World, Writing, Wealth discussion
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Mentality differences
It might help in diagnosis, and do you really want someone of mediocre intelligence prescribing you, or even worse doing surgery?
Ian wrote: "It might help in diagnosis, and do you really want someone of mediocre intelligence prescribing you, or even worse doing surgery?"I've extensive patient experience with doc-s. Surgery - I'd prefer better hands, scrupulousness and couple of other features over extraordinary intelligence.
Intelligence makes some of them arrogant, negligent and overbearing demi-gods. To me, choosing a medical profession, now vastly augmented by diagnosis and other equipment, should be from vocation. I don't want those, who choose it just from the expectation of a good dough after 10 years of slavery. Keep it simple and compassionate. Sure, you need smart people in research and elsewhere, but I don't really see intelligence as a key requirement for medical profession. With medical malpractice being one of the five major causes of death, I don't see how it contributed hitherto.
Yes, but was this medical malpractice carried out by dimmer bulbs? I agree you don't want super intelligence but I disagree with "keep it simple". I agree that the very top intelligence will probably go somewhere else anyway. You certainly need compassion and a genuine desire to be helpful. My daughter is a consultant at Wellington hospital, and as she says most of the cases she gets are fairly routine and straightforward because most of the things that go wrong with a patient are the few common ones that have familiar procedures, but every now and again you get something very uncommon. The inability to recognize this can cause real difficulties for the luckless patient. That may not require super intelligence, but getting that right is a very important skill for the minority of patients that depend on you.
Ian wrote: ".... something very uncommon. The inability to recognize this can cause real difficulties for the luckless patient. That may not require super intelligence, but getting that right is a very important skill for the minority of patients that depend on you...."That's true. Intuition, experience, acuteness should be critical for such cases. As you've described - took time to diagnose your late wife.
I think that when you look at the top in various professions, being top in one requires some specific skills necessary for that one, but maybe that person may be missing some necessary for a different one. I rather suspect that those very good at one professionj have chosen well, and may be little better than average at others.
To a large extent, I agree with Nik. Perhaps the brain surgeon with artistic hands and very good eyesight but of median intelligence is a better choice than the most intelligent candidate. Knowing it not the same as doing.On the other hand, there are certain specialities in which the diagnosis is the key as the treatment or fix is a matter of the right one and not the most difficult one. In those instances, intelligence is what matters.
My doctor has taken care of me for over 30 years. He is not the smartest, but he remembers both my kids, both my ex-husbands, and so on. And because he doesn't have the answers and he know me, he listens to my opinions on what I have read, experienced or learned from others and is willing to try things to see if they might help.
With modern technology and programs, maybe the answer is for those most knowledgeable to get with those of equal competence in programming to create programs in which symptoms can be entered to narrow down but still include conditions that are unlikely to be considered because of the lack of exposure to those rarer conditions. (It probably already exists but the cost so subscribe is too expensive for the average GP.)
If cost is a problem for such a program, then governments should band together and fund the development, similarly to what they did for Covid vaccines. To me, that is a very appropriate use of tax dollars - to fund the development of something for the general benefit of citizens where the cost and general utility lie outside all the citizens' capacity to fund.
Ian wrote: "If cost is a problem for such a program, then governments should band together and fund the development, similarly to what they did for Covid vaccines. To me, that is a very appropriate use of tax ..."In the USA, I wouldn't expect it; considering the cost of our medications and the overal health care system for those who can afford it vs those who can't. Even on disability on medicare, it cost me $50 to see a specialist, a co-pay for any tests, and because the federal government bargained away the rights to bargain on prescription costs, 2 of my meds are not covered despite me having been on them for 20 years and the private policies I had before through employers having covered those same meds.
Altruism is not part of the American health care system.
Ian wrote: "Lizzie, I said "should" not "would" :-)"Ian, I didn't take it as would. I was just commenting/complaining about the American health care system, again.
Also, I took your "governments should" to include the world and not just America, but I limited it to what is likely to happen in the USA as that is the system I know along with the frustration of the government and the citizens refusing to agree to healthcare for all.
Lizzie, you took it correctly. I was not suggesting only the US do it. I think we are coming to the point where we all have to pitch in.
Ian wrote: "Lizzie, you took it correctly. I was not suggesting only the US do it. I think we are coming to the point where we all have to pitch in."Nope
Philip, please explain your statement: "Taxation without representation if people cannot vote they are not represented. If the poor are denied votes because they are considered socialist what is the difference from 1776."
I was reflecting on attempts to prevent voter registration or adjustments of voting regions to alter mix and therefore favour one party over another. We saw some states put barriers by reducing voting sites, mail in drops. We have seen in recent history voter registrations being denied or lost.Taxation works at all levels - not just state or federal but also sales taxes.
