Wierd...

An email came in today, through the probligo’s letterbox, from a person calling herself “Estelle Schumann”. I have no idea of who this virtual person might be, but the email was a request that I allow her to write a piece on education to this noble establishment; “a blog post which discusses educational reform, learning theory, and its intersection with the state of standardized testing today could be of some potential value to your readers.”

The attraction for the request was apparently, this post from a long time ago..

Don’t bother going read it, unless you really want to; it centres on a post from another blog and relating to the Iraq war and the blind rantings of a simple American mind who was led to a belief that everything America wants and does is right.

I suspect, and I am not going to try and confirm the suspicion, that the writer of the email has exactly the same motivations in writing to me. Ah… yeah, right!! I suspect that anything he/she/it might leave on my site would be very educational for those coming behind.

The second grin comes from the postscript –

"We only truly learn when the future has become history; when we're leaping forward, turning mistakes into achievements." ~Anonymous

Since when has America ever learnt from their mistakes? When has any aggressor nation ever learnt from their mistakes?

One thing certain, this old guy is not falling for it.

On the economics of the caring society...

This past week saw the release of the government's Budget Policy Statement; this is the first step toward the Budget for 2011 and sets out "where we are at present" and "things the government wants to do". That the statement carried "bad news" is not an understatement. A deficit was forecast for the current year. The bad news is that it is in fact considerably more then forecast, and greatly more than the previous years' actual deficit. Brian Gaynor has a summary here which gives a reasonable run-down of the salient points.

Finance Minister Bill English announced on Tuesday that the Crown's operating deficit before gains and losses (obegal) is now forecast to be $11.1 billion, or 5.5 per cent of gross domestic product, for the June 2011 year. This compares with the previous deficit forecast of $8.6 billion or 4.2 per cent of GDP.

The 5.5 per cent of GDP deficit compares with a similar deficit of 6.1 per cent for the 30 OECD countries but a number of points are worth noting:

New Zealand's projected deficit is not too far off the four "pigs", which are forecast to have the following budget deficits to GDP next year: Portugal 5.0 per cent, Ireland 9.5 per cent, Spain 6.3 per cent and Greece 7.6 per cent.

As he points out, things have not been that bad...

New Zealand had a great record throughout most of the 1990s and 2000s with 15 consecutive budget surpluses between 1993 and last year. Norway was the only OECD nation to have a better performance over the same period.

But as the saying goes, all good things must (will) come to an end. And so it is.

Gaynor lists the causes of "the end" thus -

The Crown's fiscal position has deteriorated since 2008 because of a number of initiatives including KiwiSaver, Working for Families, the indexation of benefit and this year's income tax cuts.

There have also been a number of one-off items, including the Canterbury earthquake and the leaky homes scheme, while tax revenue growth has slowed because of the weaker economy.

There are essentially two elements that give rise to the deterioration of NZ's financial position over the next 40 years. They parallel the difficulties being experienced in the PIGS economies; the increasing cost of age pensions and health care. There is a common factor in the two; the "aging population". Gaynor again -

The Treasury's long-term Crown revenue and expenditure figures are based on a number of assumptions, the most important of which are population demographics. Its main assumptions are:

The total number of individuals aged 65 and over will rise from 549,900 this year to 1.3483 million in 2050. As a percentage of the population, this age group will increase from 12.6 per cent to 24.5 per cent over the same period.

The number of individuals aged 90 and over will go from just 22,400 this year to 155,100 in 2050. This age group is expected to represent 2.8 per cent of the country's population in 2050 compared with 0.5 per cent at present.

Yep, include the ol' probligo in that demographic for sure.

The first expenditure line, which is New Zealand Superannuation, demonstrates the dramatic impact of the ageing population on Crown finances. NZ Superannuation is projected to cost $71.1 billion in 2050 compared with just $8.3 billion last year.

Most retirees claim that they are entitled to full Government superannuation because they paid taxes throughout their working lives but the big question is whether the country can afford this.

There will have to be a dramatic increase in the country's economic performance, and the Crown's taxation revenue, if the current superannuation scheme is to be maintained for all those aged 65 and over.

The next major expenditure item is health, which is projected to blow out from just $13.1 billion last year to a massive $95.1 billion in 2050.

...

The basic problem is that total government expenditure on superannuation and health is projected to escalate from just $21.4 billion last year to $166.2 billion in 2050, yet the working age population - those in the 25 to 64 age group - will only increase from 2.268 million to a projected 2.612 million over the same period.

