You Want Fries with That?: The Junk Food Nature of Managed Health Care

Fast Food Nation is an expose on the "McDonaldification" of the American food industry, but it may as well had been the health care industry.  Your humble ruminator, TheYangZhu, can't help but wince anachronistically at the commingling of those two words, "health" and "industry," but the reality is in our midst.  The reasons are multitudinous, but we really need look no further than industry itself, its insuperable appetite for profit, pretty much for its own sake and with all manner of duplicity and connivance.  This has left a dispirited and alienated populace, which is nevertheless required to "burger-up" to whatever actuarians and "mammonologists" decide.

We all fully understand that only souls given to vanity would look askance at a McDonald's job, but even an honest employee might have modest preferences for something a tad removed from the front-lines, something decidedly more managerial.  Thence was born the doctor-administrator, the prototype for genetic modification, which we know is not only perfectly safe but also worthy of foisting upon the public by stealth, legislation, and stealth-legislation.  Industry basically demands it because industry is progress, which is profit.

The McDonald's Health Care Matrix is a french fry model of profit generation, where patients and doctors get cooked in the lard of administrative oversight, bureaucracy, and subterfuge.   Yet, the clamor to cover more people continues unmeasured against the pre-existing condition of individuals currently insured but receiving fast-food quality service.  Of course, most everyone knows that fast food is perfectly good for you; they even include the nutrition information to prove it.

The industry trend toward proprietary, metrics-based, actuarial medicine has little to do with the actual treating of patients.  But don't take TheYangZhu's word for it, just check out this Forbes article

   

The Impact of Monetocracy on the (com)Post Industrialization of America

The Yang Zhu has been entrapped by the Face Book beast. The past months have had yours truly exploring the entanglements of a Face Book fantasy. It is amazing how dynamic and subterranean it is, how one can get into a certain persona, profess or antagonize as much as one wishes, and partake in the on-going process of checking, censoring, pruning, blocking, along with the occasional admissions of hostility and the begging of pardon. It is an exciting experiment in civil society.

Of course, the philosopher's job is to ask the uncomfortable questions at inconvenient times. We take our pleasure in popping balloons of delusion and unaccountability. It's a pleasure, I say, though imperative is more like it. Liang yao ku kou. "The good medicine is bitter," goes ancient Chinese saying on speaking the truth. Everyone seems unnervingly preoccupied with "positivity," "good vibes," "ebb and flow." Hard questions are purposefully being unasked, avoided, raised only in hushed tones, after looking over one's shoulders, furtively in patriot-speak. Denied.

The last time I wrote was when the healthcare question was unresolved. And now that the Democrats have shown themselves to be even more shameless before the finance/insurance industries than their "foes" across the aisle, it would be easy for one to be downcast but for the hopeful responses by the states. California, for example, has precedent in exercising price controls over insurance and does so presently with regard to fires, cars, and earthquakes. There is already discussion of using a similar law to reign in private health insurance. As the central authority has taken the lead on this serious matter, it is up to the states to craft a response that vindicates the liveliness of our democratic system. At the same time, we do not want to be held captive by the vagaries of democratic processes, what amounts to nothing more than a show. That is why we have the anchoring precept of "monetocracy"--that is rule of, for, and by the money. That's the way most of us would have it.

In the Democrats' defense, their legislation must be responsive to the party's bottom line. Our monetocracy pits both political parties in vicious competition for the contributions from the most monetized sectors of society: finance, insurance, pharmaceuticals, hospitals and prisons, some of the US's biggest winners in America's (com)Post Industrial Age. Of course, democratic participation through dollars appears to be a God-given association in our system. How this association works in terms of actually "buying votes" or "getting out one's message" on airwaves literally owned by the public is not altogether clear to bumpkin like me. How dollars work in a monetocracy to affect legislation is evident in the present healthcare tax legislation, which handsomely benefits the well-monetized sectors of the party's economic base. Everyone knows the side with the most money should win. Should we feel that something is wrong when it doesn't? Shouldn't the Yanks win the World Series every year by virtue of their players salaries? Shouldn't the way legislation gets written federally, internationally and in state capitals around the country be protected from the unpredictability of representative government through money itself? Such security provisions are a testament to the efficiencies of a monetocracy over systems where the stupid people without any money have any say so over their earthly existence.

The breast-beating over health insurance legislation modeled after a system instituted by the opposition's chief presidential candidate is carefully orchestrated kabuki to leave audiences hypnotized by the predictability of pronouncements made a thousand times before. Unfortunately, the vocal and active pockets of groups awakened by the jolt of economic displacement are still wildly diverse in their apprehension of the problems, not to mention the solutions. This may be a good thing. As the Naderites get to dialog with the Ayn Randers, a new consensus around national priorities can be established. Whether it gets told by the media or whether it produces the improvements necessary to increase people's wholesale economic security depends on a willingness to examine some of the ideological and behavioral shortcomings born from our lusty attachment to self-interest. Needless to say, prospects for turning to a sustainable economic and social model still seem some way off, especially when the status quo seems so much more "secure."