You may disagree with one side or the others politics but denying them the vote leads to significant issues (In lots of nations not just US) - putting artificial barriers in place to prevent votes adds to these issues e,g, moving voting booths away from largest group of voters.
If you know that a large % of your population are unable to do something then don't use that method - another example the Indian government put COVID vaccination registration on-line ignoring the fact that large proportion of population had no Internet access.
Much of what you said is plain common sense. However (isn't there always), there is the truth and what is reported as the truth. There is not large scale denial of votes to anyone here. There is reporting of large scale vote disenfranchisement, yet it never manifests in actuality. The Democrats roll out every election that the Republicans are taking away the vote and the Republicans roll out that the Democrats are stealing elections. Yet, people vote and elections continue.
I'm very late to this rather complex conversation and could speak at length, but I'll try to keep it it short - and hopefully interesting...My wife and I love cruising. We particularly enjoy Oceania which is an American line with (typically) about 75% Americans on board. The first time we booked with them we were a little concerned about how well we'd get on with them (Australia's relationship with the US is complex to say the least). But to our surprise and delight, we found the Americans to be intelligent, charming, sophisticated people and we really enjoyed socialising with them...
Until we mentioned health care. My wife is a doctor and takes a keen interest in what other countries do, and we were just amazed at A) how different the American system is from teh Australian system; and B) how defensive the Americans got when we asked them about it.
Intelligent, charming, sophisticated people turned vicious with very little provocation so clearly health care is a severely hot button issue over there.
Of course, as a lawyer myself, I can't help but cross-examine people on their views and if I were to summarise the general attitude, it is this... Americans see health care as a status thing. They had to claw their way to a base camp on the pile and don't see why others should get their benefits without doing the same amount of clawing.
In a way I respect that but we come from a different narrative. We believe basic health care is a fundamental human right and are happy to pay for it through our taxes.
The question I always leave cruising Americans with (those still talking to us) is this: America regards itself as the greatest country in the world...so why wouldn't they want the greatest possible health system for their people?
We are a funny people. It is not really about status, but hanging on to what you have. We really do not like when someone beats the system except ourselves. So, I work very hard and put the hours in and have great healthcare. I earned it. I do not want to lose the coverage. I certainly do not want to lose my better coverage so someone else can have better coverage than they have now. At the same time, I do not want someone that has better coverage them myself having to lose their coverage so I can have better coverage. when Obama care was introduced, it was going to be the best thing since sliced bread, except it wasn't and he lied through his teeth and only admitted it after it was passed. That is the crux of the problem for us. They promise and lie. Why trust them with what I already have. It is not really about healthcare but constituents. If the politicians had to have the exact same coverage as the hoi polloi, then maybe I would consider it. Except they have excused themselves from this mess as they always do. That says it all.
There is so much ink spilled about different systems and who has the best. All systems have their benefits and minuses. part of the problem is that the United States is a very large country and the third biggest population. There is no easy way to handle everything. We cannot even agree on masks for health reasons let alone healthcare in general.
I live in New Jersey. I lived through the car insurance version of Obama care. At one time, New Jersey rates were so bad that 1 in 5 did not have insurance for their car. A system was developed that bad drivers could get group rates that would insure all. It was promised that things would get better and what happened? It became much worse and entire counties were redlined that had to go to the system regardless of driving record. It ended up costing a Governor his job and 1 in 4 ended up without insurance.
We all would like to have everyone have great healthcare. The question is how do you pay for it? Taxes? Does not work because they always spend it without getting it done as they promised. BTW, there are already programs to help the indigent.
I'm sure none of us could be bothered with another Obama care debate, but my understanding is that the version that finally got through Congress bore little resemblance to the original vision.In the end, the only way to pay for it is taxes (if you want a universal system that covers the basics). A society has to decide what is most important and what it wants to spend its taxes on - which is easy enough for an outsider to say - but the health care debate in the US has become so politically toxic that the insiders (it seems to me) can't properly focus on the health issues. Too many labels.
Adrian wrote: "I'm sure none of us could be bothered with another Obama care debate, but my understanding is that the version that finally got through Congress bore little resemblance to the original vision.In ..."
It is not about healthcare, It never was about healthcare.
Adrian wrote: "I'm sure none of us could be bothered with another Obama care debate, but my understanding is that the version that finally got through Congress bore little resemblance to the original vision.In ..."
I think that you hit on part of it without realizing it. You wrote that a society has to decide what to spend its taxes on. Understand that from an American POV society's taxes are a large part of MY hard earned money. What I buy is taxed. What I own is taxed. Even the sweat of my brow is taxed. And politicians believe that they have some right to hold a gun to my head for more of my money, so that their voters can get more butter.
