Health Care Reform

Recently, I got into an interesting discussion about the state of health care in the U.S. and it made me realize how confused this issue has become and how effective the insurance companies have been at changing the dialog.

As evidenced by articles like this, How Health Insurance Undermines Quality Competition, rather than talking about “best practices” or health care quality, the discussion has focused on the perceived abuse by patients who consume too much because it isn’t their money being spent. And the recommended solution, of course, is to shift more of the cost to the patient.

Ok, I am not saying the patient shouldn’t be involved in the decision nor am I saying the patient shouldn’t have visibility into the costs.

What I am saying is that everyone should have access to quality healthcare. Healthcare should be a basic service just like the police, fire, etc. If the police operated under a model like the current health care system, I should get a Protection Savings Account and then decide when the police should respond and how they should respond to crime.

Secondly, our current system rewards providers based on quantity not quality. The system is skewed by drug companies that come out with significantly higher cost products with only marginal, if any, improvements and influencing doctors to prescribe them.

Thirdly, a significant if not major factor in over all health cost is that we, as a society, spend an inordinate amount on questionable procedures in terminal cases rather than focusing on quality of life. When this issue is highlighted, the emotional Death Panel label and accusations of health care rationing are thrown about.

We spend the highest amount per capita on health care with nowhere near the highest quality outcome (I think we’re rated 30th in the world or something like that). The current system has many problems and is unsustainable and needs to be changed. Now if our lawmakers only had the intestinal fortitude to ignore the big money lobbyists and make rational decisions…

The problem with Libertarians

 This article was emailed to me but I wasn’t able to find a source for it. I do like the way it articulates the arguments against all de-regulation.

People like Ron and Rand Paul would have you believe that all government is bad but there is a place for some regulation.

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Why I am not a libertarian

Not only is no man an island, but no man is self-made. I’m going to tell you why I am almost, but not quite, a libertarian.

First, capitalism, unless moderated by Christian virtue or government, is just as brutal and cruel as communism.

I know that’s hard for baby boomers to believe. After all, they grew up in the incredibly prosperous post-World War II United States. Most have never experienced really hard times. Most have not bothered to read much history or literature. Many were content to believe the fairy tales woven by Ayn Rand and her cohorts.

• Try digging coal for a few pennies a ton in an unsafe mine where you are forced to buy your own tools.
• Try imagining a disabling injury and, instead of receiving workers’ compensation or disability insurance, your broken body is just tossed off the company property.

That’s capitalism.

• Try a six- or seven-day work week with 12-hour days, a pittance for wages, in a hellish and unhealthy environment and absolutely no benefits.

That’s capitalism.

You can still see pure capitalism in places such as Calcutta or Mogadishu. Capitalism is great if you’re the capitalist, just as communism is great if you’re the commissar or the party bigwig.

I wonder how many Americans would be willing to cut and sew a pair of finished blue jeans for 75 cents in a sweltering, bug-infested building. How many pair do you think you would have to cut and sew in order to feed your family?

Those $30 to $50 pair of jeans we wear were made by what amounts to slave labor in Central America or Asia.

I’ve never been a union member and don’t intend to be one, but I can at least appreciate the struggle that union men undertook to improve the lives of working men and women. I guarantee you that without the “threat” of unionization, most working men and women would see a quite different face on their employers.

And that may not be too far off. Under phony free-trade deals, unions are being broken and pressured by the movement of and the threat to move factories overseas. Anybody who expects real compassion from a corporation would mistake Hannibal Lecter for a vegetarian. Unfortunately, the union leadership is so infected with socialists that they would rather pursue their ideological goals than look out for their members.

So, although I strongly believe in the maximum possible freedom, I also believe in community and in responsibility to that community. Not only is no man an island, but no man is self-made. Some people are just good at forgetting all the people who helped them get where they are.

If you aspire to total freedom and want to be entirely self-made, then go to a deserted island and live entirely off your own labor. If you survive, you can claim to be a self-sufficient person.

But don’t live in a community with all its protections and benefits, don’t go to public schools, ride on public roads, enjoy the benefits of publicly provided clean water and sanitary sewers and proclaim yourself an individual who owes nobody anything. That’s just bravo sierra, and you know it.

