=== From a Scarcity Society to a Gift-based One? ===
Will we transform ourselves from an archaic Scarcity Economy to a "Gift Economy" - much as portrayed in Star Trek? Is philanthropy a crucial recycling direction for wealth to take? I participate in round tables on philanthropy theory. Here is an important one.
Philosopher Fed Turner has some interesting insights: ”There is a myth that we as a species have moved from having an edenic and arcadian gift exchange economy to a cold and corrupt market economy. As a myth it has its uses; as a fact it will not fly. Archaeologists and physical anthropologists now find trading practices among the earliest humans nearly 200,000 years ago; we were always buying, selling, hiring, trucking and bartering. And economists tell us that even in today’s advanced industrial economies the amount of value that is transferred by gift is greater than the amount transferred by market exchanges. This may sound counter-intuitive until we reflect that gift includes the free services rendered by parents to their children, husbands and wives to each other, friends to friends, hobbyists to their community, and the bequests of the dying to their heirs.
“We have plenty of theory about markets, since Locke and Smith and their ilk. There is some theory about gift exchange in traditional tribal societies (Marcel Mauss, for instance), but very little until now about the economic, moral, social, political, ecological, aesthetic, and spiritual implications of today’s gift economy in advanced societies like the United States.”
Finally, there's a fun item -- EON: the Eye of the Needle Foundation -- my own article that stimulated discussion in philanthropic circles, about an entirely new kind of charitable institution, one that might help dramatically enlarge the pot of modern generosity by offering the super-wealthy (and many of the rest of us, too) some unique incentives. Something for the man or woman who has everything.
Can We Learn Useful Things About Society/Security From Fiction & Magic?
Is fiction a security issue? DARPA wants to know how stories influence our thoughts and actions. And what form of literature can be more radical than science fiction – which teaches that the future can be different than the past – that humans might stop making the same mistakes over and over again.... and hence, that it will be our fault, if we choose not to stop.
Recording Police Abuse Could Get You ARRESTED! Magician, supertainer and paladin of freedom Penn Jillette recorded this episode of Penn Point back in June. I highly recommend Penn's rants; they are uniformly smart, vivid and informative. Even when I disagree, I feel glad he is out there, fighting for us, and proud to know him. (I have an ulterior motive in this case; Penn repeatedly touts my nonfiction book The Transparent Society.
I especially like one of Penn's aphorisms: "Always look for the solution that's for more freedom." I say something almost identical in The Transparent Society. Alas, in the info age, people point to problems and all-too often suggest solving them with LESS information flow.
Take recent arguments over renewing the Patriot Act. I despise the damned thing. See where I predicted it - as well as terror-doom for the WTC towers - in The Transparent Society on page 206 (shown above).
But I don't waste my time writhing over the parts of the Patriot Act that let government see more. That trend is inevitable and unstoppable and freedom knights who rail against those parts are just foolish. It is the OTHER portions of the Patriot Act that are demonic, hateful and downright dangerous... the sections that remove oversight and allow government to operate more in secret and less under our supervision. Those are the parts we should be fighting to eliminate. But political reflexes tend to be dumb, and liberals are no exception, even when they are on the right side of an issue.
== Symptoms of Sickness... Signs of Health ==
Want to perk up? Here are 25 minutes worth watching: Kevin Kelly on the future of book publishing, speaking about how value will be generated in a free copy world: “The internet is the world’s largest copy machine.” We can’t stop books from being copied, so we need to make it easier to pay for immediate, interactive, personalized content. Kevin is very smart and always worth-heeding. It happens I think he's wrong here in several ways. But tune in!
Caltech basketball team just won its first victory since 1986! A 310 game losing streak... done!
The team controlling the Kepler planet-hunter telescope has released a small part of its 1st 4 months of data recently. It revealed more than 1200 potential extrasolar planets. If a reasonable percentage of these worlds turn out to be independently verified, this treasure trove will yield more results in 4 months (1200+) than astronomy had found in the past 15+ years (550+ objects). (Um, than astronomy had found in the last 5,000 years.)
Kepler uses the transit or partial eclipse method to identify new planets. It keeps a constant vigil on 156,000 stars that are up to 3000 light-years away in a region close to the star dense galactic plane in the constellations of Cygnus and Lyra.... Since other planetary systems can exist at all different angles, we would only expect that a small percentage of extrasolar systems (1-10%) would be edge on to us. That means that Kepler is really only sampling 1,500 to 15,000 systems. That makes the fact that they have found 1200 potential planets all the more impressive!
Findings. Neptune-type worlds seem dominant. The large number of Super Earths (23.3%) that may be determined to be rocky after further study, combined with the significant percentage of Earth sized bodies (5.5%) suggests that a sizable percentage of stars that could show evidence of Earths seem to have them.
But note, Kepler’s results are so-far weighted toward finding planets with quick orbital “years.” Later data must gather to find those orbiting farther out. “There were 54 planets detected in the water-possible zone. Five (5) of those were Earth sized or smaller. This is where things really get interesting. These are the gems in the group.”
Those who have read (and enjoyed) STAR WARS ON TRIAL... or the original Salon article that first accused the Lucasian universe of nostalgic-romantic hatred of the future... might enjoy an hour-long podcast discussion that assesses the article, from the perspective of several british and australian writer-fans. They try hard. They are very silly, but they do try hard. (Someone tell them about STAR WARS ON TRIAL, in which George Lucas’s defenders have their chance... and come up wanting.
=== Unabashedly Political -- Be Afraid! ===
“Spending cuts approved by the House would end America's reign as a scientific leader if they are enacted into law, a former Bush administration Energy Department official said yesterday. "Left intact, the massive cuts in research contained in the bill passed on 19 February would effectively end America's legendary status as the leader of the worldwide scientific community," Raymond Orbach wrote in an editorial published online by the journal Science.
I guess the Saudis haven't changed their plans for us, after all. Their lackeys are still trying to end Pax Americana from within. This is war.
Speaking of mouthpieces for the real, behind-the-scenes instigators of Culture War... try this Glenn Beck conspiracy generator.
See this: How Rich are the Super rich?
If you spread nothing else this year, spread that one link.
I consider myself a libertarian who believes in competition as THE great creative human force. Objecting to the rise of a dominant oligarchy is not a SOCIALIST issue! It is an issue to anyone who wants the enlightenment... including its competitive markets and small businesses... to survive.
I hated the soviets and commies as dangerous ignoramuses and threats to the enlightenment, markets and freedom.
I hate the new oligarchy for exactly the same reasons -- both bands of would be aristocratic lords think they can "allocate" wisely in secret cabals. Both communists and oligarchs believe that history and justice back up their monopoly of power. Both replicate EXACTLY the failure mode that ruined every other brief renaissance of openness and market freedom. The oligarchs try to hide this by relentlessly claiming to favor market competition -- without ever showing a single example of a competition-enhancing action on their parts.
I’ve said it again and again. The people who should be angriest at the neocons aren’t the liberals or even the pinko socialists (two very different things). The ones who should despise the neocons most of all - with red-hot livid hatred - should be the libertarians. And fools like the Pauls, who think that the GOP is a hold-your-nose choice that’s better than the democrats, are all profoundly stupid fools.
251 comments:1 – 200 of 251 Newer› Newest»
Re: The inequality charts.
Yeah, any time I see something so clearly biased in just one direction with no attempt to show the whole picture, I tend to discount it - even if I happen to agree that a more balanced presentation would likely demonstrate the point the creator was trying to make.
Some charts are missing that would add a little more balance.
Distribution of consumption - a more meaningful representation of the richness of one's life. In simple dollar terms, someone earning 400x as much is unlikely to be consuming 400x as much. And the value they get for their increased spending is certainly not going to make their life 400x better.
Distribution of taxes paid - a balanced summary should include this because taxes cut into and re-distribute the benefits of income.
Another example of how the charts are biased - they focus on only on national income.
Do you think those charts would be nearly as convincing to Americans, if they showed global income distribution, and were intended to imply a need to re-distribute not just the wealth of the greedy uber-rich, but also the wealth of the merely middle class Americans?
After all, the ratio of US per-capita GDP to that of Zimbabwe is about the same as the ratio of a CEO's income to the average income.
Yes, TwinBeam, it's from Mother Jones.
Nevertheless, would you care to state in detail why the charts are biased? Try to present the data as a more reasonable diamond structure?
The problem with oligarchies is precisely that they *don't* consume, only amass.
Supply-side economics is like the permafrost that locked the fallow vegetable nutrients into the arctic peat bog, leaving only sour tundra moss. Neocons are the guys that killed the recycling mammoths off.
Also: Beware of Canadian Prime Ministers continually touting the virtues of becoming an "energy super-power"...particularly in light of the First Law of Petropolitics.
Re: Exo-planetary systems
"(1-10%) would be edge on to us"
Why the broad range?
I had hoped the Arthur C Clarke estate would be large enough (and ACC desirous enough) to allow for an Arthur C Clarke Memorial Solar Sail Race. A prize in the tens of $millions, once every four years, perhaps jackpotting until someone tried it.
Since that didn't happen, my suggestion for a philanthrocapitalist billionaire's gift-to-their-own-legacy is... well, that.
Or alternatively, a Paris-Dakar style rally on the moon. (Again, once every four years, prize jackpotting.)
Or, you know, schools in Africa. That's good too. I suppose.
TwinBeam, I find your argument to be a bit of a red herring.
To say they should use consumption distribution charts instead of wealth distribution is to side-step the entire reason we should care about distribution of wealth in the first place.
Yes, we KNOW the rich don't consume according to the means of their income. Stated another way, we KNOW the rich don't need, or even meaningfully make use of all the income they have. That's not news; in fact, that's the entire point we're trying to make.
If every person who made more than a million dollars every year was taxed for 80% of that income, it would literally make no practical difference to them. If they made ten million a year, and because of taxation, only walked away with a little over 2 million a year, it would make no practical difference, because at that point, your income literally gets to be an abstract figure.
That same 7+ million dollars given to other parts of society, on the other hand, could, say, build a public school for a thousand children, or put 116 students through $60,000 of four year college (this is just what you could do with ONE PERSON giving this much, mind you).
This is the entire problem. Our wealth distribution prohibits the maximum number of people from having the maximum quantity of meaningful resources, and so, is not conducive to a society in which the maximum number of people are enjoying the maximum possible quality of life (which should basically be the very utilitarian definition of a successful society).
Correct me if I'm wrong, but isn't minimum wage almost $15/hour in your nation?
I know a number of Australians, and that seems to be the figure I remember. If I might make a quick comparison between the US and Australia, it seems to me that in many ways you mirror us.
What we pay for a loaf of bread isn't terribly different from what you pay for a loaf of bread (though your computer hardware prices are through the roof D: ). Your dollar is worth just about what our dollar is. Really, aside from being a smaller economy due to you having less people, your economy seems to be, in many ways, very similar to ours.
However, and correct me if I'm wrong on this, your economy seems to put a lot more wealth into the hands of the everyday person. In fact, you have to land a decent job her to make $14 or $15 an hour. I work in the "upper end" of retail at a Walgreens photolab when not in school, and even I only get $8.50 (which might be $9-10 in places like New England, with higher costs of living).
Despite this fact, and the fact that SSEers would cringe at such notions, has your economy not, in fact, been in a state of pretty significant growth? I mean, your energy consumption has exploded, so I would assume so.
Dr.B. -- re EON and new tools for philanthropy and large-problem-solving: do you think there would be any interest (among philanthropists or elsewhere) in an organization-and-software-tool designed to:
1. account for every dollar put into it: how it was spent, how the decision to spend it was made, what the expected benefits were, and (after the money is spent and as the data comes back in) how those expectations played out
2. provide tools to aid rational decision-making and minimize pockets of information-vacuum, so all decisionmakers have the best and most complete information possible
3. allow all donors to vote on how funds are spent, using range-voting so as to minimize the net error between what voters want and what they actually get
4. network with other instances of itself, so that multiple organizations could work together on common goals
5. be open-source and freely copyable -- so that the project's successes can be built on and its weaknesses and failures learned from, and so that existing organizations could make use of these tools to improve their efficiency and to network with each other
Even if there isn't any big-money interest in such a project, it would be heartening to hear of any interest at all. KickStarter.com is always an option, but there has to be some kind of interest first.
An entertaining exercise, (In the U. S., possibly relevant in other economies) look up the minimum wage and official price of gold in your birth year, divide the price into the wage, than multiply the current gold price by that result. Isn't inflation wonderful?
By the way, Dr. Brin, I have to ask something on a whimsical note: have you ever read the mad science webcomic Narbonic? It wrapped up a couple years ago, and the cartoonist is rereleasing it with commentary now, but I had reason recently to reread it and enjoyed it immensely. I only ask because I remember how you continually talk about the decline of American science fiction... and while mad science is definitely on the soft end of science fiction, I figure it's still scifi of a sort. That, and once you start piecing together the various elements of the comic... well, it's rather fun when you realize how things interconnect, especially with bits that seemed like one-off segments.
Take care. :)
Robert A. Howard, Tangents Reviews
(Sixth attempt to post, removed the links.)
NextBigFuture summarises a Brookings Institute paper on the plummeting rates of global poverty in the last decade. Speculating that we may have already exceeded the UN's Millennium Development Goal of halving 1990 poverty levels by 2015.
The graph that NBF uses is the more illustrative, but I found the bubble-plot in the PDF amazing.
The danger, as near as I can read it, is that we've now picked the low hanging fruit. An increasing proportion of the remaining poor will be those in failed (or "fragile") states, so the methods that have worked so far may be ineffective.
(Indeed, my monkey pattern recognition tells me the reduction is a curve with an asymptote at 400 million.)
"They estimate that between 2005 and 2010, the total number of poor people around the world fell by nearly half a billion, from over 1.3 billion in 2005 to under 900 million in 2010."
"Providing every person in the world with a minimum income of $1.25/day — in other words guaranteeing the right not to live in absolute poverty — is rapidly becoming feasible. In 2010, the cost of such a global safety net would be just $66 billion, or slightly more than half of all official aid."
The robot marathon has a winner. First and second place finished just two seconds apart after 57 hours.
Robert, looks like fun!
Woozle there are many sincere attempts to create structures for accountable philanthropy.
I wish I succeeded at persuading some billionaire to buy a strip -- 200 meter wide, straight through Port Au Prince. For a few millions, he would then have a TOTAL right of way corridor to install rail, boulevard, utilities and grow businesses from the port to factory zone to airport. He would get rich while every citizen benefited
"However, and correct me if I'm wrong on this, your economy seems to put a lot more wealth into the hands of the everyday person. In fact, you have to land a decent job her to make $14 or $15 an hour. I work in the "upper end" of retail at a Walgreens photolab when not in school, and even I only get $8.50 (which might be $9-10 in places like New England, with higher costs of living).
Despite this fact, and the fact that SSEers would cringe at such notions, has your economy not, in fact, been in a state of pretty significant growth? I mean, your energy consumption has exploded, so I would assume so."
Australia does pretty well - but we've been lucky over the last decade or so.
The profits from our mining and farming industries are exploding due to Asian demand and that in turn lets us keep taxes low on the rest of the economy and subsidizes our government services.
Most of the developed world pays considerably higher wages for entry-level jobs than the US.
All that money for the top 1% has to come from somewhere.
It's interesting to note that while US GDP per capita is higher than for many European countries, the median whousehold income is generally higher in Europe.
America as a whole may be richer but most Americans aren't.
DARPA is building the first Terminator. And his pet cat. [pics]
Just tried posting, four times, about another Brookings institute article about youth news consumption.
Giving up. Google: "brookings youth news".
How do the actual spambots do it?
(ingran: to fix deeply the notion that you're getting too old for this shit.)
As to accountable philanthropy, I'm having a little fun with kiva.org. Basically, I invest a little cash in a project that looks interesting/worthy to me, kiva does the bookkeeping and tells me when my loan has been paid back. I hope it's not too disrespectful to think of it as a sort of investment game.
Heh, that's pretty awesome Paul.
Unfortunately (or maybe fortunately, depends on how you look at it), the problem with a robotic soldier, imo, has always been that what you've managed to create is a $3 million ground pounder that's an absolutely ripe target for a $50 RPG round. There's just no way that can ever be cost-effective, not when humans breed so quickly and are more than willing to take up a fight at something like a thousand bucks a pop.
It just seems like a useless and expensive replication of hardware.
Now if DARPA wants to make an exoskeleton out of that technology, or better yet, scale it up a thousand times and make a Battletech Timberwolf (or scale up the cat and make God only knows what :O), well then as a taxpayer maybe we can talk :D
Sure, it'll just end up just being a $300 million target for $50 RPG rounds, but in the meantime, it'll scare the living $^%# out of everything that encounters it :)
"Free" market fetishism is the driver of income inequality. FDR's New Deal policies--still decried by the antisocial(ist) right--ended the last bout of hyperinequality, and created the longest sustained economic boom in US history. The top tax bracket in the 50s was 90%, NINETY percent. Our society essentially said that nobody is allowed to make over $2million. And our econonmy flourished because of it. But so-called libertarian free marketeers have spent the better part of 40 years dismantling the New Deal...with predictable results. The solution to our current predicament is a more well-planned economy, not a more free market economy. You don't go for a spin in a car without a steering wheel, and you shouldn't stand for an economy without steering mechanisms. I say this, not as a big-government Democrat or Republican, but as an anarchist--a libertarian socialist--who believes we can convince people to adhere to a planned cooperative economy without forcing it from above. The trick is to out-argue those who think competition is a magic bullet.
