Friday, August 14, 2009

Nobody Asked Me, But...

1) RIP, Les Paul. The finest guitar I've ever laid hands on was a 1959 Les Paul that my buddy saved for years to buy. Astounding instrument, astounding man. Go read his obit.
2) Senator Webb is in Burma to plead for Aung San Suu Kyi. Clever move on Obama's part. Webb could end up with a Noble Peace Prize for this.
3) I am glad this situation was resolved with little outcry. This man deserves no clemency.
4) It's getting so in California that they should have two seasons: winter and fire. Glad I didn't move out there when I had the chance!
5) Thanks for pointing that out, Captain Obvious!
6) But we brought them FREEEDOM!
7) Sometimes Apple pisses even me off with their delays.
8) I think Brad Pitt underestimates his chances. He has two things going for him: Angelina's tits and...wait, THREE things going for him...
9) Remember that moran at the Specter town hall meeting who kept running his mouth about socialism? The little prick's on a government disability!
10) PROTIP: You've worked really hard to win the coveted award of Green Company of the Year from Forbes Magazine, so don't screw it up by killing birds en masse!

Thursday, August 13, 2009

Evolution Inaction

If you are concerned about the current debate over healthcare reform, you should be:

Frankly, what is surfacing is a survival of the fittest mentality. One demographic, being pitted against another, risks any true reform of the system and compromises the pursuit of good health for all.

One group in particular, unconvinced that change will not be destabilizing, has been the senior citizen population. Whether cautiously reluctant or downright suspect, seniors, many of whom are satisfied with Medicare, do not want to be scapegoated in the process to redress health-care grievances. At the crux, is the perceived threat that health care will be rationed for the elderly at the expense of insuring younger, healthier Americans. Seniors are not "on the chopping block," but propaganda and rhetoric would have you believe their interests will be disposed of readily.

What is true, however, is that there is already rationing in the America health care system. Insurance companies are able to differentiate which treatments are covered versus those deemed unnecessary. We, in the public, find this mediation palatable, but we question whether the government will interfere arbitrarily in our medical affairs.

Dr. Pernell goes on to point out what I pointed out yesterday: Healthcare reform can ONLY drive down the cost of healthcare, freeing more money for more treatment.
But her trope of "survival of the fittest" is intriguing and got me to thinking: what if the living room gibbons that have infested the Congressional town hall meetings win? What will happen to healthcare reform in this country?
It won't, frankly. We'll get the same lip service crap that President Bush offered up with Medicare prescription "reform" which turned out to be a boon for insurers and a muddle, ugly mess for consumers. And it will be decades again until someone straps on some cojones and decides to take the plunge into reforming a disastrous health insurance scam that private insurers have foisted on this nation.
We spend more, far more, per person on healthcare than any other nation on the planet, yet we rank in the 30s in life expectancy, have higher cancer and heart disease death rates than any country with "socialized" medicine, and have an infant mortality rate higher than many Third World nations (including Cuba)
So much for the "right-to-life," huh?
One bright spot in the whole town hall astroturfing is that we see now citizens who are on a government-provided healthcare plan are so satisfied with it that they will fight tooth and nail to keep it intact.
"I got mines, Joe, and I ain't giving it up!" A clever President and Congress would use this as an opening.
Getting AARP on board would be a big first step. They have reluctantly and half-heartedly endorsed some of the proposals bandied about. Even if they took the next logical step and just made a push to get people to realize this is not going to cut their Medicare, that would be a big help. People look at AARP and have respect for it as an organization devoted to the needs of the aging. I myself am a member, primarily because of that image.
We liberals have to begin to make the case that the Obama administration has been unable to: healthcare reform will save and prolong lives, and not force the elderly into euthanasia.

