Xpatriated Texan - A Maverick Believer in the Garden State

Christian Liberal is not an oxymoron

Location: United States

Thursday, September 29, 2005

A Little More of That

From Western Democrat, there is much to think about for Democrats gaining popularity in the West. WD gives a pass-along link to This Blog Hates America, but adds well thought out commentary on why.

Red State looks at Tom DeLay's impact on state races in Texas. Florida News looks at who takes money from Tom DeLay and who gives it back.

Wednesday, September 28, 2005

This and That

Blogging friends Frogsdong and my non-relative Steve Hart have some interesting things to say about the peace rally this past weekend.

No More Apples has an attention-worthy note about Tom DeLay and the all-out attack on Ronnie Earle. I'd sure like to see one single Democrat stand up for Ronnie Earle. Even when things are going the right way for Dems, we can't seem to rally the troops. This should vindicate Chris Bell's ethics charges, though I'm sure there will still be a ton of Republicans saying that Mr. Bell just filed the charges out of sour grapes.

Daily Doormatt has some info about the NJ Governor's race, baseball, and a rally to stop Steve Lipski.

As for me, I have to compliment the FBI on a quick response. I notified them via email that I had received email spam containing child pornography. I think it took them about eighty-five seconds to call me for a follow up and ask me to pass along the email to National Center for Missing and Exploited Children. Hopefully, whoever is responsible will be found and shot while resisting arrest.

Tuesday, September 27, 2005

Making New Jersey Stupid in the Name of the Lord

A friend sent a notice of this story from the Star Ledger yesterday. I have to admit that my first tendency was to roll my eyes at the incredible stupidity of people to try and push things that they claim to have no stake in. After I called several people in the story a liar, I looked a bit deeper at the issue.

I've already looked at the "discussion" on "Intelligent Design" and how its proponents like to lie (or maybe they prefer to be purposely ill informed) about evolution. I'll try not to rehash old territory too much here.

First, the liars exposed:

Annie Imbesi - the woman who is pushing this issue, but claims that her aim is scientific, not religious. Right. Her claim is that "Darwin's theory is contested by many people in the scientific community". Sure it is. Actually, Darwin's theory isn't even taught. Evolutionists consider themselves to be "neo-Darwinians" because they have plugged several problems that Darwin foresaw in his theories.

As for the "scientific community" that opposes evolution, they do so on very unscientific grounds. For example, John Locke likes to quote Michael Denton that the "missing link" has yet to be found. This is simply a stupid argument. The fact is that there is not a single "missing link" theorized by evolution, but an infinite number of them. To dispel this critique would require a complete fossil of every creature that has ever lived. That is simply not possible. One of the basis of scientific theories is that they have to be falsifiable - they have to be able to be proven false. This applies to objections to scientific theories as well. Since it is not possible to have every single creature saved in perfect fossilized remains, Locke's reliance on Denton is not a scietific objection at all.

His contention that "the more we dig, the more we keep finding the same forms over and over again, never the intermediates" is patently false. For his statement to be true, we would have exactly two specimens of humanoids - one very ancient and one modern. There are dozens of intermediates that have been dated sequentially. Here, Locke is simply lying.

His contention that a computer program has disproven evolution is also weak. A computer program can be made to say anything the designer wants it to say. You can make a program that predicts birds will swim and fish will fly, but that doesn't make it so. If you consider a dog's tail a leg, how many legs does a dog have? Four. Calling a tail a leg doesn't make it so. Calling a tail a leg a scientific grounds for disagreement doesn't make it so, either.

There are similar problems with the discussion Darwin's Black Box. How, it asks, is half a wing useful? No where in any evolutionary text does it theorize that half a wing was ever developed. A bird that developed half a wing would die and that change would not have survived. It's a question that an eighth grade science student can refute - if they are actually taught what evolution says and what it does not.

Locke concludes by comparing Newton with Darwin and throwing in Sir Karl Popper. Newton's theories of gravitation, you see, were overthrown by Einstein and Newton's gravitational equation was discarded. But, there is significant information left out of that. You see, Newton knew he was wrong. He didn't know why his calculations weren't correct, but he did predict that someone else would improve on his theory based on inaccuracies. So did Darwin. The exact weaknesses predicted by Darwin have been explored, greater evidence has been found, and the theory strengthened (not weakened as Locke claims) by new evidence. This is exactly what Popper said about how science should proceed.

So, if Ms. Imbesi is to be taken seriously, the best we can teach is that some scientists refuse to believe their own science and are willing to turn off their brains to do so. This is hardly, in my view, what we need to do in science classes.

Ms. Imbesi is simply lying about not wanting faith-based explanations to be taught. She admits to using the Discovery Institute as a resource to come to her conclusion that evolution is wrong. Folks, the Discovery Institution is a religious organization dedicated to putting creationism into public school curriculum in some form or other.

For example, the Discovery Institute says "its work includes a belief in God-given reason and the permanency of human nature; the principles of representative democracy and public service expounded by the American Founders; free market economics domestically and internationally; the social requirement to balance personal liberty with responsibility; the spirit of voluntarism crucial to civil society; the continuing validity of American international leadership; and the potential of science and technology to promote an improved future for individuals, families and communities". This is what I teach my students to read as a "values laden statement" and indicative of institutional bias.

"a belief in God-given reason" states openly that it is religiously based and the "permanency of human nature" indicates that it is inherently against evolution. You should expect as much "fair and balanced" reporting of this issue as you do from FOX NEWS - which is to say none. What the Discovery Institute is is an organization dedicated to a fundamentalist view of Christian America - whether such a history exists or not (it generally doesn't). Their goals are lies because their whole organization is built upon a lie that was built upon yet another lie.

The President of the Institute is not even a scientist - he's a specialist in public policy development. One VP is a co-founder of Stewardship Partners and one is a lawyer and software design manager. Only one of the four principles has any scientific credentials at all. Yet his credentials are limited to his dissertation on the history of creational biology and a stint as a geophysicist - so his "scientific credentials" are limited to, effectively, a history of disputed theories of creation and a rock collector. Rather than publishing for academic presses (where his blindness to real scientific theory would be exposed) he prefers to write for the Wall Street Journal and the National Review - neither of which is particularly well-known for rigorous scientific review of material.

The problem is that Social Conservatives - Republivangelicals who are intent on mixing church and state in all its myriad forms - have created a false credentialling system so that their points-of-view can take on a thin veneer of academia. For the person who is only vaguely aware of the issues, it becomes a competition of Ph.D.'s and the result is a push - let's teach both so we don't do the wrong thing.

But teaching anything that is not science as science is inherently the wrong thing. Intelligent Design does not hold up to any criterion of a scientific theory. It is untestable, it makes no predictions, and it is not based on any observable occurence. It holds its own truth - it creates its own truth.

ID is a creational response to the hard science of evolutionary biology and paleontology. It is an attempt to get creationism into schools by creating a false sense of science around it. It is pseudo-science that cannot be argued on scientific grounds. If you want to believe it, that's fine. However, you can't say it's science and insist that it should be taught in science class. Doing so is, at best, stupid and at worst dis-honest.

Monday, September 26, 2005

Taking Aim at Corruption

Anyone who has stumbled by this blog before should know that I'm not a big fan of Tom DeLay - in fact, I'm pretty well set to support anyone (even a Yella Dog) who'd run against him (okay, maybe not if Charles Manson ran against him - I do have some limits). If you look over at Tammany on the Hudson, you'll see that it isn't just Congressmen, Texans, or Republicans that I hold in contempt for this cause. Perhaps I am naive, but I believe that holding a public office is an honor and a public service - not a way to make your family and friends rich.

Now there is CREW - Citizens for Responsibility and Ethics in Washington who are aiming "Beyond DeLay". Forgive me, but I think you should actually aim at DeLay, whose crimes are rapidly becoming documented public record as his associates learn the frog-walk. The hobgoblin of public action is to get ahead of yourself. You eat an elephant one bite at a time - not by unhinging your jaw and cramming the elephants hindquarters in your gullet.

