Universe On The Couch

Want to know why America sucks more all the time? Socialism. That's right. Sure there are a number of reasons, but this is one of the primary factors.

Sure, we still have a large degree of free enterprise and this is the vital growth that socialism attaches to like parasite to host. A small degree of social programs can be sustained by a vital economy without real problems. Hence the problem.

Currently our economic vitality is diminishing. We no longer manufacture. Those were great jobs for blue collar workers. They could have two cars, home, kids and stay at home wife. Not to mention a pension and health care. Now our so-called vitality is in finance. This has set up some pretty bogus schemes where no real value is created, but actually sucked out of other people like mom and pop stockholders. And American workers. Think Enron. The whole tech fall was based on financial nonsense. Our faux recovery is based on the same tricks, this time much via the federal government and Federal Reserve Bank. The patient has metastatic cancer and will soon be in the hospital. Denial won't make it go away.

The other side is that small degree factor. It is out-of-control. The main problem with democracy is that the masses are stupid, selfish and lazy to some extent. It's human nature, especially the last two parts. In this day and age, most people want something for nothing. Observe the current popularity of gambling, poker and the lottery. And litigation. Politicians make promises to get elected and vote for this crap. The people are gullible and short-sighted. The politicians should know better, but they feed first on the taxpayer's carcass.

Early in the last century, we got income tax. It was sold as only for the rich. But its graduated set-up over time took in more and more workers as the currency was inflated. That way the banks and the feds got a bigger and bigger piece of the pie.

The Great Depression brought in FDR and The New Deal. My grandfather called it the raw deal. That clearly flawed distortion of Keyne's was used to bloat spending all over and we got Social Security. Actually some real good came of those programs like in our parks and public works. However, Social Security would come to bit us hard in coming decades.

Our big socialist decade came in the sixties. LBJ pushed through all sorts of "Great Society" legislation. Civil Rights was the good part. The welfare stuff has been a growing cancer in this country. Over time the programs got more bloated. Even W has contributed with his Medicare Drug Benefit.

So now we have generations of Welfare addicts breeding and filling our courts and prisons. Our taxes are high. We fought a revolution for this? Immigrants off the boat are quickly in line for the easy cash.

We are taxed everywhere. Your employer pays social security, Medicare, workmen's comp on top of your salary and benefits. Then your paycheck comes with Social Security, Medicare, Federal and State tax taken out. Some even pay city taxes. Sales tax on most of what you buy. Taxes at the gas pump. Popery taxes. Vacationing? Hotel tax. Saving? Taxes on your interest. Investing? Taxes on your capital gains. Dead? Taxes on your estate.

What to do? First of all, slash out that Medicare drug benefit. Let people import their drugs from Canada and England. Stop direct drug marketing to patients. Go generic and off-patent as often as possible. People won't be missing that much.

Second is to strip down Social Security Disabilty. Burden of proof on the claimant. Program doctors make the decisions, not administrators. No more child benefits, they don't work anyways.

Third is to trim Social Security retirement. Raise the age levels. We're living longer than we did in the thirties.

Fourth is stripping health costs for prisoners. I've seen many convicts taking over $10K a month in medications. Nothing is denies them. One inmate was court ruled to need a liver transplant on death row.

Fifth is AFDC. One five year period per vagina. End of story. That gives them five years to raise the kid before school and figure out how the fuck (pun intended) they got pregnant.

I'll end here. It is clear that the current situation is not sustainable. The economy is headed south big-time. Likely the turn will happen in the next few years and the current assholes will be out. The Democrats, perhaps Hillary, will promise a New Deal. That will only make things worse. It doesn't look good. The medicine is tough indeed. And America is to wimpy to do the right thing.

The Female Migration

A big problem today is the migration of women from some of their traditional roles to those of higher pay and status. This is a side effect of the totally appropriate removing of occupational barriers to women of the past. But like most things there are side effects.Four groups are considered here.

First is teachers, a traditional job for educated women. With Summer off and early work days it was compatible with mothering. But the poor pay and status in this going-to-hell country has pushed good people away from this very important and honorable profession. Few jobs are more important.

Second is nursing. We are in a great shortage now. Bright ambitious nurses move into bloated health care management, escalating health costs with no improvement in care. Some skip nursing for medicine. More power to them, but it strips plenty of talent form nursing.

