Coronavirus is like a really lousy snow day

It’s been a while since I’ve written anything, and it’s not every generation that gets to fight a global pandemic. So, it’s time to immortalize some thoughts on this blog.

Like most of the news today, I find solace in knowing this isn’t entirely new. In the 1918 Flu Pandemic people would drop dead in the middle of the street and no one knew why. It might seem silly to think we’re reminding people to wash their hands, but at least we have the good sense to wash our hands. Our understanding is vastly improved. And we’ve learned how to manage health before we totally overrun our healthcare network.

I see rumblings of people irritated that if they can work from home now, clearly we always could and “capitalism wouldn’t let us”. That strikes me as a little self-serving. An immense amount of value is brought into the world through collaboration, teamwork, and just bumping into other smart people. Also, to say nothing of the fact we all know work is different at home. Sometimes better, sometimes worse, but rarely has purposeful. There’s a big difference between sitting on the couch with Netflix on in the background vs. the conference room.

Likewise, much of humanity’s greatest works of art, literature, science, and math came from people who sequestered themselves off from humanity for long periods. But no one operated in a total vacuum. They relied on spouses, kids, and the collaboration of others before and after their best work.

Unlike 1918, our ability to work remotely at all is itself a remarkable bit of progress. Cities ground to a halt and entire economies just stopped when cities closed schools, public gatherings, and quarantined themselves 100 years ago.

We’ve experienced all parts of this COVID-19 situation before. Just never all at once. This is like if we had the flu of 1918 and the stock market crash of 1929 at the same time. But it’s all overseen by Harding’s total incompetence, Andrew Johnson’s racism, combined with Nixon’s fragile ego and paranoia.

What’s more remarkable is if this situation continues for several weeks or months, and it looks like it will, this will be the first time a generation of Americans will have to live with scarce resources.

It’s one thing to talk about a dwindling social safety net, but most Americans haven’t had to live without access to on-demand toilet paper, dining out, and other supply shortages in a long time. Our parents surely remember the gas lines of the 70s, but gas is cheaper than ever right now. Prior to that, this nation hasn’t had to “do without” something since the 40s.

It is fruitful timing considering this nation continues to debate healthcare, too. As reports from the BBC have noted, “America does not have a health system. They have a health sector.” That’s about the best description I’ve heard of how we choose to operate healthcare.

Repeal and replace…with what? How about this?

It seems likely that Republicans in the House and Senate are going to have their way with the Affordable Care Act someday soon. Trump, for his part, has expressed interest in keeping the more popular provisions, like children 26-and-under staying on their parents’ insurance and not denying people with pre-existing conditions.

Those are two rules that are likely to survive. The individual mandate, however, is likely not going to. Which is a key part of the system working. It already had a big hole poked in it from the Supreme Court at its inception. Another poke is likely to be a huge undoing.

“Repeal and replace” isn’t likely to happen, either. But people say they want it. They just never say what should be the replacement. Paul Ryan has been leading the way on this “A Better Way” campaign. When it comes to healthcare they’re largely hands-off, saying what they always said, like “buy insurance across state lines”. This won’t fix anything because the operations aren’t transparent enough for consumers to make informed choices. It’s another cozy relationship with Washington that’s going to begat more problems.

So I thought about it. I have routinely said for healthcare to work for Americans you have to pick a “side”. Either full-single-payer or full-free-market. Any mix of the two and you have too many special interests mucking things up. We know what we get with single-payer, and it does have downsides, but it’s easy to understand.

I happen to think a free market system would be more uniquely American and healthier in the long-term. Here’s Hartercare:

First, we’re going to require hospitals, medical providers, and pharmacies publish their prices clearly and consistently for everyone. If Starbucks can put the calorie count on a muffin, you can tell me how much a pill costs. This will give consumers the critical piece they need to make informed decisions on non-emergency care.

