As I grumbled over the protracted news coverage of Larry King’s latest divorce, one gram of information sparked my interest. It was reported that King’s current contract with CNN was worth $50 million. Here is a competent interviewer in the very twilight of his career, who (in my opinion) is on cruise mode when compared to the dynamics of his industry, and still he can command an income the equivalent of a lotto bonanza to a middle class American. It’s not that Larry is an icon for humanity, his desire to be cryogenically preserved upon death speaks volumes as to his character, not to mention his eight divorces (one pending). Sure, it’s all show business, but when two hours of Larry King’s often rambling conversation is the equivalent of a provider for a family of four, working full time at a wage above the poverty line... for about 43 years…it gets me thinking.
What is it about the disparity of wealth in our country that the general population doesn’t get? In formal Economics wealth is more simply defined as the claim on resources, or what an individual (or wealth holder generally) can demand from society as a whole. It relates closely to power over other individuals. Inequality of such demand has always, and undoubtedly will always be the case to some degreee. What’s interesting is the trends that have taken place, especially here in the US.
With the founding of the country and the expansion of free enterprise (combined with universal education and representative government) the lack of parity between financial classes (if you will) went on a steady decline, with some minor exceptions, for about 200 years. It is only in the last 30 years, thereabouts, that such class structure did an about face and began to widen dramatically. The reasons are varied and complex, some simply due to demographic changes like massive population increases, many intentionally created. The point of this analysis is not to point fingers necessarily, but rather to look at the results of such disparity and how we as a nation react to it.
POTUS radio has done several man in the street interview sessions at “Tea Party” rallies in various locations. I was impressed that the producers made an honest attempt to circumvent the wacko Theodore Kaczynski types (of which there are many – including those who think writing checks out to Sarah Palin is patriotic) to interview thoughtful individuals who have attempted to reason out their activism. These Tea Party warriors have points which are often grounded in solid dirt, expounding, for example, on the long term consequences of huge budget deficits, incomprehensible national debt, the role of government in business ownership to name a few. However, one theme kept creeping back into the conversations, like the recognition of the boogie man that lives under the bed – taxation. The very concept of taxation is poison in the tea cups of these “activists”, ergo the actual name of the group based on the Colonial tax protest of 1773 (which BTW had nothing to do with assessing tax, rather representation in deciding the use of that tax).
Now let’s not be too confused with their Boston “Indian” counterparts. These 21st century “patriots” love their massive national defense bureaucracy, they like quality universal education, hurricane clean ups, filled potholes, Social Security/Medicare/Medicaid (at least for their moms – bless their hearts), food subsidies, suspension bridges, intelligence agencies, crime fighters of every description, 911, attractive roadsides, national parks and on and on. They just don’t want to be taxed - plain and simple. One well thinking person I know put it this way: “I just don’t trust Government” period. Where did this thinking come from, that the funding of our government (which is effectively funding ourselves) wasn’t just a question of the efficient use of accumulated wealth, but an inherent evil or, at best, the propagation of evil. How many of such middle class Tea Party people could honestly identify how their lives were literally less meaningful due to the taxes they have paid. The contradictions are so obvious and pervasive that it nearly defies understanding.
In 2001 George Bush’s first order of business as President presiding over a Republican Congress was to enact enormous tax cuts, followed again in 2003. The CBO projected at that time that such cuts would add $1.2 trillion to the National Debt over the following 10 years (which has come to pass – further they are currently projecting an additional $1.8 trillion deficit if the cuts are extended). This was done before Bush went on a $1.2 trillion (or more) spending spree in the Middle East. The rank and file Tea Partiers don’t have a problem with any of that. Their conclusions remain unchanged, that out of control spending is the culprit (unless it's for something worth while - like killing Saddam Hussain) and that any tax cut is a good cut. But who did these tax cuts go to and who has the interest to leave them in place?
The tax cuts were spread primarily from the middleclass up. However, those who make little income have little to gain by an income based tax cut. The benefit (or lack thereof) to the poor is obvious. In the case of the Bush tax cuts, the more income the more fun at the party. The middle 20% of middle class taxpayers received 8.9% of the cut. That would be 8.9% distributed among about 50 million people. The top 0.2% of income earners received 15.3% of the benefit. The nation’s 257,000 millionaires (at that time - based on income) received an initial $30 billion in benefits. This disparity between the haves and the have-nots just doesn’t resonate with the have-nots (even the have-nots who rally at Tea Party conventions shouting rage at efforts to reverse these disparities as “Obama Socialism” pounding on their doors). Why has this complacency with those of wealth and power, never more obvious since post WWII America, been so inherent in Conservative ethics?
There’s nothing unique about Larry King. He is only one of several million individuals who by fate, ingenuity, or cunning have found themselves economically separated from mainstream America. There is a further gap between our middle class and those who struggle at the bottom of claims on resources (which may include a disproportionate portion of our next generation). The “Contract with America” Conservatism that drives the Republican caucus, the Tea Partiers, the Palins, the Limbaughs, and others has a vitriolic subtext which contains the frightening ability to get people to energetically act against their own self interest. The fight over the recent health care law couldn’t have proved it better. The benefits from such Conservatism has yielded enormous tangible benefits for those seek to retain their claim to resources and illusionary benefits for those who shout on public malls.
The musical 1776 (the life’s passion of composer-lyricist Sherman Edwards to accurately put the struggle of the founding of this country to music) has a song in it called Cool, Cool Considerate Men. It was originally entitled “Cool, Cool Conservative Men” but the producers forced the change so as not to turn away a segment of possible patrons. The song recounts what was occurring both in the Continental Congress of 1776 and the Colonies as a whole – the fight between those who advocated independence and those who wanted reconciliation with Britain. It is sung in the form of a minuet by those who felt reconciliation would protect their wealth and lifestyle. Near the end of the minuet John Rutledge, the Conservative representative from South Carolina, stops the song and asks John Hancock why he supports John Adams in Adam’s quest for independence, since he (Hancock) was “one of us” - a man of property. Hancock says “…fortunately there aren’t enough men of property in America to dictate policy”. Rutledge responds by saying “…but don’t forget that most men would rather protect the possibility of being rich than face the reality of being poor…so they will follow us.”
One could argue that Rutledge’s belief was wrong in his assessment that control over an effort to exact a common good was vested in a select group of people. After all, the Revolution proceeded. Then again, maybe the only thing wrong with the prediction…was his timing.
Friday, April 16, 2010
Tuesday, March 23, 2010
The Genie is Out of the Bottle
On Sunday night I was one of the many millions of people doing something rarely done, watching our Congress in action, live, during and just prior to the House vote on health care. In the course of the “debate” portion (an absurd misnomer for sure), one of the Republican speakers (I don’t recall which) used a 1964 quote from Ronald Reagan, which I found interesting. He used the quote both to inject the name Ronald Reagan, which has deity status with the Conservative Right, and to argue that even in 1964 Reagan was shooting bull’s-eyes on the subject of health care. What Reagan was attacking at that time with his predictions of lost freedom and lost liberty was Medicare. It was Reagan’s first political issue delivered on a national stage which he began to preach in 1961, the same year he was dropped as spokesman for General Electric and changed his party affiliation from Democrat to Republican. In fact, he did little else during those years other than campaign against Medicare, ending with his famous keynote speech at the nomination of Barry Goldwater.
I couldn’t help but wonder how many Republicans in last Sunday's “debate” would openly demonstrate their devotion to Reagan’s “insight” by advocating the dismantling of Medicare (& Medicaid) along with stopping any attempt to make health care realistically available to the general population. John Boehner, the House minority leader and a champion of the if you say a lie with enough conviction and repetition it’s as good as true philosophy, screamed how shameful the House was in not carrying out the “will of the people”. Perhaps he felt the specter of Ronald Reagan behind him breathing sweet sound bites in his ears since Medicare never polled anything close to a 51% majority prior to its adoption into law. Nah…because the fact of the matter is that Reagan ended up as most Republicans are today, as stalwart defenders of Medicare, at least in any public setting.
The true opposition to the newly passed Health Care Reform bill (which is really more accurately a health care insurance reform bill) had little to do with health care. Every politically ambitious Republican I’ve seen interviewed since the passing of the bill is now putting emphasis on the righteousness of Health care reform and the injustice of their plans not being included (the 200 plus Republican articles contained not withstanding). The fact that the Republicans had control of the House for 15 of the past 23 years and never introduced any comprehensive health reform (but did manage to kill reform during 2 of the years they were out of power) makes their postulating a comedy, albeit a dark one. Why would they? They would never never never originate health reform because it would be contrary to the interests of their constituents. Not the duped tea party crowd I assure you, rather those powerful interests that are on the nipple end of our $1.7 trillion transfer of wealth: funds transferred from the health care consumers, taxpayers, and debtors to the for-profit health care industry. Whether you believe it or not, it’s the only thing that makes any sense.
