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McAllen, TX: America's Destiny?
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After the Washington Post ran a big article about how nobody in McAllen, TX down on the Mexican border can understand why anybody in the rest of the country is worried about immigration’s effects, readers keep pointing out Bottom Ten lists of cities featuring McAllen. For example, from 247WallSt:

Ten Cities Where Young People Can’t Find Work
By Vince Calio and Thomas C. Frohlich April 1, 2014 4:52 am EDT

… #1 McAllen-Edinburg-Mission, Texas
> Employment rate, ages 20-24: 50.6%
> Total unemployment rate: 11.0% (7th highest)
> Pct. high school graduate or higher: 63.5% (the lowest)
> Median household income: $33,761 (the lowest)

As of 2012, just 50.6% of McAllen area adults under 25 years old had a job — the lowest rate in the country. Unlike many of these cities, the employment rate of young adults has been low for some time, barely falling from 2000 to 2012. One contributing factor may have been the low educational attainment among young adults. Just 4.2% of adults ages 20 to 24 had a college degree, the fourth lowest rate of any major metro area. Residents of the McAllen metro area were also among the nation’s poorest. As of 2012, 34.5% of McAllen area residents lived below the poverty line, the second highest percentage in the nation and more than double the national rate of 15.9%.

 
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  1. BenKenobi says:

    I’m pretty sure during the election “McAllen, TX” was Reason #7 on Letterman’s ‘Top Ten Reasons I’m With Her.”

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  2. theguardian.com article on “white male fragility” and mass shootings. Procedes to linst “white male” shooters.

    Mass shootings show why we must stop pandering to white male fragility

    Jarrod Ramos…Dimitrios Pagourtzis…Omar Mateen…Nikolas Cruz…

    Read More
    • Replies: @El Dato
    It's the usual feminist writing. These are the people wearing T-Shirts saying "feminism is the future" while they check in the nearby muslim neighborhood for signs of oppression by marching fascists.

    “In many of these mass shootings,” Jennifer Wright observed at Harper’s Bazaar, “the desire to kill seems to be driven by a catastrophic sense of male entitlement.” That sense of entitlement may well be the greatest threat to what remains of civil society.
     
    Because this is what George Orwell was actually writing about in "1984": Winston Smith's sense of male entitlement and his persistent stalking behaviour got Julia sent to the rape cellar and then the glue factory.
    , @Hunsdon
    For a given definition of white, yeah.
    , @AndrewR
    O wise one, if it suits you to deign yourself to help a simple fool like me, please tell us who should be counted as White™ and who shouldn't.
    , @Tiny Duck
    The truth hurts

    Also race is a social construct and state of mind so shooting people is an incredibly white male thing to do
    , @Reg Cæsar

    rightwing “provocateur” Milo Yiannopoulos...

    Not all misogynists are violent...
     
    No, some of them, like Milo, express their misogyny by choosing to share a bed with anyone but a woman.

    Every description of "MSM" activity I've come across induces a similar feeling: "You've really got to hate women to prefer men. Gag."
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  3. I examined McAllen’s homicide rate for the past 5 years. The average homicide rate was 2.0 per 100,000 inhabitants. For comparison, the Non-Hispanic White homicide rate was roughly 2.6 per 100,000.

    For the previous 5 years, McAllen had a violent crime rate of 73 incidents per 100,000 inhabitants. The national rate was 209 incidents per 100,000 inhabitants.

    For the previous 5 years, McAllen had a property crime rate of 241 incidents per 100,000 inhabitants. The national rate was 237 incidents per 100,000 inhabitants.

    So it appears that McAllen is a fairly safe city to live in.

    Read More
    • Replies: @guy lombardo
    Yeah, it's ridiculously safe. Even the national crime rate is outrageously low in America. 209 out of 100,000 people victims of violent crime? It almost feels like a national embarrassment. Whatever happened to tough guys like me who beat people up? And to think that rate is significantly lower than it was 28 years ago when we had a white majority.
    , @Savage Indifference
    McAllen is not unpleasant. It used to be best-known as a place for moderately wealthy Texans to fly down and play golf. It is the MSA of Hidalgo County and parts of Starr County as a whole that must be fueling this. Lots of colonia-dwellers.

    My impression is that the state and feds pour money into higher education spending there - a friend from the Valley says "leadership" degrees are all the rage.
    , @Hippopotamusdrome


    I examined McAllen’s homicide rate for the past 5 years.

     

    Mcallen with a Black population of 00.4% has a lower crime rate than 12% Black USA. And then still manages to have higher property crime rate.
    , @Neoconned
    I walked around downtown El Paso in the middle of the night both last summer and in 2016. Mind you most of the shops downtown have metal burglar grates on them but what spooked me more was that even in the afternoon as you walk between the skyscrapers there are very few people around once you get away from the border area where the flea market shops are locayed.

    Most of what you see are homeless black dudes....

    I felt completely safe walking around El Paso at night and if anything I think I scared people.

    As was explained to me....El Paso has a huge law enforcement presence and thus there isn't much crime. I didn't even find streerwalkers. The Mexican guys told me to cross the river into Juarez for that kinda zhit.

    Brownsville and McAllen are the same.

    Huge state and federal law enforcement presence so not as much riff raff and bs.

    As for property crime....pronanly illegals stealing shit to aid their move north.
    , @TWS
    You want a cookie for that? Your big argument is that they don't commit crime ask that often? You're not supposed to commit any crime.
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  4. In the top 10 of the best US cities named after somebody Scottish? (not until we get Trump, USA, of course)

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  5. McAllen, Texas is what the cloud people want our entire nation to look like.

    It seems like a place where Frederico Reed would feel right at home.

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  6. angmojo says:

    Not to mention the several articles that made Atul Gawande’s writing career when he profiled the largess and inefficiency of McAllen’s health care system as well as the ill health of its residents:

    https://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

    Read More
    • Replies: @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.
    , @Jimi
    Close reading of the article reveals that doctors of McAllen are making millions of dollars by over-treating and over-diagnosing a diffident, ignorant population of immigrants and their children. Most of this funded by Medicaid and Medicare.
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  7. https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen’s per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen’s housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen’s residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen’s inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    Read More
    • Replies: @3g4me
    @7 JohnnyWalker123: "McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there."

    Gee, ya think? Wow Steve, Picketty's compatriot is secretly frequenting your blog with all his numbers and statistics and a complete lack of understanding of the racial reality or true character of heritage America.

    Johnny, you have to go back.
    , @Twinkie

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    I grant you some people around here throw around that term excessively. However, McAllen (or other Hispanic ghettoes) doesn’t seem “that bad” in comparison to black ghettoes and other dysfunctional places, because there are still many more nicer places. When 40%+ of the country becomes like McAllen and nice places become more scarce...

    As others mentioned, historically, border areas (or marches) have been wilder, seedier places. You can live with a thin strip of that without impacting the quality of life in the core. But when that border zone becomes very deep, the core won’t stay nice much longer.
    , @syonredux

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    Heck, compared to Haiti, it looks pretty great.....

    Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.
     
    Not to mention the third and fourth generation Latinx who live there....

    When boxes of original files from a 1965 survey of Mexican Americans were discovered behind a dusty bookshelf at UCLA, sociologists Edward Telles and Vilma Ortiz recognized a unique opportunity to examine how the Mexican American experience has evolved over the past four decades. Telles and Ortiz located and re-interviewed most of the original respondents and many of their children. Then, they combined the findings of both studies to construct a thirty-five year analysis of Mexican American integration into American society. Generations of Exclusion is the result of this extraordinary project.

     


    Generations of Exclusion measures Mexican American integration across a wide number of dimensions: education, English and Spanish language use, socioeconomic status, intermarriage, residential segregation, ethnic identity, and political participation. The study contains some encouraging findings, but many more that are troubling. Linguistically, Mexican Americans assimilate into mainstream America quite well—by the second generation, nearly all Mexican Americans achieve English proficiency. In many domains, however, the Mexican American story doesn’t fit with traditional models of assimilation. The majority of fourth generation Mexican Americans continue to live in Hispanic neighborhoods, marry other Hispanics, and think of themselves as Mexican. And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

     

    https://www.amazon.com/Generations-Exclusion-Mexican-Americans-Assimilation-Race/dp/0871548496
    , @Jack D

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.
     
    One thing you can say for Mexicans is that they are long lasting. Despite the fact that Mexico spends like 5 cents on its health care system and we spend trillions, life expectancy there is within spitting distance of the US. I assume it is the usual suspects - favorable genetics, a native diet that is healthier than the US diet (although obesity is climbing in Mexico too) and a lifestyle that involves more activity. These things have a bigger influence on life expectancy than all those MRI machines and other worthless crap that drive up US healthcare costs.
    , @Talleyrand
    Have you ever been to McAllen? I have. It is a hell hole.
    , @AnotherDad
    Johnny you're just pointing out that McAllen is not terrible but ... mediocre. (Which i believe was the point of Steve's post.)

    Hispanics do not create black ghetto conditions. Especially not in violent crime--or at least murderously violent crime. Latin Americans are not dysfunctional at modern life. But the standards--including critical standards like corruption, rule-of-law--are just mediocre across the board.

    These McAllen economic numbers run roughly 25% below national norms, and that's being attached to the still predominately white American economy, getting an inflow of social security and pension dollars through the snowbird influx. Separate these folks from the US and the numbers would tumble toward Mexican numbers at 25% or so of developed white nations.

    What you simply don't get--will never get--from these McAllens is anything dynamic. No Boeings, no Microsofts, no Amazons, no Intels, no GE jet engines and medical devices, no Qualcoms, no International Harvester (whatever they call it now), John Deere, Caterpillar, Ford, no Mayo Clinic or John Hopkins, no Space X, no Tesla, no great research universities, no human genome project, etc. etc. McAllen--and every place like it--muddle along, but never produces anything that anyone else would want.

    That's the problem.

    The US could drag along a bunch of Hispanics, as it has dragged along blacks. In fact it would be much, much easier to drag along a similar or even larger number of Hispanics than blacks. The Hispanics actually work at useful--though usually low-skill--jobs and don't destroy prime urban real estate with violent crime.

    However if you Hispanify the joint, eventually the sheer mediocrity catches up with you. You're no longer the dynamic white nation that creates the standard of living we enjoy. All the technical advance will be in East Asia and whatever European remanants remain. And we're stuck living in McAllens from sea to shining sea.
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  8. 3g4me says:
    @JohnnyWalker123
    https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen's per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen's housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen's residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen's inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn't sound a particularly inspiring place, but it's hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    @7 JohnnyWalker123: “McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.”

    Gee, ya think? Wow Steve, Picketty’s compatriot is secretly frequenting your blog with all his numbers and statistics and a complete lack of understanding of the racial reality or true character of heritage America.

    Johnny, you have to go back.

    Read More
    • Replies: @JohnnyWalker123

    Johnny, you have to go back.

     

    and you have to lay off the bottle. I'm starting to get worried about you.
    , @JohnnyWalker123

    Wow Steve, Picketty’s compatriot is secretly frequenting your blog with all his numbers and statistics
     
    Let me explain something to you. Make sure to read this slowly.

    "Numbers" and "statistics" are useful metrics for gaining an understanding of the world around us. This is why the "government" gathers this information.

    By looking at these "numbers" and "statistics," you can see a glimpse of the situation on the ground in a particular area. This is why we want to know the poverty rate, median income, college attainment, labor force participation, etc.

    It seems like you've lived many years in this world without actually learning anything. So it'd probably be a good idea to read up on some of these metrics that I've included in my posts.
    , @Jack D

    and a complete lack of understanding of the racial reality or true character of heritage America.
     
    I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white "heritage America" of your imagination never existed, at least not in McAllen.
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  9. @angmojo
    Not to mention the several articles that made Atul Gawande's writing career when he profiled the largess and inefficiency of McAllen's health care system as well as the ill health of its residents:

    https://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

    My cousin (who’s a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would’ve made up here.

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen’s doctors are so rich. McAllen’s doctors are getting rich through outright fraud.

    It’d be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of “overutilization.” That’s one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who’ve committed billing fraud, there are lot of immigrant names. “White Hispanics” (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there’s less opportunity for fraud.

    Read More
    • Replies: @Twinkie

    Especially those with their own independent practices.
     
    Those are a dying breed, especially in desirable places to live. Border areas of Texas? Not so much.
    , @Karl
    9 JohnyWalker123 > overutilization

    so patronize a cash-only doctor. There's many, they even have an association.

    And many more of them, than even ADVERTISE it.... if you ask correctly. Very few things in life, are truly non-negotiable.


    High-unemployment rate of 20-24 aged Latina females.... what's not to like?
    , @ben tillman

    My cousin (who’s a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would’ve made up here.

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen’s doctors are so rich. McAllen’s doctors are getting rich through outright fraud.

    It’d be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of “overutilization.”
     
    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants "engage in a very high rate of 'overutilization'”.
    , @ben tillman

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures.
     
    In other words, low-trust, third-world corruption. Which is why we need to turn the whole country into McAllen.
    , @george
    McAllen #1 in unnecessary care! But is it also #1 for needed but not performed care?

    “The Cost Conundrum,” which explored the problem of unnecessary care in McAllen, Texas, a community with some of the highest per-capita costs for Medicare in the nation.

    Overkill
    An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

    https://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

    BTW, author Atul Gawande (who let the Gawandes into this country) would become the point man Bezos Buffett Diamond chose for their new healthcare alliance. For the sake of McAllen, let's wish this son of immigrants well.

    , @Anonymous
    Any patterns among white names? What about Asians?
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  10. Jimi says:
    @angmojo
    Not to mention the several articles that made Atul Gawande's writing career when he profiled the largess and inefficiency of McAllen's health care system as well as the ill health of its residents:

    https://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

    Close reading of the article reveals that doctors of McAllen are making millions of dollars by over-treating and over-diagnosing a diffident, ignorant population of immigrants and their children. Most of this funded by Medicaid and Medicare.

    Read More
    • Replies: @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.
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  11. @3g4me
    @7 JohnnyWalker123: "McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there."

    Gee, ya think? Wow Steve, Picketty's compatriot is secretly frequenting your blog with all his numbers and statistics and a complete lack of understanding of the racial reality or true character of heritage America.

    Johnny, you have to go back.

    Johnny, you have to go back.

    and you have to lay off the bottle. I’m starting to get worried about you.

    Read More
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  12. @3g4me
    @7 JohnnyWalker123: "McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there."

    Gee, ya think? Wow Steve, Picketty's compatriot is secretly frequenting your blog with all his numbers and statistics and a complete lack of understanding of the racial reality or true character of heritage America.

    Johnny, you have to go back.

    Wow Steve, Picketty’s compatriot is secretly frequenting your blog with all his numbers and statistics

    Let me explain something to you. Make sure to read this slowly.

    “Numbers” and “statistics” are useful metrics for gaining an understanding of the world around us. This is why the “government” gathers this information.

    By looking at these “numbers” and “statistics,” you can see a glimpse of the situation on the ground in a particular area. This is why we want to know the poverty rate, median income, college attainment, labor force participation, etc.

    It seems like you’ve lived many years in this world without actually learning anything. So it’d probably be a good idea to read up on some of these metrics that I’ve included in my posts.

    Read More
    • Replies: @Twinkie

    “Numbers” and “statistics” are useful metrics for gaining an understanding of the world around us. This is why the “government” gathers this information.
     
    I agree that objective quantification is very useful and, yes, necessary. Sometimes they can disabuse people of wrongly held prejudices and false myths. But, it is not everything - it doesn’t, for example, capture well real world phenomena such as degradation of culture and loss of civics that have real, profound, and long-term consequences.
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  13. Thomas says:

    OT:

    Pretty much full-on emergency: McConnell snatching defeat from victory by pushing "Maximum Immigration" Kethledge for SCOTUS. All possible pushback needed. Try calling McConnell's Senate office 202 224-2541 if can't get through to Leader's office via switchboard (202 224 3121) https://t.co/6QBkBO8201— Mickey Kaus (@kausmickey) July 8, 2018

    Read More
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  14. Twinkie says:
    @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.

    Especially those with their own independent practices.

    Those are a dying breed, especially in desirable places to live. Border areas of Texas? Not so much.

    Read More
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  15. Twinkie says:
    @JohnnyWalker123
    https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen's per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen's housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen's residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen's inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn't sound a particularly inspiring place, but it's hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.

    I grant you some people around here throw around that term excessively. However, McAllen (or other Hispanic ghettoes) doesn’t seem “that bad” in comparison to black ghettoes and other dysfunctional places, because there are still many more nicer places. When 40%+ of the country becomes like McAllen and nice places become more scarce…

    As others mentioned, historically, border areas (or marches) have been wilder, seedier places. You can live with a thin strip of that without impacting the quality of life in the core. But when that border zone becomes very deep, the core won’t stay nice much longer.

    Read More
    • Replies: @JohnnyWalker123

    When 40%+ of the country becomes like McAllen and nice places become more scarce…

     

    I don't disagree with this. If 40% of the country is McAllen, that'd be different than if (let's say) 20% of America is McAllen. The national dynamics change as the proportion increases.

    Sometimes they can disabuse people of wrongly held prejudices and false myths. But, it is not everything – it doesn’t, for example, capture well real world phenomena such as degradation of culture and loss of civics that have real, profound, and long-term consequences.

     

    True enough, but living in a socially atomized, uncultured Walmartville isn't quite the same thing as living in a favela. Though both may be less than optimal.

    Of course if you look at the people who've been fighting against the Walmartization of America for decades, it's generally been the far left types. Like Michael Moore and Ralph Nader.

    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy – both government and non-profit – that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.

     

    The "wild west" comment was in reference to the overall economy.

    However, I do think that with respect to prescribing painkillers, we sort of were operating in that type of "wild west" atmosphere for many years. That's why we have an opioid epidemic.
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  16. Twinkie says:
    @JohnnyWalker123

    Wow Steve, Picketty’s compatriot is secretly frequenting your blog with all his numbers and statistics
     
    Let me explain something to you. Make sure to read this slowly.

    "Numbers" and "statistics" are useful metrics for gaining an understanding of the world around us. This is why the "government" gathers this information.

    By looking at these "numbers" and "statistics," you can see a glimpse of the situation on the ground in a particular area. This is why we want to know the poverty rate, median income, college attainment, labor force participation, etc.

    It seems like you've lived many years in this world without actually learning anything. So it'd probably be a good idea to read up on some of these metrics that I've included in my posts.

    “Numbers” and “statistics” are useful metrics for gaining an understanding of the world around us. This is why the “government” gathers this information.

    I agree that objective quantification is very useful and, yes, necessary. Sometimes they can disabuse people of wrongly held prejudices and false myths. But, it is not everything – it doesn’t, for example, capture well real world phenomena such as degradation of culture and loss of civics that have real, profound, and long-term consequences.

    Read More
    • Agree: TheBoom
    • Replies: @Yak-15
    It’s also likely that statistics vastly undercount criminality amongst a population hesitant to report crime to police who also view crime through a very different cultural lens. I imagine petty larceny and trespassing is reported at 5% of occurrences.
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  17. @Jimi
    Close reading of the article reveals that doctors of McAllen are making millions of dollars by over-treating and over-diagnosing a diffident, ignorant population of immigrants and their children. Most of this funded by Medicaid and Medicare.

    It’s outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.

    True enough, but it’s not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, “speaking” fees,” “consulting” jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive “pill mills”), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it’s nice to live in a country that tightly regulates the private sector. It’s nice to live in a country with health and safety regulations. It’s also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a “wild west” free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the “socialist” nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not “high-investment k-strategists.” Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need “big govt” and “socialism” to take care of them.

    Read More
    • Replies: @JohnnyWalker123
    This is the type of stuff that White-Americans need.

    https://www.youtube.com/watch?v=SnI_Mw_Yjv8

    Even conservatives are realizing what happens when you let the "free market" run wild.

    https://www.youtube.com/watch?v=nbWMPlBpl8I

    Capitalism run amok.

    https://www.youtube.com/watch?v=NPIrV4MMcqw

    It's not just "NAMs" who have difficulty surviving and competing in the "free market."
    , @Jimi
    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.
    , @Twinkie

    When you live in a “wild west” free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population.
     
    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy - both government and non-profit - that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.
    , @El Dato

    This is why it’s nice to live in a country that tightly regulates the private sector. It’s nice to live in a country with health and safety regulations.

     

    Uh... yes? Is this the twin situation of demanding "gun controls" in a country with gun controls?

    How Government Regulations Made Healthcare So Expensive


    Since the early 1900s, medical special interests have been lobbying politicians to reduce competition. By the 1980s, the U.S. was restricting the supply of physicians, hospitals, insurance and pharmaceuticals, while subsidizing demand. Since then, the U.S. has been trying to control high costs by moving toward something perhaps best described by the House Budget Committee: “In too many areas of the economy — especially energy, housing, finance, and health care — free enterprise has given way to government control in “partnership” with a few large or politically well-connected companies” (Ryan 2012). The following are past major laws and other policies implemented by the Federal and state governments that have interfered with the health care marketplace (HHS 2013): ...

    The history of medical cost inflation and government interference in health care markets appears to support the hypothesis that prices were set by the laws of supply and demand before 1980 and perhaps 1990. Even the degree of monopolization and nationalization promoted by politicians before 1965 was not enough to cause significant cost inflation and spending increases (Figure 2) until demands created by Medicare and Medicaid outstripped the restricted supply of physicians and hospitals.
     

    It's like the subsidized schoolbook price inflation. Dog-standard schoolbooks that should be a couple of bucks are sold at Springer-level specialist pricing. Because somebody else pays for them.

    The lack of competition between hospitals and other health care institutions also limited cost control incentives placed on executives. The lack of competition between both medical institutions and the doctors that control most of their spending could explain why hospital costs have been inflating twice as fast as even physician fees. Hospitals are loaded with waste and inefficiency. For example, a hospital stitch costs more than $500 today.

    Health care may be the only industry in which suppliers blame technology for high costs. But researchers at the Robert Wood Johnson Foundation reported that small medical expenses controlled by physicians, such as blood tests and ordinary x-rays, were responsible for medical inflation, not complex technologies. The article stated that if the annual operating costs of the nation's more complex technologies — kidney dialysis, coronary bypass, electronic fetal monitoring, and computerized x-rays — were reduced one-half, the net savings would be less than one percent of the nations medical bill. They proposed income incentives for physicians as motivation for cost control (Robert 1979).
     

    , @jill
    Note most of the Medicare fraud fugitives are foreigners. They come to America, set up Medicare mills, loot 24/ 7 till caught, then they flee after being released on bail.

    I actually believe Congress welcomes this type of fraud. Why else let it continue?


    https://oig.hhs.gov/fraud/fugitives/profiles.asp#other-fugitives
    , @IBC
    I agree with most of what you're saying and especially with your apparent sentiments, but consider that opiate abuse is also a major problem in Canada. In fact, depending on the source, Canada is the number-one per-capita consumer of prescription opiates; or they're only second to the US:

    https://canadians.org/blog/who-behind-canadas-opioid-epidemic

    http://healthydebate.ca/2014/01/topic/politics-of-health-care/prescription-opioid-crisis-canada

    But it does seem like pharmaceutical lobbying and over-prescribing doctors are major factors in both countries.
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  18. syonredux says:
    @JohnnyWalker123
    https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen's per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen's housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen's residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen's inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn't sound a particularly inspiring place, but it's hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.

    Heck, compared to Haiti, it looks pretty great…..

    Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    Not to mention the third and fourth generation Latinx who live there….

    When boxes of original files from a 1965 survey of Mexican Americans were discovered behind a dusty bookshelf at UCLA, sociologists Edward Telles and Vilma Ortiz recognized a unique opportunity to examine how the Mexican American experience has evolved over the past four decades. Telles and Ortiz located and re-interviewed most of the original respondents and many of their children. Then, they combined the findings of both studies to construct a thirty-five year analysis of Mexican American integration into American society. Generations of Exclusion is the result of this extraordinary project.

    Generations of Exclusion measures Mexican American integration across a wide number of dimensions: education, English and Spanish language use, socioeconomic status, intermarriage, residential segregation, ethnic identity, and political participation. The study contains some encouraging findings, but many more that are troubling. Linguistically, Mexican Americans assimilate into mainstream America quite well—by the second generation, nearly all Mexican Americans achieve English proficiency. In many domains, however, the Mexican American story doesn’t fit with traditional models of assimilation. The majority of fourth generation Mexican Americans continue to live in Hispanic neighborhoods, marry other Hispanics, and think of themselves as Mexican. And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

    https://www.amazon.com/Generations-Exclusion-Mexican-Americans-Assimilation-Race/dp/0871548496

    Read More
    • Replies: @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?
    , @Intelligent Dasein

    And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.
     
    Apropos of this very subject, Stefan Molyneux has a new video up (helpfully hosted on this very website) in which he discusses the fact that 70% of wealthy families have lost their wealth by the second generation and a stunning 90% have lost theirs by the third generation. If poor Hispanics migrating to America and instantly benefiting from access to American largess can be conceived of as analogous to a windfall or an "inheritance," then there is every reason to expect that similar dynamics would apply in their case. In other words, it is not a lack of integration that causes Hispanics to fall behind by the second, third, and fourth generations; it is simply the ever-present human tendency to fritter away the wealth of the past. We should not expect one-way upward mobility from Hispanics when we cannot reasonably expect it from anyone else, either.

    And this dovetails nicely with a point that I often think about but seldom mention, viz. the self-immolation of the American middle class. It is customary in Alt-Right circles to discuss middle class woes in terms of globalism, greedy oligarchs, and spendthrift socialist governments, but are these things a cause or an effect of the current problems? I would say they are at least as much effect as cause, for it's not as if the middle class had no agency in producing its present tribulations. Nobody forced the great bulk of Americans to buy houses and cars they couldn't afford or to adopt a consumerist lifestyle on credit.

    I would say that the American middle class miracle, especially as it pertains to the Baby Boom generation, was the one-off result of certain well-known factors, notably the emergence of the US industrial as base as the sole survivor of WWII, which happened to coincide nicely with the era of cheap oil, thus allowing us to thoroughly exploit the abundance of the great North American continent and to dollar-imperialize the rest of the world. This was the "inheritance." And the Boomers, true to form, spent money like it was going out of style, living well beyond their means while the bank balance steadily drained away. Now everyone today speaks of the Millennials as a generation of spoiled brats who want everything handed to them and who do not know how to work or even why they should have to. But really this is precisely what we should expect of them. That generation as a whole is living out the persona of the sulky, third- or fourth-generation rich kid who never developed any connection with productive society, whose only talent consists in being accustomed to the arrogance and power of wealth but who no longer has any, and who therefore descends into a morally blighted lifestyle which may include substance abuse, perverse sexuality, crime, and revolutionary politics.

    On this view, we must say that the ongoing liquidation of the American middle class is not something entirely attributable to the depredations of a globalist elite, but is in many ways an historically inevitable reversion to the mean. And while the elite certainly are not innocent, the middle class itself bears its own share of the blame in the crisis that is about to befall us. I've always appreciated how this fact was summed up in the famous scene from Margin Call.

    https://www.youtube.com/watch?v=2f2kGHcdJYU
    , @Seth Largo
    That overview matches my maternal family's experience. Squandering the hard work of our parents and grandparents seems to be the general rule among my many cousins. But they're all 100% assimilated . . . to lower class white, dude-bro, school-sucks, drink-every-night norms, unfortunately.

    As far as third and fourth gen. Hispanics "continuing to live in Hispanic neighborhoods," well that's because the majority of Hispanics live in places where Hispanics are the majority. Hell, my mom married a gringo and I hang out at i-Steve, but even the SoCal neighborhood I'm typing this from could be considered "Hispanic" by some measures. Because it's a SoCal neighborhood.
    , @JohnnyWalker123
    According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became "White." However, less successful Hispanics in-married and remained in ethnic enclaves. So the typical 3rd/4th generation Hispanic represents the least successful element of the population.

    At least that was Ron Unz's interpretation and analysis. I'm not sure if he's correct, but his analysis seems plausible to me.
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  19. @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.

    This is the type of stuff that White-Americans need.

    Even conservatives are realizing what happens when you let the “free market” run wild.

    Capitalism run amok.

    It’s not just “NAMs” who have difficulty surviving and competing in the “free market.”

    Read More
    • Replies: @Anon
    You make a good point . I will play devils advocate. No one put a gun to their head and forced them to take opiates. It has been well known for a very long time that they are highly addictive , yet people seek them out and doctor shop etc.

    My wife had a C section with one of our children and was prescribed opiods , which she never used . If she was able to tough it out , I suspect many others could do the same and forego opiods.
    , @Aardvark
    Bernie loves to portray himself as a sort of modern day Robin Hood. He will “alleviate” these evil capitalists of their ill gotten gain and correct their wrong doings. Except that zero of the money collected in fines will ever flow to the true victims.

    They (the Bernie’s of the political landscape) know the revolving door between the pharma industry and the FDA. Isn’t the government supposed to “protect” us? Aren’t we told we can’t live our lives without government there to “save” us? If Government had been able to protect us, why did the opioid crisis ever happen in the first place? Socialists will always champion massive regulation and when it fails, the socialist runs way from it like a stinky diaper and blames the smell on a nearby capitalist. People who love to blame capitalism for failures of government live in some imaginary world where regulation has zero effect on anything.
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  20. Jimi says:
    @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.

    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.

    Read More
    • Replies: @Twinkie

    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.
     
    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).
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  21. Karl says:
    @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.

    9 JohnyWalker123 > overutilization

    so patronize a cash-only doctor. There’s many, they even have an association.

    And many more of them, than even ADVERTISE it…. if you ask correctly. Very few things in life, are truly non-negotiable.

    High-unemployment rate of 20-24 aged Latina females…. what’s not to like?

    Read More
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  22. I forget, are the immigrationistas for or against income inequality.

    Read More
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  23. @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.

    My cousin (who’s a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would’ve made up here.

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen’s doctors are so rich. McAllen’s doctors are getting rich through outright fraud.

    It’d be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of “overutilization.”

    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants “engage in a very high rate of ‘overutilization’”.

    Read More
    • Replies: @ben tillman

    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants “engage in a very high rate of ‘overutilization’”.
     
    But, to be sure, it does go beyond that, and the genesis of the health-care boondoggle is the central government's imposition of wage freezes in the 1940's to induce employers to offer health insurance to workers in place of (illegal) wage increases. That's how the central government separated the patient from payment, which is 90% of the problem.
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  24. @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures.

    In other words, low-trust, third-world corruption. Which is why we need to turn the whole country into McAllen.

    Read More
    • Replies: @CCZ
    "Which is why we need to turn the whole country into McAllen."

    The question is, how much will become "McAllenized" and how much will become "Seattleized"?

    https://www.youtube.com/watch?v=pCloTOCdJSs
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  25. No, not all of it. Just the parts outside of their gated communities.

    Read More
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  26. @ben tillman

    My cousin (who’s a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would’ve made up here.

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen’s doctors are so rich. McAllen’s doctors are getting rich through outright fraud.

    It’d be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of “overutilization.”
     
    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants "engage in a very high rate of 'overutilization'”.

    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants “engage in a very high rate of ‘overutilization’”.

    But, to be sure, it does go beyond that, and the genesis of the health-care boondoggle is the central government’s imposition of wage freezes in the 1940′s to induce employers to offer health insurance to workers in place of (illegal) wage increases. That’s how the central government separated the patient from payment, which is 90% of the problem.

    Read More
    • Replies: @Twinkie

    That’s how the central government separated the patient from payment, which is 90% of the problem.
     
    You got that right. Medical insurance is bizarre in the U.S. in that it is EXPECTED to be used and used heavily. Is it any wonder it is costly?

    Imagine how expensive other forms of insurance would be if they had similar payout rates.
    , @MBlanc46
    Third-party payment is the principal part of the high cost of medical care. I have a hard time conceiving of a fee-for-service model in modern circumstances. Anyone know of serious research on this?
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  27. Anon[358] • Disclaimer says:
    @JohnnyWalker123
    This is the type of stuff that White-Americans need.

    https://www.youtube.com/watch?v=SnI_Mw_Yjv8

    Even conservatives are realizing what happens when you let the "free market" run wild.

    https://www.youtube.com/watch?v=nbWMPlBpl8I

    Capitalism run amok.

    https://www.youtube.com/watch?v=NPIrV4MMcqw

    It's not just "NAMs" who have difficulty surviving and competing in the "free market."

    You make a good point . I will play devils advocate. No one put a gun to their head and forced them to take opiates. It has been well known for a very long time that they are highly addictive , yet people seek them out and doctor shop etc.

    My wife had a C section with one of our children and was prescribed opiods , which she never used . If she was able to tough it out , I suspect many others could do the same and forego opiods.

    Read More
    • Replies: @Jack D
    Maybe not everyone is as tough as your wife. There have been times when I have been prescribed opiates after surgery and I have been very glad that they were available. No one should be forced to bear unbearable pain when it is possible to relieve it with medication. However, I found them to be constipating (a known side effect) and derived no real enjoyment from them (other than pain relief) and could not wait to get off of them as soon as my pain subsided. But a certain % of the population becomes rapidly addicted. This is a terrible problem but I am glad that I did not have to suffer in pain because those people exist. People with addictions will obtain drugs anyway through illegal means so making it impossible to prescribe necessary pain relief to people in pain doesn't fix the problem and causes people suffering pain to suffer unnecessarily. If my doctor's answer was "you have to tough it out because some other people are addicts" I would not have been happy.

    I agree that the "addiction as disease" model is in some respects false. You can chose to quit taking pills but you can't chose to quit having cancer. There is a voluntary element to addiction but the urges are strong and not everyone has the strength to quit. But just calling it a "disease" implies that there is no element of choice involved and that is false.
    , @carol
    Gee it's nice to have a bogeyman everyone can safely agree on. Teh doctorz, Big Pharma!

    A close friend recently died after dealing with cancer for 7 years. He stayed very active in music and tried to live normally...the only things that kept him going all that time were caffeine and Lortabs.

    I just hope we'll still be able to get opioids for similar circumstances when this latest hysteria blows over. Assume we'll still have caffeine.
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  28. @JohnnyWalker123
    I examined McAllen's homicide rate for the past 5 years. The average homicide rate was 2.0 per 100,000 inhabitants. For comparison, the Non-Hispanic White homicide rate was roughly 2.6 per 100,000.

