Because 2016 is a political year, intelligent discussion of many of the problems facing humankind in the immediate future will be hampered. I would like to raise some of these issues anyway because they will definitely affect our grandchildren.
- The world is already overpopulated. We’ve had all the growth that Earth can stand. There are over seven billion humans on Earth, a high percentage living in poverty. The well-to-do consume at an unsustainable rate that pollutes the air, water, and ground. Birthrates in impoverished regions are usually high, so the population in these most miserable areas grows at the fastest rate, increasing the misery and danger of starvation. In the industrialized countries of Europe and North America, birth rates are below replacement levels and immigrant workers are needed to staff the manual labor force. This creates the hypocritical political discussion in which immigration is condemned by people who hire undocumented workers because they will work for lower wages.There is considerable discussion about what the world’s population may grow to and what the ideal human population should be. For everyone to have the opportunity to live the lifestyle of the American and European middle classes, estimates range from one to two billion, total. We have over seven billion. How can we reduce our population by a factor of three or four peacefully and without some major disaster? One approach would be to provide free birth control pills and devices throughout the world and abortion on demand. There are those who would oppose these proposals on religious grounds but following such religious principles has us driving at high speed toward the edge of a cliff. Educating women is also a very effective way to reduce birth rates. Women who want to have professional careers and who know how to control their own reproductive lives will do so. In some societies men will not let women be educated. This must change.
These proposals will be easier to accomplish (though still difficult) in North America and Europe. In Africa, most of the Middle East, and Southeast Asia they will be extremely difficult due to the cultures that have developed there. If we could somehow throw off our shackles of tribalism, so people from elsewhere or people with different skin color were not automatically viewed as “other” and somehow less worthy, we might have a chance. So far, we are making no progress toward this absolutely necessary goal. I would remind everyone that the Biblical story of Adam and Eve and the gene sequencing data of the Human Genome Project both teach that we are all brothers and sisters. Genetically we are 99.9% the same, the world over. Our continuing sense of tribalism may have a genetic component but is mostly cultural.
- A more mundane concern is delivering the best possible healthcare to the most people at the lowest possible cost. The United States is far behind other developed countries in this matter. In the United States, The Affordable Care Act (Obamacare) expanded health insurance coverage to tens of millions of people who previously had none. It was accomplished through a mixture of private insurance companies and government subsidies. This has been resisted mightily by the Republican Party. They have offered no plan to replace it but have voted over fifty times in the House of Representatives to repeal it. The Democrats want to keep it or improve it. Hillary Clinton wants to make incremental improvements and Bernie Sanders wants to move toward a single payer, income tax funded, Medicare for all plan. Here are some data from 2008.
The ratios of spending haven’t changed much since 2008. The United States has a hodgepodge system of health care funding based on private insurance, group insurance, government sponsored insurance (Medicare, Medicaid, and VA) and no insurance, where poor, sick people show up in emergency rooms with diseases that would have been far less expensive to treat had they been treated promptly. These costs are borne by city and county tax payers. The poor people who have no insurance live shorter lives than the rest of us. The average person in states where governors have refused to implement the federally funded extension of Medicaid to all poor people also has a shorter lifespan. At least they are not Socialists.
You will notice that the United States spends more of its GDP on health care than anyone else. The Scandinavian countries spend about two thirds of what we spend. They all have cradle to grave health care funded by taxes. They also have big sin taxes on alcohol and tobacco. I go to Norway every year for a cancer biology meeting. A pint of draft beer costs about $10, most of it tax. The tax goes into the healthcare system. Mentioning taxes at all in a political, or any other year, causes both mental constipation and verbal diarrhea in conservatives. One point that needs emphasis when considering paying for medical care through taxes is that one would not have to pay any private health insurance premiums. And, by taking insurance company profits out of health care funding, one can see from the data above that the total expenditures of countries for health care go down–a lot. Administrative costs for Medicare are much, much lower than they are for any private health insurance company. These companies may provide profits for their investors but they do not do a very good job of delivering health care. Indeed they account it as “medical losses.”