The stark evidence of this could be seen in the days and hours before the vote. With Republican leaders holding signs from the Capital porticos egging protestors below to amplify their rage; protestors who held pictures of Obama portrayed as Hitler (as if fascism played a role?), signs with guns portrayed as a solution to meddling proponents, “activists” hurling homophobic slurs at Congressman Frank, and “patriotic” Americans outside and in the halls of the Capitol Building spitting on and calling out “nigger” to distinguished black Congressmen, including Congressman Lewis. The lunatic fringe that performed such acts may have been only the tip of an iceberg, but it was all the same iceberg. It is the sad result of unleashed profiteering zealots like Limbaugh and Beck, and political leaders like Boehner and Cantor, totally focused on their political ambitions, who have mastered the use of such meaningless generalizations as “government takeover”, “will destroy America”, “Socialism”, “rob you of your freedom”, “enslave your children”, “lose your job”, “lose your coverage”, and this Limbaugh predictive threat (which I think says it all): “lose your right to fish”!! None of it had anything to do with health care reform, let alone health care insurance reform. It only prays on ignorance and it undermines the moral integrity of a nation for the benefit of a small minority.
Ronald Reagan used the following phrase as a mantra in his election and re-election: government is not the solution to the problem, government is the problem. It resonated because it was combined with a conservative axiom that taxation is fundamentally evil, even if it’s necessary. The Reagan administration and the two Bush Administration then began to dismantle government regulations even as they expanded government and government debt exponentially (note that debt is just deferred taxation). Only in the Clinton “pay as you go” administration was debt accumulation temporarily paused. Republicans will now argue that “government” is the cause of all health care short comings, that “government” (currently with a distorted likeness of Obama) is poised to rob you of your wealth and happiness, and “government” can only be contained by, as Limbaugh announced yesterday, “ridding ourselves of those bastards”. They'll claim this even as they claw and scratch to be elected to (dare I say it)...government.
But on this one the genie is out of the bottle. They can’t go back, any more than they could on Medicare. The greater question is whether those who just succeeded can continue to turn an imperfect but necessary beginning into a workable future, in spite of the distortion and self interest.
I couldn’t help but wonder how many Republicans in last Sunday's “debate” would openly demonstrate their devotion to Reagan’s “insight” by advocating the dismantling of Medicare (& Medicaid) along with stopping any attempt to make health care realistically available to the general population. John Boehner, the House minority leader and a champion of the if you say a lie with enough conviction and repetition it’s as good as true philosophy, screamed how shameful the House was in not carrying out the “will of the people”. Perhaps he felt the specter of Ronald Reagan behind him breathing sweet sound bites in his ears since Medicare never polled anything close to a 51% majority prior to its adoption into law. Nah…because the fact of the matter is that Reagan ended up as most Republicans are today, as stalwart defenders of Medicare, at least in any public setting.
The true opposition to the newly passed Health Care Reform bill (which is really more accurately a health care insurance reform bill) had little to do with health care. Every politically ambitious Republican I’ve seen interviewed since the passing of the bill is now putting emphasis on the righteousness of Health care reform and the injustice of their plans not being included (the 200 plus Republican articles contained not withstanding). The fact that the Republicans had control of the House for 15 of the past 23 years and never introduced any comprehensive health reform (but did manage to kill reform during 2 of the years they were out of power) makes their postulating a comedy, albeit a dark one. Why would they? They would never never never originate health reform because it would be contrary to the interests of their constituents. Not the duped tea party crowd I assure you, rather those powerful interests that are on the nipple end of our $1.7 trillion transfer of wealth: funds transferred from the health care consumers, taxpayers, and debtors to the for-profit health care industry. Whether you believe it or not, it’s the only thing that makes any sense.
The stark evidence of this could be seen in the days and hours before the vote. With Republican leaders holding signs from the Capital porticos egging protestors below to amplify their rage; protestors who held pictures of Obama portrayed as Hitler (as if fascism played a role?), signs with guns portrayed as a solution to meddling proponents, “activists” hurling homophobic slurs at Congressman Frank, and “patriotic” Americans outside and in the halls of the Capitol Building spitting on and calling out “nigger” to distinguished black Congressmen, including Congressman Lewis. The lunatic fringe that performed such acts may have been only the tip of an iceberg, but it was all the same iceberg. It is the sad result of unleashed profiteering zealots like Limbaugh and Beck, and political leaders like Boehner and Cantor, totally focused on their political ambitions, who have mastered the use of such meaningless generalizations as “government takeover”, “will destroy America”, “Socialism”, “rob you of your freedom”, “enslave your children”, “lose your job”, “lose your coverage”, and this Limbaugh predictive threat (which I think says it all): “lose your right to fish”!! None of it had anything to do with health care reform, let alone health care insurance reform. It only prays on ignorance and it undermines the moral integrity of a nation for the benefit of a small minority.
Ronald Reagan used the following phrase as a mantra in his election and re-election: government is not the solution to the problem, government is the problem. It resonated because it was combined with a conservative axiom that taxation is fundamentally evil, even if it’s necessary. The Reagan administration and the two Bush Administration then began to dismantle government regulations even as they expanded government and government debt exponentially (note that debt is just deferred taxation). Only in the Clinton “pay as you go” administration was debt accumulation temporarily paused. Republicans will now argue that “government” is the cause of all health care short comings, that “government” (currently with a distorted likeness of Obama) is poised to rob you of your wealth and happiness, and “government” can only be contained by, as Limbaugh announced yesterday, “ridding ourselves of those bastards”. They'll claim this even as they claw and scratch to be elected to (dare I say it)...government.
But on this one the genie is out of the bottle. They can’t go back, any more than they could on Medicare. The greater question is whether those who just succeeded can continue to turn an imperfect but necessary beginning into a workable future, in spite of the distortion and self interest.
Thursday, March 11, 2010
What is So Special About People Over 65?
One of the great ironies attached to our national health care debate is the avid support that individuals over the age of 65 (seniors) have for the status quo. I don’t mean to suggest that all seniors think alike, even on national issues, but as a group they fall pretty solidly with the Conservative message on health care - that things are better left unchanged instead of embarking onto something as demonic as Government supported health care. Anecdotally, it has been my experience in talking with many seniors that the vast majority do abhor the idea of change, even as many criticize their personal experience within our current system (interestingly, they don’t necessarily fault the System; rather they’re more likely to blame the insensitivities of subsequent generations). The irony, of course, is that they are already active and satisfied recipients of what they argue so vehemently against expanding– Medicare.
Why should they support change? I can’t think of any good reason - even the truth - as long as self interest prevails. They are one of two sets of beneficiaries in our flawed system (the other beneficiaries are those on the receiving end of the $1.7 trillion transfer that takes place every year in the United States). How did this happen? What makes Americans over 65 so special, that their health and well being is somehow more important than say children 16 and under, or pregnant women, or perhaps young adults with multiple sclerosis? Like most things, you have to go back to the beginning:
What we fondly and simply know as Social Security began as our nation was just rising in 1935 out of the first major dip in the Great Depression. After experiencing the inhumanity caused by failed financial systems, the concept was simple; provide a base line of income to a class of citizens who, as a result of age, no longer had the capacity to earn income. Like insurance, the cost would be borne by all working people in order to contain cost, but unlike free market insurance (as with annuities) participation could not be an option. However, in order to pass the legislation with the votes of those who raised the specter of Socialism, the taxes and benefits would be restricted to working Americans. Of course, as it gained in popularity and, therefore, became politically attractive, it began to grow in complexity and benefits. Even as the projected benefits began to outweigh the projected “assets”, and even as the “assets” were in the form of purchased US Debt (Treasuries) during periods of overall deficits (a bit like an individual who puts $1 into savings for every $3 he puts on his credit card), the reality of Social Security became sacrosanct to Conservative politicians (Republican or Democrat). None…I repeat none would openly argue against it today. Why? Because, even with it's flaws, the nation sees it's value. Enter Medicare.
The Social Security Act of 1965 was the first (and really the last) attempt in dealing with the problem of health care in the US. Other major laws since, such as the Balanced Budget Act of 1997 which included Medicare Advantage, or the Medicare Prescription Drug (et al) Act of 2006 were attempts at fine tuning (often for votes) and whose primary beneficiaries ended up being the Medical Insurance Industry and the Pharmaceutical Industry. The idea of the Medicare law of 1965 (which included state controlled Medicaid for the indigent) was to address the growing need to provide nationally guaranteed health care beginning with those most vulnerable to the costs (those with fixed incomes), and it had a vehicle to use – the Social Security System. It was fought vigorously by Conservatives. Ronald Reagan claimed it would rob us of our freedom, George H.W. Bush, while running for the Senate in 1964, echoed it as “Socialized Medicine”. Those who supported it openly saw it as a first step toward bringing health care to the US in line with what had already happened throughout the world.
In the post WW2 years, the developed democracies, other than the US, figured out that in a new free world, where there was a desperate overall need for health care by people rising from devastation, the overall cost had to be borne by everyone in order to make it work. Universal Health Care, or as often described now as a Single Payer System, either through direct payment or manditory public insurance, became the law of the land in these democracies. This was especially (and interestingly) true of the two nations for which the United States took the primary role in rebuilding, namely Japan and Germany. Only Canada, the other major Western ally whose homeland was physically untouched by war, did not adopt a true single payer system, but they offered public health insurance immediately after the War, which evolved into full universal coverage in 1984. The United States, the great engine of free enterprise, alone chose the road of a for-profit health care system, a system that now costs multiples of what the rest of the world pays and is rife with gross and tragic inequities, discouraging patients and medical providers alike.
