But I still think the debate has merit, so I'll start it here...

Working from the question of health care, I had to wonder...how DO you effectively change the system.

Damn, I keep telling myself I'm going to pick up Thomas Kuhn's The Structure of Scientific Revolutions, but another summer gone by and not enough time in my reading schedule...

arborman was talking about how to improve our health care system, what sort of provider would be best.

I'm just not sure that changing one element in the system is feasible...

In the case of health care, the current measure of economic health actually considers sickness as a boon...in the sense that it contributes to the GDP.

That, **I think**, sets up an unmanageable inflation in health care costs promising to eventually bankrupt the system regardless of what provider you chose.

So shouldn't you go after the system?

I'm not saying that is the right way to go...honestly, I don't know! How do you go about changing the system? Element by element (divide into conquerable chunks?) or go to the source?

Pragmatically (pragmatism itself is an issue that tortures me) do we aim for something like Cobb's Genuine Progess Indicator (link to a pdf) which aims to change the measure used to describe the health of the economy...

How do you think we should try to change things?

I agree, totally, with arborman when he says that defensive strategies don't win wars and that if we want to be able to address the conservative agenda we *must* have viable alternatives of our own.

quote:

---

Originally posted by arborman:
We on the left are very good at pointing out what's wrong with current institutions and right wing solutions, but less adept at developing and presenting solutions of our own.

---

Too true. Small 'l' liberal philosophy: to strive to consider all sides of an issue...both our greatest strength and our greatest weakness?

As you can see, though I consider myself reasonably well read, I haven't been able to offer solutions...only point out problems.

And yeah, in politics thats a loser's game...

Maybe a year and a half ago I was reading a Jim Hightower book (don't remember which) and he was talking about this group called the New Party, supposed to be active in a few areas in the states. Their preposition is that we need to take back politics on the local level first. They worked through individuals holding block parties, gathering together neighbors to discuss issues of local concern in order to organize responses to local government.

I liked it. I mean, at least in Ottawa, voter interest in city government is pretty low, and that allows some laughably weak people get into office.

And in a curious way that could be to our advantage. City Hall certainly isn't as slick with spin as the big boys.

In city elections your vote has the largest representative power (smaller voting pool), if you could mobilize even small support locally it could have a relatively large impact in a city election.

Further, the New Party was supposed to be bi-partisan...trying to rally support from both parties on local issues like Living Wage bylaws and local purchasing...

Its an exciting idea: cellular activism growing in different cities and working off of issues that are shared by the majority, in turn holding some promise of renewing a sense of civic representation which could be a jumping board towards larger shared actions.

In terms of health care, I guess I just don't know enough about co-operative solutions.

I intend to keep following your original thread arborman...I'm hoping to learn a few things!

I did some fairly simple math when the Romanow Report was asking for the input of the common Canadian.

The numbers between Canada and the US are:
US 6.21% GNP spent publically, 7.29% of GNP spent privately
Can 7.14% GNP spent publically, 3.06% of GNP spent privately

The difference, 0.93% of GNP publically equates to 4.23% privately. Or, for each extra dollar spent by the Canadian government, there's $4.45 dollars not spent by the consumer.

Taken beyond it's logical limit, it suggests if governmental medical spending increased to 8% of GNP, then no money would have to be spent privately. Obviously, that doesn't work out, but a 1% increase in Government spending would reduce private spending by more that 1%.

To complete this analysis, one should look at other first world countries, and see how the split works out. Also, one should consider the differences in quality of health care. For instance, using mortality as a measure, Canadian health care is significantly better than US at every age group.

I also looked at the aging population. I assumed that the people between 35 and 65 produce the vast majority of the goods and services that support health of the elderly. I ignored inflation and increases in efficiency, to keep it simple.

Just looking at demographics, in 2030, the per capita costs will have risen by 36% (not including inflation) as a result of the aging population, while the number of people between 35 and 65 will have dropped from 40.6% of the population, to 35.5%. So while the costs go up, the number of people to pay for those costs go down. But this effect won't be seen at all in 10 years, will be severe in 20, will reach a maximum in about 30, and be getting better in 40 (as all the boomers die off).

Thus, in 30 years, the tax payer will be paying 41% more in health care costs, just to get the same quality of service we have today.

The sources of this data were readily available population and health statistics that I assembled from searching the internet. Unfortunately, I currently only have my results, not my research, sources, or spreadsheets.

quote:

---

We on the left are very good at pointing out what's wrong with current institutions and right wing solutions, but less adept at developing and presenting solutions of our own.

---