Third is secretary. I mean Administrative Assistants. There is nothing degrading about the first term anyways. So now these women are in other fields and a lesser group has replaced them. The simple use of a phone to do professional or personal business reveals incompetence 50% of the time.

Finally is mothering. What could be more important? Here is a failing part of our society. Kids are more important than careers. Argue? If you disagree, tie your tubes and be on with your job.

And where are all these women now? Many are in gainful work. But many are in useless jobs that only glut the society with bullshit. The extra money in circulation drives up costs, especially for real estate. The consumption is destroying the planet. The commuter traffic has never been worse. All day sales reps and other service industry types clog roads. Getting anything done requires layers of crap.

The most useless: Sales, marketing, real estate, finance and law.

The Great Depression of the Twenty-first Century

Yes this new century. Worse than the Great Depression of the last century to be sure. Perhaps the end of the United States and Western Civilization as we know it. These great depressions are part of the cycle of economics. Each prosperity carries the seeds of its own destruction.

First we must look at the current situation. We start with the Federal Government. Even during the Roaring Nineties there was no real surplus, just a lower creation of debt. You see the federal accounting is Enron and then some. About half is hidden from view, so there has been deficit spending all along. Yet those turkeys were licking their chops on how to waste the imaginary surplus. Now our deficit, which is nothing more than debt, is at record levels and increasing at record levels. Some say the Debt doesn't matter. It's all owed to the people anyways. Well both are wrong statements. Our debt is being bought up by foreigners, especially the Japanese and Chinese. They do this to prop up our spending so we can buy their stuff. Problem is, now the dollar is sinking and less attractive. When they decrease or stop buying or worse yet sell these issues, we are out of cash stream.

The only way to make the dollar attractive is to reduce the Federal Deficit, reduce our trade imbalance or raise interest rates. How about spending less? I hope you are laughing. The pork-barrel Congress is like a bulimic at a buffet. President Bush has yet to veto a spending bill. The outlays for Iraq, Afghanistan, The War on Terror and Homeland Security are endless. Bush even further increased Medicare commitments with his drug plan. So reducing spending is out. How about a tax increase? Oh yea, I forgot we gave refunds to the rich and child credits to the poor who didn't even pay taxes. This one is very unpopular. Hardly a way to re-election.

Finally you can cop out and "print more money." This has been going on with the creation of credit by the Federal Reserve. This makes our dollars less valuable and fuels inflation. Inflated dollars make debt less expensive. If you can understate the true inflation rate with the Consumer Price Index, then you can look better too. Plus you can use that formula to figure into entitlements indexed to the CPI, when in fact their true value is less. Remember the CPI doesn't include gasoline and food. Most of need the former and all the latter. And inflation is wild with important big items like college tuition, home prices and health care. This "solution" is a quick dangerous fix that will encourage foreigners to get rid of not only federal debt issues, but anything in dollars-like US stocks and bonds. Crash anyone?

Raising interest rates is the only real solution to inflation. But if the Fed raises rates, then the debt machine no longer fuels the false recovery that re-elected Bush. But if the lenders don't want dollars, then rates will have to rise. Between a rock and a hard place? The Fed doesn't really control most rates anyhow, especially longer term rates. Now let us look at the banking industry which includes insurance companies, brokerage houses, savings and loans and anybody else in the lending business. They are out on a limb. The Fed has let them keep almost nothing in cash reserves. The money is out of the vault. They are counting on it to be re-paid. And much of it is actually in complicated leverage positions called derivatives. Nobody really knows how the damn things work. They could work like bombs. And much of the loaning is now in real estate, which we shall see is a shaky place. Pun intended.

Corporate America is seemingly doing fine. Or is it? The big old companies in steel and autos are heavily behind in their ability to meet pension promises. And the federal bail-out agency has limited funds. Companies are beholdent to stcokholders and are still fixing the books Enron style. Gotta keep those stock options too. The best fix is to let go of workers.The stock market is up again. Joy. Now is a good time to buy. Right. Insiders are selling out. Mom and Pop America are still holding the hot potato. Price-to-earning are still sky-high. The public believes they own a piece of the company. Please. A stock price is a social and fluid agreement on what is worth. Based on nothing else.

And finally to Mom and Pop America. They live the middle class middle age life, both employed with two kids and own their home-well sort of. Their budget is tight and they save little, mostly in their retirement accounts. The money goes so fast: Mortgage, property tax, repairs, car payments, various insurances, food, clothing, taxes, memberships,...... There is money owed on the house, the credit cards and cars. Not much room for any problems financially.