Even so, going back to the beginning of that post-war period, such “radical liberals” as Harry Truman saw the need to create the means by which all citizens could have access to health care and that the key to access was cost. They and others understood the obvious, that health care is a commodity that does not fit ordinary economic models. In economic terms, the demand is inelastic; it does not decline when the price increases. Therefore, in the absence of a system which includes everyone, and with an exponentially rising population, they saw that the Government (Federal, State, and Local) would become the de facto payer of last resort, and there was absolutely nothing to restrain costs from rising by those benefiting from that revenue.
The need for Universal Health Coverage was advocated during the Roosevelt administration, but attempting to create law really started during the Truman administration. Truman, for his efforts, was given the honor to sign up as the first participant in the new Medicare program in 1965. The widespread belief at that time was that an expanded version of Medicare provided to the entire American populous was only a matter of time. Of course, few foresaw the huge industry that would balloon as a result of stratospheric revenues, and how that industry would fight to keep that cash flowing. It was aided by tax law which allowed companies providing health insurance benefits to bury the costs (borne by their employees) out of their worker’s sight.
Still, Medicare/Medicaid made it under the wire, and although it is an imperfect public insurance program it pretty much accomplishes what the supporters wanted – universal health coverage for the participants funded through general payroll taxation. What it never did nor could ever do was impact general health care costs, because it controlled less than 15% of all Americans (albeit a larger percentage of cost). Which is why Medicare is now essentially funded through debt. The participants don’t care, they’re not paying, and all in all they’ve been pretty happy with the result; ergo you won’t hear a Republican advocate the dissolution of Medicare - even as they deride the idea of Medicare expanded to the rest of the population as socialistic mania.
There is nothing special about the 36 million Americans over age 65 (74 million by 2050), at least not when it comes to health care. In less than 5 years I will be 65 and be invited under that protective umbrella. If the Republicans, Conservative Democrats, and the financial recipients of the largest transfer of wealth any nation has ever seen succeed in thwarting any changes, then I will be forced to watch my children and grandchildren suffer under this system, even as I benefit. I can’t call that a benefit.
My gut winces a little each time I hear a Republican or Conservative Democratic politician announce that we have “the best health care (system) in the world” as I heard Rep. John Boehner (R-Ohio) recently said at the March 2010 “Health Summit”, shrouding his obstructionism in patriotism. I feel that way because I know many believe him, just as they believe the rhetorical lie that describes attempts to reform health care as a “government takeover”.
We do not have the best health care system in the world, or even the best health care for that matter (by published international standards), although we pay many times what everyone else does. If we just reduced our per capital spending on health care to that of Germany’s, the second most expensive nation, we would save enough money in ONE YEAR to pay the current health care costs for the 3 billion people in China, India, Russia, and Indonesia for the NEXT FIVE YEARS!!! We do not have the best health care system in the world, but we may have the worst. Why? Because it is a system in which the above statement on cost does not resonate at all with those who, contrary to their own best interest, have been manipulated to oppose health reform, including those contented senior beneficiaries who already enjoy guaranteed health care. In a world where access is inextricably and inversely depended on cost, what kind of vile system is that?
Why should they support change? I can’t think of any good reason - even the truth - as long as self interest prevails. They are one of two sets of beneficiaries in our flawed system (the other beneficiaries are those on the receiving end of the $1.7 trillion transfer that takes place every year in the United States). How did this happen? What makes Americans over 65 so special, that their health and well being is somehow more important than say children 16 and under, or pregnant women, or perhaps young adults with multiple sclerosis? Like most things, you have to go back to the beginning:
What we fondly and simply know as Social Security began as our nation was just rising in 1935 out of the first major dip in the Great Depression. After experiencing the inhumanity caused by failed financial systems, the concept was simple; provide a base line of income to a class of citizens who, as a result of age, no longer had the capacity to earn income. Like insurance, the cost would be borne by all working people in order to contain cost, but unlike free market insurance (as with annuities) participation could not be an option. However, in order to pass the legislation with the votes of those who raised the specter of Socialism, the taxes and benefits would be restricted to working Americans. Of course, as it gained in popularity and, therefore, became politically attractive, it began to grow in complexity and benefits. Even as the projected benefits began to outweigh the projected “assets”, and even as the “assets” were in the form of purchased US Debt (Treasuries) during periods of overall deficits (a bit like an individual who puts $1 into savings for every $3 he puts on his credit card), the reality of Social Security became sacrosanct to Conservative politicians (Republican or Democrat). None…I repeat none would openly argue against it today. Why? Because, even with it's flaws, the nation sees it's value. Enter Medicare.
The Social Security Act of 1965 was the first (and really the last) attempt in dealing with the problem of health care in the US. Other major laws since, such as the Balanced Budget Act of 1997 which included Medicare Advantage, or the Medicare Prescription Drug (et al) Act of 2006 were attempts at fine tuning (often for votes) and whose primary beneficiaries ended up being the Medical Insurance Industry and the Pharmaceutical Industry. The idea of the Medicare law of 1965 (which included state controlled Medicaid for the indigent) was to address the growing need to provide nationally guaranteed health care beginning with those most vulnerable to the costs (those with fixed incomes), and it had a vehicle to use – the Social Security System. It was fought vigorously by Conservatives. Ronald Reagan claimed it would rob us of our freedom, George H.W. Bush, while running for the Senate in 1964, echoed it as “Socialized Medicine”. Those who supported it openly saw it as a first step toward bringing health care to the US in line with what had already happened throughout the world.
In the post WW2 years, the developed democracies, other than the US, figured out that in a new free world, where there was a desperate overall need for health care by people rising from devastation, the overall cost had to be borne by everyone in order to make it work. Universal Health Care, or as often described now as a Single Payer System, either through direct payment or manditory public insurance, became the law of the land in these democracies. This was especially (and interestingly) true of the two nations for which the United States took the primary role in rebuilding, namely Japan and Germany. Only Canada, the other major Western ally whose homeland was physically untouched by war, did not adopt a true single payer system, but they offered public health insurance immediately after the War, which evolved into full universal coverage in 1984. The United States, the great engine of free enterprise, alone chose the road of a for-profit health care system, a system that now costs multiples of what the rest of the world pays and is rife with gross and tragic inequities, discouraging patients and medical providers alike.
Even so, going back to the beginning of that post-war period, such “radical liberals” as Harry Truman saw the need to create the means by which all citizens could have access to health care and that the key to access was cost. They and others understood the obvious, that health care is a commodity that does not fit ordinary economic models. In economic terms, the demand is inelastic; it does not decline when the price increases. Therefore, in the absence of a system which includes everyone, and with an exponentially rising population, they saw that the Government (Federal, State, and Local) would become the de facto payer of last resort, and there was absolutely nothing to restrain costs from rising by those benefiting from that revenue.
The need for Universal Health Coverage was advocated during the Roosevelt administration, but attempting to create law really started during the Truman administration. Truman, for his efforts, was given the honor to sign up as the first participant in the new Medicare program in 1965. The widespread belief at that time was that an expanded version of Medicare provided to the entire American populous was only a matter of time. Of course, few foresaw the huge industry that would balloon as a result of stratospheric revenues, and how that industry would fight to keep that cash flowing. It was aided by tax law which allowed companies providing health insurance benefits to bury the costs (borne by their employees) out of their worker’s sight.
Still, Medicare/Medicaid made it under the wire, and although it is an imperfect public insurance program it pretty much accomplishes what the supporters wanted – universal health coverage for the participants funded through general payroll taxation. What it never did nor could ever do was impact general health care costs, because it controlled less than 15% of all Americans (albeit a larger percentage of cost). Which is why Medicare is now essentially funded through debt. The participants don’t care, they’re not paying, and all in all they’ve been pretty happy with the result; ergo you won’t hear a Republican advocate the dissolution of Medicare - even as they deride the idea of Medicare expanded to the rest of the population as socialistic mania.
There is nothing special about the 36 million Americans over age 65 (74 million by 2050), at least not when it comes to health care. In less than 5 years I will be 65 and be invited under that protective umbrella. If the Republicans, Conservative Democrats, and the financial recipients of the largest transfer of wealth any nation has ever seen succeed in thwarting any changes, then I will be forced to watch my children and grandchildren suffer under this system, even as I benefit. I can’t call that a benefit.
My gut winces a little each time I hear a Republican or Conservative Democratic politician announce that we have “the best health care (system) in the world” as I heard Rep. John Boehner (R-Ohio) recently said at the March 2010 “Health Summit”, shrouding his obstructionism in patriotism. I feel that way because I know many believe him, just as they believe the rhetorical lie that describes attempts to reform health care as a “government takeover”.
