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25 October 2016


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U.S. Army's chief of staff General Mark A. Milley recently said the following:
''And we know from history that unipolar and bipolar international systems tend to be very stable, but we also know that multipolar systems are inherently prone to competition, confrontation, instability and state on state wars.''

starting from 46:19

Although it very much depends on the point of view, many people felt it in the 90's that unipolar systems are not natural, perhaps making an analogy with nature and Newton's 3rd Law of Motion. That is also my firm belief.
But I cannot make a clear difference between bipolar and mulitpolar systems, in terms of history. Any thoughts?


The first thing that I wonder about the health care industry, about which I don't know too much about, is how it compares to the higher education, about which I do know a decent bit, and I'm glad that you drew the comparison.

Increasingly larger share of costs in higher education go into various infrastructure of questionable (education) value--nice dorms and facilities for students, a lot of technology to generate data (but not necessarily for improving instruction), more administrators and staff to oversee these things, etc. In a paradoxical way, at least a decent chunk of it is driven by a demand for "accountability," since "accountability" is taken to mean generating ever more data to justify this or that, which in turn, demands ever more infrastructure at more cost. Of course, since universities are non-profit, at least in principle, it needs to spend all its "profits" so the surpluses thus generated get recycled back as additional expenses, completing the self-licking ice cream cone logic. Curious if something comparable is at work in the health care industry: the calls for data-ization of the health care industry has been ongoing for some time, and while there is no doubt much improvement in efficiency that can be achieved by making patient records electronic and so forth, I always wondered if that is/was an especially big cost center or a potential boondoggle, for example.

Eric Newhill

OMB, please see my response to TTG. As you are a medically oriented man, I want to add, from a clinical standpoint, that obesity is a huge driver of cost in the US. It leads to a myriad of conditions which, per my answer to TTG, are all treatable at high cost; everything from knee and hip replacements, to cardiac/vascular problems, diabetes, kidney failure.

A few years ago I did a cost/benefit analysis based on healthy lifestyles programs potential (if they worked). I was amazed to find out how much obesity is related to medical costs. Conservatively 25% and, stretching to include more peripheral symptoms 35%. That's a lot of money. Maybe 4.5% of GDP going to address the consequences of obesity. The population in my study = millions of covered individual. So I am pretty confident in my results.


Some endorsement. I guess he's planning to make a fortune from from his military related stock at our expense.

Colin Powell complained to a Democratic mega-donor that Hillary Clinton “screws up everything she touches with hubris,” and expressed concern over Hillary’s health back in 2015.


Eric Newhill,

As an actuary, you'd be in a good position to know how healthcare might work financially. I'd be curious as to what you thought a solution might be, if you could take politics (or name your obstruction) out of the way. I'd guess there are probably multiple answers to that question, all of which are far better than what we have today.


Wages are much lower in Columbia. Building cost are also much lower so if you are using a product with a significant local work and housing costs than it is not surprising that the product is much cheaper.

Eric Newhill


You can purchase ACA insurance (aka Obamacare) on line on the government "exchange" (aka "marketplace" - it's their official website) or you can purchase through an insurance broker or directly through an insurance company. Govt, subsidies (the feds pay part - or all - of your premium) are only available through the exchange. No subsidy is available if you purchase through the other channels.

Subsidy amount is based on your income level. I cannot remember up to what income level a subsidy is available, but it isn't all that high. The govt website has a calculator that tells you if you qualify for a subsidy or not and, if "yes", how much. Do not to cheat b/c you have to enter your SSN and that links to the IRS who, supposedly, verifies your income level against your tax returns.

There are different levels of coverage available ("metals"); bronze, silver, gold and platinum. In that order, the premium increases in cost, but the benefit coverage also increases (lower copay/deductible and more goods and service that will be covered).

I kind of assume you don't qualify for subsidy (I think I recall you saying you are a lawyer). Therefore you will pay the full premium and it is not cheap. In fact, premium-wise, it might be more expensive than a non-ACA policy. Depends on where you live, who you purchase from, etc.

The big advantage to a non-subsidy qualified individual is that pre-existing conditions do not exclude you and treatment will be covered, if you have that issue.

There is opportunity to take advantage of the corruption. If you have a pre-existing condition, especially and acute and expensive one, you can sign-up for the platinum plan, pay your initial premium amount, get the treatment and then drop the coverage when you are all better. Repeat as necessary (that is one way we are losing $ on this thing).

Otherwise, I think you'd do fine with Medicare. Best to see what Medicare costs and compare to what the ACA would cost. I can't imagine the ACA being the better deal unless you need to take advantage of its design as I outlined above.

