My wife went to vote at 7:30 and had a 45 minute wait. I went at 8:45 and had a 15 minute wait. Minnesota typically has high voter turnout (and paper ballots that can be recounted) and the pattern I saw today seemed about on par with the past 5 presidential elections.
Vote as if your country depends on it... because it does.
I see that Skitt's Law (or Bell's First Law of USENET, if you prefer, as they cover similar ground- Bell more parsimoniously than Skitt) still holds. Hilarious!
Reading through many of these comments I think I see the problem you don't:
Linux sucks to use unless you are skilled in using it.
The market share of Linux/BSD/etc. is less than 1% because it is too hard to use for 99% of the computing public. Compile their own applications? Seriously? Write a shell script- what's that, a play written for mollusks? Try to find a driver for their printer? Sync their iPhone or iPad or Android phone? If it's not plug and play most computer users cannot operate it.
Thee folks want to bring their new computer home, turn it on and be able to use it. They don't want to configure stuff. They don't want to read a manual. They don't want to learn about it. They don't give a baboon's ass crack about the differences between the GPLs. They just want to use it and look at Facebook and Pinterest and send Aunt Martha an e-mail with a LOLcat they found. Why do you think the Web browser is the only application most computer users run? They've figured out how it works. That's why people buy Macs and Windows- those companies have spent time figuring out how to make software usable and make the interface work. Linux geeks tend to wear unusability like a badge of honor. They like having 400 ways to make their interface unique to their needs. That scares off everybody else.
You want to make Linux catch on? Figure out an interface that is as simple and elegant and attractive as the Mac, not the 20 year old quasi medieval look that most Linux interfaces sport. Too much of it still looks like Windows95.
Maybe they are (probably in vain) trying to keep the API out of the hands of malefactors so that there aren't a raft of zero day exploits waiting when Dub-8 hits the streets.
Here's what I want a high quality, fast and truly usable tablet for: medical care. It should be possible to walk into a patient's room carrying a clipboard sized device that resembled a giant iphone.
As a psychologist working in medical settings I want a similar thing. I want an integrated system with a touchscreen that allows me to take notes while talking to my patients and generate a readable, final report from that information. I'd probably have to get the devkit and write the app myself. Using a laptop creates too much separation from the patient- they feel you're paying more attention to the computer than to them.
As a jazz guitarist, I want an 8.5 x 11" or A4 form factor that will allow me to use digitized lead sheets instead of having to lug 500 pages of sheet music with me.
The biggest technical problems I foresee are back end problems, problems with the EMR software, and battery life.(hospital IT departments tend to fuck things up. If they bought a bunch of apple tablets, they probably wouldn't build and maintain the back end servers and wireless AP correctly)
Hospital IT departments and EMR programmers can't even manage sane password and username requirements ("passwords must have twelve characters with at least one and no more than two capitals and three digits, and must not match any of your ten previous passwords." Meaning everyone has to write down their username and passwords to keep track of them, creating a security risk. Duh.). They are a particular subtype of paranoid electron jockey who fail to understand that their job is to make information *available* to providers, not hide it from them.
Remember, YOU (the typical slashdotter running Linux with a windows box for games on desktop machines) are not the intended users for this tablet. YOU probably sit at a desk all day. You have enough technical expertise that tinkering is fun for you, and you don't mind the idea of a tablet on kludgey, cheap hardware that is running open source software.
There's always an inherent culture clash between computer enthusiasts and information appliance users. The majority of users fall into the latter category while the majority of Slashdotters are in the former group. If you understand regexps, you're probably out of touch with most users.
I agree. When considering the statement "The web is becoming an integral part of the computer and the basic distinction between the OS and the browser doesn't matter very much any more," one has to consider the bias of the source. My laptop spends the majority of its time not connected to the internets and that time is its most important use as a tool- I make my living in part with my computer offline. The OS matters much more to me than the browser- I can use Safari, Camino, Firefox, etc. with equal outcomes (Google hasn't yet released Chrome for OS X). The browser is just an application. Google is positioning the browser as middleware- more than a browser, less than an OS.
