Raise tariffs, re-tool America, lower retirement age, and go for universal health care…

July 17, 2009

I watched Charlie Rose last night and heard Bob Woodward say that President Barack Obama has not really been tested by his own crisis yet. He said that he did not know what crisis might be in the offing, but perhaps unemployment might be it. And today I read that unemployment has reached 10 percent in 15 states. I know it is higher than that in my local area, and maybe in yours. If unemployment remains high, I think the Obama administration will be seen as a failure. Actually we are already in an unemployment crisis — so let’s see how Obama handles it.

Raise tariffs and provide tax incentives to U.S. industry that employs people right here in America, lower — not constantly raise — the retirement age to increase job opportunities for younger folks, and relieve businesses of providing costly health plans and thereby at the same time free up workers to more easily go to better or more suitable jobs by providing some type of universal health care scheme not tied to employment.

And so the doctors, and others, will not gripe that government bureaucrats (as opposed to private health insurance bureaucrats?) are dictating health decisions, let doctors serve on public boards to oversee the government-guaranteed health care. Notice, I have not written “government-sponsored”. Actually I assume that under any scheme to guarantee that everyone has health care coverage there will be government funding.

How about those ideas to put America back to work and get the economy going?

And while I don’t want to just concentrate on health care, I can see from my own personal experience that health care rules so much in our lives (it’s the cost and availability).

So I will address health care and then go back to some of the other economic recovery ideas.

The only way I can see that there is ever going to be health care for everyone is for the government to be involved, the free market can’t seem to do it.

I watched part of a documentary on PBS some time ago about how other nations handle health care, but it was kind of hard to follow or at least remember, except that it seems to have a lot to do with attitude of the public. For some reason maybe the rest of the world is just crazy, but they see a role for their governments to serve the interests of their citizens. For all the need and talk about health care reform in this nation, I sometimes get the idea that the general public is not into it as much as one might imagine, that is until something bad happens in one’s personal life, but then you’re so mired in your own mess, it’s hard to see the forest for the trees. But if the public really cared as much as it is reputed to, I think we would have had reform long ago. I keep hearing that Teddy Roosevelt ( a Republican – a progressive one) pushed for some type of national health care. That’s a century ago.

I’m extremely surprised the business sector has not pushed for national health care, seeing as how providing health care coverage for employees is such a major expense. And if employees don’t have coverage they will eventually be less productive and certainly it would seem more vulnerable to worker’s comp claims, which really can cost employers a lot.

Right now with so much of the work force out of work, huge numbers of people are without or soon to be without health care coverage or are trying to figure out how poor they have to let themselves get to become eligible for government programs.

Health care has become so expensive but is so necessary that it has become one of the most important, yet hard to meet, requirements in life, darn near beating out food and shelter.

Unless you have the fortune required to pay out of your pocket for all health services you might need, you generally have to join together with others in some type of group plan. So why can’t virtually the whole nation join together as a group? Yes it is going to cost, and everyone should have to pay a fair amount according to their means. And the amount of taxes raised for health care cannot be unlimited. So, yes, that means that decisions as to what is covered and how much the insurance will pay will have to be made. They always are, even in private insurance.

Taxing the rich (and who figures out what rich is?) to pay for health care is a bad idea. Social Security, the one program with “social (ism)” in its name that seems to have near universal support or at least acceptance, was designed so everyone (almost) pays for it and everyone is eligible and everyone has a stake in it.

A doctor who writes a column for my local newspaper said he dreaded any type of public option because the government would be telling him how long or what kind of treatment he can give his patients. Not any more than private or so-called group insurance does. And no one would tell him how long he can spend with a patient. That is up to him. He’s talking about his reimbursement. He can spend longer with his patient than the reimbursement covers (the government or other insurance entities only limit the money, not the time), and he can charge the patient the difference (and that is what is often done). Whether the patient can pay that extra amount is always in question (and do doctors consider themselves mere hourly employees?). And it might seem nice to compare the medical care market with any other consumer offering, but, you know, there is just not much competition. In fact, a lot of doctors do not accept new patients.

There is a concern that the number of family practitioners is dwindling because there is just not the money in the field there once was (still better than when they used to accept chickens from farmers). Maybe there needs to be more incentives to create new family practitioners, such as subsidized training for promising students. And maybe if the private sector cannot offer enough services, there needs to be government clinics staffed by well trained doctors and support personnel.

Such clinics would have to be well funded, because if not, you get the stereotypical zoo.

And then there is the problem – who wants to go to a cut rate doctor?

