Thursday, August 13, 2009

I am safe in the boat, but you have to swim with the sharks.

I have added some colorful language to my intended title. I trust this statement best reflects the feeling of opponents of healthcare reform. This sense might be better described as the Politics of the Unlucky. The Republican party has no desire for domestic policy. This is evident by the birther movement and behavior during the healthcare reform town hall meetings. All we are left is a question, what is the morally right thing to do with healthcare?

Before getting into the argument lets look at the stats driving the debate. The World Health Organization ranks the United States 37th in healthcare provided to its citizens. Half of Americans this year will have minimal (cost under $1,000) this year. 20% of our country's population will incur 80% of our nation's healthcare costs. 1% of the population will have costs totally $150,000. To complicate the problem, the US has an over-reliance on private health insurance. This over-reliance creates a situation in which at any one time 15% of the population is uninsured. Consequently, this changes our question to is it morally right to have 15% of the population uninsured and without healthcare?

The answer is no, it is not morally right and I am embarrassed to say the party of values do not see it the same way. Why are people scared of healthcare reform? Are they intend scared of healthcare reform or the man that won the Presidency? I add that last statement because part of these healthcare town hall meetings are turning into McCain/Palin rallies.

The solution to the American healthcare debate is socialized insurance, not socialized medicine. If you do not understand the difference in the two, then in my opinion, you have forfeited your right to debate this issue. We spend twice as much as France and Germany for healthcare as Canada and Germany. The number compared to the United Kingdom is 2.5 times the costs. America spends more but gets less in terms of number of days in the hospital, number of office visits, and number of prescribed drugs. In addition, these countries wait less for emergency services and voluntarily procedures.

Dwight Schrute: In the wild, there is no health care. In the wild, health care is, 'Ow, I hurt my leg. I can't run. A lion eats me. I'm dead.' Well, I'm not dead. I'm the lion. You're dead.

What's the specific problem with a system in which we pay more and get less? The American healthcare system is rife with inefficiencies and malaise. Large sums of money are spent on denying healthcare coverage to people. How do I know this? Well private insurances do not make money on paying for healthcare. They make money on collecting premiums and not paying healthcare. The correct term used by insurance companies to pay for healthcare is medical loses. None of this happens in a socialized insurance system.

A recent study on administration costs of private insurance companies show that 15% of healthcare funds are spent of administrative operations. Anyone know what Medicare's admin costs are? The answer is 2%. The total monetary amount is approximately $84 billion. Another problem is the prescription drug problem. Americans spend approximately $100 billion for drugs and receive far less when compared to other industrialized countries.

We have been down this road before. We have add the statistics on the side of healthcare reform. We have the morality to reform a bundled system so why have we not. The first reason is Rightwing ideologues. In 1993, William Kristol, an conservative political analyst and commentator and founder and editor of the political magazine The Weekly Standard, issued a policy statement that encoruaged GOP Representatives and Senators to kill healthcare reform because it would guarantee Federal government intrusion and lead to a New New Deal. Funny how Mr. Kristol had to throw in the New Deal. The insurance industry was a seriors thorn in the backside of reform in 1993. Remember the Harry and Lousie commericals. This fact is also funny because the Clinton-Gore plan provided a great opportunity for private insurances to regulate the healthcare system. Looks like we will be having the same types of fights this time around. But this is not the purpose of this blog.

So what really needs to get accomplished in this time around. Here are some very crucial elements of healthcare reform:
1.Reduce the cost of administrative costs.
2.Elinate rish selection.
3.Use the econmy of scale and reform the prescribtion drug system.
4.Invest in preventive care.

