Medical Expenses Quotes

But money spent while manic doesn't fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you're given excellent reason to be even more so.

It is very expensive to give bad medical care to poor people in a rich country.

When I am high I couldn’t worry about money if I tried. So I don’t. The money will come from somewhere; I am entitled; God will provide. Credit cards are disastrous, personal checks worse. Unfortunately, for manics anyway, mania is a natural extension of the economy. What with credit cards and bank accounts there is little beyond reach. So I bought twelve snakebite kits, with a sense of urgency and importance. I bought precious stones, elegant and unnecessary furniture, three watches within an hour of one another (in the Rolex rather than Timex class: champagne tastes bubble to the surface, are the surface, in mania), and totally inappropriate sirenlike clothes. During one spree in London I spent several hundred pounds on books having titles or covers that somehow caught my fancy: books on the natural history of the mole, twenty sundry Penguin books because I thought it could be nice if the penguins could form a colony. Once I think I shoplifted a blouse because I could not wait a minute longer for the woman-with-molasses feet in front of me in line. Or maybe I just thought about shoplifting, I don’t remember, I was totally confused. I imagine I must have spent far more than thirty thousand dollars during my two major manic episodes, and God only knows how much more during my frequent milder manias. But then back on lithium and rotating on the planet at the same pace as everyone else, you find your credit is decimated, your mortification complete: mania is not a luxury one can easily afford. It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn’t fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you’re given excellent reason to be even more so.

There are two visions of America a half century from now. One is of a society more divided between the haves and the have-nots, a country in which the rich live in gated communities, send their children to expensive schools, and have access to first-rate medical care. Meanwhile, the rest live in a world marked by insecurity, at best mediocre education, and in effect rationed health care―they hope and pray they don't get seriously sick. At the bottom are millions of young people alienated and without hope. I have seen that picture in many developing countries; economists have given it a name, a dual economy, two societies living side by side, but hardly knowing each other, hardly imagining what life is like for the other. Whether we will fall to the depths of some countries, where the gates grow higher and the societies split farther and farther apart, I do not know. It is, however, the nightmare towards which we are slowly marching.

No one 'just adopts'.

Do you want to have free medical care at the expense of other people, whether they wish to provide it or not? But this would require them to work longer for you whether they want to or not, and other men's lives are not yours to dispose of.

We don’t need anything. Just listen to us and try to understand. Society is good at doing things, ‘giving’ medical help, pensions, flats. But all this so-called giving has been paid for in very expensive currency. Our blood.

If you demand the collective to pay for your medical expenses, then be prepared for the collective to demand to make your medical decisions for you.

When my parents passed on, and we read their wills, we discovered something we didn’t at all expect, especially from our devoutly Catholic mother: they had both left instructions that their bodies be donated to science. We were bewildered and we were pissed. They wanted their cadavers to be used by medical students, they wanted their flesh to be cut into and their cancerous organs examined. We were breathless. They wanted no elaborate funerals, no expense incurred for such stuff – they hated wasting money or time on ceremony, on appearances. When they died there was little left – the house, the cars. And their bodies, and they gave those away. To offer them to strangers was disgusting, wrong, embarrassing. And selfish to us, their children, who would have to live with the thought of their cold weight sinking on silver tables, surrounded by students chewing gum and making jokes about the location of freckles. But then again: Nothing can be preserved. It’s all on the way out, from the second it appears, and whatever you have always has one eye on the exit, and so screw it. As hideous and uncouth as it is, we have to give it all away, our bodies, our secrets, our money, everything we know: All must be given away, given away every day, because to be human means: 1. To be good 2. To save nothing

I remember my mother telling me, when she was in the midst of settling my grandfather's estate, that fifty percent of a person's medical expenses are incurred in the last six months of life. My grandfather's history of himself was distributed even more disproportionately: Ninety percent of everything he ever told me about his life, I heard during its final ten days.

that fifty percent of a person’s medical expenses are incurred in the last six months of life.

Right up until the middle of the eighteenth century, doctors were so destructive that it is likely that aristocrats with access to expensive medics lived less long than peasants with none.

Since my symptoms began 13 years ago, I’ve tried every form of pain management I could access — NSAIDS, nonopioid analgesics, neurologic medications, acupuncture, laser therapy, physical therapy, prolotherapy, massage, and trigger-point injections. Most of these have been unhelpful; others provide temporary relief, often at great expense. At the end of the day, when my body is fully depleted of its resources and in the most pain, a single dose of Percocet is the only tool that silences the pain enough for me to fall asleep. I honestly don’t know what I’d do if Percocet became unavailable to me, and the very thought scares me. I’ve been taking it for five years. To avoid any chance of addiction, I only take it at night and have stayed on a consistently low dose.

The HSA (Health Savings Account) is a great way to save on premiums. The high deductible creates a much lower premium, and this plan allows you to save for medical expenses in a tax-free savings account.

Do you work a job that slowly kills you so you can afford health coverage to pay medical expenses? Or do you live right with the earth and make your own way, keep things simple, and take care of yourself?

There’s no medical expense can break us now. They called LBJ every name in the book but believe me he did a lot of good for the little man. Wherever he went wrong, it was his big heart betrayed him. These pretty boys in the sky right now, Nixon’ll hog the credit but it was the Democrats put ’em there, it’s been the same story ever since I can remember, ever since Wilson—the Republicans don’t do a thing for the little man.

USRC: $15,000 ($208,000) as a cash lump sum for each woman, a pension of $600 ($8,316) a year for life, past and future medical expenses, and USRC to cover all court costs. The firm would have the weekend to think it over.

Ethanol is a volatile, flammable, colourless liquid with a slight chemical odour. It is used as an antiseptic, a solvent, in medical wipes and antibacterial formulas because it kills organisms by denaturing their proteins. Ethanol is an important industrial ingredient. Ethanol is a good general purpose solvent and is found in paints, tinctures, markers and personal care products such as perfumes and deodorants. The largest single use of ethanol is as an engine fuel and fuel additive. In other words, we drink, for fun, the same thing we use to make rocket fuel, house paint, anti-septics, solvents, perfumes, and deodorants and to denature, i.e. to take away the natural properties of, or kill, living organisms. Which might make sense on some level if we weren’t a generation of green minded, organic, health-conscious, truth seeking individuals. But we are. We read labels, we shun gluten, dairy, processed foods, and refined sugars. We buy organic, we use natural sunscreen and beauty products. We worry about fluoride in our water, smog in our air, hydrogenated oils in our food, and we debate whether plastic bottles are safe to drink from. We replace toxic cleaning products with Mrs. Myers and homemade vinegar concoctions. We do yoga, we run, we SoulCycle and Fitbit, we go paleo and keto, we juice, we cleanse. We do coffee enemas and steam our yonis, and drink clay and charcoal, and shoot up vitamins, and sit in infrared foil boxes, and hire naturopaths, and shamans, and functional doctors, and we take nootropics and we stress about our telomeres. These are all real words. We are hyper-vigilant about everything we put into our body, everything we do to our body, and we are proud of this. We Instagram how proud we are of this, and we follow Goop and Well+Good, and we drop 40 bucks on an exercise class because there are healing crystals in the floor. The global wellness economy is estimated to be worth $4 trillion. $4 TRILLION DOLLARS. We are on an endless and expensive quest for wellness and vitality and youth. And we drink fucking rocket fuel.

Hospitals are supposed to help heal the sick. How, then, do we explain the thousands of Americans harmed in hospitals every year when patients are given the wrong medication? In addition to the devastating human toll, these preventable errors cost an estimated $3.5 billion in extra medical expenses.

There’s a reason they call childbirth labor. Making a healthy baby takes effort: It requires foresight and self-denial and courage. It’s expensive and demanding and tiring. You have to learn new things, change many habits, possibly deal with complicated medical situations, make difficult decisions, and undergo stressful ordeals. I had a wisdom tooth pulled without Novocaine while I was pregnant—it hurt a lot and seemed to go on forever. The kindness of the very young dental assistant, holding back my hair as I spat blood into a bowl, will stay with me for the rest of my life. Pregnant women do such things, and much harder things, all the time. For example, they give birth, which is somewhere on the scale between painful and excruciating. Or they have a cesarean, as I did, which is major surgery. None of this is without risk of death or damage or trauma, including psychological trauma. To force girls and women to undergo all this against their will is to annihilate their humanity. When they undertake it by choice, we should all be grateful.

