The componentization phase of globalization has begun. One can’t roll the world back to pre-globalization days, but for it to be sustainable, things have to be encapsulated to safeguard protected memory spaces. There is a need for standard interfaces, not “open borders.” The networked world has been overwhelmed by complexity, whether it takes the form of the breakdown of trusted authority or the dazzling profusion of “collusion.” The intellectual challenge is how to make it safe for people to deal with strangers in a connected world. The problem can be solved but it can’t be solved by people who don’t think it’s a potential problem.
See also Sarah Hoyt’s post Imagine There’s No Nations and my post Coupling.
Additionally, a relevant article at Commentary: The Global Citizen Fraud.
Too much Podhoretz at Commentary for me.
One nice essay about what happened to Labour.
The hollowing out of US manufacturing was equivalent to enemy action as far as I am concerned. The owners and ,managers gave no thought to the future of the country. Many , like movie actors, have second homes in other countries, like Italy. They give no thought to the existence and importance of the United Stated of America. I know people who have retired to Mexico, as it is cheaper and they were comfortable with the climate. The lawlessness was not an issue as there were many ways to get around Mexican property laws.
I wonder how many are still living there ? I have been to London many times, the most recent in 2015. I am not interested in going to Khan’s London. No more.
We could not win a war now. The military, at least the officer corps, has been feminized, as we saw with the Navy collisions. The Army may not be much better,.
There is no way we could built 200,000 airplanes as we did in WWII. The industrial base is beginning to recover but it will take years. A skilled workforce does not exist.
60% of medical students are now female. That is fine with me but medical schools turned down female applicants in the 50s and 60s because of concerns that women physicians would not work full time and there was a doctor shortage. Now, physician recruitment firms (physicians have become part of the “Gig economy”) say that women work 27% fewer hours per week than men. The male physicians I see now tend to work fewer hours than we did, largely an economic issue. And the Baby Boomers are retiring.
That’s not exactly a “Globalization” problem but the same people gave it to us.
Mike K…”Now, physician recruitment firms (physicians have become part of the “Gig economy”) say that women work 27% fewer hours per week than men. The male physicians I see now tend to work fewer hours than we did, largely an economic issue.”
But this shouldn’t be a problem, I would think, *unless* there are artificial constraints on medical-school capacity. My perception, although I haven’t really studied this, are that such supply constraints *do* exist…any comments on this, Mike?
I bet there’s a decent correlation between hand grip strength and voting at this point, that probably wasn’t there a generation or two ago. Exit polls should look into that. I bet it would be particularly strong in the UK vote last week.
I’ve noted here before that it’s very striking in reading about UK politics after the War that many of the Labour politicians were guys who had cracked heads. Now they’re a bunch of academics. There’s really no reason to give any respect to any Western leftist politicians of today that I’m aware of. They’re all completely pathetic nobodies. Imagine what the Labour luminaries of 50 years ago would think of the likes of Barack Obama and Justin Trudeau? They’re pitiful shadows of men. They’d probably think that the modern right is more or less familiar, although degraded somewhat, but they’d hang their heads in shame at what the left has become.
The workers that built the 200,000 planes and the rest, that built a liberty ship in three days, learned on the job. they sure weren’t doing anything like it at the beginning of the war.
I saw an article on the return of the furniture business to the Southeast. It bemoaned the fact that skilled furniture workers were hard to find. The successful companies will find a way to take the workers they can get and teach them to do the jobs they need done.
We seem to be far too enamored of credentials of late. As if no one can do a job without starting preparation from elementary school. This is a very European attitude, all tied into guilds and unions and a feudal mindset that sees the world as a zero sum game. This didn’t used to be the American way.
Just got back from seeing “Richard Jewell.”
such supply constraints *do* exist…any comments on this, Mike?
Medical schools have cropped up all over. There is a myth that the AMA is controlling supply. The AMA has nothing to do with medical schools.
Medical school accreditation is done by the AAMC, which is another organization unrelated to the AMA. There are also osteopathic schools and foreign medical schools.
My class had 66 students. five years later the classes were 240,.
Yet there do seem to be less docs than there need to be. Is this a function of…insufficient number of people who are interested?…expense of the training…something else?
“There are 661, 400 physicians and surgeons in the United States in 2008.”
Here is a curve. Look what happened after 1965.
That is only MDs.
“There are now more than 100,000 US DOs, report confirms
Osteopathic medicine is one of the fastest-growing health care professions; since 1986, the number of DOs has increased by 276%.
By AOA Staff Email Tuesday, Jan. 10, 2017”
In 1965 the Osteopathic Board in California was abolished and all DOs who wanted to, became MDs. The osteopaths came back about 20 years later. There are osteopathic schools all over.
