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June 21, 2012


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I encountered Bill Harris when he spoke at a Nucleus Club (Maricopa Co. Dem group) luncheon in 2009. He was singing the praises of Tom Friedman and Ireland while poor mouthing the AZ Science Center. I asked him why the big corporations involved with the Center were constantly down at the Lege demanding, and getting, massive tax cuts and suggested that maybe if they'd stop doing that the Legislature wouldn't be able to justify sweeping the Science Center funds.

Needless to say, Dr. Harris wasn't pleased with my question. He got huffy and babbled incoherent nonsense about the Yankees and George Steinbrenner and Ireland. I concluded that the good Dr. was nothing but a corporate stooge and that he wants science centers funded so long as it's done via regressive taxation of the little people.

Oh, also, during his talk Harris said he wanted to write a book but then he read Tom Friedman's The World is Flat and realized he didn't need to write a book because Friedman had already written the book he wanted to write. Moronic minds think alike, I guess.

From the stooge's article:

"The people of this state deserve better than alarmism and histrionics."

The pot calling the kettle black? How many Friedman units until the next collapse? I'm guessing just in time for Xmas.

And yet...Banner Health "expects the Southwest Valley to grow by almost 8 percent by 2020, compared with 3 percent growth in Phoenix during the same period".

This from an article about a $161 million Banner Estrella Medical Center expansion at Loop 101 and Thomas Road.

According to the article, Banner is also building two ambulatory facilities in the Southwest Valley: Banner Verrado, which opens in September, and Banner Estrella Mountain, which isn't yet under construction.

The $161 million Tower Two expansion "will support patients from both ambulatory facilities as well as new patients from Avondale, Goodyear, Buckeye, Glendale, Litchfield Park, Peoria, Surprise, Tolleson and west Phoenix".


So has Banner, the second largest metro Phoenix employer (after Wal-Mart) drunk the Kool-Aid, or do they know something we don't? Maybe someone could ask them the source of their growth projections...

The real question is jobs. I can see why health care has been a mainstay of the local economy, accounting for nearly a quarter of new private sector payroll jobs in Phoenix over the past year:

(1) To some degree, health care is a fundamental rather than a discretionary purchase;

(2) Metro Phoenix saw a huge influx of immigrants from other states in the 2000s prior to the recession, and the health care industry hasn't caught up yet with previous growth on the fringes;

(3) the Medicaid (AHCCS) rolls were swollen by hundreds of thousands during and post recession (before enrollment for many was frozen), and many of these may have previously had no insurance (being unable to afford it or else deciding they didn't need it), or else had high-deductible policies with large out of pocket costs that deterred them from preventive care, some diagnostic exams and some treatments. Now, for the first time, they have easily usable insurance with little out of pocket cost and can see to long deferred health care issues.

But unless population growth continues industry expansions like this won't continue forever. The state population has been static since the recession, as far as I can tell; but I wonder if there is a trend for intra-state immigration from rural areas where jobs are even less plentiful, to job centers like metro Phoenix. If so, where will they settle?

In the previous thread, I noted that the other side (southeast) of the Valley accounts for about 35 percent of the metro area's population but that less than 20 percent of the region's jobs are located there.

What is the situation on the southwest side?

This was published in the Phoenix Business Journal at the end of last August:

New population estimates show that the Phoenix-Mesa-Glendale metro area will have 4,310,999 residents as of Sept. 1. That's up from 4,192,887 on April 1, 2010, according to the U.S. Census Bureau.

The Phoenix area is now the No. 13 metro area in the U.S., passing up Detroit over the past 17 months.


That's nearly 3 percent growth. Banner expects 8 percent growth in the southwest Valley (see above).

P.S. If the southwest Valley is included in the Phoenix-Mesa-Glendale MSA then (accepting Banner's projections) this seems to suggest a much lower, nearly static growth percentage for the city of Phoenix with much of the area-wide three percent growth concentrated at the fringes (which have a smaller population to begin with, hence give a larger growth percentage with the same absolute number of added residents).

Is desertification the future of the high country, where our great-grandchildren will marvel at old photos of endless pine vistas, long gone (and curse us)?

Nah. They are too busy updating their facebook "wall" (or driving and texting) to care about the future. So care about the way the past was? Come out of the sun old son...

