Health Care Facts August 28, 2009

The following summary from a colleague on LinkedIn concisely and emphatically resolves every major concern about having a health care system which includes a public option. Bravo and thank you David!!! ~Christine

By David Vernon, a Management Consulting Professional

1) Private insurers have almost a monopoly on employer plans, so there is now no competiton on price and service. Risk pools are regional, so inter-state private insurance will not change this. Federal jurisdiction does not extend to regulation of insurance policies written within States, but it does extend to plans receiving Federal funds. That is why we need a public option – so that Federally funded plans can offer features private insurers do not now offer, forcing all private insurers to compete on price and service (ignoring pre-existing conditions, eliminating “exclusions”, etc.)

2) 30% of current costs are accrued at municipal hospitals providing routine care for the uninsured in emergency rooms for ten times the cost of routine care in clinics and doctor’s offices. Providing Federal coverage for anyone, no questions asked, for routine care would allow these people to get care for one tenth what it costs now. A 90% reduction in 30% of costs saves 27% of current costs. That is the “indeterminate” savings from covering everybody, at Federal expense, at a cost of 1.4 trillion dollars over ten years. That is how expanding coverage could actually save money and lower overall costs.

3) 80% of lifetime expenses are accrued in the last six months of life for intensive care while dying. Absent clear instructions from the patient, medical ethics and current law require that no expense be spared to prolong life, at least unitl the $1 million lifetime insurance coverage is exhausted. Every patient who elects not to have intensive care while dying saves the system $500,000, $400,000 in insurance payments and $100,000 in copayments from the family of the patient. The cost of covering a living will conference is $100. Net savings is $499,900 per patient who makes a living will refusing intensive care while dying. Absent living wills, the 40 million Baby Boomers will incur $20 trillion in intensive care costs while dying over the next 25 years.

4) After end-of-life and routine care in ER, the next biggest cost item is 15% of current costs due to lack of proper medical information. These costs involve 98,000 excess deaths annually, duplicate diagnostic testing and imaging, and the care required to recover from mistakes in dosage and treatment. The existence of complete, accessible, lifetime electronic health records, such as now exist in the VA system, will eliminate this 15% of costs.

Bottom line = without a public option, it will not be reform. without mandatory living will coverage, it will not be reform. with electronic health records, the living will savings will not accrue because the doctor at the hospital will not know you have one, and it will not be reform. Costs can be nine times the CBO estimate and will still be half the $20 trillion that no reform will cost. Savings potential for living wills and guaranteed routine care for everyone are more than half of what we spend now.

5) Current costs of about $16 trillion annually amount to $8,000+ per capita. Results rank between 20th and 37th worldwide. The “best” results worldwide are achieved in France, which has a “public” option but not “national health.” Costs there are 30% lower than ours per capita, and private insurers continue to make profits, although not as huge as they do in the USA.

The only losers if the proposed reforms pass are the private insurers, who now reap most of the benefits of this system that lets 20,000 people a year die for lack of coverage and costs half again as much as the next most expensive national system in the world. ~~~

Health Care Coops part two August 25, 2009

The Policy-Speak Disaster by George Lakoff, Author and Professor of Cognitive Science and Linguistics at UC Berkeley, was referenced to me by colleague at LinkedIn in response to my previous post about health care policy. I enjoyed the article and heartily agree with the assertions.

For one thing, the quaility of the health care we afford ourselves does absolutely have a direct bearing on every other aspect of our aggregate life quality. Also, it is fact to me that people are not persuaded to change their inculcated preconceptions by reason or logic — at least not so long as their consciousness is ruled by inculcated preconceptions…

Are you much aware of the ‘pubic relations / social engineering’ work done by Bernaise (see: Century of the Self — 1 hour video) who demonstrated that people in general are not moved by logic, but by emotion…

Then, after they have made an emotional decision, they use logic to rationalize the ‘correctness’ of it.  

And until this ‘knee-jerk’ reactionary cycle is understood as the compelling mechanism of behavior, we (individually) are the subjects of it. That is, we have little to no actual control over our own conduct tho we most adamantly fight to prove that we are in control by clamouring to gain power over others (aka: the ‘dominator paradigm’).

