Date: Nov 9, 2012 4:08 PM
Author: Paul A. Tanner III
Subject: Re: Obama's win - good or bad for the US/the world?

You proved me right. You did not actually answer a single question I
actually put to you in any useful way. That is, all your answers were
just a beating around the bush.

On Fri, Nov 9, 2012 at 2:24 PM, kirby urner <> wrote:
> On Thu, Nov 8, 2012 at 11:51 PM, Paul Tanner <> wrote:
> << snip >>

>> Your whole reply above is an example of what I was talking about.
>> If you think "toilet paper" is infantile as a metaphor for what we
>> need and which needs to get paid for if we're going to get it (unless
>> you're lucky enough enough to get every doctor and so on you'll ever
>> need to do it all on a volunteer basis), then let's try "health care".
>> And so let's get real, and confront the facts with respect to health
>> care, shall we?
>> Would you kill Medicare?

> To review, I've been arguing the people who think quite strictly in
> terms of budgets and money (as in "should we kill this or spend more
> on that") are not really conceptually grappling with designing and/or
> planning for the delivery of services to needy populations.
> Nor are the purely money-minded interested in zoning for the growth of
> cities or doing land use planning of any kind.
> They're looking at a column on numbers and saying "do we up this or
> lower that or what?"
> It's not clear to me that people who think purely in monetary terms
> have much if anything to do with the engineering work it takes to
> design and build much of anything.
> The money-oriented tend to be the least conscious and aware of all the
> variables in play, the options provided by current and expected
> technology.
> They've narrowed the world to some numbers and now they insist that
> reality follow them down the rabbit hole and be manageable in those
> terms.
> How do you spell "rubber room" (as in straitjacketing thinking). Such
> is economics, at least half the time (GST is bringing fresh
> perspectives).
> Economics is a form of mental retardation, for the most part (true of
> many academic subjects, which doesn't mean they can't feature tough
> puzzles and/or "higher math"). FYI: I've just been perusing some
> early MAD -- 1950s -- re "how to look smart" (pretty funny). I found
> this Tom Lehrer contribution in issue 35:

>> Would you do the conservatives' thing and make it so that old people
>> either pay more and more in terms of the total of premiums,
>> deductibles, and copays or they get no health care, statistically
>> guaranteeing that more and more old people with all those already
>> existing conditions will not be able to have health care via not being
>> able to afford it? Yes? No?

> It's not just about "old people". People at all ages tend to need
> health care, many times for congenital conditions.
> What's true today is some retirees flee the USA jurisdiction and set
> up with their savings in Mexico or the Philippines, where their dollar
> goes much further and health care is much more affordable.
> Others stay where they are but mail order their drugs from Canada,
> although the Wal*Mart strategy of going $4 on generics (to iTunes the
> meds business) has helped alter those distribution patterns.
> Huge numbers of health care workers, including for longer term care
> facilities (it's not just about hospitals) migrate to North America in
> response to vacancies and remit some of their earnings to families
> elsewhere around the globe.
> Point: it's a global operation already, and like the electrical
> grids, the health care networks are tending to hook up and integrate
> on many levels.
> What would I like to see?
> More floating hospitals, an industry as big as the cruise ship
> industry, with lifestyles to go with, and these put in to port for
> non-trivial amounts of time. Some park there for the duration, pretty
> much. It's a way to build something state of the art and float it to
> where it needs to go.
> Who would pay for these?
> Based on current projections, probably not the USAers. Their role is
> more to put people into these hospitals, by upping violence levels in
> various parts of the world. This has been their role recently (we can
> run some numbers if you like) and they seem eager to "hold the
> course".
> The Russians? Lets talk about long range plans for an eye care
> facility / hospital / complex in Siberia. It's under some big domes
> and is warm and cozy 24/7 and has resort hotel aspects. People fly in
> from all over the globe because the eye care is good and affordable
> here.
> Extrapolating from existing trends, health care will be more of a
> global enterprise than it is even today. South Africa is likely to be
> a player (already is).
> However do we want to do all our accounting in terms of sovereign
> nations? If I'm Ford, looking at Ford around the world, then it may
> really confuse me to try thinking in terms of Ford / USA versus Ford /
> Germany and Ford / Mexico. We're talking about integrated operations
> and a bottom line. These political demarcations are interesting but
> certainly not the whole story.
> Health care planners who think in purely nationalistic terms may not
> have had the best educations money can buy, eh?
> When you study an airplane's schematics in CAD and want to look at the
> electrical system, you don't just look at controls in the passenger
> seats or the coffee making circuitry in the gallies.
> Likewise, when looking at health care planning, you may choose to
> thinking just in terms of some "USA" and its budget. You may simply
> brand yourself an "an economist". You may get a cubicle in DC and get
> to right papers for politicians to base speeches on. You may be
> considered successful in your line of work, and have the Nissan Leaf
> to prove it.