Wednesday, August 12, 2009

Morons Amaze Me

Ask people their opinions on tax cuts, and many of them will give you the free market rant that letting me spend my money will help the economy.
Ask people their opinions with respect to healthcare reforms, and many of these same people suddenly forget about market dynamics:

Since his days on the campaign trail, Obama has promised the public that those who like their health insurance plans won't have to give them up, but he's stopped short of saying at what cost.

"I think that's the fear," said Diana Owen, an associate professor of political science and the director of American studies at Georgetown University. "Even though they are going to keep the plan, the plan is going to be at a much greater cost. And he's not been able to really allay that fear."

The themes coming up at town hall meetings across the country are broadly the same as doubts expressed during the campaign. Critics are voicing fears about socialism and the dismantling of the government they are used to. And those who have sufficient health care coverage worry they'll have to foot the bill for reform, echoing concerns heard during the presidential campaign that Obama would "spread the wealth around."

Utter rubbish, as even a moment's thought will evidence.
Right now, healthcare costs, particularly health insurance premiums, are rocketing skyward with no ceiling in sight. There are plenty of reasons for this (not least of which is too many doctors are underpaid by HMOs and are forced to identify profit centers in treating patients and requiring extraneous tests) and that could be the subject of a book.
Among the myriad reasons are two key elements to lowering costs: insuring a larger pool of healthier patients, and free market competition.
The larger pool of uninsured but healthy people can be found in twenty- and even thirty-somethings who delay picking up health insurance because they have not worked through that they are not immortal yet. By including them in the overall pool of insured, this will lower the relative risk an insurer takes in issuing policies to a particular person: that insurer is not inclined to make rapacious profits off the backs of middle-class families. In addition, many of the young who will be insuring under reform will already have banked a fair amount of equity in their policies that will generate income to offset the higher costs they will incur later.
Government insisting on mandatory participation in health insurance will do that.
Number two, free market competition.
Why is it that Wal-Mart's presence in a given market actually drives prices down?
Simple. Because it can order in such large volumes, this forces manufacturers to cut prices to a bare minimum profit. Since the law requires that, if I offer price X to Wal-Mart, I have to offer price X to you, this dynamic naturally brings down the price of the product.
Now let's look at government healthcare. Medicare has already provided a small obstacle to willy-nilly price inflation on the part of medical companies, big pharma and insurers, because it can negotiate on behalf of the millions of its insured, with the guarantee of government's backing on any deals made.
But it's not been enough. A larger pool of healthier individuals is needed and necessary in order to truly harness the increases of the future. Government plans provide that pool with mandatory insurance, much of which will go to those healthy people not currently insured.
Thus creating a single entity with the power to negotiate price declines, just like Wal-Mart does.

Tuesday, August 11, 2009

Town Bawls

Never underestimate the power of the volume of the thunderingly stupid.

WASHINGTON — President Barack Obama is switching his message on his overhaul of the nation's health care system, readying a fresh pitch designed for those who already have insurance.

The White House is retooling its message amid polling that shows Americans — especially those who already have coverage — skeptical of the Democratic proposals to expand coverage to millions. Instead, Obama will use a potentially boisterous town hall-style meeting in New Hampshire to highlight how his proposals would affect workers whose employers provide their health insurance.

The shift also is a potential blueprint for lawmakers' August recess. Critics of the president's plan have grabbed headlines by disrupting town hall meetings, and the White House expects that Tuesday's event may be bumpy.