The time when cleptocrats are enriched by entities that enrich themselves through decay will come to be known as the (com)Post Industrial Era. In the Industrial Age the villains made their money by building things and creating jobs. In the (com)Post Industrial Age they make money when the factory closes, or when any number of gambling options "manifest." In a monetocracy there is little distinction between money and wealth. Hence, cleptocrats and populace alike bit-by-bit sell the priceless wealth of the commons in exchange for the worthless hope of casinoismo, private rights redeemable on a speculative basis. Those who do not hold deeds to some such Ponzified promise, even the ones who do but are questioning for how long, need to hurry up and make a lot of money to prove they are not irretrievably stupid or in the alternative rethink monetocracy as a viable model for creating secure and stable societies.

Healthcare Debate

Recently, I went to a Meetup of "Deep-thinkers," who are brave enough to tackle rancorous issues like healthcare reform. I listened carefully to the complaints and compliments that people had for our current system. These individuals, a fairly well-educated, all white, by-and-large believed in our system fundamentally, insofar as it provides the most state-of-the-art diagnoses, procedures, and medications. Perhaps all and certainly most of the eight persons convened were atheists and skeptics, those otherwise known as rational-materialists.

Even though many medical doctors acknowledge emotional, i.e., non-material, factors in health outcomes, ironically emotions are still nevertheless reduced to factors and co-factors, cursors and precursors, meaningless blips of molecules to be manipulated with this pill or that.

One women in the group was very bitter about her insurer. These were individuals who did not belong to insurance covered by an employer. They purchased insurance as individuals. Most of the "healthcare" debate has had nothing to do with healthcare, just the paying for it. Whether the pooling of costs occurs under a private corporation or under a government entity, both are socialist, both recognize that the benefit of the one comes through the contributions of many. At the same time health-access decisions are equally "socialist", i.e., non-democratic. Whether "the government", i.e., some administrator, rejects your claim or Aetna, i.e., an administrator, access to care is not volitional (i.e., I want it. I should have it at any cost personally and even societally) nor is it democratic, evidence-based, or even a "right" owed by virtue of tribute, so-called premiums.

Tribute seems to be the right word because the obeisance paid medicine rather obscures the substantive healthcare issues, like iatrogenic deaths from overdoses and drug cross-reactions, wanton prescription of medications which has rendered valuable tools like antibiotics useless, and patient and family choice to NOT have procedures should they so choose. Even more primary than these issues with regard to true healthcare is food and sleep.

This assertion may seem to run afield from healthcare, but it has everything to do with health. I heard recently that the category of farmer is being removed from the census because the numbers who now claim that occupation have diminished beyond "STATISTICAL SIGNIFICANCE." That booming voice is not my own, rather the invocational resonance of rational-materialism. One nonetheless wonders whether the rocketing rates of obesity and its issuing complications are just a coincidence. True socialist deviants are apt to even draw a connection between an increasing reliance upon agribusiness, its role in the suicides of over 250 thousand Punjabi farmers and its obdurate nontransparency around genetically modified organisms (tm), as part of a rational strategy to create sickness.

Fortunately, the right-minded members of tribute clubs trust The Market's rationality, as a Catholic parent does their child alone with the priest. The tribute member notes that she would not mind having a socialist system like in Sweden, but "they don't have to deal with the ethic complications." At the moment, a tribute club can ensure that at least a modicum of the flotsam and jetsam don't become members. This is known as Tributary Exclusion, see Tribute manual, p. 431, sec. 2, verse 13.

The Tributary Exclusionists, as they've come to be known, are rankled by by the loss of their exclusivity, even though the present reality of 10 minute visits with doctors has done nothing to make them consider how profit compels rationing at every nonprofitable opportunity, i.e., when not administering Lab A,B,C,D,E,F,G, then H, and I. Then the X-rays, then the gizmo a la modismotronic (tm)-- every last bit rituals to gods of techno-mono-particularlism, its priest specialists and specialized technicians, fastidiously coveting their particulation, each modernizing triumph that rolls into "the market" yet another step deeper into the trees of the forest of health we fail to discern.

Health cannot be as simple as broccoli and a binki, not to mention the impact it would have on advertising revenues and "growth" in the healthcare industry. Hmmm. Wouldn't a rational society at least consider that growth in certain sectors of society a particularly bad thing? Is growth in healthcare and military expenditures really what we should be spending our money on when there are perfectly good prisons full of illegal flotsam and jetsam out there waiting for our tax dollars?

