Pensieri di un lunatico minore

Health-care

Of late, there has been on both my mind and my reading list, the recurring thoughts of health-care in the United States. I work for a small (approximately 20 person) technology start-up in the Washington, DC area, and am fortunate to have excellent insurance coverage. In talking with our CEO the other day, we were discussing insurance and specifically the concept of single-payer systems and “nationalized health-care.”

Now, it is important to understand that my boss is both a Marine and a died-in-the-wool Republican, but his instinctive reaction is that as a small-business owner—it’s his money on the line as much as any venture capitalist—the nature of his company puts him in the worst of all possible worlds. This comes as a shock, but is completely logical from a conservative and free-market perspective.

In order to attract the talent that we need, something we have been very successful at, we have to offer good pay and good benefits. In addition, we generally pursue a more mature workforce than many companies have: the average employee in the company is late 30s, early 40s, and has a spouse and kids. They represent the substantial intellectual resource that the company needs.

Unfortunately, this workforce also represents the most expensive to insure. As a small company, we are thrown into a risk pool that is not as diluted as many at a large company might be experienced with, further increasing the premiums that we have to shell out for. This represents a double disadvantage for a small company. We are fortunate that we do not compete in our space against any “large companies.”

So, the argument goes with my boss and I, that a single-payer, nationalized system for health insurance—at least as a core benefit, if not the full benefit—would level the playing field between companies large and small, and reduce the disadvantage that start-ups face in competing. In addition, it would open up the employment pool more by reducing the penalty that employees face in changing jobs between companies.

The current system, codified in the war-focused 1940s, is built on premises that no longer apply. People no longer work for the same company for their entire life—which are now much longer than they were before. Start-ups now spring up and compete much faster, but also may not have the staying-power that traditional big companies have demonstrated. Neither of these are “bad things” for the dynamism of the market. Continuing to cling to outmoded thinking is holding us back as a Nation.

What we both agreed on, though in minor ways we differ, is that the United States desperately needs a nationalized system, paid for by the Federal government, without intermediaries like insurance companies who sole goal is to make a profit, not to demonstrate value and manage long-term care requirements. More tax-breaks are laughable, and will only further enlarge the deficit and reduce our future options.

We already spend $1.9 trillion dollars on healthcare, or approximately 16% of our GDP (_The Economist_, 28 January 2006) between public and private funding, with over half of it funded through the public side. This is more than any other wealthy nation, by a substantial amount and is more than adequate to fund a new system without any new taxes. What is needed is not money, but the political spine to see this happen.

Ever since Mrs. Clinton’s doomed initiative—a piss-poor half-effort—politicians have feared to tackle the enormous pink elephant in the room and instead have salved our collective wounds with tax breaks and homilies about how America has the “greatest health-care system in the world,” something that is only true if you are both insured and wealthy enough to exploit its available resources.

The President is expected to discuss health-care as his vision for the future. While this is an admirable thing to bring into focus, my fear is that it will be done with the same political mendacity that all of his initiatives demonstrate. A proposal beholden to tax-break driven mania and special interests is potentially the only thing worse than our current disaster, and we all must hope that true leadership is demonstrated, rather than the parroting of palliative missives and lobbyist talking points.

1 thought

Foreign policy

I present, two people on the US foreign policy, who often would be considered opposite ends of the spectrum by many people. I am not going to comment on them other than to quote a little and ask people to read them and think about what is being said. First, from the intellegent, yet looney right, comes a piece by Patrick Buchanan:

Empathy, a capacity for participating in another’s feelings or ideas, is indispensable to diplomacy. Carried too far, as it was by the Brits in the 1930s, it can lead to appeasement. But an absence of empathy can leave statesmen oblivious as to why their nation is hated, and with equally fateful consequences.

And from the slightly looney, yet very intellegent left, comes everyone’s favorite whipping boy, Noam Chomsky, in an interview on Alternet:

George Bush would be in severe political trouble if there were an opposition political party in the country. Just about every day, they’re shooting themselves in the foot. The striking fact about contemporary American politics is that the Democrats are making almost no gain from this. The only gain that they’re getting is that the Republicans are losing support. Now, again, an opposition party would be making hay, but the Democrats are so close in policy to the Republicans that they can’t do anything about it. When they try to say something about Iraq, George Bush turns back to them, or Karl Rove turns back to them, and says, “How can you criticize it? You all voted for it.” And, yeah, they’re basically correct.

It’s an interesting read on both accounts, and a higher level of discussion than one would find in “mainstream media” of any persuasion.

No thoughts

Stupidity in polling at CNN

CNN is currently running a poll that asks a yes or no question, but the problem is in the way it’s phrased. Behind the “no” answer lies multiple other answers that are diametrically opposed in their core values, One, that someone believes these people don’t deserve any form of trial at all, the other that they believe they deserve a normal civilian structure to their trial. Those two could easily skew the results to make it look like something totally different is being said, depending on how you, as the poll writer, interpret the values.

An example of why polling is such a dangerous thing, and how agendas can easily be slipped into the poll without those reading it knowing. While I realize that this is just a quick poll, it wouldn’t take much to structure it as 3 answers, rather than 2.

No thoughts