Now you only need one event to tumble this house of cards. Another major terrorist attack on our soil. A major disruption in oil supplies. A natural disaster. Or the Japanese or Chinese to balk at our stuff like stocks. South Korea has already decided to leave the dollar.Let us go with the last scenario. Asians see the dollar decline and decide to significantly reduce their US exposure. Bond issues from the Treasury to corporate go down in value raising interest rates. Corporate borrowing decreases and we head into recession. Stocks go down as Asians don't want assets dollar valued. Workers get laid off.Now we have more people unemployed. Some find new jobs with less pay and benefits. And others fearing for their jobs. So spending goes down and/or more debt is built up.

Consumer spending has driven the economy since Y2K. But that debt is ever more expensive. Less spending means less jobs again, accelerating the cycle. After all that car is good another year or two, a driving vacation for a week is OK rather than fly far away, the fridge still works fine,... Some will cut back and survive. Others will not fare so well.

But these A-bombs are only to ignite the H-bomb: Real Estate. Where the money is. Or debt anyways. The real estate bubble is real. Low interest rates have inflated it. The good loan prospects have been tapped. Now they are tapping the less able borrowers. People with no credit history, prior bankruptcies,... And the loans themselves are dangerous: No money down, interest only, adjustable rates. Adding to this problem is that homeowners have fueled a spending binge borrowing against their house. When you "take money out" of your home, you are really just borrowing more money.So rates go up. Harder to make those adjustable payments on that already tight budget. Maybe not possible. Lost or less income is tougher too. The buyers market is tapped out. The market is flat. Tough on all the people in or dependent on real estate movement. This is a huge industry, only afloat via selling and buying. This is the next step in furthering the recession.Demand is down so prices stop escalating. They even start to go down.

The whole economy slows down, each factor building on the others. With higher interest rates and a poor economy, there is little action. We start to see accelerating pace of folks that can no longer afford to keep their home. Some cannot take the higher rates on the adjustable. Others now have higher payments as principle is added. Others cannot keep up due to loss of income. They will sell. Some will be foreclosed on. People will declare bankruptcy.Suddenly it will be a buyer's market. But with few buyers. The "house rich" will find their home values in decent, perhaps owing more now on that house than it is worth. Some will sell at a big loss with no other choice.

Prices will plummet.Shock waves over and over as the cycle repeats. Money in GSE's like Fannie and Freddie and Ginnae spirals down. Companies fail. Unemployment hits new peaks. People are wiped out.Government will have little power here. They cannot bail it all out. They cannot tax more. Likely many programs will have to be cut. We may see New Deal nonsense.It will be a time of crisis. People may not take it so well. There may be mass violence or even revolts. Government response may be harsh, even martial law. Chaos brings the risk of totalitarianism.

Of course it could be good too. People may turn to the real quality things in life-which are not things: Peace and quiet, nature, spiritual paths, friendships, family,... The environment may heal. Our marked decrease in consumption would dry up all the Muslim terrorist funding and the growth of Chinese military and economic power.Of course I could be wrong.

A Day Without a Mexican

I saw this movie hoping to get a laugh. Instead I got propaganda. I had hoped to enjoy a parody where life got really screwy when those who do most of the real work are missing. Anybody with a brain knows that Southern Cal would fall apart without Latin labor.But here we get preached to. Statistics and all.

The characters are shallow caricatures. All the Mexican people are wonderful. The Anglos and blacks are polarized into those who view Mexicans with pollyannic admiration and blatant racists. Please. Few people of any background are all good or bad. And most of us "Americans" including Hispanics have ambivalent feelings on these issues.

For fun let's look at a movie from the other extreme bias...Our hero, a white professional, or black professional to be strangely PC, gets up for work. But it is pleasantly quiet for once. There are no leaf-blowers, lawnmowers or chippers.His commute is lighter. Where is the traffic? The road speed is faster.

Now fade to his wife. This selfish user bitch is in a frenzy. Where is the maid who performs all the functions of a housewife and mother? The house is chaos as the kids run amok. She pops a Xanax or two. She is in a fit as she rushes late to take the kids to school whining on the cell phone as she mis-drives the oversized Lexus SUV or Bummer II. She nearly runs over a kid at the school because she is more involved in her phone call than watching the road. In fact let's change that scene and let her cripple the poor kid. She will certainly be late for her hair appointment, affair with the tennis pro or perhaps a useless job like cellular sales rep.

