A real crisis for Congress to tackle
The health-care system is this country is far from perfect. That's true of essentially every country's health-care system: in countries with single payer elective procedures that massively affect one's quality of life like joint replacements are rationed--but everyone gets general care from a general practitioner, not a doctor in the Emergency Department who shouldn't have to be a GP. Aging populations in the first world are going to stretch these entitlement schemes to unprecedented levels; some countries face doctor shortages due to price controls altering incentive structures; tax rates in countries with socialized medicine are typically higher than they have been in the U.S. in the last 30 years--and most of those countries essentially have their national defense subsidized by the U.S., which spends more on its military than all of the EU combined ($311 billion in the entire EU, population about 500 million, $713 billion in the US, population about 300 million.)
The U.S. faces other problems that arise from its less government controlled structure (it's far from a free market, and the degree of government intervention varies from state to state.) Some people can't get health insurance coverage despite all their efforts because they don't qualify for Medicare or Medicaid, they don't have the money to pay for private insurance (a problem exacerbated by having a pre-existing condition) and their employer (if they have a job) doesn't provide them coverage. Others are uninsured because they either don't know how to or chose not to take advantage of government programs they qualify for, or choose not to buy private insurance that they could afford (the latter class being mostly young, healthy people who rarely need medical attention and who on average are probably making a rational financial decision not buying insurance.) This lack of universal coverage means that instead of problems like worse cure rates for many types of cancer and long waiting times for scans and surgeries that the problems are more like the some in the middle class and lower class either having to use ED's for primary care or being financially ruined by an illness or injury.
The case for reform is there to be made, but the case for non-incremental, whole-cloth, very expensive reform during a time of unprecedented deficits is hard to make, in my opinion. There's not a crisis in health-care, to be frank; the reality is that the status quo, which was never a perfect system, continues unabated. That said, the vast majority of Americans are happy with their coverage, so the emergency is hard for me to recognize. A national emergency that calls for massive government spending would seem to be a problem that affects more than a small minority of people, puts the people it effects in danger, and not fixing it now could lead to a much greater expense to fix it later. Health-care seems to meet none of those criteria; our nation's crumbling infrastructure, however, does.
This post was inspired by watching a PBS NOW documentary about the way that standard shipping containers (one of the most unsung technological advancements of the 20th century) are moved across the country, by truck or by railroad. Basically everyone interviewed was loathsome for trying to influence the government in order to further their personal interests, but the general tenor of the writing seemed to be (surprise) against trucks, and frankly, highways in general. One prominent interviewee was Bill Graves, former Governor of Kansas and now the head American Trucking Association, who started off the show by noting something that the PBS narrator described as if it happens almost "magically:" technology in the form of tractor trailers, freight trains, shipping containers, container ships and modern port infrastructure lead to a massive flow of goods across America allowing almost anything we want to be accessible at at most a few days' notice. In other words, technology has made the standard of living in America, in real terms, better than almost anywhere in the world, even for those who are relatively poor... Imagine the reaction you'd get if you could go back in time to say, the 1950s and tell a poor American that 60 years later that even most people who society considers poor would have at least one color television (possibly one that is 3 inches deep) and a phone that is portable, fits in their pocket, and works virtually anywhere in the country.
From the narration, however, it seemed like the fact that America is rich enough that it has a problem that it needs to figure out how to deal with distributing TOO MUCH STUFF was not just a logistical problem, but a moral one. Especially when tied into environmentalism, you'd think that our nation's prosperity was at best a necessary evil, not something to celebrate. Trains were favored to move containers since they use about 1/3 as much fuel per container... but there were a few problems they noticed. Government price controls in the 1970s killed most of America's private railroad companies and left behind only a shell of an industry that once embodied private capitalism accomplishing massive feats (the race to build the transcontinental railroad, the gorgeous and iconic Penn Stations in Newark and New York built by the Pennsylvania Railroad company.) Virtually all passenger railroads today are government run either as local public transportation systems (like NJ Transit, which runs along many of the same routes as the old Pennsylvania Railraod) or else old private railroads folded into Amtrak. The lack of investment in railroad infrastructure and in further the deprecation or outright abandonment of much old railroad infrastructure means that that the super-efficient, green solution of putting freight on rails is a pipe-dream with our current infrastructure. Freight rail-lines are just as clogged as the highways--on the tracks down the street from my house freight trains go by at a brisk walking pace, a situation reflected around the nation, and in Chicago containers are taken off of trains and put on trucks to be put back on trains once they pass the bottleneck of the city.
