This is longer than a tweet, but I'm going to keep it short.

I am not defending the Congress Critter that shouted out. He's not the first to do it and I dare say he won't be the last and besides, his word choice was wrong. He should have said 'Yet'. More importantly, he should have respected the office and held out comment for a more appropriate moment.

Most political officials will say what's expedient, it's how the game is played. It is 'politcally' untenable to say we'll cover illegal's but viruses don't care about politics. If you truly want a healthy nation, you're going to have to provide basic healthcare for everyone that is within our borders or you'll end up with a bunch, millions maybe, of Typhoid Mary's running around.

And just to add an historical reminder, most all of us come from illegal/immoral immigration to this particular landmass. Also, in case you forgot, our forebearers helped conquer the region using smallpox and other European diseases. Whether intentional or not, it definitely helped in the conquest.

Traffic

Every day you hear people complain about commute times, lost portions of their lives due to traffic jams, air pollution and a host of other issues related to commuting from one physical location to another. Here in the Dallas/Fort Worth area we have massive road construction projects that make driving worse for years to come and then probably be undersized when they're done.

Are concrete deserts really the solution?

While I no longer commute in traffic every day I did for many years and noticed a couple of things.

1. When schools out and people take vacations, the existing roadways, for the most part, easily handle the traffic needs.
2. When the economy started faltering and people were laid off, the roadways were sufficient to handle the traffic as well.

Stuck in the Industrial Age

We need a great highway system for moving physical goods around the country. We need local roads for distributing those goods within regions and communities. Why, given the technologies we have available today, are we stuck in the industrial age?

• Does every worker really need to be at the same physical location at the same time before work can begin?
• Why do companies insist on building or leasing facilities sufficient to house all their employees simultaneously?
• In larger areas why are we allowing more super-highways instead of demanding public transportation?

Based on the observations above. Traffic jams appear to me, for the most part, to be self induced. Even if we hold that housing everyone at a location is the best method of doing business, do all businesses need all workers at 8am? Why are city planners not working with businesses to more efficiently use the capacity we have today instead of collecting more taxpayer dollars to expand systems that will always run into capacity issues.

I could spend more time on arguing the current system, but we're all familiar with it so lets move on.

Localization

I took a few mintues to look up some statistics, no telling if they're still accurate, but I'm willing to believe that the relative differences are still applicable. It seems to cost about $100 per fiber strand per mile to lay dark fiber. Constructing a highway lane-mile can run from $3 million and up depending on terrain. So we could install 30,000 fiber optic strands per mile for each lane of highway Obviously that's for dark fiber, but even at $10,000 per strand mile 300 fiber strands is a lot of fiber.

For those jobs that really don't require a daily physical presence at a central location, why are telecommunication services not a "no-brainer" solution? Could it be that management schools aren't teaching graduates how to manage effectively? Is it a case of "well that's how business works" so we must do it that way? Are companies afraid that without someone marching up and down the hallway ensuring that people are "in their seats" that no one would do the work they're hired to do? Personally, I think it's a mixture of those issues and more.

Telecommuting or as I like to call it, "Work from Anywhere" (WFA), is very easy to accomplish at very reasonable costs. Even if you couldn't afford or didn't want to allow services in every home. Local commuting centers could be used to house workers on an as needed basis. Additionally they could be set up in suburbs, rural locations, or college campuses, to allow business to pull employees from all over the nation to fill their needs.

Imagine if the commute for each of your employees was 10 minutes or less each way, you'd be giving many people back an hour or two every day that's lost to mindless traveling. Roads would become less crowded and so people that did need to come to a central location would get their faster and also get time back.

It's going to be difficult to break out of the Industrial age mindset, but if our education system adapts and begins training students to manage and work in environments where a physical presence is not a daily requirement then the transistion would be much smoother. I believe the businesses and municipalities that recognize that continual physical presence is a habit and not a requirement are going to be much more successful and may ultimately survive when those that don't die off.

From Politicians, Manipulation, and the Healthcare Problem from my blog http://donthorp.net

In general, I'm not a big fan of politicians. I know they're a necessary evil but I am troubled when they step over the line and over simplify and possibly just misstate facts just enough to inflame support for their position, whether their position is right/wrong, good/bad is immaterial.

What I'm not trying to do with this post is bash Obama, it is just an example of the type of speech that bothers me. Take a look at the two paragraphs below. This link was brought to my attention by @repeatnone. I have included the link to the original letter, so please read it.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

Three weeks ago, the President suggested that a surgeon’s decision to remove a child’s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.