Instead of using booming healthcare "success" as a means of criticism, perhaps it is possible to see how their profits reflect something about the value we have for them. After Pasteur, we got rid of the power of genuflection and the power of juju, or so we thought. The same veneration was only projected upon a pill or a procedure that lay so concretely beyond our ken: medicine worship. Such a palpable need is this veneration that diet, sleep, stress, and exercise, things that directly impact health most, get sacrificed before the altar of fear and powerlessness.

Data is starting to show that people are becoming more "syncretic" in their ways, less devout, if you will, searching for solutions that are often articulated as "more natural," "less invasive," and "complementary." The influx of many immigrant peoples who take traditional medicines has had a normalizing effect toward these options in many of the more cosmopolitan parts of the country, and major research institutions like Harvard, UCLA, and the University of Michigan are researching and treating patients using the ancient Chinese medical system extensively.

Somewhere in the healthcare debate account has to made for the individuals who choose not to worship at the alter of medicine. The incident of the Midwestern mother compelled to treat her child's cancer in a manner not of her choosing is a gross violation of parental and individual rights. I cannot help but imagine that given monetary ambitions that something could go horribly wrong with any type of "reform" being discussed presently.

Here's what I think might work. Everybody, that is every legal citizen, annually gets a 5k healthcare account to spend as they wish. The money doesn't roll over. People can spend the money on private or government health insurance, or the can use it to spend on the understanding that waiting till you're sick isn't the best healthcare strategy and that although mamograms and PSA tests may be reasonable diagnostic exams, taking a test does not prevention constitute. So, if an individual feels that spending $3000 on a vacation is best for their health (who knows they might be sleeping), so be it. Others will choose to be proactive with their health, seeking services that directly impact health maintenance and improvement, i.e., dietitians, personal trainers, psychotherapists, and Ayurvedic medicine, which is a lot cheaper than a gastrologist, cardiologist, and the slew of other specialists. If a person feels that getting a carpet pulled up is key to their health, they'll have the latitude to do so. If the person exceeds their $5k then they will enter "the system" of administrative over site. Government or private, the nature of bureaucracy is same.

So how do we pay for a 1.5 trillion dollar healthcare plan? Well, we can use Enron accounting, which we've been doing since the 70s to fuel our military "growth." We can also get 75% of the money by cutting our military and levying a healthcare tariff upon every multinational corporation. Every company that imports that has products sourced or produced abroad would be subject to the tariff. If these companies don't want to pay the tax, they have the ingenious option of actually producing their stuff here. Go figure.

The present breast-beating over healthcare payment has obscured a more substantive discussion about health. Hence, the assumptions that the current debate proceeds upon are unsatisfactory for the non-rational-materialist who chooses not to worship at the temple of modern medicine. By structuring individual healthcare accounts, individuals will be encouraged to be more proactive in their healthcare, while still having the option pay an insurer. Data suggests that more and more people are choosing to broaden their healthcare options, the current debate needs to recognize this growing demand for what it is by ensuring that individuals have full latitude to explore the health options they see fit. Anything less is just another corporate money-grab. In the end, until we start talking about food and sleep, I remain very skeptical.

Anti-Microbial Soap and America's War on Terror

There is much debate about what "spiritualism" is, particularly in relation to natural law. It is an important question because if you deny the existence of spiritual components of natural law, then you are pretty much free to believe in Machiavellianism: that the ends justify the means. If, on the other hand, you believe that, as Dr. King put it, "the long arc of history bends towards justice“, then you are apt to adopt a perspective that holds that the means and ends must be in harmony.

Natural law is the stuff that inquisitive minds have been seeking to discern forever. Whether speaking of deep meditation or the highest technological innovation, observation is the means by which we have sought to discover the laws of nature. Much modern focus on natural law takes place in the sciences, where manipulation of said laws are applied to serve "modern convenience” and "progress", as the mantras go. Much of this is true, but not without consequences that we might often call side-effects, runoff, or particulate matter.

Many scientific laws appear to confirm spiritual principles which, we'll say for purposes of this discussion, are principles that are meant to guide human behavior in light of the presence of a free will. Even narrower, let us say that a spiritual person adheres to the belief that ends and means are not separate, which is to say that the spiritual person recognizes being bound by the arcing consequences of that which arises from having a free will. The rational-materialists, the Machiavellianists whose imaginations have been strangled by Faustian illogic, believe that spiritualism and the laws of nature are unrelated. Furthermore, they would charge that any rendering of natural law beyond the generally accepted principles of science (however derived, for this in itself is nub of how we get at and accept truth) is a delusional construct. In most cases, the rational-materialist is not interested in observing and often bent on disclaiming the mechanisms of spiritual law. Biomedicine and its battle with bacteria, however, demonstrates the simplicity of natural law.

