Unemployment and Entitlement

You know what bites?  Actually, lots of things bite, but here’s a big one.  The American economy (as measured by the success of American businesses) doesn’t need that many American workers anymore – and never will again.  Increasing automation—along with a doctrinaire free-trade agenda—have conspired to make a broad spectrum of American workers obsolete.   When times are bad, Americans are laid off, then when things pick up, workers are hired in China, India, Malaysia, etc. 

We’re told to ‘make ourselves matter’, and to stay relevant, but are given no real guidance as to what that means – because there is no way for the large population of displaced American workers to ‘matter’ again.  I welcome any INFORMED rebuttal of this point. 

Kurt Vonnegut’s 1952 book, ‘Player Piano’ postulated a fully automated US economy that didn’t need workers anymore – just managers and engineers.  The rest of the population were given make-work jobs in the Reconstruction and Reclamation Corps.  It seemed bleak and dystopian at the time, but by contrast to the economy that has evolved in the US, it was actually relatively optimistic.  At least in the book, the displaced workers weren’t blamed for the overwhelming forces that displaced them.  And more importantly, they were cared for.  In today’s society, they are blamed for not making themselves ‘matter’.  Those who try to matter find a moving target of job skills which appear promising, but then are moved offshore, or made obsolete by technology.  The retraining is so expensive that, even when a job pans out, the burden of student debt is crushing. 

Those who have managed to maintain their status in today’s society are not called upon to do much to help those who’ve been cast aside – and are taught to scorn those who have lost everything, so as not to be troubled by their plight.  Basics, such as retraining, unemployment insurance, healthcare, and foodstamps are painted as luxuries, and treated as though they encourage dependency, and a sense of ‘entitlement’, when in reality, they only allow people to bounce along the very bottom of our society.  

The very companies who have moved cut jobs wholesale, and moved others overseas, are applauded as ‘job creators’, and rewarded with perks like the Foreign Investment Tax Credits, to help finance the transition. 

And those whose income is derived their investments in these businesses, enjoy a tax rate less than half that paid by those who earn their income from actually working. 

Entitlement, indeed! 

Wealth and Power - a Cosmic View

The attraction between wealth and power is no mere infatuation or passing fancy.  It is as perennial and as inexorable as gravity.  Each seeks to aggrandize itself, and to acquire the other. 

The drive to acquire wealth and power has very understandable roots; that being the desire to meet comfort, security, and/or ego needs.  But beyond some point, further accumulations of wealth and power serve no human purpose—taking on a life of their own, perpetuating themselves under their own inertia—consuming and controlling the possessor, even as they exploit others. 

As with gravity, the more massive an accumulation of wealth or power, the greater the force it exerts to draw in and accumulate even more.  Like a hyper-massive celestial object, it warps the very fabric of reality to achieve this end.  In the absence of a strong countervailing force, the inevitably result is a total consolidation of wealth and power within a single monopolistic/monarchical entity – a black hole which absorbs all nearby matter and energy, and from which not even light or truth can escape.   

The legal and regulatory institutions of government must be this countervailing force, balancing the drive toward plutocratic consolidation—like cosmic ‘dark energy’, (to strain the metaphor a bit)—promoting a just, sustainable socio-economic cosmos.  If it fails in this role, it loses its main raison d’être, and exists simply as an inert entity.  Worse, if these institutions become mere agents for the leviathan—promoting and accelerating the process of consolidation—it is worse than no government at all, and societal collapse cannot be averted.   

Healthcare Reform and Socialism

The word ‘socialist’ it thrown around freely as a perjorative any time the subject of universal healthcare comes up. The intent is generally to end the discussion, or to taint it by implication. Socialism is a pretty loaded concept in our society—lumped in with Communism, and the abuses of Stalin and Mao—and getting stuck with this label is often enough to kill an idea in infancy. It’s worth noting though that insurance is an inherently socialistic concept – pooling risk against individual adverse occurences. It’s not by any means beyond the pale to consider putting the entire population into the pool, and insuring them as a single risk group. That is what has been done in every other advanced industrialized nation – including many that one would be hard pressed to seriously label socialist. Once such a population-wide risk pool is in place, no countries have ever considered changing back to a more fractured approach.

That’s not to say that all the other countries have arrived at the same model. The systems vary widely – the one common denominator being that there is one risk group, and everybody’s in it. It is a shame that during what passed for a debate of the US healthcare system over last couple years, none of these other systems were examined at all – other than by disparaging generalizations, shouted angrily, or reduced to bumper sticker length soundbites. Contrast this with Taiwan, which undertook an overhaul of their system in the 1990’s by first examining the best of the other systems in depth, commissioning a major study in which the advantages and disadvantages of each was studied, and designing a system which cherry-picked the best features of the best systems, and fit their culture. As a result, they came away with one of the most cost-effective, service-driven system anywhere.

