The Environment in Perspective:Is Everything Getting Steadily Worse? Much of the discussion of environmental problems in the popular press leaves the reader with the impression that matters have been growing steadily worse, and that pollution is largely a product of the profit system and modern industrialization. There are environmental problems today that are both enormous and pressing, but in fact pollution is nothing new. Medieval cities were pestholes—the streets and rivers were littered with garbage and the air stank of rotting wastes. At the beginning of the eighteenth century, a German traveler reported that to get a view of London from the tower of St. Paul’s, one had to get there very early in the morning “before the air was full of coal smoke.” Since 1960 there has been progress in solving some pollution problems, much of it the result of concerted efforts to protect the environment. The quality of the air in most Canadian cities has improved. In Toronto, for example, the concentration of suspended particulates, or soot, in the air has fallen dramatically since 1962. To put this figure in perspective, it should be noted that the current health advisory level for the index is 32. At a level of 58, people with chronic respiratory diseases may be affected. At 100, even healthy people may be affected by prolonged conditions, and those with cardiac and respiratory diseases could suffer severe effects Recently in Toronto, the index has exceeded 32 on fewer than half a dozen days annually. Similar improvements have occurred elsewhere in Canada and in other industrialized countries. Even the famous, or rather infamous, “fogs” of London are almost a thing of the past. There have been two high readings of particular note in the British capital in 1959 (when the index rose to 275 and there was a 10 percent increase over the normal number of deaths) and in 1962 (when the index rose to 575 and there was a 20 percent increase in mortality). But more recently, London’s, cleaner air has resulted in an astounding 50 percent increase in the number of hours of winter sunshine. In short, pollution problems are not a uniquely modem phenomenon, nor is every part of the environment deteriorating relentlessly. Environmental problems do not occur exclusively in capitalist economies. For example, in the People’s Republic of China, coal soot from factory smokestacks in Beijing envelops the city in a thick black haze. Similarly, smoke from brown-coal furnaces pollutes the air almost everywhere in Eastern Europe. It has been estimated that a third of Poland’s citizens live in areas of “ecological disaster”. The citizens of Leipzig, a major industrial city in what was formerly East Germany, have a life expectancy a full six years shorter than the national average. However, we do not mean to suggest that all is well with the environment in market-oriented economies or that there is nothing more to do. While there have been some improvements, serious problems remain. Our world is now subject to a number of new pollutants, most of which are far more dangerous than those we have reduced, even though they may be less visible and less malodorous While environmental problems are neither new nor confined only to capitalist, industrialized economies, these facts are not legitimate grounds for complacency. The potential damage that we are inflicting on ourselves and on our surroundings is very real and very substantial.
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Healthcare Reform During the past two decades, all of the industrialized nations have enacted some form of healthcare reform. America is no exception. Just a few years ago, the U. S. was consumed by a vigorous public debate about healthcare. In the end, the debate reaffirmed that the U. S. would retain its essentially market-based system. Instead of reform imposed from the top down, 3 the American healthcare system underwent some rather profound self-reform, driven by powerful market forces. The market—not the government—managed to wring inflation out of the private healthcare market. 4 Today, it appears that U.S. healthcare costs are again on the rise. At the same time, American patients—like patients elsewhere—are becoming more vocal5 about the restrictions many face in their healthcare plans. Talk of government-led reform is once again in the air. 6 We must think twice, though, before embarking on “reform” if that means imposing further restrictions on our healthcare markets. The more sensible course is to introduce policies that make the market work better—that is, to the advantage of consumers. I base this argument on our company’s decades of experience in healthcare systems around the world, which has given us a unique global perspective on the right and wrong way to reform healthcare. The wrong way is to impose layer after layer of regulation and restrictions. We have seen this approach tried in many countries, and we have always see it fail—fail to hold down costs, and fail to provide the best quality care. Medicine is changing at so rapid a pace that no government agency or expert commission can keep up with it. Only an open, informed and competitive market can do that. This lesson holds true for the U. S., and for all countries contemplating healthcare reform. Free markets do what governments mean to do—but can’t. The right approach10 is to foster a flexible, market-based system in which consumers have rights, responsibilities, and choices. Healthcare systems do not work if patients are treated as passive recipients of services: 11 they do work if consumers are well-informed about quality, costs, and new treatments, and are free to act responsibly on that knowledge. Of course, reform should never be driven purely by cost considerations. Instead, we ought to devise new ways of funding healthcare that will make it possible for all patients to afford the best care. Ideally, these new approaches would not only reward individuals and families but also encourage innovation, which can make healthcare systems more efficient, more productive, and ultimately of greater value for patients. The path we choose will have enormous implications for all of us. We are in a golden age of science, and no field of scientific inquiry holds more promise than that of biomedicine. 