Posts Tagged ‘wasteful practices’

Health care, or wealth care? (Part two)


Let us say that the unthinkable happens, and the United States adopts nationalized health insurance.  What will this mean?  For one thing, everyone will have to see a doctor at least once a year, and probably more often.  Regular check ups are the single best way of reducing health care costs, by catching problems early.  If a person is injured in an accident, at work, at home, commuting, or out partying, all of their expenses will be covered, including physical therapy.  Bankruptcies as a result of medical costs will cease, and case loads in Emergency Rooms will likely decline significantly.

Who needs the most health care?  The elderly.  As the emphasis in medicine shifts to preventative care from catastrophe care, the elderly will receive more care in terms of check-ups, tests, and evaluations.  Exercise and diet, along with social activities, will become medically directed, instead of individually initiated.  Health care will be about health instead of care.  The elderly are likely to gain in importance to the rest of us, because so many activities will be oriented around the them, because it is much easier to keep an elderly person healthy than it is to get them to recover after being seriously ill.

Extreme procedures, which can prolong life for a short time in an elderly person, or for many years in a younger person, will become rare, because few young people need extreme procedures, and we simply cannot afford to provide them to large numbers of people.  Quality of life will become more important than simply keeping a person alive a little longer, when they are unlikely to ever leave the hospital.  The elderly will be less likely to suffer from cross drug reactions, when a doctor monitors all of their care, instead of people being seen only be specialists.  Tests will become less common, as doctors opinions are not contradicted because of costs to an insurance company which threaten its profits.

Because the emphasis will be on preventing catastrophic illness, specialists will be in less demand.  Instead of expending huge amounts of resources to repair damage caused by lifestyle, huge amounts of resources will be spent changing lifestyles.  Most people have accepted that it is cheaper to wear a bicycle helmet than it is to hire a brain surgeon to repair the effects of a head injury.  Regular exercise is much cheaper than open heart surgery.  Preventing diabetes is much cheaper than treating it.

That isn’t the way things are right now because it is more profitable to deal with catastrophe than it is to prevent one.  Great strides are being made in the treatment of various disorders, but little progress has been made in learning how to get people to change their behavior to prevent the disorders in the first place.  If diabetes is becoming a national epidemic, shouldn’t we be focused on changing behaviors rather than accepting  higher disease rates?


Health care, or wealth care?


As the debate intensifies regarding health care reform, keep in mind a few things.  Such as; a reasonable profit on the part of health care providers is to be expected.  Hospitals, clinics, and doctors have to be able to cover their expenses, and make a little profit.  Also, insurance companies have absolutely no part in providing health care.  And, insurance companies are involved in health care strictly to make a profit.  It is the insurance company profits which are at the bottom of the health care crisis, because the insurance companies make more profit the higher the costs of care go.  They operate on a percentage basis, charging a certain percentage of total costs.  The higher the costs, the higher their profit margin.  (Ten percent of 100 is 10,  ten percent of 1,000 is 100)

These profits are what many people are trying to protect, irregardless of the costs of care.  Nationalizing health care would eliminate the insurance industry’s involvement in the health care system, meaning no more profits for shareholders.  This is what the wealthy want to avoid at any cost.  They are not concerned with the availability of health care, its affordability, or its quality, because they can always afford whatever health care that they desire.  Their only concern is maintaining their dividend checks, the cash payment they receive from companies that they own stock in.

Health care providers have watched their profits shrink even as the costs of health care have skyrocketed.  How can this be so?  Because the insurance companies have been driving the increase in costs, not the providers.  Every insurance company employees its own claims adjusters, its own billing department, its own management staff.  Each and every one of these insurance companies must cover all of these costs, as well as making a profit.

There is going to be a lot of mumbo-jumbo, a lot of smoke and mirrors, a lot of misdirection in this debate.  Patients are not trying to change the way that they receive their health care, and health care providers are not trying to change the methods that said care is provided, but everyone is trying to cut health care costs.  Who is going to be on the defensive?  The insurance companies.

bringing young and old together


As the realization of how broke we all are sets in, perhaps we can contemplate some changes to save money.  We need new ways of doing things, ways which do not depend on the flagrant spending of money that we don’t have.  We need to look to the past, to see how thing were done before people could use energy so freely and easily.  We need to remember ways of living together which made us stronger, more unified, comfortable.  We need to be open to new ideas, willing to embrace change in the hope that we can learn from the results.  One such new idea is to hold day care classes at assisted living centers and nursing homes.