We do not have the best health care system in the world, or even the best health care for that matter (by published international standards), although we pay many times what everyone else does. If we just reduced our per capital spending on health care to that of Germany’s, the second most expensive nation, we would save enough money in ONE YEAR to pay the current health care costs for the 3 billion people in China, India, Russia, and Indonesia for the NEXT FIVE YEARS!!! We do not have the best health care system in the world, but we may have the worst. Why? Because it is a system in which the above statement on cost does not resonate at all with those who, contrary to their own best interest, have been manipulated to oppose health reform, including those contented senior beneficiaries who already enjoy guaranteed health care. In a world where access is inextricably and inversely depended on cost, what kind of vile system is that?
Thursday, March 4, 2010
The Most Evil Man in America
I know I know…I write a title like that and most everyone can conjure up a quick image of the individual they believe fits the bill - and then may read on with curiosity to see why their choice isn’t the same as mine. Besides, the word evil itself is more closely aligned with comics or soap operas than real life. If I were to let my first image surface it would, of course, be Dick Cheney, the Darth Vader of American politics. With the news of Cheney’s most recent coronary I had an immediate picture in my head of Lucifer sitting in his fiery office, leaning back in a smoking overstuffed desk chair, and on the phone saying “…okay Dick, this is the fifth one I’ve bailed you out on. Now you either start a new war or I’ll be out of town when the Man hits you with the sixth.” But to really determine who most exemplifies the personification of villainy in America one must really define what evil is.
If evil were merely a relative concept, then for those who see Dick Cheney as a John Wayne understudy, he is hardly evil. They are right…but then, is anyone wrong? Despite the distain I harbor for Cheney (by the boatload), I actually think he is no more evil than most anyone else’s oxen you feel deserves to be gored. That’s because evil is not relative. Cheney participates in our national drama through his own self interest and lust for recognition in a manner which reflects his constituency. If he wasn’t feeding off public attitude Cheney would fall off our collective radar like a bronze medal winner. But is that evil? I think not. Maybe one might find what he does appalling, perhaps maniacal, or maybe even criminal…but not evil. He really doesn’t create opinion, he merely uses it.
Evil should not be misconstrued with its fruit. When one is told to think of an apple tree they naturally envision the apple itself and not the nature or description of the tree which bears it. There is a pervasive evil which has been growing in our country for long enough now that I, for one, have to concentrate back a while to realize that it didn’t always exist in my lifetime. It is an imbalance in the collective identity of our nation, which has permitted us to hate ourselves.
So who do I believe is the most evil man in America, and why? I give that honor to Rush Limbaugh III. Seriously…I consider the master of Conservative talk radio to be the dean, the linchpin, the standard by which a considerable handful of mostly conservative and some liberal commentators/entertainers/writers have watered the tree of divisiveness in our country, without which its fruit might not have found itself on practically every kitchen table in America. His influence has been extraordinary, or even greater than extraordinary based on Limbaugh’s own swagger. You have to go back to when it started, which some might find was not so long ago.
To say Limbaugh is smart would be a debate unto itself. I for one give the word “smart” a colloquial meaning which includes positive ethics. However, there is no doubt that Limbaugh has innate abilities that make him uniquely qualified for the roll he fell upon. His intelligence is validated by his pedigree. Father, siblings, grandfather, uncle, cousins are all jurists of note. A giggle of irony escapes me when I think that they are now all known primarily as the relative of Rush the radio guy. Rush III was an anomaly to the group. He was a bad student, his mother quoted to say “he flunked everything”. He managed his way into a lesser know state university in time to drop out almost immediately. He had to have been a black spot on the family refrigerator.
To his credit he focused early on a career in radio working a standard circuit of DJ jobs around the country and apparently, along the way, discovered his talent for glibness. I suspect that Limbaugh, a man with an ego the size of Montana, also discovered that in his chosen venue he could compete with his accomplished and certified family members at their own conservative game. Good luck, Rush. I’d guess that ultimately all his money, his influence, and his buffoonery never allowed him into the inner circle of Conservative lawyers and judges that is his family tree - just a guess, consistent with prescription drug abuse, and lawyers generally.
By the late 80’s his style of commentary had hit a cord. Freed by the repeal of the FCC Fairness Doctrine in 1987 (after being law for 38 years) he was one of the first to exploit bias as a form of entertainment. However, the use of a target as a means of gathering listenership had not yet gelled. During the administration of George HW Bush the Republicans had their problems even as they still rode the Reagan tsunami. His attraction was more his style and comedy which he intermixed with home spun commentary, a counter to the likes of Howard Stern. Although his reach through the number of participating stations was significant, his market was still not that large and actually pulled from a wider political segment which enjoyed his antics and clowning.
It was the election of Bill Clinton that changed everything. It was the 9/11 for Rush and the true beginning of his crafting the vilification of anyone not Conservative. As his listeners, comprised primarily of disappointed Conservative Republicans, began to expand exponentially, he saw the writing on the wall (and bank statement). The tone of his commentary notably changed. He was now selling fear wrapped in patriotism and he sold it well. So well in fact that for many today he has made the Clinton years of prosperity, surpluses, growth, and security a time of national shame, and the Bush years of preemptive war, terror, lost civil rights, political stagnation, colossal deficits, and near economic collapse a period of national pride. Can it get any more bizarre?
In the process of making himself a household name he also made a couple hundred million dollars, by some accounts. He certainly became in less than 15 years one of the richest men in America, simply by talking on a microphone. Incredibly, polling after the last presidential election also had him named as the Conservative Republican standard bearer, over everyone else…in America!!
His financial and influential success did not go unnoticed by others in the field. Such “commentators” as Glenn Beck, Mark Levin, and Sean Hannity jumped aboard the H&F (Hate & Fear) Gravy Train. They saw that by making “Liberals” the true enemies of “patriotic” America they could tap the kind of enthusiasm usually engendered by invasions. No wonder Sarah Palin recently got on board. Mark Levin, who renamed Liberals “Statists” because he thought the word “liberal” sounded too much like “liberty”, wrote the following in his best selling ($$) book Liberty and Tyranny:
"The Conservative must accept that the Statist does not share his passion for liberty and all the good that flows from it. The Statist does not acknowledge the tremendous benefits to society from the individual pursuits of tens of millions of others. The Statist rejects the Founder's idea of the dignity of the individual, who can flourish through ordered liberty, for one rooted in unpredictability, irrationality and, ultimately, tyranny." pp15
That kind of wholesale categorizing of people is the kind of dehumanization that can be found in Hitler’s Mein Kampf and his description of the Jews. That was a best seller too.
So just what is the Evil that I associate so closely with Rush Limbaugh and his disciples? It is what now pervades our nation, but more importantly our individual neighborhoods and even families. It is the new distain that we have for each other without the necessity of recognizing our humanity.
I remember hearing a Catholic priest once say in a lecture that if Satin could do only one thing to solidify his malevolence throughout mankind he would make us hate our bodies. He was suggesting that self deprecation of that which is the most basic and natural to us in this life was the surest way to abandon that which we revere in God. Rush has given this a socialogical twist.
As a nation and a society we have, since inception, had ideological conflict which has manifested itself into periods of tragedy and suffering. Students of the Civil War could successfully argue that period as the most obvious and poignant. At each such time there has been an imbalance caused by the demands of ideology requiring a dehumanization of those who don’t agree, essentially managing to get us to hate ourselves. Within the current health care debate there is so much hate that people virtually cannot see the problem to the point that they will actively work against their own self interest. Could anything make the devil smile more?
We are experiencing a civil war right now…and it is obvious. It began with people like Rush Limbaugh and has spread to the far left end of the spectrum in a vain attempt to create balance. It is aggravated by the nature of our political system which has currently become a manic struggle for power without substance and job security for its participants. This chapter in our history was made possible by a new age of communication, a new message of hate and fear, and was brought to you by the embodiment of the most evil man in America – Rush Limbaugh.
If evil were merely a relative concept, then for those who see Dick Cheney as a John Wayne understudy, he is hardly evil. They are right…but then, is anyone wrong? Despite the distain I harbor for Cheney (by the boatload), I actually think he is no more evil than most anyone else’s oxen you feel deserves to be gored. That’s because evil is not relative. Cheney participates in our national drama through his own self interest and lust for recognition in a manner which reflects his constituency. If he wasn’t feeding off public attitude Cheney would fall off our collective radar like a bronze medal winner. But is that evil? I think not. Maybe one might find what he does appalling, perhaps maniacal, or maybe even criminal…but not evil. He really doesn’t create opinion, he merely uses it.
Evil should not be misconstrued with its fruit. When one is told to think of an apple tree they naturally envision the apple itself and not the nature or description of the tree which bears it. There is a pervasive evil which has been growing in our country for long enough now that I, for one, have to concentrate back a while to realize that it didn’t always exist in my lifetime. It is an imbalance in the collective identity of our nation, which has permitted us to hate ourselves.
So who do I believe is the most evil man in America, and why? I give that honor to Rush Limbaugh III. Seriously…I consider the master of Conservative talk radio to be the dean, the linchpin, the standard by which a considerable handful of mostly conservative and some liberal commentators/entertainers/writers have watered the tree of divisiveness in our country, without which its fruit might not have found itself on practically every kitchen table in America. His influence has been extraordinary, or even greater than extraordinary based on Limbaugh’s own swagger. You have to go back to when it started, which some might find was not so long ago.
