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	<title>The Fed&#039;s HR Department &#187; Medical Industry</title>
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		<title>WTF, Beer and Toilet Subsidies?</title>
		<link>http://dchrdept.com/archives/172</link>
		<comments>http://dchrdept.com/archives/172#comments</comments>
		<pubDate>Tue, 01 Feb 2011 04:48:57 +0000</pubDate>
		<dc:creator>Shannon Rodgers</dc:creator>
				<category><![CDATA[Federal Debt]]></category>
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		<description><![CDATA[In-vest-ment noun \in-ves(t)-mənt\ &#8211; the outlay of money usually for income or profit. Much political discussion involves terms and phrases used in ways contrary to their definition. The cynical call it spin. President Obama says he wants to “invest” in &#8230; <a href="http://dchrdept.com/archives/172">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
			<content:encoded><![CDATA[<p>In-vest-ment noun \in-ves(t)-mənt\ &#8211; the outlay of money usually for income or profit.</p>
<p>Much political discussion involves terms and phrases used in ways contrary to their definition.  The cynical call it spin.  President Obama says he wants to “invest” in research, education, and infrastructure.  In part, his motivation for this “investment” is to get ahead of the Chinese in the green technologies race and fabricate a “sputnik” moment.  He wants us to “Win the Future.”  On the surface, this sounds great, after all who would not want to “Win The Future”, which I will abbreviate WTF.  Would I be a loon if I wanted to loose the future green race to the Chinese?  After all, they are so interested in being green in China, they have a head start, right?  They have demonstrated some technological advance on par with the Russians beating us into space to prompt a Sputnik moment, right?  So what could the President possibly mean?  As an attorney, he understands that words have meaning, and that reasonable people turn to the dictionary to determine the common accepted definition, so let’s start there.  He obviously did not intend for us to understand a meaning different from the common accepted definition.  Did he?  He would not count on us reacting to our feelings about the word instead of critically checking to see if he used it properly.  Would he?</p>
<p>I have to believe his intentions are pure, that he thinks he is doing this for our own good.  But his perspective, and belief in economic salvation through government fiat makes me skeptical that he has the usual understanding of the word investment.  So consider the following, recognizing my skepticism, and decide.  For example, an office manager might invest in training for the staff, invest in education.  But buying everyone beer one evening after a training session is spending on a consumable expense.  The training should lead to improved production, team cohesion, etc., payback in excess of the costs.  The beer, leads to trips to the bathroom.  Similarly, truthful investment in research would be in technologies with potential for a return on that investment.  Spending on research in thousand year old technology with physical or chemical limitations that limit financial feasibility, would not be investment.  Do you agree?  We would not, for instance invest in research in windmills or ethanol.  If we are to invest in education, like the office manager, we should choose those areas in which we expect the greatest, financial, return on our investment.  Such investment might be in the form of incentives to attract medical students to increase medical professionals and lessen the shortage, especially in anticipation of all the new people expected to be on Medicaid in 2014.  Investment in education would not be in subjects with no practical use, except to produce future professors.   Investment in education would be in science, economics, and business management.  There would be no investment in educating people in trades with no market demand as there would be no return on that investment.  And any investment in infrastructure would be along the lines of the Panama Canal.  We would invest in infrastructure with proven economic advantage over our current methods.  We certainly would not invest in more government operated railway, for instance, high speed or otherwise.  It would be easy to see the evidence of sincerity and understanding of the word investment.  We should not see a line waiting outside the men’s room, or hear talk of free beer.</p>
<p>Simple investment is made in assets which are expected to go up in value with time.  This can be raw materials which are tooled or modified so as to add value to them, or it can be real estate which can be improved to add value.  Investment can be in people, by increasing their ability to do such things.  In other words, investment is the act of taking wealth (capital) and using its ability to produce work to create more wealth.  A factory owner might invest in more efficient tools and in the education of the workers to operate them, only if it allowed that owner to increase production value and therefore see a return on that investment.  Without a return, spending is consumption, or charity, not investing.  A factory owner could find busy work for his employees and call it investment, for a while.  But just as beer is a fools investment, his capital would soon be flushed down the proverbial toilet, and he would not long be a factory owner.</p>
<p>“Green” is not relevant to this discussion..  When we spend tax money on research on such limited use technology as solar panels or windmills, we are duplicating research conducted for generations by the private sector.  The areas where this method of power generation is preferable to other methods is well understood and found unfeasible outside of limited, remote situations.  My family uses solar powered devises and I have seen solar powered wells provide water where it was not feasible to bring power lines.  For as long as there has been written record, windmills have lifted water into elevated tanks for later use.  But, whenever we must rely on such devices, we must have an alternative for days when the wind does not blow or clouds persist.  Any savings in the “free’ energy is lost in redundant spending on duplicate structure.  When we can tolerate intermittent failure, we put up with the inefficiency and losses for the savings.   But, make no mistake, energy companies have thoroughly tested known material and aerodynamic technology and continue to do so secretly.  Each is desperate to be the marketer of the next nuclear fusion plant or any other fossil fuel replacing technology.  Are we likely to get that kind of fanatical zeal for discovery through government-grant-investment research? Perhaps, but will the zeal be to find something economically feasible, or something popular, or the answers which bring more congressional funding?</p>