Currently, we are paying one group of people to take care of our kids, and another group of people to take care of our parents.  There was a time, not all that long ago, when our parents would have raised our children, while we were busy supporting both our children and our parents.  There were no such things as nursing homes, or day care, because those functions were performed within the family.  This is how culture was passed on, not through school.

A great many of the people who have been sentenced to a nursing home are still physically capable of looking after children, they just have some problem which their family did not want to deal with.  Having these people be involved in taking care of children, any children, would be beneficial for both the children and the elders.  And the children don’t have to be related to the elders, because children will accept almost any elder, and elders will accept almost any child.

Elders who actively participate in the care of the children could be compensated in some way, perhaps reducing the cost of their care that their family must cover, or receiving credit towards purchases.  Elders who merely interact with the children would not be considered employees of the day care, and would only receive the attention of young children.

Too many children today don’t know their grandparents, and there are children who have no idea what an elderly person looks like.  Far too many day cares merely take the children for a certain time, without much interaction between the workers and the children.  The children do not get an opportunity to discover what their heritage is, what it is that makes them who they are.

We can save money by having our elders do what they have traditionally done for most of human history, taking care of the children.  Doing so would also provide the benefits of young people learning about their culture, as well as seeing the world through the eyes of someone who has watched the world for a long time.

Going down the drain.


The way that we live, the processes that make our lives possible, the nature of the work that we do, how we school our children, all of these in the midst of upheaval.  We have discovered that we are using energy in ways that are foolish and unsustainable.  The very fabric of our society is being changed by forces far removed from our homes.

In order to keep things affordable in times of inflation, quality has been sacrificed over and over again.  Many homes today will not last as long as the mortgage taken out to have them built.  Cars have become complex machines which are usually wrecks by the time that they are paid for.  Easy credit has been the sole reason for the economic growth of the last decade or longer,  and easy credit has come to an end.  Wealth measured in numbers in computers is still disappering rapidly, while bridges and schools are still there.

Underground houses, high speed rail systems, education tailored to the individual, given to the individual at that person’s pace.  The ending of using drinking water to flush toilets with, the end of giant sewage treatment plants, the end of driving everywhere, the end of flying everywhere, the end of supertankers, the end of newspapers.

We have managed to avoid drastic change for so long that we have lost all control over change, and now we are likely to change drastically, chaotically.  Our culture, our very dietary habits, were altered profoundly by the Industrial Revolution.  Now we are dealing with the fallout of sacrificing the family to the factory.  In a culture where the term ‘murder-suicide’ has become common usage, we have to hope for some kind of change.

There are better ways


Someone just asked me why I started this blog.  For one thing, I love to write, and write a lot.  Sharing my thoughts with others is important to me, because I want to know just how crazy I am.  But mainly, I look around me and see things that don’t have to be, as well as seeing ways to do things better.  I have studied history, and have some understanding of the forces that affect our lives, such as economics.

One of my greatest concerns is the environment.  Everyone wants a bigger slice of the ‘pie’, but the pie is not getting any bigger.  Yet, there are more and more people asking for a slice.  The ‘pie’ is the combined resources of our planet, not just the wealth that is made by exploiting them.  As standards of living rise, the amount of resources used by individuals increases.

Our future may be one of conserving increasingly scarce resources, with a steadily declining standard of living.  Or we could choose to expand beyond this one planet we inhabit, to make use of the resources which abound in our Solar System.  That path leads to increasing monetary wealth for all, through the benefits of advanced technology, as well as a cleaner environment, because it will become cheaper and easier to process resources outside of our atmosphere, where the energy is free.

Our greed threatens our very survival, as we foul our nest with the wastes created by our technology.  It is my hope to channel that greed into pushing the sphere of human activity beyond our home, into the Solar System.  That is the only way that I can see a better future for all, for generations to come.  The Earth should be a residential area, with no industry or mining to foul the air and water.

Money, money, money!