"...I say this, not as a big-government Democrat or Republican, but as an anarchist--a libertarian socialist..."
Or a pragmatist?
I have no idea what a completely correct theory of human political economics may be, but on the evidence I suspect it is intrinsically weirder than quantum physics ... perhaps the theory itself is unknowable or at least affected by the act of observing the theory.
Having dallied with catholicism, capitalism, capitalism from a christian standpoint, marxism, libertarianism, socialism, socialism from a christian standpoint and many other -isms, all I can say at this point is that the chief virtue of all of these theories is that, when stated with sufficient self-assurance, each may be persuasive, which is a long way from being correct or even helpful in every situation.
Perhaps at this point in history, we have to just solve problems, and the big problem facing us is, IMO, precisely as @Nathan has stated.
Yep, all we have to do is slap on an 80% marginal income tax rate.
Exactly the sort of simplistic thinking such one-sided presentations inspire.
The idea behind "Soak the rich" was to de-fang huge fortunes, limiting their ability to destabilize the economy, might've been nice to have a stabilized economy when the housing bubble popped. IMO, the right is winding up a potential backlash that might make FDR seem positively libertarian.
"Yep, all we have to do is slap on an 80% marginal income tax rate.
Exactly the sort of simplistic thinking such one-sided presentations inspire."
The sad thing is, Twinbeam, that while this sort of absurd strawman doesn't even remotely resemble a complete strategy for economics from progressives...
it does do a very good job of matching the downright childish simplicity of the view of economics from the right, which can basically be summed up, in total, as "just cut all taxes until there's nothing left of government but a military, drop all regulations of any kind on business, and everything will just work itself out, magically".
Back in the 19th century, that sort of thinking might have been excusable, but we have hindsight today that people of the 1800s lacked. We successfully implemented everything, down to the last detail, that conservatives wanted on economics and government, during the late 1800s, and the result was mass ecological decimation, a state of de-facto slavery imposed on many, if not most, US workers, and a state of corporate oligarchy over the US government (and then there was that whole nonsense about Federal soldiers moving in and shooting crowds of strikers in 1877, after the West Virginia state troops refused to open fire). It probably also didn't help that this all ended in a depression in the 1890s (the panic started in 1893).
Then, of course, you had the Progressive Movement, initiated by Republican Theodore Roosevelt. At the time, it was said that it was difficult to tell whether the most powerful man in the nation was Roosevelt, or JP Morgan, but of course, history went in favor of Roosevelt, he beat the oligarchy, created the middle class, and virtually invented government intervention in economics. All of these are, or course, "mistakes" the right and their corporate allies would love to redress.
Then we had the 1920s, not a much better result than the Guilded Age from total government de-regulation and anti-progressivism (which was sugar coated by being called the "return to normalcy"). Again, the wealth disparity grew until the average American had next to nothing while the affluent had everything, and the system limped along until finally it collapsed under the weight of its own corruption. Hoover's response was to say that it wasn't "governments place" to end the Depression (as if it matters WHO ends is!). That sure went over well, since the large masses of homeless and jobless accumulating in makeshift slum settlements became known as "Hoovervilles".
Then, of course, the New Deal came and put power back into the hands of the everyday man, and put public safety nets in place to prevent the kind of suffering that conservatives had subjected us to in the 1920s and early 30s. More importantly, the US economy was resurrected under the biggest government stimulus program in the history of civilization: World War II. After that, large taxes were put on the rich, organized labor gained power, wealth redistribution was at an all-time high... and it was a period of unprecedented economic boom and technological development.
Then, of course, some moderate troubles began to occur in the early 1970s, caused largely by the 1973 oil crisis, though things were still not as bad in the grand scheme of things as they could have been. The Government had paid off most of its WWII debt. Carter and Reagan were both faced with the issue, but plenty of resources were available to correct the US economics troubles that cropped up. Reagan took the big stab at it with what was, basically, a debt-funded stimulus, but this stimulus was... different.
First, Reagan didn't make any serious effort to address the actual causes of the economic problems. If anything, he dismantled any serious efforts in the US for energy independence and alternative energy (2 sides of the same coin), even though it would have probably spurred mass investment to try to push for developing those technologies. Secondly, he made no attempt to make his growth anything but short-term, by putting everything into tax cuts (and some serious defense spending) instead of investing in infrastructure or research (two areas that got it big from both the New Deal and WWII, and the subsequent decades). So he put forth an economic stimulus that tripled the national debt, and fizzled out after a very short time, and managed to crash the US savings rate... which leads into continuation of those policies from Bush Sr, and "it's the economy, Stupid", and Clinton's boom, and Bush's bust (culminating in 2008), and here we are.
Basically, history clearly shows that when we make an entire economic policy out of conservative ideas, when we do the things they want to do, two things happen: the economic middle sinks down into the poor, who are then subject to mass suffering, and the system ends in mass economic collapse. We implemented their ideas, in total, twice, and twice that was the result.
On the other hand, history also shows us that an economy based on an even distribution of wealth (whether intrinsic from high wages, or a redistribution), have more often than not, been far, far, far, far, far more successful than the conservative "utopia" economies of no government influence and no taxes.
Most importantly, by far, both history AND other nations teach us one point that should be central to all US economic policy: We DO NOT have to sacrifice the working class or the existence of a robust middle class, with the wealth distributed in a way such as to give the maximum number of people the maximum number of practical resources, in order to have a successful economy. We didn't in the past, and other nations don't now, and the economics results are both successful, and the setup that provides the best economic situation to the most people, ergo, it has shown itself to be the most pragmatic setup (though there are many smaller, more nuanced considerations that remain important within that broad paradigm).
I'm sorry, Twinbeam, but I just can't find any real substance to these particular arguments of yours, especially given the lack of substantive response to criticisms of your previous posts.
This is where adults would negotiate.
Tax increases for the rich, in exchange for modifications on civil servant influence and malpractice and things where conservatives have some legitimate (as opposed to utterly bogus) complaints.
But these are not adult times. a third of the nation listens to a man who screeches "you're a fatty!" at the first lady and rails at her for "demanding we eat bark and twigs" when all of science says to get up off the couch and add a little fruit to your diet.
I have not posted on Wisconsin doings for a week. It's good to let things settle out a bit for clarity. Its also good to have a life. But as I see it...
So far things have been fairly civil. For the best on the ground view I again suggest Ann Althouse
The central questions, and anwers as I see them.
1.Can Governor Walker limit the power of the public sector unions in this fashion? Yes.
2.Will it be an electoral debacle along the lines of the US House vote on healthcare reform? Perhaps, but probably not.
3.Are the protests helping or hurting the union cause? Mostly helping so far, but with a subtext. Any local elected officials watching the impressive and enthusiastic turnout will be thinking that a mini version of the same will be out in force if there is ever an effort, under existing collective bargaining, to impact union benefits. At some point it starts to make Walker's point.
4. Will it get out of control? And when? Probably not. But the red line seems to be Tues or Wed. At that point the bond refinancing falls through and the antics of the Democrats clearly become detrimental to the state as a whole while attempting to benefit a not especially disadvantaged subset of same.
5.Should you believe all you see and hear about this? No.
I look forward to the thoughts of contrary views. But as a favor to old Tacitus, when bringing the heat, why not identify what state or country you pay taxes in. Unlike most of you, this impacts my community directly. There are divergent ideas afoot, and I would like to see what your community is doing regards the general budgetary crisis.
Good to see you back. As per your request, I'm a Wisconsin native, attended college at UW-Madison for engineering, and moved to New Mexico to work on national security related projects. I have plenty of friends and family who are directly affected. Here are some of my objections:
1) The refusal of Walker to accept any compromise such as the Republican proposed sunset clause on the part of collective bargaining abilities, when most of the unions have already agreed to everything else. Walker could solve the budget problem today with that compromise. Unfortunately, he sees compromise as unnecessary. Perhaps in the short term he is correct, but he is a fool to think fortunes will not one day turn; they always do and sewage runs downhill both ways.
2) The issue of collective bargaining is partially framed in an inherently dishonest way. The benefits are not some "sweet deal" but deferred compensation considering public employees have a lower salary than their corresponding peers. Really, this should be sold as a pay cut. Note that the taxpayers are really on the hook if the state does poor management of the accounts, which it did, but it seems disingenuous to blame the other side.
3) Provisions that allow Walker to sell certain state facilities to anyone at any price with no oversight is just plain unconscionable and, quite frankly, such an anti-free market provision should disgust economic conservatives. Smells like the no bid contracts of the Iraq war that costed the US billions.
4) It destroys the ability of the public sector to compete for the best people. People like to think of public workers as admins and janitors, but there are plenty of positions requiring highly educated individuals: college professors, lawyers, etc. The market is competitive for these people, and there is no way for institutions to make exceptions to allow competition. Good luck for UW to recruit quality graduate students anymore: lower salary gets compensated with cheap health insurance.
5) This bill destroys a lot to dismantle the public sector's ability to influence policy, but does nothing to limit the ability of the private sector to do so, either positively or negatively. At this point, there is a suboptimal balance as these interests contrast. Failure to recognize that the private sector can use its weight to bring anti-competitive activities at the government level leads me to believe this bill is essentially one step forward, seven steps back in terms of government efficiency.
I await any response to my points.
The fake Koch Brother phone call lured Walker into making his aim clear. It is 100% political. He sees himself at war against enemies who deserve no negotiation and against whom any weapon is worth considering.
Hell I'll talk. But I'm not negotiating
The argument against taxes on rich people is that the government doesn't "do anything" for them, right? They've earned everything they have by their own bootstraps, and now that they've made it big, the rest of us want to take their money to use for the common good, but we have no right to make use of their private property. Right?
So to me, the solution becomes...when any private individual or corporation requires that the government act to protect THEIR private interests--propping up or toppling foreign leaders, threatening or shooting domestic protestors, or even protecting shipping lanes from Somali pirates, for example--the government should charge the appropriate number of Millions or BILLIONS in fees for service.
Otherwise, the uber-wealthy can protect their own g-d-ed interests, and leave the rest of us--the society they claim to be no part of--out of it.
In deference to T2's request, I state that I am speaking from a country which has a relatively intact economy (as long as China doesn't hit a wall) I have no business judging what goes down in Wisconsin.
It's a state issue.
Still, I will point out what I see, such as this Info graphic on the relationship between Scott Walker and some guys from Kansas.
The rest of you, butt out. It's a state issue.
Not avoiding ya, but two long posts have been eaten by the system. It seems to be knocking out things with html links.
I may let it rest and try tomorrow.
The truly sad thing is, Obama has proven himself time and time again not to be the intelligent and canny politician he had been painted to be in the elections. For instance, he could easily force the Republicans into repudiating their patron saint, Reagan, by offering to restore the taxation levels of the country to the point that they were at when Reagan left office in 1988. If the Republicans squeal and say "that is a tax increase!" he could have then said "Republicans have long stated that Reagan was a master of smaller government and less taxes. Yet when I offered to reset the tax system to what was offered under Reagan, they claim it's a tax increase. Does this mean they're saying Reagan increased taxes?"
All at once you will see a lot of backpedaling and squirming on the part of Republicans. They can try to claim it was the Democrats that did it at which point Obama could point out how good the economy was in 1988 and how the Middle Class was doing extremely well... and that they have suffered significant declines in the 23 years since Reagan has left office... working with Democrats to create an effective economy.
In short, he starts using Reagan as a weapon against Republicans. He uses him as the Patron Saint of cooperative government and every single time a Republican tries to filibuster something or refuses to negotiate? Obama could have stated how this is contrary to what Reagan would have wanted. And when Republicans try to turn on him he just points out that he offered to restore things to what Reagan had set things at when he worked cooperatively with Democrats to build the best military and best economy the nation has had in 50 years.
There are a lot of Democrats and Republicans with fond memories of Reagan. By forcing Republican politicians to either back down in honor of Reagan... or to turn on their patron saint of conservatism... he destroys one of their most potent weapons - the sense of "things were better back then."
He hasn't. He won't. And I must admit I am strongly tempted to vote Republican in 2012 if a decent Republican candidate comes out of the pack to get Obama out of office because he's proven he's not a leader. Instead, he's working to work within the constitutional boundaries of power as he sees it as a teacher of constitutional law. But Reagan and subsequent presidents have moved beyond that. They lead, they recommend legislation packages and then work with the House and Senate to get something similar hammered out.
I'm strongly disappointed with Obama. And this is despite my extreme strong aversion to what the Republican Party has become.
Rob, I appreciate your frustrations.
In Australia last year, we had the opposition leader Turnbull ousted for insisting his party support an emissions tradings scheme (because, crap as it was, it was the only thing rolling the ball along). Trouble is, the 'wrong' guy Tony ("climate change is a crock") Abbott got in by default. He promptly blocked ETS legislation, which caused Rudd to show true leadership by turning his back on the 'greatest moral issue of our time'. In turning his back, he got knifed by his deputy Julia Gillard, who has been variously depicted as a right wing stooge and sound bite mouthpiece. Having scraped through the last election by the narrowest of margins that would make a butterfly voter look like a heavyweight boxer, she has just launched into announcing that Australia will have a carbon 'tax' next year. This act of leadership has caused her to be called an outright liar and reneging on an election promise ('never, ever, ever' quoth he!).
So, interesting times wherein we are spoiled for choice!
Back to your woes, wasn't the GFC strategy/conspiracy to hand Obama a poisoned chalice? It's hardly surprising he's not achieving as much as was expected. (although it's worth rephrasing the question to 'what has he achieved?')
By all means choose a better leader from the Republican pack if you see one. I gather they're critically endangered.
"Not avoiding ya, but two long posts have been eaten by the system. It seems to be knocking out things with html links.
I may let it rest and try tomorrow.
Tacitus, that's apparently been happening a lot these past couple of days (yet somehow my silly rant made it through unabated, go figure).
As we all know, Blogger goes through periods of simply having fits and eating posts, and this seems to be one of them. As a suggestion for the future, I recommend that every single time you post, just as a matter of habit, you select all and copy the text of your post to the windows clipboard before actually hitting "Publish Your Comment"; it saves a lot of headache, as you can just then re-paste anything that gets swallowed by Blogger.
I will try without links
to your points
1.there is a sunset clause built into the system...future elections, and if Walker misjudges the wishes of the state he will suffer the usual consequences. We are likely to have a face saving measure by about Tuesday, and it seems little cost to either side to sunset the provisions against collective bargaining in two years. They could just as easily be extended then, should the citizens of WI so desire and indicate.
2.yes its a pay cut. auterity measures tend to cut things. And with the payroll/benefits making up about 80% of most local government's budgets there are few other places to make them. Benefits have a tendency to spiral out of control more than salaries.
As to mismanaged accounts, surely you do not mean union pension funds? Those are privately mismanaged.
3. I am trying to figure out the power plant issue. It is not straightforward. I would prefer a competitive bid but there are some people who are saying there might not be any bidders, as the value is nil due to envirnomental clean up issues. There was also something that seemed a little funny in the prior admin...a huge rush to convert them to biomass units. Maybe economically unviable in present state? The Koch bros have said they are not interested.
4.As a former business owner I can say that you have it backwards. We could never compete with gov. benefits! Our best hires had spouses with gov. jobs. I see your point on needing to keep top flight people. If the current system does not permit adjusting benefit packages to do so, then we have another thing that needs to change.
5. Your last point is important but too big to address in this format.
My links were going to point out that, as opposed to some shadowy support from the brothers Koch, the Wisconsin Ed. Assn outspent all other entities for lobbying last year. By a 2:1 margain.
And I had a nice compilation of 50 state fiscal status.
WI budget deficit 346 million, or 2.5% of FY 2009 operating fund.
New Mexico 454 million deficit 7.5% of FY 2009 operating fund.
California? too ugly to look at.
This sounds familiar:
The use of music therapy to assist in the rehabilitation of Gabrielle Gifford.
"Twinkle, twinkle little star..."
I will point out what I see, such as this Info graphic on the relationship between Scott Walker and some guys from Kansas.
The rest of you, butt out. It's a state issue.
Under different circumstances, I might agree, but isn't this graph of yours, in and of itself, compelling evidence that this ISN'T a state issue?
What's going on here is that a multi-billion dollar corporation from Kansas is coming in, and spending millions of dollars running ads and pulling strings to abolish union power in Wisconsin.
It would be one thing if this was simply a case of a Wisconsin governor getting electing on a platform of union-busting, and following through with ubiquitous popular support, but that seems far from the case, and as such, this seems like anything but an internal state affair, imho.
