Fragility

We are living in the aftermath of several huge hurricanes, and a couple earthquakes. There was also some talk recently on the news about the first American to climb some dangerous summit, about Elon Musk’s plan to emigrate to Mars, and a joint US-Russia moon base. Good luck with that. All have something in common. Hubris.

When I hear about climbing, diving, trekking, soaring or blasting off, my heart does not beat fast, my adrenaline pump, not do I begin packing pitons, parachutes, scuba tanks or ray guns. Call me timorous, lazy or unimaginative, but I am happy in my comfort zone. And so are all living things. Like the birds and the bees, seaweed and sequoias, humans evolved to operate n a limited range of conditions.

Like the Goldilocks in “The Three Little Bears,” we can’t survive if our environmental porridge is too hot or too cold, our beds too hard or too soft. We need conditions to be just right. Above a certain temperature, our lives are threatened; below a certain temperature hypothermia does us in. Too little oxygen in the atmosphere, adios. Too many pollutants, same story. Foods are essential, but adulterated they are poison. Bad water or too little hydration kills us. Life is a delicate balance, easily upset.

Yes, human endurance, will, and audacity can permit us to push ourselves to the limit, but they ain’t called limits for nothing. They are real. If you crash in the Andes, shipwreck in the Antarctic, are pursued by murderous men or beasts, you may attempt prodigious feats to survive — crossing deserts, ice fields, mountain passes.

But to risk your life voluntarily for a thrill or an entry in Guinness is frankly cuckoo. The fittest who survive are rarely the lunatic risk takers of a phylum, genus or species. More often they are the slow and steady moss, unobtrusive guppies or highly adaptable beetles.

Yes, our ingenuity has allowed us to engineer ways to dive deeper and stay down longer than our physical equipment has evolved to handle. We can soar high using G-suits, oxygen tanks, space suits, but we can only pay visits to alien habitats for brief periods and only if heavily armored.

Most of the universe and a lot of our planet is hostile to our frail form of life, maybe to all forms of life. A creature that needs sunblock, socks and shoes, and an atmosphere that shelters it from invisible rays probably isn’t going to thrive on the Moon, Mars or Titan. The first men into space drew the obvious environmental conclusions. Our island earth is our home, and if we continue to degrade it we are dead ducks.

We are also enmeshed in a vast web and messing with any of it cam have unforeseen consequences. Nomadic tribes grazed their flocks promiscuously and soon they created deserts where oases had been. Dumping garbage, poisons, sewerage into rivers and oceans once seemed fine. The waters carried it away. But they don’t. The seas are vast, but not as vast as our ability to despoil.

Climate change deniers believe the endless sky can take any amount of pollutants we pump into it, but they too are wrong. As are fans of nuclear power and nuclear arms. The half life of these ghastly radioactive substance is hundreds of thousands of years longer than our own trivial span. Grown-up campers are expected to leave their campsites as clean as they found them. Time to treat the planet the same way. Not to be polite but to survive.

This week we have received another wake-up call. Puerto Rico was ground zero for a major catastrophe. Trees fell, roofs blew off, waters rose. But the real problem is the interdependency of the complex, fragile systems we all depend on — roads, the electric grid, telecommunications, ports. When one is disrupted, others fail. Pretty soon, we can find ourselves rocketed back 300 years, before the industrial revolution and living in a world that requires skills we don’t have and can only support a few resourceful humans, not millions.

And what happened to Puerto Rico due to a storm can happen to the rest of us by accident or malice or over dependence on a delicate web of systems. The big quake that California has been bracing for would make Puerto Rico look like a picnic. A crashing electric grid could kill tens of thousands. Hackers can reintroduce people to winter by shutting down pipelines, rob our banks, self-drive our cars or planes into oblivion.

An example from Puerto Rico is instructive. Congress in its wisdom gifted the territory with tax breaks that made it financially advantageous for pharmaceutical companies to locate plants there. Since it was cheaper to produce there, offshore competitors flocked to the island. Lower prices for sick people were supposed to result, higher profits surely did.

But Maria knocked out plants of Baxter, Pfizer, Merck, Eli Lilly, Bristol Meyer-Squibb, Amgen and many more, not to mention the factories of 30 medical device manufacturers. Seventy-two percent of Puerto Rican exports are involved, dealing a major whammy to its already stricken economy, but the real worry is a potential shortage of medicines for you and me and grandma.

