Category Archives: Politics

Why I’ve Soured on Obama’s Health Care Bill

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When Congress finally passed Obama’s health care bill back in 2010, I was fairly happy with it. Among many other items, the bill addressed three huge problems with our previous ways of managing healthcare:

  1. Denial of coverage for pre-existing conditions (prohibited for childen now, prohibited for adults starting in 2014),
  2. The huge number of uninsured Americans (about 30 million more Americans will get coverage through expanded Medicaid)
  3. Lack of options for the self-employed, uninsured, and small business employees (each state will have an insurance exchange in which these people can pool their resources for more competitive coverage)

I was, and continue to be, frustrated by the ignorance among the general public regarding the bill. Its detractors generally call it Obamacare. Many of them mistakenly believe it calls for socialized medicine, prevents people from choosing their own doctors, creates government “death panels” who decide whether individual patients get to live or die, and other fallacies. Wikipedia offers a nice summary of the bill and the effective dates for each of its provisions. For many people, including our family, this bill has very little impact. But millions of Americans will benefit if all provisions are implemented. One potential obstacle, other than a retraction of the bill by Congress, is the Supreme Court case that will decide whether the bill is constitutional. Some argue that the government doesn’t have the power to force people to buy health insurance or penalize them if they don’t. That case will be decided next summer.

So why have I soured on the bill? I don’t think it goes far enough. It still leaves millions of Americans without coverage. It still keeps our healthcare hostage to for-profit companies who have financial incentive to deny claims. It doesn’t address the tremendous inefficiency in the system.

I want to see a universal healthcare system, also known as a single-payer system. I want every person in this country to have the ability to get the medical care they need without having to worry about how much it costs.

There are many ways to accomplish universal healthcare, and many pros and cons associated with it. This site offers several good points on both sides. It also clarifies an important point regarding universal healthcare versus socialized medicine:

It is important to note the distinction between universal health care and socialized medicine before we proceed. Many people confuse the terms. Under universal health care, hospitals, doctors, drug companies, nurses, dentists, etc can all remain independent. They can be for-profit or non-profit. In socialized medicine the whole industry is the government. So if you wanted to be a doctor, you would work for the government.

The main difference between today’s healthcare system and a universal healthcare system is how the providers get paid.

In today’s system, providers get paid in a variety of ways and need one or several employees just to handle all the financial paperwork. One patient might pay cash. One might pay with Medicare. Another might pay with private insurance, which limits the pool of potential patients to those who are “in-network” and forces the provider’s insurance guru to figure out the right way to code everything about the visit to ensure that the insurance company pays correctly. The guru sends the insurance company a bill for some outlandish amount, well beyond the actual cost to provide the service, and the insurance company agrees to pay some fraction of that amount. It’s all a game. Naturally, if a potential patient lacks insurance and can’t afford to pay cash, the provider doesn’t make any money, and the patient stays sick or injured. No one wins there.

In a single-payer system, the provider treats a patient just like today. To get paid, the provider notifies the plan administrator about the treatment, and the administrator reimburses the provider. The difference? The provider no longer needs an army of office workers to deal with dozens of insurance companies and hundreds of different plans. The patient doesn’t have to worry about whether he/she has insurance or what the insurance company will or won’t cover. The patient probably has a set fee for the visit unless he/she is unable to pay. The government pays for the rest. The provider gets paid. The patient gets treated. Both parties win.

Thanks to Medicare and Medicaid, a large part of our nation’s healthcare system is already single-payer. Yes, Medicaid has a variety of issues. Medicare isn’t perfect, but it seems to work pretty well for older Americans, and its administrative costs are much lower than those of private insurance companies. Although its payments to providers might be lower than those of private insurance companies or patients who pay cash, working with Medicare is much less of a headache for the providers. That’s one of the main reasons why one poll indicated that a majority of providers favor a single-payer system.

Obviously, the elephant in the discussion is how to pay for all this. No doubt it would be expensive since more people would receive care. But the funding model is much different. Rather than paying for health insurance for their employees, companies could pay a healthcare tax instead. Individuals could stop paying insurance premiums and pay more in taxes. Since private insurance companies and their $48 million CEOs would no longer be necessary, their disappearance would reduce the cost of healthcare per patient. Plus the providers’ cost would drop due to greatly simplified billing. The system would become much more streamlined. Also, in theory, a single-payer system would make it easier to improve preventative medicine, both through better accessibility and through financial incentives for the providers. It’s much cheaper to keep people healthy than to heal the sick and injured.

