Thoughts on Health Care

A friend of mine likes to say that you can't ignore health care without being seen as cruel. I guess I agree, but I must be a little cruel or heartless. Of all the hot button political issues out there, health care is the one I have the least opinion on when discussing with others. I am from an military family, so I know what "free" government health care looks like, and being able to compare it with the private health insurance I am fortunate to have now, I 100% prefer the latter.

Growing up, I remember my mom spending hours on the phone trying to get through in an effort to schedule an appointment. If she was lucky enough to get someone on the line, it became another feat to get a time slot inside two months. It seems like I never saw the same doctor twice, and I never had an appointment that took less than 4 hours. Most of the time, our only choice was to go to the emergency room, and wait for even longer, usually 6-10 hours, to see someone. Luckily, I was a pretty healthy. And fortunately, once we actually saw a licensed medical professional, they took their job seriously and usually provided adequate service. Yay Hippocratic Oath.

Looking back, a couple things stick out. First, I played sports growing up, and they required physicals. My parents would pay close to $100 at a local clinic for my physical, as the season would be over before I got one from the Army medical center. Knowing now how tight money was in my family, this was a HUGE sacrifice. Second, my parents still see a different doctor pretty much every time they go, and have never had a doctor that built a long-term relationship with them or took a special interest in their care. This, given their age and ailments, is sad.

So while I am very fortunate to have good health insurance at my current job, and have built good relationships with my health care providers of choice, I know there are millions of people without this benefit. So what is the solution? I don't really know, and it seems I am not alone.

I know for sure that I don't want a bunch of government-run hospitals like I experienced as a child. The private sector health care in this country is pretty darn good, just ask the rich Canadians and British who come here to escape their single-provider systems. The fundamental challenge is not of health care, but the lack of access and prohibitive costs for those not insured.

All this leads me to this article which partly through research and partly through opinion, discusses what can be learned from several European health systems:

The best healthcare system, from a conservative perspective, is that of Switzerland: it beats the U.S. system in terms of its performance, efficiency, universal coverage, and consumer empowerment. Although the Swiss system is not perfect, in empowering consumers and providing universal health insurance through market mechanisms, it merits serious consideration.

Wilhelm Röpke would be proud. I'll leave Röpke for another post, but it bears noting because his preference for solving problems with local government fostering pro-market solutions can be seen in Switzerland's approach:

Regina Herzlinger, McPherson Professor of Business Administration at Harvard and the “godmother of consumer-driven healthcare”, wrote in late 2008:

“The country of Switzerland has universal coverage, costs that are 40% lower than ours and that inflate at lower rates, and an excellent health care system in terms of outcomes and resources. The key to their success is that the Swiss system is consumer-driven: consumers buy their own health insurance from more than 90 private health insurance firms. If they cannot afford it, the cantons subsidize it. If they are sick, they pay no more for their health insurance than the well (the Swiss insurers risk-adjust each other). Consumer oversight insures value for the money better than oversight by governments and employers.”

The cantons are in control as opposed to the federal government, the consumers are empowered with choice and oversight control, and private insurance companies both compete and work together to manage costs and risks. The key is moving health insurance from an employer benefit to an individual purchasing decision, much like auto and home insurance. In order for this to work in America, there would have to be a massive overhaul to the complicated web of state regulations that make private health insurance ridiculously expensive. Less regulation would be very welcomed by me. To make the Swiss system better, the author recommends open access to doctor and hospital performance metrics. Sounds good to me.

The thing is, the Swiss approach is at least close to what Mitt Romney enacted as Governor of Massachusetts. Under current federal and state regulations, it was impossible to move away from an employer system, but he filled in the gaps through a private/public approach to getting everyone insured. I would love to have a mostly pro-market system that hinges on individual choice and responsibility, while giving everyone access to great health care.

That reminds me, doesn't Obama have an open cabinet position?

Picture Time

Politics aside, whoever created this is really good at Photoshop:



If I figure out where this came from, I will give recognition to its creator.

Encouraging Words From Obama

I was encouraged to read that Obama wants to remove protectionist measures from the proposed spending bills:

President Barack Obama risked a backlash within his own party by criticizing "Buy American" provisions in the huge stimulus bill that would ensure that most of the big infrastructure money goes to U.S. suppliers.

While he risks angering some in his own party, he will upset several countries if he allows the protectionist measures currently included to stand. Some have even threatened legal action or countering legislation.

The real drama will come if the bill arrives at his desk with the "buy America" requirements still included. WWOD?

