Does wanting affordable health care make me a Democrat?

No, and yes.  Wanting a national healthcare policy stems from my paying attention to rising costs and exclusionary techniques used by the health insurance industry.  I have a better than average health care plan that will last as long as I live, if I can make the payments.  If I fail to make those very reasonable payments, of course, I’ll lose my health care plan and be forced to find a new provider. Both my wife and I have pre-existing conditions (because we’re in our fifties, because I broke my back while ditching my plane). Several pre-existing conditions.

So, I’m currently without a paycheck because I’m a public servant, and the Republican Party is out to make sure I pay for my pre-existing condition, no matter how much my provider wants to charge, and because barring that, they want to pretend that downsizing me out of a job will make enough difference to the national debt that the can re-balance the budget.  Forget or ignore the fact that only a Democrat has managed to balance the budget in my lifetime. Remember that the Republican party has never allowed any national health care plan to reach a floor vote, even though some of them have proposed or cosponsored national health care plans.

AARP has endorsed Obamacare, and I’m assured that this makes them an arm of the Democratic party.  I’m not so sure.  I think they’ve recognized that A Plan is better than No Plan.

WebMD has also answered some questions about Obamacare in a positive light.  Does this mean they’re also a bunch of commie Democrat sympathizers?  Probably only on the issue of health care.

I’m registered as a Dem, even though I have unregistered guns in my house and don’t intend to stop.  Perfectly legal in my red state.  If the Republican party ever came up with a comprehensive health care plan more inclusive than “Nooooo……” then I might register with them to support a specific candidate.

But for now, I’ve had my life saved by my health care program.  I want everybody in the nation to have that buffer against disaster, and I’m willing to call availability of health care a right, and not a privilege of wealth.  I guess that wanting everybody to have affordable health care has made me a Democrat.

I’ll probably be jumping parties when the issue at the top of my agenda becomes gun ownership.  But until everybody has health care, and can afford it, I won’t know, because that will the top, middle, and bottom of my political agenda.

Affordable Health Care is possible, and can be done by this generation.

Certain people are paying large sums of money to front the bald-faced lie that health care should not be available to every person in the U.S.

Time to remember why we are fighting for Affordable Health Care.

Here’s one reason: Prescription Medicine.

Here’s another, more personal story.

Medical indigence.  Interesting term.  It applies to millions of people who work more than one job.

Here’s a look at several more issues.v

It isn’t a question of whether the Democrats or Republicans have the moral high ground. It’s a matter of making sure that my children can have a health care plan even when they don’t turn out to be millionaires.  About 15% of Americans have no comprehensive health care, and the percentage climes each year.  We start fixing it with this generation, or it will be 30% of us without a plan in the next generation.

And the politicians who tell me that it can’t be done, or that it will bankrupt the country, or that the time isn’t right, are either lying or just plain wrong. I’m voting for lying, because they are politicians, and they are moving their lips. It can be done, and it can be done by this generation.

Healthcare Myths: Bloated Bureaucracies Cruel Necessities


Originally posted by lj user kaath9  at Healthcare Myths #3 & 4: Bloated Bureaucracies & Cruel Necessities

This first of two related myths, as summed up by TR Reid, has it that the universal healthcare systems of other wealthy countries are run by bloated bureaucracies.

This is simply not true.

Every other system Reid cited is less wasteful than ours. This is true whether they are public or private systems. Our for-profit setup has the highest administrative costs in the world.

This is a major reason we spend more on healthcare and get less in return. Our insurance companies spend roughly 20 cents on the dollar (that is, 20% of every dollar they spend) for the non-medical, administrative costs required for a profit-making venture: paperwork, reviewing claims, rescission, marketing, etc.

In comparison, France, with its private, non-profit system, spends about 5% to cover every resident of France; Canada spends about 6%; Taiwan–which broke in its brand new system in 1995–spends only 2%.

Reid refers to Japan as the “world champion” of cost control. This, despite the fact that Japan’s population is aging. They have better health outcomes, as well, and have the longest-lived and healthiest population in the world, though they are spending half as much per capita as we are.

One of the chief reasons these systems are so efficient has to do with the very fact that they DO cover everyone–in most cases, even visitors to the country. Why? Here are a few reasons:

  1. There is a vast pool of healthy people who–through taxes or premiums–pay into the system
  2. There’s no need for a claims adjustment staff who are charged with finding reasons to not pay claims (this means doctors don’t require people in their offices to handle claims either, by the way, which brings their costs down).
  3. There’s no need to spend millions for marketing and other profit-making schemes.
  4. There’s no need for a rescission department charged with finding reasons to cut people from the rolls … just when they need the coverage the most

Actually, this ties into another myth:

Myth #4: if insurance companies covered everyone they’d go broke.

