Wednesday, November 20, 2013


Obamacare rage is all the rage at the moment and since I have been a supporter of healthcare reform I will chime in.  It’s not elegant but I’ve organized this into sections that reflect my thinking on the ACA.

Legitimate Healthcare System Problems Unaddressed by The Critics

·         Millions of people like myself are shut-out of health insurance outside of a large group, employment based plan.

·         Thousands of people are routinely dropped by their health insurers when they get sick and/or reach a lifetime policy cap

·         Thousands of the ones who get sick and don’t get dropped have their premiums increased to unaffordable rates because they are costing insurers too much.

·         49 million people are completely uninsured.  If acknowledging the basic immorality and inhumanity of this is too much to ask, just focus on the fact that these uninsured people are making YOUR healthcare costs higher via expensive emergency room treatment.  You’re already subsidizing them, just in the least efficient way possible.

·         60%+ of all bankruptcies in the US are medical bill related.  The majority of those bankruptcies are from people who HAVE health insurance.

·         The US spends twice the per capita average of the OECD countries for results that are average.

The people who are so giddy about all of the negative headlines are offering no solutions for these very real problems.  Why?  Because they don’t actually care about improving healthcare access and delivery, they only care about attacking a president who makes them crazy. 

Media Hyperventilation

If the media would have devoted this level of sensationalism and attention to the problems of the pre-ACA healthcare system Americans would have demanded reform decades ago and we’d probably already be on a single-payer style system like the rest of the civilized world.  The pre-ACA world has thousands of people who were suddenly dropped from their coverage, or told their favorite doctor is no longer in-network, or who had their premiums skyrocket from one year to the next, or who were just flat denied coverage altogether due to a pre-existing condition;  plenty of real-life cases that the media could have highlighted.   

If the pre-ACA and post-ACA healthcare systems were given a fair trial in the public media I have no doubt that “Obamacare” would come out the clear winner.  Interestingly, the media has given zero coverage to the people who have already benefited from the ACA or who will be benefiting over the next couple of years.  And many of the ACA victim stories have been roundly debunked, two prominent ones involved major features in the WSJ and on CBS news.  We are often presented with an incomplete story that turns out to be not as clear cut as the headline sounds.  The ACA has some very real problems. The rollout has been terrible, and many of the criticisms are legit.  But the media presentation is making it out like the new healthcare law is ushering in the apocalypse for what was a healthcare utopia.  And comparing it to Bush’s response to hurricane Katrina?  Because having some website glitches while you are trying to give people better access to healthcare is JUST LIKE leaving hundreds of thousands of people stranded and helpless after a devastating natural disaster. Please. 

Republican Paradox

Conservatives have claimed from day one that Obamacare will be an unmitigated disaster.  If they truly believe this to be the case then they should view it as political gold.  Allowing Obamacare to be fully implemented and then fail miserably could do more to discredit democrats/liberalism than Roger Ailes could ever dream of.  But they’ve tried 40+ times to repeal the law.  They’ve desperately attempted to sabotage and defund it at every step of the way, anything to prevent it from getting off the ground.  Why?  Because their true fear is that Obamacare will SUCCEED.  And their true expectations are evident from their actions.  If you really believe something will destroy your opponents, you sit back and enjoy the carnage.  You don’t fight desperately to stop it from happening.  If Obamacare does succeed it will be a devastating blow to the republican party.  For a party already suffering from considerable demographic and image problems this cannot be a pleasant prospect.   

Incidentally, it’s been hilarious to see conservative media and republican politicians all of the sudden playing the role of consumer advocate.  What hypocrites.  Where was this breathless concern when insurance companies were cancelling policies, denying coverage, and jacking up premiums prior to the ACA?

Rationale For The Healthcare Law

Insurance is simply the pooling of risk.  The larger the pool, the lower the cost per individual in the pool.  This is an actuarial fact.  The idea behind Obamacare is to get more people into the risk pool, thereby lowering the overall cost. It’s a sound concept.  Healthcare is not a “product” that a person can simply opt in or out of.  Everyone will use the healthcare system.  Therefore, everyone who can afford to should pay into it.  The main problem with Obamacare is that it relies on a patchwork of private, for-profit insurance companies to achieve this larger insurance pool.  It was set up this way in order to be “market based” and therefore more palatable to conservatives.  A single, mandatory, all-inclusive insurance pool (aka: single payer) would achieve the ACA’s objectives far more effectively.  It’s interesting that most of the ACA’s problems being pounced on by the opposition stem directly from the compromises in the law that were intended to placate them.  (Them being the republicans who believe in the magical fairy dust of the so called free-market.)

