Third Party & Independents Archives

David,

Good and timely piece. Obama has stated that he intends to proceed with this and from both polls and fiscal considerations, I think he is dead on target.

While I agree, it will likely take a piecemeal approach as to how this is implemented. First to partially defray opposition and to not cause serious disruption, there will need to be some phasing in of whatever plan he chooses. However, making it clear that the goal is cost reduction at the outset, will begin to peel the onion back. EVERYONE is going to have to sacrifice. Whining medical providers, pharmaceuticals and insurance companies will go the same route as Wall Street bankers if they act stupidly. The game is up. Ralph and Louise will not work on Americans this time. We’ve been round that merry-go-round.

Racing to a globalized economy has thus far effected the middle class and poor to the point where some 40% of citizens pay no income tax and are receiving some social benefits. 10% of the public is paying 90% of the tax revenue. We are nearing the time when some companies will have to take a hit as well. Notably, GM will henceforth be selling cars for less. However, their profit margin will increase as their manufacturing base is now in China. So, if GM can offer a cheaper product by operating from overseas why can not the big pharmas do the same? For instance, why can Merck not relocate overseas and sell us cheap drugs? In fact, why do we need to purchase drugs and/or healthcare from so-called US companies? Why would we not want to negotiate with pharmas and insurance companies around the world for the best product at the best price? Only difference is where to send the bill. I don’t want so-called ‘free trade’ where we are told what we can buy overseas and what we can’t. You can’t be some pregnant. Let’s get on with it. Get the big pharm’s and insurance companies out of the US and compete to give us a better product based on cheap labor. That’s what our VISION for USA page calls for at www.republicsentry.com

Otherwise, we have the government we deserve.

This is a facinating issue.

Let me give you an example. Right now, longevity increases are subsidized. For instance if I spend money with my insurance in ways that increase my longevity, that means I live longer by definition, which increases the burden on Social Security and medicare in the future which at that time will be taxed to the young. (I am 53).

On the other hand as my generation looses power when we age, it is very much in the young’s benefit to limit longevity. We die sooner, and their will be more for them in terms of Social Security.

As David has rightly said, the cost of our care is very much in the very last months of life.

There is another factor. We are consuming more and more of health care. We use health care for many things that in the past our parents and grandparents would never consider. Elective use is climbing as well.

The inter generation politics are going to be very interesting as we go forward. The post baby boomers will not vote to bankrupt themselves. For people my age (53) that means that in my last years on earth if I live long, say 30 years from now, medical rationing will be a fact of life.

You know we go about thsi medical/financial question showing how we will all go bankrupt. Another discipline I have never seen would be to see what the future can actually pay without bankruptsy, and then work backwards to see what medicine will look like say 30 years from now. For instance what would happen to medicine if the amount of money American’s pay as a % of GDP were frozen right now? What would medicine look like going forward?

gergle:

“Whining medical providers, pharmaceuticals and insurance companies will go the same route as Wall Street bankers if they act stupidly.”

And the whining patients….? It seems the biggest problem will be to get patients to accept the necessary rationing.

I’m not sure I want my whining medical provider to go the way of Wall Street. I’d like for him to be in business for at least a few more years.

And it’s nice to have profitable pharmaceutical companies making quality drugs and investing in the necessary R&D for the new ones. Discouraging them might not be in our long term best interests, unless, that is, Idiocracy comes true and they devote all of their profits and R&D to male ehancement. What a great movie!

David very good article. I am very interested in this topic, my wife and son suffer from M.D. I find myself in a situation where my insurance costs and uncovered expenses are fast approaching 50% of my income. I am however dubious that any reform attempt will produce results. The same interests that have quashed all past attempts are only stronger now.

Ted, keep hope alive. The polls show a dramatic shift in the public’s view of how our country should be run. Example, a poll released just today shows the majority now trust government to better manage our economic future than private industry. That is a tsunamic shift in public opinion.

Combined with the polling support for a universal health care system which creates an affordable and sustainable health care system for all, I think the special interests who want to sink UHC will be playing the role of Sisyphus trying to roll the rock up the mountain.

One poll done a couple years ago showed that a growing number of Republicans were favoring a universal health insurance system. The tide has turned on this issue, and President Obama is the right person in the White House to use the power of that tide against those in Congress who would attempt to dam this tide.

Craig, I forget who, perhaps Larry Summers, said yesterday that the Obama health care planning team were focusing right from the beginning of the meeting last week on last year of life costs.

I like your idea of projecting forward what we as a nation can afford for health care, and work backwards to design a system to fit affordability. I don’t know if the Obama team is following that prescription, but, some of what is being said about the work groups alludes to the possibility that they are at least in part, subscribing to such a long term strategy.

It is such a monstrously complex values and economic issue to attempt to halt the inflation in health care at the same time as providing universal health insurance and essential health care services to all in need.