By focusing on four general goals, healthcare reform would have a greater chance of passing this year. The Obama Administration needs to be out every day touting these four goals and some objectives under each goal. The objective for administrative cost reduction could be the Medicare standard. Risk selection has everything to do with preexisting conditions. Preexisting conditions should be defined and after all private health insurance have been exhausted, these people should be transferred to a private-public partnership where regional premiums are established. For people employed by companies providing insurance coverage to its employees, the average of those premiums would be applied to this private-public partnership. The federal government should use its buying power to purchase in bulk prescription drugs and other durable medical equipment. And finally, the most important is preventive care. America has higher rates of diabetes and hypertension. Private and public healthcare coverage should focus on healthy living standards, active life styles, and weight loss.

So there it is. My simple four point plan to win the healthcare reform debate.

Saturday, August 8, 2009

Sitting here having a Taco salad and reading about the Teabaggers shouting down Congresspeople. Why do they do that? I keep hearing there arguments are so sound.

Who the hell is Betsey McCaughey?

First off read this quote:
The health care reform bill "would make it mandatory — absolutely require — that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner."

-Betsy McCaughey on Thursday, July 16th, 2009 in on the Fred Thompson radio show

As far as I can tell that comment is the genesis of the “end of life” debate. From this comment the following statements have been inferred:

This bill "may start us down a treacherous path toward government-encouraged euthanasia," House Republican Leader John Boehner of Ohio said July 23.

"Some people are saying, well, this is a health care reform, other people say -- maybe me -- that this is a subtle form of euthanasia. And when you start looking at the proposals, you say, God, what's happening? One of the proposals, Section 1233, talks about advanced care planning consultations. And that's a fancy term where a doctor goes to you every five years once you're 65, or more if you're chronically ill, and explains to you the benefits of so-called palliative care, of not giving active treatment." Co-host Brian Kilmeade subsequently claimed, "Wow. Somebody you don't even know will decide if you're going to live." [Fox & Friends, 7/27/09]

"They're going to counsel you on preparing you to die," Rush Limbaugh pronounced a few weeks ago (Sorry, couldn’t find the exact date).

"I'll bet he doesn't know that there is end-of-life counseling for senior citizens on page 425 to 430. What is this counseling going to be? Why would you need mandatory counseling for all seniors, and who's going to pay for this? Mandatory counseling for all seniors at a minimum of every five years, more often if the seasoned citizen is sick or in a nursing home. And as Don Parker writes here at the American Thinker, "Don't even think that anyone should receive mandatory counseling regarding the end-of-life issues surrounding abortion." That's an invasion of the right to privacy. We can't have counseling for mothers who are thinking of terminating their pregnancy, but we can go in there and counsel people about to die. I'm sure you could get some counselors from the Hemlock Society to go in and do this. Kevorkian might want to come back to life and handle this. End-of-life counselors, end-of-life treatment for senior citizens, mandatory." Rush Limbaugh July 21, 2009 to a caller.

Rep. Virginia Foxx (R-NC) stated on the floor of the House that the Republicans' health care reform legislation, unlike that of the Democrats, would not put seniors "to death." July 28, 2009

The Heritage Foundation's Thomas Sowell wrote a column, "Utopia Versus Freedom," in which he warned readers to "not be surprised when life-and-death decisions about you or your family are taken out of your hands — and out of the hands of your doctor — and transferred to bureaucrats in Washington."

Let me say this right off the bat: planning for end of life care is not an effort by the Obama administration to “kill old people”.

THE FACTS: The bill would require Medicare to pay for advance directive consultations with health care professionals. But it would not require anyone to use the benefit.

Advance directives lay out a patient's wishes for life-extending measures under various scenarios involving terminal illness, severe brain damage and situations. Patients and their families would consult with health professionals, not government agents, if they used the proposed benefit.

Now who is Betsey McCaughey?

She is currently an Adjunct Fellow at the Hudson Institute. Before that she was the Lieutenant Governor of the State of New York from 1995 to 1998, during the first term of Republican Governor George Pataki. The Hudson Institute is an American, conservative, non-profit think tank founded in 1961, in Croton-on-Hudson, New York, by futurist, military strategist, and systems theorist Herman Kahn and his colleagues at the RAND Corporation. The Institute promotes public policy change in accordance with its stated values of a "commitment to free markets and individual responsibility, confidence in the power of technology to assist progress, respect for the importance of culture and religion in human affairs, and determination to preserve America's national security."

