Sunday, August 9, 2009

August 9 2009: Renewable Redundancy


Harris & Ewing Renewable Energy 1915
Francis Sayre Jr., baby, with Woodrow Wilson.
The President and new grandson, less than a year after the death of his wife Ellen.


Ilargi: As Stoneleigh delves deeper into renewable energy issues, let me ask you just this one thing: how renewable would you reckon debt is? For the US government, I gather, not all that much. Why else would they want more all the time? They're asking Congress to raise the debt ceiling yet again, and, as you might have guessed, they say it's for the greater benefit of the people and that highly valued democratic system they live in.






Stoneleigh: The Automatic Earth has received quite a number of viable renewable energy questions lately, particularly with regards to my own personal energy strategy. People have also asked why I work in grid connections for renewable energy, given that I do not believe we are going to see a wholesale societal conversion to renewable power as fossil fuels deplete (see Renewable Power - Not in Your Lifetime). Someone even suggested I was facilitating something I knew would not work. That, however, is not the case. Please allow me to explain.

Renewable power will never be able to run an energy-profligate industrial society such as the one most of us have grown up in, due to, among other reasons,
  • low energy density,
  • low EROEI,
  • intermittency,
  • lack of energy storage capacity,
  • mismatched supply and demand profiles,
  • poor grid infrastructure,
  • inability of distributed renewable energy to sustain grid operational parameters,
  • looming financing difficulties,
  • receding horizons,
  • inability to scale up RE production before the credit crunch puts the brakes on
  • etc. etc.

Still, that does not mean renewable energy (which I'll from now on refer to as RE) has no value. On the contrary, it has the potential to be extremely valuable to those who install it while it is still possible to do so, although debt must be avoided and, as several readers have pointed out, maintenance may well be a significant problem as parts and expertise may not be locally available. It is a matter of knowing what renewable power can and cannot do and making the most of the latter while not pinning our hopes on the impossible. It reminds me of a passage I came across, which ran something like this:

Grant me the strength to change what I can, the serenity to accept what I cannot change, and the wisdom to know the difference.

There is an important distinction to make between grid-tied and stand-alone RE systems. For household-scale RE systems I think grid connection generally makes little sense. Some jurisdictions pay a premium for renewable power, especially if it is generated by very small systems, and this may tempt some people.

Here in Ontario for instance, rooftop solar less than 10kW will be paid about 80 cents/kWh (about 10 times what is paid for conventional energy sources). However, the income will be taxable and the ability to earn an income may also result in an increase in property taxes. In Ontario this is not yet the case, but only because the property tax agency (MPAC) is reactive, not proactive. It is entirely possible that homeowners could make very little money after tax.
 
In addition, premium payment programs may require renewable generators to sell all the power they produce to the grid and then obtain their own supply back from the grid, with no potential for storage and use of their own power during blackouts. This is a serious compromise to make, as back-up power is a major advantage of owning renewable power generation. If the only advantage is to be the -potential- money made, and most of that could be clawed back in taxes, then there would be little point in installing a system. 

A grid connection could also allow power generated to be commandeered without payment ‘for the public good’ in times of crisis. This is unlikely to happen soon, but as mains power becomes increasingly unreliable in a collapsing economy, circumstances may change. The premium payments that are supposed to be guaranteed for 20 years could easily be repudiated if they become a political liability.
 
For larger systems, such as farm-based or community power projects, a grid connection may well be necessary in order to make best use of the generation potential in supplying a larger area. For instance, a farmer supplementing his dairy manure with off-farm organic wastes could generate 500kW from methane produced through anaerobic digestion, and this would exceed farm-load considerably. He could use a grid connection to supply many close neighbours, and be paid a premium price for his power.

Taxes would still be an issue though, as would the debt that most would need to incur in order to finance the construction of such a project. Grid reliability is likely to be much reduced in the future, but even unstable areas generally have some power, so exporting power to neighbours could still be viable intermittently. The importance of storage, of gas or electricity or both, would increase significantly under those circumstances.
 
Alternatively a farmer could design a smaller system using only his own on-farm waste streams to supply only his own load. It would be harder to find the money for construction without an income stream, and some components would have to be oversized in order to cover demand peaks, further adding to the cost. A farmer who could afford to do this would have a secure source of power, assuming at least some maintenance expertise and access to parts, and could therefore be able to continue producing food - and electricity-. Of course, finding someone who could afford to buy his produce could be difficult, as it was during the Great Depression, but not producing food has its own obvious consequences.
 
There is no guarantee that building an RE project will provide what the owner is looking for, given all the confounding factors approaching once the credit crunch resumes, but doing nothing is risky too. People will have to choose the risks they feel they can live with. In general, minimizing demand before attempting to provide supply is a good idea.

For a stand-alone project, supplying only the essentials will be most cost-effective. Obtaining spare parts in advance and learning how to install them independently is highly advisable. Building a robust system with as few moving parts and complex components as possible would be best, but complex components are hard to avoid. Energy storage will be an essential component. Back-up power will probably be called for.
 
Cash reserves for maintenance costs would help, assuming parts and expertise are available, which they probably will be in some areas and not in others. In some ways renewable power is best regarded as a bridge between our current comfortable reality and a much less comfortable lower energy future.  For those who can afford them (a small minority unfortunately), these systems can buy some time to make mental and physical adjustments to a new reality.
 
Our own 3kW solar array is not grid connected. It will continue to operate in a stand-alone manner, feeding the battery bank that runs the essential loads 24/7. It was installed for the power, not in order to produce an income. The essentials (well pump, sump pump, circulating pumps for the outdoor wood furnace and the solar thermal system, fridge, freezer, security system, minimal lighting) are powered from the batteries through the inverter.

We have six 4V Rolls Surette 4ks-25ps connected in series, which provide 1350 amphrs of battery storage. They are manufactured specifically for solar and other renewable energy applications, with dual-container construction, a ten year warranty and up to a twenty year life span. We can charge the batteries from the panels, or from a gas generator, or from a diesel generator run by the tractor, or with the mains. The batteries are meant to keep these essentials running for at least four days of no sun, no mains and no generator.

The next most important things (geothermal back-up system, furnace fan, microwave, another freezer, ceiling fans, and a few sockets) are wired into a generator panel. We can run those from the mains or with a generator if we have fuel for it.  If we have no mains power, no fuel and no sun for more than four days, we can still keep warm, heat water and cook using a 1928 kitchen wood range and two supplementary wood stoves.

We can also run radiators connected to the outdoor wood furnace, so we can distribute the heat from outside using only the circulating pump rather than the furnace fan, as the furnace fan is too large a load to run off a renewable energy system. We also have two bicycle powered generators and portable battery packs that we can use to power incidental things if necessary.

Independence in the face of great uncertainty over energy supply comes from flexibility and a degree of redundancy. Redundancy is important as one does not know quite what one will be facing, what resources will be available when, and how long one may have to cope alone. Having more than one way of doing the essentials expands the range of circumstances one can handle. There needs to be more than one way of doing essential things, so that one can adapt to changing circumstances quickly.

RE investments probably need to be made sooner rather than later, as they would tend to fall into the category of items that will not be available later, although there could be a period where they may be cheaper for those who have managed to preserve purchasing power as liquidity. The need to make such investments at today’s high prices will unfortunately restrict the number of people who are able go the RE route without taking on debt.

While one could argue that such an investment will only make one a target for confiscation or vandalism, vulnerability will depend greatly on local circumstances. These risks are real, but will not be equal everywhere, and risk cannot be avoided no matter what people choose to do. We are simply moving into a high-risk world that all of us will find acutely uncomfortable.








Geithner asks Congress for higher U.S. debt limit
U.S. Treasury Secretary Timothy Geithner formally requested that Congress raise the $12.1 trillion statutory debt limit on Friday, saying that it could be breached as early as mid-October. "It is critically important that Congress act before the limit is reached so that citizens and investors here and around the world can remain confident that the United States will always meet its obligations," Geithner said in a letter to Senate Majority Leader Harry Reid that was obtained by Reuters.

Treasury officials earlier this week said that the debt limit, last raised in February when the $787 billion economic stimulus legislation was passed, would be hit sometime in the October-December quarter. Geithner's letter said the breach could be two weeks into that period, just as the 2010 fiscal year is getting underway. The latest request comes as the Treasury is ramping up borrowing to unprecedented levels to fund stimulus and financial bailout programs and cope with a deep recession that has devastated tax revenues.

It is expected to issue net new debt of as much as $2 trillion in the 2009 fiscal year ended September 30 and up to $1.6 trillion in the 2010 fiscal year, according to bond dealer forecasts. The request to increase the debt limit will likely raise the ire of Republicans who have accused President Barack Obama of runaway spending. They may try to hold up the legislation in effort to win concessions on Obama's health care reform plan.

Geithner urged Reid to not let politics hamper U.S. credit-worthiness and said he looked forward to working with the Nevada Democrat to secure enactment of legislation on the debt limit as early as possible. "Congress has never failed to raise the debt limit when necessary. Because members of both parties have long recognized the need to keep politics away from this issue, these actions have traditionally received bipartisan support," he wrote. "This is clearly a moment in our history that calls for continuation of that tradition."




Job Growth Lacking in the Private Sector
For the first time since the Depression, the American economy has added virtually no jobs in the private sector over a 10-year period. The total number of jobs has grown a bit, but that is only because of government hiring. The accompanying charts show the job performance from July 1999, when the economy was booming and companies were complaining about how hard it was to find workers, through July of this year, when the economy was mired in the deepest and longest recession since World War II.

For the decade, there was a net gain of 121,000 private sector jobs, according to the survey of employers conducted each month by the Bureau of Labor Statistics. In an economy with 109 million such jobs, that indicated an annual growth rate for the 10 years of 0.01 percent. Until the current downturn, the long-term annual growth rate for private sector jobs had not dipped below 1 percent since the early 1960s. Most often, the rate was well above that.

As can be seen from the charts, there were some areas of strength in the economy. Health care jobs continued to grow, particularly jobs that involve caring for the elderly. Home health care employment rose at an annual rate of 5 percent, a rate that indicates a total gain of more than 60 percent. On an annual basis, that was twice the overall rate for health care of 2.4 percent a year. There were also job gains in education and in a host of service industries, including lawyers (0.7 percent a year), accountants (0.9 percent) and computer systems designers (2.4 percent). The field of management and technical consulting leaped at an annual rate of 5 percent.

But while designing computers and related equipment was a growth field, building them was a very different story, as the manufacturing shifted largely to Asia. The number of jobs making computer and electronic equipment in the United States fell at an annual rate of 4.4 percent, substantially more than the overall decline in manufacturing jobs, of 3.7 percent. That was a better showing than that of the automakers, which shed jobs at a rate of 6.7 percent a year. By contrast, auto dealers cut jobs at a much slower rate of 1.3 percent a year, although that rate may accelerate later this year as General Motors and Chrysler dealerships are closed.

Hard as it may be to believe, the consumer economy of the United States actually lost retail jobs over the decade, at a rate of 0.2 percent. There were fewer people working in food stores. But the category of general merchandise stores — like Wal-Mart and Costco — showed an impressive gain of 1 percent a year, even though the category also includes department stores like Macy’s, where the number of jobs has fallen. For a good part of the decade, the construction business was a growth industry. But there are now fewer jobs there than there were a decade ago.

The total picture is of an economy that has changed in substantial ways over the decade. After the recession ends, job growth is likely to resume. But there is no indication that the secular trend toward a more service-oriented economy will reverse. A decade from now, there are likely to be still more jobs at architecture and engineering firms (up 1.2 percent a year over the last decade) and at bars and restaurants (up 1.8 percent a year). But few expect that manufacturing will reverse its long decline as a major employer in the United States.










Alabama's Jefferson County lays off two-thirds of its workers
Alabama's debt-ridden Jefferson County laid off about two-thirds of its 3,600 employees on Monday because of plummeting revenues, a move that will sharply curtail services in areas ranging from roads to courthouses. The cuts are just the latest blow to Jefferson, whose population of 660,000 includes Birmingham, the state's largest city and its economic powerhouse. They come after the county racked up around $4 billion in debt by using exotic financial instruments to fund a revamp of its sewer system.

The work-force cuts will hit the roads and transportation, revenue and security departments, and reductions will also affect the courthouse and information technology department as well as laborers paid on an hourly basis, according to a senior county official. One senior county employee said his land development department was slashed from 29 employees to just eight but they were nevertheless adjusting, a process eased because there were fewer queries from the public on Monday.

"Our traffic has slowed (because) ... people are following the news. People did not take a chance by waiting until this week to do their business," said Bo Duncan, deputy director of land development at the county. "We are having to make do," he said. For some families, the layoffs were particularly hard, he said, adding he knew one family in which both husband and wife had lost their jobs.

Jefferson County has been forced to make drastic cuts because of a lawsuit questioning the legality of a county occupational tax, which raised $78 million annually and was vital to the county's operation. Although the revenue is still being collected, it is being held in escrow under orders from an Alabama Supreme Court justice pending a decision on the tax case. Some members of the state Legislature hope to pass a new tax bill this month to raise revenue for Jefferson County. County workers placed on administrative leave under the cuts will be entitled to unemployment and some health-care benefits and will be called back after 45 days, according to a senior county official.




Guess What? Unemployment's Really at 16.3 Percent
How is it possible for the unemployment rate to essentially remain unchanged when 247,000 jobs have been lost? Because the number of people who gave up and stopped looking for work rose dramatically. The announcement today that the unemployment rate declined slightly to 9.4 percent in July while only 247,000 additional jobs were lost has been greeted as good news.  The change in the unemployment rate puts the rate at what it was in May. Yet, even a rough look at the numbers indicates that the true unemployment rate has been getting significantly worse over the last few months.

How is it possible for the unemployment rate to essentially remain unchanged when 247,000 jobs have been lost?  The reason is simple -- the number of people who stopped looking for work rose dramatically.  Six hundred thirty-seven thousand additional people no longer consider themselves looking for work. This is by far the largest drop in the number of people who consider themselves in the labor force during the last year. -- It is almost twice the 358,000 increase in the people who left the labor force during June and almost four times the average monthly increase of 167,333 over the last year.  

Jobs are sufficiently scarce and the prospects of people finding them at wages that they are willing to work for so low that many individuals don't think that it is worth their time to even look for a job.   Part of the drop in unemployment is also due to the fact that some people are running out of unemployment benefits and taking part-time jobs.  There is usually a big increase in the rate that people find jobs during the last few weeks that they have unemployment benefits.  In July 102,670 people saw their unemployment benefits run out. That number rose to 141,538 in August and is expected to soar to 486,049 in September.  

It will keep on rising each month hitting 1.5 million in just December alone.  This past Sunday on ABC's "This Week" Treasury Secretary Tim Geithner only promised "to look very carefully at [these lost benefits] as we get closer to the end of this year." Larry Summers, President Obama's chief economic advisor, was similarly noncommittal when he was interviewed that same day on CBS's "Face the Nation."

If we include the normally counted number of unemployed as well as those who have recently given up looking for work and those who have taken a part-time low paying job because they can't find full-time work, the implication is that the unemployment rate for July would be at 16.3 percent These discouraged workers will again look for work once the economy starts to improve, but this 6.9 percentage point gap between publicly discussed unemployment rate and these discouraged workers is unusually large.

The changes in unemployment also mask the large drops that are still occurring in private employment -- construction, manufacturing, retail trade, and professional and business services all suffered large declines.  The two of the three areas where employment has increased are government related, either education and health services or general government employment.