I must admit that I find it socially irresponsible that Republicans are so against taxing businesses and rich people that they will destroy the social contract that exists and eliminate safety nets while pushing through tax cuts and claiming they are necessary. From what I understand, the current problem in WI is due to tax cuts that the Republican Governor is unwilling to, oh, say, delay for a couple of years until the economy has allowed for stronger tax revenues. Instead, he wants to destroy the backbone of the civil service. First you destroy collective bargaining. Then you cut taxes. Then you claim that there is a massive shortfall and that massive layoffs has to occur. And then you repeat this until you start eliminating program after program.
At the very end, if our governor of WI had his way, public schools would be privatized, people would have to pay to send their children to school and would be mandated to do so, and police and fire departments would likewise be private mercenary groups that would protect government facilities in lieu of taxation but would require protection money from private citizens in order for them to be protected. Meanwhile, paychecks for government would be forced out of the people's paychecks.
I have no idea why Republicans have grown to feel government should not be doing anything for the people and should instead be doing everything for corporate entities which don't actually exist in a biological sense, don't even vote, and thus should not be given priority over people when it comes to services and benefits. It's insanity. And it's worse, insanity that is infecting Democrats as well.
Meanwhile, I must remember that irony is not something that translates well to inflammatory media like internet fora.
My apologies, Tony, I've had a very long day at work, so I'm not the sharpest tool in the shed right now (my brain... and legs, feel like oatmeal right now) :D
Yes, according to Robert Lang's WI state analysis of the situation, the primary causes of WI's budget shortfalls are as follows:
1.) Governor Walker's large-scale tax breaks reducing revenue
2.) The end of a tax arrangement with Minnesota that leaves WI owing them money
3.) A state judge ordering the WI state government to re-pay funds it had raided earlier from a medical mal-practice fund
The document is here:
A groundswell boycott campaign is directed against the infamous Koch brothers. Making it simple, the recommendation is simply to look at your PAPER PRODUCTS (like Dixie, Northern, Brawny etc) and see if there is a GEORGIA PACIFIC logo anywhere. If you see that logo, well, considere where your money will go.
Want evidence this is necessary?
“Governor Walker's union-busting budget plan contains a clause that went nearly un-noticed. This clause would allow the sale of publicly owned utility plants in Wisconsin to private parties (specifically, Koch Industries) at any price, no matter how low, without a public bidding process.
"The Koch's have helped to fuel the unrest in Wisconsin and the drive behind the bill to eliminate the collective bargaining power of unions in a bid to gain a monopoly over the state's power supplies.”
And on an unrelated note, here's a rather interesting article concerning daydreaming and creativity. Here's a paragraph from the article: [t]he way I see it, it's not distractibility, per se, that is the most relevant thing for creativity. Instead, I think the key is to keep your wonder and excitement for the world, being open to everything in the environment as well as your own internal stream of consciousness. I think putting things in these terms allows for more useful practical applications.
Non-linked URL since the damn Blogger is being a #&(%ing pain in the ass again, and I've no idea why Dr. Brin doesn't switch over to WordPress seeing we've complained of this problem a multiple number of times....
Sadly, there's a point where you can be too easily distracted. It's difficult to get things completed when you let things pull your attention away time and time again. ^^;;
Thank you for the response.
1) Yes, laws can always be undone by the next administration. Democracy, however, does not only occur on election day. Further, I'm not convinced the consequences will be easily reversible. If union membership declines or good people leave, I don't see that spontaneously repairing itself.
On another divisive issue, I was at UW for the amendment to the WI Constitution that forbids the state from granting benefits to domestic partners. The impact I saw: some professors up and left, taking millions of dollars to other institutions. If we reversed that tomorrow, it would not bring that money back.
2) I largely agree with your response; my issue is with how it's being sold. All I'm saying is call it what it is: a pay cut for public employees rather than the current framing that somehow public employees have it so much better than their private counterparts.
3) If a power is granted, you can count on it being abused at some point, even if not by the current admin. If there are no bids, then I'm fine with the state doing what is necessary to cut its losses; however, there should at least be a defined period of time where bidding should be open.
4) Agree most privates industries cannot compete with benefits unless they're large corporations. it's great if you can get the best of both worlds by having a spouse, but not an option for everyone. If you are single and have a choice between private or public, you pick either a higher salary with less benefits or a lower salary with better benefits.
Now you just get a lower salary with about the same benefits. Why would anyone work in the public sector if they can do better in private industry? Do we want good teachers or not? Do we want effective police and firefighters? I suppose some want everything privatized, but I don't see that as a positive. Look, I'm a capitalist and understand if the best people look elsewhere. All I'm saying is that if you want good people, you have to pay somehow.
I think most people agree that this bill is not perfect. Reality is we have until June to pass a budget in WI. If we need to do something now, it can be small and on things most agree with, like requiring public employees pay more. For the remainder, we have time to debate and fix issues despite the false urgency Walker is trying to instill.
If the Union must say goodbye to Wisconsin and Indiana and see them joining the Confederacy... and we get Virginia and North Carolina - vibrant and rising - in exchange?
Well I'll live. So long as the internet still lets us talk to Tacitus and BCRion
Dr Brin, I live in North Carolina, and while I've only been here for three years, I can tell you that it's rapidly becoming astoundingly progressive (in fact, Charlotte just elected a Democratic mayor just recently).
Now, there are still a lot of conservative people here. Basically, the reason it averages out in favor of progressives is because the population is relatively centered on large, metropolitan areas, and these are also the centers of education in the state, so the state has had a massive influx of people looking for both education and jobs in the cities here, especially from up north (I lived in NH for ~15 years previously, for example).
While most of the rural areas are still very conservative, and frankly, downright cut off from the rest of the world in many places, these cities, especially Charlotte (and to a lesser extent, places like Raleigh and Asheville, which both also have Democratic mayors now, incidentally), have really come to be the places that define this state, politically, again, because they are the population centers.
Basically, the state is no longer occupied primarily by US Southeasterners, because the population has grown this past decade primarily from a very diverse (and often progressive group). Even a lot of Europeans seem to be popping up (British accents are surprisingly common here; my last polysci prof was even British).
In short, NC seems to be getting more and more progressive, and I don't see that trend ever reversing itself, mostly because this part of the South is now having exposure to diverse ways of thinking, which are causing a lot of shakeup of long-ingrained ideas in this region.
Frankly, I think it's good to see.
That is why Obama chose Charlotte for the 2012 Dem convention. A savvy move.
Not touching the Walker/Union issue. But I am curious what the public response is in-state (both polls and gut-feel.)
"Obama ... could easily force the Republicans into repudiating their patron saint, Reagan, by offering to restore the taxation levels of the country to the point that they were at when Reagan left office in 1988..."
You assume that a) The Republicans would stand still while being set-up, and b) Obama would even be heard by voters when he says "But Reagan did it!"
The reality is that he'd be setting himself up for a 2012 campaign of endless "Obama called for massive tax increases! Obama wants to raise your taxes!"
And Obama saying, "Well, yes, but I was trying to be clever..." isn't going to get much traction in return.
Let's be honest, the Democrats collectively failed when they spent two years not passing the legislation they passed in the few weeks after losing the mid-terms. They lost all momentum after Obama's win, showing them to be unworthy of government, so then when they did pass the legislation it merely reinforced their aura of cowardice.
They had an overwhelming mandate for reform, and they failed. No trick can now make the public hear their claims of Republican hypocrisy, it will just reinforce the idea that Democrats can't be trusted.
(As usual, I qualify this by noting the half-a-planet lying between these events and myself.)
"Unfortunately (or maybe fortunately, depends on how you look at it), the problem with a robotic soldier, imo, has always been that what you've managed to create is a $3 million ground pounder that's an absolutely ripe target for a $50 RPG round. There's just no way that can ever be cost-effective, not when humans breed so quickly and are more than willing to take up a fight at something like a thousand bucks a pop."
An infantryman costs fan more than $1,000.
Figure medical, living and educational expenses plus basic training plus any specialised training and we're talking hundreds of thousands to millions of dollars.
The prototype robot soldier will cost more than that, the 100,000th production model will probably cost far less.
"I look forward to the thoughts of contrary views. But as a favor to old Tacitus, when bringing the heat, why not identify what state or country you pay taxes in. Unlike most of you, this impacts my community directly. There are divergent ideas afoot, and I would like to see what your community is doing regards the general budgetary crisis."
What general budget crisis?
Australia may be forced to push the return to a budget surplus back to 2013 from 2012 as a result of thr catastrophic floods here in Queensland.
But a few years back, when we were recording massive surpluses, a right-wing Australian government, rather than giving massive tax cuts to the top 2% of the population decided to bank the surpluses and invest the cash.
"the problem with a robotic soldier ... a $3 million ground pounder that's an absolutely ripe target for a $50 RPG round."
The same is true of most mil hardware. Gunships, tanks, etc.
(Likewise, $10b (B-for-Billion) for each next-gen aircraft carrier, vs. say $10m for a next-gen anti-ship cruise missile.)
"Now if DARPA wants to make an exoskeleton"
They're doing that too. Also autonomous swarm-bots.
"(or scale up the cat and make God only knows what :O) "
I don't care what they call it as long as it breaks into five parts that look like ordinary vehicles, each a different colour.
"it'll just end up just being a $300 million target for $50 RPG rounds,"
a) DARPA & Friends are also working on a ballistic RPG shield. A gun that detects and kills incoming RPGs mid-air.
b) Existing wheeled/tracked 'bots are apparently better shots than humans. Sniper accuracy with standard SAWs.
c) A field-ready soldier-bot may be able to detect and shoot down incoming RPGs.
And if that doesn't
"scare the living $^%# out of everything that encounters it"
I don't know what would.
(phileias: The City of Brotherly Fogg.)
Said right-wing government then proceeded to present a $37 billion tax re-structure as a cash rebate, rather than invest it in infrastructure. (There was an election on: the timing of this windfall struck me as 'fortuitous')
Anyway, Ian, I think you're comparing apples with oranges. Americans are in dire straits and we think we dodged a bullet. I don't think there's any point in rubbing it in.
An interesting comment on the Wisconsin situation here:
Some of the denizens of Jefferson City might be sympathetic to Governor Walker and endeavor to make Missouri more miserable, so I feel like I may have a dog in this fight.
Ian and Tony
I added the "or country" clause specifically to hear what the experience of other countries was. Does Australia handle entitlements and health care expenses in a completely different manner?
We have the occasional comment from Italy and eventually someone from Greece will wander into the Postman Saloon.
If nothing else the assertiveness of Walker and his ilk is moving the goalposts a bit....six weeks ago you would be unlikely to find public comment by union members and progressives to the effect that benefits needed to be trimmed.
There is a push and pull to politics that hopefully ends in a middle ground, although getting there can be difficult. Nobody likes being pushed or pulled.*
*in my attempt to reduce the perception of snark I have with difficulty avoided reference to the conservative, nay, reactionary nature of the protests....how resistant to change they are! At this point in history the Progressives become regressives and do not appear to be offering new ideas! T2
"But a few years back, when we were recording massive surpluses, a right-wing Australian government, rather than giving massive tax cuts to the top 2% of the population decided to bank the surpluses and invest the cash."
Either would have been anti-inflationary. Giving more money to the rich effectively takes it out of circulation, slowing the economy, reducing job growth, etc. Good tactic during a boom. Paying down debt and disproportionately taxing small business would do the same thing.
Of course, all four are bad tactics during a stalled economy with high-unemployment, such as in the US.
Dr Brin, I live in North Carolina, and while I've only been here for three years, I can tell you that it's rapidly becoming astoundingly progressive (in fact, Charlotte just elected a Democratic mayor just recently).
I well remember the election returns beginning to roll in from the East Coast on Nov 4, 2008. At that time, I was by no means certain that Barack Hussein Obama would be our next President. Pennsylvania was very much in doubt, and despite exciting polling indicating Virgina would go blue, the early returns were going for McCain.
Then, North Carolina was called for Obama! It hadn't even occured to me that that state was in play, nor had I known that it has MORE electoral votes than Virginia does.
Perhaps it was all over when Pennsylvania, Florida, and Indiana (Indiana!) went for Obama, but it all begain when North Carolina did.
The sad thing is, Walker claims he's doing what the majority of the people want. So then, where is the massive counter-demonstration stating that what Walker is doing is what they want? We have a bunch of anonymous bloggers posting "go Walker!" on news sites, but we already know those are paid shills who create dozens of accounts to pad their online appearances, a trick learned by countless internet trolls and attention-seekers over the last couple decades.
So we have on one hand a massive demonstration of people stating they want their right of collective bargaining but are willing to give on everything else. On the other hand we have a couple small (and I mean only a couple hundred or a thousand people) counter-demonstrations and a significant online presence that can likely be attributed to the paid work of a few dozen individuals.
Walker claims he's doing what the majority elected him for. What he is doing is trying to kill the Unions. And he's also waking up the Progressives. Be sure that next midterm election, Democrats will be giving warnings to people to vote because if they don't, conservatives will get into office and pull another Walker. I mean, what's next? Cutting the minimum wage? Cutting corporate taxes and then eliminating social programs to "pay" for the corporate largess?
We're seeing what could either be the death of American Democracy... or a resurgence of it. Because the situation with Walker is showing one important thing: you need to vote lest you allow monsters to get into public office. And currently... Republicans are the Greater of Two Evils.
Outside of Obama, that is. ;)
And I must admit I am strongly tempted to vote Republican in 2012 if a decent Republican candidate comes out of the pack to get Obama out of office because he's proven he's not a leader.
I feel your pain. Really. But...
Given a choice between Democrats you don't like and Republicans you don't like, keep this in mind.
Despite right-wing rhetoric, Democrats are incapable of forcing an agenda upon an unwilling public. They coudn't get relatively-POPULAR measures passed with the White House, the House and 60 Senators on their side.
Republicans, on the other hand are insatiable enough when they're in the minority (see what 41 Senators were able to accomplish), and positively arrogant about wielding power when they actually have it (see Wisconsin).
Give office to disappointing Democrats, and they're not likely to actually do any harm that can't immediately be un-done. Give office to disappointing Republicans, and you're likely to wonder where your country went by next Tuesday.
And another link for Dr. Brin, gathered from the Livejournal of fantasy author Martha Wells (who wrote the gaslamp fantasy "Death of the Necromancer," which includes a Moriarty-style character as the protagonist who puts his plots on hold to deal with a greater threat to the entire region): a link to an overview of International Science Fiction and Fantasy literature.
(I'm truly hating Blogger these days. Just want to say.)
I think many of the protesters understand that reform in the current system is necessary; going back to effectively gilded age policies and unraveling a century's worth of labor reforms is not one of them. Evidence for this is the democrats have already agreed with the increase in contributions. I see Walker's proposals as a LOT more regressive than anything the protesters are supporting.
I have no problem with Walker moving the discussion along; however, it is quite clear that he will accept no compromise, period. He's already solved the budget problem, but that's not enough for him.
In fact, this last part has cost him considerable conservative/libertarian support in WI. The conservative paper in Madison's editorial page has become much more harsh on Walker in the last week, even going so far as to dub him "Generalissimo Walker", after two weeks of largely supportive coverage.
I have conservative leaning friends who are becoming less supportive of Walker's proposal. Reasons they cite are failure to compromise after the stated problem is effectively solved, no bid contracts, the decimation of the UW system, and his dishonesty revealed by the infamous phone call incident.
My take is Walker will win the battle, but he will probably lose the war. This fight has cost him much political capital among independents and even some conservatives. Of course, the next election cycle is an eternity away in political time scales, so that is anyone's guess.
Thx for the vox-pop. Is the opinion of Walker likely to swing if he gets a "Win"? In local politics, I've noticed that even an unpopular policy can give the party leader a bump in popularity because the other side folded.
"Does Australia handle entitlements and health care expenses in a completely different manner?"
I assume you know we've got socialist healthcare? An estimate was that it costs us about half as much for equivalent healthcare as the US.
Administratively, it probably makes hiring labour cheaper (for both governments and business.) You're not buying health-insurance in addition to wages.
(There are moves afoot to "nationalise" workers compensation too.)
Other entitlements are pretty much the same I think (not having equal experience of both systems), except we will generally have a broader/simpler version (which I suspect lowers the cost.)
(cocco: Oh Blogger, I can't stay mad at you.)
Hard to say what the impact of the law passing, other than in vague terms, will be. I suspect a lot will depend upon Walker's future actions. The souring of some of the conservative editorial boards may have an impact as they may be less inclined to throw full support behind the governor in the future, and opinions can be shaped by what material we read.
Beyond that, this bill touches just about everyone in the state, if indirectly, because most people at least know someone who works in the public sector personally. Considering the impacts on those people are material and significant, it is unlikely that this will simply vanish as an issue altogether.
Will it be enough to cause Walker trouble in the future? That's anyone's guess.
Enough to poison the issue for other Red states?
(raphol: An organic compound containing twelve carbon chains, an -OH group, and a self-portrait.)
Hmm, interesting points to discuss on robots. Where to begin...
"The same is true of most mil hardware. Gunships, tanks, etc.
(Likewise, $10b (B-for-Billion) for each next-gen aircraft carrier, vs. say $10m for a next-gen anti-ship cruise missile.)"
