Governtment Medical Care, Why it does matter and why it can work

Recently I was told in the matter of Government or Private Health Insurance

"It wouldn't matter. The world either wants a government monopoly or a private monopoly on insurance when it doesn't work.

I happen to believe that the 'World' hasn't had a real debate over what options there are. Nothing about private Medical Insurance (MI) is harmed because of govt health insurance except levels of profit for the industry and the need for that industry to follow any rules or create new products and markets. They have become lazy and don't want to actually work at their business. They like a locked in customer base and see no reason to change that. Setting aside the morality of making a profit from what is supposed to be an altruistic endeavor for a moment.

The MI industry can ignore rules because the people making those rules (politicians) look to the industry for the "experts in the field" when making any rules. How much money a company paid to get a politician elected seems to correspond with the level of expertise a company has in the field of making it's rules. If politicians are asking people with a vested interest in profitability (not health care) the best rules to create to regulate them what kind of rules do you honestly think will get made?

MI also doesn't have to improve the insurance markets or it's products except in profitability. And it has the option of picking an chooses who it wants to bother with in the customer base because it CAN. You can only purchase private MI and many have to go without regardless of an obvious need. Why should the MI industry bother doing anything except providing what is profitable when you have no choice but to go to them? Why work at creating good products when the customer base has no choice?

For example, Private Transportation industries have to go against Public Transportation. The Private Transportation industries have to get people to want their product and that takes aggressively looking for good new ideas and creating a good products. Because of that people have options in fulfilling their transportation needs. Some people choose private vehicles, some public transportation by choice , some a combination of both and those who need it because they can't afford a choice have a viable option to enjoy freedom of movement, a public good.

I don't see why Govt MI can't be created that augments what the private sector obviously cannot maintain well and produce at a profit without harming or depriving it's customer base of a basic level that anyone can use if necessary. Govt MI just means that Private MI would have to 'specialize' and create new products to sell to the market. Nothing more. They would have to create a need for their product that doesn't hamper the real needs of the overall populous for real health care as opposed to medical insurance. As you say, they are not the same.

They would simply lose a monopoly on the customer base. They would have to work to create new markets and products beyond the scope of or to augment the Govt MI.

A couple of examples:

1) Plastic Surgery Insurance. This is not something that the govt would cover unless it was of a life saving operation or the results of something covered by the Govt MI. This means that if you decide to do it you need to pay insurance to cover it. This means that an actor or someone who believes their personal appearance is relevant to their income and they are concerned about how they will handle such costs could pay for MI at a younger age and reap the benefits if needed in the future. Hell, they might not need it because they age well and the MI company would make a profit on that beneficial outcome for both their customer and themselves. Some would pay and never need it because they didn't make it to the "big times" where anyone cared if they changed the way the looked.

2) Deductible: A flat rate you pay every month instead of paying the deductible whenever you go to a doctor. If the Govt MI deductible is 5 dollars (refundable if you are actually sick) because some stipend must be paid in order to get people who would just be going in to waste medical staff time because their lonely or something. You charge someone 1 dollar a month for that policy and pay that deductible if they have a card. If they are shown to abuse the product (going on multiple visits a month based on the "lonely or something" scenario above) the insurance can be canceled for abuse without actually harming that person's ability to actually receive care if really needed.

3) In-Home Visits: For all those who don't want to wait for a doctor they could pay any deductible insurance you may incur for a "home visit" from a group of doctors willing to do home visits as opposed to seeing a patient in a clinic or hospital.


Like Flood or Earthquake insurance, some people would need them and some won't. Some would be able to afford the extra "insurance" and some won't. Obviously the legal terminology of the proposals would have to be hammered out by experts but those are examples of products that I don't think I should have to pay for. I think if you want that in home service or just want to show a card paying the inevitable deductible and all you have is a hangnail, a cold or need some company you as the individual should need to pay for that service if you think it's necessary so I don't think I should be tossing into the kitty so that Michael Jackson can have his 5th nose job.

However, if you have a heart attack, lung cancer or need life saving drugs or operations I have no problem putting a little bit in. That's what "charity" would be like in a country that really didn't mind giving charity to anyone who needs it. I also don't think that someone should go bankrupt or lose their home because they needed to help a loved one in a time of real need. That doesn't sound civilized to me. It sounds careless and barbaric.

Giving the MI a monopoly on people's basic health care regardless of need just seems stupid and cruel and a ripe seed for misuse. It's putting health insurance decisions on the same level of Cable vs. Satellite TV or Broadband vs. Phone Line. It's not the same. Whether you can live or die is not the same as the quality of what you get to see on television or how fast your internet connection is.

