Category: values

Healthcare Reform: More than simply redistribution of insurance cost!

1) Accept that life is not fair and government can not make it fair.

2) Accept that markets are efficient allocators of resources, which will reallocate human and capital resources to meet needs and allows for individual freedom and is not dependent on political power to meet those needs.

3) Accept that human systems are not perfect. There is a place for charity. Charity fills in the gaps or fills in during intervals between resource reallocations. Charity maybe individual,familial,or institutional. It is different from governmental programs because it is based upon a voluntary exercise of personal choice and not an exercise of majority power,

4) Accept that insurance companies are not the sole driver of cost. Health insurance is not and should not be equated to healthcare. Access to insurance does not equal good healthcare. Insurance companies are not inherently good nor are they inherently bad. Health insurance itself is not the sole answer to provision of adequate healthcare and it should not be treated as such.

5) Big government solutions are exercises of power and societal promises that even when outdated they are not rolled back and seldom evaluated in light of a changing environment.

How long will we persist in our belief that government can care for individuals from cradle to grave?  We continue to prop up  every failed government progam and deceive the public as to their long term sustainability.

Now we are on the verge of ushering into permanency unsustainable government health insurance for some unknown number of additional insured’s at the expense of all.  The true costs of this program cannot be determined.  (Congressional Budget Office (CBO)projections have proven themselves inaccurate.  See initial Medicare cost estimates as one example and Obamacare projections as a second example of inaccuracies) Democrats argue that the system would be sustainable with just a little more income redistribution and single payor solution just like the unsustainable medicare program.   (Perhaps the Democrats should campaign on a new more robust second coming of the VA Health system.)  The solvency of the Medicare trust fund is only guaranteed at 100% to 2024.

It is argued that this is the best system available because it removes the profit motive of the private sector. Please consider this.  There are already non profit options available in the insurance universe and when a government solution is adopted, it is seldom evaluated to determine its cost effectiveness or its sustainability.  Only a crisis precipitates second look at a program, then the program is reinvigorated with additional taxpayer funds, but never seriously scrutinized for efficiency and effectiveness.

Never is there consideration given to the lost opportunity cost, when adopting such  programs.  What do I mean by this?  Programs are adopted institutionalizing payment structures and distribution techniques available at the time of adoption,   This means a fee for service structure will be perpetualized in any health insurance solution.  Innovative cost and life saving measures will not be pursued, as long as a government subsidized consumer base is guaranteed to insurers and health care providers.

Insurance principles are supposedly built into the healthcare system except in instances, where the outcome is disliked by the citizenry or seen as “unfair”  e.g. Insurance is about many paying a small amount (premium) for protection against unlikely risk.  If the cost (risk)is guaranteed, it is no longer insurance.  It is redistribution.

Life is not fair and we can not wish and make it so, nor can we design a human insurance system to handle all circumstances without creating staggering insurance premium increases.  We refuse to allow those with chronic preexisting conditions to pay more in premium as required in the private insurance market,(even if the chronically ill potential insured’s have the ability to pay more) so we mandate acceptance at prescribed rate despite the built in additional cost of insuring these individuals.  This guarantee increases premium for all and prices many out of the market or provides coverage with obscene deductibles.

We demonstrate our distaste for the economic facts by characterizing any, who oppose this type of (health insurance) socialism as discriminators or haters, who wish others to go away and die.  Be honest!  This is a small group of individuals.  Most will be absorbed into a group plan through employment.  Some have the ability to pay increased premium or will be self paying.   Some will be treated in poverty programs and some may need charitable assistance.  Finally as a last resort, some may need assistance from a non insurance health assistance fund.  Why demand change to the entire health insurance industry to cover these relative few.  Please be honest and admit some of these individuals simply are not insurable for the same rate as the general population.  We may not like it, but it is not discrimination and it is an economic fact

