Can America afford it’s rural communities

We hear a lot about the “takers” in America, a classification for, usually inner-city people who survive on benefits, unemployment, housing, medical, food stamps and more. Mostly the venom about takers also contains a racial element, it’s directed at black and minority groups who many assume benefit from Government programs without paying in.

It’s not often directed at the President himself, but as the New York times pointed out last year, Trump himself could be the ultimate taker.

Picture of small town America decaying
Decaying Texas – Mark Cathcart

What we don’t hear much about is the affordability of rural towns, and even many of the suburbs. One of America’s greatest strengths, it’s size, is also one of it’s biggest problems, small town sustainability. I’m no expert on the economy and sustainability, but if you drive long distance in America away from the Interstates, you can see the problem everywhere. Decaying towns, decaying infrastructure, slowing or declining population growth. I own and subsidize a rental home in one such town in Texas.

Back in 2014, I made my only drive from Austin TX to Boulder CO with my Mum, on what was to be her last grand tour. What struck me at the time were the endless poor quality roads, and the nearly, seemingly deserted small towns.

We covered 2,500 miles, mostly north west Texas, also New Mexico, and Colorado. On the way back we went via Taos, Santa Fe, and Roswell and then back through west Texas.

They had almost no choice in terms of food, restaurants and shops. I wrote this blog post “Decaying Texas”. It has a couple of slideshows of pictures taken along the way home.

The question of affordability will be right in the headlights in the coming years of the Trump administration. Almost every major program that the administration seems to want to change or cut will have a major impact on these rural societies. Downsizing the Federal government, a project of the Cato Institute, says:

Even if rural subsidy programs were administered efficiently, they represent an unfair redistribution of wealth. In many ways, rural Americans are better off than urban and suburban Americans. They enjoy cheaper housing, cleaner air, less congestion, and other advantages. So people who live in rural areas should not be a privileged class receiving special subsidies.

The Cato Institute couches the benefits in the usual political-speak weasel words as “Scholars at Cato believe that cutting the federal budget would enhance personal freedom, increase prosperity, and leave a positive fiscal legacy to the next generation.”

Rural communities for the most part exist to allow the exploitation of the land and resources. Hence the reason why America’s size is a strength, there is plenty to exploit. From farming for cattle, corn, wheat, to mineral extraction, to oil and gas fracking, America has it in abundance.

However, most of the infrastructure to support the communities is decades or more old and needs investment to sustain. Building roads, laying pipelines for water, sewage, telephone and internet service are expensive per capita. Roads particularly require a massive subsidy given the distances involved and the low number of people they service.

Trump Pence sign
Image: thehill.com / Getty Images

What is clear is that the new administration wants to cut regulations, budgets, and “Make America Great Again” #MAGA. I fear though for these communities, as they are likely to become unintended consequences of poorly thought through, and rushed changes in policy.