"what is it about desktop Linux, and specifically Ubuntu, that has Microsoft spooked?" How dumb a question is that? Linux runs on the same hardware as Windows and is free. OS X does not (without more hacking than the vast majority of computer users can do). With distributions like Ubuntu, Linux becomes an easily installed option.
As long as the P2P apps and file transfers can run at full speed when nothing time sensitive is using the network, this is the RIGHT way to do things.
But it won't. Look at what's being throttled: decentralized services that are not controlled by a content provider. The point is not Web congestion, data flow, etc. The point is to centralize access to data by disadvantaging decentralized services, so that it's easier to wring more profit from the Internet. This is about nothing more than separating users from their money.
I'm a psychologist and work for a large clinic (93 clinicians, 25 support staff, five clinic locations and a lot of "out in the field" services). My specialty is nursing home services; there are about 15 of us in the nursing home division and we work in about 150 nursing homes. Often a client is referred to me and it turns out they were seen by a colleague in another nursing home. If we had an EMR that I could query remotely, I could find that out and streamline the delivery of services and provide better care. This would be the "added power" part of the discussion and the rosy picture that EMRs present
The flip side is that computer security is not reliable. Any system connected to the outside world can be hacked remotely one way or another. We have thousands of clients with a lot of sensitive data sitting in our files, currently in locked cabinets behind two locked doors with limited access to maximize security as much as we can. The risk of data exposure is minimal and happens as a result of sloppiness by practitioners (e.g. leaving a file sitting on a desk unwatched). With an EMR, however, the risk of exposure is potentially much higher (e.g., downloading *all* the files instead of swiping or reading just one).
We have made no provisions for using an EMR in our clinic. We have a computerized billing system which contains insurance information and diagnostic codes- only the information required to send out a bill- but none of our clinical records are in an EMR. AFAIK we are not required to do so.
"After years of boasting about the Mac's near invincibility..." I've been a Mac user for over 22 years. While I have heard many of my fellow Mac users boast about the lack of viruses and other malware for Macs- mainly out of ignorance or just to taunt Windows users- there have been Mac viruses in the past (e.g., nVIR) and there will be Mac viruses in the future. I've always been concerned that complacency regarding Mac malware would eventually result in heinousness once some bad actor sunk their teeth into it.
The result of these years of complacency is that there are no good Mac antivirus applications. There are some passable ones and there are some awful ones. One of the better ones is ClamXAV but it is only as good as its virus definitions.
Could you explain more about the Buddhist concept of human functioning? Does that contradict the idea of reincarnation? What exactly is being reincarnated if not a permanent immortal soul?
I understand there are different sects of Buddhism with varying beliefs and practices, just curious if this belief marks a separation from mainstream Buddhist practice.
morgan greywolf replied before me but I don't know where this will be placed in the thread, so I wanted to mention that.
One of the tenets of Buddhism is that things are "empty" meaning that they lack a separate self. Things are made up of non-self elements, to paraphrase Thich Nhat Hanh- for example, a tree is made up of soil, rain, sun, carbon dioxide, etc. The tree exists as a confluence of conditions; change one of those conditions and there would be no tree or at least a different tree. If you burn the tree, what happens? The things the tree is made up of are released and eventually become part of something else. This is rebirth (by the way, the Buddhist term is "rebirth" rather than "reincarnation"); I think if it as being closer to recycling than to the transmission of a soul from one body to another.
It is fundamental to human experience, most of the time anyway, to perceive ourselves as having an ongoing constancy- an "I" which is the foundation of the idea of the soul. This is probably an illusion, since who change throughout our lives- if we did not, we could neither grow nor learn.
Upstream, Kazoo mentioned brain injuries and memory problems. Memory is critical to a sense of a lasting self, of course. It may even be that memory *is* the sense of being a lasting self. But memories can be faked, can be lost, can be twisted beyond recognition. Memory is as much imagination as it is recollection. Disorders that affect cognitive functions can significantly alter the sense of self and, in the case of diseases like Alzheimer's, seem to destroy the sense of self in the long run. (Disclosure: I am a psychologist and one of my specialties is dementing illnesses). Diseases like depression and bipolar disorder distort the perception of being a self.
