Month: December 2013 Page 1 of 2

Women in combat

On December 27, 2013

prompted by this Atlantic article on integrating women into combat, I thought I’d run through the basics (as I understand them), on this issue.

Let’s start with capability. On the con side, women generally:

have less upper body strength;
suffer stress fractures more easily;
run more slowly.

On the plus side, women generally:

have more long term endurance under adverse conditions. The list of endurance swimmers is as dominated by women as the list of weightlifters is by men: there are no male distance swimmers who can come even close to the best women. This translates into military jobs such as forward observing and sniping.
Appear to have far better fire control than men.

On the even side:

As best I can tell from looking at Olympic shooting and sniper records from WWII (where Russian female snipers feature on the list of top snipers), as well as anecdotally from gun-clubs, women are just as good a shot as men. A common joke runs that husbands try to convince their wives to shoot, then are upset when their wives are better than them.

In terms of capability, I don’t see a ton of argument for keeping women out of combat.

There are, however, social realities. The Israelis, who have a lot of experience with this, decided that the problem with women in combat wasn’t women, it was men: the men couldn’t get over the possibility of harm, or worse, coming to women. On the flip side, in the US military, rape by fellow soldiers is far too common.

And rape is likely to be the reality for women who are captured, as well. Do we want that? Men may be raped if captured, but they will not become pregnant as a result.

I do firmly believe that everyone in society should be combat trained. I think it ups the compliance costs for governments who wish to head in authoritarian directions for combat training to be given to the sort of people who normally wouldn’t have it. People who have authoritarian personalities are, generally, more comfortable with violence and more likely to be trained in its use. It’s good for society for everyone to have that training so authoritarians don’t have a near monopoly. It is for this reason that despite all the problems with it, I support the draft: when the US moved to a volunteer army, made up primarily of southerners, it created a dangerous situation: an army that is not representative of the population, which considers itself (and is considered) superior to civilians.

Combat training, however, is not the same as being combat troops. Everyone may receive Basic and even some advanced training, without being expected to fight except in the most desperate of situations.

Finally, if a nation does want to go down the route of female combatants, I tend to think that combat units should be gender segregated: this protects women from both men’s concern in combat, where it is inappropriate, and from their predation back on base.

Hope you’re all having a good Christmas

By Ian Welsh

On December 25, 2013

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me, I’m eating duck, so Christmas is good.

Living in a rich society

By Ian Welsh

On December 20, 2013

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We, in the West, live in scarcity economies. The key bottleneck resources are scarce, and the decision has been made to keep them scarce. Our entire economic policy from about 1979 can be summarized as follows: ordinary people cannot be allowed to have a real raise which translates into spending on oil.

When Bush screwed up the second part of that, and oil went to 150, it was one of the major causes of the financial collapse.

In a rich society, like the one we had in the 60s and 70s, big projects get completed. The interstate freeway system; the moon shot; the huge build-out of the university system. Artists and musicians sprout everywhere, good jobs exist in abundance, it’s not hard to make a living, so you can do what you want most of the rest of the time, and you can tell your Boss to go screw himself if he treats you badly. (Even in the mid eighties, I could do this. I knew I’d be employed the next day, and I had no special skills, NONE.)

When you live in a scarcity society, it’s almost impossible to receive permission to do anything real, and you have to put up with how your boss treats you, unless you have a very in-demand skillset, because the next job isn’t a sure thing. Infrastructure isn’t maintained, new institutions aren’t built, and every old institution tries to create a rental stream (thus the huge increases in tuition and the huge decreases in grants.) You can’t build high-speed rail, heck you can’t even maintain the freeways properly. Bridges start collapsing, and so on.

(I am fundraising to determine how much I’ll write this year. If you value my writing, and want more of it, please consider donating.)

This isn’t just about resource shortages. A resource shortage may start the sequence, but it is the deliberate refusal to deal with the resource shortage which turns it from a challenge into an era, which turns a rich society into a scarcity society.