Yes, but these are all things that are very few in number, and are well-guarded. A tank, all by itself, is nothing but a sitting duck in many situations. It's one thing to have one in an open field, where it can move quickly and see its surroundings, but they're extremely vulnerable in any kind of remotely urban situation. The reason tanks do survive those kinds of engagements is because you make sure that each and every one has a number of infantry guarding it. Nations have learned the hard way about that kind of infantry support for tanks.
For aircraft carriers, it's EVEN MORE ridiculous how well protected they are. Do you remember the carrier-busting scene in The Sum of All Fears? That would never, ever happen. Why? Because even if that number of missiles could make it past the carrier's own CIWS guns (and it would take a lot), they have an entire battle-group of supporting ships, multiplying that defense by many times. It would take a pretty serious air force to even summon the number of aircraft and missiles needed to get through all that, and if the carrier group honestly had anything close to that coming toward it, it could also scramble fighters, as something like that would both be blatantly hostile, and would probably stick out like a soar thumb on radar.
All of these things more or less defeat the point on a human-sized robot, since the point is to replace or supplement humans, not be guareded by them at a 10:1 ratio. I'm not saying mechanized gear like that is a waste of time, FAR from it. I honestly wouldn't be surprised if we started taking a page out of the Battletech universe with some of the smaller equipment down the road (again, larger exoskeletons and small, mobile mechs), but those can do things beyond what a human-sized package can do, so they buy you something for the expense and risk of loss.
"Terminators" don't really do that for you. Sure, they might have advantages over humans, though it's worth nothing they'd have many disadvantages too. They'd have really limited run-time, even with absurdly good battery technology (that gets better as you scale things up; eventually you'd be able to run them on something like a small polywell fusion reactor). They also lack flexibility there. A human needs sleep, yes, but they can put that off. A human can stay awake for several days if needed (though that's pushing it), instead of the normal ~16 hours or so, but a robot? Once its power is up, it can't "put off sleep"; it becomes a paperweight, and forget hauling around spares on the huge batteries (because then you could just ferry in more human soldiers... and again, a human doesn't operate that rigidly anyways). They'd also need absurdly powerful computers, and you'd have to keep those cool, making desert warfare a NIGHTMARE for them. They'd also be very detectable compared to a simple human, which only gives off heat (and technology to mask that wouldn't be super-difficult, unlike the EM signature of a big robot).
Honestly, like I said, I think the technology is going to go very far. Really, again, the cat is really what you should be keeping an eye on. A feline is vastly better designed, physically, than a human (or any other terrestrial animal for that matter...), so take one and mount some scary weapons on it and you have a downright frightening weapon platform.
I just think that this technology is going to be best with the proper scale. I think we need to think in terms of size being scaled up and numbers down, vs human-sized soldiers, who already exist in our citizenry hundreds of millions at a time (no need to make extra hardware).
"An infantryman costs fan more than $1,000.
Figure medical, living and educational expenses plus basic training plus any specialised training and we're talking hundreds of thousands to millions of dollars.
The prototype robot soldier will cost more than that, the 100,000th production model will probably cost far less."
The robot will never be cheap, period. Millions of dollars IS the high-volume production cost.
Remember, you're starting with a computer with nothing less that the equivalent of today's most powerful desktops, and that's just the bare minimum. That would power an AI sophisticated enough to be able to engage an enemy, though not sophisticated enough to be able to demonstrate any kind of judgement.
You'd also need to water-proof the entire package. Then we're talking about a chassis itself that's just horrendounsly complex, and probably made of enormously expensive materials to keep weight down.
You'd not only need to house that computer, but you'd need to cool it in the worst of conditions, as with the rest of the robot (and it would put out a frak ton of heat). That's an expensive cooling solution. Then you'd have to power it all, and that's a really high-capacity battery. That's all very, very expensive. You'd need a very sophisticated sensor package; that's more cost.
We're talking about something that probably rivals a fighter jet in complexity.
So what about the sustained costs of a soldier vs a robot?
Even the most sophisticated lithium air battery would be lucky to give you an hour of power with one of these things. Even if you could make that many times better (unlikely, for the moment), that's a lot of VERY expensive logistics swapping those. Humans just need food and water, and food to power a human for days can be kept in a tiny package weighing only a few pounds, and water can be drawn from the environment, at worst, with a 1 ounce protable pump/filter. Ilithi Dragon and I are about to do just that on a 3-day backpacking trip; something a robot could only DREAM of for autonomy.
Also, humans might be expensive medically, but our maintenance costs are basically zero, because we self-repair normal wear and tear. A robot would be a nightmare, on the other hand. would get just as expensive, immediately, from normal wear and tear. I can't think of a single combat environment that would be kind to them, from grinding sand of deserts, to caked in muck from forests, jungles and swamps. You'd even have the wear and tear on them every time they fired a weapon. With something that complex? You'd be lucky of they stood up to a year of deployment before it was just cheaper to field another, imo.
In a major fight, like WWII, each dead robot costs more than a dead soldier. In a nasty, long guerrilla fight like Vietnam, each robot takes wear and tear faster than a human. In a long occupation, like Iraq, each robot (who is less cognizant and capable of good judgement) becomes a logistical nightmare compared to a human.
Mechanized tech is a great idea, but I have no fear of terminators EVER becoming practical. They only became practical IN Terminator because the machines took over what was left of global infrastructure, and we efficient, meagerly-needy humand STILL beat them, with basically nothing.
That's assuming you go with a humanform humansize robot. If you're able to build a smaller-scale unit, then you could have a unit with a limited number of shots... but with greater accuracy and due to its smaller size greater stealth. A dozen robotic canines going down a street could eliminate every single hostile there very likely escape with minimal damage.
What's more, cover becomes far less effective. If accuracy is significantly improved, then peeking out of cover means you get targeted and shot. Trying to use things like mirrors and the like to look for you? If the robot has IR sensors and the like, it might very well know there's a half dozen lifeforms behind that wall and just fire a RPG at it to take out the entire wall.
You build these things with modular parts, repairs become far easier as well. You just switch out the damaged section for a functional one and the robot is ready to go once more.
Terminators are silly things. You use smaller robotic forms which use less power, chemical-based weapons so that weapon systems don't use energy, and modular systems for ease of repair, and you suddenly have a far greater threat.
(Though to be honest, the Terminators were designed for psychological reasons, and because Skynet was trying to infiltrate regions (thus the rubber and flesh-covered versions.)
Random subject change...
Elsewhere on teh web, someone suggested changing US electoral law to require a "quorum" of voters in order for an election to be valid. He (she/it) suggested setting it at 40% turn-out.
Do you think that would change US politics?
In Australia, we have "compulsory voting." Due to ballot secrecy, it effectively means "mandatory turning up." Turnout in state and federal elections rarely falls below 90%. (Council elections are voluntary, and we don't vote for judges or dog-catchers.)
(Constitutionally, we also have a "quorum" rule, set at two thirds.)
Anyway, I know that our right-wing party has long opposed "compulsory voting", while the centre-left party supports it. This implies (assuming the parties have selfish motives (oh vile cynic me)) that right-leaning people vote more readily than left-leaning ones.
So does voluntary (hell actively discouraged) voting in the US result in a more right-wing political pool?
While I have no idea of the practicality of a humanoid robot soldier (vs. a human), I would point out the sheer number of robots being deployed in Afghanistan. The intent is to have them as the first line of defence in place of humans, to be the first through the door.
Soldiers don't live off the land. All water is trucked in. (At considerable risk/cost apparently.) Moreso, modern soldiers do not spend much time on foot. Infantry are mobile infantry. Special forces helicopter in and out. The only exception I can think of is the SAS (oh and guerrillas of course.)
UAVs aside, all 'bots currently in the field have those limits, and yet they are increasingly used.
That said, I'd like the "terminator" to have a small diesel generator. Purely for the diesel-punk aesthetic.
More seriously, I would expect humanoid soldier-bots to be used a bit like UAVs. They are delivered to an area, move forward, find a perch, cover and observe (on minimal power). If something walks into sensor-range, they radio-query homebase for kill/no-kill or "spot" for an air-strike.
Ie, the humanoid-ness is purely terrain adaptation to get into position. 99% of their life is spent on their arse, behind cover.
Re: Scaling up.
You just want to own an army-surplus Mech. :)
I love the look of battle-bots/mechs/etc, but I suspect they are vastly less practical than a regular tank/APV/humvee/etc. In spite of what Japanese anime tries to tell me.
Re: Powered exo-skeleton.
These are mostly being built for lifting, with an possible eye on range extension walkers. They aren't intended to hold multiple cannons, rocket-batteries, etc. :) I think that in practice, even the range-extenders would be dropped when the soldier takes cover.
I did see an exo-skeleton built for support guys to lift equipment (like loading missiles onto jets). It had the look of an early small-scale version of the Aliens "Loader". So there's hope yet. :)
"Mechanized tech is a great idea, but I have no fear of terminators EVER becoming practical."
No. AI will not switch to kill-all-humans mode. The greatest danger of kill-bots is a trigger solinoid jamming "On". (Apparently has already happened.)
5am, bedtime for Paul. You can have your thread back...
"$10b for next-gen aircraft carrier, vs. say $10m for a next-gen anti-ship cruise missile."
"For aircraft carriers, [...] Because even if that number of missiles could make it past the carrier's own CIWS guns (and it would take a lot) [...] It would take a pretty serious air force to even summon the number of aircraft and missiles needed to get through all that, and [...] something like that would both be blatantly hostile, and would probably stick out like a soar thumb on radar."
Well, yes, sinking a US aircraft carrier may just be a little "hostile". :)
Re: CIWS. That's how the new RPG-shield is intended to work. (Except one-shot one-kill.)
But I remembered afterwards, the Chinese are developing a stealthed cruise missile. (Well, they showed a model at an airshow...) Assume high-end manoeuvrability, active ECMs, ~2000km range, etc.
If it is $10m per missile (probably on the high-side) and $10b per carrier (apparently on the low side), you can buy 1000 missiles for the price of one carrier. How many rounds in a CIWS system? And that's assuming the CIWS can even "see" it.
Asymmetrical tech like that is apparently scaring DoD strategists. During WWII, everyone built battleships, but no one was willing to actually send them into harms way. Carriers, OTOH, could "force project" hundreds of miles. Battleships could only fire 5-10 miles. WWII battleships were the final perfection of a technology intended for the wrong war.
The Chinese apparently see US aircraft carriers in that role in the next war. (Or rather the threat alone allowing China more freedom to use force against regional rivals without US interference.)
(All of which goes against my original argument, BTW, and supports yours. A $50 RPG beats a $3m robot.)
Didn't read the comments, so apologies if I'm repeating.
This passage gave me a little cognitive dissonance:
"I especially like one of Penn's aphorisms: "Always look for the solution that's for more freedom." I say something almost identical in The Transparent Society. Alas, in the info age, people point to problems and all-too often suggest solving them with LESS information flow. "
I agree with this sentiment, but it doesn't line up with your positions on Prohibition (aka the Drug War). I've seen you line up time and time again with the sado-moralists on this issue, which is most certainly the lesser solution in terms of individual freedom (this is not even touching on the violence and corruption which always accompanies Prohibition). Interestingly, this version of Prohibition has an information flow -- unfortunately it is one of emotional manipulation and propaganda.
In short, Freedom is much more than just the free flow of information -- it's also about the freedom to control one's body without interference from the State (among many other issues).
I'd like to see some "thought experiments" performed by economists in reductio ad absurdum styles. Such as "What if we ended all payroll taxes and funded the Federal government with taxes on coprporations and capital gains only?" Or, "What if we funded the entire Federal government with import duties ONLY?"
Not that I'm pushing for either, but the models would be very interesting.
There is some virtue to smaller robots, to a point, not just for the reasons you outline, but also because smaller things like that are intrinsically sturdier.
This goes to the old point of why King Kong would break his leg if he tried to take a step. As volume increases, the cross-section size of structural features (like bones) only square, while overall size cubes, meaning that mass outruns the structures built to support it. This also works backward, however, when you make things smaller.
That said, you'd also be sacrificing armor, and you REALLY want to protect something that sophisticated.
RE: modularity- this would help, but remember, today's machines are modular and yet logistics costs from operating in desert nations have still proved huge. There's a lot of real internal stuff that you can only protect so much, and even replacing an external part, like an arm, is probably going to cost hundreds of thousands of dollars.
RE: sensors- Humans only emit one form of radiation, and that's IR. The only works under certain circumstances, however. If it's daytime in Iraq, and the air temperature and any given object is 105F, trying to spot humans by IR will be a fruitless exercise. In colder environments, it would probably be possible to simply shield those emissions making us effectively invisible except to optics (remember, we're already talking about a future with pretty advanced stuff here). No matter what, a robot will always be vastly easier to detect as a giant hunk of metal than a human will be to a robot.
Humans also don't have to "pop up" right where a robot is looking. Tactics would evolve to suit the combat.
Now, I think today's soldiers would be subject to absolute shock and awe by such technology, but it's not without the possibility for VERY effective counters, like anything (will address that more next).
Hmm, blogger seemed to eat one of my posts on the whole mechanized soldier topic :(
I'll discuss it later when I get back from class
"glarbi" said: "I agree with this sentiment, but it doesn't line up with your positions on Prohibition (aka the Drug War). I've seen you line up time and time again with the sado-moralists on this issue..."
This is one of the most absurd things I have read in years. I voted for repeal in California and have spoken against theDrug War... probably... since before you were born. Try looking up the drug that you clearly are high on. The one that makes people leap to conclusions like the one that you just slandered me with:
Get help for this addiction.
Larry said "Give office to disappointing Democrats, and they're not likely to actually do any harm that can't immediately be un-done. Give office to disappointing Republicans, and you're likely to wonder where your country went by next Tuesday."
The dems act more as a herd of cats - operating largely as individuals. The GOP at present is the most tightly disciplined party machine in US history.
There are no "mavericks." Whatsoever. Not even the Paul father & son. Their agenda is pure and adamant. And if you think you are voting for a republican "maverick" just look at who surrounds him.
"...I have no idea why Republicans have grown to feel government should not be doing anything for the people and should instead be doing everything for corporate entities which don't actually exist in a biological sense, ..."
Because humanity is no longer the only form of intelligent life on this planet.
The corporate form (...and in this, you may include unions and religious orders if you please...) has assumed the relationship to humanity that humanity has to eukaryotes. Those who kick against the corporate form don't succeed within their party, whether they are Ron Paul or Dennis Kucinich.
This is not a "false equivalence" argument ( I recognize significant differences between the parties ) nor to ignore individual bad actors, such as the carbon barons and sheikhs. But the environment that permits carbon barons to run a political party seems resistant to reform because if fights back to preserve itself with great intelligence.
It's just not life as we know it, Jim.
Earlier I had tried commenting on the rise of micronews channels in following contemporary events. While corporate media focussed on the Oscars, kids with iPhones were broadcasting from inside the Wisconsin Capitol and anyone can set up their own Youtube News channel such as this one. Perhaps these are the neuronic connections that may let humanity control the corporate form of life, sort of like an anime' hero in the head of a giant fighting robot. Otherwise, we're toast.
Cyber warfare ramps up a few notches (on both sides: it's a cool war.).
Does anyone have any thoughts about how to deal with sockbot armies?
exalambl (NZ sheep census!)
"Ian and Tony
I added the "or country" clause specifically to hear what the experience of other countries was. Does Australia handle entitlements and health care expenses in a completely different manner?"
Australia's heathcare is funded by a mix of taxes and private inusrance premiums (which are heavily subsidized throguh the tax system).
Roughly 2/3's of Australians rely on the state system with 1/3 holding private inusrance.
Importantly, the perovision of medical services is competitive. Unlike the UK or Canada where rthe government is the main or soel provider of medical services, in Australia state-owned not-for-profit and private hospitals compete for a piece of the government pie, either by tendering to provide a specified number of medical services or competing in convincing GPs to refer patients to them.
There are problems, especially in regional areas and in some public hospitals but overall the system works well.
Our welfare system is generally far more generous than the US - there's no time limit on unemployment benefits and they aren't tied to previous contributions into the system.
We're actually further ahead than many western coutnries in coping with the economic consequences of an ageing population. There's a universal means-tested age pension but for the past 20-odd years we've been setting up a system of mandatory private retirement investment (superannuation).
Employers pay mandatory contributions into savings accounts which are roughly equivalent to 401(K)s - except you can't access them early even if you pay a tax penalty.
Rumor has it the US already has robot soldiers.
Allegedly, some units in Iraq and Afghanistan have rigged packbots with grenade launchers and other offensive weapons.
Packbots currently cost around $120,000.
There's a Sniper Detection variant of the packbot that locates the exact origin point of incoming gunfire.
So a semi-autonomous robot soldier isn't that far off.
"Basically, the state is no longer occupied primarily by US Southeasterners, because the population has grown this past decade primarily from a very diverse (and often progressive group). Even a lot of Europeans seem to be popping up (British accents are surprisingly common here; my last polysci prof was even British)."
It's worth noting that the demographic shift to the US south has, so far, tended to advantage Republicans because they retained majority support and the rising population increased their Congressional and electoral college representation.