These changes do coincide with what is happening with GDP.  During the second quarter the private sector kept on shrinking at an annual rate of 3 percent.  Overall, GDP declined by "only" 1 percent at an annual rate, but that was because real federal government consumption expenditures and gross investment soared by 11 percent. Real state and local government consumption expenditures and gross investment increased, too, but by a more modest 2.4 percent. The large and growing number of discouraged workers will make the real unemployment rate hard to bring down in the future




Max Keiser on US Unemployment Numbers




How To Blow A Bubble
by Simon Johnson

Matt Taibbi has rightly directed our attention towards the talent, organization, and power that together produce damaging (for us) yet profitable (for a few) bubbles.  Most of Taibbi’s best points are about market microstructure – not the technological variety usually studied in mainstream finance, but more the politics of how you construct a multi-billion dollar opportunity so that you can get in, pull others after you, and then get out before it all collapses.  (This is also, by the way, how things work in Pakistan.)

In addition, of course, all good bubble-blowing needs ideology.  Someone needs to persuade policymakers and the investing public that we are looking at a change in fundamentals, rather than an unsustainable and dangerous surge in the price of some assets.

It used to be that the Federal Reserve was the bubble-maker-in-chief. In the Big Housing Boom/Bust, Alan Greenspan was ably assisted by Ben Bernanke – culminating in the latter’s argument to cut interest rates to zero in August 2003 and to state that interest rates would be held low for “a considerable period”.  (David Wessel’s new book is very good on this period and the Bernanke-Greenspan relationship.)

Now it seems the ideological initiative may be shifting towards Goldman Sachs.

As Bloomberg reported on August 5th, “Goldman economists, led by Jan Hatzius in New York, now see a 3 percent increase in gross domestic product at an annual rate in the last six months of this year, versus a previous estimate of 1 percent. The new projections were included in a research note e-mailed to clients.”

Goldman’s public thinking, of course, has been that we face such slow growth that interest rates should be kept low indefinitely.  There is, in their view, no risk of inflation – and no such thing as potentially new bubbles (e.g., in emerging markets).  The adjustment process will go well, as long as monetary policy stays very loose – it’s back to Bernanke’s 2003 line of thinking.

This line of reasoning has been very influential – reinforcing Bernanke’s commitment not to tighten monetary policy in the foreseeable future and fitting in very much with the Summers model of crisis recovery.  Just a couple of weeks ago, in his July 14 report, Jan Hatzius argued, “further stimulus remains appropriate” and “the appropriate debate is not whether fiscal and monetary expansion is appropriate in principle but whether it has been sufficiently aggressive.”  I don’t know if he has revised this line in the light of the big upward revision in his growth forecast or whether he is still saying, “Ultimately, we do expect further stimulus, but it may take significant disappointments in the economic data and the financial markets before policymakers move further in this direction.”

Much faster growth than expected is, of course, in today’s context a good thing.  But it also brings complications.  If you keep monetary policy this loose for much longer, you will feed bubbles.  And if you encourage even looser monetary and fiscal policy, there will be a costly reckoning not too far down the road.

Monetary policy orthodoxy under Greenspan did not care about bubbles in the least.  Now we (led by Greenspan) have massively damaged our financial system, our real economy, and our job prospects, this view is under revision.

Of course, in principle you should tighten regulation around lending but, just like 2003-2007, who is really going to do that: the US, China, the G20?  On this point, all our economic leadership is letting us down – although they are getting a powerful assist from people like Goldman (and Citi and JP Morgan and almost everyone else on Wall Street.)

Next time, our big banks will take another massive hit – quite possibly bigger than what we saw in 2008.  Goldman and its insiders are ready for this.  Are you?





Congress may extend unemployment benefits
The U.S. Congress will consider extending unemployment benefits after it returns in September to help 1.5 million Americans who risk exhausting them, Senate Majority Leader Harry Reid said on Friday. "Soon after Congress returns to Washington we'll need to address this matter," Reid said. "There is an economic case to be made for extending unemployment benefits." The unemployment rate eased to 9.4 percent in July from 9.5 percent the prior month, according to Labor Department data released on Friday. It was the first time the U.S. jobless rate has fallen since April 2008.

But the number of long-term unemployed continues to rise as the country struggles with the longest recession since the Great Depression of the 1930s, and many analysts attributed the dip in July to people giving up the job hunt. Data ranging from home sales to manufacturing have pointed to an economic revival, but the unemployment rate is expected to remain high, which could lead to an anemic recovery. Obama administration officials say they still expect the unemployment rate to reach 10 percent this year.

As of July 25, 6.31 million people were collecting long-term unemployment benefits, according to Labor Department data. Some 1.5 million of those people could exhaust those benefits by the end of the end of the year, according to the National Employment Law Project. "We must help those who are suffering as a result of an economic crisis they did not create," Reid said.

Congress has already extended unemployment benefits for up to 79 weeks and Obama administration officials and Democratic leaders in the House of Representatives have said they will work to extend them further. But that could widen the already yawning budget deficit, which shot up another $300 billion in July to reach a record $1.3 trillion for the first 10 months of fiscal 2009, according to the Congressional Budget Office.

The CBO expects the budget deficit to top $1.8 trillion for the fiscal year which ends September 30, in large measure due to a $787 economic stimulus bill passed by Congress in February. Polls show rising public unease with the record deficit and Republicans have sharply criticized it. "Instead of seeking new ways to expand the government, this Congress needs to get back to the basics of deficit reduction," Republican Senator Judd Gregg said in a statement.




Nine Roadblocks to a Bull Rally
Before the bulls break out the champagne here, I would warn them not to get too far ahead of themselves.

After all, euphoria is a dangerous emotion that can lead to big losses — in this market, or in any other, for that matter.

And as for Dennis Kneale's breathless prediction that the "recession is now over," the picture on that score is about as clear as mud. . . the U.S. Economic Outlook is murky, to say the least.

What is crystal clear, however, is that our problems are actually getting worse, not better. Fundamentally, is as bad as it has ever been — even though the bulls have broken out the party hats, insisting that somehow the markets really can grow to the sky.

Of course, we know otherwise. If only it were so. . .

Instead, I'm firmly in the camp that believes a "new normal" has begun, and it's based more upon frugality more than frivolity.

That's because as unemployment surges, home prices continue to drop, and more wealth evaporates, consumers are more likely to try a least to live within their means. . . no matter how hard that may be.

As a result, without an uptick in jobs and a boost in income, a repeat of the debt-financed binge we just lived through simply isn't going to happen.

It can't be recreated either — even though the Fed is trying its best to do just that.

So, what we're essentially left with is a classic case of a reluctance to borrow or consume: a big problem, since that is what the lion share of the U.S. Economy has been based on since 1982.

As a result, we have too many cars, we have too many houses, and we have too many debt holders teetering on the brink.

What we don't have — or what we have a lot less of — are people with the cash flow to support it all. Sure, money still exists and there is lots of it, but it has very little velocity when a nation of "Good Time Charlies" suddenly turns frugal.

That being said, I thought we would play a game of connect the dots today as we view the current rally not only with awe, but also a deep-seeded suspicion.

Here are nine reasons why the champagne will have to stay on ice for the time being. . .

9 Hurdles to the U.S. Economic Outlook

1. The Wealth Effect in Reverse

During the heydays, rising asset prices were all it took to get consumers to spend themselves into deeper into debt. However, these days the reverse is actually true.

Because according to the Federal Reserve, U.S. household net worth fell by $1.3 trillion in the first quarter, proving that green shoots are something of a fairy tale — at least for the American consumer.

In fact, since its peak in the third quarter of 2007, household wealth has decreased by 21.6%, or more than a fifth. That is the most dramatic fall in the series since reporting began more than 50 years ago.

Yet somehow, the bulls keep pounding the table, saying there is light at the end of the tunnel, even though consumer spending is over 70% of the U.S. GDP. The truth is when taking huge losses, belts usually get tightened, not loosened.

2. The Heavy Chains of Debt

Meanwhile, consumer debt is still off the charts. In fact, household debt as a proportion of disposable income hit 133% as the recession began. Since then it has eased a bit to 128%, but its still way too high — not to mention unsustainable. At minimum, consumer debt should be 100%, and even that is a slippery slope.

By comparison, the consumer debt level coming off of the tech bubble in 2003 was around 85%, which tells you where all that "growth" came from: Households levered up. This time that's impossible — for a whole host of reasons. So the while the FED has cut this rate to zero, it hasn't done much to get people to the mall this go-round. . .

So just looking at it from a balance sheet perspective, either wages have rise quite a bit or debts have to be reduced dramatically. Otherwise the numbers for the average consumer just won't add up.

3. Rising Unemployment

On a day when the stock market shot up by more than 250 points two weeks ago, the Fed minutes from June were quite a bit more sobering. Unemployment, according to the Fed, will top 10% this year. . . while most Fed policy makers said it could take "five or six years" for the economy and the labor market to get back on a path of full health in the long term.

So it looks like 2015 will be the year to look forward to. At best, the recovery will be jobless — which makes you wonder how it could be called a recovery at all.

Here's betting unemployment tops 11%.

Meanwhile, 7.2 million people have lost their jobs since December 2008, making this the only recession since the Great Depression to wipe out all of the job growth from prior periods of expansion:

unemployment

By the way, the real unemployment rate, or U-6, is 16.5% It accounts for those poor folks who are unemployed but are so discouraged that they have stopped looking.

4. Tax Revenues are Plummeting

California's fiscal woes are only the tip of the iceberg. Falling tax revenues in 45 of the 50 states have left all of them facing fresh budget shortfalls.

In fact, according to a recent report from the Rockefeller Institute of Government, tax collections dropped by 11.7 % the first quarter — the largest fall on record. Meanwhile, early figures for April and May show an overall decline of nearly 20 per cent for total taxes. That will undoubtedly reduce demand and slow down the recovery, since government spending accounts for 18% of U.S. GDP:

state taxes

As for the Federal government, there has been a 22% drop in individual tax receipts so far this year, along with a 57% drop in corporate taxes.

In short, while the government is always out of money, it has never been close to this bad. Without the printing presses, we would already be bankrupt.

5. Rising Prime Mortgage Defaults

Remember when subprime mortgages began to blow up? Of course you do. . . that's old hat at this point. Today, those defaults have moved right on up the value chain.

Delinquency rates on the least risky mortgages more than doubled in the first quarter from a year earlier, as prime mortgages 60 days or more past due climbed to 2.9 percent through March. Serious delinquencies on prime loans, which account for two-thirds of all U.S. mortgages, rose to 661,914 in the first quarter from 250,986 a year earlier. Meanwhile, mortgages 60 days or more past due rose 88 percent from last year.

The good news is this is the last of the mortgage dominoes. After prime mortgages, there's nothing left to fail. Unfortunately, this is the biggest domino of them all.

6. Oh, but Wait. . . I Forgot about Option ARMs

As my pal Ian Copper has been writing for some time now, Option ARM resets will be tougher for the economy to handle than subprime and we will see greater numbers of bank failures, foreclosures, delinquencies, and economic hardships because of it.

What should concern you is that about $750 billion worth of option ARMs were issued between 2004 and 2007 and will begin resetting shortly. Worse, as of December 2008, about 28% of option ARMs were either delinquent or in foreclosure, according to reports.

But here's the kicker: nearly 61% of option ARMs originated in 2007 will eventually default, according to a Goldman Sachs report. And due to the way these mortgage nightmares are structured, the rest of them won't fare much better.

61%??? That's enough to make a banker take a leap.

7. Next Up: The Credit Card Debacle

According to reports earlier this month, credit card losses are continuing to accelerate with Capital One reporting that write-offs have reached 9.4%. . . with no end in sight. Meanwhile, American Express Co. (AXP), the largest U.S. credit card company by purchases, wrote off 10 percent of its own loans.

Simultaneously, revolving credit totaled $939.6 billion in March and the Federal Reserve reported that 6.5 percent of it was at least 30 days past due. That is the highest percentage since the Fed began tracking this number back in 1991.

What has evolved is an environment where banks are much less eager to hand out the plastic, since the business isn't exactly what it used to be. And as a result, banks sent out only about 500 million credit card solicitations in the first quarter. That is fewer than in any year since 2000, as overall available credit shrinks.

And when the credit card swamp finally gets drained, a "new normal" will be here to stay.

8. The Commercial Real Estate Crash

At this point in the cycle, most people recognize that commercial real estate is following the same exact path as the housing bubble — the exact same path!

And we all know how that one turned out.

In fact, losses on commercial loans could reach as high as $30 billion by the end of the year as property values plummet, rents decline, and defaults reach record levels. All of this is a recipe for disaster. . . and industry leaders have estimated that 200,000 businesses and 10 percent of the nation's shopping malls will shut their doors over the next year.

That means that we're maybe only in the second inning here as this crisis unfolds.

So, with roughly $530 billion in commercial mortgages coming due for refinancing in 2009-2011, and some estimates showing that as many as 68% of loans maturing during that time will FAIL TO QUALIFY for refinancing, you have to wonder how it will all get done.

The short answer is. . . it won't.

In fact, as Federal Reserve Bank of Atlanta President Dennis Lockhart said earlier this year, the mortgage bonds due this year and next "are coming up against capital markets not active enough to deal with those maturities."

When that happens. . . big companies go under.

9. The Ghost in the Machine

Here's a chart that speaks for itself. It is a measure of U.S. Industrial capacity that shows almost one third of US industry is now sitting idle:

cap utilization

Enough said.

Now if there is a pony somewhere in all of that mess, I just can't find it. And I haven't even brought up the prospect of higher taxes through cap and trade, or what a massive health care package will do to small businesses.

Meanwhile, I think we are going to find out this fall that the government doesn't have any of the answers after all.

Besides, violent bear market rallies are entirely commonplace. In fact, some of strongest occurred after Black Monday in 1929.

Take a look:

bear market rallies

So while the bulls have had their way here lately, the bigger picture lurks in the background.But to see it, you have to have the courage to connect the dots.

That means that now, more than ever, it's a stock picker's market — especially if you have a taste for champagne.





Colonial BancGroup faces criminal probe, FDIC action
Colonial BancGroup Inc said it faces a criminal probe by the U.S. Department of Justice (DoJ) related to accounting irregularities at its mortgage lending unit, and the struggling lender warned it may be put under receivership. In a regulatory filing, the company said the Alabama State Banking Department may appoint the Federal Deposit Insurance Corp as receiver or conservator for its banking unit after August 12.

Earlier this week, the agency that investigates misuse of U.S. banking bailout money raided Colonial's mortgage warehouse lending division in Orlando, Florida. The U.S. Securities and Exchange Commission also issued subpoenas to the company seeking disclosures related to its participation in the U.S. Treasury Department's Troubled Asset Relief Program (TARP) and its accounting for loan-loss reserves.

Colonial announced in December that it was to receive $550 million in TARP money. Shareholders subsequently filed a class action lawsuit accusing Colonial of failing to disclose that the TARP money was contingent on the company raising $300 million in private financing. Taylor, Bean and Whitaker Mortgage Corp, the 12th-largest U.S. mortgage lender, had offered $300 million to help keep the troubled Montgomery, Alabama-based lender afloat, but the agreement fell apart last week.

In the following week, Taylor Bean shut down its mortgage lending operations after the Federal Housing Administration barred it from making loans that the agency insures. The DoJ's allegations of irregularities relate to more than one year's audited financial statements and regulatory financial reporting, Colonial said in the regulatory filing. Colonial said it intends to cooperate with the investigation.

The company operates 355 branches in Florida, Alabama, Georgia, Nevada and Texas and has over $25 billion in assets. If it fails, it would be the largest failure this year. The company said it continues to explore all possible capital-raising alternatives to comply with the regulatory orders. Colonial did not immediately return calls seeking comments. The State of Alabama Banking Department and the FDIC, which insures deposits of up to $250,000 per account, declined to comment.