I am encouraged however, by what I am hearing in the way of their being a public and private layered system being designed, wherein the public provides essential and basic health care insurance and access, while the private sector provides far more in addition as upper tier coverage for those who can afford it.

At first, I didn’t like the concept of a two tiered system of health care with the wealthy receiving far superior services and advanced methodologies. Having followed all the known options however, it has become obvious to me, that there never was a possible way around such a two tiered health care system while keeping good health care available to all.

There is the world of the ideal, and then there is the real one we all have to live in. I have come to accept the real world of economics where everyone cannot afford Bentley or Rolls Royce class health care. Not even remotely possible.

I don’t accept MoveOn.Org’s following statement as valid:

“If Congress passes Obama’s plan and Americans are given the choice of a public health insurance option similar to Medicare, we could all save up to 30% on our health care premiums.1”

Because it fails to substitute increased taxation for the savings in health care premiums for the Middle Class who opt in for the Universal coverage. If we can hold the line on health care inflation however, such that the middle class does not have to pay more in taxes and premiums than they currently do, while receiving most ofl the same coverages they now do, that will be a highly effective universal health insurance system and arrest the debt crisis now being created in the Medicare system.

George,

Agreed. Whining patients will also have to learn about reasonable limits, but my point is not to run Pharma, or medical providers out of business. These businesses have grown in profitability way above other business and the CPI. It shouldn’t be a pathway to instant wealth. Health Insurance should be nationalized, in my opinion.

More nursing and preventative care are needed.

My Grandparents lived longer than their children. They lived their entire lives on a farm. They rarely used doctors until late in their lives. My grandfather died of Pancreatic cancer within a few months of diagnosis. My grandmother lingered longer, she had heart disease. My other grandfather, I never met. My other grandmother died in a car wreck from a drunk driver in her 50’s. My father developed diabetes in his late 40’s and my mother died of colon cancer in her late sixties. Frankly, with the exception of my father, medicine did little to extend their lives at great expense.

I have some coronary heart disease. I had a heart attack a few years ago, and had stents inserted. I have rejected taking anti-cholesterol, or blood pressure drugs. I continue to try to reduce my weight and increase my exercise. I reduced my stress by taking an easier job for less money. I don’t expect to live forever and will not seek to artificially extend my life. Frankly, I don’t think Pharma has figured out how to deal with heart disease yet. Most of the medications have severe side effects and low efficacy.

I had to lie about my medical condition to get reemployed after my employer fired me, and canceled my health insurance while I was in the hospital. (I had just changed jobs). I was presented with a $40,000 bill for my week long hospital stay.

I watched a great uncle (and step grandfather) have heart attacks beginning in his mid thirties. His life was severely limited by these. He was essentially bed bound for months and physically very limited in later life. Stents would have likely helped him. By-pass surgery was considered, but was new and he decided against it. I’m not sure if cost was a factor.

Americans are paying way to much to medical sharks and not getting bang for their buck. This is the biggest factor in our rising debt. Employer based health care is not serving Americans well. It is hurting our competitiveness. It has to be dealt with, just like the Pirates.

gergle, all good points. I truly hope the Obama administration incorporates into their plan incentives for non-profit health care clinics, centers, and hospitals, and incentives for their capital formation. That would truly be an investment that would pay dividends in lower health care costs in perpetuity, returning the investment of tax dollars many, many, many times over in the decades to come via universal health insurance premium savings, (i.e. the tax payers.)

Our President continues to say there is no authorship for any of the reforms. He maintains that if there are good or better ideas available, they can be merged or even replace anything currently in planning or being written. I expect the bill, when it is presented will have many aspects not being mentioned at the moment. Perhaps some of Gephart’s and Daschle’s and Hillary’s and???

DR
Nice and timely piece.
You should be aware that many of the big players in health care are non-profits, Kaiser for example. When we left CA they were charging me close to $900 a month for myself and family for the privelege of making co-pays.

Any long term solution should include a reform of how we educate doctors. The expense of medical school and often the debt load physicians have when they graduate too often make the calling a business decision.Its about money.Sure they work hard. A lot of people work hard, but do not become millionairs after a couple of years. France, for example provides free medical school but the doctors are expected to work under the French system with limited recompense. Students are accepted on merit only and the competition is tough. This generally ensures quality graduates.
Gephardt is usually right IMO. I hope he is wrong this time. Paying for the reforms looks more a matter of timing than increases in revenues. How soon will negotiated drug prices or treatment comparisons start delivering savings,for example. We already spend plenty of money on health care. We just do not get a good deal nationally.
A little anecdote. My 87 yo mother has difficult time trimming her toenails. They are brittle and sensitive as often occurs to the elderly. She was taken to a podiatrist. He billed medical for two surgeries,one for each foot. A little common sense is in order but is being fought tooth and nail by the industries involved.
Passage of meaningful reform will be tough. It is up to us to look into the campaign contributions of any politician that opposes it and make it public as possible and it is up to the AG and FBI to to look into and prosecute any Ted Stevens remodels etc. I hope the AG is up to the task.Us too.