They have to be cruel to stay in business, they say. If that’s the case, then why do the systems that cover everyone continue to exist? Because everyone is covered, as I mentioned. There are young and healthy people paying in to balance the older, sicker people. Then when those people are no longer young and healthy, they’re covered, in part, by the next generation of young and healthies coming along behind. It’s sort of “paying forward” … or maybe it’s paying backward. The point is that at some point, everyone will benefit from the system, so everyone pays in.

To balance this, in the other developed countries, if a doctor okays a procedure, it’s covered. Period. The costs are known, the claim is submitted, the sick fund or government agency or insurance company cuts a check. The doctors are paid within strict time limits. Coverage can’t be canceled or refused for any reason except non-payment of premiums in systems that use that method.

These plans don’t go broke; some, such as Switzerland’s fairly new privatized universal system, are doing very well indeed. Even if the government has to put more money in or raise premiums, they’ve still got massive amounts of headroom before they’d even be in the ballpark of what we’re spending.

Hey, today was a two-fer!

TR Reid’s next myth is that these plans are too “foreign” to work in our unique country. More later.

Health care. Mine is taken care of, why should I care about you?

My uncle forwarded me an e-mail claiming that the Obama health care reform legislation will secretly bring about a 3.8% tax on sale of all houses, starting next year, in 2013. The thing that this misses is that the 3.8% tax only applies to home sales profits that are in excess of $250,000 or 500,000 in the case of married filers.  I’ve never made $250,000 profit on reselling a house, but I suppose you might have.  Still, the base price of the house plus $250,000 is not taxable under this law, nor are expenses that would directly impact the profit line.  Here is a link to an explanation that seems fairly complete.

In other words, it’s a long term capital gains tax, and doesn’t have any impact at all on somebody like me, whose house is only worth $300,000 and has only appreciated by 50% since I bought it. Even if it had doubled in cost, and I had to pay tax on the profits in excess of $250,000, then I’d be paying 3.8% of $50,000 minus my expenses in owning the home and depreciated value over the last ten years.  If I wanted to ignore total expenses on the home over the last ten years, and pretend there was no depreciation, and paid the full amount of the tax, it would come out to $1750.00 on my house if sold at $400K, which is about $100k more than it is worth.

Yes, I am willing to see my taxes go up some in order to bring about universal health care. I honestly believe that if we don’t bite the bullet and make health care available to all citizens now, the costs will continue to skyrocket until the 44 million of us with no health care insurance, and the 38 million of us with inadequate health care insurance, which brings us to almost a third of all US citizens who are financially unable to weather the storm of a major medical emergency, will be joined by basically everybody who isn’t actively employed by a major corporation, the government, or a land-grant university. This info below is ©2000.

Numbers continue to get worse.  In 2011, the uninsured went up to 49.9 Million.

Universal health care isn’t pie in the sky, it exists in many first world countries, and has been tested thoroughly in the last 50 years.  Switzerland may have the best plan, and it’s privately funded by each person.  But that required, and requires, complex regulatory control and cost controls.

The Swiss method is impossible in the U.S. because it would be implacably fought, regardless of proven success, by both sides of our very skinny political spectrum. Liberals would hate it because it isn’t friendly to the uneducated or the addicted spend-thrift, conservatives would hate it because it should somehow magically self regulate, and still cover everybody. Well, conservatives generally seem to feel that it just won’t be available to everybody, and that it shouldn’t be.  From a certain conservative perspective, if you can’t afford a health care plan and you get sick, you should accept your mortal fate, and get the dying over with.

I have friends now who are paying $1800.00 per month for their family of four to have health insurance, since the wife has a minor, non-life threatening, preexisting condition.  I know a good, multiply published, writer who is only alive today because she had major surgery on charity, about a month ago.  We aren’t taking care of the poorest 30% of us, and we’re putting that group into the reality that if they do get sick, they lose their homes, jobs, and generally whatever health insurance they do have.  Americans die in the tens of thousands every year because they can’t afford health care, and can’t find somebody charitable enough to front the bill.

An average waitress in the U.S. makes $20,380 per year.  She can’t afford to have a family or a health care plan.  She almost certainly works two or more jobs, or her boss would be forced to pay her a benefits package, and restaurants just can’t do that for most of their people.

