Michael Vassar is a non-profit director and serial entrepreneur.  In an earlier life, he has been a Peace Corps volunteer, city school teacher, actuary, and a molecular biologist studying, at one time or another, membrane lipids, yeast mustard and fruit fly genetics, nanoscale polymer structures and optical tweezers.  His 33 year failure to identify a coherent, official world-view has forced him to go with whatever perspective on reality he has been able to kludge together for himself, with due acknowledgement to the many insightful thinkers who have helped him along the way.

He used to read a great deal, and would like to get back to that eventually, but has been busy dealing with the apparently urgent global problems which all that reading brought to his attention.  Other interests, such as piano, martial arts, cooking, yoga, nature, exercise, art, travel, strategy gaming and participation in America’s middle class and mainstream culture have likewise fallen by the wayside, replaced with streamlined hobbies like contributing to the electric sheep collective and occasionally binging on TV Tropes.  On the plus side, he’s a sucker for a pretty face, and can probably tell you where the world is going, how to satisfy your wildest dreams and who you need to talk to along the way, but probably not how to escape from the vector field of shame which permeates the default world and guides it’s inhabitants towards posing as if for the Abercrombie and Fitch catalog.

The US spends over a hundred billion dollars a year on medical research, and even with terrible standards and incentives for publication, this effort supports a tremendous amount of high quality science.  In the last 50 years, the US has won most of the Nobel prizes in medicine.  During that same 50 years, US life expectancy has risen by less than a decade.  Despite wars and dictators, Libya’s life expectancy has risen by over three decades during the same period, and US health outcomes are now flanked by those of Libya and Jordan. (graph Libya, Americans, White Americans, Jordan).  Despite its longer life expectancy, Jordan spends about $250 per capita per year on health care, and typical Americans spend far more on healthcare than Jordanians spend in total.  I find myself particularly struck by the fact that Americans have drugs for HIV associated belly fat but still loose 17,000 lives a year to AIDS.  Given this and similar information, a neutral observer would find it unreasonable to reject the null hypothesis and to conclude that the US health-care system makes use of the medical science it develops.  I propose that we change this, and that we do it by applying the service models that are typically applied to every other service good or high tech product.