Caveat: Incentives and U.S. Healthcare

I heard a part of a speech by Mike Huckabee, with whom I was certain I would find very little in common, and was stunned to hear a compelling and cogent argument about the core problem with healthcare in the U.S.

It comes down to an MBA-style incentives analysis:  why do insurance companies prefer paying for major healthcare interventions when prevention would be cheaper, in the long run?  Because, from a strictly actuarial standpoint, they have almost zero interest in the long run, since the average person is covered by a single given healthcare provider only for a short or medium run (i.e. a person keeps a given job at a given company for, say, 5 years, when prevention-oriented healthcare requires much wider windows of 8 or 10 years, at the least).  Thus, to pay for prevention-oriented healthcare for covered workers is only to subsidize a competitor, who would be the next insurance provider down the line in a given worker's career track.

One can question the accuracy of the individual bits of fact or statistic in the above analysis, and I didn't get a chance to hear what he thought the solution might be, but I was nevertheless pleased by the argument's underlying clarity and logic – it had an almost marxist-dialectic appeal.

No doubt, someone's been writing Huckabee's policies and speeches, but that he would sign on to such an assumption-challenging exposition speaks well of his intellectual integrity.  I'm not saying I would vote for him – he is, after all, the current favorite of a fundamentally intolerant Christian right – the all-American Jihad, made-in-Arkansas.  But, he's been condemned more than once as a new example of something that might be called an "evangelical liberal," and this example may provide some support to that categorization.

Caveat: Public arrogance

I had the opportunity to hear on the radio this morning (CBC via MPR via internet) an interview with John Bolton, former U.S. ambassador to the U.N.  I always suspected this man was a nutjob, but I was nevertheless stunned by the degree of condescension and arrogance he managed to express in this short interview.  If he's at all typical of the people in the Bush administration who have been creating and conducting foreign policy, it's no wonder we're where we are.  Of course, I knew that… but it just got brought home categorically, I guess.

It's 2 degrees C and raining.   I have the flu.

Caveat: The longest war

I overheard on the radio part of a book review of Susan Faludi's new book, Terror Dream.  Without having read the book, I'm probably as skeptical as the reviewer with respect to Faludi's apparent core thesis:  that Bush/Cheney's war-on-terror is resulting in significant rollbacks of feminist gains of previous decades.

Nevertheless, one sub-thesis that the reviewer mentioned, that I found compelling and powerful, was the idea that, far from being a strange and unwonted new type of war, the new "war-on-terror" is, in fact, America's oldest and most formative experience of war:  after all, wasn't the idea of a besieged city-on-a-hill at the heart of the White Man / Native American conflict, from the time of the first British settlements in North America?  A community of "innocents" victimized by fanatical, unknowable others who, "unprovoked," would come into the community and attack civilians.  As a nation, after a long period of aberrant integrative practice, we've finally reconnected with our long lost old demons, now conveniently externalized into the broader world.

In this sense, we've been fighting the war-on-terror since the mid 1600's.  By comparison, all other wars are irrelevant internecine squabbles.  Regardless of the validity of the parallel, the drawing of it is quite thought-provoking.  Are these Islamic fundamentalists, our fellow humans, the new Injuns?  Wow.

Listening to:  Magnetic Fields' "Strange Powers;" "The Trouble I've Been Looking For."

[Youtube embed later as part of Background Noise.]

Caveat: Apocalypse News

It is probably a bias of the BBC/NPR axis – the sort of radio I listen to – but it seems to me that news-radio programming has been harping a subtly apocalyptic set of themes lately, focusing on such issues as sustainability, global warming, the obesity epidemic and rampant consumerism.  Frankly, despite the self-evident importance of these issues, I find them more depressing than the more standard war/murder/terror/chaos/scandal fare.  That's because it's possible to be optimistic for the long-term future in the face of the latter, as we've been living with that sort of thing throughout history and things nevertheless persist in getting better.  But the former themes of environmental degradation and ecological imbalance are genuinely scary vis-a-vis the long term, and there's little precedent for a human society successfully overcoming such dangers, while there's plenty of evidence of societies succumbing to them (e.g. Jared Diamond's well-documented histories of the Maya or Easter Islanders).

I listen to these radio articles about the upcoming virtually inevitable end-of-the-world and I find myself ideating (is that a word?  it is now…) pulling a Kaczynski – go live in the mountains and be anti-human.  Of course, my family is rife with tendencies in this general direction, anyway.  So I'm predisposed.  But seriously, what can one do in the face of 7 billion people hell-bent on consuming themselves into extinction?  On the other hand, is this just another episode of apocalypto-science, like the malthusian alarmism of an earlier, pre-"green revolution" era?  Because human societies seem to crave an end-of-the-world narrative to keep things interesting….