But the do-nothing, deny-science crowd is in charge and, hey, you don't have to shovel sunshine!

Yep. But I'd like to provide an auto-response to that favorite quote of yours Jon:

You don't have to shovel snow in hell either!

If somehow the growth machine musters dying twitches amid the rubble of debt and collapse, this far-out freeway will merely subsidize more sprawl...

Yep. After the collapse (sudden and brutal) sections of it will be used as the roof of new "cliff dwellings".

This is a civilization worth caring about?

Double nope. I stopped caring about AZ two years ago. Buy nearly everything out of state to avoid sales tax. Even if it costs more. Whatever it takes. I don't abet kooks.

Mr. Talton wrote:

"Can the beauty and diversity of the Sonoran Desert survive much hotter summers? Will the renewable water supplies of the Salt/Verde rivers remain viable? But the do-nothing, deny-science crowd is in charge and, hey, you don't have to shovel sunshine!"

Both good questions, but I don't think the Arizona political establishment has much to do with the global phenomenon of climate change affecting Sonoran desert temperatures.

As for the second question, "viability" depends not only upon changes in rainfall patterns (which are beyond local control) but also on use rates (which are subject to local control). Use rates in turn depend on population numbers (not only in Phoenix but elsewhere in the southwest region of the United States) as well as irrigation habits and limits, and other water use controls.

But to what end, Emil?

It's no surprise that metro Phoenix attracts lots of old people with Medicare and the means conferred by a working life in pre-1980s America. So we get some healthcare jobs. At the end of the day, the overall economy is low-wage and lacks diversification or competitiveness, especially for a place so populous, which brings huge carrying costs.

Banner has radically de-centralized its facilities so people in the far suburbs can get care "with their own kind." The outward economics seem good, too: A relatively affluent population base and greenfield land on which to build. But these would not be attractive without the freeways and other public infrastructure built to give value to otherwise much less valuable farmland. Then there are the many externalities not "priced in," but which must be paid. There are also the opportunity costs, e.g. if the infrastructure and capital investment had been used to reinvest in close-in neighborhoods and downtown.

Another result is that Good Samaritan, once one of the finest hospitals, is a shell of itself. As with almost everything else, sprawl on the fringes works only by hurting Phoenix. Without a robust medical cluster in central Phoenix, the downtown biosciences campus, which could be a game-changer, becomes impossible. Banner killed a hospital there. Houston has tons of suburbs and even satellite care centers, but the medical hub is in the central city, the Texas Medical Center. Same in Seattle, with three major hospitals all virtually next to each other on Pill Hill by downtown. Not so in Phoenix. This pattern is so inefficient and costly, but the playerz benefit and the suburbanites love their apartheid.

So, to what end? Phoenix still doesn't have a competitive, quality economy. The big problems are getting worse. This is so in part because of a "strategy" that merely depends on population growth, itself a sharp double-edge sword.

Emil: "I don't think the Arizona political establishment has much to do with the global phenomenon of climate change affecting Sonoran desert temperatures."

That establishment pulled out of multi-state efforts to try some solutions and study. Seems like a small thing, but of such actions are big opportunities missed. One would think people living in such a beautiful and unique place would want to protect it; of such an ethic comes the beginnings of national voter demands that America, one of the two biggest gas emitters, stop this madness of inaction and even making the situation worse (coal exports, fracking, drill, baby, drill).

In addition, the state establishment pushes policies that degrade the environment locally: Sprawl, land swaps, subdivisions in the forests, exurban development in fragile ecosystems, adding to the heat and smog islands, and, most importantly, refusing to address water issues and playing fast-and-loose with real vs. fantasy water supplies.

It is doing nothing to prepare the region for this future. Its policies will make the situation much worse. (Here I really miss Soleri because I feel mighty lonely having to point out these things. Maybe Phx Planner will join in.)

Sorry, I forgot to update you about soleri.

He is training for a run and he suffered a minor injury.

His doctor told him to just run 5 miles a day and call him in two weeks.

Last we heard, he called his doctor and said, hey doc, I did what you said. Now I'm 70 miles from home, what should I do now?

(parts of that story are true)

The air quality and heat of the last two days has really been the "Dog Days". Yuck.

I believe we are 14 years into a 20 year drought, so hang on, only 6 years until happy days are here again.