    For the previous 5 years, McAllen had a violent crime rate of 73 incidents per 100,000 inhabitants. The national rate was 209 incidents per 100,000 inhabitants.

    For the previous 5 years, McAllen had a property crime rate of 241 incidents per 100,000 inhabitants. The national rate was 237 incidents per 100,000 inhabitants.

    So it appears that McAllen is a fairly safe city to live in.

    Yeah, it’s ridiculously safe. Even the national crime rate is outrageously low in America. 209 out of 100,000 people victims of violent crime? It almost feels like a national embarrassment. Whatever happened to tough guys like me who beat people up? And to think that rate is significantly lower than it was 28 years ago when we had a white majority.

    Read More
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  29. CCZ says:
    @ben tillman

    It turns out that physicians in McAllen engage in a very high level of “overutilization.” Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures.
     
    In other words, low-trust, third-world corruption. Which is why we need to turn the whole country into McAllen.

    “Which is why we need to turn the whole country into McAllen.”

    The question is, how much will become “McAllenized” and how much will become “Seattleized”?

    Read More
    • LOL: AndrewR
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  30. Goatweed says:

    Off to see how many snow birds live in McAllen.

    Read More
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  31. Anon[425] • Disclaimer says:

    Mexicans are Browndo. They got electo-rights. What every city or town in the US needs is more Browndo.

    Read More
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  32. @syonredux

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    Heck, compared to Haiti, it looks pretty great.....

    Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.
     
    Not to mention the third and fourth generation Latinx who live there....

    When boxes of original files from a 1965 survey of Mexican Americans were discovered behind a dusty bookshelf at UCLA, sociologists Edward Telles and Vilma Ortiz recognized a unique opportunity to examine how the Mexican American experience has evolved over the past four decades. Telles and Ortiz located and re-interviewed most of the original respondents and many of their children. Then, they combined the findings of both studies to construct a thirty-five year analysis of Mexican American integration into American society. Generations of Exclusion is the result of this extraordinary project.

     


    Generations of Exclusion measures Mexican American integration across a wide number of dimensions: education, English and Spanish language use, socioeconomic status, intermarriage, residential segregation, ethnic identity, and political participation. The study contains some encouraging findings, but many more that are troubling. Linguistically, Mexican Americans assimilate into mainstream America quite well—by the second generation, nearly all Mexican Americans achieve English proficiency. In many domains, however, the Mexican American story doesn’t fit with traditional models of assimilation. The majority of fourth generation Mexican Americans continue to live in Hispanic neighborhoods, marry other Hispanics, and think of themselves as Mexican. And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

     

    https://www.amazon.com/Generations-Exclusion-Mexican-Americans-Assimilation-Race/dp/0871548496

    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    Read More
    • Replies: @AndrewR
    Latin equis?

    "I don't always adhere to PC idiocy, but when I do I say Latin Equis."

    , @Cloudbuster
    Why does "Latinx" even get used when there is the perfectly serviceable and accurate "Hispanic?"
    , @Father O'Hara
    LatinX sounds like a civil rights leader.
    , @Hippopotamusdrome


    Is it pronounced “Latinks”, which sounds kind of effeminate

     

    But it also sounds like lynx, which is a wildcat. Rawr.
    , @40 Acres and A Kardashian

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?
     
    Don't even use the word, let alone worry about pronouncing it correctly. That's just playing their game. Just call 'em Mexicans, even if some of them are from Colombia or Guatemala.
    , @Big Bill
    It's getting even more complicated. Recently the new SJW word "Chicanx" has appeared.

    I think it is pronounced "chih-CONKS". Or perhaps "chih-CAN-icks".

    If this "x" trend continues among our dusky south-of-the-border brethren it is going to get quite confusing.

    A Mexican fireman is a "bombero". Will he/she/it/xir soon be a "bomberx" [bomb-bear-icks"]? Will a postman (cartero) become a "car-TEAR-icks"? Will a cook (cocinero) be come a "ko-sin-AIR-icks"? A laundress (lavandera) become a "lah-vahn-derricks"?

    Whenever lefties re-engineer the lexicon, they should be required to agree on (and publish) the proper PC pronunciation. Perhaps it could be added to the NYT/LAT/WSJ style guides, at least for the first year or two.
    , @MBlanc46
    It used to be Latinas/Latinos, but I suppose that was homophobic or transphobic or something.
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  33. Twinkie says:
    @ben tillman

    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants “engage in a very high rate of ‘overutilization’”.
     
    But, to be sure, it does go beyond that, and the genesis of the health-care boondoggle is the central government's imposition of wage freezes in the 1940's to induce employers to offer health insurance to workers in place of (illegal) wage increases. That's how the central government separated the patient from payment, which is 90% of the problem.

    That’s how the central government separated the patient from payment, which is 90% of the problem.

    You got that right. Medical insurance is bizarre in the U.S. in that it is EXPECTED to be used and used heavily. Is it any wonder it is costly?

    Imagine how expensive other forms of insurance would be if they had similar payout rates.

    Read More
    • Agree: bomag
    • Replies: @MarkinLA
    How does insurance make patients overuse the system and cause the providers to bill 10 times what they know the insurance company will pay? Most insurance companies have to pre-approve procedures that cost more than a few hundred dollars or you pay. People are seeing insurance companies refuse to pay their emergency room visits even after the patient was told to do so by his primary care doctor's office.

    Why do patients have to pay for procedures that don't work or were needed because of the actions of the doctors in the first place - like when I was having an adverse drug reaction to a prescription medication? The hospital bill was 46,000 or which only 8000 was paid by insurance and me. Part of the reason I was there so long was because the normal medications I take to prevent for A-fib was not on the hospital's formulary and what they could give me didn't work so I sent two unnecessary days in the cardiac ward for something I normally just ignore.

    It seems the insurance companies are the only ones holding the line on costs. If I didn't have insurance, I would be legally liable for that whole 46,000.
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  34. Twinkie says:
    @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.

    When you live in a “wild west” free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population.

    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy – both government and non-profit – that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.

    Read More
    • Replies: @MarkinLA
    It is also true that NOBODY can tell anybody what to charge. It is highway robbery. What is regulated is what CAN be put on the market or what procedures CAN be done in US medical facilities. Remember that gyuy who tried to get rich by bying that small pharmaceutical company and gouging his patients.

    http://www.newsweek.com/pharma-bro-martin-shkreli-sentenced-years-jail-838242

    You can gouge terminally ill people all you want, just don't try and cheat investors.
    , @MBlanc46
    I’ve done some work in medical publishing. “Compliance” is a major topic of discussion.
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  35. Twinkie says:
    @Jimi
    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.

    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.

    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).

    Read More
    • Agree: Chrisnonymous
    • Replies: @bomag
    Thanks for the succinct analysis.

    I'd add administrative overhead. Healthcare has become a jobs program; an economic driver, with lots of hires for compliance, construction, maintenance, and all the ancillary activities.
    , @JohnnyWalker123
    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.

    In the same time period, median household income rose from $50,000 to $59,000.

    So physician median income rose by 26% over 7 years, but the median household income increased by merely 18%. So that's a fairly substantial difference, especially when you consider that the base salaries (50K vs 160K) are already so far apart.

    It'd be like if I got a $10,000/yr raise while the rest of you saw your incomes stagnate.

    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

     

    47% of physicians own their own practice. Which is extremely substantial.

    Your point is actually not correct. Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to "overutilize" the system. Not to the same extent as owner-operator physicians, but the incentive remains.

    You are correct that primary care physicians typically don't make $300,000/yr salaries, but specialists (who are around 2/3 of physicians) often make that level of income.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).

     

    "Overutilization" occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to "overutilize." Much like a mechanic has an incentive to claim that your brakes, engine, windshield, and tires are all defective and must be replaced immediately.

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates. See below quote.

    https://www.healthpopuli.com/2013/04/02/u-s-health-costs-vs-the-world-is-it-still-the-prices-and-are-we-still-stupid/

    A routine office visit to a doctor cost an average of $95 in the U.S. in 2012. The same visit was priced at $30 in Canada and $30 in France, as well. A hip replacement cost $40,364 on average in the U.S. in 2012. The total hospital and physician cost for a hip replacement in the UK was $11,889 and in France, $10,927.Apr 2, 2013

     

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.

    You're correct that other populations do seem to have better health habits, especially eating habits. America probably needs to do something to encourage better eating habits in the general population.

    Not stuff like this.

    https://www.youtube.com/watch?v=RpV4ot-VEyA
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  36. El Dato says:
    @Hippopotamusdrome
    theguardian.com article on "white male fragility" and mass shootings. Procedes to linst "white male" shooters.


    Mass shootings show why we must stop pandering to white male fragility
    ...
    Jarrod Ramos...Dimitrios Pagourtzis...Omar Mateen...Nikolas Cruz...

     

    It’s the usual feminist writing. These are the people wearing T-Shirts saying “feminism is the future” while they check in the nearby muslim neighborhood for signs of oppression by marching fascists.

    “In many of these mass shootings,” Jennifer Wright observed at Harper’s Bazaar, “the desire to kill seems to be driven by a catastrophic sense of male entitlement.” That sense of entitlement may well be the greatest threat to what remains of civil society.

    Because this is what George Orwell was actually writing about in “1984″: Winston Smith’s sense of male entitlement and his persistent stalking behaviour got Julia sent to the rape cellar and then the glue factory.

    Read More
    • Replies: @Bugg
    1993 WTC, 9/11, John Muhmmad, the Tsanrnaev brothers, Orlando, San Bernandino, Little Rock, Major Hassan, all proponents of inclusive anfd diverse feminist....uh....
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  37. El Dato says:
    @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.

    This is why it’s nice to live in a country that tightly regulates the private sector. It’s nice to live in a country with health and safety regulations.

    Uh… yes? Is this the twin situation of demanding “gun controls” in a country with gun controls?

    How Government Regulations Made Healthcare So Expensive

    Since the early 1900s, medical special interests have been lobbying politicians to reduce competition. By the 1980s, the U.S. was restricting the supply of physicians, hospitals, insurance and pharmaceuticals, while subsidizing demand. Since then, the U.S. has been trying to control high costs by moving toward something perhaps best described by the House Budget Committee: “In too many areas of the economy — especially energy, housing, finance, and health care — free enterprise has given way to government control in “partnership” with a few large or politically well-connected companies” (Ryan 2012). The following are past major laws and other policies implemented by the Federal and state governments that have interfered with the health care marketplace (HHS 2013): …

    The history of medical cost inflation and government interference in health care markets appears to support the hypothesis that prices were set by the laws of supply and demand before 1980 and perhaps 1990. Even the degree of monopolization and nationalization promoted by politicians before 1965 was not enough to cause significant cost inflation and spending increases (Figure 2) until demands created by Medicare and Medicaid outstripped the restricted supply of physicians and hospitals.

    It’s like the subsidized schoolbook price inflation. Dog-standard schoolbooks that should be a couple of bucks are sold at Springer-level specialist pricing. Because somebody else pays for them.

    The lack of competition between hospitals and other health care institutions also limited cost control incentives placed on executives. The lack of competition between both medical institutions and the doctors that control most of their spending could explain why hospital costs have been inflating twice as fast as even physician fees. Hospitals are loaded with waste and inefficiency. For example, a hospital stitch costs more than $500 today.

    Health care may be the only industry in which suppliers blame technology for high costs. But researchers at the Robert Wood Johnson Foundation reported that small medical expenses controlled by physicians, such as blood tests and ordinary x-rays, were responsible for medical inflation, not complex technologies. The article stated that if the annual operating costs of the nation’s more complex technologies — kidney dialysis, coronary bypass, electronic fetal monitoring, and computerized x-rays — were reduced one-half, the net savings would be less than one percent of the nations medical bill. They proposed income incentives for physicians as motivation for cost control (Robert 1979).

    Read More
    • Replies: @JohnnyWalker123
    It's actually pretty easy to buy a gun in this country.

    It also used to be very easy to get opioids in this country, mostly due to lax regulation. Regulations are so minimal that pharmaceutical companies flooded the market with painkillers.

    https://www.youtube.com/watch?v=QE7HrsnHhIc

    Your article actually makes some good points.

    One huge driver of high healthcare costs is that the AMA (the national union of American physicians) is basically a cartel. It seeks to constraint the number of American medical schools. It also restricts the ability of other healthcare providers (like mid-level nurses) to provide healthcare services. This results in high medical reimbursement (due to healthcare provider shortages) and an under supply of healthcare providers.

    Physicians provide valuable services, but their power over the healthcare industry has to be diminished.

    Competition could certainly bring down healthcare costs, but that assumes that consumers (ie sick patients) are in a position to make quick decisions concerning their healthcare. That may not be the case. If you're having a heart attack, are you really in a position to figure out whether you should go to Swedish or Kaiser? Is choosing between hospitals really the same as choosing between a Ford or a Toyota? Can the average American really understand what they're doing?

    In much of the first world, the govt has the authority to set healthcare procedure prices. That keeps costs reasonable. Even govt-provided healthcare (like the NHS) works reasonably well.
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  38. Medvedev says:

    Corporations push and doctors overprescribe opioids. They have to face consequences and jail time for their deceptive tactics. Most people aren’t experts in the field and supposed to trust those who have a degree and 20-30 years of experience and education in the field.
    To see the degree of influence MSM and corporations may have a look at tobacco usage since 1960s. If people/government allowed corporations to roam free they would teach children how to smoke from the kindergarten. Or even better, if allowed they would stock Walmart/Costco shelves with opioids, advertise and sell them everywhere even without a need for prescription.

    Read More
    • Replies: @jim jones
    Even kids can buy from cigarette vending machines in Japan and, guess what, they have the longest lifespan of any humans. Compare this to Zimbabwe where nobody smokes and the lifespan is 59 years.
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  39. mhowell says:

    This one hits close to home. I work at a Gulf Coast chemical plant, one of the smaller ones along the Coastal Bend between Corpus Christi and Houston. Almost all of these plants require a TWIC (Transportation Worker ID Card) as a prerequisite to work on site. These cards came about Post 9-11 as a maritime security measure for plants with port access. And you have to be a US citizen to get a TWIC.

    Some background on the industry: Insulators and scaffold builders are near the low end of the job spectrum in chemical plants. Both are tough, thankless jobs that are nevertheless critical to plant operations, especially during a maintenance turn around or TAR. During a TAR these guys are the first to come and the last to go. Every outage (and every job within an outage) starts with Erect Scaffold/Demo Insulation, then scheduled maintenance activities, and ends with Install Insulation/Demo Scaffolding. And, as we enter the second year of the Trump economy, the industries down here are booming. Plants up and down the coast are running wide open, selling as much product as we can make.

    When the TAR’s come around, their requirements completely overwhelm the resources of in-house staff. The on-site need for workers will be three-to-five times higher than normal. The folks coming in to work the TAR’s have to have their TWIC’s, and pass a hair follicle drug screen that tests for marijuana, cocaine, meth and other narcotics. The locals that can meet these requirements already have jobs. So, to meet the need, plant planners look to the south … specifically, to the Rio Grande Valley. Thousands of Valley folks, maybe tens of thousands, commute to the Coastal Bend for the TAR’s and other contract work in the plants. They live frugally on the road and send the bulk of their earnings back to the Valley.

    The foremen for the TAR contractors are all, by necessity, bilingual. They speak English with the plant customer and convey instructions in Spanish to their workers. The scaffolders & insulators at our site get their own plant radio channel, Channel 13, during the TAR. Its the only channel where Spanish is permitted.

    Read More
    • Replies: @Autochthon
    That's all very interesting; really, it is, but the perennial question arises: Have the plants' owners even considered paying wages sufficient to clear the market for labour by actual Americans rather than importing foreign helots?

    It's a rhetorical question, of course, because, from the Rio Grande Valley to the Santa Clara Valley, we all know the answer.
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  40. Anonymous[658] • Disclaimer says:

    Speaking of the fall of Superpowers, here is an outstanding documentary on the fall of Rome. It is about Attila, the Turanid monster who, by the sheer degree of his savagery and ruthlessness, drove the Visigoths, Ostrogoths and Vandals to cross Rhine. Eventually, the Romans had to join the Visigoths to stop them.

    At the battle of Châlon, the Romans utilized their 12 consular legions, the elite of the elite, and another 8 auxiliary legions and 200,000 Visigoths to stop Attila. By that time, the Roman Military was in shambles, the result of 3 centuries of a declining economy and constant border raids that bled the military slowly but surely. Rome became weakened because provinces starting trading with each other and not with Rome, while still expecting Rome to pay the bulk for aqueducts, roads, military garrisons and such. Millions upon millions of savages attacking the Superpower constantly, the economy weakening, and the spirit of civic duty eroded due to wealth and the professionalization of the military. It all combined to speel catastrophe.

    However, Rome still had a small elite of highly skilled soldiers, drawn from the aristocratic and of land owners of Italy, about a dozen legions that Rome trained to the highest standard and had state-of-the-art weaponry. This was a force Rome saved as a last resort. They refused to use it even when the Vandals saced Ravenna years before. Realizing that the Huns were extremely numerous and completely barbarous and vicious even when compared to the Goths, the Romans realized that a Hun victory would mean absolute annihilation of all peoples of Europe. The time had come for them to use their last reserve of truly elite Roman soldiers. Commanding them was Aetius, a stoic Roman in the tradition of Cato, and the last man in Rome who publicly boasted about the virtues of Cincinnatus and tried to live up to them.

    The battle of Châlon was the last gasp of a superpower. That day, Rome did what all peoples of the Mediterranean and middle east thought were impossible: they defeated the Huns. But it came at a terrible cost: 10 of the 12 elite legions were completely destroyed, and one severely depleted. The auxiliary legions had lower loses because they fought together with the Visigoths in the flanks. But they still lost 4 of those. In fact, the first elite legion was crushed in minutes.

    The Romans were not used to the kind of steppe warfare of the Huns, which involved heavy ranged attacks with high mobility. The compound bows of the Huns could pierce through the lorica segmentata armor of the Romans. The Romans overcome that advantage with their famous cunning, by denying the Huns their horses, and by building new shields that with iron plates that could resist the compound bows. Their built hills so that they would have the upper terrain, and diverted the course of rivers and flooded the lands and turned them into marshes so that the horses couldn’t ride. The Romans forced the Huns into a man-to-man heavy infantry warfare, which they excelled at and had centuries of experience. Like the Parthians once said, you just cant beat the Romans in infantry: they are just too skilled, too experienced and too tough. That day, the Romans gave the Huns a taste of their medicine: the number of casualties among the Huns is hard to estimate, but it is put as high as 400,000.

    That day, Rome saved Europe from annihilation, but it was the last gasp of a superpower. It was it’s last “hurra”. Losing it’s last elite army and now depending on barbarian allies and amateur troops recruited from across the empire, Rome would fall less than a generation after Chalon. If Rome had failed that day, Europeans nowadays would have epicantic folds to their eyes and European culture would be no more. Rome sacrificed itself and bled to death in a last titanic struggle so that Europe could live. The Ancients were no more. Classical antiquity was over.

    It’s really nice to see a yung Gerard Butler as Attila. The actor that plays Emperor Justinian is great, too. Most Roman Emperors by that time were either degenerate perverts or mental defectives, and he played it well. The Roman Emperor was a sort of “king of kings”. It’s crazy to think that 27% of the World’s population could be ruled by a sexual pervert or feeble minded neurotic.

    And Aetius is an utter badass. He is called “the last of the true Romans” for a reason. Maybe if all Roman men were still like him by that time, Rome would never have fallen. It is really worth watching it all. Amazing: https://youtu.be/IOYy4Lj56rU

    Read More
    • Replies: @El Dato
    That day, the Romans gave the Huns a taste of their medicine: the number of casualties among the Huns is hard to estimate, but it is put as high as 400,000.

    Sounds like an order of magnitude too large. 30-40'000 I could believe.

    Imagine the logistics of getting all those people on the battlefield, and even of killing them in a couple of days with tech of AD 300. 400'000 is the battle of the Somme.

    Also:

    https://en.wikipedia.org/wiki/Battle_of_the_Catalaunian_Plains
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  41. Hunsdon says:
    @Hippopotamusdrome
    theguardian.com article on "white male fragility" and mass shootings. Procedes to linst "white male" shooters.


    Mass shootings show why we must stop pandering to white male fragility
    ...
    Jarrod Ramos...Dimitrios Pagourtzis...Omar Mateen...Nikolas Cruz...

     

    For a given definition of white, yeah.

    Read More
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  42. @mhowell
    This one hits close to home. I work at a Gulf Coast chemical plant, one of the smaller ones along the Coastal Bend between Corpus Christi and Houston. Almost all of these plants require a TWIC (Transportation Worker ID Card) as a prerequisite to work on site. These cards came about Post 9-11 as a maritime security measure for plants with port access. And you have to be a US citizen to get a TWIC.

    Some background on the industry: Insulators and scaffold builders are near the low end of the job spectrum in chemical plants. Both are tough, thankless jobs that are nevertheless critical to plant operations, especially during a maintenance turn around or TAR. During a TAR these guys are the first to come and the last to go. Every outage (and every job within an outage) starts with Erect Scaffold/Demo Insulation, then scheduled maintenance activities, and ends with Install Insulation/Demo Scaffolding. And, as we enter the second year of the Trump economy, the industries down here are booming. Plants up and down the coast are running wide open, selling as much product as we can make.

    When the TAR's come around, their requirements completely overwhelm the resources of in-house staff. The on-site need for workers will be three-to-five times higher than normal. The folks coming in to work the TAR's have to have their TWIC's, and pass a hair follicle drug screen that tests for marijuana, cocaine, meth and other narcotics. The locals that can meet these requirements already have jobs. So, to meet the need, plant planners look to the south ... specifically, to the Rio Grande Valley. Thousands of Valley folks, maybe tens of thousands, commute to the Coastal Bend for the TAR's and other contract work in the plants. They live frugally on the road and send the bulk of their earnings back to the Valley.

    The foremen for the TAR contractors are all, by necessity, bilingual. They speak English with the plant customer and convey instructions in Spanish to their workers. The scaffolders & insulators at our site get their own plant radio channel, Channel 13, during the TAR. Its the only channel where Spanish is permitted.

    That’s all very interesting; really, it is, but the perennial question arises: Have the plants’ owners even considered paying wages sufficient to clear the market for labour by actual Americans rather than importing foreign helots?

    It’s a rhetorical question, of course, because, from the Rio Grande Valley to the Santa Clara Valley, we all know the answer.

    Read More
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  43. Aardvark says:
    @JohnnyWalker123
    This is the type of stuff that White-Americans need.

    https://www.youtube.com/watch?v=SnI_Mw_Yjv8

    Even conservatives are realizing what happens when you let the "free market" run wild.

    https://www.youtube.com/watch?v=nbWMPlBpl8I

    Capitalism run amok.

    https://www.youtube.com/watch?v=NPIrV4MMcqw

    It's not just "NAMs" who have difficulty surviving and competing in the "free market."

    Bernie loves to portray himself as a sort of modern day Robin Hood. He will “alleviate” these evil capitalists of their ill gotten gain and correct their wrong doings. Except that zero of the money collected in fines will ever flow to the true victims.

    They (the Bernie’s of the political landscape) know the revolving door between the pharma industry and the FDA. Isn’t the government supposed to “protect” us? Aren’t we told we can’t live our lives without government there to “save” us? If Government had been able to protect us, why did the opioid crisis ever happen in the first place? Socialists will always champion massive regulation and when it fails, the socialist runs way from it like a stinky diaper and blames the smell on a nearby capitalist. People who love to blame capitalism for failures of government live in some imaginary world where regulation has zero effect on anything.

    Read More
    • Replies: @JohnnyWalker123

    these evil capitalists of their ill gotten gain
     
    Aren't you guys always complaining about how American companies (Google, Facebook, Apple, etc.) make their money in nefarious ways? Don't you guys always complain about cheap immigrant labor pushing down labor costs?

    Aren’t we told we can’t live our lives without government there to “save” us?
     
    Given how huge the opioid epidemic has become, the answer is clearly "NO." Especially in working-class White areas.

    If Government had been able to protect us, why did the opioid crisis ever happen in the first place?
     
    How has the European Union avoided the opioid crisis?

    In 2015, 7,587 European Union residents died from drug overdoses, compared with 52,404 in the U.S. America has only 60% of the EU's population.

    Why?

    Socialists will always champion massive regulation and when it fails, the socialist runs way from it like a stinky diaper and blames the smell on a nearby capitalist. People who love to blame capitalism for failures of government live in some imaginary world where regulation has zero effect on anything.
     
    It seems like the "socialists" of the European Union have been able to avoid an opioid epidemic. While "free market" America has around 12x the overdose rate of the EU.

    Of course, the problem must be that there's too much "socialism" in America! For years, the "socialists" were putting painkillers into the mouths of the Hillbillies, while the "capitalists" would've never done anything so nefarious.

    America's problem is that it's a "socialist" economy.
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  44. jim jones says:
    @Medvedev
    Corporations push and doctors overprescribe opioids. They have to face consequences and jail time for their deceptive tactics. Most people aren't experts in the field and supposed to trust those who have a degree and 20-30 years of experience and education in the field.
    To see the degree of influence MSM and corporations may have a look at tobacco usage since 1960s. If people/government allowed corporations to roam free they would teach children how to smoke from the kindergarten. Or even better, if allowed they would stock Walmart/Costco shelves with opioids, advertise and sell them everywhere even without a need for prescription.

    Even kids can buy from cigarette vending machines in Japan and, guess what, they have the longest lifespan of any humans. Compare this to Zimbabwe where nobody smokes and the lifespan is 59 years.

    Read More
    • Replies: @Medvedev
    Don't know about vending machines in Japan or prevalence of smoking in Zimbabwe. But even if your words were true, this is still strawman argument. Japanese do not live longer than Zimbabweans because smoking is more prevalent in Japan.
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  45. AndrewR says:
    @Hippopotamusdrome
    theguardian.com article on "white male fragility" and mass shootings. Procedes to linst "white male" shooters.


    Mass shootings show why we must stop pandering to white male fragility
    ...
    Jarrod Ramos...Dimitrios Pagourtzis...Omar Mateen...Nikolas Cruz...

     

    O wise one, if it suits you to deign yourself to help a simple fool like me, please tell us who should be counted as White™ and who shouldn’t.

    Read More
    • Replies: @Hippopotamusdrome
    I refer you to a SNL episode:


    Saturday Night Live Transcripts [1988]
    Vote Bush III
    [ show each President's head encircled over a North European country ]
    Announcer: Franklin Delano Roosevelt was of white northern European heritage.
    Thomas Jefferson was of white northern European heritage.
    John F. Kennedy was of white northern European heritage.
    George Herbert Walker Bush is of white northern European heritage.
    [ show Dukakis' encircled just above the Mediterranean Sea ]
    But Michael Dukakis?
    Bush. He's whiter.
    [ SUPER: "Bush. He's Whiter." ]

     

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  46. El Dato says:
    @Anonymous
    Speaking of the fall of Superpowers, here is an outstanding documentary on the fall of Rome. It is about Attila, the Turanid monster who, by the sheer degree of his savagery and ruthlessness, drove the Visigoths, Ostrogoths and Vandals to cross Rhine. Eventually, the Romans had to join the Visigoths to stop them.

    At the battle of Châlon, the Romans utilized their 12 consular legions, the elite of the elite, and another 8 auxiliary legions and 200,000 Visigoths to stop Attila. By that time, the Roman Military was in shambles, the result of 3 centuries of a declining economy and constant border raids that bled the military slowly but surely. Rome became weakened because provinces starting trading with each other and not with Rome, while still expecting Rome to pay the bulk for aqueducts, roads, military garrisons and such. Millions upon millions of savages attacking the Superpower constantly, the economy weakening, and the spirit of civic duty eroded due to wealth and the professionalization of the military. It all combined to speel catastrophe.

    However, Rome still had a small elite of highly skilled soldiers, drawn from the aristocratic and of land owners of Italy, about a dozen legions that Rome trained to the highest standard and had state-of-the-art weaponry. This was a force Rome saved as a last resort. They refused to use it even when the Vandals saced Ravenna years before. Realizing that the Huns were extremely numerous and completely barbarous and vicious even when compared to the Goths, the Romans realized that a Hun victory would mean absolute annihilation of all peoples of Europe. The time had come for them to use their last reserve of truly elite Roman soldiers. Commanding them was Aetius, a stoic Roman in the tradition of Cato, and the last man in Rome who publicly boasted about the virtues of Cincinnatus and tried to live up to them.

    The battle of Châlon was the last gasp of a superpower. That day, Rome did what all peoples of the Mediterranean and middle east thought were impossible: they defeated the Huns. But it came at a terrible cost: 10 of the 12 elite legions were completely destroyed, and one severely depleted. The auxiliary legions had lower loses because they fought together with the Visigoths in the flanks. But they still lost 4 of those. In fact, the first elite legion was crushed in minutes.

    The Romans were not used to the kind of steppe warfare of the Huns, which involved heavy ranged attacks with high mobility. The compound bows of the Huns could pierce through the lorica segmentata armor of the Romans. The Romans overcome that advantage with their famous cunning, by denying the Huns their horses, and by building new shields that with iron plates that could resist the compound bows. Their built hills so that they would have the upper terrain, and diverted the course of rivers and flooded the lands and turned them into marshes so that the horses couldn't ride. The Romans forced the Huns into a man-to-man heavy infantry warfare, which they excelled at and had centuries of experience. Like the Parthians once said, you just cant beat the Romans in infantry: they are just too skilled, too experienced and too tough. That day, the Romans gave the Huns a taste of their medicine: the number of casualties among the Huns is hard to estimate, but it is put as high as 400,000.

    That day, Rome saved Europe from annihilation, but it was the last gasp of a superpower. It was it's last "hurra". Losing it's last elite army and now depending on barbarian allies and amateur troops recruited from across the empire, Rome would fall less than a generation after Chalon. If Rome had failed that day, Europeans nowadays would have epicantic folds to their eyes and European culture would be no more. Rome sacrificed itself and bled to death in a last titanic struggle so that Europe could live. The Ancients were no more. Classical antiquity was over.

    It's really nice to see a yung Gerard Butler as Attila. The actor that plays Emperor Justinian is great, too. Most Roman Emperors by that time were either degenerate perverts or mental defectives, and he played it well. The Roman Emperor was a sort of "king of kings". It's crazy to think that 27% of the World's population could be ruled by a sexual pervert or feeble minded neurotic.

    And Aetius is an utter badass. He is called "the last of the true Romans" for a reason. Maybe if all Roman men were still like him by that time, Rome would never have fallen. It is really worth watching it all. Amazing: https://youtu.be/IOYy4Lj56rU

    That day, the Romans gave the Huns a taste of their medicine: the number of casualties among the Huns is hard to estimate, but it is put as high as 400,000.

    Sounds like an order of magnitude too large. 30-40’000 I could believe.

    Imagine the logistics of getting all those people on the battlefield, and even of killing them in a couple of days with tech of AD 300. 400’000 is the battle of the Somme.

    Also:

    https://en.wikipedia.org/wiki/Battle_of_the_Catalaunian_Plains

    Read More
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  47. AndrewR says:
    @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    Latin equis?

    “I don’t always adhere to PC idiocy, but when I do I say Latin Equis.”

    Read More
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  48. george says:
    @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.

    McAllen #1 in unnecessary care! But is it also #1 for needed but not performed care?

    “The Cost Conundrum,” which explored the problem of unnecessary care in McAllen, Texas, a community with some of the highest per-capita costs for Medicare in the nation.

    Overkill
    An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

    https://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

    BTW, author Atul Gawande (who let the Gawandes into this country) would become the point man Bezos Buffett Diamond chose for their new healthcare alliance. For the sake of McAllen, let’s wish this son of immigrants well.

    Read More
    • Replies: @George
    I perused the Gawande article and he thinks El Paso and McAllen are similar enough to compare. El Paso is, however, more successful. Which kind of raises a question, if El Paso is a better example, why did the Goofus who wrote the Washington Post article choose McAllen?
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  49. bomag says:
    @Twinkie

    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.
     
    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).

    Thanks for the succinct analysis.

    I’d add administrative overhead. Healthcare has become a jobs program; an economic driver, with lots of hires for compliance, construction, maintenance, and all the ancillary activities.

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  50. Tiny Duck says:
    @Hippopotamusdrome
    theguardian.com article on "white male fragility" and mass shootings. Procedes to linst "white male" shooters.


    Mass shootings show why we must stop pandering to white male fragility
    ...
    Jarrod Ramos...Dimitrios Pagourtzis...Omar Mateen...Nikolas Cruz...

     

    The truth hurts

    Also race is a social construct and state of mind so shooting people is an incredibly white male thing to do

    Read More
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  51. KenH says:

    This can’t be. The punditocracy incessantly tell us that endless immigration is an economic windfall, so McAllen, TX must be one of the wealthiest, healthiest and culturally advanced locales anywhere in Merica. It should be a sister city to Beverly Hill, CA.

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  52. DG says:

    I lived in the Rio Grande Valley for two years (Harlingen, specifically) and loved it. Granted I am a 6 foot tall young male but I always felt safe there. The place has some areas of grinding poverty but is overall a very decent place to live. It’s very unpretentious and prole with a charming cruddiness (very anti-SWPL) and the people are nice and (by my estimate) majority bilingual. There are a lot of (nice) trailer parks where retirees from the midwest come down and live for the winter. The beaches at South Padre Island are the nicest you can find on the gulf coast west of Florida. The cost of living is low, traffic is low. There isn’t much going on down there but it’s far from a hellhole. I’d rather live there than a coastal big metro city. As others have noted, the educational attainment is low but that does present an opportunity for others. I met a lot of people who were doing traveler jobs in medicine who were making wages higher than they could anywhere else.

    It’s not going to make anybody’s “100 Places to See Before You Die” list but it’s not Tiajuana.

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  53. Jack D says:
    @JohnnyWalker123
    https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen's per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen's housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen's residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen's inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn't sound a particularly inspiring place, but it's hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    One thing you can say for Mexicans is that they are long lasting. Despite the fact that Mexico spends like 5 cents on its health care system and we spend trillions, life expectancy there is within spitting distance of the US. I assume it is the usual suspects – favorable genetics, a native diet that is healthier than the US diet (although obesity is climbing in Mexico too) and a lifestyle that involves more activity. These things have a bigger influence on life expectancy than all those MRI machines and other worthless crap that drive up US healthcare costs.

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    • Agree: Johann Ricke
    • Replies: @Flip
    It's the beans.

