Ian Welsh

The horizon is not so far as we can see, but as far as we can imagine

Category: health care Page 28 of 35

Illness and the price of prosperity

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On May 21, 2011

59 Comments

One of the pathologies of American, and to a lesser extent, Western society, which really stands out yet is rarely remarked on, is the absolute epidemic of chronic diseases we suffer from.  From historically apocalyptic rates of cancer to asthma, to heart and stroke disease, we’re one sick bunch.  We walk around, not dead yet, but chronically sick.

This is a direct result of our economic arrangements.  We dump huge amounts of carcinogens into the air, water and the food chain.  We pollute the air in so many ways they’re uncountable.  We build our residential areas to actively discourage exercise.  We subsidize food that is bad for us, especially corn derived foods, and we eat so much sugar it’s surprising we aren’t all crazed.  We dump such massive amounts of hormones into the water and food chain that our children are experiencing record early puberty.  And this is the short list.

All of these are what economists call “negative externalities”, which is to say, the cost of someone’s profits is paid in illness and chronic bad health, which also has a monetary cost.  But, y’know, forget the monetary cost for a moment.  If you or someone you know has a chronic health condition, let alone cancer, do you care how many rich people the US has?  If you’re one of the few doing well out of this system, does it matter to you when someone you love is suffering from cancer or chemo, or has diabetes, or struggles to breathe?

A society which makes itself sick and unhealthy the way we do can’t be said to be a good society to live in.  Human welfare is about how enjoyable it is to be alive, and there’s nothing enjoyable about illness, or watching someone you love puking from chemotherapy.

So next time someone talks about pollution, or additives, or “negative externalities”, remember, what they’re talking about is making you or someone you care about unhealthy or downright sick.  Your suffering, or the pain of your fatther, mother, lover, son, or daughter is what makes other people rich and enables the “lifestyle” of various other folks.  The poorer you are, the sicker you are, as a rule, because all you can afford is the highly subsidized crap food, but even if you’re rich and you eat straight organic, hire a trainer, and so on, you can’t avoid all the water, air and food pollution. You or someone you know is still likely to wind up sick, who shouldn’t have.

The suffering of sickness and ill health is one of the prices of what passes, less and less, for prosperity.

When Medicare is destroyed is only a matter of when

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On April 5, 2011

55 Comments

Folks, this won’t pass this year, but a version of it will pass:

That plan would transform Medicare from a government insurance program to one in which seniors would chose from private, federally subsidized coverage. Americans 55 and older would stay in the current system.

Remember, Obama’s health care reform was essentially the Republican plan from the 90s.  The Republicans, whom everyone was sneering at for running crazies, have put in place a team of hard right ideologues, who have moved DC significantly to the right even of where it was.  At some point they will pass this, because they want it badly, and the Democrats have no alternative vision other than “right wing, but not as right wing”, which goes nowhere.

I’ve said this before: get out.  If you can’t get out, get your kids out.  This is not going to end well.  Obama has institutionalized Bush rather than rolling him back, and in some areas, such as civil liberties and unilateral Presidential war powers, has actually moved further to the right than Bush was.  It is not impossible that this will get better in the next couple decades (as 5 year old Ian once argued, almost nothing is impossible), but it is unlikely.  Americans spent the last 35 years spending their retirement, their children’s retirement and running infrastructure and capital into the ground, and they were good with that.  Every effort to repeal Prop 13, for example, failed miserably.  America is the culture of the free lunch, what Americans don’t realize is that they’re the free lunch.

That doesn’t mean the US couldn’t fix its problems, in theory, but the point is that socially and politically, the US does not want to fix its problems.  It wants to continue to make them worse.  Yes, a majority of Americans may prefer different policies on some issues, but they aren’t willing to MAKE it happen or to actually pay for it (see Prop 13 above).  They aren’t willing to die for it, and at this point, that’s what it would take because your elites see no reason not take everything you have and turn you into slaves in all but name.  You will be debt slaves, who own almost nothing, not your house, not your phone, not your car, not your books.  Anything which can be rented to you, rather than than sold, will be.

Welcome to the Repo culture.  Everything you have, everything you are, can be taken away from you, and you are nothing but a series of revenue streams to your lords and masters.  Fail to pay, and you won’t even be allowed to be a debt and wage slave, you’ll be in a cardboard box or a debtor’s prison.

Modern Americans are mostly descended from people who didn’t say “this pisshole country is worth fighting for”, they’re descended from people who said “screw this, I’m outta here”.  Emulate them and leave, if you can’t leave do the other thing they were willing to do: prepare for a revolution and be willing to die in it.

Or accept your fate as slaves.

Your choice.

Washington State May Cut Medicaid Drug Benefits

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On October 14, 2010

9 Comments

I notice that of the solutions suggested, raising taxes on the rich isn’t one of them. Truly, such a thing is unthinkable: far more unthinkable than poor people dying because they don’t have medication.

Interesting set of priorities.

I also strongly suspect that the savings will be less than the government thinks, since without medication many folks will wind up in the hospital.

Just sayin’.

Tai Chi better for Fibromyalgia than drugs

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On August 18, 2010

25 Comments

Imagine that.

What’s remarkable, actually, is how often some form of exercise is better for a variety of conditions than pharmaceuticals.  From depression to osteoperosis to preventing the effects of Alzheimer, getting active generally works as well or better than drugs.

In terms of societal health, doing everything we can so that people eat healthily and get exercise would probably do more than anything else.

Instead we subsidize corn syrup and build suburbs without sidewalks.

