Friday, August 28, 2009

More Damn Questions

1. With the shocking prices that hospitals charge, why isn't there a hospital on every street corner in America? There's certainly a drug store on every corner, which follows from the profitability of drugs.
2. If there were no medical insurance available, would medical care cost as much as it does? Would fat people lose weight if they couldn't afford their cholesterol meds and angioplasty?
3. Without financing, would cars and houses cost as much as they do? If we knew the exact amount that it increased the cost of these two essential American possessions, would we tolerate government regulations and building codes?
4. Fire departments cost a lot of money. Wouldn't it be easier to build homes that don't burn? Mark Twain asked this question over a century ago.
5. Which is cheaper for the U.S. government to subsidize, oil wars or wind generators and solar panels?

4 comments:

  1. 1. Kaiser built a new facility in my city. It cost over $200M. The cost of entry is simply a killer, it's cheaper to just buy up all the existing hospitals and shut down some of them to decrease supply and therefore increase prices.

    2. Yes, but - we'd basically be back at 1950's medicine then, when many diseases that are now survivable such as leukemia were death sentences. Rare diseases that require complex procedures that require millions of dollars to develop and millions of dollars of equipment to perform simply are never going to be as cheap as LASIK, which targets a "disease" that afflicts 150 million Americans. Amortizing those costs over 150 million people is doable. Amortizing them over the 20,000 per year who get leukemia is not.

    3. Cars - pretty much yes. Today's automobiles are incredibly complex and can't be made much cheaper without impacting safety, emissions, or performance. Financing makes possible those improvements over the terrible 1950's cars (which were unsafe at any speed, with brakes that were mush, steering that was as heavy as an anvil, a thirst for gas that rivals an alcoholic's thirst for vodka, and steering wheels that would impale you in any accident and oh yeah, terrible wipers, terrible heaters, and no air conditioning). We as a society have decided that the comforts and safety of modern cars is worth the price. Regarding houses, well, that's a different story. The actual cost of building a home is maybe $40K-$80K in materials and labor. So when you see a regular ole' ranch house here in the Silly Cone Valley selling for $500K, that's not the price of the house -- they're charging that much because they can, because financing makes it possible.

    4. Plywood is needed to meet California earthquake codes. Or you could go to heavily reinforced concrete and steel, but that's astoundingly expensive. In parts of the country where earthquakes are rare, though, I suppose homes that don't burn are possible for a decent price.

    5. The problem is that wind generators and solar panels lack the energy density of oil. So while they are undeniably cheaper than oil wars, I expect to see more oil wars as oil grows scarcer...

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  2. Hi BadTux,
    Thanks for your comments. I always enjoy reading your slant on things.
    Wind and Solar may lack "energy" density, but their bigger lack is "political" density. Sadness can also burn, like stupidity.
    If you'd like to check out an earthquake-proof, tornado-proof, and fireproof house, please go to http://www.pbase.com/deanne_123/earth_sheltered_home. Our home was built on a carpenter's salary.

    Dave

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  3. Yeah, I saw your house being built as you built it. I have difficulty, however, believing that it is earthquake proof -- making the basements and foundations of tall office buildings earthquake-proof here in the Bay Area is a major production involving a lot of steel-reinforced concrete, the earth basically turns to a liquid when shaken violently in an earthquake and the building has to be able to "float" as an intact entity in that sea of dirt. Plywood shear walls allow the topside of residential buildings to wobble and flex enough to avoid shaking to pieces, to get that level of earthquake-proofness without an inherently flexible medium like wood requires a lot of steel to make the result not shake apart in an earthquake.

    In short, my suspicion is that your unique home would not pass California's earthquake code. It's a nice system for areas not prone to earthquakes, but the cheapest way to build earthquake-proof here in shakey-land is still plywood (or OSB equivalent) shear walls...

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  4. Hi BadTux,
    I like your "liquid earth" description. Our structural engineer is a California-licensed PE, and indeed our home is up to Cal earthquake standards as of 2005. I put 75 tons of rebar in the house. The footings have two mats of rebar 6 inches each way, and there are slip-joints every 40 feet for movement. Even as far away as Arizona, we feel the California earthquakes. I think our land submarine can take whatever nature dishes.

    Dave

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All comments are welcome.