    The Hispanic Paradox

    https://www.youtube.com/watch?v=NO91dfafzGQ
    , @republic
    Mexicans have free medical care.
    , @JohnnyWalker123
    A large fraction of the healthcare that we receive isn't particularly useful, especially when much of it is received far too late in life.

    There needs to be more of an emphasis on preventative healthcare. Catch problems before they become metastatic.

    There also needs to be more emphasis of healthy living habits, like vitamin supplementation (Fish oil, Magnesium, Probiotics, Turmeric, Vitamin C, Zinc, Resveratrol, Berberine, Vitamin D), nutritious eating (veggies, beans, tomatoes, berries, low-GI carbs), effective exercises (high-intensity cardio and strength training), lowering toxic metals (such as iron), avoiding harmful substances (sugar, white flour), and hormetic interventions (sun bathing, sauna, cold baths).

    There are some exciting anti-aging interventions on the horizon, such as eliminating senescent cells (through Quercetin, Tocotrionels, and Resveratrol), normalizing the Omega 6/3 ratio (through supplementation), fighting oxidative stress (through N-Acetylcysteine supplementation), and lowering iron (through phlebotomy).

    The govt did a pretty good job at fighting tobacco usage. It should implement a large-scale health campaign aimed at improving the health of the masses.

    Unfortunately, most of the above will probably not happen. Mostly because our current system is extremely lucrative for hospitals, medical groups, and healthcare providers. My suggestions might make Americans healthier, but these suggestions would lower healthcare needs substantially. That'd result in the healthcare industry taking a huge hit to their profitability and salaries.

    I hate to say it, but our healthcare authorities are overly invested in preserving the status quo due to financial considerations. Certainly there are those who'd like to reform the system, but they don't have the clout to change the system. Furthermore, there are many healthcare providers who are well-meaning, but ignorant about many of these issues.

    So Americans will continue to spend massively on healthcare, while still not being particularly healthy or long-lived.
    , @Jefferson
    "a native diet that is healthier than the US diet"

    What's so healthy about burritos, tacos, and Mexican coca colas which have even more sugar than American coca colas.

    Also Mexico has a higher obesity rate than The U.S
    https://m.huffpost.com/us/entry/3568537

    I stay in hotels a lot and I would say the average Mexican room maid has the same body shape as Rosie O'Donnell.

    I don't see too many Mexican hotel maids with bodies like Eva Longoria.

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  54. Jack D says:
    @Anon
    You make a good point . I will play devils advocate. No one put a gun to their head and forced them to take opiates. It has been well known for a very long time that they are highly addictive , yet people seek them out and doctor shop etc.

    My wife had a C section with one of our children and was prescribed opiods , which she never used . If she was able to tough it out , I suspect many others could do the same and forego opiods.

    Maybe not everyone is as tough as your wife. There have been times when I have been prescribed opiates after surgery and I have been very glad that they were available. No one should be forced to bear unbearable pain when it is possible to relieve it with medication. However, I found them to be constipating (a known side effect) and derived no real enjoyment from them (other than pain relief) and could not wait to get off of them as soon as my pain subsided. But a certain % of the population becomes rapidly addicted. This is a terrible problem but I am glad that I did not have to suffer in pain because those people exist. People with addictions will obtain drugs anyway through illegal means so making it impossible to prescribe necessary pain relief to people in pain doesn’t fix the problem and causes people suffering pain to suffer unnecessarily. If my doctor’s answer was “you have to tough it out because some other people are addicts” I would not have been happy.

    I agree that the “addiction as disease” model is in some respects false. You can chose to quit taking pills but you can’t chose to quit having cancer. There is a voluntary element to addiction but the urges are strong and not everyone has the strength to quit. But just calling it a “disease” implies that there is no element of choice involved and that is false.

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    • Replies: @vinteuil
    Great comment - agreed.
    , @Buck Turgidson
    Agreed and one also cannot choose to stop fibromyalgia, spinal stenosis, rheumatoid arthritis, degenerating and bulging disks, and a long list of painful chronic conditions. Pain from these conditions cannot be treated with bufferin or tylenol. For decades pain patients were able to access relatively safe prescribed opioid pain medicine for relief. Now bc of heroin and illicit fentanyl these pain patients are being cut off and cruelly told tough luck. Some of them are committing suicide. No other nation has this fear of rx pain medicine.
    , @Harry Baldwin
    My daughter was a heroin addict for seven years and has been clean for three years now. She agrees with you about the “addiction as disease” model. It may be hard to stop, but it is a choice. She decided to stop after she hit bottom and she's committed to sobriety.

    Like you, I've had opiate pain relievers when I needed them and I neither got addicted nor felt high. They say that when you have actual pain, you don't get the high. Also, some people have a tendency toward addiction and others do not. An alcoholic once told me that after he had his first drink, he thought, "So this is what it's like to feel normal." I never had that reaction to a drink.
    , @Johann Ricke

    However, I found them to be constipating (a known side effect)
     
    Oddly enough, this used to be one of the medicinal uses for opium - to treat diarrhea.
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  55. @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    Why does “Latinx” even get used when there is the perfectly serviceable and accurate “Hispanic?”

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  56. Jack D says:
    @3g4me
    @7 JohnnyWalker123: "McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there."

    Gee, ya think? Wow Steve, Picketty's compatriot is secretly frequenting your blog with all his numbers and statistics and a complete lack of understanding of the racial reality or true character of heritage America.

    Johnny, you have to go back.

    and a complete lack of understanding of the racial reality or true character of heritage America.

    I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen.

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    • Replies: @Hippopotamusdrome


    The Mexicans were there first.

     

    All several dozen of them.
    Timeline of McAllen, Texas: 1910 - Population: 150


    The all white “heritage America” of your imagination never existed, at least not in McAllen.

     

    Au contraire.
    See this:


    Segregation was most obvious in the sales policies of the McAllen Real Estate Board and Delta Development Company, which made certain that the town was fully segregated. Schools in McAllen were segregated through the fifth grade; Mexican children were not expected to go beyond that level. Not until the late 1920s were segregated junior and senior high schools established. Segregation was a reality in all facets of life. In 1939, for instance, Hispanics could be admitted to the hospital but were housed in a separate section in the basement. Even Hispanic doctors were refused entry into the city hospital, despite the fact that the entire community contributed to the maintenance of the facility.

     

    , @JohnnyWalker123
    McAllen was around 60% Hispanic in 1940.

    https://www.researchgate.net/publication/304364798_Recent_Demographic_Change_in_the_Rio_Grande_Valley_of_Texas_The_Importance_of_Domestic_Migration

    However, it's important to never let facts get in the way of a good narrative.
    , @3g4me
    @56 Jack D: "I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen."

    Gee Jack, thanks so much for edumacatin' little ol' me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That's why they invited Whites in the first place - to be expendable in meat space and make Texas territory safe for their brand of White and brown people - except the Anglosphere Whites decided to stay and take over.

    I realize you believe, like a certain other didactic commenter whose name I shall not mention, that googling and wikipedia make you an expert on everything, but I did learn a thing or two reading on my own, as well as shepherding two sons through their required Texas history classes, not to mention living in Texas for more than 23 years. I realize you desperately want America to have been your mystical melting pot from the get-go but you'll just have to express your anti-gentile animus another way this time.
    , @syonredux

    The Mexicans were there first.
     
    Well, if you want to get technical, the Amerinds were there first.....


    https://www.youtube.com/watch?v=XBPrLU4Zspo

    Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen.
     
    I think that most Heritage Americans would be satisfied with the Anglo-White super-majority that we had in 1960 (85.4%).....
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  57. They should interview the residents of Montgomery County, Maryland where Roberto A. Garza Palacios plowed into 2 people stranded on the side of the road, killing them both.

    He hit them so hard that both flew clear across the median into oncoming traffic, where they were hit again, like something out of a Zucker Bros. movie.

    Palacios is an illegal immigrant, convicted drunk driver and recidivist criminal. He paid a $280 fine for the accident, but was not tested for sobriety, because Maryland values civil rights of illegal immigrants so strongly. Also, he gets to stay in the U.S.

    This happened in a Blue state and indications are both of the victims are Democrats. It’s always ironic when your pets turn on you.

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  58. carol says:
    @Anon
    You make a good point . I will play devils advocate. No one put a gun to their head and forced them to take opiates. It has been well known for a very long time that they are highly addictive , yet people seek them out and doctor shop etc.

    My wife had a C section with one of our children and was prescribed opiods , which she never used . If she was able to tough it out , I suspect many others could do the same and forego opiods.

    Gee it’s nice to have a bogeyman everyone can safely agree on. Teh doctorz, Big Pharma!

    A close friend recently died after dealing with cancer for 7 years. He stayed very active in music and tried to live normally…the only things that kept him going all that time were caffeine and Lortabs.

    I just hope we’ll still be able to get opioids for similar circumstances when this latest hysteria blows over. Assume we’ll still have caffeine.

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  59. Anonymous[148] • Disclaimer says:

    There should be federal tax incentives to get people from McAllen and other Hispanic majority cities with job creation problems to more white parts of the country with job opportunities. That’s an initiative both the business right and cultural left can unite on. One group craves a way to stem the rise in wages that might have to occur with the unemployment rate at a multi-decade low and the other would like to see a more even demographic distribution to promote the race mixing agenda, which is the intended final step behind Hart-Cellar. (Mixing not race replacement is the idea.)

    Why can’t places like McAllen supply restaurants in Minnesota with workers? Throwing small business owners a big tax break for hiring will help the process along.

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  60. Anonymous[148] • Disclaimer says:
    @JohnnyWalker123
    My cousin (who's a surgeon) was offered a ton of money to work in a practice down in McAllen, Texas. About double what he would've made up here.

    It turns out that physicians in McAllen engage in a very high level of "overutilization." Which is a fancy way of saying that the doctors do a lot of billing for unnecessary procedures. Which is a major factor in why McAllen's doctors are so rich. McAllen's doctors are getting rich through outright fraud.

    It'd be like if you came into the mechanic because your car was running a little slowly. So the mechanic fixed your car, but he then unnecessarily rebuilt the engine and replaced the windshield for no reason. He then gave you a huge bill. Fortunately, Medicare/Medicaid/Insurance/TriCare paid for your auto repair bill.

    The unfortunate reality is that American doctors engage in a very high rate of "overutilization." That's one reason why they make so much money. Not all doctors, but many. Especially those with their own independent practices.

    Doctors also played a huge role in starting the opioid epidemic.

    Foreign-born physicians seem to be especially egregious. Whenever I look at lists of physicians who've committed billing fraud, there are lot of immigrant names. "White Hispanics" (usually of Cuban or South American origin) and Middle Easterners are especially bad about this. To a lesser extent, the same is true of Subcons. Africans seem over represented too, but their numbers are smaller so there's less opportunity for fraud.

    Any patterns among white names? What about Asians?

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  61. Yak-15 says:
    @Twinkie

    “Numbers” and “statistics” are useful metrics for gaining an understanding of the world around us. This is why the “government” gathers this information.
     
    I agree that objective quantification is very useful and, yes, necessary. Sometimes they can disabuse people of wrongly held prejudices and false myths. But, it is not everything - it doesn’t, for example, capture well real world phenomena such as degradation of culture and loss of civics that have real, profound, and long-term consequences.

    It’s also likely that statistics vastly undercount criminality amongst a population hesitant to report crime to police who also view crime through a very different cultural lens. I imagine petty larceny and trespassing is reported at 5% of occurrences.

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  62. MarkinLA says:
    @Twinkie

    That’s how the central government separated the patient from payment, which is 90% of the problem.
     
    You got that right. Medical insurance is bizarre in the U.S. in that it is EXPECTED to be used and used heavily. Is it any wonder it is costly?

    Imagine how expensive other forms of insurance would be if they had similar payout rates.

    How does insurance make patients overuse the system and cause the providers to bill 10 times what they know the insurance company will pay? Most insurance companies have to pre-approve procedures that cost more than a few hundred dollars or you pay. People are seeing insurance companies refuse to pay their emergency room visits even after the patient was told to do so by his primary care doctor’s office.

    Why do patients have to pay for procedures that don’t work or were needed because of the actions of the doctors in the first place – like when I was having an adverse drug reaction to a prescription medication? The hospital bill was 46,000 or which only 8000 was paid by insurance and me. Part of the reason I was there so long was because the normal medications I take to prevent for A-fib was not on the hospital’s formulary and what they could give me didn’t work so I sent two unnecessary days in the cardiac ward for something I normally just ignore.

    It seems the insurance companies are the only ones holding the line on costs. If I didn’t have insurance, I would be legally liable for that whole 46,000.

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  63. CCZ says:

    Parts of the US North have already been “McAllenized.”

    “Almost a third of New Jersey residents above the age of 5 now speak a language other than English at home, according to Census data.

    That eclipses New York and places the state fourth overall in the number of non-English speaking residents, following Texas, New Mexico and California.”

    https://www.nj.com/data/2018/07/top_20_nj_towns_where_english_is_not_the_dominant.html

    In at least 20 New Jersey cities, a language other than English (overwhelmingly Spanish) is the dominant language used by between 60 and 87% of the population. Welcome to “El New Jersey.”

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  64. MarkinLA says:
    @Twinkie

    When you live in a “wild west” free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population.
     
    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy - both government and non-profit - that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.

    It is also true that NOBODY can tell anybody what to charge. It is highway robbery. What is regulated is what CAN be put on the market or what procedures CAN be done in US medical facilities. Remember that gyuy who tried to get rich by bying that small pharmaceutical company and gouging his patients.

    http://www.newsweek.com/pharma-bro-martin-shkreli-sentenced-years-jail-838242

    You can gouge terminally ill people all you want, just don’t try and cheat investors.

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  65. @JohnnyWalker123
    I examined McAllen's homicide rate for the past 5 years. The average homicide rate was 2.0 per 100,000 inhabitants. For comparison, the Non-Hispanic White homicide rate was roughly 2.6 per 100,000.

    For the previous 5 years, McAllen had a violent crime rate of 73 incidents per 100,000 inhabitants. The national rate was 209 incidents per 100,000 inhabitants.

    For the previous 5 years, McAllen had a property crime rate of 241 incidents per 100,000 inhabitants. The national rate was 237 incidents per 100,000 inhabitants.

    So it appears that McAllen is a fairly safe city to live in.

    McAllen is not unpleasant. It used to be best-known as a place for moderately wealthy Texans to fly down and play golf. It is the MSA of Hidalgo County and parts of Starr County as a whole that must be fueling this. Lots of colonia-dwellers.

    My impression is that the state and feds pour money into higher education spending there – a friend from the Valley says “leadership” degrees are all the rage.

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  66. vinteuil says:
    @Jack D
    Maybe not everyone is as tough as your wife. There have been times when I have been prescribed opiates after surgery and I have been very glad that they were available. No one should be forced to bear unbearable pain when it is possible to relieve it with medication. However, I found them to be constipating (a known side effect) and derived no real enjoyment from them (other than pain relief) and could not wait to get off of them as soon as my pain subsided. But a certain % of the population becomes rapidly addicted. This is a terrible problem but I am glad that I did not have to suffer in pain because those people exist. People with addictions will obtain drugs anyway through illegal means so making it impossible to prescribe necessary pain relief to people in pain doesn't fix the problem and causes people suffering pain to suffer unnecessarily. If my doctor's answer was "you have to tough it out because some other people are addicts" I would not have been happy.

    I agree that the "addiction as disease" model is in some respects false. You can chose to quit taking pills but you can't chose to quit having cancer. There is a voluntary element to addiction but the urges are strong and not everyone has the strength to quit. But just calling it a "disease" implies that there is no element of choice involved and that is false.

    Great comment – agreed.

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  67. @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    LatinX sounds like a civil rights leader.

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  68. @syonredux

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    Heck, compared to Haiti, it looks pretty great.....

    Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.
     
    Not to mention the third and fourth generation Latinx who live there....

    When boxes of original files from a 1965 survey of Mexican Americans were discovered behind a dusty bookshelf at UCLA, sociologists Edward Telles and Vilma Ortiz recognized a unique opportunity to examine how the Mexican American experience has evolved over the past four decades. Telles and Ortiz located and re-interviewed most of the original respondents and many of their children. Then, they combined the findings of both studies to construct a thirty-five year analysis of Mexican American integration into American society. Generations of Exclusion is the result of this extraordinary project.

     


    Generations of Exclusion measures Mexican American integration across a wide number of dimensions: education, English and Spanish language use, socioeconomic status, intermarriage, residential segregation, ethnic identity, and political participation. The study contains some encouraging findings, but many more that are troubling. Linguistically, Mexican Americans assimilate into mainstream America quite well—by the second generation, nearly all Mexican Americans achieve English proficiency. In many domains, however, the Mexican American story doesn’t fit with traditional models of assimilation. The majority of fourth generation Mexican Americans continue to live in Hispanic neighborhoods, marry other Hispanics, and think of themselves as Mexican. And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

     

    https://www.amazon.com/Generations-Exclusion-Mexican-Americans-Assimilation-Race/dp/0871548496

    And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

    Apropos of this very subject, Stefan Molyneux has a new video up (helpfully hosted on this very website) in which he discusses the fact that 70% of wealthy families have lost their wealth by the second generation and a stunning 90% have lost theirs by the third generation. If poor Hispanics migrating to America and instantly benefiting from access to American largess can be conceived of as analogous to a windfall or an “inheritance,” then there is every reason to expect that similar dynamics would apply in their case. In other words, it is not a lack of integration that causes Hispanics to fall behind by the second, third, and fourth generations; it is simply the ever-present human tendency to fritter away the wealth of the past. We should not expect one-way upward mobility from Hispanics when we cannot reasonably expect it from anyone else, either.

    And this dovetails nicely with a point that I often think about but seldom mention, viz. the self-immolation of the American middle class. It is customary in Alt-Right circles to discuss middle class woes in terms of globalism, greedy oligarchs, and spendthrift socialist governments, but are these things a cause or an effect of the current problems? I would say they are at least as much effect as cause, for it’s not as if the middle class had no agency in producing its present tribulations. Nobody forced the great bulk of Americans to buy houses and cars they couldn’t afford or to adopt a consumerist lifestyle on credit.

    I would say that the American middle class miracle, especially as it pertains to the Baby Boom generation, was the one-off result of certain well-known factors, notably the emergence of the US industrial as base as the sole survivor of WWII, which happened to coincide nicely with the era of cheap oil, thus allowing us to thoroughly exploit the abundance of the great North American continent and to dollar-imperialize the rest of the world. This was the “inheritance.” And the Boomers, true to form, spent money like it was going out of style, living well beyond their means while the bank balance steadily drained away. Now everyone today speaks of the Millennials as a generation of spoiled brats who want everything handed to them and who do not know how to work or even why they should have to. But really this is precisely what we should expect of them. That generation as a whole is living out the persona of the sulky, third- or fourth-generation rich kid who never developed any connection with productive society, whose only talent consists in being accustomed to the arrogance and power of wealth but who no longer has any, and who therefore descends into a morally blighted lifestyle which may include substance abuse, perverse sexuality, crime, and revolutionary politics.

    On this view, we must say that the ongoing liquidation of the American middle class is not something entirely attributable to the depredations of a globalist elite, but is in many ways an historically inevitable reversion to the mean. And while the elite certainly are not innocent, the middle class itself bears its own share of the blame in the crisis that is about to befall us. I’ve always appreciated how this fact was summed up in the famous scene from Margin Call.

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  69. @JohnnyWalker123
    https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen's per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen's housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen's residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen's inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn't sound a particularly inspiring place, but it's hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    Have you ever been to McAllen? I have. It is a hell hole.

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  70. @JohnnyWalker123
    I examined McAllen's homicide rate for the past 5 years. The average homicide rate was 2.0 per 100,000 inhabitants. For comparison, the Non-Hispanic White homicide rate was roughly 2.6 per 100,000.

    For the previous 5 years, McAllen had a violent crime rate of 73 incidents per 100,000 inhabitants. The national rate was 209 incidents per 100,000 inhabitants.

    For the previous 5 years, McAllen had a property crime rate of 241 incidents per 100,000 inhabitants. The national rate was 237 incidents per 100,000 inhabitants.

    So it appears that McAllen is a fairly safe city to live in.

    I examined McAllen’s homicide rate for the past 5 years.

    Mcallen with a Black population of 00.4% has a lower crime rate than 12% Black USA. And then still manages to have higher property crime rate.

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    • Replies: @JohnnyWalker123
    McAllen's homicide rate is about 25% lower than the Non-Hispanic White average.

    McAllen's violent crime rate is 65% than the national average. The property crime rate is 2% higher.

    Boise's homicide rate is 1.4 incidents per 100,000 inhabitants. The violent crime rate is 175 incidents per 100,000 inhabitants. The property crime rate is 178 incidents per 100,000 inhabitants. Boise is 84% Non-Hispanic White and 1.4% Black.

    McAllen is 0.9% Black.

    So McAllen is not that different from Boise in its level of criminality.
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  71. jill says:
    @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.

    Note most of the Medicare fraud fugitives are foreigners. They come to America, set up Medicare mills, loot 24/ 7 till caught, then they flee after being released on bail.

    I actually believe Congress welcomes this type of fraud. Why else let it continue?

    https://oig.hhs.gov/fraud/fugitives/profiles.asp#other-fugitives

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    • Replies: @JohnnyWalker123
    Interesting.

    One reason Medicare fugitives are disproportionately foreign is because foreigners can flee to their homelands. Americans can't really flee anywhere outside of America, usually.

    However, from my experience, foreigners do seem to engage in more medical fraud than Americans.

    I looked through the list and saw very large numbers of "White Hispanic" and Middle Eastern names. Also, many Africans, Subcons, and Eastern Euros.

    Not too many East Asians or Western Euros.
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  72. Flip says:
    @Jack D

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.
     
    One thing you can say for Mexicans is that they are long lasting. Despite the fact that Mexico spends like 5 cents on its health care system and we spend trillions, life expectancy there is within spitting distance of the US. I assume it is the usual suspects - favorable genetics, a native diet that is healthier than the US diet (although obesity is climbing in Mexico too) and a lifestyle that involves more activity. These things have a bigger influence on life expectancy than all those MRI machines and other worthless crap that drive up US healthcare costs.

    It’s the beans.

    The Hispanic Paradox

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  73. @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    Is it pronounced “Latinks”, which sounds kind of effeminate

    But it also sounds like lynx, which is a wildcat. Rawr.

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  74. @Jack D
    Maybe not everyone is as tough as your wife. There have been times when I have been prescribed opiates after surgery and I have been very glad that they were available. No one should be forced to bear unbearable pain when it is possible to relieve it with medication. However, I found them to be constipating (a known side effect) and derived no real enjoyment from them (other than pain relief) and could not wait to get off of them as soon as my pain subsided. But a certain % of the population becomes rapidly addicted. This is a terrible problem but I am glad that I did not have to suffer in pain because those people exist. People with addictions will obtain drugs anyway through illegal means so making it impossible to prescribe necessary pain relief to people in pain doesn't fix the problem and causes people suffering pain to suffer unnecessarily. If my doctor's answer was "you have to tough it out because some other people are addicts" I would not have been happy.

    I agree that the "addiction as disease" model is in some respects false. You can chose to quit taking pills but you can't chose to quit having cancer. There is a voluntary element to addiction but the urges are strong and not everyone has the strength to quit. But just calling it a "disease" implies that there is no element of choice involved and that is false.

    Agreed and one also cannot choose to stop fibromyalgia, spinal stenosis, rheumatoid arthritis, degenerating and bulging disks, and a long list of painful chronic conditions. Pain from these conditions cannot be treated with bufferin or tylenol. For decades pain patients were able to access relatively safe prescribed opioid pain medicine for relief. Now bc of heroin and illicit fentanyl these pain patients are being cut off and cruelly told tough luck. Some of them are committing suicide. No other nation has this fear of rx pain medicine.

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    • Replies: @JohnnyWalker123
    There are certain supplements that are effective at treating bone and arthritis pain. For example, Turmeric/Curcumin and Omega 3 supplementation (Fish Oil, Astaxanthin, Krill Oil).

    However, there are many conditions that need painkillers to be treated properly.

    The basic problem is that when physicians were given the freedom to prescribe painkillers, a lot of them took advantage of that and over prescribed to the general population. Much of this over prescription can be attributed to financial incentives from pharmaceutical groups (vacations, speaking fees, consulting payments). Physicians were bribed by Big Pharma into over prescribing painkillers to the masses, which created the opioid epidemic.
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  75. @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    Don’t even use the word, let alone worry about pronouncing it correctly. That’s just playing their game. Just call ‘em Mexicans, even if some of them are from Colombia or Guatemala.

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  76. Anon[225] • Disclaimer says:
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  77. Bugg says:
    @El Dato
    It's the usual feminist writing. These are the people wearing T-Shirts saying "feminism is the future" while they check in the nearby muslim neighborhood for signs of oppression by marching fascists.

    “In many of these mass shootings,” Jennifer Wright observed at Harper’s Bazaar, “the desire to kill seems to be driven by a catastrophic sense of male entitlement.” That sense of entitlement may well be the greatest threat to what remains of civil society.
     
    Because this is what George Orwell was actually writing about in "1984": Winston Smith's sense of male entitlement and his persistent stalking behaviour got Julia sent to the rape cellar and then the glue factory.

    1993 WTC, 9/11, John Muhmmad, the Tsanrnaev brothers, Orlando, San Bernandino, Little Rock, Major Hassan, all proponents of inclusive anfd diverse feminist….uh….

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  78. George says:
    @george
    McAllen #1 in unnecessary care! But is it also #1 for needed but not performed care?

    “The Cost Conundrum,” which explored the problem of unnecessary care in McAllen, Texas, a community with some of the highest per-capita costs for Medicare in the nation.

    Overkill
    An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

    https://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

    BTW, author Atul Gawande (who let the Gawandes into this country) would become the point man Bezos Buffett Diamond chose for their new healthcare alliance. For the sake of McAllen, let's wish this son of immigrants well.

    I perused the Gawande article and he thinks El Paso and McAllen are similar enough to compare. El Paso is, however, more successful. Which kind of raises a question, if El Paso is a better example, why did the Goofus who wrote the Washington Post article choose McAllen?

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    • Replies: @Pepe
    McAllen was chosen because it's been the center of the huge surge of illegal immigration since about 2014. The surge with all the Central Americans and families, etc.

    McAllen has one of those facilities where the kids were being separated from the parents. It's called the Ursula facility, because it's on Ursula road in McAllen.

    Brownsville has been the subject of several articles as well, because they have the similar Casa Padre facility, an old Walmart building.

    El Paso is missing out out on this.
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  79. Big Bill says:
    @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    It’s getting even more complicated. Recently the new SJW word “Chicanx” has appeared.

    I think it is pronounced “chih-CONKS”. Or perhaps “chih-CAN-icks”.

    If this “x” trend continues among our dusky south-of-the-border brethren it is going to get quite confusing.

    A Mexican fireman is a “bombero”. Will he/she/it/xir soon be a “bomberx” [bomb-bear-icks"]? Will a postman (cartero) become a “car-TEAR-icks”? Will a cook (cocinero) be come a “ko-sin-AIR-icks”? A laundress (lavandera) become a “lah-vahn-derricks”?

    Whenever lefties re-engineer the lexicon, they should be required to agree on (and publish) the proper PC pronunciation. Perhaps it could be added to the NYT/LAT/WSJ style guides, at least for the first year or two.

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    • Replies: @snorlax
    She-Canucks.
    , @Harry Baldwin
    When I was in Mexico, I learned that "x" in Mayan place names is pronounced "sh", so Uxmal is pronounced "Ooshmal." I don't know if this is a general rule, but if it is, then we should pronounce these neologisms as "Lateensh" and "Chihcansh."
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  80. republic says:
    @Jack D

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.
     
    One thing you can say for Mexicans is that they are long lasting. Despite the fact that Mexico spends like 5 cents on its health care system and we spend trillions, life expectancy there is within spitting distance of the US. I assume it is the usual suspects - favorable genetics, a native diet that is healthier than the US diet (although obesity is climbing in Mexico too) and a lifestyle that involves more activity. These things have a bigger influence on life expectancy than all those MRI machines and other worthless crap that drive up US healthcare costs.

    Mexicans have free medical care.

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  81. @Jack D

    and a complete lack of understanding of the racial reality or true character of heritage America.
     
    I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white "heritage America" of your imagination never existed, at least not in McAllen.

    The Mexicans were there first.

    All several dozen of them.
    Timeline of McAllen, Texas: 1910 – Population: 150

    The all white “heritage America” of your imagination never existed, at least not in McAllen.

    Au contraire.
    See this:

    Segregation was most obvious in the sales policies of the McAllen Real Estate Board and Delta Development Company, which made certain that the town was fully segregated. Schools in McAllen were segregated through the fifth grade; Mexican children were not expected to go beyond that level. Not until the late 1920s were segregated junior and senior high schools established. Segregation was a reality in all facets of life. In 1939, for instance, Hispanics could be admitted to the hospital but were housed in a separate section in the basement. Even Hispanic doctors were refused entry into the city hospital, despite the fact that the entire community contributed to the maintenance of the facility.

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  82. @Twinkie

    One underreported phenomenon is the medical salaries of physicians. American doctors are no longer content with being members of the local upper middle class or gentry. A lot of them want to become 8 digit millionaires with huge mansions and extravagant vacations.

    You cannot do that on a 200K-300K salary. Hence all this over-treatment. Its like a business. You sell as many services as you can convince the patient (or his insurer) to buy.
     
    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).

    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.

    In the same time period, median household income rose from $50,000 to $59,000.

    So physician median income rose by 26% over 7 years, but the median household income increased by merely 18%. So that’s a fairly substantial difference, especially when you consider that the base salaries (50K vs 160K) are already so far apart.

    It’d be like if I got a $10,000/yr raise while the rest of you saw your incomes stagnate.

    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

    47% of physicians own their own practice. Which is extremely substantial.

    Your point is actually not correct. Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to “overutilize” the system. Not to the same extent as owner-operator physicians, but the incentive remains.

    You are correct that primary care physicians typically don’t make $300,000/yr salaries, but specialists (who are around 2/3 of physicians) often make that level of income.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).

    “Overutilization” occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to “overutilize.” Much like a mechanic has an incentive to claim that your brakes, engine, windshield, and tires are all defective and must be replaced immediately.

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates. See below quote.

    https://www.healthpopuli.com/2013/04/02/u-s-health-costs-vs-the-world-is-it-still-the-prices-and-are-we-still-stupid/

    A routine office visit to a doctor cost an average of $95 in the U.S. in 2012. The same visit was priced at $30 in Canada and $30 in France, as well. A hip replacement cost $40,364 on average in the U.S. in 2012. The total hospital and physician cost for a hip replacement in the UK was $11,889 and in France, $10,927.Apr 2, 2013

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.

    You’re correct that other populations do seem to have better health habits, especially eating habits. America probably needs to do something to encourage better eating habits in the general population.

    Not stuff like this.

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    • Replies: @Twinkie

    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.
     
    Your number is very deceptive for a number of reasons.

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

    On a side note, I sit on the board of a large healthcare system (multiple hospitals across the South). It has been having trouble recruiting physicians in the last several years for the same reason, and for the first time in 20 years or so, it has had to offer significantly increased salaries.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

    “I tracked internal medicine physician income between 1990 and 2010 and found an average annual income increase of 1%. That was $140k in 1990, $170k by 2010 and $183k in 2017. Therefore, overall, physician incomes are flat, and even at our low 2-3% rate of inflation, physician income buying power is declining,” he concludes.
     
    And this at a time when the medical student debt load has risen substantially (here is a happy article about being a doctor today: https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/).

    But that's not even a very accurate view of physician income trends. Why?

    While the opinions and data suggest that incomes are trending down, there are even some interesting theories suggesting that physicians may be taking on less pro bono work as a result. Physician complaints about salaries are generally not well received, and are often labeled as whining. Yet signs of dissatisfaction are reflected more through action than through words. Doctors leaving medicine, taking on side jobs, retiring early and even succumbing to depression and suicide are on the rise. It is not clear how much of this is due to declining salaries and what has happened to the medical profession.
     
    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income - bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

    47% of physicians own their own practice. Which is extremely substantial.
     
    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

    Flash back to today, among physicians who are 40 years old or younger, 75% are employees. Do you really think that these doctors, who are now wage slaves to large, impersonal, risk-averse, and highly bureaucratic medical corporations, are going to be "entrepreneurial" and over-prescribe to line the profits for these companies (most of which now give the doctors WORSE medical insurance plans than those of the patients, forget about disability and other perks that used to be the norm)?

    Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to “overutilize” the system. Not to the same extent as owner-operator physicians, but the incentive remains.
     
    Bonuses to salaried physicians range typically $10,000-$25,000 a year and that includes extra compensation for taking on administrative duties (such as being chair of departments or being medical directors of facilities). For anyone remotely acquainted with hospital economics, the idea of salaried physicians over-prescribing pain medication to get that extra $10,000 a year is utterly laughable. What's that, $6,500 after taxes... all for the pleasure of having DEA looking into your practice? (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians - e.g. anesthesiologists and their staff with DEA numbers - able to access.)

    “Overutilization” occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to “overutilize.”
     
    Doctors can't force patients to come to hospitals.

    There is a far less nefarious reason for overutilization than doctors scheming to bilk insurance companies or the government (although that does happen with a very small minority of, ahem, "certain" doctors). First of all, there is today a perverse incentive for PATIENTS to utilize medical services at high rates due to (historically) declining out-of-pocket expenses (which reversed in the last several years, but the long-term trend is very downward). In 1970, for example, about 40% of healthcare expenditures were paid out of pocket in the U.S. By 1990, that number dipped below 20%. At the same time, Medicare and Medicaid increased demands for services dramatically. The outcome is that there is now a MASSIVE demand for medical services from the public itself, without any need for the specter of supposedly greedy doctors ordering every procedure in the book.

    Furthermore, the explosive rise of medical malpractice litigations during this period meant that "defensive medicine" has become doctrine. Doctors today routinely order additional (and very costly) tests and scans (and even extra procedures sometimes), not because that lines their pockets (that extra money generally goes to someone else or even other facilities), but because that "thoroughness" affords them some protection during malpractice lawsuits and trials ("I did everything I could - there was nothing else I could do to prevent the negative outcome").

    By the way, aside from actual criminal schemes, no sane physician today takes on MORE Medicare and Medicaid patients willingly. Their reimbursements are pitiful and often generate no additional income (and not so infrequently losses).

