Political Correctness and being liberal

if you mean I’m someone who can have a civil conversation without reverting to juvenile name calling, swear words and who thinks a man can do better than trying to be offensive by using slang names for women’s anatomy, then I take your attempt at intimidation and wear it with pride.

It’s always amusing when people try to dismiss you by accusing you of being “politically correct or PC” or worse still, a “liberal”.

I guess because it’s inauguration day, feelings are running high. I’ve tried to stay away from political discourse on facebook, until a friend posted a clip from Elizabeth Warren grilling the CEO of Wells Fargo bank, the point of the post was to ask for accountability.

One of the few responses was from “Jim”. I’ll call him that here, because, well, that was his name. In his response he didn’t much address the accountability point of the post, but fairly quickly turned to attacking Elizabeth Warren, calling her “a douche bag“.

And so I posted, and the response I got back was to call me one of the “PC crowd”. I’m always amused when people try to use that as an insult. Called one of these “names” don’t be intimidated.

pc

 

Doctors and Money

The NHS is funded(or should be) to take care of everyone to a level of minimum care. No one(in practice) should have to pay for any medical care.

One question that comes up regularly when discussing how to fix the healthcare system in the USA, is Doctors and Money. While Doctors are far from the only important people in a healthcare service, they are possibly the most visibly important.

It is often asked, or asserted, that if you had a single-payer healthcare system where Doctors were possibly salaried this would act as a disincentive, and over time you’d lose the best doctors to purely private practice. This belies the fact that experienced doctors in the British NHS can make additional money in private practise.

It also completely ignores the fact that while the NHS is a meets minimum, free at the source of treatment health service, there is a thriving private, and private insurance marketplace.

The NHS is funded(or should be) to take care of everyone to a level of minimum care. No one(in practice) should have to pay for any medical care.

However, these days the cost of drugs, the number of highly complex surgical procedures that are “standard” has grown beyond the normal funding of the NHS from say 20-years ago. Cancer care and the drugs for it now consume huge amounts of money, as does the treatment for obesity and the treatment of it, including heart disease.

If you are in a car crash, some form of violent attack, or other urgent care need, the NHS will supply an ambulance, emergency care, surgery, drugs, Dr’s, everything and you’ll never see anything related to billing or cost. Same for almost any minor health care problems, even many elective surgeries, and pregnancy, cancer care, pretty much any medical need.

Elective surgery does tend to get backed up, there are often long waits to see a specialist, as well as to get surgery. This depends though on the problem, the area of the country, and the time of year.

This time of the year the NHS is always stretched to and beyond its limit. It’s damp in the UK, older people tend to have been life long smokers and are very susceptible to respiratory illness. Both my parents died this way after a few weeks of gradually declining health as they were unable to recover from pneumonia. My Dads complicated by heart disease; my Mum a 7-year lung cancer survivor.

Both received 100% free NHS service, they were not rushed or hurried to move out of their hospital beds. The nursing and medical attention was top class. In fact, I’d go as far as to say  much better than here in the USA because there was never a discussion, question or insinuation that insurance might not cover something.

For those that a “meets minimum”, free healthcare service won’t do, you can always pay. Many companies offer private “top-up” insurance, which provides priority appointments, private hospital beds etc. And you can always elect to pay for the treatment you need need.

luton-news-sept-21st-1978I had two major hospital admissions, one on the NHS for a tib/fib fracture in 1978; the 2nd some 16-years later for corrective surgery. The 2nd I was working for IBM with top-up insurance. I saw the same specialist who’d saved my leg 16-years earlier. If I’d wanted to see him on the NHS, there was an 4-week wait; I saw him the next week at a local private hospital.

He recommended corrective surgery. On the NHS he would have done it in 4-6 weeks, depending on lots of things. I was able to schedule a specific day for 10-weeks out that better suited IBM’s schedule, private hospital, private staff, same consultant.

