Recovery and health care, and other important matters

Monday, May 8, 2017

If you like your health care plan, you can keep your health care plan.

Barrack Obama

The map is not the territory.

Alfred Korzybski

If a foreign government had imposed this system of education on the United States, we would rightfully consider it an act of war.

Glenn T. Seaborg, National Commission on Education, 1983


Recovery remains slow, but the vector seems to be in the right direction. My malaise is definitely not helped by the near winter conditions we are experiencing. The late Jack Smith, a Los Angeles columnist I read since I came to LA in the 60’s, used to remind us that LA had a season most ignored: Wummer, Winter in Summer, sometimes called “June Gloom” but worse than that; but this is early May. I have poor lower body circulation and try to keep me feet warm, sometimes warming my feet against my legs; an uncomfortable and time consuming ritual. Last night was too much, and in the middle of the night I found the hot water bottle I had put away last April or so. I use it every night in winter – my bed is a long way from an electrical outlet, and running wires across the floor is dangerous for late night bathroom expeditions with a walker – and soon had warm feet. Alas I also had a wet bed as well, because the hot water bottle had sprung a small leak I had not detected. No great problem; my upper body circulation and heat generation are fine. But it was uncomfortable for a while.

Of course I threw the old water bottle away and ordered another, but it won’t get here for a day or so. I suppose I’ll microwave a towel – carefully – and try that. My feet don’t get cold under the covers, but if they’re cold when I go to bed they don’t warm up without another heat source. Not your problem, but time consuming. Very. Which is why I don’t have a lot of time to work on this.

I do find that it improves my demeanor and attitude if I get some work done, and I’m determined to keep that up. I have notes on finishing Mamelukes, and I’ve done some work on that. I’m not just vegetating.

Roberta continues to improve, and seems to have escaped the lower bronchial infection that plagues me. Between us we need 24 hour attention — she more than me, as she is less mobile – and that proves to be expensive. I have no choice but to keep working: I need the money. Getting old is expensive.


I continue to have nothing to add to the health “insurance” debate. Obamacare declared that for most of us, the responsibility to pay for our medical expenses did not rest on us, but on other citizens and residents of the United States; and we were all “entitled” to equal treatment, no matter how expensive. This is of course impossible. There isn’t room for all of us at Sloan Kettering, and if everyone who got cancer went there, it wouldn’t BE Sloan Kettering. “Insuring” against something that has already happened – pre-existing conditions — isn’t insurance, it’s a subsidy, it’s someone else paying your bills. A prominent intellectual said on television tonight that he wished everyone who wanted to repeal Obamacare had pre-existing conditions to a painful fatal disease. He is saying in effect that if you don’t want to pay for his problems, he wishes you a plague, a painful death, and he will be glad to dance at your deathbed. I have heard no liberal comments on this. Fox news showed him making the statement but did not comment as I watched.

And that is what we have been driven to.

The Senate is unlikely to approve the House deal; Obamacare will continue to govern. Millions who previously had no health insurance now have something called “insurance”, for as long as the funds continue.

The President will continue to try; he’s a pragmatist. Democrats in both Houses will continue to say no one is allowed to govern but them, and they will say no to any attempts to do otherwise.

Perhaps the economy will grow so rapidly that it will not matter. The economic boom, and the increased productivity due to robots, will save us.


You approvingly quoted J. Neil Shulman, who proposed that there be Medicare for all with pre-existing conditions. I left this comment:
Medicare for pre-existing conditions? Not bad… but it leads straight to single-payer, as the insurance industry widens the definition of pre-existing condition. Ultimately we all have a fatal pre-existing condition, called Life.
To this I add: “Your money or your life” is not a normal market.


If you read my essay it is obvious that I do not approve or advocate relieving people of their individual health care expense responsibility; at least not with money collected at the point of a gun, which is to say, taxes. I have no objection to you paying someone else’s medical bills, including mine. Does that make me obliged to pay yours? When I was a lad, all the tenants bought burial insurance; they knew they would eventually need it. The insurance companies threw annual parties instead of paying dividends. Everyone seemed happy.

