22 August 2009

Accessible and Affordable Health Care

Simple Changes

First, reform medical litigation limiting medical damages and penalties;

Second, offer malpractice insurance to doctors substantially below current rates. Supported, but not entirely backed by the government, sort of like flood insurance.

My cardiologist says most of his colleagues in various specialties pay 20 to 30 percent of their revenue stream for mal-practice insurance today and it constantly goes up for the same coverage. And that’s for coverage not likely to cover the average malpractice settlement or court award.

Third, redirect one hundred billion dollars of the stimulus money to increasing hospitals and clinics all around the country where medical care services are thin. Double the training funds for doctors, nurses, and other medical technologists and give them a break on repayment if they go to these new hospitals and clinics.

Increase supply everywhere; make medical care plentiful. It will markedly increase accessibility and reduce costs.

So instead of thousands of pages of legislation and multiple new untested government programs and several new and expanded bureaucracies trying to fix hundreds of things a few malcontents think are wrong, actually fix a couple of the most important things first.

Make a list of other lesser important things and after we are sure the first two things are evaluated, adjusted and fixed, consider the next couple things on the list to see if they are still relevant and necessary.

Also, not everyone needs health insurance.

Illegal immigrants aren’t eligible for taxpayer supported health insurance. If they want it, they can buy it, here or in their home country. They all ready have easy access to emergency medical care.

Eighty five percent of citizens have health insurance they happy with.

Some people have medical savings accounts or other savings and investments they can use for medical expenses; they don’t want any government interference in their access to medical care.

60 million or more have been paying for Medicare, some for nearly five decades. They are at or near retirement. It’s way too late to change their plans now.

About 15 million young people have much higher priority needs for their money than health insurance, they don’t want it. They may be sorry they don’t have it, but that should be their problem, not ours.

About 15 million people wish someone would pay for health insurance for them. You know, give it to them free, so they can use their meager paychecks, or entitlements sold on the black market at deep discounts, for personal indulgences they find more valuable than health care, until they are sick and dying and whining about not being able to get health care.

Basically, there is no one unable to get health care. There’s no one that wants health insurance that doesn’t have it, if they can afford to pay for it.

We can barely afford health insurance for ourselves after actually paying our excessive taxes when due; unlike many members of Congress and the President Cabinet. I certainly can’t afford to buy any kind of health care or insurance for any one else.

No new or increased national health programs are needed. A public health insurance plan is unnecessary.

Make a couple targeted adjustments to improve access and increase supply to reduce costs. It shouldn’t take a thousand pages of legislation; it shouldn’t even take a hundred. If the House and Senate can’t improve health care with less than twenty five pages, they should be replaced.

17 August 2009

Some Reasons Geography is Difficult

Many are Direction Challenged

I’ve often listened to poorly provided directions to someplace by a well meaning, but ill informed person; it’s excruciating. They don’t know the Cardinal directions; North, South, East, and West. Seven of ten people can’t point to East; where the sun comes up each morning. Sometimes they don’t even know left or right reliably. Many also are distance challenged with no idea of how far things are in feet, yards, or miles. They sometimes know relationships that are meaningful to them, but unknowable by you, like turn at the old house, or the dead tree, or the big stone, or a local business, or a used to be long gone business, or a place where some event occurred you couldn’t possibly have known. Sometimes it’s a reliable landmark, sometimes its not.

I have a few explanations why I think we have these problems.

1. First, I doubt it’s ever mentioned in school. Good understanding of distances, directions and relationship require logic and analytical thought. Most teachers can’t construct logical, succinct, meaningful instructions themselves. Never ask a teacher or a convenience market clerk for directions to anywhere.

2. Next, there are many misuses of the Cardinal direction relationships in common use.

Here are a couple of my nominees for most egregious abuses:

a. Referring to any location east of the Mississippi River as Mid-West. This happens nearly everyday on every TV or radio weather broadcast, and often in TV programming and newspaper stories. Simply take a look at the US map; Iowa, Illinois, Indiana, Ohio, Missouri, Arkansas, and Tennessee are not even in the west, let alone Mid-West. If anything they are Mid-East.

b. States like Nebraska, Colorado, Kansas New Mexico and Oklahoma are not even middle-west; they are more logically central states.

c. Any simple look at the map will show states like Idaho, Wyoming, Colorado, Nevada, and Utah are in the center of the west and therefore, logically Mid-West.

3. A similar problem exists in common use in California. The center of California is nearly always referred to as Northern California.

a. Again, a simple look at the proportions of the map will tell any logical person Northern California would be North of Central California, and Southern California is South of Central California. No one says San Francisco is in Western California, and most certainly not in nasty Central California with those primitive agricultural types and ignorant Oklahoma transplants that settled in the Central Valley in the 1940’s and made it into the most productive food producing region on our planet.

b. Northern California on the map clearly includes Redding, Alturas, Crescent City, Eureka, Chico, and doubtfully, Sacramento, Davis or Santa Rosa. Everything South of Sacramento to Bakersfield should be Central California. Everything South of Bakersfield should be Southern California.

c. No one, save me and a few other malcontents refer to Eastern California as those places east of the Sierra Nevada and north of the San Bernardino Mountains to the Nevada and Arizona borders that would rather not be considered part of the craziness associated with Southern California. Places like Mojave, Palmdale, Lancaster, Victorville, Barstow, Twentynine Palms, Ridgecrest, Bishop, and Needles, that could clearly be Eastern California.

