Meanwhile, Beyond These Borders….

Earlier this month, I went to a professional conference in London.  One of my immediate observations is that while the US has been in the economic doldrums for the last few years, much of the world has dusted itself off and gotten back to work.  The presentations at the conference are about new and bigger infrastructure improvements going on in cities all over the world… except in the US.

What happened?

On the first day, one of the presenters told the story of the Docklands Light Rail, which was built to revive the disused Docklands to the east of London.  The system opened in 1987 as a two lines that ran single cars.  It was enormously successful: today there are seven lines that run 2- and 3-car trains.

Meanwhile, Detroit has been puttering about with the idea of a Woodward Avenue light rail line.  They were going to build it, and then they decided to run buses, and now construction has begun on a line expected to carry about 1 million passengers/year when it opens in 2016.  (The Docklands, in its first year, carried 17 million, and now carries five times that.)

To be sure, there’s an obvious difference: the Docklands are just east of central London, a dynamic business district that is thirsting for more space.  The Woodward Avenue line is in… Detroit.

But the Docklands story was one among many.  What are we doing wrong?

One easy answer is: Obamacare.  All across the US, employers have been cutting staff and hours in an effort to escape the law’s mandates.  Meanwhile, people all over the country are getting sticker shock over the insurance premiums they now have to pay themselves.  Not exactly a recipe for a booming economy.

But the problem is broader than that….

3 thoughts on “Meanwhile, Beyond These Borders….”

  1. Docklands Light Rail was workable because England has the population density and relative lack of dependence on cars necessary. We decided back in the 1950s to go with cars. Even in North Yorkshire, they have reliable, frequent rail and bus lines that are relatively inexpensive. The taxes that the British levy on gasoline makes mass transit the cheaper option.

    I’ve been covered by the National Health Service as part of the status of forces agreement between the US and UK. In 1996-99, a thirty day supply of any drug in the UK formulary was about $4. However, people with certain medical conditions, such as diabetes and hypothyroidism get free prescriptions. I also used the German health care system when I lived in Wiesbaden. `

    The mistake that we are making is to try to preserve the insurance industry while trying to ensure that everyone has access to health care. A single-payer system makes more sense. There is still a niche for private insurance that allows people to get elective care faster in that sort of model.

  2. We have a light rail line here — it connects 2 counties.

    The ridership on it is fairly heavy. I wish the light rail was extended to our town; there’d be less use for cars in this area.

    In this country, it is simply TOO EASY to provide meds that are needed for certain conditions, and free prescriptions at that. It’s as simple as that,

    And too much money to be made from the meds.

    1. The argument that drug companies give is that the blockbuster drugs have to pay for the research and development of drugs that don’t work out. I am not that certain that this argument is correct. Once the drugs go to generics after the patent expires, they do get cheaper to provide, despite the company’s efforts to extend the patent for making it time-released or some other small tweak.

      What makes it too easy to provide drugs and drugs for free? I’d really like to know where I can go and take advantage of this service. Please tell me. The free/low price drug dispensaries that come to mind for working-age people and their families are the military/VA/TRICARE and Medicaid, and even they require co-payments. Medicaid co-payments do vary from state to state, and often are waived for certain drugs. Medicare requires a fairly standard co-payment, and you have to be in Medicare part D to get that price, and pay those premiums. I get 90 days of both of my prescriptions for $10 each through my health care plan, so it costs about $80/year for prescriptions. I pay about $1300 a year for my employer-subsidized health insurance plan.

      Prescriptions are more expensive than they seem, if you look only at co-payments. I have a minimum of two doctor visits per year to continue on my prescriptions, plus some blood tests. These visits and tests will easily exceed my annual deductible of $300. In the best case, I pay roughly $1800/year to stay on two prescriptions.

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