Health Care Costs
I must say I’m worried that the Democrats are setting a trap for themselves on Health Care Reform by not really confronting the issue of cost inflation. Why does a CT Scan in America cost so much more than any other country. And it’s not just scans, it’s the whole range of services. Although it’s very hard to find, there is certain anecdotal evidence that part of the problem is an oversupply of hospitals and medical technology providers. Take Washington, DC for example.
The Washington, D.C., hospital sector has an excess of hospital beds and a concentration of services at the high end. Four community hospitals; three academic medical centers; a large, nonacademic tertiary care hospital; five specialty hospitals; and a public general hospital all compete to serve a city with a population of only 500,000. In addition, there are two military facilities. Forty percent of patients in this market are drawn from the adjacent Maryland and Virginia suburbs.
In the Libertarian’s “perfect market” pipe-dreams, an oversupply should drive down costs of individual services. But that’s not what happens. Each hospital that has invested millions in buying CT Scanners must amortize the cost over fewer patients by raising the cost of each scan. The same problem is plaguing Pittsburgh.
The region’s hospitals are trying to add nearly 1 million square feet of clinical space between 2006 and 2009 — a construction boom that is raising questions about a potential oversupply of costly hospital resources…
“There happens to be a lot of construction going on, but most of it deals with aging plants and the need to stay current with advances in technology,” said Ms. Riefner, who helps hospitals obtain financing for capital projects. “It’s not a matter of just spending money for the sake of spending money — they truly want to deliver the best possible care that they can.”
So all the region’s hospitals are caught in a technology arms race. No one is trying to figure out how many CT Scanners we need in a region and normal market mechanisms that would punish hospitals or clinics for spending too much on technology don’t work because we don’t have single payer system that disciplines the free market in every other developed country.
So are we about to pass a big giveaway to the hospitals, insurance companies, and pharmaceutical firms without any way to control the medical technology arms race?
Not surprisingly, Surgeon General C. Everett Koop addressed this same issue over 20 years ago. In the typically screwy topsy-turvy world of marketing healthcare, for-profit hospitals measure occupancy as the litmus test regarding the “success” of a hospital. Bed count is the end all and be all. One standard practice, stupid as it may be, is to have all the latest and greatest gee-whizzy tools and diagnostics available, even if (as in the case of many large metroplexes) another facility just blocks away may have the same equipment.
Koop suggested at the time that “shared services” could significantly reduce investment and overhead costs per hospital. Of course, this would require either co-operation between competing facilities (you know, where the focus would be on logical, affordable healthcare for the patient, rather than more honkin’ profits for the “better” facility) or a government mandate; neither of which sat real well in the Reagan Era.
In my own town, there are 2 hospitals less than a quarter of a mile apart that boast state of the art facilities, but rather than competition driving costs down, the constant technological one-upmanship has increased costs yearly.
I love how nutty the 21st century is.
Not surprisingly, Surgeon General C. Everett Koop addressed this same issue over 20 years ago. In the typically screwy topsy-turvy world of marketing healthcare, for-profit hospitals measure occupancy as the litmus test regarding the “success” of a hospital. Bed count is the end all and be all. One standard practice, stupid as it may be, is to have all the latest and greatest gee-whizzy tools and diagnostics available, even if (as in the case of many large metroplexes) another facility just blocks away may have the same equipment.
Koop suggested at the time that “shared services” could significantly reduce investment and overhead costs per hospital. Of course, this would require either co-operation between competing facilities (you know, where the focus would be on logical, affordable healthcare for the patient, rather than more honkin’ profits for the “better” facility) or a government mandate; neither of which sat real well in the Reagan Era.
In my own town, there are 2 hospitals less than a quarter of a mile apart that boast state of the art facilities, but rather than competition driving costs down, the constant technological one-upmanship has increased costs yearly.
I love how nutty the 21st century is.
Good question, Jon. I note that most of our local services are owned by local doctor partnerships or the franchise centers like the cancer center. Also, if one has full coverage, one gets all of the check up scans. If not, less.
The co-pay food chain ensures specialization: 1 specialist == one answer. Next. Repeat as often as covered. Because they look after each other, are a tight community, and very fearful of lawsuits, there is no way for the patient to affect the costs except to get healthy faster.
It’s a machine. I’m not saying they aren’t good at it or even kind. It’s a well-oiled machine.
Good question, Jon. I note that most of our local services are owned by local doctor partnerships or the franchise centers like the cancer center. Also, if one has full coverage, one gets all of the check up scans. If not, less.
The co-pay food chain ensures specialization: 1 specialist == one answer. Next. Repeat as often as covered. Because they look after each other, are a tight community, and very fearful of lawsuits, there is no way for the patient to affect the costs except to get healthy faster.
It’s a machine. I’m not saying they aren’t good at it or even kind. It’s a well-oiled machine.
My late mentor, Ivan Illich, once mused about this very point, and he came to much the same conclusion, Jon. At the time of his musing about this, in all Latin America there was only one CATScan device, and he wondered how much common healing might be dealt instead of that fancy machine reserved for dictators and their preferred persons.
My late mentor, Ivan Illich, once mused about this very point, and he came to much the same conclusion, Jon. At the time of his musing about this, in all Latin America there was only one CATScan device, and he wondered how much common healing might be dealt instead of that fancy machine reserved for dictators and their preferred persons.
To hell with good intentions.
http://www.swaraj.org/illich_hell.htm
To hell with good intentions.
http://www.swaraj.org/illich_hell.htm
Thank you, len, for smoking me out of the closet. Perhaps you know that that the address you posted was one of the causes of Illich’s summoning to the Holy Office.
It all seems so esoteric now, and yet the presucatorial prelate is now the Pontif.
So, not very unimportant.
Thank you, len, for smoking me out of the closet. Perhaps you know that that the address you posted was one of the causes of Illich’s summoning to the Holy Office.
It all seems so esoteric now, and yet the presucatorial prelate is now the Pontif.
So, not very unimportant.
I didn’t know but Google knew. If that many links are pointing to it, it stirred some sh**.
A fiery point of view had he.
I didn’t know but Google knew. If that many links are pointing to it, it stirred some sh**.
A fiery point of view had he.
Oh yeah, he did stir some shit, in his time. He disturbed categories, habitually and recrecreationally. It’s almost frightening to guess what he might want to make of our present Internet, but you could be pretty sure that he wouldn’t like it; he’d either call for its radical reform or else he denounce it altogether.
Oh yeah, he did stir some shit, in his time. He disturbed categories, habitually and recrecreationally. It’s almost frightening to guess what he might want to make of our present Internet, but you could be pretty sure that he wouldn’t like it; he’d either call for its radical reform or else he denounce it altogether.
Hmm. I see this Illich person had some very radical ideas that in light of today’s technologies may be of this time and not his own.
Thanks Hugo. I love it when someone gives me something I really have to think about to think about it.
Hmm. I see this Illich person had some very radical ideas that in light of today’s technologies may be of this time and not his own.
Thanks Hugo. I love it when someone gives me something I really have to think about to think about it.
Actually, this Internet can make what it talks about not just possible but practical and pragmatic.
