Healthcare & rationing

[MSimon]

It may be decades longer before we see the result of the fallacies of the 60s, though the evidence of them lies everywhere about us.

A computer with the power of a Cray 1 (minimum) in every home is definitely nuts. And that Paul Allen guy (you know what that beard means) spending on Tri-Alpha? Another nut.

The biggest error made was an incorrect appreciation of communism/socialism. And that has been corrected some.

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In any modern society there will be about 10% who are unable to contribute. You will probably need to carry those people to varying degrees to keep the peace. Bread and circuses have been a part of government for a very long time.

We really do forget that at one time slavery was a pretty good deal. Regular meals. The trade of liberty for security was much starker once.

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If it wasn't for modern appliances and government assistance, out of wedlock births would be much more difficult. We simply outlaw electrical appliances - washers, dryers, microwaves, etc. and the women will fall in line. Government is only part of the problem.

[vankirkc]

What kind of relief will be required when the average income (PPP) of the bottom 20% is $50,000 in todays dollars?

This will never happen.

The planet can't support it.

[Helius]

What kind of relief will be required when the average income (PPP) of the bottom 20% is $50,000 in todays dollars?

This will never happen.

The planet can't support it.

You can't imagine scenarios in which the earth can? Also, who said "on planet"?

[vankirkc]

What kind of relief will be required when the average income (PPP) of the bottom 20% is $50,000 in todays dollars?

This will never happen.

The planet can't support it.

You can't imagine scenarios in which the earth can? Also, who said "on planet"?

Okay, I can imagine some scenarios where the Earth could support that level. They aren't pretty, though, as they involve very substantial reductions in global population.

As for U.S. standard of living, I think that's on a permanent decline thanks to globalization. Arbing the low labor cost of the far east has been nice for a while, but eventually arbitrage leads to equilibrium, which means U.S. lifestyle has to fall to the global mean.

[Helius]

This will never happen.

The planet can't support it.

You can't imagine scenarios in which the earth can? Also, who said "on planet"?

Okay, I can imagine some scenarios where the Earth could support that level. They aren't pretty, though, as they involve very substantial reductions in global population.

As for U.S. standard of living, I think that's on a permanent decline thanks to globalization. Arbing the low labor cost of the far east has been nice for a while, but eventually arbitrage leads to equilibrium, which means U.S. lifestyle has to fall to the global mean.

I disagree;
$50,000 represents value, it has not a measure of material consumption. If we could increase energy production, and decrease material consumption, then the world could easily support $50,000 worth of family life style value. The money needs to be spent on low material consumption "consumerism", but it can be done and at higher population levels. Reduced population levels? No. That is not "support", that's non-support, or worse, a die-off. It depends on how you spend it. Low materials consumption is good.

The thing is, we in the United States is planning to reduce energy production while increasing the mass of material infrastructure in it's production and distribution which is absolutely hats - backwards.

There is the "feeling" in the US that supply minimalization of energy is a necessary component of energy conservation. It's as if Energy poverty helps energy frugality, at least in the minds eye of many Americans.

In poverty, people cut down trees. In wealth, they go to school.

[MSimon]

What kind of relief will be required when the average income (PPP) of the bottom 20% is $50,000 in todays dollars?

This will never happen.

The planet can't support it.

You have mathematical proof of this? You know the technologies of 90 years from now as well as the person in 1910 could figure the technology of 2000?

We have a history of doing more with less. Do you think that trend is going to stop within a few decades?

Do you think the person of 1910 would be worried about the 2000 person spending less than 10% of his household budget on food? After all with the 1910 number being closer to 30% - 10% would mean starvation wouldn't it?

And who could afford a personal two way wireless set? And what the heck is a computer? And Boolean Algebra? Useless math tricks.

And yet the trajectory from 1910 to 2000 was pretty much predicted in the aggregate. About 3% growth compounded annually. The USA can do that for about another 50 years (at least). So in 50 years the poor person of today ($10,000 a year) will be making $44,000 a year in constant dollars.

