Concerns Based on Reality
Several recent events and actions lend credence to concerns by citizens, including these:
• The coal conveyor & access damage at the nearby Westshore Coal Terminal in BC resulting from a late night collision by a large Bulk Carrier vessel with a pilot on board.
• The railroad bridge collapse south of Bellingham on the BNSF main line used by heavy coal trains.
• The derailment of a coal train east of Tri-Cities, spilling 34 loaded cars.
• The protracted delays of traffic in Skagit County due to a stalled coal train with brake problems.
• The unseemly acts by the GPT Applicant to recruit allies to pack public meetings designed to gather citizen concerns.
• The repeated dismissals of legitimately expressed citizen concerns as only NIMBYism by GPT spokespersons.
• The ongoing media advertising campaign designed to influence public opinion during the 120-day EIS Scoping period, which advocates multiple coal terminals -not just GPT- which seems like a concerted effort on behalf of an entire industry. Doesn't that justify a programmatic EIS approach is necessary?
There is likely available statistical information on the frequency and severity of both large bulk vessel and coal train accidents. I request that this information be researched and applied to the rail and marine traffic projected by the Applicant for GPT.
Additionally, the costs to the natural environment, existing businesses, residents, governments services and facilities need to be ascertained for inclusion into the EIS evaluation.
A programmatic EIS appears necessary to include all of the possible impacts, whether to the GPT site or anywhere along the proposed transport routes.
It would also include impacts to the atmosphere, the oceans and inland waterways, the land, human health and impacts to each ecosystem likely to be affected over time.
Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts
Sunday, December 9, 2012
Tuesday, October 9, 2012
GPT: EIS Scoping Comment No. 16
Climate Change: Who's Responsible?
The GPT Application Chapter 5.7 Air Quality - Section 5.7.2.3 is titled 'Energy and Climate Change'
It reads, in part;
The Council on Environmental Quality (CEQ) and Ecology have issued guidance on considering the effects of greenhouse gas emissions in the evaluation of proposed agency actions under NEPA and SEPA, respectively. These guidance documents advise agencies to identify and quantify meaningful greenhouse gas emissions directly associated with a proposed action.
However, CEQ has acknowledged that the utility of analyzing greenhouse gas emissions in an environmental review under NEPA is limited because of the indeterminate linkage between specific environmental or climatological affects and a specific project or emission source. ....blah, blah, blah.....
Remember that underlined part, because it's the prelude to GPT's strategy to escape responsibility.
Section 5.7.2.3 continues, thus;
As a bulk products terminal, the Gateway Pacific Terminal would not be required to conduct greenhouse gas reporting under current local, state, or federal regulations. ....blah, blah, blah......
Then it goes on;
The Gateway Pacific Terminal would function as a transfer point in an international transportation system.
Pacific International Terminals would not own, or process in any way, the commodities that would be received and dispatched by the Terminal.
Likewise, the company would have no direct control over the source or destination of individual commodities, or the volumes of such commodities transferred from land-based transportation to oceangoing transportation. The volume, type, and mix of commodities transferred at the Terminal would be determined primarily by international market forces and the business interests of the Terminal’s customers. ...blah, blah, blah.....
What would GPT agree to be responsible for, one might ask;
Greenhouse gas emissions from the Terminal would include carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) associated with such Terminal activities as loading and unloading, stockpile shaping, rail and marine traffic, heating, and construction. ...blah, blah, blah.....
OK, you get the idea, GPT is trying to avoid the obvious impacts of shipping 54 million metric tons of coal to Asia to fuel power plants. Nice work, if you can get it!
But, GPT would be glad to comply with all standards for the minuscule portion of greenhouse gases [ghg] that happen to escape from its 350 acres;
Measurements of each gas are converted to carbon dioxide equivalents (CO2e) using EPA-specified calculations. The emissions estimate will be prepared following final design and permitting, so that any final project changes are reflected in these estimates.
The emissions estimate shall be performed consistent with the Greenhouse Gas Protocol Corporate Accounting and Reporting Standard, a set of standards developed on behalf of the World Resources Institute and the World Business Council for Sustainable Development. ...blah, blah, blah....
No one blames an entrepreneurial corporation -with deep-pocket, arm's length partners- to try and limit it's liabilities and maximize its profits, do they?
Before you answer that question, please understand what all that coal GPT wants to collect handling fee on will be used for in China or some other Asian country.
---------------------------
Now, the point of this concern:
There exists near Macon, Georgia, a large power plant called Plant Scherer, which in 2006 was the largest single point-source for carbon dioxide emissions in the United States.
It was also ranked the 20th in the world in terms of carbon dioxide emissions by the Center for Global Development on its list of global power plants in November 2007.
It was the only power plant in the United States that was listed in the world's top 25 Carbon Dioxide producers.
The coal used at the Scherer plant comes from Wyoming's Powder River Basin, and is delivered by BNSF to the plant by in unit trains of up to 124 cars.
The GPT Application Chapter 5.7 Air Quality - Section 5.7.2.3 is titled 'Energy and Climate Change'
It reads, in part;
The Council on Environmental Quality (CEQ) and Ecology have issued guidance on considering the effects of greenhouse gas emissions in the evaluation of proposed agency actions under NEPA and SEPA, respectively. These guidance documents advise agencies to identify and quantify meaningful greenhouse gas emissions directly associated with a proposed action.
However, CEQ has acknowledged that the utility of analyzing greenhouse gas emissions in an environmental review under NEPA is limited because of the indeterminate linkage between specific environmental or climatological affects and a specific project or emission source. ....blah, blah, blah.....
Remember that underlined part, because it's the prelude to GPT's strategy to escape responsibility.
Section 5.7.2.3 continues, thus;
As a bulk products terminal, the Gateway Pacific Terminal would not be required to conduct greenhouse gas reporting under current local, state, or federal regulations. ....blah, blah, blah......
The Gateway Pacific Terminal would function as a transfer point in an international transportation system.
Pacific International Terminals would not own, or process in any way, the commodities that would be received and dispatched by the Terminal.
Likewise, the company would have no direct control over the source or destination of individual commodities, or the volumes of such commodities transferred from land-based transportation to oceangoing transportation. The volume, type, and mix of commodities transferred at the Terminal would be determined primarily by international market forces and the business interests of the Terminal’s customers. ...blah, blah, blah.....
What would GPT agree to be responsible for, one might ask;
Greenhouse gas emissions from the Terminal would include carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) associated with such Terminal activities as loading and unloading, stockpile shaping, rail and marine traffic, heating, and construction. ...blah, blah, blah.....
OK, you get the idea, GPT is trying to avoid the obvious impacts of shipping 54 million metric tons of coal to Asia to fuel power plants. Nice work, if you can get it!
But, GPT would be glad to comply with all standards for the minuscule portion of greenhouse gases [ghg] that happen to escape from its 350 acres;
Measurements of each gas are converted to carbon dioxide equivalents (CO2e) using EPA-specified calculations. The emissions estimate will be prepared following final design and permitting, so that any final project changes are reflected in these estimates.
The emissions estimate shall be performed consistent with the Greenhouse Gas Protocol Corporate Accounting and Reporting Standard, a set of standards developed on behalf of the World Resources Institute and the World Business Council for Sustainable Development. ...blah, blah, blah....
No one blames an entrepreneurial corporation -with deep-pocket, arm's length partners- to try and limit it's liabilities and maximize its profits, do they?
Before you answer that question, please understand what all that coal GPT wants to collect handling fee on will be used for in China or some other Asian country.
---------------------------
Now, the point of this concern:
There exists near Macon, Georgia, a large power plant called Plant Scherer, which in 2006 was the largest single point-source for carbon dioxide emissions in the United States.
It was also ranked the 20th in the world in terms of carbon dioxide emissions by the Center for Global Development on its list of global power plants in November 2007.
It was the only power plant in the United States that was listed in the world's top 25 Carbon Dioxide producers.
The coal used at the Scherer plant comes from Wyoming's Powder River Basin, and is delivered by BNSF to the plant by in unit trains of up to 124 cars.
Plant Scherer burns nearly thirteen hundred coal trains a year -- two thousand miles of coal cars, twelve million tons of the bedrock of Wyoming.
It unloads, on average, three and a half coal trains a day.
Plant Scherer produces a total of 3520 megawatts [MW] of electrical power, using four 880 MW units.
The 54 million metric tons of coal that GPT wants to ship to China would be enough to fuel 2.26 times the amount that Plant Scherer produces.
That is the equivalent of eight (8) new 1000 MW power plants.
What is wrong with this picture?
No one wants to accept responsibility for the new greenhouse gases [ghg's] that combustion of all this coal will produce, that's what!
These huge emissions need to be accounted for in the EIS, in terms of directly related impacts, as a large factor in a benefit versus cost analysis, and included in a comprehensive health effects evaluation that includes not only green house gases, but also particulates, like mercury, that have been proven to fall in the US.
----------------------
Sunday, November 20, 2011
Now, It's Come To This?
----------------------------
“Compound interest is the eighth wonder of the world. He who understands it, earns it ... he who doesn't ... pays it.” ― Albert Einstein
----------------------------
The gap between the 'haves' and 'have-nots' is getting wider and deeper, yet not many in our National politics seem to care enough to even acknowledge it, much less try doing anything about it.
This article confirms what some have felt was true; that a there are many more Americans in the near-poor category than we wanted to believe. Yet, at some level, many did know all along.
How else would you expect the constant -and sometimes irresistible- pressure to use easy credit to purchase what we want, but don't necessarily need? In turn, this leads to a reliance on credit to obtain even those things we do need!
Because compound interest is a really marvelous invention. - Albert Einstein (1879 - 1955) called it the 8th Wonder - It can work for you, or against you. When you invest it works for you. When you borrow it works against you!
We do need credit, but not an overdose of it. Even more, we need honesty and effective action on the part of those who would be our political leaders!
The latter is certainly not happening, as tuning into any of the current 'debates' about how to reduce our Federal deficit, who will be the Republican candidate for President, how to 'create' jobs, how to repair our crumbling infrastructure, how to reform our increasingly unfair tax system, how to ensure affordable basic health care, how to deal with the proliferation of wars & terrorism, how to strengthen our public education system, how to curtail the rising dominance of corporate & monetary influence in politics, how to deal with climate change, and almost any other issue of universal importance to all citizens.
It should be getting pretty obvious -to everyone paying attention- who is serious about doing anything positive about any of these pervasive problems and who isn't.
Right now, to me, our great experiment in Democracy is on the verge of failure.
Consider for a moment this caution, issued many years ago, then tell me if it hasn't already come true:
"A democracy cannot exist as a permanent form of government. It can only exist until the majority discovers it can vote itself largess out of the public treasury. After that, the majority always votes for the candidate promising the most benefits with the result the democracy collapses because of the loose fiscal policy ensuing, always to be followed by a dictatorship, then a monarchy."
Now, tell me why you doubt this isn't coming to pass right now. It seems to me that we are having our freedoms constantly eroded by a tyranny of wealth & power that is controlled by the few. Whether that few equates to the 1% of very wealthy & powerful, I don't know, but that seems probable, particularly with the tremendous, growing gap between the few & the many.
That may constitute something of a 'dictatorship' by oligarchy, but by any name it amounts to a form of economic slavery.