McCaughey shot to fame during the first healthcare debate. In 1994, she wrote a scathing review of the Clinton administration's health care plan in the New Republic, arguing that the proposal would lead to rationing of treatment and would prevent patients from choosing health insurance. Republicans seized on the key points of "No Exit," forcing the Clintons to issue a response to the article. Politicos should be sending me emails stating that the New Republic (TNR) is a left leaning journal. True but during this period TNR was edited by Andrew Sullivan. During his tenure as editor (1991 to 1996), TNR had a somewhat more conservative bent.

Again, healthcare reform is in her sights!

In her chat with Thompson, McCaughey said the language can be found on page 425 of the health care bill, so we started there. Indeed, Sec. 1233 of the bill, labeled "Advance Care Planning Consultation" details how the bill would, for the first time, require Medicare to cover the cost of end-of-life counseling sessions.

According to the bill, "such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy."

So what are people that work in the field saying about this provision:
Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, said the bill doesn't encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration.

"These are very serious conversations," he said. "It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families."

In no way would these sessions be designed to encourage patients to end their lives, said Jim Dau, national spokeman for AARP, a group that represents people over 50 that has lobbied in support of the advanced planning provision.

McCaughey's comments are "not just wrong, they are cruel," said Dau. "We want to make sure people are making the right decision. If someone wants to take every life-saving measure, that's their call. Others will decide it's not worth going through this trauma just for themselves and their families, and that's their decision, too."

This is the tactic that erodes trust in a democratic system. I have been thinking a lot about the reform debate and it worries me. People are taking McCaughey’s false assertions and running with them to Town Hall meetings with their Representatives. People are yelling, screaming, and crying. People are scared the government will kill their grandparents and parents. It is truly unfortunate the basis of all this raw emotion is a lie. Rightwing ideologues are playing on memories of relatives that have passed away and drudging up those gut wrenching feelings, forcing people into an emotional state. How dare they kill my mother? Then people run out to these Town Hall Meeting, and with the camera’s rolling, cry and yell at someone that really is not the enemy. The enemy in this case is the person that started it all, Betsey McCaughey.

Thursday, August 6, 2009

My Eastern Kentuckian Dilemma

One of my relatives had a post on Facebook that created tons of inner turmoil for me. I have come to find out there is a groundswell of opposition in eastern Kentucky to the "Cap and Trade" bill. I am a liberal, progressive, communist, freedom hater, and Democrat. Just pick how you wish to describe me. I am also an eastern Kentuckian, that is very proud of my roots. My father was a coal miner and died of black lung. My brother is a disabled miner. I have been a supporter of the UMW, miner healthcare rights, tighter regulations to ensure a reduction in miner deaths, and advocated for a coal burning plant in Florida to the dismay of some of my friends.

However, I find myself struggling with a stance on this issue. I am not an environmental Democrat. My focus is on global terrorism, healthcare, and increasing community service. I come to this fight without a dog. The central reason why I struggle with this so much is eastern Kentucky has been trying for years to diversify its economy. Now it is getting a nudge in form of the "Cap and Trade" bill to do this very thing I have been hearing politicians in eastern Kentucky preach on for years. Why is this bad?

Eastern Kentucky has been impacted in nearly every way because of coal: healthcare, home ownership, quality of life, entertainment, education ....you name it, coal has left its economic imprint all over the region. I ask you, what would eastern Kentucky look like or be without coal. That is a very hard question to answer. Would it be a waste land? Miles and miles of call centers? The truth of the matter is eastern Kentucky needs a new brand.