Second, we’re going to have a debate about patent reform. The fact hospitals often don’t seem to know how much an MRI costs or how much a drug costs is part-and-parcel with patents. A $30 million piece of equipment costs $30 million because of patents. Patents are important for a lot of things, but healthcare seems to be an area where that profit is more problematic. If transparent pricing doesn’t work, then let’s setup patent reform. This could be government buy-backs of technology, front-loading the research grants (maintaining our status as a research powerhouse), limiting their duration for drugs and life-saving patents, or all the above.

Third, encourage employers to stop granting health benefits at all to their employees. This was always a weird hack from WWII and it needs to stop. No one likes it when their employer issues them a phone or a laptop because it’s usually a crappy one. Health insurance should be about the same. The pool is now “everyone”.

We can ween people off this by slowly reducing tax write-offs and other incentives for employers over a period of 3-5 years.

Protect low-income, the elderly, and everyone else with a universal emergency plan. When your heart stops beating it’s not a time to Google around for price lists. And no matter what kind of private insurance exists on the market, low-income people are likely never going to be able to afford it. If we as a country are going to do something about that, we must have a universal system. I propose a universal emergency plan that covers everyone with basic care, preventative care, and emergency room care. This is paid for through taxation and distributed to everyone.

To supplement that, private insurance carriers, complying with the same rules on transparent and consistent pricing can offer add-on services. We already do this for a bunch of stuff, like supplemental Medicare plans, supplemental deductible coverage, and other benefits like Aflac.

Plus, having preventative care available to everyone saves money in the long-run for everyone. And having a “Basics” system removes all debate over contraceptives, abortions, and other hot-button issues.

Forget state lines, let’s open this up to the world. Insurance carriers and pharmaceutical companies’ cozy relationships with legislators are over. Let’s open competition globally. Drugs in Canada cheaper? Buy ‘em there mail-order. Health insurers in South Korea think they can provide better service to Americans than Anthem? Bring it on. Doctors in Japan want to provide tele-health services to look at grandma’s bunion? Let’s try it.

If Samsung can manufacture dishwashers from Korea and sell them against GE, and Tylenol can be made in Mexico and sold here, so can anything else. We have the systems and incentives in place to ensure people stay no less safe than they are now.

Stop incentives for the wrong things. If you read “Reinventing American Health Care” by Ezekiel Emanuel, one of the architects of the ACA, you’ll discover two important things:

  1. The Obama administration didn’t know what impact it would have on healthcare. They assumed it would either cut the costs and we’d see a permanent decline, or, we’d take “a big whack” where it went down for a few years and would proceed back up again. Seems we’re on the big whack track.
  2. Medicaid and particularly Medicare is incredibly distorting to the health system. Hospitals, for example, get more money back on reimbursement rates from the government for the same procedures if they’re in a new hospital. Thus, every hospital in the country is consolidating and merging and building shiny new buildings. Shiny, expensive, buildings. Because the government is mostly paying for the construction through higher reimbursements. Stop. That.

There’s no reason a little bit of profit with some healthy competition can’t be a solution that brings affordable care for everyone. Yes, some people are going to have better care than others. But that’s always been that way and always will be. We’re talking about ways to sustainably build a robust system that can scale to everyone, on demand, and without distorted incentives. These steps would go a long way.

And, there’s always single-payer system, too. Which is what most carriers think we’re moving toward anyway. It’s also what Emanuel points out in his book as one of the Administration’s “That’d be nice” goals anyway.

This is what Indianapolis and Indiana will look like in the year 2036

Indy’s Plan 2020 is getting a lot of attention. I tried looking at their site, but almost every link I encountered said nothing or was broken. From what I hear, it’s a lot of zoning and land re-use plans that everyone is holding up as “the key to the city’s future”. I rarely believe that sort of stuff because Indianapolis, like most cities, doesn’t have any money to turn effort into momentum.

Doug Masson is doing an excellent job of summarizing Indiana’s history in his Indiana Bicentennial series.