So is the answer the status quo, or just add more trucks to our interstate system? Living in Minneapolis, Northern New Jersey and New York City, I have lived in places where both the inadequate capacity and dangerous levels of depreciation of our highway infrastructure have been driven home very clearly. Driving to New York City from New Jersey or to Queens for a Mets game from NYC both show how the interstates in highly populated areas are hopelessly over-crowded. Rush hour is now a general time of day that starts at about 5 AM and last til about midnight. In Minneapolis while the highways aren't as crowded they're falling apart. The 35W bridge over the Mississippi River literally collapsed, but what many people who don't live around here don't realize is that the collapse triggered an investigation into the stability and safety of all the bridges in the area and that many either required extensive maintenance work to to repair them or, in the case of a bridge just down the road from my house on Lowry Ave, a year and change of initial repair work and inspection led to the conclusion that the bridge simply was so decayed that it could not be repaired and had to be demolished and rebuilt from scratch. The bridge in that picture no longer exists and there's no river crossing at the location currently (the new bridge should be done next fall.)
While Minneapolis is particularly hard on bridges due to the cold winters (meaning many freeze/thaw cycles for concrete, steel, etc.) the idea that the 35W bridge collapse was an isolated incident or that similar initiatives in other cities wouldn't find decaying infrastructure seems hard to believe. This infrastructure needs to be repaired and upgraded no matter how freight is moved since they're used for personal transportation as well as moving freight. Unfortunately for a community organizer in Newark's Ironbound district who blame increased asthma rates on the large number of trucks driving around to get from the Port of Newark to the interstates we're not going to stop having car and truck traffic (and in Newark I'd posit that there are more pressing problems regarding young people's safety than smog... namely bullets.) But the truckers aren't some sort of breed of genuine altruist, either; when a truck school instructor was asked about upgrading infrastructure to accommodate more efficient kinds of trucks--specifically trailers that can carry two containers and increase fuel efficiency per container moved--she opposed it because the brakes would get too hot (a problem which technology certainly could not ever address) and that decrease the need for truck drivers. She's right about that, of course, but it would benefit everyone who's not a truck driver.
Basically, everyone except for an engineer who studied freight transportation logistics (including PBS) had an interest in benefiting a certain class of people at the expense of everyone else. Barack Obama,-shortly after signing the stimulus bill which allocated funds which are largely unspent-- said that some of the money in the bill would go towards the largest overhaul of infrastructure in the U.S. since the interstate highway system was built under Eisenhower. Of course while the interstate was designed both to move people and as a strategic military asset to move missiles and so forth quickly during the Cold War it was an actual investment by the government that yielded a huge benefit to the nation as a whole. In short, it was one of the few occasions when the government spent money in a way that benefited nearly everyone and harmed only a few (the people whose land was bought or seized to create the right of way) which is the exact opposite of most laws written before or since then which benefit the few (sugar farmers in Louisiana and Hawai'i) at the small cost of the many (everyone who doesn't farm sugar.) While one sugar tariff is hardly noticed, the piling up of these awful laws is a massive problem and is coming to a head in the health-care debate, as people finally notice the cumulative debt that these laws generate and the harm to them is not as small as normal.