There is another problem with the CREW list - the heavy concentration of Republicans leaves it open to charges of partisanship and bias. True, there are two Democrats on the list - Maxine Waters of California and William Jefferson of Louisianna. Though I am a Democrat, I find it hard to believe that one specific Hudson County Democratic Representative/Senatorial Hopeful didn't make the list - Bob Menendez. Other Democrats could have made the list as well.

The big problem is acknowledged by CREW in its "blog" -

[CREW] has been searching for a Member of Congress to file with the committee, but so far, no Member has stepped up to the plate. Do they fear retribution? We think they do..."

Yeah, they know what happened to the last member of Congress who filed an ethics complaint - Houston's Chris Bell

But serving in Congress also gave Chris a chance to see firsthand the crippling effect of cynical partisanship. Honest debate was less common than partisan gamesmanship, genuine compromise was virtually unheard of, and the public interest consistently took a backseat to political interest. Chris became a prime target of the infamous 2003 Republican redistricting effort in the Texas Legislature, and he was defeated in his bid for reelection after his district was redrawn.

Not content to stand idly by and stomach the violation of laws and abuse of power that accompanied the redistricting effort, Chris filed a formal ethics complaint against House Majority Leader Tom DeLay in June, 2004, breaking a seven-year "ethics truce" in Congress. Four months later, the House Ethics Committee responded by unanimously admonishing DeLay on two of Chris's charges and leaving a third on the table pending a criminal investigation in Texas.

More than that, however, they know they all have an ethics problem. I simply don't think that Congress can effectively investigate Congress. Much is made about how the Attorney General is caught in an automatic conflict-of-interest when the White House is being investigated (because he's appointed by the President), but we seem okay with the idea that a few Congresspersons who are hand-picked by the rest of Congress will do a good job of policing its members. Hogwash. It's like telling the convicts to elect a warden and then not expecting a jailbreak.

Obviously, the Republican leadership is at the top of the news cycle with its recent ethical problems. But elections are a poor way of enforcing ethics. After all, people often send the worst possible people back to Congress. Incumbency is a grand weapon to wield over reformers.

I consider it to be an infinitely good step that the SEC Chairman recused himself from an investigation into his friend Bill Frist. Yet, the SEC chair is ultimately appointed by the President - so the same conflict of interest exists when the person being investigated is part of the same party leadership as the President. The oral-sex "scandal" of the Clinton White House shows the problem of having an "independent" Special Prosecutor who is a partisan hack. However, as much money as was wasted to hang Monica AlbatrossLewinsky around BIll Clinton's neck, even more is wasted by not having such an office to investigate Congress and keep them honest.

I'll close by quoting Barry Goldwater -

Tonight, there is violence in our streets, corruption in our highest offices, aimlessness amongst our youth, anxiety among our elders, and there's a virtual despair among the many who look beyond material success for the inner meaning of their lives. And where examples of morality should be set, the opposite is seen. Small men, seeking great wealth or power, have too often and too long turned even the highest levels of public service into mere personal opportunity.

Now, certainly, simple honesty is not too much to demand of men in government.

Yes, there would be no place for Mr. Goldwater in politics today. And we are all the poorer for it.

Thursday, September 22, 2005

A Glass House Begs for Breakage

When you write about Hudson County politics, strange things happen. So far, there have been no late-night phone calls with throaty mobsters or anything like that. However, I have received a somewhat anonymous email concerning a Jersey City politician - City Councilman Steve Lipski.

It seems there is a website now dedicated to bringing down Mr. Lipski. Apparently, it was started by Mr. Lipski's former campaign manager, Steve Kush of Kush and Associates. Apparently, there is some bad blood between Kush and Lipski over campaign related expenses. If you're really interested, read the site.

Personally, it is nothing to me what happens between Lipski and his campaign crew. However, there are a number of allegations made that may bear further investigation. Among other things, Mr. Lipski is accused of drinking and driving, causing damage to a City owned vehicle, and generally being a slob. Of more interest to me is the accusation that Lipski's mayoral bid was nothing more than a thinly veiled attempt to prevent Lou Manzo from winning the mayoral contest - which tipped the contest to Hudson County Democratic Committee nominee Jerry Healy.

The way municipal politics often works is that the official candidate will also secretly back a stalking horse to split the "reform" ticket. In the special election of which we are speaking there was hardly a need to do that as there were, to my recollection, about seven or eight mayoral candidates. The vote was about as split as it could get. I'm more than a bit suspicious that Lipski's sole purpose was to split votes from Manzo. However, it also has to be said that Lipski placed fifth in the overall vote count. At the same time, it has to be noted that he did collect enough votes to easily have swung the vote either way.

What makes the idea credible in my mind is that both the fourth and fifth place finishers (Lipski and Willie Flood) both appeared as if by magic on Jerry Healy's ticket for the regularly scheduled elections under the HCDC banner earlier this year. There are two explanations for this - one less vile than the other. One explanation is that their strong vote tallies proved to the HCDC that they are real candidates - and thus they were simply added as common sense would dictate. Obviously there is evidence on the face of the issue that this is a legitimate answer.

The other is that Lipski and/or Flood were rewarded for their stalking horse rolls. They were backed, either directly or indirectly, for the sole purpose of shaving enough votes from the competition to ensure victory. Having shown themselves faithful, they were then given their position alongside the mayor in this election - a position that all but guaranteed victory.

The Kush site brings other questions to my mind, though. First of all, Steve Kush advertises (one might say he brags) about representing REPUBLICAN candidates. Now, it is entirely possibly that he was so struck with Mr. Lipski that he made an exception. That doesn't seem to be the case - or if it is, it is a well hidden secret. Of course, people who know Mr. Lipski from his youth tell me that he was a fervent Young Republican who jumped to the Democratic Party just to get into office. Given Mr. Lipski's support for Bret Schundler, it seems that perhaps he hasn't gotten that red-ness out of his blood.

Personally, I don't care if Mr. Lipski is Democrat or Republican. I do think he should be honest about his allegiances, though. I will concede, however, that it is a small point.

Another point about Mr. Lipski comes out from his speech announcing his mayoral bid.

There are 49 days left to the election, and this number 49 is
significant because in 1949 a young reform mayoral candidate beat the
Frank Hague machine, and now a young reformer is going to beat the
current machine and turn government back to you. That reformer is me.

Here's the problem: John V. Kenny won the mayoral race in 1949. Kenny was hardly a "reformer". He was a member of Frank Hague's machine until he became powerful enough to take over himself. He then implemented all of the corrupt practices that Hague was known for.

Is this who Lipski wants us to believe he really is? A backstabbing opportunist who is just as crooked as the man he double-crosses?

It brings to mind another Lipski quote from the investigation over his mismanagement of the CREATE school he loves to brag about: "I was cited, not indicted" or perhaps his claim: "But were [the improprieties] criminal or are they moral? And I would say absolutely not.". It also brings to mind the recent revelation that he has some times to Russel Thomas Fallacara - an alleged mobster.

The Kush site also alleges that Lipski took a campaign contribution from developer Steve Hyman. More than that, his mailing was paid for by Hyman's wife through her company - Platinum Design. He then understated the amount contributed by over $17,000 in his public disclosures - or so the Kush site alleges. (Platinum Design has a website, but it's an annoying flashy boxy piece of crap. Look it up in Yahoo search if you want to see it.) Kush also reports that Lipski recused himself from discussing Hyman's case at the City Council meeting - but not in voting on it. Odd that he would not listen to the debate, but still be willing to vote on it.

It could be that Mr. Lipski is just exceptionally unlucky in picking political friends. I have no proof otherwise. However, at some point, that sort of judgment problem needs to be held accountable. A less favorable interpretation is that Mr. Lipski has built a glass house out of political patronage and sleight-of-hand corruption. If so, it looks like the hail of rocks may just have begun.

Wednesday, September 21, 2005

Corporate Giveaway Instead of Help

Tragedy, as always, brings out the best and the worst in people. Uncommon kindness has become almost common as survivors of Hurricane Katrina have fanned out over the entire country. Homes, schools, hospitals, and hearts have been flung open wide to accept all who are in need. If ever America aspired to be a nation founded and ruled by Christian principles, it was this time, in these places, for these people.

