Commentary on Demand

                                    Editorials by Request

                                             Fuel your discussions

ISSUES and Thoughts

1 Mar 09 Healthcare - Make it Cheaper by getting rid of he Hanger Ons.  Currently, the healthcare system supports not only hospitals, doctors, nurses, pharmaceutical workers, drug and medical equipment manufacturers but also insurers and lawyers.  If I were working on healthcare reform the primary consideration would be how I could accomplish the healthcare specific benefits associated with having lawyers and insurers in the system while significantly lowering the cost.  There is also opportunity to provide the same service more efficiently with fewer negative affects.  I'll address lawyers and insurers in separate paragraphs. The two types of insurance coverage I think need to be addressed are malpractice insurance and what we normally consider to be health insurance. Health insurance:  Health insurance helps to standardize the cost of health care per individual and makes the amounts people pay monthly and yearly more predictable.  The current debate has all solutions involve making it possible for more people / everyone to get this type of insurance. I personally believe the rise in popularity and expansion of this type of insurance is the primary reason for the explosion of healthcare costs.  This is a simple supply and demand argument.  With more people getting health insurance this causes higher demand from the available healthcare providers.  Since the healthcare profession in this country successfully limits the number in training of qualified doctors the supply is limited and thus expensive.  Currently, the competition between private health insurance and government health insurance has done nothing to increase supply and they really just stress the demand sector.  I'm normally a fan of this type of competition however the public's demand for these services are non-elastic and in fact most people are willing to spend "whatever they have and whatever they can barrow"  to get the health services they desire.   This results in a perverse system where healthy rich people who want enlarged breasts suck up the resources that would otherwise be dedicated to repairing burn damage from auto accidents.  The health insurance system we employ now has gotten so bad I think it is obvious even a poorly managed system that worked to hit optimum percentages of each medical specialty would make up the composition of public medical care would be a better system than what we see from the combined competition of private and government health insurance.  Unless the current system undertakes a concerted effort to increase the supply of health care services I'd rather see the government become the employer of 80% of all health care providers and then manages who ends up getting to see their employees.  Malpractice insurance:  I would eliminate this insurance for all of the government employed healthcare providers.  Instead I would set up a government provided compensation plan in the event a patient becomes handicapped and a medical review board that would eliminate a persons ability to practice medicine if they should be proved to be incompetent.  In this implementation we would replace an inefficient and costly system and replace it with one that will ensure more of the basic needs of handicapped people are fulfilled.  The number of displaced malpractice insurance employees should be about the same as those needed to work in providing for the needs of the handicapped.  I advocate this approach because it provides because it is likely to get more handicapped people into a place where they can contribute to the greater good of society.  In the current system a person gets what they need for care only if they can get a lawyer to take their case, they are lucky enough to get time in the court system and they don't die before it is resolved.  This system is more like a lottery for the patient only they are guaranteed they will be sharing the majority of their winnings with the lawyers and tax collectors.   Lawyers:  They occasionally bring forth an issue that correctly makes a company adjust their product or practice.  I would like to see the system set up so that if a lawyer comes across real problems that need this intervention then they can sue in a class action.  However, the proceeds of the winnings should go primarily to the government to partially fund taking care of handicapped people.  Their payment would be structured more like a finders fee than the traditional attorney fee.   Related Article Evaluation of Obama Biden healthcare proposal
8 Feb 09 The First 19 Days - of President Obama A lot of things have happened in the first 19 days of the new president's administration.  I have been spending most of my free time with the family so I haven't sat down and wrote the lengthy article I have in my head concerning the $780,000,000,000 (or will it  be the $915,000,000,000) waste of money.  What I should write is the completion of my application to become the Secretary of the Air Force.  I could also spend some time comparing bipartisanship of President Bush's first 9 months compared to what we are seeing in the first 19 days of Democratic power.  Instead I'm going to write about Andy Card's remark about President Obama working without a suit jacket on. I was deployed to the AOR last year and worked in the CAOC as a Liaison Officer representing NATO.  While there it became necessary to arrange for the remains of a foreign national back to their home country.  This was arranged through  the US Air Force logistic system.  One leg before the person was repatriated they were transferred from the US travel coffin to one provided by his country.  The travel coffin ended up at a upscale hotel in a country were the US Air Force doesn't have a presence.  I contacted the Air Force Chief Master Sergeant working in theater logistics hoping to arranging to get the item back.  She told me "We wouldn't know how to do that, why don't you look on the internet and see if Fed Ex couldn't pick it up".   A few weeks later she and the Capt she worked with picked me up at the share a ride.  On the way there they saw a woman jogger with earphones in.  The Capt pulled over and the Chief yelled out the window "you're not allowed to jog with headphones on". It's true that there is a rule that tells us not to run with headphones on.  There are also rules on dress and appearance.  Just like my experience you can  be assured those that run around all hyped up about things like earphones and dress codes have to be concerned about these items because these are the only things they understand.  Just like my experience most of them can't handle the intricacies of their primary functions.  When I heard of the Andy Card remark and see that he use to be Chief of Staff, its no wonder President Bush had so little clue on what was going on during his eight years.	7 Dec 08 I respectfully disagree with President Elect Obama's assertion today on Meet The Press that the reason not to implement a large gas tax is because the additional tax would produce a detrimental additional burden on tax payers. I do promote having the government get away from propping up industries with subsidies.  With subsidies we get perverted industries like ethanol that use more energy to produce than they give.  That is why if we want to promote the development of alternate industries for transportation or waste management or energy efficient construction then we should make the current version more expensive.  If we as a society want to reduce gas usage, taxing gas will make natural gas or fuel cells more economically feasible. More importantly the deployment of alternate energy vehicles will happen in a time frame and on a scale that is sustainable. The way around the President elects concern is to switch taxes.  Currently almost all counties implement sales tax on goods.  This 6 to 8 % it cost people to purchase could be reduced which would promote purchasing more goods.  In Erie County New York the sales tax on a $20,000 car or truck is $1600.  This additional cost alone could be the deciding factor on a car purchase decision.  Eliminate this tax - sell a car and keep the economy ruining.  Replace the lost sales tax revenue with a tax on gasoline and promote the development of alternates to gasoline.  Seems like a win win situation.