Health care conundrums

February 17, 2017

As I advance in age, I am exposed more and more to the health care industry, despite having enjoyed relatively good health until recently.  As a retired New York State employee, I am blessed with excellent health insurance that covers most doctor visits, medical tests and procedures, as well as prescription drugs, with only a relatively modest co-pay. Here are a few observations:

First, it appears that many of our health problems are what a friend of mine calls “diseases of affluence.”  More appropriately, they should be called “diseases of lifestyle,” since they affect people of all socioeconomic strata.  A lot of these are directly influenced by government policies.  For instance, our auto-centric physical infrastructure minimizes the opportunities for and pleasures of walking and cycling, and cannot help but contribute to obesity and other problems based on lack of physical activity.  Our government subsidies to cane sugar and corn (the main ingredient of high fructose corn syrup) help make junk food and sugared soft drinks attractively priced.  This is especially so for the poor, since the SNAP program (formerly known as Food Stamps) allows their purchase with SNAP benefits.  If we collectively spent more on complete streets that were friendly to pedestrians and cyclists, as well as cars, how much could we save on health care (not to mention on school transportation)?  How about if we stopped subsidizing sugar?  I think it would be worth a try.

For all the criticism leveled against it, the Affordable Care Act (“Obamacare”) has achieved something great — it has shifted the dialog from whether health care insurance should be extended to many of those who don’t have it to how the present system should be replaced or improved.  Neither Trump nor his minions are suggesting that those who obtained health insurance through Obamacare should lose it, meaning that they recognize that there is no going back on government’s commitment to growing numbers of its citizens.  Whether things actually get better or worse remains to be seen, but at least no one is talking a bout a pre-Obamacare “reset.”  To me, that is yuge.


Traffic management

January 21, 2017

The delays occasioned by traffic jams, red lights and other things that slow our automotive travel are a major source of frustration to most of us.  As individuals, we can mitigate this frustration by choosing our home and work locations, and the times at which we work.  We may be able to telecommute, walk or bike, or take public transit (which has its own frustrations).  But in today’s automobile-dominated society, most of us have to use the private automobile for most of our travel, much of which must be done on a rigid schedule.

We deal with this frustration with fancy sound systems, luxury seating and blue tooth connections that allow us to use some of our automotive downtime productively.  However, those measures do not address the tremendous waste of oil-based fuel and its concomitant pollution. Government, on behalf of us all, can do more to manage traffic and its related delays, but in our geographic area it has largely failed to act.

While I was driving down Washington Avenue in Albany recently, hitting red light after red light, my frustration triggered some early memories — from the 1960s — of driving up and down avenues in Manhattan with my father, watching each light turn green as we approached it.  My dad explained to me that the lights were timed so that you would rarely have to stop, if you maintained a steady speed at or around the limit.  I am aware of nowhere in our area that employs this proven (and by now, probably more affordable), technology.

Another local failure, on the part of the Thruway Authority, is its lagging behind the Mass Pike in eliminating toll plazas at exits and entries to its highways, with all tolls being tallied by gantries over the road that read E-Z Pass transponders without the need for cars to slow down (a few such gantries do exist on the Thruway, most notably near the Harriman exit, but they have not replaced the toll plazas at the entries and exits).  Although the demolition of the toll plazas and barriers on the Mass Pike is not complete, travel time savings already have been noted.

While we now do have electronic signs on many of our primary roads advising of travel time to various points, these signs do not offer alternatives when delays are indicated, and in most cases no alternatives exist.  While information may reduce frustration during times of congestion, expenditures aimed at reducing congestion would be a better use of taxpayer funds.

Money spent on reducing traffic congestion, as well as on things like bike paths and libraries, benefits everyone by making the area a more attractive one in which to live.  Unfortunately, in New York, “everyone” is not a special interest, which may be why government under-spends in many of these areas.


Dealing with vehicular terrorists

June 1, 2016

Has this happened to you?  You’re driving along an expressway at or slightly above the speed limit and, without warning, a car passes you and cuts in front of you, missing you by inches, and continues on at a speed so excessive you feel you are standing still, and it repeats the process each time it approaches another vehicle.  I have to believe that  drivers of these vehicles cause far more than their fair share of accidents, some being immediately due to the terror they strike in other motorists, who may react erratically, and others because they misjudge and hit other vehicles and fail to negotiate turns and other hazards more often than most drivers.