What I’m saying is that regardless of political convictions, millions of Americans cannot get health care packages because Obamacare was castrated before it began, and that most of those millions, if they do suffer catastrophic illness, will die.  26,000 people in that category die early every year, and the vast majority of them are productive, employed citizens until they have the bad taste to contract a major illness.  We could do something, we can afford it, but a lot of Americans have been hoodwinked into believing that it would be the end of America if we actually fixed the clearly broken and getting worse health care system. Obamacare is a start, which the Republicans flatly refused to make. But Obamacare will never actually accomplish the goal if it isn’t improved.  Dropping Obamacare is going back to square one for 16.8% of us.  Fixing Obamacare, even if it requires a complete overhaul, is the best way to go.  Don’t back down.


Another health care rant.

I don’t approve of using the insurance industry to pay for health care reform. That’s thirty percent of our medical care dollars going into corporate coffers, and enough money each year to pay for healthcare for all the deadbeats the industry keeps telling us are out there trying to steal our hard-earned insurance dollars.

I think that the health care insurance industry is just another corporate Colossus that has managed to completely separate health care costs from market realities, and will continue blindly jacking up the price of health care costs until the system breaks down.  Not the value of health care, just the cost of it.

I think that the federal government should go into competition with AETNA, and set out to win. If laissez faire is so fair, if private business is so much more effective and competitive, then AETNA will win out in the end against those lazy bureaucrats in the public sector, and find ways to make sure private citizens can afford health care programs that won’t vanish when things get ugly, and the patient becomes too weak to hold his job.

I think that the federal government ought to be in the business of keeping successful and competent obstetricians from having to pay a couple hundred thousand dollars a year in malpractice insurance, because they have to protect themselves from desperate customers who’ve lost everything, and a loved one, paying for an unsuccessful outcome.  That is just plain sad and sinful.  The reason so many health care professionals want reform is because they aren’t getting the money we pay for our care. Insurers, boards of trustees, and lawyers are getting more health care dollars than many of our doctors are.  Let’s face it.  Americans spend 16% of the largest GNP in the world on health care. That is the largest percentage of the very largest GNP going, and we aren’t living any longer than any of the other first world nations.  That is probably because our medical care providers are paying half of their income into what amounts to a protection industry.  Call it what it is: a protection racket.

As individuals, we cannot control the collective might of the corporate insurance industry.  Medical Insurance invalidates the entire concept of market forces at work when it comes to controlling prices.  It’s time and past time to put our federal government to work sorting out the morass of insurance industry malfeasance that is slowly but inexorably making health care something that only the wealthiest of our children will be able to afford.

Lemonade or Grape flavored?

I woke up this morning to a lie from the political party I most side with. Guy Cecil from the Democratic Senatorial Campaign Committee wrote to tell me that the “Republicans are so against funding women’s healthcare that they would shut down the federal government over it.” He was lying, and we both knew it. Of course, he probably thought I didn’t, but that just goes to show the incredible gall many politicos have — the unvarnished disdain they have toward their constituency.

If it wasn’t for the serious avalanche of tripe my tea-partying friends are swallowing without any hint of critical appraisal, I’d be more angry with my party. Instead, I’m mildly disgusted, but mostly just worn out. I guess when it comes down to it, the Democrats aren’t my party. They’re just the team that pisses me off the least, this year.

I voted for Barack Obama, even though I’ve always liked John McCain. I’ll vote for Obama again in a year or so, even though I think he’ll lose. I admire the fact that he put his own political career in the shredder to push through a health care bill that we badly need, as a people, if health care is to remain available to everybody. We need to begin thinking of health care as a necessary public service like electric power or running water, or long and healthy life will become the special domain of the wealthy, an elitist privilege.

But President Obama told us that he could be a bipartisan president, at the same time as the DNCC was pushing me for donations to make sure that the Republican’s were so outnumbered that they couldn’t even front a filibuster when “my” party of the moment wanted to have a free hand at whatever legislation they wanted to pass.

As it happens, I don’t want to turn my guns over to the democrats any more than I want to watch the Republicans walk us in lockstep into their most desperately, trenchantly, right leaning members’ idea of a moral utopia. Abortion is not murder — probably 30% of all first pregnancies self terminate. That whole argument is stupid — God isn’t murdering those miscarriages. We are a Christian people, but not a Christian country, and our founding fathers made sure of that. Funny how the wisdom of the founding fathers is plenty of excuse to allow the poor to starve or freeze to death without public aid, but inadequate to bind the country to remaining religiously tolerant.

When it comes down to it, both sides are grandstanding to get attention. If the Republicans blew off their most rabid supporters, and the Democrats really tried to figure out why the Republican middle doesn’t want to give up their guns, give up their sense of traditional values, home as castle, etc, then maybe we could move forward on some really important things.