One issue of need is the aging population but my point is that newer medical students, not just the 60% that are now women, don’t put the hours in. My uncle,. a GP in Millbank SD, was in the hospital with a hip fracture when my father died in 1969. Two nuns from the hospital drove to Chicago to represent him at the funeral and they had fixed up the his hospital room so he could see his patients in his room in bed. Can you imagine that today ?
Interesting data. But it’s a common observation that it’s hard to get an appointment, especially from any kind of specialist, and once the appointment happens, the doc seems very rushed with little time for questions or discussion.
In any normally-functioning market, one would expect supply to rise to eliminate persistent shortages. (Of course, the balancing of supply and demand might also involve price increases)
Surely the (lack of) appeal of going through years of med school only to be an employee of a big medical firm (or, if the Dems get their way, the government) is an understandable cause of doctor shortages. In my experience doctors in most rural areas are immigrants, which tracks what you read about the UK, etc. It seems obvious that the medical profession is suffering from the same problems that are suppressing entrepreneurship in general over the past several decades.
I think most doctors are now employees rather than independent practitioners. As such, there is always someone looking over their shoulder, monitoring their productivity. For this, they get regular hours and the billing hassle is someone else’s. I haven’t heard about anyone having a license suspended for making a house call but I’m sure a lot of administrators would go along.
This is just another unintended consequence of delegating all of our health care decisions to insurance companies. He who pays the piper calls the tune.
Of course, the big groups that buy doctors in bulk get a discount. The doctors are paid on the basis of hitting their numbers.
On the other hand, there were doctors, especially in small towns, that more or less worked themselves to death. That isn’t likely to happen as employees.
once the appointment happens, the doc seems very rushed with little time for questions or discussion.
This is the pet peeve of young doctors. Obamacare required that an electronic medical record be adopted or lose 5% (I think) of Medicare payment. I was an enthusiast for electronic records in the past but have seen how clumsy and poorly designed they are in practice. Doctors I talk to tell me it takes about 25% of their time. Secondly, the most enthusiastic adopters of Obamacare were hospital administrators. They would finally get control over those damned doctors. Administrators and doctors have been enemies forever. I’ve talked to them about it in the past. We were patient advocates. I remember one time learning that my hospital was marking up pacemakers by more than 100%. I went to the administrator and told him that, if the hospital tried to sue for collection of the balance, I would be a witness for the patient. Those days are gone. Hospitals bought up medical practices in most areas, certainly in the community where I spent 40 years. Doctors are employees.
The surgical group that I was a member of and which founded the trauma center in 1979, was fired by the hospital several years ago. There had been no problem but the hospital was able to hire a group of women surgeons from elsewhere to take over and charge less. The other doctors had no say and nobody knew anything about them except that the one male surgeon, who was the head of the group, had applied to the trauma group a few years earlier and had been turned down. I would do a long post but I have been away for 25 years and may not be up to date.
I do know that physician burnout is now a major concern of the AMA and other physician organizations. Tnis will eventually translate into a decline in quality of medical school applicants.
Mike K’s comments about the medical profession could be echoed in many other fields. The generic form of the observation is: “We used to be able to do much better than this. Now we can’t”. It applies to a patient’s medical experience, putting men into space, or steering Navy ships around obstacles.
To some extent, big improvements in technology have compensated for the decline in competence — such as medical scanners, GPS, or anti-skid brakes — although we should be concerned that the technology increasingly has to be imported from Taiwan, Korea, China, India. But what has caused this observable decline in competence?
The worthlessness of most of today’s academia needs no further discussion, and that certainly contributes to the decline in competence. However, the most significant educational failure is occurring in K-12. And when the under-prepared hit the labor force, they find an environment where there are too many lawyers, too many laws, too many regulations — and where competence is less important than having the approved gonads or the approved melanin level.
After the revolution, we could — impose a maximum wage on attorneys; require applicants to law school to have served a minimum of 3 years in a front-line military unit in an enlisted capacity; close down most law schools; disqualify anyone with a law degree or a law license from ever holding an elected position; roll back most laws & regulations to 1970-level; enforce anti-discrimination laws rigorously and even-handedly; prohibit government agencies from issuing regulations — democratically elected officials have to pass laws individually approving each regulation; eliminate pensions for government employees; make corruption in government a capital offense. This would not solve all the competence problems … but it would be a start.
We are entering an era when competence is less important than skin shade or genitals.
The colleges have adjusted by grade inflation and by adding useless majors like Gender Studies or Critical Race Theory. Classical authors are ignored or attacked for sexism or racism using standards that are ahistorical.
Steve Hayward comes up with some doozies.
We take issue with the use of ‘supremacy’ when referring to quantum computers that can out-calculate even the fastest supercomputers (F. Arute et al. Nature 574, 505–510; 2019). We consider it irresponsible to override the historical context of this descriptor, which risks sustaining divisions in race, gender and class. We call for the community to use ‘quantum advantage’ instead.
Next step is to require that white men give up science.