AZA contacted EMR and said that the second half of his comment on the 25,000 jobs lost post by Jim Bacon has been deleted three times since 8:00 this AM. (The time stamp on the Blog is off by an hour.)
EMR saw the third attempt to post when it was up at about noon. It is gone again. AZA asked that EMR read over his comment and if it made sense, to post it as an original post since Jim had asked a question raised by the first part when the second part was removed.
EMR is pleased that former students can understand what EMR has been saying and often get ahead of him. AZA’s comment seems like a fair statement and may temper Jim’s tone at the Whoop Ass session later today.
Here is AZA’s revised complete post that was originally forced to be divided in two because of length and the second half deleted on three occasions:
...............
Mr. Bacon asked:
“AZA, If it makes economic sense for there medical facilities to be based on the scale of the territory served – Neighborhood, Villages, Communities, Regions, etc. -- then you have to explain why that distribution does not exist today.”
We would refer those who do not yet understand this issue to Professor Risse’s treatise The Shape of the Future (SotF). In Volume I he demonstrates that the organic framework does exist but that human economic, social and physical activities are not yet distributed based on organic reality for reasons that he spells out in the book.
Some Agency malfunctions result in bad regulations as you suggest. No sane person would disagree.
However, as eggs, hamburger and salad greens that are intended for humans consumption; as deep well drilling to tap the last of the stored natural capital; and as the demise of Maytag – to say noting of the collapse of the housing finance structure – demonstrate, it is Enterprise malfunction and rigged markets that are at the roots of many of societies worst dysfunctions.
As Katrina demonstrates often major disasters are a combination of malfunctioning Agency, Enterprise and Institutional activities in a context of human ignorance parading as ‘culture,’ ‘freedom,’ ‘patriotism’ or gods will.
“The idea of making different types of medical services available at different geographic levels is an elegant one.”
Yes, and it is also a condition precedent for efficiency and effectiveness in the delivery of all the services upon which humans depend for health, safety and welfare.
“But economies of scale will continually change with new technology and new delivery models.”
The illusion that churn, flux and ‘innovation’ will continue or accelerate is just that an optimistic illusion, a Myth. Natural systems do not work that way. They ebb and flow. Humans are running out of resources (including natural capital) to fund the luxury of continual change and ‘innovation.’ Professor Risse addressed this 10 years ago in the ‘Past Shock’ section in Vol II of SotF.
(End of Part 1)
The next really big innovation in medicine will be delivering a doctor to the bedside by wire. Not the doctors image or the patients image but the doctor himself. Do not hold your breath for this innovation to occur.
Even today the vast majority of the medical ‘solutions’ are available to only a very few at the very top of Ziggurat. It these procedures and interventions were subsidized so all citizens could benefit, the medical costs alone would bankrupt society long before Boomergeddon.
This reality is a key problem with Enterprise provision of medical services. It is EXACTLY like the drivers of the Affordable and Accessible Housing Crisis about which Professor Risse pontificates. Trickle Down does NOT work for any except those at the very top of the Ziggurat.
Trickle Down drives the Wealth Gap.
“Who decides what is appropriate at which level on an ongoing basis? Whom do you trust to do that, if not the marketplace?”
The only answer we have ever heard that COULD actually work and preserve Democracy and market economies is “enlightened Citizens.”
It is not regulations (Agencies), not markets (Enterprises) and not faith or Myths (Institutions) that alone can achieve what Prof. Risse calls a sustainable trajectory for civilization.
Citizens are the voters, the owners and the members of Agencies, Enterprises and Institutions.
Citizens and their Households are also the sole members of the New Fourth Estate.
As Professor Risse demonstrates in THE ESTATES MATRIX that it takes all FOUR legs of the MATRIX to manage a modern technologically based society.
As demonstrated by eggs, hamburger, etc. noted above ‘markets’ can only be a rational distributor of the resources necessary to support health safety and welfare of society IF citizens are well informed and all Four Estates work in harmony.
Enterprise controlled markets will always work to optimize short term profits not the happiness, safety or long term sustainability of citizens, Households or civilization.
The only possible ‘solution’ is for citizens to understand the need for and them support implementation of :
Fundamental Transformation of governance structure (Agency Transformation – including rational regulation with controls, programs, policies and education exercised at the level of impact.)
Fundamental Transformation of economic structure (Enterprise Transformation – a market economy is essential but they must be enlightened markets and Enterprise scale is as important as Agency scale.)
Fundamental Transformation of human settlement pattern (This is essential so that citizens and their Households and their Organizations (Agencies, Enterprises, and Institutions) – can manage society.)
In this context blaming the current president for killing 25,000 jobs as Mr. Bacon’s earlier post does is not just wrong, it feeds the Anger of Ignorance.
Larry G’s cautionary note about the Google searches is ABSOLUTELY RIGHT. That is why tossing rocks at empty pigeon holes (or tossing cans of Glen Beck Red Meat Whoop Ass) is akin to yelling FIRE in a crowded theater.
That is also why civilization as we know it may be doomed.
Pandering governance practitioners, including those selling ‘traditional values’ as well as Enterprises (including MainStream Media) and Institutions (especially the political Clans) have been lying to citizens to stoke Mass OverConsumption.
For their part, citizens are not taking responsibility for the collective impact of their actions.
The longer the meaningless rock tossing goes on, the less chance of citizens making better choices at Google and everywhere else.
AZA