Increasingly, we who manage manage less because our cohorts find what they need on their own and use it to achieve what we ask and more. I’m not saying it is completely bottom-up, but at the point of inspiration, it mostly is. Global goals; local agendas. Local needs; global distribution.
What else IS a learning web?
Actually, this Internet can make what it talks about not just possible but practical and pragmatic.
Increasingly, we who manage manage less because our cohorts find what they need on their own and use it to achieve what we ask and more. I’m not saying it is completely bottom-up, but at the point of inspiration, it mostly is. Global goals; local agendas. Local needs; global distribution.
What else IS a learning web?
My CT scan was $3300. I had to pay $900 of that. I was extremely irate. My doctor will suggest next year that I go back and get another one.
“Fat chance” will about sum up my reply.
My CT scan was $3300. I had to pay $900 of that. I was extremely irate. My doctor will suggest next year that I go back and get another one.
“Fat chance” will about sum up my reply.
I’ve seen these charts referenced on other blogs, and a question asked by many commentators is whether or not the charts include the amount taken in tax used to provide those services in most countries.
After all if the Canadian cost to a patient is low it may be unfair to compare it directly to a higher U.S charge if the Canadian price is subsidised from taxation.
Some people want to know what the total cost to people is and worry these charts obsfucate that by hiding amounts subsidising users from tax revenue.
In an effort to convince U.S citizens that single payer (or other systems) benefit everyone by reducing unneccesary costs statistics provided have to include the costs/portions of any taxation or they’re not being honest.
And advocates shouldn’t fear revealing such information if they are convinced of their argument.
If a person pays %? of their income annually in health related taxation they have a right to consider that cost to themself (and others) and to compare it to what private insurance would have cost when judging if they support the idea.
If the argument is they would have instead paid more or less in health insurance, paid more or less in the visits for health care they do make, the effort of proving the point needs to be made with complete and honest arguments.
I’ve read that PDF and it seems to be a list of fees charged to the recipient (patient or their insurer) of those services but not a list of the cost of the service.
The total cost appears to often be hidden and a person might reasonably believe because U.S health care is not tax subsidised then it’s fees are a more accurate reflection of the services cost rather than a rort of purchasers.
Which (unless I’m mistaken and corrected) makes those charts a bad argument for they will quickly be dismissed as misleading propaganda which serves people badly.
To use such charts as argument for change of U.S policy in health provision they must include information of the contribution of tax revenues.
I’ve seen these charts referenced on other blogs, and a question asked by many commentators is whether or not the charts include the amount taken in tax used to provide those services in most countries.
After all if the Canadian cost to a patient is low it may be unfair to compare it directly to a higher U.S charge if the Canadian price is subsidised from taxation.
Some people want to know what the total cost to people is and worry these charts obsfucate that by hiding amounts subsidising users from tax revenue.
In an effort to convince U.S citizens that single payer (or other systems) benefit everyone by reducing unneccesary costs statistics provided have to include the costs/portions of any taxation or they’re not being honest.
And advocates shouldn’t fear revealing such information if they are convinced of their argument.
If a person pays %? of their income annually in health related taxation they have a right to consider that cost to themself (and others) and to compare it to what private insurance would have cost when judging if they support the idea.
If the argument is they would have instead paid more or less in health insurance, paid more or less in the visits for health care they do make, the effort of proving the point needs to be made with complete and honest arguments.
I’ve read that PDF and it seems to be a list of fees charged to the recipient (patient or their insurer) of those services but not a list of the cost of the service.
The total cost appears to often be hidden and a person might reasonably believe because U.S health care is not tax subsidised then it’s fees are a more accurate reflection of the services cost rather than a rort of purchasers.
Which (unless I’m mistaken and corrected) makes those charts a bad argument for they will quickly be dismissed as misleading propaganda which serves people badly.
To use such charts as argument for change of U.S policy in health provision they must include information of the contribution of tax revenues.
I’ve seen these charts referenced on other blogs, and a question asked by many commentators is whether or not the charts include the amount taken in tax used to provide those services in most countries.
After all if the Canadian cost to a patient is low it may be unfair to compare it directly to a higher U.S charge if the Canadian price is subsidised from taxation.
Some people want to know what the total cost to people is and worry these charts obsfucate that by hiding amounts subsidising users from tax revenue.
In an effort to convince U.S citizens that single payer (or other systems) benefit everyone by reducing unneccesary costs statistics provided have to include the costs/portions of any taxation or they’re not being honest.
And advocates shouldn’t fear revealing such information if they are convinced of their argument.
If a person pays %? of their income annually in health related taxation they have a right to consider that cost to themself (and others) and to compare it to what private insurance would have cost when judging if they support the idea.
If the argument is they would have instead paid more or less in health insurance, paid more or less in the visits for health care they do make, the effort of proving the point needs to be made with complete and honest arguments.
I’ve read that PDF and it seems to be a list of fees charged to the recipient (patient or their insurer) of those services but not a list of the cost of the service.
The total cost appears to often be hidden and a person might reasonably believe because U.S health care is not tax subsidised then it’s fees are a more accurate reflection of the services cost rather than a rort of purchasers.
Which (unless I’m mistaken and corrected) makes those charts a bad argument for they will quickly be dismissed as misleading propaganda which serves people badly.
To use such charts as argument for change of U.S policy in health provision they must include information of the contribution of tax revenues.
The other thing about CTs in America’s “world’s best health Unsurance system” is that not only do they empty the wallet, they also give you a pretty good dose of ionizing radiation that you might not really need. There’s a lot, a LOT, of profitable “diagnostic testing” that is just mere surplusage, as the lawyers would say about the unneeded parts of opponents’ briefs and unfavorable judicial opinions.
Ask to see the “read” or report on your next x-ray or CT or MRI. You might be surprised what you are paying for. How about one patient’s paper that I saw, a person with a complex spinal fusion and multiple titanium rods and screws: “The lumbar spine is visualized, There is hardware. Thank you for allowing me the opportunity to take part in your patient’s care.” And while you’re here, meet my friend, Bill…
I wish I knew how to organize — it would have been helpful to collect all the anecdotes and incidents of cruelty and fraud and wasted motion and bad-faith denials of coverage and all the rest that nurses see every day. Just screw all those reactionary and self-interested-lobbying sons of bitches who say that a “robust public option,” let alone single payer, will be budget-busting. Never bothered the motherfuckers before when it came to “pricing adjustments” (aka too-often-fraudulent “overruns”) on military procurement programs, or even, speaking of the effects of antitrust exemptions, how much the Yankees infield gets paid, I won’t say “earns,” every year (more than the GDPs of 20 actual nations.)
The other thing about CTs in America’s “world’s best health Unsurance system” is that not only do they empty the wallet, they also give you a pretty good dose of ionizing radiation that you might not really need. There’s a lot, a LOT, of profitable “diagnostic testing” that is just mere surplusage, as the lawyers would say about the unneeded parts of opponents’ briefs and unfavorable judicial opinions.