Freedom is not a virtue per se. It can mean the freedom of the strong to bully and enslave the weak. It can mean the freedom to exploit the poor, to despoil the land and the water, to turn your back on the oppressed, the sick, the dying.

That’s why, instead of a libertarian, I fall in with those old-fashioned conservatives who believe in ordered liberty, strict observances of the Constitution and a mind-our-own-business foreign policy. Don’t confuse me with the neo-conservatives who like big government and imperialism as long as they run it. Most of those guys are just ex-Troskyites, anyway. And don’t confuse me with chamber-of -commerce conservatives who say that anything good for big business is good for the country. That’s horse manure.

At the same time, I’m definitely not a socialist. An ex-socialist, John Dos Passos, has remarked that the world was becoming a museum of socialist failures. And so it is.

The idea of a mean, something-short-of-pure, unregulated capitalism and pure, over-regulated socialism is what we should strive for.

Ah yes, the Good, Old Days

I just watched a documentary about the history of the Ku Klux Klan on the History Channel (see excerpts here). Like many people, I knew a little about the KKK on an abstract level but didn’t realize how old the KKK is (founded 1866) or how many times it has gone away only to be resurrected.

While watching the documentary, I couldn’t help but notice similarities between the KKK and the conservative right’s current attacks.

• Preaching love and peace, yet practicing hatred and violence
• Claiming fidelity to the constitution yet systematically abrogating the rights of other citizens
• Their record seems clearly one of moral bankruptcy and staggering hypocrisy

While claiming to want the government out of our lives, the conservative right opposes any legislation that impedes their goals while simultaneously supporting intrusive government regulations that support their agenda. Just like the KKK wrapped themselves in the flag and the bible, the neo-conservatives label their laws with patriotic sounding names that hide the real intent. The controversial Arizona immigration law, Arizona Senate Bill 1070, is named the “Support Our Law Enforcement and Safe Neighborhoods Act” but is just a way to institutionalize anti-Hispanic bigotry.

The same group is pushing anti-gay legislation but calls it the “Defense of Marriage Act”. And when it comes to hate crimes, we like to think the violence is all in the past. But it still happens. And just like in the old days, law enforcement isn’t always helpful. As detailed in the same article:

According to statistics from the Texas Department of Public Safety, since Texas enacted its hate crime law back in 2001, more than 2,500 hate crimes offenses have been reported. Of those, only 11 have been prosecuted.

Wyn Craig Wade, author of The Fiery Cross, summarized it best:

Today, you see a number of groups who are like the Klansmen but they simply are not wearing the white sheets. They take the same stands. They believe in the same things. They are willing to commit violence. They just don’t wear the sheets because the sheets now look silly.

Politicians are the only people in the world who create problems and then campaign against them.

I recently received two emails that started me thinking about how our federal government works. One was a modified version of an old Orlando Sentinel article by Charley Reese about how 545 people are responsible for the whole federal government. The other email was a short video of Glenn Beck on Fox News highlighting how many new agencies have been formed because of “Obama’s Health Care Bill”.

I encourage you to read Reese’s article, the point of which is

One hundred senators, 435 congressmen, one president and nine Supreme Court justices – 545 human beings out of the 235 million – are directly, legally, morally and individually responsible for the domestic problems that plague this country.

Those 545 human beings spend much of their energy convincing you that what they did is not their fault. They cooperate in this common con regardless of party.

Our system of government is based on an underlying assumption of a well-informed electorate. But a recent poll by Newsweek indicates a significant percentage of Americans aren’t knowledgeable about our government and how it works. This makes it easy, especially among the Fox News crowd, to blame the President for the ills of the country. As opposed to what Glenn Beck and many of the neo-conservatives would like you to believe, Congress, not the President, is the responsible party. As the Orlando Sentinel summarized here:

Partisans on both sides like to blame presidents for deficits, but all deficits are congressional deficits. The president may, by custom, recommend a budget, but it carries no legal weight. Only Congress is authorized by the Constitution to authorize and appropriate and to levy taxes. That’s what the federal budget consists of: expenditures authorized, funds appropriated and taxes levied.

 Is the President blameless? Of course not. He sets the tone and can sway the discussion. But make no mistake, Congress bears the ultimate responsibility for the current mess. From the failed policies during the Republican majority of the late ‘90s and early 2000s through the Democratic years, Congress has systematically pandered to fringe groups and large financial donors.

