Another Insurance Primer

Private health insurance can only be profitable under certain circumstances:

1) Insurers must to avoid sick people. They do this by 1) denying coverage to people with preexisting conditions, and 2) by using the workplace as a market. Employers tend to hire mostly healthy people, so pre-selection is done for the insurers before the policies are sold. That’s why private health insurance sold through employers, though too expensive, is an otherwise effective system.

2) By definition, insurers have to avoid people who can’t afford premiums. They either do without coverage, or are dumped on government.

3) Wherever possible, insurers have to avoid paying claims. They have many weapons at their disposal – they write the policies and understand them. Consumers don’t. They have tremendous and unequal bargaining power. It’s very hard to fight a claim denied – first you have to appeal to the very people who denied the claim, and second to the courts.

4) If insurers are forced to offer coverage to everyone (the Dutch model), then all people must be forced to buy coverage. This ensures that the companies will he covering a mix of healthy and sick people, and costs will be kept down.

5) Insurers have to avoid competing with one another. They already do this – all companies follow the Dwayne Andreas maxim that competitors are friends, customers enemies. “Free markets” are kind of a sick joke, an illusion, as markets are cruel and destructive. The whole point of accumulating wealth and bribing government officials is to buy insulation from market forces. We all know this. We just don’t say it. (There are over 1,300 private health insurance companies – if one turns you down for a preexisting condition, all do. You’d think that in a free market, one of those companies would take a chance.)

6) If insurers are forced to cover sick people, and if they have to cover people who can’t afford their policies, they will not be profitable investments, and will have to be subsidized to survive.

Hence the Max Baucus plan: 1) Insurance companies must survive, at all costs; 2) The IRS will force us to buy policies; 3) Competition (a strong “public option”) is not allowed, and 4) subsidy, subsidy, subsidy. Baucus is an private insurance tool, so it should come as no surprise that his plan reflects insurance company needs, and not ours.

The illusion of the free market holds strong in this country, so that we will probably stick with the private insurance model. So we will be faced with mandates and subsidy. I doubt we will save any money. More people will be covered, but insurance companies will still operate as a barrier between the public and the health care system. It’s crazy, it doesn’t work, and is what happens when ideologues of the right rule Washington.

Single-payer works because it is not a “free market” concept – it undermines the illusions and bypasses the profit seekers. It provides care to sick people in one easy step. Every country that has tried it has kept it. Every country that has gone to a public system has kept that system with one exception: Iraq. Paul Bremer forced them into the U.S. model.

That appears to be the only way anyone else will buy our health care system. At the point of a gun.

How awful it is in Canada

My wife’s daughter flew in from Canada today. She’s working a temporary job, and it will end sometime this fall. My wife asked her what she would do about health coverage once her job ended. “Mom,” she was reminded. “it’s Canada. We all have health insurance all the time.”

Later in the conversation, she talked about a friend of hers who works in a laboratory of some sort. She gets fed up with her job on a regular basis, and takes off, this time for Africa.

Imagine such freedom, telling her boss to shove it. Health security is a big part of it. She doesn’t have to worry about health coverage, and so can save some money, leave her job at will, and take off. Do you know anyone down here in the states that has that much control of their own lives?

Universal health coverage is part of the essential freedom we say we love so much in this country, but practice so little. It gives us control of our own lives. This is an unspoken, but important part of the debate we are now having.

Free trade as a two-edged sword

The notion of “free trade” is not so easy to be “for” or “against”. Depending on the circumstances in which it is implemented, it can be good or bad.

For instance, free trade among the free states of the U.S. yields mostly positive results. We surely would have not grown to be a powerhouse without it. But there is a downside – for years manufacturers (before they ran off to China, Mexico, Vietnam and other exotic locales) ran to the southern states to be free of unions. So free trade tended to keep wages lower than they otherwise would have been. The south is poorer today than the rest of the country, and surely that has something to do with it.

