TribTown

Where human developments are concerned, "green" usually exists only as some matter of degree, and not as an absolute.

Consider of the story of the tiny Indiana bat in a corner of West Virginia. Environmentalists and developers are at odds, not over a coal mine or uranium mill, but over what both sides probably generally view as a social good -- a wind farm, that would produce "green" power.

But environmentalists say the wind turbines also could be devastating for the little bat.

It's not so much that bats collide with wind turbines. "It's actually the down-draft of those blades explodes their lungs -- literally sucks their lungs out their front end," Brian Rutledge, executive director of Audubon Wyoming, says. Some studies suggest the bloody impacts could be reduced by slowing rotor speeds during bat migrations.

Wyoming bats, presumably, would fare no better than others of their kind when faced with blades spinning too fast, but we're more concerned about another creature at the moment.

The sage grouse has been flirting with an endangered species designation, which could cripple not only wind projects, but the oil and gas industry as well. And of course, if that day does come, the once-abundant sage hen will be very near the end of the line.

Skeptics argue that little is known about how wind projects affect sage grouse, but Rutledge said much actually is known about grouse preferences, based on research conducted in natural gas fields.

Sage grouse don't like roads, power lines and other fragmentation of their home terrain. They don't like overhead motion, which forces them to keep checking warily while trying to feed. And they don't like tall structures, much as wind turbines are tall. Golden eagles are fond of high perches, the better to swoop down and make a meal of the unsuspecting.

Pretty much, it seems, sage grouse would just like to be left alone. But the degree to which that's possible is open to question. And it's not just the sage grouse. Rutledge said there are other species, less well-studied, that might already be in tougher shape.

Rutledge thinks that the best sites for wind energy projects are in southeastern Wyoming, where human impacts are already substantial.

Managing species like the sage grouse in areas with economic value also reveals something fundamental about the "multiple use" of public lands. Not every use can or should be accommodated everywhere; a coal mine and a campground simply cannot coexist. We make trade-offs, based on precedence and preferences and economics. Sometimes, a net effect is that bats get their lungs vacuumed out.

Zero greenhouse gas emissions, associated with climate change, is viewed by environmental groups as a laudable outcome of wind farms. So it's more than a little ironic that the tiny Indiana bat could fall victim to the kind of technology environmental groups hope will help save the entire planet.

Assume, for a moment, you're in the path of a runaway bus. Rather than move, you just stand there.

You learn, the hard way, that doing nothing is not really nothing. Your tombstone might read, "It's all about choices. Even when they're bad ones."

Small businesses represent 44 percent of total private payrolls in the U.S., and account for more than half of nonfarm, private sector GDP. They also produce 13 times more patents per employee than large patenting firms. They are the engines of innovation.

But small businesses and health care costs are on a collision course.

The Commonwealth Fund predicts that if nothing changes, family premiums for employer-sponsored health could increase another 94 percent by 2020. The average would be nearly $24,000.

In Wyoming, the Robert Wood Johnson Foundation offers a more rosy outlook; that is, if a 78 percent increase in employer premium spending can be called rosy for a less-than-worst-case scenario.

The National Federation of Independent Business says small businesses need a more efficient marketplace for health insurance, including more competition and access to larger pools. Portability of benefits wouldn't hurt, either.

Businesses have an enormous stake in a healthy work force. Health is fundamental to economic output. In 2005, the Commonwealth Fund estimated health issues in the U.S. are related to $260 billion each year in lost productivity.

For small-business people, the status quo is just an illusion. Without real action, the whole entrepreneurial underpinning for economic growth is at risk.

If nothing changes, the Robert Wood Johnson study estimates the number of people with employer-based insurance coverage in Wyoming will decline by between 19,000 and 40,000 over the next decade, depending on several factors.

Much of this erosion would occur among small businesses, many of which would be finally and forever priced out of the health insurance market.

A dysfunctional health-care system threatens to sink the creators and risk takers, and the entrepreneurs in every conceivable quarter who will be responsible for creating jobs of the future. If we're serious about ensuring the vitality of small business, doing nothing is not an option.

Business Editor Tom Mast can be reached at tom.mast@trib.com, or call 307-266-0574. Or check out his "Two Bits Worth" blog at tribtown.trib.com/TomMast/blog

A European leader, at last month's G20 Summit in Pittsburgh, was perplexed because some Americans have compared Barack Obama to Adolf Hitler.

"That doesn't make sense to me," he told the president. "Explain that to me."

He was probably bewildered because Europe experienced the real Adolph Hitler, not a mustached caricature ginned up by angry protestors at town hall meetings.

This and other world leaders are no doubt even more befuddled now that President Obama has won the Nobel Peace Prize for "his extraordinary efforts to strengthen international diplomacy and cooperation between peoples."

Here's the Fuhrer that Europe remembers:

-- Adolph Hitler was responsible for the deaths, by mass murder, war and starvation, of more than 24 million men, women and children in the Soviet Union alone. That's greater than the current population of all the Rocky Mountain states combined, including Arizona.

Adolph Hitler and his minions were responsible, by one means or another, for the deaths of 2 million civilians in Poland, a quarter-million France and 2 million in Germany itself.

Perhaps 6 million Jews died, along with 500,000 Gypsies, 200,000 handicapped people and even a thousand Jehovah's Witnesses.

Of course, these are just guesses. Actual numbers can never be known.

President Obama, on the other hand, hopes to provide the means for more Americans to see a doctor when they get sick. That's about life, breathless nonsense about "death panels" notwithstanding.

-- The real Adolph Hitler simply murdered his political enemies. When they were no longer of use, even his friends were murdered.

Ernst Rohm helped organize the Sturmabteilung, an organization of street thugs also known as the SA or "brownshirts." They helped Hitler rise to power. But when Rohm became a political liability, he was shot to death in a prison cell.

