09 September 2009

Health Care Changes

New Demand, New Supply Needed

The current discussions and congressional bills say nothing about how more health care capability would be created.

If 40 million more people are added and get free medical care and unlimited insurance, how would the current number of doctors, staff, hospitals and clinics possibly match the new demand?

Apparently no one has thought about where from or how a 20 percent increase in demand will be supplied. It could take at least 15 years before you could increase the number of doctors to meet demand. It could take 6 years or more for a 20% increase in medical technicians, nurses and other staff. It would cost hundreds of billions of dollars to increase hospitals and clinics and all their medical equipment by 20 percent, and who knows how many years it might take.

If we want to make medical care more available and cheaper the supply must be made larger than demand. Medical care delivery must be expanded by about 30 percent. Otherwise, very high prices will follow the short supply, extremely long lines, and necessarily, rationing.

Everything in shortage is invariably rationed. Extremely short supply is always followed by rapid price inflation. Exactly the opposite outcome of what the well meaning, but uninformed profess to be seeking; reduced access and higher costs, and probably lower quality.

A surplus of medical services will markedly increase access and dramatically lower costs, and probably provide much higher quality.

I don’t think the President, Representatives or Senators actually care about access or costs at all. They just want to create another crisis so they can seem to fix it with a massive and expensive increase in government entitlement programs that gives them massive political power and intrusive influence over your life decisions and imposes communist style wage and price controls over more than 10 percent of this nation’s economy.

All under the guise of an eminent crisis that hasn’t changed much for 70 year, except for the steady decline in the number of citizens who can’t get health care to almost zero. And does nothing to make them capable of paying for the valuable care they’ve gotten.

Increase supply, discourage frivolous and excessive medical suits, and permit interstate health insurance competition; problem solved.

Oh you might say, “How does that give free health care and insurance to poor people?” It doesn’t, nor should it. It’s about improving health care. It’s not about increasing welfare benefits. Most of them already get low quality, rationed, excessively bureaucratic health care for free; which is about what it is worth. They don’t need improved access or lower costs.

THEY DON’T PAY ANYTHING NOW!

06 September 2009

Religious Ceremonies

And Public Property

Stop conducting religious ceremonies, practices, programs, and prayers and displaying artifacts and symbols on taxpayer owned, or financed, or at monetarily supported events or official activities.

That, as the Supreme Court has decided in many cases since McCollum v. Board of Education Dist.71 in 1948, Torcaso v. Watkins 1961, Engels v. Vitale 1962, Abington School Dist. V. Schempp 1963, Epperson v. Arkansas 1968, Lemon v. Kurtzman 1971, Stone v. Graham 1980, Wallace v. Jaffree 1986, Edwards v. Aquillard 1987, Allegheny County v. ACLU 1989, Lee v. Weisman 1992, Church of Lukumi Babalu Ave, v. Hialeah 1993; these acts amount to, ".... an establishment of religion,” a violation of the First Amendment. The Fourteenth Amendment had the effect of applying all Federal laws and rights to all states and citizens.

The way that Christian prayers have been included in public ceremonies for decade’s amounts to unequal treatment of many other religions with hundreds of millions of believers that have never been invited, let alone scheduled, into ceremonial programs to exhibit their religious practices.

Equal treatment would add, for even a few of this nation’s major religions, an hour or two to any officially conducted public gathering. The United States probably is the most religiously diverse country in the world.

I’ve met US citizens from most of the world’s many religions; Christian 2.1B, Islam 1.5B, Hinduism 900M, Chinese Traditional (Taoism, Confucianism, Chinese Buddhism, Ancestor worship 394M), Indigenous-Shamanism 300M, African Traditional 100M, Sikhism 23M, Spiritism 15M, Judaism 14M, Baha’i 7M, Jainism 4.2M, and Shinto 4M; listed in order of their estimated worldwide believers.

I’ve not yet met believers from Juche (North Korean, 19M), Cao Dai (Vietnamese, 4M), Zoroastrianism 2.6M, Tenrikyo (Japanese 2M), Neo-Paganism 1M, Unitarian .8M, Rastafarianism .6M, Scientology.5M; all with lower numbers of estimated believers. There are thousands of recognized religions in the United States.

