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As an American with personal direct experience of the European Healthcare like the UK's NHS can you convey your experience and judgement? Please, first hand accounts only, no hearsay, (s) he said stories, second hand anecdotes or things you've heard.—•—The following is a critique of an answer which has since been deleted.The text which is …block quoted… is from the original question, the interspersed comments are my response.Please keep this in mind if you comment.—•—It’s really easy to tell who doesn’t have personal experience of the NHS in this thread.Aaron Bosen.Want to know why?Because everything he says is distorted or just plain untrue.For example*Because if you’re not a legal citizen of the UK who maintains what they consider to be a valid address, phone number, and has paid all your taxes on time, the only way you’re getting *seen* much less treated in the country in any NHS hospital is if either you, or your insurance pays for the cost in full, which by the way, is anywhere from 3 to 8 times what is in the US.This is all a lie.If it’s an emergency you get treated, no questions asked. If it’s not, yes you have to pay, but at a massively lower rate than in the US.You know, assuming they’re willing to treat you at all. Yes, that’s right. The NHS charges, even for the fairly basic stuff. Particularly when treating foreign nationals without permanent residences, and they have an entire system of what they will and won’t do at taxpayer expense even for actual residents. Anyone who’s actually had to use an NHS clinic in the country would’ve told you that. Foreigner or resident.Again, this is a lie. It’s just more of the same as the previous paragraph but now the lie is extended to British citizens and resident foreigners.Need to see a dentist? The backlog’s so long for NHS ones, that the Brits *re-legalized private dentistry* just so they could allow people access to it at all.Another lie, well two actually.It depends on where you live as to NHS dentistry availability but local health authorities have to make provision for it.Last time I needed to access an NHS dentist I was signed on in less than a day and seen that day.Second lie, there have always been private dentist practices in the UK.Need X-rays? Hope you weren’t planning on the NHS handling that. Most of the time the x-ray machine’s busted, and most people who need x-rays go to private clinics that that’s *pretty much* all they do.Oh, two more lies.NHS x-ray machines are not habitually broken and there aren’t any private clinics specialising in x-rays as far as I know.My local hospital has at least 2 maybe 3 x-ray machines as well as at least 2 MRI machines, I’ve never needed a CAT scan so I have no personal knowledge of those.We don’t even have *have* dedicated rrradiology clinics in the US in comparison. This is literally a private industry existing in the UK specifically to meet the demand the NHS can’t supply.Again just a continuation of the previous lie.Because they generally still want what they deem to be a valid address and phone number. Valid in this case meaning “at bare minimum located in the United Kingdom and matching an issued ID, and with a phone number matching an address located in the United Kingdom.” And they do like to quibble about what’s deemed a “proper” address. I had a friend who spent *two years* trying to convince the NHS the apartment building she’d lived in for the last 6 years, that she received mail at daily, had absolutely no problem with getting stuff shipped directly to, and had given as her address to get ID for even existed.Well, having been overwhelmed by the lack of honesty up to now, I’ll put this down as probably a lie.All his mythical friend would have to provide would be the postcode and house or flat number, they would then look that up. If the address existed it would be in the postcode register.Oh, and by the way, said friend is a British national since birth who’s never lived in any other country.That’s irrelevant as to whether the address exists.And if you’re assuming they’d offer treatment to their own homeless, well, again, you clearly haven’t visited the UK, much less actually lived there.Another lie, if the homeless need treatment they can get it, in fact not just in hospitals but at GP surgeries as well.I was sat waiting for an appointment just two weeks ago and a well known local homeless man came in for his appointment.They literally put spikes in the sidewalk and on windowsills there just to make sure the homeless don’t try to say, spend time outside of the rain.Hmm, never seen this and if they did put spikes out they would be to stop people damaging the property.Hang on, spikes in the pavement? Now that sounds delusional.They sure as hell aren’t going to suddenly start treating them for all the conditions being homeless can cause you.Another lie, they treat the homeless all the time.But they’ll definitely arrest you for giving them food or basic necessary supplies such as blankets, toothbrushes, warm clothing, ect.Nope, there is no legal barrier to handing out such items to the homeless, yet another lie.So, if for example, you’re there as a tourist and you’re injured, say in a mugging in London (another thing, the UK has a very bad violent crime problem everyone tries to pretend doesn’t exist) you are often shit out of luck without traveler’s insurance, unless you end up at one of the extreme handful of private clinics or hospitals only recently and very tenatively re-legalized, and even those will be heavily restricted by law on what medical care they can offer you.The lies just never stop.Yes, there is violent crime in the UK same as anywhere but you're unlikely to get shot and the people most likely to get assaulted are young men or gang members.If you are unlucky enough to get injured in an attack you would get a free ambulance ride to the accident and emergency department of a hospital followed by free emergency treatment.If you had to stay in the hospital for treatment, you or your insurance might get charged for that.Oh, nearly missed the bit about private clinics and hospitals. These have always been a feature of health care in the UK, so another lie.The hospitals in the UK also do not have the legal obligation to provide you with emergency care like exists in the US. They will quite literally toss you out if they simply *believe* you might not be able to pay up front, don’t meet their eligibility criterira, orr if the receptionist just wants a bit of a power trip that day.Massive lie.If you go to an NHS hospital needing emergency care you will get it.And if you think American healthcare is expensive, wait until you’re forcibly put into an NHS hospital following a minor injury as a foreign national. And you get to see first hand just what “free” healthcare costs to a non resident of a country.Yes, you’ll be pleasantly surprised at how cheap it is.This is the first thing he’s said that’s true but wasn’t what he meant.

