HEALTH CARE, ONE LAST TIME

The recent Democratic political debates made clear only that there was utterly no clarity as to either the problem or any common-sense way of fixing that problem.  I have written too many times before what the problem with health care is and how best to go about fixing it.  I do it again this one last time.  If you think it makes sense, please pass it on to anyone who might be interested, including legislators and other people in office.

 

 

The problem with health care in America is that it costs way too much and that it doesn’t cover everyone.  Oddly enough, those who are covered are probably over-covered.  Consider.  You have health insurance.  It covers your medical bills, and your premium reflects the cost of that care.  You have homeowner’s insurance.  It covers some of those same bills, and your premium redundantly reflects the cost of that care.  You have auto insurance.  It covers some of those same bills, and your premium again reflects the cost of that care.  You may have worker’s compensation coverage, which may cover those same bills, general liability insurance, which may cover some of those same bills, and Medicare and Medicaid, which may cover some of those same bills.

Because you may have more than one insurer providing for your bills, the insurers who paid the bills try to see if they can get another insurer to reimburse them.  It is a process called subrogation, and it is a remarkably huge industry.  It is also very expensive.  It is also completely worthless.  Not very long ago, the administrative cost of insrance was 5% of the expense of insurance.  That cost is now a startling 35% of the cost of insurance.  That increase is due, in large part, to subrogation.

So, what do we want?  We want everybody to have health care, and we want to greatly reduce the cost of that care.  We do not, however, want to simply shut down the existing health insurance system.  That would be throwing away a huge trove of institutional knowledge.  So we want to do all this while still taking advantage of the men and women who have been running our health insurance for lo these many years.

We who are already insured also want the right to keep the insurance that we have.  Note, however, that that doesn’t mean we want the same insurance company, but rather that we want the same insurance coverage.  I really don’t care if my insurance is called Blue Cross or if it’s called Uncle Willy’s Midnight Insurance Company.  What I want is to know that I can keep the doctors I have and that their services will be paid as they always have.

So here is how you do all that.  Run health care like a utility.  Grid the country.  Auction off the grids to the highest bidder.  If nobody wants a particular section, let those people be covered by a public option.  Give the high bidder a monopoly in the area.  Put a Public Service Commission over it to protect the people against gouging.  Dictate to that bidder what coverage it has to provide.

And then, outlaw subrogation.

There is not enough space here to show why subrogation is a total waste of time.  Look, however, at what it does to your other insurance coverage.  Take medical expense out of worker’s compensation and you will automatically reduce the cost of worker’s compensation by over fifty percent.  Remove medical expense from personal injury claims, and you will slash the cost of auto liability insurance, homeowner’s insurance, products liability and medical negligence insurance.  And more.

What you get in return is the power of the entire nation to use its collective weight in negotiating reasonable prices from medical product providers and drug companies.  You also get a voice as to whether some guy running an insurance company deserved twenty or thirty million dollars a year for whatever it is he or she does.  The insurers and the drug companies will also likely slash their advertising, generating another huge saving.

There are problems here, not the least of which would be a loud lobbying pushback from those whose profits would be greatly reduced with such a plan.  In the end, though, this is about the people’s health, the interests of the people, and in the end that must ultimately be what we need to achieve.

So send this around.  I’m going to do the same.  The way I’ll know is right is if it receives a loud condemnation from those enjoying huge profits on how we do it — or misdo it — now.  Cheers.

 

TRUMP IS A SOCIALIST

Words have meaning.  It is a fundamental rule of reasoned discourse that, when we use words, we promise that we are giving the words we use their true meaning.  The only people who do not give words their true meaning are the ignorant and the devious.  Ignorance is forgivable.  Deviousness is not.

I am a socialist.  So are you.  So is Trump.  Why?  Because socialism is not a fixed thing.  It is a continuum, like “hot” and “cold” and “long” and “short.”  Socialism is not a fixed political doctrine.  In fact, it is not a political doctrine at all.  It is an economic doctrine, like its contrary, capitalism.  Democracy is a political doctrine, as is its contrary, autocracy.