The point is it would be extremely difficult to invite their participation in planned and conducted public events, let alone include a few of the largest group’s prayers in the public ceremony. It would take hours to bless everyone and everything, display symbols, establish contact and summon the proper spirits. On these two bases alone it is impractical to include many equally, or exhibit their practices and artifacts without the benefit of publicly owned or operated facilities or public resources.

Many such assemblies are government events, (conference, meetings, training, ceremonies, etc.) The best practice would be not to bless these unholy government events with any sort of invocation. It’s completely unnecessary to sanctify these events with any religiousness, and somewhat despicable to even make the attempt.

The other religious part of the First Amendment says, “...or prohibiting the free exercise thereof;” Citizens, visitors, resident aliens, and even convicted felons are all free to pray to their God, Gods, ancestors, spirits or whatever by themselves in un-conducted, non-ceremonial, non-coercive, unobtrusive and non-obstructive ways anytime and anyplace including public property.

Tax exempt churches, synagogues, temples, mosques, shrines, etc. are provided in nearly every community for the conducted celebration of ones religion. Nothing prohibits believers from going there to pray, or for scheduled ceremonial events, and the display of symbols.

Private property, owned, rented or leased, is unrestricted for the private exercise of ones religious beliefs, providing they do violate laws or the privacy of other citizens. They can even sacrifice animals if their state permits hunting or livestock slaughter, which I believe is every state.

So, religious believers rejoice. The United States has the most religious freedom of any nation in the world. You are free to practice privately and publicly, in inoffensive and sometimes offensive but legal ways, everywhere except using public resources and facilities in planned and executed governmental sanctioned events where attendance is required or coerced.

Stop trying to get your religion “established” as official, most right, largest, the light, the word, the way, or the one true religion. Not only is it illegal, but it is unwise to even seek to appear to have official governmental recognition. It harms your cause to clamor for "establishment" that should only come from the merit of good works.

Go practice your religion in this the greatest country on this planet, where you are guaranteed the right to the religious beliefs you choose.

And, prohibited from imposing them upon others, especially children, using any facility or event made available by the passage of laws that appropriate public resources.

02 September 2009

Save Taxpayer Money

Amend the Constitution

You could start with this part of Amendment XVII.

“When vacancies happen in the representation of any State in the Senate, the executive authority of such State shall issue writs of election to fill such vacancies: Provided, that the legislature of any State may empower the executive thereof to make temporary appointments until the people fill the vacancies by election as the legislature may direct.”

Historically there has not been any interest in minor clerical improvements to the constitution. Changing how Senate vacancies are filled, since it’s amending an amendment, probably wouldn’t get much support. Because it saves a lot of state taxpayer money, but very little Federal taxpayer money, it won’t help foster a national movement. No Senators ox is getting fed and many would be gored. The two major political parties would hate it, and that’s another good reason to do it.

Here’s the improvement idea anyway. Stop filling vacancies by temporary appointment or special election. Stop filling them at all until the normal election cycle. This would mean no added out of sequence costs for the state missing a senator. Federal savings would be salary, benefits and some staff expenses for however long it’s vacant. If it’s vacant for retirement there would be very little, if any, Federal savings.

The missing state Senators' vote could be made by the governor of that state. The governors are elected by statewide popular vote just like senators. They are usually experienced executive decision makers, probably better judgment than most Senators.

The workload increase wouldn’t be that much. Most states have Lieutenant Governors who could fill in during brief interruptions to the governor’s schedule. Everything, including voting, could be done by computers or video conferencing, and television appearances can be done anywhere. Senators don’t do much else anyway and their staffs do most of the work.

Only loss would be some political corruption. The savings from statewide election costs would be tens of million in some larger states, many having revenue problems. Citizens would be spared added stupid political commercials, endless inane direct mail pamphlets just disguised appeals for political contributions, and out of sequence sanctuary disturbing phone calls begging for money.

Any Constitutional Ammendment that reduces state or Federal spending and puts representatives in closer contact with their constituents should be undertaken immediately.

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.)

Notes:
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.