Another excellent piece on "the public option"

In salon.com I read I love my socialist kidney . Excellent piece with a combination of personal experience and hard data.

A few bits to point out:

The author explains how private insurance outright refused to provide coverage for kidney failure. None. Zip. Zilch. Zero. Until the government stepped in.

Shows how Medicare is cost effective and private insurance is not.

Points out how for-profit dialysis "centers" (as opposed to government supported home care in other countries) have crappy outcomes.

The Republicans once upon a time supported universal health care (Nixon, for crying out loud, tried to enact it).

Good to read the whole piece if you have time.

I love the use of language. When clever people figure out ways to combine internet with chaos theory we obtain results such as the following:

As a result of a gay humorist, Dan Savage, and a relatively small number of people maintaining blogs or web sites, the name "Santorum" has become a slang word for a substance resulting from anal sex. It only takes a small number of people to "Google bomb" a given word. Here's how it works:

After you perform a search on Google, you see a ranked list of links. How does Google rank the search results? Google will not tell. But some people have found that one of the algorithms involves examining whether the word(s) appear as a "link name" and if so, the linking address (URL) that appears the most for the word or phrase searched rises to the top of Google's search results. If you click on the hyper link Rick Santorum, the link takes you to the URL : http://www.spreadingsantorum.com/

After enough people do that, you can type in either "Santorum" or "Rick Santorum" into a Google search, and the definition at http://www.spreadingsantorum.com/ will appear at the top of the results. If you click on the "I'm feeling lucky" button, it will take you directly to the "Spreading Santorum blog." Although Savage has not done anything with this blog since 2004, it still appears as the number 1 first link on all searches using the word "Santorum."

Now that former Senator Santorum has decided to run for President, we can anticipate the Google bombing of phrases such as Santorum for President, Elect Santorum, and whatever campaign slogans he comes up with.

I have heard that all it takes is 10 people to tie a given phrase to a given web address. I first heard of this when some people google-bombed the phrase "Miserable failure" to President George W. Bush's official biography on the White House web site. Sadly, this doesn't work anymore (Google fixed it). Since as of this writing, the Santorum bomb still works, I am guessing that Google needs to "fix" these bombs manually, one at a time, and therefore the algorithm continues to work as before.

Single-payer vs. two-tier healthcare

Updated below.

I wrote a lengthy reply to a friend's message containing an idea about providing greater efficiency to the health care system in the coming years. My reply took on a life of its own and turned into an editorial on the current state of the "reform effort."

Keep in mind I reproduce below mostly as I originally wrote it a message to a friend. This provides the context: I replied to an idea that promises to streamline the presently bureaucratic process we all must suffer when we need to go to the hospital.

Well if the right-wing is going to combat healthcare reform with "Obama wants to kill your grandmother" then what do you expect them to do with this? There exist some privacy, security and fraud "holes" that I see no iron-clad air-tight way to fix. You know how Republicans/Conservatives combat reform: they point to the problems and ignore the benefits thus making it impossible to defend a change unless it's a 100% solution. Anyone can nit-pick a plan to death. Given the viciousness we have seen already I am reluctant to invest any money and (no offense) even much time in a technological element that has such obvious vulnerabilities to political attack.

Now to the other political/social consideration. You know I respect you and realize you have knowledge, expertise and experience in this field that goes way beyond my meager collection of information. I will venture an opinion/argument anyway. When Cindy and Alex visited Canada a few years ago Cindy sustained a minor injury and needed to go to the hospital for outpatient care. When they asked about payment or insurance the Canadians laughed and told them there was nothing for them to sign, no forms to fill out, no idiocy with which they had to deal. They walked out of the hospital without so much as a co-payment. If you want efficiency, single-payer makes any sort of plan such as you envision totally unnecessary.

Single-payer also obtains greater cost-effectiveness than any private insurance. It's a myth and a lie that government is intrinsically incapable of accomplishing anything. The overhead expressed in dollars per $100 of reimbursement for most HMOs is $15. The most efficient is Kaiser which has about $12 per $100. What about Medicare and Medicaid? Try $3 each. This from the GAO and also reported (twice) in Consumer Reports (non-partisan and accepts no advertising). Recall also that back on April or May the Health Insurance industry offered Obama a trillion dollars in savings over 5 years. Think about it - that's how much they planned to over-charge us.

