Capitalism Begets Socialism

Imagine the average wage a bit higher and the average intelligence a bit lower but other than that this bit of dialog from Forty Signs of Rain by Kim Stanley Robinson caught my attention this morning while I spent 2.78 hours at the Nevada DMV. Speaking of which--you know if you change the address on your driver's license and you get a sticker to put on the back with the new address. Then some time in the future you wish to change it back to the address that is already on the license, well that cannot be fathomed by the computer mediated system. I fear I no longer exist in the Silver State, but I am registered to vote in Neverland.

But back to capitalism, socialism and other fantasies:

"The average surplus value created by American workers is thirty-three dollars an hour."

Anna said: "I wonder how they define surplus value."

"Profit," Frank said.

Edgardo shook his head. "You can cook the books and get rid of profit, but the surplus value, the value created beyond the pay for labor, is still there."

Anna said, "There was a page in here that said the average American worker puts in 1,950 hours a year. I thought that was questionable too, that's forty hours a week for about forty-nine weeks."

. . .

"What's the average income?" Edgardo asked. "Thirty thousand?"

"Maybe less," Frank said.

"Call it thirty, and what's the average taxes paid?"

"About ten? Or is it less?"

Edgardo said, "Call it ten. So let's see. You work every day of the year, except for three lousy weeks. You create around a hundred thousand dollars. Your boss takes two thirds, and give you one third, and you give a third of that to the government. Your government uses what it takes to build all the roads and schools and police and pensions, and you boss takes his share and buys a mansion on an island somewhere. So naturally you complain about your bloated inefficient Big Brother of a government, and you always vote for the pro-owner party."

He grinned at Frank and Anna. "How stupid is that?"

I know. Too simplistic, the bosses take all the risks. Socialism doesn't work; Capitalism does (see Federal Financial Institutions Bailout, Sept. 2008). Be kind, I was into my third hour at the DMV, the man next to me was reading Super System II.

Health Care: 80% or eighty percent?

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In the midst of all the words about health care reform, you have probably heard a survey quoted that says that "80% of Americans are satisfied with the quality of health care coverage they are receiving." That tidbit of information has been used by literally thousands of opponents of health care reform to bolster their position that reform is not needed, despite the fact that we all know such a position is absurd. In fact, in that same survey, when asked how they felt about the overall cost of health care more than three out of four said it was too high and they were dissatisfied with that part of the health care system. So 80% are satisfied but more than three-quarters are unsatisfied. All of this numerical sound and fury comes from a CNN telephone poll conducted March 11th-15th, before the health care reform legislation even hit congress, a total of 1,019 adults were surveyed.

Now we all know deep in our coronary chambers and right on surface of our cerebellum that surveys and statistics are generally abused and misused by media pundits and other talking heads to bolster there political positions, even when the numbers really don't say what they say they say. Right? So, here are a couple of observations of this virtual 80% of all Americans.

-Did you know that nearly 46 million Americans or 18% of the population under 65 had no health care coverage in 2007, the latest census data available.

-The largest increase in uninsured since 2007 has been in working age adults, who have lost their jobs and their health insurance benefits.

One has to wonder if 18% of the population under 65 has no health insurance, how can 80% of the population be satisfied with their coverage? Perhaps a disproportionate number of those over 65 are home to answer phone surveys. The 18% are out looking for a job. Also notice that the survey only takes answers from adults and does not consider if their lack of or loss of coverage effects any children.

Here are few more statistical "facts" that might inform the health care debate:

-80% of those with health insurance of some kind do not use the health care system in any given year. Might we not assume that many of those "satisfied" with their coverage are simply happy to have any coverage at all and have not actually interacted with the health care system?

-of those who use the health care system, most adults between the ages of 21-45, only see their physician for an annual check-up or a prescription renewal visit.

-"annual" doctor visits for check-ups on average happen about every 21 months.

We have to assume then that of those surveyed to come up with the "80% satisfied" statistic, easily more than half did not use the health care system at all in the past year and those that did may have seen their doctor for less than 7.2 minutes (the average doctor-patient interface in another survey). When was the last time seven minutes was actually satisfying to you?

Finally, some hard facts and other questions about where our health care dollars actually go.

-80% of health expenses go to senior citizens and the chronically ill, which probably means those are the people we should be asking about the quality of health care. Care to guess how "satisfied" they are?

-wouldn't we get more useful survey results if we asked these questions of people leaving a doctor's office or a hospital or better yet survey patients in the hospital?

-no one wants to talk about the huge expense of "end of life" health care. Yet medical professionals who deal with the costs of the system know full well that we spend a huge proportion of medical costs on ineffective treatment in order to show compassion. End of life health care often causes such severe side effects that the treatment diminishes rather than enhances quality of life.

I leave you with no answers but a quote from a physician friend of mine on the issue of end of life health care expenditures:

"Family rather than the patient are often those who demand we 'do everything' for a terminal patient. They want their loved one around as long as possible. Yet our interventions at most extend the life of perhaps one in every twenty patients and very often, too often, that extra time is spent in a fog of confusion and even pain because of the side effects of our medical interventions. We waste money sure, but more importantly we destroy the quality of our patients final days."