Tag Archives: healthcare

104. Underemphasized Political Facts

5 May

I listen to a lot of political commentators and government leaders. It disturbs me that many important factors are rarely mentioned. Here is a list of very important facts that should affect political judgments:

1. The inheritance tax (a.k.a. death tax) is only for very rich folks and starts at $5.45 million. So when GOP people want to end it, it is done to support millionaires and take money away from us.

2. Tax simplification does not help ordinary folks, as their tax is already simple. It helps rich folks cheat, because there are fewer rules governing their very complex returns. Fewer tax categories are always designed by Republicans to make rates lower for high earners, not you and me.

3. When highly respected conservative George Will says a fellow Republican, Donald Trump, cannot “think and speak clearly”, it is significant.

4. Scientists have found that lack of sleep seriously promotes Alzheimer’s disease. Pres. Trump brags about the little time he devotes to sleeping.

5. Those who believe that Bill Clinton’s affairs tarnish his wife Hillary, should recognize that Trump, the actual candidate, has worse transgressions.

6. In Trump’s recent interactions with Chinese President Xi Jinping, he was the losing negotiator. Trump was forced to reverse his accusation of currency manipulation while China only reinforced previous policies.

7. Our House of Reps. just passed a healthcare bill for which there was little time to read and discuss, and was not evaluated by the Congressional Budget Office. This bill is also not consistent with Trump’s many promises, which proves he has no ideals and just supports rich Republicans and himself.

8. There is a tendency for commentators to look for one cause for each result. The recent Dem. loss by Hillary is one such case. Most likely, is that a combination of 7 or 8 factors (mostly “dirty tricks”) lead to the defeat. Please see my Blog Number 95.

9. Trump would have lost most of his followers if he told them in advance of his cabinet choices of several Wall Street billionaires, and his extreme conflicts with personal business interests. He has not done any divesting.

10. In the last 50 years or so, Republicans have always favored very rich folks over ordinary citizens. This is clear if you go to GOP candidate web-sites and examine their U.S. Budget plans. Current plans are to increase U.S. debt by lowering taxes for the rich, and offset this with reductions in services and programs for the rest of us.

11. FBI Director Comey has excuses for making announcements of Hillary investigations, but the bottom line is that he violated Justice Dept. rules. Almost all FBI investigations are secret and not announced until the final result. Investigations of Republicans were secret.

12. Republicans want to decrease regulations because that helps their rich industrial donors and Wall Street.  But most regulations are designed to protect the citizens from air and water pollution, hazards in the workplace and elsewhere, and taxpayer bail outs for bankrupt financial institutions.  Regulations are based on actual abuses and now are being eliminated in a secretive way.  There are supposed to be hearings on such matters.

103. Republicans Hate ObamaCare: Why?

28 Apr

“Insurance companies must use more of the premiums they receive for patient care rather than administrative costs…” (see reference below)

As I watched a number of news programs, it became apparent that commentators were not fully aware of the ACA (ObamaCare) provisions, or for whatever reason, ignored some of the most important points.

I am already familiar with most of the significant features, but I decided to search for a good summary. Here is one that is very useful and authoritative by Norma Goodwin, MD:
12 Simply Stated Features of the Affordable Care Act/Obamacare
The above (beginning) quotation is from this very useful summary (search Internet for this title). This feature alone, can explain why the GOP wants to abolish the ACA rather than just improve it. Rich insurance company owners don’t want to be limited in their lust for profits.

There are a few additional points that I would like to emphasize. There is much discussion about “pre-existing conditions.” But often overlooked are many other features that are critical (life-and-death) for good heath care. These include:

1. Eliminates annual and lifetime insurance policy limits.  Many people have died because their insurance money ran out.
2. Parent insurance coverage for offspring up to the age 26.
3. Medicaid is supported, but some states have refused to accept the free financial support.
4. Medicare is protected and now many preventive screenings are included.
5. Costs for vital medications are reduced.
6. Other provisions of the ACA are designed to lower the general cost of health care, and improve the quality of care.

The ACA is not perfect, but includes many great ideas. Keeping it will insure that the people will be well taken care of. New plans by the GOP will eliminate many more citizens from insurance coverage, decrease the quality of care, and will insure that rich insurance company owners will become even richer. Hopefully, some day we will have a “single payer” system, a Medicare for all.