Ask to see the “read” or report on your next x-ray or CT or MRI. You might be surprised what you are paying for. How about one patient’s paper that I saw, a person with a complex spinal fusion and multiple titanium rods and screws: “The lumbar spine is visualized, There is hardware. Thank you for allowing me the opportunity to take part in your patient’s care.” And while you’re here, meet my friend, Bill…
I wish I knew how to organize — it would have been helpful to collect all the anecdotes and incidents of cruelty and fraud and wasted motion and bad-faith denials of coverage and all the rest that nurses see every day. Just screw all those reactionary and self-interested-lobbying sons of bitches who say that a “robust public option,” let alone single payer, will be budget-busting. Never bothered the motherfuckers before when it came to “pricing adjustments” (aka too-often-fraudulent “overruns”) on military procurement programs, or even, speaking of the effects of antitrust exemptions, how much the Yankees infield gets paid, I won’t say “earns,” every year (more than the GDPs of 20 actual nations.)
The other thing about CTs in America’s “world’s best health Unsurance system” is that not only do they empty the wallet, they also give you a pretty good dose of ionizing radiation that you might not really need. There’s a lot, a LOT, of profitable “diagnostic testing” that is just mere surplusage, as the lawyers would say about the unneeded parts of opponents’ briefs and unfavorable judicial opinions.
Ask to see the “read” or report on your next x-ray or CT or MRI. You might be surprised what you are paying for. How about one patient’s paper that I saw, a person with a complex spinal fusion and multiple titanium rods and screws: “The lumbar spine is visualized, There is hardware. Thank you for allowing me the opportunity to take part in your patient’s care.” And while you’re here, meet my friend, Bill…
I wish I knew how to organize — it would have been helpful to collect all the anecdotes and incidents of cruelty and fraud and wasted motion and bad-faith denials of coverage and all the rest that nurses see every day. Just screw all those reactionary and self-interested-lobbying sons of bitches who say that a “robust public option,” let alone single payer, will be budget-busting. Never bothered the motherfuckers before when it came to “pricing adjustments” (aka too-often-fraudulent “overruns”) on military procurement programs, or even, speaking of the effects of antitrust exemptions, how much the Yankees infield gets paid, I won’t say “earns,” every year (more than the GDPs of 20 actual nations.)
JTM I was going to mention the radiation but decided against it. That’s another reason I’d say “fat chance.”
JTM I was going to mention the radiation but decided against it. That’s another reason I’d say “fat chance.”
JTM I was going to mention the radiation but decided against it. That’s another reason I’d say “fat chance.”
And they also ought to use accounting tools to capture the actual cost of the service — not the overhead of the doctor’s office, billing staff, nurses, dues and fees and all the other stuff that an efficient, free-standing, not-beholden-to-make-an-unconscionable-sneaky-profit-for-anyone provider would need to charge to keep the doors open and lights on.
And they also ought to use accounting tools to capture the actual cost of the service — not the overhead of the doctor’s office, billing staff, nurses, dues and fees and all the other stuff that an efficient, free-standing, not-beholden-to-make-an-unconscionable-sneaky-profit-for-anyone provider would need to charge to keep the doors open and lights on.
And they also ought to use accounting tools to capture the actual cost of the service — not the overhead of the doctor’s office, billing staff, nurses, dues and fees and all the other stuff that an efficient, free-standing, not-beholden-to-make-an-unconscionable-sneaky-profit-for-anyone provider would need to charge to keep the doors open and lights on.
And they also ought to use accounting tools to capture the actual cost of the service — not the overhead of the doctor’s office, billing staff, nurses, dues and fees and all the other stuff that an efficient, free-standing, not-beholden-to-make-an-unconscionable-sneaky-profit-for-anyone provider would need to charge to keep the doors open and lights on.
“NOT need to charge”
“NOT need to charge”
“NOT need to charge”
“NOT need to charge”
As an aside, the last time I had an x-ray (to update a surgeon on the condition of my collapsing knee) I wanted (oh, and by the way, I bought it direct from an unsubsidised service at a private hospital for ~USD 25) a digital copy of the image.
It’s all digital today anyway so I thought I could just ask for a copy of the image on the USB drive I carry on my keyring.
But for some reason all they would do is print a film for double the price. How odd.
As an aside, the last time I had an x-ray (to update a surgeon on the condition of my collapsing knee) I wanted (oh, and by the way, I bought it direct from an unsubsidised service at a private hospital for ~USD 25) a digital copy of the image.
It’s all digital today anyway so I thought I could just ask for a copy of the image on the USB drive I carry on my keyring.
But for some reason all they would do is print a film for double the price. How odd.
As an aside, the last time I had an x-ray (to update a surgeon on the condition of my collapsing knee) I wanted (oh, and by the way, I bought it direct from an unsubsidised service at a private hospital for ~USD 25) a digital copy of the image.
It’s all digital today anyway so I thought I could just ask for a copy of the image on the USB drive I carry on my keyring.
But for some reason all they would do is print a film for double the price. How odd.
As an aside, the last time I had an x-ray (to update a surgeon on the condition of my collapsing knee) I wanted (oh, and by the way, I bought it direct from an unsubsidised service at a private hospital for ~USD 25) a digital copy of the image.
It’s all digital today anyway so I thought I could just ask for a copy of the image on the USB drive I carry on my keyring.
But for some reason all they would do is print a film for double the price. How odd.
I disagree – you want to capture those costs.
It’s the whole point, to compare the extra costs incurred by the incumbent system to examples of different systems that it is argued trim those costs.
I disagree – you want to capture those costs.
It’s the whole point, to compare the extra costs incurred by the incumbent system to examples of different systems that it is argued trim those costs.
I disagree – you want to capture those costs.
It’s the whole point, to compare the extra costs incurred by the incumbent system to examples of different systems that it is argued trim those costs.
I disagree – you want to capture those costs.
It’s the whole point, to compare the extra costs incurred by the incumbent system to examples of different systems that it is argued trim those costs.
Sorry for the confusion, I think we are saying the same thing — I would just like a separate column in the ledger that breaks out the overhead and profit from the other actual stuff. And maybe one that totes up the number of “procedures” and stuff that are just for the profit of it. That latter is a very hard one to break out, of course.
Sorry for the confusion, I think we are saying the same thing — I would just like a separate column in the ledger that breaks out the overhead and profit from the other actual stuff. And maybe one that totes up the number of “procedures” and stuff that are just for the profit of it. That latter is a very hard one to break out, of course.
Sorry for the confusion, I think we are saying the same thing — I would just like a separate column in the ledger that breaks out the overhead and profit from the other actual stuff. And maybe one that totes up the number of “procedures” and stuff that are just for the profit of it. That latter is a very hard one to break out, of course.
Sorry for the confusion, I think we are saying the same thing — I would just like a separate column in the ledger that breaks out the overhead and profit from the other actual stuff. And maybe one that totes up the number of “procedures” and stuff that are just for the profit of it. That latter is a very hard one to break out, of course.
I thnk that would be asking too much. When you try and measure real world metrics it quickly becomes problematic when you try to separate out classes of information from the easily measured whole.
Attempts to capture increasing detail are costly, diffilcult and soon rife with debateable choices.
All distractions.
If the question is ‘what are the benefits of differently organised national systems?’ you need only care about nationally scaled measurements.
