|
Thu Oct 8 22:43:41 2009 Open Letter An open letter to my congressional representatives. |
I can't remember the last time I wrote a letter with a pen...Image courtesy of Hatework (the band) I finally took the time to write up a letter to my congressional
representatives about the
healthcare debate. I had done enough research that I feel like I understood the core
issues (see
The Healthcare Debate), so I figured it was my duty to tell them what I'd learned.
After all, I wrote an
open letter to them a year ago about the bailout, and it didn't work (I asked them not to fund
TARP). So why not try another letter?
So this is what I sent to my representative (Jim McDermott), Senators (Maria
Cantwell and Patty Murray) and President Obama as well:
Dear Representative McDermott, Senator Cantwell, Senator Murray, and President
Obama-
First, thank you for taking the time and energy to tackle healthcare!
The current healthcare system (public and private) is
going to run out of money soon, and that could have disastrous
consequences. I know the issues are difficult and emotions are
high, making the job harder still.
I had three requests.
1) Please fix the core issues. Expanding coverage is good, and
I'm even willing to pay a bit more myself if that improves
overall coverage, but coverage isn't the main problem. Getting
sidetracked with coverage won't help the country in the long run.
2) Please publish a short list of the principles you will
use to fix the system. The current healthcare bills are
unreadable. We (voters and taxpayers) probably won't read them
anyway. But we do care how the problems are solved.
Will you commit to transparency in
healthcare pricing? Will you commit to solvency of Medicare and
Medicaid? Will you commit to hard limits on federal healthcare
expenditure?
3) Please move away from medical insurance as the main form of
healthcare funding. We don't pay for car maintenance with car
insurance: instead, we plan ahead and pay for those expenses out
of our savings. We don't pay for home maintenance with home
insurance: instead, we plan ahead and pay for those expenses out
of our savings, or perhaps borrow to cover them. Paying for
everything with insurance doesn't work for cars and houses, and it
doesn't work for people either. Insurance should be there for
catastrophes only. All other expenditures should be covered by
our savings and borrowing if necessary.
I know moving away from health insurance scares people. But as our
representatives, and the stewards of our economy, hopefully you are
aware that all healthcare costs have to be paid for somehow.
We pay today out of insurance and special fees paid by employers,
which is a convoluted and obscure process. Asking people to pay directly
out of their pockets will
force hospitals to make bills understandable,
costs transparent, and introduce positive market economics that
rewards hospitals for improved healthcare at lower prices, which
is the reverse of what happens today.
You can still improve coverage
by having the government help low-income families with healthcare
costs. Doing that would cost no more than an insurance-based
program today (since after all,
it is medical costs you'd be paying anyway), but it would be through a
much more transparent system.
But whatever you do, please fix healthcare (and not just expand coverage
of a broken system), and make clear what principles are guiding your
decisions.
Sincerely-
(me)
Comments
|
Related:
> economics <
Unrelated:
books
energy
environment
geopolitics
lists
mathematics
predictions
science
|
|
Mon Oct 5 23:08:30 2009 My Charitable Giving How I give... |
I was catching up on finances last night, and realized I was behind
schedule on my charitable giving (I promised myself to give every
month). Furthermore, I had lost track of who I was giving to so I
had to go back over the past year of donations and see what charity
I was supposed to give to next.
I'd been meaning to reorganize my charitable giving for a while, so now I went
ahead and did it.
Why reorganize?
Because, with these economic times, I've seen more people out on
the streets asking for money. You should never give money to
pahhandlers, because many are scams, and even for those that aren't,
if you give them money you are encouraging them to panhandle instead of
working with local charities themselves to get themselves off the street. If
you really think someone needs help, give them food instead (I tried that
once and was rejected--the panhandler just wanted money!).
But not giving money to panhandlers is only acceptable (to me) if I'm sure I
am giving money to charities that will help people that really need it. But I
realized that all of the charities I was giving to were political, so I wasn't
actually giving a dime to charities that were helping people in need.
So, as I said, it was time to reorganize. I went through and made sure I was
giving to the organizations that I thought deserved or needed the most, and
tried to make sure I had a good balance between political causes important to
me and just generally helping people in need. When I was done I still felt
like I was short-changing one charity, so I decided to give double in
December.
So here is my new allocation. There are 10 charities that I give to, three of
them twice a year. It breaks down as:
I didn't drop any charities in the reorganization, but a number are now
getting less money a year so I can give more to the United Way, and
environmental causes.
How much do I give? Many years ago I started giving just $40 a month (I think
that was it), and then every New Year one of my resolutions was to increase
how much I was giving. Now I give enough that I watch who I'm giving to
pretty carefully. But for a long time I didn't give anything, because I
didn't think I could afford to. Now that I can, I feel like I should.
I don't think how much is given matters that much--and donating time is
usually better than donating money anyway! The important thing is to give.
