Friday, October 9, 2009

and in conclusion...

What I'm really here to say, with my overly and overtly simple equation, with my assumptions that don't take a lot into consideration, is that the rhetoric, and the general assumptions about "the other guy" and what s/he's thinking aren't necessarily true.

So please... if you want to make your point to your audience, on facebook, on your blog or where-ever, don't post groups that propose jonathan swift-type responses to people's oppositions.

Just give me the facts, from a reputable source, and let me decide for myself how I feel about it.

Tell me how many uninsured people are, right now, going to the emergency room every time they have a cold.
Tell me how many, and what percentage, and what the cost impacts are, for people who walk out on their bills.
Tell me what happens to the fiscal health of the bill's proposed healthcare system if presently uninsured people do not opt to take advantage of it... and perhaps that's the reason the latest version of the bill says that it will be required for everyone to purchase insurance, or pay a penalty for not doing so.
Tell me what you're going to do about people depending on doctors to fix them, rather than taking personal responsibility.
Tell me how much my healthcare is going to cost me, and what the quality of my care will be, under the new plan. And back it up with numbers.

Because really, all the whining about the opposition to the bill, and how stupid, or partisan, or greedy, or racist "THEY" are, just makes me stay away from you, too.

Thursday, October 8, 2009

The Healthcare Bill, Reform, and all that that implies...

The healthcare debate has been giving me a headache...

Where do I stand? Let me make it clear that I am not in opposition to people having access to affordable health insurance. I think it is a great idea. I am personally grateful that I am in a position where I purchase my health insurance within a plan at a corporation.

What I have been having difficulty accepting is that so far, is the nature and discussion of the reform, the bill, and whether or not it's actually really good for me or for anyone else.

I also have found it difficult to separate rhetoric from truth, and question everything I'm hearing on both sides of the aisle in regard to this bill... And all I really wanted to know is:

(1) How much will this cost me / save me?
(2) How will this impact the quality of available healthcare for me?
(3) What is the overall impact to society in having this bill become "universal health care"?


So, I focused, like my geometry teacher taught me to: work from what I know to what I don't know... so I built a very basic formula in my head.

The current healthcare system has "A" citizens paying into it, at an average rate of "a" per citizen. Now, those who are paying in are assumed to, largely be able to afford it, and are buying typically, at a bulk rate from their company's packaged plan. There are also those paying in via individual rates, and those are notably higher.

The future healthcare system, however it is designed, will have in addition to "A" quantity of citizens, "B" quantity of citizens who previously couldn't afford healthcare, paying in at rate "b". If they could afford healthcare now, they'd be in group "A", so let's assume for the model that they can't. Rate "b" is less than rate "a", because it is assumed to be subsidized by the government.

Outside of both groups "A" and "B" lies any costs for anyone who walks away from costs of healthcare incurred, such as illegal aliens who can't afford, or even get, coverage. As it is, this number will impact the model, no matter how it's drawn, so it is outside the discussion as not having an impact to the cost.

For the sake of this modeling, "A" and "B" and "a" and "b" are all constants

The current system looks like this:
(A * a) / A = a available funds per person for healthcare in group A,
and a very big expense for any incidents to people in group B, but no monthly expense to them at all when they are healthy.

The universal healthcare system looks like this
(A * a) + (B * b) / (A+B) = available funds per person for healthcare in group A+B

What does this mean, and how do the two systems compare?
well, we've already established that b < a ("b" is less than "a" for the liberal arts majors ;) )
but let's just run the numbers a bit...

if the number of people in group B is 10% the number of people in group A (I'm assuming 10% of the citizen population not having health care right now).. B = 0.1*A
and the cost of healthcare for group B is subsidized at an average rate of 30%.. b = 0.7*a
then the equation for universal healthcare looks like this
(A * a) + (0.1A * 0.7a) / (A+0.1A) =
(A*a) + (0.07A*a) / (1.1A) = 0.973a available funds per person...
in other words, where the health care needs for citizens in group A and B are held constant, under the universal healthcare plan, no matter how its designed, as long as someone is subsidizing the care for group B the available funds per paying citizen under the new universal plan is, at best, 97% of what it is now, for a combined group of A and B.

This initial estimate may sound FANTASTIC for group B, and tolerable for group A, and "why are all you Group A people WHINING about paying for my healthcare, lets get rid of all fire departments, roads and schools because clearly you must think it's all socialism, etc etc etc...and why are you being so unreasonable..."

That 97% is at best. If the people in group B have more dependents, their healthcare cost per person goes up. If the people in group B have preexisting conditions requiring care, their cost goes up. If there are more people in group B than my estimate, or their subsidised at an average higher rate... in all of these cases, the available funds per citizen DROPS... which affects the quality of care. (now.. give some thought to what you suspect is the actual demographic of group B ....)

(and if you didn't bother working thru the basic algebra with me... well... tell me again the bit about the public school system being a public good??)

so as I thought more... hmmm... "maybe the health insurance companies are making big money, and if they just cut profits we'd be ok to cover that slack."
Guess what. Health insurance companies AREN'T making big profits. At most, they are making a profit margin of about 4 percent. That's it.
http://finance.yahoo.com/news/Why-Health-Insurers-Make-usnews-2363456358.html?x=0&.v=2

as you can see in this article, the higher profits are for Biotech and Big Pharma (big surprise there...). But I haven't heard much in this debate about Pharma and I've heard nothing on Biotech. Both Pharma and Health Insurance can be discussed in a per-citizen kind of way, because of what they provide... why the f*** are we focused on building another healthcare system to add to the government bureaucracies, when the for-profit businesses aren't making a mad amount of profit anyway? The truth is, for-profit businesses do whatever they can to make that profit, so if they are only making 4%, it isn't a great business to be in to begin with!