Now the scene is lunch. Our hero goes to his favorite lunch joint, but they are closed. And the next. No carne asada. Hell, he can't even get Burger King without a long wait. So much for "fast" food. He finishes off the sludge at the bottom of the coffee pot. He licks the wax paper from the donuts when nobody is looking.

Now the day goes on. The prison guards are perplexed and the Warden alarmed. Thirty percent of the inmates are missing. Ditto at the city and county jails. The cops are bored, especially in the barrio. Lines are short at the DMV and welfare offices.Our hero comes home on a traffic-jam free commute. How weird. As he turns the stereo tuner there are no Spanish stations in between his favorites. Strange.

Next is a most enjoyable sequence of white guys trying to do various tasks like mow the lawn. As their wives bitch, they give us a wonderful Three Stooges slapstick of incompetence. The afternoon ends with the Border Patrol napping in their vehicles.

Now its dinnertime and it sucks. Our hero's incompetent wife struggles to make something. The phone lines are full and busy to all the take-out and delivery places. Can't get through. The kids pick at the nasty shit she has microwaved together. "I'm not eating this!"

Our hero figures he and the kids can get some food at the ballgame tonight.Again the drive in and the parking are easy. But the lines for food are long. Many of the kiosks are closed. The kids want Mexican food and all he can get is nachos with that horrible cheese-like product on top. The beer line is worse. All the men seem to be in need and there are less vendors.Even the game sucks. Dropped balls. Weak hitting. Lots of walks, balks and hit batters. Half the starters are missing. White and black guys play positions they haven't played since high school.

The drive home and even exiting the park are a breeze, but a somber mood fills our hero. His wife is frazzled at the prospect of getting the kids into bed. They cry out for Maria. After all, Biomom is so selfishly involved in her own life to make the appropriate bond.Our story ends with the wife refusing our hero sex. Some things in the universe are constant.

During the credits we first see hordes of Cholo gang members skewered on sticks amid flames with a heavy metal soundtrack.Then finish off with fiesta music, kids hitting a pinata and Jesus with carne asada in one hand and a Tecate in the other.

Much of the increase in health care costs has been prescription medication. There are actually some fairly simple solutions here.

It starts with the patients. They go to the doctor with an expectation of a medication. They often feel ripped off or they wasted their time if they don't leave with a script. they need to understand that not every problem needs treatment or is that serious. Some things go away on their own. Others need treatment that is not a medication. Some things need to simply be followed over time for now. They also must understand the newest and latest "ask your doctor" drug may not be suitable for them, better than what they are taking, has not had a long record of safety issues and is expensive. The newest, latest marketed as best drug is always expensive and often not anything so great anyhow.

Then the doctors. We need to be honest and tough with our patients. We need to educate them. We need to offer them choices too. We also need to get beyond the bias of our perks and "education" sponsored by the drug companies. We need to realize the wonderful studies cited are a biased sample and lok closely at the data and see if it really makes sense in the "real world" of clinical practice. Cost must be part of the equation, no matter who is paying. Not so much the cost of the med itself, but overall costs realted to it as well. When SSRI's were restricted, the higher costs were actually justified over the old meds. The overdose potential and the ICU time, along with the costs of untreated depression due to patients not taking them due to side effects outweighed the med costs.

The drug companies are of course to blame. They do provide much good and without them we would have a feeble system of care indeed. They are also a business and if you beleive in capitalism, then they have a right to make a profit. One can only cringe at the idea of the government taking over this industry.

Still the marketing is relentless. Only twenty percent of new meds are really novel. Most are "me-too" drugs based on another companies big seller. They only release the studies that are favorable. They control much of medical education. Worst of all, they advertise to the public. This creates a demand for something that the patient is ignorant about and a decision that is really the doctor's. Billions spent on marketing are passed on to the patients.

Our federal government is complicit in this too. The expanded Medicare drug benefit flew through both parties and the President. Here was everyone's get the senior vote and look humanitarian. Now they're all crying they didn't know it was going to cost that much. Bullshit. Ever look at the thing? It's pretty convoluted and unclear who it will actually help. And goodbye cheaper imported meds. Now Grandma is a drug smuggler. They cite safety of these meds. Yea, I'm sure Canada and England are real lax. This really is a giveaway to the drug companies at the expense of the taxpayers.