Long ago, it seems, money was a symbolic representation of work.  Or, at least, value.  But when money is created simply by charging a fee, what is there behind it to make it worth something.  What has been invested to make this new wealth?  For money, in any amount, is wealth.  We claimed to be a wealthy nation, but a great deal of that wealth was created out of whole cloth.

You may be familiar with the process, for it has happened to countless Americans.  You have a credit card, with a fairly low limit.  Because of one thing and another, you get behind on your payments.  If you were close to your credit limit when you got behind, very quickly the late payment fees put you over your limit, so you are charged an overlimit fee each month, and a late payment fee, because you have not paid off the amount overlimit.

As result of these fees, every month, 60 dollars is created out of nothing.  A bank charging an overdraft fee for each check which comes in while the account is overdrawn does the same thing.  Now, imagine this kind of wealth creation going on all over the country, on a grand scale.  Our economy swells quickly because of all the wealth that is being created, leading people to believe that there is enough wealth in the system to raise prices.

As prices go up, workers demand more compensation, which adds upward pressure on prices.  As prices increase, management decides that the current profit margin is too small, and increases it.  Yet, no work has been performed to create any new wealth, no value has been added to anything, just fees charged.  Now, what happens if the credit card holder defaults on their account, walks away from it?  Where is all that wealth that was created by charging late fees and overlimit fees?  It has just vanished, because those fees cannot be collected.

This is merely one example of how wealth can evaporate, something that wealth has been doing enmass recently.   We must begin doing real work, to create real wealth, not imaginary, accounting trick type wealth, or we all are likely to be homeless.

Learning old lessons again


There is an ancient rule that any individual who becomes wealthy at the expense of the group is threatening the survival of the group, and must be isolated from the rest of the group, irregardless of the individuals eventual survival.  This law was enforced by evolution, natural selection, survival of the fittest.  It appears that civilization has caused us to forget this ancient law, because society has so much inertia that it can survive individuals who make themselves wealthy at the expense of the group.

But that condition is changing, the result of a small number of individuals who have enriched themselves enormously at the expense of the rest of us.  The brakes could have been put on the financial bubble long ago, preventing the carnage that surrounds us today.  But Greed motivated very wealthy, powerful individuals to intervene in the attempts to reign in the explosive growth.  Regulatory bodies were discouraged from investigating suspicious activity, Congress was lobbied not to enact certain laws, and a few overseas governments were manipulated into providing shelters for the wealth.

We all were encouraged to borrow, cash out equity, and to shop until we dropped.  Insanity began to take over, as the stock market kept growing beyond any reasonable limits, prices for homes doubled, and doubled again and again, and we succeeded in exporting our materialistic culture to even much older nations, under the guise of ‘globalization’.  Why should someone in Thailand make shoes for people in America if all they are going to get is material compensation.  The old ways may not have been prosperous, but the people were happy.

Greed manipulated us through the media into believing that owning things could make us happy, and accepting that our self-worth was dependent upon the things that we could by.  We became so desperate to prove our worth that we would buy cars that cost so much we had to get a 5 year contract to buy them.  Tho contract would last longer than the car would.  The same thing happened with houses, where the 30 year mortgage became the standard.  Very few people in this country actually own their home, most are paying a bank for the ability to live in the place.  By the time that you get it paid off, you are too old to take care of it, and often have to sell it for far less than what you have put into it.

All of these things made a lot of people rich, but they made a few people much, much wealthier.  I don’t know their names, and don’t want to know their names, because they are evil people.  They have been willing to run the world economy into the ground to satisfy their insatiable desire for MORE!  It would not be nearly as bad as it is if they had only played with their money, but they had to go and use ours, too.  Basically, we have all been broke for about 20 years, but we have been part of a shell game, a con, to convince us that really could spend more than we make.  It was inevitable that the powers behind this con would eventually lose track of where everything was.  When other nations with more wealth than us began to compete with us for resources, the sham collapsed, victim of gasoline prices which Americans simply could not afford.  It is one thing to put a big screen TV on your credit card, but entirely another to put a tank of gas on it.

Now, we are seeing values return to the levels they would have been at if the ‘irrational exuberance’ had been discouraged with higher interest levels, restrictions on leverage, mark to market rules, and other arcane things which are extremely boring to talk about, but which have such incredible impact on our lives when they are ignored.  Unfortunately, because so many of us have been sucked into jobs that catered to the Greed, such as selling people things that they didn’t really need, values are likely to keep on dropping.  Deflation could become a black hole, sucking the wealth out of the entire system.

