Showing posts with label healthcare musings. Show all posts
Showing posts with label healthcare musings. Show all posts

7.22.2009

One Giant Leap

Working in Gary Indiana this week. And next week. Oh, and the week after that. Sweet.

I’m confused. Six months ago banks stocks were tanking, financial institutions were hemorrhaging money and taxpayers were turning over their life savings to bail them out. It was generally agreed that this was a bad thing. Yesterday, Goldman Sachs and J.P. Morgan Chase notified Wall Street that they had repaid the billions of dollars loaned to them under the TARP (money many “experts” swore we would never get back), and oh, by the way, made a neat little profit on the side. Sweet. That’s what we wanted, right? Wrong. Apparently there are some people who believe this is somehow also a bad thing. They’re wrong, but they’re loud and annoying and obscuring a very important detail. The market is experiencing somewhat of a recovery. Instead of watching the stock ticker bleed all over their balance sheets, many of the bulwarks of the American economy are actually beginning to reverse their 10 month tailspin. That, is a good thing. General Motors emerging from bankruptcy in 45 days instead of the “impossible” 60 days promised by the government, is a good thing. The fact that factory orders new home starts and consumer purchases have increased over the last quarter, is a good thing. The fact that in spite of record deficits and unprecedented levels of borrowing inflation is still virtually non-existent, is a good thing. Yes, things are still bad, but they’re better than they were three months ago, which is better than they were six months ago. It’s sad to actually have to remind people of this, but improvement is always good. Get a grip people!

Apparently, some people think they voted for Jesus Christ on November 4, 2008, instead of Barack Obama. Two months prior to the election, the American economy completely imploded. In less than six months the market lost nearly half its value, icons of Americana were driven out of business and the unemployment rate almost doubled. President Obama took office in late January, and by April politicians, reporters and citizens alike were demanding to know why he hadn’t fixed the economy. When did we exit reality and enter bizarro world? Things take time. Something we don’t seem to have any concept of anymore. We’re like a bunch of four-year-olds on a road trip to grandma’s house driving our parents crazy asking, “Are we there yet?” as soon as we pull out of the driveway and every five minutes after that. How about we cut back on the double shot expressos and give things a little time to work. If by January 2011 the stock market is hovering around 7,000, the Federal Reserve has major banks on life support and unemployment is still rising at a rate of half-a-million jobs a month I will entertain all the critics.

And now for this week’s musings on healthcare. There’s been a lot of talk on Capitol Hill, leading to stark raving panic regarding the projected cost of a proposed healthcare overhaul. The Congressional Budget Office pegs the cost of the current House proposal at about $1.6 trillion over 10 years and the cost of the most recent Senate proposal at approximately $600 billion over 10 years, averaging about $1.1 trillion over the coming decade. Sounds like a lot of money, doesn’t it? Congress seems to think so. At the mere mention of a trillion dollars Republicans call down lightning from heaven to smite the socialist president while Democrats run for the hills and beg for the rocks to fall on them. But let’s put that number in perspective, shall we? Like Denzel Washington said in Philadelphia, “Explain it to me like I’m a six-year-old.”

One trillion dollars over 10 years. The most recent calculation of US GDP (gross domestic product) puts the market value of all final goods and services produced within our borders within the year at approximately $13 trillion per annum, $130 trillion over 10 years. That puts the cost of this healthcare reform at a whopping 0.85% of the US economy. According to RNC chairman Michael Steele, this 0.85% of American wealth is too much to risk to ensure healthcare to 97% percent of our citizens.

If you prefer to reduce these to annual figures, healthcare breaks down to about $110 billion dollars a year. In comparison, this country spends almost a trillion dollars each year on defense-related purposes. This country spends nearly ten times as much per year on defense as Congress is thinking about spending on healthcare reform. Ten times! In 2003, 47% of the WORLD’S total military spending was spent by the United States. By 2005 the United States was spending almost as much on defense as the rest of the world COMBINED. And none of that includes the black ops budget. Why is it that we can always seem to find enough money to blow things up, but have such difficulty finding the cash to keep people healthy?