An officer who lost an eye or a limb would receive a year’s pay and medical expenses; the widows of officers killed in action would also get a year’s pay, plus another third for each child. Those who died of their wounds within six months were “deemed slain in battle.” No bonuses were announced for enlisted men.

Do you want to have kids?” I ask. “Sometimes,” he says. “When I’m feeling optimistic.” I bump sideways into him, the skin of our arms sticking slightly from the heat. “Does that happen often?” He looks down his shoulder at me with a slight smirk. “Not often, no.” “So the rest of the time,” I say, “when you’re not feeling optimistic, what do you think?” “The rest of the time …” Another long exhale, his eyes straight ahead as we go back to ambling down the block. “The rest of the time, I think, what if the polar ice caps keep melting? What if medical care keeps getting more expensive, and social security runs out, and housing prices keep rising while minimum wage doesn’t, and what if they resent me for bringing them into all of this? “What if they just hate me? Not because of the state of the world, but just because they hate me. Or what if they’re sick? What if they join a cult, and I can’t convince them to come home? What if they start a cult? What if they get into some heinous shit, and I can’t love them anymore—or worse, I keep loving them even though I can’t change anything? “What if there’s another world war? Or what if … what if everything else goes right, but at the end of my life, they’re sitting in hospice with me …” His voice thickens uncharacteristically, wavering just the slightest bit. “And there are things they wish they could say to me, or hear from me, but I don’t remember who I am, let alone who they are. What if they have to care for me, for years, after I’ve stopped calling them by their nicknames or telling them I love them?

And yet it has been estimated that in the developed world, 75 per cent of our lifetime medical costs are incurred in the last six months of our lives. This is the price of hope, hope which, by the laws of probability, is so often unrealistic. And thus we often end up inflicting both great suffering on ourselves and unsustainable expense on society.

CCA finds ways to minimize its obligation to provide adequate health care. At the out-of-state prisons where California ships some of its inmates, CCA will not accept any prisoners who are over sixty-five years old, have mental health issues, or serious conditions like HIV. The company's Idaho prison contract specified that the 'primary criteria' for screening incoming offenders was 'no chronic mental health or health care issues.' The contracts of some CCA prisons in Tennessee and Hawaii stipulate that the states will bear the cost of HIV treatment. Such exemptions allow CCA to tout its cost efficiency while taxpayers assume the medical expenses for the inmates the company won't take or treat.

Humility allows us to take risks at the expense of our ego.

bring in some money to help cover the mounting medical bills. Private insurance and specialists were expensive.

It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn’t fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you’re given excellent reason to be even more so.

I remember my mother telling me, when she was in the midst of settling my grandfather’s estate, that fifty percent of a person’s medical expenses are incurred in the last six months of life. My grandfather’s history of himself was distributed even more disproportionately: Ninety percent of everything he ever told me about his life, I heard during its final ten days.

The traditional gross anatomy lab represented a sort of sink-or-swim mentality about dealing with death. To cope with what was being asked of them, medical students had to find ways to desensitize themselves. They quickly learned to objectify cadavers, to think of the dead as structures and tissues, and not a former human being. Humor--at the cadaver's expense--was tolerated, condoned even.

ECONOMIC RULES OF THE DYSFUNCTIONAL MEDICAL MARKET More treatment is always better. Default to the most expensive option. A lifetime of treatment is preferable to a cure. Amenities and marketing matter more than good care. As technologies age, prices can rise rather than fall. There is no free choice. Patients are stuck. And they’re stuck buying American. More competitors vying for business doesn’t mean better prices; it can drive prices up, not down. Economies of scale don’t translate to lower prices. With their market power, big providers can simply demand more. There is no such thing as a fixed price for a procedure or test. And the uninsured pay the highest prices of all. There are no standards for billing. There’s money to be made in billing for anything and everything. Prices will rise to whatever the market will bear.

Or, if your out-of-pocket medical expenses amount to $50,000 per night (as they did for my father’s hospital stay at the end of his life), does it really matter whether you’ve saved $10,000 or $50,000 or even $250,000? No, it doesn’t, because the extra $50,000 will buy you one extra night, a night that might well have taken you a year’s worth of work to earn! Similarly, $250,000 saved over however many years will get wiped out in five days. I’m not suggesting that you should rack up large hospital costs with a plan to then stiff the hospital on those bills. What I’m saying is that you can’t pay your way out of high-priced end-of-life medical care; since uninsured medical care is so expensive, it won’t make any real difference for the vast majority of us whether we save for it or not. Either the government will pay for it or you will die.

s medical expenses. When he was finally released from the hospital, he convalesced at home for a long time. He couldn’t work for years, and my mother, with nine kids, including a newborn, to take care of, couldn’t earn any money either. Eventually our money ran out, and we had to live on welfare. We used to joke that we were so poor you could look up the word poor in the dictionary and it would say, “SEE THE BILTZ FAMILY.

Many people from the UK have the impression that the USA medical profession is the best in the world. After a decade of treatment from them, I had concluded that it is a very expensive system that is riddle with incompetence and delivers mediocre care.

In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression. Spending one’s final days in an I.C.U. because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place. The end comes with no chance for you to have said goodbye or “It’s O.K.” or “I’m sorry” or “I love you.” People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.

The cost spikes for the government programs that protected the elderly and the poor were even worse. Better medical care kept people alive longer, and that meant Medicare had to pay for more complicated and more expensive treatment during those prolonged lives.

• Auto and Homeowner Insurance—Choose higher deductibles in order to save on premiums. With high liability limits, these are the best buys in the insurance world. • Life Insurance—Purchase twenty-year level term insurance equal to about ten times your income. Term insurance is cheap and the only way to go; never use life insurance as a place to save money. • Long-Term Disability—If you are thirty-two years old, you are twelve times more likely to become disabled than to die by age sixty-five. The best place to buy disability insurance is through work at a fraction of the cost. You can usually get coverage that equals from 50 to 70 percent of your income. • Health Insurance—The number one cause of bankruptcy today is medical bills; number two is credit cards. One way to control costs is to look for large deductibles to lower your premium. The HSA (Health Savings Account) is a great way to save on premiums. The high deductible creates a much lower premium, and this plan allows you to save for medical expenses in a tax-free savings account.

But the worst of the expense lies with the medications, and there is no reason for their high and fluctuating prices: the drugs have been off patent for decades, and we know that the same companies sell the same drugs at wildly different prices in different countries. Drug prices should not constitute the chief barrier to effective therapy for all patients... With less complaining, and more coordination, international public health authorities could have brought these prices down rapidly, as we have learned by our efforts to do so.

The rest of the time, I think, what if the polar ice caps keep melting? What if medical care keeps getting more expensive, and social security runs out, and housing prices keep rising while minimum wage doesn’t, and what if they resent me for bringing them into all of this?

But then back on lithium and rotating on the planet at the same pace as everyone else, you find your credit is decimated, your mortification complete: mania is not a luxury one can easily afford. It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn't fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you're given excellent reason to be even more so.

Also, the high standard held up to the public mind by the College of which which gave its peculiar sanction to the expensive and highly rarefied medical instruction obtained by graduates of Oxford and Cambridge, did not hinder quackery from having an excellent time of it; for since professional practice chiefly consisted in giving a great many drugs, the public inferred that it might be better off with more drugs still, if they could only be got cheaply, and hence swallowed large cubic measures of physic prescribed by unscrupulous ignorance which had taken no degrees.

So much of what is broadly called wellness now involves an expensive kind of burrowing into our selves, wobbling on the plank between self-care and self-obsession. Many get lost in the labyrinth of internal observation, an endless cycle of maintenance of muscle, mood and self-medication.

