Health Reform Success Criteria: Part 2

OK, so the other day we talked about some basic things that would make for good health care reform: denying the "preexisting condition" clause that health care companies pull, and requiring that everyone sign up for health care insurance if they could afford it, and government assistance for those who can't.

With all of that money rolling in from an additional 50,000,000 new clients, this gives insurance companies plenty of money to provide care for people. But we still have a basic problem of how do we know we're getting *good* health care coverage? What's to stop the health insurance companies from just running off with the money? What if you sign up with a health insurance company because it's the cheapest - then find out you're going to die because the only thing they cover are cotton swabs and you signed up for a crappy insurance service. Congratulations, it's the market at work, and now you're going to die!

Yeah. Doesn't sound that great to me. So there are few more reforms so we can make sure we get a good health care system.

Minimum Health Care Standards

One of the things I got our of reading Tom Daschle's book is the idea of the Government Health Agency - kind of like the FDA or the FED. Now, hold up. People are now going to start running screaming through the streets. OMG THE GOV'MENT IS GOING TO TELL MY DOCTOR WHAT TO DO! WE'RE ALL GOING TO DIIIIIEEEEE!

As opposed to know, where INSURANCE COMPANIES TELL YOUR DOCTOR WHAT THEY'LL PAY FOR, YOU GIT. That's right. When you go to the doctor, and they say "Guess what - you need to have your filangee removed - but your insurance company doesn't cover that," you've just had a private industry bureaucrat decide your health care procedures.

That's not to say the doctor *won't* remove your filangee anyway - but now you have to pay for it out of your own pocket. That's what already happens, folks - if the insurance company doesn't pay for it, you have to.

What the Government Health Agency (GHA) would look like - if you follow the Daschle plan - is a committee formed of various doctor representatives, nurse representatives, some insurance representatives, patient advocacy representatives, and some others. How these will be selected is probably the same way the Fed is - the President appoints someone, Congress approves, and off we go.

The GHA would look at the various diseases and treatments out there, then say "OK - if you're a health insurance company, by law you have to provide these minimum things. Like, check ups every six months with tests A, B, C. If someone gets leukemia, you have to pay for X percent of bone marrow transplants. You must provide contraceptives for women as part of the package. So on and so forth."

Now, if a health insurance company wanted to offer *more* than the minimum government mandates amount, great! It's like how some states require car insurance if you drive - they have to offer at least a minimum coverage amount, but then insurance companies compete over who can offer more coverage and what kinds at the cheapest price.

This makes sure that everyone, even the people who get the cheapest health insurance, at least gets certain minimum of care. Highest on my list would be preventative measures, like checkups every six months with tests like mammograms for women, prostate checks for men - simple things that can detect diseases far before they get into trouble.

Now, with that, there will have to be minimum standards for the patients as well. If you don't get your checkups every six months or so, or don't show up for your tests - you can't complain if you get sick. Now, if you do the things you're asked to do - within reason, of course - and you get sick anyway, then the insurance company has to cover what they contracted to.

This does two things:

1. Makes sure people are getting preventative care which reduces costs for health insurance companies and the patients.

2. Makes sure insurance companies don't go broke when people people get sick, because they'll be catching diseases at the earliest, most preventable state. And, if they're really smart, they'll encourage patients to do things like lose excess weight, watch their diet, so on and so forth.

There is one other element that I believe will make health care reform a success. And that is - the Public Option.

The Public Option

OMG, run for the hills! It's government provided health care! Run for the wind!

Or, that's what some people want you to believe. Think about the FDIC a moment. Every bank is *required* to use some form of insurance on accounts in the event that they go under, their client's checking and savings accounts are protected.

The FDIC isn't the only game in town, though. There are other alternatives, but every bank is under a requirement to own account insurance, whether through the FDIC or some other institution that offers similar protection.

The Public Option Health Insurance plan would be like the FDIC - it's kind of the option of last resort for people. If you don't have any good health care insurers in your area, or they're too expensive, or maybe you can't afford insurance on your own - there's the Public Option to cover you. It will likely only cover the minimum level (I believe the current proposals have a 3 tier system, with minimum care being the lowest and cheapest).

Why even have the Public Option instead of just letting the private industry cover it? Well, for the reasons above. Some private insurance companies don't cover small towns or rural areas.

The Public Option would simply be a not-for-profit health insurance company, like the FDIC, started up with taxpayer seed money, and after that would rise or fall on its own. If it can succeed better than private insurance companies by not worrying about paying out stockholders or owners - then I guess private insurance companies will have to work harder to keep up. Which means people will get better care, and everyone wins.

