More insurance reform responses

My father-in-law sent me an interesting blog post about health care reform, written from the perspective of someone at a small non-profit hospital in the Ozarks:
http://ochhealthcarereform.blogspot.com/2009/10/reform-letter-to-editor.html

Anyhow, he seems to have 3 main points:

• The much maligned public option is ironically exactly how the biggest for profit insurance agencies started out,
• government run health care (in the form of medicare) pays more than the big for profit insurance companies, and
  
• the government actually pays bills in a timely fashion, whereas the hospital in question has to get its employees to chase down the payments from the insurance company.

The first point is a misunderstanding of the public option, I believe. Creating a number of non-profit insurance companies to provide low cost insurance to the uninsured who cannot afford regular coverage was a separate proposal from the public option, at least according to the health care reporters from NPR. It is a proposal that made sense to me, but it was rejected by some Democrats and so didn't make it into the bill. I think the writer's point of view is also discredited by the number of people interviewed on NPR (in the talk shows and on the news shows) who say that the public option was the best way to get to a single-payer government-run system.

The second point is disputed in the comments, where a commentor from the Northwest says that insurance companies pay above 80% of costs, while Medicare pays 50%. This is what is frustrating about the insurance debate to me---I simply do not have the ability to judge between the two competing claims. Based on this, I'll go with what is "common knowledge," taking the author's viewpoint into consideration.

Finally, he says that the insurance companies do not actually want to pay the bills. I have some experience with this and agree. But on the other hand, Medicare paying the bills right away isn't necessarily a great thing. Peter Orszag testified this spring that Medicare's costs could be cut by 30% without cutting benefits because Medicare is so filled with "waste, fraud and abuse." Presidents have been trying for years to get rid of the unnecessary spending without much success. Also, Medicare is due to go bankrupt in just a few years---this does not fill me with trust in a government run health insurance option.

I think his main point is correct, though---he is afraid this will just be a way to get government money to the health care companies. Like the drug benefit before it, this plan seems to try to fix the problem of access but not of cost, using taxpayer money.

One other part of his post interested me, and that is the idea that his hospital is trying to do the right thing towards people in need, without any rewards from the government or financial rewards. The reason this whole reform is so hard is that the people who are trying just to do the right thing are not the people in charge of the bill and the debate.

Correction: The hospital is a for profit hospital----they just haven't made much of a profit.

Argumentation

Beware the argument your opponents cannot win. If your response means that there is nothing they can do to change your mind, then it's not an argument, just a couple of speeches. If your mind can't be changed, then your opinion becomes less rational and more like a gut reaction. Not that gut reactions should be ignored, but they deserve less respect.

Also beware the argument that lets you dismiss your opponent. Even if they are racist, stupid, liberal, religious, or bound to have wrong ideas for any number of reasons, almost always there is something in their argument that you need to think about. It's better to ignore the person and their motivations for making the argument, and focus on the argument itself. I know, it might lead to an outbreak of civil dialogue, but why not try it?

One of the most frustrating things about this whole health care debate is the way each side doesn't answer the pressing questions of the other. People are getting cut off by their insurance when they need it most for dumb reasons. People who work hard can't afford insurance. On the other hand, someone in the government (as opposed to private insurers) is going to decide what counts as health insurance, what gets covered and for whom. Medicare covers lots of people, but it is going bankrupt, is wasteful, people need additional insurance, and is not controlling costs (it might even be fueling some of the fast increases). Anyhow, these questions are treated rhetorically, not substantively, and I'm getting fed up.

Odd couple?

I just heard the Rev. Al Sharpton and Newt Gingrich being interviewed on Weekend Edition by Scott Simon. They were having a respectful conversation. They were working together to promote education.

They did not try to hide the fact that the two of them had serious disagreements. But they both said that what they were working for was so important, they needed to work together. I never thought I'd say that Gingrich and Sharpton are good role models for restrained, polite, bipartisan (and hopefull effective) work. But here we are..

Speech

Pres. Obama gave a "back to school" speech a week ago. (Funnily enough, many districts weren't back to school yet. But oh well.) Many people have been protesting. Some silly things have been said on both sides.

Here is my take: it is true that GHWBush gave a speech to school kids, as did Reagan, and no one complained. It's not quite the same for a number of reasons, the biggest one being the availability of technology for watching the speech. When there is a computer in every classroom, that's not quite the same as having a few TVs for the whole school. More people could watch the speech.

Moreover, people did complain. GHWB spent $28,000 on what was called a campaign ad for a captive audience. Hearings were held in congress. People did complain. (See Byron York in the Washington Examiner for details.) For those who are saying, "I would have been fine if GWB had given a speech," I remind you that people were calling for his assassination, comparing him to Hitler, 35 % of democrats believed as of 2007 that he knew about and did not prevent, or planned the 9/11 attacks (See Jay Nordlinger at The National Review Online for details). I really don't believe that all of the people who are saying this so blithely would have let their kids sit for one of GWB's speeches.