I don’t want to spend $4.10 per gallon for the privilege of burning Exxon’s industrial waste in my car. I want Shell to use that oil for important things, and treat gasoline as the industrial waste that it is. I want BP to acknowledge that most of the gasoline we burn is something they would otherwise need to dispose of themselves, and stop playing cynical games with charging the absolute maximum they can get from us. Yes, it is possible to engineer a crash in the U.S. economy by charging enough for gasoline.

Wallstreet crashed twice in the first decade of the 21st Century, and we pretend that there is a reason to argue about regulating that place. Most of my friends who lost money during those crashes have never recovered their basis. I had almost recovered my investment from the first crash at the beginning of the decade when the next one hit at the end of the Republican monopoly on congress. Both sides of the fence look away from the fact that the stock-market is just legalized gambling. There are legitimate stocks available for purchase, but most of what goes on there is just addicted gamblers pushing paper around, hoping that their scrip will sell for more of more than it is worth than they paid for it. When the stock market isn’t in freefall, it bounces ten percent on some days. This is not a viable place to keep any money that isn’t absolutely available to be lost.

One of my best retired-military friends owns a bar and grill in Oregon. He spends more on his cook than he earns for himself. His costs are mostly in the form of required benefits, and unless the economy goes back into overdrive, he’ll probably end up selling the place. Too many social programs are being paid for by small business owners.

My sister has lived in and around San Francisco for ahem years. She spent about twenty of them in the food service industry, working three or four jobs at a time. A huge chunk of the food service industry in that area can’t afford full time employees because of the required benefit packages. They avoid that by having five employees doing the job of two full time employees, so that nobody goes over half-time.

A lot of people want to argue that laissez faire business without legal controls is the only way to make the country work, because that’s the way it was when Beaver Cleaver was a sprite. Big business wants us to believe that, because it does work out well for big business. Unfortunate, really, that there isn’t enough big business to go around. But millions, maybe even billions, of dollars are spent to keep the American people from recognizing just how far from true it is that the board of directors or stockholders of GM care a whit about the twenty people who applied to work for that company but were turned down for every one person who actually found employment there. The mobilization of money, deceit and influence that went into fighting health care reform was awe inspiring, and continues to be intimidating, especially when you consider that health care reform is saving lives, and that with some concerted effort on the part of lawmakers, could be economically freeing for 99% of the people in this country, without putting anybody at all in the poor house. This is particularly agonizing to me, since it would work so much better if there weren’t so many people trying to get it to fail because it originated in the wrong camp, and not because it’s a bad idea. Health care reform is a stellar idea, and most of the people in the health care industry approve of it.

Why is it so very easy for me to find out how much money the average American makes, and how many of us there are, and what the average family earns, but so impossible for me to find out how much money the US corporations make, and what portion of the U.S. economy is tied up in corporate accounts? That question practically answers itself. We have big problems in this country, both sides of the political divide are fully aware of it, and they’d rather keep us fighting about abortion, entitlement mentality, and freedom of religion than turn our corporate gaze on what was really going on during the budget crisis this week. The Republicans and the rebranded republicans in the Tea Party were pissing on the American people with lemonade flavored piss. The Democrats were pissing on the American people with Grape flavored piss. But it was all piss.

Screw the first responders! We have millionaires to protect!

Welcome back Republican Senators. President Obama will surely respect your strength. He fairly gave up a second term to see through the first step on the road to national health care. You filibustered the 9/11 first responders in order to make sure your millionaire buddies don’t face a tax increase. I understand. You’re afraid that the greater body of American millionaires will flee the country in despair if they’re forced to lie about 1% more of their incomes at tax time The lies they’ve generally told for years to make sure their real taxes run 10% or less are nothing compared to the insult of having to lie about 1% more. A tough decision, just like the president made. I hope those millionaires appreciate your unstinting sacrifice, you know, in letting New York first responders die and bankrupt their families trying to pay for medical care for the cancers and heart/lung conditions they developed while responding to what you call the first battle in the war on terrorism.

I admire your stances on party solidarity. While I’m not sure you really earned your pay as senators, I think you’ve more than earned your campaign contributions and side incomes. I’m sure several of you have bright futures with Halliburton and like industries.

An Unholy Alliance: The insurance and litigation industries

A friend of mine recently commented that health insurance is a weird model for the insurance industry to follow, and I very much agree. His comment was a comparison between doctor visits and automotive maintenance, and the fact that you wouldn’t file an insurance claim for bringing your car in for scheduled maintenance.

