On the Contrary

Change is so damn hard.  Watching the Health Care Summit was a case in point.  Many of us have been arguing for years that health care system was a disaster waiting to happen, but only now are we going to have a real discussion.  The change that is allowing this discussion is that all the problems we have been pointing out (high cost, poor coverage, poor outcomes) are starting to be felt by our entire population.  Unless you are rich, you are now the recipient of either higher cost for your insurance with lower coverage, or no coverage at all.  Businesses are being priced out of the market providing health care to their employees.

Sadly there is only one answer and I wonder how many years it will take until we finally get there, and that is a single payer system.  Socialized Medicine!  Socialized Medicine!  I hear Rush Limbaugh has already started to beat that drum of fear.  So let’s consider this two part problem; why single payer, and is it socialized medicine, and why is that bad?

Why a single payer system?  Because medicine for profit (private insurers) puts all the incentives on lots of enrollees and few payouts.  Remember that private insurance is primarily not about providing health care, but profit for the owners/stockholders.  So ask yourself how one would do this:  Enrolling healthy people and denying claims.  I won’t belabor the details which I did in my blog Issues – Healthcare.  The reality is that that is how they operate today and their administration costs in this pursuit adds 30% to the cost of medical care delivery.  It has to go.

Now for the really scary part:  Socialized Medicine!  This terrifies everyone because they see some Soviet hospital with limited access and mediocre to poor care delivery.  But that view is a result of our own myopia.  This model is one of the government owning and employing all health care modes of delivery.  This is the model used by the British and, although not one I would recommend, is not the envisioned horror by the Republicans.  One the other hand we have the model of the Japanese where health care delivery systems are maintained in private hands, but there is only one insurer, the government.  There are pros and cons to both these systems, but both do a better job than our system does.  Needless to say there are plenty of other models out there to study if we could just overcome our panic attack at the thought of government provided health care.

So the solution is obvious, but we can’t say it out loud because the Republicans, the people who have kept us in the dark ages, especially the ones with Southern accents, will go ballistic.  President Obama is employing an old management trick right out of Project Management 101.  If you want to bring about real change, invest the opposition in it and instead of letting them sit on the sidelines taking pot shots, have them face the hard choices as part of the process.  If they are part of the solution it is hard to criticize.  My guess on this one is the answer is obvious, but it will take years of iteration to get there because most people can’t just face up to the change required and as we are seeing now, it will take harsh reality to force the inevitable changes.  As some sage person said, politics is the art of possible and for the near term in the political world the possible will be some bastardization of a single payer system and insurers.

Here are a couple of other things that are high on my frustration index:

• Proposition 8 in California that denied gays and lesbians equal rights – California must be proud of itself being led around by the Mormons and the Russian immigrants (top contributors to the Yes on 8).  If you don’t believe in gay marriage, don’t marry a gay.
• Super Majorities for anything but constitutional amendments – With the filibuster in the Senate and the two-thirds requirement for budgets in California, we have handed ourselves over to the radical minority.
• As an adjunct to this, Cuba politics – Two Hispanic Senators. one Democrat, one Republican, sent the budget bill down (keeping it from getting 60 votes) because they want to strip out the loosening of travel and commerce restriction on Cuba.  How long do we have to tolerate these morons?
• Adjusting Mortgage interest rates and principal in bankruptcies – Let’s see, we can do this in any bankruptcy proceeding except for personal bankruptcy.  Don’t you think lenders would be more willing to deal if they faced this possibility?
• Understanding the Economic downturn is global, not local – Until the debt and over valued assets are wrung out of the system, there will be continued bad news.  It is time to bite the bullet and admit that most of the crap Wall Street is selling is worthless and reboot the system.
• Listening to Republicans do nothing but criticize – Next time a Republican says no, ask them what their plan is and ask how they will address our real problems of a lagging middle class and failing infrastructure.  They are all about the status quo because it made them rich.

But change, even when reality tells us everything we having been doing is wrong, is not going to be easy.  Then there are those morons out there (usually wealthy Republicans who don’t want a change to the status quo that has been so good to them) who are now blaming everything on the Obama administration.  This is the ultimate in denial.  I wonder how much longer we have to tolerate these people?

There is a belief around here that the way California goes, so goes the rest of the country.  California sets a an example for most of the rest of nation in its approach to the environment, alternate energy, and global warming.  Well in some cases let’s hope not.

