Curiosity Over Pride (FYI: To comment, send an e-mail to scifidink@gmail.com)

Monday, May 10, 2010

A demon of our own design



H/T Greg Manikw

All the "other" things I like are only 23%!

28 comments:

Thai said...

Comments

Dr John said...

Impossible is what comes to mind. We cannot maintain this trajectory. I am 46 and do not expect to see a single dime I put into Social Security. I would gladly give up all of it if someone would walk in and say they were cutting 25% of all Govt. spending across the board and eliminating the Dept. of Transportation and Education now. Also the BAFT and I think the FCC too. There are lots of others but that's a start.

Thai said...

The only way you will not see it is if it is stolen from you.

And your trade off would be a pretty bad deal

Look at he chart yourself, government spending as you think of it (dept of education, etc...) is less than 30% of all spending

The rest is military, interest payments and income transfers (which medicare is a form of)

Dr John said...
This comment has been removed by the author.
Dr John said...

That is why I said we need to cut ALL spending by 25% Thai. This means slashing military spending too along with everything else. We cannot afford to be involved in perpetual would conflicts and run a welfare state.

Dr John said...

sorry for my typos.

Thai said...

I hear you on the wars

Having said that, we should call a spade a spade

Even with the wars, we are not in "high territory" re: military spending

And if you compare this to others nations over the last 500 years, it does not look so bad for us at all.

JP said...

Social Security is not going to be eliminated absent some sort of massive political revolution/war.

It's simply too popular and (along with food stamps) too many people require it to survive.

That's not to say that it won't be means tested and cut through the magic of massive inflation, but it's here to stay.

Thai said...

I totally agree.

I don't think it is going anywhere and the more volatility we experience, the more this will be reinforced.

It is more one of those "how to keep the termites out of the wood" issues, which is admittedly tough with colleagues of Dr John and I qualifying methadone users in ever increasing numbers.

We live in interesting times.

Dr John said...

I agree SS is not going away.I can dream however. Does anyone have any predictions on if and or when we will see the roster of those on SS cut back. I will go on record saying that in over 15 years I have never agreed support anyone's claim for SSI.

JP said...

Dr. John says:

"I will go on record saying that in over 15 years I have never agreed support anyone's claim for SSI."

So what do you propose the solution is for the unemployable mentally retarded schizophrenic population if you don't like SSI?

Thai said...

Amen. There is no good solution. If you have thought of one I'd love your thoughts.

FWIW- My issue has never been this group by the way, my issue is with the healthy malingerer as I said earlier.

One idea I've toyed with is the amount available is fixed against some kind benchmark (say as a percentage of SS total). The amount that is paid out monthly depending on the number of people sipping fom the pool. Further, the people deciding who qualifies are paid from the pool and they are appointed (or voted) into this role.

Of course there are problems with this approach so I'm not wed to it

JP said...

Thai says:

"If you have thought of one I'd love your thoughts."

Some sort of subsidized supervised group living arrangement, I suppose. Most of these people need representative payees to handle their money, anyway.

I didn't realize that there was such a large population without the ability to simply funtion in life until I started actually meeting some of these people.

I've met some of the "educable mentally retarded" as they used to call them. It appears that with appropriate supervision and training, they can do some productive things. However, if it's mental retardation plus additional problems, it becomes much harder to obtain any employment whatsoever.

Thai said...

This is fine individually but it does not adress the global tragedy of the commons issue

how do we get people to see this?

Dr John said...

There is really no such thing JP as "mentally retarded Schizophrenic". The construct of Schizophrenia is not applicable to those with IQ's below 70 in reality if it is even valid which I have doubts about. This does not keep misguided doctors who do not understand the definition of the term "construct" of making wild claims that people suffer from multiple psychiatric disorders like MR, BAD, PTSD and Schizophrenia all at the same time. I guess that is for another post. You may find this of interest.