Population pooling is both theoretically and empirically the most efficient way to approach this problem. Theoretically it’s not unlike investment portfolio analysis – which was my area of focus in graduate school. The most efficient way to eliminate unique risk is to diversify, and the most efficient way to do that is to ‘buy the market’ – which explains the efficiency and popularity of broadly-based, low-management cost index funds. This approach diversifies away all idiosyncratic risk, and forms one risk pool. As with managing index funds, there is no need to employ teams of analysts (underwriters and actuaries), since there is no need to evaluate individual risk. Unlike investment portfolio management, there is no human cost to those entities in which one chooses to not invest.

In practice, I’m sure you are familiar with the cost statistics. We have the most expensive system on Earth. The next most expensive system is the one which is most similar to ours; The Swiss pay about 70% of what we do, on a per capita basis, and cover everybody. But consideration of the cost of living in Switzerland helps put that into context; most countries are much less. And in terms of outcomes, the US is ranked somewhere in the mid-thirties among industrialized nations.

The only people getting much of a bang for the buck here are those in the industry. Our system is characterized by inert highly profitable middle positions, and costly overhead – precisely the problems often associated with government or socialist systems. Every doctor’s or dentist’s office has to employ claims analysts – who have to be familiar with a variety of different claims management systems; one for each insurer with which they work.  And each employer needs to dedicate resources to shopping for and evaluating health insurance for employees, and managing the benefit. This cost is passed on to the patients and their employers. The insurance companies employ people to analyse the claim, and see if there’s any way to avoid paying it.

Neither a person's employer, not the insurance company has fiduciary duty to the insured indivudual.  In both cases, their legal responsibility is to their shareholders.  This often results in policies and claims practices which are not in the best interest of either the patient or the healthcare practitioner.  Whatever one might say about a government run, or regulated system, the stated legal responsibility is to the patient. 

Science and Spirituality

When I fly, I know there are angels beneath the wings holding us aloft. I don’t have to see them to know they’re there – and don’t expect I ever will see one. But flying is magical, and wouldn’t be possible without divine intervention. I am not ignorant of the science behind flight. In college I studied Bernoulli’s laws, and the dynamics of how wings pull a plane up into the sky. After 21 years, I’m a little rusty on the equations, but I know more or less how wings work. That knowledge never for a moment made it any less magical.

I also know that sometimes planes fall out of the sky with devastating effect, and pray that mine will not be one of them. Typically my prayers never rise to the level of consciousness, but on particularly turbulent flights, they are very much the center of my attention. But I’m also aware that when planes fall from the sky, the good folks at NTSB can usually piece together what went wrong from the parts that remain – and that the results of their investigation are never ‘angelic inattention’.

As much as I find the technological details of flight fascinating, there are existential questions for which these reveal nothing. Though unnatural, flight is the manifestation of one of humanity’s longest held dreams, and its reduction to mere aerodynamics and metallurgy somehow seems a vulgarity.

On the other hand, it is precisely that vulgarity I hope for on the part of those designing, building, and maintaining these lofty miracles. It does not matter to me at all whether these engineers, technicians and mechanics find poetry in human flight, or consider it a gift from God, or whatever. I want them to know and flawlessly apply the relevant science – period.

When somebody I care about is sick, I pray for a quick recovery and a return to full health. Those prayers are as sincere, and immediate (if perhaps less demonstrative) as any medieval supplicant depicted by the creative minds of Monte Python. I believe fully in the power of those prayers – and take comfort in sharing them. But for many illnesses there is a scientifically prescribed treatment – whether it is bed-rest, antibiotics, surgery, or whatever; and my prayers are accompanied by advice to follow doctor’s orders. When my Mother was fighting lymphoma our fervent prayers were accompanied by helping Mom stay on her meds schedule. Six years have passed, and Mom’s smile remains a part of our lives today. Was it the prayers, the meds, the dietary changes? I don’t know and don’t care.

So am I a hypocrite? A man of science who falls back on religion when I’m insecure? Maybe – but if so, I’m a sincere hypocrite, because I truly believe in both science and faith, and don’t feel any irreconcilable conflict between them. Maybe a term would be a ‘belt and suspenders’ believer. Am I superstitious? Yup! Let’s go to the source – Stevie Wonder defines ‘superstitious’ as ‘when you believe in things that you don’t understand …’, and I’m willing to cop to that. I also happen to believe in quantum theory, and I don’t really understand that (and neither do you).

Science and faith fulfill different yearnings in our desire to understand our universe. While they sometimes overlap—and occasionally even come into conflict—that conflict often disappears upon further reflection.

