English Language & Usage: Multi-Layered Discourse Room

People who smoke, drink, and are morbidly obese for years spending their lives ignoring the advice of doctors ... But, the minute they are dying, we put them in an ICU and spend billions trying to save them,

Cerberus

Yeah, well, to some extent that is the humane thing to do.

David M

@Cerberus It is. Because there is a fundamental bias that it is evil to profit.

@Cerberus Not at the expense of other people's care.

Cerberus

Well, evil...

David M

4:21 AM

Futile care is not humane.

Cerberus

The state should not be about good and evil, but about what works.

David M

Comfort care is humane

@Cerberus Agreed.

I'm actually a proponent of socialized medicine plus in the US.

Cerberus

If too much money goes from the public to pharmaceutical companies, the state should perhaps reconsider the monopolies it grants them.

@DavidM Plus?

David M

Give everyone basic coverage and catastrophic care. But, if you want your less emergent stuff now, you have to pay.

Cerberus

By emergent you mean urgent?

David M

4:23 AM

For example: seeing your physician for physicals, care of diseases, etc. covered 100%.

Yes emergent = urgent.

Cerberus

OK.

David M

Medicine stratifies: Elective --> Urgent --> Emergent --> Life-threatening

Cerberus

Ah, jargon.

David M

Yes, sorry.

Cerberus

I would normally read emergent as emerging.

But it makes sense.

David M

4:25 AM

It's reflex for me

So for example: You have diabetes, no cost to you for treatment.

Cerberus

But what to do with something like...a girl who is suffering from back pain because her breasts are too large? My friend had that. It was not super serious, nor urgent.

David M

You need a knee-replacement ... Wait on the waiting list. Or get a supplementary insurance that allows you to pick a surgeon and time.

@Cerberus She would be treated for free, but she might have to wait her turn.

Cerberus

Why does there have to be a turn?

I mean, waiting lists can be reduced for everyone.

David M

Most socialized systems involve some form of rationing.

Cerberus

In what way?

David M

4:27 AM

You have x amount of available resources.

You have y people.

You have to ration.

Cerberus

For certain procedures, I think there is a shortage of specialists, so you may have to wait longer. But for most things, we managed to get rid of the longer waiting lists we had a decade or two ago.

David M

Of course.

But, the incentive to be a specialist runs thin when the compensation doesn't match.

If they cut my salary, I won't work the way I do now.

Cerberus

I think reducing waiting lists for everyone is not that expensive compared to the other factors that drive up costs?

David M

Americans tend to have zero-tolerance for waiting lists.

We want it done yesterday.

Cerberus

Heh.

David M

4:29 AM

So, I say: if you want it done yesterday, pay.

If you can wait, it's free.

Cerberus

I have no idea how long you'd have to wait for, say, a non-urgent knee operation. It could be next week, it could be months.

David M

Right.

Cerberus

I would expect it to be...maybe one or three weeks.

David M

Americans have more available health care but poorer access if that makes sense.

Cerberus

Right.

The article by Brill also mentioned that you had more elective procedures, of which a large proportion was unnecessary, or something.

David M

4:31 AM

The problem is this: You mention the word socialized, and people trot out the concept of waiting lists, etc.

@Cerberus That was part of his being full of shit.

Cerberus

Ah.

David M

We don't specialize in sham operations.

Cerberus

So people can't demand another MRI even if the doctor has told them that it would be no use?

David M

Yes, they can.

And, they will get it.

Cerberus

Right.

So that costs money.

David M

4:33 AM

But, it's not the physician's fault as Brill was asserting.

Cerberus

By the way, suppose I needed a non-urgent knee operation in your city, and I called the hospital to make an appointment; how long do you imagine I would have to wait?

David M

It's the fault of the expectations of the consumer. And, the fact that should you be wrong, the patient can sue you with impunity.

@Cerberus It depends upon the surgeon.

Some will have you in surgery that afternoon.

Cerberus

Oh, I don't remember his saying that doctors were to blame: I rather read it as that doctors were sort of obligated to comply if the insured patient wanted something. Maybe the claim-culture thing had something to do with that.

David M

Then some have backlogs of weeks or months.

Cerberus

Ah OK.

The same day, I would not expect that to happen here.

David M

4:36 AM

@Cerberus He tried to make it sound like we were pulling people off the streets, and offering them MRIs and other unnecessary procedures.

Cerberus

Haha.

David M

@Cerberus It would be unusual here, too. Probably next week, though.

Cerberus

Ah OK.

David M

More logistics, though.

Patient has to be fasting, etc.

Meanwhile, to see a primary care physician can take months . . . They're way over booked.

And, under paid.

Cerberus

Oh.

Hmm that's odd.

David M

4:38 AM

Yup

Cerberus

You can't call your GP to make an appointment the same day?

David M

It's the specialist heavy nature of American medicine.

Cerberus

Right, that makes sense.

David M

A sick visit, perhaps. A physical, not typically.

