*For a long time, I have noticed that in small towns or mid-sized cities, the two biggest buildings belonged to a college and a hospital. But only recently did a bright observation occur to me, namely that the two institutions had several characteristics in common: the service they provide is terribly overpriced, the outcomes they deliver are disappointing by any reasonable metric, and structurally their entire systems – higher education and healthcare—need to be taken apart and put back together in a more customer-friendly manner.

*Speaking of commonality, what is shared by shared by discussions of abortion, charter schools, and immigration?  One can win the debate on merit and not change a single person’s mind. Maybe vaccines belong with the above trio of topics. And QAnon.

*Once in a while, it’s useful to look up from the daily negativity – you know the long list of American transgressions, both home and abroad – and mention a handful of rather unique characteristics:

a nation of multiple minorities is evolving in front of the world’s eyes, the same nation is one which consistently heads the list when people from elsewhere are seeking jobs, it is quite possible in that place for people to call the President or the cop on the block an idiot and suffer no real repercussions.

P.S. Even those in the United States who delight in the trashing their country are not exactly rushing to airports to cling to airplane wings in an attempt to go live elsewhere.

*Any grant-seeker knows that mentioning the word “community” evokes nothing but positivity. Ditto for any reference to “collaborations.” Maybe “bonding” should be on that short list of – ‘whatever the non-profit leader is saying must be good; let’s give them some money.” Does anybody think of the relationship between a drug dealer and an addict as bonding or a collaborative effort or involving a community, even though the descriptors fit. The point? No word should be accorded a characteristic without some thought.

*The stock market soars, regardless of how many financial historians claim that our nation’s printing press economics makes no sense or that we are incurring debt payable by future generations or that we are increasingly beholden to trading “partners” like China. P.S. If debt is meaningless, do I still have to pay my mortgage?

Anyway, we’re not smiling. In “We Weren’t happy before the Pandemic” (New York Times, 8-22-21), author Esau McCaulley suggests we were previously reluctant to recognize what we were giving up in the pursuit of whatever. Now, “the pandemic has disabused us of the illusion of time as a limitless resource and of the false promise that the sacrifices we make for our careers are worth it.”

Meanwhile, as supporting evidence (or confirmation bias) Anna Lembke (Wall Street Journal, 8-14-21, “Digital addictions are Drowning us in Dopamine’) notes that new cases of depression worldwide were up 50% from 1990 to 2017 (the biggest increases in areas with the highest incomes) and Americans self-reported as being less happy in 2018 than in 2008. Again, pre-pandemic.

*If you draw a line to show the techno/social media penetration of American life, let’s say at a 45-degree angle, and then draw a line to show happiness or educational accomplishment or median income, you would see no such lines in the vicinity of that of techno/social media. In fact, all three lines of possible outcome metrics are flat. If you knew nothing, you might say that the techno/social media boom has been a waste (except to a relative handful of incredibly enriched venture capitalists and investors). Or you might say this is a case of meaningless non-correlation. From a high-level standpoint, it is hard to make the case for its benefits, which is a totally crazy statement given the ease with which we can find out …. stuff. So pick your metric. If I can build a house faster in a factory than on-site, does not the house still need a satisfied occupant to give the thumbs-up to the revised process.

*I was thinking the other day that reacting to the pain in my infected finger was analogous to coping with a weird noise in my car.  You walk into the fix-it place and you immediately owe the proprietor a fee for simply having crossed the threshold of his or her enterprise and asking for some degree of analysis. In the case of my finger, it was a mere $315. Not to worry, taxpayers en masse provided $210.56 through a Medicare adjustment, and that same payor sent $83.79 to the insurance company. Don’t cry for the latter; they make it up elsewhere. I was on the hook for only $20.65.

The procedure itself, a somewhat painful lancing of an infection, was less expensive than walking in, specifically $245. Of this, the Medicare adjustment took care of $90.78 and the Medicare payment to a Big Insurance Entity was $123.73 I had to cough up $30.49. (Hope all these numbers add!).

Do you wonder why everybody from a neophyte financial analyst to a public health policy wonk to an aging frequent user of medical services regards this convoluted billing approach as, uh, rather strange. What is the actual cost of what took place! With my car repair, I know what the hourly labor rate is for the mechanic who fixes everything and I have a fairly good idea as how much of that rate finds its way into his or her paycheck. Impossible with the purchase of healthcare services.

*Let’s see – alcohol, cigarettes, gambling; marijuana – the latter two on their way to full, “controlled” availability.  What is the underlying message? “Please don’t engage in these terrible sinful pleasures, but if you do, be careful not to overdo it – call an 800 number if you have a sudden understanding that your excess is about to cost you — let’s see, your health, your family, your house, whatever.”

What nonsense buried in a truth, like the saying in a Chinese fortune cookie that is otherwise edible. Each of these purveyors of the above quartet relies in their economic model on people overdoing it, and government is quite happy to collect its taxes without doing any accounting for the remedial costs involved; those show up in somebody else’s budget. Will prostitution eventually be legalized and join this happy collection of no-nos.

*To be continued on another day of high wattage inspiration!