Fast forward to 2013. I’ve done over 100 triathlons and running races, including 6-Ironman races. Despite an initial prognosis in 1979 that I’d never run again. My knees are not so good. I wanted to see the same consultant, he is no longer practicing, wished me luck. I was recommended to the British Olympic Association’s Orthopedic Consultant. Chances of seeing him on the NHS, zero to very little.

I scheduled an appointment with him at Private hospital, flew to the UK, and he came in to see me especially. We spent the whole hour together, what I’d paid 450 UKP for. We discussed options, did measurements, x-rays, looked at different types of replacement knees etc.

He said that when I was ready for surgery to let him know, he would schedule me on his NHS roster and I could fly back. When discussing the same surgery here in the USA, he told me not to bother.

His experience had been that in the USA even dedicated specialist consultants didn’t have nearly the experience as NHS Specialist. In the USA they spend too much time consulting with patients and negotiating over billing. Patients in general take 3x as long to consult with in America because the options, cost and insurance options, and choices are so daunting and often when a preference is stated it has to be negotiated with insurance, co-pays, deductibles etc. all have to be understood by the Doctor and patient. The alternative is you get the Doctor, but little or no choice in replacement technology.

He has 2x 6-hour surgery days per week, they do 6-8 knee replacements per day; he spends 1-day NHS consulting, and 1-day private consulting and has 1-day open for Private surgery or additional consulting.. If he wants he can do private surgeries on Saturdays, vacation days or early mornings before NHS work. Average cost for NHS Surgery $0.

A US Specialist, according to him, does 6-10 operations per month, and my US research was cost around $30,000. In terms of knee replacements, the UK has much better insight, and much less medical device and insurance company influence on the type of replacement, they base their choices on OUTCOMES.

I’ll return to the discussion on healthcare systems shortly, but suffice to say, I’ll be going back to the UK when my time finally comes.

Giant fleet of small scheduling nightmares

In tenuous link between my recent posts on automation, here and especially here, where back in November I discussed autonomous vehicles and their impact on employment. I also said:

While many cities are salivating over the ability of self-driving, autonomous vehicles to fix their broken road and transport infrastructure, that’s missing the point.

Sometime between then and last weekend I became a weekend subscriber to the (Boulder) Daily Camera, a great local paper for the Boulder/Denver metro area. Right on queue, my first Sunday paper was laying in the snow on the drive this weekend and I opened it up and parsed it during the day. One item that particularly caught my eye was Dave Kriegers main editorial entitled “Imagine a giant fleet of tiny buses“.

serveimageI grabbed a pen, marked the editorial up, scribbled in the margins and sat down on Monday morning and wrote an open forum letter. It didn’t get published, I have no idea if it’s policy not to publish corrections on staff written op-ed pieces, or they just didn’t think it interesting enough to include?

Since a big fuss has blown up about an Uber self driving car today, running a red light yesterday(in full transparency, Uber self driving development has a big office here in Louisville that is a build-up from the Uber acquisition of Microsofts Bing mapping service.) I thought I’d turn Mondays open forum letter into a blog post.

This also lets me correct one misstatement. Self-driving cars will help with congestion theoretically. In heavy traffic, they will drive at a regulation speed, a safe distance from the vehicle in front, thus avoid the hard braking and the impact that can have on several miles of traffic.

It is hard to respond to Dave Kriegers editorial imaging “a giant fleet of tiny buses” in 300-words, but I’d like to have a try.

First, I completely agree with his sentiment that if you keep trying the same old thing, you’ll keep failing. However, when it comes to his “giant fleet of small buses” he falls into the same trap most transport ‘imagineers’ do when the come to self-driving vehicles. For the sake of brevity, let’s assume they’ll be electric; let’s assume they can dock themselves; let’s assume they have a slightly better range than current electric cars.

Dave jumps to the conclusion that less space will be needed for parking. Sort of, except the cars have to be charged somewhere. But yes, they could be charged in either fields or reclaimed parking garages outfitted with self-docking chargers. Dave then makes the confusing jump to the conclusion that “[they] could reduce congestion because fewer cars would serve more people”.