In June, the banking unit had agreed to a cease-and-desist order with regulators, requiring the bank to increase capital levels and reduce problem assets, among other things.
The company has been badly battered by the credit crisis, as higher charge-offs and rising foreclosures in the bank's Florida construction-loan portfolio continue to strain its balance sheet. The company's shares, which have lost 90 percent of their value in the past year, were down 19 percent at 57 cents in morning trade on the New York Stock Exchange. The stock traded as high as $13 in September last year.




Angry Americans disrupt town-hall healthcare talks
At scattered events across the United States, protesters are confronting members of Congress whose summer "town hall" meetings aim to get a sense of how Americans feel about overhauling healthcare. Boiling Springs in South Carolina -- population 4,500 -- was true to its name on Thursday, giving U.S. Representative Bob Inglis a taste of rising anger among conservative voters toward President Barack Obama's reform plan.

"There is no way, shape or form we need to have a national healthcare system. No! Nothing! None! It's got to stop now," said one man who addressed the audience of 300 people to sustained applause. The plans seek to provide coverage to nearly 46 million uninsured Americans and bring down healthcare costs. Conservatives say they will lead to a nationalized healthcare system where government, rather than doctors, will make medical decisions. They say the plans will end up costing them more and boost the federal deficit.

With lawmakers gone from Washington for a month and much of the plans still to be drafted, the rancorous battle has spread to usually staid, relaxed town hall meetings. A chorus of people in the audience heckled, shouted down and interrupted Inglis, a Republican, even as he tried to explain why he opposed the plans put forward by Obama, a Democrat who became president six months ago.

"I consider myself just an average American but there is not a day or a week that goes by that I don't hear talk about revolution in our country because (of) the government," said a man who called himself a "conservative, mainstream American." "We (the United States under Obama) have gone so far out of the Constitution," he said to a standing ovation. Other speakers asked about "martial law" and "forced vaccinations" and when the topic turned to illegal immigrants in the Bible Belt town, someone shouted: "Bus them home."

Last week, a crowd in Philadelphia directed boos at Obama's Health and Human Services secretary, Kathleen Sibelius, and Democratic Senator Arlen Specter. Protesters disrupted another meeting on Thursday in Tampa, Florida, with cries of "tyranny," and police made arrests at a similar meeting in St. Louis, Missouri. Opinion polls show that many Americans feel the U.S. healthcare system, the costliest in the world, is in need of reform. They also show millions of Americans with health insurance are satisfied with it.

A group called the Tea Party protesters -- named for the Boston tax revolt that helped spark the American Revolution -- has launched a campaign to disrupt Democratic town hall meetings on healthcare. "Public opinion is the only way the Republicans can stop this," said James Ceaser, a political science professor at the University of Virginia. "They need to check Obama's momentum."

Around a thousand miles northwest of Boiling Springs -- in Oconto Falls, Wisconsin -- the mood was different. Vic Bast, 86, a World War Two fighter pilot and retired school principal, attended a meeting with Democratic Congressman Steve Kagen. "I'm a veteran, so I have good healthcare. But my daughter has just retired and she has to pay $1,000 a month in premiums," Bast said. "Healthcare costs are getting out of control. I don't know if this bill will pass, but something must be done."

"We are engaged in the most critical debate in our country in this century," Kagen told Reuters after meeting around 50 constituents in the dairy farming community of around 2,800. "We don't have an option, we have to reform or this country will go broke," he said, but added: "People in my district are afraid of what they don't know, which is why I'm here." Kagen's district tends to vote Republican and he is the target of radio advertisements attacking his policies in an attempt to undermine support for his reelection bid in 2010.

In Boiling Springs, Inglis was repeatedly interrupted when he said government could in some cases play a positive role in people's lives -- a sign that conservative anger could potentially threaten some Republicans as well as Democrats. A few people waved pink slips to suggest he should lose his job and a banner read: "Inglis loves big government." Aides praised Inglis for standing his ground. The lawmaker later told Reuters the mood at one town hall meeting did not reflect the entire district.

"Fear is driving people to the extremes," he said. "Tonight we had people that are very fearful about President Obama and very distrustful of him as a person and his agenda." White House spokesman Robert Gibbs urged that people go on discussing the issues but without the rancor. "It's important that people be civil. We can discuss these issues without being uncivilized. It's the same thing I tell my 6-year-old," he told reporters on Friday.




U.K. Insolvencies, Liquidations Soar
Company liquidations and individual insolvencies in England and Wales soared to record levels in the second quarter as the economy was throttled by recession and the global credit crisis, data from the government's Insolvency Service showed Friday. There were 33,073 individual insolvencies in the second quarter on a nonseasonally adjusted basis, the highest level since records began in 1960. That compared with 30,253 in the first quarter of this year and marked a 27.4% increase from the second quarter of last year.

Company liquidations totaled 5,055 on a seasonally adjusted basis, the highest level since that series began in 1998. That was 2.9% above the total seen in the first three months of this year and represented an increase of 39.1% from the second quarter of last year. Andrew MacCallum, managing director at restructuring and turnaround firm Alvarez and Marsal, said companies had survived the past year by significantly cutting costs, but many were now exhausted financially just as some positive signs on the economy were emerging.

"More than five thousand companies may have gone into administration in the last quarter, but we can expect to see that figure exceeded in every quarter until at least the end of 2010," he said in a note. "Credit is still tight and many businesses are loaded with debt that they can't service." The breakdown of the figures showed there were 1,457 compulsory company liquidations, 6.8% less than in the first quarter but 8.7% more than in the second quarter of last year. However, voluntary corporate liquidations totaled 3,598, a 7.4% increase on the first three months of the year and 56.8% higher than in the second quarter of 2008.

Nonseasonally adjusted figures showed there were also 1,529 other corporate insolvencies in the second quarter, including a 94.9% year-to-year increase in receiverships, a 19.8% rise in company voluntary arrangements, and 9.5% gain in administrations. The breakdown of the individual insolvency figures showed the number of individual bankruptcies rose 15.3% from a year earlier to 18,870. Individual voluntary arrangements -- a formal agreement drawn up through an insolvency practitioner for an individual to repay debt to creditors -- increased 27.4% on the year to 12,225. There were also 1,978 debt relief orders.




Housing downturn will leave property the domain of the wealthy
The recession has caused a huge shift in the housing market that will lock out first-time buyers and amateur landlords and leave only wealthy families, wealthy investors and Middle East billionaires with a chance of buying. Research carried out for The Times by Savills, the estate agent, suggests that many people who need a mortgage may have to abandon hope of ever owning a home.

The research shows that in the post-downturn housing market, the sort of new-build flats snapped up by first-time buyers and small buy-to-let investors before the credit crunch will fall into the hands of cash-rich investors and young people in receipt of big parental handouts. At every stage of the new-model housing ladder, equity-rich buyers will dominate, Savills said. The number of people who own their home outright has been growing steadily for the past 15 years and stands at 6.35 million, or 45 per cent of homeowners, against 7.98 million who have bought with a mortgage, according to the Survey of English Housing.

This shift will also skew the speed and scale of recovery for different types of property in different locations. Savills expects the average house price in the UK to fall 7.2 per cent in 2009 and 3.1 per cent in 2010, before returning to growth and rising by 26.7 per cent by the end of 2014. But prices at the bottom of the market are forecast to recover by only 10 per cent by 2014, compared with 43.6 per cent for five-bed family homes in London. Yolande Barnes, head of research at Savills, said: “In places where there is a lot of equity, we will see a lot more growth. Where there is more job uncertainty and reliance on mortgages, there will be less.”

Cash-strapped would-be buyers are already being squeezed out of the running by an acute shortage of homes for sale. They are being beaten in bidding battles by buyers with more cash to put down, as sellers see them as safer. Ms Barnes added: “In the equity- starved areas, where 20 years ago people on lower incomes were able to buy and work their way up the ladder, you will find that this won’t be able to happen any more as equity-rich investors will buy homes and let them.”

The predictions come amid claims that lenders are dragging homeowners deeper into debt by forcing them to pay extra charges. The Commons Treasury Select Committee has demanded that the Financial Services Authority (FSA) cracks down on the “intolerable” fees imposed on borrowers who are struggling to meet their repayments. It also reported that, so far, only six households have been helped by the Government’s Mortgage Rescue Scheme. The Committee said the City regulator must take a tougher stance on charges for those in mortgage arrears of up to £35 for a letter and £150 for a visit from a debt counsellor.

It also accused the FSA of putting the interests of lenders above those of consumers by failing to name the firms that are under investigation. John McFall, chairman of the committee, said: “I am shocked at the length of time it is taking the FSA to complete enforcement action against firms it suspects are breaking the rules. Many thousands of consumers will have suffered and some will have lost their homes.”




Ilargi: The Economist, ever more established as the magazine for the clueless.

How long till the lights go out?
In the frigid opening days of 2009, Britain’s electricity demand peaked at 59 gigawatts (GW). Just over 45% of that came from power plants fuelled by gas from the North Sea. A further 35% or so came from coal, less than 15% from nuclear power and the rest from a hotch-potch of other sources. By 2015, assuming that modest economic growth resumes, a reasonable guess is that Britain will need around 64GW to cope with similar conditions. Where will that come from?

North Sea gas has served Britain well, but supply peaked in 1999. Since then the flow has fallen by half; by 2015 it will have dropped by two-thirds. By 2015 four of Britain’s ten nuclear stations will have shut and no new ones could be ready for years after that. As for coal, it is fiendishly dirty: Britain will be breaking just about every green promise it has ever made if it is using anything like as much as it does today. Renewable energy sources will help, but even if the wind and waves can be harnessed (and Britain has plenty of both), these on-off forces cannot easily replace more predictable gas, nuclear and coal power. There will be a shortfall—perhaps of as much as 20GW—which, if nothing radical is done, will have to be met from imported gas. A large chunk of it may come from Vladimir Putin’s deeply unreliable and corrupt Russia.

Many of Britain’s neighbours may find this rather amusing. Britain, the only big west European country that could have joined the oil producers’ club OPEC, the country that used to lecture the world about energy liberalisation, is heading towards South African-style power cuts, with homes and factories plunged intermittently into third-world darkness. In terms of energy policy, this is almost criminal—as bad as any other planning failure in New Labour’s 12-year reign (though the opposition Tories are hardly brimming with ideas). British politicians, after all, have had 30 years to prepare for the day when the hydrocarbons beneath the North Sea run out; it is hardly a national secret that the country’s nuclear plants are old and its coal-power stations filthy. Recession has only delayed the looming energy crunch. How did Britain end up in this mess?

To the extent that successive governments had a strategy, it was on the face of it an attractive one: they believed in open energy markets. Beginning in 1990, the state divested itself of control of the energy industry. Power plants were privatised and a competitive internal electricity market was set up. Whereas most continental power providers, often state-backed, tied in supplies through long-term contracts (notably with Russia), British firms happily tapped the North Sea and planned to top up as necessary on the open market. This approach for the most part kept consumer prices down, but practical problems have long been clear.

Most obviously, the rest of Europe (wrongly) failed to liberalise wholeheartedly too. The market is thus a highly imperfect one: Britain was unable to buy gas at any price in 2004 and 2005, for example. Meanwhile, without any clear guidance from the government, Britain’s electricity providers have had little incentive to start adding the sort of capacity that would help the system as a whole function more robustly—let alone diversify the sources. Tony Blair spent most of his prime ministership running around the issue of nuclear power (at the last minute deciding it was all right). Asked about energy, Gordon Brown has tended to waffle on about his (unfulfilled) ambitions for renewable energy. Nobody has been willing to discuss pipelines, terminals and power generation.

To make matters worse, the new capacity that is in the works is probably the wrong sort. With no official energy policy, the power firms look sure to go for the easiest option—building more gas plants, which are cheap, relatively clean and quick to build. Britain’s dependence on gas for its electricity seems set to rise from just under half to three-quarters in a decade. Even if this new dash for gas happens fast enough to keep most of the lights on, which is by no means certain, it would leave the country overly reliant on one power source.

Electricity prices in Britain would be tied directly to gas prices, which can fluctuate wildly. Although many sources of gas are already bound up in long-term contracts, optimists think Britain might be able to get more of it fairly easily. Norway’s North Sea reserves have life in them yet. New technology to capture gas from coalfields has recently boosted supplies, which could help keep prices down. But those sources are unlikely to meet all the extra demand, leaving Britain in a position familiar to many of its neighbours: relying on Russia. It is not just that relations with Russia are at their worst since the cold war; Mr Putin’s crew seem more interested in terrorising their customers than developing new gasfields.

With gas too risky, coal too dirty, nuclear too slow and renewables too unreliable, Britain is in a bind. What can it do to get out of it? At this stage, there is no lightning-bolt solution, but two things would prevent matters from getting worse.

The first has to do with infrastructure. Companies must be cajoled or bribed into building gas storage. At the moment there is barely a week’s worth, so there is nothing to lessen the impact of price rises and the shenanigans of foreign powers. More cross-Channel power cables would help, allowing Britain to import electricity directly from its better-supplied neighbours (and also helping create a Europe-wide power grid, thus improving security for all EU members).

Second, carbon must be taxed if firms are to invest in long-term, expensive, technology-heavy projects such as nuclear plants, cleaning up coal and taming renewable sources of power. Carbon is already assigned a price through the European cap-and-trade mechanism, but the system is focused on the short term, vulnerable to gaming and plagued by hugely fluctuating prices. A tax on carbon is hardly going to stop the lights going out in a few years, but it would provide a floor price for power, giving investors a clearer sense of likely profits. In the meantime you know who to blame.




Scientists study huge plastic patch in Pacific
Marine scientists from California are venturing this week to the middle of the North Pacific for a study of plastic debris accumulating across hundreds of miles (km) of open sea dubbed the "Great Pacific Garbage Patch."A research vessel carrying a team of about 30 researchers, technicians and crew members embarked on Sunday on a three-week voyage from the Scripps Institution of Oceanography, based at the University of California at San Diego.

The expedition will study how much debris -- mostly tiny plastic fragments -- is collecting in an expanse of sea known as the North Pacific Ocean Gyre, how that material is distributed and how it affects marine life. The debris ends up concentrated by circular, clockwise ocean currents within an oblong-shaped "convergence zone" hundreds of miles (km) across from end to end near the Hawaiian Islands, about midway between Japan and the West Coast of the United States. The focus of the study will be on plankton, other microorganisms, small fish and birds.

"The concern is what kind of impact those plastic bits are having on the small critters on the low end of the ocean food chain," Bob Knox, deputy director of research at Scripps, said on Monday after the ship had spent its first full day at sea. The 170-foot vessel New Horizon is equipped with a laboratory for on-board research, but scientists also will bring back samples for further study. Little is known about the exact size and scope of the vast debris field discovered some years ago by fishermen and others in the North Pacific that is widely referred to as the "Great Pacific Garbage Patch."

Large items readily visible from the deck of a boat are few and far between. Most of the debris consists of small plastic particles suspended at or just below the water surface, making it impossible to detect by aircraft or satellite images. The debris zone shifts by as much as a thousand miles north and south on a seasonal basis, and drifts even farther south during periods of warmer-than-normal ocean temperatures known as El Nino, according to information from the National Oceanic and Atmospheric Administration (NOAA).

Besides the potential harm to sea life caused by ingesting bits of plastic, the expedition team will look at whether the particles could carry other pollutants, such as pesticides, far out to sea, and whether tiny organisms attached to the debris could be transported to distant regions and thus become invasive species.


155 comments:

Rick James said...

Concerning the turning of the maker stoneleigh expects the market to tank this fall. However, since the main thrust of the stimulus is for now until next year, isn't it possible we could see a flat economy and stock market until a out the middle of next year? This is particularly directed at stoneleigh. Sorry for the poor grammar. Typing on a handheld.

Iowa Boy said...

I'm very impressed by your prep work and it pains me that I'm just keeping my nose above water. I should have had such things done long ago, but life has other plans for me :-(

Joseph j7uy5 said...