Antibiotics, heralded as the greatest invention of modern medicine, are facing a crisis. Their efficacy is waning, as germs have developed a resistance or evolved into "super strains”, due mostly to profligate use through standard medical practices. Darwin's observations on natural selection indicate that in the face of an inability to completely eliminate any given population, the likelihood of subsequent generations carrying immunity, resistance, and/or mutation increases. Such "uberfication" can also be found among rats, cockroaches and otherwise "targeted" vermin. Why the CDC or FDA didn't greet "antibacterial" fetishism in the form of soaps, detergents, air fresheners and hand purifiers with immediate alarm not only makes one question their underlying profit motives but also their ability to apply the very principles they ostensibly extol. Was there something particularly bacterial about the soap we've been using? Could applied science actually be implicated in causing the evolution of the very bacterial strains that petrify us?

We all know that one of the Ten Commandments tells us not to kill. We also know that among the Abrahamic traditions adherence to this principle varies. Few in our tradition are willing to go as far as the Jains, but could it be that the proscription on killing has a basis in natural law? Within Darwin's "discovery" appears to be a latent spiritual answer, one that can be gleaned from our losing battle with bacteria. Jesus says something about "reaping what you sow" and Newton something about "every action producing an equal and opposite reaction”. Hmm. Could this mean that killing bacteria leads to being killed by bacteria? The answer is before us. Yet the foolish pursuit for "better, more powerful" antibiotics continues unabated. Consider, however, how absurd it would be to hear a public official say "we should live in harmony with germs”. On the other hand, how successful do you think we'll be in eliminating germs that are as basic to life as life itself?

And so we come to America's brazen denial of natural law through its germ theory approach to "terror”, exerting pressures upon populations that are expressing equal and opposite reactions. But we're the cannibalists, the Machiavellians, who somehow believe that consumption of so much flesh will not result in inflammatory conditions like heart disease and hardening of the arteries. Some argue that the populations upon which we administer such "antibiotical" agents as depleted uranium, phosphorus, and bunker busters must be "cleansed" in order to prevent spreading the infection. But antibiotics kill indiscriminately, creating a toxic vacuum in which only more virulent populations survive.

The natural answer is to devise methods that are in harmony with the outcomes we seek to enjoy. Obama's speech in Cairo was one of the best speeches I've ever heard. The search for common ground through spiritual principles like "do on to others" is a profound departure from the previous administration, but remember Bush the first promised us "a kinder, gentler America" before invading Iraq. In the meantime, germ theory proceeds afoot under Obama: our military expenditures increased by 4%; no withdrawal from Iraq is in the foreseeable future; extra troops for Afghanistan; one million displaced Pakistanis... all in three months. The costs from the effects of the patent inhumanity of war for soldiers, their families, and national resources are huge. The festering consequences of believing in the fallacious (N)PR of germ theory are all about us, and still we ignorantly look for new and improved ways for only deepening our karmic bonds. What would Darwin do?

Vanilla Green and Change

A friend of mine send me a sampler of tea from the company Adagio Teas. The blends range from the traditional to the adventurous, with many possessing suggestive names like Sencha Overture. The quality of each tea varies, perhaps according to my tastes or what actually is. The Gun Powder, for instance, looks like juicy caviar, but it brews up a little darker than what I usually prefer in Gun Powder. The Bi Luo Chun is typical. It's very hard to get a superior picking outside China. Bi Luo Chun was one of the varieties I had "on account" at a very pleasant tea house in the Xi Dan district of Beijing back in the day. I'm particularly persnickety about this variety.

As the creative imperative of our modern time often takes expression by viewing the ancient in contexts that reflect the here and now, tea has similarly "modernized". For instance, the traditional Orange Pekoe is transmogrified into Green Pekoe. Sencha, the crystal clean green favored among Japanese, becomes Sencha Overture, though discerning what the overture is is neither apparent to my taste buds nor to my inner-marketing-self. You see, on some level I feel like "why add legs to the snake?", a Chinese aphorism that essentially means to leave well enough alone.

Isn't Sencha just fine without such overtures? It's gotten by for a good millennium without overtures and now they're necessary?... which brings me to the matter of Vanilla Green. The very idea of it struck me as cacophonous. Vanilla is Barry White smooth, best when mixed with the mellow tones of good black tea. I can even see red tea as being a good match, but not green, which is chlorophyll clean, dancing to the innocuous notes of nothingness, below the high tones of citrus.

I was guilty, resistant on purely ideological grounds to the commingling of vanilla and green teas. It got me to wondering about just how much of a traditionalist I am and how receptive to change I am. Sure, change sounds nice, but how do we react with the changes we don't anticipate? In retrospect, I can say that I didn't expect to like Vanilla Green, and my first-day's encounter proved right. I got to thinking more abstractly about vanilla in the green movement, perhaps in the Chocolate Rain vein but more with respect to change.