In spending some of the already allocated money on repairing and expanding the capacity of our nation's infrastructure, both road and rail--since both are currently used and will continue to be used to move freight-- and then letting the free market allocate where and how to move the freight, he'd had have a chance to take something of a government boondoggle and do something truly rare for a politician: spend taxpayers' money in a way that actually benefits more than a tiny fraction of the taxpayers.
The U.S. faces other problems that arise from its less government controlled structure (it's far from a free market, and the degree of government intervention varies from state to state.) Some people can't get health insurance coverage despite all their efforts because they don't qualify for Medicare or Medicaid, they don't have the money to pay for private insurance (a problem exacerbated by having a pre-existing condition) and their employer (if they have a job) doesn't provide them coverage. Others are uninsured because they either don't know how to or chose not to take advantage of government programs they qualify for, or choose not to buy private insurance that they could afford (the latter class being mostly young, healthy people who rarely need medical attention and who on average are probably making a rational financial decision not buying insurance.) This lack of universal coverage means that instead of problems like worse cure rates for many types of cancer and long waiting times for scans and surgeries that the problems are more like the some in the middle class and lower class either having to use ED's for primary care or being financially ruined by an illness or injury.
The case for reform is there to be made, but the case for non-incremental, whole-cloth, very expensive reform during a time of unprecedented deficits is hard to make, in my opinion. There's not a crisis in health-care, to be frank; the reality is that the status quo, which was never a perfect system, continues unabated. That said, the vast majority of Americans are happy with their coverage, so the emergency is hard for me to recognize. A national emergency that calls for massive government spending would seem to be a problem that affects more than a small minority of people, puts the people it effects in danger, and not fixing it now could lead to a much greater expense to fix it later. Health-care seems to meet none of those criteria; our nation's crumbling infrastructure, however, does.
This post was inspired by watching a PBS NOW documentary about the way that standard shipping containers (one of the most unsung technological advancements of the 20th century) are moved across the country, by truck or by railroad. Basically everyone interviewed was loathsome for trying to influence the government in order to further their personal interests, but the general tenor of the writing seemed to be (surprise) against trucks, and frankly, highways in general. One prominent interviewee was Bill Graves, former Governor of Kansas and now the head American Trucking Association, who started off the show by noting something that the PBS narrator described as if it happens almost "magically:" technology in the form of tractor trailers, freight trains, shipping containers, container ships and modern port infrastructure lead to a massive flow of goods across America allowing almost anything we want to be accessible at at most a few days' notice. In other words, technology has made the standard of living in America, in real terms, better than almost anywhere in the world, even for those who are relatively poor... Imagine the reaction you'd get if you could go back in time to say, the 1950s and tell a poor American that 60 years later that even most people who society considers poor would have at least one color television (possibly one that is 3 inches deep) and a phone that is portable, fits in their pocket, and works virtually anywhere in the country.
From the narration, however, it seemed like the fact that America is rich enough that it has a problem that it needs to figure out how to deal with distributing TOO MUCH STUFF was not just a logistical problem, but a moral one. Especially when tied into environmentalism, you'd think that our nation's prosperity was at best a necessary evil, not something to celebrate. Trains were favored to move containers since they use about 1/3 as much fuel per container... but there were a few problems they noticed. Government price controls in the 1970s killed most of America's private railroad companies and left behind only a shell of an industry that once embodied private capitalism accomplishing massive feats (the race to build the transcontinental railroad, the gorgeous and iconic Penn Stations in Newark and New York built by the Pennsylvania Railroad company.) Virtually all passenger railroads today are government run either as local public transportation systems (like NJ Transit, which runs along many of the same routes as the old Pennsylvania Railraod) or else old private railroads folded into Amtrak. The lack of investment in railroad infrastructure and in further the deprecation or outright abandonment of much old railroad infrastructure means that that the super-efficient, green solution of putting freight on rails is a pipe-dream with our current infrastructure. Freight rail-lines are just as clogged as the highways--on the tracks down the street from my house freight trains go by at a brisk walking pace, a situation reflected around the nation, and in Chicago containers are taken off of trains and put on trucks to be put back on trains once they pass the bottleneck of the city.
