The diagnosis of many medical problems is relatively simple since most patients present with common ailments. There are, however, frequent situations where reaching an accurate conclusion is not easy. Hence the batteries of expensive tests that are prescribed.
The acronym CAD generally refers to a tool used by engineers and stands for 'Computer Aided Design'. The same letters could well refer to a 'Computer Aided Diagnosis' tool used by physicians. In fact, Computer Aided Diagnosis does exist but is limited to the interpretation of x-ray images.
Few would dispute that the corpus of medical knowledge has grown so large that no physician or surgeon can retain it all in memory. Why, then, do we not see computers, in examining rooms, programmed to search a database of symptoms and able to suggest potential diagnoses together with the tests required for confirmation?
Can it be that doctors are so arrogant that they believe that they can remember everything? Or are they so insecure that they believe that their patients would lose confidence in them if they were to be seen consulting a database?
The medical profession's resistance to the use of information technology ("IT") is only very slowly being overcome. Part of that is the conservative nature of most doctors. A greater obstacle, however, is the fact that doctors do not receive any payment for the high costs of adopting IT and, even worse from the perspective of a practice manager, less intervention is likely to lead to lower revenue.
There is little doubt that we would get better quality medicine, at lower cost, if doctors were to use modern information technology: electronic records that are accessible to every one of a patient's doctors, together with computer aided diagnosis, would be a useful beginning. Unfortunately, the perverse financial incentives that dominate the American health care system will ensure that nothing happens soon.
Sunday, February 28, 2010
Friday, February 26, 2010
A Hostage Problem (2)
Secretary of State Hilary Clinton has done a very politically incorrect thing. She actually dared to mention the 800 pound pink gorilla that is sitting in the middle of the living room.
Yesterday, she described the USA's budget deficit, and our overall level of indebtedness, as a 'Security Problem'. She also pounded another nail into the coffin of former Federal Reserve Chairman Alan Greenspan's rapidly declining reputation.
While beating up on Mr. Bubblespan may be satisfying, it is a bit of a cheap show. Secretary Clinton, however, speaks serious and important truth about the deficit and our debt. That part of our national debt which is held by other, not always friendly, countries is a hostage which might well be used to coerce us into actions that we do not wish to take.
We can only hope that President Obama and the Congress are not only paying attention but that they will actually do something.
For an example of what was done by the USA to the British, who were in similar straits in 1956, see my post from February 10, 2010:
http://noslogans.blogspot.com/2010/02/hostage-problem.html
Secretary Clinton, keep up the good work.
Yesterday, she described the USA's budget deficit, and our overall level of indebtedness, as a 'Security Problem'. She also pounded another nail into the coffin of former Federal Reserve Chairman Alan Greenspan's rapidly declining reputation.
While beating up on Mr. Bubblespan may be satisfying, it is a bit of a cheap show. Secretary Clinton, however, speaks serious and important truth about the deficit and our debt. That part of our national debt which is held by other, not always friendly, countries is a hostage which might well be used to coerce us into actions that we do not wish to take.
We can only hope that President Obama and the Congress are not only paying attention but that they will actually do something.
For an example of what was done by the USA to the British, who were in similar straits in 1956, see my post from February 10, 2010:
http://noslogans.blogspot.com/2010/02/hostage-problem.html
Secretary Clinton, keep up the good work.
Tuesday, February 23, 2010
Politicians and Health Care Reform
American health care, including the way that we pay for, is badly broken.
Start with doctors, who are terrified of being sued, and reimbursements to doctors, and hospitals, that are based on the perverse principle that the more they do to you the more they get paid. Then include makers of pharmaceuticals and medical devices whose second largest expenditure, after development, is marketing.
The result, inevitably, is expensive over treatment.
While payment for results, rather than activity, would rapidly improve quality and reduce cost, there are many powerful vested interests to oppose it. Such a system is possible but overcoming the vested interests, and their allies in Congress, will require determination and patience.
Next, consider for-profit, and so-called non-profit, insurance companies whose administrative costs are monstrous and who seem to care little about controlling costs by improving quality. They do, however, spend vast sums of money to avoid covering people with pre-existing conditions or, if forced to, they charge outrageously high rates. Finally, stir into this noxious mix patients who take the position that "something must be done" even when there is no effective treatment or when the cure, as the old saying goes, is worse than the disease.
President Obama abandoned his responsibility to lead by providing little or no guidance to Congress as it spent the past twelve months attempting to produce a health care reform bill. What was created fails to solve the real problems of quality and cost while the goal of universal coverage is only partially met at great expense.