It is unfortunate that a lot of people are going around inventing new terms for concepts that already have been named and described by prominant theorists. The terms “fragile narcissist” and “fragile ego” fit into this situation.So what is a fragile narcissist?This appears to be a newly invented term for what the well known personality disorder theorist James F. Masterson (1926–2010) called “Closet Narcissistic Disorder of the Self.” Masterson literally wrote the book on this form of Narcissistic Personality Disorder in 1993, The Emerging Self: A Developmental Self and Object Relations Approach to the Treatment of Closet Narcissistic Disorder of the Self.The “Closet Narcissistic PD” is one of the three main subsets of Narcissistic Personality Disorder recognized by Masterson:The Exhibitionist Narcissistic Disorder of the SelfThe Closet Narcissistic Disorder of the SelfThe Devaluing Narcissistic Disorder of the SelfThe Exhibitionist Narcissist: Most theorists agree on how to define an Exhibitionistic Narcissist. This diagnosis is commonly given to those people who:Meet the criteria for a diagnosis of NPD.Are hypersensitive to minor slights.Are continually seeking external validation that they are special, entitled, and flawless.Seek to be in the spotlight.Engage in obvious attention seeking behaviors.Are extremely aware of everyone’s relative status according to the prevailing status hierarchies of their group.Use what I have named the “GOD Defense. They act Grandiose and Omnipotent, and Devalue other people.The Closet Narcissist: This subtype is sometimes described as a “covert” or “introverted” or “fragile” narcissist. I do not like any of these three terms because they can be confusing and imprecise. Masterson devoted a whole book to specifying what he meant by “Closet Narcissist.”Most people seem to be using these other terms—fragile, covert, introverted— quite loosely, without bothering to give readers very much in the way of a definition. Serious writers about personality disorders understand the need to do a review of the already existing literature to contextualize their current work.Ideally, I would want the writer who introduces new terminology, such as fragile, introverted, or covert NPD, to explain the need for the new term and how it differs from pre-existing terms, such as Masterson’s “Closet Narcissistic Disorder of the Self.”Common characteristics of people diagnosed as having the Closet Narcissistic Disorder of the Self:They meet the criteria for NPD.They are just as aware of status hierarchies as the Exhibitionist Narcissist.They use the approval of those they idealize as their main source of narcissistic supplies.They are afraid of the spotlight.They do not directly exhibit themselves for admiration.They do not utilize a GOD Defense.They get their narcissistic supplies indirectly.They try to attach themselves to people, organizations, philosophies, religions that they idealize as special and bask in the reflected glory.They are more in touch with their self-doubt than Exhibitionist Narcissists.They frequently feel inadequate.They are envious of everyone who appears more confident than them or who has more of what they desire.They can be passive-aggressive.They are more likely to complain about you behind your back than to directly confront you.They often blend into their surroundings while secretly wishing that they dared do things that would make them stand out.They are conflicted about being the center of attention. They want to be admired and praised, but they are too afraid of being publicly exposed as a fake to openly exhibit themselves.The Devaluing Narcissist: Masterson used the term “Devaluing Narcissist” to emphasize that this type of Narcissist gets their main narcissistic supplies from devaluing other people (as opposed to exhibiting themselves for admiration for like the “Exhibitionist Narcissist” or trying to indirectly get narcissistic supplies like the “Closet Narcissist).Here Masterson is causing a bit of confusion. All three types of Narcissists devalue other people. I prefer one of the two other usual names for this subtype: Malignant Narcissist or Toxic Narcissist. I think that they better capture the intention to harm the other person’s self esteem that is the hallmark of how this subtype gets their narcissistic supplies.Some common characteristics of the “Devaluing” or “Malignant Narcissist”:They lead with devaluation.They can be direct or subtle in how they devalue.They have a sadistic streak and enjoy humiliating other people.They do not care if you like them. They prefer that you fear them and show it publicly.So…where does a fragile ego fit into this picture?“Fragile ego” is another imprecise term. In Sigmund Freud’s theory of the personality, he identified three separate parts: Id, Ego, Super-Ego. Each has its own domain in our psyche and a role to play.The Id: This is the seat of our instinctual drives, sex and aggression. You could think of this as the part of us that lives in a free floating state of fantasy and desire.The Super-Ego: This part of our psyche keeps our Id in check by using shame, guilt, praise and blame. Our S-E is based on our young child self’s understanding of our parents’ values and our culture’s values.The Ego: This develops to deal with reality. It mediates between the instinctive desires of the Id, the constraints of the Super-Ego, and the need to adapt to the current reality around us.What does it mean to have a fragile ego?Most non-psychoanalysts who use this term are not likely to be referencing Freud’s concept of the “Ego.” They usually mean that the person has unstable self-esteem.Narcissists have unstable self-esteem primarily because they did not develop a realistic, integrated, and stable self-image during childhood that contains both their liked and disliked traits. Such an integrated image is robust and stable because it is based on reality.A realistic and