And for states like Montana, resource-rich but far away from population centers, we tend to suffer from a mild kind of colonialism where we sell cheap so that others can make a handsome profit on the natural resources that we have. Years ago we enacted a coal severance tax and put the money in a trust fund. That’s not quite the same thing as establishing a manufacturing base, but it is something – perhaps the only thing we ever done for ourselves to protect from exploitation by wealthy corporations.

Mostly, free trade among equals is a good thing – the U.S. and Canada and Western Europe are mostly equals, and if they eliminate trade barriers, we won’t get hurt.

But among unequals, it is disastrous. For poor countries, it opens the door for rich countries to buy their resources on the cheap and exploit their labor forces. “Third world” countries, as they were once known, have suffered from “free trade” for centuries. For that reason, I prefer to call free trade by its old and more proper name – imperialism. The reason why poor countries tend to stay poor is that they cannot close their borders, install tariffs, and avoid malicious interference by the likes of the United States, Europe and Japan. All of these wars we have fought over the years with Cuba and Latin American and Southeast Asia have been aimed at preventing development. We need, and cannot live without, cheap labor and cheap resources.

When they stand tall, resist, install tariffs, monopolize their control of resources (OPEC), use their own resources for internal development (Cuba and Venezuela), we attack and embargo them, and do whatever necessary to undermine them. It’s an old story – every citizen of every poor country knows about it, and Americans are clueless.

But it’s a two-edged sword, as we are finding out. There was a time when the United States was protectionist – our country imposed heavy tariffs well into the late 20th century even as we knocked them down elsewhere. But under Clinton, those tariffs were removed (except to protect “intellectual property”), and our labor force was thrown to the wolves. We are left to compete with dollar-a-day workers in Vietnam and China and Honduras, and flip burgers for one another.

It’s by design, I suspect, a decision within the upper echelons of our plutocracy who decided that Americans workers had prospered too much. We were, after all, just another work force.

So “free trade” came back to bite us. We can’t complain much – for two centuries we were the beneficiaries of tariffs and imperialism, our jobs and lifestyles protected. But American workers lived off the cheap resources of others while we enjoyed protection. So it makes sense now that we are spiraling downward. Who ever thought, for even a second, that the multinational corporations that control our government and foreign policy cared any more about us than the citizens of Iraq or Vietnam?

This quote, supposedly by Ulysses S. Grant in 1865, was translated into Spanish and then back into English, and was cited by Andre Gunder Frank in his book Capitalism and Underdevelopment in Latin America. It was repeated in the New York Times, September 30, 1981 by L.S. Stavrianos, professor emeritus of history at Northwestern University, who at that time taught at the University of California, San Diego. Even if Grant never said it, he should have.

”For centuries England relied on protection, carried it to extremes, and got good results from it . . . . England has found it desirable to adopt free trade because protection no longer offers advantages.

”Very well, gentlemen, the knowledge that I have of my own country leads me to believe that within two hundred years, when America has gotten all that she can from protection, she too will adopt free trade.”

It’s a sentiment is understood by all on the receiving end of free trade policies, and denied by all who profit therefrom.

P.S. I fell into the trap of using the language of the right, saying “free trade”. Better to say “unregulated” trade. “Free”, by definition, sounds like something desirable. People get paid for dreaming up names like that.

Similarities abound …

Wow – that election outcome surprised a lot of people. We had a moderate challenger to a hard right winger, and the challenger almost pulled it off, and now his supporters are screaming “Election fraud!” But prominent Democrats are saying to back off – that the outcome is legitimate. In the meantime, no one talks about how the real power in that country lies elsewhere – that it is not in the presidency.

I’m talking, of course, about the U.S. election in 2004. I hear they had one in Iran recently too.

P.S. It’s a big complicated world full of good and bud guys, and Iran, like our own country, has many bad actors. But the agitation before the election and riots and agitprop after has CIA destablization written all over it. We interfere freely in the elections of other countries, and the “fairness” of those elections depends only on if we like the outcome.

Differences in Colorado and Montana

Later this summer, my wife and I are going to move from our beloved Montana down here to Colorado. We are renting our home in Bozeman, kind of an escape clause in case we want to go back, but the move is meant to be permanent.

