Healthcare Part 1 - It's not a market

Much of the debate about healthcare is between those who think the "market" can solve the problem, and those who think that "universal coverage" is the answer. Both are wrong.

A "market" is a place where a user can purchase goods or services. In healthcare, who is the user? Not the patient. The patient can't order her own tests. The patient doesn't even pay for the services. Some third party pays, such as insurance or Medicare. The recipient of the funds, the seller, is the healthcare provider. The reality is that the "market" in healthcare has one party as both the buyer and the seller -the healthcare provider himself. The doctor determines the services that will be rendered and then orders those services to be bought from himself or his associates. Rest assured, there is no "market" in healthcare.

The claim from the other side for "universal coverage" is a red herring. Is universal auto insurance an effective mechanism for keeping down the cost charged by the collision repair shop? No. One has nothing to do with the other. Insurance is simply a transfer mechanism. It's a way to take money from group A (those buying the insurance) and giving it to group B (the providers of healthcare services). Note that we've already posited that healthcare services providers are both sellers and buyers of their own goods. It's quite a perverse system.

All the answers on the table today ignore these simple facts, and in so doing exacerbate the problem. They're simply missing the boat.

Hawking & God, #2

There was an absolutely fascinating documentary recently in which Stephen Hawking made the following two points (obviously among many other brilliant points):

1. Mathematics proves that we did not need God to create the universe, and
2. Time did not exist before God, so there was no"eternity" within which God could exist.

Well, ol' buddy ol' pal, let's take a look at that (for the record, once again, I'm a mental midget compared to Hawking, but then again, aren't we all). So, why argue with a genius? I'm not arguing. My position is that science need not (actually can't) encompass God. Attempts to explain God with science are inherently silly. I tire of the myopic scientific view that deists, theists, or all other believers are all of one ilk - narrowly defining God as being contained entirely in one of a smattering of 1,500 page books. For science to claim there is no God is as arrogant as it is for religion to claim that there is no science. So... with that said:

1. The claim that we did not "need" God to create the universe does not negate the existence of God. Hawking was clear in his use of the word "need." I don't "need" for there to exist someone by the name of Mei Li in Ghezhai in Central Eastern China. And yet someone does. Lack of need does not preclude existence.
2. There are numerous references in the Bible (and other texts) to God existing "before time." If sacred texts were written by individuals with some gifted insight into divinity (much like Hawkins has a gift for insight into science), then we have to ask about these references to time in these texts. Were they poetic references, or understandings that God transcended time? I find it interesting that they were written by individuals who lived in eras that predated current theories about space and time.

Remember NASA?

Posted February 12, 2053

Colonial Governor Vladimir Putinovich, reiterated his government's position that it will not release additional power reserves to New Shanghai Colony's medical research facility. The research facility, having achieved significant success in gerontological and osteological research, has nonetheless suffered from poor maintenance management. Significant portions of the facility have been shut down in recent years, resulting in consolidation of operations and living areas. Its most recent innovations have led to advancements in bone regeneration with a focus on joints and arthritis.

Despite these success, the Chinese Central Government has been slow to share the benefits it has received with the lunar colony that created the benefits. New Shanghai officials are a colony without representation, and have been forced to barter with Putinovich, trading supplies in exchange for additional power to maintain systems. Meanwhile, Putinovich's colony, Novapetrigrad, has been attempting to balance its own power needs from a booming tourism trade with the supplies needed to satisfy tourists' needs.

On a related note, Congress has passed new tariffs on space travel, citing Russian, Chinese, and Indian price gouging. According to the Speaker of the House, "These countries' monopoly on manned space flight does not give them carte blanche to disregard their ethical and moral responsibility to the rest of mankind. Their price gouging and profiteering is cost prohibitive to science and research. These tariffs send a strong message that the US will not be bullied or manipulated because of its reliance on their space programs."

Big Government Part 2

As the debt debate rages on, we can each appreciate, from our personal and professional lives, the folly of spending more than we have or earn. We each, one way or another, are limited in our spending. Why should we, collectively as a government, be any different? There will, one day, be a reckoning. Perhaps it will come when all government revenues go to pay only debt service. It's simply inevitable.