Hope that

mike allen

Colonel -

I have read "The General Danced at Dawn" but had a memory lapse on that part. Getting old is better than the alternative, but it sometimes plays tricks on my brain. Read most of Fraser's fiction, "the whole cheese, the hail clanjamfry" as McAuslan would say - but just with the exception of eight or so of his Flashman series which IMHO he overdid.

I do read and appreciate good fiction. I try to alternate between fiction and non. Favorites are Traven, Conrad, Cooper, Abbey, O'Brian, Urrea, Beach, Cornwell(B), O'Flaherty, and the spy novels of LeCarre, Furst and a few others. Plus the crime fiction of Connely, MacDonald, and the many Seattle or Swedish crime writers.

I realize that many so-called non-fiction Histories and Biographies are sometimes puff pieces or hit jobs and perhaps contain more fictional fantasy than Edgar Rice Burroughs.


apenultimate linked to an IBT article at the top of this thread.

people have hissyfits over pussy but ignore the cat's paw

is the James-Ghilarducci plan getting much attention? there are 16,600 results from google and 1 from google news,



Clinton’s pension adviser, Teresa Ghilarducci, a professor at the New School, is teaming up with Tony James to revamp our current 401(k) system.

Their proposal, called the Retirement Savings Plan, would require workers and their employers to contribute at least 3 percent of the employee’s salary each year into a “Guaranteed Retirement Account” that “could be invested in opportunities typically reserved for institutional investors—less liquid, higher return asset classes. These include high-yielding and risk-reducing alternative asset classes like real estate, hedge funds, managed futures and commodities.”

mike allen

Good luck Ty! I'll take you up on that election bet - some of your AZ venison against my WA smoked steelhead. I will collect after Christmas when I am wandering around Yuma or Quartzite with the rest of us WA and BC rain & snowbirds.

Dr Puck

I agree 100%. As Eric Newhill put it, "his position on healthcare is pre nonsensical idiocy." My post duplicated Trump's pitch to his supporters, some of whom, amazingly, actually believe Trump will insure everybody, cut premiums and co-pays, and, offer 'more for less.'

Trump has spelled out a GOP boilerplate wish list on his web site:

**Repeal and replace Obamacare with Health Savings Accounts (HSAs).

^Work with Congress to create a patient-centered health care system that promotes choice, quality, and affordability.

Work with states to establish high-risk pools to ensure access to coverage for individuals who have not maintained continuous coverage.

**Allow people to purchase insurance across state lines, in all 50 states, creating a dynamic market.

**Maximize flexibility for states via block grants so that local leaders can design innovative Medicaid programs that will better serve their low-income citizens.

**will tend to reduce quality of coverage and increase bureaucratic management

^obviously offers a fantasy about Congress and how the two parties work together for the greater good

Obviously, if Trump became President, if he just blew up the healthcare system on day one, flesh and blood people would die, and, eventually people would take their Stage IV cancer to the emergency room and we'd end up paying for it all, anyway.

mike allen

thanks for the recommendation. Can't find him at our small town library, but will check the local and online bookstores.

Bill Herschel

This is the moment to mention Greenmantle by John Buchan. It's about Islamists being agitated to take over the world, so it's timely. And like every Buchan book it's a pleasure to read.

robt willmann

Now, Britain is sending 800 troops, drones, and tanks to Estonia near Russia's border as part of a "NATO" something or the other, according to the British Mirror tabloid newspaper--


Arrogance can lead to trouble.



In my layman's opinion, a Republican can only win the presidency in a change election. They have an inherent disadvantage in the electoral college. Take a look at the 2012 results by county. It is a sea of red with the blue concentrated in urban areas. But the blue areas have large population. If the election were decided by winning counties instead of states the GOP would have an inherent advantage. There is as much of an urban vs rural divide as there are are racial and education divide. This chasm between the urban and rural population is as wide as I've ever known. So, the swing that shifts the tide in favor of the GOP in the electoral college comes pretty much from a small shift in urban voters.

Even in a reliable blue state like California if you look at the 2012 results by county you can see how the Democrat advantage is narrowly concentrated in and around the big urban areas of San Francisco and Los Angeles which have the large population. The big problem is how each side feels about the other. The urban folks have a very condescending attitude towards the rurals while the rurals feel under siege as their culture and livelihoods comes under increasing attack.

I am convinced that if we survive the colossal miscalculations by the Borg Queen in her military escalations, her condescension towards Les Deplorables and her deep corruption will continue to exacerbate this divide.


When did waging war on Syria become a NATO mission? My understanding was it was just the colonial powers that were illegally waging war in Syria. If this is in fact a NATO mission then first of all NATO should be disbanded. After that every damn member of NATO should have to contribute.

