Another exciting adventure in the US medical system

Well, perhaps not so exciting.

I was in Washington a couple of weeks ago for the AGU Chapman conference on the East Asian Monsoon. My trip there was long enough that I needed a dialysis session, which I had tentatively arranged through Fresenius. I had identified a clinic near the conference, and had received word that they would schedule me in for either the Tuesday or the Wednesday that I was there. Unfortunately, my phone was not working properly, so I needed to have them contact me via the hotel. There was also a brief hang-up over the transfer of necessary medical records from Canada, but everything seemed to be in order by lunchtime Tuesday--I had been introduced to my coordinator and was advised to wait for their call.

This meant that I had to run back to the hotel lobby during every break (of which there were several) to see if the clinic had called. Making matters worse, I was never given any direct number to call the clinic directly, so I had to go through the company's national switchboard each time, and deal with a different operator who had to locate my file and see how things were going. Every time I was advised to await their call.

It was the same thing on Wednesday. Await their call. And by evening, it seemed clear I was not going to get dialysis--I was flying back on Thursday afternoon, and would have a session in Toronto on the Friday. No explanation, or indeed any attempt a communication, seems to have been made. I have to add that the situation at the hotel was mildly chaotic as well, as the hotel had just been bought by a new operator and was undergoing transformation to a European-style hostel, and their phone system was a little bit erratic. It was impossible to call out, for instance. I thought it possible that a call from the clinic might have been missed . . . except whenever I called, they told me they hadn't called yet.

By Thursday, the fluid levels were high enough that I had a little trouble breathing, but luckily my potassium levels stayed below the point where it triggers heart attacks (the main worry of the nurses back home) and I was able to survive until Friday.

I don't officially know the reason I was ultimately rejected for dialysis. I suspect it was that I may have triggered a poverty alert--no phone, and staying at a hostel (it wasn't actually a hostel yet, but the hotel was listing itself as such). I gather that under the US rules, if a poor person somehow tricks a medical clinic into providing some medical care, and then can't afford to pay, the clinic has no real recourse. Having a national operator is one more way of heading off poor people before they get in the door. They were willing to let me die because they thought I might not be able to pay a $200 bill.

It's a mad, mad, mad world

The new New Age

Anthropocene is a movie which appeared in the Toronto Film Festival this year. It has since gone on to appear in a few cinemas hereabouts.

It is a visually striking film. But if you are already familiar with its message, it is a little slow.

The movie trailer is unfair to the gentleman from Hong Kong who owns the ivory shop. All of the ivory depicted in his segment in his store is fossil ivory, something made clear in the film, but not the trailer. I went to one such shop when I visited Hong Kong--if you want a carved tusk, you can have one for about the price of a house.

I first encountered the term "Anthropocene" as a proposed name for a new geological epoch--one in which the forces modifying the earth's surface are dominated by human activities--in 1987 or 1988, in an issue of Geology. I only remember the time because it was when I was in Newfoundland, and looking back casually through recent publications only shows more recent references.

The original article was very short, and as I recall, attracted a firestorm of responses in the form of letters to the editor. Most of these suggested alternative names to this epoch, ranging from "Neocene" and "Cenocene" (often accompanied by dry, pedantic discussions about why one name was superior to another), but there was one clever wag who proposed we call this new epoch the "Shouldhavecene". Yes, we should have.

Anthropocene seems to have won out, or at least it has the upper hand.

Thirty years ago the world was a different place. At the time the first article appeared, it seemed like a joke, this idea that humans could dominate the surface features of the planet. Part of this is a kind of blindness. Grow up in cities surrounded by farms and this landscape seems like the most natural in the world. Add to this Canada's managed forests, some tourism commercials, and it was easy to think that nearly the entire country was untouched wilderness.

Onwards in the theme of human impacts on the world. Yesterday we had the second (annual?) Progressive Mine Forum, held in the MaRS Discovery District, which is a sort of breeding tank for tech industries. It covered numerous themes related to modernizing the industry, from mechanization, reducing fossil fuel usage, "green" mining, battery metals, and so forth.

Quote of the day: "You know who likes big trucks? Ten-year-old boys and mining engineers." I think that was Nathan Stubina of McEwen Mining.

Interesting idea of the day: Just as Uber is the largest taxi company in the world (which owns no taxis) and Airbnb is the largest hotel chain in the world (which owns no hotels), might there arise a large mining company that owns no mines? The speaker, George Hemingway of The Stratalis Group mentioned that Apple is proposing to use only recycled material in their products. What if they do the recycling? What if they became so good at it that they begin to supply recycled material to everyone else. Apple (or any other large tech company) has a huge advantage over traditional mining companies--they have no trouble attracting financing to projects with no projected return.

Beginning

I want to write this here so I don’t have to keep repeating it.

1. You are wealthy at birth. By wealth, I am referring to the net present value of your life’s earnings, discounted at a reasonable rate—or at least what was a reasonable rate before our current inflationary economic system.

2. There are those who believe it is unfair that you should be wealthy by right of birth. These people are frequently (but not always born wealthy by virtue of wealth within the family). This wealth is necessary because many of them would not earn any wealth during the course of their life otherwise.

3. The goal of the system in which you are embedded is to strip of you of that (in their eyes) “undeserved” wealth. After all, any fool can be born. Why should they be wealthy?

4. The means of stripping you of your natural wealth is by inflationary means, which increases the discount rate so much that the net present value of your future labours becomes zero (you can learn how to perform NPV calculations here ).

5. The role of government in all of this is to deliver you into this system. To this end, you are educated to be passive, docile, and ignorant of financial matters. You are blinded from this reality by a succession of atrocities and entertainments.

6. Government must handle your education so that you will cooperate with the system. Among the first things you learn is that government and its agents are your friends. Consequently, in early primary school you were introduced to firemen (your friends), the police (your friends), the principal (spelt ‘pal’ because he is your pal).

7. Any group that does not recognize the primacy of government must be eliminated. Hence, the Branch Davidians, the home schoolers, the FLDS (see here, for instance), and even the Muslims are demonized. The differences between ‘us’ and ‘them’ are emphasized and expressed as a reason for their demonization.

8. We must be educated to be divided, for if we were to unite, there could be unpleasant consequences for the architects of the system into which we have been born. We are divided by age into cohorts, and any social mixing of these cohorts is discouraged. Similarly we are divided in school by grade (A, B, C, D, and F, although those are not given much any more) similar to the alphas, betas, gammas, deltas, and epsilons of Huxley’s Brave New World.

9. The coming goal is to place controls on all forms of economic activity so that the flow of money can be tracked from your employer or business to your pocket to your local merchants.

10. The plan requires top-down control of all activities.

11. All transactions could be taxed. But what if we bartered. Or what if we used something outside of the system as money. Like the stone wheels of Yap, if we trusted each other, the commodity used might not change hands, merely ownership. Consider two individuals. One has money in Canada. One has money in Singapore. They wish to exchange, in order to move the money. But the money doesn’t move, only the ownership changes. In a system based on trust, no money crosses the borders. And the powers that be cannot trace the ownership, for it is purely conceptual. But this can only work if we trust one another and have respect for rights of ownership.

12. Our respect for the right of ownership has been degraded by the politics of democracy. Each of us is a participant in a scheme by which the majority expropriates property of some minority for some purpose. Actually, the expropriation is ordered by a majority of politicians each of which can claim they were voted in by the population of a particular area (not always a majority). We may or may not agree with the expropriation, but have little ability to change it.

13. The remedy is trust. Trust and faith in ourselves, and in each other. And distrust in authoritarianism.