Overseas

Not to harp on about Australia, but when I go into a health care provider for a service that isn't covered by Medicare (the gov't insurance) - for instance, buying eye glasses, or a therpeutic massage, I hand them my private insurance card, they put in into a machine similar to one used for a credit card, and it automatically pays the provider what my policy will pay, and I just have to pay the difference. All the insurers are on the same IT system, and it is all automated. So they can automate it all, and make it all interchangeable. I agree it is inexcusable.

Just to clarify - I wasn't necessarily holding the UK out as a good system. On a macro-economic level, it may be - they seem to get more bang for the buck, so to speak, based on a comparison of results (life expectancy, survival rates) etc. versus money spent. But they also have a large number of horror stories, wait lists are a serious problem, and certain areas you definitely don't want to just rely on the NHS (cancer has long been a real weakness). Such a system is wholly unsuited to the US. But I do think it interesting that the seemingly most efficient health care system in the developed world (based on return on the dollar) is the one that is the most socialized.

We do have something similar in the US - also called Medicare. Everyone over 65 has insurance provided to them. If you want more services, you can get more - if you pay. But if you can't afford extras, you won't be denied health coverage. There is more a focus on cost containment in the Australian Medicare, which is why, if you feel it necessary, it is possible (and in fact encouraged) to also obtain private insurance. Why should someone who earns $15,000 a year - say, a farm worker - be condemned to die from a disease because they can't afford insurance? So either we as a society think their life isn't worth anything, or we do something about it. Considering we are currently starting to bankrupt ourselves with our current system, and don't even cover everyone, I'd say we have a serious issue that we need to address. Alas, we have a political climate that seems to think dicussing Paris Hilton and moose hunting is a valid way to decide the future of the nation.

First, let's dismiss the argument that we don't ration health care/have waiting lists in the US- we just do it by how much money you have. We have 45 million people without insurance - that's who are on the wait lists for care in this country. Every system rations health care. It is just that every other modern industrialized nation has made the determination that health care should be rationed on a different - and, to be honest, more equitable basis. Every other nation has also decided that people should not be bankrupted because they become ill. They also are generally uncomfortable with the determination of whether your care will be paid for being made by a company which has a direct financial interest in not paying for that care. And there is a recognition that with health coverage, you really can't have true competition (e.g., if you don't like the level of service you get, you can't go somewhere else - that would usually entail changing jobs and/or trying to get a new insurance company to cover you at the exact moment when you are ill and need the coverage). These points are really only issues in a health care system where coverage is primarily private. On a macro level, the UK used to spend something like 6% of GDP on health care, and with life expectancies exceeding the US, and survival rates for major illnesses generally comparable to that of the US. On an economic analysis level, they did seem to make the right choice. In comparison, the US spends close to 15% of GDP - and considering a baby born in Cuba has a better statistical chance of living to its first birthday than one born in the US (Cuba, for heaven's sake!) we don't seem to be spending our money perhaps as wisely as we could. However, the UK was really trying to get health care on the cheap (and as a former resident of London, it was noticeable). While survival rates were generally comparable, they were well behind in certain areas (cancer, especially). They have increased spending up to closer to 9% of GDP, I believe - which is close to the European average to address that. We also need to differentiate between the provision of health care by the government, and the provision of health insurance by the government (e.g., the actual health care providers are not government run). In the UK, the National Health Service actually runs the hosptials, employs the doctors, etc - it is truly socialized medicine (although since Thatcher started some reforms, a certain level of private health care has developed). I don't believe anywhere else is quite so socialized as the UK, though everywhere obviously has certain degrees of government provided health care (look at Ben Taub and the VA here, for instance). The UK is pretty unique - few places have the full socialized medicine as they do. Most everywhere else has something something like Medicare here - government provided basic insurance with some private insurance in addition, and a mix of private and government provided health care. I believe that Canada, however, has been quite strict on not allowing too many private insurance providers, and also tries to centrally plan the provision of health care as well. My sense - and I may be wrong - is that wait lists generally develop not because the coverage won't cover you for your hip replacement surgery or chemotherapy, but because there isn't the capacity to actually provide the services. And when the capacity is solely provided by the government, that seems to be where things really break down. I think that Australia, where I currently live, has a good balance of goverment and private, and is something the US might want to look for ideas. They have what they call Medicare, which is the government provided insurance that everyone has. You may also have private insurance, which provides for certain extra coverage, and can help you avoid wait lists. If you earn over a certain income, you are actually taxed at a higher rate (and extra 1% of your income) if you do not have private insurance. Hospitals are a mixture of private and public - although I think the private are mainly non-profit. And the public hospitals have a private "wing" where coverage is provided for those with private insurance. It is a real mix. There doesn't appear to be the same service delivery issues you do wtih the UK - this is one area where a bit of competition might seems to work, perhaps because you can pick a different hospital or doctor more easily - especially if your insurance will cover anywhere you go. There are still wait lists, but (based on personal stories and media coverage at least), they don't seem to be as problematic as in the UK. And insurance companies and health care providers do seem to compete on providing better services in Australia - you get private rooms here with insurance, and the insurance companies compete on how many extras they'll provide (which they can do as the main bulk of an expense is picked up by Medicare). Many of the main hospitals are run by the states, but they don't have a complete monopoly. Australia's system of involving publc and private seems to insure (pardon the pun) that everyone is covered, wait lists don't seem to be huge issue, people who want more or quicker coverage can purchase it, and that the provision of health care isn't caught up in as many bottlenecks. Apologies for the long reply...