As to the need for a safety net for those who cannot provide for themselves, I agree with one. It should not be a program that I am told will be my retirement account or so easy to get to.

Doctors have no particular expertise in identifying the disabled anymore than a lawyer or a housekeeper does. I see people with very grave impairment working and others who have no visible sign of impairment not. How does one now if someone is disabled? Disabled for what?

Giving people money who are "disabled" to spend on crack and whores, which I see every day does not appear to be a wise utilization of tax dollars or as importantly doing much good. Unless perhaps you are a crack dealer or a whore making your living off the disabled. Or even worse a Dr or a lawyer doing so. I want to puke every time I see the smarmy lawyer on TV trying to convince me he can get me my "rightful" disability claim.

Thai makes reference to this problem I think and I agree.

The obviously disabled do not need me arguing their case in court.

JP said...

"Giving people money who are "disabled" to spend on crack and whores, which I see every day does not appear to be a wise utilization of tax dollars or as importantly doing much good. Unless perhaps you are a crack dealer or a whore making your living off the disabled. Or even worse a Dr or a lawyer doing so."

Yes!

I'm worse than a crack dealer and whore!

Sadly, I don't have any television advertisements.

My only redeeming quality is my love of fractals.

JP said...

Social Secuity Disability is essentially a governmental "insurance policy", since you have to pay into it if you are employed, as a portion of your Social Security Tax.

SSI is the welfare component.

The Social Security Administration basically denies about 2/3 of the claims it receives, essentially on a quota basis.

I can also prosecute patent applications (and litigate), which reverses the tax flow, directing money into the federal coffers from corporations and individuals.

Thai said...

LOL!!

... You did deserve that John ;-)

So if there is some kind of global cop, what happened?

I'm not at all aware of the historical details that got us here. But how did we get to 20% of all monies?

PS- fractals are enough;-)

Dr John said...

I am not sure what I got Thai from JP. Notice I put Drs before lawyers, both less honorable than crack dealers or whores on the disability chuck wagon in my book. We are supposed to have some sort of ethical code that I don't think whores do.

Do not misunderstand my statements as me being preachy or somehow implying I am above this. I am in the gutter looking up at the stars.

The irony is not lost on me that I am making a terrific living off a system I find reprehensible. I just don't know what to do about it.

Thai said...

Re: "We are supposed to have some sort of ethical code that I don't think whores do."

Actually I think it is the whore in our profession that demanded we come up with a code. ;-)

Forgive me from diverging with you a bit (only a bit mind you) as I do love medicine and our profession. I truly am honored to call many of the people I work with colleague.

... FWIW, your frustration at the mess/prison we physicians have created for ourselves definitely includes you in that honor.

I do suggest you read Rich a bit more. He definitely helped clarify for me the issue of "Who do I serve?"

Physicians are not trained to think "what is the value of this relative to everything else my patient might do with these same resources"

Similarly, there is no framework to put the needs of the individual in the context of the needs of the many in most of medicine- yet I'm bless in the ED to have the word "Triage" staring me in the face every day that I work.

I am optimistic we will one day get agreement on these issues again, though I readily admit it may not be in my lifetime.

Lack of clarity in this regard is to no one's advantage long term.

Dr John said...

Thai, I have been reading the Dr Rich blog on a regular basis. Please elaborate on how doing so helped you clarify "who you serve". John

JP said...

Dr. John says:

"Do not misunderstand my statements as me being preachy or somehow implying I am above this. I am in the gutter looking up at the stars."

I'm mostly amused and entertained, more than anything else.

Even Okie told me that he was sorry that I was a laywer.

Dr John said...

JP, why does Okie say that? I am new. John

Thai said...

JP- My wife would say the same thing to you as well if she ever met you as (she's an ex attorney who volunteers pro bono occasionally for a group which assists low income individuals with their legal needs)

... Indeed, as I count, there are 6 Ivy League law school grad stay at home moms on my block and all of them refer to themselves "recovering ex-lawyers".