Given Plan 2020 seems rather lofty and best-case-scenario for the future, and Doug has the State’s overall past covered, I thought it might be interesting to think about what Indianapolis and Indiana might look like in 20 years. That seems like a reasonable amount of time for gears of government to work enough to induce some noticeable policy changes at the state and local levels.

In 20 years this puts Indianapolis in the year 2036. Most millennials will now be somewhere in their 40’s. A new generation will have graduated out of K-12 education.

Indianapolis Neighborhoods

Broad Ripple will experience an overall suburbanization effect. As present-day millennials age and decide they want to hang near work and decent schools with their new families, Broad Ripple is going to look more like an old-school suburb.

Which means all the nightlife, music, and other noisy stuff will continue its trend and firmly supplant itself in Fountain Square. The current colony of artists and other industries that rely on extremely low-rents and low-cost spaces will now be setup around Garfield Park. The Cultural Trail will have extended south to Garfield Park, and East through the New York St/Michigan Street areas. However, we’ll be buzzled as to why all the growth will take place near Garfield Park and not so much on the near east side.

The 16th street corridor will continue its growth just north of Downtown and is likely to grow into something we’ve not seen much before in Indy. I think it’ll become a sort of “uppercrust young people with money” corridor. College students that have wealthy parents, Downtown workers with well-paying jobs, but with a taste that eschews the sort of shiny all-glass all-chrome aesthetic that defines Fountain Square’s new developments today. A new aesthetic of urban, gritty, classical-architecture is likely to take shape here.

The City’s continued investments in new roads, sidewalks, transit corridors, and trails will continue to expand primarily on the north side, north of Washington Street, east of Michigan Road, and west of College Ave. Nothing new here.

Lafayette Square and Washington Square malls will drag down everything around them like a collapsing star. They’ll kill spontaneity, aesthetics, and drag down safety and drive up costs in transportation. Best case is the city will work with Simon to demolish the properties and replace them with a dense node of mixed-use residential and commercial that is affordable and pushes the boundaries of quality, low-cost, office and retail space for entrepreneurs and super small businesses. “Mall to Small” we’ll call it.

Development on the south side will likely cease in this period. The south side will be waiting another 20 years (40 total from today) for suburban counties to struggle with their over-development and sprawl. Their costs will skyrocket, their residents will leave for newer exurbs, and taxes will increase. This will put Fishers, Avon, Plainfield, and Greenwood on a similar tax rate with Marion County. Thus, new development will in-fill on the south side of Marion County to at least get benefits of proximity since costs are equalized.

Shelby and Hancock Counties will benefit from that south side growth in 50-60 years from today as they become the new affordable suburbs.

Families and adults looking to flee from the City will setup shop in Westfield, Whitestown, Lebanon, New Whiteland, and Franklin. These places will resemble Fishers and Carmel today. Danville may also enjoy some exurban growth. Brownsburg will miss this boat because of a lack of vision and planning today. This will be their “lost generation”. Greenfield and Shelbyville will grow once that aforementioned south-side infill occurs.

Greenwood, Avon, Plainfield, Fishers, and Carmel will look like present-day Beech Grove and Lawrence, in that order. Carmel seems to be attempting to avoid this fate by investing heavily now, but heavy debt loads on a fickle population of residents may be their undoing. Greenwood, Avon, and Plainfield are likely unable to avoid this fate and will become old, expensive, and unsustainable once their water, sewer, road, and school systems start requiring immense repairs – all at around the same time. As property ages and becomes less valuable, they will see revenue shrink even more.

It could be that Carmel grows into an urban center unto itself, and between Indianapolis’ core and Carmel’s core the northside of Marion County becomes something else entirely. I think Carmel’s gambles today are likely to be dangerous long-term with debt. Debt is everyone’s undoing.

