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View 570 May 11 - 17, 2009

 

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Monday, May 11, 2009

.The May column is up at Chaos Manor Reviews.

I may have pointed to this before, but it takes little time to look:
http://rankexploits.com/musings/2009/
longish-trends-much-lower-than-models/

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Breaking good news

Reporter Freed

 http://news.yahoo.com/s/ap/ml_iran_us_journalist      

 There will be implications and the inference that we are learning to get along with Iran. Let us hope those will be true.

Niven will be over in half an hour for a long hike up the hill. Last night I took Sable out at midnight for her first walk in a couple of days. She was overjoyed. I guess I am recovering, although I did sleep a bit late.

The news is full of the story of how the government transferred Chrysler to the unions at the expense of those who loaned money to the company. Bankruptcy law is now entirely in the wind with no act of Congress having changed it. This looks to me like a fundamental change in the Constitution as we move toward the European style of managed economy.  Obama meanwhile seems bent on changing our health care system using the same methods as were used on the banks who had loaned money top Chrysler.

Note that Britain moved farther than we did, to full nationalization of industries, and partially recovered in the Thatcher era.

The fundamental problem with nationalized single payer health care is that it's impossible to give everyone what they want. The demand for a free good is infinite.

==============

Niven and I had a great hike up to the top of the ridge. About 4 miles round trip and 800 feet climb. The remedy for funk is to ignore and get out there and do something. I then had errands for a couple of hours, and I will admit being a bit tired. Sable is flat in the back hall, but she enjoyed the walk. We went out last night about midnight because she hadn't had a hike in 3 days and she was driving us nuts -- which is, after all, her job, to see that these lazy humans get some exercise. The result was a good night's sleep and I woke up with some ambition and energy.

Larry and I are eager to get going on Lucifer's Anvil. We came up with a good scene and some really good lines while hiking -- well, the best line was while walking back to his car after eating at the Thai place on Ventura. Anyway, it can be a great book. And maybe do some good.

 

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Tuesday, May 11, 2009

Late start today.

We'll be hearing a lot more about Obama-care. If the private health care outfits can cut cost, what took them so long? It is a bit like Morton's Fork: "You have been living frugally and not spending. You must have some money, fork over for the king.  You have been living lavishly, so you obviously have lots of money. Fork over for the king."  It works about the same with health care: you make profits so you are gouging. Government will give your clients a better deal. You don't make profits, so you're not efficient. Government will streamline things.

The principle to keep in mind is that the demand for a free good is infinite. That doesn't mean that everyone will make use of that good, but many will. The only way to keep demand down is to attach a cost. That works just fine with diamonds, and no one really complains, but then few argue that anyone has a right to diamonds. When it comes to food or "health care" it's a different story. A significant part of the population believes everyone has a right to as much of those as they "need" without regard to their ability -- or willingness -- to pay for them. That includes those who cannot pay at all.

This sounds noble, but the results are generally not so, as we can see from what has happened elsewhere. Eventually the demand overwhelms the supply. At that point the "payment" is time: time spent waiting for something to happen, whether sitting in an emergency room or simply waiting for a transplant or a "voluntary" operation. Of course those with money will then circumvent the system by going to private health care providers. As provider feel the squeeze they drop out of the system and become private providers, reducing the number of providers available to the public free system. The next step is to forbid private health care, and make criminals out of doctors and others who don't accept what is done to them in the public system.

It's an easy prediction. Everyone knows it will happen. Go to Hillary-care or Obama-care and eventually doctors will be fined or jailed for charging fees for services provided.

What all this does to Kaiser, which has in my experience worked very well for many years, is not predictable, but I'd bet it will not be good.

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Wednesday,  May 13, 2009

This is typical (although that implies that there are many more people sending me these sentiments than there really are) of response to yesterday's notes:

Why is it, of all the industrialized nations in the world, we are the only country that cannot tackle health care reform?  You of all people should be its strongest champion, for at the heart of the debate is realizing the ideal that Henry Kaiser had when he founded his program, providing low cost health care for his employees.   Why cannot we, the richest nation in the world provide affordable health care for all citizens?  Why is it that Medicare, a government run program, has such a lower overhead than private insurers and healthcare providers?

 If you looked at a detailed analysis of where cost go in the insurance and pharmaceutical industries, you would be completely shocked and dumbfounded.

 In some cases, 60% of the cost of prescription drugs goes to advertising and promotion.  Big Pharma negotiated a deal with the last Administration to remove the cost of drugs from any future Medicare negotiations, allowing them to sell Canadians prescription drugs at a lower cost than they do Americans, then banning the import of “Canadian pharmaceuticals” on safety grounds.

 I have a few questions. First, I would like to know which countries have so much better systems. Secondly, I believe that Medicare is in dire need of new funding: they'll have to raise taxes to sustain it.