In Ontario recently, on the Queen Elizabeth Way, a major highway, I noticed large billboards advising that drivers exceeding the speed limit by 50% would be subject to a CAD 10,000 fine (about $7,700 US) and immediate license suspension and vehicle impoundment.

Whether such a policy here would withstand a due process challenge is not entirely clear.  The fine, presumably imposed by a judge after a trial, could be challenged as excessive, but evidence of the disproportionate danger speeding at that level produces would probably justify it.  The immediate license suspension and vehicle impoundment gives a single officer a lot of discretion.  However, if a radar speed measurement is required, and immediate judicial review provided, that might be enough, given the great danger to which the penalty is directed and the high excessive speed required, for which it is hard to imagine any motorist having a valid excuse.  New York courts have upheld a “prompt suspension” law for those charged with DWI, but it is not as prompt as the Canadian measure, calling for a judge to first sustain the validity of an accusatory instrument.  Whether the courts here would approve a measure as strict as Ontario’s is not clear, but it may be worthwhile to find out.

 


A welcome addition

April 14, 2016

20160414_144125

Today I had a chance to walk the paved portion of the new Albany County bike path between Delmar and the Port of Albany. The path is great — newly paved, and therefore smooth, and not too crowded, at least on a weekday afternoon. I look forward to riding on it with my bike, and to trying out the new sections heading toward Voorheeseville as they are added.

Unfortunately, the paved section is only about three miles long at present, but it’s a lot better than nothing. What would really help would be a nice marked bike route connecting this trail with the Corning Preserve bike path, and maybe some better parking at the Delmar end (there’s a nice lot off South Pearl on the Albany end).20160414_150247


Too loud and too sweet

August 12, 2015

I just returned from a trip to, among other places, Las Vegas, and I was very bothered by the volume of sound in several places I visited.  While I may be over-sensitive, I can’t believe that ear-splitting sound levels are good for the health of either the patrons or the employees of these loud establishments, and I question whether they are good for the bottom line.  When time permits, I’ll look for studies, but I find it hard to believe that sound levels I find uncomfortable to be present in are enjoyed by anyone.  Loud noise in other public places has become endemic — in addition to the dreaded airport CNN monitors, about which I’ve previously written, I often find televisions — usually competing with other background music — blaring in restaurants and bars.  In an age when everyone has a smart phone or other device that allows them to listen to whatever they want, is it really necessary for airports and other public places to bother those of us who prefer silence?

My trip exposed me to another of my pet peeves — screaming babies on airplanes.  Ear plugs are not a complete solution; what also would help would be to ask families who travel with young children, in exchange for the preferred boarding and the ability to bring infants along for free they now get, to sit in the last few rows of the plane.  It astounds me that Southwest, the airline I usually fly, will require a “Customer of Size” to purchase an extra seat if he or she intrudes on the space of one other passenger (the cost of which is reimbursed if not every seat on the plane is taken), while a screaming infant can terrorize dozens of people with impunity.  If the airlines really care about the comfort and well-being of their customers, they will pay more attention to the screaming baby issue.  I for one will gladly shift my patronage to any airline that does.

Further on the theme of too much, why is everything over-sweetened?  I have read that a can of regular Coke contains the equivalent of 10 teaspoons of sugar, which seems objectionable on health grounds.  Why not offer an alternative containing about half as much sugar, which might be more pleasing to adult palates and less objectionable than artificially sweetened alternatives, most of which also are cloyingly sweet.  Reduced sugar drinks would appeal to those watching their calories and would result in good public relations for their makers, something the soft drink industry could use right now.

Oscar Wilde admonished “everything in moderation, including moderation.”  Time to return to the time when moderation is the general rule and not the exception.


Third World New York revisited

March 29, 2015

Sitting through my second extended water main break-induced dry spell of the week, I am reminded of my post a few years back bemoaning the poor quality of basic physical infrastructure and government services in this area.  Although millions have been spent locally on replacing curbs, sidewalk and street lighting in downtown Rensselaer, not to mention on the construction of our rail station, we can’t get through a winter or cold spring season without being deprived of water, a basic need.  It’s easy to complain, as do all public officials, about a lack of resources (and some, but not all, of the complaints have validity), but the job of our public officials is to prioritize the spending of the available resources to provide the greatest good for all.