To say Limbaugh is smart would be a debate unto itself. I for one give the word “smart” a colloquial meaning which includes positive ethics. However, there is no doubt that Limbaugh has innate abilities that make him uniquely qualified for the roll he fell upon. His intelligence is validated by his pedigree. Father, siblings, grandfather, uncle, cousins are all jurists of note. A giggle of irony escapes me when I think that they are now all known primarily as the relative of Rush the radio guy. Rush III was an anomaly to the group. He was a bad student, his mother quoted to say “he flunked everything”. He managed his way into a lesser know state university in time to drop out almost immediately. He had to have been a black spot on the family refrigerator.
To his credit he focused early on a career in radio working a standard circuit of DJ jobs around the country and apparently, along the way, discovered his talent for glibness. I suspect that Limbaugh, a man with an ego the size of Montana, also discovered that in his chosen venue he could compete with his accomplished and certified family members at their own conservative game. Good luck, Rush. I’d guess that ultimately all his money, his influence, and his buffoonery never allowed him into the inner circle of Conservative lawyers and judges that is his family tree - just a guess, consistent with prescription drug abuse, and lawyers generally.
By the late 80’s his style of commentary had hit a cord. Freed by the repeal of the FCC Fairness Doctrine in 1987 (after being law for 38 years) he was one of the first to exploit bias as a form of entertainment. However, the use of a target as a means of gathering listenership had not yet gelled. During the administration of George HW Bush the Republicans had their problems even as they still rode the Reagan tsunami. His attraction was more his style and comedy which he intermixed with home spun commentary, a counter to the likes of Howard Stern. Although his reach through the number of participating stations was significant, his market was still not that large and actually pulled from a wider political segment which enjoyed his antics and clowning.
It was the election of Bill Clinton that changed everything. It was the 9/11 for Rush and the true beginning of his crafting the vilification of anyone not Conservative. As his listeners, comprised primarily of disappointed Conservative Republicans, began to expand exponentially, he saw the writing on the wall (and bank statement). The tone of his commentary notably changed. He was now selling fear wrapped in patriotism and he sold it well. So well in fact that for many today he has made the Clinton years of prosperity, surpluses, growth, and security a time of national shame, and the Bush years of preemptive war, terror, lost civil rights, political stagnation, colossal deficits, and near economic collapse a period of national pride. Can it get any more bizarre?
In the process of making himself a household name he also made a couple hundred million dollars, by some accounts. He certainly became in less than 15 years one of the richest men in America, simply by talking on a microphone. Incredibly, polling after the last presidential election also had him named as the Conservative Republican standard bearer, over everyone else…in America!!
His financial and influential success did not go unnoticed by others in the field. Such “commentators” as Glenn Beck, Mark Levin, and Sean Hannity jumped aboard the H&F (Hate & Fear) Gravy Train. They saw that by making “Liberals” the true enemies of “patriotic” America they could tap the kind of enthusiasm usually engendered by invasions. No wonder Sarah Palin recently got on board. Mark Levin, who renamed Liberals “Statists” because he thought the word “liberal” sounded too much like “liberty”, wrote the following in his best selling ($$) book Liberty and Tyranny:
"The Conservative must accept that the Statist does not share his passion for liberty and all the good that flows from it. The Statist does not acknowledge the tremendous benefits to society from the individual pursuits of tens of millions of others. The Statist rejects the Founder's idea of the dignity of the individual, who can flourish through ordered liberty, for one rooted in unpredictability, irrationality and, ultimately, tyranny." pp15
That kind of wholesale categorizing of people is the kind of dehumanization that can be found in Hitler’s Mein Kampf and his description of the Jews. That was a best seller too.
So just what is the Evil that I associate so closely with Rush Limbaugh and his disciples? It is what now pervades our nation, but more importantly our individual neighborhoods and even families. It is the new distain that we have for each other without the necessity of recognizing our humanity.
I remember hearing a Catholic priest once say in a lecture that if Satin could do only one thing to solidify his malevolence throughout mankind he would make us hate our bodies. He was suggesting that self deprecation of that which is the most basic and natural to us in this life was the surest way to abandon that which we revere in God. Rush has given this a socialogical twist.
As a nation and a society we have, since inception, had ideological conflict which has manifested itself into periods of tragedy and suffering. Students of the Civil War could successfully argue that period as the most obvious and poignant. At each such time there has been an imbalance caused by the demands of ideology requiring a dehumanization of those who don’t agree, essentially managing to get us to hate ourselves. Within the current health care debate there is so much hate that people virtually cannot see the problem to the point that they will actively work against their own self interest. Could anything make the devil smile more?
We are experiencing a civil war right now…and it is obvious. It began with people like Rush Limbaugh and has spread to the far left end of the spectrum in a vain attempt to create balance. It is aggravated by the nature of our political system which has currently become a manic struggle for power without substance and job security for its participants. This chapter in our history was made possible by a new age of communication, a new message of hate and fear, and was brought to you by the embodiment of the most evil man in America – Rush Limbaugh.
Thursday, August 13, 2009
Healthcare: No Relief in Sight
Please see my article of August 26, 2008 written during the Presidential election. It's just as relevant with today's debate...perhaps more.
Sunday, July 5, 2009
Ignoring the Obvious
I am appalled, astounded, and generally peeved at the recent coverage over the latest Palin pronouncement; her resigning as Alaska’s governor. It’s as if stating the obvious was somehow too risky for primetime. The endless babble over whether or not Sarah Palin ruined her chances to run for the Presidency is below the accuracy of lunatic repartee, let alone intellectual discourse. I guess that means it’s just perfect for national news.
Sarah Palin was a small town mayor who parlayed a couple of smart political moves and an attractive presentation into winning the governorship of a state that’s hardly known for conventional judgment. She was picked out of obscurity by John McCain in an insane and inane move to bolster his candidacy, a move that failed badly. She never was, is not, and never will be an even remotely viable candidate for national office. To include her name in the same context as "national office" is disinformation for marketing purposes that only belongs with the other entertainment celebrity news at the grocery store checkout counter.
However, to steal a phrase from A Coal Miner’s Daughter; the lady may be dumb…but she’s not stupid. I think she knows she’s not Vice-Presidential (let alone Presidential) timber, and to her credit she’s seems to have figured out she’s not Governor material either. She knows that remaining in office as the Governor of Alaska carries risks with it that could easily undermine her maximizing her potential, much like a football star might realize that spending two more years at the college gridiron might forever end his chances for making it big in the pros with one crushing tackle. Whether it is some bonehead scandal or an incompetent administration, she runs the potential of undermining the unique credibility she has with her fans. At the very least, finishing out her term as governor could use up precious time, and possibly leave her as an historical (and hysterical) blip in the American past.
In all likelihood she has seen how Rush Limbaugh has a reported worth of $400 million and is often described as the number one influence of what remains of the Republican Party. This former beauty contestant, turned local sportscaster, turned media starlet has probably seen that niche and fashions herself nestling into it. She couldn’t be more correct. She may want to sell the idea that she is in it for God, truth, justice, and the American way (good grief, even Rush Limbaugh touts that as his objective) and she may be delusional enough to believe that such is a half-truth, but the reality is that she wants what many of national fame have tasted: money and power. You can't fault her much for that. The beauty is that she’ll be able to do it right from her broadcast booth in Wasilla. She may end up owning more of Alaska than anyone other than Exxon-Mobil.
Sarah Palin was a small town mayor who parlayed a couple of smart political moves and an attractive presentation into winning the governorship of a state that’s hardly known for conventional judgment. She was picked out of obscurity by John McCain in an insane and inane move to bolster his candidacy, a move that failed badly. She never was, is not, and never will be an even remotely viable candidate for national office. To include her name in the same context as "national office" is disinformation for marketing purposes that only belongs with the other entertainment celebrity news at the grocery store checkout counter.
However, to steal a phrase from A Coal Miner’s Daughter; the lady may be dumb…but she’s not stupid. I think she knows she’s not Vice-Presidential (let alone Presidential) timber, and to her credit she’s seems to have figured out she’s not Governor material either. She knows that remaining in office as the Governor of Alaska carries risks with it that could easily undermine her maximizing her potential, much like a football star might realize that spending two more years at the college gridiron might forever end his chances for making it big in the pros with one crushing tackle. Whether it is some bonehead scandal or an incompetent administration, she runs the potential of undermining the unique credibility she has with her fans. At the very least, finishing out her term as governor could use up precious time, and possibly leave her as an historical (and hysterical) blip in the American past.
In all likelihood she has seen how Rush Limbaugh has a reported worth of $400 million and is often described as the number one influence of what remains of the Republican Party. This former beauty contestant, turned local sportscaster, turned media starlet has probably seen that niche and fashions herself nestling into it. She couldn’t be more correct. She may want to sell the idea that she is in it for God, truth, justice, and the American way (good grief, even Rush Limbaugh touts that as his objective) and she may be delusional enough to believe that such is a half-truth, but the reality is that she wants what many of national fame have tasted: money and power. You can't fault her much for that. The beauty is that she’ll be able to do it right from her broadcast booth in Wasilla. She may end up owning more of Alaska than anyone other than Exxon-Mobil.
