Health Care Thoughts

As the final federal health care bill is assembled, there should be some consideration given to how this might work, and work well.

No Medicare-for-All option? No Anti-Trust? No Mandate!

Our country was founded on the principle of freedom, and forcing citizens to buy health insurance goes against this principle. If we are to give this up, we should get something in return, namely something that works. 'Keeping Them Honest' can be done with a real Medicare-for-All option, or with regulation. We know Medicare works, and regulation of gas, electric and such utilities works – These are two models we can understand – Let's have both. Mandates for automobile insurance does not apply as a model – Each of us choose whether to drive a car on public roads or not, while living, and thus having health risks, is not a choice. If Obama-care beats nothing at all, they will come – a good plan needs no mandate. If the uncovered must be treated, let them join then – If they can not sign then, let someone sign for them. But more to the point, why should we even settle for either/or, when both would be best?

In Sum, Medicare-for-all Option, No Industry Cartel, Strong Healthcare Police and No Mandate!

Finance Health Care Fairly, and Keep Costs Sane:

Taxing those with big health care plans the most, as opposed to those with big incomes, to pay for care for the poor, is not fair, nor particularly noble, when most of the elaborate plans are held by union members. A third way here is to tax most those who can most afford to pay; those who own the most. A federal property tax would not disproportionately hit poor communities like local property taxes do, and since you own something if and only if the government says you do, owners have the best of incentives to pay property taxes.

'This American Life' reports a third of medical costs are not medically necessary. This is an enormous opportunity that we should all take advantage of, and co-payments can inspire individuals to serve the common good here while they serve their own. But a fixed percentage co-pay can become unaffordable if one really needs healthcare – if you get very ill. One way to balance this conundrum is to let the co-pay rise as the logarithm of the expense. Here if you chose an operation ten times the cost of an alternative, you would pay twice as much – a powerful incentive, without a financially flattening upper range of values for the really unfortunate. So Health care costs should come in from those with the means, and go out with thoughtful oversight.

Why Trap Poor Women in Poverty with Unwanted Children, Just Because a Vocal Few Do Not Like Abortion?

There are plenty of cases in which the desires of a minority of us are sacrificed to the majority, as it should be in a democracy. A fetus is not a child and abortion is not murder under our law. The majority of us need not cave to a vociferous minority and add to this crowded world more children than we, individually or collectively, are ready to raise well. Life can be a blessing, or a curse. To be sure, there are moral issues on both sides of this argument, which we can safely entrust to the parents involved.

Let's fix this health care bill right, and get on to other pressing issues: Green Jobs for All Who Want Them, for fuller employment, a better economy, and a climate we can live well with,

False health care system dicotomy?

Isn't there a third way beside nationalized single payer and the total financial free-for-all we have now?

Aren't the regulated utilities pretty well run and pretty cost effective at providing services or resources?

I do think Medicare for all could work well, but maybe there are other choices here.

There are anti-trust laws on the books already that should 'keep them honest' like single-payer is said to, if we better-regulated the now-free-market health care system to form a fair-market system.

Decades ago, the economist Samuel Bowles eloquently described how health care does not meet the four conditions needed for successful free markets:

1) There isn't ease of entry and exit from the market for buyers and sellers - When you need health care, you often can not wait to shop around. Similarly, becoming a doctor or other healthcare worker is not easy, and hospitals are not quickly opened or shut.

2) Perfect information is not perfectly available - As a patient with even a non-emergency illness, there is no time to learn the intricacies of health care science so as to be prepared to negotiate prices or choose products.

3) We can not assure lack of collusion between buyers and between sellers - Medical science requires extensive co-operation between healthcare providers - collusion is always possible, and organizations like the American Medical Association have seemed to most to be the best way to deal with the complexity of licencing, but necessarily range in behavior into collusion between sellers.

4) We can not practically have large numbers of buyers and sellers in each local health care market - Hospitals are big compared to patients, and necessarily so, I believe.

We will always want police in the streets, umpires on the field and someone looking over the health care system to make it work right and affordably, because this method of designated responsibility excells in large groups of busy equals with unequal power to coerce each other.

Single payer could work, but regulated utilities have also worked well in similar circumstances, and might be a workable solution that also fits the USA's character better.

