| Sunday, August
9, 2009
Healthcare
It would appear that the celebration for the early
demise of healthcare reform may be premature. I just read that big pharma is
going to pump $150M-$200M of support for expanding healthcare during the
congressional recess. It seems the plan is to counter the scare-tactics of
the out-of-power party.
Capitalism rears its ugly head again; expanded
healthcare to some 50 million non-covered Americans will result in
increasing the number of prescriptions being written for drugs. Talk about
instant sales growth!
It's a win-win for big pharma. Better duck.
Bruce
Apparently some insurance companies are
planning to put a good bit or money into a campaign for compulsory health
insurance, since lots of young people don't see the need for it. I recall
when I first went to work at Boeing, back in the 1950's, I was a young man
who didn't need much in the way of health insurance; I bought catastrophe
insurance, but nothing else. Of course I worked with the Boeing flight
surgeon (my first job as as Aviation Psychologist/Human Factors Engineer) so
I had a colleague to give me advice on minor problems. Lots of younger
people are doing much the same, which means they aren't paying into the
pool. And of course will all the pressure to accept everyone regardless of
pre-existing conditions, the proper strategy is not to buy insurance until
you're sick. (Don't do that yet; they can still exclude you! But the
pressure is on from government.) The insurance companies see that coming so
they want to make everyone pay -- which is about the only way they can stay
in business.
We haven't seen the end of all this.
==
07 Daybook Posting
I believe that I detect a bit of bitterness in some of
your postings these days. While I can understand that feeling, I also find
it a little bit uncomfortable to see it from you, without your usual bit of
panache to leaven it.
While of course you are right about profit being the
driving motive behind the development of new medical technology, most
especially including drugs, what in the world justifies the same companies
selling the same drugs outside the U.S. at drastically reduced costs? A pill
that may cost $30 here is sold elsewhere for $3. Or less. Why? Surely basic
economics would allow that a more modest price universally applied would
result in as much ultimate profit as the unequal pricing scale now in
effect.
As to the argument "the U.S. can afford it" - often
expressed by congresscritters - well perhaps they can. Rank and file members
of the House and Senate draw a salary of $174K per year, with the leadership
members salary being a bit higher, from $193K for majority party leaders to
about a quarter of a million for the Speaker. They also have available to
them a wide selection of health plans, and a great pension plan that can
provide up to 80% of their salary (based on the three highest earning
years.)
I personally pay around $600/month in health insurance
premiums, over and on top of what the company pays, which is around
$460/month. Even with these premiums, I still have some medications come up
with a $50 copay per month, $35/per visit copays, and $10,000/year
deductible costs for hospitalization and tests. A MRI for example, costs me
around $1500 out of my pocket. And I have pretty good health insurance, at
least in the Austin market.
While I can afford that, I sure don't like it. And
there are a lot of people who find the cost of medical insurance
backbreaking. This is before you get into the constant battle most insurance
companies will present when asked to actually pay for a hospital stay.
I might be totally wrong, but I think you are a couple
or three years older than I am, which would make you eligible for Medicare.
I am assuming that medical services (prescriptions, radiation, etc.) were at
least partially covered by Medicare for you. If I am wrong I sincerely
apologize - however, I don't see how medicare, which all in all works pretty
well, is much different from the Obama sponsored health care initiative.
People still carry "supplemental" insurance to cover the costs that medicare
does not cover. People must do so, or risk bankruptcy. Or perhaps avoidable
death; neither option is desirable.
Honestly, if a government run health care plan would
run even as smoothly as medicare, and allow supplemental coverage, then why
would anyone object to it? We are going to pay and pay and pay in every
case, so why not try to get the best value for the tax money, insurance
premiums, deductibles, co-pays, and such we are going to pay *in any case?*
-Paul
Given the size of the deficits and the
Congressional Budget Office's estimates of costs, "we can afford it" seems
at best debatable. My Kaiser dues are covered by Medicare (with various
copayments). When I turned 65, my dues (for both me and my wife) went from
about $400/month to $1750 a month; or I could accept Medicare and let you
pay for it. I couldn't afford the option, but why my dues changed by more
than a factor of 3 in one month was not clear. (Actually it was clear: the
Medicare law didn't really leave anyone any choice in the matter.) And yes,
Medicare works very well. I am told that it will go broke in a few years,
but it hasn't yet. And I almost certainly would be here to write this
without it. The copayments for my radiation treatments were nominal, and the
(fairly frequent) laboratory fees were always under $50. Between medicare
and subscribers like you I managed to get past it.