If this isn't a NATO mission then NATO guy should shut his hole and stop interfering in the affairs of a member state then be fired. NATO is subservient to it's members not the other way around.



There's got to be a reason why the same brand name pharmaceutical drug and the same high-tech procedure costs 10x to 1000x more here in the US compared to Germany or Switzerland.

In any other industry, the price arbitrage at least for physical goods like pharmaceuticals would have been leveled. It hasn't because of regulatory interference. This is purely a function of their lobbying power and ability to fund Congessional campaigns. And of course staff the revolving door.

I don't think the Swiss and Germans have any less high-tech medicine than we have. We may consume way more because price-value has been removed from consumption decision making.


I suggest valuing free financial advice at what you paid for it.

However, they are a good assimilator of news Re: the Borg and always link to originals, which saves me time.


My kidneys failed in China...... cost for sucessful treatment using top of line macines USD $20
I suffered a stroke in Greece...... cost for ambulance to hospital, drugs, CAT and MRI scans, lab work, hospitalization, and MDs...... $250
My crew suffered a severe concussion in Spain..... cost for 1 week in hospital, MDs, drugs, labs, CAT and MRI scans $1000

My wife is a board certified MD in the US... She says that in Russia.... where she trained initially...... treatments are simpler..... and work! The patients get better and walk home..... In the US treatments are complex and quite often fail........ the patients go home in coffins......

Were every US MD put on an average salary of $350,000 /yr would cost each citizen of USA $70/month.
It's not the wage costs of MDs that makes med care in the US so expensive.. it's the implied and real overhead of regulations...... and payment structures

Martin Oline

Amazing stuff about Trump from a Politico site. I know you Pat doesn't like us to mention other sites but I was so happy to read this part about Jim Webb. This makes me feel so much better about my home made Jim Webb for President sign:
“Donald Trump is a stunning outlier. His linguistic style is startlingly feminine, so much so that the chasm between Trump and the next most feminine speaker, Ben Carson, is about as great as the difference between Carson and the least feminine candidate, Jim Webb. And Trump earns his ranking not just because he talks a lot about himself or avoids big words (both of which are true); according to Jones, he also shows feminine patterns on the more subtle measures, such as his use of prepositions and articles. The key then is not what Trump talks about—making Mexico pay for the wall or bombing the hell out of ISIL—but rather how he says it.”


Do you think the anti-Russia fervor, and even the apparent desire to go to war against Russia, is merely a projection of the current anti-white male sentiment in America? I'm constantly reading and hearing college students and millennials opening speaking about how America's evil, and all the world's evil, is a product of the white male. And it's not challenged by the white males in those setting (though in fairness, they tend to be self-loathing liberal cucks). Here's a piece by a UCLA political science professor (btw, could you imagine similar talk about any other group?):

UCLA political science professor Michael Suk-Young Chwe:

In a blog post for the Princeton University Press, Chwe argues that white men are dangerous to the country, as evidenced by their support of Trump. Democracy in America, Chwe claims, will only be safe when whites and men — and especially white men — willingly surrender their power to “multiracial and multi-gender coalitions.”


martine oline

what I don't like is to have SST used as a bulleting board for other sites. If you post a link here discuss it. pl



With regards the latter point, about condescension from the city folk, and, really, the depth of alienation between the urban and the rural, I'm in 100% agreement. A lot of it is driven by fundamental inability to reconcile differences in worldviews, except by insisting that the other side is simply wrong and unworthy of understanding beyond being caricatured. These are truly dangerous times.

I don't know if you know of Chris Arnade, a former Wall St. finance professional who left it behind to photograph and write about the flyover country, both inner cities and rural places. His articles currently show up on the Guardian, and his insightful tweets are something to pay close attention to. Other than that I went into social science academia and he went into finance after our PhD's, we have very similar backgrounds (exc., well, my immigration background, but he is also from rural South) and worldviews, and I wish I academia paid like Wall St. so that I could just quit what I do now and do what he is doing, but alas, that is not something that would happen.

Babak Makkinejad

The costs cannot be separated from the tax structure in those countries; what are the income tax rates as well as corporate and small business rates?

Do you know?

Allen Thomson

WRT to the Politico article that says Trump's speech is way more like feminine patterns than any of the other candidates', I tend to be skeptical of this kind of thing until seeing the actual methodologies. I've written to the author of the article to see if any papers describing how it was done are available.

That said, it's undeniable that Trump doesn't talk and act like your usual candidate. Earlier articles have noted that he has a reduced vocabulary, simple syntax and seems to rely on various verbal and nonverbal cues. I'd be very interested to see a study on who else has been like Trump in those regards.

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