You understand the insurance business better than I do. You understand then, why when Canada changed the rules to allow private insurance to operate the one most important rule they enforce is that the private insurance can not underprice the government. In other words, there's no poaching the good risks. If you only insure the people who have a very low incidence of serious illness or injury, and who recover from injuries quickly, you rake in money. Freed from the expense of actually providing healthcare, you can spend the profits on bonuses so your executives can afford yachts and summer homes. The money is not spent on healthcare. Then, when the "good risks" age and become "bad risks" you either cancel their policies or price them so astronomically high that the "customer" must opt into the government-run system.

This is what I foresee happening: a two-tiered system in which the very wealthy have the very best healthcare but the private insurance companies otherwise will insure only the good risks, then dump them into the government-run half of the "system" when they actually need expensive treatments. Essentially what, according to documented cases, the private insurance companies do now. And I'm not just talking about "Sicko." I have also read numerous cases of policy cancellations and/or denial of treatment outside of Moore and his grandstanding silliness. The difference between $3 per $100 vs. $15 is not better health care (at least not in most cases). It's yachts and summer houses. A single-payer system will give us greatly reduced costs just by spending the money on healthcare.

In England the doctors have incentives to encourage their patients to lose weight and to quit smoking. With more time spent with patients the doctor can spend more time on educating patients and that can translate to more effectiveness in changing diet and behaviors that lead to obesity and other maladies. The present system of pressuring the doctors to see patients for as little time as possible does not serve me. I find it ultimately a self-fulfilling prophecy the argument that there are some who ruin their own health and drive costs up for everybody but then we do not let doctors have the time necessary with their patients to help them change. There are also some "cross purposes" with other industries, in particular the agribusiness industry which does research to design foods that lead to over-eating (especially snack foods are specifically designed to encourage the consumer to eat the whole package and still feel hungry). We have lots of people trying to gouge as much money from us as possible without regard to any sort of "greater good."

The English and Canadian systems are not perfect. But they are well liked by the majority of the populations of those countries. This morning on my clock radio NPR reported that some U.S. anti-healthcare liars duped some English people into complaining about their National Health Service on camera for what the English thought was a documentary. The two dupes have stated publicly that they have complaints but would never dream of replacing the NHS with an "American style" system. Likewise, when Canadian journalists at a press conference chided Michael Moore about "Sicko" pointing out that they thought he painted an unrealistically rosy picture of the Canadian healthcare system he asked them if they would prefer to switch to the American one instead. The Canadian journalists did the equivalent of crossing themselves a dozen times and said absolutely not.

In the present farce of a debate taking place you have a Senate full of millionaires (no exaggeration, I think that Al Franken is one too, given his successful show business career) all of whom enjoy government-provided healthcare, many of them telling us how evil, inefficient, bad and (gasp!) socialist a government-run system would be. I don't see any of these jackals signing up for Kaiser. I want what they're having.

Related links:

Fear and loathing in healthcare "reform"

Are you a good risk or a bad risk?

Update

Joan Walsh in salon.com has a great post of the "liberal" media covering the "town hells" astroturfing while ignoring a three-day long effort by Remote Area Medical group to provide free healthcare in Los Angeles, mostly to employed people without insurance. It's worth reading in its entirety. My favorite part: Katy Abram, the supposedly "just folks" shouter at Arlen Specter's town hall is a leader of the "9/12" group as shown by her own words on her own networking web site. Oh, and she compares herself to Martin Luther King.

What does "Green" mean?

Update I and Update II below.


One of the great advantages to working in academia comes from what you can learn just chatting with a colleague. A few weeks ago one of my colleagues explained to me what he learned from a moslem member of his department: What green means. In a discussion about the use of the word "green" in the U.S. (and enthusiastically adopted by our workplace) to mean "environmentally friendly" he told me that in the Islamic world, green is the symbolic color of Islam itself. "Going green" in that context means becoming more Islamic, more religious.


In the news reports about the political unrest in Iran following an obviously (and sloppily) rigged election, I have yet to find any news outlet that points out the symbolic meaning of the green head gear, green flags, green banners, etc. that we see on the TV. Maybe someone did explain and I just missed it. Nonetheless, the idea of right-wing bloggers changing their color schemes on their blogs in support of the protesters in Iran makes me chuckle a bit. Nevermind, that only a short time ago (a couple of years) Senator McCain made a tasteless joke about killing Iranian en masse ("Bomb, Bomb, Bomb... Bomb, Bomb Iran"). I have grown accustomed to the ease with which ideologues can turn on a dime. But I digress...