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates.
     
    That's nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history. That's not the reason why our national medical care costs have skyrocketed in comparison to those of other countries.

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.
     
    "Preventative healthcare" programs have been shown to do... wait for it... nothing to improve health outcomes. Americans don't smoke or over-eat because they have not been exposed to preventative healthcare programs.

    Americans in 1970 (or before) had far LOWER numbers of visits to doctors than today (much lower access to, and utilization of, healthcare), yet were less likely to suffer from obesity and many related illness. You are intelligent enough to realize why.

    You’re correct that other populations do seem to have better health habits, especially eating habits.
     
    Eating habits are half the equation. The other is sedentary lifestyle.

    Cross country "health outcome" comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won't matter much what kind of medical care system you have - you will end up with a healthy population with low overall medical care costs.

    Our - American - problem today is very simple. We have an increasingly unhealthy bottom half of the population (obesity is strongly inverse-correlated to income/education attainment) with correspondingly high demand for medical services, which we have worsened considerably by increasingly subsidizing healthcare services.

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play "Look, squirrel!" with the real problem.

    *By the way, there has been a high degree of "consolidation" among hospitals in the last 10 years or so, due to decreased profitability. Massive numbers of communities have lost hospitals and now have longer travel time to access healthcare, especially TERTIARY care.
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  83. @Jack D

    and a complete lack of understanding of the racial reality or true character of heritage America.
     
    I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white "heritage America" of your imagination never existed, at least not in McAllen.

    McAllen was around 60% Hispanic in 1940.

    https://www.researchgate.net/publication/304364798_Recent_Demographic_Change_in_the_Rio_Grande_Valley_of_Texas_The_Importance_of_Domestic_Migration

    However, it’s important to never let facts get in the way of a good narrative.

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  84. @syonredux

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    Heck, compared to Haiti, it looks pretty great.....

    Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.
     
    Not to mention the third and fourth generation Latinx who live there....

    When boxes of original files from a 1965 survey of Mexican Americans were discovered behind a dusty bookshelf at UCLA, sociologists Edward Telles and Vilma Ortiz recognized a unique opportunity to examine how the Mexican American experience has evolved over the past four decades. Telles and Ortiz located and re-interviewed most of the original respondents and many of their children. Then, they combined the findings of both studies to construct a thirty-five year analysis of Mexican American integration into American society. Generations of Exclusion is the result of this extraordinary project.

     


    Generations of Exclusion measures Mexican American integration across a wide number of dimensions: education, English and Spanish language use, socioeconomic status, intermarriage, residential segregation, ethnic identity, and political participation. The study contains some encouraging findings, but many more that are troubling. Linguistically, Mexican Americans assimilate into mainstream America quite well—by the second generation, nearly all Mexican Americans achieve English proficiency. In many domains, however, the Mexican American story doesn’t fit with traditional models of assimilation. The majority of fourth generation Mexican Americans continue to live in Hispanic neighborhoods, marry other Hispanics, and think of themselves as Mexican. And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

     

    https://www.amazon.com/Generations-Exclusion-Mexican-Americans-Assimilation-Race/dp/0871548496

    That overview matches my maternal family’s experience. Squandering the hard work of our parents and grandparents seems to be the general rule among my many cousins. But they’re all 100% assimilated . . . to lower class white, dude-bro, school-sucks, drink-every-night norms, unfortunately.

    As far as third and fourth gen. Hispanics “continuing to live in Hispanic neighborhoods,” well that’s because the majority of Hispanics live in places where Hispanics are the majority. Hell, my mom married a gringo and I hang out at i-Steve, but even the SoCal neighborhood I’m typing this from could be considered “Hispanic” by some measures. Because it’s a SoCal neighborhood.

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  85. @Jack D

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.
     
    One thing you can say for Mexicans is that they are long lasting. Despite the fact that Mexico spends like 5 cents on its health care system and we spend trillions, life expectancy there is within spitting distance of the US. I assume it is the usual suspects - favorable genetics, a native diet that is healthier than the US diet (although obesity is climbing in Mexico too) and a lifestyle that involves more activity. These things have a bigger influence on life expectancy than all those MRI machines and other worthless crap that drive up US healthcare costs.

    A large fraction of the healthcare that we receive isn’t particularly useful, especially when much of it is received far too late in life.

    There needs to be more of an emphasis on preventative healthcare. Catch problems before they become metastatic.

    There also needs to be more emphasis of healthy living habits, like vitamin supplementation (Fish oil, Magnesium, Probiotics, Turmeric, Vitamin C, Zinc, Resveratrol, Berberine, Vitamin D), nutritious eating (veggies, beans, tomatoes, berries, low-GI carbs), effective exercises (high-intensity cardio and strength training), lowering toxic metals (such as iron), avoiding harmful substances (sugar, white flour), and hormetic interventions (sun bathing, sauna, cold baths).

    There are some exciting anti-aging interventions on the horizon, such as eliminating senescent cells (through Quercetin, Tocotrionels, and Resveratrol), normalizing the Omega 6/3 ratio (through supplementation), fighting oxidative stress (through N-Acetylcysteine supplementation), and lowering iron (through phlebotomy).

    The govt did a pretty good job at fighting tobacco usage. It should implement a large-scale health campaign aimed at improving the health of the masses.

    Unfortunately, most of the above will probably not happen. Mostly because our current system is extremely lucrative for hospitals, medical groups, and healthcare providers. My suggestions might make Americans healthier, but these suggestions would lower healthcare needs substantially. That’d result in the healthcare industry taking a huge hit to their profitability and salaries.

    I hate to say it, but our healthcare authorities are overly invested in preserving the status quo due to financial considerations. Certainly there are those who’d like to reform the system, but they don’t have the clout to change the system. Furthermore, there are many healthcare providers who are well-meaning, but ignorant about many of these issues.

    So Americans will continue to spend massively on healthcare, while still not being particularly healthy or long-lived.

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  86. @Buck Turgidson
    Agreed and one also cannot choose to stop fibromyalgia, spinal stenosis, rheumatoid arthritis, degenerating and bulging disks, and a long list of painful chronic conditions. Pain from these conditions cannot be treated with bufferin or tylenol. For decades pain patients were able to access relatively safe prescribed opioid pain medicine for relief. Now bc of heroin and illicit fentanyl these pain patients are being cut off and cruelly told tough luck. Some of them are committing suicide. No other nation has this fear of rx pain medicine.

    There are certain supplements that are effective at treating bone and arthritis pain. For example, Turmeric/Curcumin and Omega 3 supplementation (Fish Oil, Astaxanthin, Krill Oil).

    However, there are many conditions that need painkillers to be treated properly.

    The basic problem is that when physicians were given the freedom to prescribe painkillers, a lot of them took advantage of that and over prescribed to the general population. Much of this over prescription can be attributed to financial incentives from pharmaceutical groups (vacations, speaking fees, consulting payments). Physicians were bribed by Big Pharma into over prescribing painkillers to the masses, which created the opioid epidemic.

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    • Replies: @Buck Turgidson
    Fish oil or turmeric do not relieve pain from bone spurs rhematic arthtitis or herniated disks. Few people die from taking rx medicine as rx. More ppl die from medical errors each year than heroin ods. Medical errors epidemic
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  87. @Hippopotamusdrome
    theguardian.com article on "white male fragility" and mass shootings. Procedes to linst "white male" shooters.


    Mass shootings show why we must stop pandering to white male fragility
    ...
    Jarrod Ramos...Dimitrios Pagourtzis...Omar Mateen...Nikolas Cruz...

     

    rightwing “provocateur” Milo Yiannopoulos…

    Not all misogynists are violent…

    No, some of them, like Milo, express their misogyny by choosing to share a bed with anyone but a woman.

    Every description of “MSM” activity I’ve come across induces a similar feeling: “You’ve really got to hate women to prefer men. Gag.”

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  88. ATBOTL says:

    McAllen, Texas is where Dubya style conservatism leads. Dull, obese proles sitting in parked SUVs with the engine and AC running, in the Walmart parking lot eating fast food and junk food.

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    • Replies: @JohnnyWalker123
    Pretty much.

    and it's the far left who have been fighting against that type of America for decades.........

    https://www.youtube.com/watch?v=pqHHWs4TvUM

    https://www.youtube.com/watch?v=gOwXkstRaBw

    The post-1980 Dubyaization of America has created McAllens across the country.
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  89. @Hippopotamusdrome


    I examined McAllen’s homicide rate for the past 5 years.

     

    Mcallen with a Black population of 00.4% has a lower crime rate than 12% Black USA. And then still manages to have higher property crime rate.

    McAllen’s homicide rate is about 25% lower than the Non-Hispanic White average.

    McAllen’s violent crime rate is 65% than the national average. The property crime rate is 2% higher.

    Boise’s homicide rate is 1.4 incidents per 100,000 inhabitants. The violent crime rate is 175 incidents per 100,000 inhabitants. The property crime rate is 178 incidents per 100,000 inhabitants. Boise is 84% Non-Hispanic White and 1.4% Black.

    McAllen is 0.9% Black.

    So McAllen is not that different from Boise in its level of criminality.

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  90. @Jack D
    Maybe not everyone is as tough as your wife. There have been times when I have been prescribed opiates after surgery and I have been very glad that they were available. No one should be forced to bear unbearable pain when it is possible to relieve it with medication. However, I found them to be constipating (a known side effect) and derived no real enjoyment from them (other than pain relief) and could not wait to get off of them as soon as my pain subsided. But a certain % of the population becomes rapidly addicted. This is a terrible problem but I am glad that I did not have to suffer in pain because those people exist. People with addictions will obtain drugs anyway through illegal means so making it impossible to prescribe necessary pain relief to people in pain doesn't fix the problem and causes people suffering pain to suffer unnecessarily. If my doctor's answer was "you have to tough it out because some other people are addicts" I would not have been happy.

    I agree that the "addiction as disease" model is in some respects false. You can chose to quit taking pills but you can't chose to quit having cancer. There is a voluntary element to addiction but the urges are strong and not everyone has the strength to quit. But just calling it a "disease" implies that there is no element of choice involved and that is false.

    My daughter was a heroin addict for seven years and has been clean for three years now. She agrees with you about the “addiction as disease” model. It may be hard to stop, but it is a choice. She decided to stop after she hit bottom and she’s committed to sobriety.

    Like you, I’ve had opiate pain relievers when I needed them and I neither got addicted nor felt high. They say that when you have actual pain, you don’t get the high. Also, some people have a tendency toward addiction and others do not. An alcoholic once told me that after he had his first drink, he thought, “So this is what it’s like to feel normal.” I never had that reaction to a drink.

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    • Replies: @JohnnyWalker123
    Unlike America, Portugal treats addiction as an illness rather than a disease.

    https://www.youtube.com/watch?v=uQJ7n-JpcCk
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  91. @syonredux

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    Heck, compared to Haiti, it looks pretty great.....

    Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.
     
    Not to mention the third and fourth generation Latinx who live there....

    When boxes of original files from a 1965 survey of Mexican Americans were discovered behind a dusty bookshelf at UCLA, sociologists Edward Telles and Vilma Ortiz recognized a unique opportunity to examine how the Mexican American experience has evolved over the past four decades. Telles and Ortiz located and re-interviewed most of the original respondents and many of their children. Then, they combined the findings of both studies to construct a thirty-five year analysis of Mexican American integration into American society. Generations of Exclusion is the result of this extraordinary project.

     


    Generations of Exclusion measures Mexican American integration across a wide number of dimensions: education, English and Spanish language use, socioeconomic status, intermarriage, residential segregation, ethnic identity, and political participation. The study contains some encouraging findings, but many more that are troubling. Linguistically, Mexican Americans assimilate into mainstream America quite well—by the second generation, nearly all Mexican Americans achieve English proficiency. In many domains, however, the Mexican American story doesn’t fit with traditional models of assimilation. The majority of fourth generation Mexican Americans continue to live in Hispanic neighborhoods, marry other Hispanics, and think of themselves as Mexican. And while Mexican Americans make financial strides from the first to the second generation, economic progress halts at the second generation, and poverty rates remain high for later generations. Similarly, educational attainment peaks among second generation children of immigrants, but declines for the third and fourth generations.

     

    https://www.amazon.com/Generations-Exclusion-Mexican-Americans-Assimilation-Race/dp/0871548496

    According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became “White.” However, less successful Hispanics in-married and remained in ethnic enclaves. So the typical 3rd/4th generation Hispanic represents the least successful element of the population.

    At least that was Ron Unz’s interpretation and analysis. I’m not sure if he’s correct, but his analysis seems plausible to me.

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    • Replies: @Jefferson
    "According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became “White.” 

    Interracial marriage among Hispanics is decreasing as the share of Hispanics in The U.S becomes larger because the available pool of Hispanic partners for marriage is a lot bigger.

    SB10001424052748703630304575271543285254312
    There is no incentive for a Hispanic in Miami for example to marry a White Gringo when Miami is already a whopping 73% Hispanic.

    Same thing for other basically Latin American cities in The U.S like McAllen, Texas, Yuma, Arizona, Hialeah, Florida, etc. If you are a Hispanic living in these Latin American cities why would you want to marry Northwest European American mayonnaise who do not share your love of novelas, Sabado Gigante With Don Francisco, and soccer.
    , @syonredux

    According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became “White.” However, less successful Hispanics in-married and remained in ethnic enclaves. So the typical 3rd/4th generation Hispanic represents the least successful element of the population.

    At least that was Ron Unz’s interpretation and analysis. I’m not sure if he’s correct, but his analysis seems plausible to me.
     

    Main problem with Ron's theory is that he has no statistical evidence to back it up; it's all conjecture on his part....And it's highly motivated conjecture, as Ron desperately wants to believe that Latinx are the 2.0 version of Ellis Island-era immigrants....

    And, while I'm here, I'll offer some additional problems with Ron's theory....

    Why are all the upwardly-mobile Latinx marrying out? Wouldn't that imply that the number of upwardly-mobile Latinx is so vanishingly small that they can't find Latinx spouses and have to marry Anglos? There's lots of out marriage in the Asian-American community, but it's not hard to find successful Asian-Americans who are married to other Asian-Americans...


    Do all these upwardly-mobile Latinx change their surnames? If not, wouldn't we be able to track them via their Latinx surnames? Or does Ron think that most of the upwardly-mobile Latinx are female?

    What's the racial composition of this talented tenth? Are the upwardly-mobile, out marrying ones more European in ancestry than their less successful co-ethnics? If so, that presents something of a problem, as the heavily Amerind Mestizos outnumber the Castizos....

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  92. @Jack D
    Maybe not everyone is as tough as your wife. There have been times when I have been prescribed opiates after surgery and I have been very glad that they were available. No one should be forced to bear unbearable pain when it is possible to relieve it with medication. However, I found them to be constipating (a known side effect) and derived no real enjoyment from them (other than pain relief) and could not wait to get off of them as soon as my pain subsided. But a certain % of the population becomes rapidly addicted. This is a terrible problem but I am glad that I did not have to suffer in pain because those people exist. People with addictions will obtain drugs anyway through illegal means so making it impossible to prescribe necessary pain relief to people in pain doesn't fix the problem and causes people suffering pain to suffer unnecessarily. If my doctor's answer was "you have to tough it out because some other people are addicts" I would not have been happy.

    I agree that the "addiction as disease" model is in some respects false. You can chose to quit taking pills but you can't chose to quit having cancer. There is a voluntary element to addiction but the urges are strong and not everyone has the strength to quit. But just calling it a "disease" implies that there is no element of choice involved and that is false.

    However, I found them to be constipating (a known side effect)

    Oddly enough, this used to be one of the medicinal uses for opium – to treat diarrhea.

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    • Replies: @Jack D
    Immodium (loperimide), the modern treatment for diarrhea is actually an opiate but one that only acts to slow down your intestine. It does not cross the blood-brain barrier so it doesn't get you high.
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  93. @jill
    Note most of the Medicare fraud fugitives are foreigners. They come to America, set up Medicare mills, loot 24/ 7 till caught, then they flee after being released on bail.

    I actually believe Congress welcomes this type of fraud. Why else let it continue?


    https://oig.hhs.gov/fraud/fugitives/profiles.asp#other-fugitives

    Interesting.

    One reason Medicare fugitives are disproportionately foreign is because foreigners can flee to their homelands. Americans can’t really flee anywhere outside of America, usually.

    However, from my experience, foreigners do seem to engage in more medical fraud than Americans.

    I looked through the list and saw very large numbers of “White Hispanic” and Middle Eastern names. Also, many Africans, Subcons, and Eastern Euros.

    Not too many East Asians or Western Euros.

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    • Replies: @Rob McX
    Also America is a soft touch. Things would be different if they only accepted immigrants from countries that have signed an agreement to send back any wanted fugitives to face trial in the US. Considering the scope for multimillion-dollar fraud, it would be a reasonable condition for people in the medical field.
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  94. Jefferson says:

    In the sequel Sicario: Day Of The Soldado there are American born Mexicans who become coyotes for the Mexican drug cartels because there are simply not enough jobs in these heavily Mexican U.S border towns who share a border with Mexico.

    Mexican immigration has not created a job market boom in these border towns. The vibrant diversity of Mexican immigration has not been a strength for these border towns.

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  95. @Aardvark
    Bernie loves to portray himself as a sort of modern day Robin Hood. He will “alleviate” these evil capitalists of their ill gotten gain and correct their wrong doings. Except that zero of the money collected in fines will ever flow to the true victims.

    They (the Bernie’s of the political landscape) know the revolving door between the pharma industry and the FDA. Isn’t the government supposed to “protect” us? Aren’t we told we can’t live our lives without government there to “save” us? If Government had been able to protect us, why did the opioid crisis ever happen in the first place? Socialists will always champion massive regulation and when it fails, the socialist runs way from it like a stinky diaper and blames the smell on a nearby capitalist. People who love to blame capitalism for failures of government live in some imaginary world where regulation has zero effect on anything.

    these evil capitalists of their ill gotten gain

    Aren’t you guys always complaining about how American companies (Google, Facebook, Apple, etc.) make their money in nefarious ways? Don’t you guys always complain about cheap immigrant labor pushing down labor costs?

    Aren’t we told we can’t live our lives without government there to “save” us?

    Given how huge the opioid epidemic has become, the answer is clearly “NO.” Especially in working-class White areas.

    If Government had been able to protect us, why did the opioid crisis ever happen in the first place?

    How has the European Union avoided the opioid crisis?

    In 2015, 7,587 European Union residents died from drug overdoses, compared with 52,404 in the U.S. America has only 60% of the EU’s population.

    Why?

    Socialists will always champion massive regulation and when it fails, the socialist runs way from it like a stinky diaper and blames the smell on a nearby capitalist. People who love to blame capitalism for failures of government live in some imaginary world where regulation has zero effect on anything.

    It seems like the “socialists” of the European Union have been able to avoid an opioid epidemic. While “free market” America has around 12x the overdose rate of the EU.

    Of course, the problem must be that there’s too much “socialism” in America! For years, the “socialists” were putting painkillers into the mouths of the Hillbillies, while the “capitalists” would’ve never done anything so nefarious.

    America’s problem is that it’s a “socialist” economy.

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  96. Jefferson says:
    @Jack D

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.
     
    One thing you can say for Mexicans is that they are long lasting. Despite the fact that Mexico spends like 5 cents on its health care system and we spend trillions, life expectancy there is within spitting distance of the US. I assume it is the usual suspects - favorable genetics, a native diet that is healthier than the US diet (although obesity is climbing in Mexico too) and a lifestyle that involves more activity. These things have a bigger influence on life expectancy than all those MRI machines and other worthless crap that drive up US healthcare costs.

    “a native diet that is healthier than the US diet”

    What’s so healthy about burritos, tacos, and Mexican coca colas which have even more sugar than American coca colas.

    Also Mexico has a higher obesity rate than The U.S

    https://m.huffpost.com/us/entry/3568537

    I stay in hotels a lot and I would say the average Mexican room maid has the same body shape as Rosie O’Donnell.

    I don’t see too many Mexican hotel maids with bodies like Eva Longoria.

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  97. Rob McX says:
    @JohnnyWalker123
    Interesting.

    One reason Medicare fugitives are disproportionately foreign is because foreigners can flee to their homelands. Americans can't really flee anywhere outside of America, usually.

    However, from my experience, foreigners do seem to engage in more medical fraud than Americans.

    I looked through the list and saw very large numbers of "White Hispanic" and Middle Eastern names. Also, many Africans, Subcons, and Eastern Euros.

    Not too many East Asians or Western Euros.

    Also America is a soft touch. Things would be different if they only accepted immigrants from countries that have signed an agreement to send back any wanted fugitives to face trial in the US. Considering the scope for multimillion-dollar fraud, it would be a reasonable condition for people in the medical field.

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    • Replies: @JohnnyWalker123
    Very reasonable.
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  98. I find it bizarre that so many of the posters here decry “Big Govt” and “Socialism.”

    Bizarre because many of you either work for the federal or state govt, or have spouses that work for the govt. Others here are contractors that get govt contracts.

    If the U.S.&state-level govts were ever scaled back, a lot of you guys would be royally screwed.

    The lack of self-awareness is amazing to behold.

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  99. @Rob McX
    Also America is a soft touch. Things would be different if they only accepted immigrants from countries that have signed an agreement to send back any wanted fugitives to face trial in the US. Considering the scope for multimillion-dollar fraud, it would be a reasonable condition for people in the medical field.

    Very reasonable.

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  100. IBC says:
    @JohnnyWalker123
    It's outright fraud. Ultimately, this all gets added to our ever-expanding, unpayable national debt.

    When a doctor fradulently bills Medicare/Medicaid/Tricare/SCHIP for healthcare services, our federal govt goes further into debt to pay for that. This has been going on for decades, especially since the 80s.

    ignorant population of immigrants and their children.
     
    True enough, but it's not just immigrants. Plenty of ignorant White hillbillies got addicted to opioids due to over prescribing by doctors.

    Why did doctors over prescribe? One reason was because pharmaceutical representatives lavished gifts (such as vacations, "speaking" fees," "consulting" jobs) on doctors who prescribed large quantities of opioids. So essentially doctors were bribed by pharma. Bribed into literally poisoning and drug dealing to their patients.

    A second reason was because many doctors realized by filling lots of prescriptions (often done in massive "pill mills"), they could make a ton of money for their practices.

    If you look at the people who were seduced into opoioids, a very fraction were the sort of uneducated Hillbilly who was totally unable to understand what they were getting themselves into. Over time, these people became addicts. Then many transitioned to harder drugs, like heroin or fetanyl.

    Doctors and pharmaceutical companies got rich off poisoning Hillbillies.

    This is why it's nice to live in a country that tightly regulates the private sector. It's nice to live in a country with health and safety regulations. It's also nice to live in a country that treats drug addiction as an illness, rather than a crime.

    When you live in a "wild west" free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population. This is why fanatically pro-business America has so much more of a problem with opioids than the "socialist" nations of the Anglosphere and Europe.

    Contrary to what you read on here, most Whites are not "high-investment k-strategists." Most Whites are incapable of competing or surviving in deregulated globalized economy. More than anything else, they need "big govt" and "socialism" to take care of them.

    I agree with most of what you’re saying and especially with your apparent sentiments, but consider that opiate abuse is also a major problem in Canada. In fact, depending on the source, Canada is the number-one per-capita consumer of prescription opiates; or they’re only second to the US:

    https://canadians.org/blog/who-behind-canadas-opioid-epidemic

    http://healthydebate.ca/2014/01/topic/politics-of-health-care/prescription-opioid-crisis-canada

    But it does seem like pharmaceutical lobbying and over-prescribing doctors are major factors in both countries.

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    • Replies: @JohnnyWalker123
    I'm going to have to do more research into Canada.

    I do know that the European Union has about 1/12th the rate of overdose as the U.S.
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  101. Jefferson says:
    @JohnnyWalker123
    According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became "White." However, less successful Hispanics in-married and remained in ethnic enclaves. So the typical 3rd/4th generation Hispanic represents the least successful element of the population.

    At least that was Ron Unz's interpretation and analysis. I'm not sure if he's correct, but his analysis seems plausible to me.

    “According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became “White.” 

    Interracial marriage among Hispanics is decreasing as the share of Hispanics in The U.S becomes larger because the available pool of Hispanic partners for marriage is a lot bigger.

    SB10001424052748703630304575271543285254312
    There is no incentive for a Hispanic in Miami for example to marry a White Gringo when Miami is already a whopping 73% Hispanic.

    Same thing for other basically Latin American cities in The U.S like McAllen, Texas, Yuma, Arizona, Hialeah, Florida, etc. If you are a Hispanic living in these Latin American cities why would you want to marry Northwest European American mayonnaise who do not share your love of novelas, Sabado Gigante With Don Francisco, and soccer.

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  102. @El Dato

    This is why it’s nice to live in a country that tightly regulates the private sector. It’s nice to live in a country with health and safety regulations.

     

    Uh... yes? Is this the twin situation of demanding "gun controls" in a country with gun controls?

    How Government Regulations Made Healthcare So Expensive


    Since the early 1900s, medical special interests have been lobbying politicians to reduce competition. By the 1980s, the U.S. was restricting the supply of physicians, hospitals, insurance and pharmaceuticals, while subsidizing demand. Since then, the U.S. has been trying to control high costs by moving toward something perhaps best described by the House Budget Committee: “In too many areas of the economy — especially energy, housing, finance, and health care — free enterprise has given way to government control in “partnership” with a few large or politically well-connected companies” (Ryan 2012). The following are past major laws and other policies implemented by the Federal and state governments that have interfered with the health care marketplace (HHS 2013): ...

    The history of medical cost inflation and government interference in health care markets appears to support the hypothesis that prices were set by the laws of supply and demand before 1980 and perhaps 1990. Even the degree of monopolization and nationalization promoted by politicians before 1965 was not enough to cause significant cost inflation and spending increases (Figure 2) until demands created by Medicare and Medicaid outstripped the restricted supply of physicians and hospitals.
     

    It's like the subsidized schoolbook price inflation. Dog-standard schoolbooks that should be a couple of bucks are sold at Springer-level specialist pricing. Because somebody else pays for them.

    The lack of competition between hospitals and other health care institutions also limited cost control incentives placed on executives. The lack of competition between both medical institutions and the doctors that control most of their spending could explain why hospital costs have been inflating twice as fast as even physician fees. Hospitals are loaded with waste and inefficiency. For example, a hospital stitch costs more than $500 today.

    Health care may be the only industry in which suppliers blame technology for high costs. But researchers at the Robert Wood Johnson Foundation reported that small medical expenses controlled by physicians, such as blood tests and ordinary x-rays, were responsible for medical inflation, not complex technologies. The article stated that if the annual operating costs of the nation's more complex technologies — kidney dialysis, coronary bypass, electronic fetal monitoring, and computerized x-rays — were reduced one-half, the net savings would be less than one percent of the nations medical bill. They proposed income incentives for physicians as motivation for cost control (Robert 1979).
     

    It’s actually pretty easy to buy a gun in this country.

    It also used to be very easy to get opioids in this country, mostly due to lax regulation. Regulations are so minimal that pharmaceutical companies flooded the market with painkillers.

    Your article actually makes some good points.

    One huge driver of high healthcare costs is that the AMA (the national union of American physicians) is basically a cartel. It seeks to constraint the number of American medical schools. It also restricts the ability of other healthcare providers (like mid-level nurses) to provide healthcare services. This results in high medical reimbursement (due to healthcare provider shortages) and an under supply of healthcare providers.

    Physicians provide valuable services, but their power over the healthcare industry has to be diminished.

    Competition could certainly bring down healthcare costs, but that assumes that consumers (ie sick patients) are in a position to make quick decisions concerning their healthcare. That may not be the case. If you’re having a heart attack, are you really in a position to figure out whether you should go to Swedish or Kaiser? Is choosing between hospitals really the same as choosing between a Ford or a Toyota? Can the average American really understand what they’re doing?

    In much of the first world, the govt has the authority to set healthcare procedure prices. That keeps costs reasonable. Even govt-provided healthcare (like the NHS) works reasonably well.

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    • Replies: @Anonymous

    One huge driver of high healthcare costs is that the AMA (the national union of American physicians) is basically a cartel. It seeks to constraint the number of American medical schools. It also restricts the ability of other healthcare providers (like mid-level nurses) to provide healthcare services. This results in high medical reimbursement (due to healthcare provider shortages) and an under supply of healthcare providers.
     
    The AMA desperately needs to be cut down to size, it is more powerful than the Teamsters was at its peak under old man Hoffa. Hoffa was a crook and a thug, but the country was on the whole better off when big labor swung a big hard one: it counterbalanced corporate power. There's no counterweight to the AMA.
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  103. @Twinkie

    McAllen doesn’t sound a particularly inspiring place, but it’s hardly a hell hole.
     
    I grant you some people around here throw around that term excessively. However, McAllen (or other Hispanic ghettoes) doesn’t seem “that bad” in comparison to black ghettoes and other dysfunctional places, because there are still many more nicer places. When 40%+ of the country becomes like McAllen and nice places become more scarce...

    As others mentioned, historically, border areas (or marches) have been wilder, seedier places. You can live with a thin strip of that without impacting the quality of life in the core. But when that border zone becomes very deep, the core won’t stay nice much longer.

    When 40%+ of the country becomes like McAllen and nice places become more scarce…

    I don’t disagree with this. If 40% of the country is McAllen, that’d be different than if (let’s say) 20% of America is McAllen. The national dynamics change as the proportion increases.

    Sometimes they can disabuse people of wrongly held prejudices and false myths. But, it is not everything – it doesn’t, for example, capture well real world phenomena such as degradation of culture and loss of civics that have real, profound, and long-term consequences.

    True enough, but living in a socially atomized, uncultured Walmartville isn’t quite the same thing as living in a favela. Though both may be less than optimal.

    Of course if you look at the people who’ve been fighting against the Walmartization of America for decades, it’s generally been the far left types. Like Michael Moore and Ralph Nader.

    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy – both government and non-profit – that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.

    The “wild west” comment was in reference to the overall economy.

    However, I do think that with respect to prescribing painkillers, we sort of were operating in that type of “wild west” atmosphere for many years. That’s why we have an opioid epidemic.

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    • Replies: @Twinkie

    Of course if you look at the people who’ve been fighting against the Walmartization of America for decades, it’s generally been the far left types. Like Michael Moore and Ralph Nader.
     
    Because those lefties are demagogues. They create a problem and then blame the solution-provider.

    Walmart didn't create the underclass. It's a solution (of sorts) to the consumption wants of the said underclass.
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  104. @IBC
    I agree with most of what you're saying and especially with your apparent sentiments, but consider that opiate abuse is also a major problem in Canada. In fact, depending on the source, Canada is the number-one per-capita consumer of prescription opiates; or they're only second to the US:

    https://canadians.org/blog/who-behind-canadas-opioid-epidemic

    http://healthydebate.ca/2014/01/topic/politics-of-health-care/prescription-opioid-crisis-canada

    But it does seem like pharmaceutical lobbying and over-prescribing doctors are major factors in both countries.

    I’m going to have to do more research into Canada.

    I do know that the European Union has about 1/12th the rate of overdose as the U.S.

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  105. @ATBOTL
    McAllen, Texas is where Dubya style conservatism leads. Dull, obese proles sitting in parked SUVs with the engine and AC running, in the Walmart parking lot eating fast food and junk food.

    Pretty much.

    and it’s the far left who have been fighting against that type of America for decades………

    The post-1980 Dubyaization of America has created McAllens across the country.

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  106. @Harry Baldwin
    My daughter was a heroin addict for seven years and has been clean for three years now. She agrees with you about the “addiction as disease” model. It may be hard to stop, but it is a choice. She decided to stop after she hit bottom and she's committed to sobriety.

    Like you, I've had opiate pain relievers when I needed them and I neither got addicted nor felt high. They say that when you have actual pain, you don't get the high. Also, some people have a tendency toward addiction and others do not. An alcoholic once told me that after he had his first drink, he thought, "So this is what it's like to feel normal." I never had that reaction to a drink.

    Unlike America, Portugal treats addiction as an illness rather than a disease.

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  107. @AndrewR
    O wise one, if it suits you to deign yourself to help a simple fool like me, please tell us who should be counted as White™ and who shouldn't.

    I refer you to a SNL episode:

    Saturday Night Live Transcripts [1988]
    Vote Bush III
    [ show each President's head encircled over a North European country ]
    Announcer: Franklin Delano Roosevelt was of white northern European heritage.
    Thomas Jefferson was of white northern European heritage.
    John F. Kennedy was of white northern European heritage.
    George Herbert Walker Bush is of white northern European heritage.
    [ show Dukakis' encircled just above the Mediterranean Sea ]
    But Michael Dukakis?
    Bush. He’s whiter.
    [ SUPER: "Bush. He's Whiter." ]

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    • Replies: @AndrewR
    Kennedy was purebred Irish. Might as well have had a Somalian as president.
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  108. snorlax says:
    @Big Bill
    It's getting even more complicated. Recently the new SJW word "Chicanx" has appeared.

    I think it is pronounced "chih-CONKS". Or perhaps "chih-CAN-icks".

    If this "x" trend continues among our dusky south-of-the-border brethren it is going to get quite confusing.

    A Mexican fireman is a "bombero". Will he/she/it/xir soon be a "bomberx" [bomb-bear-icks"]? Will a postman (cartero) become a "car-TEAR-icks"? Will a cook (cocinero) be come a "ko-sin-AIR-icks"? A laundress (lavandera) become a "lah-vahn-derricks"?

    Whenever lefties re-engineer the lexicon, they should be required to agree on (and publish) the proper PC pronunciation. Perhaps it could be added to the NYT/LAT/WSJ style guides, at least for the first year or two.

    She-Canucks.

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  109. Jack D says:
    @Johann Ricke

    However, I found them to be constipating (a known side effect)
     
    Oddly enough, this used to be one of the medicinal uses for opium - to treat diarrhea.

    Immodium (loperimide), the modern treatment for diarrhea is actually an opiate but one that only acts to slow down your intestine. It does not cross the blood-brain barrier so it doesn’t get you high.

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    • Replies: @Johann Ricke

    Immodium (loperimide), the modern treatment for diarrhea is actually an opiate but one that only acts to slow down your intestine. It does not cross the blood-brain barrier so it doesn’t get you high.
     