However, before we get there, we struggle with priorities. We simply can't cut off funding and expect proportionate shrinkage. Let's think big. What laws will we choose to stop enforcing, or outright repeal? Employment laws? Environment laws? Education laws? Energy laws? And that's just the "E's"!!!

Or maybe we go after the real culprit: Debt. Isn't that what we do in our personal lives? Pay off the debt so we can piece our lives together? Maybe we sell off assets. Let's bite the bullet and be done with it. Sell oil. Sell gold. Sell land. Sell oil leases. Renegotiate debt. It's now or later.

Big Government?

"Big" is relative. Drive a Smart Car long enough and a Corolla will seem cavernous. Drive a Ford Excursion for a few weeks and you'll feel cramped in a Suburban. So when is government "too" big?

One common measure is reflecting government size (i.e., spending) as a percentage of GDP. That oversimplifies the issue. Delving into the components of government spending sheds a bit more light. It's clear that some components have grown aggressively over time, while others grown less so. State and local government often gets hit with the same accusation. What are some clearer ways to frame the issue?

• Which large program do we want to eliminate? Chipping away may work for small problems, but it won't work for big ones.
• Which large programs do we keep? Roads, police, waste - all those are best handled by government oversight. Safety and security are too important to be left to a provider whose core mission is profit.
• Where do we make real sacrifices?
• What's the best relative metric for defining the size of government? No one would claim that India should have the same size government payroll as does Monaco. But it's also not exactly a linear relationship. Larger populations beget not only larger, but more complex problems.

So what size should government be? How small is too small and how big is too big?

Successful Relationships

The relationships between men and women have changed substantially over time. That which worked decades ago or centuries ago no longer suffices. Clearly, the physical ingredient of relationships is roughly (no pun intended) as it has been for thousands of years. That's a matter of personal taste; to each his own. In all other areas, the dynamics are radically different.

The ancient Greeks weren't too far off in their analysis of love. Frankly, despite our arrogant belief that we have evolved light years beyond our ancestors, the nature of love hasn't changed too much. The Greeks broke down love into Storge (the love of a parent for their children), Filia (love among true friends), Agape (love for the human race and its community), and Eros (sexual love). Can mixing those definitions together be sufficient to create a worthwhile, long term relationship, such as marriage? Arguably, a good relationship mixes Eros and Filia; it's an exciting and deeply caring friendship. It then starts looking outward jointly with Agape. It often will manifest itself with kids, an opportunity to experience Storge.

Will that last? Well, people change. Excitement wanes. New interests develop. Kids grow up. Decades ago and centuries ago, our fairly narrow worlds limited the amount of change. Less change meant less reason to grow apart. Moreover, the economics were very different. Couples needed to be together. Neither could really survive on their own, and it was extremely difficult for a family to survive with only one parent. That need doesn't exist anymore. Going solo in life is much easier today. Superficial needs can be satisfied (or obfuscated) with petty pursuits, and economic needs can be more easily satisified without someone along for the ride. Men, by and large, haven't kept up emotionally with women's independence. Men don't get an ego boost by being the provider anymore, because they're often not the provider. The role models men had in their fathers and grandfathers no longer hold sway. It's uncharted territory, and it's the future.

So how do you make it last? Obviously, you need all the pieces listed above. But in addition I think there needs to be a purposeful partnership. Couples need to build something together. They both need to have skin in the game. Whether you're building your retirement or building a family, there needs to be something that keeps pulling the couple together. A common goal is the best long-term answer.

Hawking - Really?

It's hard not to be a fan of Stephen Hawking's. Even if you're only mildly nerdy, and regardless of the fact that his brilliance is light years ahead of your own, he has an amazing mind. Nonetheless, he recently opined about the existence of God, stating that belief in such was a crutch for the weak-minded and frightened.

Really? Come on. Gimme a break Steve. A brilliant mind like yours should be able to immediately recognize the folly of trying to "prove" the existence of God. If I, as the counterpoint, lay a premise for "God" as "a being which is beyond our senses, our reason, our science, our understanding and our grasp," that God becomes immediately unprovable.

The concept of an ineffable, almighty God is by definition outside the realm of science. They may coexist, and the concept of one may enlighten thoughts of the other, but God simply isn't subject to the laws of any form of physics or mathematics.