Health care

March 22, 2010

So, at last, it seems like we will have a huge reform of the health care establishment in this country.  It’s about time that the USA joined the rest of the civilized industrial democracies!  Of course, the bill is imperfect and does not do many things it should do, and it contains absurdities necessary to placate the regional crotchets of various constituencies, e.g, language on abortion, but it is a big step.  And it can be improved upon.

My hope is that the Democrats will run like hell on this bill and crush the Republicans in the mid-term election.  If people start hearing what the bill does for them, as opposed to the fantasies the Republicans have woven about it – it will usher in death committees, Soviet-style government, crushing taxes on the working man, lack of choice in doctors, etc. etc. – they will realize it works for them, i.e., 95% of the electorate.  The other 5% is so rich, they don’t care either way.

I want to hear the Republicans run on why extending insurance to 30 million people, most of them children, is a bad thing.  And why you should loose all your insurance if you loose your job.  And why you should be denied insurance because you  changed jobs and you have a heart condition that makes you…ahem…expensive to keep  healthy. 

Here’s hoping!  Below is a list of the things that I think are most important about this bill, from MoveOn.org:

  • Once reform is fully implemented, over 95% of Americans will have health insurance coverage, including 32 million who are currently uninsured.
  • Health insurance companies will no longer be allowed to deny people coverage because of preexisting conditions—or to drop coverage when people become sick.
  • Just like members of Congress, individuals and small businesses who can’t afford to purchase insurance on their own will be able to pool together and choose from a variety of competing plans with lower premiums.
  • Health care will be more affordable for families and small businesses thanks to new tax credits, subsidies, and other assistance—paid for largely by taxing insurance companies, drug companies, and the very wealthiest Americans.
  • Seniors on Medicare will pay less for their prescription drugs because the legislation closes the “donut hole” gap in existing coverage.
  •  Medicaid will be expanded to offer health insurance coverage to an additional 16 million low-income people.
  •  Instead of losing coverage after they leave home or graduate from college, young adults will be able to remain on their families’ insurance plans until age 26.
  •  Community health centers would receive an additional $11 billion, doubling the number of patients who can be treated regardless of their insurance or ability to pay.

Play the odds

January 4, 2010

David Brooks, the columnist I love to hate, wrote on New Years Day about the failed bomb attack on the Northwest Air jet:

…we seem to expect perfection from government and then throw temper tantrums when it is not achieved. We seem to be in the position of young adolescents — who believe mommy and daddy can take care of everything, and then grow angry and cynical when it becomes clear they can’t.

…  But, of course, the system is bound to fail sometimes. Reality is unpredictable, and no amount of computer technology is going to change that. Bureaucracies are always blind because they convert the rich flow of personalities and events into crude notations that can be filed and collated. Human institutions are always going to miss crucial clues because the information in the universe is infinite and events do not conform to algorithmic regularity. [link]

I happen to agree with him on this, and I think our social conceptions of risk are way off.  I don’t think, however, that this case is a good example of that.  A decent system should have caught that guy.  Oh well, easy for me to say in hindsight, right?  Absolutely. 

I think Brooks’ column is barking up the wrong tree.  It is so hard to make a large organization function well, and to allow the full power of individual human intelligence to be brought to bear on problems.  Organizations that handle information, quickly become, as you move up the chain, detached and mechanical in their procedures.  How can they not?  There’s all that paper, all those calls, all those lists to go through!!  Has it always been so?  Did Assyrian bureaucrats miss vital clues on food supply and impending invasions?  Did they loose their heads because of it, literally that is?

But Brooks is wrong because he doesn’t say why it is so hard to do right.  He just seems to accept it as a fact of nature – the odds are stacked against the system.  It’s hard because it goes against such entrenched political interests.  Turf wars, egos, prestige, the usual culprits.  He seems to have the attitude that, in principal, the systems are being reformed correctly, and that that their failure is an inevitable “wastage” that we must expect.  I doubt that the efforts have even scratched the surface of what should be done, and I haven’t the foggiest notion of what should be done to change it.  So maybe we agree after all?


Liberty for all

December 24, 2009

“When I am old, I shall write criticism; that will console me, for I often choke with suppressed opinions.”

Gustave Flaubert in a letter to Georges Sand

I feel compelled to unburden myself on the topic of libertarianism.  There are all sorts of people who describe themselves as libertarians, and it’s hard to make sense of the mix.

  • You have gun-obsessed Rambo-wannabees like the guy who created the picture here (Click on it to visit his blog if you have a robust tolerance for the way out!).
  • There are folks like Clint Eastwood who once remarked, “My political philosophy is simple.  Everybody should leave everyone else alone.”  Yep, good one, Clint.  That’s a real roadmap for governing a modern industrial state of 300 million.
  • There are those inpsired by the crackpot intellectual, Ayn Rand, who at least must be granted the credit for inventing a new literary genre, the philosophical soap opera.
  • And then there are thoughtful people, like a fellow I work with, who are quite reasonable but seem to revel in the libertarian cachet of ornery contrarian thinking.