There are many of us who, out of the necessities of human induced climate change (HICC), belief in dramatic down scaling in lifestyle. Still some of us believe, as a result of the very same purported necessities, that shifting to new technologies, such as electric automobiles, will allow us to have a vanilla greening of sorts, making room for greater consumptive capacity. Neither camp seems to have made any allowances for the possibility that the earth's changes may be independent of human behavior, and those that have raised such questions seem so set on debunking the theology of HICC, that people concerned for the responsible extraction, production, and consumption of natural resources have skeptically concluded that these apostates are simply in the pocket of some of the earth's chief culprits.

I must admit to being pretty skeptical of any broad appeal: Darfur, breast cancer, the Dallas Cowboys. What has most disappointed me about the green discussion has been what has appeared to be an abandonment of some of its very own interesting principles. The Gaia Hypothesis, for example, maintains that the earth is a sentient being, self-regulating, much as the human body is. I have read very interesting articles about the earth's underwater volcanoes, natural shifts in the earth's poles, and have personally considered the imponderable effects of deforestation in Brazil, Congo, Borneo, and Sumatra. What kind of equilibrium does the earth seek as a result of and independent from human behavior? How about the earth's equilibrium vis-a-vis the sun? Is the earth's equilibrium consistent with human equilibrium? We know well that humans can affect the earth's equilibrium at least on the level of an ecosystem. For example, deforestation has turned once-tropical parts of the Philippines into desert. But I've never heard any discussion on the possible ways in which the earth may seek balance from such conditions. How much does the drought in the Southeast have to do with blasting of mountain tops in West Virginia?

Back when they introduced the railroads to China, there were many local traditionalists who howled that the laying of tracks would cause irreparable damage to the earth's qi. Just recently, I heard a story that the ancient continent from which the Atlantians descended sank after the tapping of geo-thermals. We can chalk this type of thinking up to superstition (We need to note, however, that even Plato made reference to Atlantis) or we just might begin to consider the presence of earthly qi and our effect on it. Is deforesting the earth for more copper and cadmium to put in electric cars really going to make this situation better? Don't get me wrong; I'm in favor of fresh air, but is air pollution as much a culprit of HICC as, say, the hundreds of thousands of miles of concrete and asphalt, which magnify and collect heat from the sun? I placed the Vanilla Green on the shelf, satisfying myself with the mysterious overtures of Sencha and quizzical implications of Green Pekoe till they were exhausted.

Here's where a side discussion on aesthetics, the fusion of form and function, becomes necessary. Tea must be brewed and drunk from the proper vessel according to its type. Black tea drunk from tiny porcelain cups meant for green tea just won't do. Many will complain about an unpleasant bitterness of green tea after having brewed it in a teapot not altogether dissimilar from the pot that Auntie Agatha enjoyed her sassafras in. Like drinking wine from a tumbler, to do so masks the layered subtleties of the leaf's personality. It's like the Chinese landscape painting that distinguishes between shades of gray. Drinking high-quality leaves, brewed at proper temperature, from small white cups affords one the opportunity to appreciate subtlety. Of course, not all tea is to be drunk in this manner. It was clear that I had failed to discern, or stated differently, had only begun to discover which vessel most properly accommodated that which formed as a co-function of vanilla and green.

I have two Mao teacups, the mug type. Chairman Mao had a real thing for tea, so much so that it is said that his teeth were usually caked with a blackened paste of tea, which he used instead of brushing. One cup has a kitschy Andy Warhol-like image of Mao as a youthful revolutionary. It's bona fide artsy because it comes from the artsy company turned luxury brand Shanghai Tang. The other is a 100th birthday anniversary cup from Mao's hometown. I like this cup a lot. It's pale green on the outside, with a crude " arte volken" feel. It is pure white inside, reflecting the trueness of the liquor. Vanilla green possessed a beautiful jade quality. The sides of the cup formed a pool in which vanilla's aroma could pool, a kind of Barry White meets Zatoichi in all the right ways.

It only took the changing of the vessel for me to get my head around Vanilla Green. In what conceptual vessel do we hold the earth at present? More important, in what ways must it change to accommodate the genuine form and function of earth in all its layered subtleties?

What is Prevention

The current hub-bub regarding the latest contagious airborne disease had me receive a few queries on prevention, which in turn got me to crack open the Chinese medical textbook on Warm Pathogens (wen bing). Much of what is relayed is common sense stuff, like avoiding crowds and wearing face masks, if crowd contact is necessary. There's also discussion on quarantining and immune function. I may go into these at a later date on my other blog (http://chinesemeridiantheory.blogspot.com), which is geared much more for the clinician and those who want to get juicy with Chinese medical theory.