I could go on and on, but A) I’ve only scratched the surface in my own research and have much to learn, and B) this post is already quite long.

For me, the bottom line is simple. I have very good health insurance for my whole family through my employer. It has covered two c-sections, biannual mole removals, a gall bladder removal, ER visits for my son, and much more at a reasonable cost. I want every person in this country to have access to the same level of care that we do, if not better. It is inexcusable that in the wealthiest nation in the history of the world, a nation that many claim is founded on Christian principles, thousands of people die and millions suffer needlessly because they cannot afford healthcare. We can debate how to change that, and there are many different ideas, but that change is long overdue.

Repeal Obamacare. Enact universal healthcare.

Things I Don’t Get

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A few things to ponder this beautiful Saturday morning…

  • Why do normally modest women, women who wouldn’t dream of hitting the beach in a bikini, buy formal dresses that flaunt their boobs? (not a complaint, just a question) And why is significant cleavage considered appropriate in a formal setting but potentially questionable or even slutty in other settings, such as work or school?
  • Why do we still observe daylight savings time in most parts of the country? Do you know anyone who thinks it’s a good idea? And for that matter, why are we still the Neanderthals who use the English measurement system instead of metric?
  • Why are donut shops around here run almost exclusively by Asians? (again, not a complaint, just a question)
  • Why am I willing to contribute to Baylor’s new on-campus stadium campaign but not to its scholarship fund? If I remember correctly, I went to maybe three football games as a student, but Baylor convinced me to enroll with a generous scholarship package. Seems like I got a bit more benefit from the latter.
  • Why is obesity skyrocketing in our country? And why do so few people seem to care? We’re gradually ostracizing and limiting the smokers enough to force people to quit, which is awesome, but as a society we’re taking the opposite approach with obesity.
  • Why does $25 buy a cheap sit-down dinner for two in America but nearly a month of food for a child in Africa?
  • Why do baseball players, fans, and managers continue to tolerate the wildly inconsistent strike zone used by the various umpires throughout the league? The Hawk-Eye technology used in tennis could solve that problem right now, but it seems that everyone prefers not knowing where the strike zone actually is on a given night.
  • Why is it legal for men to run around without a shirt but not for women (except in New York City and some other places)? Many men have bigger boobs than many women. They’re called moobs. They’re not cool, but they happen. Without the hairy chests, you might not be able to tell the difference.
  • Why does the US government still mint pennies? I’d rather have everything rounded to the nearest nickel. Pennies get on my nerves.
  • Why do so many people, especially in Texas, hate Obama so much? I can understand disagreeing with some of his views. So do I. But it’s amazing to me how quickly people label him a foreigner, even though he’s published his Hawaiian birth certificate, and a socialist, even though many of them don’t even know what that term really means, and a Muslim, even though he’s been a documented member of a Christian church for decades, and even the Anti-Christ, even though that term (as they understand it, in the Left Behind sense) is an product of the American evangelical church rather than the Bible itself. I guess people just believe what they want to believe.
  • Why roaches? (I’m looking at You, God.)
  • Why do so many people use Christianity as an excuse to hate and look down upon people who disagree with them?
  • Why do labor contract negotiations in the airline industry generally take 2-5 years?
  • Why don’t we have the ability to vote online? (this article tries to answer the question, but I still think the explanation is flimsy)

What about you? What exactly don’t you get?

Random Thoughts

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I’m interested in lots of things today, so fire up your randommeter.