Congress has also flung something open wide, but it isn't their hearts. It's their political opportunist instinct that has loosened their purse-strings in all the wrong ways for all the wrong people. On top of that, President Bush has promised that he will totally ignore the patent fact that increased spending requires increased revenues by repeating his father's Read My Lips pledge of no new taxes.

What Congress has done, instead of sending money and resources into Southern Louisianna, is give TAX BREAKS to survivors of Katrina. This is the kind of false aid that can only be called "aid" if you consider cutting off a leg a good cure for a sore toe. Let's totally forget the fact that a whole lot of people will not be earning any money for the rest of the year (hence not pay any taxes).

One of the things Congress has done is revoke penalties for the early withdrawal of IRAs. See, your IRA is supposed to be the first leg of your retirement planning (since Social Security isn't going to work). So, we cut off the leg to treat the sore toe of current problems. So what will they do when it comes time for these people to retire? Well, of course, they should have thought of that before they withdrew the funds early. After all, personal retirement is a personal responsibility, right?

When they file their taxes in april - SEVEN MONTHS FROM NOW - they can use their 2004 income to figure their tax credits. Now, if they can just stay alive until 2004. Don't worry about your rumbling tummy, Thiboudeaux, we'll eat in the Spring.

The idea of using your taxes to recoup uninsured and unreimbursed losses has the same problem. Don't worry about the lack of funds now, you'll have plenty later. Yeah, because no one worries about accepting cash or anything at the grocery store.

Oh yeah, there's now a good side to losing your house. If you can convince the mortgage company to completely forgive the debt you can write that off on your taxes. Seeing as how the mortgage companies just got through pushing through a bankruptcy bill that will make it harder for these people to legally have their debts forgiven, I don't see this as a big group.

Then they are giving companies a tax write-off for hiring people. Sounds great. However, most businesses already don't pay taxes on payroll. It's considered - rightly so - a cost of doing business. You pay taxes on profits, not gross receipts. Since payroll is a business expense that is taken out of the gross as part of legitimate tax expenses, this allows some employers to exempt their payroll from taxation, then write-off the entire payroll from their legitimate tax bill. The companies who benefit most will, of course, be those with high payrolls - like Halliburton (remember Halliburtion?).

Small businesses that continue to pay their employees (with non-existent money) can also write that expense off on their taxes.

Far be it for me to bring up the 2004 Presidential election, but Senator Kerry did warn about a President who displayed faith without works - and was widely criticized for doing so. Let's look back at the source of his speech - the Book of James. Specifically, let's look at the following two verses: James 2: 15-17.

Suppose a brother or sister is without clothes and daily food. If one of you says to him, "Go, I wish you well; keep warm and well fed," but does nothing about his physical needs, what good is it? In the same way, faith by itself, if it is not accompanied by action, is dead.

Here, my friends, is a real world example of the very sort of faith without works that James spoke of. Without food and shelter, without a way to maintain business or home, our Congress has told the survivors of Katrina - "Be fed. Be comfortable. Write it off on your taxes." The only real benefit here is that big government contractors - like Halliburtion - will boost their bottom line. In the most Christian outpouring of real emotion and sympathy I have ever seen in my life, Congress has sought to harness that emotion and line their pockets with it.

I am proud of my countrymen and women. I am ashamed of our leadership.

Monday, September 19, 2005

A Tragedy, A Lack of Leadership

The New York Times posted a front-page story yesterday that told the story of why women sometimes seek abortions. More to the point, it wrote about how they deal with the mental and spiritual backwash that comes from making that decision. If they wanted a complete story, however, they didn't need to run all the way to Arkansas. They could have just taken a trip across the Hudson River and watched one of the most gruesome stories of twisted secrecy and destruction known to man unfold.

It started when West New York resident Martina Russo heard an infant's cries echoing up an air shaft outside her bathroom window. A newborn infant was discovered at the bottom of the shaft, despite New Jersey's safe haven laws that allow a mother to give up her baby legally. The baby was traced to Lucila Ventura - whose own mother says she was unaware that her daughter was even pregnant..

Let's set aside the fact that the baby was carried full term and weighed well over seven pounds when it was thrown to what was intended to be its death. There is no way a parent cannot notice their daughter is that far advanced in a pregnancy. But, there was, it turns out, a lot more going on in the Ventura household that a mother would want to turn a blind eye on.

First, it was discovered that this was not the first time Lucila had thrown her own child down the air shaft to die. Then the reason for the young girl's actions came to light - she was ashamed of carrying her father's child. The final straw in this sad and tragic tale came from those who knew the family - and weren't surprised at the full story.

But the full story is that after serving jail time both father and daughter/sex-slave will be deported back to El Salvador.

I suppose the law takes the view that what happens in El Salvador stays in El Salvador.

I can't excuses Lucila's actions - she brought two lives into the world for the sole purpose of snuffing them. My heart does break for her, though. I also refuse to stick my head in the sand so deeply as to think that, in a metropolitan area with several million people living here, she is the only one to face this situation or to find this "solution". This is why we need both a legally defended right to medical privacy and universal medical care. It is highly possible that access to a doctor would not have changed anything. But, it may have saved a whole lot of suffering and one very cruel death. It may have brought this horrible situation to light before a second murder was attempted. Free access to birth control might have prevented a great deal of the story as well.

The father was a willing accomplice. He knew what he was doing and he knew his daughter was pregnant - twice. Anyone with the intelligence of an eight year old knows that baby's don't disappear. He knew what happened - and it's highly likely that he was a willing accomplice, if not the "mastermind". My opinion is that this is exactly the type of case for which the death penalty was reserved.

As for Lucila's mother - it is possible that she knew absolutely nothing about what happened. If I've learned nothing more about the human psyche I've learned that we have an incredible capacity for denial. It is difficult for me to absolve her entirely of any responsibility. If Lucila's friends suspected something was wrong, her mother should have as well.

It's easy to sit in Washington and deal with abstracts about "rights" and "Constitutional obligations". The fact of the matter is that civilization resorted to government to address real world problems encountered by real people. There is no way to construe what happened in West New York this last week without identifying several problems. These problems have real solutions - at least some do. However, you won't hear about them during the confirmation hearings or during the plans for spending even more billions without raising revenue. In fact, you won't hear about them at all from our national leadership.

Which begs the question: exactly WHY are THESE PEOPLE running our country, when they are as guilty of denial as Lucila's mother?

Friday, September 16, 2005

Count the DAMN VOTES!

September 8, 2005 marked a sad note for Democrats in New Jersey. State Senator Byron Baer retired that day for health reasons. Since it was only in April that he had heart surgery, we can be fairly sure that health really is the reason he is stepping down.

Since I'm not a native of New Jersey, I actually had to do some research on this guy. Turns out that he won the Drum Major for Justice Award from the Martin Luther King, Jr. Commission last year. He was one Hell of a guy. We need more like him.

In the wake of his resignation, Bergen County Democrat Boss (Bergen County Dems may be slightly more ethical than Hudson County Dems) Joe Ferriero picked his favored replacement - former Hackensack police chief Ken Zisa. Zisa is simply one of the Bergen County revolving-door Democrats that plays "yes man" to Ferriero. He's been Assemblyman, Police Chief, head bottlewasher - now he gets to be in the State Senate.

Unfortunately for Ferriero, Loretta Weinberg challenged Zisa for the seat. Weinberg is, literally, the most liberal member of the State Assembly - and proudly so. She was also backed by Senator and Gubernatorial candidate Jon Corzine. This would prove to be a test for Corzine and his hope to reform New Jersey corruption government. So, there was an "election"

Bergen County Representative Steve Rothman was the presiding vote-counter. At the time of this writing, Zisa has won the right to take over Baer's seat immediately by four votes and he won the right to be on the ballot (without a primary) by one vote. The kicker? Steve Rothman is holding seven ballots in his pocket that would likely reverse both decisions.

The decision not to count them was made before the count ever started under rules that (presumably) both candidates agreed was fair. However, Weinberg wanted them counted and Zisa didn't. My general feeling in all such matters is that until fraud can be proven - open the damn ballots and count them. Usually, when someone doesn't want votes counted, it's because they think they'll lose if the count goes through (like Bush v. Gore, for example). I'm guessing that Zisa doesn't want the votes counted because he knows he'll lose (after all, they know exactly who submitted these signed, sealed votes).