Stoneleigh's projections, as I understand them, are based partly on the notion of some catalyst being tied to the next phase of the crash. Not that one is necessary, as the crash will resume anyway. But the timing could be determined by a major event.

One candidate for this could arise from the phenomenon noted is the article, "Angry Americans disrupt town-hall healthcare talks"

Angry Americans always have been with us. For the most part, they have not been focused or organized. Or if they were focused, the focus was external. Thus, these people -- while annoying -- have not posed a system-wide threat.

I worry that the current situation with these angry mobs is an indication that they are becoming focused, and organized, and that the focus is within the USA. It sometimes is referred to as racism, but it is not exactly based upon race. It is, however, a reflection of an us-versus-them mentality, in which the "them" is dehumanized (from a psychological perspective). Once "they" are no longer human, or are somehow viewed as less than human, it becomes acceptable (to the perpetrators) to engage in great violence.

Unlike the race-based hatred that led to the US civil war, this conflict has no borders. That means that it would not be a rebellion that could be suppressed. The US military, for all their might, has demonstrated an inability to suppress distributed insurgencies.

This is a very dangerous situation. Hard to say if, or when, it will blow, but it could be soon.

Ed_Gorey said...

I've just returned from vacation and I'm pondering whether to or not gamble with SDS or SH.

The S&P 500 has crossed the 1000 mark, which had been my buy signal for SDS.

Decisions decisions. I never realized how hard it would be to make a contrarian investment.

Like many bears these days, Mike Morgan, a bearish Florida real-estate blogger whose writing I've followed for much of the past year, recently flipped to being short-term bullish. Last week, he covered his short positions (and presumably booked a massive loss) and considered investing in gold as well as puts for SH.

As Stoneleigh has pointed out many times in the past, this sort of capitulation among bears suggests the rally is almost finished.

Pulling the trigger on my expectations for equity market collapse is pretty tough though. Perhaps I'll simply continue to hide under my 0.1% interest rock at Treasury Direct.

Anyone else getting second thoughts about gambling in this environment?

snuffy said...

There is mobilization of "anti-teabaggers...being co-ordinated by some old acquaintances at fire dog lake blogspot,as well as other places.The "libruls "have the advantage of being well-informed literate,and many times well-spoken...which is a cool counter to irrational paranoid nutcakes that make up the majority of the disruptive ones....

This might get interesting...except I am quite aware of the basis for the teabaggers and their right-wing racist roots...Freedomworks should be labeled as a terrorist organization...and if you use the political measure of the patriot act...it is.They should haul Dick Armey ass off to the slammer for this shit[my opinion]

Should they keep adding extensions..it could keep the wolf away for another year anyway...many folks are hurting now...this winter will be grim.

time for sleep



snuffy

Bryan McNett said...

teabaggers and birthers are political automotons. they don't value facts or truth.

i have a relative who is a birther and drill-baby-driller. i sent her a link to the USGS, which shows that offlimits offshore oil is 18 billion barrels (two years of USA oil supply.)

when confronted with this fact, her response was that she required a belief that indicated infinite supply, and therefore my argument was invalid.

there are lots and lots of these people, and you can't wish them away. sadly, if you hope to prepare for a factual future of truth, your success may come at their expense.

Anonymous said...

Interesting to see Stoneleigh's RE system in more detail.

I assume the system is expandable from 3 KW. An average household generally uses 5 KW or so IIRC. Is your system designed to be expanded if/when needed?

The biggest point of failure IMO is the inverter/charger. Do you have spares or do you have the expertise and parts to cobble together your own?

Our own system design is based on homebuilt solar panels and Hugh-Piggot type wind power with 6 kw of each. The Fronius inverter is the biggest potential headache and I am learning enough to build a charger/inverter from parts as a backup plan.

Our generator is currently diesel run from a 3000 liter tank of heating oil in basement. We use wood and solar for heat so the tank is simply spare fuel for the tractor and generator.

Have you investigated other sources of generator fuel such as sugar-beets grown on your farm and converted to ethanol or wood gas by chance? There is a nice wood-gas Yahoo group here - http://tech.groups.yahoo.com/group/WoodGas with lots of discussion about practical DIY wood gas conversions for existing gasoline & diesel generators.

Brunswickian said...

Re Battery bank.

The life of batteries will be shortened if discharged more than 20% regularly.

ca said...

Stoneleigh --

Adding to what Rick James said, isn't it likely that another stimulus package will be passed so that the market doesn't fall to its prior lows before the election?

CS said...

..has anyone else considered Edison NiFe batteries? I've done a mountain of digging and found only a few refs to contemporary use. There's two Chinese cos that produce I think - and the only refs to use with panels come from one US (sales) site and an Aus site.
They don't need a regulator, are thermally robust, last 60-100 years with minimal maintenance but are some how a pariah amongst the fora because they don't hold charge as well as lead-acid ones. Any pointers to first hand use would be appreciated. TIA

scandia said...

I've just been readin an article in The Telegraph,UK, " Forget the term ' emerging markets '. they're in the driving seat now." by Liam Halligan. He like others makes a convincing argument that the power is shifting east. I was about to buy the argument hock,line and sinker, when my TAE training wondered if Halligan takes into account access to energy,water,population overshoot,desertification,soil degradation,increasingly extreme religious forces,corrupt governance,etc into his analysis?
When one does the emerging market in the drivers seat looks like less of a sure thing. Or perhaps less of a thing at all past the near term.

Anonymous said...

Thanks, Stoneleigh for a great post on RE...

Regarding property taxation for PV or RE systems, in NY State, should the assessor add the value of a PV system to your assessment (thus making it taxable), there is a 15 year exemption available by submitting a form to the assessor. Of course, rules can change. But you could reasonably argue the system is nearly fully depreciated after 15 years and nearing end-of-life.

I do not think "official" expropriation of RE electricity it the main problem to worry about for small systems. In the event of collapse, is the local utility going to send out RE police to cut off your domestic supply and use 100% to feed the grid? I don't think so.

My main concern when TSHTF is protecting the panels from theft or vandalism -- probably that is when I move them from pole-mount to roof mount.

re. Grid Tie vs. not, in NY State there had been a $4/watt rebate (since cut to something like $2.50/watt), plus income tax credits of 30% federal and NYS up to $5000. Thus, grid-tie cut the cost of our 5kW system by 75% (to about $10K). Grid tie is a hassle, but a no brainer.

The down side is our grid tie inverter (Fronius 5100) needs grid power (w/perfect sine wave) to produce usable AC -- thus it provides no back up during an outage. Our thinking is to purchase batteries and an off-grid inverter and put them on the shelf for when TSHTF.

Anonymous said...

Grant me the strength to change what I can, the serenity to accept what I cannot change, and the wisdom to know the difference

http://en.wikipedia.org/wiki/Serenity_Prayer

The Serenity Prayer is the common name for an originally untitled prayer, most commonly attributed to the theologian Reinhold Niebuhr.[1] The prayer has been adopted by Alcoholics Anonymous and other twelve-step programs. In 2008, Yale Book of Quotations editor Fred R. Shapiro published evidence that a version of the prayer existed by 1936. Shapiro believes that this casts doubt on Niebuhr's authorship of the prayer.[2]

The best-known form is:

God grant me the serenity
To accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference


Any recovering alcoholic knows that by heart:-)

Anonymous said...

A guy and his kid just drove down my street in a pickup with a horse on lashes trotting on each side of the truck, now that's what I call back up transportation and I kid you not.
LOL

ca said...

Isotope shortage means healthcare crisis:

http://www.latimes.com/features/health/la-sci-isotope9-2009aug09,0,6453741.story

mistah charley, ph.d. said...

Grant me the strength to change what I can, the serenity to accept what I cannot change, and the wisdom to know the difference.

This is called the Serenity Prayer, and attributed (although not without controversy) to American theologian Reinhold Niebuhr - see the Wikipedia article, which points to a similar sentiment in a Mother Goose verse published in 1695:

For every ailment under the sun
There is a remedy, or there is none;
If there be one, try to find it;
If there be none, never mind it.


This is why I read The Automatic Earth, despite the "for entertainment purposes only disclaimer" - I'm willing to accept the "what you do with this stuff is YOUR decision" EULA. But I can't help wondering: is there a remedy, or not? And if so, what is to be done? And if not, what is to be done?

[[And now for something completely different, for entertainment purposes only: Is Paula Abdul really not coming back to American Idol? And too bad about that small plane-helicopter crash in NYC - how many were in each craft, where were they from, what was the purpose of their flight, how do their relatives feel now?]]

Anonymous said...

With regard to the health care debate, I had a reality check two days ago. Talking with a retired teacher 67 yrs old) who told me he was against health care reform as "we have the best health care in the world" and "look at the mess communist countries like Canada and England have".

I assume folks like him never learned about appropriate conduct at meetings either.

Appreciate Stoneleigh's article and agree with her list of issues totally.

John Hemingway said...

I read the article about the "Angry Americans" (I think it was in the LA Times). I've been wondering for quite a while when the simmering discontent that you can see across the USA was going to going to morph into something more organize, more focused. Hard to predict where it will lead, but, given that the Democrats are "nominally" in power (I really don't see much of a difference between the two parties), I would think that the Republicans, and especially the far right fringe of the GOP, are odds on favorites for leading the populist charge.

Anonymous said...

I see the KosKidz found this blog.

Anonymous said...

The "Angry Americans" is a right-wing meme at this point.

Angry for the wrong reasons at the wrong 'authorities'.

The 'teabagger' ass-clowns would have never dared to question Bushitty or Darth Cheney for deploying military troops against the domestic population as Glenn Greenwald recently reported.

The question to ponder is why there is no organized effort by so called 'progressives' to take the lead and expose the Banksters and their enablers in Congress for the TOXIC assets and accounting fraud tricks deployed to steal the country into debt slavery.

Don't hold your breath, 'progressives' have always been slow on the pickup when it comes to bare knuckles activism. They classically like to bring a pillow to a knife fight.

rapier said...

The health care legislation mania is serving to keep all eyes off the Fed, the Treasury, GS, etc. etc. By coincidence or design, you decide.

While no K Street PR forces are involved in highlighting the depredations of high finance it should be noted that the nuttiest of the Howard Beals, Glen Beck, went on a long rant about fascism with poster portraits of Bernanke and Geithner the other day. This was a shock to me on many levels and suggests that FOX really doesn't know what they hell it is doing. I am sure somebody is going to set them straight, like right now.

If the rightest populists start to take off against the financial elites it would be profoundly important. Populism of both the left and right have always hated Wall Street. It's been a fine balancing act keeping that at bay,on both sides of the aisle. The GOP has been playing a very dicey game of being against the bailout regime. Able to get away with that as a political and rhetorical strategy because the legislation was going to pass anyway. If the base gets energized enough to demand say no expansion of the debt limit things could get interesting.

The Treasury has since March been working on Plan C. A catch all bailout of such things as commercial real estate. $3 trillion is the usual number being floated. How they could get it through congress is a mystery to me. Even if they try to by using their newest trick, the "line of credit",which they gave to the FDIC and for the IMF.

Blankfin's missive about GS employee not appearing to be living high on the hog is quite telling to me. It's one thing to see the signs bearing the faces of Democrats as a bulls eye but... Well, you get my drift.

I am sympathetic to the health care reform idea but the whole thing is based upon wishful thinking. At least if GDP drops much further.

I have that August 1914 feeling here. Read The Guns of August if your not familiar. However I am supposing this respite could last for quite a long period.

gasman said...

The joke about the plumber and the neurosurgeon in the previous comment section is close to reality for me. I am an anesthesiologist. Medicare pays me 20 dollars per point. A point is a 15 minute block. That works out to 80$ per hour, of course subtract out malpractice, office/billing overhead, and Continuing education requirements. I needed to replace two bathroom faucets. Home depot would send out a plumber to install them at $150 per faucet(This is Dallas). and I would need to have 2 shutoff valves sweated off and replaced at about $50 per valve. I did it myself. I already had the tools. It took me 4 hours. I am a rookie but I still saved myself more money than performing anesthesia for a coronary artery bypass graft. Now tell me, when the government takes over the medical system. How long do you think it will take before shortages of American trained docs develops.

Greenpa said...

In case you were wondering how well Asian youth is prepared for what's coming:

cosplay

Greenpa said...

Looking for a major event to trigger it? It could be underway-100 inches of rain in 24 hours

How about- this typhoon which has wrought havoc on Taiwan does the same to south China- putting major stress on the central Chinese government to provide extraordinary services- which causes them to start selling US Treasuries even faster to get the money- which makes the price go down- other holders freak- and all the dominoes go...

I'm NOT saying this will happen; what I AM saying is that the entire Ponzi tower is so extremely fragile now- ANYTHING like this could trigger it.

Anonymous said...

I do think there is a mostly racist element to the Angry Americans. The labels 'birthers' and 'teabaggers' gives them some cover, but you barely need to scratch the surface to see the ugliness.

I agree this stuff is very dangerous. The folks at Orcinus write about this: http://dneiwert.blogspot.com/

Eliza

Greenpa said...

for those not in on the joke; ask a gay friend what "teabagger" means... they're getting a huge kick out of it.

Anonymous said...

Greenpa,

Yes, Rachel Maddow had lots of fun with the teabaggers:

http://www.youtube.com/watch?v=OLsKt4O4Yw8

The cosplay stuff is a bit creepy.

Eliza

Brian said...

speaking of solar... this was written by dairymandave over at the EnergyRoundTable a while back... we were talking about societal regression through different levels of oil consumption... i have always wondered why we would wish to delay our inevitable transition to a life like our grandparents and great-grandparents....

he is referring to life just 60 years ago:

"Their lives were powered 100% by solar energy. The ice, the ice box, the horses and the man power were all solar powered. I bring this up because folks tend to think solar power is "solar panels".

Their power was free, everywhere, no waste or pollution and never ran out. Living with only solar power required communities, people
cooperating and working."

When we think this way, the future (non-transcendental) looks better.


he goes on to say:

I want to add another thought here about solar energy, "sunshine". Folks say the problem with sunshine is that it is so diffuse, not concentrated like fossil fuels. I say that the diffuse nature of solar is not the problem but is the Solution. Look at what man has accomplished with concentrated energy. And we aren't going to stop until we absolutely have to. Why? Because for the past 3 billion years, organisms have been evolving primarily to capture
diffuse solar energy. Organisms must work to get enough energy
and the work itself takes energy. Thus we are wired to maximize our EROEI. People working together in communities is a way to do
that.

Even though a few of us know this and may choose to change our ways, most folks just react to their wired impulses. Man can't handle cheap, concentrated energy. He will binge on it like a glutton. This IS the definition of "maximize EROEI". This situation has never happened before and will never happen again.

Ilargi said...

"Now tell me, when the government takes over the medical system. How long do you think it will take before shortages of American trained docs develops."

I don't know really, I'm going to have to guess here.

As long as it has taken in France?

Susan said...

RE: Gasman asking about how long it will take for American trained docs to develop...

Don't be stupid. We are in the middle of a recession, if not depression, the likes of which have literally never been seen before. What will you do for money? It's not like you can just go get another job. There aren't any to be had. Or are you just going to teach? Yeah, I'm sure that pays as well as being an anesthesiologist. Or are you going to emigrate? To where, pray tell? Most any other country you might think of as being acceptable in their 'values' or standard of living ALREADY has 'socialized' medicine.

Again, don't be stupid. You'll work like everyone else, because your pension fund went 'poof' in the stock market crash just like everyone else's. And you'll be glad you have a secure job, just like everyone else.

Frankly, my children learned to intubate and monitor tidal volume and rate when they were 10, 8, and 6. It's not like it requires years of schooling (although I will give you that it does require assessment and math skills to deliver and monitor anesthetic). I think you might be way overpaid. And I also think that you way overvalue your contribution to society as it were. And I also think you really need to recheck your motivations for going into a 'helping' field. If money is your primary motivation then I surely don't want you for my anesthesiologist.