My first response to that would be to note that some consumers can never afford general maintenance on their cars, so end up paying very big bills for things that wear out catastrophically, while other consumers either perform the maintenance, or pay somebody else to do so (I’m a chronic purchaser of maintenance), and don’t spend a lot on major maintenance. I think that the health insurance industry notices that it spends less on catastrophic care if customers get routine care. Since it is paid enough to support the risk of short term catastrophic care among the client base, any money saved by reducing cost of that care is money in the pocket. Simple economics, complicated by the uncomfortable fact that Blue Cross doesn’t really want to get out of the business of catastrophic care, because it’s a hugely profitable business – they want to get paid for covering and administering every catastrophic medical situation in the country.  My second response would be that my Toyota RAV4, no matter what damage has been done to it, isn’t going to cost $200K to fix. Repairing me is in an entirely different economic stratus.

The insurance industry as a whole has the risk of each medical transaction covered both ways, just like the neighborhood bookie (for those neighborhoods that have bookies. Mine doesn’t have a bookie – just an insurance broker). I pay an insurance company to cover my costs if I break my leg, or develop cancer; my doctor pays an insurance company to cover his costs if he either screws up my care, or if nature takes its course and I die, then some ambulance chaser convinces my wife in her grief that I shouldn’t have died; and I pay an insurance company to cover my costs if a moose wanders into my car on the road; the body shop which repairs my car pays an insurance company in case one of their guys forgets to replace a bolt, the bumper falls off, and takes out my exhaust system.

I’ve wanted to talk about the unholy alliance of the insurance industry and the Personal Injury lawsuit industry for some time. It’s become clear to me, though, that Insurance is an across-the-board contributor to escalating costs in virtually any market that it invades.

One secret that the insurance industry holds is pretty simple. Charge people a reasonable amount per year for whatever they want to be protected from, then, when disaster strikes, pay whatever the provider wants to charge. In a short time, years or decades, the provider will be charging far more for its service than a normal person can afford. THEN, everybody must buy insurance to use that service. Once providers are no longer subject to any market forces, it’s safe to crank up the premiums, because consumers can no longer pay for the service directly. I’m reasonably convinced that this isn’t done by any sort of conspiracy, but the insurance industry has a habit of destroying market forces.

Another secret: Lawyers add fun and profit to both sides of the insurance game. A friend got into a moderate to severe, no-fault, traffic accident. His major automotive insurance company was aware that he had military medical, so low-balled him on handling his care, as well as totaling his car out for about half the blue-book value. He paid a lawyer a few hundred dollars to draft a letter from a law office. The insurance company woke up. Lawyers had become involved, and they wanted to settle this amicably (read, for about thirteen thousand more than they would have paid my friend for the claim, otherwise). It’s awe inspiring the way purses open once the real blood-suckers have become involved. I say this not in disapproval, but in admiration. Once I get past the fact that J.Q public gets low-balled by default, by many major insurance companies, I admire the way they clean up their acts fast once they start to see shark-fins in the water. When it really becomes fun to read about is when the claim becomes large enough that both sides muscle up and get the lawyers aworkin’ the case.

A drunk carrying passengers runs a red-light in downtown Atlantic City, circa 1993. His car gets hit in the side by some commuter who has the nerve to actually go through a green light without stopping to look for crazy drunks in the middle of the afternoon. The uninsured drunk is effectively penniless, and his passengers have been injured (no fatalities.) A Personal Injury law-firm takes on the case, and starts looking for deep pockets, meanwhile sending the passengers, and the drunk, out to specialists to determine how much care will be required. Injuries, bad dreams, damage to goods. The PI firm (my wife was working for them at the time) settles on the municipality as the only available deep pockets. The city does a rough calculation, based on effectiveness of the particular PI firm, and various other factors, and settles the case for about $32K in cash, and rehab for the drunk. I say about because the final take was sealed, but that was about the amount the PI firm needed to take a third of in order to turn a profit, and they did turn a profit, but not a drinking champagne profit. The PI firm’s claim was that the light had turned red too quickly (yellow light too short in duration) and that the drunk wouldn’t have had time to stop if he’d been sober. The fact that the intersection didn’t generally produce an unusual amount of accidents just never weighed into the equation. The factor to consider was court cost to defend the city, verses immediate layout to make the case go away. It was cheaper to pay out than it would have been to spend a couple days in court while the PI company rolled out its display of expert witnesses and crying victims. That PI company had a very good record of success, so the municipality folded before a single witness was heard, or even a jury empanelled. I can’t say for sure, but the odds are pretty good that the fully insured driver of the other car got less recompense for the incident than did the drunk who jumped out in front of him.