You’ll spend a life trying to understand the details and we don’t have life times to make our choices.
Measure the input and output of multiple systems, compare the differences.
Don’t worry too much about why they differ in the first instance if the point is just to support arguments that show they do.
I thnk that would be asking too much. When you try and measure real world metrics it quickly becomes problematic when you try to separate out classes of information from the easily measured whole.
Attempts to capture increasing detail are costly, diffilcult and soon rife with debateable choices.
All distractions.
If the question is ‘what are the benefits of differently organised national systems?’ you need only care about nationally scaled measurements.
You’ll spend a life trying to understand the details and we don’t have life times to make our choices.
Measure the input and output of multiple systems, compare the differences.
Don’t worry too much about why they differ in the first instance if the point is just to support arguments that show they do.
I thnk that would be asking too much. When you try and measure real world metrics it quickly becomes problematic when you try to separate out classes of information from the easily measured whole.
Attempts to capture increasing detail are costly, diffilcult and soon rife with debateable choices.
All distractions.
If the question is ‘what are the benefits of differently organised national systems?’ you need only care about nationally scaled measurements.
You’ll spend a life trying to understand the details and we don’t have life times to make our choices.
Measure the input and output of multiple systems, compare the differences.
Don’t worry too much about why they differ in the first instance if the point is just to support arguments that show they do.
I thnk that would be asking too much. When you try and measure real world metrics it quickly becomes problematic when you try to separate out classes of information from the easily measured whole.
Attempts to capture increasing detail are costly, diffilcult and soon rife with debateable choices.
All distractions.
If the question is ‘what are the benefits of differently organised national systems?’ you need only care about nationally scaled measurements.
You’ll spend a life trying to understand the details and we don’t have life times to make our choices.
Measure the input and output of multiple systems, compare the differences.
Don’t worry too much about why they differ in the first instance if the point is just to support arguments that show they do.
> In the Libertarian’s “perfect market” pipe-dreams,
> an oversupply should drive down costs of
> individual services. But that’s not what happens.
> Each hospital that has invested millions in
> buying CT Scanners must amortize the cost over
> fewer patients by raising the cost of each scan
I would imagine the counter argument is that medical provision is not an open market, that the mechanisms of supply and demand are not permitted to operate freely.
I wonder what might such mechanisms be in the U.S? What could be preventing competiton from undercutting costs?
There are competitors, the contention is they amortise expenses over small pools of customers shred increasingly sparsely between them – thus keeping prices high when they might be better served taking customers off the more
inefficient competitors.
Why don’t they compete more fiercly for customers? Surely, and here I leave my sphere of personal knowledge, it must have to do with peoples insurers.
It seems likely that simple supply and demand would drive prices down if left to the public to choose, so I suspect the public is not free to choose.
Who else plays any part in choosing where they will receive medical servcies but their insurer?
Is this not a suggestion that U.S health provision could be improved not only by perhaps adopting other countries methods but by at least improving the insurance industry?
I think U.S citizens should not let themselves be distracted by arguments about which country has the better system from at least seeing to it the existing system is not corrupted by bad regulation and priviledge granted to the incumbents.
> In the Libertarian’s “perfect market” pipe-dreams,
> an oversupply should drive down costs of
> individual services. But that’s not what happens.
> Each hospital that has invested millions in
> buying CT Scanners must amortize the cost over
> fewer patients by raising the cost of each scan
I would imagine the counter argument is that medical provision is not an open market, that the mechanisms of supply and demand are not permitted to operate freely.
I wonder what might such mechanisms be in the U.S? What could be preventing competiton from undercutting costs?
There are competitors, the contention is they amortise expenses over small pools of customers shred increasingly sparsely between them – thus keeping prices high when they might be better served taking customers off the more
inefficient competitors.
Why don’t they compete more fiercly for customers? Surely, and here I leave my sphere of personal knowledge, it must have to do with peoples insurers.
It seems likely that simple supply and demand would drive prices down if left to the public to choose, so I suspect the public is not free to choose.
Who else plays any part in choosing where they will receive medical servcies but their insurer?
Is this not a suggestion that U.S health provision could be improved not only by perhaps adopting other countries methods but by at least improving the insurance industry?
I think U.S citizens should not let themselves be distracted by arguments about which country has the better system from at least seeing to it the existing system is not corrupted by bad regulation and priviledge granted to the incumbents.
> In the Libertarian’s “perfect market” pipe-dreams,
> an oversupply should drive down costs of
> individual services. But that’s not what happens.
> Each hospital that has invested millions in
> buying CT Scanners must amortize the cost over
> fewer patients by raising the cost of each scan
I would imagine the counter argument is that medical provision is not an open market, that the mechanisms of supply and demand are not permitted to operate freely.
I wonder what might such mechanisms be in the U.S? What could be preventing competiton from undercutting costs?
There are competitors, the contention is they amortise expenses over small pools of customers shred increasingly sparsely between them – thus keeping prices high when they might be better served taking customers off the more
inefficient competitors.
Why don’t they compete more fiercly for customers? Surely, and here I leave my sphere of personal knowledge, it must have to do with peoples insurers.
It seems likely that simple supply and demand would drive prices down if left to the public to choose, so I suspect the public is not free to choose.
Who else plays any part in choosing where they will receive medical servcies but their insurer?
Is this not a suggestion that U.S health provision could be improved not only by perhaps adopting other countries methods but by at least improving the insurance industry?
I think U.S citizens should not let themselves be distracted by arguments about which country has the better system from at least seeing to it the existing system is not corrupted by bad regulation and priviledge granted to the incumbents.
> In the Libertarian’s “perfect market” pipe-dreams,
> an oversupply should drive down costs of
> individual services. But that’s not what happens.
> Each hospital that has invested millions in
> buying CT Scanners must amortize the cost over
> fewer patients by raising the cost of each scan
I would imagine the counter argument is that medical provision is not an open market, that the mechanisms of supply and demand are not permitted to operate freely.
I wonder what might such mechanisms be in the U.S? What could be preventing competiton from undercutting costs?
There are competitors, the contention is they amortise expenses over small pools of customers shred increasingly sparsely between them – thus keeping prices high when they might be better served taking customers off the more
inefficient competitors.
Why don’t they compete more fiercly for customers? Surely, and here I leave my sphere of personal knowledge, it must have to do with peoples insurers.
It seems likely that simple supply and demand would drive prices down if left to the public to choose, so I suspect the public is not free to choose.
Who else plays any part in choosing where they will receive medical servcies but their insurer?
Is this not a suggestion that U.S health provision could be improved not only by perhaps adopting other countries methods but by at least improving the insurance industry?
I think U.S citizens should not let themselves be distracted by arguments about which country has the better system from at least seeing to it the existing system is not corrupted by bad regulation and priviledge granted to the incumbents.
