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All the "other" things I like are only 23%!
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The Most Fabulous Objects In The World
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2010
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- Sol Invictus
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- OK, my first short health care thoughts
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- Why JS Mill Matters
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- Yuck
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- Are we "the mark"?
- Get those Guillotines ready!
- Along the quest to find the BEC in my head...
- It's bad enough that Rush Limbaugh is our distant ...
- Finally!! I have been wondering this forever.
- War is fractal
- Health Care Bubble Ideas
- Do you agree?
- Why the fractal nature of health care will doom he...
- Terrific Disorder?
- Why don't we do more of this?
- No one wants to admit it but we really need more o...
- Well, we finally did it...
- Wouldn't you just love one for your backyard?
- Saying "thanks" to the Flying Spaghetti Monster...
- And crazies say immigrants are the problem?????
- Bummer, Kramer's on board. It looks like gold has ...
- How many times do we have to go throught this!!!!!
- Touche!
- The dangers of retrospective modeling...
- Social Cohesion As The Ultimate Policy Goal
- Glen Beck is an Idiot!
- She Won't Float But She'll Feed the Hungry
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- So now I'm not such a fool after all?
- Curse those doctors!!!
- So I need to make $2,000,000/year to finally get a...
- My question for ANY of you (as I don't know the an...
- This is why they call it the dismal science
- Interesting Automatic Earth Post Today
- The more things change, the more they stay the same
- When we don't coopeate...
- Defending the undefendable
- Paul Says "No"
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- What a Waste.
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- For Dr John: the problem of prediction
- Another one for Okie
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- Thought of the day
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May
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27 comments:
Impossible is what comes to mind. We cannot maintain this trajectory. I am 46 and do not expect to see a single dime I put into Social Security. I would gladly give up all of it if someone would walk in and say they were cutting 25% of all Govt. spending across the board and eliminating the Dept. of Transportation and Education now. Also the BAFT and I think the FCC too. There are lots of others but that's a start.
The only way you will not see it is if it is stolen from you.
And your trade off would be a pretty bad deal
Look at he chart yourself, government spending as you think of it (dept of education, etc...) is less than 30% of all spending
The rest is military, interest payments and income transfers (which medicare is a form of)
That is why I said we need to cut ALL spending by 25% Thai. This means slashing military spending too along with everything else. We cannot afford to be involved in perpetual would conflicts and run a welfare state.
sorry for my typos.
I hear you on the wars
Having said that, we should call a spade a spade
Even with the wars, we are not in "high territory" re: military spending
And if you compare this to others nations over the last 500 years, it does not look so bad for us at all.
I totally agree.
I don't think it is going anywhere and the more volatility we experience, the more this will be reinforced.
It is more one of those "how to keep the termites out of the wood" issues, which is admittedly tough with colleagues of Dr John and I qualifying methadone users in ever increasing numbers.
We live in interesting times.
I agree SS is not going away.I can dream however. Does anyone have any predictions on if and or when we will see the roster of those on SS cut back. I will go on record saying that in over 15 years I have never agreed support anyone's claim for SSI.
Amen. There is no good solution. If you have thought of one I'd love your thoughts.
FWIW- My issue has never been this group by the way, my issue is with the healthy malingerer as I said earlier.
One idea I've toyed with is the amount available is fixed against some kind benchmark (say as a percentage of SS total). The amount that is paid out monthly depending on the number of people sipping fom the pool. Further, the people deciding who qualifies are paid from the pool and they are appointed (or voted) into this role.
Of course there are problems with this approach so I'm not wed to it
This is fine individually but it does not adress the global tragedy of the commons issue
how do we get people to see this?
There is really no such thing JP as "mentally retarded Schizophrenic". The construct of Schizophrenia is not applicable to those with IQ's below 70 in reality if it is even valid which I have doubts about. This does not keep misguided doctors who do not understand the definition of the term "construct" of making wild claims that people suffer from multiple psychiatric disorders like MR, BAD, PTSD and Schizophrenia all at the same time. I guess that is for another post. You may find this of interest.
As to the need for a safety net for those who cannot provide for themselves, I agree with one. It should not be a program that I am told will be my retirement account or so easy to get to.
Doctors have no particular expertise in identifying the disabled anymore than a lawyer or a housekeeper does. I see people with very grave impairment working and others who have no visible sign of impairment not. How does one now if someone is disabled? Disabled for what?
Giving people money who are "disabled" to spend on crack and whores, which I see every day does not appear to be a wise utilization of tax dollars or as importantly doing much good. Unless perhaps you are a crack dealer or a whore making your living off the disabled. Or even worse a Dr or a lawyer doing so. I want to puke every time I see the smarmy lawyer on TV trying to convince me he can get me my "rightful" disability claim.
