Hi Dave, I applaud your illuminating the core issues that will have a profound effect on our children and grandchildren. We keep kicking the can down the road on deficits and national debt. Our generation has been getting away with supporting our privileges through borrowing rather than increasing revenue (taxes, especially on the wealthy) or spending more wisely and efficiently. It will be interesting to see how DOGE will cut federal spending but 2/3 without defaulting on debt, reducing defense spending (at a time when the world is on fire) or reducing social security and healthcare expenses (Medicare and Medicaid). At some point, I suspect you may speak to income inequality (which you didn’t mention in your list of issues).
Unfortunately, at this time people are reacting emotionally and being driven by the cult of personality rather than rationality.
Thanks Bob! Certainly that’s on the list too. So many. Appreciate the kind words. You’re right about Doge. Non military discretionary is ~$950B. Hard to find $2T out of that. Everything else is either untouchable literally (interest) or politically (entitlements). Military is touchable but at $715B spend in a dangerous time, doesn’t have b material support either. No easy answers. Stay tuned.
Dave - Great to see you writing here to explain and help people better understand a practical and pragmatic point of view to our communities. It is only by focusing on ideas, issues and implementations that make things better for our communities and our society that we make the world better TOGETHER!
Thanks Dave - You raise important points about how to move the conversation back towards pragmatic, sensible solutions to our problems. It is a bit too both siderish for my taste though. After all if one side is endorsed by Liz Cheney, and the other side is too Conservative, who are the radical leftists we are worrying about? Also, you mention climate change, so to use that as an example, the Republican position now is that climate change is fake and something we should ignore. I would argue this isn't Conservative, it's a lie. The way back to the middle isn't to meet the lie halfway, it's to drive the lie from the conversation. Similarly on immigration, the entire debate is based around xenophobia, racism, lies, fear mongering and the dehumanization of entire populations. I don't know how to meet this halfway, nor do I want to learn how. The road back is to stop this. I don't have any great ideas on how to do that. Perhaps you will give some thoughts in future articles.
David, Thank you for doing this and terrific to hear from you. Consider me your cousin Cedric from Maine. I have been an unenrolled voter (registered but not enrolled in a party) for a number of years. And I agree we are careening from guardrail to guardrail with no ability/incentive to work together for solutions. I am also concerned that the guardrails may be gone starting early next year. I look forward to your further thoughts. I largely agree with Celeste although I think you may over credit Susan Collins. Take a look at Jared Golden, D-2, a recently reelected Democratic congressman in the Republican House District 2 which Trump carried. Re health care, I recommend a book written about 10 years ago by a college classmate on mine, TR Reid, called The Healing of America. You can read it in a couple of hours.
Thanks Steve. The great state of Maine gives me hope! Great to hear from you. Will take a look for sure. Getting a lot of interest in our healthcare system. As you know, that’s where I’ve spent the better part of my career. But honestly, I am good at the micro in that world. My macro thoughts are just OK. I’m prob gonna deep dive it tho given the interest I seem to have. Best to you and yours!!!
Well that is downright depressing. I've never dug in on incentive systems in the 'best' countries. Are the incentives 'better'? Or is it something else? (food systems, cultural norms, prices paid, one payor vs. multiples payors, etc.)
I just don’t know why we are so bad relative to almost everybody but my favorite possible explanation is our terrible food supply and the resulting effects on health. When morbid obesity becomes socially acceptable no health care system can cope. Diabetes, kidney failure, lupus, some cancers and many other diseases can be cured simply by dietary changes. Our medical system treats symptoms rather than trying to cure anything. The symptoms gradually grow worse because the underlying causes are not treated. It is very sad because the causes of many diseases have been clearly identified. The chemical pathways are known. The solutions are simple and cost effective. Unfortunately no one makes money by simple cures.
Good job David. I'm looking forward to reading all of your articles. If ever you want a perspective on healthcare from my experiences doing strategies for IBM outside of the USA (universal healthcare), let me know.
Thanks Ivo! Great to hear from you. Yeah, I want to do that. Even though I've lived in the sector, and have some level of understanding on Canada and UK systems, I'm still scratching my head on the quality / cost thing. That's next year--as I'm tackling Debt/Deficit first. No small problem. Be well!
Dave - Big kudos for stepping up and trying to help move the political needle in a better, more pragmatic direction - to the middle, and with a glass-half-full approach. The fact that so many of us (left, right and center) hold our nose when we vote certainly supports what you're doing. We look forward to your deep dives!
Thanks Buddy! Yeah no small problem. It’s always a tough issue when you’re talking about ‘shared pain’. Most reactions are that it’s not fair. Which is why the best fix is all at once (increase taxes, lower spending, put guardrails in place to avoid same issues in future). Right now there’s no political will to do a global fix. Except for discretionary spending which is DOGE. $2T is pipe dream since non military discretionary budget next year is $960B . But some is needed. The X chatter is a bummer. This is serious shit.