Faced with united Republican Party opposition, neither of the monstrosities created in the House and Senate has become law. That is the good news. The bad news is that the Democrats have done little to involve Republicans in the creation of a solution and Republicans, while capable of blocking Democratic proposals, have done nothing constructive.
President Ronald Reagan understood that it was possible to compromise without abandoning one's principles. Sadly, it seems that the current generation of politicians, regardless of party, prefers to play to an audience of extreme left and right wing activists rather than making the, admittedly difficult, compromises that lead to solutions.
Have they forgotten that they work for the People? Or have they so much contempt for us that their only objectives are re-election and the maintenance of their privileged lifestyles without actually having to do any serious work?
At the next election, politicians of both parties should keep in mind Abraham Lincoln's words:
"You can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time."
Then Senator Obama, during his Presidential campaign, offered us 'Change'. To the extent that many of our elected officials chose to retire or are defeated in November, such 'Change' would be more than welcome!
Start with doctors, who are terrified of being sued, and reimbursements to doctors, and hospitals, that are based on the perverse principle that the more they do to you the more they get paid. Then include makers of pharmaceuticals and medical devices whose second largest expenditure, after development, is marketing.
The result, inevitably, is expensive over treatment.
While payment for results, rather than activity, would rapidly improve quality and reduce cost, there are many powerful vested interests to oppose it. Such a system is possible but overcoming the vested interests, and their allies in Congress, will require determination and patience.
Next, consider for-profit, and so-called non-profit, insurance companies whose administrative costs are monstrous and who seem to care little about controlling costs by improving quality. They do, however, spend vast sums of money to avoid covering people with pre-existing conditions or, if forced to, they charge outrageously high rates. Finally, stir into this noxious mix patients who take the position that "something must be done" even when there is no effective treatment or when the cure, as the old saying goes, is worse than the disease.
President Obama abandoned his responsibility to lead by providing little or no guidance to Congress as it spent the past twelve months attempting to produce a health care reform bill. What was created fails to solve the real problems of quality and cost while the goal of universal coverage is only partially met at great expense.
Faced with united Republican Party opposition, neither of the monstrosities created in the House and Senate has become law. That is the good news. The bad news is that the Democrats have done little to involve Republicans in the creation of a solution and Republicans, while capable of blocking Democratic proposals, have done nothing constructive.
President Ronald Reagan understood that it was possible to compromise without abandoning one's principles. Sadly, it seems that the current generation of politicians, regardless of party, prefers to play to an audience of extreme left and right wing activists rather than making the, admittedly difficult, compromises that lead to solutions.
Have they forgotten that they work for the People? Or have they so much contempt for us that their only objectives are re-election and the maintenance of their privileged lifestyles without actually having to do any serious work?
At the next election, politicians of both parties should keep in mind Abraham Lincoln's words:
"You can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time."
Then Senator Obama, during his Presidential campaign, offered us 'Change'. To the extent that many of our elected officials chose to retire or are defeated in November, such 'Change' would be more than welcome!
Friday, February 19, 2010
The Corruption of Language (6)
National Public Radio (www.npr.org) can normally be relied upon for thoughtful opinions - even if you don't agree with then - and in depth reporting. When NPR's news programs detour into trivia, the reports are often clever and entertaining.
Yesterday, however, much was made of the fact that, at the Winter Olympics on Wednesday, the USA "beat its own record for Gold Medals in a single day". It is one thing to care about the total number of medals won during the Games and, perhaps, the number of medals won 'yesterday', but who cares about a meaningless record such as the number of medals won in a single day.
One of George Orwell's warnings is applicable:
"But if thought corrupts language, language can also corrupt thought."
This report, although minor, is yet another example of the corruption of language leading to foolish and worthless thought. Incidentally, adding to the zero (negative?) information value of the report, only four Gold Medals will be awarded today so there is no possibility that the USA can again beat its own meaningless record.
NPR can, and should do better!
Yesterday, however, much was made of the fact that, at the Winter Olympics on Wednesday, the USA "beat its own record for Gold Medals in a single day". It is one thing to care about the total number of medals won during the Games and, perhaps, the number of medals won 'yesterday', but who cares about a meaningless record such as the number of medals won in a single day.
One of George Orwell's warnings is applicable:
"But if thought corrupts language, language can also corrupt thought."