Cerberus

Here is a waiting list for an hospital:

> Specialisme Wachttijd in weken
Allergologie
a. allergie/hyperactiviteit luchtwegen (KNO)
b. allergische huidaandoeningen (Derma) 2
c. allergische aandoeningen (Kind)
d. astma (Longgeneeskunde) 1
Cardiologie 1
Chirurgie algemeen 1
a. Vaatchirurgie 1
b. Gastro-enterologie 1
c. Mammapoli 2 dagen
d. Oncologie 2 dagen
e. Traumatologie 1
f. Single visit Liesbreuk 1
Dermatologie 2
a. OSS 3
Gynaecologie algemeen 4
Interne geneeskunde algemeen 1
a. Endocrinologie 4
b. Nefrologie 4
d. Infectieziekten 1

David M

4:39 AM

(I can get an appointment anytime I please ...)

Cerberus

Waiting time in weeks (except where it says "dagen").

David M

Makes sense.

The problem is that socialized medicine assumes that all doctors are equal

Cerberus

So nephrology could be 4 weeks.

@DavidM How do you mean?

tchrist

And you could be dead by then.

Cerberus

Heh, we're only talking about non-urgent here.

David M

4:40 AM

@Cerberus Skills vary amongst doctors.

Cerberus

@tchrist If it's urgent, you can go immediately, of course.

@DavidM Naturally.

David M

@Cerberus Of course.

Well, what if I want to see a particular expert. Most socialized systems lock you in by geography or other methods of organization.

tchrist

People who need to see a nephrologist have serious issues.

David M

@tchrist Typically yes.

Cerberus

@DavidM How does that work? You can pick your doctor here.

Most people probably don't, they pick a nearby hospital.

David M

4:42 AM

@Cerberus Can you travel to another city?

tchrist

@DavidM “Socialized”?

Cerberus

@DavidM How do you mean can?

David M

@Cerberus Are you allowed to leave your local system in search of someone who you prefer? Or does it require a special referral.

@tchrist Socialized medicine

Cerberus

There are no local systems.

You can go anywhere.

tchrist

@DavidM I don’t know what that means.

David M

4:44 AM

@Cerberus OK, I'm not as familiar with the Dutch system.

Cerberus

Your operation even gets paid for if you want to go to Germany or Belgium. Maybe not always, but many people do it.

tchrist

David M

@tchrist State funded health care.

tchrist

What a crappy spam detector.

Cerberus

@DavidM One thing, though: you normally need a referral from your GP to see any specialist.

Or you're not covered if the specialist thinks the visit was unnecessary.

tchrist

4:45 AM

@Cerberus I know many systems like that. I do not belong to one, happily enough.

Cerberus

So, in practice, you just need the referral.

David M

@tchrist Why was it tagged?

tchrist

@DavidM I have no earthly idea. I see nothing spammy about it.

Cerberus

@tchrist Why happily? If you can't get a referral, that means you don't need a specialist, right?

David M

@tchrist Me neither.

@Cerberus American mentality.

tchrist

4:46 AM

english.stackexchange.com/review/first-posts/58694

Cerberus

Haha.

David M

@Cerberus We want it yesterday. We want what we want.

:-)

Cerberus

But anyway, going by what you told me, our average waiting lists are longer than yours.

One thing that I recently found out surprises me, though: isn't it extremely socialist how your parents can't pick any school they want in any school district?

David M

@Cerberus I won't pretend to understand that one.

Cerberus

If you live near a good school in a different school district, your child cannot go to that school, right?

David M

4:49 AM

There are conflicting notions of fairness and equality in the US.

Cerberus

I got the impression that it had something to do with school buses.

David M

And, if they let people pick, the fear is that all the good students will go to one school, and the bad students the other. Creating an inequality.

Cerberus

Yes...

That certainly happens here.

David M

No one realizes that making a mediocre standard for all schools accomplishes less.

Cerberus

Although one wonders whether it won't just happen within a district as well in your system?

David M

4:50 AM

Better to identify the bad students and redirect them into things that will be better for them.

There is too much pressure for Americans to attend university.

Cerberus

Hmm.

David M

Many people get degrees that don't serve them

Cerberus

Oh, we have that too.

Like "recreationology".

David M

Rather, had they had proper training in the trades they eventually wound up in . . .

Worse: "Business"

Cerberus

Heh.

David M

4:52 AM

Then they become secretaries

Cerberus

Hmm.

Not sure how successful those business degrees are here.

David M

Had they been identified earlier in life as heading down this path, they could have received proper training.

And, save a fortune on schooling.

Cerberus

Quite so.

Right, non-socialised education.

David M

Yup

Cerberus

It's complicated.

David M

4:53 AM

It is

Cerberus

But hey, if you don't want me to visit you next time complaining about tiredness, I should go to bed hehe.

David M

@tchrist Did you receive my email?

@Cerberus Hahahahahaha. Enjoy.

Cerberus

I have 7 hours!

tchrist

@DavidM Let me go look.

Cerberus

G'bye.

David M

4:55 AM

@tchrist Thanks

Cerberus

Hmm an e-mail...

David M

@Cerberus Pleasure chatting with you.

Cerberus

Is it about something I should be curious about?

David M

@Cerberus No, I just wanted his spammer detector.