integrated self-image requires developing the capacity for whole object relations—the ability to integrate liked and dislikes aspects of oneself into a single coherent picture. This in turn requires having parents with whole object relations who see you realistically and can lovingly accept who you actually are. Their relatively stable love, despite seeing all sides of your personality while you are growing up, helps you learn to see yourself and other people realistically and accept flaws.Instead, people with NPD have two entirely separate equally false and unrealistic self-images that they alternate between:I am special, perfect, omnipotent, and entitled to special treatment—or, I am worthless, common, defective garbage, entitled to nothing.As no one is all-good or all-bad, these two organizations of the self are vulnerable to being disrupted by any data that contradicts them and cannot be rationalized away. This vulnerability to having one’s sense of identity and self-esteem disrupted is what is usually meant by the colloquial expression “fragile ego.”Punchline: A “fragile narcissist” is another term for someone with the “Closet Narcissist” subtype of Narcissistic Personality Disorder. A “fragile ego” is shared by all people with NPD because they lack whole object relations and, therefore, cannot yet form a stable, relatively robust and realistic self-image.Their self-esteem is fragile and easily disrupted because it is based on the unrealistic belief that they are perfect. No one is perfect. No one is flawless. We all fail sometimes. This is reality.A2AElinor Greenberg, PhD, CGPIn private practice in NYC and the author of the book: Borderline, Narcissistic, and Schizoid Adaptations.www.elinorgreenberg.com

Others are saying it won’t ever happen including, interestingly enough, a Quorat¹ who is a self-confessed republican. Personally I believe “won’t ever happen” and “could never happen here” are dangerous hostages to fortune. Anyway, it isn’t an answer to the question asked. So here’s my take on that.It’s certainly conceivable that a situation could arise where the monarchy was either unpopular or simply regarded as an anachronism. It’s not going to happen right now, because Queen Elizabeth is 92 and hasn’t got much longer to go, and she’s well-liked and stays away from controversy. Also she’s all most people have ever known; few people under 70 will have clear memories of anyone else on the throne.However the monarchy hasn’t always been popular. The population won’t suddenly get together and decide its opposed to the monarchy. More likely a few prominent people will speak up, and perhaps more and more until a general consensus grows like a snowball. Perhaps a private members bill will be moved that isn’t immediately dismissed out of hand. Perhaps a future monarch reads the public mood and suggests that it’s all a bit silly and it’s time for a review of the role.A possible scenario: after a series of scandals leading to a constitutional crisis a future government calls for a public debate on general constitutional reform, being careful to avoid specifically mentioning abolition of the monarchy, but the subject arises nonetheless and vocal factions emerge on both sides. The Prime Minister calls a referendum, expecting a big win for keeping the status quo which would scotch the issue for a generation, but the win is much closer than anybody anticipated and a newly-energised republican movement emerges. The Democratic Republican Party (it exists: www.democraticrepublicanparty.co.uk), previously regarded as a tiny bunch of eccentrics, suddenly experiences a massive increase in its membership as republican-minded people from across the political spectrum and a lot of young previously unaligned people join, and a charismatic leader emerges – let’s call her Olivia Cromford: it’s just a name. Traditionalist media sets up its stall against the DRP and instructs researchers to delve into Olivia Cromford’s social media history to find anything that can be twisted into a smear. The DRP performs well in local elections, taking power in some smaller authorities and splits the vote so that Labour loses overall control of Manchester and the Conservatives of Surrey. There’s panic in the ranks of the established parties and in a general election Labour and the Conservatives both ensure that any campaign speech includes an attack on the sleazy and inexperienced Cromford as unfit for office and a dodgy partner in a coalition. The Liberal Democrats use extensive private polling to ensure that they field pro-monarchy candidates in monarchist-leaning constituencies and republicans in republican areas. In the end the DRP takes 50 seats including Olivia Cromford in Kingston-upon-Hull² Central, and a split vote means that some other seats change hands with prominent heads rolling and other notables hang on with much-reduced minorities. There’s a scrabbling for coalition agreements but neither Labour nor Conservative will work with the DRP, now the third-largest party in parliament, so they agree to form a “government of national unity” together. Unable to agree on more than the most basic programme, and with large demonstrations every weekend by both monarchist and republican factions, sometimes erupting into violence, and Olivia Cromford and her party calling for a second referendum at every opportunity, the government agrees to call a referendum, which is decisively for abolition. There is then a lengthy period of deciding what to replace the monarch with. Even when it’s settled, a lot of people won’t accept the result.The Great Reform Act of 1832 looks like a no-brainer today (though there are still dyed-in-the-wool paleaoconservatives who think that’s when the rot set in) and there were riots in the street.¹ I just made that up. I rather like it.² Hull is where some say the English Civil War started when the governor barred the gates against the king.