California has made some very bad choices in the way it governs itself.  First and foremost in bad mistakes is the two-third super majority requirement to pass a budget.  What that super majority requirement has done is gridlock our government, kind of like the filibuster in the Senate.  But here in California we are held hostage by a small minority of conservative Republicans who will never raise one tax.  When the Democrats came to them and said we will compromise, for every program cut we agree to, you will allow us a potential tax increase, they simply said all taxes are bad and nothing doing. It is cut or nothing.  Like all good conservative Republicans, it is their way or the highway.  The result is gridlock and an ever increasing state deficit.  Even the Govenator is frustrated with them when he proposed a 1 cent sales tax to help with our deficit and they balked.  But like the national elections, there is a chance that their one-third tyranny may be over if enough Democrats get elected.  On a positive note, if the Republicans keep up their intransigence, they may not be around much longer.

Second, since nothing gets done in the state government, everything is a Proposition put forward to the voters on election day.  Now there are two problems with this.  First these Propositions are complicated and a tough slog through to figure out just what they really do.  I have a degree in electrical and structural engineering and I have a hard time figuring out if what they are advertising is what the bill actually does and what could be the unintended consequences.  The second problem related to that issue is that there is no give and take like in a legislative process with amendments to fix an otherwise flawed bill.  It is what it is, take it or leave it.  Basically in this system the things that need to get fixed get thrown to a confused electorate to figure it out.    One of the favorite tactics is to take something like funding for education or firemen that we all think is important and pass a state constitutional amendment to guarantee a certain amount of state funding.  This might seem like a good idea, but it reduces the state’s ability to balance budgets when shortfalls occur, and we have so many of them now, that there is really very little discretionary spending left to manage.  This is no way to run a government and California is long over due for a financial restructuring.  Some think the constitution ought to be just thrown out and we start over again.

Speaking of Propositions, my favorite here in California is Proposition 8, the proposition that will amend the Constitution to deny gay marriage.  The California constitution guarantees equality for all its citizens and the ruling by the judge overturning an earlier proposition to outlaw gay marriage went something like this:

“The state Constitution’s guarantees of personal privacy and autonomy protect “the right of an individual to establish a legally recognized family with the person of one’s choice,” said Chief Justice Ronald George, who wrote the 121-page majority opinion. He said the Constitution “properly must be interpreted to guarantee this basic civil right to all Californians, whether gay or heterosexual, and to same-sex couples as well as opposite-sex couples.”” (San Francisco Chronicle)

Now the fruit loops on the right immediately began their activist judge chant.  I think Malbury versus Madison is lost on them, but so is rational thought.  Let’s face it, not even Sarah could name this case, but that should not be a surprise given her politics.  Worse are the moronic ads for the Proposition, paid for primarily by Morons from Utah.  No I am not kidding.  The Mormons were flooding the state with calls and money.  The basic argument is it is against their religious belief.  What I can’t ever figure out is if they are against it, then don’t marry a gay person, but don’t force your religious beliefs on the rest of us. I guess this little piece of logic just can’t enter their heads. This is always coming from those who shout the loudest about freedom, but are the first to take your freedom away if you are not like them.

Their latest ad claims that they will teach about gay marriage in schools and somehow your children will be irreparably harmed.  Right, like when I was young and somebody told me I could marry a man it would have made a difference.  It is either in your nature or it isn’t you morons.  It’s really sad when mob mentality is going to try to disenfranchise some of our citizens and make them second-class citizens under the law because they are afraid and intolerate.  Hopefully it will fail, but like the Republican machine, fear and misinformation is their tool of choice and unless the young vote, all the old homophobes will do something stupid on election day and embarrass us all with their ignorance and intolerance.

The last bit of stupidity from the Golden State is their get tough on crime.  Politicians are amazingly gutless wonders and we have passed all these mandatory sentencing laws to look tough on crime, but now their stupidity is coming home to roost.  In the last ten years prison cost have grown by 50%, will soon exceed what we spend on education in the state, and eats up 10 percent of the total state budget. It cost more to incarcerate someone than to send them to Sanford.  And it is a great system as 66 percent of parolees are back in prison after three years compared to about 40 percent nationally.  The parole system is horribly unfair, treats all offenders alike, and makes it difficult to re-enter society.   Clearly some sentencing modifications, reform of our parole system, and more focus on rehabilitation would pay big dividends, but then you might look soft on crime.  Well you gutless wonders who have thrown so many people on the heap pile of the human race, you can no longer afford it.  You can’t just look away any more.  Maybe many of them are redeemable and we simply can’t afford, meaning real money, to ignore them any more. (New York Times – California Prison Disaster)

So even in the golden state where I live in the middle of a beautiful vineyard, I am surrounded by ignorance, intolerance, fear, and stupidity.  Maybe it is the human condition.  I wonder when we will ever grow up.