Re: “Market function.” Medical providers are neither apples nor oranges. They are not “fungible’” or substitutable. Nurses will tell you there are great physicians, skills-wise, who totally lack “customer service” skills that us “consumers” come to expect as our right and due. Then there are Best Bedside Manner award winners whose medical skills are at best scanty. The Reds are right, that people want to keep the docs they have grown accustomed to and have to trust or at least “rely on” for prescription refills and referrals. But the Medical Unsurance that the Reds want to protect against all change fucks with that system, makes doctors jump through hoops in order to be listed “on plan” for the many, many, many, many different “plans.” And then have staff who can keep the care being given by dealing with all the billing and “prior authorization,” and “approved treatment” lists and “formulary limits” where company bureaucrats trying to drive down the “loss ratio” (read: increase profit) decree pretty arbitrarily that the meds you got last month suddenly are not appropriate (heh heh, too expensive) for you, and the doc has to fill out forms and maybe engage in a “peer to peer” session, uncompensated, with a company doctor whose driving force is not, repeat NOT, the good of the Unsured patient.
The doctor-patient interaction might at one point have been sort of “free market,” though in many places the choice of doctors and hospitals and such was limited to ONE, or maybe none within range. Think of all the horse dramas that have somebody saddling up, riding 20 miles to town to “go for the doctor.” It’s not a “free market,” and any more it never will be, like every other “market” in this country. Sellers and/or buyers figure out how to use concentrations of power and wealth to screw the other party, and that includes jiggering “rule of law” to suit their self-serving desire for MORE.
Those who can afford to, travel to places like Mayo and Moffett and pay cash for “the best,” within the limits of medicine. That is both an art and a chaotic science that one day says cell phones are “safe for your brain” and the next that they “may cause or contribute to brain cancer” and coffee/red/wine/even cigarettes at one time are good for you (“3 out of 4 doctors recommend Lucky Strike!”) and then bad (at least based on some minute statistical evidence within 3 or 4 standard deviations.) Medicine has no remedies for a lot of ills, including fat and other individual foolishness and self-indulgence, money tilts the table (Ted Williams jumped the line for a new liver, fucking over some poor slob who did not have that sweet swing and a bucket of cash).
So forget about trying to create a “working free market” for medicine or anything else big in America or any other place on the planet that I know of. Small towns, farm communities, barter and exchange, artisan work, maybe there. But there is no “fixing” Unsurance — the human beast will make sure to find a way to concentrate and steal wealth, and health for that matter (how’s the share prices of our tobacco companies holding up? McDonalds? Can you believe that people actually root for these teams to “succeed huge?”)
My bet as a nurse and as a vet getting VA single-payer health care is that if you want more uniformly good HEALTH CARE, as opposed to health technology, a total destruction of Unsurance would be required and in order. An office visit or major-disease, tricky-diagnosis workup is not a carload of future wheat or a lot of pork bellies.
Any system has to tolerate a certain amount of “slack,” including corruption of various forms. If all the laws on the books were enforced strictly, we would all be in judgment debt to each other and in jail. What’s happened here is that in a sophisticated way, we have as a bunch made ourselves as corrupt as any other Third World polity. Short of some major upheaval, which is not going to come from Prosperity Theology “Christians” with their “Protected by Smith&Wesson” bumper stickers, we are just going to have to ride the bear we have bound ourselves to.
It’s not distracting to look for a tidal change that might move the nation in a “healthier” direction. It is, of course, an opportunity for the shitheads who so cynically lobby for the “stakeholders” (Why does an image of Buffy the Vampire Slayer come to mind?) to buffalo the sheep, to swirl up a multi-level mixed metaphor.
Re: “Market function.” Medical providers are neither apples nor oranges. They are not “fungible’” or substitutable. Nurses will tell you there are great physicians, skills-wise, who totally lack “customer service” skills that us “consumers” come to expect as our right and due. Then there are Best Bedside Manner award winners whose medical skills are at best scanty. The Reds are right, that people want to keep the docs they have grown accustomed to and have to trust or at least “rely on” for prescription refills and referrals. But the Medical Unsurance that the Reds want to protect against all change fucks with that system, makes doctors jump through hoops in order to be listed “on plan” for the many, many, many, many different “plans.” And then have staff who can keep the care being given by dealing with all the billing and “prior authorization,” and “approved treatment” lists and “formulary limits” where company bureaucrats trying to drive down the “loss ratio” (read: increase profit) decree pretty arbitrarily that the meds you got last month suddenly are not appropriate (heh heh, too expensive) for you, and the doc has to fill out forms and maybe engage in a “peer to peer” session, uncompensated, with a company doctor whose driving force is not, repeat NOT, the good of the Unsured patient.
The doctor-patient interaction might at one point have been sort of “free market,” though in many places the choice of doctors and hospitals and such was limited to ONE, or maybe none within range. Think of all the horse dramas that have somebody saddling up, riding 20 miles to town to “go for the doctor.” It’s not a “free market,” and any more it never will be, like every other “market” in this country. Sellers and/or buyers figure out how to use concentrations of power and wealth to screw the other party, and that includes jiggering “rule of law” to suit their self-serving desire for MORE.
Those who can afford to, travel to places like Mayo and Moffett and pay cash for “the best,” within the limits of medicine. That is both an art and a chaotic science that one day says cell phones are “safe for your brain” and the next that they “may cause or contribute to brain cancer” and coffee/red/wine/even cigarettes at one time are good for you (“3 out of 4 doctors recommend Lucky Strike!”) and then bad (at least based on some minute statistical evidence within 3 or 4 standard deviations.) Medicine has no remedies for a lot of ills, including fat and other individual foolishness and self-indulgence, money tilts the table (Ted Williams jumped the line for a new liver, fucking over some poor slob who did not have that sweet swing and a bucket of cash).
So forget about trying to create a “working free market” for medicine or anything else big in America or any other place on the planet that I know of. Small towns, farm communities, barter and exchange, artisan work, maybe there. But there is no “fixing” Unsurance — the human beast will make sure to find a way to concentrate and steal wealth, and health for that matter (how’s the share prices of our tobacco companies holding up? McDonalds? Can you believe that people actually root for these teams to “succeed huge?”)
My bet as a nurse and as a vet getting VA single-payer health care is that if you want more uniformly good HEALTH CARE, as opposed to health technology, a total destruction of Unsurance would be required and in order. An office visit or major-disease, tricky-diagnosis workup is not a carload of future wheat or a lot of pork bellies.
Any system has to tolerate a certain amount of “slack,” including corruption of various forms. If all the laws on the books were enforced strictly, we would all be in judgment debt to each other and in jail. What’s happened here is that in a sophisticated way, we have as a bunch made ourselves as corrupt as any other Third World polity. Short of some major upheaval, which is not going to come from Prosperity Theology “Christians” with their “Protected by Smith&Wesson” bumper stickers, we are just going to have to ride the bear we have bound ourselves to.
It’s not distracting to look for a tidal change that might move the nation in a “healthier” direction. It is, of course, an opportunity for the shitheads who so cynically lobby for the “stakeholders” (Why does an image of Buffy the Vampire Slayer come to mind?) to buffalo the sheep, to swirl up a multi-level mixed metaphor.