If any field needs integration, it is medicine. If any field needs an integrative paradigm that can make sense out of all the different models of healing, it is medicine. The weaknesses of the conventional medical model have been clear for some time. Its procedures are too invasive and have too many harmful side effects. There is no conventional medical model for the treatment of most chronic and degenerative diseases (germ theory and genetic predisposition are not adequate explanations for most conditions in this category). Last, but not least, conventional medicine is expensive. In contrast, there are so many

People think it’s a fortune, but they don’t reckon on, well, it’s not pensionable, there’s all the medical expenses, you’ve got to buy and maintain your own gear—‘ ‘—wear and tear on virgins—‘ nodded a small fat hunter. ‘Yeah, and then there’s…what?’ ‘My specialty is unicorns,’ the hunter explained, with an embarrassed smile. ‘Oh, right.’ The first speaker looked like someone who’d always been dying to ask this question. ‘I thought they were very rare these days.’ ‘You’re right there. You don’t see many unicorns, either,’ said the unicorn hunter. Vimes got the impression that, in his whole life, this was his only joke.

Over the next few months, I set out to understand why in our country with the most expensive and advanced medical technology in the world, growing numbers of American women, disproportionately Black women, were dying as a result of pregnancy and childbirth, including African American women whose income and education should protect them.

Not one of those big-city thirty-nine-year-olds who deal with their midlife crisis by buying ridiculously expensive cycling shorts and swimming caps because they have a black hole in their soul that devours Instagram pictures, more the sort of thirty-nine-year-old whose daily consumption of cheese and carbohydrates was more likely to be classified medically as a cry for help rather than a diet.

Thomas Insel, the former director of the National Institute of Mental Health, has estimated that mental illness costs taxpayers $444 billion a year. Two-thirds of that total is eaten up by disability payments and lost productivity. Only a third is spent on medical care. “The way we pay for mental health today is the most expensive way possible,” Insel has said. “We don’t provide support early, so we end up paying for lifelong support.

Over the years Jim had heard, and more often overheard, objections to the Program’s expanding practice: Many people who worked and paid taxes struggled to pay for health insurance. Why should their money go to providing what some would consider concierge medicine for these people who lived at public expense? For people who produced nothing except indecent public spectacles, and didn’t even try to take care of themselves? Heard from inside a shelter clinic or McInnis House or out on the van, such protests seemed irrelevant. What was the alternative? Ignore chronically homeless people, as the city used to do, or imitate draconian regimes and imprison all rough sleepers in a stadium? In fact, the Program lightened the burdens that homeless people placed on other medical organizations, and did so while providing good care at lower cost than in hospital emergency departments.

Income and inheritance taxes imply the denial of private property, and in that are different in principle from all other taxes. The government says to the citizen: “Your earnings are not exclusively your own; we have a claim on them, and our claim precedes yours; we will allow you to keep some of it, because we recognize your need, not your right; but whatever we grant you for yourself is for us to decide.” This is no exaggeration. Take a look at the income-tax report that you are required by law to make out, and you will see that the government arbitrarily sets down the amount of your income you may have for your living, for your business requirements, for the maintenance of your family, for medical expenses, and so on. After granting these exemptions, with a flourish of generosity, the government decides what percentage of the remainder it will appropriate. The rest you may have.

have no way of knowing what combination of external pressures and personal failings led that physician to conceal a less costly cure from my friend and keep her on expensive and ineffective drugs with a gallery of noxious side effects instead, but from outside the walls of the office, it certainly looked like a callous betrayal of whatever ethics the medical profession might still have left—and again, the view from outside is the one that counts.

And he carefully stored what he considered the most vital piece of equipment: a satellite phone with solar-powered batteries, which would allow the men not only to record short audio dispatches but also to check in every day with an ALE operator and report their coordinates and medical condition. If the team failed to communicate for two consecutive days, ALE would dispatch a search-and-rescue plane—what Worsley called “the most expensive taxi ride in the world.

The goal in this “triumph of the therapeutic” is supposedly good “health,” but good “health” achieved at the expense of critical awareness and exploration of the oppressiveness of the roles themselves. This goal of good “health” is particularly ironic in light of the fact that the word health originally meant “whole.” As defined by the medical model, “health” values come to mean partial solutions, which go against total integrity of the body, the individual concerned, and society in general.

After manufacture, the units go into the field. With consumer products, that means they go into millions of homes where any bugs you created are enjoyed by many. With medical, aviation, or other critical products, your bugs may be catastrophic (which is why you get to do so much paperwork). With scientific or monitoring equipment, the field could be a place where the unit cannot ever be retrieved (or retrieved only at great risk and expense; consider the devices in volcano calderas), so it had better work.

In the present state of the world, not only are many people destitute but the majority of those who are not being haunted by a perfectly reasonable fear that they may become so at any moment. Wage-earners have the constant danger of unemployment; salaried employees know that their firm may go bankrupt or find it necessary to cut down its staff; businessmen, even those who are reputed to be very rich, know that the loss of all their money is by no means improbable. Professional men have a very hard struggle. After making great sacrifices for the education of their sons and daughters, they find that there are not the openings that there used to be for those who have the kinds of skills that their children have acquired. If they are lawyers, they find that people can no longer afford to go to law, although serious injustices remain unremedied; if they are doctors, they find that their formerly lucrative hypochondriac patients can no longer afford to be ill, while many genuine sufferers have to forgo much-needed medical treatment. One finds men and women of university education serving behind the counters in shops, which may save them from destitution, but only at the expense of those who would formerly have been so employed. In all classes, from the lowest to almost the highest, economic fear governs men’s thoughts by day and their dreams at night, making their work nerve-wracking and their leisure unrefreshing. This ever-present terror is, I think, the main cause of the mood of madness which has swept over great parts of the civilized world.

I can still afford the expensive medications and doctors’ bills and there are a lot of people who can’t. I’m lucky. I could be sicker. I could be dead. I could be dead. I wrote that twice because I’m saying it with two different emotions. One where I’m so grateful to be alive and another sneakier, terrible thought where I realize that if I do die I’ll get some rest. That’s fucked up. I know it. And as soon as it hits my mind I shoo it away because I know it’s the depression, but this is a place for honesty, so there it is.

the bureaucracy has arrogated the right to define certain states of mind as ‘diseased.’ A lack of desire to spend money becomes a symptom of disease that requires expensive medication. Which medication then destroys the libido, in other words destroys the appetite for the one pleasure in life that’s free, which means the person has to spend even more money on compensatory pleasures. The very definition of mental ‘health’ is the ability to participate in the consumer economy. When you buy into therapy, you’re buying into buying.

What is the Southern Strategy? It is this. It says to the South: Let the poor stay poor, let your economy trail the nation, forget about decent homes and medical care for all your people, choose officials who will oppose every effort to benefit the many at the expense of the few—and in return, we will try to overlook the rights of the black man, appoint a few southerners to high office, and lift your spirits by attacking the ‘eastern establishment’ whose bank accounts we are filling with your labor and your industry.”42 McGovern

When I am high I couldn’t worry about money if I tried. So I don’t. The money will come from somewhere; I am entitled; God will provide. Credit cards are disastrous, personal checks worse. Unfortunately, for manics anyway, mania is a natural extension of the economy. What with credit cards and bank accounts there is little beyond reach....During one spree in London I spent several hundred pounds on books having titles or covers that somehow caught my fancy: books on the natural history of the mole, twenty sundry Penguin books because I thought it could be nice if the penguins could form a colony..... But then back on lithium and rotating on the planet at the same pace as everyone else, you find your credit is decimated, your mortification complete: mania is not a luxury one can easily afford. It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn’t fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you’re given excellent reason to be even more so.