At that time, NJ was the most litigious state in the country, so that sort of consideration probably came into play more often there than in other places, but the concept is pragmatic reality in modern litigation. But where does that leave me? As a member of the general public, I need to be insured against being hit by uninsured drivers, because that is a separate insurance from liability, wherein the other guy gets paid for accidents that are my fault, or comprehensive, where the insurance company will pay for my damage if I screw up. It’s that middle ground, where I’m not at fault, but somebody else is. Lots of insurance companies demand that I file the claim for those against the other driver, and if the other driver hasn’t got a  sou, I’m SOL unless I’m paying for that special “underinsured driver” rider. If I have got the uninsured driver rider, then my insurance company becomes one of the deep pockets in the litigation dance.

If I ever end up in the cross-hairs of a PI firm, I’m all in. A 30K finding against me would probably bankrupt me and put me into foreclosure anyway, so I’m gonna be loading up for bear (hiring a lawyer), and engaging in the fight – regardless who is at fault. Those legal fees mount up fast as all get-out, but if I can get the thing laid to rest in the opening movements, I’m better off paying a few thousand dollars for that service than if I try to handle it myself. As my friend from the no-fault accident learned, even the people on my side of the argument are more forthcoming if I prove to have a pet shark on call.

So, without really believing there is a conspiracy, I have to note that the insurance companies and the litigation industry prop each other up. Insurance always has deep pockets, PI litigators can always find somebody who’s either been hard done by, or is simply pitiable and will look good in court. It’s cheaper to pay off the litigant and his lawyer than it is to fight the case in court, and take a chance that the poor drunk of the people will fare better with a jury of his peers than will the insurance company with it’s three piece suits and expert witnesses.

Here’s a bit from the National Association of Personal Injury Lawyers:

Personal Injury Settlements

Settlements occur before, during or after any lawsuit is filed. Experienced personal injury lawyers almost always seek this course first as it the fastest and easiest way to reach an acceptable conclusion for both parties. Negotiations will take place between personal injury lawyers who will then present the proposed settlement terms to both parties.

Now, here’s a bit from Monohan Law Practice, showing that personal injury cases are way down:

Payouts in Personal Injury Cases are way down too. The median payout for all personal injury cases dropped 56% between 1992 and 2001. The median inflation adjusted payout in all personal injury cases dropped by 56.3% in those same years to $28,000, according to the Bush Administration’s own study.

Oops.  Lawsuits are “way down” and payouts are only $28K, at median. Actually, formally filed lawsuits are way down. My phone book is still chockablock with yellow pages adds for lawyers who’ll take PI cases on spec. They ain’t going broke. I have no way to determine how many PI/insurance settlements are reached each year, because Google isn’t playing nice on those two questions, but I’m betting that the numbers are real healthy. A 28K PI settlement would pretty much put me out of my house, but I guess I’ll have to live with that risk.

The thing to notice though, is that whether it’s an insurance payoff or liability law-suit, the amount of money that changes hands, even when the defendant is completely innocent, would generally bankrupt me. If PI lawyers only had people like me to go up against, they would go broke. But insurance companies settle even questionable cases out of hand for amounts that would bankrupt me, and consider it cost savings.

Health care reform – my second rant.

Health care is the elephant in the room that nobody wants to see, even when they’re generally happy to see elephants in the room. President Obama is probably a one term president because he insisted on recognizing that fact, and the odds are very good that the next administration will float in on promises to ignore that fact. They’ll promise to cancel the Obama health care plan, and to bring things back to status quo, and people will vote for them in droves, with nothing but vague assurances to look into the issue sometime in the future – just like 1993. But health care is so expensive now that it crushes median income families.

I just looked up a large sampling of health care plans available to private citizens in Alaska. As non-smokers, my family of four could plan on paying out a minimum of $6.000 per year, plus copays, with a family cap of about $50,000 out of pocket for medical care. Hey, that’s more money than my family makes! That’s right. If somebody in my family were to come down with cancer, I could look forward to spending more money than I make, on medical care, before my plan would take up the rest of my medical costs. Of course, I have to keep up payments on the plan, even during that medical emergency that might go on for a couple years.

That’s assuming that I could get that plan. Since I have hardware holding my back together, and have had high blood pressure and cholesterol since the accident that caused me to go bionic, a lot of those plans would either not let me join, or specifically exclude orthopedic and coronary care from my coverage.