Education
School choice has been a great boon for suburban America. It has also been a positive benefit for the re-segregation of schools. Rich, often white people move from urban centers to suburban centers where they not only have choice, but can have their choice subsidized through vouchers, funded at the expense of public schools whose budgets are impacted by funding vouchers. Forget the furor about DeVos and if she is even qualified as U.S. secretary of Education. What is clear is that if she chooses to drive her professed support for school choice through vouchers as a policy, rural education will be screwed. Rural areas, without huge subsidy, will not have choice. Private businesses are not going to rush into towns and build new alternative charter schools, they can never make money from them.
If the alternative is distance learning, it has a double impact. 1. Distance or e-learning has typically less than optimal results, 2, by opting for choice through voucher, the local public schools are further devalued by lower attendance and either great subsidy, or lower budgets. This is a major issue, as schools in rural areas don’t just teach children, they are major social hubs for community interaction. Destroying public schools in rural areas, will further destroy their communities.  The Atlantic has a great article covering DeVos and the potential impact on rural schools and communities.
Health care (ACA and replacement)
This blog post was kicked off while driving to swimming this morning. I heard this Colorado Public Radio (CPR) piece on the rural hospitals fears for post “Obamacare”. Like schools, access to medical facilities in rural America is crucial to their survival(literally). Asides from concerns of access to healthcare and the affordability of it, the thing that struck me about the CPR interview was that  San Luis Valley Health in Alamosa provides 670 jobs and is the region’s largest employer. This is consistent with what I’ve observed elsewhere in Colorado and Texas, both large and small towns with massive health care employment.
In the UK, where the National Health Service (NHS) employees around 1.6-million people, making it the world’s 5th largest employer. The NHS is notionally is single organization, the NHS employs just under 2.5% of the UK population. Using the US Bureuau of Labor Statistics data for 2009, health care employment in private-sector health care industry employees just shy of 11-million people, add to that 100,000 of the 350,000 at the Veterans Administration, and then all the small town public health care clinics that deal with vaccinations etc. and it’s safe to say some 12-million work in health care in the USA. So, nearly 3.75% of the American population work in healthcare.
Health care in the US is much more expensive than the UK and most other developed countries in the world. This is in part due to the massive over provision and duplication of healthcare facilities. The simplest way to reduce the cost of Government programs, would be to drastically cut the provisions that support poor, rural communities. Make them travel further, pay hospitals less for the procedures, make fewer people qualify for the programs. That is exactly what these rural and small regional hospitals are concerned about, as discussed in the earlier referenced CPR piece.
Environmental Protection (EPA)
As I type this blog entry, Trump Administration EPA head, Scott Pruit is making his first address to the EPA (I’m not listening). This blog isn’t about his and the administrations dislike of the EPA and it’s regulatory overreach and climate actions. However, through executive orders that have frozen grants and programmes that impact some renewal and rejuvenation projects in rural areas and poor communities. What most won’t understand are the number of programmes the EPA supports and provides for small, rural communities and also for Native Americans. It’s unclear what the side effect of the major changes to the EPA will have on these programmes, or if they will just become Pruitts shrapnel.
Infrastructure (DOT)
While the President talks up his infrastructure goals, and decries the state of the roads, bridges and airports, outside of the wall, it’s not clear the Administration understands how much we currently spend and how poorly we budget and account for infrastructure. It’s already clear that Drivers are not paying their fair share, and that we are swimming in debt for road expansion and funding. It is hard to imagine that fiscal conservatives, the GOP and the TEA party are going to swallow more debt on a massive scale to fund this. In many rural areas, pot holed roads are being downgraded already to gravel roads also known as “unpaving“. States, cities and municipalities account for infrastructure in entirely the wrong way. They assume infrastructure itself has no value in their financial statements. They depreciate the assets over the course of its useful life until it has a no value. The problem is at that point, you can’t simply walk away.
As Strong Towns pointed out “Current accounting practices do not bear any relation to the future cash flow or the actual financial health of the city. When cities take on obligations, they should be properly accounted for as liabilities, not assets.” Given Rural towns tax base, population and business are declining, they are hit even more substantially by the errors in accounting from the past.
Agriculture (USDA)
There is significant investment by way of investment and development grants in rural areas, as well through crop subsidies. The top subsidized commodities are Feed grains, mostly corn, cotton, wheat, rice, soybeans, and dairy. Many of these would be uneconomical if the mega-corporations and farming cooperatives went unsubsidized.  America currently pays around $20 billion per year to farmers in direct subsidies as “farm income stabilization” via farm bills. These bills pre-date the economic turmoil of the Great Depression with the 1922 Grain Futures Act, the 1929 Agricultural Marketing Act, and the 1933 Agricultural Adjustment Act creating a tradition of government support.(Source: Wikipedia).
USDA goes way beyond that, it runs three other major programs through these agencies: Rural Housing Service, the Rural Utilities Service, and the Rural Business-Cooperative Service. They spent $6.5 billion in 2016 alone. USDA has about 100,000 employees, and is represented in most counties, in every state in America. It’s responsibilities include USDA oversees school lunches, meat inspection, food stamps, the Forest Service, rural electrification and much more. It’s total budget is some $140 billion in programs. The late pick of Georgia Governor Sunny Perdue concerned many in the rural community, some of his actions as Governor raise more questions, especially on his brand of rural endorsement. As governor, Perdue was caught in a more than a few scandals involving his businesses and personal property deals. He is also the first from a southern state, where rural and agriculture challenges are very different from the mid-west.
Housing (HUD)
For many people HUD stands for the “U” in Housing and Urban Development, they mostly focus on urbans areas, nothing could be further from the truth.  HUD operates many rural programs, in many cases funds pass through state agencies or other entities to rural communities. As well as development and assistance grants, HUD invests around $6.2 billion per year to provide affordable housing to low-income residents. Much of this through guaranteed low interest mortgages. How these programs will fare under Ben Carson is unknown. But without clear differentiation between urban and rural communities, many in the GOP and Administration will be going after cutting back HUD in general. HUD is also a major contributor to disaster assistance and provides many grants, relocation programmes and more.

Image: The Daily Herald – Mark Black | Staff Photographer
In an era when the GOP have spent forever convincing everyone that TAX=BAD, and portraying city folk as moochers and takers, can we really afford rural communities anymore? It’s very likely that these rural communities will experience the bulk of the pain from the Administration policy changes. Not through a single policy change, or executive order, but but through death by a thousand cuts.
If that happens, there will be no one but the current Administration and the Republican party to blame.

Why I’m Leaving Facebook

It’s not strictly true, I will have a facebook ID again in the coming months, but it will be an output only ID. By that I mean it will be an ID that I can post things to, but little more than that.