There is private security and the police. Fire departments exist but you can still buy water sprinklers and an alarm. Someone had to develop those ideas in a market that originally didn't exist. That's how a healthy economy is supposed to work. That's how the MI should work. Not taking advantage of people but creating products that actually serve a purpose beside forcing people to deal with you.

Just like you have to wait for the bus or train instead of simply hopping into your car, convenience is something that should probably be paid for. And just like without the public bus and trains, the overall economy is harmed because some people who help it survive and grow depend on them, there should be a method of providing health care for those who do the same and need to have their health care taken care of so that they can do their parts.

Hypocricy in America re: Torture

Earlier this week the President did a good thing. He released some documents that demonstrated that the previous administration acted, in my opinion, illegally by having the Department of Justice create documents that justified letting the CIA torture individuals. Torture is against both international and national laws so basically the previous administration was breaking the law and assumed that if they got some lawyers to write memos saying it was okay and this would excuse them. This is patently silly and only people as dumb or ethically challenged as the previous administration was could assume it was something that would fly. At least that's what I thought.

Earlier this week the President did a bad thing. He had the DOJ put out the message that they would not prosecute CIA agents who accepted this bogus logic as legally binding and tortured people. While I commend the first act it is obviously rendered moot based on the second act. President Obama had the nerve to say that he was doing it in an effort to "look forward" and not dwell in the past or something equally insulting to the American public.

This appears to mean that this administration has no more problem with hypocrisy as the last. The most "logical" argument I have heard is that maybe he is letting the little guy get away so that they will help them get the big guys. This is equally insulting. You let the little guy get way AFTER they have testified in court in the effort to get the big guy, not before they have done it. There is no reason at all that the CIA agents who committed these crimes should bother testifying to get the big guys.

Can anybody give a reason why these agents should be excused for their actions that isn't hypocritical? Why shouldn't any country use the same rationale to torture Americans who are captured? Why can't a murderer get off by getting a memo from his lawyer saying that it was okay? How is this different than some tin plated dictator like say, Saddam, giving legal authority to his torturers? I'm sure that they had some kind of rationale that justified their actions too. Might have even been "national security". Or can only the American govt use such logic to defend their actions?

Hypocrisy in America is becoming a standard.

Why bother with America?

I've been considering lately the dialog regarding the stimulus package put together by the federal government. There have been and will be many commenting on the respective positions of the different parties and their arguments regarding why we should or should not be printing/spending the money and 'creating debt for our children's children'. I have to admit that I am actually more 'for' than 'against' the plan put forward. Against because it is a compromise built to satisfy too many different diverse POVs therefore not nearly enough to do the job right and for it because I honestly believe that doing nothing in relation to specific aspects of the problem would result in more harm than good.

But that's not what this is about. This is about a rationale that I have heard for not helping those Americans that are suffering during this real ‘financial crisis’ as it becomes a main focus of the public discourse. It appears that people are complaining about 'helping' their fellow Americans. Comments like "Why should I bail out my neighbor when I did everything right and they screwed up?" or "They're redistributing wealth and that’s socialism/communism/anti-American.".

All of these arguments ignore one very simple point. Helping the 'others' that are being disparaged is helping other AMERICANS. You know, your fellow citizens. These are some of the people that make up the country that we are all supposed to love and work to make better. It's amazing to me that this very simple fact seems to have been removed from the equation. Americans don't appear to look at each other as fellow citizens of "The Greatest Country on Earth" but as competitors for a shrinking piece of a dying relative’s fortune. Everyone for himself and damned those that fall to the wayside. We don't even appear to like one another.

Personally I find a grand contradiction in the assumption that not helping your fellow citizens is a manifestation of good citizenship. Don't get me wrong, I'm not telling anyone what they should do with their money that they earn through honest work and effort. If an individual embraces greed and couldn't care less about their fellow citizen’s pain and suffering, fine, everyone to their own. But I’m confused how someone can claim to be a good American while turning their backs on their fellow citizens when it's obvious that there is need. I hope that’s not what people consider ‘American’.

Now the questions. If that attitude is American then why should a society that would turn it’s back on those in need or who have made a mistake be saved as a nation? Why not let it fall apart and let those who survive do whatever they want with what’s left?

Obama's First News Conference

Not bad. I watched it on the local news here is LA and they did it without commercials. I was kind of surprised actually. I thought I was watching CNN until it was over.

Anyway, Obama gave substantive answers to hard questions. He didn't make any gaffs that I could detect and he held and used the bully pulpit as if he owned it. He used it to get his point across, "Pass my bill because it's needed and let's stop playing these silly games".

I like the fact that he appeared to be speaking to adults. He's not telling me how great America is, he's telling me that this is a time America has to show everyone why we're supposed to be great. Not a bad message to tell us after the last few decades.