And if you were to create a system that had similar properties, similar level of complexity it would therefore have the same emerging [sic] property.
Non sequitur. It would very likely have an emergent property, but nothing requires that it be the same, or similar, to properties that emerge in biological systems.
That's an interesting point. It also begs the question of whether or how we'd be able to recognize that emergent property.
Basically -- what is the ghost in the machine? Your body is a machine. Increasingly, your brain is seen as a neurological computer with neurons firing and whatnot. What is your consciousness? What makes you sentient? They've poked and prodded every orifice of your body and they have still not been able to determine where your consciousness -- this 'thing' in quantum physics called 'the observer' -- is. It's not in the brain, it's not the organs, it's not anywhere. Yet, most people seem to acknowledge its existence. Even many scientists, atheist or not.
You've tossed the baby out with the bathwater in your list of where consciousness is not. It's clear from observation that consciousness exists in interaction between the nervous system and the world around it (and also the nervous system and the rest of the material of the body). It is an emergent property. Subjectively consciousness is unitary although this may not in fact be the case- there are multiple systems of consciousness (vision, hearing, haptic, cognition, etc). The works of James J. Gibson and Edward Reed- among others- are worth checking out in this regard.
The conceptual difficulty comes from the popular notions of "soul" present in various mythologies, especially the notion of an immortal soul that is somehow placed into the body at some point and which leaves the body at some point. The existence of this soul is non-demonstrable and its existence is an article of faith not observation; it becomes problematic when faith attempts to trump observable reality.
Interestingly the Buddhist conception of human functioning avoids these difficulties. It denies the existence of an immortal individual soul and identifies all aspects of existence as mutually emergent properties which are conditional, constantly changing and ultimately temporary. Over-simplistically, Buddhism proposes six types of consciousness: sight, hearing, touching, tasting, smelling and mental formations. Each arises as an interaction between the properties of the organism and the properties of its environment. No permanent, immortal and highly problematic soul (which violates the laws of physics) is needed.
This is a bit troubling for me. As a provider, you're willing to go on record that health care finance has nothing to do with the provider side?
Nothing exists in a vacuum and this is a good point to bring up. Health care is expensive, there is no doubt about it. The buildings cost a lot and must be paid for, the tools cost a lot and must be paid for, the consumable supplies cost a lot and must be paid for, and the labor costs a lot and must be paid for. Health care is among the most labor intensive if not the most labor intensive industry; most of that labor has to be extremely highly trained- and hence is expensive.
The finance side is expensive because of the massive profit insurance companies are making, perhaps?
The insurance companies add tens of not hundreds of billions of dollars in health care costs, not just in profit but in organizational inefficiency. As noted above, the industry standard is that insurance companies are 70-90% efficient (meaning 10-30% of revenues going to overhead and profits) compared to Medicare being about 98% efficient.
See, I thought the problems with it were the COST of it. As in how Medicare allows providers to charge five hundred times the actual value of a tongue depressor, and paying for cancer treatment can run into the millions of dollars.
Cost of care is an issue. you're quite right. Insurance companies are the icing on the cake, but there's still cake to deal with. Costs of providing health care services can only be brought down so far. FWIW, my hourly "shop rate" as a health care provider is less than Joe the Plumber's and slightly more than the mechanic who works on my car. My barber's shop rate is about $75 an hour if he can do five haircuts an hour. I had my house reroofed- $8000 for two days' work and that was the lowest estimate. My wife was in the hospital for two days a while back and it cost less. But we're not seeming to be having a national conversation about reducing the cost of plumbing...
Face facts - the problem here is the cost, and the cost problems are because the provider side is shielded from market forces by the prices set forth by Medicare and the percent-pay practices of the payer side.