I got off the track on this medical thing. I was really wanting to put another pitch in for the re-industrialization of America. I know all the learned economists and political historians will tell you that raising tariffs is “protectionism” and protectionism is a bad thing because it leads to retaliatory protectionism from other countries and stymies world trade and leads to even more economic hardship and that there is precedent that proves it – the Smoot-Hawley Act of 1930 and the Great Depression. But that notion has been brought into question by some. And besides, that was then and this is now. I love history, but we live now and maybe things are slightly different today.

What so-called free trade has brought us is unbalanced trade where the U.S. competes with nations with a much lower standard of living and it continues to drag the U.S. down. Free trade was sold partly on the idea that other nations would prosper and come up to our standards. And I have to admit that in my ignorance I once thought if something can be made cheaper elsewhere, so be it, I’m generally for it. But there is such a thing as buying value (something that is hard to find these days – except in foreign cars), and there is such a thing as keeping the wealth in one’s home country. In our own greed we may have been tricked into giving up the store by becoming a nation of bargain hunters rather than a nation of those who produce or support in the production of quality products  and who share in the wealth that the demand for quality brings. Developing nations may develop, but they also may surpass us while we are not paying attention.

And even though a lot of money is made out of war, our current wars are a net drag on our economy and it is morally wrong to base our economy on war anyway. We should work to get out of war situations as quickly as possible and avoid wars when we can. And we are finding out that in today’s world rapidly moving events all over the globe can cause us to be overextended easily.

Kind of a scatter shot approach here. But just some thoughts.

P.s.

I heard someone mention on a TV news talk show that even with all the hubbub about whether a health care plan will make it through congress this term, even if it did it would be five years before anything went into effect. That’s absurd.

I still think everyone is trying to make this whole thing too complicated. Complication is not what we need. And it is hard to shop for health care, especially when you need it (think about it).

Just expand Medicare for those who cannot afford to pay for private plans now on the market. The market has no interest in providing health care for those with no means to pay. In fact, left to its own devices, the private health care industry would avoid offering coverage to anyone who might actually want to use it.


How do we in good conscience deny health care to millions???

June 19, 2009

It seems that lawmakers and perhaps large numbers of voters who chose Barack Obama are getting cold feet about the cost of health care reform (a trillion dollars, yikes! But then again, doesn’t the government just print money? Yes, I’m being sarcastic).

Maybe some are rethinking the issue, wondering if we should just not leave well enough alone.

Well to anyone who thinks the present health care system works just fine, I offer this localized version of what is going on (or part of what is going on).

Here where I live at the Northern end of California’s Sacramento Valley we have two major hospitals in town. The biggest is a non-profit (and that has nothing to do with how much patients are charged – it’s still an arm and a leg and more) and a for-profit that changes ownership somewhat frequently, one that was in the national news some time back because two heart surgeons, with the blessing of the management at the time, made quite a business out of performing unneeded surgery. But that does not mean it is not a good hospital, necessarily. Both my wife and I have spent time there and had excellent care, even though there is really no way to make it enjoyable to be in a hospital.

Anyway, that for-profit hospital recently changed hands and is now run by a controversial doctor from Southern California. He began by firing virtually all of the nurses and other staff and allowing them to reapply for jobs. One of the nurses’ unions has been voted out. It couldn’t get anywhere with the new management, so apparently the nurses decided they would be better off fighting their own battles or at least keeping their jobs.

He also cancelled an insurance contract with Blue Cross. As I understand it (and I may not), the hospital says it will still honor Blue Cross and will in fact waive your deductible. I think the catch is that unlike when you have contracted insurance the hospital retains the right to go after you for the part insurance does not pay (beyond the expected deductible). Kind of a double-edged sword there. Blue Cross has advised its customers not to deal with that hospital.

As a result, apparently, the non-profit (Catholic, did I mention?) hospital has been inundated, especially in its emergency room.

Now in my local newspaper I read that the non-profit hospital is being investigated by the feds for what is called “patient dumping”, that is to say they may be releasing patients too soon or denying proper treatment because they lack insurance.

So it occurs to me that not only is the non-profit getting patients steered their way by the insurance company, but could be getting ones without insurance that the for-profit one does not want to handle (although that is not included in the current investigation by the feds as far as I know).

The story indicates that the non-profit was flooded with emergency room patients because of doubts created about the other hospital over the insurance hassle and the fact that Blue Cross sent letters to its customers telling them not to go there.

There is actually a question as to what specifically the non-profit hospital is under suspicion of doing since neither the authorities nor the hospital will say precisely, except for the feds indicating it has something to do with patient dumping.

What I am trying to point out is that private health insurance is not a panacea. The reason the for-profit hospital had a beef with the private insurance is that it does not pay them what they think they should get – and isn’t that the same beef the medical community has with public insurance – too low of payments? (And why do we patients not feel the hospitals are not getting enough money? They demand you buy everything from your pillow to the toothbrush you didn’t ask for at high retail – not even Walmart prices.)