I think that's everything I can think of for what I'd consider to be Success in health care reform. Will we get any or all of these? I hope so. I'd expect it.

I guess we'll have to see of Congress will deliver it - or give the insurance companies what *they* want - which is to keep the status as it to keep things the same so they make the most money while we spend more on less health care.

What can be considered health care reform a success

Last week, President Obama gave another prime time press conference, this time to talk about Health Care.

As my wife pointed out, if you've been following the discussion, he didn't seem to really add anything to the table. And if you weren't paying attention in the first place, I have the feeling that what he was talking about didn't make sense.

Part of the problem is that the health care debate is just complex. Just what *exactly* is the US Health Care system going to be like? Nobody really knows, because it's a huge problem.

You have 50 million people without health care. Some because they're just too poor to afford it, some because they don't think they need it (unless they get into an accident, fall off a tree, and then you'd bet they need health care). You have others that have it, but then either get denied health care for "preexisting conditions". Others who want it but can't get it because an insurance company isn't going to take on someone who's *already* sick, or someone else who had it up until they lost their job.

It's a huge complex stinking mess that, if you haven't read over the 100 years of history of health care in America to understand *why* it's so complex, it just seems like a bunch of nonsense that shouldn't be this hard.

It is a hard problem, though. It's hard because you have people who want health care, but don't want to pay anything for it. You have insurance companies who want to make money, which means (as per the capitalistic system) you provide the most care for the least amount of money - and that means if someone is already sick of cancer or some other very expensive illness, you're not going to add them on. And it's hard because there's a history of employer based health care for so many Americans, and which means once you change or lose your job (something that's happening a lot in this economy), you find yourself without health insurance even though you spent all that money on premiums for so many years.

I'm not going to go into the history here. It's long, sorted, full of lobbyists and stupidity and inaction. So instead, I'm going to list what I'd consider the basic health care plan needs to have in order to be considered "successful." Some of the things I list here are both what I'd like to see, and how I consider the country to pay for it.

No More Preexisting Condition

One comment I see a lot is "The market can solve the whole healthcare issue. Just get the government out of the way, and things will become cheaper!"

Amazingly, it hasn't worked for all these years. Unless by "get the government out of the way," you mean "don't allow health care lawsuits when doctors/hospitals screw up, don't enforce basic health care rules and regulations so people don't get defrauded out of real health care, etc, etc, etc."

The problem is that the insurance companies have already rigged themselves so they're above the fair market system. If I went to buy a car for $20,000, and the second I drove it off the lot it broke down, some people *would* say "Well, caveat emptor - let the buyer beware! Now you'll know better than to buy a car from that dealership/manufacturer again! Next time you'll spend your money more wisely!"

It's a nice thought in an Ayn Rand dominated dream world, maybe that would work. Problem is, if I just spent $20,000 on a car that I'm not going to get back, I'm just going to go out and blow it again on another car right away. I can't afford it. Maybe I can't even go to work anymore if I don't have a car. Now I can't even make another $20,000 for another car.

People realized this, and that's why we have Lemon Laws and other things to prevent people from defrauded in this country. Sure, to a certain extent, it's still "let the buyer beware", but if you offer a car and promise it can go 50,000 miles on a warranty, you have to fulfill that promise.

Right now, health insurance companies have this big escape hatch. If you get sick, and if they can prove you had a "preexisting condition", then they can deny you care. Sometimes that "preexisting condition" means things like "had a yeast infection and now that you have cervical cancer we can deny you care." Or other "reasonable" (hah!) excuses.

So that's got to be the first thing to go. If we expect people to have health care, then insurance companies can no longer be allowed to pull the "get out of paying free" card and say "Oh, um, you had a preexisting condition, we don't have to pay any more!" If you get sick, your insurance company has to pay for it.

And on top of that, health insurance companies are no longer to be allowed to refuse people to sign up for their health insurance program either. Doesn't matter who you are or what your health care issue is, if you want health care insurance, they have to give it to you.

Wait. There's a problem here. This can get expensive real quick for insurance companies. And let's face it, it isn't fair that suddenly they get hordes of sick people signing onto their lists. The way insurance is suppose to work is a kind of a bet. You're putting your money in because you're betting that sooner or later, you're going to need some help. Your $200 a month will go to pay for people who have their spot of bad luck. Or to pool resources so my $200 a month can go to pay a doctor's salary that can see a set of people, or pay for equipment so everyone pooling their $200 a month can use. If you start adding on just sick people, then you're going to have overworked doctors and have to buy new equipment all the time.

