“Bits and Pieces” Healthcare Legislation #2: Overcharging the Uninsured

Posted on August 19, 2009 | Leave a comment

Wednesday, August 19, 2009

Earlier today, in a piece entitled “A Bits and Pieces Approach to Healthcare Legislation”, I suggested that the President and Congress abandon their attempt to devise all-encompassing healthcare legislation in favor of writing new law to address individual issues. The example I gave was about resolving the problem of pre-existing conditions. Here’s a second item Congress could also dispatch with speed and efficiency even while they continue to argue more esoteric, more complicated strategies for healthcare reform.

Doctors and hospitals charge their insured patients prices which reflect what has been negotiated with the underwriters – Blue Cross/Blue Shield, Aetna, Prudential and others. Uninsured patients are often charged significantly higher prices for those same services. Why?

The only reasonable explanation would be certainty of payment. The doctor or hospital knows it’s going to get paid by the insurance company, while it may have serious collections issues with some of the uninsured – particularly given than many families who do not have coverage make lower and less stable incomes. The question is, do these price differentials reasonably compensate the service provider for the additional administrative costs and real potential for lost collections?

It’s not an easy question, but rather one which requires research by finance and industry experts which may have already been done and, if not, can certainly be done quickly.

If, as I am going to assume, the uninsured are being over-charged, there are solutions short of providing everyone with coverage. That’s our goal of course, but doing so may take time and/or may be an incomplete process, still leaving millions without any or adequate insurance.

One option is to simply legislate that the price of a medical service charged to a patient must be the same whether or not that patient is insured – and let the healthcare industry and insurance underwriters work out the details. If necessary, the legislation could include a government subsidized default insurance program – the healthcare version of mortgage insurance – to guaranty payment. Premiums would be paid by the uninsured.

Sure, I tend to over-simplify everything, which I actually consider to be positive trait. My personal intellectual deficiencies aside, the bits and pieces approach to healthcare reform is clearly superior to the overly-complicated, often incomprehensible, impossible to explain legislative process our President and Congress are struggling to accomplish. Even if it turns out that individual laws we pass, one issue at a time, need to be revised in light of future revelations, the effect of the approach for its clarity, timing and impact will be well worth these relatively minor adjustments.

-wf


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A Bits and Pieces Approach to Healthcare Legislation

Posted on August 19, 2009 | 2 comments

#1: Pre-Existing Conditions
Wednesday, August 19, 2009

President Obama and Congress are trying to accomplish comprehensive healthcare reform in a single piece of sweeping, historic legislation. Good for them, but it’s making my head hurt and doing nothing to instill confidence in the outcome.

Why not address the myriad of component issues in separate pieces of legislation? For example, the issue of pre-existing conditions.

Medical insurance underwriters give extra value to large businesses who subscribe to their programs. It’s a form of volume discounting which is supposed to reflect the administrative savings the underwriters enjoy by virtue of the centralized management of so many individual accounts.

In and of itself, there’s nothing inherently wrong with at the least the concept of volume discounting. The problem here is the extent to which the price of coverage is being discounted, and in the non-pecuniary, high value benefits that the underwriters are allowing.

What’s really happening is that the underwriters are competing for large clients in a way they don’t feel the need to compete for small company and individual family business. It is discriminatory pricing which has too little to do with the actual costs of medical care. As a rule, small business employees and unaffiliated Americans who would buy individual and family coverage are no more likely to become ill, and no more costly to treat than the employees of large companies. The underwriters are discriminating, not because it makes good economic sense, but because they can get away it. Existing law and new healthcare legislation can stop that.

There are two issues here. One is whether or not the underwriters are over-discounting to large clients at the expense of smaller companies and individual families? More to the point, is there anything truly non-competitive about their behavior – not just undesirable, but non-competitive – that existing law, aggressively applied, may be able to regulate? If there’s a problem, and if we need new legislation, okay, let’s do it.

The other issue is that underwriters waive pre-existing condition rules to attract large account business. That practice has no real economic basis and can be discontinued in a single piece of highly specific legislation not much longer than this posting – and upon which almost everyone in Congress, on both sides of the isles, can agree. Americans will love the initiative for its clarity and the sense of progress this single piece of legislation represents. The President’s polls on the issue of his management of healthcare reform will improve – as will Congress’ which have nowhere to go but up. And we can all focus our attention on the next very specific healthcare issue on our agenda, whatever that might be — one problem at a time.

There. That was easy. (Thunderous applause, followed by feigned modesty and, “Thank you. Thank you very much.”)

-wf


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Obamination: The Fallacy of the Public Option

Posted on August 17, 2009 | 8 comments

Monday, August 17, 2009

The purpose of the “Public Option” in President Obama’s healthcare reform initiative is to keep the costs of medical care down.

One of two things is true: Either prices in the healthcare industry are currently determined by competitive market forces, in which case they are what they are and the government needs to stay out of it, or the prices we pay for medical services and pharmaceutical products are too high as a result of non-competitive forces ranging from benign market anomalies to outright monopoly.

Let’s assume it’s the latter. The solution then is NOT to have the government go into competition with the private sector, but to attack and regulate out the non-competitive influences which are keeping prices higher than a competitive market would dictate.

If, for example, the auto manufacturers were to collude to fix new car prices above competitive levels, would the Obama or any other Administration start a government owned and operated automaker to give the people a competitive, lower priced alternative? Of course not. Existing government institutions would use laws already on the books, and some new ones if necessary, to break up that monopoly. Don’t like my example? Make up one of your own, but the point will be the same.

