Health care jobs will not help our economy

Healthcare jobs are no way to improve the economy. Greg Gerritt 4/25/17
For many years I have been pointing out that growing the healthcare economy makes it impossible to keep health care affordable, and that this dilemma makes the RI economic development strategy unlikely to work, seeing as it seems to be based on building new buildings for healthcare businesses. I have copied one snippet of an essay from 2012 in which I make that point.

Many healthcare professionals have agreed with my analysis, though the economic development crew seems to be immune to my consultations. In the Sunday April 22 2017 New York Times there is an op-ed by Chad Terhune (link below) that makes exactly the same points. He quotes Katherine Baicker, a Harvard University Health Economist

“The goal of increasing jobs in health care is incompatible with the goal of keeping health care affordable:”

Terhune discusses this issue in the context of the efforts to replace Obamacare and how cutting money out of the system will lead to job losses in the industry, and the fact that many Rust Belt cities (like Providence) have used the growth of the medical industrial complex to replace the manufacturing jobs that slipped away.

Terhune sticks to his main points, while my analysis is much wider, but essentially Terhune concludes we have ourselves a wicked problem. We can not afford healthcare as currently configured and paid for in the USA, but if we cut the money out of the system (as President Toxic Dump is threatening to do) the economic dislocations will be massive. And the health of our nation will suffer, especially lower income people.
I always think that if you want to solve a problem, the first thing to do is stop digging the hole you find yourself in. This means that the first thing to do is stop trying to use the health care system to create more jobs. Stop offering cheap land and tax breaks to the medical industry. I offer the snippet below to point out how long I have been reminding Rhode Islanders of the stupidity of our economic devleopment scammers, and i want to0 say I am glad the mainstream is catching up, though I doubt the folks on Smith Hill will get a clue soon.
August 30 2012
The medical industrial complex

One of the industries Rhode Island is always encouraged to pursue is the medical industrial complex. This is one of the bulwarks of the knowledge economy, but a closer examination gives us many reasons to be cautious about using the medical industrial complex as the engine of economic growth. Over the last 50 years health care has become the largest component of our economy, now responsible for 18% of the total national income. Medical costs have now become the largest cause of bankruptcy other than the housing bubble. Thousands of Americans seek bankruptcy protection each year due to the burden of health care costs, with the number growing every year. This even effects people with insurance, as often their insurance is inadequate once they actually get sick, or by virtue of being unable to work they lose their health care coverage.
Part of how Rhode Island will eventually dig out from the burden of health care costs is with single payer health care. Many refer to this as medicare for all. While i support single payer, very strongly support single payer, that alone will not solve the health care cost crisis. If we continue on our current health care industry path, even with a single payer system, costs will continue to go up two to three times as fast as costs in the rest of the economy, funneling ever more money into the medical industrial complex and causing other sectors of the community to fail due to disinvestment. There are more than a few people who want to do business in RI or start new businesses who have been stymied because of the cost of medical care and insurance.

Beyond single payer and the removal of the insurance companies from the health care field we need to do several things to stop the outrageous run away costs. One aspect of this is prevention. As long as our lifestyles and environment continue to be more toxic, people will demand high tech quick fixes to the problems our industrial civilization causes like asthma, heart disease, and cancer. While magic bullets would be nice, the pursuit of magic bullets is a chimera. Magic bullets are very expensive, which makes them much less magical for the poor, and often just perpetuate the problems rather than addressing the root causes. While we do not directly pay for all of the research that creates drugs and procedures, ultimately every penny paying the high salaries (the reason the economic development community wants these jobs here) of the people doing health care research comes out of the pockets of the public, either through governmental support of basic research, or in the cost of the procedures and drugs we use. It is fabulous that we can cure people and save lives that a generation ago would have been lost, but because of the cost of this care a few get rich providing the research and the care, while more and more people enter debt and bankruptcy. It is more of a drain on our communities than a boon, a hallucination of prosperity.
The American public may or may not be willing to shoulder the cost of the modern medical miracle. We also know it is nearly impossible to deny folks treatments that can save lives no matter what the price. But ultimately a lower tech approach, based on prevention (clean environment, healthy food, less stress economy) will return the resources to the communities of Rhode Island, rather than siphoning into the hands of the 1% the way the current system does, and no longer deny folks timely health care.
An example of how far from prevention we have drifted can be found in this comparison. 60 years ago Americans spent 15% of their income on food and 5% on healthcare. Now we spend about 13% of our income on food (the 2nd lowest percentage in the world) and over 18% on health care (the highest percentage in the world). A good year is one in which health care costs do not rise 8%. The industrialization of our food supply means that we have more obesity, more heart disease, more diabetes,. The phony trade off is that we can cure more of the cancers that the industrialized food system creates, and we have elaborate procedures that can prolong the life of the very ill for a month or two. This trade off in the costs of health care and food has less of an effect on average life spans than basic public health expenditures like sewage treatment plants. It also leads to a bankruptcy and governmental budget crisis, blocks 50 million Americans from basic care, and gives us the industrial world’s worst health care delivery system. I am not sure an expansion of the medical industrial complex is going to help RI attain prosperity.