Re: “Market function.” Medical providers are neither apples nor oranges. They are not “fungible’” or substitutable. Nurses will tell you there are great physicians, skills-wise, who totally lack “customer service” skills that us “consumers” come to expect as our right and due. Then there are Best Bedside Manner award winners whose medical skills are at best scanty. The Reds are right, that people want to keep the docs they have grown accustomed to and have to trust or at least “rely on” for prescription refills and referrals. But the Medical Unsurance that the Reds want to protect against all change fucks with that system, makes doctors jump through hoops in order to be listed “on plan” for the many, many, many, many different “plans.” And then have staff who can keep the care being given by dealing with all the billing and “prior authorization,” and “approved treatment” lists and “formulary limits” where company bureaucrats trying to drive down the “loss ratio” (read: increase profit) decree pretty arbitrarily that the meds you got last month suddenly are not appropriate (heh heh, too expensive) for you, and the doc has to fill out forms and maybe engage in a “peer to peer” session, uncompensated, with a company doctor whose driving force is not, repeat NOT, the good of the Unsured patient.
The doctor-patient interaction might at one point have been sort of “free market,” though in many places the choice of doctors and hospitals and such was limited to ONE, or maybe none within range. Think of all the horse dramas that have somebody saddling up, riding 20 miles to town to “go for the doctor.” It’s not a “free market,” and any more it never will be, like every other “market” in this country. Sellers and/or buyers figure out how to use concentrations of power and wealth to screw the other party, and that includes jiggering “rule of law” to suit their self-serving desire for MORE.
Those who can afford to, travel to places like Mayo and Moffett and pay cash for “the best,” within the limits of medicine. That is both an art and a chaotic science that one day says cell phones are “safe for your brain” and the next that they “may cause or contribute to brain cancer” and coffee/red/wine/even cigarettes at one time are good for you (“3 out of 4 doctors recommend Lucky Strike!”) and then bad (at least based on some minute statistical evidence within 3 or 4 standard deviations.) Medicine has no remedies for a lot of ills, including fat and other individual foolishness and self-indulgence, money tilts the table (Ted Williams jumped the line for a new liver, fucking over some poor slob who did not have that sweet swing and a bucket of cash).
So forget about trying to create a “working free market” for medicine or anything else big in America or any other place on the planet that I know of. Small towns, farm communities, barter and exchange, artisan work, maybe there. But there is no “fixing” Unsurance — the human beast will make sure to find a way to concentrate and steal wealth, and health for that matter (how’s the share prices of our tobacco companies holding up? McDonalds? Can you believe that people actually root for these teams to “succeed huge?”)
My bet as a nurse and as a vet getting VA single-payer health care is that if you want more uniformly good HEALTH CARE, as opposed to health technology, a total destruction of Unsurance would be required and in order. An office visit or major-disease, tricky-diagnosis workup is not a carload of future wheat or a lot of pork bellies.
Any system has to tolerate a certain amount of “slack,” including corruption of various forms. If all the laws on the books were enforced strictly, we would all be in judgment debt to each other and in jail. What’s happened here is that in a sophisticated way, we have as a bunch made ourselves as corrupt as any other Third World polity. Short of some major upheaval, which is not going to come from Prosperity Theology “Christians” with their “Protected by Smith&Wesson” bumper stickers, we are just going to have to ride the bear we have bound ourselves to.
It’s not distracting to look for a tidal change that might move the nation in a “healthier” direction. It is, of course, an opportunity for the shitheads who so cynically lobby for the “stakeholders” (Why does an image of Buffy the Vampire Slayer come to mind?) to buffalo the sheep, to swirl up a multi-level mixed metaphor.
Re: “Market function.” Medical providers are neither apples nor oranges. They are not “fungible’” or substitutable. Nurses will tell you there are great physicians, skills-wise, who totally lack “customer service” skills that us “consumers” come to expect as our right and due. Then there are Best Bedside Manner award winners whose medical skills are at best scanty. The Reds are right, that people want to keep the docs they have grown accustomed to and have to trust or at least “rely on” for prescription refills and referrals. But the Medical Unsurance that the Reds want to protect against all change fucks with that system, makes doctors jump through hoops in order to be listed “on plan” for the many, many, many, many different “plans.” And then have staff who can keep the care being given by dealing with all the billing and “prior authorization,” and “approved treatment” lists and “formulary limits” where company bureaucrats trying to drive down the “loss ratio” (read: increase profit) decree pretty arbitrarily that the meds you got last month suddenly are not appropriate (heh heh, too expensive) for you, and the doc has to fill out forms and maybe engage in a “peer to peer” session, uncompensated, with a company doctor whose driving force is not, repeat NOT, the good of the Unsured patient.
The doctor-patient interaction might at one point have been sort of “free market,” though in many places the choice of doctors and hospitals and such was limited to ONE, or maybe none within range. Think of all the horse dramas that have somebody saddling up, riding 20 miles to town to “go for the doctor.” It’s not a “free market,” and any more it never will be, like every other “market” in this country. Sellers and/or buyers figure out how to use concentrations of power and wealth to screw the other party, and that includes jiggering “rule of law” to suit their self-serving desire for MORE.
Those who can afford to, travel to places like Mayo and Moffett and pay cash for “the best,” within the limits of medicine. That is both an art and a chaotic science that one day says cell phones are “safe for your brain” and the next that they “may cause or contribute to brain cancer” and coffee/red/wine/even cigarettes at one time are good for you (“3 out of 4 doctors recommend Lucky Strike!”) and then bad (at least based on some minute statistical evidence within 3 or 4 standard deviations.) Medicine has no remedies for a lot of ills, including fat and other individual foolishness and self-indulgence, money tilts the table (Ted Williams jumped the line for a new liver, fucking over some poor slob who did not have that sweet swing and a bucket of cash).
So forget about trying to create a “working free market” for medicine or anything else big in America or any other place on the planet that I know of. Small towns, farm communities, barter and exchange, artisan work, maybe there. But there is no “fixing” Unsurance — the human beast will make sure to find a way to concentrate and steal wealth, and health for that matter (how’s the share prices of our tobacco companies holding up? McDonalds? Can you believe that people actually root for these teams to “succeed huge?”)
My bet as a nurse and as a vet getting VA single-payer health care is that if you want more uniformly good HEALTH CARE, as opposed to health technology, a total destruction of Unsurance would be required and in order. An office visit or major-disease, tricky-diagnosis workup is not a carload of future wheat or a lot of pork bellies.
Any system has to tolerate a certain amount of “slack,” including corruption of various forms. If all the laws on the books were enforced strictly, we would all be in judgment debt to each other and in jail. What’s happened here is that in a sophisticated way, we have as a bunch made ourselves as corrupt as any other Third World polity. Short of some major upheaval, which is not going to come from Prosperity Theology “Christians” with their “Protected by Smith&Wesson” bumper stickers, we are just going to have to ride the bear we have bound ourselves to.
It’s not distracting to look for a tidal change that might move the nation in a “healthier” direction. It is, of course, an opportunity for the shitheads who so cynically lobby for the “stakeholders” (Why does an image of Buffy the Vampire Slayer come to mind?) to buffalo the sheep, to swirl up a multi-level mixed metaphor.
