Friday, September 07, 2012

How We Live Now

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.

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