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 <email@example.com> wrote: > On Thu, Nov 8, 2012 at 11:51 PM, Paul Tanner <firstname.lastname@example.org> 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: > > http://www.flickr.com/photos/kirbyurner/8169129506/in/photostream > >> >> 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