This discussion is much more oriented around understanding what constitutes prevention. The Warm Pathogen text's discussion on prevention basically conforms to our modern understanding of risk reduction and immune function stimulation. The evident crisis that our current healthcare system is facing has made prevention a cry issued by all, the scare around the latest cootie perhaps only bringing the questions around prevention into greater relief.

Of course, much of this centers about the hot-button issue of immunization. As one who suffered from the ravages of chicken pox at the age of three and lived to tell the tale along with hordes of similarly affected children, and as one who at the age of 28 was compelled to take an MMR vaccination in order to receive financial aid and subsequently suffered a most disagreeable reaction for about a year, I nevertheless choose to remain dumb on the issue. Certainly, no one can blame parents on either side of this contentious issue, though when we're talking about public health and the implicit obligations of living in and among people in a social contract (albeit tattered), then there are certain rights that we must abdicate for better or worse, the right to not be vaccinated being one such instance.

When mass preventative efforts are affected by governments for the good of society, we must have the government's trust. We must be given clear indications that government is acting on behalf of the common weal and is not motivated by the quest for control or profit. The government must also demonstrate that academic/private contractors are restricted from using their relationship with government to advance interests that do not conform with social principles. After all, to the extent that they are recipients of social money, they must be compelled to act accordingly.

When government becomes controlled by private interests, then clearly profit trumps regard for the social good. Profitism or bottom-linism has nothing to do with social ethics. Companies are beholden to shareholders, who expect a return on their investment. This is not to say that profitism is antithetical to benefiting society; if it does that is icing on the cake, but serving society is not the objective. Many prominent researchers including the former Editor-in-Chief of the New England Journal of Medicine have raised issue with the effects that profitism has had on shaping study results to the detriment of patients. This is not a Democrat or Republican issue, mind you. Often the change of one party for the other only means a shifting of contracts from A to B, all companies engaged more or less in the same profit-driven chicanery. We can clearly see this in effect regarding the hearings on healthcare reform, which have omitted any consideration of single payer, despite polling data that show a greater than 40% and as much as 59% opinion in favor of such a system across occupations including and especially doctors and nurses.

These far away happenings in Washington have direct implications for the individual family living in Batavia. The schedule of vaccinations which used to be only a few in the 60s and 70s has exploded, including antidotes for quite harmless conditions like chicken pox. Profit can be the only explanation for vaccination inflation because the costs and risks of some conditions for which vaccinations are issued is no greater than the common cold. On the other hand, the risk of receiving injections of numerous pathogenic factors that do not enter the body or trigger the immune system's response directly through the blood is a risk that is difficult to gauge given the numerous factors at play with each individual. Consider, for example, the numerous risks of multiple drug interactions often unknown or unpredictable in the aged population and one gets an idea of how risky cocktail inoculation is and how unpredictable this could be for an immature immune system, which even in the most extreme circumstances will not be faced with hepatitis, small pox, and whooping cough at the same time.

Prevention cannot get in the way of profitism under our present system. This means that preventative interventions must function as a gateway to further treatment. Let us take as an example the deft media campaigns that play upon feminist, quasi-feminist, and faux feminist sympathies regarding breast cancer. The message unequivocally regarding prevention is early detection, which is not the same as prevention by a long shot. Early detection means assuming a course of treatment identical to or nearly identical to a "full-blown" condition but shifting the odds of success more in the favor of the interventionists. It has nothing to do with preventing breast cancer, which would involve a more earnest addressing of environmental and behavioral factors that would undercut profitism's directives. This is not to say that early detection is a bogus message, not at all. But it is not the same as prevention.

Individuals who are less comfortable in ceding their preventative healthcare to orthodox medical profitism are left with little choice but to be more vigilant in taking account for oneself's and families health. Just as the arcane machinations of Wall Street facilitated by sloganeering like "diversification" rendered a populace sheep before wolves, so too do we play the sheep when we pay obeisance to terms like "research and development." The accountable individual must equip themselves with tools of common sense before the claptrap of medical arcania. If something doesn't seem right or make sense to you, then you've got to listen to yourself. In many cases, it is not like you can sue for damages after the fact. Remember, many of the stock brokers who dealt in fraud were not intentionally doing so and when pressed were often as confused about what they were selling as their clients. It is not much different in the healthcare field, where just like most places it is much safer to just be a part of the herd.

Hong Kong

(Note: this is excerpted from my book Journey to Jogya, written about sever years ago.)

After my several-hour flight from New York, after being seen off by my cousin Wilhelm, Charles greeted me with a big hug in the HK airport. It is a thoroughly modern airport with lots of pale blue glass and stainless steel. It has an embarkation and disembarkation unit that is separate from the flight terminals that is linked by tram. It departs about once every four minutes, though travel fanatics invariably will rush with the utmost heedless urgency to get on so that they may inevitably wait on the other end.

