Sunday, March 8, 2009

When Enough Became Too Much

When Enough Became Too Much


“Daddy what were you doing when it all fell apart?”


Thomas Friedman, the NY times columnist recently hit the nail recently saying; “We have created a system for growth that depended on our building more and more stores to sell more and more stuff made in more and more factories in China, powered by more and more coal that would cause more and more climate change but earn China more and more dollars to buy more and more U.S. T-bills so America would have more and more money to build more and more stores and sell more and more stuff that would employ more and more Chinese ...

We can’t do this anymore.

I am not an economist or business major. I ran a dental practice for 25 years then taught high school for a few years then moved to volunteering and capacity building for non-profits. What I do know is that something just doesn’t feel right when I hear or see a mega project going up; whether it is retail shopping or residential towers; I can’t keep saying to myself...” Well that’s progress, grow or die, that’s what they say in MBA school.”

So now Mother Nature and Father Wall Street have had their fill. Our air and water, our banks and homes are all in disarray, and it is our own doing. We built and built and borrowed and speculated never looking back at what we did and how we did it. I am as guilty as the next, being in my third condo in FL and seventh home ownership in my short 58 years on Planet Earth. Seven real estate deals, seven mortgages, seven times remodeling, seven times selling.  The cost in carbon footprints for just my moving around must be in the tons. I am just one of eight million baby boomers; do the math.

My son, Adam inherited three shares of GM stock from his great-grandfather who was a janitor in a GM BOP (Buick Oldsmobile Pontiac-for history’s sake) Plant in Kansas City, MO. This morning his morning latte cost more than the three shares are worth. Meanwhile in his lifetime we have depleted our ‘natural’ stocks; water, hydrocarbons, forests, rivers, fish and arable land. We can’t go on doing this..both the earth and the markets have dealt us a wakeup blow that I believe is more than just a slump or recession.


I believe that 30 years from now we will view 2008 as hitting the Great Wall of Excess. I do not believe politics, the economy or health care will look the same in 2039 as we look at them today. The people we trusted to run the country, the banks we used, the doctors and hospitals we were treated by will all be curious footnotes in thirty years. I think that sustainable, renewable growth will be our mantra from here on. It’s not going to be “less is more” but “less is best.”

 Our children will ask us “What were you doing when it all fell apart?”  Our answers today will speak to us for years to come.


Have a peaceful week.

Nate Klarfeld


1 comment:

  1. Let's apply this to healthcare.
    As a Physician who has practiced 25 years, I must comment regarding the impending collapse of our healthcare system. I see big Pharma at the table, insurers at the table, and hospitals at the table. Where are the doctors and spokespersons for the patients. It was my understanding that the AMA came out in the recent past for a single payer system run by the government.

    aMy experience with the healthcare pie was that it originally was a 9 inch apple pie and that it was fairly reasonably distributed between hospitals, pharmaceuticals, and doctors. Patients were the bottom line. Now it is a colossal multitrillion dollar cream pie divided in a different way. In the eighties insurance, hospitals, and Pharma began to develop medicine as a business to be run like a business, profit being the bottom line. Under the guise of cost cutting, managed care (Miss Managed Care) appeared by inventing a layer of business to control what tests, hospital stays, procedures, etc. would be paid for and they basically colluded to set physicians' fees by all agreeing to pay the same amount for determined services. And this way they took away a piece of the pie from the doctors. Between malpractice premiums and reduced fees many doctors are having trouble making it. The paperwork generated by multiple insurers requiring information from doctors for services to be determined as medically necessary or not is mind-boggling. I was a psychiatrist. For psychiatric services (mental illness was treated differently from other diseases) they set the fees and the number of visits so that any patient care was limited virtually to emergencies or band aids for mental problems. The crisis over the issue of getting care was an additional scar to the life calamity that the patient came to the psychiatrist about. It is virtually a racket or a scam with CEOs of Miss Managed Care walking away with millions of dollars in salary and stock for ripping off physicians and patients. Patients were selected. Only the healthy can be insured for ridiculously high premiums.

    As a young man I had the good fortune to live in Germany for 4 1/2 years. I paid a small monthly premium to participate in the government insurance. It covered virtually everything. I had two surgeries while I was living there. The care was accessible and excellent. Three years ago my partner and I traveled to Germany. He became ill during that trip. We went to a doctor. There was no wait. A thorough history and physical were done by the doctor. The office staff were embarrassed to tell us that he would have to pay the full fee because he was not insured. Full fee for the visit was 10 Euros, a little more $10.00. We filled his prescription for about $5.00. The antibiotic in the United States would likely have cost over $100. Talk about huge profits. Where is all that money going that we're paying. It doesn't seem to be to the stockholders in Pharma, insurance, or Miss Managed Care companies. Maybe it is going to the enormous multimillion dollar salaries for the executives of some of these companies which if anything are taking care away from patients.

    I have also spoken with psychiatrists in Canada who see their patients and send one bill to the government at the end of the month and receive one check in payment. This is an enormous savings in paperwork. It seems obvious that we must bust up these racketeering businesses and go to a single payer system where the bottom line is the patient and not profit.