So, if I didn’t already have a plan provided through my military retirement, the health care that I could afford would cost $6k per year, and I’d go bankrupt if anybody in my family suffered a catastrophic illness …

A better plan, which would have a lower deductible, and a much lower maximum payout for my family, would cost us $12,000 per year up front, and would still have substantial copays, deductibles, and individual care caps in the thousands per year. How many families of four in the Anchorage area can pay out $12,000 per year on medical insurance, plus an out of pocket limit of $4500? This is one of the best plans to have if you actually come down with a catastrophic illness, but my actual take home pay right now, from two jobs and my military retirement, comes out to … Well, let’s just say that $12K per year would bite right into the feeding the kids budget, even though we’re doing a lot better than several of the families in my neighborhood.

The median household income in Alaska for 2009 was supposedly $63,505 After a fashion, I accept that. I actually know a few people who make that amount or more. My family falls slightly below the median. 11.3% of Alaskans live below the poverty line, even though we have lower unemployment than most states. Supposedly, median family income describes that point where half of families earn more than that amount, and half of families earn less. But, I don’t actually know very many families who will acknowledge earning the median, and health insurance isn’t based on household income. If we were buying our own health care plan today, and my family were at the median, we’d be paying almost 19% of our total before tax income into our health care prepay. Dental care not included. Not including extra costs for my preexisting conditions.

I’d joke that only death, taxes, and health care costs are sure things, but I don’t have to pay $1 for health care. I can choose to die of my next major illness.

What is becoming increasingly clear, and increasingly true, is that only rich people get to have reliable health care plans. The status quo cost of medical care, before Obamacare, was taking up a larger percentage of our incomes every year, excluded a larger percentage of Americans from access every year, and grew faster than household income or any other aspect of the American cost of living. Returning to status quo will renew that cycle.

Things done wrong, things done right on national health care

I think that the vast majority of Americans want health care for themselves and everybody that they love, and want the price for that to be affordable. I think that the vast majority of people who are satisfied with their existing health care insurance plan have never experienced a truly catastrophic medical emergency, or they’d have to revisit the values of their own status quo medical plan.

I was once covered by a medical program that forced me to pay 25% cost share of my family’s medical bills. This was acceptable if my wife broke a leg skiing, but would have put me into bankruptcy if she had broken her back. When I broke my back, the two hospitals that cared for me put up accounting charges of about half a million dollars in the first few weeks – but nobody came in for an early shift, no extra people were hired, and the majority of my expensive care was simply watching me either heal or fail.

Okay, 25% of 500K is $125K, which, tacked on to my permanent loss of income as a pilot, and with my traditional USian home mortgage, would have wiped me out under the insurance program that once applied, and which is similar to many that prevail today.

An awe inspiring number of Americans are perfectly comfortable with insurance programs that limit out when things go very bad. If they’re lucky and never need critical care, and nobody in the family develops a chronic catastrophic illness, they’ll never realize that they’re paying good money for a service that, if they did fall to a catastrophic illness, would put them in the poor-house, make them unable to pay their insurance bills, and then be taken away from them entirely for non-payment. Can that happen? Does it? Yes, in cases across this nation, in every calendar year.

In 1993, Congress over-rode HillaryCare because she folded on taking the insurance industry out of the driver’s seat on medical costs. Congress was absolutely correct to do so. Insurance companies create an interesting form of medical market place, that in another business would be frowned at as completely unethical, and rightfully so. I spoke to an obstetrician during Teri’s last pregnancy, who mentioned that he paid $220K per year for malpractice insurance as a successful obstetrics specialist with a good record, who hadn’t been sued. His personal malpractice insurance was about twice what my maximum pay has ever been. Health insurance companies generally spend about 30% of their income on shearly internal administration, and the medical community has to put up a good chunk of its income on staffing to meet insurance company demands for documentation. This is not done in the face of a real problem with medical embezzlement, IMO, but in an effort to make insurance companies seem necessary. I might be wrong on that.

Insurance companies have a way of making themselves absolutely mandatory by paying whatever the medical provider demands. This completely eliminates the market forces of supply and demand, and thus, any pretense of realistic free enterprise cost controls. An example would be the night I broke my back. An ambulance picked me up at Maui’s major airport and drove me four miles to Maui Memorial hospital. This ride cost about 17 grand. The whole ambulance event took an hour, and everybody involved was already at work. The people who did the work certainly didn’t make 17K for it. My insurance was handled by some combination of Tricare and the federal government, who did not authorize that much expenditure, and shut down the providers complaints when they tried to come back to haunt me for the difference. The $150K or so that Maui Memorial made during the four days I was resident there didn’t involve anybody coming in to work, or any surgery, or any major exhaustive effort. I received MRIs and CAT scans from equipment on site, by staff who were already at work. You could argue that my instantaneous costs were then spread out over time to pay for staff when there wasn’t an ICU case, but realistically, the hospitals in this country always have enough beds filled to pay for their day to day operations and building maintenance. No traditional insurance provider would have squawked a bit about those fees, for the simple reason that traditional medical insurance companies fully depend on the cost of critical care being beyond the reach of the average American. Limited duration high cost emergencies are where traditional insurance companies look best, and get the lion’s share of their letters of appreciation.