And what is this I hear about public insurance will mean health care rationing? Probably it will, but that is already in place, both through private insurance and public insurance. Private insurance is quite picky over what it will pay for. A doctor may use his or her own best medical judgment with the concern for the patient uppermost in mind, but in the end it all has to be paid for and the insurance bureaucracy is who decides.

Doctors and hospitals have to hire whole staffs of people just to work with the private (and public) insurance bureaucracy – billions of dollars are spent each year not for patient care but instead in an effort to maximize profits for private insurance and for the medical providers to get as much out of the government programs as they can.

Some of the ways private insurance maximizes profits besides denying certain types of procedures include delaying payments by bureaucratically denying them only to later pay, but in the meantime getting more interest on they money they temporarily withhold from you. Also, you might give up and not get your entitled full claim due to the bureaucracy (and I am not making this up; I have personal experience with this routine). I’m sure there are many tricks, such as bureaucratically demanding certain codes be used and requiring forms in triplicate and so on.

I hear and read about public opinion both ways. The public is demanding health care reform and in fact supports a public option. I also hear that there is a strong resistance now in the congress to the cost of a public plan, and one has to assume that they (the congress) are at least in part reflecting the concern of their constituents.

I am holding to the opinion of my most recent blog on the subject, people who have private insurance are reluctant to put it into possible jeopardy by monkeying with the system (and I understand this).

It is often noted that every other industrialized nation in the world has universal, government-sponsored health care.

Okay, forget the rest of the world if we must. But I think that it is only right and it is only practical that all U.S. citizens should have basically equal access to health care. As for illegal aliens, it would seem we only owe them initial emergency care.

Since there does not seem to be overwhelming support, to say the least, for government universal care, then I think that the only thing we can do is say if you can afford (and who decides that, I don’t know) health insurance, you must buy it (because otherwise the taxpayer gets stuck with the bill in the emergency room where it all starts out, and caring for the uninsured also adds to the cost of private insurance). If you can’t afford it, you should have a publicly-supported option. And that public option could be one that is 100 percent taxpayer funded or one that is simply backed by the government but run by a non-profit co-op or even a quasi-private entity.

Forty seven to fifty million seems to be the oft-quoted figures for the number without health insurance. But as has been pointed out, especially by foes of universal care, that figure may be both inaccurate and misleading. A certain percentage of the total uninsured, as much as 10 percent I think I’ve heard, are illegal aliens, and a certain percentage are young people and others who simply can’t be bothered but run to the emergency room when something happens and demand their right to care on the taxpayer dime. And a certain percentage may actually be entitled to some form of public care and don’t realize it.

What we do know is that there are a sizable number of people, and a large percentage of them are children, who for whatever reason are denied health care.

How anyone in good conscience could be comfortable with that continuing is beyond me.

The reason we don’t have universal care (even the kind that has extreme flexibility, allowing the continuance of private insurance) is the lack of guts on the part of so many politicians. Politicians are often people who have apparently convinced themselves that they could not make their living any other way and therefore are scared to death that if they vote against vested interests in the status quo they will lose their job. They fear the money powers who can spread propaganda and deny them campaign funds if they don’t do their bidding.

I say to all the senators and representatives:

“Try voting your conscience for once.”

 

P.s.

The line now is that any type of public option on health care will run private insurance out of business. Yes, if everyone, to include employers, was offered essentially a free plan versus a paid one, it would. So any public option has to be tightly restricted by actual need, perhaps. And once we get there, I don’t see why we didn’t just expand Medicare.


Those who have medical coverage may be biggest obstacle to universal care…

June 15, 2009

I think the biggest stumbling block to universal health care, by which I mean not necessarily what people used to decry as “socialized  medicine”, but simply access to all for care, is not the private health insurance industry or the pharmaceutical companies (although they together are a close second), or even the AMA.

No, the biggest stumbling block to everyone having adequate health care is those who smugly clutch on to their own coverage but would deny it to others. Why should they who have worked for it or paid for it or otherwise “deserve” it pay for others who are perhaps too lazy to get a job that offers health insurance? And aren’t welfare recipients covered by the government anyway? they ask. Or why should they have to pick up the slack for for those who do not have the good sense or a sense of moral responsibility to make sure on their own that they have coverage?

And I was just expressing what I think people must be thinking. What a lot of people do not realize is that if they have job-sponsored health insurance, if they lose their job, they probably will no longer be able to afford it, and if they get sick they may lose their job and find themselves without insurance (tying insurance to a job was a crazy method all along). And there is some truth to the notion that the unemployed and disabled often have some type of government insurance. But there are a lot of ways for people to slip through the cracks, such as being just over the income limit for assistance or having a job that does not have health insurance or premiums that you can afford, being cut down to part-time work and losing your benefits, long waiting periods before government insurance, such as Medicare, kicks in, and the list goes on.

