This is the first in a series of posts that I promised regarding what I think Congress should do. I hope it will generate much debate and we will end up with a list of planks to a platform that will inform the voting public.
I heard a speaker on “health care” last Wednesday. His most important point was this: If you want to learn about sickness, you study sick people. If you want to learn about Health, you study healthy people. If we want a health care plan that will actually make our country healthier, we should emphasize those things that build health, not those things that fix sickness. His point is a good one. Our system of health care in the U.S. today really is a system of “sick care.” Most of what we do today is spend resources fixing what is wrong with people instead of preventing those things from going wrong.
Here’s an example of how our government looks at ‘Health Care’ or as I prefer to call it “Sickness Care:” In the American Recovery and Reinvestment Act of 2009 (the Stimulus Bill to most of us) over 18 Billion dollars of the almost $800 Billion was earmarked for Health Care. Aside from the question as to what that has to do with Stimulating the Economy, what part of the $18 Billion do you think went to study health and wellness as opposed to the amount targeted to support our Sickness Care Model? The answer is that $1 Billion Dollars was earmarked for the HHS Prevention and Wellness Fund, $650 Million was set aside for “evidence based clinical and community based prevention strategies, and $300 Million HHS Wellness Fund Immunization Fund. that is less than $2 Billion of $18+ Billion or 10% of the total for “Sickness Care.” They spend almost as much ($1.68 Billion) on the National Coordinator for Health Information Technology.
In my opinion, the current version of the Congressional Health Care Bill is all about politics and little about health. It has a very strong emphasis on modifying a system that needs more than modification. We need to start from scratch and and set goals. Then we need measures to see if we are achieving our goals. It seems that the package in front of the Congress today has as its number one goal, “Put together something we can get through Congress so we can say we ‘fixed health care’ in this country.” To me it seems that the goal is entirely political.
The health care debate today is centered on insurance. The purpose of insurance is to pay for the unexpected/unbudgeted cost of sickness care. I have not read the entire bill, but, I would guess that most of it is concerned with preserving the status quo of employer sponsored medical insurance – sickness care insurance.
Here is a partial list of what I think Congress should set as its goals:
1. Find incentives to help citizens make healthy lifestyle choices, e.g., eating right, exercising, being part of a close knit community, etc.
2. Create disincentives for unhealthy lifestyle choices, e.g. smoking, excessive use of drugs and alcohol, etc.
3. Divert to the study of healthy people, many of the dollars set aside by government to sponsor scientific research. In the Stimulus Bill alone, the Federal Government planned to spend $7.4 Billion on scientific medical research. Why does all the money have to go to find “cures” to sickness? Why can’t we learn what makes people healthy?
4. Reform Medical Insurance: a) remove restrictions to portability of policies; b) remove inconsistent State mandates; c) Remove restrictions to competition; and d) remove the necessity for most medical insurance to be tied to employment. Medical insurance is an important part of family planning for medical care needs. It should be available much like fire insurance or auto insurance where there is less control of the market by government intervention.
5. Reform our system of ‘medical malpractice’ law and insurance. A big cost of medicine today is not just the insurance Doctors and Hospitals pay to protect against legal liability lawsuits. It is also the cost of excess procedures and tests that are prescribed by Doctors and hospitals who do so to cover their backsides due to fear of lawsuits. Limiting awards for ‘pain and suffering’ must be part of the discussion. When the trial lawyers buy a seat (or lots of seats) at the table, Congress gives too much weight to their desires.
6. Realize and establish in the law that Sickness Care is not a Right. It is a privilege. A person may earn the right to medical care in a number of ways. He or she may join a group that works together (pools) to better be able to purchase insurance. Or, it might be that a person will best be able to afford medical insurance by doing those things that lower his or her risks of medical problems. In a true free market, people could choose to buy insurance or pay as they go. They could literally live or die based on their choices. In a utopian (some would say socialist) world, everyone would have equal access and all medicine would be paid for by the state. That means the Responsible would pay for the irresponsible. This blog, from the start, has been all about Responsibility. Part of any solution to our Sickness Care, Health Care, Medical ‘Crisis” needs to be a return to individual responsibility.