As I said in my “evil empire” post, I’ve become more and more concerned about not just what data they collect, but what you can learn from it. They sell our data, and it’s pretty easy to drill down on the data and learn all sorts of things, even though the data is supposed to be anonymous.

The problem with this is not just what facebook can tell, it’s that to a degree it is a very biased view of who we are. For the longest time, the standing joke was:

if it’s not on facebook, it didn’t happen

But you know that’s not true. When was the last time you posted about your intimate desires, or genuine mistakes, or arguments you had with important people in your life, or private details of your dealings with banks, managers and so on. These all go to make up who you are, what makes you tick.

What facebook has is a simple snapshot, someone who is vastly different online than offline. Yeah, facebook knows I’m liberal, likely not religious, I read the Guardian and the New York Times and probably trust them for news as I spend more time reading articles. Facebook knows I have a generally negative view of the new President and it thinks it know what products and brands I “like“. The data says my “psychological gender” is more male than feminine, but not by much; I’m pretty laid back but do get emotional.

Our data is sold in bulk, using specialised tools, you can target data geographically, based on numerous categories. It is supposed to be anonymised when sold, but it’s relatively simple to identify. This week in Ireland the American Civil Liberties Union [ACLU] was trying to defend our privacy rights, when facebook moves our data between Europe and the USA. Europe has much stronger data protection rights. Facebook of course argued against that.

If you are not convinced, watch this video from the creators of Data Selfie, a chrome extension, see how what you do [on facebook], leaves a data trail to the person you are [on facebook].

The lack of control over our data is seriously concerning. Even though I’ve already deleted the primary facebook app from my phone, as well as Messenger. You can’t even see the data, I fear that facebook has data I can’t control, can’t delete, and somewhere in a facebook data center, I have a twin, someone I don’t know.

Positive change – WordPress update

One of my favorite aphorisms that I developed while at IBM, and used in all my career and development presentations, as well as my after dinner speeches was:

Make sure change is something that happens for you, not to you.

It was particularly apposite at IBM, where change was constant. Hopefully by the time this post is publically available, change will have happened. I have migrated my wordpress.com hosted blog over to a siteground hosted wordpress blog.

It was much more complex than I expected, mostly around hsts/https issues and having the domain name registered by wordpress. It’s on the move and will be completed by Monday when this post should become available with any other new ones written after this.

For this blog, as opposed to any of the others (triathlon, technology, house construction), I went with the bog standard twenty sixteen theme. I used twenty eleven when I first started on wordpress.com and its an easy change). My hosted blog is still out there at markcathcart.wordpress.com and will eventually be deleted. I decided in the end to move it because I want to delete all my content and account from facebook as discussed in this entry.

To do that, I wanted again a structured way to share links, videos, music etc. I was surprised how many tools there were still out there that would allow me to “currate” content, they include diigo, instapaper, pocket and even del.icio.us is still around.

Continue reading “Positive change – WordPress update”

Political Correctness and being liberal

if you mean I’m someone who can have a civil conversation without reverting to juvenile name calling, swear words and who thinks a man can do better than trying to be offensive by using slang names for women’s anatomy, then I take your attempt at intimidation and wear it with pride.

It’s always amusing when people try to dismiss you by accusing you of being “politically correct or PC” or worse still, a “liberal”.

I guess because it’s inauguration day, feelings are running high. I’ve tried to stay away from political discourse on facebook, until a friend posted a clip from Elizabeth Warren grilling the CEO of Wells Fargo bank, the point of the post was to ask for accountability.

One of the few responses was from “Jim”. I’ll call him that here, because, well, that was his name. In his response he didn’t much address the accountability point of the post, but fairly quickly turned to attacking Elizabeth Warren, calling her “a douche bag“.

And so I posted, and the response I got back was to call me one of the “PC crowd”. I’m always amused when people try to use that as an insult. Called one of these “names” don’t be intimidated.

pc

 

What is the advantage of Roku over smart tv or internet enabled dvd?

Can’t say for a DVD, but smart TV’s are likely to go the way of 3D TV’s, they are here today and will be gone tomorrow

Can’t say for a DVD, but smart TV’s are likely to go the way of 3D TV’s, they are here today and will be gone tomorrow. In my case, a 60-inch Samsung Smart TV, I’ve abandoned the Smart TV part and replace it with a Roku Premier. The advantages are more apps, integrated search across all the apps(amazon, netflix, HBO) and much more.

My Samsung had HBO GO, but I didn’t; it doesn’t have HBO Now, but I do. Apps would disappear overnight without warning, others, like Skype, would give 3-months warning and disappear forever. The Smart TV had no update control, always seemed to want to update when I wanted to watch it and more.

