Thursday, December 17, 2009

Between the Devil and the Deep Blue Sea

From time to time, I've offered up the opinion that economic, health care and environmental regulation and programs should be undertaken by government. For example, I favor universal health care run and managed by a government-base system. However, whenever I broach suggestions along this line, one or more of you will leave comments to the tune of: Government? I don't want x run by the g-o-v-e-r-n-m-e-n-t!

I can certainly understand where most of you are coming from. In the US -- as well as almost every other democracy in the world -- the government rarely represents the interests of the vast majority. No, government is there to serve the whims of the already wealthy and powerful. Consequently, if x is run by the government, it won't be run for your and my benefit.

It may surprise you, but I actually agree with that sentiment! I'll be the first to admit that the government too often mucks up good policy initiatives (e.g., look what they are doing with health care reform). They tend to include too many loopholes and look the other way when corporations refuse to get with the program. Still, despite these misgivings, I favor government-run programs.

WTF, you say. That doesn't make a lick of sense.

The problem is that the alternative is worse. If government doesn't run programs like health care, guess who does? Big business! And big business cares about you and I even less than our government!!!

The people making important life and death decisions not only aren't elected by the people but they only answer to one group -- their shareholders. Their chief concern is to turn a profit, regardless of whether or not it serves the needs of the public. While ordinary people can lobby their elected representatives -- even though it generally isn't very effective -- it's near impossible to lobby a corporation.

So, we average Janes and Joes find ourselves stuck between the devil and the deep blue sea. Will a government-run health care system be the kind that we can be proud of? Hardly. It will resemble a leaky boat taking on water in rough seas. But a corporate-managed system -- the one in place right now -- more closely resembles the Titanic with only enough lifeboats to save the "important" people.

That doesn't include you or me. :(

2 comments:

  1. I don't think government -- or business -- on its own can or should accomplish any economic solution. Government regulates, business produces and adds the value, ideally in a yin/yang balanced dynamic. Both entities are guilty of excesss if not controlled (and we can see that now.) I am too well-read in the history of post-liberation China to think any government on its own can have a long-term answer to a social problem, and the pre-New Deal depression proves the same of business.

    Funny thing--here in Hawaii, which is usually rated as the first or second best health care state in the country, we have government regulated, but privately provided health care (primarily by the local Blue Cross/Blue Shield plan and Kaiser, the big players,and some smaller guys who from time to time break into the market to shake up the duopoly.) Hawaii's scheme was the basis of Hilary Clinton's effort of 15 years ago. When I first came to Hawaii in the mid-80s I worked for BC/BS, and the general themes were "cost containment" and the great ROI we provided to our "members", better than any mainland plan, Blue or commercial. It's still good, but interesting that the BC/BS rates have gone up, (blamed on technology, malpractice, and that curious one, overutilization)along with the executive salaries, which today are among the highest of the state's corporate executives. (Thsi was embarrasingly revealed recently.)
    Still, by law,(the Hawaii Pre-paid Health Care Act) the burden of health care is on employers of a minimum size, who are required to provide access to insurance and who generally pick up the primary premium...people who don't work fall through the cracks, but there are safety nets. (Insurance for the self-employed or parttime employee is a problem...they have to pay for it!)

    The BC/BS plan has generally been the administrator of the Medicaid, CHAMPUS and Medicare programs,as a government contractor, and some plans also offer Medicare supplements.

    Historically this is all derived from the pre-statehood "plantation system" where health care was provided through the plantations. The Blue plan was a New DeaL CONCEPT, EXPANDED AFTER THE WAR TO PROVIDE INCENTIVES FOR EMPLOYERS TO OFFER HEALTH CARE AS A BENEFIT. (no significance to the caps, just my wayward dislocated pinky.)

    In any case, Hawaii is considered a liberal (some might say socialist) state, with good health care and insurance. Maybe it's because we are small.(We usually rival Vermont in this distinction.) It's too bad everyone blew off Hilary.

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  2. I never trust the government to do anything: big cuts in state health care benefits on the horizon...one of the incentives people had for being state workers in the first place.

    "Lingle, a Republican who generally opposes tax increases, does have a tax hike in her budget request. The governor would raise the tax on insurance commissions from 0.15 percent to 4 percent, generating $20 million for the state.

    The governor would save $12.5 million by not paying life insurance premiums for state workers and retirees and ending reimbursements for some Medicare costs for the spouses of retired state workers. The reimbursement reductions are in Medicare Part B, which covers a range of health-care items, including physician services, home health care and diagnostic tests."


    They're screwing with my retirement.

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