For some time I had been dithering about what to write about in my first, official after-the-introductory post. I do tend to dither, and I do use that as an excuse for a minor vice of mine, "procrastination". Dithering sounds much more professional, not morally decrepit like procrastination.
And now, God save me, I'm following Publius, at least at the time of this writing.
But I do plan to write about what I know and what I am interested in. That's all an author can really hope to do well.
I have been thinking about the varied connections that bind us all to each other and to the structures of our society. One of these connections, my 30+ years in public education is beginning to wither away and, although I will be continuing part-time, my full career is at an end. Another connection is appearing to develop, a part-time position at our local movie theater as a projectionist.
Movies have always interested me. They certainly are topics of conversation with friends or even complete strangers, whose notice often can be caught with a simple, "So, what did you think of the flick?" And many times fine conversations can begin. Family connections are vitally important, too. So, after a family get-together last Saturday in Nebraska with all my family to celebrate Mom & Dad's 60th wedding anniversary from this past January, I've been busy training to run the theater's 8 projectors.
This is the link to a couple of pictures and a short video of the family ( I'm the one kneeling in the group picture with my parents, brothers and sister, in the yellow shirt ) and another link to the type of work I'm now doing this summer. The video at the top of the site is what I'm doing now.
These are hard times. If those out of work and given up and those who are working part-time at less pay are added to the official unemployment rate, we have an unemployment rate above 15%. I feel I am lucky. Unless the State of Kansas goes completely belly up, I'll have a steady source of income for the rest of my life. My chances for a continuing part-time gig as a teacher, without any benefits, however, look iffy as the state continues to undershoot ( last week by 120 million ) its revenues and more educational cuts seem likely.
The oft-quoted Chinese proverb/curse: "Living in interesting times". I have never suffered an extended length of unemployment; I do not know what that is like, having a family with kids and no reliable steady source of good income. But I do know what it's like to scrape by on next to nothing.
As I wrote, "Lucky".
Back to my headline, "Connections". It seems to me our societal connections are disconnecting. My 2 Kansas senators and my representative are Republican, and are toeing the party line. No vote from them for the stimulus money, but we took it anyway, since we are blessed with a Democratic governor, a blessing indeed compared to the poor folk in Texas, Alaska & South Carolina. Certainly no vote from my CongressCritters for the new Cap and Trade bill that recently passed nor will they likely vote for any meaningful and effective reform of healthcare. As the "Democratic" senator from Nebraska, Ben Nelson, once proclaimed not too long ago, we need to care for the poor insurance companies. Another of our Democratic senators, Joe Lieberman, just a couple of days ago released himself from his campaign's support for a public healthcare option.
Truly, "LIE-berman".
Our current President made many personal connections with us his fellow citizens during the campaign last year and before. Some more significant than others, that's how our political leaders gain a following and get their chance at leading the country. I always try to catch Jon Stewart's show, and tonight's version was very apt for my discourse here. At the time of this writing, his July 2 show is not online, but his opening was along the lines of "Pretty speeches are fine, now fix the damn economy!" I'm afraid Obama has cut many of those connections he made with us. The "fierce advocate" for the rights of gays, hasn't been so fierce, yet, but indeed, his Department of Justice could call these fellow citizens of ours "incestuous pedophiles". Transparency in government, but the CIA can't seem to get that report on torture promised many times to be released to the public. Can't let the transcripts of Bush and Cheney concerning Valerie Pflame be released either.
It seems Obama is busy making connections to the previous administration to the detriment of those connections he made to us while on campaign.
I hope for the sake of his presidency and the good of the country that he is not. A good test of that point will be the final result of wrangling over healthcare later this year. Will it be true, that "Change we can believe in!" will become more than a smile and a verbal commitment?
FACTA, NON VERBA
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At the risk of being a pessimist, let me point out that Obama is not wrestling with health care, he is wrestling with health insurance, and the two have very little in common other than a business relationship. Health care in the US is in the mess it's in because it has been the beneficiary of insurance companies. Astronomical fees have been simply spread out into the premiums of the covered population, and finally it has reached the point where this cost spreading simply is beyond the reach of tens of millions of people, and bankrupting hundreds of thousands more. But, no one has really thought to put the beast on a real diet.
ReplyDeleteSo, what are we going to do? When the feds offer national health insurance, the private companies will simply increase their advertising budgets - which will show up, ultimately in either higher premiums or more denied claims. Think about the whole advertising issue in health care. Pharmaceutical companies spend several billion dollars a year pitching their prescription medicines directly to the population. That advertising cost ends up in our insurance premiums and copays.
Consider this from the NY Times: Even hospitals, long considered recession-resistant, are feeling the economic pinch. But they are still placing ads. Total advertising spending by United States hospitals in 2008 was $1.23 billion, a slight increase over the previous year of $1.20 billion and more than twice as much as 2001, when hospitals spent $493 million, according to TNS Media Intelligence, a research unit of WPP.