<p>We know how much energy reaches the earth from the sun.  There is not enough energy in sunlight to power our country if we could capture it all, with 100% efficiency.  Solar panels and windmills will never be 100% efficient, nor will the energy storage arrangements they charge.  Anyone who suggests we could have a breakthrough to change our understanding of physics sufficiently to overcome this fact is praying, not planning.  Such a person is praying for a change in the natural, physical world, not planning for an improvement in our understanding of it.  They are banking on an answer existing in the realm of what we do not know, no in the overall expansion of what we know.  A cynical person might attribute such folly to spin as well.</p>
<p>I suggest we let the private sector spend its own money when something new is to be gleaned, instead of spending the money confiscated from all of us because we wish it were so.  Following the real Sputnik moment, we didn’t beat the Russians to the moon, we ran there alone.  No one was following us.  The world was more than willing to let us spend the resources, and watch for the occasional discovery when we stumbled onto one.  The world is doing the same now that we are in the “green race”.  We performed a technological feat with no financially viable use for it.  The world knew it could be done, but only government would do it without answering the question of why would we.  I think it is really neat that we have been to the moon, and love the romantic images of doing so with a slide rule.  But I would never condone outpacing the Russians if it meant borrowing the money from the Chinese, giving our discoveries to them, and mothballing the program a generation later to rely on Russian rockets to get our satellites into orbit and our astronauts to a space station we share with them.  We went to the moon to prove that American ingenuity can solve any problem, the Russians went into space to prove to the Russian people that the Russian government was the solution to any problem.  Which more closely resembles the arguments President Obama makes for, “investment”?  Let us not spend money we borrow from our kids to mothball another technology without financial feasibility when we can do it now for free.</p>
<p>When we have invested (spent) tax money on education, we got more expensive education.  Don’t believe me?  Why would anyone spend the tax money to educate their kids in a public school, and also spend the tuition money to educate them in a private school, (as all private school parents do), if one were not better than the other?  As education spending doubled in this country, our student’s performance relative to the rest of the world did not change appreciably.  When we spent tax money to help students pay for college tuition, we got a corresponding increase in tuition costs.  When we use government loan guarantees, we get students studying subjects and pursuing degrees they never would on their own dime, much less if a private bank had to be convinced that demand for workers with those degrees was sufficiently high to empower the graduate to repay the loan.  Only the idle rich would pay their own money for degrees in un-marketable subjects.  A musician of moderate skill and disadvantaged background can get a loan and earn a music degree with no hope of being employed as such upon graduation.  This is not investment, it is entitlement.  We believe that this mediocre musician has a right to pursue this career path and some believe he is entitled to have the rest of us pay for it.  But more importantly, is such a young musician well served in being led to believe that a music degree and loan payments provide a better future than being a brick mason, for instance?</p>
<p>When we spend tax money on our “crumbling infrastructure”, we are doing maintenance, not investing.  Such maintenance is a consumable, not an investment.  This is not to say that maintenance is not necessary, but it is not investment.  I suggest a restructuring instead.  I suggest that we go back to the funding scheme that built much of our crumbling infrastructure.  I suggest that we use the gasoline tax for road construction and maintenance as it was originally sold to us.  I suggest that we end the practice of raiding that tax to subsidize public transportation like Amtrak and city buses.</p>
<p>I challenge you to find any area where the government operates in even tangential competition with the private sector where the government efficiency is on the same order of magnitude as the private sector.  Find any activity where the government keeps its promise of controlling costs and continuously improving customer satisfaction.  There is no private concern which can survive any substantial length of time without doing just that, and paying a return on investment.  There are legitimate uses for government, such as refereeing and national defense.  But anytime government spending is recommended as an investment, or to control costs, or as a way to provide for those who cannot provide for themselves, there has been and by the very nature of it will be, an ever increasing collection of resources and liberties in an attempt to react to the cascade of disappointments and demands.  Spending tax money on beer leads to well used toilets, not return on investment.  Unfortunately, it also assures votes from the brewer’s union, big toilet manufactures, and drunks.</p>
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		<title>Take two aspirin and meet me at the DMV in the morning.</title>
		<link>http://dchrdept.com/archives/64</link>
		<comments>http://dchrdept.com/archives/64#comments</comments>