But, Weinberg is going to appeal the vote - as soon as they know which court should hear the case. Corzine has quietly supported her this far, as have State Senators Barbara Buono and Ellen Karcher. Since there are now 21 Democratic Senators in the NJ Senate and it takes (surprise!) 21 votes to seat a Senator in these circumstance, these two women could exercise great power over the process.

Of course, we could also just open the seven votes and find out if all of this is necessary or not.

Wednesday, September 14, 2005

Katrina, Medicare B, and a Healthcare Crisis

It was a perfect storm. Saving its strength for a final assault, it lulled New Orleans into a false sense of relief. Then, with madeningly crystal clear skies above, the survivors of Hurricane Katrina awoke to find the streets flooded. The water rose quickly, drowning the vestiges of hope that clung like Spanish moss to street signs and roof tops and hotel balconies.

Even as the waters were rising, a new flood was beginning. An army of volunteers, from across the truly United States and beyond, came in trains and planes and buses and ships and brought with them food, water, clothing and, most welcomed of all, a way out of Hell. Hundreds of thousands of hard-working, hard-playing, possibly more than slightly foolish people reversed the flood, finding temporary shelter in Houston, and then out to Utah, West Virginia, New York, New Jersey, Pennsylvania, New Mexico, Oklahoma, Arkansas, and possibly every state on the continent.

It was truly a national disaster. It was truly a national rescue effort. It remains a truly national crisis.

It will remain a national crisis for months, even years. As time passes and return becomes even more unlikely for those scattered so far abroad, it may last a generation. As "Okies" fled the devastated Dust Bowl of the Great Plains, so now the Cajuns, Creole, Big Easiers, Nawlinsites - pick a name - will settle in their poverty throughout the country. People who had minimal jobs and survived by supplementing their diets with cheap crawdads and catfish will find themselves ill-suited for the job-market of Des Moines and Phoenix and Santa Fe and Boulder.

Beyond the influx of immediate problems of housing and food, there is a great potential for a lingering epidemic of slow-moving health problems. The water that many of these people waded, swam, and floated through contained raw sewage and toxic chemicals, and was tinged with the hideous sight of dead humans slowly swelling and rotting in the humid Gulf air. After days of exposure, there is no way to wash off what has already found its way into your body through cuts and scrapes and every orifice that isn't water-tight. Now, public health officials hundreds, and in some cases over a thousand, miles away will deal with problems that would otherwise have been contained in a fairly small radius.

The Center for American Progress is right to argue that immediate medical care needs to be among the primary responses of the federal government. Medicaid will provide an initial stop-gap financing of public health facilities. But Medicaid is not the proper tool for the long-term tracking of health problems for this magnitude of problem. For one thing, Medicaid is not truly a federal program, but a joint program between the federal government and the states. Many of the states currently accepting people from New Orleans are already straining to deal with their domestic caseload. The State of Missouri, under Republican Governor Blunt, has practically eliminated Medicaid already. Simply put, the states cannot withstand the financial assault the level of poverty of these people will bring with them.

Medicaid may be a stop-gap for immediate action, perhaps with federal funds or special eligibility standards, but there is a big problem lurking behind the scenes.

My brother recently called some of his friends in Lafayette, La., which is upstream from New Orleans and was spared most of the destructive fury of the storm. His friends had opened their home to three strangers from New Orleans. It's a wonderful, heart-warming story that has been repeated over and over throughout the country. The strangers had a problem, though. In the haste to "forcibly evacuate" this group, not a one of them had time to grab any vital paperwork - not a driver's license, birth certificate, social security card, baptismal certificate, or even a utility bill between them.

How are they going to prove they are from New Orleans to meet any sort of eligibility standards? Their only hope (and this is a cruel twist of fate) is that their fingerprints might have been scanned into the national crime database (assuming that any of them had ever been arrested). Barring that, they are people without faces in an age that demands proof of identity even to cash a paycheck.

I believe I have laid out a program over the last week that would benefit these people, and every state that has taken in the homeless, the suffering, the widowed, the orphaned, and the weak. It couldn't work immediately - Medicaid is free to the recipient and these people will need that for a time to get their roots planted, their homes established, and their hands turned again to work instead of comforting frightened children. But it could work very well for an extended healthcare plan for those who will face a lifetime of health effects from exposure to - well, we honestly don't know what they were exposed to.

New Orleans held something like half a million people before the tragedy. There are easily twice that number of churches in the United States. At the cost of less than $100 per week, these churches could each adopt one person for a year, maybe two. That money would pay for Medicare B coverage for these people to see healthcare professionals where ever they may have been transplanted. It would ensure follow-up coverage so that those who are healthy and able to heal can do so quickly and those who have lingering health problems can be identified early and their case can be tracked for progress.

These are real lives. The suffering is too great to ignore. All it takes is one law to authorize a voluntary program to relieve the burden from debt-crushed states and revive a people that all too often now have eyes that are vacant of hope and brimming with despair.

I wrote days ago that, even though I do not particularly like George W. Bush as a President, I need him to be the visionary leader our times demand. I still do. I was proud to hear him take full responsibility for the failures of the federal response. That's the first step, Mr. President. I still need you to take the next step - and so do the people of New Orleans. Make us strong where we are broken. Leave behind partisanship and ideology and step to the fore with the Compassion you spoke of in 1999. We can save each other. We just need you to provide a means of doing so.

Tuesday, September 13, 2005

Dealing with some Arguments

I found this short post a few day ago and decided that I needed to address some of the arguments expressed in it directly. After all, one of the newest/oldest arguments in partisan politics is that we talk at each other and not with each other. So, here we go...

#1 "It would seem that having a "free" health care system would be too easily abused for small things like hang- nails, scratches & boo-boos, which would likely drive the costs up to a prohibitive level."

First of all, what I have been proposing is not a "free" system - and there's no such thing as a free system anyway. My plan is that any American who wants to do so can buy-in to Medicare B - at full price - and thereby receive some modest amount of health care coverage at a modest price. The going rate would be around $80 per week - and I propose allowing that cost to be paid in pre-tax dollars and split by both employer and employee. Will it result in people going to the doctor more often? Well, yes, it will. That is the whole purpose of having healthcare insurance, isn't it? The idea is that by allowing them to go see a doctor when they have, for example, a chest cold that won't go away before it develops into full-blown pneumonia, you actually spend less money than otherwise.

Will some people abuse the system? Yes. There is no way to have any system of doing anything and not have some person somewhere abuse it. That is not an excuse for doing nothing. What you do is build (and fund) a system that investigates abuse, fraud, and waste. When you find people who are intentionally taking advantage of the system, then you take action.

Let's get real, here. There are definitely people who will sit in the doctor's office for eight hours waiting to be seen for a scratch - literally, a scratch. Do you think these people are not already exerting a cost on the system? Honestly, how much time and money is that scratch going to cost? If you have an honest doctor, it will take five seconds and cost next to nothing. If you have a dishonest doctor - see the above paragraph.

#2 "Government instituted programs, particularly social ones, are inefficient and costly. Once again this would be asking those of us who deal with the drudgery of every day work to support everyone, regardless of their inclination to work. It's grossly unfair to say the least."

According to the 2005 Trustees report, the total cost of administrating the Medicare B and D programs was $2.9 billion for 2004. This is a very slightly more than 2% of all expenditures. Since there were some 33.3 million recipients, this means that Medicare paid administrative costs of $87.09 per patient PER YEAR. In other words, if you pay one week of Medicare B, you have (almost) paid for all administrative costs that would be incurred for the entire year.

As means of comparison, I'll refer you to a health care expert - Matthew Holt. Search down for the term "medical loss ratio". I'll quote:

"From 2000 to 2003, medical loss ratios for the 17 companies dropped from an average of 84.8 percent four years ago to 81.5 percent last year. So while medical expenses have increased, the proportion of dollars devoted to them has dropped."

That means that administrative costs (the part eaten up by non-medical expenses) rose from 15.2% to 18.5%.