This report, although minor, is yet another example of the corruption of language leading to foolish and worthless thought. Incidentally, adding to the zero (negative?) information value of the report, only four Gold Medals will be awarded today so there is no possibility that the USA can again beat its own meaningless record.
NPR can, and should do better!
Tuesday, February 16, 2010
Academic Tenure
There is very little to be said for guaranteed job security. Typically, organizations such as Federal, State, and Local governments, as well as certain highly unionized industries provide a very high degree of job security unrelated to performance. As a consequence, they suffer from low productivity and poor quality work.
A reasonable exception to the pure rule of demanding performance in return for continued employment is the practice of granting academic tenure to university professors who spend a significant part of their time engaged in research.
New ideas, whether in the humanities or the physical and social sciences, are frequently unpopular because they challenge authority and conventional wisdom. Absent tenure, or some other form of job security, there will be instances when researchers are fired for their opinions and conclusions, avoid controversial topics, or engage in self censorship. While offering a high level of job security risks paying for poor or no performance, the cost is reasonable compared to the dangers of intimidation and the avoidance of controversial topics.
Providing job security to those engaged in research is one thing but is almost impossible to make a coherent and logical case for granting tenure to teachers of children in Grades K - 12. These teachers do little or no research so there is little risk of adverse action arising from unpopular ideas and, since there is almost no risk of that they will be fired for failure to perform, their performance is all too often less than adequate.
While too many School Districts have ineffective, and sometimes outright unfair, systems for evaluating teachers, that is not the point. What is needed is the development of reasonably fair and effective systems for evaluating teachers, and the prompt removal of those who do not measure up to the required standard. Such systems are not easy to develop but Unions know that unreasonable demands for a perfect system will ensure that nothing changes.
The current system merely ensures that raw union power is used for the benefit of poorly qualified teachers.
Meanwhile, our children suffer and that is wrong if not immoral.
A reasonable exception to the pure rule of demanding performance in return for continued employment is the practice of granting academic tenure to university professors who spend a significant part of their time engaged in research.
New ideas, whether in the humanities or the physical and social sciences, are frequently unpopular because they challenge authority and conventional wisdom. Absent tenure, or some other form of job security, there will be instances when researchers are fired for their opinions and conclusions, avoid controversial topics, or engage in self censorship. While offering a high level of job security risks paying for poor or no performance, the cost is reasonable compared to the dangers of intimidation and the avoidance of controversial topics.
Providing job security to those engaged in research is one thing but is almost impossible to make a coherent and logical case for granting tenure to teachers of children in Grades K - 12. These teachers do little or no research so there is little risk of adverse action arising from unpopular ideas and, since there is almost no risk of that they will be fired for failure to perform, their performance is all too often less than adequate.
While too many School Districts have ineffective, and sometimes outright unfair, systems for evaluating teachers, that is not the point. What is needed is the development of reasonably fair and effective systems for evaluating teachers, and the prompt removal of those who do not measure up to the required standard. Such systems are not easy to develop but Unions know that unreasonable demands for a perfect system will ensure that nothing changes.
The current system merely ensures that raw union power is used for the benefit of poorly qualified teachers.
Meanwhile, our children suffer and that is wrong if not immoral.
Saturday, February 13, 2010
A Lesson from Toyota's Travails
The problems now being experienced by Toyota - braking problems on hybrids and sudden acceleration on many other models - may be mechanical, electrical or software related. Purely mechanical problems are often relatively simple to solve. Electrical problems, however, are often intermittent and difficult to diagnose while software problems are an order of magnitude harder to find.
These thoughts, written by James Arnheim, are applicable to system design:
"Engineering: the art and science of molding materials we do not fully understand; into shapes we cannot precisely analyze; to resist forces we cannot accurately predict..."
Although he was discussing mechanical and structural engineering, Mr. Arnheim's remarks are also applicable to the design and writing of software. As an example of the difficulty of creating complex systems, defects in the various iterations of Microsoft's Windows(R) operating systems demonstrate the size of the task. It is close to impossible to create massive software structures that do not contain unpredictable and largely impossible to find errors - at least when the requirement of economic viability is applied to the testing process.
The aggravations and pain, imposed by bugs in Windows, are trivial compared to the defects that are will certainly be present in other, yet to be written, applications that will control critical processes such as, among other things, air traffic control, the electrical grid and the safe operation of our personal vehicles.
Automated systems have provided much convenience. They have also made major improvements in the quality of our lives: some appear to have even become essential. The potential dangers from unanticipated defects, however, may threaten our entire standard of living even if not our existence.