Democrats and ACA Supporters Have A Tougher PR Job

One of the central tenets of conservative politics is playing on people’s inherent fear of change. Whether it’s the government coming to get you, or the Muslims, or immigrants stealing your job and money, or “socialized medicine”, the conservative machine thrives on fear.  This is effective because fear of change is natural to the human condition.  Even if it’s changing from something terrible to something better, people are more comfortable with the devil they know.   Democrats and ACA supporters have always faced an uphill battle selling the idea that healthcare system can change for the better.  

My Criticism Of The ACA

On principle I hate the idea that government can require an individual to purchase a product from a private corporation.  But again, this strange and unfair sounding requirement stems from the fact that the ACA is a compromise designed to appease republicans who demand a “market based” approach.  Once it became clear that not a single republican would vote for healthcare reform and that democrats would be accused of being socialist Nazis no matter what they did, they should have scrapped the market-based compromised and crafted a more “socialistic” program.  At the very least they should have included a public-option that would have given individuals the ability to meet the coverage requirement without having to deal with the for-profit health insurance cartel.  At the time the law was being debated it was amusing to listen to the same people who say government can’t do anything right also complain that a public-option would have unfair advantage over our beloved private insurers. 

My second complaint with the ACA is how the individual mandate is structured.  The penalty for not buying insurance is too low.  And the enforceability of the penalty is too weak.  The viability of the ACA depends on younger, healthier individuals entering the insurance pool.  The mechanism designed to get them there has no teeth.   If the new entrants to the insurance pool are mostly older, sicker people, then health insurance companies will have no choice but to raise premiums.  This would be the true death-spiral for the healthcare law.


My Prediction
In one to two years time the benefits of the healthcare law will be evident and hundreds of thousands will be enjoying the benefits: grateful to be able to buy reasonably priced insurance even if they have a pre-existing condition, not having to fear being dropped from their insurance coverage when they need it most, and enjoying overall lower premiums due to an expanded insurance pool.  Not to mention the satisfaction of knowing their country has finally moved closer to making sure the basic human need of accessible healthcare is now a reality for most of their fellow citizens.  But I think this is just a stepping stone.  Within thirty years the absurdity and inefficiency of our privatized healthcare system will become so obvious and undeniable that no amount of right-wing fear mongering will be able to stop the move to a single-payer system.

Friday, August 30, 2013

The One Thing To Know

I'm one of those strange people who have never had the desire to have or raise children and luckily my wife is also one of those strange people.  Some of the reasons for this have been mentioned in another blog post.  Despite bearing no offspring I've often thought of some of the lessons I would try to teach to a young child based on my own life experience.  The truth is, kids or no kids, I feel like we all have an obligation to pass on some of the hard earned wisdom that has been gained through experience.  In theory the human race should be evolving for the better with each generation as the mistakes of the previous ones are avoided and knowledge is passed on.  It doesn't appear to be working out quite that neatly but it's a good thought.

Regarding the advice I would give, the first thing that comes to mind can be conveyed in two words.

Be kind.

That's more than a little cliché and too simple to be very interesting but I honestly can't imagine a more important value to instill in our little human beings in the making.  If anything will make the world a better place to be, it's more love and kindness.  Hat tip to the Beatles for preaching this message to millions of adoring and impressionable fans all over the world - all you need is love.

The problem with my simple advice of "be kind" is that part of just about anyone will be asking, "what's in for me?".  Well there is a lot in it for you.  There is now scientific evidence proving there is something in it for you, but don't take anyone's word for it, just try it and find out.  Be your own scientist.  Life is one big experiment.  Test the hypothesis and see what you get out of it. 

Knowing that there's a part in many of us that will still not have the 'what's in it for me?' feeling satisfied, and intrigued by the challenge of coming up with some less cliché words of wisdom, I'd like to contribute another small nugget. 