The Orange haired Flip Flopper

Greg gerritt  4/14/2017
The headlines the other morning were that President Toxic Dump is starting to do big flip flops now that he is President. From buddies with Putin to strong foes, from cracking down on China to cozying up, from staying out of Syria to bombs and boots on the ground amid aircraft carriers going to North Korea. Wall, No Wall and  dismantling health care before or after tax deform. Putting the Nazi sympathizer  Steve Bannon on the NSC, then taking him off.

The whole sordid affair points out the incompetence of President Toxic Dump and the cluelessness he brings to the office, But even more it shows that an unprincipled outsider can be captured by the Washington DC swamp even as he claims to be draining it. Just about every position and action Toxic Dump has flipped or flopped to is the exact same position that the last few presidents have ended up at. On some level one might think, ah, he is getting a clue, but the reality is that the policies all of the presidents have subscribed to over the last 30 years have been an unmitigated disaster for everyone in the US and for everyone on the planet, except the 1%. So as totally expected, President Toxic Dump’s true colors are a party for the 1% and pissing on everyone else. He has joined the establishment, and the easiest way to tell is that as soon as things go wrong, he starts dropping bombs on those he declares an enemy of people or whatever else he wants to call them, though the usual name is people fighting to protect their communities from the craziness of the American War Machine.

General Eisenhower, upon retiring from the White House, warned us about demagogues like President Toxic Dump, but we all know that demagoguery wins in troubled times. The 1% have so thoroughly looted America that the hard times and insecurity have left people looking for a demagogues to make them feel good. And demagogues kill people. Especially demagogues with a huge and totally out of control, military machine that is designed primarily to stuff huge wads of cash into a very few well placed hands, while undermining democracy and convincing governments around the world to buy more guns and use them on people who demand justice and healthy communities.

I tend to use the term Potomac Fever to describe the feeling in Washington DC that American governments are free to kill everyone around the world with impunity and disregard all normal international standards of conduct, in other words it is the only disease that only kills those who do not have it. I have a friend who tells me my definition is wrong, but we clearly need a shorthand way to describe the feeling that Americans are allowed to kill for world domination while pretending we are a peaceful democracy loving country that really honors the words on the statute of Liberty. One pretty much has to go to Washington DC to find people truly committed to such a stupid idea, an idea no normal human being would call sane or in tune with the values American claims to support.

Toxic Dump’s flip flops show that within 3 months what little attention span the orange haired blowhard has is now going to be directed to killing for the next 4 years to cover up the inability to achieve either peace or prosperity, and the damage his administration will do globally on the issues of climate. The Chamber of Commerce is celebrating , they have a president who will let them steal anything. But no one else in America asked for an administration that would so readily deny facts and prepare the way for poisoning your kids. And use bombing runs to cover up the bad headlines just like every other president.

Yup, President Toxic Dump has flip flopped. As expected he lasted a couple of months as an outsider, though one with no clue, and now has found his way to the levers that will be used just like all the other insiders, to the ever lasting detriment of life on earth.