I read this morning two items that have coalesced in my head, and hope to do justice to that here. Glenn Greenwald on salon.com discussed the hypocrisy we witnessed when the President sang the praises of the power of the visual image to reveal the violence and brutality of the Iranian regime while chuckling at the reporter who asked about the suppression of the torture pictures by the same President (The Neda video, Torture and the truth-revealing power of images). Evidently not only right-wing ideologues turn on a dime - lots of people have that talent these days. And Greenwald gives us more scary for the day: a Washington Post/ABC poll shows that support for torturing "terrorist" suspects stands at about 50% (?!). I realize that no empirical evidence could ever tie this to the 7 seasons of torture porn broadcast as the television series 24, but I believe that popular culture, or even culture in general, has the ability to influence opinions on that most basic level: people's assumptions (assumptions are what you don't know you're making).


To make matters even more surreal, NPR (Nominally Public Radio) has made a decision to stop using the word "torture." Consider reading (or, I hope, re-reading) the essays of George Orwell (including the one at the end of 1984) about euphemism and dishonest use of language. NPR's Alicia C. Shepard writes an apologia for dropping the use of the word "torture" that reads like something out of the Ministry of Truth. I guess she would argue that it's only torture if you actually open the rat cage? Happily, many who have left comments on this atrocity have called bullshit on her. (Read about this whopper and comment as you please).


Culture and cluelessness combine in fascinating ways in Iran now, as I read an anonymous Iranian's report about how the regime has tried to keep people at home and complacent by showing them more movies that usual. To this end, they have started a Lord of the Rings marathon. I can almost imagine these imagination-challenged, ignorant, authoritarian hacks picking this out: "Oh, look. Harmless escapist fantasy, no relationship to reality here." Right. As if religions do not pillage the popular culture of the times for their holy books. These idiots never guessed that Tolkien artfully distills hundreds of characters, myths, legends, themes from around the world -- the stuff of popular culture throughout the centuries -- into an epic story that has to touch on at least some cultural references familiar to nearly any given person anywhere in the world. Not that Lord of the Rings necessarily borrows anything directly from the Koran or Iranian epic poetry (I have no idea, maybe it does?) but that (more likely) Tolkien's trilogy borrows from the same sources. In Tehran Dispatch: The regime shows us movies the anonymous Iranian explains the Iranian interpretation of the films. Please read this yourself. I will give you a spoiler, though: the Iranian regime looks a lot like Mordor. Who'd have guessed?


Update

I can not resist mentioning my favorite of all the comments I have read thus far on Shepard's Orwellian nightmare apologia:

Don McAdam (dmc) wrote:

The next time NPR does a story on child abuse or date rape, they should refer to those immoral acts as "enhanced parenting techniques" and "harsh dating practices".

Beautiful.


Update II

Here's someone who beat me to the punch:

Overton Glavlit (Googie) wrote:

I recognize that it's frustrating for some listeners to have NPR not use the number 4 to describe certain sums of 2 and 2. But the role of a news organization is not to choose sides in this or any debate. People have different definitions of what 2+2 equals and different feelings about what constitutes "4". NPR's job is to give listeners all perspectives, and present the news as detailed as possible and put it in context.

Fear and loathing in Healthcare "reform"

Republicans know how to set people against each other. According to an AP story Senator says tax on health benefits is unnecessary we read that republican senator Chuck Grassley of Iowa has suggested that a tax on employer health benefits could fund President Obama's proposal to provide healthcare to everyone. Despite Senator Dodd's comments to the effect that such a tax is unnecessary and counter-productive the damage is done.

Just the suggestion is enough to frighten those who have healthcare benefits from their employers to fear additional taxes. The idea of taxing people with jobs to supply healthcare others already has a firm link in many people's minds.

There's an easy way to resolve this problem. I wrote back in 2007 Are you a good risk or a bad risk that private insurance poaching the "good risks" diverts money from health care and spends it on six-figure salaries, bonuses, and a huge campaign war-chest for giving to politicians and both parties as well as PR efforts to fend off a single-payer system.

According to reports from the GAO to Consumer Reports private insurance and HMOs have an overhead (measured in number of dollars per $100 in reimbursement to health care providers) of about 15%. Some have overhead as high as $18 per $100 of reimbursement. What about the "grossly inefficient" government programs? Medicare and Medicaid consistently come in at $3 per $100. If you were simply to replace the current spending on private health insurance and divert the same funds to a single-payer system, you could pay for health care for everyone and have enough left over to give back money to both employers and employees.

The republican disinformation campaign and scare tactics take advantage of existing prejudices against poor people. Not all poor people are lazy, collecting welfare and uninterested in work. Many under-employed people to not receive employer health benefits. Many small businesses can not afford to offer health benefits and state laws do not require them to either. The stereotype of the lazy welfare recipient does not hold true for millions of people without health care.