Brian Cady

Create jobs instantly: Shorten the Work Week

German unemployment is not nearly as bad now as USA's, because Germany shortened their work week from 40 hours of work, so that the burden of recession would be more equitably distributed.

We could do this now, without lessening production, without additional taxes. Perhaps Obama could do this without the bother of Congressional approval - Here a lawyer could provide insight.

If the 32-hour work week came into effect, USA could increase the number of jobs available by one fifth. We could in some ways completely eliminate the real unemployment, rated at 17.5%, as compared to the official distorted rate of 10.2%, and still provide further jobs for those seeking additional work from abroad or with large debts or ambitious goals.

In addition, we USers would have time to both work and pursue additional schooling throughout our careers, and so help make our country more capable, while expanding our individual horizons.

Level of Progress at Copenhagen

The following is in response to President Obama's call for participation in the Community Jobs Forum, which I believe is timely, important and good. First are the questions the Administration asks, beneath each line, then a response.
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From what you have seen, or seen reported about the President’s Jobs Forum on December 3rd, what seems relevant to your community?

My 'community' is one consisting of working scientists. I have not heard anything about the outcome of the Jobs forum at the White House.
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What parts of your local economy are working or thriving? What businesses and sectors are expanding and hiring?

I don't know of any, but I hear rumors of possible research funding coming in phytoremediation research and development.
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What are the opportunities for growth in your community? What businesses and sectors seem poised to rebound?

Bicycling support industries? I don't have much insight here, sorry.
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What do you see as the “jobs of the future”?

As far as 'jobs of the future' I see tremendous opportunity in shifting from research and development of 'labor-eliminating' technology to technologies which eliminate resource use and waste/pollution production. I must acknowledge that this insight is not originally mine, but comes from the brilliant and accomplished Hazel Henderson, the economist who declared conventional economics 'a form of brain damage' in that it it only acknowledges value for the easy-to-price things, unlike air, clean drinking water and other essential but hard to price things.

Please replace Geithner with Henderson, or at least see: http://www.hazelhenderson.com/

Also, if scientific grant-giving foundations like NIH and NAS, etc. were to, in the evaluation for funding of grant proposals, increase the score, to even a slight degree, of proposals creating jobs, and furthermore if the foundations were to increase the score of such proposals in proportion to how many person-years of work they would create, then enormous numbers of positions could be created very rapidly, yet in well-thought-though scientific efforts by leading scientists.

Additionally, devising a sliding scale of the extent of tax-exemption for R & D done by corporations which favored, by exxempting form more taxes, those r & D efforts which would create, or at least not eliminate, jobs could also rapidly both expand employment while also shifting from labor-elminating technologies to the more needed waste-eliminating ( or pollution-eliminating) and resource-use-eliminating technique.
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What are the obstacles to job creation in your community? What could make
local businesses more likely to start hiring?

Basically the inordinate international strength of the dollar. A correction in the valuation of the dollars global purchasing power downward would lead to import replacement, resource efficiency and export industry growth, which would induce USA to lead the world again in the globally-needed cutting edge technologies, now to be energy efficiency, pollution control, appropriate energy generation, etc.

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What other issues and ideas should the President consider?

Al Qaeda is out of Afghanistan, and riven with internal divisions (see: _The New Republic_ June 2008) the USA should declare victory in Afghanistan and return victorious to home, and should wrap up Iraq as either a draw or the previous regime's mistake.

In Copenhagen, the USA should acknowledge First World climate reparation debt, and pay for it with future appropriate technology transfers. Our only acceptable future can include us The current alliance between the pseudo-Christian fanatics in the USA and the pseudo-Zionist fanatics in Isreal serves the needs of neither nation. The USA should now support efforts towards one-nation solutions, via a single election held in both Israeli and Palastinian areas, including Israel, West Bank and Gaza, as well as among Palastinian refugee communities in Jordan, Lebanon and elsewhere. In such elections centrist peace-oriented candidates will win, leaving devisive extremist out of power.

Also, we should follow the thinking of the great USA citizen Henry George in instituting a national property tax akin to local taxes, to better fund government. Sales taxes hit the poor too disproportionately hard, and income taxes discourage employment in comparison to resource and energy use. Ownership is imaginary, but useful because it encourages stewardship. Ownership requires government, and should therefore support government, as stated elsewhere at the blog 'Envision Hope or Perish', which please see.

Brian Cady