We’re All Living in Youngstown Now

39 thoughts on “We’re All Living in Youngstown Now”

  1. “I noticed the government didn’t let “the market” sort itself out when it sent trillions to big companies to artificially prop them up.”
    And , Johnny, we have done this repeatedly over the last 50 years. We also have the Affordable Care Act to prop up insurance companies.
    I keep thinking of a line from Gil Scott Heron, “No matter how far wrong you’ve gone, you can always turn around.”
    In medical treatment we have to decide whether having people healthy is the goal or making as much “shareholder value” as possible. The “shareholder value” is getting priority.
    I am convinced that the nostalgia for the good times of the 1950s and 60s, is mostly about the fact that the USA dominated the world economically because of the destruction of WWII. Most people in the USA could afford doctors visits because there was all that wealth, here, from the rest of the world. When that began to fade, in the late 60s, there was a struggle over the remainders. So more profit can be made importing products and services and reselling them. Then you do not have to deal directly with pesky employees that actually expect to get paid and want vacations and so on.
    What almost no one talks about is, what quality of medical treatment are we getting? My observations will be dismissed as anecdotal, however most of my encounters with doctors, labs, clinics, and so on have been poor. Frequently diagnosis is done by checklists. High blood pressure? Diabetes? Trouble breathing? Everyone I have ever met goes through the same.
    The medical people can do quite well with traumatic injuries such as broken bones, severe cuts, or burns, but let’s see a show of hands if you have ever had a medical person ask about what foods you eat? Sure they will tell you to lose weight, but perhaps keep a food diary and give up certain things to see if there is improvement. Probably not.
    So before we worry about how much we are spending on medical treatment and how many people can be eliminated from the current system to streamline it and make it more efficient, we need to think about what the object is.
    Currently people get run through the checklist and cookie cutter tests with mediocre results.
    And the constant focus is on the reimbursement schedule from the medical insurance companies . Not much “health care” going on.

  2. Here in France, a few doctors usually team up, hire a secretary, and turn a large apartment into an ad-hoc office. It costs me €25 to see one (social security covers part of that, and you can have insurance to cover another part of it if you want). They don’t look like they’re struggling for money.

    Pharmacies look like small local shops, with two or three pharmacists working inside. All the labs I’ve been to look like labs, small commercial places purposefully built (or remodeled) on the ground level of a building, but they’re similarly small-ish affairs.

    It’s kind of mind-boggling to see that the very expensive, complicated systems in place in the US also seem to not work for the doctors, or at least not as well as it should.

  3. And for those of us in white collar professions who are still employed, big data and automation have made our jobs relentlessly tedious. When I was a kid, a family doctor knew all his patients and made house calls. Now a physician’s job has been reduced to reviewing and signing off medical reports. My job as a contracted writer has lately become all about feeding Google’s giant maw. In-depth research? Creativity? Innovation? Forget about it. Just stuff keywords and repeat what everyone else is writing. I’m glad to be almost at the end of my employment years.

    1. I think white collar workers have been getting the treatment for some while now. Which has often manifested as deskilling, or as it used to be called: Taylorism. While piling on administrative duties that used to be done by others. Not to mention guest worker visa abuse (think H-1B et al) to import cheaper labor, or just offshoring it instead.

      When I saw what happened to blue collar workers starting in the 1970’s I worried. Because the loss was so much more than assembly line jobs, but an entire design, supply, manufacturing ecosystem and knowledge base. So entire industries effectively disappeared. No surprise then that the same extractive tactics being applied to white collar and professional types have similar results. In the 1980’s I wondered about that eventually happening, but those further up the job ladder assumed they were safe. But I suspected otherwise.

      1. Friends here in San Francisco are telling me about massive restructurings that have accelerated in the last few months along with Covid-19. Whole divisions of tech workers are being let go and immediately replaced by cheaper equivalents in Chennai and Bangalore. This process has been going on for years, but it has swung into hyperdrive recently. The H-1B visas aren’t needed anymore since India’s tech sector can absorb the work previously done by Americans in the same way China and Mexico industrialized enough to displace American blue collar jobs. I’m happy to see other countries raise up their populations and standards of living. But this doesn’t end well for the US…

  4. By the way, I just had my twice a year checkup with the VA. Smartphone video call, took like 5 mins. “Hey, is everything ok?” “Yea I feel fine.” “Ok cool, you don’t need any tests, call us if you have any problems.”
    I’m assuming they save a lot of unnecessary expenses that way.