I'm no enemy of health insurance. I do
believe we ought to look at various models to see which works best and
whether those would work here. We need to examine VA, which has both
supporters and detractors; all the stories I have are anecdotal, but the
horrors in Walter Reed a few years ago were pretty grim and obvious. What I
do know is that we don't know so much that we can rush in to putting more
than 15% of the Gross National Product under the tender care of a new
bureaucracy without considerable thought and care: rushing to get it done
before the end of the year seems reckless and if we do it I am sure we will
regret it.
And some of the discussions of rationing
care under "quality of life" decisions by "ethicists" are a bit terrifying.
Going on one's knees before a board of ethicists doesn't much appeal: prove
that you have quality of life! "It's a good day to die." Lester Thurow, many
years ago, in lecturing on bringing down health care costs, pointed out that
among the Inuit and some other people there is an allocation of resources;
and some great portion of the costs of health care come in the last year of
life, so if those could be cut (and understand, they probably should be, but
who decides?)...
See
http://www.usatoday.com/
money/industries/health/
2006-10-18-end-of-life-costs_x.htm and
http://www.foxnews.com/
politics/2009/08/06/
end-life-counseling-intensifies-health-reform-debate/
provide some background. The question is
serious, the consequences are important, and doing it in an all-fired hurray
with 1000 page bills that no one has read does not seem an optimum way to go
about it.
==
Subject: President Obama's Health Care Bill
Jerry, I've been thinking about the Health Care Bill,
the timing of it, and the President's attempt to get it forced through
before anybody has time to read it. Right now, with our economy still
reeling from the Toxic Mortgage Mess doesn't look at all like the right time
to institute a new, highly expensive National Health Care Plan. What we need
is for the government to restore order and confidence to the housing and
lending markets, but that's not what the president is doing. Instead, he's
doing what is probably the worst thing he could do (try to spend his way out
of a recession) for the best of reasons, just like Crazy Eddie would do. I
hope I'm wrong. I really, really hope so, but I'm not exactly optimistic.
-- Joe Zeff
If you can't play with words, what good are they?
==
Health care in Sweden and France
Richard White here. You may remember me from your trip
to the 1990 World Media Conference in Moscow, or from a couple of emails
after we moved to Kirkland in 1994. Anyway, I'm in Austin now. Oldest son
(21) in the Navy's Nuclear Power Training Command. Tomorrow he gets an
automatic promotion and will be the same rank and rate I was when I got out
in 1974. Youngest (16) is aiming at the Naval Academy. Daughter (19) acting
all grown up -- part time job, saving for a car and an apartment.
Anyway, FWIW, Jeff Schreiber, who runs
www.americasright.com, relates a conversation he had with a couple of Swedes
in an airport lounge. The subject of health care came up. The Swedes said
that, while they liked theirs, they didn't think it would be a good model
for us. Find it here under "Drinking With Swedes":
http://www.americasright.com/search?q=sweden
Another friend sent me this article on France's system
from the Boston Globe of two years ago (almost to the day):
http://www.boston.com/news/globe/
editorial_opinion/oped/articles/2007/08/11/
frances_model_healthcare_system/
As the Swedes pointed out, their system serves about
nine (9) million people. To model our system on theirs, Canada's, France's
or any other such country would be folly.
Best regards, Richard __
"If there must be trouble, let it be in my day, that
my child may have peace." --Thomas Paine, (December 19, 1776)
Paine's view is not the modern view, which
will incur deficits that our grandchildren probably will be unable to pay.
We spent the surpluses. Both parties got in on that. We expected it of the
Democrats. After Newt left, the Republicans decided to go them one better.
==
Uncharted territory:
http://online.wsj.com/article/
SB10001424052970204908604
574334623330098540.html
Peggy Noonan
‘You Are Terrifying Us’
Voters send a message to Washington, and get an ugly
response.