Defeated by the Southern strategy, McGovern neatly summed it up: “What is the Southern Strategy? It is this. It says to the South: Let the poor stay poor, let your economy trail the nation, forget about decent homes and medical care for all your people, choose officials who will oppose every effort to benefit the many at the expense of the few—and in return, we will try to overlook the rights of the black man, appoint a few southerners to high office, and lift your spirits by attacking the ‘eastern establishment’ whose bank accounts we are filling with your labor and your industry.”42

It’s a demonic feedback loop. Let me see if I can get this straight. Pharmaceutical companies sell mountains of drugs to factory farms, which depend on them to maintain their abnormally intensive systems. The animals develop antibiotic resistance that spreads to humans. Humans need stronger drugs. In the meantime, the animal industries flood the government with cash in exchange for subsidies. The government, invested in keeping the generous animal food lobbies flush, runs federal programs pushing people to eat increasing amounts of animal-based foods. People oblige. People get sick, requiring medication for the rest of their lives, along with expensive medical procedures. The drugs and procedures falsely assure them that they can continue to eat the food that made them sick in the first place. People continue to support the animal agriculture industry by buying their products, which pay for studies to further convince the public that animal products are an essential part of a healthy diet. People continue to support the pharmaceutical companies because they are tethered to their prescription drugs. This allows drug companies to pay for the “education” of our doctors who prescribe more drugs to us. Then pharmaceutical companies sell mountains of drugs to factory farms…

study of thirty thousand elderly people in fifty-two countries found that switching to an overall healthy lifestyle—eating a diet rich in fruits and vegetables, not smoking, exercising moderately, and not drinking too much alcohol—lowered heart disease rates by approximately 50 percent.14 Reducing exposure to carcinogens, such as tobacco and sodium nitrite, have been shown to decrease the incidence of lung and stomach cancers, and it is likely (more evidence is needed) that lowering exposures to other known carcinogens, such as benzene and formaldehyde, will reduce the incidence of other cancers. Prevention really is the most powerful medicine, but we as a species consistently lack the political or psychological will to act preventively in our own best interests. It is worthwhile to ask to what extent efforts to treat the symptoms of common mismatch diseases have the effect of promoting dysevolution by taking attention and resources away from prevention. On an individual level, am I more likely to eat unhealthy foods and exercise insufficiently if I know I’ll have access to medical care to treat the symptoms of the diseases these choices cause many years later? More broadly within our society, is the money we allocate to treating diseases coming at the expense of money to prevent them?

Animals, including people, fight harder to prevent losses than to achieve gains. In the world of territorial animals, this principle explains the success of defenders. A biologist observed that “when a territory holder is challenged by a rival, the owner almost always wins the contest—usually within a matter of seconds.” In human affairs, the same simple rule explains much of what happens when institutions attempt to reform themselves, in “reorganizations” and “restructuring” of companies, and in efforts to rationalize a bureaucracy, simplify the tax code, or reduce medical costs. As initially conceived, plans for reform almost always produce many winners and some losers while achieving an overall improvement. If the affected parties have any political influence, however, potential losers will be more active and determined than potential winners; the outcome will be biased in their favor and inevitably more expensive and less effective than initially planned. Reforms commonly include grandfather clauses that protect current stake-holders—for example, when the existing workforce is reduced by attrition rather than by dismissals, or when cuts in salaries and benefits apply only to future workers. Loss aversion is a powerful conservative force that favors minimal changes from the status quo in the lives of both institutions and individuals.

Personal cultivation is crucial. It protects consumers from the possibility, once marijuana is legalized, that big corporations take over the market. Tobacco companies, for instance, already have the land and processing plants available—but the marijuana they may offer could be too expensive, too weak, or otherwise not as high in quality as we have grown accustomed to during the Grow American Movement. Should that occur, we have the ultimate instrument in our hands: we can refuse to purchase their commercially produced marijuana and simply grow our own. Without the right to cultivate for personal use, consumers could end up with poor choices, poor marijuana, and no real alternatives. Ed

We are under a deception similar to that which misleads the traveler in the Arabian desert. Beneath the caravan all is dry and bare; but far in advance, and far in the rear, is the semblance of refreshing waters... A similar illusion seems to haunt nations through every stage of the long progress from poverty and barbarism to the highest degrees of opulence and civilization. But if we resolutely chase the mirage backward, we shall find it recede before us into the regions of fabulous antiquity. It is now the fashion to place the golden age of England in times when noblemen were destitute of comforts the want of which would be intolerable to a modern footman, when farmers and shopkeepers breakfasted on loaves the very sight of which would raise a riot in a modern workhouse, when to have a clean shirt once a week was a privilege reserved for the higher class of gentry, when men died faster in the purest country air than they now die in the most pestilential lanes of our towns, and when men died faster in the lanes of our towns than they now die on the coast of Guiana. ... We too shall in our turn be outstripped, and in our turn be envied. It may well be, in the twentieth century, that the peasant of Dorsetshire may think himself miserably paid with twenty shillings a week; that the carpenter at Greenwich may receive ten shillings a day; that laboring men may be as little used to dine without meat as they are now to eat rye bread; that sanitary police and medical discoveries may have added several more years to the average length of human life; that numerous comforts and luxuries which are now unknown, or confined to a few, may be within the reach of every diligent and thrifty workingman. And yet it may then be the mode to assert that the increase of wealth and the progress of science have benefited the few at the expense of the many, and to talk of the reign of Queen Victoria as the time when England was truly merry England, when all classes were bound together by brotherly sympathy, when the rich did not grind the faces of the poor, and when the poor did not envy the splendor of the rich.

I'm saying the structure and f the entire culture is flawed, chip said. I'm saying the bureaucracy has arrogated the right to define certain states of mind as 'diseased.' A lack of desire to spend money becomes a symptom of disease that requires expensive medication. Which medication then destroys the libido, in other words destroys the appetite for the one pleasure in life that's free, which means the person has to spend more money on compensatory pleasures. The very definition of mental health is the ability to participate in the consumer economy. When you buy into therapy, you're buying into buying. And I'm saying that I personally am losing the battle with a commercialized, medicalized, totalitarian, modernity right this instant.

R.J. Reynolds owns a subsidiary called RJR Packaging, which produces packaging used on many food products for both human and pet consumption.[276] They also produce packaging for many medical devices and over-the-counter medications, as well as personal care, coffee, and confectionary products.[277] In order to remain in business, a company must be profitable. In order to remain profitable in the face of extensive, long-term compulsory levies by state governments via the tobacco settlement, the costs of products must go up so that income remains higher than expenses. Thus, Altria can raise prices on their Kraft food products you buy in order to pay off their tobacco settlement. R.J. Reynolds can pass along the cost by raising packaging costs for manufacturers of many different types of consumer products, who pass the increased production costs along to you.

In 1963, Robert Novak had written that many Republican leaders were intent on converting the Party of Lincoln into the White Man’s Party. The following year, Goldwater went down in crushing defeat, winning only 36 percent of the white vote. Even so, less than a decade later, the racial transmogrification of the Republicans was well underway. In 1972, Nixon’s first full dog whistle campaign netted him 67 percent of the white vote, leaving his opponent, George McGovern, with support from less than one in three whites. Defeated by the Southern strategy, McGovern neatly summed it up: “What is the Southern Strategy? It is this. It says to the South: Let the poor stay poor, let your economy trail the nation, forget about decent homes and medical care for all your people, choose officials who will oppose every effort to benefit the many at the expense of the few—and in return, we will try to overlook the

For starters, of the four so-called weapons of mass destruction, three are far less massively destructive than good old-fashioned explosives.272 Radiological or “dirty” bombs, which are conventional explosives wrapped in radioactive material (obtained, for example, from medical waste), would yield only minor and short-lived elevations of radiation, comparable to moving to a city at a higher altitude. Chemical weapons, unless they are released in an enclosed space like a subway (where they would still not do as much damage as conventional explosives), dissipate quickly, drift in the wind, and are broken down by sunlight. (Recall that poison gas was responsible for a tiny fraction of the casualties in World War I.) Biological weapons capable of causing epidemics would be prohibitively expensive to develop and deploy, as well as dangerous to the typically bungling amateur labs that would develop them.

Read the following chain of events and see whether a similar pattern might apply to other toxic products that were reported in the news during your lifetime: 1. Workers were told that the paint was nontoxic, although there was no factual basis for this declaration. The employers discounted scientists. The workers believed their superiors. 2. Health complaints were made in ever-increasing frequency. It became obvious that something was seriously wrong. 3. U.S. Radium and other watch-dial companies began a campaign of disinformation and bogus medical tests - some of which involved X-rays and may even have made the condition worse. 4. Doctors, dentists, and researchers complied with U.S. Radium's and other companies' requests and refused to release their data to the public. 5. Medical professionals also aided the companies by attributing worker deaths to other causes. Syphilis was often cited as the diagnosis, which had the added benefit to management of being a smear on the victims' reputations. 6. One worker, Grace Fryer, decided to sue U.S. Radium. It took Fryer two years to find a lawyer who was willing to take on U.S. Radium. Only four other workers joined her suit; they became known as the "Radium Girls." 7. In 1928, the case was settled in the middle of the trial before it went to the jury for deliberation. The settlement for each of the five "Radium Girls" was $10,000 (the equivalent of $124,000 in 2009 dollars), plus $600 a year while the victim lived and all medical expenses. Remember the general outline of this scenario because you will see it over and over again: The company denies everything while the doctors and researchers (and even the industrial hygienists) in the company's employ support the company's distorted version of the facts. Perhaps one worker in a hundred will finally pursue justice, one lawyer out of the hundreds of thousands in the United States will finally step up to the plate, and the case will be settled for chump change.