Response to article on China building a new city

I wonder where China thinks it will get the wood to build this new city. Or rather what south east Asian country will allow the Chinese to buy forest concessions and throw the original inhabitants off the land to end up in shanty towns or dead? As the forests of Asia (and everywhere else) disappear, this urge to build cities to spur growth will be come a less and less useful model. I know, we do not build wooden buildings in big cities. But today I walked by a typical urban downtown construction site, and while i do not believe a stick of wood has yet been incorporated into the actual building, there are vast quantities of wood being used on the site. You can not build cities without vast quantities of wood. Nor provide all the paper. And the loss of forests is making wood harder to come by, more expensive, and more valuable standing alive in the forest than cut down.

Ironically, according to the World Bank leaving the forest in the care of the original inhabitants instead of selling off concessions creates stronger local economies and generates more tax revenues for the various levels of government than do the concessions. And it is much less dangerous for the planet as intact forests are critical for moderating the climate., providing clean water, and maintaining biodiversity.

China, and every other place on the planet with rural migrants expanding the cities, is going to build cities as long as it thinks it can, but the slowdown in growth in China is already suggesting it is bumping up against ecological limits, and not only that they can not breathe the air. And this time it is not only in the neighborhood, it is global. The loss of forests is telling us we need a new approach to economic development.

Why I March for Science

We live in an age of alternative facts and destructive doctrines based on outright lies.  This is not the first time Western Civilization has come face to face with its ugly side.  The Dark Ages of Medieval Europe was filled with millennial cults, and very little knowledge.  Powerful institutions decided what was true, the facts be damned. The soil, economy, and public health deteriorated.

But we broke out of it.  Sort of anyways.  Eventually everyone had to admit the Earth went around the Sun and so did planets like Venus, Jupiter, Mars and Saturn.  Stars were distant, and we now know them to be in some ways similar to The Sun.  And they too have planets.

The Enlightenment in a few ways, for a few people, pushed back the darkness and reminded us of the power and importance of actual observations beyond dogma.  Galileo pointing a telescope at the sky and reporting exactly what he saw, Newton doing the math of gravity, the users of microscopes seeing one celled creatures in the water and learning how a few of them cause diseases, created a factual basis for knowledge and then knowledge became something that we could use to create better communities. It meant you could actually stop a cholera outbreak and save thousands of lives today, and build functional sewage treatment plants so outbreaks do not happen in the future.

I March for Science because the current mania for alternative facts creates a real risk to the public health, and to the health of the planet that we depend upon for our daily bread.  We must have clean water, clean air, a climate safe economy, healthy food if we are to thrive.  It is just that simple. And Science, Truth, the public health are under attack from the forces that have done this before.  The denying of evolution and climate change, or that smoking cigarettes causes cancer, the use of alternative facts, is being used by ideologues in high office to promulgate policy positions that threaten modern civilization based on their apocalyptic and market oriented fantasies.  It is only by demanding that we go back to a truth based system, a system based on accurately studying and measuring what is happening in human beings, in our communities, on our planet, and in the Universe, that we can design real solutions for real problems like climate change and the scourge of war rather than phony problems like how like how the election was rigged by illegal immigrants and they are stealing all the jobs.

The United States, like every industrialized nation, has supported science and reaped massive benefits in proportion to that support.  Research and development is responsible for the wonders of the modern world as well as many of its worst horrors like nuclear weapons.  But it is only a closed minded few that think it makes sense to cut off the flow of new information about how the world works or to stop using the knowledge we already have.  That those who wish to live in a fact free universe rule our nation today, and have made clear that they want to make the world safe for poisoning again, tells me how important science is to the proper functioning of our communities. So we March for Science.

I have been conducting a several year study of a population of amphibians in an urban cemetery. The pond they use for breeding is filling in. Amphibians are a global canary in the coal mine disappearing faster than any other group animals on the planet, and this pond, silting in from inappropriate land management practices that could easily be remedied if facts ruled, and threatened by climate change, needs a little restoration. To do this I have to demonstrate that I understand how the system currently operates, and how my modifications to the system will improve the health of the amphibian populations. I wish the process were easier to navigate, but I am also very happy that a fact based system based on real wetland biology, governs what I can do to a little rainwater pool. And that same real world understanding ought to govern every land use decision being made. But that real world understanding is exactly what the government is about to kick to the curb so that looting the planet can be faster as the world gets hotter and our communities less secure. So I March for Science.