What we have here is a President and a large segment of Democrats in Congress which President Obama’s election has emboldened who believe in the power of government through direct involvement in the economy to an extent which is neither supported by experience or consistent with the fundamentals of capitalism – and it’s making a lot of elected officials, businessmen and women in large and small companies, and a whole lot of us regular citizens justifiably uncomfortable.

-wf


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Guardian

Posted on August 16, 2009 | Leave a comment

Short Fiction for Guests of the WordFeeder
Sunday, August 16, 2009

Between every parent and child there is a certain magic
which the fear of an innocent can call upon
to prevail in the darkest of situations.

Lieutenant Roberts, in his late 30s, a senior Detective with the same police department where he started work after college, was all too used to getting calls in the middle of the night. It had been one of his earliest realizations that he would grow up and live his life in the state of his parents and grandparents. This place was his home and these people, all of them, were family, whatever time of day or night they needed his help.

Having been asleep when they called him, by the time he arrived before dawn that early summer morning he had to pull up a few houses down from the crime scene and walk towards the police cars and ambulances that were in front of the Colby’s two story colonial. It was a nice neighborhood, one of the newer subdivisions in this county that couldn’t resist the lure of growth.

Rushing up to where two ME Assistants were rolling a body bag down the driveway, he saw Detective Sclorowsky look up from the notes she was making to greet him. Recognizing the look of concern on Roberts’ face, she didn’t waste any time bringing him up to date.

“That’s one of the two that broke in,” she started, gesturing over her shoulder toward the open rear doors of the ambulance nearest to where they were standing. “The other one, also dead, will be out in a minute.”

“And the…”

“No one in the family was badly hurt. Just the mother and her 5 year old daughter were at home. The father’s out of state on business, but on his way back now. He should be here in a few hours.”

“Just the mother and a 5 year old took out both of them?”

“Not exactly. …Let’s go inside. You’ll need to hear this for yourself.”

The house, still busy with police officers and forensic specialists, was good sized, but not huge, comfortably furnished with the clutter and stuff of life here and there where you’d expect it to be. Waiting for them inside, the mother sat nervously on a love seat in their family room, her daughter next to her, her feet stopping a few inches short of the rug that covered the center of their hardwood floor.

Detective Sclorowsky pulled up the leather chair from the other side of the room, but Roberts wanted to be closer and sat on the refinished wooden trunk they used as their coffee table. Both women seemed remarkably calm, the events of the night not having fully affected them yet. That would happen soon enough which is why he had to talk to them now before they became any more distracted by the reality of what had happened. With some people, you have to wait a day or two. Others were best when you talked to them right away. Over the years, he’d learned to tell the difference.

“Hi, Mrs. Colby. My name is Jacob Roberts. ..and you,” he smiled ever so slightly, turning a bit to his right, “must be Emma.”

The little girl nodded her head up and down, but said nothing.

“Mrs. Colby, I know you’ve been through all this before with Detective Sclorowsky but, if you could, tell me the basics of what happened.”

An attractive, slender brunette with wavy shoulder length hair, she looked remarkable given what she’d just been through. Outward appearances aside, it seemed for a moment that she wouldn’t be able to speak. A large bruise was coming to the surface of the left side of her face where an EMT had clamped and bandaged a cut. “Mrs. Colby?”

“Emma and I have trouble getting to bed sometimes when Michael’s out of town, so we stayed up late, watched a movie together and fell asleep on the couch,” looking up and over at the overstuffed three cushion sofa against the wall behind him. “I don’t know when exactly, but I heard noises coming from the basement. It’s a walkout and I was worried someone might be someone trying to break in. Sometimes I hear sounds from the woods, deer that come up to eat the bushes around the deck, a fox sometimes, but this was different.”

Her voice was steady and deliberate as if she had to concentrate to get the words out. “Did Emma wake up, too?” he asked, thinking it best to interrupt her now and then for her to hear the sound of his voice.

“No. ..No. I…”

“Mommy woke me up.”

Impressed that the little girl was taking the initiative while her mother was clearly stuggling, he turned to encourage her. “What did she say, Emma?”

“She told me the truth. That’s what we’re supposed to do in an e-merg-en-cy.” It was a longer word she had trouble pronouncing.”

“What exactly did she tell you?”

“Mommy said it was the middle of the night, and that there was noise in the basement she was worried about.” Her confidence building, the little girl was relaxed now and anxious to help. “She told me to sneak upstairs, very very quietly, and hide in my bedroom closet while she called 911.”

“Is that what you did?”

“Of course,” Emma responded, almost as if she was wondering if he’d been paying attention.

“And, Mrs. Colby,” Sclorowsky wanted her to include a detail Roberts wouldn’t have known to ask about, “you didn’t call 911, at least not right away, did you?”

“No. I keep my phone on a…,” she paused to catch her breath, “on a charging stand on the counter there,” she explained, pointing toward the kitchen at the other end of the room, past the table where they ate most of their meals. “I came around there, past the refrigerator, but never made it.”

“ …The first one of them came up the basement stairs,” through the doorway just outside the kitchen, “and grabbed me from behind, bringing his arm diagonally across my chest, like this.” She used her right arm to demonstrate. “I could hardly breathe. ..The second man was right behind him, but went off somewhere, while the first one pulled me down the stairs, back into the basement. I tried holding on the molding around the door and then the banister, but I couldn’t get on my feet – and then I thought, maybe when I got downstairs, maybe I’d be able to fight him off. It’s my house. There’re tools in the shop if I could just…” She was starting to have trouble.