Am I shielded from market forces? Well, let's see... I get paid a lower reimbursment rate by Medicaid than I was in 1995. I get paid whatever the insurance companies think is a "usual and customary fee" and the bill I send them has no impact on what they pay me (they pay per unit of care using a CPT code). I can accept their payment or forego being a provider for that network. My cost of doing business has gone up twice as fast as the reimbursement increases from insurance companies over the past 20 years.
My own health insurance premiums went up 23% from last year to this year, but my reimbursement rates from that same company did not go up at all.
'Fixing' insurance will only make it go out of business. Obama's desire to meddle with pre-ex will only cause rates to go up for everyone else. These are for-profit entities, and no one is going to force them to stay in business. In the long run this will be tragic because without them no one can afford to pay out of pocket what Medicare pays the providers.
Then what's your solution? Let 95% of Americans be one illness away from bankruptcy, than being the system we already have?
Those are some very good points. Medicare, for example, spends something like 40% of its dollars in the last year of a patient's life. To some extent that is unavoidable- the most expensive health care problems are usually going to have the largest risk of mortality. Culturally we have this unrealistic avoidance of death and this increases the cost of health care. We have a tendency to believe that because we can provide treatment X, we should provide treatment X without necessarily looking at the larger picture. However, these are murky waters indeed! Who should decide whether a 79 year old man with prostate cancer should get treatment for it if he also has severe congestive heart failure and COPD? The current systems of Medicare and Medicaid leave these decisions up to the patient and the doctor (with some exceptions that require preauthorization like organ transplants). IMHO that is where the decision should rest, however (1) we need to make use of the insights of evidence based medicine to guide the decision making process and (2) as a culture we need to be realistic about that fact that everyone dies of something and it is not necessarily appropriate to put that day off as long as possible. But it must still end up being an individual decision.
You base a lot of the benefits on the windfall from squeezing inefficiencies out of the system. Well, the HMO's have already done that. They were able to offer health plans at a lower cost than traditional plans because they squeezed a lot of the fluff out of the system.
HMOs showed initial cost savings because they had well over a decade of being able to cherry-pick the people they insured, and chose mainly healthy low-risk individuals. When forced to take on all comers, HMOs show few cost savings over other medical policies. The problem again is one of overhead- layers of bureaucracy with readily increasing salaries as one climbs up the ladder to the obscenely reimbursed CEO. In my state, HMOs are required to be non-profits which has eliminated some of the complaints seen in other states.
My specialty as a health care provider is that I practice in nursing homes. The vast majority of those patients are on government insurance programs- Medicare and Medicaid, primarily. There is no less access to services for those patients than there is for people with private health insurance; in fact, the people on Medicare and Medicaid have more options rather than less. (There is a big exception here which is dental care; most dentists around here do no accept Medicaid; Medicare and private insurance coverage for dental care is almost nonexistent, despite the clear evidence that dental health is integral to good systemic health. Dental disease is a major risk factor for cardiac disease, for example). The issue with long wait times in almost invariably to see high-demand specialists- psychiatrists, rheumatologists, neurologists, cardiologists, etc.
One place where the HMOs and some clinics have done a good job in my area of practice is the employment of nurse practitioners. Physicians typically see nursing home patients very 90-120 days and if something comes up in between, there is a tendency to send them off to the ER for evaluation. Nurse practitioners see the patients monthly at least and are in the nursing homes at least weekly to do rounds, resulting in a much more attentive model of service delivery and the frequent ability to spot and address problems early and when they are cheaper to fix. We've seen costs lowered dramatically by this approach, sometimes by as much as 20% a year.
However, it's a bit of apples and oranges as this is a population typically with multiple chronic illnesses; the same degree of cost benefits would be much harder to come by in the general population. Many outpatient clinics and hospitals do use nurse practitioners and physician assistants as a way to make seeing a provider on a short notice much more feasible. This helps contain costs and improves the quality of care.
I realize that I am already paying for the idiocy of others (hence the "further" comment in my previous post), and I have great reservations about putting my health care in government's hands. If insurance companies screw it up, I sure don't trust a government bureaucrat to be more effective.
The numbers show that the government already is 5-15 times more efficient than the "market solution" provided by insurance companies.