David:

I think we need to put the true cost of health care on the table. By that I mean present value of future expense including additional costs due to longevity increases. (Additional Social Security costs).

One reason we should do this is because it changes our decisions today. We change many things including our eating habits because it means more expense now, which delays retirement which means we have to be healthy enough to work etc.

Another area I hear no one talking about is prepaying for our health costs based on our choices. I’m not talking abotu a “sin” tax where we punish people. There is a cost to society everytime someone takes a sip of sugar pop. Actuaries can add up exactly what the present value of every can of pop is on the national treasury in the future due to additional medicare expenses because of obesity and diabites. That cost should be levied now. The same for red meat etc.

We live in a society where we have a false market. What appears to be cheap food is actually far more expensive because of the pounds it puts on americans and the related health costs. If were were to charge a medicare fee based on real actuary numbers (not political crap), it would be a reasonable way of facing some of the true reasons for rising health care costs.

Some taxes would go down. For instance, I think cigarette taxes would go down because the taxes levied are far greater (at least I think they are) than the added true cost to society for that bac habit.

There is also another issue of equity. The poor are far more likely to have poor eating habits and smoke cigarettes. That issue could be addressed separately.

Of course this would be a tax we would all hope no one would pay, (in theory) because it would move us from junk food.

The reason I think solutions like this are important is because it puts the real cost of healthcare squarely on the table. It then is something that is moved out of denial and into real time.

bills said: “Passage of meaningful reform will be tough. It is up to us to look into the campaign contributions of any politician that opposes it and make it public as possible and it is up to the AG and FBI to to look into and prosecute any Ted Stevens remodels etc. I hope the AG is up to the task.Us too.”

Here, here, bills. Me too! I sent Obama a message just last night with recommendations. Some of the ones I sent previously have been adopted. Doesn’t mean my correspondence gave the Obama administration the ideas, but, I hope they reinforce others with the same ideas, making it easier for such ideas to get recognition by the numbers of supporters for it.

I encourage you and others to provide the Obama administration your ideas if you believe them sound and rational, at this White House link.

Craig said: “There is a cost to society everytime someone takes a sip of sugar pop. Actuaries can add up exactly what the present value of every can of pop is on the national treasury in the future due to additional medicare expenses because of obesity and diabites. That cost should be levied now. The same for red meat etc.”

Craig, while you are quite correct that our daily and routine choices of occupation, behavior, consumption, and avocations all carry a future cost, I am not able to support a government micro-management of social engineering citizen’s choices and actions in this manner. Even with resistance, such thinking results in sin taxes, and higher costs for the poor, who haven’t the resources to alter addicting behaviors for example, or have few, if any choice regarding vocation.

Life is lethal. Until medical science can provide cost effective immortality, every living person in America exacts some kind of cost upon the American society - and most also contribute to our society over their lifetimes. Weighing each person’s net worth to society and taxing or not taxing them based on their net cost or contribution to society, is a prescription for ominous and god-like authority granted to government.

It becomes all too authoritarian and fraught with unintended consequences, for me. Not to mention its representing a form of judgment and sentencing without trial or representation, when exercised en masse against classes of people in our society.

Additionally, such a proposal discounts the reality that we are all products of nurture and nature, often leaving our many choices outside our conscious control. Some people’s addiction to nicotine, for example, is far more enslaving than it is for others. The same can be true for opiate products, foods, and even need for social contact.

I am prone to leaving social engineering of utopia to Heaven and God for those who believe both exist. It is an exercise requiring omnipotence, omniscience, and the quality of acting perfectly in all matters.

I am OK with punishing crimes which leave victims behind and which were perpetrated our of either carelessness or intent. To go further and argue that lifestyles are injurious to society or incur costs to society and therefore should be subject to behavioral controls by the government, follows a path toward discrimination by government at an unprecedented level, save for perhaps Hitler’s judgments of the costs of the mentally infirm, physically handicapped, or racial net liabilities to society vs. racial net gains.

When you speak of actuarial bases for such assessments, you are speaking of statistical analysis which means correlation, not establishing cause and effect. To reward and punish based on correlation INSTEAD of cause and effect, results in a kind of social engineering we now condemn in the history of our societies.

Medicare dollars over in-hospital end of life care, while extending life by an average of 2 months over hospital end of life care. Making greater use of hospice end of life care will be one of several ways to reduce UHC spending that the public will have to accept.