Wednesday, June 24, 2009
Exchange on Healthcare
Below is an email exchange with a friend on the topic of Healthcare. I had asked him to give me his thoughts on the topic, since I suspected they differed from mine. They did, and perhaps that provides some balance:
Friend:
Well, I'm not going to be much help there. I'm not very medical. I've never really been sick, never had surgery, well oral surgery but I don't think that counts. But anecdotally I can give you some of my experiences.
In 1988 my daughter had bacterial pneumonia and spent 3 days at Children's Hospital ICU. Children's treated us like royalty. Gave us a place to stay next door and full access anytime we wanted it. I think we had Pilgrim Health Care through work which cost me $17 a paycheck. When the bill came from Children's it was around $3000 and it was marked paid in full. No deductible, no questions. And I never looked at it in any detail. Then in the 90's Hillary Clinton got on the healthcare bandwagon. It didn't last long but when she finally gave it up after a couple of years I was paying $34 a paycheck, had a deductible and the system was all screwed up. Thanks Hillary, good job.
In the late 90's Oliver North was running for senate I think. During the campaign he floated a brand new idea of the Health Saving Account. It was then that I got my first explanation of what an HSA was and how it worked. Instead of one Federal watchdog on medical costs, waste, and fraud, HSA's create 300 million watchdogs of the costs charged to their own accounts. Pretty neat idea I thought. Well, Ollie didn't get elected [whew, he was kind of a crazy] but I remembered the HSA. When I retired without any insurance, that was one of the first things we did. Now when we go to the doctor we ask. What is this test for? Why do you need these blood tests? I just had xrays last year, why again this year? Isn't it true that xrays are no longer considered an effective tool for detecting lung cancer? Ok, so why do you order the xrays? etc., etc. etc. I never did that before, And when I look back and compare my attitude before, it's no wonder that all kinds of fraud and abuse takes place. People don't ask. If somebody else is paying, let THEM ask. Well the HSA is your money in your account. The money you put into it is tax deductible and the premiums you pay for catastrophic insurance is also tax deductible.
You want a solution? In my view, there's your solution. Make everyone manage their own health care through their own account. 300 million watch dogs. Can't beat it.
OK, now having said that, I don't want to stop innovation, discovery, invention, etc. You make a strong case against profit, but it is a terrific motivator. The only reason the human gnome was mapped and currently in use by everyone is because they originally thought there was some money to be made from it. Little did they know all the possible applications that would come from it. But pure research is an essential part of a thriving society. Thousands of discoveries have come from it. Pennicillin was discovered without any idea what it's uses might be. Pure research however, is very expensive. Can we really chance not discovering the cure for AIDS, cancer, alzheimers, parkinsons, and dozens of other diseases because we somehow can't afford pure research? Can we really afford to halt the experiments of the supercollider just because no one knows what the results will be used for?
One last idea. Our founding father's did a great job.
We the People of the United States, in Order to form a more perfect Union, establishJustice, insure domestic Tranquility, provide for the common defence, promote thegeneral Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.They could have added "provide for the common education" and/or "provide for the common health care" but they didn't. They only "provide for the common defense" so as to ensure an environment where you as individuals can provide for yourselves.We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.That all men are created equal. Not that all men are equal, but when they are born they are created and begin their lives "equal". After that [by design] you're on your own. And clearly all men are not even close to being equal. And so, by design those of you who are better than the median can provide for yourselves better than those below the median. We are the ones with this wonderful system.
This system that attracts waiting lists of immigrants from all the other countries. Many other countries have nationalized health care. They pay a 40% tax for it. We are a nation of individuals whose individual liberties are ahead of all other concerns. While this quote is a bit out of context, They that can give up essential liberty to obtain a little temporary safety, deserve neither liberty or safety... Franklin It occurs to me that the nationalization of the health care industry would constitute just such a forfiture of liberty. I would advocate an increase in responsibility to the individual for his own well being. I believe nationalization would relieve the individual of all responsibility for their own well being, and as such, violate what Jefferson and his bussies had in mind.
My Reply:
Good morning - funny that you started your last email with "...not going to be much help" then proceeded to pump out a thousand words (997 to be exact). We truly do have some things in common. But plenty not in common too, as I read through your message. That's a good thing.
I'll take issue with your points this way (not sure where it will end):
Many of the arguments you presented are familiar and, for me, quite frustrating when I get into discussions on the subject. I think you set the tone correctly in your first paragraph when you implied that your experience defined your view. Perfectly reasonable. However, I believe the anecdotal approach to defining healthcare is precisely what creates the inertia we find ourselves in, much to the benefit of a select sector of our society.
In those discussions, personal experiences, good and bad, expound ad nausium. Further, people quote the personal experience of other people (as in other countries) with virtually no recollection of the source for that information. I find it frustrating that I can't (in a polite and un-aggressive way) get those individuals to look at the bigger picture. I feel it is the same, almost lemming mentality that viewed the dot.com companies in the late 90s and real estate in the mid 2000s on the other side of the balance sheet. You can make opposing lists of stories about how each system (profit/single payer) works and doesn't work that could stretch to the moon. The winner in that kind of analysis is always the status quo. People have just got to ask the question: who doesn't want things to change?
It's all about cost. Not about your cost or his cost or my cost, but the total cost. You read the piece I wrote last year, so I shouldn't need to repeat. But I just don't understand why one of the verifiable facts about healthcare doesn't resonate - total cost. People hear healthcare in Britain is great, others hear horror stories, it can all be suspect, but the fact is as a nation they care for 2.4 people for every one we take care of here (and their system is expensive by world wide standards). Why doesn't that make people here spin in their seats? Every other quantitative fact regarding healthcare (death rates, infant mortality, per capita hospital beds - US#27, per capita Drs US#52, etc) the US is either on par or below other countries. What are we getting for this huge transfer of wealth, and who's getting the money? Why is it so difficult for people to see that the (dis)information they receive about how (anecdotally) we have such a great medical system is most likely being provided by those who stand to lose if we converted to a single payer system.
Take your research argument, a popular one. Still, most medical research in this country today is done through our University system and it is mostly (if not nearly entirely) publicly funded (which includes charity - bolstered by tax policy as you described). The private (multi-national) pharmaceutical industry operating in this country has become so focused on profits and ROE that they've become counter-productive as expeditures directly relate to healthcare research. Did you read my piece on drug advertising? That aspect is like a metaphor for the entire industry. There are very few other countries that allow such to exist - for very good reason. To make the assumption that very smart dedicated people will stop pursuing careers in medical research because they won't make mega dollars at some corporation is unreasonable and doesn't reflect human behavior accurately. I would venture many if not most of those kinds of people hate working for such companies (simply because of the pressures for profits and ROE), are less productive, and work shorter careers because they can't wait to get out of that atmosphere (I clearly and personally empathize with that).
I don't even think the tax debate is relevant. We pay it one way or the other. For myself alone I pay (with my company subsidized insurance) about $8500 a year in insurance and deductibles. My tax could skyrocket and I'd be no worse off. Although with our system I am also given (at no extra cost) the added anxiety of never knowing if my own insurance costs will eventually outpace my resources or if medical illness or accident to anyone in my family will wipe out my assets. Of course, that may oddly help medical costs, since that kind of stress probably cuts years off of people's lives.
You provide a good Libertarian approach to managing cost, but I really believe that ideal ended in this country a hundred and fifty million people ago, at a time when technology was less complex and the profit aspect of medicine (by comparison to today) didn't really exist. Remember profit is defined as that in excess of fixed and variable expenditures (which includes labor). The healthcare industry in this country today (as I wrote) is almost totally inelastic. The demand side of the equation is currently unaffected by price increase. We either pay, exhaust our resources and have government pay, or decline services and die. There is virtually no impetus in the private sector for efficiency in medical care, because to do so would reduce profits, dollar for dollar. You may wisely refuse an x-ray today, but try doing it when your 85 and drooling in your wheel chair. Besides, you still pay the cost whether it's you getting the x-ray or the crack addict who bumbles into the emergency room. There has to be oversight in an industry which must meet the needs of every human in the country.
Despite what you say, I don't sense you're an 'everyone for himself' kind of guy, where healthcare is only for those smart, clever, and resourceful (or lucky) enough to properly work the system. However, you are correct that if access to adequate healthcare is not considered one of those basic "all men are created equal" inalienable rights (maybe under the “Life” right), then nationalized healthcare has no place in this country. Then you would also need to start advocating the elimination of the publicly supported healthcare already in this country (which is huge - Medicare being the biggest piece - and supplies much of the profit to the private sector) and get ready to start looking like most other third world countries with deformed children begging in the streets with their inalienable right for the pursuit of happiness.
Friend:
Well, I'm not going to be much help there. I'm not very medical. I've never really been sick, never had surgery, well oral surgery but I don't think that counts. But anecdotally I can give you some of my experiences.
In 1988 my daughter had bacterial pneumonia and spent 3 days at Children's Hospital ICU. Children's treated us like royalty. Gave us a place to stay next door and full access anytime we wanted it. I think we had Pilgrim Health Care through work which cost me $17 a paycheck. When the bill came from Children's it was around $3000 and it was marked paid in full. No deductible, no questions. And I never looked at it in any detail. Then in the 90's Hillary Clinton got on the healthcare bandwagon. It didn't last long but when she finally gave it up after a couple of years I was paying $34 a paycheck, had a deductible and the system was all screwed up. Thanks Hillary, good job.