“Keep going, Mrs. Colby. You’re doing great.”

“And then he threw me over… It’s open, the stairs are open at the bottom. He threw me over onto the floor. I must have hit my head on something. I’m not sure. It was dark.”

“And you called 911 when you regained consciousness?”

“Yes. When I woke up, it couldn’t have been too long that I was out, I remember hearing screaming and crashing sounds on my way up the basement stairs. That’s when I picked up my cell phone and called the police.”

“Emma?”

“Yes, Detective?” Her formality would have been cute under different circumstances.

“What was happening upstairs, Emma, while your mother was in the basement? What happened in your room?”

She paused for a moment, as if wondering if she should tell him.

“Go ahead honey,” her mother prompted her, reaching out to touch Emma’s hand that was pressing on the cushion between them. “Tell Detective Roberts what you told me.”

Looking up at the Detective, she answered his question with certainty. “Guardian protected me. The two men came into my room, and Guardian protected me just like Daddy said he would.”

“Just Guardian and the two men?”

“Uh huh. ..It hardly seems fair, does it? To the men, I mean.”

Leaning back to distance himself from the little girl, Detective Roberts needed to see her room. “Let’s take a break for a couple minutes. I just want to run upstairs and take a look at your room. Will you wait here for me?”

Once again, Emma nodded her agreement.

“Detective,” he said turning toward Sclorowsky, and the two of them stood up and left the room, on their way down the short hallway toward the stairs and to Emma’s room. “What’s Guardian,” he asked her with quiet impatience when they were out of the room, “the family dog?”

“No. It’s, uh, not a dog.”

“So what’s she talking about?”

“Com’on,” Sclorowsky started up the stairs first, “It’s the kind of thing you need to see to believe. The ME’s pulled the bodies, but you’ll get the point.”

Pushing open the door with her left arm, she moved to the corner of the bed, turning back to Roberts whose eyes began moving slowly from point to point in the mayhem he saw. The room was trashed. There was blood all over the place.

“The preliminary conclusion of the lead tech was that both men were ‘torn to shreds,’ his words, by… by something with very sharp teeth and claws, something powerful, strong enough to bounce a adult male off a wall,” she pointed to a large section of crushed sheetrock next to the dresser, “ and to snap major bones. All the wounds were rough. No precision cuts or holes that he could see. As far as he could tell, there were no manmade weapons involved. Ralph said, if we’d found the bodies in the woods, he be sure it was a wild animal attack.”

Roberts walked into the room, but not far, being careful where he stepped. The walk-in closet was to his right. “Are you absolutely sure there’s no way the kid and her mother did this?”

“No way. The mother was clearly beaten. There’s some blood on the wall across from the bottom of the basement stairs. I think she’s telling the truth. Besides, she’s what, 5’ 4”, maybe 120 pounds?”

“And the father? What about the father?”

“Asleep in a different time zone when all this happened.” Seeing her colleague wasn’t buying it, Sclorowsky turned back a few pages in the spiral notepad she was carrying to go over what Emma had told her when the two of them had talked earlier. “The kid is hiding in her closet, under a high bottom shelf, behind some plastic storage boxes. It’s not a great hiding place, but she feels good about it and can see the door. The closet light was off and the door, shut. Smart girl, she purposely left her bedroom door open so it wouldn’t seem so much like someone might be hiding there. ..There’s no lock on it anyway.”

That got Roberts’ attention, turning his head toward Sclorowsky, away from the gore of the room and its stark contradiction to the walk-in-the-park kids’ wall paper and phosphorescent plastic stars hanging from the ceiling. “She was thinking?” it seemed hard to believe. “With all hell breaking lose around her,” there was no missing the skepticism in the tone of his voice, “she was thinking that clearly? She wasn’t scared out of her mind? Paralyzed with fear?”

Sclorowsky ignored him and continued going through her notes… “So the two men come into the room, one checking under the bed, rummaging through the dresser, who knows, while the other one opens the closet door, looks down and stares right at her. The kid, knowing he sees her, shouts “Daaaaddddyyy!!!” at the top of her lungs, loud enough for her mother to hear her all the way down in the basement. It could have been what woke her up. It’s so loud, both men stop whatever they’re doing. Nothing happens. Zip. Emma says it was quiet for a couple of seconds and then the one looking in the closet door smiles at her, ‘eyes bulging,’ she told me. Looks left, looks right and says to her ‘in a really creepy voice,’ ‘So you were expecting what to happen?’ laughs and then starts to open the door the rest of the way to come and get her. …At which time she says it again, but this time not so loud and with a lot less confidence, ‘Daddy?’”

“All of a sudden, something dark ‘whooshes,’ according to Emma, around from behind the door, from inside the room, ripping into the intruder’s neck – which pretty much wiped the smile off his face. The man reaches up with both hands toward the arm that’s got him just as he’s yanked back, right off his feet, the closet door slamming behind him. There’s tremendous ruckus, noise of furniture crashing and adult men screaming – that even a neighbor heard. It’s suddenly quiet, so the kid gets up, pokes her face out the closet door, steps over the bodies and runs downstairs only to meet her mother on the way up. From what I can tell, the whole struggle couldn’t have taken more than a couple of minutes while the mother was calling 911.”

“And the Medical Examiner?”

