John--
There is no doubt in my mind that a complex system like "western civilization" doesn't just collapse in one piece, and all in place.
Parts of it are quite resistent -- they are very conservative, like cyanobacteria, and will not reach the limit of complexity.
Other parts, like the medical system just can't continue to function in a "business as usual" manner. It's anyone's guess how it will play out, but when 20% of the GNP is devoted to an enterprise that produces worse results than any number of other societies -- at 2 or 3 times the cost-- it doesn't seem like it can continue.
Of course, I said that in 1975 when people were complaining that medical costs were 8% of GNP and employer-based insurance was far more secure. So my sense of the timing of the collapse is not correct.
Tom
