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December 25 2013


Arnold Kling on the Economics of Health Care and the Crisis of Abundance

First an aside and then a longer post on an issue touched on in the podcast. The aside: Arnold Kling stated that health care costs appear to be excessive compared to health outcomes given that longevity in the United States is the same as in other countries that spend less. Longevity is not the only measure of health outcomes. Many other goods are purchased as well (e.g., time/convenience and the ability to remain active). Now the main point. I have always thought that auto mechanics are a good analogy to doctors when thinking of solutions to one of the possible sources of market failure in health care: the suppliers of the goods (the doctors and auto mechanics) effectively demand the goods (by instructing the patients/car owners as to which tests and treatments should be provided). I was glad to hear the podcast discuss this issue, but don't think it went far enough (although Russ Roberts almost came back to it at the end with a discussion of car insurance for oil changes). Russ Roberts indicated that the way he solves this problem is to find a car mechanic he really trusts. The transaction costs to that solution are fairly high, and the market has found another (and I think better) solution. The car makers have internalized the cost of repairs, and the consumer pays for that cost in the price of the car. My experience is that vehicle warranties (on both new cars and used "certified" cars and used cars purchased through the national vendors) have become much more comprehensive and extended warranties are much cheaper and more comprehensive (I used to never purchase them, but have with my last two cars). At least one car maker I know of (BMW) has even internalized the routine maintenance (oil changes) given that the failure to obtain that maintenance may cause more costly warranty claims. Perhaps the pervasiveness of third party payment systems is due to the high transaction costs of educating medical consumers or finding trustworthy doctors and providers. The internet may reduce some of those costs, but my guess is that most consumers only do the research after obtaining a diagnosis (and not research on whether or when to obtain tests and care in the absence of a diagnosis). Ultimately this analogy would suggest that HMOs (providers who both provide care and take on the insurance risk) as being the best solution to the transaction costs of finding trustworthy providers. And yet, my experience (I am an attorney who works with employers on their benefit plans, including medical plans) is that HMOs have dramatically declined in popularity (to the point that many employers do not offer them as an option). What's going on here? Is the analogy wrong? Interested in the thoughts of others on this point. http://www.econtalk.org/archives/2007/11/arnold_kling_on.html

December 15 2013


» Greyskull Academy Seminar Experience (Podcast Included)

Greyskull Academy Seminar Experience (Podcast Included) by Jason Kapnick This past weekend I had the privilege of attending Johnny Pain’s “Greyskull Academy of Combat Sciences” seminar. In just two days of “Full Immersion Learning,” I felt my level of preparedness rose exponentially for the unfortunate possibility of finding myself in an asocially violent situation. I’ve been involved in martial arts for much of my life (a lot of MMA, Brazilian Jiu Jitsu and Muay Thai, as well as some traditional Japanese Jiu Jitsu and Karate), and John’s blog posts and “Principles of Violence” e-book were real eye openers for me. The reality is that an asocial conflict differs fundamentally from social or sport violence. John’s real world experience, principle-based teaching system, and effective communication skills make him better suited to teach these methods than nearly anyone else on earth. To be clear, this is not “martial arts” in the traditional sense of that term. The Greyskull Academy of Combat Sciences deals little in codified and pre-determined techniques, but almost entirely in principles and outcome-based problem solving. Friday night began with several hours of lectures and demonstrations. We learned that “action” has an overwhelming advantage over “reaction”—the latter simply involves too many mental and physical steps to be effective. This point was driven home with multiple examples, drills, and scenarios. The idea of “action vs. reaction” becomes even more powerful when combined with knowledge of what constitutes “injury” and the spinal reflex arc. Indeed, “causing injury” was the central theme of the weekend. Among a few other criteria, an Injury causes one’s opponent to enter “spinal reflex”—predictable, involuntary physiological reactions to trauma. John taught us how causing injury lets us take full advantage of being the “action man” while a would-be attacker is helplessly reacting to our will. At the end of Friday night, all the attendees had a very clear idea of what needs to be done in an asocially violent situation (cause injury!), but we didn’t yet have the tools to do so. This is where we began Saturday morning. The day started with our first “Target Index” module. John and his assistant instructors explained three to five targets on our opponent, and some basic strikes to attack each (demonstrated from a variety of positions relative to the target). John was excellent at explaining the physiological effects of each target, and in differentiating between which targets were lethal and which non-lethal. We then broke out and practiced these techniques on our partners. Having such an in-depth knowledge of the principles of the system, the learning curve on each target was remarkably fast. Each target index module ended with 10-15 minutes of “problem solving” where we applied our knowledge to unstructured scenarios performed as close to live speed as we were safely able. The mantra “slow is smooth, smooth is fast” was repeated over and over again. With each target assembly module, John began layering in more and more concepts and techniques. Perhaps counter-intuitively, the more we learned, the simpler our problem solving sessions became. While our initial sessions were awkward and inefficient as we struggled to achieve our outcome with so few tools, each tool we got made us increasingly able to achieve our outcome (cause injury!). This is an important point, and herein truly lies the advantage of starting with principles rather than techniques. For most of my martial arts career, learning more techniques meant greater complexity, as each new technique expanded the amount of options I had to decide between. By contrast, at Greyskull ACS, we were “outcome focused” and learning a new strike or target fit immediately within the principle-based framework we had already established. Using this framework, we were able to impute techniques we had not even been specifically taught. For example, early in the day Saturday, John taught us the proper method for using the elbow against the solar plexus target. Later in the day, during one of my problem solving sessions, I found myself using a very similar strike to the thyroid cartilage target. Though I had not specifically learned an “elbow to the thyroid cartilage” coordination set, I was intimately familiar with how to strike effectively and with the spinal reflex arc of the thyroid cartilage target, and was thus easily able to perform the technique. By the end of the day Saturday, the problems solving looked remarkably different than it had in the morning. We were striking efficiently and moving smoothly as we problem-solved through different angles of attack, different starting positions, facing armed attackers, and more. After some awesome steaks John cooked for us Saturday evening, we returned to the academy Sunday morning eager to learn. We began with another target index lesson. By this point, the modules had become increasingly more complex – incorporating elements of footwork, striking targets that we couldn’t directly see, and the basics of joint-breaking. We continued to systematically install one skill set after another, since each skill simply built on what we had already learned. Even compared to the night before, problem solve sessions at this point were remarkably easy, despite the scenarios continuing to escalate in complexity. My seminar was cut a bit short on Sunday due to inclement weather, but I still came away with an incredibly deep understanding of John’s powerful system, and the knowledge that I am now vastly more prepared for any situation I might encounter in real life. John is a truly incredible teacher. He is patient with his students, and seems to know exactly what to say in order to help us form the proper mental framework to apply the materials. Those that have not had the opportunity to learn from John in person are absolutely missing out. I cannot recommend The Greyskull Academy of Combat Sciences highly enough. I hope you enjoyed Jason’s review of this past weekend’s event. It went exceptionally well, with both standard attendees, and instructor development program students in attendance. Check out the podcast below which features three of the attendees discussing the event. -JP Also, if you haven’t yet, pick up your copy of my book “Principles of Violence” to receive a full introduction to the principles and material taught at the live events. Click on the image below to visit the store and snag your copy. http://strengthvillain.com/podcast/seminarpodcast.mp3VillainSix Seminar Podcast. Right Click to Download Related posts:My Greyskull ACS Principles of Violence Course Experience Greyskull Academy of Combat Sciences Three-Day Seminar Overview Mental Preparedness for Self Defense- Podcast Episode 5 Included 01-13 Class Seminar Weekend Recap http://www.strengthvillain.com/?p=2170
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