Your Money or Your Life

I promised an item on healthcare, and here it is. As a polite reminder, the 40+ million Americans without health insurance — almost one in every 7 people — are breathing their germs on you every day.

Yesterday morning I was listening to comments to a gathering of state Governors by the CEO of Wal-Mart. And you know what? even though he may be part of the problem of healthcare insurance, he is right about one thing:

“The soaring cost of health care in America cannot be sustained over the long term by any business that offers health benefits to its employees. And every day that we do not work together to solve this challenge is a day our country becomes less competitive in the global economy.”

He went on to say that mandating he spend a certain percentage of his payroll on health coverage was just not going to work. Like it or not, I tend to think he is right.

As I listened to people commenting on what Mr. Scott had said, again and again I heard how the problem was at least in part that people had no incentive to limit their healthcare costs. This was interspersed with survey results showing that the overwhelming majority of respondents were paying more towards healthcare than they were a year ago. The commentators implied that the problem would be solved if corporate America offloaded more of the costs to the end users of healthcare, for example through HSAs and high deductibles/copays. After all — I actually heard someone say this — if people had to pay more of their healthcare costs they would think twice about “unneeded” emergency room visits or medical tests.

Let me take the spin out of that for you: the cost of healthcare will come down if you just don’t worry about that crushing pain in your chest at 3 AM. And somehow it will be more affordable if you pay for everything instead of letting the insurance company cut a deal with the hospital.

Let me start by puncturing a great myth of healthcare costs: healthcare costs are directly controlled by insurance companies, who alone determine what they will pay healthcare providers. You cannot go into your doctor’s office and say “Okay, you can run that cholesterol test, but I’m only paying you $X.” First of all, you are one person with no bargaining power. Second, it is illegal for your doctor to make such a deal with you. Your insurance company, on the other hand, has the ability to arbitrarily decide how much they will pay for any given procedure, and your doctor only has the power to accept the insurance payment, or not do business with that company. The fact that insurance companies are not able to contain costs in this environment is evidence that the system is broken.

I am going to say this again and hope it sinks in: if you want to “unload healthcare costs to consumers,” change the tax rules so everybody can deduct health insurance premiums. Couple this with state-level rules simplifying premiums and eligibility; who knows how many businesses are never started because the people involved can’t get individual coverage? This way, Joe and Jane Average can look at their employer’s health insurance plan, and if a better deal or better coverage is available elsewhere, they can just buy it. Of course, this does little to help the many people who can’t afford a few extra hundred dollars a month for private coverage or an HSA.

A better plan, one that will benefit everybody, is universal health care. You know, the CEO of Wal-Mart would look really progressive if he supported such an idea. Oh, and for the record? He supports a higher minimum wage too. He says it’s to benefit his customers, and while that may be true it will almost certainly impact the wages he pays, too. That sword cuts both ways.

If you want to read more on healthcare in general, please visit my friend Elisa Camahort and her colleagues over at Healthy Concerns.

The Incredible Shrinking Shorties

No, seriously, this one’s almost too short to be shorties. It is my hope to bang out something about healthcare tomorrow.

Karl Rove is planning on Hilary being the Democratic Presidential candidate in 2008. This is why a) she must not run;: b) she should pretend to be serious about running as long as possible. Let the Republican Machine figure out how to take her down, then pull a bait-and-switch.

Today I got an envelope from UNICEF. It had a nickel glued to the first page and the text on the envelope read “This nickel could save a child’s life.” Well for Heaven’s sake, why the heck haven’t they saved the child instead of mailing the nickel to me?? And this is supposed to make me want to give them more money. What will they do with it, mail it across the world one nickel at a time? Do I look like I’m made of nickels?

Tax time is closer than you think. Here’s tax pitfalls to avoid and the official IRS website, where you can download forms and instructions.

Finally, the Christian Science Monitor brings us this item on declining real income for “younger” Americans. By younger they mean anyone under 44: “Income fell 8 percent, adjusted for inflation, for those under 35 and 9 percent for those aged 35 to 44.”