We ignore the insurance principle of adverse selection, which states those most in need of benefits will flock to secure them especially, when available at an artificially low cost, while the young and healthy will simply assume the risk and move forward without coverage.   We attempt to overcome this hurdle by an employer mandate and an individual non insurance penalty.  The mandate so repulsive to many, so we push back compliance dates and minimize repugnant penalties in a dishonest effort to avoid electoral consequences. The penalty is so minor that many simply opt to pay it.  Meanwhile many potential insureds wait and upon receiving a diagnosis of cancer, diabetes (insert your chronic ailment here), then secure coverage post diagnosis and guaranteed future costs are spread over a small individual state market unfit to absorb the these extensive costs.  There is no urgency to sign up prior to need, when acceptance post diagnosis is guaranteed at the same cost.  Cost is distributed to the individual state market place raising the cost for everyone in that subgroup of insureds.

Remember politics is who gets what, when and how.  The market is the result of billions maybe trillions of choices made by individual consumers and families.  Each consumer or group of consumers acting in what they believe to be their best interest.  If a need arises, it is in the interest of someone or group to fill the need or the need maybe altruistically filled by voluntary giving.  (that’s right voluntary as opposed to entitled receipt.  Witness such charitable organizations as St. Jude’s Hospital, American Cancer Society and numerous other charitable non profit and individual healthcare benefactors.)  The private company or group in the private market is  rewarded for their risk taking by reaping a profit.  (not evil in fact frequently is distributed to shareholders including workers, who invest their savings in companies and insurance products.) Government planning and action can not better decide allocation of resources.  I would argue it never will be able to accumulate and weigh the number of variables necessary to replace the market.

Government muddles through! Merriam Webster’s Dictionary defines muddling through as to achieve a degree of success without much planning or effort.  (Doubt me?  Consider many in government service positions are career employees (carryover employees, not true believers), which means during any administration they may not agree with the agency activities or even the  stated goals of any department or agency.  How much effort and planning should you expect from this group.  Then consider Congress, which seldom agrees on the means to accomplish any single objective and may not even agree as to the goal itself)  The result of all this cognitive dissidence is government muddles through its tasks and inefficiently utilizes resources and seldom, if ever accomplishes its stated purpose.  This is hardly an acceptable replacement model for any market, let alone something as important as the health insurance market.

So what is the answer?

1) Accept that life is not fair and government can not make it fair.

2) Accept that markets are efficient allocators of resources, which will reallocate human and capital resources to meet needs and allows for individual freedom and is not dependent on political power to meet those needs.

3) Accept that human systems are not perfect. There is a place for charity. Charity fills in the gaps or fills in during intervals between resource reallocations.  Charity maybe individual,familial,or institutional. It is different from governmental programs because it is based upon a voluntary exercise of personal choice and not an exercise of majority power,

4) Accept that insurance companies are not the sole driver of cost. Health insurance is not and should not be equated to healthcare.  Access to insurance does not equal good healthcare.  Insurance companies are not inherently good nor are they inherently bad. Health insurance itself is not the sole answer to provision of adequate healthcare and it should not be treated as such.

5) Big government solutions are exercises of power and societal promises that even when outdated they are not rolled back and seldom evaluated in light of a changing environment.

Conclusion

Repeal of Obamacare is a necessary first step. We can always tinker at the edges of the system and provide means for those, who fall through the cracks in the system. (While writing this blog entry, I was watching a news reporter state that preexisting conditions handled in high risk pools totaled 115,000 policies. This is not an unmanageable number and gives credance to the idea that many with chronic health conditions are covered under the existing group plans or covered under existing poverty programs or medicare for seniors. If there is a requirement to immediately address an unfulfilled need i.e. preexisting conditions. There is more likely to be a better solution, if it is addressed as an individual issue. You can more easily identify the scope of the problem and limit the solution. The issue is not better addressed in all encompassing comprehensive legislation. (What about a deal?) Some Democrats maybe moved to lend support to gain this coverage, since the signature Obamacare legislation would be lost to them.

If there is no essential benefits package, perhaps there will be no need to keep children on their parents plan well into adulthood and if there is such a need perhaps a small adjustment in premium could produce the same result without a permanent unpaid governmental mandate. Some individuals could secure catastrophic coverage and choose to self insure by savings for some smaller medical expenses rather then pay into a massive one size fits all government mandate.