Also, I’m a little tired of all this garbage about a friend of a friend of a nephew of an aunt of a monkey’s uncle told some Republican senator from Kentucky about how his brother’s niece died in Canada because they were denied treatment due to rationed care. How many people die in this country every single year from being denied cancer treatment or AIDS medication or heart surgery or whatever else because their insurance company decided they had exceeded their coverage limit, or had a pre-existing condition, or weren’t covered under the particular plan, or simply weren’t covered at all? Quit pretending there is nothing wrong with current system. Quit trying to frighten people by relating anecdotal stories for which you have little to no proof while ignoring similar anecdotal stories occurring under the very system you are trying to defend. Please. PLEASE. Give us something more than the worn out politics of fear and loathing.

It’s been a rough couple of weeks for ESPN reporter Erin Andrews. Twelve days ago she was hit square in the chin by a foul ball during a Mets-Dodgers game and had to be taken to the hospital. Then, a few days ago, a hidden camera video hit the web of Andrews naked and changing in her hotel room. I understand that there is a huge market for videos of attractive women without their clothes on. But there is a significant difference between Kim Kardashian knowingly selling the private videotape of her sexcapades with her boyfriend for distribution over the internet, and a some creep drilling a hole in a hotel wall, inserting a camera, invading someone’s privacy and exposing a private moment never intended for public consumption to the rest of the world. There is a line. Don’t cross it.

Tiger Woods missed the cut at the British open last Friday. Wow. The apocalypse is nigh.

Finally, this week marks the fortieth anniversary of the moon landing. Forty years ago Neil Armstrong became the first human being to set foot on an extra-terrestrial body. Five other landings followed Apollo 11, but no one has returned since the end of 1972. NASA recently announced they are working on rockets that could carry men back to the moon by 2020. Why they can’t simply borrow the rocket they used in 1969 from the Smithsonian is unclear. What’s wrong with this picture? In 1970 NASA developed a plan to put a man on Mars by 1987. Yet in 2009 NASA is trumpeting sending men back to the moon by 2020. You want to know why America has lost interest in space flight? Because in 40 years we have accomplished pretty close to nothing. You want us to be excited? Give us something cheer about.

7.02.2009

Don't Cry For Me Argentina

One test down, six more to go. I think the rate of monetary compensation for a professional career is inversely proportional to the length of the professional exam.

Today, (well, yesterday by this point) is Canada Day. It is a very youthful 142 years old. Happy birthday Canada.

I take ONE week off, and all hell breaks loose. Can’t a man just take a break?

Last Thursday on my way to dinner I was flipping through the channels of my free trial satellite radio when I stumbled across Chris Cornell’s cover of Billie Jean. It was followed by the Alien Ant Farm version of Smooth Criminal and a Fall Out Boy rendition of Beat It. At the time I thought it nothing more than an interesting combination of clever cover songs and moved on to the next one. Only when I arrived at the restaurant and glanced up at the television in the corner did I realize that Michael Jackson had passed away.

Unlike a lot of people my age, I didn’t grow up on Michael Jackson. Pop music wasn’t allowed in our house, and MTV might as well have been the Playboy channel, so I don’t have the same frame of reference as the thousands of people that gathered outside UCLA medical center or the Apollo theatre. The Michael Jackson I remember slept in an oxygen chamber, replaced his nose every other week, and lived with a chimp named Bubbles. But in spite of all the weirdness, Jackson’s influence on music and pop culture is undeniable. High schools in the 80’s were filled with white gloves and leather jackets with more zippers than stitching and black penny loafers moon-walking the halls. “Thriller” killed the radio star, on a channel that prior to Michael Jackson refused to air videos from black artists. He brought Rhythm and Blues into the mainstream and inspired the work of generations of performers, including a white grunge singer from Minnesota, an alt. metal band from Southern California and a pop punk sensation grown in Illinois, not to mention prison dance troops in the Philippines. We truly have lost a legend. Sleep well Michael Jackson. May you find in death the peace you never found in life.

Rough week for deaths. Five hours prior to Michael Jackson’s passing, actress Farrah Fawcett (of Charlie’s Angels fame, among other things) lost her battle with colon cancer. And two days before that we lost “Tonight” Show veteran Ed McMahon at the age of 86. Apparently there’s an old adage that death comes in threes – the old, the sick and the sudden. But if you ordered last week, death would throw in a fourth celebrity for free. (My tribute to Billy Mays. Late night infomercials will never be the same without him.)