People in the United States and many other countries are dependent on mediations from Puerto Rico including some for HIV, diabetes, cancer, high cholesterol, and immunosuppressants for transplant recipients. In out modern, interconnected, global supply chain world, any disruption can be deadly — literally. We need to abandon our complacent faith in our self-sufficiency, our ability to go it alone, our smug superiority and rugged individualism. We are all together on a little life raft, and if some damn fool capsizes it, we all drown.

Realizing this doesn’t make me a globalist, a socialist or a tree-hugger. Rather, it makes me a me-hugger smart enough to realize I am a tiny, vulnerable mite dependent on both the physical environment to which my kind has adapted over millennia and the immense, world-spanning structure humans now depend on that we call civilization. If you think you aren’t in the same boat, look around. And if you think disruption can’t be deadly, watch the news from Puerto Rico.

One Trick Phonies

Here we go again. Donald Trump — the populist — promised to change healthcare to improve the lives of regular working people by giving them better coverage for less money. He’s now promising to pass tax reform that will be “a middle class miracle.”

But the Republican Party, to which Trump leaves the design of his policies, is not a hotbed of populism, except when they are running for office. When governing, they have a far different goal. It’s been the same for the last forty years, ever since the Reagan-infatuated party drank the supply side Kool-Aid.

According to this mythology, if you slash government programs that help regular people and cut taxes on rich people, the economy will boom and everyone will benefit. Growth will offset the loss of revenues so the windfall will be free. The trouble is, no matter how plausible the huckster, it never works out that way. Theres no free lunch, so regular people lose government programs that improve their lives, the rich get richer, but the economy does not boom, deficits skyrocket and the only thing that trickles down to us or our children is the unpaid bill.

Eventually, the regular people may begin to feel they are being conned. They noticed during the healthcare debate that Obamacare wasn’t the bogeyman described by the Republicans, but a lifeline crucial for many, and that Trumpcare would have degraded their prospects.

Will the scales fall from the eyes of an aggrieved populace regarding the “miracle” tax plan before it can be jammed through? Not if the Republicans can help it. They’re trying the same trick they did with healthcare. They are concocting the mess behind closed doors, without input from the minority party. They are speaking in glittering generalities, offer as few details as possible, and will try to enact their handiwork before the reality can dawn on the intended victims.

Trump and the minions he sends out like to front the plan, Gary Cohn and Steve Mnuchin, keep telling transparent lies, especially that millionaires and billionaires like them won’t get anything out of tax reform, only the little people will benefit. How dimwitted do they think we are?

People like Trump, his plutocratic cabinet, and the donors who call the tune for the Republican Congress will make out like bandits, because they are bandits — robbing form the poor to feather their already gold-plated nests. TrumpTax calls for eliminating the estate tax, for instance. But it only affects people with over $11 million. The Alternative Minimum Tax that prevents the super-wealthy from using loopholes to pay less tax than working stiffs would also be eliminated, and the top rate would be cut to ease the suffering of those who make more than $470,000 a year.

Analysis by the Urban-Brookings Institute suggests the plan would increase after-tax income for the bottom 80 percent of taxpayers by less than one-half of one percent. So, someone earning $1,000 a week would gain about four dollar. And the Republican budget would rub salt in the wound by cutting many government benefits that middle and low income workers depend on.

By contrast, the top 1% of taxpayers would get a tax cut of 9% which would increase their take-home pay by an average of $200,000. People like Trump, Betsy DeVos, Wilbur Ross and Cohn and Mnuchin, the authors of the plan, that is, those in the top 1/10th of 1% would receive an average tax cut per year of over $1,000,000.

But that’s peanuts compared to the Estate Tax windfall for wealthy families like the Trumps. The tax doesn’t apply to 99.8 percent of Americans. Only 5,500 tax returns a year belong to estates large enough to be taxed. But for those megarich families, the windfall will be huge. If Trump is worth the $10 billion he claims at his death, the repeal of the estate tax would give Melania, Don Jr., Eric, Ivanka, and Tiffany a tax break amounting to $1.9 billion. Wilbur Ross’s heirs would get an additional $545 million. Betsy DeVos’s heirs a cool $900,000 million. The children of the other 99.8 percent of us would get nothing, no benefit from this tax change, except we’d probably have to pay for the government services now financed by the taxes on the billionaires or kiss them good-bye.