Also keep in mind that back in 2007 GM griped about the competition from Europe. The European car companies do not have to pay health benefits but the U.S. ones do. If not for humanitarian reasons then for economic ones why not have a single-payer system that spends the premiums on health care instead of influence and astronomical salaries? Just a thought

Prolonged Preventative Detention

Although I never expected President Obama to live up to the expectations of the many liberals who jumped to the conclusion (without evidence) that he would enact the liberal's wish list, I did not see this one coming. As I viewed the President's speech yesterday I felt a growing sense of shock, astonishment and horror. He proposes the introduction of preventative detention - the detention of individuals without trial or even charge. I was expecting a centrist technocrat. Where's the pod?

Although he calls it "prolonged" detention, that word serves as a euphemism so disgusting that I shudder when I type the words. But others have done a far better job of parsing the President's speech. (See Rachel Maddow's expert deconstruction below).

Visit msnbc.com for Breaking News, World News, and News about the Economy

In addition, Glen Greenwald, a constitutional lawyer and very articulate writer of the blog Unclaimed Territory as usual did a thorough job of examining the implications and the constitutional issues. Speaking of the Constitution, that President Obama chose to deliver that attack on civil liberties and the rule of law at the National Archives in the presence of the original Constitution suggests that he used the Constitution as nothing more than a prop. For Bush it was the "Mission Accomplished" sign.

I appreciate the sort of political bind in which Democrats find themselves. Ever since Willie Horton they have lived in fear that a person released from the custody of some government agency who subsequently commits a crime will give a great campaign issue to the republicans. If someone released from U.S. custody commits or participates in an act of terrorism, then we (and I guess Obama sees this coming) will see the Republicans howling with outrage. "We had him! But then the cowardly democrats let him go!" But recall that Benjamin Franklin once said that those who would trade liberty for safety deserve neither. (And I would add that they will have neither). This from someone who had a price on his head during the Revolutionary War.

We have already seen the U.S. law enforcement mis-use the RICO statue to confiscate property of ordinary people based solely on arrest (without convictions). I wrote about that here. A law promoted as a tool to combat organized crime police subsequently use to confiscate the homes of cancer patients growing their own medicinal marijuana. And have we forgotten about George W. Bush's "free speech zones" or the police round-up of journalists and activists in advance of their doing anything during the Republican Convention last summer in Minneapolis? The notorious "no fly" list which has excluded a baby and a U.S. Senator from flying comes to mind as well. We have seen plenty of examples of laws "intended" for foreigners and/or terrorists used on citizens as well. Speaking of the distinction between "foreigners" and citizens, you may recall the interment of Japanese Americans during WWII.

Rachel Maddow used a reference to the movie Minority Report as a scary example in which police arrest people for "pre-crime" : crimes that they will commit but haven't yet. I find this a good and clever reference to the sort of Orwellian nightmare that lurks behind "prolonged detention." I can think of another movie reference: A World Apart. This film took place in Apartheid South Africa and dramatized an actual, frequent practice of preventative detention. Barbara Hershey's character stays in jail for the legal limited period of detention without charge. Then the police have to release her. She leaves the jail-house then almost makes it to a public telephone before the police arrest her again for another period of detention. Remember this if in response to public outrage President Obama amends his plan to place a time limit on how long the U.S. government entitles itself to detain a person without charge or trial.

Remember back in 2002 when Bush set up his torture regime while his head of the newly created "Homeland Security," Tom Ridge, described civil liberties as "... the most precious gift we offer our citizens." First it starts out as an inalienable right. Then turns into a gift that the government deigns to give to us. How much longer will we keep it?

Questions not asked

Here's an obvious question that I have not seen any talking heads of TV ask:

That was the little-noticed message from the made-for-TV spectacle that administration officials called a healthcare "game changer": In saying they can voluntarily slash $200 billion a year off the country's medical bills over the next decade and still preserve their profits, healthcare companies implicitly acknowledged they were plotting to fleece consumers and have been fleecing them for years. With that acknowledgment came the tacit admission that the industry's business is based not on respectable returns, but on grotesque profiteering and waste -- the kind that can give up $2 trillion and still guarantee huge margins.

From salon.com: Obama, the healthcare Riddler By David Sirota.

I like how David Sirota has grasped the obvious. But he does not plumb the depths of the depravity here. We have numerous HMOs, PPOs, and whatever other initials the health insurance industry can throw at us. But the free-enterprise champion always goes on about how competition provides us with the best of whatever at the lowest price possible. Where do you see any effectiveness of this philosophy at work in the health insurance industry? Where's the effect of this philosophy? Where's the efficiency that competition supposedly compels?