-Susan

Greenpa said...

"Now tell me, when the government takes over the medical system. How long do you think it will take before shortages of American trained docs develops."

A truly ancient canard. Even potroasting couldn't make it digestible. As Ilargi points out, the world is full of systems which disprove this crap.

In the US, medical school is a sausage grinder of the first order. Often, those motivated to put up with the years and years of insanity ARE motivated by the concept of big bucks at the end.

I would contend those may not make the best doctors, actually.

What would happen if acquiring an MD was not motivated by greed half the time? Hm. Maybe we'd get doctors who are more focused on doctoring- and maybe medical schools would get more attuned to this world. Half the nurses out there could and would become excellent MDs- if it wasn't so incredibly expensive.

Coy Ote said...

Scandia - The term now is on the west... "submerging markets".

anon 8: 28 This "...and wisdom to know the difference" is the tough part.

Gasman - "I am an anesthesiologist. So, you aren't a doctor, rather an assistant and medicare pays you $80/hr. Then there's your salary as published here...

http://www.payscale.com/research/US/Job=Anesthesiologist/Salary

Sorry, no tears for $150k to $300k from me. (Oh, and hardworking plumbers and electricians don't get a medicare supplement for their work)

Greenpa said...

Susan- I think we're on the same page! :-)

Greenpa said...

Eliza: "The cosplay stuff is a bit creepy."

Definitely! The level of delusional behavior is astonishing.

I have a word for these folks; obliviots.

I've been trying to launch that neologism for a while now; so pass it around. :-)

Coy Ote said...

def: obliviots - entities in the state of complete unawareness, unconsciousness, or forgetfulness;

ex: Glenn Beck

Greenpa said...

Coy- well hell! Honest, I made it up myself. :-) totally disgusting that someone else has, also. Poo.

Coy Ote said...

No - it was you! I tagged it with the wiki for oblivion

:-)

Greenpa said...

Tom the Dancing Bug has another good one today:

http://wpcomics.washingtonpost.com/client/wpc/td/2009/08/08/

Coy Ote said...

Greenpa - I liked this one as well. "A truly ancient canard. Even potroasting couldn't make it digestible."

Town Hall foodfights - I heard an implication on NPR that the Clinton rescue was timed to help keep prolonged coverage of the teabagging antics from the MSM.
Interesting thought.

Greenpa said...

Stoneleigh; I'm curious if you've heard of the idea my son told me about yesterday- which is that used electric car batteries might be re-purposed for local (town sized) grid storage. Batteries that no long accept enough charge to keep a car owner happy, or accept it fast enough- are not really "dead".

Apparently the people talking about this are envisioning 2 or 3 car batteries per housing block. Not much space; very local storage of any inputs, cutting transmission losses a lot.

He also said some of the BIG boys are talking about a "smart grid" option where electric car owners could opt to leave their cars plugged in all night- and allow the current to run both ways; so the utility could use them to both store extra power, and to draw power for short needs-

Sounds interesting to me. Might be REALLY interesting for any small town thinking about going off grid as a town. :-)

Greenpa said...

Coy- thank you, thank you. :-) Gotta get my fun somehow.

Dr J said...

gasman - as you can see, doctors are not automatically held in high esteem here. I am sure you have noticed that, in general, we are regarded with an odd mixture of resentment and envy. I think of it as being similar to how we view auto mechanics when our car is broken. We envy them the knowledge and skills they have acquired and upon which we are now dependent. At the same time, we resent the money they charge us for applying those assets to solve our problem. The fact that you spent 12 years studying, and probably accumulated enormous student debts, in order to provide a life-saving service to people in dire need, is easily overlooked when a gross salary figure is bandied about.

On the other hand, you may want to look further into the idea that a single-payer health care system will be the death knell of medicine as we know it. My anesthesiologist colleagues here in the Peoples Republic of Canada seem to be doing just fine.

Sam Dug said...

"..."So, you aren't a doctor, rather an assistant..."

Uhhh, you need to actually know about what happens during anesthesia and WHO is responsible for SAVING you should anything go wrong during surgery/ procedure.

Hint: It isn't the surgeon.

Coy Ote said...

Dr. J - "...doctors are not automatically held in high esteem here..."

Actually I do hold doctors in high esteem. A doctor is a scientist in my view, and i very much admire scientists--one saved my life at the age of 9. acute appendicitis.

What I don't hold in high esteem are narrow and incorrect opinions as expressed above by gasman.

Coy Ote said...

Sam dug - OK fair point, well taken.

Anonymous said...

In article Nine Roadblocks to a Bull Rally The graph of % State deficits is very skewed to show California as an extreme bad economic surfer boy in comparison to the other listed States.

Don't known how reputable 'Seeking Alpha' accuracy in reporting is,
but if that graph is an example one should be very wary.

Zuma

Dr J said...

Coy Ote - "What I don't hold in high esteem are narrow and incorrect opinions as expressed above by gasman."

Fair enough. But then you should engage him on those points and not attack on the basis of what may or may not be his salary.

Anonymous said...

Susan,
This is getting off topic, but I feel compelled to respond to you. I am confused as to why children of the ages of 6, 8 and 10 would be intubating.
There is enormous skill needed to intubate a person, as anatomy is vastly different for everyone as for example cleft palates, severe burns, radical head and neck surgery. Would your young children be capable of intubating such patients, monitoring their vital signs, administering the right dose and combination of drugs, and managing their fluid replacement, etc. during these procedures?
Anesthesia is an art as well as a science and is much more than monitoring VT, Peep, FiO2, etc. One needs to have a thorough understanding of multiple health conditions and how they will be affected by the surgical and anesthesia procedures they will be undergoing.
I am a registered nurse and have worked closely with surgeons and the physicians who administer anesthesia in the OR, ICU and cardiovascular ICUs for the past 28 years.
I can guarantee that the MDs who administer anesthesia are as valuable as the surgeon who is performing the operation.
Further, the anesthetist has as much advanced education as a surgeon or other specialist has. They also work long hours and are on call.
These people are deserving of respect.

Coy Ote said...

" But then you should engage him on those points "

I did. He decried his small salary and then disparaged the work and costs (which he saved by doing it himself) regarding tradesmen.

I posted the average low to high salaries of his profession, which is $150k to $300k, not too measly in my estimation.

Then this... " when the government takes over the medical system. How long do you think it will take before shortages of American trained docs develops."

Sorry, but i've heard that one since the Nixon administration. Don't buy it.

Nothing personal, it just did not wash.

Ilargi said...

Zuma:

"In article Nine Roadblocks to a Bull Rally The graph of % State deficits is very skewed to show California as an extreme bad economic surfer boy in comparison to the other listed States. Don't known how reputable 'Seeking Alpha' accuracy in reporting is,
but if that graph is an example one should be very wary."


What do you find wrong with that graph?

Do note that there are two different stats represented in it.

1) The absolute amount of the budget deficit, as shown in the bars, and

2) The deficit as a percentage of the general fund budget, as shown in the numbers.

These are entirely different entities. Hence, California's deficit is about twice New York's, but it only represents some 10% more of its general budget, since the state is so much bigger.

Is it possible that caught you off guard? I don't see it as skewed, but I do think it could potentially be a bit confusing.

Coy Ote said...

anon 1:31 - "Anesthesia is an art as well as a science..."

Valid point.

Actually, so are "the trades."

Roberto said...

Coyote- oh, best not to open up the can of worms about whether MDs are scientists or not. Fact- they are NOT trained in scientific method, or experimental design; unless they have a PhD to go with the MD- which many do, to be sure.

Otherwise- some PhDs I know- who do medical research- tend to joke where no one can hear them at MDs are just barbers with a bad case of science envy.

bluemarble said...

Stoneleigh,

Thanks for the article on RE. We are expanding our PV's to 1.8 KW and hoping to get off the grid soon.

Two things we are doing to lower our energy use:

We are building an ambient air refrigerator (outdoor refrigerator). In our climate (Finger Lakes, NY) this can be used for ~ 8 months of the year and we can unplug our electric frige. See this URL for the plans.

http://www.thedailygreen.com/green-homes/blogs/diy-hacks/hack-energy-efficient-refrigerator-460215

I e-mailed the inventor and he said theirs has been working very well.

Also, to save gas, we use a warm box constructed of wood and insulation to finish cooking food. I put beans in the box the other day after they had boiled for about 15 minutes. They were almost completely cooked when I removed them 4 hours later. Of course, I soaked them overnight before cooking them.

bluemarble

Anonymous said...

Gasman:

You'll have to forgive Susan and the other socialists here. They know not what they do--which is why they are remarkably unsuccessful under the present system, and yearn for a socialist one. When you say your gross pay is $80/an hour, she doesn't understand what you mean. The has no understanding of gross versus net, the costs of insurance, or the cost of running a business. When you say that an even lower wage will discourage others from entering your field, she doesn't even understand the argument; instead she focuses that you, Gasman, will keep doing what you are doing because you have no choice. She then goes on to suggest that she wouldn't want you as an anesthesiologist because you apparently want to keep making your $60,000/year net for doing so. It's a good thing that in her case, her 10-and-younger children are fully capable of intubating her and monitoring her saturation levels. Good luck with that.

jal said...

Darn ... I've got to chip in ...
"Being a skilled worker/tradesman/surgeon/carpenter is knowing the short cuts", which are only learned "on the job".
"If you don't use it you lose it"
"I've forgotten more than I remember".
----
Go back to "The Washington Post"
http://www.washingtonpost.com/wp-srv/nation/interactives/farmaid/
and look at how capitalism is milking the socialist system.

Washington Post reporters Dan Morgan, Gilbert M. Gaul and Sarah Cohen spent more than a year examining federal agriculture subsidies, generating more than a dozen stories and several interactive maps in 2006.

How to Spend an Extra $15 Billion
In the past five years alone, the U.S. government has handed out more than $95 billion in agricultural subsidies. Post reporters criss-crossed the country in 2006, identifying more than $15 billion in wasteful, unnecessary and redundant spending.
-----
This is one example of why capitalist get a bad rap ... they want their cake and eat OURS/the socialist cake as well.

Unfortunately, the capitalist have not relized that the bankers are screwing them worst that the individuals.
Here come the commercial defaults.

The soup line starts on the left or is it the right.
jal

Dr J said...

gasman said: "I needed to replace two bathroom faucets. Home depot would send out a plumber to install them at $150 per faucet(This is Dallas). and I would need to have 2 shutoff valves sweated off and replaced at about $50 per valve. I did it myself. I already had the tools. It took me 4 hours. I am a rookie but I still saved myself more money than performing anesthesia for a coronary artery bypass graft."

Coy Ote said: "He decried his small salary and then disparaged the work and costs (which he saved by doing it himself) regarding tradesmen."

You illustrate my point that doctors are not automatically held in high esteem and are viewed with resentment and envy. I am sure you were grateful to the anesthesiologist who looked after you when you had your appendectomy but when gasman points out that, based on his pay rate it was more cost-effective to DIY a plumbing project than pay for it to be done, you get all hostile with him. If an electrician had made the same point I somehow don't think he would have been subjected to the same treatment.

Ilargi - my apologies for being off-topic. I shall stop now.

Greenpa said...

"Those who demonize socialized medicine are uninformed."

Or- they have vested interests.

Bryan McNett said...

sorry for the delete, fix'd error

Nobody mentions Taiwan when national healthcare comes up.

Taiwan switched to single-payer in 1995.

I've seen the system first-hand many times. It's clean and professional. Waiting rooms were always busy, but never worse than a busy day in America.

Taiwanese doctors are highly-regarded and well-paid. I have doctor friends there, and none complains about the single-payer system.

When I grew up in America, my family had a desk job, but I don't think we even had preventive dental. Every janitor in Taiwan gets that.

Friends from France, Denmark, and England have similar stories to tell.

Those who demonize socialized medicine are uninformed.

>Or- they have vested interests.

You mean like the people on TV and their corporate masters. But even on the Internet, where nobody gets paid, there are thousands who sit there demonizing socialized medicine all day, despite having no vested interest.

Armando Gascón said...

Lack of American trained MDs.
You can always get Cuban MDs. One in four MD in America is foreign trained, according to an article in the NY Times that has been copied all over the Latinamerican press.
This year's crop of medics in Cuba has been the biggest ever. Their help in several countries is invaluable. Even in Uruguay, a country that doesn't lack MDs, they set up an eye surgery clinic with great success.
Free for all, of course.
(Yes, I know. There isn't a free lunch or a free cataract operation in this life. They have 22% VAT in Uruguay, and they pay income tax.)

Plumbers, many a scientist in Britain has retrained as a plumber. Apart from the money you don't need to shave to go to work!

DIYer said...

Stoneleigh,

Now I want solar. As Mr. Symanski pointed out it makes so much more sense at a latitude of 33° where it is rarely cloudy. In fact we are in the middle of a 50-year drought just now. In fact I'm still trying to decide whether to just drop everything and move closer to 45°.

My question is this: did you look for NiFe batteries when shopping for storage? According to the solar literature of the '70s, nickel-iron lacks storage density and efficiency but makes up for it in durability and long life. And there's no lead in them.

Anonymous said...

As a doc's daughter, I am amazed how so many doctors, who are so screwed coming [malpractice fees] AND going [inadequate reimbursement] by the insurance companies, nevertheless spew the insurance co's 'anti-single payer' [and 'pro-tort reform'] propaganda so they can keep getting screwed by insurance companies.

'Tort reform' will not coerce insurance companies to stop gouging doctors. Yet a single payer system would eliminate the medical billing bureaucracy, get around the elcheapo capitated rates, would help doctors' bottom line enormously.

To protect their own wallets, doctors should reverse their positions on these insurance company legisative goodies.

-gylangirl

Anonymous said...

Health care… lol. No more inside stories, anecdotes, etc. They’re a stupid way to argue.

There are four ways to cut costs, and four ways only:

1) Pay less overhead (non-direct health) expenses
2) Pay the people providing health services less
3) Buy fewer / pay less for, gadgets (drugs, machines, disposable nose examiners, etc lol)
4) Give fewer services (thereby collecting less money)

That’s it folks. All the systems touted as alternatives to the USA do all of the above. There is no magic.

Mr gasbag’s point is apparently lost on people who usually appear pretty sharp. He makes $150-300K, if he doesn’t see Medicare patients. If he sees them, his income goes down. (BTW, $80 for an hour – which annualized is about $165k - of treating Medicare patients is not what he gets as a salary. It’s considerably less than that.) So, he has a choice. Treat private insurance patients and make that 150-300 salary, or see government insurance patients and make less. (Not withstanding the above poster's story that her dad makes less from private insurance. Only response is that if that is so - it's not in my experience - why are there so many doctors refusing medicare/medicade patients?)

If you want to reduce costs in the USA to be more like other systems:

1) Cover 100% with government insurance
2) Mandate a ‘draft’ of doctors, nurses, etc – if you practice medicine in the US you must give ‘x’ amount of service to government paid patients
3) Mandate prices on drugs, gadgets, etc – if you want to sell anything in the US then you must provide ‘x’ amount of supplies at ‘y’ price.
4) Mandate limits on the services provided.

Two results of the above (just like in the UK, etc) will be:

1) Reduced number of health professionals, as their pay will be reduced and fewer people will do it.
2) Reduced gadgets, drugs and services given to patients, as some things provided are deemed not cost effective.

The results are speculation, but well informed, based on fact and history. But it cracks me up to have the basis of a blog here be a ‘contrarian’ view of the future, speculating about, literally, the end of the world as we know it, and then completely disregard informed speculation about what will happen if the health care system is changed.

gasman said...