I'm reminded of a cartoon which depicted a large, streaming herd of small Lemming-like animals rushing mindlessly toward falling off a big cliff. In the midst of this chaos, one animal raised its head and shouted; 'hey, we're Lemurs! LEMURS!'
At some point, we need to wake up to the signs that we are heading in a similar direction, toward a precipice from which it will become increasingly difficult to even slow down, much less reverse.
Did you know that the folks who used to be called Republicans are now called Democrats?
I don't know what present day Republicans used to be called, but it might have been Tories, a gentle version of King's dupes. That might be too harsh an indictment, but have you witnessed the current crop of Republican Presidential candidates? It's certainly true of most of them!
Newt Gingrich now is polling higher numbers than any of the others? Get serious! A more hypocritical political elite cannot be found. His recent quip about those involved in the 'Occupy' movement was 'they need to get a job, right after they take a bath' is an insensitive cheap shot, designed to appeal to the 'haves' from whom he wants support.
Lest you think I'm just picking on Republicans, there are plenty of folks who call themselves Democrats, Independents, Libertarians, T-Partyans and other names or non-names, who qualify as opportunistic, self-centered elites as well. You know the ones I mean, you see them or hear their screed every day on our public airways like TV, either as talking heads, the frequent guests of talking heads, the faceless owners of talking heads, or those paid by them, brainwashed by them, or otherwise in their thrall.
I'm really tired of the insidious line of propaganda, self-serving commentary and outright BS these people continually spout, but that is what dominates our media these days. That and constant, destructive criticism of the very leaders, institutions and values that are there to help knit us together as a nation. We are a nation, you know. But, we're acting like a bunch of spoiled brats that are constantly trying to climb over one another without regard for anything remotely resembling the greater good.
That type of trajectory is not leading us to sharing anything likely to be sustainable or worthy of our best intentions.
But, maybe that's not important to us any more?
More likely, we're too distracted with making ends meet, or in the case of the privileged 1%, making our next million?
The comparison of our gradual awareness of the effects of inequality to that of a frog being brought slowly to a boil, seems apt. Sometimes trends themselves are not noticed until some tangible benchmark is reached that gets our attention.
I believe the objective of the Occupy movement is to get our attention on matters than have steadily encroached upon us, like growing inequality and indifference to unnecessary suffering that could be significantly mitigated. When taken to their limits, these things will become intolerable, a point we are now beginning to reach.
For example, we hear many complaints about the fiscal stimulus measures taken to help jump start our economy. Here's a 'joke' I received recently from a friend, entitled What is a Financial Bail-Out ?:
It is a slow day in a damp little Irish town. The rain is beating down harshly, and all the streets are deserted. Times are tough, everybody is in debt and everybody lives on credit.
On this particular day a rich German tourist is driving through the town, stops at the local hotel and lays a ¤100 note on the desk, telling the hotel owner he wants to inspect the rooms upstairs in order to pick one to spend the night.
The owner gives him some room-keys and, as soon as the visitor has walked upstairs, the hotelier grabs the ¤100 note and runs next door to pay his debt to the butcher.
The butcher takes the ¤100 note and rushes down the street to repay his debt to the pig farmer. The pig farmer takes the ¤100 note and heads off to pay his bill at the supplier of animal feed and fuel.
The guy at the Farmers' Co-op takes the ¤100 note and runs to pay his drinks bill at the friendly neighbourhood pub. The pub owner slips the money along to the local prostitute drinking at the bar - who, in spite of facing hard times, has always gladly offered him her 'services' on credit.
The hooker then rushes over to the hotel and pays off her room bill to the hotel owner with the ¤100 note.
The hotel proprietor quietly replaces the ¤100 note back on the counter, so that the rich traveller will not suspect anything.
At that moment the traveller comes down the stairs, states that none of the rooms are satisfactory, picks up the ¤100 note, pockets it and leaves town.
No one has produced anything. No one has earned anything. However, the whole town is now out of debt and looking to the future with a lot more optimism.
And that, dear ladies and gentlemen, is how a basic financial bailout package works!
That joke is amusing, but its intent seems to be to take a shot at the very idea of any sort of bailout.
Is that necessary? After all, all the people involved were rewarded by paying off debts, and the investor got all his money back! What's wrong with that?
The debtors are relieved to no longer be in debt and the wealthy depositor got his money back. What would be a better ending than that? That the wealthy depositor got wealthier?
And, who is that depositor? A tycoon, a Good Samaritan, or a government?
To me, it's the thought -and action- that counts, not the fact that nothing was created but debt relief.
Being in debt is not fun; getting out of it is. It's that simple.
So, have we become so cynical that we discount intended good acts that do much good and little harm? And, do we now value wealth, power and intentional inaction in the face of clear need above basic human kindness, care of society's problems and degradation of our very nests here on earth?
If so, we are experiencing the compound impacts of excessive greed & cynicism, neither of which helps build upon our real values and freedoms.
I hope it hasn't come to this, but there are clear signs that is happening.
If it is, there's a better name for than the 8th wonder of the world!
When nearly one in three in our nation lives in near-poverty, maybe the correct name is more like the fatal wound of the world?
------------------------------------
Sunday, March 21, 2010
Healthcare & March Madness
--------------------------------
Some folks won't be celebrating the House's passage of the imperfect, yet necessary, healthcare reform legislation, but most will, including me.
Now, it's the Senate's turn to do the right thing and finally allow the President to sign it into law.
More important over time, is the commitment to periodically revisit this issue with the intent to improve healthcare coverage for all Americans, not just those with means to afford what we have now.
To now deny true progress on something as important as basic healthcare, after a century of debate, would be irresponsible despite ideological differences.
It's time -actually way past time- that the USA begins to get its healthcare act together.
I have confidence that these healthcare reforms will prove helpful to everyone over time, particularly with timely oversight and modification to fix glitches and improve coverage, costs and quality.
It's also time to be more caring, inclusive and realistic when it comes to the impacts of healthcare cost on every American.
That sure beats empty political rhetoric, anger and continued delaying tactics!
Wait and see, but remember this night, because it will quality as truly memorable for many years to come.
--------------------------------
The other March Madness now in progress is the NCAA Basketball Tournament to determine our national champion.
So far, it has been more exciting than usual with many close games and upsets to winnow the field down to the "Sweet Sixteen'.
As with Healthcare Reform Legislation, the final results are unknown, even though some teams seem stronger than others.
Winning it all with require talent, strategy, hard and sustained effort, coolness in adversity, plus a bit of luck.
I've got my favorites, but whoever wins will likely deserve it.
--------------------------------
Some folks won't be celebrating the House's passage of the imperfect, yet necessary, healthcare reform legislation, but most will, including me.
Now, it's the Senate's turn to do the right thing and finally allow the President to sign it into law.
More important over time, is the commitment to periodically revisit this issue with the intent to improve healthcare coverage for all Americans, not just those with means to afford what we have now.
To now deny true progress on something as important as basic healthcare, after a century of debate, would be irresponsible despite ideological differences.
It's time -actually way past time- that the USA begins to get its healthcare act together.
I have confidence that these healthcare reforms will prove helpful to everyone over time, particularly with timely oversight and modification to fix glitches and improve coverage, costs and quality.
It's also time to be more caring, inclusive and realistic when it comes to the impacts of healthcare cost on every American.
That sure beats empty political rhetoric, anger and continued delaying tactics!
Wait and see, but remember this night, because it will quality as truly memorable for many years to come.
--------------------------------
The other March Madness now in progress is the NCAA Basketball Tournament to determine our national champion.
So far, it has been more exciting than usual with many close games and upsets to winnow the field down to the "Sweet Sixteen'.
As with Healthcare Reform Legislation, the final results are unknown, even though some teams seem stronger than others.
Winning it all with require talent, strategy, hard and sustained effort, coolness in adversity, plus a bit of luck.
I've got my favorites, but whoever wins will likely deserve it.
--------------------------------
Saturday, December 26, 2009
Hallelujah, Halleluyah and Alleluia!
--------------------------
The Senate's early Christmas Eve vote on healthcare reform was another step in this slow, but necessary and overdue process.
Although some folks disagree, I welcome this as tangible progress addressing an long-standing issue of great importance to millions of Americans, and therefore clearly a reason to rejoice.
But, more hurdles must be overcome before any of the anticipated benefits are manifested.
The Senate and House bills must be reconciled and the all-important final approving votes cast, before the measure can be sent to the President for his signature.
Then, the real work begins of explaining and implementing the changes over time.
Will this measure address all the identified problems to every one's satisfaction?
Of course not, but it is the best that could be agreed upon for now.
As likely improvements are proposed and defects are discovered, these will provide valuable impetus for further refinements.
Often, initial progress on an issue is the hardest part, and the difficulty witnessed during this year's debate certainly fits that profile.
But, like it or not, adversarial debate is the primary method by which this country changes its policies and regulations.
And, despite all the vitriol, posturing rhetoric and costly lobbying, a majority -actually a super majority- of our elected Congressional representatives have supported the respective House and Senate bills now awaiting melding into a single bill that both bodies can approve.
The process has been anything but pretty to watch, fueled by unusually nasty partisan politics, ideological arguments and outrageous claims and speculation.
But, this issue is one that our President prioritized during the past election, so its debate should been no surprise.
What was a surprise -at least to me- was the partisan ferocity exhibited by those calling themselves 'conservatives', who seized upon this issue as a way to stir up public anger and frustration to help sway voters during next year's elections.
That kind of mindset and motivation has become all too prevalent lately.
While elected members of Congress do represent different constituencies, they also share the responsibility for representing all Americans and what is in the best interest of our Country as a whole.
To achieve that goal, some degree of true bipartisanship is necessary to forge workable compromises.
I find it very hard to accept that there were NO Republican Senators willing to demonstrate the caring and courage to vote their conscience instead of political party line!
The three main elements of any healthcare reform are ACCESS, COSTS and QUALITY, with their priorities in the same order.
Who really believes its not important to make some level of healthcare access to over 30 million citizens who don't have it?
Whose interests are served by continuing to ignore this situation and deny no reform is necessary?
And, who doubts that healthcare cost effectiveness can be dramatically improved by more competition, less paper shuffling and less reliance on for-profit healthcare providers?
You know, government run healthcare in this Country is pretty well administered; just think of MediCare and the Veterans Administration.
I have had MediCare as my primary health insurance for the last 2 years and find it remarkably good and easy to use, despite my earlier, uninformed doubts.
As far as healthcare quality is concerned, that is generally considered pretty good.
But, as healthcare expands to cover millions of new people, more doctors, nurses and technicians will certainly need to be trained and qualified.
Perhaps equally important is the emphasis on healthy diets and habits and wellness programs which can help prevent many illnesses and disabilities before they become major health problems.
While there will remain healthcare gaps, inequalities, financing difficulties and new methods of providing timely care, I believe the first step now being taken, is a step in the right direction.
And, it is something for which most Americans can rejoice during this Christmas season!
--------------------------------
The Senate's early Christmas Eve vote on healthcare reform was another step in this slow, but necessary and overdue process.
Although some folks disagree, I welcome this as tangible progress addressing an long-standing issue of great importance to millions of Americans, and therefore clearly a reason to rejoice.
But, more hurdles must be overcome before any of the anticipated benefits are manifested.