We are down here on a visit right now, and several differences jumped out at me:

1) I had to pee, and we stopped at a gas station south of Estes Park. There was only one unisex bathroom with one pot, and four people ahead of me in line. The guy in the stall had apparently been in there quite a while, and when one person in line knocked on the door, he yelled “I’m in here!” I don’t recall ever having to wait for a bathroom in Montana. I finally left, and peeing behind a tree down here will get you in trouble. I endured.

2) Bozeman is going to have a 4th of July tax protester rally, bringing people down from Noxon, I assume. This coming Sunday there will be a nude bike ride rally in Boulder. I assume most of the participants will be men, sadly, so I won’t be watching. The local police have threatened to arrest participants, and if they are arrested, they will have to register as sex offenders. As far as I know, exhibitionists are not the same as pedophiles, but I yield to the better judgment of the local constable.

3) Denver has charter schools, and a controversy is brewing as it becomes apparent that the charter schools are subtly, cleverly avoiding kids with disabilities. One school openly asked applicants if they had ever had special ed, and said lying about it would be grounds for dismissal. Montana doesn’t have charter schools. Bozeman has very good schools, but most public schools in Montana reflect the parents – mediocre. I like the idea of charter schools, to allow bright kids to escape. But they should not be allowed to turn down kids who are more challenging. That’s the private health insurance model applied to education.

4) Driving down through Wyoming these past two days – we came down through Dubois and Laramie – it was very green, but those forests we saw were devastated by pine beetle, as are the forests of Montana. Colorado forests that I have seen are lush and green and largely unaffected. But I haven’t seen enough to know this is universally true – I doubt it is.

5) Bozeman’s Daily Chronicle, for all its faults, is a much better newspaper than the Boulder Daily Camera, which is awful. When given a choice at the coffee shop, I always choose the Onion. The Denver Post is a very good newspaper. My vote for the best newspaper in Montana: Billings Gazette, simply for the fact that it carries more news than the others.

6) Traffic traffic everywhere – we drove down from Boulder to Morrison yesterday around 4:30 – every light back traffic up for blocks. But travel on the freeways is fast. We are going to have to adapt to that fact of life.

Our objective is to move someplace in the foothills like Evergreen where we don’t have to travel much – a self-contained community. We are looking at houses for the next few days.

As a lifelong Montanan, I’ll be able to reflect on the good and the bad about that state, and I will be in the coming weeks. I still have a mother and two brothers and a daughter in Montana. I will be traveling back frequently, but come August 15 forward, I will be a nude bike rider.

Lucy pulls the football again!

I’ve finally figured out what’s wrong with the Democrats’ position on health care, as exemplified by Matt and Jay: They think that they are merely playing politics, log rolling, compromising to get what they want. They think that if they do that, they’ll come away with part of what they want, and we’ll all be better off.

Problems with this approach:

1) If only one side is willing to compromise, then it’s not really compromise, is it. It’s more like, what’s the word – car salesmen have a word for this – they call them “marks”. Someone is being fleeced. It’s hard to watch.

2) If your own leadership is not with you, if your own leadership wants to sell you down the road, if your own leadership has taken millions of dollars from the very people you are supposed to be reining in, then it’s not really compromise, is it. It’s more like, what’s the word – Dick Morris had a word for it – triangulation.

Honestly, we are in deep trouble. The people who have appointed themselves the ‘fixers’ of our problem do not understand the rules of the game they are playing. The best we can hope for at this point is that it all blows up, and that we come away with nothing. That will be better than any of the “compromises” that are being worked out. The idea that we have to get “something” will be our undoing. The Republicans know how to play this game, the Democrat leadership knows how to play it. The followship? Not so much.

PS: In answer to the inevitable “What would you do in our shoes?”, I have two answers: 1) If the only possible outcome is a loss, do nothing. Die another day. 2) Listen closely, Democrats – I will only say this once: Try being clever. Giving up incrementally is not a strategy – it only slows down the losing process.