$1.23 BILLION to advertise hospitals!!! I thought that illness created the need for hospital care, not Madison Avenue.
And, of course, private physicians advertise, and there are firms to help them maximize their advertising dollars.
Opponents of providing health insurance to the full population speak of the billions it will cost the taxpayer. Simply outlawing advertising and redirecting these dollars to real health care would more than pay for it all.
All too much of the cost of the medical industry is a result of overhead, not contributions to our health. We don't need more affordable insurance. We need to put an end to the waste and profiteering.
Al
My opinion is similar to Al's, but more complex due of my self-guided tour of the medical industry.
ReplyDeleteIt's not just the medical insurance industry that benefits from high healthcare costs, it's the suppliers (medical device and pharmaceutical companies) and the providers (doctors, clinics, and hospitals) as well. In fact, I'd say that the insurance compaies are the smallest part of the problem in many regards although they are leaders in the patient abuse part of the problem.
I'd like to disagree with the NY Times on a minor part of their article. I've worked for two hospitals and both were always on the verge of going bankrupt because they were caught between the insurance companies efforts to reduce payments and the legal requirement that they treat everybody regardless of ability to pay. The hospitals were always trying to pass the costs of treating people unable to pay on to the paying portion of their clientele but the insurance companies usually won the fight and the hospitals were perennially in the red.
I would agree with the statement that hospitals don't particularly suffer from recessions, but that's because they are always suffering.
As for advertising costs, that's a drop in the bucket. Healthcare companies now consume 16% of the economy, roughly $2.24 trillion per year. If we assume that they spend 7% of their income on advertising (I don't know the number but that is roughly average across the entire business world), that would be $157 billion per year. Based on personal observation, that seems about right.
I used to work in the pacemaker industry and they estimated that in 1999 they spent an average of $10,000 per cardiologist per year on marketing. The reason they spent so much is that the industry is HIGHLY competitive and HIGHLY profitable.
By 2001 they had dropped their spending on doctors and were spending an average of over $100,000 per year per company (and there were 5 major companies in the industry) on EACH member of Congress because it was more cost-effective. I left the industry at that point but it appears that they've dropped Congress and are now mostly advertising directly to the public, which is no doubt, more cost-effective yet.
But back to government health insurance.
The situation breaks down pretty easily into several possible cases:
1. The goverment program will only handle those people who can't get insurance by any other means. I know this is kind of a dumb idea, but the insurance companies are pushing it and they've got a LOT of money and clout.
2. The government program will insure anybody but operate under enough restrictions that it will be at a permanent disadvantage. This is the insurance companies' backup position. Same reasoning as above.
3. The government program will insure anybody and be reasonably cost effective but not the only rational choice. This seems to be the Obama administration's goal but I view it as the least likely outcome. It is the hardest of the possible outcomes to achieve because the healthcare industry is not static and the government is going to have continually and correctly adjust their programs to be competitive without giving themselves a killer advantage. The insurance companies fear this option more than just about any other because they foresee that the government will eventually force them out of business, more or less by accident.
(1 of 2, I've got too much to say)
4. The insurance companies insure everybody and operate under government supervision. This is the insurance companies second backup plan. They are confident that they will eventually be able to tame their masters (sort of like AT&T before it was broken up) but hate the short-term pain they'd have to endure. If you don't count the fact that the insurance companies have good cause to be confident that they'd come out on top, this is a pretty good idea.
ReplyDelete5. A single payer system. This ISN'T going to happen this go-around. It is too alien to the healthcare system, which has too much control over its own fate to allow this to be enacted. It could be quite effective, at least in the short-run, depending on the model chosen but I'm concerned about the long-term costs.
Too many people in this country want to pop a pill for the occasion rather than take time to take care of their body. You see this endlessly in weight-loss advertising and it is true of the American people in general.
I'm not saying that these attitudes can't be changed, I'm just saying that the medical industry spent a lot of time and money to get us to this stage and it will take a lot of thought, time, and money to undo the damage already done. But failure to fix this problem will eventually undermine the gains made in all other areas and bring us back to the current position.
(2 of 2)
(Did you know there's a 4,096 character limitation on comments?)
the very fact that hospitals, doctors and pharmaceutical companies advertise raises a serious question - why is there the need to compete for my health care needs? The only reason that comes to mind is that they are operating in a "free market", and let's remember what poor old Alan Greenspan so sadly had to admit about the "free market".
ReplyDeleteIt's a train wreck waiting for the opportunity to happen.
Al
Al,
ReplyDeletePart of the problem is that information about new treatments does need to be sent out so people know the treatment now exists. This is a legitimate form of advertising.
Medical companies have gone WAY over that line and are now trying to persuade people that they've got medical problems they've never heard of and need to have treated immediately. Far too many doctors get tired of fighting with their patients and just give them whatever they ask for.
Although you are right that this is a train wreck, it has already happened and is very similar to the future of Medicare and Social Security. But it is not going to be easily solved. There are way too many powerful interested parties involved for that.