I like the way he's not taking sides in the debate, simply expressing why he believes his ideas can work and challenging others to come up with 'good' ideas. He's not promising pie in the sky, he's saying that things will change and we need to manage it intelligently, something that we haven't been doing the last few years.

Granted, I didn't like the dodge when asked the question if he knew of a middle-eastern country with nuclear weapons. He knows that Israel has them but then I'm not expecting miracles with even this president so I didn't see him admitting it.

Heard a lady on CNN say it perfectly. Obama's being 'pragmatic'. That makes sense in these times so I guess he gets a passing grade. I don't like his foreign policy but can't really complain about this attempt at fixing the economy because I understand the strategy and see how it could work.

Now I guess we'll have to wait and see if Mr. Obama's plan will work. He definitely instilled more confidence in me for the chance of success, if we work at it, more than Bush ever did. But then that's not really saying much given what I thought of Bush. Low bars are easily jumped.

So What’s Changed?

Barak Obama is the first black president of the United States (I never bought into the talk that said it was Clinton) and that apparently is supposed to mean something’s changed. I’ve been asked what I ‘think’ about it. Whether it’s some kind of bell weather that going to change the dynamics of racism in the country? If this means that Dr. King’s dream as finally come true in America? Can white guys now say ‘the n-word’? Answer to those questions is “I don’t know.” I try not to speak for whole groups of people so I won’t even attempt to explain what I believe ‘black people’ think this means. I don’t give a lot of thought to what ‘black people’ as a group thinks about anyway. Never understood how I was supposed to have that insight.

At first I thought there was only one way Obama’s presidency mattered to me and that’s politically. I’ve never been impressed with any politician regardless of color and was only impressed with Obama’s oratory skills not his political policies and I was perfectly capable of separating the two. I’m too politically cynical to assume that just because the color of skin of the guy running things changes to mine there’s a relationship between that and my life improving. So politically for me it doesn’t change a lot. His politics and mine aren’t even close in foreign policy and his domestic policies were to ‘democratic’ for my tastes (note the small ‘d’). Even though I consider that side of the political coin more socially reasonable in relation to domestic social policy (but not by much) I consider their methods to be needlessly incremental to the harm of those they profess to be helping. Mr. Obama presented a face in the election that gave the impression that the change he wanted was the democratic definition and that only had appeal given McCain and republicans as the alternative.

But now he’s president and given that I watch a lot of news I’ve got to see him ‘be president’ for a couple of weeks now. Again, given that he’s just a progressive, middle of the road democrat he didn’t act in any way that I didn’t expect. He made some promises and he went about attempting to keep those that were ‘politically sound now that he is president’, just like past presidents had done. He was fitting into the slot of ‘politician president’ just fine. But then I noticed a ‘change’. Something was askew visually and audibly about the presentation.

But before I get into that I’d like to make a slight side step. My niece was by last night and in a conversation about how life in general was going and how the economy was negatively affecting the lives of people that we know a tangential conversation occurred in which I pointed out how one day while riding to work with a friend early in the election I said that there was no way that Barak Obama would become president of these United States. I believed it was an interesting phenomenon that was probably just another news charade to ‘entertain’ people while the fix was in for Hillary Clinton who would lose thus giving the whole thing away to the republicans again. Because, quite frankly, I also believed that her campaign had as much chance as Barak Obama’s.

I say that to point out how far I had to come from to get used to the concept of a black and/or woman president. Don’t get me wrong, I personally didn’t have any objection if the right one came around. My issue was that I didn’t think “America” was ready to make that happen and I saw nothing about these two that changed that perception in my mind.

So what’s changed for me because there’s a black president? I have to actually get used to ‘seeing’ and ‘hearing’ a black man do the job of president. When I look at the television set and see a person with brown skin speaking for ‘this’ country in an intelligent, commanding manner there is a visual dissonance that I have to adjust to. When I hear the words come out of his mouth in a cadence that is familiar in neighborhoods and homes I’ve visited my mind still has to say, ‘yeah, he’s president’ as if the affirmation was necessary for me to accept it. It’s as if I’m still making small mental adjustments to visual and audio that I never thought I would experience.

Just that, nothing else.

So basically I am being forced to change and accept something that I didn’t’ think could happen. My mind is being forced to wrap around something that it just wasn’t particularly prepared to accept.

I’m not particularly worried about it. I’ve had other epiphanies in my life that changed the way I had to think. At 5 or 6 years old I had the honestly held belief that the opposite sex had no value and associating with them could never come to any good. That was something that was the gospel. I had an experience that changed that thought process too but that’s an entirely different story.

Oh yeah. It also means that people can stop calling Clinton the first black president. I never did understand that.