Healthcare and the Public Option

I'm trying to understand what is being put together by the Congress as a Healthcare Bill. Some arguments I've heard is that this is nothing special. Think Social Security; do you like your Social Security? Another line of discussion says that we've got to insure everyone, so why not a plan on the lines of Medicare?

Let's begin with Social Security (SS), because I believe looking at this institution can provide valuable insights. Why have something like SS, when private companies can, and do, offer life insurance?

Ans: Because only the government can require citizens to pay premiums for such a policy, even when a citizen might prefer not to pay such a premium. In short, it's coercive. Is that good? Yes, in this specific case, I believe coercion is appropriate public policy. Young adults may feel they'll never grow old, or believe they'll be able to take care of themselves in their old age. But, more often than not, that's not what happens. SS helps mitigate the poverty that once dogged older citizens. It is good policy.

Does SS have a downside? Sure, it's under the management of Congress, a vital, but very flawed, institution. SS is nothing more than public live insurance. It requires the payment of a premium, it requires a reserve, and it must operate in a financially sound manner. It doesn't sound complicated, but unfortunately it's not easily done by most of our people in Congress.

However, the consequences of not doing it properly eventually become so severe that whether they like it, or not, in the end, they must raise the retirement age, if that's what's called for. Or, they can raise the premiums (this is generally less politically palatable).

Now, the question becomes as to whether this is equally true for the "public option," or to define it more properly, "a public health insurace program." Ans: Yes and no.

On the "yes" side, there's a great deal to be said for seeing to it that every citizen be able to receive the treatment he, or she, needs for whatever illness they come down with. Extracting from them a premium for such insurance, even thought many young people see themselves as being quite healthy and not needing such insurance would seem to be in the public interest.

But there is a down side. The cost of life insurance, or mandatory life insurance in the case of SS is relatively easy to calculate. It's pretty much all based on life expectancy. The cost of health insurance has been found to be wildly unpredictable and out of most everyone's control. The Medicare that is so widely touted, by some, as a wonderful model for healthcare for all citizens is in serious, serious trouble. It is being kept afloat largely by the great American printing press and, if you see no problem with that, talk to most any responsible economist.

It's all about cost, cost, cost. In America, the cost of medical procedures ranging from colonoscopies to heart surgery can, and does, vary by roughly 50%. In other words, procedures in some areas of the country are 50% more than they are in others, or, looked at another way, they are 33% less in some areas than in others. Either way you're looking at differences that are enormous. I, for one, do not believe this is a situation that can be managed by our legistlators.

What needs to be done, in my opinion, is the following:

1. Have the government step in and require all areas of the country to follow "best practices." If you think that's easy, consider the difficulty that has been encountered in some hospitals when they tried to get their doctors to wash their hands between patients and before approaching a patient. All medical recored should be put on a computerized national healthcare bank. (Yes, I know, everyone will be trying to crack into the president's data, but nevertheless the problem must be addressed.) There is a great deal more than can be said about "best practices," but that's for another blog.

2. Deal with the constant threat of lawsuits against doctors. What complicates this issues is that some doctors richly deserve to be sued out of their practices. Finding ways of weeding out the incompetents will be the challenge.

3. End of life. That's right. It comes to all of us. Call them "death panels" or whatever, but, for some, there will have to be a determination as to when enough is enough.

4. Make the medical insurance companies more competitive. End the barriers between states that prevent insurance companies from competing for business throughout our country.

5. Require all citizens to carry a minimum policy.

In other words, try to improve the healthcare system in our country by easy steps before letting the legistlators to pull out their knives and butcher things up in a way that will be almost impossible to remedy.

Apology

Typos are a curse and I must apologize for one I made in my last blog. There you will find a sentence, early on, that reads, "The desire to keep a buffer zone between their (China's) tremendously large nation (and a free and democratic state) is really the only thing that keeps a meglomaniac in power in North Korea.' Somehow, the word "it" found its way to a place between "is" and "really." Also, I neglected to put in "and a free and democratic state." I've made plenty of typos before, but this one was the worst.

Of course, I should also have begun the sentence with "Their desire" instead of "The desire." But that weakness in the sentence is not as troubling as the placement of the "it" where it had no right to be.

Anyway, I am sorry.

Does The World Love Us Any More Today Than It Did Last Night?

The NY Times had an item on October 14th which described Guinea Boasting of a deal with the Chinese. It's a story because Guinea's bloody junta stands to gain billions. China has become like some of our financial institutions; namely, too big to fail.

It's not really a new story. Their pursuit in Africa finds the Chinese furthering the interests of leaders with no compunction about murdering humans they find inconvenient. Their trade with Burma (Mynmar) keeps another set of murderers in power. Their desire to keep a buffer between their tremendously large nation, is it really the only thing that keep a meglomaniac in power in North Korea. Taiwan, a nation, that has made tremendous strides in forging a benign and democratic nation is denied its place in an assembly of nations that gives membership to many lands far less worthy for just one reason; China opposes Taiwan's claim to nationhood.

China is not the only abuser of it's size and military power. Russia continues to act like an uncivilized lout. It wants land in Georgia for its oil and gas pipelines so it rips out chunks of that country. You may recall the chunks; South Ossetia and Abkazia. Then there is Transnistra. It's population is 31.9% Moldovan, 30.4 % Russian, and 28.6% Ukrainian. It is by right (de jure) Moldovan, but de facto independent. That's the way Russia wants it.

If you really want to see the way Russia plays the game, study Chechnya. They've installed a puppet regime, which they fully support in all it's brutality.

Let's now turn to Africa where the countries of that continent installed Muammar al-Gaddafi as prime minister of the African Union (UA). They say people deserve the leaders they choose, but can people of any continent deserve this sort of leadership.

When one considers what goes on on planet earth, and that these very countries guide the actions of the UN, is it any wonder that this organization expresses nothing but hatred toward the only democratic government in the middle east? The Scandanavians harbor as much anti-Semitism as is to be found anywhere in Europe. When they give a prize to our president, I begin to worry.

Obama Wins the Nobel Peace Prize

You've got to hand it to the left when it comes to generating positive publicity for their positions. Their support comes so frequently and so swiftly it's hard for their hero, Pres. Obama, to work up a response in a timely fashion. But, he does. He's got a really great team working for him.

Obama's response to winning the Nobel Peace Prize was brilliant.

The problem is that the media has focused largely on the recipient of the prize; what it will mean for him; what it means for his policies. For the president, it makes for good print, but it misses the more important story; namely, what it is that the Nobel Peace Prize is all about? Who are the people who choose the recipients? When Obama, in laudable modesty, asks whether it wasn't a bit premature to award him a peace prize when he hasn't yet served a year in his office and when his achievements have yet to be achieved, asking what these Nobel committee members had in mind when they made this award becomes unavoidable.

The only way this award can be understood is on the basis of politics. And, that's fine. Nobel committee members have every right to express themselves as they see fit. But, the idea of this prize having anything to do with accomplishment is now clearly dead. Getting the Nobel prize is more meaningful than finding oneself on the cover of Time in only one way; with the Nobel prize you also get $1 + million.

Clearly, the Swedes have debased their prize. But this is nothing new. Didn't they also award it to Arafat and Carter? Carter got his for what was little more than a photo op. And the award to Arafat demonstrates that perhaps it would be best to wait until someone dies before awarding him this kind of prize.