Actually, almost all federal social programs carry out their goals at a lower cost than any private company can. The reason is simple - it's an economy of scale. The per unit price of anything goes down as the number of units delivered goes up. Obviously there is a limit to this, but in general, it's why Medicare can keep costs low.

Again, this is not asking anyone to support anyone else. It is simply allowing those who want to (and who have the means to do so) to opt-in to a modest level of health care. What's unfair is that millions of people already pay for Medicare and yet have absolutely no way to qualify for Medicare coverage.

#3 "Of course, the overwhelming rejection of this idea will not stop liberals from pushing socialism on us from now until eternity."

This is the most ignorant argument ever. Generally, it comes from people who have no idea what socialism really is, but they heard Rush or Hannity say it and it sounded good.

Socialism means that government owns industries. Medicare doesn't even compete with the health care industry. In fact, if Medicare failed today, there wouldn't be a single company out there rushing to provide health care for the uninsured - just like they aren't rushing to insure those who are currently uninsured. Health insurers are welcome to start up programs to compete with Medicare any time they want.

#4 "National Health Care is socialized medicine. This has never worked without significant limitations on care. The reason that the Canadian system "works" is that the US is the "pop-off" valve where people can come to get their care."

Again, this is a throw-off line from Rush and Hannity. I've already talked about socialized medicine (which is another way of calling it socialism).

The argument that it doesn't work without limitations on care is simply without merit. We already have a system with even lower limitations on care - a self-pay system that locks the vast majority of Americans out of any other means of obtaining medical care.

As the recent row over Americans buying Canadian drugs shows, it may actually be Americans who are overburdening the Canadian health care system. Even if that isn't true at all, we still have the existing system for the "pop-off" system - no one is going to stop for-profit health care. By making Medicare available to more people, the system may actually be revolutionized where Medi-gap insurance actually can be offered to people everywhere and be a significant source of business for private insurers.

#5 "Heath care costs are being driven higher through malpractice insurance. This could be addressed by socializing tort law, capping pain and suffering claims and accepting that medical science is occasionally impacted by human error. Our citizens need to reconsider the belief that we need be compensated for everything bad that may happen to us. If a doctor is deliberately trying to cause harm, try them in criminal court. Government is hard, cold and shallow. Devoid of religion and steeped in politics. Government is no place to put medical care."

Let's look at the facts of malpractice lawsuits. 70% of all malpractice suits are dropped or thrown out of court. Out of 100 cases brought, only six go to verdict and the plaintiff wins only one case. Some specialties have a higher incidence - notably surgeons and OB/GYNs - and there are specific reasons to address problems with them. Most people, however, don't go to the doctor because they are pregnant or need surgery. The objective here is actually to prevent the need of surgery as much as possible. Early care is the best way to accomplish that.

A large part of the cost of malpractice settlements is also the need to provide life-long health care for the injured party. That cost could be cut to very manageable levels if all that was necessary was to pay Medicare B premiums. The savings would be exponential for OB/GYN's for injuries to babies that have their entire lives to claim health care costs.

I like the "cold, hard, and shallow"government compared to the "war, soft, and deep" market of health insurance argument. Is it really necessary to debunk that?

#6 "The federal government needs to get back to its original purpose as outlined in the Constitution and stop overstepping its bounds. I want less government in my life, not more."

I always love it when people say "We need to stick to the Constitution." Did you eat today? Do you know where your food came from? Do you know who handled it or how it was packaged? Did you take a pill of any kind in the last year? You do realize that the Constitution doesn't authorize a Department of Agriculture, Health Department, or FDA, don't you?

Plus, the Medicare B program is completely voluntary. You want it, you opt-in. You don't want it, you do nothing.

#7 "Bottom line: I'll get worse care and it will cost me more money. I presently have great coverage from my company. If Universal Health Care is passed, my health care will be worse, not better, because my company will drop its plan and enroll me in government plan. Plus, it will cost me more money because my taxes will go up."

You will keep your plan exactly as you have it now. Plus, if you want it, you can buy Medicare B as a back-up. Your healthcare is better, not worse. Plus your taxes won't go up because the opt-in plan pays 100% of the cost.

Your company won't drop your coverage. If anything, it will redistribute its benefits so you will get more for less.

#8 "If you're intellecually honest and truly desire answers to some of these problems, observe what is happening with physician groups locally: Skagit Medical Center no longer accepts new Medicare patients. Edmonds Family Practice is considering opting out of Medicare altogether. MAYO clinic of Jacksonville, Florida opted out of Medicare about a year ago. And you ask if Medicare is the answer to all of our woes? No, it would be merely the beginning. I welcome any reasonable response."

Providers are dropping Medicare because they limit the payment in order to keep the costs down to recipients. If several million new recipients flooded the system with additional funds, part of the money could be used to increase payments to providers.

#9 "I have personall experience with the Canadian & English health care system. They are both on the verge of failure. In England my father was diagnosed with Cancer. He had to wait more than three months to get appropriate treatment. By then it was hopeless. My mother in Canada had to wait 18 months to get a knee operation. Their was a problem and the Doctor had to re- do the operation. You guessed it, she had to get back on the list and wait another 16 months. During this time she could not walk."

I love this argument. Look, if you were here, your parents wouldn't get any kind of care at all unless they could pay for it. At best, they could be declared disabled and get the same care we are already talking about. The thing is, under my plan, you can get coverage as well.

As far as waiting is concerned, the limits in Canada and the UK are due to the government running the hospital, not from offering insurance. Even if you have to wait for 18 months, it's a lot shorter than the five years my mother has been waiting for her knee replacement. With her level of income, it's probably going to take another five years.

I was going to do a "top ten" list out of this, but honestly, this thing is going in circles at this point. The system works at a lower administrative cost than is available for private care. Private industries are not interested in providing care to the uninsured as it cannot be done profitably at their level. If this sounds like a bad idea to you - don't get it. If it sounds like something that would benefit you, though, why should you not be allowed to purchase health insurance?

As I've said before, there is nothing standing in the way of accomplishing this, and cutting the number of uninsured by half, than empty ideology. Americans deserve better. They are promised better by the Declaration of Independence and the Constitution. Continued inaction is a violation of public trust.

Lives - American lives - depend on it.

Un-American Plans for Health Care

President Bush is, at least at his words, very fond of small businesses. He is very fond of saying that he is helping them. However, his idea of help them get healthcare is allow them to band together to buy health insurance. While this noble idea fits well with the free-market ideology it doesn't really deal with the reality of the situation. How likely do you think it is that, say, 100 small businesses to gather together to do anything?

The term "small business" is intentionally vague. According to the US Census Bureau about five and a half million firms and just over seven million establishments are considered small businesses. Together, they employ some one hundred and fifteen million people and contribute close to four billion to the economy through payroll. Obviously, this is a significant segment of our economy.

Of this number, only some seventeen thousand firms and slightly more than a million establishments actually employ more than five hundred people. The vast majority of these actually have less than a hundred employees. Why is this important? Because, referring back to my earlier posting, one of the primary ways of keeping insurance costs down is to spread the costs over a large number of people. An employer with five thousand employees can demand a much better price for insurance benefits than can a firm of only five hundred. The difference is so much more exaggerated when only a few dozen employees seek benefits.

At this point, it seems like the President's idea is a good one - why not let these small businesses pool their buying power to ensure better benefits for their employees? The first reason is that many of them are in direct competition with each other. If you run a convenience store, how likely are you to go to the owner of the convenience store across the street and agree to pay for each other's employees? (Hint: Don't hold your breath.)

Of course, some are not in direct competition. However, they still must budget valuable time to create a group of businessmen to work together. More time would be needed to decide which one will bargain on their behalf. More time still to work out a benefit plan with an insurance company. More time to come back to the group with no assurance that any given offer will suit the needs of any specific businessman. In other words, it is a huge investment of time and energy with no guarantee of return.

You can also see that small businesses are at a disadvantage when dealing with insurance companies. Companies with small numbers of employees not only pay more to start with, but they face greater percentage increases in buying insurance than do larger firms. The gulf in the ability to provide benefits increases at an ever increasing rate. This is the President's plan for small businesses.

