Tag: health insurance

Ripple Effect

As I write, over 16 million people have filed for first time unemployment benefits in the last 3 weeks. There will be many ripples from the COVID-19 pandemic, and this is a good place to start.

First, I’d like to point out that at best this is a minimum number, and may in fact be a wild underestimate of the people who have lost their job in the last 3 weeks. Many state systems were slammed by not just 2 or 3 times normal volume, but 20 or 30 times normal volume. Turns out that many of these systems work using an ancient operating system called COBOL. For perspective, my late father used COBOL in the 60s and 70s. As if that’s not bad enough: “Still more people likely won’t qualify for unemployment benefits: parents who have to stay home with school-age kids, people quarantined because they’re at high risk for COVID-19 and new graduates who can’t even look for work.” That number probably doesn’t include most “gig economy” workers either.

Another direct ripple: those 16M+ people now don’t have health insurance. In a pandemic. I talked about this briefly very recently. COBRA is still a joke. If this isn’t a wake up call that we need true universal health insurance — not a patchwork of employer based benefits, not the “mandatory insurance” that Romneycare and Obamacare got us, but true “your citizenship is your insurance” universal health insurance — I don’t know what is. A lot of people are going to get a bill for tens of thousands of dollars just to keep from dying. And unlike diseases that can be traced to lifestyle, you can’t easily blame the victim. Keep that bill in mind, we’ll get back to it later.

A public health ripple: those unemployed people without insurance aren’t going to the doctor. They aren’t getting help for their small medical problem, so it’s becoming a bigger, more expensive medical problem. And if the problem turns out to be a communicable disease, they’re making other people sick. So yeah, the uninsured are a problem to your health.

Another ripple: people without jobs are having a hard time paying their rent or mortgage. Some of the renters who can’t pay in turn mean landlords can’t afford the mortgage. Sure, many areas have placed a moratorium on eviction and foreclosure, but that’s not a permanent solution. The forbearance plans in place still mean someday everything owed must be paid. Not meaning to sound insensitive, but how far do we kick the can down the road?

This ripple exposes another truth: over half of Americans had under a thousand dollars in savings just a few months ago. That hasn’t gotten better. With surging unemployment, it’s about to get worse.

Another ripple strikes the economy. About 70% of our economy is based on consumer spending. Consumers without jobs and without savings don’t spend a lot of money. Expect a drop in GDP.

And here’s where our ripples crash into the rocks. Eventually — not today, maybe not this quarter. Eventually, those rents and mortgages must be paid, or foreclosures and evictions will happen. Eventually the past due bills will grow including the medical debt, and bankruptcies will happen. Eventually we will have to confront the ways our health care system is not working. Eventually we will have to look at whether we can sustain an economy on services. Eventually we will have to come out of our shelters and see what is actually left of our economy.

Good luck, and keep your hands clean.

Lessons from a Pandemic

Some of these are things we are now learning. Some are things we should have long since learned but are now becoming obvious.

We should be taking medical advice from medical experts, not politicians. Insert the Fauci Facepalm here. Some of our Governors are remarkably well informed, because they choose to be informed by medical experts. Gov. Cuomo’s presentation Sunday was particularly level, and riddled with facts. Gov. Sisolak is doing the best with what he’s got. I wish him and NV Attorney General Aaron Ford much luck making banks follow rules.

Employer based insurance was [still] never going to cover everybody. Long time readers know I’ve been beating this drum for over a decade. First, it’s never going to cover all children. Second, it inhibits the growth of small business. And finally, there’s the unemployed. Which brings me to….

COBRA is [still] a bad joke on the newly unemployed. I said it years ago. People are now saying it on the radio!

The uninsured aren’t somebody else’s problem, they’re everybody’s problem. Cancer isn’t communicable, nor diabetes, nor hypertension. But TB sure is. And now, COVID-19 sure is. There’s a couple of problems with the uninsured in an epidemic or pandemic. First, people who don’t think they can afford a doctor are not going, not getting help, probably still going to work (because they can’t afford not to work, duh), and most importantly infecting other people. So yeah, now it’s your problem. Oh, I said a couple problems, didn’t I? All those unpaid costs are going to drive your medical costs up. The hospital isn’t getting paid for a bunch of critically ill patients? Your bed cost goes up.