For his part, President Obama has shown a willingness -- some of his supporters say too much willingness -- to work with his opponents, whether Republicans or "Blue Dog" Democrats.

-- Hitler hated Jews, a minority group he blamed for every conceivable evil, from Germany's defeat in World War I to its economic collapse in the aftermath.

Hitler vilified them, persecuted them, discriminated against them, and murdered them.

He disparaged blacks, and thought Russians, who he sometimes referred to as "Redskins," should be handled in the same way American Indians were in the 19th century -- either move out of the way or die. Racism was foundational to Hitler's thinking.

Barack Obama, our first African-American president, would not have fared well in the Third Reich.

Even so, there is at least one similarity. For both Obama and Hitler, words formed the architecture for actions. Both are known as powerful orators.

Hitler used speech to blame, to divide, to foment, and ultimately, to inspire and rationalize evil acts. The big Nazi political rallies of the 1930s were showcases of hate and Aryan-state nationalism.

Whatever the deficiencies of his ideas, President Obama addressed huge rallies during his presidential campaign with a simple message of hope: "Yes we can."

Ignorance, it might be said, is easy. It results merely from an absence of facts.

But foolishness, that takes real effort.

Onvia, with an online presence at recovery.com, says the flow of recovery funds has had a net positive impact of 8,000 jobs in Wyoming.

This mirrors an estimate by the government Web site recovery.gov, which says 8,000 jobs will be saved or created over the next two years as a result of the federal stimulus program.

All of which comes against the backdrop of statistics released last week that suggest the state's unemployment rate may be looking for a bottom at around 6.8 percent.

Onvia, whose mission is "to keep every taxpayer informed about the flow of recovery funds, especially those dollars that may impact your family, friends, and community," includes a detailed analysis.

In Wyoming, the biggest piece of stimulus money has gone for highways and bridges at $157.6 million, with another $9.3 million for transit projects.

School and college modernization projects have received $41.7 million, while water projects have been allocated $39.2 million.

In all, the state has received $332.6 million for stimulus spending, according to Onvia.

There may be a connection between the stimulus spending and flattening unemployment over the past couple months. We'll see where things stand next spring.

***

Energy efficiency remains the cheapest and cleanest source of energy, according to the American Council for an Energy Efficient Economy.

The group claims recent conventional supply side options typically have costs between seven and 15 cents per kilowatt-hour -- much more expensive than investing in energy efficiency.

Katherine Friedrich, lead author of the analysis, said saving a kilowatt-hour through energy efficiency is easily one-third less expensive than any new source of electricity supply, whether through fossil fuels or renewable energy sources.

The 70,000-square-foot Wind River Elementary School in Pavillion is equipped with a ground-source, heat-pump system.The new building is about twice the size of the old building, but the energy bills are about half as much.

Initially, officials expected to recoup the cost of the system in 12 years, but that's beginning to look more like eight or nine.

It's a good bet energy costs will increase in the years ahead. So it's hard to imagine why any large building would not be designed for optimum energy efficiency long before the first yard of concrete is poured.

Business Editor Tom Mast can be reached at tom.mast@trib.com, or call 307-266-0574. Or check out his "Two Bits Worth" blog at tribtown.trib.com/TomMast/blog

Here are recommendations from the Commonwealth Fund Commission about changing the health care system:

"In this report, the Commission recommends an integrated set of policies to extend coverage to all by: establishing a national insurance exchange that offers a choice of private plans and a new public plan; requiring everyone to have coverage, with income-related premiums to make coverage affordable; and instituting insurance market reforms that focus competition on outcomes and value. On this foundation, payment policies would change the way we pay for care to enhance the value of primary care and move from fee-for-service to more "bundled" methods of paying that encourage coordinated care and hold providers accountable for improving health outcomes and prudent use of resources. Investment policies would accelerate the spread and use of health information technology and establish a center for comparative effectiveness to enhance knowledge and appropriate use of evidence-based care. Population health policies would promote health and disease prevention, with benchmarks and goals to spur a culture of innovation and continuous improvement.

This integrated approach could achieve access for all, improve population health, and provide more positive patient experiences. Moreover, an analysis of specific policies consistent with this approach indicates that they could slow the growth in national health spending by a cumulative $3 trillion through 2020, compared with current projections (Exhibit ES-1)—if we start now.

What do you think? What changes do think would improve the system? Do you think a public option ( with the emphasis on optional) is necessary, as the report suggests? What about changing the way health care providers are paid? 

Full report here:

http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/Feb/The%20Path%20to%20a%20High%20Performance%20US%20Health%20System/1237_Commission_path_high_perform_US_hlt_sys_WEB_rev_03052009.pdf

see previous discussions

The Wyoming Medical Center in Casper expected to provide about $49 million in uncompensated care for the fiscal year ending June 30.

A recently published study in the American Journal of Medicine found that in 2007, 60 percent of personal bankruptcies in the U.S. were related to medical problems.

In addition to such financial issues, there is a public health question. If people with infectious diseases don't get treated properly, isn't everyone at greater risk? This is more than an idle concern with a major swine flu outbreak looming on the horizon.

People who turn up at emergency rooms also are more expensive to treat. A 2009 Vermont study found that doctors' office visits for new patients averaged $49 to $465. ER costs averaged $207 to $1,135, depending on the facility. Of course, emergency room visits also include major events like heart attacks, but even these often could be forestalled with better routine care.

The question is, should covering everyone in the U.S. be a goal of health care reform? If so, what would be the best of way of getting there? If not, why not?

Should we be willing to treat all people in the U.S., including people who are in the country illegally?

From a cost standpoint, what is the most reasonable and practical strategy?