When America and the West turned away from Carter (as flawed as he was) and turned towards Reagan (a disciple of Thatcher), they made a choice not to deal with the oil bottleneck except through scarcity rationing. The deliberate policy of the 80s and 90s all centered around NAIRU – the non accelerating inflation rate of unemployment. The idea was that if the unemployment rate was too tight, wages would increase, spiking inflation. So unemployment had to be kept high enough so that inflation would not occur. This is one form of inflation – so-called wage push inflation.

So whenever ordinary people started to get raises higher than the rate of inflation, the Fed would say “this rate of unemployment is lower than the NAIRU” and crush the economy and wages.

This is because wages went to doing things which increased oil prices, and Fed wanted oil prices crushed and inflation in general crushed.

The unemployment rate is, thus, not a measure of how many people are out of work, it is a measure of how close the labor market is to being tight enough to allow ordinary people to get a raise that is higher than the inflation rate.

There are a bunch of concomitants to this policy, too many to go into, but just note that is part and parcel of creating the richest rich the world has ever seen and creating asset bubbles. Money can only be created IF it won’t do anything that really matters, because anything that matters will cause oil prices to spike.

(It is also for this reason that despite all the problems fracking causes, your Lords and Masters will despoil as much of the country as necessary to continue to do so, it’s another way around the oil bottleneck.)

Note that there were other choices: massive investment in renewable energy; massive investment in energy conservation; massive investment in public transit, and a move from the suburbs back to the cities, with walkable cities. In the 90s the move should have been to telecommuting. A national income which pays people not to drive to work every day, insistent carpooling and so on, could have mitigated this problem extremely. Call the early parts of this the “super analog future that never happened.”

If you do all those things, though, the rich don’t get insanely rich, and the middle class doesn’t get to run away from black people to the suburbs. Americans voted for suburbia and against black people (and don’t tell me otherwise, I remember Reagan’s campaign, and it was based on racism). The people who made those votes, the Reagan Democrats, mostly won their bet: their house prices went up, they didn’t have to live near people with melanin, and they retired wealthy and went to live in the south, where brown people wiped their butts.

But the price of this was the end of the rich society. The end of a society where you could tell your boss to go screw himself. And it was the end of a society in which big projects were regularly undertaken. Oil is wonderful energy: it is highly dense and easily transportable, and lets you do what you want, where you want. Using oil to make plastics, to enable suburbia, to be incredibly wasteful, meant that all the big things could no longer be done.

The concomitant of this policy was the creation of the super-rich, and that meant the destruction of real Western democracy, as country after country found its politicians more and more controlled by the rich. The rich do not want change unless they control the change. Any change that already rich people can’t figure out how to control and monetize is not allowed. The state is turned into a machine for giving money and preferments to the already rich and powerful, its oversight role is hollowed out and its taxation ability is scuppered.

The great projects of the past, even when done by private enterprise, were underwritten by government. Poor governments (and yes, despite the trillions, the US government is poor) cannot engage in these huge projects.

With money printing and low interest rate borrowing monopolized by the financial sector, and within the financial sector, by a rather small number of institutions, and with demanded rates of return at least in the teens, most new businesses and projects were not, and are not, viable, in the sense that they will not be funded. Can you compete with the returns of the housing market pre 2007 (leveraged) or the leveraged returns of the stock market in the past 30 years, a stock market backed up by the Bernanke and Greenspan Puts (the knowledge that if the market goes down, the government will step in to make sure it goes back up?)

You can’t. So money floods to the highest returns, which are financial paper returns, bubbling way off the surface of the economy, and instead of building a high speed rail system, or making every building in your country energy neutral, or going to Mars, or crashing solar technology much sooner and harder, or…. anything else you want, pretty much, you get financial bubbles and history’s richest rich.

Living in a rich society is different from living in a scarcity society. There is money to create big projects. There is money to tell your boss where to go. There are jobs. Ordinary people have pricing power in a tight labor market and can get their share of productivity gains.

