A Bit of a Dissenting View on Health Care Reform

I have a friend who is in the Economics Department of Georgetown University; his name is Jim Angel.

He sometimes speaks on PBS and NPR on banking matters. I asked him to give me his thoughts on health care reform and here they are (reprinted with permission)
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Jim’s Thoughts:
Thanks for the call. As the plans in DC keep mutating, I am not sure what they are planning this minute. Here are my ideas:

We face the following problems:

1. Too many people lack appropriate access to health care. Those with access fear losing it.
2. Costs are rising rapidly.
3. Linking employment to health care is crazy. Employers are not efficient purchasers of health care. Small employers are especially hurt.
4. The current system creates numerous perverse incentives for waste. I went to my doc for athlete’s foot, mentioned I had had a headache, and she wrote me a scrip for an MRI. These bad incentives stem from the fact that 1) people don’t know or 2) don’t care what the cost is.
5. The litigation mess leads to additional waste.

We have one good thing: Our system has produced enormous innovations that have greatly extended the quality as well of quantity of life for those with good health insurance. We need to keep these incentives for innovation in whatever we do.

What the politicians have trouble facing up to is that the average middle class person will end up paying for the average middle class person’s care. Yet everyone wants to shift the cost onto someone else. We can do it efficiently or inefficiently. The more government is involved, the less efficient it gets. Worst case is a UK single payer circa 1950 program, in which the post office delivers all health care. This would freeze all further innovation.

What we need to do is:

1. Truth in Healthcare: Large providers should be required to disclose what their real prices are on the web, not the phony numbers they put on the bills, and they should be required to give good faith estimates in advance of the out of pocket cost for non-emergency care. Outcome data would also be more widely available. This will let people shop more wisely. Smaller providers will have to post price lists in their offices.

2. Health Care Civil Rights Act. Providers and insurers may not discriminate based on race, gender, religion, political affiliation, national origin, sexual orientation or identity, or pre-existing condition. Premiums may only be based on age, location, weight, and smoking status.

3. Open access and freedom to innovate. Let anyone who wants to sign up for medicare or medicaid or the federal employee plan as long as they pay the full cost. Let other insurers offer whatever types of plans they want to, so that they can compete to offer the best product.

4. Eliminate link to employment by cutting the tax break for employer subsidized health benefits.

5. Give vouchers to medicare eligible seniors that they could spend toward any private plan they want if they don’t want standard medicare. The voucher would be equal to the full cost of medicare. This would inject more competition into the system.

None of the above hurt the federal budget. Here is the expensive part:

4. Subsidy for the poor. Anyone who shows up at a health care provider who is uninsured will be automatically enrolled in a health plan, and the premium (back to the beginning of the year) charged to their IRS tax bill. Poor people will get subsidized through an expanded Earned Income Tax Credit subsidy. (Paying for this is the hard part. My favorite: raise taxes on cigarettes, booze, junk food, and carbon-based fuels.)

More details:

a. We need a national insurance regulator so that insurers can efficiently offer insurance across the country and not deal with 51 state regulators.
b. We need legal reform so docs don’t have to practice defensive medicine. Let insurers offer plans in which patients, in exchange for lower insurance bills, agree to opt out of litigation and go to binding arbitration to solve disputes.
c. A lot more anti-trust is needed to keep prices competitive.

Feel free to pass these ideas on to anyone
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Back to Ollie’s thoughts

Here is the barebones truth about what I think:

I am in favor of a plan that has these essentials:

1. Covers nearly everyone (that wants to be covered, including those with pre existing conditions)
2. Provides honest coverage (none of this rescission stuff would be allowed)
3. Is reasonably affordable (and contains subsidies for the poor)

I can live with

1. Tax increases to pay for it.
2. Reasonable rationing (e. g., not paying for quack “cures”, understands that 100,000 dollars might be better used to help a 25 year old live a normal life than to extend a cancer ridden 50 year old man’s life by 6 weeks).
3. Whatever philosophy of plan; I prefer “single payer” or at least a strong public option. But if there is a totally “market” solution that gets us the three essentials above, fine. I can live with that.
4. Prevention being a big part of it.
5. Managed care. Yes, right now, I am part of a plan where I pay more to have more flexibility on who I see but I could live with managed care.
6. Mandates. Yes, I can live with these.

Massive Ignorance in Action

This was taken in Arkansas. Notice the woman who starts crying about “wanting her country back”.