It is time to hold these 545 people accountable.

Update on Fracking

From the NY Times:

Congressional Democrats are demanding answers from the Environmental Protection Agency about the safety of hydraulic fracturing, a form of natural gas drilling also known as fracking, after revelations that wastewater from such drilling, which contains radioactive material, is regularly dumped into rivers and streams without proper treatment.

[March 22, 2011 update] 

The Texas Railroad Commission has voted that the “Environmental Protection Agency was wrong when it concluded a gas driller had contaminated domestic water wells in North Texas.”

The EPA believes Range contributed to the contamination of the wells with benzene, methane and other toxic gases.

The Myth of Education and Why We Need Good, Old Fashion Unions

The American public has been sold a myth that if you only go to college, you will get a better job. We have built a whole infrastructure of student loans, grants, community colleges, etc. to ensure everyone gets a college degree. Study after study shows how people with college degrees earn higher average wages. At least they used to…

In his NY Times Op-Ed article, Paul Krugman argues “education isn’t the answer” to building “a society of broadly shared prosperity”. He gives some data points supporting the position best summarized by the paragraph

But there are things education can’t do. In particular, the notion that putting more kids through college can restore the middle-class society we used to have is wishful thinking. It’s no longer true that having a college degree guarantees that you’ll get a good job, and it’s becoming less true with each passing decade.

When Mr. Krugman equates ‘education’ with ‘college’, he makes the same mistake most people are guilty of.

My dad, a blue-collar construction worker, had to quit school at a young age to dig ditches by hand for the water company to pay off the family water bill. He did manual labor for the rest of his life. As long as I can remember, he would tell me to go to college so I “could get a better job”. Getting a college degree is behind many programs supporting the economically disadvantaged.

Should everyone have an equal opportunity to attend college? Absolutely! Should everyone try to get a college degree? Absolutely not!

In truth, for many the answer isn’t getting a college degree but acquiring higher levels of skill. There used to be jokes about plumbers making more than lawyers but somewhere along the way, we stopped valuing journeyman. And by journeyman, I mean someone who is actually trained in his trade and can perform it proficiently.

And the dirty, little secret is many of these tradesman were actually happy. My dad loved his work and was proud of what he did. And we were proud of him.

And another secret, my dad quit school when he was 13, never went to college, but he was educated. The International Union of Operating Engineers educated him through an apprentice program. It took him eight years to achieve the highest level and other than union dues, the education was free. In fact, he was able to earn money while going through the program because the union placed him with construction companies.

Even then, there was always tension between the construction companies and the unions as each advocated for their constituents. But, for the most part, it worked because each got what they needed. The union workers saw improving, safer work conditions, more stable wages and better benefits. The companies got a pool of skilled workers.

When he retired to Texas, a right-to-work state, my dad used to visit construction job sites and just sit and watch. He was surprised by the low wages he would hear about but he was even more surprised at the low skill level. He never could understand why it would take so long to get the job finished. Like most union men of his time, he thought they could do a better job and get it done faster. In Texas, anyone can call themselves a plumber, or carpenter or Bobcat operator whether they’ve been trained or not. But they are willing to work for lower wages which devalues the work of everyone.

A lot of people complain about shoddy workmanship but then refuse to pay more than the lowest bid. To restore the middle class, we need to rebuild trust in the average working man and restore the value we place on craftsmanship. Unions aren’t the panacea but, if they return to their roots, they can help.

The danger of Gov. Walker’s union busting tactics in Wisconsin has little to do with whether the public workers can continue collective bargaining or not. The real danger is the country continues down the path of devaluing all labor and only rewards the CEOs and other executive management because they were able to increase profits through lower labor costs.

Two of my friends viewpoints of the Wisconsin union debate. One from Kentucky says

Being from Coal mining country, I have seen some of the best and some of the worst in unions.  The safety improvements in mines would not have happened without the unions—some of their best work.

Blowing up people’s homes or killing them because they would not join the union is some of their worst.

Overall I have to support the right of everyone to have collective bargaining –if they want.”