100. Basic Causes of Greatest Concern

10 Mar

In my 100 blogs to date, I have tried to cover important governmental, social, medical, and related issues, that profoundly affect our way of life. In this, my 100th blog, I will list some of our most significant current issues, and maybe some possible solutions. I know that my blogs are sometimes imperfect and not very original, but my purpose is to increase the number of voices urging important changes and understanding. So here is a list of ideas to emphasize:

Our American founding fathers when creating the Constitution and other rules, were afraid of the kind of populism that we see today. So they tried to move important decisions away from the ordinary citizens and towards more responsible and intelligent leaders. Here are two examples supporting this lack of trust:
1. The establishment of an electoral college, to prevent direct citizen voting.
2. Until 1913, senators were elected by state legislatures, and not the people.
The founding fathers were afraid that ordinary people could be scammed by unscrupulous politicians. They anticipated someone like our current President.

Societies that over emphasize capitalism and the importance of financial success, foster corruption so that clever manipulators accumulate vast wealth, much of which belongs to the people. It is apparent that anyone (or party) in office for a long time will drift away from the people’s needs and develop methods for increasing their wealth. These methods include donating to Congressmen who will legislate tax loopholes and unfair subsidies.

An age requirement for U.S. President is not enough. Tax returns must be required and other financial and business details provided. It is too easy for very rich people, once in office, to make decisions best for their businesses and not for the country. A notable example is the transport minister for Azerbaijan, formerly a part of the Soviet Union. His covert construction contracting, participation in money laundering schemes, and wide-ranging contacts made him extremely rich at the expense of the citizens.

Corruption and unjustified accumulation of wealth, is not limited to politicians. Almost every vital service needed by the people, such as healthcare, education, and insurance, has cheated the citizens and made administrators (and others) hugely wealthy. Many of these rich people donate to Congress and through resulting legislation, make themselves even richer. Donations to congressmen has shifted vast amounts of money away from ordinary citizens, to undeserving administrators (making many millions of dollars). For example, median total compensation for ceos of major teaching non-profit hospitals is 1.35 million. Many make much more. Is it right that many millions of dollars are given to hospital administrators while poor people are being rejected (even die) for lack of insurance? Important services should be provided by the government at little or no cost. I feel that administrators and certain others should be allowed to become somewhat rich, but not extremely so.

Clarification: All “Western” or developed countries are a combination of capitalism with some socialistic features. Pure capitalism allows the unlimited accumulation of wealth with no financial protections for the citizens. Pure socialism is an economy totally controlled and owned by the state. In the USA (and many other major countries) capitalism is primary, and there are “social programs” in areas such as healthcare, education, and supporting the poor. Shifting some funds from the very rich to the very poor through taxation changes and programs like Medicaid is not “socialism,” it is simply the addition of a “social program.”

Last but not least, is the unethical and self-serving practices of many doctors, dentists, and other healthcare practitioners. Diagnoses and treatments are often are more determined by cash-flow than by what is most beneficial for the patient. Here are some examples. In the area of severe back-pain, diagnosis is usually a defect in the spine, and the possibility of simple excessive muscle strain and tension is ignored. Procedures for spinal defects are very expensive whereas procedures for muscle tension simply involve (at no cost) frequent muscle stretching. Here is an example from dentistry. Several years ago, my teeth would develop a dark blue hue, which could be removed by a professional teeth cleaning. Two dentists I went to urged me to double my teeth cleaning sessions, and spent little effort in trying to determine the cause. Fortunately, I was able to figure this out myself, and saved a lot of expense. The blue colored mouthwash I was using, dyed the teeth, and there was even a warning on the label. I could provide a lot of other personal examples, and many are described in previous blogs. An excellent book on this subject is “Confessions of a Medical Heretic”, 1979, by Robert Mendelsohn, MD. This is an old book, but still very applicable to many current physicians (but definitely not all).

Is there a quick fix for all of the forementioned issues? No, but major efforts to improve education could be transformative. Knowledge is important, but developing an ability to reason and research is even more relevant. Still, I have a sneaking suspicion that our current administration would fear a well-informed electorate.

98. Teen Trump Discovers Healthcare

28 Feb

During my long life, I have had a number of contacts with teenagers. Some of the brighter ones recognize that they have much to learn, and others just assume that when they discover something, no one else knew it.  I think that most older adults are familiar the “know-it-all” teenagers.  It is sad to say that our 45th president, often having the intellect of a know-it-all teenager, has just discovered Healthcare.

Before he talked about it, teen Trump could have spent just an hour or two in research and immediately figured out that our healthcare system is extremely complicated. He could have asked specialists who wrote the ACA (Obamacare) law and others, to explain it’s intricacies. Instead, after making numerous remarks about immediately abolishing the law, he now says:

“Nobody knew that healthcare could be so complicated”

I think even the “know-it-all” teenager would not say something as naive as this.
Here are a few more teen Trump assertions:

“I understand the tax laws better than almost anyone”
“I know more about renewables than any human being on Earth”
“Nobody knows banking better than I do”
“I understand money better than anybody.”
“There’s nobody bigger or better at the military than I am.”