And one of the ways this is done is by fear mongering… which is the motivating force in the health care debate right now… 

And the only (proven) way to proactively counter ‘fear’ is (not with reason, but) by cultivating (emotional) trust. Of course the (apparent) catch-22 is that the only way to cultivate trust is to be trustworthy…

On a related ‘just for the record’ follow-up, of the folks who responded to my post there was (as I understood it) 100% agreement that the ideal is to have a health care system where everyone has immediate access to the best possible health care practices without having to go bankrupt to pay for it. Also, the general consensus of the volunteered responses (most of which came to me privately) was that doing this — for a multitude of reasons — is simply not possible. About which I feel compelled to say two things:

#1 — We are the one’s who decide what is and what is not possible. Each one of us makes up our own mind and resonates it as our individual/independent attitude, which does in fact have a butterfly-effect on the well-being of our global community while at the same time having an immediate influence on our own quality of life.

#2 — We have the absolute power to choose where we put our resources. We can ‘afford’ to do whatever we set our mind to do and what with history repeating itself (until we learn from it) we have proven this to ourselves time and time again.

#3 — In light of the foregoing, all that needs be done is for us to hold true to our highest standards and most cherished ideals… stop settling for second best… and figure out how the optimum system of health care would work… then we figure out how to pay for it. Because until we know exactly what we want, there is NO WAY to even ballpark what it is going to cost!!!

Health Care Cooperatives August 19, 2009

Are you a member of a cooperative of any sort? Here in our region of the Ozarks, our electricity is provided by a utility cooperative. This type of ‘member owned electric coop’ origniated back in the 1940s or thereabouts, with government backing to assist people in rural communities to get plugged-in to the grid. To help them ‘catch up’ modern-convenience-wise with those who resided in urban communities where women like my uptown grandma were using electic washing machines and vacuum cleaners, and listening to the radio while her country cousins were still hauling laundry to the creek, or boiling it over open fires in big tubs in the backyard.

And it wasn’t that the country folks didn’t want the electric service. The problem was that the for-profit electricity generation & delivery industry was unwilling to bite the bullet to install the infrastructure to deliver the product because the investment/payback ratio didn’t serve the company’s profit margins. Thus the government, by and thru a process of awarding grants and making very low interest loans, made the installation of the conductive infrastructure possible by and thru the enabling of (a lot of) ‘member owned electric cooperatives’ which, at inception at least, seemed to be a very good thing.

Today however, and I base this upcoming opinion on my own personal experience with our local energy cooperative of which I have been a member in good standing for 20 years, our ‘member owned cooperative’ is little more than a localized mouthpiece for mandating multi-national ‘for profit’ energy policy which seeks NOT to deliver the ‘highest quality product at the lowest possible cost’ (which is the overarching mandate of every cooperative enterprise), but panders directly to (you guessed it) the dollar-driven bottom line.

Which is not to dismiss the potential for cooperatives to be ‘good things’ or to diminish the significance of money… which itself at botton line is simply a representative form of ‘energy’ with which I may purchase creative professional service or product from you, limited only by the amount of money/energy I have to trade. A statement of fact which itself goes to the heart of the whole health care reform issue: That at those times when folks are most requiring a significant infusion of ‘energy’ from health care professionals, it is generally at the same time that their own storehouses of energy at a low ebb and/or they are impaired in their ability to generate more. 

Thus in terms of setting up health care cooperatives and in spite of the way our local electric cooperative now operates, the altruistic Pollyanna in me thinks that the system of egalitarian cooperation line-itemed for ‘cooperatives’ would be idyllic and sublime if applied to the health care paradigm. I as a member, by and thru payment of my dues, would be entitled to a certain range of health care services which would be purchased thru the cooperative at ‘the best possible’ price. My dues, combined with those of other members, could fund a full-time clinic and trauma center where members would be seen on an emergency, walk-in and appointment basis and either treated as outpatients or referred to a cooperative-owned hospital for specialist treatment and inpatient care — all the while knowing that there would be no gargantuan debt hanging over their heads when they were well enough to go back to work and hopefully pick-up life as at least no worse-off than they were before they got injured or sick.

Yet the real-world rational thinker portion of my intellect reasons that this would only work if the cooperative was unanimously nationalized, ie: the ONLY way for anyone to get health care and the only way for a doctor to practice medicine… because this is the only way to eliminate the ‘class structure’ which now regulates our health care system, wherein if one has sufficient of money one may purchase any manner of health care available in the world, but if one does not have monetary means the ‘for-profit death panel’ has already passed judgement. 