    Your mention prompted a look at the Wiki entry. If this passage is any indication, the days of OTC access to this particular drug might be numbered:

    Recreational use

    Loperamide has typically been deemed to have a relatively low risk of misuse.[60] In 2012, there were no reports of loperamide abuse.[61]

    In 2015, however, case reports of extremely high-dose loperamide resulting in opioid misuse were published.[62][63] Dubbing it “the poor man's methadone," clinicians warned that increased restrictions on the availability of prescription opioids passed in response to the opioid epidemic were prompting recreational users to turn to loperamide as an over-the-counter treatment for withdrawal symptoms.[64] The FDA responded to these warnings by calling on drug manufacturers to voluntarily limit the availability of loperamide for public safety reasons, in an analogous manner to restrictions put on the sales of pseudoephedrine, to be sold only in limited amounts.[65][66]

    Since 2015, several reports of sometimes-fatal cardiotoxicity due to high-dose loperamide abuse have been published.[67][68]
     
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  110. Medvedev says:
    @jim jones
    Even kids can buy from cigarette vending machines in Japan and, guess what, they have the longest lifespan of any humans. Compare this to Zimbabwe where nobody smokes and the lifespan is 59 years.

    Don’t know about vending machines in Japan or prevalence of smoking in Zimbabwe. But even if your words were true, this is still strawman argument. Japanese do not live longer than Zimbabweans because smoking is more prevalent in Japan.

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  111. @JohnnyWalker123
    There are certain supplements that are effective at treating bone and arthritis pain. For example, Turmeric/Curcumin and Omega 3 supplementation (Fish Oil, Astaxanthin, Krill Oil).

    However, there are many conditions that need painkillers to be treated properly.

    The basic problem is that when physicians were given the freedom to prescribe painkillers, a lot of them took advantage of that and over prescribed to the general population. Much of this over prescription can be attributed to financial incentives from pharmaceutical groups (vacations, speaking fees, consulting payments). Physicians were bribed by Big Pharma into over prescribing painkillers to the masses, which created the opioid epidemic.

    Fish oil or turmeric do not relieve pain from bone spurs rhematic arthtitis or herniated disks. Few people die from taking rx medicine as rx. More ppl die from medical errors each year than heroin ods. Medical errors epidemic

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  112. AndrewR says:
    @Hippopotamusdrome
    I refer you to a SNL episode:


    Saturday Night Live Transcripts [1988]
    Vote Bush III
    [ show each President's head encircled over a North European country ]
    Announcer: Franklin Delano Roosevelt was of white northern European heritage.
    Thomas Jefferson was of white northern European heritage.
    John F. Kennedy was of white northern European heritage.
    George Herbert Walker Bush is of white northern European heritage.
    [ show Dukakis' encircled just above the Mediterranean Sea ]
    But Michael Dukakis?
    Bush. He's whiter.
    [ SUPER: "Bush. He's Whiter." ]

     

    Kennedy was purebred Irish. Might as well have had a Somalian as president.

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  113. @Jack D
    Immodium (loperimide), the modern treatment for diarrhea is actually an opiate but one that only acts to slow down your intestine. It does not cross the blood-brain barrier so it doesn't get you high.

    Immodium (loperimide), the modern treatment for diarrhea is actually an opiate but one that only acts to slow down your intestine. It does not cross the blood-brain barrier so it doesn’t get you high.

    Your mention prompted a look at the Wiki entry. If this passage is any indication, the days of OTC access to this particular drug might be numbered:

    Recreational use

    Loperamide has typically been deemed to have a relatively low risk of misuse.[60] In 2012, there were no reports of loperamide abuse.[61]

    In 2015, however, case reports of extremely high-dose loperamide resulting in opioid misuse were published.[62][63] Dubbing it “the poor man’s methadone,” clinicians warned that increased restrictions on the availability of prescription opioids passed in response to the opioid epidemic were prompting recreational users to turn to loperamide as an over-the-counter treatment for withdrawal symptoms.[64] The FDA responded to these warnings by calling on drug manufacturers to voluntarily limit the availability of loperamide for public safety reasons, in an analogous manner to restrictions put on the sales of pseudoephedrine, to be sold only in limited amounts.[65][66]

    Since 2015, several reports of sometimes-fatal cardiotoxicity due to high-dose loperamide abuse have been published.[67][68]

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  114. syonredux says:
    @JohnnyWalker123
    According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became "White." However, less successful Hispanics in-married and remained in ethnic enclaves. So the typical 3rd/4th generation Hispanic represents the least successful element of the population.

    At least that was Ron Unz's interpretation and analysis. I'm not sure if he's correct, but his analysis seems plausible to me.

    According to Ron Unz, that study is biased. He believes that over time, better-assimilated, upwardly-mobile Hispanics married outside the Hispanic population and became “White.” However, less successful Hispanics in-married and remained in ethnic enclaves. So the typical 3rd/4th generation Hispanic represents the least successful element of the population.

    At least that was Ron Unz’s interpretation and analysis. I’m not sure if he’s correct, but his analysis seems plausible to me.

    Main problem with Ron’s theory is that he has no statistical evidence to back it up; it’s all conjecture on his part….And it’s highly motivated conjecture, as Ron desperately wants to believe that Latinx are the 2.0 version of Ellis Island-era immigrants….

    And, while I’m here, I’ll offer some additional problems with Ron’s theory….

    Why are all the upwardly-mobile Latinx marrying out? Wouldn’t that imply that the number of upwardly-mobile Latinx is so vanishingly small that they can’t find Latinx spouses and have to marry Anglos? There’s lots of out marriage in the Asian-American community, but it’s not hard to find successful Asian-Americans who are married to other Asian-Americans…

    Do all these upwardly-mobile Latinx change their surnames? If not, wouldn’t we be able to track them via their Latinx surnames? Or does Ron think that most of the upwardly-mobile Latinx are female?

    What’s the racial composition of this talented tenth? Are the upwardly-mobile, out marrying ones more European in ancestry than their less successful co-ethnics? If so, that presents something of a problem, as the heavily Amerind Mestizos outnumber the Castizos….

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  115. 3g4me says:
    @Jack D

    and a complete lack of understanding of the racial reality or true character of heritage America.
     
    I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white "heritage America" of your imagination never existed, at least not in McAllen.

    @56 Jack D: “I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen.”

    Gee Jack, thanks so much for edumacatin’ little ol’ me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That’s why they invited Whites in the first place – to be expendable in meat space and make Texas territory safe for their brand of White and brown people – except the Anglosphere Whites decided to stay and take over.

    I realize you believe, like a certain other didactic commenter whose name I shall not mention, that googling and wikipedia make you an expert on everything, but I did learn a thing or two reading on my own, as well as shepherding two sons through their required Texas history classes, not to mention living in Texas for more than 23 years. I realize you desperately want America to have been your mystical melting pot from the get-go but you’ll just have to express your anti-gentile animus another way this time.

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    • Replies: @Anonymous

    Gee Jack, thanks so much for edumacatin’ little ol’ me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That’s why they invited Whites in the first place – to be expendable in meat space and make Texas territory safe for their brand of White and brown people – except the Anglosphere Whites decided to stay and take over.
     
    The Aztecs were brutal , but one on one were no match for the Plains Indians, who would eat them for breakfast. One on one whites were also generally not much match for a young brave from these tribes.

    But the whites had better weapons, and could operate as a group, and could build fortifications, and could operate in cooperation better than the Mesoamerican tribals or the mestizos. And the Spaniard had no reason to expand because he smelled no treasure there.

    "Forty miles a day on beans and hay"-the cavalry, the pioneers, and the settlers were an onslaught the Plains Indians ultimately could not handle.
    , @Twinkie
    You are both wrong. :)

    Jack D is wrong in that "heritage America," in fact, did, exist. The first place in America I lived was such a place. I was one of a handful of nonwhite students at school there. I learned to say the Pledge of Allegiance every morning and studied about the Mayflower. I played Cowboys and Indians with my friends (who were ALL white) on the street in front of my house. It was a lovely place and I do my best to recreate that for my own children. My wife, from a small town Midwest, of course also grew up in that heritage America (funny story - when she was a tiny tot she knew two Asian kids, but because she didn't know about Asians - she did know about blacks - she thought they were rather "funny kind" of whites when she first met them).

    3g4me is (slightly) wrong in that Jack D is right about the not-so-heritage parts of America. They too existed - they just happened not to receive much attention in the national psyche, because, frankly, they didn't matter very much for the country as a whole. But they have been there a long time, in some places even before there was America as an independent country.

    But that doesn't change the fact that core (or heritage) America is shrinking and border (or fringe) America is growing, which bodes ill for both Americas.
    , @Jack D

    That’s why they invited Whites in the first place ..... except the Anglosphere Whites decided to stay and take over.
     
    Note to self - never invite Anglosphere Whites onto your territory.
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  116. Anonymous[427] • Disclaimer says:
    @JohnnyWalker123
    It's actually pretty easy to buy a gun in this country.

    It also used to be very easy to get opioids in this country, mostly due to lax regulation. Regulations are so minimal that pharmaceutical companies flooded the market with painkillers.

    https://www.youtube.com/watch?v=QE7HrsnHhIc

    Your article actually makes some good points.

    One huge driver of high healthcare costs is that the AMA (the national union of American physicians) is basically a cartel. It seeks to constraint the number of American medical schools. It also restricts the ability of other healthcare providers (like mid-level nurses) to provide healthcare services. This results in high medical reimbursement (due to healthcare provider shortages) and an under supply of healthcare providers.

    Physicians provide valuable services, but their power over the healthcare industry has to be diminished.

    Competition could certainly bring down healthcare costs, but that assumes that consumers (ie sick patients) are in a position to make quick decisions concerning their healthcare. That may not be the case. If you're having a heart attack, are you really in a position to figure out whether you should go to Swedish or Kaiser? Is choosing between hospitals really the same as choosing between a Ford or a Toyota? Can the average American really understand what they're doing?

    In much of the first world, the govt has the authority to set healthcare procedure prices. That keeps costs reasonable. Even govt-provided healthcare (like the NHS) works reasonably well.

    One huge driver of high healthcare costs is that the AMA (the national union of American physicians) is basically a cartel. It seeks to constraint the number of American medical schools. It also restricts the ability of other healthcare providers (like mid-level nurses) to provide healthcare services. This results in high medical reimbursement (due to healthcare provider shortages) and an under supply of healthcare providers.

    The AMA desperately needs to be cut down to size, it is more powerful than the Teamsters was at its peak under old man Hoffa. Hoffa was a crook and a thug, but the country was on the whole better off when big labor swung a big hard one: it counterbalanced corporate power. There’s no counterweight to the AMA.

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  117. Anonymous[427] • Disclaimer says:
    @3g4me
    @56 Jack D: "I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen."

    Gee Jack, thanks so much for edumacatin' little ol' me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That's why they invited Whites in the first place - to be expendable in meat space and make Texas territory safe for their brand of White and brown people - except the Anglosphere Whites decided to stay and take over.

    I realize you believe, like a certain other didactic commenter whose name I shall not mention, that googling and wikipedia make you an expert on everything, but I did learn a thing or two reading on my own, as well as shepherding two sons through their required Texas history classes, not to mention living in Texas for more than 23 years. I realize you desperately want America to have been your mystical melting pot from the get-go but you'll just have to express your anti-gentile animus another way this time.

    Gee Jack, thanks so much for edumacatin’ little ol’ me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That’s why they invited Whites in the first place – to be expendable in meat space and make Texas territory safe for their brand of White and brown people – except the Anglosphere Whites decided to stay and take over.

    The Aztecs were brutal , but one on one were no match for the Plains Indians, who would eat them for breakfast. One on one whites were also generally not much match for a young brave from these tribes.

    But the whites had better weapons, and could operate as a group, and could build fortifications, and could operate in cooperation better than the Mesoamerican tribals or the mestizos. And the Spaniard had no reason to expand because he smelled no treasure there.

    “Forty miles a day on beans and hay”-the cavalry, the pioneers, and the settlers were an onslaught the Plains Indians ultimately could not handle.

    Read More
    • Replies: @Guy Lombardo
    >One on one whites were also generally not much match for a young brave from these tribes.

    Yes they were. What a ridiculous thing to say.
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  118. Twinkie says:
    @JohnnyWalker123
    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.

    In the same time period, median household income rose from $50,000 to $59,000.

    So physician median income rose by 26% over 7 years, but the median household income increased by merely 18%. So that's a fairly substantial difference, especially when you consider that the base salaries (50K vs 160K) are already so far apart.

    It'd be like if I got a $10,000/yr raise while the rest of you saw your incomes stagnate.

    I regret to inform you that a majority of physicians in the U.S. are no longer shareholders or partners in practices and are, instead, wage slaves like everyone else. As such, they have no financial incentive to over-prescribe anything. Furthermore, primary care physicians are not getting 300K salaries.

     

    47% of physicians own their own practice. Which is extremely substantial.

    Your point is actually not correct. Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to "overutilize" the system. Not to the same extent as owner-operator physicians, but the incentive remains.

    You are correct that primary care physicians typically don't make $300,000/yr salaries, but specialists (who are around 2/3 of physicians) often make that level of income.

    Physician compensation growth (e.g. among internists about 1% a year, which is below inflation) is not even remotely the main driver of healthcare costs explosion in the U.S., which are high drug prices, over-utilization, and ultra-expensive high-tech treatments for marginal returns (esp. in end-of-life care). These are things that are simply unavailable or denied in other countries, even highly developed ones (which also have much healthier populations with better health habits).

     

    "Overutilization" occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to "overutilize." Much like a mechanic has an incentive to claim that your brakes, engine, windshield, and tires are all defective and must be replaced immediately.

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates. See below quote.

    https://www.healthpopuli.com/2013/04/02/u-s-health-costs-vs-the-world-is-it-still-the-prices-and-are-we-still-stupid/

    A routine office visit to a doctor cost an average of $95 in the U.S. in 2012. The same visit was priced at $30 in Canada and $30 in France, as well. A hip replacement cost $40,364 on average in the U.S. in 2012. The total hospital and physician cost for a hip replacement in the UK was $11,889 and in France, $10,927.Apr 2, 2013

     

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.

    You're correct that other populations do seem to have better health habits, especially eating habits. America probably needs to do something to encourage better eating habits in the general population.

    Not stuff like this.

    https://www.youtube.com/watch?v=RpV4ot-VEyA

    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.

    Your number is very deceptive for a number of reasons.

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

    On a side note, I sit on the board of a large healthcare system (multiple hospitals across the South). It has been having trouble recruiting physicians in the last several years for the same reason, and for the first time in 20 years or so, it has had to offer significantly increased salaries.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

    “I tracked internal medicine physician income between 1990 and 2010 and found an average annual income increase of 1%. That was $140k in 1990, $170k by 2010 and $183k in 2017. Therefore, overall, physician incomes are flat, and even at our low 2-3% rate of inflation, physician income buying power is declining,” he concludes.

    And this at a time when the medical student debt load has risen substantially (here is a happy article about being a doctor today: https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/).

    But that’s not even a very accurate view of physician income trends. Why?

    While the opinions and data suggest that incomes are trending down, there are even some interesting theories suggesting that physicians may be taking on less pro bono work as a result. Physician complaints about salaries are generally not well received, and are often labeled as whining. Yet signs of dissatisfaction are reflected more through action than through words. Doctors leaving medicine, taking on side jobs, retiring early and even succumbing to depression and suicide are on the rise. It is not clear how much of this is due to declining salaries and what has happened to the medical profession.

    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income – bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

    47% of physicians own their own practice. Which is extremely substantial.

    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

    Flash back to today, among physicians who are 40 years old or younger, 75% are employees. Do you really think that these doctors, who are now wage slaves to large, impersonal, risk-averse, and highly bureaucratic medical corporations, are going to be “entrepreneurial” and over-prescribe to line the profits for these companies (most of which now give the doctors WORSE medical insurance plans than those of the patients, forget about disability and other perks that used to be the norm)?

    Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to “overutilize” the system. Not to the same extent as owner-operator physicians, but the incentive remains.

    Bonuses to salaried physicians range typically $10,000-$25,000 a year and that includes extra compensation for taking on administrative duties (such as being chair of departments or being medical directors of facilities). For anyone remotely acquainted with hospital economics, the idea of salaried physicians over-prescribing pain medication to get that extra $10,000 a year is utterly laughable. What’s that, $6,500 after taxes… all for the pleasure of having DEA looking into your practice? (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians – e.g. anesthesiologists and their staff with DEA numbers – able to access.)

    “Overutilization” occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to “overutilize.”

    Doctors can’t force patients to come to hospitals.

    There is a far less nefarious reason for overutilization than doctors scheming to bilk insurance companies or the government (although that does happen with a very small minority of, ahem, “certain” doctors). First of all, there is today a perverse incentive for PATIENTS to utilize medical services at high rates due to (historically) declining out-of-pocket expenses (which reversed in the last several years, but the long-term trend is very downward). In 1970, for example, about 40% of healthcare expenditures were paid out of pocket in the U.S. By 1990, that number dipped below 20%. At the same time, Medicare and Medicaid increased demands for services dramatically. The outcome is that there is now a MASSIVE demand for medical services from the public itself, without any need for the specter of supposedly greedy doctors ordering every procedure in the book.

    Furthermore, the explosive rise of medical malpractice litigations during this period meant that “defensive medicine” has become doctrine. Doctors today routinely order additional (and very costly) tests and scans (and even extra procedures sometimes), not because that lines their pockets (that extra money generally goes to someone else or even other facilities), but because that “thoroughness” affords them some protection during malpractice lawsuits and trials (“I did everything I could – there was nothing else I could do to prevent the negative outcome”).

    By the way, aside from actual criminal schemes, no sane physician today takes on MORE Medicare and Medicaid patients willingly. Their reimbursements are pitiful and often generate no additional income (and not so infrequently losses).

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates.

    That’s nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history. That’s not the reason why our national medical care costs have skyrocketed in comparison to those of other countries.

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.

    “Preventative healthcare” programs have been shown to do… wait for it… nothing to improve health outcomes. Americans don’t smoke or over-eat because they have not been exposed to preventative healthcare programs.

    Americans in 1970 (or before) had far LOWER numbers of visits to doctors than today (much lower access to, and utilization of, healthcare), yet were less likely to suffer from obesity and many related illness. You are intelligent enough to realize why.

    You’re correct that other populations do seem to have better health habits, especially eating habits.

    Eating habits are half the equation. The other is sedentary lifestyle.

    Cross country “health outcome” comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won’t matter much what kind of medical care system you have – you will end up with a healthy population with low overall medical care costs.

    Our – American – problem today is very simple. We have an increasingly unhealthy bottom half of the population (obesity is strongly inverse-correlated to income/education attainment) with correspondingly high demand for medical services, which we have worsened considerably by increasingly subsidizing healthcare services.

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play “Look, squirrel!” with the real problem.

    *By the way, there has been a high degree of “consolidation” among hospitals in the last 10 years or so, due to decreased profitability. Massive numbers of communities have lost hospitals and now have longer travel time to access healthcare, especially TERTIARY care.

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    • Agree: Jim Don Bob
    • Replies: @Anonymous
    Did anyone actually read this 40,000-word rant? If so, what did he say? Guy's got a lot of time on his hands.
    , @Johann Ricke

    And this at a time when the medical student debt load has risen substantially
     
    I don't know if this is true for medical schools, but it is true that tuition at state universities has risen 3-4x in the past 30 years over what it was in the late 80's, meaning that what was once $3K a year is now $9K to $12K a year. And these are possibly the laggards in terms of tuition increases.
    , @JohnnyWalker123

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

     

    Physicians were complaining that Obamacare would kill their income potential. It turns out that the ACA has been a bit of windfall for them, due to all the new patients. There's also been cost savings due to practice consolidation.

    It has been having trouble recruiting physicians in the last several years for the same reason
     
    Another reason is that physicians restrict competitors (such as mid-level nurses) from performing certain procedures. This gives more negotiating power to physicians when they deal with Medicare and private insurance.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

     

    For internists and other primary care physicians, income has been stagnant. For specialists, income has risen substantially. Specialists are 2/3 of physicians, while primary care (including internal medicine doctors) are 1/3.

    And this at a time when the medical student debt load has risen substantially
     
    The average medical school debt is $200,000. Which is a lot, but so is a $200,000 salary. Anyway, lots of college grads are going massively into debt too, but (unlike doctors) they often have no financial payoff waiting in the end.

    So while the debt situation is worrying, doctors will be okay. I can't say the same for many other professions with more dubious prospects.

    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income – bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

     

    True. There's also a bifurcation between specialists and primary care doctors. However, even with that, my experience is that starting doctors can get at least $150,000/yr. Not bad for a 30 year-old. Especially when your peers are often unemployed/underemployed or working as an Uber driver. Heck, even lots of PHDs and adjunct professors are on food stamps these days.

    Doctors have it pretty good.

    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

     

    Doctors began over prescribing when pharmaceutical companies began bribing them with vacations, "consulting" payments, and "speaking" fees. Some doctors also figured they could make a ton of money by running "pill mills."

    The over prescription of painkillers was mostly driven by pharma. Pharma didn't get truly aggressive
    about pushing pills to the masses until around the late 90s.

    https://www.youtube.com/watch?v=U80q3AISReI

    Doctors got bribed a lot, unfortunately. They mostly got away with it. You might think it's irrational, but doctors were often highly pliable to pharmaceutical influence.

    Doctors aren't nearly as mature or high-minded as they are made out to be. Here's an article about how pharma companies hired cheerleaders to wine&dine doctors. https://abcnews.go.com/US/story?id=4438095&page=1

    More here.

    https://www.nbcnews.com/storyline/americas-heroin-epidemic/many-doctors-get-goodies-opioid-makers-n791281

    (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians – e.g. anesthesiologists and their staff with DEA numbers – able to access.)
     
    Now it is, but only after hundreds of thousands of opioid overdoses.

    That’s nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history.

     

    This is because they're paid and reimbursed more.

    Medical procedures really are reimbursed at higher rates in the U.S. than in other first world nations. This is an established fact.

    “Preventative healthcare” programs have been shown to do… wait for it… nothing to improve health outcomes. Americans don’t smoke or over-eat because they have not been exposed to preventative healthcare programs.

     

    Except the govt was very successful at decreasing smoking. That's preventative healthcare right there. More easily could be done.

    If we stopped dropping bombs on random Muslim civilians for a few month, we'd have a lot of money for all sorts of preventative healthcare programs.

    Cross country “health outcome” comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won’t matter much what kind of medical care system you have – you will end up with a healthy population with low overall medical care costs.

     

    American Whites have poorer health outcomes and higher health costs than ethnically similar Anglo populations in NZ, Australia, Canada, and the UK. Are they really that different genetically?

    Are they really that different culturally? If they are, then why do you (and nearly everyone else here) champion HBD? I thought HBDers believed that behavior and outcomes were mostly genetic, so how are ethnically Anglo Americans doing so much worse than Anglos elsEwhere?

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play “Look, squirrel!” with the real problem.

     

    The real problem is that Big Pharma got rich by getting huge numbers of Americans addicted to painkillers. This killed hundreds of thousands of peopel. In the European Union, which more stringently regulates pharmaceuticals, overdose deaths are per capita 1/12th as common.

    Also, in "socialist" Europe, per capita healthcare costs are far lower too. How do they manage that?
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  119. Twinkie says:
    @JohnnyWalker123

    When 40%+ of the country becomes like McAllen and nice places become more scarce…

     

    I don't disagree with this. If 40% of the country is McAllen, that'd be different than if (let's say) 20% of America is McAllen. The national dynamics change as the proportion increases.

    Sometimes they can disabuse people of wrongly held prejudices and false myths. But, it is not everything – it doesn’t, for example, capture well real world phenomena such as degradation of culture and loss of civics that have real, profound, and long-term consequences.

     

    True enough, but living in a socially atomized, uncultured Walmartville isn't quite the same thing as living in a favela. Though both may be less than optimal.

    Of course if you look at the people who've been fighting against the Walmartization of America for decades, it's generally been the far left types. Like Michael Moore and Ralph Nader.

    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy – both government and non-profit – that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.

     

    The "wild west" comment was in reference to the overall economy.

    However, I do think that with respect to prescribing painkillers, we sort of were operating in that type of "wild west" atmosphere for many years. That's why we have an opioid epidemic.

    Of course if you look at the people who’ve been fighting against the Walmartization of America for decades, it’s generally been the far left types. Like Michael Moore and Ralph Nader.

    Because those lefties are demagogues. They create a problem and then blame the solution-provider.

    Walmart didn’t create the underclass. It’s a solution (of sorts) to the consumption wants of the said underclass.

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    • Replies: @JohnnyWalker123
    WalMart's consumers aren't just the underclass. WalMart caters to the broad majority of Americans.

    Because those lefties are demagogues. They create a problem and then blame the solution-provider.

     

    Michael Moore and Ralph Nader have little political or economic power in this country. They didn't create anything. They just pointed out the deficiencies in the system.

    Moore actually made a lot of good points about how the Bush Whitehouse lied about WMDs in Iraq. Bush also lied about how Iraq was supposedly behind 9/11. Unfortunately, America went to war anyway, which resulted in $5 trillion being spent, while thousands of American soldiers died and 1 million American soldiers were injured. Over 1 million Iraqis also perished (while millions more were displaced, widowed, and orphaned), but nobody cares about them.

    Michael Moore addresses issues like that.

    This is what demagougery looks like.......

    https://www.youtube.com/watch?v=5bP1f_1o-zo

    and this is what truth looks like.......

    https://www.youtube.com/watch?v=yg-be2r7ouc
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  120. Twinkie says:
    @3g4me
    @56 Jack D: "I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen."

    Gee Jack, thanks so much for edumacatin' little ol' me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That's why they invited Whites in the first place - to be expendable in meat space and make Texas territory safe for their brand of White and brown people - except the Anglosphere Whites decided to stay and take over.

    I realize you believe, like a certain other didactic commenter whose name I shall not mention, that googling and wikipedia make you an expert on everything, but I did learn a thing or two reading on my own, as well as shepherding two sons through their required Texas history classes, not to mention living in Texas for more than 23 years. I realize you desperately want America to have been your mystical melting pot from the get-go but you'll just have to express your anti-gentile animus another way this time.

    You are both wrong. :)

    Jack D is wrong in that “heritage America,” in fact, did, exist. The first place in America I lived was such a place. I was one of a handful of nonwhite students at school there. I learned to say the Pledge of Allegiance every morning and studied about the Mayflower. I played Cowboys and Indians with my friends (who were ALL white) on the street in front of my house. It was a lovely place and I do my best to recreate that for my own children. My wife, from a small town Midwest, of course also grew up in that heritage America (funny story – when she was a tiny tot she knew two Asian kids, but because she didn’t know about Asians – she did know about blacks – she thought they were rather “funny kind” of whites when she first met them).

    3g4me is (slightly) wrong in that Jack D is right about the not-so-heritage parts of America. They too existed – they just happened not to receive much attention in the national psyche, because, frankly, they didn’t matter very much for the country as a whole. But they have been there a long time, in some places even before there was America as an independent country.

    But that doesn’t change the fact that core (or heritage) America is shrinking and border (or fringe) America is growing, which bodes ill for both Americas.

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  121. @Anonymous

    Gee Jack, thanks so much for edumacatin’ little ol’ me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That’s why they invited Whites in the first place – to be expendable in meat space and make Texas territory safe for their brand of White and brown people – except the Anglosphere Whites decided to stay and take over.
     
    The Aztecs were brutal , but one on one were no match for the Plains Indians, who would eat them for breakfast. One on one whites were also generally not much match for a young brave from these tribes.

    But the whites had better weapons, and could operate as a group, and could build fortifications, and could operate in cooperation better than the Mesoamerican tribals or the mestizos. And the Spaniard had no reason to expand because he smelled no treasure there.

    "Forty miles a day on beans and hay"-the cavalry, the pioneers, and the settlers were an onslaught the Plains Indians ultimately could not handle.

    >One on one whites were also generally not much match for a young brave from these tribes.

    Yes they were. What a ridiculous thing to say.

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  122. Anonymous[106] • Disclaimer says:
    @Twinkie

    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.
     
    Your number is very deceptive for a number of reasons.

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

    On a side note, I sit on the board of a large healthcare system (multiple hospitals across the South). It has been having trouble recruiting physicians in the last several years for the same reason, and for the first time in 20 years or so, it has had to offer significantly increased salaries.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

    “I tracked internal medicine physician income between 1990 and 2010 and found an average annual income increase of 1%. That was $140k in 1990, $170k by 2010 and $183k in 2017. Therefore, overall, physician incomes are flat, and even at our low 2-3% rate of inflation, physician income buying power is declining,” he concludes.
     
    And this at a time when the medical student debt load has risen substantially (here is a happy article about being a doctor today: https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/).

    But that's not even a very accurate view of physician income trends. Why?

    While the opinions and data suggest that incomes are trending down, there are even some interesting theories suggesting that physicians may be taking on less pro bono work as a result. Physician complaints about salaries are generally not well received, and are often labeled as whining. Yet signs of dissatisfaction are reflected more through action than through words. Doctors leaving medicine, taking on side jobs, retiring early and even succumbing to depression and suicide are on the rise. It is not clear how much of this is due to declining salaries and what has happened to the medical profession.
     
    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income - bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

    47% of physicians own their own practice. Which is extremely substantial.
     
    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

    Flash back to today, among physicians who are 40 years old or younger, 75% are employees. Do you really think that these doctors, who are now wage slaves to large, impersonal, risk-averse, and highly bureaucratic medical corporations, are going to be "entrepreneurial" and over-prescribe to line the profits for these companies (most of which now give the doctors WORSE medical insurance plans than those of the patients, forget about disability and other perks that used to be the norm)?

    Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to “overutilize” the system. Not to the same extent as owner-operator physicians, but the incentive remains.
     
    Bonuses to salaried physicians range typically $10,000-$25,000 a year and that includes extra compensation for taking on administrative duties (such as being chair of departments or being medical directors of facilities). For anyone remotely acquainted with hospital economics, the idea of salaried physicians over-prescribing pain medication to get that extra $10,000 a year is utterly laughable. What's that, $6,500 after taxes... all for the pleasure of having DEA looking into your practice? (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians - e.g. anesthesiologists and their staff with DEA numbers - able to access.)

    “Overutilization” occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to “overutilize.”
     
    Doctors can't force patients to come to hospitals.

    There is a far less nefarious reason for overutilization than doctors scheming to bilk insurance companies or the government (although that does happen with a very small minority of, ahem, "certain" doctors). First of all, there is today a perverse incentive for PATIENTS to utilize medical services at high rates due to (historically) declining out-of-pocket expenses (which reversed in the last several years, but the long-term trend is very downward). In 1970, for example, about 40% of healthcare expenditures were paid out of pocket in the U.S. By 1990, that number dipped below 20%. At the same time, Medicare and Medicaid increased demands for services dramatically. The outcome is that there is now a MASSIVE demand for medical services from the public itself, without any need for the specter of supposedly greedy doctors ordering every procedure in the book.

    Furthermore, the explosive rise of medical malpractice litigations during this period meant that "defensive medicine" has become doctrine. Doctors today routinely order additional (and very costly) tests and scans (and even extra procedures sometimes), not because that lines their pockets (that extra money generally goes to someone else or even other facilities), but because that "thoroughness" affords them some protection during malpractice lawsuits and trials ("I did everything I could - there was nothing else I could do to prevent the negative outcome").

    By the way, aside from actual criminal schemes, no sane physician today takes on MORE Medicare and Medicaid patients willingly. Their reimbursements are pitiful and often generate no additional income (and not so infrequently losses).

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates.
     
    That's nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history. That's not the reason why our national medical care costs have skyrocketed in comparison to those of other countries.

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.
     
    "Preventative healthcare" programs have been shown to do... wait for it... nothing to improve health outcomes. Americans don't smoke or over-eat because they have not been exposed to preventative healthcare programs.

    Americans in 1970 (or before) had far LOWER numbers of visits to doctors than today (much lower access to, and utilization of, healthcare), yet were less likely to suffer from obesity and many related illness. You are intelligent enough to realize why.

    You’re correct that other populations do seem to have better health habits, especially eating habits.
     
    Eating habits are half the equation. The other is sedentary lifestyle.

    Cross country "health outcome" comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won't matter much what kind of medical care system you have - you will end up with a healthy population with low overall medical care costs.

    Our - American - problem today is very simple. We have an increasingly unhealthy bottom half of the population (obesity is strongly inverse-correlated to income/education attainment) with correspondingly high demand for medical services, which we have worsened considerably by increasingly subsidizing healthcare services.

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play "Look, squirrel!" with the real problem.

    *By the way, there has been a high degree of "consolidation" among hospitals in the last 10 years or so, due to decreased profitability. Massive numbers of communities have lost hospitals and now have longer travel time to access healthcare, especially TERTIARY care.

    Did anyone actually read this 40,000-word rant? If so, what did he say? Guy’s got a lot of time on his hands.

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  123. @Big Bill
    It's getting even more complicated. Recently the new SJW word "Chicanx" has appeared.

    I think it is pronounced "chih-CONKS". Or perhaps "chih-CAN-icks".

    If this "x" trend continues among our dusky south-of-the-border brethren it is going to get quite confusing.

    A Mexican fireman is a "bombero". Will he/she/it/xir soon be a "bomberx" [bomb-bear-icks"]? Will a postman (cartero) become a "car-TEAR-icks"? Will a cook (cocinero) be come a "ko-sin-AIR-icks"? A laundress (lavandera) become a "lah-vahn-derricks"?

    Whenever lefties re-engineer the lexicon, they should be required to agree on (and publish) the proper PC pronunciation. Perhaps it could be added to the NYT/LAT/WSJ style guides, at least for the first year or two.

    When I was in Mexico, I learned that “x” in Mayan place names is pronounced “sh”, so Uxmal is pronounced “Ooshmal.” I don’t know if this is a general rule, but if it is, then we should pronounce these neologisms as “Lateensh” and “Chihcansh.”

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  124. Jack D says:
    @3g4me
    @56 Jack D: "I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen."

    Gee Jack, thanks so much for edumacatin' little ol' me! By the by, the Mexicans customarily traveled south, through Mexican territory, around large swathes of what became Texas up to and during the early 19th century because they had repeatedly failed to deal with the Comanches. That's why they invited Whites in the first place - to be expendable in meat space and make Texas territory safe for their brand of White and brown people - except the Anglosphere Whites decided to stay and take over.