The Senate and House bills must be reconciled and the all-important final approving votes cast, before the measure can be sent to the President for his signature.
Then, the real work begins of explaining and implementing the changes over time.
Will this measure address all the identified problems to every one's satisfaction?
Of course not, but it is the best that could be agreed upon for now.
As likely improvements are proposed and defects are discovered, these will provide valuable impetus for further refinements.
Often, initial progress on an issue is the hardest part, and the difficulty witnessed during this year's debate certainly fits that profile.
But, like it or not, adversarial debate is the primary method by which this country changes its policies and regulations.
And, despite all the vitriol, posturing rhetoric and costly lobbying, a majority -actually a super majority- of our elected Congressional representatives have supported the respective House and Senate bills now awaiting melding into a single bill that both bodies can approve.
The process has been anything but pretty to watch, fueled by unusually nasty partisan politics, ideological arguments and outrageous claims and speculation.
But, this issue is one that our President prioritized during the past election, so its debate should been no surprise.
What was a surprise -at least to me- was the partisan ferocity exhibited by those calling themselves 'conservatives', who seized upon this issue as a way to stir up public anger and frustration to help sway voters during next year's elections.
That kind of mindset and motivation has become all too prevalent lately.
While elected members of Congress do represent different constituencies, they also share the responsibility for representing all Americans and what is in the best interest of our Country as a whole.
To achieve that goal, some degree of true bipartisanship is necessary to forge workable compromises.
I find it very hard to accept that there were NO Republican Senators willing to demonstrate the caring and courage to vote their conscience instead of political party line!
The three main elements of any healthcare reform are ACCESS, COSTS and QUALITY, with their priorities in the same order.
Who really believes its not important to make some level of healthcare access to over 30 million citizens who don't have it?
Whose interests are served by continuing to ignore this situation and deny no reform is necessary?
And, who doubts that healthcare cost effectiveness can be dramatically improved by more competition, less paper shuffling and less reliance on for-profit healthcare providers?
You know, government run healthcare in this Country is pretty well administered; just think of MediCare and the Veterans Administration.
I have had MediCare as my primary health insurance for the last 2 years and find it remarkably good and easy to use, despite my earlier, uninformed doubts.
As far as healthcare quality is concerned, that is generally considered pretty good.
But, as healthcare expands to cover millions of new people, more doctors, nurses and technicians will certainly need to be trained and qualified.
Perhaps equally important is the emphasis on healthy diets and habits and wellness programs which can help prevent many illnesses and disabilities before they become major health problems.
While there will remain healthcare gaps, inequalities, financing difficulties and new methods of providing timely care, I believe the first step now being taken, is a step in the right direction.
And, it is something for which most Americans can rejoice during this Christmas season!
--------------------------------
Wednesday, December 23, 2009
US Healthcare: Big Tent or Big Top?
--------------------
Doesn't it seem like the more things change, the more they stay the same?
Over 2 months ago it seemed like the national healthcare reform debate in Congress was nearing a conclusion, but here we are 2 days before Christmas and the Senate still has not voted on this issue.
Of course, the Senate bill now under discussion bears but limited resemblance to the collection of proposals that existed 10 weeks ago.
One constant is the vehement delaying tactics being employed by the 'Party of 'No', which is embarked on a scorched earth policy designed to obstruct, delay, water down and hopefully kill any measure that comes to vote.
And, if that doesn't work, expect more misinformation/scare campaigns backed by big money, phony 'Tea Parties' and election tactics to match.
For one party to opt for non-participation, then claim not having their views heard and considered is ludicrous!
Last time I witnessed such behavior probably dates back to elementary school, maybe kindergarten.
That our Congress has come to this type of spiteful dysfunction is a real pity, but the seeds of this type of conduct have been evident for a while.
Just look at how the current administration contrasts with the previous one.
The 'W' White House years in office never advocated anything approaching a 'big tent' philosophy.
Quite the contrary, W pursued his own agenda and R ideological dogmas from the very beginning.
And the D's gave him the benefit of the doubt, much to their later chagrin.
It was only after 6 years of W's damage had been done that the D's regained a majority in Congress.
And, two years after that when Obama was elected with an ambitious agenda and an inclusive, 'big tent' approach to governing.
That is an admirable goal, but also inherently difficult to achieve.
The R's have exploited this by essentially boycotting it and substituting a militant form of obstructionism, in hopes of political gain.
The public's prolonged exposure to the congressional 'sausage-making' around healthcare reform has managed to tarnish its original beneficial objectives.
Instead, what could have been an enlightened national discussion about a very important issue has been deliberately turned into a protracted ugly squabble, with an outcome not likely to not satisfy anyone.
We may be on the verge of seeing this debate turn into a debacle, which would be most regrettable - especially after 60-plus unproductive years of failure to significantly improve healthcare in the country.
Unfortunately, the 'big tent' envisioned is instead being used as a 'big top' to house a circus with several unfunny clowns competing to be the Ringmaster!
Maybe it has always been this way, but this time it's just more visible.
Democracy isn't always pretty to watch, but militant, mean-spirited obstructionism is really ugly, and demeans the public as well as the spirit of our Constitution.
I hope the art of compromise with civility can be restored, but that kind of reform might be even more difficult, unless, we -the public- demand it with our voices and votes!
----------------------------
Winston Churchill once said he admired the Americans because they always get things right... after they have tried everything else!
----------------------------
Doesn't it seem like the more things change, the more they stay the same?
Over 2 months ago it seemed like the national healthcare reform debate in Congress was nearing a conclusion, but here we are 2 days before Christmas and the Senate still has not voted on this issue.
Of course, the Senate bill now under discussion bears but limited resemblance to the collection of proposals that existed 10 weeks ago.
One constant is the vehement delaying tactics being employed by the 'Party of 'No', which is embarked on a scorched earth policy designed to obstruct, delay, water down and hopefully kill any measure that comes to vote.
And, if that doesn't work, expect more misinformation/scare campaigns backed by big money, phony 'Tea Parties' and election tactics to match.
For one party to opt for non-participation, then claim not having their views heard and considered is ludicrous!
Last time I witnessed such behavior probably dates back to elementary school, maybe kindergarten.
That our Congress has come to this type of spiteful dysfunction is a real pity, but the seeds of this type of conduct have been evident for a while.
Just look at how the current administration contrasts with the previous one.
The 'W' White House years in office never advocated anything approaching a 'big tent' philosophy.
Quite the contrary, W pursued his own agenda and R ideological dogmas from the very beginning.
And the D's gave him the benefit of the doubt, much to their later chagrin.
It was only after 6 years of W's damage had been done that the D's regained a majority in Congress.
And, two years after that when Obama was elected with an ambitious agenda and an inclusive, 'big tent' approach to governing.
That is an admirable goal, but also inherently difficult to achieve.
The R's have exploited this by essentially boycotting it and substituting a militant form of obstructionism, in hopes of political gain.
The public's prolonged exposure to the congressional 'sausage-making' around healthcare reform has managed to tarnish its original beneficial objectives.
Instead, what could have been an enlightened national discussion about a very important issue has been deliberately turned into a protracted ugly squabble, with an outcome not likely to not satisfy anyone.
We may be on the verge of seeing this debate turn into a debacle, which would be most regrettable - especially after 60-plus unproductive years of failure to significantly improve healthcare in the country.
Unfortunately, the 'big tent' envisioned is instead being used as a 'big top' to house a circus with several unfunny clowns competing to be the Ringmaster!
Maybe it has always been this way, but this time it's just more visible.
Democracy isn't always pretty to watch, but militant, mean-spirited obstructionism is really ugly, and demeans the public as well as the spirit of our Constitution.
I hope the art of compromise with civility can be restored, but that kind of reform might be even more difficult, unless, we -the public- demand it with our voices and votes!
----------------------------
Winston Churchill once said he admired the Americans because they always get things right... after they have tried everything else!
----------------------------
Thursday, October 15, 2009
Healthcare: Trick or Treat Time
-----------------------------------
In politics its either too early to tell or too late to do anything about it.
Politics is the art of the possible.
-----------------------------------
As Halloween approaches, so does the moment of truth for National Health care Reform, or whatever will pass for it.
So far, its been a lot of stated objectives, posturing and behind the scenes roiling and boiling which have fed the media coverage, such as it is.
Lots of speculation, predictions and cautions being thrown about, but really no one knows what will result and become the new law of the land.
I think I know, but only in general terms; less than what some hope for and more than some want.
No need to worry about the 'perfect becoming the enemy of the good', because there is no such thing as perfect that can be agreed upon comprehensively by either Congress or the people they represent.
That is why we need accept what can be passed now, but also agree to revisit it periodically for improvements that become necessary or desirable.
Like maybe the 'trigger' idea for initiating a 'public option' suggested by Senator Olympia Snowe, the only Republican with enough personal integrity and courage to buck the party of 'NO'.
Or, Senator Ron Wyden's idea that seems so sensible.
Or, making existing Medicare reimbursements more fair.
Things like that.
------------------
In talking with a number of medical professionals, I find clear support for health care reform, although some are certainly fearful or adverse to what they think will be forthcoming. And change can be scary.
One respected Doctor- who is strongly opposed to reform as is now now being discussed- sees the issue this way.
A three-legged stool of important issues; ACCESS, AFFORDABILITY, QUALITY OF CARE.
He rates them in the order given, with ACCESS clearly the top priority.
The AFFORDABILITY question is of course also critical, especially with something closer to universal coverage.
His fear is that if a 'public option' is ever adopted, that would sound the death knell for the private insurance industry.
That is also what the health insurance industry wants us to believe, plus that health insurance costs will actually rise dramatically - as their 11th hour bogus 'report' claimed. Seems it left out any anticipated savings! How could that happen?
Interestingly, some of the big unions are also having concerns about partially financing health care reform by taxing so-called 'Cadillac' health care plans.
Now why would they do that?
Could it be that they see their mission as negotiating 'Cadillac' health care plans for their members?
Taxing these same plans would tend to reduce those benefits, wouldn't it? Can't have that!
But the unions are also touting a public option, which is a good idea.
But, one has to wonder if they think -as my Doctor friend does- a public option would destroy the private health industry.
Apparently not, but maybe that's a moot point since it appears NO public option is likely to be authorized this time around by our illustrious Congress.
One thing is certain, every truly progressive and comprehensive piece of legislation ever passed has had a struggle, often along partisan lines.
This one is no exception.
So, while a bi-partisan approach may be desirable, it doesn't appear likely - except token exceptions, like Sen Snowe.
And, that's OK with me.
This is something that has been needed for a long time, without any substantial resolution,
It is also something this President was elected to deliver.
And, it is something that most Americans support, despite the hype and misinformation they have to contend with.
But, I think most folks are used to that stuff and see it for what is is.
Too bad our Bill of Rights doesn't specify we are entitled to the truth!
Let's hope we get more treats than tricks when Congress gets around to voting on this important issue.
-------------------------------------
In politics its either too early to tell or too late to do anything about it.
Politics is the art of the possible.
-----------------------------------
As Halloween approaches, so does the moment of truth for National Health care Reform, or whatever will pass for it.
So far, its been a lot of stated objectives, posturing and behind the scenes roiling and boiling which have fed the media coverage, such as it is.