Shorties the 13th

A cure for boredom or a prescription for insanity? You decide!

Almost 6 months later, ” Louisiana rebuilding plan unveiled.” My favorite part? “[I]t would require that people who receive housing assistance rebuild to new federal standards that haven’t been finalized.” Because it’s so easy to plan your rebuilding budget when the rules governing what you can and can’t do haven’t been written yet. According to the Washington Post, there is a take the money and run clause — I mean a mortgage buyout provision. I wonder what happened to the people who were sent to Katrina Camps.

Soon, there may be no such thing as “public records.” Good luck getting a replacement birth certificate. Or researching disease clusters. Or finding your birth parents. Or finding the health impact of industrial sites.

Within a decade, one of every 5 dollars spent in the United States will be spent on healthcare. This number may be low, as I think the expectation that prescription drug costs will go down is unrealistic. Every month new drugs are developed and patented, and there will always be a premium charged for them. Furthermore, there are hundreds of diseases being researched at any given time, meaning new drugs to treat those illnesses will soon be under development. Keep in mind this figure includes health insurance, hospital costs, drug costs, and actual fees paid to medical professionals. Oh, and if “The [Bush] administration predicts that Americans would become more thrifty consumers if they had to pay more of the upfront costs, which occurs with health savings accounts,” then they should get the tax rules and forms changed so that Joe and Jane Average can deduct premiums for individual health insurance policies.

Neo-Conservatism is dead. Long live Neo-Conservatism. Now lay down and shut up already!

And finally, Honda may start selling a “cheap” hybrid vehicle in 2007 or 2008. Unless of course they don’t.

Here, There, and Everywhere

Last night I was reading this item from Bradford Plumer, but frankly the first paragraph is very meaty:

It’s not a big secret that the developing world suffered a major slowdown in growth starting around 1980, right about the time that the IMF began leveraging Third World debt to force poor countries into adopting its preferred mix of neoliberal policies: devaluation, “free” trade, privatization, deregulation. Among developing countries, per capita income growth plummeted from 3 percent annually in the “bad” old protectionist days of 1960-1980 down to 1.5 percent in 1980-2000. (For the poorest group of countries, things were even worse—per capita GDP growth plummeted from 1.9 percent annually in 1960-1980 to negative 0.5 percent in the heady globalization decades.)

Now think about that for a moment: after the creation of the IMF, economic development in so called “developing countries” was cut in half, and in some places went negative. Here’s one of his sources complete with charts and footnotes, he also has a link to a PDF article. Lest you think this is liberal loony left-wing propaganda, traditional conservatives* like Steve Forbes have for many years been critical of the IMF, saying “the IMF has been guilty of economic malpractice in not promoting growth policies.” As for myself, I remember thinking on September 11, 2001 that it was very interesting that the terrorists chose to target a building that housed the IMF and the World Bank.

Mr. Plumer goes on to discuss “the breathtaking rise of urban poverty” and the resultant rise of slums and super-ghettos around the world, a problem which he sees as only getting worse over the next few decades. It is an excellent item that I recommend reading, but I would prefer to focus on the IMF prescription and what it means here in the United States. So let’s get back to those “neoliberal policies: devaluation, ‘free’ trade, privatization, deregulation.”

Sound familiar?

Devaluation sure sounds like what has happened to the dollar under the Bush Administration. This was aided and abetted by John Snow, our Secretary of the Treasury, who says he is for a strong dollar, and then goes on to say that means among other things that it’s hard to counterfeit.

“Free” Trade is certainly something the Bush Administration says it is for. Now, you can’t give them blame or credit for NAFTA; that was ratified under the Clinton Administration. But you can blame them for CAFTA, the Central American Free Trade Agreement, a document whose ramifications have yet to play out. And furthermore, it is only fair to note that President Bush himself has said repeatedly he is for “free and fair trade”. In theory, this means free trade as long as it doesn’t hurt American interests. In real life it appears to mean free trade unless big American corporations stand to make a lot of money. See also: pissing contest with China, farm subsidies, steel tariffs, etc..