Unless we begin using the material wealth that we have amassed to begin creating wealth that belongs to the community, such as a nationwide fiber optic system.  Rebuilding roads and bridges is important, but so is making those same roads and bridges far less vital, by replacing them with the means to move information, to the point that we can almost believe that we are somewhere else entirely.  Virtual reality would allow us to perform tasks half a world away, to take part in events without having to leave our homes, to shop for things without having to go to a store.

Insulating our homes, business facilities, upgrading equipment, these are the investments that we will have to make to keep energy costs low enough that we can afford them in an economy which is sustainable.  Educating our populace to the highest levels that they are capable of is another survival strategy, because the solutions to our problems are not going to come from ignorance.  Who us going to pay for all of this?  We are, the average Americans, who have been duped into spending everything that we were going make for the next few years.  Instead of paying off our credit card debts and hyper-inflated mortgages, we are going to end up working our butts off just to eat and keep a roof over our heads.

The 40 hour work week may become victim to the need to pay a whole bunch of taxes, so that this program of self-improvement is not entirely at the expense of other countries.  Probably, we are going to have to get by with what TVs, stereos, and computers that we have, because importing them would mean paying somebody else real money.  But we have so much incredible potential, so much accumulated wealth, that we could turn this thing around in a matter of a decade.  If we all agreed to work together, to sacrifice together, and to believe in each other.  There is hope, but it is mighty slim.

The dance changes tempo


So far, I am not aware of anyone acknowledging the fundamental problem behind our current economic woes;  We can no longer sustain the level of consumption that we have become used to.   Between the price of many commodities going up, and home values declining, we have to spend more than we earn to live in great luxury.  Yes, luxury.

We drive ourselves around in our own cars, so that we don’t have to be close to strangers.  Many of us stand under a shower of warm water for several minutes every day.  The lights always will come on when we flick the switch, there are no open sewers running near our schools, and the water coming out of the tap is fairly safe to drink, even though it became fashionable during the Age Of Excess to only drink bottled water.  The telephones almost always work, and most people fly on airplanes when they have to go somewhere.

By the standards of most of the world, these things are great luxuries, which even the wealthy cannot always afford, because they simply don’t exist in some places.  Yet we often consider them to be ‘rights’, which cannot be infringed upon.  We have the ‘right’ to drive our own car somewhere if we want to.  But there is nothing that says that we have the ‘right’ to gasoline whenever we want to go somewhere.  If we can pay for the fuel, fine.  But what if we can’t?

The costs of energy are rising, and not simply because of demand.  Generating plants are becoming harder and harder to get permits for, the grid that transmits the energy that is generated to where it is needed is on the verge of overload, and we need a whole bunch of new lines to move wind power to where it can be used.  Crude oil is no longer found by drilling a few thousand feet in sandy soil.  Extracting it can mean working in thousands of feet of water, and penetrating the Earth’s crust with holes several miles deep is becoming common as we search for new supplies of oil.

For our society to become economically sustainable, consumption of energy has got to be reduced considerably, possibly 50 percent.  That sounds like a huge undertaking, but we are so inefficient in how we use energy that it would be fairly straight forward.  The majority of structures in this country are poorly, if at all, insulated.  Simply bringing every building up to the highest possible level of insulation would result in huge savings,  as would putting solar panels on every roof.

But the automobile is the biggest culprit, and there is simply no way to make it cheap to push around a whole bunch of metal and plastic so that one person can risk their life to get where they want to go by themselves.  We will always have cars, but we will no longer use them all the time.  Instead, we are going to have to get used to riding public transportation when we are commuting to work or school.  But we will still be able to go where we want, when we want, when we can afford it.

If we can make what we already own more valuable by making it more energy efficient, we have invested our money into something that will create wealth, or money, as long as it is used.  But this wealth will be diffused through the economy, instead of being concentrated in the hands of a few, which might be why there is such resistance to changing the consumption of energy dramatically.  The oil companies will not make huge profits if we all start riding transit to work or school.