Lots of speculation, predictions and cautions being thrown about, but really no one knows what will result and become the new law of the land.
I think I know, but only in general terms; less than what some hope for and more than some want.
No need to worry about the 'perfect becoming the enemy of the good', because there is no such thing as perfect that can be agreed upon comprehensively by either Congress or the people they represent.
That is why we need accept what can be passed now, but also agree to revisit it periodically for improvements that become necessary or desirable.
Like maybe the 'trigger' idea for initiating a 'public option' suggested by Senator Olympia Snowe, the only Republican with enough personal integrity and courage to buck the party of 'NO'.
Or, Senator Ron Wyden's idea that seems so sensible.
Or, making existing Medicare reimbursements more fair.
Things like that.
------------------
In talking with a number of medical professionals, I find clear support for health care reform, although some are certainly fearful or adverse to what they think will be forthcoming. And change can be scary.
One respected Doctor- who is strongly opposed to reform as is now now being discussed- sees the issue this way.
A three-legged stool of important issues; ACCESS, AFFORDABILITY, QUALITY OF CARE.
He rates them in the order given, with ACCESS clearly the top priority.
The AFFORDABILITY question is of course also critical, especially with something closer to universal coverage.
His fear is that if a 'public option' is ever adopted, that would sound the death knell for the private insurance industry.
That is also what the health insurance industry wants us to believe, plus that health insurance costs will actually rise dramatically - as their 11th hour bogus 'report' claimed. Seems it left out any anticipated savings! How could that happen?
Interestingly, some of the big unions are also having concerns about partially financing health care reform by taxing so-called 'Cadillac' health care plans.
Now why would they do that?
Could it be that they see their mission as negotiating 'Cadillac' health care plans for their members?
Taxing these same plans would tend to reduce those benefits, wouldn't it? Can't have that!
But the unions are also touting a public option, which is a good idea.
But, one has to wonder if they think -as my Doctor friend does- a public option would destroy the private health industry.
Apparently not, but maybe that's a moot point since it appears NO public option is likely to be authorized this time around by our illustrious Congress.
One thing is certain, every truly progressive and comprehensive piece of legislation ever passed has had a struggle, often along partisan lines.
This one is no exception.
So, while a bi-partisan approach may be desirable, it doesn't appear likely - except token exceptions, like Sen Snowe.
And, that's OK with me.
This is something that has been needed for a long time, without any substantial resolution,
It is also something this President was elected to deliver.
And, it is something that most Americans support, despite the hype and misinformation they have to contend with.
But, I think most folks are used to that stuff and see it for what is is.
Too bad our Bill of Rights doesn't specify we are entitled to the truth!
Let's hope we get more treats than tricks when Congress gets around to voting on this important issue.
-------------------------------------
Monday, September 7, 2009
More on Cake Baking
------------------------------
Two years ago about this time I published as a blog, an earlier 2004 Guest Editorial on the subject of baking a cake.
With the Healthcare debate taking such a dysfunctional life of its own, maybe it's appropriate to repeat this generic writing, which seeks to remind our elected officials of what our highest expectations of them are, regardless of which issue is being discussed.
Excellence has been described as a habit, not any single act.
With that in mind, let's hope our legislators and other elected representatives decide to get in the habit of more productive discussion, debate and progressive action in resolving the battery of problems that beset us, including something so basic as healthcare.
--------------------------
On a more practical level, here are two cake recipes that I can personally attest to as being quite good.
Obviously, these bakers got their recipes pretty well perfected before going public.
Debbie's McFadden Chocolate Cake:
4 squares chocolate
1 stick butter
1 cup coffee
------- mix together----------
then add:
2 cups flour
2 cups sugar
1/2 cup buttermilk [with 1 1/2 tsp baking soda mixed in it]
beat in 2 eggs
--------------------------------
use (2) 9-inch cake pans
bake at 350 F for 30 minutes
let cool and set
--------------------------------
Icing:
melt 1 stick butter
add 4 TBS Cocoa
add 5 TBS Milk [or coffee, juice, etc.]
-----Boil or microwave, then whisk-------
add 1 box powdered sugar
add 2 tsp Vanilla
[runny -let it sit a few minutes]
--------------------------------
Alan's Carrot Cake
From Colorado Cache, A goldmine of recipes from the Junior League of Denver ©1978
Cover Mountain Carrot Cake with adjustments for gluten-free version
1 ½ cups vegetable oil (use olive oil)
1 ½ cups sugar
4 eggs, well beaten
3 cups grated carrots
2 cups unbleached flour (substitute rice flours as listed below*)
½ teaspoon salt
2 teaspoons soda
2 teaspoons cinnamon
2 teaspoons ground allspice (1/2 tsp ground cloves works well)
1 cup chopped pecans
1 cup raisins
1 teaspoon vanilla extract
*Gluten-free substitute: 1 cup brown rice flour, 1 cup white rice flour, ¼ cup tapioca flour, 1 ½ tsp xanthum gum
Cream oil and sugar. Add eggs and carrots, and mix well. Mix dry ingredients. Add flour mixture to carrot mixture, a small amount at a time, beating well. When blended, add pecans, raisins and vanilla. Pour into a 10 X 14 inch greased and sugared pan and bake at 325 degrees for 1 hour. Cool slightly before frosting.
Frosting
½ cup butter
1 8-ounce package cream cheese, softened
2 cups sifted, powdered sugar
1 teaspoon vanilla extract
Combine butter and cream cheese with sugar and beat well. Add other ingredients, mix well and spread on cooled cake.
ENJOY!
--------------------------------
"They go on in strange paradox, decided only to be undecided, resolved to be irresolute, adamant for drift, solid for fluidity, all powerful to be impotent. . . The era of procrastination, of half measures, of soothing and baffling expedience of delays, is coming to a close. In its place we are entering a period of consequences." - Winston Churchill
--------------------------------
Two years ago about this time I published as a blog, an earlier 2004 Guest Editorial on the subject of baking a cake.
With the Healthcare debate taking such a dysfunctional life of its own, maybe it's appropriate to repeat this generic writing, which seeks to remind our elected officials of what our highest expectations of them are, regardless of which issue is being discussed.
Excellence has been described as a habit, not any single act.
With that in mind, let's hope our legislators and other elected representatives decide to get in the habit of more productive discussion, debate and progressive action in resolving the battery of problems that beset us, including something so basic as healthcare.
--------------------------
On a more practical level, here are two cake recipes that I can personally attest to as being quite good.
Obviously, these bakers got their recipes pretty well perfected before going public.
Debbie's McFadden Chocolate Cake:
4 squares chocolate
1 stick butter
1 cup coffee
------- mix together----------
then add:
2 cups flour
2 cups sugar
1/2 cup buttermilk [with 1 1/2 tsp baking soda mixed in it]
beat in 2 eggs
--------------------------------
use (2) 9-inch cake pans
bake at 350 F for 30 minutes
let cool and set
--------------------------------
Icing:
melt 1 stick butter
add 4 TBS Cocoa
add 5 TBS Milk [or coffee, juice, etc.]
-----Boil or microwave, then whisk-------
add 1 box powdered sugar
add 2 tsp Vanilla
[runny -let it sit a few minutes]
--------------------------------
Alan's Carrot Cake
From Colorado Cache, A goldmine of recipes from the Junior League of Denver ©1978
Cover Mountain Carrot Cake with adjustments for gluten-free version
1 ½ cups vegetable oil (use olive oil)
1 ½ cups sugar
4 eggs, well beaten
3 cups grated carrots
2 cups unbleached flour (substitute rice flours as listed below*)
½ teaspoon salt
2 teaspoons soda
2 teaspoons cinnamon
2 teaspoons ground allspice (1/2 tsp ground cloves works well)
1 cup chopped pecans
1 cup raisins
1 teaspoon vanilla extract
*Gluten-free substitute: 1 cup brown rice flour, 1 cup white rice flour, ¼ cup tapioca flour, 1 ½ tsp xanthum gum
Cream oil and sugar. Add eggs and carrots, and mix well. Mix dry ingredients. Add flour mixture to carrot mixture, a small amount at a time, beating well. When blended, add pecans, raisins and vanilla. Pour into a 10 X 14 inch greased and sugared pan and bake at 325 degrees for 1 hour. Cool slightly before frosting.
Frosting
½ cup butter
1 8-ounce package cream cheese, softened
2 cups sifted, powdered sugar
1 teaspoon vanilla extract
Combine butter and cream cheese with sugar and beat well. Add other ingredients, mix well and spread on cooled cake.
ENJOY!
--------------------------------
"They go on in strange paradox, decided only to be undecided, resolved to be irresolute, adamant for drift, solid for fluidity, all powerful to be impotent. . . The era of procrastination, of half measures, of soothing and baffling expedience of delays, is coming to a close. In its place we are entering a period of consequences." - Winston Churchill
--------------------------------
Saturday, August 22, 2009
Three Topics: Healthcare, Climate, NOAA
-----------------------------
Ever tried to figure out what your health insurance policy says?
healthcare terminology
-----------------------------
Think climate change might impact national security?
climate & security
-----------------------------
More on Bellingham's NOAA loss from Crosscut
noaa loss explanation
-----------------------------
Ever tried to figure out what your health insurance policy says?
healthcare terminology
-----------------------------
Think climate change might impact national security?
climate & security
-----------------------------
More on Bellingham's NOAA loss from Crosscut
noaa loss explanation
-----------------------------
Friday, August 21, 2009
Healthcare: More Perspectives
-------------------------
'If you don't read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed.' - MARK TWAIN
-------------------------
As frustrating as it has been at times listening to our national healthcare debate, the more discussion occurs, the more facts and perspectives do emerge.
This is good -even essential- despite the overcharged emotional climate that has predictably evolved.
Of course, those people exist who will not be persuaded of anything other than their own biases and opinions, but isn't it always that way?
One can only hope these do not represent a majority, or sufficient numbers to seriously test the courage of those entrusted with representing the best interests of our country as a whole on this important issue.
Rather than expound from my personal perspective any more than necessary, I will trust these three links to express their own views:
First, from the NY Times this article by Timothy Egan on cooperatives:
Next, from today's Crosscut, this article by Ted Luce, an experienced user and administrator of the British health care system, entitled The Socialized Medicine' Red Herring.
Last, from the Boston.com website, this statement from Mitt Romney:
Brief. Why should Obama NOT be listening to 'liberals', and since when is a delay in healthcare reform a concern of Romney's?
---------
The first two citations help explain and clarify some misconceptions that have been in evidence recently.
Charitably, these might be called 'urban legends', but uncharitably are accurately termed lies, half-truths and deliberate mis-conceptions.
As Richard Abanes wrote about an entirely different subject, the novel The DaVinci Code:
"The most flagrant aspect … is not that Dan Brown disagrees with Christianity but that he utterly warps it in order to disagree with it … to the point of completely rewriting a vast number of historical events. And making the matter worse has been Brown's willingness to pass off his distortions as ‘facts' with which innumerable scholars and historians agree.
And this apparently describes the origin of the term 'urban legend':
The term “urban legend,” as used by folklorists, has appeared in print since at least 1968. Jan Harold Brunvand, professor of English at the University of Utah, introduced the term to the general public in a series of popular books published beginning in 1981. Brunvand used his collection of legends, The Vanishing Hitchhiker: American Urban Legends & Their Meanings (1981) to make two points: first, that legends and folklore do not occur exclusively in so-called primitive or traditional societies, and second, that one could learn much about urban and modern culture by studying such tales.