There was an interesting recent study - which I of course can't find now - whose thesis was that the de-institutionalization of the mentally ill in the US during the 60s didn't result in the de-institutionalization of the mentally ill. Instead society replaced mental institutions with jails. When society stopped locking the mentally ill up in mental institutions (which were often extremely abusive settings for the patients), society (in usual fashion) never followed through with the proper care in the community that was supposed to replace the mental institutions. So the mentally ill who were unable to cope in society inevitably wound up in jail. Until we realize that proper mental health treatment is not only the moral thing to do, but an excellent way to reduce crime, I don't expect this trend to change. More wasted lives (both the mentally ill and the victims of their crimes). But hey look- Britney got increased visitation rights. Let's pay inordinate amounts of attention to that instead. Sigh.

I wonder if this is also designed to make Grady an outlet for the Walnut Bend/Briargrove Park kids rather than going to Paul Revere, since that school hit the skids once West Briar MS opened up.

I'm not overly fond of the name - though in part because I will always associate Titan with this ship's name...

There have been suggestions to improve Market Square by making it more lively. The idea that it is a park seems to be the reason why it wasn't. At least according to these guys: http://www.pps.org/info/newsletter/decembe...erperforming_us "Several years ago, PPS developed recommendations to locate an actual public market in Market Square. But we were told that Market Square was a "park," and as such, no commercial activity could take place there. Decision makers chose a silly design that did nothing but continue to keep people away. " I think I remember reading that a market was tried here in recently but it didn't catch on, though, so who knows, maybe the city allowed commercial activity eventually.

Actually, there is a bit of a Wal-Mart connection here to be played off of. As Niche said, Costco's whole image and marketing strategy is that it is the anti-Wal-Mart (or Sam's Club, to be precise). It is supposed to be progressive, socially aware, pays its employees well and gives them benefits, more upmarket etc. This development is the antithesis of their image, and should be pointed out to them. With Wal-Mart starting to try to embrace "green" and more responsible developments (or at least marketing themselves as such), pointing out to Costco that this sort of development is not in keeping with their image and is actually trailing behind where Wal-Mart is (sort of) going. A whole slew of emails hitting Costco might have some effect. Couldn't hurt.

Great pics - thanks for taking and posting them. It's nice to see pictures of home.

Hope this works being my first post... Naming of homes probably derived from Britain, where it is quite common. You have the large estates, which are known solely by a name (Blenheim Palace, Knole, etc). And in many rural areas, a smaller home's name was its address (rather than 15 Oak St, Stanton, Oxfordshire, it would be Oak Cottage, Stanton, Oxfordshire). This is still the case today, but to a lesser extent. I think the tradition was brought over - look at all the large plantations in the South with names, and estates up north. And in both the UK and in the US, the middle class used to name their homes to emmulate their "betters" and to seem more upper class, perhaps. In the UK now, though, naming your house is usually seen as bit naff.