But as the number of northerners and Latinos continues ot icnrease, that Republican majority is goign to be increasingly endangered.
brin from Palo Alto:
robots in the air are valuable enough to be worthe the $. Also under the sea.
On land, expect to see some like Big Dog!
Just to clarify, the humanoid robot I linked to, way back there, is not a soldier-bot. It's intended to be used as a human-form endurance tester for equipment, such as chem-suits. A lab tool.
But it's interesting to speculate whether humans are the ideal form-factor for overland soldiers. Or four-legger animal-analogues, or wheeled or tracked vehicles. (Or giant two-legged, long-tailed, theropod dino-bots with chainguns for arms. :)
I thought we could take a brief break from the politic-talk and look at some space science-based news: The Permanent Multipurpose Module is being attached to the International Space Station, giving astronauts a place to put their laundry and change in privacy. Well, okay, it's for supplies and the like. Still, they need a changing room as well, true? ;) Also, the central command post located inthe seven-window cupola stopped functioning at the end of the Monday space-walk. I'm not quire sure if this is a common occurrence or what, but they do have backup systems apparently.
Also, here's a couple of stories on the use of space tourism suborbital flights to perform science experiments; it seems that at $200,000 a pop, it's significantly less expensive than going up on the Shuttle. We can expect Fox News to start going on about scientists wasting tax-payer dollars for space tourism instead of science any minute now.
And heading back into Politics (kind of), here's another article concerning the repercussions of Walker's attempts to break the Unions, including the fact it will lead to a more significant brain-drain and will ultimately be quite damaging to the economy. Though I'm sure conservative commentators will claim otherwise. One theme that Dr. Brin will notice is "the destruction of the middle class." It also points out that Democrats share the blame for the downward trend up to Walker's ascension to power.
(fixed a broken URL)
Democracy on the surface, oligarchy to the core:
2G Spectrum Scam
The Raja-Radia Tapes
Four transcripts that were submitted to the SC along with audio recordings in May 2009 covering the cabinet formation, DMK politics and who'd get telecom portfolio
We have not edited or changed the style or spellings used in the transcripts submitted to court. Please allow a few seconds to elapse before the recordings begin.
Attempt #13. direct URL link removed to see if that's causing the issue.
And on a tech-related note, here's an interesting article suggesting the iPad may become an iWannabe. Due to the limitations inherent with the iPad and the lack of free software for it, the iPad suffers from many of the limitations of netbook computers... and in some ways is even more limited.
Personally, I think the future of tablet computers is similar to one rather innovative design from a non-Apple company: the tablet could be attached to a laptop computer housing to become the monitor to a fully-functional laptop. While this hybrid system had all of the hardware for a tablet computer in the removable monitor, the laptop housing had added hardware that took over when attached, thus eliminating the one primary weakness of tablets.
The problem with this system is, of course, cost. At a bare minimum you're going to see this sort of system cost $1,500, if not $2,000 or more. But the versatility of such a system gives it decided advantages over both the iPad and other tablets, and over all but the lightest-weight laptops.
unking: what the Libyan people are currently trying to do with Moammar Gadhafi.
"IBM’s research team is working on a billboard technology that will automatically identify the customers and would show trailers of their choice."
Can I choose "No"?
I regularly read British papers for their perspective on America-they have a clarity about them that we often lack in domestic venues. The Guardian and the Telegraph have different political leanings, but are more up front about them than US papers.
(I only read the London Times in print form, to do otherwise is to lack the full experience.)
So, a thoughtful article, but it raises some questions...are the college educated Badger staters moving to California and Massachusets to be among their enlighted fellows? Or are they moving to benighted Red states where the jobs are?
The article also seems to assume that the amount of money spent is a clear marker for the quality of the education provided. I assume all interested parties have read the ruminations of a Mr. Gates on this matter in today's paper or electronic substitute thereof.
Not to say spending less is a virtue, it probably isn't. But spending more (doubled budget K-12 past 40 years) has had modest results. New ideas needed desperately.
Locally I have seen promising, valuable programs axed during tight times....to preserve the benefit status quo of current and retired employees.
A little commented on area is the health insurance benefits of public employees...they are generally top end, the kind of benefits that drive the market. In fact, exactly the kind of "cadillac" benefits that an earlier version of health care reform rightly sought to tax.
See my previous comments on the fate of Democratic pols who would dare suggest such heresy.
A little commented on area is the health insurance benefits of public employees...they are generally top end, the kind of benefits that drive the market. In fact, exactly the kind of "cadillac" benefits that an earlier version of health care reform rightly sought to tax.
This is the other side of the "Keep your government hands off my Medicare" coin. And they're both manifestations of a characteristic I tend to associate with the rich and powerful--a tendency to prefer a lower general standard of living (as long as one remains on the RELATIVE top of the heap) to a rising tide lifting all boats.
In this case, it makes sense for workers who fought for cadillac health benefits to want to retain them, just as it makes sense for seniors not to want to lose Medicare spending on their own behalf. Just as (in a different context) it makes sense for me to want to keep deducting mortgage interest from my taxable income.
It requires an educated, counterintuitive perspective (as well as a level of trust that might be naive today) to realize that eliminating deductions AND LOWERING RATES might make a fairer tax structure without my owing all that much different than I do now. Likewise, a less-costly health-care system for all would allow states/employers to pay less into the system without negatively impacting level of care.
Asking employees to do what's right for the employer, while simultaneously arguing that the employer MAY NOT LEGALLY reciprocate that attitude is not a sustainable way of doing business. Frankly, were I in salary/benefit negotiations with an employer (public or private) right now, I wouldn't trust them to correctly tell me whether it's raining outside. But a Gordian Knot solution as suggested by "Watchmen" might be the only way out of the economic trap we're now in.
This historical Cadillac was French.
A true "Cadillac (a.k.a. French) health plan" would be less expensive both to the individual and to the nation as a whole, while delivering higher quality care (by any objective measure.) In part this is due to innovative information technology, but mostly it is through the removal of parasites ... specifically, parasitical for-profit health insurers.
Regrettably, no-one in America has such a Cadillac health care system. And no-one really knows how to solve the problem of a parasite that is so strong and intelligent.
Although, some slight limit on the personal rights of corporations has surfaced in today's FCC v. AT&T. Whether this is a meaningful limitation on Citizens United or just an anamoly in a particularly egregious case remains to be seen, but it is difficult to square the two cases (regardless of the embarassed hand-waving of Roberts) since the former was (ostensbly) decided on constitutional grounds and the latter was (apparantly) statutory (and therefore subserviant to the Constitution).
And on the Constitutional front, it appears that Wisconsin's state constitutional requirement of an open legislature has (perhaps temporarily) resulted in a court order barring an imperial executive's desire to sweep the rabble from the Capitol (insert mandatory jokes about the Imperial Walker.)
I have to head off to work.
Don't goad me regarding the shortcomings of our health care system, I live it.
And like the educational system, neither drenching it with money nor invoking technology will inevitably lead to "better" results. Unless of course you game the definition of better.
Seriously, don't get me going on the politics of health care.
Okay. Now we have a article from Forbes explaining how Walker is lying about taxpayer dollars used in the pension plan. It seems that "[t]he pension plan is the direct result of deferred compensation- money that employees would have been paid as cash salary but choose, instead, to have placed in the state operated pension fund where the money can be professionally invested (at a lower cost of management) for the future." Or in other words, the investors (public employees) contribute to the program and over time the investment increases in value. The only time taxpayers are on the hook is if the recipient lives longer than expected.
Take a look at what Sue Urahn, an expert on the subject at the Pew Center on the States, has to say about this when describing the $1 trillion gap that existed between the $2.35 trillion states had set aside to pay for employees’ retirement benefits and the $3.35 trillion price tag of those promises.at the end of 2008-
To a significant degree, the $1 trillion reflects states’ own policy choices and lack of discipline:
* • failing to make annual payments for pension systems at the levels recommended by their own actuaries;
* • expanding benefits and offering cost-of-living increases without fully considering their long-term price tag or determining how to pay for them; and
* • providing retiree health care without adequately funding it
"So, a thoughtful article, but it raises some questions...are the college educated Badger staters moving to California and Massachusets to be among their enlighted fellows? Or are they moving to benighted Red states where the jobs are?"
The latter for us engineer types, but not a red state. Most of my friends that studied at UW for engineering got their BS's and now live near Chicago because that's where most of such jobs are in the Midwest. For my more specialized training, national labs suit me best, hence NM. I could make significantly more in private industry, but none of those jobs are in WI. Professionally, the state has just about nothing for me, unless you count the private startup one of my colleagues has.
Two points about pension shortfalls.
1. One of the main underlying problems is that actuaries when setting contributions and benefits failed didn't anticipate future increases in life expectancy. (Supposedly Otto Von Bismark originally chose 65 as the eligibility age for old age pensions because the average life expectancy of a Prussian worker was 64 years 11 months.)
2. The $1 trillion gap represents the difference between the total benefits expected to be paid to all present and future pension beneficiaries and the current assets of the funds plus anticipated future contributions and investment earnings.
Some of that money won't need to be paid out for 50 or more years (in, say, the case of a currently 25 year old employee who will retire at 65 and live to 80.)
So the states could address the problem by putting aside, collectively, around $20 billion per year more.
That's around 0.15% of American GDP
Of course, for that to work, they need to stop accumulating additional unfunded future liabilities - probably by shifting employees onto defined benefit plans rather than defined contribution plans.
"...neither drenching it with money nor invoking technology will inevitably lead to "better" results..."
Nothing is "inevitable". But I have faith that America can do as well as France, and probably better.
It is difficult to understand the contrary argument; surely it cannot be defending the diversion of 30 per cent or more of health system resources into parasitic organizations as helpful to health care outcomes, or its removal as anything but neutral or better. And every health care contact I have experienced would have been better, faster and cheaper with a modern, French-style information record.
It would be very interesting to hear of reform ideas from health care professionals, including the formidable T2. But at the root, I would argue, the problem is fundamentally one of economic organization; the politics follow from that, and do not precede. Were Aetna to rename itself The Communist Party and call its shareholders "Comrade Party Member", wouldn't we have much the same result as we do today?
Rewinn, the influential part of the conservative movement learned all the wrong lessons from the cold war, as if they were envious of Stalin.
In brighter news, The Bill is throwing support to Terrapowers traveling-wave reactor project:
Someday, Nigeria may do rural electrification, it'd be a good thing if they don't have to do it with coal.
So, a thoughtful article, but it raises some questions...are the college educated Badger staters moving to California and Massachusets to be among their enlighted fellows? Or are they moving to benighted Red states where the jobs are?
I'm glad to see that BCRion already answered in much the way I was going to speculate--that I'd expect they're moving down to the Democratic stronghold of Chicago, Illinois, because THAT'S where the jobs are.
I'm not sure if I mentioned this or not; I'm not seeing it from a quick scan so if it's a repeat, my apologies.
The Government Accountability Office has revealed a number of government programs that duplicate efforts, which gives the possibility that government programs can be cut or consolidated without reducing benefits to people. Of course, considering that the Republican Party has deemed the GAO to be a partisan organization that should not be listened to unless it parrots what they want to hear, I'm not sure if it'll be listened to. But considering Republican Senator Tom Coburn called for the studies, we can have some hopes.
From the article: According to the GAO, 20 separate agencies currently run 56 different financial literacy programs. Ten agencies operate 82 teacher quality initiatives and more than 100 programs relating to surface transportation are spread across five federal entities. It takes 15 agencies to oversee food safety, including two for eggs — the Food and Drug Administration monitors unbroken "shell" eggs while the Food Safety and Inspection Service is responsible for "egg products."
"This is a chance to make smart cuts, instead of reckless cuts," Democratic Sen. Jeanne Shaheen said Tuesday. Senate Majority Leader Harry Reid called the report "constructive" and sounded open to enacting some of its recommendations. "I think there are duplicative programs around here that we could cut," he said. "I don't say this very often, but I'm glad Coburn asked for it."
(Fourth attempt to post... No links, but blogger keeps eating it. I'll try splitting it...)
" including two for eggs — the Food and Drug Administration monitors unbroken "shell" eggs while the Food Safety and Inspection Service is responsible for "egg products." "
That's not a duplication. The direct sale of whole eggs to the public is not even remotely the same as using of egg-derived products in food manufacturing.
There's no reason why those two areas of oversight would necessarily be more efficiently run by a single organisation, let alone a single program. (It might. But two specialist programs can sometimes be cheaper and more effective than one generalist.)
If that "duplication" is typical of other programs, then making "smart cuts, instead of reckless cuts," would involve more informed decision-making than merely hacking away "duplicative programs" in order to score browny-points with the small-government lobby.
part two... (Which will seem odd if only part one gets eaten.)
Simple bulk numbers don't always reflect complexity or cost. An example is the way politicians or lobbyists use the raw number of pages of legislation as an analogue of over-regulation or over-taxation. But the gross number of pages doesn't matter to me, only the parts that affect me.
You could quarter the gross number of pages, by reducing specialist clauses, and in doing so dramatically increase the amount that affects me. "Gee thanks, chief..."
DARPA's released it's new budget. Two interesting parts. One is a $25m program to find a way of empowering US civilians and veterans to help with the war effort.
("Citizen Responders" go to war, hurrah, hurrah.)
The other is a variety of medical initiatives. Seen here: www.wired.com/dangerroom/2011/03/radical-military-medicine/
1. Rapid mobile diagnostic sample analysis. Along with research on ways of rapidly isolating target molecules from blood/urine/etc for speedy analysis.
(I've often thought that this would be a boon for doctors/vets anywhere. But especially in remote areas and the third-world. But even for GPs, being able to quickly diagnose a cough as this strain of virus/bacteria, in-rooms, would be amazing.)
2. Scafold free tissue engineering. Using magnets.
3. General purpose dialysis-like disease therapy. A machine to pump out your blood, filter it, return it. With a particular eye on blood sepsis/toxic-shock. (Also out-of-body treatments where your blood is filtered through cells taken from someone else. Or GM'd.)
4. Better artificial eyes. Mimicking animal in-eye processing. (We have, from memory, 100 million photo-receptors, but only 1 million nerve fibres - there's some serious pre-processing going on.)
5. Advancing field treatment of hemorrhaging. With an emphasis on internal bleeding, if I'm reading right.
Once again, war does wonders for advancing the treatment of trauma.
Seriously, Blogger? That one was twice as long, and had a URL, and you let it go through first try. What are the rules?! I swear the whole thing is Dr.Brin's sick experiment in type I pattern recognition errors inducing pathological addictive behaviour. Keep pushing that lever, fellow pigeons.
Guys... write your remarks in a simple text file then COPY/paste it into blogger. I find that blogger finds that intimidating... it somehow knows you have a backup! And it behaves.
The Adjustment Bureau, opening Friday, adds one more movie the many adapted from Philip K. Dick books & short stories, including Blade Runner, Total Recall, A Scanner Darkly, Minority Report and Imposter. Dick continually challenged our assumptions about the nature of reality in his frequently dystopian visions. In the works: a TV series based on Dick’s classic alternate history, The Man in a High Castle
Remember my posts that have "Attempt #12" and the like in them? Those have copies in WordPad and continue to resist posting efforts. Blogger is buggy and is getting buggier the longer it runs. The only nice thing about it is it allows people with GMail and similar accounts to log in. But we'll follow you to WordPress, gladly. Gleefully. And it'll be far less aggravating. Trust me, I use it myself.
pokings - oh, they're not even making this difficult now.
According to Fox News, Wisconsin has Palm Trees:
I doubt the use of stock footage is coincidental. Another one of their many attempts to distort the truth, and make the protests seem rowdier than they actually are.
In related news, Walker has taken the extreme and unconstitutional act of attempting to close the Wisconsin state capitol even after a judge has ordered that it must stay open. The Dane County Sheriff's office has refused to enforce the closure stating that his officers will not act as Walker's "palace guards". The state troopers are now doing it, which is led by someone with family connections to a Republican member of the Wisconsin legislature.
Seriously, Walker is doing everything to make himself look like the wannabe autocrat that his harshest critics are making him out to be, and bleeding off moderate and even conservative support.
A couple links for you concerning new models concerning solar activity and sunspot formation:
I figure that it's always good to shed a little bit of light on the world. Or a lot, in this case. ;)
Heh. Paul Krugman linked to vacuum Maglevs. The guy keeps up on things, apparently.
Paul said... Darpa projects... 1. Rapid mobile diagnostic sample analysis. Along with research on ways of rapidly isolating target molecules from blood/urine/etc for speedy analysis.
One thing they're working on at my place are basic tricorders. They're working on several different type that can all do real-time chemical analysis in the field. Some are being targeted at air and water chemical sampling, others at biological samples and still others at structural analysis. A lot of these tools rely on a combination of nano-technology (physically sorting molecules), chemical analysis and even spectroscopic scans of stuff.
"Guys... write your remarks in a simple text file then COPY/paste it into blogger. I find that blogger finds that intimidating... it somehow knows you have a backup! And it behaves."
He's not kidding, guys. It's always a good anyways, for any forum, at least when making a post longer than, say, 20 or so words.