“I’m telling you, the mother and the girl couldn’t have done this.”

“So what, they have a pet bear?” Robert’s asked facetiously, searching for a reasonable explanation. “A large housecat,” he tried joking, but the room wouldn’t allow it.

“No. They don’t have any pets. The daughter insists that Guardian did it. He was a gift from her father before he went out of town, to protect her. They just moved here this summer in time to get settled and ready for the school year. The kid didn’t want to move…”

“They never do.”

“…and has been withdrawn, so the father bought her the bear to make her feel safe.”

“I thought you said they didn’t have any pets? Besides, what kind of father buys his kid a wild animal?”

“No pets. Guardian,” she explained, moving away from the end of the bed from where she had blocking Robert’s view of the headboard, is the kid’s stuffed California brown bear.”

And there he sat, as true-to-life as stuffed bears get, about the size of a new bear cub, his faux fur perfect for hugging. Sitting up between two pillows, his plastic eyes appeared to be staring right at them, the expression on his face so innocent and friendly – except, of course, for the blood soaked torn piece of one of the intruder’s t-shirt hanging out the corner of his mouth.

“This is, what, some kind of elaborate prank?” Roberts was hoping it was.

Sclorowsky looked back at him, pursing her lips, shaking her head slowly left to right. “And we’ve got two bodies to prove it. …So tell me,” she asked, walking behind him going down the stairs, “just how do you want me to write this up?”

“Home Invasion Stifled,” so the local paper ran the story, “Intruders Killed By Unidentified Party.” There was even speculation that the killer was a third intruder upset that the other two we’re planning to harm the family. They could speculate all they wanted, Emma would always know what really happened. And the bear would follow her to college and to her apartment after graduation years later – fair warning to petty thieves and worse who might be so foolish as to pay her a visit.

-wf

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The Not So Transparent Presidency of Barack Obama

Posted on August 11, 2009 | Leave a comment

Tuesday, August 11, 2009

Is it my imagination, or is President Obama getting smaller and smaller? Of course not. It must just be that the illusion of his grandeur is fading in the harsh light of his politics-as-usual Administration.

On Friday, January 23, 2009, just 3 days after his inauguration, President Obama issued a “Memorandum for the Heads of Executive Departments and Agencies” on the subject of “Transparency and Open Government.” It was touted to be an historic document, and began with these words… (The use of italics is in the original.)

“My Administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.

Government should be transparent. Transparency promotes accountability and provides information for citizens about what their Government is doing.”

Impressive, but not, as it turns out, in a good way. What’s impressive about it, we now know, is how meaningless it has turned out to be. Words without substance. Intent without execution.

Yesterday, as reported by several sources including, for example, the New York Times, the Administration admitted to having made a deal with representatives of the pharmaceutical manufacturers to get behind the Obama plan for healthcare reform. Not incidentally, this deal was struck an industry trade group, aka “lobbyists” of the sort Candidate Obama promised to rid Washington once and for all. What President Obama got was the promise of $80 billion of costs reductions over 10 years – which isn’t all that much, by the way – but in return for what? In return for concessions related to our government negotiating prices and encouraging the import of medicines from Canada.

The value of this deal to Americans is a matter for debate, but not here. One thing is pretty much certain. Whatever The Pharmaceutical Research and Manufacturers of America – which is the name of the industry trade group with which the Administration struck this backroom deal without the knowledge or participation of Congress or the American People… that whatever they gave up, they got back, and then some from a President desperate to succeed, but without the maturity and experience to do it right. Well spoken, to be sure, he’s a politician nonetheless.

This piece isn’t about healthcare reform per se. It’s about promises and bullshit. (My apologies for the vulgarity, but sometimes a good 8 letter word says it best.) It’s about a President who doesn’t believe in what he writes and says. As it turns out, the only transparent government he was talking about is the government he wants us to see.

-wf


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The Nutball Economics of President Barack Obama

Posted on August 3, 2009 | 2 comments

Monday, August 3, 2009

First things first. I know that “nutball” is not one word, but it should be. Now, what was my point? Oh, yeah…

We are a consumer driven economy in the midst of one of the most serious recessions in our history. Reported unemployment is approaching 10% and that doesn’t take into account the extent of underemployment and its devastating impact on family income.

Even in the best of times, there will be some minimum level of unemployment, somewhere around 3%, associated with people who are, let’s say, temporarily between jobs. Subtracting this 3% leaves us with approximately 7% of our workforce which has been a casualty of the recession – plus the underemployed who are still working, but not making enough.

Candidate Obama promised us he would not raise taxes paid by regular people, that he would increase taxes for only the wealthiest of Americans. Now President Obama has apparently been transported into a different reality. Faced with budget deficits of biblical proportions, his closest advisors are test-marketing the potential of increasing taxes on the “Middle Class,” broadly defined to include almost all of us. (See, for example, “Geithner Won’t Rule Out New Taxes for Middle Class” by George Stephanopoulos, August 2, 2009.)

So, let me get this straight, which is what I usually say when there’s a long sentence coming… We’re a consumer driven economy in a severe recession in reaction to which the President and Congress (mostly Democrats) have spent kuh-billions of dollars we don’t have to help certain financial and automotive sector companies – which the economy would have handled just fine without our help – leaving most of the economy to fend for itself. (Break.) But now, concerned that he’s going to be presiding over the Obankrutcy of America, and that the effect of his reckless spending will have adverse consequences far beyond his one term Presidency, he’s considering raising taxes which will further curtail consumer spending and actually impede our recovery. It’s perverse Robin Hood economics, “Robin” from the many for the benefit of the relatively few.