 
Educate the public that the majority of Obamacare’s insurance increase stems from the welfare healthcare expansion. That is medicaid. Is this how we want to cover these folks long term?  Remember this expansion was accomplished by a massive federal assumption of the expansion cost. This can not be permanent. Medicaid expansion merely kicks the can down the road with no road map to permanently assist this group to get permanent healthcare. The need for help for this group should be realistically assessed. Perhaps funding could be sunsetted as innovative healthcare delivery models are advanced to provide more affordable care.

Demand your state governments remove impediments to healthcare delivery. Examine professional licensing requirements. Examine state medical curriculum. Make certain they address healthcare needs and are not merely justification for professional fee increases!  Modify your tort laws to decrease malpractice insurance expenses.

Hey Ohio, Capitalism starts at Home

Capitalism starts at the local level. The federal government is an economic macro player with large impact, but this fact does not excuse localities from acting in a manner that maximizes the creation of wealth through grassroots entrepreneurial activity.

One of the amazing universal lessons I learned from Social Psychology was that all groups in our society experience “Diffusion of Responsibility”.  This phrase is a technical way of saying “Someone else will take care of it” or if in the workplace “That’s not my job”.

The result of this failure to take personal responsibility is the delegation of our local duty to advance our community’s economic well-being to the federal government.  After all, the national government casts a huge economic footprint with many of its decisions leading to the creation or demise of entire companies or small communities.  (Doubt me, remember the dire forecasts for the demise of companies or communities, when defense contracts are threatened or military bases even rumored to be relocated.)  (See San Diego Tribune Article: http://www.sandiegouniontribune.com/news/politics/sdut-military-base-closures-looming-again-2012may16-htmlstory.html)The federal government is an economic macro player with large impact, but this fact does not excuse localities from acting in a manner that maximizes the creation of wealth through grassroots entrepreneurial activity.

How does this apply to local capitalism.  Since and even during the national election, emphasis has been on creating jobs for our citizens.  Please notice the phrase “creating jobs” is not the same as generating wealth or increasing our gross national product.   Let’s start our conversation with a controversial statement. Creation of some jobs may actually impair real economic growth.  It is simply a method of wealth distribution.  Doubt me, witness China building empty shopping malls and unoccupied residential buildings.  Please review this article available at Forbes.com.(http://www.forbes.com/sites/kenrapoza/2015/07/20/what-will-become-of-chinas-ghost-cities/#70b1a2b0751b)   This is misallocation of resources on a grand national scale based upon the strategy of fulfilling a national plan.

Would it surprise you to learn that many US localities exercise this same economic folly?   It is done with the best of intentions and utilizes zoning laws as well as eminent domain to impose the vision of local elites upon its populace.  Why is it so widely accepted?    Individuals in our society seek to control their physical and economic environment. We are taught, since childhood the value of planning for the future, so it is counter intuitive to allow for the seeming chaos that is true capitalism.  Finally,the freedom that capitalism allows promotes uncertainty of outcome.

Residential and Commercial property owners seek certainty in their lives.  Property owners seek to grow the value of their investments by restricting the property rights of others.  How is this accomplished?  Use zoning laws to restrict competition by limiting the number of commercial sites available.  This is supply and demand at work.  If by using the force of government,  (government is majority force: witness the effectiveness of laws without consequence if you doubt this) you restrict the number of commercial sites available, then you raise the price and thereby the investment value of the already existing sites.  (fewer sites equals higher price.  More sites means greater competition and a lower price)  What is amiss here is the role of government in limiting the market by depriving property owners of use of their property as they see fit.

Does this mean there is no role for community control of its environment?  No, what it means is that the power of government should be used only in circumstances, where safety is at risk.  No property owner has a right to impose a real nuisance upon its neighbors.  This idea has been corrupted to mean that any use, which lowers property value is sufficient reason to restrict property rights.  We now have government elites crafting master plans for communities.  These are planned communities.  ( Sounds like well meaning Soviet economic planning and suffers the community with the same result.  i.e. ( use shortages, resource misallocation.)  When the local government is asked to select winners and losers, the result is no better than when the national government does so.  Why, because choices  made are based upon limited existing information and with built in biases.  Capitalism is based upon a  different idea.   Individual choices made in the property owner’s best interest will result in maximum economic benefit for all.  The net result of master plans is misallocation of local resources and lost opportunity for economic growth.