As fibers which support an integrated view of the universe, science and faith each has its strengths, and its weaknesses. But when woven together, the strengths complement and reinforce one another. It should probably not come as a surprise that some of the best minds in science and in faith often hold one another in high esteem - and that at the frontiers if knowledge, they face many of the same questions.

I suppose it is good that this esteem is not universal. A bit of creative tension between these realms of reality is good for each, since it keeps each honest, and discourages intellectual complacency. The view that the lens of faith allows us into ethical matters of science moderates the dehumanization which a purely scientific perspective might engender. And scientific advances often require a revision of the distinction between foundational tenets and traditional beliefs. Solid theology and sound scientific practice are both strengthened by this intercourse.

The wonders of our world and the universe tantalize our human need for intellectual exploration. Our imaginations soar to the furthest reaches of immense galaxy clusters millions of light years away, then return to delve into the infinitesimal quarks, leptons, and other components of sub-atomic particles; from the universe’s origins within an infinitely dense pre-Big Bang center, to our speculations of the eventual end state—these are the grist for our mental mills.

And the inestimable magnificence of God—however we perceive him/her/it to be—is likewise an incredibly tempting diet on which we may sustain ourselves. While some may maintain that everything we need to know about God was revealed long ago through a finite chain of prophets, others find fresh nourishment in the world around us, and our expanded exchange with diverse cultures. Neither is wrong, but openness breeds inquiry.

The old saw that ‘Great minds think alike’ is no truer in science than in religion. Good minds think alike; great minds diverge violently on matters most of us never consider. For every conflict between somebody like Martin Luther and Pope Leo X, there is a Newton vs. Leibnitz. The blood that is let in these exchanges fertilizes the soil on which the next generation of knowledge will flower.

It is only the failure of our own imaginations that imposes an ‘either/or’ decision in matters of science and faith. While scientific theory doesn’t require the existence or majesty of God, it also doesn’t preclude it– zealots on either side notwithstanding. When Galileo worked through the motions of the planets, it posed no threat to Christian doctrine – but the doctrinaire reaction of the church did. Likewise, the development of the science of evolution doesn’t set itself up in opposition to spirituality –evolutionary scientists include strong believers of every faith tradition. If they don’t cite God in their research, it should be no more surprising than that an aircraft engineer doesn’t cite God when he defines what weld to use to support a wing spar.

Are there evolutionary scientists who reject the existence of God? Of course there are. Atheists, agnostics, and believers of every stripe populate all professions. If somebody like Richard Dawkins can’t see outside his little silo, that doesn’t invalidate his science – it simply identifies him as a human being, with all the prejudices that accompany that status. If he wishes to nourish only his intellect, and starve his spirit, I wish him ‘vaya con dios’ … or , more to his preference, ‘vaya sin dios’. I’ll read his science, and ignore his theology. Likewise, if a spiritual leader can’t bridge the gap between spirituality and science, I will do my best to form my opinions of his spiritual teachings on their own merits – and look elsewhere for science.

I choose to see the hand of God in science – but placed there with such subtlety that no fingerprints remain. How much more wondrous it is to know a God with the skills to design a dynamic world; one which need not be micro-managed – but one in which life instead employs natural processes to adapt and achieve continuity. Rather than refuting the existence of God, to my eye, this reinforces it, and leaves me in even greater awe.

So in this spirit I applaud the 150th anniversary of the publication of The Origin of the Species – not as a poke in anybody’s eye, but as a fitting recognition of the transformative nature of knowledge.

What’s the matter with Medicare?

Medicare has been treated as a whipping boy in the discussions around reforming our current healthcare financing system. I maintain that most of the criticisms are flawed, and don’t stand up to critical scrutiny. Medicare is a fundamentally sound program, which has been compromised both by unaddressed demographic changes, and by intentionally unfunded program expansions.

Among the unavoidable challenges Medicare faces, most have nothing to do with program efficiency, and everything to do with the demographics of the beneficiaries: 
 High-cost population. Older people are simply more expensive to cover. Medicare disproportionally covers these populations. These people were not covered before, which is why Medicare was developed, and why it’s so popular.
 Increased expectation of heroic life-extension measures. Dying people seeking to extend their lives are very expensive.
 Fewer workers support more beneficiaries. Longevity increases, shifts in the demographic age profile of our population, further magnify the first two imbalances.

Despite this, by most key metrics, Medicare operates far more efficiently than do private insurance companies. Critics state that because of the client base, its 75% administrative cost advantage may be somewhat overstated. But even if we adjust for these concerns, Medicare is still much more efficient.