    I realize you believe, like a certain other didactic commenter whose name I shall not mention, that googling and wikipedia make you an expert on everything, but I did learn a thing or two reading on my own, as well as shepherding two sons through their required Texas history classes, not to mention living in Texas for more than 23 years. I realize you desperately want America to have been your mystical melting pot from the get-go but you'll just have to express your anti-gentile animus another way this time.

    That’s why they invited Whites in the first place ….. except the Anglosphere Whites decided to stay and take over.

    Note to self – never invite Anglosphere Whites onto your territory.

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  125. Pepe says:
    @George
    I perused the Gawande article and he thinks El Paso and McAllen are similar enough to compare. El Paso is, however, more successful. Which kind of raises a question, if El Paso is a better example, why did the Goofus who wrote the Washington Post article choose McAllen?

    McAllen was chosen because it’s been the center of the huge surge of illegal immigration since about 2014. The surge with all the Central Americans and families, etc.

    McAllen has one of those facilities where the kids were being separated from the parents. It’s called the Ursula facility, because it’s on Ursula road in McAllen.

    Brownsville has been the subject of several articles as well, because they have the similar Casa Padre facility, an old Walmart building.

    El Paso is missing out out on this.

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  126. MBlanc46 says:
    @ben tillman

    The comment was good until the last sentence, which totally flipped reality.

    The unfortunate reality is that immigrant doctors and doctors that cater to immigrants “engage in a very high rate of ‘overutilization’”.
     
    But, to be sure, it does go beyond that, and the genesis of the health-care boondoggle is the central government's imposition of wage freezes in the 1940's to induce employers to offer health insurance to workers in place of (illegal) wage increases. That's how the central government separated the patient from payment, which is 90% of the problem.

    Third-party payment is the principal part of the high cost of medical care. I have a hard time conceiving of a fee-for-service model in modern circumstances. Anyone know of serious research on this?

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  127. MBlanc46 says:
    @Hapalong Cassidy
    “Not to mention the third and fourth generation Latinx who live there….“

    That reminds me of a question I keep meaning to ask: how do you pronounce “Latinx”? Is it pronounced “Latinks”, which sounds kind of effeminate, or is it “Latin X”, which sounds like the name of a mutant Hispanic superhero?

    It used to be Latinas/Latinos, but I suppose that was homophobic or transphobic or something.

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  128. Neoconned says:
    @JohnnyWalker123
    I examined McAllen's homicide rate for the past 5 years. The average homicide rate was 2.0 per 100,000 inhabitants. For comparison, the Non-Hispanic White homicide rate was roughly 2.6 per 100,000.

    For the previous 5 years, McAllen had a violent crime rate of 73 incidents per 100,000 inhabitants. The national rate was 209 incidents per 100,000 inhabitants.

    For the previous 5 years, McAllen had a property crime rate of 241 incidents per 100,000 inhabitants. The national rate was 237 incidents per 100,000 inhabitants.

    So it appears that McAllen is a fairly safe city to live in.

    I walked around downtown El Paso in the middle of the night both last summer and in 2016. Mind you most of the shops downtown have metal burglar grates on them but what spooked me more was that even in the afternoon as you walk between the skyscrapers there are very few people around once you get away from the border area where the flea market shops are locayed.

    Most of what you see are homeless black dudes….

    I felt completely safe walking around El Paso at night and if anything I think I scared people.

    As was explained to me….El Paso has a huge law enforcement presence and thus there isn’t much crime. I didn’t even find streerwalkers. The Mexican guys told me to cross the river into Juarez for that kinda zhit.

    Brownsville and McAllen are the same.

    Huge state and federal law enforcement presence so not as much riff raff and bs.

    As for property crime….pronanly illegals stealing shit to aid their move north.

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    • Replies: @3g4me
    @128 Neoconned: "As was explained to me….El Paso has a huge law enforcement presence and thus there isn’t much crime. I didn’t even find streerwalkers. The Mexican guys told me to cross the river into Juarez for that kinda zhit.

    Brownsville and McAllen are the same."

    My husband, child of a career army officer, spent ages 10 - 26 in El Paso. His high school was over 50% White when he attended in the late '70s. It was still 40% White as of 1988. It is now 8% White. All the blather about statistics and crime is akin to a SJW citing official statistics about the putative Negro middle class to White homeowners fleeing the rapid browning of their neighborhood. One or two non-White families may be perfect exceptions . . . on paper . . . but in real life, they are the thin edge of the wedge. Genetics = culture, and quantity has a quality all its own. There is very little difference between El Paso and Juarez today. A superficial surface of Americana is just that - superficial - and can/will be destroyed or discarded in a matter of days when the federal largesse stops.
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  129. MBlanc46 says:
    @Twinkie

    When you live in a “wild west” free-market utopia, economic predators basically cannibalize the weaker and dimmer members of the population.
     
    What the heck are you talking about? Medical care in the U.S. is heavily regulated and are hardly “Wild West free-market.” I see you never had dealings with JCAHO. The bureaucracy - both government and non-profit - that oversee medicine in the U.S. are mind-boggling in its complexity and opaqueness.

    I’ve done some work in medical publishing. “Compliance” is a major topic of discussion.

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  130. CCZ says:

    Is Boston, giving non-citizens local voting rights, America’s destiny??

    Black female Councilwoman pushes for voting rights for as many as 190,000 legal non-citizens in Boston.

    https://www.boston.com/news/local-news/2018/07/08/boston-weighs-giving-legal-non-us-citizens-voting-rights

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  131. @Twinkie

    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.
     
    Your number is very deceptive for a number of reasons.

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

    On a side note, I sit on the board of a large healthcare system (multiple hospitals across the South). It has been having trouble recruiting physicians in the last several years for the same reason, and for the first time in 20 years or so, it has had to offer significantly increased salaries.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

    “I tracked internal medicine physician income between 1990 and 2010 and found an average annual income increase of 1%. That was $140k in 1990, $170k by 2010 and $183k in 2017. Therefore, overall, physician incomes are flat, and even at our low 2-3% rate of inflation, physician income buying power is declining,” he concludes.
     
    And this at a time when the medical student debt load has risen substantially (here is a happy article about being a doctor today: https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/).

    But that's not even a very accurate view of physician income trends. Why?

    While the opinions and data suggest that incomes are trending down, there are even some interesting theories suggesting that physicians may be taking on less pro bono work as a result. Physician complaints about salaries are generally not well received, and are often labeled as whining. Yet signs of dissatisfaction are reflected more through action than through words. Doctors leaving medicine, taking on side jobs, retiring early and even succumbing to depression and suicide are on the rise. It is not clear how much of this is due to declining salaries and what has happened to the medical profession.
     
    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income - bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

    47% of physicians own their own practice. Which is extremely substantial.
     
    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

    Flash back to today, among physicians who are 40 years old or younger, 75% are employees. Do you really think that these doctors, who are now wage slaves to large, impersonal, risk-averse, and highly bureaucratic medical corporations, are going to be "entrepreneurial" and over-prescribe to line the profits for these companies (most of which now give the doctors WORSE medical insurance plans than those of the patients, forget about disability and other perks that used to be the norm)?

    Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to “overutilize” the system. Not to the same extent as owner-operator physicians, but the incentive remains.
     
    Bonuses to salaried physicians range typically $10,000-$25,000 a year and that includes extra compensation for taking on administrative duties (such as being chair of departments or being medical directors of facilities). For anyone remotely acquainted with hospital economics, the idea of salaried physicians over-prescribing pain medication to get that extra $10,000 a year is utterly laughable. What's that, $6,500 after taxes... all for the pleasure of having DEA looking into your practice? (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians - e.g. anesthesiologists and their staff with DEA numbers - able to access.)

    “Overutilization” occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to “overutilize.”
     
    Doctors can't force patients to come to hospitals.

    There is a far less nefarious reason for overutilization than doctors scheming to bilk insurance companies or the government (although that does happen with a very small minority of, ahem, "certain" doctors). First of all, there is today a perverse incentive for PATIENTS to utilize medical services at high rates due to (historically) declining out-of-pocket expenses (which reversed in the last several years, but the long-term trend is very downward). In 1970, for example, about 40% of healthcare expenditures were paid out of pocket in the U.S. By 1990, that number dipped below 20%. At the same time, Medicare and Medicaid increased demands for services dramatically. The outcome is that there is now a MASSIVE demand for medical services from the public itself, without any need for the specter of supposedly greedy doctors ordering every procedure in the book.

    Furthermore, the explosive rise of medical malpractice litigations during this period meant that "defensive medicine" has become doctrine. Doctors today routinely order additional (and very costly) tests and scans (and even extra procedures sometimes), not because that lines their pockets (that extra money generally goes to someone else or even other facilities), but because that "thoroughness" affords them some protection during malpractice lawsuits and trials ("I did everything I could - there was nothing else I could do to prevent the negative outcome").

    By the way, aside from actual criminal schemes, no sane physician today takes on MORE Medicare and Medicaid patients willingly. Their reimbursements are pitiful and often generate no additional income (and not so infrequently losses).

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates.
     
    That's nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history. That's not the reason why our national medical care costs have skyrocketed in comparison to those of other countries.

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.
     
    "Preventative healthcare" programs have been shown to do... wait for it... nothing to improve health outcomes. Americans don't smoke or over-eat because they have not been exposed to preventative healthcare programs.

    Americans in 1970 (or before) had far LOWER numbers of visits to doctors than today (much lower access to, and utilization of, healthcare), yet were less likely to suffer from obesity and many related illness. You are intelligent enough to realize why.

    You’re correct that other populations do seem to have better health habits, especially eating habits.
     
    Eating habits are half the equation. The other is sedentary lifestyle.

    Cross country "health outcome" comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won't matter much what kind of medical care system you have - you will end up with a healthy population with low overall medical care costs.

    Our - American - problem today is very simple. We have an increasingly unhealthy bottom half of the population (obesity is strongly inverse-correlated to income/education attainment) with correspondingly high demand for medical services, which we have worsened considerably by increasingly subsidizing healthcare services.

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play "Look, squirrel!" with the real problem.

    *By the way, there has been a high degree of "consolidation" among hospitals in the last 10 years or so, due to decreased profitability. Massive numbers of communities have lost hospitals and now have longer travel time to access healthcare, especially TERTIARY care.

    And this at a time when the medical student debt load has risen substantially

    I don’t know if this is true for medical schools, but it is true that tuition at state universities has risen 3-4x in the past 30 years over what it was in the late 80′s, meaning that what was once $3K a year is now $9K to $12K a year. And these are possibly the laggards in terms of tuition increases.

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  132. At the same time, in terms of violent crime, McAllen is one of the safest cities in the country. It is safer than New York City, which is pretty much the gold standard for cities above 100K population. Its deep dark secret? A black population of 0.4% vs a Hispanic population of 85.6%.

    Hispanics can be law-abiding. But the fish rots from the head down. Somehow, stateside, we have the cultural intangibles that help keep McAllen fairly peaceful. Mexicans are certainly a heck of a lot less lawless than Puerto Ricans.

    http://www.city-data.com/city/McAllen-Texas.html

    http://www.city-data.com/city/New-York-New-York.html

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    • Replies: @Hare Krishna
    At least you don't have things like this going on in McAllen...https://heavy.com/news/2018/07/rodolfo-rodriguez/
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  133. 3g4me says:
    @Neoconned
    I walked around downtown El Paso in the middle of the night both last summer and in 2016. Mind you most of the shops downtown have metal burglar grates on them but what spooked me more was that even in the afternoon as you walk between the skyscrapers there are very few people around once you get away from the border area where the flea market shops are locayed.

    Most of what you see are homeless black dudes....

    I felt completely safe walking around El Paso at night and if anything I think I scared people.

    As was explained to me....El Paso has a huge law enforcement presence and thus there isn't much crime. I didn't even find streerwalkers. The Mexican guys told me to cross the river into Juarez for that kinda zhit.

    Brownsville and McAllen are the same.

    Huge state and federal law enforcement presence so not as much riff raff and bs.

    As for property crime....pronanly illegals stealing shit to aid their move north.

    @128 Neoconned: “As was explained to me….El Paso has a huge law enforcement presence and thus there isn’t much crime. I didn’t even find streerwalkers. The Mexican guys told me to cross the river into Juarez for that kinda zhit.

    Brownsville and McAllen are the same.”

    My husband, child of a career army officer, spent ages 10 – 26 in El Paso. His high school was over 50% White when he attended in the late ’70s. It was still 40% White as of 1988. It is now 8% White. All the blather about statistics and crime is akin to a SJW citing official statistics about the putative Negro middle class to White homeowners fleeing the rapid browning of their neighborhood. One or two non-White families may be perfect exceptions . . . on paper . . . but in real life, they are the thin edge of the wedge. Genetics = culture, and quantity has a quality all its own. There is very little difference between El Paso and Juarez today. A superficial surface of Americana is just that – superficial – and can/will be destroyed or discarded in a matter of days when the federal largesse stops.

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    • Replies: @JohnnyWalker123

    There is very little difference between El Paso and Juarez today.

     

    El Paso's average homicide rate for the past 5 years was 2.6 per 100,000. Which is the same as the Non-Hispanic White homicide rate. Ciudad Juárez had a homicide rate of 56 per 100,000 in 2017.

    If you believe the statement you made above, you're totally innumerate.

    56 is bigger than 2.6.

    Math is hard, but it's not that hard.

    The New York Times even ran a story contrasting El Paso's tranquility with the carnage of Ciudad Juárez.

    http://www.nytimes.com/2009/01/23/us/23elpaso.html

    So, no, El Paso is not Ciudad Juárez. El Paso has only 2/3 the homicide rate of Dubya's Midland, which is hardly considered a hell hole.
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  134. Dr. Doom says:

    People are perplexed at why flooding Freedonia with itinerant peasants is causing wages to stay stagnant and increasing poverty. “We have no idea why this might be happening.”, said Dr. Bean of the Bean Council of Bean Counters. People are saying its White Racism. White Racism is also responsible for the Bad Weather. “This is a completely legitimate scapegoat for everything wrong in our society.”, said Henry J. Satan, esq. He is a leading attorney for Wolff and Byrd, associates of Wolfram and Hart, attorneys at law and occult studies institute.
    A little girl has come forward and said she saw Hitler in her closet. “Its about time we brought Hitler out of the closet.”, said a QWERTY keyboard warrior. Some say it might be Hysteria. Some say they would. Should a would be a should if the would could be a should?

    WE MAY NEVER ASK THESE QUESTIONS.

    Like the controversy of why putting more criminals in jail could cause crime to go down on the streets.
    Cause and Effect does not imply Correlation.

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  135. syonredux says:
    @Jack D

    and a complete lack of understanding of the racial reality or true character of heritage America.
     
    I think you are the one who lacks understanding. Border cities like McAllen were always multi-cultural and a little rough around the edges. They were never the whitopias of your imagination. The Mexicans were there first. Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white "heritage America" of your imagination never existed, at least not in McAllen.

    The Mexicans were there first.

    Well, if you want to get technical, the Amerinds were there first…..

    Texas was also a slave state and 1/3 black at the outbreak of the Civil War. The all white “heritage America” of your imagination never existed, at least not in McAllen.

    I think that most Heritage Americans would be satisfied with the Anglo-White super-majority that we had in 1960 (85.4%)…..

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  136. TWS says:
    @JohnnyWalker123
    I examined McAllen's homicide rate for the past 5 years. The average homicide rate was 2.0 per 100,000 inhabitants. For comparison, the Non-Hispanic White homicide rate was roughly 2.6 per 100,000.

    For the previous 5 years, McAllen had a violent crime rate of 73 incidents per 100,000 inhabitants. The national rate was 209 incidents per 100,000 inhabitants.

    For the previous 5 years, McAllen had a property crime rate of 241 incidents per 100,000 inhabitants. The national rate was 237 incidents per 100,000 inhabitants.

    So it appears that McAllen is a fairly safe city to live in.

    You want a cookie for that? Your big argument is that they don’t commit crime ask that often? You’re not supposed to commit any crime.

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  137. @Johann Ricke
    At the same time, in terms of violent crime, McAllen is one of the safest cities in the country. It is safer than New York City, which is pretty much the gold standard for cities above 100K population. Its deep dark secret? A black population of 0.4% vs a Hispanic population of 85.6%.

    Hispanics can be law-abiding. But the fish rots from the head down. Somehow, stateside, we have the cultural intangibles that help keep McAllen fairly peaceful. Mexicans are certainly a heck of a lot less lawless than Puerto Ricans.

    http://www.city-data.com/city/McAllen-Texas.html
    http://www.city-data.com/city/New-York-New-York.html

    At least you don’t have things like this going on in McAllen…https://heavy.com/news/2018/07/rodolfo-rodriguez/

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  138. @3g4me
    @128 Neoconned: "As was explained to me….El Paso has a huge law enforcement presence and thus there isn’t much crime. I didn’t even find streerwalkers. The Mexican guys told me to cross the river into Juarez for that kinda zhit.

    Brownsville and McAllen are the same."

    My husband, child of a career army officer, spent ages 10 - 26 in El Paso. His high school was over 50% White when he attended in the late '70s. It was still 40% White as of 1988. It is now 8% White. All the blather about statistics and crime is akin to a SJW citing official statistics about the putative Negro middle class to White homeowners fleeing the rapid browning of their neighborhood. One or two non-White families may be perfect exceptions . . . on paper . . . but in real life, they are the thin edge of the wedge. Genetics = culture, and quantity has a quality all its own. There is very little difference between El Paso and Juarez today. A superficial surface of Americana is just that - superficial - and can/will be destroyed or discarded in a matter of days when the federal largesse stops.

    There is very little difference between El Paso and Juarez today.

    El Paso’s average homicide rate for the past 5 years was 2.6 per 100,000. Which is the same as the Non-Hispanic White homicide rate. Ciudad Juárez had a homicide rate of 56 per 100,000 in 2017.

    If you believe the statement you made above, you’re totally innumerate.

    56 is bigger than 2.6.

    Math is hard, but it’s not that hard.

    The New York Times even ran a story contrasting El Paso’s tranquility with the carnage of Ciudad Juárez.

    http://www.nytimes.com/2009/01/23/us/23elpaso.html

    So, no, El Paso is not Ciudad Juárez. El Paso has only 2/3 the homicide rate of Dubya’s Midland, which is hardly considered a hell hole.

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    @138 JohhnyWalker123: "If you believe the statement you made above, you’re totally innumerate . . . 56 is bigger than 2.6."

    It is? Well I never. Gee, the things a smart subcontinental knows.

    Mother India is calling you, Johnny. Go home and utilize your marvelous mathematical skills to predict how your particular Jati will fare in the World's Biggest Democracy Without Indoor Plumbing. Hmmn, is that part of your affection for McAllen and El Paso? The Mestizos in El Paso are wont to do their business wherever they happen to be on the street - kinda like home for you, innit?
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  139. @Twinkie

    Of course if you look at the people who’ve been fighting against the Walmartization of America for decades, it’s generally been the far left types. Like Michael Moore and Ralph Nader.
     
    Because those lefties are demagogues. They create a problem and then blame the solution-provider.

    Walmart didn't create the underclass. It's a solution (of sorts) to the consumption wants of the said underclass.

    WalMart’s consumers aren’t just the underclass. WalMart caters to the broad majority of Americans.

    Because those lefties are demagogues. They create a problem and then blame the solution-provider.

    Michael Moore and Ralph Nader have little political or economic power in this country. They didn’t create anything. They just pointed out the deficiencies in the system.

    Moore actually made a lot of good points about how the Bush Whitehouse lied about WMDs in Iraq. Bush also lied about how Iraq was supposedly behind 9/11. Unfortunately, America went to war anyway, which resulted in $5 trillion being spent, while thousands of American soldiers died and 1 million American soldiers were injured. Over 1 million Iraqis also perished (while millions more were displaced, widowed, and orphaned), but nobody cares about them.

    Michael Moore addresses issues like that.

    This is what demagougery looks like…….

    and this is what truth looks like…….

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  140. @Twinkie

    The median physician income was roughly $160,000/yr in 2009. In 2016, median physician income was approximately $200,000.
     
    Your number is very deceptive for a number of reasons.

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

    On a side note, I sit on the board of a large healthcare system (multiple hospitals across the South). It has been having trouble recruiting physicians in the last several years for the same reason, and for the first time in 20 years or so, it has had to offer significantly increased salaries.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

    “I tracked internal medicine physician income between 1990 and 2010 and found an average annual income increase of 1%. That was $140k in 1990, $170k by 2010 and $183k in 2017. Therefore, overall, physician incomes are flat, and even at our low 2-3% rate of inflation, physician income buying power is declining,” he concludes.
     
    And this at a time when the medical student debt load has risen substantially (here is a happy article about being a doctor today: https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/).

    But that's not even a very accurate view of physician income trends. Why?

    While the opinions and data suggest that incomes are trending down, there are even some interesting theories suggesting that physicians may be taking on less pro bono work as a result. Physician complaints about salaries are generally not well received, and are often labeled as whining. Yet signs of dissatisfaction are reflected more through action than through words. Doctors leaving medicine, taking on side jobs, retiring early and even succumbing to depression and suicide are on the rise. It is not clear how much of this is due to declining salaries and what has happened to the medical profession.
     
    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income - bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

    47% of physicians own their own practice. Which is extremely substantial.
     
    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

    Flash back to today, among physicians who are 40 years old or younger, 75% are employees. Do you really think that these doctors, who are now wage slaves to large, impersonal, risk-averse, and highly bureaucratic medical corporations, are going to be "entrepreneurial" and over-prescribe to line the profits for these companies (most of which now give the doctors WORSE medical insurance plans than those of the patients, forget about disability and other perks that used to be the norm)?

    Even wage-earning physicians are often given financial bonuses if their billings exceed a target. So even wage-earning physicians are incentivized to “overutilize” the system. Not to the same extent as owner-operator physicians, but the incentive remains.
     
    Bonuses to salaried physicians range typically $10,000-$25,000 a year and that includes extra compensation for taking on administrative duties (such as being chair of departments or being medical directors of facilities). For anyone remotely acquainted with hospital economics, the idea of salaried physicians over-prescribing pain medication to get that extra $10,000 a year is utterly laughable. What's that, $6,500 after taxes... all for the pleasure of having DEA looking into your practice? (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians - e.g. anesthesiologists and their staff with DEA numbers - able to access.)

    “Overutilization” occurs because it is linked to physician income. The more a physician bills these various insurance programs (Medicare, Medicaid, TriCare, SCHIP, private insurance), the more they earn. So they have an incentive to “overutilize.”
     
    Doctors can't force patients to come to hospitals.

    There is a far less nefarious reason for overutilization than doctors scheming to bilk insurance companies or the government (although that does happen with a very small minority of, ahem, "certain" doctors). First of all, there is today a perverse incentive for PATIENTS to utilize medical services at high rates due to (historically) declining out-of-pocket expenses (which reversed in the last several years, but the long-term trend is very downward). In 1970, for example, about 40% of healthcare expenditures were paid out of pocket in the U.S. By 1990, that number dipped below 20%. At the same time, Medicare and Medicaid increased demands for services dramatically. The outcome is that there is now a MASSIVE demand for medical services from the public itself, without any need for the specter of supposedly greedy doctors ordering every procedure in the book.

    Furthermore, the explosive rise of medical malpractice litigations during this period meant that "defensive medicine" has become doctrine. Doctors today routinely order additional (and very costly) tests and scans (and even extra procedures sometimes), not because that lines their pockets (that extra money generally goes to someone else or even other facilities), but because that "thoroughness" affords them some protection during malpractice lawsuits and trials ("I did everything I could - there was nothing else I could do to prevent the negative outcome").

    By the way, aside from actual criminal schemes, no sane physician today takes on MORE Medicare and Medicaid patients willingly. Their reimbursements are pitiful and often generate no additional income (and not so infrequently losses).

    A major factor in why our system is so expensive is because hospitals and physicians are simply reimbursed at much higher rates.
     
    That's nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history. That's not the reason why our national medical care costs have skyrocketed in comparison to those of other countries.

    Another factor is that Americans visit the doctor less often than other nationalities, which results in less preventative healthcare. Which means that when Americans do show up to the doctor, their medical conditions are more severe and more costly to treat.
     
    "Preventative healthcare" programs have been shown to do... wait for it... nothing to improve health outcomes. Americans don't smoke or over-eat because they have not been exposed to preventative healthcare programs.

    Americans in 1970 (or before) had far LOWER numbers of visits to doctors than today (much lower access to, and utilization of, healthcare), yet were less likely to suffer from obesity and many related illness. You are intelligent enough to realize why.

    You’re correct that other populations do seem to have better health habits, especially eating habits.
     
    Eating habits are half the equation. The other is sedentary lifestyle.

    Cross country "health outcome" comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won't matter much what kind of medical care system you have - you will end up with a healthy population with low overall medical care costs.

    Our - American - problem today is very simple. We have an increasingly unhealthy bottom half of the population (obesity is strongly inverse-correlated to income/education attainment) with correspondingly high demand for medical services, which we have worsened considerably by increasingly subsidizing healthcare services.

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play "Look, squirrel!" with the real problem.

    *By the way, there has been a high degree of "consolidation" among hospitals in the last 10 years or so, due to decreased profitability. Massive numbers of communities have lost hospitals and now have longer travel time to access healthcare, especially TERTIARY care.

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

    Physicians were complaining that Obamacare would kill their income potential. It turns out that the ACA has been a bit of windfall for them, due to all the new patients. There’s also been cost savings due to practice consolidation.

    It has been having trouble recruiting physicians in the last several years for the same reason

    Another reason is that physicians restrict competitors (such as mid-level nurses) from performing certain procedures. This gives more negotiating power to physicians when they deal with Medicare and private insurance.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

    For internists and other primary care physicians, income has been stagnant. For specialists, income has risen substantially. Specialists are 2/3 of physicians, while primary care (including internal medicine doctors) are 1/3.

    And this at a time when the medical student debt load has risen substantially

    The average medical school debt is $200,000. Which is a lot, but so is a $200,000 salary. Anyway, lots of college grads are going massively into debt too, but (unlike doctors) they often have no financial payoff waiting in the end.

    So while the debt situation is worrying, doctors will be okay. I can’t say the same for many other professions with more dubious prospects.

    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income – bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

    True. There’s also a bifurcation between specialists and primary care doctors. However, even with that, my experience is that starting doctors can get at least $150,000/yr. Not bad for a 30 year-old. Especially when your peers are often unemployed/underemployed or working as an Uber driver. Heck, even lots of PHDs and adjunct professors are on food stamps these days.

    Doctors have it pretty good.

    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

    Doctors began over prescribing when pharmaceutical companies began bribing them with vacations, “consulting” payments, and “speaking” fees. Some doctors also figured they could make a ton of money by running “pill mills.”

    The over prescription of painkillers was mostly driven by pharma. Pharma didn’t get truly aggressive
    about pushing pills to the masses until around the late 90s.

    Doctors got bribed a lot, unfortunately. They mostly got away with it. You might think it’s irrational, but doctors were often highly pliable to pharmaceutical influence.

    Doctors aren’t nearly as mature or high-minded as they are made out to be. Here’s an article about how pharma companies hired cheerleaders to wine&dine doctors. https://abcnews.go.com/US/story?id=4438095&page=1

    More here.

    https://www.nbcnews.com/storyline/americas-heroin-epidemic/many-doctors-get-goodies-opioid-makers-n791281

    (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians – e.g. anesthesiologists and their staff with DEA numbers – able to access.)

    Now it is, but only after hundreds of thousands of opioid overdoses.

    That’s nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history.

    This is because they’re paid and reimbursed more.

    Medical procedures really are reimbursed at higher rates in the U.S. than in other first world nations. This is an established fact.

    “Preventative healthcare” programs have been shown to do… wait for it… nothing to improve health outcomes. Americans don’t smoke or over-eat because they have not been exposed to preventative healthcare programs.

    Except the govt was very successful at decreasing smoking. That’s preventative healthcare right there. More easily could be done.

    If we stopped dropping bombs on random Muslim civilians for a few month, we’d have a lot of money for all sorts of preventative healthcare programs.

    Cross country “health outcome” comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won’t matter much what kind of medical care system you have – you will end up with a healthy population with low overall medical care costs.

    American Whites have poorer health outcomes and higher health costs than ethnically similar Anglo populations in NZ, Australia, Canada, and the UK. Are they really that different genetically?

    Are they really that different culturally? If they are, then why do you (and nearly everyone else here) champion HBD? I thought HBDers believed that behavior and outcomes were mostly genetic, so how are ethnically Anglo Americans doing so much worse than Anglos elsEwhere?

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play “Look, squirrel!” with the real problem.

    The real problem is that Big Pharma got rich by getting huge numbers of Americans addicted to painkillers. This killed hundreds of thousands of peopel. In the European Union, which more stringently regulates pharmaceuticals, overdose deaths are per capita 1/12th as common.

    Also, in “socialist” Europe, per capita healthcare costs are far lower too. How do they manage that?

    Read More
    • Replies: @Twinkie

    Physicians were complaining that Obamacare would kill their income potential.
     
    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby - the AMA - supported Obamacare.

    Another reason is that physicians restrict competitors (such as mid-level nurses) from performing certain procedures.
     
    If nurses had the same amount of training and overall understanding of the human body, they would be... doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called "doctors" in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

    Specialists are 2/3 of physicians, while primary care (including internal medicine doctors) are 1/3.
     
    Yes, but more than 50% of office visits to doctors are to primary care doctors. And they are generally the conduit through which specialist services can be obtained.

    The average medical school debt is $200,000. Which is a lot, but so is a $200,000 salary. Anyway, lots of college grads are going massively into debt too, but (unlike doctors) they often have no financial payoff waiting in the end.
     
    Again, read this. https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/

    Doctors began over prescribing when pharmaceutical companies began bribing them with vacations, “consulting” payments, and “speaking” fees.
     
    Only a miniscule fraction of physicians receives such largess.

    Now it is, but only after hundreds of thousands of opioid overdoses.
     
    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

    Medical procedures really are reimbursed at higher rates in the U.S. than in other first world nations. This is an established fact.
     
    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

    Except the govt was very successful at decreasing smoking. That’s preventative healthcare right there. More easily could be done.
     
    Smoking wasn't curtailed by medical "preventative healthcare" programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn't have much obesity - so let's make the country poorer!

    Are they really that different genetically? Are they really that different culturally?
     
    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale... and that's on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

    If they are, then why do you (and nearly everyone else here) champion HBD
     
    In general, environmentarians are those who believe everything is environmentally constructed (e.g. "blank slate") while hereditarians (such as Mr. Sailer) are those who believe that human outcomes are heredity + environment. I am on the latter side.

    Genetic and racial essentialists are... not scientific. So perhaps you can direct this straw man at someone else.
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  141. 3g4me says:
    @JohnnyWalker123

    There is very little difference between El Paso and Juarez today.

     

    El Paso's average homicide rate for the past 5 years was 2.6 per 100,000. Which is the same as the Non-Hispanic White homicide rate. Ciudad Juárez had a homicide rate of 56 per 100,000 in 2017.

    If you believe the statement you made above, you're totally innumerate.

    56 is bigger than 2.6.

    Math is hard, but it's not that hard.

    The New York Times even ran a story contrasting El Paso's tranquility with the carnage of Ciudad Juárez.

    http://www.nytimes.com/2009/01/23/us/23elpaso.html

    So, no, El Paso is not Ciudad Juárez. El Paso has only 2/3 the homicide rate of Dubya's Midland, which is hardly considered a hell hole.

    @138 JohhnyWalker123: “If you believe the statement you made above, you’re totally innumerate . . . 56 is bigger than 2.6.”

    It is? Well I never. Gee, the things a smart subcontinental knows.

    Mother India is calling you, Johnny. Go home and utilize your marvelous mathematical skills to predict how your particular Jati will fare in the World’s Biggest Democracy Without Indoor Plumbing. Hmmn, is that part of your affection for McAllen and El Paso? The Mestizos in El Paso are wont to do their business wherever they happen to be on the street – kinda like home for you, innit?

    Read More
    • Replies: @Twinkie

    Mother India is calling you, Johnny. Go home and utilize your marvelous mathematical skills to predict how your particular Jati will fare in the World’s Biggest Democracy Without Indoor Plumbing.
     
    Look, I fall more on your side than his on this argument about McAllen, but what you wrote above is unworthy of your intellect.

    If another "heritage American" made this rather obvious argument - "56 is bigger than 2.6" - would you be responding this way?

    Please be intellectually honest and fair, and try to come up with good - rational and plausible - reasons for your position. I personally think that living conditions on this side of the border ARE better than the other side even with similar demographics, mainly because of the superior rule of law here (and the very heavy Federalization/subsidization of the border areas), but that requires an acknowledgment that environment (along with heredity) plays a role in real life.
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  142. @JohnnyWalker123
    https://www.census.gov/quickfacts/fact/table/mcallencitytexas/POP060210

    According to the US Census Bureau, 28.2% of McAllen residents (over the age of 25) have a college degree. 74.6% were high school graduates. In comparison, 36% of Non-Hispanic Whites have a college degree and 93.3% have graduated from high school.

    25.7% of McAllen residents live in poverty. The national poverty rate is 13% and the Non-Hispanic White poverty rate is 9%.

    McAllen's per capita income is $21,726. The median household income is $45,568. The national per capita income is $29,829 and the median household income is $55,322.

    60.6% of McAllen's housing is owner-occupied. The national figure is 63.6%.

    61.0% of McAllen's residents (16 and older) are in the labor force, compared to 63.1% nationally.

    McAllen has 125 firms per 1,000 inhabitants. Nationally, the figure is 85 per 1,000 inhabitants.

    28% of McAllen's inhabitants are foreign-born (almost entirely from Mexico and Central America).

    Hidalgo County (which includes McAllen and has similar demographics) has a life expectancy of 80 years. The Non-Hispanic White life expectancy is 79 years.

    McAllen doesn't sound a particularly inspiring place, but it's hardly a hell hole. Some of its statistical shortcomings can probably be attributed to the large population of impoverished Hispanic migrants who literally cross the border and end up living there.

    Johnny you’re just pointing out that McAllen is not terrible but … mediocre. (Which i believe was the point of Steve’s post.)

    Hispanics do not create black ghetto conditions. Especially not in violent crime–or at least murderously violent crime. Latin Americans are not dysfunctional at modern life. But the standards–including critical standards like corruption, rule-of-law–are just mediocre across the board.