There are 75 million reasons why Banner is betting on a growth market.............baby boomers.

We are the lump that will choke the system, probably to death.

Sorry, AZRebel, but in the "Like A Phoenix?" thread I just mentioned that the median age of Phoenix residents is 32 whereas in the United States at large it's 37.


Now, if you can offer an argument as to why this is irrelevant, do so.

The seemingly "younger" Arizona is almost entirely an artifice of the Hispanic population, which is largely cut off from opportunity. What are the average, mean and median ages of the non-Hispanic whites in AZ and metro Phoenix? I don't have time to get that deep into the weeds of the latest Census. But the critical problem is metro Phoenix is not attracting its share of young, college-educated talent. They go to places such as Portland, SF and Seattle.

I don't have the online time tonight to reply to Rogue's latest comments, but here's something already prepared. Mr. Talton wrote:

"Its externalities will include more smog, more environmental degradation, a larger heat island and congestion."

There are some factors that might offset pollution from increased vehicular traffic/miles driven on the fringes:

First, more than half of the new cars and trucks sold in the U.S. in 2012 (through May) had four-cylinder engines. That's up from 36% in 2007, and an all time high since 1998 when J.D. Power and Associates began tracking this stat.

In 2007 the federal government began raising gas mileage minimums: by 2025 new cars and trucks sold in the U.S. will be required to average 54.6 mpg. This means fewer emissions per mile driven, since each mile driven burns less gas.

Improved emissions requirements and standards over the same period should also help.

The median age of today's cars is a record 10.8 years (one reason why U.S. auto sales are so robust), so we can expect at least two major waves of replacement by 2025.

I can't quantify the offset, nor do I have time tonight to research the percentage of carbon monoxide, carbon dioxide and particulate matter present as a result of motor vehicle emissions. More tomorrow.

The median Phoenix age may well (as I suggested earlier) be a result of the Hispanic population (more than 40 percent of Phoenix, with more school age children), but that doesn't translate into a vibrant health care industry because Phoenix is old (it isn't).

More tomorrow.


While you report from the library and from the research files, I report from the ground.

Sad to say, I am a frequent visitor of the cardio field, eye field, spine field, chiro field, etc.

The waiting rooms are packed. Each room is a sea of white hair.

The only items in these waiting rooms averaging your 32 year statistic is probably the underwear the patients are wearing.

I grant you your large population number "averages", but I give you my real world baby boomer,aging, broken down tidal wave of gray hairs.

Trust me, sixty ain't the new forty.

A short note as I am out of time. My friend says it's nighty nite time.

Donna I will have to go with your take on Dr. Harris as I don't know the guy. But after 62 years in Arizona I think the state has deteriorated to then point I would prefer a third wold country. Every day I think about a little beach hideaway about 4 hours south of the border that I frequent.

Gotta go.

"the Republic's excellent Gary Nelson"

Behold the Talton 'Kiss of Death'.

"Arizona was on track to be the 'Appalachia of the 21st century'"

That's not a great climb from being the sub-Appalachia of the 20th centruy.

We're collecting signatures for a proposition:

Taking inspiration from the tiny town of Why, Arizona, we are asking the citizens of the state to rename Arizona as 'Why'. Not so much to enjoy the new name of Why, Why, but more to ask the fundamental question of, "Why (the state of) Why?"

Or, maybe we should just shoot for the name "WTF!!" Imagine, "I live in Scottsdale, WTF!!"

Well, the summer solstice is behind us.

I can feel the days getting shorter.

There is a chill in the air this morning.

Old man winter is on his way.

It was a tough summer, but it's all down hill from here.

Reporting to you from Mesa, WTF.

The Thunder got struck by Miami Heat lightining!

Emil, I guess U probably worked out the Drew Brown "connection?" Also to work out the percentage of bad air just stand behind a city bus or get in a position high enough to look south at the mountains.

I surely appreciate your fact finding missions on behalf of the inhabitants of the Rogue planet advisory board. And AZ Rebel and I would be happy to buy you a cup of organic shade grown free trade coffee at one of our JT jam sessions.

So I would like to suggest that you take a break from fact finding as I know your capable of great writing. So how's about something really subjective, opinionated, witty, humorous with a lot of adjectives and words that AZREBEL and I will have to look up.

