{"id":16154,"date":"2013-11-12T13:33:49","date_gmt":"2013-11-12T21:33:49","guid":{"rendered":"http:\/\/www.jerrypournelle.com\/chaosmanor\/?p=16154"},"modified":"2013-11-12T16:51:31","modified_gmt":"2013-11-13T00:51:31","slug":"health-care-freedom-and-equality","status":"publish","type":"post","link":"https:\/\/www.jerrypournelle.com\/chaosmanor\/health-care-freedom-and-equality\/","title":{"rendered":"Health Care, Freedom, and Equality"},"content":{"rendered":"<p align=\"center\">View 798 Tuesday, November 12, 2013<\/p>\n<p align=\"center\">&#160;<\/p>\n<p align=\"center\">\u201cTransparency and the rule of law will be the touchstones of this presidency.\u201d<\/p>\n<p align=\"center\">President Barack Obama, January 31, 2009<\/p>\n<p align=\"center\">&#160;<\/p>\n<p align=\"center\">Christians to Beirut. Alawites to the grave.<\/p>\n<p align=\"center\">Syrian Freedom Fighters<\/p>\n<p align=\"center\">&#160;<\/p>\n<p align=\"center\">What we have now is all we will ever have.<\/p>\n<p align=\"center\">Conservationist motto<\/p>\n<p align=\"center\">&#160;<\/p>\n<p align=\"center\">If you like your health plan, you can keep your health plan.<\/p>\n<p align=\"center\">Barrack Obama, famously.<\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image00224.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image002\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image002\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image002_thumb4.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<p>Universal Health Care and Equality<\/p>\n<p>It\u2019s pretty clear that the objective of the Affordable Health Care Act is to bring about a situation of universal health care, with the goal being that it will be just free: no insurance premiums, low to zero co-payments for both drugs and medical services, pretty well free hospitals. We may adjust the system, particularly with co-payments to discourage frivolous use of medical resources, but that appears to be the goal: universal single payer health care.<\/p>\n<p>As it happens, I had breakfast with Frank Herbert the morning he was informed that the intestinal discomfort he had been feeling lately was middle stage pancreatic cancer. Frank being Frank it was a lot less unpleasant than you might have imagined. We were both making speeches at a computer convention in Seattle, and Frank gave his with aplomb, and we had dinner at Ivar\u2019s that night. During dinner he told me that he and his wife had made arrangements for him to go to the Mayo clinic the next day. He was determined to lick this thing.<\/p>\n<p>Of course he didn\u2019t, but not from lack of trying. The point is that he could do that.<\/p>\n<p>At that time I couldn\u2019t have. Indeed, when I was told I had brain cancer in late 2007, my choices were always limited to what Kaiser offered; going to the Mayo Clinic or Sloan-Kettering wasn\u2019t a financially feasible option. I hasten to add that had I had the money I wouldn\u2019t have been tempted: my experience with the Kaiser system was as pleasant as it could have been under the circumstances, and I had every reason to believe in the competence of my physicians \u2013 most of whom had actually read some of my books. <\/p>\n<p>Pass now to days of universal health care: can the Mayo Clinic exist? For that matter, can \u201cCadillac Plans\u201d such as I have had with Kaiser for more than twenty-five years continue to exist under single payer universal health care? Could the Kaiser system itself survive?<\/p>\n<p>\u201cWhy should Frank Herbert have access to better health care than I can get?\u201d Or Bill Gates, or \u2013 but you get the idea. If we ever get to single payer universal health care that will be a question that must be answered. Why should anyone have access to something better than everyone can afford?<\/p>\n<p>So you are faced with allocation of services \u2013 death panels, in popular parlance \u2013 to elite institutions, or else the elite institutions must cease to exist. They may not vanish and go out of business; there is always the alternative of expanding them enormously so that they are no longer elite institutions although they keep the same name; but effectively they will be gone.<\/p>\n<p>I invite comment. If we have universal health care, will it allow Bill Gates and Frank Herbert options that you and I won\u2019t have? How? Will physicians be allowed to offer concierge practice to the rich? How will physicians be paid?<\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image002113.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image002[1]\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image002[1]\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0021_thumb5.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0037.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image003\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image003\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image003_thumb4.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<p>&#160;<\/p>\n<blockquote>\n<p>Solar activity heads for lowest low in four centuries<\/p>\n<p>I like these quotes: &quot;The Maunder Minimum coincided with the worst European winters of the little ice age&quot; and &quot;The precise extent to which solar cycles influence global temperatures is still debated.&quot; And while the Climatologists didn&#8217;t see this coming, they know the outcome: &quot;we should not expect a new grand minimum to bring on a new little ice age&quot;.<\/p>\n<p><a href=\"http:\/\/www.newscientist.com\/article\/dn24512-solar-activity-heads-for-lowest-low-in-four-centuries.html\" class=\"external\" rel=\"nofollow\" target=\"_blank\">http:\/\/www.newscientist.com\/article\/dn24512-solar-activity-heads-for-lowest-low-in-four-centuries.html<\/a><\/p>\n<p>David Smallwood<\/p>\n<\/blockquote>\n<p>Of course the media are filled with dire warnings that \u201cClimate Change\u201d (no longer Global Warming) is responsible for the severity of the recent typhoons in the Philippines. There is no evidence for this hypothesis, but that doesn\u2019t bother the institutional bureaucrats of the UN who get to pose as scientists.&#160;&#160; Why any scientist worthy of the name participates in the UN political farce they call science is not clear.&#160; <\/p>\n<p>&#160;<\/p>\n<p>I used to build models for a living. The notion of systems analysis was to find systems you could model using mathematics that let you solve the model; you then tested the model against the real world.