Saturday, January 7, 2012

Ramblings of the Mind

Lots of deep thought at the Table today. Maybe it is something in the coffee. Here are some thoughts I have had. Some of the questions I posed are things about which I have an impression or might have heard: feel free to correct me if I am wrong. But here are some things that have been running through my mind.

Lord, give me the strength to not discuss politics on Facebook. That’s what blogs are for. I do not enjoy being involved in flame wars. Discussion is fine, but you know that discussing politics on Facebook cannot come to a happy conclusion. There really is not the room to get into thoughtful discussion there.

I have a friend on Facebook that I have know for almost forty years. She loves Robert Reich, and is forever posting links to his column where he expresses his opinion on how the US economy should be run.

I was pretty sure of his background, but I was wanted to confirm it – so I looked it up.

According to his Wikipedia article, Reich has done a number of things in his life, but having a real job has not been one of them. He has worked in academia. He has worked in law. He was worked in government. He has written books and articles. He has not ever had to make a payroll. He has not ever had to deal with customers. All he has ever done is work in an environment where all he had to do was make like-minded people believe that the Reich way is the right way – but the Reich way has never been proven in the real world. He just thinks it we should do it anyway.

So why should I get all fussed about Reich’s pronouncements on how things should be done? Show me where anything like it has worked and maybe I think about it.

This morning another friend posted this picture:



OK. I am sorry this woman had all of these tumors. Most states have health insurance programs for people who can’t get insurance elsewhere -- and these programs were in place long before Obama came into office. Is the big problem here, “Hey, I’m only 34. I don’t need no stinking insurance?” and did nothing to protect herself?

The purpose of insurance is to help in case something happens, not. “Oh something happened, let me try and get these people to pay for it.” As Rush Limbaugh put it, how well would it work if people did not get car insurance, then bought it after they had an accident and expected the insurance to pay for the damage? It does not work that way.

If insurance companies did pay for pre-existing conditions, do you have any idea how much insurance would cost? Despite how much we hear about how the insurance companies are rolling in money, they have a very narrow range of profit margin in which they can work. If they make more they are penalized for charging too much. If they have less they are deemed under capitalized.

Several years ago, a man in his 30s worked for Microsoft on a contract basis. Since he was on contract and not an employee, he could not be part of the company medical plan. Microsoft did pay him extra so that he could get his own medical coverage. Being a young man, though, he thought having a Corvette was more important than having health insurance. Then he was diagnosed as having a brain tumor. He sued for Microsoft to pay for his treatment. I never heard the outcome of the case. If I were to guess, I would say he probably lost, or it would have made large headlines. Someone making poor choices usually does not rate ink in the newspaper – sticking it to the “man” does.

I have extended health coverage through school. Yes, in Canada, people still need extended health coverage because the government plan does not pay for everything. Unless a student proves he or she has extended coverage elsewhere, it is mandatory to take part in this program. The reason is that otherwise, only people who had an immediate need would get the insurance, and the insurance would be very expensive. They require that everyone participate to spread the cost around to as many people as possible.

In the United States system, people seem to believe that “My insurance will not pay for it” means that they cannot get treatment. Lack of insurance or denial of payment does not preclude benefactors. Lack of insurance or denial of payment does not preclude friends chipping in, or having bake sales or whatever. Lack of insurance or denial of payment does not preclude some of the excellent hospitals in the United States that handle these sorts of cases. All lack of insurance or denial of payment means is that an insurance company will not pay for the treatment. It does not mean that treatment is not otherwise available to the patient.

Let’s look at the government “single payer” health care systems. First, could that woman with the tumors wait one to two years before having her surgery? What if the government bureaucrats decided that her case was too far along or that she was too old for limited resources to be spent on her (and I know of cases in BC of this happening to people in their 30s)? That means she does not get the treatment. There is no fallback plan, unless she wants to go somewhere else – such as the United States. She could also participate in the “medical tourism” industry in Canada and go to India – if her condition is treated there. In either of those cases, she pays for it herself.

By the way, US Federal health care plans have a higher rejection rate than American health insurance companies.

Within the past year or two, the Premier of New Brunswick needed emergency heart surgery. He needed it “now,” he could not wait. The government system flew him to where, Toronto, Quebec, Windsor, Vancouver? If he waited the normal wait time the Canadian system would have been, he would have died. So they flew him to – Florida. Now, quite frankly, I wonder if the night clerk at a 7-11 would have been flown to Florida, but that is another issue.