In other words, each working person will have to pay annual tax of $63,600 in 2050 just to pay for superannuation and health, compared with tax of only $9400 this year to pay for the same two items.

And that is where I drop out of the demographic. It is not as if this is a "new" problem. It was foreseen when I first started work; it was the number one reason why I started contributing to personal superannuation savings almost immediately. But let's leave that debate there because there are some very sore points within.

It is at that point that dear old Garth George chips in. Now, to explain, George is one of those media commentators who would fit very nicely with the lifestyle and attitudes of the likes of TF Stern. Not that I expect TF will pass this way, let alone comment. Unlike TF, George is a sad, angry, and probably (I am guessing) lonely old codger.

Garth George picks up on that last (quite true) comment from Gaynor and uses it to beat his anti-abortion drum.

However, when it comes to the argument that the major problem with national super is the population increase in the number of people aged 65 and older, I want to vomit.

I wonder if it occurs to any of these doomsayers - invariably comfortably well-off folk in middle age and younger - that between April 24, 1974, and the end of last year, more than 409,000 potential New Zealanders have been slaughtered in the womb by state-paid abortionists - at the cost of tens of millions of taxpayer dollars.

I do not need to quote any further from his tirade.

I wonder if it has occurred to George that if those 409,000 "potential New Zealanders" were alive in 20 years time (when the last of them might have been starting work) there would likely be 200,000 more in the unemployment lines; 60,000 on permanent benefits as permanently hospitalised adults, or enjoying the free board and lodging of HMTK (I doubt that ER will be still going in 30 years...); the rest having departed for greener pastures in Australia and further afield.

To make matters worse, he completely ignores the fact that adding 400,000 to the total population used for the Treasury numbers (quoted by Gaynor) reduces the taxation load from $63K to $55K. That assumes that all of those 400,000 people will be in full employment; an unlikely prospect.

As I said, Garth George is a sad, angry old man. He is also well past his use-by date.

On economic growth...

With the G20 or whatever the most recent international economic talk-fest is being called in Toronto this past few days - along with the obligatory silly-shirt day - thoughts are filtering through the ol probligo's neurones carrying tags like "growth", "recession" and the like.

And I keep coming back to the same brick wall.

How can there be continuing "economic growth"? What is the basis for the measure of "economic growth"?

NZ has a record of our economy growing at an annual rate of 1.8%. Over the same period, China's economy has grown at a rate of some 9.5% p.a. I have to presume that these measures exclude the impact of inflation, currency changes, and the other "influences" that impact upon monetary measures.

Y'see, if the NZ economy has "grown" by 1.8%, does this mean we have spent and consumed that much more (very likely) or produced and made that much more (less likely).

Underlying that question is an even more fundamental bother. Is there a limit to the true value of the global economy. If there is, then the fight to increase "growth" has to be considered as a change in balance; more to one meaning less to another.

The immediate suspicion is that is only part of the answer. It is as likely that the limits are in the measurement of "wealth" and "total resource".

Thoughts?

On taking quotations out of context -

How many times have these words of Adam Smith been quoted in support of the neo-capitilist ideals of disaffected Americans -

"It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity but to their self-love."

Me old mates at ALD tagged a commentary at New Statesman that picks up this point and correctly places it in the context of his earlier "The Theory of Moral Sentiments".

Read the article for the detail. I recommend it.

What does deserve quotation is another (equally out of context) relating to the "political economy" from Adam Smith -

..."first, to provide a plentiful revenue or subsistence for the people, or more properly to enable them to provide such a revenue or subsistence for themselves; and second, to supply the state or commonwealth with a revenue sufficient for the public services".

Next thing will be members of the American right quoting the likes of Karl Marx's economic theories in support of their neo-neo-capitalism. The driver behind such a move might well come from this thoughtful article from Der Spiegel -

Greece is only the beginning. The world's leading economies have long lived beyond their means, and the financial crisis caused government debt to swell dramatically. Now the bill is coming due, but not all countries will be able to pay it.
...
A Huge Bubble

The world was saved, temporarily at least, but since then it has accumulated more debt than ever before in peacetime. The national deficits of the 30 members of the Organization for Economic Cooperation and Development (OECD) have grown almost sevenfold since 2007, to about $3.4 trillion today. Their total debt burden has also grown dramatically, to a record-setting $43 trillion. In the euro zone, national deficits have even grown 12-fold in the same time period, with the euro-zone countries accumulating $7.7 trillion in debt.

