Archive for the ‘Politics’ Category
A linkorama as I board a plane:
Some attention has been focused on a recent analysis that health care costs are highly skewed. Apparently, 1% of patients accounts for a fifth of all healthcare costs. For half of us, our healthcare costs are only a few hundred bucks a year. For the top 1%, they exceed $100,000.
I’m not sure what the point of this is. The very idea of health insurance is to insure against catastrophic illness. $100,000 is the cost of a moderate to bad health problem. That 1% is not a static group; people move in and out as they get sick or healthy. We don’t need government to tax us all to help people pay bills; that’s what insurance does. The only impact his has on the healthcare debate is to either link mandated coverage with mandated purchase — i.e., prevent people from waiting until they’re sick to buy insurance. It could also argue for high-deductible plans that only cover disasters.
Naturally, this is being used to argue for all kinds of other things. Preventative care is a big one. But as I’ve noted, preventative care does not save money even if it saves lives. It’s also being used to argue for end-of-life planning, which I support but is unrelated to this.
Really, I don’t know this stat has suddenly become so big. Healthcare doesn’t cost much until you need it. We knew that, didn’t we?
I’m at a conference. It stimulates my curiosity. Expects lots of links:
Someone recently sent me this diatribe from Neal Stephenson on the lack of innovation in recent years.
Still, I worry that our inability to match the achievements of the 1960s space program might be symptomatic of a general failure of our society to get big things done. My parents and grandparents witnessed the creation of the airplane, the automobile, nuclear energy, and the computer to name only a few. Scientists and engineers who came of age during the first half of the 20th century could look forward to building things that would solve age-old problems, transform the landscape, build the economy, and provide jobs for the burgeoning middle class that was the basis for our stable democracy.
The Deepwater Horizon oil spill of 2010 crystallized my feeling that we have lost our ability to get important things done. The OPEC oil shock was in 1973—almost 40 years ago. It was obvious then that it was crazy for the United States to let itself be held economic hostage to the kinds of countries where oil was being produced. It led to Jimmy Carter’s proposal for the development of an enormous synthetic fuels industry on American soil. Whatever one might think of the merits of the Carter presidency or of this particular proposal, it was, at least, a serious effort to come to grips with the problem.
Little has been heard in that vein since. We’ve been talking about wind farms, tidal power, and solar power for decades. Some progress has been made in those areas, but energy is still all about oil. In my city, Seattle, a 35-year-old plan to run a light rail line across Lake Washington is now being blocked by a citizen initiative. Thwarted or endlessly delayed in its efforts to build things, the city plods ahead with a project to paint bicycle lanes on the pavement of thoroughfares
Stephenson goes on to criticize our space program, which threw away shuttle tanks rather than using them to build space stations and has spectacularly failed to produce cheap launch vehicles. He also criticizes the energy industry.
Both of these are valid criticisms, but something bears pointing out: the industries of which he is the most critical — energy and space — have been under the heavy hand of government. Carter’s Synthetic Fuels Corp was a fiasco, burning tens of billions. The biggest government investment in energy of late is ethanol, an ecological, economic and scientific disaster supported for political reasons. Even their attempts to jumpstart green tech has been stymied by politics, as we’ve seen with Solyndra. And the same goes with the space program. We didn’t turn shuttle tanks into cheap space stations because having an expensive space station was the whole point.
In industries with less government oversight, we’ve seen spectacular progress in the last 40 years. Medicine and communications have been especially fertile. A heart attack is a recoverable event as is cancer. A host of drugs can treat everything from impotence to Parkinson’s. And I can hold in my hand a device that can communicate with anyone in the world and provides access to the sum total of human knowledge.
To the extent that government has helped with this, it has been through supporting basic research, keeping taxes low and upholding patent law (although it’s now doing too much of the latter). Whenever it has tried to get its hands dirty with specific technologies, it has inevitably screwed the pooch. The solution to our inadequacies — in space exploration and energy — is not a Manhattan-Project level initiative. It’s a combination of supporting basic research while giving corporations the freedom — economic, scientific and regulatory — to innovate.
I do think the pace of innovation has slowed and I think it may be inevitable. The things he describes — flight, nuclear power, rocketry — were big straight-forward problems that had big straight-forward solutions. The innovations of the next century — clean energy, fighting antibiotic resistant infections, slowing down aging — are much more complex and detailed.