In the late 90's Oliver North was running for senate I think. During the campaign he floated a brand new idea of the Health Saving Account. It was then that I got my first explanation of what an HSA was and how it worked. Instead of one Federal watchdog on medical costs, waste, and fraud, HSA's create 300 million watchdogs of the costs charged to their own accounts. Pretty neat idea I thought. Well, Ollie didn't get elected [whew, he was kind of a crazy] but I remembered the HSA. When I retired without any insurance, that was one of the first things we did. Now when we go to the doctor we ask. What is this test for? Why do you need these blood tests? I just had xrays last year, why again this year? Isn't it true that xrays are no longer considered an effective tool for detecting lung cancer? Ok, so why do you order the xrays? etc., etc. etc. I never did that before, And when I look back and compare my attitude before, it's no wonder that all kinds of fraud and abuse takes place. People don't ask. If somebody else is paying, let THEM ask. Well the HSA is your money in your account. The money you put into it is tax deductible and the premiums you pay for catastrophic insurance is also tax deductible.
You want a solution? In my view, there's your solution. Make everyone manage their own health care through their own account. 300 million watch dogs. Can't beat it.
OK, now having said that, I don't want to stop innovation, discovery, invention, etc. You make a strong case against profit, but it is a terrific motivator. The only reason the human gnome was mapped and currently in use by everyone is because they originally thought there was some money to be made from it. Little did they know all the possible applications that would come from it. But pure research is an essential part of a thriving society. Thousands of discoveries have come from it. Pennicillin was discovered without any idea what it's uses might be. Pure research however, is very expensive. Can we really chance not discovering the cure for AIDS, cancer, alzheimers, parkinsons, and dozens of other diseases because we somehow can't afford pure research? Can we really afford to halt the experiments of the supercollider just because no one knows what the results will be used for?
One last idea. Our founding father's did a great job.
We the People of the United States, in Order to form a more perfect Union, establishJustice, insure domestic Tranquility, provide for the common defence, promote thegeneral Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.They could have added "provide for the common education" and/or "provide for the common health care" but they didn't. They only "provide for the common defense" so as to ensure an environment where you as individuals can provide for yourselves.We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.That all men are created equal. Not that all men are equal, but when they are born they are created and begin their lives "equal". After that [by design] you're on your own. And clearly all men are not even close to being equal. And so, by design those of you who are better than the median can provide for yourselves better than those below the median. We are the ones with this wonderful system.
This system that attracts waiting lists of immigrants from all the other countries. Many other countries have nationalized health care. They pay a 40% tax for it. We are a nation of individuals whose individual liberties are ahead of all other concerns. While this quote is a bit out of context, They that can give up essential liberty to obtain a little temporary safety, deserve neither liberty or safety... Franklin It occurs to me that the nationalization of the health care industry would constitute just such a forfiture of liberty. I would advocate an increase in responsibility to the individual for his own well being. I believe nationalization would relieve the individual of all responsibility for their own well being, and as such, violate what Jefferson and his bussies had in mind.
My Reply:
Good morning - funny that you started your last email with "...not going to be much help" then proceeded to pump out a thousand words (997 to be exact). We truly do have some things in common. But plenty not in common too, as I read through your message. That's a good thing.
I'll take issue with your points this way (not sure where it will end):
Many of the arguments you presented are familiar and, for me, quite frustrating when I get into discussions on the subject. I think you set the tone correctly in your first paragraph when you implied that your experience defined your view. Perfectly reasonable. However, I believe the anecdotal approach to defining healthcare is precisely what creates the inertia we find ourselves in, much to the benefit of a select sector of our society.
In those discussions, personal experiences, good and bad, expound ad nausium. Further, people quote the personal experience of other people (as in other countries) with virtually no recollection of the source for that information. I find it frustrating that I can't (in a polite and un-aggressive way) get those individuals to look at the bigger picture. I feel it is the same, almost lemming mentality that viewed the dot.com companies in the late 90s and real estate in the mid 2000s on the other side of the balance sheet. You can make opposing lists of stories about how each system (profit/single payer) works and doesn't work that could stretch to the moon. The winner in that kind of analysis is always the status quo. People have just got to ask the question: who doesn't want things to change?
It's all about cost. Not about your cost or his cost or my cost, but the total cost. You read the piece I wrote last year, so I shouldn't need to repeat. But I just don't understand why one of the verifiable facts about healthcare doesn't resonate - total cost. People hear healthcare in Britain is great, others hear horror stories, it can all be suspect, but the fact is as a nation they care for 2.4 people for every one we take care of here (and their system is expensive by world wide standards). Why doesn't that make people here spin in their seats? Every other quantitative fact regarding healthcare (death rates, infant mortality, per capita hospital beds - US#27, per capita Drs US#52, etc) the US is either on par or below other countries. What are we getting for this huge transfer of wealth, and who's getting the money? Why is it so difficult for people to see that the (dis)information they receive about how (anecdotally) we have such a great medical system is most likely being provided by those who stand to lose if we converted to a single payer system.
Take your research argument, a popular one. Still, most medical research in this country today is done through our University system and it is mostly (if not nearly entirely) publicly funded (which includes charity - bolstered by tax policy as you described). The private (multi-national) pharmaceutical industry operating in this country has become so focused on profits and ROE that they've become counter-productive as expeditures directly relate to healthcare research. Did you read my piece on drug advertising? That aspect is like a metaphor for the entire industry. There are very few other countries that allow such to exist - for very good reason. To make the assumption that very smart dedicated people will stop pursuing careers in medical research because they won't make mega dollars at some corporation is unreasonable and doesn't reflect human behavior accurately. I would venture many if not most of those kinds of people hate working for such companies (simply because of the pressures for profits and ROE), are less productive, and work shorter careers because they can't wait to get out of that atmosphere (I clearly and personally empathize with that).
I don't even think the tax debate is relevant. We pay it one way or the other. For myself alone I pay (with my company subsidized insurance) about $8500 a year in insurance and deductibles. My tax could skyrocket and I'd be no worse off. Although with our system I am also given (at no extra cost) the added anxiety of never knowing if my own insurance costs will eventually outpace my resources or if medical illness or accident to anyone in my family will wipe out my assets. Of course, that may oddly help medical costs, since that kind of stress probably cuts years off of people's lives.
You provide a good Libertarian approach to managing cost, but I really believe that ideal ended in this country a hundred and fifty million people ago, at a time when technology was less complex and the profit aspect of medicine (by comparison to today) didn't really exist. Remember profit is defined as that in excess of fixed and variable expenditures (which includes labor). The healthcare industry in this country today (as I wrote) is almost totally inelastic. The demand side of the equation is currently unaffected by price increase. We either pay, exhaust our resources and have government pay, or decline services and die. There is virtually no impetus in the private sector for efficiency in medical care, because to do so would reduce profits, dollar for dollar. You may wisely refuse an x-ray today, but try doing it when your 85 and drooling in your wheel chair. Besides, you still pay the cost whether it's you getting the x-ray or the crack addict who bumbles into the emergency room. There has to be oversight in an industry which must meet the needs of every human in the country.
Despite what you say, I don't sense you're an 'everyone for himself' kind of guy, where healthcare is only for those smart, clever, and resourceful (or lucky) enough to properly work the system. However, you are correct that if access to adequate healthcare is not considered one of those basic "all men are created equal" inalienable rights (maybe under the “Life” right), then nationalized healthcare has no place in this country. Then you would also need to start advocating the elimination of the publicly supported healthcare already in this country (which is huge - Medicare being the biggest piece - and supplies much of the profit to the private sector) and get ready to start looking like most other third world countries with deformed children begging in the streets with their inalienable right for the pursuit of happiness.
Monday, May 11, 2009
Marriage
With my son's engagement, it got me thinking about what makes a marriage (really a relationship) last.
I think a good marriage is built on a foundation of 3 ‘Cs’ – Commitment, Compromise, and Compassion…and probably in that order. I’m guessing being engaged has all the same factors, only instead of Commitment you have Commit without the (ce)ment.
I use the term foundation since the complexities of a relationship are so immense that to simplify the totality of a relationship is both futile and foolhardy. Therefore, you find simple axioms to act as a base on which one can deal with the minutia. If we accept that certain basic things remain constant, anchors if you will, we just might keep the boat from running adrift when the currents and individual waves begin splashing over the gunnels. Like all axioms these 3 ‘Cs’ are not subject to analysis, just as one keeps a faith. By agreeing to them, however, doesn’t mean they don’t require work, but it does mean they are not up for debate…they are not ‘gray’.
Commitment is the most important and most difficult. It is what takes you through the inevitable periods of questioning, second guessing, and (for lack of a better term) the bad times. Frankly, it is also relatively rare, but it is as necessary as yeast is to risen bread for those relationships that actually go the distance. Somewhere in the development of a relationship it must be overtly and clearly confessed to each other and then it requires periodic reinforcement, neither of which is easy to do. As difficult as it is, I feel one cannot over emphasize the importance of making the effort. The attempt, or lack thereof, will be as telling to the relationship as the Sun, or lack of it, is to vacation weather.
