Have the Rules of Politics Changed?

At the end of Star Trek II, The Wrath of Khan, Mr. Spock dies, and when asked by an anguished Jim Kirk why he sacrificed himself, he states simply: “Don’t grieve, Admiral: The needs of the many outweigh the needs of the few…or the one”

Jonah Goldberg, an editor at large of the conservative National Review Online, bemoans the shifting of the rules of politics, from what has up to now been straight lines from point A of a societal shift, to Point B, our typical response to it; I quote:

“For more than 40 years it has been a rule that environmental disasters – and scares over alleged ones – help environmentalists push tighter regulations…  According to the rules populism is a force for getting the government to do more, not less…According to the rules, Americans don’t care bout the deficit during a recession….And yet (today) none of these rules seem to be applying; at least not too strongly…As a conservative…it’s becoming harder and harder to shake the feeling that something bigger than politics as usual is at work here.”

Indeed, something bigger than “politics” as the public generally defines the concept is at work, and I believe Mr. Spock’s dying words provide the explanation.

We have…voters and legislators alike…abandoned the willingness to do what is best to meet the needs of the many, wanting instead to ensure that our idiosyncratic needs, i.e. those of the few, are met.

Thus the schizophrenic reactions from every body politic, left/middle/right.  The extreme Right wants less government….unless it negatively impacts entitlements they hold dear like Social Security and Medicare; extreme liberals want more government…unless it interferes with individual causes like immigration and sensible regulation of the internet; Centrists may see both sides of the issue, but are paralyzed by indecision, or flip-flop, because they too get mired in what will best serve an individual vs. greater good.  We want what we want when we want it, without regard for either the long-term or overall impact of our choices.  We don’t seem to care about the big picture…the needs of the many.

In Star Trek III, Mr. Spock comes back to life in perfect sci-fi form…so his sacrifice wasn’t a final one after all.  The same is true for us.  By doing what’s best for the many over time, even when it will create some hardship for the few in the (relative) short-run, our sacrifices, too, may be difficult, but will not be permanent.  From energy sources to social security, only once the many agree to place the country’s wellbeing as a whole above their own individual wish lists, will we at last be on the path to a better nation.

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The Extremists & The Rest of Us…A Fairy Tale…

Once upon a time, in a land that was the mightiest throughout the world, the people in charge known as “Boomers” became very disgruntled and returned to their roots of activism; well, actually, only a small number of them did, but the media made it seem like it was lots & lots of them…

Yes, the protestors, on both sides of the political divide, became very ugly…ooops, uh, vocal… about their unhappiness with many things the rulers of the land were doing, things like:

  • Passing “health care reform” where the peoples’ money was to be used to keep lots & lots of loyal subjects from, well, dying because they couldn’t afford care
  • Or not passing any reform on the practices of big entities called “greed factories”…oops, sorry again, “financial institutions”]
  • Or not addressing a problem called “illegal immigration” whereby millions of people from other lands could sneak in without permission & get work, a  place to live, healthcare, and generally act like they belonged there…

The most well known protestors were called “tea partiers” (not because they were much for partying or tea…but that is another fairy tale for another time) and they were lead by a beautiful & vapid princess called “Sarah” who brought them to frothy heights of discontent with beautiful images of mustached tyrants, bucolic concepts of “reloading” as in guns,  and “death panels.”  And they were portrayed by the mainstream media as representing what most people of the land believed.

But low and behold, the tea partiers were actually:

  • only 24% of all registered voters, including the Boomers
  • overwhelmingly White & male
  • retired or semi-retired so they had lots of time on their hands
  • or unemployed so they had lots of time on their hands and they were really cranky…

These subjects’ main complaint was that government programs designed to help the people of the land, are bad…except the ones they use (as, alas, many of them were on a thing called “Social Security,” a government program designed to help the aging people of the land…or something called “unemployment compensation,” a government program to help people pay their bills while they’re out of work…).