The current government debt bubble is the last of all possible bubbles. Either governments manage to slowly let out the air, or the bubble will burst. If that happens, the world will truly be on the brink of disaster.

When Greece faces a possible bankruptcy, the euro-zone countries and the IMF come to its aid. But what happens if the entire euro group bites off more than it can chew? What if the United States can no longer service its debt because, say, China is no longer willing to buy American treasury bonds? And what if Japan, which is running into more and more problems, falters in its attempts to pay for its now-chronic deficits?

The conditions that prevail in Greece exist in many countries, which is why governments around the world are paying such close attention to how -- and if -- the Europeans gain control over the crisis.

Now that is frighteningly close to some of the ol' probligo's worst fears. Galahs like MK should, but won't, listen.

Time to go play Gorillaz...

On the state of health - 1

There was an interesting comment over at TF's place stating (and I can't for the moment think of a reasonable response to it) that the Federal government "has no place in providing health services". As should be well known to readers here, that is certainly not the case in NZ. Mind you, the commenter did continue to say that it was a State responsibility, and that perhaps is the reason why I am at a bit of a loss about it.

There is one very direct parallel between NZ and the US though, and it centres on the role of the private system and medical insurance providers.

To that end there was a very interesting and somewhat blood-chilling little article in SST this week...

RISING HEALTHCARE costs have reached crisis point, pushing families to give up their health insurance and fall back onto the straining state system, says Ian McPherson, chief executive of Southern Cross Medical Care Society.

The not-for-profit insurer saw claims rise by $61 million in the year to June and McPherson said factors behind the claims blowout included the amount private surgeons earned and costly new medical technologies with little or no proven clinical benefit.

For the time being, my salary package includes medical insurance through Southern Cross at a cost of something like $35 per week. That looks like increasing by a bit in the near future.

"How much will people be able to continue to pay and not object?" McPherson asked.

"We have seen a significant downgrading from policies that are far more general to policies covering the extreme emergencies. It is difficult for people to downgrade any more. There is a significant number sitting on the bottom rung and about to jump off into the public system again."

Exactly.

Rising costs for Southern Cross could also feed the already rapid rise in the state's healthcare bill. Consultant Paul Winton, author of a report in August – Health, New Zealand's untreated addiction – said current trends suggested healthcare costs could grow from 20% of core government spending to 40% in 15 years.

McPherson said Southern Cross had begun engaging with GPs on the premium-affordability crisis, and the subtext is clear – the insurer wants to see GPs direct patients away from the more expensive private surgeons.

"We are not going to tell GPs who to refer their patients to," McPherson said, but "we would like GPs to be mindful about the cost rather than referring out of habit. Giving them an incentive to help manage our budgets is something we are exploring with them now."

Southern Cross has been developing a network of affiliated providers, but McPherson said as yet it would be a step too far to require their use in the same way a car insurer would require a claimant to go to an approved panelbeater.

Now there is little wrong with the Southern Cross response to the problem so far as I am concerned.

The truth of the matter is though that McPherson's prognosis in the opening paras is only too true. Even given the present premium levels there is little chance that I will be able to afford the present cover into my retirement. There is no question that I will become increasingly reliant upon the public health service. Not that I have any problem with that, as it has certainly been "good value" for me.

McPherson said there were instances where it appeared that profit motive and not clinical outcomes were driving that price upwards.

He cited the example of robot-assisted prostatectomy surgery which costs $30,000 compared to the $15,000-$20,000 of conventional surgery, without evidence of faster recovery or better clinical outcomes.

Southern Cross's reaction in this case was to pay only a "contribution" to the cost of the robot-assisted surgery.

Why were surgeons using it? "Because it is fun. Because it is interesting. Because you can get a margin on your investment."

Hmmm, sounds a bit like "boys toys" no?

Let's set the parameters here.

First, medicine is about curing diseases, mending injuries, and providing palliative care for the dying.

Second, it is a very highly skilled and for most a stressful occupation. (I am basing that on the comments made to me by the three medical doctors in the club I belong to). People who fit those parameters in any field deserve to earn more than those of us who cruise below the radar doing little more than subsist. There is also, as any capitalist will tell you, the need and justification for recovering a return on capital invested; let's face it, I will tell you that as an accountant.

Terry Moore, president of the Private Surgical Hospitals Association, said: "We are conscious of the increases in costs which ultimately, if left unchecked will mean fewer people will be able to afford to go private themselves."