My guess is that if we are lucky we'll get a reasonably workable solution on the third try in about five years.
(1 of 2, I've got too much to say)
ReplyDelete&
(Did you know there's a 4,096 character limitation on comments?)
ISTM that Pluto needs more space to write.
I've read that Obama wants MoveOn and SEIU to lay off Senator Landrieu of LA because of her opposition to any public health care system.
http://tinyurl.com/knyx2g
Chop!
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Honest, I try to keep my comments as short as possible, Basilbeast. But when you start discussing healthcare issues I've got A LOT to say. Sorry!
ReplyDeleteNow you've moved me to write about another topic. The Republicans have been howling about how letting the Democrats get 60 seats in the Senate essentially destroys American Democracy (they should know, they did enough to destroy it in their day...)
But your quote from the Washington Post highlights something I've been expecting since the election, the disintegration of the Democratic majority due to competiting (even contradictory) goals.
Our local newspaper printed an editorial cartoon that summarizes my views perfectly. It shows Obama as a cowboy on the plains with a big herd in the background and a guy is dropping off Al Franken saying, "Here you are, this is your 60th cat". Then you realize that the herd isn't cattle but cats and they are all heading in different directions.
I suspect it's going to take all of Obama's political skills to keep the Democrats united enough to maintain a simple majority, much less win over Republican votes or enact sweeping reform legislation.
Pluto, my reference about your wordiness was a compliment. You otta send FDChief an email to get you a seat at the bar.
ReplyDeleteThen you can be as wordy as you'd like. :-)
It's clear that you have a few things to say. There's a couple of ladies on the message board I frequent who apparently work in medical billing or something like that, and they're saying more or less the same things you are.
My "problem" with Mr. Obama is that he has not yet IMO taken hold of the Wheel of the Ship of State to steer us into a more healthy direction. At many of the political sites I go to, like dailykos and firedoglake, I'm seeing more and more WTF? comments about Obama.
I didn't vote for change so we could have a continuation of the old situation.
So get yerself a seat and tell us all about your brand spanking new US Senator Al Franken.
Or health care.
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Wow! Thanks for the compliment, Basilbeast!
ReplyDeleteI've thought about becoming a barkeep here from time to time but I'll stay on the other side of the counter for now.
Two reasons:
1. Time (how does the Chief throw out those long witty hyperlinked messages with a job, a loving wife, and two small children? I live in awe of the man)
2. I frequently start and abandon posts when I realize that they aren't going anywhere useful. So while I've got a lot of opinions on a lot of topics, I'm not sure how relevant or useful they'd be to the rest of the world.
In fact, for me, one of the most useful aspects of this website is to help me better understand my own opinions in the light of what others have said.
"Better to be thought an idiot than to open your mouth and remove all doubt..."
Well, I for one feel that the insurance companies shouldn't be doing health care period.
ReplyDeleteConflict of Interest.
They are there to make money for their investors, not pay out money so that you, me, and the schmoe with three kids can actually have a quality life.
And as to why we don't have a single payer...look at the donations to the politicians...which segment of the industry is donating more to the very ones who can do something about this.
Thats right, the Insurance and Banking institutions are pouring money into the Congress Critters pockets, hiring the staffs for the Congress Critters, and taking care of the Congress Critters once they leave public life by esconcing their happy little asses on a Board of Directors...sweet money there.
Yep, we're hosed because our Congress is bought and traded amongst the Insurance and Financial Institutions like stock on Wall Street.
Sorry...I'll end my rant.
I hate this situation and it just makes me cry.
Basil, I apologize for failing to acknowledge your initial post in a timely fashion. Chalk it up to my overall slothful nature. Having said that, I like you post very much and I have little to add to what you and the commenters have said.
ReplyDeleteI also want to tell you how happy I am that you've joined the merry crew of rabble rousers and I look forward to more great insight. One of the things I will say about this post is that it seems you're breaking the code WRT our new president and the purported new way of doing business. This warms my heart. More Americans need to be skeptics about politicians, no matter how "inspiring" they may be. It's what they do when the rubber meets the road that counts. So far, Obama disappoints.
Great looking family, BTW. Stalwart representatives of the heartland. It is—and this is not tongue-in-cheek—what drives the nation. We need more voices from that overlooked majority of our population that goes about its business every day, raises it families, pays its taxes and doesn't clamor for special favors. Keep on writing, my friend.
Well then, maybe we should "procrastinate" ourselves over to the local beer joint and practice that art in a more serious fashion.
ReplyDeleteThanks for your kind words on all counts.
The economy has hit us, although not as hard as some. One brother is doing more work and responsibility for the same money, another was offered a buyout ( Gallup IYWTK ) and a nephew was laid off this past March from his printing job at the Kansas City Star.
I'm still supportive of Obama, but as I wrote above, I'm also beginning to have my doubts. To me, he's a puzzle. He's saying and doing the right things in Russia and Africa, but it's time to see some burn marks on the road.
bb