Electronics in 2050? I'm pretty sure it will be diamond or carbon nanotube based. It will use less power, and the power electronics will run hotter increasing power density.

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Average global per capita income is around $7,000. Mexico is there.

http://www.boston.com/news/world/articl ... worldwide/

Global income is growing at about 4% a year. In 50 years that will be about $50,000 a year. So the average person in the world would be as poor as a poor person in the USA. And rich beyond measure by 1900 standards.

[TallDave]

What kind of relief will be required when the average income (PPP) of the bottom 20% is $50,000 in todays dollars?
...
Okay, I can imagine some scenarios where the Earth could support that level. They aren't pretty, though, as they involve very substantial reductions in global population.

We've been hearing that argument for centuries. It hasn't been right yet.

A lot of very smart people as recently as the 1970s said we could never have today's living standards or population.

Technology grows, often exponentially.

Most likely by 2100 we'll have 10 billion people and something between $70,000 and $350,000 GDP per capita (this is the difference between 2% and 4% growth over that period).

Arbing the low labor cost of the far east has been nice for a while, but eventually arbitrage leads to equilibrium, which means U.S. lifestyle has to fall to the global mean.

If all else was equal. But of course it isn't. American workers are far more productive. And productivity keeps rising, all over the world.

[choff]

Part of my interest in your health care reform debate comes because the largest percentage of my relatives live in the States. At one count years ago 20 million Canucks had relatives in the U.S. Every single time there's a gathering of the clans, we hear complaints about the US health care system from American relatives.
At one such gathering thirty years ago, one of my cousins told me she worked as a nurse in a old folks home. Her job was stressful because if an elderly resident died, the employer could get sued by relatives, if they got sued, the doctors would shift the blame onto the nurses, so it could come out of her life savings.
My family compared costs with the American relatives. They paid 4 times as much per month for health insurance as we did, though our taxes were higher. They also told us if an illness befell a family member that wasn't covered, a family could end up selling the house to pay for it.
They also told us a lot of people were afraid to let their kids play with neighbors kids, because they could get sued if accidental injury happened.
In Canada, I've always found its not hard to tell when someone is from the US, because they get mad about something us locals take in stride, and ask us, "who do I sue." It sounds very strange to the ear, because the threat is so hollow.

[MSimon]

They paid 4 times as much per month for health insurance as we did, though our taxes were higher. They also told us if an illness befell a family member that wasn't covered, a family could end up selling the house to pay for it.

Where as if an illness befalls a family member not covered by government insurance you will end up selling the house to pay for it.

Unless the government outlaws such "outside the system" treatments.

When in which case the relative can die and everyone gets to keep their stuff. "There was nothing we could do. There are laws against helping."

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High taxes are a theft from future generations in so far as they retard growth. And high taxes retard growth.

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Every breath is a risk. The question is: do you want to assume that risk or lay it off on others? If you lay it off on others do you wish to lay it off only on those who volunteer to join the risk pool? Or do you want everyone in the pool at the point of a gun?

[choff]

It's probably a six of one half a dozen of the other difference. The impression of the proposed Obama health care situation as described by one BBC pundit was get something passed then fix it later. To my way of thinking the only way to create a European/Canadian style system in the states would involve a head-on collision with the AMA, insurance industry, lawyers lobbies and pharmacology industry, and the right wing. Doesn't look doable.

[TallDave]

choff,

The lawyers and the pharma industry have signed their Munich agreement. The insurance industry is in the role of Czechoslovakia; they are right in the crosshairs of the public option (which Democrats are assuring their base will destroy the industry and evolve into single payer). The AMA is split, with specialists lining up against general practitiioners.

The trial lawyers believe they are too powerful and too valuable to the left for tort reform to ever see the light of day. Pharma believes no one would dare cut off the last market supporting their R&D.

if they got sued, the doctors would shift the blame onto the nurses, so it could come out of her life savings.

Personal liability? Very unlikely, in terms of legal theory. You would have agency protection in such a case, unless they could show she badly violated proper procedure. Plus they generally don't go after average people anyway.