No society is rich in everything, there are always limitations. But being rich, personally or as a society, is about freedom. When you have money you can do what you want, when you want.

We could create a rich society again. It is possible. The necessary technology is there. What is not there are the social determinants. As long as the public and private sphere are controlled by oligarchs, there will be no rich society.

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The Fed’s Taper Decision

By Ian Welsh

On December 18, 2013

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The Fed had finally decided to reduce purchases (from 85 billion a month to 75 billion.) I will simply note that 10 billion from the Fed doesn’t matter all that much when other Central Banks (like the the Bank of Japan) are also doing the same thing (and Japan is talking about increasing such purchases) and when China is creating far more new money than the US.

China does have currency controls, but they are less and less effective, but most other countries do not. It matters little if it is Japan or the US engaging in these policies, the money goes transnational.

I do not, thus, expect this to have much effect. So long as developed nations banks are as a group flushing the markets with money, and so long as China does have a financial crisis, this economy can go on for many more years like this, especially as the various bubbles are being reinflated, in large part with leaking Chinese money. Expect the stock market to continue to rise, with occasional selloffs, but generally in an upwards trend. Expect housing prices in most markets to continue to rise as well. Expect large corporations, especially financial corporations, to continue to make money. Expect the rich to continue to get richer.

Don’t expect that to mean your personal economy will get any better, mind you. Any improvements will be marginal.

Extinction is Guaranteed if We Do Not Colonize Space

By Ian Welsh

On December 16, 2013

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The Earth is a dangerous place, and humans make it more so. There are many scenarios, from nuclear war, to designer diseases, to nanotech goo, too environmental catastrophe where we can wipe ourselves out. Further, there are events almost entirely beyond our control, like meteor impacts, which could wipe us out. The Earth is a mass-graveyard: most species which have ever existed are extinct.

The Earth is a single point of failure. If all self-sustainable human breeding populations are on Earth, we are much more likely to go extinct, and far sooner.

Getting of the rock is about human survivability in the longer run. Getting out into the solar system, learning how to create habitats and breeding populations, increases our viability. Spreading to other solar systems, whenever we can, will increase it even further.

On the other hand, if we stay on Earth, especially given how incapable we are of acting in basic racial self-interest (as proved by climate change) our odds of an extinction event, and soon, go way, way up.

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Partial Transcript of My Talk

By Ian Welsh

On December 14, 2013

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On Hunter-Gatherers and the lessons for our own society and for improving our societies, courtesy of the Hipcrime Vocab, who has some smart thoughts you should read:

Jay Ackroyd: What it’s really coming down to is we’re discovering the carrying capacity of the earth is for humans under our…

Ian Welsh: Under our particular toolset…

JA: Under domestic [sic] agriculture…

IW: Under domestic agriculture, under industrialization. The carrying capacity varies. It’s not a fixed number, and people who say it is irritate me. But under the current way that we run things and under our current technology and social [organization], we’re past our carrying capacity.

JA: The history of this is that when we were hunter-gatherers up until about eight to ten-thousand years ago, the carrying capacity was much less at that agricultural technology. In fact, it wouldn’t even make sense to say agricultural technology; at that level of resource utilization. The densest population that I can think of are in the southeastern islands like New Guinea and around there where people were rubbing up against each other and quite violent conflict emerged even in a hunter-gatherer environment.

IW: Well, what you see in the late hunter-gatherers is actually a pile of violence. I mean, they’re very violent societies and about a third of all adult male deaths are by violence. If they’re not pushing up against their carrying capacity, then they’re not violent at all pretty much. It is a phase change that happens as they become close to it and it explodes.

JA: Right. There turns out to be not enough available resources for the population of two different subsectors of people and they brush up against each other and start killing each other, and New Guinea is a perfect example of that.

IW: Yeah, I mean, in general yes. Some societies are just more violent period. But again when we look at the archaeological record what we see is, as they reach the carrying capacity you start seeing a lot more violence. So, yeah, the New Guineas and so forth.