If you've followed my posts, you know what I'm about to suggest. There is no need for the President to throw these brave businessmen and women upon the vagarities of the market. Rather, a system already exists by which they could provide their employees a modest level of benefits for a reasonable price. Opening the system to these small businesses would create a stream of revenue that would help drive down the cost of providing insurance to the elderly and disabled. It would immediately create a system where benefits are 100% portable.

Medicare B currently has a full cost of less than $4,000 per person. Split between employee and employer, that drops it to a very affordable $2,000 per person per year. If employee and employer are both allowed to pay for this benefit with pre-tax dollars - as are most health benefits - then the affordability quickly becomes a non-issue. Suddenly the small employer can offer health benefits that are close to being on-par with those of larger companies. Smaller businesses are now more competitive and more profitable and employees are healthier and less likely to leave employment for a better opportunity.

All that stands between this idea and its implementation is an ideological opposition to government acting in the best interest of those whom it governs. A blind adherance to such ideology would naturally claim that the health of the citizens are of no concern of the government. If so, then let it be said and opposed on these grounds. However, the government of the United States was created to guard the rights of its citizens - chief among these are life, liberty, and the pursuit of happiness - to steal a certain famous line.

How can we claim to have a right to life if we have no right to maintain that life? In a modern society, where reasonable health care can arguably increase the length of life, the breadth of liberty, and is crucial to the pursuit of happiness, how can we turn a blind eye to the forty million plus citizens who move in and out of coverage every year?

When we have the means of doing this cheaply, including as many as we can, the continuing inaction becomes a violation of the public trust. It is a destructive cancer at the heart of our country, slowly destroying true economic opportunity. It is the proof of hollow words, hollow leadership, and hollow ambition. It is un-American.

Monday, September 12, 2005

Medicare B - Changing the Math so it Works for Everyone

As anyone who is on Medicare can tell you, it isn't perfect. One of the things that is wrong with Medicare is that doctors don't like it. The reason is simple - Medicare doesn't pay as much for services rendered as do other types of insurance. Face it, if you were a doctor, you wouldn't want to get paid less for seeing patients that are almost guaranteed to need more from you.

The problem with trying to pay doctors more under the current system of Medicare B funding is that it ends up costing both recipients and the federal government more. This is not unique to Medicare, though, it is the way every single insurance company in the world works. If you are going to pay out money; then you must bring money in. So the answer is not the one uber-conservative think tanks are trying to push - the abolition of Medicare. Doing so would do a combination of two things: 1) raise the price of other insurance as those who no longer have Medicare coverage flock to private insurers; and 2) ensure that those who can't pay for private insurance simply do without any health care coverage at all.

But this line of thinking only works so long as you remain in the tight little "Medicare as it now operates" box. That's the sort of failed thinking that has led to this crisis in the first place (if you don't think it's a real crisis, read the background links listed above). What we must do is to use some creativity and put ideology aside. We have to break out of the tiny Medicare box.

The policy intiative I have been arguing for is to allow everyone to buy into Medicare B at full cost. Currently, that cost for recipients is at $78.20 per month. That reflects only 25% of the total cost, though. The full buy-in cost would be $312.80 per month, or $3,753.60 per year for one person. It isn't chump change, but it isn't a horrible price, either. It is squarely within the price range of many of the 32% of the self-employed without health insurance. It is definitely within the range of the 68% of those who already pay someone else for it. In other words, there is a distinctive segment of society that would directly benefit from this idea and are simply waiting on the ability to use it.

According to the Bureau of Labor Statistics, that would mean some eight-and-a-half million people ready (possibly) to buy into Medicare B. If only half of those bought into Medicare B, that would be an increased revenue of some $1.3 billion per month - more than $15 billion per year. Since the government already allows self-employed persons to write off up to sixty-five percent of their health care premium, the loss in revenue would be marginal. The gain to Medicare, however, would be enormous.

Medicare B is, by law, revenue neutral. That means that an increase in spending - such as that caused by increasing pay to doctors - results in an increase in payments from recipients and the federal government. The good news is that the equation works in reverse as well. If more money comes in than is used; then premiums go down. The savings from lower payments into Medicare B for the government would more than pay for the loss of revenues that the thirty-five percent of healthcare premiums that isn't deductable would bring in. In other words - the government saves money.

Let's say for argument that premiums could be brought down by $10 per month. That would save seniors money. It would also save the people who buy-in even more money - $40 per month more, to be exact. So everyone saves money. The poor old doctors, though, are left holding the medical bag and getting paid less than what they (arguably) deserve.

Again, the answer is simple. Rather than dedicating all of the reductions to lowering premiums, why not give half of it back to doctors in the form of higher payments? Wow. That was hard. As Emeril Lagasse says, "This ain't no rocket science here." So elders only save $5 per month and buy-ins only save $20 per month. Wah. Guess what? You've still strengthened the system.

Allowing doctors to benefit (albeit in a round-about way) from keeping costs down actually gets everyone on the same side of the boat. The doctor says, "I can give you this new drug that costs the system $50 per pill and get no increase this year, or I can give you this perfectly good $0.50 pill and actually help make myself more money." That's called "using self-interest" to drive the system.

This is only using the fairly small percentage of Americans who are self-employed as an example. There are many people who work full time and have no health insurance. Every week, Medicare tax is taken out of their paycheck to pay for healthcare they may never live to receive themselves. That's wrong. They should be allowed to buy-in to Medicare B along with everyone else. Based on the working principles of insurance that every health insurer in the country already uses, this will only pump more money into the system and bring the cost down even more.

This is not a national health care system. It is an option for those who want to use it - totally voluntary. If people are allowed to use pre-tax dollars to buy their insurance through Medicare B (like they are for every other health care plan); then the enrollment will only be higher - which is good for the system. It is not "big gubmint" deciding what health care you should have. It is simply the government of the people and by the people working for the people.

Friday, September 09, 2005

Medicare's Nero and Bush's Fiddle

This is the third part in a series on Medicare B. It was previously posted at Old Town Review Chronicles.

While President Bush zooms around on Air Force One, talking to pre-screened crowds about his plans for Social Security, blithely ignoring the reality that Americans hate his ideas, he is totally ignoring the real emergency in America’s Social Safety Net.

If you look at the latest report from the Medicare Trustees (www.ssa.gov/history/pdf/tr00summary.pdf) (sorry, I can't get it to work as a link). I’ll summarize for you: Medicare is in deep doo-doo. Let me hype some hysteria before I save the universe.

The DI (Disability Income) portion of the fund will begin paying out more than it takes in no later than the year – wait for it – 2007. The HI (Hospital Insurance) portion will last a full three years later and begin losing money in 2010. The worst case scenario is that both will be flat broke by 2012. However, they are supposed to last until 2023 and 2025 respectively.

To me, burning very expensive jet fuel in Air Force One to run around playing Chicken Little about Social Security while totally ignoring Medicare is tantamount to auditioning for the role of Nero. All we need is a fire and a fiddle.

The SMI (Supplemental Medical Insurance) portion – the part that pays for Medicare B – is expected never to run a deficit because the government exercised rare good judgment and passed a law that requires annual costs be automatically split between government and recipients in such a way that costs are just covered. However, by only covering those people who are both poor and most likely to have high medical bills – the “typical” Medicare recipient makes only $14,300 and has at least two chronic medical conditions – the cost of Medicare B will continue to rise. From around $66 last year, the monthly cost of buying Medicare B for beneficiaries is now $78.20.

At the lower cost, when combined with out-of-pocket expenses, it still represented as much as 23% of the average recipient’s total expenditures. If Medicare B continues to cover only the old and sick; it will continue to rise and eventually become too expensive for recipients to pay for. Already, studies estimate that only half of all eligible people actually enroll in Medicare B programs to help pay the costs of premiums. As the cost of Medicare B rises, healthy people opt out of the program, so that only the very worst remain covered. Currently, only 5% of all Medicare recipients account for 47% of Medicare B spending. 20% of all recipients account for 84% of spending. The more that healthy people that drop out the worse the program works for everyone.