Let me control my own health care decisions. Put the consumer in the doctor-insurance-pharmacy triangle.
You already are. In fact, you're in charge about the health care you choose to receive (assuming we are talking about competent adults). The exception here is denial of service by the insurance company which has an inherent conflict of interest. People on the existing government health care programs (Medicare, Medicaid, CHIPs, etc.; the VA is a tragic exception) have more control and choice in their health care than I do...
Slashdot Mirror
My wife went to vote at 7:30 and had a 45 minute wait. I went at 8:45 and had a 15 minute wait. Minnesota typically has high voter turnout (and paper ballots that can be recounted) and the pattern I saw today seemed about on par with the past 5 presidential elections. Vote as if your country depends on it... because it does.
I see that Skitt's Law (or Bell's First Law of USENET, if you prefer, as they cover similar ground- Bell more parsimoniously than Skitt) still holds. Hilarious!
Reading through many of these comments I think I see the problem you don't: Linux sucks to use unless you are skilled in using it. The market share of Linux/BSD/etc. is less than 1% because it is too hard to use for 99% of the computing public. Compile their own applications? Seriously? Write a shell script- what's that, a play written for mollusks? Try to find a driver for their printer? Sync their iPhone or iPad or Android phone? If it's not plug and play most computer users cannot operate it. Thee folks want to bring their new computer home, turn it on and be able to use it. They don't want to configure stuff. They don't want to read a manual. They don't want to learn about it. They don't give a baboon's ass crack about the differences between the GPLs. They just want to use it and look at Facebook and Pinterest and send Aunt Martha an e-mail with a LOLcat they found. Why do you think the Web browser is the only application most computer users run? They've figured out how it works. That's why people buy Macs and Windows- those companies have spent time figuring out how to make software usable and make the interface work. Linux geeks tend to wear unusability like a badge of honor. They like having 400 ways to make their interface unique to their needs. That scares off everybody else. You want to make Linux catch on? Figure out an interface that is as simple and elegant and attractive as the Mac, not the 20 year old quasi medieval look that most Linux interfaces sport. Too much of it still looks like Windows95.
Maybe they are (probably in vain) trying to keep the API out of the hands of malefactors so that there aren't a raft of zero day exploits waiting when Dub-8 hits the streets.
Here's what I want a high quality, fast and truly usable tablet for: medical care. It should be possible to walk into a patient's room carrying a clipboard sized device that resembled a giant iphone.
As a psychologist working in medical settings I want a similar thing. I want an integrated system with a touchscreen that allows me to take notes while talking to my patients and generate a readable, final report from that information. I'd probably have to get the devkit and write the app myself. Using a laptop creates too much separation from the patient- they feel you're paying more attention to the computer than to them. As a jazz guitarist, I want an 8.5 x 11" or A4 form factor that will allow me to use digitized lead sheets instead of having to lug 500 pages of sheet music with me.
The biggest technical problems I foresee are back end problems, problems with the EMR software, and battery life.(hospital IT departments tend to fuck things up. If they bought a bunch of apple tablets, they probably wouldn't build and maintain the back end servers and wireless AP correctly)
Hospital IT departments and EMR programmers can't even manage sane password and username requirements ("passwords must have twelve characters with at least one and no more than two capitals and three digits, and must not match any of your ten previous passwords." Meaning everyone has to write down their username and passwords to keep track of them, creating a security risk. Duh.). They are a particular subtype of paranoid electron jockey who fail to understand that their job is to make information *available* to providers, not hide it from them.
Remember, YOU (the typical slashdotter running Linux with a windows box for games on desktop machines) are not the intended users for this tablet. YOU probably sit at a desk all day. You have enough technical expertise that tinkering is fun for you, and you don't mind the idea of a tablet on kludgey, cheap hardware that is running open source software.
There's always an inherent culture clash between computer enthusiasts and information appliance users. The majority of users fall into the latter category while the majority of Slashdotters are in the former group. If you understand regexps, you're probably out of touch with most users.
Who names an application framework after an infectious disease?