There is not much an average citizen can do except to become as little dependent as possible on any technology. The Amish - a uniquely American religious group that shuns technology - epitomize this lack of dependence. Most of us, without much thought, simply consider the risks and rewards of most technologies to be acceptable and the Amish way of life to be far too primitive for our tastes and our comfort.
Since technology is often a Faustian bargain, we should, but probably will not, evaluate the risk - reward proposition very carefully. But no matter how careful we are, no one should be surprised to find that the fundamental principle by which the Universe operates (the Law of Unintended Consequences) takes precedence over all others.
There just ain't no such thing as a free lunch. No matter how much we may wish it were so.
These thoughts, written by James Arnheim, are applicable to system design:
"Engineering: the art and science of molding materials we do not fully understand; into shapes we cannot precisely analyze; to resist forces we cannot accurately predict..."
Although he was discussing mechanical and structural engineering, Mr. Arnheim's remarks are also applicable to the design and writing of software. As an example of the difficulty of creating complex systems, defects in the various iterations of Microsoft's Windows(R) operating systems demonstrate the size of the task. It is close to impossible to create massive software structures that do not contain unpredictable and largely impossible to find errors - at least when the requirement of economic viability is applied to the testing process.
The aggravations and pain, imposed by bugs in Windows, are trivial compared to the defects that are will certainly be present in other, yet to be written, applications that will control critical processes such as, among other things, air traffic control, the electrical grid and the safe operation of our personal vehicles.
Automated systems have provided much convenience. They have also made major improvements in the quality of our lives: some appear to have even become essential. The potential dangers from unanticipated defects, however, may threaten our entire standard of living even if not our existence.
There is not much an average citizen can do except to become as little dependent as possible on any technology. The Amish - a uniquely American religious group that shuns technology - epitomize this lack of dependence. Most of us, without much thought, simply consider the risks and rewards of most technologies to be acceptable and the Amish way of life to be far too primitive for our tastes and our comfort.
Since technology is often a Faustian bargain, we should, but probably will not, evaluate the risk - reward proposition very carefully. But no matter how careful we are, no one should be surprised to find that the fundamental principle by which the Universe operates (the Law of Unintended Consequences) takes precedence over all others.
There just ain't no such thing as a free lunch. No matter how much we may wish it were so.
Wednesday, February 10, 2010
A Hostage Problem
On July 26, 1956, Egyptian President Gamal Abdul Nasser, responding to the British and American refusal to finance the proposed Aswan High Dam, nationalized the Suez Canal. On October 29, 1956, the United Kingdom and France, supported by Israel, invaded and, after heavy fighting in both Egypt and the Sinai Peninsula, seized the Canal.
So far, so good. The problem, however, was that the United States had not been consulted and did not approve.
The USA had two major levers.
The first was oil. Following an oil embargo on Britain and France by Saudi Arabia, the United States - then an oil exporting nation - refused to make up the difference. That was uncomfortable but not irresistible.
The second lever was a credible threat to bankrupt the United Kingdom. The United States held a massive position in British bonds as a result of the financing of World War II and funds transferred under the Marshall Plan.
President Eisenhower ordered Treasury Secretary George Humphrey to prepare to sell the bonds. The threat was real and, according to British Chancellor of the Exchequer Harold Macmillan's advice to Prime Minister Anthony Eden, British gold and foreign exchange reserves were insufficient to sustain the enormous devaluation of the pound that would result. The consequence would be an inability to import the food and fuel necessary to support the nation through the coming winter.
Eisenhower's proposition was really simple: we own so much of your debt that we can bankrupt you unless you do as we say.
The British had no choice but to capitulate and the French, with insufficient forces in Egypt to operate on their own, were also forced into a hasty and humiliating departure.
What will be our response if the Chinese, who hold hostage too much of our too large national debt, decide to use Eisenhower's tactic over, say, Taiwan?
If we wish to control our own destiny, then we must get our budget deficit and national debt under control. Starting tomorrow is not too soon.
So far, so good. The problem, however, was that the United States had not been consulted and did not approve.
The USA had two major levers.
The first was oil. Following an oil embargo on Britain and France by Saudi Arabia, the United States - then an oil exporting nation - refused to make up the difference. That was uncomfortable but not irresistible.
The second lever was a credible threat to bankrupt the United Kingdom. The United States held a massive position in British bonds as a result of the financing of World War II and funds transferred under the Marshall Plan.