(Please see Aaron Blake, Washington Post, October 4, 2016 as a reference and for more examples.)

Why didn’t his original supporters realize that the Presidency is not an entry-level position and that it’s not OK to serve with on-the-job training? Well, I guess we have to accept the fact that many of them are not knowledgeable  — and they were caught-up in the thrill of racism, violence, and over simplification. They knew and teen Trump knew that foreign policy, military actions, trade laws, treaties, education, technology and so forth are all trivial, and a great builder of buildings can master anything in a few hours.

After just a few weeks in office, teen Trump has made a mess of most everything he has done and the few positives, like the Carrier Co employee situation, are just tokens, having no substantial value. He has come up with incredibly valuable plans for making America Great, and defeating enemies like ISIS, but alas, cannot reveal any of the details. The most serious mess is his cozy relationship with Russia’s Putin.  Blackmail and election interference are possibilities that need investigation by fully independent parties.

93. Trump Chaos Easing Off (2 days later, maybe not)

14 Feb

Up until yesterday, the new administration was very disconcerting and disappointing — but this was not unexpected. Cabinet appointments were inappropriate, a directive was declared unconstitutional, there were violations of divesting rules, illegal foreign contacts, angry international phone calls, etc., and a lot of fast-talking and naive ideas. Since I mentioned fast-talking, I have to note that the really fast talkers are Kellyanne Conway and Shephen Miller, both rumored to be state-of-the-art robots programmed for double talk and downloaded each morning with alt-facts to confuse “tweet” critics.

But today, February 14, 2017, I see some improvements. “In-like-flynn” security advisor Michael Flynn is out — very significant. Trump has accepted the “One-China” concept, which is so important for this vital relationship. He is rewriting his Travel Ban directive so that it is more workable and less damaging to some of our foreign friends, and of course, he has accepted (and better understands) the judicial actions. It appears that he is accepting for now, the Iran-Nuclear-Deal, the Paris Agreement on Climate Change, and some other commitments and policies of the Pres. Obama Administration.

The ObamaCare (ACA) law is under scrutiny, but ironically may survive because any substantially different replacement plan developed by Republicans would be worse for them. Ironic, because of their numerous attempts to abolish it. Keeping the important rules like “pre-existing conditions” need to be paid for by the “mandate” (everyone must have insurance or pay a fine) or will break the budget. The best choice is to have Medicare for everyone but the GOP cannot disappoint the billionaires that run our health insurance companies and provide for their extravagant life-styles. To take insurance away from 20 million people and to take away the other popular features (like no life-time or annual limits) is too disastrous for now and future elections. ObamaCare is supported by a majority of our citizens, who would like it kept and improved. It appears that the new government is recognizing this.

We are indeed lucky to have a few sensible additions to the cabinet such as Secretary of Defense James Mattis and Secretary of State Rex Tillerson. I admit to being skeptical about Tillerson, but when I heard his speech to the State Department I was impressed by his intelligence and social skills. His rise to leadership of Exxon required great skills. He has the capability and knowledge to be a real asset. I am rooting for the two of them and a few others, to help Trump with major decisions. I also think some members of his “greater” family can encourage reasonable and maybe even progressive ideas. He has stated that Ivanka is a good influence.

The American “ship of state” is heavy and an almost irresistible object. Altering its main course is extremely difficult. It can force any irresponsible or reckless leadership into a more traditional and safer track. Donald Trump now has more appreciation for the complexities and difficulties in making presidential decisions.

91. Defining Our New President

7 Feb

Our new leader is a very colorful character. It occurred to me that an interesting undertaking would be to make a list of all the words that best describe him. Everything in the list below can be supported by recorded speeches and published reliable sources. Here is my list:

Bold, confident, expert promoter, regal, brave, administrator, businessman, articulate, well-dressed, blonde, handsome, arrogant, childish, vengeful, libidinous, unprepared (for presidency), sleep-deprived, mild Alzheimer’s, narcissistic, simplistic, tyrannical, impulsive, tweet-happy, ostentatious, unrepentant, greedy, unapologetic, scoff-law, prevaricator, devious, authoritarian, playboy, Russian-Supporter, militaristic, impatient, short span of attention, in some ways poorly educated

The core feature of his character is his self-interest: winning, and receiving flattery and adoration. This need for adoration colors everything he does. Most of his speeches, and many conversations begin with his bragging about successes. Sources close to him say that he reads a lot about himself and very little about everything else. His warm relationship with Putin may be the result of flattery. Putin has a long history of manipulation. Some responsible parties speculate that the warm Russian relationship may result from black-mail.