We have entered uncharted territory in the fight
over national health care. There’s a new tone in the debate, and it’s
ugly. At the moment the Democrats are looking like something they haven’t
looked like in years, and that is: desperate.
A fair summary, I think. The matter is far
too important to rush into with bills no one has read that contain
provisions put in by the rapacious wolves... Terrifying is not too strong a
word.
============
Not missing the 60's
'That is, I hope that the cast of corrupt opportunists
-- gurus, prophets and messiahs -- who profited from others' naiive belief
is indeed a unique '60s phenomenon, safely encapsulated in those glossy
anniversary books.'
http://www.washingtonpost.com/
wp-dyn/content/article/2009/08/07/
AR2009080702048.html?wprss=rss_print/outlook
--- Roland Dobbins
Well, encapsulated in the books, but there
are residual hippies...
==========
AARP Town Hall refuses to listen at a listen session -
Jerry,
Here is a link to a video (it was obviously edited by
someone biased against the leaders of the meeting) of part of an attempted
"Listening" session sponsored by the AARP. At the beginning an AARP
volunteer was at the podium trying to explain why they were advocating
Health Care Reform. When the meeting audience tried to ask questions and
challenge the statements being made, the volunteer took the microphone and
left. While taking the microphone she tried to say the AARP was not
advocating health care legislation.
http://www.breitbart.tv/
aarp-reps-cancel-listening-session-
after-participants-refuse-to-keep-
their-comments-quiet/
The audience wasn't violent or anything, however, they
clearly weren't buying what they were being told. So the volunteers ran.
V/R
Nathan Stiltner
There is certainly a difference between
not listening and chanting to disrupt the meetings. As I have said, I no
longer give political tactical advice (or at least I don't often). My
preference is for rational dialog; I recall the 1970's when student
organizations would pay to have me come speak, and junior faculty would
chant to keep me from talking -- even though a student organization had paid
(or in a couple of cases the University itself). I held my own, but I found
it distasteful, and no way to reach a rational conclusion.
Disrupting other people's meetings was a
common tactic for both communists and fascists; I don't recall it doing much
good for the forces of reason. On the other hand AARP needs to know that its
policies aren't those of its members.
=========
Observatory - An Aesop’s Fable Might Just Be True -
NYTimes.com
This is fascinating, one wouldn't think there was
enough brains in a crow to solve problems, yet, they do.
http://www.nytimes.com/
2009/08/11/science/11obfable.html?ref=science
Tim
Crows are very smart, and flocks are
smarter than a single crow. (And I know that the "proper" collective noun is
a murder of crows and an unkindness of ravens; but I don't know who made the
"proper" nor do I know anyone who uses them.)
===========
Temperature of the Earth
Hi Dr. Pournelle,
If I may follow up to the question "What is the ideal
temperature of the earth?": I have to say that this is a bit of a red
herring question. I would ask "ideal for what?"
Our current societies and infrastructure were designed
and built for the temperatures in effect at the time. We can look at
cultures that live at more extreme temperatures than we do, and see how they
have adapted. Or, to put it another way: we humans stand to suffer the worst
inconveniences as a result of a major climate change. We in technological
societies can easily adapt to e.g. a yard or two or sea level increase that
takes a century to occur. "Waterworld" is not on the horizon, and if there
are changes coming, I think we can deal with them. The primary thing that
concerns me, about climate change (whatever the cause) is an increase in
violent weather, which has the potential to disrupt economies and
industries, but experience has shown that we can get used to anything.
I would personally find it difficult to mourn the
submersion of much of Bangladesh, if it wasn't for the millions of people
who would need to move - but, again, this would not occur overnight, and
should not be a humanitarian disaster with a bit of planning. I have to
question the wisdom of building a large population in an area so vulnerable
to typhoons, but I understand this is my Western ego talking. Not everyone
shares my perspective, the idea that we should control what we can control,
and plan how to deal with that which we can't control.
I live in Dublin, Ireland, the epitome of a moderate
Atlantic climate, but I am currently near Houston, Texas, enjoying
temperatures in the 90s F, for most of August. I would find it miserable if
I lived outside all the time, but I am spending almost all my time in an
air-conditioned house or an air-conditioned car. Thank goodness for cheap
energy, eh? The Houston lifestyle depends on it, and when it's not there (as
was the case after Hurricane Ike), my friends learned how to conserve what
they had.