Frankly, if we are to behave like full-fledged members of the cooperative society we all deserve to share (and that religiously many of us profess supplication to the ‘do unto others’ tenets thereof), then we as individuals must (not insure, but) ensure by and thru our own independent actions that each person in every community is able to get excellent, expedient and appropriate health care all of the time.

Respectfully, it is our own congnitive comprehension of the ovararching objective that must change: We must be unwilling to settle for anything less than the finest of the best for everyone as this is the ONLY way to guarantee that we get equal treatment ourselves.

Sunday August 16, 2009

My Studio made marked progress today. Major movement of things to appropriate places. Twenty days (by my agenda) to having the project done, at least in the sense of having all my available resources (tools, supplies, workspace) in good order and having a yard sale of my excess over Labor Day weekend. 

My big project of the moment is figuring out how to get the locker full of refuse that accumulated in the course of cleaning to the local transfer station… which would be a snap if I had a pick-up truck… which (how blessed I am) my eldest son does… but his work schedule is the same as the hours of the transfer station, and thus he cannot do the deed for me. So we have to swap vehicles which hopefully will be tomorrow… but may have to wait until Tuesday.

Beyond that, tomorrow will be another day of modest labor with the objective of starting to organize merchandise for the yard sale, which means that I will be going thru every closet and cubby, winnowing wheat from chaff.  And I must say that I am mildly excited about all of this. It feels good, like the ‘right’ thing to be doing. And it always amazes me how, when I am totally in the groove of doing ‘the right thing’, things so sublimely come together as if by magical grace.

Today, for example, sweet Shawna and I had managed to sort and organize a mish-mash of lawn & garden equipment, household maintenance, plumbing, woodworking, and craft-resource things in a manner to enable us to relocate an old steel-cabinet sink to a place on a different wall where it will (eventually) be hooked up with drain and running water. And just as we were ready to move the beast, two young gentlemen friends of Shawna’s serendipitiously arrived and insisted to do the job for us.

Geeze, I love being a woman (grin). Not that we couldn’t have moved the sink… but it was so much easier for these two strapping young men. Thank God for the difference of the sexes!!!

My Studio August 15, 2009

Day 2 of cleaning and organizing what we have lovingly called ‘the shed’ since relocating to our pastoral premises 5 years ago. Tho it is much more than a shed, actually being a rather wonderful single car garage, set apart from my house by a comfortable yardspace and already having been set-up as some semblance of a workshop when we all moved in.

Five of us stormed this house like a lost tribe, parched from many days in the desert, immersing ourselves in an oasis. And since that day I have had held an image in my mind of what ‘the shed’ would look like when it was organized and set-up the way I envision it, which is as an artisan studio replete with the accoutrement to create mixed-media, involving tools like table and hand saws, drills, glues, putties, fabrics, odd bits of pieces of interesting metals, sometimes melded with computer aided graphcs and always an eye as much to making something useful as to making it art.

In fact as any true artist worth a tube of acrylics knows as an element of artistic gravity, art essentially cannot be made. Art somehow happens when the artisan assembles a variety of shapes, textures and colors in a unique combination.  The art magically emotes.

Also interestingly, the more intently we focus on ‘creating art’, the less likely it is to happen. That is, the magic of pure art must somehow coincidentally be stumbled upon and catching the artist off guard quite by surprize.

So that is the way I have seen ‘my studio’ — as a ‘created space’ in which this quality of imagineering can magically happen — since the day my horde moved in. And throughout that time, as the space was otherwise occuppied for storage or maintenance projects (usually somehow associated with my darling children <smile>), my vision remained and now is coming to life. Whe-e-e-e-e!!!!

Thus with September being my official 5 year anniversary here I am strategizing phase one of my master plan <grin>, which is essentially, as much as possible, develop ways for this house to support itself which, in acccord of my current bank balance, I have 90 days to do.

And so of course I shall too be seeking gainful employment and shall post my preliminary employment application to my LinkedIn profile and also here as a PDF after I’ve given it another read. I did submit it already to a couple of places on Friday, however, as it is necessary for me to seek employment with at least two prospective employers each week in order to be considered eligible for unemployment benefits… if I am ultimately qualified to recieve same… which I will not know for probably a month so I’m just gonna keep on truckin’ with my master plan and see what happens next.

Unemployment August 14, 2009

Yesterday I registered for Unemployment Insurance. This was a new experience for me, having never before in my 40+ years of being a business professional filed for this type of benefit before. And actually — in context of all the blame being slung at government for alleged ineptitude and incompetence as administrator of state & federal benefit programs (ie: proposed ‘single payer’ health care) — the process seemed quite purposeful and well-carried-out. Almost expedient in terms of the staff available and the number of people there to serve.