  5. I think the old Depression era song telling about building a railroad and making it run against time followed begging for a dime sort of captures it. We recovered from that disaster by building a unionized industrial base, but union busting, outsourcing and automation eliminated that. We make as much steel as ever in the US, but a big steel plant might have a few hundred, not thousands, of employees. We’re getting there with our internet and medical infrastructure, but it will be harder to come with a good set of lyrics about building a social network or e-commerce site and then begging for a fiver.

    The problem is any system that optimizes production is going to centralize and, more seriously, fire people. The government winds up having to get involved lest demand collapse completely. Whether it is free land, labor laws or handouts, we’re going to need something.

  6. My sister is an x-ray tech. You could probably teach anyone the basics of the actual job in an hour (or so it seems), but they draw it out into a 2 year+ program, complete with requirements for calculus, phyics, etc. The bloated health care system is hand in glove with the higher education racket.

    As for whether tech is the savior or villian here, I would say both. As a software engineer, I would say be careful what you wish for when replacing humans with software. The user experience may get better but the investors will scoop up any immediate savings and then use the data to get even more pounds of flesh from us, as the underlying incentives and payment mechanisms haven’t changed.

      1. Watch the “30 Million Line Problem” on YouTube (“how to prevent the collapse of civilization” is also good). Casey will correspond with you if you want. He said the problem has gotten worse since he made the video. Apparently, though BigChipMegacorps like his idea, “shareholder value” prevents them from acting on it. We have to destroy value to save it, you see.

        I’m going to miss the medical care the most. My boys are constantly breaking their bones.

    1. As a person who survived thyroid cancer caused by who knows what, I am happy X-ray technicians must spend two years learning their skill. 🙂

      1. That is a seriously flawed comment. You assume that a person who was trained for 6 months would be worse than someone who schooled for 2 years? The 6 month student would be immersed in on the job real world study while the 2 year student would have a whole lot of BS thrown in that has nothing to do with the job. The 6 month student could start a new job right away with minimal on the job training while the employer of the 2yr student needs to supplement most of the same job training that the 6 month student already got. Higher Education is a scam.

  7. Mike Rowe is right. If I was to counsel an 18 year old, I’d say start by learning to pull Romex through 2×4’s. For the girls – there’s always Camming.

  8. Who would make such plans for how to deal with it? The government? AOC? If so you’ve more faith in their abilities than I. In fact, you could argue that a lot of government policy just acted to hammer the US auto industry (two fleet rule for example).

    Around 1900 almost 40% of Americans worked in agriculture whereas today it is a fraction of that number, yet we don’t fret about those job losses and likely never did.

    Note also that US manufacturing has never stopped. American manufacturing output was at or near record highs before the pandemic, but it is highly automated, and much of it moved away from the upper midwest.

    The trick is to have an environment where new enterprise is not discouraged as someone might figure out a way to do something with the newly available people. An obvious, but apparently politically unpopular example is Uber. The best plan might be not to plan. Certainly you don’t want planning in the hands of those who want to plan.

    1. There’s theory.

      “The market will solve all our problems if it’s allowed to flourish.”

      And

      “The government is the problem, not the solution.”

      I noticed the government didn’t let “the market” sort itself out when it sent trillions to big companies to artificially prop them up.

      And when a third of the population is unemployed with no prospects for how to move forward (in an election year) there were more trillions.

      There is no free market – not even from the people who say they want one. So we proceed as we may into uncharted waters.

      1. You’ll find that most people who put more faith in the market than government are not believers in subsidizing industries. However, businesses do lobby for it and the politicians extract their own manner of benefit for providing such largess. To the extent that industries can convince politicians to hobble their competitors they will do so. You’ll also be hardpressed to find a politician who doesn’t think that picking winners and losers isn’t part of their job description (and the winners can pay well for being so favored).