    These McAllen economic numbers run roughly 25% below national norms, and that’s being attached to the still predominately white American economy, getting an inflow of social security and pension dollars through the snowbird influx. Separate these folks from the US and the numbers would tumble toward Mexican numbers at 25% or so of developed white nations.

    What you simply don’t get–will never get–from these McAllens is anything dynamic. No Boeings, no Microsofts, no Amazons, no Intels, no GE jet engines and medical devices, no Qualcoms, no International Harvester (whatever they call it now), John Deere, Caterpillar, Ford, no Mayo Clinic or John Hopkins, no Space X, no Tesla, no great research universities, no human genome project, etc. etc. McAllen–and every place like it–muddle along, but never produces anything that anyone else would want.

    That’s the problem.

    The US could drag along a bunch of Hispanics, as it has dragged along blacks. In fact it would be much, much easier to drag along a similar or even larger number of Hispanics than blacks. The Hispanics actually work at useful–though usually low-skill–jobs and don’t destroy prime urban real estate with violent crime.

    However if you Hispanify the joint, eventually the sheer mediocrity catches up with you. You’re no longer the dynamic white nation that creates the standard of living we enjoy. All the technical advance will be in East Asia and whatever European remanants remain. And we’re stuck living in McAllens from sea to shining sea.

    Read More
    • Agree: Jim Don Bob, Triumph104
    • Replies: @Twinkie

    The US could drag along a bunch of Hispanics, as it has dragged along blacks. In fact it would be much, much easier to drag along a similar or even larger number of Hispanics than blacks. The Hispanics actually work at useful–though usually low-skill–jobs and don’t destroy prime urban real estate with violent crime.

    However if you Hispanify the joint, eventually the sheer mediocrity catches up with you. You’re no longer the dynamic white nation that creates the standard of living we enjoy. All the technical advance will be in East Asia and whatever European remanants remain. And we’re stuck living in McAllens from sea to shining sea.
     
    I agree with this... however...

    Latin Americans are not dysfunctional at modern life.
     
    This statement is conditional. Latin America currently contains many dysfunctional countries, with the top three most homicidal ones - El Salvador with 82.84 intentional homicides per 100,000, Honduras with 56.52 and Venezuela with 56.33. Even most African countries don't even come close to that level of endemic homicidal violence.

    So clearly under certain conditions Latin Americans can be world champions at dysfunctionality.
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  143. Twinkie says:
    @3g4me
    @138 JohhnyWalker123: "If you believe the statement you made above, you’re totally innumerate . . . 56 is bigger than 2.6."

    It is? Well I never. Gee, the things a smart subcontinental knows.

    Mother India is calling you, Johnny. Go home and utilize your marvelous mathematical skills to predict how your particular Jati will fare in the World's Biggest Democracy Without Indoor Plumbing. Hmmn, is that part of your affection for McAllen and El Paso? The Mestizos in El Paso are wont to do their business wherever they happen to be on the street - kinda like home for you, innit?

    Mother India is calling you, Johnny. Go home and utilize your marvelous mathematical skills to predict how your particular Jati will fare in the World’s Biggest Democracy Without Indoor Plumbing.

    Look, I fall more on your side than his on this argument about McAllen, but what you wrote above is unworthy of your intellect.

    If another “heritage American” made this rather obvious argument – “56 is bigger than 2.6″ – would you be responding this way?

    Please be intellectually honest and fair, and try to come up with good – rational and plausible – reasons for your position. I personally think that living conditions on this side of the border ARE better than the other side even with similar demographics, mainly because of the superior rule of law here (and the very heavy Federalization/subsidization of the border areas), but that requires an acknowledgment that environment (along with heredity) plays a role in real life.

    Read More
    • Replies: @3g4me
    @143 Twinkie: "Look, I fall more on your side than his on this argument about McAllen, but what you wrote above is unworthy of your intellect."

    Thank you (I think?) for the backhanded compliment, but with all due respect, please read up on the use of rhetoric. When dealing with one who is 1) deliberately misrepresenting his identity and motivations and 2) unambiguously asserting that only statistics (and only his own statistics) matter when discussing a locale's desirability or livability (i.e. the homo economicus, or what I call the "What's the Matter with Kansas" argument), the only response worth making is to mock the autiste. Vox Day, despite his many failings (i.e. no different than anyone else), has written a nice little book titled "SJW's Always Lie." He addresses this issue rather well.
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  144. Twinkie says:
    @AnotherDad
    Johnny you're just pointing out that McAllen is not terrible but ... mediocre. (Which i believe was the point of Steve's post.)

    Hispanics do not create black ghetto conditions. Especially not in violent crime--or at least murderously violent crime. Latin Americans are not dysfunctional at modern life. But the standards--including critical standards like corruption, rule-of-law--are just mediocre across the board.

    These McAllen economic numbers run roughly 25% below national norms, and that's being attached to the still predominately white American economy, getting an inflow of social security and pension dollars through the snowbird influx. Separate these folks from the US and the numbers would tumble toward Mexican numbers at 25% or so of developed white nations.

    What you simply don't get--will never get--from these McAllens is anything dynamic. No Boeings, no Microsofts, no Amazons, no Intels, no GE jet engines and medical devices, no Qualcoms, no International Harvester (whatever they call it now), John Deere, Caterpillar, Ford, no Mayo Clinic or John Hopkins, no Space X, no Tesla, no great research universities, no human genome project, etc. etc. McAllen--and every place like it--muddle along, but never produces anything that anyone else would want.

    That's the problem.

    The US could drag along a bunch of Hispanics, as it has dragged along blacks. In fact it would be much, much easier to drag along a similar or even larger number of Hispanics than blacks. The Hispanics actually work at useful--though usually low-skill--jobs and don't destroy prime urban real estate with violent crime.

    However if you Hispanify the joint, eventually the sheer mediocrity catches up with you. You're no longer the dynamic white nation that creates the standard of living we enjoy. All the technical advance will be in East Asia and whatever European remanants remain. And we're stuck living in McAllens from sea to shining sea.

    The US could drag along a bunch of Hispanics, as it has dragged along blacks. In fact it would be much, much easier to drag along a similar or even larger number of Hispanics than blacks. The Hispanics actually work at useful–though usually low-skill–jobs and don’t destroy prime urban real estate with violent crime.

    However if you Hispanify the joint, eventually the sheer mediocrity catches up with you. You’re no longer the dynamic white nation that creates the standard of living we enjoy. All the technical advance will be in East Asia and whatever European remanants remain. And we’re stuck living in McAllens from sea to shining sea.

    I agree with this… however…

    Latin Americans are not dysfunctional at modern life.

    This statement is conditional. Latin America currently contains many dysfunctional countries, with the top three most homicidal ones – El Salvador with 82.84 intentional homicides per 100,000, Honduras with 56.52 and Venezuela with 56.33. Even most African countries don’t even come close to that level of endemic homicidal violence.

    So clearly under certain conditions Latin Americans can be world champions at dysfunctionality.

    Read More
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  145. Twinkie says:
    @JohnnyWalker123

    First, it picks the last several years during which there has been a large spike in demand for medical services. Can you think of a reason why that might be the case? Hmmm, what might have happened around 2010?

     

    Physicians were complaining that Obamacare would kill their income potential. It turns out that the ACA has been a bit of windfall for them, due to all the new patients. There's also been cost savings due to practice consolidation.

    It has been having trouble recruiting physicians in the last several years for the same reason
     
    Another reason is that physicians restrict competitors (such as mid-level nurses) from performing certain procedures. This gives more negotiating power to physicians when they deal with Medicare and private insurance.

    Over the long term, income increases have been minimal, to wit: http://www.medicaleconomics.com/medical-economics-blog/are-physician-incomes-falling/page/0/2

     

    For internists and other primary care physicians, income has been stagnant. For specialists, income has risen substantially. Specialists are 2/3 of physicians, while primary care (including internal medicine doctors) are 1/3.

    And this at a time when the medical student debt load has risen substantially
     
    The average medical school debt is $200,000. Which is a lot, but so is a $200,000 salary. Anyway, lots of college grads are going massively into debt too, but (unlike doctors) they often have no financial payoff waiting in the end.

    So while the debt situation is worrying, doctors will be okay. I can't say the same for many other professions with more dubious prospects.

    One thing you should keep in mind is that average or median physician salaries mask a very important phenomenon in physician income – bifurcation. In the now distant past, the variances from average income were low. Today, there is a clear separation into two groups. The older physicians who own their own practices and are often specialists make very high incomes. The younger physicians who are employees make considerably lower incomes.

     

    True. There's also a bifurcation between specialists and primary care doctors. However, even with that, my experience is that starting doctors can get at least $150,000/yr. Not bad for a 30 year-old. Especially when your peers are often unemployed/underemployed or working as an Uber driver. Heck, even lots of PHDs and adjunct professors are on food stamps these days.

    Doctors have it pretty good.

    About 20 years ago, roughly 70-80% of physicians owned their own practices, yet there was no over-prescription of pain medicine. That falsifies your notion of doctors over-prescribing to jack up their bottom line today.

     

    Doctors began over prescribing when pharmaceutical companies began bribing them with vacations, "consulting" payments, and "speaking" fees. Some doctors also figured they could make a ton of money by running "pill mills."

    The over prescription of painkillers was mostly driven by pharma. Pharma didn't get truly aggressive
    about pushing pills to the masses until around the late 90s.

    https://www.youtube.com/watch?v=U80q3AISReI

    Doctors got bribed a lot, unfortunately. They mostly got away with it. You might think it's irrational, but doctors were often highly pliable to pharmaceutical influence.

    Doctors aren't nearly as mature or high-minded as they are made out to be. Here's an article about how pharma companies hired cheerleaders to wine&dine doctors. https://abcnews.go.com/US/story?id=4438095&page=1

    More here.

    https://www.nbcnews.com/storyline/americas-heroin-epidemic/many-doctors-get-goodies-opioid-makers-n791281

    (By the way, pain medication in hospitals today is EXTREMELY tightly controlled with cameras and vaults, with only certain physicians – e.g. anesthesiologists and their staff with DEA numbers – able to access.)
     
    Now it is, but only after hundreds of thousands of opioid overdoses.

    That’s nonsense. American physicians have been ALWAYS more expensive to train and employ than physicians in other countries for much of modern history.

     

    This is because they're paid and reimbursed more.

    Medical procedures really are reimbursed at higher rates in the U.S. than in other first world nations. This is an established fact.

    “Preventative healthcare” programs have been shown to do… wait for it… nothing to improve health outcomes. Americans don’t smoke or over-eat because they have not been exposed to preventative healthcare programs.

     

    Except the govt was very successful at decreasing smoking. That's preventative healthcare right there. More easily could be done.

    If we stopped dropping bombs on random Muslim civilians for a few month, we'd have a lot of money for all sorts of preventative healthcare programs.

    Cross country “health outcome” comparisons and drawing conclusions about medical intervention efficacy based on those outcomes is idiotic, because we are comparing peoples with very different genetics and cultural health habits. If you have a healthy, conscientious population with generally good habits (e.g. Japanese), it won’t matter much what kind of medical care system you have – you will end up with a healthy population with low overall medical care costs.

     

    American Whites have poorer health outcomes and higher health costs than ethnically similar Anglo populations in NZ, Australia, Canada, and the UK. Are they really that different genetically?

    Are they really that different culturally? If they are, then why do you (and nearly everyone else here) champion HBD? I thought HBDers believed that behavior and outcomes were mostly genetic, so how are ethnically Anglo Americans doing so much worse than Anglos elsEwhere?

    Blaming doctors, hospitals*, or even Big Pharma is just demagogic attempt to play “Look, squirrel!” with the real problem.

     

    The real problem is that Big Pharma got rich by getting huge numbers of Americans addicted to painkillers. This killed hundreds of thousands of peopel. In the European Union, which more stringently regulates pharmaceuticals, overdose deaths are per capita 1/12th as common.

    Also, in "socialist" Europe, per capita healthcare costs are far lower too. How do they manage that?

    Physicians were complaining that Obamacare would kill their income potential.

    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby – the AMA – supported Obamacare.

    Another reason is that physicians restrict competitors (such as mid-level nurses) from performing certain procedures.

    If nurses had the same amount of training and overall understanding of the human body, they would be… doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called “doctors” in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

    Specialists are 2/3 of physicians, while primary care (including internal medicine doctors) are 1/3.

    Yes, but more than 50% of office visits to doctors are to primary care doctors. And they are generally the conduit through which specialist services can be obtained.

    The average medical school debt is $200,000. Which is a lot, but so is a $200,000 salary. Anyway, lots of college grads are going massively into debt too, but (unlike doctors) they often have no financial payoff waiting in the end.

    Again, read this. https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/

    Doctors began over prescribing when pharmaceutical companies began bribing them with vacations, “consulting” payments, and “speaking” fees.

    Only a miniscule fraction of physicians receives such largess.

    Now it is, but only after hundreds of thousands of opioid overdoses.

    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

    Medical procedures really are reimbursed at higher rates in the U.S. than in other first world nations. This is an established fact.

    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

    Except the govt was very successful at decreasing smoking. That’s preventative healthcare right there. More easily could be done.

    Smoking wasn’t curtailed by medical “preventative healthcare” programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn’t have much obesity – so let’s make the country poorer!

    Are they really that different genetically? Are they really that different culturally?

    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale… and that’s on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

    If they are, then why do you (and nearly everyone else here) champion HBD

    In general, environmentarians are those who believe everything is environmentally constructed (e.g. “blank slate”) while hereditarians (such as Mr. Sailer) are those who believe that human outcomes are heredity + environment. I am on the latter side.

    Genetic and racial essentialists are… not scientific. So perhaps you can direct this straw man at someone else.

    Read More
    • Replies: @JohnnyWalker123

    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby – the AMA – supported Obamacare.

     

    Many physicians were concerned that the ACA's expenses would lead to physician reimbursement being trimmed. Specifically, they were concerned about the the Independent Payment Advisory Board, which was set up to control Medicare reimbursement increases. The board's assignment was to only increase Medicare reimbursement by a number equivalent to GDP + 1%. Many physicians were worried that this reimbursement control would lead to a fall in their income. However, other physicians believed that increased patient volume and decreased practice expenses would offset this reimbursement decrease.

    If nurses had the same amount of training and overall understanding of the human body, they would be… doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called “doctors” in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

     

    Not every procedure requires a physician. Many simpler procedures can be attended to by nurse practictioners, many of whom receive additional training both in-class and on-the-job. Unfortunately, keeping the physician as the gatekeeper enables physicians to have more leverage in negotiating high reimbursement rates, while limiting the number of healthcare providers.

    If I needed simple legal work done, I'd hire a paralegal. Not every medical procedure is cardiothoraic surgery. If someone has a sinus infection, a nurse practicioner or physician assistant can treat that.

    Only a miniscule fraction of physicians receives such largess.

     

    According to this survey of physicians, overutilization is common. Physicians believe that at least 15 to 30 percent of medical care is unneccessary. Physicians believed that 22 percent of prescription medications, 24.9 percent of medical tests, 11.1 percent of procedures, and 20.6 percent of overall medical care is unnecessary.

    https://hub.jhu.edu/2017/09/06/unneeded-medical-care-hopkins-survey/

    So it's not just a "miniscule fraction." Not if physicians are to be believed.

    Another survey found that 7% of physicians recieved "gifts" (meals, speaking fees, etc) from pharmaceutical representatives. These physicians prescribed about 1/10th more opioids per capita than non-gifted physicians. Which is not trivial, especially when you consider that physicians write over 200 million opioid prescriptions per year.

    https://psmag.com/news/doctors-who-get-gifts-from-opioid-sales-reps-prescribe-more-opioids-study-finds

    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

     

    There was minimal enforcement and a very lax attitude towards overperscription. That's why the U.S. has less than 5% of the world's population, but 80% of the world's opioid prescriptions.

    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

     

    There are numerous factors. The point is that American physicians are reimbursed at a much higher rate than other countries, which inflates cost to a significant degree. Look at any medical procedure and you'll typically see that reimbursement rates are much higher in the U.S. than in other first world nations. That's one reason their healthcare costs are lower.

    As populations get older, you'd expect healthcare utilization to grow. Such variances in reimbursement structure would inflate healthcare costs to a growing extent as demographics age.

    Smoking wasn’t curtailed by medical “preventative healthcare” programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn’t have much obesity – so let’s make the country poorer!
     
    Tobacco is a major detriment to life expectancy and a major driver of healthcare costs. By using a variety of techniques (media campaigns, taxes, etc) the smoking rate has been dramatically reduced.

    This smoking rate has been falling for over four decades. You're incorrect when you say that the rate fell "suddenly."

    Tobacco "smuggling rings" across the Canadian border are miniscule. Their cost is far lower than that of high tobacco consumption.

    Some have suggested taxing sugary foods and sodas. Unfortunately, that's probably going nowhere because politicians (such as Iraq War supporter and former VP candidate Sarah Palin) don't want to offend gluttonous, fat Americans.

    You do realize that if Americans drank less Mountain Dew, they wouldn't "starve."

    Your point about making the country "poorer" is a strawman.

    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale… and that’s on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

     

    You're incorrect about this. The UK has a very substantial white urban underclass who live in subsidized housing. They're known for imitating black culture to an even greater extent than American underclass Whites. Australia also has a white underclass, much of which lives in rural areas and are the equivalent of our hillbillies.

    Not sure about Canada. They might be different.

    All those Anglosphere nations outlive American Whites. Not that healthcare isn't rationed, but rationing is something that even American people with insurance face.

    Michael Moore covered this in "Sicko."

    https://www.youtube.com/watch?v=8BJyyyRYbSk

    Given that other Anglo nations spend less than half (per capita) as much on healthcare as the U.S., their results are very impressive. America engages in very extreme levels of healthcare spending wasteage, but doesn't see better healthcare.

    Genetic and racial essentialists are… not scientific. So perhaps you can direct this straw man at someone else.

     

    If HBD (which you believe in) is true, American Whites aren't all that different from Anglo Whites. They shouldn't spend more than twice (per capita) as fellow Anglos, but have lower life expectancy.

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).

    https://www.theatlantic.com/health/archive/2016/11/cuba-health/508859/

    How is this possible?

    The reality is that medical industry (physicians, hospitals, insurance companies) is gouging the American public. This is why healthcare costs are so extravagant.
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  146. 3g4me says:
    @Twinkie

    Mother India is calling you, Johnny. Go home and utilize your marvelous mathematical skills to predict how your particular Jati will fare in the World’s Biggest Democracy Without Indoor Plumbing.
     
    Look, I fall more on your side than his on this argument about McAllen, but what you wrote above is unworthy of your intellect.

    If another "heritage American" made this rather obvious argument - "56 is bigger than 2.6" - would you be responding this way?

    Please be intellectually honest and fair, and try to come up with good - rational and plausible - reasons for your position. I personally think that living conditions on this side of the border ARE better than the other side even with similar demographics, mainly because of the superior rule of law here (and the very heavy Federalization/subsidization of the border areas), but that requires an acknowledgment that environment (along with heredity) plays a role in real life.

    @143 Twinkie: “Look, I fall more on your side than his on this argument about McAllen, but what you wrote above is unworthy of your intellect.”

    Thank you (I think?) for the backhanded compliment, but with all due respect, please read up on the use of rhetoric. When dealing with one who is 1) deliberately misrepresenting his identity and motivations and 2) unambiguously asserting that only statistics (and only his own statistics) matter when discussing a locale’s desirability or livability (i.e. the homo economicus, or what I call the “What’s the Matter with Kansas” argument), the only response worth making is to mock the autiste. Vox Day, despite his many failings (i.e. no different than anyone else), has written a nice little book titled “SJW’s Always Lie.” He addresses this issue rather well.

    Read More
    • Replies: @Twinkie

    Thank you (I think?) for the backhanded compliment
     
    I think highly of people who - even just in words - place the wellbeing of the country above their personal interests and desires. And I also recall reading a number of thoughtful comments from you. So, yes, I expect better - and smarter - from you.

    the only response worth making is to mock
     
    Why not mock AND refute?

    If it's JUST name-calling one's opponents, this thread would be no different than The Washington Post comment threads (which are full of "stupid racist re-puke-licans must die" type remarks and other inane insults and nonsense).
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  147. Twinkie says:
    @3g4me
    @143 Twinkie: "Look, I fall more on your side than his on this argument about McAllen, but what you wrote above is unworthy of your intellect."

    Thank you (I think?) for the backhanded compliment, but with all due respect, please read up on the use of rhetoric. When dealing with one who is 1) deliberately misrepresenting his identity and motivations and 2) unambiguously asserting that only statistics (and only his own statistics) matter when discussing a locale's desirability or livability (i.e. the homo economicus, or what I call the "What's the Matter with Kansas" argument), the only response worth making is to mock the autiste. Vox Day, despite his many failings (i.e. no different than anyone else), has written a nice little book titled "SJW's Always Lie." He addresses this issue rather well.

    Thank you (I think?) for the backhanded compliment

    I think highly of people who – even just in words – place the wellbeing of the country above their personal interests and desires. And I also recall reading a number of thoughtful comments from you. So, yes, I expect better – and smarter – from you.

    the only response worth making is to mock

    Why not mock AND refute?

    If it’s JUST name-calling one’s opponents, this thread would be no different than The Washington Post comment threads (which are full of “stupid racist re-puke-licans must die” type remarks and other inane insults and nonsense).

    Read More
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  148. Why not mock AND refute?

    That takes a triple digit IQ.

    Not everyone can chew gum and walk at the same time.

    Read More
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  149. @Twinkie

    Physicians were complaining that Obamacare would kill their income potential.
     
    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby - the AMA - supported Obamacare.

    Another reason is that physicians restrict competitors (such as mid-level nurses) from performing certain procedures.
     
    If nurses had the same amount of training and overall understanding of the human body, they would be... doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called "doctors" in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

    Specialists are 2/3 of physicians, while primary care (including internal medicine doctors) are 1/3.
     
    Yes, but more than 50% of office visits to doctors are to primary care doctors. And they are generally the conduit through which specialist services can be obtained.

    The average medical school debt is $200,000. Which is a lot, but so is a $200,000 salary. Anyway, lots of college grads are going massively into debt too, but (unlike doctors) they often have no financial payoff waiting in the end.
     
    Again, read this. https://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/

    Doctors began over prescribing when pharmaceutical companies began bribing them with vacations, “consulting” payments, and “speaking” fees.
     
    Only a miniscule fraction of physicians receives such largess.

    Now it is, but only after hundreds of thousands of opioid overdoses.
     
    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

    Medical procedures really are reimbursed at higher rates in the U.S. than in other first world nations. This is an established fact.
     
    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

    Except the govt was very successful at decreasing smoking. That’s preventative healthcare right there. More easily could be done.
     
    Smoking wasn't curtailed by medical "preventative healthcare" programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn't have much obesity - so let's make the country poorer!

    Are they really that different genetically? Are they really that different culturally?
     
    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale... and that's on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

    If they are, then why do you (and nearly everyone else here) champion HBD
     
    In general, environmentarians are those who believe everything is environmentally constructed (e.g. "blank slate") while hereditarians (such as Mr. Sailer) are those who believe that human outcomes are heredity + environment. I am on the latter side.

    Genetic and racial essentialists are... not scientific. So perhaps you can direct this straw man at someone else.

    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby – the AMA – supported Obamacare.

    Many physicians were concerned that the ACA’s expenses would lead to physician reimbursement being trimmed. Specifically, they were concerned about the the Independent Payment Advisory Board, which was set up to control Medicare reimbursement increases. The board’s assignment was to only increase Medicare reimbursement by a number equivalent to GDP + 1%. Many physicians were worried that this reimbursement control would lead to a fall in their income. However, other physicians believed that increased patient volume and decreased practice expenses would offset this reimbursement decrease.

    If nurses had the same amount of training and overall understanding of the human body, they would be… doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called “doctors” in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

    Not every procedure requires a physician. Many simpler procedures can be attended to by nurse practictioners, many of whom receive additional training both in-class and on-the-job. Unfortunately, keeping the physician as the gatekeeper enables physicians to have more leverage in negotiating high reimbursement rates, while limiting the number of healthcare providers.

    If I needed simple legal work done, I’d hire a paralegal. Not every medical procedure is cardiothoraic surgery. If someone has a sinus infection, a nurse practicioner or physician assistant can treat that.

    Only a miniscule fraction of physicians receives such largess.

    According to this survey of physicians, overutilization is common. Physicians believe that at least 15 to 30 percent of medical care is unneccessary. Physicians believed that 22 percent of prescription medications, 24.9 percent of medical tests, 11.1 percent of procedures, and 20.6 percent of overall medical care is unnecessary.

    https://hub.jhu.edu/2017/09/06/unneeded-medical-care-hopkins-survey/

    So it’s not just a “miniscule fraction.” Not if physicians are to be believed.

    Another survey found that 7% of physicians recieved “gifts” (meals, speaking fees, etc) from pharmaceutical representatives. These physicians prescribed about 1/10th more opioids per capita than non-gifted physicians. Which is not trivial, especially when you consider that physicians write over 200 million opioid prescriptions per year.

    https://psmag.com/news/doctors-who-get-gifts-from-opioid-sales-reps-prescribe-more-opioids-study-finds

    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

    There was minimal enforcement and a very lax attitude towards overperscription. That’s why the U.S. has less than 5% of the world’s population, but 80% of the world’s opioid prescriptions.

    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

    There are numerous factors. The point is that American physicians are reimbursed at a much higher rate than other countries, which inflates cost to a significant degree. Look at any medical procedure and you’ll typically see that reimbursement rates are much higher in the U.S. than in other first world nations. That’s one reason their healthcare costs are lower.

    As populations get older, you’d expect healthcare utilization to grow. Such variances in reimbursement structure would inflate healthcare costs to a growing extent as demographics age.

    Smoking wasn’t curtailed by medical “preventative healthcare” programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn’t have much obesity – so let’s make the country poorer!

    Tobacco is a major detriment to life expectancy and a major driver of healthcare costs. By using a variety of techniques (media campaigns, taxes, etc) the smoking rate has been dramatically reduced.

    This smoking rate has been falling for over four decades. You’re incorrect when you say that the rate fell “suddenly.”

    Tobacco “smuggling rings” across the Canadian border are miniscule. Their cost is far lower than that of high tobacco consumption.

    Some have suggested taxing sugary foods and sodas. Unfortunately, that’s probably going nowhere because politicians (such as Iraq War supporter and former VP candidate Sarah Palin) don’t want to offend gluttonous, fat Americans.

    You do realize that if Americans drank less Mountain Dew, they wouldn’t “starve.”

    Your point about making the country “poorer” is a strawman.

    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale… and that’s on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

    You’re incorrect about this. The UK has a very substantial white urban underclass who live in subsidized housing. They’re known for imitating black culture to an even greater extent than American underclass Whites. Australia also has a white underclass, much of which lives in rural areas and are the equivalent of our hillbillies.

    Not sure about Canada. They might be different.

    All those Anglosphere nations outlive American Whites. Not that healthcare isn’t rationed, but rationing is something that even American people with insurance face.

    Michael Moore covered this in “Sicko.”

    Given that other Anglo nations spend less than half (per capita) as much on healthcare as the U.S., their results are very impressive. America engages in very extreme levels of healthcare spending wasteage, but doesn’t see better healthcare.

    Genetic and racial essentialists are… not scientific. So perhaps you can direct this straw man at someone else.

    If HBD (which you believe in) is true, American Whites aren’t all that different from Anglo Whites. They shouldn’t spend more than twice (per capita) as fellow Anglos, but have lower life expectancy.

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).

    https://www.theatlantic.com/health/archive/2016/11/cuba-health/508859/

    How is this possible?

    The reality is that medical industry (physicians, hospitals, insurance companies) is gouging the American public. This is why healthcare costs are so extravagant.

    Read More
    • Replies: @Twinkie

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    If you needed a major surgery to keep yourself alive, would you go to Cuba or to an American hospital that is “gouging the American public”?
    , @Johann Ricke

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    I'd put this down to the dubious statistics for which totalitarian regimes are notorious.
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  150. Twinkie says:
    @JohnnyWalker123

    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby – the AMA – supported Obamacare.

     

    Many physicians were concerned that the ACA's expenses would lead to physician reimbursement being trimmed. Specifically, they were concerned about the the Independent Payment Advisory Board, which was set up to control Medicare reimbursement increases. The board's assignment was to only increase Medicare reimbursement by a number equivalent to GDP + 1%. Many physicians were worried that this reimbursement control would lead to a fall in their income. However, other physicians believed that increased patient volume and decreased practice expenses would offset this reimbursement decrease.

    If nurses had the same amount of training and overall understanding of the human body, they would be… doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called “doctors” in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

     

    Not every procedure requires a physician. Many simpler procedures can be attended to by nurse practictioners, many of whom receive additional training both in-class and on-the-job. Unfortunately, keeping the physician as the gatekeeper enables physicians to have more leverage in negotiating high reimbursement rates, while limiting the number of healthcare providers.

    If I needed simple legal work done, I'd hire a paralegal. Not every medical procedure is cardiothoraic surgery. If someone has a sinus infection, a nurse practicioner or physician assistant can treat that.

    Only a miniscule fraction of physicians receives such largess.

     

    According to this survey of physicians, overutilization is common. Physicians believe that at least 15 to 30 percent of medical care is unneccessary. Physicians believed that 22 percent of prescription medications, 24.9 percent of medical tests, 11.1 percent of procedures, and 20.6 percent of overall medical care is unnecessary.

    https://hub.jhu.edu/2017/09/06/unneeded-medical-care-hopkins-survey/

    So it's not just a "miniscule fraction." Not if physicians are to be believed.

    Another survey found that 7% of physicians recieved "gifts" (meals, speaking fees, etc) from pharmaceutical representatives. These physicians prescribed about 1/10th more opioids per capita than non-gifted physicians. Which is not trivial, especially when you consider that physicians write over 200 million opioid prescriptions per year.

    https://psmag.com/news/doctors-who-get-gifts-from-opioid-sales-reps-prescribe-more-opioids-study-finds

    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

     

    There was minimal enforcement and a very lax attitude towards overperscription. That's why the U.S. has less than 5% of the world's population, but 80% of the world's opioid prescriptions.

    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

     

    There are numerous factors. The point is that American physicians are reimbursed at a much higher rate than other countries, which inflates cost to a significant degree. Look at any medical procedure and you'll typically see that reimbursement rates are much higher in the U.S. than in other first world nations. That's one reason their healthcare costs are lower.

    As populations get older, you'd expect healthcare utilization to grow. Such variances in reimbursement structure would inflate healthcare costs to a growing extent as demographics age.

    Smoking wasn’t curtailed by medical “preventative healthcare” programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn’t have much obesity – so let’s make the country poorer!
     
    Tobacco is a major detriment to life expectancy and a major driver of healthcare costs. By using a variety of techniques (media campaigns, taxes, etc) the smoking rate has been dramatically reduced.

    This smoking rate has been falling for over four decades. You're incorrect when you say that the rate fell "suddenly."

    Tobacco "smuggling rings" across the Canadian border are miniscule. Their cost is far lower than that of high tobacco consumption.

    Some have suggested taxing sugary foods and sodas. Unfortunately, that's probably going nowhere because politicians (such as Iraq War supporter and former VP candidate Sarah Palin) don't want to offend gluttonous, fat Americans.

    You do realize that if Americans drank less Mountain Dew, they wouldn't "starve."

    Your point about making the country "poorer" is a strawman.

    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale… and that’s on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

     

    You're incorrect about this. The UK has a very substantial white urban underclass who live in subsidized housing. They're known for imitating black culture to an even greater extent than American underclass Whites. Australia also has a white underclass, much of which lives in rural areas and are the equivalent of our hillbillies.

    Not sure about Canada. They might be different.

    All those Anglosphere nations outlive American Whites. Not that healthcare isn't rationed, but rationing is something that even American people with insurance face.

    Michael Moore covered this in "Sicko."

    https://www.youtube.com/watch?v=8BJyyyRYbSk

    Given that other Anglo nations spend less than half (per capita) as much on healthcare as the U.S., their results are very impressive. America engages in very extreme levels of healthcare spending wasteage, but doesn't see better healthcare.

    Genetic and racial essentialists are… not scientific. So perhaps you can direct this straw man at someone else.

     

    If HBD (which you believe in) is true, American Whites aren't all that different from Anglo Whites. They shouldn't spend more than twice (per capita) as fellow Anglos, but have lower life expectancy.

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).

    https://www.theatlantic.com/health/archive/2016/11/cuba-health/508859/

    How is this possible?

    The reality is that medical industry (physicians, hospitals, insurance companies) is gouging the American public. This is why healthcare costs are so extravagant.

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).

    If you needed a major surgery to keep yourself alive, would you go to Cuba or to an American hospital that is “gouging the American public”?

    Read More
    • Replies: @JohnnyWalker123
    If I couldn't afford it (which many can't), probably Cuba.
    , @JohnnyWalker123
    https://www.youtube.com/watch?v=FsPEYervU9k

    Nearly 70% of bankruptices can be linked to medical debt.

    From 2006 through 2017, 12.8 million American households filed for bankruptcy. The average household has roughly 2.58 inhabitants. So roughly 30.4 million Americans experienced bankruptcy in their househould over the last decade. Which is about 10% of the population.

    The above number factors out bankrupt households who file for multiple bankruptcies (roughly 8% of filers). So it can be seen as a conservative estimate. The likely number is even larger. It'd be interesting to calculate the lifetime probability of household bankruptcy, which likely would be high.

    So about 20 million Americans (of the 30 million total bankrupt) went bankrupt due to medical expenses.

    Fortunately, bankruptcy filing have decreased - from 1.5 million in 2010 to 767,721 last year. Why have bankruptcy filings declined? See below.

    http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-bankruptcy-20170509-story.html

    Here's another benefit of the Affordable Care Act you may not have read much about, but is profoundly threatened by the Republican repeal effort: It has reduced the tide of healthcare-related personal bankruptcies.

    That's the finding of an analysis of bankruptcy court data and the results of a questionnaire of 2,000 consumers just published by Consumer Reports.
     

    The publication acknowledges that several factors have contributed to the decline, particularly 2005 changes in bankruptcy law that made personal bankruptcy harder and more costly to file and the general improvement in the economy since 2008. But its experts "almost all agreed that expanded health coverage played a major role in the marked, recent decline."
     