What you are seeing is NOT a “public” driven effort.
My wife is a nurse who has seen waaaay too often how it is the Medical community that drives these practices.
The American Medical establishment is still too much in the mindset of treating the disease not the person.
That is an abstract concept that in reality looks like;
85 year old person, barely alive, with multiple issues (recurring cancer, various organs in poor health, infections, whatever) and when and if some new diagnosis crops up, the Dr treats it as tho the person has some likelyhood of becoming healthy again, let alone even surviving the procedures they are planning.
My wife has fought many battles for NOT treating patients — because it makes no sense to treat.
There will NOT be a good outcome, no matter what.
Their health is already fatally compromised, their ability to respond to treatment, let alone survive surgery (if so required) is non-existant and yet to most Dr’s we’ve seen, that evaluation of the entire picture rarely, if ever occurs.
Tests, procedures, surgery, and then follow-on surgeries to deal with the inevitable complications and screw ups goes on and on (no wonder Hospice results in longer life at end of life — they are not being subjected to life-threatening surgeries and procedures and are usually in a environment that promotes peace, comfort and freedom from stress and pain — who wouldn’t live longer??? (Hospitals are NOT the place to get healthy by the way — it is not just a joke about the hospital being full of sick people — that fact most people miss — it is a concentration of disease, bacteria, bio-hazards, etc that will attack any compromised immune system introduced to it)

The American Medical establishment is still not big in promoting Pallative Care in this country — the med schools don’t teach this approach and in fact it is the Med schools that lead to the “treat the disease, not the person” style of medicine we DO see.

The Public (especially the older generation that “gets it”) will NOT have to be sold on this “sacrifice” — believe me it is NOT a sacrifice (except to selfish children who cannot let Mom or Dad go) -
It is the Medical Establishment (and the Pharm, Industry) that will scream about sacrifice!! ($$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$)

Go to England to find how Pallative Care is practiced — and it goes way beyond Hospice.
Pallative care is recognized as soon as it becomes apparent that the eventual outcome is apparent(no matter if 6 months or 6 years away — (Hospice here will only kick in if the prognosis is 6 months or less) — Pallative care changes the medical approach from early on — and prevents the types of abuses that we see in our Hospitals every day.

You want to reduce Health Care Costs
1) Eliminate all the “Health Insurance” (Subscription) companies — when you have a major University having to employ hundreds of clerks just to take care of the different insurance claim paperwork caused by the variety of insurance companies used by their students — and are contemplating just offering the students subsidized health care because it would be cheaper than employing the clerks — you know something is NOT right) (most Dr.s have full-time employees (multiple) who ONLY do Insurance claims!!! and we wonder why our “health care” costs are high?? — if you were to subtract out Clerical work — our costs would plummet!!

2) Offer FREE clinics to those on Food-Stamps or other forms of public assistance (or some other sort of means testing)
We are already paying for it anyway, why not cut out the middle men and save money and improve these people’s health in the bargain.

3) Promote Pallative care over medical/surgical interventions when approaching end of life (thru Medi-care) — see arguements above

extras — start promoting Health, rather than disease treatment
Start promoting pro-active actions that will prevent disease
and to all of you who Complain about (or worry about) the Gov’t telling you what you can or cannot eat, drink or smoke — while I don’t go along with the food police — I feel that providing nutrition information, prohibiting smoking in public places and limiting Drinking and other activities is a long way from a Nanny State
anywho — to all of you hand-wringers — fine
We won’t bother you IF
You won’t accept the Med-1 fire dept coming and treating you when you have your heart attack
You (not the insurance company) pay totally for your own diabetes, lung replacement, liver replacement, kidney dialysis, heart replacement, etc — you get the idea.
YOUR lifestyle choice end up costing the REST of us BILLIONS in health care costs, insurance premiums, lost productivity (higher prices for goods) etc etc etc
YOUR choice is costing ME money — I know How YOU Bitch when someone APPEARS to cost YOU money (taxes anyone??) so put your money where your mouth is or shut up.

David R
Why does it have to appear to be a choice between “Freedom of the Individual” and “Social Engineering” (i.e. “Nanny State”)
There are MANY actions the Fed Govt can take to promote activities that will REDUCE health care costs.
LIFESTYLE CHOICES
If the Public wants to retain the individual choice AND
THEN the Public either has to be willing to PAY for Individual choice OR
Provide the necessary resources so that it is an INFORMED choice
(unfortunately they will be battling a Trillion dollar disease industry trying to sell the American Public on a reduce quality of life)
Reduced quality of life?? they wouldn’t do THAAAT??
No??
ever see Supersize me?
Ever look at the fat and crap in the processed food?
Seen a diseased lung?
Diabetes from obesity?
Do you call any of those improved quality of life??