I agree. When considering the statement "The web is becoming an integral part of the computer and the basic distinction between the OS and the browser doesn't matter very much any more," one has to consider the bias of the source. My laptop spends the majority of its time not connected to the internets and that time is its most important use as a tool- I make my living in part with my computer offline. The OS matters much more to me than the browser- I can use Safari, Camino, Firefox, etc. with equal outcomes (Google hasn't yet released Chrome for OS X). The browser is just an application. Google is positioning the browser as middleware- more than a browser, less than an OS.
"what is it about desktop Linux, and specifically Ubuntu, that has Microsoft spooked?" How dumb a question is that? Linux runs on the same hardware as Windows and is free. OS X does not (without more hacking than the vast majority of computer users can do). With distributions like Ubuntu, Linux becomes an easily installed option.
As long as the P2P apps and file transfers can run at full speed when nothing time sensitive is using the network, this is the RIGHT way to do things.
But it won't. Look at what's being throttled: decentralized services that are not controlled by a content provider. The point is not Web congestion, data flow, etc. The point is to centralize access to data by disadvantaging decentralized services, so that it's easier to wring more profit from the Internet. This is about nothing more than separating users from their money.
Explain to me why my gaming or surfing should suffer because you want to download/upload XXX_Donkey_Love.WMV from thepiratebay, again?
Explain to me why my downloads should suffer because of your gaming? Are you more important than me?
Hire Stallman.
I'm a psychologist and work for a large clinic (93 clinicians, 25 support staff, five clinic locations and a lot of "out in the field" services). My specialty is nursing home services; there are about 15 of us in the nursing home division and we work in about 150 nursing homes. Often a client is referred to me and it turns out they were seen by a colleague in another nursing home. If we had an EMR that I could query remotely, I could find that out and streamline the delivery of services and provide better care. This would be the "added power" part of the discussion and the rosy picture that EMRs present
The flip side is that computer security is not reliable. Any system connected to the outside world can be hacked remotely one way or another. We have thousands of clients with a lot of sensitive data sitting in our files, currently in locked cabinets behind two locked doors with limited access to maximize security as much as we can. The risk of data exposure is minimal and happens as a result of sloppiness by practitioners (e.g. leaving a file sitting on a desk unwatched). With an EMR, however, the risk of exposure is potentially much higher (e.g., downloading *all* the files instead of swiping or reading just one).
We have made no provisions for using an EMR in our clinic. We have a computerized billing system which contains insurance information and diagnostic codes- only the information required to send out a bill- but none of our clinical records are in an EMR. AFAIK we are not required to do so.
You got it.
"After years of boasting about the Mac's near invincibility..." I've been a Mac user for over 22 years. While I have heard many of my fellow Mac users boast about the lack of viruses and other malware for Macs- mainly out of ignorance or just to taunt Windows users- there have been Mac viruses in the past (e.g., nVIR) and there will be Mac viruses in the future. I've always been concerned that complacency regarding Mac malware would eventually result in heinousness once some bad actor sunk their teeth into it.
The result of these years of complacency is that there are no good Mac antivirus applications. There are some passable ones and there are some awful ones. One of the better ones is ClamXAV but it is only as good as its virus definitions.
Sirius's Karmazin ran over the dogmazin.
Could you explain more about the Buddhist concept of human functioning? Does that contradict the idea of reincarnation? What exactly is being reincarnated if not a permanent immortal soul? I understand there are different sects of Buddhism with varying beliefs and practices, just curious if this belief marks a separation from mainstream Buddhist practice.
morgan greywolf replied before me but I don't know where this will be placed in the thread, so I wanted to mention that.
One of the tenets of Buddhism is that things are "empty" meaning that they lack a separate self. Things are made up of non-self elements, to paraphrase Thich Nhat Hanh- for example, a tree is made up of soil, rain, sun, carbon dioxide, etc. The tree exists as a confluence of conditions; change one of those conditions and there would be no tree or at least a different tree. If you burn the tree, what happens? The things the tree is made up of are released and eventually become part of something else. This is rebirth (by the way, the Buddhist term is "rebirth" rather than "reincarnation"); I think if it as being closer to recycling than to the transmission of a soul from one body to another.
