As someone new to peak oil quickly finds out, just about everything depends on oil and gas. One of the more startling revelations being that the entire consumer food system in most countries would collapse within a week without fossil fuels. If a shortage continued for long, nothing much would get planted, even on organic farms.
But healthcare? Let's consider it for a minute, in two very different ways. At the most extreme point of use, namely hospitals, energy is the lifeblood. If the grid electricity supply fails, diesel generators have to kick in immediately. Many hospitals have a surprisingly short supply of diesel for their generators -- though some use natural gas, which may be more robust, except in an earthquake.
All material (as opposed to maternal) deliveries and all ambulances depend completely on petroleum. How many days supply do hospitals keep of all kinds of vital devices? If they are like supermarkets, sewage stations and just about every other part of the JIT (just in time) economy, it will be about 72 hours. Just three days. Why three days? Because that's how long it takes for FEMA (the Federal Emergency Management Agency) to arrive. Try telling that to New Orleans.
However alarming these scenarios are, they are short-term issues hinging on supply interruptions. They could be ameliorated by having a larger backup supply of diesel, scalpels, syringes and so forth. Oh yes, and much larger warehouses would have to built to house all of this, not to mention more complex inventory management systems. All of this can be done, but not necessarily quickly or cheaply. Any solution will require careful planning and good execution.
So much for supply interruption issues. For the moment we'll leave aside what would happen if the whole economy got really short of oil or if the Chinese stopped making (and shipping) cheap everything, and turn to a second, much more serious aspect of the question of healthcare and oil decline.
The second issue applies most starkly to America, though it could become an issue in Europe or Canada, if those places don't take account of the dangers. (I am less familiar with other parts of the world, but am very interested to find out more.)
Here's the kind of situation I fear, and one which, thanks to the global recession now unfolding, is already starting to arrive. As an example:yYou lose or leave your job, and decide that you really want to do something that will help the world and the economy become more sustainable, for whatever reason - peak oil, climate change, guilt, love of nature, wanting a decent future for your children. Say you have an expensive graduate degree that you have only just paid off, a spouse and family, and your house now has negative equity, while you are stuck with a sky-high mortgage from the halcyon Greenspan days of borrow now, for tomorrow we die.
In other words, you have got to find some kind of work that still pays pretty well. You start looking around and you realise that if you want to become a maker of good, local furniture or become a gardener or a nurse or a science teacher, you'll have to train for years and go into more debt to pay for it all. At the end of it, you won't make a fraction of what you were earning as a software engineer, lawyer or Chief Financial Officer.
Reality begins to sink in. Something has to give. You decide to rent out your house and move into a much smaller apartment with no garden (which if you want to become a master gardener is not so wonderful), stop buying that nice local wine (not so good for the local economy), and resolve to live on rice and beans. You sell your car, join the local car share and begin to experience the joys of U.S. public transport - you learn never to leave home without a book - War & Peace, for instance.
Now you have downsized everything, given up cable television, dumped your Crackberry, use the local internet cafe for getting online, and signed up for an online course to revive your university science bachelors so that you can start to teach school children about how the world was built on cheap oil (and use Newtonian calculations to avoid the rotten tomatoes thrown at you).
However, there is one thing you dare not dump or downsize: your health insurance payments. You and your family are quite healthy, but what if your little girl really needs urgent medical help or develops one of the many new childhood afflictions that are becoming so ubiquitous? I will leave out the monstrously painful details of navigating the U.S. healthcare insurance morass. The real point is that even with so-called health insurance you never really know if you are going to be covered or whether you will find yourself saddled with six figure debts for the rest of your life. It happens every day in the United States - said to be the cause of up to half of all personal bankruptcies. In a country that calls itself civilized, private health insurance should be regarded as the number one scourge of society. National Public Radio had some poignant stories recently of children with cystic fibrosis, whose families face losing their houses or being forced to divorce in order to keep their child alive - possibly to live a long and reasonably healthy life. How can this be acceptable?
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The issue of Peak Oil is a critical one (in some respects both as critical as climate change and as complex and interconnected), but I'd like to focus this topic on health care, technology and the economy.
Understanding the best form of health care in the US is contentious, as it is elsewhere in the world. Those on one side of the issue feel that by going to a single payer model, you are opening the door to long waits, rationing of care, diminished standards, and poor staff retention rates at hospitals. On the other side are those who feel that without affordable universal health care, millions of people will be forced to go without medical coverage altogether, leading to a rise in preventable diseases and an overall decline in the quality of life for most in the country.
I'd be interested in hearing your thoughts on this, and whether there are things that information technology can do to make a better system possible.
This post has been edited by kurtcagle: 14 December 2008 - 10:05 PM