For in America this season is decreed “family season”. (Eat your hearts out, you pitiable loners who don’t have families!) Melancholy as Thanksgiving is, the Christmas-New year’s season is far worse and lasts far longer, providing rich fund of opportunities for self-medicating, mental collapse, suicide and public mayhem with firearms. In fact it might be argued that the Christmas-New year’s season which begins abruptly after Thanksgiving is now the core-sason of American life itself, the meaning of American life„ the brute existencial point of it. How without families must envy us who bask in parental love, in the glow of yule-logs burning in fireplaces stoked by our daddie’s robust pokers, we who are stuffed to bursting with our mummie’s frantic holiday cooking; how you wish you could be us, pampered/protected kids tearing expensive foil wrappings off too many packages to count, gathered about the Christmas tree on Christmas morning as Mummy gently chided: “Skyler! Bliss! Show Daddy and Mummy what you’ve just opened, please! And save the little cards, so you know who gave such nice things to you

For in America this season is decreed “family season”. (Eat your hearts out, you pitiable loners who don’t have families!) Melancholy as Thanksgiving is, the Christmas-New year’s season is far worse and lasts far longer, providing rich fund of opportunities for self-medicating, mental collapse, suicide and public mayhem with firearms. In fact it might be argued that the Christmas-New year’s season which begins abruptly after Thanksgiving is now the core-sason of American life itself, the meaning of American life„ the brute existencial point of it. How without families must envy us who bask in parental love, in the glow of yule-logs burning in fireplaces stoked by our daddie’s robust pokers, we who are stuffed to bursting with our mummie’s frantic holiday cooking; how you wish you could be us, pampered/protected kids tearing expensive foil wrappings off too many packages to count, gathered about the Christmas tree on Christmas morning as Mummy gently chided: “Skyler! Bliss! Show Daddy and Mummy what you’ve just opened, please! And save the little cards, so you know who gave such nice things to you”.

Revitalized and healthy, I started dreaming new dreams. I saw ways that I could make a significant contribution by sharing what I’ve learned. I decided to refocus my legal practice on counseling and helping start-up companies avoid liability and protect their intellectual property. To share some of what I know, I started a blog, IP Law for Startups, where I teach basic lessons on trade secrets, trademarks, copyrights, and patents and give tips for avoiding the biggest blunders that destroy the value of intellectual assets. Few start-up companies, especially women-owned companies that rarely get venture capital funding, can afford the expensive hourly rates of a large law firm to the get the critical information they need. I feel deeply rewarded when I help a company create a strategy that protects the value of their company and supports their business dreams. Further, I had a dream to help young women see their career possibilities. In partnership with my sister, Julie Simmons, I created lookilulu.com, a website where women share their insights, career paths, and ways they have integrated motherhood with their professional pursuits. When my sister and I were growing up on a farm, we had a hard time seeing that women could have rewarding careers. With Lookilulu® we want to help young women see what we couldn’t see: that dreams are not linear—they take many twists and unexpected turns. As I’ve learned the hard way, dreams change and shift as life happens. I’ve learned the value of continuing to dream new dreams after other dreams are derailed. I’m sure I’ll have many more dreams in my future. I’ve learned to be open to new and unexpected opportunities. By way of postscript, Jill writes, “I didn’t grow up planning to be lawyer. As a girl growing up in a small rural town, I was afraid to dream. I loved science, but rather than pursuing medical school, I opted for low-paying laboratory jobs, planning to quit when I had children. But then I couldn’t have children. As I awakened to the possibility that dreaming was an inalienable right, even for me, I started law school when I was thirty; intellectual property combines my love of law and science.” As a young girl, Jill’s rightsizing involved mustering the courage to expand her dreams, to dream outside of her box. Once she had children, she again transformed her dreams. In many ways her dreams are bigger and aim to help more people than before the twists and turns in her life’s path.

Addicts should not be coerced into treatment, since in the long term coercion creates more problems than it solves. On the other hand, for those addicts who opt for treatment, there must be a system of publicly funded recovery facilities with clean rooms, nutritious food, and access to outdoors and nature. Well-trained professional staff need to provide medical care, counseling, skills training, and emotional support. Our current nonsystem is utterly inadequate, with its patchwork of recovery homes run on private contracts and, here and there, a few upscale addiction treatment spas for the wealthy. No matter how committed their staff and how helpful their services may be, they are a drop in comparison to the ocean of vast need. In the absence of a coordinated rehabilitation system, the efforts of individual recovery homes are limited and occur in a vacuum, with no follow-up. It may be thought that the cost of such a drug rehabilitation and treatment system would be exorbitant. No doubt the financial expenses would be great — but surely less than the funds now freely squandered on the War on Drugs, to say nothing of the savings from the cessation of drug-related criminal activity and the diminished burden on the health care system.

Xuan pulled out his phone and searched Google. He had to ask for the correct spelling of the drug. He wanted more real information about how much of a financial burden he would be to his parents. Money was a big concern. Possibly a deal breaker. “Several sites—it’s around five hundred dollars a day! That’s fifteen thousand a month! How could I let my parents pay that much for me?” Fifteen thousand dollars. I gasped, appalled. I staggered to the chair and collapsed into it. He’ll never agree to that. Xuan opened his mouth and closed it again, in shock. The atmosphere in the room plunged from friendly and informative to frigid with mathematical figures and calculations. I sat with my elbows on my knees, my face buried in my hands. Saints, I knew cancer treatment was expensive, but I never imagined it was that expensive. That was too much. Ironically, I didn’t know if I could live with myself, knowing my parents were working day and night to keep me alive. That would be a huge financial responsibility. I just couldn’t imagine allowing it, month after month. Sadly, I wondered how many people died every year because of the cost of medication in the United States. In a way, it seemed like pharmaceutical companies were getting away with murder.

Obsessive-compulsive personality disorder (OCPD) is unhelpfully named, since it is not particularly closely related to the better known obsessive-compulsive disorder (OCD). It does not tend to co-occur with obsessive-compulsive disorder, or even run in the same families. Obsessive-compulsive disorder is an anxiety disorder, in which the sufferer feels compelled to repeat particular thoughts or actions, such as checking or hand-washing. As an anxious condition, it belongs to the same family as depression and generalized anxiety disorder, and thus is related to high Neuroticism and responds to some extent to serotonergic antidepressant medications. Some people have even seen obsessive-compulsive disorder as a low Conscientiousness problem, since the affected individual cannot inhibit the checking or washing response in rather the same manner as the alcoholic cannot inhibit his desire to drink. Whether this is the right characterization or not, it is clear that OCPD is a very different type of problem.16 What, then, does OCPD entail? Psychiatrists define it as ‘a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts’.

