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1
Environment / Re: The Oceans are Coming? BFD, I got other Worries.
« Last post by RE on Today at 07:09:33 AM »
As you many remember, we live in Larchmont and are thus well and truly fucked long term.

I see two choices possible:

1- Sell out now while you can still get a decent price from the next greatest fool.  Be sure to have the real estate agent show the house on a dry day.

2- Raise the house up on stilts and buy a kayak.

RE
2
The US is the most expensive nation in the world in which to have a baby – and it may factor into thousands of bankruptcies each year



Stella Apo Osae-Twum and her husband did everything by the book. They went to a hospital covered by insurance, saw an obstetrician in their plan, but when her three sons – triplets – were born prematurely, bills started rolling in.

The hospital charged her family $877,000 in total.

“When the bills started coming, to be very honest, I was an emotional wreck,” said Apo Osae-Twum. “And this is in the midst of trying to take care of three babies who were premature.”

America is the most expensive nation in the world to give birth. When things go wrong – from pre-eclampsia to premature birth – costs can quickly spiral into the hundreds of thousands of dollars. While the data is limited, experts in medical debt say the costs of childbirth factor into thousands of family bankruptcies in America each year.

It’s nearly impossible to put a price tag on giving birth in America, since costs vary dramatically by state and hospital. But one 2013 study by the the advocacy group Childbirth Connection found that, on average, hospitals charged $32,093 for an uncomplicated vaginal birth and newborn care, and $51,125 for a standard caesarean section and newborn care. Insurance typically covers a large chunk of those costs, but families are still often on the hook for thousands of dollars.

Another estimate from the International Federation of Health Plans put the average amount insurers paid for a vaginal birth in the US at $10,808 in 2015. That is quintuple the IFHP estimate for another industrialized nation, Spain, where it costs $1,950 to deliver a child. The amount insurers pay for births in America is lower than the amount billed by hospitals because insurers negotiate lower prices.

Even the luxurious accommodations provided to the Duchess of Cambridge for the birth of the royal family’s daughter Princess Charlotte – believed to have cost up to $18,000 – were cheaper than many births in America.

Despite these high costs, the US consistently ranks poorly in health outcomes for mothers and infants. The US rate of infant mortality is 6.1 for every 1,000 live births, higher than Slovakia and Hungary, and nearly three times the rate of Japan and Finland. The US also has the worst rate of maternal mortality in the developed world. That means America is simultaneously the most expensive and one of the riskiest industrialized nations in which to have children.

American families rarely shoulder the full costs of childbirth on their own – but still pay far more than in other industrialized nations. Nearly half of American mothers are covered by Medicaid, a program available to low income households that covers nearly all birth costs. But people with private insurance still regularly pay thousands of dollars in co-pays, deductibles and partially reimbursed services when they give birth. Childbirth Connection put the average out of pocket childbirth costs for mothers with insurance at $3,400 in 2013.

In Apo Osae-Twum’s case, private insurance covered most of the $877,000 bill, but her family was responsible for $51,000.

Apo Osae-Twum was the victim of what is called “surprise billing”. In these cases, patients have no way of knowing whether an ambulance company, emergency room physician, anesthesiologist – or, in her case, a half-dozen neonatologists – are members of the patient’s insurance plan.

Even though Apo Osae-Twum went to a hospital covered by her insurance, none of the neonatologists who attended to her sons were “in-network”. Therefore the insurance reimbursed far less of their bills.
Q&A
Did you receive an unexpected or unmanageable bill after giving birth?

There are few studies that estimate the number of families who go bankrupt from this type of unexpected expense. One of the best estimates is now outdated – conducted 10 years ago. But one of the authors of that research, Dr Steffie Woolhandler, estimates as many as 56,000 families each year still go bankrupt from adding a new family member through birth or adoption.

“Why any society should let anyone be bankrupted by medical bills is beyond me, frankly,” said Woolhandler. “It just doesn’t happen in other western democracies.”

Since Woolhandler conducted that research in 2007, 20 million Americans gained health insurance through the Affordable Care Act health reform law, and consumer protections were added for pregnant women. But Republicans and the Trump administration have pledged to repeal these consumer protections.

“People face a double whammy when they’re faced with a medical condition,” said Woolhandler. Bankruptcy is often “the combined effect of medical bills and the need to take time off work”.

There is no nationwide law that provides paid family leave in the US, meaning most families forgo income to have a child.

And although childbirth is one of the most common hospital procedures in the nation, prices are completely opaque. That means Americans don’t know how much a birth will cost in advance.

Dr Renee Hsia, an emergency department physician at the University of California San Francisco and a health policy expert likened the experience to buying a car, but not knowing whether the dealership sells Fords or Lamborghinis. “You don’t know, are you going to have a complication that is a lot more expensive? And is it going to be financially ruinous?”