Brunvand has since published a series of similar books, and is credited as the first to use the term vector (inspired by the concept of biological vectors) to describe a person or entity passing on an urban legend.
Do you know anyone around here who can be credited with being a VECTOR, creating, or promulgating, an 'urban legend'?
----------------------------
"I was brought up to believe that the only thing worth doing was to add to the sum of accurate information in the world." -
MARGARET MEAD
"All schools, all colleges, have two great functions: to confer, and to conceal, valuable knowledge. The theological knowledge which they conceal cannot justly be regarded as less valuable than that which they reveal. That is, when a man is buying a basket of strawberries it can profit him to know that the bottom half of it is rotten." - MARK TWAIN [1908, notebook]
----------------------------
'If you don't read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed.' - MARK TWAIN
-------------------------
As frustrating as it has been at times listening to our national healthcare debate, the more discussion occurs, the more facts and perspectives do emerge.
This is good -even essential- despite the overcharged emotional climate that has predictably evolved.
Of course, those people exist who will not be persuaded of anything other than their own biases and opinions, but isn't it always that way?
One can only hope these do not represent a majority, or sufficient numbers to seriously test the courage of those entrusted with representing the best interests of our country as a whole on this important issue.
Rather than expound from my personal perspective any more than necessary, I will trust these three links to express their own views:
First, from the NY Times this article by Timothy Egan on cooperatives:
Next, from today's Crosscut, this article by Ted Luce, an experienced user and administrator of the British health care system, entitled The Socialized Medicine' Red Herring.
Last, from the Boston.com website, this statement from Mitt Romney:
Brief. Why should Obama NOT be listening to 'liberals', and since when is a delay in healthcare reform a concern of Romney's?
---------
The first two citations help explain and clarify some misconceptions that have been in evidence recently.
Charitably, these might be called 'urban legends', but uncharitably are accurately termed lies, half-truths and deliberate mis-conceptions.
As Richard Abanes wrote about an entirely different subject, the novel The DaVinci Code:
"The most flagrant aspect … is not that Dan Brown disagrees with Christianity but that he utterly warps it in order to disagree with it … to the point of completely rewriting a vast number of historical events. And making the matter worse has been Brown's willingness to pass off his distortions as ‘facts' with which innumerable scholars and historians agree.
And this apparently describes the origin of the term 'urban legend':
The term “urban legend,” as used by folklorists, has appeared in print since at least 1968. Jan Harold Brunvand, professor of English at the University of Utah, introduced the term to the general public in a series of popular books published beginning in 1981. Brunvand used his collection of legends, The Vanishing Hitchhiker: American Urban Legends & Their Meanings (1981) to make two points: first, that legends and folklore do not occur exclusively in so-called primitive or traditional societies, and second, that one could learn much about urban and modern culture by studying such tales.
Brunvand has since published a series of similar books, and is credited as the first to use the term vector (inspired by the concept of biological vectors) to describe a person or entity passing on an urban legend.
Do you know anyone around here who can be credited with being a VECTOR, creating, or promulgating, an 'urban legend'?
----------------------------
"I was brought up to believe that the only thing worth doing was to add to the sum of accurate information in the world." -
MARGARET MEAD
"All schools, all colleges, have two great functions: to confer, and to conceal, valuable knowledge. The theological knowledge which they conceal cannot justly be regarded as less valuable than that which they reveal. That is, when a man is buying a basket of strawberries it can profit him to know that the bottom half of it is rotten." - MARK TWAIN [1908, notebook]
----------------------------
Monday, August 17, 2009
Healthcare: More Heat Than Light?
--------------------
Our national healthcare debate, such as it is, ought to be seriously continued every year until we develop a system that serves us much better than the current mess.
If this sounds like I doubt that a single, comprehensive program can be adopted at any one time, your interpretation is correct.
The reason is that politics is simply the art of the possible, and Congress lacks the unity, courage and visionary insights to do this job right.
Of course, President Obama and his administration don't get off the hook either, but since when has an operating manual come with our highest office?
Obama's biggest problem is that he is trying to be too inclusive and flexible under the circumstances.
That is being perceived as either weakness or waffling by both sides, for different and varying reasons.
That is a no-man's land that is unlikely to yield any productive result, save maybe one; agreement that certain aspects of healthcare do need to be changed.
Once that consensus is reached, the job becomes a little simpler, but also longer term in nature.
Simpler, because sufficient votes can likely be garnered for incremental changes that both parties can support.
Things like providing and extending at least catastrophic medical coverage for all citizens.
Or maybe even some tort reform.
Yesterday's Crosscut article by Ted Van Dyk provides a useful perspective on this general strategy.
The longer term nature of debating the healthcare issue, means that Congress and the Administration must find a way to commit to continuing good faith discussions well into the foreseeable future.
Why not bring this up every year as part of a national debate that also ties into whatever economic conditions exist, and our annual budgetary approval process?
That way, it would be harder to dismiss making controversial decisions based upon 'the time not being right'.
When is the time ever right? Especially for those who perpetually resist change?
What I'm talking about is a form of 'phased implementation', where the cumulative impact of incremental changes can fit into and become part of an evolving national healthcare strategy that leads toward a sensible system that doesn't create too many short term dislocations -either real or imaginary.
I have learned that taking heat one time is preferable to taking it multiple times, but that mainly applies to a single issue -think Lake Whatcom for example.
But, the basic weakness with trying to solve a big problem at one stroke is that it simply doesn't work very often -even if sufficient 'votes' can be garnered!
There are always new twists and turns, things that weren't anticipated, new elected officials and fiscal realities.
Think it's easy? Think again.
Maybe the best example of what I'm trying to illustrate is our own Constitution.
As good a document as that is, with its high-minded principles and visionary wisdom, it was adopted by a very slim margin and based upon the best compromise available at the time.
Since then, even our sacrosanct Constitution has been changed or modified several times by amendment, the Bill of Rights, and possibly by judicial interpretation.
As wise and courageous as our Founders were, they also understood that a democracy needs to adjust to circumstances and changing realities over time.
Just look at some of the issues they failed to adequately address over 200 years ago, like slavery and universal suffrage.
Don't you think the Founders meant for our Constitution to be a 'living document' that allows some very careful adjustment from time to time?
I know I do, and history easily demonstrates it.
Now, back to healthcare.
I believe that ready access to some practical level of healthcare is a basic human right for citizens and residents of this country.
Determining what that level is and implementing a plan to provide it is what is being debated right now.
But, a simple, one-time debate won't likely do the job needed.
That's why addressing this issue every year is necessary, and Congress needs to do the one thing it is least likely to do; discipline itself!
Only after having its collective nose rubbed in healthcare every year will Congress & the Administration - or some future iteration of both - be forced to deal with it meaningfully.
OK, I know that hasn't happened regularly on Medicare or Social Security, but it needs to in the future - without unduly burdening the present 'debate'.
The current 'debate' exemplifies what has become a national embarrassment; the substitution of uninformed and emotionally charged opinion that is exceptionally well-financed, for a fact-based and rational discussion among responsible adults.
And, this debate does need to be conducted respectfully by mature adults -on behalf of children, others and themselves at some point in the future.
Failing that, we'll have to do what we're doing; flailing and flogging individual pieces of the healthcare puzzle, without knowing what the big picture is or needs to become.
That is where broad principles can be helpful in delineating what is truly important and of deservedly lasting value.
You know, kinda like our Founders did when they conceived, debated and adopted our Constitution.
Enough of the verbalizing of things that haven't even been written down or agreed to.
That is a phantom tactic that is built on the quicksand of lies.
We can do better than that.
Much better!
Let's get that message to our elected officials, despite their distractions toward being reelected.
Why did we elect them in the first place?
--------------------
Our national healthcare debate, such as it is, ought to be seriously continued every year until we develop a system that serves us much better than the current mess.
If this sounds like I doubt that a single, comprehensive program can be adopted at any one time, your interpretation is correct.
The reason is that politics is simply the art of the possible, and Congress lacks the unity, courage and visionary insights to do this job right.
Of course, President Obama and his administration don't get off the hook either, but since when has an operating manual come with our highest office?
Obama's biggest problem is that he is trying to be too inclusive and flexible under the circumstances.
That is being perceived as either weakness or waffling by both sides, for different and varying reasons.
That is a no-man's land that is unlikely to yield any productive result, save maybe one; agreement that certain aspects of healthcare do need to be changed.
Once that consensus is reached, the job becomes a little simpler, but also longer term in nature.
Simpler, because sufficient votes can likely be garnered for incremental changes that both parties can support.
Things like providing and extending at least catastrophic medical coverage for all citizens.
Or maybe even some tort reform.
Yesterday's Crosscut article by Ted Van Dyk provides a useful perspective on this general strategy.
The longer term nature of debating the healthcare issue, means that Congress and the Administration must find a way to commit to continuing good faith discussions well into the foreseeable future.
Why not bring this up every year as part of a national debate that also ties into whatever economic conditions exist, and our annual budgetary approval process?
That way, it would be harder to dismiss making controversial decisions based upon 'the time not being right'.
When is the time ever right? Especially for those who perpetually resist change?
What I'm talking about is a form of 'phased implementation', where the cumulative impact of incremental changes can fit into and become part of an evolving national healthcare strategy that leads toward a sensible system that doesn't create too many short term dislocations -either real or imaginary.
I have learned that taking heat one time is preferable to taking it multiple times, but that mainly applies to a single issue -think Lake Whatcom for example.
But, the basic weakness with trying to solve a big problem at one stroke is that it simply doesn't work very often -even if sufficient 'votes' can be garnered!
There are always new twists and turns, things that weren't anticipated, new elected officials and fiscal realities.
Think it's easy? Think again.
Maybe the best example of what I'm trying to illustrate is our own Constitution.
As good a document as that is, with its high-minded principles and visionary wisdom, it was adopted by a very slim margin and based upon the best compromise available at the time.
Since then, even our sacrosanct Constitution has been changed or modified several times by amendment, the Bill of Rights, and possibly by judicial interpretation.
As wise and courageous as our Founders were, they also understood that a democracy needs to adjust to circumstances and changing realities over time.
Just look at some of the issues they failed to adequately address over 200 years ago, like slavery and universal suffrage.
Don't you think the Founders meant for our Constitution to be a 'living document' that allows some very careful adjustment from time to time?
I know I do, and history easily demonstrates it.
Now, back to healthcare.
I believe that ready access to some practical level of healthcare is a basic human right for citizens and residents of this country.
Determining what that level is and implementing a plan to provide it is what is being debated right now.
But, a simple, one-time debate won't likely do the job needed.
That's why addressing this issue every year is necessary, and Congress needs to do the one thing it is least likely to do; discipline itself!
Only after having its collective nose rubbed in healthcare every year will Congress & the Administration - or some future iteration of both - be forced to deal with it meaningfully.
OK, I know that hasn't happened regularly on Medicare or Social Security, but it needs to in the future - without unduly burdening the present 'debate'.