Indianapolis will maintain healthy bond and debt levels throughout this time, barring an emergency, and resemble our current “slow and steady” conservative approach to growth. But I can imagine a scenario where Indy’s “sports strategy” starts to show some cracks. The Colts are likely to be in negotiations for another new stadium. The Pacers will maintain shop here. The Speedway is going to see a decline in viewership, advertising, and attendance. Baseball, hockey, and soccer will continue to be such minor-players residents will loudly lament the expense of maintaining such expensive hobbies for the City. Particularly as investments in actual quality-of-life issues on the northside incenses people on the east, west, and south sides that don’t see those same amenities, but do see millions pouring into new stadium discussions.

Beech Grove and Lawrence will collapse and be folded into Indianapolis-Marion County government. They will be mere neighborhood names like Nora and Mars Hill conjure up today. Speedway may hang on, but only so long as Allison Transmission is around.

IUPUI will continue to expand east into Downtown for residential and healthcare work. Expect them to push west big time once they have a large enough plan to quickly take over the black neighborhood that’s there now. They’ll eschew growing “up” because of costs in taller buildings, preferring to keep things nice and cheap just over the river.

Indianapolis’ economy

Indianapolis’s economy will continue to be Indiana’s economy, and even more so, despite what state lawmakers will want to recognize, like today. I do not, however, think technology will be Indy’s future savior. I think our economy is likely to look a lot like today.

Salesforce will continue to expand in Indianapolis until the tech bubble bursts and their lack of profits for the sake of growth will cause total collapse of their workforce. Or, Salesforce will continue to expand in Indianapolis until a larger, actually profitable, company (like Microsoft or IBM) comes along and buys them out. That buyer is likely to have no allegiance to Indiana and we’ll enter a period of attrition as they move positions elsewhere. This will cause an undoing of Indy’s tech sector. Many will leave the city for the coasts in job relocations, but many will stay and reenter the workforce as solo entrepreneurs and freelancers. This is going to have a heavy impact on Indy’s income and sales tax revenues, but is likely to even out 10-15 years from then as the market sorts itself out. It’s hard to say which of these two things happens first. They’re racing neck-and-neck with each. What’s clear is that a select few on Wall Street and in San Francisco will be huge beneficiaries while everyday workers and the City wonders what happened and why.

Indianapolis will likely maintain most of its employment stability in government, retail, and biomedical industries (Lilly and Cummins will still do extremely well). Expect healthcare to take a dive as Boomers die and the echo-boomers age into middle-age with relatively modest healthcare needs. In another 50 years healthcare will likely tick up again as Millennials age further.

Indianapolis will continue to be a convention town, as another Convention Center expansion will have happened. Indianapolis will now regularly host large conventions for political parties, the NRA, and the sort of events we view as “just slightly” out of our league today from a capacity and hospitality stance. New hotels will continue to flow into Downtown.

Statewide policy

Indiana’s Legislature will have finally moved on from social issues like gay marriage, but will still be fixated on abortion and immigration. Indiana will likely continue to slide in the direction of less regulation and low taxation, but will compensate by raising more fees and use-taxes. Expect an increase in the gas tax by a bunch, likely within the next 2-5 years from today, and tied to inflation as Speaker Bosma has proposed. Just as electric cars take over more. I’d expect the gas tax to go up in 2-5 years and then a special “electric surcharge tax” will be placed on electric car charging to make up the difference going forward.

Indiana’s Legislature will continue to exert heavy control on Indiana’s municipalities, much to their chagrin. There will also be a push towards improving quality of life, noting that it’s not enough to be good for business if no one wants to live in your state. But this will focus heavily on communities with money. Expect Indianapolis, Fort Wayne, and Evansville to do well here, plus Hendricks, Hamilton, and Boone Counties. Rural decline will continue to heavily decimate the Hoosier hinterlands, placing them in America’s new ghettos: rural, lacking in services, and priced out of useful healthcare, transportation, and high-paying jobs.

Mitch Daniels in his return third term in 2020 will be able to stem the tide for a while, but by 2030 we’ll view rural residents as burdensome and unable to deliver value for the State.

Higher education will continue to be a sore point for Indiana as Hoosiers will still be priced out of it. I don’t expect changes in the pricing of higher education for another generation.