Lots of wasted education dollars on my block all to become stay at home moms.

Of course if you even question the waste of resources, you can imagine the responses it generates. ;-)


John- Rich was incredibly helpful in reminding me that I really do serve both masters and that a significant part of my training is to try and understand when to shift masters and frame the moral issues around this irreconcilable dilemma.

I only wish medical school and residency had done a better job illuminating this simple truth to me as I was training. Alas it was Rich who really helped me see the issue in its true unsolvable complexity.

FWIW, I do think it is a little easier for an ER doc because this issue faces us daily and the word "Triage" hangs right over our head. Unfortunate for many specialties like medicine or psychiatry, their training often makes it harder to come to grips with the fact that this issue is always there and that judgment is always required to balance the needs of the individual vs. the needs of the collective.

And further, that at some times, we will simply judge incorrectly through no fault of our own.

I think Rich is still having a harder time with this than I as Triage is not part of his mindset. As such, he has developed a kind of "neurosis resistant" model that takes a play from the legal profession to allow him to compartmentalize issues.

I have no problem with this, indeed I kind of like how it can give people the safety of an illusion that a distinction is there that is never really there. I do see how it can help some people continue to spend collective resources in a way that might be hard for say an attorney who really thought their client was going to kill again, etc...

I still think it is a kind of illusion but I guess we all have these/need them so this seems as good a one as any other I know.

... Now getting society to agree to it is another matter entirely. ;-)

JP said...

Thai says:

"Lots of wasted education dollars on my block all to become stay at home moms.

Of course if you even question the waste of resources, you can imagine the responses it generates. ;-)"

It's not as though I actually really attended class or did much in law school. I basically went to whatever classes I felt like and crammed the week before the exams. That was the same approach I had to my chemical engineering classes. I just wanted the Duke law degree, which I then used to get a legal job. Law firms generally hire resumes instead of people, so to speak.

You learn to pratice law on the job, not in law school. It's not like med school at all.

I can't say I actually ever had the much interest in either engineering or law. However, I had a full scholarship for engineering and basically a year's tuition for law school. Still ended up with $120K in law school debt.

I was a clerk for legal services while I was in law school. I still talk to the legal services people on a regular basis. They offered me a job, but it would not have been enough to pay any bills at all.

Thai said...

You need to find a sugar momma

Alas I thought I had it made with mine but she was WAY smarter than I

So now I'm the breadwinner

At least I remains so while this debt bubble continues to fund me

JP said...

I dishoarded all my debt, so that's not an issue.

However, I should have bought gold instead of dishoarding my debt, as my wife now admits.

I wanted to buy gold back in the early 2000s, but my wife, ever concerned about the existance of any debt on the household balance sheet, would not go along.

If I had 4 more science credits, I could apply to med school.

Alternately, I could join the ever lucrative profession of nurse anesthesist.

Thai said...

Those RN anesthetists do incredibly well!

And I too made the same mistake and paying off all debt in 2003 after I got burned in the 200 crashed and I decided the whole thing was a crap shoot.


Alas I did not understand (and still don't to a large degree) currency issues like I do now

Long term I probably has been a wash but it sure was hard to watch that property bubble when it went up up up.

No one tells you this stuff growing up.

FWIW, this was also why I was so impressed with Windward when I first listened to them in 2005.

They told me three simple things:
1. You need to be in all asset classes all the time
2. They think you will never beat the index over the long term for any given market/asset class
3. They think they see an inefficiency in the valuation of asset classes relative to each other that others do not and this is what you are paying them 1% for.

So they buy only index ETFs and try to over or underweight asset classes (a little) with a bunch of computers crunching fuzzy logic/complex-chaotic models which have back tested relationship models over varying ranges for all the interrelationships to the different asset classes they follow.

I can send you a brochure if you want.

By the way, what do you think of this?

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