Moore said uncontestable clinical proof of new technologies could take years to emerge, but acknowledged they were stoking cost escalation along with wages and surgeons' fees.

McPherson also hit out at fees in his annual report to members last month. "We hear the argument that [surgeons] are part of a globalised workforce; we point out that if their prices increase to reflect overseas rates, fewer New Zealanders will be able to afford private surgical services."

Boscawen [right wing MP] is of similar mind, arguing that the globalised workforce is more of a westernised workforce, because the wages earned by quality doctors from India, for example, where cataract surgery is cheap, are having no effect on the fees charged by private surgeons here.

Moore countered: "Surgeons are generally independent practitioners and contractors so they pretty much set their own fees in a competitive market, but I don't think the fees have gone up much more than the medical inflation rate. They have become more efficient so they are probably earning more, but probably working harder for it and doing more procedures."

He said rising premium costs for health insurers were also driven by the sheer number of procedures being done, not just the cost of each one.

All true, well I have difficulty disagreeing with most of it so it must be. No confirmation bias here!

But there are some interesting contradictions. For example, the hospitals (Moore, above) are trying to argue that "economies of scale" ideas do not apply; "rising premium costs for health insurers were also driven by the sheer number of procedures being done, not just the cost of each one." I would have thought that (as my wife found out when she had cataracts removed from one eye) being able to "mass produce/production line" operations would lead to some savings. If it costs the insurer $4M to provide 1100 cataract operations then does increasing the number by 20% mean a 50% increase in cost? It does if "industry" is currently running at or above capacity.

There is a secondary impact too, coming out of the combination of developing technology (and that is everything including drugs and personal skills) together with societal expectations. The best indicator I can give for this effect I wrote on some while back (2006?? Sheesh!) is the example of herceptin - a treatment drug for a specific kind of breast cancer. That example ended up as a $3 million programme to treat roughly 20 women per year or about $150,000 each.

No one can blame those women for wanting (or deserving) the best possible treatment, and outcome. Exactly the same justification existed in the 1970's when open heart surgery was being developed by the likes of Barratt-Boyes and the other researchers in US, Europe and South Africa. Today, that surgery is routine. Auckland Hospital does two or three operations per day at a cost each of (I was told) about $75,000.

[To be continued...]

State of Health - 2

Returning to Southern Cross, the pressures of increasing demand for new treatments and higher technology solutions are having impact. It is leading to the prospect of large increases in premiums. In many cases the premiums are already too high to be affordable - note SC's own comments on people not renewing, or down-grading, current cover.

Further, these impacts are being felt in the public health system as well. The herceptin debacle was eventually funded (in the first year) out of Auntie Helen's Charity Fund (otherwise known as "The Prime Minister's Discretionary Fund") but I do not doubt that it is now an established part of Vote Health.

If we look behind the political rhetoric and wailing and gnashing of teeth there is a very fundamental problem with the provision of health services. Essentially, no one wants to die. I can't blame people for feeling that way. After all, we have the ability today to ensure the survival of some 1% of all live births who when I was born would have been "sad but inevitable consequences" of premature birth. I would be one of the last to try and suggest that we should turn our backs on that ability. We have the ability to turn around the lives and health of reprobates like the ol' probligo with what is now a relatively routine opration, complex but routine. On pure observation, there must be some 1,000 people a year whose lives are improved immeasurably if not saved as a result. Those having pacemakers fitted come into a further 1000 a year. That is just one hospital.

The problem of the cost is one that has actually been with us for a lot longer than we might want to admit. It is not limited to NZ either.

If I return to the commenter whose thoughts started all of this off, I wish him and TF and everyone fighting the good cause against Obama the very best of luck. Why? Because the choice is very simple.

Generally, private insurance and health providers are by their very nature required to make a return on their investment if not an additional return for those whose money made the investments in the first place. The argument in favour of public provision is based (in theory) on universal cover and no profit.

Irrespective of how you add those two quite different proposals there are common impacts upon how much has to be paid for them. I have covered those already.

The truth is that there is a limit between cost, availability, technology and outcome; a "mathematical" limit as well as economic and "social".

The ultimate and universal outcome for all is death. The "social" end of the limit wants that outcome minimised as far as possible and delayed for as long as possible given that it is a certainty for all (at least at present). There is much that can be argued about the causes and nature of a person's death. I do not think that this is the place for that debate other than to suggest that its inevitability has to be recognised.