Then there is the issues of is a drug really needed. Every time I read about the cholesterol issue, the numbers for risk are lower. Meaning more people on expensive statins. Now even two or three drugs are given for the evil cholesterol. The same thing for high blood pressure, two or three meds. Add on an anti-depressant. And since all depression is really bipolar, a new anti-convulsant. And a low dose af a new anti-pschyotic just to help it all out by calming the mind. A stimulant for ADHD or the fatigue form all those meds. And a sleeping pill for bedtime. And shit, pun intended, constipation. So something for that. And those joints hurt, so COX tox too. I often see med lists that read like "War and Peace." Often the best intervention to start with is to get rid of some or most of the medications. I tell them to bring in everything in the home and they often fill half a paper shopping bag. I have seen two full bags a few times.

Often the needed intervention is not a drug. Depressed? Stop smoking pot or drinking a few weeks. Always tired? Try sleeping more than five hours a night. Anxious? Ease up on the coffee. High blood pressure or high cholesterol? Exercise and lose some weight.

Sometimes the drug is a rather cheap one. For most of us our aches and pains can be treated with the aspirin or ibuprofen in the big bottles At Costco, Walmart or Target. Generics are the same medications and should be used whenever possible.

Prozac is off patent now as generic fluoxitine. So it should be the first choice in treating depression unless otherwise contraindicated. Meaning before the doc prescribes Paxil, Zoloft, Remeron, Wellbutrin SR, .... And if you're treating PMS, prescribe the generic, not the newly marketed expensive "Pink Prozac."

So here is a place where plenty of money can be saved. Billions. And our health better besides. Every medication has risks to our health and well-being. The lifestyle alternatives are better for you anyhow. The new expensive stuff has not been out long enough to really prove its benefit and more important safety. Mice, rats and dogs followed by a 12-week human trial is not the same as years of clinical experience.

If you asked doctors in the eighties, this would be the big issue on their minds. It still is a huge issue, but other issues have grown to compete like actually getting paid for what you do. The insurance companies and government have joined the trial lawyers as the enemies of good health care for America. I suppose the press has tired of malpractice like it has from AIDS, still going strong itself.

The truth is that malpractice premiums have gone through the roof. Some specialties pay six figures each year to cover themselves. Talk about increasing health care costs. Besides money this has reduced access to care as some areas and even states now suffer a shortage of certain specialties like neurosurgery and obstetrics.

Costs are also increased by cover your ass tests and consultations. Better make sure because if something goes wrong, the lawyers will be looking for someone to blame, especially if they can get money out of it. Suspect something not my specialty? Order a consult for over a hundred bucks. Just in case one more hospital day at over a thousand dollars. Better get a CT at five thousand dollars. A few blood test, maybe under a hundred dollars. This adds up fast.

Simply stated malpractice is when a mistake leads to a bad outcome that has damage to the patient. Was there a mistake? This is often the first place where the process goes awry. If the care was within the normal limits of medical practice there should be no case. Period. Not this witch hunt of every detail that "could have/should have." Applying a common-sense typical doctor standard would reduce much of the bullshit.

A bad outcome. So everytime something bad happens, somebody is to blame. Medicine is not a science and there is much not known. Perfection is not in the cards. Bad shit happens. Everybody dies, so maybe we could sue every time somebody dies. Perfect for the Hilary Clinton health plan.

And what is this bad outcome damage? Pain and Suffering. Sounds ambiguous to me.

How about responsibility of the patients? If you did drugs while pregnant and the baby is fucked up, now you sue the OB? You were fat and smoked, so now the surgeon is the bad guy? The shrink is responsible when somebody whacks themselves off?

How about simply less lawyers? Or all civil trials by a judge rather than a jury? Those two reforms would go way beyond health care and malpractice for a better America. A review board could screen and toss these cases before trial if no real grounds. Limits on damages has helped in many states.

In summary, the Malpractice environment is a big contributor to costs. It also is quite discouraging to doctors, making a difficult career less rewarding emotionally. It reduces access to care by driving doctors away and even out of medicine. Somebody must eventually pay these costs and it ends up the taxpayers and patients.

Two more issues. Diet and exercise. Nothing earth-shattering here. Our obesity epidemic is common knowledge now. When I was a wee lad (body weight then vs. nowA) in medical school, I noticed that hospital patients on the medical/surgical floors were for the most part there because they drank too much, smoked or were fat. Hence the simple solution for health: Don't smoke. Drink in moderation or better yet less than moderate. Stay at a decent body weight.