JA: And the triumph of domesticated agriculture is you get a lot more people per unit of land mass, so it’s going to be a bigger society, so they march their way through.

IW: Well, it looks like a couple of factors. One is the population. The population is only a small part, because you see nomadic cultures that are 1/100th the size of civilized cultures and they just roll over civilized cultures until firearms, and until fairly late firearms at that. One major thing in the early part also seems to be, and this is something Stirling [Newberry] noticed, or at least brought to my attention, is disease pools. Because, to put it simply, agriculturalists shit where they eat.

JA: Unavoidably, because the population density is so high.

IW: Yeah, so you start getting parasites, you know, that’s when you start needing cats, that’s when you start having rats follow you around. So they basically become these huge disease pools, and what you see from the evidence is that the hunter-gatherers try and stay away from them, right?

JA: Well, as the Native Americans said about the arriving Europeans, they just smell bad.

IW: They smell bad, yeah, the milk smell. They smell and they’re diseased. And because you don’t live that way, because you don’t live near parasites, because you don’t shit where you eat, you don’t have the resistance, you haven’t gained the resistance. So you go near these people and from their point-of-view, bad spirits attack you and you get sick and die, right? So you get these taboos against being near them. And as they expand themselves, they just keep pushing the hunter-gatherers back. Hunter-gatherers do tend to lose the violent confrontations, but part of it is that they get weakened by the disease as well. And again, what happened in North America is primarily that ninety percent of the population gets wiped out by disease. If that doesn’t happen, we, the Europeans, don’t conquer North America.

Again the main thing about hunter-gatherers that I emphasize in a separate post, is that for most of history…being a hunter gatherer is, until you reach the carrying capacity, is about the best it ever gets for human history. It’s far better than being an agriculturalist. I mean, you have a better lifestyle. You’re healthier. You live longer. It’s just, overall, unless you’re a noble in the agricultural society, you’d far rather be a hunter-gatherer.

Even in North America you see a lot of people running away to join the Indians. People talk about running away to join the Indians, even today. That was a thing, that was a big thing, because the Indians lived better. It was a more enjoyable thing to be an Indian that to be a dirt farmer in 17th century Pennsylvania.

And you can see it in the skeletons. They’re taller, they’re healthier, they have less disease, they live longer up until, there’s a few peaks, but basically…Greek civilization for a brief period lives longer than hunter-gatherers and then it dies back down again; there are some other peaks… one thing for example is that the hip ratio on women has never recovered. Hunter-gatherer women have wider hips than even modern women do. And, of course, that’s actually a thing of health, especially when you have to have your kids. They have better dentition, et cetera, et cetera. And they have heck of lot more free time in most cases.

One of the problems that we have is that we look at modern hunter-gatherers, and they aren’t…you can’t just do that. You learn something from them, but the hunter-gatherers of the old days weren’t forced into marginal areas. They were living off the fat of the land in the best areas in the world, killing mammoths and so forth, even in the Ice Ages and so forth. So they were living in the highest carrying capacity areas in the world. I mean you read about the hunter-gatherers in the Nile. I mean, this is a good life, man! You go in there, and you gather, and there’s so many fish, and there’s so many birds, and there’s so many animals that they practically fall into your hands. People have no idea how lush the world used to be. You read about, um…

JA: The English arrival, the darkened skies of passenger pigeons, the enormous cod…

IW: …The Grand Banks. You drop a bucket into the water, pull it out, and it’s full of fish. I mean, the fat of the land, right? It’s just not that hard to live. Especially if you’re one of the groups living in one of the better areas. I mean, life for the Inuit was always pretty nasty, but if you’re living in one of the breadbaskets…

JA: The Pacific Northwest for instance. They competed by giving each other presents.

IW: Because they were so rich. I grew up in BC [British Columbia]. One of my uncles, and this is in the thirties, he used to in live in, oh I forget the town, but one of the towns in the Northwest. And to make money he would just grab a piece of fish line, put a hook on it, and go out and hook salmon. And he didn’t own a boat or anything, he just walked along the shore, threw it in, got himself some salmon, and took it back to town. And this is within living memory. You can’t do that anymore.

