vtpeaknk started this related thread in yesterday's Drumbeat. Yet Heinberg in his discussion with Caldicott (toplinked in that Drumbeat) talked about the need to keep fuel for emergency vehicles. How that would work when the roads and bridges are a mess is beyond me.

One of the biggest policy disasters of past 70 years or so has been the defunding of public health. Tainter points out how the bulk of health improvements came from public health. Now all the money is going into private health. But public health, conceived broadly, is clean water, clean fish, clean air, everything from environment to economic injustice.

In our current economic crisis, Main Street businesses and local and state governments are crashing. They are going to take out the health care system when they go. PEBO's current response is endless money for the bankers and - to save a few billion dollars - digitizing health care records. [Not only is it unlikely to save any money, but there are all the questions about increasing complexity - bad, bad, bad idea.] Rather than bailing out all the banks, businesses and states and leaving the rotten structure in place a better idea would be to take over the disease care industry/insurance and reshape it into community based public health. We used to have something a little like that, BTW, the old Blues; they had special, community based non-profit charters. [And as such could not compete profitably in Reagan world.] We need to go well beyond the old Blue Cross model.

I'd think that moving to a public health model - with minimum "police" costs, in the terms Peter Drucker would have used - would be much better. Monitoring everything increases transaction costs and creates all sorts of barriers on class and income lines - just when we want to emphasize "we're all in this together". My biggest take-away from "Power of Community" was how Cuba (apparently) framed their "Special Period" as a public health crisis. "Penicillin not paint" was the slogan if my memory is correct.

Contrast that to US, where the public health slogan is "Guns before penicillin". NOLA. How many state EMAs are under military control? Tell me that the planned response to an epidemic is not a roadblock at the corner? That's what it is here in Maine, according to a MEMA mucky-muck I cornered on the topic. I don't call that public health.

HT for most of my thinking on this to Peter Montague of Rachel's.

cfm in Gray, ME

Excellent points Keith. Much of the food we eat is not food but food stuffs. It's prepared in a factory & shipped across the country to us. Few people actually have the skills to even cook now. Higher energy costs will force people to return to a more simple diet made by them, not made by Kraft.

I lived for 6 years without a car & during that time my health was better than it's ever been. Part of the reason was because I had to walk places, the other reason was that fast food is built around car access. No car, limited access = better health.

There are two prominent examples of health improving in the face of a declining standard of living: Denmark in World War I, and Norway in the World War II. Denmark (though neutral) was subjected to the Allied blockade of the continent. The entire country was put on a lacto-vegetarian diet. Death rates dropped by 30%. Norway, occupied by the Nazis, also saw its deaths due to circulatory diseases drop dramatically. In both cases, when the war ended, people resumed eating their normal diet and the death rate went back up.

Norway under the nazis was effectively put on an "anti-Atkins" diet: Very little fat, but enough carbohydrates. "Fat hunger" is a phenomenon known to many old people, and whatever temporary advantages you'd get from turnip steak, you'd probably lose from the craving for fatty foods you aquired when they were scarce.

A far more important factor was that tobacco was in short supply, and alcohol consumption at an all-time low. A prominent alcohol researcher in Norway has commented that today, we pay ourselves out of our alcohol problems with expensive treatment facilities and social services to take care of injuries, neglected children, traffic accidents and all the other unpleasant side-effects. A hundred years ago, that was not an affordable option, so there was a strong social movement to resist and restrict alcohol instead (Teetotalism).

I think that in the current depression/long emergency, how our societies deal with alcohol will matter a lot. Will we do as countless tribal people have done when encountering new, unpleasant realities - try to drink ourselves out of our sorrows? Or will we do as the Sami did after Læstadius, harden ourselves against destructive influences, and purge our culture of the traditions which we don't see a use for in the new reality?

Very sensible comments,Keith.Same problems here in Australia although we do have a universal health care system which is well over the limits of it's capacity.There is a parallel private system which costs.

I can't see the present system surviving intact the downsizing of the economy.That may,in fact,be a good thing as there may be more effort put into preventative measures,such as diet(more vegetarian).
The public health issues remain - clean water,clean food,clean air,protection from epidemic disease etc.
But most of the money spent on the health care system could be gradually reduced by social change and that is always difficult to do voluntarily.

I suspect that circumstances will force many changes,hopefully in the right direction.