Comments
|
Related:
> economics <
environment
Unrelated:
books
energy
geopolitics
lists
mathematics
predictions
science
|
|
Thu Sep 10 23:24:51 2009 The Healthcare Debate The new proposals don't fix anything. |
Of course, the
Great Healthcare Debate is all over the news now. Obama gave a
speech to Congress yesterday--check that out, it includes the heckling!--and there have been various healthcare proposals flying around.
[Random aside: did you read his
Back to School speech? I thought it was excellent.]
I wasn't sure what to make of the healthcare debate! I had to spend some time educating
myself on the debate, and healthcare. I've had various small health care
issues (bad ankle sprain last year, for instance) where I had to visit an
Emergency Room and deal with
complicated medical bills, but nothing like a prolonged stay in a hospital. I get healthcare insurance
covered through my employer and rarely think about it.
However, this is clearly a large debate with many things at stake:
I'm not a Democrat, but I'm not a Republican either. I'm an Independent who
cares about healthcare (and no, I'm not going to any
town hall meetings). I just wanted to understand the issues and see what I thought
should be done.
I had many questions myself. Why exactly is our healthcare system
broken? Many people claim it is broken, and they all have their own
solutions to sell, but what exactly is broken about it?
Also, What is the Democratic solution? How is it going to fix the
problems?
And finally, Why is the solution so complicated? I remember everyone
complaining that
No one had actually read the healthcare bill, why didn't they?
What I discovered was:
- The current proposals don't talk about what is broken, they talk about
coverage (which can be related, but isn't the same thing).
- The Democratic solution is about increasing coverage, not fixing
anything.
- The proposal is complicated because they are adding more tweaks to
an existing complicated system, rather than fixing the root problems.
To put it succinctly, I was disappointed! I was hoping someone might fix
something. I don't think improving healthcare access is bad, but this isn't
really a fix.
My guess (and prediction) is that a version of this healthcare bill will pass.
We'll spend a bit more to increase coverage, and try to find ways to pay for
it. I doubt we'll be entirely successful at that, but increasing coverage may
be worth spending more money.
However, I do wish someone would actually fix the system. This isn't
tweaking, or addressing fraud, but really going back to basics and
rebuilding the system right.
First of all, the fix shouldn't start with a
complicated 1000 page document. Instead, there should be a simple statement of principles that fits on one
page. Then we could look at the principles and decide if they were right or
not. If they were, we could tell Congress: "go and implement a healthcare
solution that follows these principles."
So what would those principles be?
Lately, I read a
great article about the healthcare system by David Goldhill in
The Atlantic Monthly. The author gave a good overview of what was wrong, and his points on how to
fix it. You may disagree! But I thought he had a great starting point for
principles to really fix the system.
Here are Goldhill's principles:
- Move away from comprehensive health insurance, and avoid any single form of
financing. Instead, consumers would pay for healthcare in a variety of ways:
out of our pockets for major, predictable expenses, with only massive,
unpredictable expenses covered by insurance.
- Have a catastrophic insurance program that all Americans would pay into.
It would pay out only for real catastophes (medical incidents and bills over $50K
only, for instance). Most of us would never be benificiaries. This fund is
just there to cover the true, rare catastrophes.
- We'd pay for healthcare out of our income and savings. Large events that
cost more (appendectomy, birth) would be covered by credit.
- For low-income Americans, the government could fund some of this.
- The government could fund preventive medicine as a way to bring overall
costs down.
The number one complaint to the Goldhill approach (having us pay for almost
all expenses
ourselves) is that it would be too expensive. However, we are paying those
costs today! It's just hidden. If you are lucky enough to be employed, a
huge chunk of money is being paid for your healthcare by your employer. (If
you aren't lucky enough to be employed, your government healthcare payments
are coming from the paychecks of those that are working--the government
doesn't create wealth, after all, it just moves it around). You
don't see it, but it's money that is being paid and can only be used for
healthcare. Under the Goldhill plan, you would get that money and be able to
save it yourself. And you could spend it on other things besides healthcare
if you wanted to!
Goldhill's article gives a good argument for why this might work. I like how
his plan gets medical costs and bills to be very transparent, lets consumers
decide what to do, and naturally forces hospitals and healthcare providers to
lower costs while improving care.
And the
general idea, that comprehensive health insurance is a poor way to cover most
healthcare expenses, is key.
I don't know enough to say if Goldhill's plan is the best or not. But I like
how it fixes (or attempts to address) the core economics of the issue, rather
than trying to patch or extend something that is already broken.
If nothing else, ask your Congressional representatives to provide you with a
clear, short list of the principles they will use to reform health care!
Comments
|
Related:
> economics <
predictions
Unrelated:
books
energy
environment
geopolitics
lists
mathematics
science
|
|
|