Tuesday, December 22, 2009

"It's Always Sunny" health care plan

After reading over the concessions the Senate Democrats made to Republicans concerning health care, I'm noticing substantially less reform, yet it's being praised as a complete overhaul. I'm not seeing it. Inspired by the cast of "It's Always Sunny in Philadelphia," I've decided to outline my own health care bill, which I think will work seeing as the title is just damn catch. Who doesn't want health care that is "Always Sunny?"

But first, here's a list of some Senate provisions in the latest bill that make no sense to me, information for which I have lifted directly from The New York Times:

Everyone must purchase insurance

  • Penalty: $95 a year per person in 2014; $350 in 2015; $750 or 2 percent of a household’s income, whichever is greater, in 2016 and beyond. No penalty if the cost of cheapest available plan exceeds 8 percent of household income.

  • Exemptions: American Indians, people with religious objections and people who can show financial hardship.

  • No Public Option

    Regulating Insurance Companies

  • Premiums for older people cannot be more than three times the premium for young adults.

  • The legislation would not strip health insurance companies of their longstanding exemption from federal antitrust laws.

  • Insurers would be required to spend more of their premium revenues — between 80 to 85 cents of every dollar — on medical claims. According to a recent Senate Commerce Committee analysis, the largest for-profit insurance companies spends about 74 cents out of every dollar on medical care in the individual market.

  • Cost and Coverage

  • $871 billion. Expected to reduce projected federal budget deficits by $132 billion.

  • 31 million people would gain coverage, leaving 23 million uninsured.

  • No tax increase on the wealthy?!

    I think it's good to force everyone to have some type of health insurance, but when individuals have to purchase it directly, it gets tricky. You have to introduce an overly complex system of penalties (and I have no idea what religious objections one might have to not dying) that would likely leave individuals who can't afford insurance having to pay for the privilege of having no coverage. Plus, when all that is said and done, 23 million people still have no insurance. What do we do with them?

    On top of that, the regulations on insurance companies are a total joke. You can still charge the elderly a ridiculous premium triple that of young adults, not to mention this half-assed attempt to reduce overhead costs related to profits. Now, instead of 26% of our premiums going to profits for insurance companies, it's 20%; stop the fucking presses.

    Medicare has an estimated 3% of overhead costs, so it would seem logical to have some sort of government plan available, but the public option is completely dead because -- God forbid -- it might put the insurance companies out of business.

    And I have no idea how these companies are managing to exist beyond antitrust legislation. If you offer exemptions to antitrust laws, they have absolutely no power at all. (Speaking of which, I wonder if our "too big to fail" banks are exempt too.)

    Well, I say fuck 'em. If you can't provide a needed service, then you should go out of business. It's ridiculous to profit on someone's health or lack thereof anyhow. Health is the one thing that separates us from death, and we decided to make a buck on that? And then we protect it as though it was a holy establishment? Un-fucking-believable.

    And how are we going to pay for it? We're going to increase Medicare payroll taxes (I have no idea where that one came from), tax tanning service operators (I'm not making that up), tax premium health care plans (which makes no sense because it would discourage people from buying better coverage), tax health care companies (which seems logical, but more tightly regulating their profit margins would be better), and then we're going to hope the plan reforms Medicare enough to free up funds there. BUT WE"RE NOT GOING TO TAX THE WEALTHY!

    I know some people say it's unfair to tax the wealthy at a rate above the rest of us. I've actually argued for eliminating income taxes in favor of a large national sales tax, but that's a different debate, and probably a fruitless one. The graduated tax system isn't going anywhere any time soon.

    Still, when it comes to the rich, fuck them too. Odds are, they stepped over a lot of people to make their fortunes, or they were born into it rather than earning it. If increasing their taxes slightly to pay for universal health care is the only penalty they suffer, they're doing well. Besides, when you tax the rich, they're still fucking rich, so where's the harm?