Why is this capitalistic idea so universally opposed by so many?  The answer is simple.  The community believes in control and planning has been promoted in all aspects of life, so surrender to capitalism is counter intuitive and threatening because it allow uncertainty.  Residential property owners fear that a “biker bar” or a “convenience store” will be placed on their block threatening the safety of their children or a factory or commercial property increasing traffic or other pollution to a dangerous level.  These are real concerns.  Coping with them requires creation of  a more flexible method of adjudicating nuisances.  Courts and lawsuits are too slow.  Zoning boards are too easily swayed against the proposed use in our modern democratic society.  Remember NIMBY (Not in my back yard) This is why here we have a limited republican form of government.  Democracy can be as tyrannical as any dictator.  It is merely tyranny by many rather than by a few or one.  (Please think about that!  The will of the many can be as restrictive as any despot).

Zoning laws must be crafted to be minimalist in scope.  It must impose use restrictions only when there are greatly increased (demonstrable)health and safety risks.  There will be errors as with any human system.

Why do I say greatly increased risk?  Consider how past break through inventions might be perceived today in our risk averse culture.  There would be no automobiles, if a risk free environment was sought.  Who would sanction high speed projectiles hurtling through population centers with a volatile payload.  (gasoline)  Remember all economic activity engenders some risk.  The only truly risk free life is conducted under a rock in a cave with limited human interaction.  (this assumes your cave and rock are structurally sound.  Life is short, measured in days, but certain and relatively risk free).

Sure, there are now and will be errors. Please remember the community can be damaged greatly not just by the results of economic activity.  i.e. car accidents or diminished air or water quality.  Some may even lose their lives as a result of lost economic activity.  The scope and extent of this loss by decreased economic activity is indeterminable and as such is dismissed out of hand.  i. e.( it is impossible to account for the number of deaths caused by the failure to mass produce a beneficial product i.e. a pesticide or more food).  I postulate that property owner’s right must prevail absent a showing of greatly increased risk.

This sounds cold compared to the liberal platitude, which states if it costs one life the risk is too great.  The fallacy of this statement becomes evident, when it is considered in historic perspective.  Consider the number of lives that would have been lost had this standard been applied to building projects, (Yes, people die in construction) automobiles ( a big killer) or electricity production.(ever hear of an electrical fire or electrocution)  So what is right.  There is not always a clear good or bad.  I am suggesting we weigh with a presumption in favor of the property owner’s rights.  That presumption of benefit from economic freedom can only be overcome by a demonstration of greatly increased risk to the public health or safety.  Wherever possible where real concerns exist compromises should be crafted to accommodate the use, while reducing the risk to the public.  (This is not an endorsement of the status quo, where property owners are subjected to community exploitation for more parks at the owner’s expense or outright seizure by the public of a portion of the property owner’s land in exchange for a use.  Demands should be directly related to the diminution of the demonstrated risk (not just perceived risk)(remembering that some risk will always be present.)

What will result from the absence of a master community plan is growth, which will inure to the community’s benefit.  This is controversial and I expect many parents and residential property owner’s will be opposed because this approach, while promoting economic growth also promotes uncertainty of value and use.  As I indicated earlier, certainty is always the easier path and economic growth requires risk taking.  Remember along with growth comes the many benefits of a modern society.  i.e. more food, more shelter and even cleaner air and water

Your comments are welcome, whether in agreement or opposed.  No judgement here!

