Saturday, September 27, 2008

Houston Getting Power

This week, about a quarter of Houstonians are still without power -- but more are getting power restored daily. Trucks from Pennsylvania and Connecticut have been spotted, and the estimate that ten thousand imported repair workers are in town is probably accurate. One power company, Entergy, boasts that all its Houston-area subscribers are back in power.

The M.D. Anderson Cancer Center offers an example of how this weather-related disaster can wreak havoc on institutions with no material physical losses. Anderson didn't lose power, both because it has generator backup and because the backup wasn't needed: the Texas Medical Center is supplied with power by buried cables, which weren't hit by falling trees. Centerpoint has some 14,500 steel transmission towers, and zero of them were destroyed. The power losses appear to have been caused almost exclusively by lines and connections being severed by falling trees. One wonders how much economic loss might be saved in the future by an investment in increased underground cabling.

Houston hasn't got a hotel shortage, but perhaps a third of the rooms are unavailable due to damage or simple absence of power. With FEMA having bought up all the remaining unoccupied hotel rooms, people coming to Houston for business have a hard time obtaining accommodations. Since a third of M.D. Anderson's patients are out-of-towners -- all of them paying customers, as opposed to storm-turfed nonpayers -- the institution has taken a substantial economic hit.

The problem of storm-turfed nonpayers (non-paying patients "turfed" to Anderson by institutions closing shop for the storm) is vexing because they aren't Texans qualified for coverage under state indigency programs (else their care would not be uncompensated), but are people that other branches of the University of Texas Health Science Center (coughGalveston'sUTMBcough) thought they'd treat on taxpayers' nickel, for fun, despite that they flew into town from other states or countries in order to pose as broke needy locals and are scamming them for free services. Yes, people fly into Houston from Iran and similar places for cancer treatment, and try to avoid paying a nickel for it. No, Texas legislators didn't think they'd opened a worldwide free medical clinic when they funded the University of Texas system during the last legislative cycle.

Some nitwit administrators don't know how to pronounce "no" or "fraud" and just let these folks walk all over them. Maybe they think pissing away taxpayers' money on people who not only don't qualify for indigent care but aren't even Texas or even U.S. taxpayers is somehow a worthy cause. My subtle take is this: being scammed isn't a virtue, and letting people scam you out of resources you are safeguarding for the public is lazy and corrupt.

Sometimes, it's people driving across the Texas border and pretending to be an American cousin to get coverage, and sometimes it's folks flying their known-sick relatives from other continents to the Texas Medical Center to foist them on local hospitals in the hope of winning the medical lottery. I hear someone in the distance crowing about universal health care, and the need for it, as if we should be happy to suffer this indignity. (Nevermind the only reason we now lack it is federal obstruction of state regulation to create universal coverage; let's hear the plea for federal single-payor care and try not to puke.) Even under a universal health care system as exists in Hawaii, Germany, Canada, or the UK you can't just fly into town and demand outrageously expensive treatments for the serious diseases you know you've got. The public feeling of entitlement to health care really creates problems in a place like the M.D. Anderson Cancer Center, where treatments for serious illness routinely cost six and seven figures to provide. The volume of patients at Anderson are quite a bit higher on a daily basis than the emergency rooms that are forced to give uncompensated care to folks who roll in on ambulances, so the losses mount faster. Suddenly absorbing unfunded fraudulent care cases from other branches of the U.T. system (because their administrators don't bother to do the work needed to weed them out) is a serious blow atop the sudden loss of so much regular paying work.

But back to the original point: Houston's power and infrastructure are getting back into shape. Folks with actual physical damage to their power connection to their homes are having the most trouble getting re-connected. I continue to encounter intersections whose traffic signals are dead or flashing, if not laying in the median in pieces.

The Mayor stated that the driveability of Houston roads was mostly restored by citizens responding to his call to take chainsaws and axes to felled trees blockading streets, and was mostly remedied in the first forty-eight hours following the storm. The existence of civil order in Houston appears to have been key to the relatively swift restoration of infrastructure to usability. The existence of a curfew order may have been useful to prevent property crimes, but the number of citations for curfew violation seems to support my thesis regarding the order: it was designed to amplify a show of force by police units, and not to be directly enforced. I strongly suspect selective application on the basis of subjective factors, but I anticipate that officers trained to avoid appearing to conduct profiling "needed" the curfew order as cover for what amounted to a profiling-based enforcement policy.

The intentional use of a curfew order as cover for arbitrary or oppressive enforcement would be very concerning. However, I suspect the order was intended not to support invidious discrimination but to provide cover for hard-to-quantify suspicions regarding vehicles and persons believed by officers not to appear engaged in innocent behavior. The intent of the persons creating the curfew -- that is, if they didn't intend it to be applied uniformly but only selectively against persons bearing undescribed characteristics that would lead police to want to stop and search them -- is a matter that deserves some thought in respect to legality and constitutionality, but that's not this post.

The Bolivar Peninsula appears to have been largely converted into a wasteland, and I expect in time the death toll from the storm will be revised upward as known or suspected non-evacuees are presumed dead.

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