Thanks again,

Ole cal the guy that graduated last in his HS class and Spot a 22 year old dog that reads and whose favorite novel is CITY by Clifford Simak.

Emil writes:

In 2007 the federal government began raising gas mileage minimums: by 2025 new cars and trucks sold in the U.S. will be required to average 54.6 mpg. This means fewer emissions per mile driven, since each mile driven burns less gas."

True, but driving distance or what planners call VMT or Vehicle Miles Traveled, has greatly reduced - some research indicates an elimination - of the gains in fuel efficiency. Sprawl is the driver of VMT. Loop 303 and other $billion dollar misallocations of resources (like the South Mountain Freeway) is one of the primary drivers of sprawl.

Meanwhile, the taxpayer-paid 303 subsidizes developers in these horrific "car malls."


Dealerships are relocated ever outward, leaving empty hulks and huge lots to gather blight in their former locations.

One of sprawl's externalities is to privatize quick profits in the newest fringe, then abandon yesterday's sprawl, socializing the losses.

Meanwhile, closer-in areas continue to struggle:


AZRebel, the fact that medical rooms are full of elderly persons isn't surprising. It also isn't proof that Phoenix is an old town. Statistically speaking (and there are obvious exceptions) the elderly are more prone to medical problems.

Phoenix is actually a pretty young town, according to the 2010 Census Bureau data. Here it is by age group for the five oldest groups:

85 and older: 1% of Phoenix residents; 1.62% of Arizona residents; 1.78% national average

75 to 84: 2.56% Phx; 4.39% AZ; 4.23% nationally

65 to 74: 4.87% Phx; 7.79% AZ; 7.03% nationally

55 to 64: 9.62% Phx; 11.36% AZ; 11.82% nationally

45 to 54: 13.50% Phx; 13.18% AZ; 14.58% nationally


So, in every one of these groups Phoenix has a lower overall percentage than the national average, often substantially lower. Yes, lots of retirees moved to Phoenix, but so did lots of others seeking work. Note that the state at large is slightly higher than the national average in two of the five groups, and slightly lower in the other three.

I consider this to be pretty conclusive evidence; certainly a federal census is as good as we're going to get. The breakdown by ethnicity within these groups isn't relevant to the question of whether health care is booming in Phoenix because of the factors I suggested, or because of the (myth) of Phoenix being stuffed to bursting with fogeys.

And all this gets Arizona and Phoenix...what? Certainly not the young talent it needs.

As for health care, I'm not sure what "boom" means. Except for Barrow and plastic surgery, I can think of few leading institutions. Now, Boston, Houston, Cleveland, Seattle, Baltimore...these are among the world's leading health centers. Phoenix is nowhere near them in terms of research, leading-edge clinical work, worldwide reach, high-paid jobs and the ecosystem of medical education and biotech/pharma. It barely has a real medical school.

Mr. Talton wrote:

"(The Arizona political) establishment pulled out of multi-state efforts to try some solutions and study."

Good point. The state legislature and executive are part of the problem where environmental issues are concerned (as with so many other issues), including local environmental issues over which they have much greater control.

In the name of "free markets" they recently gave polluters the option of "self-auditing" and secret record keeping, a legal shield from lawsuits, and an easier time targeting whistleblowers. Not responsible stewardship and not good government.


This was passed by the state legislature and signed into law by Governor Brewer.

Also, I don't think anyone would posit that the city of Phoenix has a disproportionately large population of "fogeys." The more profitable research is to be had in their proportions in parts of the East Valley and around Sun City and other retirement hubs, and their political participation and leanings. Being a retirement "destination" substantially changed Arizona from the 1960s on, as happened in Florida.

Phoenix's youth, the last time I studied it, is heavily weighted by the immigrant and working poor (citizen) Hispanic population. Yet this is the cohort hurt worst by state and national dynamics preventing economic and social mobility. The result is that Phoenix doesn't benefit from this youth. It is thrown out by the boosters (and I don't mean Emil) selectively to claim that Arizona is not affected by being a retirement center.

Cal, city buses in Phoenix mostly run on natural gas, so they're very clean. A small percentage run on diesel.