According to Hsia’s 2013 study, a “California woman could be charged as little as $3,296 or as much as $37,227 for a vaginal delivery, and $8,312 to $70,908 for a caesarean section, depending on which hospital she was admitted to.”

Apo Osae-Twum and her family only found relief after a professional medical billing advocate agreed to take their case. Medical Cost Advocate in New Jersey, where Derek Fitteron is CEO, negotiated with doctors to lower the charges to $1,300.

“This is why people are scared to go to the doctor, why they go bankrupt, and why they forgo other things to get care from their kids,” said Hsia. “I find it heartbreaking when patients say … ‘How much does this cost?’”

Did you receive an unexpected or unmanageable bill after giving birth? Share your story using our encrypted form.

https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america

Not a fair article at all. Three premature triplets is not just "giving birth".

In most countries other than perhaps western Europe, they would have just died. All three of these kids were probably on life support, perhaps for weeks.

My daughter got a bill for nearly this much over a broken ankle that required multiple trips to  the OR and two weeks in ICU....and that was 7 years ago now.

Giving birth is expensive, but not nearly that expensive for normal deliveries, which don't even rate an overnight hospital stay these days in most US hospitals.
3
The Diner Pantry / Doomstead Diner Breakfast Special: 1/18/2018
« Last post by RE on Today at 06:55:01 AM »
Many pepole eat Gravlax the same way the eat Nova or Lox, on a Bagel with Cream Cheese.  IMHO however, because it is not smoked, only cured, Gravlax has a more delicate texture and flavor which should be enjoyed on its own, with a caper or two in each bite.  Just the FISH please! Slice thin and roll into rose like pinwheels for a nice presentation.

Gravlax
4
Marathon Man Newz / Re: Seastead of the Day
« Last post by RE on Today at 06:41:38 AM »
You have the budget consciousness of a US congressman. You're overspending by a power of ten. Not necessary.

Check out this modest yacht of 100 ft. (Anything much bigger is way too big, imho).



http://www.yachtworld.com/boats/2003/3-Mast-Schooner-Traditional-Turkish-Gulet-2019550/East-Med/Turkey#.WmCuf5M-cWo

When you have $500M to spend before TSHTF Day arrives, you want to get rid of it before it goes worthless.  ::)

It's got an extra 60' of length, so more room for more amenities than your find.  Remember, we have to fit a full floating dental office on this thing.

I will admit your boat is coming in at a great price.  You do have to go to Turkey to get it though.  Not the safest place to be as a rich Amerikan these days.

RE
5
Marathon Man Newz / Re: Seastead of the Day
« Last post by Eddie on Today at 06:29:41 AM »
You have the budget consciousness of a US congressman. You're overspending by a power of ten. Not necessary.

Check out this modest yacht of 100 ft. (Anything much bigger is way too big, imho).



http://www.yachtworld.com/boats/2003/3-Mast-Schooner-Traditional-Turkish-Gulet-2019550/East-Med/Turkey#.WmCuf5M-cWo
6
The Kitchen Sink / The Bumpy Road Down, Part 2
« Last post by Guest on Today at 06:08:59 AM »


youtube-Logo-4gc2reddit-logoOff the keyboard of Irvine Mills



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Published on The Easiest Person to Fool January 7, 2018















Lake Huron shore looking north to Bruce B Nuclear Generating Station

Taken Dec 17/17—there is much more ice on the lake now.




Discuss this article at the Kitchen Sink inside the Diner



 



In the last post in this series I started talking about the bumpy road down—the cyclic pattern of crash and partial recovery that I believe will characterize the rest of the age of scarcity and make for a slow step by step collapse, rather than a single hard and fast crash. Because I expect this to take place differently in various parts of the world and for people of various social classes, I guess it should really be "The Bumpy Roads Down".



At any rate, this led to looking at the next expected bump in the process—a financial crash of even greater magnitude than the global financial crisis in 2007-8. We looked at what's leading up to this (a huge debt bubble), how it might start (with one or more currency crashes) and what might trigger the process (a spike in the price of oil).



From where I sit this crash seems essentially inevitable. We are living beyond our means—the available surplus energy is simply not enough to support the continued growth that our economy requires. Some degree of "degrowth" is going to happen, whether we like it or not. The only uncertainly is exactly when it will occur, how far it will take us down and by what route. I'd be surprised if it started sooner than the fall of 2018. I don't really care to guess how much longer it might take to get started—years, easily.



Of course, as we learned in the Global Financial Crisis of 2007-08, these things tend to teach us new things about how they work as they are happening. While we learn more with each crisis, there are things about each one that we would never have guessed in advance. And I am certainly not claiming to be exempt from this.