JA: Now there are farms. [intelligible] was making a common reply to this, and it says that low density populations, low specialization, it doesn’t really fit the way the world really works. And of course, that’s a mistake. I’m sorry Lou, but that’s a mistake. Because the time that we’ve spent in this extensive monoculture/agriculture is a very short time in human existence.

IW: The thing is, we can’t do that now. It’s a way of life that is gone, and we can’t live that way now. Clearly we can’t. But it’s worth looking at how people once did live because that’s what we grew up in as a species. And also to remind ourselves that life doesn’t have to be shit. And also that the winning technology…this is the key point I want to make, is that the winning technology and the winning social organization doesn’t have to be the society that is better for ordinary people. If you had to choose, you would rather be a hunter-gatherer than live in most agricultural societies. It’s a better life.

JA: For 90 percent of the population. The one percent still live much, much better.

IW: Oh, of course, if you’re a winner, right? But for most of the population, you’d really rather be one. But the problem is that they lose fights and they don’t handle disease. And so in the end they wind up losing out, and they get shoved into the margins of the world, right? So just because something is new, just because you have a new technology doesn’t mean that it’s going to make the world better. The stirrup did not make ordinary people better off. The stirrup made ordinary people far worse off because feudal knights are not who you want to be ruled by. People who can afford horses being able to beat up people who have to fight on foot is not a good position to be in. So just because a technology is new and superior doesn’t mean that it’s going to make the world a better place.

And also:

[21:44]:

IW: I do want to talk about there’s less violence and we live longer. There’s a lot of confusion over how long people lived in the historical stats because everybody talks about averages. The thing is, if you made it out of your childhood, the odds of making it to 60 or 70 weren’t all that bad. But you weren’t likely to make it out of your childhood. That’s part one.

JA: I’m sorry, when are you saying, what societies are you saying that’s true of? For example, France in 1780, you had a very, very small chance; you were 1 in 4, 1 in 5, getting out of childhood. Numbers like that.

IW: It was very bad. But if you were part of the elites, you know, your odds of making it to 60 or 70…take a look at the Founding Fathers of America. Except for the guy who got run through by a duel, they pretty much all made it didn’t they? Historical stats on aging are always a little deceptive. It’s just something I want to point out.

The other thing is that in hunter-gather societies, you don’t get the massive genocides that we see. Now you do get them once you get up to agriculture; agriculture and nomads, right? But you don’t see them in the hunter-gatherer things, and they didn’t have the ability to destroy the world, which we do. So…

JA: Right, and destroy the world even as known. Somebody referred to Jared Diamond’s Guns, Germs, and Steel. But his later book that talks about collapse of civilizations – those are always civilizations. It’s not the bushmen of the Kalahari. They didn’t die of collapse and famine, they didn’t die by genocide, they simply got smaller.

IW: Well, they sort of got pushed out of the good areas…

And this part is particularly interesting considering what’s going on in China today: [45:45]:

IW: It’s worth noting for example that pre-World War Two most of the American population is still out on the farms. You have World War Two and they start moving into the cities, and they move in because they get a better life in the cities. So at that point, and this is a Stirling point, is that consumerism has to produce a better life than living on the farm produces or these people won’t come to the cities, and if they do come, they won’t stay. But once you lose the secondary option, once that option is no longer available, once you can no longer go back to the land or a different lifestyle, they don’t have to treat you well anymore.

JA: This is almost a microcosm of the hunter gather versus domesticated agriculture thing you’re talking about here.

IW: Well, one thing to bear in mind is that early agriculture is very different than hydraulic agriculture. And while there is a decline in health, they’re actually more egalitarian than late hunter-gatherers. So in certain respects there is an improvement in lifestyle. It’s still an overall down but there are some upsides. Whereas by the time you get to Pharaonic agriculture, I’m sorry, but being a peasant to the Pharaohs is worse in every single way. So once you can’t run away to the Indians, once you can’t go back to the farm, they don’t have to be nice to you anymore. Once they don’t need you to fight their ideological enemies anymore, a.k.a. the end of the Soviet Union.