And the tax collector eventually does say “Your money or your life.”


engineering shortage & the iron law

Dr. Pournelle,
This article quotes your Iron Law in re a fine levied for unlicensed engineering:
Together with this article , I think the two describe the real cause of the shortage of qualified engineers: suitability is determined by the expected cost of the employee added to the engineer’s willingness to kowtow to the “union.” My observation has always been that there are plenty of engineers, but relatively few of those are willing to toe the line.
Employers pay more and take on longer and greater non-salary financial obligations for U.S. workers.
Hoping for yours and Roberta’s continued recovery.

I see.


Where’s My Immigration Prediction Model? | Scott Adams’ Blog,


He puts some sense into the argument:


Indeed. But there are never grants for such models.



Dear Dr. Pournelle,

I’m sorry to hear you’ve been ill, but I’m glad to hear that you are recovering. Please accept my prayers for a swift one!

As towards your discussion of health care — to me, it seems very similar to the 90’s movie “The Matrix”, if the Matrix were not a simulation, but a human welfare state. In the story, the “red pills”

who were willing to live in hardship in order to be free were always a minority compared to those who were more than content to be taken care of, even at the expense of their freedom. I believe ‘Farnham’s Freehold’ by Heinlein addressed a similar topic.

I think that is the inevitable result of any civilization which becomes too successful. Politicians use the surplus wealth to buy votes, and once people are on the grain dole, or on health insurance, it’s pretty much impossible to get them off again; too many people depend on them.

It’s usually not possible to convince the mass of blue pills to live as free men, either in real life or in the movies. The most we can do is travel elsewhere , to a new frontier, and start the cycle over.

So we need to get hopping on inventing an Alderson drive!


Brian P.

I thought that way for much of the Cold War; the CoDominium was the least dangerous outcome I could see. And the dispersion. Then Star Wars and Reagan won the Cold War, but are we better off? I make no assessment in my present state. We have officially told more than half the populace that they are not responsible for their medical bills. No one wants to lose that gift.



You stated “Given the rise if CO2 and methane (CH4) it would be well to invest in techniques for removing excesses of those”
Why? CO2 is plant food; it does not cause ‘catastrophic global warming’ or ‘climate change’. There has been no significant warming for the past 20 years while CO2 concentration continued to increase. This increase in CO2 has been greening the planet; why is that a problem?
The trend of average global temperature measured over the past 8000 years since the Holocene Optimum has been cooling.
The trend of average global temperature measured over the past 400 years since the Little Ice Age has been warming.
The trend of average global temperature measured over the past 20 years shows no significant change.
Pick whichever time frame supports the political agenda you’re dealing with, the planet doesn’t care. Neither do earth scientists who are not beholden to any political masters.
To quote Matt Ridley:
“The inescapable if unfashionable conclusion is that the human use of fossil fuels has been causing the greening of the planet in three separate ways: first, by displacing firewood as a fuel; second, by warming the climate; and third, by raising carbon dioxide levels, which raise plant growth rates.”


I have discussed this before at greater length. I should not care to be part of an uncontrolled experiment to determine the tolerable upper limit of CO2; there is one, very likely and we have not begun to approach it. There are numerous ways of removing excess CO2 and CH4 from the atmosphere if the concentration gets too high; it would be well to develop one while we have the means to do it. Bankrupting ourselves by shutting down industries does not seem effective, and many won’t do it anyway. It is not an urgent project but it is eventually going to be needed.

I agree that for the moment CO2 is more like free fertilizer than pollution.


Well worth reading:

Basically, medications we usually think of as completely benign (in this case, Benadryl) can have dramatic side effects in older people, even from a single standard dose.

I had no idea.

This document scores a great many common medications:

Note that the scale here goes from “1” for the least risk to “3” for the highest risk.

.              p

Worth reading I agree. I have not had similar experience with Benadryl, which I first encountered as a prescription drug, and I have used a lot of it over time, but not much lately.


A10’s very helpful That time 4 Royal Marines strapped themselves to Apaches – YouTube

Certainly worth watching.


