| Show balt 'gala 7itibunt Zile Sunday Morning September 2 1990 Section Tribune Editorials Page 18 A Recession Looming for Nation Medical Ration May Not Hit Utah Right Away May Not Be retirement other curred debt mentators are the proaching Only Answer far that reverberate comWhile economists and an about apwarning nationwide recession the echo seems to weakly in Utah Principally because local figures still reflect a different trend The doom and gloom prophets can be especially confident because the normal indicators are uniformly drab Since gross national product is stagnant commerce is sagging and the stock mar ket is reacting to a variety of shocks the s understandably diagnose decline perhaps eventually a major one The forecast does not cause a knowing response in Utah because this state's statistics point up rather than down At least for now Not spectacularly but at least impressively For instance the University of Utah Bureau of Economic and Business Research reported in its April edition of the Utah Economic and Business Review: "In 1989 Utah experienced substantial growth in employment gross taxable sales and construction valuation" This apparently was the second r story chapter of a In its July 2 report the Utah Foundation noted that local economic indicators started showing noticeable impulse-taker- two-yea- 1988 in Utah's unemployment for example dropped to 52 percent in that period as 61000 new jobs were created statewide And — of defollowing a decade — 1978-8cline in adjusted business activity Utah started recording a turnaround that continued through last year provement 8 According to Utah Foundation findings personal income statewide improved by 64 percent in 1988 and 8 percent in 1989 Employment and rising purchasing potential then accounted for better business conditions Not that consumerism has been robust In fact Utah Foundation conclusions hold that Utah workers in 1939 spent 625 percent of their disposable income on items subject to sales tax compared to a significantly larger 796 percent in 1979 Foundation researchers speculated personal income may be going in greater proportion to interest payments housing costs medical bills taxes and of previously Should recession quickly restored strike if it lingers and conforms to past such cycles it will eventually reach here The state has however expanded and strengthened its industrial base on which a prolonged defense commitment could depend While a feeling of invincibility is not advisable the outlook does not yet justify extreme anxiety either Uncertain economic times surely lie ahead But that's not so unusual for Utah or for the nation United Germany Blueprint Friday the two Germanys signed a treaty that will guide the unification of On the divided nation Oct 3 Thus continued the remarkable events of 1990 destined to be remembered as one of the most important years in modern German history In fact no treaty was legally necessary since East Germany already had voted to join the Federal Republic of Germany (the West) under terms of its constitution However the treaty creates a plan for reconciling conflicting legal and social customs of the two societies rather than simply imposing West German law on the East overnight In order to achieve a unification treaty the two Germanys have agreed to leave final resolution of several divisive issues to a new parliament that will be elected by the united nation Dec 2 Negotiators were not able to settle all of the disparities between East and West In the matter of abortion the East allows termination of a pregnancy on demand within the first trimester the West generally does not allow abortion Under terms of the treaty both sides will keep their current arrangements or two years while the new parliament attempts to write a new law However should parliament fail to come up with a solution in that time the existing West German law will not automatically be imposed on the East No consensus was reached on the settlement of property ownership in the East either Thousands of Germans who fled the East still claim ownership in land and property they left behind Because details for settling these disputes remain undecided West German firms have been reluctant to invest in the bankrupt East German economy In an attempt to circumvent the problem the new treaty protects anyone who buys East German property for development purposes against claims by former owners and their heirs who will be compensated in cash under a system still to be worked out Even if this provision is enough to encourage investment — a questionable proposition — it is clear that property settlements will remain a complex legal and legislative issue in a united Germany for some years Another touchy matter is what will happen to the six million files accumulated over four decades by the East German secret police Under the treaty they will remain in East Germany but the new parliament will have to decide the question of their final disposition The issue is sensitive because the files contain information on millions of Germans including tens of thousands who acted as informers It was a vain hope that the many issues confronting two societies which had developed along diverging courses for 40 years could have been reconciled in a matter of six months The Germans have done a remarkable job reaching accommodation on those questions that could be settled and they have left the most difficult ones for further consideration That was the only practical courie Together with the economic treaty that took effect in July the new treaty now opens the way for a nearly complete accession of the East German states into the Federal Republic A new era is dawning for Germany and the world can applaud its crderly democratic advent Paid for Privilege A strange thing happened on the was' to Oliver North's speech at Cottonwood High School last week When a handful of disgusted but high-price- d peaceful pickets arrived Assistant Principal Gordon Beckstrom with the support of Salt Lake County sheriff's deputies threatened their arrest if they didn't move off school property Mr Beckstrcm reportedly wanted to avoid controversy Ccttonwood High officials it seems have missed some recent history They should have known they invited controversy when they permitted the central scandal to character in the Iran-Contr- a ‘ t) Diz-plival- speak at their school Wednesday evening attendance proved that many Utahns regard Oliver North as more hero than