>> Would you do the conservatives' thing and make it so that Medicare
>> covers less and less, statistically guaranteeing that more and more
>> old people with all those already existing conditions will not be able
>> to have health care that they need? Yes? No?

> Health care that takes you outside the USA jurisdiction for many of
> your elective health care needs?
> Heart surgery in South Africa?
> Eye care in Siberia?
> In some cases, that might be your best route, in terms of both patient
> experience and outcome.
> Likewise, the ability to offer lots of dental care may depend on
> relief teams coming in, some of them religiously based, whatever
> ideologies.
> A lot of people around the world depend on charitable organizations,
> funded behind the scenes by various private beneficiaries.
> My goal with CSN is to have charitable giving be more a part of the
> everyday experience for ordinary folks, starting from a young age, no
> need to be some gazillionaire. There's a game playing aspect. We're
> talking hours a day.
> A China-based set of charities wanting to provide dental care in
> Detroit would be part of a wider foreign aid effort. As most people
> know, many USAers live in dire poverty, with terrible living
> conditions, little access to services.
> Many idealistic health care workers will do some service in North
> America out of a sense of compassion for the impoverished in that
> area. Slowly but surely, the hope is to raise living standards, even
> for these malnourished and undefended.

>> What about all those 50 million below age 65 that have nothing now,
>> and what about those many more tens of millions that are what they
>> call under-insured?
>> Where would you get the money to pay for it?

> You certainly need people with an appetite to become health care
> providers. That means you need attractive lifestyles, sometimes
> serving aboard health care ships.
> All the money in the world can't make up for too few people with the
> knowledge, skills and sense of compassion (cultivated through
> meditation and tending to mental attitude -- dharma / curriculum
> stuff).
> There's this tendency among the money-thinkers to forget that it's
> part of the planning responsibility to attract and recruit.
> Making the job of health care professional more global by definition,
> offering more opportunities not just for "travel" (in the sense of
> idle tourism) for learning skills and encountering many more career
> relevant situations in one life time, is going to bring more talented
> people into the health care professions.
> These are people who might have otherwise squandered their talents as
> demolition engineers and explosives experts in the business of
> maiming, actually undoing the work of health care workers (fighting
> doctors).
> So I'd say the long range plan is to counter-recruit against the
> murder and mayhem crowd (lower skill levels on average) in part by
> upgrading the STEM curriculum, the work / study scenarios.
> We may gradually convert some of the facilities (e.g. Okinawa) into
> more health care related and relief operations as well.
> The doctor-fighting USA (the DC centric version of it) is likely to
> counter these development though, as a nation with a track record of
> militating against health and health care, even for themselves (just
> look how they eat, so many of them! -- suicidal obesity is a norm in
> the US, and not just in Texas).

>> You complain about debts and deficits but offer no suggestions as to
>> what our government should actually do in terms of these very real
>> questions of revenues and spending..

> If you're talking about Washington DC, then I'm not really interested
> in reading their "white papers". So many of these people come
> straight from college, where they received a warped view of reality,
> after years and years of heavily fictionalized "unreality TV" and now
> they have cubicle jobs writing "policy proposals".
> Sorry, but that's not a city I look to for real leadership as a rule of thumb.
> I think Obama's effectiveness in his 2nd term will have a lot to do
> with how much time he spends outside of DC. He's got all the
> telecommunications he needs. He should travel more. DC gives any
> president an less intelligent perspective on many issues.
> I think the equivalent of a White House on the west coast, where
> presidents and their staffs can get work done, might be a worthy
> investment. Somewhere in Oregon maybe? Call it Camp David West or
> something. The casinos could kick in some funding as friendly
> sovereign nations, willing to sit down with the Federalists and talk
> turkey, negotiate about the ecosystem more.
> The Pacific Rim states are less Eurocentric and might help North
> Americans outgrow their silly fascination with European thinking about
> money and stuff (not that the Swiss are stupid or anything -- they're
> invested in Asia too). People grow up thinking there's "capitalist"
> and "socialist" and every configuration of every ecosystem is supposed
> to be a mix of those two somehow. Why think in such a mediocre
> fashion? Is this the best philosophy can come up with?
> Kirby