The average quality of healthcare delivered by our very expensive system is not good. The USA ranks 34th in longevity with an average life expectancy of 79 years compared to 1st ranked Japan’s 84. As one can also see from the bar graph below, the USA has a shamefully high neonatal death rate compared to other “developed” countries. Note the positions of the countries with “socialized medicine.” We need to ask ourselves whether we want to adopt a health care financing system that delivers the best possible health care to the most people for the least cost or do we want to preserve a capitalistic system because it’s the American way? We currently have a two-tiered system. Well-to-do folks with good health insurance get excellent care, as good as the Scandinavians and Europeans. Poor folks with no health insurance get no care or care too late and drag down our statistics as well as our humanitarian reputation.
So, we can deliver better health care to all our citizens for much less money than we now spend. Taxes will go up and insurance premiums will go away. I would be willing to let rich folks pay premiums for concierge care if they want to. This is done in Great Britain.
- We can also save a lot of money on our military budget. We spend as much money for our military as the next ten countries combined. Could we cut back safely to just being in first place? With our huge expenditure and huge force have we stabilized the world? There is a corollary here that relates to the oil business. We are unduly preoccupied with the Middle East conflicts because of our need to stabilize the world’s oil markets. I propose that we let the oil industry provide its own security for its reserves. The price for oil is artificially low in the USA because we do not factor the portion of our military budget spent protecting oil reserves into the true cost of a gallon of gas. If oil companies had to defend their reserves themselves and add those costs to their overhead, the price for their form of fossil fuel would increase several times. People, even conservative politicians, would become aware of the true cost of oil and gas and resistance to developing a national power grid based on solar, wind, geothermal, hydroelectric, nuclear and a little natural gas would decrease significantly. Think of the jobs that would be created here at home establishing such a system.
The graph above shows where we could get the money to pay for the energy programs I am suggesting. These are recent data. What have we bought in terms of safety with all this money? What if we would cut it in half and spend the savings on the power grid and our infrastructure? We could do a lot with $340 billion per year. In this election season right wing politicians are scaring voters with the idea that we do not spend enough on the military to keep us safe from terrorists. By this they currently mean Iranians and Muslims in general. We all know that we kill far, far more Americans every year because of our insane policies about firearms than terrorists do. White, Christian, hate-filled, screwballs are much more of a threat to American lives than Muslim refugees from Syria or home-grown radical Islamists. Is it really preferable to be killed by people of our own race and religion?
Back to taxes. Warren Buffet, worth over $50 billion, once pointed out that his secretary paid a higher percentage of her income in federal taxes than he did. He also acknowledged that this didn’t seem fair to him. When Mitt Romney, worth a paltry $200 million or so, was running for President, he released a report on his most recent income taxes. He paid 12%. What is your tax rate? In a recent year General Electric paid no federal taxes at all because of its ability to shelter its income overseas. There is a lot of money that could be collected if we would vote for politicians who would pass laws to do it. Right now that is unlikely. Donald Trump has explained this succinctly during his campaign. When politicians call him and ask for money, he gives them some. When he wants a favor he calls them back. They deliver.
- Lastly we need to get economists interested in the problem of shrinking the human population 4-5 fold and creating economic systems and models that are not based on perpetual growth but on innovation. All our current models are based on growth and we either rejoice or lament economic news based on whether or not the economy is growing. We really do need to shrink the population. But, if everyone of the 1-2 billion people who eventually come to inhabit our planet lives a lifestyle like the middle classes of Europe and the United States, there will be plenty of demand for products to stimulate the economy to continue to innovate. After all, the upper one billion of our current seven billion people consume almost all the resources and manufactured products now. I am proposing that we have a stated goal that everybody, all our brothers and sisters, should be able to live this way. Why do we need to keep six or more billion people in misery? We don’t.None of what I am proposing will be easy but it is necessary if we are to consider ourselves moral, evolved beings who deserve to be leading and caring for the world. The alternative is a real, honest-to-God tragedy of Biblical Flood proportions.