I would not mind the pay the government proposes if they would protect me from the lawyers, but that is not part of the reform now is it?

Anonymous said...

Right on that Seeking Alpha graph ilargi. I read it wrong. I should have read down Chinese style first before reading across English style:)

Zuma

jal said...

gasman said...
I would not mind the pay the government proposes if they would protect me from the lawyers, but that is not part of the reform now is it?
-----
It's time for you to get after your "organizations" to speak up and get the "middle men" out from your gross income and your net income.
jal

Anonymous said...

Re NiFe Batteries

Found this:

http://tinyurl.com/oxxjb7

Anonymous said...

The giganntic malpractice fees and the reduced reimbursements are a big reason why many docs have left the field already.
Insurance company profits are the problem. They justify the malpractice insurance fees to their doc victims by saying the lawsuits are the reason but their huge profit margins expose the lie. The tort reform legislation [that the insurance companies get the docs to support] doesn't say anything about malpractice rates going down. So the insurance company can legally still charge big fees to the docs while they pay out less to the trial lawyers. Just like they are charging fees to health insurance enrollees but refusing to pay for the services when they actually need them.

This means MORE profits for the insurance companies. They are crooks hoodwinking doctors with empty promises that aren't backed up in the proposed tort reform legislation.

Plus the tort reform doesn't just protect docs form lawyers. It protects all corporations form being sued for wrongdoing. SO they poison your water or your food, you and your neighbors get sick or die, they can't be sued for it. That's what docs are supporting when they push tort 'reform'.

Dr J said...

gylan girl said:

"Yet a single payer system would eliminate the medical billing bureaucracy, get around the elcheapo capitated rates, would help doctors' bottom line enormously."

I agree that singe-payer would deliver huge efficiencies on the administrative side and that the savings will benefit medical practitioners but I am not so sure it will deliver huge improvements to their bottom-lines per se, nor should it. If the single-payer system is fee-for-service, physicians will still be on a financial tread-mill which is not always conducive to optimal care. A FFS physician can maximize income by seeing all the easy to deal with minor problems while avoiding the complicated, time-consuming patient and can encourage unnecessary visits to generate revenue. I have worked in both FFS and sessional (hourly) pay environments. I find that one is motivated to maximize efficiency when not worried about maximizing revenue. For instance, I would pick up the phone to discuss someone's results when working as a sessional when, on FFS, there is a huge disincentive to doing that because one doesn't get paid unless physically seeing the patient (paying for phone calls isn't the answer, either, because it would be easy to game the system by making unnecessary phone calls). Personally, I found that practicing medicine without the hovering FFS concerns was far more satisfying. Having said that, FFS probably makes sense in many of the specialties. A single-payer system would be a good start but if it is solely a FFS system, more would need to be done to optimize care while keeping costs manageable.

In all matters of system change, those who do well in the current system are going to resist change.

snuffy said...

Looking at the comments today at the whining of the "gasman"I am struck by the careful analysis,and complete demolition of his complaint. Personaly,I go with the argument that the medical training system here needs to be revamped along the lines of Cuba...any country that exports doctors is doing something right....The AMA and other organizations WANT to keep health care training and practice exclusive and expensive which is just plain wrong...Their actions create grief for the rest of society...and money orientated doctors who care more about their bottom line than proper care for those in their care...I have seen it,and have friends who are reg.nurses who regularly have told me horror stories...

I agree with the comment that liberals bring pillows to a knifefight.That has not always been the case...and righteous anger is one of the strongest types of motivation.
....
This political season will be tops for popcorn value...

My plan for power "off grid" is to have several different approches.Microhydro,small solar[200 watts of panels now]Gasifier genset for big jobs...all subject to what may come


.. back to productive things...

snuffy

Anonymous said...

Greenpa held up China as an example of a Communist country that "worked." Now Snuffy cites Cuba. You guys crack me up. You're just SO cute!

Dr J said...

Amando said:

"This year's crop of medics in Cuba has been the biggest ever. Their help in several countries is invaluable."

The problem lies largely in the North American training system. I doubt those Cuban kids graduate with $500K in student debt. My debt load was a significant determining factor in where and how I practiced after I completed my training. I wanted to do overseas work but it was financially impractical at the time.

Anonymous said...

P.S. Can anyone explain to me the conversation I had with a friend yesterday? I asked her if she had planned on having more children. She responded that for the last four years she had been living in the Netherlands, and that she did not want to bear children under their socialist system. She said that the government would not allow epidurals, and would only allow them four hours in the hospital, as examples. She said that now that she was moving back to Switzerland, she would reconsider, although at 39, she had to factor the age into the equation. So--socialists--how about a system that rations healthcare in a way that all receive some minimal level of care but a mother can't receive an epidural during labor? No thanks.

jal said...

@ gasman

I assume that you have a good accountant who is there to minimize the difference between your gross and your take home.

Like most professionals, I assume that you are operating as "gasman inc."
That is the system.

Things like ... new computer ... trip/conference/vacation to a great locations ... etc.
are tax deductible ... you take home a salary from your "inc."
Your "deductions" are all paid for by the taxpayer ...

Guess what!
I got to pay for my own computer, (no depreciation), I also got to save, (after tax dollars), to go on a vacation. (no deductions)

I've yet to meet a "professional" who is not using the "inc." to avoid paying taxes and therefore get an advantage over the salaried person.

jal

Anonymous said...

anon

The no epidurals probably refers to home births, and 4 hours in the hospital is most likely a best practices model for safest outcomes.

Your friend sounds like a wuss.

Vicky

Anonymous said...

There's an economist that crunched all the numbers and showed that when you factored in all the costs (ie higher marginal tax rate, the opportunity cost of attending undergrad and then med school, the tuition, etc) someone that started as a plumber straight out of high school would end up making more money over the course of their lifetime (after taxes) than an MD (in the US). He wrote an article in the NYTimes about it a year ago if I recall correctly.

Dr J said...

anon 3:42 - typical nonsensical hysterical fear-mongering.

Bryan McNett said...

>2) Reduced gadgets, drugs and >services given to patients, as
>some things provided are deemed
>not cost effective.

no, there are two sides to this.

socialized medicine vastly increases basic and preventive care, at the cost of reductions in extraordinary care.

yes, america has the best healthcare in the world - if you need something extraordinary, and you have the money to pay for it.

if you're just a schmo who wants to take your kid to the dentist, america's a pretty bad place for that.

it won't be long before very few will have money for extraordinary needs. so maybe we should aim to provide basic needs for the most people, instead?

Dr J said...

jal - anyone who uses a computer for business purposes can write it off, anyone who must attend educational events for business purposes can write it off, nobody gets to write off vacations. C'mon, I expect better from you.

Ben said...

Hmmm....interesting.

Quite often it seems that a "wildcard" poster will write something controversial and way off topic which gets the regulars buzzing around like mad hornets.

When this happens it distracts from the main article. What is also interesting is nurses, doctors, and doctors' daughters coming out of the woodwork to post contrary views.

It is like this entire "gasman" argument has been staged to take away from Stoneleigh's posting.

RC said...

As a Caribbean based plumber/electrician my rates are at about one third what they would they would be stateside on average, I guess. I have been here for thirty years so I'm not really sure. I have no Social Security, no medical plan, no job security other than demand, I work for myself, not a company, I'm an anarchist {not interested in government or corporations, thank you} and really, most of my choices about where to live and how to pay for that have been based on my personal, very seriously well thought out and autodidactically absorbed, prejudices. I also inspect homes, have several nurseries, sell and advise about Real Estate, consult on all types of sophisticated pumping, pool, power and Renewable Energy projects and build them. I'm allergic to anesthesia so I have had to find a way to live without it. That's not so easy, but it can be done. Gasman, try living without plumbing. I know you'll find a way. I do worry about ever getting appendicitis, but most of the time I'm busy and can't remember to worry. Too tired to worry also. Snuffy seems to operate that way too.
I have many comments and questions about the wonderful Stoneleigh post on Renewables today, but I can probably answer them for myself. Instead, I thank her for setting down the details. I have some debates about the reasons for some of the choices and I think all of the variables come down to locally occurring KWH pricing, wind availability, taxation schemes and the need to back up the grid {hurricanes, earthquakes, tsunamis, strikes, power company management failure, lightning} vs
reasons to not {don't want to have a battery bank and its cost and you have/don't have a generator available} vs reasons to engage in reverse metering vs reasons to not. Over 35 years of doing this in New York State and in Puerto Rico {and in doing many other things} have taught me that THERE IS NO UNIVERSAL ANSWER. Stoneleigh does say that, she has wonderful backup systems and backup backup systems and clearly, her words are once again like gold.
Just remember my friends, REMEMBER, who you are and where you live. Your system must be engineered {you can do most of the engineering yourself if you are intelligent enough to be a regular reader here} for your needs in your location.
Well, as I often say, the topic is worth another 500,000 words, at least, but I do second the Stoneleigh faith in the Renewables. Renewables can do some things, but not others, and for residences and small businesses, even for {non internal combustion} cars not driven more than medium distances, Renewables work. If you can afford them. There's the rub.

Coy Ote said...

I'm sure NiFe batteries have some cons, but here are some pros...

Nickle Iron Batteries are unlike most other batteries on the market today. They are made up of individual cells which means you can make up any combination of voltage and or amp/hrs.
With NiFe batteries if one cell fails you are able to replace it with a new cell.

All NiFe batteries are rechargeable and accept and withstand overcharge and over-discharge (extreme deep cycle).
They have an average efficiency of around 80% over their entire life and can remain discharged for long periods without damage. (Lead Acid batteries need to be stored in a charged state.)

Temperature has effect on all batteries performance however temperature does not effect the life of a NiFe battery unlike most other batteries.

jal said...

Dr J said...
jal - anyone who uses a computer for business purposes can write it off, anyone who must attend educational events for business purposes can write it off, nobody gets to write off vacations. C'mon, I expect better from you.
-----
Be nice Dr J ... you know exactly what I mean ...

This is the system ... you get "free time" to enjoy the scenery at the exotic location of your business trip. I call that part a subsidized vacation.

-----
It occurs often that something other than I&S posting gets more discussion.
It's all educational.
jal

Coy Ote said...

RC - A fine post.

Glad you capitalized this...
THERE IS NO UNIVERSAL ANSWER.

That's been my mantra because there are almost as many RE possibilities as there are people.

Ilargi said...

Anon 3:42,

I have a song for you by the late Kirsty MacColl, one that depicts rather precisely what you claim.

"There's a guy works down the chip shop swears he's Elvis

Just like you swore to me that you'd be true

There's a guy works down the chip shop swears he's Elvis

But he's a liar and I'm not sure about you"


That so-called friend of yours, who I'd bet doesn't exist, only serves to confirm that you are part of a large PR campaign.

You can leave out the anti-socialist crap on this site, we are not that stupid, and we know that The Netherlands is not a socialist country.

And no, I don't care to hear any of your arguments that say otherwise. I know what I'm talking about here.

If you have something reasonable and constructive to add, be our guest. But if this is your contribution, take your propaganda elsewhere.

This entire "discussion" starts to reek more and more of 'Joseph Goebbels comes to town'. With Ionesco, Salvador Dali, Luis Bunuel and Samuel Beckett as his sidekicks.

Dr J said...

jal said:

"This is the system ... you get "free time" to enjoy the scenery at the exotic location of your business trip. I call that part a subsidized vacation."

Any system can be gamed. Consider the conference I attended in Nice this year. I spent the whole time in windowless conference rooms. For the first couple of days, I could barely stay awake in the afternoon because of jetlag. In the evenings, I walked in the rain to local restaurants to eat fairly expensive food. On the final day, when it stopped raining, I walked the Promenade d'Anglais before going to the airport for the long flight home followed by days more of exhausting jet lag. From a distance it may look like fun but it's not at all what I would call a vacation.

gasman said...

To Jal:

I am a partner in a group practice. It is the largest group of anesthesiologists in the world.

To susan:

I converted my annuities and 401K's to money market in july of 2007. My divorces have cost me much more.

To anonymous:
right on

Ilargi said...

gasman,

You haven't answered my question. Reason?

RC said...

Vis a vis our arguments or discussions here. I appreciate having Gasman and Dr. J opining in comments, appreciate that they are not anonymous and appreciate that I can learn some valuable things from both. Even though I never ever visit any of these fine medical professionals with the rare exception of a DDS. I've little faith and no insurance. But there does seem to be an enormous demand for the medical services, and I guess, considering that Americans watch a lot of TV, eat a bizarre diet, and hold vast quantities of obviously deleterious opinions {anti- single payer for example} who am I to judge the American predilections about medicinal approaches since they seem to be of the same quality as the other practices they embrace?

Ahimsa said...

Re practice of US physicians

I, for one, resent that most physicians in the USA practice under the rubric of Big Pharma to the detriment of their unquestioning patients. Their insatiable avarice is reprehensible. No, Dr. J, we do not envy them, we just find them repulsive.

Agree that Cuba has an excellent healthcare system. Their doctors are altruistic and choose the profession based on their desire to serve humanity. They consider driving BMWs and Jaguars extremely decadent, unlike physicians in the USA.

I highly recommend the documentary film "Salud!" which so accurately describes Cuba's healthcare system. The film takes you all over the world (especially Africa and Latin America) where Cuban doctors work.

http://www.saludthefilm.net/ns/main.html

Here are some reviews:

"¡Salud! brings forward the most salient issues in global health today and
successfully reveals that the right to health is urgent and inescapable." -- Arachu Castro, PhD, MPH, Harvard Medical School

"Of all the so-called developing nations, Cuba has by far the best health system. And their outreach program to other countries is unequaled anywhere." -- Former President Jimmy Carter, in ¡Salud!

"Thanks...for giving us this gem of a film to help us to educate a new generation of physicians in these achievable visions, and in the process re-educate ourselves." -- Hugh H. Tilson, MD, DrPH, University of North Carolina School of Public Health

Coy Ote said...

RC - "there does seem to be an enormous demand for the medical services, and I guess, considering that Americans watch a lot of TV, eat a bizarre diet..."

You hit that one on the head. One reason reformed medical care--which I am for--will not work as efficiently here in the states as some other places is because of our personal habits. That includes too little exercise and improper diet, fats and sugars and portion sizes.

"... and hold vast quantities of obviously deleterious opinions..."

Well, indeed as Ilargi referred to "Joseph Goebbels comes to town..." his cohorts are on the airwaves here in droves.

Brunswickian said...

Re NiFe batteries

http://tinyurl.com/l6avbe

This is the Chinese manufacturer.

I don't know whether they will ship direct.

pentronicus said...

Greenpa @ 12:40PM

Though I am not an engineer, having worn out more than 30 marine and automotive lead-acid batteries in my time, I feel somewhat qualified to have an opinion about this. I have also 'lived' on battery power a couple weeks at a time.

For something like this to work on a household scale, you would need a large number of old batteries, and a very expensive computer controlled charging and monitoring system. Perhaps someone has developed such a system. I would think something like this would cost many thousands of dollars, say $20K or more. To run a typical North American household, even on a reduced energy diet, could take hundreds of aging batteries.

You would be constantly schlepping batteries in and out of the system. Batteries are heavy, full of acid that severely damages organic materials, generate explosive gasses when charging, and require eventual disposal. The lead is toxic also. Old batteries also freeze easily,killing any residual usefulness and possibly cracking and leaking acid.

Batteries are just storage devices; not sources of energy, so you would spend a lot of time and effort just to store a little energy. A horse or a mule might be more efficient. Hook him up to your generator.

Caith said...

Bicycle generators: are they home-made or commercial?

Thanks.

Nassim said...

As a non-American, I can only observe the resentment towards gasman with bemusement. I don't know if his numbers are correct but if a plumber earns more than an anaesthesist / anesthesiologist, there would seem to be some sort of problem there.