Places currently in economic decline will be largely abandoned. Muncie, Tipton, Seymour, and the like will resemble present-day Gary. Anderson and Kokomo may be able to stem this tide by throwing transit subsidies into Indianapolis’ orbit. Westfield’s gain in residents, for instance, will be Kokomo’s gain in industry.

Very rural counties today, like Cass, Washington, Greene, etc. will decline even further into a barely-self-sustaining entity that is mired in drug abuse, prostitution, underemployment, and anger.

The overarching conclusion: the more things change, the more they stay the same.

You probably are working harder and longer

Pete Ross, talking about Bernie and other countries that spend more domestically:

“That way no one has to live in fear of losing out in the lottery of life. That’s what social democracy is, and those of us who live in them recognize that what we have is pretty damn great.”

This sort of thinking is common outside America, and one that Bernie supporters hang their hat on. They’re not wrong insisting that instead of spending money on foreign matters we should spend it here. But a guy in Australia doesn’t get to claim a high horse for that country’s high domestic spending. The reality is Australia and other nations get to have high domestic spending precisely because the United States is picking up the tab for their defense. Canada, for instance, would be a much different place if they knew we weren’t here. Just as Indianapolis would be a much different place if Carmel would just pay for all our police officers.

This behavior is so pervasive even Barack Obama is pissed, urging NATO allies to increase their funding for defense based on their GDP (which is a really dumb measure: on what planet does it make sense to say “I must spend X% of my income on Y”? That’s like walking into a car dealership and saying, “I must spend $25,000.”)

Anyway, I was recently reading about the research of economists Mark Aguiar and Erik Hurst, “Measuring Trends in Leisure [PDF]”. They measured the stuff Americans do from day to day between 1965 and 2005.

“Aguiar and Hurst document what they call an increase in “leisure” that primarily affected men with low education. In the first survey, in 1965-66, men with college degrees and men who had not completed high school had nearly the same amount of leisure time per week, with just a two-hour difference. They were only an hour apart in 1985. Then something changed. “Between 1985 and 2005…men who had not completed high school increased their leisure time by eight hours per week, while men who had completed college decreased their leisure time by six hours per week.”

In other words, if you’re sitting around feeling like you’re doing a lot more work and others are doing quite the opposite, you’re probably right. More Americans, particularly low-educated men, are just plain spending more time goofing off. This research indicates college-educated people are working more hours and producing more, while the bottom has gone the other way. On a chart it almost looks like half the country is working twice as hard to make up for the opposite decrease on the other end.

And here in America, where our culture derives from four virtues of honesty, industriousness, family, and religiosity, goofing off pisses people off in the “industriousness” virtue and part of the “honesty” virtue. No one wants to work all day just so some other guy can coast along. That feeling is so pervasive a lot of people can’t get past the fact our own uncle is drowning in medical issues. This is why Trump/Cruz supporters are so mad, even if they’re the ones most likely goofing off the most.

Don’t get me wrong: I’m aware a lot of people don’t goof off and just have a hard time in life. But it doesn’t change the fact most people know more people who are plain lazy than people who have been bankrupted through medical bills or student loans. I say that as someone who lost a mother to a $2 million tumor.

And to be clear: this kind of leisure activity people are doing isn’t even what you could describe as active leisure, like reading a book or exercising. It’s mostly watching TV.

We’ve found ourselves in a cultural deadlock between not wanting to support lazy people and caring about the truly unfortunate. But apparently we spend all our time working to support a big military so every other country can have high domestic spending. This is a tough nut to crack in either direction for Bernie or Trump/Cruz.

And this increase in useless leisure on the low end and the decrease in available time on the high end probably leads us to a lot more problems, like low civic engagement, low community involvement, and less time building worthwhile relationships.

Yeah! Screw that stupid woman with no limbs!