So we need a way to pay for it. And there's one way to make it fair.

EveryOne Must Get Health Insurance

Everyone. Every single person must get health insurance. No exceptions. Many states have laws on the books saying that they to drive, everyone must have car insurance, because when even the safest driver has an accident, someone has to pay for it.

If we're going to demand that insurance companies fulfill their obligation to give everyone the care they need, then we have to make sure that every single person is covered. There are two ways of going this - either the government pays, or individuals pay. What we're really doing is saying "insurance companies, here's another 50,000,000 people who are going to pay you money every month. Of that 50,000,000 people, odds are the majority are perfectly healthy and only need annual checkups. In return, you have to give them coverage."

There are going to be some people who are too poor to be covered, and that's where the taxpayers will have to step in. But for the majority, they can pay for it.

It all comes down to this: either individuals pay a tax to the US government who then pay the insurance companies, or individuals pay the insurance companies. If someone is unable to because of income, then people can step in. Maybe that means we take some money out of the defense budget (oh, noes - no more F-22 fighters that have never flown and don't do any good!), or maybe a 1% tax on people making more than $280,000 a year, which would hit 5% of the population (oh, noes, if I make $290,000 a year, then I have to pay 40% tax on $10,000 - I'll be ruined to go from paying $3,900 to $4,000 in taxes!).
I think you can sense my sarcasm.

You still have employers who offer employees health insurance, but now the US government can offer tax breaks to those who do. Those who already have health insurance keep it.

Just the Starting Point

If we start with these two elements, then you provide care to people, and prevent insurance companies from getting around the market system by playing the "oh, preexisting condition" game.

This is a good starting point. Now, I haven't gone into how we deal with people changing insurance companies or employers, or what we hold as a "basic" level of care. I'll cover that in another post, since this one has gone on long enough. More later.

Why the "New Atheists" are Right-Wing on Foreign Policy

I would say "amen" without irony - but I can not agree enough.



Just because Mr. Hitchens has right wing tendencies (though he used to be a Marxist) doesn't mean that all atheists - or even all "new atheists" (which really means nothing - you might use the term "vocal atheists") are right wing. It's like saying that William A. Donohue speaks for all Catholics, and therefore all Catholics must be right wing voters (something I'm sure the majority of Catholics who voted for our current President would not agree with).



It doesn't mean that President Obama is "a right wing new Atheist" simply because he wants Israel to follow its commitment to not build more settlements - something Israel agreed to. Now, why are people building more land there? Oh, yes - religious reasons.



SecularParent gets it exactly right. Atheism isn't a left or right wing phenomenon, and has no leaders or spokesmen other than what others nominate.
About Terrorism
Read the Article at HuffingtonPost

Coburn can understand pregnant women

Coburn seemed very surprised that justices made up almost entirely of old, white men wouldn't be able to understand what it's like to be a pregnant teenage mother.

I can see why - I found this picture of him taken when he was 16. I guess he does understand what it's like to be a teenage mother....

Anyone else sorely tempted to go to Ireland - and start blaspheming things?

I'm usually rather nice about respecting other people's religion. I may not believe in divine beings, but I don't go wandering into their churches and insulting them (if anything, I try and interview them for a show in a very nice manner so people can see we don't have to be afraid of each other).

But this law passed in Ireland is tempting me. I want to go there now, to walk the green fields and stony paths. And blaspheme the hell out of everything. I want to make jokes about how we know that Jesus never married, or how Brigham Young would have killed for a Viagra, or who would be most insulted by a double bacon burger - a Muslim or a Hindu.

Not because I want to really insult anyone but the people who made this ridiculous blaspheme law. I'd love to see legions of people, wandering Ireland like Gandhi or Doctor King, being arrested in the name of blaspheme to show what a ridiculous law it is.

I'm probably just being an ass, but stuff like this makes me want to do things, even if its just insult the hell out of the people that are creating ridiculous laws that the world doesn't need.

Open letter to Mika Brzezinski about Real Americans

Dear Ms. Brzezinski,

I know you'll likely never read this - after all, I'm just one of those pajama clad bloggers. Sure, I volunteer to sign people up to vote so they can exercise their American rights as citizens, I read and participate in democracy with what limited time I have between my family, my job, and my work in interviewing religious leaders to understand how different faiths are about.