Overall, Amazon Fire Stick, Google Chromecast, Roku etc. have outperformed Smart TV’s in speed, features, and most especially apps. Thats not going to change, TV manufacturers don’t have deep enough pockets, long enough vision, and enough experience to catch-up

Doctors and Money

The NHS is funded(or should be) to take care of everyone to a level of minimum care. No one(in practice) should have to pay for any medical care.

One question that comes up regularly when discussing how to fix the healthcare system in the USA, is Doctors and Money. While Doctors are far from the only important people in a healthcare service, they are possibly the most visibly important.

It is often asked, or asserted, that if you had a single-payer healthcare system where Doctors were possibly salaried this would act as a disincentive, and over time you’d lose the best doctors to purely private practice. This belies the fact that experienced doctors in the British NHS can make additional money in private practise.

It also completely ignores the fact that while the NHS is a meets minimum, free at the source of treatment health service, there is a thriving private, and private insurance marketplace.

The NHS is funded(or should be) to take care of everyone to a level of minimum care. No one(in practice) should have to pay for any medical care.

However, these days the cost of drugs, the number of highly complex surgical procedures that are “standard” has grown beyond the normal funding of the NHS from say 20-years ago. Cancer care and the drugs for it now consume huge amounts of money, as does the treatment for obesity and the treatment of it, including heart disease.

If you are in a car crash, some form of violent attack, or other urgent care need, the NHS will supply an ambulance, emergency care, surgery, drugs, Dr’s, everything and you’ll never see anything related to billing or cost. Same for almost any minor health care problems, even many elective surgeries, and pregnancy, cancer care, pretty much any medical need.

Elective surgery does tend to get backed up, there are often long waits to see a specialist, as well as to get surgery. This depends though on the problem, the area of the country, and the time of year.

This time of the year the NHS is always stretched to and beyond its limit. It’s damp in the UK, older people tend to have been life long smokers and are very susceptible to respiratory illness. Both my parents died this way after a few weeks of gradually declining health as they were unable to recover from pneumonia. My Dads complicated by heart disease; my Mum a 7-year lung cancer survivor.

Both received 100% free NHS service, they were not rushed or hurried to move out of their hospital beds. The nursing and medical attention was top class. In fact, I’d go as far as to say  much better than here in the USA because there was never a discussion, question or insinuation that insurance might not cover something.

For those that a “meets minimum”, free healthcare service won’t do, you can always pay. Many companies offer private “top-up” insurance, which provides priority appointments, private hospital beds etc. And you can always elect to pay for the treatment you need need.

luton-news-sept-21st-1978I had two major hospital admissions, one on the NHS for a tib/fib fracture in 1978; the 2nd some 16-years later for corrective surgery. The 2nd I was working for IBM with top-up insurance. I saw the same specialist who’d saved my leg 16-years earlier. If I’d wanted to see him on the NHS, there was an 4-week wait; I saw him the next week at a local private hospital.

He recommended corrective surgery. On the NHS he would have done it in 4-6 weeks, depending on lots of things. I was able to schedule a specific day for 10-weeks out that better suited IBM’s schedule, private hospital, private staff, same consultant.

Fast forward to 2013. I’ve done over 100 triathlons and running races, including 6-Ironman races. Despite an initial prognosis in 1979 that I’d never run again. My knees are not so good. I wanted to see the same consultant, he is no longer practicing, wished me luck. I was recommended to the British Olympic Association’s Orthopedic Consultant. Chances of seeing him on the NHS, zero to very little.

I scheduled an appointment with him at Private hospital, flew to the UK, and he came in to see me especially. We spent the whole hour together, what I’d paid 450 UKP for. We discussed options, did measurements, x-rays, looked at different types of replacement knees etc.

He said that when I was ready for surgery to let him know, he would schedule me on his NHS roster and I could fly back. When discussing the same surgery here in the USA, he told me not to bother.

His experience had been that in the USA even dedicated specialist consultants didn’t have nearly the experience as NHS Specialist. In the USA they spend too much time consulting with patients and negotiating over billing. Patients in general take 3x as long to consult with in America because the options, cost and insurance options, and choices are so daunting and often when a preference is stated it has to be negotiated with insurance, co-pays, deductibles etc. all have to be understood by the Doctor and patient. The alternative is you get the Doctor, but little or no choice in replacement technology.

He has 2x 6-hour surgery days per week, they do 6-8 knee replacements per day; he spends 1-day NHS consulting, and 1-day private consulting and has 1-day open for Private surgery or additional consulting.. If he wants he can do private surgeries on Saturdays, vacation days or early mornings before NHS work. Average cost for NHS Surgery $0.

A US Specialist, according to him, does 6-10 operations per month, and my US research was cost around $30,000. In terms of knee replacements, the UK has much better insight, and much less medical device and insurance company influence on the type of replacement, they base their choices on OUTCOMES.

I’ll return to the discussion on healthcare systems shortly, but suffice to say, I’ll be going back to the UK when my time finally comes.