Hi Dave, I applaud your illuminating the core issues that will have a profound effect on our children and grandchildren. We keep kicking the can down the road on deficits and national debt. Our generation has been getting away with supporting our privileges through borrowing rather than increasing revenue (taxes, especially on the wealthy) or spending more wisely and efficiently. It will be interesting to see how DOGE will cut federal spending but 2/3 without defaulting on debt, reducing defense spending (at a time when the world is on fire) or reducing social security and healthcare expenses (Medicare and Medicaid). At some point, I suspect you may speak to income inequality (which you didn’t mention in your list of issues).
Unfortunately, at this time people are reacting emotionally and being driven by the cult of personality rather than rationality.
I look forward to future articles.
Bob
Thanks Bob! Certainly that’s on the list too. So many. Appreciate the kind words. You’re right about Doge. Non military discretionary is ~$950B. Hard to find $2T out of that. Everything else is either untouchable literally (interest) or politically (entitlements). Military is touchable but at $715B spend in a dangerous time, doesn’t have b material support either. No easy answers. Stay tuned.
Dave
I hope your substack gains traction. I highly recommend The Free Press for a more balanced and nuanced view than in traditional media.
Dave - Great to see you writing here to explain and help people better understand a practical and pragmatic point of view to our communities. It is only by focusing on ideas, issues and implementations that make things better for our communities and our society that we make the world better TOGETHER!
Happy to be subscribed to such a thoughtful and credible moderate.
Thanks Dave - You raise important points about how to move the conversation back towards pragmatic, sensible solutions to our problems. It is a bit too both siderish for my taste though. After all if one side is endorsed by Liz Cheney, and the other side is too Conservative, who are the radical leftists we are worrying about? Also, you mention climate change, so to use that as an example, the Republican position now is that climate change is fake and something we should ignore. I would argue this isn't Conservative, it's a lie. The way back to the middle isn't to meet the lie halfway, it's to drive the lie from the conversation. Similarly on immigration, the entire debate is based around xenophobia, racism, lies, fear mongering and the dehumanization of entire populations. I don't know how to meet this halfway, nor do I want to learn how. The road back is to stop this. I don't have any great ideas on how to do that. Perhaps you will give some thoughts in future articles.
I. Am. Celeste.
David, Thank you for doing this and terrific to hear from you. Consider me your cousin Cedric from Maine. I have been an unenrolled voter (registered but not enrolled in a party) for a number of years. And I agree we are careening from guardrail to guardrail with no ability/incentive to work together for solutions. I am also concerned that the guardrails may be gone starting early next year. I look forward to your further thoughts. I largely agree with Celeste although I think you may over credit Susan Collins. Take a look at Jared Golden, D-2, a recently reelected Democratic congressman in the Republican House District 2 which Trump carried. Re health care, I recommend a book written about 10 years ago by a college classmate on mine, TR Reid, called The Healing of America. You can read it in a couple of hours.
Thanks Steve. The great state of Maine gives me hope! Great to hear from you. Will take a look for sure. Getting a lot of interest in our healthcare system. As you know, that’s where I’ve spent the better part of my career. But honestly, I am good at the micro in that world. My macro thoughts are just OK. I’m prob gonna deep dive it tho given the interest I seem to have. Best to you and yours!!!
There’s a great graph going around that typifies the healthcare problem.
https://www.epatientdave.com/wp-content/uploads/2017/06/Health-system-and-longevity-1.jpg
Well that is downright depressing. I've never dug in on incentive systems in the 'best' countries. Are the incentives 'better'? Or is it something else? (food systems, cultural norms, prices paid, one payor vs. multiples payors, etc.)
I just don’t know why we are so bad relative to almost everybody but my favorite possible explanation is our terrible food supply and the resulting effects on health. When morbid obesity becomes socially acceptable no health care system can cope. Diabetes, kidney failure, lupus, some cancers and many other diseases can be cured simply by dietary changes. Our medical system treats symptoms rather than trying to cure anything. The symptoms gradually grow worse because the underlying causes are not treated. It is very sad because the causes of many diseases have been clearly identified. The chemical pathways are known. The solutions are simple and cost effective. Unfortunately no one makes money by simple cures.
Good job David. I'm looking forward to reading all of your articles. If ever you want a perspective on healthcare from my experiences doing strategies for IBM outside of the USA (universal healthcare), let me know.
Thanks Ivo! Great to hear from you. Yeah, I want to do that. Even though I've lived in the sector, and have some level of understanding on Canada and UK systems, I'm still scratching my head on the quality / cost thing. That's next year--as I'm tackling Debt/Deficit first. No small problem. Be well!
Dave - Big kudos for stepping up and trying to help move the political needle in a better, more pragmatic direction - to the middle, and with a glass-half-full approach. The fact that so many of us (left, right and center) hold our nose when we vote certainly supports what you're doing. We look forward to your deep dives!
Thanks Buddy! Yeah no small problem. It’s always a tough issue when you’re talking about ‘shared pain’. Most reactions are that it’s not fair. Which is why the best fix is all at once (increase taxes, lower spending, put guardrails in place to avoid same issues in future). Right now there’s no political will to do a global fix. Except for discretionary spending which is DOGE. $2T is pipe dream since non military discretionary budget next year is $960B . But some is needed. The X chatter is a bummer. This is serious shit.