Since I wrote that last post, I read David Korowicz's "Financial system supply-chain cross contagion – a study in global systemic collapse", and much of what I have to say in this post has been influenced by Korowicz's ideas.



His essay directly addresses how things may proceed once a crash gets started, and how difficult it will be to do something about it. He focuses on the degree of interconnection in our modern world and how a financial crash can spread to other parts of the economy. He also looks closely at how fragile our globalized economy is, with many supply chains based on "just in time delivery" and minimal inventories of important supplies.



Before going on with the rest of this post, I'd like to share some thoughts that came to me as I was reading Korowicz's essay. It seems to me that when talking about such subjects, one has to consider one's audience and what one is trying to achieve.



Korowicz clearly feels he is speaking to a doubtful audience and he is eager to convince them. As he says, "The consensus view, even if backed by experts is not, in and of itself, a justification for the consensus view." I sympathize with him in that—the majority of people today are functioning at a high level of complacency and denial. They will latch onto any morsel of hope and use it to convince themselves that everything is going to be fine and that no extraordinary action is required. If you give them that morsel, the rest of what you have to say may well be lost on them.



And so it is very tempting to spin (and Korowicz has spun) a rather one sided story, lacking the sorts of subtleties and nuances that are needed for a solid understanding of any subject and which I have tried to make an identifying characteristic of this blog. I am not going to change that goal, and so some of my readers will see what follows, in this and my next few posts, as unreasonably optimistic. If that is what is necessary to take a balanced approach to the subject, then so be it.



David Korowicz is an intelligent and well informed man and so even he makes some qualifying statements about the solidly gloomy picture he paints: "a collapse could have intermediate states, characterised by partial breakdown and semi-stable states." And near the end of his essay he suggests that we should classify countries as red, amber and green, according to the likelihood of their suffering severely in the crash he is talking about. And he admits that there are indeed some green countries, and interestingly (to me) includes the U.S. in that group. But the essay was written in 2012 and things have changed in the U.S. since then.



For those looking for nothing but hope and reassurance, I'm sorry, but I must make it clear that the bump I am talking about here is likely to be a big one and solidly jarring, especially to those who aren't expecting it. When I say that this shouldn't be considered a fast collapse, I mean that a significant number of people will still be able to get food, shelter, clothing—that "just enough" will still be attainable for most of us. I meet people quite regularly who clearly consider that any change in their lifestyle, however minor, amounts to "the end of the world", and who are simply unwilling to consider that such things may happen. I know they find most of what I have to say to be way too pessimistic. I think they are in for a rude awakening.



But enough of that, let's take a closer look at how the coming crash is likely to proceed. Tim Morgan predicts that it will start with a "currency crash?" What does he mean by this? Simply that at some point currency traders will lose faith in the value of some particular currency. They will all start selling out of it pretty much at once—what is known as a "run". This would cause the price of that currency to drop drastically compared to others, with negative effects on the economy of the effected country, perhaps leading it to default on its debts. But why this loss of trust? In the case of Britain, Morgan (a Brit himself) points to a lack of economic growth, high debt, Brexit and poor economic management by governments over the last couple of decades, including a laisser faire approach to regulating business and the financial industry.



It will probably only take one currency crash (or maybe not even that many, if the price of oil spikes high enough) to trigger a loss of faith in debt and start a wave of bankruptcies and government defaults. Banks and other financial institutions will be at the head of that wave. Modern banking is based on the idea of a fractional reserve—banks are allowed to create money out of thin air when they make a loan, rather than just loaning out money they already have. The loan itself then becomes an asset, a claim on the future productivity of the debtor, based on trust that the debtor will prosper and be able to pay back the money he has borrowed, with interest. Under this system banks' real assets amount to only 2 to 9% of their total assets. The rest is debt, or from the viewpoint of the bank, credit they have extended as loans. It is normal to have a very small percentage of debtors default on their loans, but according to Korowicz, defaults of around 4% are enough to leave a bank in big trouble, and it may end up going out of business, as the financial community loses faith in the debts it holds.



Since the amount of risky debt is much larger than ever before, it seems likely that many of those "too big to fail" banks will indeed be in trouble this time around. In 2008 governments took steps to prevent this, but governments whose currency has crashed and/or who have defaulted on their debts, won't be able to be of much help. Even governments which aren't in financial trouble themselves will face a bigger challenge than they did in 2008, since interest rates are already pretty much as low as they can go. And also because more banks (and other businesses) will need help, in the form of loans on very favourable terms, or outright bailouts. Still, because the effect of a crash like this touch on pretty much everyone, there will be immense pressure on governments to do whatever they can.