No one is looking to extend life indefinately — however there are CHOICES that people make EVERY DAY that is NOT paid for by the individual
and some choices made WITHOUT being informed

There are many things that can be done to promote BETTER choices
so as to reduce the incidence (and the cost) of POOR UNIFORMED choices
and as an added benefit can and will result in
IMPROVED QUALITY OF LIFE (DURING A TOTAL LIFE TIME)
(have you seen ANYONE who ENJOYS
dialyisis, nasal canulas and carrying around airtanks, insulin shots, extended hospital stays and or nursing homes???? is THAT improved quality of life??)
LONGER LIFESPANS
etc

Lets have a discussion about ways we can salvage individual choice AND reduce health care costs associated with these choices
Not some BS arguement about the two ends of the spectrum,

David:

When you speak of actuarial bases for such assessments, you are speaking of statistical analysis which means correlation, not establishing cause and effect. To reward and punish based on correlation INSTEAD of cause and effect, results in a kind of social engineering we now condemn in the history of our societies.

I am saying there is a cost to the taxpayer for our over consumption of sugar for instance. As an example:

WE LIKE french fries, doughnuts and pie as much as the next editorial board. That’s why we hope that the New York City Health Department’s push to ban trans fatty acids from the city’s foods succeeds — and inspires the federal Food and Drug Administration to catch up.

Last week New York health officials held a public hearing on a proposal to cap what are commonly called trans fats at 0.5 gram per serving in the Big Apple’s 20,000 or so restaurants. The evidence that doctors and public health experts presented makes you think twice about picking up a Whopper: Trans fats, which are …

We are already banning certain foods in certain parts of the country.

Again, I am not for “punishing” which I would define as taxing more than the true cost to society. I am for likterally counting the cost, and taxing it at the time of purchase. If someone wants to eat it, that is there business.

We do this in many areas of life. If someone has a high risk lifestyle they pay more for Life insurance (As a pilot). Car Insurance is another example.

It’s not a punishment, but just paying for the risk.

Again, it should be cause and effect. High sugar in take increases risk of Diabetes.

Russ argued: “If the Public wants to retain the individual choice AND
THEN the Public either has to be willing to PAY for Individual choice OR
Provide the necessary resources so that it is an INFORMED choice”

Russ, the problem with this argument is that there is no justifiable line to be drawn on which choices bearing risk to social cost are to be treated differently than other choices. Example: Driving between the hours of Midnight and 3AM in any city in America is an inherently more dangerous choice than driving during any other hours on our roads. Should drivers choosing for whatever reason to drive during increased hazard hours (due to drinking establishment patrons leaving to go home), be forced to pay higher insurance premiums for having increased the traffic for drunks to collide with?

If you draw the line at denying Medicare for, or increasing premiums for smokers, what is to prevent government from drawing the line at unmarried sex, which increases the public health risk for all via the transmission of venereal and other diseases? There will be no end to the government drawing and redrawing, and revoking and redrawing such actuarial risk lines in the sand to target groups of people for increased government revenues.

Being alive is inherently risky business, and everyone is going to die of something or another. The government’s role is not protect the people from themselves, but, to protect people from each other’s exploitive, unjust, and unwarranted behaviors which harm others, for personal gain, via the rule of law.

That at least is how I and many others view the role of government intrusion upon personal behaviors and choices. And there is ample legal precedent for holding such a view.

Craig Holmes said: “High sugar in take increases risk of Diabetes.”

It is nowhere near that simple, Craig.

First, there is a genetic predisposition to diabetes that comes into play. Not everyone who is obese is diabetic. Not everyone who eats high sugar and high fat diets succumb to diabetes.

To be just, the government would have to test people for genetic predisposition to diabetes, inform those people they are a higher risk of becoming diabetic, and then, tax them for continuing eating items which will further increase their medicare costs resulting from becoming diabetic.

We don’t want the government or insurance companies discriminating against people on the basis of genetics, do we?

Local government’s who require, on the basis of public health risks, that foods made available to the public are not promoting unnecessary health risks, is an entirely different issue from targeting classes of people for taxation based genetic or behavioral or cultural dispositions.

When unsaturated fats can be substituted for saturated fats at little to no additional cost to the public, the government is just in requiring foods made available for public consumption use the unsaturated fats as a matter of public health which the public charges the government for protecting.

But to charge every doughnut eater a tax on the basis that some who eat doughnuts will impose a greater cost burden for all paying into universal health insurance, is 1) indiscriminate in taxing those whose health will not be impaired by their purchase of doughnuts, and 2) discriminatory in singling out overweight contributors to public health care costs vs. old age contributors to public health care costs.

To be consistent, the government would have to require all persons to commit suicide on their 55th birthday in order that they do not create an increased burden on taxpayers for health care costs which rise dramatically after the age of 55.

David:

No we don’t want government taxing based on genetics. And this idea doesn’t do that at all. It is based on risk. No matter what your genetics if you eat certain foods you increase the risk that you will cost more for medicare in the future.

The same is true in other insurance. If you get a speeding ticket your car insurance goes up. That does not mean you are getting in an accident, only that you are a higher risk to get in an accident.

