Monday, September 21, 2009

Observations About Health Care Reform

The difficulty with reforming our health care system is that the whole situation is WAY too complicated. It does not fit into our shared cultural desire for a few slogans and buzzwords to sort everything out. Everything is so inter-related that it makes for bad politics. In an effort to untangle some of the confusion, I will offer a few observations:

1. Anybody who doesn't think there is a BIG problem with our current system is surely not paying for their own health insurance. As a businessman who pays for my own family plan (where I just got a notice that my premium is going up to $1880 per month!!), nothing irks me more than people with "jobs with benefits" who deny there is a problem, and claim "we have the greatest system in the world". It is especially galling when Republicans, who supposedly care about capitalism and entrepreneurship, are saying this.

2. In order for an insurance system to work, it needs a large enough pool so that risks can be spread, and prices can be fairly set. I don't have a real problem with making health insurance "mandatory" for all, and I don't think it's any different from law requiring motorcycle riders to wear helmets. Yes I know, some States don't require helmets, under the theory that "people have a right to be jerks and let the rest of us bear the risk of their medical bills". Health insurance is no different. It's pretty stupid not to have it, but many people choose not to, primarily because it's too damn expensive. Clearly, the costs have to be lower for all if everyone is required to be IN.

3. Which brings me to another point. Isn't is obvious that health care reform and immigration reform are inexorably related? When health insurance becomes mandatory, I want the 12 million newly legalized workers to be REQUIRED to pay for health insurance, or for their employers to pay for them. If this is too onerous, please leave. I am sick of paying for your health care. While I'm on the topic, I would also make "working off the books" and "paying people off the books" felonies. That's right. Not only do I want my health insurance costs lowered, I want my taxes lowered too, because I want everyone who should be paying, to PAY. Am I the only one who is ticked off about this???

4. I am amazed when people talk about "tort reform" in the context of health insurance. Yes, we could use some tort reform, but in the overall scheme of things, it's a pimple on the body of the problem. Maybe if there were universal health care, the doctors would be billing so much they could better afford their malpractice insurance premiums. Hey, wait a minute, another insurance issue at the heart of things. OK, let's fix too, this while we're at it

5. Does anybody truly think that under the present system the health insurance companies are competing with each other? Are they competing on price? Or service? Somebody show me where that happens.

6. Another good one....."If the government is involved, a bunch of bureaucrats will be making decisions about my health care". And who at the insurance companies is making those decisions now? And what standard are they using to make their determination?

7. I'm thinking that if millions more citizens have health insurance, this would be good for the doctoring and hospital business. Am I missing something? Oh, it will probably also be good for that other scourge of true health, the pharmaceutical industry.

8. I do fear that those who vocally support "universal health insurance" will be shocked when they find out they "have to pay for it" least to some extent. I don't think there can be any viable plan where the consumers are not paying some part of this. So, it really comes down to a TAX. To this I say, "fair is fair", and I think Obama has been tip-toeing around this issue. Fixing this mess will require EVERYONE to pay, another complication that doesn't generally go down too well.

9. The government is not some "otherly" entity. WE are the government. For this thing to get fixed, WE are going to be paying, one way or the other.

Sorry for ranting.
Sorry to my doctor friends.
Sorry to working people.
Sorry to people working off the books.
Sorry to people paying people to work off the books.
Sorry to Democrats.
Sorry to Republicans.
Sorry to tort reformers.

Sorry to say....I'm not really sorry about any of it. If everybody could just see that we are all in this together, we'd have a chance to make some progress.

Friday, September 18, 2009

Nice Things About Rosh Hashanah

When I was a kid, say from age 11 until about age 39, Rosh Hashanah was not one of my favorite holidays. There were a few reasons for this:

Summer was over and we were back to school.
The services were long if I went, and the day was guilt-ridden if I didn't.
Services were a fashion event, uncomfortable since I felt so unfashionable.
I had to think about what I had done wrong in the past year.
I felt like I was being judged.
As "irreligious" as I was, I was the most observant person in my family, which felt like an unfair burden. (It's not logical, but that's how it felt)

In the last few years, my thoughts on Rosh Hashanah have changed, dare I say "evolved"? For a quick tutorial, here is the Wikipedia version Perhaps interesting to non-Jews, and I must admit, I learned a few things myself.

Some nice things about Rosh Hashanah that I now like, enjoy and/or appreciate:

1. Coming at the end of the summer, it seems like a natural time for a "new" year to start.

2. Unlike secular New Year, it is not mushed in with the "holiday season". This is not a knock on Christmas, or the holiday season in general, I just like the idea of reviewing your personal year, and thinking about the New Year, separated from holiday hubbub, gifts, tipping, shopping and holiday intrigue.

3. I like the special greetings and positive feelings that people express.

4. Stopping and evaluating (better than "judging") where I've been and where I'm going seems very worthwhile. What if we didn't all do this at least once a year?

5. Any reason to get together with family and/or friends.....has to be good.

6. Nothing is quite like hearing the shofar being blown. Not only does it connect all the listeners with something that goes back to ancient times, but it connects the listeners together. There is nothing else like it.

7. At services on Rosh Hashanah (and on Yom Kippur), I sense that people are PRAYING more than "reciting". I realize that praying and participation in any service is personal and individual, I am simply noting that I enjoy the feeling of communal prayer more, when it feels truly communal.

8. The prayers seem to have more "fill in you own" personal issues, and I like that.

9. I like listening to good sermons, and Rabbi's are usually at their best on Rosh Hashanah.

10.These days, I'm OK doing what I do, how I do it, and it took me a long time to get to this point. I've probably spent some quality time on past Rosh Hashana's thinking about this.

L'Shanah Tovah to all.