Privatization has been going strong in this country. It brought us Enron. Proponents say that privatization and breaking up monopolies in telecom has worked, but can you really choose who runs phone lines to your house? We still hear talk of privatizing Social Security, but thankfully most people have realized that you can’t solve “not enough money” by giving the system less money. A very scary prospect indeed is those who favor water system privatization. The TSA would like to privatize frequent flier security, a bad idea several ways. The core idea of privatization is the old Reagan idea that government always does things badly and companies always do things better. Yeah, remember that next time you get bad service at some company. Proponents say it works better because there is profit motive. Some things are too important for “profit” to be a prime motive, particularly since that profit is not evenly distributed to the people who helped make it possible.

Deregulation is another thing that has been going on in this country for a lot of years. The underlying premise is that companies would do more stuff that stimulates the economy if it weren’t for pesky government rules. I suggest we ask the survivor of the Sago mine incident how he feels about that. There has been a lot of deregulation from the USDA, and if you’d like to read about the effects, I recommend “Fast Food Nation” or “Bushwhacked.” Speaking of the USDA, did you know that they predicted that “Electric utility deregulation could cause 19 states to have higher electricity costs, especially rural customers in those states…”? Yes, it costs money to comply with regulations, but the bottom line is that the regulations were put in place for a reason; often that reason is to protect real human beings and the environment they live in. Just a friendly reminder, Earth is the only place we know of where humans can live at all.

So, these things being so right here in the United States, we can hardly be surprised when the Guardian reports “37 million poor hidden in the land of plenty.” Nor can we be shocked to learn that wages are not growing relative to inflation. And that’s inflation as measured (or undermeasured, if you prefer) by the government.

Our old friend Ben Franklin once said that the definition of insanity is doing the same thing over and over and expecting different results. Our government is doing here the same things the IMF is forcing other nations to do, and getting the same results. Either our government is insane, or it is their goal to have a large, impoverished class of virtual serfs.

In closing, an excerpted scene of Security Theatre: 9700 items of checked baggage lost on average each and every day. They can’t even figure out where your bag is, and they want to tell you that’s because they want to make sure there’s not a bomb in it? And they want to poke through your underwear — that is with you, on the plane — but not all the cargo below, when the shipper is miles away? It sure would be nice if we could apply some good old fashioned logic and common sense to this airplane security thing.

* You remember them: the guys who are for things like small government, low taxes, and reducing the federal deficit.

Shorties of the Baskervilles

Maui may be running out of sand.

Romance Filter (Happy Valentines Day): Diamonds and the ethical purchase thereof.

Real conservatives don’t shut up and drink the Kool-Aid, but they may get flamed by people who claim to be real conservatives and like their Kool-Aid.

Enjoy some taxpayer-funded prepackaged news. You would think that they could have saved some of that sixteen hundred million dollars by consolidating those 343 PR contracts. For that matter, when we are talking this kind of money, wouldn’t it be cheaper to create an in-house PR agency and in-source it?

Maybe the White House thinks the Vice President shooting somebody is funny, (yeah, freaking hilarious) but Asian news sources are calling it “a bizarre and sinister episode.” So tell me, is it funnier now, since the victim has had a heart attack because “Some of the birdshot appears to have moved and lodged into part of his heart….”?

Bad enough that the courts are split on whether it’s ok for the FBI to track where you are via your cell-phone just because, now the Federal government would like to set up a giant omnibus electronic medical records database. Never mind that even Consumer Reports says “Electronic Medical Records Have Potential for Misuse.” Even news outlets less than 200 miles from Dubya’s Crawford ranch are publishing opinions against this sort of thing. Here’s the short version: creates big commercial database; subject to misuse and outright hacking; will be used by insurance companies to deny payment or coverage; will be used by other entities to “legally” discriminate based on medical conditions past or present; will probably not result in better care, particularly in the sort of emergencies where an omnibus medical record would be darn handy. ER docs are too busy saving your life to try and figure out how to get a remote computer database to barf up your records and — since they will likely contain streams of incomprehensible but succinct billing codes — then interpret them.