JA: Or if you like, post Black Death Europe.

IW: Well post Black Death Europe is mostly about a population collapse. If you lose a third of the population, there just aren’t enough people to do all the work.

JA: The labor/capital bargaining situation changes.

IW: That’s the thing. If you want to have a good economy in this sort of economy, you just have to have a tight labor market. It doesn’t matter what else you do, everything comes down to the labor market must be tight. And they have done everything they can over the last thirty years to make sure the labor market has not been tight. I mean this has been deliberate Fed policy. Every time you hear “labor push inflation,” what you heard was, “we don’t want labor to get any raises.” Because one person’s inflation is another person’s pricing power, and for labor what pricing power means is, “raise.”

You can listen to the entire Ian Welsh interview with Jay Ackroyd here.

The 90/10 rule as applied to medical practitioners

By Ian Welsh

On December 11, 2013

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I’ve spent a lot of my life sick, and a fair bit injured. In my twenties I spent 3 months in the hospital all in one go. When I left I weighed 90 lbs and could barely walk. (Full details here.) I’d had back issues in hospital (sacroiliac joint) and about 6 months later, I picked up some boxes and moved them about 50 feet. No big deal. Went to bed, woke up next morning, and the least movement would cause my lower left back to clench in the most excruciating way. It wound up that the fire department had to break down the door to my room (I was living in a moderately unpleasant rooming house), sheet pull me and take me to the hospital.

Over the next six months I saw plenty of doctors. One thought I was faking (and to this day I hate him with a blinding passion—I could barely walk, couldn’t sit down, couldn’t get out of bed without excruciating pain), the others gave me a variety of anti-inflammatories and muscle relaxants, none of which had an noticeable effect. Finally I found a doctor who wasn’t paranoid about pain killers and at least gave me a prescrition: she was 7 months pregnant.

I was amused, but not happy.

Over time it fixed itself. After about 6 months I could get out of bed, bend over, sit down, put on shoes, etc… without the expectation of major pain. Still inadvisable to do any manual labor, but I did some, because I needed the money, and I paid for that money with agony.

After a few years, it resolved itself.

About three weeks ago, the day after a heavy lower back workout in the gym, I was out for a walk. Stepped off a curb, twisting slightly as I did, and felt the left lower back go: felt it clench up agonizingly, and my left leg lost almost all its strength. I dropped into a squat with my feet together, to take pressure off my back, steadying myself against a lamp-post. Gingerly stood up. Found that I could barely walk, but that I could barely walk. Found that the least jostle or bump would cause the muscle to clench agonizingly.

I was about half way to the local farmer’s market. Because I’m cussed I walked the rest of the way, then walked home. That night I went to bed with codeine, a phone, and a book next to my bed, in case I couldn’t get out of it.

I could, but it was a long and painful operation.

I suffered for about a week, then I had an appointment with my naturopathic doctor. He said, “I have no idea what’s wrong, I want you to see this sports therapist.”

Next day I walked in to see that sport’s therapist, who has worked for multiple professional teams. Within 5 minutes of meeting me, he said, “the muscle in your lower back which attaches to your lower spine on the left side is in spasm, protecting your spine’s curve.”

A diagnosis! I went to a pile of doctors in the 90s—not one of the diagnosed what was wrong with me. Not one of them sent me to a physiotherapist, sport’s therapist, chiropractor or even a decent massage therapist. (And one of those doctors was a rheumatologist.)

The sports therpaist does some massage, using elector-accupuncture to try and tire out the muscle so it’ll relax so that magnesium can get into it so it can relax more.

Minor results: I felet a bit better. Second session didn’t seem to do anything.

So I lookedup a chiropractor, searching online till I found one who seems to deal with such problems and sounds competent. Dr. Kevin Ho. I go in, he looks me over, he tells me my hips are misaligned, so the muscle is, in part, in spasm to protect the spine from my right hip pulling it out of alignment.