I often find myself in agreement with specific critiques of libertarians, whether they are left-libertarian nearly-anarchists or right-libertarian, free market ideologues.  In fact, many of the respectable, i.e., rational and scientific, critics of the global warming point of view (AGW) are, in fact, libertarians.  But, in the end, I find it to be a bizarre and utopian political philosophy that is in full denial of the facts of human history.  As a point of view that influences the political choices you make, yes, I can see that, but anything more…?  Closer to wacko.

For libertarians of all stripes, the state, um…I mean, THE STATE, is the greatest evil.  The state, and “collectivist” actions that seek to improve life, or enslave others.  I’m all against enslavement, but I rather like improving life, even if the agent is the evil state.  Libertarians would say that’s a Faustian bargain, bound to end in the Gulag or the death camps.

Why The State?  Why not money?  Isn’t that the root of all evil?  Or…language?  Without language, no state, no money!  It’s a rather simplistic point of view.  Are they realistic in their expectations of what would succeed the present situation of vigorous state activity?  Do they care?  Do they want to revert to pre-industrial, geographically isolated “eco-regions?”  I dunno…

Sure, some state solutions fail.  Bureaucracies are cumbersome and can mutate into strange things that frustrate the very improvements they were created to bring about.  What else is new in this, the fallen state of mankind?

As a practical political philosophy, liberatarianism is hokum.  People advocating it are either naive or dishonest.  Naive if they believe that a general attempt to apply libertarian principles would result in anything other than the most powerful economic and political forces capturing the state and bending it towards their own ends, which is what they are always trying to do; or dishonest because they are part of those forces and they see libertarianism as a nifty way to pursue that goal under cover.  Mostly the former, I think, because corporate and political power has captured so much of state power today, that libertarianism is probably more of an annoyance than a help.


The face of America today

August 13, 2009

townhall

Senator Arlen Spector faces off against a dissenting constituent, a member of one of the posses of crazies who say Obama is “making our country like Russia.”  We don’t need no stinkin’ health care!!

Meanwhile, in southern California, thousands line up to get free dental care, general exams, and other medical attention.  Thousands, with families, some employed, some insured! But they can’t afford this care that is being offered free by a philanthropic organization.  I guess they don’t have time to harass and shout down their congressmen what with having to stand in line all day to get a tooth pulled.

And finally, a hard-hitting story on NPR about the California prison system.  You know, where the inmates were rioting.  And judges are ordering men released because of the inhuman crowding they are enduring on the inside.  And why are the prisons so crowded..?  Filled to the brim with rapists and murderers?  No…the population on the inside has exploded by a factor of eight over the last 20 years because of unbelievably harsh “three strikes and you’re out” laws.  If you are convicted of a third felony, like shoplifting more than $500 worth of stuff, you are in for life.  INSANE!

What sort of magical thinking led people to believe this would solve the social problem of crack addiction?  Lock them up, and throw away the key.  Fortunately, we are still more civilized than that, and now the people are having to pay the piper.  Who is that piper?  According to this report, it is the Corrections Officers Union, which benefits mightily from the growth of the prison population.


Tom Paine, Libertarian. NOT!

April 5, 2008

Poor Tom Paine! He was all for the French Revolution, and travelled to Paris to support it, but was nearly guillotined for his trouble! In his own land, with the post-revolution religious revival under way, he was reviled as a free-thinking atheist, though he was a Deist who denouced as wrongheaded those who denied the existence of a Supreme Creator (I beg to differ…) And today? He is the favorite of right wing libertarians, many of which can be found spouting off here and there around the Internet.

When I hear so-called “conservatives” say that they are against people being “forcibly taxed” to support things that some others have decided is a public good, I am reminded of Lenin’s characterization of anarchists as “infantile.” Not that I’m a Leninist, but he had a point – and these libertarians are similarly situated on the maturation-politico spectrum. In other words, like so many of us, they want something for nothing, though they will not admit it.

The excerpt below is from an essay Tom Paine wrote for the Pennsylvania Gazette in 1782. Would that it were read more widely by students of American politics and history (emphasis added):

It is a pity but some other word beside taxation had been devised for so noble and extraordinary an occasion, as the protection of liberty and the establishment of an independent world. We have given to a popular subject an unpopular name, and injured the service by a wrong assemblage of ideas.A man would be ashamed to be told that he signed a petition praying that he might pay less than his share of the public expense, or that those who had trusted the public might never receive their money; yet he does the same thing when petitions against taxation, and the only difference, that by taking shelter under the name, he seems to conceal the meanness he would otherwise blush at.Is it popular to pay our debts, to do justice, to defend an injured and insulted country, to protect the aged and the infant, and to give to Liberty a land to live in? then must taxation, as the means by which those things are to be done, be popular likewise.

…Why has the back country been ravaged by the repeated incursions of the enemy..but from the inability of the revenue to provide means for their protection?And yet the inhabitants of those countries were among the first to petition against taxation.In so doing, they eventually prayed for their own destruction, and, unhappily, for them, their prayer was answered.Their quota of taxes would have been trifling, compared with their losses, and, what is still worse, their domestic sorrows.


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