TomP at Daily Kos has a good take on this.

As an extra bonus:

more about "Daily Kos: Townhalls Gone Wild ", posted with vodpod

Stewart Slams CNN & Fox For Coverage Of Clinton’s North Korea Rescue (VIDEO)

more about "Stewart Slams CNN & Fox For Coverage …", posted with vodpod

Watch at about 5:30 or so. In short, NOTHING can please the Republicans and Fox News.

Faith Vision

Atheists who are internet junkies will catch the Pat Condel joke.

Inmates running the asylum: Forbes Rankings of Colleges

Here is the list of Forbes “Top 500 Colleges”:

Here are some highlights:

1. West Point
2. Princeton
5. Harvard
30. U. S. Naval Academy
43. Rice University
50. Notre Dame
52. Kalamazoo College
70. Drew University
71. Wofford
72. Brown University
73. California Berkeley
78. UCLA
83. Pennsylvania (Penn)
98. Dartmouth
103. Wheaton
104. Duke
105. Cornell
109. Oklahoma Baptist
111. Knox
159. North Central College (IL)
160. Hastings (NE)
173. John Hopkins
174. University of Texas (Austin)
188. Ouachita Baptist University
200. University of Michigan (Ann Arbor)
279. Bob Jones University (!!!)
318. St. Edwards University (TX)
341. Michigan State University
355. New York University
361. The Ohio State University
396. Lehigh Universtiy
415. University of Wisconsin, Madison
420. Georgia Tech
437. Rutgers
459. Illinois State
466. Bradley
498. Creighton
507. Purdue

Some of these rankings are a bit, ahem, surprising, to say the least. Here is how the rankings were done:

2008 marked the first year that Forbes entered the college ranking fray. They choose to use a methodology that included the following percentages: Listing of Alumni in the 2008 Who’s Who in America (25 percent); student evaluations of professors from Ratemyprofessors.com (25 percent); four-year graduation rates (16 2/3 percent); enrollment-adjusted numbers of students and faculty receiving nationally competitive awards (16 2/3 percent); average four year accumulated student debt of those borrowing money (16 2/3 percent). They did not break colleges down into different schools as U.S. News does, but instead choose to separate private and public colleges instead.

Complete College Rankings

Methodology: In conjunction with Dr. Richard Vedder, an economist at Ohio University, and the Center for College Affordability and Productivity (CCAP), Forbes inaugurated its first ranking of America’s Best Colleges in 2008. They based 25 percent of their rankings on seven million student evaluations of courses and instructors, as recorded on the Web site RateMyProfessors.com. Another 25 percent depended upon how many of the school’s alumni, adjusted for enrollment, are listed among the notable people in Who’s Who in America. The other half of the ranking was based equally on three factors: the average amount of student debt at graduation held by those who borrowed; the percentage of students graduating in four years; and the number of students or faculty, adjusted for enrollment, who have won nationally competitive awards like Rhodes Scholarships or Nobel Prizes. CCAP ranked only the top 15 percent or so of all undergraduate institutions.

Okkkkaaaaaayyyy….

5 August 09 (pm)

Workout notes 2 mile warm up, 1 mile in 7:19, cool down (4 total): 1:38, 3:25, 5:12 and then DIED on the last mile; I had nothing left.

Other posts

A very touching tribute to those who know that they are near death.

Bill Maher: scorches the “birthers” and other right wing nutbags.

Security: Too many security measures can lead to less security (e. g. scaring people into never clicking on pop-ups keeps them from needed updates, doors get barred open, etc. ) Note: the same thing happens with safety measures at the workplace: sometimes safety devices make it too hard for them to do their jobs so they defeat them.

Health Care Robert Reich says that the President should forge ahead on health care reform and roll over the faux populist anti-health care reform “astroturf movement”:

The Republicans’ goal isn’t ideological. It’s power. Republicans smell 1994 all over again. That’s when they defeated Clinton’s healthcare plan — and in doing so convinced large numbers of Americans that Clinton and the Democrats couldn’t be trusted. This enabled the Republicans to retake control of Congress. From then on, they blocked Clinton’s agenda. They even gave themselves a shot at the presidency in 1996.