4. Better artificial eyes. Mimicking animal in-eye processing. (We have, from memory, 100 million photo-receptors, but only 1 million nerve fibres - there's some serious pre-processing going on.)
The human eye is a fairly impressive piece of machinery. IN terms of field of view, the human eye is essentially identical to an 80mm lens (35mm equivalent).
In terms of resolving power, comparing what details I can typically see with what I can capture with a higher end camera, the human eye seems to more or less have the capacity to see detail of the equivalent of a 10-15MP digital sensor (it seems to be somewhere in between).
In terms of focus distance, the human eye is just absurdly flexible, extremely fast, VERY accruate, and (doubtless because of the dual-eye system), seems able to judge front-focus or back focus. In usage, we usually don't even recognize the fact that we are focusing; it's that instantaneous.
In short, you're sporting a pair of ~12MP cameras with flawless 80mm lenses and focusing that would blow away the best HSM lens and phase-detect sensor we can build today without even breaking a sweat, all in a package smaller than a C-battery.
Mechanical "eyes" can probably be darned effective, but this is one case where nature is definitely not slouching either :) (In some ways, advanced mollusks have better eyes still).
Then there's >Gigapixel Cameras...
I liked a joke:
A CEO, a Teabagger, and a Union member sit at a table. In the middle of the table is a plate of a dozen warm, delicious cookies. The CEO takes 11, then wispers to the teabagger, "look out, that guy wants to take a big piece of your cookie!"
Oh, and regarding the 'Bring back the tax levels that Reagan left in place' idea, I'm pretty sure that if you said it, a modern teabagger would just say that it was the fault of the democrat-controlled congress.
Someone report about it?
Review of Afrika Reich... crimeandpublishing.com/2011/02/21/guy-saville-the-afrika-reich/
I think this sums up my feelings quite succinctly.
"After nearly two decades of being a Republican, I must face the reality that my party has abandoned me.
In the early 1990s, I became a registered Republican. I was a public school English teacher in Georgia who felt betrayed by the leftward shift of the Democratic Party; it seemed that there was no longer room for moderate or conservative Democrats. I took call for the Republican Party to be a "big tent" at face value and jumped ship....."
Mind you, this is a lesson Democrats need to keep in mind in the wake of the 2010 elections. There are calls to cast off the Blue Dogs. I say don't alienate your moderate/conservative base.
Nice. It's amazing how humour can encapsulate an issue often as well as a thousand word essay.
I wonder if that would work as a campaign ad. (Three children dressed as an elephant, a donkey, and a fat-cat, all having a tea-party. Mum brings in a plate of fresh cookies...)
"the hollow cry of "Broke""
timely opinion piece at the New York Times, but ever thought about the similarity between "The education budget must be cut, because we won't take back those tax cuts" and "We're eating ramen noodles the rest of the month because Daddy went out drinking again".
Anyone seen this breathtaking video of a shuttle launch as seen from an airplane?
Concerning "Afrika Reich"...
I'm curious to how it compares to Robert Harris's novel "Fatherland" which I've read three times, and which itself has some echoes of Dr Brin's "Thor Meets Captain America" without the supernatural aspect.
Alas, what seems to me to be the deadline for a compromise in the WI standoff is slipping away....not from lack of outreach efforts, there was a clandestine meeting on Badger turf the other day, with a couple of D fugitives at least having enough trust in their R counterparts to cross into enemy territory.
I have been trying to avoid martial language in political discussions, but per my prior observations it is difficult.
This has become akin to a battle from which neither side dares disengage. It is getting ugly, and if there is not some face saving truce in the next couple of days it will get uglier.
Recall elections, ok that's democracy in action even though the TV is starting to show tacky political ads again.
Cutting off funding to legislators who are shirking their duty, borderline but largely symbolic given the money involved.
Soon there will be layoff notices sent out and delayed payments to various sources, healthcare providers who see medical assistance patients for instance.
Neither side has blinked, so you have to ask how far they would go.
Would Walker throw away any future political ambitions, perhaps even face impeachment/recall?
Will the protestors on the ground move further along the spectrum of verbal harrassment-physical intimidation-actual violence?
Will the fugitive legislators be willing to see the entire mechanism of state government stop?
Of the three, I suspect Walker has the clearest path and the most resolve.
Well, since blogger did not reject my WI post, perhaps another quick note or two. Not trying to fire up a whole new topic, but ReWinn did get me thinking...
What drives healthcare?
Not politics specifically, but demand. Our system for good or ill reflects who we are, and who we are becoming.
Americans are impatient. We are skeptical of authority. We are not resigned to our fate, believing that we can always suceed if we just persist. We are also-after a generation or two of material comfort unprecedented in human history-more than a little spoiled. And too easily swayed by glittery promises either by drug companies and by politicians.
So we insist on a health care system where we get the Best. We get in Now. And we do not give a damn about what it Costs.
It is often said that we can have two of the three, but nobody is willing to chose.
More could be said, and another day I will unlimber the main batteries, but next post a few musings on computers and medicine.
OK blogger....here goes...
On a roll I guess.
I have learned at various times six different Electronic Health Record systems, or EHRs. Each has its own virtues, much as French seems better for attempted seductions and Russian for serious cursing.
But overall they are not designed to make health care cheaper or better.
The internal structure of all EHRs is designed to enhance billing, ie to let health care entities charge at higher code levels.
click on template giving general area of interest today. menu comes up--headache. click on historical info, duration, type. add review of systems, vomiting, vision disturbance. you get the drift.
One system I used actually had a bar at the bottom. enter a complaint and it would tell you what code level to be aiming for. Keep adding data and the bar slowly filled the box, then turned green when you had enough elements to pass code muster.
It does little to enhance care to comment on skin condition for most headaches, but it makes HAL happy.
When a system has been running a while it does help you some...when a patient shows up with said headache you can review the last ten visits for same. The occasional efficiency does result.
But of course, various health care systems each have their own proprietary EHR and they do not communicate. We have privacy laws in place that make natural inertia in this regard hard to overcome.
I have previously advocated the Feds just cook up a system, give it out free and mandate its use. Recall that in this one sphere I am not a conservative but a flaming revolutionary. Likely it would go to a polically well connected firm like EPIC, but at least they turn out a better than average product.
"Then there's >Gigapixel Cameras...
I theory they exist, but remember these are mosaic-builders, as the article says.
They're cool, but I don't think you'll ever see one in a DSLR ;)
Still, for some applications (like city-wide surveillance systems), that's some really cool stuff. I had no idea that technology had come so far.
I largely agree with you on the primary issue here, but I'm at a loss as to solutions.
The primary driver of health care costs seems to be the explosion in medical technology and the demand to always have the latest and greatest, at any cost, regardless of the tangible benefits.
Right now, doctors are only sucking up about 2% of all healthcare costs for their pay (give or take, adding BLS data for all medical professionals together). Likewise, I've read many business articles that say hospitals are largely just keeping their heads above water. So all this money is being spent and yet no one seems to be getting rich off our $40,000 procedures, at least no one we or our insurance actually hands a check too. Again, this is because the money is getting sucked up the never-ending influx of new technology that we, as consumers, DEMAND we be provided.
What I don't know is how that sort of situation is supposed to be addressed. I'm a little young to have really been very aware of such things at the time, but it seems, from what I've read, that the managed care system managed to address this problem to an extent. HMOs were large enough to act as powerful market forces that could work to keep prices down, and keep the market under reasonable control. Of course, the system didn't end up working out, and in the wake of its collapse, we now have a decentralized, pluralistic system in which there are no price controls of any kind, and downright reckless demand seems to be ruining the system.
So with that said, what do you think we should do about it?
Here's an article about North Carolina's growing Hispanic population... and how the inhabitants welcome it. I must say, the Republican Party is cutting its own throat if you look at the long run by alienating and disenfranchising Latino immigrants, especially if Latinos are the ones who are willing to work in the agricultural industries that whites are turning their noses up at despite high unemployment levels.
It's yet another reason why NC is becoming a solidly progressive state. I don't think I necessarily see it spreading elsewhere for the time being, at least at any rapid pace, but there's no doubt that NC is now a rogue state, politically, when looking at the political history of this part of the nation.
I can only hope it becomes part of the face of things to come. Of course, I would be greatly disturbed by a complete collapse of the US conservative movement, but a large-scale rejection of the extremism of that movement in their biggest stronghold might also be a big segue for change on their part into a party of actual responsible conservatism, instead of the part of bat%$#@ crazy.
I have believed for a couple of years that we would see the Republican Party come apart, with a solid core of reactionary voters in smaller less urbanized regions (ie, the Party of the South, though that is apparently being turned on its ear) while middle conservatives and moderates fled to the Democratic Party. With that influx, the batshit insane liberal aspect of Democrats would then spin off their own party of liberals, allowing the Democratic Party to become a center-right party similar to where the Republicans existed 40 years ago, and a new Liberal/Progressive party for the Left.
This could even exist as a state of affairs for a number of years with two smaller Right and Left wing parties existing (the Republicans and the Progressives) and a dominant larger Democratic party in the center siding with whoever has the better ideas (or encouraging some of each side-party to vote with them to pass legislation).
It would probably be an effective evolution of the current two-party system which has proven to be defective at its core.
On medical costs...
In Australia, our Medicare system sets a schedule of charges for services. Patients can recover costs up to that scheduled amount.
(Any charge above that is called "The Gap" and patients are wholly responsible. Private medical cover isn't allowed to pay the Gap. If you want to use your private insurer, you can't apply for the Medicare rebate.)
If the medical provider charges only to the schedule, his practice can "bulk bill" and his patients don't pay anything.
As you can imagine, bulk-billing GPs are more common in poorer suburbs. For testing/scans/etc, bulk-billing seems to have almost vanished, suggesting the schedule is set too low.
None-the-less, I expect it exerts a strong downward pressure on prices.
(Doctors who over-charge Medicare (bump up too many consults into higher brackets) risk losing their "Provider Number". And doctors in Australia would rather lose an arm.)
I assume US Medicare/-caid isn't too far away from that, sans bulk-billing. But without universal coverage, I doubt it would have as much effect on prices.
The second side is medication. The Australian Government subsidises medication through the Pharmaceutical Benefits Scheme.
After a new drug is approved, it is available for doctors to prescribe, at whatever price the company sets. Government contributes nothing.
Drug companies can then apply to the PBAC to have their products listed on the PBS schedule. But they have to justify the cost against existing products. If it's too costly, the PBAC can make lowering the price a condition of listing.
Once listed, the medication is available at one of three subsidised rates.
-The "full" rate, about $15-20 a script, from memory, available for anyone.
-A lower rate (about $3.50/script) for pensioners/low-income-earners.
-Or free, for anyone who spends more than a certain amount ($120/yr?) on PBS listed medication.
As you can imagine, for patients the difference between a $65/mth unsubsidised medication and a $3.50/mth one is so great that the $65 one might as well not exist. So for drug companies, being subsidised is worth its weight in gold.
The net effect is that drugs in Australia are available much cheaper to the government than in the US.
(However, it takes longer for a new drug to get here. And some drug companies just don't bother. Example, Melatonin is an over-the-counter drug in the US, but not even available here.)
From what I've read, Medicare/Medicaid and similar programs in the US (ie, VA) have been barred from "negotiating prices" with drug companies. If not for that, I suspect the sheer size of those programs could have a huge effect on drug prices in the US.
So we insist on a health care system where we get the Best. We get in Now. And we do not give a damn about what it Costs.
I dunno, Tacitus. The two times my daughter broke her arm, the doctor said, "She needs full sedation in a surgical outpatient ward." I replied with, "Just give her some goofy juice in your office and set the bone."
The doctor refused, making the argument that the little ones shouldn't suffer. I relented because my wife didn't want the fight. And we suspected the doc would refuse to treat at all.
It's the only orthopedics outfit for 50 miles. Oh, there are other offices, but they're all part of the same medical practice group.
Now, he did marvelous work, but he didn't do what I wanted. Another doctor in the same practice didn't do what I wanted when I said, "local anesthetic; I want to watch you do this." He refused as well, making noises about how important it was that I not be involved.
Whatever, y'know? I'd watched the last inpatient surgery on my foot; it fascinated me. I should have taken pictures. I think he wasn't a people person. Well, I knew that after the first five minutes when he ordered two MRI's without a backward glance, but there you are.
You sure it's the populace with the spoiled attitudes?
The med profession was the first high elite to run into the Age of Amateurs. Because their clientele is EXTREMELY motivated. This resulted in early movements for patient participation, starting with dads in delivery rooms but then illness groups etc.
Today, the profession has PARTLY adapted to the new era. One of the first things a good doctor will do, after giving a diagnosis, is refer you to a preferred patient support group for that illness. Partly in self defense. If there's more than one, he'll steer you to the less "problematic" or confrontational one.
It is still in flux and the "you're not qualified to have an opinion" reaction is DEEPLY embedded in both habit and ego, as well as human nature.
Govt should start by Standardizing certain things like MRIs. Make them fall into biannual "models" and use purchasing power to insist that the machines benefit from economies of scale. MRIs are fantastic diagnostic tools and cost 1/10 as much in Japan.
Well, y'know with respect to MRI's, I actually didn't know until last weekend that those machines are coils of wire suspended between two liquid helium tanks, so that they superconduct.
That explains the high price, in part, and explains why older machines aren't really to be found in many places.
It also means we shouldn't be frittering that gas away on balloons.
Here's an idea, especially since we're desperately low on both investment economy wise and R&D technology wise (with other nations running right over us).
Why doesn't the government set up an agency, basically another "ARPA" entity, like ARPA-E, which gives government research grants to medical research projects, but only ones solely aimed at developing cheaper alternatives for present-day procedures (or technology that makes existing procedures cheaper to perform)?
In the long run, that should help move technology in a direct of lowering costs for greater accessibility, instead of making new medical scanners every year that cost $10 million and are .025% better than their predecessors, and the like. New technology isn't the problem so much as the fact that we only care about new technology that gives us superior treatment options, regardless of how little the gain is or how big the costs are. Clearly market forces aren't pushing the kinds of technologies that could help reduce our costs, even though they're doubtless out there in abundance, waiting to be developed. Why not have the government push for them?
Even in the short term, you'd get the gain of getting money moving in the high-tech industries, creating the kinds of jobs American REALLY needs right now to stay competitive with other nations, scientifically and technologically (places in which we're really hurting), while spurring some economic growth that would easily pay for itself in lower health care costs.
The orthopod wanted to make sure your daughter's fractures were properly reduced with the minimum amount of distress for all parties.
Inadequate sedation and analgesia isn't going to give a good result.
This is especially so with paeds.
"You sure it's the populace with the spoiled attitudes?"
It's a bit of both, as Dr. Brin pointed out.
"Whatever, y'know? I'd watched the last inpatient surgery on my foot; it fascinated me."
Would you sit still during your daughter's closed (open, if things go wrong) reduction? I've seen some eye-wateringly violent efforts required to fix fractures in my time. Orthopaedics, like most surgery, isn't pretty.
I think the PBS system is wonderful. Australia's drug approval system is one of the most conservative in the world - but that helps screen out crappy drugs (cyclosporin eyedrops without an approved indication?). Having said that, it isn't perfect (mibefradil and trovofloxacin are the most notorious ones I can recall during my medical career thus far).
"One of the first things a good doctor will do, after giving a diagnosis, is refer you to a preferred patient support group for that illness."
True for office based (outpatient) medicine, not so much for hospital based care where it's part of discharge planning.
In my antipodean (largely hospital based) experience, there aren't that many support groups and they are quite sensible. Perhaps we don't have a big enough local population.
"Govt should start by Standardizing certain things like MRIs."
That would interfere with the right of U.S. medical equipment manufacturers to charge whatever the local market can bear, though.
More seriously, what about the effects on biomedical engineering research?
Longtime lurker, anaesthetist/intensivist from Down Under
Rob OC! Welcome Oz-Boy! Speak up now 'n then! You seem a smart guy.
I think a government scheme such as you describe would take a while to address the problem. I'm not sure whether it would pass into law with the current state of the legislature. Too much interference with The Marketplace.
Part of the cost premium for equipment is related to relatively small production volumes and high materials standards and safety requirements (e.g. implanted devices, vascular conduits, joint replacements).
I agree that we shouldn't be on a 12-18 month cycle time with expensive items like CT/MR scanners, but part of that is being driven by advances in computing (volumetric reconstruction, CT/MR cardiography, MR CNS tract mapping).
As a practitioner, the technology hype cycle is irritating because we're not getting the diagnostic benefit - there are no great increments in sensitivity or specificity appearing. In part this is because you would need tens of thousands of patients to demonstrate the case, and by the time you've organised the trial the next Big New Thing has come down the pipe.
It looks to me that much of the cost of health care in the U.S. is administrative overhead and wages.
There's room to move on the former; I'm not sure about the latter (OECD data for medical specialist incomes don't seem to show gross disparities between countries).
Sorry about wandering off topic.
Thank you for the welcome; I hope that I can contribute to this thought provoking and entertaining blog!
By all indications, our sole source of cost is coming from too much incremental technological gains having too much money invested in them (just like you say), and exceedingly high costs being dedicated to high risk, high cost, low reward treatments, especially in end-of-life care (the kinds of things that either extend life very little, or give very little chance of any extension at all).
