Wednesday, August 1, 2007

Fortress Update

Another day with great progress on our safe-house! Davy and his 14 year old son Alfredo (at right) worked a long day today, and actually they're still hard at work as I write this. They're going to finish up the seventh run of block, where the wall will be just shy of five feet high.

For some reason that I don't fully understand (and probably never will), the County planning department requires an inspection when the wall is no higher than five feet high. So now all work on the project must come to a crashing halt, while we wait for the inspector to show up tomorrow. Since we have no idea when the inspector will show up (they give us no clue at all), Davy and his sons will work on another job tomorrow. Hopefully they will return to the job on Friday – assuming, of course, that we pass the inspection tomorrow.

The work done today was essentially a continuation of yesterday's process. I saw just a couple of new techniques. Davy used a piece of scrap lumber I had laying about, with a few blocks, to make a perfectly usable scaffold. If I understood him correctly, on future days when the wall is considerably higher, he'll bring a real scaffold to the work site. And I saw a simple and clever tool: a pair of cast metal pieces designed to grasp the top of the blocks on a corner while holding a string in exactly the right place to act as a guide for laying the block. With these tools, Davy had a guide string set for each new run with just a few seconds of work.

Here are some more photos of today's progress:

Scary Socialized Medicine

My mom sent me an email copy of an interesting commentary piece by a person whose name I recognized: Dr. David Gratzer. He's a Canadian doctor, practicing in both the U.S. and Canada, and a crusader for capitalist (e.g., for-profit) medicine. Here's a quote from this latest piece, which appeared in Investor's Business Daily:

Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care.

I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic — with a three-year wait list; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks.

Government researchers now note that more than 1.5 million Ontarians (or 12% of that province's population) can't find family physicians. Health officials in one Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment.

These problems are not unique to Canada — they characterize all government-run health care systems.

Dr. Gratzer is particularly good at rebutting the arguments of liberals who cite the “evils” of American medicine (think Michael Moore and Sicko). For example:

Americans live 75.3 years on average, fewer than Canadians (77.3) or the French (76.6) or the citizens of any Western European nation save Portugal. Health care influences life expectancy, of course. But a life can end because of a murder, a fall or a car accident. Such factors aren't academic — homicide rates in the U.S. are much higher than in other countries.

In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don't die in car crashes or homicides outlive people in any other Western country.

And if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50%; the European rate is just 35%. Esophageal carcinoma: 12% in the U.S., 6% in Europe. The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England — a striking variation.

If you have even the slightest inclination to support socialized medicine, or any legislation that reduces the independence or profitability of American medicine, please … read the whole thing. Another relevant commentary piece (in the Wall Street Journal) is here, an index of Dr. Gratzer's essays here, and his books here.

In my travels I have had the opportunity to meet and get to know quite a few people who live in countries with socialized medicine – especially in England, Germany, Estonia, and Russia. In each of these countries, I have posed a similar question to several people: “Suppose your spouse or child had a life-threatening cancer. Suppose that you were independently wealthy and could afford to have your loved one cared for anywhere in the world. Where would you take him or her for treatment?” Every single person I have asked this question of instantly said “America”.

Why is this so obvious to the people who live under socialized medicine? Most of the people I talked with had never even been to America – and yet they are absolutely certain our medical system delivers superior care. When I probed this, the typical answers were variants of “our system is so bad that America's must be better” and “America is where all the rich people go, and they'd know better than I”, with a few “I have friends or relatives who have moved to America, and they tell me the medical system is wonderful there”.

But our liberals tell us – against all evidence that I'm aware of
(not to mention common sense!) – that socialized medicine is superior.

My mom's reaction to this editorial was to suspect it was exaggerated, but generally on target. I'm glad her instincts are to suspect the evils of socialist medicine. But I cannot for the life of me understand why so many Americans (including my mom) have so much trouble believing just how bad socialized medicine really is. For me, the essential problems are obvious: (1) any system in which a desirable good or service is “free” will inevitably lead to shortages and rationing, and (2) any system that does not provide financial incentives for success and excellence will decay into shoddiness. Our public education system suffers from these two problems. Socialized medicine, everywhere I've ever been, suffers from them as well. Examples of drug rationing, surgery backlogs (a form of rationing), and diagnostics rationing abound. Doctors – especially the good ones – flee from those countries to America, where they can make good money. Why is this so hard for so many Americans to absorb? I cannot fathom it.