We Americans live, not in a capitalist country, but in a democratic country.  Our economic theory is somewhere in the center of the capitalism/socialism continuum.  We socialize all kinds of things — military defense, police protection, public education, roads and highways and bridges,. Interestingly enough, we often use capitalist means to achieve our socialized goals.  We hire private, for-profit companies to build military equipment.  We hire private companies to build and maintain our roads and bridges.

We even socialize our governmental representation, our legislative and executive and judicial functions.  Trump’s salary, and the money we pay to fly him and his wife and family around the world, is socialized, paid by funds obtained from all of us.

Because socialism and capitalism are economic doctrines, and because democracy and autocracy are political doctrines, there can be, and are, socialist democracies (e.g., Norway, Sweden, Denmark, Germany, etc.) and capitalist autocracies (China, Russia, Vietnam, etc.).

We now face a long and painful presidential campaign.  A main issue in this campaign is whether or not we should socialize the cost of medical care.  That means whether or not this democratic country should create a plan that insures that each person in this country will be provided basic health care.  Since we are the only developed country in the world without such a plan, it is likely a good idea to do it.  In fact, we have already socialized the cost of medical care in some very significant ways, including Medicare and the medical treatment of our veterans.  The real debate is how best to accomplish that goal for all, how, for instance, to involve the existing for-profit medical providers and insurers in the execution of that plan.

Trump and his henchmen have chosen to abandon the meaning of words and condemn the whole idea of universalizing the expense of health care.  To do so, they have thrown away the meaning of words.  They use the word “socialist” to imply, not an economic doctrine, but a political doctrine, and a seriously ugly one at that — communism, Stalinism, the doctrine of political oppression..  They do so, not out of ignorance, but out of deviousness.  That is unforgivable.

It will not be easy to find the right candidate for president in 2020, but I recommend one measuring stick.  Find the candidate who insists on being true to the meaning of words.  Vote for that person.  Above all, stay away from the devious.  I assure you that what they mean is not in your best interests.

 

P.S. (KRONENWETTER)

In the first paragraph of my last blog, I mistakenly said Clinton called half of all Americans “deplorable”.  What she actually said that half of Trump voters were in a “basket of deplorables.”  While the point remains, I apologize for the mistake.

DON’T BLAME KRONENWETTER

It is a sad but well-evidenced fact that people in politics, the press and other forms of public life often make harsh observations about large swaths of our population with little or no grounds for doing so.  Witness, for example, Mitt Romney’s assessment that 47% of Americans are freeloaders, or Hillary Clinton’s characterization of nearly half of Americans as “deplorables.”  None of us entirely escape this tendency.  It is an essential part of our prejudices — that black people are inferior. that Muslims are anti-American, that Jews are somehow sinister.   These are all common holdings, and these are all  unfounded.

Recently the press has taken to making one of these unfounded  characterizations about what they like to call Trump’s “base.”  Using poll findings about people inclined to vote for Trump, the press announces that the “base” makes up 35-40% of the population.  It then paints the entire group with a single brush, announcing that the entire group endorses Trump and everything that he has done, is doing and proposes to do.  They are, the press concludes, therefore endorsing his racism, his sexism, his misogyny, his fondness for dictators, his dedication to the superrich, and, most devastating of all, his commitment to raw self-interest.

In doing this, the press makes several glaring mistakes.  First, the people who did vote for, and may intend, at the moment, to vote for, Trump again, are a far more diverse group than those misguided folk at Trump’s rally chanting “SEND HER BACK!”  People voted for Trump for a variety of reasons — religious (reverse Roe v. Wade), financial (cut taxes), or merely frustration (Hillary would be worse).

Secondly, many, many of these voters have motivations and ideals far removed from that small group of people who are as politically and morally depraved as Trump.  I give you, as a clear example, Kronenwetter.