Anyone that’s given any serious thought to scheduling and transportation would understand implicitly that that isn’t true. It’s implied because it fits the paradigm of autonomous vehicles. If 20,000 people want to get into Boulder today between 7:15am and 9:00am in their own unshared transportation, and the demand is the same in the era of self-driving cars, then, you’ll have the same number of journeys. Add in the recharging trips, the fact that using Daves logic, there will be less self-driving cars, then some of those cars will have to drive in and out and back into Boulder, actually increasing the number of journeys and therefore contributing to the congestion.

If we take Daves “less parking space” claim at face value, then what will the space formerly used by parking garages be used for? Green space… err no, more offices/accommodation, with the potential to further increase the number of journeys and congestion.

Don’t get me wrong, self-driving cars are great, but until we have flying cars they will only help indirectly with congestion won’t help with congestion. The only way is shared transport. Bus Rapid Transport isn’t it either. Trams, street cars, metro-rail are the only real fix.

Creeping automation

Automation is everywhere, but most of us don’t notice it. Every product we buy, every service we use has been touched by automation, some more than others. Think about the products you buy about the grocery store? Come in a package? Packed by machine!

I’ve had some interesting emails from regular followers/readers about automation. I don’t think people quite understand how invasive and creeping automation is.

Here is a perfectly simple example. I live on a new development in Colorado. Some 70 single family homes, and now they are moving into the multi-family condo and town homes. They’ve built two condo buildings, and a 3rd 12-plex is going up now, literally right across the street.

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Pressed Siding, Floor and Ceiling Boards from Canada
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Crane lifts pre-constructed parts into place

First, let’s be clear, this isn’t a pre-fabricated building. It’s a unique design to this location, that most would consider “traditional construction”. Only it isn’t, it’s massively labor free, and largely “skilled-labor” free.

The construction is typical timber frame, in the old days, there would have been an army of craftsmen working on site, the continuous sound of saws and hammers. While there are some professional craftsmen on site, the bulk of the construction is being done by “nail gun jockeys” using pre-cut, assembled panels and components. They just nailed them into place.

Of course, walking pass this, you’d never normally take a second look. Since it’s directly opposite my home office, everytime I look out the window I see it. What do I see?

Creeping factory assembly and automation. All the major parts arrive pre-cut to size; the joists and all the boards for the side that need holes for windows and door arrive pre-cut. The original boards come from Canada and Mexico. Anyone who has seen the home improvement shows knows that the boards are not cut by craftsmen and craftswomen, but simply cut by operator assisted laser cutting machines. What do all these things have in common? Automation.

It would be easy to simple, let’s at least bring back the board creation, prep and the component assembly to the USA. Indeed easy to say. That assumes we have the raw material, and that the factories exist that can manage the increased workload. If they can’t then let’s assume they can be built.

What happens then? Well, the businesses that do the manufacturing either produce the same goods at the same price as they are available overseas, which will be hard. The US no longer has the same wealth of natural resources. Those that we do have are harder to extract, or come with environmental, planning or development restrictions. Even if these were lifted, they would still come with a price tag.

Those costs, plus any for plant construction, or increased raw material cost would be passed onto us. Effectively doing a “Carrier” and raising prices to cover their increased costs.

Automation is everywhere, but most of us don’t notice it. Every product we buy, every service we use has been touched by automation, some more than others. Think about the products you buy about the grocery store? Come in a package? Packed by machine! Ready made meals, the whole production line from animal slaughter to food prep and cooking are all now largely automated. It’s invisible, invasive and all encompassing.

Politics and the art of deception

Yep, lots of people are rightfully outraged at the election of Donald Trump and what the future holds. They look at his tweets, at was he says, and are super excited that he is going to do all the things he said or tweeted.

Meanwhile, back in the UK there is a whole lot of hand wringing going on about #BREXIT and what it means. It started the morning after the vote was announced, when liar, braggart, and Trump confidant Nigel Farage admitted that the £350-million for the UK National Health Service that was one of the flagship reasons for leaving the EU, was a “mistake”, or a lie.