        There are many markets, some freer than others, so it is erroneous to say there is no free market. It is easy to stop someone from building a building or opening a storefront business or from logging, mining, fracking, etc. Those markets certainly are not truly free. However, it is very hard to stop someone from creating a new software application that might become the foundation for a substantial business. The principal driver of employment growth the past few decades has been new businesses, which while by the nature of being young means they were small businesses relatively recently, they did not stay small. Few, if any, of these new firms came about because of planning.

        1. We’re having a philosophical conversation about abstract ideals. I agree with much of what you say. But there’s external reality… I see people from all sides gathering up their pitchforks and fire brands because they aren’t in a position to create new software and reinvent themselves. Violent protests are another form of free market…

          1. Social entropy, pitchforks and revolutions go hand in hand while war is a looming predator. You can’t tackle the information wave with second wave instruments and mentality.

          2. “…Violent protests are another form of free market…”

            Best comment. I like very much you’re way of thinking.

            To add not that I’m saying that should be the first response but that people who abstractly look at all things sometimes don’t get this.

  9. Good post. I appreciate the specific details – they drive the point home.

    Higher education is another sector that has been getting larger and more expensive for years; Covid appears to be forcing something of a reckoning there but I don’t know what will happen. Presumably some colleges will close permanently, some online institutions will grow, and maybe other colleges will shed administrators and sell off buildings – but who knows.

    I hear law is experiencing some of this too – why pay a law clerk to search documents when an algorithm can do a tolerable job?

    1. My brother-in-law is a tenured professor in Boston. There’s an ongoing shake out at the moment and no one knows how it will end. I have friends who work at Berkeley and others who retired just moments before things went pear shaped.

      Universities (in my opinion) will split into two camps. A small number of fancy schools will survive as luxury brands. Families who can afford them will send their kids to these places to rub shoulders with similar types.

      On the other end of the spectrum lots of budget trade schools will emerge tailored to train people of all ages in useful employable skills.

      The fair-to-middling small liberal arts schools will fail and be converted to old folks homes and such.

      1. I hadn’t thought of retirement homes as a conversion option. Given the Covid death toll at existing facilities, and the financial unsustainability of that sector even before the virus, I doubt they are going to need many new facilities.

        Dorms are easy to turn into hotels or apartments (or detention facilities, as you have speculated), but I wonder about the specialized buildings – cafeterias, labs, sports facilities, etc. Hopefully they find some adaptive reuse but after reading How Buildings Learn, I have to bet some will be uneconomic to either repurpose or demolish for quite some time.

        Between the internet and Covid, “meds, beds, and eds” is not looking like such a great strategy right now.

        1. There are nursing homes for the elderly – “God’s waiting room” as a friend once called them. And then there are places for the relatively young-ish old to live comfortably on a tight budget. College dorms would work just fine for many of them, especially since a serious percentage of near retirement age Americans have zip saved for their golden years.

          No one in 1958 would have imagined old factories and industrial warehouses becoming luxury loft condos for hedge funders. And no one in 1894 would have imagined their quaint New England fishing village becoming an artist colony and vacation spot. Who knows what may happen?

      2. Wasn’t that a plot line in Oryx & Crake, by Atwood? The smart guy goes to the good university, and the less smart kid goes to the shameful one. Good book.

      3. The way I see it, schools are 1 part education, 2 parts babysitting. That’s from pre-school to college graduation. There may reason for existence is that we need their parents in the workforce. I don’t think College will change until something else can fill that void… maybe military service or some sort of civilian jobs corps. There’s just the fundamental problem that – if given the choice – most families don’t want 18-23 years old hanging around.

        One other observation from the last month or so… one huge factor that keeps suburbs “safe” is that 1) they sweep all the indiscretions under the carpet between 0 & 18 then 2) ship everyone off to college until they’re 22-25 years old. A little longer for the less mature. Poor neighborhoods are stuck with them for the whole mischievous decade of the late teens & early 20s.

    2. That reckoning in “higher ed” has been going on for the past decade. Many of the smaller private lib arts schools have been struggling with whether to continue, some have closed down or subsumed themselves into other universities:

      https://www.educationdive.com/news/how-many-colleges-and-universities-have-closed-since-2016/539379/

      The mid-level colleges and universities have been facing shrinking enrollments themselves. Part of this is demographics, but much of it is an awareness that further education no longer does what it’s supposed to do – in any sense of the word. The resulting concentration is hitting all but the largest universities and those that act as finishing schools for the elite classes.