President Eisenhower ordered Treasury Secretary George Humphrey to prepare to sell the bonds. The threat was real and, according to British Chancellor of the Exchequer Harold Macmillan's advice to Prime Minister Anthony Eden, British gold and foreign exchange reserves were insufficient to sustain the enormous devaluation of the pound that would result. The consequence would be an inability to import the food and fuel necessary to support the nation through the coming winter.
Eisenhower's proposition was really simple: we own so much of your debt that we can bankrupt you unless you do as we say.
The British had no choice but to capitulate and the French, with insufficient forces in Egypt to operate on their own, were also forced into a hasty and humiliating departure.
What will be our response if the Chinese, who hold hostage too much of our too large national debt, decide to use Eisenhower's tactic over, say, Taiwan?
If we wish to control our own destiny, then we must get our budget deficit and national debt under control. Starting tomorrow is not too soon.
Saturday, February 6, 2010
Be Careful What You Say
The General Post Office, at 33rd Street and 8th Avenue in New York City, was opened in 1914. On the building, in large easy to read letters, is engraved the following:
Neither snow nor rain not heat nor gloom of night stays these couriers from the swift completion of their appointed rounds.
Today, in the Washington DC metropolitan area, we are in the middle of a major snowstorm with 20 - 30 inches expected before it ends and the United States Post Office has suspended service for at least today. Given the circumstances, this is quite reasonable.
Although there is no actual legal requirement to provide service regardless of conditions, nor is the statement above the motto of the USPO - it has none, organizations are frequently evaluated on their ability to live up to what is believed to be, rather than actually is, their culture and mission. Since the USPO is neither particularly efficient, nor in good financial health, its reputation will be further tarnished when today's performance is matched with public belief as stated on that historic building.
So, be careful what you say: it is guaranteed to come back and haunt you.
Neither snow nor rain not heat nor gloom of night stays these couriers from the swift completion of their appointed rounds.
Today, in the Washington DC metropolitan area, we are in the middle of a major snowstorm with 20 - 30 inches expected before it ends and the United States Post Office has suspended service for at least today. Given the circumstances, this is quite reasonable.
Although there is no actual legal requirement to provide service regardless of conditions, nor is the statement above the motto of the USPO - it has none, organizations are frequently evaluated on their ability to live up to what is believed to be, rather than actually is, their culture and mission. Since the USPO is neither particularly efficient, nor in good financial health, its reputation will be further tarnished when today's performance is matched with public belief as stated on that historic building.
So, be careful what you say: it is guaranteed to come back and haunt you.
Friday, February 5, 2010
The Corruption of Language (5)
The top business news this morning is that the unemployment rate dropped from 10% of the workforce in December to 9.7% in January. That is supposed to be good news.
Reading a little further, however, provides the information that 20,000 jobs were lost in January. So how, if there are fewer jobs, can the unemployment rate drop?
For those who understand third grade arithmetic, calculating the unemployment rate is simple. Count the number of people who say that they are unemployed, divide by the total workforce, and express it as a percentage. That is the Unemployment Rate. Although easy to calculate, it is a seriously misleading number.
To get to the next level of understanding, consider something that former President Bill Clinton might have said: "it depends what the definition of unemployed is." A person who does not have a job but is so discouraged that he or she didn't look for a job last month, or was ill and didn't look for a job either, is neither counted as unemployed nor as a part of the workforce. So, even if the Unemployment Rate drops - as it did this month - it can be because the labor force dropped faster than the increase in the number of unemployed.
Entirely ignored in the headlines are the many people who are working part-time but only because they can not find a full time job. The really important number includes not just the unemployed but also the discouraged and the underemployed. By all reports, that number is above 16% but, because it is downplayed or omitted in the government press releases, is a story that too many journalists neglect to report.
Our government corrupts the language in order to better control us and to provide job security for politicians. The press and other media are, or should be, our shield against government manipulation. If, as too often seems to be the case, the media are lazy and incompetent, then these words, uttered by Abraham Lincoln, may no longer be true:
"You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time."
If we value our liberty, we must continually challenge the government to speak the truth.
Enough said.
Reading a little further, however, provides the information that 20,000 jobs were lost in January. So how, if there are fewer jobs, can the unemployment rate drop?
For those who understand third grade arithmetic, calculating the unemployment rate is simple. Count the number of people who say that they are unemployed, divide by the total workforce, and express it as a percentage. That is the Unemployment Rate. Although easy to calculate, it is a seriously misleading number.