Drove my Chevy to the School District Levy.

So today I went and voted myself higher taxes.

About 20 local school districts are requesting more money from taxpayers. Such elections are a bit controversial: they pit the right of all children in the state to get a consistent level of education wherever they may happen to live with the right of parents to vote themselves higher taxes and better schools. Although theoretically any community can decide to pay more money for schools, the fact of the matter is that in poor communities — whether they are urban or rural — there is no more money. School inequity will be a fact of life as long as schools can receive funds from property taxes.

Another problem with such levies is that they are often approach extortion. Proponents will say that sure, you can vote against the levy, but then there will be overcrowding. Or if voters say no to the school expansion they will just have to spend the same kind of money on portable classrooms and surely you don’t want that. Or surely you don’t want to destroy the [insert popular program, class, or extracurricular here]. Or surely you want the kids to have the latest technology, don’t you?

Now, this last point is very sensitive in these parts. Large local employers include Boeing, several large medical/hospital groups, and Microsoft. Those companies all use computer technology. One of them makes computer technology. I suppose you could, through convoluted logic, say that school technology levies create local jobs. It wouldn’t be true, but you can say it. It isn’t like Microsoft has to write new code every time a school district orders a thousand new PCs.

I actually have a problem with this.

Computers are pretty expensive. Particularly when a school district wants to buy hundreds or even thousands of them. And these resources aren’t like desks, that last for many years and can be replaced piecemeal. And these resources aren’t like textbooks, where certain subjects like Math or English Literature just don’t change much from year to year. These computers that the local school district wants to buy today will be hopelessly obsolete in 5 years, unable to run modern programs and operating systems, many crippled by malware, and the school district will want to buy new ones. I have seen schools that had rooms full of obsolete computer equipment. Rooms full of taxpayer money long since spent and now occupying a room that should be full of children.

I am leaving aside for now discussion of the fact that most educational software that I have come in contact with in the last 10 years is crap. Furthermore, I will overlook the fact that the “computer curriculum” in most schools is nothing more than “Typing 1 and How to Use Microsoft Office.” Don’t tell me about how great digital textbooks can be and how schools can save on buying classroom quantities of classic literature unless you can tell me the title of the last book you read cover to cover at Project Gutenberg.

Almost all school districts would be better off leasing computer equipment. This would mean that every year or two, schools would have new, fast, virus free computers and peripherals. The money for technology could be planned and budgeted rather than begged from the populace every 5 years. Kids would consistently be using current technology — one of the stated purposes of having technology in the classroom in the first place. And school districts would not have to figure out how to dispose of ancient hardware. That is a win-win-win-win situation if I ever saw one.

If a High School or advanced Junior High group (I refuse to call it Middle School) wants to build computers, that’s wonderful and I applaud it. I wish more High Schools had hands on practical educational experiences. But the vast majority of computers in schools should really be leased.

Hundred Grand.

What kinds of things could you do if you had $100,000?

Well, you could pay off most of the student loans of a newly graduated doctor.

You could hire 5 people at $20,000 for an entire year to do whatever the heck you want. Like, oh, i don’t know, help rebuild New Orleans.

Speaking of which, you could rebuild a house in New Orleans.

You could buy over 16,000 six-packs of decent beer.

You could buy a quarter of a million winter coats for homeless people.

You could buy 7 Chevy Aveos and have a different colored one for each day of the week.

You could take a few hundred of your closest friends to dinner and a movie. Actually, you might be able to do that twice.

You could give it to President Bush and become one of his “Pioneer” level campaign contributors.

You could give it to your local school district and help them buy things like books and computers.

Ok, that’s just a short list. Consider for a moment the idea of having that kind of money to spend or waste every minute of the day.

Well, that’s what the war in Iraq is costing us. Furthermore, we are spending more on the wars in Iraq and Afghanistan (bet you forgot about Afghanistan, huh?) this year than we have since the whole mess started in 2001.

I’m just sayin.

In closing, The Man who said No to Wal-Mart, the Truth about Universal Health Care, and the Squeeze on American Pocketbooks.