I used to think the so-called single-payer insurance by the government would be the best way to go, and I still don’t know but that it would not, but there is so much automatic opposition to it in this country that it seems unlikely it would come to pass.

Even President Obama explained that in the U.S., unlike all other industrial nations where some form of government-sponsored health insurance took hold, the employer-sponsored private health insurance model took hold. And while it has worked well, too many people now have found themselves without access to health care, and that includes a lot of people who work at regular jobs. Some jobs don’t offer it, but the employees who work at those jobs don’t qualify for government health care, and some employers either quit offering it or premiums have gone so high that people can’t afford it.

The latest figures I could find indicated nearly 47 million Americans, about 15 percent of the population, are without health care, and a large portion of those are children (and with all the job losses the uninsured figure is likely much higher now). There are probably some cases where people go without it on their own volition and others in which they don’t realize that they are entitled to some type of government coverage, but I would think that is in the minority. And I have personally heard of cases where people have some type of labor union coverage or other type of employer-sponsored coverage and go in and out of it through the year because they do not work steady. How can that work? You can only get sick and get treatment at certain times? That’s absurd!

A real case: A friend and former co-worker of mine had company-paid (100 percent) health insurance, but was laid off and lost it. He then was hired back, but on what is considered a part-time (on call) basis, so he does not qualify for the insurance. He has chosen (or is forced) to go without the insurance because he cannot afford to pay the premium that would be required.

I think there is a dire enough need and possibly enough political pressure out on the hustings to force congress to come up with some type of health care reform, and maybe this year, from what I am reading.

The pressure is great enough that the health care industry is getting into the game to help save themselves and their profits. They’re funneling big money to the key players. I recently read an article, and I suppose anyone who reads the news regularly has too, that noted that many of the key people in congress on the health care issue are getting big bucks from the health care industry.

Among them is Sen. Max Baucus of Montana, who along with his own political action committee has received $3.4 million in campaign contributions over the past six years (or $1,500 per day) from various segments of the health care industry (this information thanks to the Independent Record newspaper of Helena, Mont.).

Baucus chairs the Senate Finance Committee, which is working on a health care bill.

I understand that Baucus has said that a single-payer national health care plan is “off the table”. There is a compromise proposal that would create some type of non-profit plan to offer lower-cost insurance to those who otherwise could not afford it, initiated by the government perhaps, but not run by the government. I understand Baucus has not expressed much enthusiasm for that either.

Now the way I see it, I believe anyone who now has good health insurance is one hundred percent right in wanting to hold on to it and should be able to. At the same time, we all have to have enough compassion and common sense to know that in the greater responsibility to our nation it does not make sense to deny coverage to so many and let so many continue to lose it. It’s not only compassion, it’s our own survival in a competitive world. If the trend in lack of health care continues it will make us weaker as a nation.

Obama promised in his campaign and still holds to the idea that he does not want to force anyone out of their plan, only to make health coverage available to everyone.

Everyone knows that no matter what way it is done or even if it is not done, health care will continue to eat up a larger and larger portion of the nation’s GDP.

At this point, I don’t know what the best plan going forward would be. Non-profits, if they could really offer affordable health coverage to the uncovered would seem like a good compromise between the strong opposition from vested interests in the private sector (along with vested policy holders) and a government-run plan.

And I don’t recall who it was, but not long before I sat down to blog this I heard either some Republican spokesman or the head of the U.S. Chamber of Commerce (same difference) and he said, and I paraphrase, that providing health care just now with the recession and such is just too expensive. Let’s hold off on that till a few years from now. Tell that to someone facing a life and death situation. Tell that to the sick child. If  only the Republicans could have adopted the so-called “compassionate conservative” attitude that George W. Bush campaigned on — if only he had meant it.

And there is a lot of waste and abuse in the various government-sponsored programs, but so is there in the private programs, so do we punish the innocent for that?

I find it strange indeed that in all of this the medical community largely remains silent. Well except for the fact that the AMA lobby has fought against previous health care reform proposals.

The AMA website proposes tax credits to allow people to buy private health insurance. To the extent that would help, that sounds reasonable.

It also says that those who can afford insurance have the responsibility to pay for it. I could agree with that.

But all that does not solve the problem of escalating costs and the fact so many, even with tax credits, cannot afford health coverage.

P.s.

I personally have been without and with and without and kind of with health insurance. And while I certainly don’t blame anyone for wanting to hold on to their own insurance (they need to), I hope I personally would not be inclined to not vote for or otherwise not support some type of plan that would offer coverage to all.