lawbreaker but in fact many others passionately believe ie perverted US policies and principles to the detriment of both Americans and Nicaraguans As long has they didn't interfere with the school's educational function 011ie North's critics had as much right to protest his presence on public property as his admirers had to hear and praise him Yes some of his fans paid as much as $150 for the privilege but the pickets also have paid plenty of taxes for public schools like Cottonwood Er ' i - - i S 01'1' 4111'11'1 t e 't tes Atir ( 7) - i 14100 ii ' i 1ANa : 111 O -- ‘I ' 41A- - "11' : 0 r tt! l 46 Jo— ? fe h illigarlip a 1 ' rd tioelf't isik fly or '1 '- if f&e't 'NI ' 'm not make another We should learn much more about the implications of rationing before adopting it Under rationing we would undoubtedly decide not to fund expensive procedures such as kidney dialysis or transplantation for patients classified as too old The British set the age limit for treatment of kidney failure at 55 In the abstract such a decision may seem regrettable but unavoidable Still when the guidelines affect a real person — such as yourself or a close relative — views change briskly Leonard Laster is chancellor of the University of Massachusetts Medical School A friend of mine who taught English literature developed kidney failure at age 57 Because chronic dialysis was available to him he was spared a sentence of early death and remained active for 10 more years teaching and mentoring his grateful students Was the money spent on giving this man 10 more years of productive life a waste? Did we really deprive some children of immunization against measles and polio because we spent the money prolonging the life of this teacher? Would rationing have been the more intelligent course? Under rationing major new ideas for medical treatment would be discouraged as too expensive and unnecessary The problem is what seems far-oand frivolous today could become tomorrow commonplace and essential In the early '50s one of my surgery professors developed a new technique for operating inside the human heart to repair defective or el 4 6 4 p: - 4 4111°-- g N k W t 4 'NC--- 1 P 4110 c ‘1 0 I': ' "t- -- 7- Nlt 4 41W ' damaged valves Early on the procedure was very expensive and seemed to be just a futile technical exercise but we paid for the development and evaluation costs and today valvular surgery constitutes a routine treatment providing a long and useful life to heart patients of all ages Had rationing been in effect when the procedure was first proposed in all likelihood it would have gone unfunded and left at the idea stage By and large rationing would narrow our horizons inhibit creative imagination and vision slow the progress of medicine and trap us within the limitations of today's knowledge and today's technology — a high price to pay Do we really have only a limited amount of money for medical care and must we start rationing now? Obviously we cannot allocate the bulk of our gross national product to medical care and we must continue to improve the efficiency and effectiveness of the myriad activities we group under the phrase "healthcare system" But isn't it odd that even though we are resolved to spend $500 billion for the S&I bailout when it comes to dealing with the far lesser costs of medical care we grow mightily exercised dig in our heels and turn to rationing? Could it be that our preoccupation with the bottom-lin- e has reached the point of gross insensitivity to values that cannot be quantified or incorporated into a balance sheet? What kind of people will we become after we agree to toss sick human beings onto the trash heap because they aren't worth paying for? Are we really so impoverished financially and intellectually that we see no other way out? Possibly but we ought to slow down some and get ourselves a second opinion quickly Let us volt -- 1 1 monIS - e ff7-111-7-1-- ' "" By Leonard Laster Special to The Washington Post BOSTON — After listening to economists physicians and politicians among others Oregonians have concluded that they can no longer afford unlimited medical care The only way they see to control the rising costs of such care is to ration it They have legislated a rationing system that has attracted national interest It may turn out to be a trial run that could eventually affect all of us On the surface the arguments for rationing seem reasonable Each year health-carcosts rise much faster than inflation New procedures and technologies appear at a breakneck pace and boost medical expenses Large segments of the population such as older people increase in number and need more complex care Yet as a nation we have only a limited amount of money to spend on treating the sick By not recognizing this dilemma by not realizing that we are in fact already rationing care and by not institutionalizing a fair and logical system for rationing we fly in the face of common sense We spend huge sums of money on individuals whose chances of benefiting are painfully small such as elderly patients with only days or weeks to live while depriving others such as children and pregnant women of care that could make a big difference at only a modest cost Despite the compelling power of the reasoning I'm not ready to go ahead and I don't believe that those who are ready fully understand what rationing implies We have not given enough consideration to other alternatives The financial problem is serious but by accepting the concept of rationing we cross a moral divide from which there may be no return It is no small step to decide that we will require physicians nurses and their colleagues to adhere to a formula that spells out who is worth saving and who is not We should move cautiously and try to avoid mistakes We've made some big mistakes in the past especially in medical matters In the early '70s experts persuaded us to release the bulk of the mentally ill from the back wards of institutions Lacking adequate community facilities the patients ended up fending for themselves in a hostile environment and as a result the mentally ill now make up a major segment of the street people many of them suffering worse fates than they did in the institutions We cannot reverse this mistake eas ) ) atto IT "4'4:14:""):114111:j' 601Wilt) To DIAP1 kkNN1 :-- AtITIN't soltRcvs 1‘N1)cAu Jou RZ 111 in- In any event findings generally Utah's economy has so confirm eluded the free fall occurring other places The national outlook