My own view on all this is that health care is nowhere mentioned in the Constitution, and is thus a matter for the states. If there is some wonderful solution to the health care mess, Congress has the absolute power to try the experiment in the District of Columbia, and should implement something that everyone would want to emulate. It's like education: if they can't do it in DC where they are sovereign, why do we assume they can do things from Washington that will work in Iowa and Arizona?

One reason for the high costs is, I am told, the enormous cost of malpractice insurance, and one way to reduce the costs would be to make changes in the legal system. That's far outside my area of expertise, but I can safely say that nothing will be done that reduces the amounts paid to the trial lawyers,

Great heavens, if there were a simple system whereby we would all put up a small percentage of our income in return for universal membership in something that works as well as Kaiser has worked for me, I would be among the first to advocate it; but I have seen nothing offered that looks like that, and I suspect that if we have open borders and free health care, not even the productivity of a booming economy could support it. The demand for a valuable free good is infinite. the only way to limit costs of health care is to limit benefits: now who gets to set those limits?

So which industrialized country has the system we ought to emulate?

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I returned from my walk with more thoughts on this, but I also found mail about the Japanese health care system.

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Think of this model. A gated community decides to build its own clinic/hospital for those who live in the community. There are a number of doctors there who are going mad with forms and other such stuff, and they agree: they will accept a fixed salary, dues for the homeowner association are set to a certain amount that will pay for the operating expenses including salaries and retirement of the loans taken out to build and equip the clinic. If you buy a house in that community you will have both the privilege and obligation of paying the dues which include the health care facility. If you need something the clinic doesn't provide you are on your own, but otherwise you can go to the Indian Sunset Homeowners Clinic and Hospital and pay some nominal copayment (just enough to discourage bored retired people from going in just to have something to do) and all's well.

Now a gardener is injured. He's taken to the clinic, where they take care of him. He goes home and tells his wife. Soon his family begins to show up. So does his brother's family. And others. The doctors find they are working overtime. They tell the homeowner association that they'll have to provide more staff, which will mean a raise in dues, because they can't legally turn anyone away just because they can't pay and aren't members of the association.

If the association won't raise dues they can't hire more doctors. Some doctors quit. The others are now even more overworked. And the lawyers tell the owners they can't legally close down the clinic...

That began as an analogy and became something that might end up as an incident in a story...

==========

malpractice costs

are something like 2% of total medical spending in this country. see http://www.cbo.gov/ftpdocs/
49xx/doc4968/01-08-
MedicalMalpractice.pdf , congressional budget office.

Gregory Cochran

I find that hard to believe. I know that our pediatrician gave up doing tonsils and minor surgery because of the cost of malpractice insurance, and my physician friends all point to the enormous costs of malpractice insurance; surely more than 2%.  There are also the costs of defensive medicine. I would really be astonished if the legal costs were 2% or under.

More of this in mail. Dr. Cochran is right, but there are considerations.

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Thursday,  May 14, 2009

Amazon losing money on $9.99 e-books?

http://www.teleread.org/2009/05/13/amazon-losing-money-on-999-e-books/

--- Roland Dobbins

I find this one fascinating. I also do not understand it. Publisher costs for ebooks cannot be as high as for actual physical books that have to be printed and shipped. Editorial costs are the same. Authors get a fixed percent of the cover price of a book (in most trade book contracts; computer books pay on a more exotic basis reminiscent of movie contracts). Thus the lower the price the publisher charges for an ebook, the less it costs publishers (hard cheese on authors, of course).

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The economy continues to implode. Meanwhile, government has grown like crazy during the boom years -- and it is still growing. Civil Service was supposed to protect government employees from political pressure. In return they were forbidden to be in politics. Now the government service unions are massively involved in politics, and the number of government employees continues to grow as the rest of the economy lays people off.

Can this continue? If not, is there a way out?

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We used to say that in America, we consider each man the best judge of his own interest. Obama's Arizona commencement address seems to have a different view.

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Discussion of health care in mail.

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Amazon Launches Publishing Program - 5/14/2009 7:50:00 AM - Publishers Weekly

http://www.publishersweekly.com/
article/CA6658267.html?desc=topstory 

Amazon has finally dropped the other shoe on its publishing plans. Note that the book was originally self-published and that others are planned.

Regards,

Francis Hamit

It is always good to have a new market. Amazon may become a major player; we can hope. And they start with a fantasy. Maybe they'll like SF. Scribners and other publishers used to have book stores, so it's not unprecedented that a book seller is also a publisher (indeed most publishers evolved from book sellers).

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Mamelukes

Are you ever going to finish Mamelukes? My guess is that it bores you to revisit old characters and situations. But I at least have been waiting for it for over twenty years. Storms Of Victory came out in paperback 1988. The paperbacks do get a bit worn out.