As for the brown cloud, yep. I did a little research and found this:

Elemental carbon – which has a chemical composition similar to pencil lead and exists in the atmosphere almost entirely as PM2.5 – is particularly efficient at absorbing light. It accounts for most of the “brown” in a brown cloud. Another contributor is the brown gas nitrogen dioxide, which is formed in the atmosphere from the nitrogen oxides emitted by combustion sources. In fact, nitrogen oxide is the only pollutant gas we can actually see. Other common ones, like carbon monoxide and ozone, are invisible.

Generally speaking, the primary sources of PM2.5 in urban areas are combustion sources, mostly gasoline and diesel engine exhaust. Combustion contributes to particulate pollution both directly, by emitting a variety of particles into the air, and indirectly, by emitting gases that are then oxidized in the atmosphere to create additional particles.

Combustion is also the major source of elemental carbon. Across the West, our vehicles are the No. 1 cause of brown clouds.

Scientists can apportion blame for the brown cloud in a particular area by performing chemical mass balance calculations – mathematically computing the combination of emission sources that best account for the pollutants observed in the atmosphere. According to the 1999 MAG report, gasoline engine exhaust accounts for about half of the ambient PM2.5 in Maricopa County, and diesel engine exhaust accounts for about 15 percent. Although soil dust pollution is a huge problem in the Valley, accounting for roughly half of our total PM pollution, its contribution to the visible brown cloud is less significant, because most soil dust particles are too large to efficiently scatter light. Our brown cloud exists not because we live in the desert, but because we drive in it.


Note that this is from page 2 of a five page article.

As for the lesser contributor of soil dust, doesn't construction throw up a lot of that? So I guess that exurban sprawl is a double whammy.

In 30 years the few climate change deniers left will have their heads implanted on pikes by the rest of the populace. Most of the Southwest's forests will be dead from fires, drought, and the pine bark beetle. Phoenix will be the world's largest ghost city. Despite increasingly sweltering heat in the summers, the deserted city will still be a place of mild winters, attracting a large segment of the nation's homeless population who have managed to survived the future pandemic of antibiotic resistant super-bugs. Nearly all backyard pools in the once vibrant desert metropolis will be empty, a stark reminder of the profligate mindset during the height of the fossil fuel age. Like the ocean's countless fish, oil and water were once thought to be cheap and endless. Technology was not the savior most thought it would be.
Future generations will know better.

P.S. Cal, I don't want to waste my time gassing. Facts, properly interpreted, are the basis for rational discussions of factual issues. That means you have to: (1) determine the facts, and (2) learn how to think critically, interpret properly, and make valid connections between facts.

We all need plenty of practice at this (myself included, which is why I spend so much time practicing it -- this is as much an exercise as a discussion for me). Rogue Columnist is a great forum for it because the writer is highly talented and engaged and many of the readers are literate and knowledgeable. I also like the fact that discussions can be extended over a period of days. The fact that Mr. Talton offers something sophisticated to sink your teeth into instead of the usual insipid pabulum is great too.

The Arizona Republic comment pages are full of opinionated gassers and if you don't get a comment posted early in the day it will be read by few or none. (Apparently all of these gassers are writing from work, because I almost never see any activity there after 5:00 pm of the first day a story or column appears.)

Phoenix is nowhere near them in terms of research, leading-edge clinical work, worldwide reach, high-paid jobs and the ecosystem of medical education and biotech/pharma. It barely has a real medical school.

Yeah but at least our Governor has a HS degree.

And if you think that is just a throw away line you are wrong. If Harold Meyerson is correct then we have a new and growing demographic, the poor white-right:

This year, two things are different. First, Romney is not claiming that kind of cross-class support. He personifies Wall Street at a time when even Republicans don’t like Wall Street. Second, the downscale wing of the Republican Party, more inclined toward reactionary cultural appeals than are more upscale Republicans, has grown. Just as upper-middle-class professionals have become more Democratic, so the white working class has become more Republican.

That's AZ in a wingnut shell. And who is the leader of this growing demographic? Rick Santorum. And what was Santorum's major message? College bad. Gays bad. God good.

This is the stuff of hopelessness. You do not lift a nation up by cheering your people on to avoid the hard work of college. You don't suppose China has a Santorum telling its young people that college and science are shit? Hell no. The leadership over there would put a bullet in such a creature's head and feed the body to feral pigs...

Here? It almost makes it to the party's nomination...