For Nevada Senator John Ensign, what happened in Vegas, at least stayed in Nevada. South Carolina Governor Mark Sanford wasn’t so lucky. After losing a battle with both the South Carolina Legislature and Supreme Court over federal stimulus money, Sanford simply disappeared. He drove away from the state capitol in a black SUV and dropped off the face of the earth. No one saw him or heard from him for seven days, during which time the lieutenant governor was forced to assume Sanford’s responsibilities. Then, as suddenly as he’d left, Sanford reappeared at the airport in Atlanta, his office claiming he had been “hiking the Appalachian Trail,” (on National Nude Hiking Day, over the Father’s Day Weekend), and was surprised by all the attention the disappearance of a state governor was receiving in the media. Less than 24 hours later, the governor realized that pathetic excuse for an excuse was never going to fly, and decided to come clean. So, after ten minutes of near-incomprehensible blather at his press conference, Sanford broke down and told the truth. He had not been hiking the Appalachian Trail after all. He had been in Argentina. Having an illicit affair. With a woman who was not his wife. Surprise! Sanford went on to admit that on several occasions he used taxpayer-funded trips to Argentina to visit his mistress, but most people tuned out after “I’ve been unfaithful to my wife.”

I don’t care that Mark Sanford cheated on his wife. Personally, I think that the correct way to handle falling in love with someone in a foreign country who is not your spouse would be to divorce your spouse, resign your position and then run off to Argentina, but what do I know. I don’t really care that he lied about having an affair - it’s embarrassing, who would want to admit to that. I don’t even care that the local newspaper surrendered whatever journalistic integrity it had by holding on to the e-mail communications between Sanford and his mistress for five months without reporting it. What irks me about the Mark Sanford circus is the fact that this clown refuses to resign his post as Governor of South Carolina. A decade ago, then Congressman Mark Sanford voted in favor of three of the four articles of impeachment against president Clinton because he felt leadership demanded a “moral legitimacy” that Clinton had surrendered by his infidelity. This means one of three things. One, Mark Sanford was lying. He’s never believed in “moral legitimacy” and certainly isn’t about to start now. Two, Mark Sanford believes that only Democrats need “moral legitimacy” in positions of leadership. Or three, Mark Sanford believes that “moral legitimacy” is a requirement for every leader EXCEPT Mark Sanford. That he, and he alone is somehow greater than the sum of his faults. That the fact that he espouses a belief in lower taxes gives him the right to use those taxes to fund his illicit “business.” That he is so special, so valuable to the bigger picture, that the rules don’t apply to him. The smart money is on option three. At a press conference the following day, Sanford compared himself to the biblical King David, chosen by God to lead his nation in spite of his marital infidelity. Mark Sanford believes he is in the same league with King David. And he lamented Bill Clinton’s hubris. It’s one thing to fail to live up to standards someone else has set for you – or even standards you have set for yourself. But its another thing altogether to fail to live up to the standards by which you judge everyone else.

The Minnesota Supreme Court finally ended the farce surrounding their senatorial election today by declaring Al Franken the winner of the state-wide recount by a margin of about 300 votes. All it took was seven months. Even Florida figured it out in the same calendar year. To his credit, now former Senator Norm Coleman conceded immediately after the verdict was delivered, paving the way for Minnesota to regain full representation in the Senate, just in time for major votes on healthcare, climate change and judicial confirmations. It also gives the Democratic Party the ability shut down any Republican attempt to filibuster legislation, provided they can show the same level of discipline their opponents routinely muster on the issue at hand. But the chances of that are slimmer than a supermodel on a cucumber diet. As Will Rogers so eloquently put it, “I am not a member of any organized political party. I’m a Democrat.”

Let’s get a few things straight about this healthcare debate. I keep hearing that the United States has the best healthcare system in the world. American’s also believed they manufactured the best automobiles in the world, but they were wrong about that too. According to the last ranking of world healthcare systems by the World Health Organization, the United States ranks 37th, behind such beacons of science and technology as Oman, Cyprus and Morocco. Yet on the list of most expensive healthcare systems (as a percentage of GDP), the United States ranks second. India’s largest growth industry is medical tourism. Why? Operations costing over $100,000 here are performed for less than a third of that over there - often by U.S. trained and educated doctors. American healthcare the best in the world? No. The most expensive? Yes.