Here is a partial list of things that I think have no place in Health care legislation:
1. If any employer or group (government, union, corporation, club) wants to compensate its employees or members in a way more favorably than the general public, it should do so by subsidizing that employee’s or that member’s costs for medical care or insurance, not by having special treatment written into law. Special incentives to certain groups or regions of the country to ‘buy the vote’ of that group’s/region’s legislators should be a thing of the past.
2. Any provision that would exempt any group from paying for medical care or medical care insurance on a different basis than the general public should be removed from law.
3. Any provision that would treat lawmakers, union employees, or government employees on a different basis than the general public. Any member of Congress, any member of a union, any employee of a government agency should compete for the same medical care in the same way as the rest of the population.
There are many more issues to address and questions to ask about health care. What would you add or change from the above? Would you vote for a candidate who used this as his/her health care platform?
Responsibility-Freedom Demands It 
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February 15, 2010 at 9:16 am
20 issues – 40 weeks « Responsibility-Freedom Demands It
[…] 8. Health care […]
February 15, 2010 at 10:13 pm
pmv
I think we pretty much know what keeps people healthy (a good diet, exercise, sleep, managing stress…). Getting people to buy into these concepts is the difficult part. I think we are generally well served by a gov’t that uses policy to encourage desirable behavior (healthy living, charitable giving, less pollution, etc).
Of course there is line beyond which “encouraging” good behavior becomes “government interference” in our lives. On what side of the line does mandated/public healthcare fall? It would almost certainly lead to a healthier populace (from which we all benefit), but it costs us a part of our independence/freedom.
Can we look at Hawaii, which appears to have near-mandated employer-centric healthcare? How has it affected business there? How much do they spend per capita compared to the US at large? How is the quality of care?
February 15, 2010 at 10:34 pm
ttoes
@PMV
Don’t know about Hawaii. I think whatever the data showed, it might be hard to correlate with Mainland statistics. Their population demographics are totally different than any other in the country (possible exception Alaska). I also think the variety of businesses/industries are far more limited. In short – I don’t know how their system works but have heard anecdotal evidence that outside of Honolulu, medical care can be a crap shoot. As to how their mandates for healthcare and the effects on business, it would be another tough one to correlate to Mainland data. Because of the remoteness and lack of natural resources, Agriculture and Tourism dominate the economy, somewhat like Florida, without the land bridge. I’m not sure that business in Hawaii is not mostly local and not in competition with areas not laboring under the same laws/mandates.
I do, however, know that I disagree with your statement, “On what side of the line does mandated/public healthcare fall? It would almost certainly lead to a healthier populace (from which we all benefit),….” I don’t think that sick care does lead to a healthier populace. In fact, I think an argument could be made that the opposite would be the case. If we had free “sick care” for all, what would be the incentive for many people to make the effort to stay healthy?
Thanks for the comment. I may take the time to look more into Hawaii’s ‘solution.’
February 17, 2010 at 12:53 am
pmv
I guess there are two ways of looking at it. One view is that if people have guaranteed healthcare to fall back on they have less incentive to be healthy. I think that would make for an interesting study. I would assume that people who have health insurance are more concerned with leading a healthy life, not less. I could be wrong. But I am pretty certain that while a sizeable part of healthcare, or sickcare, or whatever, deals with managing the sick, without this care and treatment most kinds of sickness can and will get worse. To me the idea that expanded, more affordable healthcare leads to better overall health is a no brainer.
I’m not trying to argue that healthcare is a right. I’m just wondering what is the best solution for our country as a whole. I agree that Hawaii doesn’t make a great case study, but it’s interesting nonetheless. From my brief research it looks like employers are required to offer healthcare to all full time employees and must pay half the premium and, if the employee’s half amounts to more than 1.5% of their income, the employer must cover the difference.
February 17, 2010 at 1:48 am
The Skald
Hi Tom,
On the whole, I’d say I agree with most of what you’ve listed concerning improvements in healthcare. Rather than list all of the things I really like, I’ll stick with the single thing I believe has become an overused panacea for “healthcare” spending. In one respect, I agree with PMV that we pretty much know the mechanics of what constitutes a “healthy” lifestyle. More to the point though, some of the notions being advocated concerning “preventative care” are not substantiated by any research.