I waited a very short time (perhaps 20-min?) to meet with the woman who conducted my initial interview, which only took about 10-minutes. She then gave me the option of completing my application on a computer, which was fine with me and I started immediately.

The questions were direct, pertinent to citizenship, residency and work history, and mostly could be answered by clicking  ‘yes’ or ‘no’ from a pull-down menu or typing in contact information and other pertinent data.  It took another 20-min. or so to complete the full application, which was printed out and submitted for my second interview.

This process too was fairly expedient. After waiting only about 10-min., I was called to a private office to meet with a woman who reviewed my full application, gathered additional information from me, explained the coming steps in the qualification process including instructions about how to report my current status weekly online and gave me a handbook and several pamphlets which detail how the whole system works. Again, this took about 20-min.

All in all, from arrival to exit, it took less than two hours, which seems reasonable and appropriate to me. Also, the women who interviewed me were friendly and informative, presented themselves with professional manners and impressed me as conducting their respective tasks with diligence and appropriate authority. If I were their work supervisor, I would be compelled to say ‘good job’.

All the more, I felt like a fish out of water. So nervous that I managed to dump the entire contents of my purse on the floor while extracting my Social Security card from my wallet. Perhaps sub-cognitive meme resistance (see: Virus of the Mind: The New Science of the Meme) to ‘asking for help’? No matter the cause, however, the feelings of being out-of-place were real and there is really nothing one can do about this except ‘notice it’ and move on.

Yet at the same time it is important — at least in terms of personal growth and professional development — to acknowledge the emotional-tugs inherent to any experience, old or new. To notice the subtext of our own (conditioned?) ‘knee-jerk reaction’ and observe the effects these innate sensations have on our routine movement thru the world, because until we enable ourselves to examine these subtextural experiences in terms of  our own self-adopted standards of  ‘reasonableness’ we cannot be self-empowered to ‘choose’ how we wish to behave ‘the next time’ similar circumstances come up.

A Stitch In Time… August 12, 2009

A lot of old sayings, no matter their relevance, have lost cognitive meaning in modern society. For example, I grew up with my elders cajoling me: “A stitch in time saves nine.” And I knew what that meant because my elders taught me how to mend and sew… a skill which seemingly today has fallen almost entirely to disuse, at least as my matriarchs practiced it.

Making it easier 'the next time'. By attaching info and tools necessary to 'get the job done' -- so long as whoever uses it keeps things together -- no one will ever have to waste time again 'looking up' or 'finding' what's necessary.

The overarching lesson, of course, was to keep things in good repair; ready to be put to immediate service, because doing so made life (in the big picture) somehow easier.

But the small lessons were multitudinous, coupling abstract dimensions of creative invention with perfected-by-practice mechanical skills — ie: have you ever stitched-up a split crotch?

Today I shared a measure such ‘stitch in time’ reasoning with my youngest daughter, age sixteen. Our task, however, had nothing to do with sewing.

Our weedeater needed a fuel refil. Not a big deal, except neither of us knew the correct mix of oil to add to the gasoline and the person in our household who has routinely attended this duty (my youngest son, age 18) is not in residence with us anymore — thus we now get to learn ‘how to’ <grin>.

And actually, I pretty much know how to do such stuff, at least in the general sense. But I didn’t know the exact oil to fuel ratio to use with this particular piece of equipment, so I called a local dealer of our particular unit and was told the correct mix is 50-to-1.

The oil tells right on the label how much of the product to add to the gas, but the instructions were for 2-gallons of fuel and we have a one-gallon can, so we divided things down to arrive at the fact that we needed to mix 2.6 ounces of oil with one gallon of gas.

So far, this took about half an hour.

Then we looked around the house to find some sort of appropriate ‘scoop’ that was ‘just the right size’ to measure 2.6 ounces and found something that works.

This took another 15 minutes or so.

Finally, we were able to add the oil to the gas, mix it thoroughly,  fill the weedwacker and get done what we set out to do…

But first, by attaching the measuring tool and the mixing instructions to the gas can which contains the fuel-oil-mix, we made sure we would not have to spend our time spinning our wheeels looking things up and finding what we need ‘the next time’ the weedwacker runs out of gas, admirably illustrating the premise that an ounce of prevention is worth a pound of cure.