Of course I realised it - that's exactly what I meant.Maybe because of the way the US commenced (as I think an earlier poster suggested) its citizens have a really different attitude to being taxed and how taxes are used than other countries.
I don't get it, but for all of us - the nomos in which we grew up seems self-evidently to make sense.
Adrian wrote: "Of course I realised it - that's exactly what I meant.Maybe because of the way the US commenced (as I think an earlier poster suggested) its citizens have a really different attitude to being tax..."
It is much more than just taxes. Perhaps I can help others to understand my POV and get at the heart of this thread. As Westerners, we all tend to believe that we have certain rights. From where do y'all, personally, believe those rights come?
That's way too big a question for one internet.
Adrian wrote: "That's way too big a question for one internet."Not unless you honestly believe that naming the source of your individual rights will take more characters than the sum of all human knowledge. My thoughts are much simpler than that.
You're talking about nothing less than the entire history of Western thought (and probably more than that).
In my opinion, rights come from the people who demand them, and refuse to let the privileged or the tyrant take them away. This is the real hurt of inequality because it creates the class that can take rights away.As for where taxes go, I gather the Afghanistan/Iraq issue cost several trillion dollars. About 80 billion worth of military equipment was left behind in a not very well executed withdrawal. Several trillion should buy a good healthcare, and 80 billion still buys something. The question really is, what does everyone want their taxes spent on? For the US it is not that there is not enough money, but rather the money is being spent elsewhere. You can argue whether the priorities are right, and only Americans really have a say in that.
Adrian,No, I'm talking about the simple, personal beliefs of those reading and commenting on this thread. That Western men and women have been thinking about it only matters in how much it informs one's response. A recounting of every relevant philosopher isn't necessary to say god(s), government, membership in the Illuminati, or any other potential source.
Rights are not granted by anyone. They just are.
Papaphilly wrote: "Rights are not granted by anyone. They just are."Not always as they can be cancelled. Victims of Stalin's purges were a little short on rights. There was one guy who was a relative of someone who helped our troops in Afghanistan who fled to Pakistan, and was beaten too death at the border - not sure which side of the border- presumably by the Taliban.
Rights are only there when the people as a whole demand them, and retain then power to demand them. They can be easily lost.
What you and I describing are different. You are talking about rights taken by force. I am not disagreeing with you in that respect. However, I also beleive that rights just exist. they are their own thing. You want to call them God given, that is fine, but I am not a man of faith. Using Gay and Women's rights as examples. They were not granted, they were always there. These groups had the same rights as other groups. The difference was that they were suppressed for various reasons. Slavery is as old as man. Yet, everyone of us has the right to be free. It was the suppression of those rights that created slavery. Slavery is a creation of man. Freedom exists of its own volition. Even people born into slavery yearned for freedom. That is how you know it is a natural state.
Ian wrote: "Papaphilly wrote: "Rights are not granted by anyone. They just are."Not always as they can be cancelled. Victims of Stalin's purges were a little short on rights. There was one guy who was a rela..."
Using your example, the Taliban is using force to suppress rights.
Yes, we are taking different views. I believe people have to earn their rights and work to keep them. The more natural order of things is for someone to impose his wishes, which takes away rights. Quite primitive tribes invariably have a chief and a shaman, and not a lot in the way of rights.
PapaP said: "So, I work very hard and put the hours in and have great healthcare. I earned it. I do not want to lose the coverage. I certainly do not want to lose my better coverage so someone else can have better coverage than they have now." I agree. I worked hard for what I have, and I don't want to lose it. I'm willing to have my taxes support a national health care, but not with the same benefits I have, since those who will benefit most haven't worked for it. Why work hard if you're treated the same as those who don't work and don't contribute to the system? I also agree that the politicians should have the same health care that they're advocating for us. But Congress has ultimate power, the power to choose their own health care, even the power to vote themselves a raise. The power to spend our taxes on whatever they want. No way to fight that.
Vote them out is how you fight it. And universal basic care is very far from the top health care you may currently enjoy.Anyway, I've had this argument a thousand times. No point dredging it out again.
Let's talk about guns instead...
Nothing like leading with the jaw, Adrian :-)
I just bought a t-shirt with a target on the chest...
Rights are won through blood, sweat and tears. The Chartists, Suffragettes and other historic groups could've told you that.
Once earnt, they sometimes come under threat and need to be defended. The WWII generation knew all about that.
If you aren't willing to defend them, rights are very easy to lose and, once lost, can only be earnt back the hard way. For those of you in areas of the world who have traded in your rights for what you hope is a little temporary safety, I'm sorry to tell you that your rights won't be coming back.