- Excerpted from http://www.facs.org/news/obama081209.html

Let's examine the statement in the first paragraph. Anyone who has looked at an EOB (Estimate of Benefits, if you have insurance) knows that $50,000 does not go to one individual doctor and the amount that insurance reimburses the doctor is typically nowhere near the initial invoice amount. A portion goes to the hospital, the anesthesiologist, re-sterilizing instruments and the operating room, etc. It's an over generalization that might lead someone not inclined to question blanket statements to take it as fact and spread the wrong message.

I have not read or seen the entire town hall transcript so I am definitely NOT trying to say it was deliberate. It could have been over simplified by an aide or later explained in full. I'm just trying to point out the danger in that type of statement. Although it's for a smaller amount of money, the doctor asking to be paid amount X but agreeing to accept amount Y is no different than a grocery store asking you to pay X for canned goods, but will accept Y if you have a coupon. That part of the statement refers to a simple business transaction that many of use are very familiar with. It seems worse because the quoted invoice amount in absolute terms is so much more than a can of beans that it immediately invokes anger at the greed of the "doctor" to bill that amount.

Which brings us to paragraph two. Assigning intent to a group of people which implies that all members of that group have that exact motivation and can have no other motivation for the given statement. There are many ways this type of statement can be expressed. We all know that very few things in life have only two possible outcomes commonly described as black and white. Most everything in we actually deal with in life is probabilistic or shades of gray. Sometimes we only have horrible choices where we try and select the least horrible choice when we have to make a choice on the issue.

One of my favorite examples is when someone says "You always" or "You never". Firstly, how many times is that ever true of anyone or any situation. Even trained dogs don't always do the same thing. This statement usually appears during an argument when you want to inflict emotional damage to make a point. It's hardly ever constructive.

To make a blanket statement that ascribes greed as the only motivation for a doctor to remove a child's tonsils is no better than saying every American is just like George Bush, Bill Clinton, or insert any other person in the country here. We all know there are extremes where some members of a population may have that characteristic and we will probably admit, if we're not being lazy, that there are many other people in that population that don't exhibit that characteristic, in fact it's probably a large portion of the population in question.

Finding a solution for healthcare in this country is a complex problem that by its very nature cannot be simplified to single one size fits all solution. I'm going to make some statements about why I believe this is true and I hope you'll put together your own list and or help me extend or reduce mine.

1) As a nation we do not have unlimited resources to throw at this problem. We already have more programs than we can fund and we do not seem to have the collective will to cut any existing programs.

2) Doctors on average come out of school $100,000 in debt (http://www.studentdoc.com/medical-school-loans.html). I did not look up the statistics for other healthcare providers, but I'm assuming that it's non-zero. Do we really expect healthcare professionals to not be responsible and not pay off the debt or strive to achieve the American dream?

If you want best in the world medical care the people in that profession must have the ability to compete and gain personally from their efforts. How many of you would honestly say you'd be willing to have your pay capped indefinitely regardless of your expenses, abilities, and effort you put towards the task.

3) People expect doctors to be perfect in a profession that is not always predictable. Part of the existing problems we face is due to the litigious environment we have created. If any person is truly negligent or willfully deceives others then the full weight of the legal system should be brought against them. Another part of the problem can be ascribed to the medical profession, because they do not actively remove members that have demonstrated that they are incompetent. Another issue is the number of people who sue because they didn't get the outcome they wanted. Things go wrong in biological systems that sometimes can't be anticipated or corrected no matter the skill of the professional.

4) Many people don't want to change their lifestyles to reduce their total medical burden. Many of the diseases that we currently face in this country can be attributed to lifestyle. People expect to be able to be sedentary, eat whatever they want, smoke, drink in excess and then have the best medical care in the world fix them when something in their body goes wrong due to that lifestyle. I believe deeply that people have the right to live how they want, but I also strongly believe that actions can have consequences and we can't always be absolved from them at any price.

In closing, because I've expanding this post enough already. This problem is not going to be fixed by political grandstanding, fear mongering, and taking sides as if it were a sporting event. I think the number of people in this country that do not want to see everyone have access to quality health care is small and maybe even non existent. And if asked do you want your friends to have access to quality care and then extend that answer to those friends, pretty soon you'll have covered everyone in the nation.

Take a stand against speech that tries to polarize or over simplify the problem into a sound byte. Act locally so it can spread nationally.  Acknowledge it for the complex problem that it is and then roll-up your sleeves and to try and help foster an environment where we can constructively build a system that we as a nation will be proud of that meets the needs of all of it's citizens, including your elected officials.