Under this type of taxation, you are free to live that additional risk lifestyle because you have paid for it. When tax dollars are involved the greater community has the right to regulate, just as in bail outs for financial institutions. What you eat effects my taxrates, as does what I eat effect yours. Additional risk requires additional cost.

Under the current arrangement, those making healthy choices pay “extra” to cover those who eat in a riskier way.

This plan allows people to make their own choices and pay for them instead of pushing the cost off on others.

Craig said: “No matter what your genetics if you eat certain foods you increase the risk that you will cost more for medicare in the future.”

That is empirically false, Craig. And there is an enormous amount of research to demonstrate that your statement is false. Skin cancer is vastly more prevalent in Caucasions than African Americans. American Indians are vastly more susceptible to diabetes as a result of certain foods than Northern Europeans and African Americans.

I can eat a pint of ice cream a day and never pose a higher risk of costing more to Medicare if 1) my family history is one of heart attacks before the age of 60 and I die suddenly of a heart attack before reaching Medicare eligibility age, or 2) the rest of my diet is traditional Japanese fare.

Like I said, you are trying to justify cause and effect policy with correlational statistics. That is a flawed approach logically and empirically, producing false conclusions like yours quoted above.

DR
Thanks for the link. It is time to take the gloves off and not just about health care.
There is an overriding issue. That is globalization. It is going to continue and it should. The lives and hopes of billions depend on it and is the best way forward for world stability. There are two possible outcomes for the US. Either we adopt policies that allow US workers to sink to the level of third world countries or we create a social safety net at least as good as Western Europe’s. Health care reform,especially if we can break the employer provided link, will help considerably. There are other areas also that need improvement for us to stay competitive. One example is education. To put it simply, if college is free or low cost then there is automatically less wage pressure to afford college education for our children, not to mention the chance to have a more highly educated workforce. If there is a garantee of a reasonably dignified retirement there is automatically less wage pressure for private pensions, etc. The controllers of the Republican Party appear to favor the former approach that lets working Americans sink into poverty. This is extremely short sighted and dangerious.

IMHO Americans need to have their Democratic and Republican Leaders grow up and realize that there is a huge difference between an Individuals Health Care and the Medical Procedures required to held them get through Emergencies (broken bones and such)and Illness.

For I do believe that most Americans could agree that a yearly check-up, meds for the common cold, and other things that insure a Healthy American Worker should be covered in the benefits and salary given by a Corporation. Since a healthy worker is more productive than one who calls in sick or comes to work and infects the whole crew. Call it part of a Livable Wage, but with a fix cost and an incentive to promote healthy living I do see the Private Sector being able to influence Labor and Management into getting in shape.

However, Emergencies and Illness needs to be born of the Individual whos own lifestyle and family heritage has more to do with the cost of Medical Care than the responsibilty of a Corporation. For if that was the case shouldn’t I be allowed to hire only citizens that are free of Medical History. And why that is a harder egg to crack, I do believe that if America is going to pay for Universal Health Care than it should be to promote Healthy Living and not focus on what to do with Emergency and Illness Treament of Individuals.

bills said: “There is an overriding issue. That is globalization. It is going to continue and it should.”

Well, I would agree that globalization, the growing interdependence of economic fortunes amongst nations and peoples, is now inevitable, for better or worse.

I have a fundamental philosophical opposition to globalization, based on the premise that dependence is an inherently good foundation for human relations. Dependence can, and often does, lead to making choices of a lesser ethical or responsible nature in deference to what one depends on others for.

I understand the international implications for good, the absence of hostile actions between nations interdependent for economic viability. However, interdependence also means that if one party to the dependent relationship fails to live up to their obligations of mutual benefit, all parties to the dependent relationship are harmed, as the result of the actions of one. That constitutes an inherent and intrinsic liability in interdependent relations.

We, in America are seeking independence from Middle Eastern oil, precisely because, Middle Eastern oil cartels have, and will, continue to seek opportunities to exploit our dependence in their favor and to our disfavor. Not to mention the fact that oil is a finite resource which will continue to decrease in supply, and consequently, become ever more expensive if demand remains the same or increases, seriously limiting our choices and opportunities to spend our resources on other needs.

There are, regardless of the international benefits of economic interdependence, many resources which NO nation should ever wish to be dependent upon others for. Those resources would be the essentials for life, water, air, food, and shelter. To allow oneself to become dependent for these resources upon others, is to relinquish all potential independence of action or thought, or life itself.

The philosophical irony is, we are by definition and evolution, a social species, which survives best on its cooperative interdependence with others of our species.

Balancing these two aspects of dependence, is no doubt what has led to globalization now being inevitable. But, globalization will require an international law and enforcement body of that law, if it is to succeed in maintaining international independence from criminal elements that would subvert global humanity in search of perceived personal and individual benefit. I offer Kim Jung Il of N. Korea as a prime example.