The other

1. Never should union dues be required to be paid or taken from employee’s checks

2. Collective bargaining between two public employee groups who are receiving  taxpayer payer money and can control their pay and/or donations should never be allowed ie politicians and public union employees

And therein lies the dilemma. Instead of helping, unions became part of the problem and just another big-business. Like many businesses, the unions quest for revenue caused questionable actions as they drifted away from their roots.

Let’s remember, unions gained a foothold in the US because business workers didn’t have many rights and were taken advantage of. Unsafe working conditions and sweat shop conditions prevailed. The unions helped to change that.

But as their successes mounted, the unions overreached and started going after other groups of workers. These workers, seeing the union successes in other industries, joined and demanded higher wages, too. As the power shifted to the unions it quickly spun out of control.

Which brings us back to Gov. Walker and Wisconsin. I don’t have enough information to know whether the public unions have caused the problem or even whether the public employees pay and benefits are out of line. I see conflicting data from different sources all with a lot of spin.

However, I think it would be far better if Gov. Walker backed off the anti-union rhetoric and learned to negotiate. Unions have a place but they need to get back to their roots of actually balancing the power with the workers as their main concern.

And the rest of the US has to re-learn that value, not just price, is the important factor and learn to appreciate quality workmanship so that once again we can earn a fair day’s wage for a fair day’s work.

Deport Everyone! (Except the People Helping Me…)

Just when I think I am starting to understand the conservative argument, they do something so bizarre it feels like my head is going to explode. In the frantic competition to see which conservative state is the strongest proponent of defending true Americans from illegal immigrants,  Texas House Bill 1202 authored by State Representative Debbie Riddle puts Texas in the pole position.

HB 1202 proposes making it a felony for any person to “intentionally, knowingly, or recklessly” employ or contract for work with an illegal immigrant except a person who:

employed or contracted with the unauthorized alien, or entered into a contract or subcontract described by Section 40.02(a)(3), for the purpose of obtaining labor or other work to be performed exclusively or primarily at a single-family residence in which the actor resides

In other words, it would not be illegal to employ undocumented workers as housekeepers, maids, nannies or gardeners. I may be wrong but it is easy to surmise that Rep. Riddle’s wealthy constituents would be the primary beneficiary of this exception.

With respect to immigration reform, my naive understanding of the goals is to get the undocumented workers:

• out of the country so they won’t take jobs from Americans
• to pay taxes
• contribute to society in a useful way

Texas conservatives like to talk about penalizing employers of undocumented workers. The theory is if employers don’t hire them the illegals will self-deport. But this new proposal seems to contradict the theory.

Instead of getting this particular set of illegals out of the country, Rep. Riddle seems to want to keep them in Texas in some kind of servitude because historically, undocumented workers in these fields earn below market wages and, if there is a dispute of any kind, the illegals can’t call the cops.

Rep. Riddle’s bill also seems to indicate there aren’t enough qualified Americans to take care of the kids. If there were, why would she want to allow an exception for this job? Could it be the age-old story that immigrants typically take the jobs that no one else wants?

In an interview with the Texas Tribune, Jon English, Rep. Riddle’s Chief of Staff, said

It is an admittedly clumsy first attempt to say, ‘We are really focusing on the big businesses’

But this doesn’t make sense, either as most large companies have large HR departments to ensure their hiring practices follow the laws. It just sounds like a spin to provide cover for a bad policy where a politician is simply helping her wealthy constituents.

Deficit-ridden Texas no longer laughing at California

As I travel around the world, when people find out I live in Texas, I’m usually in for a lot of ribbing. Questions range from “Where are your cowboy boots?” to “Where do you hide the gun?” For the record, I don’t like cowboy boots and I don’t have a concealed weapons permit which probably makes me a member of the minority in Texas.

But, due to some perverse sense of pride, I get irritated when outsiders make fun of Texas and act like we’re all just a bunch of out of control cowboys. I try to explain how Texas isn’t exactly like the popular image portrayed in movies and TV shows. I then try to explain how Austin is even more different. But events often conspire to undermine my best attempts.