It turns out a lot of jobs can indeed be done from home. I’m hearing radio shows from home studios, seeing TV shows done via videoconference. There’s a lot of “important meetings” that can now be done remotely, or not at all. That is a trend I hope sticks. Of course, this may mean that business travel is in for a longer term slump, since it’s easier, safer, faster, and cheaper to teleconference to San Jose than fly there.

It turns out a lot of jobs are essential. We all knew medical personnel, firefighters, and the like were essential. Some of us in reality-land also knew that “environmental services” (cleaning staff) were essential — I can’t keep people from getting diseases in a hospital if the hospital isn’t clean. Maintenance staff? Essential. Supermarket staff? Essential. Oh yeah, and that “kid” who makes minimum wage making your burger at lunchtime when an actual “kid” should be at school? Essential.

$1200 a month isn’t a lot of money. I don’t know if Congress actually considered this, but with a minimum wage of $7.25/hr, 40 hours of minimum wage a week for 4 weeks is $1160. Round that up to the nearest $100, and that’s $1200. So if you’re kvetching that you can’t pay your bills on that, think about the “essential” employee who does just that. More on what Congress did here.

Happy Death Shorties 2U

Hey folks, time to get some tabs closed and share a few ideas.

On AirBnB: Now let’s be clear here. Clark County Nevada (where The Strip is) does not allow short term rentals of private homes. And no, it’s not because the hospitality industry has them by the throat. It’s because the locals don’t want party houses in their neighborhoods. But here’s some actual research on the impact these short term rentals have on the local housing market — where legal.

A few items on health insurance in the United States: It’s in a state of crisis.

And a few words on Abortion: I understand that Vice President Pence wants to End Abortion In Our Time. I hope that also means he wants to end rape and severe birth defects and risks to maternal life too. Here’s a few words about some of the issues.

Measles: As long as we’re on health related topics, here’s an infographic about how fast it can spread.

Green New Deal?: I know this is not a popular position right now, but I think this idea needs some work. No mistake, I want to see more clean energy such as solar and wind. But there’s too much wrong with what’s on the table. Switching to electric cars is not an end all solution. First, it does nothing about the fact that so much sprawl has made cars a necessity — and made it almost ridiculously difficult for anybody without a car to work outside certain large metro areas. Second, it only moves the pollution from the car itself to the dirty coal plant it comes from. And finally, it’s not ready for prime time. The range on a Tesla 3 is estimated at 264 miles. Per Google, it’s 270 miles from Vegas to Los Angeles. Lots of people make that trip regularly, and sometimes traffic gets backed up. Until the day you can do it without a stop to recharge (and I only know of one charge station in between) and a comfortable margin of error, it’s a no-go.

Huh, maybe that’s why the kids are not happy: turns out most people under 40 have been shafted by the economy.

But let’s end on a fun note: Some of the best pens you can buy, at a variety of price points.

A Prediction

First of all, I’d like to start by saying that the name of the proposed legislation to “repeal and replace Obamacare” is called “World’s Greatest Healthcare Plan of 2017.” That’s a seriously great title, folks.

So my prediction is as follows: there will be enough voices on the Left saying it does not go far enough and enough voices on the Right saying it doesn’t go nearly far enough that no bill will be passed. Afterwards, each side will congratulate themselves on thwarting the other.

The fact remains that any plan that depends at all on employer coverage will never cover all children. That’s because children don’t have employers. And — I will say this every time it’s brought up — don’t tell me we can’t have true universal single payer coverage for children, because Howard Dean did it in his state.

In Closing: vouchers; I guess most-mortems are easier than admitting that Hillary could possibly have lost without outside help; yoga; right; Alcoholics Anonymous; and I don’t even know where to begin about the stupidity of a “day without women.”

Fail.

Some years ago, I read a book called the Inner Game of Music. In a manner of speaking, it was about getting out of your own way. Oddly enough, one of the things that stuck with me about this book was a peculiar concept: giving yourself permission to fail. Apparently many people have learned this lesson from many sources.

So yes, it can be a good habit to permit ourselves to fail. And although I am far from the first person to explore the concept, I would like to share why I think it is so.