It is fundamental to human experience, most of the time anyway, to perceive ourselves as having an ongoing constancy- an "I" which is the foundation of the idea of the soul. This is probably an illusion, since who change throughout our lives- if we did not, we could neither grow nor learn.
Upstream, Kazoo mentioned brain injuries and memory problems. Memory is critical to a sense of a lasting self, of course. It may even be that memory *is* the sense of being a lasting self. But memories can be faked, can be lost, can be twisted beyond recognition. Memory is as much imagination as it is recollection. Disorders that affect cognitive functions can significantly alter the sense of self and, in the case of diseases like Alzheimer's, seem to destroy the sense of self in the long run. (Disclosure: I am a psychologist and one of my specialties is dementing illnesses). Diseases like depression and bipolar disorder distort the perception of being a self.
The athiests will argue that there's no such thing as a "soul", only sentience and/or self-awareness.
Not all religions postulate a soul, so some non-atheists could argue that there is no such thing as a soul.
Non sequitur. It would very likely have an emergent property, but nothing requires that it be the same, or similar, to properties that emerge in biological systems.
That's an interesting point. It also begs the question of whether or how we'd be able to recognize that emergent property.
Basically -- what is the ghost in the machine? Your body is a machine. Increasingly, your brain is seen as a neurological computer with neurons firing and whatnot. What is your consciousness? What makes you sentient? They've poked and prodded every orifice of your body and they have still not been able to determine where your consciousness -- this 'thing' in quantum physics called 'the observer' -- is. It's not in the brain, it's not the organs, it's not anywhere. Yet, most people seem to acknowledge its existence. Even many scientists, atheist or not.
You've tossed the baby out with the bathwater in your list of where consciousness is not. It's clear from observation that consciousness exists in interaction between the nervous system and the world around it (and also the nervous system and the rest of the material of the body). It is an emergent property. Subjectively consciousness is unitary although this may not in fact be the case- there are multiple systems of consciousness (vision, hearing, haptic, cognition, etc). The works of James J. Gibson and Edward Reed- among others- are worth checking out in this regard.
The conceptual difficulty comes from the popular notions of "soul" present in various mythologies, especially the notion of an immortal soul that is somehow placed into the body at some point and which leaves the body at some point. The existence of this soul is non-demonstrable and its existence is an article of faith not observation; it becomes problematic when faith attempts to trump observable reality.
Interestingly the Buddhist conception of human functioning avoids these difficulties. It denies the existence of an immortal individual soul and identifies all aspects of existence as mutually emergent properties which are conditional, constantly changing and ultimately temporary. Over-simplistically, Buddhism proposes six types of consciousness: sight, hearing, touching, tasting, smelling and mental formations. Each arises as an interaction between the properties of the organism and the properties of its environment. No permanent, immortal and highly problematic soul (which violates the laws of physics) is needed.
Now: demonstrate its existence.
...other than Planet Earth, right? And, how many other human outposts in space are there?
Who writes this stuff?
Nothing exists in a vacuum and this is a good point to bring up. Health care is expensive, there is no doubt about it. The buildings cost a lot and must be paid for, the tools cost a lot and must be paid for, the consumable supplies cost a lot and must be paid for, and the labor costs a lot and must be paid for. Health care is among the most labor intensive if not the most labor intensive industry; most of that labor has to be extremely highly trained- and hence is expensive.
The insurance companies add tens of not hundreds of billions of dollars in health care costs, not just in profit but in organizational inefficiency. As noted above, the industry standard is that insurance companies are 70-90% efficient (meaning 10-30% of revenues going to overhead and profits) compared to Medicare being about 98% efficient.
Cost of care is an issue. you're quite right. Insurance companies are the icing on the cake, but there's still cake to deal with. Costs of providing health care services can only be brought down so far. FWIW, my hourly "shop rate" as a health care provider is less than Joe the Plumber's and slightly more than the mechanic who works on my car. My barber's shop rate is about $75 an hour if he can do five haircuts an hour. I had my house reroofed- $8000 for two days' work and that was the lowest estimate. My wife was in the hospital for two days a while back and it cost less. But we're not seeming to be having a national conversation about reducing the cost of plumbing...