What would that new brand be? I have no idea. I am not an elected leader in eastern Kentucky. I am one of the many that has had to move away to "make a living". My brother made a very good point to me when he said, "the elected officials don't want this argument (coal and economic diversity) to change, because if it did, they would have to actually do their jobs". I told him he is right. I feel the current leadership of eastern Kentucky lacks the imagination, insight, and skill to re-brand the region. In the absence of those three qualities what do they do, throw meat to the dogs. They rage for the status quo. Coal is king and always will be king.

The times have changed since coal was king. We live in a different age. Instead of fighting the Soviets, we have a war on global terror. Instead of disco, we have climate change. Coal does generate electricity for 49% of the US, a slight drop from 1997 when the number was 52.8%.
However, due to growth of the total demand for electricity, the net production of coal-generated electricity increased over the same period from 1.845 to 1.991 trillion kilowatt hour per year in absolute terms. I believe in an honest argument.

The average share of electricity generated from coal power was projected to increase again with a coal plant building boom thanks to the recommendations of former Vice President Dick Cheney's energy task force. This task force was one way to thumb the collective nose at the UN and the Kyoto Protocol. The goal of the protocol was to "stabilization of greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system.

Coal does have some detrimental impact on the environment. Coal power plants are responsible for 93 percent of the sulfur dioxide and 80 percent of the nitrogen oxide emissions generated by the electric utility industry. These emissions spawn the acid rain that is eating away red spruce forests in the Northeast and Appalachia, and rob previously pristine streams of brook trout and other fish species in the Adirondacks, upper Midwest and Rocky Mountains.

Coal emissions also cause urban smog, which has been linked to respiratory ailments, and coal-fired power plants also contribute to global climate change. Coal plants emit 73 percent of the carbon dioxide emitted into the atmosphere from electricity generators. By releasing the energy stored in coal, large quantities of carbon dioxide that have been stored in the coal for millions of years are released back into the atmosphere, increasing the threat of global warming. Coal plants are also a major source of airborne emissions of mercury, a toxic heavy metal.

Knowing these facts, why do eastern Kentuckians insist on an economy based on coal. I do not know and I do not have the answers of economic diversification. Change is hard and it is harder when you absolutely hate the man advocating change. I do have some recommendations for the leaders of the region:
1. Focus on solutions that do not harm the environment. Get away from logging as a solution. It is not.
2. Try to be out in front of the next big thing. What areas of the economy look like they are getting ready to take off? Healthcare? I would love to see some of the large durable medical equipment manufacturers stop bringing devices from over sees and set plants up in eastern Kentucky.
3. You may be the key to the immigration problem. I do believe in strong border enforcement. Not because the next terrorist will come from Mexico, but because we have tremendous opportunity for people right here to become farmers, builders and contractors, and highway workers. I would like to see an Immigration Bill tied to an Appalachia Economic Diversification Initiative. Create pools of workers that could work the jobs undocumented workers are doing. Incentivize companies that use the Appalachian Workers Corp in construction and other jobs.
4. Get real about education. Have a mandate similar to the one of President Kennedy when he challenged the country to put a man on the moon before the end of the 60’s. Have it the goal of the Commonwealth to be ion the Top 10 in Education by 2020.
5. Improve the infrastructure. Turn the Mountain Parkway into a part of the interstate system. The same with US 23. Use the lakes and river for energy creation. Innovate a means of better telephone and power lines by putting them all underground so natural disasters do not destroy these important components of life.
6. Focus on a few and master them.

I conclude with this challenge. Let’s be better than what we have been. Use these circumstances eastern Kentucky as an opportunity to make a difference. Improve the economy, environment, education, and reputation of the region. Do not go down the road I see you traveling right now of obstructionist.

Sunday, August 2, 2009

My Political Blog

I have been posting a ton of political things on my Facebook site. I think it is turning some people off and may have hurt me in other ways. Well I thought I would start my own blog here at Blogger. I am not a real big reader of blog but I do loving responding to right wing propaganda via a blog.

So now I will continue my sparing with Preston Scott, making comments about Sarah Palin, and taking on the right wing think tanks.

I am I am one man but it must start somewhere.