(About the only time I spend outside here is when I
take my friends' Siberian Husky, Aspin, for a walk/run around the landscaped
lake in their gated community - and she understandably spends about half the
walk IN the lake. I think my friends need to read about Sable, to understand
the amount of work they've taken on!)
All the best - brian thomson, in Houston TX
(temporarily)
Your friends have an unusual Husky: all of
ours have hated the water. If you live in the ice, you don't want to get
wet...
Control what we can control, and generate
as much cheap energy as possible. Yes, look for sustainable sources, and
invest in them to help them develop; but low cost energy plus freedom equals
growth and choices. We enjoy "real rights" that our ancestors could but
dream of. We have the right to cross the country on a moment's notice for a
few hundred dollars. We have the right to have teeth well into our 70's. We
have the right to communicate with nearly anyone in the world. And so forth.
Those rights are available to nearly
anyone in the West. The "developing countries" want the same things.
==========
The Blackest of Black Markets
Jerry -
Between the Niven reference and the obvious link to
your comments about the ultimate result of an unrestrained market being
commerce in human flesh, I had to forward this to you:
http://mkeamy.typepad.com/
anesthesiacaucus/2009/08/
the-blackest-of-black-markets.html
It starts: "In the1970s, science fiction author Larry
Niven envisioned a world where the rich were so anxious to procure organs
for transplantation that the death penalty was expanded from murder to
traffic infractions
(1). The liberal application of the death penalty and
the likely unconsented harvesting of organs from the condemned in China is a
variant of the world that Niven envisioned
(2). Multiple sources report that the timing of
executions in China, as well as the way they are carried out (a single
bullet into the back of the head of the condemned) is intended to optimize
organ recovery."
It then goes on to cover the recent news about the New
Jersey Rabbi accused of "organlegging" kidneys, and asks why now, 30 years
after Niven's story.
David Smith
Surprise. Now see if this gets into the
health care bill.
===========
Frozen Rivers
Jerry:
Searching for Washington crossing Hudson River
date, I found this tale.
<http://www.oldsaltblog.com/
2009/03/when-new-york-harbor-
froze-over-1779-1780#more-1787>
When New York Harbor Froze Over, 1779-1780
March 3, 2009
Here on the banks of New York harbor, March
arrived with a foot of snow and bitter cold. All things considered, it
hasn't been all that hard a winter and by historical standards, it has
been pretty mild. Both the Hudson and East River froze in the really nasty
winter of 1779-1780, "greatly alarming" the British Army occupying
Manhattan Island. The island was now accessible by foot and the Royal Navy
was completely immobilized. Without their fleet, to protect them the
British "were in a fever of anxiety". From the New York Times account of
December 24, 1911:
When New York Harbor Froze Over
"The letters of Major Gen. James Pattison of
New York, and the journal of the Hessian Lieutenant, Von Krafft, indicate
how seriously the British were concerned for their safety, owing to the
loss of their insular character of Manhattan Island and the paralysis of
the British fleet.
On January 17, 1780, Von Krafft crossed on
the ice from New York to Long Island with an orderly without fear. During
January and February people crossed the Hudson to New Jersey, and not only
cord wood but the heaviest cannon were hauled between Jersey City and and
New York on the ice - "an event unknown in the memory of man," wrote
General Pattison to Lord Germaine.
On Feb. 19 provisions were transported from
New York to Staten Island and a detachment of cavalry marched from Staten
Island to New York on the ice. The British deprived of their fleet were in
a fever of anxiety. Von Krafft says: "The rebels had now the best
opportunity to attack us from all sides to the best advantage. We expected
it hourly."
General Pattison says: "It was strongly
reported that Gen. Washington was meditating a great stroke upon New York
with his whole fore by different attacks."
Consequently the sailors from the ships were
landed, and armed with muskets and pikes to aid in repelling the expected
assaults, and all citizens between 17 and 60 years of age were mustered
into service temporally and supplied with arms. Even convalescents were
pressed into service.