      And as for the larger institutions – I look at all the new residential towers being built in East Lansing and can’t help but wonder whether East Lansing is trying to adapt to a post-Student Ghetto future. Especially when you see stuff like this:

      https://www.newmanlofts.com/

      1. About a mile from where I live……

        “…Orange Coast College is the first and only community college in Southern California offering on campus student housing. “The Harbour at Coast” offers a little more than 800 bed spaces in fully-furnished, apartment style-living…..”

        Did you say COMMUNITY COLLEGE? Whoever heard of on-campus housing for a community college? Community colleges certainly have their role, but my Dad, a high school teacher, commented several decades ago: “Junior colleges are high schools with ashtrays.” Slated to open Fall 2020 (excerpt above is from Nov. 2019). Rode my bike past a few weeks ago. Couldn’t help but think: “Bad timing, with our tax dollars.”

        https://www.architectmagazine.com/project-gallery/orange-coast-college-the-harbour-student-housing

        1. Just checked out the link and the site on Google Earth. $90M. Ouch. Then again, all those apartments will find ready renters in Costa Mesa one way or another.

        2. My local community college used to have on campus housing. We’re in a rural county, and students from even further out in the back of beyond faced serious commutes. As a bonus, it was easier to get a part time job to help pay expenses in the “big city” such as it is as. The school expanded and the dorms were torn down. For a while, it was still pretty easy to find a house to share with other students. Then came AirBnB.

      2. State universities and colleges are largely funded by the states and to a partial degree by the feds. As state budgets have become more and more oriented to other spending items (an old cynic might say towards a growing an ever more bloated bureaucracy and generous pensions) the colleges have been receiving less. CA spent about 18% of its budget on education in the ’70s but that is down to 12% today. Funding per student has also fallen (though it has increased for junior college students). Add to that more administrative bloat at state universities and you’ve got big budget increases over 50 years ago and less subsidy from the state. The gap is being filled tuition increases and international students.

        https://www.ppic.org/publication/higher-education-funding-in-california/

        As you note, schools are also facing a bit of a baby bust, the severity of which does vary from region to region, but there are fewer college age students coming down the pike. In response colleges have placed more emphasis on adults and international students who pay full freight.

        We can debate whether the quality of a college education has decreased until the cows come home, but the issue is not whether the students gain intellectually from their education but whether it is worth the cost to them and their families and years of debt service that will delay many things such as owning a home, starting a family, travel, parents’ retirment, etc.

        As observed, many small private colleges that might be as expensive as Harvard have closed or soon will (notably some historically black colleges are closing) and likely public universities will sooner or later have to dust off their 1970 budgets and try to bring their staffing levels relative to student populations back into line with what it was back then. The howls will be piercing.

        In the meantime junior college vocation programs may well become more and more popular (I look back on my two years at a JC fondly) as they can lead right to employment. Nothing stops a JC grad from continuing to learn other subjects from books or online. It’s not the deal we boomers got, but huge debts should be avoided unless you’re really convinced you’ll gain the employment that will let you pay them while still living a life.

        1. People cherry pick which institutions and populations they think are bloated and counterproductive. University administrations? Sure. Firefighter and police unions? Yep. Corporate C suites? Absolutely. Environmental non profits? Yes. Everyone and everything in D.C.? Come on. So let’s just admit that society runs in cycles where things build up and escalate incrementally until all levels of the culture are saturated and brittle. We’re due for a major crisis. (No, Covid-19 isn’t the really big crisis. It’s just part of the warm up.) And when it arrives all the old featherbeds get swept away and the system resets. After sixty or seventy years the new systems become sclerotic and dysfunctional too and the cycle repeats again.

        2. “State” colleges and universities here in B1G Ten country don’t get anything close to a majority of their funding from their respective states. In my state, I think both have dropped below 20%. Much of it tends to be for new labs, hospitals, and STEM buildings.

          That’s why they are more and more dependent on out-of-state and international students, but COVID-19 has put the short term hurt on them. And 45’s anti-immigration rhetoric and policies keep international students out.

        3. I’d like to submit prisons as where the higher ed. budgets went. The graph of higher ed. spending vs. prison spending at the state level is just an X. As prison spending goes up, higher ed spending goes down.

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