient visits as more complex than they used to be, which increases the payments they receive from insurance plans. The result: ER services have some of the fastest-growing prices in the health care system.

Many health economists think free-standing ER facilities, like the one Fischer visited — which are banned in many states but thriving in Colorado — are particularly culpable. While such ERs maintain that they can’t survive on rates paid by Medicare and Medicaid, data suggest they are profit-seeking engines built primarily in high-income ZIP codes.  Why?  Because they can get away with it.

In Fischer’s case he was given an IV, two bags of saline and a dose of Zofran, an anti-nausea medication.  Then she drew blood (why he didn’t know, but it cost $500 for a complete blood count; $20 in a doctor’s office). He left only 45 minutes later.  Later he received the bill, including  a $7,644 “facility fee”, an expense that hospital systems charge to cover their overhead costs of keeping an ER open 24 hours a day and ready for any emergency. There are no limitations on the facility fees that they can charge, and the charges nearly doubled from 2009 to 2016, outpacing overall health spending four times over. In Colorado, the average facility fee charged for a Level 4 visit grew from $1,064 to $2,336.  Insurance companies apparently paid out an average of $1,754 for a Level 4 facility fee in 2018.

The fact is that Emergency rooms tend to lose money on critically ill patients, as well as on Medicare, Medicaid and uninsured patients, and try to make up the difference with less sick, privately insured patients, like Fischer.

For Fischer, the negotiated rates under his health plan knocked the $12,460 bill down to $4,694. The plan paid $2,102. That left Fischer with a bill of $2,593, an amount he says he cannot afford to pay. “That’s quite the expensive bachelor party,” Fischer is quoted as saying.

(An edited version of an article from Kaiser Health News, a non-profit with no links to Kaiser Permanente.  22 Sept 2019)

My comment:  A few years ago, concerned that my (American) GP would stay in business-as-usual, I asked him ‘if he was making enough money out of my wife and I myself as patients (Epicurean question). If not, let us talk about it.’ Slightly surprised, he told me he didn’t go into the medical profession to get rich – he did it to help sick people and make them better.  Phew!

This is the sort of person needed in medicine. The healthcare companies are run by single-minded capitalists, totally profit-oriented, particularly the pharmaceutical companies.  The whole “industry” (as it has become) needs a big re-think: what is it there for?  In theory, a single payer system (e.g like the NHS) would greatly improve outcomes, but it has little chance of happening – too much money is at stake, and the politicians are just fine with that, thank you.

An essential aspect of Epicureanism is setting aside selfish instincts and thinking of the interests of others.  In this way you get the very best out of them and have good relationships. But good relationships, working together, thanking doctors etc. count for little in the ultra capitalist atmosphere of some branches of the US health industry.

 

The ultra-costly, underwhelming F-35 Fighter

Posted by on

From Tomgram, the site that comments on the  defence industry:

“Lockheed Martin Remains Top Gun in the Pentagon’s Cockpit

“How are you with numbers? I can deal with $1.5 million. I think I can even imagine $1.5 billion, a sum a thousand times greater. But how about a million times greater: $1.5 trillion? That happens to be the estimated cost of the Pentagon’s program to build, deploy, and maintain the no-longer-so-new F-35 jet fighter over its lifetime. How can any people invest so much in a technology whose fundamental purpose is dominance through destruction — and which, according to reports, doesn’t even work particularly well?

“The Egyptians had pyramids. The Romans had roads, aqueducts, and coliseums. The medieval Europeans had castles and cathedrals. These days, America’s pyramids, aqueducts, and cathedrals are those warplanes, among other deadly weapons programs, including a $1.7 trillion one to “modernize” the U.S. nuclear arsenal. Unlike the massive projects of ancient history, which still endure and in some fashion represent the triumph of the human spirit, America’s massive spending on military weaponry has been for totems of power that will prove either ephemeral or make our very existence ephemeral, while casting a long shadow over our moment, thanks to the sheer extravagance and colossal waste they embody.  

“As ephemeral as the F-35 stealth fighter may prove in historical terms, it’s already a classic symbol of America’s ever more fruitless forever wars. Like them, the F-35 program has proven staggeringly expensive, incredibly wasteful, and impossible to stop, no matter the woeful results.  It has come to symbolize the too-big-to-fail, too-sacrosanct-to-reject part of America’s militarized culture of technological violence.   (William J. Astore,  16 Sep 2019 in Tomgram)

Meanwhile, the cost of these weapons falls increasingly upon those least able to afford the taxes, while the really rich now have considerably more pocket money to spend.  There is something very wrong with this whole story.  One reason  for the fall of the Roman Empire was the huge cost of guarding the over-extended frontiers and the “bases” needed to do so   Over the course of centuries other empires have met similar fates.  But in the modern world the study of history doesn’t get you a job, does it?  (pathetic, but there you are!)

Emigration a greater concern than immigration

Posted by on

We hear a lot about immigration and the difficulties it presents from politicians seeking votes. But of greater concern in some countries is the flight of citizens abroad from countries like Romania, Italy, Bulgaria and Spain, according to the European Council on Foreign Relations.

Romania:  An estimated 3.4 million Romanians left the country in the decade after EU accession.  Among these are 43,000 (!) doctors . The Romanian population is slated to fall by 22% by 2050.  High mortality and a low birthrate are both contributing.

Italy:  Facing an unprecedented drop in population to 55 million.  From 2014 to 2018 the number of Italians fell by 677,000.  Nearly 157,000 left the country in 2018 alone. The population is forecast to drop further in the next five years.  After Japan it has the greatest proportion of old people in the world (168.7 people over 65 for every 100 young people).  The fewer the number of people the worse the services become, not encouraging for foreigners thinking of buying a romantic Italian vacation home. 

Spain :  The bulk of the population, 42 million, is crammed into cities and towns accounting for 30% of the land, the population density of the rest of the country being only 14 inhabitants per square kilometer.  80% of the municipalities have falling populations.  This figure rises to 90% for towns and villages with populations less than 1000. ( From The Guardian, 6 Sept 2019)

My comment: The only country with which I am a bit familiar is beautiful Italy.  Beautiful  it might be, but it is notoriously badly governed and, in part, corrupt.  I was once advised, when chatting about owning property there not on any account to do so, owing to the cost, the bureaucracy and “other” problems.  Sad. Romania, of course, is  maybe even worse, given its history.