The ultimate technology would have to be (effectively) eternal life. There was comment made last night on tv that in the Middle Ages the average life span was 30 years. A man of 40 would be considered elderly. A man of 60 years almost unheard of. Needless to say, aging diseases such as cancer, alzheimers, coronary heart disease were unheard of and unrecognised. In the 1800's in Europe and America, the average lifespan might have increased to 55. In the past 15 years the average lifespan for men in NZ has increased from 71 to 82; the life expectancy of a newborn is something like 62, but once past the age of 15 it increases to 85. It is expected that the number of people reaching 100 years in 60 years time will be double that of the present day. In very large part that increase in life expectancy is the result of improving technology.

The ultimate in availability is universal. It is here that most of the heat and darkness arises. "Why should I pay..." is fundamental to both sides; with the sentence ending "...for anyone else" on one side and "...more than the true cost" on the other leading to "...more than I can afford" again on the other side of the lake. What must be decided by society, not by the medical profession or the government, is who should be able to access medical services. The "rich" will always be able to afford to buy; "rich" because that is a matter of perspective as much as it is of fact (compared to half of NZ I am a "rich" man yet as I said at the beginning paying for personal medical insurance is almost out of reach).

The decision on public health services needs to come back to the fundamentals I began with - curing diseases, mending injuries, and providing palliative care for the dying.

The debate must centre on the immediate cost of treatment against the benefit to society of the likely outcome. Is that a simple judgement? Not in my book! What is certain is that it is a necessary debate. Nor can the availability of health services be limited to those with the ability to pay. There has to be a universality in health services. The scope of that universality has to be unlimited. That means that the universal care will necessarily provide services which are below the available technology and ability.

Not an attractive thought.

Quick note...

As an after-note to the original review I did back in July, “Samson and Delilah” has won Camera d’Or at Cannes, and is now on release in some of the US film festivals.

Keep an eye open for it.

A must-see…

This is the week, that was...

I was, earlier in the week, going to do a blast about an article that appeared in the Herald. After digging around, it became apparent that the only (at that time) other sources were Ha'aretz and the Beeb. There was no comment in Jpost, apart from one or two rather desultory letters to the Ed that skirted around... All of that seems to have gone, though the Beeb article still eads the news.google search engine. The Jewish Weekly also has the story - for those who might be interested.

This morning, I turn to the old fav ALDaily and there is an echo of the response I posted a couple weeks back to TF's item on narcissism.

Rather than being written by a "world reknowned expert on narcissism" (the one whose only qualification is an off-the-shelf Doctorate in "Philosophy of Physics")this is from a journalist, Emily Yoffe, who has taken the time to research

This is the cultural moment of the narcissist. In a New Yorker cartoon, Roz Chast suggests a line of narcissist greeting cards ("Wow! Your Birthday's Really Close to Mine!"). John Edwards outed himself as one when forced to confess an adulterous affair. (Given his comical vanity, the deceitful way he used his marriage for his advancement, and his self-elevation as an embodiment of the common man while living in a house the size of an arena, it sounds like a pretty good diagnosis.) New York Times critic Alessandra Stanley wrote of journalists who Twitter, "it's beginning to look more like yet another gateway drug to full-blown media narcissism." And what other malady could explain the simultaneous phenomena of Blago and the Octomom?

These days, "narcissist" gets tossed around as an all-purpose insult, a description of self-aggrandizing, obnoxious behavior.

And too, can I add, as a politically charged epithet for people whose politics are somewhat different to one's preference and whose appearance is far more widely praised than one's own.

She rather spoils the line of thought with this;

A recent study titled "Leader Emergence: The Case of the Narcissistic Leader" describes how narcissists have skills and qualities—confidence, extraversion, a desire for power—that propel them into leadership roles but that when true narcissists are in charge, other aspects of their makeup—a feeling the rules don't apply to them, a need for constant stroking—can have "disastrous consequences." Yes, we're talking about you, former Illinois Gov. Rod Blagojevich. After Blagojevich was caught on tape trying to sell a Senate seat, he reveled in the opportunity to appear on talk shows, making the case that he himself was a victim—self-pity being a favorite narcissist refuge.

A line from a New York Times profile of him is as trenchant a description of narcissism as is found in most psychology textbooks: "[He] is unapologetically late to almost everything, and can treat employees with disdain, cursing and erupting in fury for failings as mundane as neglecting to have at hand at all times his preferred black Paul Mitchell hairbrush." There it all is: the sense that other people don't matter, the belief others are instruments for the narcissist's use, the self-admiration.