13 Not only can we look forward to the discovery of cures for chronic and acute disease, but also to the development of enabling therapies that can help people enjoy more rewarding and productive lives.14 New drugs are already helping people who would once have been disabled by arthritis or cardiovascular disease stay active and mobile.15 More effective anti-depressants and anti-psychotics are beginning to relieve the crippling illness of the mind, allowing sufferers to function normally and happily in society. The promise is quite simply—one of longer, healthier lives. 16 What is at issue are the pace and breadth of discovery, and how quickly we can make the benefits of our knowledge available to the patients who need them. Therefore, the policy environment the biomedical industry will face in the next century may make or break the next wave of biomedical breakthroughs. 17 Will that environment include protection for intellectual property, freedom for the market to determine price, and support for a robust science base? 18 Will healthcare systems nurture innovation, or remove incentives for discovery? Will they give consumers information and options, or impose stringent rules and regulations that limit access and choice? For the U. S., as for the
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Effect of the Great Depression It is difficult to measure the human cost of the Great Depression. The material hardships were bad enough. Men and women lived in lean-tos made of scrap wood and metal, and families went without meat and fresh vegetables for months, existing on a diet of soup and beans. The psychological burden was even greater4: Americans suffered through year after year of grinding poverty with no letup in sight. The unemployed stood in line for hours waiting for relief checks, veterans sold apples or pencils on street comers, their manhood—once prized so highly by the nation—now in question. People left the city for the countryside but found no salvation on the farm. Crops rotted in the fields because prices were too low to make harvesting worthwhile; sheriffs fended off angry crowds as banks foreclosed long overdue mortgages on once prosperous farms. Few escaped the suffering. African Americans who had left the poverty of the rural South for factory jobs in the North were among the first to be laid off. Mexican Americans, who had flowed in to replace European immigrants, met with competition from angry citizens, now willing to do stoop labor in the fields and work as track layers on the railroads. Immigration officials used technicalities to halt the flow across the Rio Grande and even to reverse it; nearly a half million Mexicans were deported in the 1930s, including families with children born in the United States. The poor—black, brown, and white—survived because they knew better than most Americans how to exist in poverty. They stayed in bed in cold weather, both to keep warm and to avoid unnecessary burning up of calories; they patched their shoes with pieces of rubber from discarded tires, heated only the kitchens of their homes, and ate scraps of food that others would reject. The middle class, which had always lived with high expectations, was hit hard. Professionals and white-collar workers refused to ask for charity even while their families went without food; one New York dentist and his wife turned on the gas and left a note saying, “We want to get out of the way before we are forced to accept relief money.” People who fell behind in their mortgage payments lost their homes and then faced eviction when they could not pay the rent. Health care declined. Middle-class people stopped going to doctors and dentists regularly, unable to make the required cash payment in advance for services rendered. Even the well-to-do were affected, giving up many of their former luxuries and weighed down with guilt as they watched former friends and business associates join the ranks of the impoverished. “My father lost everything in the Depression” became an all-too-familiar refrain among young people who dropped out of college. Many Americans sought escape in movement. Men, boys, and some women, rode the rails in search of jobs, hopping freights to move south in the winter or west in the summer. On the Missouri Pacific alone, the number of vagrants increased from just over 13,000 in 1929 to nearly 200,000 in 1931. One town in the Southwest hired special policemen to keep vagrants from leaving the boxcars. Those who became tramps had to keep on the move, but they did find a sense of community in the hobo jungles that sprang up along the major railroad routes. Here a man could find a place to eat and sleep, and people with whom to share his misery. Louis Banks, a black veteran, told interviewer Studs Terkel what these informal camps were like: Black and white, it didn’t make any difference who you were, cause everybody was poor. All friendly, sleep in a jungle. We used to take a big pot and cook food, cabbage, meat and beans all together. We all set together, we made a tent. Twenty-five or thirty would be out on the side of the rail, white and colored: They didn’t have no mothers or sisters, they didn’t have no home, they were dirty, they had overalls on, they didn’t have no food, they didn’t have anything.