    A series of surveys by the U.S. Centers for Disease Control and Prevention shows that the percentage of Americans reporting problems paying medical bills fell from 56.5% in 2011 to 43.8% in 2016, consistent with the spread of ACA-related insurance coverage.
     
    , @JohnnyWalker123
    https://www.youtube.com/watch?v=irNr2fMIvTQ
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  151. @JohnnyWalker123

    No, physicians were complaining that the proposal was creating uncertainty and that the increased demand would lead to rationing of services (and lower the quality of care), which turned out to be true. But the medical lobby – the AMA – supported Obamacare.

     

    Many physicians were concerned that the ACA's expenses would lead to physician reimbursement being trimmed. Specifically, they were concerned about the the Independent Payment Advisory Board, which was set up to control Medicare reimbursement increases. The board's assignment was to only increase Medicare reimbursement by a number equivalent to GDP + 1%. Many physicians were worried that this reimbursement control would lead to a fall in their income. However, other physicians believed that increased patient volume and decreased practice expenses would offset this reimbursement decrease.

    If nurses had the same amount of training and overall understanding of the human body, they would be… doctors (indeed, the nursing profession has now created a Ph.D. in nursing and wants to be called “doctors” in the clinical setting). If you were arrested for a crime, would you hire a paralegal since he (and frequently she) may be less expensive?

     

    Not every procedure requires a physician. Many simpler procedures can be attended to by nurse practictioners, many of whom receive additional training both in-class and on-the-job. Unfortunately, keeping the physician as the gatekeeper enables physicians to have more leverage in negotiating high reimbursement rates, while limiting the number of healthcare providers.

    If I needed simple legal work done, I'd hire a paralegal. Not every medical procedure is cardiothoraic surgery. If someone has a sinus infection, a nurse practicioner or physician assistant can treat that.

    Only a miniscule fraction of physicians receives such largess.

     

    According to this survey of physicians, overutilization is common. Physicians believe that at least 15 to 30 percent of medical care is unneccessary. Physicians believed that 22 percent of prescription medications, 24.9 percent of medical tests, 11.1 percent of procedures, and 20.6 percent of overall medical care is unnecessary.

    https://hub.jhu.edu/2017/09/06/unneeded-medical-care-hopkins-survey/

    So it's not just a "miniscule fraction." Not if physicians are to be believed.

    Another survey found that 7% of physicians recieved "gifts" (meals, speaking fees, etc) from pharmaceutical representatives. These physicians prescribed about 1/10th more opioids per capita than non-gifted physicians. Which is not trivial, especially when you consider that physicians write over 200 million opioid prescriptions per year.

    https://psmag.com/news/doctors-who-get-gifts-from-opioid-sales-reps-prescribe-more-opioids-study-finds

    No. DEA-controlled licensing and securing of pain medicine at hospitals were established long before the current wave of opioid abuse.

     

    There was minimal enforcement and a very lax attitude towards overperscription. That's why the U.S. has less than 5% of the world's population, but 80% of the world's opioid prescriptions.

    Again, American doctors were HISTORICALLY more expensive to train and employ than those of other countries, even European ones. That does NOT explain why there has been a GROWING gap in the respective health expenditures of the United States on one hand and the other affluent countries.

     

    There are numerous factors. The point is that American physicians are reimbursed at a much higher rate than other countries, which inflates cost to a significant degree. Look at any medical procedure and you'll typically see that reimbursement rates are much higher in the U.S. than in other first world nations. That's one reason their healthcare costs are lower.

    As populations get older, you'd expect healthcare utilization to grow. Such variances in reimbursement structure would inflate healthcare costs to a growing extent as demographics age.

    Smoking wasn’t curtailed by medical “preventative healthcare” programs. Doctors have been hectoring their patients about tobacco and alcohol abuse for decades. Smoking was suddenly curtailed when taxes (and prices) increased dramatically and tobacco production became semi-criminalized. Of course, that did contribute to the establishment of smuggling rings across the Canadian border, which eventually moved on to other contrabands and led to increased criminality.

    Since obesity is now the number one killer, are you suggesting we increase taxes on food and semi-criminalize food production? After all, if you dramatically increased the price of food, you would be able to reduce over-eating, right? After all, when the country was much poorer, we didn’t have much obesity – so let’s make the country poorer!
     
    Tobacco is a major detriment to life expectancy and a major driver of healthcare costs. By using a variety of techniques (media campaigns, taxes, etc) the smoking rate has been dramatically reduced.

    This smoking rate has been falling for over four decades. You're incorrect when you say that the rate fell "suddenly."

    Tobacco "smuggling rings" across the Canadian border are miniscule. Their cost is far lower than that of high tobacco consumption.

    Some have suggested taxing sugary foods and sodas. Unfortunately, that's probably going nowhere because politicians (such as Iraq War supporter and former VP candidate Sarah Palin) don't want to offend gluttonous, fat Americans.

    You do realize that if Americans drank less Mountain Dew, they wouldn't "starve."

    Your point about making the country "poorer" is a strawman.

    Yes (a bit) and yes (a lot). The bottom line is that we increasingly have a white underclass that is beginning to resemble the black underclass in its pathologies, including health culture, something that other Anglophone countries (as of yet) do not possess in the same scale… and that’s on top of having a sizable black underclass. Furthermore, we do not ration healthcare (especially the advanced, expensive kind) as much as other countries do. We can lower our healthcare costs, too, if we simply denied expensive treatments and costly drugs.

     

    You're incorrect about this. The UK has a very substantial white urban underclass who live in subsidized housing. They're known for imitating black culture to an even greater extent than American underclass Whites. Australia also has a white underclass, much of which lives in rural areas and are the equivalent of our hillbillies.

    Not sure about Canada. They might be different.

    All those Anglosphere nations outlive American Whites. Not that healthcare isn't rationed, but rationing is something that even American people with insurance face.

    Michael Moore covered this in "Sicko."

    https://www.youtube.com/watch?v=8BJyyyRYbSk

    Given that other Anglo nations spend less than half (per capita) as much on healthcare as the U.S., their results are very impressive. America engages in very extreme levels of healthcare spending wasteage, but doesn't see better healthcare.

    Genetic and racial essentialists are… not scientific. So perhaps you can direct this straw man at someone else.

     

    If HBD (which you believe in) is true, American Whites aren't all that different from Anglo Whites. They shouldn't spend more than twice (per capita) as fellow Anglos, but have lower life expectancy.

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).

    https://www.theatlantic.com/health/archive/2016/11/cuba-health/508859/

    How is this possible?

    The reality is that medical industry (physicians, hospitals, insurance companies) is gouging the American public. This is why healthcare costs are so extravagant.

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).

    I’d put this down to the dubious statistics for which totalitarian regimes are notorious.

    Read More
    • Replies: @JohnnyWalker123
    That figure is from UNICEF.
    , @Twinkie

    I’d put this down to the dubious statistics for which totalitarian regimes are notorious.
     
    You don't need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. - at 38.2% - has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that's just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.

    Many American have an extremely sedentary lifestyle combined with a high degree of overeating. Cubans - on average - don't.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively. Again, I would bet the morbid obesity rates are stacked even worse against the U.S. Indeed, between 2000 and 2010, morbid obesity went up by 70% (!) in the United States, a trend that was spread identically among blacks, Hispanics, AND whites (whites are overall less obese than the other two, but the increases in morbid obesity over that period were similar among the three). The fact is, Americans (and American whites) eat more, sit around more, and drive more than whites of U.K. and Australia.

    He also doesn't seem to understand that the U.S. has some unique situations not found in other industrialized countries. For example, our administrative costs are a quarter (!) of the overall healthcare costs (that's money NOT paid to doctors and nurses). And unlike others, we have a very litigious system, which makes doctors practice "defensive medicine," the cost of which has been estimated at roughly $650 billion (!) annually. Furthermore, we have democratized very expensive procedures that are rarer in other countries. Compared to other developed countries, we use three times more mammograms and two and a half times more MRIs.

    That's why you don't look at life expectancy to evaluate healthcare system efficacy. You actually look at treatment efficacy to see if all the advanced medicine we use matters. And it does. For example, if you looked at the 5-year cancer survival rates (breast, colorectal, and prostate) among the major industrialized countries, the U.S. was top at 73.8%. Australia was 68.3% and the U.K. was 52%. Denmark was the lowest at 51%. I shudder to think what it would be in Cuba. But JohnnyWalker123 is welcome to Cuban medicine. Just don't force ME into it.
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  152. @Twinkie

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    If you needed a major surgery to keep yourself alive, would you go to Cuba or to an American hospital that is “gouging the American public”?

    If I couldn’t afford it (which many can’t), probably Cuba.

    Read More
    • Replies: @Twinkie

    If I couldn’t afford it (which many can’t), probably Cuba.
     
    That's pretty dishonest. Good luck getting the latest imaging technology to find out what is actually wrong with you in Cuba. But don't worry - your cost will only be 1/100th! Your heirs - after you die - will appreciate your thrift.
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  153. @Twinkie

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    If you needed a major surgery to keep yourself alive, would you go to Cuba or to an American hospital that is “gouging the American public”?

    Nearly 70% of bankruptices can be linked to medical debt.

    From 2006 through 2017, 12.8 million American households filed for bankruptcy. The average household has roughly 2.58 inhabitants. So roughly 30.4 million Americans experienced bankruptcy in their househould over the last decade. Which is about 10% of the population.

    The above number factors out bankrupt households who file for multiple bankruptcies (roughly 8% of filers). So it can be seen as a conservative estimate. The likely number is even larger. It’d be interesting to calculate the lifetime probability of household bankruptcy, which likely would be high.

    So about 20 million Americans (of the 30 million total bankrupt) went bankrupt due to medical expenses.

    Fortunately, bankruptcy filing have decreased – from 1.5 million in 2010 to 767,721 last year. Why have bankruptcy filings declined? See below.

    http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-bankruptcy-20170509-story.html

    Here’s another benefit of the Affordable Care Act you may not have read much about, but is profoundly threatened by the Republican repeal effort: It has reduced the tide of healthcare-related personal bankruptcies.

    That’s the finding of an analysis of bankruptcy court data and the results of a questionnaire of 2,000 consumers just published by Consumer Reports.

    The publication acknowledges that several factors have contributed to the decline, particularly 2005 changes in bankruptcy law that made personal bankruptcy harder and more costly to file and the general improvement in the economy since 2008. But its experts “almost all agreed that expanded health coverage played a major role in the marked, recent decline.”

    A series of surveys by the U.S. Centers for Disease Control and Prevention shows that the percentage of Americans reporting problems paying medical bills fell from 56.5% in 2011 to 43.8% in 2016, consistent with the spread of ACA-related insurance coverage.

    Read More
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  154. @Twinkie

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    If you needed a major surgery to keep yourself alive, would you go to Cuba or to an American hospital that is “gouging the American public”?

    Read More
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  155. @Johann Ricke

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    I'd put this down to the dubious statistics for which totalitarian regimes are notorious.

    That figure is from UNICEF.

    Read More
    • Replies: @Johann Ricke

    That figure is from UNICEF.
     
    And UNICEF presumably gets its numbers from the Cuban government.
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  156. Twinkie says:
    @JohnnyWalker123
    If I couldn't afford it (which many can't), probably Cuba.

    If I couldn’t afford it (which many can’t), probably Cuba.

    That’s pretty dishonest. Good luck getting the latest imaging technology to find out what is actually wrong with you in Cuba. But don’t worry – your cost will only be 1/100th! Your heirs – after you die – will appreciate your thrift.

    Read More
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  157. Twinkie says:
    @Johann Ricke

    Half-African Cuba has the same life expectancy as America, but spends 1/10th (per capita).
     
    I'd put this down to the dubious statistics for which totalitarian regimes are notorious.

    I’d put this down to the dubious statistics for which totalitarian regimes are notorious.

    You don’t need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. – at 38.2% – has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that’s just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.

    Many American have an extremely sedentary lifestyle combined with a high degree of overeating. Cubans – on average – don’t.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively. Again, I would bet the morbid obesity rates are stacked even worse against the U.S. Indeed, between 2000 and 2010, morbid obesity went up by 70% (!) in the United States, a trend that was spread identically among blacks, Hispanics, AND whites (whites are overall less obese than the other two, but the increases in morbid obesity over that period were similar among the three). The fact is, Americans (and American whites) eat more, sit around more, and drive more than whites of U.K. and Australia.

    He also doesn’t seem to understand that the U.S. has some unique situations not found in other industrialized countries. For example, our administrative costs are a quarter (!) of the overall healthcare costs (that’s money NOT paid to doctors and nurses). And unlike others, we have a very litigious system, which makes doctors practice “defensive medicine,” the cost of which has been estimated at roughly $650 billion (!) annually. Furthermore, we have democratized very expensive procedures that are rarer in other countries. Compared to other developed countries, we use three times more mammograms and two and a half times more MRIs.

    That’s why you don’t look at life expectancy to evaluate healthcare system efficacy. You actually look at treatment efficacy to see if all the advanced medicine we use matters. And it does. For example, if you looked at the 5-year cancer survival rates (breast, colorectal, and prostate) among the major industrialized countries, the U.S. was top at 73.8%. Australia was 68.3% and the U.K. was 52%. Denmark was the lowest at 51%. I shudder to think what it would be in Cuba. But JohnnyWalker123 is welcome to Cuban medicine. Just don’t force ME into it.

    Read More
    • Replies: @JohnnyWalker123

    That’s pretty dishonest. Good luck getting the latest imaging technology to find out what is actually wrong with you in Cuba. But don’t worry – your cost will only be 1/100th! Your heirs – after you die – will appreciate your thrift.

     

    Given their life expectancy is 1 year less than ours, I'd imagine they have decent enough access to imaging technology.

    Not that Cuba's healthcare system is perfect. Of course it could be better, but it is a poor third world nation. I'm sure America's decades of punitive sanctions and islation haven't done much to help the country. Despite all that, they live to be about 79 years old.

    I imagine that if the U.S. hadn't spent decades economically punishing Cuba (mostly because Communist Castro overthrew oligarch-friendly Batista), their life expectancy would be even higher.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively

     

    Our obesity rate in the U.S. double the OECD average, but our smoking rate is about 40% lower.

    If you factor in our obesity rate, we're losing perhaps about 0.5-1 year (relative to the other OECD nations). However, we gain a similar amount due to our lower smoking rate.

    Mexico has a similar obesity rate and a life expectancy of 77 years, while spending 1/8th as much as America (per capita).

    And unlike others, we have a very litigious system, which makes doctors practice “defensive medicine,” the cost of which has been estimated at roughly $650 billion (!) annually.

     

    The average physician has to pay $7,500 in insurance to protect themselves from law suits. That's about 0.2% of total healthcare spending in the U.S.

    For example, if you looked at the 5-year cancer survival rates

     

    The U.S. has annual cancer mortality rate of 194 per 100,000. The OECD average is 206. So we're better, but we spend per capita 2.5x more than the OECD average.

    But JohnnyWalker123 is welcome to Cuban medicine. Just don’t force ME into it.

     

    Good thing nobody is forcing you into anything.
    , @Johann Ricke

    You don’t need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. – at 38.2% – has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that’s just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.
     
    I agree with you that the US population will tend to have health issues related to excessive food consumption. However, Communist countries continue to have issues with infectious disease, sanitation and chronic disease (obesity-related or otherwise), all of which the West has more money, knowledge and other resources to ameliorate. And in the case of Cuba, it has the additional issue of being run by Latin Americans. How credible is it that Cuba, with a fraction of China's GDP per capita, and the shambolic administrative abilities of Latin Americans, has a higher life expectancy than China, despite. on average, genetically-disfavored genes re longevity relative to China's population?

    Note that the UN estimate for Cuba's GDP per capita is roughly the same as China's. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita Just how credible is this number?

    Even the left-wing Politifact, after a bit of hand-waving, discloses that the problems with Cuba's numbers. http://www.politifact.com/truth-o-meter/statements/2014/jan/31/tom-harkin/sen-tom-harkin-says-cuba-has-lower-child-mortality/ Cuban dissidents point out some of the problems with the data: http://freebeacon.com/issues/cuba-manipulating-health-care-statistics/

    Fudging statistics isn't alien to Communist regimes. During the Great Leap Forward, cadres reported glowing farm production numbers to Mao, even as tens of millions starved to death. The ones empathetic enough about the populations entrusted to them to report the actual, dismal, numbers, were treated as counter-revolutionaries and shot.

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  158. @JohnnyWalker123
    That figure is from UNICEF.

    That figure is from UNICEF.

    And UNICEF presumably gets its numbers from the Cuban government.

    Read More
    • Replies: @JohnnyWalker123
    The CIA puts life expectancy at 78.7 years in Cuba.

    So UNICEF's numbers appear to be reliable.
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  159. @Johann Ricke

    That figure is from UNICEF.
     
    And UNICEF presumably gets its numbers from the Cuban government.

    The CIA puts life expectancy at 78.7 years in Cuba.

    So UNICEF’s numbers appear to be reliable.

    Read More
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  160. @Twinkie

    I’d put this down to the dubious statistics for which totalitarian regimes are notorious.
     
    You don't need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. - at 38.2% - has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that's just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.

    Many American have an extremely sedentary lifestyle combined with a high degree of overeating. Cubans - on average - don't.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively. Again, I would bet the morbid obesity rates are stacked even worse against the U.S. Indeed, between 2000 and 2010, morbid obesity went up by 70% (!) in the United States, a trend that was spread identically among blacks, Hispanics, AND whites (whites are overall less obese than the other two, but the increases in morbid obesity over that period were similar among the three). The fact is, Americans (and American whites) eat more, sit around more, and drive more than whites of U.K. and Australia.

    He also doesn't seem to understand that the U.S. has some unique situations not found in other industrialized countries. For example, our administrative costs are a quarter (!) of the overall healthcare costs (that's money NOT paid to doctors and nurses). And unlike others, we have a very litigious system, which makes doctors practice "defensive medicine," the cost of which has been estimated at roughly $650 billion (!) annually. Furthermore, we have democratized very expensive procedures that are rarer in other countries. Compared to other developed countries, we use three times more mammograms and two and a half times more MRIs.

    That's why you don't look at life expectancy to evaluate healthcare system efficacy. You actually look at treatment efficacy to see if all the advanced medicine we use matters. And it does. For example, if you looked at the 5-year cancer survival rates (breast, colorectal, and prostate) among the major industrialized countries, the U.S. was top at 73.8%. Australia was 68.3% and the U.K. was 52%. Denmark was the lowest at 51%. I shudder to think what it would be in Cuba. But JohnnyWalker123 is welcome to Cuban medicine. Just don't force ME into it.

    That’s pretty dishonest. Good luck getting the latest imaging technology to find out what is actually wrong with you in Cuba. But don’t worry – your cost will only be 1/100th! Your heirs – after you die – will appreciate your thrift.

    Given their life expectancy is 1 year less than ours, I’d imagine they have decent enough access to imaging technology.

    Not that Cuba’s healthcare system is perfect. Of course it could be better, but it is a poor third world nation. I’m sure America’s decades of punitive sanctions and islation haven’t done much to help the country. Despite all that, they live to be about 79 years old.

    I imagine that if the U.S. hadn’t spent decades economically punishing Cuba (mostly because Communist Castro overthrew oligarch-friendly Batista), their life expectancy would be even higher.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively

    Our obesity rate in the U.S. double the OECD average, but our smoking rate is about 40% lower.

    If you factor in our obesity rate, we’re losing perhaps about 0.5-1 year (relative to the other OECD nations). However, we gain a similar amount due to our lower smoking rate.

    Mexico has a similar obesity rate and a life expectancy of 77 years, while spending 1/8th as much as America (per capita).

    And unlike others, we have a very litigious system, which makes doctors practice “defensive medicine,” the cost of which has been estimated at roughly $650 billion (!) annually.

    The average physician has to pay $7,500 in insurance to protect themselves from law suits. That’s about 0.2% of total healthcare spending in the U.S.

    For example, if you looked at the 5-year cancer survival rates

    The U.S. has annual cancer mortality rate of 194 per 100,000. The OECD average is 206. So we’re better, but we spend per capita 2.5x more than the OECD average.

    But JohnnyWalker123 is welcome to Cuban medicine. Just don’t force ME into it.

    Good thing nobody is forcing you into anything.

    Read More
    • Replies: @Twinkie

    Given their life expectancy is 1 year less than ours, I’d imagine they have decent enough access to imaging technology.
     
    You'd imagine wrong.

    Cuba doesn't make that data available, but you can guess from this: https://www.statista.com/statistics/282401/density-of-magnetic-resonance-imaging-units-by-country/

    Mexico has a similar obesity rate and a life expectancy of 77 years, while spending 1/8th as much as America (per capita).
     
    Mexicans are genetically different from American whites. Indeed, Hispanics in the U.S. outlive whites (82.8 vs. 78.9 years) despite being much poorer and having much less access to medicine. Asians in America take the cake at 86.5 (Asian privilege!). Poor blacks are screwed again by racist nature at 74.6.

    The average physician has to pay $7,500 in insurance to protect themselves from law suits. That’s about 0.2% of total healthcare spending in the U.S.
     
    Search "defensive medicine" and get back to me. Hint: it's not about liability insurance. Currently defensive medicine is estimated to cost $650 billion in the U.S. annually.

    The U.S. has annual cancer mortality rate of 194 per 100,000. The OECD average is 206. So we’re better, but we spend per capita 2.5x more than the OECD average.
     
    Annual mortality rate doesn't address TREAMENT EFFICACY. Survival rate does.
    See: https://b-i.forbesimg.com/theapothecary/files/2013/11/CONCORD-table12.jpg
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  161. @Twinkie

    I’d put this down to the dubious statistics for which totalitarian regimes are notorious.
     
    You don't need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. - at 38.2% - has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that's just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.

    Many American have an extremely sedentary lifestyle combined with a high degree of overeating. Cubans - on average - don't.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively. Again, I would bet the morbid obesity rates are stacked even worse against the U.S. Indeed, between 2000 and 2010, morbid obesity went up by 70% (!) in the United States, a trend that was spread identically among blacks, Hispanics, AND whites (whites are overall less obese than the other two, but the increases in morbid obesity over that period were similar among the three). The fact is, Americans (and American whites) eat more, sit around more, and drive more than whites of U.K. and Australia.

    He also doesn't seem to understand that the U.S. has some unique situations not found in other industrialized countries. For example, our administrative costs are a quarter (!) of the overall healthcare costs (that's money NOT paid to doctors and nurses). And unlike others, we have a very litigious system, which makes doctors practice "defensive medicine," the cost of which has been estimated at roughly $650 billion (!) annually. Furthermore, we have democratized very expensive procedures that are rarer in other countries. Compared to other developed countries, we use three times more mammograms and two and a half times more MRIs.

    That's why you don't look at life expectancy to evaluate healthcare system efficacy. You actually look at treatment efficacy to see if all the advanced medicine we use matters. And it does. For example, if you looked at the 5-year cancer survival rates (breast, colorectal, and prostate) among the major industrialized countries, the U.S. was top at 73.8%. Australia was 68.3% and the U.K. was 52%. Denmark was the lowest at 51%. I shudder to think what it would be in Cuba. But JohnnyWalker123 is welcome to Cuban medicine. Just don't force ME into it.

    You don’t need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. – at 38.2% – has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that’s just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.

    I agree with you that the US population will tend to have health issues related to excessive food consumption. However, Communist countries continue to have issues with infectious disease, sanitation and chronic disease (obesity-related or otherwise), all of which the West has more money, knowledge and other resources to ameliorate. And in the case of Cuba, it has the additional issue of being run by Latin Americans. How credible is it that Cuba, with a fraction of China’s GDP per capita, and the shambolic administrative abilities of Latin Americans, has a higher life expectancy than China, despite. on average, genetically-disfavored genes re longevity relative to China’s population?

    Note that the UN estimate for Cuba’s GDP per capita is roughly the same as China’s. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita Just how credible is this number?

    Even the left-wing Politifact, after a bit of hand-waving, discloses that the problems with Cuba’s numbers. http://www.politifact.com/truth-o-meter/statements/2014/jan/31/tom-harkin/sen-tom-harkin-says-cuba-has-lower-child-mortality/ Cuban dissidents point out some of the problems with the data: http://freebeacon.com/issues/cuba-manipulating-health-care-statistics/

    Fudging statistics isn’t alien to Communist regimes. During the Great Leap Forward, cadres reported glowing farm production numbers to Mao, even as tens of millions starved to death. The ones empathetic enough about the populations entrusted to them to report the actual, dismal, numbers, were treated as counter-revolutionaries and shot.

    Read More
    • Replies: @Twinkie

    Note that the UN estimate for Cuba’s GDP per capita is roughly the same as China’s. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita Just how credible is this number?
     
    I agree Cuba's numbers are highly suspect, but, then again, so is China's. Note that much of Chinese countryside, especially in the interiors, is cripplingly poor, which is why millions are migrating to the cities despite government restrictions.

    Coastal, urban China, of course, is a different story and is approaching First World level of development and infrastructure (in some ways more advanced due to the latest generation development).
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  162. Twinkie says:
    @JohnnyWalker123

    That’s pretty dishonest. Good luck getting the latest imaging technology to find out what is actually wrong with you in Cuba. But don’t worry – your cost will only be 1/100th! Your heirs – after you die – will appreciate your thrift.

     

    Given their life expectancy is 1 year less than ours, I'd imagine they have decent enough access to imaging technology.

    Not that Cuba's healthcare system is perfect. Of course it could be better, but it is a poor third world nation. I'm sure America's decades of punitive sanctions and islation haven't done much to help the country. Despite all that, they live to be about 79 years old.

    I imagine that if the U.S. hadn't spent decades economically punishing Cuba (mostly because Communist Castro overthrew oligarch-friendly Batista), their life expectancy would be even higher.

    JohnnyWalker123 thinks things are the same in the U.K. or Australia. Not quite. They have 26.9% and 27.9% respectively

     

    Our obesity rate in the U.S. double the OECD average, but our smoking rate is about 40% lower.

    If you factor in our obesity rate, we're losing perhaps about 0.5-1 year (relative to the other OECD nations). However, we gain a similar amount due to our lower smoking rate.

    Mexico has a similar obesity rate and a life expectancy of 77 years, while spending 1/8th as much as America (per capita).

    And unlike others, we have a very litigious system, which makes doctors practice “defensive medicine,” the cost of which has been estimated at roughly $650 billion (!) annually.

     

    The average physician has to pay $7,500 in insurance to protect themselves from law suits. That's about 0.2% of total healthcare spending in the U.S.

    For example, if you looked at the 5-year cancer survival rates

     

    The U.S. has annual cancer mortality rate of 194 per 100,000. The OECD average is 206. So we're better, but we spend per capita 2.5x more than the OECD average.

    But JohnnyWalker123 is welcome to Cuban medicine. Just don’t force ME into it.

     

    Good thing nobody is forcing you into anything.

    Given their life expectancy is 1 year less than ours, I’d imagine they have decent enough access to imaging technology.

    You’d imagine wrong.

    Cuba doesn’t make that data available, but you can guess from this: https://www.statista.com/statistics/282401/density-of-magnetic-resonance-imaging-units-by-country/

    Mexico has a similar obesity rate and a life expectancy of 77 years, while spending 1/8th as much as America (per capita).

    Mexicans are genetically different from American whites. Indeed, Hispanics in the U.S. outlive whites (82.8 vs. 78.9 years) despite being much poorer and having much less access to medicine. Asians in America take the cake at 86.5 (Asian privilege!). Poor blacks are screwed again by racist nature at 74.6.

    The average physician has to pay $7,500 in insurance to protect themselves from law suits. That’s about 0.2% of total healthcare spending in the U.S.

    Search “defensive medicine” and get back to me. Hint: it’s not about liability insurance. Currently defensive medicine is estimated to cost $650 billion in the U.S. annually.

    The U.S. has annual cancer mortality rate of 194 per 100,000. The OECD average is 206. So we’re better, but we spend per capita 2.5x more than the OECD average.

    Annual mortality rate doesn’t address TREAMENT EFFICACY. Survival rate does.
    See:

    Read More
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  163. Twinkie says:
    @Johann Ricke

    You don’t need dubious statistics to reconcile why sometimes poor countries have better or similar life expectancy as an advanced economy. The U.S. – at 38.2% – has the highest rate of obesity in the world. Cuba has the obesity rate of around 25%. And that’s just obesity. In terms of morbid obesity (the kind that eats up expensive medical care and produce high mortality), I would bet the gap is larger still.
     
    I agree with you that the US population will tend to have health issues related to excessive food consumption. However, Communist countries continue to have issues with infectious disease, sanitation and chronic disease (obesity-related or otherwise), all of which the West has more money, knowledge and other resources to ameliorate. And in the case of Cuba, it has the additional issue of being run by Latin Americans. How credible is it that Cuba, with a fraction of China's GDP per capita, and the shambolic administrative abilities of Latin Americans, has a higher life expectancy than China, despite. on average, genetically-disfavored genes re longevity relative to China's population?

    Note that the UN estimate for Cuba's GDP per capita is roughly the same as China's. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita Just how credible is this number?

    Even the left-wing Politifact, after a bit of hand-waving, discloses that the problems with Cuba's numbers. http://www.politifact.com/truth-o-meter/statements/2014/jan/31/tom-harkin/sen-tom-harkin-says-cuba-has-lower-child-mortality/ Cuban dissidents point out some of the problems with the data: http://freebeacon.com/issues/cuba-manipulating-health-care-statistics/

    Fudging statistics isn't alien to Communist regimes. During the Great Leap Forward, cadres reported glowing farm production numbers to Mao, even as tens of millions starved to death. The ones empathetic enough about the populations entrusted to them to report the actual, dismal, numbers, were treated as counter-revolutionaries and shot.

    Note that the UN estimate for Cuba’s GDP per capita is roughly the same as China’s. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita Just how credible is this number?

    I agree Cuba’s numbers are highly suspect, but, then again, so is China’s. Note that much of Chinese countryside, especially in the interiors, is cripplingly poor, which is why millions are migrating to the cities despite government restrictions.

    Coastal, urban China, of course, is a different story and is approaching First World level of development and infrastructure (in some ways more advanced due to the latest generation development).

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    • Replies: @Johann Ricke

    I agree Cuba’s numbers are highly suspect, but, then again, so is China’s. Note that much of Chinese countryside, especially in the interiors, is cripplingly poor, which is why millions are migrating to the cities despite government restrictions.

    Coastal, urban China, of course, is a different story and is approaching First World level of development and infrastructure (in some ways more advanced due to the latest generation development).
     
    I expect China's rural areas are very similar to rural areas in a lot of developing countries. Whatever adjectives come to mind, however, what's clear is that Chinese wages are higher than Mexico's. And Mexico is clearly higher-income than Cuba. Yet the UN numbers from the Wikipedia link show Cuba's GDP per capita to be roughly the same as Mexico's, which is absurd. Given that Chinese wages are higher than Mexico's, I'd say the odds are good that China's GDP per capita numbers are under-stated rather than over-stated, relative to Mexico's.
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  164. @Twinkie

    Note that the UN estimate for Cuba’s GDP per capita is roughly the same as China’s. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita Just how credible is this number?
     
    I agree Cuba's numbers are highly suspect, but, then again, so is China's. Note that much of Chinese countryside, especially in the interiors, is cripplingly poor, which is why millions are migrating to the cities despite government restrictions.

    Coastal, urban China, of course, is a different story and is approaching First World level of development and infrastructure (in some ways more advanced due to the latest generation development).

    I agree Cuba’s numbers are highly suspect, but, then again, so is China’s. Note that much of Chinese countryside, especially in the interiors, is cripplingly poor, which is why millions are migrating to the cities despite government restrictions.

    Coastal, urban China, of course, is a different story and is approaching First World level of development and infrastructure (in some ways more advanced due to the latest generation development).

    I expect China’s rural areas are very similar to rural areas in a lot of developing countries. Whatever adjectives come to mind, however, what’s clear is that Chinese wages are higher than Mexico’s. And Mexico is clearly higher-income than Cuba. Yet the UN numbers from the Wikipedia link show Cuba’s GDP per capita to be roughly the same as Mexico’s, which is absurd. Given that Chinese wages are higher than Mexico’s, I’d say the odds are good that China’s GDP per capita numbers are under-stated rather than over-stated, relative to Mexico’s.

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    • Replies: @Twinkie

    I’d say the odds are good that China’s GDP per capita numbers are under-stated rather than over-stated, relative to Mexico’s.
     
    Especially in PPP terms, yes. According to the CIA Fact Book, China’s GDP per capita in 2017 was $16,600 in PPP terms while Cuba’s in 2016 was $11,900. That’s a hefty difference, even with a year gap.
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  165. Twinkie says:
    @Johann Ricke

    I agree Cuba’s numbers are highly suspect, but, then again, so is China’s. Note that much of Chinese countryside, especially in the interiors, is cripplingly poor, which is why millions are migrating to the cities despite government restrictions.

    Coastal, urban China, of course, is a different story and is approaching First World level of development and infrastructure (in some ways more advanced due to the latest generation development).
     
    I expect China's rural areas are very similar to rural areas in a lot of developing countries. Whatever adjectives come to mind, however, what's clear is that Chinese wages are higher than Mexico's. And Mexico is clearly higher-income than Cuba. Yet the UN numbers from the Wikipedia link show Cuba's GDP per capita to be roughly the same as Mexico's, which is absurd. Given that Chinese wages are higher than Mexico's, I'd say the odds are good that China's GDP per capita numbers are under-stated rather than over-stated, relative to Mexico's.

    I’d say the odds are good that China’s GDP per capita numbers are under-stated rather than over-stated, relative to Mexico’s.

    Especially in PPP terms, yes. According to the CIA Fact Book, China’s GDP per capita in 2017 was $16,600 in PPP terms while Cuba’s in 2016 was $11,900. That’s a hefty difference, even with a year gap.

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  166. Especially in PPP terms, yes. According to the CIA Fact Book, China’s GDP per capita in 2017 was $16,600 in PPP terms while Cuba’s in 2016 was $11,900. That’s a hefty difference, even with a year gap.

    I’d expect Cuba’s nominal per capita output to be much lower than Nicaragua’s, which has a mixed economy. And Nicaragua’s per capita output is 1/4 of China’s. https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita I simply don’t see how it is credible that a command economy has a per capita output number higher than many of its immediate neighbors. Thailand isn’t run by geniuses. But even Thailand has 3x Vietnam’s per capita output. And Vietnam has a mixed economy.

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