About that same time the head of the Canadian Auto Workers Union in Windsor, Ontario, had a heart attack. Government system drove him to – Detroit.

Why did the government system transport those two men to the United States? The reason is that the Canadian system does not have the facilities to give the necessary treatment in a timely manner. If the United States adopts such a system, where will Canadian patients be sent? Where will American patients be sent?

And, with Obama as President, what would you do if you campaigned for Clinton or -- gasp -- McCain in 2008? Everyone is created equal, but some are more equal than others. Do you really doubt that Obama and his people do not track this? Even if they don’t, who’s to say someone else won’t?

If the Obama Health Care Plan is so good, why are Obama’s cronies being given exemptions?

In British Columbia, the employer pays the premium for the “free” medical care. And not only is it paid for by the employer, it is a taxable benefit. That’s right, the amount your employer pays for your “free” healthcare is added up and added to your T4 (the Canadian W2) as income.

Here is a cute video from Vancouver.



Barry and Squire even made it on the Ellen Degeneres show. Squire Barnes is a hoot, and the video is funny, but don’t let that make you miss the fact that the lottery was for a hospital. Hospitals in BC have lotteries to pay for new equipment and to make improvements to their facilities. Is that the sign of a strong medical system? Is that really how people want it to be in the United States?

It is not unusual to see “Doc in the boxes” here that are closed in the middle of the day because they cannot get physicians to work. There just are not enough doctors to go around.

There is a line in the Joni Mitchell song, “Big Yellow Taxi”: “Give me spots on apples, but leave me the birds and the bees.” I won’t even address the many doubts that have been raised about the science that lead to the banning of DDT. I just shake my head at the people who think that the use of pesticides was only to have pretty food. They do not realize it was so that we could have enough food or any food at all. People need to realize that just because you have it now does not mean you will have it if you dismantle the system that brought it to you. Granted, there are times when hard decisions need to be made. Many people, however, refuse to see the consequences of decisions made for emotional rather than practical reasons.

Before the early 1980’s, the “phone company” handled both local and long-distance service. The thought was that basic service was vital, but that long-distance was a luxury. Therefore, long-distance rates were higher, but they subsidized basic service. A lawsuit was brought to break up this monopoly. When courts ruled that the local phone company could not be the long distance provider, “consumer advocates” celebrated the decision as a win for the people. They were shocked when the cost of basic phone service doubled overnight.

“You can’t do that!” they shouted. Well, something has to pay for it. If you did not like the way it was being paid for before, we have to do something else.

We now we have a President who believes that he can do whatever he wants and bypass Congress. Does the Constitution mean anything anymore?

He has sued a state for having a law that requires that voters produce ID in order to vote. Never mind that the law provides for free ID to those who cannot afford it, or that the Supreme Court of the United States ruled in 2008 that requiring voters to have ID is not unconstitutional -- but he is suing this state anyway. And look at the states that are being sued for cracking down on illegal aliens. Most of these laws are no more stringent than what federal law says, but the DOJ is suing those states anyway.

These are frightening times. We can only hope, pray, and be active to help turn things around next November.

19 comments:

  1. Fay did correct me on one point. Notice I did say that I was talking about BC. In the other provinces, the basic medical coverage is done as a payroll tax -- and that would not be a taxable benefit. In BC, the employee would generally pay the premium for their "free" health care. My employer happened to decide to pay it -- which made it a taxable benefit, but still cheaper than paying for it myself. Fay's employer pays 50% -- which is taxable, and Fay pays the other 50%. But we still need extended coverage.

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  2. I am really torn about socialized medical care. As I have often mentioned, if not here then on other blogs, that my life was saved by early testing, diagnosis and surgery of what could have been terminal cancer. I was given the best treatment by the best specialists and surgeons and have now been cancer free for 10.5 years.

    On the other hand, I also witnessed the two year wait Matt endured to get an appointment with a cardioligist to determine whether or not he was a candidate for surgery (his condition, of course, was not critical).

    We now hear stories of hospital patients having to be treated in corridors and adjacent coffee shops just like in the UK where super viruses kill you faster than your disease.