Many forces conspire against good prioritization decisions.  Politicians know, for example, that they will be remembered for grand, visible public works far more than they will be remembered for insuring that services are provided without interruption and that existing infrastructure is maintained.  No one named a filled pot hole after a mayor.  Similarly, more federal and state funds are available for new construction than for maintenance.

In places like Rensselaer, where I live, the availability of sufficient resources also is a problem.  The tax base is low, as is the political clout to extract money from county, state and federal governments.

What’s the answer?  Unfortunately, there is no easy one.  Until things get so bad (which, judging by what people here have been putting up with for years, will have to be pretty bad) and start demanding better basic services by voting for candidates who promise them, or unless the economy improves enough to provide more resources, I don’t see things getting much better in the short run.  If enough people feel that way and start voting with their feet, the downward spiral could get worse before it gets better.


Lessons from our neighbors to the North

September 1, 2014

I just returned from a glorious cycling mini-vacation in Montreal, one of North America’s premiere cities for bicycling. I got to see a lot, compared to what pedestrians get to see; I got to see details that those who drive around miss; I got fresh air, sunshine, exercise and contact with locals. What Montreal got from me was tourist dollars, good will, great word of mouth and someone likely to return for more.

By accommodating cyclists, in addition to other tourists, Montreal has spawned a whole industry of businesses that support them – hotels and inns near bike paths, bicycle shops, and the like. It has provided its  residents an outlet for safe, outdoor, healthy recreation. And it has created a mini-boom in real estate along the major bike routes, such as the Lachine Canal trail.

By contrast, let’s look at what our area is doing to promote tourism and economic development: a convention center and a casino resort, neither world class, and therefore neither likely to attract visitors from outside the region. Both are late-comers in declining industries that already have excess capacity. While both will create one-shot jobs while they are being built, neither is likely to spur much ongoing development in their immediate surroundings, and neither will provide ongoing entertainment or recreational opportunities for locals, except perhaps for the casino, which may not be a good thing.

Some of the major benefits of encouraging bicycle tourism are:

1.  Low cost.  The bedrock principle for encouraging people to bike is to provide an area physically separate from automobiles in which they can feel safe and comfortable.  “Sharrows,” and bike route signs, the principal things our government wastes money on to promote cycling, do not achieve this goal.  However, there are relatively easy and inexpensive ways to separate cars and bikes.  Here’s a bike path in Montreal that uses no more than a painted line to demarcate a bike lane next to the curb, with cars parked on its outside to shield the cyclists from moving traffic.

Simple bike path - parked cars separate bikes and moving cars

Simple bike path – parked cars separate bikes and moving cars

For a little more money, actual temporary barriers can be installed that can be removed in winter (in Montreal, the bike paths are open from April through November):

Bike trail with stantions

Bike trail with stanchions

For a little more, you can add fancy, permanent curbing, and even a separate signaling system, but these are bells and whistles, not essentials:

Bike path with curbing

Bike path with curbing

 

 

 

 

 

Bike traffic light

Bike traffic light

2.  Benefits to residents.  While attracting tourists, a usable network of bike trails will at the same time encourage locals to use their bikes more, which will improve their health, reduce automobile traffic and its negative side effects (pollution, accidents, use of large swaths of downtown land for parking lots, etc.).

3.  Economic development.  Bikeable cities attract millenials and others who prefer urban, car-less environments.  In Montreal, I saw a lot of new residential development next to the major bike trails, as well as renovations of older warehouses, factories and the like into apartments and condos.

Montreal has as long and severe a winter season as Albany, yet it proves that bike paths make economic sense even when used only part of the year.  One advantage Montreal does have over Albany is more level terrain, but there are plenty of potential routes here that would not require major hill climbs.  The Corning Preserve and Mohawk bike trails already here are a good start that demonstrate the local demand for off-road cycling facilities, so there is little risk that if we build it, no one will come.

Expanding our network of off-road bike routes would be a win-win for residents, tourists and local businesses, at minimal cost to government.  There are few greater opportunities for government to do so much good for so many at so little cost.  What’s stopping it?