The last is the tough one for most Americans. At least for me. After over thirty years of eating freely, I wasn't so automaticaly lean. My famous reputation for gluttony was no longer refered to as a "hollow leg." Some of it was not being so on the run in my profession. I also was in the money and could live richer. I dated a former beauty queen who shared my love for large amounts of food. On my dime of course. Then a gifted cook and baker. Then another former beauty queen who was the junk food queen. Of course I got older too. And a number of orthopedic injuries limited my activity too.

For all the diet plans and all those bestsellers, the calorie theory of weight loss/gain still is at least a major factor. Calories in per diet. Calories out per activity. Simple but hard to do. Like many things in life.

We simply eat too much. Fake cream fats and sugar for the coffee along with those donuts or other junk that sits out tempting us at the office. Lunch out. Burger and fries? Supersize that sir? And the endless refills on that sugared soda. Every office celebration means food. Hard to say no. Snack time? Hit the vending machine. Search out those candy sources in the office. After dinner the TV beckons with its food ads. Like Homer Simpson we start to salivate...

And our exercise habits. Right. For all the gyms and fads, we get little. Observe the waiting and circling for that close parking space, even at the gym. Sports means food and drink at the stadium or in front of that TV again. Here in the Golden State, many or most don't do the home labor either: Lawn care, gardening, washing the car, housecleaning,... We drive everywhere. the kids stay inside on the game box. Even the working class often has machines doing the hard labor.

Like smoking, drinking and drugs; getting on-board with diet and exercise would further elevate our well-being and reduce our health care costs dramatically. These choices are the best, simplest and cheapest solutions to our health care crisis. Period.

This is also a significant way to reduce costs. The healthier we are, the less we need to spend on health care. Less medication, doctor visits, tests, nursing care and hospitalizations. The old prevention is better than cure thing.

We can start with smoking. A no-brainer. Anybody with half a brain knows that smoking is a major cause of heart disease, cancer and lung diseases such as chronic bronchitis and emphysema.

This is clear to anyone who was born after about 1955 before they would have started smoking. So what's the fucking problem? We have the freedom/right to smoke, so outlawing it is against our principles. But then expect to be provided health care when we get sick. Typical American I want my rights, but not any responsibility. We will see this all throught my health care discussion. Today's youth probably see it as rebellion against the health nazis. What a joke. Their rebellion is a well-marketed advertising scam to sell smoking and make mega-bucks. Suckers. Losers. Conformists.

The easiest solution? Don't start. Make the gum and patches cheap so the tar and other nasty stuff is eliminated besides nicotine. And the adverse effects of smoking itself and second-hand smoke. Then put the true links with wrinkles for the women and limp dick for the former men.

The next is alcohol. Here we have all sorts of cancers, high blood pressure and liver disease for starters. Then all the trauma that is alcohol related: Murders, assaults, spousal abuse, child abuse, rape, auto accidents, bicycle accidents, drownings, falls,... And finsih off our trifecta with psychiatric related issues: Depression, dementia, anxiety, impotence, insomnia,...

Prohibition was clearly a disaster. Again its individual choice. Nothing works better than 12-step programs, so they need to be encouraged and even mandated when the legal system is involved. Again we have a multi-billion dollar marketing campaign to encourage its use. So keep it under control and keep it safe. The less the better. None is best. That moderate thing is suspect. But that's another blog.

Drugs are the next issue. They already are illegal, but the war isn't working. Prohibition re-visited. Individual choice and responsibility again. Even marijuana can cause depression and anxiety. It gets worse from there. Here the worst is methamphetamine. This causes untold depression and paranoia, even after stopping it. People are literally making themselves crazy. Women who have used it often bloat up like hippos. The prisons are full of inmates who committed violent crimes on it. PCP can lead to a schizophrenia-like syndrome. Injecting drugs leads to infected heart valves, hepatitis and HIV.

I'll end today here. Simply, at least half of our health care costs can be accounted for by smoking, drinking and illicit drugs use. None are neccessary to live or even to really enjoy life. A drink or two a day and a joint a week probably won't hurt you much, but won't help either. Still, this is clearly a very simple-but not easy-area to improve our health care costs. And more importatnly our well-being and quality of life.

Fixing healthcare in America. Shit. What a mess. Four issues. The health of Americans. The quality of care. Access to care. The cost of care.