Economics writer Steven Pearlstein reports in the Washington Post the interesting fact that most voters are not yearning for a tax cut. Only those in the plutocratic class. According to a Pew survey, only 26% of us think we are paying too much in taxes. Sixty percent feel corporations and the wealthy are paying too little, which is the exact opposite of what the TrumpTax plan would do.

Instead of a tax cut for themselves, most people say they want the government to do a better job of spending the money on schools, infrastructure, healthcare and an income safety net for the elderly, veterans, and the deserving poor.

Instead of a plan along those lines, TrumpTax would provide a tax break for the rich of $1.5 trillion paid for by more deficits. And Brookings research also shows that the effective corporate tax rate is not the highest in the world 35% Republican talking points claim. Instead, but corporations pay an effective rate of 24% on average.

And half of all business profits are not taxed at all due to loopholes and pass-through provisions that gift them with a lower tax rate. Such tax avoidance schemes are not available to wage-earning tax payers, but allow the hedge-fund class to dodge $100 billion a year in tax liability.

The only middle class miracle that will occur in regard to TrumpTax is if middle class taxpayers let Trump and Congress get away with this gigantic con. Doing so would be a lot more generous to the Trump cabal than they plan to be to the rest of us. The malefactors of great wealth always cry class warfare when tax reform arises, but this too is a con. Only one side is waging class warfare, which is why they keep winning. Until the sheep wise up, they will keep getting sheared.

Doc Fix

I am friendly with a doctor of a certain age who has, for many years, been a fixture of a small-town practice and a rural hospital with their economically challenged clientele. He was born, raised and trained in Canada, but came to this country to practice medicine.

He believed the Canadian system was overly bureaucratic and constrictive whereas the United States allowed doctors to practice with fewer fetters and with greater opportunities, and he has both served his patients well and prospered here as an American citizen.

But a funny thing happened on the way to retirement age. He now thinks the Canadian system may be superior in some important ways. It has loosened up and now permits patients more choice through optional insurance plans, rather like the Supplemental or Advantage plans that Medicare recipients can opt for.

I don’t want to put words in my friend’s mouth, but it seems clear form our conversations that part of his uneasiness with our present system is that it leaves too many people out in the cold, including many of the less than affluent people in his neighborhood. Neither the Rube Goldberg complexity of Obamacare nor the heartless cruelty of Republican alternatives has seemed like a solution to what ails the system.

Though he once thought the Canadian system concentrated too much power over medical practice om the hands of government bureaucrats, at least they had the health of patients in mind. Our system concentrates power in insurance companies whose motives are mixed at best – patient welfare perhaps, but their own profits for sure.

He believes everyone has a right to medical care and believes the Canadian system’s method for achieving it is comparatively sensible and straightforward, by means of a VAT, or national sales tax, whose proceeds are dedicated to funding healthcare for all.

At one stroke, this eliminates the tethering of employment to health care and unemployment to peril. The yoking health and jobs looks increasingly problematic in a shifting economy where lifetime employment is extinct, benefits are often unavailable, and many must eke out a living in a gig economy.

A single payer system, that substitutes a dedicated consumption tax for a payroll tax on workers or a deductible business expense for employers, might therefore be expected to allow companies to charge lower prices or increase wages, and could help protect the health of workers health from unpredictable economic ups and downs

A healthcare system for all also gets the expensive insurance bureaucracy out of the middle. The overhead for running Medicare is about 3% while the insurance companies can eat up as much as 18% of health dollars. Furthermore, the huge purchasing power of a single payer system explains why pharmaceuticals, invented and manufactured in America, often cost less in Canada, France, Germany or Sweden.

Of course, the odds of such a change taking place here are slim to none. Patients might welcome it, and so might providers who can be squeezed or micromanaged by insurers. But those who profit under the present patchwork mess – insurers, pharma and so on – have got a lot of clout.

And the party in power objects to any solution to any problem, other than war, that relies on bigger government or higher taxes. A system that is good for big business is fine with them even if it is bad for small patients.

This was on vivid display when wheelchair-bound protesters, fearful of losing healthcare, were dragged out of a congressional hearing and placed under arrest. This doesn’t happen in the rest of the developed world. Perhaps we are not as developed as we like to think.