No gang, it is all over here but the shouting. The great white race has blown its nut. It's leaders no longer inspire their own children to education and science. It has turned its back on social progress and science and the hard work they inspire. All that's left are ugly social darwinists, young-earthers, and birthers, who soon will shout down public libraries as being blantantly socialistic.

The future is not only worse than you imagine.
It is worse than you can imagine.


Thanks emil. Well i gotta get back to calvin an hobbes.

Phx Planner, I can easily believe that vehicle miles traveled (VMT) has greatly reduced or eliminated fuel efficiency gains and/or emissions standards improvements. To date. But fuel efficiency increases and emissions restrictions and increased efficiencies are still an offset, even if a negated one: just imagine what it would be like without them?

The question is whether this trend will continue in future. VMT topped out in 2008 at 3.033 billion miles. Since 2009 they've been essentially static at about 2.9 billion.

Also, the new fuel efficiency standards are a quantum leap (if implemented) above past increases in fuel efficiency. So the offset may be less, even if sprawl continues.

XRAYMIKE79 is my kinda dude or duda.Well said!!

And the poor right wing religious right are being led by the Sons of Privilege- straight out of Harvard Business School -
G W Bush & Romney - who will gladly lead them to slaughter!

Hello to all! I have been reading Rogue but haven´t had the chance to post an appropriate response since I have been extremely busy. I was on the east coast (mainly (NYC) for some time and now am in Europe. It has been exhausting but loving it. After seeing some of the parks in these Beautiful European cities, you can only hope that the City of Phoenix reinvests in Encanto Park and that new plans for Hance follows through: shade, trees, and some gardens please...


These small scaled (not many highrises compared to U.S. cities, even Phoenix to an extent) but extremely dense cities makes you wonder why it is so hard to replicate in the U.S. Especially in Phoenix where so much vacant land sits near the City Center. Hope you all are enjoying your summer so far!

Hey pSf - good to see you checking in. Lot's of whining 'round these parts about the heat, but this weirdo is enjoying it... :)

Thanks for checking in, pSf!

Wow. Great dialogue! So much to ponder. As I mentioned in another forum, I am running for the AZ House in the SW Valley. Jon, it seems like you wrote this specifically for me! Yes, the challenges are many and seemingly insurmountable. Far more challenges than a poor kid from south Tucson can overcome, but I sincerely believe I can make a difference. Last night we held a fundraiser with Mayor Stanton. At the event, I unveiled a vision I call the New West. Creating the New West is all about evaluating our very real challenges and methodically creating strategies and plans to fundamentally change the modus operandi. I know that saying this in front of a group like this is naive at best, quixotic in reality. Yet, I've come to the realization that it's not enough to campaign under the mantra "at least I am not as crazy." In the absence of a competing and compelling vision, "not as crazy as the other guy" will not put the leaders in authority to make real changes. Yes, creating the New West will be extraordinarily difficult and likely impossible, but I am gonna fight like heck to present this vision as an alternative to what we have now -- the bottom of every significant socioeconomic measure. I would love for one day the Rogue Columnist to write a blog about how we built the New West with the parenthetical (WBIYMF).

With regard to the population age. I think Banner Health (whom I have done some work for) possibly looked at age population in the frame work of Avondale, Litchfield, Sun Cities, and other aging bedroom communities. The Banner Hospital in Mesa can also draw on a huge retired population plus a lot of Canadians. Age may be a reason they didnt build a new huge facility in downtown Phoenix.

Lorenzo Sierra, Besides this blog regarding your "New West" (is that like Baja AZ?)I suggest if you havent already, that you toss into your reading pile "Killing the Hidden Waters" by Charles Bowden and some Edward Abbey books like Desert Solitaire.

“Both good questions, but I don't think the Arizona political establishment has much to do with the global phenomenon of climate change affecting Sonoran desert temperatures.”

A logical response. Yes. But also a subjective approval of the current political power structure that denies anything that appears to be liberal; like “Climate change.” From my gaseous view point I think Arizona would be a lot cooler if a number of our current politics were forced into exile in Utah. It would not be humane to load them into a box car in this sweltering heat and send them to a tent city in Juarez.

Phxsunfan, we really did miss you. As we need a counter to the old negative grouches like me.

Welcome back to Phoenix a place that once had very few buildings over one story. Correct me if I am wrong but would it not be wiser to have low slung and underground buildings with natural air flows in the desert as opposed to glass and cooper tall structures?

