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jib's avatar

Economically, fossil fuels punch above their weight because they are part of the external economy. The internal economy is the largest part of any regions economy. Its the people in the region buying and selling from each other, teachers, doctors, firemen, lawyers, merchants, nurses, real estate agents, cops, etc. Every ones money being used to pay each others salaries.

But every region imports goods and services from outside the region and unless those imports are offset by exports, then the local internal economy leaks money and the region gets poorer. In contrast if your exports bring in more money than the imports, the internal economy gains money and the region gets richer.

Health care is mostly internal economy. The federal transfers for medicare/medicaid is external money but it is a product of the amount of the population that is poor or aged. The payments slowdown the rate at which the region is getting poorer, they do not provide growth.

The only way for health care to provide growth is if it is a national heath center like the Mayo Clinic, Cleveland Clinic, Fred Hutchinson Clinic. Otherwise heath care is a utility, like police/fire, or water/sewer and whatever growth it experiences comes at the expense of other sectors of the internal economy.

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William Bell's avatar

Excellent article by Mr Tooze, it nicely shows the interplay between politics and economics but also shows how Mr Manchin is being perfectly rational here. What the Biden administration needs to work out is how to squeeze him to get what they want, everyone has a price and what he's asking for at the moment is too much.

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