Yesterday morning, I caught you making a statement about how "real Americans" felt about Sarah Palin. I quote:

...people were coming to those rallies because they agreed with her (meaning Palin.) Look at the polls out there, look where people stand on life, look where real americans think, and you will find...that in the, you know, oh God I hate to say it, but in the cities where there are more liberal elite populations, you're not going to find what's representative with America.

Then, this morning, you cited a poll about how more people saying they had become "more conservative" recently, then used that to defend yourself in your statements from yesterday.

I'm not so sure how that works, and maybe you didn't mean it that way, but let me tell you what I'm hearing:

Real Americans love Sarah Palin.

People who live in "liberal elite" cities don't like Sarah Palin.

More people are becoming conservatives, so that supports your statement that "Real Americans" like Sarah Palin.

I'm trying to find a respectful way of asking this question but - who are "Real Americans"? I can think of no more ignorant and offensive term than "Real Americans."

A Real American is the reporter sitting in the White House Press room trying to find out just what it happening in the country.

A Real American is the worker at the homeless shelters.

A Real American is the Socialist who believes in the government controlling the means of production because they feel that would equal that monetary imbalance in the country.

A Real American is the Libertarian who believes that everything, from road repairs to police force to the army, should be privatized because government can not be trusted.

A Real American is the hooded KKK member who rails about how minorities are taking over the country, and a Real American is the civil rights worker who still stands up to fix the social injustices for every race and religion and gender and sexuality.

A Real American is a Democrat voting for the people they think will make their country better.

A Real American is a Republican voting for the people they think will make their country better.

The city slicker, the country rube, the people working on their lawns in the suburbs, the wall street investor living off his profits while they look at a homeless person begging for food, and the homeless person seeing the rich man in his expensive car - each of these are Real Americans.

You could have said that some conservatives love Sara Palin, or Republicans, or who knows what. But by using the loaded terms of Real Americans make it clear that those who agree with Sarah Palin and her ideals are Real Americans - and those who think differently are, well, I guess somehow less than Americans.

The only Real Americans are those who are US citizens, and the only Fake Americans are, well, I guess someone who claims to be a US citizen and isn't.

That's it.

I'm a Real American. I personally don't care for Sarah Palin because I believe she is a quitter without the stomach to do the hard things it takes to do be a leader, I find her ignorant, and I'm frankly glad she never got anywhere near the White House's corridors of power. I'm a pro-choice public health care desiring Democratic voting atheistic father of three great kids and a beautiful wife living in a pretty big city.

And while you might not think so, I am a Real American. And I'd appreciate it if you stop implying that somehow, I and others who don't particularly care for Ms. Palin's ideals are not.

Yours,

John Hummel

Religion of hate makes me fly off the handle

First, we have the video of a church group singing their song, a twist on "We are the World" only with people singins about how God Hates the World.

Holy.

Fucking.

Shit.

I'm serious. Where do you begin here? I'm really hoping Poe's Law applies, or else I'm going to be sleeping with the lights on and a shotgun by the bed in case one of these lunatics moves into my town and comes for me.

Oh, wait, it's Fred Phelp's congregation, a very *special* breed of asshole.

This is the ultimate example of a dangerous group of people. They take the song "We Are the World" - a song that was written to praise and raise money to help the poor, the sick, and the needy - the *exact fucking values that these douche nozzles profess to believe in by their god* - and they twist it into a song about hatred. They spit on the entire world by basically saying "You know what? We know this song is about helping people and loving each other - but fuck that! God's going to murder all you bitches, and when he does, we're going to have the biggest orgasm ever watching all of you BUUUUURRRRRRRNNNNN!"

...

Yeah, I went a little overboard here. But think about it. Of all the songs they could have picked, they pick the one song that people have used as a rallying cry to help others in need. You know, the stuff that Jesus talked about.

I sincerely hope that the estate of Michael Jackson and Lionel Richie sue the pants off of these people for copyright violation, the RIAA for once go after a group of people who deserve it, and finally put these people in the poorhouse and turn them into a footnote of history like they belong.

This is one of those times I wish there *was* a hell, just so I could wish to damn these people to it.

Durr, Logic can't explain good or evil so you have to have God for morals

First, there's this video - you need to fast forward to 7 minutes, 45 seconds to get to the good stuff:




His response *seems* logical, but there's a big flaw.

The lady at the beginning: "I refute your argument that logic could not have been created by minds because they are different, then use that argument to claim that god exists. Logic has resulted from thinking, through the ages...."