The anti-reform brigade plumb new lows in the effort to swing opinion:
http://www.youtube.com/watch?v=qC9lWoI43Qo
The anti-reform brigade plumb new lows in the effort to swing opinion:
http://www.youtube.com/watch?v=qC9lWoI43Qo
The anti-reform brigade plumb new lows in the effort to swing opinion:
http://www.youtube.com/watch?v=qC9lWoI43Qo
I think that’s just it, len, though I hesitate to speak for him. The Internet did indeed promise a “learning web”, and even a revival of literacy, but in no time it became a rreal worry: was it not transfooorming users into human cyyborgs, belonging to counterfeit “communities” (the Anglicization of a quintessentially Catholic concept), and cominng to regard their minds, bodiies and doings in diabolically systemic, anti-humanstic terms?
Whilst we played with our new tools, meanwile how were we being retooled, played?
I think that’s just it, len, though I hesitate to speak for him. The Internet did indeed promise a “learning web”, and even a revival of literacy, but in no time it became a rreal worry: was it not transfooorming users into human cyyborgs, belonging to counterfeit “communities” (the Anglicization of a quintessentially Catholic concept), and cominng to regard their minds, bodiies and doings in diabolically systemic, anti-humanstic terms?
Whilst we played with our new tools, meanwile how were we being retooled, played?
I think that’s just it, len, though I hesitate to speak for him. The Internet did indeed promise a “learning web”, and even a revival of literacy, but in no time it became a rreal worry: was it not transfooorming users into human cyyborgs, belonging to counterfeit “communities” (the Anglicization of a quintessentially Catholic concept), and cominng to regard their minds, bodiies and doings in diabolically systemic, anti-humanstic terms?
Whilst we played with our new tools, meanwile how were we being retooled, played?
In Beyond The Book Metaphor I began with the observation made by anthopologists that we are tool makers and added the obvious that in any cybernetic system, we make tools that shape the environment that shapes us. We choose but we don’t always know the unintended side effects, in effect, we game our destinies. It can’t be any other way. We are gamblers of evolution.
The indications are this is not evolution at the same rate for all of the players. Evolution and chance are interwoven forces. Some by accident of birth others by force of intension do advance faster, become smarter, see further, develop that talent for peering around the corners of events unfolding. For whatever accidents or intents shape their values, they will in turn apply those values to the shaping of the futures of others. They obtain the ultimate power of choice of the choices of others. One would hope they first have power over themselves and this is nothing new in ethical thinking. One would hope that they have become caring people; yet as Illich points out, they are ensnared in their own path, their own histories, the ancestors that shaped them and so stumble over civilizations not of their kind and too often upset the carefully devised and organically evolved local culture. They march into Tenochititlan to find grand stone temples ablaze with colored feathers governed by stone knives and bows and leave behind muskets and a desperation for drink and gold.
For that reason among others, societies both open and secret formed to guide each other and those within the scope of their power. Some learned the techniques of locale, learned limits and focused their efforts. Some endure. Some become notorious. Some have the pleasure of their anonymity.
Some through great discipline, effort and suffering found the ultimate joy of sitting on their own commode.
I’m a deer in the headlights in situations that are more powerful than that. It makes me not notice my rudeness and lack of grace and so I have this wonderful wife who keeps me from forgetting that fact. Today, I have this wonderful pendant with the one tool in it I need at my best and am most grateful to the hand that gave it to me. Be seein’ ya!
In Beyond The Book Metaphor I began with the observation made by anthopologists that we are tool makers and added the obvious that in any cybernetic system, we make tools that shape the environment that shapes us. We choose but we don’t always know the unintended side effects, in effect, we game our destinies. It can’t be any other way. We are gamblers of evolution.
The indications are this is not evolution at the same rate for all of the players. Evolution and chance are interwoven forces. Some by accident of birth others by force of intension do advance faster, become smarter, see further, develop that talent for peering around the corners of events unfolding. For whatever accidents or intents shape their values, they will in turn apply those values to the shaping of the futures of others. They obtain the ultimate power of choice of the choices of others. One would hope they first have power over themselves and this is nothing new in ethical thinking. One would hope that they have become caring people; yet as Illich points out, they are ensnared in their own path, their own histories, the ancestors that shaped them and so stumble over civilizations not of their kind and too often upset the carefully devised and organically evolved local culture. They march into Tenochititlan to find grand stone temples ablaze with colored feathers governed by stone knives and bows and leave behind muskets and a desperation for drink and gold.
For that reason among others, societies both open and secret formed to guide each other and those within the scope of their power. Some learned the techniques of locale, learned limits and focused their efforts. Some endure. Some become notorious. Some have the pleasure of their anonymity.
Some through great discipline, effort and suffering found the ultimate joy of sitting on their own commode.
I’m a deer in the headlights in situations that are more powerful than that. It makes me not notice my rudeness and lack of grace and so I have this wonderful wife who keeps me from forgetting that fact. Today, I have this wonderful pendant with the one tool in it I need at my best and am most grateful to the hand that gave it to me. Be seein’ ya!
In Beyond The Book Metaphor I began with the observation made by anthopologists that we are tool makers and added the obvious that in any cybernetic system, we make tools that shape the environment that shapes us. We choose but we don’t always know the unintended side effects, in effect, we game our destinies. It can’t be any other way. We are gamblers of evolution.
The indications are this is not evolution at the same rate for all of the players. Evolution and chance are interwoven forces. Some by accident of birth others by force of intension do advance faster, become smarter, see further, develop that talent for peering around the corners of events unfolding. For whatever accidents or intents shape their values, they will in turn apply those values to the shaping of the futures of others. They obtain the ultimate power of choice of the choices of others. One would hope they first have power over themselves and this is nothing new in ethical thinking. One would hope that they have become caring people; yet as Illich points out, they are ensnared in their own path, their own histories, the ancestors that shaped them and so stumble over civilizations not of their kind and too often upset the carefully devised and organically evolved local culture. They march into Tenochititlan to find grand stone temples ablaze with colored feathers governed by stone knives and bows and leave behind muskets and a desperation for drink and gold.
For that reason among others, societies both open and secret formed to guide each other and those within the scope of their power. Some learned the techniques of locale, learned limits and focused their efforts. Some endure. Some become notorious. Some have the pleasure of their anonymity.
Some through great discipline, effort and suffering found the ultimate joy of sitting on their own commode.
I’m a deer in the headlights in situations that are more powerful than that. It makes me not notice my rudeness and lack of grace and so I have this wonderful wife who keeps me from forgetting that fact. Today, I have this wonderful pendant with the one tool in it I need at my best and am most grateful to the hand that gave it to me. Be seein’ ya!
Beautifully put, len. Especially the part about your wife.
Let me ask you about something that bears upon the subject of this string. What do you think it might take for us to stop thinking of the computer in metaphorical terms? Over the years we’ve lost so much time, staring into the mirror of Narcisis, mistaking the silicon for a book, a teacher, a school, a doctor, a hospital.
Do you see progress beyond these delusions?
Beautifully put, len. Especially the part about your wife.
Let me ask you about something that bears upon the subject of this string. What do you think it might take for us to stop thinking of the computer in metaphorical terms? Over the years we’ve lost so much time, staring into the mirror of Narcisis, mistaking the silicon for a book, a teacher, a school, a doctor, a hospital.