As I understand it, what governments have done and will no doubt do in the next crash is to print money to offset the bad debts of failing financial institutions and other businesses. This has been done indirectly, by borrowing money from the central bank of the country. Because it ends up on the government's balance sheet as debt, owed to the central bank, paying the interest is a big budgetary problem. Paying back the principle is a problem for future generations.



Conventional economic wisdom holds that printing too much money causes inflation—the price of goods goes up to match the excess money circulating in the market. This didn't happen to any significant extent in the years following 2008, perhaps because that excess money, rather than going into circulation, was poured into the black holes of the banks' balance sheets.



It seems likely to me that central banks will take a lot of blame for "letting" this next crash happen. There is actually no reason that governments have to borrow money for bailouts from independent central banks. Those banks could be eliminated and governments could take on their role themselves, creating money without incurring debt or interest charges. And as long as that money goes straight to paying off bad debts, the amount in circulation won't increase, and it shouldn't cause inflation.



If this disaster was limited to the financial industry alone it would be bad enough. It is important to realize that in our capitalist system if a business is not profitable, or if investors lose hope of it eventually becoming profitable, it's not going to be running for long, especially in the middle of an economic crash. Even if it is the sole provider of goods and services that folks like you and I consider to be necessities. One would hope that governments would step in to preferentially bail out companies that really do have a vital role to play.



The financial sector also provides many critical services to businesses and in a crash such as we're talking about, those services may not be readily available, thus hurting businesses that would otherwise still be viable.



Perhaps the most basic of those services is moving wealth from what we think of as "investments" (where the point is to earn a return) to ordinary money with which one can buy goods and services. We take this for granted in "normal" times and are largely unaware of what is going on in the background to make it happen so smoothly. During a crash and in its aftermath, this will no longer be the case and without that ready access, businesses and individuals will find it difficult to continue operating as usual.



To judge from what happened in 2008, those banks that are still in business will also get very conservative in their lending practices and much less trusting of the banks at the other end of transactions. The free flow of credit and funds that the commercial world counts on would grind to a halt, at least temporarily, and so the financial crash would spread to the commercial sector. From the viewpoint of ordinary people this is very bad news.



Mind you, in 2008 things were pretty serious. Many people lost their houses because they couldn't pay their variable rate mortgages when the payments went up—indeed that was what started that crash. In the recession that followed, many businesses downsized or went bankrupt and laid people off. Some of the unemployed fell through the cracks in the social/community/family safety nets and ended up homeless and destitute. A lot of wealth and savings disappeared into thin air. But despite all this, the supply of consumer goods continued unabated. If you could afford to shop, the shelves were far from bare.



I think this is likely not to be the case in the upcoming crash. There will be some noticeable effects in the day to day lives of ordinary people, beyond the obvious increasing unemployment, tighter credit and a decrease in the value of whatever savings you may have left.



The basic issue is that today, more than at any time in our history or prehistory, we rely on a complex, internationally networked economy to provide us with the necessities of life. Supply chains have been optimized, with minimal inventories and "just in time" delivery so that they are very efficient, but also very fragile. One little thing can go wrong, a long way down the chain, and within days (sometimes within hours), the whole supply chain begins grinding to a halt.



The global economy relies of a few critical systems, which enable supply chains to function.



The first of those systems is banking itself. The sort of day to day transactions that all of us take part in really are necessary to keep the world working. Most individuals and businesses rely on chequing accounts, over draughts, lines of credit, debit cards, credit cards and so forth, all of which will stop working if your bank fails. At the international level, banks issue letters of credit that facilitate the shipping of goods from one country to another.



Shipping is itself a critical system, and is dependent not just on banking but also, among other things, on energy, mostly in the form of petroleum products: bunker fuel for ships, diesel fuel for trucks and jet fuel for air freight. I suspect that shipping will suffer a good deal of disruption during this crash, not just at the international level, but also among the trucking companies who move goods around within countries, and on which we are very dependent.



Even if mining, forestry, fishing, agriculture, the electric grid, manufacturing and retail remain untouched in a crash (which is by no means certain), problems with just banking and shipping can make for very unreliable supplies of things that we have come to take completely for granted.



When it comes to necessities, water seems straightforward, right? It comes out of the tap. But most municipal water treatment facilities keep only a very few day's supply of treatment chemicals on hand. If deliveries of those chemicals stop, it won't be long—as very few days—before you can no longer rely on the safety of your water supply.



And there is always food on the supermarket shelves, right? But that's only because of daily deliveries that rely on many long and complex supply chains. If those deliveries stop, there is probably only about three days of food available in most communities, less than that of perishable items.



In the developed world, and even many areas in the developing world, access to medical care is taken for granted (the U.S. is an exception). But modern medicine relies on pharmaceuticals and other consumable supplies of which hospitals keep a very limited inventory, relying instead on regular deliveries.