Harry and Louise and Joe Six Pack would sign up for government health care if it came to that, but of course they deserve it…

May 5, 2009

Was it Thelma and Louise? No I guess Harry and Louise, the concerned upper middle class couple who feared while sipping morning coffee and reading the Wall Street Journal that providing health care to all would eat into their 401K retirement investments.

Well their 401K went down the tube and their house, cash cow that it was, is not worth nearly as much as it used to be.

But the health insurance lobby is back. They’re warning everyone that government bureaucrats will be making life and death decisions and we’ll all be standing in line to get operations.

Well this is it folks: If you have money, lots of money, I mean whole bunches of money, you probably don’t need to worry (well actually medical bills can eat that up quickly). If you have a good insurance plan and can make the payments, or maybe if you are retired military, you probably are okay (until the government goes broke).

If you lost your job and your job-related health insurance along with it – oh oh. I know you used to gripe that so much of your tax money went to pay for health care for those undeserving slobs who don’t work for a living. But now you no longer work – although you’d like to. And you no longer have insurance – probably just when you needed it. Or maybe you did go back to work, but your company no longer offers that insurance, maybe because you were taken back on part-time.

Or maybe your company plan, whose premium goes up every year, has finally priced you out of the market.

Certainly now you feel you deserve some government health care. After all you paid taxes all those years. You’re not only needy, but you’re deserving. You’ll be the first in line for government health care. You better ask some of the more experienced at the game to learn the ropes.

I lost my job, not due to a layoff, but due to cancer. My company insurance ran out and then I had to start buying COBRA. I didn’t get in on the new Obama lower COBRA payments because I started too early (COBRA does not last forever, anyway). If you think you can get on Medicare, guess what, there’s a two-year waiting period. What you are supposed to do in the meantime is anyone’s guess.

Some people don’t worry. I sat next to a woman at a cancer support group meeting and she said her husband was self-employed and carried no insurance. He got cancer and needed an operation. The hospital “found” some program and performed it at no cost to him. No one’s offered me that. I wish him the best, though (it seems the polite attitude).

Health care and health insurance is a giant industry. The health insurance lobby probably has a point about government bureaucracy (but have you ever dealt with private health insurance and health care provider bureaucracy?).  And the lobbyists (they are the one’s running those commercials on TV against universal health care) are probably right that Canada and Western Europe and all the other modern industrialized nations that offer some form of what people like to call socialized medicine don’t necessarily offer the panacea that some might think, but when you have no insurance and run out of money, you’d probably take it (you might even like it).

Actually I think maybe the majority of the voters in those nations have felt that yes national health insurance does cost lost of money, but they also know that good health care costs no matter what. The important thing is that you get it. It may have seemed more practical to them to share the costs, kind of like businesses do when they form a consortium to purchase fuel or something like that.

Me, I just think everyone benefits from not only having good health care themselves but from everyone else having it. We can sit around and worry about who is paying their fare share and price everyone, including ourselves, out of the market or we can come to some kind of agreement on how to provide health care for all.

Filling up our emergency rooms with people who simply are looking for routine health care just makes everyone’s health care coast more. Maybe through some form of a universal system (that can still include private insurance) we could not only be able to have health care providers see everyone in a more orderly fashion but we could actually provide preventative health care to bring ultimate costs down.

And having large numbers of people unproductive in society does not help anyone.

Another problem we have had is that it seems that the so-called working poor (and that’s just a term) have been the most neglected class in health care. Those above have insurance and/or otherwise can afford it, and those out of the workforce are often on government programs that provide them with some regular form of health care (not necessarily top notch).

I think this current economic crisis has shown many that health care tied to jobs is not the way to go.

But Harry and Louise and the Joe Six Packs who still may have jobs with health insurance are probably still reluctant to support any form of universal health care, that is until theirs runs out.

But of course they deserve it.

P.s.

It would seem the simplest way to provide healthcare for all would be to expand the current Medicare program. We as a nation have accepted Social Security since the 1930s (just recall what resistance there has been to tampering with it), why is this different?


I resolve some of the issues of the day…

March 6, 2009

(Copyright 2009)

I have some ideas on how to resolve some issues of the day:

THE MORTGAGE CRISIS: President Obama has announced his program, but as far as I can tell it only offers help to a limited few. While at one time I leaned toward thinking he ought to get the foreclosure problem solved first to bring stability to the financial system since we found out nearly our whole economy was tied up in bundled mortgage securities, I no longer feel that way. Let the market sort it all out and somehow get back to a realistic system of financing housing that would probably look like the way it was done thirty years ago or so. Hefty down payment, fixed-rate mortgage, the likelihood one would have the ability to pay a prerequisite.