has analysts genuinely worried They rely for their dour forecasts on government reports noting that although output grew in the second quarter the annual rate was an anemic 12 percent And that national unemployment by last month had reached 55 percent the highest in four years And that trimming the chronic federal budget deficit is hampered by slower than expected tax collections Most commentators look to the Federal Reserve to help control the situation with interest rate reductions turning more money loose in the economy But eruption of the Persian Gulf crisis complicates such simplistic prescriptions Roaring inflation in the 1970s caused essentially by an attempt to finance this country's Vietnam war involvement through borrowing rather than tax increases prompted the Fed policy of stringently high interest rates a cure that then caused the nation's last recession Unless the US can bill some of its allies for large portions of the Persian Gulf intervention costs tax increases will be necessary to avoid greater federal budget deficits and a rerun of ruinous inflation Utah no less than the rest of the nation would be better served economically if conditions prevailing before the Persian Gulf events occurred would be Common Carrier Letters r li 1— "1W — — A St itall01 A a-r-fli- ::' :i:::-:::- t':: -- - Nob -:::- li i i C:iOiii'::::g'':::':i?'::::q::MA:'1:SON::::Be'::: -- 4111L - "211011116‘6-----4---N5kililillioll- 1?C:Z4 i1 - i: the military we're building organizations that are so technologically advanced that errors can lead to catastrophic consequences The American people will probably respond positively to successful military action in the Middle East It appears equally likely that they will respond negatively if something unpredictable happens — allied ships or planes shooting at each other hitting each other or unintentionally involving a noncombatant or worse Does the American military have the management capacity to ensure that such a catastrophe does not happen Is anyone really in charge' The predictable challenges of operating such complex systems should be considered as important as the unpredictable challenges of war US policy seems to be one in which American forces are positioned with allies to compel the Iraqi government to withdraw from Kuwait Simple enough' Not so Let us just concern ourselves with what that requires from the Navy (forget the Army and Air Force units in Saudi Arabia for the time being) In the restricted waters around thP Straits of Hormuz (at the entrance to the Persian Gulf) we have the aircraft carrier Independence and its attendant support ships The Saratoga is in the eastern Mediterranean The Eisenhower a nuclear-powereship with more staying power than the Independence or Saratoga is in the Red Sea The sheer awesomeness of such ships suggests some of the management problems each carrier battle group faces Ship's company and the air wing of each carrier are composed of about 5500 men Each aircraft carrier has :i:y::-- : 4:iii::2::::i:: in Mideast Inevitable Foul-Up- s By Karlene H Roberts Special to the Los Angeles Times In many spheres of life but particularly in "'- klt (-- - 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Military ICLccg5' 711111111111111111110L 11::'-4:- A Salt !Mt approximately 85 to 90 planes of seven different types each with different capabilities and functions Nuclear carriers can operate for about 13 years without refueling but aviation fuel must be replenished at least once a week About 200000 gallons of jet fuel are required for a normal strike operation 500 miles from the ship Enter the Kennedy and its support ships While not as large as the Eisenhower this carrier is bigger than the Saratoga or Independence But like the Saratoga and Independence the Kennedy is conventionally fueled Karlene H Roberts professor of business at University of California Berkeley's Walter A Haas School of Business focuses on the design and management of organizations We now have four battle groups (carriers and their escorts) bringing the number of ships under US control to about 40 and the aircraft aboard the carnumber of riers alone to about 345 This is in addition to other Navy ships and aircraft on station or under way To keep the men aboard each carrier and the hundreds more aboard the escort ships fed and moving stores and fuel must be replaced frequently That is a complicated management operation too Replenishing requires that the carrier and its replenishment ship travel "abeam" at about 12 knots a situation fraught with vulnerability and the threat of potential collision (the US Navy does many replenishments every day without incident) Replenishing other ships is associated with similar challenges Enter the British and the French navies We often practice with the British And those sea-base- d a practices (and our own individual practices) uncover numerous problems Some but not all of these problems are solved in exercises Now enter the Soviet navy Readiness in the Soviet fleet is considerably different from readiness in our own Their organization is structured differently (including political officers aboard ships) The Soviets sacrifice operations at sea for material readiness They go for low and close proximity to supporting bases They also rely less on training than we do Managing this geographically dispersed enterprise seems challenging enough Managing a situation in which the average age of the American crews is about 20 and their turnover rate is just 44 months seems impossible One of the great hidden dangers of this entire enterprise lies in the possibility that we may simply be asking too much of the systems we have created The government and people of the United States demand quality operations from our Navy All in all we've provided fair resources for obtaining "readiness" But because of resource constraints the Navy usually practices joint activities with two and sometimes three battle groups rarely practices with four almost never practices with numerous battle groups and our allies and certainly never practices with the Soviets wear-and-te- As a society we place large and risky demands on complex military systems and expect them not to fail But when we operate them overtime at their limits we increase the likelihood of failure When we introduce untested challenges we further increase the risk In actual combat some failures are vire tually guaranteed How will this society react to that? risk-avers- |