What kind of efficiency measures will the government be able to enact that are going to be SO fantastic that they are going to overcome what a business whose purpose it has been to make money, hasn't been able to enact?

I have personally noticed that when a for-profit company does something, that efficiency in the name of those gawdawful profits in general means they do a good job at getting the job done, in comparison to a comparable government agency. Private entities also are clearer about what they want, and don't change their project scopes over and over because it is a waste of money to do that. And government bureaucracies don't go away! By means of example: Robert Moses, enacted tolls on TBTA facilities that were supposed to end when the facility was paid for. In the 1940s and 50s. But instead, they just kept right on collecting, and funding, works of Moses' personal empire building, and it took a lot to stop him (but nobody ever stopped the money...). I have more recent onces, but I unfortunately feel compelled to remain closed lipped about them. But look around yourself for them... How did Fannie Mae do with mortgages? How did the SEC do handling Bernie Madoff?

Now you may say that the people who got Madoffed "got what they deserved (those greedy bastards)" but just think... You're an investor. you have made some money and you want to save up more so you can go on a cruise when you get older and enjoy the fruits of your labor. The American Dream. You are expecting that your money and investment is protected by laws and rules that have been enacted in the united states where you live, you understand that investments go up and down, and some guy is showing great profits. Great! Sign me up! He's a genius (until he's not)!

Plus there's a little thing called Sovereign Immunity. "In the United States, the federal government has sovereign immunity and may not be sued unless it has waived its immunity or consented to suit."
which means... unless there's a really good reason for it... have fun trying to sue the new "public option" part of the healthcare system!

And why, may I ask, if we are truly interested in "the good of the people", are we NOT focused on the sacred and profitable cow of the Pharmaceutical Industry?
Who's lobbyists do you think are better? The Health Insurance Industry, who we'll be ripping apart if this new bill goes through, putting people out of work because those meager 4% are going to DROP, or the Pharmaceutical Industry, who's making more profit, and we're not focused on them in this debate?

How about reducing the healthcare expenditures of people so the available money goes much further?
What about teaching and funding PREVENTATIVE CARE?
Are gym memberships, acupuncture, massage, all going to be covered in the universal care system? Why do I doubt it? You've got some yahoo republican senator suggesting maternity care not be insured (because he doesn't need it so he doesn't want to pay for it)!

Nope... to renovate this system.. to provide healthcare coverage for people who would like to have it... we're going after the little guy. We're going after the companies who are actually doing something by insuring for our years of self-abuse and stress, and all those free radicals causing degenerative diseases, that one day we're going to need it and get our moneys back.

I can think of a lot more things we could be doing with this system renovation. But who the heck am I? Just an infrequent blogger out in cyberspace, who has learned that you can't tell anybody anything. That people will believe what they want, and if you answer questions before they ask them, they REALLY won't listen. And if you ask the questions instead of giving them the answers... they get pissy and defensive, and declare you're clearly for "the other guy".

So, I'm going to focus on creating my reality the way I see fit. To continue to improve my life and hope that all I'll need is emergency care, eye care and dental care. I've said my piece, I've resolved my own headache with the healthcare bill, and, although I'd love it if all-y'all could afford healthcare... I acknowledge I have no power or authority to do anything about it. It is clearly outside my area of influence. And, people will believe whatever they want to believe, and go back to their existing neural pathways and repeated thoughts until they themselves choose to change. just like me.

And... any prior blog readers know I'm a proponent and believer in the Law of Attraction. What does this have to do with that? Lots. We each create our own reality. And, by taking care of ourselves First, we get an increasingly cleaner understanding of what we truly require, and we give from our abundance. I know, because it is happening with me personally. I find I'm not interested in accumulating a lot of "stuff", and I'd rather have nicer things, and fewer things around me, than being totally acquisitive. In short, focusing on my own pleasure has caused me, very naturally to live in a more sustainable, healthy, generous way. I'm still very much on this path, and have much to learn, but I can totally tell it is for the best that I am going this way. And anytime someone tries to force my hand, and make me do something out of obligation or guilt, it feels terrible to me, and I've learned to say no to it. I know that my choices are my own. Openly and in freedom. What I give comes from my abundance, not from my perceived need or someone elses need (let's face it... ever have a member of the opposite sex come up to you, and you can "smell" desparation all over them? How good does that feel to receive?)

So really... don't suggest that I should HAVE to subsidize this ineffective solution because people NEEEEED it. What they need is something that will actually work. Prevention. Jobs that serve the individual's life path. Moms who don't wear designer clothes, gold jewelry, and designer bags, and pay their grocery bills with foodstamps.

So, can we get off the bandwagon of believing the "other guy" is "evil" or "stupid" or "racist" or "" and talk about something MORE fun and pleasurable? It's WAY better for our health!!!

and... here are my last few thoughts on the subject...