Koreyel, thanks for that greatly worded post on the 22nd.

Emil, do you mean that the following four subjective items when added together equal a factual objective truth.

"Facts, properly interpreted, are the basis for rational discussions of factual issues. That means you have to: (1) determine the facts, and (2) learn how to think critically, interpret properly, and make valid connections between facts."

I guess thats why I never signed up for a logic class. All very confusing.

Speaking of Ugly. Have U all noted the cooper monstrosity going up on the west side of 7th Street north of Van Buren.

What is it?

cal, you broke the "no more than five posts in a row" rule.

Give me five Hail Mary's, ten Our Fathers, and 25 push ups.

I will find out!

It's Phase II of the downtown biomedical campus...

It's very shiny. Reflects a lot of sunlight, which is just what the "doctor" ordered.

Petro I noticed that when I was blinded by the light while driving south on 7th street in the AM.

"cal Lash" wrote:

"With regard to the population age. I think Banner Health (whom I have done some work for) possibly looked at age population in the frame work of Avondale, Litchfield, Sun Cities, and other aging bedroom communities."

This seems to be Mr. Talton's theory also. However, the Banner facility being built at Loop 101 and Thomas Road is in District 7, which has the highest Hispanic population of any in Phoenix:

Hispanic: 107,338
non-Hispanic White: 34,583
Black: 26,648
Asian: 4,741
American Indian: 3,704


And insofar as the Hispanic population has a lower median age, there goes your theory out the window. Likewise Gilbert and surrounding areas, where health expansions have occurred among a population of relatively young working professionals and their families (mostly non-Hispanic White).

Within Phoenix itself, only four districts (1, 2, and 3, the northernmost, and 6) are majority non-Hispanic White: the rest are majority Hispanic.

Almost all (if not all) of the health expansions recently have been out on the fringes. The only thing these areas have in common is phenomenal pre-recession growth. More customers equals more profit potential for something as fundamental as health care. See my other comments above for a more nuanced interpretation.

Back in the "Stanton in the Valley" thread I wrote:

"Why does Banner, the second largest private employer in Arizona in 2011 (right behind Walmart) insist on opening new facilities in places on the periphery of "the Valley" and not in central or downtown Phoenix?"

"I decided to look at Banner's facilities webpage to get the big picture. Banner lists 14 facilities:

"Cardon Children's Hospital is at 1400 S. Dobson Road in Mesa; Banner Thunderbird is at 55th Avenue and Thunderbird in Glendale; Banner MD Anderson Cancer Center is at U.S. 60 and Higley Road in Gilbert; Banner Ironwood is in San Tan Valley; Banner Heart is in Mesa; Banner Gateway is located near the Cancer Center in Gilbert; Banner Estrella is located at 92nd Avenue and Thomas; Banner Desert Medical Center is located in Mesa; Banner Del E. Webb is located in Sun City West; Banner Boswell Medical Center is located in Sun City; Banner Behavioral Health Hospital is located in Scottsdale; Banner Baywood Medical Center is located in Mesa.

"Only one facility, Banner Good Samaritan, is actually in central Phoenix, at McDowell and 11th Street. It's also the oldest: the original facility was founded four months before Arizona became a state."

Growth, Mr. Lash. Not age. If you read the Tower Two article I linked to above, you'll see that "Banner Estrella is filled to capacity about 40 percent of the time and that its emergency department has seen an increase of about a third more patients than it was built to support." And as I noted above, you'll also see Banner's projection of 8 percent growth in the Southwest Valley by 2020 compared to 3 percent in the city of Phoenix during the same period.

Emil, Banner built the Estrella hospital specifically to serve Goodyear, Litchfield Park and other relatively affluent areas that were up and coming in the 00s. This is not a supposition. I recall my conversations with their executives at the time.

The $161 million Tower Two expansion "will support patients from both ambulatory facilities as well as new patients from Avondale, Goodyear, Buckeye, Glendale, Litchfield Park, Peoria, Surprise, Tolleson and west Phoenix".

Those are by no means all affluent areas, though it scarcely matters because the relevant criterion (beyond wealth) is still growth, not age. Up and coming means growing. The Banner Estrella CEO cited growth projections for the Southwest Valley in explaining the need for expansion.