With Gov. Rick Perry’s pursuit of a Tea Party Republican utopia based on low regulation, low taxes, pro-business policies, and tough, conservative spending decisions, we have given others more ammunition with which to make fun of us. As detailed in Elias: Deficit-ridden Texas no longer laughing at California, the policies aren’t working in Texas as well as Rick Perry proclaims (in other words, they’ve failed!). And based on the reports I’m reading, I’m still not sure the governor or the state legislature really gets it. As one of the commentors to the Elias article says about our estimated deficit of $25.2 billion,

A typical example of what happens when something complex like budgeting is given to pot-bellied stupid red neck cowboys.

Gov. Perry, has demonstrated his firm grasp of the seriousness of the situation by what he has declared as emergency items for the 82nd Texas Legislature:

• strengthening private property rights
• abolishing sanctuary cities
• legislation to require a voter to present proof of identification when voting
• legislation to provide for a balanced budget amendment to the U.S. Constitution
• legislation that would require a woman to undergo a sonogram before electing to have an abortion

These are clearly the most important issues for Texas. The $25+ billion dollar deficit clearly isn’t important nor is the proposed $5 – 10 billion dollar cuts to the education system… or how about the high levels of pollutants released into the Texas environment.

These issues all require Gov. Perry to admit his past policies are flawed and, more importantly, would require Gov. Perry to go up against those wealthy Texans that support his campaigns. Not something a smart politician would do and, make no mistake about it, Gov. Perry is an astute politician.

One of my biggest frustrations with George W. Bush was his tendency to over-simplify complex issues and come out with a Fox News sounds bite. I would like to think Gov. Perry is smarter but his recent behaviour just reinforces the view that he is a G. W. protegé and has trouble understanding complex issues.

It’s time to change the game.

Ok, I will admit right up front that I live in Austin, Texas, but I don’t fit into the middle of the bell curve for Texans. I watch football now and then but only watch the Longhorns when a friend asks me and I’ve never been able to appreciate John Kelso’s column in the Austin American-Statesman. Over the past 30+ years I’ve lived in Austin, I’ve tried to understand the attraction for this columnist but I just don’t get it.

As the Texas Tribune pointed out in a recent article:

It would’ve helped, maybe, if it had been funny.

But at least in my opinion, he isn’t. He just comes across as another old, white guy that needs to follow that old western movie cliché and just ride off into the sunset. His time is past and the world won’t accept it anymore. And this is from me, someone who cares little about being politically correct.

In the Kelso column the Texas Tribune commented on, Kelso is off on some rant about Anita Perry (Gov. Rick Perry’s wife) not being happy. The Texas Tribune article focused on whether Kelso was out-of-bounds by writing a whole column on whether Gov. Perry’s wife was happy or not.

My issue is very different. Not only do I not care whether Anita Perry is happy or not, I don’t understand why Kelso would bother to try to figure out whether Anita Perry is happy or not by analyzing (and I use the term loosely) whether Anita Perry appeared to be happy in some photographs. However, I do care and am insulted by some of the phrases Kelso uses in his article.

Kelso’s writing is very sexist. First of all, just the title, “Somebody needs to goose Anita Perry to get a smile out of her” is offensive. Then further in the article, Kelso uses phrases like

I can make it all better for you, sweetheart.

and

She has that goofy blissful look that all brides have when they realize they’re about to get control of your credit cards.

How condescending and not funny, especially considering that because of the recession, many more women are the breadwinners of the family.

Discrimination comes in many forms. Phrases like “My best friend is a …” (fill in your own favorite noun) say more about the speaker than the target. Stereotypes can be very damaging and should not be used just to make a feeble joke. That is just plain insulting.

But what should I expect from a newspaper that is light on news and more concerned with whether the Longhorns … team is going to win next weekend.

If you read some of my other posts, you know I am not a big fan of Rick Perry as governor of the state of Texas. On a personal level, however, I’ve met Gov. Rick Perry and his wife a few times and think they are very nice people. Austin, you deserve better and should let the Statesman know that writing like Kelso’s is not funny and is unacceptable behavior.

Weekly Photo Challenge: Abundance

I shot this picture while diving on the Great Barrier Reef from the live-aboard, Spoilsport.

School of fish on the Great Barrier Reef

I enjoy SCUBA diving because it gives me a chance to interact with life-forms and an environment that is pretty alien to our day-to-day life. It has also enhanced my understanding of the ocean’s importance to our quality of life and the damage created by some of our policies.

If you like this picture and want to see more, click on the Flickr link on this page.