That’s right, he’s considering raising taxes which will reduce consumer spending to help pay for programs, many of which were/are intended to slow the downturn and protect consumer spending. Hmmm?

Here’s an alternative. Stop spending so much money!! Put every dollar you’ve got directly into the pockets of the consumers who have been most affected by the recession and who will put those dollars into the economy, immediately.* Otherwise, stay out of the economy, and put major programs on hold until we can afford them. Just because you can print money, doesn’t mean you can spend it.

The impression I keep having is that of a President who talks well, but has no idea what he’s doing, who is overwhelmed by circumstances beyond his control, moving way too fast and whose naïve, overconfident intellectualism hasn’t prepared him to contend with real problems of this severity.

*If you have time, you might also want to take a look at Occam’s Economics: A simple, back-of-the-envelope plan to regenerate consumer spending – immediately, posted Thursday, July 9, 2009 on the WordFeeder.

-wf


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The Illusion of Prejudice: The Minority Rules

Posted on July 29, 2009 | Leave a comment

Wednesday, July 29, 2009

Sad, but true. In the electronic age of omnipresent wall-to-wall news coverage, the opinions of the very few are quickly blown way out of proportion.

As everyone knows by now, there has been a confrontation between a white policeman and a black resident who a passerby thought, innocently enough, might be burglarizing what turned out to be his own home. Whether there was race involved in what occurred is problematic, and my personal opinion on the subject, irrelevant.

In fact, it’s not the event itself, but what happened next that is, I think, most significant. As if the event had not been newsworthy enough in and of itself, the President of the United States, admittedly without a full understanding of what transpired that day in Cambridge, chose to comment, to second guess the local police and make the assumption that racial profiling had been involved. As to latter, if that hadn’t been his assumption, why was he commenting – and, of course, we’ve since learned that that was exactly what the President was talking about when he accused the Cambridge police of having behaved stupidly.

The next thing you know, it’s all over the media, day in and day out. The opinions of a relatively few number of Americans, a miniscule proportion of our total population – virtually none of which were there or have complete knowledge of the event – become the subject of the news. Even the few polls that have been taken are based on very small samples and questions which force the respondent to form an opinion, however well poorly developed or uninformed. “My gosh,” the rest of us say, “I had no idea…” and you can fill in the rest.

The result can be that the existence of a phenomenon, in this case, adverse racial profiling, is blown way out of proportion to the point of actually convincing many people that that’s what actually happened, and that the problem is everywhere, that black Americans are being discriminated against left and right, everywhere, all the time. I certainly hope that’s not the case, but the news that is today’s excuse for legitimate journalism is no proof of anything but that your set or personal computer is on.

The problem is not just the ever-present, compelling nature of today’s electronic media technology. More to my point, it’s the people who report the news – cable news being the worst example – who spend much more time telling us what a few people think, and way too little about precisely what actually happened. As to the larger, national issue, the American people are not served well by anecdotal statements by people, whatever their color. What are the facts of the problem? What do legitimate studies of the subject of continuing racial prejudice and profiling tell us?

President Obama, in an attempt to spin positive his inappropriate and frankly prejudicial* comments on the event in Cambridge, says this should be a learning experience for all of us – and invites the two principals over for a beer. (Unbelievable.) Far from being educational, the President and the media have created a mess that does the serious issue of racial profiling a disservice, and is distracting us from more pressing issues at hand.

*Suggested reading… “President Obama: The Presumption of Prejudice“, posted July 23, 2009 on the WordFeeder.

-wf


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The Fat Tax and Fitness Incentive Program

Posted on July 28, 2009 | Leave a comment

Tuesday, July 28, 2009

Without question, the Obama plan for improving our national health needs all the help it can get. Candidate Obama campaigned relentlessly on a platform of change, and yet the best he can do is produce the mess he calls “healthcare reform.” Coming on the heels of his stimulus program, it’s no surprise.

Here’s a relatively inexpensive idea that uses nothing more than basic economics and marketing to accomplish what 1,000+ pages of legislation won’t. As bizarre as it may seem at first blush, the simplicity and power of what I’m about to suggest make it worth taking seriously. More often than not, it’s the most straightforward approach that works best.

By and large, we are a nation drowning in our own body fat. We’re addicted to the crap we eat, and can’t seem to help ourselves. The agro-manufacturers and food service retailers feed that addiction because that’s what sells.

In the midst of all this tedious debate about overly complicated healthcare legislation that you just know isn’t going to work even when they finally do pass it, clearer thinkers have pointed out that, if we just weren’t so overweight, we wouldn’t need as much healthcare in the first place.

Okay, I have a suggestion. You know those “weigh stations” you see on the highway that trucks use to confirm the load they’re carrying so they know what to charge and what taxes to pay? Well, we need something like that to provide people with an emotional and financial incentive to hit their healthy target weights and BMI (body mass indexes), and then maintain those levels.

I’m a big believer in the power of pricing to manipulate people’s behavior. To that end, we could tax foods based on their sugar, fat and other adverse content, but that’s administratively messy and doesn’t address the full scope of the problem. No. To be effective, we need to take a more direct approach, one which not only encourages healthier eating, but also fitness, while exciting our collective psyche to resolve the problem of obesity like no other program you’ll ever get out of Washington.