I mention those three areas because they are necessities for everyone, and the supply chains that provide them to us are likely to be negatively affected during a financial crash. In fact, it will be hard to find any industry that isn't affected to some degree.



Now the conventional thing for a collapse writer to do at this point is to suggest that once this starts, it will be impossible to stop and everything will grind to a halt, bringing industrial civilization to an abrupt end and likely enough the human race with it. When you've been studying collapse for a while and coping with disbelief from most of those around you, it is natural, I suppose, to be eager for something to finally happen that will prove you right beyond all doubt.



But I am not that sort of kollapsnik. I'm pretty sure that collapse has been going on for decades not and that it will take a few decades more before it is complete. And along the way, what is happening will be far from obvious to the many people.



To understand why I hold this opinion, we need to do a couple of things:



1) take a systems dynamic approach to the events we are talking about. First off, the model of a fast collapse with a catastrophic impact at the "bottom" is fundamentally flawed. It may portray fairly accurately what happens when you jump (or are pushed) off a cliff, but that is not exactly the situation our civilization faces. We need to look at what happens when overshoot occurs in nature, in systems more like the one we inhabit. Which is, after all, a subset of the ecosphere. Overshoot is a common enough phenomenon and usually works in fairly predictable ways.



2) look at the sort of things governments, communities and individuals can do to limit the damage when a financial crash spreads to other critical systems.



I set out recently to draw some graphs illustrating overshoot and pretty quickly gained some new insights into this process—insights that I think are worth sharing.



So I'll wrap this post up now and carry on with points 1 and 2 above next time.


7
Marathon Man Newz / Seastead of the Day: Seeking a Bigger Boat
« Last post by RE on Today at 06:04:10 AM »
If I don't get the REVOLUTIONARY Sailing Submarine built with my Mega-Millions, I am looking at currently available sailing vessels for the Good Ship Doomstead Diner.  In order to house all the Diners comfortably, the main requirement is that they are over 100' at the waterline.

Many of the boats in this size category are Square-Riggers, which have a lot of Nostalgic Appeal.


Biggest Square-Rigger in the World

However, let's face it, Square-Riggers have a LOT of deficiencies!  They are PIGS and generally quite slow, and they sail like shit to windward.  They also take a large crew of nimble sailing monkeys to climb up and furl the sails when the wind picks up.  Would YOU want this job?  Only a young male overloaded with testosterone would find this appealing.

So I am only looking at boats with more modern triangular rigs.  Here are the Top 5 located so far up for sale:

Sail 100+ Feet

METEOR € 25,000,000
169ft Royal Huisman 2007
Location: Florida, USA

She is described as a 'gaff rigged schooner' with the forward mast being shorter than the main. Three roller furlers serve the forward mast to achieve ease of handling. The deck work is what really makes METEOR stand out from the crowd. Details such as the raised wooden cockpit surrounds and the beautifully crafted superstructures are reminiscent of a bygone era, and provide a really social area to relax in. Her hull is dark blue with a black underwater hull. The two colours are separated with a solid white boot line.

WELLENREITER € 7,500,000
151ft Jongert 2003
Location: Golfe Juan, France

Designed by Andre Hoek, WELLENREITER is the largest yacht ever launched by Jongert. Belowdecks an air of luxury prevails. The full beam owner’s stateroom is located astern and includes an office, sitting room and vast walk-through bathroom, a spectacular feature normally found on large motoryachts. This superyacht accommodates seven guests in a master suite with an adjacent ensuite single, one double and one twin cabin, plus five crew.

THIS IS US € 5,950,000
137ft Holland Jachtbouw 2005
Location: Tarragona, Spain

Produced by a collaboration of the highly regarded Holland Jachtbouw yard and Hoek Design studio, THIS IS US represents the very best of Dutch build quality and design. Her powerful carbon rig, carbon-spectra sails and deep lifting keel allow THIS IS US to perform just as a high performance cruising yacht should. Following an extensive refit in 2013 at Holland Jachtbouw and further work including hull repaint in 2015, THIS IS US is in excellent order.

MANUTARA $ 2,750,000
115ft Valdettaro Custom 1994
Location: Palm Beach, FL, USA

MANUTARA is one of the largest, most comfortable cruising yachts in her class. Her combined upgraded condition, five-stateroom plus crew layout along with an abundance of amenities, private spaces and dining options make her ideal for family cruising. Her four guest staterooms convert from 8 single beds to 4 king-sized beds, plus the full-beam master suite with a centerline king bed provide for incredible versatility. Wide steps on the reverse transom give easy dinghy and water access. With her previous owner she has had an outstanding charter record.