The reason they wouldn't is the same problem that people have with Obama: people don't trust the president to give a non-political speech. Or at least, a not outwardly political speech---everything a politician does is by definition political. And in fact, I wouldn't want to have any politician, even one I agree with, give a speech to my kids without my having watched or read it first. I don't let my kids watch commercials without me, for goodness sake! People are too good at manipulation, and my kids are too sensitive to manipulation.

That said, the moment the text of the speech was released, there should have been no problem. I also think that schools who decided to show it on Friday made a good decision---parents who were interested could watch it or listen or find out about it, parents who were not were shirking their responsibility anyway. I was happy to let Eleanor watch it at school, no notice was sent out asking if we wanted to get her out of class, I don't think anyone kept their kids home.

Eleanor's impression is interesting. When I first asked if she had a speech from Obama in class today, she said she didn't remember. Then, "Oh, yeah, I think we did." I asked her what she remembered. She said she remembered the part when Obama said his mom would wake him up at 4:00 AM. I asked her why she did that. Eleanor said, "So he could learn."

I liked the speech. I wish people would listen and learn from it, instead of flying off the handle.

Requiring health insurance

One of the ideas that is being batted around as we talk about universal coverage for health insurance is requiring people to have insurance. Some feel this is unreasonable, that people who are healthy (or who think they are healthy) shouldn't have to pay to be insured. I disagree.

First, we require people to carry insurance on their cars because no one plans to get into an accident. Even the best driver can get rear ended, even the healthiest person can have a gene for cancer or get in an accident or be exposed to a virus. If you decide not to carry health insurance, but then need it, you are cheating the rest of the covered people who pay, even when they are well.

I read someone say that insurance companies should be allowed to not cover pre-existing conditions because getting sick and then getting coverage is cheating the other people in the plan. That's why I think we need to get these people covered in the first place, so that no condition is pre-existing.

That said, I think that having extremely high deductible plans for some people makes sense. They shouldn't be for everyone, but a high deductible plan with a HSA makes sense for healthy people without kids, who don't expect any problems. They're still paying in to the pot, but they shouldn't have to get the deluxe plan.

One thing I've read in this debate that makes sense: The well pay for the sick, and we will all die one day. I think sometimes we forget this and behave as though we need to get something out of health care, or we need our wants taken care of. In reality, we'll all need it someday, and a bit of compassion is a good thing.

Protecting Children

One of my favorite parenting blogs, Free Range Kids, has an article about the recent laws protecting kids from lead and other poisonous substances in toys. It sounds like a great idea, but the devil is in the details, as you will see by reading the article.

I can't add much to the discussion, except to slap my hand on my forehead and whimper. Michael had an interesting thought, which I will try to reproduce. The idea is that liberals think that more laws mean more protection for people, while conservatives think that if we just got rid of the laws people would behave well. I'm not sure that this is the case in all senarios, but in this case it certainly holds true.

The visual picture of libraries cordoning off their children's sections, Goodwill and such turning away children's toys, small businesses facing the decision of testing their handmade toys or shutting down, blows my mind. Michael's other idea was that we could resign from the human race----I wouldn't go that far, but I would point out that when we get something wrong the first time, we are obligated to try to fix it.

Working with your hands and your mind

Today on the Diane Reams show I heard Matthew B. Crawford speak about his book "Shop Class as Soulcraft." Then I saw a review of the book at the WSJ, so I figured I should really write some of my impressions.

Working with mind and hands as a SAHM. One of the things Mr. Crawford said that really impressed me was asking whether people who "work with their hands" don't work with their minds as well. He says that fixing motorcycles is hands on but involves his mind in solving problems. For me, using my brain is the only thing that keeps this job tolerable. On one level, it involves thinking about other things while doing mind numbing tasks---writing blog posts while washing dishes, for example. On another level, the problems that come up in parenting involve much creative problem solving. I'm not born organized, for example, so I have to come up with solutions to problems like "how can we make sure we don't forget shoes when we go out?" and "how can I tell when Eleanor should wash her hair?" (I'm still working on the second one...). Then there are the in the trenches child problems: how can I help Luke sleep? What is going on with Eleanor at school? How can I tell if Amanda is getting enough to eat? This is not mindless.

Making things at home, self reliance even when you have an intellectual job I have found that if Michael goes too long without making something, he gets antsy. So I let him add a spigot to our irrigation system, or buld a bench or a bed or desk, or fix some electrical problem. When I was studying math, one of my favorite pastimes was cross stitch, because I could see my progress on the project, instead of having non-physical progress to report. And also, I really hate solving problems at home by writing checks---if possible, I'd like to figure out how it works (or have Michael figure out how it works). Sometimes that leads to procrastination (like our garden...although I'm trying to work on that now). But sometimes I learn something new.

The WSJ best job article A while ago the Wall Street Journal published an article about the best jobs, and mathematician came up first. After looking at the article, what the study did was look at the jobs that the people doing the study wanted to have, and find the jobs that most fit them. My sister-in-law, who works as an OB nurse, had to disagree---I think she thinks her job is better than being a mathematician. The article is an example of the denigrating of physical work that is rampant in this country. Of course I like studying mathematics, but really it's not for everyone, and it's not even for me all of the time.

I think that if I ever get my "Parents with unused degrees" book club going, this would be one of the books we would read.