Caveat: Development and Sustainability

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From the standpoint of economic development, South Korea is the miracle of miracles.  In 1955, it was one of the poorest countries in the entire world.  Poorer than almost anywhere than Africa, it was utterly devastated by 50 years of brutal Japanese colonialism and war.  Fifty years later, it is, by many indices, part of the “first world” – or even ahead of most.  And unlike other postwar miracle economies such as Japan or Germany after the war, it didn’t have the same kind of Marshall plan for rebuilding, nor did it have solid prewar economic/cultural habits to build on.
Even compared to 15 years ago, when I was here while stationed in the Army, the country has changed so much.  In 1991, Korea reminded me a great deal of Mexico in many ways, when thinking about the level of economic development and the patterns of economic behavior.  Yet now, such a short time later, though there are still traces of that older Korea, the country has seemingly levitated directly into the post-industrial condition, with the proliferation of consumerism and electronics and bourgeois lifestyle.
So the dark side:  we read a great deal, these days, about the fact that if all the world lived at “first world” levels of consumption, it would be utterly unsustainable with respect to what the would can support.  And I think, well, it’s great that Korea has managed to leap into the developed world the way that it has, but is this the right path?  Is this the way China and India  are trying to go?  Wouldn’t the world be better off, ecologically, if Korea, China, and India were more Mexican?  Meaning, of course:  if these countries were more notably incompetent when it comes questions of development?  For that matter, wouldn’t Mexicanizing (or better yet, Congoizing?) the US or Europe or Japan ultimately help the planetary environment?  What about the human costs?
Robinson Jeffers, way back in the 1930’s, commented on apparent conflict between respect for the natural environment, on the one hand, and respect for human dignity, on the other.  That there was somehow a kind of “either/or” proposition.  And he propounded and extolled what he called “inhumanism” – meaning he voted against human dignity, in favor of “god” and the natural world.  His poem, “Carmel Point.”
But I think about a comment, I think it was McLuhan (or maybe David Brin?!), on the other hand, who said something to the effect that ours was the first “adolescent” civilization.  And I would add that adolescence is a time for making mistakes – e.g. vast wars of genocide, irresponsible arms races, environmental holocaust.  Not all adolescents survive to adulthood.  Especially orphans, which our “adolescent” civilization would best be characterized as, since, but for god – our imaginary father who art in heaven – we are indeed quite alone.
Or are we?  “Mother Earth” is right there, all along, but, like adolescents throughout history, we choose to pretend we’re an orphan because it’s more exciting, more romantic, makes for a more compelling narrative?
The absent, uninterested, fictionalized father… the never-acknowledged-because-neurotic mother – we keep her locked in a closet, denying she might offer wisdom.  Or…
OK… maybe all this consumerism/consumptionism is a variety of adolescent “acting out” – a passing phase on the road to a responsible adulthood.  Certainly it has always struck me that it is only societies that reach a certain very high level of wasteful consumption that are capable of beginning to become conscious of environmental issues.  Suddenly South Koreans “care” about the environment – good luck finding Mexicans (aside from the small middle class) who feel that way.  What translates this “caring” into responsible social action, and transforms that into sustainability?
I’m optimistic.  Weirdly.  I think of someone learning a new skill… say, a martial art that, when practiced maturely is graceful and beautiful but, for the beginner, is a jumble of unlikely motions and clumsy flinging about.  Our global civilization is still a clumsy adolescent.  Making mistakes and being unacceptably selfish.  But it’s a passing phase.  Perhaps it will grow into a stunningly beautiful young adult.

Caveat: A Wash

Location: Minneapolis, MN

Soundtrack: NPR News – debate about the replacement for the 35W bridge proceeds apace, already. There’s a big hue and cry about trying to ensure the new bridge is “light-rail” ready or incorporates a light-rail line, which to me is freakin obvious – they’re gonna have to build a bridge for the “central corridor” light-rail line at some point anyway, and if you just study the map, the 35W crossing would actually work quite well, allowing them to then use the old railroad right-of-way thru the U of MN campus (instead of tunneling under Washington Ave, which would be humongously expensive I suspect!) and integrating the north end of campus and Dinkytown to the LRT route, too, where you know you could accommodate lots of public-transit-minded residents. God I hope they don’t “pull an L.A.” as I call it, and allow short-sighted thinking to lead them into building transit component (bridge, etc.) that actually works against long-term needs and logic (I call it “pull an L.A.” because the L.A. “green line” is the most poorly planned piece of public transit I’ve ever examined). 

