Not to minimize the mental health provider issue, it's also true that important medical providers (cardiologists, neurologists, etc.) are hard to find as well, even if one has appropriate and acceptable coverage. Basically, the healthcare system is being slammed even in urban settings. Rural, of course, are even worse.
With M.D.s, you have an aging, unhealthy population facing an artificially restricted supply of both specialists and GPs. The number of medical schools has increased during the past 20 years or so, the number of students and consequently interns has increased — although the latter are spending historically low amounts of time with patients — but an increase in the number of residents is lagging because federally funded residency positions are capped by law. So you have increasing demand and a capped supply.
Poverty, insecurity and other factors obviously have an impact on those arenas as well as on physical health, but if you wave your magic wand people and get rid of it all people are still going to get old and their bodies fail. Pay everybody a living wage and guarantee their housing and access to decent food and prospects to educate themselves, and a lot of externally imposed mental health issues will fall away.
Eating right and exercising are good for you, but they're not gonna solve capitalism.
The aging population, of which I am a part, are not aging in an unhealthy manner, as a generality, but with aging come medical issues regardless, and my point is that even with respect to affluent, adequately insured patients, the system is slammed. I agree with you about mental health issues being significantly ameliorated by decent income, housing, food and educational opportunity, but even with all of that, the medical support system will be inadequate. I and my friends, who are mostly financially comfortable, see it every day.
Relative to other wealthy nations our population is unhealthy, and it is aging, is what I mean, not that specific people are aging unhealthily. An unhealthier population means specialist services associated with aging are required earlier than would otherwise be the case, and the number of specialists isn't growing in tandem with the demand because of that artificial bottleneck around the residencies.
You know what I mean? It's not a natural feature of the medical landscape, it's a policy decision. That's simplistic, obviously, there are a lot of factors involved, but the things that make our lower classes sicker than in other countries are policy things, and so is the specialist shortage.
Adding in the edit: I went looking for a thing about the residency bottleneck.
Hello, W.B. I was determined to send you a thank you for last week's shout-out, which I really thrilled to! Well, I was determined to send you a thank-you last week, and there were all these other things I was determined to do last week, like catch up on periodicals, and catch up on books, and learn to argue with more panache, but - well, I'm having one of those awful weeks wherein it is hard to read. My least favorite sort of week. Anyway! One thing to read if you want to learn to argue more skillfully (and you argue quite well, but sometimes it's fun to cite sources) is this book https://thebaffler.com/latest/perversity-futility-jeopardy-denison It's a very short book, and I even have a copy which I would mail to you did we not live in a historical period wherein such exertions are unnecessary. Or you could just attend to Perversity, Jeopardy, and Futility and how they scaffold the arguments of the right. Finally! For music you can have on as background music, try the pianist Brad Mehldau (he does a marvelous cover of Paranoid Android, but that's just for starters) or the band The Bad Plus, who are now in their third edit, this one without a piano but - it still works! Remain in light.
Hey, Hilary. You're welcome. That column you pointed me to was epiphany inducing. I'd thought about the two things she connected but not really in connection with one another, if you know what I mean.
I like The Baffler. I'm struggling to regain my own vicious sense of humor.
I'm familiar with The Bad Plus. I listened to the most recent album from the new incarnation after I saw your comment, and liked it a lot. Brad Mehldau rings a bell but I think I've not heard him.
I've had those kinds of weeks. Not reading and not thinking much either, and not on purpose.
Take care, thanks for the Baffler piece, and continuing thanks for the Danielle Carr column, which I was talking about with my therapist this morning.
Not to minimize the mental health provider issue, it's also true that important medical providers (cardiologists, neurologists, etc.) are hard to find as well, even if one has appropriate and acceptable coverage. Basically, the healthcare system is being slammed even in urban settings. Rural, of course, are even worse.
With M.D.s, you have an aging, unhealthy population facing an artificially restricted supply of both specialists and GPs. The number of medical schools has increased during the past 20 years or so, the number of students and consequently interns has increased — although the latter are spending historically low amounts of time with patients — but an increase in the number of residents is lagging because federally funded residency positions are capped by law. So you have increasing demand and a capped supply.
Poverty, insecurity and other factors obviously have an impact on those arenas as well as on physical health, but if you wave your magic wand people and get rid of it all people are still going to get old and their bodies fail. Pay everybody a living wage and guarantee their housing and access to decent food and prospects to educate themselves, and a lot of externally imposed mental health issues will fall away.
Eating right and exercising are good for you, but they're not gonna solve capitalism.
The aging population, of which I am a part, are not aging in an unhealthy manner, as a generality, but with aging come medical issues regardless, and my point is that even with respect to affluent, adequately insured patients, the system is slammed. I agree with you about mental health issues being significantly ameliorated by decent income, housing, food and educational opportunity, but even with all of that, the medical support system will be inadequate. I and my friends, who are mostly financially comfortable, see it every day.
Relative to other wealthy nations our population is unhealthy, and it is aging, is what I mean, not that specific people are aging unhealthily. An unhealthier population means specialist services associated with aging are required earlier than would otherwise be the case, and the number of specialists isn't growing in tandem with the demand because of that artificial bottleneck around the residencies.
You know what I mean? It's not a natural feature of the medical landscape, it's a policy decision. That's simplistic, obviously, there are a lot of factors involved, but the things that make our lower classes sicker than in other countries are policy things, and so is the specialist shortage.
Adding in the edit: I went looking for a thing about the residency bottleneck.
https://www.aamc.org/news-insights/press-releases/us-medical-school-enrollment-surpasses-expansion-goal
Hello, W.B. I was determined to send you a thank you for last week's shout-out, which I really thrilled to! Well, I was determined to send you a thank-you last week, and there were all these other things I was determined to do last week, like catch up on periodicals, and catch up on books, and learn to argue with more panache, but - well, I'm having one of those awful weeks wherein it is hard to read. My least favorite sort of week. Anyway! One thing to read if you want to learn to argue more skillfully (and you argue quite well, but sometimes it's fun to cite sources) is this book https://thebaffler.com/latest/perversity-futility-jeopardy-denison It's a very short book, and I even have a copy which I would mail to you did we not live in a historical period wherein such exertions are unnecessary. Or you could just attend to Perversity, Jeopardy, and Futility and how they scaffold the arguments of the right. Finally! For music you can have on as background music, try the pianist Brad Mehldau (he does a marvelous cover of Paranoid Android, but that's just for starters) or the band The Bad Plus, who are now in their third edit, this one without a piano but - it still works! Remain in light.
Hey, Hilary. You're welcome. That column you pointed me to was epiphany inducing. I'd thought about the two things she connected but not really in connection with one another, if you know what I mean.
I like The Baffler. I'm struggling to regain my own vicious sense of humor.
I'm familiar with The Bad Plus. I listened to the most recent album from the new incarnation after I saw your comment, and liked it a lot. Brad Mehldau rings a bell but I think I've not heard him.
I've had those kinds of weeks. Not reading and not thinking much either, and not on purpose.
Take care, thanks for the Baffler piece, and continuing thanks for the Danielle Carr column, which I was talking about with my therapist this morning.