Well, at least she chose a valid instance.

Another of ALDaily's links led to this piece from Geoff Mulgan ; one which , I recommend, requires reading and careful thought; one which, I suggest, is in the realms of far-sighted analysis that we should see far more of in future. Yes, TF, he is a "socialist" but he does not present socialism as "the answer". He raises very valid, and to the point, questions.

The US banking system faces losses of over $3,000bn. Japan is in a depression. China is headed for zero growth. Some still hope that urgent surgery can restore the status quo. But more feel that we are at one of those rare points of inflection when nothing is the same again.

But if one dream is over, what other dreams wait in the shadows? Will capitalism adapt? Or should we be asking again one of the great questions which has animated political life for nearly two centuries: what might come after capitalism?
Only a few years ago that question had been parked, deemed about as sensible as asking what would come after electricity. Global markets had pulled China and India into their orbit, and capitalism’s triumph appeared complete, with medievalist Islam and the ragged armies that surround the G8 summits jostling to be its last enfeebled competitor. Multinational companies were said to command empires greater than most nation states, and in some accounts had won the affiliation of the masses through their brands.

Yet the lesson of capitalism itself is that nothing is permanent—“all that is solid melts into air” as Marx put it. Within capitalism there are as many forces that undermine it as there are forces that carry it forward.

His conclusion -

Capitalism’s crisis is, of course, a global one, and has shown up the limitations of the global institutions that took shape half a century ago. China is set to become a dominant player in a strengthened IMF and World Bank, followed by India and Brazil. The G20 is edging out the G8 as the club that matters. And waiting in the wings are possible new institutions to police and manage carbon, to handle everything from global migration to the regulation of biotechnology, alongside less formal institutions to help the world’s public to engage, from e-parliaments to global campaigning platforms like Awaaz, an online newspaper.

No one can know which of these possibilities will come to fruition. There are in principle an infinite number of directions social systems can take. But history suggests that at key moments evolution is highly selective. Only a few models turn out to be sustainable, with an affinity to the prevailing technologies, values and power structures.

In the first phase of the crisis the most successful claimants for support have been the big, failing (and well-connected) industries of the last era of capitalism. But the arguments are moving on—to how recovery plans can back job growth, fixing the future (as in San Francisco’s electric car infrastructures or Korea’s massive green jobs programme) rather than trying to fix the mistakes of the past. It’s not clear yet which politicians will be able to articulate a vision of a “servant capitalism” better suited to the 21st century. David Cameron has made some attempts—hard though that may sometimes be for the descendant of generations of stockbrokers. Gordon Brown is a son of the manse, but also deeply implicated in the crisis. Obama should be ideally suited to offering a new vision, yet has surrounded himself with champions of the very system that now appears to be crumbling.

The result is that a large political space is opening up. In the short run it is being filled with anger, fear and confusion. In the longer run it may be filled with a new vision of capitalism, and its relationship to both society and ecology, a vision that will be clearer about what we want to grow and what we don’t. Democracies have in the past repeatedly tamed, guided and revived capitalism. They have prevented the sale of people, of votes, public offices, children’s labour and body organs, and they have enforced rights and rules, while also pouring resources in to meet capitalism’s need for science and skills, and it has been out of this mix of conflict and co-operation that the world has achieved the extraordinary progress of the last century.

To discover what comes next, maybe we should look upwards. Skylines provide the simplest test of what a society values, and where its surpluses are controlled. A few centuries ago the greatest buildings in the world’s cities were forts, churches and temples; then for a time they became palaces. Briefly in the 19th century civic buildings, railway stations and museums overshadowed them. And then in the late 20th century everywhere they were banks. Few believe that they will be for much longer. But what will come next—great leisure palaces and sports stadiums; universities and art galleries; water towers and hanging gardens; or perhaps biotech empires? We need to rekindle our capacity to imagine, and to see through the still-gathering storm to what lies beyond.

At which point I want to return to the Emily Yoffe piece, and her conclusion.

If the observers who say that part of our economic troubles result from a mass case of narcissism, from consumers who thought they should have the house of their dreams financed on bad debt to bankers who thought they deserved eight-figure bonuses for packaging that bad debt, then perhaps we are about to be cured. Twenge and Campbell point out that the 1920s was a narcissistic era whose economic collapse led to the Great Depression and the greatest generation. Perhaps it's time to dig out those Depression-era recipes for humble pie.

Humble pie that should first be served in the Middle East.