Paying attention to failure teaches how to succeed. Of course, this only applies when we pay attention, and fail “mindfully.” The truth is that most of us fail a time or two when we are learning something new. One anecdote from the Inner Game of Music relays how when a pair of musicians tried to isolate when their duet went awry, suddenly it was perfect! When we pay attention to how, when, and why we fail, we come up with solutions.

Failure teaches us about ourselves and about reality. How we react to failure can give us insight to who we really are — but again, only if we are willing to pay attention. But more importantly, failure can be the beginning of discovery! Or, as Isaac Asimov put it, “The most exciting phrase to hear in science, the one that heralds new discoveries, is not ‘Eureka’ but ‘That’s funny…'” Consider Alexander Fleming discovering that the “contamination” in his bacterial culture was actually exactly the exact bacteria-killer he’d been looking for. If he hadn’t been willing to learn, he might have thrown away that specimen and never discovered that antibiotic.

Sometimes, our failures fail spectacularly! No, I’m not talking about all those online videos we’ve watched many times of people doing stupid things on skateboards or motorcycles. I’m talking about a failure that turns out for the best. My favorite example occurred in the original Iron Chef series. Chen Kenichi was the chef who specialized in Chinese cuisine (a footnote, his father invented “shrimp in chili sauce”). A French challenger chef decided to take on Kenichi-san rather than the show’s French specialist, perhaps thinking this gave him an advantage. The secret ingredient was yogurt, unused in Chinese cuisine. You can see for yourself: between 8:30 and 9:00 minutes into the video, Kenichi-san gives himself permission to fail. After all, he’s never used this stuff, never even tasted it. But freed from the need to succeed, he experiments and innovates his way into one of his most memorable wins.

There’s nothing wrong with failing now and again, as long as you aren’t doing something colossally dangerous.

In Closing: milk fail; chart fail; vax fail (don’t do this one); wedding fail; jobs report fail; weight loss fail; just, fail; patient confidentiality fail; accidental paleontology win!

Hard Habit to Break

Today I’m actually using the official prompt:

Have you ever tried to break a habit and failed? What made it so difficult to break?

Ok, this is a weird one. I’m still not quite over this habit: I have a hard time passing up things that are cheap or free.

I’ve got dozens of books on my Kindle that I don’t know when I’ll have time to read them, but they were free! I’ve got canned food in my pantry that I only have because it was on sale — and theoretically I’ll use it eventually. I’ve been known to buy clothes that fit but aren’t really my style because they were so inexpensive.

Why is this a hard habit to break? Well, because it’s easy to think I’m being thrifty. In the case of free ebooks, it doesn’t actually cost me anything. In the case of food, well, I guess I’m well prepared for an emergency. In short, one person’s bad habit is another’s good habit.

Oh hey, and just the other day I got this free ebook on how to break bad habits!

In Closing: the case of the blonde MIT student; Ha Ha Harvard; not entirely sure how one solves problems without strong reading and math skills; crime, security, and privacy; and the intellectual heirs of MacHack.

Hello 2015

Like many people, I was happy to see 2014 go and I’m looking forward to a great 2015. This is a time of year when many people are working on habits: getting rid of bad ones, starting good ones. As you can see from the nice banner at the side, I’ll be talking quite a bit about habits this month. Be sure to check out some of the other nice people who will be doing likewise.

Oh, don’t worry, I’ll be sure to talk about the economy and politics and the freakin NSA from time to time too!

My plan is to keep it short and sweet and useful. Let’s start with a little talk about goals. Yeah I know, I beat up on goals just last week. But here’s the thing: if you don’t try, you’ll never ever succeed. Even though what Mr. Venuto says about goals is tailored to a health and fitness community, the fact is that most of what he says can be applied to any goal — and that includes habit related goals!

In Closing: Health insurance does you no good if you can’t afford to use it; slowdown; the injustice system.

Music Monday: More of the Same as it Ever Was

 

It does look like things are getting a lot more complicated in Ferguson. And that’s before the Fed’s version of the autopsy*, and before any grand jury sees evidence. The Genie’s out of the bottle now.

In Closing: imagine that, mandatory insurance didn’t fix some of the stuff it was supposed to; fake news reinvented; feminism’s benefits for men; cyberweapons.

 

*I’m glad there’s going to be another one, because this last one was done by the guy that testified in the O.J. Simpson trial. Yeah, just what we need is to put a nice controversy icing on this cake of unrest.