    What I don't understand is the inability to develop a plan that allows every tax-paying U.S. citizen the ability to walk into a hospital and receive care: no hoops, no health insurance exchanges, no nothing. That's the "Always Sunny" health plan, as inspired by this dialogue:

    Doctor: Well, actually, Ms. Reynolds, first we need to discuss how you'll be paying for your stay.
    Mac: Paying? This is a hospital.
    Charlie: Yeah. Since when do you pay to stay in a hospital?
    Doctor: Since always.
    Charlie: Uh, no, I believe that is what taxes are for.
    Mac: Yeah, you don't pay a fireman to put out a fire.
    Charlie: Or a cop to shoot a guy.

    It could seriously be that simple. What puzzles me the most is the Republican opposition. I understand being opposed to the bill that the Senate is producing -- seeing as I am opposed to it -- but it's their endless bitching that watered this thing down to nothing. Now the complaint is it costs to much and doesn't do enough, which is true, but whose fault is that?

    I would love to see something more than a vague, three page document from that side of the aisle. Instead their position seems to be that the current health care system works fine, which is empirically false, a fact which is generally agreed upon. While I don't believe you have to offer an alternative idea to mount a good criticism of an existing one, it would be nice, because right now it feels like the Democrats are failing us and the Republicans just plain don't give a shit. Who are we supposed to vote for in November?

    Saturday, December 5, 2009

    Waging the Afghan War

    I've been silent thus far on Obama's decision to send 30,000 additional troops to Afghanistan, mostly because I waiver on this war so frequently. Despite voting for the man, I find myself disagreeing with Obama frequently, but this is not one of those occasions.

    I think he made the right decision, but no one seems happy with it. The Right doesn't think the commitment is enough, and the Left thinks it's time to end this whole thing. On this particular issue, Obama's middle ground stance seems to be the best approach.

    The most common argument I've heard from the Right is that a president should "listen to his generals." Listen, yes; obey, no. Generals have a great deal of expertise, but the military component is not all that goes into a decision like this.

    Americans cannot economically or emotionally handle a drastic troop increase. The current increase would cost about $1 trillion over the next decade, and during a time of 10% plus unemployment, nobody likes to see that kind of money leaving our shores.

    And let's not forget the oft-forgotten fact that this war is already eight years in, and patience is wearing thin. During all the chaos of the last administration, the goals for Afghanistan were in a constant state of flux, and nearest I can tell we are yet to accomplish anything of real significance.

    The recently stolen election really hurts our credibility, and that could be the most important component of all. In truth, nation building cannot work without the support of those for whom the nation is being built. Early in the war, the response from Afghans was very positive because Americans drove out an unpopular government. The problem is we replaced it with one far less stable and equally corrupt, which leads to waning support and a need for more troops. Still, there comes a point when you can't fight your way through this with force, and to his credit, Obama appears to have recognized this, hence the relatively small "surge."

    And now for the Left. Their buzz word is "inherited." The democrats constantly shift the blame for the entire Middle East quagmire to the Bush administration, and for the most part I agree -- though there are several democrats who were in lock-step behind Bush and have since developed amnesia. So democrats, we get it, now please SHUT THE FUCK UP!

    Blaming the previous administration for inherited problems is a tactic nearly as old as the presidency itself. It's a great way to win an election, but a shitty way to run a country. It's important to recognize who made mistakes (W, I'm looking at you), but that doesn't change the reality of now. We have to develop a way to get out of this mess, which means being a bit more forward looking.

    But if you're going to look to the past, go a little farther back, let's say to the 1980s. Our fight in Afghanistan is teetering dangerously close to the missteps we made concerning the Soviet occupation. We ousted an oppressive dictator, became impatient and frustrated over the amount of invested resources, and withdrew. A country full of abandoned, pissed off young people became radicalized and the next thing you know there's a plane sticking out of a New York skyscraper.

    We can't afford this mistake again, otherwise we'll have wasted countless lives and resources only to have failed in capturing the man we set out to find, essentially ending up right where we started. That's the measure of true defeat: to have accomplished nothing at the sacrifice of so much.

    My biggest concern is managing the balancing act among all parties concerned. What surprises me most is that no one seems to address the fact that increased American presence in Afghanistan has been the rule rather than the exception. Eventually the point of diminishing returns will catch up to us, probably sooner than later. Hopefully we will have created some stable system in Afghanistan by then, be it democracy, theocracy, or whatever the people are ready to support. If not, we might be fucked. Ideally we can learn from that mistake, but if history is any indication, it appears that we won't