Cerberus

@DavidM Mine!

Ahh OK.

tchrist

4:55 AM

@Cerberus All things should you curious about be.

Cerberus

Where does it detect spammers?

David M

@Cerberus On ELU

Cerberus

@tchrist But curious enough to act upon...

@DavidM Ah OK.

tchrist

Found it.

Cerberus

So many wonder this world doth contain.

David M

4:56 AM

@tchrist Cool

Cerberus

Good night!

David M

@Cerberus Try not to wake due to apnea ;-)

tchrist

@DavidM Treatable.

And he likely wouldn’t know if he did.

Cerberus

@DavidM Haha I'm coming out of a cold, so it's nose spray for me tonight.

I love the stuff.

David M

@tchrist Absolutely. We had a long discussion about it earlier.

@Cerberus Good idea

Cerberus

4:57 AM

Trying not to get addicted.

David M

@Cerberus That is the tricky part.

tchrist

I think that’s overstated, but I’m not sure.

I use it when I need it.

Cerberus

Although I felt absolutely fine when I was addicted.

tchrist

Which is not once a week.

Cerberus

Good.

So, David, you should still have 6 hours left of your night, right?

Plenty for you haha.

tchrist

4:59 AM

I was directed to use it by a physician for a few days due to a sinus infection. I said but the label says not to do that or risk addiction. The physician didn’t seem to think it something to worry about. Plus he said, well, would you rather be gagging in your sleep?

Cerberus

Not to do what?

David M

@tchrist It is overstated. Because it is not exactly life-altering if you become addicted. No 12-step program needed to kick it, etc.

Cerberus

Use it at all?

David M

@Cerberus I'm off this week.

Cerberus

I also read that the addiction causes no permanent damage normally.

@DavidM Ahh good!

David M

5:00 AM

@Cerberus Nose bleeds, that sort of thing.

tchrist

Mail sent.

David M

You don't really get high off it.

tchrist

"Really"?

Not at all.

Cerberus

@DavidM Right, but, if so, that your body would eventually return to normal after not using it for a while.

tchrist

The doctor gave me the idea that the warnings were not meant for people who needed it and were under a physician’s direct instructions.

David M

5:01 AM

@tchrist True.

Cerberus

Yeah it's not about high, it is about...dependency.

David M

@Cerberus Exactly.

= Physician

Cerberus

Hehe.

Oh, bodies, why are you imperfect?

Okay, now it's really bed time.

Adieu!

poof

David M

@tchrist Thanks for the email. I will try to digest that.

tchrist

It’s easy once you get used to it. The symptoms always cluster.

I too must away, being this hours and hours past my normal bedtime.

David M

5:05 AM

@tchrist Yeah. I hate answering a question only to be informed it's a spammer troll.

Good night.

Matt Эллен

10:34 AM

misstydning

Johan Larsson

10:57 AM

@Matt If you are bored you can check this out

Matt Эллен

Hi @Johan! What is a good translation for misstydning? I guessed mistranslation.

Johan Larsson

misunderstanding perhaps

I read it like you interpret the meaning of something wrongly

why so swedish?

Feltolkning is probably more commonly used

not 100% misstydning is a word, no problem understanding what it means but not sure I ever used it

Matt Эллен

oh, I was reading you link on the star board. I asked Google translate to have a go at translating it

it couldn't figure out misstydning

Johan Larsson

Misstydning is a word

Matt Эллен

> Formen utan t har uppstått genom misstydning av gryt, som sannol. uppfattats som best

ah! misinterpreting.

Ronan

12:33 PM

Oh look a chat room! :

@Johan "not 100% misstydning is a word, no problem understanding what it means but not sure I ever used it"
I think you might be misinterpreting it...

Cerberus

@Ronan Oh, look! A Ronan.

Bienvenu.

@JohanLarsson Dutch vertolking. You think this could be related to English talk?

We do not having anything like talk in Dutch, except tolk "translator" and derivatives.

Ronan

"A wild @Cerberus appears" Like a cross between Pokemon and Final Fantasy!
Not really sure what's going on, but I'll keep an eye out! :)

Cerberus

Hey!! I ain't no Pokémon!

I am neither small nor cute.

I'm fearsome and magnificent.

Ronan

You obviously haven't levelled up enough to get the fierce and magnificent beasts!

Matt Эллен

12:59 PM

Cerberus tries sleep. It's not very effective.

2

Mr_Green

Hey

I was just wondering what the person known as who ruins magician's trick?

Johan Larsson

@Cerberus tolk means translator and gauge

@Ronan :)

Matt Эллен

1:16 PM

@Mr_Green I don't think English has a word specific to that situation. If you're looking for a word for someone who ruins someone else's fun, you could call them a "spoil sport"

Mr_Green

I remember that there is one word for those people.. had one english lesson in my school days.. maybe I am wrong.. thanks

the english lesson name was "magicians revenge"

@MattЭллен english.stackexchange.com/q/159520/28409

can't control my curiosity to know.. so I asked here :)

Matt Эллен

fair enough :)

KitFox

moin

Matt Эллен

allo

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English Language & Usage: Multi-Layer…