Obamacare and Bleeding Kansas

Good morning, Dr. Pournelle –
I just read in your May 8th Chaos Manor that you feel you are improving. That is wonderful news. Even if you take three steps forward and two steps back, it’s still one step forward.
There were two comments of yours that I wanted to address;
1) I read where you posted, “It’s always better if you can give millions of people free stuff that other people must pay for. It always makes you feel much better,” in response to a post on the dems’ reaction on the vote to “overhaul” Obamacare.
Well, the only “overhaul” I’ll like is a complete repeal with no replacement, but I’m not holding my breath. Once again, republicans show themselves in competition to be the better democrat.
Anyway, I think there is one way to speedily bring about a major “overhaul” in federal healthcare all sorts of other misbegotten programs;
Take away payroll deductions for income tax. Give workers their entire paycheck and then require them to personally write the checks for their income tax burden to the government.
I’m willing to bet change will come pretty fast afterwards.
Unfortunately, I don’t see that happening, either. What I see is that it won’t be until the entire system comes crashing down around our collective heads, destroying what we know as the United States of America. Then, if other nations leave us alone – ha ha – we might be able to rebuild into something better.
Although, I spent a year teaching high school physics and I saw what the schools were putting out, so – well, maybe we won’t be able to build something better.
2) I saw your comment, “I wonder: do they even teach ‘Bleeding Kansas’ in schools any longer?” and have to say that I’ve never heard of “Bleeding Kansas.” I graduated high school in 1976, so, maybe they don’t.
Now, I’ll have to go look it up.
Cam Kirmser

It’s worth looking up. The Movie “The Outlaw Josey Wales” makes more sense, too, after you’ve done that. Many on the anti union side just wanted to be left alone. Many more fought “For our property we won by honest toil”…


Tweaked titanium turns C02 into solar fuel

I find this pretty exciting. Technical solutions to CO2 that offer additional benefits and don’t require destroying economies seem vastly preferable to me.

An ability to convert carbon dioxide into energy using only the power of the sun, as plants do through photosynthesis, would be a monumental breakthrough in green energy research. More and more we are seeing promising strides in this area, the latest of which is the work of scientists at the University of Central Florida (UCF), who have come up with synthetic material that turns visible light from the sun into solar fuels, sucking harmful C02 out of the air in the process.

“The idea would be to set up stations that capture large amounts of CO2, like next to a power plant,” says Uribe-Romo. “The gas would be sucked into the station, go through the process and recycle the greenhouse gases while producing energy that would be put back into the power plant.”

John Harlow

Vice President – Services

I have no other information.


Trump moving on handing control of education back to locals

Hope you’re feeling better. It’s pretty bad up here as well.


Since few schools teach anything that any employer would pay money to have you do, school reform is needed; it may help build an economic boom; or rather to sustain one.


NASA is Running Out of Spacewalk [spa] Suits.



Roland Dobbins

Long ago I tried to get them to invest in better and cheaper suits. Everyone agreed they were needed – “But not out of MY budget!”



Having the government as a single payer is similar to private insurance in the source of the money but has some important differences.  The executives of insurance companies are paid multi millions per year vs. the inefficiency of government bureaucracy.
The main advantage of a single payer is that the government would then have the power to actually lower medical costs, particularly drugs.  As you know, in every other advanced country the government runs the health system and it it costs 2  to 8 time less than here.  (According to Atlantic Monthly)
What we should do is look at the other countries and learn from them.  I thought one of  Singapore’s planners remarks priceless: when asked what he had learned from the American system.  “What not to do.”  He replied.
I don’t have a good answer for how to manage doctor’s pay.  I suppose in the long run having the government pay for their education might help.  I think the system will be unrecognizable in a decade due to AI and robotics anyway.
The American system isn’t as great as most believe.  Statically we don’t do as well as many other countries.  I read in Consumer Reports (May) 650,000 patients a year acquire a disease in hospital that is largely preventable and 75,000 die from it.  That’s a lot of people.  We spend a lot to reduce the 18/year killed by terrorists on average.
Best regards,
Adrian Ashfield

This needs discussion I haven’t time or energy for just now. The first thing to decide is who owes your doctor for time he spent taking care of your children? And if that’s not you, why does he owe it? Next, how much is owed him, and who determines that?




Freedom is not free. Free men are not equal. Equal men are not free.



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