For the attitude of society towards the criminal appears to be that of a community of stark lunatics. In effect, society addresses the professional criminal somewhat thus: "' You wish to practice crime as a profession, to gain a livelihood by appropriating--by violence or otherwise--the earnings of honest and industrious men. Very well, you may do so on certain conditions. If you are skilful and cautious you will not be molested. You may occasion danger, annoyance and great loss to honest men with very little danger to yourself unless you are clumsy and incautious; in which case you may be captured. If you are, we shall take possession of your person and detain you for so many months or years. During that time you will inhabit quarters better than you are accustomed to; your sleeping-room will be kept comfortably warm in all weathers; you will be provided with clothing better than you usually wear; you will have a sufficiency of excellent food; expensive officials will be paid to take charge of you; selected medical men will be retained to attend to your health; a chaplain (of your own persuasion) will minister to your spiritual needs and a librarian will supply you with books. And all this will be paid for by the industrious men whom you live by robbing. In short, from the moment that you adopt crime as a profession, we shall pay all your expenses, whether you are in prison or at large.' Such is the attitude of society; and I repeat it is that of a community of madmen. ~ Humphrey Challoner

In the story, Ivan Ilyich is forty-five years old, a midlevel Saint Petersburg magistrate whose life revolves mostly around petty concerns of social status. One day, he falls off a stepladder and develops a pain in his side. Instead of abating, the pain gets worse, and he becomes unable to work. Formerly an “intelligent, polished, lively and agreeable man,” he grows depressed and enfeebled. Friends and colleagues avoid him. His wife calls in a series of ever more expensive doctors. None of them can agree on a diagnosis, and the remedies they give him accomplish nothing. For Ilyich, it is all torture, and he simmers and rages at his situation. “What tormented Ivan Ilyich most,” Tolstoy writes, “was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and he only need keep quiet and undergo a treatment and then something very good would result.” Ivan Ilyich has flashes of hope that maybe things will turn around, but as he grows weaker and more emaciated he knows what is happening. He lives in mounting anguish and fear of death. But death is not a subject that his doctors, friends, or family can countenance. That is what causes him his most profound pain. “No one pitied him as he wished to be pitied,” writes Tolstoy. “At certain moments after prolonged suffering he wished most of all (though he would have been ashamed to confess it) for someone to pity him as a sick child is pitied. He longed to be petted and comforted. He knew he was an important functionary, that he had a beard turning grey, and that therefore what he longed for was impossible, but still he longed for it.” As we medical students saw it, the failure of those around Ivan Ilyich to offer comfort or to acknowledge what is happening to him was a failure of character and culture. The late-nineteenth-century Russia of Tolstoy’s story seemed harsh and almost primitive to us. Just as we believed that modern medicine could probably have cured Ivan Ilyich of whatever disease he had, so too we took for granted that honesty and kindness were basic responsibilities of a modern doctor. We were confident that in such a situation we would act compassionately. What worried us was knowledge. While we knew how to sympathize, we weren’t at all certain we would know how to properly diagnose and treat. We paid our medical tuition to learn about the inner process of the body, the intricate mechanisms of its pathologies, and the vast trove of discoveries and technologies that have accumulated to stop them. We didn’t imagine we needed to think about much else. So we put Ivan Ilyich out of our heads. Yet within a few years, when I came to experience surgical training and practice, I encountered patients forced to confront the realities of decline and mortality, and it did not take long to realize how unready I was to help them. *   *   *

He ran long at the White House, and arrived late to his next meeting with Hillary Clinton, Jake Sullivan and Frank Ruggiero—their first major strategy session on Taliban talks after the secret meeting with A-Rod. She was waiting in her outer office, a spacious room paneled in white and gilt wood, with tasseled blue and pink curtains and an array of colorfully upholstered chairs and couches. In my time reporting to her later, I only ever saw Clinton take the couch, with guests of honor in the large chair kitty-corner to her. She’d left it open for him that day. “He came rushing in. . . . ” Clinton later said. “And, you know, he was saying ‘oh I’m so sorry, I’m so sorry.’ ” He sat down heavily and shrugged off his coat, rattling off a litany of his latest meetings, including his stop-in at the White House. “That was typical Richard. It was, like, ‘I’m doing a million things and I’m trying to keep all the balls in the air,’ ” she remembered. As he was talking, a “scarlet red” flush went up his face, according to Clinton. He pressed his hands over his eyes, his chest heaving. “Richard, what’s the matter?” Clinton asked. “Something horrible is happening,” he said. A few minutes later, Holbrooke was in an ambulance, strapped to a gurney, headed to nearby George Washington University Hospital, where Clinton had told her own internist to prepare the emergency room. In his typically brash style, he’d demanded that the ambulance take him to the more distant Sibley Memorial Hospital. Clinton overruled him. One of our deputies on the SRAP team, Dan Feldman, rode with him and held his hand. Feldman didn’t have his BlackBerry, so he scrawled notes on a State Department expense form for a dinner at Meiwah Restaurant as Holbrooke dictated messages and a doctor assessed him. The notes are a nonlinear stream of Holbrooke’s indomitable personality, slashed through with medical realities. “Call Eric in Axelrod’s office,” the first read. Nearby: “aortic dissection—type A . . . operation risk @ > 50 percent”—that would be chance of death. A series of messages for people in his life, again interrupted by his deteriorating condition: “S”—Secretary Clinton—“why always together for medical crises?” (The year before, he’d been with Clinton when she fell to the concrete floor of the State Department garage, fracturing her elbow.) “Kids—how much love them + stepkids” . . . “best staff ever” . . . “don’t let him die here” . . . “vascular surgery” . . . “no flow, no feeling legs” . . . “clot” . . . and then, again: “don’t let him die here want to die at home w/ his fam.” The seriousness of the situation fully dawning on him, Holbrooke turned to job succession: “Tell Frank”—Ruggiero—“he’s acting.” And finally: “I love so many people . . . I have a lot left to do . . . my career in public service is over.” Holbrooke cracked wise until they put him under for surgery. “Get me anything you need,” he demanded. “A pig’s heart. Dan’s heart.

Marlboro Man and Tim were standing in the hall, not seven steps from the bathroom door. “There she is,” Tim remarked as I walked up to them and stood. I smiled nervously. Marlboro Man put his hand on my lower back, caressing it gently with his thumb. “You all right?” he asked. A valid question, considering I’d been in the bathroom for over twenty minutes. “Oh yeah…I’m fine,” I answered, looking away. I wanted Tim to disappear. Instead, the three of us made small talk before Marlboro Man asked, “Do you want something to drink?” He started toward the stairs. Gatorade. I wanted Gatorade. Ice-cold, electrolyte-replacing Gatorade. That, and vodka. “I’ll go with you,” I said. Marlboro Man and I grabbed ourselves a drink and wound up in the backyard, sitting on an ornate concrete bench by ourselves. Miraculously, my nervous system had suddenly grown tired of sending signals to my sweat glands, and the dreadful perspiration spell seemed to have reached its end. And the sun had set outside, which helped my appearance a little. I felt like a circus act. I finished my screwdriver in four seconds, and both the vitamin C and the vodka went to work almost instantly. Normally, I’d know better than to replace bodily fluids with alcohol, but this was a special case. At that point, I needed nothing more than to self-medicate. “So, did you get sick or something?” Marlboro Man asked. “You okay?” He touched his hand to my knee. “No,” I answered. “I got…I got hot.” He looked at me. “Hot?” “Yeah. Hot.” I had zero pride left. “So…what were you doing in the bathroom?” he asked. “I had to take off all my clothes and fan myself,” I answered honestly. The vitamin C and vodka had become a truth serum. “Oh, and wipe the sweat off my neck and back.” This was sure to reel him in for life. Marlboro Man looked at me to make sure I wasn’t kidding, then burst into laughter, covering his mouth to keep from spitting out his Scotch. Then, unexpectedly, he leaned over and planted a sweet, reassuring kiss on my cheek. “You’re funny,” he said, as he rubbed his hand on my tragically damp back. And just like that, all the horrors of the evening disappeared entirely from my mind. It didn’t matter how stupid I was--how dumb, or awkward, or sweaty. It became clearer to me than ever, sitting on that ornate concrete bench, that Marlboro Man loved me. Really, really loved me. He loved me with a kind of love different from any I’d felt before, a kind of love I never knew existed. Other boys--at least, the boys I’d always bothered with--would have been embarrassed that I’d disappeared into the bathroom for half the night. Others would have been grossed out by my tale of sweaty woe or made jokes at my expense. Others might have looked at me blankly, unsure of what to say. But not Marlboro Man; none of it fazed him one bit. He simply laughed, kissed me, and went on. And my heart welled up in my soul as I realized that without question, I’d found the one perfect person for me.

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Every person has short-term goals. Some are modest, such as setting aside money for a vacation next month or paying for medical bills. Other short-term goals are more ambitious, such as accruing funds for a down payment to purchase a new home within six months. Whatever the expense or purchase, you need a predictable accumulation of cash soon. If this sounds like your situation, stay away from the stock market!