Globalization mandates that no one nation can afford to act as the decider and enforcer of global international law. Nor can any one nation be allowed to assume that kind of power over other nations.

What causes me severe concern, is that we are running down the mountain toward the valley of economic interdependence, without having first established the laws and enforcement mechanisms to govern our collective and individual actions and insure mutual benefit, once we arrive in that valley to live out the future of our species.

There is poor understanding of the effects of diet on health. While some basics of nutrition are fairly established, the rest is mostly hypothesis and correlations. Some is pure myth. Remember correlation is not cause.

http://www.sciencedaily.com/releases/2009/04/090414153525.htm

From someone on reddit:

Correlation is not causation.

http://meganmcardle.theatlantic.com/Lemongraph.jpg

Bills and David, two good posts on globalization. I agree more with David. But, its not just the Rep’s who is racing for the bottom. After all, we are a Corpocracy and we do have the best government money can buy. David is right. A country that can’t clothe, feed and defend itself is highly vulnerable to extinction. Why should we lay down and bear our breast to any threat that wants to take a shot at us? Just highly stupid. That’s the flower child approach to living in the jungle. I want none of it. I don’t want the world to become one world. I appreciate, love different cultures, languages, etc. This world economy based on the lowest common denominator, cheap labor is wrong. Communist China growing at 10% GDP while we post trade and budget deficits every year. This is just stupid.
David, is right on with his analogy of racing down the mountain w/o a plan. Instead of racing down the mountain we should be walking up the mountain to live on the hilltop. Protect our Constitution and sovereignty as a nation and to the extent possible protect our standard of living while working to bring the developing countries up to our standard. We don’t need international bodies to do this. We should work with each country to help them develop as they see fit. Let’s stop exploiting in the name of ‘free trade’ and start actually helping poor countries develop and stand on their on. I recently saw an article where an American worked with the Ecuadorians’ to help them start their own chocolate processing facility to add value to their cocoa bean production. Let’s work with Africa to establish farms and food processing plants. Let’s stop exploiting through free trade and start helping through fair trade.
That is the essence of my battle. Shove the Corporacy aside. Develop fair trade policies that work with countries that want development while retaining, improving our standard of living. Restore our manufacturing base, using protectionism where required. Not full capitulation to low wages but a balanced process allowing us to survive and prosper as a nation. It’s not as clean as far as trade agreements and moving goods around the world. Won’t make the Corporations happy as they will have to deal with tariffs and trade agreements but it will work for We The People.
We better get on this road sooner rather than later. Currently, we have nearly 50% of the people paying no taxes and many of them receiving social services while 10% are paying 70% of the taxes. Many are nearing or in retirement with no annuity or income for support. This ‘free trade’ thing has failed badly. Greatest xfer of wealth in history, something like $70-80 trillion of nationwide debt that our great great kids are supposed to pay off with $6/hr jobs. Stupid, Stupid, and we better get on the right track pdq.

Well, our whole way of life is at stake here. Constitution, national sovereignty, democratic principles of life, standard of living, all to be plowed into the manure of history. Rolling fast toward Socialism and collapse. Only way I can see to set us back on the right track is to fight fire with fire. We must put accountability into the political equation. This can only be done through a third party giving members oversight of their elected officials. May not be pretty or sound ‘democratic’ to some or not main stream politic to other but that’s the only way IMO, other than a violent revolution, we can turn things around.

Otherwise, we have the Corpocracy we deserve.

Wow,DR

Set the verbose filled pipe down for a moment. What I was saying is that globalization is a good thing for the world generally.The hope of billions. So far the US has not handled it well because of the short sighted, greedy,FORMER ruling party! We still have the opportunity to reform the trade situation into something that will not devastate our standard of living, our influence on world affairs and our future. The most obvious is to provide a real and reliable safety net. I am not talking a welfare system here,rather a system where American workers can expect decent lives for themselves and their children ,if they do an honest days work.
I have gained a different perspective living in the RP I suspect. The city I live is home to a large Texas Instraments plant. They are laying off. FedX is moving from Subic to China. I guess its cheaper when the government will bring you slaves. Whatever. This is just a small part of the world. The better houses and schools are filled with TI workers. The downturn will hurt.The RP is small. How about India,1.3 BILLION people. Even with the geographical advantage we have, sooner or later we will have to deal with the needs of humanity.That’s OK . There are some great people out here in the world. The way to keep up the standard of living is to keep up the standard of living. Medical care is a right. A decent education for our children is a right.A dignified old age is a right. We need to establish a base line.We have the wealth. The market will not and cannot do this, largely because it cannot be done on a piecemeal basis and the motivation is simply different. Then we can compete and prosper.

David:

Like I said, you are trying to justify cause and effect policy with correlational statistics. That is a flawed approach logically and empirically, producing false conclusions like yours quoted above.

Sort of like the Insurance industry does with setting premiums.