Ok, enough ranting about local public policy – I’m leaving MN for a bit, now, anyway, right? I face an enormous task in the next several weeks getting my stuff together for the move to Korea, and I’m not feeling motivated, rather, kind of exhausted from the long drive back. And now that I’m in my own place again, I miss my cat. But I spoke with my sister on the phone and she says Bernie is adapting well, assiduously but successfully avoiding the dog and behaving in a friendlycat way with the boys. I’m so glad for that.

Yesterday was a complete wash, as far as getting things done.

I love being back in the Midwest , despite the hotsticky weather – there was an enormous thunderstorm on Monday night, which was wonderful.

Caveat: “Un hombre que grita no es un oso que baila”

La frase citada arriba aparece en una columna llamada "navegaciones" en la edición de hoy de mi periódico favorito La Jornada (traducción del original en francés del poeta Aimé Césaire: "un homme que crie n'est pas un ours que danse").  El autor de la columna, Pedro Miguel (también tiene blog) lo cita aludiendo al fenómeno del reality show, esta tendencia en la cultura popular contemoránea del convertir todo en espectáculo, incluso la guerra en Iraq.  Acerta que la vida real no es espectáculo:  de acuerdo.  Sin embargo, yo he vivido y sigo viviendo, de cierta manera, una vida de espectador, y suelo mirar al mundo de una manera pasiva pero interesada.   ¿Significa ésto que me he sometido a esta cultura de epectáculo a que el autor alude?  ¿Representa entonces alguna deficiencia moral para mí?

Caveat: Migration

I have finally decided to go forward attempting to build a website dedicated to the issue of free migration – see my post dated 2006.05.06.  It’s only a first draft, but it’s functional, at least.  After much time spent searching on the web, I have found nothing that coherently presents the issue as I see it, despite the overwhelming amount of content dedicated to immigration issues in general.
Now comes the process of identifying and placing appropriate content – there’s a book called “International Migration” by Jonathon Moses that advocates free human migration quite cogently, despite it’s nondescript title, which I may use as a sort of outline for the sort of content to put on the website.
The website’s “first draft” can be found at https://www.raggedsign.net/miahr, however, I’ve purchased the domain name migrationisahumanright.org and will be linking this domain into that website soon. [UPDATE: all this information is obsolete]
The recent failed immigration bill in congress (but endorsed by Bush) falls far short of the ideals for truly free human migration – yet I feel that, just like the abolition or sufferage movements, progress on this issue must be sought incrementally – for this reason I would hope that, in at least this one small area of policy, Bush will eventually get his way (this is very painful to admit, as, in most areas, the Bush presidency seems to have resulted in the greatest blow to global human rights in general in over a generation).
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Caveat: politics

Politics is making a comeback in Jared’s brain – after a nearly two-decades-long sabbatical.  This may be a false alarm.  But I’ve been feeling passionate about a certain political issue, and shocked and dismayed by my stand’s noticeable unpopularity among nearly all of those with whom I share it.

So, what has me all worked up?  Not Bush’s war(s).  That’s just “same old, same old.”  Not the environment, or nuclear proliferation, or any of the various greenishly lefty sorts of things that used to get me excited in my ill-spent youth.  No, here in my ill-spent middle age, the issue that has me fuming and actually writing letters to politicians is the issue of immigration.  And most everyone I talk to about is completely put off by the stand that I take.

That position is quite simply summarized in one short, unambiguous sentence:  “citizenship belongs to those who show up.”   Is this hard to understand?  I don’t think so – it goes all the way back to Rousseau and the idea of the social contract and all that.  It’s as democratic as things can get.  It boils down to the notion that if you want to be a part of this participatory democracy, then, welcome aboard.  Here are your rights, here are your obligations (yes, there are obligations:  pay taxes, follow the rules, etc.).  INCLUDING the Thoreauvian obligation which all citizens have to protest and resist unjust laws.  Hence my fundamental beliefs that a) illegal immigrants have as much right to be here as anyone else, and b) the argument against them that focuses on their illegality as opposed to their role as immigrants is xenophobic hogwash.  It’s the standard NIMBY / “I got mine, so f**k off” attitude.  Jim Crow laws were wrong in their time, and the laws against the free movement of otherwise law-abiding humans is wrong in ours.   To the extent that we characterize ourselves as truly a democracy embracing human rights, we MUST end this injustice.

I reject any effort to characterize my belief as incoherent – as many of my interlocutors have done.  It’s the purest, logical libertarianism imaginable, applied to the question of immigration.  It’s about the freedom of peoples to choose their homes and, more importantly, their polities.


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