 

 

 

Tolerance does not require celebration or acceptance

There has been an emphasis on ”cultural inclusion”. It has been suggested that in order to be a “tolerant person”, an individual must accept and celebrate different (Non-traditional lifestyles and households) lifestyles. If you are not celebrating and encouraging different lifestyles, then you are labeled an intolerant individual and un-American. let’s set the record straight. The Oxford Dictionary defines tolerate as: ”allow the existence, occurrence, or practice of (something that one does not necessarily like or agree with.- author’s addition -) without interference”. Please take note of the definition. It does not require one to celebrate the tolerated culture or lifestyle. Tolerance requires one to allow the culture or lifestyle to exist without interference. One need not promote or celebrate the differences. One need not allow special legal exceptions to promote or subsidize the culture or practice.

An individual is not a ”hater” because he does not believe in or wish to pRomote a practice or alternative lifestyle. An individual is allowed to believe these life choices are wrong or even sinful. Tolerance does not require acceptance or adoption of a lifestyle. I am tired of being told that we must celebrate single parenthood. This is simply not required to be tolerant.

Studies have shown that a two parent (father and mother) household is the best way to raise children. Yet we have insisted on denying the optimal way to raise children and chosen to promote and even subsidize single parent households as well as alternative lifestyle households. This celebration of cultural alternatives has become so prevalent that we now brand those, who choose not to believe in these alternative families as ”haters”. We have also silenced our clergy. We seek to use the power of government to compel acceptance. We have gone so far as to attempt to promote some alternative lifestyles as civil rights, which if denied are actionable through use of governmental force. Does anyone believe this is what our founders intended? Does anyone believe that a governmental entity should have to be involved to get a child supported? Do we need to have formulas and tax like guidelines in order to determine how to financially support our own offspring?

Obviously,those who choose to promote these choices have never had to listen to both minority and non minority men (now single fathers themselves. lament the fact that they had no father figure in their life. They have never had to hear the hurt in their voice as they spoke of life in a single family home. Don’t get me wrong.. They unanimously express love for their mother, but all express a profound sense of loss because they did not have the benefit of a loving father in their home. They all said they did not know how to be a fathers. Further they acknowledge that they have now put their offspring and the person they claimed to have loved in the same circumstance they suffered through by their absence. So the cycle continues and our self proclaimed “tolerant” society continues to celebrate single motherhood and maternal led families as if it is a new cultural norm. It is a “Women’s Issue”. They contend it is the only way women can be truly free. Meanwhile the pulpits of both the minority and non minority community remain silent. All the while society crumbles. Individuals, who could have made it financially together now flounder apart and the children continue to suffer. The politicians continue to promote programs now decades old, which purport to make government responsible for parenting. Does anyone believe these programs work? Does anyone really believe that government can replace a two parent home?

No one denies that some bad and even abusive relationships occur as do bad personal choices, but for society to continue to accept and now celebrate single parenting because some bad or abusive situations occur continues the curse that is passed down from one generation to the next. Monogamy and two parent homes must be promoted by our society. There must still be a place in society for selflessness. Life is not just about an individual’s quest for eternal bliss on earth. Life is sometimes very “real and hard” and actions do have consequences for both yourself and others. If you don’t believe that, sit in on a mandatory Court ordered parenting class.

So, I say parents tell your children, if they make children, they must find a way to live as a family and they have a duty to build a home and be a role model “for their children”. Government programs and support agencies can’t replace parents.

Actions still have consequences. SOS people, the act of sexual relations causes children. Let’s at least teach this much biology in our failing schools. Children still need two parents. If you are old enough to do the act, then you have to be old enough to take responsibility for the life you create as well as responsibility to assist the other parent in raising and nurturing “your” child/children. Pulpits can no longer be silent! The answer to procreation is not the extermination of our young, while in the womb or promotion of single parent unsustainable households,so the irresponsible pro-creators can continue in their quest for elusive happiness.

Yes, I have heard the stories of the young abandoned youth, now young men. Each would tell you of their sense of loss and many will do so, while condemning their own Offspring to the same fate by their absence.. Only we can solve this problem and it starts by understanding the real definition of tolerance. Yes, sometimes situations dictate that two individuals live apart for the safety of all, but that exceptional circumstance must not be allowed to dictate a cultural norm. Tolerance does not require celebration or even acceptance and certainly should never dictate creation of a new societal norm.

I want to hear your comments and experiences. Please share!