Thai makes reference to this problem I think and I agree.
The obviously disabled do not need me arguing their case in court.
LOL!!
... You did deserve that John ;-)
So if there is some kind of global cop, what happened?
I'm not at all aware of the historical details that got us here. But how did we get to 20% of all monies?
PS- fractals are enough;-)
I am not sure what I got Thai from JP. Notice I put Drs before lawyers, both less honorable than crack dealers or whores on the disability chuck wagon in my book. We are supposed to have some sort of ethical code that I don't think whores do.
Do not misunderstand my statements as me being preachy or somehow implying I am above this. I am in the gutter looking up at the stars.
The irony is not lost on me that I am making a terrific living off a system I find reprehensible. I just don't know what to do about it.
Re: "We are supposed to have some sort of ethical code that I don't think whores do."
Actually I think it is the whore in our profession that demanded we come up with a code. ;-)
Forgive me from diverging with you a bit (only a bit mind you) as I do love medicine and our profession. I truly am honored to call many of the people I work with colleague.
... FWIW, your frustration at the mess/prison we physicians have created for ourselves definitely includes you in that honor.
I do suggest you read Rich a bit more. He definitely helped clarify for me the issue of "Who do I serve?"
Physicians are not trained to think "what is the value of this relative to everything else my patient might do with these same resources"
Similarly, there is no framework to put the needs of the individual in the context of the needs of the many in most of medicine- yet I'm bless in the ED to have the word "Triage" staring me in the face every day that I work.
I am optimistic we will one day get agreement on these issues again, though I readily admit it may not be in my lifetime.
Lack of clarity in this regard is to no one's advantage long term.
Thai, I have been reading the Dr Rich blog on a regular basis. Please elaborate on how doing so helped you clarify "who you serve". John
JP, why does Okie say that? I am new. John
JP- My wife would say the same thing to you as well if she ever met you as (she's an ex attorney who volunteers pro bono occasionally for a group which assists low income individuals with their legal needs)
... Indeed, as I count, there are 6 Ivy League law school grad stay at home moms on my block and all of them refer to themselves "recovering ex-lawyers".
Lots of wasted education dollars on my block all to become stay at home moms.
Of course if you even question the waste of resources, you can imagine the responses it generates. ;-)
John- Rich was incredibly helpful in reminding me that I really do serve both masters and that a significant part of my training is to try and understand when to shift masters and frame the moral issues around this irreconcilable dilemma.
I only wish medical school and residency had done a better job illuminating this simple truth to me as I was training. Alas it was Rich who really helped me see the issue in its true unsolvable complexity.
FWIW, I do think it is a little easier for an ER doc because this issue faces us daily and the word "Triage" hangs right over our head. Unfortunate for many specialties like medicine or psychiatry, their training often makes it harder to come to grips with the fact that this issue is always there and that judgment is always required to balance the needs of the individual vs. the needs of the collective.
And further, that at some times, we will simply judge incorrectly through no fault of our own.
I think Rich is still having a harder time with this than I as Triage is not part of his mindset. As such, he has developed a kind of "neurosis resistant" model that takes a play from the legal profession to allow him to compartmentalize issues.
I have no problem with this, indeed I kind of like how it can give people the safety of an illusion that a distinction is there that is never really there. I do see how it can help some people continue to spend collective resources in a way that might be hard for say an attorney who really thought their client was going to kill again, etc...
I still think it is a kind of illusion but I guess we all have these/need them so this seems as good a one as any other I know.
... Now getting society to agree to it is another matter entirely. ;-)
You need to find a sugar momma
Alas I thought I had it made with mine but she was WAY smarter than I
So now I'm the breadwinner
At least I remains so while this debt bubble continues to fund me
Those RN anesthetists do incredibly well!
And I too made the same mistake and paying off all debt in 2003 after I got burned in the 200 crashed and I decided the whole thing was a crap shoot.
Alas I did not understand (and still don't to a large degree) currency issues like I do now
Long term I probably has been a wash but it sure was hard to watch that property bubble when it went up up up.
No one tells you this stuff growing up.
FWIW, this was also why I was so impressed with Windward when I first listened to them in 2005.
They told me three simple things:
1. You need to be in all asset classes all the time
2. They think you will never beat the index over the long term for any given market/asset class
3. They think they see an inefficiency in the valuation of asset classes relative to each other that others do not and this is what you are paying them 1% for.
So they buy only index ETFs and try to over or underweight asset classes (a little) with a bunch of computers crunching fuzzy logic/complex-chaotic models which have back tested relationship models over varying ranges for all the interrelationships to the different asset classes they follow.
I can send you a brochure if you want.
By the way, what do you think of this?
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