Incongruous, Bizarre

There was an interesting Supreme Court ruling yesterday – Caperton vs Massey.

A West Virginia coal company, Massey Energy, suffered a $51 million damage award to a competitor, and appealed the decision to the Supreme Court of Appeals of West Virginia. Judges to that court are elected, and Massey, using various methods of skirting campaign contribution laws, poured $3 million into the campaign of Brent Benjamin, who won the election to the bench. The $3 million equaled 60% of his total campaign costs.

Benjamin then refused to recuse himself, and sat on the Massey case, casting the decisive vote in a 3-2 ruling overturning the $51 million award.

The Supremes ruled that the conflict of interest was so blatant that Judge Benjamin had to recuse himself. They did not, however, lay out any guidelines on what an appropriate threshold is for conflict of interest.

I have never understood the reasoning behind allowing private contributions to judicial campaigns. Doesn’t that invite corruption? Any significant amount of money (say $1,000 or more) can create an apparent conflict.

Justices Roberts, Alito, Scalia and Thomas all voted against the overturning of the verdict for various reasons. But the bottom line is that they do not believe that the apparent conflict had any bearing on the outcome.

That seems absurd, but I need a better word. My Roget’s suggests ridiculous, silly, strange, illogical, meaningless, bizarre, incongruous. I’ll go with the latter two.

P.S. As Ladybug reminds me below, these four judges are ACTIVISTS!!!

A reasonable compromise?

I’m a “Unitarian”, and if people don’t understand us well, we don’t understand ourselves well either. You can’t say we are “true believers” in that we don’t have a creed. The joke about us that that we are lousy singers because we are always reading ahead to see if we agree with the words.

At our Sunday service there is time set aside for “joys and concerns”, when people step forward to talk about personal matters. A lady stood up last Sunday to talk about the killing of Dr. George Tiller. I got very uncomfortable – I don’t know about the others. It’s a liberal group, and I think it safe to say that most members favor legal abortion.

But Dr. Tiller provided “late term” abortions, and I assume that they were “medically necessary”, otherwise they would be illegal. Killing him was a heinous crime, of course, and justice should be meted out accordingly. But it is hard to be “pro-choice” when the fetus is so obviously well-formed. It seems like … murder.

I’m troubled by abortion – I finally settled on the idea that early-term abortions are a woman’s business, not mine. I know about life and how people are. I know that if abortions are outlawed, they will go on as before, only less openly. I don’t think a woman should have to pay with eighteen years of her life for one night’s foolishness. And I agree with Gloria Steinem who said that if men could get pregnant, abortion would not just be legal – it would be a sacrament.

It’s a woman’s choice up to a point. It should be.

I want to give some support to those who in good conscious decide that they oppose abortion in all cases. That’s an honest and defensible position. These folks should not have abortions, but it stops there. They don’t get to make law for all of us. They are usually driven by religious belief. They should follow their religious beliefs and be true to themselves. Its for them. Not everyone.

I think free and easy access to a morning after pill would be a nice compromise. Are there any out there who are “pro-life” who are willing to make that concession?

Just curious.

Bozeman Daily Chroncle Toolsies

The Tuesday, June 2, 2009 front page headline in the Bozeman Daily Chronicle was about a planned rally by tax protesters that will take place on July 4th here in Bozeman.

The Chronicle does not make its articles available online.

Immediately I wondered – what other groups get headlines when they merely plan an event? The anti-Baucus pro-single payer rally on Friday drew some after-the-fact coverage, but the staff writer, Daniel Person, was rather clueless, not understanding that Baucus opposes a “public option” and going to great lengths to quote all opponents of the single payer idea. It’s as if it was a fringe idea without much public support.

But back to the headline – why? Why does a fringe group warrant a headline more than a month in advance of its planned event?

The only answer I can think of is that the editors of the Chronicle, who are right wing tools, are promoting the event by giving it as much advance publicity as they can. And when it actually happens? More headlines!