First, the premise that studying healthy people is the best (read economically productive) route to determining how to build healthier citizens is a little too simplistic and ignores basic problems of logic. A small thought experiment demonstrates what I mean: Assume that no one ever gets sick, and we still want to know why we are all so healthy. How do we find that out? Any study that sought to find a correlation between ANY behavior and health would approach a value of 1.0. Constructing suitable experimental questions essentially requires a sick person. Moreover, not all, but virtually all of our current knowledge about healthy lifestyles is a result of studying sick people and their differences from healthy people. Why should we not smoke? It took awhile, but the connection was finally made to a number of cancers. Finding out what causes the illness is the surest route to preventing the illness. The point I’m making is NOT that we should devote no resources to studying healthy lifestyles, but that serious thought should be given to where resources are most useful or productive.
Second, apart from the argument above, many researchers and practicing physicians provide more pragmatic reasons to approach “preventative care” with a certain amount of caution. In September of last year, The New York Times reported on an Health Affairs report that addressed the notions of preventative care based on an epidemiological model for diabetes. Ultimately, The Times concluded:
even the long view did not show that a prevention program like this saves money. Preventive care may well be like any other kind of medical care — expensive now, and in years to come.
Dr. Kevin Pho at KevinMD.com, commenting on the Health Affairs report, similarly concludes:
The bottom line, however, remains the same. Whether you’re looking out 10 years or 25, there isn’t much evidence that preventive care saves money. I agree that we still should do what we can to prevent disease according to evidence-based practices, but advocating prevention to cut costs is misguided.
Finally, the New England Journal of Medicine (NEJM) also addressed precisely this issue in an attempt to clarify key issues in “preventative care” with respect to the presidential candidates in 2008. As indicated by PMV, the NEJM article acknowledge many of the evidenced based things we know to be “health care” rather than “sick care.” Specifically,
Indeed, some evidence does suggest that there are opportunities to save money and improve health through prevention. Preventable causes of death, such as tobacco smoking, poor diet and physical inactivity, and misuse of alcohol have been estimated to be responsible for 900,000 deaths annually — nearly 40% of total yearly mortality in the United States. Moreover, some of the measures identified by the U.S. Preventive Services Task Force, such as counseling adults to quit smoking, screening for colorectal cancer, and providing influenza vaccination, reduce mortality either at low cost or at a cost savings.
The researches then make it plain that the far-reaching “statements about the cost-saving potential of prevention, however, are overreaching.” They follow up by presenting substantial research that demonstrates that their
…findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not (emphasis added). Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical. Such analysis could identify not only cost-saving preventive measures but also preventive measures that deliver substantial health benefits relative to their net costs; this analysis could also identify treatments that are cost-saving or highly efficient (i.e., cost-effective).
Still, on the whole, I agree with virtually all of your comments, but the “preventative care” hobby horse seems to be more wishful thinking than a reasoned proposal – especially from politicians 😀 So, I would disagree with item #3 on goals for our congressmen – we learn how to keep people healthy by understanding what makes them sick, and that is a more cost effective research program. As for your three items that “have no place in Health care legislation…” ABSO-FREAKIN-LUTELY!! If there were any single thing I could change at will that would be it – the deliberate legislation of inequality or privileged classes.
Great start to your 20 issues Tom! I’m really looking forward to this series – partly because I think it’ll be great stimulus for me to participate in some small measure over at my place.
Cheers!
Steven
February 17, 2010 at 1:50 am
The Skald
Hi Tom,
On the whole, I’d say I agree with most of what you’ve listed concerning improvements in healthcare. Rather than list all of the things I really like, I’ll stick with the single thing I believe has become an overused panacea for “healthcare” spending. In one respect, I agree with PMV that we pretty much know the mechanics of what constitutes a “healthy” lifestyle. More to the point though, some of the notions being advocated concerning “preventative care” are not substantiated by any research.
First, the premise that studying healthy people is the best (read economically productive) route to determining how to build healthier citizens is a little too simplistic and ignores basic problems of logic. A small thought experiment demonstrates what I mean: Assume that no one ever gets sick, and we still want to know why we are all so healthy. How do we find that out? Any study that sought to find a correlation between ANY behavior and health would approach a value of 1.0. Constructing suitable experimental questions essentially requires a sick person. Moreover, not all, but virtually all of our current knowledge about healthy lifestyles is a result of studying sick people and their differences from healthy people. Why should we not smoke? It took awhile, but the connection was finally made to a number of cancers. Finding out what causes the illness is the surest route to preventing the illness. The point I’m making is NOT that we should devote no resources to studying healthy lifestyles, but that serious thought should be given to where resources are most useful or productive.