The whole point of politics to find a way to get things done? That often r
requires a twisted tongue so as not to upset a prevailing government, or official before they’ve agreed to do what you want. It’s what Clinton mean when she said  she often had both a ‘both a public and a private position’.

Often this comes back to bite the politicians, when what they want to do is bad, doesn’t happen or in some other way backfires. Anyone who thinks that you can be open and transparent with everyone all the time, simply has not been successful at any meaningful level. Tony Blair is a fine example of this, his legacy in tatters, all the positive work he did while in office forgotten, over the lies and deception that took the UK into the “War on Terror“.

Everyone now is overheating about what Trump might do based on what he said or tweeted. First of all most of that is simple distraction. It’s throwing crumbs to the dogs, while he actually gets on with what he wants. His deception and lies though will come back to bite him, but you can’t assume he’ll do, or more importantly, be able to do everything he has claimed. It’s what politicians do, they say what they need to get the chance to do what they want.

Did you never ever tell your kids a white lie, or something that wasn’t really true to get them to do something? Did you ever threaten them when you had no real intention of following through? If you can honestly answer this no you did not, I’ve got a country you can run post BREXIT.

Assange/Wikileaks/Trump

It will be interesting to see how they play out under Trump.

The first, and perhaps least important is that of the position of Julian Assange, the erstwhile editor-in-chief of the organisation WikiLeaks. Assange has been holed up in the Ecuador’s embassy in London trying to avoid questioning in Sweden over an alleged rape charge. Assange asserts that this is a thinly veiled first step in extraditing him to the US for trial on much more sinister charges.

I debated, aka argued, with my own son that you couldn’t take anything that Assange is now doing at face value. That when wikileaks first arrived on the Internet, it was about the leak and the injustice and not the personalities. My son, remained convinced that it was about the global banking system, and their ties with powerful politicians. I disagree, for too long, wikileaks has been about Assange.

Given the timing, and manor in which the wikileaks disclosure of the DNC/Podesta emails came about, I believe this was nothing more than an attempt by Assange and wikileaks to undermine the US election. They succeeded.

It’s almost certainly no coincidence that it was announced that Assange would finally be questioned by the Swedish authorities next week. The only question that remains, irrespective of the outcome, is will a Trump Presidency go after Assange in the same way either Obama or Clinton Presidency would?

If not, does that leave wiggle room for the return to the USA of Edward Snowden? Wikileaks can and will go on without Assange. Snowden is the real hero for exposing the secret mass survailance system that Presidents Bush/Obama had setup, and now will come under control of President Trump.

Feeling had America, you should. Don’t forget the emails, the only thing we learned from them for the mot part was how the DNC set Hillary up to fail, and they gave the chattering classes something to focus on that wasn’t policy, and wasn’t difficult.

Dystopian Future it is then

In his acceptance speech, President elect Trump said, among other things:

We are going to fix our inner cities and rebuild our highways, bridges, tunnels, airports, schools, hospitals. We’re going to rebuild our infrastructure, which will become, by the way, second to none. And we will put millions of our people to work as we rebuild it.

This from a man, who tweeted:

I’ve no idea what to expect now from the Trump Presidency, but it’s an amazing  coincidence that the original Blade Runner film was set in In Los Angeles in November 2019, just two years from now.

Hopefully Blade Runner isn’t a metaphor for a Trump Presidency; the weather and the blade runners, especially Gaff, do not foreshadow Trumps Immigration cops; and hopefully the Los Angeles in the film, nothing like the real LA in 2019; and the replicants not an extreme of the automation I wrote about yesterday.

blade-runner

What we don’t know is how Trump will do this. Just running up the deficit doesn’t seem likely given he’s from the GOP/Republican party. Taking much of what he’s said, closing tax loopholes, defunding Nato, closing overseas bases in place like Germany, Japan and more won’t likely save enough money. Your move President Trump.