In the runup to the 2016 election, I volunteered to canvas for the Democratic party in north central Wisconsin.  I was assigned to Kronenwetter, a suburb for the fairly substantial city of Wausau.  The first person I approached was out cutting his lawn.  I asked him if we could talk politics, and, with a welcoming smile, he said, “Sure, but I’m voting for Trump.”  I was to hear that from virtually every person I approached.  It was clear to me that the vast majority of the people of Kronenwetter were going to vote for Trump.

I got to make some other observations about these folks, however.  They were friendly, thoughtful, willing to reason and discuss.  They were family people with young children.  Judging on the number of churches in the area, they were religious people.  Their homes were modest, but it was clear that they did as much as they could to maintain those homes.  They all indicated they would vote, and so they are obviously interested in the issues affecting their community.

In sum, these were folks with a substantial moral base.  They care about their families and their communities, and their political issues reflect that care.  They want what we all want — good education for their children, good health care for their families, good wages to provide for the basic needs of their families, with maybe a bit more for a boat or a vacation trip.  They do not seek large fortunes, and they would never, ever undermine someone for their own profit.

They very likely voted for Trump because they felt they had no choice.  They are also likely disgusted at the conduct and language of Trump.  In sum, these are not the kind of people who show up at Trump rallies.

So it is a gross mischaracterization to say that 35-40% of our population endorse the conduct, and misconduct, of Donald Trump.  It certainly shouldn’t include the good folks of Kronenwetter, and it is likely not to include suburban areas like Kronenwetter around the country.  All those good folk, however, will be asking the same question when they go to vote that they asked in 2016 — which candidate will be best for my family and my community?

It is up to the Democrats how that question will be answered.  If they do not put forth a candidate who addresses those questions in a way that meets the concerns of those families, those good people will very likely hold their noses and vote as they did in 2016.

The mobs that populate Trump’s rallies cannot even come close to having him reelected.  It is the Democrats who have that power.  Whatever else they do, they had better talk to the folks in Kronenwetter.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Poll (this one is from Jed, the other creator of WeTheCenter)

TALK TO ME

I have been making a serious mistake, and because of that mistake I am announcing a new direction for this site.

This morning I got up and turned on the radio.  The stations to which I typically listen had been consumed with Trump this and that and Kavanaugh this and that.  But that was all over, and I wanted to hear about the issues of the day, about the coming storms in Florida and the international warnings about global warming and about the coming elections and all.

What I heard instead was the rehashing of Trump and Kavanaugh.  Trump’s a crook, blah, blah, blah.  Kavanaugh’s a liar, blah, blah, blah.  Then it dawned on me that the radio stations to which I, as a liberal, am routinely tuned were just saying what they thought I wanted to hear.  And the same was likely true for the stations to which conservatives were tuned.  These stations weren’t doing the news.  They were selling a product.

Then a second thing dawned on me.  I was doing the same thing.  With the exception of one dear conservative friend of mine, my audience is generally liberal, and I have been telling them what they want to hear.  I have been honest, and I hope I have been insightful, but I have also been selling a product.  That is precisely what has gone wrong with political speech for the past several years.  We haven’t been talking with each other.  We haven’t been reasoning together.  We haven’t been talking with each other.  We’ve been caricaturing and ridiculing.

Democracy is not in danger because of Trump.  It is in danger because of us.  Democracy, government by, of and for the people, only works when the people participate.  How?  Well, by voting, for one.  In that regard, it is relevant to my point that in the United States, particularly in mid-term elections, the turnout can be as low as thirty percent of the people.  For another, though, we participate by talking things out.  That is what we do, or should do, with our families and friends and neighbors.  And that is precisely where the news stations are failing me, and it is where I am failing you.