No less than forty companies, enrolling 2,660
citizens, were organized from the different wards. Extra patrols were
established. Cannon were placed in new situations and were mounted on
sleighs, so as to be transported rap[idly to any point. The cannon in the
principal works were kept loaded night and day.
An elaborate code of signals, by gun, fire,
rockets, and flags, was established by means of which and alarm could be
transmitted from Kingsbridge to Mc-Gown's Pass, and so down the to Battery
if the Americans should attack from the north and similar arrangements
were made to give warning of approach across either the Hudson River or
the East River. A lookout was stationed at the Battery to watch the signal
flag on Staten Island.
While the inhabitants were thus suffering
from anxiety they also suffered for lack of provisions and fuel. The
latter was so scarce that "old ships were assigned to all the English and
Hessian regiments for firewood," and even then they had only half enough.
The cold snap lasted until Feb. 22, when Gen. Pattison wrote: " The Rigor
of the Frost is now happily abated and we are flattered with the Prospect
of a Compleat Thaw, so that all Ideas of an Attack are now at an End."
-------------
Also <http://www.newsday.com/community/
guide/lihistory/ny-history-hs424a,0,6567872.story>
Frozen Ducks in the Kitchen Nations at war
shiver through the Northeast's hard winter of 1779-80
By George DeWan | Staff Writer
IT WAS so cold the ducks froze.
The snow began to fall about the 10th of
November, 1779, and continued falling almost every day until the middle of
the following March. The Northeast virtually shut down. It was known as
The Hard Winter, and may have been the coldest these parts have seen since
the Wisconsinin glacier.
It was a world of ice. The rivers, creeks and
streams on Long Island were frozen solid, as was Upper New York Bay. The
East River and the Hudson River could be crossed by foot. British cavalry
thundered from Manhattan to Staten Island. Long Island Sound was more ice
than water.
As for the frozen ducks, the Long Island
Loyalist judge, Thomas Jones, a sober man not usually given to
tongue-in-cheek tall tales, passed along a "remarkable if true" story
about a Staten Island farmer named Goosen Adriance:
"He went out in the morning upon his farm,
which adjoins the water, and going along the shore, he observed a parcel
of ducks sitting erect and in their proper posture," Jones wrote in his
book, "History of New York During the Revolutionary War." The author
continued: "He walked up to them, found them stiff, and as he supposed
perfectly dead; he carried them home, threw them down upon the table in
his kitchen, where a large wood fire was burning, and went into the next
room to breakfast with his family. Scarce was the breakfast over when a
great noise and fluttering was heard in the kitchen. Upon opening the door
how great the surprise. The supposed dead ducks were all flying about the
room."
According to weather historian David M.
Ludlum, no winter before or since was as cold.
"Long Island Sound was almost completely
clogged with ice, and people were able to cross from Long Island to the
vicinity of Stamford on the Connecticut shore for several days," Ludlum
writes in "Early American Winters: 1604-1820." "Some Hessian soldiers took
advantage of this route in order to escape from their regiments."
Judge Jones, who lived at Fort Neck (now
Massapequa), wrote in his book that 200 provision-laden sleighs, pulled by
two horses each, escorted by 200 light cavalry, made the five-mile trip
from New York to Staten Island. On Long Island, with British occupiers
making demands for firewood, cattle and living space, already harsh
conditions were made even harsher. Part of Long Island Sound became a
highway of ice. "It was so strong, that deserters went upon the ice to
Connecticut from Lloyd's Neck, upon Long Island, the distance more than 12
miles."
George Washington's troops were shivering in
winter quarters at Morristown, N.J. -- one writer said it made Valley
Forge of the previous year look like a picnic. But his men occasionally
sneaked across the frozen harbor and attacked British troops on Staten
Island. The British hauled cannon across the ice from Manhattan to defend
themselves.
WASHINGTON, an inveterate diary-keeper, has
this entry for Jan. 6, 1780: "The snow which in general is 18 inches deep
is much drifted -- roads impassable." He was apparently referring to the
new snowfall from a major storm on that date, since other records indicate
there was already close to four feet of snow on the ground.