If the genes themselves are unchanged, then deciphering the underlying genetic code at great expense is of limited usefulness. By the time work on the Cancer Genome Atlas (TCGA) started, it was already well known that changes in DNA methylation are vital to the development of some cancers.3 A number of known carcinogens are considered to act through epigenetic pathways. In colon cancer, up to 10 percent of protein-coding genes are methylated differently from normal colon cells, emphasizing the role of epigenetics.

Indirectly getting a lion’s share of patent medicine revenues, the newspapers netted more money from selling advertising to these firms than did the patent medicine firms from selling their potions after expenses. “Should the newspapers, magazines, and medical journals refuse their pages to this class of advertisements, the patent medicine business in five years would be as scandalously historic” as past financial follies and frauds. He pointed out that Hearst alone generated over half a million dollars from patent medicine advertising. But as Adams knew well, the economics of publishing was such that once the printing cost of an edition was met, each incremental advertising dollar generated was nearly all margin and dropped right to the bottom line—neither Hearst nor anyone else was likely to turn away from the industry’s largesse.

A small amount of wealth means the ability to take a few days off work when you’re sick without breaking the bank. Gaining that ability is huge if you don’t have it. A bit more means waiting for a good job to come around after you get laid off, rather than having to take the first one you find. That can be life changing. Six months’ emergency expenses means not being terrified of your boss, because you know you won’t be ruined if you have to take some time off to find a new job. More still means the ability to take a job with lower pay but flexible hours. Maybe one with a shorter commute. Or being able to deal with a medical emergency without the added burden of worrying about how you’ll pay for it. Then there’s retiring when you want to, instead of when you need to. Using your money to buy time and options has a lifestyle benefit few luxury goods can compete with.

mania is not a luxury one can easily afford. It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn’t fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you’re given excellent reason to be even more so.

Medical expenses contribute to two-thirds of all bankruptcies in the United States.

So you’re attending Shadow Grove University during the day and stripping at night to pay for your mom’s medical expenses?” I was in absolutely no way judging. In fact, it was admirable of him. Lucas’s cheeks pinked, and he dragged that lush lower lip through his teeth again before nodding. “Yeah, something like that.

If it wasn't for USA medical insurance, doctors would be broke as hardly anyone would pay their expensive fees!

Doctors are taught to write expensive prescriptions and lots of them!

When I am high I couldn’t worry about money if I tried. So I don’t. The money will come from somewhere; I am entitled; God will provide. Credit cards are disastrous, personal checks worse. Unfortunately, for manics anyway, mania is a natural extension of the economy. What with credit cards and bank accounts there is little beyond reach. So I bought twelve snakebite kits, with a sense of urgency and importance. I bought precious stones, elegant and unnecessary furniture, three watches within an hour of one another (in the Rolex rather than Timex class: champagne tastes bubble to the surface, are the surface, in mania), and totally inappropriate sirenlike clothes. During one spree in London I spent several hundred pounds on books having titles or covers that somehow caught my fancy: books on the natural history of the mole, twenty sundry Penguin books because I thought it could be nice if the penguins could form a colony. Once I think I shoplifted a blouse because I could not wait a minute longer for the woman-with-molasses feet in front of me in line. Or maybe I just thought about shoplifting, I don’t remember, I was totally confused. I imagine I must have spent far more than thirty thousand dollars during my two major manic episodes, and God only knows how much more during my frequent milder manias. But then back on lithium and rotating on the planet at the same pace as everyone else, you find your credit is decimated, your mortification complete: mania is not a luxury one can easily afford. It is devastating to have the illness and aggravating to have to pay for medications, blood tests, and psychotherapy. They, at least, are partially deductible. But money spent while manic doesn’t fit into the Internal Revenue Service concept of medical expense or business loss. So after mania, when most depressed, you’re given excellent reason to be even more so.

I once received an Explanation of Benefits statement showing that the billed services for a few weeks in the BMTU were more than $3 million. It seems shocking that the medical system can't spare dollar figures in the thousands to pay for professional in-home care. If a medical professional tells the family that the patient has a medical need for twenty-four hour care attendance, as Dr. T did, it doesn't make sense that that very very attendance is a noncovered expense.

I was amazed at how expensive economists thought doctors were. They instituted many economic maneuvers—de-skilling medicine onto nurses and physician assistants; computerizing medical decision-making; substituting algorithms for thinking—because they assumed that doctors were such expensive commodities. And yet doctors were not expensive, at least, not the doctors I knew. We cost no more than the nurses, the middle managers, and the information technicians, alas. Adding up all the time I spent with Mrs. Muller, the cost of her accurate diagnosis was about the same as one MRI scan, wholesale. Economists did the same thing with the other remedies of premodern medicine—good food, quiet surroundings, and the little things—treating them as expensive luxuries and cutting them out of their calculations. At Laguna Honda, for instance, while most patients were on fifteen or even twenty daily medications, many of which they didn’t need, the budget for a patient’s daily meals had been pared down to seven dollars, which could supply only the basics. I began to wonder: Had economists ever applied their standard of evidence-based medicine to their own economic assumptions? Under what conditions, with which patients and which diseases was it cost-effective to trade good food, clean surroundings, and doctor time for medications, tests, and procedures? Especially ones that patients didn’t need? Although Mrs. Muller was an impressive example of Laguna Honda’s Slow Medicine, she wasn’t the only one. Almost every patient I admitted had incorrect or outmoded diagnoses and was taking medications for them, too. Medications that required regular blood tests; caused side effects that necessitated still more medications; and put the patient at risk for adverse reactions. Typically my patients came in taking fifteen to twenty-five medications, of which they ended up needing, usually, only six or seven. And medications, even the cheapest, were expensive. Adding in the cost of side effects, lab tests, adverse reactions, and the time pharmacists, doctors, and nurses needed to prepare, order, and administer them, each medication cost something like six or seven dollars a day. So Laguna Honda’s Slow Medicine, to the extent that it led to discontinuing ten or twelve unnecessary medications, was more efficient than efficient health care by at least seventy dollars per day. I

etc. In the APA program abstract Dr. Jaeger wrote, “Regardless of the initial diagnosis, patients who underwent brain SPECT prior to, or during, psychiatric hospitalization had markedly shorter stays than controls. As demonstrated by this clinical database (two thousand patients), brain SPECT may lead to more effective, shorter, safer, and less expensive diagnostic and treatment modes in children and adolescents with suspected neuropsychiatric illness.” His experience completely dovetailed with mine. I wondered, “How can we not look at the brain?” Cardiologists look at the heart, orthopedic doctors have X-rays to examine bones, gastroenterologists look at the gut, pulmonologists look at the lungs, every other medical specialist looks at the particular organ they treat. And, we deal with the most complicated organ in the body. How can we treat it without having any information on how it functions? Psychiatrists are the only medical specialists who never look at the organ we treat!

Lilly Samson, The Switch, Outtakes & Quotes, shameless manipulation of. A one minute reading test I am dog --Dog, Marina Lewycka, Two Caravans, 2007 Allergies disclaimer: One must stress that this book is not intended for the unwashed masses: I delayed showering after the last switch. I’ve created a Pavlovian response: he must associate its floral sweetness with sexual fulfilment. Adam has a “Pavlovian” reaction to Elena’s BO? Bribes her with cake to lessen the wrath when asking Elena to wash? He frowns, seeing that I’m silent and trembling. ‘My perfume was weak; hers much stronger.’ I say, my temper flaring. Now, ladies and gentlemen, the usual wasteman chatting up yours truly in Sarf London would probably assume that a big phat slice of Marks & Spencer’s Strawberry Pavlova will get him into the lady’s knickers. Nope, she’s allergic to stupid. A merengue dessert will hardly cause a rash, but a moron makes her skin crawl. A female of the human species displayed an unconditioned response: shoved cream cake into the courting male’s face. Requested a substantial meal of Shchavel Borscht with hard boiled egg --Anton Pavlovich Chekhov, Russian Cookbook for Love, Romance, and mating behaviours: Humans, 1904 --Ivan Petrovich Pavlov, Neutral Triggers & Conditioned Responses: Canines,1907 It is I! I make the best Byzantine shchi to entice a female. --Nikolai Gogol, Dead Souls, Notebook (1841-1844), The Nose and other short stories Right! She turned her nose up at his advances. Idiot! I hate strawberries! The lady did not have a sweet tooth. Man didn’t do his research. This is a cleverly written book. So some of you, keen aspiring readers, please have your Oxford fictionary handy. Just saying! In the words of our hero: Bloody pricey...But God, it is a nice smell. Don’t you like it? And then he “squirts onto her wrist, playfully.” * * * Shhhh.. Doctors Pavlov & Chekhov are not amused. Shall we shuffle the deck with these random quotes? One minute! Plenty of time is a full minute for a skilled bullshit dealer to shuffle themselves out of a gloomy Russian medical clerical predicament. Not tricky when Lily Samson gives treats: All around us are dog walkers, their expensive breeds racing about, barking and sniffing each other’s genitals. ..thinking it all through those awful dog ornaments she hated... feisty feminist...she simply hates them. Men are so stupid! WORDCUNT: 397