[MSimon]

What socialist forget (Marx did not) is that socialism is a system designed for stasis. That when there were no new profits (doing more with less) to be found, socialism was in order.

Marx said that if you want capital the capitalist system was the way to go. It is a hard system - and Marx was aware of that. And yet if you need capital....

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So the question is this: has the medical system/science reached the end of its development? If not you want a capitalist system to spur development. With all the defects capitalism entails.

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I blame popular socialism which is ignorant of Marx. And it got so disgusting even in Marx's time that Marx once said that he was no Marxist.

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Of course Marx was unaware of the problem of "local knowledge" developed by Hayek.

http://nobelprize.org/nobel_prizes/econ ... cture.html

Under the conditions of local knowledge, capitalism may still be superior to socialism as an organizing principle.

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Will a $200 dollar procedure be developed for a heart replacement? No one can tell at this time.

No one in 1900 could imagine that Babbage's difference engine could be reduced to a 10 cent piece of silicon that would not only do the work 100s of times faster (you can get much more speed than that if you are willing to pay $100 for your piece of silicon) but also consume much less energy and weigh a 1/10th of an ounce (packaged).

So how do we get to that $200 cost? Keep doing the procedure for those who can afford it. We will learn things. A system run strictly by accountants is not going to make much advance. Because big advances are disruptive.

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I remember in 1975 or so that the IBM folks said that microcomputers will never amount to anything because their computing power was totally inadequate. So some guys in Evanston, Illinois started a company called Itty Bitty Microcomputers as a pun on that theme. (I think I bought my first 2708 EPROM from them)

The static vision is not uncommon even at the leading edge.

The easiest extrapolation to make is "more of the same only more of it". Bureaucrats can handle that. There are rules. Just follow the rules. Reality surprises.

So why is the American system so productive of new ideas? One of the reasons is that there is no single gate keeper deciding who gets funded and who does not. Suppose a person with a good idea has pissed off the bureaucracy? In America there are hundreds (probably thousands) of funding possibilities for new ideas. We have an industry devoted to it. Venture Capital (VC). So 99 VC guys see no opportunity and one VC guy sees something. Things get tried.

It is one of the reasons EMC2 is not going to die until a yes/no answer is produced. Would EMC2 get as good a deal from VC as they are getting from the government? No. But otherwise the money is there.

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The world is not ready for socialism. Insufficient Capital.

[choff]

The world is not ready for socialism. Insufficient Capital.
Apparently Wall street is.
Given the extent to which US banks and insurance companies were bailed out by the US taxpayer, I would think that on technical grounds the US is much more the socialist economy the Canada. These are the same companies run by the same wealthy individuals that avoid taxes offshore themselves.
You can pretty much bet they're busy creating the next big bubble,(and getting huge bonus's doing it), so that in another 5 years they can blackmail an exponentially bigger bail out from the little people that do pay taxes.
It would be interesting to see how many of the bailed out insurance companies have health insurance divisions.
Since litigation settlements effect insurance rates, the Democrats lawyer base must make them conflicted. A similar pattern occured in the Canadian Federal Liberal Party during the Trudeau era, 90%+ of sitting Liberal MP's had law degrees.

[MSimon]

choff,

Maurice Strong.

[choff]

Maurice Strong?

Don't see the connection, my parents were both card carrying Social Creditors, I probably would've become one if the movement didn't collapse. I moved from hard right to right of center about the time the cold war ended. A lot of innocent people got hurt both sides of the cold war, don't want another one.

Actually, the French president suggested going after the offshore banking industry. Wouldn't take any sort of world government, just a coalition of the willing, which would be all the big countries. The tax havens would be no match. Only problem, most politicians have offshore accounts to hide.

It's either increase revenue by flushing out the tax cheats, or cheap fusion energy comes on line not too late. The consumer is a bit stretched to expect spending to solve the recession.

I just saw Obama's speach, he say's his program will be financed by savings made in the existing plan. I gather the gentlemen sitting on their hands are the GOP.