		<pubDate>Sat, 19 Dec 2009 03:53:02 +0000</pubDate>
		<dc:creator>Shannon Rodgers</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[Doctors]]></category>
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		<category><![CDATA[Rationing]]></category>
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		<description><![CDATA[Health needs have existed longer than there has been an American medical industry. People have died of cancer and heart disease far longer than we have known of their existence. So what has changed? Technology. When it was common for &#8230; <a href="http://dchrdept.com/archives/64">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
			<content:encoded><![CDATA[<p>Health needs have existed longer than there has been an American medical industry.  People have died of cancer and heart disease far longer than we have known of their existence.  So what has changed?  Technology.</p>
<p>When it was common for a doctor to visit the sick’s home and order, “Take two aspirin and call me in the morning,” aspirin was the state of the medical art.  How ridiculous would it seem if the people of that age complained that access to aspirin was a basic human right, to be provided by the government at taxpayer expense?  How ludicrous would it have seemed if someone would have suggested that we all pay taxes to hire people to buy the aspirin from Bayer and then deliver it to us for “free”?  That generation would have wrinkled their noses at such a suggestion and said, “No thank you, I can buy my own aspirin.”</p>
<p><span id="more-64"></span></p>
<p>The only difference is that Bayer, and others in the industry, took the profits and invested them in the future.  Little did they realize that once they expanded our medical knowledge, their efforts would be demonized and labeled evil.</p>
<p>Think what might have happened if the “progressives” could go back and “fix the oversight” or our founders and included life, health care, and the pursuit of happiness in the original inalienable rights.  We would still be having 15 kids a generation, several of which would die before they were old enough to have kids of their own.  We would still be amputating limbs as a method of fighting infection.  There would be no cat scans, dialysis, open heart surgery, Botox, or Lasik eye surgery.</p>
<p>OK, so maybe there would have been the last two.  Interestingly enough, Botox and Lasik have gotten cheaper and better, more people are getting them with fewer side effects, all without government mandate.  They are generally not covered by insurance and people generally pay for them out of their own pocket.  They are now more available and the prices are going down as competition for patients increases.  Procedures covered by Medicare, on the other hand, are more expensive and fewer Doctors are providing them to Medicare patients who are also increasing in number.</p>
<p>In order to limit expenses all known socialized medical systems in the world ration treatment and drugs.  President Obama suggests that we can save $500 Billion in Medicare by simply refusing to pay doctors once the lower amount is reached, in other words by rationing procedures once we have spent $500B less than before.  If we only buy a few of something, we can limit what we spend on that something.  This has an additional affect on the research industry which further limits costs: There will be no new drugs or treatments.  Sure, there will be the occasional discovery by a housewife who mistakenly mixes the last few drops of her old brand of fabric softener with a healthy dose of her latest choice and discovers that her skin cleared up after exposure to the green cloud coming from the washing machine.  Give me enough orangutans with typewriters and enough time and one of them will accidentally type out the U.S. Declaration of Independence.  Some of you don’t know what typewriters were.  They were like laptops running Microsoft Word with the printer built in, only noisier and less likely to spontaneously produce the Declaration of Independence or auto-morphed emoticons.  <img src='http://dchrdept.com/wp-includes/images/smilies/icon_smile.gif' alt=':-)' class='wp-smiley' /> </p>
<p>The problem with rationing access and stifling development of new technology is that these are exactly the problems we are told such efforts will solve.  We complain that not everyone has access to treatment, then calmly discuss rationing.  Then we complain that new drugs cost too much while ignoring what it would cost to research new ones in government run labs staffed with government employees overseen by Congress.</p>
<p>If we could go back, would we freeze health care at a level available 40 years ago?  There was no arthroscopic surgery, no cat scans, and no contact lenses.  We would not have witnessed the last fatal case of Smallpox.  No?  How about only 30 then?  We still loose MRI’s, implanted cardioverter defibrillators, and laser eye surgery.  There would be no Hepatitis B vaccine.  No, want to keep those?  At 20 years we loose several cancer treatments and a vaccine for Lyme disease and in the last ten we loose more cancer treatments and the advances in stem cell research.  These are only a small example of the progress, (not the stuff of the progressive movement but the other direction) made in medicine over this time period.  Just think what we will know tomorrow.</p>
<p>My question, then, is why now?  Why is this the right time to stop advancing medicine?  Why is now the time to limit access to future levels of quality health care by future generations so that we can claim to offer universal access to most everyone now?  How ridiculous and ludicrous will we seem in 40 years when they look back and ask what were we thinking when we tried to eliminate the system that, although it does not offer all levels of treatments to everyone, it constantly adds to the list of treatments that are available to everyone.  No one goes without aspirin or an X-ray for that matter because they cannot pay.  One day, no one will pay for stem cell therapy.  Only after the rich buy it first, and then those with “Cadillac Insurance Plans”, and then common off-the-shelf plans, and then uninsured people who pay cash.  Just like aspirin and X-rays.</p>
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