Happy Birthday, Felix

With not too much going on in the news today besides Democrats not paying taxes (is that really news?) I will offer up a warm 200th to Felix Mendelssohn.



A great and historically underappreciated composer, Mendelssohn is also credited with reviving interest in the music of who I consider the greatest musician of all time, J.S. Bach, through a performance of the glorious St. Matthew's Passion.

(Note on the video - fast-forward to about 1:40 - the intro scene is annoying but this is the best recording of the 1st movement of the Italian Symphony that I could find on YouTube.)

The Ideal Size of Government

In his inauguration speech, Obama declared that the issue wasn't whether Government was too big or too small, but whether or not it worked. I interpreted that fairly positively. At the same time, size does matter, at least according to scientific (a term used loosely when applied to economics) study discussed by libertarian Richard Rahn in The Washington Times:

Most of the studies of the optimum size of government made by reputable scholars in recent decades have indicated that total government spending (federal plus state plus local) should be no lower than 17 percent, nor larger than about 30 percent of GDP. In a just completed paper, economists at the Institute for Market Economics in Sofia, Bulgaria, have provided new estimates of the optimum size of government, using standard models, with the latest data from a broader spectrum of countries than had been previously available. Their conclusion is that there is a 95 percent probability that the optimal size of government is less than 25 percent of GDP.

The figures for government spending in the US are between 36-40% of GDP, with the spending bill making its way through Congress representing an additional 5-6% of GDP. And more than the size of government spending, I wonder how much GDP growth in the private sector is restrained due to regulatory hurdles for small business?

Freedom of Religion?

Maybe not for the Amish. Per the Johnstown PA Tribune-Democrat:

Judge Norman Krumenacker has given two Amish couples 60 days in which to have their new houses in compliance with building and sewage regulations or face eviction.

And

Krumenacker’s order comes a week after he held another member of the sect, Andy Swartzentruver of Barr Township, in contempt of court for failing to bring two outhouses at the Amish school into compliance .

Swartzentruver owns the property on which the school is located. He may purge himself of the contempt by bringing the outhouses into compliance and paying $1,600 owed in fines and costs by Feb. 23.

Why?

They belong to the ultraconservative Swartzentruver Amish sect, whose members do not use modern conveniences, including having their outhouses meet sewage facility requirements.

What happens if they don't comply?

Otherwise, he may face a jail sentence of up to six months and an additional fine, the judge said. In addition, the school will be padlocked and the children unable to attend classes there, the judge indicated.

I could understand if they were trying to build a house in the suburbs of Philly with a latrine in the back yard, but seriously, what the hell? Padlocking schools and evicting families from their homes because some county enforcement office has nothing better to do than harass Amish people and keep them from living the way they want, in their own communities, on their own property, this is another low point.

Bookmark Reccomendation: PolitiFact

If you didn't know about Politifact.com, I would recommend a visit, if for no other reason than The Obamameter. Love him or not, you can keep track of how he is performing on all of his (over 500) campaign promises. I just learned of the site myself when another story reported Obama as breaking his first campaign promise:

No. 234: Allow five days of public comment before signing bills

The Promise:

To reduce bills rushed through Congress and to the president before the public has the opportunity to review them, Obama "will not sign any non-emergency bill without giving the American public an opportunity to review and comment on the White House website for five days."

The Update:

Obama signs first law without Web comment

Bloglinks: On Robber Barons

In scrolling through the blogs I followed, I found two that both used the term robber barons to use different, but very good, points.

First, over at CATO, a post about the current "stimulus" bill makes an important distinction between political entrepreneurs and market entrepreneurs using a historical example and tying it to big business, in this case IBM, today:

Right away this separates two groups of entrepreneurs — those who sought subsidies and those who didn’t. Those who tried to succeed in steamboating primarily through federal aid, pools, vote buying, or stock speculation we will classify as political entrepreneurs. Those who tried to succeed in steamboating primarily by creating and marketing a superior product at a low cost we will classify as market entrepreneurs. No entrepreneur fits perfectly into one category or the other, but most fall generally into one category or the other.

Enter IBM chairman and CEO Sam Palmisano

Since November, Palmisano has been making a pitch to Obama’s transition team that investing $30 billion in expanding rural broadband access, computerizing health-care records and improving the electrical grid could create 949,000 U.S. jobs. [ The stimulus package] could also create billions in revenue for Big Blue, which specializes in the technology and services used for health-care IT and smart-grid infrastructure, not to mention its recent $9.6 million contract to provide broadband service in rural America.

What we see here is IBM as the political entrepreneur.