Second, apart from the argument above, many researchers and practicing physicians provide more pragmatic reasons to approach “preventative care” with a certain amount of caution. In September of last year, The New York Times reported on an Health Affairs report that addressed the notions of preventative care based on an epidemiological model for diabetes. Ultimately, The Times concluded:
even the long view did not show that a prevention program like this saves money. Preventive care may well be like any other kind of medical care — expensive now, and in years to come.
Dr. Kevin Pho at KevinMD.com, commenting on the Health Affairs report, similarly concludes:
The bottom line, however, remains the same. Whether you’re looking out 10 years or 25, there isn’t much evidence that preventive care saves money. I agree that we still should do what we can to prevent disease according to evidence-based practices, but advocating prevention to cut costs is misguided.
Finally, the New England Journal of Medicine (NEJM) also addressed precisely this issue in an attempt to clarify key issues in “preventative care” with respect to the presidential candidates in 2008. As indicated by PMV, the NEJM article acknowledge many of the evidenced based things we know to be “health care” rather than “sick care.” Specifically,
Indeed, some evidence does suggest that there are opportunities to save money and improve health through prevention. Preventable causes of death, such as tobacco smoking, poor diet and physical inactivity, and misuse of alcohol have been estimated to be responsible for 900,000 deaths annually — nearly 40% of total yearly mortality in the United States. Moreover, some of the measures identified by the U.S. Preventive Services Task Force, such as counseling adults to quit smoking, screening for colorectal cancer, and providing influenza vaccination, reduce mortality either at low cost or at a cost savings.
The researches then make it plain that the far-reaching “statements about the cost-saving potential of prevention, however, are overreaching.” They follow up by presenting substantial research that demonstrates that their
…findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not (emphasis added). Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical. Such analysis could identify not only cost-saving preventive measures but also preventive measures that deliver substantial health benefits relative to their net costs; this analysis could also identify treatments that are cost-saving or highly efficient (i.e., cost-effective).
Still, on the whole, I agree with virtually all of your comments, but the “preventative care” hobby horse seems to be more wishful thinking than a reasoned proposal – especially from politicians 😀 So, I would disagree with item #3 on goals for our congressmen – we learn how to keep people healthy by understanding what makes them sick, and that is a more cost effective research program. As for your three items that “have no place in Health care legislation…” ABSO-FREAKIN-LUTELY!! If there were any single thing I could change at will that would be it – the deliberate legislation of inequality or privileged classes.
Great start to your 20 issues Tom! I’m really looking forward to this series – partly because I think it’ll be great stimulus for me to participate in some small measure over at my place.
Cheers!
Steven
February 17, 2010 at 1:51 am
The Skald
Let’s see, I’ve tried twice to post a comment. This is just a test for my new browser…
February 17, 2010 at 1:53 am
The Skald
Ok, maybe it was too long… I’ll post it in two parts 😀
Hi Tom,
On the whole, I’d say I agree with most of what you’ve listed concerning improvements in healthcare. Rather than list all of the things I really like, I’ll stick with the single thing I believe has become an overused panacea for “healthcare” spending. In one respect, I agree with PMV that we pretty much know the mechanics of what constitutes a “healthy” lifestyle. More to the point though, some of the notions being advocated concerning “preventative care” are not substantiated by any research.
First, the premise that studying healthy people is the best (read economically productive) route to determining how to build healthier citizens is a little too simplistic and ignores basic problems of logic. A small thought experiment demonstrates what I mean: Assume that no one ever gets sick, and we still want to know why we are all so healthy. How do we find that out? Any study that sought to find a correlation between ANY behavior and health would approach a value of 1.0. Constructing suitable experimental questions essentially requires a sick person. Moreover, not all, but virtually all of our current knowledge about healthy lifestyles is a result of studying sick people and their differences from healthy people. Why should we not smoke? It took awhile, but the connection was finally made to a number of cancers. Finding out what causes the illness is the surest route to preventing the illness. The point I’m making is NOT that we should devote no resources to studying healthy lifestyles, but that serious thought should be given to where resources are most useful or productive.