Bills, I’ll be brief. I assume when you remodel you nipa hut you will use Chinese wallboard and white vinyl siding. Should be the rave. And, don’t be suprised when TI strikes out for places with cheaper labor.

Otherwise, we have the Corpocracy we deserve.

Craig,

Yep, kinda like AIG. That worked out well didn’t it?

Roy Said, “”use Chinese wallboard and white vinyl siding”” The white Vinyl is ok it’s the only color the MFG will guarantee not to fade over it’s lifetime, That wallboard is going to be a Pandora’s box.

Obama is off to Mexico to firm up NAFTA. “My country has been greatly enriched by immigrants from Mexico,” he said. Cheez! How disingenuous! What intellectual dishonesty! His figgers don’t match my figgers.
I see where N. Va. is about 6k nurses short, 46k nation wide and they want to import 40k nurses from the PI. A report in my local paper says that colleges/universities are turning away 50% of the qualified applicants for nursing as there is no money for faculty and classroom space. Kind of strange language what with the Corpocracy whizzing away $Trillions on stimulus, recovery and everything that will stick in the name of job creation. But, should we peek between the lines, wouldn’t you know that these nurses, being part of the working middle-class, make to much money and therefore must be beaten down to prepare for globalization. Not enough money? How disingenuous, What intellectual dishonesty!

ABC reported this evening that 90% of the drugs from Mexico are coming across in 18 wheelers. Fewer than 5% are being inspected as it simply cost too much. Obama is working hard to return the Mexican trucking industry to our highways. Using the EZ pass SENTRI system they just zip across at 50 mph, wave their card and keep hittin it. Cuts down on inspection costs ya know. Cost too much? Didn’t we just give $1.4B to Mex to buy choppers and guns and stuff? And how much are we spending around the globe to ‘stop drugs’? How disingenuous! What intellectual dishonesty.

Isn’t that politically special?

Otherwise, we have the Corpocracy we deserve.

Roy, if these actions are combined with his previous commitment to seal our porous borders from illegal traffic of all kinds, then a net positive benefit to our nation and people is forthcoming. Obama’s actions at this moment regarding Mexico cannot justifiably be criticized in isolation from his comprehensive plan to put a permanent end to the growing problems at our Southern border with Mexico.

I have to give him the benefit of the doubt for the time being. A president cannot solve all ills in 3 months. It takes a great deal of time for this titanic nation to implement solutions reversing previous policies which created the problems. And that is Constitutionally by design, the case for this United States Government. It was designed to be inefficient from the beginning. It will take time and a building up of solutions layer upon layer until the end product provides a lasting solution to the problem of our Southern border. And concessions will have to be made to get these solutions in place. That too is by Constitutional design in part, as well as by the design of our multiple party political system.

America needs to get rid of the impediments to the Article V conventions which states have called for decades upon decades. The impediments are those in our Congress who have rigged the political system to insure the probability of reelection regardless of their actions and failures.

Voters must increase the number of incumbents running for Congress who fail to get reelected before the balance of them recognize the people won’t any longer tolerate their corruption of our system, their ineptitude in acting prudently, and their unwillingness to represent the objective best interests of the nation first, their states and constituents second, and their own political interests last. Americans need national statesman and women in our U.S. Congress, not partisan step-and-fetch-its for special interests back home offering bribes for special favor in legislation.

Yes, Craig. I have remained philosophically opposed to the negative consequences of the idea of insurance for decades. Talk about your moral hazard. Our implementation of Insurance breeds reckless behavior, like building homes on beaches in Hurricane prone areas.

Insurance without legal protections for refusing to sell insurance to those who demonstrate reckless, claim producing behavior, is a monumentally expensive flawed policy for society.

Hear, Hear!

While I think there is a proper place for insurance to allow for increased prudent investment, much like Hedge funds, it’s become a substitute for thoughtful, intelligent decision making.

gergle, no fault auto insurance was the ultimate corruption of the insurance concept, shifting the cost of reckless behavior from those engaging in it, to all policy holders, including the very careful and prudent. Total idiocy.

But, then, when these laws were passed, the insurance companies were the ultimate lobbyists in state governments, and lobbied mightily for and against State Insurance Board Appointees based on their own interests, not the consumers.

Roy
I live in Baguio. That’s a college town in Northern Luzon. The schools here crank out nurses by the thousands. The goal of damned near every one of them is to emigrate to the US, Canada or Europe. Its a real shame. These are pretty nice kids. When I meet them the first thing I tell them is to join the union as soon as they get to the US.
A US nursing student could do worse than comming here for schooling. The teaching is in English and living expenses are minimal.

Bills, I was in Baguio in the nud 60’s. Snow flurries, bass fishing in nearby lake. Saw an article yester evening re Canadian education. Some U’s have 12% US attendance. Between Georgetown U. and a Can. U. one parent was saving about 40 grand.