And they vowed to take their revenge on any of the land’s leaders who voted for any new such programs like health care reform, which they didn’t believe to be needed since most of them would soon be eligible for “Medicare” – another government program providing medical coverage for older subjects…

But alack, what about the other 76%?  Where did they stand?  What did they want?  Why were their voices not resounding out across the land?  Where were the women?  The non-White ethnic groups?  The non-retired & employed?

Unfortunately for the mighty land, based on a type of governance called “democracy” whereby it was the peoples’ votes and knowledge of the issues that the rules of law were made, as it turns out the majority of its subjects didn’t vote, got there “issue knowledge” from 2 minute “sound bites” designed to inflame more than inform, or just stayed silent in their own discontent about the discontented minority.

Then there were things called “polls” whereby subjects were asked what they thought about things.  And one such poll in a part of the land called “FloriDUH” showed that most subjects were against the new healthcare reform.  Alas, the poll had what was called a “margin of error” (how likely the poll sampling reflects the rest of the land’s views) of 15% – a credible poll has a margin of error of no more than 3%; 10% is considered highly unreliable – which meant that the poll reflected the actual views of… those polled….  And they lived in a State where subjects regularly re-elected legislators who polluted the environments on which the main source of income was dependent (tourism), decried “government spending” while grabbing their share of it, and balanced their budget by giving their big businesses lots of tax breaks while decimating all the programs for their most vulnerable subjects (from the developmentally disabled to abused/neglected children).

Thus, over a short period of time, and with help from the entire range of main stream media, it appeared that a minority of the land’s subjects would be able to dictate what the majority would get & what they “should” believe.  Why did the majority put up with this?

Would they remain silent no more, understanding that so long as they did, the country would not be “majority ruled” any longer?!

We don’t as yet know the answer, but the moral of the story is:

In a land where the majority rules, and that majority is a “silent” one because they are either apathetic or “too busy to get involved,” the many will see their fate sealed by the will of the few…and in any other land, that is called “dictatorship.”

The Real Issues for Health Care Reform

Boomers face the highest levels of unemployment since our post college days, which, of course, includes loss of medical benefits – none of us yet qualify for Medicare.

So, reform is crucial for us, particularly at our age (we need insurance more to stay healthy).

Yet some of us remain vehemently opposed to this legislation, purportedly because it unacceptably adds to the federal deficit, and/or does too little to impact change that is significant enough to matter.

Both objections are founded in specious reasoning (or for some, no reasoning at all, unfortunate for the most educated generation our nation has ever had…).  According to the CBO, the bill will reduce the deficit, and the elements of the bill clearly provide long overdue protections, some immediate.

The issues, it seems, are not those on which Boomer objectors have based their lack of support.

They are:

  • How the insurance companies will respond to the legislation… Will they increase their prices as soon and often as possible?  And what protections exist for that scenario?
  • What else is needed to ensure consumer protection in a capitalist system where businesses, designed to make an impressive profit for their shareholders, are key players in our health care.  And, in the case of health insurance companies, they can do so without regard for their impact on the lives of those they “serve”

So I ask my fellow Boomers to concentrate on all the ways we can make this legislation better, and more cost efficient – including Medicare Advantage plans which pay for member perks by charging all Medicare recipients – meaning the majority who don’t use/get those perks (since in as little as one year, this will impact us)

We know this process is far from over, so let’s make sure that by 2014 we have something really excellent.

We Americans, all of us (particularly our children and grandchildren), deserve it.