I can only presume that some people here don't quite realise how critical this guy's skills are. Surgeons often assess patients and decide that they can do what is necessary - they tend to presume that the anaesthesist will somehow keep the patient alive for the duration of the operation. They tend to be quite cavalier. An anaesthesist has to be prepared to take on the surgeon and let him know when he is being unrealistic. Quite difficult.

Farmerod said...

Wow, I was impressed that my 9 year old built a Titanic out of K'nex (kid loves disasters of all kinds, no idea where she gets that from). But apparently we have some catching up to do if we want to keep up with the Susan Family.

May I suggest that most commenters here are likely overpaid? I mean, not only relative to what we'll be paid in the future but relative to what the rest of the non-western world gets paid right now. I got paid so much as an air traffic controller that, with a few deft financial decisions (thanks Stoneleigh), I could conceivably not have to work for several years. Ask anyone in the third world if that seems fair.

Not that I won't work. In fact, I've not worked so hard for so long in all my life now that I grow food. One of the farmers my borrowed land is contiguous with figures he made $2/hr last year. And he's got some experience under his 72 year old belt. He's just part of small organic agriculture and low pay is pretty much a fact of life for the moment. I'd say he really earns his money though, by any measure.

Rest assured that most of us are going to take a hair cut on our pay (even hairdressers) but there will certainly be some professions that should brace themselves for more of a decline than others. Those who provide the most basic, necessary services are least at risk. And eventually the invisible hand will strangle all the occupational deadwood leaving a much smaller list of jobs. Think 1950's for starters.

In the meantime, let's all disparage occupations we know little about, especially if their practitioners make more than us, especially if the easiest part of that job a child or even a gasman could do. Doing this helps us avoid talking about difficult problems.

Coy Ote said...

Nassim - "...if a plumber earns more than an anaesthesist / anesthesiologist, there would seem to be some sort of problem there."

I won't argue that point, but of course that is not the case--even close. (see below)

BTW, I harbor no "resentment" toward gasman, nor anyone else for that matter. But I did certainly disagree with his original comment.

U.S. pay scales

Anesthesiologist $250,000+
http://www.payscale.com/research/US/Job=Anesthesiologist/Salary

Plumber: approx $25 / hour
http://www.payscale.com/research/US/Job=Plumber/Hourly_Rate

Anonymous said...

"Hmmm....interesting.

Quite often it seems that a "wildcard" poster will write something controversial and way off topic which gets the regulars buzzing around like mad hornets.

When this happens it distracts from the main article. What is also interesting is nurses, doctors, and doctors' daughters coming out of the woodwork to post contrary views.

It is like this entire "gasman" argument has been staged to take away from Stoneleigh's posting."

----


Ben why are you are attacking me? I respect everything Stoneleigh says. I don't have the luxury of setting up my own PV system, so I don't have anything to add to her excellent post.

If el g can go off on a tangent over plumber jokes and attracts a doc who's got shit for brains on health care, then so can us anonymous posters discuss it.

Get over your anonymous=troll paranoia. And if you want to gagrule yourself to discuss ONLY what stoneleigh posts go right ahead, but nobody else here limits their comments to just that.

-gylangirl

DIYer said...

Brunswickian,

The tinyurl from Anon@3:23 links to an outfit that sells them stateside. As far as I know, that is the only manufacturer of NiFe batteries on the planet.

RC said...

I very much see the merits of the Dr.J and the Gasman occupations. I'm just not one of those people that, perhaps in the {p}Oprah sense, would ever "go there". I think religion and its hierarchies also is meritorious insofar as the general scare tactics tend to reduce the public urge to run riot in the streets or overload the social or criminal services. But again, thanks, not for me. The J and the G men both seem sincere, and I do not find G's statements at all bothersome. I confess I did attend pre-med school for 18 months and decided it wasn't for me {perhaps dear readers you may allow that my reluctance to submit to the tender mercies of US medicine is not exactly an unmeasured calculation} and also, honestly, the US Military Draft was breathing down my neck somewhat less by then. While we are on the vocational/aspirational/professional/take this job and shove it topic, it seems to me we have plumbers, financiers, medical practitioners, farmers and etalians here, but a rather thin presentation of lawyers.
Hmmmm? I want to read more legal opinions here. Crime and Punishment and Liability and Jury Manipulation interest me greatly.
This is shaping up to be a great era for fixing some blame, pointing some fingers and emptying some soon to be scarce deep pockets. Esquires : Speak Up.

gasman said...

ilargi
Sorry, I thought you made a statement about France, not a question.

When I went to France I loved it. I felt very safe even at 11pm. I trained in LA and live now in Dallas. I know very little of the medical system in France. I do think that a public system would probably be much more likely to funtion well in a country that is more homogenous in its culture.

We have a tidal wave of medical problems about to hit us because of the rates of diabetes(and its sequelae) in the hispanic population.

Health care is of course a right. Same as freedom of religion, freedom of assembly, and Freedom of conscience.

The real questions will be if that 70 year old man with primary biliary cirrhosis gets his liver transplant. If you are demented, do we put you on a ventilator after you go into respiratory failure post hip fracure repair. How many people can we afford to place on hemodialysis post renal failure.

These are the questions that need to be answered. Who will decide. Who is qualified to decide. Maybe susan can do it. She must be very intelligent based on how precocious her children are.

gasman said...

one more comment about malpractice insurance. In Texas a few years ago we had tort reform. My malpractice premiums did not decrease by one dime. not one

gasman said...

nassim

I make more than a plumber. Under a single payer, using medicare payscale as a model. My net would be very close to what my uncle makes as a steamfitter.

Brunswickian said...

DIYer

The Chinese outfit is the manufacturer from which the Stateside outfit sources the NiFe cells (to be precise}.

Stoneleigh said...

As someone who came very close to going to medical school, I don't mind discussing healthcare at all. I did the medical school course in neuroanatomy and physiology as a graduate student, and spent a number of months tracking specific neurotransmitter pathways in rats' brains using immunihistofluorescence. In the end I didn't go to medical school because I couldn't face the 100 hour weeks, on call one night in two, that would have been required of junior doctors in the UK at the time. And I didn't fancy starting from scratch with school leavers when I was already a biology graduate. It would have been interesting, but it was not to be.

Healthcare is a vitally important topic, and is one area which will be radically different from what we are used to going forward. Forget health insurance - it will be pay-as-you-go past a certain point, and a large percentage of people won't be able to afford the services of actual doctors at all. Community healers, often without formal qualifications, will be very valuable individuals. I wish I had more applied clinical knowledge myself. The theory I can do, but that only takes you so far....

Dr J said...

Hey, an anesthesiologist who is a partner in a group practice in Dallas which is "the largest group of anesthesiologists in the world" and who does his own plumbing and who reads this blog and bothers to post here, too, is somebody to be appreciated. That small deficit in opinion on single-payer should not be a deal-breaker. I think it can be managed with tincture of time.

gasman said...

Stoneleigh

you are right on in that health care will be a pay as you go system. I and many others will need to learn to practice a lower tech form of medicine, with fewer heroic interventions and less medication.

Maybe if we walked everywhere like the cubans we would not have so many chronic medical problems.

The coming problems will very likely force a solution upon us

jal said...

"... it will be pay-as-you-go past a certain point, ..."

Sigh ... back to before health care... sigh!

Those were the good old days of survival of the rich and survival of the fittest.

It too bad about the statistics of today ... + 35% obese ... I guess they are goners and those obese that have money will spend it on healthcare.

C'est la vie!
jal

Dr J said...

It's the lower tech form of dentistry that scares me the most!

Coy Ote said...

Gasman - "...Maybe if we walked everywhere like the cubans we would not have so many chronic medical problems..."

Actually, to some that may sound like you are being facetious, but it is true! As I mentioned earlier about idleness being a problem.

A few years ago I worked with a couple techs from Switzerland. They were puzzled as to why there were not more sidewalks and walkways around here.

During 99%+ percent of our evolution we were moving about almost constantly. Along comes cheap and effective energy, viola, TV and beer!

jal said...

Has anyone figured out what will happen to the GDP if +35%, ( the obese), are no longer around?

Remember 70% is consumer consumption. I would think, Theoretical, the obese consume more than the average.
jal

Ilargi said...

gasman,

Why do you insist on avoiding my very simple question? You even brought it up in the first place, not me.

Ahimsa said...

Coy Ote,

Exercise alone won't make up for the junk-food diet consumed by most in the USA. What goes into our mouths contaminates the whole body. A big tax to corporations for the processed, pesticide/hormone/antibiotic/chemical preservative laden industrial foods they produce would be a start.

Coy Ote said...

Ahimsa - "Exercise alone won't make up for the junk-food diet consumed by most in the USA."

Oh no, of course not. A few years ago I would have been more in agreement that legislation might be effective, but I am no longer of that mind.

Somewhere along the line we lost the self discipline concept, or rather, we just evolved out of it into this trance-like stupor of consumption and entertainment.

But I certainly agree with you about the importance of a well rounded living routine of diet, and exercise (work) and positive mental inputs.

Coy Ote said...

...and these are anathema...

pesticide/hormone/antibiotic/chemical

thethirdcoast said...

The real questions will be if that 70 year old man with primary biliary cirrhosis gets his liver transplant. If you are demented, do we put you on a ventilator after you go into respiratory failure post hip fracure repair. How many people can we afford to place on hemodialysis post renal failure.

These are the questions that need to be answered. Who will decide. Who is qualified to decide.


gasman,

I think you raise some good points above. Especially since people have grown accustomed to the provision of extraordinary levels of care during the past few decades.

Going forward I think it will be impossible to provide that level of care to the typical individual.

I can imagine a lot of ugliness if people get the sense that they are being shortchanged with regard to care levels.

thethirdcoast said...

@ jal:


It too bad about the statistics of today ... + 35% obese ... I guess they are goners and those obese that have money will spend it on healthcare.


Actually they can live off their fat reserves while the rest of us starve to death in the dark....or a FEMA camp!

Dr J said...

"I can imagine a lot of ugliness if people get the sense that they are being shortchanged with regard to care levels."

Isn't that already the case for the 50 million (and growing) uninsured?

Anonymous said...

Re the photo of wilson and grandson,from the baby's NYT obituary 93 years later:

October 11, 2008
The Very Rev. Francis B. Sayre Jr., who in his 27 years as dean of the National Cathedral in Washington raised his sonorous voice against McCarthyism, segregation, poverty and the Vietnam War while presiding over construction of the cathedral’s majestic Gloria in Excelsis Tower, died Oct. 3 at his home on Martha’s Vineyard, in Massachusetts. He was 93...

-gylangirl

Coy Ote said...

@ Ahimsa - Some of my spare time I spend on our local greenway bike trail. At the north end I ride past a large agriculture supply station. there are scores of huge tanks of chemicals which the local farmers annually spray on their crops, corn, beans, etc.

Most of it is anhydrous ammonia!

The U. S. Occupational Safety and Health Administration (OSHA) has set a 15-minute exposure limit for gaseous ammonia of 35 ppm by volume in the environmental air and an 8-hour exposure limit of 25 ppm by volume.[50] Exposure to very high concentrations of gaseous ammonia can result in lung damage and death.

But I guess it's OK to eat?

Anonymous said...

The NYT obit also says Sayre was actually born in the White House.

Apparently his support of the civil rights movement redeemed his grandfather, who history has recorded as quite the Southern racist.

-gylangirl

thethirdcoast said...

@ Dr J:

Isn't that already the case for the 50 million (and growing) uninsured?

I should've been clearer and stated "out-and-out violence" instead of ugliness.

RC said...

Mr Coy. Ammoniates are fertilizers and there are many many gases that would kill you very quickly. Guess what? Those gases evaporate or dissipate. NH3 gets on the ground and plants in a non gaseous form. It's full of nitrogen. The air we breathe has far more nitrogen than oxygen.
Would you be happy about having large amounts of potassium salts on your organic food? It's there. I put it there. Agricultural soap {it smothers insects} is made up of that and some water.
Get real my buddy. Next week : deadly viruses sprayed on your food by insane organic farmers.
Thuringiensis anyone? Tasty stuff unless you are a caterpillar. And really, would you like to munch on any compost? Personally, I'd pass.

gasman said...

ilargi
Sorry again. I have a 7 month old at home that has a cold and I have been distracted. Please repeat the question because I forgot.

Coy Ote said...

RC - I wonder how we got along until the late 20th century without concentrated nitrogen? Of course the air has nitrogen... naturally. We evolved with that.

And I do know the "green revolution" was nitrogen based. The real crunch though is, what will we do a few years hence when we can no longer manufacture these concentrated items?

Do you have a similar positive analysis of the pesticides present at the site? The hormone additives and etc.?

Coy Ote said...
This comment has been removed by the author.
Anonymous said...

I can't get over the juxtaposition in that photo, Ilargi.

Barely two years after Wilson had initiatied racial segregation of the US government, he holds in his arms the grandchild who as an adult will feel so stongly against racial segregation that he actually walks with Martin Luther King in Montgomery and Selma Alabama.

Extraordinary photo.

-gylangirl

RC said...

Thuringiensis is a bacteria. Please excuse me. It's b.thuringiensis to be exact. There's viruses on the food too, but we'll save that topic.
Bon appetit.

Dr J said...

Hmmm - 2.14 docs per capita in Canada seems a bit high. I think it may be 2.14 per 1000.

Coy Ote said...

per cap. 1000 of course.

sorry, paste error

Anonymous said...

If American doctors ever decided to stop practicing due their personal objection to providing all their fellow citizens with health coverage, then all the government would have to do is offer to pay the airfare of foreign doctors willing to come practice here. That's how Canada once increased the number of doctors in their country.

But this whole healthcare debate is moot since the collapse of the whole complicated health system is looming.

I wonder how many doctors will even know what to do without expensive diagnostic machines, plastic supplies, and pharma. [Nevermind that everyone will be broke so they wouldn't get reimbursed.]

RC said...

Mr Coy : No I am not "in favor" of most of the items that happen to be in those tanks. But we do use hormones on the farm for trying to root rare plants, we sometimes shock certain seeds or cells with toxic substances in order to effect a mutation or to encourage diploid characteristics, some of our water received from the public sources is chlorinated, and so on.
Conversely, sicko as you may perhaps consider such a thought, I think a stomach full of green revolution food for a starving person is a miracle to them, and really, if we can wind the world population down by attrition and have maybe 10% of the humans we have now {90% reduction}, why, that would be pleasant, but as that occurs, I think "Chemicals R Us". I'm not personally mounting any crusades, encouraging any orthorexia, supporting any type of food mass movements because I HAVE considered the unintended consequences. Think about ethanol.
Is that a solution? If the only viable stomach filling system we have is all about chemicals and poisons, petroleum and seed savagery, well, I'm not sure we can turn that thing on a dime, in fact, I can't see what we can turn to. I'll go as far as saying we should eat less cattle and more vegetables and streamline all of our energy used for their production and distribution, but beyond that, I think there is wisdom in not getting everyone on the bandwagon at once.

Bigelow said...
This comment has been removed by the author.
Anonymous said...

Seriously, I work at a hospital and the ER doctors wouldn't know what the hell to do if their precious CT machine stop working...

Does anyone know where one might learn some low-tech medical skills that could be bartered later?

Coy Ote said...

RC - Obviously you have put a lot of thought into these substances, their usage, and the effects on food production, population, etc.

Most of what you say above makes sense to me actually, if I get it correctly that you would be in favor of a balanced and stair-stepped retreat from the production and usage of those pesticides and such most unnatural and dangerous.

I admit much of my perspective is from growing up on a farm (years ago) with a father that refused the store-bought additives approach, utilizing the manure spreader, etc..

Finally, as one of the commenters above said, it may be a moot point at this stage. I hope not.

gasman said...