Do you see progress beyond these delusions?
Beautifully put, len. Especially the part about your wife.
Let me ask you about something that bears upon the subject of this string. What do you think it might take for us to stop thinking of the computer in metaphorical terms? Over the years we’ve lost so much time, staring into the mirror of Narcisis, mistaking the silicon for a book, a teacher, a school, a doctor, a hospital.
Do you see progress beyond these delusions?
Time and familiarity, Hugo. People waxed poetic about the telephone, TV, radio, and so on. The computer is converging all of our means of communication and combining those with our memory, our literature and our art. It is tool, tablet and brown paper wrapper. In the beginning, after a very short period of exploration, we tend to turn it into the old forms we are comfortable with because those have a prepared audience. Then pioneers begin to emerge who do more expressive work because they need to.
I go on about the virtual reality album because I’ve made one and it has all the depth of an early Edison movie: none. We’re still focused on the technology. Somewhere along the way, it becomes an art form with some legacy techniques and gestures and then out of seemingly nowhere, a Louis Armstrong will blaze out of a garage and everyone will suddenly see and applaud and forget the players that came before. That’s the way of things.
Just like you can hear a Clapton solo and know it’s Clapton, the hand, the breath the heartbreak of the individual are the fire. Everything else is stuff. I think we are already passing the point where the technologists are the stars. We may be in a short era like disco where the audience are stars but at the same time, the first generation of real talent who’s medium is not the silver screen, not the radio and not TV are being heard.
Us old old protos have to help them out of their chrysalis and then get the hell out of the way. It’s like when your first child is born and you look at them in the cradle. If everything goes well, that face you see there will look into your coffin. That is life. If everything goes as it should, they will remember the songs you taught them.
Like Willie said, “Real country, in case you forgot.”
Respect is the wind that lifts the wings of the social contract. Jesus was notable for among other ideas one that was novel: before him, the elders were the wise men and society organized according to their principles. Christ emphasized the mind, the attitude, the heart of the child. They are not our future; they are our present. If we want what we say we want here, we ought to be more mindful of that and take less from THEIR future.
Time and familiarity, Hugo. People waxed poetic about the telephone, TV, radio, and so on. The computer is converging all of our means of communication and combining those with our memory, our literature and our art. It is tool, tablet and brown paper wrapper. In the beginning, after a very short period of exploration, we tend to turn it into the old forms we are comfortable with because those have a prepared audience. Then pioneers begin to emerge who do more expressive work because they need to.
I go on about the virtual reality album because I’ve made one and it has all the depth of an early Edison movie: none. We’re still focused on the technology. Somewhere along the way, it becomes an art form with some legacy techniques and gestures and then out of seemingly nowhere, a Louis Armstrong will blaze out of a garage and everyone will suddenly see and applaud and forget the players that came before. That’s the way of things.
Just like you can hear a Clapton solo and know it’s Clapton, the hand, the breath the heartbreak of the individual are the fire. Everything else is stuff. I think we are already passing the point where the technologists are the stars. We may be in a short era like disco where the audience are stars but at the same time, the first generation of real talent who’s medium is not the silver screen, not the radio and not TV are being heard.
Us old old protos have to help them out of their chrysalis and then get the hell out of the way. It’s like when your first child is born and you look at them in the cradle. If everything goes well, that face you see there will look into your coffin. That is life. If everything goes as it should, they will remember the songs you taught them.
Like Willie said, “Real country, in case you forgot.”
Respect is the wind that lifts the wings of the social contract. Jesus was notable for among other ideas one that was novel: before him, the elders were the wise men and society organized according to their principles. Christ emphasized the mind, the attitude, the heart of the child. They are not our future; they are our present. If we want what we say we want here, we ought to be more mindful of that and take less from THEIR future.
Time and familiarity, Hugo. People waxed poetic about the telephone, TV, radio, and so on. The computer is converging all of our means of communication and combining those with our memory, our literature and our art. It is tool, tablet and brown paper wrapper. In the beginning, after a very short period of exploration, we tend to turn it into the old forms we are comfortable with because those have a prepared audience. Then pioneers begin to emerge who do more expressive work because they need to.
I go on about the virtual reality album because I’ve made one and it has all the depth of an early Edison movie: none. We’re still focused on the technology. Somewhere along the way, it becomes an art form with some legacy techniques and gestures and then out of seemingly nowhere, a Louis Armstrong will blaze out of a garage and everyone will suddenly see and applaud and forget the players that came before. That’s the way of things.
Just like you can hear a Clapton solo and know it’s Clapton, the hand, the breath the heartbreak of the individual are the fire. Everything else is stuff. I think we are already passing the point where the technologists are the stars. We may be in a short era like disco where the audience are stars but at the same time, the first generation of real talent who’s medium is not the silver screen, not the radio and not TV are being heard.
Us old old protos have to help them out of their chrysalis and then get the hell out of the way. It’s like when your first child is born and you look at them in the cradle. If everything goes well, that face you see there will look into your coffin. That is life. If everything goes as it should, they will remember the songs you taught them.
Like Willie said, “Real country, in case you forgot.”
Respect is the wind that lifts the wings of the social contract. Jesus was notable for among other ideas one that was novel: before him, the elders were the wise men and society organized according to their principles. Christ emphasized the mind, the attitude, the heart of the child. They are not our future; they are our present. If we want what we say we want here, we ought to be more mindful of that and take less from THEIR future.
Time and familiarity, Hugo. People waxed poetic about the telephone, TV, radio, and so on. The computer is converging all of our means of communication and combining those with our memory, our literature and our art. It is tool, tablet and brown paper wrapper. In the beginning, after a very short period of exploration, we tend to turn it into the old forms we are comfortable with because those have a prepared audience. Then pioneers begin to emerge who do more expressive work because they need to.
I go on about the virtual reality album because I’ve made one and it has all the depth of an early Edison movie: none. We’re still focused on the technology. Somewhere along the way, it becomes an art form with some legacy techniques and gestures and then out of seemingly nowhere, a Louis Armstrong will blaze out of a garage and everyone will suddenly see and applaud and forget the players that came before. That’s the way of things.
Just like you can hear a Clapton solo and know it’s Clapton, the hand, the breath the heartbreak of the individual are the fire. Everything else is stuff. I think we are already passing the point where the technologists are the stars. We may be in a short era like disco where the audience are stars but at the same time, the first generation of real talent who’s medium is not the silver screen, not the radio and not TV are being heard.
Us old old protos have to help them out of their chrysalis and then get the hell out of the way. It’s like when your first child is born and you look at them in the cradle. If everything goes well, that face you see there will look into your coffin. That is life. If everything goes as it should, they will remember the songs you taught them.
Like Willie said, “Real country, in case you forgot.”
Respect is the wind that lifts the wings of the social contract. Jesus was notable for among other ideas one that was novel: before him, the elders were the wise men and society organized according to their principles. Christ emphasized the mind, the attitude, the heart of the child. They are not our future; they are our present. If we want what we say we want here, we ought to be more mindful of that and take less from THEIR future.