These modern airports are like a trip to the mall. There are numerous fancy retail establishments, which fail to get my blood pumping as they are wont to do for the committed shopper. I’ve never understood the airport shopping “experience.” Why people seem possessed with the urge to purchase perfume, ties, chocolates, and booze just because it bears the emblem of “duty-free” is beyond me. Of course, no airport experience would be complete without McDonald’s. It has a kiosk located in the arrival area, immediately visible as one emerges from baggage pickup. Such a sight is probably a comfort to the first-time traveler, perhaps a bit homesick even after only a few hours from home. For others it must elicit the question, is there no escape? After all, we mainly travel to see different things, not what we can find essentially in any godforsaken strip mall or highway stop in North America.

Hong Kong is on the northern edge of the tropics, about the same latitude as Havana. Huge elephant ears, the length of one’s arm, grow here and there, along with palm, pine, and hibiscus to provide greenery to what would otherwise be a concretely urban setting, comprised of banks, schools, hotels, and trade buildings.

Charles lives on a quasi-remote island holding the airport, scattered among ancient and prefab communities crowding the coast… and wild cows, which roam aimlessly along the undeveloped stretch of mountain. He lives in a retirement community of sorts, an enclave called Discovery Bay, Disco Bay for short or derisively Delivery Bay, since a wealth of ex-pats with children have claimed the development for themselves. Disco Bay is ½ hour high-speed ferry ride from congested Central Island, the hub of HK.

Disco Bay features a beach, a grocery store, video shop, and bank. A few Asian restaurants, the beach and a quaint plaza rests only a hop, skip, and a jump from the ferry landing. No one but a stubborn old Danish geezer dares swim in the water for fear of pollution. Many whites sun themselves there, though the Chinese and other Asians tend to hide out beneath the nearby pines, which stop at the walkway demarcating the residences from the beach. On evenings, people gather in the plaza in to drink beer by the droves, particularly on weekends. During the day, the plaza is a proxy playground for munchkins and a gathering spot for their Filipina and increasingly Indonesian nursemaids.

Hong Kong is a series of mountains. Kowloon, one island, is Cantonese for nine dragons. The dragon reference is to the mountains themselves, each hill being a hump in the spine of the dragon’s back. Given its hills, walking around HK can be a chore. On Central, there is an escalator assisting pedestrians up a sharp incline: the higher up the mountain, the more exclusive the residences. Disco Bay hasn’t an escalator, so one must catch a bus, shuttle, or huff up steep alabaster stairs, reminiscent of some polysyllabic Mayan ruin but for the lead-pipe railings and verdant drapings of well manicured vegetation. Disco Bay permits no automobiles. A finite number of golf carts, commanding a handsome price, are allowed. The carts add much to the retirement-community feel.

The stifling pollution of Central pushed Charles from his former abode on North Point. Accessible by thoroughly modern subway, North Point is like the rest of HK, situated tightly on the back of one or another dragon. It is a gathering of high-rise upon high-rise, old and slightly moldy from a perpetual sea dampness. Some seasons are worse than others. A friend told me of his first time in HK when his hanging suits grew mold in the closet from the omnipresent wetness. This is why air conditioners tend to run constantly, particularly after March, when temperatures are warm enough to ensure a good deal of mold-growing. There are about four AC free months at most. For the modern age, AC has become something of a necessity, like fire. During the sweltering months people shrink at the notion of going into the dense sardine packed spaces where even ocean breezes are reluctant to go. There’s a lot of shui and very little feng. The AC exacerbates the problem by acclimating people to abnormal frigidity given the tropical conditions. Moving indoors out is a warp from July to January, a shock to the system to which no body can become properly inured, though the professionalism of the town necessitates that most are dressed for January anyway-- more clothes is more civilized, after all. The indoor-outdoor divide is a marked contrast from the way things use to be in China. For example, during my time at the Beijing school for diplomats a teacher colleague, some years older than I, had taken a Chinese wife, inheriting, as it were, a Chinese mother-in law in the transaction. This mother-in-law insisted on opening the windows in the freezing season as well as in summer, due to a traditional belief that harmony between the outer and inner was necessary to avert illness.

Charles’s former North Point abode was on the ground floor of a 12 storey high-rise. There was a courtyard fenced on the sides by residential high rises. The dragon’s back, dripping constantly with water, formed an impassable wall off which voices echoed to the upper floors, necessitating polite parties… good parties even given the constraints on volume. By far the politest partier, resident par excellence, was Hitler, a three pound black carp confined to a shoebox-sized pool carved into the mountainside, his size being so large as to hardly allow him to turn around. Someone figured that for the fish to be in such incarcerated conditions it must be doing penance for heinous crimes from a past life. Hitler seemed to be atoning in earnest, flopping only on rare occasions.