The current 'debate' exemplifies what has become a national embarrassment; the substitution of uninformed and emotionally charged opinion that is exceptionally well-financed, for a fact-based and rational discussion among responsible adults.
And, this debate does need to be conducted respectfully by mature adults -on behalf of children, others and themselves at some point in the future.
Failing that, we'll have to do what we're doing; flailing and flogging individual pieces of the healthcare puzzle, without knowing what the big picture is or needs to become.
That is where broad principles can be helpful in delineating what is truly important and of deservedly lasting value.
You know, kinda like our Founders did when they conceived, debated and adopted our Constitution.
Enough of the verbalizing of things that haven't even been written down or agreed to.
That is a phantom tactic that is built on the quicksand of lies.
We can do better than that.
Much better!
Let's get that message to our elected officials, despite their distractions toward being reelected.
Why did we elect them in the first place?
--------------------
Wednesday, August 12, 2009
Healthcare: The Status Quo Has Got To Go!
------------------------
'To improve is to change; to be perfect is to change often.' - Winston Churchill
'The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic.'
- John F. Kennedy
'Healthy citizens are the greatest asset any country can have.'
- Winston Churchill
------------------------
A few years ago, a local right-wing politico couldn't resist shouting out 'John Watts has got to go!'
That outburst actually embarrassed some of this politico's cohorts to the extent they came up to me after the meeting and apologized.
But, you know that politico was right.
I did need to go, just like everyone does at some time.
The thing is, I get to pick the time and place, which in due course, I did.
In retrospect, I might have stayed too long, but past mistakes and decisions can't always be easily corrected.
There is one rather large mistake that has persisted over a half century which can be corrected, but only if Congress has the courage to do it.
Of course, there is again, a large chorus of politicos who are using every means at their disposal to frustrate any kind of meaningful change in our healthcare system.
And this is despite the crying need for breaking the grip of our 'status quo'.
As predicted in an earlier blog, the cacophony of noise and misinformation is reaching a crescendo of meanness, to our great shame as a democratic society.
But, there are ways to deal with this kind of strategy and associated tactics.
It won't be easy, but worthwhile things never are.
The antidote is to keep listening, talking and thinking about more elegant and efficient ways to skin the healthcare cat.
Much of this has already been done, but more is probably needed before measures can be agreed to by both the House & Senate.
Just keep explaining, answering criticisms and pushing forward, without setting any artificial deadlines.
Practical deadlines are likely necessary, but a phased implementation over time makes sense.
If the opposition proves intractable -as it is acting- then something must be accomplished anyway, with or without their support.
And, regardless of attitudes, no entity EXCEPT the Federal Government can realistically take on this task.
It is interesting to see the contest between reasonable discourse and emotional distraction.
And, anger, fear, distrust and doubt can be effective weapons, but in the end their duplicity undermines their objective.
Advertisers understand that if a message is repeated often enough it will sell.
Repeat a slogan frequently and it is believed.
Repeated messages are inherent in advertising, religion, and politics.
But this reality cuts both ways, and I have confidence that principled progress will triumph over those who so ardently oppose it.
If you don't believe that, you may be part of the problem.
This country of ours has managed to slowly but surely change itself over its relatively brief history.
Just look at the egregious civil rights issues that have been improved, including slavery, universal suffrage and the like.
Not that changing our Constitution, laws or policies automatically solves a problem, but it can change our direction in ways that are difficult to reverse.
Something similar must happen in healthcare, and one hopes sooner rather later.
You can argue about the details, but not the need for change!
That is, if one truly values their own integrity, intelligence and compassion.
I hope our elected legislators get an earful before returning to their next Congressional session.
Then, I trust they will act to meaningfully improve our healthcare system.
If that doesn't happen, I will personally make this an issue that will not go away.
This is a promise, not a threat; it will be time for some elected officials to go!
-----------------------------------
'My experience in government is that when things are non-controversial and beautifully coordinated, there is not much going on.' - John F. Kennedy
'Criticism may not be agreeable, but it is necessary. It fulfils the same function as pain in the human body. It calls attention to an unhealthy state of things. '- Winston Churchill
'To improve is to change; to be perfect is to change often.' - Winston Churchill
'The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic.'
- John F. Kennedy
'Healthy citizens are the greatest asset any country can have.'
- Winston Churchill
------------------------
A few years ago, a local right-wing politico couldn't resist shouting out 'John Watts has got to go!'
That outburst actually embarrassed some of this politico's cohorts to the extent they came up to me after the meeting and apologized.
But, you know that politico was right.
I did need to go, just like everyone does at some time.
The thing is, I get to pick the time and place, which in due course, I did.
In retrospect, I might have stayed too long, but past mistakes and decisions can't always be easily corrected.
There is one rather large mistake that has persisted over a half century which can be corrected, but only if Congress has the courage to do it.
Of course, there is again, a large chorus of politicos who are using every means at their disposal to frustrate any kind of meaningful change in our healthcare system.
And this is despite the crying need for breaking the grip of our 'status quo'.
As predicted in an earlier blog, the cacophony of noise and misinformation is reaching a crescendo of meanness, to our great shame as a democratic society.
But, there are ways to deal with this kind of strategy and associated tactics.
It won't be easy, but worthwhile things never are.
The antidote is to keep listening, talking and thinking about more elegant and efficient ways to skin the healthcare cat.
Much of this has already been done, but more is probably needed before measures can be agreed to by both the House & Senate.
Just keep explaining, answering criticisms and pushing forward, without setting any artificial deadlines.
Practical deadlines are likely necessary, but a phased implementation over time makes sense.
If the opposition proves intractable -as it is acting- then something must be accomplished anyway, with or without their support.
And, regardless of attitudes, no entity EXCEPT the Federal Government can realistically take on this task.
It is interesting to see the contest between reasonable discourse and emotional distraction.
And, anger, fear, distrust and doubt can be effective weapons, but in the end their duplicity undermines their objective.
Advertisers understand that if a message is repeated often enough it will sell.
Repeat a slogan frequently and it is believed.
Repeated messages are inherent in advertising, religion, and politics.
But this reality cuts both ways, and I have confidence that principled progress will triumph over those who so ardently oppose it.
If you don't believe that, you may be part of the problem.
This country of ours has managed to slowly but surely change itself over its relatively brief history.
Just look at the egregious civil rights issues that have been improved, including slavery, universal suffrage and the like.
Not that changing our Constitution, laws or policies automatically solves a problem, but it can change our direction in ways that are difficult to reverse.
Something similar must happen in healthcare, and one hopes sooner rather later.
You can argue about the details, but not the need for change!
That is, if one truly values their own integrity, intelligence and compassion.
I hope our elected legislators get an earful before returning to their next Congressional session.
Then, I trust they will act to meaningfully improve our healthcare system.
If that doesn't happen, I will personally make this an issue that will not go away.
This is a promise, not a threat; it will be time for some elected officials to go!
-----------------------------------
'My experience in government is that when things are non-controversial and beautifully coordinated, there is not much going on.' - John F. Kennedy
'Criticism may not be agreeable, but it is necessary. It fulfils the same function as pain in the human body. It calls attention to an unhealthy state of things. '- Winston Churchill
Friday, July 24, 2009
More on Healthcare: Knowledge as Truth
-----------------------
All progress has resulted from people who took unpopular positions.
- Adlai E. Stevenson
A little knowledge that acts is worth infinitely more than much knowledge that is idle. - KAHLIL GIBRAN
-----------------------
The healthcare debate continues as it should until the best possible combination of attributes have been incorporated into a bill that can be approved by both legislative bodies, and is worthy of signing by the President.
But, now that so much information, some of it conflicting and some of it misinformation, is out there wouldn't it be nice to able to easily verify its accuracy?
Here's an authoritative website that seems pretty unbiased regarding the current healthcare rhetoric which I found useful.
There are also two new NYT editorials on healthcare, by David Brooks and Paul Krugman, which most folks will find interesting.
Have you noticed how the ad campaigns -pro and con- have picked up in intensity?
Maybe the 'factcheck.org' website can help sort out who's spinning what, and at least zero in on the range of reasonable estimates that are used.
--------------------------------
The concept of what constitutes knowledge, and its proper application to real situations has been a constant theme of this blog, because it has been main interest of mine all of my life.
With that in mind, this Wikipedia website goes into some detail in describing knowledge.
This phrase has been closest to mine: 'The definition of knowledge is a matter of on-going debate among philosophers in the field of epistemology. The classical definition, described but not ultimately endorsed by Plato[1], has it that in order for there to be knowledge at least three criteria must be fulfilled; that in order to count as knowledge, a statement must be justified, true, and believed.'
Of course, there are other definitions, qualifications and interpretations of what knowledge means, especially those which prefer to emphasize beliefs, as opposed to provable facts.
That debate will never end, nor should it, but true knowledge ought to be communicable, capable of appealing to reason and provable to others.
As one of our Founding Fathers put it:
Society, community, family are all conserving institutions. They try to maintain stability, and to prevent, or at least to slow down, change. But the organization of the post-capitalist society of organizations is a destabilizer. Because its function is to put knowledge to work -- on tools, processes, and products; on work; on knowledge itself -- it must be organized for constant change. - PETER F. DRUCKER
If you don't read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed. - MARK TWAIN
---------------------------------
All progress has resulted from people who took unpopular positions.
- Adlai E. Stevenson
A little knowledge that acts is worth infinitely more than much knowledge that is idle. - KAHLIL GIBRAN
-----------------------
The healthcare debate continues as it should until the best possible combination of attributes have been incorporated into a bill that can be approved by both legislative bodies, and is worthy of signing by the President.
But, now that so much information, some of it conflicting and some of it misinformation, is out there wouldn't it be nice to able to easily verify its accuracy?
Here's an authoritative website that seems pretty unbiased regarding the current healthcare rhetoric which I found useful.
There are also two new NYT editorials on healthcare, by David Brooks and Paul Krugman, which most folks will find interesting.
Have you noticed how the ad campaigns -pro and con- have picked up in intensity?
Maybe the 'factcheck.org' website can help sort out who's spinning what, and at least zero in on the range of reasonable estimates that are used.
--------------------------------
The concept of what constitutes knowledge, and its proper application to real situations has been a constant theme of this blog, because it has been main interest of mine all of my life.
With that in mind, this Wikipedia website goes into some detail in describing knowledge.
This phrase has been closest to mine: 'The definition of knowledge is a matter of on-going debate among philosophers in the field of epistemology. The classical definition, described but not ultimately endorsed by Plato[1], has it that in order for there to be knowledge at least three criteria must be fulfilled; that in order to count as knowledge, a statement must be justified, true, and believed.'
Of course, there are other definitions, qualifications and interpretations of what knowledge means, especially those which prefer to emphasize beliefs, as opposed to provable facts.
That debate will never end, nor should it, but true knowledge ought to be communicable, capable of appealing to reason and provable to others.