Between the two, I think technology is honestly the bigger by far. You mention wages, but I've personally looked at and compiled a pretty inclusive list of medical professionals from the Bureau of Labor Statistics, at least insofar as doctors (of all knids), and they make up literally 2% of US health care costs, iirc. Hospitals also aren't pocketing that money; many US hospitals are actually struggling right now, financially.
I honestly can't imagine that you'd make up the rest of that difference with simple administrative inefficiency.
Really, I think it's all just new technology, and our our selfish demand for any advances in it, no matter how much it becomes a case of getting very little for very high costs. That's why I think more emphasis in our development needs to be placed on addressing costs as the desired end for new technology, not incrementally increasing effectiveness by negligible amounts while inflating costs. The market isn't interested in that, however. That said, they would be if government start setting aside research grants for it.
Government also shouldn't have a problem with this. Remember, Obama had no trouble setting up ARPA-E to do energy research, and if that can make it past "drill'n'burn" GOPers, then something much more easily stomached like cost-control medical research grants CERTAINLY should.
Yes, it'd take a while to have any appreciable affect. We'd probably be waiting a decade for costs to come down. There is no quick fix, however. The public option was the closest we had (and it would only address one problem, while leaving many untouched), and it was politically impossible. With that in mind, what we need to do in lieu of a quick fix is start building a solid foundation for long-term solutions to what will always be a long-term problem.
In the meantime, like I said, we DESPERATELY need more money in that sector of our economy and more working scientists to keep us a scientifically and technologically competitive nations. Putting out more research money will make THAT happen immediately, so it'd be killing two birds with one stone... or maybe it'd be saving two birds with one stone. How do you do that with a mere stone? I have no idea; that's why we need research! :D
@Rob OC -- And yet, 50 years ago, it's precisely what we did: send Mom (or Dad) from the room, Dad (or Mom) holds the kid, Doc sets the bone. And then the kid grew up maybe a little more careful about reckless play.
Would you sit still during your daughter's closed (open, if things go wrong) reduction?
For a clean-break radius fracture like my daughter's? Yes; we'd already seen the X-ray and heard the Doc explain what we were looking at. For more complicated stuff, not so much; the Age of Amateurs still needs it's competent professionals, after all.
I've seen some eye-wateringly violent efforts required to fix fractures in my time. Orthopaedics, like most surgery, isn't pretty.
There's no doubt that all costs aside, both of the OD's were marvelously competent artisan surgeons. But they were also clearly playing defensive legal medicine.
"...The internal structure of all EHRs is designed to enhance billing..."
This would seem to be a rather serious flaw in the system.
"...we insist on a health care system where we get the Best...."
A lot of Americans would be content with a system in which they get anything at all, at least, not at the cost of bankruptcy. Every year are more bankruptcies by reason of medical care needs among persons with insurance coverage in each and every state in our union than in all of Germany, and yet their medical outcomes are better.
I am delightfed to have the multiple POVs of medical professionals here both from Tacitusistan and the Antipodes ... parallax is so helpful to vision! May I suggest also T. R. Reid's "The Healing of America", he takes his own bum shoulder to doctors in the USA, Britain, France, Japan, India, getting different recommendations for treatment. The most expensive was here in the USA, and the one he picked was in India. His was not a case in which patient desire for "the best" drove up costs, but rather that our system is designed to maximize the use of high-margin procedures - which after all is what you would expect in a system oriented around profit.
In my own most recent case, when I started getting regular headaches last spring, I finally went to an American doctor, who recommended prescription antihistamines ... not a nasty drug but, unwilling to mess with my body chemistry unnecessarily, I talked it over with my wife over an excellent pitch of stout.
"When was the last time you had a drink of water?" she asked.
"I drink plenty of coffee, and beer in the evening. Isn't that enough liquid?"
She reframed from hitting me. I promptly soaked up a pitcher of water (plain water, no alcohol or caffiene --- they still make it!) and the headaches went away. They stay away, so long as I keep hydrated.
The point of this anecdote is not that I found a safe and cheap remedy by amateur methods, but that the doctor never asked if I was dehydrated. Are there are just too many lifestyle variables for a doctor to hit them all during the insurance-sanctioned visit of X minutes duration?
Interesting differences in policy. My daughter managed to break her arm just above the elbow a couple of years ago. We took her to the Royal Melbourne Children's
I gather breaks above the elbow are notorious: there's not much to get hold of in order to straighten the two sections. Anyway, it took a couple of 'vigorous' manipulative attempts by two medics, a few doses of Ketamine, and a very hefty application of plaster-of-paris, to get things to the surgeon's satisfaction (still wasn't perfect, but the kink has since grown out, and the patient is fine now).
Not a pleasant experience, but I don't recall there being any discussion of whether or not we, the parents, ought to have been present. The patient, when conscious, was also quite interested.
Part of the First Aid courses I've attended involve sitting through a slideshow of 'injuries of renown'. Charming, but it serves a purpose.
redblel: the photographic filter applied to graphic trauma shots.
The same daughter who broke her radius had broken her humerus just above the elbow. In contrast with Tony's doctor, my girl was fully sedated in a surgical suite, pins were inserted to exactly set the bone using a complex imaging and alignment device.
Six weeks later, she was fully sedated again to remove the pins. No kinks to grow out. The total "billed amount" came to something over $6000. The insurance company took that down by about 40%, we paid half the remainder in a combination of "deductible" and "copay". In addition to the $5000 or so in insurance premiums that year.
In other words, Blue Cross came out ahead. Last year, they decided on premiums totalling something like $16,000 for the year, so we switched providers in order to have the privilege of paying a tad less than $10,000.
Oh, it's a broken system, for sure.
Earnlancer.com is a global outsourcing solution and
freelance jobs website. Here you can find freelance coders,
writers, programmers, designers, marketers and more.The
worlds largest outsourcing marketplace ,it is freelance jobs
website. We have thousands of freelance jobs online for
freelance programmers, web designers, graphic designers.
I am not a medic but I have used the health system in the USA and here in New Zealand for my son.
The American system worked well –
BUT when the doctor recommended that Thomas had surgery (for adenoids and ears) I would have been much happier if that decision had not immediately and directly financially affected the doctor.
I think he did a good job and Thomas benefited from the operation
BUT I don't think anybody should be subjected to temptation unnecessarily.
In New Zealand it was more serious - Thomas had been getting headaches his doctor thought they were migraines but was willing to let me pay for a CT scan ($400)
At the scanner things started happening – we were taken straight from the CT scanner to the MRI – the next day Thomas and my wife were flown to Christchurch – I had to fly the day after
Thomas was operated on the next Tuesday and is now fine – last scan the surgeon doesn’t want to see him for two years
The health system worked very well – the state paid for all of our airfares and would have paid for accommodation until Thomas was ok to fly home
The two experiences were night and day
Electronic systems – our doctors use a fairly comprehensive system to track patient records
This is made simpler by the fact that there is no (almost) charging
I remember reading about a doctor who went to Canada and saved an enormous amount of his time by not having to deal with insurance companies
The fact that a doctor (or his staff) have to jump through hoops to get money from an insurance company that will be willing to jump through more hoops to prevent them must be adding a huge amount of extra cost that is inherent in the fact that the two organizations have different goals
While we do have private insurance, on that occasion, we went with the public system. The surgeon explained that, at her age (six) the kink would grow out. Pins would have been required in an older patient. There were no costs for the actual surgery, or the follow-ups.
There were queues, however. We did have to pay for the subsequent physio.
Main bit of gadgetry to report was that the X-rays were digitised and stored in a central database, so that all consultants had access to them.
My only brush with the US medical system was actually pretty benign: I came down with a case of chickenpox in a Minnesota winter (as you do). Fortunately the Mayo clinic was just down the road. They provided me with a prescription for Acyclovir and thanked me for contaminating their surgery (room put in isolation for two hours).
This is pretty stunning.
I thought the idea of growing or printing human organs was just a hypotherical.
I knew there was research going on but assumed it was years away from implementation.
Now I discover that there are people who've been walking around with printed kidneys for a decade.
They propose to print your new organ... directly onto/into you?!!
Shades of those descriptions of how teleportation devices might work!
Creepy! I think I'd like to see the meatjet version first!
It has become a cliche, but the reality that EHRs are primarily systems to enhance billing is, verily, a feature instead of a bug. They are sold with this as a desirable thing.
The only EHR I have had peripheral contact with which stands as a clear exception is that run by the VA (veterans admin. to you Antipoders). It is encyclopedic, and like an encyclopedia virtually unreadable. Trying to find the salient fact you seek is like refining very low grade ore...tonnes to the ounce. (you have me adapting my spelling today!).
Now, the radiology programs are a different beast. They are great. I can do lots of things to improve my view of things, can easily compare old films, can show patients and parents of same just what is wrong.
There are actually services that span the globe...do a CAT scan in Tacitopolis at night and it could be read in New Zealand by a guy working the day shift. (we use domestic insomniacs at present). A fax comes with the official reading.
Just so you realize I am not a complete Luddite.
Actually, printing the organ straight into you is a good thing. It means that the organ has better attachment to surrounding tissue, is directly attached to blood vessels, and is less invasive. While I doubt it could be done with, say, the heart (though using a pump to redirect blood until the new heart is constructed might work), for smaller organs it might be the best method to use.
Protesters outwitted Governor Walker by peacefully vacating the Wisconsin Capitol despite Walker's attempts to paint them as "a small minority trying to create problems and difficulties for the Capitol police." While signs will be taken down, the Wisconsin Historical Society has photographed the signs in place, and will preserve many of them, although it is likely they would be removed from where they hang.
Personally I hope Walker shoots himself in the foot again and refuses to give them access. The more intolerant and unwilling to negotiate he appears, the more people will turn against him. I'm fairly certain we're getting political cartoons of Walker as Qaddafi already. Painting him and Republicans as dictators who would fire on innocent demonstrators and refusing to listen to the will of the people... well, they might not be able to stop the damage Walker is going to inflict but this sure can encourage voters to vote in Democrats to replace them and vote out Walker's changes in a couple of years.
P.S. - Using a WordPad write-up doesn't scare Blogger, as you can see.
slyther - the preferred means of locomotion for members of House Slytherin
I thought this article might be of interest seeing that it takes the rose glasses off of the unemployment rate statistics released by the U.S. Bureau of Labor Statistics. What is especially interesting is that it not only takes off the glasses for CURRENT statistics, but it goes back in time to 2007 when the economy was theoretically humming along nicely.
The information tracks not only people who are Unemployed, but people who are not in the Labor Force but want a job now. Back in January 2007, this pushes unemployment rates from a little over 4% to just shy of 8%. The high point in November 2009, total unemployment was just shy of 14%. (The total number of Americans who wanted a job was close to 22 million people. That is a staggering number.)
It mentions that reported unemployment rates is declining slightly faster than the employment rate of all people who want a job in the U.S. (though I don't know if that information includes only legal citizens or if it also includes illegals seeking employment).
The information in these updated charts is limited, however, in that it does not list people who do have part-time work but are unable to find full-time employment. When you add those people, I'd be willing to bet rates would be a lot higher.
"There are actually services that span the globe...do a CAT scan in Tacitopolis at night and it could be read in New Zealand by a guy working the day shift. (we use domestic insomniacs at present). A fax comes with the official reading.
Just so you realize I am not a complete Luddite."
You still use faxes?
Robert, I can't access the link but there are some problems that arise when you ask people a question like whether they "want to work".
Given the high value placed on paid employment in American society and the stigma attached to unemployment, some peopel are going to say they "want" to work whether they do or not.
Are we talking about a 63 year-old who took early retirement but might consider re-entering the workforce if a plum job in their old field showed up?
A woman who left the workforce when her child was born and is thinking about re-entering the workforce some time in the future?
(On a similar note, there was a report a few years back that claimed the majority of bankruptcies in America were caused by medical expenses - based solely on interviews with bankrupts.
I'm sure no-one said "medical expenses" rather an admitting to,say, drug addiction, problem gambling or losing their job because they were caught stealing.)
Let me do one of my patented "Brin swerves" and tell you guys what's WRONG with socialized medicine!
Oh, sure, it'd be vastly better than what we've got... in most ways. But we need a clear-eyed awareness of the faults, if we're ever to rationally devise something with the benefits of both and evading the faults of both.
1) Insurance companies ration care. They do it for the most brutal of criteria But if you are savvy and can threaten with lawyers, you can overcome their rationing impulses.
Socialized systems ration care also. They do it according to committee calculations of tradeoffs of expected lifespan return and such... hence children come out very well... but there is some truth to the "granny death panels" accusation. If your odds of getting much added quality life are low, you may not get the treatment. It is less unfair (by far) than raping the poor (our method). But there is something deeply loathsome about state barons ruling life-death decisions by arguable criteria, without much chance of appeal.
Most folks know all this. What isn't discussed is another aspect. The US system drives most of the world's medical innovation. New treatments tend not to pass the socialized medicine committees, at first, till results improve, are proved and costs go down. The American system gives in to the human impulse to scream "hang the expense! Try anything!"
Frankly, I think we are gyped. The rest of the world should pay a fee to the US for playing this role.
I'm not entirely sure that our American reputation for innovation is entirely warranted at this time. How many drugs are merely "me-toos" developed to get around the expiry of patents?
I'm sure the Finns of Nokia will have something to say on the subject of an alleged reluctance to innovate.
BUT --- on the plus side of amateur innovation, a quote from the delightful SkyTruth (which used freely available satellite data to inform on the BP oil disaster better than any official or government news source:
"The folks at Google have released a great new tool called Follow Your World. Now you can sign up to get email alerts whenever they update the imagery in Google Maps and Google Earth covering your areas of interest. Using a simple interactive map interface, you can select and register points of interest ... Now anyone can do some armchair SkyTruthing, keeping on top of the latest free imagery from Google showing what's happening in the places you care about most..."
We may be headed towards being stuff-poor, but perhaps being information-rich may compensate.
Google has failed me. Can anyone point me to a good synopsis of "Earth"? I can't find my copy and I need to clarify some forgotten details about the supercomputer that formed in the end. Wasn't it an amalgamation of internet info and that one scientist woman who was killed by the angels? That computer did take control of the gravity laser, right? (gaser?) I can't remember any of these details well.
Anyway, if anybody knows a good synopsis, let me know. Meanwhile I'll go see if the library has a copy. (It isn't an important thing, I'm just playing a game, a "Sci Fi Draft" on another forum)
Hi Dr Brin
"New treatments tend not to pass the socialized medicine committees, at first, till results improve, are proved and costs go down. The American system gives in to the human impulse to scream "hang the expense! Try anything!""
Not sure this is relevant, The impression I have is that most of the real advances come from universities and other research centers - Christchurch was working on a new type of MRI for instance
Besides a better solution could be the idea of using prizes to rive innovation
The "try anything" - normally seems to be "try using medicine/techniques intended for something else
I wonder what an analysis of medical drugs, techniques and technology would look like comparing the USA to the rest of the world
I have a feeling the USA will have produced more than any single country but not more than an equivalent sized group. Europe for instance.
Found the article (I apparently came across it because of Facebook, not Google News or Huffington): The next generation of publishing is here; no wonder it stares the hell of publishers. Imagine: selling e-books for only a couple dollars and having hundreds of thousands of them purchased with you getting 70% of the profits. I must admit I'm surprised. And happy for her.
The thing that these articles praising the 'new publishing' always gloss over is the service that is lost. Editors are good and useful! Literature will be poorer without them.
I imagine that would carry some weight, if only publishers actually provided a decent editing service to authors whose publishing runs were smaller than JK Rowling's...
The number of appalling grammar errors I catch in novels I read these days is enough for me to wonder if the publisher did anything at all with the authors manuscript other than to just feed it into the typesetter.
Yes the internet gets copied into the hot superconductor perovskite layers in the Earth's mantle... along with the old lady's essence. The combination is part internet, part crafty old broad, part GEOLOGICAL and part just emergent properties.
But buy a new copy! ;-)
FiL used to work for a big publishing house as an editor, and was laid off at the end of the last big project. This happened several times in succession -- he was hired on for a series or major project, then let go at the end of it as a cost saving measure. Eventually all the publishing companies apparently decided that editors were iirelevant, or at least a glut on the market, and downsized massively. You can see the results in the current crop of books that have apparently been proofread by poorly trained chimpanzees. I blush to think of the ones I've had to read; many of them are only suited to be 'bathtub books', where you don't regret having them fall in if you are reading in the tub. Grammar as promulgated by Word isn't all that.
nonted: did not pass the TED sniff check
Pardon the intrusion, but trouble is afoot in Saudi Arabia.
Too bad none of these Arab leaders are smart enough to allow the protests to go on and just ignore them. Let them have their Day of Rage and shake their fists but treat the protests politely and just go on like nothing is happening. Omar is doing something close, from what I've heard, but outside of that (and Omar seems to be anti-corruption, not regime change).