An old and reasonably dedicated fan, ADRISDAD

Actually, I expect to finish it this month. I am working about 2 hours a day on it, and last night on a walk with Sable I figured out what I think is the last plot problem. It's a matter of energy levels, and things have been a bit slower than I thought -- I had expected to be done by now -- but I have 105,000 words, all very nearly final draft. I don't have a lot of trouble rewriting and polishing and I do that when the juices aren't flowing for new text, so when it's finished it will be very nearly ready to ship out. My editor/publisher at Baen has seen what we've done so far and she loves it.

My apologies for the long wait. I won't go into reasons, but some involve finishing some best sellers. The collapse of BYTE and the resulting scrabble for income -- for me the recession began several years ago -- are part of it, and then in 2007 I had expected to finish it by Fall of 2008. That is when we found I needed the radiation therapy, and while I tried to work while being zapped, that went pretty slow. I'm amazed that I could keep this place up while that was going on.

I can't promise to finish by the end of May but I am trying.

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addendum: 1200 words today.

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Cheer. They have found a sunspot. http://www.solarcycle24.com/

 

 

 

 

 

 

 

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Friday,  May 15, 2009

We continue the health care discussion in Mail. We will shortly run out of new things to say on the subject -- I get lots of letters on this, and if this were a traditional blog it would be very large -- but for the moment it's worth continuing.

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I am told that the problem with this flow chart on copyright expiration is that it is too simple

http://www.bromsun.com/practices/copyright
-portfolio-development/flowchart.htm and doesn't address the legal definitions of "published". Are we having fun yet?

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WHY WE HAVE TO GET POOR QUICK

This was a headline from The Futurist, a publication of the World Future Society, back in Carter times. I used it as a slide in my SURVIVAL WITH STYLE lecture which I used to give all over the country. Some of that is included in A Step Farter Out.

Survival with Style said that Carter and the gloomsters were wrong, we were not headed for a nearly inevitable collapse, we would not have an enormous die-off of humanity, there would not be a billion people dead of starvation, and the US didn't need to join the poor nations: the best thing the US could do for the world would be to get rich. And there were ways to do it. Despair is not only a sin, it's a blunder. Back in those days I was one of the few who went to college campuses to say things like that. I was opposed by the faculty; most of the students wanted to hear that they were not headed for lives of poverty and gloom. But I sure felt alone for a while there.

We're now contemplating a book called SURVIVAL WITH STYLE updating what was said back then. My son Richard thinks it could be promoted and he's willing to do some of the promotion -- I simply haven't the energy to go on all those author death marches that used to make my books well very well. I can go to local signing, and I expect I could manage a lecture or two, but I can't camp out in coffee pot radio stations with afternoon traffic shows...

Anyway it's worth thinking about. The principles haven't changes much. And current "green" proposals are almost certain formulas for how to get poor quick. One would think most people would know this, but apparently it's not longer so clear.  The nation didn't want to get poor quick, and decided that Carter's national malaise and the end of the era of growth were not satisfactory. We went on a long boom.

We could do that again.

We can in fact survive with style.

 

 

 

 

 

 

 

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Saturday,  May 16, 2009

I am sure I have referenced this before, but http://rankexploits.com/musings/
2009/longish-trends-much-lower-than-models/ shows predicted vs. observed trends in climate change.

I have almost certainly referenced http://reason.com/news/show/28479.html also, but it's worth you attention if you missed it. As you might surmise, I am thinning out the number of open windows I keep in Firefox.

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The implicati0ns in this article are staggering. They are also politically incorrect. http://www.sciencedaily.com/
releases/2009/03/090325132531.htm

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I'm batching it today. Got some plot work done on my walk,   Now to weave it all into Mamelukes...

 

 

 

 

 

 

 

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Sunday,  May 17, 2009

President Obama speaks at Notre Dame. The abortion debate reopens.

We have long has institutions whose purpose is to settle matters like abortion laws: they are called legislatures. Since abortion is nowhere mentioned in the Constitution, and every State in the Union had laws against abortion when it joined the Union, this would seem to be the simplest social issue we have: leave it to the states. The result would be that a few states would forbid it, more would regulate it, many would simply have no laws at all about it, and California would probably encourage it. It is not a federal matter.

It is to some extent a religious matter; but then there has never been an amendment that gives Congress or the Federal Government the right to disestablish a State Church. Judicial activism and "sociological jurisprudence" have purported to find such rights, but they aren't in the constitution.

An amazing number of federal problems would go away if the matters were left to the states. Note that some such matters are no longer left to the states. Slavery is the chief among them. But one doubts that there would be civil war over Maryland forbidding abortion while some other states encouraged it.

Education is another matter best left to the states. I can think of many others.

===================

Mild earthquake near LAX, no damage, no injuries. I felt it as one sharp shock but those closer say it went on for several seconds. They tell me there have been aftershocks, but I have felt none.

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