4. The power of how people see themselves and their relationship to rest of the nation often modifies what seems to be a geographic reference. New Yorkers and those from the Northeast colonies see themselves as the most important; therefore, everything west of them is considered “the West” in some way. For those on along the West Coast, the Northeast and upper East Coast is “Back East.” “Down South” refers more to a state of mind and shared experiences than geography. “Up North” can be any state near or touching the Canadian border. The “Southwest” can be any state near or eating foods like those near the Mexican border. These pseudo geographic titles convey more about perception and attitude than precise geography and are mostly cultural generalities.

So, what should be done?

The map should be viewed and referred to in geographic reality. Because Hawaii and Alaska are not contiguous, I recommend Western most for Hawaii (10,932 sq. mi. pop. 1.3M esti08) and Northwestern most for Alaska (656,425 sq. mi. pop. 0.68M esti08).

For the contiguous states I suggest only these regional designations; West, Central, East, North-central, South-central, Northwest, Southwest, Northeast, and Southeast. No more references to something called mid-anything.

West, (total area 457,564 sq. mi., total population 45.8M esti08.)

California (163,707 sq. mi.), Oregon (98,386 sq. mi.), Nevada (110,567 sq mi.) and Utah (84,904 sq. mi.)

Northwest, (total area 301,923 sq. mi., total population 9M esti08.)

Washington (71,303 sq. mi.), Idaho (83,574 sq. mi.) and Montana (147,046 sq. mi.)

Southwest, (total area 235,599 sq. mi., total population 8.4M esti.08.)

Arizona (114,006 sq. mi.) and New Mexico (121,593 sq. mi.)

Central, (total area 718,157 sq. mi., total population 46.3M esti08.)

Wyoming (97,818 sq. mi.), Colorado (104,100 sq. mi.), Nebraska (77,358 sq. mi.), Kansas (82,282 sq. mi.), Missouri (69,709 sq. mi.), Oklahoma (69,903 sq. mi.), Arkansas (53,182 sq. mi.), Indiana (36,420 sq. mi.), Ohio (44,828 sq. mi.), Kentucky (40,411 sq. mi.) and Tennessee (42,146 sq. mi.)

North Central, (total area 511,273 sq. mi., total population 38.2M esti08.)

North Dakota (70,702 sq. mi.), South Dakota (77,121 sq. mi.), Minnesota (86,943 sq. mi.), Iowa (56,276 sq. mi.), Wisconsin (65,503 sq. mi.), Michigan (96,810 sq. mi.), and Illinois (57,918 sq. mi.)

South Central, (total area 268,601 sq. mi., total population 24.3M esti08.)

Texas (268,601 sq. mi.);

East, (total area 191,507 sq. mi., total population 47.5M esti08.)

Pennsylvania (46,058 sq. mi.), New Jersey (8,722 sq. mi.), Maryland (12,407 sq. mi.), Delaware (1,954 sq. mi.), Rhode Island (1,545 sq. mi.), Virginia (42,769 sq. mi.), West Virginia (24,231 sq. mi.), and North Carolina (53,821 sq. mi.)

Northeast, (total area 124,927 sq. mi., total population 32.7M esti08.)

Maine (35,387 sq. mi.), New Hampshire (9,351 sq. mi.), Vermont (9,615 sq. mi.), New York (54,475 sq. mi.), Massachusetts (10,555 sq. mi.), and Connecticut (5,544 sq. mi.)

Southeast, (total area 299,906 sq. mi., total population 44.5M esti08.)

Louisiana (51,843 sq. mi.), South Carolina (32,007 sq. mi.), Mississippi (38,434 sq. mi.), Alabama (52,423 sq. mi.), Georgia (59,441 sq. mi.), and Florida (65,758 sq. mi.)

No conscious attempt was made to equalize the areas or populations of these regions.
Square Miles (sq. mi.) include waters of the State.
Estimates and calculations incompletely reviewed at posting.

12 August 2009

Medicare Benefits, Leave Them Alone

It was government health care assistance, not originally requested nor sought by the majority.

For forty four years those who are retiring now have paid a huge price for elderly medical benefits. An enormous amount of money was taken from our employers and from our pay checks during our prime earning years.

We were not given a choice. It was compulsory. We were not allowed to choose not to participate.

We were promised certain benefits upon reaching the age of sixty five.

The Congress, Representatives and Senators, ignored the actuarial tables of the time that clearly told everyone the program could not sustain itself without massive and rapidly increasing taxpayer contributions.

Again, we did not ask for it. It was a bribe for reelection votes by the well meaning, but uninformed. We were compelled to pay for it. And we must register for it, even if we do not want to use it. It's nearly impossible, if you are age sixty five or older, to get and pay for medical treatments of your choice without using Medicare.