"In the woods it lay at least four feet upon
a level," Jones wrote. "It was with the utmost difficulty that the farmers
got their wood . . . All the wood upon New York Island was cut down. The
forest trees planted in gardens, in court yards, in avenues, along lanes,
and about the houses of gentlemen by way of ornament, shared the same
fate. Quantities of apple trees, peach trees, plum trees, cherry trees,
and pear trees, were also cut down."
The New York Packet reported a thermometer
reading of 16 below zero in the city. Current records of Central Park
readings only go back to 1869, so this would beat the 15 below zero
recorded in 1934. The severe cold reached up and down the coast, from
Maine to Georgia. Ludlum says that the Connecticut Courant in Hartford
provided the most complete temperature record. And, due to the lack of
sophistication of the newspaper's audience, the editor believed it was
necessary to explain the nature of a thermometer and what its readings
meant.
When springtime came, New York was depleted
of wood. So on June 16, 1780, the new British governor, James Robertson,
issued an order to "the inhabitants of Long Island" to furnish wood for
the army barracks in the city, "to guard against the severities of a long
winter." Their quotas: Kings County, 1,500 cords; Queens, 4,500; western
Suffolk, 3,000 cords. The inhabitants of Southold, East Hampton and
Southampton were required to cut 3,000 cords from the Smith and Floyd
estates at Mastic. They were to be paid at varying rates, but it is not
clear whether payments were ever made.
In December 1776 cannon from Ticonderoga
were taken to General Washington in Harlem Heights by bringing them across
the frozen Hudson. I don't think the Hudson has frozen that solid since
1800, certainly not since 1840. It was COLD back then; but that was the tail
end of the Little Ice Age.
And we all know it was warmer in Viking
times when Nova Scotia was known as Vinland, and there were dairy farms in
Greenland (and no, the Gulf Stream had nothing to do with that; see the
map). This doesn't mean that there is no Global Warming but the cooling and
warming trends of those times were not due to industry.
The Earth warms and cools, and humans may
affect that; but it's clear that natural variations have been larger over
history than we are observing now.
==
EPA Supresses Climate Study
http://wattsupwiththat.com/2009/06/25/
online-global-warming-study-censored-
by-epa/#more-8907
Washington, D.C., June 26, 2009—The Competitive
Enterprise Institute is today making public an internal study on climate
science which was suppressed by the Environmental Protection Agency.
Internal EPA email messages, released by CEI earlier in the week, indicate
that the report was kept under wraps and its author silenced because of
pressure to support the Administration’s agenda of regulating carbon
dioxide.
The report finds that EPA, by adopting the United
Nations’ 2007 “Fourth Assessment” report, is relying on outdated research
and is ignoring major new developments. Those developments include a
continued decline in global temperatures, a new consensus that future
hurricanes will not be more frequent or intense, and new findings that water
vapor will moderate, rather than exacerbate, temperature.
=
Here's more on the EPA CO2 report...
http://www.examiner.com/examiner/x-9111-SF-Environmental-Policy-Examiner~y2009m6d25-The-EPAs-internal-nightmare-over-global-warming-Part-1
Julie Woodman
==
And on that subject:
"The crime which Chandrasiri Bandara committed was
publishing an astrological column which was adverse to the government."
<http://news.bbc.co.uk/2/hi/south_asia/8120859.stm>
- Roland Dobbins
Can't happen here, of course.
============
'In Bezos's mind, the Kindle is the logical evolution
of a 500-year- old analog technology, and this frightens those in the $24
billion book-publishing industry already skittish about Amazon's growing
clout.'
<http://www.fastcompany.com/node/1297929/print>
-- Roland Dobbins
============
Friedman: Treason or Murder?
<http://daviddfriedman.blogspot.com/2009/06/treason-or-murder.html>
--- Roland Dobbins
==========
'The Air Force said it will train 240 pilots to fly
Predator and Reaper drones compared with 214 fighter and bomber pilots for
fiscal year 2009 ending Sept. 30.'
<http://www.usatoday.com/news/military/2009-06-16-drones_N.htm>
-- Roland Dobbins
============= w
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thought about a subscriber section of the page. LET ME KNOW your thoughts.
.
If you subscribed:
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a Special Request.
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If this seems a lot about paying think of it as the Subscription Drive
Nag. You'll see more.
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