Here’s what I recommend…

(1) Have the Surgeon General provide everyone his or her target weight and BMI.

(2) Require every citizen to make, let’s say, quarterly visits to authorized “weigh stations” – doctors’ offices, clinics and other convenient, responsibly staffed locations – to obtain a chit confirming weight and body mass. These weight checks will be a free service for which medical service providers will be reimbursed by the government.

(3) Send people money – real money like government rebate checks – if they’re improving or maintaining their weight and body mass at their target levels.

(4) And how do we pay for this program? Are you kidding, that’s the genius of it. We pay the people who are losing or maintaining their weight with the Fat Taxes we’re going to levy on people are aren’t.

That’s right. I want to take a Fat Tax right out of their checks: Federal, state and local income taxes, Social Security, and Fat. Why not? Com’on, why not? If you’re going to eat recklessly and be a burden on the rest of us, well then, you need to make up for it by contributing your fair share – by carrying your own weight, as it were. It’s the least you can do. If, on the other hand, you’re doing what you can to lose and control your weight, you deserve to be reimbursed for the savings we’re all going to enjoy from lower healthcare costs. (Fitness incentives could be paid the same way, as a negative Fat Tax that has the effect of reducing total deductions from your pay check.)

How ‘bout them apples? (Notice I said “apples,” not “Cheetos,” or pork rinds.)

Is it the perfect program? Does it have flaws? Are there details we need to work out? Sure, but it’s a creative start in stark contrast to the unimaginative drivel our new President and Congress are producing. How about if, while I’m chewing on this stick of low fat, low cal kosher bacon-flavored turkey jerky, dreaming about my Fat Rebate Check, you think about what I’ve said and get back to me with your comments and suggestions? Think of this as the beginning of the first wiki-government program, by the people, for the people, and what better place to start than with our health. I seriously doubt we can do any worse than the Administration and Congress.

I say we take charge of our national health and kick some serious ass before that ass gets any larger.

-wf


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Bob*

Posted on July 27, 2009 | Leave a comment

*This is a story about Bob, a “Type A” person who is married to his work.

Short Fiction for Guests of the Wordfeeder
Monday, July 27, 2009

Two male coworkers at the high tech company where they were mid-level executives were on their way down the hallway – the one giving the other, newly hired, a tour of their offices, on their way to the nicest of them, the one in the corner just ahead. “Corner” wasn’t exactly true, given that the perimeter of the building was irregular and, at that point, traced a ark, like the cross section of a wing, more dramatically curved on one side (the leading edge), smoother on the other. It was empty, this nicest of all the offices, the large table that served as a desk perfectly clear as if no one had been using it.

“So who are they saving this for?” the new one asked his mentor, both of them standing just outside the one of the double doors that was open. Somehow going in, even though it was vacant, seemed out of the question. It was the only office on the floor that didn’t have glass interior walls and doors – where, if the doors were shut, you couldn’t tell from the outside what was happening on the inside.

“Don’t get your hopes up. It’s already taken. Belongs to ‘Bob,’ the creative genius behind all this. Ever have a conversation with one the new generation corporate voice mail systems, the one’s that make you think you’re talking to a real person?”

“Sure.”

“Well, thank you very much, all the way to the bank.”

“So what’s he like?” They were talking to each other, but with their eyes focused on the interior of the office, at its perfectly finished uneven plank floors, and at the almost too many plants and flowers, some inside, some on the deep balcony all around. The entire exterior wall was made of seamless glass panels that folded upon each other, to the left and right, to open the entire office to the outdoors. A gentle breeze just made to the faces of the two of them, feeding the wonder of what it would be like to work there.

This entire floor was the senior executive suite, the top floor of their terraced dome shaped building that all but disappeared in the topography of the countryside. From the air, it looked like a lush mound of dark and light green foliage, with random mixings of red, white, yellow and violet flowers that covered the edges of the various irregularly shaped balconies that were everywhere. A large center atrium in the middle of the floor, going all the way down to the basement of the building, added to a sense of openness, of almost being outdoors. Stairs lead up to the rooftop garden where they held indoor and outdoor meetings, and sometimes parties, when it was nice out and they could retract the roof. It cost a fortune to build, but was well worth it for the effect it had upon its residents during the long hours they often spent there.

“I have no idea. Never met him, and I’ve been here three years. He works from home. Communicates over the telephone or on-line with e-mail and video calls.”

“Excuse me.” Sounding highly rushed, a young woman pushed past them holding two bunches of fresh flowers which they grow in the complex.

“Jackie!” Another young woman was running down the wide hallway behind her, pushing one of the carts they give you in the company cafeteria when you’re picking up food and drinks for a meeting. The two men, not wanting to get in their way, split up and stepped back while Jackie opened the other door to Bob’s office to make room for the cart. They were there, the two men, but neither of the women noticed them. “I’ve got everything but the frozen pineapple yogurt he likes!”

“Com’on. It’ll be okay. He’s going straight to the Board meeting. We’ve got time.”

“What about the yogurt?” She was more than a bit frantic.

“First of all, it’s sorbet, pineapple sorbet. He has it flown in from New York. Call down and tell the Cafeteria Manager on duty that it’s in the Executive Pantry.”

“Hi, guys.” It was Bob who, in all their excitement, they hadn’t seen coming, standing between the two men, just outside his own office. A worn, soft leather briefcase in one hand, the other combed back the hair that flopped over his forehead to no avail.