A major discussion about our new leader is whether his false statements are contrived or simply mistakes. My guess is both. An example of contrived is when he characterized the Iran Nuclear Deal as worthless — obviously untrue. Using the same example, he said that we could have used the money given to Iran for infrastructure work in the USA. This was false, but maybe he did not know that the money given to Iran was confiscated Iranian money, and could not have been used by us. He also did not seem to know that six major countries were a part of this deal and we did not have exclusive control over it.

Our new President came into office after a life of extreme luxury, likely surrounded by subservient yes-men. His false statements, I suspect, were rarely challenged. That would explain much of what he said in his later political career.

A major flaw in his thinking is that the president makes simple solutions to simple problems. It appears that he had no idea how complicated presidential decisions really are. Many of our international relations and domestic policies are very fine tuned and are the result of considering dozens of pros and cons. And some decisions are so complicated and dangerous that they must be postponed indefinitely. It is easy to criticize our recent and long-standing policies, but when you ask the critics for better solutions, they usually stutter or pivot to other questions. For many years Republicans have criticized ObamaCare (ACA). But now that they are in full control, they cannot come up with a good replacement.

Many intelligent leaders (in both parties) warned against possible dangers of his presidency. To name a few of his actual disasters: undermining our judiciary and press, alienating many of our major allies, and creating more terrorists through his hostile foreign policies. He does not seem to understand that simplistic impulsive acts can have long-term negative effects. During his candidacy he committed to foolish and impossible promises, and now we must suffer with his irrational efforts to follow through on them.

89. Some Tweet-like World Observations

2 Feb

1. Privatizing means creating a system that has a private owner as opposed to a government-run institution. Examples are schools and prisons. The latter has been tried but is now diminishing. In privately run systems a concern for profit can cause neglect in providing required services. Often, civic-minded people working as a public governmental body can be more effective, and with less expenditure. There is a fixed budget so that workers can focus on quality work.  Some would argue that privatizing creates beneficial competition, but in fact there is little competition in areas where privatizing is being promoted.

2. Do we need insurance companies that develop extreme wealth for their executives, paid for by you and me, while benefits are diminished. Why should our world be configured so that a few can become very rich at the expense of the rest of us? Our more advanced civilization has been around for 150 years or so. In that time, the “royalty class” has become entrenched in our system — robbing many ordinary people of their means of survival. I am not against the concept that hard-work and intelligence should be financially rewarded, it is the extremes and abuses that concern me.extreme we Being rich is OK, wealth is not. I also want to make clear that I owned two businesses and believe in our form of regulated capitalism.

3. The arrival of Trump marks the creation of a new entity resulting from social/business evolution. The new creation is what I shall call the extended governing family unit. The Trump version consists of himself, his offspring and their spouses; each having a specialized function. But to clarify, effective and powerful family units are not really “new”, but a unit this large, with necessary distributed functionality, has never before been our “president.” My next blog (no. 90) will explain this further.

4. Diagnosis of all types should be separate from treatment. The fees for various treatments can be very different, and the Dx could be biased towards better income. For example, the exact diagnosis for a cancer could lead to expensive and profitable surgery or a much less expensive radiation or drug treatment.  Dentists have tough decisions in deciding what is actually a cavity that require a filling.  Any healthcare, other service, or repair company can be jaded by this factor. How to fix this is a real dilemma.

5. Our U.S. government may be doomed to failure, because of powerful relationships between very rich folks (donors) and governmental leaders. The best cure would be a great improvement in education so that we can break the donor influence. Remember that our current leaders arose to power under this system and, as you would expect, want to preserve it. Many of those at the top have little interest in teaching logic, reasoning, and correct history to our students and potential voters. We are caught in a powerful loop and will need to be coordinated and industrious to have a chance of breaking it. The current massive demonstrations in many cities is on the right track and encouraging.

6. Ironically, a thousand years from now, the invention of email may be identified by witty history professors, as the cause of the downfall of our Earth civilization. Take away email, and there would have been much less abuse of Hillary Clinton, and she could have been elected. If that had happened, a strong NATO, great international relations, better climate change efforts, fair treatment of the middle-class, control of nuclear weapons, careful communications, and other factors could have saved the world from numerous disasters.  Trump has already alienated some of our closest allies.

7. Governmental officials generally set their own salaries and rules of operation. They are only people, after all, so how can we expect them to be fair. It seems that most people in power long enough will eventually become corrupted (at least somewhat). We need a better system, but change is difficult. The press should help us, but are often limited by some very real vulnerabilities. A tough leader with violent supporters can be an awesome force that discourages needed criticism and modification.

8. I suspect that most of Trump’s early supporters voted for him for various reasons, including: his power, likability (for many), promises of jobs, identification of scapegoats, prejudices, anti-terrorism statements, etc.  What probably was overlooked, was a good estimation of what he would actually DO and SAY after taking office.  Many of us had hoped that he would change after a couple of weeks as POTUS, but he has not.