So.  We need to talk, and from now on this space is the place where we can talk.  You will find below a button for comment.  Press it.  Comment.  One rule only the rule on which this site was founded:  reasoned discourse only.  No yelling, no ridiculing.  Let’s talk.  Let’s invite others to differ, and let’s listen to what they have to say, and let’s think about it and talk some more.

I’ll start, on a very tough topic.  Abortion.  Is the implanted ovum a human?  Of course it is.  Can we kill humans?  Yes, we do it all the time.  We kill millions by allowing smoking and drinking and pollution and untested chemicals and many more.  So the real question in abortion is:  who should decide whether an abortion should be done?  A judge?  A legislator?  A religious figure?  Or the woman carrying that human?  The Supreme Court says that, at least until that human is able to live on its own, the decision should be the mother’s.

What do you think?  Talk to me.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FOX GETS A JUSTICE

Recovering alcoholics often talk about “hitting bottom.”  By that they generally mean reaching that point where you finally surrender to your powerlessness over alcohol, where you are finally willing to do whatever it takes to escape its clutch on you.

I have wondered for some time when and how we would “hit the bottom” of our descent into the political pit down which we have been going for the past decade and more.  During that time, we have traded reasoned discourse for the rhetoric of ridicule and caricature.  We have traded calm and measured interchange for shouting and labeling.  We have treated political issues, not as key elements of our commitment to the American ideal, but rather as selling a brand.  We have, in sum, succumbed to the addiction of self-absorption and of enmity toward those who would oppose us.

The Kavanaugh affair provides some hope that we have finally reached our bottom, and that we will, on reflection, be brought, through that affair, to recognize how profoundly our addiction to the politics of enmity has damaged our commitment to the American ideals and the American way of government.

Brett Kavanaugh presents the purest example possible of the installing of a governmental figure purely to attain political goals.  He is certainly not the most intelligent candidate available.  After all, what intelligent person would deliver the snarling tirade that he did?  Clever, maybe.  Intelligent?  Not so much.  He has made it clear that he is going to the Supreme Court to carry out the wishes of those who nominated him.  He has repeatedly lied to Congress.  When attacked for it, he followed White House orders and showed up on Fox News, that television station noted most for its blind commitment to right wing causes, and he claimed, ironically, that he was actually seeking “fairness.”  He will vote to repeal Roe v. Wade.  He will vote to repeal the Affordable Care Act.  He will vote to limit the rights of victims of sexual assault.  He will vote in approval of deregulation and the slashing of benefits for the needy.  He will stand in lifelong opposition to the consideration of the rights of others than those who have put him on the Court.  He will, in sum, be anything but the considerate and fair-thinking jurist that we so desperately need on the highest court in the land, the last bastion of reason in a politically tilted America.

Our salvation will come in waking up to what we have done here.  We have finally driven our politics of opposition all the way to America’s court of last resort, the one place where reason has a chance to triumph over partisanship.  I think, I hope, that the thinking and caring people of the United States will wake up and realize that the politics of opposition is the doorway to the death of the American way of government.  As I have said before, we are great, and we have always been great, not in our economics or our military might but in the profound meaningfulness of our ideals.  We are great, and we have always been great, because our country is founded on, and exists for, the inalienable rights of all human beings.  We were far from that ideal at our inception, but we have crept, in fits and starts, toward its realization.  We conquered slavery. We rejected genocide.   We recognized the rights of women.  We gave aid to the unfortunate and the oppressed and the downtrodden.  We have taken many steps backward, but always we made net gains toward the fulfillment of those ideals.

Bret Kavanaugh stands as a personification of what happens to us when we stop working toward the American ideal.  I think we will realize that.  I think we will, in that realization, find a way to return to the pursuit of the ideal of the inalienable rights of others.  I think we will surrender, that we will do whatever it takes to get back to being real Americans.

So long as he remains on the Court, Bret Kavanaugh will remind us how easy it is to abandon our ideals, and how lethal it is to do so.  We are just too good a people not to see that.  We will not just survive this.  We will rise from it.