Our national health. Fuck. It sucks. Especially considering how much we pay out. We lag many countries in significant measure like life expectancy. We are the fattest nation to be sure. Diabetes is on the rise and pretty much an epidemic already. Even though we live longer than ever, those years are often in less than healthy status. We are pumped full of medications. Many of us spend the so-called "Golden Years" in a care setting.

Quality of care. When you can get it, it's pretty good. Why the fuck would so many foriegners come here for treatment? Our doctors are among, if not the best in the world. Hardly perfect, but medicine is still an art that uses science as a tool. Sure, there is room for improvement, but its pretty good.

Access. Sucks pretty much. Try to get an appointment even with insurance. Incompetent systems for scheduling. Office staff are often less than helpful or usefull. Insurance companies do all they can to reduce utilization. Overall quite inefficient.

Cost. Help!!! This will drive us broke. Medicare is truly scary when you look to the future with an ever sicker and older population, not to mention newer and more expensive treatments. Its already a huge issue and gets more expensive every year. And the socialistic cry for universal care will only make things worse-much worse.

So we have outlined four issues. Quality of care is good, so we can focus on the other three. Access is something we can solve, especially with modern technology, to a reasonable level. The health of Americans has some real solutions that are simple, but not so easy to actually implement. I will adress this in a future entry. But my big focus will be on costs. No easy solution will be offered. Just speculations and the generation of ideas.

Prepare to be upset.

What is up with this society? Meaning America pretty much. People are pretty much the same unit everywhere, but culture takes some pretty big variations. Just look at religious beliefs from atheism to people basing their lives on religion, even to the point of suicide bombers. Some peoples eat what disgusts others. We find each others customs and rituals offensive.

We must start this idle speculation with the nature of humans. The Blank Slate theory was put forth by Behaviorists about a century ago. Humans are an open book and the environment writes their story. No free will of course. This thinking has dominated thinking in psychology and pop psychology since the sixties. Blame the parents, blame the environment, blame society. Criminals are made, not born. Males and females are the same, its just that they are enculturated differently.

Freud and company said no way. Instincts rule us just like the animals and we are barely aware of what really makes us tick. Of course we have more flexibility within those bounds than say, an ant, but instincts just the same. Our environment acts on us to be sure, but only within certain biological limits.

I would go with Freud here. Clearly the failure of communes, communism, socialism, radical feminism and other social experiments can be explained this way. Evolutionary explainations of our behaviors make much sense. Clearly the biology of our mentations and behavior are daily being discovered.

Freud and Skinner would agree that conscious free-will is nonsense. While I don't totally agree here, much of what we do is hardly free and/or rational. The examples abound. Teens starting to smoke. Gambling away life's savings. Sucking on the crack pipe. Marriage to someone you know is nuts. Even the brightest of us is capable of stupid acts.

So what is this human nature? Its not going to be covered well at all here, but we are groupers. We talk about independence, but we conform for the most part. We want to be in the group. We take on the attributes right down to dress, style of speech and leisure. Our survival once depended on it and still does pretty much. We also have hostility to those outside our group. My family, my country, my race, my city's football team,...

This basic nature is acted upon then by that social environment from the immediate contacts like family and friends and extends out through the mass media. We are essentially programmed. What we think of as our independent and original thoughts are often just insertions from the television.

As we go from individual to groups of ever larger size, we get the whole society. Here the individuality left gets bleached in the majority rule. Aggregates of actions determine elections and markets. Of course this isn't always good. Often it is manipulated such as advertising and marketing. For better or worse, money rules to a large extent. All other values seem to tremble to the almighty dollar.

Nothing else defines America today like consumption. Many of us spend our major time and energy in pursuit of money so we can get more stuff and feed our egos. Lip service is given to other things like family. The job can pretty much keep us in line, even with the nutty workplace rules and idiotic supervisors. The debt monster keeps us to the stone. We envy the rich even as they drown their sorrows in further greed, drugs and senseless affairs.

We are digging our own graves. We eat like pigs and are fat. Our health care costs will only escalate further. We drive everywhere and the vehicles are bigger than ever. Never mind we are polluting the planet and sending cash to terrorists to fight in wars we pay for in taxes. We demand our entitlements despite the programs going broke. We vote for a leader who scares us sheep with fears of terrorists so we can die in a war we can't afford.

Sounds rational to me.