Second, apart from the argument above, many researchers and practicing physicians provide more pragmatic reasons to approach “preventative care” with a certain amount of caution. In September of last year, The New York Times reported on an Health Affairs report that addressed the notions of preventative care based on an epidemiological model for diabetes. Ultimately, The Times concluded:
even the long view did not show that a prevention program like this saves money. Preventive care may well be like any other kind of medical care — expensive now, and in years to come.
Dr. Kevin Pho at KevinMD.com, commenting on the Health Affairs report, similarly concludes:
The bottom line, however, remains the same. Whether you’re looking out 10 years or 25, there isn’t much evidence that preventive care saves money. I agree that we still should do what we can to prevent disease according to evidence-based practices, but advocating prevention to cut costs is misguided.
end part 1
February 17, 2010 at 1:57 am
The Skald
I’m going to try this in a few parts to see if it works.
Hi Tom,
On the whole, I’d say I agree with most of what you’ve listed concerning improvements in healthcare. Rather than list all of the things I really like, I’ll stick with the single thing I believe has become an overused panacea for “healthcare” spending. In one respect, I agree with PMV that we pretty much know the mechanics of what constitutes a “healthy” lifestyle. More to the point though, some of the notions being advocated concerning “preventative care” are not substantiated by any research.
First, the premise that studying healthy people is the best (read economically productive) route to determining how to build healthier citizens is a little too simplistic and ignores basic problems of logic. A small thought experiment demonstrates what I mean: Assume that no one ever gets sick, and we still want to know why we are all so healthy. How do we find that out? Any study that sought to find a correlation between ANY behavior and health would approach a value of 1.0. Constructing suitable experimental questions essentially requires a sick person. Moreover, not all, but virtually all of our current knowledge about healthy lifestyles is a result of studying sick people and their differences from healthy people. Why should we not smoke? It took awhile, but the connection was finally made to a number of cancers. Finding out what causes the illness is the surest route to preventing the illness. The point I’m making is NOT that we should devote no resources to studying healthy lifestyles, but that serious thought should be given to where resources are most useful or productive.
cont.
February 17, 2010 at 1:58 am
The Skald
Second, apart from the argument above, many researchers and practicing physicians provide more pragmatic reasons to approach “preventative care” with a certain amount of caution. In September of last year, The New York Times reported on an Health Affairs report that addressed the notions of preventative care based on an epidemiological model for diabetes. Ultimately, The Times concluded:
even the long view did not show that a prevention program like this saves money. Preventive care may well be like any other kind of medical care — expensive now, and in years to come.
Dr. Kevin Pho at KevinMD.com, commenting on the Health Affairs report, similarly concludes:
The bottom line, however, remains the same. Whether you’re looking out 10 years or 25, there isn’t much evidence that preventive care saves money. I agree that we still should do what we can to prevent disease according to evidence-based practices, but advocating prevention to cut costs is misguided.
February 17, 2010 at 2:02 am
The Skald
Ok, this doesn’t seem to be accepting html or links. Here it is stripped of the reference links:
Second, apart from the argument above, many researchers and practicing physicians provide more pragmatic reasons to approach “preventative care” with a certain amount of caution. In September of last year, The New York Times reported on a Health Affairs report that addressed the notions of preventative care based on an epidemiological model for diabetes. Ultimately, The Times concluded:
even the long view did not show that a prevention program like this saves money. Preventive care may well be like any other kind of medical care — expensive now, and in years to come.
Dr. Kevin Pho at KevinMD.com, commenting on the Health Affairs report, similarly concludes:
The bottom line, however, remains the same. Whether you’re looking out 10 years or 25, there isn’t much evidence that preventive care saves money. I agree that we still should do what we can to prevent disease according to evidence-based practices, but advocating prevention to cut costs is misguided.