The only way to reverse this trend is to use the principles of insurance. Rather than the inevitable cutting of benefits, raising of entry requirements, and/or raising of taxes, it is better – and more actuarially sound – to expand the program. If you open it, as it now exists, then the government will be bound to kick in 75% of monthly premiums. That will hardly begin to save money.

However, it can be saved by operating under good insurance principles and opening it to any American to buy into at full cost. That raises the price from $78 per month to $78 per week. That’s a lot of money. If the cost is split between employer and employee, then the total out-of-pocket is $39 per week. A rise in minimum wage of $1 per hour allows an employee to pay that without actually losing any money they already have. Granting a tax abatement to small businesses to cover that same level of expense makes it a wash to small employers.

This proposal gives millions of Americans access to health care. It protects Medicare B for older Americans, and possibly even makes it cheaper for them. It allows small businesses to build a benefits package that will compete with larger employers. A safety net that makes the market place more competitive. That should be something that both Conservatives and Liberals can get behind.

Thursday, September 08, 2005

Medicare B and the Denial-of-Reality-Right

This is the second part in an ongoing series about health care costs and Medicare B. The first part is posted immediately below this.

I am forced to admit that, as much fault as I find in Ayn Rand’s Objectivism philosophy, she did provide one of my favorite quotes in arguing for it. “A lie,” she writes in Atlas Shrugged is the worst insult you can give a man. It tells him that you find him incapable of dealing with reality.”

Reality is certainly a problem for many people on the political right. Take, for instance, this quote from the 2004 State of the Union Address, “A government run health care system is the wrong prescription. By keeping costs under control, expanding access, and helping more Americans afford coverage, we will preserve the system of private medicine that makes America’s health care system the best in the world”. Actually, it is the last part that shows a distance from reality. The Heritage Foundation was quick to pick up the lie to push its own agenda for health care, though.

The truth, however, is that by almost any objective measurement, the US does not have the best health care system in the world. For instance, Health Policy Reform actually finds that the US lags behind such countries as the UK, Germany, and Switzerland. Groups like Physicians for a National Health Program are even pushing to implement systems that emulate those in other countries.

Such efforts, however, are as much lacking a touch of reality as those of the far right. The truth is that there are too many interests vested in the current system to implement such a huge upheaval. While I believe all elephants can be eaten one bite at a time, it would be pure gluttony, and foolish, to try to eat the biggest elephant simply because it looks tasty.

Health care reform is badly needed, but it must begin with where the system is now. It isn’t exactly broken, because it works for a lot of people. What is needed is a way to make it profitable for those who lack access to the system to gain that access. That means finding a way to enlarge the system while still operating on sound. Specifically, we have to utilize the principle of risk averaging and the law of large numbers.

Risk averaging is exactly what it sounds like. Let’s say there is a ten percent chance of every person in America incurring a one hundred dollar health care bill this month. If you have a group of one hundred people; then you can be sure that ten of them will need to pay one hundred dollars worth of medical bills each. You don’t know which ones, and it doesn’t matter. What matters is the risk is averaged among the whole group. To be profitable, you only have to charge the hundred people enough to pay a little more than the total of the medical expenses. In this example, you only have to charge each of the hundred people ten dollars to break even. If you charge eleven, you make profit.

The law of large numbers says that such percentages are more precise in larger groups. The ten percent chance in the above example is for every month, so some months you’ll have more and some you’ll have less. To remain solvent, you have to maintain a large amount of reserves to cover the months when lots of people get sick. If you increase the pool from one hundred people to one thousand people; the monthly expenses get larger, but the percentage fluctuation from month to month gets smaller. If you increase the pool to a million people; then the law remains true.

In other words, insurance works best when it insures a lot of people who might need it, but won’t necessarily need it all the time. If you have a small group; then it doesn’t work so well. If you have a group that has a lot of sick people; then it doesn’t work so well. Interestingly enough, a large portion of people who do without health care fall into the first group and a large portion of people in the second group are covered as a group in violation of good insurance principles.

The first group is the seventeen million people in the country who work full-time in this country but do not have health insurance. The vast majority of these people work for small employers (less than a hundred people) where it is too expensive for the employer to provide health care benefits. These people, who are generally between twenty-five and fifty, usually have at least one child to take care of – who usually doesn’t have health insurance, either.

The second group is the forty-one million people who are enrolled in Medicare. Since only the elderly and disabled are eligible for this program, it operates against principles of good insurance. Rather than spreading risk between members, it builds risk cumulatively. The result is higher costs to the government, higher costs to beneficiaries, and higher costs to taxpayers who ultimately pay for the program.

The solution is simple. Combining the two groups would create a larger group – which by itself averages costs downward – and a healthier group – which pushes average costs downward. Providing small business owners a tax incentive to help pay for this coverage would also allow them to compete more effectively with larger companies who can afford private benefit programs. Opening Medicare B for full buy-in to all Americans (and even non-Americans – why deny a foreigner the ability to see a doctor if they can pay for it?) accomplishes this and does it in a way that makes sense – and dollars.

The only thing standing in the way of this plan is an ideology that is blind to the real suffering of both elders and working people. It is an ideology that defines as good the effects of any tragedy so long as the government does not try to mitigate the effects. It is not too much of a stretch to say it is an ideology that is killing people. It is certainly an ideology that denies reality. As Rand would say (though she would choke in fury at my using her words to justify helping people), it is an ideology that hands us, the American people, the worst insult possible.

Wednesday, September 07, 2005

The Two Most Unfair Minutes of Your Day

This post was originally guest-blogged at Old Town Review Chronicles and recently re-posted at The Art of Gettting By. It is the first in a series of posts about health care costs and Medicare B.

The first two minutes of every hour you, and every American who has a job, work is dedicated to one specific government program – Medicare. If you are self-employed, you pay the equivalent of four minutes of every hour for Medicare tax. According to the Bureau of Labor Statistics that means one hundred forty million people will pay three percent of every penny they make to make sure that Medicare has enough money to provide health care for the aged, disabled, and dependent. Even setting aside the fact that Congress has decided to cut ten billion dollars over the next four years, Medicare still qualifies as the most unfair tax paid by many Americans.

It is unfair because about three and a half million self-employed persons and well over fifteen million employees do not have health insurance for themselves. Yet every week, these employees donate an hour and twenty minutes of their pay to providing someone else with insurance. What could be more unfair than to ask someone to give up money they desperately need to provide a benefit they don’t receive themselves to someone they don’t even know?

Don’t for a minute think that it is only part-timers or teens working after school, either. The Robert Wood Johnson Foundation released a statistical report this week that debunks that favorite Republican myth. In Texas, up to a third of all employees do not have health benefits. Almost a fifth of the states have more than a fifth of their employees that are ineligible for benefits. Somehow, I don’t think there are that many kids working after school. If there are that many part-time workers; then our economy is seriously about to crumble.

Let’s not forget the kids, though. In more states than not, employees with kids but without insurance outnumber employees with kids and insurance. That puts a strain on the states’ Medicaid program – which provides insurance to poor children. That, in turn, puts a strain on the states’ budgets. That would normally mean that state governments take higher taxes from their citizens – but everyone knows that all taxes are evil. So, what it really means is that money that should go to education and other vital programs are short-changed. In other words, the pain gets spread around further, but not necessarily any thinner.

What makes it even more unfair is that it is totally unnecessary. The federal government already runs a program that would alleviate this problem. It’s the very same program these people are already paying taxes for but are barred from participating in. It’s Medicare. Medicare B is an HMO-like program where recipients pay a small monthly participation fee – currently around fifty dollars a month. The government matches this at a rate of three to one to provide health insurance. For those that don’t like “big gubment” running their lives, Medicare C offers buy-in to privately run HMOs for slightly higher costs.

If Medicare B were open for buy-in at full cost (paying all four dollars instead of just one); then a completely portable and cost-efficient basic medical coverage would be available to every American. If this were enacted in conjunction with a one dollar an hour minimum wage hike, plus a tax incentive of equal value to small employers, the cost would be fully recovered by both employer and employee. It still wouldn’t cover the cost of prescription medicines or hospitalization, but it would be a step in the right direction. If existing insurance companies were allowed to compete through Medicare C; then competition will still work to keep costs down.