Frankly, I do not, but here's a highlight of the difference between the Bush empire and the Barack Obama republic: the seats were largely chosen by lottery, not party loyalty. Events are not staged and that means there will be people who play along and people who will be antagonistic.
Barack Obama can handle both, of course.
The larger reason I do not believe there will be major disruptions to the President's meeting is it would detract from the message of those who oppose healthcare. They frame it as preventing socialism. We frame it as a necessary feature of any democratic society.
The arguments for and against healthcare reform could not be starker, and the President and Congress have taken on a large task here and a big opponent: Big Medicine.
The most effective argument in Obama's arsenal right now is the clear message that there will be no forced switches of insurance plans, that there are no "death panels" (an odious and disgusting trope trotted out by the bloodthirsty fascists of the Palin Party), rebutted beautifully at that link provided by Southern Beale, and that this will actually save the US taxpayer money in the longer run.
It's an investment in our future.
The death panels meme, while offensive and outrageous and the type of tactic Joseph Goebbels would be proud of, seem to have taken on some resonance if you believe the mass media coverage of previous town halls held by Congresscritters. That theme shows up everywhere and it's clear that Congresscritters were not briefed in advance.
Had it been me talking, I would have said the following: "That is the single most absurd statement that I have ever heard in my entire life, and your teachers from kindergarten on up ought to cringe to think that you could so badly misunderstand the English language. The 'panels' of which you speak provide end-of-life counseling to help elderly patients and their families cope with the inevitable. Would you deny your grandmother a priest to talk with as she faces meeting her Maker?"
Which would shut him up and the rest of the pieholes who tried to throw that at me later.
And then, for good measure, I would add this, quoted from the Southern Beale link:
You have no idea what it's like to be called into a sterile conference room with a hospital administrator you've never met before and be told that your mother's insurance policy will only pay for 30 days in ICU. You can't imagine what it's like to be advised that you need to "make some decisions," like whether your mother should be released "HTD" which is hospital parlance for "home to die," or if you want to pay out of pocket to keep her in the ICU another week. And when you ask how much that would cost you are given a number so impossibly large that you realize there really are no decisions to make. The decision has been made for you. "Living will" or no, it doesn't matter. The bank account and the insurance policy have trumped any legal document.
If this isn't a "death panel" I don't know what is.
Insurance companies exist to make money off your death. Period. And that's the theme that Barack Obama needs to throw back at the unruly unwashed masses of the hateful and deceitful charlatans.
And this is exactly why, barring a madman on the waters, I believe the right wing astroturf organzations have worked tirelessly to ensure today's town hall does not become a madhouse. Barack Obama is a gifted debater and very good at confronting without being impolite. To give him a forum to be stern, to be Presidential, will create a blowback thus negating the very arguments the right wing wants to make.
The spectacle of such an unruly mob harassing the President over an issue nearly every American (80% or so) agrees need to be fixed when he's making an honest effort to do so will create an awful lot of sympathy and could create support for a plan that people on the right and left believe is flawed.
There will be debate, to be sure, but to disrespect the President of the United States will be seen as a signal that mob rule is imminent, and as with the student unrest in the 60s, will not be taken lightly. A polarization of this country at this time would be the wrong thing to do, and it would send a signal to the moderates of the nation that the right wing can be ignored.
So, while I do not think it will happen, I am praying for it.

Monday, August 10, 2009

The Trouble With Viruses...

As the first influenza pandemic in 41 years has spread during the Southern Hemisphere's winter over the past few months, the United States and other northern countries have been racing to prepare for a second wave of swine flu virus.

At the same time, international health authorities have become increasingly alarmed about the new virus's arrival in the poorest, least-prepared parts of the world.

They travel a lot, to be sure, but they never take vacations!
That last bit is the scariest part of this latest warning. The poor, even in this country, have terrible access to medical care, and of course, that leaves the poor as a perfect incubator for this virus as well as any mutations that might occur. This will make the virus that much harder to eradicate or at least contain.
Already, strains of the virus are showing up that are resistant to Tamiflu, one of two recognized flu fighters on the market. Too, isolation and quarantine in poor populations is harder, as people have to work merely to survive and will work until they drop dead.
Certainly, northern hemisphere governments have had plenty of warning and opportunity to set up for this winter's return and those preparations may turn out to have been overkill, although I doubt it. The virulence of this particular bug seems to be undoubted and we've already seen some extreme measures were needed last winter to contain it as best as we could.
One bright spot in all this nervous-making anxiety is this flu might be the final key in unlocking true healthcare reform, albeit at a tragic and hefty price.