  • End of Iraq War – Obama announced today that virtually all U.S. troops will return from Iraq by year’s end. I didn’t like this war when it began. I voted for Kerry and Obama largely because they promised to end it. And now it’s almost over. Is Iraq better off? In some ways, yes. In other ways, no. Is our country safer? I doubt it. Was our “victory” worth over 4000 American lives, countless Iraqi lives, $750 billion, and the huge strain it placed on our military and military families? I don’t think so. I’m not a fan of everything Obama has done (and left undone), but he delivered on this one. Now, if we could do the same with Afghanistan…
  • 33 Years – My birthday is tomorrow. I’ll be 33 years old. Supposedly that’s how old Jesus was upon his death. And He didn’t really start his ministry until age 30. So he changed the world in just 3 years. I’ll try to remember that next time I start feeling like the big kahuna.
  • Quit Sending Your Leftovers to Foreign Countries – Few things opened my eyes as much this week as Haiti Doesn’t Need Your Old T-Shirt. It describes how well-meaning Westerners destroy local economies in foreign countries by flooding their markets with unwanted goods. Free or super-cheap Western goods undercut the local merchants, growers, and manufacturers and make it much harder for them to make a living. You know how Americans are complaining about being unable to compete with the low pay and poor working conditions in foreign countries? This is a similar situation, only reversed. According to this article, the best way to help struggling people in other countries is to pump money into their economies rather than goods. Why? They can spend that money and move it around, where it works like rising water in a dry marina, raising all boats together.
  • Just Let It Go – I’m fighting the temptation to own and solve other people’s problems. From what I’ve seen and heard, other people struggle with that, too. Perhaps you’ve might have noticed that I can be a bit opinionated? It’s not necessarily bad to be opinionated, but it does give me the tendency to want to jump in with solutions when other people might not want my help. People don’t usually like that. It also stresses me out because I get frustrated if they don’t follow my wonderful advice. It’s so easy to forget that there’s only one person I can control – not my coworkers, not my wife, not my children, not my friends or family, just ME. And I don’t always do even that little job all that well. So I’m trying to stop getting so worked up about what other people do, say, and think.
  • Rangers – Nolan predicted Rangers in 6. Who am I to argue with that? So as of now, that means we take two of three in Arlington and then wrap it up Wednesday night back in St. Louis. But for the sake of the fans, I hope we win in five so it’ll happen at home. Imagine the wild rumpus at Rangers Stadium Monday night if we can pull that off.

Occupy Everywhere

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Our government is barely functional. The economy sucks. Nearly 10 percent of working-age adults are out of work, and about 10 percent more are underemployed, working part-time instead of full or waiting tables with a master’s degree. Health care costs are skyrocketing. The people in charge don’t seem to have the answers. Their primary focus seems to be staying in power, which requires catering to their most significant contributors. The wealthiest Americans control a bigger share of our nation’s wealth every year. The middle class is shrinking. Many of those who have jobs are still struggling to survive. People are angry, and they don’t feel like our leaders are paying attention.

It’s a recipe for some protestin’.

Inspired by recent anti-government movements in the Middle East, Africa, and Europe and the American protests of the 1960s, the Occupy movement gives struggling, disenfranchised people a way to express their frustration. After beginning with a small group of protesters in New York called Occupy Wall Street, the movement is spreading throughout the country and now to other countries as well. Occupy Dallas, for example, is camped out near City Hall.

With no centralized structure and coordinated largely through social media like Facebook and Twitter, the movement seems disorganized. Critics claim the protesters don’t even know what they want, have no solutions, and simply have nothing better to do than complain about corporate greed and political incompetence. Many Baby Boomers have trouble understanding the protesters’ complaints because they came of age in a different time with a much healthier economy. And yes, the protesters do look funny using their iPhones to protest the record profits of huge corporations like Apple. And some of the groups are making ridiculous demands, such as government-provided port-a-potties for them to use while they protest. But I still think there’s something to the movement.

I’m certainly not a sociologist, but this movement seems like a long-simmering pot that is finally reaching a boil. The protesters have some legitimate gripes. Although the economy hasn’t affected my job or changed our lifestyle in any way, people I know have been significantly hurt by the downturn, and I’m just as frustrated with our government’s failure to lead and get things done as you probably are. The statistics on income inequality, although not completely surprising, made me realize how big the gap is between the elite (the 1 percent – the wealthy, the political leaders, celebrities, etc.) and the rest of us (the 99 percent, which includes any poor schmucks who make less than about $290k/year according to recent census data).

If you listen to the protesters and read their signs, some of them sound like they resent the elite. As a result, the elite (and many regular people who sympathize) find it easy to blow off their criticism as jealousy and sour grapes. I don’t personally resent the elite. Many of them, probably most of them, got where they are through a combination of God-given talent, luck, and lots of hard work. But it doesn’t seem right to me that so many others work just as hard, maybe even with similar amounts of ability, but can’t stay above water. No one has full control over all aspects of his life. It’s ignorant to claim that anyone who can’t find work or can’t climb out of a financial hole is simply unwilling to work hard enough. Yes, some of those people are lazy and unmotivated, but others are just as dedicated and hardworking as you or me, if not more so. Effort is not the only variable in the equation. I don’t know the best way to narrow the gap. I’m not an economist, either. But I do think it’s a worthwhile goal.