Coy Ote

holding all other variables constant, ie. length of training, number of hours worked in training, medical school entrance requirements, debt level at matriculation, cost basis to operate as a practicing physician, practice environment and physical toil of working day and night, while reducing reimbursements, I do not think you will raise that 2.56 per 1000 number by much.

For example take the 2009 cardiothoracic surgery match. A friend Of mine(a cardiothoracic surgeon) went to his national society meeting he reported to me that out of 145 positions available that 15 american medical grads and 25 foreign medical grads applied, leaving over 100 positions unfilled. Word is out, 9 years post med school of 120+ hour weeks, few days off and reimbursements not much more than a nurse anesthesist makes. Who in their right mind would persue this field.

I know, I know bring in the cubans

gasman said...

Anonymous said...
If American doctors ever decided to stop practicing due their personal objection to providing all their fellow citizens with health coverage, then all the government would have to do is offer to pay the airfare of foreign doctors willing to come practice here. That's how Canada once increased the number of doctors in their country.

But this whole healthcare debate is moot since the collapse of the whole complicated health system is looming.

It is called labor arbitrage, and I agree it will happen. It has already been done to the manual laborers with via unlimited illegal immigration since the mid 1960's. It became a problem for the technical worker with the import of the h2b visa holders under the auspices of an engineering shortage. And it will be coming to my field next. At long last the market destruction will be complete and we will then proceed to the arduous task of reworking all of the relationships in our society.

Anonymous said...

Gasman,

Perhaps the shortage of qualified medical professionals could be addressed by restructuring and streamlining the requirements needed to become one. I certainly wouldn't want someone with an Associate's degree performing thoracic surgery on me but from my own experience, much of what I learned in college didn't end up being very useful outside of the academic environment. I don't know if that statement holds true for medicine but I imagine a lot of coursework ends up being irrelevant to the speciality you end up in (and forgotten quickly). The lengthy process ends up adding to the tremendous debt burden medical professionals take on, and well, their sense of entitlement...

Coy Ote said...

Gasman - "I know, I know bring in the cubans"
That was from another poster, not my words. I'll leave that to someone who knows Cuba better than I.

Actually I think this comment from you was the start of today's discussion...
"How long do you think it will take before shortages of American trained docs develops?"

Could be, but so far it has not happened in most of the countries listed. Still, you think it would here, OK. You are evidently a medical insider so I will at least grant you an educated opinion on the matter, even if we don't agree.

I was one of those high-priced electrician/techs! ;-)

timekeepr said...


Stoneleigh said...

Our own 3kW solar array is not grid connected. It will continue to operate in a stand-alone manner, feeding the battery bank that runs the essential loads 24/7. It was installed for the power, not in order to produce an income. The essentials (well pump, sump pump, circulating pumps for the outdoor wood furnace and the solar thermal system, fridge, freezer, security system, minimal lighting) are powered from the batteries through the inverter.


2 years ago I installed a 3.1KW grid ties PV system myself. Got $5k of rebates/tax credits back. I would like to set it up with batt. backup. I built our house and wired critical systems on 2 sub panels for this purpose.

Stoneleigh, someone told me that one could create your own mini grid using the grid tied inverter sync to a batt. tied inverter to power things when the grid is down and the sun is out. Have you done this before Stoneleigh?

In 2 years our power went off 1 time for 2 hours, we are close to the local substation. Maybe worse in the future.

gasman said...

coy ote

sorry, did'nt mean to attribute the cuban comment to you.

On when shortages will occur, It is hard to say, It will be different for the various specialties. It is very difficult to get in to a dermatologist with waits of 3 months or more. The pipline is long with cardiothoracic surgery and demand may be artificially constrained with rules regulating who gets what surgery.

anonymous

I will one day be on the receiving end of this system. I think when that time comes, I will be lucky to get a tetanus vaccination

RC said...

Mr Coy, I am in favor of less people and more food and of getting there as nicely as we can. Playing God, I control all sorts of populations at the macro and micro and sub micro {viral and atomic}levels in my dealings with semi sentient subjects each day. {That would be my dear plants and their myriad hangers on.} I have observed that when everybody {yes, I have a habit of anthropomorphic construct}in the garden is not crowded by anyone else and there's plenty of snacks for all, maladies and fatalities are limited. Not eliminated, but manageable. Population stress doesn't seem to be all that happy a part of the curve, but it is natural. There are other outlooks about this and I can appreciate some of the arguments but I'm not swayed at present. Less is more when there are more resources for fewer individuals and those individuals are able to restrain their own expansionist nature before cataclysm assists. The aphids can be set out by the ants and all can have their way with my lovely plants until deleterious effects become obvious. Then, it's soap time for the six legged and there goes that pesky population. Rinse, repeat. Literally.

Greenpa said...

pentronicus: Holy Smoke! Sorry, I had the idea so firmly in my head it didn't even occur to me that "car battery" has had an established meaning for a long time.

NOT THAT KIND of car battery! Of course.

Sorry, I meant the batteries that power hybrid and or plug in electric vehicles.

A different kettle of worms, altogether. NiMH, and Lithium mostly, I think. No lead acid. And an enormously larger storage capacity.

Dr J said...

Greenpa, or was it Snuffy, have you seen this from FEMA?

CONSTRUCTION OF A SIMPLIFIED WOOD GAS GENERATOR FOR FUELING INTERNAL COMIBUSTION ENGINES IN A PETROLEUM EMIERGENCY

"This report attempts to preserve the knowledge about wood gasification that was put into practical use during World War II. Detailed, step-by-step fabrication procedures are presented for a simplified version of the World War II, Imbert wood gas generator. This simple, stratified, downdraft gasifier unit can be constructed from materials that would be widely available in the United States in a prolonged petroleum crisis. For exampie, the body of the unit consists of a galvanized metal garbage can atop a small metal drum; common plumbing fittings throughout; and a large, stainless steel mixing bowl for the grate. The entire compact unit was mounted onto the front of a farm tractor and successfully field tested, using wood chips as the only fuel."

http://www.gengas.nu/byggbes/1.shtml

Dr J said...

Dang! I'm going to cancel that Prius I ordered.

Greenpa said...

Amid all the comment about the abilities and compassion of doctors today- and the speculation about the future of any medical "system" in any case-

This was going on a very few miles from me:

47 spend all night locked in commuter plane

200 comments so far- very high number for this venue.

My own analysis- fear of losing their jobs prevented ALL ground and air personnel from taking action- and just letting the people off the plane. And that fear overrode any considerations of human suffering. (and they were really suffering.)

Fear also kept the passengers from just breaking out.

Anonymous said...

Stonleigh,

Have you looked at propane gensets?

The cost per kilowatt is competitive and you can store large quantities of fuel essentially forever.

Regards,

JP
offgrid, 3KW solar, 1KW wind, propane backup

MarkB said...

Hi Stoneleigh,

Thank you for following up my request from the other week with your article today. It is appreciated.

For me, battery life is a bit of a turn off. Although the hybrid I'm thinking of (I do get relatively cheap "time of day" grid electricity at night, which I can use to top up the batteries and ensure their lifespan is as long as possible) would allow me to have a relatively small battery sizing today. I would save my cash to double or triple it when things start going really bad.

Talking to a friend who does this sort of installation work (he is totally off grid, mostly because the grid goes nowhere near his house), the best thing you can do is actively start reducing your load (buy one of those power point electric meters that gives you a reading of how much electricity is being used for appliances - you'll be shocked at the huge amount of power wasted with devices in "standby mode"). He is down to 3Kw/h per day - I have a long way to go to be in that league, but I'm working on it.

Regards.

MarkB :-)

Anonymous said...

Ahimsa @ 4.36

Always something intelligent coming from you. Always great to read you.

Dr. J.

Me thinks you are rather full of self importance and are either highly deluded or on drugs provided by your favorite pharmaceutical company (or both)

Ne c'est pas?

cd

ogardener said...

CONSTRUCTION OF A SIMPLIFIED WOOD GAS GENERATOR FOR FUELING INTERNAL COMIBUSTION ENGINES IN A PETROLEUM EMIERGENCY

That is so cool! I've heard of them but I never saw the plans and specs for one.

snuffy said...

Thats where I started a long time ago,,,with that booklet from FEMA

The "biogass foundation" with a guy name Das and Dr Reed are the 2 men who made sure this technology that was developed in ww2 did not fade away...I have spoke with them several times.Their books and supplies are the bibles for gasifier technology...and are where all the folks on the web got their start...they were the first.Tom Reed was one of the guys who developed that tractor setup..They were working for a organization called SERI...solar energy research institute.
Back in the day,there were more than a few people scared shitless by the arab fuel embargo...that tractor was the result..

There was a time FEMA did some good..

snuffy

snuffy said...

Oh, and they have a LOT more information on the Swedish developments...all their emergency gear runs on gasifier technology


Got some neat gizmos...

snuffy

Ilargi said...

New post up.

Martin, the Netherlands said...

@ anon 3.42: I'm Dutch, and I doubt whether our fried was correctly informed. Expecting mothers are given the option whether to have their baby at home or in a hospital. About half of the Dutch babies are born at home. I know of several babies whose mothers did have epidurals. How long a stay in hospital takes depends entirely on how things go. Both of our children were born at home, although in one case we had planned to go to hospital. (But things went so rapidly that the midwife decided on the spot to finish the job at home.) Stating that epdurals are not allowed, and that mothers who have delivered babies just hours ago are tossed out of a hospital, regardless of their condition, which you are suggesting, is factually incorrect. Whether the Dutch system should be called socialism or not is something that is quite irrelevant here. What matters is that we have a fairly efficient and cost-efficient system, that generally does the job well. I pay (for two adults aged 50 and 48, and two kids at university aged 20 and 18) somewhere between EUR 350 and EUR 400 per month, and in case we use any healthare, a maximum of EUR 155 per person per year extra.

thetinfoilhatsociety said...

Gasman, your (and others') derision of myself and my children is disingenuous. Intubation is a monkey skill and you know it. I know it. I've been doing it for 15 years, in cars while the person is sitting up, when they have half their face torn off, on the sides of roads, in bathrooms, living rooms, between beds and walls, and I now get to occasionally assist in a nice brightly lit room with shiny medical equipment. And then afterward, I get to monitor the anesthesia and make sure the patient remains appropriately sedated/anesthetized while still remaining appropriately warm/cold and perfused. That part is not the monkey skill, which I did point out in my original post.

My point was that you obviously over rate your importance in our system. And you deliberately under rate your pay...I work in the medical field, I know these things...even in the Southwest, traditionally a lower pay area, you make quite a pretty penny. Yes, there ARE many more things going on in a surgery environment than simply the intubation, but you STILL take yourself and your skills much too seriously, while at the same time deriding the skills and time of the local plumber. As you know very well, it's the nurses who do the work of maintaining what you initiated, for much less than half the pay with all the same responsibility liability- and license- wise.

And another thing -- why were you even bothering to price out the Home Depot plumbing service??? You of all people should know that those poor saps employed by HD aren't getting paid $150/hr...Home Depot is. Those guys are maybe getting minimum wage. If you want to fairly compare apples to apples, you should compare a small business plumber with yourself. Do you come out on call? Do you occasionally work weekends? Do you provide insurance for yourself, your employees, and your family? Because the plumbers, electicians, and other home related business owners I know mostly can't afford to provide insurance.

My kids don't have insurance now, and they didn't have it growing up either -- I'm still paying off a hospital bill from 7 years ago when my youngest got pneumonia and spent several days on the tele floor. I am perfectly willing to take a pay cut in order to have that money go to a tax based single payer program that has preventative care as one of its primary features. Had I been able to afford to take him to the doctor in the first place, he wouldn't have been so sick by the time I did take him in...there's only so much supportive care one can do at home even when one is in the medical field. It's a sad statement when people who work in the medical field can't afford to insure their children, and I see it all the time. I am more than willing to get paid less if it means that my children and the neighbor's children and the next town over's children all get to go to the doctor/provider on a timely basis, before they're so sick that they need hospitalization.

And finally, nurse anesthetists are a better option price and skill wise in my opinion. As someone pointed out, having a career track where one only learns the skills and knowledge directly related to the field one plans to work in, is much more cost effective. This is what nurse anesthetists are specifically trained to do and do remarkably well. For a considerably lower cost overall.

Part of the problem with our system generally is that there are so many BS certifications, 'continuing education' requirements (also mostly BS), and specialties, that it makes the whole thing cost prohibitive.

I DO believe in rationing. The 92 year old who stroked out and is going to spend 4 weeks in ICU at taxpayer expense only to die in the end, because the family wants heroic measures, is a waste of money. How many kids' teeth could we fix for that same cost? I think that sort of thing SHOULD be available, if you can afford to pay for it yourself -- just like plastic surgery. You got the money, you get whatever you want. Otherwise there's limits.

thetinfoilhatsociety said...

Gasman, your (and others') derision of myself and my children is disingenuous. Intubation is a monkey skill and you know it. I know it. I've been doing it for 15 years, in cars while the person is sitting up, when they have half their face torn off, on the sides of roads, in bathrooms, living rooms, between beds and walls, and I now get to occasionally assist in a nice brightly lit room with shiny medical equipment. And then afterward, I get to monitor the anesthesia and make sure the patient remains appropriately sedated/anesthetized while still remaining appropriately warm/cold and perfused. That part is not the monkey skill, which I did point out in my original post.

My point was that you obviously over rate your importance in our system. And you deliberately under rate your pay...I work in the medical field, I know these things...even in the Southwest, traditionally a lower pay area, you make quite a pretty penny. Yes, there ARE many more things going on in a surgery environment than simply the intubation, but you STILL take yourself and your skills much too seriously, while at the same time deriding the skills and time of the local plumber. As you know very well, it's the nurses who do the work of maintaining what you initiated, for much less than half the pay with all the same responsibility liability- and license- wise.

And another thing -- why were you even bothering to price out the Home Depot plumbing service??? You of all people should know that those poor saps employed by HD aren't getting paid $150/hr...Home Depot is. Those guys are maybe getting minimum wage. If you want to fairly compare apples to apples, you should compare a small business plumber with yourself. Do you come out on call? Do you occasionally work weekends? Do you provide insurance for yourself, your employees, and your family? Because the plumbers, electicians, and other home related business owners I know mostly can't afford to provide insurance.

My kids don't have insurance now, and they didn't have it growing up either -- I'm still paying off a hospital bill from 7 years ago when my youngest got pneumonia and spent several days on the tele floor. I am perfectly willing to take a pay cut in order to have that money go to a tax based single payer program that has preventative care as one of its primary features. Had I been able to afford to take him to the doctor in the first place, he wouldn't have been so sick by the time I did take him in...there's only so much supportive care one can do at home even when one is in the medical field. It's a sad statement when people who work in the medical field can't afford to insure their children, and I see it all the time. I am more than willing to get paid less if it means that my children and the neighbor's children and the next town over's children all get to go to the doctor/provider on a timely basis, before they're so sick that they need hospitalization.

And finally, nurse anesthetists are a better option price and skill wise in my opinion. As someone pointed out, having a career track where one only learns the skills and knowledge directly related to the field one plans to work in, is much more cost effective. This is what nurse anesthetists are specifically trained to do and do remarkably well. For a considerably lower cost overall.

Part of the problem with our system generally is that there are so many BS certifications, 'continuing education' requirements (also mostly BS), and specialties, that it makes the whole thing cost prohibitive.

I DO believe in rationing. The 92 year old who stroked out and is going to spend 4 weeks in ICU at taxpayer expense only to die in the end, because the family wants heroic measures, is a waste of money. How many kids' teeth could we fix for that same cost? I think that sort of thing SHOULD be available, if you can afford to pay for it yourself -- just like plastic surgery. You got the money, you get whatever you want. Otherwise there's limits.