&#160; The various climate models do none of this. They don\u2019t even attempt to model in known factors, and they can\u2019t even predict the real world \u2013 that is they can\u2019t take the initial conditions of 1950 and run to 2010 and get anything similar to what actually happened.&#160; And as the years go on it becomes more and more clear that there is no more warming trend now than there was in the days when the great fear was a cooling trend toward an ice age.&#160; The fact remains that we don\u2019t know what generates long term climate trends, and we have absolutely no understanding of solar radiation phenomena.<\/p>\n<p>&#160;<\/p>\n<p>We do know that Earth was much warmer in Viking times than it is now; and that it was much colder during the Little Ice Age after the cooling trend began about 1300; and that it has been warming since about 1800 with a good deal of the warming happening before 1850.&#160; CO2 has been seized as a forcing factor largely because it\u2019s hard to think of another; but then CO2 from volcanism isn\u2019t predictable either, and it\u2019s not clear just what its contribution to rising CO2 levels may be.<\/p>\n<p>We ought to be working on ways to reduce CO2 levels if they get a great deal higher, but not at the price of bankrupting ourselves.&#160; Since there is uncertainty whether climate is getting hotter or colder, Bayesian analysis would indicate that optimum strategy would be to spend more on reducing that uncertainty, not on betting on remedies that depend on guessing correctly.&#160; We know that CO2 is rising; it\u2019s wise to think up ways to deal with that; but not as climate control.&#160; Incidentally, forests are pretty good at sequestering CO2.<\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image00313.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image003[1]\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image003[1]\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0031_thumb3.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<blockquote>\n<p>&#8216;Until recently, without the knowledge of Congress, the Air Force was moving fast on a secret plan to help fund the F-35 by abolishing the A-10 fleet.&#8217;<\/p>\n<p>&lt;<a href=\"http:\/\/www.defense-aerospace.com\/articles-view\/feature\/5\/148289\/usaf-maneuvers-to-retire-a_10.html\/article\/20130923\/NEWS04\/309230002\/\" class=\"external\" rel=\"nofollow\" target=\"_blank\">http:\/\/www.defense-aerospace.com\/articles-view\/feature\/5\/148289\/usaf-maneuvers-to-retire-a_10.html\/article\/20130923\/NEWS04\/309230002\/<\/a>&gt;<\/p>\n<p>&#160;<\/p>\n<p>&#8212;&#8211;<\/p>\n<p>Roland Dobbins<\/p>\n<\/blockquote>\n<p>Droll<\/p>\n<p>&#160;<\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0043.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image004\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image004\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image004_thumb2.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<blockquote>\n<p>6 satellites ready for space<\/p>\n<p>Each one is a 10 cm cube loaded into a dispenser. They will fly to ISS next month. You can post the picture. <\/p>\n<p>Someone told me Von Braun thought kicking sats out the door of a space station was the best way to do it. You heard this? Want to ask your readers? Would love to get a source. <\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/photo-19.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"photo (19)\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"photo (19)\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/photo-19_thumb.jpg\" width=\"244\" height=\"184\" \/><\/a><\/p>\n<p>Rich<\/p>\n<\/blockquote>\n<p>Commercial space in action.&#160; I seem to recall hearing that von Braun had said that and it seems reasonable, but he never said it to me. Anyone remember it?<\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0044.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image004\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image004\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image004_thumb3.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<p>Freedom is not free. Free men are not equal. Equal men are not free. <\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image00411.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image004[1]\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image004[1]\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0041_thumb1.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0051.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image005\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; margin: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image005\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image005_thumb1.jpg\" width=\"244\" height=\"10\" \/><\/a><\/p>\n<p><a href=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image00421.gif\"><img loading=\"lazy\" decoding=\"async\" title=\"clip_image004[2]\" style=\"border-top: 0px; border-right: 0px; background-image: none; border-bottom: 0px; padding-top: 0px; padding-left: 0px; border-left: 0px; display: inline; padding-right: 0px\" border=\"0\" alt=\"clip_image004[2]\" src=\"http:\/\/www.jerrypournelle.com\/chaosmanor\/wp-content\/uploads\/2013\/11\/clip_image0042_thumb.gif\" width=\"240\" height=\"8\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>View 798 Tuesday, November 12, 2013 &#160; \u201cTransparency and the rule of law will be the touchstones of this presidency.\u201d President Barack Obama, January 31, 2009 &#160; Christians to Beirut. Alawites to the grave. Syrian Freedom Fighters &#160; What we have now is all we will ever have. Conservationist motto \u2026 <a class=\"continue-reading-link\" href=\"https:\/\/www.jerrypournelle.com\/chaosmanor\/health-care-freedom-and-equality\/\"> Continue reading <span class=\"meta-nav\">&rarr; <\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-16154","post","type-post","status-publish","format-standard","hentry","category-view"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/posts\/16154","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/comments?post=16154"}],"version-history":[{"count":0,"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/posts\/16154\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/media?parent=16154"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/categories?post=16154"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.jerrypournelle.com\/chaosmanor\/wp-json\/wp\/v2\/tags?post=16154"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}