Now, Rev Slick's argument (after diverging into the "atheists can't tell good or bad through logic," which is another fail whale of epic magnitudes we won't address here) goes like this:

1. All information comes into the brain

2. The brain forms results through neurons firing

3. Everyone's brain can't actually interact with the information, but with the information from nerves in the body - they aren't touching *direct* information, but interpreted information

4. Because you're not experiencing true objective reality, but a subjective one, you can't say whether someone else's perspective on reality is true or false

5. Because of this, minds can't create logic. Therefore, logic must come from somewhere else - which is God.

Now, I would have agreed with him up until Point 4, and then it makes that huge "watch while I dazzle you with magic!" bullshit argument.

It's true - what's inside your brain may be different from what's going on inside my brain. But that doesn't mean that just because things are different and we're not experiencing "objective" reality that we can't agree.

Suppose there's a wall in front of me. If you're an insane person, you keep bumping into the wall and say "I've just run 100 meters!" Me, as another observer, can say "Well, I don't know what's going on inside your head, but no matter how much you claim otherwise, you haven't gone more than 1 meter because you keep bouncing off this wall." Two different people, two different observations - but in the end, there is only one objective reality.

And how do we measure that objective reality when we clearly have different opinions? We both create our experiments (If you can really go 1000 meters, you should be able to get this glass of water. If not, then my hypothesis that you're running into a brick wall is correct.) We can set up the experiment, invite others to join. Sure, there may be other insane people out there, but the trend will be that far more people will reach my conclusion from the experiment than not.

The insane person may have *faith* that there is no wall there, and others may believe it, and they may even believe that they're drinking the water from the glass 500 meters on the other side of the wall. But, I'm willing to bet, 99% of the people who repeat my experiment will show "Yeah, that wall keeps blocking off his access. That dude is in*sane*."

Wait - we've just come up with a way of validating objective reality, and we can call it the scientific method. Yay! So now we have a way of establishing, via a logical system of evidence gathering, whether there is a "true" reality or not. Sure, it may take some time, but it would work.

Granted, evolution has done much of that for us. People who think they're really drinking water when they're not tended to die out, so our complex brains have evolved lots of shortcuts to judging reality - and in a way that most people would agree with - so we don't have to go through this scientific process over and over again.

"But wait," our faith based insane person says, "That may explain objective reality, but you haven't explained good and evil! How can you decide whether something is good only through logic!"

The first problem is that this is a falsehood in the question - you can't establish morality from pure logic alone. That would be like doing math to decide whether "I Wish That I Had Jesse's Girl" is the greatest song ever (which it is).

But, we can use that old "let's start with some premises and go from there." I hold out the premise that I do not want to be murdered. I enjoy breathing, so I'd prefer *not* to be bashed upon the head until I no longer breathed.

I believe I can assume that *you* don't want to be murdered, since (sharing an objective reality), likely you have the same feelings and emotions and survival drives as I do.

We now have established a shared morality: being murdered is the suxxors, so let's agree not to murder each other. But, because there may be irrational people who have faith that murder is A-OK, let's set up a system where we all agree not to murder each other, and those who don't want to participate in this system get kicked out of town - let the pro-murder people live outside. Maybe hold an election and see who we want to enforce the law of "murder - is bad for you" and patrol people to keep the pro-murder forces out. If someone does murder someone in the town, then that person will be punished (or if possible, reformed so they know that murder is bad, m'key?).

Now, again, evolution did a lot of that for us (those who ran around killing their local human beings tended to get offed by the other human beings so they couldn't reproduce. Sure, history is full of us slowly moving from cavemen who thought that was a great way of settling disputes, but over time we eliminated not all, but a lot of those genes. Sadly, too many of them were carried into chicken hawks who like to never be in the military but love them some war. I'm digressing now.).

Either way, Rev Slick's assertion that "logic can't explain good or evil because we can't get an objective reality because our brains are all subjective so God did it" is pretty quickly taken apart once you realize that yes, we *can* reach some *approximation* of reality through our senses and a system (which evolution mostly did the heavy lifting for, so we don't argue whether the car is gray or red - unless damaged, we both agree that the car is gray because it's my awesome gray Beetle and no you can't drive it). And, while logic alone - no more than math alone - could deduce morals (and reality, not its job), we can *use* those tools (created by human minds, by the way, to explain the reality around us) to deduce morality based on a few core principles and extrapolating from there.

...

I think I'm gong to get a lot of TL;DR, aren't I?