To get to the next level of understanding, consider something that former President Bill Clinton might have said: "it depends what the definition of unemployed is." A person who does not have a job but is so discouraged that he or she didn't look for a job last month, or was ill and didn't look for a job either, is neither counted as unemployed nor as a part of the workforce. So, even if the Unemployment Rate drops - as it did this month - it can be because the labor force dropped faster than the increase in the number of unemployed.
Entirely ignored in the headlines are the many people who are working part-time but only because they can not find a full time job. The really important number includes not just the unemployed but also the discouraged and the underemployed. By all reports, that number is above 16% but, because it is downplayed or omitted in the government press releases, is a story that too many journalists neglect to report.
Our government corrupts the language in order to better control us and to provide job security for politicians. The press and other media are, or should be, our shield against government manipulation. If, as too often seems to be the case, the media are lazy and incompetent, then these words, uttered by Abraham Lincoln, may no longer be true:
"You can fool some of the people all of the time, and all of the people some of the time, but you can not fool all of the people all of the time."
If we value our liberty, we must continually challenge the government to speak the truth.
Enough said.
Thursday, February 4, 2010
The Fiscal Crisis
It used to be that describing Democrats as addicted to 'taxing and spending' was an accurate epithet. Then the Republicans, obsessed with low taxes but seeing the electoral benefits of spending, became the party of 'borrow and spend'. Now Democrats, using a variety of dubious excuses, are copying Republicans.
On February 2, President Obama sent the FY2011 budget message to Congress. A common characteristic of the President's message, and almost all of the media reports, is to minimize the really serious situation into which we have put ourselves. The President, living in fantasy land, promises to freeze - not cut - $477 billion in discretionary spending. He also seems to think that the budget deficit can be cut in half by 2013 when the real need is for a budget surplus to repay debt.
The overall spending request is $3.833 trillion dollars but that is matched by only $2.576 in taxes leaving a deficit of $1.266 trillion. All of these numbers look pretty small - as they are intended to do - until a little elementary analysis is performed.
First, what is a trillion anyway. A trillion is a thousand billions or a million millions. So, line up a million millionaires and take away all of their money. That raises an extra trillion dollars in tax but still does not eliminate the deficit.
Perhaps, then, we should consider punishing those at the other end of the financial spectrum. Take 17.6 million full time workers, each making the Federal Minimum Wage of $7.25 per hour and working 2080 hours (40 hours per week for 52 weeks) each year. Confiscate all of their earnings and that will eliminate the remaining $266 billion of the deficit.
Next, consider the overall numbers: the Federal Government is planning to spend nearly 48% more than it takes in. Were a fairly average family, earning - for example - $67,500 a year to spend $100,000, it would soon be in deep financial trouble. That is where the United States is now.
Third, think about how the money is being spent. The really big items are Defense $749.5 billion (19.55%) and Veterans Benefits $124.5 billion (3.25%), Interest on the National Debt $250 billion (6.52%), Social Security $721.5 billion (18.82%) and Medicare $497 billion (12.97%).
The total of these five line items consumes more than all of the taxes to be raised so everything else to be spent, including $400 billion for Medicaid and other Health Spending, must be borrowed.
What then is the solution? Given the aging of the population, Social Security payments are projected to grow and grow and grow. In addition, given the rate at which health care costs (quantity and price) are increasing, it will not take long, unless radical action is taken, for a major crisis to occur in that sector alone. Other transfer payments - Medicaid, Food Stamps, Farm Subsidies and the like - are not likely to be reduced.
The time is soon coming when it will no longer be possible to use today's tactic of irresponsible borrowing to unload the problem onto our children and grandchildren. Growing our way out of the problem just won't happen either. We have to face the ugly reality of major spending cuts in our favorite programs and, without a doubt, tax increases.
And even if we were able to inflict the pain on succeeding generations, we take a major strategic risk by allowing China to own so much of our debt.
Will there be action in time. Only if we, the People, demand it. Unfortunately, a majority of voters are takers from, rather than contributors to, the public treasury. They can be relied upon to make their voices heard in favor of more spending. Most of those who are contributors will be equally vocal in favor of lower taxes.
If politicians, responding to the noise, are unable to see beyond re-election, then a disaster is inevitable. Whether the disaster is Weimar Republic style inflation, just a major reduction in national income and welfare, tyranny, or all of these is not yet certain. What is certain is that we need to act now to minimize the danger.
Do elected politicians have the courage to act? Do they have the will to risk the wrath of the electorate because they have done the right thing?
I doubt it but it would be a pleasant surprise if they did.