Compromise is the grease that allows the Commitment gears to mesh with less friction. Like Commitment, you enter into Compromise without analysis or other great truckloads of personal garbage. The point of compromise is the basic understanding that there can be no winner in a contest without a loser. Of course, I’m not talking about Scrabble or arm wrestling, but rather in the judgments we make in viewing the actions of someone else. What we compromise is our judgment itself. Outside a marriage to do so may be foolish or even dishonorable. However, in a marriage it is Romance without equal, because it accepts and confesses the understanding that there is someone in your life without which life would have little meaning. Like all Romances it is something to strive for, but unlike Commitment there can be real day to day evidence of the attempt. It is like money in the Bank. You may not know the balance of your account, but you’ll feel mighty rich with each deposit.
Compassion is the great reward. It should be obvious, but let me clarify anyway; Compassion is not the romance, sex, churning stomach, longing, or other treats of a new relationship. Compassion exists when you realize (not easily) that your lust for life is intrinsically bound with your chosen partner. It’s the source of such sappy (but meaningful) movie lines as “…you complete me”. It is different from simple passion because at its root it demands that it be a shared experience. But just like passion it provides the palette of colors we all search for, to paint our lives as we’d like to think they should look. Like Compromise, it should be communicated often and overtly, giving credit where credit is due. Compassion is what makes confessions like “I love you” have real meaning.
There it is, 3 'Cs'. How simpler could it be? Of course, that's like saying growing vegetables is just seed, dirt, and water. Think that and don't count on tomatoes in July.
I think a good marriage is built on a foundation of 3 ‘Cs’ – Commitment, Compromise, and Compassion…and probably in that order. I’m guessing being engaged has all the same factors, only instead of Commitment you have Commit without the (ce)ment.
I use the term foundation since the complexities of a relationship are so immense that to simplify the totality of a relationship is both futile and foolhardy. Therefore, you find simple axioms to act as a base on which one can deal with the minutia. If we accept that certain basic things remain constant, anchors if you will, we just might keep the boat from running adrift when the currents and individual waves begin splashing over the gunnels. Like all axioms these 3 ‘Cs’ are not subject to analysis, just as one keeps a faith. By agreeing to them, however, doesn’t mean they don’t require work, but it does mean they are not up for debate…they are not ‘gray’.
Commitment is the most important and most difficult. It is what takes you through the inevitable periods of questioning, second guessing, and (for lack of a better term) the bad times. Frankly, it is also relatively rare, but it is as necessary as yeast is to risen bread for those relationships that actually go the distance. Somewhere in the development of a relationship it must be overtly and clearly confessed to each other and then it requires periodic reinforcement, neither of which is easy to do. As difficult as it is, I feel one cannot over emphasize the importance of making the effort. The attempt, or lack thereof, will be as telling to the relationship as the Sun, or lack of it, is to vacation weather.
Compromise is the grease that allows the Commitment gears to mesh with less friction. Like Commitment, you enter into Compromise without analysis or other great truckloads of personal garbage. The point of compromise is the basic understanding that there can be no winner in a contest without a loser. Of course, I’m not talking about Scrabble or arm wrestling, but rather in the judgments we make in viewing the actions of someone else. What we compromise is our judgment itself. Outside a marriage to do so may be foolish or even dishonorable. However, in a marriage it is Romance without equal, because it accepts and confesses the understanding that there is someone in your life without which life would have little meaning. Like all Romances it is something to strive for, but unlike Commitment there can be real day to day evidence of the attempt. It is like money in the Bank. You may not know the balance of your account, but you’ll feel mighty rich with each deposit.
Compassion is the great reward. It should be obvious, but let me clarify anyway; Compassion is not the romance, sex, churning stomach, longing, or other treats of a new relationship. Compassion exists when you realize (not easily) that your lust for life is intrinsically bound with your chosen partner. It’s the source of such sappy (but meaningful) movie lines as “…you complete me”. It is different from simple passion because at its root it demands that it be a shared experience. But just like passion it provides the palette of colors we all search for, to paint our lives as we’d like to think they should look. Like Compromise, it should be communicated often and overtly, giving credit where credit is due. Compassion is what makes confessions like “I love you” have real meaning.
There it is, 3 'Cs'. How simpler could it be? Of course, that's like saying growing vegetables is just seed, dirt, and water. Think that and don't count on tomatoes in July.
Wednesday, January 14, 2009
Obamanomics?
When I majored in Economics the discipline was quite a bit different…and not. It makes me recall the old saying; everything is different…nothing has changed. Back then, we were on the waning cusp of the Keynesian Revolution, and the Monetarists, led by (the later Nobel Lauriat) Milton Friedman were happily waxing. The theories were different than what we see today, but the fundamental approach has remained unchanged. That lack of change continues to be the bane of most economists, politicians, and financial soothsayers of every description.
After 35 years since graduation, and even with my attempts to remain well-read, I would probably be challenged to get a respectable grade in an Econ 101 course. Nevertheless, the fundamental I took from my education remains fresh and, I believe, timeless. It is this simple fact: Economics is a behavioral science, not an exact science. That fact would not receive much debate in academic circles, yet the practical application of it seems to be lost in the practical application of economics in the real world.
The unchanging part of formal Economics is the insatiable desire to apply formula to human behavior. Our politicians are currently struggling to do just that and with resources (in the form of debt) that have no precedent (that I can think of), certainly on a scale never before imagined. Our leaders, including Obama, are tapping into their favorite economists to give them direction, probably based on what economists are currently in favor. Yet economists are like stabled horses; you check out their papers, look at their teeth, examine their gate, admire their confidence, but when you get on to ride you can’t be sure what’s going to happen. In all likelihood the economists or economic theorists chosen are the ones with the latest successes, but those successes might have been on a dry track and perhaps now the raceway is inches deep in mud. That may explain why I occasionally hear that some politicians (and academics) want to saddle up Maynard Keynes again to see if he’s good for another spirited ride.
I do believe that certain economic assumptions have value if they are consistent with the understanding that human behavior is inherently inconsistent (or erratic, to be less gentile) and it begs for the application of common sense. Human behavior, economic behavior included, reacts to two opposing stimuli: risk and certainty (more accurately predictability since certainty doesn’t exist except perhaps in natural science). In the real world, individuals (of varying numbers) get rich in an environment of risk, but societies economically flourish in an environment of predictability. What the Bush and (it appears) the Obama administrations are trying to do is create growth by heaving great loads of cash into the system, which Monetarist theories tell them will accelerate the economy. Several other nations are doing the same. What they fail to understand is that these attempts very likely will have no effect on growth since they don’t address the major underlying problem: the perceived lack of predictability by the people who comprise the Economy.
Take what most people, including me, feel is the major stumbling block to economic stability: the housing market.
Why the housing market as opposed to say, the job market (another good choice)? Housing is, I believe, one of the great fundamentals of human behavioral stability, along with food and safety. More importantly we have matured as a specie to think of the stability of our habitat as a precursor to much of the rest of our decision making (maybe we always did – leave that to the anthropologists). Of course this doesn’t include all people, but certainly a vast majority enough to drive economies. As we have come to rely on the certainty of our dwellings, and more over the value of those dwellings, we are freed to approach many other economic adventures with a sense of predictability. Now many are uncertain of the viability of remaining in their homes and most everyone feels uncertain as to the value, present and future. Restoring predictability to the housing market is what is needed, not attempting to restore value, or keep people in homes they never should have owned in the first place.
If I had the opportunity to lobby Mr. Obama, I would push him in the one direction everyone seems to be running from; underwriting prospective homebuyers who do not qualify under our current standards. Basically, go back to what many think got us (and the financial markets) into this problem in the first place, sub-prime lending. However, I would trim the fat in three ways; it would be publically funded (eliminating the greed that drove that last perfect storm), direct it only to buyers who do not currently own a home, and not eliminate the income or equity (appraisal) portion of the mortgage qualification.
The underwriting would be to lower the threshold on credit score. This would all be geared to starting the domino effect that has always been part of the modern real estate housing market, the movement of individuals from one home to another. Many renting individuals who may have defaulted on a sub-prime mortgage due to the size of the mortgage relative to the value of their home (a home they should never have been in) would be able to get the opportunity for finance to a smaller home, provided their income supports it. Just the smell of inflation in the housing market, however slight, due to movement of homeowners, would help jumpstart the entire process.
It’s impossible to predict what level housing values may evolve to in such a process or even how long it would take. However, I’m comfortable with one forecast: once the housing market has achieve a level of predictability where individuals can feel comfortable about what their home is worth and that the opportunity to leave that home or stay in it is a matter of simple choice and not necessity, then the rest of our economy (in the absence of catastrophe or conflict) will begin to show its own renewed sense of predictability and growth. The economists will rewrite their new formulas and we’ll just get on with the next crisis. I’m concerned, nonetheless, that if our leaders, especially Obama and his advisors, continue to widen this tsunami of debt in the attempt to buy confidence, then we will be left with simply a widened crisis…and some very, very rich people.
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