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Working Together Against the Infectious Diseases There is another area that really may sound like it’s outside the range of politics and Iraqi people where we’re cooperating together, but it’s an area that is vital to the well-being of the Chinese people, the American people, the people in the world, and it’s now we’re working together to deal with the dangers inherent in infectious diseases. China’s sobering experience with SARS stands as a lesson to all countries on the challenge of infectious diseases. I have called HIV/AIDS the world’s greatest weapon of mass destruction today. It threatens to kill tens of millions of men, women and children—in the Caribbean, in Latin America, in the subcontinent, especially in Africa—and yes, it is a danger to China as well. And China’s government is facing up to this crisis, working with us. The United States has told China we are ready to help. Last month, our Health and Human Services Secretary Tommy Thompson spoke in China of President Bush’s interest in furthering our practical cooperation on HIV/AIDS and other health issues. Specialists from our Centers for Disease Control are working on the ground with their Chinese counterparts. Our National Institute of Health has granted $14.8 million to help China upgrade its health care infrastructure. My friends, it is upon such concrete forms of cooperation on issues of regional and global importance that a 21st century US-China relationship will be built, issue by issue, experience by experience, challenge by challenge, initiative by initiative, program by program. As China participates more actively in world affairs, we will extend our welcome. Building and sustaining a healthy overall relationship is good for America, it is good for China, it is good for the region, and good for the international community.
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Water Crisis in Spain There’ve been floods, gales and heat waves across Europe-and some lay the blame for the unpredictable weather on climate change. Spain is undergoing its worst drought for sixty years with many areas in the south of the country not seeing a drop of rain for months. Some reservoirs are nearly empty while the volume of water in some rivers is down to a third of its normal level. Guadalajara, in the centre of the country, used to be a prosperous tourist area. Its old Moorish name, ironically, means "water running through rocks." But when Emma Jane Kirby visited the small town of Buendia, she found an ecological disaster area in the marketing. There’s a strange smell around the lake at Buendia, the sort of smell that greets you when you first open the fridge after a week or two away from home—a putrid stench of salad leaves that’ve begun to turn to compost in their cellophane bag. I’m reluctant to mention this to my companion, Marco ObisP0 because this after are is the place where he has spent every one of his summer holidays and a just few hours ago we were pouting over the family photograph books while he reminisced wistfully about his idyllic childhood. The problem is I don’t recognize this place as being the same one he showed me in the pictures Those images boasted bronzed children racing joyfully down a bank of emerald green grass towards a vast expanse of water so blue that the cornflower sky above looked dazzled. But this landscape is bleached and barren, the banks crusted white, the ponds patchy and the colour of thin ink. Guadalajara in the centre of Spain has been hit hard by drought. The rains haven’t come since spring last year, leaving the soil parched and lifeless, as cracked and scarred as the face of a small pox victim. The sun has sucked the life from anything that once had the energy to be green and stealthily, its hot tongue has lapped away at the lake’s edge reducing the reservoirs to a fifth of the size they were twenty years ago. As quickly as the water’s evaporated, so have the tourists—the holidaymakers from all over Europe with whom Marco played as a child have been lured away to other areas of Spain where swimming or sailing a boat can be done without fear of scraping knees or hulls on the lake bed. If the landscape is crying out for new water management, then it’s weeping with painful dust-dry tears. North east of Buendia, only the ancient Spanish pine forests seem able to sustain life, some atavistic survival instinct wing them triumph over droughts which long ago killed off the weaker competition. But the trees are now so dehydrated and sapless they’ve become irresistible to fire-two weeks ago, thirteen thousand hectares were lost to a spark from a barbecue-an inferno that also claimed the lives of eleven men. As far as the eye can see now, the hills are almost bare.
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Robot Even before the first robot was built, the subject of robotics was controversial. The word "robot" was coined in 1921 by a Czech playwright who wrote about a colony of machines endowed with artificial intelligence that eventually turned against3 their human creators. Although that account was fictional, the first industrial robots were in use by the early 1960s. Today, we continue to be intrigued by robots and their potential for both good and evil. Basically, a robot is any machine that performs work or other actions normally done by humans. Most robots are used in factories to make products such as cars and electronics. Others are used to explore underwater, in volcanoes and even on other planets. Robots consist of three main components: a brain, which is usually a computer; actuators and mechanical parts such as motors, wheels and gears; and sensors for detecting images, sound, temperature, motion and light. With these basic components, robots can interact with their environment and perform the tasks they are designed to carry out. The advantages are obvious — robots can do things humans just don’t want to do, and they are usually more cost effective. Robots can also do things more precisely than humans and allow progress in medical science and other useful advances. But, as with any machine, a robot can break down and even cause disaster. There’s also the possibility that wicked people will use robots for evil purposes. Yet this is also true with other forms of technology such as weapons and biological material. Robots will probably be used even more in the future. They will continue to do tasks where danger, repetition, cost or the need for precision prevents humans from performing. As to whether they will be used for good or evil, that depends on the nature of the humans who create them.