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.

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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


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?


Third World New York?

September 14, 2012

A cyclist breaks a wheel on a potholed street in a major city near the State’s capital.

A lawyer goes to the State Library to conduct legal research, only to find that several of the treatises he consulted had not been updated for several years, rendering them virtually useless.  The other public access law library in Albany is open only three days a week.

A person living in a city, two miles from the Capitol,wants to go to downtown Albany by public transit.  She will have to walk a half mile to the nearest bus stop, and even during rush hour, she may wait up to half an hour for a bus.  It may be quicker to walk, except in the winter, when the walkways on the bridges over the railroad tracks are not cleared and become icy.

Compared to what I saw in Sweden this summer, our public sphere is definitely third world.  I  think we have a right to demand — and government has an obligation to provide — basic services of decent quality.  If it can’t, we need to find out why and correct the problem, and it may not be as simple as throwing more money at it.

Even the relatively affluent cannot escape bad roads, traffic delays and, in some cases, poor public schools.  While some of the Republicans’ ideas have some validity, I absolutely disagree with their disagreement with the Obama and Warren observations that no one’s success is due to solely to his or her own efforts.  We all benefit from public services.  Why such an affluent country puts up with such poor services is beyond me.


Bicycle path controversy

June 1, 2012

This recent story in USA Today and a recent ride on the Ashuwilticook trail in the Berkshires caused a few thoughts about bicycling to pop into my head.  As one who has ridden a bicycle regularly in urban and suburban areas for over 50 years, and as one who was hit by a car while cycling in the Albany area a few years ago (fortunately, the injuries inflicted by the hit and run driver were minimal), it is clear to me that places allowing for safe on-road cycling near where many people live are rapidly disappearing.  The future of this activity is on paths and roads that are physically separated from motorized traffic.  Many great cities outside the USA have extensive networks of such bicycle paths, which benefit society by providing means of economical, non-polluting transportation, diverting automobiles from crowded roads, and providing healthful opportunities for exercise and recreation.

What’s not to like?  Apparently, in New York City, plenty.  Drivers of autos resent any infringement on their turf, which has expanded over the years (when I lived there, I was shocked to find that autos generally were allowed on park roadways in Central and Prospect Park (OK, I get the need for crosstown access through Central Park, but not for traveling on the other park roadways).  Olmstead would spin in his grave if he could see how his park lanes are jammed with taxis and other traffic. Mayors from Koch to Bloomberg have had the uncanny knack of locating bike routes and lanes where they will tick off the most motorists.  And cyclists who ignore traffic laws to the point of terrorizing pedestrians and who engage in inappropriate demonstrations have exacerbated tension between cyclists and motorists.

Motorists need to be a little more “live and let live,” particularly in urban areas where the automotive-centered lifestyle has exacted large costs in terms of traffic jams, air pollution, depletion of resources devoted to public transit, and use of land for roads and parking lots.  An extensive network of bike lanes can improve the quality of life for residents, ease the strain on roads and transit facilities, and even attract tourists.  Montreal has done it, as have many other cities around the world.  New York should be world class in this area, too, and our region, with lots of abandoned rail lines crying out for productive re-use, should be a regional leader in developing off-road bicycle routes.  Everyone would benefit, and the monetary investment required would be relatively small but would produce large rewards.