BILLY BUDD II € 3,600,000
112ft Royal Huisman 34m Luxury Sailing Yacht 1994
Location: Genova, Italy

From the legendary Royal Huisman yard with naval architecture designed by Judel Vrolijk, the 34.3m BILLY BUDD II was built for a client who holds high performance as his first criterion. She is designed to be a fast and comfortable cruising yacht with a fully-battened main, with many of the winches from Rondal.


Obviously, since Money is no object here, I would go for the Meteor at 169'.  Even after the IRS takes out the taxes on my $1B winnings, I still have $500M left so this is Pocket Change.  In fact I could buy all 5 of them for a Fleet and still be under $200K.  Maintenance costs, staffing and docking fees though would quickly burn up my winnings, so not gonna do that.

Going for Bang for the Buck and value, I would probably go for the Manutara @ 115' and a $2.75M price tag.  With just a single mast, she doesn't require much in the way of crew either, since there has to be electric assist for raising those sails and reefing them.

Despite my general penurious nature, I'll probably spring for the Meteor anyhow.  The accomodations are just too nice to pass up!  :icon_sunny:

Main Salon for Diner Meetings


RE's Stateroom

In order to keep maintenance costs down, the Good Ship Doomstead Diner will mostly be at sea, anchored in remote coves or  if near civilization then on a mooring offshore.  Docking this thing would be a ridiculous problem in most marinas, even if you had a slip big enough and bow thrusters!  It's big enough to carry a substantial size tender on davits for commuting to shore.


Tomorrow I will be interviewing for the position of Pilot/Navigator on the Good Ship Doomstead Diner.  The candidates are HOT! :icon_mrgreen:

RE
8
Knarfs Knewz / Re: Trump: Dangerous because he is effective
« Last post by Eddie on Today at 05:48:31 AM »
The political establishment in the US has classified him as an aberration, a coincidence of unfortunate circumstances, and a political phenomenon, certainly a nuisance and maybe even a scary, unpredictable man.

They do so because Donald Trump is not and does not want to be "one of them".

In fact, he campaigned on the elite's failure to understand the depth of frustration among ordinary people hit by globalisation. He plays by his own rule book, is in his own way consistent, knows what he is doing, what he wants, and how to get there.

To succeed, he needs friends outside the establishment. And he got them. American politics have been taken over by the big oil companies and corporations. The big ambition is to engineer a swing from the US, being the third-largest global net importer of fossil fuels, to a net exporter, mainly through export of Liquefied Natural Gas (LNG). The larger goal is to create protections for big business, both domestically and internationally.

To pursue these ends, Trump has mobilised the whole state apparatus.

Roadblocks put up by previous administrations are phased out and the green light is given for drilling, including off-shore.

The main activity of the Environmental Protection Agency (EPA) today is not to "protect the environment"; instead, it is busy revoking a long list of regulations and rules introduced to improve environmental quality and protect citizens against toxic substances.

    He has even been able to exploit the animosity of the establishment media to serve his agenda.

     

Deregulation normally linked to the 1980s almost dwarfs, compared with the sweeping dismantling of regulatory frameworks that has been happening over the past year. Restrictions on financial institutions introduced after the global financial crisis are disappearing, and the door is opening for financial institutions to repeat the reckless behaviour that provoked the 2008-2009 crisis.

Congress approved a tax reform at the end of 2017. It introduced lower corporate taxes, benefitting large oil and financial institutions, and lower taxes for higher income brackets. Basically, it is Republican policy sold to the electorate as a measure to stimulate the economy, without mentioning the medium-term negative effects for the middle class and public debt.

Foreign policy, too, has been submitted to the pursuit of these goals. The Chinese market for LNG, expected to be the biggest one in the future, must be conquered. That explains foreign policy vis-a-vis China, North Korea, and oil and gas exporting countries in the Middle East.

According to the rumours going around in diplomatic circles, a more aggressive trade policy is in the pipeline. This may involve not only castrating the World Trade Organization (WTO) and leaving the North American Free Trade Area (NAFTA), but specific cases of temporary import restrictions.

Meanwhile, on the domestic front, to ensure the support of his base, Trump has been keeping true to his campaign promises.

A string of measures introduced to make it more difficult for foreigners to enter the US is presented as a step to protect Americans from terrorism. A superb use of declaratory policy, it sounds good and appeals to the xenophobia among Trump's supporters.

The wall at the Mexican border is moving from being talked about to reality. In early January, Congress was asked for $18bn to build more than 700 miles of barriers.

Obamacare was not abrogated, but turning off financial flows through executive orders turns it into a shadow of what it was intended to be.

To push through all these policies, Trump has had to control or sideline, in one way or another, all three pillars of the state - executive, legislative, and judicial. He cares neither for the constitution, nor for political traditions and etiquette.

The executive branch is facing drastic cuts in financing and staff, and is focused on dismantling the regulatory system.