Medicare for Younger Boomers…

…a great idea, or an expansion of a program that has gone beyond it’s effectiveness?
Well, by the response of those Boomers chanting “keep your hands off my Medicare” it would seem the answer is clear.
I wrote the White House & a number of Senators around 2 months ago, recommending that an expansion of Medicare be the alternative to a “public option” – i.e. why reinvent the wheel; just fix the wheel you have (Medicare does need some overhauling to keep it solvent and make it far more efficient) and use it, I opined.
Although my thinking was to use it for all age groups, to start by offering it to most of we AARP types makes more sense.  If that works, it can be further expanded from there.
Given that a whopping 12% of Boomers 55-64 (4.3M) are uninsured according to a Kaiser Family Foundation study, coupled with a huge number 55 & up being forced to retire early and as a result losing the healthcare coverage that goes with their job, we represent a large portion of the population in need of coverage, at a time in our lives when such coverage is essential.
Expanding Medicare is the most palatable way to do this, with far less resistance to it than any other “public” option.  And certainly those citizens who are oh so happy with their Medicare coverage but don’t want the uninsured to have the same security if that means everyone must give a little for more to get, this may calm their fears.
And the time-frame prior to any healthcare reform legislation kicking in will give the Feds the time to clean up Medicare prior to expanding it.
My fellow Boomers, many of our generational colleagues need relief, now.  It is up to all of us to ensure they get it.
Expanding Medicare is the most efficacious way to do just that.

An Open Letter to My Peers…And Congress

I am:

  • a business owner
  • a centrist Democrat
  • a woman (we are still the gender majority and statistically the greatest users of healthcare)
  • a Boomer (we too are a large number & statistically the ones who have the most to win/lose w/any reform)
  • a member of the middle class (ditto above)
  • self-insured (e.g. not through my business)

As you see, I represent a broad cross-section of those most impacted by any healthcare reform, and as a Centrist Democrat, I believe in fiscal responsibility while helping my fellow Americans who fall ill and/or die every day because they have no insurance.  Useful reform requires thinking and/both, not either/or.

I wish to speak directly to each constituency, member to member.

To my fellow business owners:

When we want to address a problem that only our company/industry is in a position to resolve, we would not ignore it – we would most likely take out a loan (or shall I say would like to if banks were lending…), and get to work on expanding what we must to take advantage of a window of opportunity.  We would carefully calculate the risk and determine that if we do it right, we will not only be able to pay back that loan, but make a profit. 

The “problem” that needs to be resolved here is that clearly the competition created between private insurers alone has not only not reduced customers’ costs, but continues to increase them, so that model has not worked in our market place.  Therefore a new model is called for.   Applying this business model to reform, the Feds would become an insurer so that we “customers” can then reap the benefits that such good ol’ American competition would generate with private insurers (because they are the only “industry” in a position to do so).  There will be an upfront cost – of course.  But using that as a reason for not doing it at all doesn’t make sense.  Doing it in a way that will ultimately pay back the “loan” and then remain solvent, does.

We say that compelling private companies to compete with the Federal Government is not fair competition, thus insurers will be placed at a huge and unAmerican disadvantage.  After all, without significant government subsidies, no insurer has attempted to provide coverages that compete with Medicare.  That said, however, this model has worked in other industries.  The best examples: public and private colleges/universities; what has compelled the US Post Office to work more effectively (or at least try…) has been the private company competition to it.  There is simply no well-thought reason this model cannot also work with health insurance. 

As for co-ops, those few in existence work so well because they are non-profits – like the government, they are not in it to make money, but simply put their earnings-above-expenses back into improving their services.  Therefore, isn’t that unfair competition to for-profits that must pay huge salaries and give shareholders returns on investment?  Either way, private industry will be competing with a not-for-profit entity of one sort or another, so in essence, co-ops would be equally “dangerous” as competitors.  Then, there is the icing on the co-op concept-as-misguided cake: the fact that the plan being considered right now would be in very few States/areas, and most likely would not be available to the majority of Americans in our lifetime.   There is another glaring flaw to the co-op concept, and that I’ve covered in “to my fellow self-insureds” below.

To my fellow Centrist Democrats (&  you, too, Republicans): 

Given the above formula, you disappoint me greatly by not seeing the fiscally responsible window of opportunity here to both improve competition/significantly lower insurance costs for us with a public option, and do so in a way that will pay for itself so any upfront costs are “repaid” and on-going costs offset.  That is both social and fiscal responsibility… which is what you purport to be all about.