On February 2, President Obama sent the FY2011 budget message to Congress. A common characteristic of the President's message, and almost all of the media reports, is to minimize the really serious situation into which we have put ourselves. The President, living in fantasy land, promises to freeze - not cut - $477 billion in discretionary spending. He also seems to think that the budget deficit can be cut in half by 2013 when the real need is for a budget surplus to repay debt.
The overall spending request is $3.833 trillion dollars but that is matched by only $2.576 in taxes leaving a deficit of $1.266 trillion. All of these numbers look pretty small - as they are intended to do - until a little elementary analysis is performed.
First, what is a trillion anyway. A trillion is a thousand billions or a million millions. So, line up a million millionaires and take away all of their money. That raises an extra trillion dollars in tax but still does not eliminate the deficit.
Perhaps, then, we should consider punishing those at the other end of the financial spectrum. Take 17.6 million full time workers, each making the Federal Minimum Wage of $7.25 per hour and working 2080 hours (40 hours per week for 52 weeks) each year. Confiscate all of their earnings and that will eliminate the remaining $266 billion of the deficit.
Next, consider the overall numbers: the Federal Government is planning to spend nearly 48% more than it takes in. Were a fairly average family, earning - for example - $67,500 a year to spend $100,000, it would soon be in deep financial trouble. That is where the United States is now.
Third, think about how the money is being spent. The really big items are Defense $749.5 billion (19.55%) and Veterans Benefits $124.5 billion (3.25%), Interest on the National Debt $250 billion (6.52%), Social Security $721.5 billion (18.82%) and Medicare $497 billion (12.97%).
The total of these five line items consumes more than all of the taxes to be raised so everything else to be spent, including $400 billion for Medicaid and other Health Spending, must be borrowed.
What then is the solution? Given the aging of the population, Social Security payments are projected to grow and grow and grow. In addition, given the rate at which health care costs (quantity and price) are increasing, it will not take long, unless radical action is taken, for a major crisis to occur in that sector alone. Other transfer payments - Medicaid, Food Stamps, Farm Subsidies and the like - are not likely to be reduced.
The time is soon coming when it will no longer be possible to use today's tactic of irresponsible borrowing to unload the problem onto our children and grandchildren. Growing our way out of the problem just won't happen either. We have to face the ugly reality of major spending cuts in our favorite programs and, without a doubt, tax increases.
And even if we were able to inflict the pain on succeeding generations, we take a major strategic risk by allowing China to own so much of our debt.
Will there be action in time. Only if we, the People, demand it. Unfortunately, a majority of voters are takers from, rather than contributors to, the public treasury. They can be relied upon to make their voices heard in favor of more spending. Most of those who are contributors will be equally vocal in favor of lower taxes.
If politicians, responding to the noise, are unable to see beyond re-election, then a disaster is inevitable. Whether the disaster is Weimar Republic style inflation, just a major reduction in national income and welfare, tyranny, or all of these is not yet certain. What is certain is that we need to act now to minimize the danger.
Do elected politicians have the courage to act? Do they have the will to risk the wrath of the electorate because they have done the right thing?
I doubt it but it would be a pleasant surprise if they did.
Wednesday, February 3, 2010
Don't Ask, Don't Tell
The prospect of having openly gay persons serve in the military is sending shivers up the spines of right wing nuts and other bigots.
The Dutch, admittedly somewhat peculiar in that they have a unionized military, report no adverse effects from permitting openly gay citizens to serve. Nor have the Canadian and British forces suffered from their tolerance. The hard right might want to start by explaining how the United States is so different.
On a purely practical level, they should consider the current difficulties faced by the services as they attempt to recruit sufficient qualified volunteers. Given the general reluctance of most Americans to serve, excluding an entire class of citizens seems unwise.
Your correspondent is cheerfully straight, with no desire even to experiment, but knows many gay people. None of them appear to be subhuman, disgusting or, as Leviticus would have it, abominations . They deserve neither ostracism nor to be prohibited from serving their country.
More important, perhaps, are the words of the late Senator Barry Goldwater - a Conservative Republican icon - who said: "you don't have to be straight to shoot straight."
There is much to be said for tolerance.
The Dutch, admittedly somewhat peculiar in that they have a unionized military, report no adverse effects from permitting openly gay citizens to serve. Nor have the Canadian and British forces suffered from their tolerance. The hard right might want to start by explaining how the United States is so different.