Who can blame them for wanting to recreate 1994? Republicans have no other strategy. They can’t attack Obama personally because he’s just too popular. They’ve been incapable of coming up with their own plan for healthcare reform. The biggest healthcare interest groups — the AMA, private insurers, and Big Pharma — have publicly backed the major healthcare initiatives coming from congressional Democrats (although, I suspect, are quietly supporting the Republicans’ Astroturf blitz). Their “tea parties” in April were a flop. Their poll numbers are awful. Their major loudmouths — Rush Limbaugh, Sean Hannnity, and Dick Cheney — are not exactly attractive to most Americans. Their biggest nightmare, Sarah Pallin, is already on the campaign trail for 2012.

But this Republican strategy will fail. 2010 will not be 1994. There’s too much momentum behind universal health care right now to stop it. Yet the Republicans’ fake grass-roots campaign may cause some Democratic lawmakers to become even more nervous about universal health care than they already are, or at least give them an excuse to duck when it comes time to vote in September. The result will be a watered-down set of reforms that still leave millions of Americans uninsured and don’t slow healthcare costs. This is why Obama has to fight for this so hard over the August recess, why he has to be far more specific about what he wants in the bill, and why he can’t afford any more diversions — like the beer summit, or economic advisors who seem to open the door to middle-class tax increases.

Shooting in Pittsburgh

They guy who did the shooting hated women for rejecting him:

George Sodini seethed with anger and frustration toward women. He couldn’t understand why they ignored him, despite his best efforts to look nice. He hadn’t had a girlfriend since 1984, hadn’t slept with a woman in 19 years.

“Women just don’t like me. There are 30 million desirable women in the US (my estimate) and I cannot find one. Not one of them finds me attractive,” the 48-year-old computer programmer lamented in a chilling diary he posted on the Internet.

For months, he also wrote vaguely about using guns to carry out his “exit plan” at his health club, where lots of young women worked out.

On Tuesday, Sodini put his plan into action.

He went to the sprawling L.A. Fitness Club in this Pittsburgh suburb, turned out the lights on a dance-aerobics class filled with women, and opened fire with three guns, letting loose with a fusillade of at least 36 bullets.

He killed three women and wounded nine others before committing suicide.

Groan. Yeah, I know: rejection sucks and yeah, I’ve felt it. But you know what? There is a kind of woman who likes nerds and it is better for all involved for us nerds to just accept it and go after that type.

But there is more:

Interestingly, at this afternoon’s press conference, the local police chief was asked about any racial aspect to the shooting. He denied it but some may have wondered why the question even arose (the shooter and all victims were white).

In addition, I have located, with some digging, a March 13, 1994 Web posting by Sodini at a Whitewater news group which reads in full:

I got a bumper sticker that reads: “Stop Socialism Impeach Clinton” from an ad in National Review magazine. There are many neat buttons and stickers and things advertised in those conservative magazines. George

Two weeks later after posting at an “alt.clinton.politics” forum he signed off with another pro-impeachment message: “Gore in ’94.”

And on Sept. 9, 1995, he posted on a “activism.militia” newsgroup the following:

I am convinced that more drastic action is required to bring the country back to the Constitutional order that it was 200 years ago. I don’t think any group of political leaders will achieve this for us.

Here was the first entry, which explains his early desire to “exit” and take a few people with him, but deciding to stick around until past last November’s election — and his sarcastic remarks about Obama. Later in the diary he complains about the ‘Obama economy.’

Planned to do this in the summer but figure to stick around to see the election outcome. This particular one got so much attention and I was just curious. Not like I give a flying fuck who won, since this exit plan was already planned. Good luck to Obama! He will be successful. The liberal media LOVES him.

Amerika has chosen The Black Man. Good! In light of this I got ideas outside of Obama’s plans for the economy and such. Here it is: Every black man should get a young white girl hoe to hone up on. Kinda a reverse indentured servitude thing. Long ago, many a older white male landowner had a young Negro wench girl for his desires. Bout’ time tables are turned on that shit. Besides, dem young white hoez dig da bruthrs! LOL. More so than they dig the white dudes!

Every daddy know when he sends his little girl to college, she be bangin a bruthr real good. I saw it. “Not my little girl”, daddy says! (Yeah right!!) Black dudes have thier choice of best white hoez. You do the math, there are enough young white so all the brothers can each have one for 3 or 6 months or so.

He sounds like a quintessential current day Republican (of the Glenn Beck/Sean Hannity/Rush Limbaugh variety).