Every day Fox News runs an hysterical story on how millions of Canadians are streaming across the border every year to get treatment they would otherwise have to wait for in Canada. Let’s be honest, some of that does happen. But while we’re being honest, let’s tell the rest of that story. Many - if not most - of those Canadians are on waiting lists for elective surgeries, some for vanity surgeries. And while it is true that some Canadians have to wait for advanced medical care, isn’t it also true that many Americans are denied advanced medical care under the current system because they can’t afford to pay for it and their insurance company refuses to cover it? Is having to wait for treatment somehow worse than being denied treatment?

The argument pushed by opponents of an optional public plan always attempts to raise the specter of some government bureaucrat deciding what treatment you can and can’t receive. But right now, some bureaucrat from Blue Cross/Blue Shield, or Aetna or Humana decides what treatment I can and can’t receive. What’s the difference? Anyone who has ever dealt with private insurance knows it’s FAR from perfect. Public insurance is at worst, an alternate bureaucracy. If you like your private insurance bureaucrat, stay with them. If you think you’d hate the government bureaucrat less, switch. It’s not that difficult. “But Mark, private insurance companies will never be able to compete with a public plan and they’ll be driven out of business!” What a load of doo doo. For eternity conservatives have been telling anyone who will listen that competition is what drives innovation, improves quality and holds down costs. They have also built an entire political platform on the idea that government can do no right, that everything government touches becomes slow, inefficient and doomed to failure. (Somehow none of these indictments seem to ever apply to the military.) So, by their own logic, they have absolutely nothing to fear from a public insurance plan. Forced to compete against private plans providing higher quality services at lower prices, the bloated, cumbersome waste-of-time public plan will force everyone back to private insurance in a matter of months, right? Right? I hear crickets chirping.

The bottom line on healthcare is this, reform is going to cost money. In typical American fashion, everybody agrees that the current system is a failure, but nobody wants to spend any money to fix it. Everybody wants the perfect solution to his/her individual problem at the expense of the rest of the system. It is the reason universal single-payer healthcare will NEVER work in America. This country has been spoiled by too many buy one get one free sales at Walmart. You CANNOT get something for nothing. Don't demand drastic change one moment, then feign shock and awe when you discover the cost. America needs to make a decision. We either accept the system as it is or we change it. If we accept it as it is, then accept that tens of millions of people are going to continue to go without insurance, millions more will lose coverage when they lose their jobs and costs will continue to skyrocket. If we decide to change it, then accept that change is going to carry a significant price tag and quit whining about the numbers.

Additional audio tapes (what?) of former president Richard Nixon were released to the public last week. I didn’t think it was possible to loathe this man anymore than I already did, but people continue to surprise me. On one of the tapes, Nixon can be heard discussing the Roe v. Wade decision issued the day before with several aides. While somewhat ambivalent regarding the concept of abortion, we worried that greater access to it would foster “permissiveness,” and “break the family.” Then he made the following statement: “There are times when an abortion is necessary. I know that. When you have a black and a white, or a rape.” The then President of the United States felt abortion was a bad idea - unless the baby was interracial. Then it was perfectly okay. What a lovely human being. Fortunately we are light-years ahead of where we were only 36 years ago.

Last week, the Supreme Court decided 8-1 that the strip-search of a 13-year-old eighth-grader by middle-school officials in Arizona rumored to be providing ibuprofen to classmates constitutes an illegal, unreasonable search under the Fourth Amendment. I don’t know what’s more disturbing; the fact that otherwise rational adults decided to strip a 13-year-old to her underwear looking for not crack, not heroin, but Advil, or the fact that Justice Thomas doesn’t see anything wrong with that. Even Scalia and Alito got this one right.

Finally, Kodak has announced they will discontinue Kodachrome film due to declining sales volume. What is this “film” business? I’m kidding. I remember film. In fact, I had three rolls developed just last week. (Can you believe it used to come in rolls?) I don’t think I’ve ever shot anything on Kodachrome, but we’ve all seen Kodachrome images, like the famous National Geographic cover photograph of the Afghan girl with the bright green eyes. It was bound to happen, film is rapidly going the way of the 8-track, but I am a little sorry to see it go. There is something comforting about the lineal nature and the permanence of film that just isn't present with digital photography. Sorry Paul. They’ve taken your Kodachrome away.