He goes to work, tells me to see the sport therapist to wear out the muscle: next day I don’t feel much better. I go see the sport’s therapist, he does his thing.

The next day (today) I feel vastly better. I can put on shoes and pants and underwear without the expectation of agony! I go see the Chriopractor again, I ask him how much of the hip alignment he had corrected in the first session.

“Oh, about 50%, but you’ve lost 15% since then.”

Now this is interesting to me, because some time ago I saw a chiropractor regularly, for about a year. In that year, I do not recall him making as much progress as Dr. Ho has made in, oh, one session.

He works away, by the time I leave, I can bend over more than twice as far as when I came in.

Now what’s interesting to me about this (other than not being in so much pain, which is of great interest to me, but probably much less to you) is that these guys, between them, appear to have diagnosed what is happening and why, and gone a long way to fixing it when a pile of doctors before couldn’t even diagnose it, let alone fix it!

(And I left out the massage therapist on Sunday who made it worse.)

But this does accord with my experience with doctors: most doctors are mediocre. They do what they do, which is hand out prescriptions for a few problems they see regularly, they are horrible diagnosticians, and they do not care. As with most people working in any field, about 9 out of every 10 is a drone, barely competent, doing the bare minimum not to be charged with malpractice.

About 1 in 10 is actually good, knows what they are doing, and doesn’t work by rote, but can actually diagnose and fix problems.

(And about 1 in ten of the good ones is more than good, is brilliant.)

This seems to be true of healthcare practitioners in general. Over the last few years I’ve had maybe two dozen massages. One of those massage therapists was brilliant, a couple were good, and that’s it. The brilliant one was taught by her father, a blacksmith, and at age 50, as part of her two hour fitness routine, started with 20 pull ups (most marines in their 20s can’t do 20 pullups.) If you had, say, a headache, when you left it was almost gone and two hours later it was gone completely: guaranteed. She regarded your problems as a personal affront to be healed.

When I was young, to me a doctor was an M.D., and if I needed to see someone else, I figured the M.D. would refer me. As I’ve aged I’ve learned that for body mechanics issues most M.D.s are worthless, and that most physical therapists are mediocre, but the good ones are amazing. I’ve learned that, in fact, alternative medicine often has the people who can actually make you feel better, but that most of them are mediocre too. I’ve learned that if you want a doctor to actually sit down and listen to your symptoms and history, you’re going to have to pay for that out of pocket, even in Canada. Traditional Chinese Medicine is FAR better for something like Eczema than anything western Medicine has, and so on.

We have, for one thing, too few doctors right now. They are actively scared of seriously sick people, because they have to push you out the door in fifteen minutes. This is supply and demand, we need to have more doctors, they will also cost less. We have systematically chosen doctors for their cold manner for decades, because people who cared would “burn out”. Going to a TCM doctor from China was a shock to me, he looked at my skin and made what sounded like genuine sounds of sympathy: he seemed to understand it was painful, and care, in a warm, human way. I can think of maybe two M.D.s who have ever given me that feeling.

The Skeptics movement are a bunch of authority worshipers. A lot of alternative medicine does work, and they do not apply their own skepticism to standard medicine: where if you get all the studies for many medicines you discover they are little better than active placebos in many cases, only work for a minority of the population when they do work, and have nasty side effects besides. For many illnesses regularly treated with powerful neuro-active drugs, exercise is as effective, or more, and does no harm, besides. We should be prescribing a lot more exercise, for those who can stand it, and a lot less drugs, and we should be looking at drug trial results with a great deal more skepticism because many of them are badly designed and the ones which fail are generally not released to the public.

We should also be doing far more research into why some drugs are very effective only for a minority of people with the condition. What are the markers that determine such effectiveness? And we should be completely cleaning up our food system, because the reason we have so much illness is bad diet and no exercise in far too many cases (plus various forms of pollution.) Healthy food costs more, but we are subsidizing unhealthy food, and paying for it on the back end with illness and the costs of illness.