California, the state that is broke, has an asinine new program to pay a gigantic tax credit for anyone buying a brand new (just built) home. Thousands of empty homes, and we need new ones? That’s the California mentality. (There is also a similar federal program, but I understand it is not limited to new homes.  But here’s the question, why the tax incentives? Finally there are bargains galore out there — except no one knows the future of a home investment now. But we do know the government needs the tax money, to pay off the national debt if nothing else. ) 

THE BANKING CRISIS: Please! Stop the insanity! Let the too big to fail banks fail, because like the small town no government bailout bank official said on ABC News, “they’re not too big to fail, they’re just too big.

Okay, so I’m not an economist, but it would seem to me that eventually some element of capitalism will fill the void left by banks too fearful or too greedy (they want to see how much they can extort from the government first) to do what it is they are chartered to do – loan (not give away) money.

I think all along what we should have done is go around the high flying investment bankers and let them stew in their own juices. Perhaps the bailout money should have been put into a temporary government loan entity.

The government using taxpayer money has showered trillions of dollars on those boo hoo babies who can only fly in private jets away from the riffraff (I feel some of their anticipated pain – in my own world far lower down on the totem pole I find myself going to the freak show that is the low cost supermarket). The Wall Street bankers must use government bailout money to wine and dine at plush resorts because, well in their world that is the way business is done. Of course back in the not-so-old days what happened if you made bad business decisions is you slipped out of that privileged world and, well, went into real estate. But things got so out of hand in the financial industry that the piles of bad debts worked their way into the system like a cancer. But the upside for the investment bankers was that they realized they now had leverage to blackmail the government and the people.

But it’s all a bluff. Call’em on it.

THE DOMESTIC AUTOMAKERS: They were going the wrong direction way before the current economic crisis. They were not flexible enough and let their production costs soar too high. And why would any company be saddled with paying people who no longer work for it? Let poorly managed companies fail and make way for better managed ones.

Actually that does not have to mean the end of the domestic auto industry. It does mean different players, and if the United Auto Workers don’t see reality, it may push the industry into the southern states where the foreign auto makers have found willing and appreciative workers.

I realize that as long as the Big Three were rolling in doe the UAW simply took the opportunity to get in on the action. But when market share plummets, what’s left?

HEALTH CARE: Some Republican lawmaker was quoted in a blog I read pronouncing that health care is not a right. Who said it was? Well, okay, many have, but I support universal health care of some type, but I would never hold that it was a constitutional right. But that does not mean that we as the people cannot provide for ourselves some health security through the structure of government. I have some hope now that the demand from the people is going to outweigh the selfish interest groups who stood in the way of this need for so long. I saw some little sign on the news that the private health insurance industry is in more of a compromise mood now that it has seen the true power of the people and their call for change as was witnessed in the last election. Financing will be the big stumbling block. Making the “rich” pay doesn’t work because that still doesn’t get the amount needed. I hate to say it, but the late conservative William F. Buckley Jr. and the more liberal ousted former Democratic governor of California Gray Davis agreed on one thing: the bulk of the taxes always have to come from the middle class (and don’t ask me for a precise definition of that) because there are more of them. But, although they struggle, all the other industrialized nations of the world finance some form of universal health care. But we wouldn’t want to see how they do it, would we? Okay, I’ll give you a hint: they pay for it by somehow spreading the costs. And why the business community (not really a homogeneous group, I suppose) is not solidly behind universal health care, I don’t know. I realize small business people have to have mixed feelings. That’s because they go to local chamber of commerce meetings where they wear white shoes and start out their presentations with the standby Republican right wing sarcastic joke: “Hi I’m from the government and I’m here to help you.” So the point is, government help is something to shun because it comes with strings attached, that is unless it is a small business loan or a tax credit for hiring foreign workers or moving production overseas. But in reality, employees covered for health insurance without any liability on their (businesses) part would seem manna from Heaven. Then again we could just write off the part of the population that can’t or no longer can afford health care and leave them to get sick and die, thereby saving tax expense and giving us more air to breathe.


Economic crisis: thanks we needed that…

October 24, 2008

 

(Copyright 2008)

The WALTHER REPORT

By Tony Walther

As painful and scary as it is, I think that the current economic crisis we are going through in the United States is a healthy thing (as to the world-wide situation, well, that’s their problem).

Collectively as a nation we’ve been living on borrowed time or borrowed money for too long and the chickens have finally come home to roost.

