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Strategies & Market Trends : John Pitera's Market Laboratory -- Ignore unavailable to you. Want to Upgrade?

To: Libbyt who wrote (15031)	11/4/2013 11:11:47 AM
From: tosa	Respond to of 33421

I lived in Japan for a few years in the 90s and saw the money wasted building bridges and highways to remote stretches of land. Japan is a collective and consensus is necessary which means difficult decisions do not get made. The US, for very different reasons, refused to make the difficult decisions and instead rewarded the entities that failed us. Adding debt without addressing the structural problems will indeed keep us turning Japanese. I too worry about our service economy becoming increasingly automated. What can't a robot do? Even the education field will be losing jobs as colleges turn to mega online classes. I do hope you are correct regarding the breakthroughs in medicine, but do have my doubts, at least in certain fields. For instance most of the research to "cure" type 1 diabetes involves encapsulating islet cells in a pouch that will allow nutrients to pass through but at the same time protect them from the body's autoimmune system attacking the cells. So far these fall in the 10 years away category that never arrive. The other main initiative in the area is the "artificial pancreas" which is just an insulin pump worn on a belt with glucagon controlled by algorithms. Indeed such a system would provide a huge benefit to type 1 diabetics but it is not a cure. Of course new research will begin in those 20 years but at this point in time, while progress has been made, there is little that points to an actual cure. On the other hand, a research neurologist I know did tell me within the last year that after some encouraging research results, he now thinks there will be a cure for MS within his lifetime whereas before he did not.

To: Libbyt who wrote (15031)	11/4/2013 3:25:21 PM
From: ajtj99	Respond to of 33421

Libbyt, when mentioning the diseases we should eradicate in 20-years, I was speaking to the U.S. system. As for Polio, I'm very aware of the difficulties in dealing with this easily preventable disease. My dad has been involved with Rotary International for decades, and they have worked very hard in this area. The Bill and Melinda Gates Foundation has also been tireless in getting the folks in the Indian subcontinent to vaccinate. The problem in Nigeria with vaccination is the Muslims do not trust the westerners who are promoting these programs, and the sectarian violence does not help the issue. As for the ACA, I think this is going to end up as a transitioning system that eventually leads to some type of single payer system, possibly with minor deductibles so people have some skin in the system and outcome. The positive aspect of the ACA is people are actually becoming aware of the cost of health care and the variances in the system. This should drive efficiency, as people with high deductible policies or no insurance will actively seek out low cost, efficient providers. I agree that the paperwork is relentless and wasteful, probably to the tune of 15% of total health care costs. Eventually, a better system will emerge. It has to. As for the family practitioners, there are an awful lot of PA's who can do many of their tasks. Furthermore, places like CVS and Walgreens are setting up clinics to perform minor procedures, cutting visits to primary care physicians. The system must change, and it will change. I think the majority of change will be market driven rather than government driven. Low cost clinic competition for hospitals would be a big way to drive down costs, but the hospital lobby is so strong and entrenched that it is nearly suicidal to try. However, I think someone with deep pockets will eventually attempt it. We'll see.