But to bring it back to the first point: most healthcare practitioners are borderline competent, and only a small minority are actually good. Throughout my life I’ve seen that this is the case. When you’re looking for a competent one, look for one of two things:

1) someone who takes your disease or injury as a personal affront, to be defeated at all costs, because Goddamn It, no fucking disease is going to beat them; or,

2) someone who manifestly cares and wants you to be better, because they hate seeing you suffer.

Absent caring in one of these two ways, very few healthcare practitioners are any good. They fall quickly into a rut, giving out prescriptions or doing treatments just to get through patients, through the day, and back home.

If your doctor or therapist doesn’t care, either about you or their own pride, get the hell away from them.

Mandela’s NeoLiberal Compromise

By Ian Welsh

On December 10, 2013

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South Africa may no longer have apartheid, but the majority of the population still lives in poverty, the heights of the economy are controlled largely by whites, and rich blacks are concentrated in the upper ranks of the ANC and their families. The rape rate is possibly the highest in the world, with a quarter of men admitting to having committed a rape and a quarter of women to having been raped, while murder is rampant.

The ANC had originally intended to purse socialist policies, including taking away the wealth of the richest whites. Nelson Mandela decided not to do that. There are varying accounts of why, from outright bribery to being convinced, but let’s go with convinced. The story is that once Mandela was released from prison, as he traveled the world, it was explained to him that if white flight occurred, his country would mimic Zimbabwe’s fate, and taking away the wealth of the richest whites and distributing it would cause that white flight.

So most of the redistributive part of the ANC’s program was jettisoned. Blacks were to have political freedom, but whites would control the economy. (Though you certainly don’t want to be a poor white in S. Africa.) Tax rates in S. Africa are typical: low for individuals, lower for corporations.

Bear in mind that when Mandela made this decision the prices of commodities, S. Africa’s main exports, were substantially depressed.

Mandela was in a bind, take that advice as ‘warnings’ and you probably read it better: “if you do this, we will disapprove. We cannot allow such redistribution to work, so it won’t.”

Mandela chose to take what was on the table, political freedom absent redistributive justice.

Was it the right decision?

Yes. Not because it isn’t theoretically possible to do redistribution and make it work, but because at the time it was harder, and because the ANC wasn’t up to the job. Given how they have botched far simpler policy areas, like HIV, given their rampant corruption, the idea that redistribution could be managed by them in a fair way, while maintaining economic growth and avoiding being crushed by the outside reaction is not credible. These are not competent people, they are noticeably incompetent.

S. Africa has significant advantages in its mineral wealth (though that can also be a curse). Resources that the rest of the world must have give you leverage to do what you want, and tell everyone else to take a hike (see Saudi Arabia). But pulling that off requires finesse and it is harder to do if you have a redistributionist ideology, because international elites are happy to tolerate regressive regimes but do not want fair regimes to succeed, lest they show other countries that inequality and unfair trade deals are not inevitable.

Venezuela, though good has been done, is botching their experiment; so is Argentina. S. Africa could never have pulled it off.

Much of this is probably also down to Mandela’s age: he was in his late seventies when he was President. He did not have ten good years left to finesse through this sort of change, he did not have competent heirs or time to create them; instead he had the ANC, whose leaders were corrupt at best.

When the attempt is made at real redistributive justice, as it must be, it will be easiest done if a number of countries do it at about the same time, supporting each other, and acting as a bloc. If key resource nations like Canada, Russia, much of South America and S. Africa were to get together, it would be very difficult to bully them, because they control key resources which cannot be substituted away from except at great cost, and in some cases, at all.

Trade is key in the sense that countries must be able to buy certain key things they can’t make. If producers work together, in solidarity, they can gain policy independence internally. But this can only be done as a group, or great costs will be inflicted by the oligarchical forces of the developed world who do not want to, ever, see 90% tax rates create good economies ever again.