Social Security Trustees Report: No Social Security Crisis

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On August 5, 2010

22 Comments

Social Security Trustees report that social security will be able to make full payments until 2037(pdf).  Tax receipts will dip below outlays before then, but this is precisely why the Social Security program has taken in more money than it needed, so that it could handle baby boomer retirement and increased life spans.

Any projection which goes out 27  years is so incredibly reliant on the embedded assumptions about growth, employment and lifespans that it amounts to a fiction.  It is, at best, a guess.

Increase growth by just a little bit and the entire “problem” goes away.  Get rid of the taxation cap so the rich are not capped in what they pay and the entire problem goes away.  Assume higher employment, and the entire problem goes away.  Assume a reduction in inequality, and the problem goes away.

The US has a number of problems which are at or near crisis, such as employment, inequality and healthcare costs, to name just a few.  Social Security is not one of them. It isn’t even close, and politicians and billionaires like Pete Peterson who are trying to gin up a crisis should be ashamed of themselves.

If they want the US budget more in order they should look at health care, where single payer could cut costs by at least a third, and at the military, where real spending has doubled since the end of the Clinton administration.

Or they should work on increasing employment and increasing wages for ordinary people. That’s a crisis.

Instead of dealing with real problems, instead of tackling the medical industry or the military-industrial complex, instead of fixing the job situation, they want to steal money from old people.

Massive Small Business Insurance Rate Hikes In California

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On May 30, 2010

17 Comments

Twelve to twenty three percent increases are common, with increases as high as 76%. Needless to say, these increases are unsupportable by many businesses, who will drop coverage as a result.

Ok, excuse me, but is anyone surprised?  Democrats had a chance to do real  health care reform, and they balked, kludging together a mess which was guaranteed not to work.

Those of us with an actual track record of, y’know, getting policy consequences right, warned that Health Care Reform was an ineffective mess which wouldn’t control costs, but too many people wanted to be fooled, wanted to “hope”.

Hope’s all very nice, but it’s not a bloody plan, or a bloody policy, nor does it constitute good analysis.

Fiscal Sustainability Facts and Solutions

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On April 29, 2010

17 Comments

2008 Budget

2008 Budget

1) Social Security, at current rates, is not expected to run short of money before 2037.

2)The simplest way to “fix” Social Security, if you’re worried about a “problem” 27 years in the future, is simply to remove the contribution limit.  End of problem.  Period.  Social Security is not in crisis.

3) The reason politicians want to “fix” Social Security is to increase the SS surplus, so they can use it for other things.

4) Medicare has more serious issues.  However the simplest way to fix healthcare in the US is to move single payer, which would reduce healthcare per person by one-third.  It has worked for every other country in the history of the world that has done it.  It will work for the US.  Since we’ve admitted now that everyone deserves health care, and since it’s cheaper, and better, why not use the next round of healthcare to fix Medicare by fixing health care?

Global Military Spending 2008

Global Military Spending 2008

The unspoken entitlement is the US military.  The US spends about half the entire world’s military budget.  There is, actually, no one in the world who can invade or seriously threaten the US in any fashion. (Is Canada going to invade?  Mexico?) You can easily slash the military budget in half and still be so far ahead of any possible combination of enemies that it isn’t even close.

And yes, taxes are going to need to go up.  Here’s a simple fix—tax all income over 5 million at 90%.  It won’t hurt the economy (the best economy in America’s history was back when marginal tax rates were this high in the 50’s and 60’s).  It will mean that the rich, who got almost the entire bailout and whose irresponsibility threw the US into its worst economic crisis since the Great Depression will pay for it.

Oh, and change the estate tax to tax 80% of all inheritances over 5 million, too.  Remember, dead people don’t need money and 5 million tax free for choosing your parents right is enough of a head start.

There are plenty of other ways to raise money and cut costs.  For example, you can put  a tax on buying and selling derivatives or you can slap on a carbon tax or you can reform corporate taxes so corporations making billions don’t pay no taxes.

Finally, the bottom line is this.  The US owes its money in dollars.  The US can print money.  The US is not going to run out of money(pdf).  There may be some inflation but anyone who tries to tell you that the US won’t have enough money to pay SS or Medicare is simply lying to you.

Anti-depressants and ADHD meds worse than no medication for most patients

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On April 28, 2010

22 Comments

Seriously.  I’ve suspected this for years, here’s the hardcore evidence.

Honestly, if you’re depressed the best treatment for everything short of the most severe depression is exercise.  If you don’t want to exercise, get a puppy.  Having someone who is always happy to see you and who needs you is what most people need.

And with luck, going on walks with the puppy will get you started on exercise.  Double win.

Americans in particular, and westerners in general are horrendously overmedicated.   In part I suspect this is simply because American lives, for all the material splendor, suck.  Working 9-5+ overtime + 2 hour commute, always knowing that if you lose your job you’ll lose everything, eating (too much) manufactured food denatured of proper nutrients while not getting enough exercise puts people under constant stress.  Added to that is the strong pressure to act “normal” and to never be seen to be sad or anxious or moody.  Act in unexpected and socially unacceptable ways and pretty soon that job you need, no matter how good you are at it, starts becoming insecure.

So people medicate.  Heavily.  It’s the only way they can get through their lives.  Anti-depressants are more addictive than opiates.  More addictive that cocaine.

But hey, that’s a good business to be in.  For pharma.  Get people hooked on your legal drugs, make the cheap natural stuff (pot and opiates and coca leaves rather than cocaine) illegal, and clean up.

(Some quotes after the jump)

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