You are virtually forced to use it.

I didn't want it. I don't like it. I didn't ask for it. It was a socialistic mistake. I don't want it now. I wish I had the money I was forced to waste on it for 44 years. If I would have saved and invested it in a medical savings account, I would have more than 1 million dollars now to pay for my own health care needs.

Now is not the time to withhold the promised benefits.

You've already taken our money.

Now you must pay up.

If you welsh on your promises now, you will have a grey insurrection the likes of which you cannot possibly imagine.

It would be a scandal dwarfing Bernie Madoff''s pyramid scheme by a hundred fold.

If you want to make changes that decrease benefits 50 years from now, and you inform the young wage earners entering the workplace today, go ahead. But, be prepared to leave office quickly. They won't like the very high costs with the promise of very little benefit 50 years in the future.

I doubt they will trust you any more than I do now.

Medicare was a mistake 44 years ago. It's still a mistake. If you are considering any changes;

1. Your first change should be how to systematically and quickly close the program down.

2. Deliver the full benefits to those who have paid in since it started.

3. Decreasing benefits to those who have paid in less to this point.

4. Never attempt anything like it again. Especially any kind of government provided or encouraged health care for those who choose not to provide for themselves.

Health care or access to it, is not a constitutional right. The Federal Government should remove itself from all health care involvement, except for providing tax exemptions for health care costs and allowing nonprofit philanthropic and religious organization to provide for widows, orphans, and others incapable of caring for themselves, tax-free.

06 August 2009

You Don’t Have to Look Overseas

We have many decades of government medical experience here.

There’s no need to compare the proposed nationalization of medical care and insurance to Canada or the United Kingdom. We have at least four decades of government medical care in Medicaid and Medicare. And much more than that with active military personnel and veterans care. No one I know that has used Medicaid, Medicare, military, veterans or native american reservation care would say it’s the highest quality medical care available anywhere.

I suspect that, if offered a $15,000 a year voucher good for the health care insurance of their choice, hardly any of them would choose any of those systems.

I believe they would choose private insurance typical of employees of middle and large sized businesses and organizations. And if offered health insurance like Senators or Representatives have, they would certainly choose it.

So what would it cost for 200 million families, couples, and individuals to use $15,000 per year to select and pay for health insurance coverage using a voucher paid for by US taxpayers?

200,000,000 times $15,000 equals $3,000,000,000,000, that’s $3 trillion dollars.

That would be half of the $6 trillion they say the uninsured are costing our economy annually now and it would replace all other current national health systems.

I believe that is far less expensive than Medicare, Medicaid, military, veterans or reservation care costs annually today, without considering the 1.3 trillion dollars of the current national health care proposals. This would literally cover every man, women and child wishing to have medical insurance. Those who did not want medical insurance (3 to 5 million people, or $60 billion annually) could return the voucher to the Treasury to be held in a fund to pay for tourists, visiting students and visiting workers who might need medical care while legally in the United States.

It would not include people not legally here. They should not be offered or receive medical care, unless they demonstrate they can pay for it. If they are discovered illegally here, they should be transported back to their country of their citizenship at our expense. It will be cheaper than decades of education and medical care for their children.

An accident of geography at birth should not establish citizenship. It may confer a right to choose citizenship when one reaches the age of majority, if they are not criminals.

The 40 million non-citizens I believe are here illegally should come forward and begin the long and expensive citizenship process, or return immediately to their country of citizenship.

Prisoners Released from North Korea

What were they doing there?

I’m glad that Laura Ling and Euna Lee were pardoned from their 12 year hard labor sentences in North Korea. I’m glad they have been returned the relative safety of the United States and reunited with their families and friends. It is amusing that former President Bill Clinton was available to his wife’s State Department to be the photo opportunity and their escort.

It’s said that they were working in China for former Vice President Al Gore’s almost unheard of Current TV, filming a story about the trafficking of women. Why did this take them so near the border? We were led to believe they crossed over the North Korea boarder without their knowledge. Were they walking around? Were they driving on an unmapped road? It’s hard to imagine this accidentally happening. Were they by themselves? Normally, western journalists in China are escorted by Chinese officials. The Chinese escort didn’t know they were crossing into North Korea without permission?

Why were they really in China? What were they doing so close to the border? Did they just want to add North Korea to their country resume? Did they think it was as simple as sneaking across the US border? Didn’t they know most other nations consider the sanctity of their borders critical to their sovereignty? If it wasn’t an accident or a lark, it must have been on purpose.

What was the purpose of deliberating violating a sovereign nation’s boundary; following a TV story?

What ransom had to be paid to buy their freedom? Was it just the former President Clinton’s less than joyful appearance or an exchange of greetings; or an agreement about something more foreboding, sinister, or unauthorized?

What actual exchange got them released?

I don’t really care why they intruded into North Korea. But it is curious that so much effort was expended to retrieve two fledgling TV journalists and violators of national boundaries that were about something ignorant or clandestine, who probably should have served some hard labor just for being so foolish, and wasting precious resources during a time of supposed international economic crisis.

C’mon ladies, why were you really there?