As one of our Founding Fathers put it:
"A popular Government without popular information or the means of acquiring it, is but a Prologue to a Farce or a Tragedy or perhaps both. Knowledge will forever govern ignorance, and a people who mean to be their own Governors, must arm themselves with the power knowledge gives." - James Madison--------------------------------
Society, community, family are all conserving institutions. They try to maintain stability, and to prevent, or at least to slow down, change. But the organization of the post-capitalist society of organizations is a destabilizer. Because its function is to put knowledge to work -- on tools, processes, and products; on work; on knowledge itself -- it must be organized for constant change. - PETER F. DRUCKER
If you don't read the newspaper, you are uninformed; if you do read the newspaper, you are misinformed. - MARK TWAIN
---------------------------------
Thursday, July 23, 2009
Blue Dogs & 'No Hogs'
--------------------------------
Were I a member of the US Congress, I 'd probably be known as something of a 'Blue Dog' Democrat, but loosely so because of my independent streak that resists being controlled by anything other than my own analysis and carefully weighted conclusions.
But, that would not affect my determination to achieve progress on issues of major importance, like meaningful national healthcare reform.
It is sad that so many of the current minority party allow themselves to be controlled by narrow partisan edicts that are more designed for political games than for necessary action on national policy that matters.
And, its hard to understand the value system that allows that habit to persist.
Maybe these folks are so secure in their heavily gerrymandered districts that they have little worry about re-election.
Or, maybe they see their jobs more narrowly than is in the nation's best interests?
I don't know, but I do care.
And, I'm concerned with any mentality that rationalizes it is not part of a problem, and therefore doesn't need to be a part of the solution.
But, I guess these folks have always been around; you know them best as 'crown sympathizers', draft-dodgers, tax evaders, non-voters, and all manner of other self-satisfied lazy louts with attitudes.
Maybe that dynamic -in reverse- is what causes many other elected officials to waffle, wait and sometimes become co-opted into positions they may or may not wish to support.
There are times when all these dynamics come into play with a vengeance, like now -on healthcare reform, but that itself can be healthy, because better ideas are generated, compromises conceived, and a sense of urgency generated.
Some have expressed concern with deadlines, and hate being 'rushed'. [as in Limbaugh?]
But, without deadlines, is it reasonable to expect any predictability or progress?
How about things like our reaction 9/11?
Or approving annual budgets?
Or making Supreme Court appointments?
Sometimes what people call being 'rushed', simply means they don't want to do it.
Have you noticed?
The broad outlines of what seems desirable for healthcare reform have been pretty clearly known and stated for months.
Some are harder to articulate, determine sustainable financing or make compatible with other programs, but that is the main exercise that is underway -at least among those with legitimate interest in change.
Those who are proud to be 'No Hogs', prefer to block any meaningful change or progress, and leave that burden to 'others', as has been done for 61 years.
So, the 'Blue Dogs' must act as the sounding board for what reform will likely occur, and I'm good with that, because I do believe meaningful compromise is achievable.
But, the Blue Dogs need to not take such a hard line that the impression is left that failure is imminent.
The 'sausage-making' of legislation is always ugly and subject to compromise, meaning no one gets everything they want.
A few ideas that deserve serious consideration are these -maybe more:
• establishment of an independent body of healthcare professionals with the power to review any national program annually and recommend adjustments.
• achieving equity between States in Medicare reimbursement rates.
• continuously examining equitable and sustainable funding methods for national healthcare, so that the goal of NOT creating more federal deficits over time is achieved.
There is even something for the 'No Hogs' to think about:
If there is such a need for change in the existing system that an amazing array of stakeholders agree, and that enormous cost savings -maybe 2/3 of the estimated additional cost- how can this be so simply dismissed?
Think about it.
Continuing the 'status quo' just insures that substantial healthcare costs will be continued to be just wasted!
One would think it's more normal for so-called 'conservatives' to want to cut excesses and use funds more efficiently.
What has happened to that?
And, what has happened to intellectual honesty?
I do believe the Blue Dogs will find a way to responsibly compromise and find ways to pay for the anticipated additional costs of healthcare reform and make the measure 'deficit neutral', which I believe is possible.
Maybe that will take a leap of faith in the form of a commitment for periodic supplemental funding votes.
Some of those options may entail eventual elimination of healthcare cost exemptions from income tax.
Other ideas are also possible, but will require time to identify, quantify and implement.
The so-called 'August deadline' may or may not be met, without extending the legislative calendar.
All that means anyway, is that bills can be reasonably prepared for debate and passage later this Fall.
For an issue so important, it would seem some unusual measures are justified.
President Obama's Press Conference last night pretty much outlined the parameters that would be acceptable for him to sign any bill resulting from Congressional action.
And, his decision to let Congress discuss the various options before imposing any preferred bill of his own is the right way to go.
But, now time is passing quickly and the deadlines required must be respected and if possible, enforced.
If Congress misses its August break, tough luck!
If no unanimous result is possible, then a more narrow and more partisan passage is OK.
Additional delay is not justified, nor is it helpful to the hoped for eventual result.
If members of Congress are uncomfortable with making such a difficult decision, too bad!
They need to get off the fence, or out of the kitchen.
Now is the time for Healthcare reform to happen.
It is too important an issue to 'kick down the road' again, as it largely has been since Harry Truman advocated it in 1948.
We can do better than that, and this is the time!
---------------------
My neighbor and I are both retired and over 70.
Both of us did not look forward to joining Medicare.
Both of us has been very wrong in our unfounded fears!
Medicare has been the easiest and most efficient healthcare program either of us has ever had.
The only reasons I decided to buy expensive secondary healthcare insurance were (a) fear of Medicare Parts A & B, and (b) fear of Medicare Part (d) -'the donut hole'.
I no longer have any doubts about Medicare Parts A & B.
I do have concerns about Medicare Part D, because the prescription coverage is full of holes and unknown costs.
Perhaps these will be addressed in a new Medicare plan, and if they are, my wife and I will be able to save about $7800 per year in SECONDARY INSURANCE costs.
[not Supplemental Insurance of the sort promoted by so-called Medicare Part C Plans]
Think that's not a substantial savings?
But, I'm not just thinking of me, I'm thinking of the millions of Americans who will benefit from a the availability of a national healthcare plan option.
There is nothing wrong with the way the US Government administers Medicare, and much that is right, including efficiency and low costs.
It may be the best deal around for those of us who are retired or 65.
And, remember, its only been around since 1965, when another Democratic American President with courage, foresight and political clout dared to buck entrenched special interests and get it implemented.
Now, 44 years later, maybe its time for President #44 to expand it into a true national program!
--------------------------
A few related links:
NYT:Timothy Egan
NYT:David Brooks & Gail Collins
NYT:Health Care Sausagee
NYT:Editorial
NYT:History of Health Care Reform
----------------------------
Ever wonder how many Republicans have the names Sally, Straw or Rush?
The term 'Aunt Sally' is in limited use as a political idiom, indicating a false adversary or Straw Man, set up for the sole purpose of attracting negative attention and wasting an opponent's energy.
Were I a member of the US Congress, I 'd probably be known as something of a 'Blue Dog' Democrat, but loosely so because of my independent streak that resists being controlled by anything other than my own analysis and carefully weighted conclusions.
But, that would not affect my determination to achieve progress on issues of major importance, like meaningful national healthcare reform.
It is sad that so many of the current minority party allow themselves to be controlled by narrow partisan edicts that are more designed for political games than for necessary action on national policy that matters.
And, its hard to understand the value system that allows that habit to persist.
Maybe these folks are so secure in their heavily gerrymandered districts that they have little worry about re-election.
Or, maybe they see their jobs more narrowly than is in the nation's best interests?
I don't know, but I do care.
And, I'm concerned with any mentality that rationalizes it is not part of a problem, and therefore doesn't need to be a part of the solution.
But, I guess these folks have always been around; you know them best as 'crown sympathizers', draft-dodgers, tax evaders, non-voters, and all manner of other self-satisfied lazy louts with attitudes.
Maybe that dynamic -in reverse- is what causes many other elected officials to waffle, wait and sometimes become co-opted into positions they may or may not wish to support.
There are times when all these dynamics come into play with a vengeance, like now -on healthcare reform, but that itself can be healthy, because better ideas are generated, compromises conceived, and a sense of urgency generated.
Some have expressed concern with deadlines, and hate being 'rushed'. [as in Limbaugh?]
But, without deadlines, is it reasonable to expect any predictability or progress?
How about things like our reaction 9/11?
Or approving annual budgets?
Or making Supreme Court appointments?
Sometimes what people call being 'rushed', simply means they don't want to do it.
Have you noticed?
The broad outlines of what seems desirable for healthcare reform have been pretty clearly known and stated for months.
Some are harder to articulate, determine sustainable financing or make compatible with other programs, but that is the main exercise that is underway -at least among those with legitimate interest in change.
Those who are proud to be 'No Hogs', prefer to block any meaningful change or progress, and leave that burden to 'others', as has been done for 61 years.
So, the 'Blue Dogs' must act as the sounding board for what reform will likely occur, and I'm good with that, because I do believe meaningful compromise is achievable.
But, the Blue Dogs need to not take such a hard line that the impression is left that failure is imminent.
The 'sausage-making' of legislation is always ugly and subject to compromise, meaning no one gets everything they want.
A few ideas that deserve serious consideration are these -maybe more:
• establishment of an independent body of healthcare professionals with the power to review any national program annually and recommend adjustments.
• achieving equity between States in Medicare reimbursement rates.
• continuously examining equitable and sustainable funding methods for national healthcare, so that the goal of NOT creating more federal deficits over time is achieved.
There is even something for the 'No Hogs' to think about:
If there is such a need for change in the existing system that an amazing array of stakeholders agree, and that enormous cost savings -maybe 2/3 of the estimated additional cost- how can this be so simply dismissed?
Think about it.
Continuing the 'status quo' just insures that substantial healthcare costs will be continued to be just wasted!
One would think it's more normal for so-called 'conservatives' to want to cut excesses and use funds more efficiently.
What has happened to that?
And, what has happened to intellectual honesty?
I do believe the Blue Dogs will find a way to responsibly compromise and find ways to pay for the anticipated additional costs of healthcare reform and make the measure 'deficit neutral', which I believe is possible.
Maybe that will take a leap of faith in the form of a commitment for periodic supplemental funding votes.
Some of those options may entail eventual elimination of healthcare cost exemptions from income tax.
Other ideas are also possible, but will require time to identify, quantify and implement.
The so-called 'August deadline' may or may not be met, without extending the legislative calendar.
All that means anyway, is that bills can be reasonably prepared for debate and passage later this Fall.
For an issue so important, it would seem some unusual measures are justified.
President Obama's Press Conference last night pretty much outlined the parameters that would be acceptable for him to sign any bill resulting from Congressional action.
And, his decision to let Congress discuss the various options before imposing any preferred bill of his own is the right way to go.
But, now time is passing quickly and the deadlines required must be respected and if possible, enforced.
If Congress misses its August break, tough luck!
If no unanimous result is possible, then a more narrow and more partisan passage is OK.
Additional delay is not justified, nor is it helpful to the hoped for eventual result.
If members of Congress are uncomfortable with making such a difficult decision, too bad!
They need to get off the fence, or out of the kitchen.
Now is the time for Healthcare reform to happen.
It is too important an issue to 'kick down the road' again, as it largely has been since Harry Truman advocated it in 1948.
We can do better than that, and this is the time!
---------------------
My neighbor and I are both retired and over 70.
Both of us did not look forward to joining Medicare.
Both of us has been very wrong in our unfounded fears!
Medicare has been the easiest and most efficient healthcare program either of us has ever had.