More workers covered, small businesses better able to provide benefits (which results in fewer missed work days and less job turnover), and more money flowing into Medicare. Someone please tell me where there is a downside to this!

Rather than tearing Medicare apart, what needs to be done is to expand it. Insurance works best when very large groups exist to defray average costs. What group can possibly be bigger than the entire population of the United States? (Okay – technically, the world’s population, but that is beyond the scope of this discussion.) Another aspect of Medicare B is that it automatically adjusts the monthly premiums to be revenue neutral. That means that as more people enter the insured group, driving down the average cost of insuring each one, individuals are rewarded by paying a lower monthly fee. Wow! We can actually maintain benefits and lower the out-of-pocket expenses for seniors.

It isn’t wrong to stand up for those who are striving to make their lives better. In fact, it is morally reprehensible to kick them in the teeth by refusing to allow them a means to take care of them selves and their families. Medicare B is not a perfect plan. It does, however, take the injustice out of the first two minutes of every hour fifteen million Americans will work today.

Tuesday, September 06, 2005

Speaking the Unspeakable

Since Hurricane Katrina turned a near-miss of New Orleans into a backdoor sucker punch, I have been shocked to watch America turn into a Third World country. The type of devastation shown nearly continuously by cable TV would be somewhat expected in Sri Lanka, perhaps, or Bangaladesh. Seeing it in Louisianna, though, is sometimes too much to bear.

Of course, I'm fortunate. I can turn off the TV and escape. I don't have to smell the foul odors, sit in the oppressive heat, listen to the cries of despair and anger. No, I can go about my business as if it really were Sri Lanka or Bangaladesh.

That's the problem.

America is incredibly generous. Billions of dollars and pints of blood were donated in the aftermath of 9/11. The same is true for the aftermath of the tsunami that struck the Pacific islands last year. I'm sure the outpouring for this disaster will be even larger than for those two events.

There are two aspects to the problem, though. One is that I'm somehow content sitting here comfortably while Sri Lankans (and I have no idea why I'm picking on them other than I remember hearing about typhoons causing widespread destruction there) struggle and starve and die horrible deaths. The other is that I want to turn away from the Gulf Coast as if it were as distant, as mysterious, as divorced from the reality of my life as the nameless dead of Sri Lanka.

Why is it that American deaths matter more than Sri Lankans? I have no more direct connection to the citizens of New Orleans than I do to that Pacific nation. There is a language barrier, but human suffering needs no interpretation. There is a cultural barrier, but death is a cultural constant and it is mourned throughout the world when it comes in large numbers. There is only one connection to New Orleans that I lack to Sri Lanka - that a government operating in my name, supposedly by my consent, is responsible for reacting to New Orleans. Reactions to Sri Lanka are wonderful gestures, but those people do not vote in my elections and my government is no reflection of their humanity.

That is why I want to turn off the TV and leave New Orleans to the "professionals". I want New Orleans to be far away so that my connection to it does not pull me into the disaster. I want to avoid the pain - that's natural. I want to ignore the need - that's natural, too. But more than anything, I want - I NEED - to pretend that there was nothing my government could have done in my name with my tax dollars to spare the suffering. I need to believe that my government is doing everything possible to protect its citizens and to provide for the "general welfare" in the simplest of terms.

President Bush and the Republican Party did not start Hurricane Katrina and they could not possibly control where it struck. There is, however, a glaring set of evidence that demands honesty and accountability. I was pleased to hear that Mayor Bloomberg in NYC has ordered all city departments to plan for mandatory door-by-door evacuations and flooding for the potential of such a storm hitting the Manhattan area. I would be even more pleased to hear a single politician stand up and say, "We failed. It is our job to keep our citizens alive and the failure is plainly before us. We put budgets and dollars ahead of lives; patronage ahead of public safety and welfare; tax cuts and abatements ahead of building codes and common sense. We have failed - as leaders, as human beings, and collectively as a society. We cannot change this failure, but we must acknowledge it. We must face it squarely and let the full weight of responsibility rest on our shoulders. Then, we must live up to the mantle we have been entrusted and pull our people together to rebuild shattered lives, battered bodies, and devastated communities."

I'd like to hear one person honestly say, "God is merciful for sparing so many - and we ask for continued mercy from God and from our countrymen."

This is the second time in George W. Bush's Presidency that he faces a catastrophe that could truly unite the nation.

I need him to be successful. I pray for his success. However I am able, I will work for his success - and accept my part of the responsibility.

Monday, September 05, 2005


I realize that I haven't posted in a few days. I have pretty good reasons. Job interviews, teaching class, attending class, leaving town for a wedding (and a hotel that has no internet access), and today's trip to the Tuxedo Ren Faire have all conspired in keeping me away from my keyboard.

I should be back on a normal schedule - or at least make the adjustments to my new schedule - in a week or so. Until then, I simply ask that you bear with me.

In the meantime, you can read a re-tread post of mine on Medicare B at The Art of Getting By. Thanks, Janet, for letting me guest blog. Those of you whom might like a lighter topic matter once in a while may think about making her site a regular stop.

Thursday, September 01, 2005

It's a good week not to have worked your way up to mid-management:

Ford Motor Company is eliminating up to 1,000 white-collar jobs. GM is going to cut double that number.

Both companies are being hit hard by rising fuel costs that are forcing consumers to choose more fuel-efficient models - which generally means "imports". As far as that goes, I have little sympathy for either company losing market share to a better product. After all, that is supposed to be the way the market works. Better products sell more units.

If we look through the article, though, we find another problem tucked away:

"GM is seeking to cut costs as it faces vastly reduced profits this year and an expected first-quarter loss due to rising health care costs, disappointing sales and shrinking market share in North America."

In November of last year, Ford mentioned a similar problem.

It's no mistake that William Ford himself has been pushing for a national dialogue on heath care costs.

How big of a problem is it? Well, in 2001 Ford Motor Company's share of the health bill for its 500,000 workers was $2.5 billion. That was a single-year rise of over 25%. Don't get sucked into the idea that it's all about health care law suits, either. Ford sites its single biggest problem is providing prescriptions to its retirees. Put simply, those who use the most medicine are bankrupting the system.

But you can't blame them for doing so. After all, the whole reason for having insurance is to use it when you get sick and these are people who have worked their whole lives to make Ford Motor Company one of the biggest automotive companies in the world.

In the early 1990s, Ford went on a buying spree and picked up British Leyland, Isuzu, Fuji and part of Fiat. It actually gets tricky trying to figure out what Ford owns - Fuji and Subaru merged and the new company bought out Isuzu and also bought a minority share of the Brazilian operations of Cummings diesel (which is why the upsized F-250 diesel was a big hit a few years back). Ford owns Landrover and Jaguar (suddenly that Jag isn't so wonderful when it's just an expensive Ford). They also own Mazda, Panoz, Saleen, and Volvo.

With all of the big powerful engines and sports cars, it would be easy to think of Ford as trying to compensate for some inadequacy. In fact, I believe that is exactly what they are doing. They are trying to compensate for inadequacy of health care costs.

Almost every country in which Ford (and GM) snapped up subsidiaries has some sort of universal health coverage. It is the government that faces escalating health costs, not individual employers. Obviously, the government then passes on the costs in taxes, but that cost is spread out so widely that it doesn't threaten the livelihood of the companies. It should be telling that almost all of the cuts in both GM and Ford have taken place in THIS country while workforces in countries with universal coverage have actually expanded - including our northern friends in Canada. Why hire an American engineer and face millions in additional health care costs as he or she ages when you can hire on only a few hundred miles to the north and NEVER FACE A SINGLE HIKE IN HEALTH INSURANCE COSTS?

I disagree with William Ford. It's long past the time to have a national dialogue on health care and health care costs. We spent the entire twentieth century talking. It's time to do something - and not something stupid like limiting liability for malpractice. It's time to move forward on providing basic health care for everyone. Every minute that we don't, we are costing people lives and businesses money. Lives, of course, should be more important than money, but this is America - and we love our businesses that worship the Yankee Greenback.

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