Not enough time to research and finish this properly now.

I still don't get your broader point.

Within the city of Phoenix, there's eight hospitals within walking distance of light rail: Phoenix Baptist, the VA, Kindred, St. Joe's, St. Luke's, Maricopa County, State of Arizona, and Oasis. And Good Sam is less than a mile away, that's nine if you count it.

That's significant. Add to this the opening of a branch Creighton Medical School near St. Joe's (just a branch, but you don't see them locating in Gilbert) The Downtown Biomedical Campus will eventually include a serious teaching hospital.

We spend a lot of time in this forum talking about Phoenix's disadvantages. The healthcare presence in the center city (now linked together with high quality infrastructure) is a unique advantage.

The broader point is that it's growth rather than age that encourages expansion of the health care industry on the fringes. Growth at the fringes and higher household incomes sometimes coincide. What counts for shareholders is an increasing number of paying customers (and most health care is paid for by insurance, not private wealth), since this results in increasing profits, so growth is king.

When profits increase, stock prices do too. The shareholders want to maximize their investments, and since they control the board of directors, who in turn appoint the CEO and others, a policy of expansion at the fringes suits them -- provided that there is an expansion at the fringes, and the expansion consists of paying customers.

Of course, it doesn't hurt when the paying customers (or their employers) can afford good private insurance policies that offer better reimbursement rates than Medicare and Medicaid (generally, private insurance reimburses at rates 10 to 30 percent higher, since the public insurance program reimbursement rates are used as a baseline).

More expensive private policies also generally involve less out of pocket for the insured and thus encourage the insured to seek health care more proactively (which means more profits for health care providers). In addition, they may cover more types of health care (including some types of elective beauty surgery or other such procedures). And it doesn't hurt to have paying clients who can afford to pay out of pocket for elective surgeries not covered by insurance.

What I'd like to do is get the data showing the median ages in these southeast and southwest valley expansion areas and compare them to the national average.

Thanks for the info on central Phoenix hospitals, Phx Planner. Can you tell me when those hospitals were built or when they last saw significant expansion?

I appreciate all your research, Emil. At the end of the day, this radical decentralization is very costly and inefficient. As to the central city hospitals, none are really in walking distance of light rail, especially on a hot day, especially for a sick person. The only ones that have expanded substantially are Mr. Joes (the Sainthood was revoked by the Bishop) with the cash cow of Barrow, and Children's. The lack of one or more hospitals on the biosciences campus is a huge hindrance, prevents the creative friction and ability to leverage talent, discoveries, bench-to-bedside care, etc.

Yes, I agree, for the sick 1/2 mile (10 minutes for the average person to walk) is probably too far. For a healthy employee easy - especially on a walkable street.

For example, imagine that you worked at the Chase office on Mill and University in Tempe. Would making the walk from the light rail stop on 3rd down Mill each day be too far? That's about 1/2 of the same distance between LRT stops in Phoenix and many of the hospitals in central Phoenix. The key is making the connections more ped and bike friendly. (a bike rental system like Bixi would also do the trick)

But the development opportunities between the hospitals and the light rail stops are the real advantage that I'm referring to, not necessarily patient access (although walkable senior housing development is an opportunity). The good jobs that they provide and opportunities for agglomerative industry clusters in their vicinity is an asset that, if leveraged strategically, could aid in filling in the "teeth" near the light rail stops.

One question comes to mind after reading this thought-provoking discussion: WHO IS THE AUDIENCE?

My guess is that it is not really US. Rather, it is the movers and shakers and big dogs and "boyz" (Jon's term) who are outta town and enjoying their protracted summer holiday. They don't have to put up with the crappy summers, which tends to shield them from the realities of how awful the June-September period has become. If Jon had the best bully pulpit imaginable, there's hardly anybody out there with a checkbook and enough influence to make a difference.

So while we curse the darkness, how many of us can light a candle?

And Emil, thanks for probing into the Brown Cloud . . and while you're at it, please consider researching the Bad Ozone because its health effects are worse . . . and mostly due to the emissions of our mindless tail-piping through life. More 4-cylinder engines and higher fuel efficiency overall . . no doubt this will help, but the relative scarcity of public transit is a long term burden.

Maybe the worm will turn if/when Scott Smith is elected Gov. and the dumshits ride off into the sunset . . . ?

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