To my fellow(?) women:

As the greatest users of healthcare, from child-bearing to the ever increasing incidence of breast cancer, we have the most to lose with reform that does not create real and significant competition – it is only such competition that will lower costs…that is capitalism…that is the American way and it works.  As I mentioned above, relying on insurance companies, even if you can purchase “across state lines”, to lower your costs as a result would be continuing to trust an industry that clearly does not have our ability to afford them at heart.  For example, they can simply congregate in states that have far less stringent laws for coverage, and then offer a lower premium…for less coverage – this is not a savings.  They will continue to do what they do now:  the two largest health insurers held half or more of all enrollments in 40 of the 42 states studied just last year by the American Medical Association.

Without an outside force keeping their prices in check, they have proven to us over almost a century that they will simply find ways around any lesser legislation, and we will continue to pay for it.

To my fellow Boomers:

All of the above in the “women” section, plus as we age we will be the major users of healthcare, and many of us have miles to go before we qualify for Medicare (the other “public option” of which we will happily avail ourselves).  That means years of exorbitant premiums, even if insurers can no longer drop us when we get sick or refuse to cover us with a pre-existing condition.  Great – we qualify – but we still can’t afford it….

To my fellow Middle-Class:

The poor will be covered – the rich can afford designer care so they don’t care – we’re the ones who will be left to live with the final results of this legislation.  So, what will reduce our costs without sacrificing the levels of coverage we need to stay healthy…or survive a devastating illness?  We’ve said we don’t trust the government to do a plan right…do we really trust insurance companies more…?  With reforms to Medicare to bring its spending under control, it becomes an excellent model to replicate. Apparently even without those controls everyone on Medicare loves Medicare and the rest of us can’t wait to get on it… If Medicare is that effective, useful, needed, it is worthy of replicating for younger Americans as an alternative to private insurance for those who qualify (which, like Medicare, would hardly be “everyone” but in fact quite limited – enough to make a real difference without creating an unfair advantage).

There is only one way we will realize not just immediate but on-going cost reasonableness while not sacrificing our coverages.  We can have both – this is America – when we want the best approach badly enough, we make it happen.

To my fellow self-insureds:

You, like me, have most likely at some point had insurance through an employer prior to buying your own for whatever reason.  Back in 2000 when I worked for someone else, I was given a choice of diminished coverages for the same employee share cost, or increased costs for keeping the same coverages.  This trend has continued and worsened for those with employer provided coverage.  To quickly emphasize this with a real example: Dawn Smith is an aspiring writer living in Atlanta; four years ago, she was diagnosed with a rare, but treatable brain tumor; her doctors are ready to remove it, but they can’t because CIGNA refuses to pay for the surgery.  This is a battle happening right now.

We know that this is then magnified 100% when we pay the entire bill ourselves, and with no more guarantee than has Dawn that we will be covered when we need it the most.

I have seen my insurance bill rise by 33% over the past 1.5 years.  This is simply unacceptable.  Yet I have the lowest-cost insurance available to me here in Florida, and the bare minimum of coverage (“catastrophic” only).  Of the “cost-reducing” options being forwarded in lieu of a public option by some members of Congress, one is the ability for us to go across state lines – in reality, that would reduce my premium very little (I’ve checked) and “co-ops” would take years to develop to the point of efficacy – that’s only after the years it will take to get them up and running…the existing co-ops being used as models have taken as long as 20 years to get to the point where they are now the models to be emulated.  You truly want to wait 20 years? 

And as for cost, co-ops may have premium increases that are less than their competition’s, but that doesn’t make those increases necessarily affordable. Washington State’s Group Health Cooperative of Puget Sound had annual increases for averaging 12.3 percent since 2000; they were 24.2 percent in 2003.

My fellow Centrist Dem’s/Biz Owners/Boomer Women/Self-Insureds, I ask you to consider my words to you peer-to-peer; they are long in coming and carefully thought out, I promise.  I have done my homework – do my own fact-finding rather than relying on pundits with a clearly self-serving motivation (ratings) on both sides of the issue.  I, like you, have the most to gain or lose if this is done…or not done…right.  I ask you to not only refuse to dismiss a public option, but insist on it. In fact, it is our only chance for reform that will be both meaningful and lasting.