Lilly Samson, The Switch, Outtakes & Quotes, shameless manipulation of. A one minute reading test I am dog --Dog, Marina Lewycka, Two Caravans, 2007 Allergies disclaimer: One must stress that this book is not intended for the unwashed masses: I delayed showering after the last switch. I’ve created a Pavlovian response: he must associate its floral sweetness with sexual fulfilment. Adam has a “Pavlovian” reaction to Elena’s BO? Bribes her with cake to lessen the wrath when asking Elena to wash? He frowns, seeing that I’m silent and trembling. ‘My perfume was weak; hers much stronger.’ I say, my temper flaring. Now, ladies and gentlemen, the usual wasteman chatting up yours truly in Sarf London would probably assume that a big phat slice of Marks & Spencer’s Strawberry Pavlova will get him into the lady’s knickers. Nope, she’s allergic to stupid. A merengue dessert will hardly cause a rash, but a moron makes her skin crawl. A female of the human species displayed an unconditioned response: shoved cream cake into the courting male’s face. Requested a substantial meal of Shchavel Borscht with hard boiled egg --Anton Pavlovich Chekhov, Russian Cookbook for Love, Romance, and mating behaviours: Humans, 1904 --Ivan Petrovich Pavlov, Neutral Triggers & Conditioned Responses: Canines,1907 It is I! I make the best Byzantine shchi to entice a female. --Nikolai Gogol, Dead Souls, Notebook (1841-1844), The Nose and other short stories Right! She turned her nose up at his advances. Idiot! I hate strawberries! The lady did not have a sweet tooth. Man didn’t do his research. This is a cleverly written book. So some of you, keen aspiring readers, please have your Oxford fictionary handy. Just saying! In the words of our hero: Bloody pricey...But God, it is a nice smell. Don’t you like it? And then he “squirts onto her wrist, playfully.” * * * Shhhh.. Doctors Pavlov & Chekhov are not amused. Shall we shuffle the deck with these random quotes? One minute! Plenty of time is a full minute for a skilled bullshit dealer to shuffle themselves out of a gloomy Russian medical clerical predicament. Not tricky when Lily Samson gives treats: All around us are dog walkers, their expensive breeds racing about, barking and sniffing each other’s genitals. ..thinking it all through those awful dog ornaments she hated... feisty feminist...she simply hates them. Men are so stupid! WORDCUNT: 397

Lilly Samson, The Switch, Outtakes & Quotes, shameless manipulation of. A one minute reading test I am dog --Dog, Marina Lewycka, Two Caravans, 2007 Allergies disclaimer: One must stress that this book is not intended for the unwashed masses: I delayed showering after the last switch. I’ve created a Pavlovian response: he must associate its floral sweetness with sexual fulfilment. Adam has a “Pavlovian” reaction to Elena’s BO? Bribes her with cake to lessen the wrath when asking Elena to wash? He frowns, seeing that I’m silent and trembling. ‘My perfume was weak; hers much stronger.’ I say, my temper flaring. Now, ladies and gentlemen, the usual wasteman chatting up yours truly in Sarf London would probably assume that a big phat slice of Marks & Spencer’s Strawberry Pavlova will get him into the lady’s knickers. Nope, she’s allergic to stupid. A merengue dessert will hardly cause a rash, but a moron makes her skin crawl. A female of the human species displayed an unconditioned response: shoved cream cake into the courting male’s face. Requested a substantial meal of Shchavel Borscht with hard boiled egg --Anton Pavlovich Chekhov, Russian Cookbook for Love, Romance, and mating behaviours: Humans, 1904 --Ivan Petrovich Pavlov, Neutral Triggers & Conditioned Responses: Canines,1907 It is I! I make the best Byzantine shchi to entice a female. --Nikolai Gogol, Dead Souls, Notebook (1841-1844), The Nose and other short stories Right! She turned her nose up at his advances. Idiot! I hate strawberries! The lady did not have a sweet tooth. Man didn’t do his research. This is a cleverly written book. So some of you, keen aspiring readers, please have your Oxford fictionary handy. Just saying! In the words of our hero: Bloody pricey...But God, it is a nice smell. Don’t you like it? And then he “squirts onto her wrist, playfully.” Shhhh.. Doctors Pavlov & Chekhov are not amused. Shall we shuffle the deck with these random quotes? One minute! Plenty of time is a full minute for a skilled bullshit dealer to shuffle themselves out of a gloomy Russian medical clerical predicament. Not tricky when Lily Samson gives treats: All around us are dog walkers, their expensive breeds racing about, barking and sniffing each other’s genitals. ..thinking it all through those awful dog ornaments she hated... feisty feminist...she simply hates them. Men are so stupid!

The sitting area at Griffin Concierge Medical in Tampa, Florida, has the vibe of an upscale bed-and-breakfast, with sunlight casting through double-hung windows onto warm hardwood floors. Nashville’s Brentwood MD feels more like a wealthy man’s living room, with a wide, brown leather sofa and an expensive-looking wooden coffee table with photo books.

Secretiveness has an oppositional goal: shutting out independent monitoring and verification. When external inspection and verification by independent experts are shut out of the process, the floodgates are open to fraud.263

The over-use of antibiotics is also causing more bacteria to become resistant. Today, 70 percent of microbes held responsible for lung illnesses no longer respond to medications.180 The increase in resistance prompts the pharmaceutical sector to conduct more intensive research for new antibiotics. But the discovery of such molecules is a long, difficult and costly process (about $600 million per molecule).181 For many years, no important new antibiotic has come onto the market. At the same time, increasingly stronger preparations are being introduced, which only leads to the bacteria becoming even more resistant and excreting even more toxins.

Gather six to 12 months of checking, savings, and credit card statements, and break your income and expenses down into categories and then line items. I have suggested some here, but add your own as needed. Check to see if your bank or credit card company provides reporting that categorizes charges or lets you assign categories—your work may already be almost done for you: •Income—paychecks, interest, dividends, rents, royalties, business income, pension, social security, child support, spousal support •Housing—mortgage/rent, property taxes, HOA dues, insurance •Utilities—gas, electric, propane, phone, TV/Internet, trash, water/sewer •Food—groceries, dining out •Auto—car payments, gasoline, repairs, insurance •Medical—health insurance, doctor/dentist visits, prescriptions, physical therapy •Entertainment—travel, concerts/shows, sports •Clothing—personal purchases, dry cleaning, uniforms •Personal care—hair/nails, gym/yoga, vitamins/supplements •Miscellaneous—gifts, pets, donations •Children—education, activities, school lunches, childcare You can use a spreadsheet or pen and paper to take note of income and expenses as you go through statements, then calculate a monthly average for each item.

For example, in England, prior to the introduction of mandatory vaccinations in 1953, there were two smallpox deaths per 10,000 inhabitants per year. But at the beginning of the 1970s, nearly 20 years after the introduction of mandatory vaccinations, which had led to a 98 percent vaccination rate,195 England suffered 10 smallpox deaths per 10,000 inhabitants annually; five times as many as before. “The smallpox epidemic reached its peak after vaccinations had been introduced,“ summarizes William Farr, who was responsible for compiling statistics in London.