I remember bunches of Republicans in 1993 telling their constituents that getting health care under control was a huge priority for this country. But from the day the Republicans took over congress, until they were thrown out in 2009, they never once fronted a major health care reform bill. Not once. My Congressman, Don Young, and my Republican Senator Lisa Murkowski, wrote me following the passage of Obama’s health care plan to tell me, not that people don’t need or want a national health care program, but that they had voted against the plan as written, because it was a bad plan. I agree with them. It’s a bad plan because it caves in to the National Health Care Insurance corporations, just as HilaryCare did a decade and a half ago. Egads, does that mess need to be fixed.

But Obama’s plan is world’s better than the great plans the Republicans fronted during their stay in office. I guess you could say those plans were the ultimate in paperless office practice, since nobody can find them or read them.

During my years as a voter, I’ve voted Republican more times than Democrat. But I’m voting for the man or woman who commits to national health care being a reality, regardless of party, until this mess is straightened out.

What mess? The mess that has the U.S. spending 16% of our world’s largest GNP on health care, when poorer first world nations, which is to say, all of the other first world nations, spend 10% of their smaller GNPs on health care, and are in just as good of health as we Americans are. The mess that forced my wife’s mother to remain in Boise, ID, for the last several years of her life, because her health care plan only covered her while she lived in Idaho (it covered benefits while she took trips, but not if she moved away), and she couldn’t, at 90+ years old, find another insurance carrier (Age is a preexisting condition). The mess that forces small businesses to pay $1500.00 or so per month for each of their full time employees to have medical care, which forces many of them to make almost all of their employees work part time so that they won’t have to cover full time benefits (not a new situation, my sister spent twenty years working several concurrent food industry jobs, because none of her bosses could afford to pay her benefits as a full time worker). The mess that forces doctors to pay more than I’ll ever make in a year, every year, in order to be insured against the most litigious community in the world, which jacks up prices, which are paid by insurance companies who hire expensive lawyers at both ends of the deal. The Insurance and litigation societies of America are in some sort of unholy alliance that I’ll talk about during some other rant. I want to talk about it separately, because I don’t think that unholy alliance is really intentional on anybody’s part, it’s just real …

What mess? Medical professionals should be the most respected members of US society. Not just the doctors, but the daily care professionals who do most of the heavy lifting. If you’ve messed with blood and shit to help somebody survive, you’ll understand my stance that it’s the toughest work in the world, with as much heartbreak as joy to look forward to. But the people who make hospitals work aren’t where the money is going. The doctors who are making the huge incomes the Democrats tend to deride, are kicking those huge incomes back into self protection against customers who aren’t evil, and generally aren’t even convinced that the doctor was at fault. What they are is grieving and destitute from paying their cost-share. Medical care professionals should be among the most respected members of American society, but they don’t need to be the richest. Maybe they all ought to be paid as well, and as reliably, as the active duty military ought to be.

Too many messes? No fix? I don’t believe it. I think the Democrats luffed in accepting the insurance industry as a viable overlord for medical costs. I think the Republicans and libertarians are trading away the best good of America on a theory of every man is an island, when poor Republicans who can’t pay for their own emergency care nonetheless vote to support a status quo that isn’t working, and is growing worse by the month, because they fear that fixing it will somehow be worse than pretending it ain’t broke.

Compared to health care costs, I don’t care about gays in the military. I don’t care about abortion. I don’t care about civil rights. I don’t care about the ACLU. I don’t care about most of the hot-button issues that consume the media, because they are qualitative, and don’t affect the vast majority of us. America is rapidly becoming slave to health care costs. Our unemployment situation is made much, much worse by the hidden costs of being an employer, which often enough are as great as the take home pay of full-time employees, and which almost all translate out to health care costs (medical and dental and workplace injury, Oh My!). Oh, I do care about the other things, but they aren’t going to destabilize our economy or our country’s political existence. Health care costs, left to be stabilized by market forces that don’t exist, are more than sufficient to do those things, during our lifetimes.