Seems we’re all devolving back into this line of “Everyone but me is getting rich and I’m getting screwed!” mentality. Whether it’s people claiming the oil companies are gouging us or some welfare queen sucking up all the government welfare she can get her hands on. Personally, I take to the mentality that people ought to work and help themselves as much as they can, but I recognize there are limits to people’s natural or perceived abilities and that a lot of forces are working hard in the other way, either naturally or unnaturally. In which case, if we’re going to “value life”, we have to take care of each other in life. Let me give you an example.

The other day I was running around all over town (you know, working, paying taxes, that sort of thing) and I just happened to be biking on my way home when I saw the bus that runs by my house come around the corner. “Meh, I’ll just take it. It’s there.” So I hopped on.

I got on the bus and sat down on the side and as I pulled my helmet off I noticed a woman in a mobility device (a motorized wheelchair of some kind, they all have different names and features, I have come to learn). She had a bag strung on the back with what looked like a frozen dinner inside from Marsh.

“Hi, how are you?” I asked.

“I’m fine, thanks.” She replied.

She was sitting in her chair and the driver had already strapped her chair into the wheelchair securements present on the bus, thanks to the Americans with Disability Act. All of IndyGo’s busses are equipped with motorized ramps that can extend out to the sidewalk, and the busses can also “kneel” down to the curb to allow these people to get on board, too. IndyGo probably would have that anyway, despite the ADA, but the fact that sidewalks are built with ramps and businesses, like the Marsh she just went into, have to make reasonable accommodations for the disabled is clearly a good thing. How can you argue otherwise?

But let me tell you about this woman (caucasian, if you’re wondering).

She was probably in her 60’s, maybe 70’s. She reminded me a lot of my own grandmother. She had stark white hair. She had no teeth. She was wearing sweat pants and a sweat shirt, probably because she was cold due to her very low body weight. She probably weighed somewhere in the neighborhood of 90 pounds. Probably much less, but I’m bad at guessing weights of things. “How can she weigh so little?” you ask. Well, it’s  because most of her wasn’t there.

Her right arm stopped just before what would have been her elbow. Her left arm stopped at the shoulder. Her left leg stopped at the hip. Her right leg was of full function, but was short — maybe she had part of her shin removed, or maybe she was just that short. That leg was what helped keep her from falling out of the chair.

She wasn’t wearing any shoes, just a thick sock on her right foot, because that’s what she was angling to use to pull the stop cord to signal to the driver she was ready to get off the bus. I noticed her struggling and asked, “Is this your stop?” To which she replied, “Yes”, and I reached up to pull the cord for her. The driver stopped at the next stop, got up, unhooked her chair from the bus mounts, deployed the ramp, and set her on her way…onto Southeastern Avenue. No sidewalks, no shoulder (it’s crumbled over the years into visible cliffs, holes, and chunks). She scooted along, using her right arm limb to control her chair as it bounced down the obviously well-worn and beaten path over to a side street that had no sidewalks at all. She was just in a chair riding down the side of a road.

When I hear Republicans claim that every American has to take responsibility for themselves, for their health, for their transportation, for their lives, I think, “What more do they want this woman to do? Grow new limbs with advancements from stem cells? …oh, right.”

She was old, she was limbless, obviously could not get a job even is she wanted to (what could she do?), and relied entirely on a transit system that’s woefully inadequate to get her around town. She was probably drawing Social Security to pay for her frozen microwave lunch and she probably draws Medicare, Medicaid, or both, to cover her obvious health issues. While she was of what seemed like sound mind, she was not of sound body. But she still had a personality, a character, and the ability to have emotion. She may well live alone, or with someone else. Maybe she had kids to take care of her, or grandkids, but it being the middle of the day and her being out on the bus, I assume she didn’t, or they were at work or school.

I’m not saying the country should be put her up in a 5 bedroom house and give her a chauffeur, but for Pete’s sake stop trying to take away the only stuff that’s probably keeping this woman alive. Talk about a death panel from hell.

Mitt Romney thinks she should just figure stuff out. That she can soar to new heights! And that makes him a douche hat. And if you think the same thing about people, well, that’s a nice hat you’re wearing.