NY Times yesterday described three separate efforts to lower the cost of medical care for the elderly, creating, as they put it, a space between hospital and hospice. Proponents believe that it is saving thousands of dollars but, sadly, here, as elsewhere in medicine, there is no formal accounting analysis to prove the truth of that belief. Also in the weekend papers was an article by a first-year medical student at Stanford bewailing the fact that medical students are taught nothing while they are in school about the medical system as opposed to medicine. In particular, they learn nothing about the accounting, or lack thereof, for medical delivery. It is a sad business that costs us dearly as a country.
I was tickled by Joe Nocera’s observation in the NY Times that we were celebrating three half centuries. The first of the Beatles appearance on the Ed Sullivan show. The second the launching by LBJ of a War on Poverty. The third being the Surgeon General’s report linking smoking to cancer. Each, in its own way, defines my lifetime.
A recent article pointed out that the old Kodak employed 140,000 people in a wide variety of positions, using a wide variety of skill sets. It’s modern digital equivalent sold recently for one billion dollars and had all of 13 employees. Where, one wonders are the other 139,987 employed? And what happens to America as middle class jobs continue to be hollowed out? Are we returning to Downton Abbey days when a few rich people are cared for by a mass of poor people? Where a handful of the very rich can spend $500,000 we are told slaughtering thousands of pheasants in an afternoon?
I have just learned of the passing of Colin Wilson, author of The Outsider on December 5th, the same day that Mandela passed away. His book had a profound influence on my life, enabling me to turn from feeling like a plain misfit into something much more noble called an Outsider. Instead of feeling worse than society Wilson helped us to feel better. We were exalted souls lost in a cultural wasteland. While very narcissistic, it did have its positive side, enabling me – and I suspect many others – to go out and do battle with the world. It was a lot better than falling into a slough of despondency. So Mr. Wilson, thank you.
There was a fascinating oped piece in the NYTimes by David Brooks on the Colorado marijuana experiment. It was not so much his comments on how he and his friends had outgrown the weed, but his comments on what constituted the good life – of which the weed was not a part in his opinion. As he sees it our goal is to become “more integrated, coherent and responsible people. This process” he says, “usually involves using the powers of reason, temperance and self-control — not qualities one associates with being high.” He then goes further and links these admirable virtues to happiness. As he then says, “The deeper sources of happiness usually involve a state of going somewhere, becoming better at something, learning more about something, overcoming difficulty and experiencing a sense of satisfaction and accomplishment.” In found the connection between his comments that focused on the work dimension and those of AEI that covered faith, family, friends as well as work interesting and worth exploring further.
Arthur Brooks, President of the American Enterprise Institue, believes that happiness is a function of faith, family, friends and work. Ramesh Ponnuru a visiting fellow at the AEI worries that all four factors are in decline, especially for men. They are less involved in church, less likely to marry or stay married, have fewer close friends, and are having increasing difficulty in finding a job.
One of the very noticeable differences between American footfall and South African rugby, as I played it and coached it, is the role of the coach. In rugby the game is in the hands of the players. The coach is a spectator with no role to play once the game has started. In football, though, one has the sense of two generals pacing the sidelines like Napoleon and Wellington and directing every move. The players are merely pawns in this game. Their task is simply to execute the plays that they are given, which they do with varying success. One wonders whether the Cowboys would have won against Philadelphia if one had swapped the coaches?