By almost any measure, Palookaville and its surrounding county are pretty small potatoes. We're only 220,000; about 15 percent Hispanic, with more Native Americans than African-Americans, more Asians than either. There are some pockets of social stress: the relatively large Hmong cohort is about the same size as the minuscule African-American population. If you count the non-profit hospital as "public," then this is a "public sector" town: the top six private employers in aggregate have fewer employees than the hospital, or the university, or the pubic school system. So, a pretty stable, solvent, well-manicured environment.
All by way of background for this morning's sighting: from a bin in a food store, something called the county "Medical Directory"--an advertising promo, that is: one-line listings plus a scattering of display ads for medical services. Altogether, something like 50 pages. This is not all MDs. The alphabetic index includes, I don't know, maybe 30--maybe 50?--medical specialties, but also dentists and chiropractors, midwives, hearing aid dealers, nutritionists, opticians, optometrists, opthalmologists, all tucked in between oncologists and orthopedists. You get the idea.
And I certainly do not mean to sneer; I am the happy consumer of a variety of these services. And like (I suspect) many of the consumers, my capacity to consume is a function of Medicare in conjunction with a generous public employment package benefit. And I'd turn that point around: suppose we abolished all Medicare and public employee benefit plans from this county: how many pages of this directory would just vanish like the leaves? I expect quite a lot.
I gave some numbers above on public versus private employment: actually the largest non-public employer in Palookaville is Walmart (number five on the top-ten-employer list). The largest old fashioned "make-something" employer is the brewery. It weighs in at number six, with a work force about 14 percent the size of the workforce at the hospital. I once heard the economist Lester Thurow, explaining the concept of a gross national product, remark that "I mean we can't get rich just by all taking out each other's appendix." He hadn't seen Palookaville.
All by way of background for this morning's sighting: from a bin in a food store, something called the county "Medical Directory"--an advertising promo, that is: one-line listings plus a scattering of display ads for medical services. Altogether, something like 50 pages. This is not all MDs. The alphabetic index includes, I don't know, maybe 30--maybe 50?--medical specialties, but also dentists and chiropractors, midwives, hearing aid dealers, nutritionists, opticians, optometrists, opthalmologists, all tucked in between oncologists and orthopedists. You get the idea.
And I certainly do not mean to sneer; I am the happy consumer of a variety of these services. And like (I suspect) many of the consumers, my capacity to consume is a function of Medicare in conjunction with a generous public employment package benefit. And I'd turn that point around: suppose we abolished all Medicare and public employee benefit plans from this county: how many pages of this directory would just vanish like the leaves? I expect quite a lot.
I gave some numbers above on public versus private employment: actually the largest non-public employer in Palookaville is Walmart (number five on the top-ten-employer list). The largest old fashioned "make-something" employer is the brewery. It weighs in at number six, with a work force about 14 percent the size of the workforce at the hospital. I once heard the economist Lester Thurow, explaining the concept of a gross national product, remark that "I mean we can't get rich just by all taking out each other's appendix." He hadn't seen Palookaville.
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