Trump likes to operate through executive orders, circumventing the legislative branch. Congress has been pushed aside and almost no time has been set aside for building coalitions. Trump's partnership with the Republican congressmen has mainly been focused on removing Obama-era regulations.

Trump's administration has also challenged the judiciary, which has tried to block some of his executive orders. Almost surreptitiously, he has taken advantage of a high number of judicial vacancies to appoint more federal judges, in his first year as president, than any of his predecessors.

He has even been able to exploit the animosity of the establishment media to serve his agenda. Accusing cable networks and newspapers of deceiving the public and publishing "fake news", he has encouraged his supporters to reject mainstream media outlets. But, more importantly, he has used the media obsession with his persona to drive attention away from major policies he is pushing for.

Much of what he does flies under the radar because the media and general public pay attention to the controversial tweets he posts on a regular basis.

In short, Trump has proven to be quite effective at achieving what he wants. And that makes him quite dangerous.

Over the past year, he has demonstrated that the checks and balances supposedly set in place in the US political system, to prevent a president from pursuing rash and ill-considered decisions, do not really function properly. By the time he is done with his presidential term, he might have done irreparable damage to the US political system and US foreign relations.

http://www.aljazeera.com/indepth/opinion/trump-dangerous-effective-180118095302716.html

On the money, for sure.
9
Knarfs Knewz / Extraordinary Stress and Pessimism Take a Grim Toll
« Last post by knarf on Today at 04:48:35 AM »
Why poor Americans are dying younger.


Shrinking lifespan.

Life expectancy in the U.S. declined slightly in 2016, as it did in 2015, and — at least as important — the overall trends continue to mask increasing disparities across socioeconomic groups. Carol Graham of the Brookings Institution helps explain why. Her important new book is the empirical version of "Hillbilly Elegy."

I have long suspected that stress and lack of hope are to blame for widening the gap in life expectancy between lower and higher earners. Graham uses survey data to support this explanation, documenting striking differences in stress and optimism across segments of the population.

It's little surprise that low-income Americans report significantly higher levels of daily stress than high-income Americans do. But Graham also notes that the type of stress they typically experience is especially harmful to health, because it seems to be outside the individual’s locus of control. She argues that “stress that is associated with daily struggles and circumstances beyond individuals’ control — as is more common for the poor — has more negative effects than that associated with goal achievement.”

One example of what can cause this type of stress is an unpredictable work schedule. More than 40 percent of early-career hourly workers in the U.S. learn of their work schedules less than a week in advance, recent evidence shows. Among retail and food-service workers, almost 90 percent face variation in at least half of their usual work hours.

Graham also finds major differences across income groups in reported physical pain. Almost 80 percent of people with household income below $24,000 a year reported being in physical pain the day before they were asked, compared with only about 30 percent of those with incomes above $90,000 a year. Her basic findings have been confirmed by David Blanchflower of Dartmouth College and Andrew Oswald of the University of Warwick, using a different data set. These researchers conclude that an astonishing 34 percent of Americans experience bodily aches and pains either often or very often.

The U.S. stands out on many of these measures compared with other countries. The gap in stress levels between low- and high-income people is noticeably smaller in Latin American countries, for example. Low-income American workers are also less likely than Latin Americans to believe that “hard work gets you ahead.” And Blanchflower and Oswald show that reported pain is higher in the U.S. than in any other country they study. “As the U.S. is one of the richest countries in the world, and in principle might be expected to have one of the most comfortable lifestyles in the world,” they note, “it seems strange — to put it at its mildest — that the nation should report such a lot of pain.”

Graham notes one encouraging trend: While the differences among income groups are growing, the gaps between races are shrinking. Life expectancy differences between whites and African Americans are narrowing, even as the gaps by income within each race are widening. And low-income African Americans are quite hopeful about the future — more so even than non-poor white Americans.

After illuminating striking differences across income groups in pain, hope, optimism and stress, Graham is correct in pointing out there are no easy fixes at hand. She's also right to say that the best way to start to address the gaps is to work to better understand them.

https://www.bloomberg.com/view/articles/2018-01-17/extraordinary-stress-and-pessimism-take-a-grim-toll?utm_content=view&utm_campaign=socialflow-organic&utm_source=twitter&utm_medium=social&cmpid%3D=socialflow-twitter-view
10
Knarfs Knewz / Why does it cost $32,093 just to give birth in America?
« Last post by knarf on Today at 04:44:38 AM »
The US is the most expensive nation in the world in which to have a baby – and it may factor into thousands of bankruptcies each year



Stella Apo Osae-Twum and her husband did everything by the book. They went to a hospital covered by insurance, saw an obstetrician in their plan, but when her three sons – triplets – were born prematurely, bills started rolling in.

The hospital charged her family $877,000 in total.