He was tall, and thin too, taller than any of them had expected, his boyish good looks and warm smile leaving the two young women speechless, and the two junior executives invisible. Bob was the poster boy for purposely unassuming technology sector billionaires at their creative peak: Jeans and a plain gray t-shirt, untucked of course, with a blue and green plaid flannel shirt on top of it, open in the front, sleeves rolled up in a hurry. Well worn Nikes. Hair unkempt, but it could have been cut to look that way. If it was, the cut was so good, no one could tell. Money will do that for you. One of the girls would speculate later that he only shaved every third day, this being the second judging from the stubble, as if she had any idea what she was talking about.

“I just need to use my computer to print something out before the meeting.” His tone was apologetic, almost as if he were asking their permission.

No introductions. No shaking of hands. Nothing more than a polite “Hey” to the two men as he walked into his office and they headed back down the hallway, one whispering to the other, “So that’s what a billionaire genius looks like.” They, as if anyone cared, were wearing “business casual” to be safe and to remind the t-shirted staff under them that they were in charge. Bob, on the other hand, had nothing to prove and couldn’t have cared less that they were clearly in violation of the de factor company dress code.

“Do you want us to leave, …Bob,” she added reluctantly, having been told to call him by his first name.

“No, no. Sorry to get in your way. …Wait,” he said to the one of them that was stocking his refrigerator, “Let me have one those boxes of cran-grape juice.” Holding up his open palm of his hand, he clearly wanted her to toss it to where he was standing, maybe 15 feet from her, behind his desk, his other hand busy on the synapse pad of his notebook computer.

Glancing over at her friend for reassurance, she stood up from where she had been kneeling and prepared herself for the toss of her corporate life. Over-handed? No, too short a distance. She’d go for a soft, underhanded lob – but it had to be right on target to make a favorable impression. “Casual precision” was the effect she was after.

“Hey,” he said looking up, knowing that he tended, for reasons he really didn’t get, to sometimes make people who worked for him nervous. “The worse thing that’ll happen is that I’ll miss, and you’ll be fired.” Noticing that his attempt to set her at ease seemed to have backfired, he decided to encourage her. (By this time, she could have walked over and handed it to him, but it was too late now.) “Com’on,” he smiled at her, mostly with his eyes. “Go for it.” And she smiled back and did. He caught it, unwrapped the straw, pushed it through and took a long zip on the way past the printer next to his desk and out the door. “See you later.” Not likely, but it was the nice thing to say.

“Right,” the girl at the refrigerator responded, the other one just managing to nod. But then when he was gone… “God damn, I had no idea he’d be so cute in person. He’s not gay, is he? I didn’t get any gay vibes.”

“Gay, no. Married yes.”

“I know, I caught the ring, but a girl can dream. Maybe his marriage will tank and he’ll remember the moment we shared over a box of cran-grape Juicy Juice.”

“Savor it. The Board only meets once a quarter, and the word is he doesn’t like hanging around people, particularly when he’s crashing on something. Myra, the girl in bookkeeping who processes his receipts, says the only person he’s really comfortable around is his wife. They’re newlyweds. Myra says they eloped.”

The other one, leaning on the door watching Bob going up the stairs to his meeting, wondered out loud. “I’m surprised. He doesn’t seem the least bit weird,” she thought to herself out loud, almost sighing.

“Hey. Back to earth. We’re still here when he gets back, and we’ll both be looking for work.”

“I don’t think so. He seemed way too nice.”

“He is nice. It’s our ass-kissing supervisor I’m worried about.”

As it turned out, the meeting took longer than expected, a good deal of it spent convincing the Board that the time and money he was spending, had been spending for more than year now on his current project would be worth every dollar of it. Refusing to give them details or more than the most general status report didn’t help. They’d believed in him before and he made them rich, but they wanted him paying attention to the development of their existing product lines, securing their market share before he ran off in a new direction. Whatever it was, it had better be worth the wait.

When it was over, Bob stopped by his office for a hour, enough time to meet with a couple of administrative department heads. Two perfect deviled eggs and some pineapple sorbet later, he was out of there. Down the highway to the high-rise luxury condo where he and his wife lived in relative seclusion, seldom leaving their apartment.

“Hey, Howard,” he smiled at the well-dressed receptionist at the front desk, stopping by the mailroom on his way to the elevator from the garage door.

“Good evening, Bob.” Even off campus, he insisted everyone call him by his first name. Building management had actually issued a bulletin to that effect to all building staff. “My regards to… to Sarah?” Too late. He’d already made it sound like a question. That was awkward. Maybe he should have used her last name, “My regards to Mrs. …”? The fact is, he was just being polite, having never met Bob’s wife in the several months he’d been working there, except to talk to her on the building intercom and receive a package for her now and then that he would take upstairs and leave outside their door. Bob and Sarah were known to be big tippers, and he was right to expect a substantial holiday bonus if only he could manage not to annoy them.

“She’s fine. Thanks for asking,” he said, clearly too busy sorting through his mail to be paying attention. “We’ll be ordering some delivery, probably Italian. Just let him bring up,” Bob told him just as the elevator doors were closing, flipping the pages of one of the technical journals he was holding.

“Sure thing,” the attendant responded, smirking and rolling his eyes in an expression of “What the hell,” knowing it was too late for Bob to hear him.