Protesters have one of two choices in this case: first they can eventually run out of steam and go home... or two, they can turn violent. But the moment they turn violent, they've lost and the government has a moral obligation to protect the citizens from the deviants that are causing trouble while protesting... and can even state "we are moving in on X-day. We are supporting your right to protest, but certain lawless elements are using your protests to cause destruction. Please, leave the area before X-day as we don't want any innocents to be harmed when we move in to stop the destruction."
Then again, that's probably something listed in the Evil Overlords Handbook and few world leaders would willingly admit to utilizing that for advice. No matter how logical some of the suggestions are. ;)
I'd really like to see what the figures are on medical innovations.
Certainly there are major pharmaceutical companies based in Europe and on an anecdotal basis I can point to a lot of major innovations coming from outside the US.
The Australian-developed HPV vaccine is probably the most important advance in public health in the last decade.
There is a third option: turn the protests into strikes(remember Egypt?).
Mass strikes can bring a country to a halt and governments have to respond some way. They could crack down or make compromises. Compromise means making changes whereas governments prefer the status quo. The whole point of dictatorship is that you get to call the shots - not the people. Giving in to popular demand, even a little, undermines this dynamic.
geez. No way the thousand princes will let it happen there. But if only... ah ...
I know smart fools who actually think we need the Saudis as a counterbalance vs Iran. What twaddle! Suppose all the arab shiites were suddenly free. Would they become Iranian stooges?
Nonsense. You identify yourself according to your conflicts. Arab shiites think of themselves as shiites first... only till that stops being the significant distinction. When Iran starts bossing them around, watch how quickly Arab shiites recall that they are... arab!
Not to mention that the Shiites are a minority in Saudi Arabia and any revolt will not succeed without significant sunni involvement.
Given a choice between their arab brethren, next to whom they stand shoulder to should against the House of Saud, and the meddling persians from across the gulf, I suspect they'll go with the former.
The last thing they'll want to be accused of is dual loyalties.
At the rates events in the middle east are progressing there may not be an Iranian theocracy in a few months in any case.
Even this is the first time I am visiting this blog for first time I am proud to say that I am the great fan for this blog officially.
Some interesting comments on German innovation in medical technology: "Universities and research institutions in Germany, unlike in the United States, only just began with a more intensive commercialization of their proprietary research findings in 2002, when basic legal conditions were modified...".
...it's written by an interested party, but still food for thought.
Who would have guessed that "The Seven Pillars Of Wisdom" would be supplanted by "The Seven Layers Of OSI" ?
Quote attributed to Rachel Maddow:
"I'm undoubtedly a liberal, which means that I'm in almost total agreement with the Eisenhower-era Republican party platform."
Here's an article that makes you think. It's from a young woman who is studying to become an abortion provider.
One of the scary things is the bit at the end of the article, concerning women soldiers and the fact they are forced to pay for abortions out-of-pocket, and can't get them on most military bases... and their career basically ends with pregnancy.
I don't care if you're for, or against... read the article.
Rob H., who personally feels abortion is wrong... but will fight for the right of anyone to get one.
Libyan opposition have released a "Declaration of the Establishment of the National Transitional Temporary Council in Libya"
Original - http://www.libya-alyoum.com/news/index.php?id=21&textid=2554
Article 1, Section 5. "To supervise the election of a founding assembly charged with developing a new constitution for the country to be submitted to public referendum, so that the legitimacy of the constitution is founded on: the will of the people, the triumphant uprising of February 17th, respect for human rights, guarantee of civil liberties, separation of powers, an independent judiciary and the establishment of national institutions that provide for broad and pluralistic participation, the peaceful transition of authority and the right of representation for every segment of Libyan society"
Section 6. "To form a transitional government to pave the way for free elections"
Article 2, Section 1. "The Council is composed of 30 members, representing all of Libya's regions and all segments of Libyan society, with youth membership representing no less than 5 members."
Article 5. "Based on agreement of municipal councils across various liberated areas, the Council selects Mr. Mustafa Abdul Jaleel as the President of the National Transitional Temporary Council and Mr. Abdul Hafid Abdul Qader Ghoga as his Deputy and the Official Spokesperson for the Council."
I wouldn't know about medical innovation being such a good reason for keeping the system as it is.
On the face of it, the argument seems to be "Americans are dying so that rich Americans, and the rest of the world with socialized medicine, can enjoy the benefits of innovation."
Quite the selfless sacrifice! It reeks of feudal overlords trying to convince their peons that the scraps they subsist on are actually gourmet food. I googled a bit and it comes up all over the usual conservative think tanks and propaganda mouthpieces - CATO, Washington Times, etc.
On the other hand, by and large the biggest chunk of medical R&D in the USA comes from the NIH - evil government money.
Taking the top 12 global pharmaceutical companies, half of which are American, you can see that R&D spending is broadly similar (non-American ones are spending more, but I think that's due to currency fluctuations).
So the differential is clearly government money. And I don't think that money would go away with universal healthcare.
It would probably go away if the current anti-science Republicans have their way. And this is what I am most worried about, because America IS the shining city on the hill when it comes to innovation - but most of that comes from government money (and the rest from its brilliant universities).
If the government became the sole provider of healthcare (and it doesn't have to be like that, in Italy you can either go with the national system or privately, if you can pay or have private insurance) companies would have to compete to sell their products to the government. Right now American pharmaceuticals spend more three times as much on advertising as they do on research. If they were selling to the government, a customer that isn't swayed by advertising but by effective products, they could just focus on research.
I think universal healthcare in the USA would produce more innovation, not less!
I think I disagree with Hilary Clinton about the state of the media - at least, the PRINT media. Of course, the writer of this article did have some excellent material to work from, but if our reporters were in fact so lackluster in talent, then I doubt this would have had quite the impact.
I'm tempted to say "let them secede" and then refuse to send troops when the Mexican drug war boils over into Texas, vote in the U.N. to condemn them if they end up killing people who are trying to enter into Texas from Mexico, and send them a bill to repay all of the infrastructure the U.S. has built in Texas over the decades.
A NASA scientists is claiming to have found fossil evidence of extraterrestrial micro-organisms in a meteorite.
our sole source of cost is coming from too much incremental technological gains having too much money invested in them (just like you say), and exceedingly high costs being dedicated to high risk, high cost, low reward treatments, especially in end-of-life care
The latter concerns me because U.S. ICU costs per diem are about 5x that here in Australia and I have yet to find a reason why (we're using the same equipment and have better staffing ratios per patient!)
ICU lengths of stay here tend to be shorter, but not that much shorter.
You mention wages, but I've personally looked at and compiled a pretty inclusive list of medical professionals from the Bureau of Labor Statistics, at least insofar as doctors (of all knids), and
they make up literally 2% of US health care costs, iirc.
Fair enough; I thought that as far as wages go, that was where you could cut 'fat' relatively painlessly from the system. Nursing and allied health wages are nowhere near as luxurious, but aggregated wages were 50+% of operating costs, IIRC from the last time I looked at this.
And yet, 50 years ago, it's precisely what we did: send Mom (or Dad) from the room, Dad (or Mom) holds the kid, Doc sets the bone.
Or doesn't set the bone. Failure rates were higher 50 years ago.
I agree about the defensive medicine issue.
The standard of care from 50 years ago is entirely inadequate now.
Medicolegally the standard of care from 5 years ago is entirely inadequate now.
The current perception seems to be that failure in any aspect of a procedure is not an option.
I don't have an answer to resolve the ongoing escalation in expectations of the parties involved in the doctor-patient interaction.
For more complicated stuff, not so much; the Age of Amateurs still
needs it's competent professionals, after all.
Sorry; I got the impression from your initial post that you could be one of those parents who would dangerously interfere in your child's care, information or no. I apologise for thinking ill of you.
I gather breaks above the elbow are notorious: there's not much to get hold of in order to straighten the two sections.
Sometimes they fall apart so there are more pieces, which is annoying.
Supracondylar fractures (just above the elbow) also get attention because they are potentially limb threatening (brachial artery is an end-artery).
The Royal Children's approach (ketamine and pull/push) is traditional, but I don't know whether you could get away with it locally in most cases.
Perhaps this is because we're usually one of the top three or four jurisdictions in the world for medical litigation (California and New York being the top two most years).
Practice in New South Wales is closer to Rob's example - but there would be no out of pocket cost in a public hospital and a small gap fee in the private sector (a few hundred $AU).
There are actually services that span the globe...do a CAT scan in Tacitopolis at night and it could be read in New Zealand by a guy working the day shift.
Prior to the GFC, this practice was quite lucrative for Australian radiologists, even with the medico-legal premium.
...but there is some truth to the "granny death panels" accusation.
If your odds of getting much added quality life are low, you may not
get the treatment.
Not really, in my experience (10 years of acute medicine, 5 in other bits of the NSW health system).
To be politically incorrect, it's often said that the reason coffins are nailed shut is to prevent attempts at dialysis or chemotherapy.
The rationing mechanism here is waiting lists for elective surgery and limiting access to some tests (e.g. some MR scans not covered by Medicare, the government insurance system).
However, if you need acute care you will get it. The intensity of this will be decided by the patient or their delegates and the treating doctors.
So if there are death panels they are ad hoc and made up of the people who you would want making the decision.
The US system drives most of the world's medical innovation.
OECD statistics (R&D expenditure) over 2001-2008 would support this:
EU27 ~1.7-1.8% GDP
US 2.5-2.8% GDP
The rest of the world should pay a fee to the US for playing this role.
Over and above existing profit margins and royalty/licensing fees?
On the other hand, by and large the biggest chunk of medical R&D in the USA comes from the NIH - evil government money.
No; drug company R&D spending has exceeded NIH's total since 1991.
It's about 2/3-60% private, 1/3-40% government now for drug research.
NIH does far more basic research than the pharmas though.
e.g. CBO report from 2006 (chapter 4) and subsequent NIH stats:
Sorry about rabbiting on.
Here's an article on a book concerning U.S. President Abraham Lincoln's racial views and how he continued to privately advocate for blacks to emigrate from the U.S. to what is now Belize due to beliefs that whites and blacks couldn't get along. It does note that at the time of Lincoln's death, his racial views were still evolving, but for a time past what historians normally consider when he gave up colonization of blacks publicly, he was still working behind the scenes to bring it about.
Personally, I think Dr. Brin's idea would have worked better. Give them South Carolina as a warning to the rest of the South that things could be worse for them. ;) But then, there'd probably have been massive race riots in South Carolina and a resumption of fighting between former white landowners (and poor whites brainwashed into believing they were at risk too) and Feds trying to protect new black landowners.
On a side note, it's sad that historians feel the need to rewrite history to make Lincoln into a paragon when in fact he was not all about black rights and black freedom, but instead felt that having blacks having their own separate nation would be better for the nation as a whole. The truly sad thing is, given race riots during the Civil Rights movement, lynchings, and general maltreatment... I have to wonder if maybe Lincoln was prescient in this.
And yet... would America be the wonderfully diverse place it is today if this plan had gone through? Or would we be lacking something fundamental to our very soul?
"Sorry about rabbiting on."
On the contrary, there's a lot of wonderful stuff in there. It's good to hear the position of someone with some experience.
Lincoln's racial views were something that had been pointed out by more than history teacher during my K-12 education, so it's not a fact entirely lost to history.
As for what happened with the blacks during the Jim Crow era and the civil rights movement, they did a hell of a lot more to our society than just secure a few protections under law for their particular minority.
The truth is that we probably owe them a great debt of gratitude, because they changed our outlook on diversity, not just of race, but of culture and thinking. They shook off a lot of closed-minded and provincial attitudes in this nation, and that goes to issues far beyond race.
I find it telling that the same sectors of society that refuse to abandon bigotry towards other races are usually the same groups who are intolerant of other religions; who hate science, and embrace people like Kent Hovind and Steve Milloy; who think any form of society or collectivism is evil, and refer to the government as "the beast".
At least people like that have managed to band into a single political movement (the Tea Party, of course), so we can dismiss their anachronistic views more easily. For the rest of us, however, it's good that forces have been there throughout history to teach us to be more enlightened.
PZ Myers debunks the alien bacteria story - sorry for wasting people's time.
@Ian: I wasn't getting excited about the bacteria story. We went though that 15 years ago.
@Rob OC. Thanks for the background briefing. I might add that said surgeon had X-rays to hand at every step. It was a clean break, and we felt no need to consult an 'ambulance chaser'.
Mind you, there's this recent report:
Hospital blunder probe.
Thanks for the link to the Age article; the paper cited is not yet available at the journal site. I must read it once it's available.
I suspect that their results could be generalised to the highest tier of Australasian intensive care units.
Royal Children's in Melbourne does everything - major organ transplants and cardiac surgery, complicated haematology/oncology, etc. So they are dealing on average with complex problems in truly critically ill children in the ICU there.
The margins for error are very small and cascading failures lead to catastrophic outcomes.
Wait a minute.
This is referring to an article published in May of last year!
I thought there was a follow-up study. Silly me.
Rob H, Re: Texas secession protest.
"I'm tempted to say "let them secede" and..."
I've always wished one of those flash-mobs-as-performance-art organisers would hold a secession protest in a state other than the one they were calling on to secede.
"People in New York held a rally today to demand the secession of Texas from the United States."
"and send them a bill to repay all of the infrastructure the U.S. has built in Texas over the decades."
You'd have to work out total taxes paid by the state, minus total Federal funds spent in that state. After all, the whole protest was just another tax rant.
Simpler to shut down and strip all military bases and other Federal facilities.
(Of course, the USA needs to figure out how to keep cool cities like Austin.)
It is difficult to believe that the US spends 2.5% of GDP on medical technology R&D ... unless you want to count warfighting technology as a form of medicine (in the sense of "increasing demand for services").
There is evidence that our American research pipeline is clogged up with searches for "me-too" compounds, that are not more effective than existing pharmaceuticals, but are free of licensing issues. See "Sometimes they're just the same old, same old".
I have every confidence that Our Great Nation has the *ability* to lead the world in innovation, but our current economic incentives are perverse in that regard.
@Rob OC. Glad you found the article of interest. While the issue is disturbing, and a few bums need some correction, it should be noted that the hype boils down to 12 'catastrophic' outcomes.
Only one involves legal action.
I read something years ago in a thread on drug-patents, that only 10% of corporate R&D spending was on genuinely novel research. The rest was split between manufacturing R&D, patent-busting (so-called "me too" drugs) and counter-patenting (locking up all variants before your market leader can be me-too'd.)
Anyone know how much truth there is to that?
(The thesis was to eliminate drug patents, put a 10% tax on drugs, throw that into government sponsored research. Drug manufacturing would then work like the "generic" drug market. Ie, you get the same dollar amoung of research, but increased competition between manufacturers, lowering the retail price of drugs.)
Trump for President?
The cost of DNA sequencing is falling faster than Moore's Law. Eventually it will be cheaper to re-do a sequence as needed rather than keep the data.
(corapi: Watson:"How do you feel now, Human?")
“It is difficult to believe that the US spends 2.5% of GDP on medical technology R&D ... unless you want to count warfighting technology as a form of medicine (in the sense of "increasing demand for services").”
I doubt it’s significant in the overall economic picture but some military R&D has directly led to improved medical care.
For example, the wound dressings used in Iraq and Afghanistan that are treated with anticoagulant to stop bleeding are a major reason the American death toll in those wars has been so much lower than in Vietnam.
Those same dressings are now being used in civilian trauma treatments.
Earlier the military funded research on smaller, lighter X-ray machines for field hospitals which led to improvements in the civilian versions.
There are other examples too – treatment for hypothermia originally developed to treat pilots is now used regularly for civilians.
Paul's estimate of 10% of pharmaceutical "research" spending actually being for novel work sounds about right.
In my working career I have seen roughly one major breakthrough in pharmacology every five years...with more of them being the results of 80s research than later work.
Specifically and roughly chronologically-
improved childhood vaccinations, hemophilus and later pneumococcus. Whole categories of childhood illness become rare birds, and given long term impact of improving the health of children, a big deal.
thrombolytics of acute MIs. Previously we just rode things out and hoped.
statin drugs to lower cholesterol..first class of drugs that were actually effective and practical.
Prozac and its sibs. not the first effective antidepressants but perhaps the first practical ones.
anti-retrovirals for HIV. Sure, a niche class of drugs but domestically a moderate advance and globally huge.
Viagra. Not life and death (with the odd exception of folks with pulmonary hypertension who take it at Heffnerian doses!), but a game changer in other ways for our increasingly geriatric world.
As to more recent work, maybe the newer insulin formulations make the list, but that is building on very old work indeed.
Krugman (and friend) mimic a certain popular SF author in observing "the remarkable solidarity of corporate executives, who seem to support their class interests even when their individual firms would benefit from the policies they oppose." (Noting the CEO of GM opposing universal healthcare, even though it would lower his company's costs, something he'd repeatedly complained about.)
It isn't about wealth, or power. They're just means to an end.
It's about control.
Reading a BBC interview with Sarah Palin when a comment stood out, "Obama has already said he's going to spend a billion dollars on this race".
The interviewer didn't pick up on it, but it reminds me so much of the "$200m-a-day" trip to India. So I was wondering if anyone here knows if it's a genuine figure, or another internet/Fox myth.
Post a Comment