Among the other obstacles, some have the specific intention of driving Medicare to bankruptcy – and discrediting the idea of any public approach to insurance:
 A steadfast refusal to adapt the funding model to address the looming demographic imbalances listed above. A system designed in the 1960s, with contemporary life-span and treatment expectations, needs updating to reflect current and future realities.
 Medicare Part D. (See Below)

What’s Wrong with Medicare Part D (prescription drug coverage)

From its inception, Medicare supporters have tried to add prescription drug benefits to the plan. This was always blocked by the pharmaceutical lobby, because it posed a threat to their profits.

But when the Republican Party gained control of both houses of Congress and the administration in 2002, the pharmaceutical industry was able to customize an plan that would create a cash cow. They literally wrote the Medicare Part D law that was then passed with virtually no amendments. It contains a key provision which prohibits Medicare from negotiating prescription drugs prices. This means that the pharmaceutical industry was to be given a huge captive base of high usage customers, who pay retail. This would have been a budget-buster – except that there was no budget to pay for Medicare Part D in the first place. This exorbitant expense was piled on top of an already fiscally challenged program.

The plan has another bizarre provision, commonly known as the ‘donut hole’. Above a certain annual spending threshold, the program stops paying for drugs until a second threshold is reached. This was presented as a way of controlling costs – but in reality it was a way of placating the insurance industry, which immediately moved in with a whole new portfolio of products to ‘fill the gap’ which had been created for them.
Medicare Part D was a perfect finesse for the national Republican Party:
 It was designed to be difficult to vote against—despite the poison pill—because it provides a needed benefit to seniors.
 It tremendously increased the profits of the pharmaceutical industry, who wrote the law. These increased profits now bankroll resistance to any meaningful modifications.
 Created an entirely new, highly profitable category of insurance (‘donut hole’ coverage).
 Greatly accelerates the insolvency of the overall Medicare program, setting it up as an example of government inefficiency, and justifying continued resistance to any public insurance plan.

Despite the finesse, House Democrats were nearly unanimous in opposition to this fiscally irresponsible program. And despite incredible pressure from their leadership, many conscientious House Republicans opposed it as well. Despite a large Republican majority in the House, passage was only achieved after an unprecedented three-hour roll-call vote in the middle of the night (roll-call votes normally last 15 minutes), during which some members of the Republican caucus were blackmailed to change their votes. Rep. Walter Jones (R-N.C.) refers to this as the ‘ugliest night’ he has ever seen in politics. Check out this interview with him and fellow House Republican Dan Burton (R-Indiana):
http://www.cbsnews.com/stories/2007/03/29/60minutes/main2625305.shtml

Two months after passage of Medicare Part D, the man who steered it through the House, Rep Billy Tauzin (R-LA), left government to become the President and CEO of the pharmaceutical lobbying group PhRMA.  This was a job change for Tauzin in name only.  His seven-figure salary was a small thanks for the billions in profit they will reap from his efforts. 

The blatant corruption of this act, and the perpetrators, presupposes that the American people—distracted as we were by the War on Terror®—were not paying attention, or would soon forget.  They were wrong.  We were watching every corrupt step, and we will not forget.

William Safire

William Safire died Sunday.
http://www.nytimes.com/2009/09/28/us/28safire.html
I almost always disagreed with him on issues—sometimes less than politely—but I admired and learned from his style. He was of a disappearing breed of commentators who would listen carefully to opposing views, then fully incorporate them in his rebuttal. If his opponent needed more verbal rope to hang himself, Safire was confident enough in his position to play it out for them. I don’t know if it’s out of my own love for a healthy exchange of opposing ideas, or the fact that he reminds me so much of my Dad, but I have always had affection for him.

Safire had the respect for his the other speaker and his audience—as well as the confidence in his own position and ability to communicate it—to truly match wits.  This is such a sad contrast to the excuse for political discourse that dominates today. It seems that success now hinges upon making one’s point within the bounds of what can be printed on a bumper sticker, and repeating it until supporters learn it by rote – a methodology more useful in training a hunting dog than trying to resolve complex societal issues.

I shared, and continue to share Bill Safire’s love of the English language.  Though I learned from opposition to him politically, I learned in harmony with him linguistically.  He knew that—as a living language—English must nourish and maintain the strength of its fundamental structure, even as we encourage it to breathe in the fresh air of new learning.  And, lest there be any doubt, he would not tolerate that word (learning) being used as a noun, with the risk of an ‘s’ being appended to make it plural. There are some basics that cross party lines.

But I digress – as, I dare say, Mr. Safire may have done on occasion.

I will sign off with two quotes attributed to this worthy gentleman. His sense of skepticism and subtle wit are present in each:
 ‘Never assume the obvious is true.’
 ‘Last, but not least, avoid cliches like the plague.’


It is not for me to judge whether the world is a better place because William Safire lived and achieved prominence. But I know my life is richer for witnessing his.