The only reasons I decided to buy expensive secondary healthcare insurance were (a) fear of Medicare Parts A & B, and (b) fear of Medicare Part (d) -'the donut hole'.
I no longer have any doubts about Medicare Parts A & B.
I do have concerns about Medicare Part D, because the prescription coverage is full of holes and unknown costs.
Perhaps these will be addressed in a new Medicare plan, and if they are, my wife and I will be able to save about $7800 per year in SECONDARY INSURANCE costs.
[not Supplemental Insurance of the sort promoted by so-called Medicare Part C Plans]
Think that's not a substantial savings?
But, I'm not just thinking of me, I'm thinking of the millions of Americans who will benefit from a the availability of a national healthcare plan option.
There is nothing wrong with the way the US Government administers Medicare, and much that is right, including efficiency and low costs.
It may be the best deal around for those of us who are retired or 65.
And, remember, its only been around since 1965, when another Democratic American President with courage, foresight and political clout dared to buck entrenched special interests and get it implemented.
Now, 44 years later, maybe its time for President #44 to expand it into a true national program!
--------------------------
A few related links:
NYT:Timothy Egan
NYT:David Brooks & Gail Collins
NYT:Health Care Sausagee
NYT:Editorial
NYT:History of Health Care Reform
----------------------------
Ever wonder how many Republicans have the names Sally, Straw or Rush?
The term 'Aunt Sally' is in limited use as a political idiom, indicating a false adversary or Straw Man, set up for the sole purpose of attracting negative attention and wasting an opponent's energy.
Sunday, July 12, 2009
Healthcare: Simple or Complicated?
----------------------------
The concept of universal health is amazingly simple.
So, why is it that our national discussion is getting so complicated?
Do you think money -big money- has anything to do with it?
It seems there are powerful interests who really don't want to see the status quo changed at all, unless it benefits them.
But, self-serving resistance to change isn't exactly new, is it?
The real question is 'who is to be served'?
And, health care-wise, the priority needs to be all Americans.
Period. End of story.
It is a national embarrassment and tragedy that the USA hasn't got an effective health care program.
In my mind, only three things are absolutely critical;
• everyone is covered
• a public health plan option is required
• a reasonable method of determining 'levels of service' and financing is needed
None of these are simple, but since when are complications not expected?
And, many folks think some other things are also critically important, too.
Cutting through all the excuses for non-action, delay and watering down, a recent letter to the editor got it right:
It addressed our elected members of Congress, cited the fact that they all had excellent US government health plans, and requested the same for all citizens.
If that's too rich, then let's have a talk.
That seems pretty simple approach too, doesn't it?
Soon, all the proposals, concerns and discussion will begin to get more serious.
That usually happens once Congress agrees to something that may be voted upon.
That is also the time when all the arrayed opposition comes together with a concerted attack designed to instill doubt, plead too expensive, engender fear, and spread deliberate misinformation.
Can't wait for that spectacle, can you?
One can only hope that our elected officials have the courage to do what they have needed to do for so long.
--------------------------------
Here are two links to recent articles on this subject:
A Bill Moyers interview about 'the Select Few'.
A NY Times collection of three pro & con arguments.
--------------------------------
A final thought:
I have been blessed with two things for most of my life; good health and good jobs that provided me and my family with excellent health care coverage.
There are many people who have not been nearly so fortunate.
When I last retired and became reliant on Medicare as my my primary health care provider, it was with a combination of uniformed doubt and trepidation.
The doubt was based upon my own ignorance.
The fear was based upon what I thought was to be the frustration of dealing with a large government bureaucracy with complicated rules, procedures and complicated paperwork.
You know, like the IRS.
I was wrong.
Medicare has proven to be the least complicated health care system I have dealt with!
And, that is despite the fact that my health care needs have been greater during the past year than at any time of my life.
So, I have become a believer in Medicare and in the government's ability to manage such a program with efficiency, simplicity and fairness.
I'm sure there will be other things for me to learn, but so far, the use of my expensive secondary health insurance has been negligible.
So, don't worry you private health insurance providers; I'll still pay your premiums, but won't likely submit nearly as many claims.
That alone ought to help keep the existing private health care system profitable!
And, I know there are many others who feel the same way I used to about Medicare, as well as about the government's ability to sustainably finance such a system for everyone.
I believe those fears are legitimate, but will also prove false -providing our elected representatives decide to stand up to the pressures of the lobbyists for the status quo.
There are few things more important than our health, and no method is more effective than preventative care, which any universal health care program should emphasize and reward.
I am confident that America will 'do the right thing' as Winston Churchill once said - after it has tried every other course of action!
I hope I'm wrong about that last part.
But, the concept is simple and we deserve it, both as a nation and as individuals.
--------------------------------
The concept of universal health is amazingly simple.
So, why is it that our national discussion is getting so complicated?
Do you think money -big money- has anything to do with it?
It seems there are powerful interests who really don't want to see the status quo changed at all, unless it benefits them.
But, self-serving resistance to change isn't exactly new, is it?
The real question is 'who is to be served'?
And, health care-wise, the priority needs to be all Americans.
Period. End of story.
It is a national embarrassment and tragedy that the USA hasn't got an effective health care program.
In my mind, only three things are absolutely critical;
• everyone is covered
• a public health plan option is required
• a reasonable method of determining 'levels of service' and financing is needed
None of these are simple, but since when are complications not expected?
And, many folks think some other things are also critically important, too.
Cutting through all the excuses for non-action, delay and watering down, a recent letter to the editor got it right:
It addressed our elected members of Congress, cited the fact that they all had excellent US government health plans, and requested the same for all citizens.
If that's too rich, then let's have a talk.
That seems pretty simple approach too, doesn't it?
Soon, all the proposals, concerns and discussion will begin to get more serious.
That usually happens once Congress agrees to something that may be voted upon.
That is also the time when all the arrayed opposition comes together with a concerted attack designed to instill doubt, plead too expensive, engender fear, and spread deliberate misinformation.
Can't wait for that spectacle, can you?
One can only hope that our elected officials have the courage to do what they have needed to do for so long.
--------------------------------
Here are two links to recent articles on this subject:
A Bill Moyers interview about 'the Select Few'.
A NY Times collection of three pro & con arguments.
--------------------------------
A final thought:
I have been blessed with two things for most of my life; good health and good jobs that provided me and my family with excellent health care coverage.
There are many people who have not been nearly so fortunate.
When I last retired and became reliant on Medicare as my my primary health care provider, it was with a combination of uniformed doubt and trepidation.
The doubt was based upon my own ignorance.
The fear was based upon what I thought was to be the frustration of dealing with a large government bureaucracy with complicated rules, procedures and complicated paperwork.
You know, like the IRS.
I was wrong.
Medicare has proven to be the least complicated health care system I have dealt with!
And, that is despite the fact that my health care needs have been greater during the past year than at any time of my life.
So, I have become a believer in Medicare and in the government's ability to manage such a program with efficiency, simplicity and fairness.
I'm sure there will be other things for me to learn, but so far, the use of my expensive secondary health insurance has been negligible.
So, don't worry you private health insurance providers; I'll still pay your premiums, but won't likely submit nearly as many claims.
That alone ought to help keep the existing private health care system profitable!
And, I know there are many others who feel the same way I used to about Medicare, as well as about the government's ability to sustainably finance such a system for everyone.
I believe those fears are legitimate, but will also prove false -providing our elected representatives decide to stand up to the pressures of the lobbyists for the status quo.
There are few things more important than our health, and no method is more effective than preventative care, which any universal health care program should emphasize and reward.
I am confident that America will 'do the right thing' as Winston Churchill once said - after it has tried every other course of action!
I hope I'm wrong about that last part.
But, the concept is simple and we deserve it, both as a nation and as individuals.
--------------------------------
Thursday, July 2, 2009
Healthcare & Walmart
-----------------------------
This topic ought to be a hot one, irrespective of anyone's view.
Would you believe Walmart's new stance on this issue?
Think they might see some major advantages that favor them which had not been apparent up to now?
I'd bet on that, because that's what free enterprise is all about.
But, the real question is, can companies like Walmart help make the changes that most of us seem to believe are necessary?
You can think of Walmart what you will, but they can -and do- have a major effect on buying habits when they go after something!
--------------------
First, here's what outgoing Walmart CEO Lee Scott had to say about its plan to establish up to 400 health clinics during the next 2-3 years. [Click here]
And, second, here's someone's opinion on 20 ways these new Walmart clinics might impact the existing healthcare system: [Click here]
Next, here's a short summary of Walmart's reversal on supporting a national healthcare system: [Click here]
And, finally, here's a link to yet another opinion that we ought to let Walmart actually run our healthcare system -on the theory they would do a better job than either the government or the existing providers: [Click here]
-----------------------
Just when we think that we've figured out where folks stand on an issue, things do seem to change, don't they?
This will be an interesting subject to follow the next several months, and beyond.
Let's see what actually occurs, as something certainly will.
Whatever happens, we will not be likely to have the same healthcare system -or lack of it- that we have now.
Neither will we get the system that many strongly favor.
Likely, we'll get some collection of compromises that can gather sufficient support to pass Congress.
I hope the compromise ultimately adopted includes universal basic coverage for everyone, and a public system that people can choose if they want it.
There may be some other features that are desirable too, but those two are essential.
Also, there needs to be a system of periodic review, where changes can be made as the need arises.
It is well past the time that a country, like ours, ought to have a decent healthcare system.
Access to reasonable healthcare is something most people think of as a basic right.
Maybe we should consider adding that to the Bill of Rights?
---------------------------
This topic ought to be a hot one, irrespective of anyone's view.
Would you believe Walmart's new stance on this issue?
Think they might see some major advantages that favor them which had not been apparent up to now?
I'd bet on that, because that's what free enterprise is all about.
But, the real question is, can companies like Walmart help make the changes that most of us seem to believe are necessary?
You can think of Walmart what you will, but they can -and do- have a major effect on buying habits when they go after something!
--------------------
First, here's what outgoing Walmart CEO Lee Scott had to say about its plan to establish up to 400 health clinics during the next 2-3 years. [Click here]
And, second, here's someone's opinion on 20 ways these new Walmart clinics might impact the existing healthcare system: [Click here]
Next, here's a short summary of Walmart's reversal on supporting a national healthcare system: [Click here]
And, finally, here's a link to yet another opinion that we ought to let Walmart actually run our healthcare system -on the theory they would do a better job than either the government or the existing providers: [Click here]
-----------------------
Just when we think that we've figured out where folks stand on an issue, things do seem to change, don't they?
This will be an interesting subject to follow the next several months, and beyond.
Let's see what actually occurs, as something certainly will.
Whatever happens, we will not be likely to have the same healthcare system -or lack of it- that we have now.
Neither will we get the system that many strongly favor.
Likely, we'll get some collection of compromises that can gather sufficient support to pass Congress.
I hope the compromise ultimately adopted includes universal basic coverage for everyone, and a public system that people can choose if they want it.
There may be some other features that are desirable too, but those two are essential.
Also, there needs to be a system of periodic review, where changes can be made as the need arises.
It is well past the time that a country, like ours, ought to have a decent healthcare system.
Access to reasonable healthcare is something most people think of as a basic right.
Maybe we should consider adding that to the Bill of Rights?
---------------------------
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