This will be a drastic change in the American lifestyle, but we are facing something worse than War.  We are dealing with the consequences of unbridled Greed getting its way for too long.  A lot of money was made, but the value of money is coming into question, because so much has been ‘made’ that just disappeared all of a sudden.  Real wealth is the kind that everyone benefits from, and which won’t just go away.  A bridge, a rapid transit system, a fiber optic network, insulation in every building, these are things that make all of us wealthier.

If we are equals, why aren’t our taxes?


The economic stimulus bill being rushed through the Senate right now focuses more on tax cuts than the House version of the bill, which promotes federal spending.  Why are the Republicans so obsessed with tax cuts?  Because many of the wealthy in this country object to having to pay higher taxes than the middle class.  At some point in the past, when the liberals controlled the government, it was decided that the wealthy could afford to pay more of their income in taxes than the middle class, so the tax rate for the wealthy was raised to 50 percent.

That inequity still persists, although the highest tax brackets are no longer taxed at the 50 percent level.  Another item that was to be included in the stimulus package was relief from the Alternative Minimum Tax, the liberals attempt to stop the wealthy from using various tax loopholes to escape from the high tax burden.  All this talk about taxes is boring as sin, but when you are talking about a pile of paper over 5 feet high, of letter sized pages, typed single space, who could avoid being bored?  That is the size of the United States tax code.  No one knows the whole thing, and there are people whose lives revolve around a few inches of that stack.  Armies of people work to prevent companies and individuals from paying more than they absolutely have to.

Wouldn’t it make sense to throw that pile of paper away, and replace it with a single, flat tax rate, which applies only to individuals, and represents the portion of the Gross Domestic Product that it costs to operate the government?  If we want to modify behavior, call it a fine or fee, or a subsidy, but leave it out of the tax code.  This is where the complexity has come from, trying to change behaviors.  If the government doesn’t want people doing something, they put a tax on it.  Conversely, if the government wants to encourage something, they create a tax break for it.  All of this leads to thousands of pages of legalese, which usually doesn’t go away when the activity it addresses does.

If we went to a flat tax rate, and did away with all the shelters, deductions, and other loopholes, so that everyone paid the same rate, we could get by with a tax rate of about 17 or 18 percent.  That is the proportion of the G.D.P. that the government has spent every year for some time.  This slightly higher than what most middle class people are paying, and a lot lower than what the higher tax brackets face.  If we are equal before the law, why can’t we be equal before the I.R.S.?

Feeding the Greed.


Greed is alive and well in the United States, in spite of the carnage that it has already caused.  Just recently, several homes were carried off of their foundations when a holding pond full of ash from a coal plant broke open.  This type of ash has been shown to be high in heavy metals, and calls have been made to sequester the waste product in isolated tanks.

But, because ash from coal-fired power plants constitutes the second-largest waste stream in the nation, behind solid waste, the utilities have managed to keep regulation light.  So, we get our power more cheaply, while incurring hidden costs that will not be known for generations, perhaps.  Substantially reducing power consumption in the United States is never even discussed, even though we are the most inefficient user of energy on the planet.

Consumption of energy generates wealth for a certain few, and those few are very powerful.  So they will resist efforts to reduce the amount of wealth that they can make in a year.  But, unless we begin to use some of that wealth to make things better for everyone, things are going to get a lot worse for everyone, even the rich and powerful.

Generating electricity using coal creates 129 million tons of ash, or combustion by-product, as it is called in the industry, every year.  Increasing coal use will increase this waste stream, which is already being handled at the absolute minimum cost.  Substantial evidence indicates that this waste is extremely toxic.  As storage costs increase, accidental releases are sure to increase.

Using energy always has costs, which are not always obvious.  The ‘clean’ hydro-electric damns of the American West have turned out to be environmental nightmares, destroying fish runs, impounding silt, and affecting aquifer renewal.  Using less energy to do more is the only way that we are going to be able to avoid a true energy crisis, one where the use of energy is so destructive to the environment that it cannot be allowed.

Simply maintaining our consumption levels to enrich a few wealthy individuals can not be sustained.  Public outcry is needed to overwhelm the power that wealth can throw at avoiding change.  We have got to stop feeding the Greed, and start putting Greed to work for us, instead of the few.  We don’t have to prevent anyone from making money, we just need to reduce the rate at which they are accumulating new wealth, because that wealth is coming out of our future.