Coming off the elevator, Bob’s condo was one of only four on his floor. It was large, with the kind of high ceilings and glass only rich people can afford, but surprisingly modest for a person of his wealth. The door to his place was the only one with a 10 key security panel. It looked normal enough, until you realized that each button on the key pad was fingerprint sensitive – different finger prints for different buttons depending upon how he programmed it – which isn’t something you or an intruder would have been able to tell. It was one of Bob’s designs for their new security products division.

“Hi, honey. Sorry I’m late,” he said, dropping his keys on the table next to their front door.

“Hey, I’m used to it,” she shouted back sarcastically from around the corner. It was the voice that first made him love her coming from the kitchen in their great room with the floor to ceiling glass that looked out over the entire valley. It was dark out, and the lights he could see seemed like the view from the cockpit of a jet on its final approach. “Are we going to order something?” She sounded hungry.

“Yeh. Take a look at the menu for that new Italian place, and order something for both of us” he said, asking for her help while pulling off his flannel shirt and tossing it over one of their two brown leather couches.” I’ve got to play [on my computer] for a few minutes.” His voice trailed off as he entered his password and clicked to open the file on which he had been working before leaving for the office earlier that day.

Forty-five minutes later, the door bell rang, a picture of the delivery boy popping up on Bob’s screen. “Can you get that honey?” It was Sarah asking for his help this time.

“Sure,” Bob responded, wondering humorously to himself what she could be doing that was that important.

Getting up, he walked to the door, reaching for his wallet along the way.

“Hi,” the kid said, “Are you,” he paused, looking down at the delivery tag, “Sarah?”

“That depends, I guess, on what you have in the bag.” (No reaction from the kid.) “…No, I’m Bob. Sarah is much better looking.”

Holding up the bag, paper inside of plastic, the kid read from the attached receipt: “Caesar salad, Spiedino di Mare with broccoli and garlic mashed potatoes, fresh bread,” and then added, having thought about it for a moment, “…Didn’t she order anything for you?” as if that were any of his business.

“We’re going to share.”

“It’s already paid for,” the kid volunteered, seeing Bob opening his wallet. Your wife gave us a credit card.”

“I’m sure she did. Don’t you want a tip?” Bob asked the kid rhetorically, pulling out a $5 bill, but then, looking up at him, taking out another.

“Hey,” the kid said trying not to gush. “Thanks.”

Walking back toward the great room, the front door closed silently behind him, followed by a soft “boop” to confirm that it was locked. Bob turned left this time toward the kitchen area. “Sarah, would you join me for dinner, on the couch please?” And woman of his dreams materialized from a barely visible light above the couch across from the table where he was putting out a plate, silverware and napkins.”

“Hi, honey,” he said with real appreciation to her exceptionally real holographic image.

“So did you give the kid a decent tip?”

“He seemed pleased enough.”

“Are we working tonight?”

“Don’t we work every night, Sarah?”

“I was thinking,” she laughed at the impossibility of it, “that maybe we could take a break and catch a movie, in a real theater.”

“Soon,” he encouraged her. “Sooner than you think. I’ve got our robotics people working overtime but, to be honest, I’ve seen their prototypes and they have a way to go. …Tonight we’re testing your sensitivity programming. …Have you been studying the books and tapes I picked out for you?”

“Don’t I do everything you tell me, Bob?”

No response.

“Bob?”

“What?”

“Is it too soon for us to be talking about having children?” She did her best to pretend it was a serious question, but wasn’t that good an actor – not yet, anyway.

“Funny,” Bob looked up from where he dishing out his dinner, smiled back at her, complementing the quality of his programming. “Well done,” he said, and then added, “Are you sure you don’t want some?”

And they laughed and talked about how their days had gone while Bob savored his dinner and the moment with a glass of homemade Sangria.

-wf

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President Obama: The Presumption of Prejudice

Posted on July 23, 2009 | Leave a comment

Thursday, July 23, 2009

Without question, there is still racism and other ethnic discrimination in the United States, and there will be for some time to come. Prejudice dies hard.

Black Americans have certainly done their part, heroically, to make their case and for that effort deserve, at the very least, the respect of those for whom a belief in equality isn’t second nature.

For the most part, equality has become a technical reality. Having accomplished those objectives, we’re now in that awkward, unfortunately long-term endgame for when people need to go beyond accepting the fact of equality, to not recognizing the differences between our people which some once thought made discrimination appropriate, even necessary.

It’s a process that takes time, understanding and patience, and that often requires subtle, but nonetheless exceptional efforts by both sides of the problem.

Unfortunately, in a press conference yesterday that was supposed to be about healthcare reform and the economy, President Obama chose to enter the fray over the arrest of noted scholar Louis Gates, Jr. in Boston. While admittedly not knowing all the facts of the situation, he nevertheless expressed his opinion that Boston Police – including the one of three officers on the scene who is also black – behaved stupidly when they arrested his friend and, let’s say it, fellow black person.

That the President would even comment on a local police matter is odd. That he would risk diverting the attention of the media from the primary objectives of his press conference is bad politics and frankly disrespectful to those major issues he was there, in prime time, to argue. More to the point, that he would express a critical opinion about police behavior without knowing all the facts is, almost by definition, discriminatory in and of itself, and sets a bad example for Americans of all persuasions who are doing their best, in their everyday behavior, to put an end to inequality.

Had a passerby seen two white men apparently breaking into a house, would he or she have called the police? Had Professor Gates been white, would the President have commented about the event at a prime time press conference? No. What President Obama did was act on the presumption of prejudice, which may be understandable, but is also unfortunate and tells us something interesting about how he sees the world.

-wf


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