Once earnt, they sometimes come under threat and need to be defended. The WWII generation knew all about that.
If you aren't willing to defend them, rights are very easy to lose and, once lost, can only be earnt back the hard way. For those of you in areas of the world who have traded in your rights for what you hope is a little temporary safety, I'm sorry to tell you that your rights won't be coming back.
Adrian wrote: "Let's talk about guns instead..."Sure thing, but you still haven't stated from where it is that you believe that your rights arise.
From the same place wrongs come from. Our minds, by deciding what we want, what we are prepared to put up with, and what we are prepared to do to get what we want. They are not lying around under some cosmic flat rock.
J. wrote: "Adrian wrote: "Let's talk about guns instead..."Sure thing, but you still haven't stated from where it is that you believe that your rights arise."
I believe I did when I referred to the entire canon of Western liberal thought. You can't compartmentalise or identify any one source for these things - they are constantly evolving and for every watershed moment you identify I'll show you its predecessor. Unless of course you start with the Hammurabian Code because I must confess... I can't think of an earlier source than that.
I am an American who does believe in universal healthcare. What I had under Obamacare (which was a ghost of the original plan) cost me the same as my medicare under social security when I take into account my medication costs. I have worked for small businesses during the majuority of my career and obtaining any health insurance thorugh employment was difficult to impossible. My family and I suffered because of it, including being forced into bankruptcy. I think the biggest problem is that it has become a defiining issue for Democrats and Republicans.
Adrian wrote: The question I always leave cruising Americans with (those still talking to us) is this: America regards itself as the greatest country in the world...so why wouldn't they want the greatest possible health system for their people? We in the US do have the greatest possible health care. When people of means have the ability to travel anywhere to treat serious health conditions, they come to the US. Just talk to anyone who works in a US hospital on the Canadian/US border. Whenever possible, our friends to the north come into the US for cancer treatment, heart, neurological and orthopedic surgery. You do not see Americans opting to go to Canada for the same treatments.
Other than certain cosmetic procedures, Americans do not leave the country for their medical care.
But the whole discussion tends to get confused because people talk about "health care" when they mean "health insurance" - health care in the US is high quality, but quality comes at a cost.
Barbara wrote: "But the whole discussion tends to get confused because people talk about "health care" when they mean "health insurance" - health care in the US is high quality, but quality comes at a cost. ..."That is perfectly said.
Adrian wrote: "J. wrote: "Adrian wrote: "Let's talk about guns instead..."Sure thing, but you still haven't stated from where it is that you believe that your rights arise."
I believe I did when I referred to ..."
You believe that your rights arise from your library? That is certainly a virtuous statement for this venue. But will the Magna Carta stop the jack booted government functionaries from seizing your property and tossing you into a gulag? Despots are rarely persuaded by proper citation.
Papaphilly is correct in his belief that our rights are inate. Ian and Beau are correct in that the preservation of our liberties must often be accomplished through bloodshed.
Papaphilly wrote: "Barbara wrote: "But the whole discussion tends to get confused because people talk about "health care" when they mean "health insurance" - health care in the US is high quality, but quality comes a..."Point well made - I have no doubt having experienced it that the USA has excellent healthcare available; however, it is only available to those that can afford it via insurance (to the limits of that cover) or wealth
Other nations offer perhaps not quite as high quality (many countries would argue) but make it universal irrespective of insurance or wealth status.
It's an obvious demonstration of haves and have nots.
Other countries have implemented a tax (Insurance) system to pay for universal care. The USA despite Obama Care/Medicare/Charities has not.
Living in the USA with cover was fine. If I had been there without cover I would have feared bankruptcy was just around the corner. If I add USA to travel Insurance my premium immediately doubles - trying to do that now we are allowed back in.
There is another reason why people go to the US. It has the best medical research in the world, mainly because with the biggest economy it can afford to maintain the biggest. That means it has medical people who can treat the really unusual. Thus in NZ I am sure our hospitals have professionals who are as good in general as anywhere, but there are some weird situations where they are so unusual the doctors here might never have seen a case before. In those circumstances, the patient is sent to where there are the best chances of success.
Adrian said in response to my post about no way to fight Congress's power: "Vote them out is how you fight it." Nonsense. The next guys you vote in will be just as dependent on big money for contributions and just as controlled by them. It's freaking impossible to change the system. Agree or disagree?
Beau wrote: "Rights are won through blood, sweat and tears. The Chartists, Suffragettes and other historic groups could've told you that.Once earnt, they sometimes come under threat and need to be defended. T..."
I agree with you, Beau
That's very accurate both retrospectively and concurrently. I'd rather have best students studying philosophy these days. And I'm not sure the best/smartest should be doctors. I don't see how it helps in the profession.