The Great American Health Care Non-Debate

A friend of mine who lives in South Carolina was admitted to a hospital with cholecystitis (inflamed gallbladder). Her condition was severe enough that the ER physicians recommended immediate surgery. Tests showed her to be anemic, and so she was given an IV prior to surgery. In the process, she was asked what sort of health insurance she has, and she was foolish enough to actually answer the question instead of saying something like “I feel too sick to handle paperwork.” She has no health insurance because there are no options available in her state that would be affordable to her. She was discharged and out on the street a few minutes later with a prescription for a pain medication that is available without a prescription. She has been in intermittent pain ever since. If her gallbladder bursts, she will die. If she dies, her three children will become wards of the state, costing the state many times what her gallbladder surgery would have cost. You may feel free to conclude that South Carolina is run by idiots, but as we shall see the problem is much bigger than that.

Meanwhile, a mere half a planet away, another friend of mine got caught up in a street fight somewhere in Russia and ended up with a concussion and a broken bone. He was checked into a local hospital, where he convalesced for two weeks. He was provided with all the necessary treatments, including radiology, minor surgery, a cast for the broken bone, pain control medication, a regular change of bedclothes, three meals a day, TV time and internet access. He is not a Russian citizen and his knowledge of Russian is fragmentary, so the doctors and the nurses got to practice their English. He had an expired foreign passport with an expired Ukrainian (long story) tourist visa but nobody cared. He had no health insurance of any kind but nobody batted an eye. Upon discharge he was made to pay 8500 rubles (around 150 US dollars) which he did quite happily.

“Facts on the Ground”

It is a sad fact that people in the West, and in the US especially, are presently living in a world that is bereft of actual news about what goes on in many parts of the world, especially the active conflict zones, such as Syria, Yemen and Libya. What they do hear is often based not on facts but on ideology, which is endlessly spouted by officials and think tanks in Washington. For instance, in Syria, Bashar al Assad, the Russians and the Iranians are said to be destroying the country and the Turks, the Kurds and various rebels supported by Saudi Arabia are attempting to “liberate” it whereas in fact Syrian government forces, aided by Russia and Iran, are liberating Syria from terrorists, including ISIS, which are supported by the Turks, Saudi Arabia and the US, and are doing quite a good job of it.

But perhaps nowhere is this ideological bias more blatant and obvious than in the treatment Russia receives in American mass media. Obama claimed that the Russian economy is “in tatters” because of Western sanctions; Senator John McCain is famously quoted as saying that Russia is “a gas station masquerading as a country”; and mass media echoes these fancies. But what if this “just ain’t so”? It is one thing to view a certain place through a certain lens, giving it a slightly misleading hue; it is another to suffer a psychotic break with reality and let wishful thinking, quite uncontaminated by any facts, serve as one’s guide.

Last week I flew back to St. Petersburg, Russia, after a five-year absence. As usual, it has turned out to be insightful to catch a periodic glimpse of a very familiar place. I grew up in St. Petersburg and have visited it seven times over the past 28 years. Catching periodic snapshots of a place allows one to see just the changes. This may not matter so much for places that don’t undergo drastic change; for example, over the same period, Washington or New York have hardly changed at all, their essential character remaining largely the same. But over this same period St. Petersburg, along with the rest of Russia, has been on a tare: it has undergone a total transformation from a stagnant backwater to a depressed hollowed-out shell to a thriving and vibrant place and a prime tourist destination.

To listen to and accept talk of “shreds” and “gas stations” is to choose to inhabit some parallel universe run by people who are willfully ignorant or psychotic and deluded or hell-bent on misleading everyone. And so plenty of people in the West, and in the US especially, are walking around with an assortment of fanciful notions in their heads: that Russians drink more than anyone (actually, that would be the Lithuanians); are the most depressed and suicidal (that would be the Latvians); or choose flee their country in greatest numbers (the Estonians). Or they think that Russia is an oppressive, corrupt dictatorship that sustains itself solely through oil exports (Saudi Arabia); or that it is hell-bent on world domination (that would be the United States).