    One thing I will say that the UK has over our system is that citizens are allowed to buy private health insurance (and indeed many employers offer this as an employee benefit). Canada does not allow for the provision of private health care. I think it should as it would free up a lot of government resources for those who really need them.

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  3. I wil be forever grateful to the care Fay received when she needed it. However, the question does arise: was it because of the Canadian socialized medicine model, or because she was in a Catholic hospital system?

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  4. Matt, the Catholic hospital actually had nothing to do with my diagnosis or fast tracking through the system, or the first class surgeon who performed my operation.

    Was I glad that I was in a Providence (Catholic) Hospital? Yes, I most certainly was. I loved that they prayed every day for me and the nurses and the doctors. One thing I have always said about that period of my life is that the power of prayer comforted, sustained and elevated me.

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  5. Outstanding post Matt...so much to think about!

    The politics vs facebook thing has been a real thorn in my side. I learned early on not to mix the two. Many of my "friends" on fb are actually classmates or RNs who work in my area. One in particular posts so many lib talking points that it drives me crazy. I x out her posts, because engaging her creates a frothing, spitting onslaught of her friends, and they are MEAN critters. I end up spending too much of my valuable time trying to calm them down. It's not worth it. The tunnel-vision and vitriol unleashed by the far left is dizzying, and the manic tinge to it is sometimes frightening in its intensity.

    I also have a cousin who is a fervent OWSer. I have no idea where THAT came from, but hey, I still love her and respect her point of view.

    I keep my fb posts light, and do my utmost not to upset anyone. I also keep in mind that future employers may check my fb page to see if I'm a crackpot.

    I wish fb had a way to separate groups of people, and I wish it weren't so nosey and obtrusive. However, it's a wonderful way for me to connect to the lives of my far-flung family. It also allows me to network with people who may someday be holding my employment application in their hands.

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  6. Health care and how it is delivered and paid for is the burning problem of our time. The very subject frightens some people half to death; after all, let's face it: it's our very lives we're talking about, both biologically and financially.

    I'm uninsured. I will be uninsured for at least two more years. I cannot afford health insurance, and even if I could, it would not cover most health events because I have a chronic, degenerative autoimmune disease. No biggie. I'm certainly not unique; I think there are probably many people in the same boat.

    I discussed my life-plans with my family doctor before making the leap into school. The company I was working for was going belly-up, and I knew my job would not survive restructuring, and my health insurance was about to be kaput.

    My family doctor only charges me $48 per visit. I pay cash. He monitors my drug regimen closely, charges me his cost plus a small percentage for periodic lab work, and has me on the most cost-effective medications, for which I also pay cash.

    If Noah has a health crisis, I can take him to the VA clinic in Little Rock. If I have a health crisis, we're on the hook. It may take us the rest of our lives to pay the bill, but we will. We take very good care of our health, and do not engage in any risky behavior, like skiing or smoking.

    Sometimes I feel very badly for not being insured. I read scathing columns about how irresponsible it is not to carry health insurance. It weighs on me heavily. I feel like I'm running a race against time and fate, and I find myself holding my breath and praying that we make it through this financially dark time. We've cut our bills back as far as they will go. Any extra dollars we have are spent augmenting our education; this is a one-time shot for us.

    Still, even with all of this, I DO NOT feel it's my neighbor's responsibility to pay for MY health care. It's MY responsibility. Charity health care should be voluntary and a function of churches, civic organizations, and private business, NOT GOVERNMENT picking the pockets of people who already pay for their own coverage.

    Sorry if this is TMI, but I wanted you guys to know my perspective.

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  7. These are frightening times. We can only hope, pray, and be active to help turn things around next November.

    Amen Matt.

    One thing I have always said about that period of my life is that the power of prayer comforted, sustained and elevated me.

    Fay, I'm so thankful that you had such good care, and that you are healthy and vibrant! I've always believed that prayer is an powerful force for healing.

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  8. Thank you, Lady Red. I am glad you have a good doctor. As I said in my post, many doctors would probably bill insurance for $100.00 to get the $48.00.

    You also have a close-knit group of family and friends that they would find a way to have you taken care of -- but if a government system said "no," the government system said no.

    Too many people assume that if the US went to a government system that we would keep the world-class health care that we have.