I think the distinction between political and market entrepreneurs is critical, as I am pro-business for market entrepreneurs but not pro-business when it comes to the lobby ridden political entrepreneurs.

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Next, David Theroux has a post with passages quoted from one of my few heroes, C.S. Lewis, who would prefer life under robbers barrons before allowing others to rule with our "best" interests in mind:

If we are to be mothered, mother must know best. . . . In every age the men who want us under their thumb, if they have any sense, will put forward the particular pretension which the hopes and fears of that age render most potent. They ‘cash in.’ It has been magic, it has been Christianity. Now it will certainly be science. . . . Let us not be deceived by phrases about ‘Man taking charge of his own destiny.’ All that can really happen is that some men will take charge of the destiny of others. . . . The more completely we are planned the more powerful they will be.
. . . .

Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience. They may be more likely to go to Heaven yet at the same time likelier to make a Hell of earth. Their very kindness stings with intolerable insult. To be ‘cured’ against one’s will and cured of states which we may not regard as disease is to be put on a level of those who have not yet reached the age of reason or those who never will; to be classed with infants, imbeciles, and domestic animals.
—C. S. Lewis, God in the Dock

As the old saying goes, hell is paved with good intentions.

The Best Homemade Buffalo Wings in the World

Being Super Bowl weekend and all, I wanted to share my personal recipe for Bufallo Wings. While good fried wings from the restaurant are awesome, I find that an oven yields the best results at home. I have a convection roast mode on my oven that is great for this, but the regular bake setting works fine:

Sauce

1/2 stick (4 tablespoons) butter - the good stuff
1/2 cup Frank's Red Hot - Original (Not the Buffalo flavor)
1 tablespoon Louisiana Hot Sauce - Original
1-2 tablespoons Tabasco pepper sauce (depending on desired heat level)
1 tablespoon brown sugar
1 tablespoon apple cider vinegar

Wings

up to 36 wing pieces (flats and/or drumettes) - Fresh, room temperature, patted dry
salt
pepper
cayenne pepper (optional)
canola oil
Pam cooking oil spray

1. Sauce - Melt the butter over low heat. Add the brown sugar, then add vinegar, and hot sauces. Cook on lowest heat for 3-5 minutes, then turn off heat source.

2. Wings.
a. Pre-heat oven to 425. Use convection or convection roast feature if available.
b. Sprinkle a little salt, pepper, and cayenne pepper to all sides of wing pieces.
c. Brush a thin coating of canola oil to all side of wings. (This helps crispiness.)
d. Line sheet pan with aluminum foil, add wire rack insert, and spray rack with Pam.
e. Evenly space on rack(s) making sure they don't touch, and place in middle rack of oven.
f. The wings take 25-30 minutes to cook. Depending on the oven, setting, and number of wings, you may need to move the wings around or even flip them. The skin should be crispy and golden.

Once the wings are done and out of the oven but still on the racks, use a clean brush to brush on the Buffalo sauce. Instead of a big soupy bowl of sauced wings, I prefer to serve the wings crispy with a side of additional sauce to dip one by one. Add another side of blue cheese dressing and you are good to go.

If you have a good exhaust fan, you will appreciate it. If not, be prepared to open a window. The oil and aluminum foil help, but the chicken fat dripping into the sheet pan tends to smoke.

Conservatives are Happier than Liberals...

... Because conservatives don't buy the dogma of equality. So says a NYU research paper.

Rationalizing inequality—for example, by seeing it as emerging from a fair, legitimate, and meritocratic system—serves a palliative function not only in the United States, but in nine other countries as well. That is, right-wingers report greater happiness and satisfaction than left-wingers around the world, and most especially in countries where the overall quality of life is relatively low. The endorsement of meritocratic beliefs is also associated with subjective well-being in these countries. Furthermore, meritocratic beliefs account for the association between political orientation and subjective well-being to a significant degree.

Now, I don't like placing myself on the left-right spectrum, but if I do subscribe to the traditional Protestant work ethic, and accept inequality, so I guess that puts me on the right. And happy I am.

To go Bible for a minute, I think about Jesus' parable on the talents shows that even though each of us inherit or are given unequal resources, we are expected to do the most we can in our life to be better and do better. At the same time, the poor will always be with us, and the Proverbs make it clear that "He who oppresses the poor shows contempt for their Maker, but whoever is kind to the needy honors God."

So I am pro-meritocracy and pro-charity. I give credit and thanks to God for my good blessings, and recognize that the more blessings I have the bigger my responsibility to do good for others. But I don't think you can have virtue without choice, so taxes and a collectivist society are not the tools I prefer to help the needy.