This one is meant to appeal purely to the sentiment of self-interest but will make being kind and everything else a much easier proposition.  Unfortunately I can't summarize this one in two short words or even two long sentences but if I were given the opportunity to tip off a younger version of myself to a concept that would make all of life flow much more easily, this would be it:

There is a part of you that is already whole, happy, peaceful, and perfectly at ease at all points within the wide range of human experience, from the beautiful to the horrifying.  Seek out this part of yourself with every ounce of effort you can muster.  Pardon another cliché, but look within.  Be still and quiet.  Take it on faith at first.  Just know that it's there and it thrives no matter what life may throw at you; and life will throw many things at you.  There will be very low and scary points and also very happy and exciting points, interspersed with periods of boredom or melancholy.  The range of human emotions and experiences is vast and there is no escaping the fact that to some degree you will find yourself at every point along that spectrum.  Just know there is that part of you that is perfectly at peace and happy regardless of outer circumstances.

Put another way, develop an inner life.  Start out with the simple faith that within yourself is this perfectly happy and peaceful awareness that is always present no matter what happens 'out there'. From that starting point seek out this part of yourself.  There are many things you can do to progress from faith to firsthand experience. The most effective is to meditate.  Learn to be still and quiet and to let all of the mental activity naturally quiet down and become familiar with what remains.  Be there for extended periods of time.  That's the most direct route.

There are many helpful references that you can consult to assist with this primary objective of cultivating an inner life.  Read and absorb the teachings of Jesus, Buddha, and more modern authentic teachers of spirituality like Ramana Maharshi, Nisargadatta, Ramakrishna, Paramahansa Yogananda, and their contemporaries such as Eckhart Tolle, Roy Eugene Davis, and Adyashanti.  These are just a few. There are many others, dozens if not hundreds of teachers that essentially have the same message presented in their own unique way. If eastern sounding teachers/teachings turn you off, there are western teachers as well.  We all possess a unique set of personality characteristics and some presentations will appeal or click with us better than others.  The point is that there are plenty of helpful guides out there if we feel inclined to consult with external sources in our effort to discover this part of ourselves that is always whole, happy, at peace, and untouched by external circumstances.

It isn't necessary to put this in a religious or spiritual context.  Religion has discredited itself over the millennia and a number of people are uncomfortable with the idea of spirituality, and if either of those apply to you, just think of it as a psychological exercise.  Again, know there is a peaceful and still center within you and find it.  The repetition here is intentional because it is the main message and theme of this post and if I could pass anything on to my own children or any that I might influence - this would be it.  Adults too.  I sincerely feel like it is the most valuable piece of advice that could be offered.  It will make every other endeavor that much easier.

This isn't the same as the grand, impossible sounding idea of Spiritual Enlightenment.  It's practical and accessible to anyone and doesn't require an excessive amount of intelligence or material wealth. If you can begin to know that part of yourself that is already whole and is untouchable by outer circumstances, it will be an invaluable refuge when times are hard and a necessary grounding force when everything seems to be going perfectly. 

In an effort at clarity here are some more characteristics of this part of you that I am referring to; nothing can be subtracted or added to it, it requires no one's approval, it is there in all of it's fullness and wholeness even when everything else seems to be falling apart, it is deeper than any temporary emotion or feeling that you may be experiencing at any point in time, it could be said that it is perfect or flawless. Also: it is always 'there', it is the silent witness to everything happening inside and outside of you, it is unchanging, and it is what you have in common with every other living being in the universe.  If any of that sounds too new agey or out there for your personal tastes, just overlook it.  I am just trying to outline something and paint a picture and I'm limited by my own personality and perspective.  Different adjectives and descriptions may work better for your disposition but the general idea is the same.

Nothing can fully exempt any of us from the perils and fragility of the human experience but what I am describing here can definitely smooth the way.  I personally haven't perfected living from the state of consciousness I am referring to but I have enough experience with it to know what I'm talking about and to confidently say it is the most valuable thing I could 'give' to another human being. (You can't give someone something they already have, but you can alert them to the fact that they have it.)

The end result of this pursuit is the intuitive and pervading sense that at all times, in every circumstance, all is well.   That doesn't mean all problems go away or that everything will always be perfect on the material or emotional level. It means they don't have to be and you are still okay.  All is well.  But please do not take my word for it. Experiment and find out for yourself.  Be patient but be diligent. 

So there it is. My words of wisdom to my non-existent children (or anyone else who's interested).

I could probably tighten this up and make it more concise but this will do for now.  Be kind. All is well.