Am I shielded from market forces? Well, let's see... I get paid a lower reimbursment rate by Medicaid than I was in 1995. I get paid whatever the insurance companies think is a "usual and customary fee" and the bill I send them has no impact on what they pay me (they pay per unit of care using a CPT code). I can accept their payment or forego being a provider for that network. My cost of doing business has gone up twice as fast as the reimbursement increases from insurance companies over the past 20 years.
My own health insurance premiums went up 23% from last year to this year, but my reimbursement rates from that same company did not go up at all.
Then what's your solution? Let 95% of Americans be one illness away from bankruptcy, than being the system we already have?
Those are some very good points. Medicare, for example, spends something like 40% of its dollars in the last year of a patient's life. To some extent that is unavoidable- the most expensive health care problems are usually going to have the largest risk of mortality. Culturally we have this unrealistic avoidance of death and this increases the cost of health care. We have a tendency to believe that because we can provide treatment X, we should provide treatment X without necessarily looking at the larger picture. However, these are murky waters indeed! Who should decide whether a 79 year old man with prostate cancer should get treatment for it if he also has severe congestive heart failure and COPD? The current systems of Medicare and Medicaid leave these decisions up to the patient and the doctor (with some exceptions that require preauthorization like organ transplants). IMHO that is where the decision should rest, however (1) we need to make use of the insights of evidence based medicine to guide the decision making process and (2) as a culture we need to be realistic about that fact that everyone dies of something and it is not necessarily appropriate to put that day off as long as possible. But it must still end up being an individual decision.
HMOs showed initial cost savings because they had well over a decade of being able to cherry-pick the people they insured, and chose mainly healthy low-risk individuals. When forced to take on all comers, HMOs show few cost savings over other medical policies. The problem again is one of overhead- layers of bureaucracy with readily increasing salaries as one climbs up the ladder to the obscenely reimbursed CEO. In my state, HMOs are required to be non-profits which has eliminated some of the complaints seen in other states.
My specialty as a health care provider is that I practice in nursing homes. The vast majority of those patients are on government insurance programs- Medicare and Medicaid, primarily. There is no less access to services for those patients than there is for people with private health insurance; in fact, the people on Medicare and Medicaid have more options rather than less. (There is a big exception here which is dental care; most dentists around here do no accept Medicaid; Medicare and private insurance coverage for dental care is almost nonexistent, despite the clear evidence that dental health is integral to good systemic health. Dental disease is a major risk factor for cardiac disease, for example). The issue with long wait times in almost invariably to see high-demand specialists- psychiatrists, rheumatologists, neurologists, cardiologists, etc.
One place where the HMOs and some clinics have done a good job in my area of practice is the employment of nurse practitioners. Physicians typically see nursing home patients very 90-120 days and if something comes up in between, there is a tendency to send them off to the ER for evaluation. Nurse practitioners see the patients monthly at least and are in the nursing homes at least weekly to do rounds, resulting in a much more attentive model of service delivery and the frequent ability to spot and address problems early and when they are cheaper to fix. We've seen costs lowered dramatically by this approach, sometimes by as much as 20% a year.
However, it's a bit of apples and oranges as this is a population typically with multiple chronic illnesses; the same degree of cost benefits would be much harder to come by in the general population. Many outpatient clinics and hospitals do use nurse practitioners and physician assistants as a way to make seeing a provider on a short notice much more feasible. This helps contain costs and improves the quality of care.
The numbers show that the government already is 5-15 times more efficient than the "market solution" provided by insurance companies.
You already are. In fact, you're in charge about the health care you choose to receive (assuming we are talking about competent adults). The exception here is denial of service by the insurance company which has an inherent conflict of interest. People on the existing government health care programs (Medicare, Medicaid, CHIPs, etc.; the VA is a tragic exception) have more control and choice in their health care than I do...