Finally, the New England Journal of Medicine (NEJM) also addressed precisely this issue in an attempt to clarify key issues in “preventative care” with respect to the presidential candidates in 2008. As indicated by PMV, the NEJM article acknowledge many of the evidenced based things we know to be “health care” rather than “sick care.” Specifically,
Indeed, some evidence does suggest that there are opportunities to save money and improve health through prevention. Preventable causes of death, such as tobacco smoking, poor diet and physical inactivity, and misuse of alcohol have been estimated to be responsible for 900,000 deaths annually — nearly 40% of total yearly mortality in the United States. Moreover, some of the measures identified by the U.S. Preventive Services Task Force, such as counseling adults to quit smoking, screening for colorectal cancer, and providing influenza vaccination, reduce mortality either at low cost or at a cost savings.
The researches then make it plain that the far-reaching “statements about the cost-saving potential of prevention, however, are overreaching.” They follow up by presenting substantial research that demonstrates that their
…findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not (emphasis added). Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical. Such analysis could identify not only cost-saving preventive measures but also preventive measures that deliver substantial health benefits relative to their net costs; this analysis could also identify treatments that are cost-saving or highly efficient (i.e., cost-effective).
Still, on the whole, I agree with virtually all of your comments, but the “preventative care” hobby horse seems to be more wishful thinking than a reasoned proposal – especially from politicians 😀 So, I would disagree with item #3 on goals for our congressmen – we learn how to keep people healthy by understanding what makes them sick, and that is a more cost effective research program. As for your three items that “have no place in Health care legislation…” ABSO-FREAKIN-LUTELY!! If there were any single thing I could change at will that would be it – the deliberate legislation of inequality or privileged classes.
Great start to your 20 issues Tom! I’m really looking forward to this series – partly because I think it’ll be great stimulus for me to participate in some small measure over at my place.
Cheers!
Steven
February 17, 2010 at 2:06 am
The Skald
Sorry about that Tom. I didn’t realize your comments didn’t accept html links to web articles. Hopefully the comments are readable as set of two – Please delete the first 😦 If any one wants the links to the artciles they are:
http://prescriptions.blogs.nytimes.com/2009/09/03/when-preventive-care-costs-more/
http://content.healthaffairs.org/cgi/content/short/hlthaff.28.5.w978
http://www.kevinmd.com/blog/2009/09/preventive-medicine-save-money-cost-long-run.html
http://content.nejm.org/cgi/content/full/358/7/661
Phew! Again, GREAT start. I’m really looking forward to the next 40 weeks!
Cheers,
Steven
February 17, 2010 at 2:09 am
The Skald
Hi Tom,
Sorry about the extended comments. I didn’t realize your site didn’t accept html or text links in the body of comments. If you or a reader wants lthe links to the articles that this information was drawn from, I’d be happy to email the links.
Again, GREAT start Tom!
February 17, 2010 at 7:22 am
ttoes
Steven,
Thanks for all the thought that went into your comments. I appreciate the discussion. Too bad we don’t seem to be having that discussion on a national level. It seems to be “my way or the highway.”
Your point about preventive care is a good one with which I agree, mostly. Many years ago, Kaiser Foundation Hospitals offered a full annual ‘preventive screening’ of all patients. Then they backed down to just offer the screening to new patients. Now they do far fewer preventive screenings. I have been told, and assume it is true, that they did this because the screenings proved to cost more than the benefit. I don’t want to believe that, but can see how it might be true. Having said that, I still think that a carefully chosen series of preventive screens could have savings as a result. Maybe we need to look at the most expensive to treat diseases and see if there isn’t a cost benefit there.
As to the simplicity of the argument “if you want to learn about health you should study healthy people” I think the issue is more the target of our study. Right now, I think, but have not researched, that the vast majority of government backed research is in the understanding or and cures for illnesses. Cancer and Alsheimers research probably get huge funding. I don’t think there is any funding that compares for things like studying the reasons why we have huge numbers of Autistic kids but somehow, very few autistic adults. Nor, do we spend a lot of money understanding the relationship between intact families and health or successful communities. I guess my point, if poorly made, is that we need to orient our research toward optimistic rather than pessimistic themes.
More response later – off to a meeting.
Tom
February 19, 2010 at 6:13 am
ttoes
Sorry, PMV and Skald.
I just did my weekly check of spam and found that somehow the above comments got labeled spam in my system. I could make some clever remark that it was all the inaccuracies in your arguments (like eveyplace you disagree with me) but it is a completely automatic system. Again sorry. I think you both have some very good points. I will try to address them later today or over the weekend. I wil also try to remove the duplicates.
Tom
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