On my previous visits, I have caught very different glimpses of St. Petersburg. In 1989 I saw pretty much the old USSR except for a lot of talk—it was the “glasnost” period—much of which later turned out to be not quite accurate. In 1990 I saw the old order teetering on the brink, empty shelves in government shops and the economy nearing a standstill. In 1993 I observed many signs of social collapse, with most people living in abject poverty and middle-class, educated people digging around in the garbage or trying to sell their belongings at flea markets to buy food. In 1995 and 1996 I saw a land in the grip of ethnic mafias, with goods sold from locked metal booths erected in city squares and on vacant lots. In 2013 I saw a city that has made a full recovery, with a vibrant economy, close to full employment and a people cautiously optimistic about their prospects. And so what did I observe this year, 2017, after several years of Western sanctions? Is it a place “in tatters,” as Obama would have it, or something else entirely? [2608 words]

Trump Trolls America

G-20

A remarkable meeting took place last week—the first face-to-face meeting between Trump and Putin—and I would be remiss not to comment on it. In viewing videos of the meeting (the few snippets shot during the brief seconds when journalists were allowed to stampede into the room, pushing and shoving) it became clear to me that these two people connected quite well, finding in each other an intelligent and sympathetic interlocutor. Many people would find this characterization strange. It is common to see in Putin an inscrutable, cryptically menacing cipher, and in Trump a chaotic, bloviating buffoon. In a sense, they are right, but only on the surface. That surface, in the case of Putin and in the case of Trump, consists of a carefully synthesized public persona honed over many iterations and practice runs. For each of them, it has been conditioned by the specifics of Russia and the US, respectively: what the people there respond to well, what they expect and what they are capable of. The specifics of their public personae and what conditioned them are interesting in their own right. But what’s really important is what lies beneath them… [2240 words]

Nature’s Conquest of Man

Simon Norfolk

For a little over four centuries now, starting in the 1600s, the dominant narrative in the West has been “Man’s Conquest of Nature.” From there it spread around the globe as “Man” (in a rather specific sense of various gentlemen and their servants) vanquished all who stood before him. And even now, as the West enters its senescence, torn apart by internal conflicts, failing demographically, overrun by migrants from a wide assortment of failed states and courting environmental disaster at a planetary scale, it remains the steadfast belief of victims of public education around the world that “the purpose of nature is to serve man.”

This belief is at odds with nature because, as it turns out, in the natural scheme of things the function of man is to be eaten, and of a lucky few to accidentally become fossilized. These days many of us are turned into ash, to save space—a wasteful process, biologically speaking—but normally, if disposed of underground our destiny is to feed the worms, the bugs, and other decomposers, while if left to rot on the surface the crows, the vultures, the rats and various other scavengers are only too happy to oblige.

Put into proper perspective, eating us up isn’t even that big a task. Fed through a compactor and stacked in 1-ton cubic blocks, all of humanity would fit into a cube a bit less than 1 kilometer on the side. Spread evenly over the entire surface of the Earth, we would form a film barely 1 micron thick—undetectable without special equipment and short work for the planet’s microscopic biota. Compare that to the thick microbial mats which gave rise to the crude oil deposits which we are currently burning through at breakneck speed: the average human burns through eight times his body weight in crude oil every year.

It is the crude oil, along with coal, natural gas and uranium, that multiply our puny power to a point where the results of our activity become visible from outer space over large stretches of the planet’s surface. Crunching the numbers, it turns out that burning crude oil allows us to multiply our physical, endosomatic energy by roughly a factor of 44,000,000. Add in coal, natural gas and uranium, and you get roughly a hundred-thousand-times amplification of our puny physical powers. It is this that has enabled man’s recent, and short-lived “conquest of nature.” Without fossil fuels the best exosomatic energy we can harness is a team of two horses, oxen, water buffalo or what have you. Any more than that becomes hard for a single human to handle. The horses and other large ruminants multiply our power by a factor of 15 or so. But that, if you think really hard, is plenty.

It is known that the hundred-thousand-times fossil-fuel-based amplification of our meager physical powers is going to dwindle over time, leaving us with a couple of horses to fall back on—if we are lucky. Going from hundred-thousand-fold to fifteen-fold is surely going to come as a shock for some people, causing them to claim that this will spell the end of human civilization. Others claim that human civilization is doomed because burning roughly half of all the recoverable fossil fuels in just a couple of centuries has destabilized the climate. As if that’s not enough, Prof. Guy McPherson boldly predicts that humans will be extinct by January 1, 2026 (which falls on a Wednesday). And at the extreme far end of the spectrum of luminaries spouting dire predictions we find Prof. Stephen Hawking. Listening to the radio, I recently heard him proclaim, in his vintage robotic voice, that Trump opting out of the Paris Agreement on Climate Change may end up making Earth resemble Venus, with lava fields and rains of sulphuric acid. He said that we better get cracking on building space colonies if we want to survive.

I vehemently disagree with pretty much all of the above. To find out where I stand, and, more importantly, to figure out where you stand, please continue reading... [2266 words]