Enough of that soapbox. No one knows what concrete impact this chaotic movement will produce. But it’s fun to watch. If nothing else, it’s getting people talking and giving frustrated people a voice. If the protesters can organize themselves and their gripes and produce some viable solutions, perhaps they might actually get something done. Go get ’em, 99.

Do We Need the Postal Service?

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Other than my Netflix DVDs, the vast majority of the mail I get is junk. Sometimes I get something interesting, such as a check addressed to me or a birthday card or a letter from one of our sponsored children. But generally the mail consists of ads that I don’t want, credit card applications that I don’t want, and legitimate business mailings that could and should reach me via email instead.

As a case in point, I recently made some changes to my retirement investments, moving money around and changing my future contributions. I made four separate changes. Yesterday I received four separate confirmation letters from JP Morgan Chase.

Really?

A recent article on CNN highlights some of the current and future difficulties of the United States Postal Service. In a nutshell, because our society is shifting to electronic communications and transactions, the volume of snail mail drops every year, meaning less revenue for the USPS. Meanwhile, the service is shackled by numerous laws imposed by Congress and contractual obligations secured by the postal workers’ union. These chains limit its ability to cut costs to match the reduced demand.

The result is easy to predict: the USPS is running out of money. Unless some things change, sometime next year it won’t be able to pay its employees anymore. Beyond the financial issues, it also has a more basic problem: it spends billions of dollars a year in gas and trucks to drive billions of miles delivering materials that the recipients often don’t even want.

This crisis is forcing us to ask some tough questions. Do we really need the postal service? If so, do we really need deliveries six days a week? Could we get by without Saturday? What about three days a week? Do we need all those post offices everywhere? Are we willing to pay the postal service’s actual cost of mailing a letter, even if it means a significant increase in the cost of a stamp?

First off, I don’t think we can function without a postal service. Yes, FedEx and UPS offer a great product for shipping many items, but delivering billions of pieces of mail among hundreds of millions of addresses doesn’t fit their business model, and I doubt they could do it as cheaply as the USPS does. Email and electronic transactions work great in many cases, but physical items such as medication obviously can’t travel digitally unless someone builds one of those teleporter machines that Willy Wonka invented. Plus many people still don’t have computers and/or internet access, and some of those who do still don’t trust computers for financial transactions.

However, the world is changing, and the USPS must change with it. I don’t know how representative I am of general mail habits, but I just don’t use the postal service that much. The main thing I send out via snail mail is my Netflix DVDs, and eventually Netflix will likely abandon its mail-order business in favor of streaming. I pay all my bills electronically except for my property tax bill. That one I pay via check only because the county charges a hefty processing fee for credit card payments. I very rarely mail cards or letters. I prefer getting information electronically since it’s easier to store and doesn’t kill trees.

I only think the USPS can survive long-term in a significantly shrunken form. Service frequency must drop, probably by eliminating Saturday delivery or perhaps even switching to thrice weekly delivery. Rates must rise enough to cover expenses, which will significantly reduce demand. If you really want to mail something, you’ll have to pay good money for it. The USPS should eliminate all bulk rates for businesses and free postage for non-profits and government agencies. The new, higher rates will significantly reduce junk mail by making it less profitable or perhaps unprofitable. Sound good?

What are your thoughts? How much do you depend on the postal service?

Our Tax Dollars at Work

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“I like to pay taxes. With them, I buy civilization.” ~ Oliver Wendell Holmes

I found a great article on BagOfNothing called 101 Things NOT to Do If You Hate Taxes. Although I certainly wouldn’t argue that every dollar spent by our various government agencies goes to a worthy cause, this article does a great job of listing dozens of services that our tax dollars provide. We all use many of these services every day. Others we’ll probably never use, but could be lifesavers if we ever need them.

Like many of you, I think our federal government spends too much money. It shouldn’t spend more than it takes in any more than a business should. But if you don’t want to raise taxes to cover what we’re already spending, which of these items would you scale back?