So is the answer the status quo, or just add more trucks to our interstate system? Living in Minneapolis, Northern New Jersey and New York City, I have lived in places where both the inadequate capacity and dangerous levels of depreciation of our highway infrastructure have been driven home very clearly. Driving to New York City from New Jersey or to Queens for a Mets game from NYC both show how the interstates in highly populated areas are hopelessly over-crowded. Rush hour is now a general time of day that starts at about 5 AM and last til about midnight. In Minneapolis while the highways aren't as crowded they're falling apart. The 35W bridge over the Mississippi River literally collapsed, but what many people who don't live around here don't realize is that the collapse triggered an investigation into the stability and safety of all the bridges in the area and that many either required extensive maintenance work to to repair them or, in the case of a bridge just down the road from my house on Lowry Ave, a year and change of initial repair work and inspection led to the conclusion that the bridge simply was so decayed that it could not be repaired and had to be demolished and rebuilt from scratch. The bridge in that picture no longer exists and there's no river crossing at the location currently (the new bridge should be done next fall.)
While Minneapolis is particularly hard on bridges due to the cold winters (meaning many freeze/thaw cycles for concrete, steel, etc.) the idea that the 35W bridge collapse was an isolated incident or that similar initiatives in other cities wouldn't find decaying infrastructure seems hard to believe. This infrastructure needs to be repaired and upgraded no matter how freight is moved since they're used for personal transportation as well as moving freight. Unfortunately for a community organizer in Newark's Ironbound district who blame increased asthma rates on the large number of trucks driving around to get from the Port of Newark to the interstates we're not going to stop having car and truck traffic (and in Newark I'd posit that there are more pressing problems regarding young people's safety than smog... namely bullets.) But the truckers aren't some sort of breed of genuine altruist, either; when a truck school instructor was asked about upgrading infrastructure to accommodate more efficient kinds of trucks--specifically trailers that can carry two containers and increase fuel efficiency per container moved--she opposed it because the brakes would get too hot (a problem which technology certainly could not ever address) and that decrease the need for truck drivers. She's right about that, of course, but it would benefit everyone who's not a truck driver.
Basically, everyone except for an engineer who studied freight transportation logistics (including PBS) had an interest in benefiting a certain class of people at the expense of everyone else. Barack Obama,-shortly after signing the stimulus bill which allocated funds which are largely unspent-- said that some of the money in the bill would go towards the largest overhaul of infrastructure in the U.S. since the interstate highway system was built under Eisenhower. Of course while the interstate was designed both to move people and as a strategic military asset to move missiles and so forth quickly during the Cold War it was an actual investment by the government that yielded a huge benefit to the nation as a whole. In short, it was one of the few occasions when the government spent money in a way that benefited nearly everyone and harmed only a few (the people whose land was bought or seized to create the right of way) which is the exact opposite of most laws written before or since then which benefit the few (sugar farmers in Louisiana and Hawai'i) at the small cost of the many (everyone who doesn't farm sugar.) While one sugar tariff is hardly noticed, the piling up of these awful laws is a massive problem and is coming to a head in the health-care debate, as people finally notice the cumulative debt that these laws generate and the harm to them is not as small as normal.
In spending some of the already allocated money on repairing and expanding the capacity of our nation's infrastructure, both road and rail--since both are currently used and will continue to be used to move freight-- and then letting the free market allocate where and how to move the freight, he'd had have a chance to take something of a government boondoggle and do something truly rare for a politician: spend taxpayers' money in a way that actually benefits more than a tiny fraction of the taxpayers.
Labels: government, politics
0 Comments:
Post a Comment
Links to this post:
Create a Link
<< Home