On a purely practical level, they should consider the current difficulties faced by the services as they attempt to recruit sufficient qualified volunteers. Given the general reluctance of most Americans to serve, excluding an entire class of citizens seems unwise.
Your correspondent is cheerfully straight, with no desire even to experiment, but knows many gay people. None of them appear to be subhuman, disgusting or, as Leviticus would have it, abominations . They deserve neither ostracism nor to be prohibited from serving their country.
More important, perhaps, are the words of the late Senator Barry Goldwater - a Conservative Republican icon - who said: "you don't have to be straight to shoot straight."
There is much to be said for tolerance.
Tuesday, February 2, 2010
Short Term Thinking
President Obama yesterday submitted his budget proposal for 2011 to Congress. Included in the package was the effective cancellation of any plans for a return to the Moon or a mission to Mars in the foreseeable future.
It would be an understatement to describe this as short sighted.
One of the valuable functions of government is to cover the costs of critical activities that are unlikely to yield profits in the time frame which, of necessity, governs for-profit corporations. Basic research and development, as well as exploration are the two of the most important activities that are deserving of substantial taxpayer funding. Both have proven themselves, over the long term, to be of enormous benefit to our nation and the world.
Thomas Jefferson, while President, funded the Lewis and Clark expedition that was the first step to opening the American West. Much later, the Eisenhower and Kennedy administrations, following the embarrassment caused by the Soviet Union's launch of Sputnik in 1957, began to fund space programs that drove the state of the art in, among many other things, the miniaturization of electronics, in computing, and in the understanding of our planet's climate and weather.
There can be little doubt that knowledge of science, technology, electronics and mathematics (STEM) is critical to the long term health and growth of any economy. Where better to provide good jobs in those fields than in a space program?
A generation of scientists and engineers, assisted by funding from the 1958 National Defense Education Act, were inspired by the Mercury, Gemini and Apollo programs. Lamenting the current lack of interest in STEM is not helpful but inspiration will encourage young men and women to enter these fields rather than becoming lawyers and financial traders whose contribution to the greater good is now marginal - if not negative.
Then there is the question of the continued existence of the human race. Sooner or later, there will be another natural disaster, similar to the asteroid strike that caused the extinction of the dinosaurs, that will render the Earth uninhabitable before that occurs. The needed skills are not easy to acquire but we must start now because Arks are not built overnight.
The time is long past for thoughtful citizens to force our government to reset its priorities: much less in the way of transfer payments and much more true investment. If our elected politicians will not act, then Oliver Cromwell's order, addressing the Rump Parliament in April 1653, is entirely applicable:
"You have sat too long here for any good you have been doing. Depart, I say, and let us have done with you. In the name of God, go!"
It would be an understatement to describe this as short sighted.
One of the valuable functions of government is to cover the costs of critical activities that are unlikely to yield profits in the time frame which, of necessity, governs for-profit corporations. Basic research and development, as well as exploration are the two of the most important activities that are deserving of substantial taxpayer funding. Both have proven themselves, over the long term, to be of enormous benefit to our nation and the world.
Thomas Jefferson, while President, funded the Lewis and Clark expedition that was the first step to opening the American West. Much later, the Eisenhower and Kennedy administrations, following the embarrassment caused by the Soviet Union's launch of Sputnik in 1957, began to fund space programs that drove the state of the art in, among many other things, the miniaturization of electronics, in computing, and in the understanding of our planet's climate and weather.
There can be little doubt that knowledge of science, technology, electronics and mathematics (STEM) is critical to the long term health and growth of any economy. Where better to provide good jobs in those fields than in a space program?
A generation of scientists and engineers, assisted by funding from the 1958 National Defense Education Act, were inspired by the Mercury, Gemini and Apollo programs. Lamenting the current lack of interest in STEM is not helpful but inspiration will encourage young men and women to enter these fields rather than becoming lawyers and financial traders whose contribution to the greater good is now marginal - if not negative.
Then there is the question of the continued existence of the human race. Sooner or later, there will be another natural disaster, similar to the asteroid strike that caused the extinction of the dinosaurs, that will render the Earth uninhabitable before that occurs. The needed skills are not easy to acquire but we must start now because Arks are not built overnight.
The time is long past for thoughtful citizens to force our government to reset its priorities: much less in the way of transfer payments and much more true investment. If our elected politicians will not act, then Oliver Cromwell's order, addressing the Rump Parliament in April 1653, is entirely applicable:
"You have sat too long here for any good you have been doing. Depart, I say, and let us have done with you. In the name of God, go!"
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