Charles shared his living space with an Irishman and a Frenchman. Fintanne the Irishman reminded me of one of the blokes from the movie Trainspotting, a thin working-class UK type who forced countless nods and smiles for the impossibility of understanding a word he said. He had that expatriate go-getter spirit, getting into virtually any kind of business to get money to get any assortment of go-getter drugs, not the least of which was cocaine (to be inflected with a minimum of three syllables). His face seemed to bear the signs of this intensity, drawn and dry like leather, accentuating darting globular eyes and rodential teeth, stained from coffee, marmalade, and fags of tobacco and hash.

It was hard to spot Jean-Jacques without a cigarette or spliff in hand. He was far more subdued than either Charles or Fintanne and his cash-flow showed this. Evidently, being a wine broker in Hong Kong is not particularly lucrative. In over three years in HK, he had dug himself quite a hole of debt from having to constantly borrow money in order to share in the HK life. It’s the kind of town in which you can go out every night. There’s always this restaurant to try or that promotional to attend, always. But going out isn’t cheap even if you go cheaply. He looked as you might expect Eddie Munster’s French cousin to look, a rectangular head with thick dark eyebrows and a goatee, a bit of a paunch. He’d often regale me between inhalations and through a haze of smoke of this “splendid” occurrence or that “absolutely brilliant” exchange. Through a little finagling he had brilliantly arranged at no cost our entry into the Hong Kong Sevens, a world famous international rugby event. Being poor he always had an eye out for the hook up, the informal economy of friends helping friends at company expense.

Phillipe was another Frenchman who was the proprietor of a restaurant specializing in French wine as much as French cuisine. Phillipe was a diminutive blond who carried a thick French accent. He had a twisted fascination for blacks, which some may construe as racist. For instance, at a 70’s party he sported an afro wig and commented copiously about my own hair with a staid jocularity that perhaps amuses the easily amused. Perhaps, it is a French thing that I’m not apt to understand. On other occasions, perhaps around a spliff while marveling about his blond dancer girlfriend he would mention that he had previously always been with black women, either from Brazil, Cote d’Ivoire, or Madagascar. The marvel was in love’s ironies, for a blond Madonna-looking American was not his design. He was so French, speaking philosophically on the minutiae of love, of making love, the love of wine and, for my part, five o’clock shadows.

Natasha is my Uzbek associate from my days in Beijing. She migrated down after doing a bit of time studying law at Yale. She’s a sister of sorts, acting as my trusty dance partner and fun-seeker wherever. She’s a culture straddle: born of an Uzbek father and Russian mother, she spoke Russian, Uzbek, Mandarin, and English through smoky eyes, sandy red hair, and the fairest skin that one could imagine, all upon a lithe frame. Central Asians sit at the crossroads of historic conquest: before the Russians, it was the Muslims, still earlier the Mongols. These layers of history are evident in the faces of Central Asians, some looking East Asian, Arabesque, European, smatterings even resembling South Asians. She identified herself and her father’s people as one of the descendants of Chingis Khan, the alpha male whom she says disparagingly uttered that grass (vegetables) is for animals and meat is for men. I take her statement to mean something more than being an avowed carnivore, rather more being an attempt to anchor identity in a time before the Sovietism and Islam.

I hadn’t always liked Natasha, though this seemed to change sometime around the crazy days of Beijing a decade earlier when she was dating my Thai friend Achop. In HK, Natasha introduced me to a circle of associates whom I wouldn’t otherwise meet by kicking it exclusively with Charles. It was on one such occasion with Natasha, at some outdoorsy club cookout that I met Wendy, a healthy Indonesian Chinese girl who chewed meat from a skewer in such a manner as to suggest that she was indeed a fine meat-eater. I couldn’t stop starring. Even though I never shared this meat impression with her directly, it seemed uncannily to rear its head in other ways, such as when shesuggested the book, My Year of Meat, a witty indictment of the American meat industry, or when she offered me some pork broth as a remedy for my slight traveler’s cold.

It isn’t every day that I run across an Indo-Chinese in my wanderings, that she was Buddhist was especially appealing. She had this Burmese wall hanging of the Buddha’s footprint in her bedroom. It was a large three-dimensional tapestry of black cloth onto which golden threads and sequins were sewn. In the center was the footprint itself, puffy and glittery surrounded by auspicious Buddhist emblems. The design was very similar to the Thai hats of puffy sequined Elephants popular a few years ago. Before I departed for Thailand, she gave me a copy of Herman Hesse’s Goldmund and Narcissus, which is essentially a tale of a wayfarer during the time of the plague, a man who mainly contents himself with existential sensualism.