    There are many ways that statistics seem to show that the American system is not as good as others. One of the big reason for this is that the American system tries to does things that others won't -- specifically in the area of childbirth. I

    read an article years ago that said the US had a high rate of infant mortality. However, the article pointed out that the US does the best that it can to same premature babies. By trying to save a premature baby, the baby is therefore declared a live birth.

    Contrast that with France where they would say, "I'm sorry" and not try anything. That baby would not be counted as a live birth, so when it died, it did not count towards the infant mortality statistic.

    The article also mentioned Japan had the lowest infant mortality rate. In Japan, a birth is not counted as a live birth unless the baby survives 72 hours.

    The result of all this? The country that does its best to save babies is "penalized" because of it. If you try, you will fail sometimes. If you don't try, you are lauded for not failing.

    Statistics are supposed to be counted the same all over. But we all know how well that works out. It does not make sense.

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  9. Good writing, Matt and such food for thought. I certainly agree with your conclusions.

    I was quite taken with the video, what a coincidence and to get the sportscaster on the phone live, lol! (Although I was halfway expecting them to draw the name and announce "RadioMattM", lol).

    When I start thinking too much about what the liberal agenda has done to our great country, I start feeling pretty depressed...and hope I don't live to see the US reduced to Europe junior.

    I know what you mean about bringing politics into FB - we're so divided, just reading comments on web articles is a real eye opener.

    Anyway, thanks for the thoughtful musings.

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  10. One thing I have always said about that period of my life is that the power of prayer comforted, sustained and elevated me.

    That is a beautiful sentiment, Fay. I too believe the same.

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  11. Damn, I lost a post without saving it. Blogger had been working so well for me I forgot my usual "hygene" of copying my post to the clipboard before hitting post. Beware.

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  12. Reading these posts makes me realize how fortunate I am to have you all as friends.

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  13. Yeah, lewy, Google Chrome has stopped signing me in automatically as well.

    *sigh*

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  14. OK, try again.

    Matt - thanks for the thoughtful post. I'm a huge fan of the idea that "the right questions are more important than so-called answers" and your post raises some very important questions.

    lady red - not TMI at all - please know that your circle of support extends to include us all.

    My wife just marked two years at her physical therapy clinic. Because she also has a marketing background, her boss (who runs the clinic) shares aspects of business strategy and market reality with her - so she has some visibility into the larger health care space. PT clinics live and die on physician's referrals so the business of doctors is something they track closely.

    She* has the following observations about the business of health care:

    - doctors in private practice are losing out to clinics and physician's groups.

    - smaller clinics are losing out to - or merging with - large ones.

    - starting new clinics or private practices of any kind (physicians, PTs, whatever) is increasingly impossible because insurance companies are increasingly closed to new providers. You have to be an existing provider to get payment from insurance.

    - hospitals are taking over clinics

    - insurance companies are increasingly in charge of how hospitals are run (or are running them outright)

    - the government is increasingly in control of insurance companies.

    The end result of this process is easy to visualize.

    Now add to this her observation that in general, people are not concerned that they are getting good healthcare - they are concerned that nobody else is getting better care than they are.

    Her conjecture is that the government, by destroying the process by which healthcare science and technology is advanced, and leveling care to a uniformly crappy state, will enhance its legitimacy - not undermine it.

    My observation is that every developed country - Europe, Japan, and the US - has huge financial and demographic incentives to do just this.

    Our conclusion is that if we want the best healthcare in 20 years, we need to emigrate to some less developed nation (Chile, Brazil, Viet Nam, Thailand, Singapore...) now. This we are reluctant to do, but still...


    *[that's her under the protein powder a few posts back...]

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  15. "My observation is that every developed country - Europe"

    Europe is a country???

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  16. florrie #10, thanks. I know you felt the same when you went through your medical nightmare a few years ago.

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  17. "*[that's her under the protein powder a few posts back...]"

    Wow!

    and Wow!

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  18. I was doing some reading in my new Communications textbook tonight. From what I read so far, the point of the chapter was that all business has to do is market well and do a good job with modern tools such as social media.

    As far as I am concerned, well marketed crap is still crap. As I have said many times before, we need to get away from the MBAization of the United States.

    This especially applies to health care.

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  19. Mrs. lewy has excellent observations. The same phenomenon is happening here, and I'm sure everywhere in our nation. I love the way she walked everything back to more gov't control; she's spot on.

    I'd sure like some of that protein powder! :)

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