You know things are bad in my local area when the home foreclosures have skyrocketed, they are starting to build smaller homes – when they build them – and the contractors are going before the city council to get public funds to build low-cost housing. That last one mystifies me. If the homes are lower cost, why do they need public funds? I mean if they are cheaper to build, why do they need help? And don’t tell me it’s the cost of union labor. Home builders to my knowledge don’t use union labor in this area, for the most part, at least. There’s a lot of “Joe the Plumber” entrepreneurs no license required types around here. There’s also a lot of under-the-table work in the best why should I pay taxes Republican tradition. Of course these same folks are quick to sign up for public assistance when they get hurt or run out of work. The underground economy is no secret here. It’s been covered in the news over the years.

But back to the economic crisis. My way of looking at it is this: maybe living on credit and living beyond one’s means is not the way to do things, even though the powers that be have encouraged us all to this very thing. And maybe an economy, nationwide, that is focused more on handling imports and the so-called service sector and delivering pizzas to one another leaves us all kind of empty.

To be sure, there are a lot of folks out there who have been prudent with their money, worked hard, and now are being made to feel some of the bad effects of the nation’s profligate and imprudent ways. While things are bad all over, it is particularly unfair to those people.

While credit at some level is apparently a necessary and integral part of our capitalist economic system, I think the idea that everyone lives on plastic was always a bad one. Consumer credit is what makes things cost so much. When businesses know that their customers can charge it, they charge more for the products and services they sell. They, the sellers, know they get paid up front, and then it is someone else’s problem to collect later. And even with all the home foreclosures and the mounting credit defaults, banks are still mass mailing credit cards, no questions asked. We get them at our house and even get calls from banks wanting to offer higher credit limits (apparently they are working on either no information or bad information).

One major problem is that there is no consistent and comprehensive program to teach basic consumer finance in the schools. I have a BA degree and never once, kindergarten through senior in college, took a basic consumer finance course. I did take a consumer law business course, but it had little about basic consumer finance. And the Bank of America did pass out bank books when I was in first grade, but no one explained what they were all about. That would have been a good start, though, and if they don’t still do that, they should, and get the schools to provide instruction assistance to the program.

And don’t get me started on what the public schools don’t teach. What they don’t teach, or at least not well enough, are the basics of reading and writing and arithmetic. That’s why the state four-year colleges in California have to send many of their students to remedial classes at the junior colleges.

Computers and technology are an essential part of life now. But we still need to get back to the basics, both in education and in our economy.

In a nation as geographically large as ours, with as many people, and as many natural resources as we have, there is no reason that we should not be a leader in manufacturing and producing everything from food to basic durable goods, to high tech, and of course we will have a service sector to support all of this.

It makes no sense to waste our resources and to have the government (read taxpayers) be forced to pay a substantial portion of the population to do nothing. We actually wind up importing workers, legally and not legally, and outsource work.

A nation with a strong manufacturing base can support all of its citizens, to include the sick and disabled and aged, defend itself, and not be dependent upon other nations for capital and the reduction in its own sovereignty that comes along with being a debtor nation.

The best days are truly ahead of us. And they can get under way with either John McCain or Barack Obama, but it looks like Obama is to be the one, “that one”, as McCain would say.

We’ve been reduced to such a wretched state with the poor leadership from both major political parties over the past several decades that we find ourselves in the uncomfortable position of adopting socialist-like state-run economic measures. This may or may not work in the short term.

History shows such measures don’t work in the long term.

Postscript:

I believe in reasonable controls on the economy that would seek to prevent the excesses that have occurred. And I support some type of universal health care for reasons I have stated in previous blogs. Health care no matter which way it is delivered is expensive. It needs to be delivered in the most efficient and equitable matter available. But leaving a large portion of working people and others out because they can’t afford health care is certainly not equitable and is not the way to achieve efficiency. One of the problems is that universal health care is often wrongly tagged as “free health care”. We all should invest, but that investment should pay us back in the form of security that would free all of us who are able to be productive members of society. And for those of us who are disabled, have some compassion. And don’t count me out. I may come back yet (and I am still paying on private insurance at the moment (won’t be able to soon), so that ought to make all of you die-hard Republicans happy).


Private health care is bureaucratic too…

October 21, 2008

(Copyright 2008)

The WALTHER REPORT

By Tony Walther

The argument against government-run health care is often that there would be too much bureaucracy.

Problem is, there is already too much bureaucracy in private-run health insurance.

I do not know the details, but Barack Obama’s claim is that his proposed program would allow anyone who has his or her own insurance and is satisfied with it to keep it. But for those who do not have it and are priced out of the market, it would be made available them. In some cases people would have to pay a portion of the cost and in others because they have no means of paying, they would not.

I have a hard time seeing a hole in that logic, unless you are just dead set against those who can’t pay for insurance being cared for.

But let’s go back to the bureaucracy problem. I currently (not for long) have private insurance. Doctors and other medical providers have to have people working full time just to handle the insurance claims and go through the bureaucracy of private health plans as well as the government programs. That costs us all a lot of money in bigger doctor bills.