“When the bills started coming, to be very honest, I was an emotional wreck,” said Apo Osae-Twum. “And this is in the midst of trying to take care of three babies who were premature.”

America is the most expensive nation in the world to give birth. When things go wrong – from pre-eclampsia to premature birth – costs can quickly spiral into the hundreds of thousands of dollars. While the data is limited, experts in medical debt say the costs of childbirth factor into thousands of family bankruptcies in America each year.

It’s nearly impossible to put a price tag on giving birth in America, since costs vary dramatically by state and hospital. But one 2013 study by the the advocacy group Childbirth Connection found that, on average, hospitals charged $32,093 for an uncomplicated vaginal birth and newborn care, and $51,125 for a standard caesarean section and newborn care. Insurance typically covers a large chunk of those costs, but families are still often on the hook for thousands of dollars.

Another estimate from the International Federation of Health Plans put the average amount insurers paid for a vaginal birth in the US at $10,808 in 2015. That is quintuple the IFHP estimate for another industrialized nation, Spain, where it costs $1,950 to deliver a child. The amount insurers pay for births in America is lower than the amount billed by hospitals because insurers negotiate lower prices.

Even the luxurious accommodations provided to the Duchess of Cambridge for the birth of the royal family’s daughter Princess Charlotte – believed to have cost up to $18,000 – were cheaper than many births in America.

Despite these high costs, the US consistently ranks poorly in health outcomes for mothers and infants. The US rate of infant mortality is 6.1 for every 1,000 live births, higher than Slovakia and Hungary, and nearly three times the rate of Japan and Finland. The US also has the worst rate of maternal mortality in the developed world. That means America is simultaneously the most expensive and one of the riskiest industrialized nations in which to have children.

American families rarely shoulder the full costs of childbirth on their own – but still pay far more than in other industrialized nations. Nearly half of American mothers are covered by Medicaid, a program available to low income households that covers nearly all birth costs. But people with private insurance still regularly pay thousands of dollars in co-pays, deductibles and partially reimbursed services when they give birth. Childbirth Connection put the average out of pocket childbirth costs for mothers with insurance at $3,400 in 2013.

In Apo Osae-Twum’s case, private insurance covered most of the $877,000 bill, but her family was responsible for $51,000.

Apo Osae-Twum was the victim of what is called “surprise billing”. In these cases, patients have no way of knowing whether an ambulance company, emergency room physician, anesthesiologist – or, in her case, a half-dozen neonatologists – are members of the patient’s insurance plan.

Even though Apo Osae-Twum went to a hospital covered by her insurance, none of the neonatologists who attended to her sons were “in-network”. Therefore the insurance reimbursed far less of their bills.
Q&A
Did you receive an unexpected or unmanageable bill after giving birth?

There are few studies that estimate the number of families who go bankrupt from this type of unexpected expense. One of the best estimates is now outdated – conducted 10 years ago. But one of the authors of that research, Dr Steffie Woolhandler, estimates as many as 56,000 families each year still go bankrupt from adding a new family member through birth or adoption.

“Why any society should let anyone be bankrupted by medical bills is beyond me, frankly,” said Woolhandler. “It just doesn’t happen in other western democracies.”

Since Woolhandler conducted that research in 2007, 20 million Americans gained health insurance through the Affordable Care Act health reform law, and consumer protections were added for pregnant women. But Republicans and the Trump administration have pledged to repeal these consumer protections.

“People face a double whammy when they’re faced with a medical condition,” said Woolhandler. Bankruptcy is often “the combined effect of medical bills and the need to take time off work”.

There is no nationwide law that provides paid family leave in the US, meaning most families forgo income to have a child.

And although childbirth is one of the most common hospital procedures in the nation, prices are completely opaque. That means Americans don’t know how much a birth will cost in advance.

Dr Renee Hsia, an emergency department physician at the University of California San Francisco and a health policy expert likened the experience to buying a car, but not knowing whether the dealership sells Fords or Lamborghinis. “You don’t know, are you going to have a complication that is a lot more expensive? And is it going to be financially ruinous?”

According to Hsia’s 2013 study, a “California woman could be charged as little as $3,296 or as much as $37,227 for a vaginal delivery, and $8,312 to $70,908 for a caesarean section, depending on which hospital she was admitted to.”

Apo Osae-Twum and her family only found relief after a professional medical billing advocate agreed to take their case. Medical Cost Advocate in New Jersey, where Derek Fitteron is CEO, negotiated with doctors to lower the charges to $1,300.

“This is why people are scared to go to the doctor, why they go bankrupt, and why they forgo other things to get care from their kids,” said Hsia. “I find it heartbreaking when patients say … ‘How much does this cost?’”

Did you receive an unexpected or unmanageable bill after giving birth? Share your story using our encrypted form.

https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america
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