And if you think government programs are too bureaucratic, well, private plans can be also:

I just spent some time this afternoon dealing with insurance claims. A lab sent me several bills saying that my insurance company (a prominent well known one, in fact probably the best known one) said that they could not identify me in the system.

Each time I go to that lab I give them my insurance card and they photocopy it.

I have paid my premiums in full and on time.

I called the insurance company and they confirmed that I had an up-to-date card and said they had not received the claims in question.

(And you already know one waits on hold as much as 15 or 20 minutes or more and then you often have to navigate the circular pre-recorded option message and enter the correct numbers and if you goof, you go back to the beginning and you do not pass go or collect $200.)

I called the lab billing office. The customer service representative finally determined that possibly they were billing the wrong office. It seems that my insurance company has offices in each state, but has told providers to bill the office in the state the medical service was provided. In my case they have been billing the California office most of the time. But my insurance is out of Illinois. But on one case, the lab sent a blood sample to a lab in South Carolina and so the lab billed the office there. That’s confusing, because as far as I am concerned, the service occurred in California because that is where they stuck a needle in my vein. But at any rate, while some of the California claims did not go through, the South Carolina one did. But, remember, my coverage is out of the Illinois office. And remember, we are talking about a private bureaucracy here.

And while I am on the subject, I get riled when John McCain suggests he’s going to give taxpayers a credit so they can shop around for health insurance. There’s a lot of holes in that idea, but one big one is that you don’t know how well your insurance is going to work until you get sick or injured and file a claim. You have no ability to shop around at that point. And McCain’s $5000 health care tax credit would not buy any more than five months of insurance at the most. And McCain proposes to tax private health insurance (I’m not sure how – but it sounds like robbing Peter to pay Paul). And at any rate, if you can’t work because you are sick, you can’t pay for the insurance anyway.

Back when a lot more people had jobs and partially-paid or fully-paid health coverage, universal health care coverage did not stand much of a chance of being enacted nationwide. Now with so much unemployment and people losing even company-paid insurance and skyrocketing medical insurance costs, there seems to be more of an acceptance of at least some type of more inclusive government-sponsored health care coverage.

I have cancer and am currently on a COBRA plan in which I keep my former employer’s coverage, but am hard pressed to pay the premiums ( I now have to pay the full premium). But I have a two-year wait for Medicare. What genius thought of that provision, the waiting period, I do not know. What am I supposed to do in the meantime? Beg? Die?

I personally think the idea of employer-sponsored health insurance was a bad one. It costs employers a lot and it is costing employees a lot these days. It also makes one a slave to a particular job. Fine if you are in love with that job, but not so good if you are not but are afraid to leave it because you will lose your insurance. And one thing I can tell you, bureaucracy aside, you do not want to lose your insurance, if you get sick or injured, you’re going to need it. And if you already have a health problem, new insurance often will not cover pre-existing conditions, especially if there has been a lapse in insurance. 

The people in the worst shape are those such as me, who have some amount of income but not really enough to pay for insurance, and those who have regular jobs that are low paid and that do not provide insurance. Walmart as we know provides its employees with info on how to get on the public health care dole. So we all subsidize Walmart. Ahhh that icon of free enterprise — not! 

There are state and federal programs for the chronically unemployed and disabled, but as I say, many are caught in between. And there are government-sponsored children’s health programs, but Republicans often prefer to vote against them, even though the so-called free marketplace they worship does not seem to provide an alternative.

But just as many conservatives have turned to government bailouts, just as the electorate seems to be abandoning the GOP, so too some type of universal health care, even if it’s private and government mixed together, may be in the offing.

The questioners at the debates seemed to be trying to elicit the answer that what with the current economic situation such plans might have to be delayed.

Strangely, most of the other industrialized nations decided long ago that public health is paramount and enacted their own forms of universal health care, even though it is true the cost is more and more of a challenge.

A major problem in the United States is the hodgepodge method in which we provide, and do not provide, health care. People without insurance crowd the emergency rooms putting a tremendous strain on other patients and the medical personnel and adding substantially to health care costs. I have personally been in the emergency rooms within the past year or two, bleeding uncontrollably due to my cancer and had to wait because someone ahead of me had a routine – albeit distressful I’m sure – ailment.

If we had universal health care people might have better health habits and have access to medical help that would save them from having to go to emergency rooms.

If compassion for your fellow man is not enough to support universal health care, then think of it this way: people who are healthy tend to feel better about themselves and have a better attitude toward life and are more likely to be productive citizens.

I would submit that a nation that spends $700 billion or maybe $1 trillion or more to bail out investment banks and that spends billions of dollars a week on wars of choice, can afford to have a decent and comprehensive health care system.